bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of anesthesia on the outcome of high-grade glioma patients undergoing supratentorial resection: study protocol for a pragmatic randomized controlled trial
Authors: Dong Jia , Wang Dexiang , Sun Huizhong , Zeng Min , Liu Xiaoyuan , Yan Xiang , Li Ruowen , Li Shu , Peng Yuming
Published: September 2022

Background

High-grade glioma (HGG) is the most malignant brain tumor with poor outcomes. Whether anesthetic methods have an impact on the outcome of these patients is still unknown. Retrospective study has found no difference between intravenous and inhalation anesthesia on the overall survival (OS) of the HGG patients, however, intravenous anesthesia with propofol might be beneficial in a subgroup of patients with a Karnofsky Performance Status (KPS) Scale less than 80. Further prospective studies are needed to evaluate the results.

Methods

This is a single-centered, randomized controlled, parallel-group trial. Three hundred forty-four patients with primary HGG for tumor resection will be randomly assigned to receive either intravenous anesthesia with propofol or inhalation anesthesia with sevoflurane. The primary outcome is the OS of the patients within 18 months. Secondary outcomes include progression-free survival (PFS), the numerical rating scale (NRS) of pain intensity and sleep quality, the postoperative encephaloedema volume, complications, and the length of hospital stay of the patients.

Discussion

This is a randomized controlled trial to compare the effect of intravenous and inhalation anesthesia maintenance on the outcome of supratentorial HGG patients. The results will contribute to optimizing the anesthesia methods in these patients.

Trial registration

ClinicalTrials.govNCT02756312. Registered on 29 April 2016 and last updated on 9 Sep 2020
ASEPTIC: primary antibiotic prophylaxis using co-trimoxazole to prevent SpontanEous bacterial PeritoniTIs in Cirrhosis—study protocol for an interventional randomised controlled trial
Authors: Crocombe Dominic , Ahmed Norin , Balakrishnan Indran , Bordea Ekaterina , Chau Marisa , China Louise , Corless Lynsey , Danquah Victoria , Dehbi Hakim-Moulay , Dillon John F. , Forrest Ewan H. , Freemantle Nick , Gear David Peter , Hollywood Coral , Hunter Rachael , Jeyapalan Tasheeka , Kallis Yiannis , McPherson Stuart , Munteanu Iulia , Portal Jim , Richardson Paul , Ryder Stephen D. , Virk Amandeep , Wright Gavin , O’Brien Alastair
Published: September 2022

Background

Bacterial infection is a major cause of mortality in patients with cirrhosis. Spontaneous bacterial peritonitis (SBP) is a serious and common infection in patients with cirrhosis and ascites. Secondary prophylactic antibiotic therapy has been shown to improve outcomes after an episode of SBP but primary prophylaxis to prevent the first episode of SBP remains contentious. The aim of this trial is to assess whether primary antibiotic prophylaxis with co-trimoxazole improves overall survival compared to placebo in adults with cirrhosis and ascites.

Methods

The ASEPTIC trial is a multicentre, placebo-controlled, double-blinded, randomised controlled trial (RCT) in England, Scotland, and Wales. Patients aged 18 years and older with cirrhosis and ascites requiring diuretic treatment or paracentesis, and no current or previous episodes of SBP, are eligible, subject to exclusion criteria. The trial aims to recruit 432 patients from at least 30 sites. Patients will be randomised in a 1:1 ratio to receive either oral co-trimoxazole 960 mg or an identical placebo once daily for 18 months, with 6 monthly follow-up visits thereafter (with a maximum possible follow-up period of 48 months, and a minimum of 18 months). The primary outcome is overall survival. Secondary outcomes include the time to the first incidence of SBP, hospital admission rates, incidence of other infections (including Clostridium difficile) and antimicrobial resistance, patients’ health-related quality of life, health and social care resource use, incidence of cirrhosis-related decompensation events, liver transplantation, and treatment-related serious adverse events.

Discussion

This trial will investigate the efficacy, safety, and cost-effectiveness of co-trimoxazole for patients with liver cirrhosis and ascites to determine whether this strategy improves clinical outcomes. Given there are no treatments that improve survival in decompensated cirrhosis outside of liver transplant, if the trial has a positive outcome, we anticipate widespread adoption of primary antibiotic prophylaxis.

Trial registration

ClinicalTrials.gov NCT043955365. Registered on 18 April 2020. Research ethical approval was granted by the Research Ethics Committee (South Central – Oxford B; REC 19/SC/0311) and the Medicines and Healthcare products Regulatory Agency (MHRA).
Influence of landscape heterogeneity on entomological and parasitological indices of malaria in Kisumu, Western Kenya
Authors: Otambo Wilfred Ouma , Onyango Patrick O. , Wang Chloe , Olumeh Julius , Ondeto Benyl M. , Lee Ming-Chieh , Atieli Harrysone , Githeko Andrew K. , Kazura James , Zhong Daibin , Zhou Guofa , Githure John , Ouma Collins , Yan Guiyun
Published: September 2022

Background

Identification and characterization of larval habitats, documentation ofAnophelesspp. composition and abundance, andPlasmodiumspp. infection burden are critical components of integrated vector management. The present study aimed to investigate the effect of landscape heterogeneity on entomological and parasitological indices of malaria in western Kenya.

Methods

A cross-sectional entomological and parasitological survey was conducted along an altitudinal transect in three eco-epidemiological zones: lakeshore along the lakeside, hillside, and highland plateau during the wet and dry seasons in 2020 in Kisumu County, Kenya. Larval habitats forAnophelesmosquitoes were identified and characterized. Adult mosquitoes were sampled using pyrethrum spray catches (PSC). Finger prick blood samples were taken from residents and examined for malaria parasites by real-time PCR (RT-PCR).

Results

Increased risk ofPlasmodium falciparuminfection was associated with residency in the lakeshore zone, school-age children, rainy season, and no ITNs (χ2 = 41.201,df = 9,P < 0.0001). Similarly, lakeshore zone and the rainy season significantly increasedAnophelesspp. abundance. However, house structures such as wall type and whether the eave spaces were closed or open, as well as the use of ITNs, did not affectAnophelesspp. densities in the homes (χ2 = 38.695,df = 7,P < 0.0001).Anopheles funestus(41.8%) andAn. arabiensis(29.1%) were the most abundant vectors in all zones. Sporozoite prevalence was 5.6% and 3.2% in the two species respectively. The lakeshore zone had the highest sporozoite prevalence (4.4%, 7/160) and inoculation rates (135.2 infective bites/person/year). High larval densities were significantly associated with lakeshore zone and hillside zones, animal hoof prints and tire truck larval habitats, wetland and pasture land, and the wet season. The larval habitat types differed significantly across the landscape zones and seasonality (χ2 = 1453.044,df = 298,P < 0.0001).

Conclusion

The empirical evidence on the impact of landscape heterogeneity and seasonality on vector densities, parasite transmission, andPlasmodiuminfections in humans emphasizes the importance of tailoring specific adaptive environmental management interventions to specific landscape attributes to have a significant impact on transmission reduction.

Graphical abstract
Species-specific climate Suitable Conditions Index and dengue transmission in Guangdong, China
Authors: Lu Xinting , Bambrick Hilary , Frentiu Francesca D. , Huang Xiaodong , Davis Callan , Li Zhongjie , Yang Weizhong , Devine Gregor J. , Hu Wenbiao
Published: September 2022

Background

Optimal climatic conditions for dengue vector mosquito species may play a significant role in dengue transmission. We previously developed a species-specific Suitable Conditions Index (SCI) for Aedes aegypti and Aedes albopictus, respectively. These SCIs rank geographic locations based on their climatic suitability for each of these two dengue vector species and theoretically define parameters for transmission probability. The aim of the study presented here was to use these SCIs together with socio-environmental factors to predict dengue outbreaks in the real world.

Methods

A negative binomial regression model was used to assess the relationship between vector species-specific SCI and autochthonous dengue cases after accounting for potential confounders in Guangdong, China. The potential interactive effect between the SCI for Ae. albopictus and the SCI for Ae. aegypti on dengue transmission was assessed.

Results

The SCI for Ae. aegypti was found to be positively associated with autochthonous dengue transmission (incidence rate ratio: 1.06, 95% confidence interval: 1.03, 1.09). A significant interaction effect between the SCI of Ae. albopictus and the SCI of Ae. aegypti was found, with the SCI of Ae. albopictus significantly reducing the effect of the SCI of Ae. aegypti on autochthonous dengue cases. The difference in SCIs had a positive effect on autochthonous dengue cases.

Conclusions

Our results suggest that dengue fever is more transmittable in regions with warmer weather conditions (high SCI for Ae. aegypti). The SCI of Ae. aegypti would be a useful index to predict dengue transmission in Guangdong, China, even in dengue epidemic regions with Ae. albopictus present. The results also support the benefit of the SCI for evaluating dengue outbreak risk in terms of vector sympatry and interactions in the absence of entomology data in future research.

Graphical Abstract
Biochemical and clinical markers of endothelial dysfunction do not outweigh traditional risk factors for the presence of diabetic retinopathy in patients with type 1 diabetes
Authors: Matheus Alessandra Saldanha de Mattos , da Matta Maria de Fátima Bevilacqua , Clemente Eliete Leão Silva , Rodrigues Maria de Lourdes Guimarães , Valença Débora Cristina Torres , Drummond Karla Rezende Guerra , Gomes Marília Brito
Published: September 2022

Background

This study aimed to evaluate whether soluble vascular cytoadhesive molecule-1 (sVCAM-1), intracellular cytoadhesive molecule-1 (sICAM-1), and endothelial function as assessed by EndoPat outweighed traditional risk factors for the presence of diabetic retinopathy (DR) in patients with type 1 diabetes (T1D).

Methods

Patients aged ≥ 12 years completed a clinical–epidemiological questionnaire. Fasting venous blood samples were obtained (lipid profile, glycemic control, and C-reactive protein levels). Vascular reactivity was assessed via peripheral arterial tonometry performed by supplying the reactive hyperemia index (RHI) through the EndoPAT device. sVCAM-1 and sICAM-1 levels were measured using multiplex assays.

Results

Data were obtained from 187 patients (51.3% female), aged 32 ± 13 years with a disease duration of 14 (6–15) years and mean hemoglobin A1c (HbA1c) of 9.1% ± 2.1%. After adjustments were made, age, HbA1c, arterial blood pressure, and use of drugs that could interfere with endothelial function were found to be associated with DR. No association was noted with sVCAM-1 and sICAM-1 levels and RHI.

Conclusions

In our sample, sVCAM-1, sICAM and EndoPAT did not outweigh the traditional DR risk factors, such as age, high HbA1c, arterial blood pressure, and use of drugs that could interfere with endothelial function and are significantly associated with DR. Further prospective studies should evaluate if markers of endothelial dysfunction could predict diabetes-related micro and macrovascular complications in T1D.
Conditional reduction of the loss value versus reinforcement learning for biassing a de-novo drug design generator
Authors: Chadi Mohamed-Amine , Mousannif Hajar , Aamouche Ahmed
Published: September 2022

Deep learning has demonstrated promising results in de novo drug design. Often, the general pipeline consists of training a generative model (G) to learn the building rules of valid molecules, then using a biassing technique such as reinforcement learning (RL) to focus G on the desired chemical space. However, this sequential training of the same model for different tasks is known to be prone to a catastrophic forgetting (CF) phenomenon. This work presents a novel yet simple approach to bias G with significantly less CF than RL. The proposed method relies on backpropagating a reduced value of the cross-entropy loss used to train G according to the proportion of desired molecules that the biased-G can generate. We named our approach CRLV, short for conditional reduction of the loss value. We compared the two biased models (RL-biased-G and CRLV-biased-G) for four different objectives related to de novo drug design.

CRLV-biased-G outperformed RL-biased-G in all four objectives and manifested appreciably less CF. Besides, an intersection analysis between molecules generated by the RL-biased-G and the CRLV-biased-G revealed that they can be used jointly without losing diversity given the low percentage of overlap between the two to further increase the desirability. Finally, we show that the difficulty of an objective is proportional to (i) its frequency in the dataset used to train G and (ii) the associated structural variance (SV), which is a new parameter we introduced in this paper, calling for novel exploration techniques for such difficult objectives.
Weak solutions to the time-fractional g-Bénard equations
Authors: Aayadi Khadija , Akhlil Khalid , Ben Aadi Sultana , Mahdioui Hicham
Published: September 2022

The Bénard problem consists in a system that couples the well-known Navier–Stokes equations and an advection-diffusion equation. In thin varying domains this leads to the g-Bénard problem, which turns out to be the classical Bénard problem when g is constant. The main goal of this paper is to, first of all, introduce the g-Bénard problem with time-fractional derivative of order $\alpha \in (0,1)$
α
∈
(
0
,
1
)
. This formulation is new even in the classical Bénard problem, that is with constant g. The second goal of this paper is to prove the existence and uniqueness of a weak solution by means of the Faedo–Galerkin approximation method. Some recent works on time-fractional Navier–Stokes equations have opened new perspectives in studying variational aspects in problems involving time-fractional derivatives.
Necrotizing pancreatitis complicated by retroperitoneal emphysema: two case reports
Authors: Chida Kohei , Ishido Keinosuke , Sakamoto Yoshiyuki , Kimura Norihisa , Morohashi Hajime , Miura Takuya , Wakiya Taiichi , Yokoyama Hiroshi , Nagase Hayato , Ichinohe Daichi , Suto Akiko , Kuwata Daisuke , Ichisawa Aika , Nakamura Akie , Kasai Daiki , Hakamada Kenichi
Published: September 2022

Background

Emphysematous pancreatitis is acute pancreatitis associated with emphysema based on imaging studies and has been considered a subtype of necrotizing pancreatitis. Although some recent studies have reported the successful use of conservative treatment, it is still considered a serious condition. Computed tomography (CT) scan is useful in identifying emphysema associated with acute pancreatitis; however, whether the presence of emphysema correlates with the severity of pancreatitis remains controversial. In this study, we managed two cases of severe acute pancreatitis complicated with retroperitoneal emphysema successfully by treatment with lavage and drainage.

Case presentation

Case 1: A 76-year-old man was referred to our hospital after being diagnosed with acute pancreatitis. At post-admission, his abdominal symptoms worsened, and a repeat CT scan revealed increased retroperitoneal gas. Due to the high risk for gastrointestinal tract perforation, emergent laparotomy was performed. Fat necrosis was observed on the anterior surface of the pancreas, and a diagnosis of acute necrotizing pancreatitis with retroperitoneal emphysema was made. Thus, retroperitoneal drainage was performed. Case 2: A 50-year-old woman developed anaphylactic shock during the induction of general anesthesia for lumbar spine surgery, and peritoneal irritation symptoms and hypotension occurred on the same day. Contrast-enhanced CT scan showed necrotic changes in the pancreatic body and emphysema surrounding the pancreas. Therefore, she was diagnosed with acute necrotizing pancreatitis with retroperitoneal emphysema, and retroperitoneal cavity lavage and drainage were performed. In the second case, the intraperitoneal abscess occurred postoperatively, requiring time for drainage treatment. Both patients showed no significant postoperative course problems and were discharged on postoperative days 18 and 108, respectively.

Conclusion

Acute pancreatitis with emphysema from the acute phase highly indicates severe necrotizing pancreatitis. Surgical drainage should be chosen without hesitation in necrotizing pancreatitis with emphysema from early onset.
Pericardiotomy under clamshell approach for large posterior mediastinal sarcoma: a case report
Authors: Shimizu Nahoko , Tanaka Yugo , Kuroda Sanae , Inoue Takeshi , Maniwa Yoshimasa
Published: September 2022

Background

Large mediastinal tumors are sometimes difficult to completely resect because they are surrounded by vital organs. We present the case of mediastinal liposarcoma successfully resected by the clamshell approach with a posterior pericardial wall incision.

Case presentation

An 81-year-old man visited the hospital because of a prolonged cough. Imaging studies revealed a large tumor of the left posterior mediastinum. The tumor surrounded the left inferior pulmonary vein and was suspected of invading the left lower lobe and esophagus. Complete resection of a large mediastinal tumor invading the left inferior pulmonary vein and esophagus was achieved by adding a posterior pericardial wall incision to the clamshell approach under cardiopulmonary bypass. Histopathological diagnosis was well-differentiated liposarcoma. Postoperative course was good, and the patient is alive without any sign of recurrence for 53 months.

Conclusions

This approach could represent a novel method to safely and effectively remove large mediastinal tumors invading the lung and esophagus.
Enhancing noise sources in stationary-phase zones for accurate phase-velocity estimation of high-frequency surface waves
Authors: Liu Ya , Xia Jianghai , Xi Chaoqiang , Zhang Hao , Guan Bo , Dai Tianyu , Ning Ling
Published: September 2022

Passive surface-wave methods are appealing tools for their ability to noninvasively obtain shear-wave velocity with high accuracy and low costs. A linear array of stations is widely adopted in urban areas for its convenient deployments and efficient utilization of ambient noise energy from stationary-phase zones (SPZs), which contributes the most to surface-wave retrieval. However, noise sources in nonstationary-phase zones may threaten the reliability of velocity estimation when they possess strong energy. To obtain reliable phase-velocity estimation of high-frequency surface waves (>1 Hz), we enhance the contribution of noise sources in SPZs by using the multichannel-coherency-weighted stack (MCWS) method for the stacking of noise crosscorrelation functions and dispersion spectra. We model a nonuniform source distribution with strong offline sources. The seismic interferometry (SI) and passive multichannel analysis of surface waves (PMASW) methods overestimate velocities at lower frequencies (<5 Hz), whereas phase velocities of short wavelengths are relatively accurate. The true velocities of short wavelengths are then set as the velocity scanning range for MCWS, and the waves whose apparent velocities lie within the scanning range would be emphasized by MCWS. Noise sources in SPZs are enhanced because the apparent velocities of waves from other noise sources are higher and not in the scanning range. After using MCWS, the phase-velocity estimations of SI and PMASW are consistent with the theoretical dispersion curve. A field data example at a crossroads demonstrates that uneven source distributions might cause serious artifacts and the feasibility of our method is again confirmed. In addition, the enhancement of noise sources in SPZs is verified through noise source distribution imaging by a matched field processing technique.
Transformations of borehole magnetic data in the frequency domain and estimation of the total magnetization direction: A case study from the Mengku iron-ore deposit, Northwest China
Authors: Li Guoli , Liu Shuang , Shi Ke , Zhang Henglei , Zuo Boxin , Zhu Dan , Hu Xiangyun
Published: September 2022

Borehole magnetic prospecting measures the three components of the magnetic field and is sensitive to the vertical depth of the magnetic source, which plays an important role in deep mineral exploration. Magnetic field transformations in the frequency domain constitute common and important processing for ground and airborne data but are rarely applied to borehole magnetic data. Here, we deduce component transformation and magnetization-direction transformation formulas for borehole data. It is found that the transformation factors differ from those of ground and airborne data. The new formulas depend on the position of the drillholes. The transformed data are then used to estimate the total magnetization direction by computing the correlation coefficient between the transformed components and the amplitude anomaly. The advantages of this method are that the borehole data yield a local and accurate magnetization direction and the total amplitude anomaly is computed directly from the individual anomalies in the observed components. The frequency-domain transformation is tested on the synthetic data, and the estimated directions are consistent with the true values. The processing procedure is applied to borehole data collected at the Mengku iron-ore deposit in Northwest China, where magnetic surveys from 55 boreholes have been acquired. The estimated magnetization directions yield good approximations of the results from the ground magnetic data and the physical property measurements of rock samples.
Associations of Symptom Clusters and Health Outcomes in Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study
Authors: Shin Hyewon , Dudley William N. , Bhakta Nickhill , Horan Madeline R. , Wang Zhaoming , Bartlett T. Robin , Srivastava Deokumar , Yasui Yutaka , Baker Justin N. , Robison Leslie L. , Ness Kirsten K. , Krull Kevin R. , Hudson Melissa M. , Huang I-Chan
Published: September 2022

PURPOSE

To identify symptom clusters among adult survivors of childhood cancers and test associations with health-related quality of life (HRQOL) and physical and neurocognitive performance.

METHODS

This cross-sectional study included 3,085 survivors (mean age at evaluation 31.9 ± 8.3 years; mean years from diagnosis 28.1 ± 9.1) participating in the St Jude Lifetime Cohort Study. Survivors self-reported the presence of 37 symptoms capturing 10 domains (cardiac, pulmonary, sensory, motor/movement, nausea, pain, fatigue, memory, anxiety, and depression). The Short Form-36's Physical/Mental Component Summaries assessed HRQOL; the Physical Performance Test evaluated physical performance; and neurocognitive batteries tested attention, processing/psychomotor speed, memory, and executive function. Latent class analysis identified subgroups of survivors experiencing different patterns of symptom burden (ie, symptom clusters). Multivariable regression models identified risk of cluster membership and tested associations with health outcomes.

RESULTS

Four symptom clusters were identified including cluster 1 (prevalence 52.4%; low physical, somatization, and psychologic domains), cluster 2 (16.1%; low physical, moderate somatic, and high psychologic domains), cluster 3 (17.6%; high physical, moderate somatic, and low psychologic domains), and cluster 4 (13.9%; high in all three domains). Compared with cluster 1, survivors in cluster 4 were more likely to have less than high school education (odds ratio [OR], 7.71; 95% CI, 4.46 to 13.31), no insurance (OR, 1.49; 95% CI, 1.04 to 2.13), and exposure to corticosteroids (OR, 1.76; 95% CI, 1.02 to 3.03); survivors in cluster 3 were more likely to have received platinum agents (OR, 2.22; 95% CI, 1.34 to 3.68) and brain radiation ≥ 30 Gy (OR, 3.99; 95% CI, 2.33 to 6.86). Survivors in cluster 4 reported the poorest Physical Component Summary/Mental Component Summary scores (31.0/26.7) and physical and neurocognitive performance versus survivors in the other clusters ( P < .001).

CONCLUSION

Nearly 50% of survivors had moderate to high multisymptom burden, which was associated with sociodemographic, treatment factors, HRQOL, and functional outcomes.
Combination Dabrafenib and Trametinib Versus Combination Nivolumab and Ipilimumab for Patients With Advanced BRAF-Mutant Melanoma: The DREAMseq Trial—ECOG-ACRIN EA6134
Authors: Atkins Michael B. , Lee Sandra J. , Chmielowski Bartosz , Tarhini Ahmad A. , Cohen Gary I. , Truong Thach-Giao , Moon Helen H. , Davar Diwakar , O'Rourke Mark , Stephenson Joseph J. , Curti Brendan D. , Urba Walter J. , Brell Joanna M. , Funchain Pauline , Kendra Kari L. , Ikeguchi Alexandra P. , Jaslowski Anthony , Bane Charles L. , Taylor Mark A. , Bajaj Madhuri , Conry Robert M. , Ellis Robert J. , Logan Theodore F. , Laudi Noel , Sosman Jeffrey A. , Crockett David G. , Pecora Andrew L. , Okazaki Ian J. , Reganti Sowjanya , Chandra Sunandana , Guild Samantha , Chen Helen X. , Streicher Howard Z. , Wolchok Jedd D. , Ribas Antoni , Kirkwood John M.
Published: September 2022

PURPOSE

Combination programmed cell death protein 1/cytotoxic T-cell lymphocyte-4–blockade and dual BRAF/MEK inhibition have each shown significant clinical benefit in patients with BRAFV600-mutant metastatic melanoma, leading to broad regulatory approval. Little prospective data exist to guide the choice of either initial therapy or treatment sequence in this population. This study was conducted to determine which initial treatment or treatment sequence produced the best efficacy.

PATIENTS AND METHODS

In a phase III trial, patients with treatment-naive BRAFV600-mutant metastatic melanoma were randomly assigned to receive either combination nivolumab/ipilimumab (arm A) or dabrafenib/trametinib (arm B) in step 1, and at disease progression were enrolled in step 2 to receive the alternate therapy, dabrafenib/trametinib (arm C) or nivolumab/ipilimumab (arm D). The primary end point was 2-year overall survival (OS). Secondary end points were 3-year OS, objective response rate, response duration, progression-free survival, crossover feasibility, and safety.

RESULTS

A total of 265 patients were enrolled, with 73 going onto step 2 (27 in arm C and 46 in arm D). The study was stopped early by the independent Data Safety Monitoring Committee because of a clinically significant end point being achieved. The 2-year OS for those starting on arm A was 71.8% (95% CI, 62.5 to 79.1) and arm B 51.5% (95% CI, 41.7 to 60.4; log-rank P = .010). Step 1 progression-free survival favored arm A ( P = .054). Objective response rates were arm A: 46.0%; arm B: 43.0%; arm C: 47.8%; and arm D: 29.6%. Median duration of response was not reached for arm A and 12.7 months for arm B ( P < .001). Crossover occurred in 52% of patients with documented disease progression. Grade ≥ 3 toxicities occurred with similar frequency between arms, and regimen toxicity profiles were as anticipated.

CONCLUSION

Combination nivolumab/ipilimumab followed by BRAF and MEK inhibitor therapy, if necessary, should be the preferred treatment sequence for a large majority of patients.
Assessing Patient-Reported Financial Hardship in Patients With Cancer in Routine Clinical Care
Authors: Voleti Sandeep S. , Warsame Rahma , Mead-Harvey Carolyn , Ailawadhi Sikander , Jain Atul , Fonseca Rafael , Griffin Joan M. , Khera Nandita
Published: September 2022

PURPOSE:

Financial hardship (FH) in cancer care is a growing challenge for patients, their caregivers, and health care providers with impact on morbidity and mortality. In this study, we report on a standardized approach to describe the prevalence and predictors for FH as part of routine clinical workflow. We also report on the association of FH with survival in our cancer patient population.

METHODS:

This study includes patients who completed a FH screen at least once between 2018 and 2020. Demographics, disease state, and mortality data were extracted from the medical records. Multivariable logistic regression models were used to examine association of sociodemographic and disease variables with FH. By using propensity score weighting to account for differences in demographic and clinical factors between patients with and without FH, we then fit Cox proportional hazards models to examine the relationship between FH and survival.

RESULTS:

The study cohort included 31,154 patients. FH was reported by 14% (n = 4,250) of the patients. A significantly higher likelihood of having FH ( P < .001 for all) was reported by racial/ethnic minority patients; those who were unemployed/disabled, single, or divorced; patients from disadvantaged neighborhoods; and those who were self-pay or had government insurance. Older age, being retired, and living farther from the cancer center were associated with significantly less likelihood of endorsing FH. Patients who endorsed FH had a lower survival (hazard ratio for mortality 1.46).

CONCLUSION:

Our study identified key groups more likely to report FH in a relatively affluent population at a large cancer center and showed an adverse association between FH and survival. Further research is needed to develop clinical care pathways for patients at high risk for worse financial and clinical outcomes.
Robustness of helical edge states under edge reconstruction
Authors: John Niels , Del Maestro Adrian , Rosenow Bernd
Published: September 2022

The helical edge states of time-reversal invariant two-dimensional topological insulators are protected against backscattering in idealized models. In more realistic scenarios with a shallow confining potential at the sample boundary, additional strongly interacting edge states may arise, that could interfere with the topological protection of edge conduction. We find that interaction effects within the reconstructed edges are well described by the Luttinger liquid model. While interactions between this Luttinger liquid and the helical edge states can in principle give rise to dynamical spin polarization and the breaking of time-reversal symmetry, we demonstrate that random spin-orbit coupling strongly suppresses such dynamical spin polarization, resulting in the persistence of near quantized edge conduction.
Viola Liuzzo / Heather Heyer: Mediating the Antiracist White Female Martyr
Authors: Bodroghkozy Aniko
Published: September 2022

Both the Martin Luther King Jr.–led Selma voting rights campaign of 1965 and the 2017 “Summer of Hate” in Charlottesville produced a white female martyr. Viola Liuzzo was murdered by KKK members at the end of the Selma-to-Montgomery march that culminated the Selma campaign. Heather Heyer was murdered in a terrorist car attack by a neo-Nazi at the end of the suspended “Unite the Right” rally. Both women were hailed in the press as heroes. Both were misogynistically attacked in white supremacist media—in ways that were almost identical. How can we understand the media representation of white women as racial justice activists and the ways white supremacists understand them in their media platforms? What about the media treatment of African American women activists in Selma and Charlottesville? What's changed, and what hasn't, in fifty years? What can this comparative case study suggest about how the media tends to portray white women and women of color in other social change movements?
A Problem of Fit: Athina Rachel Tsangari and Greek “Weird Wave” Cinema
Authors: Palis Eleni
Published: September 2022

This article uses Athina Rachel Tsangari's films to interrogate and reframe the Greek “Weird Wave” film movement (largely shaped by her frequent collaborator, Yorgos Lanthimos), revealing how the wave has obscured Tsangari's feminist authorship. In general, the Weird Wave had described a cohort of films beginning around 2009 in which familial dysfunction, violence, ineffectual communication, and corporeal “weirdness” allegorize Greek political, economic, and social crises. In a kind of temporal jumble, Tsangari's first film Fit (Greece, 1994) provides instructions for reading her later, supposedly Weird Wave films. The conceptual capaciousness of the term fit, as both a film title and a concept, refracts across Tsangari's films and career at large. This article exploits wordplay around fit as a technical standard of sound and image cohesion (how image and sound fit together), as a thematic narrative preoccupation regarding space, place, and belonging (fitting in), and as a categorizing metric (fit for inclusion). Reading diegetic and extradiegetic fit in Tsangari's film and television works, including Attenberg (Greece, 2010), The Capsule (Greece, 2012), the short 24 Frames per Century (Italy, 2013), Chevalier (Greece, 2015), and Trigonometry (BBC, 2020), reveals Tsangari's authorial signature and how Tsangari's films ambivalently benefit from “wave” marketing even as their reception bears out the costs of that uncomfortable fit. Paradoxically, Tsangari's auteur signature emerges in her struggle against category, especially Weird Wave and “women's cinema” labels. In diegetic and extradiegetic negotiations of belonging, Tsangari's auteurism emerges.
Retrovirus-derived RTL5 and RTL6 genes are novel constituents of the innate immune system in the eutherian brain
Authors: Irie Masahito , Itoh Johbu , Matsuzawa Ayumi , Ikawa Masahito , Kiyonari Hiroshi , Kihara Miho , Suzuki Toru , Hiraoka Yuichi , Ishino Fumitoshi , Kaneko-Ishino Tomoko
Published: September 2022

Retrotransposon Gag-like 5 [RTL5, also known as sushi-ichi-related retrotransposon homolog 8 (SIRH8)] and RTL6 (also known as SIRH3) are eutherian-specific genes presumably derived from a retrovirus and phylogenetically related to each other. They, respectively, encode a strongly acidic and extremely basic protein, and are well conserved among the eutherians. Here, we report that RTL5 and RTL6 are microglial genes with roles in the front line of innate brain immune response. Venus and mCherry knock-in mice exhibited expression of RTL5-mCherry and RTL6-Venus fusion proteins in microglia and appeared as extracellular dots and granules in the central nervous system. These proteins display a rapid response to pathogens such as lipopolysaccharide (LPS), double-stranded (ds) RNA analog and non-methylated CpG DNA, acting both cooperatively and/or independently. Experiments using Rtl6 or Rtl5 knockout mice provided additional evidence that RTL6 and RTL5 act as factors against LPS and dsRNA, respectively, in the brain, providing the first demonstration that retrovirus-derived genes play a role in the eutherian innate immune system. Finally, we propose a model emphasizing the importance of extra-embryonic tissues as the origin site of retrovirus-derived genes.

This article has an associated ‘The people behind the papers’ interview.
Otorhinolaryngological presentations of mucormycosis amid COVID-19 pandemic in a tertiary care hospital
Authors: Wahid Fazali , Saleem Muhammad , Rehman Habib-ur- , Din Israr ud
Published: September 2022

Objective: To describe presentations, comorbidities, investigations, and surgical treatment of patients with mucormycosis amid the COVID-19 pandemic in a tertiary care hospital in Khyber Pakhtunkhwa, Pakistan.

Methods: This descriptive study was conducted at the department of ENT, and Head and Neck Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar, Pakistan from June 2020 to June 2021. All the patients fulfilling the inclusion criteria were included. Patients with COVID-19 were diagnosed based on real-time polymerase chain reaction (RT-PCR). After diagnosing mucormycosis computed tomography (CT) scan and/or magnetic resonance imaging (MRI) were performed for subsequent surgical clearance. After taking informed consent demographic data were collected on a proforma and analyzed using SPPS version 25.

Results: Out of 23 patients males were 14(60.9%), females were 9 (39.1%) with a male: female ratio of 1.5:1. Mean ± SD age was 51.26 ± 1.41 years. Nasal obstruction and headache were the most common (8, 34.8%) presentations. The commonest co-morbidities were hypertension with diabetes mellitus (8, 34.8%). Out of 23 patients, 16(69.6%) had COVID-19 PCR positive. The majority of patients (17, 73.9%) were not vaccinated against COVID-19. Most of the patients (9, 39.1%) had HbA1c levels of 7% to 8.9%. The commonest surgery was endoscopic debridement of paranasal sinuses (9, 39.1%), while the commonest CT scan finding was a heterogeneous lesion involving the nose, maxillary and ethmoid sinuses (12, 52.2%).

Conclusion: Mucormycosis of paranasal sinuses with/or without intracranial extension is frequently seen in unvaccinated patients having uncontrolled diabetes and COVID-19 infection.

doi: https://doi.org/10.12669/pjms.38.8.6431

How to cite this:Fazal-I-Wahid, Saleem M, Habib-ur-Rehman, Israr ud Din. Otorhinolaryngological presentations of mucormycosis amid COVID-19 pandemic in a tertiary care hospital. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.6431

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Characterizing gene expression in an in vitro biomechanical strain model of joint health
Authors: Hung Anthony , Housman Genevieve , Briscoe Emilie A. , Cuevas Claudia , Gilad Yoav
Published: September 2022

Background: Both genetic and environmental factors appear to contribute to joint health and disease. For example, pathological levels of biomechanical stress on joints play a notable role in initiation and progression of osteoarthritis (OA), a common chronic degenerative joint disease affecting articular cartilage and underlying bone. Population-level gene expression studies of cartilage cells experiencing biomechanical stress may uncover gene-by-environment interactions relevant to human joint health.

Methods: To build a foundation for population-level gene expression studies in cartilage, we applied differentiation protocols to develop an in vitro system of chondrogenic cell lines (iPSC-chondrocytes). We characterized gene regulatory responses of three human iPSC-chondrocyte lines to cyclic tensile strain treatment. We measured the contribution of biological and technical factors to gene expression variation in this system.

Results: We identified patterns of gene regulation that differ between strain-treated and control iPSC-chondrocytes. Differentially expressed genes between strain and control conditions are enriched for gene sets relevant to joint health and OA. Furthermore, even in this small sample, we found several genes that exhibit inter-individual expression differences in response to mechanical strain, including genes previously implicated in OA.

Conclusions: Expanding this system to include iPSC-chondrocytes from a larger number of individuals will allow us to characterize and better understand gene-by-environment interactions related to joint health.
Modelling time-varying volatility using GARCH models: evidence from the Indian stock market
Authors: Ali Farman , Suri Pradeep , Kaur Tarunpreet , Bisht Deepa
Published: September 2022

Background: In this study, we examined the volatility of the Indian stock market from 2008 to 2021. Owing to the financial crisis, volatility forecasting of the Indian stock market has become crucial for economic and financial analysts. An empirical study of the returns of the NSE indices revealed an autoregressive conditional heteroskedastic trend in the Indian stock market.

Methods: Using GARCH 1, 1 (generalized autoregressive conditional heteroskedasticity) and FIGARCH (fractionally integrated GARCH), we examine investor behaviour and the persistence of long-term volatility.

Results: The empirical findings of the estimated models suggest that shocks persist for a long time in NSE returns. Furthermore, bad news has a greater impact on stock volatility than good news. The return on assets is stable but highly volatile, even though the Indian economy has experienced the global crash to some extent.

Conclusions: Models of volatility derived from the GARCH equation provide accurate forecasts and are useful for portfolio allocation, performance measurement, and option valuation.
Study of the Quality of the Conditions for the Implementation of Educational Activities by Educational Organizations of General, Secondary Vocational and Additional Education in 2020 and 2021
Authors: Ganeev A. , Bulaeva N. , Ruban I.
Published: September 2022

The article presents the results of the research on an independent assessment of the quality of the conditions for the implementation of educational activities by organizations engaged in educational activities in basic general education programs, educational programs of secondary vocational education, basic vocational training programs, additional general education programs, which was carried out in 2020-2021. The collection and synthesis of data as part of an independent assessment was carried out by order of the Ministry of Education of the Russian Federation on the basis of indicators approved by Order of the Ministry of Education of Russia dated March 13, 2019 No. 114, and in accordance with the Unified Procedure for Calculating Indicators approved by Order of the Ministry of Labor and Social Protection of the Russian Federation dated May 31, 2018 No. 344n.

The article compares the integral values of the quality criteria of the conditions for the implementation of educational activities for 2020 and 2021, changes in the values of the criteria for assessing the quality of the conditions for the implementation of educational activities are noted.
La guerra desde la mirada femenina
Authors: Beltran y Puga Alma Luz , Abultaif Kadamani Amira
Published: September 2022

Aunque la guerra ha sido contada fundamentalmente por hombres, su verdad no es la única que debe ser reconocida por el derecho y la historia. La abogada Alma Beltrán y Puga exalta la necesidad de acoger las voces de las mujeres excombatientes en los organismos de justicia transicional.
Rapidly Progressive Bronchiectasis and Pulmonary Fibrosis in Yellow Nail Syndrome with Possible Association with Selective IgM Deficiency
Authors: Abu-Abaa Mohammad , Hassan Mohamed , Oudah Bashar , Al-Ameri Noor
Published: September 2022

A 67-year-old man with a history of IgM deficiency and pulmonary fibrosis and bronchiectasis was admitted for management of worsening symptoms. Investigations revealed exudative pleural effusion with rapidly progressive bronchiectasis. Although a potential trigger of bronchiectasis and pulmonary fibrosis was not identified despite extensive work-up by several physicians in the past, a bedside observation of yellow dystrophic nails on all extremities revealed the diagnosis. This case report helps to remind clinicians of a rare medical disorder of still uncertain aetiology and no available cure. This case is consistent with a few previous case reports that suggest a potential association with selective immunoglobulin deficiency.
Anxiety of Final Semester Students: Mini Review
Authors: Muhammad A Dzulfikar , Rosyidawati Nafila Hana , Sudrajat Arista Ayu , Khairunnisa Nadia Hasna , Rahmawati Baiq Dwi Zulfa , Khatimah Widia Husnul , Apriyani Putri , Andriani Amalia Putri Dwi , Widyastuti Putri Anisa , Suryani Dhea Silvi , Nur Azizah Putri Faizatus Sholihah , Yuniasih Dewi
Published: September 2022

Students often experience events that may cause anxiety in the final stages of their lectures, especially at the stage of writing a thesis. Our literature review research aims to find out about anxiety in students and its prevention efforts. Approximately 80% of students who experience anxiety during thesis exams are recorded. Our literature research finds that prevention efforts are needed, including increasing individual student awareness to reduce negative thoughts and trying to focus thoughts and attention on positive things. In addition, universities need to provide adequate health facilities, including psychological assistance.
The Role of Magnesium Supplementation for Supportive Therapy in Covid-19 Infection
Authors: Solikhah Amanatus , Ihsana Nuni , Sofro Abdul Salam
Published: September 2022

The coronavirus disease 19 (COVID-19) caused by SARS-CoV-2 created global pandemic conditions. A person infected with SARS-CoV-2 increases the probability of hospitalization and admission to intensive care, with high mortality. The most common symptoms of COVID-19 patients are fever and cough, although a variety of other symptoms may also be present. Patients admitted to the intensive care unit are known to have impaired organ function including acute respiratory distress syndrome (ARDS), cardiac injury, acute kidney injury, and liver dysfunction. Increasing evidence supports that magnesium supplementation (especially magnesium sulfate and magnesium oxide) prevents or treat various types of disorders or diseases related to the respiratory system, reproductive system, nervous system, digestive system, cardiovascular system, kidney injury, diabetes and cancer.
Vitamin K and The Immune System
Authors: Putri Rachma Greta Perdana , Safitri Rosyida Awalia , Herliyanti Yuni
Published: September 2022

Vitamin K is a vitamin fat-soluble with the main function as an anticoagulant. The active form of vitamin K can be divided into two categories, namely vitamin K1 (phylloquinone) can be found in photosynthetic plants and vitamin K2 (menaquinone) comes from bacteria, source in foods we can found this in fermented foods like natto or soybean product which fermented by Bacillus natto. This literature review was conducted through searching in database like PubMed, and Elsevier using keywords like vitamin K, Immune system, and inflammation. The role of vitamin K in physiological functions is well known worldwide, such as blood coagulation, bone metabolism, and regulation of several types of enzymes. Apart from this role, vitamin K also acts as a cofactor in several plasma proteins, so this vitamin can influence immune responses. Recent studies have found vitamin K links to inflammatory diseases. Vitamin K also induced autophagy pathway. However, information regarding the role of vitamin K in the immune system is limited.
The Presence of Aedes Aegypti Mosquito larvae in Bandung City in 2021
Authors: Sutriyawan Agung , Wirawati Karlina , Suherdin Suherdin
Published: September 2022

Background: Dengue Hemorrhagic Fever (DHF) is the vector-borne disease with the highest prevalence rate in the world. Bandung city itself is included in the 5 regencies/cities with the highest number of cases today. The disease is transmitted through the Aedes aegypti mosquito. The purpose of this study is to find out the effect of mosquito nests on the presence of Aedes aegypti mosquitoes. Method: This research uses quantitative research methods with a design cross-sectional survey. The population in this study is the entire community in Bandung. The sample number was 510 respondents. The research instrument used questionnaires and observation sheets. Data analyzed descriptively, chi-square test, and binary logistic regression. Results: The presence of Aedes aegypti mosquitoes is influenced by several risk factors for Pemberantasan Sarang Nyamuk (PSN) behavior, including not draining water shelters once a week (OR=3.219; CI 95%= 2.194-4.724; p<0.025), not closing water reservoirs (OR=1.719; CI 95%= 1.171-2.521; p<0.025), and abate use behavior (OR=1.6; CI 95%= 1.070-2.437; p<0.025). Conclusion: In this study, most of them found no flicks in water reservoirs. The presence of Aedes aegypti mosquitoes can increase if it drains water reservoirs less than once a week, closes unsalted water reservoirs or open water shelters, does not use abate. To prevent the presence of a flick at home it is necessary to drain the water shelter regularly, always close the water shelter and sprinkle abate powder at least once every 3 months.