bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing Home Workers' Experience During the COVID-19 Pandemic
Authors: Kunkle Rachel , Xu Haolin , Thomas Laine E. , Webb Laura E. , O'Brien Emily C. , Geary Carol Reynolds
Published: May 2024

Purpose:

To understand nursing home workers' experience during the coronavirus disease 2019 (COVID-19) pandemic and investigate the prevalence of health-related quality of life, emotional distress, job satisfaction, and the impact of the pandemic.

Method:

The Healthcare Worker Exposure Response and Outcomes (HERO) Registry served as the data source for this descriptive cross-sectional analysis. Recruitment was conducted nationally. Eligible nursing home workers (
N
= 1,409) enrolled in the study online, self-reported demographic and employment characteristics, and completed electronic surveys.

Results:

Nursing home workers reported overall good physical health, frequent depressive symptoms, burnout, and a high prevalence of feeling tired, stressed, having trouble sleeping, and feeling worried. Age and race were found to be positively associated with the impact of the pandemic.

Conclusion:

Findings demonstrate the difficulties and challenges nursing home workers faced during the COVID-19 pandemic. Future research needs to evaluate the relationships among nursing home workers' roles, mental health, depressive symptoms, and prevalence of burnout with a larger, more diverse sample. [
Research in Gerontological Nursing, 17
(3), 131–140.]
Stability of thermoelastic Timoshenko system with variable delay in the internal feedback
Authors: Ge Xinfeng , Su Keqin
Published: May 2024

Based on the Fourier law of heat conduction, this paper was concerned with the thermoelastic Timoshenko system with memory and variable delay in the internal feedback, which describes the transverse vibration of a beam. By the Lummer-Phillips theorem and the variable norm technique suitable for the nonautonomous operator, the stability of the coupled system has been derived in space $ \mathscr{H} $.
Geografski informacijski sistemi v Sloveniji 1995–96
Authors: Černe Andrej , Hladnik David , Hudnik Jurij , Krevs Marko , Perko Drago , Rener Roman , Stančič Zoran , Šumrada Radoš
Published: May 2024

The book is a collection of the third symposium on geographical information systems organized by ZRC SAZU and co-organized by the Association of Geographical Societies of Slovenia and the Association of Surveyors of Slovenia on 28 and 29 November 1996 in Ljubljana. The book contains twenty-four scientific, research, professional, educational and technical papers in the field of geographic information systems.
Les perceptions des employeurs et les mesures mises en place pour une meilleure rétention de la main-d’œuvre d’expérience au Québec
Authors: Tremblay Diane-Gabrielle
Published: May 2024

Étant donné la rareté de main-d’œuvre observée dans plusieurs secteurs au Québec, les organisations souhaitent identifier les obstacles au maintien et au retour en emploi et les mesures qui pourraient favoriser une meilleure participation au marché du travail de la main-d’œuvre d’expérience. Nombre de personnes souhaitent aussi rester sur le marché du travail mais se voient confrontées à des obstacles. Pour ce faire, nous avons mené deux enquêtes, l’une auprès de la main-d’œuvre et l’autre auprès des employeurs afin de connaître leurs perceptions des obstacles et des mesures ou politiques qui pourraient favoriser le maintien en emploi. Certains obstacles peuvent difficilement être contournés (problèmes personnels ou de santé) mais d’autres pourraient être abordés : surcharge de travail et fatigue, charge de travail mentale ou physique, absence ou faiblesse de la formation après 50 et 60 ans, reconnaissance de l’expérience ou rémunération insuffisante. Sur le plan des mesures publiques, outre une amélioration de la fiscalité, d’autres options pourraient être considérées, comme un soutien financier ou un service-conseil pour l’embauche de travailleurs d’expérience, une banque de candidatures disponibles, ou encore la mise en place de programmes permettant d’aider les organisations à développer des mesures innovantes en matière d’aménagement du temps de travail.
Remarques sur la causa sui, l’infinitude et la puissance chez Spinoza et Descartes
Authors: GLEIZER Marcos André
Published: May 2024

Spinoza occupe une place centrale dans le long processus de l'histoire de la philosophie qui aboutit à l’époque moderne à la pleine rationalisation de Dieu, compris comme l’être infini. Cette rationalisation, qui découle de l’universalisation de la demande de cause ou raison, se manifeste clairement dans le primat accordé par Spinoza à la notion de causa sui dans son système. L’article examine la manière dont Spinoza hérite la conception cartésienne de Dieu comme causa sui positive et la transforme radicalement, à partir de son exigence d’intelligibilité intégrale et d’univocité, en cause immanente de soi et des choses. Dans cette transformation, Spinoza établit une véritable fusion (qui ne doit pas être pensée comme résultant de quelque confusion, subordination ou réduction) entre la cause efficiente et la cause formelle en Dieu, et montre que, contrairement à ce que pensait Descartes, c’est la notion de causa sui qui rend intelligibles les notions d’infinitude et de puissance en Dieu.
Application of Agile Stage Gate Hybrid Model in the Healthcare Industry
Authors: Patra Abhik , Dutta Pushan Kumar
Published: May 2024

The healthcare industry is witnessing a dynamic and rapidly evolving landscape, with an increasing need for efficient project management methodologies to adapt to changing demands, regulations, and technological advancements. Traditional project management approaches often struggle to keep pace with the dynamic nature of healthcare projects. This chapter explores the application of an Agile–Stage-Gate hybrid model as a novel project management approach tailored to the unique challenges of the healthcare industry. The Agile–Stage-Gate model combines the flexibility of Agile with the structured framework of Stage-Gate, providing a synergistic solution for enhancing project outcomes in healthcare settings.
The Use of Information Technology (IT) to Create New Marketing Strategies
Authors: Reyes Ruiz Gerardo
Published: May 2024

The new information technologies (IT) have not been ignored by large and medium-sized companies to make their products better known. This context has allowed, in turn, some companies to decide to introduce new marketing strategies, based on information from new technologies, to better position their products in the market. In this dynamic, augmented reality is a new technology that allows virtual reality to be added to a real physical environment, making it a novel tool for discovering new uses, forms, and consumption habits. AR aims to surprise the customer and get their full attention and interest and, based on all the information provided -which they have already visualized through an App via a mobile phone- of a product, it seeks to awaken the consumer's desire to buy it. This approach, undoubtedly, generates new uses of IT to know customer satisfaction that very few companies currently use or know about, since they assume that its cost is high, which is not necessarily the case.
Natural Language Processing for HR Chatbots and Virtual Assistants
Authors: Singh Archana , Lakhera Girish , Ojha Megha , Mishra Amar Kumar , Kaushik Sanjay
Published: May 2024

The purpose of this study is to explore fundamental NLP concepts, key techniques, and application across various HR processes. It addresses the challenges and limitations faced by NLP-driven HR chatbots and virtual assistants while presenting real-world success stories from leading organizations. The data for the present study was collected through secondary data formation from different articles and research papers available. To develop a theoretical framework, the literature on NLP, HR technology, and EHRM operations will be reviewed. This chapter underscores the significant role of NLP in transforming HR chatbots and virtual assistants. However, to fully harness the potential of NLP in HR applications, it is crucial to address challenges and adopt ethical practices. Moreover, the chapter delves into the future prospects of NLP in HR, considering advancements in NLP technology and its potential fusion with emerging technologies like machine learning and conversational AI.
Feedback Experience of Moroccan National Institute for Agronomic Research With Scrum Agile Method
Authors: Benfadil Naoufel , Mdaghri Alaoui Anass
Published: May 2024

The Moroccan National Institute of Agronomic Research “INRA” has set the design and development of a new Enterprise Resource Planning including three components: “Finance”, “Human Resources, Training and Payroll” and “Agronomic Research” as its objective in 2021. INRA used before the Waterfall method, it certainly had certain advantages given the constraints which pushed the IT department to use such a method, but little by little, the limitations of this methodology become more apparent, and a more agile method was required. An agile software development method Scrum was proposed to overcome the inability of the traditional waterfall method to meet changing needs at INRA. This chapter will describe the INRA's experience use of agility with the Scrum method. A description of the good practices recommended by Scrum and how the IT Department adapted and complied with them to achieve agility within the institute will be described.
Eco Lodges and their Effects on Local Communities and the Environment in Developing Countries
Authors: Weiss Adam , Borris Joseph , Kol Taya
Published: May 2024

The world is in a critical period where knowledge of our environmental impact must be used to create sustainable innovations such as eco lodges. Eco lodges are a form of accommodation that are designed to have little to no effect on the environment it is located in while also having a positive socioeconomic impact. This chapter investigates the current success and future potential of these places in Ethiopia, Kenya, Nepal, and India. When properly managed, there has been massive success for eco lodges for owners and visitors. Some highlights of these findings include many lodges recovering from startup costs in the first year, 94% of visitors to lodges in the Maguri Wetlands wanting to visit again, and eco tourists staying in lodges longer than the average tourists' vacation. It was found that these places provide a variety of activities for guests that are all ecofriendly. Through research this chapter draws the conclusion that this will be a profitable and sustainable innovation in the tourism industry.
A Case Study Review of Community-Based Tourism Ventures and Roadblocks to Sustainable Development
Authors: Cox Elisa G. Ortúzar , Klomp Fay Fabienne Wendelien , Alhimovich Christine
Published: May 2024

Community-based tourism (CBT) offers a promising avenue for sustainable development by leveraging local resources, both natural and cultural, to empower communities. Theoretically, CBT holds the potential to effectively manage natural resources while preserving socio-cultural heritage, thereby fostering social and economic benefits for local communities. This chapter reviews 20 case studies about different CBT projects implemented in different regions of the world of developing countries, with the objective of understanding their flaws, strengths, and challenges, and to contribute to the practice of future projects. After going through the main concepts treated by the research, the conclusions and discussion manifested, stating that one of the main challenges of CBT is for stakeholders to give the appropriate amount of help, but also providing training on tourism and business managerial skills, so that there is no dependency, and residents can sustain and uphold a business on their own. Finally, the limitations of the present work and recommendations for future studies are given.
Perspectives on Local Heritage
Authors: Meucci Marina , Carini Lucrezia
Published: May 2024

This chapter investigates how it is possible to remain at the forefront of technological progress without losing sight of traditions. Innovation and novelties are the key words of this project; the authors conducted an analysis on how to take advantage of novelties without destroying traditional values and local communities, followed by a thorough collection of cases where innovation has been the key to preserve local Italian heritage. The focus is on cases where innovation has been the key to revitalise traditional festival or crafts that have been attracting thousands of tourists while trying to maintain their local authenticity by keeping these traditions the same for years with the right use of innovation to highlight our origins and those of our ancestors. A main example is provided by the authors' own country: Italy, which is appealing to loads of tourists thanks to her natural heritage beauty and to the innovations that came with it in the years.
Examining the Potential for Use of ChatGPT in Recruitment for Hotel Businesses
Authors: Yaşar Emre , Alkan Bilal Nadir , Gündoğan Harun Reşit
Published: May 2024

This research reveals that the integration of ChatGPT into recruitment processes in the hotel and tourism sector provides significant advantages in terms of time and cost. ChatGPT analyzes candidates' resumes and includes detailed information about their general characteristics, strengths and weaknesses, and suitability for departments. This automated process ensures that candidates are evaluated objectively, allowing for fair recruitment free from emotional interactions. It also helps businesses select the most suitable candidate, reduce costs, and improve service quality. This proposed use can provide competitive advantages to businesses by increasing the efficiency of their recruitment processes. Therefore, it is foreseen that ChatGPT, as a digital assistant in the tourism sector, will be beneficial. ChatGPT can enable businesses to manage their recruitment processes more effectively and efficiently, enabling them to maximize the benefits of artificial intelligence.
Importance of Education and Community Engagement for Effective Waste Management Techniques
Authors: Kumari Archana , Dutta Sudev
Published: May 2024

A sustainability-oriented educational approach encourages holistic thinking for the benefit of all living organisms and future generations, equipping individuals with the skills to enhance their quality of life responsibly. This mindset empowers global citizens to make informed decisions without compromising the well-being of our planet. Sustainability education seamlessly integrates with core subjects, capturing student interest and enabling them to contextualize coursework in real-life scenarios. Recognizing the escalating global challenges of pollution and waste, UNESCO (full form) has initiated a sustainable education agenda through the Education for Sustainable Development (ESD) program. The present study mainly focuses on education on waste management techniques for sustainability. The approach of sustainability in education will help us to think in a holistic way for all the living organism's life for future aspects. It is nothing more than a skill to learn and improve the quality of life of an individual.
Exploring the Lived Experiences of African American and Latinx STEM Faculty and Students in the U.S.
Authors: Nordberg Anne , Cropps Torrie A. , Mattingly Stephen P. , Pearson Yvette E.
Published: May 2024

Racialized faculty have been under-represented in U.S. institutions of higher education for decades and this is exacerbated in STEM disciplines with gender disproportionality. This study deployed a descriptive phenomenological design to capture the experiences of 11 faculty, postdoctoral, and graduate scholars who identified as African American and/or Latinx drawn from two universities in the southern U.S.; one a predominantly White, privately funded school and the other a designated Hispanic-Serving Institution that is publicly funded. We found four main themes (and three subthemes) that captured the shared lived experiences among the participants. We consider these findings through the lens of intersectionality.
Antithrombotic therapy in clinical practice
Authors: Ker J.A. , Ker J.
Published: May 2024

No abstract available.
Historic Influenza Perspectives on an Influenza Pandemic
Authors: Martins Des
Published: May 2024

Before discussing the issues related to influenza pandemics, it is necessity to understand the mechanisms that underlie the variability, of the virus. The influenza virus, like most RNA viruses, is genetically highly variable and this variability gives rise to a constant changing of the antigenicity of the virus. This, in itself, is not peculiar to influenza. However, what is unique to the virus is that this antigenic changeability constantly gives rise to new,strains of virus which are able to escape the immunity which the population builds up to the predecessor strain. The epidemiology of influenza is thus characterized by the constant advent of new antigenic strains of the virus giving rise to recurring epidemics of infection.
Disease as a social construct
Authors: Knapp van Bogaert Donna , Ogunbanjo Gboyega A.
Published: May 2024

No abstract available.
Identification of recurrent mutations in exonuclease (nsp14); a potential drug target in SARS-CoV-2
Authors: Jha Deepak Kumar , Yashvardhini Niti , Kumar Amit
Published: May 2024

Context:

The rapid outbreak of SARS-CoV-2 has become a significant global health concern, highlighting the dire need for antiviral therapeutic agents. RNA-dependent RNA polymerase (RdRp) of coronavirus plays crucial roles in RNA synthesis, and hence remains the druggable target for the treatment of this disease. The most potent broad-spectrum inhibitors of viral RdRp are members of nucleoside analogs (NAs). However, SARS-CoV-2 proved to be a challenging one for the novel NA drug designing strategy because coronavirus possesses an exonuclease (ExoN) domain that is capable of excising NAs, thus showing resistance to existing antiviral drugs.

Aim:

The objective of our study was to compare the SARS-CoV-2 exonuclease (nsp14) protein sequence of Wuhan-type virus with those of Indian SARS-Cov-2 isolates and to study the effect of multiple mutations on the secondary structure alterations of proteins.

Subjects and Methods:

Multiple-sequence alignment of exonuclease amino-acid sequences followed by phylogenetic analysis and prediction of its secondary structure of the protein was performed.

Results:

Altogether, seven mutations were detected in the nsp14 of Indian SARS-CoV-2 isolates. Subsequently, prediction of their secondary structures revealed that mutations altered the structural stability of exonuclease proteins.

Conclusions:

Present findings, therefore, further suggest that evolvability of SARS-CoV-2 is primarily associated with the onset of multiple novel mutations that rapidly spread at several new locations of the viral genome and also provides important insight to develop specific control strategies to fight against COVID-19 infections.
Revitalising Dentin Surfaces: Unlocking Periodontal Regeneration Potential through Cutting-edge Citric Acid Techniques
Authors: Pujara Meghna J , Gupta Shalini S , Patel Vasumati Ishwarlal , Pujara Jignesh A
Published: May 2024

Introduction:

Teeth affected by periodontitis exhibit an increased mineral content and endotoxins. They do not harmonise with the neighbouring periodontal cells, whose growth is essential for periodontal regeneration. This scanning electron microscope (SEM) study evaluated and compared the in vitro effects of different citric acid application techniques on naturally preserved dentin slabs.

Materials and Methods:

Thirty-two dentinal slabs were prepared for experimentation, with one group undergoing various treatments and a control group left untreated. The citric acid solution, with a pH of 1.0, was meticulously prepared and used in four different application methods on the experimental group. The dentin slabs were prepared for SEM evaluation, which assessed parameters such as exposed dentinal tubules, the surface area occupied by tubule orifices, the demineralised zone’s width and the exposed tubules’ morphological characteristics.

Results:

The data present the mean number of exposed dentinal tubules for different application techniques and the width of the demineralised zone. While the f-test did not show significant differences in the width of the demineralised zone, the number of exposed dentinal tubules varied significantly. Immersion treatment resulted in the highest number of open tubules, followed by cotton pellet placement and brushing.

Conclusions:

The study suggests that in periodontal regenerative procedures, passive citric acid application may be more effective than vigorous methods like burnishing for exposing inter-tubular fibrils and dentinal openings.
Amphotericin B versus Voriconazole in the treatment of fungal keratitis
Authors: Mervat Mourad S. , Ahmad Ahmad H.
Published: May 2024

Purpose

Evaluate the efficiency and safety of Voriconazole compared with Amphotericin B in the treatment of fungal keratitis.

Background

Fungal keratitis in Egypt is considered the second prevalent corneal infection after bacterial keratitis. It is one of the main causes of corneal blindness in Egypt. Many recalcitrant cases are frequently met with. Delay in the diagnosis and management usually leads to complications.

Patients and methods

During the period from July 2016 to October 2019, 106 patients who were clinically diagnosed in one eye as fungal keratitis, followed by culture and histopathological proof were recruited. They were divided into groups A and B. One hundred and six eyes of 106 patients whose age ranged from 10 to 74 years of both sexes were recruited, 53 eyes in each group.

Group A received Amphotericin B while group B received Voriconazole. Adjuvant measures were used in deteriorating progressive cases in the form of cyanoacrylate glue with a high oxygen permeability contact lens in impending perforation, intrastromal Voriconazole injection, and lastly therapeutic penetrating keratoplasty.

Follow-up was done on days 1, 3, 7, then weekly until cure. Size, depth, deep vascularization, presence of satellites, intraocular pressure monitoring, hypopyon, and any complication were recorded. Visual acuity and healing outcome and duration to achieve were also recorded.

Results

In all, 80 cases (39 of group A and 41 of group B) were healed, 21 cases (11 of group A and 10 of group B) progressed and needed adjuvant treatment to heal, five cases (three of group A and two of group B) needed urgent therapeutic penetrating keratoplasty. Voriconazole group showed a shorter time for healing and less complications.

Discussion

Voriconazole was slightly better than Amphotericin B as regards the duration for healing, progression of keratitis, extent of deep vascularization, density of the healed scar, and visual acuity.

Conclusion

Both Amphotericin B and Voriconazole were successful in treating fungal keratitis. Voriconazole showed statistically significant better results.
Metastasis of primary signet ring cell carcinoma of prostate to bone marrow
Authors: Jamal Iffat , Raman Ravi Bhushan , Kumar Satish , Agrawal Rawi , Choudhary Vijayanand N.
Published: May 2024

We report a case of a 65-year-old male who presented with multiple enlarged intraabdominal lymph nodes with lytic lesions over pelvic and lumbar vertebrae. His serum prostate-specific antigen (PSA) was markedly raised. Bone marrow investigation revealed the presence of diffuse infiltration of single cells having hyperchromatic nuclei, moderate amount of eosinophilic cytoplasm, and eccentrically placed nuclei resembling signet ring cells. Hence, a diagnosis of metastatic signet cell carcinoma of prostate was made on bone marrow biopsy. This variant of prostatic carcinoma is very rare and accounts for only 2.5% of all prostatic adenoacarcinomas that make our case worth reporting. To emphasize the rare occurrence of this variant, we performed a Pubmed-based literature review of 25 years.
Bone metastases
Authors: Hui Monalisa , Balu B. , Uppin Shantveer G. , Uppin Megha S. , Chandrasekhar P. , Rao K. Nageshwara , Bhattarcharjee Suchanda , VijayaSaradhi M. , Krishna Y. Vamshi
Published: May 2024

Objective:

To analyze the clinicopathological features of metastatic bone tumors over a period of two decades and identify the primary site of malignancy in metastasis of unknown origin.

Materials and Methods:

A total number of 365 cases were included in the study. The clinical features and location of the tumors were noted. The histopathological features of all the cases were studied. Immunohistochemistry (IHC) was done either to categorize or confirm the primary diagnosis using organ specific/organ restricted markers.

Results:

A total 712 bony sites were involved by metastasis in 365 patients, of which spine was the most commonly affected. Metastasis was the initial presentation in 69.5% patients. The primary site was known in 220 patients and almost half of them were detected after the diagnosis of metastasis. IHC was used as adjunct to suggest the possible origin in cases with unknown primary in 27.4%. Among the metastatic carcinoma, adenocarcinoma was the most common histological subtype with thyroid being the most frequent primary site of origin followed by lung and breast.

Conclusion:

More than two-third of cases in surgical pathology practice present as initial manifestations. Detection rate of primary depends on extent of metastatic work-up and IHC with organ specific/organ restricted markers to facilitate treatment with bone targeting agents.
Diagnostic efficacy of neutrophil to lymphocyte ratio (NLR) in oral potentially malignant disorders and oral cancer
Authors: Singh Shruti , Singh Jaya , Ganguly Roop , Chandra Shaleen , Samadi Fahad M. , Suhail Shaista
Published: May 2024

Background and Aims:

Inflammation is considered to be the seventh hallmark of cancer and plays a pivotal role in all stages of tumor development. Systemic inflammatory responses in particular neutrophil to lymphocyte ratio (NLR) have garnered immense attention of current researchers and its role is well proven in various solid malignancies. Its prognostic role in oral cancer have been extensively studied. However, its diagnostic role is yet to be explored. The current study aims to investigate diagnostic utility of NLR in oral potentially malignant disorders and oral cancer, when compared to normal subjects.

Methods:

A total of 150 subjects were involved in the study, a total of 2.5 ml of blood was drawn from the median cubital vein of the patient in an EDTA vial and hematological parameters were assessed using Erba-Transasia B7256 Autoanalyzer and reassessed manually by two experts.

Statistical Analysis:

The NLR values were recorded and tabulated as Mean ± S.D. and comparisons were analyzed using Kruskal Wallis and Mann Whitney post hoc U test. ROC curve analysis was performed to estimate cut-off values.

Results:

The NLR values when compared between the 3 groups were statistically significant (P < 0.001). The cut off value between disease and normal subject was 2.33, while the cut-off value between potentially malignant and malignant condition is 3.20.

Conclusion:

NLR can be a valuable diagnostic adjunct in oral cancer and potentially malignant disorders of oral cavity.
Intraoral healing type of pyogenic granuloma (A benign vascular tumor)
Authors: Gupta Neetika , Thangarasu Venkatesh , Tihara Palak , ul Nisa Tauqeer
Published: May 2024

Pyogenic granulomas represent tumor-like lesions affecting the skin and the oral cavity. This classic definition can be somewhat misleading because such lesion is not associated with infection and lacks any clinical evidence of pus or histological evidence of actual granulation tissue. This case report describes a surgical excision of the growth to exclude angiomatous proliferation. The patient reported a chief complaint of localized gingival overgrowth since 4 months. Intraoral examination revealed an irregular, sessile exuberant growth in respect to labial aspect and interdental gingiva of 31, 32, and 33, measuring about 1.6 × 1.1 cm. Based on the clinical findings, the case was provisionally diagnosed as “pyogenic granuloma“. A treatment was planned for the patient. A surgical excision was done irt 31, 32, 33, and the tissue was sent for histopathological examination, which was suggestive of a healing type of pyogenic granuloma.
Effect of megaloblastic anemia on hemoglobin A2 and diagnosis of β-thalassemia trait
Authors: Sahoo Sulagna , Sahu Nageswar , Das Palash , Senapati Urmila
Published: May 2024

Context:

β-thalassemia trait is usually diagnosed by raised hemoglobin A2 (HbA2). The presence of megaloblastic anemia can cause an increase in HbA2 and create a diagnostic dilemma. Here, we have analyzed the effect of vitamin B12 and folic acid supplementation on HbA2 and diagnosis of β-thalassemia trait in cases of megaloblastic anemia with raised HbA2.

Materials and Methods:

Cases of megaloblastic anemia with raised HbA2 on high-performance liquid chromatography (HPLC) were supplemented with vitamin B12 and folic acid. Post-treatment evaluation was done after 2 months. Cases showing adequate hematological response were subjected to statistical analysis. Based on post-treatment HbA2 value, the cases were diagnosed as normal, borderline raised HbA2, or β-thalassemia trait. Pre- and post-treatment values of red cell parameters and HbA2 were analyzed.

Results:

There was a significant decrease in HbA2 value after vitamin B12 and folic acid supplementation. The diagnosis was changed in 70.97% of the cases after treatment. The chance of inconclusive diagnosis was decreased from more than 50% to less than 10%. Pre-treatment mean corpuscular volume (MCV) and HbA2% showed a significant difference between the thalassemic and normal groups.

Conclusions:

Megaloblastic anemia can lead to false-positive diagnosis of β-thalassemia trait on HPLC. Repeat HPLC should be done after adequate supplementation of vitamin B12 and folic acid in cases of megaloblastic anemia with raised HbA2. Red cell parameters are not helpful to suspect β-thalassemia trait in presence of megaloblastic anemia. However, HbA2% on HPLC can be a useful parameter to suspect or exclude β-thalassemia trait in cases of megaloblastic anemia.
Diffuse midline glioma-H3K27M mutant. A novel entity with a defining and specific IHC marker
Authors: Agarwal Prachi , Aiyer Hema Malini
Published: May 2024

Diffuse Midline Glioma-H3K27M mutant is a specific entity added to the 2016 updated WHO classification of CNS tumours that represents the majority of diffuse intrinsic pontine gliomas, although identical tumours are also found elsewhere in the midline. They are aggressive tumours with a poor prognosis and considered WHO GRADE IV regardless of histological features.[1,2] Patients with H3K27M–mutant gliomas in unusual anatomical locations have a better prognosis than those with corresponding tumors in the brainstem and this helps in the treatment stratification of diffuse gliomas. Extrapolating from the clinicopathologic features of diffuse pontine gliomas and the poor prognosis seen in pediatric diffuse midline gliomas with H3 K27M mutations, the presence of an H3 K27M mutation in an infiltrating astrocytoma of the midline automatically confers a grade IV status.[2,3] This case emphasizes the need for Immunohistochemistry using a mutation-specific H3K27M antibody in all cases of midline gliomas.
Isolated CNS relapse in FLT 3 mutation positive CMML post allogeneic stem cell transplant
Authors: Mutreja Deepti , Verma Shipra , Venkatesan S. , Sharma Sanjeevan , Das Satyaranjan
Published: May 2024

Chronic myelomonocytic leukemia is a clonal chronic hematopoietic disorder that has been classified under the category of Myelodysplastic syndrome/Myeloproliferative neoplasms (MDS/MPN). CMML has high chances of transforming to acute leukemia, however isolated CNS relapse in CMML has never been reported in literature. We report an extremely rare case of a 47 yearold female diagnosed to have CMML- 2 in remission, who developed an isolated central nervous system relapse after matched related allogeneic hematopoietic stem cell transplantation. To our knowledge this is the first report of isolated CNS relapse in CMML post allogeneic stem cell transplant.
Metastatic hobnail variant of papillary thyroid carcinoma
Authors: Mohapatra Debahuti , Naik Sujata , Das Prateek , Agrawala Sunil
Published: May 2024

Hobnail variant of papillary thyroid carcinoma (HV-PTC) is an unusual entity recently included in WHO classification of endocrine tumors (2017) and proposed as an aggressive variant of PTC. Compared to patients of classical counterparts, HV-PTC frequently has extrathyroidal extension, exhibits nodal or distant metastasis, and responds poorly to radioiodine treatment, leading to increased mortality. We hereby describe the cytohistological and immunohistochemical features of a metastatic HV-PTC in 55-year-old male, previously diagnosed as poorly differentiated papillary thyroid carcinoma in thyroidectomy specimen. Five years after total thyroidectomy with radical neck dissection the patient presented with gross pleural effusion showing multiple lung parenchymal and pleural based lesions with complete collapse of lung on computed tomography scan. The conventional cytology of pleural fluid showed dyscohesive cells arranged in micropapillary form gave the suggestion of metastatic papillary carcinoma. But the cell block preparation highlighted >30% hobnail cells arranged in micropapillary pattern showing increased atypical mitosis and occasional pseudoinclusions. Supplemented with immunohistochemistry (CK19, TTF-1, and p53), final diagnosis HV-PTC was made.
Metastatic low-grade myoepithelial carcinoma of lung managed with low-dose external beam radiotherapy
Authors: Pasricha Sunil , Bansal Divya , Batra Ullas , Durga Garima , Kamboj Meenakshi , Gupta Gurudutt , Sharma Anila , Pahuja Anjali , Jajodia Ankush , Jain Vaibhav , Gupta Manoj , B. Koyyala Venkata P. , Mehta Anurag
Published: May 2024

Myoepithelial tumor of lung is a rare tumor; the histopathological findings resemble the myoepithelial tumors of the salivary gland. Distinguishing low-grade nonmetastatic myoepithelial carcinoma from benign myoepithelioma can be challenging both radiologically and histomorphologically. We present a case report of a low-grade myoepithelial carcinoma of lung with contralateral lung metastasis which was treated with low-dose external beam radiotherapy
NRAS mutant melanoma arising in a giant congenital melanocytic nevus in an infant
Authors: Bansal Neha , Das Mou , Chatterjee Uttara , Mallick Mamata Guha , Arora Neeraj , Mishra Deepak K.
Published: May 2024

Pediatric melanomas are uncommon and sometimes arise in the background of giant congenital melanocytic nevus (GCMN). A 1-year-old girl was born with GCMN affecting her left half of the face and smaller nodules affecting trunk, hands, and feet. She developed an ulcerated lesion on the left temporoparietal scalp. The lesion showed features of GCMN along with large nests of a tumor composed of round cells with a vesicular nucleus, prominent nucleolus, plentiful mitoses, and areas of necrosis. Immunostaining for desmin, LCA, CD 20, CD 34, CD 99, BCL-2, and FLI1 was negative. Tumor cells showed immunopositivity for S-100 and HMB-45 confirming the diagnosis of melanoma. Immunostaining for BRAF V600E was negative; however, NRASmutation was detected on next-generation sequencing. Unlike adult melanomas BRAFmutations are rare but NRASmutations have been reported in pediatric melanomas. Adjunctive molecular testing will be important to understand the genetic basis of this disease and future targeted therapy.
Detection and evaluation of the presence of the BRAF V600E mutation in ameloblastomas in an Indian population
Authors: Goes Cassandra F. , Spadigam Anita , Dhupar Anita , Carvalho Karla M. , Cota Jochima , Syed Shaheen
Published: May 2024

Introduction:

Ameloblastoma is a benign epithelial odontogenic neoplasm that constitutes approximately 1% of all oral tumors and about 9 to 11% of all odontogenic tumors. They are slow-growing, locally invasive, and demonstrate a potential for metastasis and malignant transformation. The molecular pathogenesis of ameloblastoma is attributed to aberrant activity of the signal transduction pathways relating to developmental stages of odontogenesis including the mitogen-activated protein kinase (MAPK) pathway. The BRAF V600E mutation was identified as the most frequently mutated gene in this neoplasm. Studies have shown that use of BRAF inhibitors in patients diagnosed with ameloblastomas led to a significant reduction in tumor volume.

Aims:

To detect the expression of BRAF V600E mutation in ameloblastomas in an Indian population using immunohistochemistry. To compare the difference in the occurrence of the BRAF V600E mutation between mandibular and maxillary cases.

Materials and Methods:

Thirty-three formalin-fixed paraffin-embedded tissues of histopathologically proven cases of ameloblastoma were assessed for the BRAF V600E mutation by immunohistochemistry using the BRAF V600E monoclonal antibody. Patient data such as age, sex, anatomical site, recurrence were documented.

Statistical Analysis:

The statistical analysis was performed using the Pearson Chi-square test and Student's t-test.

Results:

The present study revealed a high expression of the BRAFV600E mutation in mandibular cases of ameloblastoma among Indians irrespective of the age, sex, site, recurrence or histological pattern.

Conclusions:

The identification of this driver mutation opens the possibility of an adjuvant therapeutic modality to reduce the significant facial disfigurement and morbidity following surgical management.
A case of eccrine porocarcinoma
Authors: Das Diya , Datta Chhanda , Chatterjee Uttara , De Abhishek
Published: May 2024

Eccrine porocarcinoma is a rare malignant dermal appendageal tumor notorious for its varied morphology, both clinically and histologically; and it can pose a considerable diagnostic dilemma to both the dermatologist and the pathologist. Herein, we present a case of a 74-year-old woman with slow-growing nodular masses on both buttocks, reaching a fairly large size over a course of 3 years. Although atypical morphologic features posed significant diagnostic difficulty to both the surgeon and the pathologists, it was eventually diagnosed as eccrine porocarcinoma with focal squamoid features, using immunostains. To our knowledge, this is the second reported case of bilateral eccrine porocarcinoma which highlights the need for awareness of the morphological variations that this entity is capable of producing.
Pituicytoma
Authors: Mishra Shashank , Guleria Prerna
Published: May 2024

Pituicytoma is a distinct sellar or supracellar tumor which originates from specialized glial cells of neurohypophyses and infundibulum known as pituicytes. Because of its sellar location patients present with headache, visual disturbance, and endocrine abnormalities. Pituicytoma is difficult to diagnose on neuroimaging as radiological features overlap with other more common tumors of this region. Thus, diagnosis is established by histopathology and immunohistochemistry of resected tumor only. Pituicytomas are composed of bipolar spindle cells arranged as fascicles and are immunoreactive for TTF-1, S100p, and vimentin. These tumors are extremely rare and only around 70 published cases are known in literature. We report a case of suprasellar SOL in a 58-year-old male who presented with headache and gradual visual deterioration in both eyes. He was diagnosed as a case of pituicytoma based on light microscopy findings and immunohistochemical expression of TTF-1, vimentin, S100p, and bcl-2.
Acute graft-versus-host-disease in acute myeloid leukemia
Authors: Sharma Praveen , Jandial Aditya , Keisham Amarjit , Rohilla Manish , Varma Neelam , Malhotra Pankaj , Radotra Bishan
Published: May 2024

We present a case of acute myeloid leukemia developing acute graft-versus-host-disease (GVHD) in the post transplant phase. The patient had GVHD of skin, liver and gastro-intestinal tract (resolved) with polymicrobial sepsis. The clinical course, treatment and pathological findings on autopsy including the cause of death have been discussed.
Concomittant occurence of well-differentiated thyroid carcinoma metastasis and chronic lymphocytic leukemia in the same lymph node along with internal jugular vein thrombus
Authors: Sezer Havva , Yazıcı Dilek , Tezelman Serdar , Demirkol Mehmet O. , Ünal Ömer F. , Dilege Şükrü , Taşkın Orhun Ç , Peker Önder , Kapran Yersu , Çolakoğlu Bülent , Aygün Murat S. , Ferhanoğlu Burhan , Alagöl Faruk
Published: May 2024

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is the most common adult leukemia. The coexistence of CLL and papillary thyroid carcinoma (PTC) is extremely rare. PTC sometimes shows microscopic vascular invasion but rarely cause a tumor thrombus in the internal jugular vein (IJV). It is also rare to find both differentiated and poorly differentiated types of thyroid cancer in the same metastatic location. We report a case of 63-year-old Turkish man with history of CLL who had CLL/SLL involvement and PTC metastasis in the same lymph node. Additionally, there was macroscopic metastasis to the IJV with poorly differentiated areas in the removed tumor thrombus. Patient was treated with total thyroidectomy, left radical neck dissection, resection of the left IJV segment that contained the tumor thrombus and radioactive iodine (RAI) therapy. Furthermore, metastatic lesions were found in the brain, lung and bone. Radiotherapy and chemotherapy were performed. However, our patient died approximately 12 months after thyroidectomy. To our knowledge, our present report is the first description with its current features.
Utility of orcein stain and comparison with Masson trichrome stain in chronic intestinal pseudo-obstruction
Authors: Ayyanar Pavithra , Mitra Suvradeep
Published: May 2024

Chronic intestinal pseudo-obstruction (CIPO) is caused by a plethora of primary and secondary causes, dominantly involving the neuromuscular tissue, interstitial cells of Cajal, or the connective tissue framework. The lack of the connective tissue framework, known as desmosis, is evaluated by Masson's trichrome (MT) or picrosirius red stains, both of which are recommended in the London classification. We evaluated the orcein stain in detecting desmosis in comparison to the MT stain. We performed both orcein and MT stains in six previously published cases of complete or partial desmosis along with six age-matched controls. Our results showed comparable results of the orcein stain as compared to the MT stain. Additional advantages of lower cost and a clearer background in orcein stain were noteworthy, whereas MT stain can be used for the detection of additional pathology. We believe that orcein stain can be used as a cheap alternative in resource-limited settings.
Hyperinfection with Strongyloides stercoralis presenting as acute abdomen in a patient on corticosteroid therapy
Authors: Singh K. , Ganorkar S. , Bhalekar S. , Rao R.
Published: May 2024

Infection with Strongyloides stercoralis, a human pathogenic roundworm, is common in tropical countries like India. Owing to its variable clinical presentation and irregular larval output in stool, it often remains neglected and underdiagnosed. Signs and symptoms are largely dependent on the immune status of the infected individual. Alteration in the host immunity due to chronic use of steroids can surge the number of parasites and cause hyperinfection syndrome. This can be catastrophic with a fatal outcome. Focus on early detection and treatment of the parasite in at-risk patients is imperative to reduce mortality. We summarize here an interesting case of hyper infection syndrome of strongyloidiasis with gangrenous bowel changes later progressing to burst abdomen.
MCM3 proliferative index is worthier over Ki-67 in the characterization of salivary gland tumors
Authors: Raja Ritika , Shetty Devi Charan , Chandrakanta  , Juneja Saurabh , Tandon Ankita , Gulati Nikita
Published: May 2024

Background:

Salivary gland tumors bear uncanny characteristics of being different based on their morphological aspects rather than the presence of clear demarcation. This ambiguity in the spectrum from benign to malignant salivary gland neoplasms while categorizing the neoplasm is having inherent pitfalls. The present study was, therefore, designed to characterize benign and malignant salivary gland tumors based on their proliferative indices.

Materials and Method:

Study samples comprised of 97 cases of histopathologically confirmed benign and malignant salivary gland tumors. The cases were immunohistochemically assessed for MCM3 and Ki-67 expressions and the molecular characterization was performed based on the findings.

Results:

The majority of benign and malignant salivary gland tumors were from the parotid gland, (51.2%) and (42.4%), respectively. Overall mean labeling index of MCM3 was higher i.e., (5.60 ± 3.99) in comparison to Ki-67 i.e., (2.82 ± 3.14) with P = 0.05 using paired t-test. Besides, malignant salivary gland neoplasms represented a higher mean score of MCM3 and Ki-67 than benign neoplasms.

Conclusion:

The requirement of a novel marker has led to the use of MCM3 which has a characteristic role in the entire spectrum of the cell cycle. The present study highlighted the extrapolation of MCM3 over Ki-67 for diagnosis and for true characterization of biologic behavior of salivary gland pathologies which may, in turn, influence the treatment modality employed for such lesions.
MiR-216b inhibits gastric cancer proliferation and migration by targeting PARK7
Authors: Zhu Guo-Min , Chen Shao-Qin , Jiang Qun-Guang , Cao Yi , Guo Yi , Ye Li-Qin
Published: May 2024

Objective:

Postoperative recurrence and metastasis of gastric cancer is still a difficult problem in medical field. About 60% of patients with advanced gastric cancer die from peritoneal metastasis, which has become one of the main causes of death of gastric cancer patients. To elucidate the molecular mechanism of peritoneal metastasis of gastric cancer can help us better early diagnosis and improve treatment measures.

Methods:

This project intends to validate the above hypothesis from three different levels of tissue, cell, and animal models by means of fluorescence quantitative PCR, Western blot, double Luciferase Report Analysis and immunohistochemical detection, and to further explore the molecular mechanism of peritoneal metastasis of gastric cancer.

Results:

Our previous studies have shown that PARK7 promotes peritoneal metastasis of gastric cancer through PI3K/Akt signaling pathway, but its specific regulatory mechanism remains unclear.

Conclusion:

Our preliminary study showed that the expression of microRNA-216b in gastric cancer tissues with peritoneal metastasis was significantly lower than that in patients without peritoneal metastasis, while the expression of PARK7 was the opposite.