bluuebunny/crossref_metadata_2025 huggingface dataset:
Oncological Outcome of Node‐Positive Oral Squamous Cell Carcinomas Treated With Selective and Comprehensive Neck Dissection
Authors: Voss Jan Oliver , Freund Lea , Neumann Felix , Rubarth Kerstin , Kreutzer Kilian , Sander Steffen , Golembiewski Evelyn , Mrosk Friedrich , Doll Christian , Rendenbach Carsten , Heiland Max , Koerdt Steffen
Published: July 2024

Selective neck dissection (SND) is the treatment of choice in patients with oral squamous cell carcinomas (OSCCs) and clinically node‐negative necks (cN0). The treatment of patients with positive‐staged necks (cN+) includes SND as well as comprehensive neck dissection (CND). The clear benefit of one or the other remains under debate. We aim to address this lack of clarity by analysing patients with OSCC staged with clinically node‐positive necks, treated with either CND or SND using a level‐by‐level approach. This retrospective study included patients diagnosed with OSCC with clinically (cN+) and pathologically (pN+) positive cervical lymph nodes (LNs) with clear neck level categorization during the years 2010–2019. In total, 74 patients were analysed. Cox regression analysis found no significance for the type of ND being an independent risk factor, neither for overall survival (OS) nor for disease‐free survival (DFS). Regional recurrence of CND cases (5.77%) was comparable to SND cases (9.09%). For OS, extracapsular spread (ECS) and male sex were identified as independent risk factors with poorer outcome. pT‐stage and ECS were found to be independent risk factors for DFS. The results of this study suggest that both CND and SND may be viable treatment options for certain patients with OSCC pN+.
¿Deben condonarse las deudas del Crédito con Aval del Estado?
Authors: Ponce Carlos
Published: July 2024

El artículo analiza la propuesta de condonar las deudas del Crédito con Aval del Estado (CAE) en Chile. El autor argumenta en contra de la condonación universal, explicando el CAE como una solución a las imperfecciones del mercado de créditos para educación superior. Se discuten los beneficios del CAE en términos de acceso a la educación y el retorno de la inversión en capital humano. El autor sostiene que condonar las deudas sería injusto para los contribuyentes y dañaría la credibilidad del gobierno en futuras políticas públicas.
precio del petróleo
Authors: Bobenrieth Hochfarber Eugenio S.A.
Published: July 2024

El artículo analiza la volatilidad de los precios del petróleo, contrastando la estabilidad relativa de la producción y el consumo con las fuertes fluctuaciones de precios. Se explica que estas variaciones no se deben principalmente a cambios en la oferta o demanda inmediatas, sino a ajustes en las expectativas sobre el mercado futuro. El autor presenta modelos económicos dinámicos desarrollados por él y sus colegas para predecir estos eventos de volatilidad, incluyendo situaciones extremas como precios negativos o "súper-contangos".
Supplementary Figure 2 from PTP4A2 Promotes Glioblastoma Progression and Macrophage Polarization under Microenvironmental Pressure
Authors: Chouleur Tiffanie , Emanuelli Andrea , Souleyreau Wilfried , Derieppe Marie-Alix , Leboucq Téo , Hardy Serge , Mathivet Thomas , Tremblay Michel L. , Bikfalvi Andreas
Published: July 2024

Spheroid growth assay in the presence of pharmacological PRL inhibitors
Supplementary Figure 1 from PTP4A2 Promotes Glioblastoma Progression and Macrophage Polarization under Microenvironmental Pressure
Authors: Chouleur Tiffanie , Emanuelli Andrea , Souleyreau Wilfried , Derieppe Marie-Alix , Leboucq Téo , Hardy Serge , Mathivet Thomas , Tremblay Michel L. , Bikfalvi Andreas
Published: July 2024

Effect of pharmacological PRL inhibition
The Impact of Some Vitamins and Minerals Supplements on Type 2 Diabetes (T2DM) Management
Authors: Musafer Karar Nadhum Jawad ,   Department of Pharmacy, Al-Zahrawi University College, Karbala, Iraq, Mohammed Amera Kamal , Chobok Ali Sabah , AL-Mousawi Masar Riyadh Rashid , Huyop Fahrul , Al-Thuwaini Tahreer M. ,   Clinical laboratory sciences Department., College of Pharmacy, University of Kirkuk, 36001Kirkuk -Iraq,   Department of Pharmacy, Al-Zahrawi University College, Karbala, Iraq,   Department of Microbiology, College of Medicine, Kerbela University, 56001, Iraq,   Department of Biosciences, Faculty of Science, Universiti Teknologi Malaysia, 81310 UTM, Johor Bahru,  Malaysia,   Department of Animal Production, College of Agriculture, Al-Qasim Green University, Al-Qasim, Babil 51001, Iraq
Published: July 2024

A chronic metabolic condition, type 2 diabetes mellitus (T2DM) typically presents with hyperglycemia owing to elevated tissue insulin resistance or inadequate insulin release. In addition to the use of pharmaceutical agents and lifestyle changes for the management of T2DM, supplementation with various vitamins and minerals has also been proven to be of benefit. The objective of the present research was to establish the effectiveness of vitamin B12, vitamin C, selenium, and chromium as adjunctive therapy given over 120 days in diminishing insulin resistance. In total, 32 individuals (16 men and 16 women) living with diabetes were enrolled in the study. Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum insulin concentrations, and homeostatic model assessment of insulin resistance (HOMA-IR) were quantified at baseline and on day 120 of supplementation. Mean FBG and HbA1c levels and insulin concentrations all decreased, i.e. 185.11 ± 22.67 mg/dL vs. 163.57 ± 19.31 mg/dL (P = 0.02), 8.47 ± 0.52% vs. 7.80 ± 0.48% (P = 0.003), and 23.15 ± 3.87 vs. 15.85 ± 1.46 (P = 0.02), respectively. HOMA-IR values remained unchanged. The association between therapy and clinical features was examined using logistic regres-sion analysis. In the subjects with T2DM, FBG, and HbA1c levels were diminished by a factor of 2. It was concluded that vitamin and mineral supplementation was of benefit with respect to glycemic parameters. Nevertheless, high-quality evidence that supports the efficacy of such substances to improve glucose homeostasis and insulin resistance in individuals with T2DM in a clinical setting is lacking
Bioplastic from Agar Powder: Preparation and Its Characterization
Authors: Sable Sunil , Vairal Anushka , Bhosale Vaibhavi , Surve Sahil , Raza Uwais , Thengre Mohit
Published: July 2024

The escalating environmental concerns associated with synthetic plastics have intensified the search for sustainable alternatives. Among various biodegradable materials, bioplastics derived from natural polymers present a promising solution. This study explores the preparation and characterization
of bioplastic using agar powder, a polysaccharide extracted from red algae. Agar-based bioplastic formulations were developed by varying concentrations of agar, glycerol as a plasticizer, and other eco-friendly additives to enhance the mechanical and physical properties. The bioplastics were
synthesized through a solvent casting method, and their characteristics were analyzed using tensile strength tests, biodegradability assays, and thermal stability evaluations. The results indicated that the optimal formulation achieved a significant improvement in flexibility and strength
compared to traditional agar bioplastics. Furthermore, the bioplastics exhibited excellent biodegradability in soil burial tests, highlighting their environmental benefits. This study not only contributes to the growing body of knowledge on biodegradable materials but also underscores the
potential of agar-derived bioplastics in reducing the reliance on conventional plastics, thereby supporting sustainable development goals.
Unveiling the efficacy of Bacillus faecalis and composted biochar in alleviating arsenic toxicity in maize
Authors: Liao Yonghui , Ashraf Humaira , Huang Shoucheng , Ramzan Musarrat , Saba Rabia , Baqir Muhammad , Salmen Saleh H. , Alharbi Sulaiman Ali , Hareem Misbah
Published: July 2024

Arsenic (As) contamination is a major environmental pollutant that adversely affects plant physiological processes and can hinder nutrients and water availability. Such conditions ultimately resulted in stunted growth, low yield, and poor plant health. Using rhizobacteria and composted biochar (ECB) can effectively overcome this problem. Rhizobacteria have the potential to enhance plant growth by promoting nutrient uptake, producing growth hormones, and suppressing diseases. Composted biochar can enhance plant growth by improving aeration, water retention, and nutrient cycling. Its porous structure supports beneficial microorganisms, increasing nutrient uptake and resilience to stressors, ultimately boosting yields while sequestering carbon. Therefore, the current study was conducted to investigate the combined effect of previously isolated Bacillus faecalis (B. faecalis) and ECB as amendments on maize cultivated under different As levels (0, 300, 600 mg As/kg soil). Four treatments (control, 0.5% composted biochar (0.5ECB), B. faecalis, and 0.5ECB + B. faecalis) were applied in four replications following a completely randomized design. Results showed that the 0.5ECB + B. faecalis treatment led to a significant rise in maize plant height (~ 99%), shoot length (~ 55%), root length (~ 82%), shoot fresh (~ 87%), and shoot dry weight (~ 96%), root fresh (~ 97%), and dry weight (~ 91%) over the control under 600As stress. There was a notable increase in maize chlorophyll a (~ 99%), chlorophyll b (~ 81%), total chlorophyll (~ 94%), and shoot N, P, and K concentration compared to control under As stress, also showing the potential of 0.5ECB + B. faecalis treatment. Consequently, the findings suggest that applying 0.5ECB + B. faecalis is a strategy for alleviating As stress in maize plants.
The expression and clinical significance of CFAP65 in colon cancer
Authors: Li Yunze , Ran Dongmei , Basnet Shiva , Zhang Buzhe , Pei Hongjing , Dan Chenchen , Zhang Zixuan , Zhang Liang , Lu Tianyu , Peng Yifan , Du Changzheng
Published: July 2024

Background

CFAP65 (cilia and flagella associated protein 65) is a fundamental protein in the development and formation of ciliated flagella, but few studies have focused on its role in cancer. This study aimed to investigate the prognostic significance of CFAP65 in colon cancer.

Methods

The functionally enriched genes related to CFAP65 were analyzed through the Gene Ontology (GO) database. Subsequently, CFAP65 expression levels in colon cancer were evaluated by reverse transcription and quantitative polymerase chain reaction (RT-qPCR) and immunoblotting in 20 pairs of frozen samples, including tumors and their matched paratumor tissue. Furthermore, protein expression of CFAP65 in 189 colon cancer patients were assessed via immunohistochemical staining. The correlations between CFAP65 expression and clinical features as well as long-term survival were statistically analyzed.

Results

CFAP65-related genes are significantly enriched on cellular processes of cell motility, ion channels, and GTPase-associated signaling. The expression of CFAP65 was significantly higher in colon cancer tissue compared to paratumor tissue. The proportion of high expression and low expression of CFAP65 in the clinical samples of colon cancer were 61.9% and 38.1%, respectively, and its expression level was not associated with the clinical parameters including gender, age, tumor location, histological differentiation, tumor stage, vascular invasion and mismatch repair deficiency. The five-year disease-free survival rate of the patients with CFAP65 low expression tumors was significantly lower than that those with high expression tumors (56.9% vs. 72.6%, P = 0.03), but the overall survival rate has no significant difference (69% vs. 78.6%, P = 0.171). The cox hazard regression analysis model showed that CFAP65 expression, tumor stage and tumor location were independent prognostic factors.

Conclusions

In conclusion, we demonstrate CFAP65 is a potential predictive marker for tumor progression in colon cancer.
Comparison of allergy prevalence using brinzolamide 1.0% / brimonidine 0.2% fixed combination with and without β-blocker in glaucoma patients: a retrospective cohort study
Authors: Park In Ki , Bae Seon Ha , Jeong Jae Hoon , Kim Kyoung Woo , Yi Kayoung , Chun Yeoun Sook
Published: July 2024

Background

Glaucoma treatment often involves multi-drug regimens, which can lead to poor adherence and side effects. Fixed-dose combinations aim to improve adherence and reduce side effects compared to traditional therapies. This study aimed to compare the prevalence and clinical characteristics of ocular allergy in glaucoma patients using brinzolamide 1.0%/brimonidine 0.2% fixed combination (BBFC), with and without concurrent β-blocker.

Methods

Of these, 176 patients used a β-blocker concurrently, whereas 96 patients did not. Allergy prevalence, allergy type, and allergy occurrence time were compared between the concurrent and non-concurrent β-blocker-usage groups. Ocular allergies were classified and evaluated using Kaplan–Meier survival analysis.

Results

Allergy prevalence was 10.23% and 15.63% (p = 0.193), whereas allergy occurrence time was 15.92 ± 13.80 months and 6.26 ± 6.20 months (p = 0.04) in the concurrent and non-concurrent β-blocker-usage groups, respectively. Kaplan–Meier survival analysis indicated that half of the allergies in the concurrent β-blocker-usage group occurred within 12.5 months, with the BBFC discontinuation rate gradually increasing up to 36 months. Contrarily, half of the allergies in the non-concurrent β-blocker-usage group occurred within 3.3 months, with a rapid increase in BBFC discontinuation rate the first 6 months. Intergroup differences in allergy types were significant (p = 0.015). Among all patients with allergy, the average allergy occurrence time of blepharoconjunctivitis, papillary conjunctivitis, and follicular conjunctivitis was 12.52, 9.53, and 13.23 months, respectively. Follicular conjunctivitis tended to occur later than papillary conjunctivitis (p = 0.042). In the concurrent β-blocker-usage group, follicular conjunctivitis was the most prevalent allergy type (61.1%), whereas papillary conjunctivitis was the most common (66.7%) in in the non-concurrent β-blocker-usage group.

Conclusions

Concurrent use of β-blocker with BBFC decreases allergy prevalence, delays allergy onset, and predominantly results in follicular conjunctivitis, thereby facilitating longer treatment duration. Understanding these characteristics of allergy in BBFC users is useful to manage patients and improve treatment adherence. This study provides insights into the role of β-blockers in modulating ocular allergy in BBFC-treated glaucoma patients, highlighting implications for clinical practice and patient education.
Maternal distress, parenting stress, maladaptive parenting and children’s problematic media use in China: evidence from 2022 spring in Shanghai
Authors: Wang Jingyao , Wang Shumin , Xiao Bowen , Li Juan , Feng Yuemin , Li Yan
Published: July 2024

The COVID-19 lockdown has forced young children to spend more time on media and significantly impacted their mothers’ mental health. This study explored how mothers’ individual distress influences children’s problematic media use during the Shanghai citywide lockdown caused by COVID-19. Data were collected from 1889 Chinese mothers (Mage = 34.69 years, SD = 3.94 years) with preschoolers aged 3–6 years (Mage = 4.38 years, SD = 1.06 years; 49.0% boys) via an online survey. The statistical analyses relied on SPSS Statistics version 26.0 and macro-program PROCESS 3.3. to investigate the associations and mediation analysis among all the study variables. The results indicated a positive association between maternal distress and children’s problematic media use, mediated by parenting stress and maladaptive parenting. Specifically, the serial mediation analysis revealed that high levels of maternal distress exacerbate parenting stress, which in turn leads to maladaptive parenting practices. These maladaptive practices subsequently increase problematic media use in preschool children. The findings highlighted that parents need to enhance their ability to manage risk and promote mental health during periods of significant stress and routine disruption to reduce children’s problematic media use.
Low HDL-C/ApoA-I index is associated with cardiometabolic risk factors and coronary artery calcium: a sub-analysis of the genetics of atherosclerotic disease (GEA) study
Authors: Cardoso-Saldaña Guillermo Celestino , Antonio-Villa Neftali Eduardo , Martínez-Alvarado María del Rocío , González-Salazar María del Carmen , Posadas-Sánchez Rosalinda
Published: July 2024

Background

The high-density lipoprotein cholesterol to apolipoprotein A-I index (HDL-C/ApoA-I) may be practical and useful in clinical practice as a marker of atherosclerosis. This study aimed to investigate the association between the HDL-C/ApoA-I index with cardiometabolic risk factors and subclinical atherosclerosis.

Methods

In this cross-sectional sub-analysis of the GEA study, 1,363 individuals, women (51.3%) and men (48.7%) between 20 and 75 years old, without coronary heart disease or diabetes mellitus were included. We defined an adverse cardiometabolic profile as excess adipose tissue metrics, non-alcoholic liver fat measured by non-contrasted tomography, metabolic syndrome, dyslipidemias, and insulin resistance. The population was stratified by quartiles of the HDL-C/Apo-AI index, and its dose-relationship associations were analysed using Tobit regression, binomial, and multinomial logistic regression analysis.

Results

Body mass index, visceral and pericardial fat, metabolic syndrome, fatty liver, high blood pressure, and CAC were inversely associated with the HDL-C/ApoA-I index. The CAC > 0 prevalence was higher in quartile 1 (29.2%) than in the last quartile (22%) of HDL-C/ApoA-I index (p = 0.035). The probability of having CAC > 0 was higher when the HDL-C/ApoA-I index was less than 0.28 (p < 0.001). This association was independent of classical coronary risk factors, visceral and pericardial fat measurements.

Conclusion

The HDL-C/ApoA-I index is inversely associated with an adverse cardiometabolic profile and CAC score, making it a potentially useful and practical biomarker of coronary atherosclerosis. Overall, these findings suggest that the HDL-C/ApoA-I index could be useful for evaluating the probability of having higher cardiometabolic risk factors and subclinical atherosclerosis in adults without CAD.
Evaluating the impact of social media marketing from the perspective of orthodontists
Authors: Değirmencioğlu Eyüp , Kılıçoğlu Hülya
Published: July 2024

Objective

In developed countries, orthodontists utilize social media platforms as a pivotal component of their marketing strategies. However, there exists a gap in understanding the broader perspective of healthcare professionals on the utilization of social media in healthcare service delivery. Therefore, this study aims to evaluate the perceptions of healthcare professionals in Turkey regarding the integration of social media within healthcare service delivery.

Materials & methods

This cross-sectional study, conducted between January and February 2023, surveyed 378 members of the Turkish Orthodontic Society. The survey consisted of two parts: a demographic questionnaire with 28 items and a 21-item “Social Media Marketing Activities Scale,” developed with input from three experts. Data analysis will include an explanatory factor analysis. This study provides a snapshot of orthodontists’ perspectives on social media marketing practices.

Results

When participants’ views of patient communication through social media were examined, 19.8% said they “thought it was right” and 80.2% said they “thought it was wrong”. The treatment and treatment alternatives shared with patients through social media were implemented in 16.5% of cases and not implemented in 83.5% of cases. When examining the social media accounts used by participants to communicate with patients, 56.8% used personal accounts, 43.2% used professional accounts, and when analyzing the social media accounts they used for promotional purposes, 15.8% had personal accounts, 84.2% of them used professional accounts. More than half (59.8%) of orthodontists believed that communicating with patients on social media could cause legal problems. The majority of orthodontists (88.7%) followed their competitors.

Conclusion

The prevalence of participants’ use of social media posts for advertising purposes was low, and it was determined that the main reason for this was the prohibition of advertising in the provision of health services.
Understanding learners’ experiences across three major transitions in undergraduate medical education
Authors: Weyant-Cheeseman Morgan E. , Abrams Matthew P. , Toselli Nicholas , Castiglioni Analia
Published: July 2024

Background

Medical students in the United States undergo three significant transitions as they progress from pre-clinical to clinical rotations, to acting interns, and ultimately to first-year resident. However, there is limited understanding of whether the factors and strategies that impact these transitions remain consistent or are unique to each individual transition.

Methods

Qualitative data was collected from three Nominal Group Technique (NGT) sessions held separately for third-year students (M3), fourth-year students (M4), and first-year residents (PGY-1). The participants were asked to share their perceptions on their most recent medical school transition. These responses were independently coded into thematic categories.

Results

The NGT session with M3 students (n = 9) identified 67 transition factors and 64 coping strategies. The M4 (n = 8) session identified 33 transition factors and 72 strategies to manage their transition. The PGY-1 (n = 5) session identified 28 factors and 25 strategies. The coping strategies for each session were categorized into seven themes and the transition factors were assigned to ten thematic categories.

Conclusion

Just as each transition is unique, so too are the number and variety of factors and strategies to manage each transition. Despite these differences, the themes of “Professional socialization” and “Prioritization, efficiency, and delegation” emerged as impactful in all three transitions.
Factors influencing research productivity among Syrian medical professionals amidst conflict: a case-control study
Authors: Hanafi Ibrahem , Kheder Kheder , Sabouni Rami , Rahmeh Ahmad Rami , Alsalkini Marah , Hanafi Mouaz , Naeem Ahmad , Alahdab Fares
Published: July 2024

Background

Medical research productivity is globally increasing, with a lagging progress in third-world countries due to significant challenges, including inadequate training and brain drain. Syria had been showing a slow upward trend until the war broke out and severely hindered academic growth and productivity. A deeper understanding of the factors influencing research productivity in this context are fundamental to guide educational policies and resource allocation. Previous cross-sectional studies that evaluated the perspectives of Syrian academics on the issue were limited by the small sample size of published healthcare workers, making it difficult to identify the factors that enabled them to pursue research.

Methods

To address this challenge, we employed a case-control design. We isolated published early-career Syrian healthcare workers and compared their characteristics and perceptions to unpublished matched controls. Authors in the fields of medicine, dentistry, and pharmacy affiliated with any Syrian University were identified through an extensive search of PubMed and Google Scholar.These authors were invited to complete a questionnaire that covered participants’ research contributions, alongside their self-assessed knowledge, attitudes, and barriers towards research. The questionnaire was publicly published to recruit an equal sample of matching controls, with half consisting of unpublished researchers and the other half of participants without prior research contributions.

Results

Six-hundred-sixteen participants were recruited. Their knowledge, attitudes, and perceived barriers explained 46% and 34% of the variability in research involvement and publication, respectively (P < 0.001). Getting involved in and publishing research studies associated with higher research-related knowledge and attitudes (P < 0.001). Respondents’ assessment of research-related barriers and their academic scores did not differ between cases and controls. Superior research-related knowledge and attitudes were associated with male gender, higher English competency, and better internet connectivity. Meanwhile, extracurricular training and mentors’ support were associated with more positive research-related attitudes and less perceived barriers.

Conclusions

Research productivity of medical professionals in Syria exhibits a positive correlation with their knowledge and favorable attitudes towards medical research. Noteworthy, the demographic variations are linked to disparities in research-related knowledge and motivation. In conclusion, these results suggest a potential avenue for enhancement through concentrated efforts on improving extracurricular training interventions and mentors’ support.
Access to colorectal cancer screening for Pakistani immigrants in Norway – a qualitative study
Authors: Iqbal Nadia , Berstad Paula , Solbjør Marit , Diaz Esperanza , Czapka Elżbieta , Hofvind Solveig , Bhargava Sameer
Published: July 2024

Background

The Norwegian colorectal cancer (CRC) screening program started in May 2022. Inequalities in CRC screening participation are a challenge, and we expect that certain groups, such as immigrants, are at risk of non-participation. Prior to the start of the national screening program, a pilot study showed lower participation rates in CRC screening among immigrants from Pakistan. These immigrants are a populous group with a long history in Norway and yet have a relatively low participation rate also in other cancer screening programs. The purpose of this study was to identify and explore perspectives and factors influencing CRC screening participation among immigrants from Pakistan in Norway.

Materials and methods

In this study we used a qualitative study design and conducted 12 individual interviews with Pakistani immigrants aged between 50 and 65 years. The participants varied in terms of gender, age, education, work, residence time in Norway and familiarity with the Norwegian language and culture. We performed thematic analysis with health literacy as a theoretical framework to understand Pakistani immigrants’ perspectives on CRC screening.

Results

We identified four main themes: Health-related knowledge, the health care system, screening, and social factors. Within these themes we identified several factors that affect Pakistani immigrants’ accessibility to CRC screening. These factors included knowledge of the causes and development of cancer, sources of health-related information, the general practitioner’s role, understanding of screening and the intention behind it, language skills and religious beliefs.

Conclusion

There are many factors influencing Pakistani immigrants’ decision of participation in CRC screening. The roles of the general practitioner and adult children are particularly important. Key elements to improve accessibility to CRC screening and enable informed participation for Pakistani immigrants are measures that improve personal and organizational health literacy.
Challenges of pre-hospital emergency care at Addis Ababa Fire and Disaster Risk Management Commission, Addis Ababa, Ethiopia: a qualitative study
Authors: Seid Feleku Yimer , Gete Birhanu Chekol , Endeshaw Amanuel Sisay
Published: July 2024

Background

A challenge to pre-hospital emergency care is any barrier or obstacle that impedes quality pre-hospital care or impacts community pre-hospital utilization. The Addis Ababa Fire and Disaster Risk Management Commission (AAFDRMC) provides pre-hospital emergency services in Addis Ababa, Ethiopia. These services operate under a government-funded organization that delivers free emergency services, including out-of-hospital medical care and transportation to the most appropriate health facility. This study aimed to assess the challenges of pre-hospital emergency care at the Addis Ababa Fire and Disaster Risk Management Commission in Addis Ababa, Ethiopia.

Methods

A qualitative descriptive study was conducted from November 20 to December 4, 2022. Data were collected through in-depth, semi-structured interviews with 21 experienced individuals in the field of pre-hospital emergency care, who were selected using purposeful sampling. A thematic analysis method was used to analyze the data.

Results

This study includes twenty-one participants working at the Addis Ababa Fire and Disaster Risk Management Commission. Three major themes emerged. The themes that arose were the participants’ perspectives on the challenges of pre-hospital emergency care in Addis Ababa, Ethiopia.

Conclusion and recommendation

The Fire and Disaster Risk Management Commission faces numerous challenges in providing quality pre-hospital emergency care in Addis Ababa. Respondents stated that infrastructure, communication, and resources were the main causes of pre-hospital emergency care challenges. There has to be more focus on emergency management in light of infrastructure reform, planning, staff training, and education, recruiting additional professional power, improving communication, and making pre-hospital emergency care an independent organization in the city.
Transcriptome- and DNA methylation-based cell-type deconvolutions produce similar estimates of differential gene expression and differential methylation
Authors: Hannon Emily R. , Marsit Carmen J. , Dent Arlene E. , Embury Paula , Ogolla Sidney , Midem David , Williams Scott M. , Kazura James W.
Published: July 2024

Background

Changing cell-type proportions can confound studies of differential gene expression or DNA methylation (DNAm) from peripheral blood mononuclear cells (PBMCs). We examined how cell-type proportions derived from the transcriptome versus the methylome (DNAm) influence estimates of differentially expressed genes (DEGs) and differentially methylated positions (DMPs).

Methods

Transcriptome and DNAm data were obtained from PBMC RNA and DNA of Kenyan children (n = 8) before, during, and 6 weeks following uncomplicated malaria. DEGs and DMPs between time points were detected using cell-type adjusted modeling with Cibersortx or IDOL, respectively.

Results

Most major cell types and principal components had moderate to high correlation between the two deconvolution methods (r = 0.60–0.96). Estimates of cell-type proportions and DEGs or DMPs were largely unaffected by the method, with the greatest discrepancy in the estimation of neutrophils.

Conclusion

Variation in cell-type proportions is captured similarly by both transcriptomic and methylome deconvolution methods for most major cell types.
Fluid management for sepsis-induced hypotension in patients with advanced chronic kidney disease: a secondary analysis of the CLOVERS trial
Authors: Jorda Anselm , Douglas Ivor S. , Staudinger Thomas , Heinz Gottfried , Bergmann Felix , Oberbauer Rainer , Sengölge Gürkan , Zeitlinger Markus , Jilma Bernd , Shapiro Nathan I. , Gelbenegger Georg
Published: July 2024

Background

Early fluid management in patients with advanced chronic kidney disease (CKD) and sepsis-induced hypotension is challenging with limited evidence to support treatment recommendations. We aimed to compare an early restrictive versus liberal fluid management for sepsis-induced hypotension in patients with advanced CKD.

Methods

This post-hoc analysis included patients with advanced CKD (eGFR of less than 30 mL/min/1.73 m2 or history of end-stage renal disease on chronic dialysis) from the crystalloid liberal or vasopressor early resuscitation in sepsis (CLOVERS) trial. The primary endpoint was death from any cause before discharge home by day 90.

Results

Of 1563 participants enrolled in the CLOVERS trial, 196 participants had advanced CKD (45% on chronic dialysis), with 92 participants randomly assigned to the restrictive treatment group and 104 assigned to the liberal fluid group. Death from any cause before discharge home by day 90 occurred significantly less often in the restrictive fluid group compared with the liberal fluid group (20 [21.7%] vs. 41 [39.4%], HR 0.5, 95% CI 0.29–0.85). Participants in the restrictive fluid group had more vasopressor-free days (19.7 ± 10.4 days vs. 15.4 ± 12.6 days; mean difference 4.3 days, 95% CI, 1.0–7.5) and ventilator-free days by day 28 (21.0 ± 11.8 vs. 16.5 ± 13.6 days; mean difference 4.5 days, 95% CI, 0.9–8.1).

Conclusions

In patients with advanced CKD and sepsis-induced hypotension, an early restrictive fluid strategy, prioritizing vasopressor use, was associated with a lower risk of death from any cause before discharge home by day 90 as compared with an early liberal fluid strategy.

Trial Registration

NCT03434028 (2018-02-09), BioLINCC 14149.
Breast Cancer in Women in Gaza: A Review of Clinical Characteristics and Short-Term Survival
Authors: AlWaheidi Shaymaa , Sullivan Richard , Davies Elizabeth A.
Published: July 2024

PURPOSE

To understand how breast cancer is diagnosed in Gaza, and disease stage distribution, treatment, and survival.

MATERIALS AND METHODS

A clinical record case series study of women diagnosed in 2017 and 2018 was conducted with follow-up until December 31, 2020. Breast cancer crude incidence rates and age-specific incidence rates were calculated. Clinical characteristics, including investigation, diagnosis, and treatment methods by year of diagnosis, were compared using the chi-square test. The 2-year cumulative risk of death from any cause was estimated using the Kaplan-Meier method, and univariate and multivariate Cox proportional hazard regressions estimated hazard ratios and their 95% CIs.

RESULTS

Five hundred twenty-four new diagnoses (mean age, 53 years; range, 23-100) were recorded, giving a crude annual incidence rate of 27 per 100,000 population. Six percent (32/524) were diagnosed at stage I, 35% (185/524) at stage II, 33% (171/524) at stage III, and 19% (99/524) at stage IV. More than one half (52%, 271/524) underwent modified radical mastectomy. Seventy-seven percent (405/524) received chemotherapy, 70% (368/524) hormone therapy, and 39% (204/524) radiotherapy. Data on key prognostic factors were mostly available—stage (93%), estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2; 82%), tumor grade (77%), and tumor size (70%). The overall survival was 95.4% at 1 year and 86.6% at 2 years.

CONCLUSION

Women with breast cancer in Gaza have a high short-term survival after diagnosis. However, one half were diagnosed with advanced disease, and their investigations were incomplete. Better reporting on family history, tumor grade, size, and ER, PR, and HER2 receptor status is needed for future studies.
Prostate Cancer Awareness in the Middle East: A Cross-Sectional International Study
Authors: Sayan Mutlay , Eren Ayfer Ay , Tuac Yetkin , Langoe Astrid , Alali Bader , Aynaci Ozlem , Mohammadipour Sepideh , Vahedi Farzin , Daneshmand Behrooz , Abbas Wajid , Hawsawi Yousef , Nader Toni , Joseph Jessie , Wahby Rowan , Ozgenc Ismail , Mula-Hussain Layth , Moningi Shalini , Orio Peter F. , Atalar Banu , Eren Mehmet Fuat
Published: July 2024

PURPOSE

Prostate cancer has emerged as a significant public health challenge in the Middle East, characterized by rising incidence rates and a concerning mortality-to-incidence ratio. Yet, despite these alarming trends, data regarding prostate cancer awareness in the region remain limited. To address this critical knowledge gap, this study investigates prostate cancer awareness within the Middle East.

MATERIALS AND METHODS

A cross-sectional survey was performed among 5,913 men age 40 years and older across 14 Middle Eastern countries between January 1, 2022, and July 31, 2023. Excluding those with a history of prostate cancer, a validated questionnaire assessed prostate cancer awareness. Data were analyzed using frequencies and percentages for categorical variables, medians and ranges for continuous variables, and Pearson chi-square analysis for relationships between education levels and awareness of prostate cancer.

RESULTS

The survey achieved a 74.9% response rate, with 4,431 male participants. Regarding prostate cancer awareness, 83.8% of participants had heard of the disease. However, only 31.0% correctly identified it as the most common malignancy in men, and 21.8% believed it affects both sex. Awareness of screening was limited, with just 19.1% recognizing the prostate-specific antigen test's role. Additionally, participants had a pessimistic view, with a mean perception that 75% of patients with prostate cancer die from the disease, rather than from other causes. Higher education levels were associated with significantly increased awareness of prostate cancer ( P < .001).

CONCLUSION

This study reveals that while general awareness of the disease exists, crucial knowledge deficits regarding risk factors, screening, and prognosis are evident. Addressing these knowledge gaps through culturally tailored education may improve early detection rates, treatment outcomes, and ultimately reduce the burden of prostate cancer in the Middle East.
The predictive value of the mature B cell signature in early Her2-positive breast cancer treated with neoadjuvant therapy.
Authors: Lin Po-Han , Lo Chiao , Kuo Sung-Hsin , Huang Chiun-Sheng
Published: July 2024

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Background: Neoadjuvant therapy (NAT) by combining polychemotherapy and HER2-targeted drugs has become the golden standard treatment for patients with early-stage Her2-positive breast cancer. Pathologic complete response (pCR) is a surrogate marker that predicts a favorable prognosis. Tumor infiltration lymphocytes (TILs) and immune profiling had been reported as a biomarker associated with the pCR. There are several types of immune cells such as monocytes, T and B cell; however, it’s uncertain which kind of immune cells and immune profile play the most important role to predict the pCR in Her2-positive breast cancer. Methods: We enrolled 188 breast cancer patients who were diagnosed of having stage I-III Her2-positive breast cancer. All patients received taxane in combination with Her2-targeted therapies. We performed RNA sequencing on the breast cancer samples which were collected before treatment. Immunohistochemical staining of immune markers were done, too. Results: 103 patients were treated with trastuzumab-based NAT and 85 patients were treated with dual-blockade (trastuzumab plus pertuzumab) based NAT. Among the clinical and tumor characteristics, high expression of Her2 and low expression of ESR1 were associated with the pCR (both p <0.01). Dual blockade therapy tended towards pCR, but lacked statistical significance. For the microenvironment, we deconvoluted the immune cells from the RNA-seq data to measure the cell populations. The proportion of immune cells was correlated to the TILs that was measured from the pathology slides (p<0.01). Both the TILs and the immune cell amounts from the RNA-seq were significantly associated with the pCR (both p<0.01). By the deconvoluted cell types, higher abundance of B cells was significantly associated with the pCR, compared to lower B cell amount (p<0.001). The total T cells, CD8 T cells and monocytes were trended to the pCR but not statistical significance. We then subgroup B cells into the mature B populations which express immunoglobulin genes and immature B populations which express RAG-1 gene without immunoglobulin. We found that only the mature B cells predicted the pCR and immature B cell didn’t. Multivariate logistic regression analysis adjusted for ESR1 expression, Her2 expression and dual blockade therapy, only the mature B cell independently predicted the pCR (odds ratio, 2.63; 95%CI, 1.34-5.16; p = 0.005). The total TILs by pathology slide and other immune cell types didn’t. In addition to pCR, the mature B cells were independently related to the superior recurrence-free survival by the multivariate Cox regression model after adjusting the ESR1 expression, Her2 expression, dual blockade therapy, TIL and immune cell types (hazard ratio, 0.32 ;95% CI, 0.11-0.98; p=0.047). Conclusions: Our result suggested that the mature B cell signature was more strongly associated with the pCR and recurrence-free survival than TILs.
Disparate Rates of Germline Variants in Cancer Predisposition Genes in African American/Black Compared With Non-Hispanic White Individuals Between 2015 and 2022
Authors: Wyatt Castillo Rachel B. , Nielsen Sarah M. , Chen Elaine , Heald Brandie , Ellsworth Rachel E. , Esplin Edward D. , Tomlinson Gail E.
Published: July 2024

PURPOSE

African American/Black (AA/B) individuals are under-represented in genomic databases and thus less likely to receive definitive information from germline genetic testing (GGT) than non-Hispanic White (NHW) individuals. With nearly 500,000 AA/B and NHW individuals having undergone multigene panel testing (MGPT) for hereditary cancer risk at a single commercial laboratory, to our knowledge, we present the largest study to date investigating cancer GGT results in AA/B and NHW individuals.

METHODS

MGPT results from a retrospective cohort of AA/B (n = 48,684) and NHW (n = 444,831) patients were evaluated. Frequencies of pathogenic germline variants (PGVs) and variants of uncertain significance (VUS) were compared between AA/B and NHW individuals. Changes in frequency of VUS over time were determined. Pearson's chi-squared test was used to compare categorical variables among groups. All significance tests were two-tailed, and P < .05 was considered statistically significant.

RESULTS

Between 2015 and 2022, rates of VUS decreased 2.3-fold in AA/B and 1.8-fold in NHW individuals; however, frequencies of VUS and PGV remained significantly higher (46% v 32%; P < .0001) and lower (9% v 13%; P < .0001) in AA/B compared with NHW individuals. Rates of VUS in ATM, BRCA1, BRCA2, PALB2, and PMS2 were significantly higher in AA/B compared with NHW individuals, whereas rates of PGV in BRCA1, BRCA2, and PALB2 were higher in AA/B compared with NHW individuals ( P < .001).

CONCLUSION

Despite reductions in VUS frequencies over time, disparities in definitive GGT results persist. Increasing inclusion of AA/B populations in both testing and research will further increase knowledge of genetic variants across these racial groups.
Fusion Challenges in Solid Tumors: Shaping the Landscape of Cancer Care in Precision Medicine
Authors: Ahmed Jibran , Torrado Carlos , Chelariu Anca , Kim Sun-Hee , Ahnert Jordi Rodon
Published: July 2024

Targeting actionable fusions has emerged as a promising approach to cancer treatment. Next-generation sequencing (NGS)–based techniques have unveiled the landscape of actionable fusions in cancer. However, these approaches remain insufficient to provide optimal treatment options for patients with cancer. This article provides a comprehensive overview of the actionability and clinical development of targeted agents aimed at driver fusions. It also highlights the challenges associated with fusion testing, including the evaluation of patients with cancer who could potentially benefit from testing and devising an effective strategy. The implementation of DNA NGS for all tumor types, combined with RNA sequencing, has the potential to maximize detection while considering cost effectiveness. Herein, we also present a fusion testing strategy aimed at improving outcomes in patients with cancer.
Τουρισμός, αναπαραστάσεις και φαντασιώσεις της Ελλάδας στην Ευρώπη
Authors: Δημητρούκα Αλεξάνδρα
Published: July 2024

Σε μια προσπάθεια σφαιρικότερης κατανόησης του τουρισμού και των σημασιολογικών και νοηματοδοτικών δυναμικών του, η παρούσα έρευνα επιχειρεί να εισαγάγει στο αναπτυσσόμενο πεδίο της ιστορίας του ελληνικού τουρισμού αλλά και του τουριστικού φαινομένου εν γένει, «κείμενα» που ενώ συνδέονται άρρηκτα με την ανάπτυξη της τουριστικής διαδικασίας, δεν έχουν απασχολήσει εκτεταμένα την εγχώρια βιβλιογραφία, αφήνοντας έτσι αδιερεύνητο ένα σημαντικό τμήμα της τουριστικής βιομηχανίας. Ο τουριστικός οδηγός, κύρια πηγή πληροφόρησης για τον τουρίστα, διαμορφώνει -αν και με διαφορετικές μορφές τα τελευταία χρόνια- εικόνες και προορισμούς, πρακτικές και αντιλήψεις, αναδεικνυόμενος καθ’ αυτόν τον τρόπο σε προνομιακό χώρο εγγραφής και αναπαραγωγής νοημάτων. Επίκεντρο της παρούσας μελέτης είναι η ιστορική διαμόρφωση των αναπαραστάσεων της Ελλάδας και της ελληνικότητας μέσα από τη συγκριτική μελέτη τουριστικών οδηγών του Ηνωμένου Βασιλείου και της Ομοσπονδιακής Δημοκρατίας της Γερμανίας κατά τη μεταπολεμική περίοδο, σε μια πρώτη απόπειρα να μελετηθεί η τουριστική εικόνα της Ελλάδας στο εξωτερικό και να διερευνηθεί το «δυτικό» φαντασιακό περί Ελλάδας στο β΄ μισό του εικοστού αιώνα.
Όψεις της ερωτικής εμπειρίας στην κοσμική ποίηση της μέσης και ύστερης βυζαντινής περιόδου
Authors: Σίσκος Νικόλαος
Published: July 2024

Η παρούσα διδακτορική διατριβή πραγματεύεται τον τρόπο που αποτυπώθηκε στην έμμετρη λόγια κοσμική ελληνόφωνη λογοτεχνία της μέσης και ύστερης βυζαντινής περιόδου ο ερωτισμός. Η εργασία διαρθρωμένη σε έξι κεφάλαια, που επιχειρούν να αναπαραστήσουν τα επιμέρους στάδια μιας ερωτικής σχέσης, εξετάζει ποιήματα στα οποία αποτυπώνονται εκφάνσεις του ερωτικού βιώματος. Από την θεωρητική γνώση για τον έρωτα, την εμπλοκή στην ερωτική διάδραση, τις προσπάθειες προσέγγισης μεταξύ εραστή και ερωμένου, τη σωματική ένωση, το γάμο ως τον οριστικό χωρισμό που φέρνει ο θάνατος, οι βυζαντινοί ποιητές προσπάθησαν να σκιαγραφήσουν το ερωτικό βίωμα για να τέρψουν το κοινό τους αλλά και να τοποθετηθούν οι ίδιοι πάνω σε αυτό το θεμελιώδες ζήτημα της ανθρώπινης κατάστασης. Η εργασία φιλοδοξεί να αναδείξει τους μηχανισμούς λειτουργίας των ποιητικών κειμένων υπό το πρίσμα αυτής της διπλής στόχευσης των ποιητών: να προκαλέσουν τη λογοτεχνική απόλαυση από τη μια και να εκφράσουν τις απόψεις τους για τον έρωτα από την άλλη.
Transcriptomic, signalling and secretome analysis for biomarker discovery in ageing and senescence
Authors: Σκέα Διονυσία
Published: July 2024

H κυτταρική γήρανση περιγράφεται ως μια μη αναστρέψιμη διακοπή του κυτταρικού κύκλου που προκαλείται ως απόκριση σε διάφορα είδη στρες. Μέχρι σήμερα, τα γηρασμένα κύτταρα χαρακτηρίζονται από την ενεργοποίηση ετερογενών σηματοδοτικών μονοπατιών, τον πολύπλοκο εκκριτικό φαινότυπο γνωστό ως SASP, και το ποικίλο μεταγραφομικό προφίλ. Με στόχο τη διερεύνηση της ετερογένειας της γήρανσης και τον εντοπισμό διατηρημένων μεταγραφομικών αλλαγών και καθολικών δεικτών γήρανσης, πραγματοποιήσαμε μεταγραφομική (RNA-seq) και πολυπλεκτική (multiplex) ανάλυση σε μοντέλα πρόωρης γήρανσης επαγόμενης με αναστολή πρωτεασώματος και με οξειδωτικό στρες, χρησιμοποιώντας ανθρώπινους ινοβλάστες HFL1 και BJ. Εντοπίστηκαν ποικίλα μεταγραφικά προφίλ, αλλά παράλληλα εντοπίστηκαν 231 κοινά διαφορικά εκφρασμένα γονίδια που σχετίζονται με την κυτταρική διαίρεση και την αναδιαμόρφωση της εξωκυττάριας μήτρας, καθώς και κοινά εμπλουτισμένα μονοπάτια με την έναρξη της πρόωρης γήρανσης. Επιπλέον, εντοπίσαμε ένα υποσύνολο πρωτεϊνών που σχετίζεται με τη διακοπή του κυτταρικού κύκλου και προάγουν ένα προ-φλεγμονώδες περιβάλλον στα μοντέλα πρόωρης γήρανσης. Οι πρωτεΐνες αυτές έδειξαν συναφή αποτελέσματα όταν επικυρώθηκαν στα αντίστοιχα μοντέλα αναδιπλασιαστικής γήρανσης. Τέλος, προτείνουμε τη χρήση ενός ενδοκυττάριου πρωτεϊνικoύ πάνελ που αποτελείται από τους παράγοντες p21, p-c-JUN, BCL-xL και survivin, και ενός εξωκυττάριου πρωτεϊνικού πάνελ που αποτελείται από τους παράγοντες IL-8, GM-CSF, GDF-15, MIF και GROa. Η ταυτόχρονη αξιολόγηση αυτών των δεικτών θα επιτρέψει την ευκολότερη αναγνώριση των γηρασμένων κυττάρων και την παρακολούθηση της αποτελεσματικότητας πιθανών σενοθεραπευτικών προσεγγίσεων.