bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Obstructive Sleep Disorder Treatment on Posttraumatic Stress Disorder Symptoms: A Literature Review
Authors: Carpenter Jennifer W.
Published: October 2024

Purpose

To explore whether continuous positive airway pressure (CPAP) adherence among adult patients with obstructive sleep apnea (OSA) and posttraumatic stress disorder (PTSD) affects the PTSD Checklist (PCL), a validated tool that measures severity of PTSD symptoms.

Method

Studies focusing on PTSD and OSA were searched in PubMed and CINAHL databases. Inclusion and exclusion criteria were applied, decreasing the article yield to nine. All articles chosen focused on the adult population and were conducted in North America.

Results

The literature review yielded eight observational cohort studies and one descriptive study. Seven studies were conducted with Veterans and all studies used the PCL tool. Three themes were identified: (a)
Trauma and OSA
, (b)
OSA and PTSD Symptoms
, and (c)
CPAP Therapy and PTSD Symptoms
. An area of further study is assessing how CPAP adherence might affect improvement in PTSD symptoms and how adherence can be improved.

Conclusion

OSA is correlated with more severe PTSD symptoms, but CPAP use is associated with improvement in PTSD symptoms. The literature reviewed found PCL scores improved up to 10 points within 3 months of CPAP use. These findings highlight the importance of collaboration between mental health and sleep medicine professionals and opportunity for further study in this area. [
Journal of Psychosocial Nursing and Mental Health Services, 63
(2), 17–24.]
La maurofilia en la obra de don Juan Manuel
Authors: Zaderenko Irene
Published: October 2024

En este estudio analizo dos obras de don Juan Manuel que pueden ser consideradas como textos enmarcados en la doctrina cristiana. Sin embargo, su representación del mundo islámico plantea una serie de interrogantes largamente debatidos por la crítica. En mi opinión, la maurofilia (la visión positiva de los personajes musulmanes y su cultura) se pone de manifiesto en diversos aspectos de su obra. Para demostrarlo, examino la representación de los moros en El conde Lucanor y el Libro de los estados, así como en otras obras de la literatura medieval, con el fin de explorar su visión del mundo islámico en el contexto de la extendida presencia musulmana en la península ibérica.
La abertura /e/ > /a/ condicionada por /r/ y /l/ en judeoespañol
Authors: Arias Álvaro
Published: October 2024

Analizamos la abertura de /e/ átona y tónica en /a/ condicionada por /r/ y /l/ en judeoespañol (parsona, ṿualta). Para ello, delimitamos previamente la casuística para así descartar aparentes ejemplos de abertura, tanto en lo que se refiere al léxico románico, como al turco. Nos es posible, entonces, precisar los contextos que provocan la abertura, así como la geografía del fenómeno. También profundizamos en el uso de la abertura, ya que entra en variación con la solución conservadora (puerta ~ puarta), y concluimos con una visión de conjunto del fenómeno según el contexto fonológico y el área geográfica.
“La madre nunca se olvida” Antonio Batres Jáuregui (1847-1929) y la unidad de la lengua española
Authors: Medina López Javier
Published: October 2024

“La madre nunca se olvida”, perteneciente a El castellano en América, de Antonio Batres Jáuregui, simboliza el tipo de corrección idiomática en el siglo XIX que propugnaban él y otros intelectuales de la época respecto al modelo de español que debía adoptarse en las nuevas repúblicas independientes americanas. En este artículo se analizan dos de sus aportaciones más importantes: Vicios del lenguaje y provincialismos de Guatemala. Estudio filológico (1892) y El castellano en América (1904). La continuidad de los vínculos con España se defiende en ambas obras, frente a otras corrientes rupturistas de la época.
Managing With the “Diverse”
Authors: Caccialanza Andrea , Barabaschi Barbara
Published: October 2024

This study explores the mechanisms involved in integrating and balancing individual and organizational interests, focusing on how to manage diversity, particularly the ‘diverse'. This chapter traces the elements that define and characterize the “diverse” and the organizational diversity. In particular, this chapter aims to analyze the potential of gaming as an innovative approach not only for greater integration of the diverse in organizations, but also to assess its perspective of integrating this goal in a context of promoting sustainability in the corporate environment. This discussion will then be articulated to the examination of the relationships between gaming and the promotion of the SDG agenda, gaming and the education for an effective communication, gaming to sensitize toward inequalities and disability on the job. Finally, conclusions and research agenda are proposed.
Bridging the Gap
Authors: Dash Atish Kumar , Shivananda Shashank , Singh Raghvendra , Gupta Manish
Published: October 2024

The Critical Security Controls (CIS) and National Institute of Standards and Technology Cybersecurity Framework are both important for increasing organizational cybersecurity, with each catering to certain demands and implementation approaches. The CIS Controls, which were initially announced in 2008, are organized into Implementation Groups and provide a prioritized approach suitable for companies with varying levels of cybersecurity maturity. Also, the NIST Cybersecurity Framework was established in 2014 and employs a risk-based framework focusing on six essential function. This framework includes technology like risk assessment tools, continuous monitoring systems, and incident response platforms. While the CIS Controls give specific, practical actions for immediate adoption, the NIST Framework focuses on overall risk management and compliance with larger regulatory requirements, providing a holistic, customized approach for improving cybersecurity resilience.
Safeguarding Financial Integrity Utilizing Sarbanes-Oxley for IT Audits in Modern Corporations
Authors: Anjali  , Singh Raghvendra , Shetty Pranith
Published: October 2024

This study digs into the critical intersection between the Sarbanes-Oxley Act (SOX) and corporate audits of information technology (IT). SOX, which was initially intended to improve financial transparency, has had a significant impact on IT controls, data security, and reporting accuracy. The study delves into SOX regulations, particularly Section 404, as they apply to IT, necessitating strong internal controls, data integrity, and secure record-keeping processes. This chapter highlights the strategic application of SOX for comprehensive IT audits using real-world case studies and practical insights. It emphasizes the interdependence of financial and IT controls, highlighting how SOX serves as a foundation for maintaining the integrity of electronic data and safeguarding enterprises' economic well-being.
Risk Management Framework for Cloud Migration and Selection of Suitable Cloud Service Provider
Authors: Singh Mansi Mahesh Kumar , Chandna Mansha , Kongala Venkata Yashwanth Yadav
Published: October 2024

Businesses frequently manage the complicated challenge of transitioning from on-premises systems to the cloud in the evolving world of technology. An integrated risk framework is critical for analyzing and auditing this transformation, ensuring a smooth transfer while limiting potential risks. This methodology provides proactive risk management by predicting issues such as compliance gaps, and service outages. In addition, this framework includes a thorough selection procedure for the best cloud service providers (CSPs). Organizations may find the best partner for their specific needs by examining criteria like security standards, compliance adherence, scalability, and data governance. This complete strategy not only reduces possible interruptions during migration but also fortifies the company against unanticipated obstacles, promoting a safe and efficient cloud environment, and educated decision making. As the technology landscape is changing exponentially, it is important to integrate risk framework as a strategic compass in intricacy of migration to reinforce digital infrastructure.
The Effect of Tariffs on EU Imports of Goods From the USA
Authors: Özaytürk Ibrahim
Published: October 2024

Since boundaries between nations have been quickly disappearing in the twenty-first century, the effect of customs taxes on the imports of goods by nations has been a topic of much discussion.The practice that defines countries that are not within the European continent and are not members of the union as third countries, necessitates the collection of customs duties from countries.The European Union (EU) includes the United States of America (USA) in the third country class, like other non-union countries.For this reason, in bilateral trade between the USA and the EU, customs tariffs applied by the EU on product exports from the USA to the EU.This study uses time series analysis and the Zivot-Andrew(1992) structural break unit root test using data from 1997 to 2023 to examine the effect of customs taxes on EU goods imports from the USA. ARDL limit test chosen as the method.The study-produced results are validated by the literature.Examining both the short- and long-term relationship between the EU and the USA, the findings show that over time,the EU imports fewer goods from the USA.
Regionalism vs. Bilateralism
Authors: Pluda Carolina , Aramendia-Muneta Maria Elena
Published: October 2024

This chapter analyzes the role of regionalism versus bilateral trade relationships in the context of international trade disruptions caused by the COVID-19 pandemic. The export and import flows of 11 advanced and 12 emerging economies are examined and compared to identify their primary economic interests, whether linked to regional trade blocs or bilateral partnerships, with or without formal trade agreements (preferential and non-preferential). The findings indicate that advanced economies trade similarly within their blocs and partnerships, regardless of tariff preferences, while emerging economies prioritize half of their trade through non-preferential bilateral partnerships. The trade patterns reveal strong convergence among developed economies and a latent alignment with emerging economies, which also display a uniform trade distribution.
Self-Talk, Grit, and Learning Efforts of Working Adults
Authors: Chheda Shreya Pankaj , Anthony Madalaimuthu
Published: October 2024

Based on the warranted need for effective strategies to navigate the current dynamic business environment, self-talk and grit can be useful tools. The author examined the differences in self-talk frequency and grit levels in individuals across genders, age groups, education levels, employment status, current roles, and additional learning efforts. Data was collected from 576 individuals using surveys and hypotheses were analyzed using Spearman's Rho, Mann-Whitney U-test, and Kruskal Wallis. Findings revealed that working adults who engaged in learning efforts had higher self-talk frequency and perseverance (grit dimension), of which the latter variables showed a strong positive correlation. Results are useful to learning and development specialists to utilize self-talk as a tool to garner better performance, training, and well-being outcomes. It identifies the unexplored relationship between self-talk and grit in working adults in the Indian population.
Assessment of the Influence of Features of Crack Formation in Reinforced Concrete Products on their Fire Resistance
Authors: Vasilchenko Alexey , Danilin Olexandr , Darmofal Eleonora , Lutsenko Tatiana
Published: October 2024

The paper considers possible scenarios of cracking during heating and their impact on fire resistance using the example of a bending reinforced concrete structure (beam). It is shown that if the calculated critical temperature of reinforcement is less than the critical temperature of concrete (this indicates a significant load on the structure), then cracks in the tensile zone of concrete are formed after reaching the second stage of the stress-strain state. The concrete of the protective layer does not have time to degrade, the depth of the crack remains constant, and the fire resistance limit is calculated taking into account that the thickness of the protective layer of concrete is reduced by the depth of the crack opening. If the calculated critical temperature of the reinforcement is greater than the critical temperature of the concrete (this indicates a slight load on the structure), then cracks are formed as a result of the degradation of the surface layer of concrete. Their depth should constantly increase with the progression of the concrete layer heating to the critical temperature. In this case, the calculation of the fire resistance limit can be performed without taking into account the formation of cracks. Based on the considered assumptions, a methodology for assessing the impact of cracks on the fire resistance limit of bending reinforced concrete structures is proposed, which consists in analyzing the possibility of open cracks (which is facilitated by heating) and estimating their depth. At the next stage, the heating time of the concrete layer to the crack opening depth τΔ1 and the temperature in the crack after this time are estimated. Next, the time until the critical temperature of the reinforcement τΔ2 is estimated when the concrete layer is heated from the bottom of the crack to the reinforcement. The fire resistance limit is defined as the sum of τΔ1 and τΔ2. The results of the calculations according to the proposed methodology showed that the presence of open cracks in bending reinforced concrete structures can almost halve the fire resistance limit.
Synthesis and Luminescent Properties of TiO2 Materials Single and Triple Doped with Rare Earth Ions (Sm3+ , Tb 3+ and Eu 3+)
Authors: Liu Wen Hui , Zhang Jia Rui , Naren Gerile , Bohnuud Aorigele
Published: October 2024

Four types of titanium dioxide (TiO2) materials doped with a single kind of rare earth ions Ln3+ (Eu3+, Tb3+, or Sm3+) and three rare earth ions (Eu3+, Tb3+, and Sm3+) were synthesized by the sol-gel method. The compositions, structures, and photophysical properties of these compounds were tested. The structure of the rare earth ion-doped TiO2 samples was characterized by X-ray powder diffraction (XRD) and Fourier-transform infrared spectroscopy (FT-IR). Optical absorption and fluorescence information was obtained using UV-Vis spectroscopy and fluorescence spectroscopy. The surface morphology of rare earth ion-doped TiO2 materials was observed using scanning electron microscopy (SEM). To further explore the photoluminescent properties of rare earth-doped TiO2 materials for practical applications, small-scale LED light-emitting devices were fabricated.
Method for Detecting Fire Indoors Based on Differences in Sample Averages of an Arbitrary Gas Environment Dangerous Parameter at Adjacent Observation Intervals
Authors: Pospelov Boris , Rybka Evgeniy , Mykhailovska Yuliia , Bezuhla Yuliia , Melnychenko Andriy
Published: October 2024

The object of the research is the series average of the dangerous parameters of the gas environment during the ignition of materials. The practical importance consists of using the difference between the average dangerous parameters of the gas environment on the intervals of absence and the presence of ignition to detect the ignition of materials. The theoretical substantiation of the method of detecting fires in premises is carried out based on sample averages fixed samples of current measurements of an arbitrary, dangerous parameter of the gas environment, which correspond to the general population of reliable absence and presence of fire. At a given significance level, the method determines the unbiased, uniformly most powerful fire detection rule. This allows you to determine how significant differences in sample means with a given significance level are due to ignition or are random. Laboratory experiments were conducted to verify the method of detecting the ignition of test materials. It was established, for example, that the maximum size of the effect ignition on the carbon monoxide concentration is typical for alcohol (exceeds the threshold by 8.9 times) and textiles (exceeds the threshold by 9.3 times). The size of the effect of the smoke density upon ignition of all materials is approximately the same and is determined by exceeding the corresponding thresholds from 4.62 to 3.9 times. The size of the effect on the temperature of the gaseous environment during ignition of all test materials is approximately the same order. It is characterized by exceeding the corresponding thresholds from 5.95 to 3.58 times. It is shown that the method of detecting fires allows to establish the extent to which the detected differences in sample means for samples from the general population of hazardous parameters of the gas environment are reliable with a given level of significance and are due to the ignition of materials or the action of random factors.
In Vivo CRISPR Screening Reveals CHD7 as a Positive Regulator of Short-lived Effector Cells
Authors: LaFleur Martin W , D’Andrea Jasmin M , Patterson Dillon G , Streeter Ivy S L , Coxe Matthew A , Osborn Jossef F , Milling Lauren E , Tjokrosurjo Qin , Gillis Jacob E , Nguyen Thao H , Schwartz Marc A , Hacohen Nir , Doench John G , Sharpe Arlene H
Published: October 2024

CD8+ T cells differentiate into two subpopulations in response to acute viral infection: memory precursor effector cells (MPECs) and short-lived effector cells (SLECs). MPECs and SLECs are epigenetically distinct; however, the epigenetic regulators required for formation of these subpopulations are mostly unknown. In this study, we performed an in vivo CRISPR screen in murine naive CD8+ T cells to identify the epigenetic regulators required for MPEC and SLEC formation, using the acute lymphocytic choriomeningitis virus Armstrong infection model. We identified the ATP-dependent chromatin remodeler CHD7 (chromodomain-helicase DNA-binding protein 7) as a positive regulator of SLEC formation, as knockout (KO) of Chd7 reduced SLECs numerically. In contrast, KO of Chd7 increased the formation of central memory T cells following pathogen clearance yet attenuated memory cell expansion following a rechallenge. These findings establish CHD7 as a novel positive regulator of SLEC and a negative regulator of central memory T cell formation.
IL-17: A Critical Cytokine for Defense against Oral Candidiasis
Authors: dos Santos Dias Lucas , Lionakis Michail S
Published: October 2024

This Pillars of Immunology article is a commentary on “Th17 cells and IL-17 receptor signaling are essential for mucosal host defense against oral candidiasis,” a pivotal article written by H. R. Conti, F. Shen, N. Nayyar, E. Stocum, J. N. Sun, M. J. Lindemann, A. W. Ho, J. H. Hai, J. J . Yu, J. W. Jung, S. G. Filler, P. Masso-Welch, M. Edgerton, and S. L. Gaffen, and published in The Journal of Experimental Medicine in 2009. https://doi.org/10.1084/jem.20081463.
Retrospective review: Factors impacting length of stay in Bipolar Disorder at a tertiary hospital
Authors: Mkhwebane Nomsa C. , Friedlander Wendy
Published: October 2024

Background: Bipolar disorder (BD) is a chronic, disabling mental illness that may require recurrent hospitalisation. The length of hospital stay (LOS) for BD patients is variable, and literature suggests that this is because of clinical and socio-demographic factors.Aim: To determine the average LOS for patients admitted for BD at a hospital and its relation to clinical and socio-demographic factors.Setting: A public tertiary hospital in South Africa.Methods: Clinical and socio-demographic data were obtained from a retrospective record review of patient admissions at a hospital over 1 year. Length of hospital stay, defined as the duration between admission and discharge date, and other variables were retrieved.Results: A total of 215 patients were admitted during the study period. The mean LOS was 30 days. The mean age of the patients was 35.9 years (standard deviation [s.d.] = 12.4, range 18–72 years). There were similar numbers of males and females admitted. Significantly more patients were not married (p  0.001), unemployed (p  0.001), and had a history of substance use (p  0.001). Employed patients were 2.5 times more likely to have a short stay than those unemployed (p = 0.03). There was a statistically significant association between the number of comorbidities and LOS.Conclusion: The study findings align with the literature’s results. The median length of stay was 25 days and was impacted by socio-demographic but not clinical factors.Contribution: The study provided insight into the impact of variable factors in LOS for BD patients.
Comparison of Low-dose Diluted Hyperbaric Bupivacaine and Standard Hyperbaric Bupivacaine in Subarachnoid Block for Ambulatory Endovenous Laser Ablation of Varicose Vein: A Randomized Controlled Trial
Authors: Iyyankutty Ani Mol , Chitra S.
Published: October 2024

Background:

Low-dose spinal anesthesia represents a highly coveted anesthetic technique for patients undergoing endovenous laser ablation of varicose veins in a day-care setting, given its prompt onset, reliable anesthesia, brief turnover time, and cost-effectiveness. Given that intense motor block is not required for this procedure, this trial compared the efficacy of low-dose diluted hyperbaric bupivacaine with standard hyperbaric bupivacaine in the subarachnoid block for endovenous laser ablation of varicose veins.

Methodology:

A prospective, randomized controlled trial at a tertiary care hospital, Tamil Nadu, South India. Sixty individuals with varicose veins requiring endovenous laser ablation surgery were split at random into two groups. Group A (n = 30) got 0.5% hyperbaric bupivacaine 10 mg (2 ml), Group B (n = 30) got diluted hyperbaric bupivacaine 5 mg (1 ml of 0.5% hyperbaric bupivacaine diluted with an equivalent volume of normal saline) intrathecally. This study evaluated the time to surgical readiness, peak sensory block level, motor block grade, sensory block level at the completion of surgery, duration of motor and sensory blocks, and timing of discharge.

Results:

The median peak sensory block level for Group A was T6 (T8–T6), whereas for Group B it was T8 (T10–T6), with a P = 0.03. At the conclusion of surgery, the median sensory block level was T6 (T6–T8) for Group A and T8 (T7–T10) for Group B. No patients in either group needed a rescue analgesic. The average timing of discharge for Group B was shorter (P = 0.00002).

Conclusion:

For patients receiving endovenous laser ablation therapy for varicose veins, subarachnoid blockade with low-dose diluted hyperbaric bupivacaine (5 mg) offers an effective anesthesia, the best recovery profile, and early hospital discharge.
Factors influencing radiation induced oral mucositis in head and neck cancer
Authors: Goel Gaurav , Alice K Pamela , Negi Preety , Aggarwal Navita
Published: October 2024

Introduction:

Radiotherapy alone or in combination with chemotherapy is an effective and standard treatment of head and neck carcinoma. Oral mucositis is an unavoidable consequence of chemoradiation which is seen in almost all the patients. This painful condition leads to deterioration of the quality of life and thus interferes with the overall outcome of cancer therapy. As no study has been conducted in an Indian context, we conducted this study for better identification of factors influencing the occurrence and severity of oral mucositis in this patient population.

Objectives:

Evaluation of the factors influencing the occurrence, severity, and resolution of radiation induced oral mucositis (RIOM) in patients with head and neck cancer. The relationship between RIOM and treatment volume (TV) and mean dose to oral mucosa were also explored.

Methods:

This prospective study was conducted in patients with a histopathological diagnosis of head and neck carcinoma treated with radiation and chemoradiation. The patient, tumor, and treatment-related factors influencing RIOM were evaluated.

Results:

Univariate logistic regression analysis of correlated factors with acute radiation oral mucositis revealed TV in phase one (up to 40 Gy) having P value of 0.029 with odds ratio of 1.008. Spearman rank correlation coefficient demonstrated significant positive correlation between oral mucosa dose and TV in all three phases of radiation.

Conclusion:

Our study concluded that the most important factor influencing RIOM is TV during phase one of radiation. We found positive correlation between TV and oral mucosa dose through all the phases of radiation treatment.
Pattern of care and clinical outcome of patients with carcinoma endometrium and the impact of central histopathological review on management: A tertiary cancer centre experience
Authors: Verma Rakhi , Gandhi Ajeet K. , Rastogi Madhup , Mishra Vachaspati K. , Sharma Vikas , Agarwal Akash , Shukla Saumya , Khurana Rohini , Hadi Rahat , Srivastava Anoop K. , Husain Nuzhat
Published: October 2024

Purpose/Objective:

Endometrial carcinoma (EC) is the third most common gynecological malignancy in India. Recent PORTEC-3 analysis emphasized the role of central histopathological review. We aimed to retrospectively analyze the demographic and histopathological characteristics of EC patients treated at our institute and assess the impact of the central histopathological review on management and also analyze clinical outcomes in this cohort of patients.

Materials and Methods:

Data of 75 EC patients treated at our center between 2013 and 2022 were retrieved from our departmental archives. Patients were analyzed for demographic details, histopathological findings, details of surgery and histopathology (HPE), results of a review of HPE, adjuvant treatment details, and clinical outcomes. All patients with HPE outside of our institute were reviewed at our center prior to initiation of treatment. In cases of discordance, patients were discussed in the multidisciplinary tumor board for the final treatment decisions. Patients were staged as per International Federation of Gynaecology and Obstetrics 2018.

Result:

The median age was 57 years (range: 37-74 years). Twenty-seven patients with HPE reported from the outside center were reviewed at our institute and changes were observed in 26 patients (96.3%). HPE review changes were observed in terms of histological grade, histological type, myometrial invasion, and lymph node involvement in five (18.5%), three (11.1%), seven (25.9%), and three (42.8%), respectively. HPE review leads to changes in the management of 19/26 patients. Stage distribution was I: II: III in 48 (64%): 9 (13.3%): 18 (24%) patients, respectively. The median external beam radiotherapy dose was 50 Gray (range: 45-50.4 Gray at 1.8-2 Gray per fraction). The median brachytherapy dose for patients treated with brachytherapy alone was 7 Gray each for three sessions and in combination with EBRT was 6 Gray each in two sessions. At a median follow-up of 51 months (range: 6-116 months), seven (9.3%) patients developed distant metastasis, two (2.7%) patients had local plus distant metastasis, and two (2.7%) patients had local recurrence. The overall survival and disease-free survival rates at 3 years were 93.5% and 86.7%, respectively.

Conclusion:

EC patients treated at our center have excellent local control rates with a combination of external beam radiotherapy and brachytherapy. The central histopathological review may result in changes impacting patient management and should be routinely done prior to initiation of treatment in EC.
Effect of radiation dose rates and cisplatin on cytogenetic damage in rats receiving head–neck radiotherapy
Authors: Unal Dilek , Kiraz Aslihan , Aydogan Serhat , Sarica Zeynep Soyer , Celik Harun , Akay Ebru , Eroglu Celalettin , Kaplan Bunyamin
Published: October 2024

Background:

We aimed to investigate effect of radiotherapy (RT) applications with different dose rates on cytogenetic damages, which focused on micronucleus (MN) formation, and evaluate how this damage varies by cisplatin in rats receiving head–neck RT.

Material and Methods:

Thirty-six Sprague Dawley rats were divided into five groups. The first and second groups were irradiated at a dose rate of 300 monitor unit/minute (MU/min) and 600 MU/min, respectively. The third group was irradiated at a dose rate of 300 MU/min and given cisplatin. The fourth group was irradiated at a dose rate of 600 MU/min and given cisplatin. The fifth group received neither irradiation nor cisplatin (control group). One thousand polychromatic erythrocytes were scored, and MN frequency in polychromatic erythrocytes was determined for each rat.

Results:

There was a significant difference among five groups in terms of the number of MN (p: 0.001). The number of MN was significantly higher in the 600 MU/min + cisplatin group (fourth group) compared to the control group [9.5 (1.0–23.0) vs. 1.5 (1.0–2.0), respectively]. It was also significantly higher in 600 MU/min + cisplatin group (fourth group) compared to 300 MU/min group (first group) [9.5 (1.0–23.0) vs. 2.0 (1.0–3.0), respectively]. On the other hand, there was no significant difference among other groups.

Conclusions:

Our findings suggest that RT given at a higher dose rate causes more cytogenetic damage, and this damage is increased by concurrent administration of cisplatin.
Mammary analogue secretory carcinoma involving submandibular gland: Diagnostic pitfall with review of literature
Authors: Dhankar Nimisha , Verma Nidhi , Agarwal Abhinav , Mehar Ravi , Pasricha Sunil
Published: October 2024

Mammary analogue secretory carcinoma (MASC) is a recently defined entity among salivary gland tumors. MASC bores a striking resemblance to secretory carcinoma of breast along with the characteristics of ETV6–NTRK3 translocation. Hence, the entity was designated as MASC and was formally included in the 4th edition of World Health Organization classification of head and neck tumors in 2017. To the best of our knowledge, around 12 cases of MASC have been described in the Indian literature. MASC commonly involves parotid gland (70%). Involvement of submandibular gland is still rarer (7%). Prognosis of MASC is comparable to other low grade salivary gland malignancies; however, aggressive behavior has also been reported in few cases. This case is one of the very few reported cases describing MASC with detailed clinical, cytology, and microscopy findings along with special stains and immunohistochemistry.
Idiopathic multicentric Castleman disease
Authors: Chaudhari Vipul , Thakkar Simran Jatin , Padwal Namita , Karnik Niteen
Published: October 2024

An elderly man presented with fever and chills for six months, associated with loss of appetite and weight loss, bilateral edema, and non-tender inguinal lymphadenopathy. The left-sided testicle was bulky, firm, and non-tender. Investigations revealed anemia, leukopenia, elevated erythrocyte sedimentation rate, and hypergammaglobulinemia. Ultrasound of the abdomen revealed multiple enlarged necrotic lymph nodes in the periaortic, preaortic, precaval, and bilateral pelvic regions. Fine-needle aspiration cytology (FNAC) of the inguinal nodes showed no acid-fast bacilli (AFB). However, excision biopsy revealed lymphoid tissue with effacement of architecture by diffuse proliferation of mature plasma cells, suggestive of the plasma cell variant of multicentric Castleman disease. Due to suspicion of neoplastic testicular enlargement, the patient underwent bilateral orchidectomy, and histopathology showed hematocele with atrophy of the testis and secondary involvement of the testicular parenchyma by plasma cell variant of Castleman disease.
SALL4 and C-kit positive malignant extrarenal rhabdoid tumor of the pelvis in a child: A diagnostic and therapeutic challenge
Authors: Pahwa Saloni , Pasricha Sunil , Kapoor Gauri , Jajodia Ankush , Koyyala Venkata Pradeep Babu , Mehta Anurag
Published: October 2024

Extrarenal rhabdoid tumors (ERRTs) are highly aggressive pediatric tumors with very few cases reported in the literature. These tumors, similar to their renal counterparts, are characterized by inactivating mutations of the SMARCB1/INI-1 gene, a member of the SWI/SNF chromatin remodeling pathway. Diagnosis of ERRTs appears challenging owing to its rarity, varied morphological profile with a higher tendency for rhabdoid differentiation, and overlapping features with other SMARCB-1 deficient tumors. Here, we report a case of ERRT in the pelvis of a three-year-old child with an unusual expression of SALL4 and C-kit on immunohistochemistry. A complete immunohistochemical workup might help in differentiating ERRTs from other SMARCB1/INI1-deficient soft tissue tumors. The expression of stem cell markers in the presented case also suggests that these tumors might originate from or share similarities with embryonic stem cells or germ cells.
Application of the Milan System of reporting salivary gland cytopathology and assessing its use as a risk stratification tool
Authors: Pandey Neha , DasNayak Goutami , Dash Kanakalata , Senapati Urmila , Rout Khageswar
Published: October 2024

Introduction:

The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was proposed by American Society of Cytopathology and International Academy of Cytology to standardize reporting system ensuring uniformity and better communication between clinicians and cytopathologists.

Aims and Objectives:

1. To categorize salivary lesions as per MSRSGC. 2. To establish diagnostic accuracy of MSRSGC and calculate risk of malignancy for each diagnostic category.

Materials and Methods:

An ambispective study was conducted over 5 years including 45 FNAC cases of salivary lesions. The cases were categorized according to Milan System, and diagnostic accuracy of MSRSGC was established. Risk of malignancy for each category was calculated.

Results:

The patients’ age ranged from 13 to 77 years with maximum swellings in parotid (53.3%) followed by submandibular (15.6%) and submental (2.2%). Histopathological follow-up was done in all cases. The number of cases in each category was as follows: category I: 03 (6.7%), category II: 06 (13.3%), category III: 4 (8.9%), category IVA: 25 (55.6%), category IVB: 04 (8.9%), category V: 02 (4.4%), and category VI: 01 (2.2%). The calculated ROM was as follows: category I: 0%, category II: 0%, category III: 0% category IVA: 8.0%, category IVB: 25%, category V: 50%, and category VI: 100%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy with (without) indeterminate categories for malignancy were 88.9%(96.9), 66.7%(50.0), 94.1%(94.1), 50.0%(66.7), and 85.7%(91.9), respectively.

Conclusion:

MSRSGC is an effective and standardized reporting system for categorization and risk stratification of salivary swellings which helps in enhancing patient care.
Correlation of new two-dimensional geometrical parameters to lung and heart dose-volume parameters in breast cancer radiation therapy
Authors: Bahador Maryam , Soltaninejad Simin , Mobasheri Mosayyeb
Published: October 2024

Objective:

To develop new two-dimensional geometric parameters for pulmonary and cardiac dose estimation in left-sided breast cancer radiation therapy without dose-volume histogram (DVH).

Methods:

On the CT image of 90 patients with left breast cancer, treatment planning was performed using two opposed tangent fields with/without supraclavicular. The field-in-field technique and 6MV photons were used. From DVH dosimetric parameters of mean dose, Vx (x (Gy) =5, 10, 15, 20, 30, 40, 50) were calculated, and from heart and lung outlines on the beam’s eye view, new geometric parameters of percent of lung area in tangent and supraclavicular fields (%area of the lung in the tangent (ALT), %ALS) and percent of heart in tangent field (%area of the heart in the tangent (AHT)) were measured. Correlation, regression, and diagnostic performance by receiver operating characteristic curve (ROC) were investigated for statistical analysis.

Results:

The Pearson coefficient between %ALT and Vx (x = 10, 15, 20, 30, 40) show strong correlation in patient treatment with only opposed tangents (>0.85) and weaker in treatment by opposed tangents with supraclavicular (0.56-0.88), the %ALS indicate weak correlation (<0.5) and %AHT show strong correlation (0.93-0.98). The regression analysis shows a positive relation between %ALT and mean dose (R2 = 0.8), V20Gy (R2 = 0.9) in the lung (tangent treatment), and between %AHT and mean dose (R2 = 0.9), V20Gy (R2 = 1.0) in the heart. The ROC analysis shows by %ALT <20.3 for treatment by just opposed fields, %ALT <22.1% for treatment tangents with supra, and %AHT <11.6%, practical lung and heart dose constraints are addressed.

Conclusion:

The proposed geometric parameters could replace previous one-dimensional maximum and central distances for predicting doses to lung and heart.

Advances in Knowledge:

This study presents simple geometric parameters that could estimate pulmonary and cardiac dose in left breast cancer treatment from a 2D radiograph.
Jumping translocation of 3q21 in a patient with acute myeloid leukemia and poor clinical outcome
Authors: Belnekar Mamta , Virulkar Shital , Tulpule Sameer , Kar Bibhas
Published: October 2024

Jumping translocation (JT) is a cytogenetic event in which a donor chromosomal segment is translocated to two or more recipient chromosomes. We describe a case of a 75-year-old female patient diagnosed with acute myeloid leukemia (AML) with monocytic differentiation having acquired JT involving 3q21→3qter as a donor chromosomal segment with 12 different recipient chromosomes. Each abnormal clone had monosomy 7 and trisomy 8. Patients with JT have an adverse outcome, a high risk of disease progression, and an unfavorable prognosis. This is the sixth case of JT involving 3q21 and the first case having 12 different recipient chromosomes (15 chromosomal segments) along with monosomy 7 in all abnormal clones reported in the literature.
Psychological Stress in Parents Delivering Preterm Child and Effects of Psychological Intervention on Them
Authors: Desai Shweta Shaileshbhai , Prakash R. Harihara , Mehta Jigar N. , Mahida Ankur
Published: October 2024

Background:

Mothers and fathers may experience negative emotions as a result of an unusual early delivery and giving birth to high-risk newborns who require hospitalization in the neonatal intensive care unit (NICU) adds layers of stress on them. Hence, a variety of psychological and emotional services are required.

Aim:

The aim of this study was to identify common stressors in both parents of preterm children in the NICU and determine the effect of psychological intervention in the form of acceptance and commitment therapy (ACT) on stress in both parents.

Materials and Methodology:

A total of 60 parents of preterm children were randomly assigned to Intervention Group A and Control Group B. Group A received five sessions of ACT and routine counseling, while Group B received only routine nursing staff counseling. The Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU) was used for pre- and postassessments to measure the parents’ stress levels on the 1st and 5th days, respectively.

Results:

Mothers’ stress levels in the NICU are significantly higher when they have a higher socioeconomic status, a higher education level, and a length of stay of more than 6 days, but significant stress is not found in fathers. ACT, when used along with routine counseling, is effective in reducing stress in both parents.

Conclusion:

ACT can be combined with routine counseling to help parents cope with depression, anxiety, and stress associated with preterm birth in the NICUs.
Impact of Home Stimulation on the Motor Development of Malnourished Toddlers: A Cross-sectional Study
Authors: Malhi Prahbhjot , Menon Jagadeesh , Bharti Bhavneet , Sidhu Manjit
Published: October 2024

Objectives:

The objectives of the study are to investigate the relationship between malnutrition (as measured by stunting), motor development, and early parental stimulation during the critical preschool years.

Methodology:

The sample comprised of 150 mother-child dyads. Children with a history of any chronic illness or disability were excluded. The StimQ (Toddler version) questionnaire was used to assess parental stimulation. Motor development was measured by the motor development scale of the Developmental Assessment Scales for Indian Infants. Stunting was measured by the height-for-age Z-score (2 standard deviation [SD] or more below the World Health Organization standard) and this was used as a proxy measure for malnutrition.

Results:

Among the 150 children studied, 38.7% were stunted and 36.7% were wasted. Overall, the motor development quotient was 91.11 (SD = 14.57) and one-fifth (19.3%) of the sample had a delay in the motor domain. Stunting was positively associated with delayed motor developmental status (t = 2.84, P = 0.005). The motor delayed group, relative to the normal developing preschool children, had significantly lower total StimQ scores as well as on all the subscales. Multiple stepwise linear regression analysis indicated that two variables, namely total StimQ score and extent of stunting, were significantly related to the motor quotient score and explained 23.3% variance (F = 23.68, P = 0.0001), even after controlling for socioeconomic factors.

Conclusions:

Primary care pediatricians are ideally suited to integrate the promotion of maternal-child responsive interactions, psychosocial stimulation, and child nutritional rehabilitation programs in their clinical practice to foster healthy child development, especially in the context of resource-poor settings.
Intrathecal Fentanyl versus Intrathecal Dexmedetomidine as an Adjuvant to Isobaric Levobupivacaine 0.5% in Elective Cesarean Sections: A Randomized Control Trial
Authors: Basith Mohamed , Govindan Dilip Kumar , Prasad T. Krishna , Hanan Amin , Priyadharsini K Soundarya
Published: October 2024

Background:

When a cesarean section is performed, it is crucial to have access to good postoperative analgesia. To achieve this, adjuvants are added along with local anesthetics as it has a synergistic action to improve its duration and quality. Alpha-2 adrenoceptor agonists and opioids such as dexmedetomidine and fentanyl, respectively, are used for their sedative, analgesic, and perioperative sympatholytic and cardiovascular stabilizing effects with reduced anesthetic requirements. The purpose of this research is to evaluate the effects of intrathecal fentanyl versus dexmedetomidine combined with levobupivacaine on postoperative analgesia and hemodynamic changes.

Materials and Methods:

This is a prospective randomized control trial, among 50 patients undergoing elective cesarean section. Group 1 will receive 0.5% levobupivacaine 2 ml + fentanyl 25 mcg and Group 2 will receive 0.5% levobupivacaine + dexmedetomidine 5 mcg. Duration of analgesia and onset and duration of sensory-motor block, perioperative analgesic requirements, sedation, and hemodynamic stability were compared. The data were entered into Microsoft Excel and analyzed using SPSS 16.

Results:

The baseline characteristics such as age and gender, weight, height, and body mass index were not statistically significant in both the groups. Duration of analgesia was significantly longer in the dexmedetomidine group than the fentanyl group. The mean time of onset of motor block in the group, for which dexmedetomidine was 14.23 ± 1.85 min and it was found to be much earlier than the local anesthetic group. All the patients in the dexmedetomidine group had a Visual Analog Scale (VAS) score of 0 (no pain) at the end of 4 h. In contrast, only 21 patients in the fentanyl group had a VAS score of 0, and four patients had a VAS score of 2, indicating mild pain requiring no treatment.

Conclusion:

The study showed that both fentanyl and dexmedetomidine as an adjuvant to levobupivacaine in cesarean section showed a longer duration of analgesia with increased sedation score and lesser pain score. When comparing the both, dexmedetomidine to the levobupivacaine has a more effective effect on postoperative pain management than fentanyl.
On $3$-generated axial algebras of Jordan type $\frac{1}{2}$
Authors: Bildanov Ravil , Gorshkov Ilya
Published: October 2024

Axial algebras of Jordan type $\eta$ are a special type of commutative
non-associative algebras. They are generated by idempotents whose adjoint
operators have the minimal polynomial dividing $(x-1)x(x-\eta)$, where $\eta$
is a fixed value that is not equal to $0$ or $1$. These algebras have
restrictive multiplication rules that generalize the Peirce decomposition for
idempotents in Jordan algebras.
A universal $3$-generated algebra of Jordan type $\frac{1}{2}$ as an algebra
with $4$ parameters was constructed by I. Gorshkov and A. Staroletov. Depending
on the value of the parameter, the universal algebra may contain a non-trivial
form radical. In this paper, we describe all semisimple $3$-generated algebras
of Jordan type $\frac{1}{2}$ over a quadratically closed field.
Exploring Factors Affecting the Utilization of Monitoring and Evaluation Data in Decision-Making and Accountability: Perspectives from Monitoring and Evaluation Professionals in Tanzania
Authors: Nguliki Dr Isaack Michael
Published: October 2024

This study investigated the factors affecting monitoring and evaluation (M&E) data utilization in decision-making and accountability from the perspectives of M&E professionals in Tanzania. A cross-sectional survey design was employed, and data were collected through a questionnaire in July 2024 from 106 respondents. Data analysis, which included descriptive statistics, was conducted using SPSS and Microsoft Excel. The key factors identified as influencing M&E data utilization are knowledge and skills, organizational culture and support, data quality and accessibility, and institutional and policy framework. Based on these findings, it is recommended that projects and organizations implement appropriate measures to create an environment that promotes effective M&E data utilization.
Economic uncertainty and life insurance: Bayesian Network Analysis at the level of European Union
Authors: Grigorie Elena Iulia
Published: October 2024

This paper examines the relationship between economic uncertainty and the life insurance sector in the member states of the European Union (EU), with a focus on several key macroeconomic indicators, such as inflation, Gross Domestic Product growth and unemployment. Using a comprehensive dataset covering the diversity of the EU Member States over a ten-year period, econometric methods, like Bayesian Network Analysis are used to analyse the relationship between economic uncertainty indicators and life insurance performance indicators. The findings suggest a complex interplay between economic indicators and life insurance. Inflation appears as a significant factor, and unemployment, another crucial economic indicator, shows a mixed relationship in terms of life insurance demand. Therefore, in the context of an interconnected global economy, understanding how economic uncertainty influences demand for life insurance products is essential for policymakers, insurers and consumers alike.