bluuebunny/crossref_metadata_2025 huggingface dataset:
Bengal’s Encounter with the Himalayas
Authors: Biswas Anandarup
Published: May 2024

What, this chapter asks, drove a group of young men (and later, women) who were poles apart from the privileged, Western class of mountaineers eager to establish their supremacy over nature and fellow climbers, to risk everything for climbing an Everest or a Kanchenjunga? Was it the same, intrepid albeit arrogant spirit of adventure that made colonial mountaineers conduct their assaults? Mountaineering in the age of empire had been driven by an expeditionary zeal which was justified by the post-enlightenment, colonial urge to explore and possess the uncharted territories of the earth. Bengal’s attitude to the Himalayas was not tempered by the Western spirit of conquest, even though Western modernity shaped its cultural practices in many other ways. By tracing the long history of Bengal’s encounter with the Himalayas in the form of pilgrims, scholars and walkers and by looking at the rich and diverse literature inspired by Himalayan travel (climb, pilgrimage, survey and trek), this chapter argues, that Bengal’s climbers and travellers sought to achieve goals that were different from those aspired to by the conquest-driven climbers of the West
Class, Origin, Sociability and Mutuality
Authors: Busteed Mervyn
Published: May 2024

Lack of access to lodge records mean discussion of the socio-economic background of lodge members in Great Britian was long based on observation of participants on parade, leading to the conclusion that most are working class and a significant number Irish or Scottish Protestant immigrants. Recent work on north-east England confirmed this impression but access to archival material in Liverpool has modified the picture and enabled analysis of wider aspects of lodge life. Members in the early twentieth century were overwhelmingly working-class, born in the Liverpool region, lodges were locally rooted features of the social capital of their areas and there was close bonding between members thanks to intensive socialising, informal support networks active in times of distress andformalised in mutual aid societies from quite early on, creating a notable Orange associational culture.
Defending Protestantism
Authors: Busteed Mervyn
Published: May 2024

Discusses means used to maintain group solidarity by ensuring members had minimal social contact with Catholics and analyses internal stresses arising from the puritanical religiosity of some members uneasy with consumption of alcohol and low level of church attendance. Evolution of tactics employed to combat the growing Anglo-Catholic movement within the Church of England as analysed along with the social basis of ultra-Protestant protest groups and gradual development of separatist sentiment culminating in the separatist Protestant Reformer’s church and Protestant party led by George Wise
Theorizing Almost Successfully
Authors: Steinman Lisa M.
Published: May 2024

This chapter begins with a literature review of contemporary theoretical approaches to Stevens, in particular considering how theoretical readings might fail to appreciate, and elide, the formal specificity of poetry. It surveys philosophical approaches to Stevens, especially from the perspective of American philosophy. The chapter discusses this question in relation to significant recent work by Marjorie Perloff and Susan Howe. It provides a brief theoretical history of readers reading Stevens and also offers an interpretation of what contingency means in relation to reading poetry.
THE IMPACT OF ICT EDUCATION ON GDP EVOLUTION AT LOCAL LEVEL. A ROMANIAN CASE STUDY
Authors: Plăcintă Dimitrie-Daniel , Toma Andrei , Bătăgan Lorena , Mirea Corina-Marina , Pantelimon Florin-Valeriu
Published: May 2024

Purpose – This article focusses on the impact generated on GDP growth by the number of graduates in the ICT domain of Romanian counties in the period 2014–2020.
Research methodology – We have collected the number of ICT graduates, the GDP per inhabitant in EUR per Romanian county, the number of ICT employees, the number of information service activities employees from the National Institute of Statistics (Romania) and Eurostat. Additionally, we consolidate the correlation matrix and regression analysis for previous statistics indicators.
Findings – We have revealed a strong correlation (85,77%) between the number of ICT graduates and the GDP per inhabitant in EUR per Romanian county, and very strong correlations between the number of ICT graduates and the number of ICT employees (94,80%) and the number of employees of information service activities (97,38%).
Research limitations – The data set from the National Institute of Statistics (Romania) does not contain entries for every county, due to its statistical methodology, and other socioeconomic phenomena which contribute to the development of the ICT field were just enumerated, such as natality, immigration, and emigration.
Practical implications – The study revealed that investment in ICT education (number of graduates) contributes to the local prosperity of communities, counties, and, in general, at the national level as GDP growth. Romanian government can utilize the outcomes of this paper to engage additional resources, funds from Ministry of Education, to develop a long-lived learning culture of ICT skills for the entire population.
Originality/Value – The article methodologically highlights the most important ICT hubs in Romania, which are correlated with the existence of an ICT educational infrastructure (high schools and universities) and the measure of impact on GDP growth for the number of highly skilled graduates in the ICT domain. The selected national and European indicators contributed to the novelty of this study.
Planet Formation by Gas-assisted Accretion of Small Solids
Authors: D’Angelo Gennaro , Bodenheimer Peter
Published: May 2024

We compute the accretion efficiency of small solids, with radii 1 cm ≤ R

s
≤ 10 m, on planets embedded in gaseous disks. Planets have masses 3 ≤ M

p
≤ 20 Earth masses (M
⊕) and orbit within 10 au of a solar mass star. Disk thermodynamics is modeled via 3D radiation-hydrodynamics calculations that typically resolve the planetary envelopes. Both icy and rocky solids are considered, explicitly modeling their thermodynamic evolution. The maximum efficiencies of 1 ≤ R

s
≤ 100 cm particles are generally ≲10%, whereas 10 m solids tend to accrete efficiently or be segregated beyond the planet’s orbit. A simplified approach is applied to compute the accretion efficiency of small cores, with masses M

p
≤ 1 M
⊕ and without envelopes, for which efficiencies are approximately proportional to

M

p

2

/

3

. The mass flux of solids, estimated from unperturbed drag-induced drift velocities, provides typical accretion rates dM

p
/dt ≲ 10−5
M
⊕ yr−1. In representative disk models with an initial gas-to-dust mass ratio of 70–100 and total mass of 0.05–0.06 M
⊙, the solids’ accretion falls below 10−6
M
⊕ yr−1 after 1–1.5 Myr. The derived accretion rates, as functions of time and planet mass, are applied to formation calculations that compute dust opacity self-consistently with the delivery of solids to the envelope. Assuming dust-to-solid coagulation times of ≈0.3 Myr and disk lifetimes of ≈3.5 Myr, heavy-element inventories in the range 3–7 M
⊕ require that ≈90–150 M
⊕ of solids cross the planet’s orbit. The formation calculations encompass a variety of outcomes, from planets a few times M
⊕, predominantly composed of heavy elements, to giant planets. The peak luminosities during the epoch of the solids’ accretion range from ≈10−7 to ≈10−6
L
⊙.
Comparison of Ion–Proton Differential Speed between Interplanetary Coronal Mass Ejections and Solar Wind near 1 au
Authors: Zhang Xuechao , Song Hongqiang , Zhang Chengxiao , Fu Hui , Li Leping , Li Jinrong , Wang Xiaoqian , Wang Rui , Chen Yao
Published: May 2024

The elemental abundance of interplanetary coronal mass ejections (ICMEs) and solar wind near 1 au is often adopted to represent the abundance in the corresponding coronal sources. However, the absolute abundance of heavy ions (relative to hydrogen) near 1 au might be different from the coronal abundance due to the ion–proton differential speed (V

ip
). To illustrate the V

ip
characteristics and explore whether it influences the absolute abundance analysis for ICMEs and solar wind, we perform a statistical study on the V

ip
for He2+, C5+, O6+, and Fe10+ in both ICMEs and solar wind based on measurements of Advanced Composition Explorer. The results show that the V

ip
is negligible within ICMEs and slow solar wind (< 400 km s−1), while obvious in the intermediate (400–600 km s−1) and fast wind (> 600 km s−1). Previous studies showed that the V

ip
in ICMEs keeps negligible during propagation from 0.3 to 5 au, but in solar wind it increases with the decreasing heliocentric distance. Therefore, it might be questionable to infer the absolute abundance of coronal sources through in situ abundance near 1 au for solar wind. Fortunately, the ion–oxygen (O6+) differential speed (V

io
) is negligible for He2+, C5+, and Fe10+ within both ICMEs and solar wind, and previous studies suggested that the V

io
does not vary significantly with the heliocentric distance. This indicates that various heavy ions always flow at the same bulk speed and their relative abundance (relative to oxygen) near 1 au can represent the coronal abundance for both ICMEs and solar wind.
Hopf algebra structures on generalized quaternion algebras
Authors: Chen Quanguo , Deng Yong
Published: May 2024

In this paper, we use elementary linear algebra methods to explore possible Hopf algebra structures within the generalized quaternion algebra. The sufficient and necessary conditions that make the generalized quaternion algebra a Hopf algebra are given. It is proven that not all of the generalized quaternion algebras have Hopf algebraic structures. When the generalized quaternion algebras have Hopf algebraic structures, we describe all the Hopf algebra structures. Finally, we shall prove that all the Hopf algebra structures on the generalized quaternion algebras are isomorphic to Sweedler Hopf algebra, which is consistent with the classification of 4-dimensional Hopf algebras.
H-Toeplitz operators on the Dirichlet type space
Authors: Huang Peiying , Zhang Yiyuan
Published: May 2024

In this paper, we conducted a study of H-Toeplitz operators on the Dirichlet type space $ \mathfrak{D}_{t} $, which included several aspects. To begin, we established the matrix representation of the H-Toeplitz operator $ S_{\varphi} $ with respect to the orthonormal basis of $ \mathfrak{D}_t $. Subsequently, we characterized the compactness of $ S_{\varphi} $ in terms of the symbol $ \varphi $. Furthermore, we developed a new method to investigate the algebraic properties of H-Toeplitz operators, including self-adjointness, diagonality, co-isometry, partial isometry as well as commutativity.
Management of New Automatic Ticket Vending Machine System in Urban Rail Transit
Authors: Li Yanshuo , Zhu Hao , Tian Weigang , Xiao Chengshun
Published: May 2024

The technology of automatic fare collection system for urban rail transit is an important technology for achieving automatic fare collection for public transportation facilities such as urban subways. This article studies the relevant characteristics of the AFC system. Through introducing queuing models, simulation comparative experiments, and neural network debugging, it is found that the automatic fare collection system for urban rail transit not only effectively helps station staff to allocate tickets in a timely and reasonable manner, adjust station ticket supply, but also facilitates station passengers to query tickets, and passengers can freely choose whether to take the train according to their actual needs. The experiment shows that the AFC system can effectively help passengers avoid traffic congestion during peak hours, greatly improve management level, and reduce labor intensity.
Research on the Balanced Development Strategy of Urban and Rural Preschool Education Based on “Internet Plus”
Authors: Li Jiani
Published: May 2024

In education, “Internet plus” provides a new opportunity to improve the quality of education and promote educational equity. Promoting the balanced development of urban and rural preschool education with the help of Internet technology has become an important topic. Based on the latest data and field survey, this paper compares the teachers, school condition, and teaching quality of urban and rural preschool education in Internet plus, analyzes the main problems faced by preschool education and the reasons and presents the balanced development strategy of urban and rural preschool education in Internet plus. The research results show that preschool education in Internet plus provides rich educational resources and more opportunities to learn for rural kindergartens and provides parents with more ways to know their children's situation. “Internet plus” has promoted education equity and improved education quality for urban and rural preschool education. The research results provide a theoretical basis for the balanced development of urban and rural preschool education in Internet plus.
Understanding Factors Influencing Citizens' Intentions to Use Electronic Government (e-Gov) Services
Authors: Alryalat Mohammad Abdallah Ali
Published: May 2024

This research assesses the key constructs impacting transactional e-government services in the Jordanian context. The proposed research model considers UTAUT2 as the underpinning theory alongside the other key contextual variables including perceived risk, price value, and perceived awareness. Data were gathered from 294 Jordanian citizens and covariance based structure equation modelling was utilised to analyse the model. The results indicated the significant influence of constructs such as performance expectancy, social influence, price value, perceived risk, and perceived awareness on attitude whereas attitude further influences behavioral intentions. The paper has also provided some relevant recommendations for theory and practice.
Multimedia Human-Computer Interaction Method in Video Animation Based on Artificial Intelligence Technology
Authors: Sun Linran , Kwak Nojun
Published: May 2024

With the development of computer technology innovation, be able to deal with the media comprehensive information and real-time information interaction with the computer multimedia technology arises at the historic moment, it promotes the application fields of computer widen to industrial all aspects of life. As the product of digital technology, animation technology plays an irreplaceable role in the production of multimedia courseware. However, the existing human-computer interaction methods have shortcomings such as incomplete extraction of video features and poor human-computer interaction effect. In this context, this paper designs a multimedia human-computer interaction method for animation works based on CNN model. First of all, the original video data is collected and preprocessed. Then it is input into the HCI framework based on CNN model for feature extraction. Finally, the effectiveness and practicability of the proposed method are proved by simulation experiments, which provides a reference and basis for the research of modern human-computer interaction.
CANE, a Component of the NLRP3 Inflammasome, Promotes Inflammasome Activation
Authors: Kaneko Naoe , Kurata Mie , Yamamoto Toshihiro , Sakamoto Akimasa , Takada Yasutsugu , Kosako Hidetaka , Takeda Hiroyuki , Sawasaki Tatsuya , Masumoto Junya
Published: May 2024

The nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3, also called cryopyrin) inflammasome is an intracellular innate immune complex, which consists of the pattern-recognition receptor NLRP3, the adaptor apoptosis-assciated speck-like protein containing a caspase recruitment domain, and procaspase-1. Aberrant activation of the NLRP3 inflammasome causes an autoinflammatory disease called cryopyrin-associated periodic syndrome (CAPS). CAPS is caused by gain-of-function mutations in the NLRP3-encoding gene CIAS1; however, the mechanism of CAPS pathogenesis has not been fully understood. Thus, unknown regulators of the NLRP3 inflammasome, which are associated with CAPS development, are being investigated. To identify novel components of the NLRP3 inflammasome, we performed a high-throughput screen using a human protein array, with NLRP3 as the bait. We identified a NLRP3-binding protein, which we called the cryopyrin-associated nano enhancer (CANE). We demonstrated that CANE increased IL-1β secretion after NLRP3 inflammasome reconstitution in human embryonic kidney 293T cells and formed a “speck” in the cytosol, a hallmark of NLRP3 inflammasome activity. Reduced expression of endogenous CANE decreased IL-1β secretion upon stimulation with the NLRP3 agonist nigericin. To investigate the role of CANE in vivo, we developed CANE-transgenic mice. The PBMCs and bone marrow–derived macrophages of CANE-transgenic mice exhibited increased IL-1β secretion. Moreover, increased autoinflammatory neutrophil infiltration was observed in the s.c. tissue of CANE-transgenic versus wild-type mice; these phenotypes were consistent with those of CAPS model mice. These findings suggest that CANE, a component of the NLRP3 inflammasome, is a potential modulator of the inflammasome and a contributor to CAPS pathogenesis.
“PATAGOTITAN – O MAIOR DO MUNDO”: CIÊNCIA, EDUCAÇÃO E DECOLONIALIDADE EM UMA EXPOSIÇÃO DE DINOSSAUROS
Authors: Araújo Bruno de Lima , Augusto Alexia Satie , Prates André , Moura Francisca Raiany Soares de , Cardoso Gabriel Figueiredo , Santos Greyck Willyan Marques , Dutra Letícia Lopes , Silva Lucieny Raquel da Costa , Lima Pedro Vinícius Rodrigues , Pêgas Rodrigo Vargas , França Tainá Constância de , Pombo Victor Castro , Pinto Wellton Araujo , Nobre Yuri de Oliveira Monteiro , Anelli Luiz Eduardo , Augusta Bruno Gonçalves , Gomes Amanda Alves , Marques Amanda Cristina Teagno Lopes , Dussán Camila Monje , Brilhante Natan Santos
Published: May 2024

“Patagotitan - World’s Largest Dinosaur”: Science, Education and Decoloniality in a Dinosaur Exhibition. During three months, a dinosaur exhibition was held in the Central-South Zone of the city of São Paulo, Brazil. There were 21 educators serving tens of thousands of visitors from the general public, including 157 schools and 6528 students. The exhibition featured replicas of 14 species of dinosaurs found in Argentina and one dinosaur that inhabited southern Brazil, as well as six original fossils, originally from the Egidio Feruglio Paleontological Museum, located in Chubut, Argentina. Among these, the replica of the sauropod Patagotitan mayorum stands out, one of the largest dinosaurs described so far, estimated at around 37 meters in length. In this paper, we seek to report the potentiality of this type of exhibition with regard to dissemination, teaching and scientific literacy; the training of teachers in the different areas involved; and the importance of this event for education with a decolonial aspect, promoting awareness about Latin American scientific production. Keywords: Biology, scientific dissemination, decolonial education, scientific event, Geology, Museology.
Proteomic reference map for sarcopenia research: mass spectrometric identification of key muscle proteins located in the sarcomere, cytoskeleton and the extracellular matrix
Authors: Dowling Paul , Gargan Stephen , Zweyer Margit , Henry Michael , Meleady Paula , Swandulla Dieter , Ohlendieck Kay
Published: May 2024

Sarcopenia of old age is characterized by the progressive loss of skeletal muscle mass and concomitant decrease in contractile strength. Age-related skeletal muscle dysfunctions play a key pathophysiological role in the frailty syndrome and can result in a drastically diminished quality of life in the elderly. Here we have used mass spectrometric analysis of the mouse hindlimb musculature to establish the muscle protein constellation at advanced age of a widely used sarcopenic animal model. Proteomic results were further analyzed by systems bioinformatics of voluntary muscles. In this report, the proteomic survey of aged muscles has focused on the expression patterns of proteins involved in the contraction-relaxation cycle, membrane cytoskeletal maintenance and the formation of the extracellular matrix. This includes proteomic markers of the fast versus slow phenotypes of myosin-containing thick filaments and actin-containing thin filaments, as well as proteins that are associated with the non-sarcomeric cytoskeleton and various matrisomal layers. The bioanalytical usefulness of the newly established reference map was demonstrated by the comparative screening of normal versus dystrophic muscles of old age, and findings were verified by immunoblot analysis.
Value of cognitive fusion targeted and standard systematic transrectal prostate biopsy for prostate cancer diagnosis
Authors: Yu Lu-Ping , Du Yi-Qing , Sun Yi-Ran , Qin Cai-Peng , Yang Wen-Bo , Huang Zi-Xiong , Xu Tao
Published: May 2024

The aim of this study was to compare the accuracies of cognitive fusion-guided targeted biopsy (TB), systematic biopsy (SB), and combined TB+SB for the detection of prostate cancer (PCa) and clinically significant PCa (csPCa) in males with lesions detected by magnetic resonance imaging (MRI). We conducted a retrospective analysis of individuals who underwent prostate biopsy at Peking University People’s Hospital (Beijing, China), with an emphasis on patients with both transrectal TB and SB. The main objective was to determine the precisions of SB, TB, and TB+SB for diagnosing PCa and csPCa. We also evaluated the detection rates of TB, SB, TB+ipsilateral-SB (ipsi-SB), TB+contralateral-SB (contra-SB), and TB+SB for PCa and csPCa in patients with unilateral MRI lesions. We compared the diagnostic yields of the various biopsy schemes using the McNemar’s test. A total of 180 patients were enrolled. The rates of PCa detection using TB, SB, and TB+SB were 52.8%, 62.2%, and 66.7%, respectively, and the corresponding rates for csPCa were 46.1%, 56.7%, and 58.3%, respectively. Among patients with unilateral MRI lesions, the PCa detection rates for TB, SB, TB+ipsi-SB, TB+contra-SB, and TB+SB were 53.3%, 64.8%, 65.6%, 61.5%, and 68.0%, respectively. TB+ipsi-SB detected 96.4% of PCa and 95.9% of csPCa cases. These findings suggest that the combination of TB+SB has better diagnostic accuracy compared with SB or TB alone. For patients with unilateral MRI lesions, the combination of TB+ipsi-SB may be suitable in clinical settings.
Predictive parameters of the efficacy of varicocele repair: a review
Authors: Crafa Andrea , Cannarella Rossella , Condorelli Rosita A , Mongioì Laura M , Vignera Sandro La , Calogero Aldo E
Published: May 2024

Varicocele has a prevalence of 15% in the population and represents a primary cause of infertility in 40% of cases and a secondary cause in approximately 80% of cases. It is considered the major correctable cause of male infertility. Despite its high prevalence in the infertile population, a large number of patients with varicocele do not experience reproductive difficulties. For this reason, it is still highly debated which parameters could be used to predict which patients with varicocele will be most likely to benefit from its repair. The main international and European guidelines state that treatment should only be considered in infertile patients with abnormal sperm quality. However, these guidelines do not help physicians to identify which of these patients may benefit from the treatment. Therefore, this narrative review collects the evidence in the literature on the usefulness of some factors as predictors of improvement, highlighting how some of them may be effective in an initial selection of patients to be treated, while others are promising but further studies are needed. Finally, a brief consideration on the possible role of artificial intelligence is proposed.
Developing Porcine Acellular Dermal Matrix by Using Sodium Dodecyl Sulfate and Biomechanical Property Testing
Authors: Primasari Medisa , Saputro Iswinarno Doso , Hariani Lynda , Velusamy Glorian Paul Bosco
Published: May 2024

ABSTRACT

Introduction:

An alternative for supporting wound closure is acellular dermal matrix (ADM), which serves as a scaffold. Humans and porcine possess a similar biochemical makeup. Using sodium dodecyl sulfate (SDS), a decellularization technique was developed and its biomechanical properties were assessed.

Methods:

This work uses a pig dermis layer for an in vitro experimental investigation with a posttest-only control group. Using SDS 0.5% for 14 days, the decellularization procedure compares the biomechanical properties and cellular components of the ADM with control. The Mann–Whitney U-test for data with a nonnormal distribution or the t-test for continuous variables with a normal distribution was used for the study.

Results:

Histological analysis revealed that none of the cells were detected in four fields of analysis in the treatment group; however, 48.00 ± 4.86 cells were observed in the control group (P < 0.001); the collagen organization in the control group appeared to be identical. The variables elastic modulus (MPa) (136.78 vs. 129.19; P = 0.556), thickness (mm) (3.27 vs. 3.15; P = 0.397), and width (mm) (8.50 vs. 8.56; P = 0.40) did not differ statistically. The following data showed significant differences between the treatment group and the control group: break strain (%) (108.46 vs. 67.48; P < 0.001) and tensile strength stress (MPa) (19.916 vs. 22.1; P = 0.030).

Conclusions:

SDS decellularization is an efficient method for creating an ADM. Although the break strain was considerably lower, the treatment group’s tensile strength was higher. Elastic modulus changes were not observed.
Intrachromosomal amplification of chromosome 21 in Egyptian pediatric B-lineage acute lymphoblastic leukemia: a hospital-based observational study
Authors: Elhameed Amal Abd , El-Gamal Rasha , Hasan Esraa , Mohamed Nagy Reham
Published: May 2024

Objective

This study was conducted to evaluate the clinicopathologic features as well as the association between the intrachromosomal amplification of chromosome 21 (iAMP21) and the clinical outcome in Egyptian patients with B-cell acute lymphoblastic leukemia (B-ALL) attending/admitted in the Department of Pediatric Oncology of our university hospital.

Patients and methods

This was a prospective study conducted on 25 newly diagnosed and five relapsed pediatric patients with B-ALL (23 males and seven females), with a mean age of 7.76 ± 5.11 years. Bone marrow aspiration was done to diagnose and evaluate remission of participants, and fluorescence in situ hybridization (FISH) analysis using the ETV6-RUNX1 probes was used to detect RUNX1 amplification.

Results

iAMP21 was identified in 28% of newly diagnosed patients with B-ALL and in 80% of relapsed cases with B-ALL. There was a significant association between positive iAMP21 cases and failure to attain complete remission at day 28 (P=0.004). A significant relationship among the 14 patients monitored for disease outcome was found between the presence of iAMP21 and occurrence of relapse or death in newly diagnosed, or failure to achieve complete remission or death in relapsed cases (P=0.036).

Conclusion

There was a higher incidence of iAMP21 among our Egyptian pediatric B-ALL cases and unfavorable effect of iAMP21 on patients’ prognosis even with coexistence of ETV6-RUNX1.
Does platelet aggregation differ among chronic myeloid leukemia-chronic phase (CML-CP) patients on tyrosine kinase inhibitors (TKIs)? A tertiary center experience
Authors: Moeen Sawsan M , Afifi Ola A , Thabet Ahmad F , Saleh Medhat A , Morad Mohamed A
Published: May 2024

Background

Tyrosine kinase inhibitors (TKIs) have improved the prognosis of chronic myeloid leukemia (CML) by inhibiting the BCR-ABL kinase. There are concerns regarding the effect of TKI on hemostasis by inhibiting platelet aggregation; the possible reason for this is yet unclear.

Objectives

To study platelet aggregation response to different agonists [(adenosine diphosphate (ADP), collagen, and arachidonic acid (AA)] using platelet aggregometry in 75 CML-chronic phase (CML-CP) patients on TKI therapy, in complete hematologic response (CHR).

Patients and methods

This study included 75 CML patients of both sexes of age 32–66 years. A detailed medical history, clinical examination, and platelet aggregation by PAP-4 platelet aggregometer were done for all patients.

Results

Imatinib-treated CML patients had a lower platelet aggregation response to AA (less than 50% aggregation) than those on nilotinib either first- or second-line treatment, in a statistically significant manner (P=0.001, P=0.025) for both comparisons. But there was no statistically significant difference in platelet aggregation between patients on nilotinib either first- or second-line therapy (P=0.073).

Conclusion

Platelet aggregation response to collagen and ADP was normal in all CML-CP patients, but it had an impaired response to AA. Further studies are needed to establish the particular mechanism of this inhibition.
Quality Assurance and Improvement Project in Echocardiography Laboratory
Authors: Kossaify Antoine
Published: May 2024

Echocardiography plays a vital role in the diagnosis and management of cardiovascular conditions. Echocardiography use is progressively increasing nowadays, and this is correlated to the evolving echo indications, to the relatively new available echocardiography modes (tissue Doppler imaging, speckle tracking imaging, three-dimensional mode, etc.) and modalities (transthoracic, transesophageal, and intracardiac) along with the various available clinical approaches (point of care echo, portable echo, etc.). Quality assurance in echocardiography is correlated to appropriate use criteria, adequate equipment, standardization of performance and reporting, along with timely storage and archiving. Quality improvement plan must target strategic planning, with metrics and timeline for assessment and re-assessment of results. Improvement project aims to ensure and enhance conformity with appropriate use criteria and standardization, timely completion of exams and reports, detection of discrepancies, and continuous improvement of knowledge and skills. Strategic planning is essential in this context in order to develop organizational and managerial processes, with regular auditing for a highly professional and advanced level of echocardiography, while ensuring teamwork and standards of ethical values.
Sepsis-Induced Takotsubo Cardiomyopathy Mimicking ST-Elevation Myocardial Infarction
Authors: Al-Wahaibi Kamla , Al-Wahshi Yahya , Rajagopal Vaseeharan Lux , Al-Sarhani Amal
Published: May 2024

Takotsubo cardiomyopathy (TCM) was first initially reported in 1990 in Japan and has been increasingly recognized in clinical practice. It is characterized by transient regional left ventricular dysfunction without evidence of obstructive coronary artery disease, often precipitated by emotional and physical stressors. Although TCM does occur in young women and men, it is most commonly seen in postmenopausal women. Sepsis induced TCM is an infrequently encountered entity. We present a case of TCM in a middle age gentleman who presented with septic shock due to acute cholecystitis. Two days later, the patient developed clinical features of acute myocardial infarction. Echocardiography revealed hypokinesis of the left ventricle. Coronary angiography revealed normal arteries without any obstruction. Diagnosis of sepsis induced TCM was finally made. The patient made a dramatic recovery and discharged home in stable condition. Follow-up echocardiography showed improvement in left ventricular systolic function.
Patent Ductus Arteriosus Device Closure in Interrupted Inferior Vena Cava
Authors: Rajan Palanivel , Barwad Parag , Aggarwal Pankaj , Rohit Manoj Kumar
Published: May 2024

Interrupted inferior vena cava (IVC) with azygous continuation provides technical challenge in many percutaneous cardiac interventions. They are performed via the femoral venous access route. We describe four such cases in whom, patent ductus arteriosus (PDA) device closure was done in interrupted IVC. All the four cases were done using the femoral route. Two cases were done via retrograde approach through femoral artery access, in which one was closed with a muscular VSD device and the other with a Gianturco coil.

The introduction of newer closure devices helps in the retrograde approach. Two cases were done via anterograde approach through the femoral venous route, with a loop through the azygous vein. One child had transient bradycardia due to cardiac stretch which normalized after the device deployment and introducer system removal.

Thus, we describe different femoral approaches in interrupted IVC patients for PDA closure, with the difficulties faced and the complications managed.
Out-of-Hospital Cardiac Arrest in the Young
Authors: Albizreh Bassim , Arabi Abdulrahman , Al Suwaidi Jassim , Patel Ashfaq , Singh Rajvir , Albinali Hajar
Published: May 2024

Background:

Worldwide, limited data are available about young patients (≤40 years) who present with out-of-hospital cardiac arrest (OHCA). We compared demographic characteristics, clinical presentation, and outcome in younger patients (≤40 years) versus older patients (>40 years) with OHCA.

Materials and Methods:

This was a retrospective analysis of a registry of patients hospitalized with OHCA over a 23-year period (1991–2013) in Hamad Medical Corporation, Doha, Qatar.

Results:

Of 1146 patients admitted to our institution with OHCA, 159 patients (13.9%) were 40 years of age or younger. Compared to the older group (>40 years), younger group patients were more likely to be males (84.9% vs. 71.5%; P = 0.001) and to be smokers (27.7% vs. 19.7%; P = 0.012). They are less likely to have diabetes (6.3% vs. 49.2%; P = 0.001), hypertension (8.3% vs. 49.9%; P = 0.001), prior myocardial infarction (3.1% vs. 23.4%; P = 0.001), or chronic renal disease (0% vs. 8.5%; P = 0.001). There was no significant difference in ejection fraction, ST-elevation myocardial infarction (13.2% vs. 15.7%; P = 0.41), utilization of inotropes (36.5% vs. 44%; P = 0.08), or utilization of reperfusion therapy (thrombolytic: 16.4% vs. 12.2%, P = 0.14, and percutaneous intervention: 6.3% vs. 5.3%, P = 0.60, for the younger and older groups, respectively); on the other hand, younger patients were more likely to receive antiarrhythmic medications (33.3% vs. 21.2%; P = 0.001). Inhospital mortality was lower in the younger group (52.1% vs. 68.3%; P = 0.001) even after adjustment for baseline variables.

Conclusion:

In the Middle East it is not uncommon to present with OHCA in young age. These patients are predominantly males, more likely to present with arrhythmia and they have a better survival rate.
COVID-19 Pandemic and Volume of Cardiac Catheterization Procedures in Jordan
Authors: Alhaddad Imad A. , Tabbalat Ramzi , Hammoudeh Ayman
Published: May 2024

Introduction:

Global surge of COVID-19 forced most countries to impose variable measures to curb the disease. Jordan imposed one of the strictest lockdowns from mid-March through April 2020. Hospitals deferred elective cardiac catheterization procedures and most of those performed during that period were limited to urgent presentations. Our purpose is to evaluate the impact of strict lockdown on cardiac catheterization procedural volume.

Methods and Results:

We collected data about the numbers of all coronary angiography (CA) and percutaneous coronary intervention (PCI) procedures performed in 5 tertiary care hospitals in Amman, Jordan, from January through June 2020. We compared the volume of procedures performed in April 2020 (the strict lockdown month) to the corresponding period of prior year (April 2019) and to volumes performed prior to the lockdown in January–February 2020.

There was a 64% decline in CA and PCI volumes in April 2020 compared to April 2019. Comparing number of procedures performed in April 2020 to those in January–February 2020, there was 59% decline in CA and a 60% decline in PCI volumes. Following partial lifting of lockdown in May–June 2020, procedural volumes increased gradually.

Conclusion:

Strict COVID-19-related lockdown in Jordan was associated with drastic declines in cardiac catheterization procedural volumes.
Complications of White-coat Hypertension Compared to a Normotensive and Hypertensive Population
Authors: Taher Ziad Abdullah , Khayyat Waleed W. , Balubaid Marwan M. , Tashkandi Mohamed Y. , Alamoudi Saeed M. , Kinsara Abdulhalim Jamal
Published: May 2024

Background:

Accumulating evidence demonstrates that white-coat hypertension (WCH) are associated with several risks and complications. In this study, we aimed to investigate the adverse effects of WCH compared with hypertensive and normotensive patients.

Methods:

A retrospective cohort study was conducted over five years. Blood pressure (BP) data was collected from both clinic visits and 24-h ambulatory blood pressure monitoring (ABPM) reports. Epidemiological data and complications, cardiac and noncardiac, were also recorded.

Results:

In total, 286 participants who were followed up for at least three years were included. The sample was divided into 99 normotensive patients (as a control group), 94 patients with clinically diagnosed hypertension (HTN), and 93 patients with WCH. Ischemic heart disease (IHD) was the most noted complication in the WCH group with a relative risk of 9.58 (1.23–74.16) (P = 0.008). Acute coronary syndrome (ACS) was significantly correlated with a relative risk of 2.06 (0.52–13.38). No significant correlation was noted with noncardiac complications. Both HTN and WCH groups showed a significant association with blood pressure variability (BPV). WCH was associated with an increased BPV in ambulatory daytime systolic measurements (P = 0.031) and a unique increase in diastolic measurement variability in office BP measurements (P = 0.020).

Conclusion:

WCH should be managed as HTN. WCH is associated with cardiac complications, particularly IHD, specifically in patients 55 years and older. WCH was significantly associated with a higher BPV in both ABPM and office-based measurements.
Probiotics in Dermatology: An Evidence-based Approach
Authors: Gowda Vaishnavi , Sarkar Rashmi , Verma Damini , Das Anupam
Published: May 2024

Probiotics are viable microorganisms that confer health benefits when administered to the host in adequate amounts. Over the past decade, there has been a growing demand for the use of oral and topical probiotics in several inflammatory conditions such as atopic dermatitis, psoriasis, acne vulgaris, etc., although their role in a few areas still remains controversial. The objective of this article is to shed light on understanding the origin and implications of microbiota in the pathophysiology of these dermatological conditions and the effect of probiotic usage. We have conducted a comprehensive search of the literature across multiple databases (PubMed, EMBASE, MEDLINE, and Google Scholar) on the role of probiotics in dermatological disorders. Commensal microbes of the skin and gastrointestinal tract play an important role in both health and disease. Increased use of probiotics has asserted a good safety profile, especially in this era of antibiotic resistance. With the advent of new products in the market, the indications, mechanism of action, efficacy, and safety profile of these agents need to be validated. Further studies are required. Oral and topical probiotics may be tried as a treatment or prevention modality in cutaneous inflammatory disorders, thus facilitating decreased requirement for topical or systemic steroids and antimicrobial agents. Tempering microbiota with probiotics is a safe and well-tolerated approach in this era of antimicrobial resistance.
Vascular Endothelial Growth Factor Expression by Immunohistochemistry as a Possible Indicator of Prognosis in Invasive Breast Carcinoma of No Special Type
Authors: Sindhura Nugala , Kaumudi Konkay
Published: May 2024

Context:

Angiogenesis, the formation of new blood vessels from preexisting vascular network, is essential for tumor growth and spread. Vascular endothelial growth factor (VEGF) is a potent angiogenic growth factor.

Aims:

To assess the expression of VEGF in invasive carcinoma of no special type and its correlation with all the known prognostic factors of breast carcinoma.

Settings and Design:

Descriptive.

Materials and Methods:

Mastectomy specimens were studied noting the clinical details. The formalin-fixed tissues were subjected to routine processing and hematoxylin and eosin sections and studied extensively for all the histological prognostic factors. Representative sections from each case with the tumor were subjected to immunohistochemistry (IHC) staining with VEGF, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) antibodies.

Statistical Analysis Used:

Descriptive statistics, Chi-square tests, contingency table analysis using SPSS for Windows.

Results:

One hundred and twelve cases of invasive carcinoma of special type were studied to evaluate various clinicopathological parameters. The association of VEGF with clinicopathological parameters and all the known prognostic factors was studied to note its significance. VEGF overexpression was observed in 69% of the cases. It was noted that larger tumor size, higher histological grade, lymphovascular invasion, nodal involvement, tumor necrosis, high microvessel density, ER negativity, PR negativity, and HER2/neu positivity had a significant statistical association with VEGF overexpression.

Conclusions:

We conclude that incorporating VEGF as a biomarker along with the known factors into a prognostic index will not only help predict clinical outcome more accurately, but also determines the patient who can be benefited with combinational therapy including anti-VEGF factors.
Association of Serum Proteins Electrophoretic Pattern and Serum Hormones in Women with Spontaneous Pregnancy Loss
Authors: Shah Prithvi Bahadur , Gupta Kapil , Bedi Mini
Published: May 2024

Background:

Pregnancy is the state of carrying a developing embryo or fetus within a female body. Once pregnancy is established, a range of endocrinological events appear in its maintenance, finally helping in the successful pregnancy. The complications which are usually observed in pregnancy are gestational diabetes, preeclampsia, preterm labor, and spontaneous pregnancy loss or miscarriage, while 10%–15% of clinically recognized pregnancies terminate into spontaneous miscarriage. Thus, many attempts have been made by different researchers for the diagnosis of high-risk pregnancy on altered protein pattern using placental villous tissue or follicular fluid, but these are difficult to obtain and results of different studies are not constant.

Aim:

This study was designed to identify the association (if any) among serum protein(s) electrophoretic pattern and different serum hormones in normal pregnant women (controls) and gestational age-matched women with spontaneous pregnancy loss (cases).

Materials and Methods:

This study was carried out for 1½ year from October 2018 to March 2020 and included 120 participants (60 normal pregnant women and 60 women with spontaneous pregnancy loss) between 20 and 45 years of age with no mean age difference. The electrophoresis of serum was carried out using slab gel electrophoretic unit and serum thyroid-stimulating hormone (TSH), total tri-iodothyronine (TT3), total thyroxine (TT4), prolactin, and beta human chorionic gonadotropin (β-hCG) levels were analyzed using TSOSH AIA analyzer at Adesh University, Bathinda.

Results:

Significant variations in the expression of proteins with molecular weight around ~150 kDa, ~50 kDa, and ~25 kDa were observed in normal pregnant women and women with spontaneous pregnancy loss. However, the protein band of ~50 kDa was found to be highly expressed in the serum of 1st and 2nd trimester women experiencing spontaneous pregnancy loss. Therefore, selected protein band of ~50 kDa was further processed by ECI-mass spectrophotometry QUAD time of flight and 365 different proteins were found, out of these; 34 proteins were found to be unidentified protein products (Verified
using
NCBI
data
base). Further, TT3, total proteins, β-hCG, and prolactin level were found to be low, whereas, TSH was found to be high in women experiencing spontaneous pregnancy loss. However, difference in the level of β-hCG in the 1st trimester and TT4 among normal pregnant women and women with spontaneous pregnancy loss was observed to be statistically insignificant.

Conclusion:

This study indicated that the evaluation of serum protein variations along with hormonal profile may provide valuable information about high-risk pregnancy. Moreover, the differential expression of proteins in women with spontaneous pregnancy loss can be further explored to develop potential biomarker for the early identification of high-risk pregnancy and appropriate preventive measure.
Divergent Gender Identity in a Phenotypic Male with 46XX Karyotype Caused by a Mutation in CYP21A2 Gene with Congenital Adrenal Hyperplasia
Authors: Kumar K. C. Pradheep , Banik Suranjana , Joy Praisy , Sahoo Sanjukta
Published: May 2024

A male patient in his late twenties presented with ambiguous genitalia to our tertiary specialist unit with complaints of short stature and inadequate copulation. There was no history of consanguinity, and a physical examination raised concerns about possible disorders of sexual development (DSD). Karyotyping and fluorescence in situ hybridization results were consistent with the presence of two X chromosomes, revealing the patient to be a genotypic female. Sanger sequencing showed a heterozygous pathogenic mutation in the CYP21A2 gene known to be associated with 21-hydroxylase deficiency, thus confirming the diagnosis of congenital adrenal hyperplasia (CAH), Prader stage V. DSD with CAH is distressing for the patient and their families, and the management needs a multidimensional approach involving diverse medical, genetic, and psychological considerations. Cytogenetic and molecular genetic studies play an essential role in diagnosis and decision-making and should be made affordable in developing countries for better patient care.
Clinical Performance of I-gel® and BlockBuster™ Laryngeal Mask Airway in Adult Patients during General Anesthesia: A Randomized Comparison
Authors: Das Prerna Prabhat , Tiwari Tanmay , Raman Rajesh , Gautam Shefali , Kushwaha B. B. , Kumar Yatendra
Published: May 2024

Background:

Supraglottic devices have revolutionized the current practice of airway management. We compared the clinical performance of a recently introduced BlockBuster™ Laryngeal mask airway with i-gel® in adult patients under general anesthesia.

Methods:

Following Institutional ethical clearance, the present study was conducted on 62 patients belonging to American Society of Anesthesiologists physical status 1 and 2 of either sex in the age group of 20–60 years under general anesthesia. Patients were randomly assigned to i-gel® (I) and BlockBuster™ (B) groups (31 per group). Time for successful insertion, insertion success rate, ease of insertion, oropharyngeal leak pressures (OLPs), and complications were assessed.

Results:

Mean insertion time of device was less in Group I (13.52 ± 2.58 s) than that of Group B (14.10 ± 2.04 s), which was neither clinically nor statistically significant (P = 0.330). OLP in Group B (24.52 ± 2.77 cm of H2O) was found to be significantly higher compared to Group I (20.81 ± 2.56 cm of H2O) with P < 0.001. Overall insertion and first attempt success was similar (i-gel® 31/31 [100%] and 29/31 [93.5%] and BlockBuster™ 31/31 [100%] and 29/31 [93.5%], respectively). Ease of insertion (P = 0.684) and complications (P = 0.782) of both the devices were comparable.

Conclusions:

Both the devices are useful and effective for airway management in adult under general anesthesia. Having a high OLP and comparable insertion time, risk of aspiration may be further reduced with the use of BlockBuster™ in comparison to i-gel®.