bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Spectral Evolution of Hot White Dwarf Stars. IV. The Diffusion and Mixing of Residual Hydrogen in Helium-rich White Dwarfs
Authors: Bédard A. , Bergeron P. , Brassard P.
Published: March 2023

In the framework of our extensive modeling study of the spectral evolution of white dwarfs, we present here a new set of detailed calculations of the transport of residual hydrogen in helium-rich white dwarfs. First, we investigate the so-called float-up process at high effective temperatures, whereby the upward diffusion of trace hydrogen leads to the formation of a hydrogen atmosphere. We examine the dependence of this phenomenon on the initial hydrogen abundance and on the strength of the radiative wind that opposes gravitational settling. Combined with our empirical knowledge of spectral evolution, our simulations provide new quantitative constraints on the hydrogen content of the hot helium-dominated white dwarf population. Then, we study the outcome of the so-called convective dilution process at low effective temperatures, whereby the superficial hydrogen layer is mixed within the underlying helium-rich envelope. In stark contrast with previous works on convective dilution, we demonstrate that, under reasonable assumptions, our models successfully reproduce the observed atmospheric composition of cool DBA stars, thereby solving one of the most important problems of the theory of spectral evolution. This major improvement is due to our self-consistent modeling of the earlier float-up process, which predicts the existence of a massive hydrogen reservoir underneath the thin superficial layer. We argue that the trace hydrogen detected at the surface of DBA white dwarfs is, in most cases, of primordial origin rather than the result of external accretion.
Restaurer la confiance : pour une gouvernance éthique des organisations
Authors: Martineau Joé T. , Lulin Emmanuel , Gril Emmanuelle
Published: March 2023

Traditionnellement, la gouvernance au sein des organisations était centrée sur la performance, le leadership et les revenus. Or, depuis quelques décennies, nombre d’organisations font face à une grave crise de confiance. Et si le rôle de la gouvernance était désormais de rebâtir cette confiance et de la maintenir, tout en donnant le ton en matière d’éthique ?
La littératie permettrait-elle une meilleure gestion algorithmique ?
Authors: Gaudet Marie-Claude , Parent-Rocheleau Xavier , Pasquier Vincent
Published: March 2023

Il ne nous viendrait jamais à l’idée de confier le volant à une personne qui n’a pas son permis de conduire et qui n’a jamais pris la route. Mais, de manière surprenante, peu de gens sont choqués par le fait que l’on confie des algorithmes de gestion à des travailleurs et à des gestionnaires qui ne savent pas vraiment comment les utiliser !
Occurrence and associated risk factors of aflatoxin contamination in animal feeds and raw milk from three agroecological zones of Tanzania
Authors: Kitigwa S.J. , Kimaro E.G. , Nagagi Y.P. , Kussaga J.B. , Suleiman R.A. , Matemu A.
Published: March 2023

Aflatoxins (AFs) are natural toxic compounds produced by a specific type of fungi, which subsequently contaminate foods and animal feeds, potentially carcinogenic to humans. This study assessed the AFs awareness, prevalence and associated risk factors through a survey of the smallholder dairy farmers (SDFs) and livestock feeds and raw cow milk samples from three agroecological zones in Tanzania. The aflatoxin awareness among SDFs (419) and agrovet dealers (26) was 23.2% and 50%, respectively. The prevalence of aflatoxin B1 (AFB1) in livestock feeds from agrovet dealers, and SDFs was 88.5 and 86.2%, with a concentration ranging from a limit of detection (LOD) to 22.99 and 32.9 μg/kg, respectively. However, 15.38 and 22.5% of AFB1 detected samples from agrovet dealers and SDFs exceeded the European Union (EU) and Tanzanian Bureau of Standards (TBS) limits of 5 μg/kg for dairy cow feeds. The prevalence of aflatoxin M1 (AFM1) in raw cow milk was 30.7%, of which 27.9% exceeded the EU and TBS limits of 0.05 μg/l for raw cow milk. The risk factors associated with AFB1 and AFM1 were cattle feeding systems: zero-grazing (odds ratio (OR) = 11.3 (1.5-22.9)) and mixed feeding (OR=16.0 (1.4-43.6)), use of concentrates feeds (OR=12.0 (0.6-55.6)), mixed feeding (OR=5.0 (0.5-11.1)); feed handling and storage practices: no moisture content measurement (OR=2.0 (0.3-15.0)) and storing feeds (OR=3.6 (1.7-8.5)); agroecological zones: central zone (OR=15.2 (5.4-50.6)) and northern zone (OR=2.1 (0.7-7.3)); aflatoxin (AF) awareness and level of education: primary (OR=16.0 (2.5-155.3)) and secondary education (OR=8.0 (2.14-43.9)) (P<0.05). This study revealed a high prevalence of aflatoxin contamination in animal feeds and raw cow milk, suggesting a potential health risk to consumers. Therefore, it is vital to increase awareness and knowledge on AFs, proper handling, storage and monitoring of feeds among the stakeholders in the dairy value chain.
T-spherical linear Diophantine fuzzy aggregation operators for multiple attribute decision-making
Authors: Al-Quran Ashraf
Published: March 2023

This paper aims to amalgamate the notion of a T-spherical fuzzy set (T-SFS) and a linear Diophantine fuzzy set (LDFS) to elaborate on the notion of the T-spherical linear Diophantine fuzzy set (T-SLDFS). The new concept is very effective and is more dominant as compared to T-SFS and LDFS. Then, we advance the basic operations of T-SLDFS and examine their properties. To effectively aggregate the T-spherical linear Diophantine fuzzy data, a T-spherical linear Diophantine fuzzy weighted averaging (T-SLDFWA) operator and a T-spherical linear Diophantine fuzzy weighted geometric (T-SLDFWG) operator are proposed. Then, the properties of these operators are also provided. Furthermore, the notions of the T-spherical linear Diophantine fuzzy-ordered weighted averaging (T-SLDFOWA) operator; T-spherical linear Diophantine fuzzy hybrid weighted averaging (T-SLDFHWA) operator; T-spherical linear Diophantine fuzzy-ordered weighted geometric (T-SLDFOWG) operator; and T-spherical linear Diophantine fuzzy hybrid weighted geometric (T-SLDFHWG) operator are proposed. To compare T-spherical linear Diophantine fuzzy numbers (T-SLDFNs), different types of score and accuracy functions are defined. On the basis of the T-SLDFWA and T-SLDFWG operators, a multiple attribute decision-making (MADM) method within the framework of T-SLDFNs is designed, and the ranking results are examined by different types of score functions. A numerical example is provided to depict the practicality and ascendancy of the proposed method. Finally, to demonstrate the excellence and accessibility of the proposed method, a comparison analysis with other methods is conducted.
A robust adaptive grid method for first-order nonlinear singularly perturbed Fredholm integro-differential equations
Authors: Mao Zhi , Luo Dan
Published: March 2023

In this paper, a robust adaptive grid method is developed for solving first-order nonlinear singularly perturbed Fredholm integro-differential equations (SPFIDEs). Firstly such SPFIDEs are discretized by the backward Euler formula for differential part and the composite numerical quadrature rule for integral part. Then both a prior and an a posterior error analysis in the maximum norm are derived. Based on the prior error bound and the mesh equidistribution principle, it is proved that there exists a mesh gives optimal first-order convergence which is robust with respect to the perturbation parameter. Finally, the posterior error bound is used to choose a suitable monitor function and design a corresponding adaptive grid generation algorithm. Numerical results are given to illustrate our theoretical result.
Aplicaciones de la tecnología geofísica de georradar junto con la termografía infrarroja, el perfilómetro y otras tecnologías complementarias, en la construcción. Limitaciones y posibilidades
Authors: García Ruiz-Espiga Adolfo , Avial Bell Luis , Soler Severino Manuel José
Published: March 2023

La tecnología del georradar se ha probado de gran eficacia en la diagnosis y análisis de suelos y las más diversas aplicaciones gracias a su efectividad y sus características no destructivas. El presente artículo describe y analiza la utilización de la tecnología del georradar apoyada en otras complementarias, como son el perfilómetro, la termografía infrarroja, la fotografía infrarroja y la fotografía multiespectral, empleadas conjuntamente en ejemplos concretos de análisis de construcciones con objetivos relacionados con la detección y diagnóstico de deficiencias en los proyectos. Posteriormente, se analizan las características de los sistemas constructivos y del entorno que pueden condicionar la efectividad de los resultados y merma las ventajas de la utilización conjunta de los distintos sistemas, lo que permitirá en futuras actuaciones ajustar el alcance de los objetivos, optimizar las ventajas de la complementariedad de los distintos sistemas y, por tanto, permitirá abrir un abanico de posibilidades de utilización futura.
Les représentations des prisonniers à l’égard des mesures de réduction des risques
Authors: Filipe Estelle , Trouiller-Gerfaux Philippe , Abel Sylvie , Bayet Guillaume , Jauffret-Roustide Marie
Published: March 2023

À partir de l’enquête quantitative ANRS-Coquelicot-Prisons, cet article interroge les représentations des prisonniers sur la mise en place de kits d’injection et l’accessibilité des préservatifs en prison. Les kits d’injection ne sont pas disponibles dans les prisons en France et leur mise en place cristallise les débats. Quant aux préservatifs, leur accessibilité reste variable selon les établissements. Afin de connaître les opinions des prisonniers vis-à-vis de ces mesures de réduction des risques, une typologie a été construite à partir de réponses ouvertes, celle-ci met en évidence les divergences d’opinions au sein des groupes et leurs caractéristiques. Ces résultats amènent à repenser la manière dont la parole des concernés peut être associée pour améliorer ces dispositifs.
Étude du manuscrit du Journal du Kauthara de Cung Giũ Nguyên
Authors: Pham Van Quang
Published: March 2023

Notre objectif est ici d’évoquer la trajectoire littéraire de Cung Giũ Nguyên à partir du manuscrit mis au net du Journal du Kauthara. Cette approche génétique permet d’interroger, dans une perspective sociologique, la façon dont l’écrivain construit progressivement sa position dans le champ littéraire, c’est-à-dire sa stratégie d’élaboration d’un habitus. Après une brève présentation biographique, nous aborderons les conditions d’archivage et d’édition de son œuvre, avant de nous focaliser sur le Journal du Kauthara : sa genèse paradoxale et son caractère hybride.
Research Retraction and Its Communication
Authors: Xu Shaoxiong Brian , Hu Guangwei
Published: March 2023

This article presents a comprehensive overview of retraction research. It introduces retraction as a self-correcting mechanism of science involving various stakeholders and a complicated process operating centrally through retraction notices authored by different retraction stakeholders. It presents the main reasons for retraction, discusses the consequences of retraction for various stakeholders, identifies contributing factors to the unsatisfactory handling of retractions, and provides suggestions on how to handle retractions more effectively and efficiently. By way of conclusion, the article recommends directions for future research on retraction. This up-to-date overview of retraction research is an accessible source of information for those who are new to the phenomenon of retraction or unfamiliar with the extant research on retraction. It aims to advance the scientific community's understanding of research retraction and its communication.
Implementation of E-Learning Holistic Education in First Middle School
Authors: Damayanti Dian , Yusuf Muhammad , Mustami H. Muh Khalifah , Mania Sitti , Hafid Erwin
Published: March 2023

The implementation of e-learning holistic education has been widely carried out, but few have studied it related to aspects of the development of the use of communication and information technology in the world of education. Due to an abrupt outbreak of the global COVID-19 pandemic, the educational paradigm has to be shifted to a new era of online education at all levels while maintaining the Sustainable Development Goals (SDGs). The implementation of e-learning holistic education at SMP Bosowa School Makassar is constrained by several things, such as the existence of community groups who do not understand and agree about holistic education and the learning culture of students from early school which is not in line with the learning culture in SMP Bosowa School. However, despite facing various challenges, the implementation of e-learning holistic education at SMP Bosowa School went smoothly because it was supported by stakeholders and the applicable curriculum.
Identifying the Concept of Modularity in IS/IT Outsourcing Cases
Authors: Benazeer Shahzada , Verelst Jan , Huysmans Philip
Published: March 2023

Information systems and information technology (IS/IT) services are often outsourced to external partners for multiple reasons, but the main drivers are savings in cost, access to specialized expertise and technology, and focus on core competencies. The outsourcing literature is persistently reporting high failure rates in IS/IT project outsourcing. Literature suggests that the IS/IT project outsourcing is a complex maneuver, but unfortunately, none of the proposed remedies have considered to address the complexity related issue. It has been revealed from an in-depth literature review that the concept of modularity has been applied in many other fields in order to manage complexity and enhance agility/flexibility. The research objective of this study is to explore whether and how the concept of modularity can be applied in the context of IS/IT project outsourcing. Applying a newly developed systematic approach, this study analyzed two cases using the lens of modularity in order to understand and identify the relationship between the concept of modularity and IS/IT project outsourcing.
Youngsters Hedonic Shopping Motives in Different Genders and its Influence on Impulse Buying Tendencies: The Moderating Effect of Situational Factors
Authors: Dinesha P. K. C.
Published: March 2023

In consumer behaviour hue, though the shopping motives-impulse buying intention nexus is well documented, the influence with situation factors for it as well as its gender differences on its nodes still underexplored. Consequently, this paper aim to study the relationship between hedonistic shopping motives of young consumers and their impulse shopping intention under the control of situational factors. The study will be contributed to the academia with filling the gap of knowledge in the intentions nexus with encountered hedonistic motives of consumers. Primary data were collect for survey with 117 respondents on conveniently through self-administered questionnaire. The findings revealed variables in hedonistic shopping motives, novelty, and social interaction for females, and fun for both males and female respondents indicate significant positive relationship. The moderating effect of money was significant for both groups and time effect also significant for female consumers. The incurred limitation and the future research implications have discussed.
Influence of Popular Culture on Consumer Behaviour of Youth in Sri Lanka
Authors: Ihalagama Swarna , Harischandra M. K. Ruwan
Published: March 2023

In Sri Lanka recently, youth antisocial behavior has become a serious national and worldwide concern: Due to adolescent antisocial behavior over the previous 20 years, the rule of law and the law are challenged: Quantitative and qualitative data are collected. Snowball theory was used to collect qualitative data. In addition to this, the behavior of randomly selected individuals is studied through participant observation. Data was collected by conducting consensus interviews with individuals. According to police reports, ganging is a major issue. The previously mentioned organizational structure is well-known in urban areas, although it is less prevalent in rural areas. However, throughout the past two decades, the antisocial behavior of the youth has had a direct or indirect impact on Sri Lanka's popular culture. Additionally, juvenile gangs use a variety of tactics to trick and mislead victims of crime. Their actions are presented to the audience as vibrant and appealing visual images.
Cullin 3–Mediated Regulation of Intracellular Iron Homeostasis Promotes Thymic Invariant NKT Cell Maturation
Authors: Yarosz Emily L , Kumar Ajay , Singer Jeffrey D , Chang Cheong-Hee
Published: March 2023

The E3 ubiquitin ligase cullin 3 (Cul3) is critical for invariant NKT (iNKT) cell development, as iNKT cells lacking Cul3 accumulate in the immature developmental stages. However, the mechanisms by which Cul3 mediates iNKT cell development remain unknown. In this study, we investigated the role of Cul3 in both immature and mature thymic iNKT cells using a mouse model with a T cell–specific deletion of Cul3. We found that mature iNKT cells lacking Cul3 proliferated and died more than wild-type cells did. These cells also displayed increased glucose metabolism and autophagy. Interestingly, we found that tight regulation of iron homeostasis is critical for iNKT cell development. Without Cul3, mature iNKT cells harbored higher levels of cytosolic iron, a phenotype associated with increased cell death. Taken together, our data suggest that Cul3 promotes iNKT cell development partially through intracellular iron homeostasis.
Indicator mineral studies at the Brazil Lake LCT Pegmatites, southwest Nova Scotia
Authors: McClenaghan M B , Brushett D M , Beckett-Brown C E , Paulen R C , Rice J M , Haji Egeh A , Nissen A
Published: March 2023

Indicator mineral research is currently being undertaken in partnership with the Nova Scotia Department of Natural Resources and Renewables at the Brazil Lake lithium-cesium-tantalum (LCT) pegmatites in southwest Nova Scotia as part of the Geological Survey of
Canada's Targeted Geoscience Initiative(TGI) program. The pegmatites, discovered in 1960, are well known from previous detailed bedrock mapping and surficial studies, and are informally named based on their relative geographic positions as the South and North pegmatites. The South pegmatite
naturally outcrops, and both pegmatites are surrounded by spodumene-rich boulders on the surface of the thin-till covered (<4 m) drumlinized glacial landscape. For these reasons, the pegmatites are excellent sites to test indicator mineral exploration methods for Li and associated
critical elements (e.g. Ce, Ta). Five pegmatite samples were collected for detailed study and analysis of potential indicator minerals. Close to the pegmatite and up to 13 km down ice (south-southeast), 87 bulk (10-14 kg), till sediment samples were collected for indicator mineral analysis. A total
of 105 till samples were collected around the pegmatite and across the region for matrix geochemistry. A preliminary list of indicator minerals includes mid-density (e.g., spodumene, tourmaline, blue apatite) and high-density mineral species (e.g., columbite-tantalite, cassiterite) and this list is
expected to expand as the detailed studies progress. Trenches dug in the Fall 2022 to collect till samples on the proximal down ice (south) sides of both pegmatites revealed abundant spodumene pebbles and small cobbles in the till, indicating that the local till should display strong indicator
mineral and matrix geochemical signatures derived from the pegmatites.
Direct transfer for thrombectomy in patients with large vessel occlusions on computed tomography angiography results in safe revascularization
Authors: Eaton Ryan G. , Duru Olivia , Powers Ciaran James
Published: March 2023

INTRODUCTION:

Endovascular mechanical thrombectomy (EVT) has become the standard of care treatment for both intravenous tissue plasminogen activator eligible and ineligible patients presenting with an acute ischemic stroke due to a large vessel occlusion (LVO) within 24 h. Due to limited access to EVT, patients typically present to a non-EVT-capable center and are transferred to a larger, EVT-capable center. Quality improvement work has focused on improving this process to shorten the time to definitive recanalization of the affected vessel.

MATERIALS AND METHODS:

We retrospectively reviewed 98 consecutive patients who were transferred from an outside institution to our Comprehensive Stroke Center from July 2019 to September 2021. Thirty-nine of these patients had a diagnosed LVO at the transferring center on computed tomography angiography and were transferred directly to the angiography suite (DAT) whereas 59 patients were transferred to our Emergency Department for further imaging (EDT). Three of the patients in the DAT group did not undergo thrombectomy as there was no LVO identified on catheter angiography and were excluded from the study.

RESULTS:

Demographic and medical comorbidities were similar between the two groups. The DAT group had more severe strokes on presentation compared to the EDT group as measured by the National Institute of Health Stroke Severity (17.5 vs. 15, P = 0.048). Last known well (LKW) to arrival time in the angiography suite was significantly shorter in the DAT group (280 min vs. 474 min, P = 0.002). Patients in the DAT group were revascularized faster than the EDT group relative to LKW (320 min vs. 534 min, P < 0.001) while door-to-groin puncture and door-to-revascularization rates were similar. Modified Rankin score, incidence of symptomatic intracranial hemorrhage, and need for decompressive hemicraniectomy were similar between the two groups. Successful revascularization as measured by thrombolysis in cerebral infarction score occurred at a higher rate in the DAT group but was not statistical significance (97% vs. 85%, P = 0.055).

DISCUSSION/CONCLUSION:

DAT resulted in safe EVT compared to EDT with significant improvement in LKW to angiography suite presentation and subsequent vessel recanalization. Patients who underwent DAT experienced similar functional outcomes compared to EDT despite experiencing more severe strokes.
National Early Warning Score 2 is superior to quick Sequential Organ Failure Assessment in predicting mortality in sepsis patients presenting to the emergency department in India
Authors: Verma Ankur , Farooq Aasiya , Jaiswal Sanjay , Haldar Meghna , Sheikh Wasil Rasool , Khanna Palak , Vishen Amit , Ahuja Rinkey , Khatai Abbas Ali , Prasad Nilesh
Published: March 2023

Background:

High in-hospital mortality in sepsis patients remains challenging for clinicians worldwide. Early recognition, prognostication, and aggressive management are essential for treating septic patients. Many scores have been formulated to guide clinicians to predict the early deterioration of such patients. Our objective was to compare predictive values of quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2) with respect to in-hospital mortality.

Methods:

This prospective observational study was conducted in a tertiary care center in India. Adults with suspected infection with at least two Systemic Inflammatory Response Syndrome criteria presenting to the emergency department (ED) were enrolled. NEWS2 and qSOFA scores were calculated, and patients were followed until their primary outcome of mortality or hospital discharge. The diagnostic accuracy of qSOFA and NEWS2 for predicting mortality was analyzed.

Results:

Three hundred and seventy-three patients were enrolled. Overall mortality was 35.12%. A majority of patients had LOS between 2 and 6 days (43.70%). NEWS2 had higher area under curve at 0.781 (95% confidence interval [CI] (0.59, 0.97)) than qSOFA at 0.729 (95% CI [0.51, 0.94]), with P < 0.001. Sensitivity, specificity, and diagnostic efficiency to predict mortality by NEWS2 were 83.21% (95% CI [83.17%, 83.24%]); 57.44% (95% CI [57.39%, 57.49%]); and 66.48% (95% CI [66.43%, 66.53%]), respectively. qSOFA score had sensitivity, specificity, and diagnostic efficiency to predict mortality of 77.10% (95% CI [77.06%, 77.14%]); 42.98% (95% CI [42.92%, 43.03%]); and 54.95% (95% CI [54.90%, 55.00%]), respectively.

Conclusion:

NEWS2 is superior to qSOFA in predicting in-hospital mortality for sepsis patients presenting to the ED in India.
Prognosis of Patients with Venous Thromboembolism and Cancer in India
Authors: Chukka Kereena , Sharma Pritee , Ramnadh G Satyendra , Yerramsetty Vamsikrishna , Mohammad Fayazuddin , Gupta Prem Chand , Atturu Gnaneswar
Published: March 2023

Introduction:

Venous thromboembolism (VTE) is common in cancer patients and is considered one of the leading causes of death. Although activation of coagulation system is linked to tumor biology and considered as poor prognostic feature, there are several temporary/provoking factors such as perioperative period, immobilization, and debility that may cause VTE in these patients. It is not clear whether patients with such provoked VTE have different prognoses compared to patients without provoked VTE.

Aim:

To understand the overall prognosis of patients with cancer-associated thrombosis deep vein thrombosis (DVT) and whether there is a difference in survival between patients who underwent surgery (with or without chemotherapy) and patients who did not undergo surgery.

Materials and Methods:

This is a combined retrospective and prospective study. Electronic medical records of all patients who underwent VTE treatment between September 2014 and September 2019 were reviewed. Only patients who had DVT in the lower limb associated with malignancy were included in the study. Demographics, clinical, type, stage and type of cancer, and prophylactic treatment received and mortality data were collected.

Results:

Of 1364 patients treated for VTE, 86 patients (6.3%) had cancer-associated DVT. The mean age was 57 years (range 26–80 years) and 52 patients (60.46%) were female. The most common malignancies were cervix (15.11%), breast (12.79%), and colorectal (12.79%). Majority (68.60%) of the cancer patients were in the stages III and IV, other than having malignancy the most common risk factors were age, obesity, and postsurgery. Forty-three patients had surgery (with or without chemotherapy/radiotherapy). The left leg was commonly involved (53.48%) and the site of thrombus was in iliac (51.68%), femoral (16.85%), or popliteal veins (2.24%). All patients were initially started on low-molecular-weight heparin (LMWH) and then switched to Non-Vitamin K antagonist oral anticoagulants (NOAC) in 29 patients (33.72%) and VKA in 43 patients (50%). In seven patients, LMWH was continued (8.13%). Fifty-seven out of 86 patients (66.27%) were available for follow-up. Eighteen out of 57 patients (31.57%) were alive with an overall mortality of 59.64% and 1 year mortality of 37.5%. In patients who underwent surgery (with or without chemotherapy/radiotherapy), the overall mortality was 58.13% compared to 85.71% in patients who did not undergo surgery.

Conclusion:

VTE in cancer patients is not uncommon in India and is associated with high mortality. Patients with provoked DVT due to surgery (perioperative period) might have better survival compared to patients who did not undergo surgery.
Obscure Presentation of Postthrombotic Syndrome
Authors: Patel Jayesh , Asrani Manisha Rajesh , Patel Arya , Patel Gazal
Published: March 2023

Postthrombotic syndrome (PTS) will develop in 20% to 50% of patients within 1 to 2 years of symptomatic deep venous thrombosis (DVT). Limbs afflicted with PTS have more than three times the odds of having combined reflux and obstruction compared with limbs without PTS. Here, we present a case of an involvement of the right lower limb with classical features of PTS. Due to its low prevalence and similar presentations as those of chronic venous insufficiency lead to a missed diagnosis and prolonged follow up and complications of PTS. This can be prevented by employing CT venography as an early investigation modality. Here we treated the patient with open method as endovascular procedure was not successful.
Evaluation of Morphological Alteration in Human Mandible
Authors: Bohra Ankita , Harsh Aditya
Published: March 2023

Background:

The aim of the study is to evaluate the morphological alterations of the mandiblebetween different age groups, gender, and dentition status.

Materials and Methods:

A total of 1000 patients (500 males and 500 females), panoramic radiographs, were included in the study out of 57,640 patients in the outpatient department for 1 year. The patients were categorized according to age, gender, and dentition status that were assessed.

Results:

Statistically significant relation was observed between the mean antegonial angle, depth, gonial angle, and mandibular cortical index (MCI) with respect to the age, gender, and dentition status. The value of antegonial angle decreased with age and edentulousness, while antegonial depth increased with age and edentulousness. Females had higher values of antegonial angles as compared to males for antegonial angle, while the opposite is true for antegonial depth.

Conclusion:

There is an inherent asymmetry in the antegonial regions between the right and left sides. The gonial angle can serve as an adjuvant and additional forensic parameter, which guides for age group assessment and gender identification. MCI can be used as a diagnostic tool for screening patients with or without osteoporotic changes.
Patterns of Methicillin-Resistant Staphylococcus aureus (MRSA) Strains Isolated at a Tertiary Care Hospital
Authors: Sannathimmappa Mohan B. , Nambiar Vinod , Aravindakshan Rajeev , Al-Kasaby Nashwa M.
Published: March 2023

Background:

The current study was aimed to investigate the patterns of Methicillin-resistant Staphylococcus aureus (MRSA) isolates and their antibiotic susceptibility in Oman with a special focus on determining the changing resistance patterns.

Materials and Methods:

The current study was a retrospective cross-sectional study, conducted at a referral hospital in Oman. The socio-demographic characteristics and the microbiological data of MRSA strains isolated between January 2015 and December 2018 were reviewed. Descriptive statistics were presented as frequencies and percentages.

Results:

In total, 1190 MRSA isolates from clinical specimens were studied. Infection was predominant among males (59%). There was an increasing trend of MRSA infection (19.2%–28.5%) from 2015 to 2018. The frequency of infection was less among elderly as compared to other age groups. Majority (58.7%) of MRSA was recovered from pus and wound swabs. The overall resistance to the tested antibiotics was as follows; ciprofloxacin (30.2%), erythromycin (27.1%), clindamycin (21.8%), gentamicin (10.7%), trimethoprim-sulfamethoxazole (5.2%), linezolid (0.3%), and vancomycin (0.2%). Furthermore, a significant increase in resistance to antibiotics such as ciprofloxacin (from 16.8% to 37.1%), erythromycin (from 13.4% to 27.7%), gentamicin (5.2% to 16.1%), clindamycin (from 11.5% to 26.6%), and trimethoprim-sulfamethoxazole (from 1.8% to 7.2%) over time from 2015 to 2018 was observed.

Conclusions:

The present study revealed a relatively high frequency of MRSA infection and changes in their antibiotic-resistance patterns to some commonly used antibiotics over time in Sohar Hospital. Optimized antibiotic prescription through targeted stewardship interventions to preserve formulary antibiotics that still maintain their effectiveness and updating existing infection control practices is crucial.
Effectiveness of Incremental Aerobic Exercise Program in Patients with Myocardial iNfarction Using 6-Min Walk Test
Authors: Kukolore Sarika , Naqvi Waqar Mohsin , Arora Sakshi Pritam
Published: March 2023

Background:

Myocardial infarction (MI), which is also called as heart attack, happens as a phenomenon due to reduced or no blood supply to a certain part of heart, leading to damaging heart musculature.

Aims and Objectives:

To investigate the efficacy of aerobic exercise training in Phase II rehabilitation program of myocardial infarction (MI) patients, 40 MI subjects were randomly selected (n = 40), age ranging from 50 to 70 years.

Materials and Methods:

The subjects were prescribed an incremental aerobic exercise training program to be performed for 6 weeks with initial intensity on 50% maximum heart rate (HRmax); then, in Group B, we have asked the subjects to perform on 55% HRmax, then on 60% HRmax, and up to 75% of HRmax; then, at the end of 6 weeks, we have recorded the parameters again.

Results:

The data obtained were then analyzed using related t-test, and the results were found to be statistically significant (t = 0.300, P < 0.01).

Conclusion:

The study shows that incremental aerobic exercise can significantly improve the performance of MI subjects in 6-min walk test distance.
A Review of Mechanism of Autologous Platelet-Rich Plasma in the Management of Chronic Wound Ulcers
Authors: Kshirsagar Shivani , Mahakalkar Chandrashekhar , Kaple Meghali
Published: March 2023

Platelet-rich plasma (PRP) uses autologous plasma containing growth factors that help in wound healing. PRP is being used extensively and is under research for wound treatment. The efficacy of PRP in wound healing is mediated by enhanced cellular response through various mechanisms through activation of growth factors. The cell proliferation, migration, and matrix formation is enhanced and that helps in rapid wound healing.
Correlation of Aerobic Capacity and Fatigue in Multiple Sclerosis Patients
Authors: Dhawale Tushar , Yeole Ujwal , Shevale Pooja
Published: March 2023

Background:

Aerobic capacity (VO2 max) in multiple sclerosis (MS) is considered to be a key physiological measure as it is a strong health and performance predictor. Fatigue is the common disabling symptom in MS patients. The study was done to assess correlation between aerobic capacity and fatigue in MS patients.

Methodology:

A study was carried on 30 patients of relapse remitting MS across Multiple Sclerosis Society of India, Pune, chapter participate in study and assess for aerobic capacity and fatigue. These patients were selected according to inclusion and exclusion criteria and were evaluated for assessing aerobic capacity (VO2 max) by 2 min walk test and fatigue by Modified Fatigue Impact Scale (MFIS).

Results:

Our study found aerobic capacity (VO2 max) (17.71 ± 2.966), MFIS (60.712 ± 22.191) with (P < 0.0001, r = −0.7168) and very significant correlation between aerobic capacity with fatigue in MS patients.

Conclusion:

The study concludes that there is a significant negative correlation of aerobic capacity with fatigue in MS patients.
Utility of Image-Guided Fine-Needle Aspiration Cytology from Neoplastic Hepatic and Gallbladder Lesions
Authors: Mahla Rohit , Iyengar Sudha
Published: March 2023

Introduction:

Fine-needle aspiration cytology (FNAC) is an important and successful method for liver and gallbladder (GB) lesion diagnosis. Aspiration from liver and GB masses and its cytological evaluation differentiate whether it is benign or malignant. It is of huge help to the clinician for deciding on timely and appropriate management of the patient. Image-guided FNAC of liver lesions helps to know lesion localization whether it is multifocal, with the benefit of multiple passes for adequate sampling.

Aims and Objective:

This study aims at finding the importance and effectivity of image-guided FNAC of liver and GB masses with the main focus on the diagnosis of neoplastic lesions.

Materials and Methods:

The study was a prospective study conducted in the Cytology Section in the Department of Pathology, Gajra Raja Medical College, Gwalior, from January 2019 to March 2021. All the slides of liver and GB fossa mass aspiration done with help of image guidance were stained and examined.

Results:

There were a total of 86 cases, out of which six cases had unsatisfactory material, thus rendering them as nondiagnostic (7%). The diagnostic efficacy is 93%. Out of 80 cases, 71 (87.5%) were reported neoplastic and 9 (12.5%) were nonneoplastic. Among neoplastic lesions (71/80, i.e., 88.7%), 70 were malignant and one case was reported as suspicious for malignancy. Out of 71 neoplastic lesions, 39 were from liver mass and 32 were from GB fossa. Among 38 malignant neoplastic tumors of the liver, six cases were hepatocellular carcinoma (15.7%). Out of 32 metastatic lesions to the liver, 30 were of adenocarcinoma and one case each of small-cell morphology and lymphoma.

Conclusions:

Cytological evaluation is an important tool and can be applied as the first line of diagnostics in the management of liver masses and can characterize liver masses. GB lesion cytology has more diagnostic yields and accuracy of differentiating neoplastic lesions from nonneoplastic lesions. Hence, from the study, we can conclude that advanced techniques in the cytological study of liver and GB mass can give an early diagnosis.
Effect of Home-Based Exercise Program in Patients with Hip Arthroplasty
Authors: Vyas Axita , Mukkamala Neha , Mehta Megha , Parmar Lata , Golwala Paresh
Published: March 2023

Background:

Physiotherapy has been a routine component of rehabilitation to improve strength and function following hip arthroplasty (HA). Supervised outpatient exercise program can be costly and inconvenient for people who live in the remote areas. Hence, the present study developed Home-based exercise program (HEP) and studied its effect in patients with HA.

Materials and Methods:

Thirty-six patients with HA were allocated into HEP and control group through the lottery method. Both groups received physiotherapy during hospital stay and were assessed for muscle strength of hip abductors and extensor apparatus with sphygmomanometer, Numerical Pain Rating Scale (NPRS), and Harris hip score (HHS) at discharge. At discharge, HEP group was given a written home program leaflet, record sheet, and telephonic reminder once a week. The control group received all instructions and demonstration of exercises. All patients were assessed at the 1-month follow-up.

Results:

A total of 36 patients; 18 in HEP group, (12 males and 6 females) with a mean age 39.24 ± 14.59 years and 18 in the control group (11 males and 7 females) mean age 53.44 ± 19.24 years, out of which 35 completed follow-up (18 in HEP, 17 in control group). A statistically significant difference was found in NPRS (P = 0.001), muscle strength-hip abductors (P < 0.001), extensors apparatus (P = 0.008), and HHS in HEP group between discharge and follow-up. No significant difference was found between the two groups.

Conclusion:

HEP was effective in reducing postoperative pain, improving hip muscle strength, and function in patients with HA. There was no difference found between the groups
Study of Vitamin D Supplementation on Selected Hematological and Inflammatory Parameters in Type 2 Diabetes Mellitus with Vitamin D Deficiency
Authors: Jankar Deepali Sadashiv , Wingkar Kanchan Chandrashekhar , Kanetkar Sujata V. , Bodhe Chintamani Dilip
Published: March 2023

Introduction:

Diabetes mellitus (DM) results from decreased insulin secretion and/or increased insulin resistance. Vitamin D deficiency (VDD) is linked with decreased insulin secretion, increased insulin resistance, inflammation, and complications of DM. Few studies have reported association of VDD with anemia or decreased hemoglobin level in diabetic patients. Animal studies have reported some improvement in various blood parameters such as hemoglobin (Hb), hematocrit, red blood cell (RBC) and white blood cell count, and mononuclear cell count after Vitamin D supplementation. Neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) are cheap, easy, reproducible, and dynamic parameters of inflammation with high predictive value. NLR can be associated with DM and its complications. PLR is reported to be associated with cardiovascular disease, diabetic complications, end-stage renal disease, and malignancies. Both have prognostic value.

Materials and Methods:

Sixty-three Type 2 DM (T2DM) patients on oral hypoglycemic agents aged 30–60 years with VDD (Vitamin D level <20 ng/ml) participated in this comparative and interventional study. Vitamin D, Hb, total leukocyte count (TLC), mean corpuscular volume (MCV), platelet, red cell distribution width (RDW), mean corpuscular hemoglobin (MCH), MCH concentration (MCHC), packed cell volume (PCV), RBC count, NLR, and PLR were determined at baseline. Participants received Vitamin D 2000 IU daily orally for 12 weeks. All the parameters were estimated again after 12 weeks.

Results:

We found no correlation of Vitamin D with Hb, TLC, MCV, platelet, RDW, MCH, MCHC, PCV, RBC count, NLR, and PLR at baseline. Extremely significant rise in Vitamin D; nonsignificant fall in Hb, TLC, RDW, MCH, NLR, and PLR; and nonsignificant rise in MCV, MCHC, RBC count, and PCV were reported.

Conclusion:

There was no association of Vitamin D with hematological and inflammatory parameters. Nonsignificant improvement in the parameters was seen with Vitamin D supplementation.
Hygiene Practices and its Association with Diarrhea
Authors: Kumari Lovely , Sourabh Kumar , Laishram Guddi , Jumade Prashil , Wagh Vasant
Published: March 2023

Background:

Diarrhoea in India estimates about 2 million episodes per year. An average Indian child less than 5 years of age will have 2-3 episodes of diarrhoea per year. Every year, 2.2 million deaths are attributed to diarrhoea alone, with the vast majority of deaths among children under the age of five.

Aims and Objectives:

The present study aims to study the association between hygiene practices of mother or caregiver with diarrhea among under five children.

Methods:

The study was carried out in Seloo block, which is the field practice area and the study participants were the mothers or caregivers of the children between 6 months to 5 years of age of the selected villages. Results : It was found that the frequency of diarrhoeal disease was 53.33% among girls, while it was 38.75% among boys. On asking about the method of purification and filtration used, 68.6% mother or caregivers were using straining through cloth or strainer followed by 20.5% were using water filter (ceramic/composite) while 6.9% would boil the water and 0.98 used electronic purifier. When binary logistic regression was applied for hand washing practices and diarrhoea, it was found that regression coefficient was significant for hand washing before cooking showing regression coefficient value of - 0.84 (odd ratio-0.432) and hand washing before meal regression coefficient value of - 0.73 (odd ratio-0.481)

Conclusion:

The association between hand washing before meals and before cooking was found to be statistically significant indicating the importance of hand washing before cooking and before meals in preventing diarrhoeal episode in under five children.
Analysis of Correlation between Demographic Data, Inflammatory Markers, and Coronavirus Disease 2019 Illness
Authors: Karigoudar Rashmi Mahesh , Wavare Sanjay M. , Karigoudar Mahesh H. , Bagali Smitha , Shahapur Praveen , Kakhandki Lakshmi
Published: March 2023

Introduction:

The coronavirus disease 2019 (COVID-19) is an on-going pandemic caused by severe acute respiratory syndrome coronavirus 2. Majority of people infected with this virus will suffer from mild to moderate respiratory disease and recover without therapy, whereas the elderly and, as well as those who have underlying comorbidities are more prone to have severe infection. Several inflammatory indicators, like procalcitonin (PCT), serum ferritin, C-reactive protein (CRP), and interleukin-6 (IL-6), linked to the increased the risk of development of severe COVID-19 disease.

Objective:

The goal of this research was to see if there was a link between inflammatory markers and the severity of COVID-19 disease, as well as the sociodemographic characteristics that influence COVID-19-positive findings.

Materials and Methods:

This is a cross-sectional at Shri B.M. Patil Medical College, Research Center and Karigoudar Diagnostic Laboratory Vijayapur for a period of 2 months from October to November 2020. This study included 600 COVID-19-positive patients confirmed by real-time polymerase chain reaction (RT-PCR). Investigations included (RT-PCR) and inflammatory markers. The details collected were sociodemographic data and clinical history. Investigations included RT-PCR using throat swab/nasopharyngeal swab and inflammatory markers like CRP, D-Dimer levels, ferritin, IL-6, lactate dehydrogenase (LDH), PCT were performed accordingly. Data were analyzed using the SPSS version 18.0. Results were presented as percentages and mean ± standard deviation. The categorical variables were analyzed using the Chi-square test.

Results:

The mean age of the patients was 43.7 ± 16.7 years with male preponderance. The majority of the patients were between the ages of 21 and 60 (76.7%) years. Increasing age was significantly associated with severity of the disease, similarly CRP levels, D-dimer, ferritin, and LDH levels were significantly higher among those with increasing age and severe disease, i.e., severe acute respiratory infection (P < 0.05).

Conclusion:

There was a link between age and inflammatory indicators such as CRP, D dimer, ferritin, and LDH levels, as well as the severity of disease. Hence, measuring these inflammatory markers could help clinicians track and assess the severity and prognosis of COVID-19.
Sawangi's Presurgical Cartilage Molder in Infants with Type D Unilateral Cleft Lip and Palate
Authors: Vora Savi Manoj , Pallavi Daigavane S.
Published: March 2023

Objective:

The purpose of this article is to introduce a newer presurgical nasal cartilage molding device–Sawangi presurgical cartilage molder (SPCM) used extraorally for treating infants with unilateral cleft lip and alveolus; classified as type D according to the Daigavane and Hazarey classification.

Methods:

A 7-day-old male presented with unilateral cleft lip and alveolus categorized as type D according to the Daigavane and Hazarey classification. A head tape with a rectangular frame was used to support and mold the nasal cartilage with wireframe and nasal component fabricated with 0.8-mm stainless steel loaded with a soft liner nasal ball which was activated with the elastic.

Discussion:

The position of the nasal cartilaginous septum, nasal alar cartilage tip, medial and lateral crura were restored to normal. SPCM can be a helpful device in cleft lip ± alveolus to mold the cartilage and promote breastfeed simultaneously. It is easy to fabricate, less time-consuming, comfortable for the infant, and cost-effective.
A Case of Hodgkin's Lymphoma Presenting with Pleural Effusion
Authors: Aurangabadkar Gaurang , Lanjewar Ajay , Jadhav Ulhas , Wagh Pankaj
Published: March 2023

Pleural effusion has been reported in 7%–30% of patients with Hodgkin's lymphoma.[1] Unilateral and bilateral effusions are equally prevalent. Increasing stage, any extranodal involvement, and bulky mediastinal disease were each predictive of pleural effusions.[2] Pleural fluid Adenosine deaminase (ADA) levels in such cases may be elevated, normal, or in the indeterminate range (40–60 IU/l), which alone should not be the criteria for starting anti-tubercular therapy without comprehensive radiological and pathological investigations to look for any malignant etiology.