Acute kidney injury (AKI) is a common and life-threatening complication in cancer patients, often leading to treatment interruption and increased mortality. When AKI progresses to the stage requiring hemodialysis, the prognosis becomes particularly poor. This study aimed to evaluate the etiologies, dialysis indications, and outcomes of malignancy-associated AKI requiring emergency hemodialysis over 25 years. This retrospective study included adult patients with malignancies who underwent emergency hemodialysis for AKI at a tertiary referral center between January 2000 and March 2025. Patients were categorized into five malignancy groups—respiratory, hematologic, gastrointestinal, genitourinary, and other—and stratified by two time periods (2000–2010 and 2011–2025), representing the eras of conventional chemotherapy and targeted or immune-based therapies, respectively. Among 2,490 patients who underwent emergency hemodialysis, 539 (21.6%) had malignancies. The median age was 63 years, and 59% of the participants were male. Genitourinary cancers (38%) were the most frequent, followed by hematologic (24%) and gastrointestinal (22%) malignancies. Postrenal obstruction (37%) was the leading etiology of AKI, while uremia (34%) and hyperkalemia (23%) were the main dialysis indications. The median number of dialysis sessions was 4 (range, 1–89), and dialysis independence was achieved in 56% of patients. After 2010, postrenal obstruction and hypercalcemia-related AKI increased, whereas uremia declined, and renal recovery improved significantly. In conclusion, this study provides real-world data on cancer-associated AKI requiring emergency hemodialysis, demonstrating heterogeneity in etiologies and dialysis indications across malignancy types. Temporal improvements in renal recovery suggest better kidney outcomes over time, emphasizing the need for optimized management and multidisciplinary care.
Pediatric Hodgkin lymphoma (HL) treatment has increasingly shifted toward response-adapted protocols, aiming to minimize radiotherapy and employ intensive chemotherapy such as OEPA/COPDAC. We retrospectively reviewed treatment outcomes and toxicities in pediatric HL patients treated with OEPA/COPDAC between 2015 and 2019 at a tertiary care center in Pakistan, a resource limited country, following the Euronet PHL-C1 protocol with radiotherapy reserved for inadequate interim responses. Clinical features, treatment-related toxicities, and hospital admissions were documented. The cohort included 20 patients with a median age of 12 years; 13 (65%) achieved complete remission after OEPA induction and avoided radiotherapy. Toxicities were frequent—15 (75%) after OEPA-1 and 13 (68%) after OEPA-2—most commonly gastrointestinal symptoms and febrile neutropenia. Hospitalization was required in 9 (45%) after the first cycle and 11 (58%) after the second, with one treatment-related death from febrile neutropenia. At median follow-up, overall survival was 95% (95% CI: 69.47–99.28%) and event-free survival was 85% (95% CI: 60.38–94.90%). These findings highlight that OEPA/COPDAC achieves high survival rates even in advanced-stage pediatric HL within low-resource settings. However, the substantial toxicity burden and frequent hospitalizations underscore the need for enhanced supportive care and further evaluation in larger, long-term studies.
Slurry bubble columns find extensive applications in three-phase reactions, including biological wastewater treatment, fermentation, and hydrotreating, among others. Despite their merits, these reactors suffer from drawbacks such as high back mixing and challenges in product-catalyst separation. This study introduces a novel approach to address these issues by employing a horizontally placed spiral tube within the column, serving as both a catalyst support and a heat exchanger. The study investigates the impact of two-phase flow on mass transfer at the outer surface of the spiral tube using the limiting current based electrochemical technique. The experimental setup involves varying spiral tube diameter and pitch, as well as distances between successive spiral tubes. The results showed that the mass transfer coefficient increases with increasing superficial gas and solution velocities but decreases with increasing spiral tube diameter and pitch. An array of three separated horizontal spiral tubes was also tested, and the mass transfer coefficient was found to be slightly lower than that of a single spiral tube by an amount ranged from 4 to 19%. The study provides valuable insights into optimizing reactor design for improved efficiency, offering a potential solution to challenges in slurry bubble column reactors.
Close Quarters Battle (CQB) is an operational approach in confined spaces gaining increasing significance in urban combat missions. Due to its high psychophysiological demands, the CQB ability is an essential selection criterion for special forces. Until now, there has been no research on predictors of CQB capability. This study examined the influence of the Big Five personality traits, self-esteem, resilience, attentional ability, 2D:4D digit ratio, and mindfulness on the CQB performance. The German sample comprised a total of n = 45 individuals ( n = 29police special forces; n = 16 unspecialized soldiers) who conducted psychometrics and a CQB test consisting of three scenarios. In these scenarios, two independent experts evaluated tactical behavior, weapon handling, gaze behavior, response time, and failures using a standardized behavioral observation instrument based on video recordings (external cameras and mobile eye-tracking). The results revealed that only extraversion predicted the CQB performance (β = -.40, p = .035). However, the mean 2D:4D ratio was strongly associated with gaze behavior ( r = .45, p = .007), tactical behavior ( r = .41, p = .019), and attentional ability ( p = .57, p < .001). Surprisingly, the findings indicate that CQB, as a high-risk and analytical task, is better performed by introverted personnel.
Anemia has been observed in up to 46% of individuals with acute brain injury. Blood transfusions are commonly performed to raise hemoglobin levels, so we aimed to compare the restrictive and liberal blood transfusion strategies in acute brain injury patients. A systematic search was conducted on Web of Science, Embase, Scopus, Cochrane, and Medline/PubMed up to February 10, 2025. Continuous data were combined using mean differences (MD), and dichotomous outcomes were synthesized using risk ratios (RR); both were detailed with a 95% confidence interval (CI), applying R software (version 4.3). This study was registered and published with PROSPERO (ID CRD42025630392). The analysis incorporated six randomized controlled trials involving 2599 participants. There were no substantial variations between the liberal and restrictive transfusion groups in unfavorable neurological outcomes (RR: 0.90 [95% CI: 0.79–1.03]; P = 0.13), favorable neurological outcomes (RR: 1.16 [95% CI: 1.00–1.35]; P = 0.05), hospital length of stay (MD: −0.66 [95% CI: −2.48–1.16]; P = 0.48), or intensive care unit length of stay (MD: 0.15 [95% CI: −0.68–0.99]; P = 0.72). However, the liberal transfusion strategy was accompanied with an increased number of red cell units transfused (MD: 2.28, 95% CI: [1.75–2.80]; P < 0.01) and reduced sepsis or septic shock compared to the restrictive strategy (RR: 0.73 [95% CI: 0.56–0.96]; P = 0.02). The liberal strategy of blood transfusion for patients with acute brain injury and anemia did not impact neurological outcomes. It reduced the incidence of sepsis or septic shock, but this came with an increase in the number of red blood cells transfused without affecting overall mortality or thrombotic events.
Graphene oxide (GO) and graphene quantum dots (GQDs) are two well-known graphene-related materials derived from a single layer of C-atoms which are arranged in a honeycomb structure. Due to their unique physicochemical properties such as high specific surface area, excellent electrical conductivity, good mechanical strength, and intrinsic biocompatibility, GO and GQDs have drawn great attention in versatile scientific domains, especially in biomedical applications. Recently, they have been recognised as potential sources for new therapeutic approaches, particularly in influencing inflammatory responses and cancer therapy. The drug and imaging agent loading and delivery ability, ease of transport and release, targeting ability, and imaging canny have met them to be attractive carriers for next generation nanomedicine. Particularly their involvement in selective drug delivery systems represents an opportunity to improve so to speak the therapeutic efficacy, by confining the exposure to the therapeutic such to reach the desired tissue/tumor further abating the treatment of the healthy cells. In this review, we discuss the recent advances in the development and application of GO- or GQD-based delivery systems and put emphasis on strategies utilized to improve the targeting capability, biocompatibility, and therapeutic efficacy for cancer treatment.
Alteration in photoperiodic conditions has a detrimental impact on circadian physiology. Agomelatine, a synthetic melatonin analogue, is a novel antidepressant with the ability to modulate circadian rhythms. We have investigated the chronobiotic effect of agomelatine on cellular redox homeostasis in a circadian disrupted rat model. A total of 36 male Wistar rats were randomly divided into six groups: control (C), control+agomelatine (C+AGM), continuous light (CL), CL+AGM, continuous darkness (CD), and CD+AGM. The oxidative stress biomarkers and lipid profile parameters were assessed. CL rats exhibited a significant ( p ≤ 0.05) increase in the biomarkers of oxidative stress. Significant ( p ≤ 0.05) decrease was observed in the levels of reduced glutathione (GSH), ferric reducing antioxidant potential (FRAP), acetylcholinesterase (AChE) activity, high-density lipoprotein (HDL), alanine aminotransferase (ALT), and Aspartate aminotransferase (AST). Supplementation of agomelatine exhibited a significant ( p ≤ 0.05) protective effect on elevated levels of biomarkers of oxidative stress, while reduced FRAP, HDL, GSH, AChE, ALT, and AST activities were restored in CL rats. The findings demonstrate that chronic exposure to artificial light is a crucial factor that leads to the development of oxidative stress. Agomelatine may be a potential chronotherapeutic drug for addressing circadian redox disturbances.
This study investigated the antidiabetic potential of methanolic extracts of Cassia absus (seeds), Gymnema sylvestre (whole plant), Nigella sativa (seeds), and Piper nigrum (fruits) in alloxan-induced diabetic female Wistar rats. Extracts were prepared using 70% methanol and administered orally at 500 mg/kg/day for 42 days, while glibenclamide (10 mg/kg/day) served as a reference drug. All plant extracts significantly ( p < 0.05) reduced fasting blood glucose, attenuated body weight loss, improved glycometabolic and inflammatory markers, and decreased pancreatic oxidative stress. Notably, N. sativa and P. nigrum extracts showed superior efficacy by modulating JNK/MAPK and Nrf2/Keap1 pathways and enhancing insulin secretion compared with other extracts and glibenclamide. Histopathological findings supported these results. Overall, N. sativa and P. nigrum demonstrated the strongest antidiabetic, antioxidant, and anti-inflammatory effects, while C. absus showed the least efficacy.
The current investigation examined carrageenan model-induced paw inflammation in mice, as well as the potential protective effects of celery leaf extract. Apparently, signs of inflammatory reactions triggered by carrageenan infusion include elevated levels of inflammatory and antioxidant markers, including C-reactive protein levels. Transcription of tumour necrosis factor-alpha, interleukin-1beta, interleukin-2, nitric oxide, cyclooxygenase-2, prostaglandin E2, monocyte chemoattractant protein-1, and myeloperoxidase activity, as well as decreases in other factors, such as interleukin-10 and glutathione content were also observed. Remarkably, it became apparent that extracts derived from celery leaves could prevent the formation of oxidative damage, suppress inflammatory signaling, and alleviate histological alterations in painful, inflamed, reddish paw tissue upon being infused with carrageenan. Our documented scientific findings provide promising evidence that the herbal extract of celery leaves may be employed as a complementary approach for ameliorating the pathophysiological and histological alterations associated with the onset of paw edema.