bluuebunny/crossref_metadata_2025 huggingface dataset:
Supply Chain Finance Assistance for Small and Medium-Sized Enterprises Using Cognitive Web Services
Authors: Ye Yingnan , Xiu Jinghui
Published: January 2023

When it comes to offering loans to small and medium-sized enterprises, the supply chain finance industries will produce cash flow and commodities (SMEs). The supply management is implemented with cognitive web service. Under the terms of information exchange, a credit risk assessment will be performed for supply chain finance with data analytics. In support vector machine technology, parameters are chosen using a genetic algorithm. To analyze the credit risk of support vector machines, a BP neural network was used to link the evolutionary algorithm with supply chain finance (GA-SVM-BPNN-SCF). Using a genetic algorithm and a support vector machine has overall classification accuracy equal to the BP neural network method. In addition, the role of the supply chain (SC) in mediating the link between SCF adoption, and the importance of supply chain effectiveness (SCE) is discussed. This research helps marketers and professionals better understand how to use SCF in their enterprises to reduce risk and improve SCF by providing data and connecting with financial institutions.
Early Prediction of Heart Diseases using Naive Bayes Classification Algorithm and Laplace Smoothing Technique
Authors: Narayan Subhashini , Sathiyamoorthy E.
Published: January 2023

Nowadays, medical diseases are one of the primary causes of death, and it is one the major concerns of developed countries. So, the disease identification process needs a lot of attention since if the diseases are idenfied at the early stage, the rate of death can be decreased. Machine learning techniques is one of the popular approaches that is used for identifying the diseases at the early stage. In this paper, two machine learning techniques, namely Naive Bayes classification algorithm and Laplace smoothing technique are used to predict the heart disease. Here, many medical details are used, such as gender, age, fasting blood sugar, blood pressure, cholesterol, etc. to predict the hearth disease of a patient. The proposed decision system supports avoiding unnecessary diagnosis test, which can be highly beneficial to start the treatment quickly. Thus, both time and money can be saved. Both the performance analysis and the experimental results show the efficiency of the proposed scheme over the existing schemes.
Evaluation of Agricultural Policies and Programmes for Sustainable Future Farming Intensification in Nigeria
Authors: Amuda Yusuff Jelili
Published: January 2023

Nigeria is enthusiastic with strong ambition and immense potential, which has been manifested in various agricultural frameworks and policies. Most of the agricultural frameworks and policies are meant by the government to attain food self-sufficiency and rapid economic development. Several studies have explored historical trends of government interventions and liberalization in the agricultural sector. However, the objective of the government has not been attained as a result of trajectory in efficient implementations of agricultural policies in the country. This paper therefore primarily aims at evaluating the agricultural policies and programmes for sustainability of future farming in Nigeria with specific focus on various determinants of sustainability of the agricultural sector, which will consequently bring food self-sufficiency, create employment, and bring about rapid economic growth in the country. The methodology used is qualitative content analysis of secondary data. The first part of the findings demonstrated that there is need to fill the gap in the existing agricultural frameworks and policies towards making future farming sustainable in the country. The second part of the result indicated that sustainability of agricultural sector for future farming intensification focused on the improvement of some major aspects such as viable implementation of agricultural policy, productive land for agricultural productivity, and government inputs to the farmers in reviving the agricultural sector. It is also noted that the interventions of the government through the building of shopping malls and establishment of national markets for marketability of various products such as groundnut, palm oil, rubber, cocoa, among others, can be instrumental in achieving sustainable future farming food domestic food production to attain food self-sufficiency and rapid economic development. In conclusion, the study showed that the implementation of agricultural policy is meaningful, and it can foster the sustainability of farming specifically in adequately utilizing unused land across the country. It is therefore suggested that the government needs to improve the input subsidies and to establish various national markets for selling different by-products and many others in order to achieve sustainability of the agricultural sector for future farming in the country.
Collaborative Social Metric Learning in Trust Network for Recommender Systems
Authors: Kim Taehan , Chung Wonzoo
Published: January 2023

In this study, a novel top-K ranking recommendation method called collaborative social metric learning (CSML) is proposed, which implements a trust network that provides both user-item and user-user interactions in simple structure. Most existing recommender systems adopting trust networks focus on item ratings, but this does not always guarantee optimal top-K ranking prediction. Conventional direct ranking systems in trust networks are based on sub-optimal correlation approaches that do not consider item-item relations. The proposed CSML algorithm utilizes the metric learning method to directly predict the top-K items in a trust network. A new triplet loss is further proposed, called socio-centric loss, which represents user-user interactions to fully exploit the information contained in a trust network, as an addition to the two commonly used triplet losses in metric learning for recommender systems, which consider user-item and item-item relations. Experimental results demonstrate that the proposed CSML outperformed existing recommender systems for real-world trust network data.
A brief review of the classic methods of experimental statistics
Authors: Carvalho André Mundstock Xavier de , Mendes Fabrícia Queiroz , Borges Pedro Henrique de Castro , Kramer Matthew
Published: January 2023

Experimental statistics are a key element for innovation in the agricultural sector. Commonly used statistical methods in experimentation are relatively simple, reliable, and widely used. However, the many problems in the quality of statistical analyses reported in the agricultural science literature highlight a need for continuing discussion on and updating of this topic. This article reviews critical points about classic linear models procedures commonly used in agricultural statistics, frequent procedures in publications in the agricultural sciences. Due to the evolution of statistical science some common recommendations from the past should no longer be followed.
Low-cost system for multispectral image acquisition and its applicability to analysis of the physiological potential of soybean seeds
Authors: Soares Júlia Martins , Medeiros André Dantas de , Pinheiro Daniel Teixeira , Rosas Jorge Tadeu Fim , Silva Laércio Junio da , Machado Daniel Lucas Magalhães , Dias Denise Cunha Fernandes dos Santos
Published: January 2023

The use of multispectral images has great potential to assess seed quality and represents a significant technological advance in the search for fast and non-destructive analysis techniques. However, the devices currently available are expensive. Thus, this study aimed to propose a low-cost method for acquisition and processing of multispectral images of soybean seeds and to evaluate their potential for rapid determination of seed physiological potential. The study was conducted in three steps: implementation of the multispectral image acquisition system, development of an algorithm for automatic image processing, and evaluation of the relationship between the data obtained through image analysis and the results of standard tests used to evaluate seed physiological potential. A total of 43 variables were assessed, eight related to seed physiological potential (germination and vigor) and 35 obtained from the analysis of the multispectral images. Of the variables obtained from multispectral images, 21 were related to pixel values in the images in the different bands evaluated (green, red, and infrared) and 14 associated with seed morphometric characteristics. The proposed system is efficient in obtaining multispectral images and the algorithm developed was efficient to extract morphometric characteristics and pixel information from the images. The parameters obtained from the NIR spectrum region showed a good relationship with the physiological potential of soybean seeds.
Selectivity and efficacy of PROTOX inhibitors in cassava varieties cultivated in clayey and sandy soils
Authors: Costa Neumárcio Vilanova da , Takahashi Mário , Costa Andreia Cristina Peres Rodrigues da , Ferreira Silvio Douglas , Brustolin Dyogo Bortot , Vasconcelos Edmar Soares de
Published: January 2023

The selectivity and efficacy of protoporphyrinogen oxidase (PROTOX) inhibitor herbicides in cassava varieties depend on product formulation, dosage, and soil texture. The aim of this study was to assess the selectivity and efficacy of flumioxazin and sulfentrazone in the cassava variety ‘IPR B36’ and the clone ‘VN 117’. Two experiments were carried out: one in a clayey soil and one in a sandy soil. Both experiments were laid in a split-plot randomized block design with three replicates. The two cassava varieties were used as main plots, with subplots consisting in 10 treatments including, flumioxazin at 50, 75, 100, and 125 g ha-1; sulfentrazone at 250, 500, 750, and 1000 g ha-1; one weed-free control, and one unweeded control. Flumioxazin (≥75 g ha-1) and sulfentrazone (≥250 g ha-1) achieved mean weed control rates > 70 and 90% in both types of soil for up to 90 days after application. Flumioxazin exhibited fewer residual effects on the cassava varieties than sulfentrazone, particularly in clayey soil. Flumioxazin was selective to the different cassava varieties planted in both soil types, whereas sulfentrazone was more selective in clayey soil. PROTOX inhibitors were effective in controlling weed growth in cassava plots, and there were no varietal differences in herbicide selectivity; however, the use of sulfentrazone should be restricted to maximum spray rates of 250 g ha-1 in sandy soils.
The management of phosphate fertilization affects soil phosphorus and yield of autumn/winter crops
Authors: Macedo Júlia Rodrigues , Moreira Silvino Guimarães , Moraes Flávio Araújo de , Reis Junior Daniel de Souza , Peixoto Devison Souza , Silva Bruno Montoani , Silva Júnior Cézar Resende
Published: January 2023

In soils with adequate levels of fertility, it is possible to manage phosphate fertilization aiming at the grain production system, instead of each isolated crop. The objective was to evaluate the effects of the management of phosphate fertilization, place and time, on the soil and leaf P content, and crop yield in grain production systems. An experiment was conducted at the farm level in the municipality of Nazareno, state of Minas Gerais, Brazil, for four years on soil with adequate level of fertility. The treatments consisted of the management of phosphate fertilization by broadcast or furrow and dose for each crop or for the production system (spring/summer and autumn/winter crops), being: Control = without phosphate fertilization; Conventional = phosphate fertilization in the furrow in each crop; BTP = phosphate fertilization of the grain production system to broadcast; TPS = phosphate fertilization of the grain production system in the furrow of the spring/summer crop; TPW = phosphate fertilization of the grain production system in the furrow of the autumn/winter crop. Soil P content was evaluated in the third year of implantation, and the crops yield every season crop (maize, soybean, common bean and wheat). The P content in the leaves of maize and soybeans were evaluated in the spring/summer crops. The application of the total dose of phosphate fertilization for both crops in the sowing furrow of the spring/summer or autumn/winter crops (TPS and TPW) promoted operational advantages and increased soil P content in the 0-0.20 m layer, without reducing the yield of the spring/summer crops. Leaf P content was not affected. The Conventional management (phosphate fertilization in the furrow in each crop) provide greater yield of common beans and wheat during autumn/winter crops, which are more subject to water restriction due to less rainfall, even without increasing the soil P content.
Digital platform for experimental and technical support to the cultivation of cactus pear
Authors: Guimarães Bruno Vinícius Castro , Donato Sérgio Luiz Rodrigues , Aspiazú Ignacio , Azevedo Alcinei Mistico , Lima Fábio dos Santos , Macêdo Samuel Victor Medeiros de , Brito Cleiton Fernando Barbosa , Couto Hiago Fagundes
Published: January 2023

Among the forage species, especially in semiarid ecosystems, cactus pear is exceptional because of its high tolerance to adverse conditions and high productivity. Due to this alone, several studies have been conducted to identify the main technologies for this crop. Despite being consolidated and integrated, the cactus pear production system has limited accessibility, technical assistance, and availability of information for those dedicated to its production. This study aimed to present a digital platform, website, and applications to provide technical information on the cactus pear and demonstrate the efficiency of these applications through experimental data. On this digital platform, applications were made available for predicting the productivity of cactus pear using artificial neural networks (ANN) on a computer with routines in the R software and by simple linear regression (SLR) on smartphones on the Android system of the MIT App Inventor 2 platform. In addition, using the smartphone app, it is possible to obtain the cladode area through multiple linear regression (MLR). It is also possible to obtain the estimates of the experimental plot sizes by the maximum modified curvature, linear and quadratic methods with plateau response, relative information, comparison of variances, and convenient plot size. The platform provides technical information associated with the cactus pear crop from different sources (dissertations, theses, articles) and formats (video classes and teaching resources), offline for applications, and online with download for publications, dissertations, theses and articles, video classes, and several didactic resources. The biomathematical models integrated with the applications were highly precise in predicting the phenomena, in which the variation explained by the models in the prediction of responses for future observations had R² values of 0.95, 0.72, and 0.92, respectively, for productivity with computer-ANN and smartphone-SLR, and for the cladode area with a smartphone - MLR.
Tragacanth and xanthan gum natural polymers for formulation of clotrimazole mucoadhesive gel
Authors: Hesari Zahra , Emmamzadehhashemi Mohammad Sadegh Bakhshi , Aboutaleb Ehsan
Published: January 2023

Clotrimazole is an antifungal agent, widely used in vulvovaginal and oropharyngeal candidiasis. Currently available clotrimazole (especially vaginal) dosage forms, have some limitations, including: leakage, messiness and low residence time, which leads to poor patient compliance. Therefore, in this study, a clotrimazole mucoadhesive gel has been developed as a suitable strategy due to their high water content, increased local retention time, lubrication and patient compliance. Xanthan gum and tragacanth with different portions were utilized as natural mucoadhesive gel forming polymers. Gel formulations were subjected to physico-chemical evaluations including gel viscosity, FTIR spectroscopy, spreadability, scanning electron microscopy (SEM) images of hydrogel chains, and release kinetic. Results demonstrated that among 8 developed formulas, formulation F1 showed the appropriate properties including controlled drug release (63.13% in 6h) with higuchi release kinetic, higher mucoadhesion (77.71 dyne cm-1) and drug content (94.47%) and relatively low spreadability (3.5 cm) which is suitable for local drug delivery. FTIR spectroscopy revealed there is not incompatibility between clotrimazole and other excipients in formulations. Combination of natural polysaccharides can form a proper mucoadhesive gel matrix for delivery of synthetic or natural drugs.
Anatomical in vivo study of variations in zygomatic bone: pneumatization and foramina
Authors: Carvalho César Felipe de Gouvêa , Tolentino Elen de Souza , Herreira-Ferreira Matheus , Takeshita Wilton Mitsunari , Iwaki Lilian Cristina Vessoni , Chicarelli Mariliani
Published: January 2023

To determine the prevalence and characteristics of the zygomatic bone pneumatization (ZBP) and the presence and diameter of zygomaticofacial (ZFF), zygomaticoorbital (ZOF) and zygomaticotemporal (ZTF) foramina, correlating the findings with sex, age and facial skeletal pattern using cone beam CT (CBCT). 563 CBCT scans (1,126 ZB) were assessed and the type (uni/multilocular) and laterality of ZBP were determined, in addition to the presence and diameter of ZFF, ZOF and ZTF. Data was correlated with sex, age and facial pattern. 64 patients (11.37%) presented ZBP, with no differences among sex, age, facial patterns and types (p>0.05). Most pneumatizations were bilateral (68%; p<0.01). ZFF, ZOF and ZTF were detected in 926 (82.2%), 988 (87.7%) and 818 (72.6%) ZB, respectively. Differences were found for ZFF between age groups (p <0.005; >21-60 years). No differences were found for diameters (p >0.05). There is no relationship between sex, age and facial skeletal pattern with the presence of ZBP. The presence of ZFF was related to the age group. The knowledge about ZB anatomy and its variations is helpful for image interpretation as part of clinical and surgical treatment planning for this region.
Association between chronic pain, depression, somatization and temporomandibular disorders in a southern brazilian population
Authors: Silva Tatiana Bernardon , Salbego Rafaela Stocker , Ilha Rachel Seeger , Dutra Thais Fernanda Hahn , Tomazoni Fernanda , Chami Vitória de Oliveira , Nascimento Luiza Pereira do , Marquezan Mariana
Published: January 2023

Introduction: Temporomandibular disorder (TMD) is defined as a set of pathological clinical conditions involving the masticatory muscles, the temporomandibular joint, or both, and the associated structures. It is often associated with chronic headaches, cervical pain, otologic symptoms and may be accompanied by some degree of physical or psychological disability in patients. Objective: To investigate the association of chronic pain-related disability, depression, and somatization with temporomandibular disorders. Methods: It was a transversal study with 275 patients evaluated using the RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders). The variables of Axis I (myofascial pain, disc displacement and other joint conditions) and Axis II (chronic pain-related disability, depression and somatization) were crossed using Fischer’s Exact Test (p <0.05). Results: Statistically significant association was found among factors of chronic pain-related disability, depression and somatization with myofascial pain diagnosis (p =0.000, p =0.001, p =0.000, respectively), as well as joint conditions (arthralgia, osteoarthritis and osteoarthrosis) (p =0.000, p =0.008, p =0.003, respectively). Conclusion: There is a positive association between chronic pain, depression and somatization (Axis II variables) with and myofascial pain and other joint conditions (Axis I). Disc displacements were not associated to variables of Axis II.
The relationship between social media addiction levels and alexithymia in young people at home during pandemic process
Authors: Çelik Melike Yavaş , Karasu Fatma
Published: January 2023

This study was conducted to determine the relationship between social media addiction levels and alexithymia in young people who were at home during the pandemic process. The descriptive and cross-sectional study was conducted with 520 young people between 01.01.2021-15.01.2021. Data were collected using a personal information form, Social Media Addiction Scale and Toronto Alexithymia Scale. Kruskal-Wallis, Mann-Whitney U tests and correlation and regression analysis were used to evaluate the data. The total score average of the Social Media Addiction Scale of the youth was 94.65 ± 37.63 and the total score average of the Toronto Alexithymia Scale was 50.04 ± 12.14. It was determined that 44.6% of the Toronto Alexithymia Scale received 51 points. A positive and moderate correlation was found between Social Media Addiction Scale and Toronto Alexithymia Scale (r = 0.463, p = 0.001). Social media addiction was found to affect alexithymia by 21.3% according to the regression analysis. It has been determined that the social media addiction levels of the young people are medium and their alexithymia levels are high. It has been found that there is a significant relationship between social media addiction and alexithymia.
Annona muricata leaf extracts obtained with subcritical water and conventional methods: evaluation of antioxidant activities, total polyphenol and rutin contents
Authors: Santos Ronald Keverson da Silva , Silva Junior Reinaldo Alves da , Ferreira Magda Rhayanny Assunção , Soares Luiz Alberto Lira , Stragevitch Luiz , Danielski Leandro
Published: January 2023

Annona muricata (soursop) is a native American plant and is well known for its leafy canopy and its fruits, widely consumed in South America and Southeast Asia. The objective of this work was to obtain Annona muricata leaf extracts and to evaluate their antioxidant activities, which were obtained by four different extraction methods: Soxhlet, maceration, ultrasound, and pressurized hot (subcritical) water. In order to assess and compare the extracts bioactivities, total polyphenol contents of the extracts were evaluated by the Folin-Ciocalteu method and the antioxidant activities were determined by DPPH and ABTS methods. High performance liquid chromatography was used to identify and quantify rutin, a special flavonoid, which was found to be the most representative component, for all extracts obtained. Rutin is known for its benefits has a potential natural antioxidant. Among all extraction methods investigated, extracts obtained by the Soxhlet method using ethanol as solvent showed a higher total polyphenol content, 2.83% of gallic acid equivalent/g plant material, as well as higher antioxidant activity. A correlation between rutin content and antioxidant activity was found. Soxhlet extractions revealed samples with the highest rutin content of 0.130 ± 0.003 g g-1, what may explain the high antioxidant activity of the obtained A. muricata leaf extracts.
L’impostazione intersoggettiva nel lavoro psicoanalitico
Authors: Benetti Rosa Giuliana , Cavicchioli Giorgio , Scalvini Tiziana
Published: January 2023

Gli autori propongono una riflessione di natura teorica e tecnica sulle principali caratteristiche di una impostazione intersoggettiva del lavoro psicoanalitico. Dopo aver considerato alcuni tra i principali orientamenti teorici che sviluppano l’approccio relazionale in senso intersoggettivo, individuandone gli elementi fondamentali, considerano alcune conseguenze sul piano dell’azione terapeutica e quindi della tecnica nel lavoro clinico. Le metafore teoriche di ‘campo’, ‘terzo analitico intersoggettivo’, ‘co-costruzione intersoggettiva’ vengono considerate come referenti basilari degli sviluppi intersoggettivi nel lavoro psicoanalitico. Nell’ambito dell’orientamento intersoggettivo del lavoro psicoanalitico viene inoltre richiamata la teoria dei Quadri Relazionali e le nozioni ad essa connesse, quale quella di ‘convincimento emotivo’, nonché la sua valenza per una riflessione diagnostica coerente con una impostazione relazionale intersoggettiva. Alcuni elementi relativi a fronti di ricerca ancora aperti sui temi trattati concludono le argomentazioni del testo.
Pensieri su soggetto e relazione
Authors: Coin Romina
Published: January 2023

L’Autrice propone alcune riflessioni sulla declinazione teorica del rapporto tra soggetto e relazione, nel tentativo di tradurre le categorie della epistemologia della complessità nella prospettiva della Psicoanalisi della Relazione. La concezione relazionale di essere umano che ne deriva offre utili stimoli per ripensare alcuni presupposti fondamentali dell’agire clinico. A ispirare il lavoro è il contributo di Michele Minolli, che negli ultimi vent’anni si è sempre più concentrato sulla elaborazione di una teoria dell’essere umano e del suo processo di vita.
Study of the Severity of Depression and Quality of Life in Adults with HIV/Acquired Immunodeficiency Syndrome at Antiretroviral Therapy Center in western Maharashtra
Authors: Salunkhe Rajkiran A. , Khot Pawan V. , Ainapur Krutika , Patil Vishal Ganpati
Published: January 2023

Introduction:

The universal access to antiretroviral therapy (ART) has caused a significant reduction in morbidity and mortality in HIV-infected individuals. Depression is one of the most prevalent psychiatric diagnoses seen in HIV-positive individuals, which has a significant impact on health-care utilization, adherence to ART, and quality of life (QOL). Hence, this study was planned to study the depression severity and health-related QOL in HIV-positive individuals.

Aim:

The aim was to study the severity of depression and QOL in adults with HIV/acquired immunodeficiency syndrome (AIDS).

Methods:

This was a cross-sectional study conducted at the regional ART center of a tertiary care hospital where 90 adult patients with HIV/AIDS in the age group of 18–60 years fulfilling DSM V criteria for depression were interviewed. A semistructured questionnaire was applied to obtain sociodemographic data. Quick Inventory of Depressive Symptomatology and QOL Scale (WHO QOL-HIV BREF) were used to assess the severity of depression and QOL in patients.

Results:

Of 90 patients, 40% had severe depression and 60% had mild-to-moderate depression. The severity of depression had a significant correlation with duration of HIV illness, duration of depressive symptoms, and socioeconomic status. The low QOL mean score was observed in all domains of QOL questionnaire. There was a significant correlation between the severity of disease and QOL. No correlation was found between CD4 count and QOL or severity of depression.

Conclusions:

Early diagnosis and treatment of depression in HIV may help improve the QOL of patients. CD4 cell count alone may be inadequate criteria for the prediction of mental health status and QOL.
Social Media Fatigue during the Lockdown Phase of the COVID-19 Pandemic
Authors: Lodha Pragya , Thakkar Anoushka , Gupta Ankita , Appasani Raghu , Essien Emmanuel , Audu Alexander
Published: January 2023

Background:

The coronavirus pandemic has led to deleterious effects on health, physical, and mental. The pandemic, onset since the end of 2019, has negatively impacted individuals across all sociodemographic variables. The widespread pandemic pushed global governments to enforce sanitizing, masking, and maintaining physical distancing. This lockdown meant that everyone was restricted at home, pushing academic, and work activities to take virtual means. Furthermore, this implicated excessive screen use due to increased virtual means of working.

Methodology:

The present study investigates social media fatigue (SMF) and the psychological effect of the same among participants of India and Nigeria. The study deploys 299 participants (males and females) for the same.

Results:

The findings from the study indicate that though SMF exists, it is not a prominent effect seen, considering that social media use helped people emotionally connect to their loved ones.

Conclusion:

This study provides data on SMF in participants from India and Nigeria during the lockdown period of the pandemic, an area of research that has not been looked into much. The study builds a scope for further research to delve into the impact of SMF at a global level, studying it with more robust statistical methods.
Knowledge and Attitudes of Parents, Teachers, and Doctors Regarding Screen Overuse and its Addiction in Children, Adolescents, and Young Adults
Authors: Rao Shirish Ravichandra , Saraf Prashant Harish , Adarkar Shilpa Amit , Inamdar Gayatri Sachin , Mhatre Pauras Pritam , Gupta Vidushi Chandrabhan , Ambike Amey Abhijit , Dedhia Keval Tushar , Raul Shreeya Kuldeepsing
Published: January 2023

Background:

Media and technology have become an integral part of today's life. Internet addiction, video gaming, binge-watching, social media use, and hence the overall screen time is rising. There are physical, psychological, and social adverse consequences of screen overuse.

Objective:

The objective is to assess the knowledge and attitudes of the study participants and to present solutions for screen addiction.

Subjects and Methods:

A structured questionnaire was developed content validity ratio (CVR >0.65). It was sent via email to more than 500 participants and also on more than 70 WhatsApp groups. It was an online cross-sectional study where 800 participants were recruited using convenience and snowball sampling. Microsoft Excel 2019 and SPSS version 26 were used to obtain and analyze data. P value was determined by using the Chi-square test.

Results:

Knowledge of screen use guidelines and health concerns was highest in doctors followed by teachers and least in parents (P 0.001). 95% of doctors believed any kind of screen overuse should be classified as an addiction. For preventing screen addiction, the role of parents was voted to be most important (49% participants) and for overcoming screen addiction, the role of the person himself was voted to be most important (48% participants).

Conclusion:

The level of knowledge in our study population regarding screen use guidelines was moderate to low. The attitude of parents for tackling their child's screen use was found to be appropriate. The multi-stakeholder approach should be considered for tackling screen addiction.
Z score analysis
Authors: Chauhan Kriti , Bisht Bhumika , Kathuria Komal , Bisht Ritu , Hatwal Varun
Published: January 2023

Context:

Z score defines the shift of an observed value from the mean.

Aims:

By determining the direction of this shift and its absolute value for mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC), one can quickly screen the hemogram for any spurious results in RBC parameters and also predict the type of anemia. This is because MCH and MCHC are derived parameters (from Hb, RBC, MCV) and thereby reflect the true as well as false changes in an erythrogram.

Materials and Methods:

A total of 975 hemograms were studied retrospectively. Basic statistical formulae using mean and standard deviation were applied to calculate z scores for MCH and MCHC. Results obtained were compared with the standard method and validated by an independent cohort of 100 random samples run on a different machine.

Results and Statistical Analysis:

Z score was found to be statistically significant (p <.001) in diagnosing iron deficiency anemias, megaloblastic anemias, hemolytic anemias, regenerative anemias, anemia of chronic disease and spurious findings. Z score was not significant (p = 0.9) in predicting beta thalassemia trait. The sensitivity was low for the differentials of microcytic hypochromic anemias.

Conclusions:

Despite this, Z score can be of immense help to the clinicians and pathologists in making quick interpretation of the underlying red cell abnormalities. Also, it can be used as a quality assessment tool in hematology laboratories taking pre analytical and analytical factors into account.
Evaluation of tumor budding and its correlation with histomorphological prognostic markers in oral squamous cell carcinoma and its association with the epithelial-mesenchymal transition process
Authors: Yadav Kusum , Singh Tejasvita , Varma Kachnar , Bhargava Mudita , Misra Vatsala
Published: January 2023

Objective:

To evaluate the association of tumor budding (TB) with prognostic histomorphological parameters in oral squamous cell carcinoma (OSCC) and to investigate the correlation of TB intensity with epithelial to mesenchymal transition (EMT).

Material and Method:

A total of 200 cases diagnosed as OSCC were selected and their TB status was reviewed using Hematoxylin and eosin (H and E) and Immunohistochemistry (IHC). Correlation with histomorphological prognostic parameters was done. Also, IHC for Vimentin and E-cadherin was performed to look for EMT.

Results:

On H and E examination, TB was observed in 154/200 (77%). About 88/154 (57.14%) cases showed a high TB (>5 TB/10 hpf) which increased to 100/154 (64.9%) cases on IHC staining. The intensity of TB was significantly associated with tumor grade and depth of invasion. It was also significantly associated with reduced expression for E-Cadherin and upregulation of Vimentin establishing a pathogenetic correlation between the TB and EMT.

Conclusion:

Therefore, our results suggest that TB is associated with poor prognosis and histologically represents EMT in OSCC which further adds to the aggressiveness of the tumor.
A rare case of metastatic malignant phyllodes tumor with osteosarcomatous differentiation presenting with intestinal obstruction
Authors: Bhandari Neelam R. , Karegar Manjusha M. , Vaideeswar Pradeep
Published: January 2023

Phyllodes tumors (PTs) are uncommon biphasic breast neoplasms constituting 0.5 to 1.0% of all breast tumors. Malignant PTs form a very small proportion of these and may metastasize, especially to the lungs and bones. Aggression and metastatic potential are accentuated in tumors exhibiting heterologous differentiation. Metastases to the gastrointestinal tract (GIT) have seldom been reported and are often confined to a segment of the digestive tract. In the absence of relevant clinical history, such patients presenting with gastrointestinal symptoms can lead to diagnostic perplexities. We report a unique case of a malignant PT with extensive osteosarcomatous differentiation and widespread metastases to the GIT.
Role of neutrophil-to-lymphocyte, neutrophil-to-eosinophil and platelet-to-lymphocyte ratios in the diagnosis of bullous pemphigoid and Pemphigus disease
Authors: Rai Preethi
Published: January 2023

Context:

Bullous pemphigoid (BP) and “Pemphigus diseases” (PD) can have overlapping clinical manifestations and accurate distinction is crucial for appropriate management.

Aims:

The study aimed at analyzing the utility of simple hematological markers of systemic inflammation like neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-eosinophil ratio (NER), and platelet-to-lymphocyte ratio (PLR) in clinical decision making in the setting of clinical differentials of BP and PD in a particular case.

Methods:

This single-centre based retrospective observational analytical study included adult subjects newly diagnosed to have BP (n=66) or PD (n=53), confirmed with direct immune-fluorescence testing, over a period of six years. Blood counts performed using Coulter™ hematology analyser, at the time of their initial presentation, were retrieved from the hospital medical records, and the leucocyte ratios were calculated.

Statistical Analysis:

The data were compared between the two groups, using Mann–Whitney U test and chi-square test /Fisher's exact test. ROC curve analysis was performed to estimate cut-off values.

Results:

The BP group had a significantly higher NLR, total leukocyte counts (TLC), absolute eosinophil counts (AEC), and absolute lymphocyte counts (ALC), and lower NER values compared to the PD group (P < 0.05). Areas under ROC for NLR, NER, TLC, AEC, and ALC were between 0.5 and 0.7. NLR ≥ 7, AEC ≥ 2055/cumm, and TLC ≥ 15,000/cumm had a specificity of 90.6, 100, and 100% respectively for identifying BP patients out of the two groups, but with a low sensitivity of 22.7, 21, and 22.7%, respectively.

Conclusions:

NLR can be a valuable diagnostic adjunct in subtyping autoimmune bullous disorders, albeit in a small proportion of cases.
Lineage switch of acute myeloid leukemia to T-Cell acute lymphoblastic leukemia – A unique case report
Authors: Jamil Syeda Firdos , Sharma Upendra , Singh Chaitali , Bansal Shashi
Published: January 2023

“Lineage switch” is term described when leukemic cells on relapse exhibit a new phenotype, where losses of one lineage defining markers with simultaneous gain of another lineage defining markers occur. Relapse of acute leukemia is although a very common event, lineage switch occurs and reported very rarely in such cases. The pathogenesis involved in this phenomenon remains unclear; however plasticity of hematopoietic progenitor affected by intrinsic and extrinsic environmental cues can be a possible explanation. In most of the cases at the time of relapse conversion of B-acute lymphoblastic leukemia (ALL) to acute myeloid leukemia (AML) occurs. Here, we presented an unusual case of 10 year old boy with AML switched to T-ALL upon relapse, which is very rare and not well documented till date in literature. The diagnosis was further supported by morphologic, cytochemistry and flowcytometric immunophenotyping (FCM-IPT). Prognosis and survival of such cases remains poor even by the use of standard chemotherapy.
A case of TFE3 translocation renal cell carcinoma with rare morphological features and literature review
Authors: Xia Tian , Long Hanan , Liao Dawei , Wang Wenyuan , Xiao Xiuli
Published: January 2023

Context:

TFE3 translocation renal cell carcinoma (RCC) is a rare tumor that represents approximately 1% of RCC. It was classifed as a member of MiT family translocation RCCs by the World Health Organization in 2016. It is characterized by Xp11 translocation gene fusions involving TFE3. The diagnosis of TFE3 translocation RCC is based on immunohistochemical analysis and TFE3 break apart probes in FISH analysis, rather than histological characteristics and imaging examination.

Aims:

To determine the clinico-pathological, immuno-phenotypic, and cytogenetic characteristics of TFE3 translocation RCC.

Methods and Materials:

The clinical data of a 52-year-old-female patient with TFE3 translocation RCC exhibiting rare morphological characteristics was analyzed, and the tumor tissues were probed using histopathological staining, immunohistochemistry, and fluorescence in situ hybridization (FISH). In addition, the relevant literature was reviewed.

Results:

This case is a TFE3 translocation RCC with rare morphological features. It composed of two types of tumor cells. TFE3 and pax-8 were diffusely and strongly expressed in both tumor cells, and they were partially positive for CAIX, RCC, CK, EMA, CD10, Vim, Melan-A, and p504s. Only 2% of the cells were positive for the proliferation marker Ki-67, and the tumor was negative for CK7, CD117, Inhibin-α, HBM45, and p53. FISH showed a positive signal for TFE3 translocation.

Conclusions:

This case was a TFE3 translocation RCC with rare morphological features. Through this case report, we emphasize the importance of in situ detection of TFE3 gene translocation and protein in TFE3 translocation RCC.
Kocuria kristinae - An unusual opportunistic pathogen in head and neck malignancy
Authors: Chaubey Priyanka , Mohta Vandana , Mishra Manisha , Wagh Aniruddha , Sapre Satsheel
Published: January 2023

Introduction:

Kocuria kristinae is a commensal organism, sometimes considered as a lab contaminant, but its repeated isolation from clinical samples in immunocompromised patients should raise red flags.

Materials and Methods:

We confirmed the infection with re-isolation of the organism from the same site before starting treatment. For the identification of Kocuria kristinae we used IDGP cards on VITEK 2 compact system. Antibiotic susceptibility test was done manually following CLSI guidelines 2018 for Coagulase-negative staphylococci.

Results:

A total of 510 major head neck oncosurgeries were performed during the period of two years. Out of which 120 patients had skin and soft tissue infections. Out of these infected patients, 90 were culture positive and of these Kocuria kristinae were isolated in 12 patients. Resistance to penicillin and oxacillin is seen in all isolates.

Conclusion:

Kocuria kristinae should not be ignored as a commensal flora or lab contaminant in immunocompromised hosts. Its Increase in resistance pattern is a matter of concern. It is an ignored opportunistic pathogen whose detailed sensitivity test should be developed to treat patients timely and effectively.
SMARCB1 deficient sinonasal carcinoma
Authors: Anila KR , Ginju V , Vishnu VL , Kumar Rejnish , Jayasree K
Published: January 2023

SMARCB1 deficient sinonasal carcinomas are rare neoplasms, classified under sinonasal undifferentiated carcinomas by the fourth edition of the World Health Organization (WHO) classification of head and neck tumors. It is characterized immunohistochemically by loss of SMARCB1(INI1) expression. We are reporting the case of a 63-year-old man who was evaluated for nasal stuffiness of 3 months duration in another hospital where a radiological evaluation showed a polypoidal soft tissue lesion in the right maxillary sinus extending to the right nasal cavity and spheno-ethmoidal sinus. He underwent excision biopsy which was reported as non- keratinizing nasopharyngeal carcinoma. He was referred to our center with residual disease in spheno-ethmoidal recess for which radiotherapy was given. After completion of radiotherapy, the primary site had no residual disease, but while on follow-up he developed left sided neck nodes within 4 months of completion of treatment. Excision of the lesion was done and histopathological and immunohistochemical analysis revealed it to be metastasis from SMARCB1 deficient sinonasal carcinoma and not nasopharyngeal carcinoma as diagnosed from the other center. This case is being reported to highlight the diagnostic challenge associated with this rare entity.
Myeloid sarcoma presenting as nasopharyngeal mass
Authors: Diwan Himanshi , Pasricha Sunil , Jajodia Ankush , Gupta Gurudutt , Agarwal Mudit , Mehta Anurag
Published: January 2023

Myeloid sarcoma (MS) is considered as an extramedullary manifestation of acute myeloid leukemia (AML) with or without concurrent AML. It can present at any age and any site, however, nasopharynx being an extremely rare site of manifestation. MS may precede AML by weeks, months or years, thereby necessitating an early diagnosis and timely intervention and treatment. We report a case of MS in a young female who presented with nasal obstruction and epistaxis for 3 months. The present case also highlights the significance of judicious use of immunohistochemistry panel while dealing with a hematolymphoid neoplasm devoid of expression of B-cell or T cell specific markers in head and neck region.
Tuberculosis presenting as immune thrombocytopenia
Authors: Moka Deepak , Pappu Sai Subrahmanyam , Badavath Rajender , Rao M. Nageshwar
Published: January 2023

A 19-year-old male presented with chief complaints of generalised weakness and unintentional weight loss from 50 Kg to 45 Kg within a span of 1 month. He complained of fever for 15 days and had developed petechiae over bilateral upper limbs and bilateral subconjunctival haemorrhage. Laboratory investigations done elsewhere showed platelet count of 10,000/mm3. On further investigation, Widal test, dengue serology, and smear examination for malarial parasite, antinuclear antibodies, and viral markers were negative. Abdominal ultrasonography showed multiple conglomerative enlarged lymph nodes in peripancreatic, peripatetic and paracaval, with few of them showing necrosis and loss of hilum and minimal ascites. Bone marrow examination showed megakaryocytic hyperplasia features, suggestive of immune thrombocytopenic purpura (ITP). No improvement in the platelet count was noted with intravenous methylprednisolone. On examination, the patient had ecchymotic patches over bilateral upper limbs and bilateral subconjunctival haemorrhages. Bilateral supraclavicular lymph nodes were palpable, non-tender, mobile, measuring 3 cm × 3 cm in the right side and 2 cm × 2 cm in the left side and firm in consistency. Cervical lymph node biopsy showed caseous necrotising granulomatous inflammation. Contrast-enhanced computed tomography neck, chest and abdomen showed multiple enlarged conglomerated heterogeneous enhancing lymph nodes with central non-enhancing areas s/o necrosis noted in the neck, mediastinum and abdomen. Tuberculin skin test (Mantoux test) revealed induration of 20 mm. The patient was started on eltrombopag, and four doses of intravenous immunoglobulin were given without improvement. The patient was started on liver-friendly anti-tuberculosis treatment in view of deranged liver function tests with isoniazid, rifampicin, ethambutol and levofloxacin and later pyrazinamide was added. The platelet count increased after 1 month of ATT to 40,000, and after 2 months, the count was 100,000/mm3.
Interstitial lung disease with congenital erythrocytosis
Authors: Katyarmal D. T. , Haneesha M. , Bhargav K. M. , Chandrasekhar C. , Vijayalakshmi B. , Mounika N.
Published: January 2023

A 45-year-old male weaver, smoker, known case of interstitial lung disease with cor pulmonale on long-term oxygen therapy diagnosed 6 months ago who is on tapering doses of oral steroids presented to our tertiary care teaching hospital with complaints of worsened shortness of breath, cough with expectoration and fever for the past 4 days. The patient had headache, dizziness for the past 6 months. On examination, he was febrile with plethoric facies, conjunctival congestion and digital clubbing were noted. Tachycardia and tachypnoea were noted. Haemoglobin saturation on pulse oximetry was 75% while breathing on room air, 94% with 0.4 fraction of inspired oxygen. On respiratory system examination, bilateral infraaxillary crepts were present, jugular venous pressure was elevated. Remaining systemic examination was unremarkable. Investigations revealed elevated haemoglobin, elevated leucocyte count with neutrophilic leucocytosis, raised packed cell volume and red cell count. Platelet count 1.67 × 105/mm3, erythrocyte sedimentation rate 4 mm at the end of the first hour. Computed tomography (CT) of the chest (plain) showed inter and intralobular septal thickening with honeycombing in the bilateral lower lobes predominantly features suggestive of interstitial lung disease. Ultrasonography of the abdomen showed no hepatosplenomegaly. Two dimensional echocardiography was suggestive of corpulmonale. As patient had hyperviscosity symptoms due to polycythaemia and no improvement in haemoglobin with supplemental oxygen for the past 6 months, patient was further evaluated for alternate cause of polycythaemia. Serum erythropoietin (Epo) levels were normal. Arterial oxygen tension at which oxygen saturation was 50% (P50) was 28 mm Hg. Epo gene receptor mutation was positive suggestive of congenital erythrocytosis. Patient was advised long-term oxygen therapy and regular therapeutic phlebotomy to maintain haemoglobin levels and was discharged in a haemodynamically stable condition.