Intermittent hemodialysis as a rewarming strategy for severe hypothermia in patients without renal failure: a case report.

This case report highlights the effective use of intermittent hemodialysis (IHD) in warming a 71-year-old female patient with severe hypothermia who presented with a rectal temperature of 25 °C and signs of hemodynamic instability. The patient, found unconscious after prolonged exposure to cold exacerbated by alcohol consumption, initially showed some improvement in core temperature through active external rewarming methods. However, soon, her temperature plateaued at 27 °C. Patient was deemed unsuitable for extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass (CPB) due to her age, and urgent IHD was initiated. This approach resulted in a stable increase in core temperature at approximately 2.0 °C/hr, along with normalization of lactic acidosis, creatinine phosphokinase, and correction of electrolyte imbalances, culminating in her full recovery and discharge after seven days in the hospital.After reviewing this case alongside similar ones from before, this case report highlights the efficacy and safety of IHD as an efficient, readily available, and less invasive method for rewarming moderate to severe hypothermic patients who are hemodynamically unstable patients but do not have cardiac arrest or renal dysfunction. IHD is especially useful when less invasive cooling devices (Artic Sun/ CoolGard) are not available or more invasive extracorporeal life support options (ECMO/ CPB) are either not indicated or unavailable. IHD can also help improve concurrent electrolyte imbalances and/or toxin buildup. The report further emphasizes the necessity of monitoring for potential complications, such as post-dialysis hypophosphatemia and rebound hyperkalemia, following successful rewarming.

Ocrelizumab-induced organizing pneumonia in multiple sclerosis: case report and literature review.

Patients with relapsing-remitting multiple sclerosis should be offered disease-modifying therapies as part of their management. Recommended options include integrin antagonist therapy including natalizumab as well as anti-CD20 monoclonal antibodies like, ocrelizumab, rituximab, ofatumumab, and ublituximab. These therapies reduce relapse rates and slow brain lesion accumulation. Disease-modifying therapies selection may depend on patient preferences, potential fetal harm, and specific drug risks, requiring continuous monitoring via tracking clinical relapses and new MRI brain lesions. Natalizumab carries a risk of progressive multifocal leukoencephalopathy, particularly in anti-JCV antibody-positive patients, necessitating regular monitoring. Ocrelizumab, rituximab, and ublituximab are associated with an increased risk of infections (especially respiratory and skin infections), infusion reactions, and hypogammaglobulinemia. Ocrelizumab additionally poses a heightened risk of immune-mediated colitis and breast cancer, and it is contraindicated for patients with active hepatitis B due to the risk of viral reactivation. Ublituximab has been noted to be linked to potential fetal harm. We report the case of a 42-year-old male with relapsing-remitting multiple sclerosis on ocrelizumab who developed persistent fever and shortness of breath, two weeks after his last ocrelizumab dose. Despite antibiotic treatment for suspected pneumonia, his symptoms persisted. A chest CT scan revealed multifocal ground-glass opacities suggestive of organizing pneumonia, likely secondary to ocrelizumab. The patient's condition improved with high-dose corticosteroids, underscoring the importance of vigilance for extremely rare ocrelizumab-associated pulmonary side effects and the need for prompt, appropriate intervention.

Fatal Hemoptysis With Pleural Effusions Secondary to Superior Vena Cava Obstruction as a Complication of Central Venous Catheterization.

This report outlines a rare case of superior vena cava (SVC) syndrome presenting with hemoptysis in a 33-year-old female Jehovah's Witness patient with a complex medical history, including systemic lupus erythematosus (SLE) and chronic hemodialysis dependency due to end-stage renal disease and a failed renal transplant. The SVC syndrome was attributed to occlusion from a right subclavian dialysis catheter. The management of this case was particularly challenging due to the patient's severe anemia and the development of a tension hemothorax following thoracentesis, compounded by her refusal of blood transfusions in adherence to her religious beliefs. A multidisciplinary approach, incorporating bloodless medical techniques such as erythropoietin and iron infusions alongside surgical interventions without blood transfusion, was successfully employed. This case sheds light on the evolving etiology of SVC syndrome and highlights the uncommon but potentially fatal occurrence of hemoptysis as a complication. It also emphasizes the importance of respecting patient values in complex medical decisions.

Effects of eggshell and seashell powder as natural dietary calcium supplements on growth, molting frequency, and carapace calcium composition of juvenile red claw crayfish, Cherax quadricarinatus.

The growth performance of red claw crayfish, Cherax quadricarinatus, fed diets with different sources and concentrations of natural calcium was evaluated. Formulated diets containing 30% protein and 8% lipid were prepared using supplementation of 0 (control), 3%, 6%, 9% eggshell, and 6% seashell. C. quadricarinatus juveniles with an average total weight of 0.21 ± 0.01 g and length of 25.0 ± 0.10 mm were obtained from ten ovigerous females bred in captivity. An aquarium with a size of 0.72 m² was divided into eight compartments with an area of 0.09 m² per compartment and was individually stocked with juvenile crayfish. A total of eight juvenile crayfish were used per dietary treatment. There were five dietary treatments in total and each of these treatments were replicated three times. The addition of eggshell and seashell powder exerted positive effects on the growth performance, molting frequency, and survival of the crayfish. Crayfish fed with a 6% eggshell-supplemented diet exhibited the best overall growth performance. The calcium percentage of the carapace increased with the increase in calcium content of the diets. Meanwhile, the performance of diets comprising eggshells and seashells was not significantly different (P > 0.05). Considering the low cost and abundance of eggshells, the addition of 6% of this product to the diet is recommended for the best growth of juvenile C. quadricarinatus.

Entropy and Gaussian Filter-Based Adaptive Active Contour for Segmentation of Skin Lesions.

Malignant melanoma is considered one of the deadliest skin diseases if ignored without treatment. The mortality rate caused by melanoma is more than two times that of other skin malignancy diseases. These facts encourage computer scientists to find automated methods to discover skin cancers. Nowadays, the analysis of skin images is widely used by assistant physicians to discover the first stage of the disease automatically. One of the challenges the computer science researchers faced when developing such a system is the un-clarity of the existing images, such as noise like shadows, low contrast, hairs, and specular reflections, which complicates detecting the skin lesions in that images. This paper proposes the solution to the problem mentioned earlier using the active contour method. Still, seed selection in the dynamic contour method has the main drawback of where it should start the segmentation process. This paper uses Gaussian filter-based maximum entropy and morphological processing methods to find automatic seed points for active contour. By incorporating this, it can segment the lesion from dermoscopic images automatically. Our proposed methodology tested quantitative and qualitative measures on standard dataset dermis and used to test the proposed method's reliability which shows encouraging results.

Free-living marine nematodes community structure in the conservation area (Chaojing Park) and its adjacent area of Keelung, Taiwan.

Studies conducted in the same seas or even study sites nearby each other, showed very different community structure, implying the patchiness of free-living marine nematodes which may be related to the sedimentary environment such as sediment type and food availability of the study area. This study was motivated by the concerns about the impacts of high level of anthropogenic activities on Chaojing Park (gazetted as Wanghaixiang's Chao-Jing Bay Resource Conservation Area (WCJBRA) in 2016). The present study provides baseline knowledge of free-living marine nematode community structure in WCJBRA and identify potential marine nematodes as bioindicators to indicate possible impacts of the anthropogenic activities to the Chaojing Park. A total of 15 stations were selected in the subtidal zones of WCJBRA and its adjacent area. Marine nematode sample collection was carried out on the 13th and 14th of September 2019 using SCUBA diving technique. Results showed positive correlation between nematode density and medium sand (500µm-1.0mm). Presence of certain species such as Daptonema sp., Pomponema sp. and Innocuonema sp. indicates presence of disturbances in S12 and S13. Several species also showed potential to be introduced as indicator for healthy environment subjected to further studies on nematode-pollutants relationship, particularly on autecology as per se. Higher species diversity, H' index of S1-S8 and S11 was categorised as Good Condition; followed by station with moderate species diversity index (S9, S10, S14 -Moderate Condition) zone; and lastly S12, S13 and S15 (Poor Condition).

A new record of the spiny lobster, Panulirusfemoristriga (von Martens, 1872) from the coastal waters of Malaysia, with revision of global distribution.

BACKGROUND: Spiny lobsters of the family Palinuridae Latreille, 1802 are known to be industrial crustaceans in the global fishing market amongst other crustacean marine species. Panulirusfemoristriga has been reported in the Maldives, Japan, Taiwan, Vietnam, the Philippines, Indonesia (Ambon, Irian Jaya, Celebes Island, Seram Island), the Polynesian Islands, Solomon Islands, New Hebrides, Wallis and Futuna and off the coast of northern Australia, but there is uncertainty about their distributions due to the morphological similarity with Panulirusfemoristriga, Panuliruslongipesbispinosus and Panulirusbrunneiflagellum. However, the identification on P.femoristiga can only be confirmed if the morphological descriptions are mentioned in literature. NEW INFORMATION: A specimen of the spiny lobster Panulirusfemoristriga Von Martens, 1872 was discovered in Semporna, located on the west coast of Sabah State, Malaysia Borneo. While the status of P.femoristriga has been classified as "least concern" on the International Union for Conservation of Nature Red List, studies on the species' population size, habitat and distribution are still inadequate. This study adopted both morphological and molecular approaches for species delimitation.The phylogenetic position of the Sabah P.femoristriga was revealed by the mitochondrial cytochrome c oxidase gene (COI) marker. This represents the first record of the species in the coastal waters of Sabah, despite its wide geographical distribution in the Indo-West Pacific. A revision on the species global distribution was also conducted by harvesting all literature with species named Panuliruslongipesfemoristriga and Panulirusfemoristriga which were available online including those prior to year 2001 before the presence of P.femoristriga is confirmed. Due to the uncertainties on the morphological distribution in previous literature, further studies are required to fill in the missing data for confirmation.

Nutritional value of black soldier fly (Hermetia illucens) larvae processed by different methods.

Nutritional value of black soldier fly (Hermetia illucens) larvae (BSFL) processed by three different methods of treatment was compared. The resulting products were the spray-dried BSFL (SPR), oven-dried BSFL 1 (OVN1) and oven-dried BSFL 2 (OVN2). Proximate chemical composition, and profiles of amino acids, fatty acids, minerals, heavy metals, vitamins and nucleotides were analysed and compared. The tested BSFL meals were considered to have a good profile of essential amino acids (EAAs), with leucine, lysine, valine, and histidine being the dominant EAAs. Their content of saturated fatty acids exceeded that of the unsaturated fatty acids. Vitamins B1, B2, and C were also present in the samples. Minerals such as calcium, potassium, phosphorus, sodium, magnesium, zinc, iron, manganese and copper were found to be in adequate amounts in almost all the samples. Heavy metals in the BSFL meals were mostly below 1g kg-1. Nucleotides such as inosine monophosphate and uridine monophosphate occurred in all the BSFL meals. Other nucleotides, including guanosine monophosphate, adenosine monophosphate, xanthosine monophosphate, and cytidine monophosphate were detected in either or both of SPR and OVN2. In general, the nutritional value of the BSFL meals tested in the present study was influenced by the method of processing.

Endovascular Management of Type III Perimedullary Spinal Arteriovenous Malformations in Pediatric Population.

BACKGROUND: Spinal arteriovenous malformations (AVMs) are a cause of 20-30 of all spinal vascular malformation. The treatment option for the AVM depends upon the type of AVM. Here, we present a case series to discuss the type, management, and post-operative conclusion of the spinal AVMs. METHOD: Four patients with spinal AVMs were retrospectively reviewed. All 4 patients were with a nidus-type AVM. Treatment for all patients required embolization. Clinical features, imaging, treatment, and clinical results were observed. All 4 patient's clinical outcome was assessed using the Modified Ranked Scale. RESULT: The follow-up after management showed that all four-patient recovered without any residual deficit. All four-patient scored zero (0) on the Modified Ranked Scale. CONCLUSION: Pediatric spinal AVMs are rare and require complex multimodal approach to achieve favorable outcomes.

Chemosensitivity and role of swimming legs of mud crab, Scylla paramamosain, in feeding activity as determined by electrocardiographic and behavioural observations.

Swimming crabs have a characteristic fifth pair of legs that are flattened into paddles for swimming purposes. The dactyl of these legs bears a thick seta along its edge. The chemoreceptive and feeding properties of the seta are supported with scientific evidence; however, there is no available data on the sensitivity of the setae in portunid crabs. The underlying mechanisms of the chemo- and mechano-sensitivity of appendages and their involvement in feeding activities of the mud crab (Scylla paramamosain) were investigated using electrocardiography and behavioural assay, which focused on the responses of the mud crab to chemical and touch stimulus. Electrocardiography revealed the sensory properties of the appendages. The dactyls of swimming legs and the antennules were chemosensitive, but not mechanosensitive and vice versa for the antennae. However, the mouthparts, claws, and walking legs were chemo- and mechanosensitive. Only the chemosensitive appendages, including the swimming legs, were directly involved in feeding. The flattened dactyls of the swimming legs were more efficient than the pointed dactyls of the walking legs in detecting the food organism crawling on the substrate. The structural features enhanced the capacity of the crab in coming into contact with scattered food items. This study revealed that the swimming legs are important appendages for feeding in the mud crab.

Diel osmorespiration rhythms of juvenile marble goby (Oxyeleotris marmorata).

Oxyeleotris marmorata is an ambush predator. It is known for slow growth rate and high market demand. Farming of O. marmorata still remains a challenge. In order to establish a proper feeding practice to stimulate growth, knowledge of its metabolic processes and cost should be examined. Therefore, this study was designed to investigate the diel osmorespiration rhythms of O. marmorata in response to feeding challenge by using an osmorespirometry assay. The results have shown that oxygen consumption rate of the fed fish was approximately 3 times higher than that of the unfed fish in early evening to support specific dynamic action. Digestion and ingestion processes were likely to be completed within 18-20 h in parallel with the ammonia excretion noticeable in early morning. Under resting metabolism, metabolic oxygen consumption was influenced by diel phase, but no effect was noted in ammonia excretion. As a nocturnal species, O. marmorata exhibited standard aerobic metabolic mode under dark phase followed by light phase, with high oxygen consumption rate found in either fed or unfed fish. It can be confirmed that both the diel phase and feeding have a significant interactive impact on oxygen consumption rate, whereas ammonia metabolism is impacted by feeding state. High metabolic rate of O. marmorata supports the nocturnal foraging activity in this fish. This finding suggested that feeding of O. marmorata should be performed during nighttime and water renewal should be conducted during daytime.

Identification of Vibrio harveyi isolated from diseased Asian seabass Lates calcarifer by use of 16S ribosomal DNA sequencing.

The grow out of Asian seabass Lates calcarifer in marine net-cages is a popular aquaculture activity in Malaysia. Production of this species is greatly affected by the occurrence of vibriosis, which causes heavy mortality. Generally, young fish are more susceptible; they exhibit anorexia and skin darkening, followed by heavy mortality. The acutely affected older fish may also exhibit bloody lesions around the anus and the base of the fins. Twenty-one bacterial isolates obtained from internal organs (kidney, heart, spleen and liver) of the affected specimens were subjected to phenotypic characterization, testing for antibiotic susceptibility, and 16S ribosomal DNA sequencing. The sequencing result showed that all of the bacterial isolates belonged to Vibrio harveyi. The phenotypic characterization, however, identified 4 of the bacterial isolates as V. harveyi, 16 as V. parahaemolyticus, and 1 as V. alginolyticus. These findings suggest that biochemical features alone cannot be reliably used to identify bacterial pathogens, including V. harveyi, in aquaculture. Antibiotic susceptibility assays showed that some antibiotics, including oxytetracycline, nitrofurantoin, furazolidone, streptomycin, sulfamethoxazole, chloramphenicol, nalidixic acid, and oxolinic acid were effective against V. harveyi. Considering the side effects of these antibiotics, however, their use is not recommended in the aquaculture of Asian seabass.