bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-protect or revenge? Disabled employees’ psychological and behavioral responses to workplace ostracism: The role of belief in a just world
Authors: Wang Rong , Zhang Yue , Jiang Jiang
Published: July 2024

People with disabilities often encounter numerous obstacles in securing and maintaining employment, as well as achieving success in their professional roles. This study initially examined how workplace ostracism influenced self-views and workplace behaviors of disabled employees. More importantly, using belief in a just-world theory as the overarching framework, we further explored whether these linkages were contingent on personal belief in a just world (BJW), which was considered to be a personal contract between the individual and the social world (i.e., the world is fair to me). A total of 1,605 Chinese employees with different categories and degrees of disabilities were invited to participate in an online survey. The results showed that self-esteem partially mediated the relationship between workplace ostracism and workplace deviance. Specifically, workplace ostracism had a detrimental effect on the self-esteem of disabled employees, subsequently leading to engagement in deviant behaviors at work. Furthermore, personal BJW played a moderating role in the links between ostracism, self-esteem, and deviance. When employees with disabilities held stronger BJW, they tended to experience more significant adverse effects of workplace ostracism, resulting in lower self-esteem and increased deviant behaviors. Supporting a first-stage moderated mediation model, the indirect effect of workplace ostracism on deviance through self-esteem was contingent on BJW. This indirect effect was more pronounced when participants exhibited higher levels of BJW. Our findings highlight the importance of fair treatment and the meaningfulness of personal BJW by uncovering diverse response patterns to workplace ostracism among employees with disabilities with varying levels of BJW.
Hidradenocarcinoma in a Crohn’s patient on ustekinumab: A case report
Authors: Alizadeh Madeline , Zisman Erin , Wong Uni
Published: July 2024

Hidradenocarcinoma is a locally aggressive malignancy of the sweat glands, most commonly found on the head, neck, and upper body. Although rare, it has been seen in patients with hidradenitis supparativa, who have an increased risk of non-melanoma skin cancers. Ustekinumab, a biologic agent used to treat inflammatory bowel disease, has been associated with development of cancer in some patients. We present a case of a 36-year-old female with hidradenitis supparativa and Crohn’s disease who developed hidradenocarcinoma in setting of ustekinumab use, demonstrating the need for further study of the relationship between biologic therapy and malignancy.
Successful treatment of severe and recurrent hand eczema with infection in human immunodeficiency virus patients: A case report
Authors: Chen Dongmei , Liu Wei , Li Yanxi
Published: July 2024

Hand eczema is a common allergic disease characterized by a chronic relapsing course with a 15% lifetime prevalence. Human immunodeficiency virus-infected individuals have a higher risk of Staphylococcus aureus infection which is associated with the severity of hand eczema. Incidences of allergic diseases including hand eczema and chronic itch are higher in patients with human immunodeficiency virus. Pruritus is one of the most common symptoms in hand eczema, sometimes intractable pruritus provokes repeated scratching, picking, disfigurement, and can even worsen the lesion. Currently, there is no ideal treatment for hand eczema, the treatment of hand eczema in human immunodeficiency virus patients is even more difficult. Here, we present a case of recurrent and therapy-resistant hand eczema patients combined with Staphylococcus aureus infection, human immunodeficiency virus infection was better improved by being treated with topical ozone therapy.
Atypical hepatic metastases of pancreatic adenocarcinoma unveiled through persistent and unresolved pyrexia: Case report
Authors: Nirmal Chamod , Jayarajah Umesh , Wijesinghe Harshima , Fernandopulle Nilesh , Subasinghe Duminda
Published: July 2024

Diagnosing neoplastic fever requires excluding identifiable causes, making it a diagnostic challenge. Fever as a primary manifestation of pancreatic adenocarcinoma is uncommon with few cases reported in the literature. Here we present an unusual case of metastatic pancreatic adenocarcinoma primarily manifesting as pyrexia of unknown origin. A 63-year-old Sri Lankan male, a non-smoker who was diagnosed with diabetes, hypertension and dyslipidaemia presented with a history of fever, anorexia and weight loss for 2 months. Despite the completion of treatment for positive serology for paratyphi, his symptoms and inflammatory markers remained elevated while the rest of the infectious screening was negative. On further evaluation, the patient was found to have a hypodense distal pancreas with ring-enhancing multiple liver lesions on imaging. Histology confirmed pancreatic adenocarcinoma with liver metastasis. Atypical liver metastases may present with evidence of ring enhancement in computed tomography imaging; thus, the biopsy is mandatory for diagnosis and decision-making. Usually, tumours of the pancreatic tail are resectable but if they are associated with liver metastatic disease, surgical resection is not recommended because it is not potentially curative. Therefore, in the context of metastatic pancreatic adenocarcinoma, palliative chemotherapy and pharmacological management of fever are required.
Atypical presentation of pellagra with black urine: A clinical conundrum
Authors: Munagama Chathuri Lakna , Silva Shehan
Published: July 2024

Niacin (Vitamin B3) plays a crucial role as a vitamin in cellular energy production, metabolism, and DNA repair. A severe deficiency of this vitamin can lead to pellagra, which is characterized by dermatitis, dementia, diarrhoea and eventually death if untreated. A 68-year-old woman with a poor socioeconomic background presented with photosensitive dermatitis, fever, abdominal pain, and diarrhoea. Her urine changed to port wine colour following sun exposure. Porphyria cutanea tarda was excluded in the absence of demonstrable urine spectrophotometry. A diagnosis of pellagra was made, and timely management led to a complete cure. Proper diagnosis and effective treatment of pellagra are imperative as this condition can be life-threatening if left untreated.
Lifelog-based daily step counts, walking speed, and metabolically healthy status
Authors: Lim Ga-Young , Park Eunkyo , Song Ji-Young , Kwon Ria , Kang Jeonggyu , Cho Yoosun , Jung Se Young , Chang Yoosoo , Ryu Seungho
Published: July 2024

Objective

Optimal metabolically healthy status is important to prevent various chronic diseases. This study investigated the association between lifelog-derived physical activity and metabolically healthy status.

Methods

This cross-sectional study included 51 Korean adults aged 30–40 years with no history of chronic diseases. Physical activity data were obtained by the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Lifelog-derived physical activity was defined by step counts and walking speed for 1 week, as recorded by the Samsung Health application on both the Samsung Galaxy Fit2 and mobile phones. Participants without metabolic syndrome components were categorized as the metabolically healthy group ( n = 31) and the remaining participants as the metabolically unhealthy group ( n = 20). Prevalence ratios and 95% confidence intervals were estimated using Poisson regression models. The predictive ability of each physical activity measure was evaluated according to the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) values.

Results

Among the physical activity measures, lifelog-derived walking speed was significantly inversely associated with prevalent metabolically unhealthy status. The lifelog component model including walking speed, age, and sex had the highest AUC value for metabolically unhealthy status. Adding lifelog-derived step counts to the IPAQ-SF-derived metabolic equivalent (MET) model (including age, sex, and IPAQ-SF-METs) yielded 37% and 13% increases in the NRI and IDI values, respectively. Incorporating walking speed into the IPAQ-SF-derived MET model improved metabolically unhealthy status prediction by 42% and 21% in the NRI and IDI analyses, respectively.

Conclusions

Slow walking speed derived from the lifelog was associated with a higher prevalence of metabolically unhealthy status. Lifelog-derived physical activity information may aid in identifying individuals with metabolic abnormalities.
Chronic Cellulitis in the Unhoused: Case Study and Treatment Considerations
Authors: Klamen Amelia , Bryce Richard , Martin Symone , Benchell Eisman Eli
Published: July 2024

This report seeks to discuss sequelae of chronic cellulitis that is commonly treated in the ambulatory setting, as exacerbated by the conditions of living outside. Further we hope to identify etiologic factors that contribute to complication development. Additionally, this article will touch on unique treatment plan considerations for unhoused patients with the intention to educate providers and reduce mortality and morbidity relating to pedal skin and soft tissue infections in this population. This piece examines the case of a 52-year-old man with a history of chronic diseases, substance use disorder, and recurrent cellulitis. We highlight systemic issues in healthcare delivery for unhoused patients, including inadequate discharge planning, limited access to medication, and challenges in shelter placement. The discussion section emphasizes the importance of accurate diagnosis and tailored treatment plans for cellulitis in houseless individuals, the importance of a multidisciplinary approach incorporating social work services, and addressing chronic illnesses, substance use disorder, and housing issues. The report advocates for heightened awareness of bilateral cellulitis in unhoused populations, emphasizing the need for comprehensive, individualized treatment plans.
The Importance of Network Intentionality: Examining Predictors of Interagency Collaboration for Secondary Special Educators
Authors: Bumble Jennifer L. , Raley Sheida K. , Biggs Elizabeth E. , Sanderson Kelli A. , Dean Evan E. , Shogren Karrie A.
Published: July 2024

Interagency collaboration (IAC) is mandated by federal legislation and is a well-established best practice in the transition literature. At the same time, there is limited research that examines the predictors of greater IAC, and the breadth of partners that secondary special educators collaborate with across school systems, service systems, and communities to support the transition process. Using a quantitative survey of 376 secondary special educators in a Midwestern state, we examined their IAC practices by documenting the characteristics of their social networks (i.e., diversity, communication patterns, and supports exchanged). Furthermore, we examined which malleable factors including network intentionality, collaboration self-efficacy, innovative action, and access to transition-focused professional development were associated with greater IAC. These findings provide a deeper portrait of transition-focused IAC and have implications for special educators and teacher preparation programs.
Reliability of Angle Measurements Based on the Epiphyseal Scar for Knee Osteotomy: An International Multicenter Radiographic Study
Authors: Schippers Philipp , Peras Matthieu , de Geofroy Bernard , Drees Philipp , Gercek Erol , Junker Marius , Micicoi Lolita , Gonzalez Jean-François , Micicoi Grégoire
Published: July 2024

Background:

The proximal tibial epiphyseal inclination can be used as a prognostic factor for good results after knee osteotomy and measured using the tibial bone varus angle (TBVA). This angle depends on the visibility of the epiphyseal plate, which has shown poor reproducibility when measured on standard radiographs by conventional methods.

Purpose:

To evaluate the measurement reliability of the TBVA and other angles based on the epiphyseal scar using a digital image display.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

A total of 100 whole-leg radiographs were analyzed twice by 3 orthopaedic surgeons from 2 countries in a blinded and randomized manner. Observers measured the hip-knee-ankle angle, mechanical lateral distal femoral angle, medial proximal tibial angle, and TBVA. The growth plate–tibial plateau (GPTP) angle, defined as the angle between the epiphyseal scar and tibial plateau, was measured; this angle has not yet been described for osteotomy. In addition, a modified version of the TBVA (mTBVA), defined as that between the epiphyseal scar, its center, and the center of the talus, was measured. The Ahlbäck score for osteoarthritis and a 3-grade score for epiphyseal scar visibility were also determined. The reliability of the angle measurements and scoring was evaluated using the Fleiss kappa and intraclass correlation coefficient (ICC).

Results:

The scores for epiphyseal scar visibility showed fair interobserver (Fleiss kappa correlation coefficient [κ] = 0.29-0.35) and strong intraobserver (Fleiss κ = 0.62-0.69) reliability. TBVA, GPTP angle, and mTBVA measurements showed good interobserver reliability (ICC, 0.76-0.77), while the GPTP angle achieved excellent intraobserver reliability (ICC, >0.9).

Conclusion:

Using digital image display, angles that depend on the epiphyseal scar—such as TBVA, GPTP angle, and mTBVA—can achieve acceptable measurement reliability despite the low agreement on the visibility of the epiphyseal scar.
Talent Selection Under Uncertainty: Exploring Cognitive Biases Through the Lens of a Professional Basketball Entry Draft
Authors: Fiset John
Published: July 2024

Every year, professional basketball franchises convene for an entry draft to select the next generation of talent for their respective teams. This article describes an experiential exercise that places students in the role of team executives of a fictionalized professional basketball franchise. Students are tasked with evaluating a group of draft-eligible athletes and making the optimal selection for their team, considering a wide array of skills, abilities, and attributes. The Basketball Draft Night Exercise is informed by extensive research on sport entry drafts spanning several decades and sheds light on the systematic errors, fallacies, and decision-making biases that arise when making talent selections under uncertainty. Furthermore, this exercise illuminates the potential pitfalls and cognitive errors committed by experts when assessing and selecting talent under uncertainty.
Cognitive Behavioral Therapy in the Management Classroom: An Experiential Exercise to Improve Oral Communication
Authors: Sigdyal Pratigya , Paris Lori , Rodriguez Marvin Molina
Published: July 2024

Oral communication is a critical skill for business students. This article presents a 100-minute experiential exercise that utilizes cognitive behavioral therapy principles to enhance in-class discussion and presentation skills. It enables students to engage in self or group reflection and identify the thoughts, emotions, and behavior tendencies that influence their performance in oral interactions. An essential aspect of the exercise is to help students recognize and address “thinking traps,” which are counterproductive thought patterns that negatively impact their emotions and behaviors related to oral communication. The exercise concludes with goal-setting strategies to develop agency over oral communication skill development, equipping students to tackle the demands of college-level communication and skills required in their careers. While this exercise has been designed for integration into any undergraduate course that prioritizes classroom discussions and presentations, this exercise can be particularly beneficial for first-year students transitioning to college.
Effect of iron bearing minerals on iron ore processing
Authors: Ostadrahimi Mahdi , Farrokhpay Saeed , Karimnejad Khodayar , Karimi Mohammad Reza , Sadeghi Morteza
Published: July 2024

In the current study, elemental analysis and microscopic investigations were conducted to characterize the minerals present in an iron ore sample. The iron content was below 24%, with the dominant iron-bearing minerals being hematite and magnetite. Consequently, gravity and magnetic separation methods were employed to enhance the iron content. However, the processing results less than what was expecting due to incomplete sample characterization. The sample was further analyzed using quantitative X-ray diffraction analysis. This more comprehensive examination revealed additional iron-bearing minerals as goethite, ankerite, and limonite. The behavior of these minerals likely contributed to the unsuccessful separation process which was thoroughly explored in this article. Understanding the mineralogical composition of iron ores is paramount for optimizing processing operations and achieving successful outcomes.
Provenance and tectonic setting of greywacke and siltstone of the Nampala gold deposit, Southern Mali
Authors: Konate Sory I.M. , Bolarinwa Anthony T. , Kwayisi Daniel , Kazapoe Raymond Webrah , Traore Elhadji Mory , N'Tcha Daniel Kouagou N'Dah , Bouare Mamadou L.
Published: July 2024

The petrographical and geochemical analyses of greywacke and siltstone samples from the Nampala gold deposit of the Paleoproterozoic Birimian supergroup, Southern Mali, have been carried out to make inferences on the provenance, tectonic settings, and weathering history of the sediments. Petrographical investigations revealed that greywackes can be classified as feldspathic wackes, with immature to moderately mature sediments, with the siltstones being immature. Geochemically, greywackes show features that resemble typical wacke sedimentary rocks, whereas the siltstones are arkose to litharenite. Overall, Nampala sedimentary rocks experienced low intensity of paleoweathering with <70 CIA and <90 CIW values and have not undergone significant sediment recycling having >1 CIV values. Their quartz and feldspar contents, together with the ratio of Al2O3/TiO2 and La/Sc, suggest the derivation of sediments from felsic igneous rocks, with a possible minor contribution from mafic proto-source rock. The petrographic and geochemical features of the greywackes and siltstones are consistent with siliciclastic rocks formed in an active continental margin, similar to other sedimentary rocks of the Paleoproterozoic Birimian terrane. These findings put positive constraints on the subduction-accretion geodynamic model proposed for the evolution of the Birimian terrane of the West African Craton.
Safeguarding Accuracy: The Impact of Interventions on Reducing Blood Culture Contamination
Authors: Adnan Fareeha , Khursheed Nazia , Khan Moiz Ahmed , Parveen Nazia
Published: July 2024

Introduction:

Blood culture is the gold standard for diagnosing bacteremia and direct the physicians to select appropriate antimicrobials. In hospitals, blood culture contamination (BCC) is a common problem that has a detrimental effect on patient outcomes. Hence, we implemented strategies in our tertiary care setup, for training phlebotomists and nurses in proper blood sampling techniques, and assessed their effectiveness in reducing BCC rates.

Methods:

This interventional study was conducted at the Indus Hospital, Karachi, Pakistan from 1st January 2021 to 30th June 2023. All blood cultures received from different departments of the hospital were included. The 2.5-year study period was divided into pre-intervention and intervention periods, with monthly monitoring of BCC. The BCC data between 1st January 2021 and 31st December 2021 was taken as the baseline pre-intervention period and the next 1.5 years comprised the intervention period (1st January 2022-30th June 2023). To improve compliance, various strategies were implemented, such as regular training sessions, didactic sessions, and re-competencies.

Results:

A total of 86 774 Blood cultures were received from all departments of the hospital, out of which n = 30 672 were received in the pre-intervention period whereas, n = 56 102 were received in the intervention period. Mean BCC rate in the pre-intervention period was found to be 4.6%. However, after the implementation of different measures to reduce BCC, the contamination rate decreased to a mean of 3.1% by the end of the intervention period. Emergency department accounted for the highest proportion of BCC in the pre-intervention and intervention periods.

Conclusion:

We decreased BCC in our tertiary care setup by implementing a simple and inexpensive collaborative intervention, and came to the conclusion that the higher incidence of BCC was probably caused by factors unique to the emergency department and provided measures to successfully address them.
Actually existing smart forests: A proposal for pluralizing eco-technical worlds
Authors: Gabrys Jennifer , Westerlaken Michelle , Fatimah Yuti Ariani
Published: July 2024

The “actually existing smart city” is a familiar figure and concept within smart environments research. Usually, “actually existing” analyses challenge the often-hyperbolic proposals for smart cities by grounding research in built urban conditions. Cities are not exemplars of digital interconnectivity and seamless functioning, many smart cities researchers note. Instead, they are complicated sites of uneven urban development. Such research places speculative urban visions in contrast with empirical conditions to reflect upon and re-evaluate smart city proposals as they hit the ground. Building on this critical research, this article considers how smart environments are proliferating beyond cities to other milieus, including forests. By first reviewing “actually existing” smart cities literature along with “actually existing” references in social and political theory, we consider how to update and advance the “actually existing” analytic by revisiting the perceived rift between speculative and actual environments. Drawing on interviews with smart forest stakeholders, the second part of the article develops three examples of “actually existing” smart forests that demonstrate how inseparable the envisioning, making, and sustaining of smart environments can be. Even more than empirical conditions counteracting fantastical visions, we propose the “actually existing” analytic can be updated and mobilized to examine how plurality, contestation, and democratic participation are at stake not just in the lived conditions of smart environments but also in the abstract and provisional contours of computational technologies as they shape and transform milieus. We suggest that engagement with the plurality of speculations, material conditions, and practices is crucial for ensuring “actually existing” eco-technical worlds and relations are attuned to equity and environmental flourishing.
A Rare Case of Massive Juvenile Ossifying Fibroma Requiring Total Maxillectomy and Craniofacial Reconstruction
Authors: Bercu Caleb H. , Wo Luccie M. , Moon Savannah L. , Brathwaite Carole , Perlyn Chad A. , Steinberg Jordan P.
Published: July 2024

Trabecular juvenile ossifying fibromas (JTOFs) are uncommon aggressive benign neoplasms frequently involving the maxilla. Reports of JTOFs involving the entire maxilla in children 5 years or younger are exceptionally rare. Although various treatment options for maxillary reconstruction exist, there is no consensus on best practices following JOF resection. In this case study, we present a young girl with an extensive JTOF managed with a single-stage total maxillectomy and reconstruction utilizing split calvarial bone grafting and bilateral temporalis muscle flaps.
A comparative analysis of congruent triangle units in textbooks from China and the United States
Authors: Lo Jane-Jane , Zhou Lili , Liu Jinqing
Published: July 2024

In this article, we report findings from a comparative study of the introduction and development of triangle congruence in two textbooks: a high school geometry textbook from the United States and an eighth-grade mathematics textbook from China. Using the mathematics curriculum as a story (MCS) framework developed by Dietiker and additional coding schemes, we illustrate how each textbook designs its congruent triangle lessons with the goal to provide students a fertile ground for the development of geometry reasoning and proof. Through the analysis of the characters, actions, settings, and plots of each story, we identify both similarities and differences. Both textbooks introduced the same sets of side–angle criteria that proved the existence of the unique triangle as well as that did not support a unique triangle. Yet, the U.S. textbooks introduced side–angle–side first while the Chinese textbooks started with side–side–side. In addition, the findings demonstrate the illuminating power of the MCS framework to fill the gap of current textbook analysis research.
Spatial repertoires of power in the production of mining territories in northern Cauca, Colombia: Between imposition and negotiation
Authors: Welter Zabrina , Rojas Axel
Published: July 2024

Territorial conflicts driven by the expansion of various forms of mining have escalated in the Global South. This article builds on the concept of territorialization, which often highlights the control of sociogeographical spaces by powerful through legal and coercive strategies. While existing literature addresses these power dynamics and resistance by less powerful actors, there is a gap in exploring the microscalar interactions that shape these territorial struggles. This study, based on ethnographic interviews and participant observation in the Afro-Colombian territories of the Quinamayó river basin, contributes to critical scholarship by decoupling the logic of territorialization from a top-down domination approach, emphasizing instead the everyday interactions and power relations that underpin territorial control. We explore the production of new mining territorialities from a quotidian and relational perspective, focusing on spatial repertoires of power, or a range of power strategies and relations that update extractive geographies in time. We find that territorial appropriation is defined and transformed through everyday moments of imposition and negotiation between multiple actors with different degrees of power. This microscale perspective deepens the understanding of territorial production, showing how daily interactions transform people’s connection to the territory, and highlighting the context-specific, agency-driven nature of these processes.
Facilitators and barriers in acceptance of telemedicine among healthcare providers in Pakistan: A cross-sectional survey
Authors: Wasi Abbas Muhammad , Nawaz Tahir Hasan , Jaffar Nazish , Raza Ghana , Aman Ali Syed , Jabeen Rawshan
Published: July 2024

Objectives:

This study aimed to assess healthcare professionals’ awareness and acceptance of telemedicine residing in Pakistan.

Materials and Methods:

A cross-sectional study was conducted across Pakistan from November 2021 to March 2022. Data entry was done through a self-administered questionnaire. In this survey, the non-probability purposive sampling method was adopted. Medical doctors from all specialties that fall into the age category of 20–60 years were included in this study. Statistical Package for Social Sciences (SPSS) version 22.0 was used for univariate data analysis.

Results:

Among the 860 healthcare professionals who received the survey, 198 responded (23.0% response rate). The mean ± SD age of the participants was 31.16 ± 8.56. The results were found to be statistically significant for knowledge about telemedicine among healthcare professionals workplace, that is, healthcare professionals working in the private sector indicated a high level of awareness regarding telemedicine as compared to those in the public sector ( p = 0.03). A significant difference ( p-value ⩽ 0.05) in knowledge was seen among doctors working in the public sector and those working in a private setup. Results indicate significant positive associations between telemedicine utilization and perceived benefits over disadvantages ( β = 1.03, p = 0.017), reliance among healthcare professionals (β = 1.22, p = 0.008), and enhancement in healthcare quality ( β = 1.42, p = 0.001). Moreover, familiarity with telemedicine correlates strongly with its usage ( β = 2.56, p < 0.000).

Conclusion:

Overall, healthcare professionals exhibited satisfactory knowledge regarding telemedicine and showed an accepting attitude toward telemedicine. Our study recommends enhancing the importance of Telemedicine training at the Healthcare professionals’ level to produce quality service delivery in healthcare organizations.
Quality of antiretroviral, antimalarial and antituberculosis medicines in Zambia: Findings of routine post-marketing surveillance
Authors: Jere Elimas , Munkombwe Derrick , Mukosha Moses , Mudenda Steward , Kalungia Aubrey Chichonyi , Chabalenge Billy
Published: July 2024

Background:

There is growing concern in sub-Saharan Africa that poor-quality antimicrobial medicines may negate management of infectious diseases of public health importance should they fail to meet the set criteria of quality, safety and efficacy.

Objectives:

The objective was to ascertain the quality of antiretroviral, antimalarial and antituberculosis medicines supplied and available in the public health sector in Zambia.

Design:

A descriptive cross-sectional study was conducted involving the analysis of data from the continuous routine in-country post-marketing surveillance programme in Zambia that assessed the quality of antiretroviral, antimalarial and antituberculosis medicines supplied to public healthcare facilities between January 2018 and June 2023.

Methods:

Data were extracted from laboratory quality analysis results from samples collected as part of routine post-marketing surveillance by the Zambia Medicines Regulatory Authority between January 2018 and June 2023. The samples were collected from various levels of the pharmaceutical supply chain across Zambia. Samples were analysed according to their respective pharmacopoeia standards at the Medicines Control Authority of Zimbabwe Quality Control Laboratory, a World Health Organization prequalified laboratory. Data were extracted using a structured Excel database and analysed using Microsoft Excel, and GraphPad Prism Software was used for visualizations.

Results:

Of the 198 samples, 86 (43.43%) were antiretrovirals, 54 (27.27%) antimalarials and 58 (29.29%) antituberculosis medicines. Of these 198 samples, 171 (86.36%) originated from Asia, 19 (9.60%) Africa and 8 (4.04%) Europe. All sampled medicines met their respective quality specifications with respect to tests, which included appearance, identification, assay, uniformity of mass, weight variation, disintegration, dissolution, pH and specific gravity, giving a compliance rate of 100%.

Conclusion:

Antiretrovirals, antimalarials and antituberculosis medicines obtained from public healthcare facilities in Zambia through routine post-marketing surveillance met their quality standards. This might positively impact treatment outcomes for HIV/AIDS, malaria and tuberculosis. There is a need for large-scale continuous monitoring of the quality of medicines in order to ensure quality is maintained and substandard products removed from the pharmaceutical supply chain.
Multi-parametric MRI-based machine learning model for prediction of pathological grade of renal injury in a rat kidney cold ischemia-reperfusion injury model
Authors: Chen Lihua , Ren Yan , Yuan Yizhong , Xu Jipan , Wen Baole , Xie Shuangshuang , Zhu Jinxia , Li Wenshuo , Gong Xiaoli , Shen Wen
Published: July 2024

Background

Renal cold ischemia-reperfusion injury (CIRI), a pathological process during kidney transplantation, may result in delayed graft function and negatively impact graft survival and function. There is a lack of an accurate and non-invasive tool for evaluating the degree of CIRI. Multi-parametric MRI has been widely used to detect and evaluate kidney injury. The machine learning algorithms introduced the opportunity to combine biomarkers from different MRI metrics into a single classifier.

Objective

To evaluate the performance of multi-parametric magnetic resonance imaging for grading renal injury in a rat model of renal cold ischemia-reperfusion injury using a machine learning approach.

Methods

Eighty male SD rats were selected to establish a renal cold ischemia -reperfusion model, and all performed multiparametric MRI scans (DWI, IVIM, DKI, BOLD, T1mapping and ASL), followed by pathological analysis. A total of 25 parameters of renal cortex and medulla were analyzed as features. The pathology scores were divided into 3 groups using K-means clustering method. Lasso regression was applied for the initial selecting of features. The optimal features and the best techniques for pathological grading were obtained. Multiple classifiers were used to construct models to evaluate the predictive value for pathology grading.

Results

All rats were categorized into mild, moderate, and severe injury group according the pathologic scores. The 8 features that correlated better with the pathologic classification were medullary and cortical Dp, cortical T2*, cortical Fp, medullary T2*, ∆T1, cortical RBF, medullary T1. The accuracy(0.83, 0.850, 0.81, respectively) and AUC (0.95, 0.93, 0.90, respectively) for pathologic classification of the logistic regression, SVM, and RF are significantly higher than other classifiers. For the logistic model and combining logistic, RF and SVM model of different techniques for pathology grading, the stable and perform are both well. Based on logistic regression, IVIM has the highest AUC (0.93) for pathological grading, followed by BOLD(0.90).

Conclusion

The multi-parametric MRI-based machine learning model could be valuable for noninvasive assessment of the degree of renal injury.
Prediction of leukemia peptides using convolutional neural network and protein compositions
Authors: Khawaja Seher Ansar , Farooq Muhammad Shoaib , Ishaq Kashif , Alsubaie Najah , Karamti Hanen , Montero Elizabeth Caro , Alvarado Eduardo Silva , Ashraf Imran
Published: July 2024

Leukemia is a type of blood cell cancer that is in the bone marrow’s blood-forming cells. Two types of Leukemia are acute and chronic; acute enhances fast and chronic growth gradually which are further classified into lymphocytic and myeloid leukemias. This work evaluates a unique deep convolutional neural network (CNN) classifier that improves identification precision by carefully examining concatenated peptide patterns. The study uses leukemia protein expression for experiments supporting two different techniques including independence and applied cross-validation. In addition to CNN, multilayer perceptron (MLP), gated recurrent unit (GRU), and recurrent neural network (RNN) are applied. The experimental results show that the CNN model surpasses competitors with its outstanding predictability in independent and cross-validation testing applied on different features extracted from protein expressions such as amino acid composition (AAC) with a group of AAC (GAAC), tripeptide composition (TPC) with a group of TPC (GTPC), and dipeptide composition (DPC) for calculating its accuracies with their receiver operating characteristic (ROC) curve. In independence testing, a feature expression of AAC and a group of GAAC are applied using MLP and CNN modules, and ROC curves are achieved with overall 100% accuracy for the detection of protein patterns. In cross-validation testing, a feature expression on a group of AAC and GAAC patterns achieved 98.33% accuracy which is the highest for the CNN module. Furthermore, ROC curves show a 0.965% extraordinary result for the GRU module. The findings show that the CNN model is excellent at figuring out leukemia illnesses from protein expressions with higher accuracy.
Landscape of clinical drug development of ADCs used for the pharmacotherapy of cancers: an overview of clinical trial registry data from 2002 to 2022
Authors: Zhou Wenjing , Xu Zhiyuan , Liu Shu , Lou Xiaohuan , Liu Pengcheng , Xie Huali , Zhang Shuiyan , Liu Xi , Zhuo Baoshan , Huang Hongbing
Published: July 2024

Background

To provide reference for clinical development of ADCs in the industry, we analyzed the landscape and characteristics of clinical trials about antibody-drug conjugates (ADCs).

Method

Clinical trials to study ADCs used for the pharmacotherapy of cancers initiated by the sponsor were searched in the Cite line Pharma Intelligence (Trialtrove database), and the landscape and characteristics of these clinical trials were analyzed from multiple perspectives, such as the number, phases, status, indications, and targets of the clinical trials.

Result

As of December 31, 2022, a total of 431 clinical trials have been initiated to study ADCs used for the pharmacotherapy of cancers, and the number of the last 10 years was 5.5 times as large as the first 11 years. These clinical trials involved 47 indications, including breast cancer, lymphoma (lymphoma, non-Hodgkin’s and lymphoma, Hodgkin’s), unspecified solid tumor, bladder cancer and lung cancer (lung, non-small cell cancer and lung, small cell cancer). As for each of these five indications, 50 + clinical trials have been carried out, accounting for as high as 48.50% (454/936). ADCs involve 38 targets, which are relatively concentrated. Among them, ERBB2 (HER2) and TNFRSF8 (CD30) involve in 100 + registered clinical trials, and TNFRSF17 (BCMA), NECTIN4 and CD19 in 10 + trials. The clinical trials for these five targets account for 79.02% (354/448) of the total number. Up to 93.97% (405/431) of these clinical trials explored the correlation between biomarkers and efficacy. Up to 45.91% (292/636) of Lots (lines of treatment) applied in the clinical trials were the second line. Until December 31, 2022, 54.52% (235/431) of the clinical trials have been completed or terminated.

Conclusion

ADCs are a hotspot of research and development in oncology clinical trials, but the indications, targets, phases, and Lot that have been registered are seemingly relatively concentrated at present. This study provides a comprehensive analysis which can assist researchers/developer quickly grasp relevant knowledge to assess a product and also providing new clues and ideas for future research.
Conducting an objective structured clinical examination under COVID-restricted conditions
Authors: Gotzmann Andrea , Boulet John , Zhang Yichi , McCormick Judy , Wojcik Mathieu , Bartman Ilona , Pugh Debra
Published: July 2024

Background

The administration of performance assessments during the coronavirus disease of 2019 (COVID-19) pandemic posed many challenges, especially for examinations employed as part of certification and licensure. The National Assessment Collaboration (NAC) Examination, an Objective Structured Clinical Examination (OSCE), was modified during the pandemic. The purpose of this study was to gather evidence to support the reliability and validity of the modified NAC Examination.

Methods

The modified NAC Examination was delivered to 2,433 candidates in 2020 and 2021. Cronbach’s alpha, decision consistency, and accuracy values were calculated. Validity evidence includes comparisons of scores and sub-scores for demographic groups: gender (male vs. female), type of International Medical Graduate (IMG) (Canadians Studying Abroad (CSA) vs. non-CSA), postgraduate training (PGT) (no PGT vs. PGT), and language of examination (English vs. French). Criterion relationships were summarized using correlations within and between the NAC Examination and the Medical Council of Canada Qualifying Examination (MCCQE) Part I scores.

Results

Reliability estimates were consistent with other OSCEs similar in length and previous NAC Examination administrations. Both total score and sub-score differences for gender were statistically significant. Total score differences by type of IMG and PGT were not statistically significant, but sub-score differences were statistically significant. Administration language was not statistically significant for either the total scores or sub-scores. Correlations were all statistically significant with some relationships being small or moderate (0.20 to 0.40) or large (> 0.40).

Conclusions

The NAC Examination yields reliable total scores and pass/fail decisions. Expected differences in total scores and sub-scores for defined groups were consistent with previous literature, and internal relationships amongst NAC Examination sub-scores and their external relationships with the MCCQE Part I supported both discriminant and criterion-related validity arguments. Modifications to OSCEs to address health restrictions can be implemented without compromising the overall quality of the assessment. This study outlines some of the validity and reliability analyses for OSCEs that required modifications due to COVID.
Novel hypoxia-induced HIF-1αactivation in asthma pathogenesis
Authors: Wan Mengzhi , Yu Qi , Xu Fei , You Lu Xia , Liang Xiao , kang Ren Kang , Zhou Jing
Published: July 2024

Background

Asthma’s complexity, marked by airway inflammation and remodeling, is influenced by hypoxic conditions. This study focuses on the role of Hypoxia-Inducible Factor-1 Alpha (HIF-1α) and P53 ubiquitination in asthma exacerbation.

Methods

High-throughput sequencing and bioinformatics were used to identify genes associated with asthma progression, with an emphasis on GO and KEGG pathway analyses. An asthma mouse model was developed, and airway smooth muscle cells (ASMCs) were isolated to create an in vitro hypoxia model. Cell viability, proliferation, migration, and apoptosis were assessed, along with ELISA and Hematoxylin and Eosin (H&E) staining.

Results

A notable increase in HIF-1α was observed in both in vivo and in vitro asthma models. HIF-1α upregulation enhanced ASMCs’ viability, proliferation, and migration, while reducing apoptosis, primarily via the promotion of P53 ubiquitination through MDM2. In vivo studies showed increased inflammatory cell infiltration and airway structural changes, which were mitigated by the inhibitor IDF-11,774.

Conclusion

The study highlights the critical role of the HIF-1α-MDM2-P53 axis in asthma, suggesting its potential as a target for therapeutic interventions. The findings indicate that modulating this pathway could offer new avenues for treating the complex respiratory disorder of asthma.
Study of the therapeutic strategy to improve survival outcomes from the perspective of perioperative conditions in elderly gastric cancer patients: a propensity score-matched analysis
Authors: Nomura Eiji , Seki Takatoshi , Yatabe Kentaro , Yoshii Hisamichi , Izumi Hideki , Okada Kazutake , Kayano Hajime , Yamamoto Soichiro , Mukai Masaya , Makuuchi Hiroyasu
Published: July 2024

Background

Elderly gastric cancer patients (EGCPs) require treatment according to not just the stage of their cancer, but also to their general condition and organ function, and rather than full treatment, the appropriate amount of treatment is necessary.

Methods

A total of 425 patients who underwent gastrectomy for primary gastric cancer in our institution between April 2013 and March 2020 were classified by age into two groups: elderly patients (EP, age ≥ 80 years, n = 89); and younger patients (YP, age < 80 years, n = 336). The preoperative, intraoperative, and postoperative conditions of the two groups were then compared. Propensity score matching (PSM) was performed, and factors affecting complications and survival outcomes were examined in detail. In addition, the necessary treatment strategy for EGCPs in the preoperative, intraoperative, and postoperative periods was investigated.

Results

Of the preoperative factors, American Society of Anesthesiologists physical status (ASA-PS) was significantly higher, and respiratory function was significantly lower in the EP group than in the YP group, and the prognostic nutritional index (PNI) also tended to be lower. Of the intraoperative factors, there was no difference in the level of lymph node dissection. However, the EP group had significantly higher rates of postoperative pneumonia and anastomotic leakage. Of the postoperative factors, on simple comparison, postoperative long-term outcomes of the EP group were significantly worse (63.8% vs. 85.4%, p < 0.001), but there was no significant difference in disease-specific survival (DSS), and the DSS survival curves after PSM were almost identical, indicating that the survival rate in the EP group was decreased by death from other disease. Though the survival rate of laparoscopic surgery was significantly better than that of open surgery in the YP group, there was a significantly lower rate of postoperative complications in the EP group after PSM.

Conclusions

In EGCPs, one needs to be aware of short-term complications such as pneumonia and anastomotic leakage due to respiratory dysfunction and malnutrition that are present before surgery. Furthermore, to suppress deaths from other diseases that reduce postoperative survival rates, prevention of postoperative complications (particularly pneumonia) through minimally invasive surgery can be effective.
Predictors of functional improvement and pain reduction in rheumatoid arthritis patients who achieved low disease activity with disease-modifying antirheumatic drugs: a retrospective study of the FIRST Registry
Authors: Ochi Sae , Sonomoto Koshiro , Nakayamada Shingo , Tanaka Yoshiya
Published: July 2024

Background

Rheumatoid arthritis (RA) patients sometimes exhibit different levels of improvement in health assessment questionnaire-disability index (HAQ-DI) and subjective pain visual analogue score (VAS) even after achieving low disease activities (LDA). This study aimed to identify factors associated with improvement in HAQ-DI and pain VAS among those who achieved LDA.

Methods

Data of the FIRST registry, a multi-institutional cohort of RA patients treated with biological and targeted-synthetic DMARDs (b/tsDMARDs) were analyzed. Patients who were enrolled from August 2013 to February 2023 and who achieved clinical LDA [clinical disease activity index (CDAI) ≤ 10.0] at 6 months after starting treatment were included. Multiple logistic regression analyses were conducted to identify the factors that associated with achieving HAQ-DI normalization (< 0.5), HAQ-DI improvement (by > 0.22), or pain VAS reduction (≤ 40 mm).

Results

Among 1424 patients who achieved LDA at 6 months, 732 patients achieved HAQ-DI normalization and 454 achieved pain VAS reduction. The seropositivity and the use of JAK inhibitor compared with TNF inhibitor were associated with both HAQ-DI < 0.5 and pain VAS reduction at 6 months. On the other hand, older age, past failure in ≥ 2 classes of b/tsDMARDs, higher HAQ-DI at baseline, and use of glucocorticoid were associated with the lower likelihood of HAQ-DI normalization and pain VAS reduction. Longer disease duration, being female, and higher disease activity at baseline was negatively associated HAQ-DI normalization alone. Comorbidities were not associated with the outcomes.

Conclusions

These results suggest some preferable treatment may exist for improvement of HAQ-DI and pain VAS reduction in the early stage of the treatment, which is a clue to prevention of a criteria of difficult-to-treat RA.