bluuebunny/crossref_metadata_2025 huggingface dataset:
Pro-/Anti-Inflammatory Bioactive Proteins and Peptides
Authors: Güneş Fatma Esra
Published: December 2021

Bioactive peptides (BP) are specific protein fragments that can affect biological processes or substrates that have a positive impact on functions and conditions on body health. Plant and animal sources that contain physiologically active food proteins, native or processed, are rich sources of bioactive peptides. Bioactive peptides derived from food proteins have been demostrated to have variety of beneficial effects, such as anti-inflammatory and antioxidant properties. BP are accepted the new generation of biologically active regulators; they can prevent oxidation and microbial degradation in foods and furthermore improve quality of life by treating various diseases and disorders. The present review highlights the recent findings on the roles of various food-derived bioactive peptides in inflammation and oxidative stress and discuss the potential benefits and limitations of using these compounds against the burden of chronic diseases.
Nutritional and Pharmacological Properties of Bay Leaves (Laurus nobilis L.)
Authors: Srivastava Rashmi
Published: December 2021

Laurus nobilis L., commonly known as bay leaves, is native to the southern Mediterranean region. It is a small tree belonging to the genus Laurus of the family Lauraceae. The essential oils created from the different parts of this plant, such as the leaves and flowers, have been used in the food, drug, and cosmetic industries. The essential oil chiefly consists of 1,8-cineole, sabinene, α-pinene, and p-Cymene. Researchers have reported that bay leaves possess various biological and pharmacological properties, such as antibacterial, antifungal, antioxidant, insecticidal, and nematicidal activities. Pharmacological studies found that bay leaf oil could be a promising candidate with the potential for designing new drugs. The goal of this review is to summarize the ethnomedicinal importance, phytochemistry, and wide spectrum of pharmacological and therapeutic applications of bay leaves, which will be useful to researchers for further study.
Reaching the New Tourist Through Creativity
Authors: Stipanović Christian , Rudan Elena , Zubović Vedran
Published: December 2021

In today's modern world, creative expression is opening up new dimensions of business and new opportunities for economic development. One field of economic activities in which this is evident is tourism. Creativity in tourist destinations can be viewed in different ways, for example, through creative action (undertaken by destination management, residents, entrepreneurs, and tourists) and through creative spaces and creative events. Creativity plays a vital role in all elements involved in the creation of a destination's offering, regardless of which form of tourism is the focus of development efforts. Given the growing role of self-actualisation of individuals in society and the displaying of social status, creativity has in the past 20 years begun to positively impact on economy activities taking place in tourist destinations. Creativity is especially important in developing cultural tourism in all its sub-types, where it is seen as a means of animating and adding value to cultural heritage locations.
Multilingual Ability Among Deaf Students in Multicultural Education Contexts
Authors: Musengi Martin
Published: December 2021

The chapter intends to provide a conceptual basis for bilingual educators who filter their understanding of deafness through the socio-cultural lens of deafness. To do this, various types of simultaneous and sequential bilingualism en route to bilingual education for young deaf children are explored in relation to the language choices of their parents and educators. In light of these varied routes, the chapter discusses a typology of bilingual education ranging from weak forms aimed at assimilating signing deaf children into majority language and culture to strong forms focussing on development and maintenance of sign language and cultural pluralism.
Bilingualism, Deafness, and Literacy
Authors: Williams Jr. Douglas C.
Published: December 2021

Deaf students commonly leave high school with no higher than a fourth-grade reading level. This commonality may prompt certain assumptions regarding deaf children's strengths and weaknesses, particularly relating to reading development as well as broader academic and professional endeavors. The following review examines reading development among deaf, native sign language users as a bilingual process. Specifically, four common assumptions surrounding deaf learners' potential for ASL-English bilingual development are addressed including those relating to phonological accessibility, English-based signed system efficacy, ASL-English transference of language proficiency, and strategies for emergent literacy development in young, deaf learners. Finally, suggestions for future research endeavors are posed by the author.
GIS and Geo-Positioning Developments in Coping With the Pandemic
Authors: Arias-Gomez Helmuth Yesid , Antošová Gabriela
Published: December 2021

This chapter deals with some technical aspects of the spatial strategy for overcoming the huge challenges posed by the pandemic. The focus of this chapter is to highlight the use of GIS tools and positioning technologies in diverse contexts to manage the threat of COVID-19. For this task, three stages of analysis are proposed. In a first preventive stage, some governments applied socioeconomic criteria drawn from existent statistical information to spatially identify the areas with a clear predisposition toward the accelerated spread of the contagion. In a second stage, when the pandemic fully reached a rapid pace of expansion and lockdown measures became necessary, the technologies helped to monitor the most affected areas and to establish a dashboard deployment for visualizing the severity of the catastrophe. In the third stage, after the establishment of control and mobility protocols, different governments resorted to mobile phone positioning as a resource for monitoring quarantine compliance and recognizing if social group behavior entailed any evident risk or spread.
Improvements of Virtual and Augmented Reality for Advanced Treatments in Urology
Authors: Barua Ranjit , Das Surajit
Published: December 2021

Present signs of development in virtual and augmented reality have offered an important amount of inventive outfits into the customer market. Virtual reality (VR) technology has now affected the optimistic features of treatment. Surgeries in especially urology are constantly emerging, and the virtual reality model has become an important supplement in urologist teaching and training lists. This chapter provides a summary of the significance and varieties of virtual reality methods, their present applications in the area of urology (surgery), and upcoming implications.
Emerging Advancement for Augmented Reality (AR) and Virtual Reality (VR) in Dentistry
Authors: Bagaria Anmol , Mahilkar Sonal , Sonkar Subash C.
Published: December 2021

The skill of visual reality has matured, and VR and AR are increasingly being used in educational and surgical settings. The development of virtual reality technologies allows users to mix medical knowledge, medical data, and graphical data. It can provide more precise information, allowing users to increase their safety and reduce their risk. Virtual reality (VR) or augmented reality (AR) simulators that provide direct feedback and objective evaluation could be a useful tool in dental education in the future. Not only has it been applied to education, but it has also been created in therapeutic therapy. The authors believe that in the future VR and AR training and teaching will be extended and used in every aspect of dentistry, enabling students to develop their abilities on their own. In comparison to augmented reality, virtual reality offers a far more immersive experience. It would establish a trusting relationship between patients and doctors based on the experience of the dentists and the use of different hardware and software.
Exploring Strategies to Strengthen Re-Engagement Through Second Chance Education for Early School Leavers
Authors: Bitsakos Nikolaos
Published: December 2021

This survey is a qualitative analysis of written interviews of teachers (n= 367) working in Second Chance Schools, an educational institution consisting of structures operating inside and outside detention facilities in Greece. In particular, it examines teachers' proposals for reforms that will increase the socio-economic integration prospects of second-chance learners, who make up a population of former early school leaver and prisoners. This research provides a focused assessment of the inclusive teaching and learning offered by school second education. The results highlight the need for reforms in the structure and operation of second-chance structures that operate inside and outside detention centers, enhancing the training-labor market connection and creating a competitive working profile, and also the need of establishing equivalent to second-chance structures at all levels of education from primary to upper secondary to ensure a seamless educational path to entry into higher and vocational education institutions.
Assessing Pragmatic Skills in Speech Act Production and Perception
Authors: Gesuato Sara , Trubnikova Victoriya
Published: December 2021

This chapter offers an overview of the research on the assessment of pragmatic skills among L2 speakers, focusing on speech act production and reception. The main characteristics of the key variables involved in the assessment process are also outlined. These include: language users whose pragmatic skills are assessed; raters assessing language users' discourse; discursive phenomena being assessed; approaches adopted for collecting and assessing discursive data; and the criteria used as the standards for assessment. The overall aim of this chapter is to explore how inclusive the assessment of language use in its scope, methods and social relevance. The major trends challenges involved in pragmatic skills assessment practices are identified, implications are drawn from the findings, and suggestions for future research are offered.
Inclusive Teaching and Learning
Authors: Pace Doreen Said
Published: December 2021

This chapter focuses on the important role of educators' beliefs as they shape and consequently influence their teaching and learning approach from the planning to the implementation stage. Such beliefs were investigated using collaborative action research (CAR) on the belief-to-practice relationship of prospective teacher users of formative assessment (FA). A nine-month qualitative study with three Maltese state primary school teachers indicated that even with the transformation in the teachers' understanding, knowledge, and practice about FA, their belief was that success of FA depends on the learner motivation, hence shifting the problem onto the learner when it might well have been a problem with the system shaping the teaching and learning context. The point that will be made here is to look at FA as an inclusive teaching and learning approach if its strategies are used to attend to student diversity.
Inclusive Assessment Methods for a Heterogeneous Group
Authors: Blumenthal Teresa
Published: December 2021

Contextualizing course materials is a fundamental step in integrating inclusive and appropriate methods of assessment into a post-secondary introductory-level Spanish as a Heritage Language course. The author discusses why a portfolio project is an appropriate assessment choice in the heritage language classroom. While the focus of the chapter is the implementation of contextualized input through a portfolio project, other methods of assessments, along with changes to syllabi, are discussed. The chapter outlines a contextualized assessment implementation in the form of a portfolio project in a post-secondary heritage language course.
Enhancing Inclusive Teaching and Learning via University Courses Built on Needs Analysis
Authors: Shtepani Elvana , Alhasani Mirela Dubali , Kolaj Elona Mehilli , Delija Shpresa
Published: December 2021

This study examines the added beneficial value of needs analysis prior to designing ESP university courses to guarantee inclusive teaching and learning at English language programs in Albania. The study is conducted by combining both research methods of textual analysis with the survey questionnaire delivered to 150 students of English major at Tirana State University, EPOKA University, and Catholic University “Our Lady of Good Counsel” in Albania. It analyzes the feedback and perceptions of students on the content and inclusivity of the courses to better match their linguistic needs. The findings from this study reveal the need to systematically consider learners' needs prior to deciding the content materials and assessment methods aiming at a fair and transparent teaching, learning, and knowledge evaluation process. The last criteria comprise essential contributors to realizing inclusive teaching at university courses of English for Specific Purposes in Albania.
#DeleteDeficitThinking
Authors: Lambert Rachel , Greene Quinn , Lai Vanessa
Published: December 2021

In this chapter, the authors propose that Universal Design for Learning can be a way to resist and reframe pervasive deficit thinking in exceptional education. While UDL is based on a radical framework, it has been taken up in practice in a diluted way, de-emphasizing the radical conception of learners at its core. In this chapter, the researchers argue that in order to eliminate deficit thinking in UDL, users and scholars alike will need to 1) interrogate gaps and erasures in UDL professional development that affect its anti-racist and anti-ablest potential and 2) provide professional development that can challenge deficit thinking. This chapter describes findings in two studies working towards these goals. The first preliminary study investigates gaps in the conceptualization of the “user” of UDL in professional texts on UDL. The second study reports on how a professional development course on UDL actively disrupted deficit thinking about disability.
Deficit Thinking and Additional Language Learners in Exceptional Education
Authors: Blackmon Janat R.
Published: December 2021

In the 2018–19 school year, additional language learners (ALL) represented 10% of total student enrollment K–12 schools with over 5 million ALL learners enrolled in U.S. schools. Additional language learners are the fastest growing population in education in America. There is a disproportionality in the number of ALL learners referred to exceptional education programing in the U.S. instead of being taught in culturally responsive ways specifically to develop language skills in additional languages. Teachers often refer for Exceptional Education assessments ALL learners who are not progressing as fast as students with English as their home language for a learning disability. This chapter aims to identify the acculturation process and best practices for teaching English as an Additional Language specifically in the acculturation period for learners. This chapter will give an overview of ALL learners, culture, acculturation, and differentiation in instruction and assessment for ALL learners in working towards more appropriate and effective programming for ALL learners in American schools.
Do Religion and Spirituality in the Workplace Matter?
Authors: Saunders Bradley , Naser Hanan , Alaali Fatema
Published: December 2021

Although spirituality in the workplace has recently received extensive attention from many researchers in the field of management, it has often been interchanged with the term religion. Yet religion is neglected. According to Vitell, religion contributes to setting a framework for moral and ethical behavior in a business context, creating a spiritual workplace that is aligned with organizational goals and has a positive impact on productivity and profitability. Therefore, there is a need to conduct more investigations not only to explain the core concept of each, but also to evaluate the effectiveness of each and their integration in the workplace. This chapter addresses the increased demand to better conceptualize, define, and contrast the concepts of religion and spirituality in the workplace. In addition, the impact of leaders' life standards and personal values on behavior in the workplace are examined, with attention on the discussion of the impact of religion and spirituality.
Islamic Work Ethic
Authors: Özdemir Burak , Özcan Hamid Murad
Published: December 2021

Islamic work ethic (IWE) has been on the rise in the last 10 years and started to attract the attention of researchers. This study examines the development of IWE studies. In this direction, studies with the theme of Islamic work ethic were determined by examining the studies published in the Web of Science database. How IWE research has changed and developed was interpreted by the content analysis method. For that purpose, scientific publications were analyzed in terms of publication year, type of study, research design, sample type, sample size, data collection method, country where the study was carried out, variable types, antecedents and consequences of the IWE by descriptive review model When past studies were examined, it was seen that there was no study examining the literature on IWE in the context of content analysis. This study aims to fill this gap in the literature, to evaluate the situation of the IWE phenomenon in the literature, and to reveal which variables it is associated with.
Afetos, processos e crônicas: um estudo sobre as práticas de sociabilidade (Porto Alegre, 1890-1920).
Authors: Millen Grosso Carlos Eduardo
Published: December 2021

O presente artigo objetiva analisar as maneiras de interação social em Porto Alegre entre os anos de 1890 e 1920. Por meio de processos criminais de defloramento e de crônicas literárias, busco relacionar o processo de organização e controle do espaço público com as formas de sociabilidade vividas pelos diversos atores urbanos, dando especial atenção aos arranjos afetivos que envolveram estes atores.
A hanseníase no Espírito Santo a partir dos prontuários dos internos da Colônia de Itanhenga.
Authors: Pimentel Franco Sebastião
Published: December 2021

Este artigo busca traçar um perfil dos internos da Colônia de Itanhenga em Cariacica Estado do Espirito Santo entre 1937, ano de sua fundação até 1962, quando por Decreto Federal n.  968, a internação compulsória de hansenianos foi extinta no Brasil, assim como, trazer à luz, suas passagens pelo confinamento, possibilitando-nos conhecer as normas da internação compulsória, as formas de tratamento que recebiam os internos, suas reações ao confinamento, as punições a que eram submetidos ao quebrarem as normas, o cotidiano institucional. As fontes utilizadas foram os 685 prontuários dos internos da Colônia, cotejadas ainda com outras fontes como as correspondências expedidas e recebidas da direção da Colônia, o Livro de Termos de e Causas Criminais, os relatórios emanados pela direção da Colônia, depoimentos de ex internos e periódicos. Verificamos que a maioria dos internos eram homens oriundos das regiões interioranas, pertencentes aos estratos sociais mais desprivilegiados economicamente, havendo uma predominância de internos do sexo masculino. Vivendo na Colônia, tiveram que resinificar suas vidas, encontrando formas de se reinventarem.
The pursuit of a life less ordinary. The trajectory of afro-brazilian actor Milton Gonçalves.
Authors: Rocha Elaine
Published: December 2021

Milton Gonçalves is one of the most awarded actors in Brazil. He is a descendant of slaves, born in 1933 and, as such, he faced the challenges imposed on Afro-Brazilians during post-abolition: poverty and racial discrimination. This article utilizes interviews, newspapers and other media to examine the trajectory of Milton Gonçalves: his origins, life in São Paulo during the Vargas Era, the Teatro de Arena, the TV Channel Globo. Milton goes from being a shy young man to becoming the face and voice recognized by hundreds of millions in Brazil. He also became engaged in the struggle for racial equality in Brazil.
O feitiço e o transe no romance O Feiticeiro¸ de Xavier Marques.
Authors: Araújo Moura Milton
Published: December 2021

O escritor baiano Xavier Marques tem uma obra diversificada, voltada para várias temáticas no âmbito da sociabilidade na Baía de Todos os Santos. Esta contribuição trata do modo singular como o autor descreve, no romance O Feiticeiro, publicado em 1922, cenas relacionadas à tradição dos Orixás, buscando mostrar como, num meio intelectual marcado pelo etnocentrismo epistemológico, próprio de uma sociedade racista, reconstituiu a trama do feitiço e do transe, no que consiste sua originalidade.
Prosurvival IL-7–Stimulated Weak Strength of mTORC1-S6K Controls T Cell Memory via Transcriptional FOXO1–TCF1–Id3 and Metabolic AMPKα1–ULK1–ATG7 Pathways
Authors: Xu Aizhang , Leary Scot C , Islam Md Fahmid , Wu Zhaojia , Bhanumathy Kalpana Kalyanasundaram , Ara Anjuman , Chibbar Rajni , Fleywald Andrew , Ahmed Khawaja Ashfaque , Xiang Jim
Published: December 2021

CD8+ memory T (TM) cells play a critical role in immune defense against infection. Two common γ-chain family cytokines, IL-2 and IL-7, although triggering the same mTORC1–S6K pathway, distinctly induce effector T (TE) cells and TM cells, respectively, but the underlying mechanism(s) remains elusive. In this study, we generated IL-7R-/and AMPKα1-knockout (KO)/OTI mice. By using genetic and pharmaceutical tools, we demonstrate that IL-7 deficiency represses expression of FOXO1, TCF1, p-AMPKα1 (T172), and p-ULK1 (S555) and abolishes T cell memory differentiation in IL-7R KO T cells after Listeria monocytogenesis rLmOVA infection. IL-2– and IL-7–stimulated strong and weak S6K (IL-2/S6Kstrong and IL-7/S6Kweak) signals control short-lived IL-7R−CD62L−KLRG1+ TE and long-term IL-7R+CD62L+KLRG1− TM cell formations, respectively. To assess underlying molecular pathway(s), we performed flow cytometry, Western blotting, confocal microscopy, and Seahorse assay analyses by using the IL-7/S6Kweak–stimulated TM (IL-7/TM) and the control IL-2/S6Kstrong–stimulated TE (IL-2/TE) cells. We determine that the IL-7/S6Kweak signal activates transcriptional FOXO1, TCF1, and Id3 and metabolic p-AMPKα1, p-ULK1, and ATG7 molecules in IL-7/TM cells. IL-7/TM cells upregulate IL-7R and CD62L, promote mitochondria biogenesis and fatty acid oxidation metabolism, and show long-term cell survival and functional recall responses. Interestingly, AMPKα1 deficiency abolishes the AMPKα1 but maintains the FOXO1 pathway and induces a metabolic switch from fatty acid oxidation to glycolysis in AMPKα1 KO IL-7/TM cells, leading to loss of cell survival and recall responses. Taken together, our data demonstrate that IL-7–stimulated weak strength of mTORC1–S6K signaling controls T cell memory via activation of transcriptional FOXO1–TCF1–Id3 and metabolic AMPKα1–ULK1–ATG7 pathways. This (to our knowledge) novel finding provides a new mechanism for a distinct IL-2/IL-7 stimulation model in T cell memory and greatly impacts vaccine development.
A Rare Case of Patent Foramen Ovale Occluder Embolization
Authors: Allievi Luca , Bongarzoni Amedeo , Tassinario Guido , Conconi Barbara , Tumminello Gabriele , Carugo Stefano
Published: December 2021

Patent foramen ovale (PFO) is a common congenital defect in adults; its closure with an occluder device is usually a safe procedure. However, a rare and potentially fatal complication is the device embolization. We report a case of a 52-year-old man with bicuspid aortic valve and surgically corrected aortic coarctation, in which a PFO occluder device migrated to the abdominal aorta. We recommend paying attention to the risk factors before the intervention (PFO characteristics and multiple congenital defects) and to the clinical-echocardiographic follow-up, to prevent, recognize, and treat this severe complication as soon as possible.
Platypnea-Orthodeoxia Syndrome Years after Acute Pulmonary Embolism
Authors: Allievi Luca , Bongarzoni Amedeo , Conconi Barbara , Tumminello Gabriele , Barbieri Lucia , Carugo Stefano
Published: December 2021

Platypnea-Orthodeoxia syndrome (POS) is a rare condition in which dyspnoea and arterial oxygen desaturation are present in the upright position, while in the supine position, they are alleviated. It is observed in the presence of an anatomical (intra- or extracardiac) communication between the right and left heart causing a right-to-left shunt. POS is most frequently caused by a patent foramen ovale (PFO) and usually, the clinical assessment and a transthoracic echocardiograms with bubble study are enough to reach the diagnosis. The only possible treatment of POS is the percutaneous closure of the defect. We describe two cases of POS due to a PFO which manifested itself years after an episode of acute pulmonary embolism (PE), a finding never reported to date in the literature. Few cases describe the relationship between PE and POS, but these conditions may be more closely related than we currently think.
Prediction of Cardiovascular Risk among Healthcare Professionals using Atherosclerotic Cardiovascular Disease Risk Score in a Tertiary Care Hospital in Aurangabad, India
Authors: Naik Manjiri R. , Jacob Rohit Manoj , Reddy Sanjana P.
Published: December 2021

Background:

The current scenario of long working hours, sedentary lifestyle, and occupational stress has led to an increased prevalence of noncommunicable risk factors among the medical fraternity. Hence, determining the risk of developing atherosclerotic cardiovascular disease (ASCVD) has become highly essential to curb the predisposing factors leading to it.

Objectives:

The objectives of the study are to cluster the cardiovascular risk factors among healthcare professionals and to estimate the ASCVD Risk Score among healthcare professionals of a teaching hospital in Aurangabad.

Methods:

A population of 200 subjects were considered for the study. Cardiovascular risk factors such as age, race, gender, diabetes mellitus, antihypertensive medications, dyslipidemia, alcohol consumption, smoking, family history of hypertension, physical activity, waist circumference (central obesity), obesity, and stress/mental status were studied. Assessing each of its prevalence to predict the risk of cardiovascular disease using ASCVD Risk Score formed the crux of the study.

Results:

On assessing the risk factors in all subjects, it was found that type 2 diabetes mellitus (34.6%), dyslipidemia (32%), and hypertension (22.09%) were predominantly seen among majority of the healthcare professionals. The average lifetime ASCVD Score among healthcare professionals was 57.8%. It was observed that as age advances, the risk of developing an ASCVD also increased.

Conclusion:

Utilizing a simple tool such as the ASCVD Risk Score Calculator can not only predict the risk of ASCVD but can also help initiate preventive strategies and prolong the life of a medico!
Effect of leukotriene receptor antagonist therapy in bronchial asthma — A prospective, preliminary, hospital-based, randomized study in rural Konaseema, Andhra Pradesh
Authors: Bathula Bhargav Prasad , Bandela Pandit Vinodh , Ravikumar Pentakota , Duvvuri Bhima Sankar , Polimati Subba Rao
Published: December 2021

BACKGROUND:

The role of leukotriene receptor antagonist is well documented in the management of chronic asthma. However, the efficacy in acute asthma is not yet established.

AIM AND OBJECTIVES:

This study was designed to evaluate the clinical efficacy of oral montelukast as an add-on drug to the standard therapy of the acute attack of bronchial asthma.

MATERIALS AND METHODS:

A prospective, institutional-based, single-blinded, randomized control study was done. A total of 100 (aged between 18 and 60 years) participants diagnosed with acute exacerbations due to bronchial asthma were enrolled in the study. They were divided into study and control groups randomly. The study group patients were treated with 10 mg of montelukast once in a day for 4 weeks as an add-on drug, whereas the control group received only standard medication of acute bronchial asthma (as per Global Initiative for Asthma guidelines). All the participants were monitored at baseline to every week for a month.

RESULTS:

All the 100 participants were assessed finally without any dropouts. The baseline characteristics were noted similarly in both groups. The mean age was 35.46 + 13.17 years in the control and 37.86 + 14.43 years in the study group. Majority were males in both the groups. At the end of the 4 weeks of oral montelukast administration, there was improvement in forced expiratory volume in 1 s (FEV1) and peak expiratory flow rate at 2 weeks and 1 month. On many occasions, there was a strong improvement in FEV1 and other clinical parameters after continuous treatment with beta-2 agonists and parenteral corticosteroids for patients with acute asthma. Even though there was no improvement in FEV1/forced vital capacity ratio among both the groups at 2 weeks and 4 weeks, statistically significant improvement was seen between 2 weeks to 1 month on baseline parameters.

CONCLUSION:

Administration of oral montelukast 10 mg as an add-on drug to standard therapy may help in quick recovery from acute bronchial asthma and relapse.
A rare case of allergic bronchopulmonary aspergillosis with allergic fungal rhinosinusitis masquerading as granulomatous vasculitis
Authors: Kumar Sudhir , Rai Deependra Kumar , Kumar Subhash
Published: December 2021

The combination of allergic bronchopulmonary aspergillosis (ABPA) and eosinophilic granulomatosis with polyangiitis (EGPA) or Grnaulomatosis polyangitis (GPA) has been well described in the literature, but this is the first case report of ABPA with allergic fungal rhinosinusitis (AFRS) mimicking as granulomatous vasculitis (EGPA and GPA) as per the authors. A 25-year-old woman, symptomatic for the past 4 years and initially treated for bronchial asthma, presented with worsening dyspnea, cough, fever, anorexia, and leg pain. There were increasing pulmonary opacities in the chest radiograph, and a computed tomography scan demonstrated left hilar adenopathy and consolidation. The patient was diagnosed with ABPA after the initial workup and prescribed oral prednisolone with itraconazole. The patient also had nasal polyposis, sinusitis, mucin in sinuses, and fungal growth in mucin favoring the diagnosis of AFRS. Fiberoptic bronchoscopy showed plaque-like endobronchial lesions and bronchial stenosis, and histopathologic examination of the biopsy from the nodular lesion demonstrated eosinophilic bronchitis. Normal serum angiotensin-converting enzyme levels, positive Mantoux test, and the eosinophilic inflammation in the endobronchial biopsy ruled out the possibility of sarcoidosis. Both cytoplasmic and perinuclear antineutrophil cytoplasmic antibodies (c- and p-ANCA, respectively) were found positive in a vasculitis panel test, the positive p-ANCA favoring the diagnosis of EGPA, while the combination of endobronchial lesion, sinus abnormality, and nonresolving consolidation along with positive c-ANCA favoring the diagnosis of GPA as well. However, in the absence of histopathological evidence of vasculitis, ANCA may be false positive. Accordingly, a final diagnosis of ABPA combined with AFRS was made. The patient responded well to oral prednisolone along with inhaled asthma medications. Our case highlights the overlapping clinical features of eosinophilic lung diseases and small-vessel vasculitis, which may coexist, and the need to investigate thoroughly for better clinical outcomes.
The study of fractional exhaled nitric oxide in newly diagnosed cases of bronchial asthma and chronic obstructive pulmonary disease
Authors: Lakshmi V. , Meshram Priti , Kumar Ujjwal , Pujari Vishwanath , Sagar Pinkutty
Published: December 2021

INTRODUCTION:

Fractional exhaled nitric oxide (FENO) is a measurement of fractional nitric oxide (NO) concentration in exhaled breath. It is a quantitative, noninvasive, simple, and safe method to measure airway inflammation for the assessment of airways diseases.

OBJECTIVE:

The study was conducted at the tertiary care hospital to study the FENO levels in newly diagnosed patients of bronchial asthma and chronic obstructive pulmonary disease (COPD).

MATERIALS AND METHODS:

A total number of 105 patients were included in the study, diagnosed based on pulmonary function test and symptomatology. FENO levels were measured using Medisoft FENO machine, and the results were analyzed.

RESULTS AND CONCLUSIONS:

We found that both COPD and bronchial asthma are more prevalent among males. FENO levels were higher in bronchial asthma patients as compared to COPD patients. In bronchial asthma, FENO levels were higher in patients with very severe obstruction, and in COPD, patients with mild obstruction had slightly higher FENO values.
Imaging findings in common variable immunodeficiency
Authors: Rafiq Suhail , Kiran Sumiaya , Dar Musaib Ahmad , Shabir Uroosa , Birjees Sanna , Ashraf Obaid
Published: December 2021

Common variable immunodeficiency is characterized by decreased levels of immunoglobulins leading to repeated infections of chest, gastrointestinal tract, etc., Radiological findings and clinical suspicion could be helpful in diagnosing common variable immunodeficiency thereby decreasing mortality and morbidity associated with disease. We present radiological findings in a 20-year-old patient with laboratory findings supporting the diagnosis of common variable immunodeficiency.
Diagnostic accuracy of respiratory impedance parameters to detect airflow obstruction in adults
Authors: De Sajal
Published: December 2021

OBJECTIVE:

The present study was aimed to evaluate the diagnostic accuracy of impedance parameters to detect airflow obstruction and the severity of airflow obstruction in adults.

METHODS:

The spirometry parameters (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC], FEV1/FVC, FVC3/FVC, and FEF25-75) and respiratory impedance parameters (R5, R19, R5-19, and X5) measured by forced oscillation technique of consecutive 299 adults (male: 186) were included in the present analysis. The Spearman correlation coefficient (ρ) was used to assess the correlations of impedance parameters with spirometry indices. The area under the curve (AUC) was used to assess respiratory impedance parameters' diagnostic accuracy.

RESULTS:

The mean age of the study population was 54.1 ± 12.3 years, and 99 individuals (33%) had airflow obstruction (FEV1/FVC < 0.70) in spirometry. All spirometry indices (% of predicted) showed a weak negative correlation with R5, R19, R5-19, and weak positive correlation with X5. The R5 >142% predicted and X5 >136% predicted had the maximum AUC (0.75) with a sensitivity of up to 56% and specificity up to 86% to identify airflow obstruction. The impedance parameters showed low concordance with the severity of airflow obstruction.

CONCLUSION:

Respiratory impedance parameters had insufficient sensitivity to diagnose airflow obstruction and the severity of obstruction in adults. Thus, impedance parameters cannot a substitute for spirometry in diagnosing obstructive lung function.
Drug repurposing for identification of potential inhibitors against SARS-CoV-2 spike receptor-binding domain
Authors: Behera Santosh Kumar , Mahapatra Namita , Tripathy Chandra Sekhar , Pati Sanghamitra
Published: December 2021

Background & objectives:

The world is currently under the threat of coronavirus disease 2019 (COVID-19) infection, caused by SARS-CoV-2. The objective of the present investigation was to repurpose the drugs with potential antiviral activity against receptor-binding domain (RBD) of SARS-CoV-2 spike (S) protein among 56 commercially available drugs. Therefore, an integrative computational approach, using molecular docking, quantum chemical calculation and molecular dynamics, was performed to unzip the effective drug-target interactions between RBD and 56 commercially available drugs.

Methods:

The present in silico approach was based on information of drugs and experimentally derived crystal structure of RBD of SARS-CoV-2 S protein. Molecular docking analysis was performed for RBD against all 56 reported drugs using AutoDock 4.2 tool to screen the drugs with better potential antiviral activity which were further analysed by other computational tools for repurposing potential drug or drugs for COVID-19 therapeutics.

Results:

Drugs such as chalcone, grazoprevir, enzaplatovir, dolutegravir, daclatasvir, tideglusib, presatovir, remdesivir and simeprevir were predicted to be potentially effective antiviral drugs against RBD and could have good COVID-19 therapeutic efficacy. Simeprevir displayed the highest binding affinity and reactivity against RBD with the values of −8.52 kcal/mol (binding energy) and 9.254 kcal/mol (band energy gap) among all the 56 drugs under investigation.

Interpretation & conclusions:

In the current investigation, simeprevir was identified as the potential antiviral drug based on the in silico findings in comparison to remdesivir, favipiravir and other 53 drugs. Further, laboratory and clinical investigations are needed to be carried out which will aid in the development of quick therapeutics designed for COVID-19.
First seroprevalence report of scrub typhus from the tribal belts of the Nilgiris district, Tamil Nadu, India
Authors: Paulraj Philip Samuel , Renu Govindarajan , Ranganathan Krishnamoorthi , Leo Victor Jerald , Veeramanoharan Rajamannar
Published: December 2021

Background & objectives:

Scrub typhus, an acute febrile Rickettsial disease is caused by the bacterial pathogen Orientia tsutsugamushi which is spread by the bite of infected chigger mite vectors belonging to the family Trombiculidae. A study was undertaken to find out the prevalence of scrub typhus among the indigenous population from Nilgiris, Tamil Nadu.

Methods:

This study was conducted among 214 patients with fever of unknown aetiology and a recent history of febrile illness attending the Nilgiris Adivasi Welfare Association medical facilities available at Nilgiris district, Tamil Nadu. Serum samples were tested for scrub typhus IgM enzyme-linked immunosorbent assay.

Results:

Overall, 13 (6.07%) of the 214 samples tested were positive for scrub typhus. This is the first seroprevalence report of scrub typhus from the indigenous people belonging to Irula, Kurumba, Paniyar, and Kota tribes from the Nilgiris district, Tamil Nadu.

Interpretation & conclusions:

Early diagnosis and effective management will protect this indigenous population from this disease. This report would help in creating awareness regarding scrub typhus infection among clinicians and public health authorities in the region and take appropriate measures for treatment and control.
Health-related quality of life in patients with chronic obstructive pulmonary disease
Authors: Kharbanda Sidharth , Anand R.
Published: December 2021

Background & objectives:

Chronic obstructive pulmonary disease (COPD) adversely affects various functional and structural domains of the lungs, in addition to having an array of extra-pulmonary effects which affect overall well-being of a patient. This study was aimed at measuring the health-related quality of life (HRQOL) in COPD patients and relating the severity of disease and other factors with the degree of impairment of HRQOL.

Methods:

This cross-sectional study was conducted on 100 individuals with established COPD aged 45 yr or above. COPD severity was graded based on the Global Initiative for Obstructive Lung Disease (GOLD) staging system. Pulmonary function test was carried out as per the American Thoracic Society and European Respiratory Society task force standardised lung function testing guidelines. The quality of life was measured using the COPD-specific version of the St. George's Respiratory Questionnaire (SGRQ). The three component scores (activity, impact and symptoms) and the total score were compared across the various categories of age, gender and COPD grades. Using multivariable linear regression analysis, the relationship between COPD grades and various component scores, adjusting for age and gender, was determined.

Results:

The mean total SGRQ Classification score was found to be 48.5±17.1. There was a significant increase in the symptom, activity and impact component scores and the total scores of the participants with worsening of COPD grade. The activity, impact component scores and total score showed an increasing trend with age. However, the values of these three scores were lower in participants in the age group of 56-65 yr in comparison to those in the 45-55 yr age group. There was a significant increase in the symptom component score with increasing age across the study population. The difference in the various scores between males and females was not significant.

Interpretation & conclusions:

HRQOL is impaired in patients with COPD, and it deteriorates with increasing severity of the disease. The onset of COPD at a younger age has a much more significant deterioration of HRQOL, due to the early onset of symptoms and complications. These findings call for better early care and integration of pulmonary rehabilitation programmes into current health policies.
Cardiovascular manifestations of COVID-19
Authors: Sharma Yash Paul , Agstam Sourabh , Yadav Ashutosh , Gupta Anunay , Gupta Ankur
Published: December 2021

The recent outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization on March 11, 2020. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, primarily involves the respiratory system with viral pneumonia as a predominant manifestation. In addition, SARS-CoV-2 has various cardiovascular manifestations which increase morbidity and mortality in COVID-19. Patients with underlying cardiovascular diseases and conventional cardiovascular risk factors are predisposed for COVID-19 with worse prognosis. The possible mechanisms of cardiovascular injury are endothelial dysfunction, diffuse microangiopathy with thrombosis and increased angiotensin II levels. Hyperinflammation in the myocardium can result in acute coronary syndrome, myocarditis, heart failure, cardiac arrhythmias and sudden death. The high level of cardiac troponins and natriuretic peptides in the early course of COVID-19 reflects an acute myocardial injury. The complex association between COVID-19 and cardiovascular manifestations requires an in-depth understanding for appropriate management of these patients. Till the time a specific antiviral drug is available for COVID-19, treatment remains symptomatic. This review provides information on the cardiovascular risk factors and cardiovascular manifestations of COVID-19.
Phylogenetic classification of the whole-genome sequences of SARS-CoV-2 from India & evolutionary trends
Authors: Potdar Varsha , Vipat Veena , Ramdasi Ashwini , Jadhav Santosh , Pawar-Patil Jayashri , Walimbe Atul , Patil Sucheta S. , Choudhury Manohar L. , Shastri Jayanthi , Agrawal Sachee , Pawar Shailesh , Lole Kavita , Abraham Priya , Cherian Sarah
Published: December 2021

Background & objectives:

Several phylogenetic classification systems have been devised to trace the viral lineages of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, inconsistency in the nomenclature limits uniformity in its epidemiological understanding. This study provides an integration of existing classifications and describes evolutionary trends of the SARS-CoV-2 strains circulating in India.

Methods:

The whole genomes of 330 SARS-CoV-2 samples were sequenced using next-generation sequencing (NGS). Phylogenetic and sequence analysis of a total of 3014 Indian SARS-CoV-2 sequences from 20 different States/Union Territories (January to September 2020) from the Global Initiative on Sharing All Influenza Data (GISAID) database was performed to observe the clustering of Nextstrain and Phylogenetic Assignment of Named Global Outbreak LINeages (Pangolin) lineages with the GISAID clades. The identification of mutational sites under selection pressure was performed using Mixed Effects Model of Evolution and Single-Likelihood Ancestor Counting methods available in the Datamonkey server.

Results:

Temporal data of the Indian SARS-CoV-2 genomes revealed that except for Uttarakhand, West Bengal and Haryana that showed the circulation of GISAID clade O even after July 2020, the rest of the States showed a complete switch to GR/GH clades. Pangolin lineages B.1.1.8 and B.1.113 identified within GR and GH clades, respectively, were noted to be indigenous evolutions. Sites identified to be under positive selection pressure within these clades were found to occur majorly in the non-structural proteins coded by ORF1a and ORF1b.

Interpretation & conclusions:

This study interpreted the geographical and temporal dominance of SARS-CoV-2 strains in India over a period of nine months based on the GISAID classification. An integration of the GISAID, Nextstrain and Pangolin classifications is also provided. The emergence of new lineages B.1.1.8 and B.1.113 was indicative of host-specific evolution of the SARS-CoV-2 strains in India. The hotspot mutations such as those driven by positive selection need to be further characterized.
Modelling the spread of SARS-CoV-2 pandemic - Impact of lockdowns & interventions
Authors: Agrawal Manindra , Kanitkar Madhuri , Vidyasagar M.
Published: December 2021

Background & objectives:

To handle the current COVID-19 pandemic in India, multiple strategies have been applied and implemented to slow down the virus transmission. These included clinical management of active cases, rapid development of treatment strategies, vaccines computational modelling and statistical tools to name a few. This article presents a mathematical model for a time series prediction and analyzes the impact of the lockdown.

Methods:

Several existing mathematical models were not able to account for asymptomatic patients, with limited testing capability at onset and no data on serosurveillance. In this study, a new model was used which was developed on lines of susceptible-asymptomatic-infected-recovered (SAIR) to assess the impact of the lockdown and make predictions on its future course. Four parameters were used, namely β, γ, η and ε. β measures the likelihood of the susceptible person getting infected, and γ denotes recovery rate of patients. The ratio β/γ is denoted by R0 (basic reproduction number).

Results:

The disease spread was reduced due to initial lockdown. An increase in γ reflects healthcare and hospital services, medications and protocols put in place. In Delhi, the predictions from the model were corroborated with July and September serosurveys, which showed antibodies in 23.5 and 33 per cent population, respectively.

Interpretation & conclusions:

The SAIR model has helped understand the disease better. If the model is correct, we may have reached herd immunity with about 380 million people already infected. However, personal protective measures remain crucial. If there was no lockdown, the number of active infections would have peaked at close to 14.7 million, resulted in more than 2.6 million deaths, and the peak would have arrived by June 2020. The number of deaths with the current trends may be less than 0.2 million.