bluuebunny/crossref_metadata_2025 huggingface dataset:
Smartwatch Fall Detection and Emotional Intelligence
Authors: Ramanath Meera , Menon Vishnu Achutha , Prasad Aswathi
Published: December 2024

Smartwatch fall detection is a crucial feature that enables smartwatches to automatically detect falls using built-in sensors such as accelerometers and gyroscopes, which identify sudden changes in movement indicative of a fall. This feature is particularly significant for older adults, as it ensures prompt assistance by sending alerts to predefined contacts or emergency services upon detecting a fall. This study examines the influence of technology adoption on various psychological factors among older adults in Central Kerala. This study in Central Kerala examines how technology adoption impacts psychological factors among older adults. A survey of 511 participants used TAM, STAI, Rosenberg Self-Esteem Scale, and UTAUT2. Results show technology adoption strongly predicts performance expectancy (53.2%) and self-esteem (81.0%), and significantly predicts effort expectancy (35.6%), hedonic motivation (31.2%), and anxiety (57.2%). This highlights technology's significant influence on older adults' psychological well-being.
Fostering Sustainable Tourism in India
Authors: Wani Mehraj Din , Shah Shamim Ahmad , Dada Zubair Ahmad
Published: December 2024

This chapter explores how the intersection of cultural heritage and sustainable tourism can foster economic growth, community development, and environmental preservation in India. By critically examining the literature on cultural heritage tourism, it highlights challenges such as site degradation, cultural commodification, and socioeconomic disparities. Utilizing Sustainable Development Theory and sustainable tourism principles, the study proposes a strategic model integrating heritage conservation with community-based tourism. A qualitative approach analyzes secondary data from academic journals, government reports, and industry publications to identify key strategies, challenges, and opportunities. Findings show that while heritage tourism enhances local economies, benefits often exclude marginalized communities. The study underscores the need for inclusive policymaking, better site management, and innovative tourism products, proposing a framework aligning heritage preservation with sustainability for broader socio-economic and environmental benefits.
Preparation of Graphene Using Rice Husk via Pyrolysis Technique for CO2 Adsorption
Authors: Mohd Najib Siti Sarah Aliah , Ann Lee Wei , Rashid Norhana Mohamed , Mohd Sokri Mohd Nazri , Mohd Yusop Mohd Zamri
Published: December 2024

Graphene is the only carbon allotrope in which every carbon atom is densely connected to its neighbours by an electronic cloud, raising various quantum physics concerns. In recent years, many researchers have focused their efforts on developing more efficient methods for synthesizing graphene. However, only few methods can simultaneously synthesize mass-produced, cost-effective, and high-quality graphene. In this study, we are emphasizing the use of rice husk (RH) as the raw material to prepare graphene by using two-step pyrolysis. Zinc chloride (ZnCl2) is an example of an activating agent that is used to improve the efficiency of the synthesis of graphene from rice husk. After conducting pre-treatment of rice husk, the first stage of pyrolysis was conducted by varying the ratio of ZnCl2 to the RH (1:1, 2:1, 3:1) at a carbonization temperature of 500 °C for 1 hour, followed by second-stage pyrolysis under 900 °C for 90 minutes and post-treatment. The findings of the characterizations, which included yield analysis, scanning electron microscopy (SEM) and Raman spectroscopy, Brunauer-Emmett-Teller (BET), and CO2 adsorption analysis, revealed the impacts of the ZnCl2 as activating agent, on the yield and graphitic structure of graphene and the potential application of graphene as a CO2 adsorbent. Raman spectroscopy confirmed the graphitic properties of graphene synthesized in all samples with RH1:1 produced the best quality of graphene due to its low ID/IG intensity ratio (0.8913) and the highest I2D/IG intensity at 0.24. In addition, RH1:1 exhibited the highest surface area, whereby the highest total pore and micropore volume is contributing to the highest CO2 adsorption capacity of 8.73 mmol/g. This proves that the activating agent ratio has significant effects on the graphene quality produced from rice husk as well as the adsorption performance.
Numerical Investigation on Improving Shear Strength of RC Beams with Various Web Opening Shapes Using Pre-Stressed Fe-SMA Bars
Authors: Khalil Ahmed Mohsen , Elkafrawy Mohamed , Hawileh Rami , Al-Hamaydeh Mohammad
Published: December 2024

The presence of web openings in the shear span significantly impacts the structural behavior of reinforced concrete (RC) beams, affecting both shear capacity and crack propagation. This study explores the feasibility of strengthening web openings in the shear zone of RC beams using iron-based shape memory alloy (Fe-SMA) bars through numerical analysis with ABAQUS software. The investigation considered various web opening shapes; diamond, circular, and square strengthened with pre-stressed Fe-SMA bars. Results showed that web openings notably decrease the ultimate loads of beams by 53%, 44%, and 39% for square, circular, and diamond shapes, respectively. However, pre-stressed Fe-SMA bars enhanced the shear capacity of beams with unstrengthened web openings by approximately 60%, making their behavior comparable to solid beams. The proposed strengthening technique was most effective for diamond web openings, nearly restoring both shear strength and stiffness, while circular openings recovered nearly 90% of shear capacity and square openings about 75%. Additionally, Fe-SMA bars effectively controlled cracking at the corners of the openings. This study highlights the importance of strengthening web openings in RC beams, especially in shear zones, and provides significant insights into enhancing such beams, contributing to safer structural designs. Further laboratory experiments are recommended to validate and extend these numerical findings.
Construction Innovation - Graphene Oxide as the Differentiating Nanoadditive for Concrete and Coatings
Authors: Hernández-Sánchez Dania , Navarro-Rosales Maribel , Sala-Arceo Amilcar , Miramontes-Ortega Antonio , Priego-Mondragón Eduardo
Published: December 2024

When discussing graphene materials, their mechanical strength, impermeability, flexibility, thermal and electrical conductivity, and lightness are key reference points, earning them the moniker "all-in-one material. “This versatility makes graphene suitable for various applications, including electronics, medicine, plastics, coatings, construction, and renewable energies. However, it's crucial to note that the behavior of these materials at the nanometric scale depends on factors such as the type of graphene, functionalization, concentration, and the specific processes involved in each industry. Since the isolation of graphene in 2004, significant efforts have been made to comprehend its multifunctional properties. Nevertheless, the primary challenge lies in translating this knowledge from the laboratory to industrial applications, hampered by the high cost and low yield of graphene. Fortunately, the construction industry, particularly the concrete and coatings sector, appears to be one of the most promising fields for the integration of this nanotechnology. In this context, we present a diverse array of representative trials conducted on various concrete designs and environmentally friendly, antimicrobial, and anticorrosive coatings enhanced with graphene materials. These trials showcase the multifunctional enhancement of properties thanks to the incorporation of graphene materials in different commercially available products tailored for industrial applications, demonstrating that graphene not only represents a technological innovation but is also a catalyst for more sustainable practices in various industries. Its ability to improve the efficiency of different products and applications, becomes graphene as a key material in the immediate future with which industries operate within ecological limits while meeting human needs.
Slope Stability Assessment of Tailings Dam
Authors: Radchuk Oleksandr
Published: December 2024

The paper examines a complex methodology for calculating the slope stability of a tailing storage facility based on comparing the results obtained through deterministic and probabilistic approaches. The analysis is performed in GeoStudio software, based on the limit equilibrium method, and with a probabilistic approach that uses a Monte Carlo simulation to compute a probability distribution of the resulting factor of safety. A slope stability assessment of tailing dam was conducted on the example of Ferrexpo Poltava Mining, and a conclusion was reached about their reliability and safety. The results of the deterministic analysis showed that the calculated factor of safety is by those established in Ukrainian regulatory standards. It has been recognized that the factor of safety is not a consistent measure of risk for tailings dam. Considering the variability inherent in the soil materials of tailings dam is a way to achieve more accurate results. The importance of obtaining a failure probability and a reliability index due to tailing dam stability was highlighted by comparing deterministic and probabilistic approaches.
N and Fe Doped-Carbon Aerogel for High Performance of Oxygen Reduction Reactions Electrocatalyst in Magnesium-Air Battery
Authors: Susanto Susanto , Avabel Netanya , Septianingrum Nais , Nurtono Tantular , Setyawan Heru
Published: December 2024

The development of seawater batteries has constraints on oxygen reduction reactions in the battery discharge process that runs slowly. Therefore, an electrocatalyst is needed that accelerates the process. The electrocatalyst developed is a carbon-rich material doped with doping atoms of N and Fe. The effect of adding non-precious metal Fe to nitrogen doped carbon aerogel on the performance of the cathode electrocatalyst in seawater batteries was investigated in this study. This study began with the synthesis of cellulose pulp from palm empty fruit bunch, then progressed to the synthesis of cellulose aerogel by crosslinking NaOH‒Ammonia-Urea with the addition of Fe 5% wt., followed by pyrolysis into carbon aerogel at a temperature of 700 °C. Based on research data, N and Fe doped carbon aerogels have better seawater battery performance than N‒doped carbon aerogels without Fe. Carbon aerogels doped with N and Fe have an iron oxide phase in the form of Fe3O4 (magnetite) with a specific surface area of 2869.9 m2/g. Based on the battery test with magnesium alloy anode and 3.5% NaCl electrolyte, cathode with carbon aerogel with N-Fe codoping produces a voltage of 1.4 V, discharge energy of 269.71 mWh and discharge capacity in 1C of 189.76 mWh.
Development of an Electrochemical Biosensor Using Magnetite Nanoparticles
Authors: Thonglor Panakamon , Sonsupup Somchai , Sinprachim Tanayt , Albutt Naphat
Published: December 2024

An electrochemical sensor was enhanced with magnetite nanoparticles for biosensor application. Nanoparticles of magnetite (Fe3O4) ranging in size from 5 to 30 nm were produced by the co-precipitation method and further modified with an amine functional group (Fe3O4@SiO2_NH2). During the process, the functional amine served as a supporting biomaterial and coating agent, regulating particle size and aggregation. The Fe3O4@SiO2_NH2 nanoparticles were incorporated into gold nanoparticle planes on a conductive graphene electrode in a diluted solution of the ultrafast redox probe K3[Fe(CN)6]. Using scanning electron microscopy to investigate the morphology of the modified graphene sheets and gold (Au) nanoparticles on screen printed electrodes (SCPE). The results clearly demonstrated the even distribution of Fe3O4 nanoparticles, almost always less than 30 nm in size, on AuNPs and graphene sheets. Adding these magnetite particles has created active sites, facilitating the movement of electrons from redox-active species in the solution. In addition, the electrochemical reduction of flawed graphene sheets has greatly limited the oxygen groups, making the material more conductive or enhancing signal. The sensor was subsequently investigated with the use of magnetite nanocomposites for electrochemical biosensing applications with (bovine serum albumin) BSA.
Un interessante reperto in Val Camonica (BS): Doydirhynchus austriacus (Olivier, 1807)
Authors: Pedersoli Davide , Grottolo Mario
Published: December 2024

Viene segnalato il primo ritrovamento per la Lombardia di Doydirhynchus austriacus (Olivier, 1807).
Sulla presenza in Italia di Phytocoris (Ktenocoris) jordani
Authors: Tescari Giuseppe
Published: December 2024

Viene segnalata la presenza in Italia di Phytocoris (Ktenocoris) jordani Wagner, 1954, di cui vengono discussi i caratteri biometrici distintivi.
Arge scita (Mocsáry, 1880): osservazioni sul campo
Authors: Rolli Erminio
Published: December 2024

Nel presente lavoro vengono riportate alcune osservazioni riguardanti il comportamento di Arge scita (Mocsáry, 1880) un fitofago di recente rinvenuto nella sola provincia di Lecce (Puglia, Italia-Sud-Orientale), le cui larve attaccano gli alberi di mandorlo (Prunus amygdalus Batsch, 1801) defogliandoli. È indispensabile, pertanto, riuscire ad individuare possibili antagonisti naturali e realizzare strategie di controllo sostenibili del fitofago così da impedirne una sua possibile diffusione in altre zone.
A new species of Anillini from Anatolia
Authors: Giachino Pier Mauro
Published: December 2024

Caecoparvus gardinii n. sp. is described from the Haçi Akif Isle, in Beysehir Lake, SW Anatolia. This new species is closely related to C. lydiae Giachino & Vailati, 2019 from Nif Dagi Mt. (Izmir).
The neoliberal turn in higher education: Pitfalls, challenges, possibilities in the global South
Authors: Hlatshwayo Mlamuli N. , Moloi Tshepo M.
Published: December 2024

No abstract available
Acute Onset Myopia and Angle Closure Glaucoma after Topiramate Administration
Authors: Verma Nidhi , Kumar Ashok
Published: December 2024

Topiramate is a new anti-convulsant which is used for the prophylaxis of migraine and cluster headache. We report a 17 year old male with bilateral induced acute onset myopia and secondary angle closure glaucoma following topiramate intake. In cases of bilateral acute angle closure glaucoma and induced myopia, drug induced ciliary body rotation should be excluded.
Role of Radio Imaging in Ophthalmology
Authors: Karna Satya , Gogia Varun
Published: December 2024

With rapid development in imaging techniques their role in diagnosis, management and follow up of cases in Ophthalmology has increased multifold. Need for imaging can be diverse more so when there is a diagnostic dilemma. Neuroimaging however can only supplement a good clinical examination and never replace it. In all cases of suspected intracranial lesion, it is important to clinically localise it so that the appropriate investigation with correct site is imaged. A wrong investigation or one that does not image the site of likely lesion is more dangerous than no investigation as it leads us into a sense of complacency and may delay diagnosis with fatal outcomes. The current article gives a set of guidelines for imaging in cases where good clinical examination may not provide the answer.
Atypical Presentation of Conjunctival Neoplasia
Authors: Jain Vandana , Gupta S. , Matai R. , Srivastava R. K.
Published: December 2024

This communication delineates variable presentations in two cases of conjunctival neoplasia, histopathology of the same was suggestive of squamous neoplasia. Though incidence of conjunctival neoplasia is low, any case presenting as non resolving chronic conjunctivitis or recurrent pterigium should undergo cytological examination to rule out malignancy.
Synoptophore
Authors: Phuljhele Swati , Aalok Lalit , Sharma Reena , Saxena Rohit
Published: December 2024

Synoptophore is comprehensive orthoptic unit which helps in complete evaluation of a case of strabismus. It can be used diagnostically to measure the amount of deviation in all three axes and to assess binocular status of the patient. Therapeutically it can be used to provide fusional exercises, treat eccentric fixation and abnormal retinal correspondence.
Fatigue in Parkinson’s disease—A narrative review
Authors: Panigrahi Baikuntha , Pillai Kanchana S. , Radhakrishnan Divya M. , Rajan Roopa , Srivastava Achal K.
Published: December 2024

Although fatigue is a common non-motor symptom of Parkinson’s disease (PD), it is often overlooked during routine assessments of individuals with PD. This can be attributed partly to the lack of recognition of this symptom and the coexistence of other confounding symptoms, such as apathy, somnolence, and depression. However, considering the effects of fatigue on the quality of life (QoL) of individuals with PD, it is crucial to review its causes and management strategies. According to the diagnostic criteria for PD-related fatigue, patients must report significantly reduced energy levels or an increased perception of effort disproportionate to their attempted activities. PD-related fatigue can be divided into central and peripheral types. Peripheral fatigue involves muscle weakness and impaired voluntary movements, influenced by tremors and bradykinesia. Central fatigue, which can be divided into mental and physical subtypes, manifests as persistent exhaustion without peripheral motor deficits. The pathophysiology of central fatigue in PD is complex. It involves dysfunction in the striato–limbic–serotonergic system, imbalance of neurotransmitters (dopamine and serotonin), as well as hypoconnectivity in the supplementary motor area and hyperconnectivity in the default mode network. Emerging evidence suggests that neuroinflammation and autonomic dysfunction may contribute to fatigue. Fatigue in PD is treated using pharmacological therapies (such as dopaminergic agents, antidepressants, methylphenidate, and modafinil) and non-pharmacological interventions (such as exercise). There is a gap in the current understanding, measurement, and treatment of fatigue in PD. A deeper understanding of the patho-mechanisms of fatigue in PD is needed to establish evidence-based treatment guidelines. The QoL of individuals with PD can be improved by focusing on person-centered interventions targeting fatigue.
Glaucoma Trials Simplified
Authors: Singh Arshi , Singh Kirti , Chawla Khushboo
Published: December 2024

In the past few decades, glaucoma research has produced a veritable alphabet soup of clinical trials. These landmark randomized studies have greatly enhanced knowledge of the disease and have provided rational, evidence-based treatment algorithms. This article highlights key findings from these studies and their impact on clinical practice.
Preference of Near-optical Low-vision Devices among Patients with Low Vision Attending Low-vision Clinic of a Tertiary Eye Hospital in Nepal
Authors: Bhusal Bigyan , Thapa Hari Bahadur , Khadka Dikshya
Published: December 2024

Background:

This study assessed the preference for near-optical low-vision devices by patients visiting the low-vision clinic of a tertiary eye hospital.

Methods:

A hospital-based descriptive cross-sectional study was conducted among 66 participants at the Low Vision Department of Lumbini Eye Institute and Research Center, Rupandehi, Nepal, from April 2023 to September 2023. A nonprobability, purposive sampling technique was used for sampling. Patients with the best-corrected visual acuity worse than 6/18 to Perception of light (PL) were included in the study. A detailed ophthalmological evaluation, visual acuity assessment, distance and near refractive correction, and low-vision evaluation were done. The patient’s preference for a low-vision device was assessed during low-vision evaluation based on visual acuity improvement and the patient’s subjective response. Statistical analysis was carried out using SPSS software, version 17.0.

Results:

Among 66 patients, 40 were male and 26 were female. The mean age of patients was 28.50 ± 18.350 years. Overall 47 patients preferred near-optical low-vision devices. Among them, handheld (HH), stand, and spectacle magnifiers were preferred by 44.6%, 40.4%, and 14.9% of patients, respectively. The major causes of low vision were retinitis pigmentosa (16.7%) followed by nystagmus (15.2%).

Conclusion:

HH magnifiers were the most commonly preferred devices in a short period with proper counseling and demonstration. Identifying the preferred low-vision devices can help develop and implement the low-vision rehabilitation service effectively and reduce patient chair time for selecting low-vision devices.
Multiple Subconjunctival “Tahitian Pearls”
Authors: Godbole Anushri , Kamble Gaurav , Nene Amit S. , Divate Sheetal , Pirdankar Onkar H.
Published: December 2024

The present report aims to describe the anterior optical coherence tomography findings of subconjunctival silicone oil bubbles in a 27-year-old female who had undergone retina surgery.
Phacoemulsification with Negative Power IOL Implantation in Pathological Myopia: A Life-changing Procedure
Authors: Punjabi Dharti , Joshi Devika S. , Khandelwal Vishranti
Published: December 2024

Pathological myopia refers to a spherical equivalent of −8.00 D or more or axial length of 32.5 mm or more. Pathological myopia can lead to complications of the posterior segment such as retinal detachment and staphyloma in long term. Cataract in a high myope can significantly affect the quality of life as it can hamper routine activities of individuals. We report a case of dense cataract in a patient with pathological myopia who underwent uneventful phacoemulsification with negative power Intraocular lens (IOL) implantation after meticulous planning.
Updates on Amblyopia
Authors: Rath Soveeta , Gupta Shalini , Ganesh Suma
Published: December 2024

Amblyopia is the most common cause of reversible low vision if an appropriate visual stimulation is provided within the sensitive period of visual development. Various treatment modalities include correcting any organic cause, prescribing optical correction, and providing occlusion/penalization for the dominant eye within this period. Patching has always been the most effective therapy, but parents are usually seen struggling, thereby decreasing the compliance. Newer modalities like use of Liquid crystal glasses, perceptual learning, videogames, dichoptic training and transcranial magnetic stimulation have shown variable but comparable results. This article provides a comprehensive account of various modalities in the management of amblyopia.
Abnormal Presentation of Foster Kennedy Syndrome Due to Schwannoma of Optic Nerve
Authors: Mishra Tuhina , Singh Smita , Shukla Ajay Kumar
Published: December 2024

Foster Kennedy syndrome (FKS) is a rare neuro-ophthalmic syndrome that occurs because of an intracranial mass, most commonly a tumor. As a result of the intracranial mass, the patient develops optic atrophy on the same side of the lesion and papilledema on the contralateral side. In this case report, we present the case of a 25-year-old male who presented to the ophthalmology clinic with unusual complaints of proptosis and diminution of vision in the right eye. A diagnosis of schwannoma of the optic nerve was made on magnetic resonance imaging retrospectively after diagnosing FKS in the patient clinically.
Situs Inversus of Optic Disc
Authors: Virkar Rajlaxmi , Nene Amit S. , Pirdankar Onkar H. , Meshram Madhuri , Badole Pushpanjali , Shah Smitesh
Published: December 2024

Situs Inversus of the Optic Disc (SIOD) is characterized by abnormal retinal vasculature where emergence of retinal vessels is in nasal direction in contrast to temporal. We report bilateral Situs Inversus Optic Disc in 19 year old female. We describe clinical findings, optical coherence tomography and visual field analysis. SIOD is a rare incidental finding which clinician can come across in their practice.
Optics of Operating Microscope
Authors: Sanoria Abhilasha , Gupta Ruchi , Ghosh Shilpa
Published: December 2024

Operating microscope is an instrument which is imperative for modern eye surgery. The entire system helps to form an enlarged and erect image at the intended working distance. Its major components include the eyepiece, a telescope system, an inverting prism, a magnification changer and the objective lens. The proper and coordinated functioning of each of these parts is very important for optimal functioning of this instrument.
An Occult Lacrimal Sac Diverticula Incidentally Found on Exploration after Tectonic Penetrating Keratoplasty for a Leaky Cicatrix in a Patient with Marfan Syndrome
Authors: Narayanan Niveditha , Nissar Sonam Poonam , Nagpal Nimisha
Published: December 2024

We report a lacrimal sac diverticulum found incidentally on exploration after a tectonic penetrating keratoplasty performed for an anterior staphyloma with a leaky cicatrix. It was done in the left eye (LE) of a Marfan’s syndrome patient with bilateral congenital subluxated lenses who developed corneal decompensation after he underwent cataract surgery elsewhere with anterior chamber intraocular lenses 13 years ago. The fibrillin-1 gene mutation in Marfan’s syndrome could have predisposed to the diverticulum formation in the LE and corneal perforation in that eye highlights the importance of a protective healthy ocular environment.
Prevalence of Bacterial Pathogens and their Antimicrobial Susceptibility Patterns at a Tertiary Care Hospital in Riyadh
Authors: Khalid Fizza , Elsheikh Azza , Mahmood Abid , Poulose Christy , Khojah Osamah T.
Published: December 2024

Objectives:

The current study aimed to set up the prevalence of commonly isolated pathogens and their susceptibility patterns in a tertiary care reference center in Riyadh through a 3-year retrospective study.

Materials and Methodology:

Patient samples from two tertiary care hospitals with approximately 450 beds were submitted for culture and sensitivity to MDLab, Riyadh. Microsoft Office Excel was used to analyze all the data.

Results:

Among a total of 8389 positive cultures, urine was the most common sample submitted for bacterial culture over these 3 years, followed by pus and wounds. Gram-negative bacteria were prevalent compared to gram-positive bacteria. However, Staphylococcus aureus was the most commonly isolated pathogen from pus and wounds. From outpatients, Escherichia coli was the leading pathogen (50.5%), followed by Klebsiella and S. aureus (15.8% and 13.5%, respectively). In contrast, Pseudomonas was the most frequently isolated pathogen (20.8%) from hospitalized patients, followed by Klebsiella (18.7%) and E. coli (16%). Percent resistance was found to be higher in admitted patients as compared to walk-in patients. High resistance was noted in Acinetobacter baumannii complex to almost all classes of antibiotics among the gram-negative bacterial isolates. Oxacillin resistance ranged from 35% to 40% in Staphylococci.

Conclusion:

Overall, in our study, a high resistance of more than 30% up to 84% was noted in gram-negative bacterial isolates against the commonly used beta-lactam drugs and co-trimoxazole. A report from this type of local investigation is highly beneficial in guiding physicians on empirical therapy by providing insights into the level of antibiotic resistance within their specific settings.
Effect of Ergonomic Intervention on Cognitive Function of Office Workers
Authors: Mottaghi Zahra , Halvani Gholamhossein , Jambarsang Sara , Mehrparvar Amir H.
Published: December 2024

Background:

Different domains of cognitive function are important in some jobs, such as office work. Ergonomic risk factors may affect cognitive function.

Aim:

This study was designed to assess the effect of an ergonomic training intervention on the cognitive function of office workers.

Materials and Methods:

This was a before-after study performed in 2020 in Yazd, Iran on female office workers. Cognitive function (working memory, attention, and response time) was assessed by Wechsler working memory and Stroop tests before and after the intervention. Ergonomic intervention consisted of an ergonomic modification of the workstation and a training program about ergonomic principles of office work. Data were analyzed by SPSS (ver. 24) using paired t-test and the multiple regression linear model.

Results:

Mean age and work experience of the participants were 35.38 ± 1.60 and 8.54 ± 1.24 yr., respectively. Forward visual memory, response time, and interference time were significantly changed after the intervention, but the change in other aspects of cognitive function (i.e., memory span, backward visual memory, and interference score) was not statistically significant. Marital status, age, and working hours significantly affected working memory, test duration and response time, and number of errors, respectively.

Conclusion:

This study showed that ergonomic intervention (modification of workstation and training) may significantly affect some aspects of cognitive function in office workers.
Challenges in ABO-incompatible Renal Transplantation: A Case Report of Acute Antibody-mediated Rejection with Late Graft Thrombosis
Authors: Singh Abhishek Pratap , Beniwal Pankaj , Malhotra Vinay
Published: December 2024

Late graft thrombosis is an infrequent yet severe complication post renal transplantation, profoundly affecting graft survival and patient prognosis. We report a case of a 29-year-old male with end-stage renal disease due to IgA nephropathy who underwent ABO-incompatible renal transplantation. Despite effective desensitization, the patient experienced late graft thrombosis 3 months posttransplant, resulting in irreversible graft failure and necessitating hemodialysis initiation. This case underscores the complexities of late graft thrombosis and emphasizes the significance of timely identification and intervention for optimizing transplant outcomes.
Recurrent Lower Respiratory Tract Infection in a Renal Allograft Recipient: A Rare Case of Tracheobronchomegaly (Mounier-Kuhn Syndrome)
Authors: Saha Monideep , Panigrahi Deepak , Khullar Dinesh , Singh Kulwant , Singh Abhishek , Lall Ajay
Published: December 2024

Mounier-Kuhn syndrome (MKS), also known as tracheobronchomegaly (TBM), is a rare disorder characterized by marked dilatation of the trachea and proximal bronchi. We hereby present a case of MKS in a 40-year-old renal transplant recipient. He had multiple admissions in the recent past for lower respiratory tract infections. During recent admission for lobar pneumonia, he continued to exhibit respiratory symptoms including cough and fever, despite culture-sensitive antibiotics. Imaging studies revealed tracheal and bronchial dilatation with right lower lobe consolidation. Bronchoscopy confirmed TBM and severe excessive dynamic airway collapse. Mucolytics, chest physiotherapy, and intermittent continuous positive airway pressure were game changers in this case. This case highlights the importance of recognizing structural lung pathology in solid organ transplant recipients presenting with recurrent respiratory tract infections.
The Effect of Kidney Transplantation on Pulmonary Hypertension in End-stage Kidney Disease Patients on Hemodialysis
Authors: Jane Christine Mary , Kumar K. Vinod , Kumar R. Anil , Unni V. Narayanan , Prasannan Bipi K. , Pullockara Jojo K. , Dev U. R. S. Vishnu
Published: December 2024

Introduction:

Pulmonary hypertension (PH) is highly prevalent in chronic kidney disease (CKD) patients, especially those undergoing hemodialysis. PH is a strong independent predictor of mortality in dialysis patients. Kidney transplantation (KT) is the best treatment modality for reversing adverse cardiac effects of CKD.

Methods:

A prospective cohort study was done in end-stage kidney disease (ESKD) patients on hemodialysis with PH (defined as pulmonary artery systolic pressure [PASP] of 35 mmHg or above) who subsequently underwent KT. Follow-up echocardiogram was done at an average of 15 months post KT.

Results:

A total of 277 patients underwent KT, out of which 95 had PH (prevalence 34.3%). Our study included 65 patients with PH who consented for the study. There was a significant improvement in PH as evidenced by a reduction in PASP (PASP pre KT 44.8 [±9.91] post KT 32.77 [±6.33], P = 0.001). 72.3% of patients achieved normal pulmonary pressures. There was also a significant improvement in ejection fraction (63.01 [±7.4] vs. 65.06 [±5.61], P = 0.04) and left atrial diameter (3.9 [±0.45] vs. 3.52 [±0.51], P = 0.001) post KT. There was an improvement in mean hemoglobin level (10.4 [±2.17] vs. 13.5 [±2.13], P = 0.001), serum calcium levels (serum Ca 8.76 [±0.72] vs. 9.19 [±0.82], P = 0.001) and improvement in the New York Heart Association (NYHA) class.

Conclusions:

KT significantly improves PH in ESKD patients on hemodialysis and can potentially normalize it. There is also improvement in overall cardiac functions, serum hemoglobin, and calcium levels. This translates to better physical endurance as evidenced by improvement in NYHA class post KT.
Extramedullary hematopoiesis in a case of rhabdomyosarcoma with bone marrow metastasis
Authors: Pulappadi Vishnu Prasad , Chandrashekhara Sheragaru Hanumanthappa , Pal Chandan Kumar , Ratre Brajesh Kumar
Published: December 2024

Extramedullary hematopoiesis (EMH) occurs in bone marrow failure due to a variety of causes. Although common in hematological disorders like myelofibrosis and hemoglobinopathies, EMH occurring as a result of bone marrow metastasis from solid tumors is very rare. We report a case of EMH subsequent to bone marrow metastasis from parameningeal rhabdomyosarcoma in a 17-year-old girl. The patient presented with anemia and thrombocytopenia. Bone marrow biopsy revealed metastasis from rhabdomyosarcoma. Contrast-enhanced computed tomography (CECT) was performed and revealed an enhancing mass in the left nasal cavity, with adjacent bone erosion suggestive of parameningeal rhabdomyosarcoma. Additionally, multiple homogenously enhancing masses were seen in the paravertebral location, adjoining multiple bilateral ribs, along the anterior surface of the sternum and in the presacral space, suggestive of EMH. Chemotherapy was subsequently started, but the patient developed febrile neutropenia and expired as a result of septic shock.
Palliative radiotherapy in a patient with Erdheim–Chester disease
Authors: Katano Atsuto , Yamashita Hideomi
Published: December 2024

Erdheim–Chester disease (ECD) is a rare type of non-Langerhans cell histiocytosis, which is reported in less than a thousand cases. Although palliative radiotherapy is the principal treatment of patients with painful bone metastasis, there is very limited evidence for the efficacy of palliative radiotherapy for ECD. A 50-year-old female patient with ECD was referred to our department with a complaint of back pain and numbness in the lower limbs owing to spinal cord compression. She underwent several courses of palliative radiation therapy, some of which resulted in a marked response. She was treated with palliative radiotherapy of 30 Gy in 10 fractions for the knee. Almost complete disappearance of the pain was achieved after radiation therapy. Radiotherapy comprising 20 Gy in five fractions was performed for spinal cord compression in the upper thoracic spine. Post-treatment magnetic resonance imaging showed marked improvement in spinal compression. The present case report represented the effect of radiotherapy on bone lesions associated with ECD. Further research on radiotherapy for ECD should be conducted in the future.
Pretreatment C-reactive protein level predicts the response to neoadjuvant chemotherapy of muscle-invasive bladder cancer
Authors: Tochigi Kosuke , Nagayama Jun , Yuguchi Yuri , Hattori Kyosuke , Morishita Koya , Nakane Wataru , Sai Hiroki , Matsui Hirotaka , Kanada Yoshie , Akamatsu Susuke
Published: December 2024

Introduction:

There is no established predictor of the neoadjuvant chemotherapy (NAC) response in patients with muscle-invasive bladder cancer (MIBC) treated via radical cystectomy (RC). We assessed the predictive utility of the pretreatment C-reactive protein (CRP) level in terms of the response to NAC in patients with MIBC treated with RC.

Patients and Methods:

This retrospective study enrolled patients with MIBC treated via RC following NAC at Nagoya University Hospital and affiliated hospitals from January 2004 to December 2020. An elevated CRP was defined as a CRP level ≥1 mg/dL. The association between the response to NAC and the pretreatment CRP level was investigated.

Results:

We retrospectively identified 192 patients of whom 101 (52.6%) were NAC nonresponders (pathological ≥T2 or node-positive). Nonresponders exhibited poorer 5-year disease-free survival (DFS) (82.5% vs. 42.7%, P < 0.01) and overall survival (OS) (95.3% vs. 48.8%, P < 0.01) than responders. Thirty patients (15.6%) showed elevated CRP levels that correlated with poorer 5 year DFS (66.7% vs. 33.0%, P < 0.01) and OS (74.6% vs. 48.3%, P < 0.01) than others. In multivariate analyses, an elevated CRP level was significantly associated with poorer 5-year DFS [hazard ratio (HR) 3.35, 95% confidence interval (CI) 1.88–5.97, P < 0.01)], OS (HR 2.13, 95% CI 1.13–4.03, P = 0.02), and nonresponder status (odds ratio 3.83, 95% CI 1.4–10.3, P < 0.01).

Conclusion:

An elevated CRP level may predict NAC nonresponder status and poorer oncological outcome. Upfront RC should be considered for patients with an elevated CRP level.
A prospective randomized control study of neo-adjuvant chemo radiation followed by surgery versus upfront surgery in resectable and borderline resectable pancreatic head cancer: Pilot study
Authors: Kumar Vipan , Singh Abhinav , Khosla Divya , Rana Surinder , Kang Mandeep , Singh Harjeet , Kapoor Rakesh , Gupta Rajesh
Published: December 2024

Introduction:

Neo-adjuvant chemoradiotherapy may improve survival in resectable or borderline resectable pancreatic cancer, but its feasibility, benefits, and challenges remain unproven in the resource constraint setup of developing countries.

Patients and Methods:

In this single-center randomized trial, patients with resectable or borderline resectable pancreatic cancer were randomly assigned to receive preoperative chemoradiotherapy or upfront surgery. Neo-adjuvant therapy consisted of two cycles of chemotherapy of gemcitabine and Nab-paclitaxel, followed by concurrent chemoradiotherapy with oral capecitabine combined with radiation therapy to a dose of 25 fractions × 1.8 Gray, followed by surgery and four cycles of adjuvant therapy or upfront surgery and six cycles of adjuvant chemotherapy. The primary end point was overall survival.

Results:

From March 2019 to March 2021, 80 patients were randomly assigned into two groups: 41 in neo-adjuvant therapy and 39 in upfront surgery. Per protocol analysis, 25/31 (80.65%) patients completed the intended neo-adjuvant treatment, with a dropout rate of 19.35%. Recurrent cholangitis due to stent block was the foremost reason for dropout. The median overall survival was 18.90 months with neo-adjuvant and 14.7 months in the upfront surgery group (hazard ratio, 0.78; 95% confidence interval, 0.58 to 1.05; P = .096). The resection rate was 36/41 (87.80%) in the upfront surgery group versus 14/31 (45.61%) in the NACRT group (P = <.001). The secondary end points favoured neo-adjuvant therapy, R0 resection rate, 92.86% vs. 75%; P = .18, pathologic lymph nodes, 00% vs. 30.56%; P = .006, perineural invasion, 14.29% vs. 36.11%; P = .14.

Conclusion:

The median overall survival and disease-free survival showed an advantage with neo-adjuvant therapy but did not reach statistical significance. The secondary end points favoured neo-adjuvant treatment, but logistics, multiple visits, prolonged treatment, and financial constraints are some of the main hurdles for developing countries to deliver multimodality treatment.
Evaluation of the dose rate and energy dependence of GafchromicTM EBT3 film for the application of total body irradiation and total skin electron therapy dosimetry
Authors: Sundaramoorthy Dhivya , Chandrasekaran Anuradha
Published: December 2024

Aim:

Total body irradiation (TBI) and total skin electron therapy (TSET) are special radiotherapy techniques that differ from routine radiotherapy therapy. They are intended to deliver a uniform dose to the entire body or skin and involve complex treatment procedures. It is therefore mandatory to perform an in-vivo dosimetry check to ensure dose accuracy and dose homogeneity during treatment. This study aims to investigate the dosimetric characteristics of GafchromicTM EBT3 film aimed at the application of TBI and TSET dosimetry.

Materials and Methods:

GafchromicTM EBT3 film by Ashland is a more widely used and convenient in-vivo detector than other detectors. Though many studies have reported the dosimetric characteristics of EBT3 film, those based on the electron beam are very limited. In our hospital, we perform in-vivo dosimetry in TBI and TSET with EBT3 films. Since TSET is performed with a high dose rate, the calibration curves of the low, nominal and high dose rates of the 6 MeV electron beam were evaluated in this study. Additionally, the change in response of a 6 MV photon beam to a 6 MeV electron beam was compared. Furthermore the orientation and stabilization time of EBT3 film were analysed in this study.

Results:

This study confirms that EBT3 films are dose-rate independent, and the change in response of a 6 MV photon beam to a 6 MeV electron beam was negligible. Further, this study shows that the photon calibration curve can be used in the dosimetric evaluation of both TBI and TSET.

Conclusions:

Consequently, Gafchromic EBT3 films are shown to be reliable for TBI and TSET in-vivo dosimetry..
Investigation on the TMR10 and convolution algorithms of the gamma plan treatment planning system utilizing the lightning software for the treatment of vestibular schwannoma in the gamma knife icon unit
Authors: Natesan Ponnusamy , Palaniappan Senthil Manikandan , Bahadur Sulthan Asath , Muthuvinayagam Muthiah , Sadashiva Nishanth
Published: December 2024

Introduction:

Leksell Gamma Plan (LGP) treatment planning is a software system that offers two-dose calculation algorithms for stereotactic radiosurgery/stereotactic radiotherapy treatments. The latest version of LGP is based on lightning software and includes TMR10 and convolution algorithms. TMR10 considers all brain structures as water and calculates the dose based on attenuation in water, while convolution accounts for the heterogeneous tissue inside the brain based on electron densities of all structures in the planning CT images. This study compares the dosimetric outcomes of these two algorithms for vestibular schwannoma cases and evaluates the impact of lightning software in heterogeneity corrections.

Materials and Methods:

Our Institute has conducted a comprehensive analysis of data from 16 patients who were diagnosed with vestibular schwannoma and underwent treatment with LGK SRS plans utilizing LGP Version 11.3 lighting software. These plans were developed using both TMR10 and convolution algorithms, with a prescribed dose of 12 Gy to the planning target volume (PTV) and a 50% isodose curve utilized to effectively cover the PTV while minimizing potential harm to healthy tissue. Our analysis focused on assessing the dosimetry data for the treatment plans, specifically in relation to the brainstem and cochlea as organs at risk. In our study, we conducted a comparison of the treatment plan indices for TMR and convolution using paired t-test analysis.

Results:

The maximum dose of PTV was 22.1 (1.7) Gy in the TMR10 algorithm and 21.4 (2.0) Gy in the convolution algorithm. The mean dose was 16 Gy and 15.2 Gy for TMR10 and convolution, respectively, with a difference of –5.00%. The Paddick conformity index was 0.82 and 0.84 for TMR10 and convolution, respectively, with a difference of 2.43%. The maximum and mean doses of the brainstem were 10.1 Gy and 9.8 Gy, and 2.6 Gy and 2.5 Gy in TMR10 and convolution algorithms, respectively.

Conclusion:

The TMR10 algorithm assumes all structures are unit densities and is traditionally used in LGK units for dose calculation. However, the convolution algorithm accurately predicts the delivered dose by accounting for in-homogeneities in the head structure. The use of a convolution algorithm may be necessary when the target is surrounded by highly tissue in-homogeneities such as air tissue interface and bone structures. Additionally, it may be necessary for patients with anterior venous malformation who require embolization to arrest bleeding. The use of a convolution algorithm in clinical practice needs to be validated before implementation.
Deficient mismatch repair and BRAF-V600E-mutated metastatic colorectal cancer responds to nivolumab therapy after progression under bevacizumab plus FOLFIRI
Authors: Chen Po-Jung , Yeh Yung-Sung , Tsai Hsiang-Lin , Huang Ching-Wen , Yang Sheau-Fang , Wang Jaw-Yuan
Published: December 2024

Nivolumab, a PD-1 immune checkpoint inhibitor, has been demonstrated to be clinically effective in patients with deficient mismatch repair (dMMR) and BRAF-V600E-mutated metastatic colorectal cancer (mCRC). We present the case of an 81-year-old Taiwanese woman with mCRC who responded favorably to nivolumab for 20 months after the failure of bevacizumab plus FOLFIRI (5-fluorouracil, folinic acid, and irinotecan) treatment. The woman visited our institute and received a diagnosis of ascending colon cancer in December 2019. She underwent right hemicolectomy; the pathologic stage was T3N1bM0, stage IIIb. After 7 months, multiple liver metastases had developed and bevacizumab plus FOLFIRI were administered. However, the disease progressed even after targeted therapy plus chemotherapy. Since February 2021, she has received 3 mg/kg nivolumab biweekly and the best objective response has been found to be partial response as per the response evaluation criteria in solid tumors criteria. No severe adverse events have occurred. The patient has received 33 cycles of nivolumab over 20 months without exhibiting eventual tumor progression. Nivolumab could be considered for dMMR and BRAF-V600E-mutated mCRC that has progressed despite treatment with bevacizumab plus FOLFIRI.
Patterns and stages of breast cancer in Northern Kerala, India; Results based on 2016 Hospital-Based Cancer Registry of a Tertiary Cancer Center
Authors: Ambali Parambil Neethu , Kannan Srinivasan
Published: December 2024

Background:

Breast cancer is leading globally in 2020, with mortality being a concern in developing countries. Cancer registration can help in studying systematically collected data about breast cancer. The aim of this study is (1) to describe demographic aspects, stage at diagnosis, histological types, and treatment availed by evaluating the 2016 Hospital-Based Cancer Registry (HBCR) of a Tertiary Cancer Centre (TCC), (2) to study the relationship between sociodemographic factors, the stage of the disease, the time between diagnosis and registration at TCC and the treatment status.

Methodology:

The data of all breast cancer patients who registered at the institution in 2016 was included in the study. The variables in the HBCR core form were used as a baseline for collecting data from hospital records.

Results:

The number of patients registered in 2016 was 534. The mean age was 53.8 (SD 53.8 ± 12.11). Majority (59.2%) presented in the early stages. Seventy-two percent were from rural areas, and 59.5% had a middle school education and above. Our study found a significant association between education status, the stage of disease, and treatment status.

Conclusion:

Education level plays an important role in early presentation and treatment completion. Registry data analysis can be used as a guideline for understanding patterns and for formulating cancer control activities in the state.