bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging Insights: The Impact of Real-world Evidence on Rheumatoid Arthritis. Latest Evidence from Janus Kinase (JAK) Inhibitors
Authors: Taylor Peter
Published: November 2024

Baricitinib, an oral selective Janus kinase (JAK)1/JAK2 inhibitor, is approved as monotherapy or in combination with methotrexate for treating adults with moderate-to-severe active rheumatoid arthritis (RA) and provides improvements in clinical signs, symptoms and patient-reported outcomes. In several pivotal Phase II and III RA trials, up to seven years of baricitinib treatment was well tolerated and provided rapid and sustained efficacy. These findings have been substantiated in the context of “real-world” settings. Real-world evidence (RWE) helps health authorities and healthcare providers gain further insights regarding treatment effectiveness and safety in real-life settings as they focus on heterogenous patient populations (who may be older, more treatment refractory, and with more comorbid conditions than clinical trial populations). RWE permits the identification of associations between treatment and rare AEs and also helps the medical community to better understand treatment patterns, such as line of therapy utilisation, and to define risks associated with lower effectiveness or poorer drug survival. This talk will explore the clinical and real-world data investigating the benefit: risk profile of baricitinib, confirming that the improved disease activity and physical function of patients with RA treated with this JAK inhibitor observed in clinical trials is translated into effectiveness in real-world clinical practice, with a low rate of discontinuations. The post-marketing Phase IIIb/IV trial Oral Rheumatoid Arthritis Trial (ORAL) Surveillance identified venous thrombotic events (VTE), major adverse cardiovascular events (MACE), and malignancy as potential safety signals associated with tofacitinib, a JAK1,3 inhibitor, in comparison to biologic anti-TNFs. In the case of baricitinib, while some, but not all, RWE points to potential VTE risks, data regarding MACE have been generally reassuring. Several real world and registry studies indicate that drug survival is consistently higher with baricitinib than with biological anti-cytokine drugs. In the case of patients with inadequate response to a first anti-TNF, EULAR recommendations for treatment change include cycling within drug class or switching the mode of action of advanced therapy. However, clinical trials and RWE confirm that switching to an advanced therapy of a different mode of action after anti-TNF failure is more effective and associated with lower rates of withdrawal than cycling to a different anti-TNF. In the case of patients with inadequate response to a first JAK inhibitor, RWE indicates that patients who cycle to another JAK inhibitor are more likely to achieve a good clinical response and have higher drug survival than patients switched to bDMARDs.
Osteoporosis for Rheumatologists: Latest Updates and Controversies
Authors: Saag Kenneth
Published: November 2024

While many agents now exist for osteoporosis treatment, their clinical use is attenuated my questions about comparative effectiveness and safety. Calcium and Vitamin D are essential for optimal bone health and may have other health benefits but excessive supplemental doses, in the absence of deficiencies, may be deleterious. Greatest interest has been directed to rare occurrences of osteonecrosis of the jaw and atypical femoral fractures associated with bisphosphonates and denosumab. These potential adverse effects may be offset by selective use of a bisphosphonate “drug holiday”. On the other hand, denosumab discontinuation leads to rapid bone loss and a heightened risk of fracture, necessitating an “exit strategy.” Teriparatide may have comparatively greater efficacy than other drugs in high risk patients. Romosozumab, while highly efficacious in comparator studies with bisphosphonates, has shown a controversial increase in cardiovascular adverse outcomes. Data is emerging on novel osteoanabolics and their regulatory approval will be aided by surrogate endpoints. Using incidental CT scans and other newer technologies will help detect more at risk patients sooner. Despite the potential for mostly rare adverse effects, for the vast majority of patients the benefits of osteoporosis therapy far outweigh their risks.
Protocol of a Randomised Controlled Trial to Assess the Efficacy and Safety of a Oral Complementary Medicine Combination in People with Knee Osteoarthritis
Authors: Liu Xiaoqian , Shahid Arashi , Bracken Karen , Christensen Robin , Deveza Leticia , Collins Simone , Harnett Joanna , Hunter David , McLachlan Andrew , Robbins Sarah , Bowden Jocelyn
Published: November 2024

Background

Osteoarthritis (OA) is a leading cause of pain and disability in middle-aged or older adults worldwide. The prevalence of symptomatic knee OA has been increasing over the past several decades, indicating the need for the deployment of innovative prevention and treatment strategies for knee OA. The aim of this study is to investigate the efficacy and safety of an oral complementary medicine formulation in people with symptomatic knee OA.

Methods

This is a randomised, placebo-controlled, double-blinded (participants and investigators), two-arm, superiority, parallel, phase II trial. The study will recruit 82 ([Formula: see text]41 per arm) community-based participants with knee OA living in Australia. Participants aged [Formula: see text] 40 years with a clinical diagnosis of symptomatic knee OA and radiographic change on X-ray (Kellgren-Lawrence Grade [Formula: see text] 2) will be recruited. Participants will be randomly allocated to receive either a complementary medicine formulation containing a daily dose of Boswellia serrata extract (Boswellin[Formula: see text]Super, 250 mg/day), pine bark extract (Fenoprolic™70 Organic 100mg/day), curcumin (500mg/day), piperine (5mg/day), and methylsulfonylmethane (MSM, 1500mg/day), or placebo, for 12 weeks. The primary endpoint is change from baseline in average index knee pain at 12 weeks (visual analogue scale). Secondary endpoints include change in knee pain at other timepoints, the Knee Injury and Osteoarthritis Outcome Score (KOOS), global assessment of disease activity, global rating of change, health-related quality of life (AQoL-8D), and adverse events.

Ethics, trial registration and dissemination:

The study protocol has been approved by the University of Sydney Human Research Ethics Committee (#2021/877). The trial has been prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12623000380695, 14/04/2023). Dissemination will occur through lay summaries, scientific publications, conference abstracts, poster or oral presentations, infographics, and theses.

Conclusion

The outcomes of this study will provide high-quality evidence guiding the clinical use of the complementary medicine combination and will inform updates on international OA clinical practice standards on the use of complementary medicines.
Insights into Rheumatoid Arthritis in Kuwait: The Prevalence of Comorbidities
Authors: Khudadah Mohammad , Aldabie Ghaydaa , Albasri Anwar , Al-Herz Adeeba , Alsaber Ahmad , Saleh Khulood , Alawadhi Adel , Hasan Eman , Al-Kandari Waleed , Muhanna Aqeel , Ali Yaser , Alhadhood Naser , Tarakmeh Huda , Hayat Sawsan , Aldei Ali , Baroun Fatemah , kadi Amjad Al , Alhajeri Hebah , Abutiban Fatma , Alenzi Ahemd
Published: November 2024

Introduction

Rheumatoid Arthritis (RA) is a chronic autoimmune disease that causes joint inflammation and potential disability. (1). The relationship between comorbidities and RA is well-known and is associated with poor outcomes. (3,4, 5) Furthermore, patients with RA are at an increased risk of cardiovascular disease (CVD). (6) This study investigates the epidemiology of RA in Kuwait, focusing on the prevalence of comorbidities such as hypertension, type 2 diabetes, hyperlipidemia and obesity using the Kuwait Rheumatoid Arthritis registry.

Methods

This retrospective study analyzes data from 2239 RA patients in Kuwait, enrolled from February 2012 to May 2024

Results

As shown in Table 1, (71.0%) are females with a mean age of 55.6 years and a mean disease duration of 11.1 years. The average body mass index (BMI) is 29.2, with 39.2%% having a BMIˆ3 of 30 and 11.3% are active smokers.

Analysis of comorbidities in RA patients shows that hypertension (23%) and diabetes Type 2 (20%) are the most prevalent conditions, followed by thyroid disease and hyperlipidemia (13%), as demonstrated in Figure 1.

Conclusion

This study reveals a high prevalence of hypertension, diabetes, dyslipidemia and obesity, all of which are modifiable risk factors for CVD. This finding emphasizes the importance of pre-emptive screening for these comorbid conditions, establishing a comprehensive care plan, and optimizing treatment protocol to improve patient outcome.
Unravelling a Case of Coronary Vasculitis
Authors: Lafir Raahya , Atukorala Inoshi , Vidanapathirana Manudi
Published: November 2024

Background

Coronary vasculitis is a rare cause of myocardial infarction through varied mechanisms. We report the case of a 32-year-old female found to have diffuse coronary microaneurysms during treatment for an Inferior ST Elevation Myocardial Infarction (STEMI), with challenges in pinpointing the underlying aetiology.

Results

Our patient has been diagnosed with a seronegative arthritis and had been initiated on regular Golimumab 4 months prior. She presented with prolonged fever for 4 weeks and inflammatory oligoarthritis with left sacroiliac joint pain. During this admission, Antinuclear antibody was 1:2560 and anti ds DNA was 1:80. She had highly positive Rickettsia conorii IgG titres of 1:128, suggestive of acute infection with Orientia tsustsugamushi. Meropenem and doxycyclin for presumed typhus had no impact on her fever spikes. In the 10th week of the illness, she developed ischaemic chest pain with electrocardiographic changes of inferior STEMI and was thrombolysed. Invasive coronary angiography revealed numerous coronary microaneurysms affecting all major myocardial vessels, with minimal coronary artery disease. Following multidisciplinary discussion, she was treated with intravenous methylprednisolone, antiplatelets, a statin and warfarin for a diagnosis of coronary vasculitis.

Repeat angiography showed complete resolution of the microaneurysms. She continues on anticoagulation and has since had no coronary events.

Conclusion

Typhus and medium vessel vasculitis such as Kawasaki and Polyarteritis Nodosa were potential diagnoses for this presentation. A diagnosis of SLE was established due to the highly specific immunological profile. As there are reports of high Rickettsial titres in autoimmune disease, which alongside the lack of response to doxycyclin makes Typhus unlikely. The possibility of golimumab induced SLE was briefly entertained due to similar reports, but the positivity of ds DNA and major organ involvement made this possibility unlikely.

We highlight the cardiac involvement in this case due to its high morbidity on young patients, and the current paucity of knowledge on SLE-related endothelial dysfunction and immune-mediated vascular damage. The role of anticoagulation in this inflammatory milieu too, is controversial.

This case highlights a rare presentation of SLE, with an emphasis on coronary vasculitis. It adds to the current knowledge on the complex cardiovascular risk in SLE and highlights ambiguous areas in current management strategies to prompt further research.
Development of Non-Genetic Risk Stratification Model of Severe Allopurinol Hypersensitivity (NoG-ALLOH Score): A Multicenter Study in Thailand
Authors: Towiwat Patapong , Lawanaskol Suppachai , Tassaneeyakul Wichittra , Sukasem Chonlaphat , Saksit Niwat , Nakkam Nontaya , Poolpun Duangkamon , Rerkpattanapipat Ticha , Klaewsongkram Jettanong , Rerknimitr Pawinee , Louthrenoo Worawit
Published: November 2024

Background

The side effect of allopurinol was severe allopurinol hypersensitivity (SAH). There are two major causes including genetic risk factor, HLA-B*58:01 and non-genetic risk factors including female, old age, renal impairment, inadequate starting dosage of allopurinol and received diuretic. Although HLA-B*58:01 testing is recommended in Thai, the several problems including cost, limitation of the testing and the delay of the result. Therefore, we aimed to use these non-genetic risk factors for developing the model to predict SAH.

Method

The study was a retrospective observational incidence density sampling. SAH cases were collected from tertiary care medical center which some cases were referred from primary care medical center; where most non-SAH cases were collected from primary care hospitals and tertiary care medical centers. The data of non-genetic factors particularly sex, age, renal function, co-diuresis, starting dosage of allopurinol and serum uric acid (SUA) of non-SAH cases selected the first description of allopurinol. The binary prevalence-weighted logistic regression statistical method was used to develop the prediction models. Three models were developed following general practice.

Result

Totally, there were 209 cases of SAH and 23,068 cases of non-SAH. Factors that were associated with the development of SAH within 90 days were female, old age (¿ 65 years old), renal impairment, inadequate starting dosage of allopurinol, co-medication(s) with diuretic and high SUA before prescription of allopurinol. Model 1a and model 1b were applied for patients who did not have and have SUA when starting allopurinol, respectively. Model 2 was applied for patients who had all non-genetic risk factors and started allopurinol within 60 days but have not SAH. The area under the receiver operating characteristic curve for model 1a, model 1b and model 2 were 0.72, 0.81 and 0.82, respectively (Figure 1). The performance for each predictions SAH were good.

Conclusion

Model 1a and model 1b predict SAH for the patients who had their first prescribed allopurinol, model 2 predicts SAH for the patients who had been taken allopurinol within 60 days but no SAH. The scoring system of each model helps clinician to prescribe allopurinol in real clinical practice before the patients develop SAH. The score of 0-1%, 1-2% and 2-100% indicates the low, moderate and high risk, respectively. The low-risk group can start allopurinol. The moderate-risk group considers to start allopurinol with closed monitoring of SAH. The high-risk group suggests to change to other urate lowering agents for preventing SAH (Table 1).
Ruminating on Bovine Implantation: Its Importance in Fertility, Food Production, Conservation, and Health
Authors: Amelkina Olga , Gardner Samantha , Edge Jessica C. , Butt Zenab , Tinning Haidee , Forde Niamh
Published: November 2024

Implantation in cattle is a key developmental checkpoint for pregnancy success. It involves careful spatiotemporal changes to the transcriptional landscape of the endometrium, with the heterogeneous nature of the endometrium increasing the complexity of understanding of the mechanism involved. Implantation is impacted by the developmental competency of the embryo, use of assisted reproductive technologies, and the environment in which this process occurs. We identify the factors that most impact the implantation process in cattle and highlight how it differs with that in other placental mammals. We propose the major areas that lack evidence are the mechanism(s) by which implantation itself occurs and how different stressors alter this process. Our understanding is hindered by a lack of appropriate in vitro models; however, development of novel 3D tools and available data sets will further elucidate the implantation process. Perhaps more importantly, this will develop methods to mitigate against these stressors to improve implantation success and offspring health.
Advances in Therapy for Refractory Epilepsy
Authors: Jehi Lara
Published: November 2024

Drug-resistant epilepsy (DRE) is defined as failure to achieve sustained seizure control with adequate trials of two appropriate antiseizure medications (ASMs). DRE affects one-third of patients with epilepsy and is associated with significant morbidity and mortality. Newer ASMs provide pharmacological therapy that is better tolerated but not necessarily more effective than older ASMs. Resective brain surgery is the gold standard to treat DRE and achieve seizure freedom, with laser ablation offering an alternative with less morbidity but lower effectiveness. For patients who are not candidates for resection or ablation, multiple neuromodulation options can reduce seizure burden. These neuromodulation devices have shown comparable effectiveness in randomized clinical trials, but the results vary in open-label follow-up cohorts, as do the risks of complications and associated costs. Dietary therapies can help, particularly in pediatric genetic epilepsies. Innovative genetic therapy approaches are being pursued, offering the promise of precision medicine.
Preterm Brain Injury: Mechanisms and Challenges
Authors: Beacom Michael J. , Gunn Alistair J. , Bennet Laura
Published: November 2024

Preterm fetuses and newborns have a high risk of neural injury and impaired neural maturation, leading to neurodevelopmental disability. Developing effective treatments is rather challenging, as preterm brain injury may occur at any time during pregnancy and postnatally, and many cases involve multiple pathogenic factors. This review examines research on how the preterm fetus responds to hypoxia-ischemia and how brain injury evolves after hypoxia-ischemia, offering windows of opportunity for treatment and insights into the mechanisms of injury during key phases. We highlight research showing that preterm fetuses can survive hypoxia-ischemia and continue development in utero with evolving brain injury. Early detection of fetal brain injury would provide an opportunity for treatments to reduce adverse neurodevelopmental outcomes, including cerebral palsy. However, this requires that we can detect injury using noninvasive methods. We discuss how circadian changes in fetal heart rate variability may offer utility as a biomarker for detecting injury and phases of injury.
Epithelial Na+ Channels, Immune Cells, and Salt
Authors: Kirabo Annet , Masenga Sepiso K. , Kleyman Thomas R.
Published: November 2024

Epithelial Na+ channels (ENaCs) are known to affect blood pressure through their role in transporting Na+ in the distal nephron of the kidney. While expressed in other epithelial tissues, there is growing evidence that ENaCs are also expressed in nonepithelial tissues where their activity influences blood pressure. This review provides an overview of ENaCs and key mechanisms that regulate channel activity. The role of ENaCs in antigen-presenting dendritic cells is discussed, where ENaC-dependent sensing of increases in the extracellular Na+ concentration leads to activation of a signaling cascade, T cell activation with the release of proinflammatory cytokines, and an increase in blood pressure. The potential contribution of this pathway to human hypertension is discussed.
State of the Science of Structural Stigma and LGBTQ+ Health: Meta-Analytic Evidence, Research Gaps, and Future Directions
Authors: Lattanner Micah R. , McKetta Sarah , Pachankis John E. , Hatzenbuehler Mark L.
Published: November 2024

While public health practitioners and scholars have long theorized that structural forms of stigma shape the health of disadvantaged groups, they have frequently bemoaned the lack of research on this topic. A unique opportunity to address this lacuna occurred in the past two decades, with the advent of dramatic changes in laws, social attitudes, and other structural manifestations of stigma surrounding LGBTQ+ individuals. In a review of this literature, we conducted a meta-analysis of LGBTQ+ structural stigma and health, finding an effect size comparable to several other well-established macrolevel risk factors for poor health (e.g., income inequality, racial residential segregation, neighborhood socioeconomic status). In addition, we enumerated a range of established methodological strategies that studies have used to strengthen inferences; these strategies include documenting result specificity (i.e., structural stigma is unrelated to the health of cisgender heterosexuals), addressing alternative explanations (e.g., social selection), and triangulating evidence across multiple methods, measures, and health outcomes. We offer suggestions for future research to advance this rapidly expanding field, including identifying sources of unexplained heterogeneity in the structural stigma–health association. Finally, we discuss implications for other marginalized groups and for public health interventions and policies to reduce LGBTQ+ health disparities.
Electrolyzed Water: A Promising Strategy for Improving Food Quality and Safety of Fruits, Vegetables, and Meat
Authors: Meghwar Parkash , Saeed Syed Muhammad Ghufran , Forte Lucrezia , Smaoui Slim , Khalid Nurul Izzah , De Palo Pasquale , Maggiolino Aristide
Published: November 2024

The growing demand for sustainable and healthy practices has led to an increased interest in the electrolyzed water (EW) application. This technology has garnered widespread acceptance as a sanitizer within the food industry. It also enhances the nutritional, functional, and sensory properties of food products to improve quality and safety. This review undertakes a comprehensive review of the recent advancements in electrolysis technology, exploring its applications in fruits and meat industry and its impact on nutritional, functional, microbiological, safety, and sensory characteristics. It is concluded that the EW should be considered an essential component of industrial equipment sanitization and food product decontamination by offering antimicrobial benefits and promoting functional component accumulation. Nevertheless, the effectiveness of EW can be compromised by the presence of organic matter and equipment corrosion. Furthermore, it provides a concise overview of EW generation, elucidates the influential factors governing its production, and delineates prospective directions for research and development in this field.
Optic Neuropathy AFG3L2 Related in a Patient Affected by Congenital Stationary Night Blindness
Authors: Cammarata Gabriella , Mihalich Alessandra , Manfredini Emanuela , Lamperti Costanza , Bianchi Marzoli Stefania , Di Blasio Anna Maria
Published: November 2024

Objective: We describe a patient affected by congenital stationary night blindness (CSNB) secondary to CACNA1F and optic neuropathy associated with an AFG3L2 variant.

Methods: We performed comprehensive neuro‐ophthalmologic examinations, retinal imaging, complete ocular electrophysiology, and brain and optic nerve MRI. Genomic DNA was extracted from the peripheral blood. The patient’s DNA was then investigated by next‐generation sequencing (NGS) with a panel including 32 genes associated with retinal dystrophy and therefore with a panel including seven genes associated with genetic forms of optic atrophy.

Results: The genetic analysis identified a pathogenetic CACNA1F variant causing CSNB and a heterozygous variant in AFG3L2 that alters OPA1 processing and is known to be associated with OPA1‐like optic neuropathy.

Conclusion: Optic disc atrophy has been previously described as an atypical feature in the phenotype of CSNB CACNA1F‐related. In this patient, we found a variant of the AFG3L2 gene that presumably explains the presence of optic atrophy in a subject affected by CSNB.

Clinical Relevance: The clinical evidence of optic atrophy, which is atypical in CSNB, should raise the suspicion of concomitant hereditary optic neuropathy and emphasize the importance of broad genetic diagnostic testing to better define the genotype–phenotype correlation.
A Weighted Diffusion Graph Convolutional Network for Relation Extraction
Authors: Chen Jiusheng , Li Zhenlin , Yu Hang , Zhang Xiaoyu
Published: November 2024

Currently, graph convolutional network (GCN) is widely used in relation extraction (RE) tasks. Within RE tasks in the form of directed graphs, the placement of entities in the sentence context generates a large number of remote entity nodes in the directed graph. However, the GCN has an acceptance domain limitation and can only aggregate consecutive neighbor nodes, making it ineffective for remote node information extraction. To tackle the above issues, a new model GCN based on weighted diffusion is proposed, including two improvements. First, the pretrained BERT model is introduced to extract the semantic features from the original sentences, and then the diffusion convolution is modified by the weighted matrix using the Gaussian kernel function to calculate the distance of nodes on the graph, enabling the diffusion convolution to selectively aggregate information of remote nodes. The effect of remote node information aggregation can be improved by shortening the distance of related nodes and increasing the distance of unrelated nodes. Second, an identity mapping is added to ensure that the weight matrix can match each layer adaptively. The efficacy of our proposed model has been demonstrated through experimental results on two publicly available datasets, TACRED and SemEval, which have shown that it outperforms other baseline models.
Supplementary Table S5 from Region-Based Analyses of Existing Genome-Wide Association Studies Identifies Novel Potential Genetic Susceptibility Regions for Glioma
Authors: Alpen Karen , Maclnnis Robert J. , Vajdic Claire M. , Lai John , Dowty James G. , Koh Eng-Siew , Hovey Elizabeth , Harrup Rosemary , Nguyen Tuong L. , Li Shuai , Joseph David , Benke Geza , Dugué Pierre-Antoine , Southey Melissa C. , Giles Graham G. , Nowak Anna K. , Drummond Katharine J. , Schmidt Daniel F. , Hopper John L. , Kapuscinski Miroslaw K. , Makalic Enes
Published: November 2024

Supplementary Table S5 shows the generalised Berk-Jones statistic (GBJ) p-values for the candidate novel susceptibility regions for glioma by study and sex.
Supplementary Table S4 from Region-Based Analyses of Existing Genome-Wide Association Studies Identifies Novel Potential Genetic Susceptibility Regions for Glioma
Authors: Alpen Karen , Maclnnis Robert J. , Vajdic Claire M. , Lai John , Dowty James G. , Koh Eng-Siew , Hovey Elizabeth , Harrup Rosemary , Nguyen Tuong L. , Li Shuai , Joseph David , Benke Geza , Dugué Pierre-Antoine , Southey Melissa C. , Giles Graham G. , Nowak Anna K. , Drummond Katharine J. , Schmidt Daniel F. , Hopper John L. , Kapuscinski Miroslaw K. , Makalic Enes
Published: November 2024

Supplementary Table S4 shows the number of samples excluded from the GICC data and reasons for exclusion.
Figure 1 from Region-Based Analyses of Existing Genome-Wide Association Studies Identifies Novel Potential Genetic Susceptibility Regions for Glioma
Authors: Alpen Karen , Maclnnis Robert J. , Vajdic Claire M. , Lai John , Dowty James G. , Koh Eng-Siew , Hovey Elizabeth , Harrup Rosemary , Nguyen Tuong L. , Li Shuai , Joseph David , Benke Geza , Dugué Pierre-Antoine , Southey Melissa C. , Giles Graham G. , Nowak Anna K. , Drummond Katharine J. , Schmidt Daniel F. , Hopper John L. , Kapuscinski Miroslaw K. , Makalic Enes
Published: November 2024

Methodology flowchart. An outline of the stages used to identify potential glioma risk regions. PLO, Bayesian posterior log odds in favor of association; PC, principal component.
Different Patterns of Platelet Count Fluctuation in Response to Various Anticancer Chemotherapies among Patient with Bladder Cancer
Authors: Watanabe Ayako , Ogawa Yu , Saeki Misa , Nagata Takuya , Morita Masashi , Momo Kenji
Published: November 2024

Introduction: In general, platelet counts fluctuate in cancer patients receiving anticancer therapy. It may include thrombocytopenia caused by bone marrow suppression due to cytotoxic anticancer agents and thrombocytosis due to rebound during recovery. This should not be the case in the case of administration of immune checkpoint inhibitors, given their mechanism of action. Case Presentation: However, we have experienced a case of thrombocytosis in a patient treated with an immune checkpoint inhibitor. We present a platelet count pattern in patient with bladder cancer underwent Gemcitabine and Cisplatin (GC) therapy and pembrolizumab monotherapy. Conclusion: This case underscores the need for a diverse perspective on platelet behavior in clinical settings.
College Students' Perception of State-Managed Debt
Authors: Korniawan Rostamaji
Published: November 2024

State-managed debt has always been a polemic in every country, including Indonesia. Some people's perceptions did not align with the Government's debt policy, including some college students'students' perceptions. Therefore, this study, which is of significant importance, aims to determine the public's understanding, especially college students, of state-managed debt. The Government values the insights of college students, as their perceptions are crucial in shaping public learning regarding debt management. The research was conducted using a qualitative approach through in-depth interviews with five informants outside Jabodetabek (Jakarta, Bogor, Depok, Tangerang, and Bekasi) in Indonesia. The five informants represent the college student community with different educational backgrounds and genders. Based on the in-depth interviews, the results found that all informants' perceptions described the terminology of state-managed debt sufficiently. Likewise, when they described what the investment was. Despite differences in educational backgrounds, each college student could articulate their perceptions of state-managed debt. The study found that the literature on public finance was still limited. Therefore, this research underscores the potential for growth in public finance literacy among college students, highlighting the crucial and reassuring role of the Government in providing comprehensive lessons and accurate information to the younger generation about the benefits of prudent state-managed debt.
El Museo do Ipiranga (Sao Paulo, Brasil): una mirada desde los sentimientos y las emociones.
Authors: Vélaz Ciaurriz David
Published: November 2024

Se ha hablado mucho de la importancia que los sentimientos y emociones tienen para las ciencias sociales y las humanidades, en general, y para la museología, en particular. Pero poco se ha dicho sobre propuestas de trabajo concretas que permitan identificarlas y analizarlas. En este sentido, este trabajo pretende identificar y analizar los sentimientos y emociones que el Museo de Ipiranga (São Paulo, Brasil) despierta entre sus visitantes. Se presenta una propuesta metodológica desde un entorno de programación en Lenguaje R que permite extrapolar sentimientos y emociones que subyacen en textos, en este caso reseñas de Google. Para ello se hace uso de diferentes librerías, entre las que destaca Syuzhet. No obstante, la propuesta de trabajo no es exclusiva de las instituciones museísticas, sino que es susceptible de ser aplicada con diferentes muestras de datos en diferentes entidades o proyectos culturales. Respecto a los resultados obtenidos, se identifica una polaridad sentimental que puede considerarse como manifiestamente positiva y un predominio de emociones que hay que poner en relación con la alegría y la confianza, según el modelo de Robert Plutchik.
Developing Supportive Work-Life Initiatives: A Systemic and Intersectional Framework
Authors: Rodriguez Ana Carolina , Cavallo Taylor
Published: November 2024

Although supportive work-life initiatives have advanced in recent years, existing literature shows inconsistent outcomes regarding the adoption and effectiveness of these initiatives. In this conceptual paper, we aim to highlight that an individual’s ability to freely negotiate and decide how to manage the relationships between their paid work and the rest of their life domains depends on their contexts and social identities. Leveraging literature from HRD and other fields, we argue that the design and implementation of effective supportive work-life initiatives require using systemic and intersectional perspectives. We propose a conceptual framework that maps various interconnected factors at the individual, organizational, and societal levels that influence an individual’s ability to access resources, adopt supportive work-life policies, and negotiate expectations about how they allocate their time. Scholars can use the proposed framework to analyze work-life issues from a contextualized and intersectional lens. For practitioners, the proposed framework can be a valuable tool to design and implement supportive work-life initiatives. We claim that organization development interventions, a significant stream within the HRD field, can be a powerful approach to designing and implementing supportive work-life initiatives that embrace the complexities and interconnections of individuals, organizations, and societies.
The Effect of the Nasal Structure on the Olfactory Cleft Airflow: A Systematic Review
Authors: Chen Lina , Liu Yuxing , Wu Dawei
Published: November 2024

Objective

Conductive olfactory losses mainly involve obstruction of the olfactory cleft (OC) and diminished OC airflow. This study investigated the association between abnormal nasal structure and OC airflow.

Methods

A systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis to identify studies on the effect of the nasal structure on the OC airflow and olfaction.

Results

A total of 11 studies were included. Nasal vestibule morphological variabilities directly impact the transport of molecules in odorant-laden air to the OC. A greater airflow vortex and a narrower vestibule region intensified the airflow vortex toward the olfactory region. Middle turbinectomy significantly increased the average flux to the OC. The location of the major airflow and airflow velocity maxima shifted towards the OC in patients with septal deviation. The airflow has been redirected into the upper part of the nasal airway in patients with inferior turbinate hypertrophy. For patients with unilateral cleft lip, unilateral nasal airflow on the cleft side has a lower rate and flow. The mean velocity in the posterior OC correlated well with olfaction compared to that in the anterior OC. The nasal polyps (NP) within the middle meatus increased the olfactory airflow but did not enhance the olfaction. NP in the olfactory region or anterior to the olfactory region significantly decreased the olfactory airflow and olfaction. Furthermore, obstruction of the OC did not change the nasal patency. When the OC shape presented with a stenotic slit or lumen structure among patients with conductive olfactory dysfunction without NP, the inspiratory velocity and flow rate within OC were significantly lower than in the healthy control group.

Conclusion

Various nasal structural factors affect patterns of OC airflow and olfaction. Identifying the related airflow-limiting structures may promote the comprehensive evaluation of conductive olfactory losses in patients with olfactory dysfunction.
Mitigating excessive heat in Arabica coffee using nanosilicon and seaweed extract to enhance element homeostasis and photosynthetic recovery
Authors: Chandon Ekkachak , Nualkhao Patchawee , Vibulkeaw Metee , Tisarum Rujira , Samphumphuang Thapanee , Sun Jianqiang , Cha-um Suriyan , Yooyongwech Suravoot
Published: November 2024

Background

Global warming-related temperature increases have a substantial effect on plant and human health. The Arabica coffee plant is susceptible to growing in many places across the world where temperatures are rising. This study examines how nanosilicon and seaweed extracts can improve Arabica coffee plant resilience during heat stress treatment (49.0 ± 0.3 °C) by maintaining mineral homeostasis and photosynthetic ability upon recovery.

Results

The principal component analysis arrangement of four treatments, nanosilicon (Si), seaweed extract (SWE), Si + SWE, and control (CT), showed each element ratio of magnesium, phosphorus, chloride, potassium, manganese, iron, copper, and zinc per silicon in ambient temperature and heat stress that found influenced upper shoot rather than basal shoot and root within 74.4% of largest feasible variance as first principal component. Magnesium and iron were clustered within the silicon group, with magnesium dominating and leading to a significant increase (p ≤ 0.05) in magnesium-to-silicon ratio in the upper shoot under heat conditions, especially in Si and Si + SWE treated plants (1.11 and 1.29 fold over SWE treated plant, respectively). The SWE and Si + SWE treated plants preserved chlorophyll content (15.01% and 28.67% over Si-treated plant, respectively) under heat stress, while the Si and Si + SWE treated plants restored photosynthetic efficiency (Fv/Fm) better than the SWE treated plant.

Conclusions

The concomitant of the Si + SWE treatment synergistically protected photosynthetic pigments and Fv/Fm by adjusting the magnesium-silicon homeostasis perspective in Arabica coffee to protect real-world agricultural practices and coffee cultivation under climate change scenarios.
Prevalence and severity of pediatric cases in Stockholm’s physician-staffed prehospital units: a retrospective cohort study
Authors: Bäckström Denise , Jörnvall Henrik , Strandqvist Erik , Ahlerup Robert , Wahlin Rebecka Rubenson
Published: November 2024

Background

Ambulance missions involving pediatric patients are common in emergency medical services (EMS) globally, with variations in prevalence based on geographic location.

This retrospective cohort study analyzes the prehospital physician staffed units (p-EMS) in Stockholm, assignment dispatches and the prehospital characteristics and interventions involved, from January 1, 2021, to December 31, 2022.

Methods

Utilizing data from LogEze, a quality assurance system, we reviewed all Rapid Response Vehicle (RRV) operations in the Stockholm Region, which totaled 4,682 pediatric assignments. The analysis included dispatch types and interventions assessing the frequency and nature of pediatric prehospital missions.

Results

Pediatric cases constituted 20.0 % of RRV dispatches, with the majority involving respiratory distress, seizures, and blunt trauma. Despite high dispatch rates, advanced medical interventions were seldom required, indicating most pediatric cases were not severe. Stand-downs occurred in 30.1 % of cases, reflecting the cautious approach in pediatric dispatches. Furthermore, the study observed a significant reliance on p-EMS for complex pediatric cases, underscoring the value of specialized training and resources in managing such emergencies.

Conclusion

The study highlights the crucial role of p-EMS in enhancing pediatric emergency care in Stockholm. Despite frequent pediatric dispatches, the low incidence of severe cases underscores the need for precise triage and resource allocation. This analysis supports the need for continuous training and resource optimization in p-EMS to ensure high-quality care for pediatric patients across varied emergency scenarios.
Screen time and obesity prevalence in adolescents: an isotemporal substitution analysis
Authors: Byun Dohyun , Kim Yujin , Jang Hajin , Oh Hannah
Published: November 2024

Background

We examined the associations between screen time and adolescent obesity and the associations of reallocating screen time to other activities using isotemporal substitution models. Understanding the association between screen time and obesity may provide additional insights into effective obesity prevention strategies in adolescents.

Methods

We conducted a cross-sectional analysis of 5,180 adolescents (4th and 7th grade students) from the Korean Children and Youth Panel Survey 2018. Participants reported their height, weight, and average time spent watching television, using computer, using smartphone, and other after-school activities. Obesity was defined as BMI-for-age and -sex ≥ 95th percentile based on the 2017 Korean National Growth Charts. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between screen time and obesity prevalence, adjusting for potential confounders.

Results

Prolonged smartphone use (≥ 180 vs. <60 m/d: OR [95% CI] = 2.75 [2.06, 3.68]) was associated with a higher obesity prevalence. Television watching (≥ 120 vs. <60 min/d) was positively associated with obesity prevalence among 4th grade students (2.09 [1.51, 2.89]) but the association was not observed among 7th grade students (0.97 [0.63, 1.49]). One-hour increments of any non-screen time activities, with a simultaneous 1-hour decrease in combined screen time, were associated with a lower obesity prevalence (physical activity: 0.75 [0.65, 0.85]; sleeping: 0.69 [0.62, 0.78]; hanging out with friends: 0.80 [0.71, 0.89]; reading: 0.82 [0.69, 0.97]; studying: 0.84 [0.78, 0.90]; chatting with parents: 0.89 [0.88, 0.98]).

Conclusions

Our data suggest that public health strategies that reduce screen time and increase time for non-screen time activities, such as physical activity, may be effective in lowering adolescent obesity prevalence.
Trends in the health status of Ukrainian refugees in Norway according to month of arrival during 2022
Authors: Labberton Angela S. , Ozeryansky Larisa , Helland Ylva , Skogheim Thea Steen , Hansen Tonya Moen
Published: November 2024

Background

More than 35 000 refugees from Ukraine applied for temporary collective protection in Norway during 2022. Previous studies have shown that the refugees have poor health in several domains, and crude reports have suggested that those fleeing Ukraine at later stages have even poorer health. However, more systematic knowledge is lacking. This study aimed to analyse trends in self-reported health in a sample of adult refugees from Ukraine, by month of arrival to Norway during 2022.

Methods

Data were collected via an online, digital questionnaire, in a cross-sectional study design between 28.10.22–31.01.23. Recruitment was via multiple physical and social media contact points, including asylum reception centres, municipalities, non-profit organisations, and Facebook groups for refugees in Norway. The survey included the following self-reported health outcomes: overall health, oral health, presence of long-term illnesses or disabilities, and a short version of the Hopkins Symptom Checklist (HSCL-5).

Results

Among the 727 respondents, 82% were female, 65% were aged 30–49 years, 69% had higher education and 53% were responsible for children in Norway. There were 383 respondents who arrived between February-April (T1), 200 between May-August (T2) and 144 between September-December (T3). Compared to T1, respondents who arrived in the two later time periods were more often male, had younger age distributions, and were less likely to have completed higher education. The proportions of respondents reporting poor/very poor overall health, presence of long-term illnesses and long-term disabilities were highest in T3. Oral health and HSCL-5 showed the opposite trend, with lower proportions reporting poorer health among respondents in both later periods. Respondents in T3 were still more likely to report poor/very poor health and long-term illnesses after adjusting for sex, age group and education (adjusted odds ratio, aOR: 2.71 [95%CI 1.51–4.89]) and 1.74 [1.14–2.65], respectively).

Conclusions

Respondents who arrived later in 2022 generally reported poorer long-term health, but less psychological distress than those who arrived earlier in the year. These findings may help inform the planning of health services for refugees from Ukraine, especially in areas receiving large numbers of refugees.
Diagnostic imaging, therapeutic interventions and suggestions for thoracic duct congestion in postoperative hepatic lymphorrhea: a retrospective analysis of 20 cases
Authors: Liu Xin , Liu Zhong , Shen Wenbin , Xia Song , Sun Yuguang , Chang Kun , Xin Jianfeng , An Ran , Liang Chen , Zhou Chenxiao
Published: November 2024

Objective

To retrospectively evaluate thoracic duct (TD) congestion in hepatic lymphorrhea (HL) and propose treatment suggestions.

Methods

Retrospectively analyze cases of postoperative HL admitted from August 2007 to November 2023. Twenty cases were enrolled and followed up. The medical history, ascites characteristics, lymphoscintigraphy, direct lymphangiography, and other clinical data were reviewed.

Results

Twenty patients with ascites after cholecystectomy or radical gastrectomy were included. There were 15 patients with cirrhosis and 5 patients with hepatitis. Ascites were light yellow even if the patients had a non-low-fat diet. Triglyceride level mean of ascites was 0.61 ± 0.20 mmol/L. There were 94.1% (16/17) of patients whose ascitic cholesterol ≥ 45 mg/dL or SAAG < 11.0 g/L. Mild abdominal radioactivity was shown in 89.5% (17/19) patients. Left subclavian-jugular venous angle radioactivity was observed in 84.2% (16/19) patients. In 10% (2/20) cases, lipiodol presenting as oil droplets traveled upwards quickly and flowed into the vein rapidly. In 90% (18/20) cases, tortuous and dilated thoracic duct, stagnant lipiodol, and poor flow into the vein were demonstrated. One patient refused treatment and died soon. By thoracic duct outlet reconstruction combined with other treatments, 16 patients were cured and the ascites of another 3 patients were controlled.

Conclusions

TD congestion and elevated lymphatic pressure could be caused by increased lymph flow and TD outlet stenosis. TD decompression by outlet reconstruction may be an alternative approach to HL.
Single stage direct -to- implant breast reconstruction following mastectomy (The use of Ultrapro® Mesh)
Authors: Ibraheem Maher H. , Essawy Omnia Mohammed Mohammed , Moaz Inas , Osman Zakaria Saeed Mohammed , Omara Yomna Sherif , farouk Amr , Amin Ahmed , Elzohery Yasmine Hany Abdel Moamen , Awad Mohammed Gamal Ahmed
Published: November 2024

Background

Immediate breast reconstruction (IBR) with direct to implant (DTI) is the preferred method of reconstruction by many surgeons and patients, however, acellular dermal matrix (ADM) and other synthetic meshes are expensive especially in low- and middle-income countries.

Aim of the work

To evaluate the technique, indications, aesthetic outcomes, and short and long-term complications of DTI breast reconstruction performed with Ultrapro®, a low-cost alternative mesh to ADM and other synthetic meshes.

Methods

Our study is a prospective cohort study that was conducted on 133 patients who experienced IBR following nipple-sparing mastectomy (NSM) or skin sparing mastectomy (SSM) using silicone implants and Ultrapro® mesh between December 2020 and December 2023. Techniques used were either sub-pectoral or pre-pectoral, evaluating aesthetic outcome, complication rate and patient satisfaction using breast Q questionnaire.

Results

We included 133 patients (141 breasts) with a median age of 39 years. Mean duration of follow up: 20.364 ± 5.39 months. The sub-pectoral and the pre pectoral techniques were used for 80 breasts and 61 breasts respectively. We used the Ultrapro® mesh in all our patients. Smooth round silicone implants were used. The overall Major complications rate was 16.3%. 8 implants (5.7%) were lost within 6 months post-operatively while 2 implants were removed in the late post-operative period (after 6 months) one due to rupture and the other due to local recurrence.

Capsular contracture Baker 3 and 4 was observed in 36 breasts (25%), 31 of them had post mastectomy radiotherapy treatment. 11 (7.8%) were managed by capsulotomies and re-insertion of the same implant.

Radiotherapy was a significant risk factors for major complications and capsular contracture with p value of (0.01) and (0.0001) respectively.

Conclusion

DTI in properly selected patients offers excellent outcomes and patient satisfaction. The complication rate is low and improves with the experience of the surgeon. The Ultrapro® mesh is a safe, low-cost alternative to ADM or other synthetic meshes especially in low socioeconomic countries. Radiotherapy is a significant risk factor for major complications and capsular contractures.