This study provides a seasonal and spatial characterization of surface-water physicochemical conditions and zooplankton diversity across seven stations in Merja Zerga Lagoon (Moroccan Atlantic coast). The seasonal variability in temperature, salinity, and conductivity governs the environmental structuring of Merja Zerga Lagoon. Zooplankton communities were highly diverse (108 taxa from 56 samples) and strongly dominated by copepods (91 taxa), with Euterpina acutifrons and Acartia spp. as the most abundant taxa (up to 1.31 × 105 and 8.92 × 104 ind. m-3, respectively). Community abundance and diversity peaked in autumn (440 × 102 ind. m-3) and were significantly lower in winter (50 × 102 ind. m-3), with distinct differences among stations indicating localized hydrodynamic influences and habitat heterogeneity. The seasonal shifts in zooplankton assemblages were primarily structured by temperature-driven seasonality and marine-inflow–related gradients (salinity/oxygen), providing a quantitative baseline for long-term monitoring and management of this ecologically important coastal lagoon.
Chlorophyll-a (Chl-a) variability in Indonesian waters is influenced by a combination of oceanographic and climatic processes operating across multiple spatial and temporal scales, making it an important indicator of marine ecosystem productivity and environmental change. This study investigates the multiscale spatiotemporal variability of Chl-a and its relationships with major ocean–climate drivers. Monthly satellite-derived Chl-a data from 2015 to 2024 were analyzed using Extended Empirical Orthogonal Function (EEOF) analysis to identify dominant modes and their temporal evolution. The total variance explained by the first four EEOF modes was 44.20%. EEOF1 and EEOF2 accounted for 33.76% of the variance and primarily represented the seasonal cycle associated with monsoon-driven upwelling, whereas EEOF3 and EEOF4 explained 10.44% and were associated with interannual variability related to the El Niño–Southern Oscillation (ENSO). The two mode pairs indicate that Chl-a variability results from seasonal monsoon forcing, basin-scale climate variability, and regional oceanographic conditions. The reconstructed anomaly fields and observed anomaly fields resemble each other closely, which means that the EEOF method effectively separates overlapping signals over a large range of time scales. It also mitigates edge effects. It, therefore, will be useful for ecosystem monitoring, climate-informed fisheries forecasting, and adaptive marine resource management.
Variation in growth and demographic structure across habitats is a crucial determinant of the sustainable management of tropical inland fisheries. However, information on habitat-related variation in growth and demographic structure across contrasting freshwater ecosystems remains limited. Therefore, this study aimed to investigate population ecology of Oxyeleotris marmorata across three contrasting freshwater ecosystems in South Kalimantan, Indonesia. The three ecosystems included Riam Kanan Reservoir, Martapura River, and Barito River, which represented distinct lentic–lotic environments. A total of 1800 individuals were analyzed from December 2024 to May 2025 to evaluate morphometric patterns, age structure, and reproductive balance in relation to environmental conditions. Length–weight relationship (LWR), Von Bertalanffy Growth Function (VBGF) modelling, and multivariate analyses (MANOVA, PCA, and CCA) were applied to integrate biological and environmental datasets. The results showed that there were clear spatial differences in growth and population structure. Riam Kanan population showed the highest growth (K = 0.45), a wider size range (120–490 mm TL), and more age cohorts, showing stable recruitment. Meanwhile, fish from Martapura and Barito had slower growth (K ≈ 0.056–0.06), smaller size (≤316 mm TL), and fewer cohorts. Sex-specific growth analysis showed that females reached larger asymptotic sizes (445 mm) despite lower growth rates. Growth was positively associated with dissolved oxygen and water transparency, but negatively affected by turbidity and flow velocity. These results indicated that growth variability in O. marmorata was driven by habitat-mediated eco-physiological mechanisms and energy allocation trade-offs, showing the importance of environmental filtering and life-history plasticity for ecosystem-based fisheries management and habitat-specific conservation strategies.
Tenebrio molitor meal is a high-protein alternative feed ingredient for aquaculture. This study evaluated the effects of replacing fish meal with T. molitor meal on feed efficiency, growth, and hemolymph profile in whiteleg shrimp (Litopenaeus vannamei). A completely randomized design was used with five dietary treatments (0%, 25%, 50%, 75%, and 100% substitution) and three replicates. Results showed that T. molitor meal significantly (P < 0.05) increased total feed intake, feed utilization efficiency, protein efficiency ratio, specific growth rate, total hemocyte count, differential hemocyte counts and decreased feed conversion ratio. The best performance was observed in the 100% substitution group: total feed intake 73.18 ± 0.51 g, feed utilization efficiency 98.84 ± 0.71%, feed conversion ratio 1.01 ± 0.01, specific growth rate 1.11 ± 0.02% day−1, survival rate 100%, total hemocyte count 4.2 ± 0.40 × 106 cells mL−1, and differential hemocyte counts: hyaline 92.00 ± 2.00%. Treatment B and D yielded the highest granular cell percentage at 13.00 ± 3.00% and a protein efficiency ratio of 3.35 ± 0.03%. Nutritional analysis also confirmed the presence of essential amino acids, EPA, DHA, and palmitic acid. These demonstrate that T. molitor meal can replace fish meal in L. vannamei diets while maintaining shrimp performance, improving nutritional and immune parameters, and supporting more sustainable feed formulation.
The level of vulnerability to thermal stress can profoundly affect sea urchin physiology and may also influence overall fitness, particularly by increasing mortality rates. The biological performance of sea urchins, including their viability, functional health, and reproductive output, is strongly determined by the prevailing ecological conditions. High temperatures can increase metabolic rates, thereby imposing metabolic constraints that place additional pressure on reproduction and growth, ultimately reducing overall fitness. Furthermore, under extreme conditions, these heightened temperatures can lead to die-offs that affect local marine ecosystems, in which sea urchins play a vital role in by grazing on algae and helping to maintain ecological balance. With climate change continuing to drive ocean warming, understanding these repercussions is becoming increasingly important for conserving sea urchin populations and maintaining marine ecosystem health. This study aimed to evaluate environmental factors, particularly heat stress, and their possible effects on the survival of sea urchins (Diadema savignyi). Specifically, the study investigated the impact of different temperature levels on the mortality rate of sea urchins (Diadema savignyi). Sea urchins were exposed to temperatures of 22, 25, 28, and 31C for up to 10 days. Mortality rates were assessed on days 2, 4, 6, 8, and 10. The findings indicated a mortality rate of 8.89% at 22C, which increased to 15.56% at 25C. At 28C, the mortality rate was 93.33%, and at 31C, it reached 100%. The environmental parameters of the organism's natural habitat were thoroughly assessed using a comprehensive range of physicochemical and biological measurements. This study confirmed the absence of other environmental stressors that could potentially have influenced sea urchin the survival rates. These findings provide a clearer understanding of the relationship between temperature change and species resilience, namely D. savignyi, in marine ecosystems such as the Gulf of Aqaba. The findings demonstrated that raising the temperature by 3C above the ambient level increased the mortality rate by 1.75-fold. The highest mortality rates were observed at 28C and 31C, demonstrating the high sensitivity of sea urchins to elevated temperatures. The current research showed that survival declined significantly at temperatures of 28C or higher, suggesting that future ocean warming may surpass the species' thermal tolerance thresholds, increase population susceptibility, and potentially disrupt coral reef ecosystem dynamics. These results highlight the importance of maintaining stable environmental conditions to preserve healthy sea urchin populations.
Coastal activities on small islands increasingly pressure mangrove ecosystems through pollutant inputs linked to the island's long history of tin extraction. This study assessed the distribution of heavy metals in sediments and their relationship with the estuarine mangroves's water quality of Bangka Island, Indonesia, using contamination indices, ecological risk metrics, and principal component analysis (PCA). Heavy metal concentrations were generally low, ranging from 0.100 mg kg−1 (Cd) to 11.24 mg kg−1 (Pb), decreasing in the order Pb > Zn > Cr > Cu > Cd. Enrichment factor (EF) analysis indicated predominantly natural sources for most metals; however, Cd showed localised anthropogenic enrichment (EF up to 13.44), while Cu exhibited moderate enrichment at selected sites (EF up to 5.06). PCA revealed that Zn and Cr were associated with fine sediment fractions, while Cu was influenced by salinity and correlated with Cd. Water quality parameters, particularly ammonia, nitrate, and the Pollution Index (IP = 5.62–6.37), indicated fair-to-moderate nutrient pollution at all stations, contrasting with the less impacted sediments and suggesting Bangka Island mangroves cannot be uniformly characterised as optimal ecologically. This enrichment of Cd, Pb, and Cu likely stems from runoff, wastewater, antifouling paints, and mining, highlighting the necessity for integrated coastal management.
Background Contamination of water with hazardous organics is a global problem because these compounds resist natural degradation and threaten human health. Among them, waste pharmaceuticals and dyes are particularly hazardous when discharged into water resources. Aim Current research focuses on developing low-cost, eco-friendly, sustainable, and efficient technologies for wastewater remediation. In this study, we report the fabrication of a novel nanobiosorbent, Enz-MIL-88 A@KRT, synthesized by immobilizing an enzymatic metal-organic framework (Enz-MIL-88 A) with keratin (KRT). Methods Keratin was extracted by using a cysteine reducing agent from chicken nail waste and confirmed to coordinate with Cu2+ ions, as evidenced by FTIR (peak at 555 cm−1) and XRD (2Ɵ = 15.22°, 18.45° and 28.48°). Results The resulting nanobiosorbent demonstrated remarkable adsorption efficiency, achieving 93.52% and 96.48% removal of doxorubicin (Dox) and neutral red dye (Nrd), respectively, within 40 min at 20 °C and pH 6. The removal was attributed to electrostatic interactions, hydrogen bonding, π–π stacking, and pore-filling. Adsorption data were highly fitted to the Freundlich expression (R2 = 0.919 for Dox and 0.983 for Nrd), indicating multilayer adsorption on heterogeneous surfaces. Notably, the Enz-MIL-88 A@KRT nanobiosorbent retained high performance after five reuse cycles, confirming its efficient stability and reusability. Conclusion These findings could establish Enz-MIL-88 A@KRT as a sustainable and highly efficient nanobiosorbent, highlighting its potential for wastewater treatment and resource valorization, while addressing critical water pollution challenges.
Marine biofouling remains a persistent operational and environmental challenge, while conventional metal-based antifouling coatings raise ecological concerns due to toxicity and bioaccumulation. In this study, a sustainable enzymatic antifouling strategy was developed by using keratinase overproduced from the marine isolate Pseudomonas otitidis EGY-NIOF-A1 (OQ547301). Cultivation in feather-based medium yielded 0.482 mg/mL protein with 73 units per mL (U/mL) keratinolytic activities. The enzyme demonstrated antioxidant capacity (29% 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging) and antimicrobial activity against Escherichia coli, Staphylococcus aureus, and Enterococcus faecalis, with no hemolytic effects, supporting its biosafety profile. The keratinase gene (1596 bp) was successfully amplified, representing the first reported keratinase sequence from P. otitidis. To enhance catalytic performance, a composite of keratinase with nano‑molybdenum trioxide (MoO3NP) was prepared. In vitro assays showed increased proteolytic and keratinolytic activities (3.9 U vs 2.3 U for crude enzyme), consistent with molecular docking simulations revealing stable non-covalent interactions (ΔG = −4.26 kcal/mol). Keratinase-MoO3NP-composite was incorporated into marine coatings and evaluated by using standardized panel immersion assays on wood and steel substrates for up to four weeks. Log10-transformed colony-forming units (CFU) enumeration combined with factorial general linear modeling demonstrated that keratinase-supplemented coatings significantly reduced microbial colonization relative to blank controls (p < 0.001), with efficacy modulated by substrate type, immersion duration, enzyme concentration, and paint pH. Notably, sustained antifouling activity was observed over extended exposure, frequently rivaling or exceeding a commercial benchmark. After four weeks of immersion for wood panels, the effect of pH on the keratinase-MoO3NP-composite with the Blank for 10% (PKB 2) suppressive action at pH 4 was the highest value of 99.73%. On a steel panel at pH 7, the highest suppressive effect was 97.43% for PKB 2. These findings establish enzyme–nano hybrid coatings as promising environmentally benign alternatives to conventional biocidal antifouling systems and provide mechanistic and statistical validation for their further development. The coordinated overexpression of multiple enzymes enabled by gene cloning approaches represents a promising direction for advancing next-generation antifouling coatings.
Hydrothermal venting is a key indicator of active submarine volcanism, visible as gas bubble streams and acoustic turbidity in shallow marine environments. Despite its significance, high-resolution acoustic imaging of vent bubble plumes in shallow volcanic coastal settings remains limited. This study aimed to apply a high-frequency single-beam echosounder (SBES) to characterize shallow-water hydrothermal venting. A field survey was conducted on March 16, 2023 at Sirui coastal area of Weh Island. Echogram analyses were used to identify four primary vent hotspots characterized by vertically coherent acoustic bubble plumes with volume backscattering strength (SV) values within −30 to −50 dB. The strongest backscatter intensities were identified close to the vent outlets. A distinct NE-SW-trending offshore bubble-vent line was identified, consistent with local fault structures and indicative of spatially coherent hydrothermal venting during the survey. Vertical backscatter profiles further reflected a progressive decrease in SV with increasing height above the seabed as a sign of bubble dispersion within the water column. The results showed the capability of a low-cost SBES to resolve fine-scale plume geometry and fault-controlled vent organization in shallow volcanic coastal environments. Future studies should integrate multi-frequency acoustics and direct bubble imaging to further constrain bubble dynamics and gas flux variability.
Abstract Background Carpal tunnel syndrome (CTS) is the most common peripheral nerve compression disorder and a frequent indication for neurosurgical consultation. Patients increasingly obtain medical information from artificial intelligence (AI) chatbots and social media platforms prior to clinical evaluation. The comparative quality and safety of these digital information sources in CTS remain insufficiently defined. The aim of this study was to systematically compare the quality of AI-generated medical advice with social media influencer–generated content regarding CTS, using a blinded, multi-rater evaluation framework. Specific objectives were to (i) quantify differences in accuracy, safety, clarity, and evidence-based alignment between the two information sources; (ii) characterize platform-level variability among social media sources; and (iii) evaluate inter-rater reliability of expert assessment. Methods In this blinded comparative study, twenty-five patient-oriented CTS questions were developed to reflect common inquiries encountered in neurosurgical and peripheral nerve practice. Matched responses were generated from ChatGPT (GPT-4) and from high-reach social media influencers across TikTok, Instagram, and YouTube (total responses n = 50). Three independent expert raters evaluated each response across four domains—accuracy, safety, clarity, and evidence-based alignment—using a 0–5 scale per domain (total score 0–20). Paired statistical analyses were performed, and inter-rater reliability was assessed using intraclass correlation coefficients (ICC). Results AI-generated responses demonstrated significantly higher total quality scores than social media influencer content (17.1 ± 0.9 vs. 12.4 ± 1.4; p < 0.001; Cohen’s d = 3.23). Superior performance was observed across all domains: accuracy (4.3 ± 0.3 vs. 3.1 ± 0.5), safety (4.4 ± 0.4 vs. 3.1 ± 0.6), clarity (4.2 ± 0.4 vs. 3.6 ± 0.5), and evidence-based alignment (4.1 ± 0.5 vs. 2.7 ± 0.8) (all p < 0.001). Among platforms, YouTube demonstrated higher scores than Instagram and TikTok, although all remained inferior to AI-generated responses. Inter-rater reliability was good (overall ICC = 0.76). Conclusions In this blinded expert evaluation, AI-generated responses provided more accurate, safer, and more evidence-aligned CTS information than social media influencer content. While AI systems cannot replace clinical assessment, they may serve as structured adjuncts for patient education in peripheral nerve disorders. The variability observed in social media content underscores the need for neurosurgical engagement in guiding patients toward reliable digital health resources.
Abstract Introduction Post-operative cerebral venous sinus thrombosis (CVST) is increasingly recognised after lateral skull-base surgery. When centres use routine early venography, asymptomatic thrombi are commonly detected; clinically symptomatic events are less frequent. A single-centre experience applying a sinus-sparing strategy (Bill’s Island during TL exposure, avoidance of fixed venous-sinus retraction in all cases) with selective lumbar drainage (LD) reports observed CVST rates with selective venography. Methods Retrospective cohort of 54 consecutive vestibular schwannoma resections (translabyrinthine [TL] or retrosigmoid [RS]) at a tertiary neurosurgical centre from February 2016 to December 2023. Venography was selective, using CT venography (CTV) for clinical triggers. The primary outcome was clinical CVST, defined as symptomatic CVST with imaging confirmation. Secondary outcomes were radiological CVST detected under selective venography, longitudinal functional outcomes measured by the Modified Rankin Scale (mRS) and Barthel Index (BI), cerebrospinal-fluid (CSF) complications, lumbar-drain use, and other postoperative events. Functional outcomes were assessed at 3, 6, 12 and 24 months. Results Clinical CVST was 0/54 (one-sided 95% upper confidence limit 5.40%). Post-operative CTV was performed selectively in 15/54 patients (27.8%) at a median of postoperative day 2. Radiological CVST occurred in 1/15 (6.7%) among those imaged; this corresponded to 1 event in the full cohort (1/54, 1.9%; 95% CI 0.047%–9.89%), although this should not be interpreted as the true radiological incidence because venography was selective rather than protocolised. The single radiological CVST arose adjacent to a minor intra-operative sigmoid-sinus wall injury, was asymptomatic, and occurred in a case without prophylactic LD; anticoagulation was not used. Patients who did not undergo venography did not develop symptoms prompting imaging or meet criteria for clinical CVST during the recorded postoperative course. Median mRS improved from 2 (3–6 months) to 1 (12–24 months); BI median was 100 at all time-points. Conclusion In this selective-venography series using a sinus-sparing, retraction-avoiding operative strategy, no clinical CVST and a low rate of radiological thrombosis were observed. Because imaging was selective, the true burden of silent radiological thrombosis cannot be determined from this study. Prospective multicentre studies with protocolised venography and harmonised endpoints are warranted.
A rare condition that can mimic spontaneous spinal epidural hematoma (SSEH) is hemorrhagic transformation of lumbar facet cysts. Clinical and magnetic resonance imaging (MRI) findings often overlap, making preoperative differential diagnosis challenging. The patient, a 72-year-old woman, had right S1 radiculopathy and low back pain. A cystic lesion at the right L5-S1 facet joint was first seen on MRI; later, the lesion became hypointense, indicating bleeding. The patient had the cyst completely removed and a partial hemilaminectomy performed on the right L5. There was a hemorrhagic facet cyst confirmed by histology. Six months following surgery, there was no sign of a recurrence of the symptoms. Decompression without fusion produces good outcomes, and sequential MRI is useful for diagnosis. In order to avoid misdiagnosis and unnecessary surgical procedures, it is critical to identify this condition.
Abstract Background and objective To evaluate the impact of integral dose (ID) delivered to the trigeminal nerve (TN) during Gamma Knife radiosurgery (GKRS) on durability of pain relief and its relationship with other clinical and dosimetric variables in patients with idiopathic TN. Methods and material Cohort of 101 patients with idiopathic TN underwent GKRS using a single 4-mm isocentre targeted to the cisternal segment. Prescription doses from 70 to 90 Gy. For each patient, trigeminal nerve length, volume, ID within the 50% isodose line, proximity to brainstem, beam blocking, and presence of neurovascular conflict were recorded. Pain outcomes were assessed using Barrow Neurological Institute Pain Score (BNI-PS), with follow-up up to 60 months. Correlation statistics, logistic regression, and Cox regression were applied to identify predictors of pain relief and recurrence. Results At three months, 51% of patients achieved significant pain relief, maintained in 70% at last follow-up. Median time to best pain relief was three months, and median pain-free survival was 72 months. Higher ID showed statistically significant positive correlation with long-term pain relief at 60 months (Spearman r = 0.45, p = 0.008), and logistic regression demonstrated nearly two-fold greater odds of improvement with increasing ID (OR = 2.4, p = 0.01). Nerve volume, nerve length, prescription dose, number of blocked sectors, and treatment time did not correlate with pain durability. Prior surgery was only independent predictor of treatment responsiveness on multivariate analysis (HR = 8.6, p = 0.0067). Sensory dysfunction occurred in 4.9% of patients and was not associated with ID. Conclusions GKRS is safe and effective treatment for idiopathic TN, offering durable pain control with minimal sensory morbidity. ID demonstrates weak but significant association with long-term pain relief, supporting its consideration in personalised radiosurgical planning. However, optimal BED, prescription isodose selection, and ID thresholds remain uncertain, necessitating further research.
Abstract Background Among the secondary complications of aneurysmal subarachnoid hemorrhage (aSAH), cerebral vasospasm stands as the leading contributor to delayed neurological deterioration, disability, and death. Angiographic evidence of vasospasm is detected in approximately 40–70% of affected individuals, with clinically symptomatic episodes occurring in 17–40%. Although systemic nimodipine administration and hemodynamic optimization form the mainstay of current treatment, a notable subset of patients exhibits vasospasm that proves resistant to these conventional approaches, thereby necessitating targeted endovascular rescue. The therapeutic potential of simultaneously delivering intra-arterial (IA) nimodipine and milrinone—a dual vasodilatory strategy exploiting complementary pharmacological pathways—has yet to be comprehensively evaluated. Objective To evaluate the safety and efficacy of combined IA nimodipine and milrinone infusion in patients with angiographic vasospasm refractory to maximal medical therapy following aSAH. Methods This retrospective, single-center study analyzed 50 consecutive patients with angiographically confirmed cerebral vasospasm following aSAH over a 3-year period (2022–2025). All patients underwent aneurysm securing (clipping or coiling) followed by combined IA nimodipine and milrinone infusion for refractory vasospasm. A total of 108 therapeutic digital subtraction angiography (DSA) sessions were performed. Primary outcomes included angiographic response and functional outcome assessed by the modified Rankin Scale (mRS) at discharge. Post-treatment outcomes were compared with published series using similar dual-agent approaches. Results Angiographic benefit was observed in 47 of 50 patients (94%). Immediate clinical improvement was noted in 18 patients (36%). A good functional outcome (mRS 0–2) was achieved in 41 patients (82%) at discharge. Among the 50 patients, 18 required three treatment sessions, 15 required two sessions, and 17 underwent a single session. The treatment mix included 20 patients (40%) treated with microsurgical clipping and 30 patients (60%) with endovascular coiling. No drug-related mortality was observed. Conclusions Concurrent IA delivery of nimodipine and milrinone constitutes a well-tolerated and efficacious endovascular rescue strategy for medically refractory post-aSAH vasospasm, producing angiographic reversal in 94% and discharge functional independence in 82% of treated patients. These findings are comparable to or better than existing single-agent and dual-agent series. Prospective multicenter trials are needed to confirm these observations and to establish an optimized treatment protocol.
Abstract Background Lumbar disc herniation surgery is among the most frequently performed procedures in neurosurgical practice, yet it remains one of the leading causes of medicolegal disputes. Understanding the judiciary’s perspective on such cases can provide valuable insights for improving both clinical decision-making and risk management. Methods This study analyzed 22 high court rulings issued by the Turkish Court of Cassation and the Council of State concerning alleged malpractice following lumbar disc herniation surgery. The legal decisions reviewed represented appeals submitted after local court verdicts and were systematically evaluated to identify recurring judicial considerations and medico-legal themes. The first author holds dual qualifications as a neurosurgeon and an attorney-at-law, providing a distinctive medico-legal perspective that bridges clinical practice and judicial analysis. Results The analysis demonstrated that the judiciary places particular emphasis on several recurrent factors that determine liability. Among these, accurate history-taking and comprehensive clinical examination were consistently highlighted as the foundation of appropriate diagnosis and treatment. The courts also underscored the necessity of using suitable diagnostic imaging to establish surgical indication and to justify operative intervention. Furthermore, meticulous surgical technique, intraoperative diligence, and detailed documentation of every step of the process were regarded as critical indicators of professional responsibility. Comprehensive patient information and properly obtained informed consent were likewise viewed as essential to prevent disputes. Finally, attention to postoperative care, including early recognition and management of complications, and adequate follow-up were closely associated with favorable judicial outcomes for physicians. Conclusion By adhering to the standards highlighted in these judicial rulings, physicians can substantially reduce their criminal, civil, and administrative liability. Greater awareness of these medico-legal expectations can promote safer neurosurgical practices, reinforce documentation and consent protocols, and foster a more transparent physician–patient relationship—ultimately strengthening legal protection in neurosurgical care.
Crabs are valuable fishery commodities, with increasing cultivation efforts to meet global demand. However, cannibalism during the critical molting phase remains a major challenge, especially in soft-shell crab farming, where asynchronous molting heightens vulnerability. This review employed bibliometric analysis of 392 publications from the Scopus database (2014–2024) to investigate mechanisms and factors influencing crab molting. The analysis revealed research trends focusing on transcriptomics, antioxidant responses, and studies on Scylla paramamosain. Recent shifts towards an emphasis on metabolism, physiology, and genetic regulation highlight the complexity of molting as an interplay of hormonal, genetic, cellular, and environmental factors. These findings provide valuable insights to enhance sustainable and efficient crab farming practices, particularly through improved molting management strategies.
Abstract Background Hemangioendothelioma is a rare vascular tumor with biological behavior intermediate between hemangioma and angiosarcoma. It occurs more frequently in young adults than in children and most commonly involves the liver, lungs, lymph nodes, and bones. Combined intra- and extracranial involvement is exceptionally rare. The rarity of such cases necessitates careful analysis of the available literature to guide diagnostic evaluation, treatment strategies, and prognostic assessment. Case description We present a clinical case of a 10-year-old girl with a giant hypervascular epithelioid hemangioendothelioma of the cranial vault. The tumor was first diagnosed in 2023 as an intracranial mass in the frontotemporal region associated with bone destruction. Subsequently, the lesion demonstrated progressive aggressive growth, reaching giant dimensions with extension into the fronto-orbital, parietal, and temporal regions. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a hypervascular tumor measuring 13.5 × 7.0 × 12.4 cm with combined intra- and extracranial components. Digital subtraction angiography (DSA) confirmed tumor vascularization from branches of the external carotid artery. The feeding vessels were embolized using a liquid embolic agent. On the following day, radical surgical resection of the tumor was performed. Histopathological examination confirmed the diagnosis of epithelioid hemangioendothelioma. The postoperative course was uneventful, with gradual regression of clinical symptoms and no neurological deficit. Conclusion This case highlights the effectiveness of preoperative embolization as an adjunct to surgical resection of hypervascular cranial tumors in pediatric patients, significantly reducing intraoperative blood loss and related complications. Keywords: epithelioid hemangioendothelioma; preoperative embolization; gross total resection; intra-extracranial extension.
Abstract Introduction Restoring elbow flexion is a primary goal in brachial plexus injury (BPI) reconstruction, as it is crucial for daily function. Ulnar nerve fascicle transfer and intercostal nerve (ICN) transfer are common surgical options. However, there is limited comparative data on their effectiveness, particularly within the Indonesian population. This study aimed to compare the clinical outcomes of these two procedures. Methods A retrospective comparative study was conducted on 24 adult BPI patients at RSUP H. Adam Malik. Patients were divided into two indication-based groups: ulnar nerve fascicle transfer for upper-type/upper-extended-type BPI (n = 12) and intercostal nerve (ICN) transfer for total-type BPI (n = 12). Clinical outcomes were assessed at the latest documented postoperative follow-up (minimum 2 months) using the Medical Research Council (MRC) scale for biceps muscle strength and goniometric measurement for active elbow flexion range of motion (ROM). Between-group comparisons were performed using the Mann-Whitney U test. Results The ulnar nerve transfer group achieved significantly better outcomes. The mean MRC score for the ulnar group was 2.45 (± 1.97), compared to 0.54 (± 0.25) for the ICN group (p = 0.021). The mean active elbow flexion ROM was 72.73° (± 59.18°) in the ulnar group, versus 22.31° (± 12.76°) in the ICN group (p = 0.041). Discussion The superior results of the ulnar nerve fascicle transfer are likely attributable to a shorter axonal regeneration distance and better physiological synergy between the donor (ulnar nerve) and recipient (musculocutaneous nerve) functions. Conclusion Ulnar nerve fascicle transfer provides significantly better clinical outcomes in restoring elbow flexion, in terms of both muscle strength and range of motion, compared to ICN transfer for BPI patients in this cohort.
Abstract Background Serum biomarkers are increasingly recognized as non-invasive ways of screening and prognostic evaluation for various medical conditions. The utility of ubiquitin C-terminal hydrolase L1 (UCH-L1), glial fibrillary acidic protein (GFAP), and S100β in traumatic brain injury (TBI) needs detailed examination. The present work examined GFAP, UCH-L1, and S100β levels in TBI from mild to severe injuries. Methods Patients with a Glasgow Coma Scale (GCS) score of 3–15 were recruited, and plasma levels of UCH-L1, GFAP, and S100β were measured by ELISA. Results 280 individuals participated in the study, comprising 140 healthy controls and 140 TBI patients. The mean ± standard deviation (SD) ages were 34.82 ± 3.14 years (controls) and 35.50 ± 11.05 years (TBI). In TBI patients S100β increased significantly from Day 0 at the time of admission with values of 1.86 ± 0.47 ng/mL, 1017.43 ± 56.31 pg/mL and 1.713 ± 0.31 ng/mL and decreased significantly by Day 7 of hospitalization with values of 0.266 ± 0.12 ng/mL, 267.98 ± 36.01 pg/mL and 0.05 ± 0.023 ng/mL, respectively (p < 0.001). A significant decline in biomarker levels was observed over the one week in TBI patients. Conclusions This study demonstrates that serum levels of GFAP, UCH-L1, and S100β are strongly elevated in TBI patients and correlate significantly with the severity of injury as measured by the GCS. Furthermore, high initial levels of these biomarkers, particularly GFAP and UCH-L1, are predictive of unfavourable functional outcomes at discharge. These biomarkers provide valuable complementary prognostic information alongside traditional clinical assessments. Also, these biomarkers demonstrated strong evidence as a reliable marker of neuronal injury and associated morbidity risk that provided complementary prognostic value along with the GCS score.
Abstract Background Aneurysmal subarachnoid haemorrhages (aSAH) have global variation in epidemiology, risk factors, management and outcomes. Data from Africa remain limited, particularly regarding endovascular management and functional recovery. Methods We conducted a 7-year retrospective single-centre review of patients admitted with aSAH to a tertiary hospital in Johannesburg, South Africa (June 2015-June 2022). Demographic, risk factor, clinical, radiological, management and outcome data were collected. Outcomes were assessed at discharge using the modified Rankin Scale (mRS). Results 137 patients were identified with a mean age of 47.6 years, 65.0% were female and 80.3% were Black. Hypertension was the most prevalent risk factor (56.9%). Headache was the leading presenting symptom (81.8%), and most patients (71.5%) presented with WFNS of 1 to 3. Most aneurysms were in the anterior circulation (94.9%) and saccular in morphology (90.5%). Management was predominantly endovascular, with coiling performed in 87.6% of cases. A good functional outcome (mRS 0–2) was seen in 67.2% of patients. Higher WFNS and H&H grades, and IPH was associated with clipping. WFNS and H&H had the strongest association with poor outcomes. Conclusion This study presents one of the few African reports documenting predominantly endovascular management of aSAH, with 87.6% of patients treated by coiling and 67.2% achieving a good functional outcome (mRS 0–2). Clinical severity at presentation, as measured by WFNS and H&H grades, was the strongest independent determinant of poor prognosis and should guide treatment decisions and prognostic counselling at African neurosurgical centres.
