bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmaceutical Care in Patients with Side Effects to Oral Antineoplastic Agents: A Case Report
Authors: Alarcon Teresa Chinchilla , Muñoz- Cejudo Belen Maria , Mora- Mora Maria Antonia
Published: October 2024

Background

Chronic myeloid leukaemia (CML) is a haematopoietic stem cell disease characterised by the proliferation of granulocytes and their immature myeloid precursors. The treatments recommended are oral treatments dispensed in the outpatient unit (OU) of the hospital’s pharmacy service (PS), where patient-centred pharmaceutical care (PC) is essential to enhance therapeutic adherence, detect drug interactions and create a pharmacist-patient relationship to educate the patient on the main potential toxicities derived from the treatment and warning signs or symptoms requiring immediate attention.

Methodology

We present the case of a 55-year-old woman, followed up in consultation by the Haematology Service (HS) since October 2021 for CML in the chronic phase.

Results

She started treatment on nilotinib 300 mg every 12 hours. The patient attended OU and was offered PC. After 12 months, nilotinib was well tolerated, but our patient experienced a loss of effectiveness, so HS decided to switch to dasatinib 100 mg daily. After one year of treatment, our patient was presented with symptoms of swelling and dyspnoea on moderate exertion. In January 2024, following a joint Haematology-Pharmacy session, a switch to bosutinib 400 mg daily was decided. After 15 days of treatment, the patient presented without an appointment due to a pruritic generalised rash on the torso, face, and extremities, being diagnosed with leukocytoclastic vasculitis.

Conclusion

In conclusion, we describe case reports of a patient who has a lack of effectiveness and ARs in several TKIs and the importance of identifying side effects, through early and close PC, in order for the patient’s evolution to be favourable.
Fault diagnosis of planetary gearboxes under small and imbalanced samples based on enhanced Siamese network with improved downsampling module
Authors: Zhang Na , Duan Lixiang , Fan Xiaoxuan
Published: October 2024

Due to the limitations of the operating conditions and equipment status, in practice, the normal data for planetary gearboxes are often sufficient, but the fault data are scarce and difficult to obtain, causing the fault diagnosis to face not only an imbalance problem but also a small sample problem. It leads to serious misdiagnosis and poor generalizability. To overcome above challenges, an enhanced Siamese network with improved downsampling module is proposed to reduce the negative impact of small and imbalanced datasets on fault diagnosis. Firstly, the Siamese network is combined with data enhancement to adaptively increase the fault training data with different small sample degrees. It can make the number of training data of each class get rid of small sample, while avoiding the excessive use of scarce fault data causing additional overfitting, so as to improve the generalization of the model. Among them, the data enhancement adopts the extreme noise expansion method proposed in this work, which can quickly generate samples that meet the requirements and help to improve the performance of the model in noisy environments. Secondly, adding the improved downsampling module to the Siamese network. The improved downsampling module introduces density-based spatial clustering of applications with noise (DBSCAN) and distribution ratio calculation, which can consider the distribution range and density of data when selecting. It can not only balance the training data, but also avoid serious information loss, and then reduce the probability of misdiagnosis. Finally, using six imbalanced planetary gearbox datasets with different small sample degrees for verification. The experimental results show that the proposed method can efficiently increase and balance the training data, which greatly improves the accuracy of fault diagnosis under the condition of small and imbalanced samples, especially when the small sample degree is very serious, the accuracy is improved by 57.76% on average.
Child Sexual Abuse and Boundary Violating Behaviors in Youth Serving Organizations: National Prevalence and Distribution by Organizational Type
Authors: Assini-Meytin Luciana C. , McPhail Ian , Sun Yi , Mathews Ben , Kaufman Keith L. , Letourneau Elizabeth J.
Published: October 2024

Many youth serving organizations (YSOs) implement child sexual abuse (CSA) prevention strategies. We examined the potential impact of those strategies by retrospectively estimating the prevalence of CSA and boundary violating behaviors experienced in five broad organizational settings: organized sports, religious organizations, music or arts programs, K-12 schools, and the “Big 6 settings” (i.e., 4-H, Big Brothers Big Sisters of America, Boys and Girls Clubs of America, Boy Scouts of America, Girl Scouts of the USA, and the YMCA of the USA). We compared victimization rates between nationally representative cohorts of younger adults (age 18–22; N = 3174) and slightly older adults (age 32–36, N = 3237). Across all participants and settings, 3.75% ( n = 363) experienced CSA in YSOs. Among survivors, younger adults reported experiencing a lower proportion of CSA within Big 6 settings than older adults (29.1% vs. 44.5%; p < .05), suggesting that prevention efforts may be having the desired effects in Big 6 settings.
A Pilot Feasibility Study of Delivering a Quit & Win Tobacco-Free Contest in Community Mental Health Programs
Authors: Okoli Chizimuzo T. C. , Abufarsakh Bassema , Seng Sarret , Xie Wanqing , McGovern Christy , Arrows Tiffany , Koyagi Emily , Robertson Heather
Published: October 2024

Objective

Quit & Win contests are a community-based tobacco cessation strategy that has demonstrated success in supporting tobacco cessation efforts in the general population. However, such contests have not been implemented and evaluated among people living with mental illnesses (MIs). This pilot study aimed to evaluate the feasibility of implementing Quit & Win contests in terms of program delivery, engagement, and cessation outcomes among people with MIs.

Methods

A single-group posttest design to evaluate the feasibility of Quit & Win contests conducted at three community mental health programs.

Results

Flyers introducing the contest were posted at study sites 2 weeks prior to recruitment. Recruitment occurred on 2 days over a 2-week period. Eligible participants received a pamphlet with information about tobacco treatment resources. At the follow-up, postsurveys and expired CO levels were obtained. Participants ( N = 28) were mostly male, Non-Hispanic White, with a high school or higher education, unemployed, and 46.4% had a primary substance use disorder diagnosis. Among those who engaged in the program, seven (25.0%) returned for the follow-up, of which three (42.9%) successfully stopped cigarette use. Four (57.1%) described using nicotine replacement therapy in their attempt to stop using cigarettes. Challenges to cessation included difficulty finding available tobacco treatment programs, limited access to treatment medications, and experiencing nicotine withdrawal symptoms.

Conclusions

Our findings suggest the feasibility of Quit & Win interventions in community mental health settings. Further efforts are required to enhance recruitment, engagement, and retention, and to support access to community-based tobacco treatment resources.
Dismantling Racism in Research Methods and Practices
Authors: Leong Frederick T. L. , Kalibatseva Zornitsa , Scott Nordia A.
Published: October 2024

Dismantling racism in American psychology has recently emerged as a critical goal of the field accompanied by actionable steps being developed in training, research, and practice. To contribute to this significant undertaking, we offer an exploration of the impact of racism on psychological research methods and practices using the ABC model. First, antecedents to the present manifestation of the problem are identified as an advancement of research topics that supported a hereditary hierarchy based on race, the normalization of White participants as standard in comparative studies, and the use of biased measures to investigate various constructs, particularly as it relates to psychological testing. Second, sampling bias is discussed as a systemic behavior that produces racism in psychological research methods; specifically, issues of omission and commission are described along with the use of WEIRD samples and the role of implicit bias in the limited production of knowledge on people of color. Third, the antecedents and behaviors give way to consequences that include threats to cultural validity, unequal treatment and health disparities, and epistemic oppression in the field. We end with recommendations for avoiding a continuation of the field’s racist legacy in present-day psychology.
Serum and Fecal Metabolite Profiles Linking With Gut Microbiome in Triple-Negative Breast Cancer Patients
Authors: Liu Jiawei , Shi Jing , Zhang Tingting , Chen Mie , Li Zhennan , Lu Cheng , Wang Fengliang
Published: October 2024

Background:

Triple-negative breast cancer (TNBC) is a subtype of breast cancer characterized by poor prognosis due to the absence of effective targeted therapies. Emerging evidence indicates that the gut microbiota and its metabolites play a key role in the occurrence and development of TNBC. This study aimed to explore the metabolic changes and potential mechanisms associated with TNBC.

Objectives:

This study aimed to explore the potential relationship between targeted metabolites and the gut microbiota in TNBC.

Design:

We recruited 8 participants, including 4 with TNBC and 4 with benign fibroadenomas as controls.

Methods:

The gut microbiota was analyzed using metagenomics on fecal samples. Liquid chromatography–mass spectrometry (LC-MS) was employed to identify differential metabolites in serum and fecal samples. The correlation between the gut microbiota and metabolites was analyzed using Spearman’s correlation analysis.

Results:

Analysis of altered serum metabolites in the TNBC group revealed changes, particularly in carboxylic acids and derivatives, benzene, and substituted derivatives. Kyoto Encyclopedia of Genes and Genomes (KEGG) metabolic pathway analysis revealed significant enrichment in 18 pathways. Regarding fecal metabolites, differences between the 2 groups also included carboxylic acids and derivatives, benzene, and substituted derivatives, with 28 metabolic pathways enriched based on KEGG pathway analysis. Metagenomics analysis showed differences in the relative abundance of Anaerococcus, Fischerella, and Schizosaccharomyces at the genus level, which have been previously associated with breast cancer. Furthermore, 4 serum metabolites—L-glutamine, citrate, creatinine, and creatine—along with 9 fecal metabolites, were associated with the aforementioned microbiota.

Conclusion:

Our findings highlight distinct metabolite profiles in the serum and feces of patients with TNBC. The identification of gut microbiota and their associated metabolites provides new insights into the pathophysiological mechanisms underlying TNBC.
Exploring the Impediments: Investigating Barriers to Participation in Phase-2 Cardiac Rehabilitation Following Coronary Artery Bypass Graft Among Thai Patients
Authors: Rangkla Sarissa , Petrutchatachart Tanawat , Vitoonpong Timporn , Rattananupong Thanapoom , Champaiboon Jirapa
Published: October 2024

Background:

Despite the known benefits of cardiac rehabilitation (CR), the rate of participation is low following coronary artery bypass graft (CABG). The reasons for this lack of participation are unclear and there have been few studies investigating this, particularly in Asian countries. The present study aimed to address this lack of information and identify reasons for non-participation in phase-2 CR among patients who underwent CABG.

Methods:

We enrolled 42 patients who underwent CABG or CABG combined with valvular heart surgery in a university hospital between October 2016 to September 2018. Patients who participated in phase-1 but not phase-2 CR were interviewed by phone following an 11-item questionnaire.

Results:

The rate of participation in phase-2 CR was only 12.5%. The most frequently reported reason for non-participation was “Did not know that there was phase-2 CR” (61.9%), followed by “Transportation problems” (31%). “Unable to take leave due to work schedule” was fairly frequently reported (19%) as was “Did not participate due to chronic diseases and complications” (14.3%).

Conclusion:

Our study revealed low participation in phase-2 CR, despite its well-known benefits. The primary reason identified was a lack of awareness and understanding among patients regarding phase-2 CR. This highlights the need for targeted interventions aimed at increasing knowledge and awareness of the benefits and availability of CR. Additionally, it is crucial to establish an efficient referral system that ensures seamless transitions from the initial cardiac treatment to the rehabilitation phase. Implementing these strategies is expected to boost CR participation, leading to improved patient outcomes and overall cardiac health.
Compassion in Italian palliative care: Investigating healthcre professionals’ perspectives using focus groups
Authors: Bovero Andrea , Tos Chiara , Pesce Sara , Pidinchedda Alexa , Botto Rossana , Ostacoli Luca , Malandrone Francesca
Published: October 2024

Compassion, a complex response aimed at alleviating suffering, plays a crucial role in healthcare professionals’ (HCPs) patient care, especially in palliative settings. This study explored compassion in Italian palliative care HCPs using focus groups. A total of 52 palliative care HCPs participated in this study across five focus groups. The transcripts of the discussions were subjected to content analysis. Compassion emerged as “being with someone,” a relational dimension deeply influenced by various factors, including patients, caregivers, work environment, and HCPs themselves. While often perceived as innate, the participants expressed their potential to be nurtured through training and group discussions. Compassion is integral to the HCP-patient relationship, shaped by multifaceted aspects. These findings emphasize the importance of cultivating and enhancing compassion through training and group discussions.
Autistic individuals benefit from gestures during degraded speech comprehension
Authors: Mazzini Sara , Seijdel Noor , Drijvers Linda
Published: October 2024

Meaningful gestures enhance degraded speech comprehension in neurotypical adults, but it is unknown whether this is the case for neurodivergent populations, such as autistic individuals. Previous research demonstrated atypical multisensory and speech-gesture integration in autistic individuals, suggesting that integrating speech and gestures may be more challenging and less beneficial for speech comprehension in adverse listening conditions in comparison to neurotypicals. Conversely, autistic individuals could also benefit from additional cues to comprehend speech in noise, as they encounter difficulties in filtering relevant information from noise. We here investigated whether gestural enhancement of degraded speech comprehension differs for neurotypical ( n = 40, mean age = 24.1) compared to autistic (n = 40, mean age = 26.8) adults. Participants watched videos of an actress uttering a Dutch action verb in clear or degraded speech accompanied with or without a gesture, and completed a free-recall task. Gestural enhancement was observed for both autistic and neurotypical individuals, and did not differ between groups. In contrast to previous literature, our results demonstrate that autistic individuals do benefit from gestures during degraded speech comprehension, similar to neurotypicals. These findings provide relevant insights to improve communication practices with autistic individuals and to develop new interventions for speech comprehension.

Lay Abstract

Our study explored how meaningful hand gestures, alongside spoken words, can help autistic individuals to understand speech, especially when the speech quality is poor, such as when there is a lot of noise around. Previous research has suggested that meaningful hand gestures might be processed differently in autistic individuals, and we therefore expected that these hand gestures might aid them less in understanding speech in adverse listening conditions than for non-autistic people. To this end, we asked participants to watch and listen to videos of a woman uttering a Dutch action verb. In these videos, she either made a meaningful gesture while speaking, or not, and speech was clear, or noisy. The task for participants was to identify the verb in the videos. Contrary to what we expected, we found that both autistic and non-autistic individuals use meaningful information from hand gestures when understanding unclear speech. This means that gestural information can aid in communication, especially when communicative settings are suboptimal.
Self-compassion, mental health, and parenting: Comparing parents of autistic and non-autistic children
Authors: Liang Kaixin , Lai Lam Kelly Ka , Huang Liuyue , Lin Xiuyun , Wang Zhiyong , Liu Honghai , Chi Peilian
Published: October 2024

Parenting stress experienced by parents of autistic children is well-documented. Recent evidence suggests that self-compassion may be a protective factor against parenting stress. However, it’s not clear how self-compassion contributes to better parenting outcomes. This study examined the associations among self-compassion, mental health (ill-being and well-being indicators), and parenting experience (parenting stress and parenting competence) in 178 parents of autistic children and 178 parents of non-autistic children. Results indicated that parents of autistic children had lower levels of self-compassion compared to parents of non-autistic children. In both groups of parents, self-compassion was linked to lower levels of ill-being and high levels of well-being, and directly related to higher levels of parenting competence. In parents of non-autistic children, both ill-being and well-being acted as mediators in the relationships between self-compassion and parenting outcomes. However, in parents of autistic children, only well-being (but not ill-being) mediated the relationships between self-compassion and parenting outcomes. These findings underscore the importance of promoting self-compassion and well-being to enhance parenting experiences for parents of autistic children.

Lay abstract

Parenting can be challenging for any parent, particularly for those parenting autistic children. Research has shown that being kind, accepting, and mindful toward oneself during suffering, a concept known as self-compassion, can help enhance mental health. However, it is not fully understood how self-compassion benefits parenting experiences for parents of autistic children. Therefore, we conducted a study involving 178 parents of autistic children and 178 of autistic children to explore the associations between self-compassion, mental health, and parenting experiences. We found that parents of autistic children reported less self-compassion compared to parents of non-autistic children. For both groups of parents, self-compassion was linked to lower levels of ill-being and parenting stress, as well as higher levels of well-being and parenting competence. In parents of non-autistic children, both ill-being and well-being played a mediating role in the relationship between self-compassion and parenting experiences. However, in parents of autistic children, only well-being was found to mediate this relationship. These findings emphasize the importance of self-compassion and well-being in improving parenting experiences for parents of autistic children.
Securitization of the 2017 Kurdistan independence referendum
Authors: Hama Hawre Hasan , Mamshai Farhad Hassan Abdullah , Mawlood Faruq Abdul
Published: October 2024

The Kurdish right to self-determination within Iraq has consistently been framed as a security issue by successive Iraqi governments. This paper applies securitization theory to analyze the Iraqi Government’s response to the Kurdistan Region’s unilateral independence referendum held on September 25, 2017. The referendum, which resulted in a strong vote in favor of independence, was viewed as a serious threat to Iraq’s unity by Iraqi Arab political and military forces, as well as Turkmen groups. In response, the Iraqi Government chose to take military action. On October 16, 2017, the Iraqi military, along with Popular Mobilization Forces (PM), launched an attack on Kurdish Peshmerga forces in the disputed territories, taking control of them. While many studies have explored various aspects of the Kurdistan referendum, including its timing, motivations, and consequences, there has been limited focus on how the Iraqi federal government’s securitization of the referendum facilitated military interventions in the contested territories. This article explores how Iraqi leaders’ rhetoric and securitizing language framed the referendum as an existential threat.
Barbarians at the Tills? Post-pandemic reflections on violence and abuse against workers in the retail industry
Authors: Bushell Mark , Braithwaite Chelsea
Published: October 2024

The UK retail sector is witnessing substantial increases in violence and abuse towards its customer-facing workers in the post-pandemic era. The costs of this violence to employee wellbeing, local community stability and economic losses to the retail industry are manifold. COVID-19 has been implicated as a central driver in these increases, as the legacy of abuse in retail settings during the pandemic lockdowns continues to affect workers across the sector. This article adopts a series of conceptual tools from critical criminology to argue that rising violence against retail staff cannot be explained by the pandemic alone. Rather, criminology must consider these trends against a background of longer-standing increases in interpersonal violence and rapidly shifting cultural currents under late-neoliberal capitalism. This article also reflects on the hardening of consumer subjectivities and declining deference to mechanisms of authority that continue to manifest under postmodern cultural conditions. These all serve as prominent features in the contextual aetiology of abuse against retail staff and render the possibility of addressing retail violence through deterrence and prevention measures problematic.
Cultural adaptations of the WHO iSupport for dementia: A scoping review
Authors: Sani Tara P , Cheung Gary , Peri Kathy , Yates Susan , Kerse Ngaire , Whaanga Hēmi , Cullum Sarah
Published: October 2024

Introduction

The World Health Organisation (WHO) has developed iSupport for Dementia, a self-paced online training programme for caregivers of people with dementia which is adaptable to different cultural contexts. This scoping review aims to understand the iSupport adaptation process in different countries and provide recommendations for future adaptations.

Methods

A systematic search was done in electronic databases such as Pubmed, MEDLINE, APA PsycINFO, and EMBASE to obtain relevant publications up to 18 February 2024. Only full-text publications describing iSupport cultural adaptation process were included. The publications obtained were reviewed using the Cultural Adaptation Process framework.

Results

Thirteen publications from ten studies were eligible for inclusion. Based on the Cultural Adaptation Process framework, the steps undertaken in the studies were grouped into: (i) setting the stage, (ii) initial adaptation, and (iii) adaptation iterations. The three significant players in this process are the intervention developer (researchers), the cultural adaptation specialist (researchers, caregivers, and dementia care professionals), and the target community (caregivers). In the publications reviewed, cultural adaptation was mostly undertaken using a co-design process between researchers, caregivers, and dementia care professionals deciding on necessary modifications.

Conclusion

iSupport for Dementia is a versatile programme to support caregivers and is readily available for adaptation to different cultural settings. It is essential to engage caregivers early in co-designing its cultural adaptations to ensure their needs can be met by this online tool.
Optimization of jute nonwoven fabric reinforcement for the development of a rigid composite
Authors: Lakshmanan Ammayappan , Chakraborty Sujay
Published: October 2024

An attempt has been made to optimize areal density and number of layers of needle-punched jute nonwoven fabric for the development of a rigid composite with desirable performance properties using Taguchi L9 experimental design. The hand lay-up followed by compression molding protocol was used to prepare composite sheet with jute nonwoven fabric as reinforcement and unsaturated polyester resin as matrix. We evaluated the tensile strength, flexural strength, and volume of reinforcement of the developed composites, and analyzed the data in Minitab 18.0 software to optimize the processing conditions. Results inferred that the areal density of jute fabric reinforcement positively influenced the mechanical properties of the composite sheet, while the number of layers had a negative impact. Statistical analysis revealed that 400 GSM jute nonwoven fabric in three layers could be an optimum condition to develop a rigid composite sheet with the desirable properties of an automobile product.
The Use of Herbal Medicine and Dietary Supplements in Cancer Patients Receiving Immune Checkpoint Inhibitors: A Multicenter Cross-Sectional Study
Authors: Kus Fatih , Can Guven Deniz , Yildirim Hasan Cagri , Akagunduz Baran , Karakaya Serdar , Sutcuoglu Osman , Chalabiyev Elvin , Akyildiz Arif , Koksal Baris , Sahin Yigit Berk , Karaca Ece , Kavruk Oguz Alp , Zor Nefise Tugce , Sirvan Firat , Yazici Ozan , Yalcin Suayib
Published: October 2024

Aims:

This study aimed to assess the habits and knowledge of cancer patients regarding the use of herbal medicines and dietary supplements in cancer patients receiving immune checkpoint inhibitors (ICI).

Methods:

The data of 181 cancer patients who were over 18 years old and received ICIs were collected. The usage patterns, anticipated benefits and harms, and sources of supply were evaluated by filling researcher-prepared forms.

Results:

Most patients did not use any kind of herbal medicine (91.2%) or dietary supplements (75.9%) during their immunotherapy. Boosting the immune system is the primary motivation for use among users. Multivitamins are the most frequently used supplements. Family members and TV advertisements were the main sources of information, in addition to limited advice from healthcare professionals. A minority of participants reported gastrointestinal side effects. Herbal medicine and dietary supplement use were more prevalent among patients with stage IV cancer and renal cell carcinoma (RCC).

Discussion:

This study revealed that the limited uptake of herbal medicines and dietary supplements alongside ICI treatment among cancer patients. The lack of adequate information from healthcare professionals poses potential risks to patients. Improved communication with patients, education regarding herbal medicine and dietary supplement use, potential interactions, and associated risks during ICI treatment are essential. Further research is needed to identify the specific needs of patients, anticipated benefits, and potential harms of herbal medicine and dietary supplement use, together with ICIs.
Comparison of Safety and Efficacy of Aspiration Thrombectomy and Ultrasound Accelerated Thrombolysis for Management of Pulmonary Embolism: A Systematic Review and Meta-Analysis
Authors: Choksi Eshani J. , Sare Antony , Shukla Pratik A. , Kumar Abhishek
Published: October 2024

Purpose

To compare the safety and efficacy of mechanical thrombectomy (MT) and ultrasound-accelerated thrombolysis (USAT) in pulmonary embolism (PE) management by performing a systematic review of the literature.

Materials and Methods

The PubMed database was searched to identify articles on Inari’s FlowTriever and Penumbra’s Indigo mechanical thrombectomy devices (Group A) and the Ekos Endovascular system (Group B). Outcomes variables analyzed include pre- and post-procedure RV/LV ratio, pre- and post-procedure pulmonary artery pressure, hospital length of stay, technical success, specific complications, and mortality rate. Mean values were calculated using the weighted mean approach. RevMan Version 5.4 (Cochrane Collaboration) was used to perform the meta-analysis for this study. Cochrane Collaboration’s Risk of Bias (RoB 2.0) approach was used to perform a quality assessment of the included articles in order to verify the validity and reliability of the research.

Results

27 studies were in Group A and 28 studies pertained to Group B. There were 1662 patients in Group A and 1273 patients in Group B. Both groups had similar technical success (99.6% vs 99.4%). Thrombectomy showed longer mean procedure time (73.03 ± 14.57 min vs 47.35 ± 3.15 min), lower mean blood loss (325.20 ± 69.15 mL vs 423.05 ± 64.95 mL), shorter mean ICU stay (2.35 ± 1.64 days vs 3.22 ± 1.27 days), and shorter mean overall hospital stay (6.94 ± 4.38 days vs 7.23 ± 2.31 days). EKOS showed greater mean change in Miller Index (9.05 ± 3.35 vs 4.91 ± 3.70) and greater mean change in pulmonary artery pressure (14.17 ± 6.35 mmHg vs 8.11 ± 4.39 mmHg).

Conclusion

Ultrasound accelerated thrombolysis and percutaneous mechanical thrombectomy are effective therapies for pulmonary embolism with comparable clinical outcomes.
The Efficacy of Cabazitaxel in Treating Prostate Cancer: A Systematic Review and Meta-Analysis
Authors: Hashim Hashim Talib , Khan Mudassir Ahmad , Shah Safa Irfan , Al-Ghuraibawi Mohammedbaqer Ali , Sulaiman Fatimah Abdullah , Nasrallah Jamil , Maroun Ralph , Hashim Ali Talib , Ahmed Naseer , Merza Zahraa Hamaza
Published: October 2024

Cabazitaxel, a second-generation taxane chemotherapy agent, has demonstrated efficacy in treating metastatic castration-resistant prostate cancer (mCRPC) in patients who have previously received docetaxel-based therapy. By targeting microtubule dynamics, cabazitaxel inhibits cancer cell division and induces apoptosis, thereby extending survival and delaying disease progression in this challenging patient population. A systematic review and meta-analysis were done by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess; OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tools assessment for RCTs. In the analysis, we used RevMan Cochrane software. Our research reveals significantly improved outcomes in terms of patient survival rates, both progression-free survival (PFS) and overall survival (OS), for cabazitaxel over comparative treatment (PFS HR 0.77 [0.61, 0.97]) (OS HR 0.79 [0.70, 0.88]). The treatment response rates were also favorable for cabazitaxel, reported as PSA Reduction Response of more than 50% (PRR) (odds ratio (OR) = 1.59 [0.56, 4.52]) and tumor response rate (TRR) (OR = 2.34 [1.28, 4.28]). Cabazitaxel was associated with significantly more incidence of adverse events. The risk ratio (RR) for serious adverse events was 1.64 [1.14, 2.35] for cabazitaxel compared to the current regimen. A systematic review and meta-analysis were done by searching in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess; OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tools assessment for RCTs. In the analysis, we used RevMan Cochrane software.
The Effect of Patient-Reported Allergies on Patient-Reported Outcomes in Carpal Tunnel Release
Authors: Mitchell Anthony , Martin Sean , Haider Mohammad N. , Kovacs Alexander , Mogerman Jacob , Ablove Robert
Published: October 2024

Background:

Patient-reported allergies have been shown to be a risk factor for poor surgical outcomes in a variety of orthopedic procedures. The relationship between patient-reported allergies and outcomes in carpal tunnel surgery remains unclear.

Methods:

A retrospective electronic medical chart review was conducted on 390 patients who underwent primary carpal tunnel releases, without concomitant procedures, who completed preoperative and postoperative Quick Disabilities of Arm, Shoulder, and Hand or Patient-Rated Wrist Evaluation scores, with a minimum of 1-year follow-up. Patient demographic data and patient-reported outcome measures were collected. Patients were grouped based on the number of allergies reported (≤3 allergies or ≥4 allergies), and statistical analysis was performed.

Results:

Three hundred and ninety patients were included in the analysis (347 patients [89.0%] with ≤3 allergies; 43 patients [11.0%] with ≥4 allergies). Patients were predominantly female (n = 243, 62.3%), and the median age at surgery was 61 years. Patients with ≥4 allergies were more likely to be female (88.4% vs 59.1%), older (64.3 years vs 60.3 years), and more likely to be taking psychotropic medication (51.2% vs 28.2%). No differences were seen in patient-reported outcomes at any time point preoperatively or postoperatively, with both groups showing similar postoperative improvement.

Conclusions:

Patients with a high number of reported allergies have similar improvement in patient-reported outcomes following carpal tunnel release as low-allergy cohorts.
Comparative outcomes of surgical and conservative management in carotid artery dissection
Authors: Feng Yuyao , Zhu Zhan , Shao Jiang , Li Kang , Xie Yiyun , Xie Lizhi , Wang Yuru , Wang Lin , Dai Huanyu , Lai Zhichao , Liu Bao
Published: October 2024

Objectives

Carotid artery dissection (CAD) is a significant cause of strokes in young individuals, leading to severe complications and socioeconomic burdens. Despite antithrombotic therapy being the primary management strategy, optimal treatment for patients with recurrent or worsening symptoms remains undefined. This study aims to describe the characteristics and evaluate the outcomes of conservative versus surgical management in CAD patients.

Methods

A total of 23 patients presenting with CAD from November 2014 to December 2021 were reviewed retrospectively. Patient demographics, vascular risk factors, symptoms, imaging results, treatment details, and follow-up information were collected and analyzed. Propensity score matching (PSM) was utilized to enhance comparability.

Results

The mean age of the patients was 46.4 ± 9.4 years, with a median follow-up of 12 (range 3–90) months. Of the 23 patients reviewed, seven underwent endovascular treatment or open surgery due to unresponsiveness to conservative therapy, while 16 received conservative management. All patients showed regression of symptoms. Surgical patients showed a significant improvement with a 100% patency rate during the follow-up. PS matching adjusted for baseline differences, yielding comparable groups for analysis. No significant difference between treatment approaches was observed in stroke recurrence rates, although surgical intervention showed promising outcomes in symptom resolution and stroke prevention.

Conclusion

Both conservative and surgical management of CAD can lead to favorable outcomes. While conservative therapy remains the initial approach and proves effective, surgery appears beneficial and safe in certain cases unresponsive to conservative treatment. Further investigation through larger prospective and randomized trials is necessary to establish its safety and efficacy.
Stroke severity and outcomes in patients with intracerebral hemorrhage on anticoagulants and antiplatelet agents: An analysis from the Japan Stroke Data Bank
Authors: Arakaki Yoshito , Yoshimura Sohei , Toyoda Kazunori , Sonoda Kazutaka , Wada Shinichi , Nakai Michikazu , Nakahara Jin , Shiozawa Masayuki , Koge Junpei , Ishigami Akiko , Miwa Kaori , Torii-Yoshimura Takako , Miyazaki Junji , Miyamoto Yoshihiro , Minematsu Kazuo , Koga Masatoshi
Published: October 2024

Background and aim:

Some patients with intracerebral hemorrhage are on antithrombotic agents at the time of the event and these may worsen outcome, but the relative risk of different oral anticoagulants and antiplatelet agents is uncertain. We determined associations between pre-onset intake of antithrombotic agents and initial stroke severity, and outcomes, in patients with intracerebral hemorrhage.

Methods:

Patients with intracerebral hemorrhage admitted within 24 h after onset between January 2017 and December 2020 and recruited to the Japan Stroke Data Bank, a hospital-based multicenter prospective registry, were included. Enrolled patients were classified into four groups based on the type of antithrombotic agents being used on admission. The outcomes were the National Institutes of Health Stroke Scale (NIHSS) score on admission and modified Rankin Scale (mRS) of 5–6 at discharge.

Results:

Of a total 9810 patients with intracerebral hemorrhage (4267 females; mean age = 70 ± 15 years), 77.1% were classified into the no-antithrombotic group, 13.2% into the antiplatelet group, 4.0% into the warfarin group, and 5.8% into the direct oral anticoagulant (DOAC) group. Median (interquartile range) NIHSS score on admission was 12 (5–22), 13 (5–26), 15 (5–30), and 13 (6–24), respectively, in the four groups. In multivariable analysis, the prestroke warfarin use was associated with higher NIHSS score (adjusted incidence rate ratio = 1.09 (95% confidence interval (CI) = 1.06–1.13), with the no-antithrombotic group as the reference), but the antiplatelet group (1.00 (95% CI = 0.98–1.02)) and DOAC group (0.98 (95% CI = 0.95–1.01)) were not. The rate of mRS 5–6 at discharge was 30.8%, 41.9%, 48.6%, and 41.5%, respectively, in the four groups. In multivariable analysis, prestroke warfarin use was associated with mRS 5–6 (adjusted odds ratio = 1.90 (95% CI = 1.28–2.81), with the no-antithrombotic group as the reference), but the antiplatelet group (1.12 (95% CI = 0.91–1.37)) and DOAC group (1.25 (95% CI = 0.88–1.77)) were not.

Conclusion:

Patients who were taking warfarin prior to intracerebral hemorrhage onset suffered more severe intracerebral hemorrhage as evidenced by higher admission NIHSS and higher discharge mRS. In contrast, no increase in severity was seen with antiplatelet agents.
Reliability optimization of reliability-redundancy allocation problems based on K-mixed strategy
Authors: Ge Haiyang , Gao Haibo , Li Xin
Published: October 2024

In a reliability-redundancy allocation problem (RRAP), system reliability is maximized by selecting component reliabilities and finding the most suitable redundancy of subsystems. The advantages of a K-mixed strategy were introduced by modeling, so as to better improve system reliability. Compared with other existing redundancy strategies, the performance of a K-mixed strategy was verified using redundancy allocation problems (RAP). In this study, for the first time, a reliability calculation model under the new structure ( [Formula: see text] = 2 and [Formula: see text] = 1) is proposed, and the K-mixed strategy under the new structure is used in the reliability-RAP (RRAP), which is more complex than the RAP and further saves the production cost. In practical optimization, there was a complex decision-making problem to ensure optimal system reliability while minimizing system volume, weight, and cost. Then, this K-mixed strategy was adopted for modeling three benchmark problems in RRAP to seek a better and more flexible system structure. A powerful evolutionary algorithm (NSGA-II) was used to solve the new RRAP model to obtain the best system structure and reliability. The advantages of this model were confirmed by comparison with results from previous reliability optimization studies. The results show that the cost-saving advantages of the new structure in ensuring maximum reliability are significant. All the optimized remaining costs are noticeably higher than those of other methods, with the cost savings of the series-parallel system being the greatest. The difference in remaining costs compared to previous optimizations remains in the tens. Moreover, in more complex systems (Complex bridge system), the advantage in remaining volume is very significant, with the improvement being three times that of the optimization results of other methods.
Association between handgrip strength and small airway disease in patients with stable chronic obstructive pulmonary disease
Authors: Keawon Thanapon , Saiphoklang Narongkorn
Published: October 2024

Background:

Chronic obstructive pulmonary disease (COPD) is associated with airflow limitation resulting from a combination of small airway disease (SAD) and parenchymal destruction. Although various diagnostic methods for SAD exist, access to these tools can be limited.

Objectives:

This study aimed to explore the correlation between handgrip strength (HGS) and SAD in COPD patients.

Design:

Cross-sectional prospective study.

Methods:

HGS was measured using a hand dynamometer. SAD was evaluated using impulse oscillometry, with results reported as the difference between respiratory resistance at 5 and 20 Hz (R5–R20). SAD was defined as R5–R20 ⩾0.07 kPa/L/s. The receiver operator characteristic (ROC) curves, sensitivity, and specificity values were calculated to determine the optimal cutoff value of HGS for predicting SAD.

Results:

Sixty-four patients (90.6% male) were included. The average age was 72.1 ± 8.3 years, and body mass index was 23.4 ± 4.2 kg/m2. FEV1 was 71.6 ± 21.3%, and HGS was 30.2 ± 8.1 kg. R5–R20 was 0.11 ± 0.08 kPa/L/s. SAD was found in 64.1% of patients. A negative correlation between HGS and R5–R20 was observed ( r = −0.332, p = 0.007). The best cutoff value for HGS in detecting SAD was determined to be 28.25 kg, with a sensitivity of 73.9%, specificity of 65.9%, and an area under ROC curve of 0.685 (95% CI 0.550–0.819, p = 0.015).

Conclusion:

SAD is common in COPD patients, and HGS is significantly negatively correlated with SAD. This tool might serve as an alternative or adjunctive assessment for small airway dysfunction in COPD patients.

Registration:

This study was registered with ClinicalTrials.gov with number NCT06223139.
The Deceptive Reassurance of a “Negative” Test – A Difficult Case Highlighting the BioFire© Meningitis/Encephalitis Panel and Medical Heuristics
Authors: Hoang Hai E.
Published: October 2024

Purpose: Neurolisteriosis is a difficult neurologic infectious disease to diagnose. Here, we present a case in which the diagnosis was suspected, but repeated testing for the pathogen was negative. Ultimately the diagnosis was made after the patient iatrogenically worsened.

Results: This prompted an investigation into the widely used diagnostic test, the BioFire© Meningitis/Encephalitis Panel. Although the company reports high sensitivities and specificities for the panel, real world studies have demonstrated insufficient evidence that all 14 pathogens tested on the panel have similar results.

Conclusion: This case is a reminder of the heuristics involved in medicine and how with every medical advancement, clinicians should always go back to the fundamentals of history-taking and physical examinations to ensure no steps have been overlooked in the diagnosis and management of challenging cases.
Exosomal non-coding RNAs: Emerging insights into therapeutic potential and mechanisms in bone healing
Authors: Shi Huixin , Yang Yang , Xing Hao , Jia Jialin , Xiong Wei , Guo Shu , Yang Shude
Published: October 2024

Exosomes are nano-sized extracellular vesicles (EVs) released by diverse types of cells, which affect the functions of targeted cells by transporting bioactive substances. As the main component of exosomes, non-coding RNA (ncRNA) is demonstrated to impact multiple pathways participating in bone healing. Herein, this review first introduces the biogenesis and secretion of exosomes, and elucidates the role of the main cargo in exosomes, ncRNAs, in mediating intercellular communication. Subsequently, the potential molecular mechanism of exosomes accelerating bone healing is elucidated from the following four aspects: macrophage polarization, vascularization, osteogenesis and osteoclastogenesis. Then, we systematically introduce construction strategies based on modified exosomes in bone regeneration field. Finally, the clinical trials of exosomes for bone healing and the challenges of exosome-based therapies in the biomedical field are briefly introduced, providing solid theoretical frameworks and optimization methods for the clinical application of exosomes in orthopedics.
The biomechanical principles of restoring a dentition with dental implants: A General Dental Practitioner’s perspective
Authors: Nandra Anoup , Dattani Shushil , Aminian Amin
Published: October 2024

Dental implants continue to increase in popularity as a method of replacing missing or failing teeth and, in doing so, this increased prevalence is likely to present as a range of scenarios for the general dental practitioner and dental hygienist, whether they have an interest in the field or not. Many of these scenarios will relate to the restorative and post-treatment phases of treatment, where the biomechanical performance of the restoration will need to be understood by the treating clinician in the primary care setting. This article aims to highlight the unique biomechanical nature of dental implant restorations, the differences between a natural tooth held by periodontal ligament fibres and a dental implant ankylosed to bone, the consideration of restoring a natural tooth opposing a dental implant, and the long-term effect of changes in the occlusion and their impact on previously placed dental implant restorations.
Developing implant mentoring programmes: breaking down the components
Authors: Pal Abhijit , George Pynadath
Published: October 2024

Mentoring has been identified as a key component of training in implant dentistry. However there has been little guidance about how this should take place, the expected outcomes, who should be providing mentoring, and the processes involved. Dentists are required to ensure they are appropriately trained, competent and confident when undertaking clinical tasks. Mentoring will play a key role in giving assurance that these are in place. This article, which is partly based on the College of General Dentistry publication Mentoring in Implant Dentistry: Good Practice Guidelines, provides background and context to the role of mentoring in implant dentistry training programmes. Key components of structured mentoring programmes are described to assist mentors, mentees, and implant education providers.
Dental Nursing in implant dentistry: a skillset apart and how to get there
Authors: Brand Michelle , Culley Nicola
Published: October 2024

The role of the dental nurse is fundamental in the provision of implant treatment, both from a surgical and restorative aspect. While the restoration of an implant can be largely based on the foundation knowledge of restorative dentistry, the surgical stages require a unique skillset. This article aims to highlight the benefits of undertaking further training for the dental nurse in providing surgical support, the skillset needed, and the pathways for achieving career progression.
Initial Development and Validation of the School Counselor 504 Activities Scale
Authors: Boulden Rawn , Goodman-Scott Emily
Published: October 2024

The purpose of this study was to develop and validate the School Counselor 504 Activities Scale, a practical tool to assess how often school counselors engage in various ASCA recommended and non-recommended duties. Utilizing a sample of 379 practicing school counselors, this process resulted in two subscales: (a) Collaboration, Advocacy, and Development and (b) Consultation, Clerical, and Administrative Tasks. This instrument can serve as a vital resource to support school counselors’ role congruence and advocacy efforts specific to Section 504 involvement. We describe implications for preparation and practice, and discuss limitations and future directions for research.