bluuebunny/crossref_metadata_2025 huggingface dataset:
Drivers, Barriers and Success Factors in Climate Change Adaptation for Smallholder Farmers: A Case Study in Thai Nguyen Province, Vietnam
Authors: Ha Tuan M. , Truong Tuyet , Hoang Huong , Ho Bac
Published: January 2021

This paper aims to identify appropriate approaches and interventions of local governments and extension services through identifying the most potential adaptive measures in agricultural production of local farmers in Thai Nguyen province (Vietnam) and analyses of key drivers, barriers and success factors for climate change adaptation (CCA).The study was conducted during October 2019 – April 2020 in Thai Nguyen and two selected communes with 92 smallholder farmers and relevant stakeholders from the provincial to commune levels using both quantitative and qualitative methods.Results showed a highly vulnerable situation of the local farmers under the context of climate change with 60.9% and 44.6% of the interviewed farmers stating reduced crop/livestock productivity and crop losses, and reduced arable production land and number of crop seasons/year respectively.Ten most potential livelihood models and production practices were identified. For example, animal husbandry (pigs, cattle) combined with biogas digester installation; intercropping between fruit crops and annual crops; use of drought and disease resistant maize varieties; changes of crop patterns and calendars; water saving production techniques, etc. Driver, barriers and success factors for CCA suggestguiding actions for the local government and extension services to plan adequate approaches and interventions for embracing and upscalingthe CCA initiatives towards climate resilient farming communities.The guiding actions include:strengthening capacity of extension staff; providing update market information to farmers for their decisions of crops and livestock; disseminating new and locally appropriate CCA models and practices together with on-field demo-plots and farmer field schools; and building capacity for community organisations, production groups/cooperatives to promote community learning for wider adoption and thus sustainability of their farming systems in response to the changing environment.
Teleconnection Between ENSO and Wind-Wave Climate Under the Influence of Monsoon in the Bay of Bengal Region
Authors: Sinha Mourani , Jana Amitava
Published: January 2021

Wind-wave parameters like the significant wave height (SWH)impacts considerably deep ocean and maritime activities and lives of all those dwelling near the coast.Prediction of such a parameter has immense utility during extreme conditions. Teleconnection features are explored between the most widely studied climate mode, the El Niño-Southern Oscillation or ENSO and the SWHparameter in the Bay of Bengal (BB) region under the influence of monsoon in this study.In two separate experiments the SWH data of the BB region for the period 1958-2001 and the period 2006-2016 is subjected to empirical orthogonal function analysis to split the data into spatial and temporal parts.The temporal variations are of annual periodicity for both the data sets. On analysis teleconnection feature of lower (higher) SWH during El Niño (La Niña) episodes is observed in the BB region. Significant correlationis observed between SWH and the ENSO indices during the summer monsoon months.The continuous wavelet power spectrum is generated using the first principal component (PC1) extracted above. It exhibits significant regions in the 0.5-1 year band resembling the monsoon variability in the BB region. To determine how SWH is related to the ENSO indices wavelet coherence is applied for the BB region.The higher coherency regions are found in the 0.5-1 year band which maybe related to the monsoon oscillation having similar periodicity. Thus the SWH and ENSO relationship in the BB region is influenced by the monsoon significantly.
Meteorological Drought Analysis Using Standardized Precipitation Index
Authors: Pandya Parthsarthi , Kumarkhaniya Rohit , Parmar Ravina , Ajani Piyush
Published: January 2021

Drought is a natural hazard which is challenging to quantify in terms of severity, duration, areal extent and impact. The present study was aimed to assess the meteorological drought for Junagadh (Gujarat), India using Standardized Precipitation Index (SPI) and evaluate its correlation with the productivity of Groundnut and Cotton. The SPI was computed for eight durations including monthly (June to August each), 3 monthly (June to August and July to September) and 6 monthly (June to November) time scales for the year1988 to 2018. The results revealed that 54% to 67% of years suffered from drought for SPI-1. Drought years based on SPI-3 and SPI-6 were 48 % to 58%. Among all the eight durations, mild drought was the most dominant drought category. Years 1993, 1999, 2002 and 2012 experienced the most severe droughts for Junagadh. Severe droughts were observed only for SPI-1 (July), SPI-3 and SPI-6. No extreme drought was witnessed in Junagadh. Correlation of groundnut yield with SPI was higher as compared to cotton for all time scales. Kharif groundnut and cotton yield were better correlated with SPI-3 and SPI-6 for Junagadh with significant correlation coefficient ranging from 0.57 to 0.79 for groundnut and 0.46 to 0.56 for cotton. Among monthly SPI, the significantly highest correlation was found for June (0.59) for groundnut and September (0.48) for cotton. The SPI-3 and SPI-6 shown ability to quantify the drought and also shown the potential of yield prediction.
Water and Soil Quality of Coffee Plantations in the Western Ghats Region, Chikkamagaluru District, Karnataka, India
Authors: Raghavendra Lingayya , Venkatesha Melally Giddegowda
Published: January 2021

To assess water and soil quality in the Western Ghats' coffee plantations, 66 water and 224 soil samples were collected at four locations for estimation 20 parameters in water and 16 parameters in soil samples. Principal component analysis as applied to a set of chemical data obtained by the laboratory analysis of water and soil. Study locations represented arabica coffee (Coffea arabica) plantations around 50 km2 from Chikkamagaluru town. PCA showed the interrelationship of water and soil parameters for four sampling locations. The clustering of sampling location results was due to the consequence and concentration of water and soil variables. The principal component bi-plot of phosphorous, conductivity, hardness, total dissolved solids, sulphate, magnesium, and alkalinity determined water quality factors. Heavy metals, nitrogen, and total phosphorous greatly influenced the quality of soil samples at different locations.
Seasonal Nature and Trends of Tropical Cyclone Frequency and Intensity over the North Indian Ocean
Authors: Pal Abhisek , Chatterjee Soumendu
Published: January 2021

Tropical cyclone (TC) genesis over the North Indian Ocean (NIO) region showed significant amount of both spatial and temporal variability.It was observed that the TC genesis was significantly suppressed during the monsoon (June-September) compared to pre-monsoon (March-May) and post-monsoon (October-December) season specifically in terms of severe cyclonic storms (SCS) frequency. The Bay of Bengal (BoB) was characterized by higher TC frequency but lower intensity compared to the Arabian Sea (AS). It was also observed that the TC genesis locations were shifted significantly seasonally.The movement of the TCs also portrayed some significant seasonal differences. The pre-monsoon and post-monsoon season was responsible for generating TCs with higher values of accumulated cyclone energy (ACE) compared to the monsoon. The time series of TC frequency showed a statistically significant decreasing trend whereas the time series of ACE showed astatistically significant increasing trend over the NIO.
Chemical and Microbiological Analysis of Organic Manure of Nisargruna Biogas Plant and its Applications as Carrier Materials for Biofertilizers
Authors: Nayak Shubhada , Kale Sharad
Published: January 2021

Theuse ofNisargruna biogas plant is an efficient approach to recycle the biodegradable wastematerials into valuable products like organic manure, methane carbon dioxide and water. In the current study, the manureobtained from five different Nisargruna biogas plants was analyzed for its characteristic properties. These properties included their chemical composition (carbon, hydrogen, nitrogen, sulphur and macro/micro-nutrients), water holding capacity and heavy metal concentration and coliform bacteria and fungi. The results indicated the presence of a high concentration of macro- and micronutrients, and the absence of coliforms. The samples with good nutrient contents were used as a carrier material forAzotobactersp., Rhizobiumsp. and phosphate solubilizing Bacillussp. On analysis, themanurewas found to be useful as carrier for selected cultures even after six months of production, hence confirming its stability and practical application.
A Study of Availability and Utilization of Water Resources in Punjab
Authors: Sidhu B S , Sharda Rakesh , Singh Sandeep
Published: January 2021

While water is renewable, only a finite amount of it is available. Rapid urbanization, industrial development, and growth in food demand contribute to the shortage of freshwater in many countries. The limited availability of surface water and its uneven distribution in time and space has increased the dependence on groundwater (GW) in Punjab. Its irrigation development is characterized by excessive extraction of GW to meet the crop water requirements for ensuring the country’s self-reliance in food. GW development guided by populist political pronouncements has contributed to serious environmental and ecological concerns. The paper, using the GW resource estimation methodology-2015, assesses the net annual replenish able GW availability (21.58 billion cubic meters) and GW extraction (35.78 billion cubic meters), and thus a stage of GW extraction of 166%. It analyses the impact of continuous GW mining on the long-term behaviour of water table. Considering the declining availability of surface water under climate change, it is a high time to study the emerging GW scenario more scientifically and prescribe a policy framework for the future.
Lockdown Due to COVID-19 Pandemic Improves Overall Air Quality: An Evidence Based Study from Siliguri Metropolitan, West Bengal, India
Authors: Roy Subham , Singha Nimai , Majumdar Nishikanta , Roy Barsha
Published: January 2021

About more than two months of lockdown due to the COVID-19 pandemic, from the end of March to the end of May in the Siliguri city of West Bengal, India, results in a momentous change in the overall air quality. The study aimed to identify the propensity of the concentration of pollutants during the period pre, during and post lockdown through trend analysis and to evaluate the alteration of air quality at different phases of lockdown (including Phase I, II, III and IV). Also, to compares the changes in the concentration of various pollutants, including Air quality index (AQI) for pre-during and pre-post lockdown periods. Data were obtained for the time-span of before, during and after lockdown and the entire lockdown period (from 25th March to 31st May) was divided into four phases to better comprehend the extent of air quality variation. Each phase of lockdown reveals different air quality scenarios, with a tendency to reduce during the first phase, increase by the third phase, and again lessens to a minimum at the fourth phase. The result shows a significant reduction in the concentration of Particulate matter (PM2.5 and PM10) (upto -66% respectively), Nitrogen dioxide (NO2) (upto -46%), Sulphur dioxide (SO2) (upto -20%), Ammonia (NH3) (upto -19%) and AQI (upto -68%) during the lockdown period compared to before lockdown. On the other hand, overall Air quality was further improved after the lockdown as the concentration of the pollutants, including AQI, was further reduced to minimal. The changes for PM2.5 (upto -78%), PM10 (upto -76%), NO2 (upto -48%), SO2 (upto -40%), NH3 (upto -41%) and AQI (upto -80%) after the lockdown compared to the period of pre-lockdown. In contrast, the concentration of Ozone (O3) was increased by 21% and 25% for the same period. Similarly, the mean AQI of the city shows a poor AQI before lockdown, came to a satisfactory during the lockdown, which further changes to good air after the lockdown ended. Therefore, it is clear from the study that the lockdown has an impact on improving the overall air quality and further lockdown with appropriate planning in the future should be seen as an alternative solution to reducing excessive pollution.
Covid 19 The Environmental Wake up Call
Authors: Mawlong Banshaikupar Lyngdoh
Published: January 2021

The COVID-19 crisis has thrown the world upside down. While many theories may have been postulated regarding the nature of its origin, one theory that needs to be explored is the casual factor of mankind’s own destructive actions on nature that may have attracted the evolution of the deadly COVID-19. This article is an attempt to explore the linkage between the deteriorating environmental conditions across the globe and the genesis of the COVID-19. The article will also try to implore upon the world community to remodel its developmental strategy to complement the need of the hour.
Study of Physiochemical Parameters of Small Lakes in Sangamner, Ahmednagar District of Maharashtra State, India
Authors: Bhagde Rupendra Vinayak , Deshmukh Dnyaneshwar Ramrao , Pansambal Shreyas Sambhajirao , Bhoye Manish Ramesh
Published: January 2021

Water resources have great importance for the existence of life. Freshwater resources in the plateau area in Sangamner Taluka of Ahmednagar district are limited. Therefore, there is a need of sustainable use of water resources especially lakes. The physicochemical analysis is necessary to know the water quality. This study aimed at the monitoring of water quality for its sustainable use by assessing the physicochemical parameters of small lakes in the plateau region of Sangamner Taluka. In the present study, the water samples were collected from the spots selected for the study in different seasons. The physicochemical parameters viz. temperature, pH, dissolved oxygen, dissolved Carbon dioxide, alkalinity, hardness and T.D.S. were recorded by using standard methods. The dissolved oxygen was found in the range of 5.1 mg/L to 7.9 mg/L. The dissolved Carbon dioxide was in the range of 32 mg/L to 48 mg/L. The alkalinity was in the range of 120 mg/L to 330 mg/L. The temperature was in the range of 21oC to 32oC. The hardness was in the range of 58 mg/L to 140 mg/L. Seasonal variations in the physicochemical parameters were observed at different spots. Observations in the present study have emphasized the need to raise awareness among the people for water conservation and management.
Assessment of Phytoplankton Diversityin Midstream of Achankovil River during Monsoon and Post Monsoon Seasons
Authors: Krishnan Meera , Dhar Praveen , R Sreejai , Thankappan Sreeja
Published: January 2021

Algae are organisms with size ranging from microscopic to hundred feet to large seaweeds. The present study focuseson the algal diversity in Pandalam area of Achankovil river, Kerala, India. Pilgrims of Sabarimala uses the water of Achankovil River for various sanitary purposes and there by waste dump in river may cause water pollution and related ecological problems.Water samples werecollected during the monsoon and post monsoon seasons in the early morning before increasing the intensity of sunlight. Phytoplanktonic forms were collected using plankton net.The analysis of physico-chemical parameters such as temperature, pH, salinity and productivity show a slight variation in mean value during the two seasons. The study reveals presence of forty one algal genera belongings to four algal classes.Theresults showed that parameters such as dissolved oxygen, carbon dioxide, total hardness and silicate indicatevariations with relation to seasons.The variations and distribution of phytoplankton and changes in physico-chemical parameters in freshwater helps to know the water quality of the river.
Physico-Chemical Analysis of Mangrove Soil, Kundapura, Karnataka, India
Authors: Kallushettihalli Mallappa Vijaya Kumar , Kumara Vijaya
Published: January 2021

The present study was carried out to determine the periodic variation in physico-chemical characteristics of mangrove soil samples. The soil samples had been accrued from four distinctive places of Kundapura mangrove areas in three seasons, monsoon, pre-monsoon and post-monsoon. Soil analysis pertaining to various variables such as total Nitrogen, Phosphorus, Potassium, pH and Electrical conductivity. Soil pH is assorted from 3.84 to 6.66. Electrical conductivity is assorted from 0.02 dSm-1 to 9.60 dSm-1. Available nitrogen is assorted from 30.7 kg/ha to 323 kg/ha. Available phosphorus concentration has ranged between 1.37 kg/ha and 47.27 kg/ha. Available potassium is differed from 117.43 kg/ha to 537.63 kg/ha. The results confirmed variations in all of the analyzed parameters of the soils amassed from four stations.
Response Surface Optimization of Fixed Bed Adsorption of Cr+6 Onto Low-cost Adsorbent
Authors: Megham Padmaja , Bhavani R
Published: January 2021

The paper emphasizes the removal ofChromium from tanning industryeffluent using adsorption as a cost effective option. The essential source of contamination identified from variable amounts of liquid discharges was Chromium (Cr+6). A column study was carried out using Shrimp shell waste (SSW) as an adsorbent in the removal of Cr+6 ion from synthetic solutions. Operational factors such as the size of adsorbent, bed depthand compared their adsorption capacities thereof. For a given size, the adsorption capacity increased by a reduction in the amount of Chromium. TheCr+6removal based on adsorbent size was in the order: 150 microns> 300 microns> 600 microns.The experimental data was optimized and modelled using Response Surface method, and a 23 factorial Central composite design (CCD) was applied, and the data was analyzed for ANOVA. A P-Value<0.005 indicated that the probability of the experimental results was significant.
AHP and GIS-based Risk Zonation of COVID-19 in North East India
Authors: Mahato Ranjit , Bushi Dhoni , Nimasow Gibji
Published: January 2021

On 31st December 2019, a novel virus was reported from Wuhan City of Hubei Province of China, and later it was recognized as SARS-COV-2 (COVID-19). As the virus is highly human to human contagious, it has spread worldwide within a very short time. Since 24th March 2020, after the first reported case in North East India, the total confirmed cases reached up to 4,633 on 11th June 2020. In this work, an attempt has been made to delineate risk zones of COVID-19 in North East India using the Analytic Hierarchy Process (AHP) and overlay analysis in Geographical Information System (GIS). The evaluation is based on 14 criteria that were classified into promoting and controlling factors. The promoting factors include population size, population density, urban population, elderly population, population below the national poverty line, and percentage of marginal workers. In contrast, the controlling factors include available doctors, other health workers, public health facilities, available beds, governance index (composite and health), and testing laboratories. The results were classified into very high, high, moderate, low, and very low risk zones. Most densely populated states with massive pressure on health facilities are likely to have a higher risk of COVID-19. Assam, Tripura, Meghalaya, and Nagaland show a high COVID-19 risk, which constitutes almost 76.93% of the North East India population, covering 48.80% of surface area. The states under a moderate risk zone include 6.92% of the population over 8.52% of the area. Lastly, 16.15% of the people living over 42.69% of the total area belong to the states with a lower risk zone.
Environmental Impact Assessment of Anthropogenic Activities and Conceptual Restoration Strategy for Kham River in Aurangabad, India.
Authors: Karhade Vedant Ramchandra , Kamble Amol Laxman , Vangujare Shraddha Balwant , Wadgaonkar Prasanna Santosh , Gadekar Ganesh Sonaji , Godihal Jagdish
Published: January 2021

In present study, the environmental impact assessment of the anthropogenic activities on the Kham River is carried out. 8Km stretch of the Kham River from downstream of Harsul Lake to the upstream of Chavani Bridge in the Aurangabad city has been selected as the study area for the assessment with regards to water quality, flooding risk, ecological and aesthetical aspects using Battelle environmental evaluation system. For the water quality monitoring eight sampling stations along the length of the river were selected and samples were taken in each season for laboratory analysis of Dissolved oxygen, Biochemical oxygen demand, pH, Total dissolved solids and total suspended solids. The results of the water quality analysis shows that the water quality in the upstream stretch of 3kms upto Himayat Baug is considerably good in comparison to the remaining 5kms stretch from Himayat Baug to Chavani Bridge. The cross sectional survey of the river basin is carried out to measure the extent of the enchorachment along the basin. The results of the cross sectional survey shows that the river basin has mean width of 36.16 meters. The ecological assessment was carried out along the vicinity of the river basin and the species of flora, birds and fishes were listed. The result of the ecological survey shows that the river has variety of species of flora and birds and fishes are found in the upstream reach of the river. The survey of recreational and historically important monuments along the basin was carried out and those places were listed for study of aesthetical aspects. The results of aesthetical survey shows that there are many places of that importance along the vicinity of the basin namely Harsul Lake, Himayat Baug, Bibi-ka-Maqbara, Panchakki, Makai Gate, Barapulla Gate, Mehmood Gate and Siddarth garden. The Battelle environmental evaluation system result shows a negative impact of – 375 units and the conceptual strategies for the restoration of Kham River are also recommended.
If we can't get to theatre, we can't learn to operate
Authors: James HK , Fisher JD , Griffin DR , Pattison GTR
Published: January 2021

This is a qualitative research study using in-depth, semi-structured interviews with CT1–ST3 trainees in trauma & orthopaedics (T&O) to characterise the factors that affect core surgical trainees’ access to the operating theatre for training.

There were significant reported difficulties in accessing the operating theatre among core surgical T&O trainees in our study sample. The considerable service provision demands of the administrative and routine daily ward work, much of which offers negligible educational value in this group of trainees, is in direct conflict with the need to gain operative experience to meet the learning objectives of the curriculum. These results merit attention as the consequence of being unable to access the appropriate training environment threatens preparedness for registrar practice at ST3, and may serve to exacerbate the known morale issues, career dissatisfaction and burnout in this group.
Impact of COVID-19 on UK orthopaedic training
Authors: Bodansky D , Thornton L , Sargazi N , Philpott M , Davies R , Banks J
Published: January 2021

Introduction

Drastic restructuring of the UK’s National Health Service was undertaken in response to the COVID-19 pandemic with alterations to service delivery introduced from March 2020. This has affected surgical training programmes. This study quantifies the impact of the pandemic on postgraduate orthopaedic training.

Methods

A prospective study was undertaken between 16 March and 3 May 2020 to capture alterations to training activity. Data were collected regionally by all trauma and orthopaedic specialty registrars in the West sector of the North West School of Surgery using a live online proforma.

Results

A total of 1,018 entries were analysed from 10 hospitals with a median of 21 entries per trainee (interquartile range: 17.5–26). Overall, 382 elective and 169 trauma lists were cancelled during the study period in addition to 155 elective and 132 fracture clinics. Seven trainees self-isolated during this period, losing 39 sessions. All nine candidates who were due to sit their FRCS exit examinations had them cancelled. Trainees were redeployed to other specialties in 231 entries (22.7%), with altered duties undertaken in intensive care (24.4%), accident and emergency (25.1%), and general medicine (50.3%). Trainees had no assigned alternative duties in 192 sessions (18.9%), and provided 90 extra fracture clinics and 70 extra trauma lists. Teaching and administration were logged for the remaining eight entries.

Conclusions

The COVID-19 pandemic has resulted in an overall 43% reduction in training opportunities, which must be addressed in order for trainees to achieve their Certificate of Completion of Training competences.
Think before you cut! Is surgery about ‘doing’ or about ‘thinking’?
Authors: Grounds R
Published: January 2021

Is surgery about ‘doing’ or about ‘thinking’? The question is pertinent, because only if we know what we are trying to achieve can we hope to use the right educational method to reach our goal!

It could be argued that surgery is an inextricable combination of doing, thinking and interacting with others. Educational theory teaches us that there are three main models of teaching: behaviourism (learning by ‘doing’), cognitivism (learning by ‘thinking’) or social constructivism (learning by ‘interacting’). Furthermore, most education systems advocate the models to be used in that order, with behaviourist techniques for the novice and constructivism reserved for the expert. Yet on reflection, today's medical students start their learning in a lecture theatre, spend core training years revising for exams and only the last few years of training actually ‘doing’ surgery – quite the opposite of what educational theory mandates.

If the expert surgeon ‘does’ while the novice only ‘knows’, then is it not time to start teaching in reverse? Rather than surgical training beginning with a period of ‘thinking’ in isolation, an integrated curriculum incorporating ‘doing’ from the outset should allow trainee surgeons to reach their goal of ‘doing’ more efficiently and effectively.
Clinical excellence and the dental school mission
Authors: Thomson Peter
Published: January 2021

Delivering clinical excellence is fundamental to the success of a 21st century dental school's mission and yet, our ability to define clinical excellence in practice remains surprisingly elusive. In this paper, Peter Thomson explores the complex and multi-faceted nature of clinical excellence, confirming its pivotal role throughout knowledge creation, teaching, training, lifelong education and clinical practice. Ultimately, our ability to deliver optimal patient care, manage new and emergent disease and enhance prevention and health promotion for the future require dental education and clinical service to be better aligned and more fully integrated with general healthcare provision for all.
Remote delivery of FDS examinations
Authors: Landau Alex , Voerman Kim , Cobourne Martyn
Published: January 2021

The challenge of COVID-19 meant that there was an imperative to provide an alternative to face-to-face delivery for those trainees who required examination in autumn 2020 to progress within, or exit from specialty training programmes. Written examinations were most easily adaptable to online delivery, with established platforms readily available for this purpose. The key consideration related to invigilation of candidates in a remote context. Candidates were invigilated through a combination of their webcams and mobile phones, to ensure that any potentially aberrant behaviour was identifiable. Oral elements proved to be more complicated to implement remotely. As a consequence, it was necessary for Examinations Directorate staff to explore ways of accommodating the oral assessment delivery requirements within existing videoconferencing software used by the College. The experience of remote delivery appears to have been a very positive one, for both candidates and examiners, due in part to the significant training provided for both groups prior to each examination to ensure effective delivery. Attention is now turning to the question of future delivery of examinations; some recent initiatives, such as the online delivery of written examinations, appear to be appropriate for retention in perpetuity. A final consideration is the impact of remote examination delivery on assessment of international candidate cohorts. Remote delivery appears to be the most efficient and sustainable mode of overseas examination delivery, and ensures that prestigious College qualifications become more accessible than ever to those overseas.
Dental x-roads
Authors: Knott Nigel
Published: January 2021

Various Governments have grappled over the years with the burgeoning economic cost of dentistry without ever providing a long-term solution. The mouth and its dental contents are a vital part of the human body and should be an integral part of any free NHS offering. A preventive dental plan for children should be a guaranteed ingredient.
Comparison of implant provision at the Birmingham Dental Hospital with national guidelines
Authors: Mylonas Petros , Shahzad Bisma , Ahmed Bilal
Published: January 2021

Implant provision is provided for certain patient groups under NHS regulations. As a regional teaching and training centre, we share the findings from our implant provision audit with the wider dental community so that other centres can also consider how their own provision varies from national policy.
January 2021 Critical Care Case of the Month: A 35-Year-Old Man Found Down on the Street
Authors:   University of Arizona, Tucson, AZ USA, Lee John , Obrand Ling , Campion Janet
Published: January 2021

No abstract available. Article truncated after 150 words. History of Present Illness A 35-year-old African-American man with a history of alcohol abuse presented to Emergency Department after he was found down. He was seen by a passerby on the street who witnessed the patient fall with a possible convulsive event. He was brought in by ambulance and was unconscious and unresponsive. PMH, SH, and FH The patient had a history of prior ICU admission in Yuma with septic shock secondary to a dental procedure requiring a tracheostomy in 2018. He also had a history of alcohol intoxication requiring an ED visit about 10 years ago and history of sickle cell trait. Per chart review, the patient took no home medications. Further history was unable to be obtained due to the patient's condition. Physical Examination On arrival the patient had a core temperature of 41°C, systolic blood pressure in the 70s-80s, heart rate of 185, respiratory rate of 19 …
Tear hypoxia-inducible factor-1α expression, lactate dehydrogenase, and malate dehydrogenase activity changes in soft contact lens wear
Authors: Rahayu Tri , Gondhowiardjo Tjahjono Darminto , Artini Widya , Wanandi Septelia Inawati
Published: January 2021

BACKGROUND Soft contact lens (SCL) wear can lead to a corneal hypoxia. However, there is a lack of studies looking for corneal hypoxia biomarkers in tear. This study aimed to investigate corneal hypoxia among SCL wearers based on hypoxia-inducible factor-1α (HIF-1α) expression, tear lactate dehydrogenase (LDH), and malate dehydrogenase (MDH) activities. METHODS A nonrandomized clinical trial was conducted on two groups. SCLs were prescribed for 2 months to a group of new wearers. Meanwhile, SCL wear was discontinued for 1 month in a group of long-term wearers. Tear samples were then collected on days 1, 7, 14, 28, and 56 after treatment. Repeated-measures analysis of variance and Friedman’s test with post-hoc statistical analysis were used to evaluate biomolecular changes (HIF-1α concentration, LDH, and MDH activities) in both groups. RESULTS A total of 14 subjects (28 eyes) were enrolled in each group. In new wearers, there was a significant decrease in MDH level (p = 0.010) and no effect on HIF-1α level. In long-term wearers, HIF-1α and LDH levels tended to decrease (p = 0.054). A significant decrease on MDH level was noted on days 7 (p = 0.003), 14 (p = 0.026), and 28 (p<0.010). Long-term wearers had a higher LDH baseline level than new wearers (p = 0.04). CONCLUSIONS Corneal hypoxia was not proven after 2 months of SCL wear using biomarkers. However, LDH and MDH activities in tears were found to be decline after SCL discontinuation.
Association between SOX2 and OCT4 expression and the chemoradiation therapeutic response in undifferentiated non-keratinizing nasopharyngeal carcinoma
Authors: Rachmadi Lisnawati , Kusmardi  , Miranda Monik Ediana , Vianney Maria Mayella
Published: January 2021

BACKGROUND Self-renewal ability of cancer stem cells (CSS) is one of the possible causes for nasopharyngeal carcinoma (NPC) to relapse and metastasize. SOX2 and OCT4 are markers for expression of the embryonic stem cells and crucial for the progression of various malignancies. This study was aimed to analyze the association between SOX2 and OCT4 expression and chemoradiation therapeutic response in undifferentiated non-keratinizing NPC.

METHODS This cross-sectional study used archival data from Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital from January 2014 to December 2016. The outcomes were classified into good-response (complete and partial response) and poor-response groups (progressive and stable disease) based on response evaluation criteria in solid tumors (RECIST). SOX2 and OCT4 immunohistochemistry staining was performed using the initial specimen (before chemoradiation therapy) and positively expressing tumor cells were counted. Staining intensity was graded as: strong, moderate, weak, and negative. Strong and moderate staining was considered positive expression.

RESULTS 33 males and 8 females were included; 48% were ≥50 years old. Most of the patients had stage IV (n = 35) and several patients had stage II (n = 3) and III (n = 3). More cells expressed OCT4 in the good-response group than the poor-response group (61.3% versus 37.0%, p = 0.009). Meanwhile, there were less cells expressing SOX2 in the good-response group than the poor-response group (36.3% versus 61.1%, p = 0.097).

CONCLUSIONS This study suggests that OCT4 is a potential predictive marker for therapeutic response in patients with NPC.
The impact of sleep quality and duration on leptin, appetite, and obesity indices in adults
Authors: Muhammad Harry Freitag Luglio , Pratama Satwika Arya , Sulistyoningrum Dian Caturini , Hartono Maya Nurfitriani , Huriyati Emy , Lee Yi Yi , Muda Wan Abdul Manan Wan
Published: January 2021

BACKGROUND Poor sleep duration and quality were previously reported to increase the risk of obesity. This study was aimed to evaluate the impact of sleep quality and duration on leptin, appetite, and adiposity in Indonesian adults.

METHODS This cross-sectional study recruited adults in Yogyakarta, Indonesia, in 2016. Sleep quality was assessed using the Pittsburgh sleep quality index, appetite was evaluated using the community nutrition appetite questionnaire, and dietary intake was assessed by interviews using the semi-quantitative food frequency questionnaire. Sleep duration was also asked. Obesity indices were measured using the body mass index (BMI), waist-hip circumference, and percentage of body fat. Leptin was analyzed using the enzyme-linked immunosorbent assay. A Spearman analysis was done to evaluate the correlation between sleep quality, sleep duration, anthropometric measures, dietary intake, appetite, and leptin.

RESULTS 244 adults participated in this study. This study showed that lower sleep quality and duration was significantly correlated with higher body weight (r = 0.129, p = 0.043 and r = −0.228, p<0.001), BMI (r = 0.176, p = 0.006 and r = −0.202, p = 0.001), and waist circumference (r = 0.179, p = 0.005 and r = −0.254, p<0.001). There was a correlation between poor sleep quality and higher leptin concentration (r = 0.186, p = 0.004). Sleep quality and duration were not associated with appetite (r = 0.109, p = 0.109 and r = −0.043, p = 0.500).

CONCLUSIONS This study found that lower sleep quality was correlated with higher BMI, higher leptin concentration, but not appetite.
Retinal vascular caliber changes after laser photocoagulation in diabetic retinopathy
Authors: Muhiddin Habibah Setyawati , Panggalo Idayani , Ichsan Andi Muhammad , Budu  , Trucco Emanuele , Ellis John
Published: January 2021

BACKGROUND Diabetic retinopathy causes vascular dilatation caused by hypoxia, whereas oxygen tension improvement leads to retinal vessels narrowing. Given that laser photocoagulation aims to increase the oxygen tension in the retina, we hypothesized that the narrowing of vessel caliber after the treatment could be possibly demonstrated. This study aimed to assess the changes in the caliber of retinal vessels before and after laser photocoagulation in diabetic retinopathy. METHODS This research was a prospective cohort study on the treatment of diabetic retinopathy by laser photocoagulation, and it was conducted at Universitas Hasanuddin Hospital, Makassar, Indonesia between November 2017–April 2018. Retinal vascular caliber changes were analyzed before and 6–8 weeks after photocoagulation in 30 diabetic eyes. Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were measured using the vessel assessment and measurement platform software for images of the retina (VAMPIRE) manual annotation tool. RESULTS A significant decrease of CRVE was observed after laser photocoagulation (p<0.001), but CRAE was not reduced significantly (p = 0.067). No difference was recorded between CRVE and CRAE post-laser photocoagulation (p = 0.14), implying a reduction in vein caliber toward normal in the treated eyes. CONCLUSIONS Laser photocoagulation decreases the CRVE in diabetic retinopathy despite the absence of changes in the grade of diabetic retinopathy.
Comparison of a set of cognitive ability screening test for primary school-aged children in Indonesia
Authors: Togas Meitha , Gunardi Hartono , Sekartini Rini , Pudjiati Sri Redatin Retno , Hogervorst Eef
Published: January 2021

BACKGROUND Monitoring children’s intellectual development is important to align their educational needs. This study compared nonverbal intelligence subtest of the cognitive test battery for Individuals with or without intellectual disability (CIID) to measure visual logical reasoning, verbal intelligence subtest (verbal fluency [VF]–animal test) to assess vocabulary and semantic memory, and the modified Indonesian version of Hopkins verbal learning test (IHVLT) to assess learning ability and episodic memory, against the Wechsler intelligence scale for children (WISC) as an alternative cognitive screening tool in school-aged children.

METHODS A cross-sectional study was conducted in 145 grade 1–6 elementary school students in Jakarta between March and May 2017. Performance on the CIID subtest, VF, and modified IHVLT was assessed by a pediatrician, and the WISC test was performed by a psychologist. The associations between variables were evaluated using nonparametric Spearman’s rank correlations, regressions, and box plots.

RESULTS The correlation between total intelligence quotient (IQ) WISC and CIID was 0.42 (p<0.001) and 0.34 (p<0.001) for both IHVLT and VF. Box plots suggested possible discriminative capacity of CIID but insufficient specificity. However, CIID was associated with stunting (height) and health (weight) independent of age, sex, father’s education, or income.

CONCLUSIONS The CIID subtest series, VF, and modified IHVLT correlated with total IQ WISC. However, CIID may be better to test predictors of poor cognitive performance in primary school-aged children than an IQ screening test.
Amniotic membrane transplantation for infectious corneal ulcer treatment: a cohort retrospective study
Authors: Casalita Vega , Nora Rina La Distia , Edwar Lukman , Susiyanti Made , Sitompul Ratna
Published: January 2021

BACKGROUND Corneal ulcer is one of the most common causes of corneal blindness. This study aimed to describe the outcomes of amniotic membrane transplantation (AMT) in patients with infectious corneal ulcer.
METHODS A retrospective cohort study based on medical records of patients who underwent an adjuvant AMT procedure over a 2-year period (2015–2017) was conducted at Cipto Mangunkusumo Hospital Jakarta. Uncorrected visual acuity (UCVA) was measured with the Snellen chart. Treatment success was marked by complete healing (disappearance of corneal infiltrates, epithelial defect closure, and corneal scar formation). Healing time was the duration from AMT surgery to complete healing.
RESULTS 50 cases of infectious corneal ulcer, 12 of which had perforation were included. Gram-positive cocci (18%), gram-negative rods (14%), fungi (4%), and Acanthamoeba (2%) were isolated from culture specimens. Successful results were observed in 90% of cases (20/21 moderate cases and 25/29 severe cases). Healing time was 21 (14–63) days in moderate cases and 28 (14–90) days in severe cases. Baseline UCVA improved from 2.48 (0.22–2.80) logMAR to 1.30 (0–2.80) logMAR within 3–4 weeks postoperatively and to 0.94 (0–2.80) logMAR at the last follow-up. Post-AMT complications included recurrent perforation in 4 eyes, persistent epithelial defects in 2 eyes, amniotic membrane infection in 1 eye, and membrane retraction in 1 eye.
CONCLUSIONS AMT was successfully used to treat moderate and severe infectious corneal ulcer, particularly in nonresponsive and some perforated cases. AMT provides biochemical and mechanical support for corneal wound healing with good visual outcomes.
Self-medication among health care workers in a tertiary hospital in Southern Nigeria: knowledge, attitude, and practices
Authors: Tobin Ekaete Alice , Erhazele Jovita , Okonofua Martha , Nnadi Chinelo , Nmema Eucharia Ezenwanyi , Odigie George
Published: January 2021

BACKGROUND Self-medication is linked to the inappropriate and irrational use of medicines. This study aimed to determine the knowledge, attitude, and practice of self-medication among health care workers (HCWs) in a tertiary hospital in Southern Nigeria.

METHODS In a cross-sectional study carried out between June 2018 and December 2018 at Irrua Specialist Teaching Hospital, Edo State, 206 consenting HCWs were interviewed using validated questionnaires on their knowledge (assessed as good, fair, and poor), attitude (positive and negative), and practice of self-medication. Data analysis was performed using SPSS version 21 (IBM Corp., USA). Bivariate analysis was carried out using chi-square. Statistical significance was set as p<0.05.

RESULTS Prevalence of self-medication in the last 4 months was 89.3%, and significantly decreased with increasing age (p = 0.04) and holding a positive attitude toward self-medication (p<0.01). Knowledge of self-medication was fair for the majority 111 (53.9%). Most of the medications were used for headache (92.4%), fever (81.5%), diarrhea (75.0%), and respiratory infections (61.4%). Common drugs self-medicated included antimalarials (91.3%), analgesics (81.0%), and antibiotics (71.2%). 39 subjects (21.2%) self-medicated with tranquilizers. Familiarity with the treatment options was the main reason for self-medication for 60.9% of the respondents.

CONCLUSIONS Self-medication was prevalent among HCWs in the study area. Concerted efforts are needed to educate HCWs on responsible self-medication. On a broader scale, restrictions should be enforced on the sale of prescription drugs, such as antibiotics and sleeping pills, and drug dispensers should provide effective counseling before dispensing.
Optical properties of a waveguide-mediated chain of randomly positioned atoms
Authors: Song Guo-Zhu , Guo Jin-Liang , Nie Wei , Kwek Leong-Chuan , Long Gui-Lu
Published: January 2021

We theoretically study the optical properties of an ensemble of two-level atoms coupled to a one-dimensional waveguide. In our model, the atoms are randomly located in the lattice sites along the one-dimensional waveguide. The results reveal that the optical transport properties of the atomic ensemble are influenced by the lattice constant and the filling factor of the lattice sites. We also focus on the atomic mirror configuration and quantify the effect of the inhomogeneous broadening in atomic resonant transition on the scattering spectrum. Furthermore, we find that initial bunching and persistent quantum beats appear in photon-photon correlation function of the transmitted field, which are significantly changed by the filling factor of the lattice sites. With great progress to interface quantum emitters with nanophotonics, our results should be experimentally realizable in the near future.
Rabi resonance in coherent population trapping: microwave mixing scheme
Authors: Liu Xiaochi , Lv Ya-Nan , Kang Songbai , Zou Chang-Lin , Duan Junyi , Ru Ning , Qu Jifeng
Published: January 2021

Coherent population trapping (CPT) resonance signals have promise in a wide range of applications involving precision sensing. Generally, the CPT phenomenon occurs in a three-level Λ system with a bichromatic phase-coherent light fields. We theoretically and experimentally studied an Rb vapor-cell-based atomic system involving bichromatic CPT optical fields and an external microwave (MW) field simultaneously. In such a mixing scheme, the coherence of the ground states could be controlled either by the Rabi frequency of the microwave field or by the relative phase between the optical fields and the MW field. Moreover, we investigated the Rabi resonance in this mixing scheme. The Rabi frequency of the MW field can be measured SI (International System of Units)-traceably based on the Rabi resonance lineshape, and thus holds the potential to realize intensity stabilization of the optical field in this system. Simple theoretical models and numerical calculations are also presented to explain the experimental results. There is scope to use the proposed technique in future development of SI-traceable optical field strength standards.
Optical amplification from high vibrational states of ionized nitrogen molecules generated by 800-nm femtosecond laser pulses
Authors: Miao Zhiming , Zheng Wei , Wang Yang , Dai Chen , Li Zheng , Wu Chengyin
Published: January 2021

We experimentally investigated the interaction between nitrogen molecules and intense femtosecond laser pulses. When irradiated by an 800-nm pump laser and a delayed 355-nm seed laser, the spectral lines around 353.3 nm and 353.8 nm are observed to be greatly amplified, no matter whether the pump laser is circularly or linearly polarized. The two spectral lines correspond to the transition of N2+ (B, ν’ = 5 → X, ν = 4) and N2+ (B, ν’ = 4 → X, ν = 3), respectively. In comparison with the spectral lines related with ground vibrational states of nitrogen molecular ion, the observed amplification exhibits different polarization dependence of the pump laser. This distinctive change can be explained by the population variation of high vibrational states caused by the pump laser with different polarizations.