bluuebunny/crossref_metadata_2025 huggingface dataset:
Trophic ecology and niche overlap of two sympatric species of Rhamdia (Siluriformes, Heptapteridae) from northeast Oaxaca, Mexico
Authors: Julián-Caballero César Camilo , Martínez-Ramírez Emilio , Gómez-Ugalde Rosa María , Cruz-Arenas Eufemia
Published: June 2024

The trophic ecology of fishes in the genus Rhamdia remains poorly reported. Here, we aim to describe the diet composition and infer the trophic levels, niche breadth, and niche overlap between Rhamdia guatemalensis and Rhamdia laticauda in northeast Oaxaca, Mexico. Fishes were sampled using an electrofishing device between 2016 and 2017. We calculated the Quotient index and the diet composition was analyzed using the percentage of the Index of Relative Importance (%IRI) to analyze possible ontogenetic and sexual differences on feeding ecology. We then calculated the trophic niche breadth using the Levins´ standardized index (BA). Trophic levels (TLk) of each species were calculated using the trophic index and trophic niche overlap using Pianka´s index (Ojk). The results indicate that both species are carnivorous and tend to prey on aquatic insects, with R. guatemalensis feeding on nine different orders of animals and R. laticauda displaying a broader diet spectrum, encompassing 19 orders. Our data showed ontogeny and sex differences in the trophic ecology of R. guatemalensis. They were secondary consumers (TLk > 3) and showed a specialized diet (BA < 0.4). We found evidence of trophic niche partitioning between adults (Ojk = 0.40) and females (Ojk = 0.42). Our results highlight the fundamental role of this species in the area as a carnivorous/insectivorous, predatory fishes, secondary consumers, and biological control for Diptera, Ephemeroptera, and Megaloptera. Both species minimize the trophic overlap through food resource partitioning mediated by fish body size. Additionally, adults and females consume different prey, which allows the coexistence of closely related species. Our findings regarding trophic ecology could be crucial for devising conservation and management plans for these particular Rhamdia species.
First record of the seed beetle Bruchidius siliquastri (Coleoptera, Chrysomelidae, Bruchinae) from Greece
Authors: Gastouniotis Georgios , Boulas Athanasios , Gastouniotis Panagiotis
Published: June 2024

Bruchidius siliquastri Delobel, 2007, a chrysomelid species presumably of East Asian origin, is recorded for the first time in Greece. It is regarded as an invasive species in Europe that feeds on the seeds of Cercis siliquastrum L. (Fabaceae). The species distribution and ecology are briefly discussed. An additional record of Bruchidius terrenus (Sharp 1886) in Greece is also provided.
Ophiusa tirhaca (Lepidoptera, Erebidae) in the Romanian fauna
Authors: Pintilioaie Alexandru-Mihai , Székely Levente , Dincă Vlad
Published: June 2024

The palaeotropical-subtropical moth Ophiusa tirhaca (Cramer, 1777) (Lepidoptera: Erebidae) has been known in Romania based on a single (undated) specimen collected in Iași (north-eastern Romania), at least 55–60 years ago. As a consequence, this species has either been excluded or regarded as data deficient in various checklists of Romanian Lepidoptera. Here we present the first fully documented record of O. tirhaca from Romania. A single specimen was found in August 2022 on the Black Sea coast, east of Agigea town (Marine Dunes from Agigea nature reserve), caught by a mist net. Since this thermophilous species cannot become established in the climatic conditions of Romania, the specimen is most likely an immigrant, although it might also represent an accidental arrival due to the close proximity of Constanța harbour (virtually bordering the collection site). The occurrence of O. tirhaca in south-eastern Romania underlines the importance of the western Black Sea coast as a corridor for migratory or expansive species, adding to an increasing series of recent Lepidoptera reports such as Grammodes bifasciata (Petagna, 1787), Acontia candefacta (Hübner, 1831), Dysgonia rogenhoferi (Bohatsch, 1880), Thysanoplusia orichalcea (Fabricius, 1775), Utetheisa pulchella (Linnaeus, 1758).
Distributed optimization of nonlinear singularly perturbed multi-agent systems via a small-gain approach and sliding mode control
Authors: Li Qian , Jin Zhenghong , Qiao Linyan , Du Aichun , Liu Gang
Published: June 2024

This paper addressed the challenging problem of distributed optimization for nonlinear singular perturbation multi-agent systems. The main focus lies in steering the system outputs toward the optimal points of a globally objective function, which was formed by the combination of several local functions. To achieve this objective, the singular perturbation multi-agent system was initially decomposed into fast and slow subsystems. Compared to traditional methods, robustness in reference-tracking signals was ensured through the design of fast-slow sliding mode controllers. Additionally, our method ensured robustness against errors between reference signals and optimal values by employing a distributed optimizer to generate precise reference signals. Furthermore, the stability of the entire closed-loop system was rigorously guaranteed through the application of the small-gain theorem. To demonstrate the efficacy of the proposed approach, a numerical example was presented, providing empirical validation of its effectiveness in practical scenarios.
A new double inertial subgradient extragradient method for solving a non-monotone variational inequality problem in Hilbert space
Authors: Zhu Ziqi , Zheng Kaiye , Wang Shenghua
Published: June 2024

In this paper, we introduced a new double inertial subgradient extragradient method for solving a variational inequality problem in Hilbert space. In our method, the mapping needed not to satisfy any assumption of monotonicity and two different self-adaptive step sizes were used for avoiding the need of Lipschitz constant of the mapping. The strong convergence of the proposed method was proved under some new conditions. Finally, some numerical examples were presented to illustrate the convergence of our method and compare with some related methods in the literature.
Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients With Cancer
Authors: Tran Binh Thang , Nguyen Thanh Gia , Le Dinh Duong , Nguyen Minh Tu , Nguyen Nhan P. T. , Nguyen Minh Hanh , Ong The Due
Published: June 2024

Objectives: This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients.Methods: This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking.Results: The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT.Conclusions: FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.
Les hôtels parisiens du xv e siècle vus par Guillebert de Mets: un simple inventaire au service du prestige de la ville
Authors: Ribémont Bernard
Published: June 2024

Guillebert de Mets is a fascinating Flemish figure of the end of the Middle Ages: in the service of the dukes of Burgundy, he was a scribe, a collector, an amateur of arts, a diplomat and a reader of literature and treatises of his time, particularly those proceeding from the French first humanists, like Laurent de Premierfait. He staid in Paris, visiting the city and he was particularly interested in the rich hotels of princes and some rich people. After the presentation of Guillebert, this paper is devoted to analyse how he considers these buildings as a ‘bourgeois lige’ of the duke of Burgundy.
La quête d’Astarté dans les chroniques de voyages en Espagne de Jean Lorrain
Authors: Montiel Victoria Ferrety
Published: June 2024

In search of the timeless sacred, Jean Lorrain shows a true obsession with the various manifestations of mythology, as well as the controversial symbols it presents. Indeed, there are many works in which he gives an account of this incessant search to respond to the existential premises that define the world and the birth of Humanity. As a travel chronicler, touring the Mediterranean – this blue immensity – allows him to go towards the Other, define his mythological divinity and at the same time capture the immemorial quintessence that can be divined in him. Valencia, Barcelona, Venice and other cities of the Maghreb will be the beacons that direct him towards the goddess Astarte, torch of the city of Cádiz.
Esquisse d’une réception critique de l’œuvre d’Hervé Guibert en deux moments: 1990/2001
Authors: Genon Arnaud
Published: June 2024

Initially confidential, Hervé Guibert’s work was revealed to the general public with the publication of À l’ami qui ne m’a pas sauvé la vie in 1990. The confession of his illness and the indiscretions about Michel Foucault’s life made the writer a media phenomenon, and there were few literary pages in French and French-speaking weeklies and dailies that did not report on this novel. However, the treatment of the novel in the newspapers goes beyond the simple literary debate and is crossed by moral and ethical considerations. More than ten years later, in 2001, Le Mausolée des amants, the writer’s diary, appeared posthumously. This shorter media period, circumscribed to this single publication, really gives us a purely critical view, detached from the emotional impact of the author’s illness and imminent death. A more distant view, therefore, but also, perhaps, more accurate in that it focuses more on the work of an author than on the author of a work. It is these two periods of reception of Hervé Guibert’s work that the present article wishes to examine, in order to study the way in which critics seize upon subversive texts that destabilise the bourgeois order and the political correctness.
De l’usage du mythe à l’ère de la médiacratie. Le théâtre d’Axel Cornil
Authors: Watthee-Delmotte Myriam
Published: June 2024

What happens to Greco-Roman myths for a young author in the age of the mediacracy, when their learning is no longer primarily framed by the school, but relayed by various media? This question is addressed using the work of Axel Cornil, one of Belgium’s leading French-language playwrights, born in 1990. What is the particularity of the author’s relationship with myths as a citizen of the hyper-mediatised cultural world, reflecting the concerns, desires and difficulties of a generation marked by the rise of mediacracy? What hermeneutic approach does he apply to myths, and what implications does this have for the mythocritical tools to be deployed?
“Le Chat”, “Les soldats” e “Le peigne de Simone de Beauvoir”. Tre inediti di Violette Leduc
Authors: Doni Luana
Published: June 2024

The study aims to provide a reflection on the writing of one of the most controversial authors of the 20th century: Violette Leduc (1907-1972). This article includes the transcription of three unpublished texts from Violette Leduc’s autobiographical novel La Folie en tête (1972), conserved at the Manuscript Department of the Bibliothèque Nationale de France. Le Chat, Les soldats and Le peigne de Simone de Beauvoir are three emblematic examples of Leduc’s stylistic variety and her ability to weave intertextual relationships within her work, as in the case of Les soldats, or relating to other authors of her contemporaries, such as Colette and Nathalie Sarraute in the case of Le Chat and Le peigne de Simone de Beauvoir.
Tessitrici di seta in due romanzi oitanici duecenteschi: rifunzionalizzazione di un motivo cristianiano?
Authors: Prota Mariateresa
Published: June 2024

The episode of the Chastel de Pesme Aventure, in Chrétien de Troyes’s Le Chevalier au lion, is well known for the presence of a passage that is the subject of a debate among critics: three hundred women, underpaid and malnourished, are condemned to weave silk. Chrétien was the first to introduce the motif of forced weaving into the romance genre, but it has been accepted by a small number of epigonic romans: up to now, it has only been recognized in the Continuation Gauvain, the Merveilles de Rigomer and the Jaufre. However, while introducing changes, these three romances continue to insist on the coercive nature of the practice of weaving. The present essay aims to highlight the existence of two other romances which are linked to the episode of Pesme Aventure or which present a reference to silk weaving, that is to say Floriant et Florete and Reinbert. However these two, unlike the first three that judge the weaving work negatively, cast a positive light on it. For this reason, the study also aims to try to provide an explanation regarding the change in attitude towards weaving. We will see that it probably depends on the importance of textile production in the territories from which the two texts come.
Postnatal social support experiences in primiparous women in Korea: a hermeneutic phenomenological study
Authors: Lee Eunjoo , Hong Kyongsuk
Published: June 2024

Purpose: Social support is essential for postpartum well-being, but little is known about the postpnatal social support preferred by primiparous women. This study aimed to comprehensively understand and describe the meaning of postnatal social support experience in primiparous women.Methods: The participants were seven primiparous women who were within 1 year after childbirth, recruited through purposive and snowball sampling from an online parenting community. The data were collected through in-depth interviews from November 14 to 28, 2022. Participants were interviewed face-to-face or via phone or online platform, according to their choice. Colaizzi’s phenomenological qualitative research method was applied to analyze the meaning of the participants’ experience.Results: Five theme clusters and fourteen themes were identified from the data. The five theme clusters are as follows: (1) Shortcomings of the childbirth and postpartum care system I learned through my experience; (2) Government policies focusing on childbirth and child-rearing rather than postpartum recovery; (3) Driving force of postpartum recovery: Shared childbirth process; (4) Childcare on my own; and (5) Conflicted between being a stay-at-home mom and a working mom under inadequate maternity protection policies.Conclusion: Despite postpartum support from the government that was perceived as inadequate, first-time mothers regained confidence and motivation for parenting with the help of family, peers, and social networks. First-time mothers need support from professionals and reliable online communities for postpartum recovery and parenting.
Betulin protects against isoproterenol-induced myocardial injury by inhibiting NF-κB signaling and attenuating cardiac inflammation and oxidative stress in rats
Authors: Shah Hital , Gandhi Tejal
Published: June 2024

Objective:

To investigate the cardioprotective potential of betulin in isoproterenol (ISO)-induced myocardial injury in rats.

Methods:

Wistar rats were divided into five groups (n=10): normal, ISO, nebivolol 5 mg/kg, and betulin (20 & 40 mg/kg). Nebivolol and betulin were administered orally for 29 days. ISO (85 mg/kg) was administered subcutaneously on day 27 and day 28 to induce myocardial injury. On day 29, blood was collected for determination of cardiac markers, and hemodynamic parameters were investigated. The levels of oxidative stress markers and the gene expressions of apoptotic markers and inflammatory mediators were evaluated. Moreover, 2,3,5-triphenyltetrazolium chloride staining and histopathological analysis were also performed.

Results:

Betulin reduced the size of myocardial infarction, decreased elevated levels of cardiac enzymes, and maintained hemodynamic functions. It also inhibited ISO-induced upregulation of Bax, caspase-3, NF-κB, and 1L-6, enhanced endogenous antioxidant enzymes, and reduced lipid peroxidation. Additionally, pretreatment with betulin alleviated myocardial ischemic damage, as reflected by reduced myonecrosis, edema, and inflammatory changes.

Conclusions:

Betulin exhibits strong cardioprotective activity against ISO-induced myocardial injury by anti-inflammatory, anti-apoptotic, and antioxidant activities.
Wedelolactone from Eclipta prostrata (L) L. suppresses inflammation and improves insulin resistance
Authors: Cuong Trinh Tat , Thien Duong Duc , Yen Hoang Hai , Duc Nguyen Anh , Nam Trinh Quang , Khanh Do Viet
Published: June 2024

Objective:

To evaluate the effects of wedelolactone, a major flavonoid from Vietnamese Eclipta prostrata (L) L., on inflammation and insulin resistance.

Methods:

Wedelolactone was extracted from the leaves of Vietnamese Eclipta prostrata (L.) L. with methanol by Soxhlet. The effects of wedelolactone on lipopolysaccharide (LPS)-induced cytokine production, reactive oxygen species (ROS) generation, and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activities in Raw 264.7 cells were measured by enzyme-linked immunosorbent assay (ELISA), specific immunofluorescent dyes and luminometric analysis, respectively. In addition, its effects on glucose uptake and the protein expression of insulin receptor substrate 1 (IRS1) and glucose transporter 4 (GLUT4) were examined in 3T3-L1 cells by immunofluorescent dyes and Western blot.

Results:

Wedelolactone at 30 μg/mL significantly inhibited LPS-induced production of tumor necrosis factor-α, interleukin (IL)-6, and IL-8 (P<0.01) with no noticeable effects on IL-10 level. It also reduced ROS generation and NADPH oxidase activities in LPS-stimulated Raw 264.7 cells (P<0.01). Furthermore, wedelolactone showed anti-insulin resistance activity, as evidenced by improved glucose uptake and the upregulated expression of IRS1 and GLUT4 in 3T3-L1 cells (P<0.01).

Conclusions:

Wedelolactone exhibits anti-inflammation and anti-insulin resistance effects, which may be used for the treatment of diabetes and inflammation-associated diseases.
Boeravinone B ameliorates allergic nasal inflammation by modulating the GATA-3/T-bet signaling pathway in a mouse model of allergic rhinitis
Authors: Ye Ben , Wang Ji-Zhe
Published: June 2024

Objective:

To evaluate the anti-allergic effect of boeravinone B against ovalbumin-induced allergic rhinitis in mice and explore its possible mechanism.

Methods:

For the induction of allergic rhinitis, mice were intraperitoneally sensitized and intranasally challenged with ovalbumin, as well as orally received various concentrations of boeravinone B. Nasal mucosal inflammation, and the levels of nitric oxide, β-hexosaminidase, IFN-γ, LTC-4, myeloperoxidase, Nrf2, HO-1, GATA-3, ROR-γ, T-bet, antioxidant parameters, and allergen-specific cytokines were assessed.

Results:

Boeravinone B markedly reduced ovalbumin-induced increase in the number of episodes of nasal sneezing, rubbing, and discharge, as well as the levels of IgE, IgG1, and β-hexosaminidase (P<0.05). It also significantly reduced differential cell count, myeloperoxidase, oxide-nitrosative stress, and the levels of 1B-1β, IL-4, IL-5, IL-6, IL-13, IL-17, tumor necrosis factor-α, GATA-3, and ROR-γ while enhancing the level of T-bet.

Conclusions:

Boeravinone B is a potential therapeutic agent for allergic rhinitis by modulating various inflammatory mediators and immune responses.
Examining the Impact of Incorporating Silicon Dioxide Nanoparticles on the Surface Roughness, Surface Hardness, Tensile Strength, and Shear Bond Strength of Chairside Room Temperature Silicone-based Soft Denture Liners: An In-Vitro Study
Authors: Mahmood Wasmaa S. , Abdullah Zainab S. , Salah Zinah , Fatalla Abdalbseet A.
Published: June 2024

Introduction: This study aimed to assess the effect of the addition of 1%, 1.5%, and 2% by weight silicon dioxide nanoparticles on the surface roughness, surface hardness, tensile strength, and shear bond strength of chairside room temperature silicone-based soft denture liners. Methods: SiO2 nanoparticles (NPs) were added to the soft liner in different concentrations: 0% (control group), 1%, 1.5%, and 2% by weight; surface roughness was measured by profilometer, surface hardness, tensile strength, and shear strength were measured by Instron testing machine. Results: Statistically significant differences were found among study groups regarding surface roughness (p = 0.01), surface hardness (p < 0.0001), tensile bond strength (p = 0.002), and shear bond strength (p < 0.0001). Conclusion: The addition of 1.5% SiO2NPs demonstrated an enhancement in shear stress and tensile strength with a decrease in surface hardness and did not affect surface roughness.
Intentional saccadic eye movements in patients with vestibular migraine
Authors: Gu Pan , Feng Jing , Cai Lipeng , Fan Huimin , Wang Hailing , Geng Xiaokun , Ding Yuchuan
Published: June 2024

Objectives:

Patients with vestibular migraine (VM) show a significant decrease in gray matter cortical regions associated with pain and vestibular processing, as revealed by head functional magnetic resonance imaging. We predict that these changes can be reflected in intentional saccadic eye movements. This study aims to establish whether there are abnormalities in intentional saccadic eye movements in patients with VM.

Subjects and Methods:

This is a retrospective study involving two groups of patients, including 39 patients in the VM group and 38 patients in the control group. The VM group and control group matched for age and gender were collected from Beijing Luhe Hospital affiliated with Capital Medical University, between June 2021 and May 2022. All patients received antisaccade (AS) and memory-guided saccade (MGS) tasks.

Results:

Compared with the control group, there were no significant differences in VM group in latency and gain of ASs. However, there were significant differences in the AS error rate between the two groups (right side 44% in VM and 32% in the control group; P = 0.041, left side 41% in VM and 29% in the control group; P = 0.011), with higher error rates observed in the VM group compared to the control group. Compared with the control group, there were no significant differences in the accuracy and final eye position gain of MGSs. However, there were significant differences in the valid saccade accurate percentage of MGS between the two groups (right side 59% in VM and 81% in the control group; P = 0.009, left side 59% in VM and 90% in the control group; P = 0.012), with lower accurate percentages observed in patients with VM compared to the normal control group. Furthermore, the latency of MGS between the two groups differed significantly (right side 677 ms in VM and 491.5 ms in the control group; P = 0.024, left side 670 ms in VM and 555 ms in the control group; P = 0.024), with longer latencies observed in patients with VM compared to normal control group. The results showed that VM disease duration had a positive correlation with the AS error rate (right: P =0.043, r = 0.326; left: P =0.000, r = 0.535).

Conclusions:

We found abnormalities in the AS and MGS tasks in patients with VM. The duration of VM is positively correlated with the AS error rate. Our study discovered that in addition to headache, dizziness, and autonomic symptoms, VM patients also exhibit impaired intentional saccadic eye movements, which may be related to reduced gray matter volume involved in pain and vestibular processing and cognitive impairment in VM patients.
Military Injuries: Helocasting Accident
Authors: Katiyar Anand , Sibi Eranki , Kumar Anil , Solanki Nimit , Dabas Ajay K. , Bharathi Ramanathan Saranga
Published: June 2024

Background:

Accidental injuries sustained during helocasting remain unexamined.

Methods:

Conditions prevalent during a helocasting exercise performed at a still water body and the resulting casualties were analyzed.

Results:

Despatch from greater-than-ideal height (>7 m) and speed (>5 knots) causes a high-velocity impact of the body with water in a non-aerodynamic configuration, exposing maximal body area at penetration. The brunt is borne by the torso/back, specifically, the lungs, ribs, and posterior aspect of the spine. The injuries result from direct trauma, sudden deceleration, barotrauma, and hyperflexion. Computerized tomography (CT) is the imaging of choice in the assessment of these injuries. Prompt evacuation to an equipped center, whilst stabilizing the spine in the suspected, proves pivotal to the outcome.

Conclusions:

Adverse slamming dynamics cause accidental injuries in helocasting. Thorax and spine are predominantly traumatized, both directly and indirectly, and are assessed best using CT. Timely spine stabilization and evacuation prove vital. Accurate assessment of height/speed and adherence to their ideal limits, at despatch, may avert such injuries.
Respiratory Morbidity Among Seed-Processing Industry Workers: A Cross-Sectional Study in Rural West Bengal, 2022–2023
Authors: Dasgupta Akash , Sahu Monalisha , Paul Bobby , Bandyopadhyay Lina , Chaudhari Ankur , Dhara Abhijit
Published: June 2024

Background:

Seed processing workers are exposed to dust particles generated during the processing of seeds, which can have adverse effects on their respiratory health. Aim: to estimate the prevalence and patterns of respiratory morbidity among seed processing workers in Hooghly district, West Bengal, India, and to explore their use of respiratory personal protective equipment (PPE).

Methods:

A cross sectional observational study was conducted in 5 seed processing plants from December 2022 to February 2023. A sample size of 129 workers was selected using probability proportionate to population size to select seed processing plants and simple random sampling to select workers at selected plants. Data on sociodemographic characteristics, occupational profile, substance use patterns, respiratory PPE use, and respiratory symptoms were collected through structured interviews. Spirometry was performed with a hand held tabletop spirometer (RMS Helios 401) to assess respiratory function.

Results:

52.7% of participants reported at least one chronic respiratory symptom, while 17.1% had evident respiratory morbidity based on spirometry results, with most having restrictive patterns (10.1%). Multivariable regression analysis revealed that factors associated with respiratory morbidity included increasing work years of exposure [1.10 (1.02 1.18)], irregular use of respiratory PPE [4.36 (1.22 15.57)], and primary or below education level [6.09 (1.38 26.98)].

Conclusion:

The study highlights the high prevalence of respiratory symptoms and morbidity among seed processing workers. It emphasizes the importance of implementing effective respiratory protection measures and raising awareness about occupational lung diseases in this industry. Further research and interventions are needed to improve the respiratory health and well being of seed processing workers.
Study of Respiratory Symptoms and Pulmonary Function among Neem Oil Industry Workers
Authors: Subramaniam Shankar , Ganesan Abbas , Raju Naveenkumar , Rajavel Nithyaprakash , Chenniappan Maheswari , Surendra Mohanty Rakesh Mohanty , Angamuthu Sabarinathan , Sivakumar Karthick , Prakash Chander , Pramanik Alokesh , Basak Animesh Kumar
Published: June 2024

This study aims to investigate the pulmonary functions and respiratory symptoms of workers in the neem oil extraction industry in Tamil Nadu, India, who are exposed to neem oil dust and chemicalsin their occupational environment. Fifty male workers from the exposed group and 50 male workers from the non-exposed group to neem dust and chemicals were investigated for this study. A modified respiratory assessment questionnaire based on the American Thoracic Society (ATS) standard and portable hand-held spirometry were used to assess their respiratory symptoms and pulmonary function. Respiratory symptoms such as coughing, sneezing, wheezing, and, nasal irritation are found to be higher in the exposed groups than in the controlled groups. The pulmonary function of exposed workers had doubled respiratory problems than the controlled groups, which indicates the impacts of dust and chemicals generated during neem oil extraction on workers’ health. Forced expiratory volume in one second (FEV1)/forced vital capacity FVC)% was noted regarding the duration of exposure to neem oil dust (P < 0.001). Also, there was a high difference between the heavily exposed and the lightly exposed (P < 0.001). Hence, to mitigate these problems, the oil mill workers should be cautious and wear personal protection equipment during working hours, and it is recommended to have an exhaust ventilation system.
Perioperative Management of 6-way Simultaneous Paired Kidney Exchange Transplantation – An Observational Study
Authors: Danduri Suma Katyaeni , Mittal Saurabh , Shekhrajka Praveenkumar , Bhardwaj Medha , Goyal Vipin Kumar , Nimje Ganesh Ramaji
Published: June 2024

Objective:

The presence of donor-specific antigens (human leukocyte antigen [HLA] incompatibility) leads to positive T-cell or B-cell crossmatch. Kidney transplant after desensitization protocols not only poses a financial burden on the patients but also there is an increased rate of infections and graft rejection. Paired kidney exchange (PKE) is cost-effective and offers better postoperative graft outcome.

Methods:

We included six pairs of kidney transplant donors and recipients for 6-way simultaneous PKE transplantation. These patients were ABO incompatible or HLA incompatible or both.

Results:

All patients underwent transplant in a single day without any perioperative surgical and anesthesia complications except for the need of mechanical ventilation in one patient in the postoperative care unit. The graft function was excellent in all recipients.

Conclusion:

This is the first 6-way simultaneous kidney exchange transplantation in the northwestern region of India. The inclusion of multiple donors and recipients for a paired exchange kidney transplant, although challenging, increases the donor pool and decreases the waiting time and financial constraints.
Thrombotic Microangiopathy in Renal Transplant Recipients
Authors: Anand S. Murugesh , Mohanasundaram Subashri , Fernando M. Edwin
Published: June 2024

Background and Aim:

Thrombotic microangiopathy (TMA) is a disease of microvasculature, triggered by numerous immunological and nonimmunological factors. The aim of this study is to identify the incidence, etiology, and clinical characteristics of posttransplant TMA in renal allografts and its impact on graft outcome.

Patients and Methods:

In this retrospective study, the records of patients who underwent renal transplantation between January 2013 and December 2017 were reviewed, and those recipients who had allograft biopsy-proven TMA were analyzed. Based on the clinical characteristics and investigations, the recipients were divided into two groups: those with systemic features of TMA and those with allograft-limited TMA. The clinical course and graft outcome of both the groups were compared and analyzed.

Results:

The number of patients who underwent renal transplantation during the study period was 212. Out of them, 16 patients had biopsy-proven TMA. Five patients had TMA with systemic features and the remaining 11 patients had allograft-limited TMA. In this study, the incidence of TMA among postrenal transplant recipients was 7.5%. The most common cause for TMA was acute antibody-mediated rejection (ABMR), followed by TMA due to tacrolimus toxicity. In one patient, TMA was secondary to disseminated tuberculosis (TB). TB as a cause of TMA is rarely reported. One-year graft survival in patients with allograft-limited TMA was 72.7% when compared to 50% in patients with systemic TMA, but this difference was statistically insignificant (P = 0.2). The graft loss was high in patients with TMA secondary to ABMR in both the groups.

Conclusion:

One-year graft survival is better in patients with allograft-limited TMA. Diligent search for an etiology for TMA should be made in all patients with TMA, as the treatment differs between each category.
A Case of Posttransplant Recurrence of Focal Segmental Glomerulosclerosis with Donor-derived Immunoglobulin A Nephropathy and Banff IIA Acute Cell-mediated Rejection: A Therapeutic Challenge
Authors: Rajan Ramprasath , Kumar P. K. Senthil , Velu Kannan Bhaba , Viswanathan Ramasubramanian
Published: June 2024

Primary focal segmental glomerulosclerosis (FSGS) recurrence varies between 10% and 60% and is an important predictor of graft survival. Here, we report the case with a combination of recurrence of FSGS, acute cell-mediated rejection, and donor-derived immunoglobulin A (IgA) nephropathy which required treatment with plasmapheresis and antithymocyte globulin. This patient is an 18-year-old female whose native kidney disease was a biopsy-proven FSGS and underwent ABO compatible live-related renal transplant with her mother as a donor. No induction agents were given and the patient was put on triple immunosuppression with Calcineurin inhibitors (CNIs), Mycophenolate mofetil (MMF), and steroids. On postoperative Day 2, the patient developed nephrotic range proteinuria. A transplant kidney biopsy was done. Biopsy revealed acute cell-mediated rejection, Banff II A with i3, t3, ptc1, v1, and C4d negative. There was also an increase in mesangial cellularity with IgA 3+ and C3 1+ on immunofluorescence which is IgA nephropathy, likely donor derived. Electron microscopy revealed significant effacement of podocytes. CNI levels are adequate. Pulse methylprednisolone 5 doses given. The patient was given two sessions of plasmapheresis with albumin and a single dose of rabbit antithymocyte globulin (ATG) 1.5 mg/kg was given. Plasmapheresis was withheld in view of studies reporting the removal of ATG following plasmapheresis. There was a gradual worsening of renal function with peak serum creatinine of 9 mg/dL which required three sessions of hemodialysis. The second renal biopsy on Day 13 showed features of acute tubular injury with borderline changes suspicious of acute cell mediated rejection (ACMR)–i1, t1. Currently, the patient is on regular follow-up with normal renal function with urine polymerase chain reaction of 0.4. We report this case which presented with a puzzling combination of ACMR, possible recurrence of native disease, and likely donor-derived IgA nephropathy that provided us with challenges in management. Treatment protocols with optimal dosing strategies and assessing response to treatment in these situations are still unclear due to the lack of large randomized trials.
Multiple Renal Arteries in Live Donor Renal Transplantation and Impact on Graft Function and Outcome: A Retrospective Study
Authors: Modi Ankit , Sadasushi Nripesh , Gupta Manish , Gupta Hoti Lal , Sharma Ashish , Sadasukhi Trilok Chand , Giri Anant , Rizvi Jaun Zeb
Published: June 2024

Objective:

The objective of the study is to evaluate the outcomes of live-donor renal allografts with multiple and single renal arteries taking into consideration ischemia times, graft function, and other complications including vascular and urological.

Materials and Methods:

We conducted a retrospective study by analyzing a prospectively maintained database from January 2021 to December 2021 of all patients undergoing live-related renal allograft transplants at a tertiary care center in North India. A total of 239 live donor kidney transplants were performed during this period. Patients were divided into two groups – Group 1: Single artery single anastomosis and Group 2: Multiple arteries with two or more anastomoses. Duplex imaging of the graft was done at 6 months. Recipients were followed up for possible graft dysfunction, arterial insufficiency, and major urological complications.

Results:

Mean ischemia times in the two groups were 20.62 ± 1.05 and 30.45 ± 1.77 min, respectively. Failure to normalize creatinine (<1.2 mg/dl) within 72 h was seen in 6/183 and 3/56 (P > 0.05). Slow graft function was encountered in 6 cases in Group 1 and 3 cases in Group 2. Delayed graft function occurred in two patients in both groups. One-year graft survival among the groups was 5/183 and 2/56, respectively (P > 0.05). One patient from Group 1 developed transplant renal artery stenosis. Six patients from Group 1 developed ureteric complications.

Conclusion:

Donor grafts with multiple renal arteries may be accepted safely with careful surgical reconstruction and close surveillance posttransplant.
The Framework for Value Based Purchasing in Health Care
Authors: Lighter Donald E. , Campbell Adam , bin Hussain Ibrahim
Published: June 2024

Supporting the health needs of populations of people has become a complex and expensive endeavor. As health systems have evolved around the world, the cost of care has become increasingly unsustainable, leading to gaps in care, financial hardship, and worsening measures of clinical effectiveness. Many nations around the world have begun migrating to a system of “value-based care,” which relies heavily on the ability of health care providers to deliver data-driven, high quality care that meets budgetary guidelines. To be effective in this effort, providers must revamp their business models to accommodate measurements of quality and cost to ensure that services that are provided to populations of people are not only cost effective but also meet higher standards of quality and equity. This new model of value-based purchasing relies on approaches to care and measurement that exceed those in current practice. This paper discusses the key components of value-based purchasing, from the business model to measurement systems and the impact expected on provider economics. All sectors of the health care industry will be impacted by this new approach, creating an imperative for physicians and other health care leaders to understand the new model and align incentives to achieve high levels of performance. Implementation of the new system of care is proceeding rapidly in many countries, including the Kingdom of Saudi Arabia and the United States, and the adjustments needed to conform in this new era will continue to drive change and alter traditional practice patterns. The foundational elements of the new system comprise the subject of this report.
Association of Fibroblast Growth Factor-1 Promoter Polymorphism and its Serum Concentrations with Repeated Implantation Failure after In vitro Fertilisation: A Cross-sectional Study
Authors: Kharamani Afshin , Mashayekhi Farhad , Salehi Zivar
Published: June 2024

ABSTRACT

Background:

Fibroblast growth factors (FGFs) play a key role in embryo implantation and support endometrial trophoblastic interaction.

Aim:

The aim of the study was to evaluate the association between FGF-1 (rs34011) gene variety and its serum concentration with repeated implantation failure (RIF).

Setting and Design:

The design of the study was a cross-sectional study.

Materials and Methods:

Four hundred infertile women with a history of RIF and 400 healthy women undergoing the first in vitro fertilisation-embryo transfer attempt with successful delivery (controls) were enrolled in the study. Genomic DNA was extracted from peripheral blood leucocytes and genotyped by Tetra-Primer Amplification Refractory Mutation System-Polymerase Chain Reaction. Serum FGF-1 concentration was evaluated with enzyme-linked immunosorbent assay.

Statistical Analysis Used:

The ANOVA test was used to analyse the difference between the means of the groups.

Results:

In RIF group, the genotype frequencies of the GG, GA and AA were 59%, 33.5% and 7.5%, respectively, whereas in controls were 72.5%, 24% and 3.5%, respectively. The G and A allele frequencies in the RIF group were 75.75% and 24.25%, while in controls were 84.5% and 15.5%, respectively (P < 0.0001). We have also shown that serum FGF-1 concentration in RIF and control groups was 17 ± 3.55 and 23.62 ± 4.91 pg/mL, respectively (P = 0.008). We have also shown that AA genotype is significantly associated with decreased serum FGF-1 concentration in RIF (AA, GA and GG serum levels were 9.55 ± 2.65, 14 ± 3.35 and 22.55 ± 7.26 pg/mL, and in controls were 12.22 ± 2.27, 18.44 ± 5.98 and 26.66 ± 8.29 pg/mL, respectively).

Conclusion:

The current study suggests that a significant association between FGF-1 (rs34011) promoter polymorphism and its serum concentration with RIF. The study also suggests that AA genotype is linked to lower FGF-1 serum levels and may play a risk factor for RIF.
Effect of Incorporating Chitosan to Resin Modified Glass Ionomer Cement on Shear Bond Strength to Dentin (An In vitro Comparative Study)
Authors: Khudhair Aya Tahseen , Khalaf Muna Saleem
Published: June 2024

Abstract

Aim:

Resin-modified glass ionomer cement tends to shrink due to polymerization of the resin component. Additionally, they are more prone to syneresis and imbibition during the setting process. This in vitro study evaluates the impact of chitosan, a biopolymer that is, both biomaterial and biocompatible, on the strength of dentin bonding and compares it with ACTIVA Bio-ACTIVE Restorative. The present study was aimed to assess the impact of including chitosan into Fuji II on the shear bond strength between. the restoration material and tooth dentin, in contrast to Bioactiva in permanent teeth.

Materials and Methods:

A total of 30 premolar teeth were recently extracted. The study involved three distinct sample groups. Group 1 (10 teeth) is the negative control (Fuji II), Group 2 (10 teeth) is the positive control (ACTIVA Bio-ACTIVE Restorative), and Group 3 (10 teeth) is treated with a mixture of Chitosan and Fuji II (CH-Fuji II). Each tooth’s buccal and palatal cusps were eliminated to achieve a horizontal surface. Using a periodontal probe, 1.5 mm from the mesial pit to the mesial marginal ridge were removed. Restoration was implemented in all groups following manufacturer directions. Thermocycling the teeth by immersing them in a water bath with temperatures ranging from 5°C to 55°C (± 1–2°C) for 30 s (500 cycles). Each sample was attached to the universal testing machine’s jig at a cross-head speed of 1 mm/min. Shear force was used until breakage, and the bond’s adhesive strength was then calculated. Statistical analysis using ANOVA with Dunnett’s T3 post hoc test. Results were significant at P < 0.05.

Results:

Statistically significant difference was present between Chitosan and Fuji II and between Chitosan and Activa by reducing the shear bond strength.

Conclusions:

Addition of chitosan to Fuji II had a negative effect on the shear bond with a significant difference while Activa and Fuji II exhibited favorable shear bond strength.
Weight loss following lifestyle modification interventions among adults with overweight and obesity in low- and middle-income countries – A systematic review and meta-analysis protocol
Authors: Patel Namita , Menon Athira , Aiswariya J. S. , Loganathan Vignesh , Lakshminarayanan Subitha
Published: June 2024

Introduction:

Overweight and obesity have become complex public health issues affecting all age, gender, and socioeconomic groups. It is a significant risk factor for various noncommunicable diseases such as hypertension, liver and kidney disease, diabetes, cardiovascular diseases, and depression. Despite this, obesity screening, prevention, and treatment are insufficiently focused in the health systems in low- and middle-income countries. There is a need for targeted interventions that are more realistic, applicable to all population groups, and have the potential for higher success rates. With this idea in mind, the current review has focused on systematically gathering evidence on the effect of weight management interventions compared to the standard of care among adults with overweight and obesity from low- and middle-income countries.

Methodology:

We will systematically search four electronic databases – PubMed, Google Scholar, Embase, and the Cochrane Library from their inception until July 2023 for relevant studies. A combination of medical subject headings and free text terms will be used for carrying out literature searches. All the experimental studies randomized controlled trials or nonrandomized trials conducted in a clinic-, hospital-, or community-based setting will be included in our review. Studies conducted among adults aged 18 years and above with overweight or obesity with nonpharmacological weight management given as intervention and standard of care given as comparator will be looked for. The outcome measures include the standardized mean difference of weight, body mass index, waist or hip circumference, or odds ratio of obesity or overweight between the treatment groups. Meta-regression or subgroup analyses will be performed to explore the heterogeneity. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines will be used to report the review.

Study Design:

Systematic review and meta-analysis.

Ethics and Dissemination:

There are no ethical concerns about the conduct of this review. Evidence will be disseminated at relevant conferences and by submitting scientific articles to academic peer-reviewed journals.

Conclusion:

Findings from this systematic review will significantly contribute to enhancing knowledge about evidence of the effectiveness of various obesity management strategies. This evidence-based approach will guide informed decision-making processes and support the development of effective interventions or programs to address the obesity epidemic in low- and middle-income countries.

Prospero Registration:

CRD42022352118.