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IJMS, Vol. 20, Pages 1504: Unique Regulation of Enterocyte Brush Border Membrane Na-Glutamine and Na-Alanine Co-Transport by Peroxynitrite during Chronic Intestinal Inflammation

IJMS, Vol. 20, Pages 1504: Unique Regulation of Enterocyte Brush Border Membrane Na-Glutamine and Na-Alanine Co-Transport by Peroxynitrite during Chronic Intestinal Inflammation International Journal of Molecular Sciences doi: 10.3390/ijms20061504 Authors: Subha Arthur Palanikumar Manoharan Shanmuga Sundaram M Motiur Rahman Balasubramanian Palaniappan Uma Sundaram Na-amino acid co-transporters (NaAAcT) are uniquely affected in rabbit intestinal villus cell brush border...

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Molecules, Vol. 24, Pages 1180: Oligonucleotide–Palladacycle Conjugates as Splice-Correcting Agents

Molecules, Vol. 24, Pages 1180: Oligonucleotide–Palladacycle Conjugates as Splice-Correcting Agents Molecules doi: 10.3390/molecules24061180 Authors: Madhuri Hande Osama Saher Karin E. Lundin C. I. Edvard Smith Rula Zain Tuomas Lönnberg 2’-O-Methylribo phosphorothioate oligonucleotides incorporating cyclopalladated benzylamine conjugate groups at their 5’-termini have been prepared and their ability to hybridize with a designated target sequence was...

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Sensors, Vol. 19, Pages 1466: How to Efficiently Determine the Range Precision of 3D Terrestrial Laser Scanners

Sensors, Vol. 19, Pages 1466: How to Efficiently Determine the Range Precision of 3D Terrestrial Laser Scanners Sensors doi: 10.3390/s19061466 Authors: Berit Schmitz Christoph Holst Tomislav Medic Derek D. Lichti Heiner Kuhlmann As laser scanning technology has improved a lot in recent years, terrestrial laser scanners (TLS) have become popular devices for surveying tasks with high accuracy demands, such as deformation analyses. For this reason, finding a stochastic model...

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Energies, Vol. 12, Pages 1167: Impedance Estimation with an Enhanced Particle Swarm Optimization for Low-Voltage Distribution Networks

Energies, Vol. 12, Pages 1167: Impedance Estimation with an Enhanced Particle Swarm Optimization for Low-Voltage Distribution Networks Energies doi: 10.3390/en12061167 Authors: Daisuke Kodaira Jingyeong Park Sung Yeol Kim Soohee Han Sekyung Han Many researchers in recent years have studied voltage deviation issues in distribution networks. Characterizing the impedance between consuming nodes in a network is the key to controlling the network voltage. Existing impedance estimation...

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Remote Sensing, Vol. 11, Pages 721: UAV RTK/PPK Method—An Optimal Solution for Mapping Inaccessible Forested Areas?

Remote Sensing, Vol. 11, Pages 721: UAV RTK/PPK Method—An Optimal Solution for Mapping Inaccessible Forested Areas? Remote Sensing doi: 10.3390/rs11060721 Authors: Julián Tomaštík Martin Mokroš Peter Surový Alžbeta Grznárová Ján Merganič Mapping hard-to-access and hazardous parts of forests by terrestrial surveying methods is a challenging task. Remote sensing techniques can provide an alternative solution to such cases. Unmanned aerial vehicles (UAVs) can provide on-demand...

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Econometrics, Vol. 7, Pages 16: Monte Carlo Inference on Two-Sided Matching Models

Econometrics, Vol. 7, Pages 16: Monte Carlo Inference on Two-Sided Matching Models Econometrics doi: 10.3390/econometrics7010016 Authors: Taehoon Kim Jacob Schwartz Kyungchul Song Yoon-Jae Whang This paper considers two-sided matching models with nontransferable utilities, with one side having homogeneous preferences over the other side. When one observes only one or several large matchings, despite the large number of agents involved, asymptotic inference is difficult because...

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IJMS, Vol. 20, Pages 1502: Levan-Capped Silver Nanoparticles for Bactericidal Formulations: Release and Activity Modelling

IJMS, Vol. 20, Pages 1502: Levan-Capped Silver Nanoparticles for Bactericidal Formulations: Release and Activity Modelling International Journal of Molecular Sciences doi: 10.3390/ijms20061502 Authors: Álvaro González-Garcinuño Rubén Masa María Hernández Ángel Domínguez Antonio Tabernero Eva Martín del Valle An environmentally friendly technique was used to produce levan-capped silver nanoparticles of about 30 nm (with a loading of 30%) that showed bactericide effect,...

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Viruses, Vol. 11, Pages 300: Innovation in Newcastle Disease Virus Vectored Avian Influenza Vaccines

Viruses, Vol. 11, Pages 300: Innovation in Newcastle Disease Virus Vectored Avian Influenza Vaccines Viruses doi: 10.3390/v11030300 Authors: Shin-Hee Kim Siba K. Samal Highly pathogenic avian influenza (HPAI) and Newcastle disease are economically important avian diseases worldwide. Effective vaccination is critical to control these diseases in poultry. Live attenuated Newcastle disease virus (NDV) vectored vaccines have been developed for bivalent vaccination against HPAI viruses...

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Sustainability, Vol. 11, Pages 1812: Using RISKPLAN for Earthquake Risk Assessment in Sichuan Province, China

Sustainability, Vol. 11, Pages 1812: Using RISKPLAN for Earthquake Risk Assessment in Sichuan Province, China Sustainability doi: 10.3390/su11061812 Authors: Yan Shi Klaus Seeland Sichuan Province of China is a prominent population and economic growth center as well as an earthquake-stricken region. A sound understanding of the seismic risk that Sichuan Province is facing is useful to raise risk awareness, achieve disaster risk reduction (DRR), and guarantee sustainable socio-economic...

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Polymers, Vol. 11, Pages 564: Oxidative Depolymerization of Cellulolytic Enzyme Lignin over Silicotungvanadium Polyoxometalates

Polymers, Vol. 11, Pages 564: Oxidative Depolymerization of Cellulolytic Enzyme Lignin over Silicotungvanadium Polyoxometalates Polymers doi: 10.3390/polym11030564 Authors: Wenbiao Xu Xiangyu Li Junyou Shi The aim of this study was to explore the catalytic performance of the oxidative depolymerization of enzymatic hydrolysis lignin from cellulosic ethanol fermentation residue by different vanadium substituted Keggin-type polyoxometalates (K5[SiVW11O40], K6[SiV2W10O40], and K6H[SiV3W9O40])....

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Energies, Vol. 12, Pages 1165: A Class-E Amplifier for a Loosely Coupled Inductive Power Transfer System with Multiple Receivers

Energies, Vol. 12, Pages 1165: A Class-E Amplifier for a Loosely Coupled Inductive Power Transfer System with Multiple Receivers Energies doi: 10.3390/en12061165 Authors: Alexander Sutor Martin Heining Rainer Buchholz We present a method for optimizing the electronic power system for a new type of photobioreactor or photoreactor in general. In the case of photobioreactors, photosynthetic active microorganisms or cells are grown. A novel concept for the illumination of photobioreactors...

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Sensors, Vol. 19, Pages 1467: A Trust-Based Predictive Model for Mobile Ad Hoc Network in Internet of Things

Sensors, Vol. 19, Pages 1467: A Trust-Based Predictive Model for Mobile Ad Hoc Network in Internet of Things Sensors doi: 10.3390/s19061467 Authors: Waleed Alnumay Uttam Ghosh Pushpita Chatterjee The Internet of things (IoT) is a heterogeneous network of different types of wireless networks such as wireless sensor networks (WSNs), ZigBee, Wi-Fi, mobile ad hoc networks (MANETs), and RFID. To make IoT a reality for smart environment, more attractive to end users, and economically...

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Polymers, Vol. 11, Pages 563: A Quinacridone-Diphenylquinoxaline-Based Copolymer for Organic Field-Effect Transistors

Polymers, Vol. 11, Pages 563: A Quinacridone-Diphenylquinoxaline-Based Copolymer for Organic Field-Effect Transistors Polymers doi: 10.3390/polym11030563 Authors: Yong Jin Jeong Jeong Hyun Oh Ho Jun Song Tae Kyu An In this work, we characterized poly(quinacridone-diphenylquinoxaline) (PQCTQx). PQCTQx was synthesized by a Suzuki coupling reaction and the synthesized PQCTQx was used as a polymeric semiconducting material in organic field-effect transistors (OFETs) to research...

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Remote Sensing, Vol. 11, Pages 722: Analyzing the Uncertainty of Estimating Forest Aboveground Biomass Using Optical Imagery and Spaceborne LiDAR

Remote Sensing, Vol. 11, Pages 722: Analyzing the Uncertainty of Estimating Forest Aboveground Biomass Using Optical Imagery and Spaceborne LiDAR Remote Sensing doi: 10.3390/rs11060722 Authors: Xiaofang Sun Guicai Li Meng Wang Zemeng Fan Accurate estimation of forest aboveground biomass (AGB) is important for carbon accounting. Forest AGB estimation has been conducted with a variety of data sources and prediction methods, but many uncertainties still exist. In this study, six...

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Energies, Vol. 12, Pages 1164: Data-Driven Decentralized Algorithm for Wind Farm Control with Population-Games Assistance

Energies, Vol. 12, Pages 1164: Data-Driven Decentralized Algorithm for Wind Farm Control with Population-Games Assistance Energies doi: 10.3390/en12061164 Authors: Julian Barreiro-Gomez Carlos Ocampo-Martinez Fernando D. Bianchi Nicanor Quijano In wind farms, the interaction between turbines that operate close by experience some problems in terms of their power generation. Wakes caused by upstream turbines are mainly responsible of these interactions, and the phenomena involved...

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IJMS, Vol. 20, Pages 1501: Metabolic Inhibition Induces Transient Increase of L-type Ca2+ Current in Human and Rat Cardiac Myocytes

IJMS, Vol. 20, Pages 1501: Metabolic Inhibition Induces Transient Increase of L-type Ca2+ Current in Human and Rat Cardiac Myocytes International Journal of Molecular Sciences doi: 10.3390/ijms20061501 Authors: Rimantas Treinys Giedrius Kanaporis Rodolphe Fischmeister Jonas Jurevičius Metabolic inhibition is a common condition observed during ischemic heart disease and heart failure. It is usually accompanied by a reduction in L-type Ca2+ channel (LTCC) activity. In this study,...

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Micromachines, Vol. 10, Pages 210: Design and Analysis of a Turning Dynamometer Embedded in Thin-Film Sensor

Micromachines, Vol. 10, Pages 210: Design and Analysis of a Turning Dynamometer Embedded in Thin-Film Sensor Micromachines doi: 10.3390/mi10030210 Authors: Yuntao Zhang Wenge Wu Yanwen Han Haijun Wen Yunping Cheng Lijuan Liu This paper proposes a high-strain sensitivity turning dynamometer that combines several thin-film resistor grids into three Wheatstone full-bridge circuits that can measure triaxial cutting forces. This dynamometer can replace different cutter heads...

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IJMS, Vol. 20, Pages 1503: Role of SIRT-3, p-mTOR and HIF-1α in Hepatocellular Carcinoma Patients Affected by Metabolic Dysfunctions and in Chronic Treatment with Metformin

IJMS, Vol. 20, Pages 1503: Role of SIRT-3, p-mTOR and HIF-1α in Hepatocellular Carcinoma Patients Affected by Metabolic Dysfunctions and in Chronic Treatment with Metformin International Journal of Molecular Sciences doi: 10.3390/ijms20061503 Authors: Serena De Matteis Emanuela Scarpi Anna Maria Granato Umberto Vespasiani-Gentilucci Giuliano La Barba Francesco Giuseppe Foschi Erika Bandini Martina Ghetti Giorgia Marisi Paola Cravero Laura Gramantieri Alessandro...

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IJERPH, Vol. 16, Pages 1074: New Health Care Reform and Impoverishment among Chronic Households in China: A Random-Intercept Approach

IJERPH, Vol. 16, Pages 1074: New Health Care Reform and Impoverishment among Chronic Households in China: A Random-Intercept Approach International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16061074 Authors: Yongjian Xu Anupam Garrib Zhongliang Zhou Duolao Wang Jianmin Gao Xiaowei Yang Xiaojing Fan Gang Chen High out-of-pocket (OOP) payments for chronic disease care often contribute directly to household poverty. Although previous studies...

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Materials, Vol. 12, Pages 990: Thermal, Mechanical, Viscoelastic and Morphological Properties of Poly(lactic acid) based Biocomposites with Potato Pulp Powder Treated with Waxes

Materials, Vol. 12, Pages 990: Thermal, Mechanical, Viscoelastic and Morphological Properties of Poly(lactic acid) based Biocomposites with Potato Pulp Powder Treated with Waxes Materials doi: 10.3390/ma12060990 Authors: Maria Cristina Righetti Patrizia Cinelli Norma Mallegni Carlo Andrea Massa Laura Aliotta Andrea Lazzeri The thermal, mechanical and viscoelastic properties of biocomposites of poly(lactic acid) (PLA) with 20 wt.% of potato pulp powder were investigated....

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Electronics, Vol. 8, Pages 365: Analysis and Experimental Test of Electrical Characteristics on Bonding Wire

Electronics, Vol. 8, Pages 365: Analysis and Experimental Test of Electrical Characteristics on Bonding Wire Electronics doi: 10.3390/electronics8030365 Authors: Wenchao Tian Hao Cui Wenbo Yu In this paper, electrical characteristic analysis and corresponding experimental tests on gold bonding wire are presented. Firstly, according to EIA (Electronic Industries Association)/JEDEC97 standards, this paper establishes the electromagnetic structure model of gold bonding wire. The parameters,...

MDPI Publishing

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Sustainability, Vol. 11, Pages 1808: Spatial Justice of a Chinese Metropolis: A Perspective on Housing Price-to-Income Ratios in Nanjing, China

Sustainability, Vol. 11, Pages 1808: Spatial Justice of a Chinese Metropolis: A Perspective on Housing Price-to-Income Ratios in Nanjing, China Sustainability doi: 10.3390/su11061808 Authors: Shanggang Yin Zhifei Ma Weixuan Song Chunhui Liu The housing price-to-income ratio is an important index for measuring the health of real estate, as well as detecting residents’ housing affordability and regional spatial justice. This paper considers 1833 residential districts...

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Agronomy, Vol. 9, Pages 159: Resistance of Multiple Diploid and Tetraploid Perennial Ryegrass (Lolium perenne L.) Varieties to Three Projected Drought Scenarios for the UK in 2080

Agronomy, Vol. 9, Pages 159: Resistance of Multiple Diploid and Tetraploid Perennial Ryegrass (Lolium perenne L.) Varieties to Three Projected Drought Scenarios for the UK in 2080 Agronomy doi: 10.3390/agronomy9030159 Authors: Mark A. Lee Victoria Howard-Andrews Michael Chester Forage plants underpin the livestock industry. Selective breeding, including polyploidization, where genome size is increased by whole genome duplication, changes the productivity and stress tolerance of...

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Sustainability, Vol. 11, Pages 1810: Sustainable Reuse of Military Facilities with a Carbon Inventory: Kinmen, Taiwan

Sustainability, Vol. 11, Pages 1810: Sustainable Reuse of Military Facilities with a Carbon Inventory: Kinmen, Taiwan Sustainability doi: 10.3390/su11061810 Authors: Hua-Yueh Liu Military government was lifted from Kinmen in 1992. The opening-up of cross-strait relations transformed the island into a tourist destination. This transformation led to electricity and water shortages in Kinmen. With the reduction in the number of troops, military facilities fell into disuse and are now being...

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Sustainability, Vol. 11, Pages 1809: Assessment of Aesthetic Preferences in Relation to Vegetation-Created Enclosure in Chinese Urban Parks: A Case Study of Shenzhen Litchi Park

Sustainability, Vol. 11, Pages 1809: Assessment of Aesthetic Preferences in Relation to Vegetation-Created Enclosure in Chinese Urban Parks: A Case Study of Shenzhen Litchi Park Sustainability doi: 10.3390/su11061809 Authors: Mei Liu Olaf Schroth Building on the mystery/complexity/legibility/coherence model of Kaplan and Kaplan (1989) and up-to-date landscape visualization techniques, this paper presents a case study analyzing people’s aesthetic preferences for scenes with...

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Applied Sciences, Vol. 9, Pages 1257: Influence of CeO2 Addition to Ni–Cu/HZSM-5 Catalysts on Hydrodeoxygenation of Bio-Oil

Applied Sciences, Vol. 9, Pages 1257: Influence of CeO2 Addition to Ni–Cu/HZSM-5 Catalysts on Hydrodeoxygenation of Bio-Oil Applied Sciences doi: 10.3390/app9061257 Authors: Wenhe Wang Changsen Zhang Guanghui Chen Ruiqin Zhang Hydrodeoxygenation (HDO) of bio-oil is a method of bio-oil upgrading. In this paper, x%CeO2–Ni–Cu/HZSM-5 (x = 5, 15, and 20) was synthesized as an HDO catalyst by the co-impregnation method. The HDO performances of x%CeO2–Ni–Cu/HZSM-5...

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Energies, Vol. 12, Pages 1163: A Novel Approach to Stabilize Foam Using Fluorinated Surfactants

Energies, Vol. 12, Pages 1163: A Novel Approach to Stabilize Foam Using Fluorinated Surfactants Energies doi: 10.3390/en12061163 Authors: Muhammad Shahzad Kamal Selection of surfactants for enhanced oil recovery and other upstream applications is a challenging task. For enhanced oil recovery applications, a surfactant should be thermally stable, compatible with reservoir brine, and have lower adsorption on reservoir rock, have high foamability and foam stability, and should be economically...

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Sensors, Vol. 19, Pages 1464: A Posture Recognition Method Based on Indoor Positioning Technology

Sensors, Vol. 19, Pages 1464: A Posture Recognition Method Based on Indoor Positioning Technology Sensors doi: 10.3390/s19061464 Authors: Xiaoping Huang Fei Wang Jian Zhang Zelin Hu Jian Jin Posture recognition has been widely applied in fields such as physical training, environmental awareness, human-computer-interaction, surveillance system and elderly health care. The traditional methods consist of two main variations: machine vision methods and acceleration sensor methods....

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IJMS, Vol. 20, Pages 1500: Neuromuscular Plasticity in a Mouse Neurotoxic Model of Spinal Motoneuronal Loss

IJMS, Vol. 20, Pages 1500: Neuromuscular Plasticity in a Mouse Neurotoxic Model of Spinal Motoneuronal Loss International Journal of Molecular Sciences doi: 10.3390/ijms20061500 Authors: Rosario Gulino Nunzio Vicario Maria A.S. Giunta Graziana Spoto Giovanna Calabrese Michele Vecchio Massimo Gulisano Giampiero Leanza Rosalba Parenti Despite the relevant research efforts, the causes of amyotrophic lateral sclerosis (ALS) are still unknown and no effective cure...

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IJERPH, Vol. 16, Pages 1073: Comparing the Effects of Road, Railway, and Aircraft Noise on Sleep: Exposure–Response Relationships from Pooled Data of Three Laboratory Studies

IJERPH, Vol. 16, Pages 1073: Comparing the Effects of Road, Railway, and Aircraft Noise on Sleep: Exposure–Response Relationships from Pooled Data of Three Laboratory Studies International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16061073 Authors: Eva-Maria Elmenhorst Barbara Griefahn Vinzent Rolny Mathias Basner Objectives: Air, road, and railway traffic, the three major sources of traffic noise, have been reported to differently impact on annoyance....

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Sustainability, Vol. 11, Pages 1811: Testing the Influence of Purity-Based Interventions on Pro-environmental Behavior

Sustainability, Vol. 11, Pages 1811: Testing the Influence of Purity-Based Interventions on Pro-environmental Behavior Sustainability doi: 10.3390/su11061811 Authors: Sonya Sachdeva Reihane Boghrati Morteza Dehghani Environmental issues are often discussed in purity-related terms. For instance, pollution, contamination, toxicity, and degradation are all concepts that can evoke notions of (im)purity in an environmental context. In this paper, we assess the efficacy of purity-based...

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Materials, Vol. 12, Pages 989: Self-Flushing in EDM Drilling of Ti6Al4V Using Rotating Shaped Electrodes

Materials, Vol. 12, Pages 989: Self-Flushing in EDM Drilling of Ti6Al4V Using Rotating Shaped Electrodes Materials doi: 10.3390/ma12060989 Authors: Manu Goiogana Ahmed Elkaseer This article reports an experimental investigation of the efficacy of self-flushing in the Electrical Discharge Machining (EDM) process in terms of tool wear rate (TWR), hole taper angle and material removal rate (MRR). In addition to a plain cylindrical shape, electrodes of different cross sections (slotted...

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Sensors, Vol. 19, Pages 1465: Evaluating the Potential of LJ1-01 Nighttime Light Data for Modeling Socio-Economic Parameters

Sensors, Vol. 19, Pages 1465: Evaluating the Potential of LJ1-01 Nighttime Light Data for Modeling Socio-Economic Parameters Sensors doi: 10.3390/s19061465 Authors: Guo Zhang Xueyao Guo Deren Li Boyang Jiang The LJ1-01 satellite is the first dedicated nighttime light remote sensing satellite in the world and offers a higher spatial resolution than the Defense Meteorological Satellite Program’s Operational Linescan System (DMSP/OLS) and the Visible Infrared Imaging...

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IJMS, Vol. 20, Pages 1499: MicroRNA-29a Disrupts DNMT3b to Ameliorate Diet-Induced Non-Alcoholic Steatohepatitis in Mice

IJMS, Vol. 20, Pages 1499: MicroRNA-29a Disrupts DNMT3b to Ameliorate Diet-Induced Non-Alcoholic Steatohepatitis in Mice International Journal of Molecular Sciences doi: 10.3390/ijms20061499 Authors: Ya-Ling Yang Hsing-Chun Kuo Feng-Sheng Wang Ying-Hsien Huang MicroRNA-29 (miR-29) has been found to reduce liver inflammation and fibrosis following a liver injury. Meanwhile, DNA methyltransferase has been reported to participate in the development of non-alcoholic steatohepatitis...

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Crystals, Vol. 9, Pages 176: Deep Etched Gallium Nitride Waveguide for Raman Spectroscopic Applications

Crystals, Vol. 9, Pages 176: Deep Etched Gallium Nitride Waveguide for Raman Spectroscopic Applications Crystals doi: 10.3390/cryst9030176 Authors: Yu-Li Hsieh Wen-Shao Chen Liann-Be Chang Lee Chow Samuel Borges Alfons Schulte Shiang-Fu Huang Ming-Jer Jeng Chih-Jen Yu Gallium nitride (GaN) materials with a high chemical stability and biocompatibility are well suited for bio-sensing applications and evanescent wave spectroscopy. However, GaN poses challenges for...

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Applied Sciences, Vol. 9, Pages 1256: Effect of Process Parameters on the Generated Surface Roughness of Down-Facing Surfaces in Selective Laser Melting

Applied Sciences, Vol. 9, Pages 1256: Effect of Process Parameters on the Generated Surface Roughness of Down-Facing Surfaces in Selective Laser Melting Applied Sciences doi: 10.3390/app9061256 Authors: Amal Charles Ahmed Elkaseer Lore Thijs Veit Hagenmeyer Steffen Scholz Additive manufacturing provides a number of benefits in terms of infinite freedom to design complex parts and reduced lead-times while globally reducing the size of supply chains as it brings all production...

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Coatings, Vol. 9, Pages 212: Sol-Gel and Electrospinning Synthesis of Lithium Niobate-Silica Nanofibers

Coatings, Vol. 9, Pages 212: Sol-Gel and Electrospinning Synthesis of Lithium Niobate-Silica Nanofibers Coatings doi: 10.3390/coatings9030212 Authors: Jesús Alberto Garibay-Alvarado Rurik Farías Simón Yobanny Reyes-López Lithium niobate-silica fibers were produced by the combination of the sol-gel method and the electrospinning technique. Two sol-gel solutions starting from niobium-lithium ethoxide and tetraethyl orthosilicate were prepared and then mixed with polyvinylpyrrolidone;...

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IJMS, Vol. 20, Pages 1498: The Role of Tyrosine Phosphorylation of Protein Kinase C Delta in Infection and Inflammation

IJMS, Vol. 20, Pages 1498: The Role of Tyrosine Phosphorylation of Protein Kinase C Delta in Infection and Inflammation International Journal of Molecular Sciences doi: 10.3390/ijms20061498 Authors: Qingliang Yang Jordan C. Langston Yuan Tang Mohammad F. Kiani Laurie E. Kilpatrick Protein Kinase C (PKC) is a family composed of phospholipid-dependent serine/threonine kinases that are master regulators of inflammatory signaling. The activity of different PKCs is context-sensitive...

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Anesthesiology

An Updated Review on Liposome Bupivacaine

Abstract Purpose of Review In this review, we discuss the evidence for the use of liposome bupivacaine during the perioperative period when used for surgical site infiltration or as part of a peripheral/epidural nerve block. Recent Findings There is sparse high-quality evidence from randomized controlled trials that liposome bupivacaine is superior to traditional...

Latest Results for Current Anesthesiology Reports

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Inotropes and Vasoactive Agents: Differences Between Europe and the United States

Abstract Purpose of Review This review focuses on the place of vasoactive agents in the treatment of shock. We will discuss evidence and compare available guidelines and current treatment patterns between Europe and the United States (US). Recent Findings Retrospective data from large registries demonstrated a wide variability between physicians and hospitals...

Latest Results for Current Anesthesiology Reports

Mon Mar 25, 2019 02:00

Pediatric Dentistry

Incontinentia pigmenti: A case report and literature review Chaitanya Prakash Puranik, Deborah A Redford-Badwal Journal of Pediatric Dentistry 2017 5(2):29-35 Incontinentia pigmenti (IP; OMIM#308300) is a rare multisystem disorder with an incidence of 0.7:100,000 live births. IP is rare and predominantly seen in females. Mutations in IKBKG gene (Xq28, GenBank: NM_003639.3, OMIM#300248) were reported as underlying cause of IP. IKBKG encode NFkB protein, which controls the expression of other genes involved in cell proliferation, immunity, and inflammation. Oro-dental abnormalities have been documented in 50%–75% IP cases. We present a case report of a 16-year-old female with probable clinical IP, Arnold–Chiari malformation, hydrocephalus, delayed psychological development, and seizures. The IP hallmark feature: hyperpigmentation of the skin along the Blaschko's lines was present only on the left side of the body. Left-sided hemifacial and tongue hypertrophy were present, which have not been reported previously. Consistent with published reports, tooth size and shape discrepancies were present. However, unlike previous reports, discrepancies were prominent on affected versus unaffected side. This paper provides IP literature review, clinical considerations, and insight on management.

Pain perception and effectiveness of palatal approach anterior superior alveolar block anesthesia using single tooth anesthesia in children: A randomized controlled trial Sherine B Y Badr, Riad H Bacho Journal of Pediatric Dentistry 2017 5(2):36-42 Background: Restoring multiple anterior teeth in children using conventional infiltration is challenging due to the need of multiple injections, a considerable amount of anesthetic solution, and lip numbness. The palatal approach anterior superior alveolar block injection (P-ASA) using the Wand single tooth anesthesia (STA) provides an alternative and innovative technique that overcomes several challenges and should be furtherly tested. Aim: The aim of this study was to compare the pain perception and the effectiveness of P-ASA injection using STA (Milestone Scientific, Inc.) and a 30 G × 0.5 inch needle, to the regular multiple maxillary infiltration local anesthetic technique (MIT) in restoring primary anterior maxillary teeth. Design: This study was designed as a randomized controlled clinical trial in which 64 healthy children who need restoration and/or pulp treatment on primary maxillary anterior teeth were assigned to either receiving P-ASA block injection or regular (MIT). Children's behavior was assessed during anesthesia administration objectively using face, legs, activity, cry, and consolability behavioral pain assessment scale (FLACC). Children's self-reported pain was evaluated subjectively at two different time points (directly after injection of anesthesia and after full dental treatment) using the Wong–Baker FACES pain rating scale (WBFPRS). Data were statistically analyzed using SPSS version 13.0 and statistical significance was determined as P ≤ 0.05. Results: Children receiving the P-ASA reported less pain both during and after anesthesia administration (P = 0.0001). Similar results of pain were reported after treatment completion using both techniques (P = 0.464). Conclusion: P-ASA can be considered as an excellent alternative to administer deep, fast, effective, and less painful anesthesia of the upper primary anterior teeth and related gingival tissues compared to MIT.

Evaluation of pediatric oral and maxillofacial biopsies from a Tertiary Hospital in Sub-Saharan Africa Olujide Oladele Soyele, Adetayo O Aborisade, Abiodun S Olatunji, Henry Ademola Adeola Journal of Pediatric Dentistry 2017 5(2):43-49 Introduction: Despite the large number of published studies on indications for biopsy during investigation of adult oral and maxillofacial pathologies, there is a dearth of literature focusing on biopsies for pediatric orofacial pathologies (particularly in sub-Saharan Africa). Objectives: Hence, this study analysed data on maxillofacial pediatric lesions from the surgical pathology archives of the Oral Maxillofacial surgery/Oral pathology unit of Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. Method: Data was collected over a ten year period (2007-2016). Result: From a total of 790 biopsies recorded within the study period, only 105 (13.3%) were found to be pediatric cases. Lesions such as ameloblastoma (24%), benign bone pathologies (25%), hyperplastic reactive lesions (22%) and primary oro-facial malignancies (6%), were found within the 105 pediatric cases. Lesions tended to occur more in the mixed dentition to permanent dentition, than primary dentition age groups. A female preponderance in frequency of lesions was also observed in our study. The commonest non-odontogenic tumor was found to be fi brous dysplasia, while pyogenic granuloma was the most prevalent hyperplastic reactive lesions. Lymphangioma and Heck's disease were the commonest soft tissue tumours, and mucous extravasation phenomenon was equally the most frequent salivary gland lesion. Malignancies were found to be rare in pediatric age groups. Overall, we compared our findings to previously published literature on pediatric biopsies. Conclusion: We are hopeful that the knowledge provided in this study, may assist general dental practitioners, oral pathologists, and pediatric dentists in sub-Saharan Africa in making precise diagnostic and management decisions.

Dental sequelae of pediatric maxillofacial trauma Sanjay Naran, Liliana Camison, Brian Lam, Osama Basri, Lindsay Schuster, Brian Martin, Joseph E Losee Journal of Pediatric Dentistry 2017 5(2):50-53 Purpose: Our goal was to explore dental complications in the pediatric population following facial trauma and identify those at risk. Patients and Methods: We queried children with fractures of tooth-supporting regions presenting from 2000 to 2014. Data elements included demographics, treatment method, and dental outcome measures. Results: A total of 117 subjects were identified. The average age at injury was 10.41 years, and average follow-up was 2.9 years. Fractures were grouped as mandibular (62.39%), maxillary (22.22%), or combination (15.39%). Dentition at time of injury was classified as primary (17.95%), mixed (38.46%), or permanent (43.59%). Conservative management was employed in 41.88%, open reduction and internal fixation (ORIF) in 49.57%, and closed reduction and external fixation in 8.55%. The majority (67.52%) did not experience any dental trauma or sequela. Dental avulsion (10.26%), subluxation (10.26%), dysgenesis (5.13%), and development of a crossbite (5.13%), openbite (3.42%), and occlusal cant (0.85%) were observed. Avulsion was more likely in subjects requiring ORIF (P < 0.05). Development of an openbite, crossbite, or occlusal cant was more likely in subjects requiring ORIF or with combination fractures (P < 0.05). Conclusions: Fracture severity, treatment method, and dental age are all strong predictors for adverse dental complications. Treating specialists should be cognizant of the increase in risk of complication in these patients.

Neurosciences

Diet in stroke: Beyond antiplatelets and statins Joe James Journal of Neurosciences in Rural Practice 2019 10(2):173-174

Depression, suicidal ideation, and resilience among rural farmers Kabir Garg Journal of Neurosciences in Rural Practice 2019 10(2):175-175

Depression, suicidal ideation, and resilience among rural drought-affected farmers: Methodological issues Vikas Menon Journal of Neurosciences in Rural Practice 2019 10(2):176-177

Developing normative reference values for nerve conduction studies of commonly tested nerves among a sample Pakistani population Zaitoon Shivji, Anita Jabeen, Safia Awan, Sara Khan Journal of Neurosciences in Rural Practice 2019 10(2):178-184 Introduction: Most neurophysiology departments around the world establish their own normative data. However, ethnic differences are not taken into account. Our aim was to establish normal nerve conduction studies (NCS) data for routinely tested nerves in individuals of Pakistani (South Asian) origin and to compare with Western published data. Materials and Methods: One hundred healthy adults' nerves were assessed, using standardized techniques. Individuals were grouped into age groups. Gender differences were assessed. Results: Of the 100 volunteers, 49 were female and 51 were male. Their mean age was 39.8 years. Findings showed statistically significant prolongation of median distal motor latency (DML) and F-wave latency with age and reduction of median, ulnar, and sural sensory amplitudes as age increased. Gender differences showed consistent difference in the normal values for median, ulnar, and peroneal DMLs and respective F-wave latencies, which were significantly shorter in females. Sensory amplitudes of tested upper extremity nerves were significantly lower in males. Comparing with available data, our findings are similar to the Saudi population but significantly different from the American and multiethnic Malaysian populations. Pakistani individuals generally have significantly higher amplitudes and faster conduction velocities with similarities to South Asian studies. Conclusions: We recommend normative NCS parameters for commonly tested nerves for the Pakistani population, using standardized techniques to ensure highest quality testing and outcomes.

Mindbomb Homolog-1 index in the prognosis of high-grade glioma and its clinicopathological correlation Shyam Sundar Krishnan, Shanmugam Muthiah, Shilpa Rao, Suganthi Srinivasan Salem, Vasudevan Chakravarthy Madabhushi, Anita Mahadevan Journal of Neurosciences in Rural Practice 2019 10(2):185-193 Introduction: Gliomas are the most common brain tumors in adults originating from the glial cells. Glioblastoma multiforme is the most malignant and frequent among all gliomas. In recent years, the antibody Mindbomb Homolog-1 (MIB-1) has evolved as a measure of the proliferative nature of the glial tumors. This study aims to investigate the MIB-1 index value as an independent prognostic factor in high-grade gliomas and its correlation with outcome and survival. Materials and Methods: Mean MIB-1 index was determined in 51 high-grade glioma tissue samples in formalin. Its correlation with outcome by assessing the clinicoradiological parameters and median survival of patients in months were assessed. Survival analysis was studied by using the Kaplan–Meier bivariate analysis and Cox proportional ratio. Results: Preoperative Karnofsky Performance Score, WHO-PS, Neurological Performance Scale, and Mini–Mental Status Examination (MMSE) were statistically significant with respect to outcome and survival, whereas tumor factors such as size and perilesional edema were not. In particular, midline-crossing tumors and deep-seated tumors were significantly associated with high MIB-1 index and by correlation with outcome. There were significantly higher number (P < 0.0001) of patients with Grade IV tumors, with an MIB-1 index value above an arbitrary cutoff of 10% compared to Grade III tumors. In addition, median survival period of patients with low MIB-1 index was longer irrespective of tumor grade. Conclusion: Significant correlation between high-grade glioma and MIB-1 index suggests MIB-1 index to be a good prognostic tool, with MIB-1 index and midline-crossing variables being independent prognostic parameters.

Does universal bypass before carotid artery occlusion obviate the need for balloon test occlusion: Personal experience with extracranial–Intracranial bypass in 23 patients Girish Menon, Sudha Menon, Ajay Hegde Journal of Neurosciences in Rural Practice 2019 10(2):194-200 Aim: Carotid artery ligation carries a potential risk of ischemic complications even in patients with good collaterals and adequate cross-circulation. Preoperative assessment through balloon test occlusion (BTO) is technically challenging and not feasible in all patients. We analyze our experience with universal bypass without performing detailed cerebrovascular reserve (CVR) studies in 23 patients before carotid artery ligation. Patients and Methods: This was a retrospective analysis of the case records of 23 patients who underwent cervical carotid artery ligation for various indications since January 2009. Results: The study included 21 patients with cavernous carotid aneurysms, one patient with a large fusiform petrous carotid aneurysm, and one patient with recurrent glomus jugulare encasing the cervical internal carotid artery. The initial 12 patients underwent preoperative BTO with hypotensive challenge. All patients underwent a bypass procedure followed by carotid artery ligation irrespective of the BTO findings. Patients who successfully completed a BTO underwent a low-flow superficial temporal artery to middle cerebral artery bypass. A high-flow extracranial–intracranial bypass using a saphenous vein graft from external carotid artery to middle cerebral artery was done in all patients who either failed the BTO or did not undergo BTO. We had two operative mortalities and one poor outcome. All the other patients had a good recovery with a Glasgow outcome score of 5 at the last follow-up. Graft patency rates were 81.1% in both the low-flow and high-flow groups. Conclusion: Universal high-flow bypass is safe, effective, and should be preferred in all patients before carotid artery ligation. It obviates the need for detailed CVR assessment, especially in centers with limited resources.

Oral health behavior and treatment needs among drug addicts and controls in Amritsar District: A case-controlled study Preeti Chawla Arora, Komal Gurpreet Singh Ragi, Aman Arora, Ambika Gupta Journal of Neurosciences in Rural Practice 2019 10(2):201-206 Background: Substance and drug abuse is associated with severe psychosocial problems, violence and health complications. Aims: The aim of the study was to evaluate and compare the oral hygiene status and sugar eating patterns among drug addicts with their age, gender and socio-economic status matched controls. Settings and Design: The present study comprised of two groups-Group A comprised of 100 drug addicts and Group B included 100 controls. The study sample were interviewed and subjected to a comprehensive intra-oral examination. Methods and Material: Standardized methods of evaluation were performed using mouth mirror, dental probe, explorer and WHO probe. Statistical Analysis: The data was subjected to statistical analysis using Chi Square test and student t-test. Results and Conclusions: CPITN index revealed bleeding in 56% addicts and calculus in 20% addicts. The mean DMFT of group A was 5.71 as compared to 2.45 in group B. The frequency of sugar consumption was found to be high in addicts as compared to the controls. Significant P values (< 0.001) of DMFT index, periodontal status and frequency of sugar consumption were obtained on statistical analysis. The caries status was found to be poor in addicts, but the periodontal treatment needs were similar for both group A and B. Oral health promotion should be undertaken in drug rehabilitation centers for overall success of withdrawl treatment.

Pattern of emergent head computed tomography findings in a tertiary care hospital during off working hours: Retrospective analysis Rajneesh K Patel, Amit Kumar Choubey, Brijesh K Soni, Rajeev Sivasankar, Vikash Chauhan Journal of Neurosciences in Rural Practice 2019 10(2):207-211 Introduction: Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient's expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings. Materials and Methods: A retrospective analysis of all emergent noncontrast CT head during off working hours in the Department of Radiodiagnosis of a Tertiary Care Hospital, Mumbai, India, which were performed from June 2017 to May 2018. CT findings of 308 patients were analyzed. Results: About 63.6% of total head CT showed no significant abnormality. The most common abnormality was intracranial hemorrhage which was just 9.1% followed by acute infarct which was 6.2%. Extradural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage was only 1% each of total head CT findings. No significant abnormality was detected in 74.65%, 70.21%, 89.13%, 31.37%, 100%, and 69.09% in cases of head injury, seizure, giddiness/dizziness/syncope, cerebrovascular accident, transient ischemic attack, and altered sensorium, respectively. Conclusion: Pattern analysis of emergent head CT reveals that most of the emergent CT head shows no significant abnormality. There is a need for stringent guidelines for emergent head CT, training of emergency physician as well as CT technician for common findings to bridge the radiologist demand-supply gap for providing effective health care in peripheral hospitals.

Radiological parameters to predict hemorrhagic progression of traumatic contusional brain injury Lal Rehman, Ali Afzal, Hafiza Fatima Aziz, Sana Akbar, Asad Abbas, Raza Rizvi Journal of Neurosciences in Rural Practice 2019 10(2):212-217 Introduction: Traumatic intracerebral contusion is a frequent factor culminating in death and disability, and its progression relates to unfavorable outcome. We evaluated the radiological factors associated with hemorrhagic progression of contusions (HPC). Materials and Methods: Two hundred and forty-six patients were enrolled in this prospective cohort over a period of 1 year. Contusion volume was quantified using the “ABC/2” technique, whereas progression was considered as >30% increase in the initial volume. Univariate and multivariate statistics were used to examine the correlation between the risk factors of interest and HPC. Results: HPC was seen in 110 (44.7%) patients. Binary logistic regression showed in the final adjusted model that multiplicity (relative risk [RR]: 2.24, 95% confidence limit [CL]: 1.00–5.48), bilateral lesions (RR: 2.99, 95% CL: 1.08–8.25), initial volume of contusion (RR: 4.96, 95% CL: 1.87–13.13), frontal location (RR: 1.42, 95% CL: 1.08–3.56), and presence of concomitant intracranial hematoma (extradural-RR: 3.90, 95% CL: 1.51–10.01, subdural-RR: 2.91, 95% CL: 1.26–6.69, and subarachnoid-RR: 2.27, 95% CL: 1.01–5.80) were significantly associated with HPC. The overall mortality was 18.7% and was almost equal among patients with and without HPC. Mortality was significantly associated with Glasgow Coma Scale on admission (adjusted RR: 12.386, 95% CL: 4.789–32.035) and presence of comorbid conditions (adjusted RR: 0.313, 95% CL: 0.114–0.860). Conclusion: Initial computed tomography scan is a good predictor of high-risk group for HPC.

Prevalence of elder abuse and its association with psychiatric morbidity in a rural setting Aseem Mehra, Sandeep Grover, Arun Agarwal, Mohammad Bashar, Ajit Avasthi Journal of Neurosciences in Rural Practice 2019 10(2):218-224 Aim: The aim of this study was to evaluate the prevalence of elder abuse in a rural setting. In addition, the study aimed to evaluate the association of elder abuse with psychiatric morbidity and demographic factors. Methodology: A total of 125 elderly (age ≥55 years) were evaluated for psychiatric diagnosis as per the International Classification of Diseases, 10th revision (ICD-10) criteria by the qualified psychiatrist and were evaluated on Vulnerability to Abuse Screening Scale for elder abuse. Results: More than half (58.4%) of the participants had one psychiatric disorder, with depression being the most common. Elder abuse was seen in more than one-third (41.6%) of the study participants. Those with psychiatric morbidity had significantly higher prevalence of abuse. None of the demographic factors was associated with abuse. Conclusion: Elder abuse is highly prevalent in rural setting, especially among those with psychiatric morbidity. Implications: Considering the high prevalence of elder abuse, there is an urgent need to address the problem. Public awareness, education, and sensitization of people toward the abuse are need of the day.

Medical Journal of Dr. D.Y. Patil Vidyapeeth (Med J DY Patil Vidyapeeth)

Machine learning in medicine: Will doctors meet their waterloo? Amitav Banerjee Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):95-97

Artificial intelligence in medicine: The way forward Pranay Goel Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):98-99

The good old family doctor Dilip Kanade Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):100-100

Home visits and family physician Vadisha Bhat Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):101-102

Rare presentation of squamous cell carcinoma: A case report Subhashish Das Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):103-104

Fungal corneal ulcer: A prospective study on the causative fungus and the response to the present treatment protocol at ANIIMS, Andaman and Nicobar Islands-first time present Sujit Das, H Sanjeev, Amit Banik Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):105-110 Background: Fungal keratitis accounts for 50% of all microbial keratitis, depending upon the geographic location. Filamentary fungi are predominant in tropical and subtropical climates. Treatment is given based on clinical diagnosis supported by the presence of fungus in potassium hydroxide (KOH) mounting, rather than on culture report because culture takes time. Reported studies from northern part of the country revealed Aspergillus as the most common fungus, whereas Fusarium was reported to be the most common fungus in southern part of the country. Aspergillus fumigatus is the most common fungus isolated in our study and the response to standard treatment is good. Aim of the Study: To identify spectrum of fungi, response to the standard treatment given, and sensitivity of KOH preparation in clinically diagnosed fungal corneal ulcers and to identify the predisposing factors and culture-positive cases (both Sabouraud's and blood culture). Methods: All patients who were clinically diagnosed to have fungal corneal ulcer, based on history, clinical features, and slit-lamp findings over a period of 1 year, were included in the study. All patients were subjected to corneal scraping and the material was examined by KOH mounting, Gram staining, and specific culture techniques. The ulcer was treated as per the standard treatment protocol followed in the institution, and the response to treatment was analyzed. Results: The study included 40 patients, with males being predominated (n = 36). KOH positivity was seen in 34 (85%) cases whereas KOH negativity was seen in 6 (15%) cases. Gram stain was positive in 6 (15%) cases. The culture was positive in all cases (100%). The most common fungus isolated was A. fumigatus – 24 (60%) cases. The response to the treatment after 8 weeks was found in 34 (85%) cases. Enucleation was done in 7 (17.5%) cases. Total therapeutic keratoplasty was done in 7 (17.5%) cases. Total penetrating keratoplasty was done in 4 (10%) cases. Conclusions: Rapid diagnosis and early institution of antifungal therapy are necessary to prevent ocular morbidity and blindness. Although culture helps in definite diagnosis and identification, direct microscopic detection of fungal structures in corneal scrapes permits a rapid presumptive diagnosis.

Correlation and comparison of dactyloscopy and palatoscopy with blood groups among dental students from Western Maharashtra Smriti Ramdas, Sushma Bommanavar, Rajendra Baad, Nupura Vibhute, Uzma Belgaumi, Vidya Kadashetti, Wasim Kamate Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):111-115 Background: Identification plays a major role in any crime investigation. Study of finger prints (Dactyloscopy) and palatal rugae patterns (Palatoscopy) have been recognized and accepted as gold standard for personal identification worldwide. Yet another biological record that remains timeless throughout the lifespan of a person is the blood group. Research works have been carried out on Dactyloscopy/Palatoscopy and blood groups independently. However, studies focusing on correlation and comparison of both these parameters have not been undertaken to a great extent. Aim: The aim of the present study is to correlate and compare Dactyloscopy and Palatoscopy with blood group among dental students from western Maharashtra population. Materials and Methods: A total of 200 dental students with age group ranging between 18-25 years with known blood group were included in the study. Finger print, Palatal rugae patterns were obtained and compared and the data was subjected to Excel sheet 2016 and Chi square test. Results: There was significant association between finger print patterns and ABO - Rh factors (χ2 statistic= 30.6, P value = < 0.05) and No correlation exists between palatal rugae patterns with blood groups and Rh factor (χ2 statistic= 17.71, P value = P > 0.05). Conclusion: Hence, the study concluded that finger prints rather than palatal rugae when correlated with suspect's specific blood group - Rh factor can be used to narrow down the suspect list and can also prove significant in identifying individuals in case of any disaster. Though the comparison of palatal rugae and finger print with blood group - Rh factor yielded no result.

Client satisfaction and its correlates of directly observed treatment short course therapy in a tuberculosis unit of Bankura, West Bengal Sumana Samanta, Aditya Prasad Sarkar, Dibakar Haldar, Asit Baran Saren, Gautam Narayan Sarkar, Indrajit Saha Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):116-121 Background: Tuberculosis (TB) is a curable disease still millions of people suffer and many of them die from this disease. Just providing anti-TB medication is not sufficient to ensure that patient to be cured. Objective: The objective of this study is to assess the treatment outcome rates and to find out the determinants of patient satisfaction. Materials and Methods: A clinic-based, descriptive, crosssectional study was conducted in Lokepur Tuberculosis unit (TU) from July 2015 to June 2016. Simple random sampling was adopted to select 50% of the Directly Observed Treatment Short Course (DOTS) centers under that TU. Afterward, complete enumeration of the adult TB patients receiving Category I treatment and registered from June to October 2015 was done from the selected DOTS centers. Exit interview of the patients was conducted using pretested predesigned questionnaire and treatment outcomes were recorded from TB register. Data were entered in MS Excel Spreadsheet and analyzed by SPSS 22.0 version. Results: Treatment success rate of Category I TB patients was about 87%. Almost 76% patients were satisfied with the given services. Treatment success rate was higher among the satisfied (97%) than the not satisfied (57%) clients and the difference was statistically significant. Client satisfaction was statistically associated with gender, residence, educational level, first caregiving person, and decision maker in getting treatment. Conclusion: Concern given to urban slum areas, improvement of literacy status of the patients, arrangement of the alternative sources of income for TB-affected family, and improvement of the knowledge of first caregiving persons are the steps to be taken at this hour.

Anorectal malformations: Early outcome analysis from a high-volume tertiary care institute Rahul Gupta, Arun Kumar Gupta, Arvind Kumar Shukla, Vinita Chaturvedi, Pramila Sharma, Ramesh Tanger Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):122-130 Context: Associated malformations in anorectal malformation (ARM) are of important implication with regard to final outcomes since the anorectal lesions that cause intestinal obstruction are correctable with operative intervention. Aims: To study the presentation, types of anomalies, associated malformations, and procedures performed in relation to the type of anomaly and early outcomes analysis of ARM patients in the neonatal period. Settings and Design: A retrospective study was performed from January 2016 to December 2016. Subjects and Methods: The study included all patients with ARM admitted in the Neonatal Intensive Care Unit. Results: There were 216 neonates having ARM with 173 males and 43 females (m:f = 4:1). High-type ARM was seen in 177 (81.94%) cases, while low type in 39 (18.06%) neonates. Associated malformations were documented in 67 (31.02%) neonates. Esophageal atresia (EA) was the most common (51) associated anomaly. Among the 200 procedures undertaken for ARM, left transverse loop colostomy was the most common (132). Only 83 (38.42%) neonates were diagnosed on the 1st day of life. There were 67 (31.02%) deaths, 145 (67.13%) survivors, and 4 (1.85%) cases left against medical advice. There were only 9 (17.65%) survivors among those associated with EA. Cardiovascular was the most common (39) cause of mortality followed by septicemia (30). Conclusions: An overall high mortality rate of 31.02% and an extremely high rate (74.51%) among those associated with EA were present. In spite of the progress made in the field of neonatal care, associated malformations compounded with a high volume of patients in our resource-limited institution negatively influence the outcome of ARM in the newborn period. Strict infection control measures for prevention of septicemia and investigations for other associated malformations are recommended to improve the outcomes.

Prospective randomized comparative trial of dexmedetomidine versus esmolol for attenuation of extubation response Nirav Kotak, Rahul Mamde, Pushkar M Desai Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):131-135 Background and Aims: General anesthesia is known to elicit stress response during endotracheal intubation, but the equally important period of extubation is usually not addressed. The aim was to compare dexmedetomidine and esmolol for attenuation of extubation response. Materials and Methods: In this prospective randomized double-blind trial, 100 American Society of Anesthesiologists I/II patients between 18 and 60 years of age undergoing abdominal and lower-limb surgeries were randomly allocated into two groups (n = 50 each). Patients in Group D received dexmedetomidine (0.5 μg/kg intravenous [IV] bolus) over 10 min and in Group E received esmolol (1 mg/kg bolus IV) before extubation. Hemodynamic parameters, namely, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were compared at baseline, 10 min before extubation, at extubation, and at 1, 3, 5, 10, and 15 min thereafter. Data were expressed as mean ± standard deviation and analyzed using Student's unpaired t-test and Chi-square test. P <0.05 was considered statistically significant. Results: Patients in Group D exhibited lower HR, SBP, DBP, and MAP at the time of extubation till 15 min postextubation (P < 0.001) although the difference was clinically insignificant. Incidence of hypotension was similar in both groups (6% vs. 4%). Two patients in Group D developed bradycardia which was successfully treated with injection glycopyrrolate, while none exhibited any complication in Group E. Conclusion: Dexmedetomidine is a better, effective, and safe alternative to esmolol in attenuating stress response during extubation.

Tzu Chi Medical Journal (Tzu Chi Med J)

Molecular basis for the association between depression and circadian rhythm Peeraporn Varinthra, Ingrid Y Liu Tzu Chi Medical Journal 2019 31(2):67-72 Depression is a life-threatening psychiatric disorder and a major public health concern worldwide with an incidence of 5% and a lifetime prevalence of 15%–20%. It is related with the social disability, decreased quality of life, and a high incidence of suicide. Along with increased depressive cases, health care cost in treating patients suffering from depression has also surged. Previous evidence have reported that depressed patients often exhibit altered circadian rhythms. Circadian rhythm involves physical, mental, and behavioral changes in a daily cycle, and is controlled by the suprachiasmatic nucleus of the hypothalamus in responding to light and darkness in an environment. Circadian rhythm disturbance in depressive patients causes early morning waking, sleep disturbances, diurnal mood variation, changes of the mean core temperature, endocrine release, and metabolic functions. Many medical interventions have been used to treat depression; however, several adverse effects are noted. This article reviews the types, causes of depression, mechanism of circadian rhythm, and the relationship between circadian rhythm disturbance with depression. Pharmaceutical and alternative interventions used to treat depressed patients are also discussed.

Improving the assessment of medication adherence: Challenges and considerations with a focus on low-resource settings Saurav Basu, Suneela Garg, Nandini Sharma, M Meghachandra Singh Tzu Chi Medical Journal 2019 31(2):73-80 Improving patient survival and quality of life in chronic diseases requires prolonged and often lifelong medication intake. Less than half of patients with chronic diseases globally are adherent to their prescribed medications which preclude the full benefit of treatment, worsens therapeutic outcomes, accelerates disease progression, and causes enormous economic losses. The accurate assessment of medication adherence is pivotal for both researchers and clinicians. Medication adherence can be assessed through both direct and indirect measures. Indirect measures include both subjective (self-report measures such as questionnaire and interview) and objective (pill count and secondary database analysis) measures and constitute the mainstay of assessing medication adherence. However, the lack of an inexpensive, ubiquitous, universal gold standard for assessment of medication adherence emphasizes the need to utilize a combination of measures to differentiate adherent and nonadherent patients. The global heterogeneity in health systems precludes the development of a universal guideline for evaluating medication adherence. Methods based on the secondary database analysis are mostly ineffectual in low-resource settings lacking electronic pharmacy and insurance databases and allowing refills without updated, valid prescriptions from private pharmacies. This significantly restricts the choices for assessing adherence until digitization of medical data takes root in much of the developing world. Nevertheless, there is ample scope for improving self-report measures of adherence. Effective interview techniques, especially accounting for suboptimal patient health literacy, validation of adherence questionnaires, and avoiding conceptual fallacies in reporting adherence can improve the assessment of medication adherence and promote understanding of its causal factors.

Antinociceptive and anti-inflammatory effects of the citrus flavanone naringenin Ting-Wen Chung, Shiming Li, Chi-Chien Lin, Sen-Wei Tsai Tzu Chi Medical Journal 2019 31(2):81-85 Objective: Naringenin, a flavonoid found in citrus fruits, has notably diverse pharmacological properties. In the present study, we investigated the antinociceptive and anti-inflammatory effects of naringenin. Materials and Methods: The antinociceptive effects were evaluated using hot-plate, acetic acid-induced writhing, and tail-flick assays in mice and rats. The anti-inflammatory effects were examined by a carrageenan-induced paw edema test in rats. Results: Naringenin (100 or 200 mg/kg, oral administration) significantly delayed the reaction time of mice to thermal stimulation generated by a hot plate and a tail-flick unit and reduced the acetic acid-induced writhing response in mice. In addition, naringenin significantly decreased paw edema induced by carrageenan in rats, showing its anti-inflammatory effect. Conclusion: Our results show that naringenin has therapeutic potential with antinociceptive and anti-inflammatory properties and can further be exploited for the development of drugs for pain and inflammatory-related diseases.

HLA-A*29:01-B*07:05-C*15:29*DRB1*10:01-DQB1*05:01, a deduced probable human leukocyte antigen haplotype in association with a human leukocyte antigen-C low-incidence allele C*15:29 in Taiwanese individuals Kuo-Liang Yang, Zheng-Zhong Zheng Tzu Chi Medical Journal 2019 31(2):86-89 Objective: HLA-C*15:29 is a low-frequency allele in the human leukocyte antigen (HLA)-C locus. The aim of this study is to confirm the ethnicity of C*15:29 and to deduce a probable HLA haplotype in association with C*15:29 in Taiwanese population. Materials and Methods: A total of 12,534 healthy unrelated Taiwanese individuals were tested for HLA using a sequence-based typing method. The DNA material was subjected to HLA genotyping for the HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1 loci using a commercial polymerase chain reaction–sequencing-based typing kit as per the manufacturer's protocols. Results: The DNA sequence of C*15:29 is identical to C*15:02:01:01 in exons 1, 2, 3, 4, 5, and 6 except for residues 420 and 1034 where A and G of C*15:02:01:01 are substituted by C and A in C*15:29, respectively. The nucleotide substitutions introduce two amino acid replacements at residues 116 and 321 where leucine (L) and cysteine (C) of C*15:02:01:01 are replaced by phenylalanine (F) and tyrosine (Y) in C*15:29, respectively. A probable HLA haplotype associated with C*15:29 in Taiwanese was deduced as A*29:01-B*07:05-C*15:29-DRB1*10:01-DQB1*05:01. The frequency of C*15:29 is estimated at about 0.064%. Conclusion: Information on the ethnicity and distribution of C*15:29 and its deduced probable HLA haplotype is of value for HLA testing laboratories for reference purposes and can help bone marrow donor registries find compatible donors for patients with this uncommon HLA allele.

Bertolotti's syndrome in low-backache population: Classification and imaging findings Reddy Ravikanth, Pooja Majumdar Tzu Chi Medical Journal 2019 31(2):90-95 Objective: Lumbosacral transition vertebrae (LSTVs) are associated with alterations in biomechanics and anatomy of spinal and paraspinal structures, which have important implications on surgical approaches and techniques. LSTVs are often inaccurately detected and classified on standard anteroposterior radiographs and magnetic resonance imaging. The use of whole-spine images as well as geometric relationships between the sacrum and lumbar vertebra increases accuracy. The diagnosis of symptomatic LSTV is considered with appropriate patient history and imaging studies. This study aimed to classify the anatomical variations in LSTV and determine, by plain radiography, if there exists a relationship between sacralization and low backache (LBP). Materials and Methods: Five hundred lumbosacral radiographs of LBP patients were examined after obtaining prior consent from the patient and approval from the “institutional ethics committee.” Data collection consisted of the patient's age at the time of imaging gender and number of lumbar vertebral bodies. Dysplastic transverse processes were classified according to the Castellvi radiographic classification system. The incidence of sacralization in patients and the control groups was reported, and the anomaly was compared according to the groups. Results: Of these patient groups, 134 were classified as positive for sacralization, which resulted in an incidence of 26.8%. The most common anatomical variant was Castellvi Type IA (7.6%). There were no statistically significant differences between men and women who had anomaly (P = 0.9256). Higher incidences of Type IB and Type IIB were found in men, but those results were not statistically significant (P = 0.133 and P = 0.581, respectively) when compared with the female group. Daily frequency and intensity of LBP were assessed in patients using visual analog scale (VAS) scores. The patients with LBP and no malformation reported an average pain level on the VAS for pain of 2.2 versus 5.2 in patients with LBP and a transitional vertebra, respectively. Conclusion: Based on our data, we conclude that lumbosacral transitional segments are a common cause in the low-backache population. However, no relationship was found between age and genders in this study. However, in comparison with the nonspecific low-backache group, the VAS scores were significantly higher and the pain duration was significantly longer in the LSTV group.

Treatment of moderate-to-severe otosclerosis with simultaneous piston surgery and incus vibroplasty Chan-Jung Chang, Yu-Hsuan Wen, Chuan-Hung Sun, Millo Achille Beltrame, Hung-Pin Wu Tzu Chi Medical Journal 2019 31(2):96-101 Objective: Whereas the nature of otosclerosis has been extensively investigated, treatment modalities in advanced otosclerosis with the sensorineural hearing loss (SNHL) are relatively unexplored. Materials and Methods: This article presents a retrospective case series study of nine patients who received a one-stage piston coupled with Vibrant Soundbridge® vibroplasty in treating otosclerosis with moderate-to-severe SNHL. Results: The findings suggest that hearing loss could be restored across frequencies and no significant change in the bone-conduction threshold were measured. Conclusion: One-stage piston surgery coupled with incus vibroplasty is a safe procedure and has sufficient efficacy to restore hearing loss in patients with otosclerosis with moderate-to-severe SNHL.

The serum sclerostin level is positively associated with the aortic augmentation index in patients on peritoneal dialysis Lin Lin, Yu-Hsien Lai, Liang-Te Chiu, Jen-Pi Tsai, Chih-Hsien Wang, Bang-Gee Hsu Tzu Chi Medical Journal 2019 31(2):102-106 Objective: Sclerostin is a canonical Wingless (Wnt)/β-catenin signaling pathway inhibitor and had been associated with high arterial stiffness in patients with chronic kidney disease. The aortic augmentation index (AIx), a noninvasive method of assessing central hemodynamics/wave reflections, has been widely used as a clinical index of arterial stiffness. The aim of this study was to evaluate the relationship between fasting serum sclerostin levels and AIx values in peritoneal dialysis (PD) patients. Materials and Methods: Fasting blood samples were obtained from 75 PD patients. The aortic AIx value was measured using a validated tonometry system (SphygmoCor, AtCor Medical, Sydney, New South Wales, Australia). Serum sclerostin and dickkopf-1 (DKK1) levels were quantified using commercial enzyme-linked immunosorbent assay kits. Results: Women PD patients had higher aortic AIx values than men (P = 0.039), while lower aortic AIx values were found in PD patients who used statins (P = 0.004). Univariate linear analysis of the aortic AIx values in PD patients showed that systolic blood pressure (P = 0.001), diastolic blood pressure (P = 0.018), and serum sclerostin levels (P = 0.001) were positively correlated, while height (P = 0.018), body weight (P = 0.001), body mass index (P = 0.043), and weekly total creatinine clearance (P = 0.015) were negatively correlated with aortic AIx values in PD patients. Multivariate linear regression analysis of the factors significantly associated with the aortic AIx values showed that serum sclerostin levels (adjusted R2 = 0.057, P = 0.011) and systolic blood pressure (adjusted R2 = 0.125, P = 0.004) were positively associated, while body weight (adjusted R2 = 0.113, P = 0.002) was inversely associated with aortic AIx values in PD patients. Conclusion: In this study, the serum sclerostin level, but not DKK1, was positively associated with aortic AIx values in PD patients.

Quality of life in patients with Parkinson's disease after subthalamic stimulation: An observational cohort study for outcome prediction Jiin-Ling Jiang, Shin-Yuan Chen, Sheng-Tzung Tsai Tzu Chi Medical Journal 2019 31(2):107-112 Objective: The objective of this study was to investigate the changes in health-related quality of life (HRQoL) and motor and depressive symptoms in patients with Parkinson's disease (PD) from baseline to 12 months following subthalamic nucleus deep brain stimulation (STN-DBS). Materials and Methods: The study utilized a prospective observational cohort design. Thirty-three PD patients with a good levodopa response but drug-related morbidity were included. PD Questionnaire-39 (PDQ-39) scores, unified PD rating scale (UPDRS) scores, Hoehn and Yahr stages, Beck Depression Inventory-II scores, and levodopa equivalent daily doses (LEDD) were obtained at baseline and 1 year after surgery. Results: The enrolled patients showed a significant HRQoL improvement of 21.43% at 12 months after STN-DBS as assessed by the PDQ-39 total score. There was a 34.92% improvement in UPDRS scores after STN-DBS at 1 year follow-up. Subitem analysis revealed significant improvement in UPDRS part II, III, and IV scores. The LEDD was significantly reduced by up to 27.36% 12 months after surgery. The preoperative PDQ-39 total score and LEDD predicted postoperative HRQoL in PD following STN-DBS. Conclusions: The current study demonstrated that STN-DBS surgery significantly improved HRQoL and motor outcomes of patients with PD. The preoperative PDQ-39 score and LEDD were predictors of the efficacy of postoperative HRQoL following surgery.

Is prone sleeping dangerous for neonates? Polysomnographic characteristics and NDN gene analysis Shi-Bing Wong, Lu-Lu Zhao, Shu-Hua Chuang, Wen-Hsin Tsai, Chun-Hsien Yu, Li-Ping Tsai Tzu Chi Medical Journal 2019 31(2):113-117 Objective: Prone sleep is an identified risk factor for sudden infant death syndrome, possibly due to reduced blood pressure, cerebral oxygenation, and impaired cerebral vascular control. Cardiac and respiratory responses in neonates during supine and prone sleep have not been reported. Materials and Methods: In this study, daytime polysomnography (PSG) data from 17 neonates aged 2–3 days during supine and prone sleep were reported and the NDN gene, an important gene for neonatal respiratory control, was sequenced for correlation with neonatal respiratory parameters. Heart rate (HR), oxygen saturation, carbon dioxide concentration, sleep stages, central apnea index (CAI), obstructive apnea/hypopnea index (OAHI), and oxygen nadir were compared between supine and prone sleep and between participants with different single-nucleotide polymorphisms (SNPs) in the NDN gene. Results: During prone sleep, neonates had a faster HR, decreased oxygen saturation, and a longer duration of oxygen saturation <90% than during supine sleep, suggesting that cardiopulmonary responsiveness was impaired. Sleep efficiency, sleep stages, oxygen nadir, and carbon dioxide tension were not different during supine and prone sleep. Central apnea occurred more significantly than obstructive apnea. During supine and prone sleep, the CAI was 3.3 ± 2.9/h and 2.3 ± 2.6/h and the OAHI was 0.6 ± 0.7/h and 0.6 ± 0.8/h, respectively. We found one SNP rs3743340 in the NDN gene that had no effect on the sleep and respiratory parameters of PSG. Conclusion: Tachycardia and respiratory instability were recorded in neonates during prone sleep, suggesting that neonates are vulnerable to cardiopulmonary events during prone sleep. Therefore, young neonates should be kept in the supine sleep position unless there are contraindications.

Evaluation of mandibular anterior nutrient canals in hypertensive and diabetes mellitus patients: A comparative radiographic study Sukhleen Kaur, Pradhuman Verma, Anjali Saigal Tzu Chi Medical Journal 2019 31(2):118-123 Objective: Radiographic evaluation of nutrient canals (NCs) in the mandibular anterior region using intraoral periapical radiographs (IOPARs) and to determine whether they can be used as a potential marker for hypertension (HT) and diabetes mellitus (DM). Materials and Methods: Randomly selected 600 patients of 21-60 years age group (Group I: 200 HT; Group II: 200 DM; Group III: Healthy subjects) were considered. The case history was recorded including details for DM and HT (duration, type, and medication). Blood pressure was measured, followed by blood examination for blood sugar levels. Selected patients were subjected to IOPARs using CS-2100C machine by the paralleling technique. Selected radiographs were evaluated by two observers independently for the presence/absence, number, and location of NCs between #33 and #43. Data obtained were tabulated and subjected to statistical analysis using SPSS 20.0 statistical software and intergroup reliability was checked using Cohen's kappa test. Results: Evaluation of various parameters of NCs showed an insignificant interobserver bias. The incidence of NCs presence was noted maximum in Group II (93.5%), followed by Group I (88.5%) and III (44.5%). Of total 888 NCs found, maximum were found in Group I, followed by II and III. On comparing the incidence of NCs present among both genders and location in study groups, no statistical correlation was found. Conclusion: Statistically significant increase in the incidence and number of NCs in Group I and II compared to controls can act as an adjunct diagnostic marker for the detection of DM and HT; although, no significant correlation was obtained between gender and location of NCs in different study groups. Furthermore, there was no significant correlation was found between the severity of disease and incidence of the presence of NCs.