bluuebunny/crossref_metadata_2025 huggingface dataset:
High-DNA Stainability Is Not Related to Embryonic Development and Clinical Outcomes on In Vitro Fertilization Cycles: A Retrospective Study Using a Propensity Score-Matching Analysis
Authors: Song Mingzhe , Huang Wensi , Ye Lijun , Liu Zhiqiang , Xiao Weiqiang , Xiong Feng , Peng Yueqin , Cai Jing , Zeng Yong
Published: October 2023

The high-DNA stainability (HDS) might be an indicator for the detection of sperm chromatin decondensation structure resulting from the incomplete histone-to-protamine exchange. The aim of our study was to investigate the association of HDS with embryonic development and clinical outcomes after in vitro fertilization (IVF) treatment. Couples underwent IVF cycles from January 2016 to December 2020 were retrospectively studied, including a total of 2,604 target couples undergoing IVF treatment and 628 couples undergoing fresh IVF-embryo transplantation (IVF-ET) treatment. Couples were divided into HDS > 15% group and HDS ≤ 15% group according to HDS levels. After controlling the bias between groups using the propensity score-matching method, data of embryonic development, and clinical outcomes were analyzed. No significant differences were observed between HDS > 15% group and HDS ≤ 15% group regarding fertilization rate (83.33% vs. 84.62%,P=0.349), two pronuclei rate (81.82% vs. 83.33%,P=0.613), cleavage rate (100.00% vs. 100.00%,P=0.172), and high-quality embryo rate (60.00% vs. 60.00%,P=0.961). Linear regression analysis showed that HDS was negatively associated with fertilization rate (B value = −0.094, 95% CI: −0.184 to −0.005,P=0.039), whereas no correlation (adjusted B value = −0.081, 95% CI: −0.170 to 0.008,P=0.074) was observed after adjusting potential confounding factors. The clinical pregnancy rate (62.11% vs. 60.39%,P=0.699), ongoing pregnancy rate (52.17% vs. 53.10%,P=0.838), early miscarriage rate (9.94% vs. 7.28%,P=0.283), late miscarriage rate (0.62% vs. 2.14%,P=0.305), and live birth rate (51.55% vs. 50.96%,P=0.838) were not significantly different between groups. Binary logistic regression analysis showed that HDS levels did not affect clinical outcomes after fresh IVF-ET treatments. HDS was not significantly associated with embryonic development and clinical outcomes of IVF. Our findings suggested that HDS evaluation before IVF treatment might be with limited potential to predict embryo development and clinical outcomes.
Long-Term Rainfall Variability and Trends for Climate Risk Management in the Summer Monsoon Region of Southeast Asia
Authors: Edirisinghe Mahesh , Alahacoon Niranga , Ranagalage Manjula , Murayama Yuji
Published: October 2023

This study presents an analysis of long-term rainfall variability and trends in the summer monsoon region of Southeast Asia, encompassing Lao People’s Democratic Republic (Lao PDR), Thailand, Vietnam, Cambodia, and Myanmar, as well as their respective river basins. Utilizing Climate Hazards Group InfraRed Precipitation with Station Data (CHIRPS) having a spatial resolution of 5 km spanning from 1981 to 2021, rainfall variability and trends were examined. Data preprocessing and geospatial analysis were conducted using R-Studio and ArcGIS software. The Mann–Kendall (MK) test and Sen’s slope estimator were employed for annual and seasonal rainfall trend analysis. Myanmar exhibited the highest average annual rainfall of 2137 mm during the study period, while Thailand had the lowest (1641 mm). Over the past four decades, the Peninsula Malaysian Basin experienced the highest average annual rainfall (2691 mm), whereas the Chao Praya Basin recorded the lowest (1311 mm). Increasing trends in rainfall were observed across all five countries and nine major river basins. Vietnam displayed the highest annual rainfall trend of 5.63 mm/year, while Lao PDR exhibited the lowest trend (3.16 mm/year). Among the river basins, the Chao Phraya Basin demonstrated the maximum annual rainfall trend (11.21 mm/year), while the Peninsula Malaysia Basin had the minimum trend (1.21 mm/year). These findings could significantly contribute to climate change monitoring in the region and can aid policymakers in sectors such as agriculture, urban planning, and disaster management.
Use of Genetically Modified Canola Oil as a Replacement for Fish Oil in Practical Diets for Whiteleg Shrimp Litopeneaus vannamei Reared in Green Water Conditions
Authors: Weldon Alexis , Davis D. Allen , Rhodes Melanie , Morey Amit , Iassonova Diliara , Roy Luke A.
Published: October 2023

With current advancements in technology allowing for genetic modification of crops, canola has been modified to contain n3 long-chain polyunsaturated fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). The purpose of this study was to determine the efficacy of using genetically modified canola oil as a DHA and EPA replacement for Menhaden fish oil (FO) in practical diets for Pacific white shrimp Litopeneaus vannamei. This trial was conducted using twenty-four 750 L tanks stocked at 40 shrimp per tank (0.1 ± 0.007 g initial weight) and grown for 63 days. Shrimp were fed one of five experimental diets (36% protein, 8% lipid) with supplemental FO replacement varying from 75% to 100% twice daily (7 a.m. and 7 p.m.). Two of the diets contained 15% fishmeal (FM) as the basal protein source, while the other three diets were FM free, allowing for complete removal of DHA sources in the basal formulation. While basal FO was removed, none of the experimental diets were completely devoid of FO. Shrimp were harvested and frozen after 9 weeks to be used for lipid extraction and taste and texture analysis by an untrained panel to mimic consumer responses. Results were subjected to a two-way analysis of variance, with significant differences observed in final mean weight (8.47–10.59 g) (

p
=
0.0275

), individual weight gain (8.37–10.48 g) (

p
=
0.0279

), and weekly gain (0.84–1.05 g) (

p
=
0.0378

). Human sensory analysis did not yield significant differences between measured taste parameters (

p
>
0.05

). Lipid extraction and analysis results showed that fatty acid concentrations from whole shrimp samples correlate with diet lipid profiles except for EPA. There is no significant difference (

p
>
0.05

) in EPA concentrations in whole shrimp samples regardless of diet. These results suggest that Latitude™ oil can be successfully used as a partial replacement for FO in commercial shrimp diets.
Challenges and Proven Recommendations of Praziquantel Formulation
Authors: Kuevi Deryl Nii Okantey , Acquah Francis Asiedu , Amuquandoh Amy , Abbey Andrew Papa
Published: October 2023

Background. Schistosomiasis, ranked second to malaria as one of the crucial parasitic infections in the world, infects close to 240 million people as at 2019. Praziquantel, an oral anthelmintic, is the first-line drug for the treatment of schistosomiasis. Although the drug is safe and effective, the formulated tablets come with some limitations such as low bioavailability and bitter taste. This literature review aims to provide information on how to improve the issues of solubility, low bioavailability, and bitter taste associated with the praziquantel formulation and, subsequently, to be helpful in improving patient’s compliance. Materials and Methods. For gathering all pertinent data in this review on improving the praziquantel formulation, the following databases were used: Google Scholar, Science Direct, Scopus, PubMed, Springer Link, Elsevier, and Wiley online library. Results. Literature revealed that in improving the bioavailability of praziquantel, loading the drug with hydrogenated castor oil solid lipid nanoparticles has shown to be effective in prolonging systemic circulation from 7.6 to 95.9 hours after oral administration. Moreover, employing the solid dispersion technique using the fusion method increases the bioavailability of praziquantel about twice as much. Furthermore, incorporating a superdisintegrant or more than one disintegrant to the formulation can enhance the release of praziquantel. The addition of hydroxypropyl-beta-cyclodextrin (HP-β-CD) and sucralose as sweeteners can mask the bitter taste of praziquantel. Conclusion. The formulation approaches outlined in this review can be employed to greatly enhance the solubility, bioavailability, and taste of praziquantel. Although several techniques to improve praziquantel formulation have been widely studied, further studies on the release profile and compatibility studies with other excipients need to be investigated.
Extracellular Synthesis of Iron Oxide Nanoparticles Using an Extract of Bacillus circulans: Characterization and In Vitro Antioxidant Activity
Authors: Rabani Ghulam , Dilshad Muhammad , Sohail Aamir , Salman Aqsa , Ibrahim Saba , Zafar Iqra , Arshad Hafiz Muhammad
Published: October 2023

This study explores the biosynthesis of iron oxide nanoparticles (IONPs) using Bacillus circulans bacterial supernatant as an inexpensive and sustainable alternative to traditional synthesis approaches. The resulting nanoparticles were found to have a uniform size distribution and a spherical shape and agglomerated to form clusters as observed through scanning electron microscopy (SEM). The average diameter of IONPs determined using SEM was 18.37 nm. Characterization using energy-dispersive X-ray spectroscopy (EDX) and X-ray diffraction (XRD) confirmed the synthesis of maghemite (γ-Fe2O3) nanoparticles, with a crystallite size of 13.84 nm. Fourier-transform infrared spectroscopy (FT-IR) revealed the surface functional groups of IONPs. Additionally, the IONPs were evaluated for antioxidant activity using the DPPH and ABTS assays, displaying 39.44% inhibition of ABTS radical cations and 35.44% DPPH scavenging. Calcination of IONPs for two hours at 300°C resulted in the conversion to the hematite (α-Fe2O3) phase, with a crystallite size of 23.18 nm, and slightly lower antioxidant activity, 35.04% inhibition of ABTS radical cations, and 26.5% DPPH scavenging.
Pharmacovigilance and Adverse Drug Reactions Reporting: Healthcare Providers’ Experiences from Southern Highland Tanzania
Authors: Mwakawanga Dorkasi L. , Kilonzi Manase , Philipo Erick G. , Martine Aron , Mbilinyi Tusaligwe , Kileo Nancy F. , Mkinga Bryceson , Shonyella Cleopatra Justine , Mohamedi Juma A. , Clement Aurelia , Mwasomola Davance , Mushy Stella E. , Sirili Nathanael
Published: October 2023

Purpose. This exploratory qualitative study aimed to analyze the experiences of healthcare providers (HCPs) in pharmacovigilance (PV) and ADR reporting in the southern highland zone of Tanzania. Methods. In 2022, an exploratory qualitative case study using in-depth interviews (IDIs) was conducted to explore the experiences of PV and ADR reporting among HCPs (doctors, nurses, and pharmacists). The study was carried out in a zonal referral hospital and a regional referral hospital of the Tanzanian southern highlands zone. Inductive-deductive thematic analysis was adopted for data analysis. Results. Participants demonstrated adequate knowledge of PV and its related activities including ADR reporting. Knowing the interactions and wrong medication dosage as sources of ADR, signs, and symptoms, stopping the drug, and treating the symptoms following ADR emerged as subthemes linked with adequate knowledge in identifying and managing ADR. Participants perceived reporting ADR as laborious, posing a subjective burden and that not all ADRs needed to be reported. The latter contributed to limited participation in ADR reporting despite that participants were conversant with both physical and online ADR reporting platforms. Conclusion. Although HCPs are well informed about PV and ADR reporting including the benefits to public health, their involvement in ADR reporting is low. In addition to the ongoing on-the-job training and regular supportive supervision for HCPs to improve the ADR practice, there is still a need to explore other strategies to be used as motives for HCPs to report ADR regularly.
Nanoemulsification of Rose (Rosa damascena) Essential Oil: Characterization, Anti-Salmonella, In Vitro Cytotoxicity to Cancer Cells, and Advantages in Sheep Meat Application
Authors: Saffari Iman , Motallebi Moghanjoghi Abbasali , Sharafati Chaleshtori Reza , Ataee Maryam , Khaledi Azad
Published: October 2023

Nowadays, consumers are pushing for the use of natural preservatives such as essential oils (EOs) in the fresh and processed foods, including meat. However, this action is related to a variety of challenges that are associated with essential oils, including low solubility in water, high volatility, and limited long-term stability. These factors collectively reduce their effective utilization in this application. Therefore, the objective of this research was to investigate the morphology and stability of the Rosa damascena essential oil nanoemulsion (RDNE), as well as its antibacterial and anticancer properties. Also, we examined its effects on the quality characteristics of ground sheep meat during the refrigerated storage. The zeta potential and particle size of RDNE were −47.5 mV and 100 nm, respectively. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the RDNE against Salmonella typhimurium were 375 and 750 µg/mL, respectively. The most inhibition of biofilm formation (80%) was observed for RDNE at 2 MIC. The RDNE had an inhibitory effect on the expression of the Salmonella enterotoxin gene (stn). The obtained IC50 of RDNE against colon and cervical cancer cell lines (HCT 116 and HeLa cells) were 3.31 and 4.6 µg/mL, respectively. Adding RDNE at a concentration of 250 µg/g to fresh ground meat resulted in the total bacterial count (TBC) remaining below 8 log CFU/g during storage. Moreover, the samples coated with RDNE (250 µg/g) had the fewest coliforms, lactic acid bacteria (LAB), S. typhimurium, pH, and total volatile basic nitrogen (TVB-N) content. RDNE coating improved the flavor and overall acceptability of the samples. Therefore, RDNE is recommended as a natural preservative agent to enhance the bacterial and chemical stability of sheep meat.
Fractional Soliton and Semirational Solutions of a Fractional Two-Component Generalized Hirota Equation
Authors: Zhang Sheng , Zhu Feng , Xu Bo
Published: October 2023

The Darboux transformation (DT) and generalized DT (GDT) have played important roles in constructing multisoliton solutions, rogue wave solutions, and semirational solutions of integrable systems. The main purpose of this article is to extend the DT and GDT to a conformable fractional two-component generalized Hirota (TCGH) equation for revealing novel dynamic characteristics of fractional soliton and semirational solutions. As for the main contributions, specifically, we propose a fractional form of the TCGH equation, provide the associated fractional Lax pair, and obtain fractional soliton and semirational solutions of the fractional TCGH equation by constructing its fractional DT and GDT. In addition, we find that the dominant role of fractional order leads to new dynamic characteristics of the obtained fractional soliton and semirational solutions, mainly including a certain degree of tilt of wave crests and the variations in velocities and wave widths over time during propagation, which are not possessed by the corresponding integer-order TCGH equation. Meanwhile, this study predicts the deceleration propagation of solitons in fractional dimensional media and brings the possibility of exploring the asymmetric regulation mechanism of rogue waves from the perspective of fractional-order dominance.
Zoledronic Acid Add-on Therapy for Standard-Risk Ewing Sarcoma Patients in the Ewing 2008R1 Trial
Authors: Koch Raphael , Haveman Lianne , Ladenstein Ruth , Brichard Benedicte , Jürgens Heribert , Cyprova Sona , van den Berg Henk , Hassenpflug Wolf , Raciborska Anna , Ek Torben , Baumhoer Daniel , Egerer Gerlinde , Kager Leo , Renard Marleen , Hauser Peter , Burdach Stefan , Bovee Judith V.M.G. , Hong Angela M. , Reichardt Peter , Kruseova Jarmila , Streitbürger Arne , Kühne Thomas , Kessler Torsten , Bernkopf Marie , Butterfaß-Bahloul Trude , Dhooge Catharina , Bauer Sebastian , Kiss János , Paulussen Michael , Bonar Fiona , Ranft Andreas , Timmermann Beate , Rascon Jelena , Vieth Volker , Kanerva Jukka , Faldum Andreas , Hartmann Wolfgang , Hjorth Lars , Bhadri Vivek A. , Metzler Markus , Gelderblom Hans , Dirksen Uta
Published: October 2023

Purpose:

The phase III, open-label, prospective, multicenter, randomized Ewing 2008R1 trial (EudraCT2008-003658-13) was conducted in 12 countries to evaluate the effect of zoledronic acid (ZOL) maintenance therapy compared with no add-on regarding event-free survival (EFS, primary endpoint) and overall survival (OS) in standard-risk Ewing sarcoma (EWS).

Patients and Methods:

Eligible patients had localized EWS with either good histologic response to induction chemotherapy and/or small tumors (<200 mL). Patients received six cycles of VIDE induction and eight cycles of VAI (male) or eight cycles of VAC (female) consolidation. ZOL treatment started parallel to the sixth consolidation cycle. Randomization was stratified by tumor site (pelvis/other). The two-sided adaptive inverse–normal four-stage design (planned sample size 448 patients, significance level 5%, power 80%) was changed after the first interim analysis using the Müller–Schäfer method.

Results:

Between April 2010 and November 2018, 284 patients were randomized (142 ZOL/142 no add-on). With a median follow-up of 3.9 years, EFS was not significantly different between ZOL and no add-on group in the adaptive design (HR, 0.74; 95% CI, 0.43–1.28, P = 0.27, intention-to-treat). Three-year EFS rates were 84.0% (95% CI, 77.7%–90.8%) for ZOL vs. 81.7% (95% CI, 75.2%–88.8%) for no add-on. Results were similar in the per-protocol collective. OS was not different between groups. The 3-year OS was 92.8% (95% CI, 88.4%–97.5%) for ZOL and 94.6% (95% CI, 90.9%–98.6%) for no add-on. Noticeable more renal, neurologic, and gastrointestinal toxicities were observed for ZOL (P < 0.05). Severe renal toxicities occurred more often in the ZOL arm (P = 0.003).

Conclusions:

In patients with standard-risk localized EWS, there is no additional benefit from maintenance treatment with ZOL.
FIGURE 4 from DNA2 Nuclease Inhibition Confers Synthetic Lethality in Cancers with Mutant p53 and Synergizes with PARP Inhibitors
Authors: Folly-Kossi Helena , Graves Joshua D. , Garan Lidija A. Wilhelms , Lin Fang-Tsyr , Lin Weei-Chin
Published: October 2023

Targeting DNA2 with d16 inhibits ATR function and enhances cisplatin sensitivity in cancer cells harboring mutp53. A, H1299 stable cells expressing an empty vector, WT p53, mutp53-R273H or mutp53-R175H were treated for 72 hours with increasing concentrations of d16. Cell proliferation was measured by MTT assay. Top panels are immunoblots showing the expression of WT p53, mutp53, and GAPDH, respectively. B, MDAH-2774, BT549, and C33A cells stably expressing either a scrambled shRNA (shScr) or an shRNA against mutp53 (shp53) were treated with d16 (5 µmol/L for BT549 and MDAH-2774, 2.5 µmol/L for C33A) for 72 hours. Cell viability was then measured by MTT assay. The data shown represent mean ± SD (n = 3 biological replicates). P values are *, P < 0.05; **, P < 0.01; and ***, P < 0.001 indicating statistically significant difference (two-tailed t test). Right: Immunoblots of mutp53 and GAPDH, respectively. C, H1299 cells transiently expressing an empty vector or mutp53-R273H were treated with d16 (10 µmol/L) for 24 hours, followed by HU (2 mmol/L) treatment for 0, 2, or 4 hours. Cell lysates were subjected to Western blotting. The right panel shows the quantification of pChk1 protein levels normalized by Chk1 protein; *, P < 0.05. D, A2780cis cells were treated with vehicle control or d16 (5 µmol/L) with increasing doses of cisplatin for 72 hours. Cell proliferation was then measured by MTT assay. CI analysis was performed using CompuSyn software. Fa (Fraction affected)-CI plot and CI values (in brackets) were calculated and shown in the right. CI < 1 indicates synergism. E, Clonogenic survival assay was performed by treating A2780cis cells with d16 (2.5 µmol/L), cisplatin (2 µmol/L), or both for 24 hours. After PBS washing, cells were cultured for 10 days. The data shown represent mean ± SD (n = 3 biological replicates). *, P < 0.05; **, P < 0.01; and ***, P < 0.001 indicating statistically significant difference (two-tailed t test).
FIGURE 2 from DNA2 Nuclease Inhibition Confers Synthetic Lethality in Cancers with Mutant p53 and Synergizes with PARP Inhibitors
Authors: Folly-Kossi Helena , Graves Joshua D. , Garan Lidija A. Wilhelms , Lin Fang-Tsyr , Lin Weei-Chin
Published: October 2023

Cytotoxic effects of DNA2 inhibitor C5 and its analogs in human cancer cells. A, Molecular docking of C5 or its analog d16 in the Site 1 pocket of DNA2. A, C5 chemical structure and its docking score. B and C, The three-dimensional structure of DNA2 with C5 docked in the Site 1 pocket, surface view and cartoon view. D, Crystal structure of DNA2 in complex with an ssDNA (PDB: 5EAX; ref. 37). E, The positions of DNA and C5 in DNA2. F–I, The lowest-energy docking positions of d16, d11, d18, and d24 in DNA2 show potential interference with the passage of DNA strand (orange dotted line). B, Chemical structures of C5 analogs and their docking scores in DNA2. MDA-MB-468, BT549, and MDAH-2774 cells were treated for 72 hours with 20 µmol/L of one of the 24 C5 analogs (C) or with increasing concentrations of C5 or d16 (D). Cell proliferation was measured by MTT assay. The data shown represent mean ± SD (n = 3 biological replicates). *, P < 0.05 indicating statistically significant difference between vehicle (Veh) and C5 analogs (two-tailed t test). E, Structure-activity relationship analysis identifies the core structure of the active compounds.
An Unusual Complication of Self-Expandable Metal Stent Placement in Malignant Sigmoid Obstruction
Authors: Kang Qingjie , Hu Denghua , Wen Guangxu , Wei Zhengqiang
Published: October 2023

Self-expandable metal stent (SEMS) for malignant colorectal obstruction is widely used as a bridge to elective surgery or palliative treatment. However, with the increasing use of SEMS for treatment, complication rates associated with stents have been raised as a concern. We experienced a rare migration-related complication that a stent partially migrated out of the anus with an incarceration. A 62-year-old man was admitted with sigmoid malignant obstruction. Due to multiple metastases, he refused to undergo colostomy, and an uncovered SEMS was placed. Subsequently, he started chemotherapy. Seven months after placement, the stent migrated into the rectum. After unsuccessful attempts to extract the stent, he sought our assistance. We observed that half of the stent was outside the anus, and a 15 mm lump of mucosa was embedded in the proximal end of the stent. After several attempts, we successfully removed the SEMS. Stent incarceration following migration is not a common occurrence, but it serves as a reminder that clinicians need to be more vigilant about complications that may arise after stent implantation. We describe this unusual complication and share our experience about the removal of the stent.
Indocyanine Green-Labeled Platelets for Survival and Recovery Studies
Authors: von Behren Johannes-Moritz , Wesche Jan , Greinacher Andreas , Aurich Konstanze
Published: October 2023

Introduction: Before being implemented in daily clinical routine, new production strategies for platelet concentrates (PCs) must be validated for their efficacy. Besides in vitro testing, the establishment of new methods requires the labeling of platelets for in vivo studies of platelets’ survival and recovery. Indocyanine green (ICG) is a Food and Drug Administration-approved near-infrared (NIR) fluorescent dye for diagnostic use in vivo, suitable for non-radioactive direct cell labeling of platelets. Methods: Platelets from PCs in storage solutions with different plasma concentrations were labeled with ICG up to concentrations of 200 μm. Whole blood (WB) was used as an ex vivo matrix to monitor the labeling stability of ICG-labeled platelets. The impact of labeling processes was assessed by the quantification of CD62P expression and PAC-1 binding as platelet function markers. Platelet aggregation was analyzed by light transmission aggregometry. ICG-labeling efficiency and stability of platelets were determined by flow cytometry. Results: Platelets from PCs could be successfully labeled with 10 μm ICG after 1 and 4 days of storage. The best labeling efficiency of 99.8% ± 0.1% (immediately after labeling) and 81% ± 6.2% (after 24 h incubation with WB) was achieved by plasma replacement by 100% platelet additive solution for the labeling process. Since the washing process slightly impaired platelet function, ICG labeling itself did not affect platelets. Immediately after the ICG-labeling process, plasma was re-added, resulting in a recovered platelet function. Conclusion: We developed a Good Manufacturing Practice compatible protocol for ICG fluorescent platelet labeling suitable for survival and recovery studies in vivo as a non-radioactive labeling alternative.
Case Series: Cemiplimab and Nivolumab Immunotherapy as Promising Treatment in Advanced or Metastatic Cutaneous Squamous Cell Carcinoma
Authors: Lai Fei Ya , Clarke Rachel , Cooper Patrick , Stokes John , Calvert Paula
Published: October 2023

Cutaneous squamous cell carcinoma (CSCC) is the second most common skin cancer. Surgery is usually curative; however, some locally advanced or metastatic CSCC may be unresectable. Current novel therapeutic options with immune checkpoint inhibition (ICI) of programmed-death receptor 1 (PD-1) such as cemiplimab and nivolumab have demonstrated promising and sustained results with good tolerability in patients with CSCC. This study looks at 2 cases of CSCC treated with cemiplimab and nivolumab, respectively, demonstrating dramatic response within 2 cycles with significant reduction in tumour size and minimal toxicities or adverse outcomes reported. Immunotherapy has shown positive results as an effective treatment option for unresectable, recurrent, or metastatic CSCC. It is currently approved for use in the USA and Europe.
An Intestinal Type Gastric Neuroendocrine Tumor: A Case Report
Authors: Abu-Jeyyab Mohammad , Kakish Renata , Alkatib Malak , Alshawabkeh Leen , Bani Hamad Rawan , Almadani Mary , Santarisi Ma'wia , Al-Jafari Mohammad , Nashwan Abdulqadir J.
Published: October 2023

Neuroendocrine tumors (NETs) represent a diverse set of malignancies, originating from the neuroendocrine cells dispersed throughout the body. Their symptoms are associated with the secretion of bioactive peptides by tumor cells. Five-year survival rates depend on the disease stage: 93% for local, 74% for regional, and 19% for metastatic disease. This report describes a case involving a 64-year-old male patient, who was enduring high blood pressure and anemia. His symptomatology included frequent fainting and bloody vomiting without prior bleeding, coupled with persistent abdominal pain and weight loss. A complete blood count revealed microcytic anemia. His condition improved postoperatively after the transfusion of two units of packed red blood cells, normalizing all parameters. Further biochemistry and serology tests did not provide significant insights. However, an upper endoscopy unveiled a deep ulcer below the gastroesophageal junction with ulcer desquamation. A combination of clinical, laboratory, and radiographic data initially indicated a gastric carcinoma of the intestinal type, characterized by extensive extracellular mucin secretion. The surgical intervention led to the extraction of multiple tumors from lymph nodes, culminating in a postoperative diagnosis of a gastrointestinal (GI) mesenchymal tumor. NETs predominantly manifest in the GI tract, initiating primarily in the small intestine but can also originate in the stomach, appendix, colon, and other parts of the GI tract. Their development from neuroendocrine cells enables them to produce high concentrations of hormone-like substances such as neuropeptides and amines.
Pan-Enteric Capsule Endoscopy: Current Applications and Future Perspectives
Authors: Rosa Bruno , Andrade Patrícia , Lopes Sandra , Gonçalves Ana Rita , Serrazina Juliana , Marílio Cardoso Pedro , Silva Andrea , Macedo Silva Vítor , Cotter José , Macedo Guilherme , Figueiredo Pedro Narra , Chagas Cristina
Published: October 2023

Background: The role of capsule endoscopy in the evaluation of the small bowel is well established, and current guidelines position it as a first-line test in a variety of clinical scenarios. The advent of double-headed capsules further enabled the endoscopic assessment of colonic mucosa and the opportunity for a one-step noninvasive examination of the entire bowel (pan-enteric capsule endoscopy [PCE]). Summary: We reviewed the technical procedure and preparation of patients for PCE, as well as its current clinical applications and future perspectives. In non-stricturing and non-penetrating Crohn’s disease affecting the small bowel and colon, PCE monitors disease activity by assessing mucosal healing, a major treatment outcome, with a higher diagnostic yield than cross-sectional imaging or conventional colonoscopy. Also in ulcerative colitis, double-headed capsules have been used to monitor disease activity noninvasively. Currently, validated scoring systems have been specifically devised for these double-headed capsules and permit a standardized assessment of the inflammatory burden. In suspected mid-lower digestive bleeding, some exploratory studies have demonstrated the feasibility and high diagnostic yield of PCE, which may work as a filter indicating which patients may benefit of further invasive procedures, namely, for planned hemostatic procedures. The possibility of using PCE is also discussed in the context of polyposis syndromes with simultaneous involvement of the small intestine and colon. Key Messages: PCE is a feasible, effective, and safe diagnostic procedure to evaluate the small bowel and colon. It has been increasingly explored in the setting of inflammatory bowel diseases and, more recently, in suspected mid-lower digestive bleeding. PCE is expected to reduce the demand for invasive procedures and expand the scope of noninvasive intestinal evaluation in the coming future.
Safety and Efficacy of Atezolizumab/Bevacizumab in Patients with Hepatocellular Carcinoma and Impaired Liver Function: A Systematic Review and Meta-Analysis
Authors: Pasta Andrea , Calabrese Francesco , Jaffe Ariel , Labanca Sara , Marenco Simona , Pieri Giulia , Plaz Torres Maria Corina , Strazzabosco Mario , Giannini Edoardo G.
Published: October 2023

Background: Safety and outcome of atezolizumab/bevacizumab in Child-Pugh B patients with hepatocellular carcinoma (HCC) have not been completely characterized. Objectives: In this study, we aimed at addressing safety and efficacy of atezolizumab/bevacizumab in Child-Pugh B patients by reviewing the available data and analyzing them by meta-analysis. Methods: We compared the safety and efficacy of atezolizumab/becavizumab treatment in patients with unresectable HCC and various degrees of liver dysfunction. A total of 8 retrospective, non-randomized, cohort studies were included in this meta-analysis, for a total of 1,071 Child-Pugh A and 225 Child-Pugh B patients. The albumin-bilirubin (ALBI) grade was also used to assess liver function, when available. Results: Grade ≥3 adverse events were observed in 11.8% of Child-Pugh class A and 26.8% class B patients (p = 0.0001), with an odds ratio (OR) of 0.43 (confidence interval [CI] 0.21–0.90; p = 0.02). Progression-free survival (PFS) at both 6 months (4.90 ± 2.08 vs. 4.75 ± 2.08 months; p = 0.0004) and 12 months (8.83 ± 2.32 vs. 7.26 ± 2.33 months; p = 0.002) was lower in Child-Pugh class B patients. A trend toward a higher objective response rate (ORR) was observed in Child-Pugh class A patients (219/856, 25.6%) as compared to Child-Pugh class B patients (25/138, 18.1%; p = 0.070), while the probability of obtaining an ORR was significantly greater in Child-Pugh A patients (OR 1.79, CI 1.12–2.86; p = 0.02). Median overall survival (OS) was 16.8 ± 2.0 and 6.8 ± 3.2 months in Child-Pugh A and B patients, respectively (mean difference 9.06 months, CI 7.01–11.1, p < 0.0001). Lastly, OS was longer in patients with ALBI grades 1–2 than in those with grade 3 (8.3 ± 11.4 vs. 3.3 ± 5.0 months, p = 0.0008). Conclusions: Oncological efficacy of atezolizumab/bevacizumab is moderate in Child-Pugh class B patients, and the shorter PFS and OS associated with the greater likelihood of experiencing treatment-related adverse events observed in these patients suggest great caution and individualization of treatment, possibly with the support of the ALBI grade.
Belching Disorders and Rumination Syndrome: A Literature Review
Authors: Sawada Akinari , Fujiwara Yasuhiro
Published: October 2023

Background: Belching disorders and rumination syndrome (RS) are disorders of gut-brain interaction (DGBIs) in Rome IV. Belching disorders are composed of excessive gastric belching (GB) and supragastric belching (SGB). Excessive GB is related to physiological phenomenon whereas excessive SGB and RS are behavioral disorders. Summary: A recent large internet survey found that prevalence of belching disorders and RS were 1% and 2.8%, respectively. It has been recognized that not a few patients with two behavioral disorders, excessive SGB and RS, could be misdiagnosed as proton pump inhibitors (PPI)-refractory gastroesophageal reflux disease (GERD). In patients with reflux symptoms, distinguishing these conditions is essential because they need psychological treatment (i.e., cognitive behavioral therapy (CBT) rather than acid suppressants. Clinicians should take a medical history meticulously first to identify possible excessive SGB and/or RS. High-resolution impedance manometry and/or 24-h impedance-pH monitoring can offer an objective diagnosis of the disorders. Several therapeutic options are available for excessive SGB and RS. The first-line therapy should be CBT using diaphragmatic breathing that can stop the behaviors involving complex muscle contraction (e.g., abdominal straining) to generate SGB or rumination. Overlap with eating disorders and/or other DGBIs such as functional dyspepsia can make management of the behavioral disorders challenging since such coexisting conditions often require additional treatments. Key Messages: Excessive SGB and RS are not unusual conditions. It is important to raise awareness of the behavioral disorders for appropriate management.
Association of Chronic Kidney Disease with Cardiovascular Disease in Cancer Patients: A Cross-Sectional Study
Authors: Liu An-Bang , Zhang Dan , Meng Ting-Ting , Zhang Yu , Tian Peng , Chen Jian-Lin , Zheng Yan , Su Guo-Hai
Published: October 2023

Introduction: Due to the cardiotoxicity of cancer treatment and traditional risk factors for cardiovascular disease (CVD) such as obesity, diabetes, dyslipidemia, and hypertension, cancer patients are at higher risk of developing CVD. However, limited research exists on the correlation between chronic kidney disease (CKD) and CVD risk in cancer patients. Methods: This cross-sectional study selected cancer patients aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) conducted from 2015 to 2020. Multivariable logistic regression was used to assess the association between CKD and CVD in cancer patients. Additionally, subgroup analyses were conducted to investigate the association among different groups of cancer patients. Results: We included 1,700 adult cancer patients (52.53% were females). After multivariable adjustment for covariates including traditional CVD factors, CKD was significantly associated with CVD, with an odds ratio (95% confidence interval) and p value of 1.61 (1.18, 2.19) and 0.004. Subgroup analyses after multivariable adjustment showed a significant correlation between CKD and increased CVD risk in the following cancer patients: age ≥60 years, males, white ethnicity, and individuals with or without traditional CVD factors (obesity, diabetes, dyslipidemia, and hypertension). Conclusions: CKD remains a significant factor in the higher risk of CVD among adult cancer patients in the United States, even after adjustment for traditional CVD risk factors. Therefore, to reduce the risk of CVD in cancer patients, it is important to treat CKD as a non-traditional risk factor for CVD and actively manage it.
Cardiac Output Changes during Renal Replacement Therapy: A Scoping Review
Authors: Spano Sofia , Maeda Akinori , Lam Joey , Chaba Anis , See Emily , Mount Peter , Nichols-Boyd Mina , Bellomo Rinaldo
Published: October 2023

Introduction: Renal replacement therapy (RRT) is associated with hypotension. However, its impact on cardiac output (CO) is less understood. We aimed to describe current knowledge of CO monitoring and changes during RRT. Methods: We searched MEDLINE, Embase, and Cochrane from January 1, 2000, to January 31, 2023, using Covidence for studies of intermittent hemodialysis (IHD) and continuous RRT (CRRT) with at least three CO measurements during treatment. Two independent reviewers screened citations, and a third resolved disagreements. The findings did not allow meta-analysis and are presented descriptively. Results: We screened 3,285 articles and included 48 (37 during IHD, nine during CRRT, and two during both). Non-invasive devices (electrical conductivity techniques and finger cuff pulse contour) were the most common CO measurement techniques (21 studies). The median baseline cardiac index in IHD studies was 3 L/min/m2 (95% CI, 2.7–3.39). Among the 88 patient cohorts studied, a decrease in CO occurred in 63 (72%). In 16 cohorts, the decrease was severe (>25%). Changes in blood pressure (BP) were not concordant in extent or direction with changes in CO. The decrease in CO correlated weakly with ultrafiltration rate (r = −0.3, p = 0.05) and strongly with changes in systemic vascular resistance (SVR) (r = −0.6, p < 0.001). Conclusion: There are limited data on CO changes during RRT. However, a decrease in CO appeared common and was marked in 1 of 5 patient cohorts. Such decreases often occurred without BP changes and were associated with increased SVR.
A STUDY ON WELFARE AND LIVING CONDITIONS OF DISADVANTAGED GROUPS: THE CASE OF BURDUR PROVINCE
Authors: ÖÇAL Mehmet , KUTLU Özge
Published: October 2023

Leaving differences and variances aside, the ultimate intention of social states or welfare regimes, acting with the humanitarian pursuit of social policy, is to offer a standard, decent living condition to those under its banner. In this sense, welfare states often undertake constitutionally binding commitments to citizens and implement minimum, fair social policies not to undermine the citizens’ living conditions below the level of “worthy of human dignity.” Whereas these policies, introduced against any social risks to adversely affect one’s welfare, should be implemented equally for everyone, states may also adopt positive discrimination while implementing these policies for groups denoted as fragile or disadvantaged that are likely to be more affected by social risks to retain their welfare within “humane” standards. However, the effect of in-kind or cash social transfers within the mentioned policies to the aforementioned groups often remains veiled. Moreover, debates go on about targeting of these transfers.

The present descriptive survey research attempted to measure the effectiveness of social policies aimed at improving the living conditions of individuals by contributing to their welfare. We surveyed 582 Burdur-based individuals who could be denoted as disadvantaged due to some tangible reasons. Our findings demonstrated that the participants had worse health status, higher disability rates, and severe housing health-related problems compared to the general population. We also discovered that the participants considered poor had much more inadequate living standards and welfare than those not. The participants’ poverty - calculated based on their income levels – was 54.7% before receiving social assistance and became 39.5% after being opted for social assistance. In other words, we figured out that social assistance reduced the participants’ poverty by 15.1%.
Willingness-to-pay for a Haze Adaptation Program and a Haze Eradication Program in Singapore: The 2015 Transboundary Haze
Authors: Quah Euston , Chia Wai-Mun , Tan Tsiat-Siong , Ho Nick
Published: October 2023

In Southeast Asia, the seasonal transboundary haze pollution stemming from slash-and-burn practices of traditional Indonesian farmers affects several countries in the region including Indonesia, Singapore, Malaysia, and Brunei. Despite both domestic and regional efforts that have been put in place to help fight against haze, Southeast Asian haze remains a long-term issue that recurs in a varying degree of intensity during every dry season in the region. While we remain optimistic that the problem will eventually be resolved, given that most of these fires are the result of human activity, solutions can be executed successfully only in the longer run. In the interim, one of Singapore's options is to adapt. A contingent valuation (CV) survey on 793 Singapore residents was conducted in Singapore between November and December 2017 to elicit their willingness-to-pay (WTP) for a haze adaptation program and a haze eradication program in Singapore. We use a double-bounded dichotomous choice CV survey design and the Kaplan-Meier-Turnbull method and the probit regression to infer the distribution of Singapore residents’ WTP for the two programs and find that they are willing to pay between S$ 46.46 and S$ 60.06 for a haze adaptation program that reduces the local impacts of haze and between S$ 51.66 and S$ 66.76 for a haze eradication program. These findings suggest that Singapore residents continue to value the government's effort to derive solutions to resolve the haze crisis that recurs intermittently.
Decarbonization Pathways in Laos: The Challenges and Solutions
Authors: Kyophilavong Phouphet
Published: October 2023

Climate change is a severe threat to humankind. To keep global warming limited to 1.5C, it must reach net-zero emission by 2050. It is ambitious and challenging for Laos to achieve the target. The main objective of this paper is to identify the challenges and solutions to the decarbonization pathway in Laos. The net-zero emission by 2025 goal is too ambitious for Laos and the LDC countries, and there are several challenges, including human resources, funding, and technologies. Achieving the target requires extensive funding, human resources, and technologies. Therefore, the roles of developed countries and international donors are crucial.
Freshwater fishes of Iraq: a revised and updated annotated checklist—2023
Authors: ÇIÇEK ERDOĞAN , JAWAD LAITH , EAGDERI SOHEIL , ESMAEILI HAMID REZA , MOULUDI-SALEH ATTA , SUNGUR SEVIL , FRICKE RONALD
Published: October 2023

The current status of the freshwater fishes of Iraq is revised, and an updated checklist is presented. The confirmed freshwater fishes of Iraq comprise 98 species belonging to 16 orders, 28 families, and 56 genera. Among these, 21 species (21.4%) are alien, and three species (3.0%) are considered endemic to Iraq. The orders with the largest numbers of species in the ichthyofauna of Iraq are Cypriniformes (57 species), followed by Siluriformes (12 species), Mugiliformes and Cyprinodontiformes (six species in each), Acanthuriformes and Cichliformes (three species in each), Centrarchiformes and Gobiiformes (two species in each), and the others represent only one species. At the family level, the Cyprinidae have the greatest number of species (28; 28.3% of the total species), followed by Nemacheilidae (16 species), Leuciscidae (eight species), Mugilidae (six species), Sisoridae (five species), and Xenocyprididae (four species in each). A total of 20 species that have been previously reported from Iraq have been excluded from the checklist. According to IUCN Red List criteria, among 77 naturally distributed species (alien species not included), 10 species (13.0%) are categorized as threatened extinctions, with three (3.9%) as CR, one (1.3%) as EN, and six (7.8%) as VU. A total of 38 taxa were assessed (49.4%) as LC, 27 species were not assigned NE (35.1%), and two species (2.0%) were classified as DD, i.e., with insufficient knowledge.
Surface Solar Radiation Compositions Observed from Himawari-8/9 and Fengyun-4 Series
Authors: Letu Husi , Ma Run , Nakajima Takashi Y. , Shi Chong , Hashimoto Makiko , Nagao Takashi M. , Baran Anthony J. , Nakajima Teruyuki , Xu Jian , Wang Tianxing , Tana Gegen , Bilige Sude , Shang Huazhe , Chen Liangfu , Ji Dabin , Lei Yonghui , Wei Lesi , Zhang Peng , Li Jun , Li Lei , Zheng Yu , Khatri Pradeep , Shi Jiancheng
Published: October 2023

Surface downward solar radiation compositions (SSRC), including photosynthetically active radiation (PAR), ultraviolet-A (UVA), ultraviolet-B (UVB), and shortwave radiation (SWR), with high spatial–temporal resolutions and precision are essential for applications including solar power, vegetation photosynthesis, and environmental health. In this study, an optimal algorithm was developed to calculate SSRC, including their direct and diffuse components. Key features of the algorithm include combining the radiative transfer model with machine learning techniques, including full consideration of the effects of aerosol types, cloud phases, and gas components. A near-real-time monitoring system was developed based on this algorithm, with SSRC products generated from Himawari-8/9 and Fengyun-4 series data. Validation with ground-based data shows that the accuracy of the SWR and PAR compositions (daily mean RMSEs of 19.7 and 9.2 W m−2, respectively) are significantly better than those of state-of-the-art products from CERES, ERA5, and GLASS. The accuracy of UVA and UVB measurements is comparable with CERES. Characteristics of aerosols, clouds, gases, and their impacts on SSRC are investigated before, during, and post COVID-19; in particular, significant SSRC variations due to the reduction of aerosols and increase of ozone are identified in the Chinese central and eastern areas during that period. The spatial–temporal resolution of data products [up to 0.05° (10 min)−1 for the full-disk region] is one of the most important advantages. Data for the East Asia–Pacific region during 2016–20 is available from the CARE home page (www.slrss.cn/care/sp/pc/).
Barotropic and Moisture–Vortex Growth of Monsoon Low Pressure Systems
Authors: Luo Haochang , Adames Corraliza Ángel F. , Rood Richard B.
Published: October 2023

As one of the most prominent weather systems over the Indian subcontinent, the Indian summer monsoon low pressure systems (MLPSs) have been studied extensively over the past decades. However, the processes that govern the growth of the MLPSs are not well understood. To better understand these processes, we created an MLPS index using bandpass-filtered precipitation data. Lag regression maps and vertical cross sections are used to document the distribution of moisture, moist static energy (MSE), geopotential, and horizontal and vertical motions in these systems. It is shown that moisture governs the distribution of MSE and is in phase with precipitation, vertical motion, and geopotential during the MLPS cycle. Examination of the MSE budget reveals that longwave radiative heating maintains the MSE anomalies against dissipation from vertical MSE advection. These processes nearly cancel one another, and it is variations in horizontal MSE advection that are found to explain the growth and decay of the MSE anomalies. Horizontal MSE advection contributes to the growth of the MSE anomalies in MLPSs prior to the system attaining a maximum amplitude and contributes to decay thereafter. The horizontal MSE advection is largely due to meridional advection of mean state MSE by the anomalous winds, suggesting that the MSE anomalies undergo a moisture–vortex instability (MVI)-like growth. In contrast, perturbation kinetic energy (PKE) is generated through barotropic conversion. The structure, propagation, and energetics of the regressed MLPSs are consistent with both barotropic and moisture–vortex growth.