bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of Tensile Test Specimens for Fused Deposition Modeling
Authors: Schwicker Maurice , Nikolov Nikolay
Published: April 2022

Standard test specimens are usually used to determine the tensile strengths of plastics. Their shape assumes that the material is homogeneous and only normal stress occur inside their nominal length. Unlike injection molding, which is a common technology to produce plastic parts, the structure of additively manufactured parts is not homogeneous. In areas with variable geometry, an additional internal stress concentration occurs, which often leads to failure of the test specimens outside their nominal length, which in turn compromises the tensile test. The stress concentration increases with the nozzle diameter used. This requires improvement of the test specimens shape. In the present work a new form of the test specimens is proposed, in accordance with the peculiarities of the Fused Deposition Modeling (FDM) process. A series of test specimens have been produced, using a 1mm and 2mm nozzle as well as one wall, no walls and milled specimens with newly developed geometry. All specimens were tensile tested and the results were shown and compared. It has been found that the proposed new shape ensures failure within the parallel length for successful testing, provided infill strands are correctly positioned.
Influence of Cement on Concrete Mix Designs through Sustainability Indicators
Authors: Gil Lucero , Ruiz Sheyla , Rodríguez Jose , Vise Juan
Published: April 2022

Internationally, the most widely used concrete mix design methods are the American Concrete Institute, Department of Environment, Indian Standard, Fineness Modulus and Walker. These methods propose the dosage of materials from tables and graphs developed from multiple experiments and generalize the designs to achieve optimum strength, durability, and quality performance. However, sustainability does not contemplate the design, especially cement, which is responsible for CO2 emissions and the cost of concrete. The study analyzed the procedure and dosage of five methods for a 20 MPa strength concrete mix in the laboratory and applied them to beams and columns in a multi-family building using sustainability indicators. The results indicate that the IS method uses water efficiently, is more economical, and requires less cement, while the ACI method generates a positive environmental and social impact due to the efficient consumption of materials.
Preparation of GH3536 Spherical Powder for Addictive Manufacturing by Plasma Spheroidization
Authors: Li Yan , Song Mei Hui , Zhang Yu , Li Yan Chun , Zhang Xiao Chen
Published: April 2022

GH3536 superalloy powder was prepared by the plasma spheroidization. The powder characteristics and effects of the plasma power on the percento spheroidization were studied.The phase and morphological properties of the powder were characterized by scanning electron microscope (SEM),Malven M4 particle size and shape analyzer and Leco ON736 oxygen-nitrogen analyzer.The results show that GH3536 fine spherical powder has favorable dispersity, smooth surface and high spheroidizing rate of 99%.The particle size distribution of the powder is narrowed,and the apparent density and tap density are significantly increased,which can meet the requirements of addictive manufacturing.
ZnO Powder Nanostructures: Characterization and Ab Initio Study
Authors: Oudjertli Salah , Tahraoui Tarek , Kouhlane Yacine , Daoui Abdelkader , Ibrir Miloud
Published: April 2022

This work presents the structural and microstructural properties of zinc oxide (ZnO) powders, for that, we used X-ray diffraction (XRD), Optical microscope as characterization methods. Powder X-ray diffraction data confirm a hexagonal crystal structure formation with space group p63mc of ZnO. By Rietveld refinement, we have determined the microstructural parameters with the c axis of the preferential orientation, the ZnO replicas were clearly observed under an optical microscope. Band structure and density of states of the phase of crystal ZnO computed using Ab Initio methods, confirmed that pure ZnO is a direct band gap semiconductor in hexagonal wurtzite structure.
Die and Punch Wear Reduction in Stamping Process by Lean Six Sigma Approach
Authors: Karnsarng Piyathida , Chutima Parames , Suanpong Kwanrat
Published: April 2022

This research aimed to reduce die and punch wear and improved the quality of the production process with the application of the Lean Six Sigma methodology. Die and punch had limited capability in cutting material edges in the case study company. The root-cause analysis showed a correlation between the hard coating and the lubricant effect on wear reduction using the design of experiments and DMAIC based on the Six Sigma approach. The results indicated that a combination of AICrN-PVD coating and aloe vera oil provided the most outstanding results in terms of wear reduction. Moreover, it had the potential to minimize the cost of product defects or repairs significantly. These findings showed the effect of the Lean Six-Sigma approach at the die production process, which increased operational efficiency and consistency to enhance business performance and meet customer requirements.
Effect of Area Type Defect of the First Ring Groove on Damage Tolerance of Piston System during Service
Authors: Tang Jin Jun , Liang Cui , Xu Chen Guang
Published: April 2022

This paper mainly studies the position of the contact surface of the first ring groove of the piston under the condition of thermal mechanical coupling under the service conditions of the piston component of high-power diesel engine at the temperature of 350°C-420°C and the detonation pressure of the piston top of 28Mpa. For typical NDT defects such as surface crac0k, internal crack, shrinkage cavity and cold lap, the sensitivity of scale, morphology and position and their quantitative relationship. The crack defect on the upper joint surface of the piston ring causes the maximum stress in the range of 56.8 MPa-81.3 MPa. Among them, 8% of the circumference of a single defect will cause material damage and failure. Defects larger than this scale must be detected in eddy current NDT.
Adsorptive Capacity Study of Mesoporous Carbon-Doped TiO2 and its Application in Cu(II) Removal from Water
Authors: Wang Wu Kang , Yan Xiao Ying , Zhong Nai Fei , Yuan Rong Hui , Hu Guo Qian
Published: April 2022

Mesoporous carbon-doped TiO2 (MCT) was synthesized via a template-free method in combination with solvothermal treatments. The structure, particle size and composition of this adsorbent were measured using XRD, TEM and XPS. Also, the usability of isothermal models for Cu (II) onto mesostructured adsorbent was implicated in these cases. The adsorptive capacity of MCT for Cu (II) was assessed using ICP-MS technique. The maximal adsorptive capacity was 16.9 mg g-1, and the ion-exchange action of Cu (II) was found to be the predominant adsorption.
Zn-Doped Iron Oxide Thin Films Prepared by Spray Pyrolysis Technique and Characterized for Use as an Efficient Photocatalyst for Methyl Green Organic Dye
Authors: Moussa Zahra , Hadjeris Lazhar , Herissi Labidi , Attaf Nadhir , Moussa Nadjet
Published: April 2022

Ultrasonic Spray Pyrolysis (USP) technique was used to prepare undoped and (2, 4, 6 and 10 at. %) Zn-doped iron oxide (FexOy:Zn) thin films for use in photocatalytic applications. The effect of Zn ion substitution on structural, optical, and electrical properties was studied. The X-ray diffraction patterns showed that there are two different phases of iron oxide, a hematite phase (α‑Fe2O3) and a magnetite phase (Fe3O4) that crystallized in the prepared samples. The nominal fractions of α‑Fe2O3 and Fe3O4 phases changed from 74 % to 42 % for the hematite phase and from 26 % to 58 % for the magnetite phase and this confirmed that the Zn doping favored the growth of Fe3O4 phase. The crystallite size decreased from 15.43 nm to 8.99 nm, while the micro-strain changed from 0.0056 to 0.0215 and the dislocation density from 0.0099 nm‑2 to 0.0639 nm‑2. The unit cell parameters were also improved when the doping rate was changed. Optical measurements showed that the energy gap decreased from 2.26 eV to 2.16 eV, the film thickness changed from 569 nm to 479 nm while the refractive index increased from 2.99 to 3.51 and the Urbach energy from 544 meV to 558 meV. Electrical measurements performed by the two-point probe method showed that the electrical conductivity increased directly with increasing Zn concentration reaching 18.5 10‑15 (Ω.cm)‑1 with 10 at. % Zn concentration. The variation of the electrical conductivity curves versus the sample heating temperature as well as the activation energy showed a semiconductor behavior of the films. Zinc doped iron oxide thin films exhibit 51.85 % photocatalytic degradation efficiency for methyl green organic dye.
The Performance of Zn-Ni Alloy Coating Electrodeposited from Stabilized Bath
Authors: Anwar Shams , Khan Faisal , Zhang Ya Hui
Published: April 2022

A metallic part corrodes when it undergoes electrochemical reactions which cause the surface and structural deterioration of the metal. Through electroplating, metallic components can be protected from corrosion by coating them with Zn-Ni alloys. This study examined the electrodeposition of a Zn-Ni alloy film on a steel substrate from a chloride bath containing ethylene-diamine-tetraacetic acid (EDTA). A Pourbaix diagram using the OLI software was used to determine the stability of the Zn-Ni plating bath and the suppression of hydrogen evolution reaction (HER). Comparing the composition of Zn-Ni coating deposited in the EDTA bath with the pure Zn-Ni coating, the EDTA bath yielded higher deposition thickness and an average crystallite size reduction. The Zn-Ni coating deposited from the EDTA bath has a lower dissolution rate and better corrosion resistance properties than the non-EDTA bath. Polarization tests exhibited that the Zn-Ni alloy deposited from 0.119 mol/l EDTA bath at 20 mA/cm2 current density showed lower corrosion current (Icorr) and more positive corrosion potential (Ecorr). Atomic force microscopy (AFM) and Vickers microhardness testing were used to characterize the morphological properties, topographic structures, and microhardness of Zn-Ni coatings.
Concept of Elastocaloric Granular Material Made from SMA Wires in Bending
Authors: Jongchansitto Kunanon , Jongchansitto Pawarut , Preechawuttipong Itthichai , Balandraud Xavier
Published: April 2022

Shape memory alloys (SMAs) are promising materials for the creation of heating or cooling systems due to their elastocaloric character. The paper proposes a concept of elastocaloric “porous” SMA beam working in bending. The beam was made with superelastic nickel-titanium SMA wires of different diameters placed in a flexible tube. While water was flowing through the tube, bending was manually applied using 3D printed wavy profiles with portions of arcs with constant curvatures. Preliminary results showed an oscillation of the fluid temperature at the outlet of the flexible tube (containing the SMA wires) at the same frequency as the mechanical loading, validating therefore the concept of elastocaloric porous SMA beam operating in bending.
The abundance of mosquito larvae in relation to associated microbiota and physicochemical parameters of marshland habitats in Kelaniya in Gampaha district of Sri Lanka
Authors: Amarasinghe L. D. , Menike P. M. I. D.
Published: April 2022

The abundance of mosquito larvae in relation to associated microbiota and physicochemical parameters of water in marshes from selected habitats in Kelaniya divisional secretariat area, of the Gampaha district, Sri Lanka were studied. Culex gelidus was found to be the dominant mosquito species found in marshes followed by Culex whitmorei, Culex tritaeniorhynchus, Culex quinquefasciatus, Culex fuscocephala, and Anopheles peytoni. Fourteen species/taxa of microbiota were identified. There was a significant positive correlation between the abundance of Cx. gelidus larvae and level of organic pollution in marshes as measured by the five-day Biological Oxygen Demand. A positive correlation for the presence of Cx. fuscocephala and Cx. gelidus in the marshland was also observed. Nevertheless, abundance of Cx. gelidus was negatively correlated with Cx. quinquefasciatus and Cx. whitmorei. The presence of Culex gelidus and Cx. tritaeniorhynchus were positively correlated with Daphnia magna indicating their co-existence in the same habitat requirement. Culex gelidus was negatively affected by the epibiont, Vorticella microstoma, when the latter organisms were present in higher densities. In contrast, the presence of Cx. whitmorei was positively influenced by the Vorticella microstoma, Difflugia corona, nauplius larva, and Keratella valga. There was a negative correlation between Cx. whitmorei and Monostyla bulla (Rotifera; Monogononta) and between the abundance of Cx. fuscocephala and Lecane luna in the same marshland. This study concludes that mosquito larvae and some microbiota are interdependent in marshlands. The level of abundance of mosquito larvae and microbiota varied with the level of water pollution. Cx. gelidus larvae are biologically affected by Vorticella microstoma. Many microbiota species compete with mosquito larvae for the same food items.
Comparing Sleep in Shared and Individual Rooms During Training Camps in Elite Youth Soccer Players: A Short Report
Authors: Costa Júlio A. , Figueiredo Pedro , Lastella Michele , Nakamura Fábio Y. , Guilherme José , Brito João
Published: April 2022

Context

Athletes' sleep is the most important recovery strategy and has received growing attention. However, athletes may experience sleep disruptions due to numerous factors, such as training and competition workloads, travel, changes in sleep-wake schedules, and sleeping environments. They often spend nights in unfamiliar hotels, and sharing a bed, room, or both with another person might affect sleep duration and quality.

Objective

To analyze the effect of sleeping in shared (SRs) versus individual (IRs) rooms on objective and subjective sleep and on slow-wave-sleep–derived cardiac autonomic activity during an official training camp in elite youth soccer players. Training and match workloads were characterized.

Design

Observational case study.

Setting

Hotel accommodations.

Patients or Other Participants

Thirteen elite male youth soccer players.

Results

Players slept longer in IRs than in SRs (+1:28 [95% CI = 1:18, 1:42] hours:minutes; P < .001). Sleep efficiency was higher in IRs than in SRs (+12% [95% CI = 10%, 15%]; P < .001), whereas sleep latency was shorter in IRs than in SRs (−3 [95% CI = −15, −4] minutes; P < .001). Subjective sleep quality was lower in IRs than in SRs (−2 [−3 to −2] arbitrary units; P < .001). No differences were found for slow-wave-sleep–derived cardiac autonomic activity or for training or match workloads between training camps.

Conclusions

During soccer training camps, sleep may be affected by whether the athlete is in an SR versus an IR.
A Multiyear Assessment of the Effect of Sport Participation on the Health of Adolescent Athletes During the COVID-19 Pandemic
Authors: McGuine Timothy , Biese Kevin , Hetzel Scott , Schwarz Allison , Reardon Claudia , Bell David R. , Brooks Alison , Dickman James , Watson Andrew M.
Published: April 2022

Context

Sport cancellations early in the COVID-19 pandemic had a significant negative effect on the health of US adolescents. The effect of restarting sports during the pandemic has not been described.

Objective

To identify the effect of sport participation on the health of adolescents before and during the COVID-19 pandemic.

Design

Cross-sectional study.

Setting

Sample recruited via social media.

Patients or Other Participants

Wisconsin adolescent athletes.

Main Outcome Measure(s)

Participants provided information regarding their age, sex, and sport(s) involvement and completed the Patient Health Questionnaire-9 Item to assess depression symptoms, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to measure physical activity, and the Pediatric Quality of Life Inventory 4.0 to measure quality of life (QoL). Data were collected in spring 2021 (Spring21; n = 1906, age = 16.0 ± 1.2 years, females = 48.8%), when interscholastic sports had fully resumed, and were compared with similar cohorts of adolescent athletes at 2 time points: (1) spring 2020 (Spring20; n = 3243, age = 16.2 ± 1.2 years, females = 57.9%) when sports were cancelled and (2) 2016–2018 (PreCOVID-19) before the pandemic (n = 5231, age = 15.7 ± 1.1 years, females = 65.0%). Comparisons were conducted via analysis-of-variance models and ordinal regressions with age and sex as covariates.

Results

The prevalence of moderate to severe depression was lower in Spring21 than in Spring20 but higher than in PreCOVID-19 (PreCOVID-19 = 5.3%, Spring20 = 37.8%, Spring21 = 22.8%; P < .001). Physical activity scores (mean [95% CI]) were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 23.1 [22.7, 23.5], Spring20 = 13.5 [13.3, 13.7], Spring21 = 21.9 [21.6, 22.2]). Similarly, QoL scores were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 92.8 [92.5, 93.1], Spring20 = 80.7 [80.3, 81.1], Spring21 = 84.3 [83.8, 84.8]).

Conclusions

Although sports have restarted, clinicians should be aware that physical activity, mental health, and QoL are still significantly affected in adolescent athletes by the ongoing pandemic.
DEFB126 polymorphisms and association with idiopathic asthenozoospermia in China
Authors: He Jiao-Yu , Peng Jian-Ying , Li Qiu-Fu , Lin Xiao-Li , Cui Yan-Ru , Ma Shi-Yu , Fan Shi-Yun , Liu Yi-Ran , Song Zhi-Lin , Deng Jun-Hang , Wei Xia , Ding Xian-Ping
Published: April 2022

Idiopathic asthenozoospermia, a common factor in male infertility, is characterized by altered sperm motility function in fresh ejaculate. Although the β-defensin 126 (DEFB126) protein is associated with asthenozoospermia, DEFB126 gene polymorphisms have not been extensively studied. Therefore, the association between DEFB126 gene polymorphisms and asthenozoospermia requires further investigation. Screening was performed by semen analysis, karyotype analysis, and Y microdeletion detection, and 102 fertile men and 106 men with asthenozoospermia in Chengdu, China, were selected for DEFB126 gene sequence analyses. Seven nucleotide mutations and two nucleotide deletions in the DEFB126 gene were detected. rs11467417 (317–318 del/del), rs11467497 (163–166 wt/del), c.152T>C, and c.227A>G were significantly different between the control and asthenozoospermia groups, likely representing high-risk genetic factors for asthenozoospermia among males. DEFB126 expression was not observed in sperm with rs11467497 homozygous deletion and was unstable in sperm with rs11467417 homozygous deletion. The rs11467497 four-nucleotide deletion leads to truncation of DEFB126 at the carboxy-terminus, and the rs11467417 binucleotide deletion produces a non-stop messenger RNA (mRNA). The above deletions may be responsible for male hypofertility and infertility by reducing DEFB126 affinity to sperm surfaces. Based on in silico analysis, the amino acids 51M and 76K are located in the highly conserved domain; c.152T>C (M51T) and c.227A>G (K76R) are predicted to be damaging and capable of changing alternative splice, structural and posttranslational modification sites of the RNA, as well as the secondary structure, structural stability, and hydrophobicity of the protein, suggesting that these mutations are associated with asthenozoospermia.
A comprehensive evaluation of sexual and reproductive outcomes following robot-assisted retroperitoneal lymph node dissection for nonseminomatous germ cell tumor
Authors: Mistretta Francesco A , Cobelli Ottavio de , Verze Paolo , Botticelli Francesco , Jannello Letizia , Luzzago Stefano , Cozzi Gabriele , Bianchi Roberto , Trapani Ettore Di , Ferro Matteo , Cordima Giovanni , Bottero Danilo , Matei Deliu Victor , Mirone Vincenzo , Musi Gennaro
Published: April 2022

Sexual disorders following retroperitoneal pelvic lymph node dissection (RPLND) for testis tumor can affect the quality of life of patients. The aim of the current study was to investigate several different andrological outcomes, which may be influenced by robot-assisted (RA) RPLND. From January 2012 to March 2020, 32 patients underwent RA-RPLND for stage I nonseminomatous testis cancer or postchemotherapy (PC) residual mass. Modified unilateral RPLND nerve-sparing template was always used. Major variables of interest were erectile dysfunction (ED), premature ejaculation (PE), dry ejaculation (DE), or orgasm alteration. Finally, fertility as well as the fecundation process (sexual intercourse or medically assisted procreation [MAP]) was investigated. Ten patients (31.3%) presented an andrological disorder of any type after RA-RPLND. Hypospermia was present in 4 (12.5%) patients, DE (International Index of Erectile Function-5 [IIEF-5] <25) in 3 (9.4%) patients, and ED in 3 (9.4%) patients. No PE or orgasmic alterations were described. Similar median age at surgery, body mass index (BMI), number of nodes removed, scholar status, and preoperative risk factor rates were identified between groups. Of all these 10 patients, 6 (60.0%) were treated at the beginning of our robotic experience (2012–2016). Of all 32 patients, 5 (15.6%) attempted to have a child after RA-RPLND. All of these 5 patients have successfully fathered children, but 2 (40.0%) required a MAP. In conclusion, a nonnegligible number of andrological complications occurred after RA-RPLND, mainly represented by ejaculation disorders, but ED occurrence and overall sexual satisfaction deficit should be definitely considered. No negative impact on fertility was described after RA-RPLND.
Clinical features and microsurgical reconstruction of congenital unilateral absence of the vas deferens with obstructive azoospermia: a tertiary care center experience
Authors: Zhou Yi-Hong , Dong Jian-Jun , Zhi Er-Lei , Yao Chen-Cheng , Huang Yu-Hua , Tian Ru-Hui , Chen Hui-Xing , Dai Ying-Bo , Tang Yu-Xin , Liu Na-Chuan , Chen Hui-Rong , Zhao Fu-Jun , Li Zheng , Li Peng
Published: April 2022

Patients with congenital unilateral absence of the vas deferens (CUAVD) manifest diverse symptoms from normospermia to azoospermia. Treatment for CUAVD patients with obstructive azoospermia (OA) is complicated, and there is a lack of relevant reports. In this study, we describe the clinical features and evaluate the treatments and outcomes of CUAVD patients with OA. From December 2015 to December 2020, 33 patients were diagnosed as CUAVD with OA in Shanghai General Hospital (Shanghai, China). Patient information, ultrasound findings, semen analysis, hormone profiles, and treatment information were collected, and the clinical outcomes were evaluated. Of 33 patients, 29 patients were retrospectively analyzed. Vasoepididymostomy (VE) or cross VE was performed in 12 patients, the patency rate was 41.7% (5/12), and natural pregnancy was achieved in one of the patients. The other 17 patients underwent testicular sperm extraction as the distal vas deferens (contralateral side) was obstructed. These findings showed that VE or cross VE remains an alternative treatment for CUAVD patients with OA, even with a relatively low rate of patency and natural pregnancy.
Conviviality in Disrupted Socionatural Landscapes
Authors: Hsiao Elaine (Lan Yin)
Published: April 2022

Convivial conservation presents itself as a vision of radical cohabitation across the Whole Earth, requiring people at the fringes of protected areas or people everywhere to manage day-to-day coexistence and conflicts with non-human species. This article assesses human-wildlife conflict interventions—an electric fence, compensation for wildlife damages, and traditional ecological knowledge—in a disrupted socionatural landscape, Akagera National Park in Rwanda, from the perspective of a framework of ecological peace. Ecological peace is defined through Galtung's (1969) theory of negative peace (freedom from direct violence) and positive peace (freedom from physical, cultural, and structural violence) as applied to relations between human and non-human species. While barriers and compensation schemes may make sense from the perspective of the conservation community's interests in reducing the negative impacts of wildlife on people, or vice versa, and especially towards improving people's perceptions of wildlife and environmental conservation, these human-wildlife conflict interventions may offer only negative ecological peace. Convivial conservation requires human-wildlife conflict interventions to go beyond negative and liberal peace approaches towards positive ecological peace to transform human and non-human relations for radical cohabitation across the Whole Earth.
The Small British Cat Debate
Authors: Palmer Alexandra
Published: April 2022

This article examines why cat predation is not on the agenda for most UK-focused conservation NGOs. Drawing on interviews and an analysis of scientific literatures and social media, I show that there are genuine epistemic uncertainties about whether cat predation presents a widespread conservation problem in the UK. This means that characterising NGOs' position as science denialism is unjustified. However, I argue that NGOs may wish to avoid looking into the issue too closely, due to a belief that the matter is irresolvable: a view founded on assumptions about what the British public thinks, and what politicians think the public thinks. Finally, I show that while there is little fighting about cats between conservationists and cat advocates, cats are readily 'grafted' onto existing disagreements about gamekeeping and predator control. I conclude that the small British cat debate is unlikely to get any bigger in future, and that the case illustrates the importance of bringing together social science literatures on NGO politics, science and technology, and human-animal relationships when seeking to understand 'issue creation' by conservation NGOs. Furthermore, it highlights the need to attend to local cultures, practices, and ecologies rather than assuming that issues will translate across contexts.
Issues and Concerns in the Management of Progressive Allograft Dysfunction
Authors: Anandh Urmila , Deshpande Pradeep
Published: April 2022

Nephrologists taking care of dialysis patients are increasingly encountering patients returning to dialysis after a failed transplant. These patients have a different pathophysiology and their medical issues differ from transplant-naïve dialysis patients. Prolonged cumulative immunosuppression and long-term exposure to chronic kidney disease (CKD) pathology are major factors responsible for increased complications and mortality. Often, their CKD-related issues are managed suboptimally as the emphasis is mostly on endeavors related to protecting allograft function. Managing their immunosuppression and allograft-related symptomatology poses serious challenges. There is also a dilemma as to whether the failed allograft should be left in situ or not. Considerate and appropriate decisions are required when these kidney allograft failure patients are offered re-transplantation. This review aims to address the major issues faced by transplant nephrologists in managing patients with allograft failure.
Epidemiology, Risk Factors, and Major Outcomes in Post Kidney Transplant Infections at National Hospital Kandy
Authors: Nayanamali M. A. Ayesha , Athapaththu A. M. Muditha Piyumali , Basnayake B. M. Duminda Bandara , Gunarathne T. G. Nadeeka Shyamali , Wazil Abdul W. M. , Mahanama R. M. Buddhisha S. S. , Thangarajah U. E. W. D. R. Thangarajah , Nanayakkara Nishantha
Published: April 2022

Background:

Postkidney transplant (PKT) infections are associated with significant morbidity and mortality, especially in the early posttransplant period. The type of infection, associated risk factors, and predicted outcomes of the infections are essential for targeted appropriate management. Scientific published data, especially in local settings, are lacking. This study was conducted to assess the epidemiology, risk factors, and major outcomes of PKT infections requiring hospitalization.

Methods:

This was a prospective observational study, conducted at the Nephrology and Transplant Unit, National Hospital Kandy, Sri Lanka, for a period of 2 months from December 1, 2018, to January 30, 2019.

Results:

A total of 38 infectious episodes were recorded in 35 kidney recipients. The most common type of infection was urinary tract infection (UTI) noted in 36.6% (n = 14) of cases. The most frequent organisms isolated were coliform (7.9%, n = 3). Seven potential risk factors including age, gender, comorbidities, source of kidney, induction modality, enhancement therapy, and months after renal transplant were evaluated. Among those potential risk factors, age was significantly associated with gastrointestinal tract infections (P = 0.033). There was a significant association between the gender and the severity of infections (P = 0.047). Majority of patients discharged from the hospital following complete recovery. Three patients were offered intensive care, two developed acute renal failure requiring renal replacement therapy and one was expired.

Conclusion:

The most common type of infection in PKT patients is UTI. Patient's age is significantly associated with gastrointestinal infections. Large-scale studies warrant for adequately concluding risk factors, epidemiology, and outcomes.
Spontaneous renal allograft rupture due to acute rejection in early post-transplant period – A case report
Authors: Godara Suraj , Saraf Karan
Published: April 2022

Renal allograft rupture (RAR) is a rare but lethal complication of renal transplantation. This can be a threat to the graft and patient survival. Over the decades, allograft nephrectomy has been the standard treatment for renal allograft rupture. But now, recent evidences suggest that graft salvage treatment can be safely done in complicated cases also. We describe a case of 30-year-old male who received a living donor kidney transplant and had spontaneous graft rupture in early post transplant period due to acute rejection. Graft was successfully repaired surgically, along with medical management and now the graft is functioning well.
Clinical Outcome of ABO-Incompatible Kidney Transplant with Low Baseline Anti-A/B Antibody Titer without the Use of Plasma Exchange - A Retrospective Study
Authors: Jeloka Tarun Kumar , Dharaskar Anand , Singh Ravindra
Published: April 2022

Background:

The outcome of ABO-incompatible (ABOi) transplant (Tx) may be compromised because of the need for added immunosuppression. Many centers still use plasma exchange (PEX) even when anti-A/B titers are low. We compared the outcome of ABOi kidney Tx with low baseline anti-A/B titers without PEX to those with high titers managed with PEX and to ABO-compatible (ABOc) Tx.

Materials and Methods:

In this retrospective study, all adult kidney Tx done at our institute were eligible. Patients <18 years of age, deceased donor transplant recipients, and those with hepatitis B, C or HIV infections at the time of transplant were excluded from this analysis. Outcomes including biopsy-proven AR, estimated glomerular filtration rate (eGFR) (Modification of Diet in Renal Disease equation), infections, and patient and graft survival were determined in ABOi kidney Tx with low baseline anti-A/B antibody titers managed without PEX (Group A). These outcomes were compared to a contemporary cohort of those with high titers and use of PEX (Group B) and ABOc Tx (Group C). Continuous variables were compared by Student's t-test and categorical variables with Chi-square test. Patient and graft survival was calculated by Kaplan–Meier curve and compared between the groups by log-rank test.

Results:

Baseline characteristics reveal no difference in recipients and donor factors such as age, gender, and HLA match. Initial immunoglobulin G anti-A/B titers were higher in Group B as compared to Group A (P = 0.04), but final titers pretransplant were similar (P = 0.6). Biopsy-proven rejections were not different between Groups A and B or Groups A and C. Serum creatinine and eGFR at 1 month and at last follow-up were also similar in all the groups. Infections were seen in 22.2% of the patients in Group A, 44.4% in Group B, and 27.7% in Group C. Patient survival and death-censored graft survival were similar in all three groups.

Conclusion:

This retrospective study shows that patients with low baseline anti-ABO antibodies managed without PEX are safe and have similar outcomes such as patient and graft survival, rejections, infections, and renal function.
Outcomes of Supraflex Sirolimus Eluting Coronary Stents
Authors: Singh Vishal Virendra , Tahir Sheikh Mohammad , Sharma Sanjiv
Published: April 2022

Background:

The introduction of Sirolimus Eluting Coronary Stents (SES) was a major breakthrough in interventional cardiology. The large, randomized, clinical trials using SES have shown a remarkable reduction in angiographic restenosis and target vessel revascularization (TVR) compared with bare-metal stents as well as other drug-eluting stents (DESs). However, there is only limited data on the outcome of Indian patients treated by DES of Indian origin. The purpose of the study was to evaluate the outcomes of the supraflex sirolimus-eluting coronary stents for the treatment of coronary artery disease and to determine major adverse cardiovascular and cerebrovascular events (MACCE).

Materials and Methods:

This was a single-centre, observational, nonrandomized study that enrolled unselected real-world patients at a tertiary care center who had undergone implantation with supraflex sirolimus-eluting stents. The primary end-point of the study was MACCE, which is a conglomeration of cardiac death, target lesion revascularization (TLR), TVR, cerebrovascular accident (CVA), and heart failure at 1-year follow-up.

Results:

A total of 100 patients were intervened successfully with sirolimus-eluting stents. Out of total patients, diabetes and hypertension were observed in 38% and 35% of patients. According to ACC/AHA classification, there were 68% Type B lesions and 32% Type C lesions. At 1-year follow-up, MACE was found to be 11%, which is a composite of 4% TLR, 3% TVR, 1% CVA, and 5% heart failure. Diabetes (P = 0.02), hypertension (P = 0.01), kidney dysfunction (P = 0.002), and LV function (P = 0.01) strongly correlate with outcome (MACCE).

Conclusion:

There was an acceptable rate of adverse events after implantation of the supraflex sirolimus-eluting stents, although it was slightly higher compared to other studies. Diabetes, hypertension, kidney dysfunction, and LV function strongly correlate with outcome (MACCE).
Dental Decay and Salivary Flow in Patients Taking Systemic Isotretinoin
Authors: Alkanhal Norah A. , Aldaij Mohammed H. , Alkanhal Haya A. , Al-Haddab Mohammed , Alfaifi Fawziah
Published: April 2022

Background:

Isotretinoin causes dryness of the mucous membranes. Medications altering the salivary flow are a risk factor for dental caries.

Purpose:

To prospectively assess caries and salivary flow in patients taking systemic isotretinoin.

Methods:

Twenty-four patients treated with 0.5 mg/kg of isotretinoin every day for 8 months were studied. The control group was the same patients before start taking oral Isotretinoin. Salivary flow, buffer capacity, bacterial tests, and caries status based on the decay, missing, and filled teeth (DMFT) index were assessed.

Results:

At baseline, there was slight to moderate calculus on the teeth. DMFT index, stimulated saliva flow, and bacterial tests for Streptococcus mutans increased during isotretinoin treatment (P < 0.05). There was no significant difference (P > 0.05) in buffering capacity or Lactobacillus.

Conclusion:

Systemic isotretinoin increased the DMFT index and bacteria rate and decreased salivary flow that might lead to dental caries.
Epidemiology of Viral Skin Disease
Authors: Himed Sonia , Muddasani Suraj , Fleischer Alan B.
Published: April 2022

Background:

Viral cutaneous infections have impact globally due to several factors, including changing rates of atopic dermatitis (AD), vaccination rates, and access to trained dermatologists. Furthermore, advancements in treatments and access to vaccinations suggest an association between the wealth of countries and the burden of their disease.

Purpose:

The overall purpose of this study is to better understand the global impact of viral skin disease across differing demographics and time periods, as well as the burden in relation to national wealth.

Methods:

In this article, the prevalence, incidence, and years lived with disability (YLDs) were analyzed for viral cutaneous infections in 195 countries from 1990 to 2019, using the global burden of disease dataset. Furthermore, the disease burden was assessed as a function of gross-domestic product (GDP) and AD.

Results:

The prevalence of individuals affected by viral skin diseases is approximately 154 million globally. Young children (1–9 years old) were more likely to be affected. The age-standardized prevalence rates per 100,000 in the Americas and Asia decreased between 1990 and 2019 from 2819 to 2650 and from 2074 to 1906, respectively. This decrease was outside the 95% uncertainty interval. Increased GDP predicted increased prevalence and YLD (P < 0.0001). There was a relationship between 1 year lived with disability per capita of AD and an increase of 0.14 (0.07, 0.21) cases of viral skin diseases (P = 0.002).

Conclusion:

The increase in disease burden with increased GDP may be correlated to decreased access to dermatologists in developing countries. An increased burden with AD is likely due to skin barrier and immune regulatory dysfunction. The morbidity of skin diseases demonstrates the need for increased access to vaccination campaigns and dermatologic care across developing nations.
Prevalence of Microvascular Complications in Adolescents and Adults with Type 1 Diabetes
Authors: Saiyed Mahira , Saboo Banshi , Pancholi Maitry , Saraf Vishakh , Shah Meet
Published: April 2022

Objective:

The aim of this work was to study the prevalence of microvascular complications in type 1 diabetes among the young adolescents and adults of Ahmedabad, Gujarat.

Materials and Methods:

This descriptive study was carried out at the diabetes care center from August 1, 2020 to March 31, 2021 by setting the inclusion criteria of patients with type 1 diabetes who had a history of at least 5 years or more and all adolescents and young adults who visited the clinic and who were willingly prepared to undergo for fundoscopy. Patients recently detected with type 1 diabetes and patients with previous retinal examination report and other forms of diabetes were excluded from the study. A total of 530 patients visited the clinic during this screening period, of which 125 patients took part in the screening. Microvascular complications screening consisted of fundoscopy and urine examination for microalbuminuria.

Results:

Of 125, 10 patients (8%) had diabetic retinopathy and 27 patients (21.6%) showed the presence of albumin in urine. The overall prevalence of microvascular complications was 29.6%. There were five patients with a positive history of both microvascular complications. The mean duration of diabetes was 19.6 years and the mean average glucose levels were 8.5% and 8.8%, respectively.

Conclusion:

We conclude that despite the higher glycemic values the chances of development of complications are negligible during the initial course of type 1 diabetes. With an increase in the duration of diabetes, the prevalence of complications is observed more. Hence, in addition to constant high glycemic values, the course of the disease is also a major responsible factor.
Cognitive Decline in Diabetics
Authors: Tipnis Natasha , Rajadhyaksha Girish , Shah Meghav
Published: April 2022

Background:

The association between cognitive decline and diabetes mellitus has been evidenced throughout recent decades.

Objectives:

The objective of this study was to determine the prevalence of cognitive decline in diabetics and nondiabetics in association with age, gender, level of education, risk factors, and duration of diabetes mellitus in middle-aged and elderly patients.

Materials and Methods:

A prospective, case-control study was conducted at a tertiary-care center between May 2014 and December 2015. Patients with diabetes (n = 150) and normal patients (n = 150) were compared. Patients were divided into groups according to age, gender, education, and duration of diabetes mellitus. The Hindi mini-mental state examination (HMMSE) was used to detect cognitive decline.

Results:

In diabetics with HMMSE score <27, 24 (46.1%) were aged <60 years, whereas 28 (53.9%) were aged ≥60 years. In diabetics with HMMSE score ≥27, 52 (53.1%) were aged <60 years, whereas 46 (46.9%) were aged ≥60 years. This finding was not statistically significant. In nondiabetics with HMMSE score <27, 13 (34.2%) nondiabetics were aged <60 years, whereas 25 (65.8%) were aged ≥60 years. In nondiabetics with HMMSE score ≥27, 61 (54.4%) were aged <60 years, whereas 51 (45.6%) were aged ≥60 years. This finding was statistically significant.

Conclusion:

Our study findings revealed no statistically significant findings in diabetics. However, specific cognitive domains such as orientation to place, concentration, and drawing displayed statistical significance for cognitive decline.
Type 1 Diabetes Peer Support Groups
Authors: Salis Sheryl , Verma Seema , Kohli Harsh , Mohan Viswanathan
Published: April 2022

Type 1 diabetes (T1D) is emerging as a major healthcare challenge impacting a significant percentage of the population. Management of T1D remains a concern in India with the diversity in socio-economic backgrounds, poor literacy levels, and inadequate resources and facilities which impact timely diagnosis, treatment, and management of this condition. All over the world in general, and in India, many peer support groups have come into existence and are even blossoming. A peer support system instils a sense of security, allows for better care practices, and builds quality relationships and a sense of belonging which can help improve their glycemic control and self-confidence and help them live a good quality of life. There are more than 40 T1D peer support groups in India offering emotional and financial support, knowledge, clinic services, matrimonial support as well as guidance in specialized areas of need such as celiac disease, sports, etc. While there is a need to understand and evaluate the most effective way to deliver these programs to effectually meet the various needs of people with T1D, there is also a need to integrate the various T1D peer support programs in India as there are many good practices that one group can learn and emulate from the other. The aim of this review article is to share the experience of the authors and to review available literature on T1D peer support groups to understand the role and impact of peer support groups in improving health outcomes and quality of life in people with T1D.
Nutritional and Glycemic Properties of Brown and White Rice Flakes “Upma”
Authors: Shobana Shanmugam , Gopinath Viswanathan , Kavitha Vasudevan , Kalpana Natarajan , Vijayalakshmi Parthasarathy , Gayathri Rajagopal , Ramya Bai R Mookambika , Ganeshjeevan Raman , Malleshi Nagappa Gurusiddappa , Unnikrishnan Ranjit , Anjana Ranjit Mohan , Henry Christiani Jeyakumar , Krishnaswamy Kamala , Sudha Vasudevan , Mohan Viswanathan
Published: April 2022

Background and Objectives:

Beaten or flattened rice (flakes) is very popular in India for preparing the meal “upma.” Commonly marketed rice flakes are fiber depleted, starchy, and may be nutritionally poor. Hence, this study aimed at preparing brown rice flakes (BRF) for such “upma” preparation and compared the nutritional and glycemic properties of it with those of white rice flakes (WRF).

Materials and Methods:

Flakes were prepared from brown rice (BR, ADT-45 variety) by steaming and flattening using a roller flaker. The BRF and commercial WRF were analyzed for nutrient composition, and upma prepared from both the flakes was evaluated for glycemic index (GI) in normal healthy volunteers by using a validated protocol.

Results:

BRF contained significantly higher (6.2 g%) dietary fiber as compared with WRF (1.8 g%, P < 0.001). Stereo-zoom microscopic examination of BRF revealed retention of bran and germ. BRF was thicker, firmer, and had a lower surface area compared with WRF. BRF upma exhibited medium GI (63.3 ± 6.2), whereas WRF upma showed high GI (70.4 ± 5.6), though the GI values were not statistically significant.

Interpretation and Conclusions:

BRF upma, a medium GI category meal choice, could be considered a healthier option compared to high GI WRF upma considering the nutritional profile. The BRF described in the study is easy to cook and suitable enough to replace WRF. More trials are required to design and devise innovative protocols for the preparation of BRF with significantly lower glycemic properties.
Villous adenoma of the prostatic urethra
Authors: Ho SY , Rosli N , Lim LY
Published: April 2022

Primary villous adenoma originating from the urinary tract is an infrequent entity. We present a rare case of villous adenoma arising from a prostatic urethra with no sign of malignant transformation. Villous adenoma should be considered as one of the differential diagnoses of urethral lesions, especially if it has similar magnetic resonance imaging features as its colonic counterpart. Due to its potential for malignant transformation, its complete resection is mandatory.
Effectiveness of pune shoulder rehab protocol on patients with frozen shoulder
Authors: Saini Seema , Bhagat Gargee , Palekar Tushar J
Published: April 2022

Context:

Frozen shoulder is a common condition which is seen in 2%–5% of the general population. It is a self-limiting condition which affects the range of motion of the patients in a capsular pattern.

Aims:

Although Pune Shoulder Rehabilitation Programme (PSRP) is being used for treating this condition still no study has been documented to find its efficacy as compared to conventional physiotherapy methods.

Settings and Design:

This was a quasi-experimental study and the study was done at Smt. Kashibai Navale General Hospital and Physiotherapy Outpatient Department, Pune. Institutional ethical clearance was taken on 7/8/2018 ref no. SKNCOPT/IEC/16/2018 before the commencement of this study.

Subjects and Methods:

Based on the study's inclusion criteria, 32 subjects were selected. The PSRP exercises were taught to each subject and given 10 repetitions with a hold of 10 s. For at least 45 min, each patient was treated. Patient's shoulder range of motion and visual analog scale were taken at the pretreatment, 2nd week, 4th week, and 6th week, respectively.

Statistical Analysis Used:

The data were analyzed using Primer software with a level of significance P < 0.05. Repeated measure ANOVA was used to compare the outcome measures within the group.

Results:

The findings showed that over the 6th-week protocol, statistically significant improvements were found in pain and shoulder range of motion.

Conclusion:

PSRP exercise protocol is effective in increasing the range of motion and decreasing the pain in the shoulder caused by frozen shoulder.