Dilated Cardiomyopathy and Severe Functional Valvular Regurgitation in a Young Adult with Prior Childhood Chemotherapy: Progressive Ventricular Dysfunction Despite Surgical Correction and Optimal Medical Therapy

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Background: Late cardiotoxicity is a recognized complication in survivors of childhood cancer treated with potentially cardiotoxic agents, particularly anthracyclines. These therapies may cause progressive myocardial injury through mechanisms involving oxidative stress, mitochondrial dysfunction, and cardiomyocyte apoptosis. Over time, this process can lead to ventricular remodeling, dilated cardiomyopathy, and heart failure. Advanced ventricular dilation frequently results in functional mitral and tricuspid regurgitation, further worsening hemodynamic burden and clinical outcomes.

Case summary: We report the case of a 42-year-old man with a history of non-Hodgkin lymphoma diagnosed in childhood and treated with chemotherapy, without subsequent cardiologic follow-up. From the age of 29, he developed progressive heart failure symptoms. Transthoracic echocardiography revealed severe functional mitral regurgitation with mixed mechanism (Carpentier type I due to annular dilation and type IIIa due to leaflet restriction) and massive tricuspid regurgitation, associated with severe atrial dilation, grade III diastolic dysfunction, and pulmonary hypertension. Left ventricular systolic dysfunction was documented with an ejection fraction of 36% and markedly reduced global longitudinal strain (−11%), consistent with non-ischemic dilated cardiomyopathy.

The patient underwent mitral valve replacement and tricuspid valve repair but developed intraoperative cardiac arrest and postoperative mixed shock. Persistent severe ventricular dysfunction (LVEF 26%, GLS −8%) and multiple complications were observed.

Conclusion: This case highlights the importance of long-term cardiovascular surveillance in childhood cancer survivors and the role of strain imaging in detecting chemotherapy-related cardiomyopathy.

Free Acidity in Hydrometallurgy is not pH: A Critical Review of Measurement Methods, Errors, and Process Consequences

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Free acidity is a key control parameter in hydrometallurgical processes, governing dissolution, precipitation, solvent extraction, neutralization, and corrosion behavior, yet its determination in real process liquors remains poorly standardized and often misunderstood. In industrial solutions, the distinction between total acidity, free acidity, and active acidity is frequently obscured by high ionic strength, metal hydrolysis, ion pairing, and complexation reactions, making simple pH measurement or conventional titration unreliable. This review critically examines the main analytical approaches used to determine free acidity in hydrometallurgical liquors, including classical acid–base titration, potentiometric and Gran methods, oxalate and complexation-based procedures, Ba(OH)₂ and other selective titrations, inline monitoring techniques, and speciation-based modeling calculations. Particular emphasis is given to the effect of interfering species commonly present in industrial circuits, such as Fe³⁺, Al³⁺, SO₄²⁻, Cl⁻, and F⁻, which strongly influence endpoint detection, hydrogen ion activity, and the apparent acid balance. The review shows that discrepancies between analytical methods are not only experimental but also thermodynamic, arising from differences between proton concentration, activity, and chemically bound acidity. These inconsistencies can lead to significant errors in process control, affecting reagent consumption, precipitation efficiency, scaling, solvent extraction stability, and environmental performance. By comparing reported methods and industrial practices, this work identifies the limitations of current procedures and highlights the need for standardized definitions, speciation-aware analysis, and improved inline monitoring strategies for reliable acidity control in modern hydrometallurgical operations.

Technology Management Approach and Semiotic Theory in The Works of Shahnon Ahmad

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This study aims to analyse the management approach portrayed by the author Shahnon Ahmad in his selected novels, namely Sampah, Tivi and Kemelut. Specifically, it focuses on the management of technology as constructed in these novels as a contribution to the field of literary studies. The novel functions as a medium reflecting society and is regarded as a platform through which the author expresses views, opinions, criticisms, and even satire concerning issues perceived as falling short of humanitarian values, while simultaneously offering moral lessons. The study seeks to raise awareness among all levels of society to be more attentive and cautious in embracing the rhetoric of progress and modernity brought about by technology. The narratives presented in Shahnon Ahmad’s novels depict human life exposed to issues and conflicts arising from the ineffective management of technology. The implications of these conflicts reveal managerial shortcomings through characters, dialogues, and the background of events portrayed. Accordingly, management aspects and semiotic theory are introduced to examine and discuss the narrative of technology management. The objectives of this study are twofold: first, to identify the narrative of technology in the selected novels through the application of semiotic theory; and second, to employ a management approach in evaluating the implications of technology use that is poorly managed, based on core management principles namely planning, organizing, leadership, staffing, and control.

A Qualitative Study of Mosquito Nest Eradication Behavior Using the Health Belief Model Approach in Bandarsari Village, Padang Ratu District, Central Lampung Regency

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: Dengue Hemorrhagic Fever (DHF) remains a serious public health issue in Indonesia. Bandarsari Village in the working area of Surabaya Community Health Center is the location with the highest DHF incidence rate. Primary prevention through Mosquito Nest Eradication (MNE) with the 3M Plus strategy heavily relies on community participation, whose behavior is influenced by individual perceptions. This phenomenological qualitative study aims to explore the perceptions of the community and health workers regarding MNE using the Health Belief Model (HBM) framework. The research was conducted in September 2025 in Bandarsari Village, involving 11 key informants selected purposively, including the Village Head, Village Midwife, Program Manager, Hamlet Heads, and Neighborhood Association Heads. Data were collected through in-depth interviews and Focus Group Discussions (FGD), then analyzed using thematic analysis with data validity ensured through source triangulation. The analysis revealed six main themes aligned with the HBM constructs: perceptions of susceptibility and severity that were adequate yet reactive, high perceived benefits of MNE, strong socio-behavioral barriers (such as low sustained motivation and lack of community motivators), action cues dependent on case occurrences and external socialization, and still low self-efficacy at the community level for independent preventive actions. Critical findings indicate that the success of MNE is not solely determined by environmental factors and knowledge but is significantly influenced by psychosocial dynamics and community self-confidence. This study reinforces the need for a comprehensive intervention framework that not only focuses on education but also builds community self-reliance through approaches that address behavioral barriers, enhance collective self-efficacy, and establish a structured and sustainable system of action cues within DHF prevention programs.

Biochemical Composition of Selected low value fish species from Visakhapatnam Fishing Harbour

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Understanding the biochemical composition of marine fishes is important for evaluating their nutritional value, ecological role, and suitability for human consumption. The present study examined the biochemical characteristics of three commercially important marine species namely, Thryssa mystax, Upeneus sulphureus, and Priacanthus hamrur. Key components such as protein, lipid, and carbohydrate content were analyzed in the species.

The results showed clear differences in nutrient composition between the three fishes. Thryssa mystax contained relatively high protein levels with moderate lipid content, which may be related to its active pelagic lifestyle. Upeneus sulphureus showed comparatively higher lipid content, suggesting a greater capacity for energy storage associated with its benthic feeding habits. Priacanthus hamrur exhibited a more balanced biochemical profile, with moderate levels of protein, lipids, and carbohydrates, reflecting its adaptable feeding behavior. The observed variations highlight how feeding patterns, habitat, and environmental conditions influence biochemical composition. Overall, the findings provide useful information for fisheries management, nutritional evaluation, and potential applications in aquaculture and food industries.

The Impact of Mediterranean Diet on Global Challenges

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Mediterranean diet is considered healthy compared to typical western diets while it was used by populations residing in Mediterranean basin since centuries. Several studies indicate that Mediterranean diet offers many health and environmental benefits. The positive impacts of this diet in treating various global challenges have been examined. Reviewing  several published papers the impacts of Mediterranean diet on managing obesity and malnutrition, on climate change mitigation and in the achievement of the sustainable development goals have been investigated. The results indicate that the use of Mediterranean diet helps in treating obesity and malnutrition, while it contributes positively in climate change mitigation and in achieving the 17 sustainable development goals. Unfortunately, for several reasons, the traditional Mediterranean diet  has been nowadays replaced by unhealthy western type diets burdening various global challenges that humanity faces. Our work is important since it indicates that the change of our dietary pattern shifting from western diet to Mediterranean diet will result in the mitigation of several global challenges. The results of the present study could be useful to medicinal doctors, policy makers, public authorities, non-governmental environmental organizations and other institutions related with the abovementioned issues.

Artificial Intelligence and Automation in Hospital Administrative Systems: A Scoping Review

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Background: Hospital administrative processes including billing, scheduling, and medical records management—are critical to health system performance but are often characterized by inefficiencies, high operational costs, and workforce burden. Artificial intelligence (AI) and automation technologies, including robotic process automation (RPA) and natural language processing (NLP), have emerged as potential solutions to streamline these processes and enhance productivity.

Objective: This scoping review aimed to synthesize existing evidence on the use of AI and automation in hospital administrative functions, focusing on efficiency gains, cost savings, implementation barriers, and ethical and regulatory considerations.

Methods: A scoping search of peer-reviewed literature was conducted across major electronic databases including PubMed, Scopus, Web of Science, and Google Scholar. Studies published between 2015 and 2025 that examined AI-based or automation-driven interventions in hospital administrative settings were included. Eligible studies addressed applications in billing, scheduling, records management, hospital information systems, or workflow optimization. Data was extracted and synthesized narratively due to heterogeneity in study designs and outcome measures.

Results: The review identified substantial evidence that AI and automation improve administrative efficiency through reduction of processing time, minimization of manual errors, and optimization of resource allocation. RPA demonstrated significant benefits in billing and claims processing, while NLP enhanced documentation accuracy and records retrieval. Several studies reported measurable cost savings and productivity improvements following implementation. However, common barriers included integration challenges with legacy systems, limited interoperability, data quality concerns, staff resistance, insufficient training, high upfront costs, and uncertain short-term return on investment. Regulatory and governance challenges, particularly data protection compliance and algorithm transparency were also frequently highlighted.

Conclusion: AI and automation technologies show considerable promise in transforming hospital administrative processes by improving efficiency and reducing operational costs. Nevertheless, successful implementation requires strong governance frameworks, workforce capacity building, financial planning, and ethical oversight. Future research should focus on longitudinal cost-effectiveness evaluations and context-specific implementation strategies, particularly in resource-limited health systems.

Phytomining as an Emerging Metal Recovery Route: A Critical Review of Plant Uptake Mechanisms, Processing Strategies, And Industrial Constraints (2020–2025)

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Phytomining has re-emerged as a promising strategy for the sustainable recovery of valuable and critical metals from soils, mine tailings, and industrial residues, while simultaneously contributing to environmental remediation. This critical review synthesizes advances published between 2020 and 2025, focusing on the biological, agronomic, and metallurgical foundations that govern phytomining performance and scalability. Recent progress in hyperaccumulator selection, soil amendments, plant–microbe interactions, and biomass processing has expanded the range of target metals beyond nickel to include gold, platinum-group metals, rare-earth elements, and scandium. However, field-scale deployment remains constrained by trade-offs between biomass productivity and metal concentration, as well as by the efficiency and cost of downstream ash processing and metal recovery. By integrating reported case studies, techno-economic assessments, and environmental indicators, this review positions phytomining within circular economy and nature-based remediation frameworks. Key knowledge gaps have been identified in process integration, quantitative performance metrics, and long-term sustainability, providing a roadmap for transitioning phytomining from experimental trials to industrially relevant applications.

Factors Influencing English Teachers’ Use of Generative Ai for Teaching Speaking Activities at a Language Center in Ca Mau

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Despite the potential of Generative AI (GenAI) to reduce Foreign Language Anxiety (FLA) in speaking instruction, its implementation in resource-constrained settings like a language center in Ca Mau province, Vietnam, remains underexplored. This study investigates the paradox of “digital native” instructors who possess high digital literacy but face infrastructural and pedagogical barriers in the Mekong Delta region of Vietnam. Employing an explanatory sequential mixed-methods design, quantitative data were collected from 58 EFL teachers via surveys, followed by semi-structured interviews. Utilizing the SAMR model as a diagnostic framework, the findings revealed the existence of a Substitution Plateau. Although teachers frequently used GenAI for administrative tasks (Substitution level, M = 3.91), its application for transformative, real-time voice interactions was notably limited (Redefinition level, M = 1.96). Stepwise multiple regression and thematic analyses demonstrated that infrastructural barriers (beta = -.52) and ethical concerns regarding “synthetic fluency” significantly inhibited advanced GenAI adoption, outweighing the positive influence of teachers’ TPACK competence. The study concludes that in peripheral educational settings, the primary limiting factor is not technological illiteracy, but rather a contextually driven “safety-first” pedagogical strategy. These findings challenge the universality of tech-integration models and provide localized implications for AI adoption in the Global South.

Integrating Targeting, Branding, And Advertising Through Instagram: A Case Study of Marketing Strategy at Rumah Cantik Cila

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This study examines Instagram as a central platform in the marketing strategy of DRW Skincare at Rumah Cantik Cila. In the digital era, social media has evolved beyond communication functions to become an integrated marketing instrument encompassing targeting, branding, advertising, and social media management. Employing a qualitative descriptive case study approach, this research investigates how Instagram’s features and account management practices are utilized to enhance brand awareness, expand market reach, and maintain customer engagement. Data were collected through interviews, observation, and documentation involving the business owner and a social media specialist. The findings indicate that Instagram plays a pivotal role in supporting marketing performance through professional account management and the strategic use of features such as feeds, stories, reels, live streaming, and paid advertising. These tools enable Rumah Cantik Cila to access both local and international audiences while fostering interactive relationships with customers. The study also reveals that Instagram functions as a central hub integrating social media management, diverse promotional features, and wide market reach, which collectively support the implementation of targeting, branding, and advertising strategies in a cohesive framework. Overall, Instagram contributes not only to increased sales but also to sustained brand loyalty through consistent and strategic engagement. This study highlights Instagram’s significance as an effective digital marketing platform for small businesses in the beauty industry, offering practical insights for enterprises seeking to optimize social media–based marketing strategies.