bluuebunny/crossref_metadata_2025 huggingface dataset:
Peran Supervisi Akademik Kepala Sekolah dalam Optimalisasi Implementasi Kurikulum Merdeka di Sekolah
Authors: Wahidah Asni , Amrulloh Amrulloh , Hakim Dhikrul
Published: January 2025

SMA Darul Ulum 2 Unggulan BPPT Jombang has successfully integrated the Merdeka Curriculum effectively, supported by academic supervision practices carried out by the school principal. The purpose of this supervision is to prepare and optimize the implementation of the Merdeka Curriculum, as evidenced by the school's achievements as the best in Jombang and the high number of students accepted through the SNBP. However, there are several challenges in the implementation of supervision, including the presence of teachers who have surpassed retirement age, time limitations, and variations in human resources. This study aims to identify the role of the school principal in academic supervision that supports the implementation of the Merdeka Curriculum, as well as the factors that contribute to or hinder this process. The research method used is qualitative with an interactive approach, and data is collected through observations, interviews, and document analysis. Data analysis is conducted through triangulation, verification, reduction, and systematic presentation. The study's results reveal that the principal's academic supervision encompasses four important aspects: pre-observation, socialization, mentoring, and monitoring. Nevertheless, various obstacles such as teacher age, time constraints, and varying competencies among teachers need to be addressed to enhance the effectiveness of supervision.
Manajemen Perguruan Tinggi Berbasis Pesantren
Authors: Jaudi Jaudi
Published: January 2025

The management of pesantren-based higher education institutions in Indonesia faces various challenges in balancing Islamic values with modern academic demands. Pesantren-based universities have a unique potential to develop an educational model rooted in pesantren values while also meeting higher education standards. This study aims to analyze how the management model of pesantren-based universities can be optimized to remain relevant and competitive. The research uses a descriptive qualitative method with data collection through a literature review, providing insights into ideal management practices in this context. The results indicate that the success of pesantren-based university management is greatly influenced by the integration of pesantren values within a professional management system, particularly in areas such as human resource management, curriculum development, and community engagement. This research contributes by offering adaptive, value-based management recommendations, providing a reference for sustainable and innovative management of pesantren-based higher education institutions.
Pengembangan Sumber Daya Manusia dalam Manajemen Pendidikan Islam Berbasis Nilai-nilai Qurani
Authors: Ilhamsyah Rizal
Published: January 2025

In Islamic education administration, human resource development (HR) is crucial to building a competent, honorable, and high-quality educational system. Qur'anic values are one strategy that can support human resource development by giving managers, teachers, and students moral guidance and standards. The necessity to match Islamic education management with Qur'anic principles in order to create individuals who are balanced in both intellectual and spiritual dimensions is the basis of this study. The purpose of this study is to examine howthe basis of this study. The purpose of this study is to examine how Qur'anic ideals are used to the development of human resources in Islamic educational institutions and how this affects the standard of education management. The approach involves a review of the literature using a variety of pertinent sources, such as the Qur'an, Islamic education management publications, and scholarly publications that are relevant. According to the study's findings, developing human resources in accordance with Qur'anic principles greatly enhances the moral and academic quality of teachers, school administrators, and students. The Qur'anic values of justice, trust, and cooperation can improve managerial efficacy and foster a more peaceful and fruitful learning environment. This study's contribution is to offer fresh perspectives for the creation of a more comprehensive Islamic education policy that prioritizes moral and spiritual considerations in addition to cognitive ones as the cornerstones of educational administration.
STATUS DAN KEDUDUKAN WALI DALAM PERNIKAHAN TERHADAP ANAK HASIL ZINA MENURUT PERSPEKTIF MADZHAB SYAFI’I DAN KUHPERDATA
Authors: Rahman Arif
Published: January 2025

This study aims to analyze the status and position of guardians in the marriage of children resulting from adultery from the perspective of the Syafi'i School of Law and the Civil Code (KUHPerdata). Marriage is one of the important institutions in Islam, with guardians playing a key role in determining the validity of a marriage. However, the status of children resulting from adultery who are not recognized as legitimate descendants by their biological fathers raises questions about who has the right to be a guardian in the child's marriage. This study uses a qualitative research method with a library research approach, reviewing various literature and related books to understand the position of guardians in the marriage of children resulting from adultery. The results of the study show that according to the Syafi'i School of Law, children resulting from adultery do not have a guardian from the father's lineage, so the judge guardian becomes the legal guardian in their marriage. Meanwhile, in the Civil Code, children resulting from adultery only have a civil relationship with their mother and her family. This analysis highlights the important role of guardians in protecting children's rights and ensuring the validity of marriage, as well as the differences in views between Islamic law and the Civil Code in determining guardians for children resulting from adultery. Thus, this research is expected to provide a more comprehensive understanding of legal protection for children resulting from adultery in the context of marriage.
ANALISIS KEDUDUKAN WALI HAKIM SEBAGAI WALI NIKAH PENGGANTI DALAM HUKUM ISLAM PERSPEKTIF MAZHAB SYAFI'I
Authors: Aswat Hazarul , Hidayat Taufik
Published: January 2025

Marriage in Islamic law requires the fulfillment of certain conditions and pillars, including the presence of a guardian (wali) for the marriage. The guardian plays a crucial role in ensuring that the marriage is conducted in accordance with religious guidelines. This study aims to analyze the transition of the role of nasab guardians to that of judicial guardians in marriage practices according to Islamic law, as well as to understand the implications of this transition in the context of contemporary society. The research employs a library research method with a normative approach, exploring literature and references from various sources, including fiqh texts and scholars' opinions. The findings reveal that marriage guardians consist of wali mujbir, who is a nasab guardian, and wali hakim, who acts as a substitute when the nasab guardian is unable to fulfill their duty. The criteria for appointing a wali hakim based on scholarly ijtihad provide flexibility in marriage practices. This research contributes to understanding the dynamics of guardianship in marriage and clarifies the provisions for wali hakim according to the Shafi'i school of thought. The results are expected to serve as a reference and guideline for the community in conducting marriages in accordance with Islamic principles.
PENGELOLAAN WAKAF UANG BERKEADILAN SOSIAL: PENGELOLAAN INVESTASI DAN MANFAAT WAKAF UANG MELALUI PEMBIAYAAN MIKRO OLEH BMT
Authors: Hilmi Hasbullah
Published: January 2025

Empowering the poor can be achieved by expanding access to financial institutions and funding. This study explores a financing and business incubation model based on cash waqf through Baitul Mal wa Tamwil (BMT). The research begins with an analysis of cash waqf instruments, regulations, and their implementation in Indonesia, drawing insights from M.A. Mannan's Cash Waqf Certificate and Muhammad Yunus' Grameen Bank concept. BMT, as a unique mikrofinance institution in Indonesia, integrates sosial and economic functions within a single entity. The findings indicate that BMT is an ideal institution for managing cash waqf. Waqf funds are invested in mikro-business financing, with returns allocated for training and business development programs targeting the poor. By synergizing its sosial and economic roles, BMT serves as a strategic solution for sustainable, waqf-based economic empowerment.
KÖPEK VE KEDİLERDE KULAK VE GÖZ HASTALIKLARINDA KULLANILAN İLAÇLAR
Authors: Tuğan Mehmet Serkan , Baydan Emine
Published: January 2025

Sistemik uygulanan ilaçların geçişi bakımından zor organlar olan kulak ve göze ilişkin hastalıklar köpek ve kedilerde sıklıkla problemlere yol açar. Her iki organda da tedavi genellikle topikal ilaç uygulamaları ile yapılır. Fakat bazı durumlarda topikal uygulama sistemik ilaç tedavisi ile desteklenebilir. Bazen de topikal ilaç uygulamanın mümkün/uygun olmadığı hallerde sistemik ilaç uygulaması yapılır. Kulak ve göz hastalıklarının tedavisinde antibakteriyel ilaç uygulamaları başta gelir. Bunu glukokortikoid uygulamaları takip eder. Gözde ise hastalık nedenlerine bağlı olarak oldukça farklı farmakolojik gruplardan ilaç uygulamaları söz konusudur. Bu makalede köpek ve kedilerde kulak ve göz hastalıklarının nedenleri, tanısı ve tedavilerinde kullanılan ilaçlar hakkında bilgiler verilmiştir.
Analisis Dampak Budaya Organisasi dan Kompetensi dalam Meningkatkan Kinerja Pegawai DISDIK Jawa Barat
Authors: Sholihannisa Lulu Ulfa
Published: January 2025

This research aims to analyze the impact of organizational culture and competence on employee performance at the West Java Ministry of Education, both simultaneously and partially. The method used is a descriptive-verificative method, with the population being the employees at the West Java Ministry of Education and a sample of 50 people, in addition to using primary data. This research yields an average interpretation of the organizational culture variable at 3.75%, the competence variable at 3.75%, and the employee performance variable at 3.82%. The analysis using path analysis shows that there is a positive and highly significant influence of organizational culture and competence on employee performance at the West Java Ministry of Education, both partially and simultaneously, amounting to 60.8%.
Implementasi Model Hybrid CNN-LSTM untuk Optimasi Pengalaman Pengguna Perangkat Seluler
Authors: Yuhefizar  , Ismael  , Arif Rizki Marsa  , Dedi Mardianto  , Ronal Watrianthos
Published: January 2025

This research employs a convolutional neural network (CNN) with long short-term memory (LSTM) to analyse and predict the behaviour of users of mobile devices, utilising a dataset comprising 700 users. The model combines the strengths of convolutional neural networks (CNNs) in spatial feature extraction and long short-term memory (LSTM) networks in temporal sequential analysis. The results demonstrate that the model exhibits excellent performance, with  92% accuracy, 89% precision, 91% recall, and 90% F1 score. The temporal pattern analysis revealed significant variation between the user classes, with the intensive class showing consistently high usage, averaging 300 minutes per day. The key factors influencing the user experience were identified as app usage time (25%), screen on time (22%), and battery consumption (18%). The segmentation of users resulted in the identification of five distinct groups, with Segment 2 exhibiting the highest usage level (6.2 hours per day) and Segment 5 displaying the lowest (1.3 hours per day). The strong correlation (0.89) between app usage time and screen time serves to confirm the importance of optimising the performance of apps. These findings provide a basis for more effective service personalisation and more targeted app development, thereby paving the way for the optimisation of the user experience on mobile devices.
Manfaat Kecerdasan Buatan pada Proses Belajar Mengajar di Pendidikan Tinggi
Authors: Zen Munawar  , Sri Sutjiningtyas  , Novianti Indah Putri  , Rita Komalasari  , Herru Soerjono
Published: January 2025

This research aims to determine the benefits of using artificial intelligence in the teaching and learning process in higher education. The contribution of computer science, especially artificial intelligence, to the field of education is very much felt. From robotic teaching to the emergence of automated systems for answer sheet analysis, artificial intelligence always helps lecturers and students. This study also investigates the educational implications of emerging technologies on how students learn and how the teaching and learning process in higher education is developing. Data analysis is carried out comprehensively on various analytical developments applied worldwide such as computer science techniques applied to the education sector so as to summarize and highlight the role of artificial intelligence in the teaching and learning process. The latest technological advances and the increasing speed of application of new technologies in higher education are explored to predict the nature of higher education today and in a world where artificial intelligence becomes part of the higher education structure. The results of the study indicate several challenges for higher education institutions and student learning in adopting this technology for the teaching and learning process, support from students, and administration and the need to explore further research directions.
From Moral Distress to Moral Integrity: Qualitative Evaluation of a New Moral Conflict Assessment Tool
Authors: Jolaei Soudabeh , Rodney Patricia , Starzomski Rosalie , Dodek Peter
Published: January 2025

Background

Moral distress affects the well-being of health care professionals and can lead to burnout and attrition. Assessing moral distress and taking action based on this assessment are important. A new moral conflict assessment (MCA) designed to prompt action was developed and tested.

Objective

To evaluate the utility of the MCA.

Methods

All intensive care unit professionals in 3 hospitals were invited to attend a presentation about the MCA and to participate in semistructured interviews that followed the steps of the MCA. Transcriptions of interviews were interpreted by using qualitative content analysis.

Results

Analysis of individual interviews of 7 participants and 1 focus group of 3 participants revealed that the MCA was a catalyst for expressing feelings and characterizing moral distress, but optimal use required a facilitator. Participants noted that prevention and amelioration of moral distress were determined by organizational culture issues such as consistent understanding of what can be accomplished in the intensive care unit, resolution of power imbalances among staff, and psychological safety to mention moral issues. Structural determinants included disparate work and education schedules between nurses and physicians. Leader determinants included listening to staff and ensuring accountability to address causes and consequences of moral distress. Education and communication were proposed most often as solutions for moral distress.

Conclusions

The evaluation revealed positive and negative features of the MCA. Prevention and amelioration of moral distress require attention to cultural, structural, and leadership issues through education and communication.
Patient- and Family-Centered Outcomes After Intensive Care Unit Admission
Authors: Schreiner Misty N. , Gee Perry M. , Hopkins Ramona O. , Butler Jorie M. , Groat Danielle , Stokes Stephanie C. , Beesley Sarah , Brown Samuel M. , Hirshberg Eliotte L.
Published: January 2025

Background

Family satisfaction with intensive care is a measure of patient experience and patient-centered care. Among the factors that might influence family satisfaction are the timing of patient admittance to the intensive care unit (ICU), the ICU environment, and individual health care providers.

Objective

To evaluate family satisfaction with the ICU and to explore associations between satisfaction and specific characteristics of the ICU stay.

Methods

Participants were adult family members of ICU patients. One family member per patient was enrolled. Regression was used to test the association between time or day of admittance and scores on the Family Satisfaction With Care in the Intensive Care Unit survey. Additionally, we explored exposure to admitting physicians and registered nurses. Free-text survey comments were grouped by using qualitative content analysis.

Results

Surveys were completed by 401 family members. There was no association between survey scores and providers, nor between scores and the time or day of the ICU admission. Three major themes emerged as important to patient and family satisfaction: (1) communication and information, (2) personalization or the patient as expert, and (3) staff and environment.

Conclusions

Family satisfaction with an ICU admission was not influenced by the timing of the admission. Overall satisfaction with the ICU was high. The qualitative analysis points to the importance of collecting qualitative data in addition to using standard survey tools to capture the richness of patient experience. Ongoing efforts to engage with families remain critical to the practice of family- and patient-centered care in the ICU.
Securement of Tracheostomy Collar After Free Flap Surgery for Patients With Head And Neck Cancer
Authors: DeGuzman Pamela B. , Cousins Michele N. , Miller-Davis Claiborne , Park Sookyung
Published: January 2025

Background

For patients with head and neck cancer who have undergone microvascular free flap surgery, securing a tracheostomy collar onto the neck using the traditional method (ie, with tracheostomy ties) is contraindicated because the ties may compress the newly vascularized tissue. However, no clear guidance exists for the use of other methods in these patients. Current techniques often use safety pins, which can cause injury to staff members.

Objective

To identify 1 or more methods of securing a tracheostomy collar that would maximize patient mobility, minimize the risk of staff injury, and be easy to use.

Methods

This pilot study had a descriptive design, with data collected from staff members caring for patients with head and neck cancer after microvascular free flap surgery. Three models of tracheostomy securement were evaluated, with each used for 10 postoperative patients with head and neck cancer (n = 30). Staff members rated each model on a 4-point Likert scale.

Results

The overall median score of all models was 3.5. Model 2 (collar secured to tubular bandages using binder rings) was rated significantly higher than model 3 (collar secured to tubular bandages using tracheostomy ties) overall (P = .04) as well as for staying in place when the patient was mobile (P = .04) and for ease of changing out parts (P = .01).

Conclusion

Several practical methods exist for securing a tracheostomy collar in patients with head and neck cancer who have undergone free flap surgery. These methods may be good alternatives to the use of safety pins.
Does the male’s parameters always exceed female’s parameters in a generally coexisting patterns of death under generalized Makeham’s mortality intensity?
Authors: Ogungbenle G. M.
Published: January 2025

Although the results in actuarial statistics and mortality analysis for (x) are currently being rediscovered, till now,  the generation of individual mortality rate and the comparison of gender-specific parameters within the framework of Makeham’s law remain inadvertently neglected. Mortality rate intensities serve as an effective tool for analyzing mortality levels within the insured population. These intensities are derived from the instantaneous measure of the probability of death at a specific moment, conditional upon survival up to that point. In this study, an algebraic method is employed to measure the mortality intensities of both males and females using survival data from the US actuarial surveillance area.  Further, this paper intends to stimulate computational derivations using R software for further use in pension and annuity applications within the framework of our algebraic technique. Consequently, the specific objectives are (i) to estimate the main parameters {A, B, C} of the Makeham’s law (ii) to compute the individual mortality rate intensity based on the parameters as against interval estimate (iii) to investigate if the disparity between the male and female parameters has significant effect on the overall mortality rates of either gender. From the trajectories of the computed mortality results, the mortality intensities of both gender exhibit same asymptotic behaviour along the x-axis initially and then smoothly rises exponentially around age 75. Consequently, the mortality law could not explain the decline in mortality. Although the ageing rate C of female is higher than that of men, computational evidence from our results confirms that the men’s overall mortality rate is correspondingly still higher than women’s mortality.
Impact of Soil Suitability Class, Variety, Milling Method, and Ageing Status on Some Chemical Properties of Coco Pith
Authors: Gunasena R. K. R. M. A. , Weerasinghe K. W. L. K. , Weerakkody W. A. P. , Samita S. , Perera L.
Published: January 2025

Given that coco pith is a versatile growing medium, understanding the factors that influence its physicochemical properties is crucial for optimizing its use. This study examines how soil suitability class, coconut variety, milling method, and ageing status affect electrical conductivity, pH, and the concentrations of Na+ and K+ in coco pith. Husks from Tall×Tall (TT) and Dwarf×Tall (DT) varieties were processed using dry and wet milling methods, with and without ageing, across 43 blocks representing different soil suitability classes. Results showed that milling method significantly (P<0.0002) influences electrical conductivity, with dry milling producing higher conductivity (1887.07 μS cm-1) than wet milling (1337.25 μS cm-1). Ageing markedly reduced electrical conductivity (P<0.0001), and no significant differences between milling methods were observed for aged coco pith. A three-way interaction between variety, milling method, and ageing status influenced pH (P=0.0007). DT variety processed via dry milling exhibited higher pH values (6.6±0.1), while wet milling consistently yielded lower pH (6.3±0.1). Aged coco pith had an average pH of 6.4, slightly lower than the 6.7 of non-aged pith. Soil suitability class also impacted pH, with S2 showing the lowest (6.4) and S4 the highest (6.7) (P<0.05). Na+ levels were significantly reduced in aged coco pith across all combinations due to enhanced particle breakdown (P=0.0488). Both milling method and ageing status affected K+ levels (P<0.0001), with ageing leading to reduced concentrations. These findings underscore the importance of ageing and milling methods in improving coco pith quality by optimizing its chemical properties.
Two - Stage Catalytic Activation of Coconut Shell Biochar for Effective Malachite Green Removal from Water
Authors: Bavithira T. , Kannan N. , Karunarathna A. K.
Published: January 2025

This study investigates scientific insights into the adsorption mechanism of novel engineered biochar derived from coconut s hells via catalytic conversion with FeCl3 for Malachite Green removal. This is a unique research report describing the use of novel engineered biochar derived from waste coconut shells for the removal of the cationic dye “Malachite Green” by understanding the insights into the adsorptive removal mechanism. The engineered biochar was prep ared with different concentrations (5 %, 7 %, and 9 %) of iron catalyst (FeCl3) and at different pyrolysis temperature s: 200 °C, 300 °C, and 400 °C with residence time of 4 hours. An adsorption analysis was planned under the set of experimental conditions: dosage 1g/L; pH 6; rpm 150; holding ti me 72 hours to identify the best-engineered biochar. The adsorptive performance was checked with artificially polluted water. The engineered biochar with the high qe value (amount of adsorbate removed by unit weight of engineer ed biochar) was selected. Detailed isotherm analysis, Kinetics study, thermodynamics analysis, and rate-limiting fac tor analysis were carried out for engineered biochar with higher adsorptive capacity. The biochar treated with 9% F eCl3 and pyrolysed at 400 °C showed the highest adsorption capacity of 50.20 mg/g for Malachite Green due to increased mineral components and a denser carbon network. I sotherm analysis revealed that the Freundlich model fits well, and the adsorption nature of Malachite Green by 9% CSBC 400 is a multilayer. The results of the adsorption kinetic study revealed that the pseudo-second order model fits well, indicating that the chemisorption process play s a significant role in the removal of Malachite Green by 9% CSBC 400. The adsorption process is spontaneous and endothermic. Therefore, the engineered biochar produced by the iron catalyst is a novel adsorbent for Malachite Green removal. This innovative finding of the use of engineered biochar produced from coconut shells for the removal of malachite green opens the door to the development of novel strategies for the effective removal of dye at the commercial level.
Investigation of Accuracy for Rice Crop Parameters Predicted Using UAV Multispectral Imagery
Authors: Dharmaratne P. P. , Salgadoe A. S. A. , Rathnayake W. M. U. K. , Weerasinghe A. D. A. J. K.
Published: January 2025

Remote measurement of rice crop parameters; Leaf- Chlorophyll, Above-ground biomass, Plant Height, Leaf Moisture and Rice Yield of rice plants before the actual harvest are vital for the early management of rice crops. This study was conducted in controlled rice fields and extended to farmer rice fields in the Maha season in Sri Lanka. The multispectral aerial images of the field were acquired by an Unmanned Ariel Vehicle (UAV) and processed. Vegetation indices (VIs) were then derived and selected the best combination of VIs explaining the respective groundmeasured parameters. The combination of selected VIs showed significant association (R2=0.84, RMSE=0.28; R2=0.81, RMSE=0.06 kg/m2; R2=0.63, RMSE=0.11 cm; R2=0.57, RMSE= 0.16% and R2=0.98, RMSE=128.5 kg/ha, Leaf-Chlorophyll, Above-ground biomass, Plant height, Leaf moisture, and Rice yield respectively) with the ground data in the controlled rice field experiment conducted at the Rice Research and Development Institute (RRDI), Bathalagoda, Sri Lanka. When these selected vegetation indices were transferred to a farmer rice field they showed a relationship as R2=0.57, RMSE=1.35; R2=0.60, RMSE=1.23 kg/m2; R2=0.41, RMSE= 9.95 cm; R2=0.36, RMSE= 34.4% and R2=0.53, RMSE=563.04 kg/ha respectively., The vegetation indices derived from UAV-multispectral images were able to associate and estimate the rice crop parameters like Leaf- Chlorophyll, Above-ground biomass and Rice Yield at booting stage and 25 m flying height. Therefore, VIs developed using UAV multispectral imagery to measure Leaf-Chl, AGB, PHt, LM and RY behave differently across rice fields in different soils, rice varieties, weedy conditions and agronomic practices.
Leaf Morphological and Molecular Characterization of Selected Accessions of Jackfruit (Artocarpus heterophyllus Lam) in the Field Gene Bank- Gannoruwa Sri Lanka
Authors: Dayarathna P. G. N. N. , Sirimalwatta V. N. S.
Published: January 2025

Jackfruit (Artocarpus heterophyllus Lam) belongs to the family Moraceae. Selected jackfruit accessions in Gannoruwa Fruit Crop Research and Development Station were studied based on molecular markers and leaf morphology. The main objective of the study was to evaluate the morphological and molecular diversity of specific jackfruit accessions collected from an or chard in Udayalkattikulam Mullaitivu, Sri Lanka. Morphological studies were conducted on two recommend ed accessions (Maharagama and Mandoor) and 11 other accessions. Four accessions were subsequently selected for molecular analysis. Leaf morphology was studied usi ng the descriptors provided by the International Plant Genetic Resources Institute (IPGRI). Molecular characteriz ation focused on the Internal Transcribe Spacer (ITS) region in ribosomal RNA. Morphological data were analyzed u sing PAST 4.03. A scatter plot was obtained from the Principal Component Analysis (PCoA). ITS sequence data were analy zed by MEGA 11 and DnaSP 5.10. Based on the leaf morphology, accession ACC-17-267 was found to be morpholog ically distinct from other accessions, while Maharagama and ACC-15-27 showed close morphological similarity. The four accessions (ACC-1-275, ACC-3-265, ACC-7-249, ACC-8-271) selected for molecular analysis were closely related to Mandoor for their leaf morphology. Molecular analysis revealed no genetic distance between Maharagama Mandoor and ACC-7-249. According to the dendrogra m resulting from MEGA 11, Maharagama, Mandoor and ACC-7-249 clustered into one group. Diversity analysis revealed that the selected Jackfruit accessions exhibited high haplotype diversity and moderate level of nucleotide di versity (Pi: 0.115). These findings suggest that the ITS locus is an effective marker for characterizing the genetic diversity of Jackfruit.
A MULTICENTER ICET-A SURVEY ON ADHERENCE TO ANNUAL ORAL GLUCOSE TOLERANCE TEST (OGTT) SCREENING IN TRANSFUSION-DEPENDENT THALASSEMIA (TDT) PATIENTS - THE EXPERT CLINICIANS’ OPINION ON FACTORS INFLUENCING THE ADHERENCE AND ON ALTERNATIVE STRATEGIES FOR ADHERENCE OPTIMIZATION
Authors: De Sanctis Vincenzo
Published: January 2025

Abstract. Background: Current guidelines for screening glucose dysregulation (GD) in patients with transfusion-dependent thalassemia (TDT) recommend an annual 2-hour oral glucose tolerance test (OGTT) starting at the age of 10 years. Objective: Assessment of adherence to OGTT screening in patients with TDT.
Methods: A questionnaire was distributed to 18 Thalassemia Centers in 10 different countries, targeting factors influencing adherence to annual OGTT screening in specialized multidisciplinary pediatric and adult TDT units and identifying strategies to improve adherence  to OGTT in TDT patients.
Results: The mean reported percentage of all types of GD across 16 of the 18 centers ,at last OGTT assessment, was 32.0%  while the mean percentage for thalassemia-related diabetes mellitus (Th-RDM)  was 12.2 ± 9.7% (range: 0% - 41%; median:13.2 % ) in all participating centers. Notably, a high percentage of suboptimal or poor adherence to annual OGTT screening (mean 41.3%; range 10-90%) was reported by 17/18 centers. Poor adherence to annual OGTT among eligible patients was multifactorial, related to both  patient-, and healthcare system barriers. The most commonly suggested actions  by hematologists and endocrinologists for improving the adherence to OGTT were: flexibility in timing, easy approach to test location, improved collaboration among team members and persistent reminding.
Conclusions: Young adult patients with TDT are at high risk for developing GD and Th-RDM, thus annual screening with a 2-hour OGTT is recommended. Nevertheless, there are several patient barriers associated with low adherence to annual OGTT. It is desirable to develop intensive initiatives to improve screening rate for GD, while studies are warranted to update the current guidelines in TDT patients with low risk factors for GD and for countries with low-resource settings.
West Nile Virus Encephalitis in A Patient with Chronic Lymphocytic Leukemia
Authors: D'Arena Giovanni , Palladino Carmela , Bosco Michele , Gambardella Michele
Published: January 2025

N/A
IMPACT OF RED CELL EXCHANGE TRANSFUSION ON INFLAMMATORY MARKERS IN SICKLE CELL DISEASE
Authors: Costa Adriana , Mendes Inês , Lage Joana , Moniz Marta , Amorim Catarina , Nunes Pedro , Almeida Helena , Escobar Carlos , Ventura Ana , Ferreira Teresa
Published: January 2025

Background: Red Blood Cell Exchange (RBCX) is a common treatment for pediatric sickle cell disease (SCD), particularly in cases complicated by cerebrovascular disease. Since inflammation plays a crucial role in SCD and elevated pro-inflammatory cytokines are observed in these patients, this study hypothesized that RBCX might lower these cytokines and aimed to assess the impact of this technique on these markers.
Methods: This prospective and observational study included pediatric SCD patients (HbSS genotype) enrolled in a chronic RBCX program at a Portuguese Hospital from October 2022 to May 2024. Patients with acute exacerbations were excluded. Blood samples were collected before and after RBCX to assess hematological parameters and inflammatory cytokines. Data were analyzed using SPSSv25Ⓡ (Significance level set at p < 0.05); Informed consents were obtained.
Results: Thirty-one children (median age 10 years) were studied. Fourteen patients were new to RBCX, while 17 were already in a chronic RBCX program. RBCX mainly aimed to prevent cerebrovascular disease (81%). A total of 286 RBCXs were analyzed, showing no major adverse events or disease-related hospitalizations. Hemoglobin levels increased by 1.5g/dL, HbS decreased by 69%, and leukocytes decreased by 20%. IL-1, ferritin and procalcitonin showed high levels before RBCX. IL-1 levels dropped significantly post-RBCX (p<0.001), while other markers like C-Reactive Protein, IL-6, and TNF-α showed no significant changes.
Conclusions: RBCX safely reduces HbS, leukocytes, and IL-1 levels, suggesting a modulatory effect on inflammation in SCD patients. Further research is needed to explore cytokine mechanisms in SCD.
Integration of Ayurveda in the management of multiple myeloma – A case report on therapeutic synergism
Authors: Julka Ayesha , Venate Parvathy , Huddar Vitthal G.
Published: January 2025

Multiple myeloma (MM) is a malignancy of the plasma cells resulting in the abnormal proliferation of monoclonal antibodies within the bone marrow and subsequent infiltration in the bones and solid organs manifesting as pancytopenias, renal failure, bony pain, and fractures. Current treatment options involve chemotherapy and radiotherapy with lifelong maintenance that can significantly compromise the quality of life of the survivors. Here, we present the case of a 68-year-old female who presented with myeloma-induced paraplegia and associated deep vein thrombosis causing severe pain, swelling, and redness. She was treated with multimodal intervention comprising of Panchakarma, Rasayana, and Shamana chikitsa along with ongoing maintenance chemotherapy. At the end of 16 months, the patient is now able to carry out her self-care with minimal assistance, free of pain and swelling, and continuing chemotherapy without any side effects. A holistic treatment approach comprising of traditional systems of medicine with the conventional care can be beneficial in providing enhanced outcomes in plasma cell dyscrasias like MM.
Integrative pathways to wellness: Exploring Ayurvedic principles and practices in cancer management
Authors: Dedge Amrish Prakash , Kadam Sujata , Mumbaraddi Shweta
Published: January 2025

The rising prevalence of cancer in India over the last few decades has led to a significant increase in health-seeking behavior among cancer patients toward Ayurveda. These patients incorporate Ayurvedic treatment into their cancer care for the following benefits – Patients with ongoing conventional care, patients expecting for mitigation of conventional care adverse effects, patients willing for standalone Ayurveda care for cancer, patients willing for prevention of recurrence, healthy persons having a strong family history of cancer, patients on palliative care, left out cases of cancer with no conventional care option. Most of the time, patients and their family members have less correct, less realistic information about the role, and scope of Ayurveda in this domain. Lack of authentic information and tall claims make the picture hazier and more confusing for patients. This also creates and increases confusion and/or skeptical approach in the minds of Oncologists, which proves a hurdle in the execution of an integrative approach in cancer care. The article discusses the role and scope of classical Ayurveda and contemporary clinical practice scenarios in Ayurveda for cancer. This will put forward a realistic and transparent picture in front of the scientific community to accelerate the action of integration. However, the need of scientific communication for better patient education about Ayurveda is discussed.
Topical silymarin versus combined topical silymarin and microneedling in treatment of melasma: split-face study
Authors: Ismail Sahar A. , Attay Dina A.E. , Shehata Rofaida R.
Published: January 2025

Background

Melasma is a common acquired pigmentary skin disease that is more predominant in females and darker skin types.

Objectives

To evaluate and to compare the efficacy and safety of topical silymarin alone and of combined topical silymarin and microneedling in the treatment of melasma.

Patients and methods

The study design was a split-face, right-left, randomized controlled trial, which was done on 30 adult patients with melasma. History taking and dermatological examination were done. Each side of the patient’s face was randomly (by closed envelop method) allocated to either topical silymarin 0.7% and microneedling or topical silymarin 0.7% alone. All patients were assessed monthly by hemi-Melasma Area and Severity Index (MASI) score hemi-modified Melasma Area and Severity Index (mMASI) score by comparing hemi-mMASI score throughout the 3-month treatment course, patient self-assessment scale, and Melasma Quality of Life Scale.

Results

There was an insignificant difference in the mean hemi-MASI and hemi-mMASI scores between both sides at each study point (P>0.05 for each). Mean hemi-MASI and hemi-mMASI scores showed significant (P<0.001 for each) steady reduction after treatment for both groups.

Conclusions

Both modalities of treatment can be used effectively and safely in the treatment of melasma.
Assessment of serum levels of total thiol, thiol-disulfide, and total thiol/thiol-disulfide ratio in patients with vitiligo before and after narrowband ultraviolet B therapy
Authors: Ali Nura A. , Atwa Mona A. , El-Sayed Marie Radwa , Abdelmaogood Asmaa K.
Published: January 2025

Background

Vitiligo pathogenesis entails an autoimmune response targeting melanocytes. Oxidative stress is a major contributor to melanocyte cytotoxicity in vitiligo. One useful therapeutic option for vitiligo is the narrowband ultraviolet B (NB-UVB) therapy. However, ultraviolet radiation is associated with elevated oxidative stress. The thiol/disulfide equilibrium is the balance between thiols, as potent antioxidants, and their oxidized molecules, thiol disulfides. This balance is altered with increased oxidative stress.

Patients and methods

The study included 33 vitiligo patients and 33 controls. The severity and activity of vitiligo were evaluated using the Vitiligo Extent Score and Vitiligo Disease Activity Score, respectively. Serum levels of total thiol and thiol-disulfide were assessed, before and after NB-UVB therapy, using enzyme-linked immunosorbent assay. Finally, the total thiol/thiol-disulfide ratio was calculated.

Results

Pretreatment and posttreatment serum levels of total thiol were found to be significantly lower in vitiligo patients compared with controls (P=0.001), while pretreatment and posttreatment serum levels of thiol-disulfide were significantly higher (P=0.001 and 0.012, respectively), and the pretreatment and posttreatment total thiol/thiol-disulfide ratios were significantly lower (P=0.001). There were insignificant differences between pretreatment and posttreatment levels of total thiols, thiol-disulfide, or their ratios among vitiligo patients.

Conclusions

NB-UVB therapy does not probably improve the disrupted thiol/thiol-disulfide equilibrium in vitiligo patients. Combining NB-UVB with antioxidants, such as thiols, may therefore achieve a better outcome in vitiligo treatment.
Secondary pyoderma in dermatology patient: clinical and microbiological profile
Authors: Ahuja Jayshree , Patil Ankita , Talanikar Hemant , Mathur Ajay K. , Sharma Yugal K. , Mukhida Sahjid
Published: January 2025

Introduction

Pyoderma is a purulent skin infection influenced by a variety of factors like, poor hygiene, along with poverty, malnourishment, overcrowding, and climatic conditions. Primary infections are initiated by a single organism and occur in healthy skin. Secondary infections are a superimposed condition in diseased skin where organisms do not play a significant role. The present study was designed to check the clinical and microbiological profile and antibiotic resistance patterns in secondary pyodermas patients to choose appropriate antibiotic treatment.

Patients and methods

A prospective observational study was conducted in the Outpatient Department of a dermatology clinic in a tertiary care hospital in western India for 1 year on 33 secondary pyoderma patients. A detailed history and complete physical examination of patients was undertaken. Pus collection was done and bacterial culture along with drug susceptibility testing was carried out.

Results

Of 33 patients, 57.57% were male and 42.42% were female. Among all secondary pyoderma patients, 42.42% of patients belonging to the above 40 years age group. Contact history regarding infection was reported in 54.54% of cases. Most frequently occurring in our study was infectious eczema, seen in 3030% of patients. The most commonly encountered organisms were Staphylococcus species in 87.09% of patients. The highest resistance was notified against gentamicin at 78.57% for methicillin-susceptible Staphylococcus aureus and 50% methicillin-resistant Staphylococcus aureus.

Conclusion

Pyodermas were frequently encountered in the elderly male patients who mainly belonged to the lower socioeconomic strata of the society. Eczema constituted the major portion of secondary pyodermas and Staphylococcus aureus was the frequently isolated organism in the majority of the cases from skin lesions of pyoderma patients.
Atypical location of Becker nevus on face − clinical and dermoscopic features: a case report
Authors: Mahajan Mohita , Mahajan Bharat Bhushan
Published: January 2025

Becker nevus also known as pigmented hairy epidermal nevus, is a cutaneous hamartoma localized on upper extremities and trunk. It is characterized by a unilateral, hyperpigmented patch with irregular border and hypertrichosis.

In most cases, the lesions are more common in males than in females and appear in late childhood or adolescence. The etiology of Becker nevus remains uncertain but it is thought that there is a relationship between androgen metabolism and Becker nevus. There have been rare reports of cases with atypical location such as the face and lower extremities. Here we report a case of a young boy with Becker nevus localized on the left cheek with asymmetrical growth of beard hair. Becker nevus must be kept in mind in the differential diagnosis of hyperpigmented lesions with hypertrichosis which are located on the face.
Oncological outcomes and complications following radical cystectomy with or without neoadjuvant chemotherapy – A retrospective comparative cohort study from a single-center in South India
Authors: Jayanth E Selvin Theodore , Jat Subhash L. , Samuel Benedict P. , Singh Ashish , John Nirmal Thampi , Joel Anjana , Mukha Rajiv Paul , Rebecca Grace , Mahasampath Gowri , Berry Chandrasingh Jeyachandra , Devasia Antony , Kekre Nitin , Kumar Santosh
Published: January 2025

Introduction:

Neoadjuvant chemotherapy (NAC) in the management of muscle-invasive bladder carcinoma has not been adopted universally. We studied the oncological outcomes and complications in patients who underwent radical cystectomy (RC) with or without NAC.

Methods:

A retrospective review of patients who underwent RC with or without NAC from June 2009 to June 2020 was conducted. Oncological outcomes, overall survival (OS) and recurrence-free survival (RFS), complications, and prognostic factors were analyzed.

Results:

Of the 314 patients who underwent RC, 83 patients received NAC (Group A), and 231 underwent RC alone (Group B). The median age was 58 years. The median follow-up duration was 22 (3–64) and 24 (3–62) months, respectively. The median OS in Group A was significantly higher than Group B (38 months [confidence interval (CI): 34–42] and 32 [CI: 29–35], respectively, [P = 0.033]). The RFS in Groups A and B was 34 (CI: 30–39) and 31 (CI: 28–34) months, respectively (P = 0.47). Higher pathological T stage (T3/4), node positivity and lymphovascular invasion (LVI) were predictors of poor OS and RFS (P < 0.0001). Clavien grades 3/4 complications were comparable (8% vs. 15%; P = 0.19). Glomerular filtration rate (GFR) <60 mL/min/1.73 m2 was associated with higher postoperative complications in both groups (P = 0.012).

Conclusion:

The OS with NAC was superior to upfront RC. RFS was, however, comparable. NAC was safe and well-tolerated. Pathologically, higher T stage, node positivity, and LVI were associated with poorer OS and RFS. Low GFR negatively influenced postoperative complications.
An endeavor for excellent and aberration-free vision in advanced keratoconus: Penetrating or deep anterior keratoplasty?
Authors: Joshi Shilpa Dike , Gundecha Nikita Vilas
Published: January 2025

Purpose:

The purpose of this study was to describe the refractive outcomes and finer aspects of visual acuity such as contrast, aberrations, and quality of vision after keratoplasty for keratoconus.

Design:

This was a longitudinal clinical study of 50 eyes of 50 patients undergoing optical penetrating keratoplasty (OPK) or deep anterior lamellar keratoplasty (DALK).

Materials and Methods:

Visual acuity, slit-lamp evaluation, corneal topography, fundus evaluation, intraocular pressure measurement, contrast, and aberrometry were performed preoperatively and postoperatively at 1, 3, 6, and 12 months. The Visual Function Questionnaire-25 criteria were used to determine the quality of life.

Results:

Contrast sensitivity and visual acuity had significantly improved at each assessment postoperatively. There was a statistically significant improvement in the postoperative 1-year subjective visual score and maximum keratometry in both groups. In the OPK group, all aberration values showed significant improvements in the anterior and total corneal surfaces. The DALK group showed significant improvements in spherical aberration, root mean square (RMS) total, and RMS higher-order aberrations in the anterior corneal surface. The total corneal surface showed a significant improvement only in spherical aberration and RMS total values.

Conclusion:

From our study we conclude, that there was a statistically significant improvement in preoperative versus postoperative 1-year logMAR visual acuity, contrast sensitivity, subjective visual score, maximum keratometry, spherical aberration, and total aberrations in both OPK and DALK. OPK patients also show a statistically significant improvement in vertical coma, RMS higher-order aberration, and trefoil as compared to DALK. The selection of the surgical procedure depends on the surgeon’s preference, the patient profile, cone size, and pachymetry.