bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the Relationship Between the Characteristics of the Blood Internal Environment and Early Prognosis in Patients with Cardiac Arrest
Authors: Wang Yuwei , Wang Meiling , Yan Danping , Liu Yajie , Zhou Shuaishuai , Fang Jue , Zhan Fenfang , Wang Sa
Published: October 2024

Background：Cardiac arrest is a highly time-dependent condition, and there is limited evidence regarding the relationship between changes in the blood internal environment before and after arrest and resuscitation and the return of spontaneous circulation (ROSC) in patients. This study aims to understand the dynamic changes in the internal environment of blood at different time points and to identify blood biomarkers for patients who achieve ROSC.
Methods：A retrospective analysis was conducted on patients with CA in a tertiary hospital in China from January 2021 to December 2023. The study described and compared laboratory blood indicators at different time points: prior to cardiac arrest, during resuscitation, and after ROSC. Multivariate logistic regression analysis was employed to identify independent influencing factors for ROSC, and receiver operating characteristic (ROC) curves were plotted to evaluate their predictive value.
Result Among the 270 patients included in the final analysis, 122 achieved ROSC. Compared to pre-arrest and post-ROSC levels, WBC count, neutrophils, pH, and PO2 were lower during resuscitation, while lymphocytes, potassium, and PCO2 were higher (P < 0.05). In further comparison to the non-ROSC group, the ROSC group had higher WBC count, neutrophils, lymphocytes, platelets, and PO2 during resuscitation, but lower INR, D-dimer, and BE. WBC, D-dimer, and PO2 were identified as independent influencing factors for ROSC in cardiac arrest patients, with AUC of 0.686, 0.374, and 0.775. The combined detection of these three factors yielded an AUC of 0.826, with a sensitivity of 71.2% and specificity of 85.2%.
Conclusion：The different stages of CA and resuscitation exhibit distinct characteristics in the internal environment of blood. Factors such as WBC, neutrophils, and PO2 are significant influencing factors for ROSC in CA patients.
Effectiveness of self-care supported motivational interview to increase self-care agency and disease adaptation levels of hemodialysis patients: A randomized controlled trial
Authors: gerçek abdullah , KILIÇ Phd SERAP PARLAR
Published: October 2024

Background
This study aimed to determine the effect of self-care-supported motivational interview on the self-care and disease adaptation of patients with hemodialysis treatment. Self-care training supported by motivational interviewing affects both patients' self-care and adaptation to the disease.
Methods
The research was conducted between October 2020 and March 2021 in the Hemodialysis Unit of a state hospital in a province in the east of Turkey. 77 hemodialysis patients participated in this study conducted with randomized controlled research pattern. Personal Information Form, Adaptation to Chronic Illness Scale and Self Care Agency Scale were used in the collection of data.
Results
It was found that the average score in the experimental and control groups was similar prior to, and the score averages of the experimental group increased significantly after compared to those of the control group. In-group comparisons revealed that the difference between pre-test, post-test and follow-up test mean scores of patients in the experimental group and their mean scores has changed significantly. Pre-test, post-test and follow-up test total scores, physical scores and social scores of the patients in the control group showed significant differences.
Conclusions
In order to increase patients' adaptation to chronic diseases and their self-care power, self-care supported motivational interviewing technique should be applied to patients. In order to increase the health level of patients, nurses should use the self-care supported motivational interviewing technique during care practices.
Ventilator-associated lower respiratory tract infections and bacteremia in medical and surgical critical care patients colonized by multidrug-resistant bacteria
Authors: Torres Ignacio , Ferrer Josep , Colomina Javier , Clari María Ángeles , Olea Beatriz , Giménez Estela , Albert Eliseo , Sánchez-Jordán Pablo , Aguilar Gerardo , Carbonell Nieves , Navarro David
Published: October 2024

Purpose: We investigated the risk of bloodstream infections (BSI) and ventilator-associated lower respiratory tract (LRT) infections, including pneumonia (VAP) and tracheobronchitis (VAT), due to multidrug-resistant bacteria (MDRB) in colonized critical care patients attended in the medical intensive care unit (MICU) and surgical critical care unit (SCCU).
Methods: Observational, unicentric study including 573 consecutive adult patients (median age of 66 years; range, 18-85 years) and comprising a total of 585 admissions. Universal MDRB screening cultures (from nasal, pharyngeal, rectal, and axillary sites) were regularly performed. Blood cultures and (semi)quantitative cultures of endotracheal or bronchoscopic specimens were performed and interpreted following consensus guidelines.
Results: Colonization by MDRB was documented in 201 out of 585 admissions (34.4%), in which 261 MDRB were isolated, most frequently extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (n=102) followed by MDR-S. maltophilia (n=45), carbapenemase-producing Enterobacterales (n=40), MDR-Gram-positive bacteria (n=35), and MDR-P. aeruginosa (n=28). There were 21 MDRB BSI, mostly caused by Gram-negative bacteria (95.8%). Colonization by MDRB was independently associated with subsequent MDRB BSI (HR14.1; 95% CI, 3.29-60.65 P<0.001). MDRB were recovered in 157/430 admissions requiring invasive mechanical ventilation (36.5%) and there were 25 episodes of ventilator-associated LRT infections due to MDRB, mostly MDR-Gram-negative bacteria. Colonization by MDRB was independently associated with subsequent MDRB LRT infections (HR, 6.59; 95% CI, 2.67-16.26; P<0.001).
Conclusion: MDRB colonization is a significant risk factor for the occurrence of MRDB-matched invasive infections in a mixed cohort of MICU and SCCU patients. MDRB screening cultures using a multi-site sampling approach may be useful for tailoring empirical antimicrobial treatments on an individual basis.
Effective Lumbar Facet Joint Cyst Treatment with Biportal Endoscopic Spine Surgery: a Rare Case Report
Authors: Hardiansyah Nicko Perdana , Randy Randy
Published: October 2024

Introduction: Facet joint cyst (FJC) are rare, benign lesions that most commonly affect the lumbar region. They are frequently associated with degenerative changes or instability in the spine. FJC often asymptomatic, but in some cases may cause significant neurological symptoms by compressing nearby neural structures causing lumbar spinal stenosis and lumbar foraminal stenosis, resulting in back pain, radicular pain, and neurological deficit. Surgical intervention, including minimally invasive approaches, is often required in symptomatic cases where conservative treatments fail. Case Presentation: A 64-year-old female presented with severe low back pain and left leg radicular pain for three months, unrelieved by conservative treatment. Her pain was rated 7–8 on Visual Analog Scale (VAS), and she exhibited neurological deficits with a high Owestry Disability Index (ODI) of 84%. MRI revealed lumbar FJC at L5-S1 causing severe spinal stenosis. Biportal endoscopic spine surgery (BESS) cyst decompression and resection were performed. Postoperatively, the patient experienced significant pain relief and improved function. At one-year follow-up, the patient was pain-free, with no recurrence or complications. Discussion: FJC, though uncommon, can cause significant neurological symptoms when compressing nerve structures. Surgical management is often required for symptomatic cses, with BESS offering a minimally invasive option. This case showed excellent outcomes with no recurrence, aligning with similar reports in the literature. However, further studies are needed to assess long-term efficacy and recurrence rates. Conclusion: BESS provides a safe and effective approach for treating Lumbar Facet Joint Cysts, offering symptomatic relief and functional recovery in patients resistant to conservative treatment. Further research is warranted to validate ling-term outcomes.
Effects of bread fortification with pomegranate peel powder on inflammation biomarkers, oxidative stress, and mood status in patients with type 2 diabetes: A randomized placebo-controlled trial
Authors: Zare Maryam , Tarrahi Mohammad Javad , Sadeghi Omid , Karimifar Mozhgan , Goli Amir Hossein , Amani Reza
Published: October 2024

Background: To assess the effects of bread fortified with pomegranate peel powder (PPP) on inflammation, oxidative stress, and mood indices in patients with type 2 diabetes mellitus (T2DM).
Methods: In total, 90 T2DM patients were randomized to receive either bread fortified with 3.5% pomegranate peel powder (PPP) (n=45) or PPP-free bread for 12 weeks. Dietary intake throughout the trial was assessed via food records. Laboratory parameters, including total antioxidant capacity (TAC), malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), and psychological disorders, including depression, anxiety, and stress, were assessed at the beginning and end of the study.
Results: 77 diabetic patients completed the trial (PPP group = 39 and control group = 38). Based on the compliance assessment, adherence to the interventions was high in the trial. We detected significant reductions in hs-CRP levels (intervention group: change = -0.56 ± 1.29, P=0.01; control group: change = -0.81± 1.16, p<0.001) and depression scores (intervention group: change= -1.33 ± 3.66, P=0.04; control group): -1.44 ± 2.83, p=0.01). There was no significant difference between the groups. After adjusting for confounding factors, the significant effect within the group disappeared. Other variables, including MDA, TAC, anxiety, and stress, did not significantly change in the PPP-fortified bread group.
Conclusion: While intake of PPP-fortified bread for 12 weeks did not significantly affect oxidative stress, hs-CRP, or mental health in T2DM patients, some positive outcomes related to inflammatory and mood states should be explored.
Trial registration Iranian Registry of Clinical Trials: The trial was registered in the Iranian Registry of Clinical Trials (available at www.irct.ir, with ID: IRCT20191209045672N1) on 21/09/2020.
Single-slice MRI for body composition assessment: repeatability, reproducibility, and observer variability
Authors: Nowak Magdalena , Núñez Luis , Hill Charles Edward , Davis Tom , Cardiel Luis Felipe , Schooler Gary , Mermekli Asimenia , Salvati Roberto , Brears Helena Thomaides , Pansini Michele , Robson Matthew David
Published: October 2024

Purpose
The single-slice MRI at L3 vertebra offers an efficient way to assess body composition but the evidence on the reliability of this method is scarce. This study evaluates the accuracy and precision of this method for adipose and muscle tissue measurements.
Methods
The technical performance of single-slice (L3) MRI body composition measurements was assessed in a prospective study of 12 participants, focusing on scan-rescan repeatability, cross-scanner reproducibility, and analyst variability. Additionally, retrospective data from 36 participants were analyzed to evaluate inter-device and inter-observer (analyst vs. radiologist) variability across a wide range of scanners and body types. Blinded analyses were performed for visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) cross-sectional areas (CSA), VAT and SAT indices, VAT/SAT ratio, skeletal muscle CSA, skeletal muscle index (SMI), psoas muscle CSA, and psoas muscle index.
Results
Single-slice MRI-based body composition measurements showed high scan-rescan repeatability (CoV: 1.5%–7.9%, ICC: 0.97–1.0), with low repeatability coefficients (RC) across key metrics, including 12 cm2 for SAT CSA, 15 cm2 for VAT CSA, 5 cm2 for skeletal muscle CSA, and 1.4 cm2 for psoas muscle CSA. Cross-scanner reproducibility was consistent (CoV: 2.3%–15%, ICC: 0.90–1.0). Inter- and intra-analyst variability was minimal (CoV: 0.5%–5.0%, ICC: 0.98–1.0). Analyst-radiologist comparisons showed near-perfect correlations (r = 0.97–1.00, p < 0.001) and excellent reliability (ICC: 0.96–1.0).
Conclusion
The results demonstrate that MRI-based single-slice method at the L3 vertebral level provides accurate, repeatable, and reproducible measurements of adipose and muscle tissue across a wide range of body types, consistent between trained analysts and experienced radiologists. These findings support the method’s accuracy and consistency for longitudinal assessments.
The PLOD2 promotes tumor progression in colorectal cancer through the PI3K-AKT pathway
Authors: Chen Dezhen , Zhang Mili , Zhou Yuxuan , Zhu Haiqiang , Deng Zhongquan , Li Ouxuan , Zhou Yuan
Published: October 2024

Based on reports, Procollagen-Lysine, 2-Oxoglutarate 5-Dioxygenase 2 (PLOD2) constitutes an oncogenic gene that undergoes upregulation in multiple malignancies, encompassing cervical cancer, endometrial cancer, and lung cancer. PLOD2 is competent to stiffen the extracellular matrix and modify the ECM architecture. Despite the fact that PLOD2 has been demonstrated to be associated with an unfavorable prognosis in colorectal cancer (CRC), the regulatory mechanism and functionality of PLOD2 in human colorectal cancer remain enigmatic. In this investigation, we validated the elevated expression of PLOD2 in human CRC tissue and its correlation with tumor pathological staging. Concurrently, we discerned through public databases that the expression of PLOD2 is interrelated with patient prognosis. Furthermore, functional experiments have manifested that PLOD2 facilitates CRC cell metastasis and proliferation via the PI3K-AKT pathway and predicts the potential binding of compounds to its protein.
Gonadotropin-Releasing Hormone Analogue Treatment: Differentiating Effects on Body Mass Index in Normal-Weight, Overweight, and Obese Girls
Authors: Thaneetrakool Thanaporn , Aroonparkmongkol Suphab , Numsriskulrat Nattakarn , Supornsilchai Vichit , Wacharasindhu Suttipong , Srilancha Khomsak
Published: October 2024

Introduction: Weight gain and BMI changes are concerns while treating central precocious puberty (CPP) with gonadotropin-releasing hormone agonist (GnRHa). This study investigates BMI changes with GnRHa treatment in idiopathic CPP girls of normal, overweight, and obese weight.
Method: This study collected data from 188 girls with idiopathic CPP who received GnRHa therapy. BMI changes were analyzed during the treatment period, with participants stratified based on their baseline BMI status: normal weight (BMI < 1 SDS), overweight (BMI ≥ 1 SDS), and obese (BMI ≥ 2 SDS).
Results: Obesity and overweight were prevalent, observed in 24.5% and 14.9% of the cases, respectively. The BMI-SDS of the normal-weight group increased significantly during the treatment period at the beginning of treatment, 12-months after treatment, and the end of treatment (0.01 ± 0.7, 0.23 ± 0.9, and 0.37 ± 1.0, P < 0.05). However, no significant changes in BMI-SDS were noted in the overweight and obese groups during the treatment period.
Conclusion: The findings of our study indicate that the variations in BMI alterations observed in our CPP patients imply that the impact of GnRHa treatment-induced delayed puberty on linear growth may differ based on the initial body composition.
Pregnancy in a Chinese woman with nonclassical 11β-hydroxylase deficiency caused by novel compound heterozygous mutations: a case report, literature review and functional validation
Authors: Yang Yuhong , Gao Maoting , Wu Wei , Sun Min , Wang Zhixiao
Published: October 2024

Background
Congenital adrenocortical hyperplasia caused by 11β-hydroxylase deficiency (11β-OHD) due to CYP11B1 mutations in 46,XX patients is typically characterized by hyporeninemic hypokalemia hypertension, virilization, precocious pseudopuberty, accelerated skeletal maturation and short stature. Impaired fertility has been reported in the virilizing 11β-OHD form unless properly treated.
Case presentation:
A 35-year-old female patient with nonclassical 11β-OHD due to novel compound heterozygous mutations (V316M; C262_F264del) in CYP11B1 suffered from menstrual irregularities, infertility, hirsutism and low-renin hypertension with typical hormone profiles including an elevated 11-deoxycorticosterone and testosterone. Her reduced fertility recovered after the initiation of corticosteroid therapy, and conception was later successfully achieved by in vitro fertilization and frozen-thawed embryo transfer. Functional characterization of CYP11B1 V316M and C262_F264del mutations in human adrenocortical cells confirmed 7%-16% of residual enzyme activity (V316M: 11.5% ± 2.4%; C262_F264del: 7.8% ± 2.9%; V316M; C262_F264del: 16.5% ± 0.6%).
Conclusions
We reported a successful pregnancy in a female patient with nonclassical 11β-OHD due to compound heterozygosity of novel CYP11B1 mutations by in vitro fertilization. The close coordination of care by a multidisciplinary medical team is beneficial for patients with congenital adrenocortical hyperplasia to achieve an accurate diagnosis, proper fertility management and uneventful pregnancy.
Genetic Variants and Phenotypic Data Curated for the CAGI6 Intellectual Disability Panel Challenge
Authors: Aspromonte Maria Cristina , Conte Alessio Del , Polli Roberta , Baldo Demetrio , Benedicenti Francesco , Bettella Elisa , Bigoni Stefania , Boni Stefania , Ciaccio Claudia , D’Arrigo Stefano , Donati Ilaria , Granocchio Elisa , Mammi Isabella , Milani Donatella , Negrin Susanna , Nosadini Margherita , Soli Fiorenza , Stanzial Franco , Turolla Licia , Piovesan Damiano , Tosatto Silvio C.E. , Murgia Alessandra , Leonardi Emanuela
Published: October 2024

Neurodevelopmental disorders (NDDs) are common conditions including clinically diverse and genetically heterogeneous diseases, such as intellectual disability, autism spectrum disorders, and epilepsy. The intricate genetic underpinnings of NDDs pose a formidable challenge, given their multifaceted genetic architecture and heterogeneous clinical presentations. This work delves into the intricate interplay between genetic variants and phenotypic manifestations in neurodevelopmental disorders, presenting a dataset curated for the Critical Assessment of Genome Interpretation (CAGI6) ID Panel Challenge. The CAGI6 competition serves as a platform for evaluating the efficacy of computational methods in predicting phenotypic outcomes from genetic data.
In this study, a targeted gene panel sequencing has been used to investigate the genetic causes of NDDs in a cohort of 415 paediatric patients. We identified 60 pathogenic/likely pathogenic and 49 variants of Uncertain Significance (VUSs) in 102 individuals that accounted for 25% of NDD cases in the cohort. The most mutated genes were ANKRD11, MECP2, ARID1B, ASH1L, CHD8, KDM5C, MED12 and PTCHD1 The majority of pathogenic variants were de novo, with some inherited from mildly affected parents. Loss-of-function variants were the most common type of pathogenic variant. In silicoanalysis tools were used to assess the potential impact of variants on splicing and structural/functional effects of missense variants. The study highlights the challenges in variant interpretation especially in cases with atypical phenotypic manifestations. Overall, this study provides further insights into the genetic causes of NDDs and emphasises the importance of understanding the underlying genetic factors for accurate diagnosis, and intervention development in neurodevelopmental conditions.
Decoding Hashimoto’s Thyroiditis: Key Genes and Pathways in Inflammation and Pyroptosis
Authors: Sun Baihui , Ding Ruoting , Tan Jie , Yu Shitong , Ge Junna , Wei Zhigang , Lei Shangtong , Li Guoxin
Published: October 2024

Purpose Inflammation is recognized as a hallmark of Hashimoto’s thyroiditis (HT). Although inflammation is an important pathogenic factor that leads to thyroid follicular epithelial cell injury after HT, anti-inflammatory treatments remain controversial in the management of HT. Moreover, the molecular signatures involved in the pathophysiological changes that occur during the course of HT remain ambiguous.Methods The current study investigated the genes and pathways involved in HT by transcriptome sequencing analysis. Furthermore, western blot assays, ELISA and immunohistochemical staining were conducted to validate the expression levels of dysregulated proteins.Results HT was found to be associated with the enrichment of genes related to the inflammatory response, pyroptosis, and regulation of the lipid metabolic process. Further analysis revealed that genes associated with the interleukin (IL)-18 signaling pathway and the NLRP3 inflammasome were upregulated, and the expression levels of the IL-18, NLRP3, and APOC1 proteins were increased.Conclusion The transcriptome data obtained from HT patient samples revealed notable genes and pathways that may be novel therapeutic targets for the treatment of HT.
Melphalan-Based Conditioning with Post-Transplant Cyclophosphamide for Peripheral Blood Stem Cell Transplantation: Donor Effect
Authors: Malki Monzr Al , Koller Paul , Othman Tamer , Yang Dongyun , Mokhtari Sally , Samara Yazeed , Blackmon Amanda , Agrawal Vaibhav , Pourhassan Hoda , Ball Brian , Amanam Idoroenyi , Arslan Shukaib , Otoukesh Salman , Sandhu Karamjeet , Aldoss Ibrahim , Ali Haris , Salhotra Amandeep , Aribi Ahmed , Artz Andrew , Becker Pamela , Pullarkat Vinod , Stewart Forrest , Smith Eileen , Stein Anthony , Marcucci Guido , Forman Stephen , Nakamura Ryotaro
Published: October 2024

Fludarabine and melphalan (FM) conditioning offers effective disease control with an acceptable toxicity profile. Post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis has improved transplant outcomes. We retrospectively reviewed patients receiving FM-based transplants with PTCy at City of Hope. Of 248 patients included, 89 (35.9%) received hematopoietic cell transplant (HCT) from a matched related/unrelated donor (MRD/MUD), 118 (47.6%) from a haploidentical (HID) donor, and 49 (19.8%) from a mismatched unrelated donor (MMUD). There were no differences in acute and chronic GVHD based on donor type. The 2-year overall survival (OS) for patients receiving HID, MMUD, and MRD/MUD was 58%, 55%, and 70%; disease-free survival (DFS) was 52%, 48%, and 66%; and graft-versus-host/relapse-free survival (GRFS) were 48%, 40%, and 59%, respectively. OS, DFS, and GRFS were similar regardless of donor type on multivariable analysis. However, donor age ≥ 35 years was associated with lower OS and GRFS and higher 2-year non-relapse mortality (NRM) on multivariable analysis across all patients, regardless of donor type. FM with PTCy appears to produce similar outcomes between MRD/MUD, MMUD, and HID when adjusting for donors < 35 years, and donor age seems to be the most important factor when selecting a donor with this regimen.
Dynamics of color vision recovery in Vogt-Koyanagi-Harada disease: A longitudinal study using cone contrast test and adaptive optics imaging
Authors: Nakamura Tomoko , Abe Shinya , Yamazaki Hitoshi , Oiwake Toshihiko , Hayashi Atsushi
Published: October 2024

Background: Vogt-Koyanagi-Harada (VKH) disease affects visual function, but the recovery process of color vision remains incompletely understood. This study aimed to assess color vision recovery in VKH using cone contrast testing and explore its relationship with cone cell density measured using adaptive optics imaging.
Methods: Twenty-two eyes of 11 patients with VKH were evaluated at baseline (serous retinal detachment resolution) and at 3, 6, and 12 months post-treatment. Cone contrast scores and cone cell density were measured using the ColorDx® CCT-HD™ system and rtx1™ adaptive optics fundus camera, respectively. Pre-treatment optical coherence tomography (OCT) was used to analyze the cystoid spaces.
Results: Color vision defects observed at baseline—especially in S-cones—significantly improved by 6 months for all cone types. Cone contrast scores correlated significantly with cone cell density (ρ=0.63–0.66, p<0.0001). Eyes with cystoid spaces on pre-treatment OCT showed lower cone contrast scores and cone density. S-cones demonstrated greater vulnerability and slower recovery than L- and M-cones.
Conclusion: This study emphasizes the importance of comprehensive visual function assessment, including color vision evaluation, in VKH patients. Cone contrast testing captures qualitative aspects of visual function not reflected in standard acuity tests. The combination of cone contrast testing and adaptive optics imaging provides insights into the structure-function relationship in color vision recovery.
Role of consolidative surgery after chemotherapy in recurrent/metastatic adrenal cortical cancer (ACC): Princess Margaret Cancer Center Experience
Authors: Mittal Abhenil , Amer Lama , Ayodele Olubukola , Radi Suhaib , Li Xuan , Araujo Daniel Vilarim , Malone Eoghan Ruadh , Al-Ezzi Esmail Mutahar , Pasternak Jesse , Mete Ozgur , Jiang Di Maria , Kumar Vikaash , Joshua Anthony , Ezzat Shereen , Hansen Aaron Richard
Published: October 2024

Background
Metastatic ACC is aggressive with few effective treatment options. It is unclear if surgery after chemotherapy impacts survival in recurrent/metastatic (R/M) ACC. Moreover, prognostic factors in R/M ACC are not well defined.
Methods
R/M ACC patients treated at Princess Margaret Cancer Center (2002–2019) were retrospectively reviewed. Descriptive statistics were used to summarize clinical characteristics. OS was estimated by Kaplan-Meier method. Cox regression analysis was used to compute prognostic variables.
Results
Among 83 patients with metastatic ACC [36.2% de novo and 63.8% recurrent], 49 (59.0%) received systemic therapy (ST) with which 15 (30.6%) had a partial response (PR) and 8 (16.3%) had stable disease (SD). 9 (18.4%) had surgery after ST (combined therapy group); 6 (66.6%) were rendered disease free with surgery. The median OS was 26 months (20.4–40.5) for entire cohort (f/up 18 months) with trend for better OS in patients having combined therapy (31.2 (21.4–63.3) vs 24.7 months (17.7–35.2), p = 0.48]. Being disease free after surgery was associated with better OS [39.6 (24.8-NR), vs 23.5 months (21.4-NR), p = 0.02].
Conclusions
Selected patients with R/M ACC may benefit from surgery after chemotherapy. These data highlight the potential role for multimodal therapy in managing such patients.
Implications for Practice:
Chemotherapy remains the standard of care in advanced adrenal cortical carcinoma (ACC). However, the response to chemotherapy remains suboptimal and overall outcomes for these patients remains poor. The role of surgery for patients with advanced ACC remains uncertain. In a large cohort of patients treated at a large referral center in Canada, we observed that selected patients with advanced ACC may benefit from surgery after chemotherapy. This is especially true if surgery can lead to resection of all macroscopic disease. Based on this data, such approach can be individualised after discussion in multidisciplinary tumor boards
Risk factors for cardiovascular death in urgent-start peritoneal dialysis patients: a multicenter retrospective cohort study
Authors: Meng Lingfei , Yang Liming , Zhu Xueyan , Sun Zhanshan , Zhang Xiaoxuan , Cui Wenpeng
Published: October 2024

Background: Urgent-start peritoneal dialysis (USPD) has been identified as the efficient approach to initiate renal replacement treatment in end-stage renal disease patients. Cardiovascular mortality of urgent dialysis is an important issue. The present work focused on assessing risk factors related to cardiovascular death in USPD patients.
Methods: We carried out the present multicenter retrospective cohort study in Northeast China, included adults initiating USPD between 2013 to 2019. Follow-up was conducted in every patient till the occurrence events below: technical failure, death, loss-to-follow-up, and renal transplantation.
Results: There were altogether 1549 cases enrolled into this work. Among them, 123 encountered cardiovascular death. Upon multivariate regression, predictors of cardiovascular death included advanced age (HR 1.045, 95%CI [1.031, 1.060]; p < 0.001), higher eGFR (HR 1.084, 95%CI [1.052, 1.117]; p = 0.001), combined with diabetes (HR 1.471, 95%CI [1.026, 2.110]; p = 0.036), and advanced heart failure stages (class III versus class 0-I, HR 5.262; 95%CI [3.281, 8.437]; p < 0.001; class IV versus class 0-I, HR 6.409; 95%CI [4.145, 9.912]; p < 0.001). In addition, the predictors of cardiovascular death in diabetic USPD patients included advanced age (HR 1.050, 95%CI [1.024, 1.076]; p < 0.001), low serum creatinine (HR 0.999, 95%CI [0.998, 1.000]; p = 0.036) and advanced heart failure stage (class III versus class 0-I, HR 8.814; 95%CI [4.709, 16.501]; p< 0.001; class IV versus class 0-I, HR 5.334; 95%CI [2.904, 9.796]; p < 0.001). Moreover, the predictors of cardiovascular death in elderly USPD patients were advancedheart failure stage (class III versus class 0-I, HR 4.081; 95%CI [2.323, 7.170]; p < 0.001; class IV versus class 0-I, HR 5.178; 95%CI [3.066, 8.746]; p < 0.001).
Conclusions: Risk factors related to cardiovascular death included advanced age, higher eGFR, combined with diabetes, and advanced heart failure stages among USPD patients.
The Importance of Adult Self-education and Cultural Awareness When Creating a Sustainable Organizational Culture
Authors: Supranavičienė Ugnė , Gedvilienė Genutė , Stancikas Egidijus , Karasevičiūtė Salomėja
Published: October 2024

Relevance.Culture and education are undoubtedly two of the major factors that determine both the level of societal development and an individual’s full-fledged social life in contemporary society. Cultural awareness and adult self-education serve to produce various forms of activities; they help accumulate and transform diverse culture forms and create essentially new potential for anyone whose aim is to transition to a higher level of organizational culture. The growth of organizational culture also depends on the quality of cultural awareness and adult self-education, whereas the perspective of an individual’s life in general is determined by opportunities created for the individual to participate in an organization’s system.
Methodology. The results were quantified with further developed qualitative research methods. The research was performed in compliance with the following main principles of ethics: beneficence and ethical and honestly expressed opinions. The research was based on the methodological dispositions of transformative learning and experiential learning theory. Research was conducted in the following three stages: 1) research into generic competences (GC), identifying the importance of self-education of cultural awareness and how this relates to other competences; 2) research into the openness of adults to cultural awareness and self-education; and 3) hosting of a focus group discussion to identify prerequisites for the creation of a sustainable organizational culture.
This paper presents the conditions needed for an employee to self-educate and acquire cultural awareness competency and how it relates to building a sustainable organizational culture. Can organizations achieve this?
The aim of this paper is to reveal the importance of adult education and cultural awareness when creating a sustainable organizational culture.
The Impact of Organizational Culture on Career Leaving Among Nurses: Examining Global Nurses’ Shortage Through the Lenses of Organizational Culture: A Systematic Review
Authors: Kiptulon Evans Kasmai , Elmadani Mohammed , Szőllősi Anna , Galgalo Dahabo Adi , Wami Girma Alemu , Siket Adrienn Ujváriné ,   Maté Orsolya1
Published: October 2024

Background: Globally, healthcare settings are facing significant nursing staff shortages occasioned by nurse turnover and experiencing difficulties in recruitment and retention of nursing professionals. The pressure of shortage of nurses and other healthcare workforce is so severe that World Health Organization has warned European countries and the globe that this shortage is a “ticking timebomb” if an action is not taken. Organizational culture is an important antecedent of nurse turnover that remains weakly studied. Despite a plethora of research on the global shortage of nurses and turnover, there have been few dedicated systematic literature reviews, and this study aimed to fill this gap.
Objective: To collect and collate evidence available in the literature on the impact of organizational culture on career and professional leaving among nurses and emphasize the critical role of organizational culture in turnover and retention of nurses.
Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive literature search according to the Population, Exposure and Outcome search strategy model was performed in six major electronic databases, including PubMed, Ovid Medline, Embase, CINAHL, Scopus and Web of Science, in July 2023. Studies that met the inclusion criteria set were screened using Rayyan and Covidence. Mixed Methods Appraisal Tool was used to assess the quality and risk of bias of the included articles.
RESULTS: The search yielded a total of 2,396 articles, of which 30 were included. The results demonstrate that nurse turnover remains a complex issue and continues to plague nations of the world. Organizational culture is an important antecedent of nurse turnover, with different types of organizational culture affecting turnover differently. We found overall that, negative organizational culture and climate was consistently associated with nurse’s turnover while positive culture improved nurse retention.
Conclusion: This study confirmed that organizational culture seriously influences nurse turnover. Nurse managers and hospital managements should strive to continuously monitor and build positive organizational cultures to raise quality of service delivery and retain nurse workforce.
The Joint Influence of Farm Production Diversity and Food Market Visits on Smallholder Household Diets in Northern Ethiopia
Authors: Balcha Tsegay , Lahiff Edward , Donnellan Trevor , Chisholm Nick
Published: October 2024

Although various studies have examined the relative influence of farm production diversity and market access on household dietary diversity, few studies have empirically investigated their joint interplay in shaping such diversity. This research addresses this gap based on cross-sectional data from 396 smallholder households in rural Tigray in Northern Ethiopia. In the analysis, a graphical interpretation of the relationship between farm production diversity and market access is followed by a deeper investigation using Poisson estimation methods. We use an alternative measure of market access, households’ frequency of food market visits, rigorously tested for stability, and compare it with alternative measures. Our findings reveal that farm production diversity and market access, jointly and independently, have a positive and significant nonlinear influence on rural smallholder household dietary diversity. The right mix between farm production diversity and smallholder households’ frequency of food market visits increases rural household dietary diversity.
Domaining based on geological information, variogram analysis and clustering algorithms
Authors: Khorram Farzaneh , Morshedy Amin Hossein
Published: October 2024

Domaining plays a significant role when major statistical or geostatistical variations are observed across a site, which can influence the results of spatial modeling. In this paper, hard and fuzzy clustering algorithms are used as a tool for domaining, with the input containing a combination of geological layers (lithology, alteration, and mineral zone), geochemical layers (Cu, Mo, Ag, and Au grade), and coordinates of boreholes from two exploration campaigns in eastern Kahang deposit, central Iran. The algorithms include the K-means, hierarchical, affinity propagation, self-organizing map (SOM), fuzzy c-means, and Gustafson-Kessel. The optimal number of clusters was determined between 3 and 4. The fuzziness and weighting parameters were respectively obtained in the ranges of 1.1-1.3 and 0.1-0.3, by considering and comparing several hard and fuzzy cluster validity indices.
Directional variograms were then calculated to define the anisotropy ellipsoid for the data within each domain to detect the model with the highest degree of anisotropic discrimination among domains. Based on the Jensen-Shannon measure, this model was found to be SOM, using a combination of qualitative and quantitative data as input information, and providing three domains as an output.
FACTORES ASSOCIADOS AO ABANDONO ESCOLAR DA RAPARIGA NO 3º CICLO DO ENSINO BÁSICO NA ESCOLA PRIMÁRIA COMPLETA 25 DE JUNHO, DISTRITO DE NHAMATANDA 2021-2022
Authors: Domingos Armando , Magande Edson Evaristo
Published: October 2024

RESUMO
O presente artigo visa analisar os factores associados à disortográfica como dificuldade especifica de aprendizagem nos alunos de 3º ciclo de Ensino Básico na Escola Primária Completa 25 de Junho. Para efectivação deste objetivo, utilizamos as seguintes metodologias: a pesquisa mista (qualitativa e quantitativa) método bibliográfico, com recursos as técnicas, a observação directa, entrevista e questionário. No que tange a população e amostra de estudo, tivemos como população 960 alunos e 14 professores, nesse âmbito a amostra foi escolhida aleatoriamente 100 alunos (50 rapazes e 50 raparigas) de idade compreendida de 12-14 anos e 10 professores da Escola Primária Completa 25 de Junho. O problema em questão nesta temática é a dificuldade de escrita, onde confundem os fonemas, discordância de número, de gênero, pontuação deslocada, junção de palavras e letras e no outro momento omissão de algumas letras nas palavras.  Relativamente aos principais resultados de pesquisa, constatamos no 3º ciclo de Ensino Básico na Escola Primária Completa 25 de Junho, os factores do tipo percetivo, intelectual, linguístico, afetivo-emocional, e factores de tipo pedagógico. Para efeito, há necessidade de promoção de capacitações aos professores em matéria de cognição e linguagem, metodologias de ensino diferenciadas para melhorar as suas práticas.
 
Palavras-Chave: Aprendizagem. Disortografia. Factores. Dificuldade.
ÁGUAS DAS ORIGENS, PEDRINHAS MIÚDAS E UM CADINHO DE POESIA
Authors: Guimarães Rodrigues Vieira Pedro Vitor
Published: October 2024

Este ensaio é um convite ao mergulho em águas de diferentes origens do pensamento e que banham diferentes modos de ser e praticar os mundos, tomando as artes da cena como um espaço capaz de receber as tensões e contradições desse desafio. O texto em si carrega o encantamento do escritor pelas culturas Bantu e Nagô, oferecendo às subjetividades leitoras uma narrativa que não se coloca à margem da linguagem poética na sua apresentação. Ironicamente, ele é fruto de uma pesquisa que foi iniciada durante um exercício de leitura crítica da obra Teogonia, de Hesíodo, poeta grego do século VIII a.C. Os apontamentos sobre tempo, humanidade e as histórias por meio das quais criamos as representações de muitas divindades tornaram-se objetos do desejo de conhecer, discutir e experimentar as águas sagradas de diferentes tempos e mundos. Águas evocadas desde o começo desses mundos, como as do Oceano, Titã que sibilava entre os terreiros de Gaia ou as do mundo pantanoso encontrado por Obatalá. Interessa-nos estudar os modos de pensar-fazer de uma corporeidade que bebe dessas cosmovisões de mundo para criar artes da cena. Por isso, a abordagem utilizada para desenhar as narrativas deste ensaio propõe um cenário mito-poético pluriversal e a atualização – ou reinvenção – dos corpos em seus processos criativos. Interessa-nos, também, discutir os artifícios que reservam às águas das origens das mito-poéticas africanas, mais escuridão que textualidades; mais apagamentos que sombras; mais negações que reparações; mais silêncios prescritos que vozes autorizadas; e mais lastro de navios que títulos outorgados.
LEI Nº 10.639/2003
Authors: Sant Ana Borges Seemann Marina Jenifer , Noyama Samon
Published: October 2024

Em um contexto em que a produção de saberes emancipatórios é afetada pela construção de um currículo com bases ideológicas neoliberais, cumpre verificar a validade, vigência e eficácia da legislação antirracista na área da educação, visando discutir as transformações curriculares na educação básica e a inserção de metodologias afroperspectivistas no currículo de Filosofia pós-reforma da educação. Ao reconhecer que ainda estamos trabalhando para consolidar o ensino de Filosofia como área de conhecimento e campo de pesquisa, e que os desdobramentos da Lei nº 10.639/2003 ainda alimentam o debate nacional, o presente artigo analisa o ensino de Filosofia do novo Currículo Paulista e a legislação responsável pela sua implementação, objetivando apontar se nos conteúdos presentes nas habilidades e competências do atual currículo, ou nos itinerários formativos, há o cumprimento da Lei nº 10.639/2003, uma legislação antirracista do ordenamento jurídico brasileiro, que estabelece o estudo da história e cultura africana e afro-brasileira em todo o âmbito curricular nacional.
Synthesis Techniques and Biomedical Applications of Cyclodextrin Metal-Organic Frameworks
Authors: Kankva Divyesh , Prajapati Parixit , Elossaily Gehan M. , Prajapati Bhupendra
Published: October 2024

Cyclodextrin Metal-Organic Frameworks (CD MOFs) represent an innovative
class of materials with remarkable properties and a broad range of applications.
This review provides a comprehensive overview of the synthesis techniques, structural
characterization, and diverse applications of CD-MOFs. By combining cyclodextrins
(CDs) with metal-organic frameworks (MOFs), CD-MOFs are developed with enhanced
functionality. The synthesis methods, including various metal sources, coordination
modes, and post-synthesis modifications, are discussed alongside advanced structural
characterization techniques like X-ray crystallography and spectroscopic methods. The
unique characteristics of CD-MOFs, such as high specific surface area, tunable porosity,
and customizable chemical structure, make them exceptional candidates for applications
in gas adsorption, drug delivery, catalysis, sensing, and environmental remediation.
Notably, CD-MOFs show significant promise as nanocarriers in drug delivery systems,
offering improved therapeutic outcomes due to their efficient encapsulation and controlled
release capabilities. The review highlights recent advancements and underscores
the potential impact of CD-MOFs in driving future innovations across various scientific
fields.
Exploring the Structure-Activity Relationship of COX Inhibitors with Anticancer Effects: A Comprehensive Review
Authors: Akgul Ozlem , Gul Mustafa , Gul Halise Inci
Published: October 2024

Cancer is a multifaceted disease with high mortality rates, and current treatments face
challenges such as chemoresistance and tumor adaptation. Since Virchow reported the first case of
cancer-related chronic inflammation, numerous clinical and epidemiological studies have indicated
that around 15-20% of malignant tumors are caused by inflammation. Cyclooxygenase-2 (COX-2),
which is the key enzyme in inflammation, has been implicated in tumorigenesis through various
mechanisms, including promoting angiogenesis, inhibiting apoptosis, and enhancing the invasiveness
of cancer cells. Moreover, COX inhibitors have demonstrated a substantial reduction in death
rates associated with esophageal and colon cancer. In this context, targeting COX-2 is an effective
strategy for cancer prevention and treatment.

This review focuses on the analysis of studies conducted between 2014 and 2024, which evaluate
the structure-activity relationship of molecules intended to exhibit cytotoxic activity through COX
inhibition. The studies followed both classical and non-classical COX-2 selective drug design
strategies. While some focused on the classical approach, utilizing diaryl heterocyclic structures,
others explored non-classical designs with a cyclic central scaffold and a linear core. Additionally,
several manuscripts employed well-known COX inhibitors, including licofelone, indomethacin,
naproxen, tolfenamate, celecoxib, flumizole, and ketoprofen, as starting points for further derivatization
and optimization. Cytotoxic activity was evaluated using various cell lines, including MCF-
7, HCT-116, and A549, through assays such as MTT, CellTiter, and MTS. Additionally, studies
examined the relationship between COX-2 inhibition and key cancer pathways, including apoptosis
and the involvement of enzymes like HDAC, EGFR, and topoisomerase.

The majority of studies reported promising cytotoxic activity in COX-2 selective inhibitors. Compounds
synthesized with diphenyl heterocyclic scaffolds exhibited enhanced COX-2 selectivity
and anticancer efficacy. In particular, derivatives in studies 9, 16, and 24 demonstrated significant
activity comparable to standard drugs like celecoxib and doxorubicin. However, only a few studies
indicated a weak correlation between COX-2 inhibition and cytotoxicity, suggesting the need for
further investigation into other cancer-related mechanisms.

This review highlights the potential of COX-2 selective inhibitors in anticancer drug development.
The findings support the development of selective COX-2 inhibitors with diverse chemical structures
as a promising strategy for cancer therapy.
Efficacy and Safety of Sarpogrelate on Symptom Improvement in Patients with Peripheral Arterial Disease (PAD) and/or Being at Risk of PAD: A Single Arm, Multi-Centered, Open-Label Trial
Authors: Won Jong Chul , Song Tae-Jin , Park Jae Hyoung , Kim Hee-Tae , Lee Kyong Hoon , Park Keun Yong , Jeong Ho-Seung , Jeon Ung , Min Kyung Wan , Lim Soo
Published: October 2024

Aims:

To assess the efficacy and safety of sarpogrelate (300 mg) for symptom improvement
in patients having peripheral arterial disease (PAD) and/or being at risk of PAD in clinical
practice using the Peripheral Artery Questionnaire (PAQ).

Background:

Symptomatic changes with antiplatelets in patients with PAD are limited.

Objective:

To determine the effect and safety of sarpogrelate on the PAQ at 24 weeks from baseline.

Methods:

A total of 1003 patients having PAD and/or being at risk of PAD from 17 tertiary hospitals
in South Korea who were treated with sarpogrelate, were enrolled in this study. PAQs were
collected at baseline and at 12 and 24 weeks, together with physical examination and vital signs
measurements. Lifestyle pattern was also investigated.

Results:

The average PAQ Summary Score in the efficacy evaluation analysis group significantly
improved from 62.9 ± 23.7 at baseline to 68.9 ± 21.7 at 24 weeks (P<0.0001). Physical limitation
items significantly improved from 69.5 ± 30.0 at baseline to 72.9 ± 28.3 after 24 weeks
(P=0.0011). Symptom stability also significantly improved from 52.1 ± 21.6 at baseline to 63.6 ±
22.9 after 24 weeks (P<0.0001). Symptoms, treatment satisfaction, quality of life, and social limitation
domains all improved after treatment. A total of 201 patients reported adverse events
(20.0%), not directly associated with treatment.

Conclusion:

Treatment with 300 mg (orally) of sarpogrelate demonstrated statistically significant
improvements in all domains and for the summary score of the PAQ at 24 weeks, it gave good results
in terms of safety. Sarpogrelate may be helpful in reducing symptoms related to PAD.