bluuebunny/crossref_metadata_2025 huggingface dataset:
Availability and readiness of health facilities providing services for other infectious diseases to treat neglected tropical diseases in Ethiopia: implications for service integration in high burden areas
Authors: Asmamaw Getahun , Minwagaw Tefera , Samuel Mastewal , Ayenew Wondim
Published: July 2024

Background

The burden of neglected tropical diseases (NTDs), HIV/AIDS, tuberculosis, and malaria pose significant public health challenges in Ethiopia. This study aimed to the explore service availability and readiness for NTD care among Ethiopian health facilities treating tuberculosis (TB), HIV/AIDS, and/or malaria.

Methods

This study utilized secondary data from the Ethiopian Service Provision Assessment 2021–22 survey. The availability of services was calculated as the percentage of HIV/AIDS, tuberculosis, or malaria facilities providing NTD services. Facilities were considered highly prepared to manage any type of NTD if they scored at least half (> 50%) of the tracer items listed in each of the three domains (staff training and guidelines, equipment, and essential medicines). Descriptive statistics and logistic regression models were employed to present the study findings and analyze factors influencing facility readiness, respectively.

Results

Out of 403 health facilities providing NTD care nationally, 179, 183, and 197 also offer TB, HIV/AIDS, and malaria services, respectively. The majority of TB (90.1%), HIV/AIDS (89.6%), and malaria (90.9%) facilities offer soil-transmitted helminth services, followed by trachoma (range 87–90%). The percentages of the aforementioned facilities with at least one trained staff member for any type of NTD were 87.2%, 88.4%, and 82.1%, respectively. The percentage of facilities with guidelines for any type of NTD was relatively low (range 3.7–4.1%). Mebendazole was the most widely available essential medicine, ranging from 69 to 70%. The overall readiness analysis indicated that none of the included facilities (TB = 11.9%; HIV/AIDS = 11.6%; and malaria = 10.6%) were ready to offer NTD care. Specifically, a higher level of readiness was observed only in the domain of medicines across these facilities. Hospitals had better readiness to offer NTD care than did health centers and clinics. Furthermore, a significant associations were observed between facility readiness and factors such as facility type, region, presence of routine management meetings, types of NTD services provided, and fixed costs for services.

Conclusions

Ethiopian health facilities treating TB, HIV/AIDS, and malaria had an unsatisfactory overall service availability and a lack of readiness to provide NTD care. Given the existing epidemiological risks and high burden of TB, HIV/AIDS, malaria, and NTDs in Ethiopia, there is an urgent need to consider preparing and implementing a collaborative infectious disease care plan to integrate NTD services in these facilities.
Unlocking cardioprotection: iPSC exosomes deliver Nec-1 to target PARP1/AIFM1 axis, alleviating HF oxidative stress and mitochondrial dysfunction
Authors: Lv Xiaobing , Liu Boqin , Su Xiaoting , Tian Xintao , Wang Huating
Published: July 2024

Background

Heart failure (HF) is characterized by oxidative stress and mitochondrial dysfunction. This study investigates the therapeutic potential of Necrostatin-1 (Nec-1) delivered through exosomes derived from induced pluripotent stem cells (iPSCs) to address these pathologies in HF.

Methods

An HF rat model was established, and comprehensive assessments were performed using echocardiography, hemodynamics, and ventricular mass index measurements. iPSCs were used to isolate exosomes, loaded with Nec-1, and characterized for efficient delivery into cardiomyocytes. The interaction between Nec-1-loaded exosomes (Nec-1-Exos), poly (ADP-ribose) polymerase 1 (PARP1), and apoptosis-inducing factor mitochondria-associated 1 (AIFM1) was explored. Gain-of-function experiments assessed changes in cardiomyocyte parameters, and histological analyses were conducted on myocardial tissues.

Results

Cardiomyocytes successfully internalized Nec-1-loaded exosomes, leading to downregulation of PARP1, inhibition of AIFM1 nuclear translocation, increased ATP and superoxide dismutase levels, reduced reactive oxygen species and malonaldehyde levels, and restored mitochondrial membrane potential. Histological examinations confirmed the modulation of the PARP1/AIFM1 axis by Nec-1, mitigating HF.

Conclusions

iPSC-derived exosomes carrying Nec-1 attenuate oxidative stress and mitochondrial dysfunction in HF by targeting the PARP1/AIFM1 axis. This study proposes a promising therapeutic strategy for HF management and highlights the potential of exosome-mediated drug delivery.
Efficacy of color Doppler ultrasound and contrast-enhanced ultrasound in identifying vascular invasion in pancreatic ductal adenocarcinoma
Authors: Jia Wan-Ying , Gui Yang , Chen Xue-Qi , Tan Li , Zhang Jing , Xiao Meng-Su , Chang Xiao-Yan , Dai Meng-Hua , Guo Jun-Chao , Cheng Yue-Juan , Wang Xiang , Zhang Jia-Hui , Zhang Xiao-Qian , Lv Ke
Published: July 2024

Objectives

To compare color Doppler ultrasound and contrast-enhanced ultrasound (CEUS) in evaluating vascular invasion in pancreatic ductal adenocarcinoma (PDAC).

Materials and methods

This retrospective study included 210 patients with PDAC who were evaluated by color Doppler ultrasound, CEUS, and contrast-enhanced computed tomography (CECT) at our institution between January 2017 and December 2020. Pathologic results were used as the gold standard in patients who underwent surgical and intraoperative exploration. For nonsurgical patients, CECT results were used as the reference standard. The vessels evaluated included those in the peripancreatic arterial system and venous system. The diagnostic performances of color Doppler ultrasound and CEUS for vascular invasion were compared.

Results

In 51 patients who underwent surgery and intraoperative exploration, color Doppler ultrasound and CEUS differed only in assessing venous system invasion in patients with PDAC of the pancreatic body and tail, with the former being superior to the latter. In 159 nonsurgical patients, there was no difference between CEUS and color Doppler ultrasound in assessing superior mesenteric arteriovenous invasion. CEUS was superior to color Doppler ultrasound in evaluating the celiac artery and its branches, with an accuracy of up to 97.8% for some vessels. Color Doppler ultrasound was ideal for evaluating the splenic and portal veins.

Conclusion

CEUS is more suitable for the evaluation of peripancreatic arteries than color Doppler. CEUS combined with color Doppler ultrasound can be used as a potential supplement to CECT and is also expected to be used to evaluate vascular invasion of PDAC after chemotherapy.

Critical relevance statement

Contrast-enhanced US and color Doppler in the assessment of vascular invasion in pancreatic ductal adenocarcinoma have their respective advantages, through standardized ultrasound processes are expected to improve the efficiency of inspection.

Key Points

Contrast-enhanced US has unique advantages in assessing pancreatic ductal adenocarcinoma invasion of the celiac artery.

Doppler imaging is of high value in assessing venous system invasion.

Standardization of ultrasound imaging procedures for pancreatic ductal adenocarcinoma is expected to improve efficiency.

Graphical Abstract
Superficial temporal artery aneurysm misdiagnosed in a patient with long-term migraine headache treatment: a case report
Authors: Ghasemi Gorji Meghdad , Rafiei Ali , Rajabi Amirhossein
Published: July 2024

Background

Superficial temporal artery aneurysm is a rare vascular abnormality without specific clinical symptoms. In this case report, we present the case of a patient with superficial temporal artery aneurysm who was diagnosed with migraine headache at first.

Case presentation

A 60-year-old Iranian man with a previous history of headaches, who did not respond properly to the treatments following the initial diagnosis of migraine, presented with a painless lump in the left temporal region, and he was diagnosed with superficial temporal artery aneurysm via Doppler ultrasound. Finally, surgical removal of the left superficial temporal artery aneurysm was performed.

Conclusions

This case shows the importance of vascular causes in the approach to headache etiologies, especially when the headache is prolonged without proper responses to treatment. Computed tomography angiography and magnetic resonance angiography are appropriate diagnostic methods for aneurysm detection that should be considered in future studies.
Existence results for coupled sequential ψ-Hilfer fractional impulsive BVPs: topological degree theory approach
Authors: Latha Maheswari M. , Keerthana Shri K. S. , Muthusamy Karthik
Published: July 2024

In this paper, the coupled system of sequential ψ-Hilfer fractional boundary value problems with non-instantaneous impulses is investigated. The existence results of the system are proved by means of topological degree theory. An example is constructed to demonstrate our results. Additionally, a graphical analysis is performed to verify our results.
Developing the EPI Symptom Questionnaire (EPI-SQ): a qualitative study to understand the symptom experience of patients with exocrine pancreatic insufficiency (EPI)
Authors: Mannix Sally , Bodhani Amit , Kleinman Leah , Khandelwal Nikhil , Singh Vikesh K.
Published: July 2024

Background

Symptom assessment is the key factor in determining disease status and optimal management of exocrine pancreatic insufficiency (EPI). There is a need for a standardized patient-reported outcome (PRO) questionnaire to assess symptoms in patients diagnosed with EPI. The purpose of this qualitative study was to increase understanding of the EPI symptom experience from the patients’ perspective, and to develop and evaluate the content validity of the EPI Symptom Questionnaire (EPI-SQ) in US patients with EPI.

Methods

Concept elicitation interviews (Phase I) were conducted to understand the symptom experience in patients with a clinical diagnosis of EPI (i.e., fecal pancreatic elastase value of ≤ 200 mcg/g based on most recent value) due to chronic pancreatitis or pancreatectomy. The EPI-SQ was developed based on the data extracted from Phase I interviews and feedback from clinical experts. Next, separate cognitive interviews (Phase II) were conducted to evaluate participants’ understanding of the instructions, items, response scales, and recall periods of the instrument.

Results

During Phase I interviews (n = 21), 19 participants (90%) reported abdominal pain as the most frequent EPI symptom and lifestyle changes were the most frequently endorsed impacts (n = 18; 86%). Phase II results indicated that all participants (n = 7) felt the 12-item EPI-SQ was relevant to their symptom experience and that they understood the items, instructions, and response options as intended.

Conclusion

The qualitative data from this study support the content validity of the EPI-SQ in measuring EPI symptom severity in US patient populations diagnosed with EPI.
Supply of bioelectricity from sugarcane bagasse in Brazil: a space–time analysis
Authors: Coelho Junior Luiz Moreira , Santos Júnior Edvaldo Pereira , da Silva Cleani Figueredo Fideles , de Oliveira Brunna Hillary Calixto , Dantas João Batista Cordeiro , dos Reis Josimar Vieira , Schramm Vanessa Batista , Schramm Fernando , Carvalho Monica
Published: July 2024

Bioelectricity generation from sugarcane is significant across Brazil and is related to regional market structure characteristics where the mills are located. To understand the distribution and conjuncture of this sector, this study analyzes the pattern of location, concentration and clustering of the bioelectricity supply from sugarcane bagasse in Brazil, for 2017 and 2022. The data were obtained from the Brazilian National Electric Energy Agency, and the methodology was based on concentration indices and scan statistics. The results showed that the Southeast region presented the most thermoelectric power plants and installed capacity. The Southeast and Midwest regions were highly concentrated in terms of quantity and sugarcane bioelectricity installed capacity. Five clusters were identified for the number of power plants in 2017; for 2022, there were eight clusters. Regarding installed potential, there were 14 clusters in 2017 and 23 clusters in 2022, all statistically significant. The existence of clusters provides information on the competitive advantages in the national market, which can drive new investments in more densified areas or in the neighborhood. Identification of the location and concentration pattern showed that facilities in the state of São Paulo and the Northeast coast were responsible for the most important share of supply. These results indicate to investors the impact of electricity generation on the sector and the most relevant location for installing new thermoelectric plants.
Modeling of seismic wave scattering in poroelastic media
Authors: Huang Xingguo , Sun Tong , Greenhalgh Stewart
Published: July 2024

Understanding wave scattering in the earth is considered fundamental in describing seismic wave propagation and providing information on structural features of the earth’s interior. Petrophysical parameters (especially porosity and permeability) affect the reflection coefficients of subsurface interfaces, which can better explain the field data and infer the subsurface structure. However, the numerical solutions to the scattering problem for efficient modeling of wave propagation in poroelastic earth structures have limitations. We develop a numerical algorithm for solving the poroelastic scattering integral equations. Specifically, applying perturbation theory to Biot’s equations, the solutions are expressed by the Lippman-Schwinger integral equations, which can express the displacement and pressure fields. We derive the contrast-source integral equations of the decoupled poroelastic wave equations. We apply a conjugate-gradient fast Fourier transform method for fast solutions of the integral equations. We show that despite the complexity of the geologic structure, the numerical method enables the modeling of the displacement and pressure fields in the frequency and time domains. We determine that the wave scattering problem for the Biot model provides a good description to understand the earth’s interior.
Nonstationary adaptive S-wave leakage suppression of ocean-bottom node data
Authors: Chen Zhihao , Zhu Zhaolin , Wu Bangyu , Chen Yangkang
Published: July 2024

Ocean-bottom nodes (OBNs) are widely used because of their wide azimuth, long-offset, and low-frequency advantages. However, in the vertical component of the OBN geophone, a significant amount of S-wave induced noise may be recorded. This significantly impacts the quality of the vertical component data and may affect the follow-up merging of dual-sensor data. Some commercially available methods apply normal-moveout correction, which requires velocity data. We avoid this with an adaptive matching method, which relies solely on seismic data. Therefore, we develop a novel adaptive subtraction method for S-wave leakage suppression using the horizontal component as the noise model. Our method effectively handles the nonstationarity of the input seismic data in all time and space directions, mitigating instability caused by manual selection of the smoothing radius. A method is introduced for estimating a global nonstationary smoothing radius using the noise model. Compared with commercial and stationary smoothing methods, our method can better suppress S-wave noise while balancing residual noise and signal leakage more effectively. Synthetic and field data examples demonstrate significant improvement with our method.
The clinical characteristics of autistic women with restrictive eating disorders
Authors: Brede Janina , Babb Charli , Jones Catherine R.G. , Serpell Lucy , Hull Laura , Adamson James , Baker Hannah , Fox John R.E. , Mandy Will
Published: July 2024

Background

Autistic women are at high risk of developing restrictive eating disorders (REDs), such as anorexia nervosa.

Aims

This study provides an overview of the clinical characteristics of autistic women with REDs to (i) enhance understanding of increased risk, and (ii) support the identification of autistic women in eating disorder services.

Method

We compared self-reported autistic and disordered eating characteristics of: autistic participants with REDs (Autism + REDs; n = 57); autistic participants without REDs (Autism; n = 69); and women with REDs who are not autistic (REDs; n = 80). We also included a group of women with high autistic traits (HATs) and REDs, but no formal autism diagnosis (HATs + REDs; n = 38).

Results

Autism + REDs participants scored similarly to Autism participants in terms of autistic characteristics and to REDs participants in terms of experiencing traditional disordered eating symptoms. Autism + REDs participants were distinguished from both groups by having more restricted and repetitive behaviours and autism-specific eating behaviours related to sensory processing, flexibility and social differences. HATs + REDs participants showed a similar pattern of scores to Autism + REDs participants, and both also presented with high levels of co-occurring mental health difficulties, particularly social anxiety.

Conclusion

The presentation of autistic women with REDs is complex, including both traditional disordered eating symptoms and autism-related needs, as well as high levels of co-occurring mental health difficulties. In eating disorder services, the REDs presentation of autistic women and those with HATs should be formulated with reference to autism-specific eating behaviours and co-occurring difficulties. Treatment adaptations should be offered to accommodate autistic characteristics and related needs.
Mortality Rate of Oncological Patients Undergoing Pancreaticoduodenectomy Procedure in Brazil From 2021 to 2023: A Cross-Sectional Study
Authors: Filipin Von Muhlen Pedro Henrique , Hass Yasmin Ricarte , Lech Gabriele Eckerdt
Published: July 2024

PURPOSE

Pancreatic cancer is the fourth leading cause of cancer death for men and the fifth for women. The current standard therapy for pancreatic tumors situated in the head of the pancreas is pancreaticoduodenectomy. However, this surgery is associated with significant postoperative morbidity. Great improvement in pancreatic surgery has led to mortality rates of less than 5% at high-volume centers, and the majority of case series in the literature reported a mortality rate of 8%. The study aims to analyze the mortality rate over three-years among Brazilian regions associated with treatment by pancreaticoduodenectomy in oncological patients.

METHODS

A cross-sectional study was designed using data collected from DATASUS, a Brazilian Health Ministry database. The study compared and analyzed the number of deaths and the total number of pancreaticoduodenectomies performed on oncological patients among Brazilian macro-regions (North, Northeast, Southeast, South, and Midwest) in the period of 2021 to 2023. Statistical analysis was performed using SPSS software v.18.

RESULTS

In this three-year, 1,871 pancreaticoduodenectomies were performed on oncological patients in Brazil. The year with the highest number of surgeries was 2021, with 633, and the year with the lowest number was 2022, with 611. Among these cases, 268 patients died during the procedure or in the postoperative period 14.32% of patients. The Southeast region had the highest number of pancreaticoduodenectomies, 979, and the highest number of recorded deaths, 139. However, its mortality rate is the second lowest among the five regions (14.20%). The South region, with the second highest number of surgeries and deaths, had the highest mortality rate, 16.16%.

CONCLUSION

Brazil had a significantly higher mortality rate than what is presented in the literature. Nevertheless, the number of surgeries performed in the country was significantly low in four of the five regions, but the Southeast region, with a considerable number of pancreaticoduodenectomies, also had a high rate. Two databases, from an American study and a French study, reported that mortality rates were significantly higher in lower-volume services. Another detail is the profile of the populations evaluated. Brazil tends to have a more compromised socioeconomic level.
Nanoparticle's Encapsulation Ability Is More Efficient for Characterization of Invading Breast Cancer Cells Than EMT Markers
Authors: Kontareva Elizaveta , Maksimova Ksenia , Pustovalova Margarita , Leonov Sergey , Merkher Yulia
Published: July 2024

PURPOSE

Metastasis is leading cause of cancer death. The essential step of metastasis is invasion. The actin cytoskeleton plays a pivotal role in invasion and is closely linked to endocytosis process. We previously distinguished highly and lowly invasive breast cancer (BC) cell lines based on their tendency to encapsulate 100-200 nm nanoparticles. Epithelial-to-mesenchymal transition (EMT) primarily initiates invasion, with EMT marker expression often used to gauge tumor invasiveness. The Boyden chamber migration assay serves as the gold standard for assessing tumor invasiveness, measuring cancer cells' migration towards a chemoattractant through subcellular pores. This study aims to characterize BC cell subpopulations, separated by the Boyden chamber, based on nanoparticle encapsulation and EMT marker expression.

METHODS

The highly invasive (HI) and lowly invasive (LI) BC cell lines (MDA-MB-231 and MCF-7, respectively) were separated into migrated and non-migrated subpopulations by Boyden chambers with 8µm membrane pores for 72 h. To assess encapsulation ability, cells were incubated with 200nm fluorescent carboxylated nanoparticles and nuclei stain for 1 hour, extensively washed with PBS and trypsin, and fixed. The images were captured by fluorescent microscopy, and nanoparticle colocalization with cells was quantified using Pearson`s coefficients. The standard antibody staining protocols were utilized for EMT markers: E-cadherin, N-cadherin, Vimentin and Snail1/2. The fluorescence intensity per image for each marker was normalized, and statistical significance was determined by ANOVA analysis.

RESULTS

The subpopulations of migrated cells were 32% and 2.2% for HI and LI cell lines, respectively. The significant differences between the expression of EMT markers in subpopulations were observed only in vimentin of HI cells (5% difference) and E-cadherin of LI (11% difference). At the same time, the differences in encapsulation efficiency between separated subpopulations of HI and LI cells were 30 % and 43%, respectively.

CONCLUSION

The EMT markers were found to be able to differentiate HI and LI cell lines, however they were not effective for distinguishing subpopulations within the same cell line. In contrast, the subpopulations can be clearly differentiated by the efficiency of nanoparticles encapsulation.
Nek2A Prevents Centrosome Clustering and Induces Cell Death in Cancer Cells Via KIF2C Interaction
Authors: Kalkan Batuhan , Ozcan Can , Cicek Enes , Acilan Ceyda
Published: July 2024

PURPOSE

Modern chemotherapeutics frequently suffer from selective targeting of cancer cells. In contrast to normal cells, cancer cells frequently exhibit extra centrosomes, which tend to form multipolar spindles (MPS), triggering cell death. Nevertheless, cancer cells can divide successfully by coalescing their extra centrosomes into two poles. Nek2 is a mitotic kinase regulating several mitotic processes. Our preliminary data showed that Nek2 overexpression unclusters extra centrosomes while its disruption favors centrosome clustering. Thus, revealing the molecular mechanism and targeting Nek2 in cells with extra centrosomes may be an alternative strategy for selective targeting for cancer cells.

METHODS

IF stainings, cell viability, apoptosis and competition assays were performed to investigate the effect of Nek2 overexpression to induce MPS. To investigate how Nek2 regulates centrosome clustering, we tested known Nek2 targets with relevant function (C-NAP1, Rootlein, Trf1, Hec1, Gas2L1) and assessed their involvement in centrosome clustering by knock out or siRNA mediated silencing. Next, we identified the interactome of Nek2 using TurboID proximity labelling and validated our results with co-IP.

RESULTS

Cells harboring supernumerary centrosomes were depleted from the population upon Nek2 overexpression. Known Nek2 targets exhibited no effect on centrosome clustering. Furthermore, the effect of Nek2 overexpression on MPS was additive with other known unclustering factors such as HSET, suggesting an independent mechanism. We identified several potential targets of Nek2 using TurboID proximity labelling. NuMA - also previously known to uncluster centrosomes, was significantly enriched in our samples. Interestingly, while NuMA did not co-IP with Nek2, its knockdown reverted the unclustering activity. Another significantly enriched motor protein, Kif2C not only reverted Nek2 activity, but also co-IP'ed with Nek2. Moreover, we identified MAPRE3 a regulator of microtubule dynamics, as interaction partners of both Nek2 and Kif2C. Our data suggests that Nek2 partners with Kif2C and MAPRE3, regulating centrosome clustering.

CONCLUSION

We assigned a novel function for Nek2 in centrosome clustering. We are currently elucidating the detailed mechanism of action for how target proteins interact with Nek2 regulating its centrosome unclustering activity in cancer cells. Understanding the mechanism will provide new translational approaches for cancer-specific treatment.
Screening Will Always Be Essential. Providers and Staff Discuss the Implementation of Anal Cancer Screening for Persons Living With HIV in Mexico City
Authors: McClellan Sean P. , Unger-Saldaña Karla , Gómez-Zepeda Mario , Gabriela-Hernández Julia , Hernández-Salazar Sonia , Palefksy Joel M. , Potter Michael B. , Salmerón Jorge , Torres-Ibarra Leticia , Koester Kimberly A.
Published: July 2024

PURPOSE

Screening for and treating anal squamous intraepithelial lesions (ASIL) in persons living with HIV (PLWH) prevents anal cancer but has not been widely implemented, especially in low-and-middle income countries.

METHODS

We conducted semi-structured qualitative interviews with providers and staff affiliated with two clinics from the Mexico City HIV program to understand barriers and facilitators to the implementation of a permanent anal cancer screening program. A limited program for anal cancer was already in place at these clinics as part of an international research collaboration. Interviews in Spanish were conducted in person or by video conference, audio-recorded, transcribed and thematically analyzed using domains from the Consolidated Framework for Implementation Research.

RESULTS

Between October 2023 and January 2024, we conducted 17 interviews, of which 9 were with nurses or physicians who were part of the existing screening research program and 8 were with referring physicians or administrators. Interviewees agreed that establishing a permanent screening program was necessary given documented high rates of ASIL. The most significant barriers were related to resources required to sustain a program, especially infrastructure for collecting and processing pathology specimens. The clinics’ current participation in a research collaboration was recognized as a facilitator that could help overcome barriers related to procurement of anoscopes and training staff. Some interviewees believed that given resource limitations, screening would have to be scaled up in a stepwise process, requiring the creation of triage strategies to identify and prioritize high risk patients for screening. Barriers related to patient participation included lack of patient knowledge and, particularly among cis-women, stigmatization and logistical challenges to attending appointments. The clinics’ patient-centered culture and existing educational and clinical workflows promoting preventive health were facilitators that could help overcome patient-level barriers.

CONCLUSION

Staff believed that establishing a permanent anal cancer screening program was necessary and possible but acknowledged that it would require additional external resources. In the next phase of data collection, we will interview PLWH who receive care at the clinics.
Prevalence of Hospitalizations for Malignant Brain Neoplasms in Adults in the Last 5 Years in the Brazilian Territory
Authors: Gonçalves Castelo Ana Carolina , Guidugli Enrico Lázaro , Rahal de Albuquerque Roberta , Paesi Dutra Pedro Henrique , Loureiro Yasmin Marques
Published: July 2024

PURPOSE

The presence of abnormal cells that originate within the brain tissue characterizes malignant neoplasia of the brain, a form of brain tumor. The study aims to analyze hospitalizations for malignant brain neoplasia in adults in the five regions of Brazil from 2019 to 2023, investigating the demographic distribution in terms of regions of the country, year, age group, sex and ethnicity. In addition, seek to evaluate the characteristics of care, including the nature of hospitalizations, length of stay and mortality rates.

METHODS

A cross-sectional, descriptive, retrospective and quantitative study was carried out on hospitalizations for malignant neoplasia of the brain in adults in the 5 regions of Brazil (North, Northeast, Center-West, South, Southeast) between January 2019 and December 2023. The data used were collected through the Department of Informatics of the “Unified Health System of Brazil” (DATASUS) in the “SUS Hospital Information System” section, gathering those that discussed the age group, sex, ethnicity of the patient, character of care, the rate of hospital stay and the mortality rate.

RESULTS

The analysis covers the years 2019 to 2023, totaling 75,719 hospitalizations. The region that received the highest number of hospitalizations was the southeast (43.24%), while the north had the lowest number (4.28%). The highest number of cases occurred in 2022 (20.56%), followed by 2019 (19.76%). Urgent hospitalizations represented 76.71% of the total. The most affected age group was 60 to 69 years old (19.88%). Men were more affected than women (52.07%) and white people represented 43.4% of hospitalizations. The average stay was 9.2 days and the mortality rate was 13.60%.

CONCLUSION

Given the data analyzed, it is possible to draw an epidemiological profile in which non-white men are the population most affected by brain cancer. Furthermore, there is an alarming number of urgent hospitalizations, highlighting the severity of the disease. Therefore, based on the observed profile and other data collected, it is important that measures are developed to mitigate this serious public health problem in Brazil.
Prostate Cancer Observed Survival for Harare, Zimbabwe: Utilizing a Population-Based Cancer Registry Platform
Authors: Mazhindu Tinashe A. , Ndlovu Ntokozo , Borok Margaret Z. , Meki Shingirai , Campbell Thomas B. , Flaig Thomas W.
Published: July 2024

PURPOSE

The population-based cancer observed survival rate is affected by patient, disease and treatment factors. Survival of prostate cancer (PC) patients has improved over the past three decades globally. In low-to-middle-income countries the increasing incidence of cancer risks globally reversing this improvement. Population-based cancer registries can help estimate cancer survival, the emerging trend and guide interventions. This study aimed at determining the PC observed survival in Harare, Zimbabwe and the utility of data available in the registry to assess factors impacting survival.

METHODS

In a cohort study, 615 prostate cancer patients, were registered in Zimbabwe National Cancer Registry which is a population-based cancer registry between 1 January 2017 and 31 December 2018. Basic demographic, disease-related, and treatment-related data was extracted exclusively from the registry. Vital status was determined through direct patient or family contact telephonically. The Hazard Ratio (HR) for survival was assessed using the log-rank test, and observed survival estimated up to 2-years from date of diagnosis.

RESULTS

The median age of the patients was 71 years, 99% were ethnic Africans, and 8% had health insurance. Clinical stage 1, stage 2, stage 3, stage 4 and unknown stage was recorded for 2 (0%), 11 (2%), 69 (11%), 155 (25%) and 381 (62%) study participants. Histological diagnosis was recorded for 83% of participants. The 6, 12, 18 and 24-month observed survival rates were 88.5, 77.9. 62.5, and 22.5%, respectively. The 2-year OS rate for stage 1, stage 2, stage 3, stage 4 and unknown stage disease was 100, 90, 40, 10 and 20% (p= 0.0000033%). The Hazard Ratio for PC survival: Health insurance (HR= 0.51, 95% CI 0.36-0.73, p=0.003), age at diagnosis (≥64-years old) (HR=1.14, 95% CI: 0.81-1.61, p=0.47) and any treatment vs no-treatment received (HR= 1.16, 95% CI 0.817-1.64, p = 0.39).

CONCLUSION

The study demonstrated that a LMIC population-based cancer registry is a feasible platform for cancer survival estimations. The PC observed survival in this study is poor. More detailed data capturing of biochemical, stage of disease, Gleason score, and specific treatments received is needed in order to evaluate survival impact.
Quality and Diagnostic Characterization of Bone Marrow Biopsies at Kamuzu Central Hospital, Malawi: A Retrospective Study
Authors: Kasonkanji Edwards , Chikaonda Tarsizious , Fastburg Luke , Mulenga Maurice , Tomoka Tamiwe , Fedoriw Yuri , Painschab Matthew S.
Published: July 2024

PURPOSE

Diagnosis and management of many hematologic diseases depends on BM evaluation though data on diseases diagnosed and quality of bone marrow biopsies from Malawi is limited.

METHODS

We conducted a retrospective study of bone marrow biopsies taken for routine care from 2013-2023 at Kamuzu Central Hospital in Lilongwe, Malawi. We queried the laboratory database for patients age ≥18 with a pathology sample for “bone marrow biopsy” with location “iliac crest.” Patient characteristics were limited to those available from the pathology request request forms for each case including: age, sex, HIV status, details on history and laboratory findings. Diagnoses were made by routine care and recorded in the laboratory information system database (LIS), completed by the provider during the biopsy. Descriptive statistics were conducted in R.

RESULTS

498 participants were identified; 273(55%) were male with median age of 41 (range 18-82). 305(61%) were HIV negative, 131(26%) HIV positive, and 62(12%) HIV unknown. Specimens collected and analyzed were either trephine and aspirates or both. Of the 498, 283(57%) were trephines, 88(18%) were aspirates and 127(25%) were both trephine and aspirate. Quality of biopsies was excellent, as only 29(6%) were sub-optimal or un-interpretable. Biopsy indications included unexplained anemia 40(8%), cancer staging 29(6%), pancytopenia 8(2%), lymphadenopathy 8(2%), and splenomegaly 5(1%). Indication was not given for 377(76%). The most common diagnosis was benign or reactive bone marrow (i.e., non-malignant) 275(60%). Other diagnoses included ALL 27(6%), AML 19(4%), Benign lesions-NOS 18(4%), DLBCL 16(4%), Aplastic anemias 11(2%), CLL 10(2%), Multiple myeloma 10(2%), MDS 8(2%), CML 8(2%), Carcinomas 8(2%), Hodgkin lymphoma 5(1%), HIV-infection 4(0.9%) among others.

CONCLUSION

Quality of bone marrow biopsies done under routine care is good in Malawi. However, the most common diagnosis in this population was a reactive bone marrow, for which the underlying cause was not evident to the treating provider. Therefore, further research is needed on the causes of cytopenia in this population.
Racial Disparities in Pediatric Patients With Acute Lymphoblastic Leukemia: An NCDB Analysis
Authors: Mishra Anjali , Mathews Maya , Becker Ashley , Al-Qurnas Mohammed , Silberstein Peter , Swedek Michelle
Published: July 2024

PURPOSE

Acute Lymphoblastic Leukemia (ALL) is the most common type of pediatric cancer. The American Cancer Society notes that the risk of ALL is higher in White patients than in Black patients. The goal of this study was to provide an updated investigation of racial disparities in overall survival (OS) of pediatric patients with ALL.

METHODS

Using the National Cancer Database, this retrospective cohort study identified 23,397 ALL patients between the ages of 0-18 who received chemotherapy from 2004-2020. Patients with race listed as “unknown” or “other” were excluded. Kaplan Meier survival analysis and cox multivariate analysis was used to evaluate OS across race categories.

RESULTS

OS was 196.8 months [95% confidence interval 195.8 – 197.8] for White patients, 189.7 months [187.6 - 191.8] for Spanish/Hispanic, 182.6 months [179.0 – 186.3] for Black patients, 183.6 months [174.5 to 192.7] for Native American patients, and 192.3 months [188.7 to 195.8] for AAPI patients. Multivariate analysis accommodated for sex, insurance status, median income quartiles, and Charlson-Deyo comorbidity score. Pairwise log rank test revealed Black patients had statistically significantly lower OS compared to White (p < 0.0001) and AAPI patients (p < 0.0001). Black patients had a higher survival hazard ratio compared to White (HR=1.309, 95% CI 1.117 to 1.533, p<0.001). Spanish/Hispanic patients had statistically significant lower OS (p < 0.0001) and higher hazard ratio (HR=1.188, 95% CI 1.058 to 1.334, p = 0.004) compared to non-Spanish/Hispanic patients. 5-year event-free survival (EFS) to be 90.9% for White patients, 87.1% for Black patients, 88.1% for Native American patients, and 92.4% for AAPI patients.

CONCLUSION

Black patients had decreased OS and greater hazard ratios compared to White patients with ALL. In addition, Hispanic patients had decreased OS and greater hazard ratios compared to non-Hispanic patients. After accommodating for sex, insurance status, median income quartiles, and Charlson-Deyo comorbidity score, we find these racial disparities continue to persist. Reducing the disparities in ALL incidence among pediatric patients from different racial backgrounds is not only a matter of health equity but also a testament to our commitment to ensuring the well-being of all children.
Regulation of Osteopontin in Prostate Cancer: Potential Therapeutic Implications for Bone Metastasis
Authors: Sanchis Pablo , Sabater Agustina , Bizzotto Juan , Valacco Pia , Vazquez Elba , Navone Nora , Gueron Geraldine , Anselmino Nicolas
Published: July 2024

PURPOSE

Prostate cancer (PCa) bone metastasis (BM) plays a crucial role in disease outcome and poses a significant clinical obstacle due to its heterogeneity. In this sense, Osteopontin (SPP1/OPN) is elevated in a subset of patients with advanced disease. However understanding its regulation is an unmet need. In this work we investigated the factors controlling SPP1/OPN expression in a subgroup of patients with BM.

METHODS

We performed a comprehensive transcriptomics analysis (DEG, Ingenuity Pathway Analysis (IPA)) of publicly available patients datasets (GSE74685, SU2C-PCF and Westbrooke et al), comparing PCa on different metastatic sites and/or treatment status. Using an indirect co-culture (24h) to mimic the dialogue between PCa cells (PC3/C42B) and osteoblast precursors (MC3T3) in vitro, we integrated transcriptomics (RT-qPCR and RNAseq) and secretomic (ESI-MS/MS of conditioned media (CM)) data to dissect key players involved in the bi-directional crosstalk between PCa and bone cells. Protein Kinase A (PKA) pathway implication was evaluated by its induction (forskolin 1uM) or suppression (H89 10uM). Clinically relevant patient derived xenograft (PDX) models growing intrafemorally (i.f.) were used for in vivo validation.

RESULTS

Across different datasets, we consistently found a sub-population of patients with BM characterized by high levels of SPP1 expression, associated with an active PKA pathway. By functionalizing this response experimentally, we demonstrated that specific bone secreted factors, particularly Col1a1 and Fn1, significantly induce SPP1 expression in PCa cells via PKA activation. Further, experimental and clinical settings suggest that the androgen receptor (AR) is implicated on this bone-induced PKA/SPP1 axis. Notably, longitudinal analysis of patients samples revealed an increased SPP1 expression alongside signs of PKA pathway activation, in a subpopulation of BM upon AR signaling inhibition with enzalutamide.

CONCLUSION

Herein, we uncovered PKA as a novel upstream regulator of SPP1/OPN expression in PCa triggered by the bone microenvironment that could possibly be implicated in treatment resistance. These results highlight the potential of SPP1/OPN as a marker of tumors with active PKA to improve disease management.
Smoking Rates, Attitudes Towards Second Hand Smoking and Lung Cancer Awareness Among Medical and Dental Students in India
Authors: Francis Delfin
Published: July 2024

PURPOSE

There is no safe level of second hand smoke and conclusive evidence exists about the association between life threatening disease and passive smoking. Breathing even a little second hand smoke can be dangerous. Second hand smoke contains over 4,000 chemicals, 200 of which are toxins and 43 are carcinogens. Those who have heart disease and/or asthma are particularly susceptible to exposure to second hand smoke exposure Passive smoking, according to the recent global assessment of the burden of environmental tobacco smoke (ETS), is still one of the most important threats to public health. The aim of the study was to determine the smoking rates and perceptions of students towards second hand smoke in a University setting.

MATERIALS AND METHODS

A questionnaire was prepared based on the guidelines of WHO global adult tobacco surveillance data. The study proposal was approved by ethics committee. A comparative study was done to determine the smoking rates and attitudes towards second hand smoke between the Medical and Dental students at Tagore dental and medical college, India. The responses were tabled and data was analysed statistically using SPSS and other data analysis software.

RESULTS

A total of 118 dental students and 63 medical students completed the survey. Fewer dental students (2.5%) have smoked more than 100 cigarettes in their life when compared to the medical students (19.05 %) who were also current smokers. Current smokers averaged 6.4 cigarettes per day and smoked 2.6 per day on campus. A majority of dental students (37.2%) and medical students (11.1%) believed air quality to be poor. All medical had an experience of second hand smoke while (3.4%) dental students have never experienced second hand smoke. On the other hand (81.3%) of the Dental students and (30.2%) of medical students believed that a smoking ban would greatly improve the public image of college. Though (95%) of Dental students and (71.4%) of medical students agreed that tobacco smoke is dangerous for smokers and non-smokers health; only the dental students (85%) wanted the campus to be smoke free in the future, while the medical students (38%) only wanted campus to be smoke free. The difference is because of the higher smoking rates among the medical students.

CONCLUSION

It is clear that there is considerable support for a smoke free policy in the college campus but there must be adequate education and consultation. In the meantime, students should be provided health education to discourage tobacco use. Information on tobacco control policies needs to be more widely disseminated.
Social Support As a Predictor of Opioid Misuse Risk in Cancer Patients
Authors: Zhu Jonathan , Quinn Ryan , Chittams Jesse , Meghani Salimah
Published: July 2024

PURPOSE

In cancer patients, prescription opioid analgesics are a staple medication for cancer-related-pain management. Amidst the onslaught of legislative efforts to decrease opioid prescribing, cancer patients have been inadequately protected from increased restrictions. This fear of opioid misuse has made it more difficult for these patients to access opioids for necessary pain management purposes. In order to safely prescribe and administer opioids in these populations, predictors of opioid misuse and the development of OUD need to be studied.

METHODS

This study concerns the analysis of preliminary data from an ongoing parent study (1R01NR017853) looking at longitudinal outcomes of opioid therapy in patients with cancer and how patterns of opioid use over time relate to patient-reported outcomes and healthcare utilization. Adult patients with cancer receiving outpatient oncology care were recruited from three different sites affiliated with the University of Pennsylvania Health System. A multivariable linear regression model was used to analyze the predictive value of different factors on opioid misuse risk.

RESULTS

The regression model was significant overall (F(25, 389) = 7.64, p < .001) and captured 28.62% of the variance in opioid misuse risk scores. In this model, moderate depression (b = 4.16, p < .001), moderately severe depression (b = 7.07, p < .001), and severe depression (b = 8.27, p < .001) were correlated with higher opioid misuse risk scores than participants with 'none-minimal' depression levels. Social support (b = -1.42, p < .001) had a significant inverse correlation with opioid misuse risk scores.

CONCLUSION

The results of this study suggest that depression and social support are correlated with opioid misuse risk in cancer patients with opioid prescriptions. Increases in depression severity were more strongly correlated with opioid misuse risk, suggesting that cancer patients with more severe depression are especially susceptible to opioid misuse. Social support was inversely correlated with opioid misuse risk. To minimize the risk of opioid misuse and provide proper support for cancer patients who are prescribed opioids for pain management, patients should be screened for depression and social support levels prior to starting opioid analgesics. Patients who have depression or low levels of social support should receive additional interdisciplinary support services to address those modalities concurrently with their opioid regimen.