bluuebunny/crossref_metadata_2025 huggingface dataset:
Sequential intravesical valrubicin and docetaxel for the treatment of nonmuscle invasive bladder cancer.
Authors: McElree Ian Mitchell , Packiam Vignesh T. , Steinberg Ryan L. , Mott Sarah L. , Gellhaus Paul T. , Nepple Kenneth G. , O'Donnell Michael A.
Published: February 2022

496

Background: Intravesical gemcitabine-docetaxel (Gem/Doce) has emerged as an efficacious and well-tolerated therapy for NMIBC. At first cytoscopic evaluation, success rate for BCG failures is 75-80% with 60% of responders remaining disease free at 24 months. Success rates are even higher for BCG naïve patients with close to 90% disease free at 3 months, and 93% of responders HG disease free at 24 months. There is an unmet need for effective bladder-sparing regimens for Gem/Doce failures. FDA-approved agents in this setting have poor long-term efficacy; Valrubicin has an 8% 24-month disease free rate, and recently approved Pembrolizumab has less than 20% complete response at 1 year. Based on poor efficacy of alternatives, we evaluated sequential intravesical valrubicin-docetaxel (Val/Doce) as a rescue therapy for NMIBC. Methods: We retrospectively identified all patients with NMIBC who were treated with Val/Doce between April 2013 and June 2021. Patients were included with intent to receive 6 weekly intravesical instillations of sequential 800 mg valrubicin and 37.5 mg docetaxel after complete TURBT. Monthly maintenance of 2 years was initiated if disease free at 3-month cytoscopic evaluation. The primary outcome was recurrence-free survival (RFS). Progression events included the development of muscle invasive or metastatic disease as well as any cystectomy. Survival was assessed using the Kaplan-Meier method and log rank test, indexed from start of Val/Doce induction. Surveillance was performed according to AUA guidelines. Results: The final cohort included 75 patients with median follow-up of 21 months. Of these patients, 12 were treated with Val/Doce for low-grade Ta disease, with 60% disease free at 2 years and no subsequent HG occurrences. The remaining 63 patients had high-grade disease of which 86% were BCG failures and 89% were Gem/Doce unresponsive. The 2 year RFS for high-grade patients was 39%. CIS was present in 56% of the cohort. RFS was similar for those with and without CIS. Progression occurred in 12 of the patients with high-grade disease. Of note, 10 underwent cystectomy and 2 died of metastatic bladder cancer, yielding a bladder cancer specific death rate of 3%. Overall and cystectomy-free survival was 88 and 85% at 24 months, respectively. The most commonly reported side effects were bladder spasms (24%), urinary frequency (13%), and dysuria (11%). There were 3 patients who could not tolerant a full induction course. Conclusions: Sequential intravesical valrubicin-docetaxel will rescue a substantial portion of patients with HG NMIBC failing Gem/Doce or BCG. Thus, the regimen allows a high proportion of patients ( > 80%) to retain their bladders with an acceptable ( < 20%) progression rate without succumbing to bladder cancer-related death ( < 5%).[Table: see text]
Real-world study of chemotherapy plus immunotherapy versus chemotherapy alone as neoadjuvant treatment guided bladder-sparing therapy for localized muscle-invasive bladder cancer.
Authors: Shen Yali , Wen Feng , Zhang Peng , Lin Tianhai
Published: February 2022

499

Background: Bladder-preserving combined-modality therapy has been a popular research field as an alternative to radical cystectomy for selected patients with localized muscle-invasive bladder cancer (MIBC). This real-world study aimed to compare the efficacy of neoadjuvant chemotherapy plus immunotherapy versus chemotherapy alone as one of bladder-sparing therapies for localized MIBC. Methods: Patients with cT2-4bN0-3M0-1a pathological and imaging diagnosed MIBC were included in the study. Either chemotherapy (gemcitabine and cisplatin/carboplatin) plus immunotherapy (PD-1 checkpoint inhibitor, including pembrolizumab，tislelizumab and toripalimab) or chemotherapy alone were given as patients’ wish. The primary endpoint was complete response rate (CR, T0/Ta/Tis), and the secondary endpoints were disease control rate (DCR), progression-free survival (PFS), bladder-intact disease-free survival (BI-DFS) and toxicity. Results: In total, 41 patients were included, 25 in combination group and 16 in chemotherapy group respectively. The baseline characteristics were well balanced in two groups. Median follow-up time was 15.3 ±4.4 months(m). No patient died. The efficacy evaluable population was consisted of 34 pts (22 in combination group; 12 in chemotherapy alone group). The CR rate for combination group was 50.0% and 0 for chemotherapy alone group. One patient suffered from disease progression in combination group and three in chemotherapy group. The DCRs for combination group and chemotherapy group were 95.5% and 66.7%, respectively ( p= 0.003). Twelve patients had radiotherapy and six patients had radical cystectomy followed by neoadjuvant treatments in combination group. And two patients had radiotherapy and three patients had radical cystectomy in chemotherapy group. The one-year PFS rates were 95.5% and 62.5% for combination group and chemotherapy group( p= 0.010), and the one-year BI-DFS were 66.1% versus 27.5% respectively( p= 0.159). The bladder-preserving combined-modality therapies used were well-tolerated with acceptable and manageable toxicities. Grade ¾ hematological system adverse events were 15.9% and 6.4% in combination group and chemotherapy group, respectively ( p= 0.021). Conclusions: Neoadjuvant chemotherapy plus immunotherapy showed better efficacy compared with chemotherapy alone as an important bladder-sparing therapy for locally advanced MIBC with acceptable and manageable toxicities.
Post hoc pooled analysis of first-line (1L) pembrolizumab (pembro) for advanced urothelial carcinoma (UC): Outcomes by response at week nine in KEYNOTE-052 and KEYNOTE-361.
Authors: Powles Thomas , Alva Ajjai Shivaram , Ozguroglu Mustafa , O'Donnell Peter H. , Loriot Yohann , Csoszi Tibor , Vuky Jacqueline , Morales-Barrera Rafael , Plimack Elizabeth R. , Matsubara Nobuaki , Fradet Yves , Geczi Lajos , Gunduz Seyda , Mamtani Ronac , Bajorin Dean F. , Liu Chih-Chin , Imai Kentaro , Homet Moreno Blanca , Bellmunt Joaquim , Balar Arjun Vasant
Published: February 2022

519

Background: Pembro is a 1L treatment for cisplatin-ineligible pts with UC. This post hoc landmark analysis evaluated clinical outcomes by response at 9 wk to 1L pembro monotherapy in pts with advanced/unresectable or metastatic UC from the single-arm phase 2 KEYNOTE-052 (NCT02335424) and the randomized phase 3 KEYNOTE-361 (NCT02853305) trials. Methods: Cisplatin-ineligible pts with advanced UC were enrolled in KEYNOTE-052 and received pembro (200 mg Q3W for ≤2 y). Platinum-eligible pts with advanced UC who had not previously received systemic chemotherapy (chemo) were enrolled in KEYNOTE-361 and randomly assigned 1:1:1 to receive pembro (200 mg Q3W for ≤2 y), pembro + chemo (1000 mg/m2 gemcitabine on d1 and d8 + cisplatin [70 mg/m2] or carboplatin [AUC 5] on d1 of each 3-wk cycle), or chemo. The primary analysis group included pembro monotherapy–treated pts; the sensitivity analysis group included pembro monotherapy–treated pts from KEYNOTE-052 and the choice of carboplatin subpopulation of pembro monotherapy–treated pts from KEYNOTE-361. Landmark analyses of OS by pts with CR, PR, SD, or PD per RECIST v1.1 by BICR at first imaging assessment (wk 9) were pooled for the ITT populations. Duration of CR/PR/SD and OS were estimated using the Kaplan-Meier method. Data cutoffs were Sep 26, 2020 (KEYNOTE-052) and Apr 29, 2020 (KEYNOTE-361). Results: The primary analysis group included 681 pembro-treated pts (KEYNOTE-052, N = 374; KEYNOTE-361, N = 307); the sensitivity analysis group included 544 pembro-treated pts (KEYNOTE-052, N = 374; KEYNOTE-361, N = 170). Median time from randomization to cutoff was 51.9 mo (range, 22.0-65.3) and 53.7 mo (range, 22.0-65.3) for the primary and sensitivity analysis groups, respectively. Twenty-five pts (4.6%) had CR and 135 (24.6%) had PR (primary group); 17 pts (3.9%) had CR and 105 (24.1%) had PR (sensitivity group). Median DOR was 25.9 mo for pts with CR/PR at wk 9; pts with CR/PR or SD at wk 9 had longer OS than pts with PD at wk 9 (Table). Conclusions: In this post hoc analysis, pts with advanced UC in KEYNOTE-052 and KEYNOTE-361 with CR/PR at wk 9 had better clinical outcomes with pembro monotherapy than pts with SD or PD; 1L pembro monotherapy continues to show efficacy in advanced UC. Clinical trial information: NCT02335424 and NCT02853305. [Table: see text]
Prognostic impact of fibroblast growth factor receptor (FGFR) genomic alterations and outcomes in patients with metastatic urothelial.
Authors: Sevillano Elena , Madurga Rodrigo , Rodriguez Moreno Juan Francisco , Barquin Arantzazu , Yagüe Monica , Navarro Paloma , Barba María , Quiralte Miguel , García-Donas Jesús
Published: February 2022

537

Background: FGFR mutations/translocations are druggable targets in metastatic urothelial cancer (mUC). However, the prognostic effect of these genomic alterations (GA) and their role in the response to conventional therapy remain poorly characterized. Methods: We undertook an observational retrospective study in four Academic Hospitals in Madrid, Spain. Clinical and molecular information of patients diagnosed of Urothelial Cancer (UC) between January 2010 and December 2020 was systematically reviewed. The objective of this work was to compare the outcome of mUC patients with GA in the FGFR 2-3 genes versus wild type tumors. Analyses for detection of FGFR translocations and mutations using DNA isolated from formalin-fixed and paraffinized tumor tissue samples consisted of either next-generation sequencing (Foundation One test; n = 68) or qualitative real-time polymerase chain reaction–based assays (n = 9) with TFGFR or QIAGEN therascreen® tests that evaluated somatic mutations within the FGFR2-3 gene: R248C, S249C, G370C and Y373C and fusions: FGFR3-TACC3v3, FGFR3-TACC3v1 and FGFR3-BAIAP2L1, FGFR2-BICC1 and FGFR2-CASP7. Overall response rate (ORR), Progression Free Survival (PFS) and Overall Survival (OS) were determined and Cox-regression analysis were performed to assess the prognostic impact of these alterations. Results: We identified 201 patients diagnosed with UC. Genomic profiling was available in 77 mUC with 28 patients harboring any FGFR GA. Regarding ORR to first line a trend towards a better outcome was identified in FGFR GA (mutation/translocation/fusion) vs wild type cases (57,7% vs 45,5%, p=0,46). However, median OS was significantly worse among FGFR GA (mutation/translocation) vs FGFR wt tumours (13.8 vs 26.2 months, p=0,021). Prognostic factors associated with an unfavorable outcome in multivariable analysis were visceral metastases (HR 7,29 95% CI 1.6-32,3), ECOG >1 (HR 7,03 95% CI 2,59-19,1), first line treatment with checkpoint inhibitors (HR 2,67; 95% CI 1,06-6,74) and the presence of FGFR GAs (HR 2,98, 95% CI 1.37-6.5). Conclusions: Despite a better response to first line treatment, overall FGFR GA showed to be an independent risk factor in mUC. Thus, this determination should be included in new prognostic models.[Table: see text]
Immune characterization of urothelial bladder carcinoma integrating transurethral resection of bladder tumor (TURBT) samples and serum: A feasibility study.
Authors: Alvarez-Dominguez Carmen , Azueta Ainara , Muñoz Unceta Nerea , Gutierrez-Baños Jose Luis , Teran Hector , Ocejo-Viñals Javier , Gonzalez-Lopez Elena , Caramelo Belen , Marcos-Gonzalez Sara , Salcines-Cuevas David , Dominguez Mario , Madureira-Rivero Rebeca , Campos-Juanatey Felix , Sotelo Marta , Zeoli Andrea , Revuelta Laura , Duran Ignacio
Published: February 2022

538

Background: Urothelial bladder cancer (UBC) is characterized by high immunogenicity. Multiple immunotherapies both in the perioperative and advanced setting are being developed. However, we lack good predictive biomarkers of response to immunotherapy in UBC. We aimed to characterize the immune profile of UBC patients using TURBT and serum samples. Methods: 13 UBC biopsies from TURBT samples were analyzed along with sera of these patients. Biopsy samples were divided in two equal parts. One part was formalin-fixed paraffin embedded and stained for immune histochemistry [IHC] for the following markers (CD3, CD4, CD8, CD20, CD68 and PD-L1 using SP142 antibody) and results expressed in percentages. The other part was homogenized and processed for immune cell isolation (human tumor isolation Miltenyi Kit). Tumor cells were stained with PHK and double positive CD8 and PHK were isolated using a MACSTM procedure. Different immune cell populations were analyzed by flow cytometry for the following markers (CD3, CD4, CD8, CD20 and CD68) and results expressed in percentages. Cytokines were examined in sera using the Luminex multiparametric procedure and results were expressed as pg/mL. Results: IHC and flow cytometry data were comparable and identified three groups according to the immune cells associated with the tumors (Table). Groups 1 and 2 showed high and moderate levels of tumor activated CD8+ T cells (1-4%) along with a higher expression of PD-L1 (40-20%). Group 3 lacked tumor activated CD8+ T cells and show lower expression of PD-L1 (15%). All groups showed significant levels of Th2 cytokines (IL-4, IL-6 or IL-10) while very low or lack of Th1 cytokines (IFN or IL-2) was observed except in group 2. Conclusions: TURBT biopsies and serum analysis of cytokines could represent a valid approach to further evaluate potential predictive biomarkers of response to immunotherapy in UBC. Different immune populations subgroups were identified in our series and could potentially predict for diverse responses to treatment. Further prospective validation in larger series is ongoing to confirm these results.[Table: see text]
Incidence and outcomes of nodal metastasis in clinically nonmuscle-invasive bladder cancer.
Authors: Alsyouf Muhannad , Ladi Seyedian Seyedeh Sanam , Ghoreifi Alireza , Douglawi Antoin , Schuckman Anne K. , Djaladat Hooman , Daneshmand Siamak
Published: February 2022

577

Background: Radical cystectomy (RC) is recommended in NMIBC patients with high risk of progression or persistent disease despite intravesical therapy. The role and extent of lymphadenectomy is controversial and not universally performed in this population. The objective of this study is to evaluate the incidence and pattern of nodal metastasis in patients undergoing radical cystectomy for treatment of clinically non-muscle invasive bladder cancer. Methods: Prospectively collected data of patients who underwent RC and ‘super-extended’ LND with intent-to-cure for urothelial carcinoma of the bladder between 2002 and 2019 were examined. Inclusion criteria were(a) clinical stage Ta, Tis,or T1, (b) muscle present and not involved,(c) no prior diagnosis of T2 disease, (d) no prior neoadjuvant therapy, and (e) super-extended lymphadenectomy performed to level of IMA with mapping information available. Logistic regression analysis was used to evaluate for predictors of node metastasis. Results: A total of 223 patients met inclusion criteria with a median follow up of 8.2 years (IQR 4.1-10.7). Lymph node metastasis was identified in 8.1% (18/223) of the cohort. Nodal metastasis was present in 0 patients with cTis, 0 patients with cTa, and 11.6% (18/155) of patients with cT1 disease. Of the 18 patients with LNM in cT1 disease, 61% (11/18) had positive nodes below the common ileac vessel bifurcation, 6% (1/18) had positive nodes below the level of aortic bifurcation, and 33% (6/18) had distant metastasis to lymph nodes beyond aortic bifurcation. No skip metastasis were identified. After RC, 89% of cT1 with nodal metastasis had muscle invasive disease. On logistic regression analysis, presence of LVI on TURBT specimen was a significant predictor of LNM (OR 6.8, CI 2.2-20.9). Five-year RFS was 91%, 82%, and 61% in patients with pNMIBC, cNMIBC, and pMIBC, respectively. Conclusions: Routine lymph node dissection is necessary in patients undergoing RC for cT1 disease due to risk of upstaging and LNMs. Presence of LVI in TURBT specimen of cNMIBC is a predictor of nodal metastasis. In patients with nodal disease, metastasis beyond the limits of a standard lymph node template occurred in two-thirds of patients, however a standard pelvic node dissection would have identified all patients with node positive disease.
PSMAddition: A phase 3 trial to compare treatment with 177Lu-PSMA-617 plus standard of care (SOC) versus SOC alone in patients with metastatic hormone-sensitive prostate cancer.
Authors: Sartor A. Oliver , Tagawa Scott T. , Saad Fred , De Bono Johann S. , Feng Felix Y , Fizazi Karim , Sakharova Olga V. , Morris Michael J.
Published: February 2022

TPS210

Background: [177Lu]Lu-PSMA-617 (177Lu-PSMA-617) is a high-affinity prostate-specific membrane antigen (PSMA)-targeted radioligand therapy that delivers β-particle radiation to PSMA-expressing cells and the surrounding microenvironment. Androgen receptor pathway inhibitors (ARPI) may alter PSMA expression and radiosensitivity. PSMAddition will assess the efficacy and safety of 177Lu-PSMA-617 plus standard of care (SOC) versus SOC alone in adults with metastatic hormone-sensitive prostate cancer (mHSPC). Methods: PSMAddition ( NCT04720157 ) is an international, prospective, open-label, randomized, phase 3 trial in adults with mHSPC. Eligible patients are treatment-naïve or minimally treated candidates for hormonal therapy, with PSMA-positive disease (determined by [68Ga]Ga-PSMA-11 PET/CT), Eastern Cooperative Oncology Group performance status of 0 to 2 and adequate major organ function. Patients are excluded if they have rapidly progressing tumors that require chemotherapy. Approximately 1126 patients will be randomized 1:1 to receive 177Lu-PSMA-617 (7.4 GBq i.v. every 6 weeks, ≤6 cycles) plus SOC or SOC alone (control arm). SOC is ARPI and androgen deprivation therapy. Stratification factors are tumor volume (high/low), age (≥70/ < 70 years) and previous/planned prostatectomy or radiation treatment of the primary prostate tumor (yes/no). The primary endpoint is radiographic progression-free survival (rPFS), as assessed by blinded independent centralized review. Upon centrally confirmed radiographic progression, participants in the control arm can cross over to the 177Lu-PSMA-617 arm. The planned sample size provides 95% power to detect a hazard ratio of 0.7 for rPFS after 418 events with an overall one-sided significance level of 0.025. The key secondary endpoint is overall survival. Other secondary endpoints are the proportion of patients with a prostate-specific antigen (PSA) decline of ≥90% from baseline, time to development of metastatic castration-resistant prostate cancer, composite progression-free survival (radiographic, clinical or PSA progression), safety and tolerability, and health-related quality of life. Previously presented at the 2021 European Society for Medical Oncology Congress, FPN 3035, Tagawa S et al. Reused with permission. Clinical trial information: NCT04720157.
Nkrumah and the Ghana Revolution
Authors: James C. L. R.
Published: February 2022

In this new edition of Nkrumah and the Ghana Revolution, C. L. R. James tells the history of the socialist revolution led by Kwame Nkrumah, the first president and prime minister of Ghana. Although James wrote it in the immediate post-independence period around 1958, he did not publish it until nearly twenty years later, when he added a series of his own letters, speeches, and articles from the 1960s. Although Nkrumah led the revolution, James emphasizes that it was a popular mass movement fundamentally realized by the actions of everyday Ghanaians. Moreover, James shows that Ghana’s independence movement was an exceptional moment in global revolutionary history: it moved revolutionary activity to the African continent and employed new tactics not seen in previous revolutions. Featuring a new introduction by Leslie James, an unpublished draft of C. L. R. James's introduction to the 1977 edition, and correspondence, this definitive edition of Nkrumah and the Ghana Revolution offers a revised understanding of Africa’s shaping of freedom movements and insight into the possibilities for decolonial futures.
Spatio-temporal characteristics of Tuberculosis in Ghana
Authors: Iddrisu Abdul-Karim , A. Amikiya Emmanuel , Kwame Bukari Francis
Published: February 2022

Background: The number of Tuberculosis (TB) cases or deaths is declining, however, the rate of decline is not adequate to meet the World Health Organization's (WHO's) mitigation. TB remains a public health problem in Ghana with a significant economic and health burden on its citizens and health care system.  Consequently, there is a need for further studies about the disease aimed at accelerating the rate of decline in cases.

Methods:  The spatio-temporal characteristics of TB in Ghana using Bayesian spatial and spatio-temporal regression models was analysed in this study. Data were obtained from Ghana National Tuberculosis Programme (NTP) for the 10 regions of Ghana, collected over a six-year period. The study also examines some baseline predictors of TB infections to ascertain their effects on the TB risk across the ten regions in Ghana.

Results: Hot-spots of TB cases are observed in the Upper East, Upper West, Volta, Western, and Central regions and low risk in the Northern, Ashanti, Greater Accra, Brong Ahafo, Eastern and Western regions. The results indicated a clustering of risk between neighboring regions. TB cure rate, TB success rate, knowledge about TB, awareness that TB is airborne, HIV prevalence, percentage of literacy, and high income are important predictors of  detection for this disease across the ten regions of Ghana.

Conclusion: Most regions in Ghana have similar TB risks. A substantial reduction in TB cases  requires measures that will increase  detection, success and cure rates, awareness, knowledge about how this disease spreads as well adequate health facilities with easy access.
Bayes Lines Tool (BLT): a SQL-script for analyzing diagnostic test results with an application to SARS-CoV-2-testing
Authors: Aukema Wouter , Malhotra Bobby Rajesh , Goddek Simon , Kämmerer Ulrike , Borger Peter , McKernan Kevin , Klement Rainer Johannes
Published: February 2022

The performance of diagnostic tests crucially depends on the disease prevalence, test sensitivity, and test specificity. However, these quantities are often not well known when tests are performed outside defined routine lab procedures which make the rating of the test results somewhat problematic. A current example is the mass testing taking place within the context of the world-wide SARS-CoV-2 crisis. Here, for the first time in history, laboratory test results have a dramatic impact on political decisions. Therefore, transparent, comprehensible, and reliable data is mandatory. It is in the nature of wet lab tests that their quality and outcome are influenced by multiple factors reducing their performance by handling procedures, underlying test protocols, and analytical reagents. These limitations in sensitivity and specificity have to be taken into account when calculating the real test results. As a resolution method, we have developed a Bayesian calculator, the Bayes Lines Tool (BLT), for analyzing disease prevalence, test sensitivity, test specificity, and, therefore, true positive, false positive, true negative, and false negative numbers from official test outcome reports. The calculator performs a simple SQL (Structured Query Language) query and can easily be implemented on any system supporting SQL. We provide an example of influenza test results from California, USA, as well as two examples of SARS-CoV-2 test results from official government reports from The Netherlands and Germany-Bavaria, to illustrate the possible parameter space of prevalence, sensitivity, and specificity consistent with the observed data. Finally, we discuss this tool’s multiple applications, including its putative importance for informing policy decisions.
Case Report: Cutaneous metastases indicative of endometrial cancer: A case report and review of the literature
Authors: Zoukar Olfa , Haddad Anis , Jemaa Yosra , Zouari Ines , Issa Rahma , Bayar Amel , Khouildi Ghada , Sebri Amal , Naguez Dalel , Boukadida Asma , Ghannouchi Mossaab , Faleh Raja
Published: February 2022

Secondary localizations of cutaneous  metastases from endometrial cancer  are rarely observed  with a prevalence of 0.8% and can be indicative of deep pelvic cancer (ovarian or endometrial). The prognosis is usually poor, with skin metastases most often indicating  advanced disease.

This work, based on a case observed in our department and a review of the literature, aims to highlight the existence of this dramatic form of cutaneous  extension of a common disease. Dermatologists are often consulted due to the non-specific nature of the lesions and should be aware of this entity. As with other cutaneous  metastases, an accurate diagnosis  is based on a the patient’s thorough medical and surgical history in conjunction with histopathology
Canonical analysis of neuroendocrine-metabolic and neuroendocrine-immune relationships at female rats
Authors: Mel’nyk Oksana , Zukow Walery , Hrytsak Myroslava , Popovych Dariya , Zavidnyuk Yuriy , Bilas Volodymyra , Popovych Igor
Published: February 2022

Background. It has been shown before that drinking mineral waters of different composition has a significant effect on the neuroendocrine, metabolic and immune parameters of healthy rats. We analyzed the canonical correlations between neuroendocrine parameters, on the one hand, and metabolic and immune parameters, on the other hand. Materials and Methods. Experiment was performed on 58 healthy female Wistar rats 240-290 g. HRV parameters, major adaptation hormones, metabolism and immunity parameters were recorded. Results. The method of canonical correlation analysis revealed causal relationships between neuroendocrine and metabolic and neuroendocrine and immune parameters of the organism. The degree of neuroendocrine determination of individual sets of metabolic parameters ranges from 60% to 92%, and immune status from 87% to 96,5%. Conclusion. Effects of mineral waters on metabolism and immunity are realized through nervous and hormonal mechanisms.
Orthodontic retainers: now you have finished your orthodontic treatment how do you manage long-term post-orthodontic retention?
Authors: Shah Rupal , Noar Joseph
Published: February 2022

Retention is a key phase of orthodontic treatment that aims to maintain teeth in their corrected position following active orthodontic treatment. Although the evidence base is limited, there is now general consensus that orthodontic patients should wear their retainers life-long. This poses serious questions as to who is responsible for ensuring that the retainers are in good working order and fit for purpose. This article aims to set out some guidance for specialists, general dental practitioners and patients on the management of long-term retention, taking into consideration the best available knowledge. This article also aims to provide some guidance and rationale for retention wear and regimens. It is understood of course that these should be modified and individually assessed for each patient and their malocclusion.

CPD/Clinical Relevance: A knowledge of how to assess and maintain orthodontic retainers is essential for the practising dentist.
Cervical necrotizing fasciitis of odontogenic origin
Authors: Chai Aaron , Chandran Anupam , Crank Stephen
Published: February 2022

Cervical necrotizing fasciitis (CNF) is a rare, but serious condition that can develop as a result of an odontogenic infection spreading into the deep fascial planes of the neck. The infection is associated with significant morbidity and mortality due to septic shock, disseminated intravascular coagulation (DIC) and consequent multiple organ failure. A case of CNF affecting a 42-year-old woman who was treated with rapid surgical debridement and intravenous antibiotics is presented. She subsequently required further head and neck reconstruction as a result of morbidity from the disease.

CPD/Clinical Relevance: Although rare, it is pertinent that dental practitioners recognize that untreated dental infection might trigger necrotizing fasciitis, especially in high-risk patients.
Palatal hyperplasia associated with hereditary gingival fibromatosis
Authors: Patrick Amy , Savla Adesh , Eyeson Josiah
Published: February 2022

Hereditary gingival fibromatosis (HGF) is a benign, non-haemorrhagic, fibrous gingival overgrowth of unknown cause. Clinically, gingivae can be seen to partially or fully cover teeth, and can limit oral function, for example eating, speaking, and maintaining oral hygiene. HGF normally starts in the transition between the primary and secondary dentition. Surgical excision is often required. This case describes the management of a 37-year-old male with generalized HGF with extensive bilateral palatal growths extending into the oropharynx; not a reported presentation of HGF. Awareness of the condition and familial history could aid management at an earlier stage.

CPD/Clinical Relevance: This article describes the management of an uncommon presentation of hereditary gingival fibromatosis in the palate that affected the patient's oral function.
Using inhalation sedation in practice
Authors: Anand Prabhleen Singh , Adams Leah Rachel
Published: February 2022

This article outlines considerations for use of inhalation sedation (IS) in a primary care setting. It looks at indications, contra-indications and case selection for use of IS in practice. The article also considers relevant rules, regulations and guidelines a practitioner should be aware of if practicing inhalation sedation. Some useful practical tips are included on setting up an inhalation sedation practice and being compliant with the Care Quality Commission (CQC) regulations. Standard requirements for staff and patient safety in practice setting are discussed, as are training, governance and CPD requirements for the dental team providing sedation in accordance with latest guidelines on conscious sedation.

CPD/Clinical Relevance: This article will be useful for clinicians looking to update their knowledge on the use of inhalation sedation in the primary care setting.
Adaptive reconstruction imaging based on K-means clustering in off-axis digital holography
Authors: Sun Qiuya , Liu Yiwei , Chen Hao , Jiang Zhuqing
Published: February 2022

An adaptive filtering method for off-axis digital holographic reconstruction is presented. The spatial spectrum distribution of an off-axis digital hologram is clustered based on the K-means clustering algorithm of unsupervised machine learning . The spatial-spectrum filtering can be carried out by the quantitative comparison of different filtering interception windows. The first-order spectrum including the object information can be automatically located and intercepted after clustering the spatial spectrum distribution of the hologram. The experiment results demonstrate that the reconstruction images with better resolution and imaging quality can be achieved by the adaptive filtering algorithm. This adaptive filtering reconstruction based on K-means clustering provides a new way of automatic reconstruction imaging for off-axis digital holography.
Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle
Authors: Plaut Shiloh
Published: February 2022

Background

Myofascial Pain Syndrome (MPS) is a common, overlooked, and underdiagnosed condition and has significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease.

Methods

Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews.

Findings

799 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence.

Conclusions

MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue (“fascial armoring”). Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. A “global percutaneous needle fasciotomy” that respects tensegrity principles may treat MPS/fibromyalgia more effectively. “Functional-somatic syndromes” can be seen as one entity (myofibroblast-generated-tensegrity-tension), sharing a common rheuma-psycho-neurological mechanism.
Practice of people towards COVID-19 infection prevention strategies in Benishangul Gumuz Region, North–West Ethiopia: Multilevel analysis
Authors: Zelka Muluwas Amentie , Jimma Melkamu Senbeta , Wondashu Paulos Jaleta , Aldo Atnafu Morka , Abshoko Nigatu Disassa , Sadi Dula Ayana , Gibina Wagari Kelbessa
Published: February 2022

Introduction

Coronavirus 2019 (COVID– 19) is an acute respiratory viral infectious disease in human being caused by RNA virus that belonged to the family of corona virus. The incidence of this disease was growing exponentially and affects millions of the world population that leads to expose thousands of peoples for death. Thus, this study was targeted to assess the practice of people on COVID-19 infections prevention strategies in the region.

Methods

A community based cross sectional study design was conducted in Benishangul Gumuz Region from May 25 –June 15, 2020. Multistage sampling technique was carried out to select 21 kebeles/ketena and 422 study participants. Data were collected by face to face interview using semi-structured questionnaires. The collected data were entered, cleaned and analyzed using STATA software version 14.0. Descriptive, bi-variable and multivariable multilevel models were applied. Variables with p value < 0.25 in bi-variable analysis were selected as candidates for multivariable analysis. Finally, the variables with p-value < 0.5 were considered as statistically significant, then variables with odds ratio, 95% CI were used to interpret the effect of association.

Results

The magnitude of good practice on prevention strategies of COVID– 19 infections was 62.1%. The most frequently practiced prevention strategies for COVID-19 infections were hand washing with water and soap (80.7%), alcohol-based hand rub (68.8%), maintaining social/physical distance (74.2%) and avoiding touching eyes. Individual and community level factors that affecting practice of COVID– 19 infection prevention strategies were discovered. Hence, community level factor was place of origin (AOR = 0.1; 95%CI: 0.03, 0.35) whereas individual level factors were able to read and write (AOR = 0.18; 95%CI: 0.04, 0.81) and being merchant (AOR = 2.07; 95%CI: 1.01, 4.28).

Conclusion

The level of practice of community towards COVID-19 infections prevention strategies were low as compared with the expected outcome. Individual and community level factors were identified. This implies that social mobilization and community engagement was not effective. Thus, designing appropriate strategies to improve of practice prevention strategies are strongly recommend.
A robust multivariate structure of interindividual covariation between psychosocial characteristics and arousal responses to visual narratives
Authors: Kim Jinyoung , Bae Eunseong , Kim Yeonhwa , Lim Chae Young , Hur Ji-Won , Kwon Jun Soo , Lee Sang-Hun
Published: February 2022

People experience the same event but do not feel the same way. Such individual differences in emotion response are believed to be far greater than those in any other mental functions. Thus, to understand what makes people individuals, it is important to identify the systematic structures of individual differences in emotion response and elucidate how such structures relate to what aspects of psychological characteristics. Reflecting this importance, many studies have attempted to relate emotions to psychological characteristics such as personality traits, psychosocial states, and pathological symptoms across individuals. However, systematic and global structures that govern the across-individual covariation between the domain of emotion responses and that of psychological characteristics have been rarely explored previously, which limits our understanding of the relationship between individual differences in emotion response and psychological characteristics. To overcome this limitation, we acquired high-dimensional data sets in both emotion-response (8 measures) and psychological-characteristic (68 measures) domains from the same pool of individuals (86 undergraduate or graduate students) and carried out the canonical correlation analysis in conjunction with the principal component analysis on those data sets. For each participant, the emotion-response measures were quantified by regressing affective-rating responses to visual narrative stimuli onto the across-participant average responses to those stimuli, while the psychological-characteristic measures were acquired from 19 different psychometric questionnaires grounded in personality, psychosocial-factor, and clinical-problem taxonomies. We found a single robust mode of population covariation, particularly between the ’accuracy’ and ’sensitivity’ measures of arousal responses in the emotion domain and many ‘psychosocial’ measures in the psychological-characteristics domain. This mode of covariation suggests that individuals characterized with positive social assets tend to show polarized arousal responses to life events.
Extratendinous migration of calcific tendinitis of the rotator cuff: imaging findings and clinical characteristics with temporal changes
Authors: Kim Mee Jeong , Sung Mi Sook , Jeong Chang Hoon , Park Hae-il
Published: February 2022

Purpose: The aim of this study was to analyze the imaging findings and clinical characteristics of extratendinous migration of calcific tendinitis of the shoulder with temporal changes.Methods: Seventy-six patients with extratendinous calcific tendinitis of the shoulder diagnosed by ultrasonography (US) or magnetic resonance imaging (MRI) were enrolled in this retrospective study. Clinical symptoms and imaging findings (on radiography, US, and MRI) of extratendinous calcific tendinitis during an acute painful attack were analyzed. Temporal changes were analyzed in 28 patients before an acute attack and 40 patients after an acute attack. For comparison, 65 patients with intratendinous calcific tendinitis were included.Results: Patients with extratendinous calcific tendinitis had a significantly higher average visual analogue scale (VAS) score (8.8±1.6) than the intratendinous group (6.4±2.2) (P<0.001). The fragmented type (80.5%) was the most common shape on US; sonographic black hole appearance (14.6%) and echogenic fluid (9.8%) were characteristic findings of intrabursal calcifications. In 28 patients with previous radiographs, radiographic type III (78.6%) was dominant and the location of calcific deposits changed (82.1%) during the acute painful attack, which was also perceivable in 12 patients with previous US or MRI. In follow-up radiographs of 40 patients, calcifications shrunk by more than 50% or became invisible in 82.5% of patients, with symptom improvement (VAS score, 8.9±1.5 to 1.9±1.2). Follow-up US and MRI of 16 patients also showed decreased size (56.3%) or disappearance (43.7%) of calcific deposits.Conclusion: Extratendinous calcific tendinitis has distinctive imaging features, the temporal changes of which correlate well with clinical symptoms.
Fadilah Kidung Rumeksa Ing Wengi dalam Tinjauan Hizib Wali Tarekat Nusantara
Authors: Arif Muzayin Shofwan Arif Muzayin
Published: February 2022

Kidung Rumeksa Ing Wengi is the work of Sunan Kalijaga which has literary, philosophical, mystical, and practical dimensions. Sunan Kalijaga as a writer and humanist create this poem in Javanese to make it easy to understand, live and practice by the Javanese people. This study aims to review the Kidung Rumeksa Ing Wengi in the hizib perspective composed by the wali of the tarekat in archipelago. This paper is a literature research. The technique of data analysis uses content analysis by sorting and grouping similar data and then analyzing its contents. This study found that the Kidung of Rumeksa Ing Wengi is believed to contain the same fadilah (practical virtues) and is in harmony with the hizibs composed by the founders of the tarekat in archipelago, such as Hizib Nashar by Shaykh Abul Hasan As-Syadzili, Hizib Nawawi by Shaykh Imam An-Nawawi, Hizib Ghazali by Shaykh Imam Al-Ghazali, and several other hizibs which are believed to be able to provide protection from various magical disorders, spirits, evil, and the fulfillment of any other wish.
[Kidung Rumeksa Ing Wengi merupakan karya Sunan Kalijaga yang memiliki kandungan sastrawi, filosofis, mistis, dan praktis. Sunan Kalijaga sebagai sastrawan dan budayawan meramu kidung ini dengan bahasa Jawa agar mudah dimengerti, dihayati, dan dilaksanakan oleh masyarakat Jawa. Penelitian ini bertujuan meninjau Kidung Rumeksa Ing Wengi dalam prespektif hizib para wali pendiri tarekat di nusantara. Tulisan ini merupakan penelitian literatur. Teknik analisa datanya menggunakan content analisis dengan memilah dan mengelompokkan data yang sejenis kemudian menganalisis isinya. Dalam studi ini ditemukan bahwa Kidung Rumeksa Ing Wengi karya Sunan Kalijaga diyakini mengandung fadilah (keutamaan praktis) yang sama dan selaras dengan hizib-hizib yang disusun para wali pendiri tarekat di nusantara, seperti Hizib Nashar karya Syaikh Abul Hasan As-Syadzili, Hizib Nawawi karya Syaikh Imam An-Nawawi, Hizib Ghazali karya Syaikh Imam Al-Ghazali, dan beberapa hizib lainnya yang diyakini dapat memberi penjagaan dari berbagai gangguan sihir, makhluk halus, kejahatan, dan pemenuhan berbagai macam hajat.]
Expositions sportives et formes de communication. Médiacultures, positionnements et narrations
Authors: Féménias Damien
Published: February 2022

S’il n’existe pas de champion, de héros ou de vedette sans récit ou sans dispositif de mise en scène, force est de constater que ces récits et ces dispositifs ont pendant longtemps été délaissés par les recherches. Les recherches dédiées à ces questions se sont multipliées depuis une vingtaine d’années. Avant de présenter les apports spécifiques du numéro, l'article présente, très sommairement, les grands principes d’analyse qui ont longtemps prévalu dans les regards portés sur les célébrités sportives. Il pointe aussi les connaissances qui manquent encore aux analyses et qui tiennent au travail d'alimentation-commentaire et de relai-diffusion des réseaux sociaux, dans lesquels les destinataires et les algorithmes sont actifs, et dont les rôles de structuration-diffusion sont à la fois essentiels et largement méconnus.
Estrategias para el control de los riesgos biológicos y accidentabilidad en el personal asistencial y administrativo en una clínica de tercer nivel de Santa Marta (Colombia).
Authors: Quintero-Ramírez Nini , Campo-Torregrosa Yelis , Toncel Yasmina , Pérez-Anaya Oskarly , Sánchez-García Yuris , Puello- Viloria Yamile , Paredes Bermúdez Marta
Published: February 2022

Objetivo: Diseñar estrategias para el control de los riesgos biológicos y accidentabilidad enel personal asistencial y administrativo en una clínica de tercer nivel en la ciudad de SantaMarta (Colombia). Metodología: El diseño de la investigación corresponde a un enfoque descriptivo de cortetransversal propositivo. La población objeto de estudio fue de 150 personas, y una muestrapoblacional de 39 casos de personas con riesgos biológicos, las cuales cumplieron criteriosde inclusión representados en el talento humano del área asistencial administrativa quelabora en la clínica. Resultados: Se evidenció que en el periodo de enero-diciembre de 2017 y 2018, el áreaasistencial es la población más afectada, con una participación de 59 % para las auxiliaresde enfermería y un 7,7 % para médicos y enfermeras simultáneamente, y las manos son laparte del cuerpo con mayor afectación (82,1%). Conclusión: Los resultados demuestran la necesidad de implementación de estrategias deprevención, enfocadas en fortalecer el conocimiento de las buenas prácticas asistencialesque mitiguen la exposición a riesgos biológicos y accidentabilidad en el personal con mayorvulnerabilidad.
Roll-Over Test as PredictiveValue of Pre-eclampsia.
Authors: Torres-Coronado Jorge , Loo-Valverde Maria , De La Cruz-Vargas Jhony A. , Pérez Miguel A. , Smith Jenette
Published: February 2022

Objective: To determine the effectiveness of the roll-over test as a predictor of pre-eclampsia.Methodology: The studied population had a size of 272, with a sample of 262 pregnant women, between 28 and 32 weeks of gestational age, who obtained pre-natal care at the Guillermo Almenara Irigoyen National Hospital, between January and September of 2017. The ROC curve, and the sensitivity and specificity of the roll-over test to predict pre-eclamp-sia, were calculated.Results: The prevalence of the roll-over test in this study was 9%, with a 95% confidence interval (5.43 - 12.22). In this study, the ROC curve was determined (0.725 and 0.734, for the first and second measurements, respectively) and found to be statistically significant at the p <0.05 level. The sensitivity of the roll-over test for a cutoff point of 20 mmHg was 60%, and the specificity of 95% also had a PPV of 37% and a NPV of 98%. Differences be-tween the first and second measurements suggest that the second measurement is more sensitive than the first one.Conclusions: The roll-over test is a simple, cost-effective test with potential application in initial evaluation of pre-eclampsia in pregnant women with a history of pre-eclampsia and/or other risk factors.