University Research Center Research Articles

Causal mediation analysis of factors influencing physical activity and community access among people with mild to moderate Parkinson's disease

ObjectiveTo examine how known causal factors (exercise self-efficacy, balance, walking capacity) affect outcomes (moderate intensity physical activity, community access) in people with Parkinson's disease (PD): through a direct pathway, indirectly through potential mediators (non-motor impairments), or through combined direct and mediated paths. DesignCausal mediation analyses using baseline and three-month data from pooled treatment groups in a randomized controlled trial. SettingData were collected at two university clinical research centers. ParticipantsOne hundred thirty-eight people with PD. InterventionsHome and community-based walking and strength exercise program. Main Outcome Measure(s)Exposures were exercise self-efficacy, walking ability, and balance. Potential mediators included pain, fatigue, mood (anxiety, depression, affect, apathy), stigma, and cognition (executive function and cognitive flexibility). Outcomes were physical activity and community access behaviour at three-month follow-up. Separate models were developed for each causal factor-mediator-outcome combination. To minimise bias, all models were adjusted for known confounders (comorbidities, freezing of gait, severity of motor impairments, and/or age) and baseline values of the outcomes. ResultsSelf-efficacy of walking duration had a causal relationship with moderate intensity physical activity through direct and combined paths (p<.001). Walking capacity had a causal relationship with community access through direct (p=.03-.04) and combined (p=.02-.03) paths. Balance did not affect community access (p>.05). There were no significant mediation effects through indirect pathways for either outcome. ConclusionsThe effect of known causal factors on physical activity and community access was not mediated by non-motor impairments. Walking self-efficacy and walking capacity remain the primary intervention targets for improving physical activity and community access, respectively, in people with PD.

Clinical implications of dual therapy of acarbose plus myo-inositol on the thyroid profile in women with polycystic ovary syndrome

Context: Polycystic ovary syndrome (PCOS) and thyroid are the most common endocrine disorders affecting women of childbearing age, causing anovulation and infertility. There is an increased prevalence of thyroid dysfunction reported among PCOS women. Aims: To evaluate the benefits of acarbose plus myo-inositol therapy on the thyroid profile of PCOS. Methods: An open-labelled, parallel randomised clinical trial on 80 PCOS women based on inclusion and exclusion criteria was performed at the Department of Gynaecology, SRM Medical College Hospital and Research Centre, Kattankulathur. Institutional ethics committee approval and prior informed consent were obtained. The trial was registered in CTRI (No: CTRI/2022/04/041877). Group A (n = 38) received metformin 500 mg TID, and group B (n = 39) received acarbose 50 mg TID along with myoinositol 1000 mg BID. Assessment of metabolic and hormonal profile was done at baseline and at the end of six months. Results: Both groups showed significant reductions in luteinising hormone (p &lt;0.0001), total testosterone (p&lt;0.05), thyroid stimulating hormone (p&lt;0.05), fasting insulin (p&lt;0.05), and homeostatic model assessment for insulin resistance (p&lt;0.0001). The follicle-stimulating hormone was increased only in the metformin group. No significant changes in body mass index, free triiodothyronine, free tetraiodothyronine, and fasting glucose were observed in any group. Both therapies were safe, and no side effects or hypoglycaemia were recorded. Conclusions: In consideration of the beneficial effects of the study, we conclude that the administration of acarbose plus myo-inositol exerts positive effects on the thyroid and other endocrinological profiles in PCOS women.

Analysis of the mean electrical axis of the heart from standard electrographic leads in normal adult males

Background: Electrocardiogram has been widely applied as a diagnostic tool for cardiovascular disease. The concept of the cardiac vector is crucial for the clinical application in ECG interpretation. Methods: A prospective cross-sectional study was conducted among 116 male subjects, aged 18-25 years, comprising students and staff of Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal, over the period from June to September 2023. Electrocardiograms (ECGs) were recorded using a standard ECG machine with conventional limb leads. The mean electrical axis of the heart for each individual was determined by plotting the net voltage of the QRS complex in Lead-I and Lead-III. The study aimed to analyze the correlation between the cardiac vector and physical measurements, such as height, weight, Body Surface Area (BSA), and Body Mass Index (BMI). Data analysis was performed using SPSS version 27.0. Results: The normal mean electrical axis of the healthy male subjects was observed as 57.88±24.55°. There was significant positive correlation of cardiac vector with height (p&lt; 0.05), whereas negative correlation was observed with weight and BMI (p&lt; 0.01). However, there was no significant correlation with BSA. In our study we observed the maximum left axis cardiac vector as -10° and right axis as 90° among 116 male subjects. Conclusion: We established a cardiac vector with values differing from those reported in other studies, using standard bipolar limb leads in normal, healthy male subjects. It is also examined that greater BMI has shifted the electrical activity of the ventricles to the left.

Screening of Klebsiella pneumoniae isolates reveals the spread of strong biofilm formers and class 1 integrons.

Klebsiella pneumoniae is a Gram-negative bacterium that can colonize, penetrate, and cause infections at several human anatomical locations. The emergence of hypervirulent K. pneumoniae and its ability to evade the immune system and develop antibiotic resistance has made it a key concern in the healthcare industry. The hypervirulent variants are increasingly involved in community-acquired infections. Therefore, it is pertinent to understand the biofilm formation potential among the clinical isolates. We acquired 225 isolates of K. pneumoniae from the Department of Microbiology, Symbiosis University Hospital and Research Centre (SUHRC), Pune, India over 1 year from March 2022- March 2023, and evaluated antimicrobial susceptibility, hypermucoviscous phenotype, virulence, and antimicrobial-resistant gene distribution in K. pneumoniae isolates and established a correlation between antimicrobial resistance and integrons. Most isolates were strong biofilm formers (76%). The isolates harbored one or more carbapenemase/ beta-lactamase encoding gene combinations. Hypermucoviscous (HMKP) isolates had considerably greater positive rates for iutA, magA, K2 serotype, rmpA, and rmpA2 than non-HMKP isolates. Isolates carrying integrons (43%) showed significantly more antibiotic resistance. The study reveals spread of strong biofilm formers with extensive virulence and antimicrobial-resistant genes, and integrons responsible for multi-drug resistance among the clinical isolates of K. pneumoniae in Pune, India, posing a threat to the public health and necessitating close surveillance, accurate diagnosis, control, and therapeutic management of infections.

Exposure of antral follicles to medroxyprogesterone acetate during stimulation does not cause molecular perturbations in gonadotropin-responsiveness and steroidogenic function of granulosa cells in progestin-primed cycles.

Does medroxyprogesterone acetate (MPA) exposure in progestin-primed ovarian stimulation (PPOS) cycles cause molecular perturbations in the steroidogenic function and gonadotropin responsiveness of the granulosa cells? PPOS cycles are identical to traditional GnRH antagonist cycles not only for clinical IVF characteristics but also for gonadotropin receptor expression, response to gonadotropins, and steroidogenic function at the molecular level. PPOS is increasingly used as an alternative to GnRH antagonists due to the inhibitory effect of progesterone on LH release by reducing GnRH pulsatility at the hypothalamic level. Although a growing body of evidence from clinical studies did not indicate significant differences between PPOS and antagonist protocols for IVF cycle characteristics and obstetrical outcomes, it is still unknown whether exposure of the antral follicle cohort to progesterone or its synthetic derivatives during ovarian stimulation causes any subtle molecular aberrations in terms of steroidogenesis and gonadotropin responsiveness. To address this issue, detailed comparative molecular analyses were conducted in the luteinized mural granulosa cells (GCs) obtained from normal responding IVF patients undergoing PPOS and antagonist cycles. A clinical translational research study was conducted with IVF patients. This study included 55 normal responding IVF patients who underwent ovarian stimulation with either PPOS using MPA (5 mg twice daily) or GnRH antagonist cetrorelix acetate. Recombinant forms of FSH and hCG were used for ovarian stimulation and ovulation triggering, respectively. Luteinized mural GCs obtained during the oocyte retrieval procedure were used for the experiments. Cell culture, quantitative real-time PCR, immunoblotting, confocal time-lapse live cell imaging, and hormone assays were used. Demographic and IVF cycle characteristics of the patients undergoing ovarian stimulation with PPOS and GnRH antagonist were similar, including ovarian response, mature oocyte yield, and fertilization rates. Molecular analyses revealed that the expression of the enzymes involved in sex-steroid synthesis (StAR, SCC, 3β-HSD, 17β-HSD, aromatase) and the uptake/storage/utilization of cholesterol (LDL receptor, Hormone-sensitive lipase, hydroxy-methyl glutaryl Co-enzyme-A reductase, and Sterol O-acyltransferase1) in the GCs of the PPOS cycles were comparable to those of the antagonist cycles. The expression of the receptors for gonadotropins, estrogen, and progesterone hormones was also similar. Basal and hCG-induced increases in 3β-HSD expression and progesterone production and basal and FSH-induced increases in aromatase expression and E2 output of the GCs from PPOS patients did not exhibit any meaningful differences when compared with GCs from antagonist cycles. Furthermore, basal and hCG-induced up-regulation in the LDL receptor expression and cholesterol uptake did not differ between the groups. Confocal imaging also revealed similar patterns of expression for the steroidogenic enzymes and their co-localization with mitochondria. Lastly, the expression of the other important genes regulating cumulus expansion, ovulation, and luteal function [Relaxin, ADAMTS-1, and epidermal growth factor (EGF)-like growth factor amphiregulin] in the GCs of the PPOS and antagonist cycles were similar. N/A. Caution should be exercised when interpreting our data which was derived from normally responding patients whose ovulation was triggered with hCG. It is unclear whether the molecular parameters assessed vary according to infertility etiologies, magnitude of ovarian response, mode of trigger, and any other underlying ovarian pathologies or systemic diseases. MPA was the progestin used for PPOS and whether these findings can be generalized to other progestins is unknown. This study provides reassuring molecular evidence that exposure of antral follicle cohorts to MPA during the follicular growth phase does not have any detrimental effects on steroidogenic, ovulatory, and luteal functions when compared with GnRH antagonist cycles. This study was funded by the School of Medicine, the Graduate School of Health Sciences of Koc University and Koç University Research Center for Translational Medicine (KUTTAM), and equally funded by the Republic of Turkey Ministry of Development Research Infrastructure Support Program. All authors declare no conflict of interest. N/A.

From Awareness to Action: Addressing Folic Acid Supplementation in Western India Among Women of Reproductive Age.

Background Folate, a vitamin B9, can be sourced naturally in the diet or the form of supplements. Studies highlight the prevention of neural tube abnormalities in women of reproductive age. To prevent these, low daily doses of FA (400-800 μg) are recommended for all women planning pregnancy, with higher doses for those with previous NTD-affected pregnancies. Folic acid supplementation lowers the risk of NTDs, other birth defects, and obstetrical complications. Methods The study explored awareness of and knowledge of folic acid supplements among women of childbearing age in Pune City, western Maharashtra, India. The cross-sectional survey was carried out at Symbiosis University Hospital and Research Centre (SUHRC), involving 300 female participants aged 16-44 years. The study utilized a structured questionnaire to evaluate participants' knowledge of folic acid supplements, their benefits, and usage patterns. Results Use as well as awareness of folic acid supplements was strongly associated with educational attainment. The awareness was low or none in participants who never attended school, and highest among the university graduates. The study included 300 women aged 16-45. About 43% of the study participants were between the ages of 23 and 29 years old; 57.7% were single, and 59.3% among them were university graduates. 59.7% of the study participants knew about folic acid supplements, but only 20% took them regularly. Knowledge about ideal timing and benefits was limited among them. 38% correctly identified prepregnancy as the ideal time to start. Only 18% knew it prevents neural tube defects, and 27% knew it could be obtained naturally. Conclusion The study highlights a lack of detailed knowledge about folic acid supplements among the study participants. Recommendations to enhance the supplement's intake include public health campaigns, enhanced healthcare provider education, easy-to-read informational materials, and strengthening government supplement programs to improve awareness and food fortification. Further research on consumption barriers for the supplement needs to be carried out.

Use of information technologies in lean management: the case of Gazi University Research Center in Turkey

Purpose Sustainability and accessibility of education are the main purposes of educational institutions. Higher education institutions (HEIs) have been addressing these concerns through their distance education departments for years. Especially during and after the COVID-19 pandemic, HEIs encountered challenges related to productivity, escalating costs and decreasing user satisfaction with distance education. This study proposes the integration of new and suitable information technologies (ITs) into the steps of lean management (LM) implementation. It suggests that this approach will be highly effective and beneficial, providing solutions to the problems above in higher education (HE) field. The study aims to highlight the effectiveness and benefits of incorporating new and suitable ITs into the application stages of LM principles. Sample applications in HE will be provided to enhance understanding. Design/methodology/approach A model is introduced for researching new ITs and incorporating appropriate ones in the application steps of LM. This model has been applied and analyzed in two case studies at Gazi University for a more comprehensive understanding. Findings When examining periodic surveys and usage statistics from case studies, it becomes evident that implementing LM with the support of ITs reduces waste and enhances the quality of existing work. The success observed in the case studies was notably influenced by managers’ proficiency in business processes, experience in ITs, managerial skills and support from senior management. Practical implications This case study provides a roadmap and step-by-step implementation of LM with IT support for HEIs. The implementation process and results will also be guiding for other sectors. Originality/value There is a notable absence of significant studies on integrating ITs, which have become crucial in today’s context in the stages of LM implementation. This study is envisioned as a pioneering endeavor to address this gap in the literature. Notably, challenges exist in applying LM principles outside production sectors, and limited research has been conducted. This study aims to pave the way for further research in diverse fields by conducting a comprehensive case study in the realm of HE.

You Work for Us Now: Concentration in University-Performed Defense R&D

ABSTRACT Concentration in university research funded by the Department of Defense (DOD) has been rising in recent years, deviating from the steady levels of concentration in other federally-funded university research. The purpose of this paper is to explain that rise in concentration. When the DOD funds defense-specific R&D projects, there are two priorities affecting bureaucratic incentives: 1) Coordination incentivizes steering research toward specific technological ends, and 2) Security incentivizes actively limiting risks of information leakage. Sole source research center contracts make the necessary coordination and monitoring easier to achieve. As demand for projects that require more coordination and security increases, spending is allocated to sole source research centers leading to increasing concentration. Spending on military research projects awarded to universities such as aircrafts rapidly increased from 2008 to 2020 with much of that spending accruing to DOD-sponsored university research centers. Over that period, the share of obligations awarded to the 16 universities that manage DOD research centers rose from 37 percent in 2008 to 59 percent in 2020. This paper contributes to our understanding of the conditions under which policy makers choose to deviate from using grants to fund early-stage research and concentrate funding in a select group of performers.

Management of Hand Eczema with Unani Medicine: A Case Study

Background: Eczema, is a common chronic skin condition that can lead to recurrent infections and poor quality of life if left untreated. This paper presents the case of a 30-year-old male patient, who came to the outpatient department (OPD) of the Kashmir Tibbia College Hospital and Research Centre, Shilvath, Bandipora, Kashmir, India. Clinical presentation: His chief complaints were lesions on the palm of his left hand for one year. The patient also complains that his skin is black and thickened with severe itching on the affected area. Diagnosis: The patient was diagnosed clinically with hand eczema resembling Nar-e-Farsi in the Unani system of medicine. Interventions: For 30 days, Marham Kafoor was topically applied twice a day at a dose of 8-10 gm. Outcome: The patient was assessed before, the 15th day and 30th day of treatment based on the EASI, POEM, and VAS. Results: After the intervention, significant improvement was observed in all scales from baseline to 30th day. EASI changes from 18 (moderate) to 5 (mild), POEM changes from 19 (severe) to 7(mild), and VAS from 8 (severe) to 1 (mild). Conclusion: Marham Kafoor has been proven beneficial in treating hand eczema and enhancing patients' quality of life Keywords: Eczema; Marham Kafoor; Unani Medicine

188 Prediction of individual grazing beef cattle dry matter intake

Abstract Estimation of individual dry matter intake (DMI) of pastured beef cattle is critical to grassland management, genetic improvement of efficiency, and increasing the sustainability of animal agriculture. Currently, the only way to measure individual DMI of grazing cattle is through expensive, labor intensive, and spatially demanding research protocol. Very few options for assessment of individual DMI of grazing animals exist for cattle producers. We have developed a machine learning approach to predicting individual DMI of pastured beef cattle that requires only body weight (BW), water intake, and open-source climate variables. Training data were collected in Wardensville, WV at the West Virginia University Research, Outreach, and Education Center. Crossbred steers (n = 32) were phenotyped for Residual Feed Intake (RFI) in the barn. Animals were split into four groups of two low RFI and two high RFI. After a grazing acclimation period, animal groups were rotationally grazed concurrently through 0.05 ha plots for 7 d. Daily BW and water intake data were collected throughout the experiment using an RFID-equipped front-end scale and metered waterers. Beginning on d 2, animals were provided a bolus of Cr2O3 (10 g) at 0700 and 1900 h. Beginning on d 5, fecal samples were collected from each animal at 0700 and 1900 h. Samples were analyzed for Cr2O3 content and used in conjunction with forage digestibility from paired clipped samples to generate individual intakes. These data were used as ground truth data to assess model performance. We used our Repeated Measures Random Forest (RMRF) model to predict individual DMI of animals using daily BW, water intake, and climate variables. Intakes estimated by RMRF were compared with intakes estimated by NASEM equations. Our model outperformed NASEM predictions by 70%, indicating that our method achieves better results than the current most efficient approach. Though iterative model improvements will be made (collection of more training data, collection of more diverse training data, and use of first-differenced, moving average, and seasonally adjusted variables), our work demonstrates a novel, efficient method for researchers and producers to more accurately estimate DMI of individual pastured beef cattle.

Study on incidence and clinical profile of anemia in children aged 1 years to 15 years attending tertiary care hospital

Background: Children are considered as an important asset for any country and their health as one of the important indicators of a healthy country. There are various factors influencing children's health, with anemia being one of them. Anemia is a major global health problem, especially in developing countries like India, despite the fact that this problem is largely preventable and easily treatable. Methods: It is a descriptive study conducted in 140 children aged 1 year to 15 years who presented with anemia in the department of pediatrics at Navodaya Medical College Hospital and Research Center, Raichur. Aim was to study the incidence and profile of anemia in children aged 1 years to 15 years. Results: A total 0f 140 cases aged between 1- 15 years were included in the study. The highest number of cases occurred in the 11-15 years age group (38.5%), followed by the 6-10 years group (35.0%). There is more female preponderance in this study (55.7%) compared to males (44.2%). Moderate degree of anemia was the commonest grade of anemia (42.8%) The most common cause of anemia in this study was iron deficiency, accounting for 58 cases (41.4%) followed by 17 cases (12.1%) had megaloblastic anemia. Conclusions: Iron deficiency anemia is a preventable cause of cognitive impairment, and early interventions can prevent the morbidity and mortality associated with anemia. Despite the implementation of national programs to combat iron deficiency, the problem persists. Early detection of anemia among these children enables the planning of suitable interventions, such as nutritional education for mothers, growth monitoring, nutritional supplementation, deworming, and more, to effectively address and mitigate the issue.

Prospective Assessment of Transforaminal Lumbar Interbody Fusion (TLIF) in Spondylolisthesis: A Radiological and Functional Outcome Study in an Indian Population.

Spondylolisthesis is a common spinal condition in which one vertebra slips over another, leading to pain and disability. Transforaminal lumbar interbody fusion (TLIF) has emerged as a surgical option for addressing spondylolisthesis; however, limited research exists, especially in the Indian context, evaluating its radiological and functional outcomes. The study aimed to evaluate the radiological and functional outcomes of TLIF in spondylolisthesis using standardized scoring systems, to evaluate the sagittal balance of the spine radiologically in patients who have undergone TLIF for spondylolisthesis, and to evaluate the correlation between the functional and radiological outcomes after TLIF. This prospective observational study included spondylolisthesis patients undergoing TLIF at SRM Medical College Hospital and Research Centre from August 2022 to August 2024. Criteria included Meyerding grade 1-4 spondylolisthesis, single-segment fusion, and willingness for 12-month follow-up. Forty-five patients were included with age 36.6 ± 12.2 years, with 73.3% being female. L4-L5 is the most common level affected in 21 patients (46.7%). Significant improvements were observed in pelvic tilt 19.07 ± 2.05, sacral slope 30.6 ± 4.4, segmental lordosis 18.4 ± 1.4, lumbar lordosis 57.1 ± 1.8, sagittal vertical axis (SVA) 2.5 ± 0.3, Visual Analog Scale for pain 0.4 ± 0.5, and Oswestry Disability Index (ODI) scores 5.23 ± 2.6 postoperatively (p < 0.05). At one-year follow-up, 84.4% of patients had good-to-excellent outcomes, and 44.4% had definitive fusion according to modified Lee criteria. However, there was no correlation between ODI score and grade of listhesis, pelvic incidence (PI), or SVA of the spine (p > 0.05). This study provides valuable insights into the effectiveness of TLIF surgery in addressing spondylolisthesis, both in terms of radiological and functional outcomes. However, there was no correlation between improvement in functional and radiological parameters (PI vs. ODI, SVA vs. ODI). TLIF appears to offer significant improvements in patient well-being and quality of life. These findings contribute to understanding TLIF's suitability as a treatment for spondylolisthesis and can inform clinical practice, ultimately benefiting patients suffering from this condition.

The Relationship Between Fibrinogen and Glycated Hemoglobin (HbA1c) in Diabetic Foot Ulcers.

Diabetic foot ulcers (DFUs) are a common complication of diabetes that affects patients' quality and prognosis of life. The study aims to assess the correlation between fibrinogen and glycated hemoglobin (HbA1c) in DFUs at the firstand sixth months and to compare fibrinogen levels with Wagner classification in DFU patients. This observational study was conducted at SRM Medical College Hospital and Research Centre from January 2021 to July 2022. Fifty diabetes patients with DFUs were selected, and informed consent was obtained before the study started. Blood samples were collected from all the participants for HbA1C, serum fibrinogen, hemoglobin, and white blood cells. In this study, data were entered into MS Excel (Microsoft Corporation, Redmond, WA) and analyzed using SPSS version 24 (IBM Corp., Armonk, NY). ANOVA and Pearson's correlation were used to examine the relationships between serum fibrinogen levels and clinical parameters. Among 50 patients, the females were 16 (32%), and the males were 34 (68%). Most patients (34%) were in the 56-60 age group. Twenty patients haddiabetes for 10 years, and 24 were diabetic for 11-15 years. The ankle-brachial index (ABI score) was mild in 14 patients (28%), moderate in 28 patients (56%), and normal in eightpatients (16%). There is a significant difference in comparison between the Wagner classification and ABI. A significant difference was observed in fibrinogen at the first and sixth months between HbA1c first, third, and sixth months. Significant differences were also observed in fibrinogen and ABI in the first and sixth months. Key findings include significant differences between fibrinogen and HbA1c levels (p < 0.0001) and a strong association between fibrinogen levels and ABI scores (p < 0.0001), underscoring fibrinogen's potential as an early marker for glycemic control and peripheral arterial disease in DFU patients. We concluded that simple fibrinogen estimation helps predict glycemic control in diabetic patients with DFUs.

MRI Evaluation of Traumatic and Non-traumatic Pathologies of the Ankle Joint and Hindfoot: A Single-Center Observational Study.

Background Pathologies affecting the ankle joint and hindfoot can present with a variety of clinical symptoms and etiologies, necessitating accurate diagnostic tools for effective management. Magnetic resonance imaging (MRI) is a valuable imaging modality for assessing these pathologies, providing detailed visualization of bone, joint, tendon, and other soft tissue abnormalities. Objectives To evaluate MRI findings in a diverse cohort of 105 participants with pathologies affecting the ankle joint and hindfoot, focusing on the prevalence and types of bone, joint, tendon, and soft tissue abnormalities. Materials and methods A single-center observational descriptive study was conducted at Dr. D. Y. Patil Medical College and Hospital and Research Centre, Pune, India, over a period from August 2022 to July 2024, involving 105 participants (54.3% male, 45.7% female) with a mean age of 39.04 years. MRI scans were analyzed to assess the prevalence of bone, joint, tendon, and soft tissue pathologies. Clinical profiles, symptom duration, and etiological classifications were documented. Results Analysis of the results obtained from 105 (N = 105) study participants revealed that pain (94.3%, or 99 cases) was the most common symptom, followed by restricted movement (86.7%, or 91 cases), trauma history (75.2%, or 79 cases), and swelling (73.3%, or 77 cases). Traumatic causes (76.2%, or 80 cases) predominated, while inflammatory (48.3%, or 14 cases) and infective (34.5%, or 10 cases) causes were also significant. MRI findings showed marrow edema in 41.9%, or 44 cases, subchondral cysts in 22.9% (24 cases), fractures in 17.1% (18 cases), and erosions in 10.5% of participants (11 cases). Joint involvement was most frequent in the tibiotalar (76.2%, or 80 cases) and subtalar joints (58.1%, or 61 cases). Tendon pathologies included peritendonitis (55.2%, or 58 cases) and tendinosis (23.8%, or 25 cases), with the Achilles tendon being the most frequently affected (39%, or 41 cases). Ligament injuries were predominantly sprains (46.7%, or 49 cases), with less frequent partial (18.1%, or 19 cases) and complete tears (7.6%, or eight cases). Soft tissue findings included subcutaneous edema (76.2%, or 80 cases) and bursitis (24.8%, or 26 cases). Among the study participants who presented with non-traumatic pathologies, inflammatory pathologies (48.3%, or 14 cases) were the most common, followed by infective (34.5%, or 10 cases) and neoplastic (17.2%, or five cases) pathologies. Conclusion MRI effectively identifies a wide range of pathologies in the ankle and hindfoot, with marrow edema, joint effusion, and tendon pathologies being prevalent. The study underscores the utility of MRI in diagnosing and assessing various conditions in the ankle joint complex and highlights the need for accurate imaging to guide treatment decisions. Future research should focus on correlating MRI findings with clinical outcomes to enhance diagnostic accuracy and management strategies.

Evaluating the Status of Hepatitis B Vaccination in Healthcare Workers at a Central Laboratory in a Tertiary Care Hospital and Research Centre.

Introduction Hepatitis B virusis a significant occupational hazard for healthcare workers worldwide. Long-term protection against hepatitis B infection is conferred by the vaccineand the protective immune response is indicated by anti-hepatitis B surface antigen (HBsAg) titre. It is crucial to monitor anti-HBsAg titres as their levels decrease over time. The study aims to evaluate thestatus of hepatitis B vaccination among personnel working in the Central Laboratory of Shri B.M. Patil Medical College Hospital and Research Centre. The focus is on understanding the immunization practices and protection levels against HBV within this high-risk group. Materials and methods A cross-sectional analysis was conducted, including collecting demographic data, determining HBsAgstatus, evaluating anti-HBsAg titre value, and getting vaccination details of the laboratory personnel. The study participants included doctors, lab technicians, and attendants who were assessed for both vaccination coverage and immunity levels. After obtaining their written consent, 4 ml of blood was collected in sterile blood collection tubes. All the samples were tested for HBsAg. The negative samples were tested for anti-hepatitis B surface antigen antibody (HBsAg-Ab (IgG)) titre. The enzyme-linked immunosorbent assay (ELISA) method was used to evaluate the obtained samples for HBsAg and anti-HBsAg titre. Results A total of 99 healthcare workerswere included in the study. Most of the laboratory healthcare workers were in the age range of 20-30 years.In 84.8% of the subjects, protective antibody levels (>10 IU/ml) were found. The highest protection was seen among doctors (94.5%), followed by lab technicians (82.9%) and attendants (66.6%). However, 15.2% exhibited inadequate immunity, predominantly among the attendants (33.3%). The highest vaccination coverage was among doctors (91.8%), followed by lab technicians (78.7%) and attendants (53.3%). Most doctors had completed the full vaccination schedule (70.2%) or received a booster dose (24.3%) compared to lab technicians (57.4%)and attendants (46.6%). Conclusion The study highlights effective preventive measures against HBV among laboratory healthcare workers, as indicated by the absence of active infections. But it also emphasizes the necessity of focused initiatives to raise vaccination rates, particularly among attendants, in order to guarantee complete protection against HBV for all levels of laboratory workers.

Evaluation of Immunohistochemical Marker Bcl-2 in Epithelial Dysplasia and Squamous Cell Carcinoma of the Oral Cavity.

Squamous cell carcinoma of the oral cavity is the most common malignancy noted globally.Pathogenesis of premalignant and malignant oral lesions is mainly attributed to the alteration in the molecular mechanisms that regulate apoptosis and cell proliferation. B-cell lymphoma gene 2 (Bcl-2) is the anti-apoptotic gene that prolongs cell survival by inhibiting apoptosis and is associated with the aggressive behaviour of malignant tumours. The aim of the study was to evaluate Bcl-2 expression in oral squamous cell carcinoma and dysplastic lesions of the oral cavity and to compare its expression with various grades of dysplasia and carcinoma. A hospital-based cross-sectional study was done on 80 clinically suspected cases of dysplastic and malignant oral cavity lesions received in the histopathology section of the Department of Pathology of Shri BM Patil Medical College Hospital and Research Center, Vijaypura, Karnataka. Out of 80 cases, 40 were squamous cell carcinoma, and 40 were dysplastic lesions of the oral cavity. For each case, two sections measuring 4 μm thickness were prepared. Hematoxylin and eosin staining was performed on one section, and Bcl-2 IHC staining was performed on another. Bcl-2 expression evaluation was done for each case of oral epithelial dysplasia and squamous cell carcinoma. Out of 40 cases of squamous cell carcinoma, 15 were well-differentiated, 22 were moderately differentiated, and three were poorly differentiated. In well-differentiated oral squamous cell carcinoma, Bcl-2 positivity was grade 0 in 66.7% of cases and grade 1 in 33.3% of cases. In moderately differentiated oral squamous cell carcinoma, Bcl-2 positivity was grade 1 in 63.6% of cases and grade 2 in 36.4% of cases. In poorly differentiated oral squamous cell carcinoma, Bcl-2 positivity was grade 1 in 33.3% and grade 2 in 66.7% of cases. Out of 40 cases of dysplastic lesions, 11 cases showed severe dysplasia, 11 cases showed moderate dysplasia and 18 cases showed mild dysplasia. grade 2 positivity was seen in 72.7% of cases of severe dysplasia and 63.6 % of cases of moderate dysplasia. In mild dysplasia, all of the cases showed grade 0 Bcl-2 expression. In poorly differentiated oral squamous cell carcinoma Bcl-2 positivity was high and low in well-differentiated oral squamous cell carcinoma. Bcl-2 expression was higher in severe dysplasia compared to moderate dysplasia, which may indicate aggressive behaviour of tumour in poorly differentiated oral squamous cell carcinoma and severe dysplasia.

Responses of Soil Enzymes Activities to Sprinkler Irrigation and Differentiated Nitrogen Fertilization in Barley Cultivation

Our study aimed to assess the impact of sprinkler irrigation on the activity of selected soil enzymes in terms of nitrogen metabolism and oxidation–reduction processes in soil with different doses of inorganic nitrogen fertilizers. An Alfisol was sampled from an experimental field of spring barley within the University Research Center in the central part of Poland, namely the village of Mochełek with a moderate transitory climate, during the growing seasons of 2015–2017. The soil resistance (RS) was derived to recognize the resistance enzymes during drought. In the maturity phase, nitrate reductase activity was 18% higher in irrigated soil and the activities of other enzymes were higher than in the non-irrigated plots by 25% for dehydrogenase, 22% for peroxidase, 33% for catalase, and 17% for urease. The development phase in the barley influenced nitrate reductase activity. Enzymatic activities changed throughout the research years. During the maturity stage, a lower ammonium nitrogen content in the soil resulted from a higher spring barley uptake due to drought stress. Irrigation probably contributed to increased leaching of nitrate in the soil. The highest index of resilience was found in the soil catalase activity.

Towards a comprehensive framework to support project studies in the context of university research centres: a design science research

PurposeKnowledge production in project studies is continuously challenged to combine scientific rigour and practical relevance, and a professional graduate programme in Project Management is a suitable environment for addressing this issue. This research aims to generate a framework of the Ecosystem of a University Research Centre in Project Studies (URC-PS) to enhance the benefits of research developed in a professional graduate programme.Design/methodology/approachThe research was developed under the paradigm of Design Science and operationalised through a method of Design Science Research. The prescriptive approach was used to identify, design, develop, demonstrate, and evaluate the framework.FindingsThe framework comprises four macro-elements: Project Studies; Impact Generation Process; Circumstances, Governance and Management; and Context, broken into sixty elements. It provides a structure that is simultaneously holistic, integrative, and procedural. It also develops a perspective of knowledge co-creation between academics and practitioners in an engaged scholarship approach.Practical implicationsThe framework provides a more thorough understanding of the ecosystem university management to the research centre itself, to engaged academics, and to external actors, which allows them to discuss, plan, execute, and evaluate the co-creation of knowledge in Project Studies.Originality/valueThe framework contributes to Organisational Knowledge Creation Theory by including and discussing outcomes and impacts from co-created knowledge in a URC-Project Studies environment. It also explores the concept of “Ba” in its proposal for structuring, organising, and operationalising the “Ba”.

Evaluation of the Bio-Speedy Meningitis/Encephalitis Panel in the Diagnosis of Central Nervous System Infections

Infections of the central nervous system (CNS) can lead to severe outcomes if not accurately diagnosed and treated. The broad spectrum of pathogens involved in CNS infections can make diagnosis challenging. Polymerase chain reaction (PCR) -based multiplex molecular diagnostic panels can rapidly and simultaneously detect multiple neuropathogens in cerebrospinal fluid (CSF). This study was aimed to assess the Bio-Speedy Meningitis/Encephalitis RT-PCR MX-17 panel (Bioeksen, İstanbul, Türkiye), a novel multiplex PCR test, in diagnosing CNS infections. The panel can detect a range of pathogens, including Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Streptococcus agalactiae, enterovirus (EV), herpes simplex virus (HSV) 1 and 2, HHV-6, HHV-7, HHV-8, human parechovirus (HPeV), varicella zoster virus (VZV), cytomegalovirus (CMV) and Cryptococcus gatti/neoformans in CSF samples. This retrospective study included 128 CSF samples from 128 patients sent to Bursa Uludağ University Health Application and Research Center Microbiology Laboratory between June 2022 and July 2023 to search for CNS infectious agents. Patient clinical, radiological and laboratory data were collected from the Hospital Information Record System (HIRS). Bacterial pathogens were identified through culture, while viral pathogens were detected in CSF samples using the Fast Track Diagnostics (FTD) multiplex RT-PCR panel (Fast Track Diagnostics Ltd., Luxembourg) for HSV-1, HSV-2, VZV, EV, mumps virus and HPeV. The stored CSF samples were then tested using the BioSpeedy panel and the results were compared with those of the culture and the FTD panel. Pathogens that were detected were considered positive if they were consistent with the patient's symptoms and CSF characteristics according to infectious disease and pediatric infectious disease specialists. Pathogens detected but not supported by the patient's symptoms and CSF characteristics were classified as uncertain clinical relevance (UCR). Out of the 128 patients tested for CNS infectious agents, 44 (34.4%) were diagnosed with a CNS infection. The overall pathogen detection rate with all methods was 43.2% (19/44). The Bio-Speedy panel identified pathogens in 29.5% (13/44) of the patients, followed by the FTD panel (20.5%, 9/44) and culture (9.1%, 4/44). Four bacteria were identified with culture, three of which were also detected by the Bio-Speedy panel. Additionally, six bacteria were identified with Bio-Speedy panel, that were not identified by culture. The FTD panel identified nine viruses, four of which were also identified by Bio-Speedy. In total, the Bio-Speedy panel detected 13 of the 19 positive pathogens (nine bacteria and four viruses: [S.pneumoniae (n= 3), VZV (n= 3), N.meningitidis (n= 2), H.influenzae (n= 2), L.monocytogenes (n= 1), E.coli (n= 1) ve EV (n= 1)]. However, the Bio-Speedy panel identified 15 pathogens [S.pneumoniae (n= 1), E.coli (n= 1), C.gatti/neoformans (n= 1), CMV (n= 8), HHV-6 (n= 3) ve HHV-7 (n= 1)] considered as UCR. The Bio-Speedy identified the causative pathogens in the highest percentage (29.5%) of patients with confirmed CNS infections. Nevertheless, test results should be interpreted based on patient characteristics to ensure appropriate patient management. Using multiple methods and multiplex tests may improve diagnostic accuracy for CNS infections.

Comparison of Fentanyl With Midazolam As Adjuvants to Levobupivacaine in Spinal Anesthesia for Cesarean Sections: A Randomized Controlled Trial.

Background and objectives Spinal anesthesia stands as a cornerstone for patients undergoing lower segment cesarean section (LSCS), offering advantages like faster onset and high block density. Levobupivacaine, known for its high potency and long-acting nature, has a slower onset. The safety of intrathecal fentanyl or midazolam is evaluated as an adjuvant to levobupivacaine in parturients. This study aims to compare the duration of postoperative analgesia provided by fentanyl or midazolam added to 0.5% hyperbaric levobupivacaine in elective cesarean sections. Secondary objectives include evaluating the onset and duration of sensory and motor blockade and the incidence of nausea and vomiting. Identifying the more effective adjuvant will help optimize spinal anesthesia protocols, improve postoperative outcomes, and enhance patient comfort and recovery. Methods This study was conducted at SRM Medical College Hospital and Research Centre, Chennai, India, over six months (May 1, 2023, to October 1, 2023). A total of 90 patients undergoing elective LSCS received spinal anesthesia in a prospective randomized double-blinded controlled trial. Patients were allocated to three groups: Group A received levobupivacaine with fentanyl, Group B received levobupivacaine with midazolam, and Group C received levobupivacaine with normal saline. Block characteristics, postoperative analgesia, hemodynamic stability, and complications were assessed. Assessments were conducted at specified time points: intraoperatively, every five minutes for the first 30 minutes, every 10 minutes for the next hour, every two hours for six hours, and every four hours up to 24 hours postoperatively. Statistical analysis utilized one-way analysis of variance (ANOVA). Results Group B (levobupivacaine with midazolam) exhibited a shorter time to sensory block onset (88 seconds) compared to Groups A and C (both 145 seconds) (p < 0.001). Group A (levobupivacaine with fentanyl) showed a shorter time to maximum motor block (p = 0.045) than Groups B and C. The sensory block duration was significantly longer in Group A (127.5 minutes) compared to Group B (60 minutes) and Group C (69 minutes) (p < 0.001). Motor block duration was also prolonged in Group A (251 minutes) compared to Group B (147 minutes) and Group C (177 minutes) (p = 0.045). The first analgesic requirement was delayed in Group A (248 minutes), whereas Groups B (115 minutes) and C (90 minutes) (p < 0.001) required more frequent analgesia. Group A experienced a higher incidence of postoperative nausea and vomiting. Conclusion Midazolam accelerated sensory block onset, while fentanyl prolonged anesthesia duration without significantly affecting motor block. Fentanyl delayed the first analgesic requirement, whereas midazolam reduced postoperative nausea, vomiting, and shivering.