A Subjective Assessment of Chemotherapy Drug-Induced Taste and Smell Alteration in Non-head and Neck Cancer Patients: A Questionnaire-Based Cross-Sectional Study.

OBJECTIVE: This study aimed to evaluate alterations in taste and smell perceptions among non-head and neck cancer patients receiving chemotherapy, aiming to identify factors influencing these changes. METHODS: A cohort of 70 non-head and neck cancer patients undergoing one to four cycles or more than four cycles, over a six-month period, from oncology outpatient clinics was recruited. Participants completed structured taste and smell questionnaires with assistance from interviewers. Demographic data, recurrence history, chemotherapy cycles, drug regimens, and taste and smell perceptions were analyzed using descriptive statistics and chi-square tests. RESULTS: The mean age of participants was 46.5 years, with a predominance of females (81.4%) and breast cancer cases (42.9%). Taste changes were more prevalent (62.9%) than smell changes (32.9%) post chemotherapy, particularly among those on combination drug regimens. Salty taste alterations were the most common (30.0%), followed by sweet taste (22.9%) and sour/bitter tastes (14.3%). Moreover, 38.57% of patients reported experiencing dysgeusia, while 30% noted the occurrence of parosmia post chemotherapy. CONCLUSION: Chemotherapy-induced alterations in taste and smell significantly impact the quality of life and nutritional status of cancer patients. Despite often being overlooked, these changes warrant increased attention in oncological practice to inform treatment decisions and enhance symptom management, particularly in palliative care settings. Further research is needed to explore the implications of chemosensory alterations on patient outcomes and treatment strategies.

Nitric oxide, energy and redox-dependent responses to hypoxia.

Hypoxia occurs when the oxygen levels fall below the levels required for mitochondria to support respiration. Regulated hypoxia is associated with quiescence, particularly in storage organs (seeds) and stem cell niches. In contrast, environmentally-induced hypoxia poses significant challenges for metabolically-active cells that are adapted to aerobic respiration. The perception of oxygen availability through cysteine oxidases, which function as oxygen-sensing enzymes in plants that control the N-degron pathway, and the regulation of hypoxia-responsive genes and processes is essential to survival. Functioning together with reactive oxygen species (ROS), particularly hydrogen peroxide and reactive nitrogen species (RNS), such as nitric oxide (•NO), nitrogen dioxide (•NO2), S-nitrosothiols (SNOs), and peroxynitrite (ONOO-), hypoxia signaling pathways trigger anatomical adaptations such as formation of aerenchyma, mobilization of sugar reserves for anaerobic germination, formation of aerial adventitious roots and hyponastic response. NO and hydrogen peroxide (H2O2) participate in local and systemic signaling pathways that facilitate acclimation to changing energetic requirements, controlling glycolytic fermentation, the GABA shunt and amino acid synthesis. NO enhances antioxidant capacity and contributes to the recycling of redox equivalents energy metabolism through the phytoglobin (Pgb)-NO cycle. Here, we summarize current knowledge, highlighting the central role of NO and redox regulation in adaptive responses that prevent hypoxia-induced death in challenging conditions such as flooding.

Definition and characteristics of climate-adaptive cities: a systematic review.

BACKGROUND: Cities, as frontline responders to climate change, necessitate a precise understanding of climate-adaptive features. This systematic review aims to define and outline the characteristics of climate-adaptive cities, contributing vital insights for resilient urban planning. METHODS: This systematic review, initiated on March 6, 2018, and concluded on August 26, 2021, involved reviewing multiple electronic databases based on the study's objectives. The Critical Appraisal Skills Program (CASP) tool was used for quality assessment and critical evaluation of articles retrieved through a comprehensive and systematic text search. Descriptive and thematic analyses were conducted to extract definitions, features, and characteristics of climate-adaptive cities. RESULTS: Out of 6104 identified articles, 38 articles met the inclusion criteria. In total, 20 definitions and 55 features for climate-adaptive cities were identified in this review. Codes were categorized into two categories and ten subcategories. The categories included definitions and features or characteristics of climate-adaptive cities. CONCLUSION: A climate-adaptive city, as derived from the findings of this study, is a city that, through effective resource management, future-oriented planning, education, knowledge utilization, innovation in governance and industry, decentralized management, and low-carbon economy, leads to the adaptability, resilience, sustainability, and flexibility of the capacity of individuals, communities, institutions, businesses, and systems within a city against all climate change impacts and reduces their negative consequences.

Hemodynamics: Strangers to Lung-kidney Crosstalk in ARDS?

How to cite this article: Magoon R, Sharma AG, Yadav N, Choupoo NS. Hemodynamics: Strangers to Lung-kidney Crosstalk in ARDS? Indian J Crit Care Med 2024;28(2):177-178.

Artificial intelligence and machine learning algorithms in the detection of heavy metals in water and wastewater: Methodological and ethical challenges.

Heavy metals (HMs) enter waterbodies through various means, which, when exceeding a threshold limit, cause toxic effects both on the environment and in humans upon entering their systems. Recent times have seen an increase in such HM influx incident rates. This requires an instant response in this regard to review the challenges in the available classical methods for HM detection and removal. As well as provide an opportunity to explore the applications of artificial intelligence (AI) and machine learning (ML) for the identification and further redemption of water and wastewater from the HMs. This review of research focuses on such applications in conjunction with the available in-silico models producing worldwide data for HM levels. Furthermore, the effect of HMs on various disease progressions has been provided, along with a brief account of prediction models analysing the health impact of HM intoxication. Also discussing the ethical and other challenges associated with the use of AI and ML in this field is the futuristic approach intended to follow, opening a wide scope of possibilities for improvement in wastewater treatment methodologies.

The emerging roles of nitric oxide and its associated scavengers-phytoglobins-in plant symbiotic interactions.

A key feature in the establishment of symbiosis between plants and microbes is the maintenance of the balance between the production of the small redox-related molecule, nitric oxide (NO), and its cognate scavenging pathways. During the establishment of symbiosis, a transition from a normoxic to a microoxic environment often takes place, triggering the production of NO from nitrite via a reductive production pathway. Plant hemoglobins [phytoglobins (Phytogbs)] are a central tenant of NO scavenging, with NO homeostasis maintained via the Phytogb-NO cycle. While the first plant hemoglobin (leghemoglobin), associated with the symbiotic relationship between leguminous plants and bacterial Rhizobium species, was discovered in 1939, most other plant hemoglobins, identified only in the 1990s, were considered as non-symbiotic. From recent studies, it is becoming evident that the role of Phytogbs1 in the establishment and maintenance of plant-bacterial and plant-fungal symbiosis is also essential in roots. Consequently, the division of plant hemoglobins into symbiotic and non-symbiotic groups becomes less justified. While the main function of Phytogbs1 is related to the regulation of NO levels, participation of these proteins in the establishment of symbiotic relationships between plants and microorganisms represents another important dimension among the other processes in which these key redox-regulatory proteins play a central role.

Brief interventions for alcohol misuse among people living with HIV: a meta-analysis.

Background: One-third of people living with HIV (PLHIV) have alcohol misuse or alcohol use disorders which negatively affect course and outcome of HIV.Objectives: The meta-analysis sought to evaluate the effectiveness of brief interventions (BI) on alcohol and HIV outcomes in PLHIV with alcohol misuse.Methods: We included clinical trials published between 1990 and September 2022 on adults with harmful/hazardous alcohol use; only randomized clinical trials (RCTs) were included in the meta-analysis. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials.Gov, and the World Health Organization's International Clinical Trials Registry Platform databases. Cochrane's risk-of-bias assessment was used.Results: Eighteen studies were included in the narrative synthesis, and a meta-analysis could be performed on 13 studies. Among the included RCTs, seven showed a low risk and two showed a high risk of bias; others showed some concerns. There was no evidence of publication bias. Compared to the control, BI significantly reduces the drinks per drinking day (N = 5, Hedge's g= -0.45, 95%CI = -0.58, -0.32) and the number of heavy drinking days (N = 4, Hedge'sg = -0.81, 95% CI= -0.94, -0.67) between 3-6 months post-intervention. BI also reduces the odds of mortality by 42% (N = 7, OR = 0.58, 95% CI = 0.34, 0.99) in 6-12 months. BI does not change the alcohol risk scores and transition to harmful alcohol use; it does not improve adherence to Anti-Retroviral Therapy and increase viral suppression.Conclusion: Policymakers must introduce and scale up integrated screening and brief intervention services within HIV clinics and primary care.

Two Parallel Roads Impacting the Functional Preparedness of Accredited Hospitals: The Indian Healthcare Quality Standards and Disaster Management Act 2005.

Background: Quality management of healthcare service providers and disaster preparedness are two important aspects that affect patient safety and the overall outcome of care delivery. Accreditation standards and legal framework for disaster management are intertwined and pave the way for achieving the optimum level of safety in healthcare system. Aims: The aim of the study is to evaluate the functional preparedness of hospital staff for managing disaster situations. Materials and Methods: It was a quantitative, cross-sectional, ex-post-facto study to understand the functional elements by deeply studying the Knowledge, Attitude and Practice (KAP) scores of various level hospital staff. Results: Knowledge scores of the participants showed positive correlation with attitude scores (r = 0.424, P < 0.001) and practice scores (r = 0.446, P < 0.001). The study showed a significant difference between mean KAP score of males (14.96 ± 3.5) and female (16.38 ± 2.6). Similarly, the staff who obtained excellent scores in the KAP study belonged to a higher age group while those who obtained poor were in the lowest age group (F (2, 715) =10.739; P < 0.001). The performance of staff significantly increased (P < 0.01) with increase in age as number of years of experience and on-the-job training enriched their understanding. Inspite, of the same level of inputs in terms of training and sensitization inputs, the staff of Administration departments showed higher knowledge than other staff (χ2 =97.37, P < 0.001). Analysis of educational qualification of participants elicits that it has a statistically significant effect on their performance in KAP study (F (5, 709) = 12.82; P < 0.001). Conclusion: The KAP scores are direct indicator of effectiveness of quality standards in preparing the hospital for disaster management. The study shows that variables like age, gender, department, educational qualification are correlated with performance and affect the attitude and practice during a disaster event.

Case Report: Nocardia amamiensis Infection Leading to Worsening of Chronic Obstructive Pulmonary Disease Symptoms in an Elderly Man.

Nocardiosis is a rare opportunistic infection mostly affecting the lungs, brain, or skin of immunocompromised individuals. Most pulmonary nocardiosis patients present with nonspecific clinical features such as productive cough, exertional dyspnea, and fever. The disease is uncommonly suspected, especially in tuberculosis-endemic regions, and clinical diagnosis is often delayed, resulting in high mortality. Pulmonary nocardiosis in apparently immunocompetent individuals is uncommon. Here, we present the case of an elderly gentleman with a background history of poorly controlled diabetes but no history of systemic steroid use who presented with worsening symptoms of chronic obstructive pulmonary disease in the form of productive cough and dyspnea. The patient had diffuse crepitations in bilateral lung fields and an arterial oxygen saturation of 86% at admission. Sputum microscopy revealed gram-positive filamentous bacteria that could be successfully cultured and identified as Nocardia amamiensis on 16S ribosomal RNA sequencing. Contrast-enhanced computed tomography of the lungs revealed cavitary nodules and consolidation. The patient responded well to treatment with specific antibiotics based on sensitivity patterns. Because of the nonspecific clinical and radiological findings in pulmonary nocardiosis, a high index of suspicion is required, especially in tuberculosis-endemic regions.

Advances in biomass derived low-cost carbon catalyst for biodiesel production: preparation methods, reaction conditions, and mechanisms.

Biodiesel is a less hazardous, environmentally friendly biofuel that has been extensively investigated in modern years to ensure that we lessen our dependency on fossil fuels and mitigate climate change. While fossil fuel substitutes like biodiesel may help transition to a less polluted world, industrial-scale manufacturing still relies highly on chemical catalysis. However, heterogeneous solid catalysts result in less activity for biodiesel production due to their deactivation effects, porosity, surface area, material stability, and lower reactivity under moderate conditions. The "sulfonated carbons" are metal-free solid protonic acids distinguished by their distinctive carbon structure and Brønsted acidity (H0 = 8-11). Heterogeneous sulfonated catalysts derived from waste biomass were a significant focus of the most advanced biodiesel processing techniques for simple and low-cost manufacturing processes. This study discusses the advantages and disadvantages of various catalysts, biomass sources and properties, synthesis of catalysts, and factors influencing the insertion of active sulfonic sites on biomass surfaces. Additionally, transesterification and esterification reaction mechanisms and kinetics are discussed. At last, future directions are provided for young, dynamic researchers.

A smart and sustainable pathway for abatement of single and binary mixtures of dyes through magnetically retrievable Ca4Fe9O17 anchored on Biochar matrix.

In this work, the author developed Ca4Fe9O17/biochar (CFB) via a green method through a facile co-precipitation procedure involving egg shells as calcium precursor and investigating its performance in single as well as binary solution of methylene blue (MB) and rhodamine B (RhB). The CFB nanocomposite was characterized by XRD, SEM, TEM, XPS, Raman, FTIR, BET, and VSM. ESR studies show the presence of hydroxyl (·OH) and superoxide (O2·¯) radicals, which are primary radical species for pollutant degradation. The average crystalline size of CFB nanocomposites was found to be 32.992 nm using XRD, whereas TEM analysis indicates a particle diameter of 35-36 nm. The degradation efficacy of MB and RhB dyes was achieved at 99.2% and 98.6%, respectively, in a single solution, whereas 99.4% and 99.2%, respectively, in a binary solution within 36 min. Additionally, an iron cluster was formed during the degradation process of MB dye. The degradation of organic contaminants and generation of iron clusters from the degraded dye products were both expedited by the remarkable extension effect of the Ca4Fe9O17 in the CFB nanocomposites. The three processes were achieved using CFB nanocomposite: (1) the advanced oxidation process; (2) degradation of MB and RhB dye in single as well as binary solution with enhanced efficiency, (3) the production of the iron cluster from degraded products. Thus, these three steps constitute a smart and sustainable way that leads to an effective effluent water treatment system and the generation of iron clusters preventing secondary pollution.

Case Report: Diffuse Cutaneous Leishmaniasis Successfully Treated with a Combination of Oral Rifampicin and Fluconazole.

Diffuse cutaneous leishmaniasis (DCL) is a rare parasitic infection caused by the Leishmania species. Diffuse cutaneous leishmaniasis commonly presents as non-ulcerating papules and nodules over the face, neck, and arms. A middle-aged female presented with multiple nodular lesions on her face, neck, and chest region. Histopathology of the lesions showed multiple amastigotes, confirming the diagnosis of DCL. She was successfully treated with a combination course of rifampicin and fluconazole. Here, we report the first case of DCL in north India, a non-endemic area for cutaneous leishmaniasis.

Microwave-assisted biodiesel production using -SO3H functionalized heterogeneous catalyst derived from a lignin-rich biomass.

The synthesis of biodiesel from renewable resources has immense potential as a sustainable and cost-effective energy alternative. In this work, a reusable -SO3H functionalized heterogeneous catalyst that has a total acid density of 2.06 mmol/g was prepared from walnut (Juglans regia) shell powder by low-temperature hydrothermal carbonization (WNS-SO3H). Walnut shell (WNS) contains more lignin (50.3%), which shows great resistance toward moisture. The prepared catalyst was employed for the effective conversion of oleic acid to methyl oleate by a microwave-assisted esterification reaction. The EDS analysis revealed the significant presence of sulfur (4.76 wt%), oxygen (51.24 wt%), and carbon (44 wt%) content. The results of the XPS analysis confirm the bonding of C-S, C-C, C=C, C-O, and C=O. Meanwhile, the presence of -SO3H (the responsible factor for the esterification of oleic acid) was confirmed by FTIR analysis. Under the optimized conditions (9 wt% catalyst loading, 1:16 oleic acid to methanol molar ratio, 60 min reaction time, and 85 °C temperature), the conversion of oleic acid to biodiesel was found to be 99.01 ± 0.3%. The obtained methyl oleate was characterized by employing 13C and 1H nuclear magnetic spectroscopy. The conversion yield and chemical composition of methyl oleate were confirmed by gas chromatography analysis. In conclusion, it can be a sustainable catalyst because the catalyst preparation controls the agro-waste, a great conversion is achieved due to the high lignin content, and the catalyst was reusable for five effective reaction cycles.

Nitric oxide regulates mitochondrial biogenesis in plants.

The site of nitric oxide (NO) production in mitochondrial cytochrome c oxidase and the role of NO in mitochondrial biogenesis are not known in plants. By imposing osmotic stress and recovery on Arabidopsis seedlings we investigated the site of NO production and its role in mitochondrial biogenesis. Osmotic stress reduced growth and mitochondrial number while increasing NO production. During the recovery phase the mitochondrial number increased and this increase was higher in wild type and the high NO-producing Pgb1 silencing line in comparison to the NO-deficient nitrate reductase double mutant (nia1/nia2). Application of nitrite stimulated NO production and mitochondrial number in the nia1/nia2 mutant. Osmotic stress induced COX6b- 3 and COA6-L genes encoding subunits of COX. The mutants cox6b-3 and coa6-l were impaired both in NO production and mitochondrial number during stress to recovery suggesting the involvement of these subunits in nitrite-dependent NO production. Transcripts encoding the mitochondrial protein import machinery showed reduced expression in cox6b-3 and coa6-l mutants. Finally, COX6b-3 and COA6-L interacted with the VQ27 motif-containing protein in the presence of NO. The vq27 mutant was impaired in mitochondrial biogenesis. Our results suggest the involvement of COX derived NO in mitochondrial biogenesis.

Blockchain technology for sustainable supply chains: a network cluster analysis and future research propositions.

Achieving the sustainable goals of the United Nations requires improving supply chain sustainability (SSC). Blockchain technology (BCT) has attracted attention on a global level with the ability to transform supply chain management and sustainability efforts. Recognizing this, this study investigates how BCT plays a role in SSC. The current study looks into the importance of BCT in order to move supply networks towards sustainability by performing bibliometric analysis, and network cluster analysis. Through the literature review, the current literature was analyzed and future research directions were concluded. We begin our study by selecting 297 papers on the relevant subjects by applying various filters to the Web of Science (WoS) database. Influential individuals, journals, and organizations in this field were identified using bibliometric analysis. A network analysis was performed to identify influential co-author, and keywords, and for page rank, and cluster analysis. The network analysis was revealed ten distinct study clusters, and ten propositions were suggested from the analysis of these clusters. Additionally, a conceptual framework for the research was proposed, which can advise managers, practitioners, and researcher communities on the key trends and topics in this emerging research domain. Furthermore, to guide research scholars in this field, 33 future research directions were suggested.

Microwave-assisted synthesis of biodiesel by a green carbon-based heterogeneous catalyst derived from areca nut husk by one-pot hydrothermal carbonization.

In this study, we have synthesized a solid acid catalyst by areca nut husk using low temperature hydrothermal carbonization method. The fabricated catalyst has enhanced sulfonic actives sites (3.12%) and high acid density (1.88 mmol g-1) due to -SO3H, which are used significantly for effective biodiesel synthesis at low temperatures. The chemical composition and morphology of the catalyst is determined by various techniques, such as Fourier transform infrared (FTIR), powder X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET), Scanning electron microscope (SEM), Energy disruptive spectroscopy (EDS), Mapping, Thermogravimetric analysis (TGA), CHNS analyzer, Transmission electron microscopy (TEM), particle size analyzer, and X-ray photoelectron spectroscopy (XPS). Acid-base back titration method was used to determine the acid density of the synthesized material. In the presence of the as-fabricated catalyst, the conversion of oleic acid (OA) to methyl oleate reached 96.4% in 60 min under optimized conditions (1:25 Oleic acid: methanol ratio, 80 °C, 60 min, 9 wt% catalyst dosage) and observed low activation energy of 45.377 kJ mol-1. The presence of the porous structure and sulfonic groups of the catalyst contributes to the high activity of the catalyst. The biodiesel synthesis was confirmed by gas-chromatography mass spectrometer (GC-MS) and Nuclear magnetic resonance (NMR). The reusability of the catalyst was examined up to four consecutive cycles, yielding a high 85% transformation of OA to methyl oleate on the fourth catalytic cycle.

Efficacy and safety of biosimilar versus originator infliximab in patients with inflammatory bowel disease: A real-world cohort analysis.

BACKGROUND: Anti-tumor necrosis factor (anti-TNF) monoclonal antibody, infliximab, is the primary therapeutic modality for patients with Crohn's disease (CD) and ulcerative colitis (UC), refractory to conventional therapy. Biosimilars of infliximab have been shown to have equivalent efficacy to originator infliximab. We compared the safety and efficacy of infliximab biosimilar with the originator in Indian patients with inflammatory bowel disease (IBD). METHODS: Patients with IBD treated with either originator or biosimilar infliximab from January 2005 to October 2020 were included in this retrospective analysis. The safety and efficacy of originator or biosimilar infliximab in inducing and maintaining clinical remission at weeks 14 and 52 for CD and UC were evaluated. Disease activity was estimated at baseline, after induction therapy, after 1 year of treatment, and during 12 months of follow-up. RESULTS: In all, 137 patients (82 CD; 55 UC) were included, of whom 102 were on originator, and 35 patients received biosimilar. In biosimilar group, clinical response and remission rates at weeks 14 and 52 were 84.2%, 58% and 68.4%, 52.6% in CD and 81.2%, 56.2% and 68.7%, 62.5% in UC patients, respectively. Among patients who were on originator, clinical response and remission rates at weeks 14 and 52 were 79.4%, 46% and 57.1%, 43% in CD and 72%, 64.1% and 66.7%, 56.4% in UC patients, respectively. Thirty-three (24.1%) patients experienced adverse events; eighteen developed tuberculosis (TB), of whom 17 received originator and one patient received biosimilar. CONCLUSIONS: Infliximab biosimilar is comparable to originator infliximab in terms of safety profile and its efficacy in inducing and maintaining remission in patients with IBD.

Thromboembolism is associated with poor prognosis and high mortality in patients with inflammatory bowel disease: A case-control study.

BACKGROUND: The information on the risk of thromboembolism (TE) in inflammatory bowel disease (IBD) and its predictors are lacking, especially from developing countries. The present study evaluated the prevalence, predictors, and prognosis of TE in IBD. METHODS: This case-control study included 35 patients with IBD (ulcerative colitis [UC, n = 25]; Crohn's disease [CD], n = 10) and history of TE, from a cohort of 3597 patients (UC n = 2752, CD n = 845) under follow-up from 2005 to 2018. Details on demographics, extraintestinal manifestations (EIMs), patient status, type and outcomes of TE, treatment details, and disease course were compared with IBD patients without TE (age, gender, and duration of follow-up matched) in the ratio of 1:4. RESULTS: Prevalence of TE in IBD was 0.9% (UC-0.89%, CD-1.2%). Among TE patients (mean age: 34.9 ± 13.1 years, 48.6% males), median duration from diagnosis to TE was 12 (inter-quartile range [IQR]: 3-36) months, 37% had other EIMs, 94.1% had moderate/severe disease at time of TE, 62.8% had steroid-dependent/refractory disease, and 5 patients (14.2%) died because of disease-related complications. Lower limb was the commonest site (57.1%), 14.3% had pulmonary TE, and 31.4% had involvement of multiple sites. Phenotypically, more patients with TE (among UC) had steroid-dependent disease (60% vs. 25%, p = 0.001), pancolitis (76% vs. 36%, p = 0.002), chronic continuous disease course (44% vs. 19%, p = 0.009), and acute severe colitis (48% vs. 18%, p = 0.002), of which the latter three were also independent predictors of TE. CONCLUSION: Approximately 1% of patients with IBD develop thromboembolism relatively early during their disease course, and TE is associated with severe disease and higher disease-related complications including mortality.