bluuebunny/crossref_metadata_2025 huggingface dataset:
A Short-lived Rejuvenation during the Decades-long Changing-look Transition in the Nucleus of Mrk 1018
Authors: Lu Kai-Xing , Li Yan-Rong , Wu Qingwen , Ho Luis C. , Zhang Zhi-Xiang , Feng Hai-Cheng , Li Sha-Sha , Chen Yong-Jie , Sun Mouyuan , Shu Xinwen , Guo Wei-Jian , Cheng Cheng , Wang Jian-Guo , Kim Dongchan , Wang Jian-Min , Bai Jin-Ming
Published: January 2025

Changing-look active galactic nuclei (CL-AGNs), characterized by the emergence or disappearance of broad lines accompanied by extreme continuum flux variability, have drawn much attention for their potential to reveal physical processes underlying AGN evolution. We perform seven-season spectroscopic monitoring on Mrk1018, one of the earliest identified CL-AGN. Around 2020, we detect a full-cycle changing-look transition of Mrk 1018 within one year, associated with a nucleus outburst, which likely arose from the disk instability in the transition region between the outer standard rotation-dominated disk and inner advection-dominated accretion flow. Over the past 45 years, the accretion rate of Mrk 1018 changed 1000 times and the maximum Eddington ratio reached 0.02. By investigating the relation between the broad-line properties and the Eddington ratio (L
bol/L
Edd), we find strong evidence that the full-cycle-type transition is regulated by accretion. There exists a turnover point in the Balmer decrement, which is observed for the first time. The broad Balmer lines change from a single peak in Types 1.0–1.2 to double peaks in Types 1.5–1.8, and the double-peak separation decreases with increasing accretion rate. We also find that the FWHM of the broad Balmer lines obeys FWHM

∝

(

L

bol

/

L

Edd

)

−
0.27

, as expected for a virialized broad-line region (BLR). The velocity dispersion σ
line follows a similar trend in Types 1.5–1.8 but displays a sharp increase in Types 1.0–1.2, resulting in a dramatic drop in FWHM/σ
line. These findings suggest that a virialized BLR together with accretion-dependent turbulent motions might be responsible for the diversity of BLR phenomena across the AGN population.
Evolutionary dynamics of the B chromosomes in the fish species Prochilodus lineatus Valenciennes, 1837 of the Paraná River Basin
Authors: Penitente Manolo , Goes Caio Augusto Gomes , dos Santos Rodrigo Zeni , Utsunomia Ricardo , Foresti Fausto , Porto-Foresti Fabio
Published: January 2025

The fish species Prochilodus lineatus has an interesting B chromosome system, with three morphological types as acrocentric, metacentric, and submetacentric. However, most cytogenetic studies on this species are restricted to the natural population of the Mogi Guaçu River. Given this, the present work aimed to study the structure karyotypic profile as well as the occurrence of supernumeraries in P. lineatus in several localities in the Paraná River basin, where this species is abundant. The results obtained showed a predominantly conserved karyotypic macrostructure and the presence of B chromosomes in all the seven localities studied, with the exception of the Apa River. Additionally, new variants of morphological characteristics were found in the population of the Batalha River (Reginópolis). These results allow us to infer that there is a large occurrence of B chromosomes in this species, with important differences in B chromosome frequency between the populations, especially in acrocentric and submetacentric B variants. Considering the possible origin and evolution of B chromosomes in P. lineatus, our results allow us to describe the dispersion of metacentric B variants, in contrast with the elimination observed in acrocentric and submetacentric variants.
Three new species of Apiospora (Amphisphaeriales, Apiosporaceae) in China
Authors: Yu Kunmin , Zhang Hong , Cheng Kexin , Jiang Yulan
Published: January 2025

China is located in eastern Asia and has a large quantity and rich variety of bamboo resources. Bamboo resources also contain various fungal species such as Apiospora. The genus Apiospora is commonly used as plant pathogens, endophytes, and saprophytes, which are widely present in various host ranges around the world. The discovery of metabolites has been proven to play an important role in the pharmaceutical industry. Recently, 10 strains were isolated from bamboo in Guizhou Province, China, which were identified as five species of Apiospora based on multigene phylogenetic analysis of ITS, LSU, TEF1-α, and TUB2, and morphological observations, including two recognized species, Ap. arundinis and Ap. lophatheri, and three novel species, viz. Ap. bambusicaulis, Ap. bambusirimae, and Ap. bambusilentiginis. Illustrations and descriptions of these taxa are provided.
Acorus shannai (Acoraceae), a new species from Southern China
Authors: Cheng Zhuo , Liu Xinyu , Yu Nianting , Chen Weizhe , Zhao Haofeng , Li Feifei , Long Chunlin
Published: January 2025

Acorus shannai (Acoraceae) is a commonly used seasoning in southern China. It was previously misidentified as A. macrospadiceus (Yamam.) F. N. Wei & Y. K. Li before. Through comparison of morphological characteristics, distribution locations, and type specimen, we determined that the elevation of A. gramineus var. macrospadiceus Yamam to species status was incorrect. Therefore, we propose a formal description of a new species following nomenclature regulations. Based on morphological and plastid genomic data, this study formally describes and illustrates Acorus shannai, distributed in the Qiandongnan area of Guizhou Province and its surroundings, confirming it as a new species within the genus Acorus. This species is morphologically and phylogenetically distinct from other members of the A. gramineus group. Key distinguishing features include a strong fennel odor (vs. aromatic in “A. tatarinowii” and A. gramineus), fruit with prominent dorsal sutures (vs. inconspicuous dorsal sutures in “A. tatarinowii” and A. gramineus), and a leaf-shaped spathe that is about 2–3 times as long as the spadix (vs. more than 3 times in “A. tatarinowii”). Phylogenetic analysis showed that A. shannai is closely related to the other species in the A. gramineus group. The recognition of A. shannai is not only important for the species diversity and phylogenetic relationship of Acorus, but also can avoid the drug safety caused by using other Acorus species as A. shannai to eat and promote the conservation of A. shannai resources.
Phylogeny of Macrobrachium spp. (Decapoda, Pleocyemata) from Peru based on mitochondrial and nuclear data reveals a species complex comprising M. digueti (Bouvier, 1895) and M. transandicum Holthuis, 1950
Authors: Zelada-Mázmela Eliana , Reyes-Flores Lorenzo E. , De Stefano-Beltrán Luis
Published: January 2025

Prawns of the genus Macrobrachium represent a highly diverse group of high commercial value worldwide. Eight Macrobrachium species have been reported from the Peruvian Pacific slope, but their phylogenetic relationships are still unknown. To investigate the systematics of Macrobrachium species from Peru, morphological identification and molecular data from nucleotide sequences of three genes were used: cytochrome c oxidase subunit I, 16S rRNA, and 28S rRNA. Based on morphological taxonomy, six species were successfully identified: M. americanum, M. digueti, M. gallus, M. inca, M. panamense, and M. transandicum. However, the phylogenetic inference results supported the species validity of only the first five species; all prawn individuals that were morphologically identified as M. transandicum were recovered within the M. digueti group, showing interspecific genetic distances near zero, suggesting that both species belong to the same species-level lineage, which may represent in the “olfersii species complex”. Our analyses also corroborated the genetic proximity of sibling species M. inca–M. americanum and M. gallus–M. panamense, and the monophyletic origin of Macrobrachium species from Peruvian populations. This study represents the first comprehensive phylogenetic analyses of Macrobrachium species from Peru, and contributes the first publicly available DNA sequences for M. inca and M. gallus, as well as the first sequences of M. americanum, M. panamense, M. digueti, and M. transandicum collected from Peruvian rivers.
Optimization of the production of grade A liquid smoke from Patchouli solid residue using a distillation-adsorption process
Authors: Ginting Zainuddin , Setiawan Adi , Anshar Khairul , Ibrahin Ishak , Jalaluddin  , Hasanah Indri Riski , Fitriyaningsih  , Fazira Zetta
Published: January 2025

Patchouli cultivation in Lhokseumawe, Aceh Province, produces a significant amount of biomass, with approximately 96%–98.5% of the raw material ending up as solid residue after the oil distillation process. This waste is often discarded or burned, leading to environmental problems. However, this residue is rich in compounds derived from the breakdown of lignocellulose and can be pyrolyzed to produce liquid smoke. Liquid smoke contains valuable phenols, acids, and carbonyls but may also generate harmful byproducts such as polycyclic aromatic hydrocarbons (PAHs). This study aimed to optimize the production of grade A liquid smoke through purification using a distillation and adsorption process. Pyrolysis of patchouli residue was conducted at 400 ℃ to produce liquid smoke. Furthermore, the raw liquid smoke was purified by distillation and adsorption. The distillation process was conducted at a temperature range (X1) of 150–200 ℃ for 30–90 min (X2). The weight of activated biochar used during the adsorption process varied between 5 and 15 g (X3). The experimental design was carried out using Design Expert version 13. Research findings indicate that the optimal condition for liquid smoke was achieved with the equation Y = 1.26 + 0.53X1 + 0.0319X2 + 0.8023X3 – (4.91X1)2 – (0.0015X2)2 – (0.2147X3)2 – 0. 0644 X1X2 – 0.0327X1X3 + 2.15X2X3. The best results were obtained at a distillation temperature of 175 ℃, a duration of 90 minutes, and using 13.4 g of activated carbon, which resulted in a high total phenol yield of 8.06%. The produced liquid smoke was classified as grade A, with a yield of 74.33%, a density of 0.9928 g/m³, a viscosity of 1.6203 cP, and a pH of 3.32. This research highlights an eco-friendly solution for valorizing patchouli waste, transforming it into a product with a wide range of applications as a food preservative, flavor enhancer, and medicinal agent.
An optimization-inspired intrusion detection model for software-defined networking
Authors: Xu Hui , Bai Longtan , Huang Wei
Published: January 2025

As an emerging network architecture, software-defined networking (SDN) has the core concept of separating the control plane from the network hardware and unifying its management by a central controller. Since the centralized control of SDN is such that an attack on the controller can lead to the paralysis of the entire network, intrusion detection has become particularly significant for SDN. Currently, more and more intrusion detection systems based on machine learning and deep learning are being applied to SDN, but most have drawbacks such as complex models and low detection accuracy. This paper proposes an enhanced spider wasp optimizer (ESWO) algorithm for feature dimensionality reduction of intrusion detection datasets and constructs a new intrusion detection model (IDM), namely ESWO-IDM, for SDN. The ESWO algorithm integrates multiple strategies, including tent chaotic map strategy and elite opposition learning strategy to improve the diversity of the population, Lévy flight strategy to prevent the algorithm from falling into local optimum in the early stage, and dynamic adjustment strategy of control parameters to balance exploration and exploitation of the algorithm. ESWO was empirically evaluated using eight benchmark test functions and four UCI datasets to comprehensively demonstrate its advantages. Binary and multiclassification experiments were conducted using the InSDN dataset to analyze the ESWO-IDM performance and compare it with other IDMs. The experimental results show that the ESWO-IDM achieves the best performance in all the metrics in both binary classification and multiclassification and has the most prominent effect on the detection of normal, denial of service (DoS), distributed DoS, and Brute Force Attack types, which effectively improves SDN intrusion detection from the viewpoint of optimization.
Study of Atmospheric Corrosion of Galvanized Steel Sheet in Addis Ababa Region Using Atmospheric Corrosion Models
Authors: Mekuria Bereket Mengesha , Panjiar Himanshu
Published: January 2025

The present study deals with the investigation of the long term atmospheric corrosion phenomena for galvanized steel sheet in the region of Addis Ababa in Ethiopia using various atmospheric corrosion models. Addis Ababa have transforming atmosphere type of urban/industrial atmosphere, and these changes are going to affect the atmospheric corrosion phenomena for galvanized steel sheet used in this region, which is investigated through atmospheric corrosion models using atmospheric data collected from National Meteorology Agency, Ethiopia for 21 years from 2000 to 2020. Atmospheric corrosivity category for Addis Ababa is determined, and it is found that with little deviation in atmospheric pollutant these categories can shift between C2 and C3 corrosivity category for galvanized steel sheet atmospheric corrosion. Further to study the atmospheric corrosion of galvanized steel sheet, standard atmospheric corrosion models were employed namely Feliu et al. model and Kucera et al. model. These studies corroborate the findings of atmospheric corrosion of galvanized steel sheet and cross verified with the similar region atmospheric corrosion experimental studies performed earlier on the same material. All the atmospheric corrosion models confirmed the trend of the atmospheric corrosion of galvanized steel sheet in the region of urban/industrial atmosphere type. And based on the comparative analysis of all models predictions with experimental results in literature, it is confirmed that the atmospheric corrosion model results are reliable for the study of short and long period of atmospheric corrosion of galvanized steel sheet in Addis Ababa region.
Climate-Multi-Criteria Optimization of the Reliability and Maintainability of a Distribution System by MARKOV Chains and Elitist Genetic Algorithms
Authors: Oloulade Arouna , Richard Gilles Agbokpanzo , Ousseyni Ibrahim Hassane , Marcaire Agbomahena , Moukengue Imano Adolphe , Sèminvo Montcho Arnaud , Antoine Vianou
Published: January 2025

The reliability of the distribution networks has been threatened by the disturbances which have occurred on the said networks and which have led to supply interruptions to customers. From the analysis of the faults that have occurred on these networks, it emerged that the most recurring disturbances are faults originating from external causes (atmospheric overvoltages, violent winds) and which represent 90% of the causes, transient faults (70%) and broken conductors (40%). The study of the reliability indices showed that the most disturbed departures are the MV departures from Ouidah, ITTA, Calavi and Togba whose SAIDIs are respectively 15.64; 13.9; 10.05; and 8.52. The optimization of the maintenance plan by genetic algorithms of the NSGA II type made it possible to identify the number of inspections which is 5 days and 11 days respectively during the rainy season and the dry season. The inter-inspection period related to these inspection periods is (21 days). This study led to the proposal of an optimal plan taking into account climatological criticalities and the aim of which is to reduce these disturbances which are more untimely in the rainy season. The resolution of the reliability problem by genetic algorithms of the NSGA-II type made it possible to deduce that the undistributed energies are reduced by 92.22% on the departure of Togba, 93.43% on the departure of ITTA and 95, 54% on departure from Ouidah. This energy could have brought Beninese Electricity Company (SBEE) a sum of nine hundred fifty-one million eighty-four thousand two hundred and fifty CFA francs (951,084,250 FCFA) on only three MV departures. This optimization denotes the technical and financial interest of SBEE by focusing more on strategies for reducing disruptions on its networks while giving priority to the rehabilitations, effectiveness and efficiency of its maintenance plans. The methodology used is efficient and effective and can allow SBEE to make substantial savings which will enable it to make a reinvestment in its distribution networks.
Stabilization of Soil by Using Construction & Demolition Waste, Calcium Carbide Residue, Molasses and Glass Fiber Reinforcement
Authors: Abhishek Abhishek , Sharma R.K. , Shandil Priyanka
Published: January 2025

Soil stabilization is crucial for enhancing the engineering properties of soil and constructing durable infrastructure, such as highways, airports, and roadways. The study's constituents were previously employed separately, and the soil's strength improved when they were coupled with other ingredients. Experimental investigations were conducted to assess the effects of varying proportions of C&D waste, CCR, and molasses on key soil characteristics, including compaction, shear strength, and plasticity. A series of crucial tests, including Atterberg limits, compaction characteristics, differential swell index, unconfined compressive strength (UCS), California Bearing Ratio (CBR), and Scanning Electron Microscope (SEM) analysis, were conducted to evaluate the performance of the stabilized soil. Test results indicated marked improvements in the Atterberg limits, reduced swell potential, and elevated values of UCS and CBR, demonstrating the effectiveness of the proposed stabilization method. CDW, CCR, and molasses enhance Unconfined Compressive Strength (UCS) by improving strength and cohesion. The addition of these chemicals significantly improved the performance of the soil, as seen by the decreased settling, enhanced strength, and greater infrastructure durability. Molasses served as an effective natural binder, while glass fibers improved tensile strength and durability by distributing stress evenly. This approach addresses waste management issues and promotes sustainable construction practices, offering a cost-effective solution for enhancing soil performance and paving the way for resilient infrastructure development.
Considering Luminance In-situ in Building Interiors Using Innovative Mobile Phone App: Exploratory Study in USA and Australia
Authors: Hébert P. R. , Jayadas A. , Wijetunge M. N. R.
Published: January 2025

The people world over enjoys theatres, museums, food service and hair salons etc. A key design element in all architectural interiors is lighting. Architectural lighting is a complex field. Older adults need more light, but are sensitive to glare. Glare is caused by excessive luminance or contrast. Luminance on the other hand, is the intensity of emitted light, and cd/m2 is its unit of measure. Although many studies measuring Illuminance exist, research measuring interior building luminance however, has not been widely published. Hence, there is a critical need to: understand the vision challenges facing older adults as confounded by lighting; explore luminance in different building types; quantify levels; visually communicate plots in false colour. This study begins to fill a gap in the literature. This exploratory study tackles luminance in in two countries. A convenience sample of six various building interiors were visited in the USA, and Australia. Objectives: Use smart phones and innovative free app to photo-document Interior scenes; capture images of luminance in false colour; record luminance quantities. A number of 87 digital photographs, and false colour image luminance plots were captured. The luminance ranged from 0.49 to 316.36 cp/m². The results were compared to 100 cd/m² lower boundary for adequate light prescribed for tasks, and 84 measurements (96.56%) did not comply. The measurements taken demonstrated high contrast. While taking measurements, bare bulbs and large windows contributed to glare. Such an app could potentially aid in assessing interior properties for the general population, but also for the ageing contingent within it.
Impact of Successful Timely Completion of Construction Projects on the Economic Development of Sri Lanka
Authors: Weerasingha W. A. M. N. , Jayasooriya S. D. , Kawmadi W. N. , Lakmal A. H.
Published: January 2025

The construction industry is identified as an income-driven sector, especially in developing countries. However, in the Sri Lankan construction industry, the vital factor of ‘on-time project completion’ is not been achieved at all times. Since, the public sector projects are not being completed within the anticipated duration, their expected outcomes are not well-received, resulting in a form of unconstructive economic development. The purpose of this study is to resolve the highlighted problem statement – the impact on the economic development in Sri Lanka, if the construction projects were successfully timely completed – through achievement of the laid down objectives. The main objective is to illustrate the impact of the successful timely completion of construction projects on the economic development of Sri Lanka. The research employs a qualitative research methodology, delving on semi-structured interviews. The impact of successful timely completion of construction projects on the economic development of Sri Lanka are determined through a detailed literature survey. The potential implementations to mitigate adverse time impact on public sector construction projects are identified, by analyzing the qualitative data through a content analysis, using frequency tables gathered from a sample of 30 professionals. The data covers the wider Sri Lankan construction industry, obtained through conducting comprehensive interview sessions. The major findings deliberate a greater impact from the specified time factors that derives the project’s successful completion on the economic development of Sri Lanka. It concludes with key mitigating implementations such as contracting qualified/competent parties, increased ethical professionalism of parties and proper supply chain management etc. This research is conducted to provide key implementation factors for the Sri Lankan construction industry, aiming to achieve timely project completion and enhance contributions to the national economy, while also guiding future studies.
Successful management of transformed chronic myelomonocytic leukemia in a background of CKD in a resource poor setting
Authors: Piyasundara L. N. , Ranasinghe N. , Samaraweera Y. R.
Published: January 2025

Chronic myelomonocytic leukemia (CMML), a myeloid neoplasm with features of both myelo-proliferative neoplasm (MPN) and myelodys-plastic syndrome (MDS), presents with peripheral blood (PB) monocytosis and has an inherent risk for transformation to acute myeloid leukemia (AML)1,2. Clonal cytogenetic changes are seen in around 30% of patients, while gene mutations are seen in >90% of patients4. Transformed AML shows a poor median overall survival (OS) and a modest survival advantage only with curative allogenic haemopoietic stem cell transplant (HSCT) [4]. We report here a patient with CMML, transformed to AML who achieved a good response with a hypomethylating agent (HMA). A 76-year-old man with multiple co-morbidities including stage 3B chronic kidney disease (CKD), was diagnosed with CMML with subdivision categories of myelopro-liferative-CMML, CMML-1 and managed with hydroxyurea and supportive care. Three years after the initial diagnosis of CMML, he presented with acute blast transformation (BT) along with further deranged renal functions, compromised cardiac functions and early features of tumor lysis. He was successfully managed with subcutaneous (SC) azacitidine and achieved a good response even though he didn’t reach true complete remission.
Presentation of posters at annual academic aessions (AAS)
Authors: Vidyatilake S.
Published: January 2025

No abstract available
Long-term cognitive impairment, psychological disorders, and functional limitations in COVID-19 survivors: A 2-year follow-up at a tertiary care hospital in Bengaluru
Authors: Shivamadhu Shivani , Ram V Ananth , Singh Hemendra , Raj Madhu P , Thyagaraj Vijayashree
Published: January 2025

Introduction:

Given the COVID-19 pandemic, a significant number of patients experience postacute/long COVID-19. Neurological manifestations, possibly stemming from direct viral effects or systemic inflammation, are increasingly recognized. The current study aimed to better understand the psychological, cognitive, and functional outcomes of COVID-19 survivors 2 years postdischarge.

Materials and Methods:

This analytical cross-sectional study included 98 COVID-19 survivors aged ≥18 years, referred to a post-COVID-19 clinic, and informed consent was procured. After administering a semi-structured interview constituting sociodemographic details, treatment profile, and validated assessment tools, subjects were categorized based on anxiety, depression, cognitive failure, and functional disability scores accordingly.

Results:

The median age of participants was 55 years, with 58.2% being male. The median hospital stay was 13 days, and 27.6% required intensive care unit care. Anxiety, depression, and functional disability were prevalent in 22.1%, 25.3%, and 60% of participants, respectively. The median scores of the domains of cognitive failure, i.e., forgetfulness, distractibility, and false triggering among the subjects were 6, 5, and 6, respectively, out of the highest possible score of 32. Depression and functional disability were more common in those over 45 years, with lower education, and unemployed (P < 0.01). Increased anxiety (P < 0.01) was seen associated with longer hospital stays. Patients aged above 45 years had significantly higher scores of depression, cognitive failure, and anxiety. Depression and cognitive issues were associated with lower education and unemployment which correlated positively with anxiety and forgetfulness.

Conclusion:

Due to the significant correlation of certain sociodemographic and treatment factors with depression, anxiety, and domains of cognitive failure, early identification and treatment of the same through specialized clinics are crucial.
Postbariatric Hypoglycaemia
Authors: Dharini Ravichandran , Jain Sudeep , Bhake Ragini , Purandare Vedavati B. , Unnikrishnan Ambika G.
Published: January 2025

Post-bariatric hypoglycaemia (PBH) is a metabolic complication of bariatric surgery which is characterized by low glucose levels in patients following bariatric procedures. The development of postbariatric hypoglycaemia can be dangerous and also significantly impact patients’ quality of life and mental health. Timely diagnosis of PBH and prompt treatment in patients suffering from it is crucial. This case report describes the management of postbariatric hypoglycaemia in a 56-year-old female who had undergone sleeve gastrectomy 16 years ago. She presented to our outpatient department with postprandial hypoglycaemic episodes. She was advised medical nutrition therapy (MNT) and pharmacological agents such as voglibose and diazoxide were added due to the recurrence of hypoglycemic episodes. Eventually, with education and medical management, she gained a better understanding of her condition and started adhering to the MNT prescribed and she chose to transition away from the continuous glucose monitoring. Instead, she opted for self-monitoring of glucose levels using a home glucometer, allowing for greater autonomy.
Role of Immunization in Adults with Diabetes in India: An Overview
Authors: Kale Mayura C. , Saboo Banshi , Inamdar Aniket , Khadke Rajendra , Gokalani Rutul , Chawla Manoj , Indurkar Sanjiv
Published: January 2025

Vaccination is one of the most cost-effective public health strategies. Millions of adults globally suffer from diseases preventable by vaccines. Vaccination in persons with diabetes mellitus is crucial for enhancing immunity, protecting against new infectious agents, and boosting the efficacy of childhood vaccines. It also reduces the community spread of infectious diseases. People with diabetes (PWD) are particularly vulnerable to infections such as Streptococcus pneumoniae, influenza, hepatitis B, and COVID-19 due to hyperglycemia-induced immune system alterations. As diabetes prevalence rises, so does the susceptibility of large populations to infectious diseases, resulting in serious complications and high mortality rates among PWD. Increasing vaccination coverage can significantly reduce mortality and improve health outcomes in PWD. Studies reveal a significant lack of awareness and knowledge about vaccines among PWD, with barriers including fear of complications, financial constraints, and lack of information. Healthcare providers should educate patients about the benefits of vaccinations, integrate vaccination recommendations into routine care, and address barriers through consistent guidance and support.
Post hematopoietic stem cell transplant (HSCT) outcomes in pediatric intensive care unit, experience from a referral center for cellular therapy and hematopoietic stem cell transplantation
Authors: AlAbdullah Hussain , Alanzi Fawaz , Alhuthil Raghad , Alshaibani Tahani , AlBeeshi Nourah , Alqahtani Ali , Alabdulsalam Moath , Alayed Tareq , Alturki Abdullah , Alofisan Tariq , Aljofan Fahad
Published: January 2025

Background

Patients who underwent hematopoietic stem cell transplantation (HSCT) are considered at high risk for pediatric intensive care unit (PICU) admission. Therefore, this study aimed to assess outcomes and mortality-related risk factors among pediatric HSCT recipients admitted to the PICU.

Methods

This retrospective cohort study was conducted at a Saudi Arabian tertiary care center and involved pediatric patients (aged 4 weeks to 14 years) who underwent HSCTs between January 2015 and December 2019 and were admitted to the PICU.

Results

Of the 173 pediatric HSCT recipients admitted to the PICU, 65.3% were admitted for respiratory failure. Graft-versus-host disease and chronic infections affected 48.6% and 71.7% of the cases, respectively. Pulmonary hemorrhage and veno-occlusive disease occurred in 15.0% and 32.4% of the patients, respectively. Ventilation and inotropic support were administered to 79.8% and 41.0%, respectively. Acute kidney injury (AKI) occurred in 47.4% of the patients, of which 23.2% required continuous renal replacement therapy/hemodialysis. The PICU survival rate was 59.0% (102/173), and the mortality rate was 41.0% (71/173). In the univariate analysis, chronic infection, pulmonary hemorrhage, ventilation, inotropic support, AKI, higher PRISM III score, and prolonged PICU stay were associated with mortality (P < 0.05). In the multivariable analysis, only prolonged PICU stay (P = 0.016), AKI (P = 0.040), inotropic support (P < 0.001), and ventilation (P = 0.017) showed potential association with mortality.

Conclusion

Early recognition and targeted interventions for these complications are crucial for improving outcomes in this vulnerable population. More research is needed to validate these findings and optimize care practices for HSCT recipients in the PICU setting.
Incidence, distribution, and patient characteristics of childhood cancer in Jordan: an updated population-based study
Authors: Baddourah Ranya , Baddourah Dana , Alsweedan Dalia , Al Sheyyab Mahmoud , Nimri Omar F. , Alsweedan Suleiman
Published: January 2025

Background and Objectives

The most recent study on pediatric cancer epidemiology in Jordan was published in 2003. This study aims to provide updated epidemiological data for local clinicians, policymakers, and international physicians interested in Middle Eastern patient populations.

Materials and Methods

We analyzed data from the Jordanian National Cancer Registry for pediatric patients (ages 0–18) diagnosed between 2000 and 2017, classified according to the International Classification of Childhood Cancer, third edition.

Results

Our cohort comprised 7639 patients. The mean age at diagnosis was 8.68 years, with a male-to-female ratio of 1.4 and an annual incidence rate of 191 per million population. We identified significant differences in cancer distribution between Jordan and neighboring Middle Eastern countries, as well as regional discrepancies in the number of diagnosed childhood cancer cases. A comparison of cancer incidence between 1996–1998 and 2000–2017 in Jordan was conducted. Our findings align with established trends, such as the correlation between the male-to-female cancer incidence ratio and GDP per capita.

Conclusion

This study provides the latest organized and accessible data on childhood malignancies in Jordan.
Prevalence of depressive disorder in asthma patients as seen in an outpatient facility of a tertiary care hospital in Kashmir, India
Authors: Wani Chandni , Mushtaq Mehvish , Shah Naveed Nazir , Dar Shabir Ahmad , Hussain Arshad
Published: January 2025

INTRODUCTION:

Globally, the prevalence of depression in individuals with bronchial asthma has been determined to be 9%. A significantly higher proportion of bronchial asthma patients, namely 28%, experience psychiatric morbidity compared with the national average of 14% in the general population. This study was conducted at a specialized tertiary care hospital dedicated to respiratory diseases, to assess the prevalence of depression in patients diagnosed and treated for bronchial asthma.

MATERIALS AND METHODS:

A total of 126 confirmed cases of bronchial asthma who were on regular follow-up care at our outpatient department were included in this study. Depression was diagnosed by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria utilizing the Mini-International Neuropsychiatric Interview (MINI English version 7.0.2).

RESULTS:

Out of 126 patients, 52 were males and 74 were females. In the 15–29 years age group, three patients (16%) exhibited symptoms consistent with the criteria of major depressive disorder (MDD). Among the 30–45 years age group, 6 out of 34 patients (17.6%) had MDD. The majority of patients fell into the 46–60 years age group, with 9 out of 67 patients (13.4%) having MDD in the said age group. Our study revealed that 15% of asthma patients attending our outpatient department were diagnosed with MDD.

CONCLUSION:

Given the significant impact of asthma and depression on the quality of life (QoL) of patients, as well as the burden these conditions impose on healthcare facilities even if not coexist in an individual, it is crucial for researchers to assess asthma patients for psychiatric comorbidities. This will not only lead to improved QoL for the patients but also ensure the appropriate allocation of healthcare resources.
Use of casirivimab and imdevimab to prevent progression to severe COVID-19
Authors: Shahnawaz Mir , Hussain Tajamul , Firdous Naeem , Yousoof Mohammad , Gundroo Hafsa M. , Sharma YashPal , Shah Naveed Nazir
Published: January 2025

BACKGROUND:

Advanced age and the presence of comorbid illnesses increase the risk of disease progression and death in patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Several neutralizing antibodies against SARS-CoV2 have been developed for the management of mild to moderate coronavirus disease 2019 (COVID-19) at risk of disease progression. This study aimed to evaluate the effect of a combination of casirivimab and imdevimab (REGN-COV2) on disease progression/hospitalization in mild-to-moderate COVID-19.

MATERIALS AND METHODS:

It is a prospective interventional study, patients with mild-to-moderate COVID-19 were included in the study. The illnesses with risk factors for disease progression were divided into two groups, one who received a combination of casirivimab and imdevimab (REGN-COV2) cocktail and the other who received usual care. The primary outcome of the study was a comparison of disease progression or hospitalization on day 14 after treatment. Secondary outcomes included viral clearance, mortality, and effect on proinflammatory markers.

RESULTS:

A total of 169 patients with mild-to-moderate COVID-19 illness with risk factors for disease progression were included in the study. About 85 patients (50.3%) as cases received REGN-COV2 whereas 84 (49.7%) as control received usual care only. Hospitalization or progression of disease was significantly lower in patients who received REGN-COV2 than in the usual care only [14.12% vs. 27.38%; relative risk (RR) = 0.51, 95% confidence interval (CI) = 0.27−0.95, P = 0.03]. Time taken for viral clearance was again lower in intervention group [median = 9 days, interquartile range (IQR) = [8–11] vs. median =13 days, IQR [10–14], P < 0.001] as was serum levels of C-reactive protein (CRP) and interleukin (IL)-6 significantly reduced in patients who received REGN-COV2 [CRP, median = 11.5 (5.75–34) to 4 (2–9), P = 0.001 and IL-6, median 10 (4–23.5) to 3 (2–7), P = 0.001]. Three patients in the usual care group died due to worsening respiratory failure compared with none in the REGN-COV2 group. Only minor adverse events were noticed in 8.2% (n = 7) patients in the REGN-COV2 group with no life-threatening events observed.

CONCLUSION:

In mild-to-moderate COVID-19 patients at high risk of disease progression REGN-COV2 treatment significantly reduced progression of disease and hospitalization without significant adverse events.
Forensic botany: Unraveling crimes with nature’s clues
Authors: Khan Aymaan , Bashir Khalid , Rashid Arsalaan F. , Khan S. Muhammad Salim , Janan Mariya
Published: January 2025

Forensic botany harnesses the characteristics of plant materials to yield vital insights in criminal investigations, linking suspects to crime scenes and unraveling details about criminal events. This review delves into various applications of forensic botany, including pollen analysis, diatom examination, mycology, and bryology, which play critical roles in forensic inquiries. Despite its significant potential, forensic botany remains underutilized in practical forensics. By synthesizing the existing research, identifying gaps, and suggesting future research directions, this review emphasizes the crucial role of botanical evidence in forensic science.
Comprehensive Ayurveda Management of Achalasia Cardia: Clinical Insights from a Case Report
Authors: Urvashi Patel , Anup Thakar , Rita Khagram , Hitesh Ghetiya
Published: January 2025

INTRODUCTION:

Achalasia Cardia (AC) is a rare esophageal motility disorder marked by the loss of inhibitory neuronal function, leading to impaired relaxation of the lower esophageal sphincter (LES) and absence of normal esophageal peristalsis, which disrupts coordinated swallowing. Achalasia has been regarded as an uncommon disorder with an annual incidence of approximately 1.6 cases per 1,00,000 individuals and a prevalence of 10 cases per 100,000 individuals. Treatment options for AC aim to reduce lower esophageal sphincter (LES) pressure and alleviate symptoms, utilizing pharmacologic therapies like calcium channel blockers and nitrates, endoscopic botulinum toxin injections, pneumatic dilation, or surgical interventions.

PATIENT INFORMATION:

A 42-year-old female presented to the Panchakarma OPD with a confirmed diagnosis of AC for the past four years. Her chief complaints included difficulty swallowing (dysphagia), regurgitation of food, excessive belching, a burning sensation in the chest and abdomen, occasional chest pain associated with food intake, and intermittent episodes of vomiting. The patient reported undergoing surgical intervention previously; however, it did not result in significant symptomatic relief.

THERAPEUTIC INTERVENTIONS:

The patient was managed with comprehensive Ayurvedic therapy, targeting the symptoms attributed to Vata impairment. Virechana Karma (therapeutic purgation), a Panchakarma procedure, was administered to facilitate Vatanulomana (normalization of the downward movement of Vata). Nasya Karma (nasal administration) was also performed for Vata Shamana. Orally, Shankha Vati 1 Tab (250 mg) twice a day and Avipattikara Choorna 3 gm with Madhu (honey) twice a day were administered during the treatment.

RESULTS:

This comprehensive therapeutic approach from May 6 to August 25 resulted in significant improvements in symptoms such as regurgitation, difficulty in swallowing (dysphagia), and change in esophageal motility and esophageal muscle tone. The patient was monitored and followed up for three months under the prescribed Ayurvedic regimen, during which consistent symptomatic relief was observed.

CONCLUSION:

The outcomes indicate the potential of Ayurvedic interventions, including Panchakarma, in producing symptomatic improvement in AC.
Impact of a high inspired oxygen fraction on oxidative stress in pediatric patients: reassuring results based on a randomized trial
Authors: Li Ting , Han Ying , Zhang Xiaodie , Zhao Jialian , Suo Yaojun , Hu Yaoqin
Published: January 2025

High-concentration oxygen inhalation is the primary intervention to prevent perioperative hypoxemia. However, there are concerns that this may induce an imbalance in oxidation‒reduction processes, particularly in pediatric patients with compromised antioxidant defenses. This study aimed to evaluate the impact of varying intraoperative concentrations of oxygen inhalation on oxidative stress in children by analyzing plasma biomarkers, oxygenation indices, and the duration of surgery and oxygen inhalation. Forty-five children scheduled for laparoscopic pyeloplasty under general anesthesia were randomly assigned to three groups, each receiving different fractions of inspired oxygen during surgery: 30%, 50%, or 80%. The primary outcome was the plasma concentration of oxidative stress markers, and the other measurements included the surgical duration and duration of oxygen exposure. Thirty-five children completed the study, with 11 in the low group, 12 in the medium group and 12 in the high group. The levels of superoxide dismutase at immediately post-tracheal intubation, hydrogen peroxide at 1 hour post-intubation, and 8-isoprostane at immediately post-surgical procedure were significantly higher in the high group than in the low group. The S100B levels at immediately post-surgical procedure were higher than those at immediately post-tracheal intubation and 1 hour post-intubation within the low group. Therefore, we conclude that inhaling a high concentration of oxygen during laparoscopic pyeloplasty under general anesthesia, for a duration of less than 3 hours, does not significantly increase oxidative stress in pediatric patients. This study was registered at the Chinese Clinical Trial Registry (registration No. ChiCTR2400083143).
Heme oxygenase/carbon monoxide system affects the placenta and preeclampsia
Authors: Mahan Vicki L.
Published: January 2025

Preeclampsia affects 2% to 8% of pregnancies worldwide and results in significantly high maternal and perinatal morbidity and mortality, with delivery being the only definitive treatment. It is not a single disorder, but rather a manifestation of an insult(s) to the uteroplacental unit —whether maternal, fetal, and/or placental. Multiple etiologies have been implicated, including uteroplacental ischemia, maternal infection and/or inflammation, maternal obesity, sleep disorders, hydatidiform mole, maternal intestinal dysbiosis, autoimmune disorders, fetal diseases, breakdown of maternal-fetal immune tolerance, placental aging, and endocrine disorders. Early- and late-onset preeclampsia are associated with different etiologies: early-onset preeclampsia develops because of poor placentation, while late-onset preeclampsia occurs in women with latent maternal endothelial dysfunction. In preeclamptic placentas, acquired, genetic, and immune risk factors may result in impaired trophoblast invasion and spiral artery remodeling, which affects uteroplacental perfusion. The resulting placental hypoxia affects the heme oxygenase system—a known stress response pathway affected by hypoxia that is important during normal pregnancy and may offer a therapeutic approach in preeclampsia. This review will address the effect of the heme oxygenase/carbon monoxide system on the placenta and preeclampsia.
Theoretical evaluation of the biological activity of hydrogen
Authors: Russell Grace
Published: January 2025

Hydrogen (H2), the simplest and most ubiquitous molecule in the universe, has garnered significant scientific interest over the past two decades because of its potential as an effective antioxidant and anti-inflammatory agent. Traditionally considered inert, H2 is now being re-evaluated for its unique bioactive properties. H2 selectively neutralizes reactive oxygen and nitrogen species, mitigating oxidative stress without disrupting essential cellular functions. This review therefore aims to provide a theoretical evaluation of the biological activity of H2, focusing on its pharmacokinetics, including absorption, distribution, and retention within biological systems. The pharmacokinetic profile of H2 is crucial for understanding its potential therapeutic applications. The interaction of H2 with protein pockets is of particular interest, as these sites may serve as reservoirs or active sites for H2, influencing its biological activity and retention time. Additionally, the impact of H2 on cellular signaling pathways, including those regulating glucose metabolism and oxidative stress responses, will be explored, offering insights into its potential as a modulator of metabolic and redox homeostasis. Finally, interactions with ferromagnetic molecules within biological environments, as well as effects on cellular signaling mechanisms, add another layer of complexity to the biological role of H2. By synthesizing the current research, this review seeks to elucidate the underlying mechanisms by which H2 may exert therapeutic effects while also identifying critical areas for further investigation. Understanding these aspects is essential for fully characterizing the pharmacodynamic profile of H2 and assessing its clinical potential in the treatment of oxidative stress–related disorders.
A “Sage on the Stage” to a “Guide on the Side”: Flipping the Conventional Classroom
Authors: Gosavi Manasi A. , Hungund Bhagyashri , Ratnakar Ashwini V. , Kangle Ranjit
Published: January 2025

ABSTRACT

Background:

In the constantly changing field of medical education, it is imperative for educators to adopt newer methods of teaching-learning. Flipped classroom [FC] is a student-centric method where the students gain knowledge outside the classroom with class time being used for application of knowledge. There is paucity of data about the use of FC’s for teaching pathology.

Materials and Methods:

Two batches of MBBS Phase II students were enrolled. The first batch underwent a flipped classroom. Students were given pre-class material followed by in-class activities like case scenarios to prompt in-depth discussion. Feedback was collected about the flipped class. Another batch of MBBS students was subjected to conventional classroom teaching. Both batches were administered pre- and post-tests.

Results:

In the flipped class, the mean post-test score was higher by 2.26 ± 3.11 and this value was statistically significant. There was a statistically significant increase in number of students acquiring A or B grade. A greater number of students got upgraded to A grade in post-test after attending flipped class as compared to conventional class. 50.6% students felt that flipped class helped in understanding key concepts.

Conclusion:

Flipped classrooms are a unique and student-centric method of teaching where the role of a teacher shifts from being a “Sage on the stage” to a “Guide on the Side.” Strategic planning on the part of the instructors and adequate preparation on the part of the students is vital. Flipped classroom had a more positive influence on high achievers.