bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiotherapy improved the efficacy of immunotherapy for advanced esophageal cancer.
Authors: Chen Yicong , Yu Ruixuan , Zhou Xiaojuan , Zeng Xiaoxiao , Xu Yong , Peng Feng , Zou Bingwen , Zhou Lin , Gong Youling , Wang Jin , Wang Yongsheng , Huang Meijuan , Lu You , Liu Yongmei
Published: July 2024

e16063

Background: The development of immunotherapy has changed treatment methods for advanced esophageal cancer (EC).However, the efficacy of ICIs in advanced EC is not ideal, and the clinical research on the combination of ICIs and Radiotherapy(RT) in advanced EC remains insufficient. This study aimed to evaluate the effectiveness and safety of radiation in first-line immunotherapy for advanced EC. Methods: We conducted 201 advanced EC patients who received first-line ICIs in West China Hospital. The enrolled patients were divided into 2 groups based on whether they received radiation therapy. Results: The analysis included data from 201 patients. The radiotherapy (RT) group had 103 patients (51.2%), whereas the non-radiotherapy (NRT) group included 98 individuals (48.8%). The RT sites include esophagus lesions (83, 80.6%), metastatic lymph nodes (11, 10.7%), liver metastases (4, 3.9%), bone metastases (2, 1.9%), brain metastases (2, 1.9%), lung metastases(1, 0.97%). The median radiation dose was 50.4 Gy (range, 12-68). The RT group had a median OS of 22.8 months (95% CI, 17.8-NA), which was longer than the NRT group's 14.6 months (95% CI, 12.8-26.5) (p = 0.038). And the median PFS was 12.9 months (95% CI, 11.2-14.0) in the RT group versus 7.3 months (95% CI, 6.3-9.7) in the NRT group (p = 0.006). Patients in the RT group had a higher disease control rate (DCR) (99.0% vs. 76.5%, P < 0.001). However, a higher proportion of patients in the RT group developed grade 3-4 myelosuppression (37.86% V.S. 20.20%, P = 0.006), and there was no significant difference in the other AEs. Conclusions: In the first-line immunotherapy for advanced esophageal cancer, radiotherapy has been attributed to improved survival with tolerable toxicity.
Homologous recombination deficiency score served as an independent prognosis factor in esophageal squamous cell carcinoma.
Authors: Wang Yulu , Ding Bowen , Tao Yunlan , Huang Lingli , Zhu Qian , Gao Chengying , Feng Mingli , Han Yuchen
Published: July 2024

e16080

Background: Homologous recombination deficiency (HRD) is a functional impairment of the homologous recombination repair (HRR) pathway, pivotal for mending DNA double-strand breaks, contributing significantly to cancer-associated genomic instability. While BRCA mutations traditionally underlie HRR defects, recent studies highlight varied responses to poly (ADP-ribose) polymerase (PARP) inhibitors based on specific HRR-related gene alterations. Despite HRD's relevance in various cancers, its role in esophageal squamous cell carcinoma (ESCC) remains underexplored. Methods: We conducted a retrospective analysis of HRD scores in 96 ESCC patients, assessing correlations with clinical characteristics and survival outcomes. Genomic sequencing was performed using a customized superHRD NGS panel. HRD scores were calculated based on 54,000 single-nucleotide polymorphisms, employing Kruskal-Wallis ranksum tests and two cut-off points for quantitative analysis. Kaplan-Meier survival and Cox regression model were employed to evaluate disease-free survival (DFS) and overall survival (OS). Results: Higher HRD scores correlated with advanced tumor stages, recurrence, and specific gene mutations ( TP53 and ABCB1). APC mutations were associated with lower HRD scores. Patients with high HRD scores demonstrated significantly shorter disease-free survival (DFS) and a trend towards shorter overall survival (OS), especially those who did not receive adjuvant therapy, emphasizing HRD's prognostic value. Conversely, HRD-high patients undergoing adjuvant therapy showed a tendency towards extended OS. Multivariate analysis identified HRD as an independent prognostic factor (HR = 2.814 for recurrence, HR = 1.772 for death). Validation with The Cancer Genome Atlas (TCGA) ESCC dataset supported our findings. Conclusions: This study unveils associations between HRD scores, clinical characteristics, and genomic mutations in ESCC, emphasizing HRD's potential as a prognostic biomarker. HRD assessment may aid in patient stratification and personalized treatment strategies. Future investigations should explore underlying molecular mechanisms and therapeutic implications of HRD-associated pathways in ESCC management.
Social factors in the receipt of treatment for locally advanced esophageal cancer.
Authors: Ricker Ansley Beth , Robinson Jordan , Shea Reilly , Cockerham Katelyn , Simpson Matigan , Squires Malcolm Hart , Salo Jonathan C.
Published: July 2024

e16093

Background: Treatment for locally advanced esophageal cancer consists of chemoradiation (chemoRT) followed by esophagectomy. Studies have suggested Black patients were less likely to undergo surgery for esophageal cancer with inferior survival rates, attributing this to differences in access to surgery. These studies have not always accounted for differences in the natural history of adenocarcinoma and squamous cell carcinoma, which have strong racial correlations and different rates of surgical resection. The current study examined outcomes and patterns of care for patients with locally advanced esophageal cancer, both adenocarcinoma and squamous cell carcinoma, in relation to their sociodemographic characteristics. Methods: Patients with clinical stage T2-4, N0-2, and M0 adenocarcinoma or squamous cell carcinoma of the mid or distal esophagus diagnosed between 2010-2021 were included from 11 hospitals across our healthcare system. Treatment decision-points included receipt of chemoRT, unresectable disease after chemoRT defined by metastatic disease or upper mediastinal lymphadenopathy, and receipt of surgery stratified by histology. Age, race, sex, insurance status, socioeconomic status measured by social deprivation index (SDI), and outcome data were collected. Chi-squared test was used for categorical variables and Kruskal-Wallis for continuous variables. Results: 513 patients were included, of whom 472 patients underwent chemoRT (366 adenocarcinoma, 106 squamous cell). Female patients (n =97) were less likely to undergo chemoRT (84% vs. 94%, p = 0.003). Patients without insurance were less likely to undergo chemoRT (86% vs 93%, p = 0.023). After completing chemoRT, 419 patients (82%) were resectable. Surgery was performed in 262/330 patients (79%) with adenocarcinoma and 38/89 patients (43%) with squamous cell carcinoma, reflecting the differences in natural history by histology. Among 330 patients with resectable adenocarcinoma, higher SDI was associated with a lower rate of surgery, while there was no difference in the receipt of surgery based on sex, race or insurance status. There were no detectable social factors associated with receipt of surgery for squamous cell carcinoma. Conclusions: Within our healthcare system, female and Medicaid/uninsured patients are less likely to undergo chemoRT for locally advanced esophageal cancer. Further studies are needed to evaluate whether sex-specific bias plays a role in the receipt of chemoRT. Among patients with resectable locally advanced esophageal adenocarcinoma treated with chemoRT, those with high SDI are less likely to undergo surgery. Further studies are needed to assess which component factors of socioeconomic status most impact the receipt of surgery so they can be targeted. The previous findings that race impacts treatment of locally advanced esophageal cancer are not seen in our healthcare system when accounting for histology.
Revealing heterogeneity in chronic lymphocytic leukemia: AI-driven insights into aggressive and indolent disease subtypes.
Authors: Qorri Bessi , Geraci Joseph , Tsay Mike , Cumbaa Christian , Alphs Larry , Pani Luca
Published: July 2024

e19029

Background: Chronic lymphocytic leukemia (CLL) exhibits a broad spectrum of clinical behaviors, from indolent courses requiring minimal intervention to aggressive forms demanding immediate treatment. The underlying heterogeneity of CLL poses significant challenges in predicting disease progression and tailoring patient-specific therapeutic strategies. Leveraging advanced and novel artificial intelligence (AI) and machine learning (ML) methodologies, our study aims to dissect the complexity of CLL, focusing on the identification and characterization of biomarkers that differentiate aggressive and indolent disease forms. Methods: The NetraAI is a priorietaryAI/ML system that is also being utilized in a research collaboration at a leading American oncology institute (not disclosed) that integrates machine intelligence, augmented intelligence, and an agent that interacts with AI-derived patient representations. This system was designed to learn from datasets with a small number of samples and many independent variables. This system operates by generating hypotheses in the form of interactive representations of patient populations that reveal heterogeneity along with statistically significant driving factors. Finally, an automated agent called AutoPlay interacts with these representations and generates an accounting of all variables, subpopulations of samples, and it also generates a human readable perspective on what was discovered by the data set. Results: We applied the NetraAI to a CLL dataset and used it to refine the analysis and interpretation of the corresponding transcriptomic data (GSE39411). Significantly lower levels of FADS3, GSDME, LPL, IMMT, NMB, and AEBP1 and higher expressions of COBLL1, P2RY1R, PDE8A, SYNE2, and FCRL3 were identified as hallmarks of indolent CLL, suggesting these markers could inform less aggressive disease management strategies. Furthermore, within a total of 104 CLL samples, we uncovered two distinct subpopulations within aggressive CLL, delineated by unique genetic markers. Group A, encompassing 31 aggressive CLL samples is predominantly characterized by the expression of lipoprotein lipase (LPL), while Group B, comprising 22/23 aggressive samples, is characterized by ZBTB20 and SYNE2. Our poster will also provide glimpses into a more refined heterogeneity that emerged from the analysis. Our results not only underscore the heterogeneity within aggressive CLL, but also highlights the potential for these markers to guide prognostic assessments and therapeutic decisions. Conclusions: This study not only advances our understanding of CLL heterogeneity, but also sets the stage for the development of more personalized and effective treatment modalities. By identifying drivers of disease aggression and indolence, we pave the way for targeted therapies that could significantly improve patient outcomes in CLL.
A phase 1, multi-center, safety, feasibility, and preliminary efficacy study evaluating a single dose of UNO101 in relapsed or refractory, unresectable, primary, or metastatic cutaneous and subcutaneous malignancies.
Authors: Dirbas Frederick M. , Meirovitz Amichay , Greenberg David , Dekel Edith , Choy Gavin S. , Monson Jedidiah
Published: July 2024

TPS2686

Background: Tumor ablation is a minimally invasive technique commonly used to treat solid tumors in the liver, kidney, bone, and lung and is usually based on thermal and nonthermal approaches. Local and in-situ tumor ablation methods demonstrate enhanced anti-tumor immune responses resulting in the destruction of residual malignant cells in primary tumors and distant metastases. Nitric oxide (NO) is a colorless gas and a short-lived free radical. It is a ubiquitous, endogenously generated gas implicated in the homeostatic regulation of physiological processes. Preclinical studies evaluating the effect of high concentration exogenously administered NO demonstrated its anti-cancer properties and suggested that it may serve as a potent tumoricidal agent. We have previously shown that treating mouse colon carcinoma (CT26) tumor-bearing mice with ultra-high concentrations of nitric oxide (UNO101) upregulates innate and adaptive immune cells both locally and systemically. Beyond Cancer is currently conducting a first-in-human, first-in-class, Phase 1 safety, feasibility, and preliminary efficacy clinical study of UNO101 at multiple institutions in Israel. Methods: The study is a 2-part Phase 1 trial with a Dose Escalation and a Dose Expansion portion (NCT05351502). A conventional 3+3 dose escalation will evaluate three cohorts of UNO101 single dose: 25,000, 50,000 and 100,000 parts per million (PPM) delivered intratumorally over 5 minutes in subjects with an ECOG PS of 0–3, at least 3 months of life expectancy, with relapsed or refractory unresectable primary or metastatic cutaneous and subcutaneous measurable solid tumors being eligible for enrollment. Upon determination of the maximum tolerated dose or biological effective dose, whichever occurs first, the proposed recommended Phase 2 dose will be further evaluated in the Dose Expansion portion of the study. RECIST version 1.1 and iRECIST will be utilized to assess the rate of malignant tumor response after UNO administration and toxicity will be graded per NCI CTCAE version 5.0. Evaluation of response per itRECIST will also be explored. Up to thirty-eight enrolled subjects are anticipated. Cohort 1, 25,000 PPM have been completed without a reported DLT. Enrollment to Cohort 2, 50,000 PPM, began in January 2024. This study was approved by Israel Ministry of Health (IMOH) as well as the participating institution’s Ethics Board. Written informed consent was obtained for all enrolled subjects and a copy of the written consent is available for review. Clinical trial information: NCT05351502 .
Dynamic Response of Musclin, a Myokine, to Aerobic Exercise and Its Interplay With Natriuretic Peptides and Receptor C
Authors: Nam Ji Sun , Cho Eun-Suk , Kwon Yu Rim , Park Jong Suk , Kim YuSik
Published: July 2024

Objectives

Musclin, recently identified as a myokine, has been recognized for its physiological significance in potentiating the functional properties of natrieutic peptides (NPs) through competitive inhibition of their clearance receptor, natrieutic peptide receptor C (NPR-C). This study, for the first time in the literature, investigated the dynamic response of musclin during and after aerobic exercise in humans, exploring its potential as a myokine and its interaction with NPs and NPR-C in the context of exercise-induced metabolic responses.

Methods

Twenty-one inactive young males participated, and we assessed changes in serum levels of musclin, atrial natriuretic peptide (ANP), brain natriuretic peptide, epinephrine, and glycerol as indicative of lipid mobilization, during and after moderate-intensity aerobic exercise. Furthermore, we evaluated the gene expression of NPR-C in subcutaneous fat biopsies.

Results

Serum musclin levels increased significantly during aerobic exercise, followed by a decline during recovery, remaining elevated compared to baseline. Significant correlations were found between musclin responses and lean body mass (LBM), indicating its regulation by skeletal muscle mass and exercise. Exercise-induced changes in musclin positively correlated with those of ANP, potentially preventing ANP degradation. Additionally, a potential interplay between NPR-C expression and musclin dynamics on ANP was suggested. However, musclin's influence on lipid mobilization was not predominant when considering other lipolytic factors during exercise.

Discussion

Musclin's classification as a myokine is supported by its response to aerobic exercise and its association with LBM. Additionally, its interactions with NPR-C and NPs suggest its physiological relevance and potential clinical implications.
“Your Story Becomes Our Universe”: Fan Edits, Shitposts, and the BTS Database
Authors: Zhou Jaclyn
Published: July 2024

K-Pop has always depended on multimedia performance and platforms to reach global audiences, and on the versatility of its performers as not just singers, rappers and dancers, but also actors, fashion icons, and television and Internet personalities. With each new game, BTS circulates in proliferating media forms—from in-game cosmetic “skins” to mobile, manipulable elements in a digital sandbox—that result in novel forms of fan mobilization. In “‘Your Story Becomes Our Universe’: Fan Edits, Shitposts, and the BTS Database,” Jaclyn Zhou asks how BTS games such as BTS Universe Story–and the communities and practices of play surrounding them–give new shape to ongoing conversations in K-Pop fandom and scholarship about fan labor, the ownership of digital assets, the relationship between idols and their images, and the limits of intimacy between fans and idols.
Like a Criminal Undercover: Love, Hate, and the Performance of Inclusion
Authors: Kuo Rachel
Published: July 2024

In “Like a Criminal Undercover: Love, Hate, and the Performance of Inclusion,” Rachel Kuo follows the coverage of BTS’s 2022 visit to the White House to shed their starlight on rising anti-Asian violence. Kuo examines the limitations of BTS’s positioning and statements against Asian hate in the United States within the context of broader US imperial ambitions in Asia, cautioning us to consider the state’s love of BTS against its ongoing support of other forms of racial violence. In particular, Kuo contrasts different forms of Asian hate, from the spectacularized attacks that peaked during the COVID-19 pandemic, which garnered the most political attention, to the structural violences that enable racialized labor extraction of Asian migrants in the US and continued militarism and war in Asia.
Break the Structure: BTS ARMY Digital Activism and State Surveillance in Indonesia's Omnibus Law Protest
Authors: Octaviany Karlina
Published: July 2024

In “Break the Structure: BTS ARMY Digital Activism and State Surveillance in Indonesia’s Omnibus Law Protest,” Karlina Octaviany grapples with how Indonesian ARMY’s social media practices created a space to protest a controversial Omnibus Law in 2020 that proposed the removal of labor protections and rights. In the midst of a pandemic, Indonesian ARMY’s activities accelerated awareness and consolidated opposition to the Omnibus Law in the face of gender-based violence and state and state-sponsored surveillance. Despite such state policing and harassment, Indonesian feminists consolidated support for protestors arrested by the police, shedding light on the relationship between K-Pop and activism outside South Korea. This chapter examines ARMY activists’ social media practices and asks how did BTS ARMY digital activism during the Indonesia Omnibus Law protest map the potential of contemporary collective action. And, correspondingly, how does it illustrate the power of state surveillance against fandom movements?
The Skinship Diaries
Authors: Murphy Sara
Published: July 2024

Written in the wake of the COVID-19 pandemic in which social distancing and isolation entered public consciousness and altered daily life on a global scale, Sara Murphy contemplates the allure of touch and emotional intimacy. As a woman whose autoimmune disease has meant that physical intimacy is always accompanied by heightened risk, Murphy narrates the complex nexus of the terrible loss she feels (particularly sharp in the midst of the 2020 lockdown in her hometown) and the poignant pleasure she derives from watching the members of BTS engage in moments of affection with one another. Murphy observes how, through skinship, BTS illustrates a tactile life not limited to traditional notions of sex and sexuality, and afforded to her a mediated closeness in the midst of its necessary absence.
For Youth
Authors: Ahn Patty , Cho Michelle , Gonzalez Vernadette Vicuña , Neutill Rani , Nguyen Mimi Thi , Wong Yutian
Published: July 2024

This concluding section discusses the end of BTS’s first era as a group, in their ninth year since debut. In 2022, the group suspended activities as a band and embarked on solo projects prior to enlisting in the military. This transitional moment marks a break that allowed their fandom to reflect, celebrate, and mourn the substantial body of work they had produced. The “Outro” focuses on Yet to Come in Busan (2022), the last live concert BTS held, as well as the nostalgic repackaging of that concert in theatrical cinematic release.
Understanding Barriers to Guideline-Concordant Treatment in Foregut Cancer: From Data to Solutions
Authors: Fonseca Annabelle L. , Ahmad Rida , Amin Krisha , Tripathi Manish , Abdalla Ahmed , Hearld Larry , Bhatia Smita , Heslin Martin J.
Published: July 2024

Background

A large proportion of patients with foregut cancers do not receive guideline-concordant treatment (GCT). This study sought to understand underlying barriers to GCT through a root cause analysis approach.

Methods

A single-institution retrospective review of 498 patients with foregut (gastric, pancreatic, and hepatobiliary) adenocarcinoma from 2018 to 2022 was performed. Guideline-concordant treatment was defined based on National Comprehensive Cancer Network guidelines. The Ishikawa cause and effect model was used to establish main contributing factors to non-GCT.

Results

Overall, 34% did not receive GCT. Root causes of non-GCT included Patient, Physician, Institutional Environment and Broader System-related factors. In decreasing order of frequency, the following contributed to non-GCT: receipt of incomplete therapy (N = 28, 16.5%), deconditioning on chemotherapy (N = 26, 15.3%), delays in care because of patient resource constraints followed by loss to follow-up (N = 19, 11.2%), physician factors (N = 19, 11.2%), no documentation of treatment plan after referral to oncologic expertise (N = 19, 11.2%), loss to follow-up before oncology referral (N = 17, 10%), nonreferral to medical oncologic expertise (N = 16, 9.4%), nonreferral to surgical oncology in patients with resectable disease (N = 15, 8.8%), and complications preventing completion of treatment (N = 11, 6.5%). Non-GCT often was a function of multiple intersecting patient, physician, and institutional factors.

Conclusions

A substantial percentage of patients with foregut cancer do not receive GCT. Solutions that may improve receipt of GCT include development of automated systems to improve patient follow-up; institutional prioritization of resources to enhance staffing; financial counseling and assistance programs; and development and integration of structured prehabilitation programs into cancer treatment pathways.
Interdisciplinary Implementation of a Synoptic Reporting Template for Melanoma Nodal Surveillance Ultrasound
Authors: Montgomery Kelsey B. , Duncan Zoey N. , Holder Ashley M. , Burgan Constantine M. , Galgano Samuel J. , Broman Kristy K.
Published: July 2024

Background

With nodal surveillance increasingly used for sentinel lymph node-positive (SLN+) melanoma following the Second Multicenter Selective Lymphadenectomy Trial (MSLT-II), high-quality nodal ultrasonography (U/S) has become a critical need. Previous work has demonstrated low utilization of MSLT-II U/S criteria to define abnormal lymph nodes requiring intervention or biopsy. To address this gap, an evidence-based synoptic template was designed and implemented in this single-center study.

Methods

Sentinel lymph node-positive patients undergoing nodal surveillance at a tertiary cancer center from July 2017 to June 2023 were identified retrospectively. Ultrasound reporting language was analyzed for MSLT-II criteria reported and clinically actionable recommendations (e.g., normal, abnormal with recommendation for biopsy). Following a multidisciplinary design process, the synoptic template was implemented in January 2023. Postimplementation outcomes were evaluated by using U/S reports and provider surveys.

Results

A total of 337 U/S studies were performed on 94 SLN+ patients, with a median of 3 U/S per patient (range 1–12). Among 42 synoptic-eligible U/S performed postimplementation, 32 U/S (76.0%) were reported synoptically. Significant increases were seen in the number of MSLT-II criteria reported (Pre 0.5 ± 0.8 vs. Post 2.5 ± 1.0, p < 0.001), and clinically actionable recommendations for abnormal findings (Pre 64.0% vs. Post 93.0%, p = 0.04). Nearly all surgeon and radiologist survey respondents were “very” or “completely” satisfied with the clinical utility of the synoptic template (90.0%).

Conclusions

Following implementation of a synoptic template, U/S reports were significantly more likely to document MSLT-II criteria and provide an actionable recommendation, increasing usefulness to providers. Efforts to disseminate this synoptic template to other centers are ongoing.
Surveillance Strategies After Primary Treatment for Patients with Invasive Lobular Carcinoma of the Breast: Method of Local Recurrence Detection After Breast-Conserving Surgery
Authors: Clelland Elle N. , Quirarte Astrid , Rothschild Harriet T. , Kaur Mandeep , Mujir Firdows , Record Helena , Wong Jasmine M. , Mukhtar Rita A.
Published: July 2024

Background

Invasive lobular carcinoma (ILC) is the second most common subtype of breast cancer. Although mammography is known to have low sensitivity for ILC, there are no data to guide the optimal surveillance after treatment. We explored surveillance strategies after breast-conserving surgery (BCS) for ILC and determined the proportion of imaging-detected recurrences versus interval cancers.

Methods

From an institutional database of 813 women, we retrospectively identified patients who underwent BCS for stage I–III ILC and subsequently had a recurrence. We categorized patients by surveillance strategy and determined the modality of recurrence detection. Interval cancer rates for local recurrences were compared across surveillance strategies using the Chi-square test. We evaluated overall survival with the log-rank test and a Cox proportional hazards model.

Results

We included 58 patients with ILC who had a recurrence after BCS. Of these, 22 (37.9%) had local recurrence, 27 (46.6%) had distant recurrence, and 9 (15.5%) had both local and distant recurrence. Most patients underwent routine mammographic surveillance (65.2%), with 19.6% having supplemental breast magnetic resonance imaging (MRI) and 15.2% having no surveillance. The interval cancer rate was significantly higher in the mammographic surveillance group compared with the MRI surveillance group (61.9% vs. 16.7%; p < 0.001).

Conclusion

In this study of patients with recurrence after BCS for primary treatment of stage I–III ILC, we found that most local recurrences were not detected by surveillance mammography. These data support further investigation of supplemental imaging beyond mammography specifically for patients with ILC who undergo BCS.
Not all patients with a headache need a CT scan, but they should be listened to, and also with a stethoscope: a report of a large arteriovenous malformation with a loud cranial bruit
Authors: Matthews Thomas , Salzberg Noah , Thayeswaran Trisheekeshan , Jacobs Nikhil , Colwell Niall S.
Published: July 2024

Background: Arteriovenous malformations (AVMs) are abnormal direct connections between arterial and venous systems, without an interposed capillary bed. This permits high-flow arteriovenous shunting, which precipitates structural changes in the afferent and efferent vessels, namely arterial smooth muscle hyperplasia and thinning of venous walls. Patients with intracranial AVMs typically present with a haemorrhage, headache or seizure. Treatment is either via medical management aimed at control of seizures, headache and blood pressure, or interventional via surgical, radiation or radiologically guided embolisation. Case description: We report the case of a woman in her early 40s presenting with a tonic-clonic seizure against a background of a 31-year history of migraine and an 18-month history of tremors in her right arm. The clinical examination was remarkable for an extremely loud cranial bruit and a right homonymous hemianopia. Imaging diagnosed an 8 cm Martin-Spetzler grade V intracranial arteriovenous malformation in her left parietal lobe, which was deemed unsuitable for operative or radiotherapy-based intervention. Conclusion: The patient was managed through observation and relatively good control of her breakthrough seizures was achieved through the addition of brivaracetam to her lamotrigine and carbamazepine-based therapy, six years after her initial presentation.
Compassion is key to patient safety
Authors: Foster Sam
Published: July 2024

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, describes how compassionate leadership results in engaged and motivated staff, in turn leading to high-quality care
Synthesis, Spectroscopic and Biological Activity Studies of Zinc(II) Complexes of N1,N’4-bis((1E,2E)-2-(hydroxyimino) -1-(4-R)-phenylethylidene) terephthalohydrazide Schiff Base
Authors: Chavan Jotiram Krishna , Patil Raju Maruti
Published: July 2024

In this work, we have synthesized various zinc metal complexes with different acylhydrazoneoxime derivatives. The synthesis process involved condensation of para-substituted isonitrosoacetophenones (4-R-INAP) and terephthalohydrazide (TPHD). To produce these complexes, we reacted zinc chloride with various 4-substituted isonitrosoacetophenone terephthalohydrazide ligands (4-R-INAP-TPHD), where R= -H, -CH3, -OCH3 and -Cl. We employed different physicochemical and spectroscopic methods like elemental analysis, TG-DTA, UV-visible, FTIR, and NMR spectroscopy, electrical conductance, and magnetic susceptibility to analyze the Schiffs base and zinc metal complexes. In addition, we tested the antibacterial activities of these compounds against selected bacteria strains.
Antimicrobial Study of Novel Triazoles Synthesized from Chalcones
Authors: Barat Gaman G. , Solanki Mahesh R.
Published: July 2024

Heterocyclic compound such as quinazoline derivatives shows wide range of medicinal application in the area such as anticonvulsant, antitumor, antifungal, antimalaria, anti-hyperlipidemic and anti-inflammatory etc. activity because of these it shows great interest to study. In the presence study, we have synthesized triazole based quinazolinones by condensation reaction between α-methyl ketone and aromatic aldehydes under ethanol as the solvent to produced chalcones derivatives. This chalcone derivative have α, β-unsaturated part which is enhanced the reactivity of compound. Chalcone further reacted with 2-aminotriazole under alkali media in the presence of ethanol as the solvent to produced quinazolinone. This prepared compound has further possibility to modified at N atom upon reaction with halogen containing compound. Prepared quinazolinone were further treated with cyanuric chloride to increase heterocyclic part in the compound. Characterization of all synthesized product were done using spectroscopic techniques. All prepared compounds were screen for their biological evaluation against gram +ve and gram -ve bacteria.
Elucidating Reaction Mechanism of Gefitinib- An Anticancer Drug by Computational Technique
Authors: Chavan Arun B. , Reddy Sanjeev M. , Chaitanya G. Krishna
Published: July 2024

The present investigation centres on the application of quantum chemistry to clarify the innovative synthetic pathway for Gefitinib derived from methyl 2-isocyano-4,5-dimethoxybenzoate. This pathway encompasses various chemical reactions such as cyclization, halogenation, regioselective demethylation, Williamson's ether synthesis, and nucleophilic aromatic substitution. The reaction necessitates the presence of four intermediate species and yields a total of 11 transition states [TS]. The energies of each reactant, intermediate, and product were determined through the utilisation of density functional theory (DFT) with B3LYP/6-311+G(d) serving as the basis set. The energy diagram that was obtained shows that the new plan that was suggested could follow an easy path to obtaining the product.
The Reading of Deaf Arabic Children in Israel
Authors: Wattad Haneen , Abu-Rabia Salim , Haddad-Shehadeh Sara
Published: July 2024

Abstract: Studies on the reading acquisition of deaf children investigate the similarities and differences in the reading process between these readers and typical hearing readers. There is no consensus on the nature of the reading process among deaf readers, whether they use the same reading processing strategies as typical readers or depend on other strategies to close the gap. The present study aimed to test the types of strategies used to process written words by deaf Arabic readers with prelingual deafness, compared to their hearing peers, and to test the effectiveness of deaf readers' use of these strategies. Three experimental paradigms were tested. The findings indicated that deaf Arabic readers rely on essentially similar processing strategies to those used by hearing readers. However, deaf Arabic readers employ these strategies with significantly less effectiveness. The results are discussed in light of international data.
Mental Health, Parenting Stress, and Parenting Practices of Parents of Deaf or Hard of Hearing Children During the Pandemic
Authors: Coto Jennifer , Galicia Marcela , Sanchez Chrisanda , Sawafta Jenna , Cejas Ivette
Published: July 2024

Abstract: The authors investigated parent mental health during the COVID-19 pandemic and its association with parenting behaviors of parents of children who are deaf or hard of hearing. An electronic survey was distributed to parents ( N = 103). The results showed that they were experiencing elevated anxiety, depression, and symptoms of post-traumatic stress disorder. A combined model demonstrated that parental distress was significantly associated with depression and with parental reports of symptoms indicating significantly higher distress. Parental distress was also significantly associated with parenting strategies: Parents who endorsed positive strategies reported significantly lower levels of distress, while parents who endorsed negative strategies reporting significantly higher levels. It was found that screening protocols to identify parents in need of support are crucial, particularly among the parent population considered in the present study. Additionally, access to mental health services and evidence-based positive parenting programs is essential.
The Role of Bullying and Perceived Racial Discrimination on the Mental Health of Asian American High School Students During the COVID-19 Pandemic
Authors: Wong Tracy
Published: July 2024

Abstract: The COVID-19 pandemic had a devastating impact on the mental health outcomes of high school students in the U.S. Asian American students were additionally confronted with widespread anti-Asian political rhetoric and an increasing escalation of anti-Asian violence. To better understand this phenomenon, this paper employs Asian American critical race theory as a theoretical framework and utilizes data from the U.S. Centers for Disease Control’s 2021 Adolescent Behaviors and Experiences Survey (ABES) and hierarchical regression modeling, to explore the relative impact of ill treatment and key demographics on negative mental health outcomes among Asian American and White high school students. Further, to unpack the unique racial differences, analyses are first performed for these two racial groups combined, and then for each separately. Results indicated that, for Asian American students, being bullied was not a significant predictor of poor mental health, however being treated unfairly at school because of their race or ethnicity was a strong predictor. Moreover, demographic characteristics such as age, grade, and gender were more significantly predictive of poor mental health among Asian American students than their White counterparts. Implications, including structural level interventions to address adolescent mental health in a post-pandemic reality, reflections on Asian American adolescent needs going forward, and future research needs, are discussed.
Internet of Thing (IOT) Based Sensor Technologies and Smart Irrigation System: An Analysis of Critical Success Factors in Emerging Markets
Authors: Mohiuddin Muhammad , Hosseini Elahe , Tajpour Mehdi , Bahman-Zangi Behrooz
Published: July 2024

ABSTRACT: This study explores how smart irrigation systems can be improved by introducing advanced technologies and reducing water consumption to fight climate change. This study aims to identify the factors affecting the success of smart irrigation systems based on the Internet of Things with the mediation of optimal consumption management. This is an applied research employing mixed methodologies (qualitative-quantitative). Initially, the semi-structured interviews were carried out to obtain the effective success factors of the smart irrigation system. Analysis in the qualitative section has been conducted using the Maxqda software. For the quantitative study, a 25-statement questionnaire was applied according to the selected codes obtained with a five-point Likert scale to validate the obtained model. The questionnaire was distributed online in January 2023, and analysis was conducted using SmartPLS3 software. The technical aspects of the questionnaire were assessed using validity and reliability criteria, which can guarantee the precision of the research findings. Construct and content validity were employed in this study to examine the questionnaire’s validity. The researchers employed Cronbach’s alpha coefficient to evaluate the reliability of the measurement instrument. Besides, it can be said that the research instrument has acceptable reliability because obtained Cronbach’s alpha for all variables was greater than 0.70 and the questionnaire’s overall alpha was determined to be 0.810. Furthermore, the t-statistics for all research hypotheses is higher than 1.96 at the 95% confidence level. In this sense, the hypotheses of the research were confirmed. The Internet of Things and will change the nature of activities and services in the market. In fact, for emerging markets, the untapped and growing investment opportunities and the economic leap against the Internet of Things are so enticing and facilitating that it is impossible to resist. and neglecting it will cause irreparable damage to agility. Therefore, the success of the Internet of Things for emerging markets depends on the preconditions of integration of activities carried out by decision-making organizations, facilitation of regulations, and communication and interaction between relevant sectors, which should be considered a priority through cross-sectoral research.
Quantum key distribution in optical fibers: a comprehensive design view of the overall quantum layer beyond transmission
Authors: Pagano Annachiara , Mercinelli Roberto , Valvo Maurizio , Manzalini Antonio
Published: July 2024

This paper reports the network operator point of view about the introduction of quantum key distribution (QKD) in optical networks to secure the data plane and/or specific applications, focusing on the design aspects that go beyond pure transmission. The functional architecture of a quantum key distribution network is depicted focusing on the integration in the existing telecommunications infrastructure. Some use cases of the utilization of the QKD layer, presenting results from in-field demonstrations, are reported together with a technology agnostic numerical model about resource sharing in a metropolitan area network environment.
Critical evaluation of non-uniform optical phased arrays for real-world beam-steering applications
Authors: de Cea Marc , Ram Rajeev J.
Published: July 2024

Optical phased arrays (OPAs) are a promising technology for the realization of fast and compact non-mechanical optical beam steering. While many experimental demonstrations of integrated OPAs exist in the literature, it is challenging to evaluate their suitability for real-world applications due to the lack of system-level performance requirements. Here, we derive such performance requirements for two of the most promising OPA applications - namely free space optical communications (FSOC) and light detection and ranging (LIDAR) - and show that traditional uniformly spaced OPA architectures likely cannot reach the required performance. In response, we propose the use of non-uniformly spaced OPAs, analyze its performance tradeoffs and show that in certain scenarios they can offer superior performance with decreased complexity.
Determination of the nonlinear thermal expansion coefficient of an epoxy used as an expander and its effects over a Fabry-Perot cavity filled with a polymer
Authors: Vargas-Rodriguez Everardo , Guzman-Chavez Ana Dinora , Raja Ibrahim Raja Kamarulzaman
Published: July 2024

In this work, the nonlinear thermal expansion coefficient (TEC) of epoxy clay is determined by means of monitoring the changes induced in the optical thickness of a Fabry-Perot cavity filled with polymer. Here, the epoxy is used to form a long sleeve that holds all elements that form a multilayer interferometric fiber tip filter. Additionally, it is shown that this sleeve acts as an axial strain actuator to change the thickness of a polymer cavity in the order of a few microns. This allows the filter’s spectral fringe pattern to be tuned by several orders of interference, inducing considerable changes in its free spectral range (FSR). Furthermore, it is shown that this filter design has an additional advantage that makes it possible to determine either the TEC or the thermo-optic coefficient (TOC) of another layer material of the filter by using the same measured spectra. Here, as a proof of principle, experimental results of the TEC of silicon were estimated, showing that they are quite close to what was reported in the literature and, therefore, that these can be used for reference purposes. Finally, it is demonstrated that by considering the determined TEC of the epoxy, the overall filter spectrum can be very well modeled, and its main features can be explained for a wide range of temperatures.
Cavity-enhanced dual-comb spectroscopy in the molecular fingerprint region using free-running quantum cascade lasers
Authors: Okumura Mitchio , Markus Charles , Hayden Jakob , Herman Dan , Kocheril Philip , Ober Douglas , Bashiri Termeh , Mangold Markus
Published: July 2024

Cavity-enhanced dual-comb spectroscopy promises broadband, high-resolution, and highly sensitive spectroscopic measurements on sub-millisecond timescales, making it highly attractive for trace gas monitoring.
In this work, we demonstrate cavity-enhanced dual-comb spectroscopy in the molecular fingerprint region using two quantum cascade lasers (QCLs) operating as optical frequency combs centered at 1063 cm^-1 spanning 56 cm^-1. The high-finesse bow-tie cavity provided a 285 m effective pathlength, and the high power-per-mode of the QCL combs granted a strong multi-heterodyne signal of the swept-cavity transmission.
This ultimately resulted in a noise equivalent absorption per spectral element of 1.8×10^-9 cm^-1 Hz^-1/2. Measurements of the ν₈ fundamental band of methanol determined concentrations as low as 1.3 ppm in a single shot, with a detection limit of 20 ppb after 30 averages. This demonstrates the potential of cavity-enhanced dual-comb spectroscopy in challenging applications such as free radical kinetics and environmental monitoring.
Real-time full-duplex transmission experiment for air and underwater invisible light communication system
Authors: Kodama Takahiro , Tanaka Keita , Kariya Ayumu , Kuwahara Kiichiro , Kobori Fumiya , Shimada Keiji , Hayashida Shogo
Published: July 2024

Specifications for highly secure and large-capacity optical transceivers are necessary when wireless communication is used over different transmission channels, such as underwater and air, in shallow sea areas. We evaluated the dynamic characteristics of bidirectional real-time transmission using an LED Backhaul® that can generate and process direct current-added orthogonal frequency division multiplexing signals in the 850 nm band to demonstrate the feasibility of invisibility light communication. A composite channel that is 1.2 m in water and 10 m in the air was used as an optical radio channel. This experiment is the first report on real-time and 4K video stream transmission for a line-of-sight full-duplex optical wireless communication in the invisible light band via heterogeneous transmission channels such as shallow water and air.
“We only trust each other”: A qualitative study exploring the overdose risk environment among persons who inject drugs living with HIV in Nairobi, Kenya
Authors: Maurano Megan , Bukusi David , Masyuko Sarah , Bosire Rose , Gitau Esther , Guthrie Brandon L. , Monroe-Wise Aliza , Musyoki Helgar , Owuor Mercy Apiyo , Sambai Betsy , Sinkele William , Kingston Hanley , Farquhar Carey , Mbogo Loice , Ludwig-Barron Natasha T.
Published: July 2024

In Kenya, overdose remains a major public health concern with approximately 40% of persons who inject drugs (PWID) reporting personal overdoses. PWID living with HIV (PWID-LH) are particularly vulnerable to experiencing fatal and non-fatal overdoses because of the surrounding physical, social, economic, and political environments, which are not fully understood in Kenya. Through qualitative inquiry, this study characterizes Kenya’s overdose risk environment. Participants were purposively recruited from a larger cohort study from September to December 2018 using the following inclusion criteria: HIV-positive, age ≥18 years, injected drugs in the last year, and completed cohort study visits. Semi-structured interviews explored experiences of personal and observed overdoses, including injection settings, sequence of events (e.g., pre-, during, and post-overdose), safety strategies, and treatment. Interviews were transcribed, translated (Swahili to English), reviewed, and analyzed thematically, applying a risk environment framework. Nearly all participants described personal and/or observed overdose experiences (96%) and heroin was the most frequently reported substance (79%). Overdose precursors included increased consumption, polysubstance use, recent incarceration, and rushed injections. There were also indications of female-specific precursors, including violence and accessing prefilled syringes within occupational settings. Overdose safety strategies included avoiding injecting alone, injecting drugs incrementally, assessing drug quality, and avoiding polysubstance use. Basic first-aid techniques and naloxone use were common treatment strategies; however, naloxone awareness was low (25%). Barriers to treatment included social network abandonment, police discrimination, medical stigma, fatalism/religiosity, medical and transportation costs, and limited access to treatment services. In Kenya, the overdose risk environment highlights the need for comprehensive overdose strategies that address the physical, social, economic, and political environments. Morbidity and mortality from overdose among PWID-LH could be reduced through overdose prevention initiatives that support harm reduction education, naloxone awareness, and access, destigmatization of PWID, and reforming punitive policies that criminalize PWID-LH.