bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Avicennan unani drug saad kufi (Cyperus scariosus R.Br) for cardiac activity on isolated Langendorff rat heart
Authors: Nafees Sana , Nafees Huda , Amin Kunwar Mohammad Yousuf , Rahman Syed Ziaur
Published: August 2024

Cardioprotective Unani drug, Saad Kufi (Cyperus scariosus R.Br.), mentioned by the intellectual colossus Ibn Sina (Avicenna) a thousand years back in his book, “Kitab al-Adviya al-Qalbia” and still widely used by Unani physicians, was selected for experimental study. The main objective of the study was to explore the trial drug ex vivo for validation, hemodynamic elucidation, and molecular mechanism identification for the improvement of Unani therapeutics and to identify a safe and effective novel cardiovascular drug for mainstream medicine. Five doses of 50% ethanolic extract of the physiochemically standardized root were studied in a normal rat heart, on a semi-automated Langendorff apparatus supported with an advanced data acquisition system, perfused with carbogenated non-recirculating Kreb’s-Hensleit solution, at constant flow mode, by continuous recording. The effect of 6 repetitions (n = 6) of each dose was studied with the following parameters on the Lab chart pro version: heart rate, left ventricular developed pressure, cardiac work, and coronary pressure. The significance of the difference was determined by the student’s “t” test. Results of all doses of Saad Kufi showed a significant increase in the above parameters. The maximum increase was observed by Dose III. It could be concluded that Unani’s clinical use of Saad Kufi (C. scariosus R.Br) as cardioprotective was validated and higher doses were indicated to be clinically optimal. Hemodynamically and molecular mechanism-wise, it is indicated to be a sympathomimetic or inotropic-like agent and possibly a direct vasodilator. Since existing long-term treatment of heart failure is not done by cardiac stimulants or positive inotropic and chronotropic agents, the possible future clinical demonstration of therapeutic improvement in heart failure will bring Saad Kufi as a novel drug in mainstream medicine.
Biological aspects of the lingual papillae of the Arab Zebu cattle: a new perspicuity of its chad ecological adaptations
Authors: Abumandour Mohamed , Haddad Seham , Farrag Foad , Kandyel Ramadan , Roshdy Karam , Massoud Diaa , Khalil Eman Kamal
Published: August 2024

Background

Our research is the first to explore the ultrastructural features of the lingual papillary system of Arab Zebu cattle, highlighting their Chadian environmental adaptations.

Results

There were two types of papillary systems: gustatory (fungiform and circumvallate) and mechanical (filiform, conical, and lentiform). The dorsal surface of the apex and rostral parts of the body had well-developed filiform papillae, whereas the tip’s surface had mucosal folds, tubercles, and few filiform papillae. The torus lingua’s dorsal surface displayed few lentiform papillae, while two conical papillae subtypes and numerous circumvallate papillae were present on its lateral surfaces. A slight median ridge on the dorsal surface of the body had not been described previously. Six filiform papillae subtypes were identified: long and rod-like on the tip; tongue-like and elongated on the lateral area of the apex and body; transient conical and leaf-like on the median line. The accessory processes were: one pair (on long, tongue-like, and transient conical), two pairs (on leaf-like and elongated), and four pairs on the large conical papillae. The two fungiform papillae subtypes were surrounded by a groove and had taste pores (3–5 on the oval and 5–9 on the round papillae). The U-shaped annular bad were observed around the ovoid circumvallate papillae, and the circular bad were observed around the round ones. The circumvallate had taste pores (8–14 on the round’s dorsal and lateral surfaces and 6–10 on the ovoid’s lateral surface).

Conclusion

The papillary system’s regional divergence was specialized for its harsh and semi-harsh diet.
Evaluating crown scorch predictions from a computational fluid dynamics wildland fire simulator
Authors: Atchley Adam L. , Hoffman Chad M. , Bonner Sophie R. , Ritter Scott M. , O’Brien Joseph , Linn Rodman R.
Published: August 2024

Background

Crown scorch—the heating of live leaves, needles, and buds in the vegetative canopy to lethal temperatures without widespread combustion—is one of the most common fire effects shaping post-fire canopies. Despite the ability of computational fluid dynamic models to finely resolve fire activity and buoyant plume dynamics including heterogenous 3D distributions of forest canopy heating, these models have had only limited use in simulating fire effects and have not been used to evaluate crown scorch. Here, we demonstrate a method of evaluating crown scorch using a computational fluid dynamics model, FIRETEC, and validate this approach by simulating the experiments that were used to develop Van Wagner’s 1973 crown scorch model.

Results

The average scorch height prediction from FIRETEC compares well with the empirical model derived by Van Wagner, which is the most widely used empirical model for crown scorch. We further find that the 3D buoyant plume dynamics from a steady and homogeneous idealized heat source on the ground results in a spatially heterogenous crown scorch pattern reflecting complex heating dynamics that are best represented by percent scorch rather than height of scorch.

Conclusions

The ability of the computational fluid dynamics model to capture variation in crown scorch due to 3D buoyant plume dynamics provides direct links between forest structure, fire behavior, and fire effects that can be used by forest managers and researchers to better understand how fires result in crown damage under various environmental and management scenarios.
Fire effects on plant communities in Ozark woodlands and glades
Authors: Stephen Carolyn A. , Drees Dan G. , Ladner Jamie H. , Sullivan Lauren L.
Published: August 2024

Background

Decades of fire suppression caused drastic changes to community structure and composition across ecosystems, including in Ozark woodlands in Missouri, USA. Reintroducing fire can restore ground flora by reducing midstory tree density, increasing ground layer light, and reducing leaf litter accumulation, but we lack a clear understanding of how these effects vary across time and space. We investigated the effects of repeated prescribed fire on ground flora species richness, floristic quality, abundance, community composition, and stand structure over 20 years in a landscape matrix of dry-mesic woodlands, dry woodlands, and glades using data collected from the Ozark National Scenic Riverways Fire Effects Monitoring program in the Current River Watershed in the Missouri Ozarks.

Results

We found that fire plays a key role in driving community structure and dynamics across community types, although with varying levels of intensity. Herbaceous species richness, abundance, and floristic quality index increased across all community types, while mean coefficient of conservatism decreased. Abundance and floristic quality effects were stronger in drier sites. Community composition changed with successive burns, resulting in several indicator species for post burn treatments. The density of midstory trees declined across community types with repeated fire. The number of burns significantly affected overstory tree density overall, but overstory tree density only declined in dry woodlands and glades and not in dry-mesic woodlands.

Conclusions

Our results suggest that landscape fire shapes plant community structure and dynamics. Specifically, these findings show that fire effects vary among community types and suggest that land managers should consider landscape heterogeneity in fire application for restoration. Separate community types imbedded in the same landscape may respond to fire differently. Understanding repeated fire effects over several decades across multiple community types is critical to informing fire-driven woodland restoration across landscape scales.
Inhibition of Sesn2 has negative regulatory effects on the myogenic differentiation of C2C12 myoblasts
Authors: Song Zubiao , Lin Qing , Liang Jiahui , Zhang Weixi
Published: August 2024

Sestrin2 (Sesn2) has been previously confirmed to be a stress-response molecule. However, the influence of Sesn2 on myogenic differentiation remains elusive. This study was conducted to analyze the role of Sesn2 in the myogenic differentiation of C2C12 myoblasts and related aspects in mdx mice, an animal model of Duchenne muscular dystrophy (DMD). Our results showed that knockdown of Sesn2 reduced the myogenic differentiation capacity of C2C12 myoblasts. Predictive analysis from two databases suggested that miR-182-5p is a potential regulator of Sesn2. Further experimental validation revealed that overexpression of miR-182-5p decreased both the protein and mRNA levels of Sesn2 and inhibited myogenesis of C2C12 myoblasts. These findings suggest that miR-182-5p negatively regulates myogenesis by repressing Sesn2 expression. Extending to an in vivo model of DMD, knockdown of Sesn2 led to decreased Myogenin (Myog) expression and increased Pax7 expression, while its overexpression upregulated Myog levels and enhanced the proportion of slow-switch myofibers. These findings indicate the crucial role of Sesn2 in promoting myogenic differentiation and skeletal muscle regeneration, providing potential therapeutic targets for muscular dystrophy.
Ethane integration project—a study for Egyptian NGLs plants and their economics
Authors: Elzohairy Hamdy R. , Ahmed Tamer S. , El-Marsafy Sahar M.
Published: August 2024

For Egypt, ethane is a vital chemical precursor, with the potential to significantly attract financial resources and drive economic growth. Enhancing its added value necessitates efficient recovery of ethane before it enters the national grid without processing. This research investigates the technical and economic feasibility of integrating natural gas liquids (NGLs) from three Egyptian NGLs plants—South Western Desert NGLs (SWD NGLs), North Western Desert NGLs (NWD NGLs), and East Mediterranean NGLs (EMD NGLs)—to improve ethane recovery from natural gas fields. The study focuses on revamping these NGLs plants using various NGLs recovery techniques, conducting a comprehensive comparison to identify the most effective methods for processing rich feed gas. Detailed design of the NGLs recovery processes was developed using HYSYS V.14 simulation software and supplementary calculation sheets. The design criteria encompass both technical and economic parameters to ensure a holistic approach in meeting project requirements. Results indicate a significant increase in ethane recovery: 16% for SWD NGLs, 10% for NWD NGLs (A, B, C), and 85% for EMD NGLs. This improvement will boost ethane feedstock for petrochemical companies from 2000 ton/day to 3500 ton/day, enabling increased polyethylene production. Economic analysis for the base case shows an expected internal rate of return (IRR) of 26%, a net present value (NPV) of USD 73 million, and a payback period of approximately 3 years. Sensitivity analysis on product prices, feed gas prices, and total capital investment confirms the project’s economic viability, with all cases showing feasibility (IRR ≥ 15%) except when product prices fall below USD 225/ton for propane, USD 215/ton for liquefied petroleum gas (LPG), and USD 25/bbl for condensate. This study highlights the potential for enhanced ethane recovery, offering substantial economic benefits and supporting the growth of Egypt’s petrochemical industry.
The benefits and hazards of psychodrama in the management of mental illness: qualitative study linked to nidotherapy
Authors: Ahmed Zenab , Tyrer Peter
Published: August 2024

Drama therapy is a popular form of management in mental illness, as it reaches out beyond many other therapies. Few studies have examined both the advantages and disadvantages of this medium. This qualitative study examines both, and finds gains and hazards.
Nationwide analysis of patients with ovarian cancer: Racial status and risk of metastasis.
Authors: Suenghataiphorn Thanathip , Kulthamrongsri Narathorn , Lohawatcharagul Tuntanut , Kansuttiviwat Chalermkiat , Saowapa Sakditad
Published: August 2024

124

Background: Literature review has found profound disparities in clinical outcomes, for patient with ovarian cancer. Metastasis is the primary cause of cancer morbidity and mortality. However, data on the metastasis risks on hospitalized individuals with ovarian cancer is still limited. Therefore, we aim to assess the association between metastatic ovarian cancer and racial differences using large database analysis. Methods: We analyzed the 2020 U.S. National Inpatient Sample (NIS) to explore patients who have ovarian cancer as the primary diagnosis. Additionally, we identified evidence of metastasis, as recorded by ICD-10-CM. Adjusted odds ratios (aORs) for specified outcomes were calculated through multivariable logistic and linear regression analyses. The primary outcome was racial differences in organ metastasis and secondary outcomes included mortality and length of stay. Statistical significance was established at p-value of 0.05. Results: We identified 19,789 patients with primary diagnosis of ovarian cancer at discharge. The mean age was 61.6 years. Caucasians accounted for 68.3%, with Hispanics at 11.1 % and African Americans at 9.7%. We found that 7% of the patients had liver metastasis. In a multivariate analysis adjusting for patient, COVID-19, chemotherapy usage and hospital factors, African Americans and Hispanics had higher risk of liver metastasis (aOR 1.95; 95%CI (1.32, 2.88), p = 0.001) (aOR 1.78; 95%CI (1.19, 2.66), p = 0.004). We also observed reduced length of stay for Asian Americans (b = -0.74; 95%CI (-1.31, -0.17), p = 0.011). We observed an increase in risk of metastasis and mortality but non-statistically significant in some parameters and races, as shown in table provided. Conclusions: In conclusion, our study revealed that racial difference is associated with higher risk of metastasis, as well as other outcomes. More studies following patients over time are needed to determine if race directly affects how ovarian cancer spreads and other clinical outcomes. [Table: see text]
Longitudinal tracing of on-treatment plasma Epstein-Barr virus DNA as a biomarker for real-time dynamic risk monitoring in patients with nasopharyngeal carcinoma: The EP-SEASON study.
Authors: Xu Ling-Xin , Li Zhi-Xuan , Lin Li , Wu Chen-Fei , Zhou Guan-Qun , Sun Ying , Lv Jiawei , Ma Jun
Published: August 2024

136

Background: Plasma Epstein-Barr virus (EBV) DNA is a biomarker for nasopharyngeal carcinoma (NPC). However, whether longitudinal on-treatment EBV DNA tracing would inform real-time recurrence risk in NPC remains to be elucidated. To address this issue, we conducted EP-SEASON (NCT03855020), a prospective cohort study of longitudinal on-treatment EBV DNA in EBV-positive NPC patients. Methods: Non-metastatic NPC with detectable pretreatment EBV DNA that received standard sequential chemo-radiotherapy were recruited. Serial EBV DNA in blood specimens were collected across pretreatment, 3-week after each induction chemotherapy (IC), every-week during radiotherapy (RT), within 1-week and 1-3 months upon RT completion. EBV DNA extracted from plasma was quantified by a real-time quantitative polymerase chain reaction assay targeting the BamHI-W region of the EBV genome. Longitudinal changing patterns of EBV DNA and their clinical relevance were analyzed. Results: Between May 2019 and April 2021, a total of 1000 patients underwent per-protocol EBV DNA assessments and treatment; 248 and 752 patients received concurrent chemoradiotherapy (CCRT, subcochortno-IC) and IC plus CCRT (subcochortIC), respectively. Longitudinal changes and clearance rates of EBV DNA displayed unique patterns during IC and RT phases. Throughout IC and RT phases, the rate of EBV DNA clearance decreased with repeated IC cycles; interestingly, the rate re-rose upon the introduction of RT, and then dropped to low levels (<10%/week) after the 4th week of RT (post-RT4w). Patients in subcochortno-IC and subcochortIC also exhibited differential clearance patterns during RT, with the rate of clearance being higher in subcochortno-IC before the 2nd week of RT (post-RT2w). Notably, despite the prognostic significance of EBV DNA at each timepoint ( Pall < 0.05), longitudinal EBV DNA displayed a linkage changing map with dynamic recurrence risks: 3-year disease-free survival (DFS) rate steadily dropped with delayed EBV DNA clearance during IC; it re-rose at the 2nd RT week upon EBV DNA clearance, followed by a sharp decrease at the 4th RT week in subcochortIC. In contrast, 3-year DFS rate continuously decreased with delayed EBV DNA clearance in subcochortno-IC. Finally, we identified different phenotypes of whole-course circulating tumor DNA changing dynamics that showed distinct prognosis ( P < 0.05). Conclusions: Longitudinal on-treatment EBV DNA tracing could forecast real-time risks and facilitate risk-adapted decision-making in NPC.
A randomized, multicenter, phase II trial of camrelizumab (Cam) with and without metastasis-directed therapy (MDT) in recurrent/metastatic nasopharyngeal carcinoma (R/M-NPC).
Authors: Zhang Xin , Yan Jin , Lei Qianqian , Zhang Lu , Yang Jieying , Tan Sze Huey , Chua Melvin L.K. , Wang Ying , Sui Jiangdong
Published: August 2024

141

Background: To investigate the on- and off-target treatment responses of MDT when added to camrelizumab – an anti-programmed cell death 1 antibody in patients with R/M-NPC. Methods: We conducted an open-label, randomized, controlled, multicenter, phase II trial in 3 centers from China (NCT04830267). Patients with R/M NPC, without prior exposure to immune checkpoint inhibitors, who presented with ≥2 lesions, and at least 1 measurable lesion were screened and randomized 1:1 to either Cam (200 mg IV 2-weekly) alone or Cam plus MDT (Cam+MDT). Patients randomized to the MDT group must have 1 lesion that is amendable to MDT using stereotactic body radiotherapy (SBRT) prescribed to 27Gy in 3 fractions every other day between the first and second dose of Cam. Primary endpoint was off-target objective response rate (ORR) by RECIST v1.1. Secondary endpoints included on-target ORR, disease control rate (DCR), progression-free (PFS), overall survival (OS), and safety. Results: Between March 1, 2021, and August 16, 2023, 39 patients with R/M NPC were randomly assigned to receive either Cam alone (n=20) or Cam+MDT (n=19). 17/39 (44%) patients had oligometastatic disease (≤3 lesions); 18/39 (46%) had liver metastasis. Median duration of Cam was 4.1 mo (95%CI: 2.4-10.9) and 4.7 mo (95% CI: 2.3-11.0) in both treatment groups, respectively. Sites of MDT included lungs (8/19, 42%), followed by liver (4/19, 21%), bones (4/19, 21%), and lymph nodes (3/19, 16%); median SBRT target volume was 5.8 cc (IQR: 2.7-13.5). Off-target ORR did not differ between the treatment groups (26% vs 30%, P=0.51), although DCR was 74% in the Cam+MDT group compared with 60% in the Cam only group ( P=0.37, Table). After a median follow up of 25.8 mo, median PFS was 9.3 mo (95% CI:6.2-NR) in the Cam+MDT group and 8.8 mo (95% CI: 3.3-NR) in the Cam group (P=0.75), and median OS was not reached in the Cam+MDT gorup (95% CI: 20-NR) and 13.7 mo (95% CI: 11-NR) in the Cam group. Interestingly, exploratory analyses suggest a longer OS with Cam+MDT for patients with >3 metastatic lesions ( HR 0.228 [95% CI: 0.067-0.769]), and no liver involvement ( HR 0.287 [95% CI: 0.068-1.208]). G3 and above adverse events were comparable between the treatment groups (14.3% vs 12.5%). Conclusions: We did not observe a difference for off-target ORR with the addition of MDT to Cam in patients with R/M-NPC, although DCR was higher with combinatorial treatment due to a higher proportion of stable disease. Interestingly, OS was prolonged with Cam+MDT in a subset of patients with >3 lesions and no liver involvement. Clinical trial information: NCT04830267 . [Table: see text]
Laser ablation of stage 4 buccal cancer: A paradigm shift in management.
Authors: Bhalla Rusy , Bhalla Seemantini
Published: August 2024

164

Background: Laser ablation of soft tissue tumors is fast gaining ground in the field of Oncology. Conventional Oral cancer treatment is blamed most often for a radical dip in Quality of Life post-surgery and Radiotherapy. Mutilation, Mouth closure, inability to speak, eat or drink normally discourages patients to adopt surgery in early stages or even treatment as a whole. Laser technology uses controlled heat to burn the cancer affected tissues under sonography control. The new technique of Laser Ablation has removed the need for cutting of face and the need for radiotherapy. Methods: 54 patients were diagnosed with stage 4 inoperable cancer on clinical and radiological examination. Criteria for inoperability were size of tumor more than 3.5 cms and less than 5 cms, involvement of upper or lower Gingivo buccal sulcus with or without involvement of bone. Laser ablation was achieved by using 980mm diode laser. The margins of effective tumor ablation are assessed under sonography. The lymph nodes were laserised percutaneously under sonography control. Post operatively patients were administered chemotherapy by a standard cisplatin, paclitaxel and 5Fu 3 weekly for 6 cycles. Results: All patients showed a decrease in their swelling within 1 month of the procedure. There was an increase in appetite and well being within 2 weeks of the procedure. 47 (90%) patients had a total resolution of the tumor with laser and chemotherapy at 2 months. MRI scans done after 3 months showed a resolution of the original lesion with resolution of lymph nodes. 8 patients (9%) showed a recurrence in the operated area which did not settle on repeat laserisation. These patients underwent standard commando operation at other institutions. 41(75%) patients showed an MRI consistent with no active cancer at 8 months. All of these patients had a weight increase from 4 to 10 kgs compared from pre laser weight over this period. 13 (24%) patients showed a recurrence in neck lymph nodes after 8 months. Of these patients 8 (60%) patients showed a good response to laserisation of the affected node. Over all 80% of patients of stage 4 inoperable buccal cancer were in remission at 2 years with no sign of cancer on MRI scans. Conclusions: Laser ablation of oral cancer in late stage oral cancer should be offered as an alternative to patients not willing for a standard commando operation. Skill sets required for the same are different from conventional surgery. It involves a working knowledge of sonography and has a short learning curve.
Descriptive and content analysis of breast cancer vlogs on YouTube.
Authors: Meguerditchian Ari N. , Htite Elly , Ahisar Yitzchok , Hayman Victoria , Rentschler Carrie A. , Morena Nina
Published: August 2024

18

Background: Vlogs, or “video blogs,” are personally-created experiential videos based on wide-ranging topics, usually posted to YouTube. Many women with breast cancer (BC) document their cancer experiences in YouTube vlogs. These may have the potential to serve as peer-to-peer support and provide community. This study provides a descriptive and content analysis of vlogs by women with BC. Methods: YouTube was searched in incognito mode in 11/2023 using the search terms “breast cancer vlog.” A maximum of 10 videos/creator were included based on viewership and date created. Video characteristics collected included: title, length, number of views, likes, comments, and playlist inclusion. Videos were assessed for sponsorship, presence of explanation and discussion on BC, type of content, and themes. Creator characteristics included age, location, and engagement approaches. Descriptive and content analysis were performed to assess and analyze video content and potential areas where peer-to-peer support may be provided. Results: 90 vlogs by 13 creators were included, all originating from personal accounts. Mean video length, number of views, and number of comments were 21.4 minutes (SD 9.1), 266,780 (SD 534,465), and 1485 (SD 3422), respectively. 38.9% included hashtags. 12.2% included paid sponsorships. Most common filming location was at home (96.7%), followed by the hospital (31.1%), or in the car (21.1%). Home vlogs were most often set in the living room (44.3%), bedroom (33.0%), or kitchen (20.6%). 56.7% included visuals of treatment as well as physical findings. Creators addressed motivation for vlogging in 48.9%; the two most common reasons were wanting to build a community and helping others in a similar situation. In 46.7%, creators explicitly expressed emotion. Most common themes were treatment (85.6%), mental health (81.1%), side effects (72.2%), appearance (63.3%), and family relationships (36.7%). Subthemes included young age, finances, and the importance of online community support. Patient-directed advice was offered in 60.0%, mostly on treatment-related issues. In 56.7%, creators provided explicit treatment definitions. Chemotherapy was discussed in 70.0%; surgery in 57.8%, primarily mastectomy; radiation in 30.0%; general side effects in 71.1%. 24.4% were about a new diagnosis. When mentioned (44.4%), most common creator location was the USA. When mentioned (30.0%), most common age demographic was 20-29 years old. Conclusions: Vlogs by women with BC receive significant levels of engagement. The dedication to building community demonstrated by vlog creators, and the personal nature of their storytelling, advice, and suggestions, may make these vlogs a potential resource for peer-to-peer support.
The impact of HRD mutation on survival in patients with KRAS-mutated advanced pancreatic cancer: A real-world database study.
Authors: Kawanaka Yusuke , Inagaki Chiaki , Takahama Takayuki , Watanabe Satomi , Mitani Seiichiro , Tanizaki Junko , Tanaka Kaoru , Yoshida Takeshi , Iwasa Tsutomu , Kawakami Hisato , Sakai Kazuko , Yonesaka Kimio , Nishio Kazuto , Nakagawa Kazuhiko , Hayashi Hidetoshi
Published: August 2024

221

Background: Advanced pancreatic ductal adenocarcinoma (PDAC) is associated with a poor prognosis. Prior studies indicate that homologous repair deficient (HRD+ve) PDAC patients (pts) have improved survival and greater response to platinum agents, but the optimal treatment for these population is still unclear. Here, we evaluate the survival impact of HRD mutations in KRAS-mutated PDAC, which represent 90% of cases, in a real-world setting. Methods: We retrospectively reviewed all pts diagnosed with KRAS-mutated PDAC from Jun 2019 to Dec 2021, who were registered in the Center for Cancer Genomics and Advanced Therapeutics (C-CAT), the cancer registry with comprehensive genomic profiling (CGP) data. Pts were stratified with the presence or absence of HRD mutations identified through Foundation One, including ATM, ATR, BRCA1, BRCA2, BRIP1, CHEK2, FANCA, PALB2, and RAD51. We analyzed the prevalence of co-alterations and the impact of HRD status on survival. Pts with a history of systemic therapy for curative intent were excluded from the survival analysis. Results: In 2251 PDAC cases (HRD+ve 232pts, HRD-ve 2019pts) enrolled, we found that HRD+ve PDAC had a significantly lower incidence of TP53 mutation (p<0.001), CDKN2A mutation (p<0.046), and CDKN2A loss (p<0.046). Survival analysis was performed in 823 pts (HRD+ve 92pts, HRD-ve 731pts). HRD+ve pts had significantly longer overall survival (OS, 28.8m vs 23.5m, P=0.030). In the first line setting, HRD+ve pts had exhibited a markedly extended time-to-treatment failure (TTF; [HRD+ve, 19pts vs. HRD-ve, 177pts]; 7.6m vs. 5.4m; p=0.026) and OS ([HRD+ve, 30pts vs. HRD-ve, 239pts]; 28.8m vs. 23.5m; p=0.019) when treated with mFOLFIRINOX (mFFX), but not when treated with gemcitabine plus nab-paclitaxel (GA; [HRD+ve, 34pts vs. HRD-ve 276pts]; OS, 29.3m vs 26.3m; p=0.34; TTF, 5.2m vs. 5.2m; p=0.80). In the second line setting, there were no differences in TTF between HRD+ve and HRD-ve irrespective of these regimens. Among HRD+ve PDAC pts, pts who having received mFFX tend to have better survival compared to those who did not (46pts vs. 46pts; OS, 31.7m vs 26.3m; p=0.09). Conclusions: Our analysis has identified a unique profile in HRD+ve PDAC, underscoring the importance of platinum-based chemotherapy in the initial treatment to enhance survival, which highlights the practical clinical benefits of routine CGP for pts with KRAS-mutated PDAC.
Implementation of hippocampal sparing whole brain radiotherapy in a resource-limited setting.
Authors: Lee David Dai-Wee , Jamalludin Zulaikha , Abdul Satar Nur Fadhlina , Ho Gwo Fuang
Published: August 2024

31

Background: Whole brain radiotherapy (WBRT) is a common treatment for brain metastases, but it often leads to cognitive decline due to hippocampal damage. Hippocampal avoidant technique has emerged to mitigate this cognitive toxicity. Our institution began hippocampal-avoidant WBRT (HA-WBRT) in 2021. We report our experience in implementing this technique in a resource-limited setting. Methods: We reviewed the medical records of patients who underwent HA-WBRT in our institution between January 2021 and March 2024. Clinical characteristics, treatment details, and dosimetry were reviewed. Hippocampal sparing was achieved using volumetric-modulated arc therapy (VMAT). Results: A total of 11 patients were included in the analysis. The median age was 57 years old, with a male-to-female ratio of 3:8. Most patients had metastatic breast cancer (7/11) followed by lung cancer (2/11). Among the breast cancer patients, 5 of them had HER2 positive subtype. Ten patients had good performance status (ECOG 0). Most patients (8/11) were treated with 20Gy in 5 fractions (with or without boost to tumor), and 3 patients with 30Gy in 10 fractions. The median time from CT simulation to treatment was 20.5 days. The target volume and organ-at-risk contouring were performed as per the AROMA trial (20Gy in 5 fractions) or RTOG 0933 study (30Gy in 10 fractions). The median beam-on time was 5.61 minutes. Nine patients completed WBRT with minimal acute toxicities. Two patients did not complete treatment due to a decline in performance status. Most patients were treated in multiple institutions thus, follow-up data was scarce. Conclusions: In our experience, HA-WBRT is feasible for suitable patients. Patients that benefit from this technique are younger, have good performance status, and have longer life expectancy e.g. breast primary. The challenges of implementing this treatment are a longer time for contouring and treatment planning, and longer treatment time compared with 2D or 3D WBRT. Long-term follow-up is needed to validate the benefit of this technique. Patient selection is key in implementing HA-WBRT in a resource-limited setting.
Effect of TTYH3 on cholangiocarcinoma invasion, metastasis and lymph node metastasis through Wnt/β-catenin pathway.
Authors: Xie Yuwei , Wu Shengze , Du Fangqian , Gao Ruiqian , Wu Tingting , Jin Chen , Cao Jingyu , Zhu Chengzhan
Published: August 2024

57

Background: Cholangiocarcinoma is a malignant tumor originating from the bile duct epithelium. Metastasis is an important factor affecting the prognosis of cholangiocarcinoma. To explore the role and mechanism of calcium-activated chloride channel protein Tweety homolog 3 (TTYH3) in cholangiocarcinoma metastasis. Methods: TTYH3 was overexpressed and knocked down in cholangiocarcinoma cells, and in vitro experiments were performed to clarify the biological function of TTYH3 in cholangiocarcinoma. Experiments on xenograft tumor mice model have shown that TTYH3 promotes tumorigenesis of cholangiocarcinoma cells. Analysis of the relationship between TTYH3 expression and patient prognosis and lymph node metastasis in cholangiocarcinoma tissue specimens. Exosomes were extracted from bile of patients with cholangiocarcinoma and bile duct stones, and the expression of TTYH3 in exosomes was compared. TTYH3 overexpressed exosomes were used to treat endothelial cells, and their function and mechanism in promoting lymphangiogenesis were analyzed. Results: In vitro experiments confirmed that TTYH3 promoted the migration and invasion of cholangiocarcinoma cell line QBC939. In vivo experiments confirmed that TTYH3 promotes the tumorigenesis of cholangiocarcinoma cells. TTYH3 promotes epithelial-to-mesenchymal transition of cholangiocarcinoma cells through the Wnt/β-catenin signaling pathway. TTYH3 promotes cholangiocarcinoma cell self-expression through positive feedback. TTYH3 is highly expressed in cholangiocarcinoma tissues. Patients with high TTYH3 expression have poor prognosis and a high incidence of lymph node metastasis. The TTYH3 protein content of bile exosomes in patients with cholangiocarcinoma is increased, which promotes the invasion and metastasis of cholangiocarcinoma cells, while also promoting lymphangiogenesis and increased permeability. TTYH3 promotes the uptake of exosomes by lymphatic cells and promotes lymphangiogenesis by regulating the influx of calcium ions and chloride ions in lymphatic cells. Conclusions: TTYH3 promotes the invasion and metastasis of cholangiocarcinoma cells through the Wnt/β-catenin signaling pathway, and exosome TTYH3 promotes lymphangiogenesis and lymph node metastasis.
Clinical Anatomy of the Sacral Nerve Roots and Its Relevance to Their Reconstruction After Sacrectomy
Authors: Kaiser Radek , Khadanovich Anhelina , Benes Michal , Reynolds Jeremy , Mawhinney Gerard , Giele Henk , Kachlik David
Published: August 2024

BACKGROUND AND OBJECTIVES:

En bloc sacrectomy is associated with sacral root transection causing loss of urinary bladder, rectum, and sexual function. The aim of the study was to determine the position of the pudendal branches (sensorimotor) and pelvic splanchnic nerves (parasympathetic) on the sacral roots relative to the sacrum, and the minimal and maximal defects in the sacral roots that can be reconstructed by grafting after various types of sacrectomy.

METHODS:

Five cadaveric pelves were dissected bilaterally. The lengths and widths of the S1-S4 roots and their branches were measured. Then, the minimal and maximal defects between the proximal and distal stumps of the sacrificed roots were measured following 3 models of sacrectomy (below S2, below S1, and total sacrectomy).

RESULTS:

The mean distance of the splanchnic nerves from the S2 and S3 anterior sacral foramina was 17.7 ± 7.3 and 23.6 ± 11.1 mm, respectively, and the mean distance of the pudendal S2 and S3 branches was 36.8 ± 13.7 and 30.2 ± 10.8 mm, respectively. The mean widths of the S2 and S3 roots were 9.3 ± 1.9 and 5.4 ± 1.2 mm, respectively. The mean maximal defects in S2 and S3 roots after various types of sacrectomies were between 61.8 ± 16.3 and 100.7 ± 14.3 mm and between 62.7 ± 20.2 and 84.7 ± 25.1 mm, respectively. There were no statistically significant differences between sides or sexes for all obtained measurements.

CONCLUSION:

The reconstruction of the S2-S3 roots is anatomically feasible after partial or total sacrectomies in which the resection of the soft tissue does not extend further than approximately 1.5 to 2 cm ventrally from the sacrum.
Comparative Analysis of Duroplasty Techniques in Decompressive Craniectomy: The CANDID Study
Authors: Ramola Mahesh , Ramola Monika , Singh Jagjeet , Khurana Lavleen , Chhabra Sarab , Garg Ritish , Singh Udisha , Nath Kavindra
Published: August 2024

BACKGROUND AND OBJECTIVE:

At present, there is no consensus regarding the most optimal dural substitute to use for duroplasty in primary decompressive craniectomy (PDC) for traumatic brain injury (TBI). The author's objective was to conduct a retrospective analysis comparing 2 techniques of PDC: duroplasty using anterior-based vascularized galea pericranium (VP group) with synthetic dural substitute duroplasty (SR group).

METHODS:

From April 2015 to February 2022, 379 craniotomies were done for TBI. The outcome of eligible 97 consecutive patients receiving PDC treatment were examined. Out of 97, 60 received vascularized galea pericranium and 37 received synthetic dural graft for dural augmentation. Propensity matching generated 28 pairs (56 patients) for analysis. The primary outcome was extended Glasgow Outcome Scale (GOS-E) measured at 6 months after injury. Secondary outcomes included were incidence of surgical complications (neurosurgical site infections, and hemorrhagic and hydrodynamic complications), surgical time, days in intensive care unit, hospital length of stay, hospital mortality, and GOS-E at 1 year after injury.

RESULTS:

Patients in VP group, compared with those in SR group had better GOS-E score at 6 months (P = .011) and 1 year (P = .026). Hospital mortality (P = .342), days in intensive care unit (P = .574), hospital stay (P = .155), surgical time (P = .131), medical and surgical complications including neurosurgical infections, and hemorrhagic and hydrodynamic complications did not differ significantly in both groups. Complication of brain abscess was found exclusively in the SR group (P = .327).

CONCLUSION:

In this retrospective study, adults who underwent PDC for TBI using anterior-based vascularized galea pericranial graft were associated with better clinical outcomes at 6 months and 1 year compared with standard repair group using synthetic dural substitute (G patch).
Microsurgical Repair of Ventral Cerebrospinal Fluid Leaks in Spontaneous Intracranial Hypotension: Efficacy and Safety of Patch-Sealing Versus Suturing
Authors: Petutschnigg Thomas , Häni Levin , Goldberg Johannes , Dobrocky Tomas , Piechowiak Eike I. , Raabe Andreas , Jesse C. Marvin , Schär Ralph T.
Published: August 2024

BACKGROUND AND OBJECTIVES:

In patients with spontaneous intracranial hypotension (SIH), microsurgical repair is recommended in Type 1 (ventral) dural leaks, when conservative measures fail. However, there is lacking consensus on the optimal surgical technique for permanent and safe closure of ventral leaks.

METHODS:

We performed a retrospective analysis of surgically treated SIH patients with Type 1 leaks at our institution between 2013 and 2023. Patients were analyzed according to the type of surgical technique: (1) Microsurgical suture vs (2) extradural and intradural patching (sealing technique). End points were resolution of spinal longitudinal epidural cerebrospinal fluid collection (SLEC), change in brain SIH-Score (Bern-Score), headache resolution after 3 months, surgery time, complications, and reoperation rates.

RESULTS:

In total, 85 (66% women) patients with consecutive SIH (mean age 47 ± 11 years) underwent transdural microsurgical repair. The leak was sutured in 53 (62%) patients (suture group) and patch-sealed in 32 (38%) patients (sealing group). We found no significant difference in the rates of residual SLEC and resolution of headache between suture and sealing groups (13% vs 22%, P = .238 and 89% vs 94%, P = .508). No changes were found in the postoperative Bern-Score between suture and sealing groups (1.4 [±1.6] vs 1.7 [±2.1] P = 1). Mean surgery time was significantly shorter in the sealing group than in the suture group (139 ± 48 vs 169 ± 51 minutes; P = .007). Ten patients of the suture and 3 of the sealing group had a complication (23% vs 9%, P = .212), whereas 6 patients of the suture and 2 patients of the sealing group required reoperation (11% vs 6%, P = .438).

CONCLUSION:

Microsurgical suturing and patch-sealing of ventral dural leaks in patients with SIH are equally effective. Sealing alone is a significantly faster technique, requiring less spinal cord manipulation and may therefore minimize the risk of surgical complications.
Membrane structures and functional correlates in the bi-segmented eye lens of the cephalopod
Authors: Regini Justyn W. , Yagi Naoto , Young Robert D. , Tanioka Hidetoshi , Kinoshita Shigeru , Hoshino Masato , Uesugi Kentaro , Meek Keith M. , Augousti Andy T. , Knupp Carlo , Pierscionek Barbara K. , Quantock Andrew J. , Elliott Gerald F.
Published: August 2024

The cephalopod eye lens is unique because it has evolved as a compound structure with two physiologically distinct segments. However, the detailed ultrastructure of this lens and precise optical role of each segment are far from clear. To help elucidate structure–function relationships in the cephalopod lens, we conducted multiple structural investigations on squid. Synchrotron x-ray scattering and transmission electron microscopy disclose that an extensive network of structural features that resemble cell membrane complexes form a substantial component of both anterior and posterior lens segments. Optically, the segments are distinct, however, and Talbot interferometry indicates that the posterior segment possesses a noticeably higher refractive index gradient. We propose that the hitherto unrecognised network of membrane structures in the cephalopod lens has evolved to act as an essential conduit for the internal passage of ions and other metabolic agents through what is otherwise a highly dense structure owing to a very high protein concentration.
Genetic identification of alien larch taxa – the case of the Tatra National Park
Authors: Kempf Marta , Hebda Anna , Zięba Antoni , Zwijacz-Kozica Tomasz
Published: August 2024

The natural consequences of introducing alien species can be significant. This is particularly a concern where the taxa have an invasive nature of spreading or in those that freely crossbreed with native species. The hybridization process may lead to impoverishment or even loss of the native gene pool. This is especially dangerous in unique areas that stand out due to their special natural characteristics, such as the Tatra National Park. The determination of the scale of occurrence of alien larch species in the national park and the evaluation of the genetic diversity of the native population is crucial for the conservation of genetic resources and strictly adheres to the latest conservation genetics trends. We evaluated the possibility of effective use of molecular markers for taxonomic identification of the native European larch (Larix decidua Mill.), as well as the alien Japanese larch (Larix kaempferi [Lambert] Carriere) and the hybrid form (Larix × eurolepis Henry). Microsatellite markers were used to analyse the genetic diversity of individuals identified as European larch from natural refuges and artificial plantings. Of the 148 trees analysed, 105 were identified as the European larch, 38 as Japanese larch, and five as hybrids. The analysis of the molecular variability of two European larch groups of indigenous and artificial origin showed comparable level of diversity. This study confirmed the effectiveness of the use of selected molecular markers in identification of larch species, which is difficult based on morphological traits. The results indicate the possibility for the effective use of genetic tools in the creation of protection programmes, especially for naturally valuable sites, based on genetic taxonomic identification and richness verification of protected gene pools.
Comparative evaluation of efficacy of Trayodashang Guggul versus Rasona Pinda as an adjuvant with Katibasti in the management of Grudhrasi (Sciatica): A randomized controlled trial
Authors: Rai Mayank , Misar Sadhana , Gamne Reeya
Published: August 2024

Background In ayurveda, sciatica can be correlated to ‘Grudhrasi’ under Vata Nanatmaja-Vyadhi (neurological disorders caused by Vata, one of the bodily humour). In this mainly bodily humours vata and kapha are vitiating producing symptoms like piercing pain, stiffness, twitching, numbness and pain radiating from lumbosacral region to lower limb up to the foot. Therapeutic plan includes stabilizing and bringing back the vitiated vata and kapha humours to equilibrium. The prevalence of sciatica varies considerably ranging from 3.8% in the working population to 7.9% in the nonworking population. Aim Comparative evaluation of efficacy of Rasonapinda and Trayodashang guggul as an adjuvant to katibasti (oil pooling therapy) in the management of Grudhrasi (Sciatica). Objectives To assess the efficacy of Rasonapinda as an adjuvant to katibasti in subjective and objective parameters of Grudhrasi (Sciatica). To assess the efficacy of Trayodashang guggul as an adjuvant to katibasti in subjective and objective parameters of Grudhrasi (Sciatica). To compare the efficacy of Rasonapinda and Trayodashang guggul as an adjuvant to katibasti in subjective and objective parameters. Standardisation of Rasonapinda (modified formvati). Methods In this study, a total of 60 patients will be enrolled and divided equally into two groups. In group A, Trayodashang Guggul 500 mg twice a day after meal with warm water for 30 days adjuvant with katibasti for the initial 7 days will be given. In group B, Rasonapinda 500 mg twice a day after meal with warm water adjuvant with katibasti for the initial 7 days will be given for 30 days. Result The result will be assessed on baseline of subjective and objective parameters and data will be compared after treatment. Conclusions It will be based on observations and results obtained. Trial registration CTRI No. - CTRI/2022/12/048534 Dated – 27/12/2022.
Acute Kidney Injury Complicating Critical Forms of COVID-19: risk Factors and Prognostic Impact
Authors: Guissouma Jihene , Ben Ali Hana , Allouche Hend , Trabelsi Insaf , Hammami Olfa , Yahia Yosra , Hatem Ghadhoune
Published: August 2024

Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mainly affects the respiratory tract, but different organs may be involved including the kidney. Data on acute kidney injury (AKI) in critical forms of coronavirus disease 2019 (COVID-19) are scarce. We aimed to assess the incidence, risk factors and prognostic impact of AKI complicating critical forms of COVID-19. Methods A retrospective descriptive case/control monocentric study conducted in a medical intensive care unit of a tertiary teaching hospital over a period of 18 months. Results We enrolled 144 patients, with a mean age of 58±13 years old and a male predominance (sex-ratio: 1.25). Forty-one (28%) developed AKI within a median of 4 days (Q1: 3, Q3: 8.5) after hospitalization. It was staged KDIGO class 3, in about half of the cases. Thirteen patients underwent renal replacement therapy and renal function improved in seven cases. Diabetes (OR: 6.07; 95% CI: (1,30-28,4); p: 0.022), nephrotoxic antibiotics (OR: 21; 95% CI: (3,2-146); p: 0.002), and shock (OR: 12.21; 95% CI: (2.87-51.85); p: 0.031,) were the three independent risk factors of AKI onset. Mortality was significantly higher in AKI group (OR: 3.94; 95% CI: (1.65-9.43); p<10−3) but AKI didn’t appear to be an independent risk factor of poor outcome. In fact, age (p: 0.004), shock (p: 0.045) and MV (p<10−3) were the three prognostic factors in multivariate analysis. Conclusions The incidence of AKI was high in this study and associated to an increased mortality. Diabetes, use of nephrotoxic antibiotics and shock contributed significantly to its occurrence. This underlines the importance of rationalizing antibiotic prescription and providing adequate management of patients with hemodynamic instability in order to prevent consequent AKI.