bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of End-of-Life Strategies to Improve Health Outcomes and Reduce Disparities in Rural Appalachia: An Analytic Codebook
Authors: Svynarenko Radion , Huang Guoping , Profant Theresa L. , Lindley Lisa C.
Published: February 2023

Appalachia is one of the most medically underserved areas in the nation. The region has provider shortages and limited healthcare infrastructure. Children and adolescents in this area are in poor health and do not receive the needed quality care. Implementation of section 2302 of the 2010 Patient Protection and Affordable Care Act (ACA) enabled children enrolled in Medicaid/Children's Health Insurance Program with a terminal illness to use hospice care while continuing treatment for their terminal illness. In addition to being more comprehensive than standard hospice care, this relatively new type of care is more culturally congruent with the end-of-life values of rural Appalachian families, who often view standard hospice as hastening death. The overall goal of this project was to investigate access to pediatric concurrent hospice care in Appalachia. Our central hypothesis was that concurrent care reduces rural/urban disparities in access to hospice care. Data from the Centers for Medicare and Medicaid Services (CMS) used in this project was used and included 1,788 children who resided in the Appalachian region– from January 1, 2011, to December 31, 2013. Observations with missing birth dates, death dates, and participants older than 21 years were removed from the final sample. Geographic Information Systems (GIS) databases were created to map the boundaries of the Appalachian region, hospice locations, and driving times to them.
Plasma screening effect on electron-electron interactions
Authors: Li Xiang-Fu , Zhu Xiao-Lu , Jiang Gang ,   Department of Physics, Longdong University, Qingyang 745000, China,   Institute of Atomic and Molecular Physics, Sichuan University, Chengdu 610065, China
Published: February 2023

In the calculation of atomic structures within the plasma environment, the plasma screening effect on nuclei - electron interactions is generally considered, but the plasma screening effect on electron - electron interactions is less considered. In this work, the MCDHF method combined with the screening potential is used to study plasma screening effect on the atomic structure parameters versus the electron density, electron temperature, nuclear charge and the number of bound electrons. For the ground states and the first excited states of helium-like ions, the energy shifts, transition energy shifts and transition probability shifts caused by the plasma screening effect on electron-electron interactions increase with the increase of electron densities and decrease with increasing the electron temperatures, respectively. With the increase of nuclear charge, the energy shifts increase gradually and tends to a stable value, while the transition energy shifts and transition probability shifts decrease gradually and tend to 0. The energy shifts increase with the increase of the number of bound electrons. The electron density, electron temperature, nuclear charge and number of bound electrons corresponding to the percentages of transition energy shifts and transition probability shifts caused by plasma screening on electron-electron interactions greater than or equal to 10%, are called as the critical electron density, critical electron temperature, critical nuclear charge and critical number of bound electrons, respectively. When one of the following four conditions is satisfied, the percentages of transition energy shifts and transition probability shifts caused by plasma screening on electron-electron interactions will be greater than or equal to 10%, and the plasma screening effect on electron - electron interactions can not be ignored. 1) The electron density is greater than or equal to the critical electron density, when the electron temperature is a fixed value. 2) The electron temperature is less than or equal to the critical electron temperature, when the electron density is a fixed value. 3) The nuclear charge is less than or equal to the critical nuclear charge, when the electron density and temperature are both fixed. 4) The number of bound electrons is greater than or equal to the critical number of bound electrons, when the electron density and temperature are both fixed.
Phase-field-method-studied mechanism of Cu-rich phase precipitation in AlxCuMnNiFe high-entropy alloy
Authors: Wang Kai-Le , Yang Wen-Kui , Shi Xin-Cheng , Hou Hua , Zhao Yu-Hong ,   School of Materials Science and Engineering, North University of China, Taiyuan 030051, China,   Beijing Advanced Innovation Center for Materials Genome Engineering, University of Science and Technology Beijing, Beijing 100083, China,   School of Materials Science and Engineering, Taiyuan University of Science and Technology, Taiyuan 030025, China
Published: February 2023

High-entropy alloys with BCC and FCC coexisting structures usually have excellent comprehensive mechanical properties, and Al element can promote the transformation of Cu-containing high-entropy alloys from FCC structure to BCC structure to obtain the BCC and FCC coexisting structures. In order to illustrate the process of phase separation of high entropy alloys, a low-cost Al-TM transition group element high-entropy alloy is selected in this work. Based on the Chan-Hilliard equation and Allen-Cahn equation, a three-dimensional phase field model of AlxCuMnNiFe high-entropy alloy is established, and the microscopic evolution of the nano-Cu-rich phase of AlxCuMnNiFe high-entropy alloy (x = 0.4, 0.5, 0.6, 0.7) at 823 K isothermal aging is simulated. The results show that the AlxCuMnNiFe high-entropy alloy generates two complex core-shell structures upon aging: Cu-rich core/B2s shell and B2c core/FeMn shell, and it is found through discussion and analysis that the formed B2c plays an inhibitory role in the formation of the nano-Cu-rich phase, and that this inhibitory role becomes larger with the increase of Al element. Combining the empirical formula, the curve of yield strength of the Cu-rich phase varying with the aging time is obtained for the AlxCuMnNiFe high-entropy alloy, and the overall yield strength of the high-entropy alloy has a rising-and-then-falling trend with the change of time, and the aging time of the peak yield strength and the alloy system are obtained from the change of the curve, so that the best alloy system and aging time of the high-entropy alloy can provide a reference for aging process.
Isolation of multiple electrocardiogram artifacts using independent vector analysis
Authors: Uddin Zahoor , Altaf Muhammad , Ahmad Ayaz , Qamar Aamir , Orakzai Farooq Alam
Published: February 2023

Electrocardiogram (ECG) signals are normally contaminated by various physiological and nonphysiological artifacts. Among these artifacts baseline wandering, electrode movement and muscle artifacts are particularly difficult to remove. Independent component analysis (ICA) is a well-known technique of blind source separation (BSS) and is extensively used in literature for ECG artifact elimination. In this article, the independent vector analysis (IVA) is used for artifact removal in the ECG data. This technique takes advantage of both the canonical correlation analysis (CCA) and the ICA due to the utilization of second-order and high order statistics for un-mixing of the recorded mixed data. The utilization of recorded signals along with their delayed versions makes the IVA-based technique more practical. The proposed technique is evaluated on real and simulated ECG signals and it shows that the proposed technique outperforms the CCA and ICA because it removes the artifacts while altering the ECG signals minimally.
A data-centric way to improve entity linking in knowledge-based question answering
Authors: Liu Shuo , Zhou Gang , Xia Yi , Wu Hao , Li Zhufeng
Published: February 2023

Entity linking in knowledge-based question answering (KBQA) is intended to construct a mapping relation between a mention in a natural language question and an entity in the knowledge base. Most research in entity linking focuses on long text, but entity linking in open domain KBQA is more concerned with short text. Many recent models have tried to extract the features of raw data by adjusting the neural network structure. However, the models only perform well with several datasets. We therefore concentrate on the data rather than the model itself and created a model DME (Domain information Mining and Explicit expressing) to extract domain information from short text and append it to the data. The entity linking model will be enhanced by training with DME-processed data. Besides, we also developed a novel negative sampling approach to make the model more robust. We conducted experiments using the large Chinese open source benchmark KgCLUE to assess model performance with DME-processed data. The experiments showed that our approach can improve entity linking in the baseline models without the need to change their structure and our approach is demonstrably transferable to other datasets.
A taxonomic revision of the Sinopterus complex (Pterosauria, Tapejaridae) from the Early Cretaceous Jehol Biota, with the new genus Huaxiadraco
Authors: Pêgas Rodrigo V. , Zhou Xuanyu , Jin Xingsheng , Wang Kai , Ma Waisum
Published: February 2023

Tapejarids are edentulous pterosaurs particularly abundant in the Chinese Jiufotang Formation, counting with over 10 described specimens and dozens of undescribed ones. A total of seven nominal tapejarid species (within two genera) have been proposed, though it is disputed how many of those are valid instead of sexual or ontogenetic morphs of fewer, or a single, species. However, detailed revisions of the matter are still lacking. In the present work, we provide a specimen-level survey of anatomical variation in previously described Jiufotang tapejarid specimens, as well as of six new ones. We present qualitative and morphometric comparisons, aiming to provide a basis for a taxonomic reappraisal of the complex. Our results lead us to interpret two Jiufotang tapejarid species as valid: Sinopterus dongi and Huaxiadraco corollatus (gen. et comb. nov.). Our primary taxonomic decisions did not rely around cranial crest features, which have typically been regarded as diagnostic for most of these proposed species albeit ever-growing evidence that these structures are highly variable in pterosaurs, due to ontogeny and sexual dimorphism. However, a reassessment of premaxillary crest variation in the Sinopterus complex reveals that while much of the observed variation (crest presence and size) can easily be attributed to intraspecific (ontogenetic and sexual) variation, some of it (crest shape) does seem to represent interspecific variation indeed. A phylogenetic analysis including the species regarded as valid was also performed.
Pesquisa-ação: uma alternativa metodológica nos estudos de consumo e marketing
Authors: Lodi Marluce Dantas de Freitas
Published: February 2023

Desde a primeira metade dos anos 2000 pesquisadores do campo da teoria social passaram a dedicar esforços no sentido de oferecer novas bases teóricas para a compreensão das práticas sociais. O empenho desses pesquisadores muito tem contribuído para o desenvolvimento da pesquisa acadêmica, o que possibilita diversas mudanças no campo do conhecimento. No entanto, a maioria dessas pesquisas é de abordagens positivistas, as quais são dominantes na área de marketing. Uma alternativa metodológica é a Pesquisa-ação que permite a aproximação e interferência do pesquisador sobre uma prática social de consumo que pode ser prejudicial ao consumidor. O bem-estar do consumidor já vem sendo pesquisado há muito tempo, utilizando abordagens positivistas e interpretativas, mas alguns pesquisadores sugerem que há uma necessidade de pesquisas com diferentes abordagens. Neste artigo o objetivo é apresentar e descrever aspectos da Pesquisa-ação que podem contribuir para os estudos de consumo e de marketing. Para tanto foi realizado um levantamento bibliográfico sobre a Pesquisa-ação, suas etapas e limitações. Assim espera-se contribuir com pesquisadores da área de estudos de consumo e marketing, com uma alternativa metodológica para futuras pesquisas que privilegiem o pensamento coletivo e o bem-estar da sociedade.
Formação de Joint venture pelas distribuidoras de combustíveis como estratégica para vantagem competitiva
Authors: Lima Thales Abreu da Costa , Duarte Kamilla da Silva , Bernardo Júnior (em memória) Ronaldo
Published: February 2023

O planeta passa por uma transição energética e uma busca por produção de combustíveis de baixo nível de emissão de carbono. O objetivo do estudo, é investigar consequências de ações esg idealizadas para obtenção de vantagem competitiva por joint ventures formadas por empresas de combustíveis. O método está dividido em três etapas: pesquisa docum tal, revisão bibliográfica e análise dos relatórios. Este estudo é relevante, para a prática gerencial e mostra que empresas que unem forças, através de coopetição, tem mais chances de sobrevivência e expansão de seus negócios. Os estudos evidenciam que grandes players do mercado buscam parcerias, com base em uma gestão sustentável.
Políticas de Gestão de Pessoas (GP) e Responsabilidade Social Corporativa (RSC): relação propositiva por meio da revisão integrativa
Authors: Lima Ana Cristina da Costa , Bizarria Fabiana Pinto de Almeida , Barbosa Flávia Lorenne Sampaio , do Nascimento Maria Emanuelly Pinheiro , Linhares Francisca Juliana Miranda
Published: February 2023

A pesquisa visa desenvolver argumentos sobre relação entre a área da Gestão de Pessoas (GP) com o campo da Responsabilidade Social Corporativa (RSC) por meio de revisão integrativa da literatura. Para tanto, segue-se com uma abordagem descritiva, por meio de seleção de artigos disponíveis no Scientific Electronic Library Online (Scielo) e Scientific Periodicals Electronic Library (SPELL), dos últimos 5 anos com coleta de dados em novembro de 2021. Após 4 levantamentos com os descritores ‘gestão’ e ‘responsabilidade’ ‘pessoas’ ou ‘recursos humanos’, resultou em 47 artigos no SPELL e 21 artigos no Scielo. Com a análise de conteúdo foram tecidos argumentos em torno da integração das categorias ‘Recursos humanos e organizações sociais’, ‘Organizações sociais e a representação voluntária’, ‘Dilemas éticos sobre as informações’, ‘Guardiões da ética’, ‘Suporte’, ‘Mão-de-obra, capital e qualidade’, ‘Servidores públicos’, ‘Conduta humanizadora dos processos’, ‘Gestão de recursos humanos no setor público’, ‘Público interno, postura socialmente responsável’, ‘Negociações’, ‘Criatividade, função geração de ideias’, ‘Avaliação de desempenho e participação’, ‘Recursos humanos, Leis e Teletrabalho’, ‘Pró-negócio inclusivo e Sustentável’, ‘Ausência de modelo transcultural (oriente e ocidente)’, ‘Discursos versus prática’, ‘Ecossistema, diversificação da economia local’, ‘Equidade de gênero, diversidade geracional, interseccionalidade – diferenças sociais, de gênero e competências’, ‘Hierarquias, burocracias excessivas’, ‘Economia do conhecimento’, ‘Visão de mundo progressista’. Os argumentos envolvem a urgência face a emergência dos estudos com foco no pensar coletivamente sobre como responder às necessidades da sociedade, convocando as pessoas para projetar organizações mais colaborativas, resilientes e responsivas.
Aggressive Non-Hodgkin’s Lymphoma: A Case Series and Literature Review
Authors: Manjani S , Preethi S , Balamurugan S , Khowsalyasubraja K
Published: February 2023

Aggressive lymphoma of non-Hodgkin’s type is uncommon. The most common clinical presentation is lymphadenopathy and fever. One-fifth of Non-Hodgkin’s Lymphoma (NHL) present with serous effusions involves the body cavities like pleural, abdominal and pericardial cavities. Ten percent of aggressive lymphomas occur without an underlying immunosuppressive status. The NHL is more common in the elderly with a male preponderance. Paraneoplastic syndromes are rarely associated with non-Hodgkin’s lymphoma. Peritoneal lymphomatosis is extremely rare and associated with a poor prognosis. Since clinical suspicion for underlying malignancy is higher with peritoneal carcinomatosis (than for serous effusion of body cavities), they get recognised early. However, peritoneal lymphomatosis can be neglected and misdiagnosed. This series is about five cases of aggressive non-Hodgkin’s lymphoma. These cases are presented here for their rarity and diverse clinical manifestations. The case of angioimmunoblastic lymphoma was seen in an elderly male who presented with hypoglycaemia serous effusion and lymphadenopathy. Two patients were diagnosed with Natural Killer (NK) cell lymphoma and they presented with serous effusion with a jejunal thickening, as visible in the CT scan. One case of Diffuse Large B Cell Lymphoma (DLBCL) was seen in an elderly female presenting with inguinal lymphadenopathy. Lymphoma shows a varied clinical and radiological presentation and it should always be a differential diagnosis in the massive serous effusion and unexplained bowel thickening in Computed Tomography (CT) imaging with or without lymphadenopathy. The cases reported here emphasise the importance of early pathological diagnosis and immunohistochemical confirmation to ensure that the right treatment can be started at an appropriate time.
Evaluation of the Effectiveness of Topical Anaesthetic Gel and Needle Free Jet Anaesthesia in Root Planing: A Cross-sectional Study
Authors: Shetty Bhavya , Irfana Khadijathul , Fazal Ibrahim , Shabeeba Irfana
Published: February 2023

Introduction: Although traditional local anaesthetic technique by injection is considered as gold standard for dental procedure, the resultant pain and anxiety caused by the needle prick makes the patient less compliant for further treatment. Many alternatives have been developed by the researchers in the last two decades. Jet anaesthesia and the topical gel are the commonly used alternatives to anaesthetise the local area. Aim: To evaluate and compare the effectiveness of topical anaesthetic gel (MucopainR gel) and jet anaesthesia (Sure ShotR needle free jet injection) during root planing. Materials and Methods: After taking consent, 20 patients who required root planning in the maxillary quadrant bilaterally were recruited for this study. A split mouth study was planned where one quadrant was anaesthetised with benzocaine 20% (MucopainR) gel, whereas sure shotR jet anaesthesia was used on the adjacent quadrant. The side and order of placement of topical gel and jet anaesthesia were randomised. The same operator delivered anaesthesia on both the sides. The root planning was carried out by another operator at two sittings and pain was assessed immediately using Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) and Verbal Response Scale Statistical . Results: The mean NRS score of the jet injection group was 1.50±1.54 and that for the gel group was 3.15±2.16. Also, the mean VAS score of the jet injection group was 1.50±1.54 and that for the gel was 3.15±2.16. The difference between two groups were statistically significantly (p-value=0.008). Conclusion: Jet anaesthesia was significantly superior to gel in providing anaesthesia during root planing.
Total Spinal Anaesthesia after Interscalene Brachial Plexus Blockade- A Case Report
Authors: Khandelwal Kapil Kamlesh , Bhalerao Nikhil , Sen Jayashree
Published: February 2023

Brachial plexus blockade has been used for a variety of procedures on the hand, upper extremities, and shoulder. After giving an effective brachial plexus block, total spinal anaesthesia may develop, perhaps due to epidural or prevertebral diffusion of anaesthetic drugs. When administering regional nerve blocks, the findings should underline the significance of cautious technique, but more significantly, the requirement for good patient monitoring and fast availability of resuscitation equipment. This case report was about a 45-year-old woman who underwent an external fixator application to a forearm injury under an interscalene nerve block. Subsequently, she developed haemodynamic deterioration and respiratory arrest. She was manually ventilated with positive pressure and was administered crystalloids intravenously with complete recovery of neurological function. This is being reported as total spinal anaesthesia, an extremely rare complication of the interscalene brachial plexus block.
ASSESSMENT OF DADRU BASED ON DASHAVIDHA PARIKSHA
Authors: Tiwari Lalit , Tiwari Shashi Kant , Agarwal Ruby Rani
Published: February 2023

Dadru is described under kustha in Ayurvedic Samhitas. It is included under kshudra kustha by Acharya Charaka. Acharya Sushruta and Vagbhata included it under maha kustha. Dashavidha pariksha comes under the aatur desha. In dashavidha pariksha, ten points are examined to access the roga and rogi bala. These points are prakriti, vikriti, sara, samhanana, parmana, satmaya, satwa, aaharshakti, vyayam shakti, vaya. Assessment of Dadru with the help of dashavidha pariksha. The conceptual study, i.e., reviews of Ayurvedic and modern medical science literature related to Dadru. A total of 50 patients between the age group of 16-70 years were selected. The predominant age group was 31-60 years. No patient of pravar twak sara was registered in the study; the maximum number of patients were madhyamam samhanana, madhyamam pramana, madhyamam satmya, madhyamam sattva, madhyamam aahar shakti, and madhyamam vyayam shakti. Kapha and pitta dosha are mainly dominating in Dadru. The disease is kruchasadhya. The avara twak sara person is affected primarily in Dadru. Most of the patients registered in the study had madhyamam samhanan, madhyamam parmana, and madhyamam vyayam shakti. The disease occurs mainly in the person who takes ati amla and ati lavan food. The patients who were for study have madhyamam sattva and madhyamam aahara shakti, kandu, raga and mandal present in all patients.
ROLE OF JEERAK CHURNA IN MANAGEMENT OF MANDAGNI IN DIFFERENT DEHA PRAKRITI
Authors: Sudewad Savita Vaijanathrao
Published: February 2023

The substance which converts ahara (food) into body components is called Agni. Entire body strength, its fighting capacity in adverse conditions and many physiological conditions depend on the status of Agni. Prakriti is the nature of an individual. According to the Acharya Charaka state of Agni is influenced by the prakriti of individuals. Day by day, the number of mandagni subjects is increasing due to improper dietary habits, excessive competitive pressure, etc. mandagni is that which can’t digest even little quantity of food in a scheduled time, produces heaviness in the abdomen and head, pain all over the body, vomiting, etc. According to Ayurveda, mandagni is the root cause of all diseases. Mandagni can be treated by using substances with the same property as Agni. According to Ayurveda, Jeerak (Cuminum cyminum) has katu rasa (taste), katu vipak (post-digestive effect of any ingested substances), ushna guna (quality), deepan (appetizer) and pachan (digestives) karmas (functions) resembling Agni. Aim – To study the effect of Jeerak churna (refined power) on mandagni in different dehaprakruti. It is an open, randomized, prospective clinical study conducted during 2014-2017. As per inclusion criteria, 90 subjects of mandagni are divided into three groups: vatapradhan, pittapradhan and kaphapradhan (pradhan – dominance of that dosha) prakriti. Then Agni Bala Index (tool for assessment of Agni) of the subject assessed before. The conclusion is that the agnivardhak (increase digestive power) effect of Jeerak churna is dependent on deha prakriti, and it shows the highest agnivardhak effect in pittapradhan prakriti subjects.
ANTIBACTERIAL ACTIVITY OF ABUTILON INDICUM LEAF EXTRACT AGAINST PERIODONTAL PATHOGENS: AN IN VITRO STUDY
Authors: Pattanashetti Jyoti I , Kalburgi Nagaraj B , Patil Kavita A , Sulakod Kavya , Hannahson Puladas
Published: February 2023

Purpose: Periodontitis, the leading cause of tooth loss, is ascribed to periodontopathic bacteria in periodontal tissues. Amongst them, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Tannerella forsythia are contemplated to be prime consortium in the succession of periodontitis. As there has been a gradual escalation in antibiotic resistance over the last decade, phyto drugs have presumed an eminent part as a feasible substitute therapy in dentistry. Hence experimentation of new antimicrobial compounds procured from the herbal product is the need of the hour. Functional components of Abutilon indicum, i.e., flavonoids, alkaloids, sterols, triterpenoids and glycosides, bring about an anti-inflammatory and antimicrobial effect. So, the present study is conducted to estimate the antimicrobial activity of Abutilon indicum extract against Aggregatibacter actimomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Tannerella forsythia. Methodology: Bacterial strains, particularly Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Tannerella forsythia, were cultured on Thioglycollate broth. Minimum inhibitory concentration was detected by serial broth dilution of Abutilon indicum extract to 100, 50, 25, 12.5, 6.5, 3.12, 1.6, 0.8, 0.4, and 0.2 mg/ml, respectively. The tubes were subsequently incubated for 48 hours at 37 °C. Results: Abutilon indicum impeded the growth of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Tannerella forsythia in a dose-dependent manner. Conclusion: Abutilon indicum has the property of antibacterial activity against periodontopathic bacteria and may be an effective and efficient agent for averting periodontitis.
DOSAGE FORMS OF DASAMOOLA IN AYURVEDIC THERAPEUTICS: AN OVERVIEW
Authors: Panda Purnendu , S Indu , S Krishna Rao , Rao MM
Published: February 2023

Ayurveda is a science of life that has been around for thousands of years. In Ayurvedic medicine, polyherbal combinations are common for treating various ailments, especially Vata Roga. In the Classical literature of Ayurveda, so many compound formulations are found with more than two ingredients, and Dasamoola is one of them. The health benefits of Dasamoola have been used in several formulations for different diseases like Swasa (Bronchial asthma), Kasa (Cough), Siroroga (disease-related Brain), Tandra (Drowsiness), Sotha (Inflammation), Anaha (distended abdomen), Parswa Sula and Aruchi (Anorexia). Even though this formulation has been widely used in the Ayurvedic system of medicine to cure inflammation-related diseases, no more profound research studies have been conducted to prove its antioxidant and anti-inflammatory activities. From the pharmacological study, Dasamoola had impeccable anti-inflammatory activity. The Dasamoola preparation contains various phytochemicals such as alkaloids, tannins, saponins, flavonoids and quinones, total phenolic content and exhibits antioxidant and anti-inflammatory activities.
PUNARNAVA BIDALAKA IN MANAGEMENT OF BLEPHARITIS: A CASE STUDY
Authors: Hule Divya , Pradhan Nilakshi S.
Published: February 2023

Acharya Sushruta has explained 21 vartmaroga (eyelid disorders) in Sushruta Samhita. Blepharitis is an eyelid disorder defined as inflammation of lid margins and is common worldwide. It accounts for 45% of all ophthalmic diseases. Blepharitis has two major types anterior and posterior Blepharitis. Seborrheic Blepharitis is a subtype of anterior Blepharitis. In modern sciences, various antibiotic and steroidal ointments are provided as treatment for Blepharitis, which has its limitations and side effects. Bidalaka is a kriyakalpa (Ayurvedic therapy) advised for treating eyelid disorders due to its direct action and longer contact time with targeted tissues. Punarnava is preferred as a drug of choice for bidalaka in treating inflammation, itching, scaling and redness in Blepharitis with its anti-inflammatory, anti-edematic, anti-tumour, anti-allergic, and anti-bacterial properties. A 27-year-old female patient was diagnosed with Seborrheic blepharitis and is treated with Punarnava bidalaka, where the results prove to be significantly influential based on its clinical assessment.
CRITICAL STUDY OF ANGAMARDA PRASHMANA, SHOOLAHARA AND VEDNASTHAPANA MAHAKASHAYA OF ACHARYA CHARAKA: A REVIEW
Authors: Anand Parul , Patel Bhupesh R , Kapdiya Bhavna
Published: February 2023

Introduction: Ayurveda offers a holistic way of living life. An altered lifestyle today is totally against the principles of Ayurveda and hence is a bundle of diseases emerging today. PAIN is one of such challenges in the medical world today. According to Ayurveda texts, chronic pain is caused by imbalances in doshas and is influenced by many factors, like diet, digestion, toxic accumulation, stress, energy levels and daily routine. Angamarda prashmana mahakashaya, Shoolahara mahakashaya and Vedanasthapana mahakashaya of Acharya Charaka usually find their shadow under the broad umbrella of the concept of pain. The conceptual approach to all these in the management of pain not being same; hence needs conceptual and clinical exploration. The present paper discusses the role of the above three drug groups in managing pains of various origins. All the relevant texts, along with the introductory text of Charaka Samhita, were taken to explore the current topic. Angamarda prashmana mahakashaya finds its appropriate selectivity in Swatantra vata prakopa, while Shoolahara mahakashaya primarily aims at the pain of colic origins. Vedanasthapana drugs, on the other hand, have their action on pains of psychosomatic origin. The difference in the mode of action of Angamarda prashmana Mahakashaya, Shoolahara Mahakashaya and Vednasthapana Mahakashaya has also been discussed in the present article.
A REVIEW OF ADHIPATI MARMA
Authors: Kumar Giriraj , Upadhyay Subhash , . Sakshi
Published: February 2023

Background: The Adhipati Marma is Sandhi Marma and Sadyapranahara in nature; measurement is about half angula. There is a controversy about sandhi in the context of Adhipati Marma. The Sushruta School thought it was Asthi Sandhi, but the recent commentator of Sushruta Samhita, like Acharaya Dalhana and Ghanekar, considered it a Sira Sandhi. Aims and objective: To analyze the structural entity of Adhipati Marma. Material and methods: Classical textbooks of Ayurveda and contemporary science, journals, publications, articles, e-journals etc., related to Adhipati Marma. Discussion: The Adhipati Marma is situated in Shira Pradesha, which is Sandhi Marma. The posterior fontanelle or lambda is an anatomical landmark in the skull, which may be delayed in the closure and can cause hydrocephalus or congenital hypothyroidism. The Torcular Herophili, or confluence of sinuses, is a highly variable structure which constitutes a network of dural venous sinuses. Injury to Torcular Herophili or confluence of sinuses is infrequent, but sepsis, thrombosis and embolism may occur, which can be fatal. Conclusion: Due to controversies of Adhipati Marma, From Sushruta's point of view, Adhipati Marma can be compared as lambda or posterior fontanelle. At the same time, Acharya Dalhan and Ghanekar's point of view may be considered lambda or Torcular Herophili or confluence of sinuses.
PHYSICAL PROPERTIES AND CHEMICAL CONSTITUENTS ON DRAVYA OF MUKHALEPA: A LITERARY REVIEW
Authors: . Arati , Gaur MB
Published: February 2023

Skin is the body's largest organ and has excellent cosmetic value. It is one of the five gyanendriya (sense organs). i.e., sparsha gyan (touch sensation) gets from it. So, it has immense importance for an individual's physical and mental well-being. It is most vulnerable to diseases as it exposes to the external environment. There are many reasons behind skin problems; the most striking is today’s busy and stressful life. Skin disorders affect all ages, from neonates to elderly persons. Ayurveda has explained vast descriptions of lepa kalpana, of various skin diseases and beauty. The medicines in the form of a paste used for external applications are called lepas. Ayurveda has explained a lot of things which are unique concepts about beauty and also an effective and cheaper, long-lasting therapy without any side effects. Mukha lepa (face pack) is a concept in which a thick and consistent paste is applied on the face to treat acne, pimples, scars, marks and pigments in Ayurveda Mukha lepa is simply effective skin care treatment mainly for the nourishment of skin and also aids in skin cleansing and make it soft and transparent. Mukha lepa also helps to increase the skin's elasticity and thereby prevents skin ageing, avoids wrinkles on the face and gives a good elasticity and tone. The primary purpose of this article is to provide details about the lepa kalpana from Ayurveda, which offers more benefits to the skin for complexion and skin ailments.
AYURVEDIC MANAGEMENT OF PURISHAJA KRIMI ROGA: A CASE STUDY
Authors: EA Soumya , Jagani Poornasri
Published: February 2023

Introduction: Worm infection is the most common problem in developing countries and occurs as an intestinal infection. Pinworm infection is an intestinal infection that occurs due to poor hygiene, sanitization, poverty and improper washing. Krimi roga is an important disease in Ayurveda and is used to denote tiny organisms in the human body. Case presentation: A 44-year-old female was admitted with the following complaints of anal itching, bloating of the abdomen, itching on hands, reduced appetite and discolouration on the hand. A thorough clinical examination and investigations like sputum microscopy confirmed the worm infection. The Ayurvedic aspect of this disease can be considered as krimi and specifically as purishaja krimi. Diagnosis and management: The diagnosis is based on the clinical features of the disease, and the management approach of worm infection includes anthelmintic medications and hygienic measures. In Ayurveda, the diagnosis is based on signs and symptoms along with dosha involvement. The treatment approach includes agni deepana, ama pachana, apakarshana, prakruti vighata and nidana parivarjana chikitsa and procedures like kashaya dhara and krimighna basti. Outcome: There was a marked improvement in the disease's clinical features, increased appetite, and decreased worm infection. Discussion: Satisfactory results were obtained, discharged with oral medications, and follow-up was done. This case highlights the role of Ayurveda in managing the disease, and proper diagnosis of the disease, along with oral medications and panchakarma procedures, can be given for significant results.
Assessment of Left Ventricular Diastolic Dysfunction in Cases with Liver Cirrhosis
Authors: El-Mashad Mohammed El-Refaey , El-Masry Magdy Mohamed , Al-Hefnawy Suzan Bayoumy , Elsheikh Ayman Ahmed
Published: February 2023

Background:  Cirrhosis is a long-term inflammatory process of hepatic tissue condition that mainly affects people aged 50 to 60. This study aims to assess Left ventricular diastolic dysfunction (LVDD) in cases with cirrhotic liver by conventional, tissue Doppler and two-dimensional speckle tracking echocardiography to clarify the correlation between the severity of cirrhotic liver and LVDD.

Methods: A prospective case-control research involved 100 adult cases with confirmed HCV and HBV. Cases were divided into 4 equal group: Group A: Child A cases, group B: Child B cases, group C: Child C cases and group D (Controls): healthy non-hepatic subjects of the same age and sex who have normal blood pressure, nonsmoking participants with no further concomitant problems.

Results:  Number of cases with LVDD had a statistical noticeable increase in Child A, B, and C (p =0.004, <0.001, and <0.001 respectively. LAVi had a statistical noticeable increase in Child C / B   (p =0.013 and p =0.014).

Conclusion:  Left atrial volume index (LAVi) had a statistical noticeable increase in Child C / B in comparison to the controls but E m, E l were statistical noticeable lower in Child C / B. /E had a statistical noticeable increase in Child C group, LVSRe had a statistical noticeable  decrease in Child C group  but it was insignificantly different across Child A / B/ C and controls and across Child B / C and controls.
Rhizobacteria-Based Biostimulant Mixture Effect on Chickpea (Cicer arietinum L.) in Greenhouse and Cultivation Assays
Authors: Gabilondo Regina , Sánchez Jorge , Gandía María Luisa , Montero-Muñoz Iris , Mauri Pedro V. , Marín José , Muñoz Pedro , Mostaza-Colado David
Published: February 2023

This study aims to contribute to the improvement of the chickpea agri-food industry and adapt it to future challenges. For this, the effect of a Rhizobacteria-based biostimulant mixture was analyzed in Amelia variety of chickpea (Cicer arietinum L.) in two different experiments: one in flowerpots in a greenhouse and the other one in the field grown under rainfed conditions. Germination success, vegetative development and phenological stages of the plants were studied after applying liquid biostimulant mixture on the seeds 24 h before sowing or spraying it on the soil after sowing. The results indicated that the way of application of the biostimulant was relevant concerning germination success, vegetative development, and phenological state of chickpea plants and it should be adapted to intensive agriculture with the use of seed drill that requires dry seeds. Regarding germination success, vegetative development and phenological stages in the flower pot assay, the volume of biostimulant mixture applied to the seeds was remarkable as higher volumes affected negatively while lower volumes were positive. Biostimulant had a negative effect on the development of chickpea plants in the field assay, probably because it also promoted the growth of weeds, which lessened the growth of the chickpea plants.
Maintaining Health Care Innovations After the Pandemic
Authors: Herzlinger Regina , Richman Barak D. , Schulman Kevin A.
Published: February 2023

This Viewpoint discusses evaluating and perhaps extending the record of successful innovation arising from the COVID-19 pandemic.
Bilateral Purtscher-Like Retinopathy Associated With COVID-19 Infection
Authors: Thatcher Mitchell D. , Wu Laura Z. , Varma Renatta
Published: February 2023

This case report describes a 37-year-old female individual who presented with sudden-onset blurred vision in both eyes 4 days after testing positive for COVID-19.
Complication Rate of Percutaneous Dilatational Tracheostomy in Critically Ill Adults With Obesity
Authors: Roy Catherine F. , Silver Jennifer A. , Turkdogan Sena , Siafa Lyna , Correa José A. , Kost Karen
Published: February 2023

Importance

Obesity has traditionally been described as a relative contraindication to percutaneous dilatational tracheostomy (PDT). Increased familiarity with the technique and use of bronchoscopy or real-time ultrasonography to enhance visualization have led many practitioners to expand the indication for PDT to patients historically deemed to have high risk of perioperative complications.

Objective

To assess the reported complication rate of PDT in critically ill adults with obesity and compare it with that of open surgical tracheostomies (OSTs) in this patient population and with that of PDT in their counterparts without obesity.

Data Sources

In this systematic review and meta-analysis, Ovid MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from January 1, 2000, to March 1, 2022. Key terms related to percutaneous tracheostomy and obesity were included.

Study Selection

Original investigations of critically ill adult patients (age ≥18 years) with obesity who underwent PDT that reported at least 1 complication of interest were included. Case reports or series with fewer than 5 patients were excluded, as were studies in a language other than English or French.

Data Extraction and Synthesis

Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) were used, with independent extraction by multiple observers. Frequencies were reported for all dichotomous variables. Relative risks for complications were calculated using both fixed-effects and random-effects models in the meta-analysis.

Main Outcomes and Measures

Main outcomes included mortality directly associated with the procedure, conversion to OST, and complications associated with the procedure (subclassified into life-threatening or non–life-threatening adverse events).

Results

Eighteen studies were included in the systematic review, comprising 1355 patients with obesity who underwent PDT. The PDT-related complication rate was 16.6% among patients with obesity overall (791 patients, 17 studies), most of which were non–life-threatening. Only 0.6% of cases (8 of 1314 patients, 17 studies) were aborted or converted to an OST. A meta-analysis of 12 studies (N = 4212; 1078 with obesity and 3134 without obesity) showed that patients with obesity had a higher rate of complications associated with PDT compared with their counterparts without obesity (risk ratio, 1.78; 95% CI, 1.38-2.28). A single study compared PDT with OST directly for critically ill adults with obesity; thus, the intended meta-analysis could not be performed in this subgroup.

Conclusions and Relevance

The findings suggest that the rate of complications of PDT is low in critically ill individuals with obesity, although the risk of complications may be higher than in individuals without obesity.
Multi-organ carcinogenicity by inhalation exposure to 2-Bromopropane in rats
Authors: Senoh Hideki , Kasai Tatsuya , Hirai Shigeyuki , Furukawa Yusuke , Misumi Kyohei , Goto Yuko , Takanobu Kenji , Matsumoto Michiharu , Fukushima Shoji , Aiso Shigetoshi
Published: February 2023

Objective

The purpose of this study was to investigate the carcinogenicity of 2-bromopropane (2-BP) in rats.

Methods

Male and female F344 rats were exposed by whole body inhalation to 2-BP vapor at concentrations of 0, 67, 200, and 600 ppm for 6 h/day, 5 days/week for 2 years.

Results

All rats of both sexes exposed to 600 ppm died or became moribund within 85 weeks. Death/moribundity was caused by 2-BP induced tumors. In males, significantly increased tumors were malignant Zymbal’s gland tumors; sebaceous adenoma and basal cell carcinoma of the skin/appendage; adenocarcinoma of the small/large intestine; follicular cell adenoma of the thyroid; fibroma of the subcutis, and malignant lymphoma of the lymph node. In addition, an increased trend in tumor incidence was found in the preputial gland, lung, forestomach, pancreas islet, brain, and spleen. In females, significantly increased tumors were adenocarcinoma and fibroadenoma of the mammary gland, squamous cell papilloma of the vagina, and large granular lymphocytic leukemia of the spleen. In addition, an increased trend in tumor incidence was found in Zymbal’s gland, the clitoral gland, skin, large intestine, pancreas islet, uterus, and subcutis. Particularly, malignant Zymbal’s gland tumors were induced even in males exposed to the lowest concentration, 67 ppm.

Conclusion

Two-year inhalation exposure to 2-BP resulted in multi-organ carcinogenicity in rats. Based on sufficient evidence of carcinogenicity in this study, 2-BP has the potential to be a human carcinogen.
Assessing the variability and correlation between SUV and ADC parameters of head and neck cancers derived from simultaneous PET/MRI: A single‐center study
Authors: Wongsa Paramest , Nantasuk Mayurachat , Singhnoi Sinirun , Pawano Phattarasaya , Jantarato Attapon , Siripongsatian Dheeratama , Lerdsirisuk Pradith , Phonlakrai Monchai
Published: February 2023

Objective

Intratumoral heterogeneity is associated with poor outcomes in head and neck cancer (HNC) patients owing to chemoradiotherapy resistance. [18F]‐FDG positron emission tomography (PET) / Magnetic Resonance Imaging (MRI) provides spatial information about tumor mass, allowing intratumor heterogeneity assessment through histogram analysis. However, variability in quantitative PET/MRI parameter measurements could influence their reliability in assessing patient prognosis. Therefore, to use standardized uptake value (SUV) and apparent diffusion coefficient (ADC) parameters for assessing tumor response, this study aimed to measure SUV and ADC's variability and assess their relationship in HNC.

Methods

First, ADC variability was measured in an in‐house diffusion phantom and in five healthy volunteers. The SUV variability was only measured with the NEMA phantom using a clinical imaging protocol. Furthermore, simultaneous PET/MRI data of 11 HNC patients were retrospectively collected from the National Cyclotron and PET center in Chulabhorn Hospital. Tumor contours were manually drawn from PET images by an experienced nuclear medicine radiologist before tumor volume segmentation. Next, SUV and ADC's histogram were used to extract statistic variables of ADC and SUV: mean, median, min, max, skewness, kurtosis, and 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles. Finally, the correlation between the statistic variables of ADC and SUV, as well as Metabolic Tumor volume and Total Lesion Glycolysis parameters was assessed using Pearson's correlation.

Results

This pilot study showed that both parameters’ maximum coefficient of variation was 13.9% and 9.8% in the phantom and in vivo, respectively. Furthermore, we found a strong and negative correlation between SUVmax and ADVmed (r = −0.75, P = 0.01).

Conclusion

The SUV and ADC obtained by simultaneous PET/MRI can be potentially used as an imaging biomarker for assessing intratumoral heterogeneity in patients with HNC. The low variability and relationship between SUV and ADC could allow multimodal prediction of tumor response in future studies.
Catching Our Breath: Updates on the Role of Dendritic Cell Subsets in Asthma
Authors: Lajiness Jacquelyn D. , Cook‐Mills Joan M.
Published: February 2023

Dendritic cells (DCs), as potent antigen presenting cells, are known to play a central role in the pathophysiology of asthma. The understanding of DC biology has evolved over the years to include multiple subsets of DCs with distinct functions in the initiation and maintenance of asthma. Furthermore, asthma is increasingly recognized as a heterogeneous disease with potentially diverse underlying mechanisms. The goal of this review is to summarize the role of DCs and the various subsets therein in the pathophysiology of asthma and highlight some of the crucial animal models shaping the field today. Potential future avenues of investigation to address existing gaps in knowledge are discussed.
A Matrix‐Metalloproteinase‐Responsive Hydrogel System for Modulating the Immune Microenvironment in Myocardial Infarction
Authors: Chen Wei , Wang Changyong , Liu Wei , Zhao Bicheng , Zeng Zhicheng , Long Fen , Wang Chunlan , Li Siwei , Lin Naibo , Zhou Jin
Published: February 2023

Injectable hydrogels carrying therapeutic factors to modulate the infarct immune microenvironment show great potential in the treatment of myocardial infarction (MI). However, conventional injectable hydrogels release therapeutic factors in an uncontrolled manner, which leads to poor treatment efficacy and acute side effects on normal tissues. In this work, a matrix metalloproteinase (MMP)2/9‐responsive hydrogel system (MPGC4) is developed, considering the characteristics of the post‐MI microenvironment. MPGC4 consists of tetra‐poly(ethylene glycol) (PEG) hydrogels and a composite gene nanocarrier (CTL4) that is composed of carbon dots (CDots) coupled with interleukin‐4 plasmid DNA via electrostatic interactions. MPGC4 can be automatically triggered to release CTL4 on demand after MI to regulate the infarct immune microenvironment. In addition, due to the photoluminescence properties of CDots, a large amount of viscoelastic MPGC4 is found to be retained in situ after injection into the infarct region without leakage. The in vitro results demonstrate that CTL4 promotes proinflammatory M1 macrophage polarization to the anti‐inflammatory M2 subtype and contributes to cardiomyocyte survival through macrophage transition. In a rat model of MI, MPGC4 clears MMPs and precisely targets CTL4 to the infarcted region. In particular, MPGC4 improves cardiac function by modulating macrophage transition to reduce early inflammatory responses and proangiogenic activity.