bluuebunny/crossref_metadata_2025 huggingface dataset:
Spinal Neuronal miR-124 Inhibits Microglial Activation and Contributes to Preventive Effect of Electroacupuncture on Chemotherapy-Induced Peripheral Neuropathy in Mice
Authors: Li Xiao-Chen , Chen Hui , Chen Yu , Chu Yu-Xia , Mi Wen-Li , Wang Yan-Qing , Mao-Ying Qi-Liang
Published: December 2023

Chemotherapy-induced peripheral neuropathy (CIPN) is a persistent and irreversible side effect of antineoplastic agents. Patients with CIPN usually show chronic pain and sensory deficits with glove-and-stocking distribution. However, whether spinal neuronal microRNA (miR)-124 is involved in cisplatin-induced peripheral neuropathy remains to be studied. In this study, miR-124 was significantly reduced in the spinal dorsal horn in CIPN mice. Overexpression of neuronal miR-124 induced by injecting adeno-associated virus with neuron-specific promoter into the spinal cord of mice prevented the development of mechanical allodynia, sensory deficits, and the loss of intraepidermal nerve fibers induced by cisplatin. Meanwhile, cisplatin-induced M1 microglia activation and the release of proinflammatory cytokines were significantly inhibited by overexpression of neuronal miR-124. Furthermore, electroacupuncture (EA) treatment upregulated miR-124 expression in the spinal dorsal horn of CIPN mice. Interestingly, downregulation of spinal neuronal miR-124 significantly inhibited the regulatory effect of EA on CIPN and microglia activity as well as spinal neuroinflammation induced by cisplatin. These results demonstrate that spinal neuronal miR-124 is involved in the prevention and treatment of EA on cisplatin-induced peripheral neuropathy in mice. Our findings suggest that spinal neuronal miR-124 might be a potential target for EA effect, and we provide, to our knowledge, a new experimental basis for EA prevention of CIPN.
A Rare Case of Cutaneous Metastasis of Osteosarcoma
Authors: Kachapur Chandrashekhar , Seetaram N. K. , Kulkarni Shruti Nitin , Hasabi Ishwar , Gayatri BH
Published: December 2023

Osteosarcoma (OS) is a primary bone tumor, usually seen in childhood or adolescence. With an estimated incidence of 5 in every 100,000 new cases detected per year, OS is an aggressive malignant mesenchymal tumor. The most common sites for this tumor are the distal end of the femur and the proximal tibia. Metastases from OS are most commonly seen in the lung or other bones. Patients with skin and subcutaneous tissue metastases are a relatively rare subset. Here, we report a rare case of an 18-year-old girl who presented to the hospital with an unusual site of metastasis from OS.
Predictors of quality of life of cancer patients: A psycho-oncological study conducted at Tripura, North-East India
Authors: Bhattacharjee Anjana , Ghosh Tatini
Published: December 2023

Background:

Cancer is, no doubt, a life-threatening illness, and it has a long-term effect on the physical and mental health of the patients, particularly on their quality of life (QOL). The present article is an attempt to examine the role of socioeconomic factors, illness duration and spirituality on the QOL of cancer patients.

Methods:

The sample consisted of 200 cancer patients (100 men and 100 women patients) belonging to the state of Tripura, a Northeastern state of India. Out of 200 cancer patients, most of them (100, 50%) were suffering from oral cancer, followed by lung and breast cancer. General Information Schedule, Quality of Life Patient/Cancer Survivor Version (developed by Ferrell, Hassey-Dow and Grant), and The Spiritual Experience Index- Revised (developed by Genia) were used for data collection. For analysis of data, independent t-test, analysis of variance, and multiple linear regression were computed. The statistical analysis was carried out using IBM SPSS Version 25.0.

Results:

The findings showed no significant difference in QOL scores among the subgroups of cancer patients in socioeconomic and illness factor, except for family income. Further analysis revealed that only spirituality and educational qualification of cancer patients significantly predicted their QOL.

Conclusion:

The current article can act as a springboard for further studies in this area and provide aid for socioeconomic development while improvising cancer patients’ QOL.
Cancer pattern in Varanasi district from Uttar Pradesh state of India, a foundation for cancer control based on the first report of the population-based cancer registry
Authors: Budukh Atul M , Pradhan Satyajit , Singh Virendra B , Khanna Divya , Bagal Sonali S , Chakravarti Priyal S , Sharma Anand N , Vishwakarma Rajesh K , Shinde Shraddha S , Khargekar Naveen C , Chaturvedi Pankaj , Dikshit Rajesh P , Shukla Vijay K , Badwe Rajendra A
Published: December 2023

Background:

The cancer registry provides reliable data from the population. In this article, we provide cancer burden and its patterns from the Varanasi district.

Methods:

The method adopted by the Varanasi cancer registry is community interaction along with regular visits to more than 60 sources to collect data on cancer patients. The cancer registry was established by the Tata Memorial Centre, Mumbai, in 2017 covering 4 million population (57% rural and 43% urban population).

Results:

The registry has recorded 1,907 incidence cases (1,058 male and 849 female). The age-adjusted incidence rate per 100,000 population in male and female of Varanasi district is 59.2 and 52.1, respectively. One in 15 male and one in 17 female are at risk of developing the disease. Mouth and tongue cancers are the predominant cancers in male, whereas breast, cervix uteri, and gallbladder are the leading cancer sites among the female. In female, cervix uteri cancer is significantly higher (double) in rural areas when compared with urban areas (rate ratio [RR] 0.5, 95% confidence interval [CI; 0.36, 0.72]), whereas in male, mouth cancer is higher in urban areas when compared with rural areas (RR 1.4, 95% CI [1.11, 1.72]). More than 50% of cancer cases in male are due to tobacco consumption. There may be underreporting of the cases.

Conclusion:

The results of the registry warrant policies and activities related to early detection services for the mouth, cervix uteri, and breast cancers. The Varanasi cancer registry is the foundation for cancer control and will play an important role in the evaluation of the interventions.
Prognostic value of proliferation markers Ki-67 and PCNA in esophageal squamous cell carcinoma
Authors: Deng Jiaying , Luo Lumeng , Ren Wenjia , Zhang Junhua , Hu Chenghao , Zhao Kuaile
Published: December 2023

Background:

Ki-67 and proliferating cell nuclear antigen (PCNA) are markers of proliferation used to assess the growth fraction of the cell population. The present study aimed to explore the prognostic value of these proliferative markers in patients with resected esophageal squamous cell cancer (ESCC) in a large cohort.

Methods:

A total of 807 patients with ESCC who underwent radical resection were retrospectively reviewed. Ki-67 and PCNA index were examined as the percentage of positively nuclear-stained cells among total number of cancer cells in three high-power fields by a pathologist who was blinded to the patients’ history and outcome. Overall survival (OS) and disease-free survival (DFS) were estimated. The Cox regression model was used to evaluate the independent factor.

Results:

The cut-off value as 60 and 80% for Ki-67 and PCNA were verified, respectively. Higher Ki-67 expression was associated with low differentiation and more lymph node metastasis. Higher PCNA expression was associated with elevated T stage. However, either expression of Ki-67 or PCNA was not correlated with OS and DFS. While in combination of Ki-67 and PCNA analysis, higher expression of these two proliferative markers predicted worse prognosis (median OS, 47 months versus 54 months, P = 0.04). Whatever the combined proliferative marker, differentiation, lymph node metastasis stage and vascular invasion act as factors in univariate survival analysis, but combined Ki-67 and PCNA is not an independent prognostic variable in multivariate analysis (P = 0.10).

Conclusion:

Our results suggest that proliferative markers of Ki-67 and PCNA may correlate with tumor stage but cannot act as independent predictor of prognosis in ESCC patients.
Analysis of the most viewed Hindi YouTube videos on breast cancer
Authors: Sinha Nibha , Sharma Alka
Published: December 2023

Background:

Breast cancer is the most common cancer diagnosed in women worldwide. Social media channels are a significant source of health information including breast cancer. YouTube has a broad range of educational materials on various health issues in many languages. However, the accuracy of these videos is contentious. This study aimed to examine the accuracy of the most viewed Hindi videos on YouTube related to breast cancer.

Methods:

On YouTube, the “Breast Cancer-Hindi” term was searched for the 50 most viewed Hindi videos. To evaluate the videos’ quality and reliability, global quality scores (GQS) and DISCERN (quality criteria for the assessment of written health information), and for credibility and usefulness Journal of the American Medical Association (JAMA) tool were used. Popularity was measured using a video power index (VPI). Comparisons of scores were made between professionals’ and consumers’ videos. Two health researchers independently rated the videos and their correlation was calculated for agreement.

Results:

Of all the 50 videos viewed, 23 (46%) each were uploaded by consumers and professionals. GQS median 3 (1–5), DISCERN median 13 (5–23), JAMA median 2 (0.50–4), and VPI median 90.7 (50–96.93) were reported. All scores of professionals were higher than consumers at a significant level (P < 0.05). A significant correlation was found between both observers (P < 0.01).

Conclusion:

YouTube has some good quality and reliable videos on breast cancer in the Hindi language. These videos are mostly of professionals in comparison with consumers with wide viewership. However, they are limited in numbers; therefore, health professionals should upload more videos with accurate information to spread awareness about breast cancer.
Determinants of pathological complete response to neoadjuvant chemotherapy in breast cancer: A single-institution experience
Authors: Joshi Shalaka , Chougle Qurratulain , Noronha Jarin , Hawaldar Rohini , Nair Nita , Vanmali Vaibhav , Parmar Vani , Thakkar Purvi , Chitkara Garvit , Shet Tanuja , Badwe Rajendra A.
Published: December 2023

Background:

Neoadjuvant chemotherapy (NACT) is routinely used in all cases of locally advanced breast cancer and some cases of early breast cancer. We previously reported a pathological complete response (pCR) rate of 8.3%. With the increasing use of taxanes and human epidermal growth factor receptor 2 (HER2)-directed NACT, we conducted this study to understand the current pCR rate and its determinants.

Methods:

A prospective database of breast cancer patients who underwent NACT followed by surgery between January and December 2017 was evaluated.

Results:

Of the 664 patients, 87.7% were cT3/T4, 91.6% were grade III, and 89.8% were node-positive at presentation (54.4% cN1, 35.4% cN2). The median age was 47 years; median pre-NACT clinical tumor size was 5.5 cm. Molecular subclassification was 30.3% hormone receptor positive (HR+) HER2−, 18.4% HR+HER2+, 14.9% HR−HER2+, and 31.6% triple negative (TN). Both anthracyclines and taxanes were given preoperatively in 31.2% patients whereas 58.5% of HER2 positive patients received HER2-targeted NACT. The overall pCR rate was 22.4% (149/664), 9.3% in HR+HER2-, 15.6% in HR+HER2+, 35.4% in HR−HER2+, and 33.4% in TN. On univariate analysis, duration of NACT (P < 0.001), cN stage at presentation (P = 0.022), HR status (P < 0.001), and lymphovascular invasion (P < 0.001) were associated with pCR. On logistic regression, HR negative status (Odds ratio [OR] 3.314, P < 0.001), longer duration of NACT (OR 2.332, P < 0.001), cN2 stage (OR 0.57, P = 0.012), and HER2 negativity (OR 1.583, P = 0.034) were significantly associated with pCR.

Conclusion:

Response to chemotherapy depends on molecular subtype and duration of NACT. A low rate of pCR in the HR+ subgroup of patients warrants reconsideration of neoadjuvant strategies.
Apatinib plus drug-eluting bead transarterial chemoembolization as bridging therapy to surgical resection displays an acceptable efficacy and safety profile in hepatocellular carcinoma patients
Authors: Yan Jingwei , Sun Yumei , Fan Daguang , Mu Wei
Published: December 2023

Background:

Apatinib exhibits a synergistic effect with transarterial chemoembolization (TACE) by inhibiting TACE-induced neoangiogenic reaction in hepatocellular carcinoma (HCC) patients. But apatinib plus drug-eluting bead TACE (DEB-TACE) is rarely reported as a bridging therapy to surgery. This study aimed to evaluate the efficacy and safety of apatinib plus DEB-TACE as a bridge to surgical resection in intermediate-stage HCC patients.

Materials and Methods:

Thirty-one intermediate-stage HCC patients who received apatinib plus DEB-TACE as a bridging therapy to surgery were enrolled. After the bridging therapy, complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), and objective response rate (ORR) were evaluated; meanwhile, relapse-free survival (RFS) and overall survival (OS) were determined.

Results:

After the bridging therapy, three (9.7%), twenty one (67.7%), seven (22.6%), and twenty four (77.4%) patients achieved CR, PR, SD, and ORR, respectively; besides, PD did not occur. The successful downstaging rate was 18 (58.1%). The median (95% confidence interval [CI]) accumulating RFS was 33.0 (19.6 - 46.6) months. Besides, the median (95% CI) accumulating OS was 37.0 (24.8 - 49.2) months. HCC patients with successful downstaging showed a higher accumulating RFS rate (P = 0.038) and similar accumulating OS rate (P = 0.073) compared to those without successful downstaging. The overall incidence of adverse events was relatively low. Besides, all the adverse events were mild and controllable. The most frequent adverse events included pain (14 [45.2%]) and fever (9 [29.0%]).

Conclusion:

Apatinib plus DEB-TACE as a bridging therapy to surgical resection displays good efficacy and safety profile in intermediate-stage HCC patients.
Retrospective audit of the yield of internal mammary lymph node dissection and literature review in the management of breast cancer
Authors: Joshi Shalaka , Chigurupati Pragnya , Reddy Asha , Noronha Jarin , Hawaldar Rohini , Nair Nita , Parmar Vani , Chitkara Garvit , Thakkar Purvi , Shet Tanuja , Badwe R A
Published: December 2023

Background:

Treatment of lymph node basins is prognostic and therapeutic for axillary lymph nodes (ALN) as well as internal mammary lymph nodes (IMLNs) in breast cancer. IMLNs can be the first echelon node for the inner/central quadrants of the breast. We evaluated the yield of IMLN dissection (IMLND) mainly in patients with inner and central tumors.

Methods:

IMLND was performed in 199 patients between 2000 and 2018, 127 of whom had tumors in the inner/central quadrants. Clinico-pathological data were retrieved from Electronic Medical Records (EMR).

Results:

The median age was 50 (range: 24–81). Primary surgery was performed in 82 (41.2%), while 117 (58.8%) were operated post-chemotherapy. Overall, 124/199 (62.3%) had nodes identified in the specimen, more often in primary (61/82, 74.4%) than post-chemotherapy settings (63/117, 53.8%) (P = 0.003). A median of 1 (average: 1.24, range: 0–7) lymph nodes was dissected, and 1 (average: 1.5, range: 1–4) was involved. IMLN was positive in 46/199 (23.1%) patients, not significantly different in primary (21/82, 25.6%) versus post-chemotherapy (25/117, 21.4%) settings (P = 0.545). IMLN was involved in 44.8% of patients with ≥4 involved ALN and 8.2% with uninvolved ALN (P < 0.001). In the absence of ALN involvement and <2cm pT size, 9% of patients had positive IMLN in inner/central quadrant tumors. In univariate analysis, ALN positivity (P < 0.001), pT size (P = 0.023), and grade (P = 0.041) in primary and ALN involvement (P = 0.011) in post-chemotherapy patients were associated with IMLN involvement. On logistic regression, tumor size (OR: 13.914, P = 0.017) and ALN involvement (OR: 11.400, P = 0.005) in primary surgery and ALN involvement (OR: 7.294, P = 0.003) in post-chemotherapy patients correlated with IMLN involvement.

Conclusions:

In inner/central quadrant tumors, IMLN is more likely involved with high ALN burden and tumor size >2 cm, whereas those with ≤2cm inner/central quadrant tumors and negative ALN have <10% probability of IMLN involvement.
Outcomes of Transaortic Celiac Plexus Block for Upper Abdominal Malignancies Performed as a Day-care Procedure: A Retrospective Observational Study
Authors: Diwan Sandeep Madhusudan , Panchawagh Suhrud , Nair Abhijit Sukumaran
Published: December 2023

Background:

Severe abdominal pain refractory to opioids significantly affects the quality of life (QoL) in patients with abdominal primary cancer or metastatic disease. A neurolytic celiac plexus block (CPB) would be necessary to alleviate pain and improve QoL until death.

Aims:

The aim of this retrospective study is to investigate pain relief after a transaortic celiac plexus neurolysis for patients with upper gastrointestinal malignancies.

Settings and Design:

This retrospective observational study was done in the Pain Department, Shri Siddhivinayak Cancer Hospital, Miraj from January 2005 to January 2015.

Materials and Methods:

One hundred and twenty-four patients with upper abdominal malignancy received a computed trans-aortic celiac plexus block (TAoCPB) on a day-care basis. The primary outcome was pain as assessed with numerical rating scale ranging from 0 to 10; the secondary outcome measures were morphine consumption per day, QoL, and complications, if any. These were recorded before intervention, on day 1 after the block and at 1 month interval until 6 months.

Statistical Analysis Used:

Bonferroni correction for multiple comparisons and a P < 0.0167 (0.05/3) was considered to be statistically significant due to 3 co-primary outcomes being measured (visual analog scale [VAS] scores, morphine consumption, and QoL).

Results:

Up to 4.5 months, the VAS score, daily morphine consumption, and the QoL showed improvement for the duration of the study. Pain gradually increased at 6 months with a deterioration of QoL. Respiratory distress and burning sensation in chest occurred in one patient each.

Conclusions:

A low-volume TAoCPB is effective and established procedure as a day-care procedure. Although pain relief occurs until 4.5 months, a gradual increase was perceived with a decline of quality of health at 6 months.
Management of Bilateral Cervical Headache with Right-sided Cooled Radiofrequency Ablation of the Second and Third Cervical Median Branch
Authors: Shah Maitri Manish , Sharma Aanchal , Bhalla Akhil , Lotliker Sasmit Dipak , Verma Sidharth
Published: December 2023

This report describes a case of bilateral cervicogenic headache treated with cooled radiofrequency ablation (RFA). The case is considered to review a longstanding cervicogenic headache and the use of cooled RFA of cervical facet joint as a treatment of choice. In this case, a 50-year-old female patient with intermittent dull aching bilateral headache in occipital, temporal, and cervical region for 20 years was diagnosed with bilateral greater occipital neuralgia. She underwent cooled RFA of unilateral right-sided 3rd occipital nerve (cervical 2/3 facet joint) with minimal or no side effects and 100% pain reduction at 24 h of follow-up. After 4 weeks of follow-up, the patient reported a single incident where she experienced pain that settled with medication and had a lower intensity as compared to that which was experienced before the procedure. Cooled RFA of the cervical facet joint in challenging cases can be a line of treatment to alleviate pain with lower side effects and potential for long-term efficacy.
A Case of Refractory Intractable Bladder Pain Syndrome Treated with Superior Hypogastric Nerve Chemical Neurolysis
Authors: Mody Rutvi Manoj , Bhargude Yogita M. , Kothari Kailash M.
Published: December 2023

Bladder pain syndrome (BPS) is a severely debilitating condition. BPS is a symptom complex affecting the urinary bladder, which is characterized by pelvic pain, urinary urgency, frequency, and nocturia. In this case report, we have presented a patient with BPS who was not responsive to conventional treatment and was managed successfully by diagnostic superior hypogastric plexus block followed by alcohol neurolysis.
The feasibility of the pretreatment verification of 2D dose distributions in radiation therapy with small fields using the electronic portal imaging device
Authors: Tuncel Nina , Mahdavi Seied Rabi , Haghparast Mohammad , Karakus Ismail , Haghparast Abbas , Nazari Vahideh
Published: December 2023

Background:

The present study aims to evaluate the performance of an Electronic portal imaging device (EPID) for measuring dosimetric parameters and for verification of dose in small photon fields.

Material and Methods:

In this study, the beam profiles were obtained using the amorphous silicon (a-Si) EPID for field sizes ranging from 1 × 1 to 10 × 10 cm2 at energies 6 and 18 mega-voltage (MV). For comparison, the dosimetric parameters, including penumbra widths and field sizes, were measured with the pinpoint, diode, and Semiflex dosimeters. Finally, Rando Phantom was used to compare the two-dimensional (2D) Dose distribution between EPID and Treatment Planning System (TPS).

Results:

In both 5 cm and 10 cm depths, there were large differences between the measured doses obtained from TPS, Pinpoint detector, and Farmer detector in 1 × 1 field size. The differences become negligible as the field sizes increase and from 3 × 3 field size to 10 × 10 field size, the maximum observed differences are 2 cGy and 2.4 cGy for 5 cm and 10 cm depths, respectively. The results indicate that the penumbra widths are smaller in the Gantry-Target (GT) direction compared to the Right-Left (RL) direction. The maximum difference (47.6%) was observed for EPID in the 10 × 10 field size, and the minimum difference (16.6%) was observed for TPS in the 1 × 1 field size. Finally, 2D dose distributions obtained by EPID and TPS exhibit excellent agreement.

Conclusion:

EPID is an excellent tool for the measurement of dosimetry parameters such as dose profiles, penumbra widths, field sizes, and pretreatment verification of 2D dose distributions, especially in small fields.
Factors affecting vancomycin-resistant Enterococcus faecium colonization of in-hospital patients in different wards
Authors: Wang Yun-Cheng , Wang Lih-Shinn , Hsieh Tsung-Cheng , Chung Hui-Chun
Published: December 2023

ABSTRACT

Objectives:

The prevalence of vancomycin-resistant Enterococcus
faecium (VRE) infection at a medical center in Eastern Taiwan rose to 80.6%, exceeding the average prevalence of 55.6% among all medical centers nationwide during the same period. In recent years, the number of cases of VRE infection detected among hospitalized patients has increased annually. However, most of these patients in different wards are asymptomatic carriers. Therefore, restricting active screening to high-risk units will not improve the current situation, and it is necessary to review the risk factors for VRE colonization to provide a reference for future infection control policies.

Materials and Methods:

Between 2014 and 2019, there were 3188 VRE-positive cultures reported at our institution, as per the electronic medical records system.

Results:

In the medical and surgical wards, patients who received penicillin (odds ratios [ORs]: 2.84 and 4.16, respectively) and third-generation cephalosporins (ORs: 3.17 and 6.19, respectively) were at higher risk of VRE colonization. In intensive care units, the use of carbapenems (OR: 2.08) was the most significant variable.

Conclusion:

This study demonstrated that the risk factors for VRE colonization differed between wards. Thus, policies should be established according to the attributes of patients in each ward, and active screening tests should be performed according to individual risks, instead of a policy for comprehensive mass screening.
Effect of hypoalbuminemia on mortality in cirrhotic patients with spontaneous bacterial peritonitis
Authors: Hung Tsung-Hsing , Ko Ping-Hung , Wang Chih-Ying , Tsai Chih-Chun , Lee Hsing-Feng
Published: December 2023

ABSTRACT

Objective:

The impact of hypoalbuminemia on the short-term and long-term mortality of cirrhotic patients with spontaneous bacterial peritonitis (SBP), both with and without renal function impairment, remains insufficiently elucidated based on population-based data.

Materials and Methods:

We retrieved data from Taiwan’s National Health Insurance Database encompassing 14,583 hospitalized patients diagnosed with both cirrhosis and SBP during the period from January 1, 2010, to December 31, 2013. Prognostic factors influencing 30-day and 3-year survival were computed. Furthermore, the impact of hypoalbuminemia on the mortality rate among SBP patients, with or without concurrent renal function impairment, was also assessed.

Results:

The 30-day mortality rates for patients with SBP, comparing those with hypoalbuminemia and those without, were 18.3% and 29.4%, respectively (P < 0.001). Similarly, the 3-year mortality rates for SBP patients with hypoalbuminemia and those without were 73.7% and 85.8%, respectively (P < 0.001). Cox proportional hazard regression analysis, adjusted for patients’ gender, age, and comorbid conditions, substantiated that individuals with hypoalbuminemia exhibit an inferior 30-day survival (hazard ratio [HR]: 1.62, 95% confidence interval [CI]: 1.51–1.74, P < 0.001) and reduced 3-year survival (HR: 1.57, 95% CI: 1.50–1.63, P < 0.001) in comparison to those lacking hypoalbuminemia. Among SBP patients with renal function impairment, those presenting hypoalbuminemia also experienced diminished 30-day survival (HR: 1.81, 95% CI 1.57–2.07, P < 0.001) as well as reduced 3-year survival (HR: 1.70, 95% CI 1.54–1.87, P < 0.001). Likewise, in SBP patients without renal function impairment, the presence of hypoalbuminemia was associated with poorer 30-day survival (HR: 1.54, 95% CI 1.42–1.67, P < 0.001) and 3-year survival (HR: 1.53, 95% CI 1.46–1.60, P < 0.001).

Conclusions:

Among cirrhotic patients with SBP, the presence of hypoalbuminemia predicts inferior short-term and long-term outcomes, regardless of renal function.
Internal and marginal adaptation of self-adhesive and flowable composite resins
Authors: Hala Amira N. , Etman Wedad M. , Geniad Thuraia M.
Published: December 2023

Purpose

Thisin vitrostudy evaluated the internal and marginal adaptability of different composite resins in class V cavities.

Materials and methods

Thirty human maxillary premolars were selected. Trapezoidal class V were prepared on buccal surface. Flowable, self-adhering flowable and nanohybrid composites were applied following their manufacture instructions, in groups I, II and III respectively. Specimens were subjected to 500 thermal cycles and then examined under a stereomicroscope to determine the marginal gap width. All specimens were then sectioned buccolingually into two sections to detect and measure the internal gap width.

Results

The highest mean value of occlusal gap was recorded for Group II followed by Group I while the lowest value was recorded in Group III. Similar results were found regarding the cervical margins, with no statistically significant difference between the groups. Comparing occlusal versus cervical marginal gap a highly significance difference was recorded in each group. The highest internal mean gap width was recorded in Group III, followed by Group II while the lowest in Group I, with no significant difference between them.

Conclusion

All tested materials showed satisfactory marginal adaptation with no significant benefits of the self-adhesive composite. The nano hybrid composite showed the best marginal adaptation while the flowable composite showed the best internal adaptation.
Different treatments modalities for tempromandibular dysfunction
Authors: El-Sayed Marwa Abd El-Aziz Abd El-Wahab , Kashef Nahed Ahmed Kamel , El-Segai Azza Abd El-Moneim , El-Deeb Ali Eed
Published: December 2023

Aim

To clinically compare treatment of TMDs using hard occlusal stent constructed by CAD/CAM technology, low-level laser therapy (LLLT) and a combination of hard occlusal stent and LLLT.

Patients and methods

Twenty-one adult patients have suffered from chronic myofascial pain for at least three months. The patients were randomly divided into three equal groups based on the kind of treatment. Group A: Patients have received hard occlusal stent constructed by CAD/CAM technology. Group B: Patients have received LLLT. Group C: Patients have received a combination of hard occlusal stents constructed by CAD/CAM technology and LLLT. Clinical evaluations were done using Visual Analogue Scale (VAS) evaluation before therapy, at the fifth week, the third and sixth months after the onset of the study period. Data at the end of the trial was gathered, tabulated and statistically analyzed.

Results

Clinical results revealed that all three groups showed a general improvement in TMDs symptoms throughout the study period. The improvement was significant in all the study group periods. There was no statistically significant difference between the groups.

Conclusions

It has been established that the CAD/CAM occlusal stent, LLLT, and combination of CAD/CAM occlusal stent and LLLT enhances patient satisfaction and pain alleviation in individuals with TMDs.
Efficacy of different natural remineralizing agents on treatment of artificially induced enamel caries (An in vitro comparative study)
Authors: Bolty Hamdy A. , El-Olimy Gehan Abd Elmonem , Elbahrawy Eman
Published: December 2023

Objectives

To evaluate and compare the remineralizing efficacy of chicken egg shell (CESP), propolis and grape seed extract (GSE) powder solutions in the treatment of artificially induced enamel caries in permanent human teeth (an in vitro study).

Materials and methods

Three different natural products (CESP, propolis, and GSE) were used. four groups were grouped according to the type of treatment for each group (n = 20). Control group (n = 10) (group B remineralized by CESP solution, group C remineralized by propolis powder solution and group D remineralized by GSP solution). Each group was divided into 2 subgroups (n = 10) according to the application frequency of remernerailizing agent: once (evening) (B1, C1, and D1) and twice daily (morning and evening) (B2, C2, and D2). Then all specimens were subjected to the PH cycle protocol. All specimens have been examined by scanning electron microscopy (SEM) coupled with energy dispersive X-ray (EDX) spectroscopy, surface micro hardness by Digital Vickers Micro hardness testing, and Surface roughness by a 3D optical profilometer testing before and after each step.

Results

The Ca/P ratio was significantly enhanced for all groups evaluated by (SEM) and (EDX). Vicker hardness number (VHN) was significantly enhanced for all subgroups treated twice daily (morning and evening) (B2, C2, and D2) followed by all subgroups treated once (evening) (B1, C1, and D1) before and after PH cycle. Surface roughness was significantly decreased for all subgroups except for subgroups (C2, D1, and D2) before and after the PH cycle.

Conclusion

CESP, prpolis powder and GSE powder solution could be used as remenerailizing agent as it has promising effect in treatment of initially demenarlized enamel surface. The efficacy of these remineralizing agents twice daily is better than once daily in treatment of initially demenarlized enamel surface.
Fracture resistance of ultrathin occlusal veneer fabricated by different CAD/CAM materials
Authors: El Zak Wafaa Talat , Shakal Mahmoud A.-E. , ElSharkawy Sherif M.
Published: December 2023

Purpose

The purpose of this in vitro study was to evaluate the fracture resistance of ultrathin occlusal veneer fabricated by different CAD/CAM materials.

Methods

The occlusal surface of 40 extracted lower premolars was prepared in the enamel layer and restored with occlusal veneers with fissures/cusp thickness of 0.5/1 ml made from two different dental CAD/CAM materials. Groups of the study included the following. Group I: lithium disilicate glass-ceramic n = 20; the group was further divided into two subgroups according to the thickness of each of them. Subgroup A: (n = 10) 0.5 mm and subgroup B: (n = 10) 1 mm. Group II: Cerasmart n = 20 is further divided into two subgroups according to the thickness of each of them. Subgroup A: (n = 10) 0.5mm, subgroup B: (n = 10) 1 mm. Occlusal veneers were etched with ceramic etch (Ips ceramic etching gel/ATZGEL-IVOCLAR AG) and then bonded using an adhesive luting system (G-MULTI PRIMER and G-CEMTM Veneer) light cure adhesive resin cement (G-CEHTM veneer). The prepared teeth were etched using phosphoric gel and bonded using Bisco All bond universal. All specimens were subjected to load till fracture; these loads were recorded and statistically analyzed using the one-way ANOVA. The mode of failure of the specimen was classified; the correlation between fracture strength and mode of failure was analyzed.

Results

In this study, fracture strengths (mean ± standard deviation) of cerasmart recorded were 0.5 mm (887.71 ± 284.79N), 1 mm (953.73 ± 214.06N), and for lithium disilicate 0.5 mm (455.16 ± 134.96N), 1 mm (768.59 ± 154.08N). Cerasmart had significantly higher fracture strength than lithium disilicate in 0.5 mm thickness, and significantly different fracture strength in 1 mm thickness. Most specimens (31 from 40) had been fractured in the restoration without involving the tooth structure.

Conclusion

The Cerasmart material could be considered a valid alternative to IPS e.max material.
Application of remimazolam transversus abdominis plane block in gastrointestinal tumor surgery
Authors: Liu Jun , Tian Jian-Min , Liu Guo-Ze , Sun Jun-Na , Gao Peng-Fei , Zhang Yong-Qiang , Yue Xiu-Qin
Published: December 2023

BACKGROUND

Transversus abdominis plane block (TAPB) is a block of the abdominal afferent nerve fibers between the internal oblique muscle and the transverse abdominal muscle achieved with local anesthetics. It can effectively block the conduction of the anterior nerve of the abdominal wall and exert a good analgesic effect. However, the effect of combining the block with remimazolam on anesthesia in patients undergoing gastrointestinal tumor surgery is still unclear.

AIM

To examine the effects of combining TAPB with remimazolam on the stress response and postoperative recovery of gastrointestinal tumor surgery patients.

METHODS

A retrospective analysis was conducted on the clinical data of 102 individuals diagnosed with gastrointestinal malignancies who underwent laparoscopic surgery under general anesthesia between April 2020 and June 2023. The patients were categorized into a control group (n = 51), receiving remimazolam for general anesthesia, and an observation group (n = 51), receiving TAPB combined with remimazolam for general anesthesia. A comparison was made between both groups in terms of hemodynamic parameters, stress markers, pain levels, recovery quality, analgesic effects, and adverse reactions during the perioperative period.

RESULTS

The observation group had significantly higher heart rates at time points 1 min after induction and upon leaving the operating room than the control group (P < 0.05). The mean arterial pressure at time point T1 in the observation group was significantly higher than that in the control group (P < 0.05). Five minutes after extubation, the levels of the hormones adrenaline and noradrenaline in the observation group were considerably lower than those in the control group (P < 0.05). At 12 h, 24 h, and 48 h following surgery, the visual analog scale scores of the observation group were considerably lower than those of the control group (P < 0.05). The observation group had shorter awakening and extubation times and lower Riker sedation-agitation scale scores than the control group (P < 0.05). The observation group exhibited considerably fewer effective pump presses, lower fentanyl dosages, and lower incidences of rescue analgesia within 24 h following surgery than the control group (P < 0.05).

CONCLUSION

The application effect of TAPB combined with remimazolam general anesthesia in anesthesia of patients undergoing gastrointestinal tumor surgery is good, which is helpful to promote faster recovery after operation.
Conversion immunotherapy for deficient mismatch repair locally unresectable colon cancer: A case report
Authors: Sun Zhen , Liu He , Zhang Guan-Nan , Xiao Yi
Published: December 2023

BACKGROUND

Owing to the special features of biologics, deficient mismatch repair (dMMR) in patients with colon cancer has achieved little treatment efficacy from chemoradiotherapy. Immunotherapy has shown promising results for the treatment of colon cancer. The high response rate observed suggests a great option for patients presenting with unresectable tumors, as it allows for better oncological resection. Here, we aimed to highlight the significant effects of immunotherapy on dMMR in colon cancer.

CASE SUMMARY

A 54-year-old man diagnosed with locally unresectable dMMR colon cancer received preoperative immunotherapy (three cycles of pembrolizumab) and achieved a pathological complete response after surgery.

CONCLUSION

Immunotherapy can be used as a conversion treatment for locally unresectable colon cancer with dMMR.
The New Mobility Handbook, 2024 Edition
Authors:   Smarter Cars podcast., Kyrouz Michele
Published: December 2023

Are new mobility technologies the key to unlocking the future of urban living, or do they pose a threat to established public transit systems? Dive into this groundbreaking book that unveils the potential for a harmonious coexistence. The New Mobility Handbook, 2024 Edition challenges the belief that ride services, autonomous vehicles, and micromobility are at odds with public transit in a zero-sum transportation game. Discover how new mobility options, immensely popular and fostering multimodal travel, can be paired with classic urban planning principles to offer attractive alternatives to personal car use. Learn how road pricing, road space reallocation, and innovative policies can transform cities when new mobility technologies turn detractors into allies. Ride services and micromobility emerge not as adversaries to transit, but as advocates for a smarter, more inclusive urban ecosystem. Part I sparks a paradigm shift, advocating to change how we use cars through fair pricing and shared street space. Part II champions micromobility as a crucial city transportation element, while Part III underscores the pivotal role of public transit, positioning it as a first-choice option. Join us in reshaping the narrative! Embrace a future where cars, micromobility, and public transit unite, creating a dynamic, sustainable, and inclusive mobility system for the next century.
A Systematic Review of Metrics Utilized in the Selection and Prediction of Future Performance of Residents in the United States
Authors: Lipman Jeremy M. , Colbert Colleen Y. , Ashton Rendell , French Judith , Warren Christine , Yepes-Rios Monica , King Rachel S. , Bierer S. Beth , Kline Theresa , Stoller James K.
Published: December 2023

Background Aligning resident and training program attributes is critical. Many programs screen and select residents using assessment tools not grounded in available evidence. This can introduce bias and inappropriate trainee recruitment. Prior reviews of this literature did not include the important lens of diversity, equity, and inclusion (DEI).

Objective This study’s objective is to summarize the evidence linking elements in the Electronic Residency Application Service (ERAS) application with selection and training outcomes, including DEI factors.

Methods A systematic review was conducted on March 30, 2022, concordant with PRISMA guidelines, to identify the data supporting the use of elements contained in ERAS and interviews for residency training programs in the United States. Studies were coded into the topics of research, awards, United States Medical Licensing Examination (USMLE) scores, personal statement, letters of recommendation, medical school transcripts, work and volunteer experiences, medical school demographics, DEI, and presence of additional degrees, as well as the interview.

Results The 2599 identified unique studies were reviewed by 2 authors with conflicts adjudicated by a third. Ultimately, 231 meeting inclusion criteria were included (kappa=0.53).

Conclusions Based on the studies reviewed, low-quality research supports use of the interview, Medical Student Performance Evaluation, personal statement, research productivity, prior experience, and letters of recommendation in resident selection, while USMLE scores, grades, national ranking, attainment of additional degrees, and receipt of awards should have a limited role in this process.
Geographic Reach of Surgery Residency Applicants During In-Person and Virtual Interviews
Authors: Storino Alessandra , Polanco-Santana John C. , Sampson Rachel , Glass Charity , Fabrizio Anne , Kent Tara S.
Published: December 2023

Background Virtual interviews for surgery residency may improve interview opportunities for applicants from underrepresented in medicine (UIM) and lower socioeconomic backgrounds.

Objective To compare the geographic reach of surgical residency applicants during in-person versus virtual interviews.

Methods This study compared applicants for the 2019 (in-person) and 2020 (virtual interviews) application cycle for surgery residency. Geographic reach (GR) was defined as the distance between applicants’ current location and the program. Federal Financial Institutions Examination Council’s website supplied socioeconomic data using applicants’ geographic locations. Applicant demographics, United States Medical Licensing Examination (USMLE) scores, and geographic distance to program were collected. Multivariable analyses examined GR with interaction terms between interview type, UIM status, and socioeconomic status, while controlling for USMLE scores.

Results A total of 667 (2019) and 698 (2020) National Resident Matching Program applications were reviewed. Overall, there was no difference in GR for applicants during in-person and virtual interviews in multivariable testing. UIM status had no association with GR for in-person interviews, but virtual interviews were associated with an increased GR for UIM applicants compared to non-UIM applicants (235.17; 95% CI 28.87-441.47; P=.02). For in-person interviews, applicants living in communities with poverty levels ≥7% had less GR vs those in communities with levels <7% (-332.45; 95% CI -492.10, -172.79; P<.001), an effect not observed during virtual interviews.

Conclusions There was no difference in overall GR, or the proportion of UIM applicants or those from higher poverty level communities, but virtual survey interviews during the COVID-19 pandemic were associated with increased GR for UIM and from lower socioeconomic backgrounds applicants.
Implementation of Urban Policy and Sustainable Development Goal 11 in Federal Capital Territory (FCT), Abuja
Authors: Ibe Ezechi , Aliegba Eugene , Umar Shuaibu
Published: December 2023

The quest to achieve Sustainable Development Goal (SDG) 11 target through implementation of urban policies has continued to pose challenges in developing countries including Nigeria and Federal Capital Territory (FCT) Abuja in particular. The purpose of this paper is to examine the ways implementation of urban policies has influenced the realization of SDG 11 goals in the FCT given the challenges confronting the residents in the city, particularly in the areas of clean water and efficient transportation system. The paper was anchored on the elite theory which helps in explaining the connection between implementation of SDG 11 target and elite preferences. The population of the study consisted of 3,510 respondents, while the sample size of the study was 360 respondents determined using Rakesh sample size formula.360 questionnaires were administered. Twenty-five (25) respondents were selected for an in-depth interview on the basis of their knowledge on issues under study. Data, particularly in the areas of clean water were also collected using secondary sources. Data from questionnaires were analyzed using percentages and frequency tables, while data from in-depth interviews were analyzed using textual methods. Data from secondary sources were analyzed using relational-content analysis. Among other things, findings revealed that the level of implementation of urban development before the introduction of SDG 11 has been very poor, while the SDG 11 has not brought meaningful development in FCT since inception based on the records available. On the basis of the findings, it is concluded that significant improvement in the level of implementation of urban development policies in the FCT is vital to ensuring the objectives of SDG 11 target in the city and in its suburban areas are achieved. Among other things, it was recommended that urban development policies regarding availability of clean water should be adequately implemented in FCT in order to achieve SDG 11 targets in the city, while at the same time, implementing the Abuja Master Plan to achieve an efficient transportation system in the city.
Review Article : Economic abuse as a form of intimate partner violence in sub-Saharan Africa: A review of the literature
Authors: Nduka Chinelo , Omuemu Vivian , Tella Adedayo , Obi Darlington
Published: December 2023

Background: Economic abuse (EA) is a form of intimate partner violence (IPV) whereby one partner controls the ability of the other to acquire, use and maintain economic resources. It is significant because economic concerns are a major reason survivors remain in abusive relationships, as they lack the means to cater for themselves and their children if they leave.Aim: This paper reviews the literature on measurement, prevalence, and response to EA within the context of IPV in sub-Saharan Africa.Method: A comprehensive desk-based review was conducted between November 2020 and February 2022. Google, Google Scholar, Pubmed, ResearchGate, Web of Science, and Science Direct were searched using relevant keywords such as IPV, EA, domestic violence and financial abuse. Full-text publications of quantitative and qualitative studies written in English were included.Findings: Various measurement scales for EA have been created, revised, and adapted over the years with some being more inclusive. The prevalence of EA in sub-Saharan Africa varied across countries, and no context- specific measurement scale is available for the region. Economic abuse was found to be the form of IPV with the least legislative response and often absent from plans of action on violence against women.Conclusion: This review buttresses the need to develop measurement scales for EA specific to sub-Saharan Africa to properly assess the regional prevalence. There is also a need to heighten awareness of EA to promote recognition and appropriate response.
Wine tourism – a chance for the development of rural regions: A case study from Eastern Poland
Authors: Krukowska Renata
Published: December 2023

European wine tourism has long been carried out in the traditional wine areas of France, Portugal or Germany. In the countries of Central Europe, these traditions also occur, but they have a more local meaning. The article presents one of the wine regions in Eastern Poland – the Lesser Poland Gorge of the Vistula River, where the development of small wineries has been observed for several years. The article’s primary goal is to present vineyards in the Lesser Poland Gorge of the Vistula River concerning the possibilities of development of wine tourism and its impact on the region’s functioning. It seems that the concept of “terroir” can be used by local winemakers to identify the particularities of wines from vineyards. This can be an excellent contribution to the development of wine tourism, considering that nowadays, tourists search for authentic experiences. The production of local grape wine and its promotion may be the basis for rebuilding the region’s wine production tradition, as well as contributing to the region’s development.