bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Prospective Single-Arm Study of Melphalan, Prednisolone and Lenalidomide (MPL) as First Line Treatment in Elderly Patients with Multiple Myeloma – An Institutional Study
Authors: Lakshmi Haridas K. , Narayanan Geetha , Abdul Shahid P. P. , Sreejith G. Nair 
Published: October 2022

Abstract
Introduction Multiple myeloma in the elderly population is rising in India. Such frail transplant-ineligible patients are less frequently included in clinical trials. Moreover, novel agents are not accessible to everyone. Melphalan-based chemotherapy regimens are frequently used in elderly myeloma patients. Our study revisited the role of melphalan, prednisone, and lenalidomide (MPL) as front-line therapy in this subgroup of patients.
Objective The aim of this study was to determine the response, tolerance, and outcome of MPL in elderly patients with newly diagnosed multiple myeloma.
Materials and Methods This prospective study was conducted at the Department of Medical Oncology at a tertiary cancer center during January 2012 to September 2013. Newly diagnosed patients with multiple myeloma >60 years who were transplant ineligible formed the study subjects. Eligible patients received oral melphalan 0.18 mg/kg from D1 to 4, prednisone 2 mg/kg from D1 to 4, and lenalidomide 10 mg from D1 to 21 q28 days. Patients who achieved complete response/very good partial response (CR/VGPR) after 6 cycles of MPL received maintenance with lenalidomide 10 mg from D1 to 21 q28 days (MPL-L) until progression or 1 year whichever was earlier. Quality of life was assessed using the Eq. 5D questionnaire.
Results Out of 46 patients, 25 were males and 21 were females. Median age was 67 years (range: 60—83 years). Majority had immunoglobulin G myeloma, followed by immunoglobulin A subtype. The median quality of life score at baseline was 50 (range: 30–70). Forty patients completed six cycles of MPL. The main toxicity was grade 1 to 2 hematological. There were no treatment-related deaths. Twenty-two (55%) achieved CR, 5 (13%) achieved VGPR, 4 (10%) achieved partial response, 6 (15%) achieved stable disease, and 3 (7%) had progressive disease. Twenty-seven patients received lenalidomide maintenance. At a median follow-up of 55 months, the 2- and 5-year progression-free survival was 60 and 18%, respectively. The overall survival at 2 and 5 years were 80 and 53%, respectively. The median number of subsequent lines of treatment was 2 (range: 1–4). The quality of life was improved and preserved in all study subjects. At 8 years, three patients had second malignant neoplasms and seven are alive.
Conclusion MPL-L is a well-tolerated and effective regimen in elderly myeloma with good overall response rates.
Amelanotic Melanoma: A Great Masquerader
Authors: Osama Md Ali , Rao Seema , Bakshi Neha , Badwal Sonia , Aggarwal Shyam 
Published: October 2022

AbstractMalignant melanoma is an aggressive, notorious tumor showing great variability in morphological and immunohistochemical expression, thus commonly leading to an erroneous diagnosis. Within the melanoma group, amelanotic melanoma, with its wide clinical presentations, lack of pigmentation, and varied histological appearances, has taken on a new persona as a master masquerader. Use of immunohistochemistry in the diagnosis of malignant tumors, including melanoma, is primordial and indispensable. However, the problem gets compounded in scenario of aberrant antigenic expression. The present case posed multiple diagnostic challenges in form of atypical clinical presentation, variant morphology, as well as aberrant antigenic expression. Here, we present the case of a 72-year-old male who, upon his initial presentation, was thought to be sarcomatoid anaplastic plasmacytoma, but 5 months later another biopsy from a different site revealed the actual diagnosis of amelanotic melanoma.
Association between Hypocalcemia and Outcome in COVID-19 Patients: A Retrospective Study
Authors: Patidar Bhagwan Singh , Mukhopadhyay Tapasyapreeti , Subramanian Arulselvi , Aggarwal Richa , Soni Kapil Dev , Nischal Neeraj , Sahoo Debasis , Surbhi Surbhi , Wig Naveet , Pandey Ravindra Mohan , Malhotra Rajesh , Trikha Anjan 
Published: October 2022

Abstract
Background Calcium has been shown to play a vital role in the pathophysiology of severe acute respiratory syndrome-coronavirus-2 and middle east respiratory syndrome coronavirus diseases, but less is known about hypocalcemia in coronavirus disease 2019 (COVID-19) patients and its association with the disease severity and the final outcome. Therefore, this study was conducted with an aim to assess clinical features in COVID-19 patients having hypocalcemia and to observe its impact on COVID-19 disease severity and the final outcome.
Methods In this retrospective study, consecutive COVID-19 patients of all age groups were enrolled. Demographical, clinical, and laboratory details were collected and analyzed. On the basis of albumin-corrected calcium levels, patients were classified into normocalcemic (n = 51) and hypocalcemic (n = 110) groups. Death was the primary outcome.
Results The mean age of patients in the hypocalcemic group was significantly lower (p < 0.05). A significantly higher number of hypocalcemic patients had severe COVID-19 infection (92.73%; p < 0.01), had comorbidities (82.73%, p < 0.05), and required ventilator support (39.09%; p < 0.01) compared with normocalcemic patients. The mortality rate was significantly higher in the hypocalcemic patients (33.63%; p < 0.05). Hemoglobin (p < 0.01), hematocrit (p < 0.01), and red cell count (p < 0.01) were significantly lower with higher levels of absolute neutrophil count (ANC; p < 0.05) and neutrophil-to-lymphocyte ratio (NLR; p < 0.01) in the hypocalcemic patients.Albumin-corrected calcium levels had a significant positive correlation with hemoglobin levels, hematocrit, red cell count, total protein, albumin, and albumin-to-globulin ratio and a significant negative correlation with ANC and NLR.
Conclusion The disease severity, ventilator requirement, and mortality were considerably higher in hypocalcemic COVID-19 patients.
Strategies to Decrease the Prevalence of Soil-Transmitted Helminths in Central India
Authors: Sharma Archa , Purwar Shashank , Gupta Shipra , Gupta Ayush , Gautam Disha 
Published: October 2022

Abstract
Background Intestinal parasites are a major public health problem in tropical countries. Over 1.5 billion people are infected with soil-transmitted helminths (STH), of which 225 million are in India. Parasitic infections are associated with poor sanitation, lack of safe potable water, and improper hygiene.
Materials and Methods The study was undertaken to ascertain the impact of control strategies, namely open-defecation free drive and mass drug administration of single dose albendazole. Stool samples received at AIIMS Bhopal Microbiology laboratory, across all age groups, were studied for protozoan trophozoites/cysts and helminthic ova.
Results Out of 4,620 stool samples, 389 (8.41%) were positive either for protozoal or helminthic infections. Protozoan infections were more common than helminthic infections with Giardia duodenalis infection being the most common, 201 (51.67%), followed by Entamoeba histolytica, 174 (44.73%). The helminthic infections constituted 14 (3.5%) of the positive stool samples with Hookworm ova in 6 (1.5%) cases.
Conclusion This study proves that strategies, namely “Swachh Bharat Abhiyan” and “National Deworming Day” started in 2014 and 2015 led to significant reduction of intestinal parasite infections in Central India, with a higher reduction of STH compared with protozoan parasite infection being ascribed to the activity spectrum of albendazole.
Evaluation of Xpert MTB/RIF Assay on Stool Samples for the Diagnosis of Pulmonary Tuberculosis among the Pediatric Population
Authors: Jayagandan Sangitha , Singh Jitendra , Mudliar Shivkumar Rashmi , Shankar Prem , Maurya Anand Kumar , Malhotra Anvita Gupta , Malik Shikha , Purwar Shashank , Singh Sarman 
Published: October 2022

Abstract
Objective Microbiological confirmation of tuberculosis (TB) in pediatric cases is challenging due to its paucibacillary nature and difficulty in specimen collection. This study aimed to validate stool as an alternative sample for the diagnosis of pediatric pulmonary TB via Xpert MTB/RIF (Xpert) assay.
Materials and Methods This cross-sectional study included 75 pediatric patients up to 10 years of age with signs and symptoms suggestive of TB. From each recruited patient, pulmonary and stool samples were collected in a sterile container. The collected samples were subjected to Ziehl-Neelsen staining, BACTEC MGIT 960 culture (MGIT), Xpert, and in-house multiplex polymerase chain reaction for TB diagnosis.
Results About 13.33% (10/75) of the pulmonary samples and, of them, 50% (5/75) of the stool samples were positive by Xpert assay. The sensitivity and specificity of Xpert assay with stool and pulmonary samples were 50 (95% confidence interval [CI]: 18.71–81.29%) and 100% (95% CI: 94.48–100%), respectively.
Conclusion The Xpert assay on stool samples showed limited sensitivity and good specificity in the diagnosis of pulmonary TB. Therefore, it can be proposed as an alternative screening sample to diagnose TB in pediatric cases for which getting a respiratory sample is extremely difficult. However, further studies with greater number of samples and multiple baseline variables are required to support our findings. Strategies to optimize stool Xpert assay should be performed to enhance the sensitivity of this method to detect Mycobacterium tuberculosis in children.
Early and Effective Diagnosis of Sepsis Using Flow Cytometry
Authors: Verma Pratima , Singh Anurag , Kushwaha Rashmi , Yadav Geeta , Verma Shailendra P. , Singh Uma S. , Reddy Himanshu D. , Agarwal Avinash 
Published: October 2022

Abstract
Objective Sepsis is a major global health issue due to its high death and morbidity rates. To avoid the negative effects of sepsis and decrease mortality, it is vital to diagnose and treat it as soon as possible. Blood cultures can take up to 2 days to give result, and they are not always reliable. According to recent studies, neutrophil CD64 expression might be a sensitive and specific option for assessing sepsis. This study aimed to evaluate the diagnostic performance of a flow cytometry analysis for the expression of neutrophil CD64 in sepsis and its comparison with other standard tests in a tertiary care center.
Materials and Methods Prospective analysis on 40 blood samples from suspected sepsis patients admitted to intensive care units with criteria for the systemic inflammatory response syndrome on presentation was performed for expression of neutrophil CD64, C-reactive protein, procalcitonin, and complete blood count. Ten healthy volunteers were also enrolled in this prospective study. The laboratory results were compared in different groups.
Results The neutrophil CD64 had the highest diagnostic value to differentiate between patients of sepsis and nonsepsis groups with a sensitivity of 100% (95% confidence interval [CI]: 77.19–100%) and 100% (95% CI: 55.32–86.83%); specificity of 90.00% (95% CI: 59.58–99.49%) and 87.24% (95% CI: 66.69–99.61%); and likelihood ratio of 10.00 and 7.84, respectively.
Conclusion The neutrophil CD64 expression provides a more sensitive, specific, and novel marker for the early detection of sepsis in critically ill patients.
Utility of Prostate-Specific Antigen Isoforms and Prostate Health Index in the Diagnosis of Metastatic Prostate Cancer
Authors: Raju Govinda Nanjaiah Laxmana , Bhat Parineetha P. , Nagini Siddavaram 
Published: October 2022

Abstract
Objective The current study was undertaken to investigate the utility of total prostate-specific antigen (tPSA), its isoform [-2] proPSA (p2PSA), and prostate health index (PHI) in the diagnosis of metastatic prostate cancer (PCa).
Materials and Methods This study was conducted from March 2016 to May 2019. Eighty-five subjects who were diagnosed with PCa for the first time, following transrectal ultrasound-guided prostate biopsy, were included in the study. The prebiopsy blood samples were analyzed in Beckman Coulter Access-2 Immunoanalyzer for tPSA, p2PSA, and free PSA (fPSA), and the calculated parameters included %p2PSA, %fPSA, and PHI. Mann–Whitney's U test was used as test of significance, and p-value less than 0.05 was considered statistically significant.
Results Of the 85 participants, 81.2% (n = 69) had evidence of metastasis, both clinically and pathologically. The median tPSA (ng/mL), p2PSA (pg/mL), %p2PSA, and PHI were significantly higher in the group with evidence of metastasis (46.5 vs. 13.76; 198.0 vs. 35.72; 3.25 vs. 1.51; 237.58 vs. 59.74, respectively). The sensitivity (%), specificity (%), negative predictive value (%), and positive predictive value (%) to diagnose metastatic PCa of tPSA at a cutoff of 20 ng/mL, PHI at a cutoff of 55, and %p2PSA at a cutoff of 1.66 were 92.7, 98.5, and 94.2; 37.5, 43.7, and 62.5; 54.5, 87.5, and 71.4; and 86.4, 88.3, and 91.5, respectively.
Conclusion Using tests such as %p2PSA and PHI in the standard armamentarium for the diagnosis of metastatic PCa in addition to PSA will help in selecting the appropriate treatment strategy, including active surveillance.
Changes in informal society and slavery during the Chosun-Era in Korea
Authors: Kim Heeho 
Published: October 2022

AbstractWhile slavery was unconventional in Northeast Asia in the eighteenth and nineteenth centuries, it has been documented in Korea from the Three Kingdoms period (BC 57–AD 668). In 1731, a new slavery regulation was introduced in Korea that stipulated that a child was a slave only if its mother was a slave, regardless of the status of the child’s father. This led to a dramatic decrease in the number of slaves. In addition, slaves also deserted more frequently after 1731 because the ‘not-freed’, remaining slaves tried various ways to secure their freedom amid the ensuing societal instability. The easiest way for slaves in Korea to achieve freedom was to flee their owners since they were of native descent. Slave desertions and entry into the informal economy may be attributed to the exclusion of slaves from social institution. Slaves attempted to escape from their current status to the informal sectors of society, where they could manage a subsistence-level existence without being caught. This study explores government registries of household tallies in three counties of Korea’s Kyungsang province and data on slave transaction. We consider the role of slave desertion in order to examine a relationship between the 1731 regulation change, the institution of slavery, and society. We find that the evidence indicates that the 1731 regulation change led to more desertions, and the costs of monitoring slaves increased; slaves were replaced with daily-wage workers on farmlands. This study contributes to the literature by tracing the causality of slave desertions to informal society that led to the collapse of slavery in eighteenth- and nineteenth-century Korea.
Charge transfer dynamics and interlayer exciton formation in MoS2/VOPc mixed dimensional heterojunction
Authors: Schwinn Madison C. , Rather Shahnawaz R. , Lee Changmin , Bland Matthew P. , Song Thomas W. , Sangwan Vinod K. , Hersam Mark C. , Chen Lin X. 
Published: October 2022

Mixed-dimensional van der Waals heterojunctions involve interfacing materials with different dimensionalities, such as a 2D transition metal dichalcogenide and a 0D organic semiconductor. These heterojunctions have shown unique interfacial properties not found in either individual component. Here, we use femtosecond transient absorption to reveal photoinduced charge transfer and interlayer exciton formation in a mixed-dimensional type-II heterojunction between monolayer MoS2 and vanadyl phthalocyanine (VOPc). Selective excitation of the MoS2 exciton leads to hole transfer from the MoS2 valence band to VOPc highest occupied molecular orbit in ∼710 fs. On the contrary, selective photoexcitation of the VOPc layer leads to instantaneous electron transfer from its excited state to the conduction band of MoS2 in less than 100 fs. This light-initiated ultrafast separation of electrons and holes across the heterojunction interface leads to the formation of an interlayer exciton. These interlayer excitons formed across the interface lead to longer-lived charge-separated states of up to 2.5 ns, longer than in each individual layer of this heterojunction. Thus, the longer charge-separated state along with ultrafast charge transfer times provide promising results for photovoltaic and optoelectronic device applications.
Clinician perspectives on rapid transition to telehealth during COVID-19 in Australia – a qualitative study
Authors: Smyth Lillian , Roushdy Suzannah , Jeyasingham Jerusha , Whitbread Joshua , O’Brien Peta , Lloyd Charles , Lueck Christian J. , Hawkins Carolyn A. , Reynolds Graham , Perriman Diana 
Published: October 2022

Objective The coronavirus disease 2019 (COVID-19) pandemic precipitated a major shift in the use of telehealth in Australia. The changes highlighted gaps in our knowledge regarding the efficacy of, and clinician attitudes to, the use of telehealth. The current study expands and deepens the available evidence as a result of being collected in unique circumstances that removed one of the major barriers (lack of Medicare rebates) and also one major enablers (willingness) of telehealth uptake. Methods Using a semi-structured interview, we invited clinicians (N = 39) to share their perspectives, attitudes and experiences of using telehealth. Topics covered included perceptions of the strengths and challenges of telehealth, and how experience of using telehealth during the COVID-19 pandemic had influenced clinicians’ views and intentions regarding their future practice. Participants included clinicians from five disciplines across public and private practice: paediatrics, neurology, immunology, rural general practice, and orthopaedics. Results We found three key dimensions for consideration when assessing the suitability of telehealth for ongoing practice: the attributes of the patient population, the attributes of the clinical context and environment, and the risks and benefits of a telehealth approach. These findings map to the existing literature and allow us to infer that the experiences of clinicians who previously would have chosen telehealth did not differ significantly from those of our ‘pandemic-conscripted’ clinicians. Conclusions Our findings map clearly to the existing literature and allow us to infer that the experiences of the clinicians who have chosen telehealth (and are already represented in the literature) did not differ significantly from those trying out telehealth under the unique circumstances of the removal of the Medicare Benefits Scheme barrier and external pressure that over-rides the ‘willingness’ enabling factor in uptake decisions.
What factors affect species richness and distribution dynamics within two Afromontane protected areas?
Authors: Uzabaho Eustrate , Kayijamahe Charles Birasa , Musana Abel , Uwingeli Prosper , Masaba Christopher , Nyiratuza Madeleine , Moore Jennifer Frances 
Published: October 2022

Context Biodiversity monitoring programs provide information on the status and trends in wildlife populations. These trends are unknown for most mammals within African montane forests, which harbour many endemic and threatened species. Camera traps are useful for assessing mammal populations, because they allow for the estimation of species richness, occupancy, and activity patterns. Aims We sought to explore the richness and distribution of small- to large-sized mammals by using occupancy models while accounting for imperfect detection in Volcanoes and Mgahinga Gorilla National Parks, in Rwanda and Uganda. Methods We used camera-trap data collected from 2014 to 2017 by the Tropical Ecology Assessment and Monitoring (TEAM) network and multi-season occupancy models with multispecies data to assess the dynamics of species richness and distribution in the Virunga Massif and the influence of site covariates on species detection probability, occupancy, colonisation and extinction. Key results We identified 17 species from 7047 trap-days, with most of them showing an uneven distributional pattern throughout the park. We found that average species richness per site increased from five to seven species in 2017. Average local colonisation was estimated at 0.13 (s.e. 0.014), but the probability of local extinction was 0.17 (s.e. 0.028) and negatively influenced by distance from the park boundary. Detection probability was highest for medium-sized species. For species distribution, we found that black-fronted duiker, Cephalophus nigrifrons, and bushbuck, Tragelaphus scriptus, declined in distribution but remained widespread in our study area, while all other species showed an increase in distribution over the study period. Conclusions Our approach allowed us to draw inferences on rare species, such as African golden cat, Caracal aurata, by estimating detection probability on the basis of shared covariate information with more common, widespread species. As such, we were able to estimate all occupancy parameters across the terrestrial mammal community. Implications The results of this study on the distribution of terrestrial mammal species can be used by park management to inform optimal ranger patrolling efforts for mitigating threats in areas of high species presence. Additionally, the results can highlight locations of potential human–wildlife conflicts on the basis of species commonly found along the park boundary.
Update of the BIPM comparison BIPM.RI(II)-K1.Ba-133 of activity measurements of the radionuclide 133Ba to include the 2016 result of the NRC (Canada), the 2018 result of the TENMAK-NÜKEN (Türkiye), the 2019 result of the NMISA (South Africa) and the 2019 result of the NIST (United States)
Authors: Michotte C , Courte S , Coulon R , Nonis M , Judge S , Laureano-Perez L , Fytzgerald R , Rooy M W van , Staden M J van , Lubbe J , Galea R , Moore K , Yeltepe E , Dirican A 
Published: October 2022

Main text
Since 1977, 23 laboratories have submitted 45 samples of 133Ba to the International Reference System (SIR) for activity comparison at the Bureau International des Poids et Mesures (BIPM), with comparison identifier BIPM.RI(II)-K1.Ba-133. Recently, the NRC (Canada), the TENMAK-NÜKEN (Türkiye), the NMISA (South Africa) and the NIST (United States) participated in the comparison and the key comparison reference value (KCRV) has been updated. The degrees of equivalence between the updated KCRV and each equivalent activity measured in the SIR or linked to the SIR from the APMP.RI(II)-K2.Ba-133 comparison have been calculated and the results are given in the form of a table. A graphical representation is also given.
To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database https://www.bipm.org/kcdb/.
The final report has been peer-reviewed and approved for publication by the CCRI, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Modeling of vibrational excitation dynamics in a nanosecond CO2 discharge
Authors: Naidis G V , Babaeva N Yu 
Published: October 2022

Abstract
The temporal dynamics of excitation of the asymmetric vibrational mode of CO2 molecules in a nanosecond discharge is simulated. The values of the electric field andthe number density of electrons versus time, calculated for a known experimental dependence of the discharge current on time, are used to evaluate the number densities of the first and second vibrational levels of the asymmetric mode. It is shown that the dynamics of the densities of these levels, calculated using generally accepted values of the vibrational excitation rate constants, is in reasonable agreement with experimental data.