bluuebunny/crossref_metadata_2025 huggingface dataset:
Women’s knowledge, perception, practice, and experience of using of skin-lightening products in the United Arab Emirates (UAE): A cross-sectional survey
Authors: Beshir Semira , Shamseldin Al Gailani Ali Eiman , Ramadan Doaa , Bassam Ghina , Maher Esraa , Ismail Samar , Hamdi Hebatallah
Published: October 2023

Background:

Skin lightening products (SLPs) are popular among women for medical and non-medical reasons. Therefore, this study aimed to determine the extent of SLP use among women, identify their sources of information, explore factors associated with SLP use and SLP related knowledge, attitudes, and practices (KAP) among women in the UAE.

Methods:

A structured questionnaire in English and Arabic was distributed to women in the UAE. The questionnaire included demographic characteristics, knowledge (10 items), attitudes (10 items), practices (9 items), and four additional questions on SLP use. Adequate KAP scores were defined as a score of ≥70% out of the maximum score for each KAP section. Chi-square tests were used to test associations between demographic characteristics, dichotomized KAP scores, and SLP use.

Results:

The study included 370 participants, 50% of the respondents were aged 18–24, and 40% were from the Middle East, 64.8% were unmarried, 91% had university degrees, and 50% had healthcare related profession. Among the respondents 25% use SLPs, the majority use SLPs for non-medical reasons. Employment status is significantly associated with SLP use. The percentage of participants with a knowledge, attitude, and practice score of ≥70% is 66.48%, 76.75%, and 74.72% respectively. Type of profession was significantly associated knowledge and practice. In addition, nationality was also associated with practice.

Conclusion:

This study highlighted knowledge, attitude and practice gaps and varied levels of SLP-related KAP among women in the UAE. To promote the rational use of SLPs, educational campaigns and stricter regulations are necessary.
Kinematic and Kinetic Comparisons of Arm Slot Position Between High School and Professional Pitchers
Authors: Manzi Joseph E. , Ruzbarsky Joseph J. , Krichevsky Spencer , Sudah Suleiman Y. , Estrada Jennifer , Wang Zhaorui , Moran Jay , Kunze Kyle N. , Ciccotti Michael C. , Chen Frank R. , Dines Joshua S.
Published: October 2023

Background:

Throwing arm kinetics differ in pitchers at varying arm slot (AS) positions (frontal-plane arm position at ball release relative to the vertical axis).

Purpose:

To determine how kinematic and kinetic values differ between professional and high school pitchers with varying AS positions, and whether these differences are similarly observed in both populations.

Methods:

High school (n = 130) and professional (n = 288) pitchers threw 8 to 12 fastballs under 3-dimensional motion capture technology. Pitchers in each cohort were subdivided based on mean AS position at ball release: AS1 (least degree of AS: most overhand throwing styles), AS2 (intermediate degree of AS: three-quarter throwing styles), or AS3 (greatest degree of AS: most sidearm throwing styles). Kinetic and kinematic parameters were compared between groups.

Study Design:

Controlled laboratory study.

Results:

High school pitchers had a more overhand AS at ball release (50° ± 11°) compared with professional pitchers (58° ± 14°) ( P < .001). In both cohorts, AS1 pitchers had significantly greater shoulder abduction (high school, P <0.001; professional, P <0.0001) and lateral trunk flexion (high school, P < 0.001; professional, P <0.0001) at ball release compared with AS3 pitchers. Professional pitchers with an AS3 position had significantly delayed timing of maximum upper trunk angular velocity compared with AS1 pitchers (64% ± 7% vs 57% ± 7% of pitch time, respectively; P < .0001). A significant positive correlation between AS and elbow flexion torque was found in high school pitchers ( P = .002; β = 0.28), and a significant negative correlation between AS and elbow varus torque ( P < .001; β = –0.22) and shoulder internal rotation torque ( P < .001; β = –0.20) was noted in professional pitchers.

Conclusion:

AS position was related to shoulder abduction and trunk lateral tilt. Professional and high school pitchers with varying AS positions did not experience similar changes in throwing arm kinetics.

Clinical Relevance:

In professional pitchers, the earlier onset of maximum upper trunk angular velocity with overhand throwing style may reflect inappropriate pelvis-trunk timing separation, a parameter implicated in upper extremity injury, and the negative correlation between AS and elbow varus and shoulder internal rotation torque suggests that both excessive and minimal AS positions have negative implications.
Social Determinants of Learning: Implications for Research, Policy, and Practice
Authors: Levinson Meira , Cohen Alison K.
Published: October 2023

The COVID-19 pandemic revealed what educators, policymakers, and researchers have long known—namely, that learning opportunities and outcomes are intimately intertwined with other aspects of children’s and families’ lives. The list of social forces outside the education sector that can affect learning is endless and includes economic experiences that are inequitably distributed, such as housing security (Gallagher et al., 2020), income (Hoynes & Rothstein, 2019), and wealth (Pfeffer, 2018), as well as social experiences, such as interpersonal and structural racism, (dis)ability, and xenophobia (Anderson-Nathe, 2020; DeMatthews, 2020). Now, it is time to lock in this learning among policymakers, practitioners, and researchers. We posit that the concept of “social determinants of learning” can serve as a powerful reframing tool for promoting educational equity, similar to the conceptual shift and policy impact we have seen in public health as “social determinants of health” has become an accepted and eventually essential concept.
Special Issue Guest Editorial: The Challenges of Experimental Designs in Entrepreneurship Education Research - An Interview With Thomas D. Cook
Authors: Costa Sílvia , Tegtmeier Silke , Santos Susana C. , Schenkel Mark T.
Published: October 2023

Research into entrepreneurship education is on the rise, yet the assessment of causality resulting from various teaching methods and their impacts on students and society at large remains limited. Consequently, incorporating experimental designs into entrepreneurship education research becomes imperative to move the field forward. Establishing cause-and-effect relationships, discerning which approaches yield desired outcomes (and which do not), contributes to a clearer understanding of the connections between educational activities and their results. This special issue underscores the importance of experiments as a methodological tool for showcasing causality. In this editorial, we expand on the reasons for the need for more experiments within the field. Additionally, we feature an interview with Dr. Thomas D. Cook, a pioneer in education research experiments, and offer an overview of the articles included in this special issue. We finish with a shortlist of tips for anyone interested in conducting experiments.
The effect of alloying element on the thermophysical properties of carbon fiber-graphite flakes/copper composites
Authors: Chen Youming , Liu Tongle , Miao Guodong , Huang Junchen , Yang Bing , Liu Qian
Published: October 2023

In this study, carbon fiber-graphite flake/copper composites were prepared by powder metallurgy. The impact of the alloying elements Ti and Zr on the composites’ properties was investigated, and the influence of varying Zr contents on the phase structure and thermal conductivity of the composites was also explored. The results indicate that composites containing Zr exhibit better flexural strength and thermal conductivity compared to those containing Ti. When the volume fraction of carbon fiber is 2% and 2 wt% Zr is added to copper matrix, the carbide layer at the composite interface is uniform and has a thickness of 0.36 μm. The thermal conductivity of the composite material is up to 597.5 W/(m∙K). The mechanical properties of the composites are enhanced by the synergistic effect of adding carbon fiber and alloying matrix and the composite shows a remarkable flexural strength of 150.5 MPa, which is 58.3% higher compared to composites without carbon fiber. Furthermore, the strengthening mechanism of carbon fiber on the mechanical properties of the composites was examined. The thermal conductivity of the multiphase composites was effectively predicted using the Acoustic Mismatch Model (AMM) combined with the MF module of Digimat software, and the impact of Ti or Zr elements on the composites’ thermal conductivity was analyzed.
Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization
Authors: Sullivan Marlysa B. , Hill Kelsea , Ballengee Lindsay A. , Knoblach Daniel , Fowler Christopher , Haun Jolie , Saenger Michael
Published: October 2023

Background

While there is recognition by the greater medical community and physical therapists to address the biopsychosocial needs of people with chronic, persistent pain, there are challenges in implementation and delivery including wide variability in interventions, lack of clear rationale, and absence of clinical models that are feasible and acceptable on a large scale. Important components for psychologically informed physical therapy (PiPT) for pain care include behavioral approaches (e.g., Acceptance and Commitment Therapy), mindfulness, pain neuroscience education, motivational interviewing (MI), and interoceptive skills-building. The Empower Veterans Program (EVP) Mindful Movement framework blends these components and emphasizes a mindfulness and self-compassion approach with MI and body-based experiential learning. This program was offered in-person at the Atlanta and Maryland VA Health Care Centers with published positive Patient Reported Outcomes (PRO) pre-COVID 19 crisis and shifted to entirely remote delivery in March 2020.

Objective

This paper offers an evidence-based and theory driven framework to operationalize a remotely delivered group-based psychologically informed mindful movement physical therapy intervention as part of an interdisciplinary pain care program.

Methods

Since 2021 PRO and demographics are collected using a survey administered through Qualtrics over a 12-month period at baseline, immediately post TelePain EVP, at 6 months, and at 12 months, with findings forthcoming.

Discussion/Results

Tele-pain EVP offers 6-9 groups a week with 7-9 veterans from Atlanta based team and 3-4 groups a week with 5-9 veterans from Maryland based team. Adaptations for remote delivery optimized mindfulness and active learning strategies including interoceptive skills-building and use of MI to support self-efficacy to trust, restore a sense of safety in the body, and explore adaptations for safe movement.

Conclusion

TelePain-EVP Mindful Movement provides a framework for other programs to translate for their populations and systems to further develop best practices in PiPT for pain care and integration into interdisciplinary care.
Phase 2 study of inotuzumab ozogamicin for measurable residual disease in acute lymphoblastic leukemia in remission
Authors: Jabbour Elias , Haddad Fadi G. , Short Nicholas J. , Senapati Jayastu , Jain Nitin , Sasaki Koji , Jorgensen Jeffrey , Wang Sa A. , Alvarado Yesid , Wang Xuemei , DiNardo Courtney , Masarova Lucia , Kadia Tapan , Garris Rebecca S. , Ravandi Farhad , Kantarjian Hagop
Published: October 2023

The detection of measurable residual disease (MRD) is the strongest predictor of relapse in acute lymphoblastic leukemia (ALL). Using inotuzumab ozogamicin in the setting of MRD may improve outcomes. Patients with ALL in first complete remission (CR1) or beyond (CR2+) with MRD ≥ 1 × 10−4 were enrolled in this phase 2 trial. Inotuzumab was administered at 0.6 mg/m2 on day 1 and 0.3 mg/m2 on day 8 of cycle 1, then at 0.3 mg/m2 on days 1 and 8 of cycles 2-6. Twenty-six consecutive patients with a median age of 46 years (range, 19-70 years) were treated. Nineteen (73%) were in CR1 and seven (27%) in CR2+; 16 (62%) had Philadelphia chromosome–positive ALL. Fifteen (58%) had baseline MRD ≥ 1 × 10−3. A median of 3 cycles (range, 1-6) were administered. Eighteen (69%) patients responded and achieved MRD negativity. After a median follow-up of 24 months (range, 9-43), the 2-year relapse-free survival rate was 54% and the 2-year overall survival rate was 60% in the entire cohort. Most adverse events were low grade; sinusoidal obstruction syndrome was noted in 2 patients (8%). In summary, inotuzumab ozogamicin resulted in favorable survival, MRD negativity rates, and safety profiles for patients with ALL and MRD-positive status. This study was registered at www.ClinicalTrials.gov as #NCT03441061.
Mass spectrometry quantifies target engagement for a KRASG12C inhibitor in FFPE tumor tissue
Authors: Chambers Andrew G. , Chain David C. , Sweet Steve M. , Song Zifeng , Martin Philip L. , Ellis Matthew J. , Rooney Claire , Kim Yeoun Jin
Published: October 2023

Background

Quantification of drug-target binding is critical for confirming that drugs reach their intended protein targets, understanding the mechanism of action, and interpreting dose-response relationships. For covalent inhibitors, target engagement can be inferred by free target levels before and after treatment. Targeted mass spectrometry assays offer precise protein quantification in complex biological samples and have been routinely applied in pre-clinical studies to quantify target engagement in frozen tumor tissues for oncology drug development. However, frozen tissues are often not available from clinical trials so it is critical that assays are applicable to formalin-fixed, paraffin-embedded (FFPE) tissues in order to extend mass spectrometry-based target engagement studies into clinical settings.

Methods

Wild-type RAS and RASG12C was quantified in FFPE tissues by a highly optimized targeted mass spectrometry assay that couples high-field asymmetric waveform ion mobility spectrometry (FAIMS) and parallel reaction monitoring (PRM) with internal standards. In a subset of samples, technical reproducibility was evaluated by analyzing consecutive tissue sections from the same tumor block and biological variation was accessed among adjacent tumor regions in the same tissue section.

Results

Wild-type RAS protein was measured in 32 clinical non-small cell lung cancer tumors (622–2525 amol/µg) as measured by FAIMS-PRM mass spectrometry. Tumors with a known KRASG12C mutation (n = 17) expressed a wide range of RASG12C mutant protein (127–2012 amol/µg). The variation in wild-type RAS and RASG12C measurements ranged 0–18% CV across consecutive tissue sections and 5–20% CV among adjacent tissue regions. Quantitative target engagement was then demonstrated in FFPE tissues from 2 xenograft models (MIA PaCa-2 and NCI-H2122) treated with a RASG12C inhibitor (AZD4625).

Conclusions

This work illustrates the potential to expand mass spectrometry-based proteomics in preclinical and clinical oncology drug development through analysis of FFPE tumor biopsies.
Impact of Seed Origin and Genetic Drift of Improved Rice Variety IR841 in Benin
Authors: Sedah Paulin , Djedatin Lambert Gustave , Loko Laura Yêyinou Estelle , Ewedje Eben-Ezer Baba Kayodé , Orobiyi Azize , Gbemavo Chalemagne Dossou Seblodo Judes , Toffa Joelle , Tchakpa Cyrille , Cubry Philippe , Sabot Francois
Published: October 2023

Background

Rice production is important for food security in Benin, with a national production largely dominated by the cultivation of the aromatic ecotype IR841, by far the most appreciated by Beninese consumers. However, to maintain agronomical qualities of a given cultivar, the origin and quality of seeds are mandatory and at the heart of the maintenance of yield and of market requests. Following this idea, the objective of the current study was thus to investigate the genetic purity of IR841 varieties collected from rice producers across 22 villages in Benin in relation to their agronomical performances.

Results

For this, agromorphological evaluation of 72 accessions based on 13 quantitative descriptors followed by genotyping with the Illumina Infinium rice 7 K SNP array of 9 accessions was carried out in the presence of 2 controls. Agromorphologic as well as genetic and phylogenetic analyses revealed two groups, the first one Okouta97, Koum47, Nana30, Man118, Ang1 and control sample IR841-2) was characterized by seed accessions provided by the formal seed system, while the second (Koum53, Tchaka41 and Koud46) comprising seeds from local markets or from previous harvests and showing a depression in agronomic performances.

Conclusion

We showed that IR841 seed purity is mandatory for the completion of agronomical performance, and that the farmers’ choice of seeds must be guided and informed to ensure sustainability and food security.
Modelling public attitude towards drone delivery in Germany
Authors: Kellermann Robin , Biehle Tobias , Mostofi Hamid
Published: October 2023

Background

Last-mile delivery by drone is expected to be a promising innovation for future urban logistics. However, in addition to adoption of services by customers, leveraging this delivery method will depend essentially on a positive public perception of such services in urban airspace.

Objective

This article provides novel and comprehensive insights into factors driving or impeding citizens' attitudes towards drone delivery.

Methodology

The article develops a structural equation model that  derives from a sequential exploratory mixed methods design. In the first step, factors affecting attitudes towards drone delivery were identified within the scope of five focus groups and converted into the development of a questionnaire. In the second step, a German population-representative survey was conducted through telephone interviews, which provided reliable data to test the model (n = 819).

Results

Expected risks (particularly stress due to traffic in lower airspace, noise, and visual disturbances), as well as expected benefits (particularly fast and time-flexible delivery), significantly affect attitudes towards drone-based delivery, while the individual level of technological openness (technophilia) does not have a significant association. Moreover, the model reveals that the expected risks of drone deliveries are stronger associated with public attitude than with expected benefits.

Conclusions

The provided framework suggests fashioning policies and drone delivery applications that focus on mitigating social, spatial, and visual risks while achieving maximum utility for customers.
Adaptive evolution and co-evolution of chloroplast genomes in Pteridaceae species occupying different habitats: overlapping residues are always highly mutated
Authors: Gu Xiaolin , Li Lingling , Li Sicong , Shi Wanxin , Zhong Xiaona , Su Yingjuan , Wang Ting
Published: October 2023

Background

The evolution of protein residues depends on the mutation rates of their encoding nucleotides, but it may also be affected by co-evolution with other residues. Chloroplasts function as environmental sensors, transforming fluctuating environmental signals into different physiological responses. We reasoned that habitat diversity may affect their rate and mode of evolution, which might be evidenced in the chloroplast genome. The Pteridaceae family of ferns occupy an unusually broad range of ecological niches, which provides an ideal system for analysis.

Results

We conducted adaptive evolution and intra-molecular co-evolution analyses of Pteridaceae chloroplast DNAs (cpDNAs). The results indicate that the residues undergoing adaptive evolution and co-evolution were mostly independent, with only a few residues being simultaneously involved in both processes, and these overlapping residues tend to exhibit high mutations. Additionally, our data showed that Pteridaceae chloroplast genes are under purifying selection. Regardless of whether we grouped species by lineage (which corresponded with ecological niches), we determined that positively selected residues mainly target photosynthetic genes.

Conclusions

Our work provides evidence for the adaptive evolution of Pteridaceae cpDNAs, especially photosynthetic genes, to different habitats and sheds light on the adaptive evolution and co-evolution of proteins.
Statin use and the risk of hepatocellular carcinoma among patients with chronic hepatitis B: an emulated target trial using longitudinal nationwide population cohort data
Authors: Sinn Dong Hyun , Kang Danbee , Park Yewan , Kim Hyunsoo , Hong Yun Soo , Cho Juhee , Gwak Geum-Youn
Published: October 2023

Background

No randomized controlled trials have been completed to see whether statin can decrease hepatocellular carcinoma (HCC) risk in chronic hepatitis B (CHB) patients. We used large-scale, population-based, observational data to emulate a target trial with two groups, statin user and statin non-user.

Methods

Among 1,379,708 nonunique individuals from the Korean National Health Insurance Service data, 2,915 CHB patients with serum cholesterol level of 200 mg/dL or higher who started statin therapy and 8,525 propensity-score matched CHB patients with serum cholesterol level of 200 mg/dL or higher who did not start statin therapy were analyzed for the development of HCC. In addition, liver cancer or liver-related mortality and all-cause mortality were assessed.

Results

During follow-up, 207 participants developed HCC. Incidence rate of HCC was 0.2 per 1,000 person-years in the statin user group and 0.3 per 1,000 person-years in the statin non-user group. Fully adjusted hazard ratio (HR) for incident HCC comparing statin user group to statin nonuser group was 0.56 (95% confidence interval [CI]: 0.39 to 0.80). The association between statin use and decreased HCC risk was consistent in all subgroups analyzed. Fully adjusted HR comparing statin user to statin nonuser was 0.59 (95% CI: 0.35 to 0.99) for liver cancer or liver-related mortality and 0.93 (95% CI: 0.78 to 1.11) for all-cause mortality.

Conclusions

Statin might have a benefit for preventing HCC in CHB patients with elevated cholesterol levels. Statin should be actively considered for CHB patients with dyslipidemia.
Comparative effectiveness of seven interventions for chronic hepatitis D: a systematic review and network meta-analysis of randomized controlled trials
Authors: Rong Yangdan , Ju Xuegui , Sun Peng , Wang Yali
Published: October 2023

Objective

To compare the effectiveness of seven major interventions [Bulevirtide (BLV), Interferon (IFN), Nucleoside analogs (NAs), BLV + IFN, BLV + NAs, IFN + NAs, and Placebo] to treat chronic hepatitis D.

Methods

We followed PRISMA-NMA guidelines, searched databases (Cochrane Library, PubMed, EMBASE, and Web Of Science) for eligible randomized controlled trials (RCTs), and applied STATA17.0 software to execute the meta-analysis.

Results

We included 14 randomized controlled trials (814 patients) comparing seven different interventions. The results of the network meta-analysis showed that: ① Sustained virological response (after 24 weeks of follow-up): Four intervention groups (BLV + IFN, IFN alone, IFN + NAs, and NAs alone) were effective (relative risk (RR) = 13.30, 95% confidence interval (Cl) [1.68,105.32], RR = 12.13, 95% Cl [1.46,101.04], RR = 5.05, 95% Cl [1.68,15.19], RR = 5.03, 95% Cl [1.66,15.20]), with no statistically significant differences between the four groups. The top three in probability rankings were: BLV + NAs, BLV + IFN, and BLV alone (surface under the cumulative ranking curve (SUCRA) = 86.8%, 80.3%, and 48.4%; ② Sustained biochemical response (after 24 weeks of follow-up): BLV + IFN and IFN were superior to BLV (RR = 14.71, 95% Cl [1.14,189.07], RR = 16.67, 95% Cl [1.39,199.52]). The top three were BLV alone, BLV + NAs, and BLV + IFN (SUCRA = 86.9%,81.2%, and 64.3%). ③ Histological response: NAs were superior to BLV (RR = 2.08, 95% Cl [1.10,3.93]), whereas the difference between other treatment regimens was not statistically significant, and the top three in the probability ranking were BLV alone, BLV + NAs, and BLV + IFN (SUCRA = 75.6%, 75.6%, and 61.8%).

Conclusions

IFN, IFN + BLV, and IFN + NAs were effective in clearing HDV RNA and normalizing alanine aminotransferase levels; however, IFN and IFN + NAs had a high rate of viral relapse at 24 weeks post-treatment follow-up. There was no additional benefit of adding NAs to IFN therapy for chronic hepatitis D; however, the combination of IFN + BLV significantly improved short-term HDV RNA clearance, which showed strong synergistic effects. The seven regimens included in the study did not contribute significantly to liver histological improvement. Therefore, the IFN + BLV combination has the most potential as a treatment option to improve the long-term prognosis or even cure chronic hepatitis D.

Trial registration

This systematic evaluation and meta-analysis was registered with PROSPERO under the registration number: CRD42022314544.)
UK Kidney Association Clinical Practice Guideline: Sodium-Glucose Co-transporter-2 (SGLT-2) Inhibition in Adults with Kidney Disease 2023 UPDATE
Authors: Roddick Alistair J. , Wonnacott Alexa , Webb David , Watt Angela , Watson Michael A. , Staplin Natalie , Riding Alex , Lioudaki Eirini , Kuverji Apexa , Kossi Mohsen El , Holmes Patrick , Holloway Matt , Fraser Donald , Carvalho Chris , Burton James O. , Bhandari Sunil , Herrington William G. , Frankel Andrew H.
Published: October 2023

Large placebo-controlled trials have demonstrated kidney and cardiovascular clinical benefits of SGLT-2 inhibitors. Data from the EMPA-KIDNEY and DELIVER trials and associated meta-analyses triggered an update to the UK Kidney Association Clinical Practice Guideline on Sodium-Glucose Co-transporter-2 (SGLT-2) Inhibition in Adults with Kidney Disease. We provide a summary of the full guideline and highlight the rationale for recent updates. The use of SGLT-2 inhibitors in people with specific medical conditions, including type 1 diabetes, kidney transplants, and people admitted to hospital with heart failure is also considered, along with Recommendations for future research and Recommendations for implementation. A full “lay” summary of the guidelines is provided as an appendix to ensure that these guidelines are accessible and understandable to people who are not medical professionals.
Developing and designing an internet-based support and education program for patients awaiting kidney transplantation with deceased donors through: a Delphi study
Authors: Nilsson Kristina , Andersson Gerhard , Johansson Peter , Lundgren Johan
Published: October 2023

Aims

The aim of this study was to develop and refine the content and design of an internet-based support and education program for patients awaiting kidney transplantation from deceased donors.

Design

A Delphi process was used.

Methods

A prototype internet-based intervention was drafted, based on previous research. The intervention included educational and psychological support to manage the uncertain waiting time and specific education enabling preparation for transplantation and adjustment to life after transplantation. In a two-round Delphi process, patients who had received a kidney transplant from a deceased donor within the last 2 years (n = 27), significant others (n = 6), health-care personnel with renal (n = 20) or transplant (n = 14) expertise, rated importance of content and design aspects of the prototype intervention on a 5-point scale using web questionnaires. A median of ≥ 3 was considered as consensus. Quantitative data was analyzed using descriptive statistics. Free text answers were encouraged and analyzed using deductive content analysis. The STROBE-checklist was used.

Results

Consensus was reached for all suggested content and design items in round 1, with median ratings of 4 or 5. Qualitative analysis from round 1 suggested four new content and design items which were rated in round 2, on all which consensus was reached; information about life with young children as relatives, expansion of kidney transplantation specific information, program extension by one week and individualization by making information available based on individual needs.

Conclusion

There was consensus among heterogenous experts regarding suggested educational and psychological support content and design aspects, and additional content and design aspects were identified for an internet-based support and education program for patients awaiting kidney transplantation from deceased donors.
Efficacy and safety analysis of TACE + Donafenib + Toripalimab versus TACE + Sorafenib in the treatment of unresectable hepatocellular carcinoma: a retrospective study
Authors: Lu Haohao , Liang Bin , Xia Xiangwen , Zheng Chuansheng
Published: October 2023

Objective

To compare the efficacy and safety of TACE combined with Donafenib and Toripalimab versus TACE combined with Sorafenib in the treatment of unresectable hepatocellular carcinoma (HCC), aiming to guide personalized treatment strategies for HCC and improve patient prognosis.

Materials and methods

A retrospective analysis was conducted on the clinical data of 169 patients with unresectable advanced-stage HCC who underwent treatment at the Interventional Department of Wuhan Union Hospital from January 2020 to December 2022. Based on the patients’ treatment strategies, they were divided into two groups: TACE + Donafenib + Toripalimab group (N = 81) and TACE + Sorafenib group (N = 88). The primary endpoints were objective response rate (ORR), disease control rate (DCR), overall survival (OS), and progression-free survival (PFS) of the two groups’ tumors. The secondary endpoint was the occurrence of treatment-related adverse events in the two groups of patients.

Results

The TACE + Donafenib + Toripalimab group showed higher ORR and DCR compared to the TACE + Sorafenib group (66.7% vs. 38.6%, 82.6% vs. 68.2%, P < 0.05). The TACE + Donafenib + Toripalimab group also demonstrated longer median progression-free survival (mPFS) (10.9 months vs. 7.0 months, P < 0.001) and median overall survival (mOS) (19.6 months vs. 10.9 months, P < 0.001) compared to the TACE + Sorafenib group. When comparing the two groups, the TACE + Sorafenib group had a higher incidence of grade 3–4 hypertension (14.8% vs. 4.9%, P = 0.041), higher incidence of diarrhea (all grades) (18.2% vs. 7.4%, P = 0.042), and higher incidence of hand-foot syndrome (all grades) (26.1% vs. 12.3%, P = 0.032).

Conclusion

TACE combined with Donafenib and Toripalimab demonstrates superior efficacy and safety in treating unresectable HCC patients. This combination therapy may serve as a feasible option to improve the prognosis of unresectable HCC patients.
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in combination with FOLFOX chemotherapy as a first-line treatment for gastric cancer patients with peritoneal metastases: single-arm phase II study
Authors: Luksta Martynas , Bausys Augustinas , Bickaite Klaudija , Rackauskas Rokas , Paskonis Marius , Luksaite-Lukste Raminta , Ranceva Anastasija , Stulpinas Rokas , Brasiuniene Birute , Baltruskeviciene Edita , Lachej Nadezda , Sabaliauskaite Rasa , Bausys Rimantas , Tulyte Skaiste , Strupas Kestutis
Published: October 2023

Background

Gastric cancer (GC) remains among the most common and most lethal cancers worldwide. Peritoneum is the most common site for distant dissemination. Standard treatment for GC peritoneal metastases (PM) is a systemic therapy, but treatment outcomes remain very poor, with median overall survival ranging between 3-9 months. Thus, novel treatment methods are necessary. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is the most novel technique for intraperitoneal chemotherapy. Some preliminary data suggest PIPAC can achieve improved long-term outcomes in patients with GC PM, especially when used in combination with systemic chemotherapy. However, there is a lack of data from well-design prospective studies that would confirm the efficacy of PIPAC and systemic therapy combination for first-line treatment.

Methods

This study is an investigator-initiated single-arm, phase II trial to investigate the efficacy of PIPAC combined with systemic FOLFOX (5-fluorouracil, oxaliplatin, leucovorin) as a first-line treatment for GC PM. The study is conducted in 2 specialized GC treatment centers in Lithuania. It enrolls GC patients with histologically confirmed PM without prior treatment. The treatment protocol consists of PIPAC with cisplatin (10.5 mg/m2 body surface in 150 mL NaCl 0.9%) and doxorubicin (2.1 mg/m2 in 50 mL NaCl 0.9%) followed by 2 cycles of FOLFOX every 6–7 weeks. In total 3 PIPACs and 6 cycles of FOLFOX will be utilized. The primary outcome of the study is the objective response rate (ORR) according to RECIST v. 1.1 criteria (Eisenhauer et al., Eur J Cancer 45:228–47) in a CT scan performed 7 days after the 4th cycle of FOLFOX. Secondary outcomes include ORR after all experimental treatment, PIPAC characteristics, postoperative morbidity, histological and biochemical response, ascites volume, quality of life, overall survival, and toxicity.

Discussion

This study aims to assess PIPAC and FOLFOX combination efficacy for previously untreated GC patients with PM.

Trial registration

NCT05644249. Registered on December 9, 2022.
Central retinal artery occlusion without cherry-red spots
Authors: Fan Wei , Huang Yanming , Zhao Yuancheng , Yuan Rongdi
Published: October 2023

Background

Cherry-red spots are a very important sign for the clinical diagnosis of central retinal artery occlusion (CRAO). We retrospectively summarized the clinical manifestations of CRAO and analysed the causes and characteristics of CRAO without cherry-red spots. In this study, we explored a diagnostic method for CRAO without cherry red spots.

Methods

Seventy patients (70 eyes) with CRAO were examined retrospectively. Corrected distance visual acuity, fundus photos, FA and OCT images were collected at the first outpatient visit. The causes of CRAO without cherry-red spots were analysed through fundus photos. The incidence of increased hyperreflectivity of the inner retina, central macular thickness (CMT) and arteriovenous transit time in patients with and without cherry-red spots were compared.

Results

Fundus examination showed posterior retinal whitening in 57 cases (81.43%) and cherry-red spots in 39 cases (55.71%). Thirty-one patients presented at the first outpatient visit without cherry-red spots. The reasons for the absence of cherry-red spots included leopard fundus (32.26%), retinal vein occlusion (25.81%), no obvious inner retinal coagulative necrosis (19.35%), ciliary retinal artery sparing (12.90%), high macular oedema (9.68%) and cherry-red spot enlargement (3.23%). OCT revealed increased hyperreflectivity of the inner retina in 67 CRAO patients (95.71%). All 3 patients without increased hyperreflectivity of the inner retina did not present with cherry-red spots at the first visit. The median CMT in patients without cherry-red spots was 166.00 μm, while the median MCT in patients with cherry-red spots was 180.00 μm; there was no significant difference between these two groups (P = 0.467). FA showed delayed arteriovenous transit time > 23 s in 20 patients (28.57%), > 15 s in 43 patients (61.43%) and no delay in 27 patients (30.77%). The median arteriovenous transit time in patients without cherry-red spots was 19.00 s, while it was 18.00 s in patients with cherry-red spots; there was no significant difference between these two groups (P = 0.727).

Conclusions

There are multiple factors that could cause the absence of cherry-red spots in CRAO. The use of OCT to observe increased hyperreflectivity of the inner retina is the most effective imaging method for the early diagnosis of CRAO without cherry-red spots.
Differential care-seeking behaviors during the beginning of the COVID-19 pandemic in Michigan: a population-based cross-sectional study
Authors: Vander Woude Catherine A. , King Elizabeth J. , Hirschtick Jana L. , Titus Andrea R. , Power Laura E. , Elliott Michael R. , Fleischer Nancy L.
Published: October 2023

Background

At the beginning of the COVID-19 pandemic in the United States in the spring of 2020, many Americans avoided the healthcare system, while those with COVID-19 symptoms were faced with decisions about seeking healthcare services for this novel virus.

Methods

Using a probability sample (n = 1088) from the Michigan adult population of PCR-confirmed COVID-19 cases who were diagnosed prior to July 31, 2020, we used logistic regression to examine sociodemographic and symptom severity predictors of care-seeking behaviors. The analyses examined three different outcomes: (1) whether respondents sought care and, among those who sought care, whether they sought care from (2) a primary care provider or (3) an emergency room. Final models were adjusted for sex, age, race and ethnicity, income, education, marital status, living arrangement, health insurance, and self-reported symptom severity.

Results

We found that participants ages 65 and older had 4.00 times higher odds of seeking care than 18-34-year-olds (95% CI: 2.21, 7.24), while adults reporting very severe symptoms had roughly 15 times higher odds of seeking care than those with mild symptoms (95% CI: 7.73, 27.01). Adults who were non-Hispanic Black or were uninsured had lower odds of seeking care from a primary care physician versus seeking care from other locations in comparison to adults who were non-Hispanic White or were privately insured, respectively (non-Hispanic Black: aOR = 0.27, 95% CI: 0.16, 0.44; Uninsured: aOR = 0.19, 95% CI: 0.09, 0.42). Conversely, adults who were older or reported more severe symptoms had higher odds of seeking care from an emergency room versus other locations in comparison to adults who were younger or reported less severe symptoms (Age 65+: aOR = 2.96, 95% CI: 1.40, 6.28; Very Severe Symptoms: aOR = 6.63, 95% CI: 3.33, 13.20).

Conclusions

Our results suggest differential utilization of healthcare services early in the COVID-19 pandemic. Further analyses are needed to examine the reasons for these differences.
Prediction of musculoskeletal pain after the first intravenous zoledronic acid injection in patients with primary osteoporosis: development and evaluation of a new nomogram
Authors: Zheng Xiaoxia , Ye Jiangnan , Zhan Qunzhang , Zhao Weifeng , Liao Zhongqin , Ye Xiaolin , Qu Chongzheng
Published: October 2023

Objective

To construct a new prediction nomogram to predict the risk of musculoskeletal pain in patients with primary osteoporosis who receive zoledronic acid intravenously for the first time.

Method

Clinical data of 368 patients with primary osteoporosis who received the first intravenous injection of zoledronic acid in our hospital from December 2019 to December 2022 were studied. Patients were divided into a musculoskeletal pain group (n = 258) and a non-musculoskeletal pain group (n = 110) based on the presence or absence of musculoskeletal pain 3 days after injection. Statistically significant predictors were screened by logistic regression analysis and the minimum absolute contraction and selection operator (LASSO) to construct a nomogram. The nomogram was evaluated by the receiver operating characteristic (ROC) curve, the calibration curve, the C-index, and the decision curve analysis (DCA) and verified in a validation cohort.

Results

The independent predictors of the nomogram were age, serum 25-hydroxyvitamin D, NSAIDs, prior Vitamin D intake, and BMI. The area under the ROC curve (AUC) was 0.980 (95% CI, 0.915–0.987), showing excellent predictive performance. The nomogram c index was 0.980, and the nomogram c index for internal verification remained high at 0.979. Moreover, calibration curves show that the nomogram has good consistency. Finally, the DCA showed that the net benefit of the nomogram was 0.20–0.49.

Conclusion

Musculoskeletal pain is a common symptom of APR in OP patients treated with intravenous zoledronic acid. Risk factors for musculoskeletal pain after zoledronic acid injection in OP patients were: non-use of NSAIDs, youth (<80 years old), serum 25 (OH) D<30ng /mL, no prior intake of vitamin D, BMI<24 kg /m2. A nomogram constructed from the above predictors can be used to predict musculoskeletal pain after the first zoledronic acid injection.
Medicinal plants for treatment of diarrhoeal diseases among under-five children: experience from traditional healers in North-eastern Tanzania
Authors: Liheluka Edwin , Gibore Nyasiro Sophia , Lusingu John P. A. , Gesase Samwel , Minja Daniel T. R. , Lamshöft Maike , Dekker Denise , Bali Theodora
Published: October 2023

Background

Right through history, humans have relied heavily on plants for sustenance and the healing of different ailments. One of the long-standing traditions that communities have inherited from earlier generations is the use of herbal medicines for the treatment of paediatric ailments, including diarrhoea. This study showcased medicinal plants used by traditional healers for the treatment of diarrhoeal diseases among under-five children in North-eastern Tanzania.

Methods and design

A qualitative research approach and a narrative research design were employed. The research was carried out in the districts of Korogwe and Handeni in North-eastern Tanzania, with 52 in-depth interviews performed with participants (traditional healers). Purposive sampling method was used to select participants, and a thematic analysis framework was used to analyze the data.

Results

Study results indicate that traditional healers had enormous insights and were well informed about medicinal plants that were perceived to be efficacious in treating diarrhoeal diseases among under-five children. A total of 54 medicinal plants were reported by the participants to be effective in healing diarrhoeal diseases among under-five children. However, out of 54 medicinal plants, 15 were predominantly disclosed by the majority of participants. Those medicinal plants include Psidium guajava, Rhus natalensis, Ozoroa insignis, Tamarindus indica, Ocimum suave, Combretum molle, Zanha africana, Solanum incanum, and Ximenia americana. Other medicinal plants mentioned by most participants include, Ochna holstii, Elaeodendron schlechterianum, Albizia anthelmintica, Commiphora pteleifolia, Salacia stuhlmanniana, and Zenkerella grotei.

Conclusion

All traditional healers seemed to have a clear understanding regarding the medicinal plants that were used to treat diarrhoeal diseases among under-five children. The participants acknowledged to treating under-five children with diarrhoeal diseases using herbal medications on multiple occasions. The findings of this study should inspire more in-depth botanical research to determine whether the medicinal plants reported in this study have anti-diarrhoeal properties.
Melittin as a safe compound to BALB/c mice immune system; a tiered approach immunotoxicity screening
Authors: Karimi Gholamreza , Fatemi Sina , Memar Bahram , Khorrami Mohammad-Bagher , Amali Arian , Sadeghi Mahmood , Esmaeili Seyed-Alireza , Riahi-Zanjani Bamdad
Published: October 2023

Background

Maintenance of immune system integrity is a vital requirement to protect human body against pathogens/cancers. Natural compounds have long been used due to their benefits for the immune system. One of which is bee venom that contains a peptide called melittin having antimicrobial and anticancer effects. Since a limited number of studies regarding the effects of melittin on the immune system have been carried out, we aimed to evaluate the effects of melittin on BALB/c mice immune system parameters.

Methods

Female BALB /c mice were treated intraperitoneally (i.p) with 0.75 and 1.5 mg/kg doses of melittin for 14 days (5 doses per week). The negative control group received i.p normal saline whereas the positive controls received i.p 20 mg/kg cyclophosphamide (CYP). Immunological parameters such as hematological parameters, delayed-type hypersensitivity (DTH), hemagglutination titer (HA), spleen cellularity, splenocytes proliferation, as well as spleen and bone marrow histopathological assessment were evaluated.

Results

Our findings showed that melittin has no gross pathological effect on the spleen and bone marrow. It was also demonstrated that melittin has no any significant effect on hematological parameters. Melittin did not cause any significant changes to proliferation response of splenocytes to PHA and LPS, spleen cellularity, DTH response, as well as the production of anti-SRBC antibodies. According to our results, melittin at 0.75 and 1.5 mg/kg doses could not induce significant changes on immune parameters and as a result, melittin was found to be safe for the mice immune system.
The impact of theory of mind, stress and professional experience on empathy in Romanian community nurses—a cross-sectional study
Authors: Onofrei Lidia , Serban Costela Lacrimioara , Chirita-Emandi Adela , Jeleriu Roxana Maria , Puiu Maria
Published: October 2023

Background

High empathy levels in health professionals represent an important factor in patient satisfaction and compliance, reducing patient anxiety and pain, enhancing diagnostic and clinical results and strengthening patient empowerment. Our purpose was to determine empathy level and to identify which of the socioeconomic status (SES) and psychological factors were able to predict highest empathy levels in a Romanian sample of community nurses.

Methods

Community nurses were invited in January-February 2023 to provide an answer to an online survey, using an advertisement in a professional network. 1580 participants voluntarily agreed to take part in this study, with a response rate of 85.8%. The survey included the Toronto Empathy Questionnaire, the Reading the Mind in the Eyes Test and socio-economic status items. A multivariate model for the prediction of belonging to the highest quartile of empathy as opposed to lowest quartile was constructed using SES and psychological variables as factors.

Results

The mean (SD) empathy level was 49.1 (6.7), with 74.7% of participants over the threshold of high empathy level. In the multivariate analysis, predictors of belonging to the highest quartile of TEQ, as opposed to the lowest quartile were: low self-perceived stress level (OR = 2.098, 95%CI 1.362–3.231), higher experience as a community nurse (OR = 1.561, 95%CI 1.120–2.175) and higher levels of the theory of mind (OR = 1.158, 95%CI 1.118–1.199), when controlling for gender, age, relationship status, presence of children in families, education, and income.

Conclusions

Training programs targeting to increase emotional competences, reduce levels of stress and encourage personnel retention have the potential to increase the quality of community nursing in Romania.
Lymph node metastasis related gene BICC1 promotes tumor progression by promoting EMT and immune infiltration in pancreatic cancer
Authors: Meng Feilong , Hua Shuai , Chen Xuedong , Meng Nanfeng , Lan Ting
Published: October 2023

Background

Pancreatic cancer (PC) is one of the most aggressive abdominal malignancies with a poor prognosis and it is urgent to find effective biomarkers for prediction. Although BICC1 expression is related to the survival, no evidence for its role in PC development has been found.

Methods

We used RNA-seq data to screen for molecular markers highly associated with lymph node metastasis. The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) public databases were used to analyze the expression and prognosis of Differential Expressed Genes (DEGs) in PC. R studio was used for visualization and functional analysis.

Results

BicC Family RNA Binding Protein 1 (BICC1) was a lymph node metastasis-related DEGs in PC patients. Our study found that BICC1 mRNA levels in the tumor tissue were significantly higher and associated with poorer prognosis. Enrichment analysis found that BICC1 was enriched primarily in the Epithelial Mesenchymal Transition (EMT) pathway. Using the ESTIMATE and CIBERSORT algorithms, we found that BICC1 was related to immune cell infiltration. As a regulator of multiple immune checkpoints, BICC1 was also involved in PC’s immune response.

Conclusions

BICC1 has the potential to be a new marker in association with lymph node metastasis as well as immune infiltration of PC. In addition to being a prognostic indicator, it may also be a potential therapeutic target.