bluuebunny/crossref_metadata_2025 huggingface dataset:
Properties of the C ii 1334 Å Line in Coronal Hole and Quiet Sun as Observed by IRIS
Authors: Upendran Vishal , Tripathi Durgesh
Published: November 2021

Coronal holes (CHs) have subdued intensity and net blueshifts when compared to the quiet Sun (QS) at coronal temperatures. At transition region temperatures, such differences are obtained for regions with identical absolute photospheric magnetic flux density (∣B∣). In this work, we use spectroscopic measurements of the Cii1334 Å line from the Interface Region Imaging Spectrograph, formed at chromospheric temperatures, to investigate the intensity, Doppler shift, line width, skew, and excess kurtosis variations with ∣B∣. We find the intensity, Doppler shift, and linewidths to increase with ∣B∣ for CHs and QS. The CHs show deficit in intensity and excess total widths over QS for regions with identical ∣B∣. For pixels with only upflows, CHs show excess upflows over QS, while for pixels with only downflows, CHs show excess downflows over QS that cease to exist at ∣B∣ ≤ 40. Finally, the spectral profiles are found to be more skewed and flatter than a Gaussian, with no difference between CHs and QS. These results are important in understanding the heating of the atmosphere in CH and QS, including solar wind formation, and provide further constraints on the modeling of the solar atmosphere.
Understanding the Initiation of the M2.4 Flare on 2017 July 14
Authors: Jing Ju , Inoue Satoshi , Lee Jeongwoo , Li Qin , Nita Gelu M. , Xu Yan , Liu Chang , Gary Dale E. , Wang Haimin
Published: November 2021

We present both the observation and the magnetohydrodynamics (MHD) simulation of the M2.4 flare (SOL2017-07-14T02:09) of NOAA active region (AR) 12665 with a goal to identify its initiation mechanism. The observation by the Atmospheric Image Assembly (AIA) on board the Solar Dynamics Observatory (SDO) shows that the major topology of the AR is a sigmoidal configuration associated with a filament/flux rope. A persistent emerging magnetic flux and the rotation of the sunspot in the core region were observed with Magnetic Imager (HMI) on board the SDO on the timescale of hours before and during the flare, which may provide free magnetic energy needed for the flare/coronal mass ejection (CME). A high-lying coronal loop is seen moving outward in AIA EUV passbands, which is immediately followed by the impulsive phase of the flare. We perform an MHD simulation using the potential magnetic field extrapolated from the measured pre-flare photospheric magnetic field as initial conditions and adopting the observed sunspot rotation and flux emergence as the driving boundary conditions. In our simulation, a sigmoidal magnetic structure and an overlying magnetic flux rope (MFR) form as a response to the imposed sunspot rotation, and the MFR rises to erupt like a CME. These simulation results in good agreement with the observation suggest that the formation of the MFR due to the sunspot rotation and the resulting torus and kink instabilities were essential to the initiation of this flare and the associated coronal mass ejection.
Evidence of X-Ray Plateaus Driven by the Magnetar Spindown Winds in Gamma-Ray Burst Afterglows
Authors: Hou Shu-Jin , Du Shuang , Liu Tong , Mu Hui-Jun , Xu Ren-Xin
Published: November 2021

The central engine of gamma-ray bursts (GRBs) remains an open and cutting-edge topic in the era of multimessenger astrophysics. X-ray plateaus appear in some GRB afterglows, which are widely considered to originate from the spindown of magnetars. According to the stable magnetar scenario of GRBs, an X-ray plateau and a decay phase ∼t
−2 should appear in X-ray afterglows. Meanwhile, the “normal” X-ray afterglow is produced by the external shock from a GRB fireball. We analyze the Neil Gehrels Swift GRB data, then find three gold samples that have an X-ray plateau and a decay phase ∼t
−2 superimposed on the jet-driven normal component. Based on these features of the lightcurves, we argue that the magnetars should be the central engines of these three GRBs. Future joint multimessenger observations might further test this possibility, which can then be beneficial to constrain GRB physics.
Association of Comorbid with Developmental Quotient in Down Syndrome Children
Authors: Trisna Windiani I Gusti Ayu , Aryati Ni Made Dewi , Sugitha Adnyana I Gusti Agung Ngurah , Murti Ni Luh Sukma Pratiwi , Soetjiningsih Soetjiningsih
Published: November 2021

BACKGROUND: Down syndrome (DS) is the most common genetic disorder in children. Children with DS tend to have various comorbid due to developmental abnormalities of chromosome 21, such as congenital heart defects, hearing loss, otitis media, eye disorders, obstructive sleep apnea, thyroid hormone disorders, gastrointestinal atresia, hip joint dislocation, leukemia, and Hirschsprung’s disease. Moreover, they also show cognitive impairments in concentration, communication, memory, and the ability to carry out tasks. Caput Scale/Clinical Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT-CLAMS) is one of the developmental assessment instruments to screen for cognitive disorders.

AIM: Hereby, we aimed to find the association of comorbid with developmental quotient in DS children. Data were obtained from medical record with sample age 0–18 years and suffering from DS.

METHODS: This was observational analytic study with cross-sectional approach, conducted in DS children age 0–18 years who were treated in Sanglah Hospital in 2018. Characteristic data and comorbid were obtained from medical record, meanwhile, development status was assessed using Caput Scale/CAT-CLAMS. Chi-square was applied to determine the association between comorbidities and development quotient (DQ) in DS children.

RESULTS: A total of 32 children with DS were treated in Sanglah Hospital during 2018 with median age was 2 years old and dominated by female patient (71.9%). Several comorbidities were found such as endocrine disorders in 27 children (84.3%), congenital heart disease (CHD) in 16 children (50%), and other comorbid including microcephaly, congenital cataract, palatoschizis, gastrointestinal defects, and congenital talipes equinovarus in 13 children (40.4%). The most common endocrine disorders was congenital hypothyroidism (81.25%), while the most common CHD was patent ductus arteriosus (25%). Bivariate Chi-square analysis showed significant association between comorbid and DQ (PR = 1.4 [95% CI 0.95–1.97], p = 0.03).

CONCLUSION: We found an association between comorbidities and DQ in DS children.
Efficacy and Safety of Convalescent Plasma Transfusion Administered as Adjunctive Treatment to Standard Treatment in Moderate, Severe, and/or Critically Ill Patients with COVID-19 in Dr. M. Djamil General Hospital
Authors: Wahid Irza , Faheri Eifel , Andani Eka Putra , Fauzar Fauzar , Zelly Dia Rofinda , Widyarman Widyarman , Medison Irvan , Taslim Emilzon , Handayani Tuti
Published: November 2021

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by severe acute respiratory syndrome coronavirus 2. High mortality rate due to COVID-19 has become a serious health problem globally. At present, there is no definitive therapy for COVID-19.

AIM: The objective of this study is to evaluate convalescent plasma therapy (CPT) in COVID-19 patients.

METHODS: The study was conducted in prospective experimental design with sample population of COVID-19 inpatient in Dr. M. Djamil General Hospital, Padang, isolation ward. This study was involving 20 patients consisted of 10 patients of experimental group who received standard therapy and CPT and 10 patients of control group who received standard therapy only; 10 males and 10 females. Differences in laboratory results in both groups were analyzed by T-test or Mann–Whitney U-test.

RESULTS: Twenty subjects included in this study with average of age 56.50 (9.606) years. The mean of C-reactive protein (CRP) serum of the experimental group on day 1 (CRP +1) after CPT was 17.50 (25.343) while the control group was 77.50 (75.177) with p = 0.028 (p < 0.05). However, there were no differences in sequential organ failure assessment, hemoglobin, leukocyte, platelet, partial pressure of oxygen, D-dimer, procalcitonin, interleukin-6, lactate dehydrogenase, ferritin, aspartate aminotransferase, alanine aminotransferase, urea, creatinine, glomerular filtration rate, bilirubin, cycle threshold values, and chest X-ray finding between both groups.

CONCLUSION: There was a significant difference in CRP +1 between the experimental group and control group, while no significant differences found in other parameters between both groups. As CRP is an inflammatory indicator, CPT showed benefit in reducing inflammation in COVID-19 patient.
Factors Associated with the Stunting in Toddlers in the Work Area of Tikson Raya Public Health Center
Authors: Fadjriah Rasyika Nurul , Rusdianto Rusdianto , Herman Herman , Vidyanto Vidyanto
Published: November 2021

Background: Stunting often called stunted or short, is a condition of failure to thrive due to chronic malnutrition and psychosocial stimulation and exposure to repeated infections in the First 1000 Days of Life (from fetus to child aged 2 years). Objective: The purpose of this study was to determine the factors associated with the incidence of stunting in the working area of the Tikson Raya Public Health Center, Banggai Laut District. The quantitative study with a case-control research design was applied. The number of samples used was 90 people with the Stratified Random Sampling technique. The data was collected by a questionnaire and analyzed by using univariate, bivariate, and multivariate analysis. Results: An association between breastfeeding (p=0.009), the timing of complementary feeding (p=0.009), history of infectious disease (p=0.001), basic health practices (p=0.000), environmental sanitation hygiene (p=0.000), knowledge of maternal nutrition (p = 0.000) with the incidence of stunting in the working area of the Tikson Raya Public Health Center, Banggai Laut District. The environmental sanitation hygiene variable was identified as the most related to the value of OR = 17.367. Conclusion: Exclusive breastfeeding, complementary breastfeeding, infectious diseases, basic health practices, environmental sanitation, and knowledge of maternal nutrition are associated with the incidence of stunting in toddlers in the working area of Tikson Raya Public Health Center, Banggai Laut District.
Impact of Obesity on Physical Activity
Authors: Nurmasitoh Titis , Khoiriyah Umatul , Fidianingsih Ika , Arjana Adika Zhulhi , Devita Ninda
Published: November 2021

BACKGROUND: Obesity occurs due to an imbalance between the calories and the energy released. On the animal model, obesity is considered as the ground for low physical activity. This is caused by low dopamine D2 receptor in the striatum. However, this suggestion is still unproven in the human condition.

AIM: The aim of this study was to find out difference in dopamine expression in obese subjects compared to non-obese subjects when triggered by the stimuli of physical activity.

METHODS: This is a quasi-experimental study. The sample was obese and non-obese (control) female who met inclusion and exclusion criteria. Before treatment was given, subjects were asked to fill out a depression, anxiety, and exercise motivation questionnaire. All subjects were tested for vital signs, anthropometrics, and neurological examinations to determine the initial condition. Then, the subjects saw video about physical activity and were taken for blood to measure blood dopamine levels using enzyme-linked immunosorbent assay. Differences in dopamine levels between the obese and control groups were analyzed using independent t-test. The relationship between dopamine levels and exercise motivation was analyzed using Pearson.

RESULTS: The obese group’s dopamine level was 71.19 ±3.02ng/ml and the control group was 81.15 ± 3.17ng/ml (independent t-test, p = 0.032). The obese group’s motivation score was 58.46 ± 1.59 and the control group score was 62.38 ± 1.54 (independent t-test, p = 0.09). Furthermore, there was no correlation between dopamine levels and motivation scores (Pearson test, p = 0.09).

CONCLUSION: There are significant differences in dopamine levels between the obese group and the control group but no correlation between dopamine levels and exercise motivation scores.
Protective Potential of Ginseng and/or Coenzyme Q10 on Doxorubicin-induced Testicular and Hepatic Toxicity in Rats
Authors: Khodir Suzan , Alafify Aliaa , Omar Essam , Al-Gholam Marwa
Published: November 2021

Introduction: Although doxorubicin (DOX) is a successful cancer chemotherapeutic, side effects limit the clinical utility of DOX-based therapy, including male infertility and hepatotoxicity.
Objective: To evaluate the testicular and hepatoprotective effect of ginseng and/or coenzyme Q10 (CoQ10) in rats exposed to DOX and the possible underlying mechanisms.
Materials and Methods:  Fifty adult male albino rats were divided into (10/group), control, DOX group, DOX/Gin group, DOX/CoQ10 group and DOX/Gin+CoQ10 group. Serum testosterone, serum liver enzymes, fasting serum cholesterol and triglyceride (TG), tissue malondialdehyde (MDA), tissue superoxide dismutase (SOD), serum tumor necrosis factor-alpha (TNF-α), serum interleukin 6, serum interleukin 10, nuclear factor E2‐related factor 2 (Nrf2) gene expression in liver and testis and organ indices were measured.  Histopathological and immunohistochemical assessments of apoptotic marker kaspase3 in testis and liver were also performed.
Results DOX-induced toxicity is associated with a significant decrease in serum testosterone, testis and liver index values, testicular and hepatic SOD,  testicular and hepatic Nrf2 gene expression and serum interleukin 10. However, there was a significant increase in serum liver enzymes, serum cholesterol and TG, testicular and hepatic MDA, serum TNF-α and serum interleukin 6 when compared with the control group. The combination of ginseng and CoQ10 resulted in significant improvement of DOX-induced changes when compared with other treated groups.
Conclusion: Ginseng and CoQ10 have valuable therapeutic effects on DOX-induced testicular and hepatic toxicity via up-regulation of Nrf2 gene expression, inhibition of apoptosis, anti-oxidant, anti-inflammatory and hypolipidemic effects.
Effect of Adjuvant Vitamin C on Brain-Derived Neurotrophic Factor Levels and Improvement of Negative Symptoms in Schizophrenic Patients
Authors: Tanra Andi Jayalangkara , Sabaruddin Herwina , Liaury Kristian , Zainuddin Andi Alfian
Published: November 2021

AIM: This study aims to determine the effect of adjuvant Vitamin C on brain-derived neurotropic factors (BDNF) levels and improvement of negative symptoms in schizophrenic patients.
METHODS: This study was conducted at Hasanuddin University Hospital and its affiliate with 60 schizophrenic patients (30 controls, 27 treatments, and three dropout patients). The ELISA sample examination method was used to examine blood levels of BDNF, and Vitamin C levels before and after administration of Vitamin C. In addition, the negative symptoms were measured using the PANSS score.
RESULTS: There was a significant increase in BDNF levels in treatments group compared the control at 4th–8th weeks with p = 0.005 (4th week) and ≤0.0001 (<0.05) (8th week). The improvement in PANSS scores for negative symptoms in the treatment groups compared to the controls at the 2nd, 4th, and 8th weeks resulted in p = 0.042 (2nd week) and <0.0001 (4th–8th weeks). Furthermore, there was an increase in serum Vitamin C levels in the treatment groups with an initial average value = 4.762 and after 8 weeks = 148.155. Strong correlation between increased BDNF levels and improvement in negative symptoms on the PANSS score was found with p = 0.001 (4th week) and ≤0.0001 (8th week).
CONCLUSION: The administration of Vitamin C significantly increases BDNF levels and improves the PANSS score for negative symptoms in the treatments compared to the control groups.
The Effectiveness of Cabbage Leaf Compress and the Education of Lactation Management in Reducing Breast Engorgement in Postpartum
Authors: Napisah Pipih , Widiasih Restuning , Maryati Ida , Hermayanti Yanti , Natasya Windy
Published: November 2021

BACKGROUND: Breast engorgement is a common problem of breastfeeding. The combination of nursing interventions is expected to prevent and reduce breast engorgement promptly.

AIM: This study aims to determine the effectiveness of cabbage leaf compress and education on lactation management for reducing breast engorgement in postpartum.

METHODS: This study was a quasi-experimental study with a non-equivalent control group design. The sample was 60 postpartum women (n = 30 the intervention group and n = 30 the control group) selected by purposive sampling. The instrument was the Breast Engorgement Scale. The intervention included giving compress on women’s breast using the cabbage leaf and educating them about lactation management, while the control group was given treatment according to hospital standard procedures. The study was conducted in a national referral hospital for West Java Province areas, Indonesia. Data were analyzed using the Wilcoxon sign-rank test and the effectiveness of intervention tested using the NGain score test.

RESULTS: There was a difference in breast engorgement scale before intervention with median value ± min max (3.00 ± 2-6) and after median ± min max (2.00 ± 1-2), while in the control group the breast engorgement scale before treatment showed the median was ± min-max (2.00 ± 2-5) and after treatment, was ± min-max (2.00 ± 1-5). The effectiveness of intervention was 77.56%.

CONCLUSIONS: The combination interventions of cabbage leaf compress and lactation management education were effective in reducing the breast engorgement in postpartum. This intervention can be used as an alternative intervention to solve the breast engorgement problem in postpartum women, especially for a developing country like Indonesia, because the cabbage leaf is cheap and easy to get in the traditional market. Further research is expected to conduct research on a qualitative design to understand women’s experience after interventions and the possibility to apply this intervention at home.
On an unsupervised method for parameter selection for the elastic net
Authors: Kereta Zeljko ,   Simula Research Laboratory, Martin Linges vei 25, Fornebu, Norway, Naumova Valeriya
Published: November 2021

Despite recent advances in regularization theory, the issue of parameter selection still remains a challenge for most applications. In a recent work the framework of statistical learning was used to approximate the optimal Tikhonov regularization parameter from noisy data. In this work, we improve their results and extend the analysis to the elastic net regularization. Furthermore, we design a data-driven, automated algorithm for the computation of an approximate regularization parameter. Our analysis combines statistical learning theory with insights from regularization theory. We compare our approach with state-of-the-art parameter selection criteria and show that it has superior accuracy.
Rendimiento estructural de bloques de hormigón con agregados de madera para la construcción de edificios de mediana y gran altura
Authors: Dominguez-Santos David
Published: November 2021

Los bloques de hormigón son elementos muy utilizados en edificación, debido a su bajo coste, su buen desempeño y la facilidad de montaje que tiene en los muros. Sin embargo, la baja ductilidad y resistencia a la flexión, podría perjudicar el comportamiento sismorresistente de las edificaciones, sobre todo en las construcciones de mediana y gran altura. Sin embargo, el añadido de aditivos reciclados y abundantes en la Naturaleza como la madera podrían mejorar las características estructurales desde el punto de vista sísmico y estructural. Este trabajo analiza y compara el rendimiento y el desempeño estructural que adquieren los bloques de hormigón ordinario incorporando en su elaboración diferentes tipos de aditivos de madera (desechos de aserrín y virutas de madera) en pórticos de mediana y gran altura (4, 8, 12 y 16 plantas). La modelación de los pórticos, utilizarán resultados experimentales realizados en un laboratorio de la Universidad de Talca (Chile).
La llegada del palo brasil americano a los mercados europeos: grupos mercantiles transnacionales y pretensiones monopolísticas, 1499-1530
Authors: Pérez García Rafael M.
Published: November 2021

La llegada de los españoles y portugueses a América creó un importante comercio de palo brasil hacia Europa. Durante el primer tercio del siglo XVI el brasil americano fue aceptado en los principales centros textiles europeos desplazando al de origen asiático. Este artículo estudia su distribución por los principales mercados europeos así como las pugnas entre distintos grupos de hombres de negocios por hacerse con el control de la importación del brasil traído desde las Indias de Castilla. Para ello se emplea una abundante documentación procedente del Archivo General de Indias, del Archivo General de Simancas y del Archivo de Protocolos de Sevilla.
Estrategia imperial y crédito local. El archipiélago de Malvinas en la construcción de la frontera hispánica (1767-1774)
Authors: Martínez Carolina , Wasserman Martín L. E.
Published: November 2021

El presente artículo indaga el rol del archipiélago de Malvinas en la reconfiguración del espacio hispanoamericano desde 1767. Para ello, se articulan tres variables de análisis: la importancia geopolítica de las islas Malvinas a escala global, su lugar en la redefinición de la frontera imperial de la monarquía española, y el papel que los actores económicos del Río de la Plata tuvieron en la colonización del archipiélago. Empleando documentación política, cartográfica y fiscal, este trabajo demuestra que la consolidación de las fronteras que la Monarquía precisaba asegurar confluyó con los intereses de las oligarquías financieras locales.
¿Cómo medir el subsidio soviético a la economía cubana? Una nueva propuesta
Authors: Sovilla Bruno
Published: November 2021

El comercio entre la ex Unión Soviética (URSS) y Cuba hasta el derrumbe del campo socialista, ha sido objeto de numerosos estudios que lo han tratado de medir en dólares estadounidenses, sin tomar en cuenta las peculiaridades de las relaciones entre los países socialistas miembros del CAME (Consejo de Ayuda Mutua Económica). En este trabajo, utilizando fuentes oficiales (de la oficina de estadística y del Banco Nacional de Cuba), tratamos de subsanar los errores metodológicos cometidos, proponiendo una nueva medición de la ayuda soviética a Cuba.
Nanoparticle-Induced Airway Eosinophilia Is Independent of ILC2 Signaling but Associated With Sex Differences in Macrophage Phenotype Development
Authors: Ray Jessica L , Shaw Pam K , Postma Britten , Beamer Celine A , Holian Andrij
Published: November 2021

The majority of lung diseases occur with a sex bias in terms of prevalence and/or severity. Previous studies demonstrated that, compared with males, female mice develop greater eosinophilic inflammation in the airways after multiwalled carbon nanotube (MWCNT) exposure. However, the mechanism by which this sex bias occurs is unknown. Two immune cells that could account for the sex bias are type II innate lymphoid cells (ILC2s) and alveolar macrophages (AMs). In order to determine which immune cell type was responsible for MWCNT-induced airway eosinophil recruitment and subsequent sex differences in inflammation and disease, male and female C57BL/6 mice were exposed to MWCNTs (2 mg/kg) via oropharyngeal aspiration, and the respiratory immune response was assessed 7 d later. Greater eosinophilia and eotaxin 2 levels were observed in MWCNT-treated females and corresponded with greater changes in airway hyperresponsiveness than those in MWCNT-treated males. In MWCNT-treated females, there was a significant increase in the frequency of ILC2s within the lungs compared with control animals. However, depletion of ILC2s via α-CD90.2 administration did not decrease eosinophil recruitment 24 h and 7 d after MWCNT exposure. AMs isolated from control and MWCNT-treated animals demonstrated that M2a macrophage phenotype gene expression, ex vivo cytokine production, and activation of (p)STAT6 were upregulated to a significantly greater degree in MWCNT-treated females than in males. Our findings suggest that sex differences in AM phenotype development, not ILC2 signaling, are responsible for the observed female bias in eosinophilic inflammation after MWCNT inhalation.
Misery of Living with Parthenium Dermatitis
Authors: Agarwal Shail , Saini Shivani , Kumar Ramesh , Vijay Atul
Published: November 2021

Background:

Parthenium dermatitis is caused by friable plant extracts of Parthenium hysterophorus and related species. Approximately 40% of cases of plant dermatitis in India are contributed by this single species.

Materials and Methods:

This was a cross-sectional, observational study conducted in the Department of Dermatology of Jhalawar Medical College. Ninety-nine consecutive patch test positive parthenium dermatitis human subjects of age more than 16 and either sex were included. The study period was 11 months between September 2019 and August 2020. Sociodemographic, clinical profile parthenium dermatitis severity score (PDSS) and Dermatology life quality index (DLQI) were obtained from each patient. Correlation between PDSS and DLQI was obtained using Pearson's two-tailed coefficients.

Results:

Our study included 62 men and 37 women (1.67:1). The mean age was 51 ± 10.27 years. Mean duration of disease was 8.47 ± 4.45 years, and mean PDSS was 57.25 ± 17.65, mean DLQI was 17.14 ± 5.56. ABCD with CAD was the most common clinical subtype (45.45%). A significant positive correlation was observed between PDSS and DLQI.

Conclusion:

In this study, a significant impairment in quality of life (QoL) was observed in patients with higher score of PDSS and increasing duration, emphasizing that the disease needs specialized care including multiple indoor admission at the time of flare-up of disease.
A Clinicoepidemiological Study of Psychiatric Co-Morbidity in Hansen's Disease
Authors: Rani Ritu , Tegta Gita R. , Verma Ghanshyam K. , Sharma Dinesh D. , Gupta Mudita , Negi Ajeet
Published: November 2021

Introduction:

Leprosy is a chronic disease caused by mycobacterium leprae. Chronicity of the disease leads to various psychiatric co-morbidities, which are often undiagnosed and untreated. The main objectives of this study were to evaluate the frequency and nature of psychiatric co-morbidity in patients of Hansen's disease.

Materials and Methods:

Seventy confirmed cases of Hansen's disease between the ages of 18 and 60 years attending the department of dermatology of Indira Gandhi Medical College and Hospital, Shimla were evaluated for various manifestations of Hansen's disease and screened for psychiatric co-morbidity using GHQ-12 and diagnosed using ICD-10 checklist. Severity of depression and anxiety was assessed with HAM-D and HAM-A scales, respectively.

Results:

The prevalence of psychiatric co-morbidity was found in 27.14% of enrolled patients. Depression was most prevalent in (20%) mental disorder; followed by anxiety disorder (7.14%). Moderate depressive episode was the commonest seen in 11.42% patients whereas 5.71% patients had mild depression. Generalized anxiety disorder was seen in 1.42% whereas 5.71% patients had mixed anxiety disorder. Patients with higher education status, positive family history of leprosy, lepromatous leprosy, and hand deformities were significantly associated with higher psychiatric co-morbidity.

Conclusion:

Patients suffering from Hansen's disease have significantly high prevalence of psychiatric co-morbidity complicating the Hansen's disease. High index of suspicion is required to diagnose and treat it.
Study of Latex Glove Associated Dermatoses Among Nurses in a Tertiary Care Hospital
Authors: Tomy Chitra , Joseph Bobby , Madhukara J.
Published: November 2021

Introduction:

Natural rubber latex (NRL) is processed from Hevea brasiliensis trees. Allergic reactions to certain proteins in the latex manifest as immediate hypersensitivity reactions and allergic reactions to chemicals added to latex during processing manifest as allergic contact dermatitis. Healthcare workers (HCWs) are at increased risk of developing latex allergies. As little data is available from India, this study was directed toward identifying the prevalence of latex glove-related dermatoses among nurses and the factors leading to it.

Methodology:

This cross-sectional study was undertaken among nurses in a private tertiary care hospital.

Results:

A total of 700 nurses were included in the study. Symptoms of latex allergy were present in 74 (10.6%) of study subjects, out of which 69 (9.9%) had features of contact dermatitis. Patch test was done in 50 subjects and was positive in 12 (24%); among them, patch test antigens were positive in 9 (18%) and a positive result to glove piece was seen in 3 subjects.

Conclusions:

Latex allergy in India is a significant problem; though lesser compared to western countries, its prevalence necessitates the development of pre-employment protocols to avoid workplace morbidity.
Efficacy of Autologous Smashed Follicular Dermal Graft and Epidermal Cell Suspension in the Treatment of Chronic Nonhealing Trophic Ulcers in Hansen's Patients
Authors: Dheemant M. , Yadalla Harikishan Kumar , Raju Belliappa Pemmanda
Published: November 2021

Context:

Plantar ulcers occur in patients with leprosy not because of the disease but because of its neuropathic effects on the skin on the feet. Neuropathy increases the risk of trauma to patients' feet, leading to the development of ulcers. With the introduction of new therapeutic regimens, leprosy can now be cured. However, complications of the disease, such as sensory loss, muscle palsy, absorption of extremities, and recurrent ulcers, still lead to substantial morbidity. This short article reviews the current management of leprosy plantar ulceration in such (nonhealing chronic ulcers) patients.

Aims:

To evaluate the efficacy of autologous smashed follicular dermal graft and epidermal cell suspension in the treatment of chronic nonhealing trophic ulcers in Hansen's patients.

Materials and Methods:

A total of 23 chronic nonhealing trophic ulcers were treated with autologous smashed follicular dermal graft and epidermal cell suspension. Ulcers were assessed based on the rate of ulcer size reduction every week till 12 weeks and then once a month till the sixth month.

Statistical Analysis:

Analysis was done using SPSS 26 software. Independent t-test was used and a P value of <0.05 was considered statistically significant.

Results:

Amongst the Hansen's patients who were released from treatment, all 23 (100%) ulcers had healed within the study period of six months, and all 23 (100%) ulcers had healed within 8 weeks.

Conclusion:

With this modified technique of combining autologous smashed follicular dermal graft with epidermal cell suspension, trophic ulcers heal faster with good results of reepithelialization of the ulcer bed.
Oral Isotretinoin Combined with Oral Terbinafine Versus Oral Terbinafine Alone to Treat Recurrent Dermatophytosis
Authors: Verma Kaushal K. , Senthilnathan Gridharan , Bhatia Saurabh , Xess Immaculata , Gupta Vishal , Dwivedi Sada Nand , Sahni Kanika
Published: November 2021

Background:

Recurrent dermatophytosis is becoming arduous to treat. Recently, oral itraconazole with oral isotretinoin was successful in a patient suffering from recurrent dermatophytosis.

Objectives:

To evaluate if oral isotretinoin confers any added benefit over oral terbinafine in the treatment of recurrent dermatophytosis.

Materials and Methods:

This was an open-label randomized clinical trial including 100 adult patients with recurrent tinea cruris and/or tinea corporis randomized into two groups; Group A (oral isotretinoin 0.5 mg/kg/day and oral terbinafine 250 mg twice daily) and Group B (oral terbinafine 250 mg twice daily) for 4 weeks, and followed up for 3 months. Fungal culture and antifungal susceptibility testing against terbinafine, fluconazole, amphotericin B, itraconazole, and griseofulvin were performed.

Results:

Out of the 100 patients, 91 patients (44 in Group A and 47 in Group B) completed the trial. Complete cure was seen in 19/44 (43.18%) patients in Group A and 20/47 (42.55%) patients in Group B (P = 0.951). Recurrence occurred in 12/19 (63.1%) patients in Group A and 13/20 (65%) patients in Group B (P = 0.904). Cheilitis and dryness of lips were the most common adverse effects seen in 32/44 (72.73%) patients in Group A. A total of 50 cultures were grown. The commonest species isolated was Trichophyton interdigitale in 36 (72%) patients, having a mean minimum inhibitory concentration of 3.13 μg/mL for terbinafine. However, for itraconazole, it was 0.13 μg/mL, and varied minimum inhibitory concentration (MIC) values were seen for fluconazole, griseofulvin, and amphotericin B.

Conclusion:

The addition of isotretinoin to terbinafine has no added benefit in treating patients with recurrent dermatophytosis.
Women in Dermatology Leadership
Authors: Bansal Anuva , Sarkar Rashmi
Published: November 2021

Background:

Significant progress has been made in the representation of women at various fronts in dermatology. Nonetheless, women fall far behind their male counterparts when it comes to leadership roles as indicated by recent research data.

Materials and Methods:

This was a cross-sectional study amongst 180 dermatologists. Anonymous surveys were sent to 300 dermatologists across India, in March 2021, consisting of 14 questions, discussed and made by the two authors, the senior author having held leadership positions in dermatology.

Results:

Amongst the 180 respondents, 79% were female, and 21% were male. Significant attrition of women dermatologists in academic institutions, with increasing experience in the field was observed. A higher percentage of men had been in a leadership position as compared to women. (P > .05). The majority of the female respondents agreed that women had to struggle more than men to be accepted as leaders. (P < 0.05) Most women reduced their working hours to cater to household responsibilities, and almost 70% of the women agreed to having experienced burnout as a result of low job satisfaction or an absence of work-life balance (P < 0.05). More women agreed to having faced discrimination at the workplace (P < 0.05).

Conclusion:

Gender-based gaps in dermatology leadership still exist with regard to the number of women occupying higher academic ranks. Possible solutions include gender sensitization, creating a room for equivalent leadership opportunities, mentorship and family support, which may help tip the balance in favor of gender parity in dermatology.
Hereditary Angioedema
Authors: Jindal Ankur Kumar , Bishnoi Anuradha , Dogra Sunil
Published: November 2021

Hereditary angioedema (HAE) is an uncommon disorder with a global prevalence of approximately 1 in 10,000 to 1 in 50,000 population. This disease is grossly underrecognized in India because of lack of awareness and/or lack of diagnostic facilities. Clinical manifestations include swelling over face, eyes, lips, hands, feet, and genitals, abdominal pain, and life-threatening laryngeal edema. HAE should be suspected in all patients who present with angioedema without wheals and who do not respond to antihistamines and/or steroids. C1 levels, C1-INH levels, and C1-INH function should be checked in all patients suspected to have HAE. C1q levels should be assessed in patients with suspected autoimmune-mediated acquired angioedema. Management of HAE constitutes the treatment of acute attack and short-term and long-term prophylaxis. Because of lack of all first-line recommended medications, the management of HAE in India is a challenging task. Patients are managed using fresh frozen plasma (acute treatment), tranexamic acid, and attenuated androgens (prophylaxis). Even though attenuated androgens have been shown to be effective in the prevention of attacks of HAE, the side effect profile especially in children and in females is a serious concern. Hence, the treatment needs to be individualized considering the risk-benefit ratio of long-term prophylaxis. In this review, we provide an overview of diagnostic strategy for patients with HAE and the current treatment concepts with emphasis on currently available treatment options in resource-constrained settings.
Knuckle lesions in inherited and acquired disorders
Authors: Adya Keshavmurthy A. , Inamadar Arun C. , Palit Aparna , Shivanna Ragunatha
Published: November 2021

Skin lesions occurring over the knuckles can be a primary or characteristic manifestation of a disorder. Characteristic knuckle lesions may also be important cutaneous features of various internal disorders when they serve as useful clinical pointers, as well as may speak of the disease severity in certain instances. Furthermore, knuckle lesions also speak of various external factors as the underlying cause of the disease/lesions, such as trauma – occupational or otherwise, and contact dermatitis. Although knuckles essentially imply dorsal aspect of the metacarpophalangeal joints, many of the lesions described as those 'involving the knuckles' are seen over the proximal and/or less frequently, the distal interphalangel joints as well. This review presents a compilation of various inherited and acquired dermatoses and dermatological manifestations of various internal disorders associated with different forms of knuckle lesions.
A Cross-Sectional Study of Nailfold Capillary Changes in Psoriasis
Authors: Santhosh Parvathy , Riyaz Najeeba , Bagde Pranaya , Binitha Manikoth P. , Sasidharanpillai Sarita
Published: November 2021

Background:

Microcirculation in the skin of psoriasis patients significantly differs from unaffected individuals. Vascular changes precede skin lesions and occur even in nonlesional skin.

Aims:

The primary aim of this work was to study the nailfold capillary changes in psoriasis patients, and to compare it with that of controls. The secondary aim of this work was to compare the nailfold capillary changes in psoriasis patients with and without nail changes.

Methods:

A comparative cross-sectional study of 40 psoriasis patients and 40 age and sex-matched controls analyzed the capillaries of the proximal nailfold of all fingers using a dermoscope. The mean capillary loop density/mm, tortuous capillaries, capillary hemorrhages, and avascular areas were assessed.

Results:

The mean nailfold capillary loop density in psoriasis (6.98 ± 0.54 per mm) was significantly less than that in controls (8.01 ± 0.61 per mm) (P < 0.001). Avascular areas in the nailfold of psoriasis patients (55%) were significantly more than the same in controls (22.5%) (P = 0.003). Of 40 psoriasis patients, 26 had nail psoriasis. Of this, 19 (73%) had avascular areas (P = 0.002). No significant association of nailfold capillary density or avascular areas with disease duration or severity was noted. An increase in tortuous capillaries and nailfold hemorrhages noted in psoriasis was not significant.

Limitations:

Small sample size, not having participants with psoriatic arthropathy, and lack of information on capillary diameter and capillary changes in hyponychium were the limitations.

Conclusion:

The reduced mean capillary loop density, and higher frequency of avascular areas noted in cases compared to controls, points to a pathogenic role for microvascular damage in psoriasis. Whether the lack of association of these changes with disease duration and severity suggests the possibility of these being early disease markers for psoriasis, needs further analysis in larger prospective studies.
Hydrological regionalization of streamflows for the Tocantins River Basin in Brazilian Cerrado biome
Authors: Rodrigues Jéssica Assaid Martins , Viola Marcelo Ribeiro , Mello Carlos Rogério de , Morais Marco Antônio Vieira
Published: November 2021

The Brazilian Cerrado biome is the largest and richest tropical savanna in the world and is among the 25 biodiversity hotspots identified worldwide. However, the lack of adequate hydrological monitoring in this region has led to problems in the management of water resources. In order to provide tools for the adequate management of water resources in the Brazilian Cerrado biome region, this paper develops the regionalization of maximum, mean and minimum streamflows in the Tocantins River Basin (287,405.5 km2), fully located in the Brazilian Cerrado biome. The streamflow records of 32 gauging stations in the Tocantins River Basin are examined using the Mann-Kendall test and the hydrological homogeneity non-parametric index-flood method. One homogeneous region was identified for the estimate of the streamflows Qltm (long-term mean streamflow), Q90% (streamflow with 90% of exceeding time), Q95% (streamflow with 95% of exceeding time) and Q7,10 (minimum annual streamflow over 7 days and return period of 10 years). Two homogeneous regions were identified for maximum annual streamflow estimation and the Generalized Extreme Value distribution is found to describe the distribution of maximus events appropriately within the both regions. Regional models were developed for each streamflow of each region and evaluated by cross-validation. These models can be used for the estimation of maximum, mean and minimum streamflows in ungauged basins within the Tocantins River Basin within the area boundaries identified. Therefore, the results provided in this paper are valuable tools for practicing water-resource managers in the Brazilian Cerrado biome.

Keywords: l-moments, statistical hydrology, water use rights concessions.
Removal of nutrients from aquaculture residual water: A review
Authors: Cargnin Jéssica Mendonça Ribeiro , João Jair Juarez
Published: November 2021

Aquaculture plays an important role in providing protein-rich foods, meeting the growing demand for fish. However, aquaculture is a potentially polluting activity, especially with regard to water pollution, due to the improper disposal of wastewater from the production process. Aquaculture wastewater is rich in nutrients (ammonia, nitrate, nitrite and phosphorus) and organic matter, and is commonly discharged into the environment without proper treatment. This can cause a series of environmental impacts and aggravate the current water crisis. Due to the importance and need to reduce environmental impacts, plan the use of water resources and achieve an efficient and sustainable production process, many researchers have focused their studies on effluent treatment techniques designed to remove these nutrients. This article therefore presents an updated review of the main physicochemical and biological techniques used in the removal of nutrients, which can mitigate environmental problems arising from aquaculture activities and contribute to the sustainability of the activity.

Keywords: biological removal, nitrogen compounds, sustainable activity.
Graphics-Based Service Information
Authors:   Graphics Based Service Information Committee
Published: November 2021

This document establishes standard graphical symbols and color conventions for use in either still (static) or animated graphics used for communicating service information. This document’s purpose is to communicate conventions for using those symbols and colors to accurately and consistently communicate intended information via graphics-based documentation. These practices are intended for use in service procedures, assembly instructions, training materials, and similar applications when trying to minimize the amount of human natural language text used within the document. The still and animated graphical conventions referenced should support effective communication via paper and “traditional” electronic media. The conventions can also extend to documenting via additional electronic delivery paradigms such as augmented reality (AR).

This document is intended for organizations interested in using graphics-based documentation to record and communicate assembly, adjustment, maintenance, and other service procedures.

Adoption of this document’s recommendations involves a series of business decisions. An organization choosing to follow this recommended practice is able to decide to implement the entire set of recommendations or to selectively adopt only those recommendations it determines are appropriate for their unique needs and situation. Short- and long-term retention of an organization’s legacy symbols and conventions are options to consider. Implementation may be partial or progress through multiple stages towards the full set of recommendations. In all situations, realizing this document’s maximum, long-term benefits for all companies, organizations, and people requires that the symbols, colors, and conventions recommended be widely taught and applied.
Physicochemical characteristics and green microalgae composition of selected rivers in Ogun State, Nigeria
Authors: Shokunbi O. S. , Badaru A. A. , Adesalu T. A.
Published: November 2021

The river system is the most complex of the freshwater bodies in the world and is prone to pollution especially from anthropogenic activities and the quality of water, as partially determined by physicochemical properties, is very crucial for primary productivity in the aquatic environment. This study determined the physicochemical characteristics and green microalgae of water collected from Majopa, Ogunpa and Uren rivers in Ogun State, Nigeria. Surface water samples were collected from three different rivers using direct collection method into the labelled bottles for physicochemical characteristics determination, culturing and ecological studies. Water samples for ecological studies were fixed in 4% unbuffered formalin while sample for culturing were not fixed but growth stimulated using Bold Basal Medium (BBM) and Blue- Green Medium (BG-11). The physicochemical parameters varied widely with the profile of water sample from Ogunpa River being the most favourable for widest diversity of green microalgae of all three. The pH of the water samples were slightly acidic ranging between 6.3 and 6.5 for the rivers, while the lower dissolved oxygen (2.61-3.01 mg/L) recorded pointed to a stressed environment which probably accounted for lower number of microalgae taxa observed, especially in Majopa River. The ecological studies showed the presence of ten taxa from the division Chlorophyta with nine taxa from Ogunpa River and Scenedesmus sp. being dominant genus across the rivers. The microalgae diversity of the river water was Ogunpa River˃Uren River˃Majopa River. BBM supported growth of the microalgae much better. The physicochemical properties portrayed Majopa and Ogunpa River water as unfit for drinking, while that of Uren River is relatively fit for drinking. It is highly recommended that the microalgae reported therein be further characterised for various possible economic benefits.

Keywords: Growth, Microalgae, Nutrient, Ogun State, River, WaterDepth, Geothermal Energy