Background: Aspiration pneumonitis is a syndrome resulting from the ingestion of gastric contents. The incidence in obstetric anesthesia has fallen, largely due to improved anesthetic techniques and the increased use of regional anesthesia at caesarean section. However, aspiration pneumonitis is still a cause of maternal morbidity and mortality, and it is important to use effective prophylaxis, 0.3M sodium citrate has been shown to elevate gastric pH when given as a single dose prior to induction and thereby minimizing the risk of aspiration. Aims & Objectives: aim of this study was to determine the effectiveness of 0.3M  sodium citrate, a non-particulate antacid, in neutralizing secreted gastric acid as prevention of aspiration pneumonia. To assess the ph of the gastric aspirate after induction and at the time of extubation in the study and control groups. To assess the change in gastric ph before and after giving 0.3M sodium citrate. Materials and Methods: 50 patients selected and evaluated were randomized by simple random sampling into two groups of 25 patients each. Group A-25 received 30 mL of test solution A. Group B-25 received 30 mL of Control Solution B. Both solutions were stored in identical amber bottles. 25 patients who received 30 mL of 0.3M sodium citrate were categorized into group A or study group. The remaining 25 patients who received 30 ml of distilled water were categorized into group B or control group. Conclusion: We conclude that the non-particulate antacid 0.3M sodium citrate, given orally about 20 min before induction of anesthesia, is an effective and safe antacid for prophylaxis against aspiration pneumonitis in all elective obstetric surgeries without producing any side effects.

DOI: 10.5281/zenodo.

Background: Pre eclampsia and eclampsia are responsible for more than 50,000 maternal fatalities worldwide. Controlling convulsions is the first rule in the treatment of eclampsia. Magnesium sulphate is the anticonvulsant medication of choice for both preventing and treating eclampsia, but its toxicities are dose-related, which is a serious issue. In many low-income nations, the medicine is only sometimes used due to unwarranted concern over these risks. Reducing the toxicity of magnesium sulphate without sacrificing its effectiveness in preventing seizures and reducing mortality rates is still a difficult task. Aim of the study: To study the effectiveness of low dose Magnesium sulphate Regimen- Dhaka Regimen in Eclampsia and to compare the effects of Standard regimen (Pritchard) to low dose regimen (Dhaka). Materials & Methods: This was a Prospective Clinical Study, Government Maternity Hospital attached to SVMC, Tirupati done in 200 pregnant women with severe pre-eclampsia, imminent eclampsia & eclampsia attending to Govt Maternity Hospital, Tirupati for a period of one year. Results: Unbooked cases of Pritchard regimen group were 94% and Dhaka regimen were 89%. Most of the cases were primigravida (67.5%). 44% were above 37 weeks. Level of consciousness of the patients in the 2 groups not differs significantly. No significant differences between 2 groups in number of convulsions before admission. Majority of the cases in both groups have SBP >160 mm Hg and Majority of the cases have DBP of 100-110 mm Hg. Out of 100 cases in Dhaka regimen group, 17 cases were augmented with oxytocin, 19 cases with PGE2, 57 cases with misoprostol. Conclusion: In women with eclampsia, magnesium sulphate is the anticonvulsant medication of choice. For smaller women, the Dhaka Regimen at a low dose appears to effectively regulate and avoid seizures. The current study offers more convincing evidence in favor of using magnesium sulphate frequently to treat eclampsia convulsions. Clinical surveillance seems suitable as long as there is enough urine output. There is no difference between the two magnesium sulphate regimens in terms of maternal mortality, perinatal death, maternal morbidity, or caesarean section rates.

DOI: 10.5281/zenodo.

Background: Hoarseness of voice, characterized by changes in the pitch, volume, and quality of the voice, is a common clinical symptom that can significantly impact an individual’s communication abilities and quality of life. Aim and Objectives: to analyze the clinical profile, incidence of common etiological factors and the association of common predisposing factors for hoarseness of voice. Materials and Method: This prospective clinical study was conducted in the Department of Otolaryngology at Aayan Institute of Medical Sciences, Hyderabad over a period of 1 year. The study population comprised 80 patients who presented with complaints of hoarseness of voice after following inclusion and exclusion criteria and after getting informed consent. Results: The majority of patients (47.5%) are between 41 and 60 years old, males (53.75%) were more than females, most common occupations are labourers (37.5%), most common habits are smoking (30%). Laryngeal malignancy most common aetiology, affecting 32.5% of patients. The most common finding, observed in 45% of patients observed Squamous cell carcinoma (keratin pearls). Conclusion: Laryngeal malignancy (squamous cell carcinoma) was found to be the most common cause of hoarseness of voice. Smoking was found to be the most common etiological factor for squamous cell carcinoma of Larynx (22%).

DOI: 10.5281/zenodo.

Background: The Blood bank Services play a crucial role in the healthcare system, annually saving numerous lives worldwide. All blood banks encounter the issue of a scarcity of blood donors. Significant number of donors is disqualified from donating blood, either temporarily or permanently, due to various reasons that vary among different blood banks. Materials and Methods: The study was carried out on 1900 donors who came for donation of blood. Results: Total 104 donors were deferred out of 1900 registered donors due to different reasons; anaemia was the most common reason of deferral followed by low weight. Conclusion: In the current study, the donor deferral rate was 5.47%. Understanding the reasons behind donor deferrals is crucial for blood donation centers to maintain a healthy and sustainable donor pool.

DOI: 10.5281/zenodo.

Background: Insulin Resistance can induce an imbalance in glucose metabolism that generates chronic hyperglycemia, which in turn triggers oxidative stress and causes an inflammatory response leading to cellular damage. Triglyceride Glucose index (TyG) index is a novel comprehensive marker composed of fasting blood glucose and fasting triglyceride levels with better predictive value, cost effective and easier to calculate in routine clinical practice. Therefore, the present study aims to determine the relationship between the TyG index and echocardiographic parameters which can be used to evaluate cardiac function and possibly predict the future cardiovascular risk. Method: Seventy patients in the age group 18-75 years were included in the study. TyG index was calculated by using formula Log (Fasting triglyceride (mg/dl) × fasting glucose (mg/dl)]/2). Echocardiographic parameters including LV parameters (IVSTd, LVIDd, LVPWd), ejection fraction, LA Size were measured. LVM was calculated using ASE (American Society of Echocardiography) approved cube formula as follows: LVM = 1.04 x ([IVSTd + LVIDd + LVPWTd]³ – LVIDd³) x 0.8 +0.6. Result: Study showed higher TyG index was associated with elevated LV mass. Also Diabetics were found to have higher mean TyG and thus LV mass than non-diabetics. Conclusion: TyG index is a simple indicator of insulin resistance which reflects cardiac remodelling and dysfunction and in near future could be a potential therapeutic strategy to reduce cardiovascular mortality.

DOI: 10.5281/zenodo.

Background: Spinal anaesthesia with hyperbaric Bupivacaine hydrochloride is popular for longer procedures due to its prolonged duration. With the addition of opioids, we can intensify and increase the duration of sensory blockade without increasing the intensity and duration of motor blockade, thus prolonging the duration of postoperative analgesia. This study aimed to compare the onset, duration, and recovery of sensory and motor blockade, perioperative hemodynamic parameters, level of sedation, and time to first rescue analgesia, side effects, and complications in the perioperative period. Material and Methods: In this comparative, observational, and prospective study, a total of 60 patients were enrolled undergoing lower limb surgery under spinal anaesthesia, divided into two groups. Group-F received 0.5% bupivacaine heavy 3 ml (15 mg) + fentanyl 0.5 ml (25 μg) intrathecally, and Group-T received 0.5% bupivacaine heavy 3 ml (15 mg) + tramadol 0.5 ml (25 mg) intrathecally. Both groups were observed for characteristics of motor and sensory blockade, hemodynamic parameters, and perioperative complications. Patients were monitored for a Ramsay score for sedation, a VAS score for pain, and the time required for post-operative analgesia. Result: The time to onset of sensory block at T10 level was statistically not significant between the two groups, while the time for regression of sensory blockade to the S2 dermatome was prolonged in group F as compared to group T. The mean time to achieve motor block was statistically not significant, while the time for regression of motor block from grade 3 to 0 was prolonged in group F as compared to group T. There was no significant difference in hemodynamic parameters between the two groups. The time required for first-rescue analgesia was longer in group F than in group T. Conclusion: Intrathecal 0.5% hyperbaric bupivacaine with 25 μg fentanyl significantly prolonged both sensory and motor block as well as time for the 1^st rescue analgesic when compared with 25 mg tramadol as adjuvant. Fentanyl also produces perioperative sedation.

DOI: 10.5281/zenodo.

Introduction: Organophosphorus poisoning (OPP) stands out as the predominant medical toxic emergency in India. This study aims to assess the severity of organophosphorus (OP) compound poisoning clinically through Peradeniya scale (PS). Methods: It was a prospective research conducted in the department of general Medicine, Prathima Institute of Medical sciences, Nagunoor. The study protocol was approved by the Institutional Ethics committee. Non cooperative individuals, those taken atropine treatment, doubtful OPP, mixed poisoning, those with chronic infections, known drug hypersensitive individuals were not considered in this research. A comprehensive clinical examination, focusing on vital signs, pupil size, and assessment of the central nervous, respiratory, and cardiovascular systems, was conducted following a prescribed format. The PS was administered to all, categorizing the severity of OPP. The study population were managed with decontamination, atropinisation, Pralidoxime chloride administration as per the protocol. Chisquare test were used for statistical analysis. P < 0.05 was considered statistically significant. Results: Total 60 (100%) members were included in this study.  As per the PS, 39 were mild, 20 moderate and 1 severe. Whereas, as per the consumption, it was 31m 21 and 8, respectively in <30, 31 – 50 and >50 ml consumption; statistically there was significant difference. In mild category, 33 members didn’t require ventilator support (VS) whereas 13 in moderate and 1 in sever category required; statistically there was significant difference. Conclusion: The PS proves to be a valuable tool for assessing severity and forecasting outcomes in individuals exposed to OPP. This simple and cost-effective tool holds promise in predicting the requirement for VS upon admission.

DOI: 10.5281/zenodo.

Objectives: To determine fetomaternal outcome in postdated and post term pregnancy. Material and Methods: It is data analysis of postdated and post term patients who delivered at C.U. Shah medical college over a period of 1 year (1st August 2022 to 31st July 2023). Only 195 patients fulfilled the criteria. Their detailed data was obtained from the department. Results: In the present study, total of 1660 patients were studied over a span of 1 year, i.e. 1st August 2022 to 31st July 2023.Out of these 164 deliveries were postdated and 31 deliveries were post term. Most of the patients were illiterate, unbooked and belonged to rural area. There were increased chances of instrumental delivery, failure of induction and chances of caesarean section increases with postdatism and post term pregnancies. Neonates belonging to the same group also required NICU admission with adverse outcomes. Conclusion: Maternal and fetal morbidity and mortality can be reduced by electively inducing pregnant women at 40+0 weeks as allowing them to continue beyond this gestational age has shown adverse fetal-maternal outcomes. This can be achieved by appropriate ANC care and counseling. CTG reading and partograph charting are required to reduce the neonatal adverse outcome and fetal mortality after time of induction.

DOI: 10.5281/zenodo.

Background: Diffuse axonal injury is also known as traumatic axonal injury, a severe form of traumatic brain injury and known for its severe consequences. The definitive diagnosis of DAI, especially in its early stage, is difficult. DAI represents approximately one-half of all intra axial traumatic lesions. The lesion is the most significant cause of morbidity in patients with traumatic brain injuries, which most commonly result from high-speed motor vehicle accidents, any patient with a closed head injury who will experience extensive loss of consciousness and neurological deficits warrants neuro imaging. DAI typically consists of several focal white matter lesions measuring 1 – 15 mm in a characteristic distribution. Aim: Aimof the study is to study the incidence of Diffuse Axonal Injury in Head Injuries; analyze the morbidity and mortality in DAI; predict the outcome concerning Glasgow Scale, CT, and MRI findings. Methodology: This is a prospective study consisting of 69 cases of DAI studied over a period from October 2021 to December 2023 in the Department of Neurosurgery, Guntur Medical College / Government General Hospital, Guntur. All the patients were admitted to the acute neurosurgical care unit and a variety of clinical / imaging data were collected and analyzed concerning Mode of injury, Incidence among various age groups, Sex distribution, Post resuscitative Glasgow Coma Scale (After optimization of SBP, SPO2, GRBs.), Findings on CT Scan, MRI grading, The outcome of the patient at discharge and follow up by Glasgow Outcome Scale. The mortality and morbidity were analyzed concerning GCS and CT & MRI. Scan findings. Results and Conclusion: DAI constitutes 2.98% of total head injury admissions and 27.70%in severe head injury. MRI is more sensitive compared to CT. Mortality in our series is 40.58%. Most of DAI are due to Road Traffic Accidents. Second and third decade populations are more in DAI (62.32%). Most of them sustained RTA under alcohol influence (77.41% i.e., 48 out of 62 patients). Neurological deficits improved almost completely (over the 1 ½ year to 2 years) and early recovery seen in younger age groups compared to elder age groups. In 27.5% of cases recovery is good as per GCS. The prognosis, morbidity, mortality in DAI can be predicted with GCS and CT scan and MRI findings.

DOI: 10.5281/zenodo.

Background: Dengue fever remains one of the most prevalent outbreaks caused by arboviruses, with reports emerging from various regions worldwide. As outbreaks continue to occur in diverse geographic areas, recent studies have highlighted varying clinical manifestations. This study aims to document the diverse clinical presentations and hematological parameters observed in dengue patients at a tertiary care center. Methods: This observational study included a total of 80 cases of dengue patients who tested positive for NS1 antigen, IgM card test, or IgM ELISA. Clinical and hematological parameters were recorded and subjected to statistical analysis. Results: Group A (Dengue without Warning Signs): This group, comprising 67.5% (54 patients), displayed typical dengue symptoms. Group B (Dengue with Warning Signs): Including 22 patients (27.5%), this group exhibited dengue fever alongside symptoms indicating potential progression to severe dengue. Group C (Severe Dengue): Only 4 patients (5.0%) had severe dengue, characterized by critical symptoms such as plasma leakage and organ impairment. The majority (67.5%) had mild symptoms, while 27.5% showed warning signs. A small proportion (5.0%) progressed to severe dengue. Conclusions: Fever and headache are predominant features of dengue fever; however, clinicians should remain vigilant for atypical presentations to facilitate timely diagnosis and intervention. Early identification of complications and prompt intervention are crucial for the effective management of dengue cases.

DOI: 10.5281/zenodo.

Background and Objectives: Postoperative wound complications are of common occurrence. The incidence of postoperative wound infections ranging from <2% to 38%. Based on NNIS (National Nosocomial Infections Surveillance) system reports, surgical site infections are the third most frequently reported nosocomial infections among hospitalized patient. Comparison of complications of laparotomy wound in elective and emergency surgery and various determinants affecting it. Materials and Methods: It is a prospective randomized study of 72 patients undergoing emergency and elective laparotomy. Postoperative wound complications and various factors affecting it are compared between emergency and elective surgery. Conclusion: In conclusion, laparotomy wound complications are multifactorial, this study demonstrated the increase in incidence of postoperative tissue and wound complications in emergency surgery (25%) than elective surgery (14%). It mainly depends on higher ASA score, anemia and higher wound class who are more likely to be associated with development of wound complications.

DOI: 10.5281/zenodo.

Background and Objectives: Acute cholecystitis is a common surgical problem and was usually treated with conservative management followed by a delayed laparoscopic cholecystectomy after an interval of 6 to 8 weeks. Our aim was to compare the efficacy of immediate laparoscopic cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (LLC) in patients of acute cholecystitis, and also to assess the complications between the two. Materials and Methods: This is  prospective Study randomized controlled trial in NMCH Jamuhar Sasaram. Study duration of Two years. that was conducted on 50 consecutive patients diagnosed to have acute cholecystitis. 25 patients underwent immediate laparoscopic cholecystectomy within 24-72 hours of admission and 25 patients underwent a delayed laparoscopic cholecystectomy after 6- 8 weeks of the initial episode. Conclusion: Early laparoscopic surgery had similar intraoperative and postoperative complications compared to delayed surgery in acute cholecystitis, but was associated with a shorter surgery and lesser stay in hospital.

DOI: 10.5281/zenodo.

Introduction: Scalp nerve block involves blocking nerves supplying the surgical area on the scalp to reduce sensation during surgery. The aim of this study was to assess the analgesic efficacy of scalp block (SB) with 0.25% Bupivacaine vs pre incisional local infiltration with 0.25% Bupivacaine with Adrenaline (1:400,000) in patients undergoing elective craniotomy. Methods: A prospective study was conducted at the Department of Anaesthesiology, KIMS, Amalapuram, from October 2023 to March 2024. Patients aged 18-65 years, ASA I & II, Mallampati scores I & II, and BMI <30 kg/m² were included. Group A received SB with 0.25% Bupivacaine, while group B had pre-incisional infiltration with 0.25% Bupivacaine with 1:400,000 Adrenaline. Intraoperative hemodynamics and postoperative pain were assessed. Statistical analysis included descriptive statistics and inferential tests using SPSS version 20.0, with a significance level of P<0.05. Results indicated significant differences in intraoperative parameters and postoperative pain scores between the groups. Results: Total 60 members were included, 30 in each group. Statistically there was no significant difference in the mean HR, systolic blood pressure. The mean diastolic blood pressure and MAP showed no significant difference. Group S significantly lower VAS scores compared for the first 6 hours postoperatively; afterwards, no significant differences were observed between the groups. Conclusion: Our study suggests that both scalp block with 0.25% Bupivacaine and pre-incisional local infiltration with 0.25% Bupivacaine with adrenaline are effective options for pain management in craniotomy patients.

DOI: 10.5281/zenodo.

Background: Globally, there are an approximate 171 million diabetics, and by 2030, that number is projected to reach 366 million. Without accounting for its role in cardiovascular death, the major cause of death among early diabetics, diabetes mellitus ranks as the seventh major cause of mortality as a direct cause. The traditional approach has been saline-moistened gauze, but it has been challenging to consistently maintain a wound that is moist with these dressings. The primary Negative Pressure on the wound’s surface can be changed thanks to a connection between the wound dressing and a control unit via a set of suction tubes. Negative pressure between 80 and 125mmHg is most frequently applied, either constantly or in cycles. The control unit’s container holds the wound fluid that has been suctioned into it. Aim: Aim of the study is to compare negative pressure wound therapies with conventional dressing in the treatment of diabetic foot ulcer in terms of Rate of growth of granulation tissue; Change in size and depth of the ulcer; Duration to achieve complete healing by surgery or grafting; Duration of hospital stay of patients. Materials and Methods: After taking the written informed consent, subjects were divided into two groups based on computer generated random numbers. Group NPT (negative pressure therapy) included 50 subjects and group CGD (conventional gauze dressing) included 50 cases. All participants were assessed for the demographic and clinical presentation by the principal investigator using a pre structured proforma. Following which the principal investigator assessed the detailed history of the participants and clinically examined the patients. Results and Conclusion: We infer that negative pressure wound dressing is superior to conventional gauze dressing in terms of rate of growth of granulation tissue formation as percentage of ulcer surface area, reduction in size and depth of the ulcer during treatment, duration to achieve complete healing and duration of hospital stay of the patients.

DOI: 10.5281/zenodo.

Purpose: To evaluate the change in central corneal thickness in patients with vernal keratoconjunctivitis (VKC). Method: The study was conducted in Department of Ophthalmology, at tertiary health care Centre. The study group included 100 eyes of 50 patients with vernal kerato-conjuctivitis and 100 eyes of 50 age and sex matched normal subjects were selected as a control group. The central corneal thickness was measured with (ZEISS Cirrus HD-OCT 500) Machine. Result: In the study group, out of 50 patients, 36 were males and 14 were females. Majority were in the age group of 5-10 years. The mean central corneal thickness was 490.9±20.7 µm in the study group and 545.30±30.20μm in the control group, and the difference was statistically significant. Conclusion: The central corneal thickness in patients with Vernal Keratoconjunctivitis (VKC) is low as compared to age and sex matched control population. Evaluation of corneal thickness is important in situations such as corneal refractive surgery and contact lens use, and is an essential parameter in a wide range of ocular disorders, including glaucoma and keratoconus. Therefore, ophthalmologists should be aware of the low central corneal thickness in patients with Vernal Keratoconjunctivitis.

DOI: 10.5281/zenodo.

Objective: To evaluate the benefits and harms of different inguinal and femoral hernia repair techniques in adults, specifically comparing closure with mesh versus without mesh. Methods: This prospective study included 100 patients with hernias who were divided into two groups: Group A (n=50) underwent hernia repair with mesh, and Group B (n=50) underwent hernia repair without mesh. Complications and outcomes assessed included hernia recurrence, complications (neurovascular or visceral injury, hematoma, seroma, testicular injury, infection, postoperative pain), mortality, postoperative hospital stay, and time to return to activities of daily living. The data were analyzed using appropriate statistical methods. Results: In Group A, none of the patients experienced hernia recurrence, indicating a successful outcome. However, 8% of patients developed wound infections, 2% experienced neurovascular injuries, and 6% had seroma formation. Additionally, 1% of patients had hinoma formation and Scotals Valley complication. In contrast, 6% of patients in Group B experienced hernia recurrence, while wound infection occurred in 2% of patients. Neurovascular injuries were observed in 6% of patients, and hinoma formation was observed in 4% of patients. No cases of seroma formation were reported in Group B. Similar to Group A, 6% of patients in Group B had Scotals Valley complications. Conclusion: The use of mesh in hernia repair procedures was associated with a lower recurrence rate compared to repairs performed without mesh. However, both groups experienced complications, including wound infections, neurovascular injuries, hinoma formation, seroma formation, and Scotals Valley complications. Careful consideration of patient-specific factors, surgical technique, and postoperative management are crucial to optimize outcomes and minimize complications. Further research is needed to validate these findings and explore long-term durability and patient satisfaction.

DOI: 10.5281/zenodo.

Depression is a widespread mental illness, mental health which affects million people globally with a significant prevalence in India. The condition’s multifaceted nature and unpredictable course underscore the need for tailored interventions and support systems. Depression manifests in emotional and physical symptoms, including unhappiness, cognitive deficits, and suicidal tendencies. Its impact is significant, with 264 million sufferers globally. In India, 15% of adults require mental health intervention, with women at higher risk. Moreover, it is important to emphasize that, despite all these clinical manifestations, this review also highlights the severe negative effects of depression on various functions: both cognitive impairments and social isolation and the tendency to develop comorbid conditions, including anxiety and addiction, are assumed. Based on this background, evidence-based interventions including pharmacotherapy; psychotherapy and new modalities such as TMS and ketamine infusion are considered. Particular focus is paid to the new personalized medicine field that offers the possible treatment for every specific case.

DOI: 10.5281/zenodo.

Background: Iron deficiency anemia (IDA) is a common complication of pregnancy, necessitating effective management to prevent adverse maternal and fetal outcomes. Intravenous (IV) iron supplementation is recommended when oral iron therapy is insufficient or intolerable. However, comparative data on the efficacy and safety of different IV iron formulations in pregnancy are limited. Aims and Objective: To compare the efficacy and safety of IV iron sucrose versus ferric carboxymaltose in pregnant women with IDA. Materials and Methods: A prospective, randomized controlled trial was conducted at GMERS Medical College and Hospital, Junagadh, involving 100 pregnant women diagnosed with IDA (50 in each treatment group). Participants received either iron sucrose (IS) (Group I) or ferric carboxymaltose (FCM) (Group F) according to standard dosing regimens. Primary outcomes included changes in hemoglobin, hematocrit, and serum ferritin levels from baseline to 4 weeks post-treatment. Adverse effects were recorded as the secondary outcomes. Results: Ferric carboxymaltose led to a greater increase in hemoglobin levels after 4 weeks compared to IS (FCM: 2.0 g/dL, IS: 1.5 g/dL; p < 0.05). FCM also resulted in a more significant rise in mean corpuscular volume (MCV) (FCM: 6.2 fL, IS: 4.5 fL; p < 0.05) and serum ferritin levels (FCM: 35.8 ng/mL, IS: 28.6 ng/mL; p < 0.05) after 4 weeks. Adverse reactions were less common with FCM, with lower incidences of headache, nausea, vomiting, diarrhea, rigor, fever, pain at the injection site, tingling sensation, itching, and anaphylactic reactions compared to IS (p < 0.05). These findings support FCM’s superiority over IS in managing iron deficiency anemia during pregnancy. Conclusion: Ferric carboxymaltose is superior to IS in the management of iron deficiency anemia (IDA) during pregnancy. FCM treatment resulted in a greater increase in hemoglobin levels, MCV, and serum ferritin levels after 4 weeks compared to IS. Additionally, FCM was associated with a lower incidence of adverse reactions.

DOI: 10.5281/zenodo.