bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Complaints Due to Musculoskeletal Disorders and Its Effective Factors Among Medical Staff Working in Emam-Reza Hospital of Larestan
Authors: Bazrafshan Mohammad-Rafi , Seifi Zahra , Sookhak Fatemeh , Sarvi Fatemeh , Shafiei Mohammad Reza , Soufi Omid , Kavi Esmaeil
Published: May 2022

Background: Work-related musculoskeletal injuries and complaints are widespread. Medical staff are exposed to these injuries depending on their duties. Objectives: This study aimed to investigate the occupational musculoskeletal complaints and related risk factors among medical staff working in Emam-Reza hospital of Larestan. Methods: Following a cross-sectional, descriptive-analytical design, this study was performed on 124 medical staff working in Emam-Reza hospital of Larestan city in 2021. Participants were selected using convenient sampling. Data collection was performed using questionnaires filled out by participants from August to October 2021. The questionnaires were divided into demographic and musculoskeletal complaints using the Nordic questionnaire. Data analysis was administered using SPSS version 25. Statistical significance was considered when P-value < 0.05. Results: Of 124 participants, 92 (74.2%) were women. The mean age of participants was 34.97 ± 7.51 years. Most of the musculoskeletal complaints were related to the lumbar region, followed by one or both knees, and neck in the last 12 months and 7 days, respectively. Musculoskeletal complaints in the back during the previous 12 months and lumbar complaints during the previous 12 months and 7 days were significantly higher among nurses than others (P < 0.05). Also, in all body parts, the prevalence of musculoskeletal disorders was significantly higher in women than men (P < 0.05). Conclusions: Given the musculoskeletal complaints among female nurses participating in this study, the authors recommend training them to prevent and focus attention on appropriate conditions and improving working conditions.
Prevalence of Extended-Spectrum β-Lactamase Genes and Antibiotic Resistance Pattern in Clinical Isolates of Acinetobacter baumannii from Patients Hospitalized in Mashhad, Iran
Authors: Alshami Hasan Ghali Abdulhasan , Abbasi Shaye Maryam , Bahreini Masoumeh , Sharifmoghadam Mohammad Reza
Published: May 2022

Background: Carbapenem-resistant Acinetobacter baumannii strains are one of the most severe factors in hospital infection worldwide, in which the beta-lactamase enzyme is one of the main resistance mechanisms. Objectives: This study aimed to evaluate the presence of carbapenem-resistant beta-lactamase genes and determine antibiotic resistance patterns in the clinical isolates of A. baumannii from patients hospitalized in the Shahid Kamyab Hospital, Mashhad, Iran. Methods: Out of 286 collected isolates from patients hospitalized in Shahid Kamyab Hospital (from March 2017 to June 2017), 31 isolates were confirmed to be A. baumannii using biochemical tests. Antibiotic susceptibility testing was conducted using the disc diffusion method according to the CLSI standard protocols. The presence of beta-lactamase genes, namely blaVEB, blaPER, blaAmpC, blaVIM, blaIMP, blaSHV, and blaTEM, was detected using polymerase chain reaction. Results: In this study, 31 isolates were identified as A. baumannii, all of which revealed high resistance to ceftazidime, cefixime, ceftriaxone, meropenem, imipenem, cefotaxime and cephalexin. In this case, the lowest resistance (19.35%) was observed against polymixin B. Moreover, blaAmpC, blaTEM, blaSHV, blaPER, and blaVIM were observed in 93.54% (29), 51.61% (16), 48.38% (15), 41.93% (13), and 77% (24) of the isolates, respectively. However, blaVEB and blaIMP were observed in none of the isolates. Conclusions: The results showed high carbapenem resistance and high frequency of beta-lactamase resistance genes among the clinical isolates of A. baumannii.
The Impact of “Each Home as a Health Post” Program on Community Self-care Based on a Knowledge, Attitudes, and Practice Survey: A Study Protocol
Authors: Gharibi Farid , Kokhaei Parviz , Kassaeian Sayed Saeed , Kahouei Mehdi , Moshiri Esmaeil
Published: May 2022

: Today, self-care is referred to as a fundamental and irreplaceable principle for achieving optimal health outcomes. Undoubtedly, developing and implementing targeted and effective education programs is necessary to achieve adequate self-care in society concerning various diseases. Judging the effectiveness of health education and promotion programs is impossible without effective evaluation mechanisms that can measure the achievements at the levels of knowledge, attitudes, skills, and behavior with the desired accuracy and objectivity. Recently, a national program entitled "Each Home as a Health Post" (HAHP) was launched in Iran to improve the self-care capability among community members in high priority health issues. Hence, it is essential to establish a comprehensive and ongoing evaluation mechanism for the program, as well as to implement corrective and promotional interventions based on the evaluation results. Accordingly, this Knowledge, Attitudes, and Practice (KAP) survey aimed to assess the impact of HAHP program on self-care among the community in the form of a study protocol.
Interpreting Aquinas: Resources from Gadamer’s Hermeneutics
Authors: McWhorter Matthew ,   Philosophy Documentation Center
Published: May 2022

Certain teachings found in Gadamer’s hermeneutics (especially as presented in his major work Truth and Method) are examined in order to help cultivate the historically-minded theological methodology proposed by Thomistic thinker Benedict Ashley. Consideration is given to four Gadamerian themes mentioned in Ashley’s introduction to Theologies of the Body: (1) Interpretation is an intellectual inquiry that can be enriched by adopting hermeneutic reflection where such reflection is understood as a kind of a contemplative meta-praxis. (2) Interpretation as the search for understanding involves a heuristic process. (3) Hermeneutic reflection facilitates an interpreter becoming aware that the work of interpretation itself occurs within a historical context. (4) The process of interpretation is incomplete without the contemporary application of what is understood. With respect to each of these four themes, Ashley’s work is considered first and then the same topics are considered as found in the writings of Gadamer.
"Flame Retardant Materials and Technology" Online Course Teaching Mode Research and Practice
Authors:   China People’s Police University, YAN Qi , Guo Guo Zidong , Zheng Lanfang ,   China People’s Police University
Published: May 2022

Flame retardant Materials and Technology is one of the important specialized courses in fire engineering. The teaching course of Flame retardant Materials and Technology in China People’s Police University Fire Engineering for online teaching, as for example, material and technology of online courses teaching model to explore the teaching design, teaching process, teaching effect in research and practice, the integrated use of online teaching platform for practice. The result has proved that teachers through online teaching pattern research, improve the teaching quality in exploration, communication; students from passive learning to independent learning, to achieve the learning effect optimization.
University-industry collaborative education program and supply and demand matching employment and education program promote the county economy:Journal of Rural Revitalization and County Economy calls for papers
Authors:   Creative Publishing Co., Limited, LI Changkui
Published: May 2022

The industry-university cooperative education project and the supply-demand connection employment education project have produced the Journal of Rural Revitalization and County Economy academic journals to promote rural revitalization and county economic research.
Middle and Late Holocene landslides on the northern slope of the Aibga ridge
Authors: Slyshkina Elena , Vasil'chuk Yurij Kirillovich
Published: May 2022

When studying landslide processes, researchers pay great attention not only to the geometric dimensions of landslide bodies, displacement mechanisms, geomorphological features and reasons for their activation, but also to the time of their activation. The data obtained by radiocarbon dating of organic material selected from various geomorphological elements of landslides in the upper reaches of the Mzymta river basin (Western Caucasus) with a large sample of samples allow us to confidently say about the age of the event, or several episodes of landslide formation, the frequency of repetition of the process, as well as to establish the trigger causes that triggered the landslide. To obtain more reliable definitions of the age of the landslide, a method for performing serial selection of organic matter has been developed. Organic material was selected from various elements of the landslide : a) from sections of depressions in the rear part of the landslide, b) from sections of depressions on the main body of the landslide, c) from the humus horizon buried under the lingual part of the landslide. More than 40 new dates of samples of organic material have been obtained. The chronology of late- and Mid-Holocene landslides in the valley of the Mzymta river has been performed: 1. Landslides located on the northern slope of the Aibga ridge were formed during two major stages of landslide formation; 2. The older stage of landslide formation dates from the Middle Holocene from 6310 to 5380 cal. 3. The relatively younger stage of landslide formation dates from the Middle Holocene from 2930 to 2820 cal. years ago.
Analysis of the operation of the railway track in conditions of low-draining mares and high-temperature permafrost (on the example of the area of the Bureysky reservoir bypass).
Authors: Bogdanov Andrei Ivanovich , Kvashuk Sergey Vladimirovich
Published: May 2022

The subject of research is the earthwork of the railway track and artificial structures on hazy weak-draining areas in the areas of permafrost distribution on the bypass of the Bureyskaya HPP reservoir within the Verkhnebureinskaya depression. The purpose is to identify the conditions and causes of adverse processes and phenomena that have arisen during operation. The objectives of the research are to identify the main causes and conditions for the manifestation of unfavorable geocryological processes and phenomena вЂ“ waterlogging, flooding, stagnation of water, degradation of permafrost, sediment of the roadbed. Design errors are analyzed and recommendations are given for the application of design solutions in accordance with the state and dynamics of geocryological conditions and the requirements of the current regulatory documents for the areas of distribution of low-level marys and high-temperature permafrost. For the first time, a comprehensive analysis of the conditions and causes causing adverse processes and phenomena was carried out for the described territory. Inefficient constructions and design solutions have been identified. Optimal design solutions and measures are recommended to ensure the stable and safe operation of transport facilities in the region in conditions of low-drainpipe and high-temperature permafrost. For the studied area, the characteristic features are the significant swampiness of the territory, and the wide distribution of lowвЂ“ and high-temperature permafrost soils of the merging type. There are cases of irrational and inefficient design. It is not uncommon to use unsuitable soils for filling the roadbed and its elements. Also, the excess of the volume of earthworks during construction. Under these conditions, it is recommended: When designing a railway track plan, trace the line through local elevated terrain areas, in order to ensure the necessary slope of the design profile of drainage ditches of at least 4 ppm. Drainage ditches along the path should be located at a distance that excludes the inflow of water into the base of the roadbed.
Deep and surface factors of local gas-saturated zones formation with anomalously high gas pressure and gas emission craters in frozen soils
Authors: Khimenkov Aleksandr Nikolaevich , Stanilovskaya Julia Viktorovna
Published: May 2022

The article is devoted to the consideration of surface and deep factors that trigger the mechanisms for the preparation of explosive processes that form gas emission craters. The study object is local zones of gas-saturated soils with abnormally high gas pressure and gas craters. The main method used in this article is the bibliography review. The synthesis of the analyzed materials was carried out based on the geosystem approach. In the proposed work, an analysis was made of the main hypotheses of the formation of gas-saturated zones with increased gas pressure in frozen soils: 1) due to the comprehensive freezing of taliks (completely dependent on surface conditions; 2) due to the inflow of warm gas from underlying rocks into the surface layers (depending on deep sources); 3) due to the decomposition of gas hydrates contained in the permafrost (the reasons can be both surface and deep); 4) due to the joint interaction of the freezing talik and the associated deep gas inflow channel. Possibilities of realization of these or those hypotheses in real conditions are revealed. The relevance of the topic is due to the reassessment of the role of frozen soils as a screen that protects the atmosphere from the emission of greenhouse gases from the lithosphere. Evidence has appeared that this role of the cryolithozone is significantly weakened with an increase in temperature, while the frozen soils themselves can be a source of gas release.
Ethnographic motif in the decorative and applied art of Krasnoyarsk. History and modernity.
Authors: Grishchenko Anastasiya Petrovna
Published: May 2022

The article deals with the professional decorative and applied art of Krasnoyarsk from the 50s of the twentieth century to the present. The aspect of consideration is the use of the ethnographic motif of the Krasnoyarsk Territory and the features of its embodiment in the products of Krasnoyarsk artists of decorative and applied art. Using the example of the creativity of N.V. Kasatkina, A.G. Tkachev, A.S. Moskvitin, A.S. Migas, S.E. Anufriev and E.A. Krasnova, the aspects of the use of the ethnographic motif and their transformation over time, which led to the formation of archeoart in modern decorative and applied art and the features of its embodiment in the works of the main conclusions of the study are shown. The principles of the use, functioning and transformation of signs of an ethnographic motif in works of decorative and applied art in the Krasnoyarsk Territory are presented. The process of forming a new style in art took place from quoting and simple stylization of individual objects of ethnography in the works of artists to the gradual increase of signs of an ethnographic motif in the works of masters, which led to the formation of a new understanding of the region in art. The main visual concept of modern archeoart is the representation of Yenisei Siberia as the "cradle of humanity". The ethnographic motif associated with the history and mythology of indigenous peoples becomes the starting point in the artistic image, through which the elevation of regional visual signs to symbols understandable to every person takes place.
Museology as a humanitarian science
Authors: Gerasimov Grigory Ivanovich
Published: May 2022

The purpose of the article is to substantiate the main theoretical and methodological provisions of museology as a humanitarian science. Its basic concepts are formulated from idealistic positions, its methodology is defined. As an object, the ideas of a person who creates a museum reality to achieve influence on the consciousness of other people are considered. The idea of a particular museum, realized in objective reality, is defined as the subject. The subject of museology is also the process of realization of ideas вЂ“ the functioning of museum reality and the process of its perception by visitors. The purpose of the museum is to make certain changes in the consciousness and attitude of another person вЂ“ a visitor. The methodology of museology as a humanitarian science is based on the method of understanding, which provides comprehension of the ideas underlying the museum. Methods play a special role: communicative and construction. The goals of the museum determine its functions, the most important is the communicative one, it is she who realizes the main goal of the museum вЂ“ to convey ideas and feelings from the museum employee to the visitor. The ways to achieve the goal may change with changing attitudes in society, while the museums themselves and their functions change. The main factor determining the role and social significance of museums is a person's interest in them, which manifests itself when the ideas embedded in their foundation correspond to the main ideological ideas prevailing in society and help people solve their vital problems. A museum should be relevant only when it plays an important role in the life of society. The next stage in the development of museology as a humanitarian science is its approbation in the course of solving scientific and practical tasks facing a museum employee.
Overview of applications of heralded single photon source in quantum key distribution
Authors: Meng Jie , Xu Le-Chen , Zhang Cheng-Jun , Zhang Chun-Hui , Wang Qin ,   Institute of Quantum Information and Technology, Nanjing University of Posts and Telecommunications, Nanjing 210003, China,   Key Laboratory of Broadband Wireless Communication and Sensor Network of Ministry of Education, Nanjing University of Posts and Telecommunications, Nanjing 210003, China
Published: May 2022

In this paper, we mainly introduce the preparation and physical properties of the heralded single-photon source, the development history and its applications in three typical quantum key distribution protocols, including BB84, measurement-device-independent and twin-field quantum key distribution protocols. Moreover, we make comparisons of the above quantum key distribution protocols between using heralded single-photon source and using weak coherent sources, and analyze their advantages and disadvantages. Besides, according to the characteristics of single-photon interference in twin-field quantum key distributions, the limitations of separately applying heralded single-photon sources to twin-field quantum key distributions are revealed, and possible solutions are discussed. Therefore, this work may provide valuable references and help for the practical implementation of quantum secure communication in the near future.
Synthesis of two-dimensional Bi2O2Se on silicon substrate by chemical vapor deposition and its photoelectric detection application
Authors: Fu Qun-Dong , Wang Xiao-Wei , Zhou Xiu-Xian , Zhu Chao , Liu Zheng ,   School of Materials Science and Engineering, Nanyang Technological University, Singapore 639798, Singapore
Published: May 2022

As the scaling-down of semiconductor processing technology goes on, it is urgent to find the successor of silicon-based materials since the severe short channel effect lowers down their energy efficiency as logic devices. Owing to its atomic thickness and van der Waals surface, two-dimensional semiconductors have received huge attention in this area, among which Bi2O2Se has achieved a good trade-off among the carrier mobility, stability and costing. However, the synthesis of Bi2O2Se need some polarized substrates, which hinders its processing and application. Here, a Bi2O2Se layer with 25 µm in size and 51.0 nm in thickness is directly synthesized on a silicon substrate via chemical vapor deposition . A Field-effect transistor with a carrier mobility of 80.0 cm2/(V·s) and phototransistor with a photoresponsivity of 2.45×104 A/W and a photogain of 6×104 is also demonstrated, which hpossesses quite outstanding photodetection performance. Nevertheless, the high dark current and low on/off ratio brought by the large thickness leads to a fair detectivity (5×1010 Jones). All in all, , although silicon substrate brings convenience in device fabricating, it is still needed to further optimizing the growth and integrating more applications of various two-dimensional materials .
Extraction and analysis of hierarchy in complex system
Authors: Fan Kai-Yu , Liu Yan-Hua , Yang Pei-Cai , Wu Ji-Zhe , Wang Ge-Li ,   Dalian Meteorological Bureau, Dalian 116001, China,   Key Laboratory of Middle Atmosphere and Global Environment Observation, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100029, China,   Heilongjiang Meteorological Service Center, Harbin 150036, China,   Mengyin Meteorological Bureau, Mengyin 276200, China
Published: May 2022

The non-stationary characteristics of the climate system have been widely recognized. The occurrence of this non-stationary phenomenon is caused by the hierarchical structure of the climate system. As a high-level system, the external driving forcing changes with time, which leads to the non-stationary phenomenon of atmospheric movement. Slow feature analysis (SFA) method can extract the slow-changing features from fast-changing non-stationary signal. The SFA has been applied to attribution analysis of the climate system. In this paper, we use the SFA method to extract the driving force signal from the non-stationary time series obtained by the Henon mapping model to test its extraction capability. Then we extract the external driving force signal from Beijing monthly average temperature time series, and analyze the scale characteristics and physical mechanism of external driving forcing signals combined with wavelet transform. The results show that the long-period external driving forcing signal and the short-period external driving forcing signal jointly work on the climate system. At the same time, the long-period external driving forcing signal also works on short-period external driving forcing signal. This work contributes to understanding the hierarchical characteristics of the climate system.
Influence of spatiotemporal coupling distortion on evaluation of pulse-duration-charactrization and focused intensity of ultra-fast and ultra-intensity laser
Authors: Long Tian-Yang , Li Wei , Xu Hao-Tian , Wang Xiao ,   College of Physics, Sichuan University, Chengdu 610044, China,   Research Center of Laser Fusion, China Academy of Engineering Physics, Mianyang 621900, China,   Department of Optics and Optical Engineering, University of Science and Technology of China, Hefei 230026, China,   School of Space Science and Physics, Shandong University, Weihai 264000, China,   Graduate School of China Academy of Engineering Physics, Beijing 100088, China
Published: May 2022

In a large-scale ultra-fast and ultra-intensity laser system, with the increase of spectral bandwidth and beam aperture, the spatiotemporal coupling distortion will become more and more significant. This effect will not only degrade the beam quality and reduce the focusing intensity of the laser, but also invalidate the conventional evaluation method for laser far-field parameters. A pair of beam-expanding lenses, which may bring spatiotemporal coupling distortion to an ultrashort laser pulse, is taken as an example. And the influence of spatiotemporal coupling distortion on laser parameter measurement is analyzed in detail. It shows that in an ultrashort pulse laser system, an ordinary beam-expanding lens-pair can reduce the far-field peak intensity dramatically, and the actual pulse duration in the far field is more than 10 times longer than that measured at the near field by a single-shot autocorrelator. In this case, the focusing intensity estimated by using the measured value of near-field pulse width will be one order of magnitude bigger than the real value. It is expected that the results will be helpful in the optimal design of a laser system, the accurate characterization of an ultrafast laser pulse and relevant physical experiments.
Research progress of material, physics, and device of topological superconductors for quantum computing
Authors: Jiang Da , Yu Dong-Yang , Zheng Zhan , Cao Xiao-Chao , Lin Qiang , Liu Wu-Ming ,   School of Science & Institute for Frontiers and Interdisciplinary Sciences, Zhejiang University of Technology, Hangzhou 310014, China,   Institute of Physics, Chinese Academy of Sciences, Beijing 100190, China
Published: May 2022

Since the physical limit of Moore's law is being approached, many alternative computing methods have been proposed, among which quantum computing is the most concerned and widely studied. Owing to the non closeability of quantum system, the uncontrollable external factors will lead to quantum dissipation and decoherence. In order to avoid the decoherence of quantum superposition state, the fabrication of robust quantum bits has become one of the key factors. Majorana zero mode (MZM) is a quasi-particle emerging in the topological and superconducting hybrid system. It has non-Abelian statistical properties. Therefore, the topological qubit constructed by MZM has natural robustness to quantum decoherence. Despite the arduous exploration by various experimental groups, the experimental verification of MZM is still lacking. This paper reviews the history and main technical routes of quantum computing, focusing on the theory of topological superconductors, observable experimental phenomena, and the latest experimental progress. Furthermore we discuss and analyze the present status of the topological superconductor research. Finally, we prospect the future experiments and applications of topological superconductors in quantum computing.
Damage mechanism of SiC Schottky barrier diode irradiated by heavy ions
Authors: Peng Chao , Lei Zhi-Feng , Zhang Zhan-Gang , He Yu-Juan , Chen Yi-Qiang , Lu Guo-Guang , Huang Yun ,   Science and Technology on Reliability Physics and Application of Electronic Component Laboratory, China Electronic Product Reliability and Environmental Testing Research Institute, Guangzhou 511370, China
Published: May 2022

In this paper, the failure mode and mechanism of silicon carbide (SiC) Schottky barrier diode (SBD) irradiated by high-energy tantalum (Ta) ions are studied. The experimental results show that the reverse bias voltage during irradiation is the key factor causing the failure of SiC SBDs. When the reverse bias of the device is 400 V, the heavy ions will cause the single event burnout (SEB), and a “hole” formed by the melting of SiC material appears in the irradiated device. When the reverse bias is 250–300 V, the failure is manifested as the off state leakage current increases with the ion fluence. The higher the bias voltage of the device, the higher the leakage increase rate caused by heavy ions. For the devices with increased leakage, the leakage channels caused by heavy ions are found in the whole active region, based on microscopic analysis. The TCAD simulation results show that the incidence of heavy ions will lead the lattice temperature to increase in the device, and the maximum lattice temperature increases with bias voltage increasing. When the bias voltage is large enough, the local lattice temperature inside the device reaches the melting point of SiC material, resulting in SEB. When the bias voltage is relatively low, the lattice temperature is lower than the melting point of SiC material, so it will not cause burnout. However, the maximum lattice temperature in the device is concentrated near the Schottky junction, and the melting point of Schottky metal is much lower than that of SiC material. This may lead the Schottky junction to damage locally and eventually produce leakage path.
Exciton moiré potential in twisted WSe2 homobilayers modulated by electric field
Authors: Shi Bei-Bei , Tao Guang-Yi , Dai Yu-Chen , He Xiao , Lin Feng , Zhang Han , Fang Zhe-Yu ,   State Key Laboratory for Artificial Microstructure and Mesoscopic Physics, School of Physics, Peking University, Beijing 100871, China
Published: May 2022

The nanoscale periodic energy potential is introduced by moiré pattern in two stacked transition metal dichalcogenide monolayers with lattice mismatch or crystal orientation misalignment. It is demonstrated that the moiré potential can act as a diffusion barrier that affects interlayer exciton transport, providing an opportunity for studying the electronic and optical properties of moiré excitons. However, the current research on the modulation of exciton moiré potential in twisted homobilayers is limited. In this paper the effect of externally applied perpendicular electric field on the exciton moiré potential in twisted WSe2 homobilayers with different rotation angles is studied by using first principle calculations. It is found that the amplitude and shape of the interlayer exciton moiré potential are dependent on the relative rotation angle between the layers and electric field intensity. The amplitude and shape of the moiré potential in the twisted WSe2 homobilayers with different rotation angles vary with the electric field intensity (\begin{document}$\leqslant $\end{document}1 V/nm). These results provide theoretical basis and data prediction for modulating the local and the non-local transition of interlayer excitons, and are of great significance in promoting the development of semiconductor devices such as artificial excitonic crystals and nanoarray lasers.
Carnitine Cycle Defect in Newborn: A Rare Case Report
Authors: Sankar T Hari , Ramkumar TV , Rath Saroj Sekhar , Mallik Pradeep , Das Bharati
Published: May 2022

Carnitine Acylcarnitine Translocase (CACT) deficiency and Carnitine Palmitoyl Transferase (CPT I and II) deficiency comes under a group of disorders called mitochondrial fatty acid oxidation disorders, due to defects in the carnitine cycle. The CPT and CACT enzymes play a pivotal role in the transfer of Long Chain Fatty Acids (LCFA) from the cytoplasm to the mitochondrial matrix, where β-oxidation take place. In the present case, a male baby presented on day 2 of life with chief complaints of respiratory distress, apnoea, lethargy and seizures. The baby had multiple episodes of hypoglycaemia and seizures after admission. Diagnosis was made with the help of extended newborn screening using Tandem Mass Spectrometry (TMS) showing accumulation of hexadecanoyl carnitine due to CACT/CPT II deficiency. Echocardiography showed features of cardiomyopathy with cardiomegaly. Liver Function Test (LFT) and Prothrombin Time-International Normalisation Ratio (PT-INR) of the child was also deranged, with hypotonia of all muscles. Early detection along with carnitine supplementation and further prevention of fasting episodes resulted in generalised improvement of the baby. So, a high degree of suspicion of Inborn Error of Metabolism (IEM) and timely diagnosis can save the baby
Cutaneous and Ocular Findings in Systemic Pseudohypoaldosteronism I: Early Clinical Pointers
Authors: Agarwal Neha , Gupta Alpa , Dhasmana Renu , Mehta Ashima , Agrawal Nitika
Published: May 2022

Systemic Pseudohypoaldosteronism type I (PHA I) is an uncommon and an often missed cause of salt wasting crisis in the neonatal period. In addition to dyselectrolytemia, cutaneous findings in the form of miliaria rubra, and ophthalmic findings secondary to abnormal sebum accumulation in the eye may also be present in patients with systemic PHA I. This article is about systemic PHA in a female neonate (birth weight 2.040 Kg, delivered at 34 weeks of gestation), who presented with life-threatening hyperkalemia, along with characteristic cutaneous and ophthalmic manifestations. Normal female genitalia, history of hyperkalemia with similar cutaneous and ophthalmic manifestations leading to death in the previous sibling, provided clue to the diagnosis. All relevant investigations were performed. Blood chemistry in this neonate revealed hyponatremia and hyperkalemia with metabolic acidosis. Plasma renin and serum aldosterone levels were reportedly high. Neonate was followed and electrolytes were monitored twice weekly on outpatient basis. But the life-threatening hyperkalemia led to multiple episodes of vomiting and, refusal to feed for few hours and the baby succumbed to death at age of 2.5 months. Hence, it was concluded that systemic PHA I should be considered in the differential diagnosis of neonates presenting with hyponatremic dehydration, hyperkalemia, and metabolic acidosis. Timely and appropriate electrolyte correction is pivotal for favourable outcome.
Comparison of Placental Histopathological Findings with Good and Adverse Neonatal Outcomes- A Prospective Observational Study
Authors: Sachan Nidhi , Bisht Niharika , Chaurasia Amrita
Published: May 2022

Introduction: The placenta plays a crucial role in the growth and survival of foetus by performing most of the vital functions for the foetus before delivery. Histopathological examination of placenta can help in investigating the mechanism of placental dysfunction, which can further help in devising more precise intervention strategies and can contribute to more effective therapies in the future. Aim: To compare the placental histopathological findings of patients with adverse neonatal outcomes and good neonatal outcomes. Materials and Methods: This was a prospective observational study conducted on 200 antenatal cases with gestational age >34 weeks were enrolled in the study from IPD of Department of Obstetrics and Gynaecology, Swaroop Rani Hospital, Prayagraj, Uttar Pradesh, India, over a period of 1 year. They were followed- up till delivery and assessed for neonatal outcomes. On the basis of neonatal outcome, patients were divided into two groups- group A with normal neonatal outcomes and group B with adverse neonatal outcomes. A gross and histopathological examination of placenta was performed for each case. The results were compiled and statistically analysed to compare the findings between the groups. The p-value was calculated using Chi-square score and value of <0.05 was considered significant. Results: Out of 200 cases, 143 belonged to group A (with normal neonatal outcomes), in which majority 121 (84%) had normal placental histopathology, 8 (5.5%) had villous infarcts, 9 (6.2%) had syncytial knots and 5 (3.4%) had calcifications. Mean placental weight in group A was 425.88 grams while that in group B was 363.70 grams (p-value <0.0001). Group B (with adverse neonatal outcomes) had 57 cases, 8.8% cases were delivered via vaginal delivery, with low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score in 53 (26.5%), need for Neonatal Intensive Care Unit (NICU) admission in 57 (28.5%), need for mechanical ventilation in 12 (6%) and death in 6 (3%) cases. Villous infarcts was the placental histopathological feature in all cases with neonatal complications low APGAR score, NICU admission, those requiring mechanical ventilation or neonatal death. Out of these 57 cases, 8 (14%) had normal placental histopathology while 15 (26.3%) had infarcts, 12 (21%) syncytial knots, 9 (15.8%) had calcifications, and 13 (22.8%) had necrosis. Statistically significant difference (p-value <0.05) was found between the two groups in terms of abnormal histopathological findings and mean placental weight. Conclusion: Neonates with adverse outcomes had abnormal placental histopathological findings like villous infarcts, syncytial knots, calcifications, and necrosis.
Vertical Transmission of COVID-19 Infection in a Newborn
Authors: Hajela Rita , Vinayak Rajeev , Behal Manisha
Published: May 2022

Coronavirus Disease-2019 (COVID-19), in its second wave, is infecting the young children and newborns too. Increasing number of pregnant women with COVID-19 is being reported globally, and the potential for vertical transmission of Severe Acute Respiratory Syndrome- Coronavirus-2 (SARS-CoV-2), either in-utero, intrapartum or in the early postnatal period is of concern. At present, the extent to which SARS-CoV-2 vertical transmission occurs, and timing of such transmission is unclear. This report describes the clinical course and laboratory findings in a neonate in whom SARS-CoV2 infection most likely occurred via vertical transmission. As the baby developed audible grunting and tachypnoea, 10 minutes after birth, all the relevant laboratory investigations were done. The chest X-ray showed bilateral lung opacities. The neonate developed signs and symptoms of severe COVID-19 pneumonia on day 1 of life, completely manifesting within few hours of birth. The nasopharyngeal swab was sent for Reverse Transcriptase- Polymerase Chain Reaction (RT-PCR) for SARS-CoV 2 after two days of birth. The RT-PCR test came out positive. With all other causes been ruled out and contributory laboratory findings (raised D-Dimer, lactate dehydrogenase and erythrocyte sedimentation rate) it can positively be labelled as a case of vertically transmitted intrauterine COVID-19 pneumonia in a newborn. The baby was treated with ventilator support, antibiotics and Low Molecular Weight Heparin (LMWH), and finally discharged after nine days of life and management at the hospital.
A Retrospective Study of Predictors of Mortality in Low Birth Weight Neonates in a District Hospital of Lucknow, India
Authors: Thakur Neha , Rai Narendra
Published: May 2022

Introduction: Low birth babies account for 10% of neonatal mortality. Survival of these babies depends on gestation, birth weight, presence of associated co-morbidities and quality of neonatal care. Aim: To evaluate predictors of mortality of low birth weight neonates admitted in Special Newborn Care Unit (SNCU) of a district hospital in Lucknow. Materials and Methods: A retrospective analysis of case records were done to assess predictors of mortality of low birth weight babies admitted in SNCU of a district hospital in Lucknow from January 2017 to January 2020 was done. Neonatal variables in the form of gender, place of delivery, birth weight, gestation, mode of delivery, need for resuscitation at birth, respiratory distress, need for oxygen, duration of stay in hospital, neonatal outcome in the form of death, discharge, referral or leave against medical advice was assessed. The association between qualitative variables was assessed using Fisher’s-exact test. Quantitative variables were analysed using unpaired t-test. Results: Out of 2227 babies admitted in SNCU of a district hospital, 47.4% (n=1056) babies were low birth weight. Mean age of admission was 3.32±6.35 hours and mean weight on admission was 1.8±0.46 kg. A 53.41% (n=564) were preterm, 46.31% (n=489) were term and only 3 babies (n=0.28%) were post-term babies. A total of 655 (62%) babies were discharged, 85 (8%) referred and 316 (29%) died. Using univariate Odds Ratio (OR) to calculate the risk for mortality and taking p-value <0.05 statistically significant predictors of mortality were prematurity (p-value=0.001, OR 2.223), extremely low birth weight (<0.001), birth asphyxia (p-value=0.024, OR=1.399), place of delivery p-value=0.036, OR=1.290) and duration of stay in the hospital (p-value <0.001). Conclusion: In the present study, it was seen that gestation less than 28 weeks extremely low birth weight perinatal asphyxia and duration of stay in hospital were the most important predictors of mortality. Timely referral could have saved these babies. Consolidation of the existing infrastructure with better networking among the district and tertiary hospitals is required.
Correlation of Severity of Maternal Hypertension and Birth Weight of Neonates- A Longitudinal Study
Authors: Subramanian Preethi , Pabbati Jayalakshmi , Renikuntla Mahesh , Chitgupikar Sudharshan Raj
Published: May 2022

Introduction: Pregnancy Induced Hypertension (PIH) can lead to intrauterine growth restriction resulting in Low Birth Weight (LBW) neonates. LBW remains a significant cause of under-five mortality in India and Asia. Aim: To calculate the prevalence of PIH and to study the correlation between Birth Weight (BW) of neonates and severity of maternal hypertension; and compare the incidence of neonatal morbidities across varying severity of maternal hypertension. Materials and Methods: A longitudinal study was conducted among 153 pregnant mothers, diagnosed with PIH. They were classified into mild {Systolic Blood Pressure (SBP) ≥140- 149 mmHg or Diastolic Blood Pressure (DBP) ≥90-99 mmHg}, moderate (SBP ≥150-159 mmHg or DBP ≥100-109 mmHg) and severe (SBP ≥160 mmHg or DBP ≥110 mmHg) hypertension. A total of 142 neonates, born to PIH mothers, were included. The neonates were followed-up for seven days to check for early neonatal outcomes and deaths. Correlation between maternal blood pressure (systolic and diastolic) and BW of the neonates was assessed using Pearson’s correlation coefficient (r). Binary Logistic Regression (BLR) was performed to analyse the impact of confounders on BW. Results: The prevalence of PIH was 7.76% (153/1972). The mean BW of neonates born to mothers with moderate (2.435 kg) and severe hypertension (2.342 kg) was significantly lower than that of neonates born to mothers with mild hypertension (2.828 kg) (p<0.00001). 1SD increase in SBP resulted in 0.245 kg decrease in BW, while an 1SD increase in DBP resulted in 0.312 kg decrease in BW. After accounting for confounders using BLR, maternal DBP still had a significant negative correlation with BW (r=-0.663; p<0.001). The incidence of prematurity (p<0.0001), small for Gestational Age (GA) (p=0.0283), Respiratory Distress (RD) (p=0.002), Neonatal Hyperbilirubinemia (NNH) (p=0.033) and Neonatal Intensive Care Unit (NICU) admissions (p=0.003) were significantly higher among neonates born to mothers with moderate and severe hypertension than those born to mothers with mild hypertension. Three neonatal deaths (all due to perinatal asphyxia) were observed in this study and there was no statistical significance with respect to deaths across neonates of the three groups (p=0.219). Conclusion: Maternal DBP had a significant negative correlation with BW. The mean BW of neonates born to mothers with severe hypertension was significantly lower compared to those born to mild hypertension.
A Case of Bednar Tumour in the Sacral Region- A Rare Pigmented Variant of Dermatofibrosarcoma Protuberans
Authors: Jaishankar Jaistri , Krishnan R Anantharama , Kumar K Senthil , Raghavan Vijayashree
Published: May 2022

Dermatofibrosarcoma Protuberans (DFSP) is a relatively rare soft tissue neoplasm of intermediate malignancy. Metastasis of this tumour seldom occurs. The DFSP is a locally aggressive tumour with a high recurrence rate. The DFSP accounts for less than 0.1% of all malignant neoplasms and approximately 1% of all soft tissue sarcomas. Bednar tumour is an uncommon variant of dermatofibrosarcoma protuberans. Also known as pigmented dermatofibrosarcoma protuberans, this tumour is a rare, aggressive, cutaneous tumour that constitutes 1-5% of all DFSPs of intermediate grade. These tumours can be easily mistaken for fibrosarcoma and melanoma. It is seen in adults with a predisposition to affect the shoulder region, and trunk. Authors hereby report a case of 50- years-old female presented with complaints of recurrent swelling in the lower back for a duration of 4 months. Pain aggravated on lying in the supine position, swelling was painless otherwise. Patient also had complaints of itching over the swelling with occasional blood stained discharge on self-inflicted trauma. Magnetic Resonance Imaging (MRI) scan and histopathological examination of excised tumour confirmed the diagnosis of bednar tumour. She underwent wide local excision with split skin grafting and was on follow-up for the last two years with no evidence of recurrence. Hence, adequate clearance and thorough and regular follow-up is essential to prevent recurrence.
A Study of Tuberculosis among Patients Visiting Regional Tuberculosis Centre in Central India- A Cross-sectional Study
Authors: Chauhan Vikrant Singh , Bansal Manoj , Sharma Vikash , Gupta Rajesh
Published: May 2022

Introduction: Number of Drug-Resistant Tuberculosis (DRTB) patients has increased. Determination of the causes of delay in timely diagnosis and treatment is one of the most important steps for complete cure. Delay in diagnosis and treatment of disease are important factors and these may arise from patients and by the healthcare system. Aim: To study factors contributing to Tuberculosis (TB) patients , visiting a regional DRTB centre in central India. Materials and Methods: A cross-sectional study was conducted at DRTB centre, Lashkar, Gwalior, Madhya Pradesh, India, from January 2019 to June 2019. Purposive sampling technique was used for data collection. Patients who visited the centre were requested to fill the performa regarding their TB status. Total 371 patients, who visited and filled the form, participated in the study. Patients were divided into drug resistant and drug sensitive patients. For the significant independent variables adjusted odds ratio and p-values were calculated. The p-values <0.05 was considered to be significant. Results: Total 227 (61.2%) drug-resistant and 144 (38.8%) drugsensitive patients were included in the study. Education played a significant role with only 5.7% and 6.9% of drug resistant and sensitive patients, respectively, developed disease. Overall, 186 (81.9%) participants took more than 6 months of treatment prior to final initiation of Proper Anti-Tubercular Treatment (ATT) were DRTB cases. Conclusion: Delay in proper diagnosis and multiple visits to health facility and further delay in initiation of definitive treatment poses threat for emergence of drug resistance.
Evaluation of Nitric Oxide, Endothelial Nitric Oxide Synthase and Lipid Profile in Breast Cancer: A Case-control Study
Authors: Shingarwad Shrikant Shankarrao , Sawant Swati Digambar , Bansode Amit Amrut , Yadav Ravi Ramkishan
Published: May 2022

Introduction: Breast cancer accounts for 25% of all female cancer cases in India. Although, lipids and free radicals like Nitric Oxide (NO) have been related to breast cancer, but its pathogenesis remains controversial. Aim: To estimate NO, endothelial NO Synthase (eNOS) and lipid profile in serum of breast cancer patients and also to determine their possible role in patients of breast cancer in Indian women. Material and Methods: This was a hospital-based case-control study conducted for a period of 24 months from July 2012 to June 2014 in Dr VM Government Medical College, Solapur, with a total of 100 women (50 breast cancer cases and 50 healthy age matched controls) of age group 35-65 years. Fasting venous blood samples were collected. Biochemical parameters analysed in the study were serum NO, serum eNOS, serum Total Cholesterol (TC), serum Triglycerides (TG), serum High Density Lipoprotein (HDL) and serum Low Density Lipoprotein (LDL). Results were expressed as mean±Standard Deviation (SD) and Student’s unpaired t-test was used to compare the pairs of means. Results: There was no difference in mean age between cases (49.73±8.16 years) and controls (48.23±8 years). Serum levels of NO, eNOS, TC, TG and LDL were significantly higher in cases than in controls (55.92±6.54 µmol/L v/s 49.58±6.74 µmol/L for NO; 175.4±22.92 U/mL v/s 148.6±9.77 U/mL for eNOS; 271±9.16 mg/dL v/s 177.58±6.41 mg/dL for TC; 180.70±8.48 mg/ dL v/s 107.57±8.98 mg/dL for TG ; 177.39±6.21 mg/dL v/s 98.16±8.90 mg/dL for LDL). However, serum HDL levels did not showed significant difference in case group (57.55±6.40 mg/dL) when compared with control group (57.15±5.35 mg/dL). Conclusion: The present study demonstrated that high serum levels of NO, eNOS and lipids are associated with breast cancer and thereby suggests that increased NO, eNOS and abnormal lipid profile may have a role in pathogenesis of breast cancer.