Gradual Reduction Research Articles

Blood pressure and variability responses to the down-titration of antihypertensive drugs.

Several recent guidelines have proposed the gradual reduction of antihypertensive drugs for patients with well controlled blood pressure (BP). However, no studies have examined alterations in BP variability (BPV) during the down-titration of antihypertensives. This study aims to investigate changes in home BPV during the down-titration of antihypertensives. We analyzed 83 hypertensive patients who underwent down-titration of antihypertensives and had available home BP data during the down-titration. Down-titration was performed when home SBP was less than 120 mmHg, regardless of the clinic SBP. Primary exposure variable was the standard deviation (SD) of home BP. Among 83 patients (mean age 66.3 ± 11.9 years; 45.8% men), down-titration led to increase home SBP (from 110.5 to 118.7 mmHg; P < 0.001), and home DBP (from 68.8 to 72.8 mmHg; P = 0.001) significantly. There were no significant differences in SDs of SBP [from 6.02 ± 3.79 to 5.76 ± 3.09 in morning, P = 0.570; from 6.13 ± 3.32 to 6.63 ± 3.70 in evening, P = 0.077; and from 6.54 (4.80, 8.31) to 6.37 (4.65, 8.76) in home SBP, P = 0.464] and SDs of DBP during the down-titration of antihypertensive drugs. Down-titration of antihypertensive drugs did not have notable impact on clinic BP and home BPV, while significantly increasing home BP. These findings provide important insights indicating that the potential concern related to an increase in BPV in the planned strategy of reducing antihypertensive drugs is not substantial.

Chemical and Ultrastructural Characterization of Dentin Treated with Remineralizing Dentifrices.

The aim of this study is to investigate dentin chemical and ultrastructural changes upon exposure to remineralizing dentifrices. Dentin disks were obtained from permanent human molars and treated for 7 days with the dentifrices: (1) C group-control (no dentifrice); (2) S group-Sensodyne Repair & Protect; (3) D group-Dentalclean Daily Regenerating Gel; and (4) DB group-D group + Dentalclean regenerating booster. Afterwards, samples were submitted to an additional 7 days of toothbrushing associated with daily acidic challenge. Samples were imaged and analyzed (days 1, 7, and 14) for Young's modulus by atomic force microscopy (AFM), scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX), transmission electron microscopy (TEM) and selected area electron diffraction (SAED). SEM and AFM revealed precipitate deposition on dentin surfaces in groups S, D, and DB, formed as early as day 1. Surface elemental analysis showed a Si increase on all brushed surfaces. Similar surface morphology was maintained after the acidic challenge period. Bright-field TEM/SAED revealed the formation of nanocrystalline hydroxyapatite inside the dentin tubules of groups S, D, and DB after day 7. Group C presented a gradual reduction of Young's modulus from days-1-14, whereas all remaining groups had increased values. All evaluated dentifrices led to successful formation of hydroxyapatite and increased dentin stiffness.

Effect of electron beam irradiation on the structural characteristics and functional properties of goat's milk casein

The effects of electron beam irradiation (EBI) at different doses (0, 2, 4, 6, 8, and 10 kGy) were investigated on the structural and functional properties of casein, including their interrelationship. A gradual reduction in the α-helix content of the secondary structure (as a stable structure) indicates that casein under EBI treatment mainly undergoes fragmentation and aggregation from a structural perspective. Furthermore, the hydrophobic group and tryptophan in the tertiary structure were exposed, which opened up the internal structure of the protein. In addition, a continuously increasing irradiation dose led to casein aggregation, as confirmed by electron microscopy. The structural changes affected its functional properties, such as solubility, emulsification, foaming, and rheological properties, all of which increased first and subsequently decreased. Finally, at irradiation doses of 4–6 kGy, casein was modified to exhibit optimal functional properties, which enhanced its food processing value and performance.

The impact of aggregate demand shocks on Germany’s trade balance and industry

ABSTRACT We examine the impact of aggregate demand shocks on Germany’s trade balance and industry after the adoption of the Euro. Using a Structural Vector Autoregression we find that Germany’s trade balance and industry are highly responsive to aggregate demand shocks. As Germany’s income increases, this leads to an increase in imports and a gradual reduction in its trade balance. However, Germany’s export capacity stabilizes its trade balance. This is over a period of rapid globalization, technological progress confronting all economies, several global trade disruptions and with disturbances to crucial energy requirements for Germany’s industry and export sector.

Corrosion behavior and microstructure analysis of butt welds of Q690 high strength steel in simulated marine environment

Steel components that have served in the marine environment for extended periods often face challenges in preventing surface damage caused by corrosion protection measures. These challenges can ultimately diminish the expected service life of structures. To investigate the corrosion behavior and time-varying effects in butt welds of Q690 high strength steel in the ocean splash zone, a macroscopic morphology analysis was conducted using various corrosion times involving indoor saltwater immersion and hot-humid cycling accelerated corrosion. Quantitative analysis of corrosion pits' size and distribution range was performed in both the weld zone (WZ) and heat-affected zone (HAZ) to establish a relationship between roughness parameters and corrosion time. Experimental results were compared with corrosion parameters of regular steel. The findings reveal a gradual reduction in metallic luster with increasing corrosion time on specimen surfaces. Moreover, a greater accumulation of corrosion products is observed in the butt weld region, leading to progressive corrosion damage. High strength steel (HSS) exhibits superior corrosion resistance compared to ordinary steel. However, the corrosion damage of HSS weld joints gradually approaches that of ordinary steel in the later stage of corrosion. Microscopic scanning indicates that the accumulated corrosion layer effectively impedes the penetration of corrosive media into the matrix's interior, while the surface microstructure transitions from pitting to corrosion pits. These research findings significantly contribute to assessing the performance and analyzing the reliability of high strength steel in marine environments.

First-principles study of the electronic structure and optical properties of C-doped SnS2.

Density functional theory (DFT) was used to investigate the effects of varying carbon doping concentrations on the electronic and optical properties of SnS2-doped systems. The findings show that a doping concentration of 3.7% in SnS2 results in the highest structural stability and the lowest formation energy. A pure SnS2 monolayer is an indirect bandgap semiconductor, and the result reveals that increasing carbon doping correlates with a gradual reduction in the system's bandgap. The density of states analysis reveals that the valence band comprises C-2p, S-3p, and Sn-5p orbitals, whereas the conduction band consists of S-3p, Sn-5s, and C-2p orbitals. Furthermore, doping concentration appears to cause a redshift in both the absorption coefficient and reflection peaks, which both decrease as doping concentration increases. The calculations for this study were performed using DFT within the CASTEP module of Materials Studio Segall et al.J Phys: Condens Matter 14(11):2717, 2002. The system parameters and structures were optimized to determine the electronic structure and optical properties. Geometric optimization and calculations were carried out with the generalized gradient approximation plane-wave pseudopotential method and the Perdew-Burke-Ernzerhof functional Perdew et al.Phys Rev Lett 80(4):891-891, 1998. The parameters for structural optimization included a plane-wave expansion cutoff energy set at 500eV and a k-point mesh of 6 × 6 × 1 for Brillouin zone integration. The electronic convergence criteria were established at 1.0 × 10-5eV/atom for the unit cell energy and 1.0 × 10-6 eV/atom for self-consistency. The internal stress deviation was maintained below 0.05 GPa, the atomic force interactions were kept under 0.03eV/Å, and atomic displacements during geometric optimization were confined to less than 0.001Å. To calculate the properties of the SnS2 monolayer, a vacuum spacing of 15Å along the z-axis was introduced to prevent interactions between adjacent layers.

Interactive transition of cultivated land and construction land during china's urbanization: A coordinated analytical framework of explicit and implicit forms

Despite the recognized significance of coordinated land use transitions (LUTs) between cultivated land (CL) and construction land (COL) in supporting food security and facilitating sustainable urban growth, the complexities of such transitions in the face of rapid urbanization remain largely untapped. Current literature inadequately illuminates the procedures and principles dictating these intricate transitions, leaving a substantial void in our comprehension. Addressing these research gaps, our study employs models like the linkage index and the coupled coordination degree. We leverage data regarding the CL and COL areas in China spanning from 2000 to 2020, aiming to shed light on the processes and general patterns guiding CL and COL transitions amid urbanization. We present a novel perspective that emphasizes the linkage of single and dual land types in their explicit forms and the coordination of their implicit forms. Through the analysis of empirical data from China, we observe a gradual reduction in CL size coupled with its quality improvement. This shift parallels the intensification of COL and a slowdown in COL size growth, progressing towards an optimal transition over the observation period, despite regional variations in performance. The relationship between the explicit forms of CL and COL is characterized largely by stable transition, while the coordination relationship between their implicit forms exhibits a moderate transition, influenced by differences in urbanization. Our study highlights key strategies for achieving a mutually beneficial transition from discordant to harmonious relationships between CL and COL. These include fine-tuning the spatial trade-offs of the explicit forms and decoupling the interests of the implicit forms. Our research not only adds depth and complexity to traditional LUT theory, but also offers critical insights to guide policy formulation, with the ultimate aim of bolstering food security and promoting sustainable urbanization through favorable LUTs.

Being a child in Morelia: child spatial mobility over the years

ABSTRACT The systemic crisis in Latin America, exacerbated by market-driven urban development, has led to heightened social segregation and diminished public spaces for mobility and recreation. In Mexico, childhood is particularly affected, with the last two decades witnessing a decline in children's autonomy within public areas due to escalating violence and militarization. Employing a childhood geography approach, this article examines the gradual reduction in children's spatial mobility across four generations in Morelia, Mexico. It explores key factors influencing mobility: play activities, perceived risks, and the impact of motility, all viewed through a gender lens. The study involves four cohorts of 10-year-olds from different decades, employing qualitative methods like interviews and mental maps. Results reveal the detrimental effects of rapid, fragmented urban growth and increased violence on creating spaces for children. Consequently, interactions have shifted indoors, leading to supervised play in semi-private spaces and a shift from collective, autonomous play to limited social interactions

A reinforcement learning model with choice traces for a progressive ratio schedule.

The progressive ratio (PR) lever-press task serves as a benchmark for assessing goal-oriented motivation. However, a well-recognized limitation of the PR task is that only a single data point, known as the breakpoint, is obtained from an entire session as a barometer of motivation. Because the breakpoint is defined as the final ratio of responses achieved in a PR session, variations in choice behavior during the PR task cannot be captured. We addressed this limitation by constructing four reinforcement learning models: a simple Q-learning model, an asymmetric model with two learning rates, a perseverance model with choice traces, and a perseverance model without learning. These models incorporated three behavioral choices: reinforced and non-reinforced lever presses and void magazine nosepokes, because we noticed that male mice performed frequent magazine nosepokes during PR tasks. The best model was the perseverance model, which predicted a gradual reduction in amplitudes of reward prediction errors (RPEs) upon void magazine nosepokes. We confirmed the prediction experimentally with fiber photometry of extracellular dopamine (DA) dynamics in the ventral striatum of male mice using a fluorescent protein (genetically encoded GPCR activation-based DA sensor: GRABDA2m). We verified application of the model by acute intraperitoneal injection of low-dose methamphetamine (METH) before a PR task, which increased the frequency of magazine nosepokes during the PR session without changing the breakpoint. The perseverance model captured behavioral modulation as a result of increased initial action values, which are customarily set to zero and disregarded in reinforcement learning analysis. Our findings suggest that the perseverance model reveals the effects of psychoactive drugs on choice behaviors during PR tasks.

Targeting Human Glucocorticoid Receptors in Fear Learning: A Multiscale Integrated Approach to Study Functional Connectivity.

Fear extinction is a phenomenon that involves a gradual reduction in conditioned fear responses through repeated exposure to fear-inducing cues. Functional brain connectivity assessments, such as functional magnetic resonance imaging (fMRI), provide valuable insights into how brain regions communicate during these processes. Stress, a ubiquitous aspect of life, influences fear learning and extinction by changing the activity of the amygdala, prefrontal cortex, and hippocampus, leading to enhanced fear responses and/or impaired extinction. Glucocorticoid receptors (GRs) are key to the stress response and show a dual function in fear regulation: while they enhance the consolidation of fear memories, they also facilitate extinction. Accordingly, GR dysregulation is associated with anxiety and mood disorders. Recent advancements in cognitive neuroscience underscore the need for a comprehensive understanding that integrates perspectives from the molecular, cellular, and systems levels. In particular, neuropharmacology provides valuable insights into neurotransmitter and receptor systems, aiding the investigation of mechanisms underlying fear regulation and potential therapeutic targets. A notable player in this context is cortisol, a key stress hormone, which significantly influences both fear memory reconsolidation and extinction processes. Gaining a thorough understanding of these intricate interactions has implications in terms of addressing psychiatric disorders related to stress. This review sheds light on the complex interactions between cognitive processes, emotions, and their neural bases. In this endeavor, our aim is to reshape the comprehension of fear, stress, and their implications for emotional well-being, ultimately aiding in the development of therapeutic interventions.

Cryoanesthesia in tambaqui Colossoma macropomum: Behavioral and electrocardiographic responses

Cryoanesthesia is a low-cost procedure that has advantages for use in fish, however, there are only a few studies dealing with the electrophysiological evaluation and its safety-related aspects. The relationship between behavior and electrocardiographic activity allows for the monitoring of functional changes in cardiac activity in fish submitted to low temperatures. This study aimed to describe the behavior and cardiac effects of cryoanesthesia in juvenile tambaqui (Colossoma macropomum) through electrocardiographic assessment. For this purpose, 27 juveniles of tambaqui (28.9 ± 4.2 g) were used and essayed into two experiments. Experiment 1: behavioral evaluation (n = 9) and Experiment 2: electrocardiographic recordings with control group (n = 9), and fish submitted to water at 5 °C in baths followed by subsequent recovery at a temperature of 26 ± 2 °C (n = 9). Each cardiac activity recording lasted 1200 s, after which fish were immediately transferred to a bath in water at 26 ± 2 °C, for 600 s. Heart rate, QRS amplitude, QRS complex duration and RR, PQ and QT intervals were analyzed. The results showed that four tracing patterns emerged which characterized the induction phases of cryoanesthesia throughout exposure to water at 5 °C. In phase 1, there was a decrease in the amplitude of the QRS complex. In phase 2, there was an increase in the amplitude of the QRS complex and maintenance of sinus rhythm. Phase 3 showed a gradual loss of cardiac function with the onset of an atrioventricular blockade. In phase 4, a cardiac arrest occurred, albeit reversible. Heart rate decreased as exposure time was longer at low temperatures. The fish recovered completely from cryoanesthesia after the increase in temperature, showing normal heartbeats, and QRS complex duration, QT, RR, and HR intervals being restored with maintenance of sinus rhythm, indicating recovery of fish hemodynamics. Overall, tambaqui juveniles at 5 °C showed a time-dependent and gradual reduction of motor activity with loss of postural reflex and immobility. Cardiac response was a function of temperature and progressed to a reversible cardiac arrest. During recovery, stages similar to those of induction were observed, but in the opposite direction, until recovery of the postural reflex. Cryoanesthesia can be used as an alternative method for the immobilization of C. macropomum.

A Comparison of Ovine-Reinforced Hybrid Mesh (OviTex PRS) With Porcine Acellular Dermal Matrix (STRATTICE) in the Treatment of Advanced Breast Implant Capsular Contracture.

Tissue reinforcement techniques with porcine acellular dermal matrices (ADMs) have been widely adopted as standard care in treating capsular contracture. However, the application of alternative xenograft or mesh materials has not been widely studied. To examine the efficacy of OviTex PRS Reinforced Tissue Matrix (Resorbable) (TELA Bio, Malvern, PA), a hybrid ovine-reinforced mesh, in comparison with STRATTICE Reconstructive Tissue Matrix (Allergan, Irvine, CA), in patients with advanced capsular contracture. A retrospective review was conducted on patients who underwent breast revision surgery for Baker Grade III or IV capsular contracture. Patient data were reviewed for outcomes, complications, cost, and postoperative incidence of recurrent capsular contracture after treatment with each specific mesh. Fifty-nine of 89 breasts (66.3%) were treated with OviTex and 30 (33.7%) were treated with STRATTICE. All patients experienced a reduction in Baker grades. In patients treated with OviTex, 96.6% (n = 57) of breasts had a postoperative Baker Grade I with the remaining 3.4% (n = 2) breasts presenting with a Baker Grade II. In comparison, 73.3% (n = 22), 23.3% (n = 7), and 3.3% (n = 1) of the STRATTICE cohort presented with Baker Grades I, II, and III, respectively. This demonstrated a statistically significant improvement in Baker grade capsular contracture in the OviTex cohort (P < .05) compared with STRATTICE. Average cost was $27.37/cm2 for STRATTICE compared with $22.28/cm2 for OviTex PRS. OviTex may be successfully utilized to treat capsular contracture. Patient outcomes may be superior to STRATTICE in recurrent capsular contracture, particularly when a previous ADM had been utilized. Cost data show improved savings with the use of OviTex compared with STRATTICE.

The Role of Lecturers in Avoiding Student Plagiarism Practices

This study explores the role of lecturers in avoiding students’ plagiarism practices using the qualitative method with a case study approach. The study was conducted by observing and interviewing five faculty members in Universitas Negeri Makassar. Data were obtained from the participants, and then analyzed qualitatively. The observation and interview results were noted and concluded and are presented in this article. The study presents information about the attitudes and actions of lecturers toward student plagiarism practices and the efforts made by lecturers in minimizing student plagiarism practices. This study emphasizes the importance of educating students about the dangers of plagiarism. It was found that lecturers have several attitudes and actions to avoid student plagiarism, namely promoting academic honesty and applying plagiarism punishment. Students are required to revise their writing, however, a more severe sanction is given if plagiarism is still detected, namely a reduction in grades. The lecturers should assign students to submit their assignments or theses for plagiarism check purposes. This study recommends that lecturers should provide feedback with an emphasis on academic honesty rather than punishment.&#x0D; Keywords: academic honesty, academic writing, avoiding plagiarism, the role of lecturer

Reproducing the temporal averaging process of the acoustic Doppler velocimeter and assessing its impact on turbulence measurements

The temporal averaging process (TAP) in Acoustic Doppler Velocimeters (ADVs) and its impact on turbulence measurement have been extensively studied. However, few studies have successfully replicated TAP. This paper utilizes a self-developed ultrasonic velocimeter recording raw acoustic signals, achieving TAP through pulse signal concatenation. Results from open-channel flow velocity measurements demonstrate measurement accuracy. Exploring TAP's effects on turbulence measurement, three velocity sequences with varying data qualities are analyzed. Proportion of valid data increases after TAP, with similar growth rates across different sampling volumes. Turbulence intensity decreases linearly with TAP, correlating with data quality. Employing an enhanced denoising method, a comparison suggests potential gradual reduction in Doppler noise with TAP implementation. This study offers valuable insights into turbulence measurement in ADV.

Dynamic Shifts in Soil Fungal Functional Group Characteristics across Distinct Vegetation Types during Ecological Restoration in Degraded Red Soil Regions

The red soil region in southern China has become the second-largest soil erosion area after the Loess Plateau. The evolutionary trajectory of soil fungi during vegetation restoration in acidic red soil regions remains a subject of inquiry. The investigation focused on the restoration process of an ecosystem facing intense degradation in the southern regions of China by studying four distinctive vegetation types: barren land (BL), pure Pinus massoniana forest (CF), mixed coniferous (CBF), and broad-leaved forest (BF). The outcomes revealed considerable enhancements in soil properties’ attributes, evident through a gradual reduction in the bulk density of soil (SBD) and a corresponding increment in soil moisture content (MC), total nitrogen (TN), total carbon (TC), total potassium (TK), soil organic matter (SOM), and available potassium (AK) as vegetation restoration advanced. An intriguing trend emerged where the relative abundance of Ascomycota fungi displayed a declining trajectory, whereas Basidiomycota fungi exhibited an ascending trend with the progression of vegetation restoration. Specifically, broad-leaved forests exhibited a significantly greater relative abundance of Penicillium fungi compared to other stages of vegetation restoration. The diversity of soil fungal communities increased in tandem with vegetation restoration. A redundancy analysis illuminated a strong and positive relationship between the abundance of major soil fungi and soil pH, TN, and TC (key influencers of acidic red soil fungal populations). This study provided additional evidence of an elevation in ectomycorrhizal and saprophytic trophic fungi, signifying a transition that enhances the vegetation’s ability to capture water and nutrients. This, in turn, contributes to the overall enrichment and diversity of vegetation communities during the progression of restoration.

Effect of cryotherapy in controlling spasticity of calf muscles in patients with multiple sclerosis.

Spasticity is a common symptom of multiple sclerosis (MS), affecting 80% of patients. Many studies have aimed to detect methods to reduce spasticity under these conditions and found that spasticity can be efficiently reduced using cryotherapy. To examine the impact of cryotherapy on spasticity among patients with MS. Thirty-two participants were randomized into two groups. The study group was given airflow cryotherapy and a selected physical therapy program, whereas the control group was only given a selected physical therapy program. The treatment was administered three times each week for a total of twelve consecutive sessions. The outcome measures were the modified Ashworth scale and the H/M ratio. The study group showed significant decrease in calf muscle spasticity, indicated by a reduction in spasticity grade (p = 0.001) and a decrease in the H/M ratio of 33.81% (p = 0.001). The control group also showed significant reduction in calf muscle spasticity, as indicated by a reduction in spasticity grade (p = 0.001) and a reduction in the H/M ratio of 19.58% (p = 0.001). There was a significant decrease in the spasticity grade and H/M ratio of the study group posttreatment compared with those of the control group (p = 0.02 and p = 0.001). The combined effect of cryotherapy and a selected physical therapy program are more effective in controlling the spasticity of calf muscles in patients with MS than a selected physical therapy program alone.

Study of influence of the auxiliary factors onto characteristics of elastic-plastic deformation in the stress concentrator of the beam-wall with broken edges

The thin-walled steel beam-wall with broken edges is being investigated, which is a part of many structures. The wall of this beam consists of two prismatic parts with a linear transition from a smaller to a larger wall height, together forming an angular upper edge with the edges of the prismatic parts. The lower linear edge of the wall is attached to the sheathing.The beam-wall is subjected to static and cyclic loads, under which elastic-plastic deformations strains may occur at in the stress concentrator. This leads to failure of static strength and growth of fatigue cracks. The factors influencing the parameters of elastic-plastic deformation at in the stress concentrator of this beam are practically unstudied. The article under discussion presents the results of studying the influence of the beam-wall thickness and load vector balancing on the values of static and cyclic ranges of elastic-plastic deformations strains at in the stress concentrator. It has had been found that load vector balancing significantly improves the results of elastic-plastic deformations strains under single static loading and allows for the use of a larger load increment to achieve the same results as when no balancing is applied. Applying load vector balancing stabilizes the cyclic deformation loop practically from the first cycle. If balancing is absent, stabilization occurs only from the third cycle. Unlike static ones, the values of cyclic ranges do not depend on the application or non-application of balancing and remain practically stable with fixed geometric parameters and loading. Gradual reduction in the thickness of the beam-wall causes an increase in the range (static and cyclic) of elastic-plastic deformations strains at in the stress concentrator. The obtained results will shorten the time required for planning serial calculations of elastic-plastic deformation of a the beam-wall with edge break broken edges to develop appropriate design techniques.

Pharmacovigilance. Withdrawal and rebound effects: not just with psychotropic drugs

The list of drugs whose abrupt discontinuation is likely to induce withdrawal symptoms or a rebound in the pathology being treated is not limited to psychotropic drugs. It includes a number of somatic drugs (e.g. proton pump inhibitors, opioids, triptans, fingolimod, corticosteroids, antiepileptics, nootropics, antiparkinsonians, denosumab, beta-blockers, laxatives, nasal vasoconstrictors, etc.). This type of unintended effect, often underestimated, generally results from a drug-induced homeostatic imbalance that persists after the drug has been discontinued. Taking this risk into account right from the initial prescription should make it possible to prevent such complications, by encouraging intermittent use of the drug, or by applying a very gradual reduction in dosage when a regular treatment is stopped.

Genome Analysis of Plasmodium falciparum: A Preliminary Observation - Sierra Leone, 2022-2023.

Sierra Leone, with a gross domestic product (GDP) per capita below $300 and significant poverty, ranks among the world's least developed countries (LDCs). Despite its modest population of 8.6 million, the nation reports approximately 2.6 million malaria cases annually. Previously, there has been no reporting on the malaria genome data from this country. In this study, we present the first reported whole-genome sequence analysis of 19 high parasite-density Plasmodium falciparum isolates from Sierra Leone, providing insights into the genomic epidemiology of this high-prevalence area. We found a high degree of relatedness among infections and substantial genetic diversity, consistent with the gradual reduction in overall case numbers. Moreover, our whole-genome analysis revealed that, beyond drug-resistance genes, gene families related to blood cell invasion, immune evasion, and others are undergoing directional selection. This suggests that the population in Sierra Leone has developed a relatively strong acquired immunity. The genomic data not only facilitate the creation of single nucleotide polymorphism barcodes for case tracking but also enable the analysis of evolving transmission dynamics and selection pressures. Additionally, the samples from Sierra Leone exhibited higher selective pressures on resistance genes compared to those from Asia, a trend not commonly observed in other African samples. This suggests that less stringent healthcare systems and inconsistent treatment strategies can subject parasites to increased drug pressure, thereby accelerating the development of resistant strains.

Clinical and dermoscopic profile of female pattern hair loss

Background: Female pattern hair loss (FPHL) is one of the hair loss disorders in women characterized by a gradual reduction in hair from the frontal, central, and parietal areas of the scalp. FPHL is more common than previously thought, and data regarding the same are lacking in the Indian literature. Unlike male pattern hair loss, there are not much studies regarding FPHL in South India. Hence, we intend to study the clinical features, associations, and dermoscopic findings of FPHL in our population. Aims and Objectives: The study was conducted to estimate the clinical and dermoscopic features of FPHL. The secondary objective of the study was to estimate the severity of FPHL based on clinical and dermoscopic features. Materials and Methods: The cross-sectional descriptive study was conducted in 300 patients who were clinically diagnosed with FPHL attending the Department of Dermatology, Government Medical College, Kottayam, during a period of 18 months from February 2021 to August 2022. Results: The mean age of patients with FPHL was 46.99±13.8 years. The majority of the patients were asymptomatic. Hair diameter diversity of &gt;20% and miniaturized hair were the most common dermoscopic findings seen in all patients. Honeycombing and yew dots in dermoscopy were seen in 17 and 8.4% of patients, respectively. Conclusion: Dermoscopes are a useful tool to differentiate FPHL from other causes of diffuse hair loss that could mimic FPHL. The presence of yellow dots and honeycombs indicated advanced FPHL. Thus, dermoscopy helps in detecting early FPHL and initiating early treatment of this condition.