bluuebunny/crossref_metadata_2025 huggingface dataset:
Realistic Uncertainties for Fundamental Properties of Asteroseismic Red Giants and the Interplay between Mixing Length, Metallicity, and

ν

max
Authors: Li 李 Yaguang 亚光 , Bedding Timothy R. , Huber Daniel , Stello Dennis , van Saders Jennifer , Zhou 周 Yixiao 一啸 , Crawford Courtney L. , Joyce Meridith , Li 李 Tanda 坦达 , Murphy Simon J. , Sreenivas K. R.
Published: October 2024

Asteroseismic modeling is a powerful way to derive stellar properties. However, the derived quantities are limited by built-in assumptions used in stellar models. This work presents a detailed characterization of stellar model uncertainties in asteroseismic red giants, focusing on the mixing-length parameter α
MLT, the initial helium fraction Y
init, the solar abundance scale, and the overshoot parameters. First, we estimate error floors due to model uncertainties to be ≈0.4% in mass, ≈0.2% in radius, and ≈17% in age, primarily due to the uncertain state of α
MLT and Y
init. The systematic uncertainties in age exceed typical statistical uncertainties, suggesting the importance of their evaluation in asteroseismic applications. Second, we demonstrate that the uncertainties from α
MLT can be entirely mitigated by direct radius measurements or partially through

ν

max

. Utilizing radii from Kepler eclipsing binaries, we determined the α
MLT values and calibrated the α
MLT–[M/H] relation. The correlation observed between the two variables is positive, consistent with previous studies using 1D stellar models, but in contrast with outcomes from 3D simulations. Third, we explore the implications of using asteroseismic modeling to test the

ν

max

scaling relation. We found that a perceived dependency of

ν

max

on [M/H] from individual frequency modeling can be largely removed by incorporating the calibrated α
MLT–[M/H] relation. Variations in Y
init can also affect

ν

max

predictions. These findings suggest that

ν

max

conveys information not fully captured by individual frequencies, and that it should be carefully considered as an important observable for asteroseismic modeling.
New Versus Past Silica Crush Curve Experiments: Application to Dimorphos Benchmarking Impact Simulations
Authors: Malamud Uri , Schäfer Christoph M. , Luciana San Sebastián Irina , Timpe Maximilian , Alexander Essink Karl , Kreuzig Christopher , Meier Gerwin , Blum Jürgen , Perets Hagai B. , Burger Christoph
Published: October 2024

Crush curves are of fundamental importance to numerical modeling of small and porous astrophysical bodies. The empirical literature often measures them for silica grains, and different studies have used various methods, sizes, textures, and pressure conditions. Here, we review past studies and supplement further experiments in order to develop a full and overarching understanding of the silica crush curve behavior. We suggest a new power-law function that can be used in impact simulations of analog materials similar to microgranular silica. We perform a benchmarking study to compare this new crush curve to the parametric quadratic crush curve often used in other studies, based on the study case of the DART impact onto the asteroid Dimorphos. We find that the typical quadratic crush curve parameters do not closely follow the silica crushing experiments, and as a consequence, they under (over) estimate compression close (far) from the impact site. The new crush curve presented here, applicable to pressures between a few hundred Pa and up to 1.1 GPa, might therefore be more precise. Additionally, it is not calibrated by case-specific parameters, and can be used universally for comet- or asteroid-like bodies, given an assumed composition similar to microgranular silica.
Simultaneous Proton and Electron Energization during Macroscale Magnetic Reconnection
Authors: Yin 尹 Zhiyu 志宇 , Drake J. F. , Swisdak M.
Published: October 2024

The results of simulations of magnetic reconnection accompanied by electron and proton heating and energization in a macroscale system are presented. Both species form extended power-law distributions that extend nearly three decades in energy. The primary drive mechanism for the production of these nonthermal particles is Fermi reflection within evolving and coalescing magnetic flux ropes. While the power-law indices of the two species are comparable, the protons overall gain more energy than electrons, and their power law extends to higher energy. The power laws roll into a hot thermal distribution at low energy with the transition energy occurring at lower energy for electrons compared with protons. A strong guide field diminishes the production of nonthermal particles by reducing the Fermi drive mechanism. In solar flares, proton power laws should extend down to tens of keV, far below the energies that can be directly probed via gamma-ray emission. Thus, protons should carry much more of the released magnetic energy than expected from direct observations.
NATO Support and Procurement Agency: a Powerful Instrument of Collaborative Logistics
Authors: Lopourová Radka , Funiok Richard , Procházka Josef
Published: October 2024

The paper evaluates the level of cooperation between the Ministry of Defence and the NATO Support and Procurement Agency (NSPA) in the field of procurement of military equipment. In the practical part, the results of the research on the level of participation of Czech-based suppliers in NSPA activities between 2018 and 2022 are presented. Pareto analysis comparing the participation of the Czech and international companies in contracts implemented by NSPA in terms of their subject, quantity and financial value is used. Qualitative case studies from three different areas illustrate in which NSPA projects the Czech Republic has already been involved in and which benefits and risks are associated with this cooperation for the MoD. Positives and drawbacks in the process of acquiring military equipment in-house and opportunities and threats that may arise from the acquisition of military equipment through the NSPA are summarised in the form of the SWOT analysis. Finally, recommendations are presented on how to improve the cooperation between the MoD and the NSPA in the field of acquisition.
Report on network problem formulations, targets and preferences, including guidance and data on targets and optimal TEN-N design criteria
Authors: Jung Martin , Davoli Marco , Cavalcante Thiago , O'Connor Louise , D'Alessio Alessandra , Cimatti Marta , Pacifici Michela , Beher Jutta , Visconti Piero , Di Marco Moreno , Kujala Heini
Published: October 2024

The expansion of area-based conservation measures, such as protection and restoration efforts, as well as the design of multi-functional green and blue infrastructure, are widely seen as instrumental in halting or reversing further biodiversity decline. Europe has a long history of protection for biodiversity such as through the Natura 2000 program, however there still remain several gaps in sufficiently conserving the various aspects of biodiversity (e.g. species, ecosystems, functions & services) across Europe. Given the legal, political and societal challenges in negotiating the expansion of any new areas, it is key that these are done in strategic way and make use of best-available data to identify which areas would have the highest potential to contribute meaningfully to the conservation of biodiversity. Methods from systematic conservation planning (SCP) can be used to identify where such areas could be located under various assumptions and future narratives and can help to contribute to the design of a Trans-European Nature Network (TEN-N). In this report we 1) review previous SCP applications at various spatial and temporal grains across Europe and guiding principles for identifying conservation area expansions, 2) outline a methodology building on Favourable Reference Values (FRVs) to quantitatively identify the level of ambition for ensuring the long-term persistence of species of conservation priority, 3) describe a way to account for resilience towards future climates so as to ensure that protected areas play their role now and in the future, 4) describe how different parameters and datasets can be robustly integrated in a SCP problem formulation so as to identify where to best conserve, restore or manage European landscapes across different variants. By doing so this report provides a methodological basis on how to plan for a more coherent pan-European wide TEN-N. The TEN-N variants can inform on areas with high potential for local implementation, opportunities for cross-border conservation collaborations, or regions where future funding for conservation and restoration could be allocated across European member states. Furthermore, the TEN-N variants will be closely inspired by European policy targets and definitions and can thus serve as feasibility assessment of European Biodiversity policies under different scenarios.
Medication Adherence and Functioning in Individuals With Bipolar Disorder Type I
Authors: Yilmaz Emel Bahadir , Dikmen Sema Nur Türkoğlu , Yüksel Arzu
Published: October 2024

Purpose

To determine the correlation between medication adherence and functioning in individuals with bipolar disorder (BD) and the predictors of functionality.

Method

This cross-sectional and correlational study was conducted with 145 individuals with BD type I. Data were collected using a Patient Information Form, the Medication Adherence Rating Scale, and Functioning Assessment Short Test.

Results

Findings showed that most participants did not take medication as prescribed. Medication adherence was negatively correlated with functionality. Predictors of functionality were years of treatment, number of hospitalizations, working status, medication adherence, family history of mental illness, and history of suicide.

Conclusion

Medication nonadherence is a fundamental problem for individuals with BD. Nursing interventions to increase functionality and medication adherence among this at-risk group should be planned and implemented. [
Journal of Psychosocial Nursing and Mental Health Services, 63
(2), 25–33.]
Sobre Félix Castelo y su relación con Vicente Carducho: dibujos y circulación de modelos en la mitad del siglo XVII en Madrid
Authors: Zamora Pérez Mario
Published: October 2024

El presente artículo profundiza en el conocimiento del pintor del siglo XVII Félix Castelo. Por una parte, dotarle de una individualidad y definir su propia personalidad diferenciándole de su maestro. Por la otra y complementaria a la primera, se le relaciona con cuatro dibujos que se conservan en la Biblioteca Nacional de España.
Una aproximación diacrónica a la gestación de confiar como verbo de transferencia
Authors: Conde Noguerol María Eugenia
Published: October 2024

En este trabajo se apuntan las características semántico-sintácticas de confiar como verbo de transferencia desde su gestación en la Edad Media hasta el siglo XIX. El análisis cualitativo y cuantitativo de una muestra de datos extraída de un corpus longitudinal diacrónico permite afirmar que fue en el siglo XVIII cuando se produjo el proceso de cristalización del esquema triactancial actual confiar(le) algo a alguien.
Mitigating the Humans Risks to Cybersecurity Posture
Authors: Gupta Moksh , Ryan John , Boyer Tyler
Published: October 2024

This study addresses the critical field of information security risk mitigation introduced by humans. Recognizing and fixing risk factors resulting from human behavior is essential at a time when complex cyber threats plague digital environments. This research is significant because it acknowledges that human vulnerability plays a major role in information security breaches. Despite technological advances, insufficient training, malicious intent, and human error remain major obstacles. Organizations that ignore these factors risk devastating data breaches, financial ruin, and serious harm to their reputation. By addressing human-related vulnerabilities, companies can better protect their digital assets and ensure a more secure working environment. The research illustrates the importance of comprehensive training programs, strict security policies, and a culture of awareness to mitigate risks associated with human factors. Effective risk mitigation requires a multifaceted strategy that combines technology with human-centered strategies to safeguard against evolving cyber threats.
Ensuring Sustenance of Innovation
Authors: Gupta Monal , Yasin Khan
Published: October 2024

Questions have been posed over the effectiveness of these audits in improving hospital systems, giving rise to new trends and practices in healthcare audits. Since most hospitals are in the constant chime to improve the quality and length of their patients' lives, there is an impetus to not only innovate medical practices but also improve risk management and internal audit functions to ensure controlled and sustained adoption. Internal audit trends will generally improve healthcare institutions' quality of care and operations. It leads to better data analytics tools, improved information systems, leveraging new technology, addressing evolving management needs, dealing with relationships with third-party providers carefully, and complying with new regulations. The research is critical to ensure as the healthcare industry continues to leverage new technologies and data tools to ensure better quality care to their patients and society, risks are effectively managed.
Auditing Risks of Web 3.0
Authors: Rai Shubham Rajivkumar , Shah Kevin , Yedavalli Kruthi , Modi Naman Kumar , Singh Raghvendra
Published: October 2024

With increasing reliance on internet technologies, auditing plays a critical assurance role. This chapter explores the evolution of the internet into the emerging landscape of Web 3.0, built on decentralized and semantic technologies like blockchain that transform today's web architecture. It analyzes the vision, potential applications, and inherent governance, risk, and business impact considerations involved in this blockchain-powered reinvention of the web. It further discusses key risk domains in Web 3.0 that warrant audit scrutiny, including decentralization, blockchain, cryptocurrencies, and semantic inaccuracies. This chapter provides technology leaders, auditors, and regulatory stakeholders with an overview of Web 3.0 while highlighting the pivotal governance, risk management, and assurance challenges involved in this transition. It prepares readers to evaluate the analyses and recommendations centered on securing this next-generation, decentralized web future.
Optimizing Competition
Authors: Chandra Saurabh , Boddu Harshith Sai
Published: October 2024

India's competition legislation has seen substantial modifications since the implementation of the Competition Act in 2002. An essential component of this law is the merger control framework, which is specifically intended to oversee mergers and acquisitions that have the potential to impact market competition. This article provides a comprehensive examination of the efficacy of merger control within India's competition law system, focussing specifically on its ability to achieve antitrust goals. This study assesses the efficacy of the legislative framework in dealing with anticompetitive behaviours and fostering market competitiveness. In addition, it examines the actual implementation of merger control by analysing the function of the Competition Commission of India (CCI), the effectiveness of the merger review process, and the influence of merger judgements on market dynamics. The findings suggest that although there have been improvements in the merger control mechanisms of India's competition legislation, there are still difficulties that need to be addressed. These factors include the need for increased clarity and reliability in decision-making, guaranteeing the implementation of measures to address mergers, and resolving delays in the procedural aspects of the merger assessment process. The report provides suggestions to improve the efficiency of merger control under India's competition legislation, including bolstering the institutional capacity of the CCI, simplifying merger review processes, and fostering more involvement of stakeholders. This study focusses on merger control, competition law, antitrust rules, and the examination of market dynamics and effectiveness, with a particular emphasis on the function of the Competition Commission of India. This paper analyse the effectiveness of the merger control framework under India's competition law to accomplish its antitrust objectives. It aims to understand the impact of the introduction of the “green channel route” on the efficiency and effectiveness of merger control in India. The paper analyses the main obstacles that India's merger control mechanisms are currently facing, and how can their efficiency be improved?It suggests that what can be implemented to ensure the efficient enforcement of merger remedies within India's competition law framework.
Application of Basic Strategies of Lean-Sustainable Manufacturing Relation to Reduce Industrial Waste in an Electronic Industry of Mexicali, Baja California
Authors: Sanchez Corona Ana Laura , Navarro González Carlos Raúl , Robledo Verónica Arrendondo , Muñoz Ismael Mendoza , Meza Israel Sauceda , Robles Arili Cardenas , Gonzalez Jesus Marquez , Toxqui Cicerón González , Badilla Gustavo Lopez , Valenzuela Martínez Eddna Teresa
Published: October 2024

This paper evaluates the relation of the Lean Manufacturing (LM) and Sustainable Manufacturing (SM), to determine the grade level of the Lean-Sustainable Manufacturing relation (LSMR), evaluating the industrial waste reduction, as one of the seven pillars of the LM and the adequate waste management, as a one basic characteristic of the SM. This investigation was made in three steps in an electronic industry installed in the Mexicali city, being (1) an evaluation of the industrial waste in the manufacturing areas (2) design, development and application as a pilot test of a new automatized device in industrial operations that generates the major quantity of defective products as industrial waste and (3) a correlation analysis applying the ANOVA test and the Cronbach's Alpha analysis, to validate the LSMR as the sustainable practices. With these relevant aspects were increased the productivity and quality indices, along this investigation process. This scientific study was made in 2022.
A Qualitative Study of Political and Economic Dynamics of Ethno Nationalism in Baluchistan
Authors: Idris Sofia
Published: October 2024

Balochistan is the largest province of Pakistan in terms of area& resources. However, it's the least developed region of the country albeit having a huge potential for domestic and international trade& growth. This research work is an attempt to have an insight on factors responsible for the ethnonationalism among Baluch that continues for decades. The research attempts to fully understand the Baluch nationalist movement using both the political and economic dynamics as its indicators for study. In order to understand the phenomenon of ethnonationalism, the research incorporates information on state initiatives and policies explaining different development projects& policies by the federal and Balochistan governments and response to development projects of different stakeholders including Balochistan 's community not represented by Balochistan government and their role in the implementation of these policies and projects. Moreover, it will also give an account of the Insurgencies and Contemporary ethnonationalism in this regard. The research will give findings and analysis using Theory of Relative Deprivation.
Corporate Social Responsibility and Knowledge Management
Authors: Martínez-Falcó Javier , Sánchez-García Eduardo , Marco-Lajara Bartolomé
Published: October 2024

This study investigates the impact of Corporate Social Responsibility (CSR) and Knowledge Management Infrastructure (KMI) on Organizational Ambidexterity (OA) and Sustainable Performance (SP) within the Spanish wine industry. Using structural equation modeling and survey data from 202 Spanish vineyards, the research reveals that CSR and KMI significantly enhance OA and SP. The study introduces a novel theoretical framework linking these variables, providing both theoretical insights and practical implications for the wine sector. The findings suggest that fostering a collaborative culture, embracing ICT, and decentralizing organizational structures can drive innovation and sustainability in wineries.
The Positions of Germany and Poland in the EU-China Comprehensive Agreement on Investment (CAI)
Authors: van Loon Aukje
Published: October 2024

From a European Union (EU) perspective, the prime objective of the Comprehensive Agreement on Investment (CAI) is to facilitate a rebalancing of the EU-China relationship by improving European market access in China and levelling the playing field. The CAI has undergone a rocky journey during negotiations, yet also since negotiations concluded in December 2020. China's human rights abuses in Xingjiang caused EU member governments to freeze CAI's ratification. Russia's invasion of the Ukraine and China's attitude towards this leaves the circumstances unchanged. This article assesses two country case studies (Germany and Poland) as member governments within an ongoing turbulent geopolitical context, both in favor of EU-China investment liberalization, yet with complete opposite positions towards the CAI. In line with a liberal, society-centred approach, material (industry associations, trade unions) and value-based actors (voters) particularly those stemming from Germany, one of the driving forces behind the deal, and Poland, a vocal opponent, are examined.
Relearning Age Management in Contemporary Organizations
Authors: Peterlin Judita , Dimovski Vlado , Kejžar Anamarija , Kozjek Tatjana , Roblek Vasja , Colnar Simon
Published: October 2024

This theoretical overview chapter emphasizes the critical function of relearning and, in this context, the necessity for upskilling and reskilling programs for older workers. Accordingly, the primary objective of this chapter is to address age management issues. It examines the significance of organizational adaptations to the workforce's required structural changes in this context. It provides a comprehensive overview of the challenges and opportunities in response to these changes. The primary substantive findings indicate that effective organizational learning processes facilitate employees' acquisition of new skills. The efficacy of these processes is contingent upon the efficacy of managing organizational strategies for intergenerational collaboration. This chapter presents a perspective on how intergenerational collaboration can facilitate the relearning of the older workforce in alignment with the demands of a rapidly evolving technological business environment.
The Effect of Organizational Memory in the Formation of Organizational Trust
Authors: Arıcıoğlu Mustafa Atilla , Ateşalp Zeliha
Published: October 2024

This study aimed to examine the effects of organizational memory on the formation of organizational trust of individuals. Quantitative methods were used in the research, and a questionnaire was applied to a total of 200 people, 73 women and 127 men, working in the academic staff of a university. At the end of the research, it was determined that the organizational memory of the individuals is higher than their organizational trust, the individuals trust the institution managers the most and the organization or the institution itself the least, and they have the most professional knowledge and the least sectoral knowledge. In addition, it was determined that organizational trust and organizational memory levels of individuals differ according to some socio-demographic characteristics, and there are statistically significant and positive correlation relationships between organizational trust and organizational memory levels.
Sustainability Organizational Management Governance and Technological Innovation Leading to Entrepreneurship for Sustainable Economic Growth
Authors: Vargas-Hernandez José G. , González-Àvila Francisco J. , Vargas-Gonzàlez Omar C. , de Jesús Reyes-Sànchez José
Published: October 2024

This study has the purpose to analyze the sustainability organizational management governance and technological innovation in their relationships and implications with entrepreneurship for sustainable economic growth and development. The study departs from the assumption that sustainable economic growth and development is required with theoretical and practical knowledge in sustainability management governance and technological innovation is required to move towards more sustainable production and consumption systems. The method used is the meta-analytical leading to the reflective and descriptive based on the conceptual, theoretical, and empirical literature review. The analysis concludes that the sustainability organizational management governance and technological innovation are relevant factors to have effects on to entrepreneurship for sustainable economic growth and development.
The Essential of Resources and Capabilities to Develop a Sustainable Entrepreneurial Strategy in VUCA World
Authors: Bhandari Arabinda
Published: October 2024

The main objective of this chapter is to concisely describe the role of the resource and capabilities of an enterprise that can help to create a successful strategy formulation for a sustainable competitive advantage. The research incorporated a literature review in the field of strategic management and entrepreneurship to understand the role of resources in entrepreneurial strategy setting. The chapter provided a guideline for an enterprise to develop a successful strategy based on resources and capabilities and position themselves in an industry. The identified strategic options discussed here are a transformational bridge between the two subjects. This chapter also gives a future research direction to confirm how the strategies based on resources and capabilities can create excellence in VUCA (volatility, uncertainty, complexity, ambiguity) environment and improve the shared holder value with the help of learning and growth, internal business process, customer prospective to achieve the enterprise vision with a stipulated time.
Diagnosis and Treatment of Latent Tuberculosis Infection in Adults in South Korea
Authors: Jo Kyung-Wook , Yoon Young Soon , Kim Hyung Woo , Kim Joong-Yub , Kang Young Ae ,   on Behalf of the Korean TB Guideline Development Committee
Published: October 2024

Latent tuberculosis infection (LTBI) is characterized by immune responses to Mycobacterium tuberculosis antigens without clinical symptoms or evidence of active tuberculosis. Effective LTBI management is crucial for tuberculosis elimination, requiring accurate diagnosis and treatment. In South Korea, LTBI guidelines have been updated periodically, the latest being in 2024. This review discusses the recent changes in the Korean guideline for the diagnosis and treatment of LTBI in adults.
Revolutionizing Rural Health Care: The Power of Telehealth and Digital Health Literacy
Authors: Chandrakar Mayank
Published: October 2024

For many living in remote areas, accessing quality health care remains a significant hurdle. Long distances, limited specialists, and transportation challenges create a gap in care that telehealth has the potential to bridge. This article explores how telehealth, the use of telecommunication technologies for health-care delivery, can revolutionize rural health care. Telehealth consultations can connect patients with specialists in distant locations, reducing travel burdens and wait times. It can also enhance preventative care through remote monitoring and medication management. However, the success of telehealth hinges on digital health literacy. Equipping rural communities with the skills to navigate these technologies is crucial for maximizing their benefits. This article delves into the challenges and opportunities presented by telehealth in rural areas. It discusses how initiatives promoting digital health literacy can empower communities and ensure equitable access to quality health care. Ultimately, it argues that by embracing technological advancements and fostering digital literacy, we can create a future where location no longer dictates the quality of health care received.
Lower Limb Comprehensive Reconstructive Surgery: Experiences from an Orthopedic Teaching Unit
Authors: Kurian Anand , Bliss Jeremy , Ganesh Krupakaran , Kumar Manisha J. , Inja Dan Barnabas , Ashok Anand
Published: October 2024

Introduction:

The burden of open extremity fractures is well recognized in placing a burgeoning demand on an already exhausted medical facility in low- and middle-income countries. This study aims to evaluate the functional outcome following “orthoplastic management” by orthopedic surgeons trained in limb reconstruction surgery.

Methodology:

Adult patients with open lower limb injuries treated from January 1, 2022, to December 30, 2022, who underwent single or staged fixation and reconstruction procedures were identified. Patients with Gustilo–Anderson type IIIB fractures requiring skeletal stabilization with soft-tissue cover were included. Polytrauma patients requiring multidisciplinary surgical attention were excluded. A team of orthopedic surgeons trained in limb reconstruction was involved in the management. Inpatient and outpatient department follow-up by the treating team was done to document complications (infections, reoperations, and graft failures) and functional outcomes using the Lower Extremity Function Score. The duration of mean follow-up was 1 year since index surgery.

Results:

A total of 24 adult patients with open lower limb injuries with preoperative Ganga Hospital Score (GHS) were included. Decision toward fixation with primary closure or further reconstruction was made collectively. The gray zone (GHS score of 15–16) of patients was more aggressively managed with emphasis on salvage. Additional reconstructive procedures were carried out based on the assessment at consequent follow-up. Three patients had a suboptimal joint function (less than functional range of motion for the involved joint) due to the resultant loss of compartment(s) and joint contracture. Five patients were retaken to the theater for further supplementary or corrective procedures following the index, definitive surgical procedure (bone grafting, partial flap loss, and fixator readjustment).

Conclusion:

Good-to-excellent functional outcome was demonstrated with the “orthoplastic approach” where skeletal stabilization as well as soft-tissue reconstruction was performed by trained orthopedic surgeons. This study demonstrated that orthoplastic surgery is a safe and effective method of limb salvage.
Laparoscopic Versus Open Closure of Duodenal Perforations: A Retrospective Comparative Study in a Rural Hospital, Andhra Pradesh, India
Authors: Kumar Pamisetty Anil , Dumpalapudi Ajay Babu
Published: October 2024

Introduction:

Evidence on the outcomes of laparoscopic surgeries, especially in emergency conditions such as peptic ulcer, remains unknown. A retrospective study was conducted in a rural surgical unit in Andhra Pradesh to compare morbidity, mortality, and duration of hospital admission in patients undergoing laparoscopic (Group L) and open (Group O) closure of duodenal perforations.

Methods:

Retrospective data of adult patients with peptic ulcer perforation treated by surgical approach during January 2012 and December 2017 were scrutinized. Pre- and postoperative records were abstracted for clinical conditions. Mortality was compared between the two groups with appropriate statistical tests.

Results:

A total of 120 patients, 60 in each group, were recruited for the study. The preoperative clinical characteristics of the two groups were similar. The mean duration of surgery was significantly higher in Group L (212.8 ± 29 min) compared to Group O (107 ± 16 min) (P < 0.001). Wound discharge (n = 3, 5%) and postoperative leak (n = 2, 3.3%) were the only complications noted in the L group. Several complications were noted in the O group including wound discharge (n = 51, 85%), wound dehiscence (n = 12, 20.0%), postoperative leak (n = 8, 13.3%), pneumonia (n = 1, 1.7%), and need for ventilation (n = 6, 10.0%). Three (5%) patients died in the hospital in Group O while none died in Group L. The average duration of hospital admission was 7.1 days (standard deviation [SD] =1.0 days) for Group L and 11.7 days (SD = 2.2 days) for Group O (mean difference: 4.6 days; 95% confidence interval: 4.6–5.2 days).

Conclusion:

Laparoscopic correction of duodenal ulcer perforation is both feasible and effective in reducing morbidity and mortality and overall treatment duration at peripheral centers.
The spectrum of late radiation sequelae in head and neck cancer
Authors: Vashistha Bhanu , Negi Preety , Kingsley Pamela A.
Published: October 2024

Introduction:

Concurrent Chemoradiation is the standard of care in the treatment of unresectable locally advanced head and neck cancer. Some of the acute side effects seen after or alongside the head and neck radiotherapy include dermatitis, mucositis, xerostomia, dysphagia and swallowing dysfunction. Evolving data demonstrate that acute toxicities may persist long-term and develop into late effects. In addition, late effects may manifest months or years after completion of therapy, persisting for years or even lifelong, far longer than previously believed. When severe, late effects may profoundly affect function and quality of life. The present study was conducted to analyze the spectrum of late radiation toxicities in head and neck cancer patients treated with radical external beam radiation therapy and to determine its prevalence and severity.

Materials and Methods:

This prospective observational study was conducted in the Department of Radiotherapy, Christian Medical College and Hospital, Ludhiana. In all patients with a histopathological diagnosis of head and neck carcinoma who have received radical radiation therapy alone or definitive chemoradiation as part of cancer-directed therapy.

Results:

Salivary gland toxicity was the most common toxicity encountered in head and neck cancer survivors resulting in dysphagia followed by dental caries, subcutaneous late effects and dysphagia. As expected, the spectrum of side effects correlated with the primary site, stage of disease and ECOG performance status.

Conclusion:

Technological advancement in radiation planning and equipment has resulted in a reduction in the most feared side effects of radiation which has led to improvement in the quality of life of the survivors. As no technology can entirely protect normal tissues from irradiation, utmost care should be taken to minimize the radiation dose received by normal tissues by following preventive and supportive measures.
Pediatric hepatocellular carcinoma in a 14-year-old boy: A rare case report
Authors: Rajpoot Jyoti , Jain Manjula , Pujani Mukta , Agarwal Charu , Wadhwa Ruchira , Sarohi Monica
Published: October 2024

Hepatocellular carcinoma (HCC) is much rarer in children and adolescents in comparison to adults with an incidence of 0.7/1,000,000 per year. Hepatitis B virus, a known carcinogen increases the chances of HCC at a young age. Very few case reports of HCC developing in HBV-positive male children have been published.We present a case of a 14-year-old Hepatitis B–positive boy who presented with abdominal distension and jaundice. Contrast enhanced computerized tomography (CECT) whole abdomen suggested a diagnosis of multinodular HCC with no evidence of metastasis on FDG PET-CECT. Histopathology with immunohistochemistry confirmed the diagnosis of moderately differentiated HCC.Clinical presentation of HCC in children is similar to adults. Viral hepatitis, metabolic disorders, and male gender increase the risk of HCC. In our case, boy never had any prior history of jaundice, abdominal pain/distension, or any other illness suggestive of liver dysfunction. When the boy was found to be HBV positive, his mother was also screened and turned out to be Hepatitis B virus positive. Histopathology along with a panel of immunohistochemical markers clinched the final diagnosis.
Bifocal intracranial germ cell tumor: A diagnostic and therapeutic dilemma for radiation oncologists
Authors: Antony Varghese , Pahuja Anjali K. , Sethi Jaskaran S. , Suresh Tamilarasu
Published: October 2024

An eight-year-old child presenting with increased thirst, raised intracranial tension and visual deterioration was diagnosed with synchronous suprasellar and pineal lesions, for which she underwent partial resection of the suprasellar lesion. Histopathological examination suggested pure germinoma. Tumor marker evaluation showed significantly raised levels of beta human chorionic gonadotropin (βHCG), favoring a non-germinoma germ cell tumor (NGGCT), leading to a diagnostic dilemma as the histology and βHCG levels were contradictory. Giving cognizance to the tumor marker levels, the treatment was designed on the lines of NGGCT. Planning of radiotherapy including craniospinal irradiation (CSI) and boost to both lesions was once again a challenge, given the proximity of the lesions to vital organs at risk (OAR). Given the child’s age and location of lesions, the target volumes and doses of radiation were designed to optimize between the goals of achieving long-term local control and minimizing late-onset toxicities.
The role of radiotherapy in multimodal treatment of non-rhabdomyosarcoma soft tissue sarcomas in children: A real life report from a tertiary center
Authors: Kahvecioglu Alper , Sari Sezin Yuce , Yigit Ecem , Gultekin Melis , Kosemehmetoglu Kemal , Orhan Diclehan , Kurucu Nilgun , Kutluk Mustafa Tezer , Yildiz Ferah
Published: October 2024

Objective:

The current treatment of pediatric non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) is a multimodal risk-based approach. Today, smaller fields and lower doses of radiotherapy (RT) have become standard. In this study, it was aimed to evaluate the treatment outcomes and toxicity profile in children with NRSTS that received RT as a part of multimodal therapy.

Methods:

Twenty-nine patients with pediatric NRSTS treated with neoadjuvant or adjuvant RT between 1998 and 2022 were evaluated retrospectively. Kaplan-Meier method was used for survival analyses.

Results:

Median follow-up was 36 months (range, 6-291 months). The median neoadjuvant and adjuvant RT doses were 50 Gy (range, 45–66 Gy) and 54 Gy (45–66 Gy), respectively. During follow-up, six (21%) patients developed a local recurrence and 10 (35%) had distant metastasis. The 5-year local control, overall survival (OS), local recurrence-free survival, and distant metastasis-free survival rate was 79%, 67%, 59%, and 61%, respectively. In multivariate analysis, a ≤5-cm tumor, gross tumor resection, Children’s Oncology Group (COG) low-risk group, and absence of neoadjuvant chemotherapy were independent favorable prognostic factors for OS. Severe (≥ grade 3) late toxicity was observed in 6 (20%) patients.

Conclusions:

RT is a crucial component in the multimodal risk-based treatment approach for pediatric NRSTS. However, late toxicity rates are still high and should be improved. Patients with a ≤5-cm tumor, COG low-risk group and treated with gross tumor resection have increased survival rates.
Novel swing lock denture design utilizing magnets for a patient with mandibular resection
Authors: Jing Kweh T. , Buzayan Muaiyed M. A.
Published: October 2024

Mandibular defects requiring reconstructions may result from mandibular resections due to benign or malignant lesions. Prosthesis-based rehabilitation of such cases represents a challenge due to various anatomical and functional limitations. Here we present a novel design for the fabrication of a swing lock denture utilizing a simplified hinge and magnets for a patient who had undergone hemimandibulectomy.
Adrenal ganglioneuroma with retroperitoneal lymph node metastasis: A rare scenario
Authors: Kamboj Meenakshi , Gupta Gurudutt , Pasricha Sunil , Sharma Anila , Durga Garima
Published: October 2024

Ganglioneuroma (GN) is the most differentiated and benign variant of neuroblastic tumors, most commonly located in the posterior mediastinum, followed by the retroperitoneum and adrenal gland. Children of <10 years of age are more commonly affected than adults. Though benign, GNs can very rarely metastasize to regional lymph nodes or distant sites like liver, bone, spleen, and soft tissues. Metastatic lesions are assumed to represent neuroblastomas in which the metastasis and the primary tumor, both have matured. This differentiation can occur spontaneously or after treatment. We present a primary ganglioneuroma of adrenal gland in a 4-year-old child with nodal metastasis, without any blastemal component at any site.
Study of non-invasive follicular thyroid neoplasm: A borderline entity
Authors: Bavikar Rupali , Randive Ruchi S. , Verma Anubhaw , Singh Madhuri , Viswanathan Vidya , Dharwadkar Arpana
Published: October 2024

Background:

Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a newly added entity in the fourth edition of the WHO Classification of Tumors of Endocrine Organs (2017). It is regarded as a neoplasm with very low malignant potential, thus affecting further treatment of the patients.

Aims:

To study the recently diagnosed entity, NIFTP, as not many cases have been reported of the same.

Materials and Methods:

A retrospective analysis of all thyroid neoplasms received in the Department of Pathology of our institute over two years was done. Out of the 188 cases that we reported, 38 were of non-invasive follicular neoplasms.

Results:

Thirty-two patients were female, whereas six patients were male. Thirty-five patients presented with solitary thyroid nodule and the others had an ill-defined thyroid swelling. Thirty-four patients had normal thyroid profile while two patients each presented with hypothyroidism and hyperthyroidism.

Conclusion:

It is crucial to carefully study the histopathological features of solitary thyroid swellings and correlate with clinical and radiological findings. The recently added diagnostic category of NIFTP helps clinicians prevent over-treatment of a group of low-risk thyroid tumors.
Custom made brachytherapy applicator for squamous cell carcinoma of oral commissures
Authors: Gupta Lokendra , Mukherji Ashutosh , Pujari Lincoln , Maknikar Ved Prakash , Zaidi Asim , Kumar Avinash
Published: October 2024

Primary treatment with brachytherapy for oral cancer is uncommon in large malignant lesions; however, it is preferred by radiation oncologists for initial and smaller-sized lesions in compromised anatomical locations. The purpose of this report is to introduce and discuss the fabrication of a customized brachytherapy applicator for a case of well differentiated squamous cell carcinoma (SCC) of the oral commissures using a radiotherapy thermoplastic mold (RTM). The RTM was molded into the shape of tongs and two acrylic wings were attached to these customized tongs to secure five high-dose radiotherapy catheter tubes. A mouth-stabilizing stent was used to stabilize the oral cavity throughout the brachytherapy process. A total dose of 45.5 Gy was delivered in 13 fractions to the lesion using a Cobalt-60 source over 35 days. At the end of the brachytherapy treatment and a follow-up period of 3 months, the patient responded well, and complete remission of the lesion was observed. The current brachytherapy applicator technique is a simple, viable, and curative option for patients with lesions in difficult -to- access anatomic locations.
Utility of morphological markers of chromosomal instability in breast cytology- A study of 100 cases
Authors: Londhe Mangesh M. , Jain Khushi , Buch Archana C. , Gore Charusheela R.
Published: October 2024

Aim:

Carcinogenesis is associated with multiple mutations that lead to chromosomal instability (CIN). Our aim was to study the role of markers of CIN on breast cytology and correlate with histopathological diagnosis.

Materials and Methods:

A retrospective observational study was conducted over a year on 100 breast cytology cases. Leishman-stained smears were examined for the number of micronuclei (MN), chromatin bridge (CB), and multipolar mitosis (MPM). MNs were counted manually in 1,000 cells under oil immersion (1000×). The frequency of CB and MPM was also noted. The malignant cases were graded as low (grades 1 and 2) and high (grade 3).

Results:

The mean age of the patients was 43.47 ± 15.81 years. The mean MN score for fibroadenoma cases was 4.54 (±1.5) and for malignant cases was 29.32 (±8.15). The receiver-operator curve (ROC) curve analysis confirmed >9 MN score as 100% specific and 100% sensitive for malignancy (area under the curve [AUC] =1). A significant comparison was noted between the mean MN of benign and malignant cases (P < 0.000001). The mean MN score for low-grade cases was 26.64 (±5.85) and for high-grade cases was 33.68 (±5.85) with a significant difference observed on comparing the population mean MN with a grade of malignancy (P-value = 0.01886). The difference between the frequencies of CB in low and high-grade cases was also found to be significant (P-value = 0.04135).

Conclusion:

The presence and scoring of markers of CIN (MN, CB, and MPM) on breast cytology have potential significance in the diagnosis of breast lesions.
Eminence and Ethos in Ayurveda: The Life and Legacy of Padma Bhushan Vaidyabhushanam K. Raghavan Thirumulpad
Authors: Parameswaran Karthik Kasimadom , Jinadevan Shajin Kuravanparambil
Published: October 2024

Abstract

This life description is a tribute to Padma Bhushan Vaidyabhushanam K. Raghavan Thirumulpad whose contributions span over a variety of domains. In addition to being an Ayurveda theoretician and practitioner, he made significant contributions in the fields of philosophy, literature, culture, and politics. We attempted to present his biographical sketch methodically through a comprehensive study of literature and inputs from his family and disciples. The study details Thirumulpad’s early life and education, induction to Ayurveda, and the foundations of his philosophy. It covers his contributions to Ayurvedic literature and sociopolitical initiatives. Awards, honors, and literary works have also been enumerated. The ongoing works of Vaidyabhushanam K. Raghavan Thirumulpad Foundation, Thrissur, India—which carries his legacy forward—are also mentioned.