bluuebunny/crossref_metadata_2025 huggingface dataset:
Availability of health-promoting interventions in high schools in Quebec, Canada, by school deprivation level
Authors: Kalubi Jodi , Riglea Teodora , Wellman Robert J. , O’Loughlin Jennifer , Maximova Katerina
Published: July 2023

Introduction

School-based health-promoting interventions (HPIs) foster adolescent health and well-being. Access to HPIs may differ by the socioeconomic advantage of students at each school (school deprivation). We assessed the importance of health issues and availability of HPIs and extracurricular activities by school deprivation in high schools in Quebec, Canada.

Methods

In 2016/17, 2017/18 and 2018/19, we interviewed school principals or a designee in 48 public high schools classified as disadvantaged (33%) or advantaged (67%). Schools rated whether 13 common health-related issues were important (i.e. warranted intervention) in their student population and reported whether HPIs to address these or other health issues and/or sports or special interest extracurricular activities had been available in the past year.

Results

84% of disadvantaged schools offered one or more HPIs in the past year compared to 73% of advantaged schools. Higher proportions of disadvantaged schools perceived most of 13 health-related issues as important. HPIs for bullying/exclusion, sex education and physical activity (issues subject to government mandates) were available in most schools. Higher proportions of disadvantaged schools offered non-mandated HPIs (i.e. for healthy eating, mental health/well-being and substance use). Higher proportions of advantaged schools offered extracurricular activities in all areas other than non-competitive sports, which was offered by equal proportions of advantaged and disadvantaged schools.

Conclusion

Government mandates appear to facilitate universal availability of HPIs in schools, possibly boosting equity in school-based health promotion. Further investigation of possible differences in the content, implementation and/or effects of HPIs based on school deprivation is warranted.
Les confinements et les blessures à vélo : une analyse temporelle des taux de blessures au Québec au cours de la première année de la pandémie
Authors: Auger Nathalie , Lewin Antoine , Brousseau Émilie , Ayoub Aimina , Blaser Christine , Luu Thuy Mai
Published: July 2023

Introduction

Le vélo a gagné en popularité au cours de la pandémie de COVID-19, sans que l’on connaisse l’impact de cette situation sur les blessures chez les cyclistes. Nous avons étudié l’effet des confinements sur les hospitalisations associées à des blessures à vélo.

Méthodologie

Nous avons relevé les cas d’hospitalisation pour blessure à vélo au Québec (Canada) entre avril 2006 et mars 2021. Nous avons utilisé des rapports de taux (RT) et des intervalles de confiance (IC) à 95 % pour comparer les taux d’hospitalisation par type de blessure subie à vélo et par site anatomique au cours de deux vagues de la pandémie. Nous avons appliqué un modèle de régression de type séries chronologiques interrompues afin d’évaluer l’effet des confinements sur les taux mensuels d’hospitalisation associés aux blessures à vélo, en fonction de l’âge, du sexe et d’autres caractéristiques.

Résultats

Il y a eu 2 020 hospitalisations pour blessure à vélo entre mars 2020 et mars 2021, dont 617 pendant le premier confinement et 67 pendant le deuxième confinement. Par rapport à la période prépandémique, la plus grande augmentation du risque de blessures liées aux déplacements à vélo pendant le premier confinement a concerné les fractures (RT = 1,44; IC à 95 % : 1,26 à 1,64) et les lésions traumatiques à la tête et au cou (RT = 1,59; IC à 95 % : 1,19 à 2,12). Lors de chaque mois durant le premier confinement, les taux d’hospitalisation pour blessure à vélo ont été considérablement plus élevés qu’en période prépandémique chez les adultes, les adolescents et les personnes vivant dans des quartiers favorisés sur le plan socio-économique ainsi que dans des quartiers à faible densité de population dite racisée. Aucune association avec les blessures à vélo n’a été constatée lors du deuxième confinement.

Conclusion

Le premier confinement a déclenché une augmentation marquée des hospitalisations pour blessures à vélo, en particulier chez les adultes, les adolescents et les personnes vivant dans des quartiers plus favorisés sur le plan socio-économique et à plus faible densité de population dite racisée.
Двойные последовательности и их свойства
Authors: Казаков Илья
Published: July 2023

Рассмотрены понятия сходимости двойной последовательности: поточечная, равномерная, двойной предел
Prevalensi dan Luaran Pasien dengan Spekrtum Plasenta Akreta
Authors:   Padjadjaran University, Gurnita Adiguna , Irianti Setyorini
Published: July 2023

Tujuan: Plasenta akreta mengakibatkan risiko perdarahan ibu dan morbiditas anak akibat prematuritas. Prevalensi dan luaran pasien dengan spekrum plasenta akreta di Indonesia masih rendah. Penelitian ini bertujuan mencari tingkat prevalensi serta membandingkan luaran pada ibu dengan plasenta akreta. Metode: Desain penelitian merupakan penelitian deskriptif observasional yang diperoleh dari rekam medis tahun 2015–2019 di RSUP Dr. Hasan Sadikin Bandung periode Februari-April 2020. Hasil: Pada 39 pasien dengan plasenta akreta didapatkan wanita berusia >35 tahun sebanyak 22 orang (56,4%). Kondisi yang banyak ditemui pada pasien plasenta akreta meliputi multipara sebanyak 26 orang (66,7%) dan riwayat seksio sesarea >1x sebanyak 20 orang (51.3%). Sebanyak 30 pasien (76,9%) membutuhkan 3 unit 200 mL Packed Red Cell (PRC). Sebanyak 31 bayi (83,7%) yang lahir dari ibu dengan plasenta akreta lahir kurang bulan atau prematur dan 26 bayi (70,2%) mengalami berat badan lahir rendah (BBLR), serta dari 17 bayi prematur, 8 (52,9%) bayi mengalami stunting. Kesimpulan: Pasien dengan plasenta akreta di RSUP Dr. Hasan Sadikin Bandung mayoritas berusia tua, merupakan multipara dan memiliki riwayat seksio sesarea >1x. Pasien dengan plasenta akreta cenderung mengalami pendarahan yang banyak serta terdapat banyak bayi BBLR dan stunting.
A Comparative Analysis of Trademark Rights Protection
Authors: Shuhufi Muhammad , Firdayanti
Published: July 2023

This study aims to identify the premise and types of legal protection for trademark rights, comparing Islamic and positive law to explore their roles in safeguarding these rights. Information technology, while aligned with business advancements, can create loopholes for mark violations Irresponsible acts such as brand piracy pose a significant threat to brand proprietors, making trademark rights a major source of civil disputes and illegal acts. This study conducts a comparative analysis of legal literature, focusing on books about Trademark Rights as the primary data source. Data were collected, analyzed, categorized, and conclusions are drawn. The findings showed two forms of legal protection for trademark, which included preventive and coercive. Preventive measures involve government or institutional warnings and restrictions on obligations, while coercive aspects impose penalties on counterfeiters. In Islamic law, forgery is considered the prohibited action of tazyīf, resulting in the infringement of rights of others.
Current mechanisms in the pathogenesis of lung fibrosis
Authors: Engin Muhammet Mesut Nezir , Özdemir Öner
Published: July 2023

Pulmonary fibrosis is a diverse group of lung disorders defined by varying degrees of fibrosis and inflammation in the pulmonary parenchyma. While it may be caused by a known disease, e.g., autoimmune or connective tissue disorder, drugs, hypersensitivity to inhaled organic antigens, or sarcoidosis, it also occurs to be idiopathic. When we examine the pathogenesis of lung fibrosis, we see that cellular aging plays a major role. Lung fibroblasts play an active role in the regeneration process. However, despite all the information, the pathogenesis of lung fibrosis is not clearly understood. It is not yet clear how senescent cells in the lung mingle and cause fibrosis. The pathogenesis of lung fibrosis will be understood more clearly following future studies.
Recognition of text areas with personal data on diagnostic images
Authors: Novik V. P. , Kulberg N. S. , Arzamasov K. M. , Chetverikov S. F. , Khoruzhaya A. N. , Kozlov D. V. , Kremneva E. I.
Published: July 2023

The aim of the study is to develop a method for detecting areas of text with private data on medical diagnostic images using the Tesseract module and the modified Levenshtein distance.

Materials and methods. For threshold filtering, the brightness of the points belonging to the text characters in the images is determined at the initial stage. The dynamic threshold is calculated from the histogram of the brightness of the pixels of the image. Next, the Tesseract module is used for primary text recognition. Based on the tag values from DICOM files, a set of strings was formed to search for them in the recognized text. A modified Levenshtein distance was used to search for these strings. A set of DICOM files of the “Dose Report” type was used to test the algorithm. The accuracy was assessed by experts marking up blocks of private information on images.

Results. A tool has been developed with a set of metrics and optimal thresholds for choosing decisive rules in finding matches that allow detecting areas of text with private data on medical images. For this tool, the accuracy of localization of areas with personal data on a set of 1131 medical images was determined in comparison with expert markup, which is 99.86%.

Conclusion. The tool developed within the framework of this study allows identifying personal data on digital medical images with high accuracy, which indicates the possibility of its practical application in the preparation of data sets.
High values of baseline volumetric PET biomarkers in classical Hodgkin's lymphoma as predictors of unfavourable prognosis
Authors: Metelkina M. V. , Aslanidis I. P. , Mukhortova O. V. , Pursanova D. M. , Shurupova I. V. , Manukova V. A. , Trifonova T. A. , Chekalov A. M.
Published: July 2023

Purpose: To analyse the prognostic value of the initial volumetric PET biomarkers – the total metabolic tumor volume (MTV) and the total lesion glycolysis (TLG) – in classic Hodgkin's lymphoma (cHL) and determine their optimal threshold values for prognosis.

Material and methods. This retrospective study included 62 cHL patients with different stages who underwent staging with 18F-FGD PET/CT. The follow-up period was from 6 to 61 months after the baseline PET/CT, 41 patients remained in remission, 10 patients had refractory course, 11 relapsed. The examinations were processed with automatic (multi-foci segmentation – MFS) method to obtain MTV and TLG using two fixed absolute thresholds (SUVmax ≥ 2.5 and SUVmax ≥ 4.0) and one relative threshold (41% of SUVmax).

Results. In subgroups with disease remission (n = 41) and refractory course or relapse (n = 21), statistically significant differences between MTV and TLG with the two thresholds were found – SUVmax ≥ 2.5 and 41% of SUVmax (p < 0.05). When using threshold of SUVmax ≥ 4.0 statistically differences between the mean of MTV and TLG were no detected.

Univariate analysis revealed correlation between progression-free survival and volumetric PET biomarkers (MTV and TLG) with three thresholds (SUVmax ≥ 2.5, SUVmax ≥ 4.0, and 41% of SUVmax).

Conclusion. In cHL high values of initial volumetric PET biomarkers – MTV and TLG – calculated with three thresholds (SUVmax ≥ 2.5, SUVmax ≥ 4.0, and 41% of SUVmax) are associated with unfavourable prognosis – a high probability of refractory disease course or relapse.

The optimal prognostic thresholds values of MTV and TLG in the analysed group were determined respectively: SUVmax ≥ 2.5 – 204 cm3 and 961, at 41% of SUVmax – 105 cm3 and 620.
SCREENING CRITERIA SURFAKTAN NaLS AMPAS TEBU PADA INTERMEDIATE CRUDE OIL
Authors: Pradhana Renato Aditya Patria , Fathaddin M. Taufiq , Setiati Rini , Prakoso Suryo , Rakhmanto Pri Agung , Sumirat Iwan
Published: July 2023

Tujuan  Screening criteria adalah untuk mengetahui kecocokan surfaktan NaLS ampas tebu sebagai fluida injeksi terhadap sampel minyak intermediate. Metode yang digunakan pada screening criteria ini adalah uji laboratorium  meliputi uji aqueous stability, uji perubahan fasa, uji emulsi, uji tegangan antar muka (IFT) dan kestabilan thermal. Hasil screening criteria surfaktan NaLS ampas tebu terhadap sampel intermediate crude oil menyatakan bahwa surfaktan NaLS ampas tebu tidak menggumpal dan tetap jernih, sehingga memenuhi ketentuan untuk uji selanjutnya. Surfaktan NaLS ampas tebu ini mampu membentuk emulsi fasa tengah sebesar 10% dan stabillitas thermal yang cukup baik dengan nilai IFT 4,4 – 4,9 mN/m. Dengan demikian dapat disimpulkan bahwa surfaktan NaLS ampas tebu telah memenuhi kriteria baik dengan sampel intermediate crude oil dan dapat  digunakan sebagai fluida injeksi dalam proses Enhanced Oil Recovery.
Hotel Post Covid-19: How Preparedness Affects Guest Satisfaction In A Mid-Scales Hotel
Authors: Ervina Ersy , Taufiq Riza , Ratna Ratu
Published: July 2023

Post-pandemic health strategies will be critical to hotel success. Guests' expectations regarding sanitation, cleanliness, safety, and health continue to rise. As a mitigation plan, hotel preparedness is essential to ensure guest satisfaction. Still, few studies examine the relationship between preparedness and guest satisfaction during the COVID-19 pandemic. This study aims to determine the effect of preparedness on guest satisfaction and assess the preparedness’s importance and performance on guest satisfaction in Bandung. The mid-scale hotel category was chosen as the unit of study since it contains the majority of hotels in Bandung. This quantitative cross-sectional study was undertaken. The data was gathered using a questionnaire survey of respondents who had stayed in the mid-scale hotel in Bandung during the pandemic. The data was analyzed using Structural Equation Modeling (SEM) PLS and Importance-Performance Map Analysis (IPMA). According to the research findings, hotel preparedness has a synergic effect on guest satisfaction. Preparedness is a process, not a product, and each practice cannot be attained separately but must be integrated to ensure guest satisfaction. This research contributes that implementing crisis management through preparedness has an essential role in guest satisfaction; practically, hotels are expected to focus on cleanliness quality and strengthen human resources by enhancing employee competencies since they have the highest level of importance in reducing the risk of COVID-19.
Keywords— COVID-19, Guest Satisfaction, Mid-Scale Hotel, Preparedness
ARKETIPE KEPRIBADIAN KYOUYA DALAM MANGA OURAN KOUKOU HOSUTO KURABU KARYA HATORI BISCO DENGAN PENDEKATAN PSIKOANALISIS
Authors: Putri Ratida Adela Rizka , Ainie Isnin
Published: July 2023

Penelitian ini membahas tentang arketipe kepribadian pada tokoh Ootori Kyouya dalam manga Ouran Koukou Hosuto Kurabu karya Hatori Bisco. Arketipe adalah bayangan – bayangan leluhur atau arkaik (archaic) yang datang dari ketidaksadaran kolektif. Arketipe terdiri dari tujuh macam, yaitu persona, anima-animus, shadow (bayangan), great mother (ibu agung), wise old man (orang bijak), hero (pahlawan), dan self (diri). Penelitian ini dianalisis melalui pendekatan psikoanalisis Carl Gustav Jung. Penelitian ini menggunakan metode kualitatif dengan pendekatan deskriptif. Teknik pengumpulan data yang digunakan dalam penelitian ini adalah dengan menggunakan teknik pustaka. Teknik pustaka yaitu suatu teknik penelitian yang dilakukan dengan cara pengambilan data yang berasal dari sumber data tertulis. Sumber data yang digunakan dalam penelitian ini adalah manga Ouran Koukou Hosuto Kurabu yang diunduh secara daring, sedangkan data yang digunakan berupa prolog, monolog maupun percakapan tokoh Kyouya dalam manga Ouran Koukou Hosuto Kurabu pada volume 1-11. Dari penelitian ini, ditemukan data yang menampakkan arketipe pada tokoh Kyouya, yaitu arketipe persona, arketipe anima, arketipe shadow (bayangan), arketipe great mother (ibu agung), arketipe wise old man (orang tua bijak), arketipe hero (pahlwan), dan arketipe self (diri). Arketipe animus tidak ditemukan pada diri Kyouya, karena animus adalah kepribadian maskulin dari seorang wanita, sedangkan Kyouya adalah seorang lelaki. Jadi, kyouya tidak memiliki arketipe animus. Dari arketipe-arketipe yang dimiliki oleh Kyouya tersebut, menjadikannya sebagai pribadi yang awalnya hanya memikirkan kepentingan pribadinya saja, menjadi pribadi yang akhirnya menyadari bahwa teman lebih penting dari keuntungan-keuntungan yang selama ini ia perjuangkan.

Kata kunci: arketipe; kepribadian; manga; psikoanalisis; tokoh
Negotiations of Anxiety in the Discourses of Melanie Klein and Edgar Allan Poe
Authors: Cârstea Daniela
Published: July 2023

In my discussion of a selection of Poe’s tales, I intend to reveal the latent Kleinian dynamics which abound in texts that pivot on the dialectic between aggression and reparation: the narrative can be thought of as negotiating the representation of phantasies which are deployed to avoid intolerable anxiety, requiring most often than not a withdrawal from reality. The texts under analysis seem to play out with acute awareness the pain of fragmentation and disintegration and the ambivalent phantasies arising from the need to mitigate the pain of the internal situation. Poe’s characters’ traumatic encounters will foreground the struggle, fraught with ambivalence, to separate from and discern that which is other.
Shop Steward–Management Relationships: A Predictor of Employee–Organisation Relationships
Authors: Bowler Jennifer
Published: July 2023

In this South African study, I aimed to identify the respective influence of human resources practices, procedural fairness, the shop steward–management relationship, and the employee–supervisor relationship on the state of the employee’s relationship with the organisation. The method was quantitative and cross-sectional. A total of 660 production employees from 14 organisations in the value chain of the automotive industry in the Nelson Mandela Bay area of South Africa supplied responses. The relationships between variables were determined through structural equation modelling. Although the study was a cross-sectional study, the use of structural equation modelling points to cause and effect relationships. The best-fit model revealed that the dominant predictor of the employees’ perception of their relationship with the organisation was their perception of the quality of the relationship between shop stewards and management. Trade unions as trusted leaders may fulfil a very important role in mediating workplace relationships, especially in highly unequal societies with deep social divisions. The pivotal importance of the employees’ perception of the shop steward–management relationship creates an onus on both management and trade unions to work to move this relationship from adversarial to constructive and effective. The results may be generalised to highlight the importance of employee representation, whether unionised or non-unionised, at the workplace level. As leaders in the workplace, employee representatives provide the mechanism to mediate relationships, build trust and create strong employee–supervisor and employee–organisation bonds which may have a positive impact on individual and organisational performance.
Poverty and unpreparedness make monsters out of ordinary hazards
Authors: Shah Afroz Ahmad
Published: July 2023

Flood disasters are expected to increase because of the climate change-related sea level rise. While impacts on regional and local scales may vary, mapping that variation is critical for understanding the risks our preparedness to tackle them. The historical and contemporary data show that ordinary hazards often turn into monsters because of poverty and unpreparedness.
Malignant Angiosarcoma Masquerading as Benign Epithelioid Hemangioma
Authors: Daftary Karishma , Brieva Joaquin , Chovatiya Raj
Published: July 2023

In this report, we describe a case of a healthy 67-year-old female with rapidly growing red nodules on the scalp that demonstrated histological features of benign epithelioid hemangioma on multiple instances yet behaved clinically as a malignant angiosarcoma. Despite multiple rounds of resection, radiation, and chemotherapy, the patient ultimately succumbed from her widely metastatic disease. Diagnosis of vascular neoplasms, including the spectrum of low-grade epithelioid hemangioma, intermediate-grade epithelioid hemangioendothelioma, and high-grade angiosarcoma remains challenging due to overlapping clinical and histopathological features. This report is presented to highlight the need for clinicians to interpret histopathology, whether benign or malignant, in the context of clinical observation as the clinical course may not always match the biopsy.
Syphilis in HIV Positive Individuals and the Importance of a Skin Exam: A Case Report
Authors: Chokshi Aditi , Diaz Amaury
Published: July 2023

Among HIV-positive patients, co-infection with syphilis is estimated to be as high as 20%. The diagnosis of syphilis is often missed due to its asymptomatic nature during its primary stages. A 68-year-old HIV-positive male presented with perianal lesions to his primary care physician twice. He was then referred to two different specialists before a proper physical exam was conducted after which he was diagnosed with otosyphilis and neurosyphilis. Physicians should have a higher index of clinical suspicion for syphilis in HIV-positive patients to allow for prompt diagnosis given the propensity of these patients to develop more severe neurological and ophthalmologic manifestations. This case highlights the importance of a thorough skin exam by a primary care physician when examining patients to allow for an earlier and accurate diagnosis and thus avoiding unnecessary referrals to specialists.
Atypical Human Papillomavirus Infection with Secondary Tinea in a Middle-Aged Caucasian Male
Authors: Dhandha Maulik Manharlal , Ghosh Debjit , Tyring Stephen , Rady Peter
Published: July 2023

We present a case of an atypical diffuse cutaneous eruption due to HPV infection and Tinea in a 51-year-old male patient with a past medical history of mild cytopenia, vasectomy and difficult socio-economic situation. Differential diagnosis at initial visit included Epidermodysplasia Verruciformis vs Pityriasis Rubra Pilaris vs Secondary Syphilis vs Xanthoma Disseminatum vs atypical presentation of Tinea vs less likely other. Through clinical examination, repeat biopsy, tissue culture and extensive HPV testing, it was revealed that the patient had multiple HPV infections type FA52, 96, 16 and 13, with a possible secondary Tinea infection. The patient was treated with antifungal medications first.  Topical Cidofovir was recommended but not covered by insurance. The skin eruption improved gradually  highlighting the importance of additional samples, tissue culture and extensive HPV testing in such atypical cases. Our case describes the importance of multidisciplinary care to help patients with proper diagnostics and treatment regimens.
Vesiculobullous Erythema Migrans with Central Necrosis
Authors: Stashower Julian , Wills Abigail , Zlotoff Barrett
Published: July 2023

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Cutaneous Fungal Infections Associated with Pediatric-onset Diabetes: A Case-control Study in the All of Us Research Program
Authors: Strouphauer Emily , Katta Rajani
Published: July 2023

Introduction: With the rapidly increasing incidence of pediatric diabetes mellitus (DM) in the United States, an understanding of the risk of long-term cutaneous consequences, particularly the risk of cutaneous fungal infections, is important. In this study, we evaluate the association between pediatric-onset Type 1 diabetes (T1D) and Type 2 diabetes (T2D) with the later development of cutaneous fungal infections.
Methods: Through the All of Us electronic health record database, 300 de-identified participants with a diagnosis of T1D or T2D before the age of 18 were selected at random. These 300 participants, composing our pediatric-onset diabetes cohort, were diagnosed with T1D and/or T2D before the age of 18 and developed cutaneous fungal infections between less than 1 and 24 years later. Each case was age-, race-, and sex-matched to four control participants without T1D or T2D diagnoses, and we compared cutaneous fungal infections between pediatric-onset diabetic cases and controls.
Results: Compared to the control cohort, participants with pediatric-onset diabetes were significantly more likely to present in adulthood with candidiasis of the mouth, onychomycosis, pityriasis versicolor, candidiasis of urogenital sites, and unspecified superficial mycosis, as well as dermatophytosis of the body, feet, and perianal regions than their non-diabetic counterparts.
Conclusion: With the increasing incidence of pediatric DM, it will be important for clinicians to monitor the long-term cutaneous complications, including the risk of fungal infections, to improve dermatology patient outcomes. Further research is warranted to investigate the role of childhood diabetes intervention and glycemic control in mitigating dermatologic fungal complications through adulthood.
Perspectives of Vitiligo Patients: Voices from National Vitiligo Conferences
Authors: O'Connell Katie , Youssef Ronnie M , Torres Angeli Eloise , Huggins Richard H
Published: July 2023

In the United States, many individual vitiligo support groups have collaborated on a joint national US World Vitiligo Day since 2016. As part of the 2020 and 2021 US World Vitiligo Day virtual events, polls were conducted that solicited information from participants regarding their life with vitiligo. A majority (76% in 2020; 92% in 2021) would like a cure for vitiligo. In 2020 and 2021, 40% and 35% responded they both show and hide their vitiligo when asked how they display their skin. A minority, 14% in 2020 and 5% in 2021, reported their vitiligo treatments were fully covered by their insurance. When polled about acceptance, in 2021, 40% reported they were accepting of their vitiligo most days. In 2021, 20% were interested in trying treatments, even if they included moderate side effects and 29% were interested, if minimal side effects. Results herein suggest that while many patients are accepting of their disease, many also want a cure. Additionally, dermatologists should advocate for coverage of vitiligo treatment, while also taking insurance coverage into account when discussing treatment options. Further, vitiligo patients require individualized care considering some patients may be open to attempting more aggressive treatment, despite the side effect profiles, while others are not interested in treatment or only willing to attempt treatments without side effects.
Combining the 31-gene expression profile test for cutaneous melanoma with the American Joint Committee on Cancer staging identifies the highest-risk patients with stage I-II disease
Authors: Hyams David , Byun Jung , Martin Brian , Bailey Christine , Stumpf Timothy , Petkov Valentina
Published: July 2023

Introduction: Management guidelines for cutaneous melanoma (CM) are based on patients’ recurrence risk by stage. Most newly diagnosed patients (88%) will be categorized as node-negative (stage I-II) and will be considered low-risk. However, because of the size of this group, the small percentage of stage I-II individuals who do die of melanoma account for the majority of melanoma-associated deaths. In collaboration with the Surveillance, Epidemiology, and End Results (SEER) program, we demonstrated, in a large, unselected cohort of clinically tested patients, that the 31-GEP test identifies those individuals with stage I-II disease, who have higher risk of melanoma-specific death and who may benefit from more aggressive management. 

Methods: SEER registries linked individuals diagnosed with CM between 2013-2018 were linked to data for 31-GEP-tested patients (N=9,207 after exclusions). For this study, analysis focused on the subset reported as node-negative (N=6,301). Patient 5-year melanoma-specific survival (MSS) was estimated using Kaplan-Meier analysis and the log-rank test for patients considered by the 31-GEP to be low-risk (Class 1A), intermediate-risk (Class 1B/2A), or high-risk (Class 2B). Multivariable Cox regression analysis was used to evaluate significant predictors of melanoma-specific death. Notably, at the time of diagnosis, none of the immune checkpoint inhibitor or targeted signal transduction therapies were approved for use in node-negative patients, providing a largely contemporary therapy naïve cohort.  

Results: Patients with a Class 2B 31-GEP result had significantly lower 5-year MSS than patients with Class 1B/2A or Class 1A results (85.0% vs. 95.6% vs. 97.9%, p<0.001). The 31-GEP Class 2B result (HR=4.08, p<0.001) was the strongest predictor of melanoma-specific death. Breslow thickness (HR=1.16, p=0.002), presence of ulceration (HR=2.10, p=0.006), and age (HR=1.05, p<0.001) were also significant predictors of melanoma-specific death. The 31-GEP had a sensitivity of 78.4% and a negative predictive value (NPV) of 99.4%. Combining the 31-GEP Class result with AJCC staging could increase the sensitivity to 82.0% while maintaining a high NPV (99.4%). 

Conclusion: In a large, unselected cohort of patients with stage I-II CM, the 31-GEP Class 2B identified patients with a high risk of progression and death from melanoma who should be considered for more aggressive management. Conversely, the high NPV suggests that the 31-GEP reliably identifies patients at low risk of tumor progression who could safely avoid intensive surveillance and intervention.
Evaluation of the Possible Protective Effect of Fisetin against Cyclophosphamide-induced Genotoxicity in Bone Marrow and Spleen Cells of Male Rats
Authors: Jabber Amani , Al-Shawi Nada N. , Hasan Ali F.
Published: July 2023

Fisetin is a plant flavonoid found in strawberries and other fruits and vegetables such as apples, persimmons, and onions. It has many pharmacological effects like anti-inflammatory, antioxidant, cardioprotective, neuroprotective, and anti-carcinogenicity which are attributed to its ability to reduce oxidative stress which considers the main reason for different disease conditions. Genotoxicity refers to the genetic material destruction within the cell which can be caused by different chemicals as well as radiation. The present study evaluates the effect of orally-administered fisetin daily for seven constitutive days on genotoxicity induced by cyclophosphamide in rats’ bone marrow and spleen cells. Results showed that fisetin exhibited a non-significant increase in total chromosomal aberrations, mitotic index, and micronucleus appearance in comparison with the same parameters in control group rats (p>0.05); and it produces protection when administered before cyclophosphamide by causing significant decrease (p 0.05) in the total chromosomal aberrations, chromatid breaks, ring chromosome, and chromosomal breaks in BM cells and total chromosomal aberrations and chromosomal breaks in spleen cells were shown. In conclusion, fisetin has no genotoxic effect on bone marrow and spleen cells when orally administered alone to rats, and it exhibits some protection against cyclophosphamide-induced genotoxicity.
Assessment of Serum Levels of the WNT Pathway Antagonist (Dickkopf-1) in a Sample of Type 2 Diabetic Patients with Retinopathy using Two Groups of Antidiabetics
Authors: Kadhim Sara A , Saleh Eman S. , Jaafar Aymen D.
Published: July 2023

Objectives: Dickkopf-1 (DKK-1) is WNT/b-catenin pathway antagonist which plays a detrimental role in the development of diabetic retinopathy (DR). This research aimed to assess serum DKK-1 levels in diabetic patients who have and have not developed DR and, compare them with the control subjects finding out whether we can use it as an indicator for DR early diagnosis and to find out which one of the widely used two groups of antidiabetic treatments had the greater effect on this biomarker and hence on the progression of DR. Methods: The study participants were divided into two subgroups: First, 70 patients (36 male, 34 female) with type 2 diabetes mellitus, among them 35 patients diagnosed with DR and 35 with no evidence of DR, and secondly, non-diabetic controls (11 male, 9 female) were selected from the patients attending Ibn AL-Haitham hospital for ophthalmology and a specialized center for endocrinology and diabetes. Venous blood samples of all participants were drawn after an overnight fast, and serum samples were stored at -20ºC until DKK-1 assay. Results: Serum DKK-1 showed significantly lower levels in diabetic patients with (6.1 ± 2 ng/mL) or without DR (14 ± 6.2 ng/mL) when compared to those of controls (34 ± 12.25 ng/mL) (p 0.05). Furthermore, serum DKK-1 levels were lower in the late stage of DR compared to the early stage 5.6 ± 1.7 and 7 ± 1.9 ng/mL, respectively. Furthermore, DPP-4 inhibitors cause a better increment in DKK-1 levels when compared to SU in the NDR group. Conclusions: Reduced serum levels of DKK-1 are related to the existence and worsening of DR and have the prospect to serve as an indicator for this condition.
Design, Development, and Evaluation of Transdermal Patches Containing Donepezil Hydrochloride
Authors: SK Valeveti , S Pashikanti
Published: July 2023

This study aimed to develop a donepezil hydrochloride (DH) transdermal drug delivery system to address non-compliance due to dementia in Alzheimer’s patients. DH has a low dose, balanced hydrophilicity/lipophilicity, and low toxicity making it suitable for transdermal. DH transdermal patches were prepared using a polymer and plasticizer matrix system via box-Behnken design and evaluated for properties. Formulation B2 containing hydroxy propyl methyl cellulose (HPMC), ethyl cellulose (EC), and xanthan gum was optimal, exhibiting a maximum of ~99.17% in-vitro drug release for 48 hours. In-vivo pharmacokinetic parameters studied in rabbits were superior to commercial DH tablets. The study demonstrates the potential for DH transdermal patches as an alternative to oral medication for Alzheimer’s patients. The patches can provide sustained release for prolonged periods without requiring multiple doses. However, further confirmation is needed via in-vivo pharmacodynamic and human pharmacokinetic studies.
Detecting the Concentration of Some Trace Elements in Blood Samples of Fuel Station Workers
Authors: Alhadithi Amani Q. , Kadhim Faiza
Published: July 2023

Trace elements mediate critical biological events by functioning as cofactors or catalysts for numerous enzymes and as centers for enzyme and protein structure stabilization. As a result, imbalances in trace element metabolism and homeostasis (deficiency or excess) may play a role in a number of disorders. The aim of this study was to investigate the blood concentration of essential trace elements of fuel station workers blood in AL-Ramadi city compared with any people who didn’t work in fuel station (control) by measurement of zinc (Zn), copper (Cu), iron (Fe) because they have negative effects on metabolism and considered to be carcinogenic factors.
Total 50 male fuel workers and 50 control from ten fuel stations at Al-Ramadi City- Iraq, were participated in the present study. The levels of Zn, Cu and Fe in serum were measured spectrophotometrically by using laboratory kits.
The result clarified that there was a significant increase in zinc, copper and iron mean (p 0.05) in fuel workers group compared to control group. Age had a significant correlation with copper levels and no correlation with zinc and iron. The daily hours of exposure showed no significant correlation with zinc, copper and iron. There was a significant increase in zinc levels in smokers compared to nonsmokers; copper and iron showed no correlation with smoking. The years of work in fuel stations significantly correlated with zinc and copper levels, while it showed no correlation with iron levels. The results of this study showed that there is no significant correlation between zinc, copper and the worker’s weight, while it showed a significant weak positive correlation between iron and the worker’s weight (p 0.05). There was a significant increase in copper levels in the workers with chronic illnesses compared to healthy workers, while zinc and iron had no correlation with chronic illnesses.
The conclusion of study is the role of the increase of trace elements on the health of the fuel workers group, attention to use of safety gloves and face mask is recommended for fuel workers and a long follow-up to the studied group is necessary to discover the developments. Also, it is highly recommended to reduce the working hours for fuel workers in order to decrease the accumulative effects of benzene exposure and to allow the body to detoxify the blood.
Formulation and Optimization of Colon-Specific Nanoparticles Containing A Herbal Anticancer Agent
Authors: A Saraf , N Dubey , M Sharma
Published: July 2023

Colon cancer is one of the major ailments associated with increased death rate globally. This study aimed to design and optimize a nanoparticulate system for delivering sulforaphane (SFN), a dietary phytochemical with anticancer properties, to the colon. Eudragit S100, a pH-sensitive polymer was utilized to fabricate polymeric nanoparticles for delivering the drug specifically to the colon. The nanoparticles were formulated by nanoprecipitation technique and applied design of experiments (DoE) for optimization and validation. The optimized formulation was characterized for its physicochemical properties, such as particle size, shape, surface morphology, encapsulation efficiency, zeta potential, polydispersity index, in-vitro drug release, and stability at refrigerated conditions. The prepared NPs revealed spherical and smooth surfaces and value of polydispersity index, particle size, zeta potential and encapsulation efficiency were found to be 0.255, 119.46 ± 0.09 nm and -35.68 ± 0.75 mV and 64.17 ± 0.56%, respectively. The in-vitro drug release study showed that the optimized nanoparticles exhibited minimal drug release at pH 1.2 and pH 6.8, but significant and sustained drug release at pH 7.4 corresponded to the colon’s pH. The stability study indicated that the prepared formulation was stable at refrigerated condition for six months. These findings suggest that the developed delivery system could be a promising strategy for effectively encapsulating and delivering the phytochemical anticancer agent to the colon.
Development and Evaluation of Vasoactive Intestinal Peptide Freeze-Dried Injection
Authors: Bukkawar Amit R. , Jain Amit K. , Chatap Vivekanand K.
Published: July 2023

Introduction: Vasoactive intestinal peptide (VIP), a ubiquitous, naturally synthesized human peptide is extensively documented to have diverse physiological effects like anti-inflammatory, immune-modulatory, anti-hypertensive, stimulation of contractility in the heart, vasodilation, and promoting neuroendocrine-immune communication. The synthetic form of VIP is called aviptadil (AVP). The main objective of this research was to develop a novel stable lyophilized dosage of VIP (Aviptadil) using sucrose as a bulking agent.
AVP is a peptide with known concern for aqueous stability, which seems to be challenging for storing finished drug products and supply chain management. The VIP injection was developed using the lyophilization technique in the presence of bulking agent and some other pH-adjusting agent. The bulking agent and solvent system selection depends upon the solubility, stability of the drug substance, and feasibility during manufacturing. During product formulation development, the bulk solution was evaluated for processing time and temperature impact. The lyophilization cycle was developed using the most advanced freeze-drying technology.
Result and discussion: With the usage of bulking agent (sucrose) as may act as a cryoprotectant for peptide, the formulated bulk solution was freeze-dried, and primary drying was done at-25°C (below than critical product temperature) followed by secondary drying at 25°C. The critical quality attributes of lyophilized drug products like the description of lyophilized cake/powder, moisture content, reconstitution time, active drug content and color of the solution were evaluated. The developed formulation bulk solution was stable and compatible with contact materials like SS vessels when hold up to 24 hours at 2 to 8°C. The optimized freeze-dried product meets the predefined acceptance criteria as part of the quality target product profile.
Conclusions: It can be concluded from the research work carried out that a stable lyophilized parenteral formulation containing VIP (AVP) was developed using sucrose as a bulking agent. These findings show that the freeze-dried formulation is an appropriate technological remedy for stabilizing VIP in lyophilized injectable dosage form.
Development of Novel Directly Compressible Isomalt-based Co-processed Excipient
Authors: S B Sandhan , M P Wagh , Nazma Inamdar
Published: July 2023

Objective: The study aims to improve the tableting qualities by coprocessing isomalt with PEG 4000 and crospovidone. Methodology: The melt granulation method was adopted for coprocessing isomalt with PEG 4000 and crospovidone. The proportion of constituents was optimized using full factorial design. Particle size distribution, true density, moisture content, flowability, flow rate, SEM analysis, dilution potential, and tablet ability were all examined for optimized co-processed isomalt-based excipient and compared with isomalt. Result and Discussion: Co-processed isomalt-based excipients had 40% dilution potential for paracetamol as compared with 20% for isomalt. Co-processed isomalt-based excipient showed 30% dilution potential for mefenamic acid and aspirin. Co-processed isomalt overcomes the lamination and sticking problem, which has better tablet ability, binding, disintegration, and lubricating potential.
Detect the Amount of CD4+ Foxp3+ T-regulatory (Treg) Cell in Iraqi Patients with Behcet’s Disease
Authors: Al-Tai Tharwa H. H. , Al-Hadithi Hayfaa S. , AL-Yasiry Dina S.
Published: July 2023

Background:- Behcet’s disease (BD) (beh-CHETS) disease also called Behcet’s syndrome. Characterized by urogenital ulcers, populopustular and erythema nodosum like skin lesion, uveitis, retinal vasculitis, thrombophlebitis, arterial aneurysms, and arthritis. Treg cells, whose primary roles are to reduce inflammation and decrease effector T cells, aid in maintaining the proper ratio between immunity and auto tolerance. The expression of CD4 + /CD25 + /Foxp3 + mostly identified them. Objective: To detected the amount of CD4 + Foxp3 + Treg cells in BD patients and to asses their correlation to disease activity. Patients and methods: This study was applied on 60 patients with BD compared to 30 healthy group as control group from December 2020 to the end of May 2021. Their blood samples were collected to investigate blood concentrations of CD4 + marker and Foxp3 + Treg by using flow cytometer technique. Results: The (median) of CD4 + Tcells percentage for the patient group was 10.9%, significantly higher than that of the control group 8.30% ranged (0.80–17.30). While there was a highly significant increase in the (median) 26.20% of CD4 + Foxp3 + Tcells in the patients group in comparison with the control group median (4.65%). The Treg cells determined by the proportion of CD4 + Foxp3 + in all CD4 + Tcells showed a significant increase in the (median) for patient group (10.80% ) if compared with the control group (8.50% ) (p=0.045). A significant decrease CD4 + in monocyte was detected in patient group (8.50%) in comparison to control group (12.70%)(p=0.003). Conclusion: Patients with BD had more CD4 + , Foxp3 + Treg cells than the control group did. Monocyte levels were lower in BD patients. There was a link between disease activity and Treg concentration.
A Critical Review on Natural Bioactive of Jasminum Genus as Potential Therapeutics in Various Disorders
Authors: Kushwah Manish , Mazumder Avijit , Shakya Richa
Published: July 2023

There are many widely used medicinal plants in the Oleaceae family, which also includes the species Jasminum. Typical uses for the Jasminum species, which include Jasminum auriculatum vahl, J. humile, J. flexile Vahl, J. grandiflorum L, J. polyanthum, J. officinale, J. multiflorum, J. aungustifolium, J. pubescens, and J. sambac, include anti-Jasmine oil is commonly used in aromatherapy. The presence of a wide range of bioactive substances in Jasminum plants, including fatty acids, glycosides, coumarins, sterols, terpenoids, esters, and phenolics, may be the cause of their therapeutic effects. The combined impact of essential oils is responsible for the aromatherapy’s antibacterial, anti-acne, spasmolytic, and other properties. According to phytochemical studies, phenolic compounds are significantly more bioactive than the bulk of terpenoids and other chemicals. The medicinal potentials of phenolic components have been extensively studied, including their anti-inflammatory, antiulcer, antioxidant, lipid peroxidation, ACE inhibitor, vasodilation, antioxidant, and antiaging capabilities, as well as their wound healing and protective characteristics. The medicinal potentials of phenolic chemicals are reviewed in the current research, coupled with Jasminum’s phyto screening and ethnobotanical features.
Prevalence of Stress Among Health Professionals During COVID-19 Pandemic in The UAE: A Cross-sectional Study
Authors: Budihal Sonal L. K. , Sharbatti Shatha A.
Published: July 2023

A cross-sectional study was conducted among full-time health professionals of both genders who agreed to participate and sign the consent form. A self-administered, standardized, work-related stress (WSQ) and perceived stress (PSS-10) questionnaire were used. In addition, information on socio-demography, general health, and work characteristics was obtained. Data was analyzed by SPSS version 27. The Chi-square test and logistic analysis were used. Results: The prevalence of moderate/high stress was 90%. The greatest prevalence of high stress was found among older compared to younger professionals [8.6 vs.7.5%, p=0.004], females compared to males [8.1 vs.7.8%, p=0.006], specialist/consultant compared to nurses and medical practitioners [9.7, 8, 2.6%; p=0.01]. Working > 48 hours/ week compared to ≤ 48 hours/week [8.6 vs. 6.3%, p=0.005], have chronic disease compared to No chronic disease [ 8.2 vs. 7.8%, p=0.04]. The percentage of stress in the following work domains: low influence at work; work interference with leisure time; items in “Indistinct Organization and Conflicts” and “Demands and commitments” were: 13, 70.3, 12.1 and 16.3%, respectively. Logistic analyses showed that gender and age significantly predict a high-stress level. Conclusion: The present study showed a high prevalence (90%) of moderate- to high-stress levels. Age and gender were significant predictors of high-stress levels among healthcare professionals. The most frequent work-related stress factor was work interference with leisure time (70.3%).
Preparation, Optimization, Compatibility Study of Captopril Proniosome, and In-vitro, In-vivo Evaluation of Release Study
Authors: Narwade Vaibhav L. , Singh Namrata
Published: July 2023

Coagulation compartment isolation technology has also developed transdermal proteosome arrays using various non-ionic surfactants. Span-60 proteasomes have reduced HLB values, longer chains alkyl, and high transition temperatures, resulting in higher capture efficiency (84.14 ± 4.76). The addition of cholesterol LDL and lecithin also increased bilayer stiffness. The size of the vesicles decreases with his Tween method and multiplies with wingspan and consciousness. Low polydispersity index and high zeta capacity were observed in the arrangement of proteasomes. TEM studies confirm perfectly round niosomes. Infrared studies have confirmed that the vesicular form has no drug interactions and no drug is trapped. Proniosomes demonstrated slower release kinetics than controls. Captopril in 40% PEG. Additionally, the defined emission charge of span changes compared to Tween, which can be attributed to the lipophilicity of span and captopril. The release profile was observed for the Higuchi version, suggesting that drug introduction is diffusion controlled. The transdermal flux of captopril was highest for the span 60 system in isolated and closed rat skin.