bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of vaccination on ICU admissions of hospitalized COVID-19 patients in a country with a heterologous vaccine policy
Authors: Yıldırım Süleyman , Kirakli Cenk , Özdemir Yeliz , Tosun Selma , Ermin Sinem , Polat Gülru , Yılmaz Celalettin , Bilaçeroğlu Semra , Salık Bilge , Kömürcüoğlu Berna , Ödemiş İlker , Köse Şükran , Uzun Uğur , Aydın Gaye , İlhan Enver
Published: May 2024

Introduction: Vaccination against coronavirus disease-19 (COVID-19) is highly effective in preventing severe disease and mortality. Adenoviral vector and mRNA vaccines were effective against intensive care unit (ICU) admission, but the effectiveness of inactivated vaccine on ICU admission was unclear. We aimed to evaluate the effect of vaccination status on ICU admission in hospitalized COVID-19 patients in a country with heterologous vaccination policy.
Methodology: This is a retrospective multicenter study conducted in three hospitals in Izmir, Turkey between 1 January 2021 and 31 March 2022. Patients aged ≥ 18 years and hospitalized due to COVID-19 were included in the study. Patients who had never been vaccinated and patients who had been vaccinated with a single dose were considered unvaccinated. A logistic regression analysis was performed for evaluating risk factors for ICU admission.
Results: A total of 2,110 patients were included in the final analysis. The median age was 66 years (IQR, 53-76 years) and 54% of the patients were vaccinated. During the study period, 407 patients (19.3%) were transferred to the ICU due to disease severity. Patients who were admitted to the ICU were older (median age 68 vs. 65 years, p < 0.001); and the number of unvaccinated individuals was higher among ICU patients (57% vs. 45%, p < 0.001). In multivariate regression analysis, being unvaccinated was found to be the most important independent risk factor for ICU admission with an OR of 2.06 (95% CI, 1.64-2.59).
Conclusions: Vaccination against COVID-19 is effective against ICU admission and hospital mortality.
Kodamaea ohmeri: A rare yeast causing invasive infections in immunocompromised patients
Authors: Singh Parul , Srivastava Smriti , Varma Sharin , Sharad Neha , Ningombam Aparna , Peddapulla Chandan , Malhotra Rajesh , Mathur Purva
Published: May 2024

Introduction: Kodamaea ohmeri is a rare, recognized pathogen that has previously been isolated from environmental sources. The patients commonly affected by this yeast include immunocompromised as well as immunocompetent patients having several associated risk factors.
Methodology: We report three cases in which K. ohmeri was isolated from blood using Bact T/ALERT. Identification was carried out by MALDI-TOF MS (Vitek-MS, BioMérieux, Marcy-l’Etoile, France) in addition to color characteristics on chromogenic media. The patients had diminished immune response on account of a multitude of comorbidities.
Results: K. ohmeri can be misidentified as Candida tropicalis, Candida albicans, or Candida hemolounii by conventional methods; correct and timely identification can be achieved by MALDI-TOF MS. Antifungal susceptibility breakpoints for K. ohmeri are currently not defined. An Echinocandin was added to the treatment regimen of all three of the cases.
Conclusions: Identification of K. ohmeri using conventional methods is difficult and unusual yeasts should be carefully observed, especially upon prolonged incubation.
Alert for pharynx-centered gastrointestinal and respiratory cross-infection and cryptic cross-transmission routes of 2019-nCoV
Authors: Chen Xiehui , Wang Zhanke , Wang Jiaxuan , Zhu Zhongzhen , Li Chunxin , Hu Tian
Published: May 2024

We proposed that the pharynx, as a common organ of the respiratory and digestive tracts, may be a respiratory and digestive tract cross cryptic transmission pathway for 2019-nCoV infection from the nasal cavities to the pharynx and lung, then to nasal cavities by aerosol (respiratory route) to the pharynx and the gastrointestinal tract, then to the oral cavity by feces (fecal-oral route) and to pharynx, lungs, or gastrointestinal tract.
Clinical characteristics of liver transplant recipients with COVID-19 and analysis of risk factors for the severe disease
Authors: Fu Sunya , Chen Dawei , Zhang Yuqin , Wu Mingjie
Published: May 2024

Introduction: Liver transplant (LT) recipients were at a high risk of infection during the coronavirus disease 2019 (COVID-19) pandemic. Our purpose was to compare the clinical characteristics of severe and non-severe groups of LT recipients with COVID-19, and to analyze their risk factors for severe disease.
Methodology: 79 LT recipients with COVID-19 were divided into a non-severe group (n = 60) and a severe group (n = 19), and differences in clinical characteristics, laboratory tests, and chest computed tomography (CT) performance were analyzed. Logistic regression was used to identify risk factors with severe COVID-19. Receiver operating characteristic (ROC) curves were plotted and the area under curve (AUC) values were calculated to assess the predictive value for severe COVID-19.
Results: Age was statistically different (p < 0.001) between the two groups. The difference in neutrophil-to-lymphocyte ratio (NLR), serum creatinine (Scr), D-dimer, urea, C-reactive protein (CRP), lactate dehydrogenase (LDH), and the number of lung segments involved in inflammation between the two groups were statistically significant (p < 0.05). The results revealed that age (OR = 1.255, 95% CI 1.079-1.460), NLR (OR = 1.172, 95% CI 1.019-1.348), and Scr (OR = 1.041, 95% CI 1.016-1.066) were independent risk factors for severe COVID-19. The ROC results showed that high values for age, NLR and Scr predicted severe COVID-19, with AUC values of 0.775, 0.841 and 0.820, respectively, and 0.925 for the three factors combined.
Conclusions: Advanced age, and elevated NLR and Scr are independent risk factors for severe COVID-19 in LT recipients.
Multi-locus sequence typing of Escherichia coli isolated from clinical samples in Jordan
Authors: Zueter AbdelRahman M , Mharib Taghrid , Shqair Dalal , Al-Tamimi Mohammad , Sawan Hana M , Zaiter Amani , Albalawi Hadeel , Al Balawi Dua’a
Published: May 2024

Introduction: Escherichia coli (E. coli) is the major cause of extraintestinal infections in the urinary tracts and bloodstream in humans in the community and health care institutions. Several studies on the genetic characterization of E. coli among clinical and environmental isolates were performed and revealed a wide diversity of sequence types (STs). In Jordan, phenotypic and genetic features of E. coli were extensively studied but there is still a need to identify the STs that inhabit the community.
Methodology: In this study, multi-locus sequence typing (MLST) was performed on archived clinical E. coli isolates collected from different hospitals in Jordan and the identified STs were extensively analyzed.
Results: Genotyping of 92 E. coli isolates revealed 34 STs and 9 clonal complexes. The frequencies of STs ranged between 1 to 23 observations. The most frequent STs among E. coli isolates were ST131 (n = 23), ST69 (n = 19), ST998 (n = 7), ST2083 (n = 5), and ST540 (n = 4). These five ST accounted for up to 60% of the 92 E. coli isolates. Based on the MLST database, the STs reported in this work were world widely recognized in humans, animals, and in the environment.
Conclusions: This study has elaborated more knowledge about the genotypes of E. coli in Jordan, with recommendations for future studies to correlate its genotypes with virulence and resistance genes.
Enhanced recovery urinary protocol for patients undergoing hip surgery: a quasi-experimental study
Authors: Behairy Amoura S , Al-Batanony Manal A , Alwashmi Emad A , Abdel Hakeim Eglal H
Published: May 2024

Introduction: Postoperative urinary retention (POUR) is a common complication after hip surgery. The enhanced recovery urinary protocol (ERUP) is a tool that employs several perioperative strategies to facilitate optimal conditions for surgery and recovery. The aim of this study was to evaluate the effect of ERUP on POUR in patients undergoing hip surgery.
Methodology: A controlled pre- and post-quasi-experimental study was conducted. Data was collected between May 2018 and January 2019 at the orthopedic department of one of the largest teaching hospitals affiliated with Menoufia University in Egypt. A convenience sample of 100 Egyptian patients (of both genders) undergoing elective hip surgery was equally allocated into two groups. The control group (n = 50) was given traditional routine perioperative nursing care, while the intervention group (n = 50) was subjected to ERUP. Data was collected from socio-demographic, medical, and surgical data sheets, preoperative medication assessment sheets, postoperative data sheets, and fluid balance charts.
Results: ERUP application significantly reduced the length of hospital stay and the incidence of POUR in the intervention group.
Conclusions: Implementation of the ERUP is recommended for patients undergoing hip surgery, as it has a significantly positive effect on reducing the incidence of POUR.
Possible Effects of Shipping Routes on Coral Reef Degradation and Diversity in Karimunjawa Marine National Park, Java Sea
Authors: Sabdono Agus , Wijayanti Diah Permata , Helmi Muhammad , Satya Eridhani Dharma
Published: May 2024

The Karimunjawa Marine National Park, situated in the Java Sea, Indonesia, is renowned for its rich biodiversity and lively coral reefs. However, amidst the backdrop of this natural beauty, concerns have been raised regarding the potential impacts of shipping activities on the health and diversity of these fragile ecosystems.The increase in maritime traffic, including commercial vessels, tourist boats, and fishing vessels, traversing through the Karimunjawa Marine National Park raises significant environmental concerns. The movement of these vessels, especially along specific shipping routes, has the potential to disturb and damage coral reefs through various mechanisms. Hence, the aim of this study was to investigate the possible impacts of shipping routes on the coral abundance and diversity and the coral health in the Karimunjawa Islands, Java Sea, Indonesia.

In this study, the ship routes were grouped into 3 categories (west, east, and non-routes). The West Route, East Route, and Non-Route including a total of 15 islands were investigated for their % prevalence of coral disease, % coral cover, diversity index, species richness, relative abundance, and evenness. At each island, a 15x2 m belt transect was established at 3 and 8 m in depth with 3 repetitions. The statistical analyses showed that there were significant differences in coral abundance and species richness among the ship-route groups. Nonetheless, there were no significant differences in all parameters observed between 3 m and 8 m in depths. These findings suggest that while certain aspects of coral health and diversity are not influenced by shipping routes, other factors or mechanisms may play a more dominant role in determining disease prevalence, coral cover, and overall diversity in the Karimunjawa coral reefs.
Article processing charges suppress the scholarship of doctoral students
Authors: Wang Joshua
Published: May 2024

The open access movement has drastically reconfigured the financial burdens of scholarly publishing. Yet, the influence of a marketized scholarly publishing system on doctoral education remains unexplored. I reflect on my own PhD candidature to illustrate how article processing charges disempower doctoral candidates. I argue that the current open access publishing model unfairly advantages candidates with personal, familial and/or institutional wealth. The inequalities imposed on doctoral students by our sectors’ current publishing habits ultimately bias who will be paid to produce and safeguard knowledge in the future. Doctoral students can no longer be ignored in debates over open access publishing.
Re-discovery and taxonomic clarification of Oreocharis leveilleana (Gesneriaceae) in Guizhou, China, over 100 years
Authors: Xiong Xiao-Kai , He Song-Tao , Zhou Yu-Lu , Wen Fang , Bai Xin-Xiang
Published: May 2024

Oreocharis leveilleana Fedde was collected in Ta-pin in 1910 and published in 1911. The collected location was verified within western Luodian County, Guizhou Province, China. However, there have been no records of the species’ collection for more than 100 years since then. After extensive investigations by our research team on the type locality and its surrounding areas, we found that it is widely distributed in western Luodian County and eastern Wangmo County, Guizhou Province, China. During further research on the original literature, type specimens and type locality of O. leveilleana, the taxonomic position of O. leveilleana, which was once treated as a synonym of O. auricula (S.Moore) C.B.Clarke, was found to have a taxonomic problem. Through morphological research combined with geographical distribution analysis, it has been determined that it should belong to the genus Petrocodon Hance and it is the same species as P. coccineus (C.Y.Wu ex H.W.Li) Yin Z.Wang. According to the regulations and suggestions of the 2018 "International Code of Nomenclature for Algae, Fungi, and Plants (Shenzhen Code)", we propose and confirm a new combination – Petrocodon leveilleanus (Fedde) X.X.Bai & F.Wen and treat P. coccineus as a synonym of the new combination. Due to its unique bright red flowers within Petrocodon, its original Chinese name has been retained.
Probing Genetics and Environmental Factors underlying Uterine Fibroid Tumorigenesis in Ghana, West Africa
Authors: Senbadejo Tosin , Abiola Isawumi , Paemka Lily
Published: May 2024

Uterine fibroid (UF) is the most prevalent benign tumour that affects millions of women globally, with a high incidence of 70% amongst women of reproductive age. UF has been associated with various complications, such as recurrent surgeries, infertility, anemia and pregnancy loss. Notably, women of African descent often experience more severe symptoms and complications. Although hormones, growth factors, and genetic alterations are widely associated with UF, the precise mechanism underlying its pathogenesis is not fully understood. Recent evidence suggests altered microbiota may serve as a potential risk factor for UF development. Altered microbiota can contribute to tumorigenesis via epigenetic changes to host cells or toxic effects from invasion. The lack of curative-drug treatment poses significant challenges to patients with UF. Patients often undergo surgeries that require the removal of the uterus or tumour, which can negatively impact fertility. Furthermore, uterine fibroids’ diagnosis relies on expensive imaging technologies such as ultrasound, which may not be readily available in developing countries. Moreso, diagnosis is often conducted only after patients’ symptoms become severe. Although late presentation may contribute to severe symptoms and complications among women with UF in Africa, other factors that influence severity and increase incidence in this population remain unknown. A comprehensive assessment of UF predisposing factors in high-risk populations such as Ghana could give better insights into disease pathogenesis. Hence, this study aims to assess: UF-associated demographic factors, the role of uterine microbiota dysbiosis on UF tumorigenesis; and molecular markers associated with UF in the Ghanaian population. Epidemiological data and clinical samples (tissues, blood and cervico-vaginal swabs) will be obtained. The characterization of samples will involve metagenomics, whole genome sequencing, functional validation of SNPs and SNP genotyping. The association of risk alleles with disease phenotypes will be assessed via regression analysis using PLINK v.1.9. The findings will provide information on potential disease markers that can be explored for better management strategies for UF in high-risk populations.
Neutrosophic geometric distribution: Data generation under uncertainty and practical applications
Authors: Aslam Muhammad , Albassam Mohammed
Published: May 2024

This paper introduces the geometric distribution in the context of neutrosophic statistics. The research outlines the essential properties of this new distribution and introduces novel algorithms for generating imprecise geometric data. The study explores the practical applications of this distribution in the industry, highlighting differences in data generated under deterministic and indeterminate conditions using detailed tables, simulation studies, and real-world applications. The results indicate that the level of uncertainty has a substantial impact on data generation from the geometric distribution. These findings suggest updating classical statistical algorithms to better handle the generation of imprecise data. Therefore, decision-makers should exercise caution when using data from the geometric distribution in uncertain environments.
Phylogenetic group distribution and antibiotic resistance of Escherichia coli isolates in aquatic environments of a highly populated area
Authors: Mansour Rosette , El-Dakdouki Mohammad H. , Mina Sara
Published: May 2024

Background

Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae including Escherichia coli (E. coli), are recognized as a global public health threat due to their multidrug-resistant (MDR) phenotypes and their rapid dissemination in aquatic environments. Nevertheless, studies investigating the prevalence and antimicrobial resistance (AMR) profile of ESBL-producing E. coli in Lebanese surface water are limited.

Objective

This study aimed to assess the physicochemical properties and microbial contamination load and to determine the distribution of AMR patterns of ESBL-producing E. coli in surface water samples from different sites in the North Governorate of Lebanon.

Methods

Water samples were collected from 25 major sites in North Lebanon. These samples were analyzed for the presence of total coliforms, E. coli, and fecal enterococci. Phenotypic and genetic characterizations were then performed for E. coli isolates to determine their resistance patterns and phylogenetic groups.

Results

Fifty-six samples out of 100 samples were positive for ESBL-producing E. coli, mostly harboring blaCTX-M (40/56, 71%) including blaCTX-M-15 (33/40, 82%), blaTEM gene (36/56, 64%), blaSHV (20/56, 36%), and blaOXA (16/56, 29%) including blaOXA-48 gene (11/16, 69%). Most ESBL-producing E. coli isolates belonged to the extra-intestinal pathogenic phylogroup B2 (40/56, 71.4%) while 10/56 (17.9%) belonged to the commensal phylogroup A.

Conclusion

Our results highlight the need to implement effective water monitoring strategies to control transmission of ESBL-producing E. coli in surface water and thus reduce the burden on human and animal health.
Integrating Unsupervised and Supervised ML Models for Analysis of Synthetic Data From VAE, GAN, and Clustering of Variables
Authors: Prayaga Lakshmi , Devulapalli Krishna , Prayaga Chandra , Wade Aaron , Reddy Gopi Shankar , Pola Sri Satya Harsha
Published: May 2024

Clustering of variables is a specialized approach for dimensionality reduction. This strategy is evaluated for data reduction with a Kaggle diabetes dataset. Since the original dataset is small, Generative Adversarial Networks (GAN) and Variational Autoencoders (VAE) are used to generate 100,000 records and tested for resemblance to the real data using standard statistical methods. VAE-data is more representative of the real data than GAN-data when analyzed using machine learning (ML) models. Applying Clustering of Variables on VAE-data yields new synthetic variables (SV). SV-data is then augmented with target variable data. Random Forest model is used on VAE and SV data. SV-data results matched VAE-data, proving the new data's quality. SV-data also provides insights into correlations and data dispersion patterns. This analysis implements a combination of Unsupervised learning (clustering of variables) and Supervised learning (classification) which is reflected in the results.
Optimization Design of High-Dimensional Parameters MIMO Antenna in Semantic-Based Mobile Applications
Authors: Li Qianqian , Dong Jian
Published: May 2024

To ensure the quality of semantic communication, an optimization scheme for multiple-input and multiple-output (MIMO) antenna design using in semantic-based mobile is proposed and verified. The scheme is based on a modified algorithm MOEA/D-BH, which integrates the black-hole (BH) algorithm into multi-objective EA based on decomposition (MOEA/D). By introducing controllable absorption distance and neighborhood learning mechanism, MOEA/D-BH can deal with high-dimension parameters well in a multi-objective optimization problem. Thus, in a limited design space, a satisfied antenna can be optimized by proposed scheme efficiently. This can be a feasible candidate scheme for MIMO antenna design. A single-band and dual-band MIMO antenna, which are applied for semantic-based mobile system, are optimized by proposed scheme sharing the same model. Both the data of simulation and measurement show good electrical and MIMO performances in the working frequency band. Thus not only the performance of the semantic communication definitely improved, but also it provides useful exploration for the development of intelligent semantic mobile systems.
The creative economy in Africa: The focus and scope of the African Journal of Creative Economy
Authors: Snowball Jeanette D. , Haines Richard
Published: May 2024

o abstract available.
A Cross-Sectional Study On Psychiatric Disorders among Poor Academic Performance Primary School (6-12 Years) Children with Substance Use Disorders in Their Parents
Authors: Ganiger Fakirappa B. , Bijjal Somashekhar S. , Mugali Jitendra D.
Published: May 2024

Background:

Psychiatric disorders are more prevalent among children with poor academic performance. There is limited literature on the impact of substance use disorders (SUD) in parents on psychiatric symptoms of these children.

Objectives:

(1) To assess the psychiatric disorders in primary school (6–12 years) children with poor academic performance. (2) To assess the prevalence and type of SUD in parents of these children.

Materials and Methods:

A cross-sectional study was conducted on children with poor academic performance. Simple randomization was adopted and 115 children and their parents were included in the study. Mini International Neuropsychiatry Interview-Kid (M.I.N.I. Kid) was used to screen psychiatric symptoms and various scales were used to assess the severity of symptoms. Parents of these children were interviewed for the presence of SUD. The diagnosis was made as per the International Classification of Diseases tenth revision (ICD-10). The association between psychiatric disorders and parental SUD was assessed using Chi-square test.

Results:

The prevalence of psychiatric disorders was 54.78% and most prevalent disorder was emotional disorders with onset specific to childhood with prevalence of 21.74%. Prevalence of SUD among parents of these children was found to be 18.26% and alcohol dependence syndrome (ADS) was more common type (12.17%). There was no significant association between psychiatric disorders in these children and SUD in their parents (χ2-2.93, df-10, P = 2013-.98).

Conclusion:

Emotional disorders with onset specific to childhood are more commonly prevalent psychiatric disorders among children with poor academic performance. A study found no significant association between SUD among parents of these children and psychiatric symptoms.
Pretreatment Thyroid Profile and its Relationship with Response to Treatment with Lithium in Bipolar Mood Disorder: A Longitudinal Study from Northeast India
Authors: Avinash Priya Ranjan , Pathak Kangkan , Saxena Vrinda , Singh Vithika , Mehta Sumit
Published: May 2024

Background:

The thyroid hormone’s significant impact on the treatment of depressive and other mood disorders is well documented. Even minor hypothyroidism can modify the progression and treatment results of major depressive disorder. This research aims to explore the correlation between initial thyroid levels and the treatment outcome in bipolar mood disorder using lithium, a well-established treatment method.

Methodology:

The study involved 45 bipolar mood disorder patients diagnosed according to the Diagnostic and Statistical Manual 5 criteria and admitted to a tertiary care teaching institute in Northeast India. The patients received lithium treatment, with injectable lorazepam used for immediate agitation control when necessary. On the 1st day, a semi-structured questionnaire and Brief Psychiatric Rating Scale (BPRS) 24-item scale were used to evaluate symptoms, and samples were collected for a thyroid profile, including T3, T4, FT3, FT4, and thyroid-stimulating hormone (TSH). The BPRS scale was used again on the 30th day to assess treatment response.

Results:

The BPRS subscale showed the highest treatment response for grandiosity and the lowest for depression. Factors such as age, illness duration, substance use, and family history of mood disorder were inversely correlated with the BPRS score’s decrease. Initial thyroid levels were identified as a predictor of treatment response, with baseline T4 levels showing a significant positive correlation with treatment response, while baseline TSH levels showed a negative correlation.

Conclusion:

Lithium proved to be an effective treatment for bipolar mood disorder, particularly for the manic subtype. Initial T4 and TSH levels were found to significantly predict treatment response, with T4 showing a positive correlation and TSH showing a negative correlation.
Porphyria Presenting with Psychotic Symptoms and Developmental Regression: A Diagnostic Dilemma
Authors: Pillai Sruthi Pradeep , Mathew Kathleen Anne , Jith Arya
Published: May 2024

We report a case of a 12-year-old boy who presented with acute onset of psychotic symptoms and later developed developmental regression and repetitive motor behavior. A number of investigations were done and urine was noted to be positive for porphobilinogen. A diagnosis of acute intermittent porphyria (AIP) was considered. AIP usually presents with abdominal pain, gastrointestinal disturbances, peripheral neuropathy, and psychiatric disturbances. The most common psychiatric symptoms include irritability, depression, anxiety, insomnia, hallucinations, and paranoia or altered consciousness. This case is unique as the only clinical manifestations were psychotic symptoms and developmental regression.
Extended Delirium Treated as Psychosis
Authors: Sawant Neena , Rathod Anuradha D. , Kulkarni Swara , Rupani Karishma
Published: May 2024

Delirium is a commonly seen neuropsychiatric disorder that may extend over time, lasting for more than 60 days, thus increasing the risk of cognitive and behavioral outcomes in patients. Electroconvulsive therapy (ECT) is one of the treatment modalities for behavior control but may be associated with rare complications such as tardive seizure, convulsive status epilepticus, and prolonged postictal confusion. We report a case of acute psychosis who was given consecutive 2 ECTs, after which she developed probable tardive seizure in the recovery period, followed by status epilepticus and extended delirium lasting for more than 2½ months, but was misdiagnosed as psychosis and treated with several antipsychotic medications. As there was no improvement in her condition, she was then transferred to a tertiary center for further management.
Patient-centered Management of Hyperthyroidism
Authors: Selim Shahjada , Lona Hafiza
Published: May 2024

ABSTRACT

Hyperthyroidism, characterized by excessive thyroid hormone production, demands a patient-centered approach for optimal management. Treatment aims to alleviate symptoms, normalize hormone levels, and prevent complications. It encompasses education and communication of the patients, management of the symptoms of hyperthyroidism, treatment options available, shared decision-making, monitoring, and follow-up, including keeping an eye on adversity, providing psychological support, and nutritional and lifestyle modification. A patient-centered approach to hyperthyroidism management emphasizes shared decision-making, individualized care, and ongoing support to optimize treatment outcomes and enhance patient well-being.
Assessment of knowledge, attitude, and practice of blood donation among paramedical students of a medical college in Chennai, Tamil Nadu
Authors: Devi V. Kalpana , Thirumurugan E. , Karthick R. , Indian E. Abisheak , Abinaya G. , Hemalatha R. , Sunil P.
Published: May 2024

BACKGROUND:

Blood donation is an essential global need far outweighs the available supply, rendering it a scarce and valuable resource. Within India, blood transfusion services hold significant importance and constitute a crucial aspect of the national health-care framework. Voluntary Non-Remunerated Blood Donation (VNRBD) is deemed the safest among the various ways of donating blood. The student population of educational institutions across the country, particularly those who are young and physically fit, represents one of the most promising sources of blood donations. The aim of the study was to evaluate the knowledge, attitudes, and donation practices of medical college students and motivate them to embrace voluntary blood donation as a regular habit.

MATERIAL AND METHODS:

The Department of Allied Health Science at Dr MGR Educational and Research Institute in Chennai, Tamil Nadu, India, conducted a questionnaire survey from March 2023 to October 2023. Two thousand and two hundred forty students were invited to participate, with 2331 ultimately willing to partake. The gathered data underwent analysis using the SPSS Statistics software, version 20, with a significance level fixed at a P = 5%.

RESULTS:

The study included 2331 participants, comprising 840 males (36%) and 1491 females (64%). The age range of the participants was between 17 and 25 years, with a mean age of 18.9 ± 1.3 years. Out of 2331 participants, the majority (66.7%) showed sufficient knowledge with 9 or more correct answers, while the rest (33.2%) showed below-average knowledge.

CONCLUSION:

The Tamil Nadu Health Professions Colleges possess the potential to make a noteworthy impact on the promotion of blood donation. According to a recent survey, students express a keen interest in donating blood if a camp is organized on the campus. By organizing awareness campaigns and conducting informative sessions, the colleges can inspire and motivate more students to donate blood, thereby playing a vital role in saving lives.
Histopathological analysis of skin adnexal tumors: An experience at a tertiary center
Authors: Sahin Gokhan , Koc Sahin Seda
Published: May 2024

Background:

Skin appendage tumors (SATs) are benign and malignant neoplasms. Although there are many studies on their clinical features and epidemiology in the literature, most of these studies have a small number of patients and are not classified according to the WHO 2018 classification.

Objectives:

This study aimed to reveal the clinical and histopathological features of the SATs and compare the pre-diagnosis.

Materials and Methods:

Cases diagnosed with SATs in the last 7 years in the Pathology Department were re-evaluated according to the WHO 2018 classification. Patients’ ages and genders, as well as the location and pre-diagnosis of the lesion, were all recorded.

Results:

A total of 437 patients, 198 (45.3%) male and 239 (54.7%) female, were included in the study. Of 437 patients, 399 (91.3%) were diagnosed with benign SATs and 38 (8.7%) were diagnosed with malignant SATs. Most of the cases were benign tumors with follicular differentiation. Malignant SATs were seen in patients significantly older than benign ones. The majority of SATs were in head and neck localization. Mammary Paget’s disease was the most common malignant SAT (n = 14, 36.8% of patients diagnosed with malignant SATs). It was noted that clinicians were less likely to consider a specific diagnosis of SAT before excision.

Conclusion:

SAT, a diagnosis that can be seen at any age and is difficult to predict clinically, may be malignant, especially in elderly patients. Histopathology is the gold standard in diagnosing SATs, and immunohistochemical staining may be useful in diagnosing tumors with uncertain histopathological features.
Myasthenia gravis with Castleman disease: A case report with review of literature
Authors: Nandy Sujit , Bhattacharya Debashis , Kundu Somenath , Chatterjee Uttara
Published: May 2024

Myasthenia gravis is an autoimmune disorder caused by the formation of autoantibodies directed against the synapses of neuromuscular junction. It is most commonly associated with other non-thymomatous lesions. Castleman disease is one of them, which is a benign lymphoproliferative disorder of uncertain origin. Only eight cases of myasthenia gravis associated with Castleman disease have been described so far. Here, we take the opportunity to describe a case of myasthenia gravis with Castleman disease simulating thymoma clinically and radiologically along with review of literature of this rare association. Patient developed myasthenic crisis in the immediate post-operative period which is more common in myasthenia gravis with Castleman disease rather than myasthenia gravis with thymoma.
Investigation of Hyaluronan Synthase 2 and CD44 immune reactivity as a biomarker to predict Progesterone-Resistant Endometrial Hyperplasia without atypia: A retrospective case-control study
Authors: Boybay Emine , Atilgan Remzi , Pala Şehmus , Kuloğlu Tuncay , Artaş Gökhan
Published: May 2024

Background/Aims:

In our study, the effect of hyaluronan synthase 2 (HAS2) and CD44 immunoreactivity as a predictive biomarker in the prediction of progesterone-resistant endometrial hyperplasia (EH) cases without atypia was investigated.

Settings and Design:

In this retrospective study, HAS2 and CD44 immunoreactivity in the endometrial tissues of 60 patients diagnosed with EH and treated with progesterone and 20 patients diagnosed with proliferative endometrium (PE) were evaluated.

Materials and Methods:

Eighty patients were divided into four groups. Group 1 (G1) (n = 20) = PE group, G2 (n = 20) = EH group without atypia, G3 (n = 20) = group with continued EH with treatment, G4 (n = 20) = EH with treatment without atypia.

Statistical Analysis:

Intergroup evaluation was done with One-way ANOVA and posthoc tukey test. P < 0.05 values were considered statistically significant.

Results:

The HAS2 immunoreactivity score of G2 and G3 was higher than G1 and G4. On the other hand, there was no difference between G1 and G4. When G2 and G3 were compared, HAS2 immunoreactivity scores were significantly increased in G3. When CD44 immunoreactivity was compared with G1, a significant increase was detected in G2, G3, and G4. However, CD44 immunoreactivity scores were similar in G2, G3, and G4.

Conclusion:

HAS2 immunoreactivity may be an immunohistochemical biomarker in predicting EH cases without atypia resistant to progesterone therapy. Since CD44 immunoreactivity is increased in all EH groups without atypia, it is not effective in predicting treatment resistance.
Bilateral adrenal cortical rests: An interesting innocuous intruder in the fallopian tubes
Authors: Gaffoor Nidha , Shetty Archana , Vidhya V. , Nikhil P. V. , Mysorekar Vijaya
Published: May 2024

Ectopic adrenal rests refer to the presence of adrenal tissue outside its normal anatomical location and are usually discovered incidentally on microscopic examination. Literature suggests its occurrence in diverse extrarenal sites, like the genitourinary system and pelvis. Our case describes the rare occurrence of ectopic adrenal rests in the walls of bilateral fallopian tubes of a 43-year-old female patient who presented with a complaint of heavy menstrual bleeding. A total hysterectomy with bilateral salpingo-oophorectomy was performed. Gross examination revealed adenomyosis with multiple fibroids, and the same was confirmed on microscopy. Additionally, the finding of a well-encapsulated lesion on the walls of both tubes made us relook at the fallopian tubes, which showed a small bright yellow area measuring less than 0.3 cm in the walls, which was consistent with ectopic adrenal rests after ruling out the morphological differentials of Walthard cell nests, aggregates of foamy histiocytes, metastatic renal clear cell carcinoma, displaced ovarian luteinized theca cells, heterotopia of ovarian hilus cells. Immunohistochemistry showed positivity for Melan A and CK7 was negative. The present case helps in investigating the lesser-explored aspect of adrenal rest pathology. It also reiterates need for detailed observation of fallopian tubectomy specimens by pathologists during grossing to avoid overlooking of potentially intriguing entities.
Short-term outcomes of laparoscopic and robotic limited resections of pancreatic neuroendocrine tumours of the uncinate process: Report of six cases and review of the literature
Authors: Lim Teik-Wen , Tan Hwee-Leong , Tan Ek-Khoon , Cheow Peng-Chung , Goh Brian Kim Poh
Published: May 2024

Introduction:

Minimally invasive surgery (MIS) for limited resections for pancreatic uncinate lesions is not widely performed but can adequately treat benign or low-grade malignant lesions. The aim of this study was to evaluate the short-term outcomes of MIS-limited pancreatic resections for patients with suspected pancreatic neuroendocrine tumours (PNETs).

Patients and Methods:

This was a retrospective study of six consecutive patients who underwent MIS for PNET within a single institution between 2017 and 2022.

Results:

Six patients underwent limited pancreas-preserving MIS of the uncinate process (uncinectomy or enucleation), of which two were performed through the robotic approach and four through laparoscopic approach. The median operation time was 212.5 (175–338.75) min, and the median blood loss was 50 (50–112.5) ml. The median post-operative hospital length of stay was 5.5 (3.75-11.5) days. Two patients (33.3%) had major post-operative morbidities (Clavien–Dindo ≥Grade 3). There were no open conversions or post-operative mortalities. Five patients had histologically proven Grade 1 neuroendocrine tumours. One was T2 and four were T1.

Conclusions:

This study suggests that limited MIS resections of pancreatic uncinate PNETs are a feasible procedure with good patient outcomes. It offers a safe alternative to radical surgical resections like pancreatoduodenectomies in selected patients with low-grade malignant or benign tumours.
Congenital Single Digit Deformities: Series of Cases in Multiple Families in Remote Villages of Haryana
Authors: Upadhyay Gunjan , Arya Ashish , Anchal Ved Prakash , Munde Santosh Laxmanrao , Singh Ghanapriya , Kapoor Mitali
Published: May 2024

Background and Purpose:

Congenital deformities occur due to abnormal development of limbs in the intrauterine life. The exact cause of this type of defect is not known but can be associated with environmental factors (drug history or exposure of chemical effluents from factory) or genetic predisposition. Cases involving the occurrence of single digits in all four limbs were witnessed, and the aim was to study and trace the cause of such deformities. Knowledge of thalidomide induced phocomelia which has already being published in the literature also contributed to our knowledge and understanding.

Objectives:

(1) Primary objective was to identify the causative agent or genetic factor for the occurrence of single digits in hands and feet in multiple families. (2) Secondary objective was to create awareness among patients and the general public as well as local government authorities regarding such families of “Divyang” patients. We present a case series of multiple families with complete absence of all fingers and toes except one across villages in Haryana.

Materials and Methods:

Clinical setting: (1) Study was based on a detailed questionnaire which was taken from multiple villagers (Tarawari Village, Nilokheri Village, etc.) and (2) phenotypic examination. Five affected patients from multiple families for 1 year were taken for study from March 2022 to March 2023. Their habitus, lifestyle, and environmental status were all studied and compared with other studies. Efforts were taken to study the license and toxic effluent treatment plan of a chemical factory present in the near vicinity.

Results:

A strong genetic association was suggested for the occurrence of single digits in the hands and feet of multiple patients across multiple villages close to a chemical factory. They have well adjusted with writing, eating, riding bikes, and four-wheelers with single fingers and toes.

Conclusion:

There is a need to establish genetic analysis so that the cause of such deformities could be known and prevented. There is also a need for general and government awareness toward pollutants released from chemical factories and their effects.
Nanoparticles for the treatment of spinal cord injury
Authors: Yang Qiwei , Lu Di , Wu Jiuping , Liang Fuming , Wang Huayi , Yang Junjie , Zhang Ganggang , Wang Chen , Yang Yanlian , Zhu Ling , Sun Xinzhi
Published: May 2024

Spinal cord injuries lead to significant loss of motor, sensory, and autonomic functions, presenting major challenges in neural regeneration. Achieving effective therapeutic concentrations at injury sites has been a slow process, partly due to the difficulty of delivering drugs effectively. Nanoparticles, with their targeted delivery capabilities, biocompatibility, and enhanced bioavailability over conventional drugs, are garnering attention for spinal cord injury treatment. This review explores the current mechanisms and shortcomings of existing treatments, highlighting the benefits and progress of nanoparticle-based approaches. We detail nanoparticle delivery methods for spinal cord injury, including local and intravenous injections, oral delivery, and biomaterial-assisted implantation, alongside strategies such as drug loading and surface modification. The discussion extends to how nanoparticles aid in reducing oxidative stress, dampening inflammation, fostering neural regeneration, and promoting angiogenesis. We summarize the use of various types of nanoparticles for treating spinal cord injuries, including metallic, polymeric, protein-based, inorganic non-metallic, and lipid nanoparticles. We also discuss the challenges faced, such as biosafety, effectiveness in humans, precise dosage control, standardization of production and characterization, immune responses, and targeted delivery in vivo. Additionally, we explore future directions, such as improving biosafety, standardizing manufacturing and characterization processes, and advancing human trials. Nanoparticles have shown considerable progress in targeted delivery and enhancing treatment efficacy for spinal cord injuries, presenting significant potential for clinical use and drug development.
EZH2-dependent myelination following sciatic nerve injury
Authors: Zhu Hui , Mu Li , Xu Xi , Huang Tianyi , Wang Ying , Xu Siyuan , Wang Yiting , Wang Wencong , Wang Zhiping , Wang Hongkui , Xue Chengbin
Published: May 2024

JOURNAL/nrgr/04.03/01300535-202508000-00028/figure1/v/2024-09-30T120553Z/r/image-tiff

Demyelination and remyelination have been major focal points in the study of peripheral nerve regeneration following peripheral nerve injury. Notably, the gene regulatory network of regenerated myelin differs from that of native myelin. Silencing of enhancer of zeste homolog 2 (EZH2) hinders the differentiation, maturation, and myelination of Schwann cells in vitro. To further determine the role of EZH2 in myelination and recovery post–peripheral nerve injury, conditional knockout mice lacking Ezh2 in Schwann cells (Ezh2
fl/fl;Dhh-Cre and Ezh2fl/fl;Mpz-Cre) were generated. Our results show that a significant proportion of axons in the sciatic nerve of Ezh2-depleted mice remain unmyelinated. This highlights the crucial role of Ezh2 in initiating Schwann cell myelination. Furthermore, we observed that 21 days after inducing a sciatic nerve crush injury in these mice, most axons had remyelinated at the injury site in the control nerve, while Ezh2
fl/fl;Mpz-Cre mice had significantly fewer remyelinated axons compared with their wild-type littermates. This suggests that the absence of Ezh2 in Schwann cells impairs myelin formation and remyelination. In conclusion, EZH2 has emerged as a pivotal regulatory factor in the process of demyelination and myelin regeneration following peripheral nerve injury. Modulating EZH2 activity during these processes may offer a promising therapeutic target for the treatment of peripheral nerve injuries.
The combined pioglitazone and topiramate therapy for management of pediatric patients with severe MASLD
Authors: Conroy Callen , Radulescu Aurelia , Attia Suzanna L. , Shelman Nathan , Lee James T. , Monticelli Roberto Galuppo , Hall Sara , Kohli Rohit , Softic Samir
Published: May 2024

Background:

Metabolic dysfunction associated steatotic liver disease (MASLD) is the most common cause of chronic hepatitis in adult and pediatric patients. Adolescents with severe MASLD can demonstrate a more aggressive disease phenotype as they more commonly develop liver fibrosis than BMI matched adults. Therefore, MASLD is the fastest growing indication for liver transplants in young adults.

Methods:

Pioglitazone has been shown to improve liver histology in adult patients with MASLD, and in some studies, it attenuated liver fibrosis. Despite its perceived efficacy, pioglitazone is not widely used, likely due to its side effect profile, specifically increased weight gain. Topiramate lowers body weight in adolescents and in combination with phentermine, is one of the few FDA-approved medications for the management of obesity in children over 12 years of age. We performed a retrospective review of the outcomes in pediatric patients with severe MASLD, treated with the combined pioglitazone and topiramate therapy.

Results:

Here, we report a case series of seven adolescents with severe MASLD and ≥F2 liver fibrosis treated with the combined pioglitazone and topiramate therapy. The combined therapy improved mean serum ALT from 165 ± 80 U/L to 89 ± 62 U/L after 12 months mean duration of treatment. One patient who completed 24 months of the combined therapy demonstrated a decrease in liver stiffness from 8.9 kPa to 5.6 kPa, as assessed by FibroScan elastography. There was a significant increase in body weight during this time, however, body mass index as a percentage of the 95th percentile adjusted for age and gender did not increase significantly, 151 ± 29% vs. 152 ± 28%. Moreover, waist circumference, mid-upper arm circumference, percent body fat, and muscle mass were not significantly different before and after treatment. Serum lipid levels and hemoglobin A1c also did not change with the treatment.

Conclusion:

In summary, this case series provides encouraging results about the efficacy of the combined pioglitazone and topiramate therapy for the management of adolescents with severe MASLD, which should be further explored in clinical studies.