bluuebunny/crossref_metadata_2025 huggingface dataset:
In vitro toxicological evaluation of aerosols generated by a 4th generation vaping device using nicotine salts in an air-liquid interface system
Authors: Mercier Clément , Pourchez Jérémie , Leclerc Lara , Forest Valérie
Published: February 2024

Background

Electronic cigarettes (EC) have gained popularity, especially among young people, with the introduction of fourth-generation devices based on e-liquids containing nicotine salts that promise a smoother vaping experience than freebase nicotine. However, the toxicological effects of nicotine salts are still largely unknown, and the chemical diversity of e-liquids limits the comparison between different studies to determine the contribution of each compound to the cytotoxicity of EC aerosols. Therefore, the aim of this study was to evaluate the toxicological profile of controlled composition e-liquid aerosols to accurately determine the effects of each ingredient based on exposure at the air-liquid interface.

Methods

Human lung epithelial cells (A549) were exposed to undiluted aerosols of controlled composition e-liquids containing various ratios of propylene glycol (PG)/vegetable glycerin (VG) solvents, freebase nicotine, organic acids, nicotine salts, and flavoured commercial e-liquids. Exposure of 20 puffs was performed at the air-liquid interface following a standard vaping regimen. Toxicological outcomes, including cytotoxicity, inflammation, and oxidative stress, were assessed 24 h after exposure.

Results

PG/VG aerosols elicited a strong cytotoxic response characterised by a 50% decrease in cell viability and a 200% increase in lactate dehydrogenase (LDH) production, but had no effects on inflammation and oxidative stress. These effects occurred only at a ratio of 70/30 PG/VG, suggesting that PG is the major contributor to aerosol cytotoxicity. Both freebase nicotine and organic acids had no greater effect on cell viability and LDH release than at a 70/30 PG/VG ratio, but significantly increased inflammation and oxidative stress. Interestingly, the protonated form of nicotine in salt showed a stronger proinflammatory effect than the freebase nicotine form, while benzoic acid-based nicotine salts also induced significant oxidative stress. Flavoured commercial e-liquids was found to be cytotoxic at a threshold dose of ≈ 330 µg/cm².

Conclusion

Our results showed that aerosols of e-liquids consisting only of PG/VG solvents can cause severe cytotoxicity depending on the concentration of PG, while nicotine salts elicit a stronger pro-inflammatory response than freebase nicotine. Overall, aerosols from fourth-generation devices can cause different toxicological effects, the nature of which depends on the chemical composition of the e-liquid.
The ethical foundations of patient-centered care in aesthetic medicine
Authors: da Prato Editta Buttura , Cartier Hugues , Margara Andrea , Molina Beatriz , Tateo Antonello , Grimolizzi Franco , Spagnolo Antonio Gioacchino
Published: February 2024

This article addresses some critical aspects of the relationship between aesthetic medicine (AM) and ethics and proposes a possible deontological ethical line to pursue based on current practices. The role of AM has always been controversial and suffers from unclear practical and moral boundaries, even within academic settings, since it aims to improve the appearance of individuals, not to cure a disease. Today, it is essential and pertinent to discuss these issues, as AM specialists are dealing with a growing and increasingly demanding patient population that has undergone profound evolution in recent years. Current challenges within the field of AM include a lack of global uniformity concerning the education of AM specialists, an increasing number of physicians practicing AM with diverse training backgrounds, the spread of AM being practiced outside of medical practice or hospital settings, and the influence of social media where the success is modelled and dictated by the identification of a youthful appearance). By the field of action enriched by technologies that aim not only at enhancement per se but also at the preservation and regeneration of tissues, it is necessary to establish an active multidisciplinary discussion on the definition of shared ethical limits. This discussion would allow AM to fully reclaim its identity as a specialty that aims to improve patient well-being whilst maintaining respect for patient aesthetic harmony, the expertise of specialists who practice AM, the essential role of safety, and awareness of the importance of a confidential doctor−patient relationship.
Trends in mental health before and after the onset of the COVID-19 pandemic: a longitudinal survey of a conflict-affected population in Colombia
Authors: Moreno-Serra Rodrigo , Leon-Giraldo Sebastian , Jater-Maldonado Nicolas , Casas German , Bernal Oscar
Published: February 2024

Background

Focusing on the Meta region in Colombia, we investigated the relationship between mental health, the COVID-19 pandemic, and social determinants of health influenced by over five decades of civil conflict. We studied the post-2016 peace agreement trends in mental health for the population of Meta, before and after the local onset of the pandemic.

Method

We conducted three rounds of a longitudinal health survey in years 2018 with N = 1309 (Women = 709; Men = 600); 2019 with N = 1106 (Women = 597; Men = 509); and 2020 with N = 905 (Women = 499; Men = 406). We measured mental health through the Self-Report Questionnaire (SRQ-20), investigating population trends in the average SRQ score and SRQ-positive frequency (SRQ + , indicating positive tendency towards experiencing mental health disorders).

Results

Between 2018 and 2020, there were reductions in the mean SRQ-20 score by 1.74 points (95% CI -2.30 to -1.18) and in SRQ + frequency by 15 percentage points (95% CI -21.0 to -9.0) for the Meta population. Yet specific subgroups have become more vulnerable to mental illness during the pandemic, for example older age groups (e.g., increase in mean SRQ score among over 60 s by 2.49 points, 95% CI 0.51 to 4.46) and people living with children younger than five years-old (e.g., increase in mean SRQ score by 0.64 points, 95% CI 0.07 to 1.20). Increased mental health vulnerability among specific subgroups may be related to differences in the likelihood of knowing people who tested positive for COVID-19 or died from itf having been in quarantine.

Conclusion

Our findings support the importance of public policies in Colombia (and other low- and middle-income countries) that address the social determinants of mental illness whose influence was likely exacerbated by the pandemic, including persistent job insecurity leading to work and financial pressures, and inadequate support networks for isolated individuals and vulnerable caregivers.
A retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomes
Authors: El-Halaby Hanan , Eid Riham , Elagamy Ahmed , El-Hussiny Ahmed , Moustafa Fatma , Hammad Ayman , Zeid Mayada
Published: February 2024

Background

Acute kidney injury (AKI) in patients with multisystem inflammatory syndrome (MIS), COVID-19 related infection has been increasingly recognized with a paucity of data on AKI incidence, related mortality, and the requirement of renal replacement therapy in children with MIS (MIS-C).

Methods

This is a retrospective study evaluating the prevalence, severity, management and outcomes of AKI in a cohort of Egyptian children with MIS-children (MIS-C) post-COVID infection. Patients were included if they met the criteria for MIS-C based on CDC guidelines. All patients were evaluated for AKI diagnosis and staging according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria.

Results

Between March 2021 and June 2023, a total of 655 confirmed COVID-19 cases were admitted and then followed up in our hospital, of whom 138 (21%) were diagnosed with MIS-C. Fifty-one patients developed AKI associated with MIS-C post-COVID infection, 42 of whom were included in the analysis. Thirty-one patients had AKI in a formerly healthy kidney, of whom 51% (16 patients) were classified as KDIGO stage 3, 5 patients needed hemodialysis and 13 needed mechanical ventilation. Higher WBCs count, and serum ferritin on admission were associated with more severe AKI (KDIGO stage 3) (p = 0.04), while multivariate analysis showed high serum ferritin to be independent predictor of more severe AKI (p = 0.02). Two patients (2/31) died during hospital admission, while no residual renal impairment was reported at the time of discharge of patients with previously normal kidney functions.

Conclusion

More than one-third of patients with MIS-C develop AKI. Avoidance of nephrotoxic drugs, early recognition, and prompt management of AKI, including well-timed commencement of dialysis in MIS-C cases, is associated with favorable outcomes.
Blood volume and hemodynamics during treatment of major hemorrhage with Ringer solution, 5% albumin, and 20% albumin: a single-center randomized controlled trial
Authors: Jardot François , Hahn Robert G. , Engel Dominique , Beilstein Christian M. , Wuethrich Patrick Y.
Published: February 2024

Background

Volume replacement with crystalloid fluid is the conventional treatment of hemorrhage. We challenged whether a standardized amount of 5% or 20% albumin could be a viable option to maintain the blood volume during surgery associated with major hemorrhage. Therefore, the aim of this study was to quantify and compare the plasma volume expansion properties of 5% albumin, 20% albumin, and Ringer-lactate, when infused during major surgery.

Methods

In this single-center randomized controlled trial, fluid replacement therapy to combat hypovolemia during the hemorrhagic phase of cystectomy was randomly allocated in 42 patients to receive either 5% albumin (12 mL/kg) or 20% albumin (3 mL/kg) over 30 min at the beginning of the hemorrhagic phase, both completed by a Ringer-lactate replacing blood loss in a 1:1 ratio, or Ringer-lactate alone to replace blood loss in a 3:1 ratio. Measurements of blood hemoglobin over 5 h were used to estimate the effectiveness of each fluid to expand the blood volume using the following regression equation: blood loss plus blood volume expansion = factor + volume of infused albumin + volume of infused Ringer-lactate.

Results

The median hemorrhage was 848 mL [IQR: 615–1145]. The regression equation showed that the Ringer-lactate solution expanded the plasma volume by 0.18 times the infused volume while the corresponding power of 5% and 20% albumin was 0.74 and 2.09, respectively. The Ringer-lactate only fluid program resulted in slight hypovolemia (mean, − 313 mL). The 5% and 20% albumin programs were more effective in filling the vascular system; this was evidenced by blood volume changes of only + 63 mL and − 44 mL, respectively, by long-lasting plasma volume expansion with median half time of 5.5 h and 4.8 h, respectively, and by an increase in the central venous pressure.

Conclusion

The power to expand the plasma volume was 4 and almost 12 times greater for 5% albumin and 20% albumin than for Ringer-lactate, and the effect was sustained over 5 h. The clinical efficacy of albumin during major hemorrhage was quite similar to previous studies with no hemorrhage.

Trial registration: ClinicalTrials.gov NCT05391607, date of registration May 26, 2022.
The novel phosphatase NUDT5 is a critical regulator of triple-negative breast cancer growth
Authors: Qian Jing , Ma Yanxia , Tahaney William M. , Moyer Cassandra L. , Lanier Amanda , Hill Jamal , Coleman Darian , Koupaei Negar , Hilsenbeck Susan G. , Savage Michelle I. , Page Brent D. G. , Mazumdar Abhijit , Brown Powel H.
Published: February 2024

Background

The most aggressive form of breast cancer is triple-negative breast cancer (TNBC), which lacks expression of the estrogen receptor (ER) and progesterone receptor (PR), and does not have overexpression of the human epidermal growth factor receptor 2 (HER2). Treatment options for women with TNBC tumors are limited, unlike those with ER-positive tumors that can be treated with hormone therapy, or those with HER2-positive tumors that can be treated with anti-HER2 therapy. Therefore, we have sought to identify novel targeted therapies for TNBC. In this study, we investigated the potential of a novel phosphatase, NUDT5, as a potential therapeutic target for TNBC.

Methods

The mRNA expression levels of NUDT5 in breast cancers were investigated using TCGA and METABRIC (Curtis) datasets. NUDT5 ablation was achieved through siRNA targeting and NUDT5 inhibition with the small molecule inhibitor TH5427. Xenograft TNBC animal models were employed to assess the effect of NUDT5 inhibition on in vivo tumor growth. Proliferation, death, and DNA replication assays were conducted to investigate the cellular biological effects of NUDT5 loss or inhibition. The accumulation of 8-oxo-guanine (8-oxoG) and the induction of γH2AX after NUDT5 loss was determined by immunofluorescence staining. The impact of NUDT5 loss on replication fork was assessed by measuring DNA fiber length.

Results

In this study, we demonstrated the significant role of an overexpressed phosphatase, NUDT5, in regulating oxidative DNA damage in TNBCs. Our findings indicate that loss of NUDT5 results in suppressed growth of TNBC both in vitro and in vivo. This growth inhibition is not attributed to cell death, but rather to the suppression of proliferation. The loss or inhibition of NUDT5 led to an increase in the oxidative DNA lesion 8-oxoG, and triggered the DNA damage response in the nucleus. The interference with DNA replication ultimately inhibited proliferation.

Conclusions

NUDT5 plays a crucial role in preventing oxidative DNA damage in TNBC cells. The loss or inhibition of NUDT5 significantly suppresses the growth of TNBCs. These biological and mechanistic studies provide the groundwork for future research and the potential development of NUDT5 inhibitors as a promising therapeutic approach for TNBC patients.
Eco-friendly, sensitive and inventive first derivative synchronous spectrofluorimetric determination of ciprofloxacin and phenylephrine in their pure form, single and combined eye drops
Authors: Barakat Neamat T. , El-Brashy Amina M. , Fathy Mona E.
Published: February 2024

A facile, sensitive, accurate and green spectrofluorimetric method was evolved for the assay of ciprofloxacin hydrochloride (CFX) and phenylephrine hydrochloride (PLN) in their co-formulated eye drops with their challengeable ratio of 30:1 for CFX and PLN, respectively. Such drops are clinically used for the treatment of eye bacterial infections. They relieve the symptoms of infection by stopping further growth of the causative microorganisms. The assay principle based on first-order synchronous spectrofluorometric scan using Δ λ = 40 nm in which PLN peak amplitudes were recorded at 283.4 nm, meanwhile CFX was measured at 326.2 nm in the same scans. The calibration curves were linear within the concentration ranges: 0.02–0.5 µg/mL and 0.5–5.0 µg/mL for PLN and CFX, respectively. The method validation was confirmed following the International Conference of Harmonization (ICH) Guidelines. This suggested method was the first one that described simultaneous analysis of PLN and CFX by a spectrofluorimetric technique. In this method, green analytical procedures were implemented to lessen occupational and environmental perils and method greenness was assessed by four assessment tools. GAPI, NEMI, AGREE and Analytical eco-scale were applied to this study and it was deduced from their results that the method had high degree of greenness as it fulfilled all requirements of GAPI, NEMI pictograms and it had high scores of analytical eco scale (97) and AGREE methods (0.82). Subsequently, it was successfully applied to assay both drugs in pure forms, pharmaceutical single and co-formulated eye drops.
The origin of the maximal lactate steady state (MLSS)
Authors: Heck Hermann , Wackerhage Henning
Published: February 2024

The maximal lactate steady state, abbreviated as MLSS, is the maximal exercise intensity where the concentration of earlobe capillary or arterial blood lactate remains constant over time. In the late 1970s and early 1980s, we (i.e. Hermann Heck and co-workers) developed a direct test to determine the MLSS to investigate whether it occurred at a lactate concentration of 4 mmol.L− 1, as earlier predicted by Alois Mader and colleagues. The test consisted of each participant performing several constant-intensity running bouts of ≈ 30 min at intensities close to the estimated MLSS. During each run, we measured lactate every 5 min. Based on the results, we defined the MLSS as the “workload where the concentration of blood lactate does not increase more than 1 mmo.L− 1during the last 20 min of a constant load exercise”. This MLSS protocol is impractical for performance testing as it requires too many exercise bouts, but it is a gold standard to determine the real MLSS. It is especially useful to validate indirect tests that seek to estimate the MLSS.
Adsorption and desorption capacity of different metals influenced by biomass derived biochar
Authors: Das Shaon Kumar
Published: February 2024

By expanding the surface area and/or by other chemical reactions, soil additives such as biochar help retain nutrients in the soil. n this work, the effects of biochar on the adsorption and desorption of heavy metals and soil elements necessary for plant growth were investigated. To illustrate the adsorption of nutrients and heavy metals from solution on biochar, the Freundlich isotherm was employed. The rise in mineral nutrients, pH, and EC was linked to an increase in CEC with warmth. Because of its high CEC, biochar improves soil health and increases plant nutrient availability, which can boost agricultural yield when applied to the soil. In manure + biochar at 2.5 + 7.5 t/ha application rate the NH4+-N adsorption capacity was minimum in T7 (15.9 and 117.66) followed by T4 (17.6 and 130.24), T13 (18.7 and 138.38) and maximum in T10 (20.1 and 148.74) at 25 and 200 mg kg-1 level of added NH4+-N, respectively than control T1 (10.3 and 75.3). An increase in the rate of biochar application led to a favourable effect by increasing the NO3–N adsorption capability. The effect on P adsorption was more with biochar than manures. In manure + biochar at 2.5 + 7.5 t/ha application rate the Pb adsorption capacity was minimum in T7 (4.46 and 30.77) followed by T10 (4.71 and 32.49), T13 (5.16 and 35.60) and maximum in T4 (5.48 and 37.81) at 10 and 100 mg kg-1 level of added Pb, respectively than control T1 (1.86 and 12.83). Goat manure, FYM, vermicompost, and poultry manure had the greatest effects on desorption. The desorption of all heavy metals Cd, Pb, Zn, and As decreased as the rate of biochar application increased. Based on excess nutrients and heavy metals, this study supports the use of biochar to mitigate environmental concerns.
Circulating metabolome landscape in Lynch syndrome
Authors: Jokela Tiina A. , Karppinen Jari E. , Kärkkäinen Minta , Mecklin Jukka-Pekka , Walker Simon , Seppälä Toni T. , Laakkonen Eija K.
Published: February 2024

Circulating metabolites systemically reflect cellular processes and can modulate the tissue microenvironment in complex ways, potentially impacting cancer initiation processes. Genetic background increases cancer risk in individuals with Lynch syndrome; however, not all carriers develop cancer. Various lifestyle factors can influence Lynch syndrome cancer risk, and lifestyle choices actively shape systemic metabolism, with circulating metabolites potentially serving as the mechanical link between lifestyle and cancer risk. This study aims to characterize the circulating metabolome of Lynch syndrome carriers, shedding light on the energy metabolism status in this cancer predisposition syndrome.

This study consists of a three-group cross-sectional analysis to compare the circulating metabolome of cancer-free Lynch syndrome carriers, sporadic colorectal cancer (CRC) patients, and healthy non-carrier controls. We detected elevated levels of circulating cholesterol, lipids, and lipoproteins in LS carriers. Furthermore, we unveiled that Lynch syndrome carriers and CRC patients displayed similar alterations compared to healthy non-carriers in circulating amino acid and ketone body profiles. Overall, cancer-free Lynch syndrome carriers showed a unique circulating metabolome landscape.

This study provides valuable insights into the systemic metabolic landscape of Lynch syndrome individuals. The findings hint at shared metabolic patterns between cancer-free Lynch syndrome carriers and CRC patients.
Complementary scientific techniques for the study of Mesoamerican greenstone objects
Authors: Knight Willow , Gantz Faith , Carl Matthew , Young Marcus L. , Kovacevich Brigitte , Crawford Dawn , Torok Elena , Baas Fran
Published: February 2024

Jade and greenstone objects have been held in high regard by many cultures stemming from their limited geological availability and their unique optical and mechanical properties. Jade and greenstone objects symbolized life, fertility, and eternity to early Mesoamerican people. In recent years, scientific studies on jade and greenstone objects have been performed to establish provenance and usage, identify composition, and verify the presence of a particular material. These studies of jade and greenstone objects are generally divided geographically, with considerable interest in China and Central America. Most studies are focused on objects from one particular archaeological site; however, a few studies have focused on collections from a range of sites. The use of multiple complimentary analytical techniques has been shown to be the most effective method for characterizing and understanding the technical information obtained from cultural heritage objects. In our study, we examine a set of Mesoamerican jade and greenstone objects from the collection at the Dallas Museum of Art using multiple non-destructive techniques, including scanning electron microscopy with energy dispersive spectroscopy, Raman spectroscopy, X-ray diffraction, and handheld X-ray fluorescence spectroscopy. We briefly discuss the advantages and disadvantages of each technique. Lastly, we present the results from our study and discuss them in their archaeological and historical context.
The effect of vertical skeletal proportions, skeletal maturation, and age on midpalatal suture maturation: a CBCT-based study
Authors: Ferrillo Martina , Daly Kieran , Pandis Nikolaos , Fleming Padhraig S.
Published: February 2024

Background

Midpalatal suture (MPS) maturation may be influenced by a range of parameters including age, gender, and vertical skeletal pattern. We therefore aimed to evaluate the effect of Frankfurt-mandibular angle (FMA), skeletal maturation, and age on the timing of MPS maturation.

Methods

In this cross-sectional study, cone-beam computed tomography (CBCT) and lateral cephalograms were used to assess the MPS and cervical vertebral maturation (CVM) stage. A proportional odds logistic regression model was used to assess associations between age adjusted for gender and MPS maturation, and a regression analysis was performed to analyze the effect of vertical pattern on these associations.

Results

A total of 201 patients (84 male and 117 female) with a mean age of 13.48 (SD 1.94) were included. With increasing age, the odds of belonging to a higher maturation stage increased (OR: 2.14; 95% CI 1.789; 2.567; P < 0.001); however, no association between FMA and MPS maturation was observed (OR: 1.01; 95% CI 0.964; 1.051; P = 0.76). A strong correlation between MPS maturation and CVM stage was not reported. Males had a higher probability of belonging to a lower MPS maturation stage (OR: 0.24; 95% CI 0.136; 0.415; P < 0.001).

Conclusions

Based on this cross-sectional analysis, midpalatal sutural maturation classification is associated with chronological age and occurs later in males. Neither CVM staging nor variation in vertical skeletal proportions were useful predictors of midpalatal maturation stage.
Multiscale modeling of dislocations: combining peridynamics with gradient elasticity
Authors: Ritter Jonas , Zaiser Michael
Published: February 2024

Modeling dislocations is an inherently multiscale problem as one needs to simultaneously describe the high stress fields near the dislocation cores, which depend on atomistic length scales, and a surface boundary value problem which depends on boundary conditions on the sample scale. We present a novel approach which is based on a peridynamic dislocation model to deal with the surface boundary value problem. In this model, the singularity of the stress field at the dislocation core is regularized owing to the non-local nature of peridynamics. The effective core radius is defined by the peridynamic horizon which, for reasons of computational cost, must be chosen much larger than the lattice constant. This implies that dislocation stresses in the near-core region are seriously underestimated. By exploiting relationships between peridynamics and Mindlin-type gradient elasticity, we then show that gradient elasticity can be used to construct short-range corrections to the peridynamic stress field that yield a correct description of dislocation stresses from the atomic to the sample scale.
Association between PET–CT accumulation in the hypothalamic/pituitary regions and neuron-specific enolase/primary tumor in limited-stage small cell lung cancer: a case-controlled retrospective study
Authors: Okada Yukinori , Zama Tatsuhiko , Itonaga Tomohiro , Mikami Ryuji , Okubo Mitsuru , Sugahara Shinji , Nakai Motoki , Abe Koichiro , Yoshimura Mana , Saito Kazuhiro
Published: February 2024

Background

Research on the relationship between neuron-specific enolase (NSE) levels and normal organs, particularly the central nervous system, in small cell lung cancer is limited. Therefore, this study aimed to investigate the relationship between positron emission tomography–computed tomography (PET–CT) accumulation at hypothalamic/pituitary regions, tumor activity, and NSE level in limited-stage small cell lung cancer. We retrospectively analyzed patients who were diagnosed with limited-stage small cell lung cancer at Tokyo Medical University Hospital between July 1, 2019, and May 31, 2023, and were treated with chemoradiotherapy or radiotherapy. Leukocytes, erythrocytes, hemoglobin, platelets, total protein, albumin, NSE, and carcinoembryonic antigen were measured in blood samples obtained before treatment initiation. The maximum standardized uptake value (SUVmax), volume, and total lesion glycolysis (TLG) of each hypothalamic /pituitary region, primary tumor, and lymph node metastases were extracted from PET–CT images. The total tumor volume (primary tumor volume plus lymph node metastases volume) and total TLG (primary tumor TLG plus lymph node metastases TLG) were calculated.

Results

This study included 19 patients (mean age, 70.1 ± 8.8 years; 13 men and 6 women); the pathology in all patients was small cell lung cancer. Patients were classified into two groups according to the NSE reference value (16.3 ng/mL): six patients having NSE level below the reference value and 13 having NSE level above the reference value. The SUVmax in the hypothalamic/pituitary region was 2.95 in the NSE < 16.3 ng/mL group and 4.10 in the NSE > 16.3 ng/mL group, with a statistically significant difference (p = 0.03). The total tumor volume was 17.8 mL in the NSE < 16.3 ng/mL group and 98.9 mL in the NSE > 16.3 ng/mL group, with a statistically significant difference (p < 0.01). A correlation coefficient of r = 0.458 (p = 0.0486) was observed between SUVmax in the hypothalamus/pituitary and NSE level. A correlation coefficient of r = 0.647 (p < 0.01) was also observed between total tumor volume and NSE level. Finally, a correlation coefficient of r = 0.53 (p = 0.01) was observed between hypothalamic/pituitary TLG and primary tumor TLG.

Conclusions

The findings demonstrated a correlation between hypothalamic/pituitary activity and tumor activity, suggesting the prognostic significance of NSE.
BOD characteristics and their impact on the link between ESG disclosure and integrated reporting disclosure quality: a study of Egyptian non-financial firms
Authors: Abdelmoneim Zakia , El-Deeb Mohamed Samy
Published: February 2024

This study examines the impact of environmental, social, and governance (ESG) disclosure on integrated reporting disclosure quality (IRDQ) and the moderating role of board of directors (BOD) characteristics. Prior research on ESG disclosure and IRDQ has been limited, especially in emerging economies like Egypt. Furthermore, the influence of BOD attributes has been underexplored. This study aims to address these gaps. A sample of 34 Egyptian non-financial companies under ESG disclosure mandates from 2015 to 2021 is analyzed using regression analysis. The results show a significant positive association between ESG disclosure and IRDQ. Furthermore, BOD gender diversity and size are found to positively moderate the ESG–IRDQ relationship. These findings highlight that appointing more women on boards and increasing board size can improve IRDQ when firms engage in ESG disclosure. However, the small sample size of ESG-mandated companies and inherent limitations in constructing disclosure indices constrain the generalizability of results. Overall, this study provides timely empirical evidence on ESG adoption within the unique Egyptian context and its influence on integrated reporting (IR). It contributes to literature by identifying specific BOD characteristics that enhance IRDQ. The results offer practical insights into how companies, regulators, and stakeholders can leverage board diversity and size as well as ESG disclosure to improve IRDQ.
Association between irisin and vascular complications of type 2 diabetic patients: a prospective case–control study
Authors: Kahla Hala , Hussein Mai Abdel Karim , Taha Noha , Hany Ayman Mohamed , Youssry Mona
Published: February 2024

Background

Diabetes vascular complications are classified as either macrovascular (cardiovascular disease) or microvascular (nephropathy). These complications considerably raise the risk of morbidity and death. Irisin is a myokine that has been linked to metabolic disorders and cardiovascular disease. The purpose of this study was to look at the relationship between irisin and vascular complications among type 2 diabetic (T2DM) individuals. In this case–control study, the patients were put into four groups based on the occurrence of a diabetic cardiovascular complications and the presence of diabetic nephropathy into group 1: twenty T2DM cases without complications, group 2: twenty T2DM cases with diabetic nephropathy, group 3: twenty T2DM cases with cardiovascular complications, and group 4: thirty controls. History was taken, and clinical examination was done. Laboratory investigations (fasting blood glucose, 2-h postprandial blood glucose, HbA1C, cholesterol, triglycerides, HDL-C and LDL-C, serum urea and creatinine, albumin/creatinine ratio, eGFR, serum irisin) were analyzed.

Results

Serum level of irisin was significantly lower in T2DM patients than in control. Also, irisin level was significantly lower in diabetic cases with vascular complications versus those without complications. Irisin level had a negative correlation to BMI and lipid profile in diabetic cases and had a positive correlation to eGFR in diabetic patients with cardiovascular complications.

Conclusions

Irisin level was significantly lower in T2DM patients than control and in diabetic patients with vascular complications than patients without complications. So, irisin may have a role as a marker of vascular complications in T2DM.
Predicting Recurrence-Free and Overall Survival for Patients With Stage II Melanoma: The MIA Calculator
Authors: Varey Alexander H.R. , Li Isabel , El Sharouni Mary-Ann , Simon Julie , Dedeilia Aikaterini , Ch'ng Sydney , Saw Robyn P.M. , Spillane Andrew J. , Shannon Kerwin F. , Pennington Thomas E. , Rtshiladze Michael , Stretch Jonathan R. , Nieweg Omgo E. , van Akkooi Alexander , Sullivan Ryan J. , Boland Genevieve M. , Gershenwald Jeffrey E. , van Diest Paul J. , Scolyer Richard A. , Long Georgina V. , Thompson John F. , Lo Serigne N.
Published: February 2024

PURPOSE

Improvements in recurrence-free survival (RFS) were demonstrated in two recent randomized trials for patients with sentinel node (SN)–negative stage IIB or IIC melanoma receiving adjuvant systemic therapy (pembrolizumab/nivolumab). However, adverse events also occurred. Accurate individualized prognostic estimates of RFS and overall survival (OS) would allow patients to more accurately weigh the risks and benefits of adjuvant therapy. Since the current American Joint Committee on Cancer eighth edition (AJCC-8) melanoma staging system focuses on melanoma-specific survival, we developed a multivariable risk prediction calculator that provides estimates of 5- and 10-year RFS and OS for these patients.

METHODS

Data were extracted from the Melanoma Institute Australia (MIA) database for patients diagnosed with stage II (clinical or pathological) melanoma (n = 3,220). Survival prediction models were developed using multivariable Cox regression analyses (MIA models) and externally validated twice using data sets from the United States and the Netherlands. Each model's performance was assessed using C-statistics and calibration plots and compared with Cox models on the basis of AJCC-8 staging (stage models).

RESULTS

The 5-year and 10-year RFS C-statistics were 0.70 and 0.73 (MIA-model) versus 0.61 and 0.60 (stage-model), respectively. For OS, the 5-year and 10-year C-statistics were 0.71 and 0.75 (MIA-model) compared with 0.62 and 0.61 (stage-model), respectively. The MIA models were well calibrated and externally validated.

CONCLUSION

The MIA models offer accurate and personalized estimates of both RFS and OS in patients with stage II melanoma even in the absence of pathological staging with SN biopsy. These models were robust on external validations and may be used in everyday practice both with (ideally) and without performing SN biopsy to identify high-risk patients for further management strategies. An online tool will be available at the MIA website (Risk Prediction Tools).
Analysis and design of playground equipment accessible for all kids, including those with disabilities
Authors: Κουνατίδης Γεώργιος
Published: February 2024

Το παιχνίδι είναι θεμελιώδης παράγοντας για την υγιή ανάπτυξη των παιδιών και οι παιδικές χαρές είναι ο κύριος χώρος έκφρασης τους. Κάθε μέρα, εκατομμύρια παιδιά σε όλο τον κόσμο αλληλεπιδρούν, κοινωνικοποιούνται, διασκεδάζουν και αποκτούν εμπειρίες, αλλά εκτίθενται επίσης σε πιθανούς κινδύνους στις χιλιάδες παιδικές χαρές που είναι διάσπαρτες σε όλο τον κόσμο. Είναι ευθύνη των αντίστοιχων αρχών να παρέχουν ασφαλείς χώρους για αυτές τις δραστηριότητες που προορίζονται για παιδιά όλων των ικανοτήτων. Αρχικά αναφέρεται η παιχνιδιστική αξία αυτών των χώρων, μαζί με την αναγκαιότητα τους για την κοινωνική ανάπτυξη των χρηστών. Η έννοια της αναπηρίας θα αναλυθεί σε επόμενα κεφάλαια, όπου θα γίνει προσπάθεια να εξεταστούν οι δύο διαφορετικές προσεγγίσεις της. Στη συνέχεια, μέσω των προτύπων και των τεχνικών οδηγιών της σειράς EN1176, θα αναλυθούν οι σχεδιαστικές προτάσεις σε σχέση με την ασφάλεια και την προσβασιμότητα στις παιδικές χαρές. Το ερευνητικό μέρος της διατριβής πραγματεύεται τον αριθμό του εξοπλισμού που προορίζεται για χρήστες με αναπηρία στην ελληνική επικράτεια. Με βάση δείγματα από πληθυσμούς και τη μεθοδολογία ελέγχου στατιστικών υποθέσεων, θα διεξαχθεί εξέταση για να διαπιστωθεί εάν οι παιδικές χαρές στην Ελλάδα συμμορφώνονται με την απαίτηση της εθνικής νομοθεσίας σχετικά με θέσεις για χρήστες με αναπηρία σε παιδικές χαρές.
Medical education in Bangladesh from Student and Teacher’s Perspective: Impact and challenges of the COVID-19 pandemic
Authors: Rahman M. Wakilur , Hasan Md Mahfuzul , Palash Md. Salauddin , Asaduzzaman Md
Published: February 2024

Background In low- and middle-income countries like Bangladesh, where medical education faces a range of challenges-such as lack of infrastructure, well-trained educators, and advanced technologies, abrupt changes in methodologies without adequate preparation are more challenging than in higher-income countries. This was worsened during the COVID-19 pandemic and these challenges have resulted in a change in medical education methodology. This study assesses the medical education procedure, impacts and adaptation strategies and challenges of the COVID-19 pandemic in the medical education system of Bangladesh from learners' as well as educators' perspectives. Methods The study collected data from 22 Medical Colleges/Universities across 18 districts of eight divisions using quantitative and qualitative methods. A total of 408 samples were collected consisting of 316 from students and 92 from medical teachers. Descriptive analysis and probit model were performed for obtaining results. Results The efficacy of online learning was questionable, but results showed that it was more effective for theory classes (92.4%) followed by clinical classes (75.63%) and the efficacy rate was low for practical classes (54.11%). All types of classes (theory, practical and clinical) are currently using mixed methods to some extent in medical education in Bangladesh. Regarding impacts and adaptation strategy, approximately 75.3% of the students surveyed expressed their acceptance of online education. Over 80% of the participants acknowledged the advantages of online learning, highlighting the freedom to learn from home, cost and time savings, and avoiding physical closeness with other students as major benefits. Conclusions To address future challenges like the COVID-19 pandemic in medical education in Bangladesh, a comprehensive policy approach such as strengthening technological infrastructure, promoting blended learning approaches, enhancing faculty training and support, integrating telemedicine into the curriculum, and continuously evaluating and improving policies and interventions can enhance the resilience of its medical education system, and prepare for future challenges.
INCREASING THE LEVEL OF COMPETENCIES OF OSH MANAGERS TO ENSURE HIGHER SECURITY AND PROSPERITY OF BUSINESSES
Authors: Hudakova Maria , Holla Katarina , Kuricova Alena
Published: February 2024

The essence of the contribution is to present the results of the analysis of current trends in the Occupational Health and Safety (OSH) managers' competencies and to propose a competence framework for OSH managers for the study program Crisis Management at the Faculty of Security Engineering (FSE UNIZA). The proposed framework respects the legislative, normative, and managerial requirements imposed on this position, resulting from current practice in Slovakia and global trends. The authors created a framework with the requirements for basic professional knowledge and skills in the field of OSH. Managerial knowledge, skills, tasks, responsibilities for performing activities, and the entire OSH management process are described. The position of OSH manager should be moved toward strategic management. OSH manager should bear responsibility for the entire OSH management process, i.e., design, manage, and control processes associated with the OSH management process. Increasing the competence of health and safety managers will help companies minimize adverse impacts and increase prevention, safety, and company prosperity.
INVESTIGANDO A REPRESENTAÇÃO DA MULHER AFRODESCENDENTE ESCRAVIZADA NO CONTO BEYOND THE BAYOU, DE KATE CHOPIN
Authors: Souza Anderson Alves de , Vasconcelos da Silva Isabella Dantas
Published: February 2024

Kate Chopin mostra uma representação notável de personagens femininas do sul dos Estados Unidos em suas obras literárias da virada do século XIX, especialmente em seus contos. O objetivo desse trabalho de pesquisa é analisar como a personagem protagonista afrodescendente e escravizada, Jacqueline, é representada no conto “Beyond the Bayou”, de Kate Chopin. A análise das representações de Jacqueline está baseada na teoria da Linguística Sistêmico-Funcional de Halliday e Matthiessen (2004), com foco nos três processos principais na metafunção experiencial do sistema de transitividade: processos relacionais, materiais e mentais. Para isso, a análise se concentra principalmente em identificar como Jacqueline é representada como Portadora, Identificada, Ator e Experienciadora nesses processos. Os resultados mostram uma representação de Jacqueline fundamentada em torno de três eixos temáticos: (i) loucura, medo e força física, (ii) amor materno pelo menino Chéri, e (iii) preocupação com o menino ferido e superação do trauma. Além disso, os resultados revelam que Jacqueline é representada como uma mulher capaz de lutar por sua própria identidade, existência e autonomia.
Exploring the effects of learning from excellence: a qualitative study of staff perspectives
Authors: Malone Claire , Hooker Samantha , Todman Ed , Mohabir Anne , Jones Dan JW
Published: February 2024

Background/Aims

Learning from excellence is a non-hierarchical system for staff to report episodes of good practice that they observe in the workplace, aiming to share learning from good practice, in line with the Safety-II approach. This study aimed to analyse staff perspectives of the impact of a learning from excellence system in place at a hospital in the south east of England.

Methods

A qualitative investigation was conducted using semi-structured focus groups with individuals from five departments at the hospital. Focus group guides were developed using existing literature about learning from excellence. The focus groups were recorded and transcribed verbatim. The dataset was thematically analysed using Braun and Clarke's guide to NVivo 12 software.

Results

Findings were triangulated across three main themes: positive impact of learning from excellence on individuals and teams; problems with learning from excellence; and learning from the reports.

Conclusions

Perspectives on the impact of learning from excellence were generally positive, particularly regarding the benefits for staff morale and motivation. Future studies should consider using an experimental design to compare the impact of the learning from excellence system to that of traditional incident reporting.
Use of outcome measures by UK allied health professionals: a cross-sectional online survey
Authors: Young Joshua , Bowers Roy
Published: February 2024

Background/Aims

Outcome measures are key tool for assessing the effects of healthcare on health status, but little is currently known about their use by allied health professionals in the UK. This study aims to explore the use of outcome measures by allied health professionals, with a view to informing future research and developing clinical training resources.

Methods

An online survey regarding use of outcome measure was developed, including 28 questions covering demographic and professional characteristics, frequency of use of outcome measures, perceptions of and barriers to use and confidence in use. The survey was distributed to UK allied health professionals by contacting relevant professional bodies and using social media. Comparisons between groups were made with the Mann-Whitney U test, Chi square or comparisons of column means. Significance was set at 0.05.

Results

Responses from 107 allied health professionals were analysed, representing 13 of the 14 allied health professional groups across the UK. Most respondents (85%) used outcome measures, with 37% reporting frequency of use as ‘always’ and 33% as ‘often’. Most respondents (75%) used informal approaches to interpret outcome measure data, while 17% used normative data and 15% used minimal clinically important difference values. The most commonly reported barriers were lack of time (70%), administrative support (47%), resources (41%) and training (35%). Levels of pre-registration and post-registration training in outcome measures were low (28% and 56% respectively). Postgraduate training in outcome measures was significantly associated with frequent use of outcome measures (P=0.010).

Conclusions

Most UK allied health professionals use outcome measures regularly, but few use formal approaches to interpret the data collected. This study highlights a need for training for pre-registration and post-registration allied health professionals in the use of outcome measures.
Nursing in psychedelic-assisted psychotherapy: new opportunities and future prospects
Authors: Milner Leonie , Mithoefer Annie
Published: February 2024

This article looks at the emerging field of psychedelic-assisted psychotherapy and the nurse's role within that – something which is currently unexplored and wholly undefined. It draws from lived experience in psychedelic-assisted psychotherapy and is co-authored by a significant contributor in this field. The aim of the article is to give nurses a brief introduction to the field of psychedelic-assisted psychotherapy (history and present) and provide insights on professional development opportunities in the wake of such treatments being widely recognised, accepted and in need of nursing input in the future.
Factors that influence child conveyance decisions made by prehospital clinicians
Authors: Blake-Barnard Alex , Whitley Gregory Adam
Published: February 2024

Introduction:

The decision to convey children to emergency departments is complex. This study aimed to identify barriers and enablers to making appropriate decisions, along with areas of disparity in this decision-making process by ambulance clinicians.

Methods:

A rapid evidence review was conducted. MEDLINE, CINAHL and PubMed were searched from 2012 to July 2023. Critical appraisal and thematic synthesis were performed.

Results:

Three studies were identified, which highlights the lack of research in this area. Five themes were identified: provision of care; equipment and protocols; exposure, experience and confidence; emotional and social circumstances; and education or skill set.

Findings:

Enhanced paediatric education is required before and after registration to ensure appropriate conveyance and address clinicians' lack of exposure, experience and confidence. Protocols and guidelines should be drawn up to support decision-making for lower-acuity child patients. Specialist paediatric roles are required in ambulance services to support clinicians and provide advanced patient-centred care.

Conclusions:

The findings of this review provide a basis for discussion and clinical practice improvement. Research to determine the clinical and cost effectiveness of implementing prehospital specialist paediatric roles is required.