Letter to editor: Exploring complications following cranioplasty after decompressive hemicraniectomy: A retrospective bicenter assessment of autologous, PMMA and CAD implants.

This study presents a critical analysis of complications following cranioplasty (CP) after decompressive hemicraniectomy, focusing on autologous, polymethylmethacrylate (PMMA), and computer-aided design (CAD) implants. The analysis encompasses a retrospective bicenter assessment, evaluating factors influencing surgical outcomes and emphasizing the significance of material selection in minimizing postoperative complications. The study's comprehensive examination of complication rates associated with various implant materials contributes significantly to understanding CP outcomes. While polymethylmethacrylate (PMMA) and autologous bone flaps (ABFs) exhibited higher rates of surgical site infection (SSI) and explantation, a meta-analysis revealed a contrasting lower infection rate for polyether ether ketone (PEEK) implants. The study underscores the critical role of material selection in mitigating postoperative complications. Despite its strengths, the study's retrospective design, reliance on data from two centers, and limited sample size pose limitations. Future research should prioritize prospective, multicenter studies with standardized protocols to enhance diagnostic accuracy and treatment efficacy in CP procedures.

Impact of biologically effective dose on tremor decrease after stereotactic radiosurgical thalamotomy for essential tremor: a retrospective longitudinal analysis.

This letter to the editor critiques a recent study evaluating the role of biologically effective dose (BED) in stereotactic radiosurgical thalamotomy for essential tremor (ET). The study, conducted retrospectively on 78 ET patients, demonstrates a significant correlation between BED and tremor improvement post-SRS. Moreover, the study suggests adjusting the prescribed dose rather than changing cobalt-60 sources to maintain treatment efficacy while minimizing toxicity. This suggestion aligns with previous research indicating an annual decrease in BED due to cobalt-60 decay. The letter emphasizes the importance of considering BED and cobalt-60 decay in optimizing treatment outcomes for ET patients undergoing stereotactic radiosurgery. Further research is recommended to explore innovative techniques for dose modulation in response to cobalt-60 decay and validate findings in larger cohorts.

Blue-laser-diode-based high CRI lighting and high-speed visible light communication using narrowband green-/red-emitting composite phosphor film.

We experimentally demonstrate high-speed visible light communication (VLC) and high-quality solid-state lighting (SSL) using polymethyl-methacrylate-doped phosphor film based on cesium lead bromide quantum dot (CsPbBr3-QD) and potassium fluorosilicate K2SiF6:Mn4+, which is excited by a blue gallium nitride laser diode. A 1.6 Gbps data rate is achieved by employing a non-return-to-zero on-off keying modulation scheme. The measured bit error rate of 2.7×10-3 adheres to the standard threshold (3.8×10-3) of forward error correction. Moreover, the generated white-light source has a high color rendering index of 93.8 and a correlated color temperature of 4435 K, and it exhibits a Commission Internationale de l'Eclairage (CIE) 1931 chromaticity coordinate at (0.3556, 0.3520), which is close to the ideal CIE value of white light (0.3333, 0.3333). This work opens up exciting possibilities for future high-speed indoor VLC and high-quality SSL.

A complex case of recurrent intracranial bleeds due to malaria-induced coagulopathy: A case report and literature review.

Background: Malaria, a prevalent disease in the developing world, is a significant cause of morbidity and mortality. Infection with Plasmodium falciparum, although uncommon, can lead to severe brain injury, including intracranial hemorrhages, resulting in serious neurological deficits. Malaria-induced coagulopathy, while rarely reported, poses a challenge in understanding the exact mechanisms behind the development of intracranial bleeds. Proposed mechanisms include sequestration of parasitized erythrocytes in the brain's microvasculature, leading to capillary occlusion, endothelial damage, cytokine activation, and dysregulation of the coagulation cascade. Case Description: We present the case of a 53-year-old male rapidly deteriorating following a history of traumatic brain injury (TBI). Upon admission, a computed tomography scan revealed bilateral acute on chronic hematomas, necessitating a lifesaving craniotomy. Subsequently, the patient experienced three consecutive recurrent intracranial bleeds post-surgery, attributed to Falciparum-induced coagulopathy. Prompt recognition and intervention stabilized the patient's condition, leading to discharge on the 4th post-operative day. Conclusion: This case underscores the challenges posed by consecutive recurrent intracranial bleeds following TBI exacerbated by P. falciparum infection. It highlights the obstinate nature of malaria-induced coagulopathy and underscores the importance of timely and aggressive interventions in managing such cases.

Assessment of water quality using entropy-weighted quality index, statistical methods and electrical resistivity tomography, Moti village, northern Pakistan.

In this study, twenty-two water samples were collected from boreholes (BH), and streams to evaluate drinking water quality, its distribution, identification of contamination sources and apportionment for Moti village, northern Pakistan. An atomic absorption spectrophotometer (AAS) is utilized to determine the level of heavy metals in water such as arsenic (As), zinc (Zn), lead (Pb), copper (Cu), cadmium (Cd), manganese (Mn), and ferrous (Fe). Groundwater chemistry and its quantitative driving factors were further explored using multivariate statistical methods, Principal Component Analysis (PCA) and Positive Matrix Factorization (PMF) models. Finally, a total of eight electrical resistivity tomographs (ERTs) were acquired across i) the highly contaminated streams; ii) the villages far away from contaminated streams; and iii) across the freshwater stream. In the Moti village, the mean levels (mg/l) of heavy metals in water samples were 7.2465 (As), 0.4971 (Zn), 0.5056 (Pb), 0.0422 (Cu), 0.0279 (Cd), 0.1579 (Mn), and 0.9253 (Fe) that exceeded the permissible limit for drinking water (such as 0.010 for As and Pb, 3.0 for Zn, 0.003 for Cd and 0.3 for Fe) established by the World Health Organization (WHO, 2008). The average entropy weighted water quality index (EWQI) of 200, heavy metal pollution index (HPI) of 175, heavy metal evaluation index (HEI) of 1.6 values reveal inferior water quality in the study area. Human health risk assessment, consisting of hazard quotient (HQ) and hazard index (HI), exceeded the risk threshold (>1),indicating prevention of groundwater usage. Results obtained from the PCA and PMF models indicated anthropogenic sources (i.e. industrial and solid waste) responsible for the high concentration of heavy metals in the surface and groundwater. The ERTs imaged the subsurface down to about 40 m depths and show the least resistivity values (<11 Ωm) for subsurface layers that are highly contaminated. However, the ERTs revealed relatively high resistivity values for subsurface layers containing fresh or less contaminated water. Filtering and continuous monitoring of the quality of drinking water in the village are highly recommended.

Ferric carboxymaltose for iron deficiency in patients with heart failure: a systematic review and meta-analysis.

Aim: Iron deficiency (ID) is associated with heart failure (HF) in a considerable proportion of patients. To improve the quality of life, lower the frequency of hospitalizations, and lower mortality rates of chronic HF patients (HF), this meta-analysis will look into the role of iron supplementation using ferric carboxymaltose (FCM). Methods & results: From inception until 1 October 2023, we conducted a thorough literature search of electronic databases for peer-reviewed publications. Around 5229 HF patients were included, of which 2691 received FCM while 2538 received placebo. Conclusion: FCM reduces HF-related hospitalizations but doesn't improve overall or cardiovascular mortality in those with HF and ID. The overall results support FCM's role in managing iron deficiency in heart failure.

Heart failure (HF) patients often suffer from iron deficiency (ID), worsening their symptoms and quality of life. Intravenous iron therapy, like ferric carboxymaltose (FCM), has been studied for its benefits in HF. This meta-analysis looked at existing research and found that FCM treatment reduced hospitalizations for HF but didn't significantly impact overall mortality. Although FCM improves patients' lives, more research is needed to understand its long-term effects fully. This study highlights the importance of addressing ID in HF management and supports FCM therapy as a beneficial option for HF patients.

Spatiotemporal characterization of dissolved trace elements in the Gandaki River, Central Himalaya Nepal.

A comprehensive investigation was conducted on trace elements (TEs) in the glacier-fed Gandaki River Basin, Central Himalayas Nepal. A total of 93 water samples were collected from 31 locations in pre-monsoon, monsoon and post-monsoon seasons in 2016 to evaluate the concentrations of TEs. Multivariate statistical techniques such as analysis of variance, cluster analysis, principal component analysis, and correlation analysis were applied to investigate the spatiotemporal variations and identify the major sources of the TEs. The results classified most of the TEs into two groups. Group 1 including Cs, Li, Ni, Rb, Sc, Sr, Tl, U and V were from geogenic sources, while Group 2 including Cd, Co, Cr, Cu, Pb, Ti, Y and Zn were impacted by anthropogenic activities. Group 1 showed lower concentrations in the lower-middle and downstream segments with higher precipitation and the highest concentrations during pre-monsoon. In contrast, Group 2 demonstrated higher concentrations in the densely populated lower segments with more agriculture and industries, and the highest concentrations during the post-monsoon season. Comparing to the drinking water limits suggested that special attention should be paid to the elevated concentrations of Zn and As. The results of the study provide a basic guideline for future environmental protection in the Himalaya.

Spatiotemporal variations of hydrogeochemistry and its controlling factors in the Gandaki River Basin, Central Himalaya Nepal.

The characterization and assessment of water quality in the head water region of Himalaya is necessary, given the immense importance of this region in sustaining livelihoods of people and maintaining ecological balance. A total of 165 water samples were collected from 55 sites during pre-monsoon, monsoon and post-monsoon seasons in 2016 from the Gandaki River Basin of the Central Himalaya, Nepal. The pH, EC values and TDS concentrations were measured in-situ and the concentrations of major ions (Ca2+, Mg2+, K+, Na+, Cl-, SO42-, NO3-) and Si were analyzed in laboratory. Correlation matrices, paired t-test, cluster analysis, principal component analysis (PCA), the Piper, Gibbs, and Mixing plots, and saturation index were applied to the measurements for evaluating spatiotemporal variation of the major ions. The results reveal mildly alkaline pH values and the following pattern of average ionic dominance: Ca2+>Mg2+>Na+>K+ for cations and HCO3->SO42->Cl->NO3- for anions. The results of PCA, Gibbs plot and the ionic relationships displayed the predominance of geogenic weathering processes in areas with carbonate dominant lithology. This conclusion is supported by geochemically different water facies identified in the Piper plot as Ca-HCO3 (83.03%), mixed Ca-Mg-Cl (12.73.0%) and Ca-Cl (4.24%). Pronounced spatiotemporal heterogeneity demonstrates the influence of climatic, geogenic and anthropogenic conditions. For instance, the Ca2+-SO42-, Mg2+-SO42- and Na+-Cl- pairs exhibit strong positive correlation with each other in the upstream region, whereas relatively weak correlation in the downstream region, likely indicating the influence of evapo-crystallization processes in the upstream region. Analyses of the suitability of the water supply for drinking and irrigation reveal that the river has mostly retained its natural water quality but poses safety concern at a few locations. Knowledge obtained through this study can contribute to the sustainable management of water quality in the climatically and lithologically distinct segments of the Himalayan river basins.