bluuebunny/crossref_metadata_2025 huggingface dataset:
Sacred Choices
Authors: Tariq Anum , Tanveer Yasir
Published: September 2024

This chapter provides an extensive perspective on religious and green consumer behavior, in which a fine balance is evaluated to explain this particular interaction. It analyzes how religious beliefs and practices would influence attitudes toward sustainable consumption behavior. It begins by delineating how environmental stewardship is defined theologically within a range of religious traditions: Christianity, Islam, Hinduism, and Buddhism. This concept of faith tends towards Indigenous values such as maintaining unity with the natural world, teachings about stewardship, and living simply while having a sense of admiration for all creations. The chapter uses empirical data and case studies to demonstrate how religious beliefs influence consumer choices, such as buying green products or endorsing brands promoting sustainability. Finally, it reveals the religious viewpoint behind green consumer behavior, thereby extending our understanding of how sustainability can be culturally deepened and offers a new angle on religion to make society more environmentally respectful.
Brunei Government Initiatives for Sustainable Food Packaging
Authors: Sulaiman Nor Surilawana , Mujiburrahman Nabilah Ulfah
Published: September 2024

Sustainable food packaging is essential in reducing environmental waste and protecting the environment, which aligns with the SDG. However, limiting sustainable packaging usage is often due to a lack of environmental awareness, inconvenience, associated costs, and lack of government enforcement. The chapter delves into the pivotal role of the Brunei government in spearheading sustainable food packaging initiatives to mitigate environmental impact and promote eco-friendly practices within the food industry. The study gathers qualitative data from pertinent documents. Results indicate that Brunei's government enforces stringent regulations and policies to drive the adoption of sustainable packaging materials, aligning with global sustainability goals and reducing harmful chemicals released into the environment. The research highlights the factors driving the industry's transition to sustainable packaging, primarily in the emerging economy, enhancing long-term urban sustainability and improving quality of life.
Electrically Conductive Rubber by Modified Acetylene Black via Admicellar Polymerization
Authors: Pukird Tanatcha , Methachan Boriphat , Pongprayoon Thirawudh
Published: September 2024

Nowadays, the enhancement of electrical conductivity in natural rubber has been widely studied by incorporating conductive particles with various techniques into rubber latex. Acetylene black is one of the carbon nanoparticles known for its electrical conductivity property. However, its hydrophobicity leads to poor dispersion in rubber latex. Therefore, admicellar polymerization (AP) technique was chosen to modify particle surface without changing the molecular structure. This technique alters surface hydrophobicity by means of coating ultrathin film of polymer onto the particles. Polypyrrole, a conductive polymer, was chosen to enhance the dispersion of acetylene black. The modified acetylene black was used as the electrically conductive additives in natural rubber. There were four variables in this study: i. the carbon particle-to-surfactant ratio, ii. the agitation speed during the AP step, iii. polymerization temperature, and iv. the surfactant agent-to-monomer ratio. The morphologies of modified particles were observed by SEM and TEM. The results showed that the best conditions yielding the lowest resistivity of conductive rubber at 1:3 for the carbon particle-to-surfactant mass ratio, at 1000 rpm for the agitator speed, in AP step was 4°C for the polymerization, and 1:5 for the mass ratio of the surfactant agent-to-monomer.
Influence of Temperature-Strain Parameters of Shelters Reinforcing Materials on Increasing Properties in the Z-Direction
Authors: Laukhin Dmytro , Ziborov Kyrylo , Fedoryachenko Sergey , Rott Nataliia
Published: September 2024

The work introduces an improved mode of production of steel sheets of the C355Zh2 type recommended for industrial use in factory conditions in Ukraine; this contributed to reducing the dispersion of the values of the strength and plasticity indicators of the finished product and increasing the yield of suitable products obtained using the proposed mode of controlled rolling.
Temperature-Dependence of Energy Storage and Electrocaloric Performances of Ternary PVDF-HFP/PU/PMMA Composites
Authors: Itsaradamkoeng Ponkrit , Putson Chatchai
Published: September 2024

Ternary polymer blends of ferroelectric Poly (vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP, heterostructure Polyurethane (PU) with hard and soft segments, and amorphous Polymethyl methacrylate (PMMA) has been investigated on energy storage performances and electrocaloric effect. The microstructure phase of polymer blends has been analyzed using the X-ray diffraction (XRD) technique. The frequency-dependence of dielectric properties for polymers blend has been conducted. The ferroelectric, energy storage and electrocaloric properties of polymers blend depending on temperature were studied. The result showed that the dielectric constant of PVDF-HFP@PU composite is higher than PVDF-HFP@PMMA composites due to the strong interfacial polarization effect and contribution of the polymer blend. Moreover, it was noted that the crystalline–amorphous interface properties depend on the polymer blend with PU and PMMA, resulting in ferroelectric, energy storage and electrocaloric properties when temperature increases. Therefore, the comparison based on heterostructure and amorphous structure for series polymer blends can be used to predict practical devices.
Surface Modification Rout for Date Palm Fibers-Polymer Bio-composites Towards Improved Interfacial Crosslinking
Authors: Alzebdeh Khalid , Nassar Mahmoud
Published: September 2024

Surface modifications of bio-filler and polymer matrix is critical in natural fiber reinforced composites to improve compatibility with the hosting polymer. The literature contains only a few studies on grafting bio-fillers to improve their reactivity with polymer matrix. This study focuses on introducing crosslinking between Date Palm Particles (DPP) and Polypropylene (PP) using new methods. The experimental setup starts with chemical modifications of PP that result in the formation of PP-g-mTMI. Following that, the two components are blended together, forming a urethane link between the filler and the polymer. Following the fabrication of bio-composite sheets based on the Taguchi design, various specimens were prepared and tested thoroughly to assess their chemical properties, thermal stability, and mechanical properties. The results of the experiments revealed an improvement in the interfacial adhesion of the filler/polymer, which was confirmed by experimental mechanical characterization and Scanning Electron Microscope (SEM) analysis. The new composite demonstrated improved strength, ductility, and overall durability, demonstrating its potential as a bio-based polymeric material.
Internal Electric Current Mark - A Unique Case of High-Voltage Accidental Electrocution. Is It Underreported?
Authors: Mayorathan U.
Published: September 2024

A 34-year-old male succumbed to death due to a high voltage overhead power line electrocution at work. The autopsy revealed multiple external electrical and thermal injuries, contusions, and clavicular fractures sustained when thrown away following electrocution. In addition to these, we also found internal current marks on the liver and gall bladder in addition to the above injuries, which have never been reported in scientific journals before.
An audit on the prevalence of malignancy from reported cases of TH Batticaloa; A hospital-based retrospective analysis
Authors: Subhatharshan G. , Ganesapiragas M. , Ahilan S.
Published: September 2024

Background: A retrospective analysis of reported malignant cases from Teaching Hospital Batticaloa from January 2017 to December 2022 was conducted to know the sociodemographic profile, cancer site, and histological type among the patients.
Introduction and Objectives: Cancers are one of the major health problems among people worldwide. Their incidence among the general population in Sri Lanka is also on a continuous rise. So that knowledge about sociodemographic and histopathological profiles of malignant cases is important in identifying target groups for screening and implementing preventive measures, we have conducted a retrospective analysis on reported histopathological cases from our hospital.
Methods: Histopathological reports of 2428 patients diagnosed with various types of cancers from the year 2017 to 2022 were analyzed for a sociodemographic profile, cancer site, and histological type. SPSS 21 software was used for statistical analysis.
Results: According to our analysis, more women (50.1%) were diagnosed with cancers than men. Most malignant cases reported belong to the age group of 60-64 years (n=403, 16.6%). The most common cancer site was lip, tongue, and mouth (20.7%) followed by breast (10.3%). Squamous cell carcinoma was the most common histopathological type (41.1%) in both genders. The major cancer site in females was the breast (n= 244) whereas lip tongue and mouth were the most common in males (n=301). Cancers which are lip tongue & mouth, oesophagus, and lung are more prevalent in 65-69 years, colorectal and cervix are more prevalent in 60-64 years, bladder and prostate are more prevalent in 70-74 years, breast and ovary are more prevalent in 50-54 years and thyroid is more prevalent in 35-39 years.
Though cancer cases were almost constant from 2017 to 2019, there was a drop in 2020 & 2021 in the total number of reported cases probably due to COVID-19 lockdown restrictions followed by a significant rise in 2022 (n=515, 21.2%).
Conclusion: This study highlights that breast and oral cancer burdens are still higher than other types and the need to reevaluate the adequacy of screening measures for these cancer types to have a good outcome.
Button battery ingestion in a child: is it always necessary to perform urgent endoscopy?
Authors: Dayasiri Kavinda , De Abrew Gayathree , Thadchanamoorthy V.
Published: September 2024

Button batteries are increasingly used in toys and electronic devices. They are considered highly hazardous since button batteries lodged in oesophagus can lead to oesophageal perforation, fistulation and in some children, fistulation into major thoracic blood vessels. The caustic injury to the oesophagus occurs rapidly within a duration as short as two hours. We report the case of a seven-year-old boy who presented following a potential button ingestion. The button battery was visualised within the pylorus of the stomach. The boy was managed with conservative approach since he remained asymptomatic and button battery had moved passed the oesophagus. This case highlights the importance of early evaluation of any child with button battery ingestion. Button battery ingestion must be recognised and treated promptly using a multidisciplinary approach to optimise outcomes for patients.
Artificial Intelligence in Medical Research
Authors: Francis G.R.
Published: September 2024

No abstract available.
A case report of bilateral above-knee amputation in a treatment-defaulted patient with Rheumatoid arthritis
Authors: Kogulan T. , Jeyaruban J. , Ubhayasiri S.K.
Published: September 2024

No abstract available
Overcoming Moral Challenges in the Medical Profession
Authors: Anthony Angela Arulpragasam
Published: September 2024

No abstract available.
Influence of food habits and supplementations in causing anaemia; a study among the pregnant women attending Antenatal Clinics at Teaching Hospital, Batticaloa
Authors: Deshabandu V.M. , Junaideen F.J. , Wanasinghe H.K. , Wellage S.S. , Karunakaran K.E.
Published: September 2024

Introduction: Anaemia in pregnancy is a well-recognized condition. The pre-pregnancy and antenatal care are designed to identify and correct this condition. This study aimed to analyse the meal pattern, iron supplementation and deworming treatment by the pregnant mother in Batticaloa Sri Lanka, concerning the prevalence of anaemia.
Materials & Methods: A descriptive study was conducted among pregnant mothers in Batticaloa, Sri Lanka in 2022. A self-administered questionnaire was used. A report on the haemoglobin level was obtained from the pregnancy record. A haemoglobin level, of less than 11 g/dL was taken as the reference point. Descriptive statistics was used to analyse the data. Statistical software SPSS V.19 was used for this.
Results: 207 pregnant women were enrolled; 82(39.61%) had anaemia. Fifty per cent of women with a monthly income up to Rs. 10,000.00 had anaemia. Mothers who had two meals a day had a higher incidence (68.75%). Those who consumed fruit and vegetables daily had the lowest level (27.27%). Avoiding iron-rich food showed a higher incidence (53.57%). Fifty-four per cent of the mothers did not take iron supplementation; anaemia was noted in 51.79% of them. Eighty-nine per cent of the women did not take deworming treatment and anaemia was noted in 40.22% of them. On those who consumed tea immediately after meals (n-16), 9 mothers developed anaemia.
Conclusion: A higher prevalence of anaemia among pregnant women in the Batticaloa region compared to other regions of Sri Lanka could be attributed to poor compliance with iron supplementation. Meal patterns had an association with family income. Avoiding consuming tea immediately after a meal appeared a good practice. Pregnant mothers must be encouraged to have deworming treatment, to minimize the incidence of anaemia.
Moral issues about certain interventions on human foetuses/embryos
Authors: Tettamanzi Dionigi
Published: September 2024

Interventions on the human foetus are certainly not of today. Today, however, they pose new and more serious problems from various points of view, not least the ethical one. The increasing development of prenatal medicine has expanded knowledge through diagnostic means and, at the same time, opened the way for in utero therapy. Human foetuses, also as a result of the spread of provoked and legally permitted abortions, have increasingly become possible ‘donors’ of organs and tissue.
The meaning of life in medical action
Authors: Brera Giuseppe R.
Published: September 2024

Not available.
Boxing: an issue of medical ethics?
Authors: Spinsanti Sandro
Published: September 2024

The ring kills. Without producing carnage like road traffic, it is nevertheless fatal for a considerable number of boxers. According to statistics, 357 boxers have fallen victim to the ring since the war, with an annual average of ten boxers, amateurs and professionals. A trickle, a slow haemorrhage. Enough, however, to ask whether something can or should be done to prevent those deaths. When a boxer falls into a coma or dies in the course of a fight, the controversy between boxing abolitionists and anti-abolitionists flares up for a moment; then the issue slips out of the field of interest, and is soon forgotten.
Ethical aspects of rehabilitation
Authors: Sgreccia Elio
Published: September 2024

Not available.
The legislative situation regarding medical objection in Europe
Authors: Stella Federico
Published: September 2024

The comparative reflection on the regulation of conscientious objection must necessarily start from an awareness of the ‘abortion situation in our country and the ability of objector doctors and auxiliaries to influence the evolution of that situation’.
Medico-legal and deontological problems related to the hospitalisation of the elderly
Authors: Zamperini Daniele , Marchetti Marco
Published: September 2024

In recent years, due to the demographic changes that have taken place with the progressive, significant increase in average life expectancy and, consequently, the increase in the percentage of the elderly population, greater attention has been paid, also in Italy, to the problems related to geriatric care.
Caring for the dying: guidelines and perspectives
Authors: Petrini Massimo
Published: September 2024

The subject of death is today enjoying a reawakening of interest on the part of a society that believes, in some areas, that it has worked out a humane answer to this problem, which is what euthanasia wants to be. It is almost a stoic gasp of a culture that wants to affirm that human life contains within itself its own exhaustive meaning; a gasp of a culture that, wanting to forget Revelation, is no longer capable of realising a right attitude in the face of birth and dying.
Answers to the problem of death between classical and early Christian mentality
Authors: Pizzolato Luigi Franco
Published: September 2024

Death constitutes a decisive problem for any mentality, but particularly for the Greek mentality, which is inclined to investigate the problems, so to speak, of ultimate meaning, of man and the world, more than to describe phenomena. And it is a fact that tragically touches everyone and that instils in everyone that fear, which comes from the impossibility of fully grasping its explanation.
The epilepsy problem: reality, ideas, proposals
Authors: Mazza Salvatore , Bartocci Arnaldo , Azzoni Antonella
Published: September 2024

Not available.
The child with speech disorders: clinical aspects and ethical reflections
Authors: Errante Antonio
Published: September 2024

In children, language is an evolutionary process. This is of decisive importance for any attempt at interpreting disorders and defining diagnostics A slight deficit detected early on may indeed be mild, but it may also herald profound disturbances whose consequences will reveal themselves over time. Typically, the first warning sign is a real delay in the onset of organised speech, in the absence of noticeable sensory impairments such as deafness.
Perspectives and attitudes of South African medical professionals towards active euthanasia
Authors: Steyn Willem-Johan , Bondo Mukinay C.
Published: September 2024

Background: Active euthanasia is a controversial subject both globally and in South Africa. Recent legal cases have kept this topic in the public discourse. Yet, there remains a dearth of quality local research on this issue. This study aimed to explore the views of medical professionals towards active euthanasia to gain a better understanding of this phenomenon in South Africa.Methods: A descriptive-interpretive qualitative research design, using semi-structured in-depth interviews of purposively sampled South African medical professionals, was used to collect the data. The data were analysed using an inductive thematic analysis framework, which included familiarisation, coding, summarising, theme development and thematic review, revision and interpretation.Results: Four general themes, with sub-themes, were identified and inductively analysed: modern medical practice and euthanasia; the problem of suffering in end-of-life care; euthanasia is complex; palliative care in South Africa is poor. Some themes and sub-themes were common to all participants while other themes underscored more diverse views – often because of religious factors.Conclusion: Active euthanasia is a complex and nuanced issue. An understanding of the perceptions and attitudes of medical professionals will contribute to the overall discussion of this phenomenon in ethical, legal, social and political spheres in South Africa. This is of utmost importance given the relevance of this topic in South Africa in the 21st century.Contribution: This study highlights the complex nature of active euthanasia in South Africa among medical professionals while providing a greater understanding of its nuances and the strengths and weaknesses of arguments for or against it.
Impact of liver metastasis on immunotherapy in gastric carcinoma
Authors: Chalkoo Mushtaq , Bhat Mohd Yaqoob , Wani Yaser Hussain
Published: September 2024

The editorial discusses the impact of liver metastasis on immunotherapy efficacy in gastric cancer (GC) patients. Liver metastasis can hinder the effectiveness of immunotherapy by altering the immune microenvironment, leading to systemic loss of T-cells and reduced treatment response. Studies suggest that liver metastases serve as a negative baseline factor for immunotherapy efficacy, resulting in poorer progression-free survival and objective response rates. Strategies such as liver-mediated radiotherapy may help improve treatment outcomes by reshaping the liver’s immune microenvironment and reducing T-cell depletion. Understanding the complex interplay between liver metastasis and immunotherapy response is crucial for optimising patient care in GC.
Exploring the landscape of minimally invasive pancreatic surgery: Progress, challenges, and future directions
Authors: Donisi Greta , Zerbi Alessandro
Published: September 2024

Minimally invasive surgery (MI) has become the standard of care for many surgical procedures aimed at reducing the burden on patients. However, its adoption in pancreatic surgery (PS) has been limited by the pancreas’s unique location and the complexity of the dissection and reconstruction phases. These factors continue to contribute to PS having one of the highest morbidity and mortality rates in general surgery. Despite a rough start, MIPS has gained widespread acceptance in clinical practice recently. Robust evidence supports MI distal pancreatectomy safety, even in oncological cases, indicating its potential superiority over open surgery. However, definitive evidence of MI pancreaticoduodenectomy (MIPD) feasibility and safety, particularly for malignant lesions, is still lacking. Nonetheless, reports from high-volume centers are emerging, suggesting outcomes comparable to those of the open approach. The robotic PS increasing adoption, facilitated by the wider availability of robotic platforms, may further facilitate the transition to MIPD by overcoming the technical constraints associated with laparoscopy and accelerating the learning curve. Although the MIPS implementation process cannot be stopped in this evolving world, ensuring patient safety through strict outcome monitoring is critical. Investing in younger surgeons with structured and recognized training programs can promote safe expansion.
Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients
Authors: Shayimu Paerhati , Awula Maitisaidi , Wang Chang-Yong , Jiapaer Rexida , Pan Yi-Peng , Wu Zhi-Min , Chen Yi , Zhao Ze-Liang
Published: September 2024

BACKGROUND

Anastomotic leakage (AL) is one of the severest complications after laparoscopic surgery for middle/low rectal cancer, significantly impacting patient outcomes. Identifying reliable predictive factors for AL remains a clinical challenge. Serum nutritional biomarkers have been implicated in surgical outcomes but are underexplored as predictive tools for AL in this setting. Our study hypothesizes that preoperative serum levels of prealbumin (PA), albumin (ALB), and transferrin (TRF), along with surgical factors, can accurately predict AL risk.

AIM

To determine the predictive value of preoperative serum nutritional biomarkers for rectal cancer AL following laparoscopic surgery.

METHODS

In the retrospective cohort study carried out at a tertiary cancer center, we examined 560 individuals who underwent laparoscopic procedures for rectal cancer from 2018 to 2022. Preoperative serum levels of PA, ALB, and TRF were measured. We employed multivariate logistic regression to determine the independent risk factors for AL, and a predictive model was constructed and evaluated using receiver operating characteristic curve analysis.

RESULTS

AL occurred in 11.96% of cases, affecting 67 out of 560 patients. Multivariate analysis identified PA, ALB, and TRF as the independent risk factor, each with an odds ratio of 2.621 [95% confidence interval (CI): 1.582-3.812, P = 0.012], 3.982 (95%CI: 1.927-4.887, P = 0.024), and 2.109 (95%CI: 1.162-2.981, P = 0.031), respectively. Tumor location (< 7 cm from anal verge) and intraoperative bleeding ≥ 300 mL also increased AL risk. The predictive model demonstrated an excellent accuracy, achieving an area under the receiver operating characteristic curve of 0.942, a sensitivity of 0.844, and a specificity of 0.922, demonstrating an excellent ability to discriminate.

CONCLUSION

Preoperative serum nutritional biomarkers, combined with surgical factors, reliably predict anastomotic leakage risk after rectal cancer surgery, highlighting their importance in preoperative assessment.
Adjuvant chemotherapy for isolated resectable colorectal lung metastasis: A retrospective study using inverse probability treatment weighting propensity analysis
Authors: Gao Zhao , Wu Shi-Kai , Zhang Shi-Jie , Wang Xin , Wu Ying-Chao , Jin Xuan
Published: September 2024

BACKGROUND

The benefit of adjuvant chemotherapy (ACT) for patients with no evidence of disease after pulmonary metastasis resection (PM) from colorectal cancer (CRC) remains controversial.

AIM

To assess the efficacy of ACT in patients after PM resection for CRC.

METHODS

This study included 96 patients who underwent pulmonary metastasectomy for CRC at a single institution between April 2008 and July 2023. The primary endpoint was overall survival (OS); secondary endpoints included cancer-specific survival (CSS) and disease-free survival (DFS). An inverse probability of treatment-weighting (IPTW) analysis was conducted to address indication bias. Survival outcomes compared using Kaplan-Meier curves, log-rank test, Cox regression and confirmed by propensity score-matching (PSM).

RESULTS

With a median follow-up of 27.5 months (range, 18.3-50.4 months), the 5-year OS, CSS and DFS were 72.0%, 74.4% and 51.3%, respectively. ACT had no significant effect on OS after PM resection from CRC [original cohort: P = 0.8; IPTW: P = 0.17]. No differences were observed for CSS (P = 0.12) and DFS (P = 0.68) between the ACT and non-ACT groups. Multivariate analysis showed no association of ACT with better survival, while sublobar resection (HR = 0.45; 95%CI: 0.20-1.00, P = 0.049) and longer disease-free interval (HR = 0.45; 95%CI: 0.20-0.98, P = 0.044) were associated with improved survival.

CONCLUSION

ACT does not improve survival after PM resection for CRC. Further well-designed randomized controlled trials are needed to determine the optimal ACT regimen and duration.
Effects of postoperative treatment with chemotherapy and cellular immunotherapy on patients with colorectal cancer
Authors: Ding Zhen-Yu , Piao Ying , Jiang Tong , Chen Juan , Wang Yi-Nuo , Yu Hui-Ying , Zheng Zhen-Dong
Published: September 2024

BACKGROUND

The outcome of surgical treatment for colorectal cancer (CRC) remains unsatisfactory and warrants further exploration and optimization.

AIM

To clarify the impact of chemotherapy plus cellular immunotherapy [dendritic cell-cytokine-induced killer (DC-CIK) cell immunotherapy] on patients after CRC surgery and to explore the mediating variables.

METHODS

A total cohort of 121 patients who underwent CRC surgery between July 2020 and October 2023 were selected. The sample comprised a control group of 55 patients who received the XELOX chemotherapy regimen and a research group of 66 patients who received XELOX + DC-CIK immunotherapy. We performed comparative analyses of the clinical and pathological data of the two groups, including efficacy, the incidence of adverse events (diarrhea, myelosuppression, gastrointestinal reactions, and peripheral neuritis), serum levels of tumor markers [carcinoembryonic antigens and carbohydrate antigens (CA)19-9 and CA242], and T-cell subsets [cluster of differentiation (CD)3+, CD3+ CD4+, CD3+ CD8+, natural killer (NK), and NK T cells]. We also conducted preliminary univariate and multivariate analyses of the variables that affected the efficacy of the treatments.

RESULTS

We found a significantly higher rate of treatment efficacy in the research group than in the control group, with a statistically lower incidence of adverse events. Both groups showed a reduction in serum tumor markers after treatment but there was no marked intergroup difference. After treatment, the various T-cell subgroup indicators in the control group were significantly lower than those in the research group. The indices of T-cell subsets in the research group showed no significant change from preoperative levels. Univariate analysis revealed a significant correlation between TNM staging, tumor differentiation, and the rates of nonresponse to treatment in CRC patients after surgery. Multivariate results indicated that the treatment approach significantly affected the efficacy of postoperative CRC treatment.

CONCLUSION

We concluded that XELOX + DC-CIK immunotherapy for postsurgical CRC patients offers reduced rates of treatment-induced adverse events, improved curative effects, enhanced immunity, and increased physiological antitumor responses.
Comparison of efficacy and safety of nab-paclitaxel and oxaliplatin + S-1 and standard S-1 and oxaliplatin chemotherapy regimens for treatment of gastric cancer
Authors: Wang Yi-Cong , Feng Long , Wang Gong-Ping , Yu Peng-Jie , Guo Can , Cai Bao-Jia , Song Yan , Pan Ting , Lin Bo-Hao , Li Yuan-Dong , Xiao Jing-Jing
Published: September 2024

BACKGROUND

Gastric cancer (GC) is a relatively frequent clinical phenomenon, referring to malignant tumors emerging in the gastric mucosal epithelial cells. It has a high morbidity and mortality rate, posing a significant threat to the health of patients. Hence, how to diagnose and treat GC has become a heated topic in this research field.

AIM

To discuss the effectiveness and safety of nab-paclitaxel in combination with oxaliplatin and S-1 (P-SOX) for the treatment of GC, and to analyze the factors that may influence its outcomes.

METHODS

A total of 219 eligible patients with advanced GC, who were treated at Qinghai University Affiliated Hospital Gastrointestinal Oncology between January 2018 and March 2020, were included in the study. Among them, 149 patients received SOX regimen and 70 patients received S-1 regimen. All patients underwent both preoperative and postoperative chemotherapy consisting of 2-4 cycles each, totaling 6-8 cycles, along with parallel D2 radical surgical treatment. The patients were followed up for a period of three years or until reaching the event endpoint.

RESULTS

The short-term and long-term efficacy of the P-SOX group was significantly higher than that of the SOX group, and the safety was manageable. Cox multivariate analysis revealed that progression-free survival was associated with perioperative chemotherapy efficacy, tumor diameter ≤ 2cm, high differentiation, and early cTNM (T stands for invasion depth; N stands for node metastasis; M stands for distant invasion) stage.

CONCLUSION

In comparison to the SOX regimen, the P-SOX regimen demonstrates improved short-term and long-term efficacy with tolerable adverse reactions. It is anticipated that the P-SOX regimen will emerge as a first-line chemotherapy option for GC. Patients with GC who receive effective perioperative chemotherapy (Response Evaluation Criteria in Solid Tumors 1.1, Tumor Regression Grade), have a tumor diameter ≤ 2cm, exhibit high degree of differentiation, and are at an early cTNM stage show better prognosis.
Relationship between intracranial pressure and neurocognitive function among older adults after radical resection of rectal cancer
Authors: Song Bo , Li Li-Ping , Wang Xiao-Lin , Guo Yong , Li Jun
Published: September 2024

BACKGROUND

Older patients are prone to postoperative cognitive decline after laparoscopic rectal cancer surgery, which may be associated with increased intraoperative intracranial pressure (ICP). This study investigated the correlation between intraoperative ICP changes, as indicated by measurements of the optic nerve sheath diameter (ONSD) using ultrasonography, and subsequent cognitive function to provide better patient care.

AIM

To evaluate changes in ICP and associated postoperative neurocognition in older adults after laparoscopic radical resection for rectal cancer.

METHODS

We included 140 patients who visited the Mianyang Central Hospital for malignant rectal tumors, measured their ONSDs before surgery and 30 and 60 minutes after the Trendelenburg position during surgery, and evaluated the patients’ cognitive function 1 day before surgery and 1, 4, and 7 days after surgery. The Mini-Mental State Examination (MMSE) and confusion assessment method (CAM) scores of the patients with different ONSDs were compared at different times after surgery.

RESULTS

In patients with an ONSD greater than 5.00 mm (group A1), the MMSE scores at 1 day and 4 days after surgery were significantly lower than those of patients with an ONSD less than or equal to 4.00 mm (group A2) (P < 0.05). The CAM scores of group A1 were significantly higher than those of group A2 (P < 0.05). The MMSE scores of group A1 on days 1 and 4 after surgery were significantly lower than those 1 day before and 7 days after surgery (P < 0.05), while the CAM scores 1 day and 4 days after surgery were significantly higher than those 1 day before and 7 days after surgery.

CONCLUSION

Decline in cognitive function among older adults after the procedure may be related to intracranial hypertension during surgery.
Prevention and management of postoperative deep vein thrombosis in lower extremities of patients with gastrointestinal tumor
Authors: Shu Liang , Xia Cheng-Wei , Pang Yu-Fan
Published: September 2024

BACKGROUND

Deep vein thrombosis (DVT) is a significant postoperative concern, particularly in patients undergoing surgery for gastrointestinal (GI) cancers. These patients often present multiple risk factors, including advanced age and elevated body mass index (BMI), which can increase the likelihood of thromboembolic events. Effective prophylaxis is crucial in this high-risk population to minimize complications such as DVT and pulmonary embolism (PE). This study investigates a comprehensive DVT prevention protocol, combining mechanical and pharmacological strategies alongside early mobilization, to evaluate its effectiveness and safety in reducing postoperative thrombosis rates among GI cancer surgery patients.

AIM

To evaluate the effectiveness and safety of postoperative DVT prevention strategies in patients with GI cancer.

METHODS

A prospective cohort study was conducted involving 100 patients who underwent surgery for GI tumors between January and December 2022. All patients received a standardized DVT prevention protocol, which included risk assessment, mechanical prophylaxis, pharmacological prophylaxis, and early mobilization. The primary endpoint was the incidence of DVT within 30 days postoperatively. Secondary outcomes included the occurrence of PE, bleeding complications, and adherence to the protocol.

RESULTS

The overall incidence of DVT was 7% (7/100 patients). One patient (1%) developed PE. The adherence rate to the prevention protocol was 92%. Bleeding complications were observed in 3% of patients. Significant risk factors for DVT development included advanced age [odds ratio (OR): 1.05; 95% confidence interval (95%CI): 1.01-1.09], higher BMI (OR: 1.11; 95%CI: 1.03-1.19), and longer operative time (OR: 1.007; 95%CI: 1.001-1.013).

CONCLUSION

Implementing a comprehensive DVT prevention and management protocol for patients undergoing GI tumor surgery resulted in a lower incidence. Strict adherence and individualized risk assessment are crucial for optimizing outcomes.
Modified technical protocol for single-port laparoscopic appendectomy using needle-type grasping forceps for acute simple appendicitis: A case report
Authors: Chen Yang , Fan Zong-Qi , Fu Xin-Ao , Zhang Xiao-Xin , Yuan Jie-Qing , Guo Shi-Gang
Published: September 2024

BACKGROUND

Because of the mild inflammatory status in acute uncomplicated appendicitis, our team developed a novel technical protocol for single-port laparoscopic appendectomy using needle-type grasping forceps (SLAN) and achieved positive clinical outcomes. However, the intraoperative procedure lacked stability and fluency due to a series of problems highlighted by the small incision design of the protocol (only 1 cm long). Therefore, there is a growing clinical demand to further optimize the SLAN protocol.

CASE SUMMARY

An adult male patient was admitted for persistent right lower abdominal pain with preoperative computed tomography findings suggestive of appendicitis accompanied by localized peritonitis. A modified technical protocol for SLAN based on minimally invasive surgical principles was used, and the patient was confirmed to have acute simple appendicitis by postoperative pathological analysis. Postoperative recovery was uneventful, and no postoperative complications, such as incision infection or severe incision pain, were observed. The patient was discharged successfully on postoperative day 2.

CONCLUSION

The modified technical protocol of SLAN may be a new minimally invasive surgical alternative for patients with acute simple appendicitis.
Can serious postoperative complications in patients with Crohn’s disease be predicted using machine learning?
Authors: Zbar Andrew Paul
Published: September 2024

The routine introduction of novel anti-inflammatory therapies into the management algorithms of patients with Crohn’s disease over the last 2 decades has not substantially changed the likelihood of ultimate surgery. Rather it has delayed the operative need and altered the presentation phenotype. The prospect of complications continues to remain high in this modern era but depending upon the cohort assessed, it remains difficult to make strict comparisons between individual specialist centres. Those patients who present rather late after their diagnosis with a septic complication like an intra-abdominal abscess and a penetrating/fistulizing pattern of disease are more likely to have a complicated course particularly if they have clinical features such as difficult percutaneous access to the collection or multilocularity both of which can make preoperative drainage unsuccessful. Equally, those cases with extensive adhesions where an initial laparoscopic approach needs open conversion and where there is an extended operative time, unsurprisingly will suffer more significant complications that impact their length of hospital stay. The need for a protective stoma also introduces its own derivative costs, utilizing a range of health resources as well as resulting in important alterations in quality of life outcomes. Having established the parameters of the problem can the statistical analysis of the available data identify high-risk cases, promote the notion of centralization of specialist services or improve the allocation of disease-specific health expenditure?
Evaluation of preoperative blood markers for predicting intra-abdominal infection during colorectal cancer resection: A commentary on recent findings
Authors: Zhang Shi-Yan , Chen Juan , Cai Na
Published: September 2024

This commentary evaluates the study by Liu et al . This study investigates the predictive utility of the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, systemic immune-inflammation index, and carcinoembryonic antigen levels for post-operative intra-abdominal infection following colorectal cancer (CRC) surgery. The study highlights the critical need for analyzing diverse patient demographics and delves into the potential impact of various confounding factors on the predictive accuracy of these markers. Additionally, the commentary advocates for the initiation of prospective studies aimed at validating and enhancing the clinical utility of these biomarkers in the context of CRC treatment. The commentary aims to underscore the importance of broadening the research framework to include a wider patient demographic and more comprehensive factor analyses, thereby enriching the predictive model's applicability and relevance in clinical settings.
Metaforika v Jarčevi kratki prozi (1922−1929)
Authors: Čeh Steger Jožica
Published: September 2024

In Jarc’s short prose of the 1920s, scattered in various newspapers and magazines, the dominant elements are those of Expressionism, along with a sediment of Cankarian symbolism. To the thematisation of the post-war moral and social chaos in its catastrophic dimensions, the writer, also influenced by the anti-intellectual movements of the time (he was an admirer of Buddhism and Tagore) added a sharp criticism of reason, technology, and of modern civilization, and presented his idea of the spiritual rebirth of man and society through art and recourse to the mysticism of the universe and nature. The central motif-topic blocks consist of metaphors based on flowers, water, light from space, music, technology, mechanisation and animals, including some of the symbolic images of animals and dance. Jarc’s metaphor often serves as an illustration of ideas, especially regarding the moral degradation of man and society, existential states of mind and catastrophic sentiments, but it is also an expression of the beauty of nature and the universe.
Pekel odtujenosti v izbrani kratki prozi Dušana Čatra
Authors: Bošnjak Blanka
Published: September 2024

Advanced reading and analysis of Dušan Čater’s collection of short stories entitled Džehenem (2010) reveals some of its fundamental features: the dominant minimalism from the point of view of literary style (e.g., the dialogic or performative nature of discourse, the integration of everyday non-literary discourse – the mimetic character of speech with all of the linguistic peculiarities, examples of miscommunication, intertextuality, humour, irony) and the thematisation of foreignness or alienation as a result of the identity of the so-called “subject in crisis”, interculturalism, the interweaving of the rural with the urban, etc.
Deformation and cavitation at the spherulite scale of an isotactic polypropylene
Authors: Laiarinandrasana Lucien , Klinkova Olga , Ovalle Cristian , Cloetens Peter , Proudhon Henry , Morgeneyer Thilo
Published: September 2024

Engineering stress-strain curves are generated from tensile tests on semi-crystalline thermoplastics, which may exhibit non-linearity and/or peak stress associated with striction/necking phenomenon of the specimen at the macroscopic scale. This work addresses this state of deformed specimen, on an isotactic polypropylene, where irreversible strains have led to a variable cross-sectional area along the necked region. 3D images in this region, obtained through Synchrotron Radiation Computed Tomography with two high resolutions are exploited. The best resolution (1 pixel length = 0.05 μm) allowed better understanding of the morphology of several deformed spherulites within which polar fan arrangements are clearly detailed. Thanks to the dentification of the boundaries of spherulite patterns, with a 0.7 μm resolution, the longitudinal and transverse elongations of larger numbers of spherulites are measured. The evolution of the volumetric plastic strains due to cavitation at the spherulitic scale along the necked regions is comprehensively analysed. Volume changes at this scale are highlighted, consisting of an increase in the case of void growth followed by a decrease at large strains due to the collapse of elongated voids. The effects of these results on the establishment of reliable constitutive model are discussed. It is found that accounting for plastic dilation is necessary for the accuracy of constitutive models.
Solitons in 4d Wess-Zumino-Witten models -- Towards unification of integrable systems --
Authors: Hamanaka Masashi , Huang Shan-Chi
Published: September 2024

We construct soliton solutions of the four-dimensional Wess-Zumino-Witten
(4dWZW) model in the context of a unified theory of integrable systems with
relation to the 4d/6d Chern-Simons theory. We calculate the action density of
the solutions and find that the soliton solutions behave as the KP-type
solitons, that is, the one-soliton solution has a localized action/energy
density on a 3d hyperplane in 4-dimensions (soliton wall) and the n-soliton
solution describes n intersecting soliton walls with phase shifts. We note that
the Ward conjecture holds mostly in the split signature (+,+,-,-). Furthermore,
the 4dWZW model describes the string field theory action of the open N=2 string
theory in the four-dimensional space-time with the split signature and hence
our soliton solutions would describe a new-type of physical objects in the N=2
string theory. We discuss instanton solutions in the 4dWZW model as well.
Noncommutative extension and quantization of the unified theory of integrable
systems are also discussed.
Pastern wound associated with a type II fracture of the third phalanx in a Mule
Authors: Kabura Eric , Kadja Catherine Mireille , Adamou Sahidi , Kay Gigi , Lepage Olivier M
Published: September 2024

An adult mule was presented with a purulent wound on the distal and medial third of the pastern of his right forelimb (MAD) accompanied by grade 5 lameness. A type II fracture of the third phalanx (P3) was diagnosed by radiological examination. Treatment consisted of analgesics, antibiotics, wound care and a flanged boot bandage, replaced by a Monkey splint the following week. Six (6) months later, a follow-up clinical examination showed a clear reduction in lameness estimated at grade 2 and a clear reduction in pain on palpation.

Un mulet adulte est présenté avec une plaie purulente sur le tiers distal et médial du paturon de son membre antérieur droit (MAD) accompagné d’une boiterie de grade 5. Une fracture de type II de la troisième phalange (P3) a été diagnostiqué par examen radiologique. Le traitement a consisté en l’administration d’antalgique, d’antibiotiques, de soins de la plaie et de la mise en place d’un bandage renforcé par chaussure à rebord remplacé par une attelle de Monkey la semaine suivante. Six (6) mois plus tard, un examen clinique de suivi a montré une nette diminution de la boiterie estimée au grade 2 et une nette diminution de douleur à la palpation.