bluuebunny/crossref_metadata_2025 huggingface dataset:
Can you be a peer if you don’t share the same health or social conditions? A qualitative study on peer integration in a primary care setting
Authors: Lessard Émilie , O’Brien Nadia , Panaite Andreea-Catalina , Leclaire Marie , Castonguay Geneviève , Rouly Ghislaine , Boivin Antoine
Published: August 2024

Background

Peer support has been extensively studied in specific areas of community-based primary care such as mental health, substance use, HIV, homelessness, and Indigenous health. These programs are often built on the assumption that peers must share similar social identities or lived experiences of disease to be effective. However, it remains unclear how peers can be integrated in general primary care setting that serves people with a diversity of health conditions and social backgrounds.

Methods

A participatory qualitative study was conducted between 2020 and 2022 to explore the feasibility, acceptability, and perceived effects of the integration of a peer support worker in a primary care setting in Montreal, Canada. A thematic analysis was performed based on semi-structured interviews (n = 18) with patients, relatives, clinicians, and a peer support worker.

Findings

Findings show that peers connect with patients through sharing their own hardships and how they overcame them, rather than sharing similar health or social conditions. Peers provide social support and coaching beyond the care trajectory and link identified needs with available resources in the community, bridging the gap between health and social care. Primary care clinicians benefit from peer support work, as it helps overcome therapeutic impasses and facilitates communication of patient needs. However, integrating a peer into a primary care team can be challenging due to clinicians’ understanding of the nature and limits of peer support work, financial compensation, and the absence of a formal status within healthcare system.

Conclusion

Our results show that to establish a relationship of trust, a peer does not need to share similar health or social conditions. Instead, they leverage their experiential knowledge, strengths, and abilities to create meaningful relationships and reliable connections that bridge the gap between health and social care. This, in turn, instills patients with hope for a better life, empowers them to take an active role in their own care, and helps them achieve life goals beyond healthcare. Finally, integrating peers in primary care contributes in overcoming obstacles to prevention and care, reduce distrust of institutions, prioritize needs, and help patients navigate the complexities of healthcare services.
Implementation of WHO guidelines for cervical cancer screening, diagnosis and treatment: knowledge and perceptions of health providers from Argentina
Authors: Arrossi Silvina , Straw Cecilia , Sanchez Antelo Victoria , Paolino Melisa , Baena Armando , Forestier Mathilde , Rol Maryluz , Almonte Maribel
Published: August 2024

Background

The 2021 World Health Organization (WHO) guidelines on cervical cancer screening and treatment provide countries with evidence-based recommendations to accelerate disease elimination. However, evidence shows that health providers’ adherence to screening guidelines is low. We conducted a study in Argentina to analyze health providers’ knowledge and perceptions regarding the 2021 WHO Guidelines.

Methods

A qualitative study was conducted based on individual, semi-structured interviews with health providers specializing in gynecology (n = 15). The themes explored were selected and analyzed using domains and constructs of the Consolidated Framework for Implementation Research.

Results

Although health providers perceive WHO as a reliable institution, they do not know the 2021 guidelines, its supporting evidence, and its elaboration process. Their clinical practice is mainly guided by local recommendations developed by national professional medical associations (PMAs). For interviewees, WHO guidelines should be disseminated through health authorities and national PMAs, mainly through in-service training. Health providers had a positive assessment regarding WHO Recommendation 1 (screen, triage, and treatment for women aged 30 + with HPV-testing every 5 to 10 years) and perceived a favorable climate for its implementation. HPV-testing followed by triage was considered a low-complexity practice, enabling a better detection of HPV, a better selection of the patients who will need diagnosis and treatment, and a more efficient use of health system resources. However, they suggested adapting this recommendation by removing screening interval beyond 5 years. WHO Recommendation 2 (screen-and-treat approach with HPV-testing for women aged 30 + every 5 to 10 years) was predominantly rejected by interviewees, was considered an algorithm that did not respond to women’s needs, and was not adequate for the Argentinean context. Regarding the HPV-test modality, clinician-collected tests were the preferred mode. Health providers considered that HPV self-collection should be used primarily among socially vulnerable women to increase screening coverage.

Conclusion

WHO guidelines should be widely disseminated among health providers, especially in settings that could benefit from a screen-and-treat approach. Identifying areas of partnership and collaboration with PMAs in implementing WHO guidelines is essential.
Promoting vigorous intermittent lifestyle physical activity (vilpa) in middle-aged adults: an evaluation of the movsnax mobile app
Authors: Thøgersen-Ntoumani Cecilie , Grunseit Anne , Holtermann Andreas , Steiner Sarah , Tudor-Locke Catrine , Koster Annemarie , Johnson Nathan , Maher Carol , Ahmadi Matthew , Chau Josephine Y. , Stamatakis Emmanuel
Published: August 2024

Background

Most adults fail to meet the moderate to vigorous physical activity-based recommendations needed to maintain or improve health. Vigorous Intermittent Lifestyle Physical Activity (VILPA) refers to short (1–2 min) high-intensity activities that are integrated into activities of daily living. VILPA has shown strong potential to improve health and addresses commonly reported barriers to physical activity. However, it is unknown how VILPA can best be promoted among the adult population. This study aimed to evaluate the usability, user engagement, and satisfaction of a mobile application (MovSnax) designed to promote VILPA.

Methods

A concurrent mixed methods design was used. It comprised four parts. Part A was a survey with n = 8 mHealth and physical activity experts who had used the app over 7–10 days. Part B was think-aloud interviews with n = 5 end-users aged 40–65 years old. Part C was a survey with a new group of 40-65-year-old end-users (n = 35) who had used the MovSnax app over 7–10 days. Part D was semi-structured interviews with n = 18 participants who took part in Part C. Directed content analysis was used to analyze the results from Parts A, B, and D, and descriptive statistics were used to analyze findings from Part C.

Results

Participants reported positive views on the MovSnax app for promoting VILPA but also identified usability issues such as unclear purpose, difficulties in manual data entry, and limited customization options. Across the different data collections, they consistently emphasized the need for more motivational features, clearer feedback, and gamification elements to enhance engagement. Quantitative assessment showed satisfactory scores on objective measures but lower ratings on subjective aspects, possibly due to unfamiliarity with the VILPA concept and/or technical barriers.

Conclusions

The MovSnax app, tested in the present study, is the world’s first digital tool aimed specifically at increasing VILPA. The findings of the present study underscore the need for further app refinement, focusing on clarifying its purpose and instructions, boosting user engagement through personalization and added motivational elements, enhancing accuracy in detecting VILPA bouts, implementing clearer feedback mechanisms, expanding customization choices (such as font size and comparative data), and ensuring transparent and meaningful activity tracking.
Anterior tibial tendon transfer in idiopathic clubfoot: pull-out vs. other fixations – a systematic review
Authors: Moreira Andreia , Benjamin Ravetti Luciano , Carrapeiro Prina Douglas , Paschoal Nogueira Monica
Published: August 2024

Purpose

Review the literature and describe the complications associated with each of the anterior tibial tendon transfer (ATTT) techniques described.

Methods

A systematic review of the literature was performed with the keywords ‘’clubfoot’’, ‘’Ponseti’’ and ‘’anterior tibial’’. Studies in patients with clubfoot recurrence, who underwent ATTT, whose method of tendon fixation was different from the classical method, were included.

Results

Six studies were included in this systematic review, which described multiple techniques for tibialis anterior fixation: bone anchors, interference screws, endobotton, K-wires, transosseous suture, and suture to the plantar fascia. In the papers that described postoperative complications, no major complications were reported, however the samples are generally small.

Conclusion

Several options have now emerged for tendon fixation in tendon transfers around the foot and ankle, including ATTT for treatment of relapsed clubfoot. To our knowledge this is the first paper that questioned the potential complications associated with the use of these new techniques. Due to the scarcity of published works in favor of other fixation methods, we believe that the traditional method is the optimal one for the transfer of the tendon of the tibialis anterior muscle.
The impact of a nutrition course on self-epistemic authority, professional meaning as mediating factors on professional identity among nursing students
Authors: Theilla Miriam , Weil-Lotan Dorit
Published: August 2024

Background

The professional competence of nursing personnel is integral to the efficacy of nursing procedures. Educational endeavors, especially those encompassing professional training programs, are critical in fostering a professional identity among nurses. The role of nurses within a multi-disciplinary nutrition team has the potential to enhance professional identity and improve the quality of care provided.

Objective

This study aimed to explore the potential impact of knowledge acquisition and practical nutrition education on the development of professional identity among nursing school students. Furthermore, we hypothesize that professional autonomy and self-epistemic authority mediated the relationship between a sense of meaning, professional mission, and professional identity.

Design

A cross-sectional survey compared nursing students who had completed a practical nutrition course with those who had not. The study measured professional identity, professional autonomy, self-epistemic authority, and sense of meaning. Data collection was conducted using validated questionnaires, with questions tailored to suit the study demographic. Mediation analysis was conducted on the combined sample of both groups.

Participants

The study included 98 nursing students, divided into a study group (57 students who completed a nutrition course) and a control group (41 students who did not complete the course).

Results

Significant differences were found between the groups in measures of professional identity (t = 3.42, p < .001), professional autonomy (t = 2.93, p < .005), and self-epistemic authority (t = 2.78, p < .007). There was no significant difference in the sense of meaning (t = 1.45, p = .150). Mediation analysis on the combined sample revealed that self-epistemic authority mediated the relationship between professional meaning and professional identity, while professional autonomy did not.

Conclusion

The findings suggest that practical nutrition education enhances nursing students’ professional identity, autonomy, and self-epistemic authority. Future studies should include larger and more diverse samples to further explore these relationships.
Patient responsiveness as a safewards fidelity indicator: a qualitative interview study on an acute psychiatric in-patient ward
Authors: Pelto-Piri Veikko , Kjellin Lars , Backman Gabriella , Carlsson Karoline , Björkdahl Anna
Published: August 2024

Background

The Safewards model aims to reduce conflict and use of containment on psychiatric wards. To evaluate the implementation of Safewards and understand why it is effective in some settings but not in others, it is important to assess the level of implementation fidelity. To do this, the Safewards Fidelity Checklist (SFC) is often used, which focuses on objective visual observations of interventions but does not include patient responsiveness. The latter is a key indicator of implementation fidelity and includes engagement, relevance, acceptability and usefulness. The aim of the present study was to investigate the fidelity of Safewards implementation on an acute psychiatric ward from the perspective of patient responsiveness.

Method

The study was conducted on a ward for patients with mainly affective disorders. To assess the general level of fidelity the SFC was used together with a detailed ward walkthrough. Ten patients were interviewed with a focus on patient responsiveness to each of the seven interventions implemented on the ward. Data were analysed using qualitative descriptive analysis.

Results

The findings indicate high implementation fidelity, which was reflected in the SFC assessment, walkthrough and patient responsiveness. Patients gave examples of improvements that had happened over time or of the ward being better than other wards. They felt respected, less alone, hopeful and safe. They also described supporting fellow patients and taking responsibility for the ward climate. However, some patients were unfamiliar with a ward where so much communication was expected. Several suggestions were made about improving Safewards.

Conclusions

This study confirms previous research that patient responsiveness is an important factor for achieving fidelity in a prevention programme. The patients’ descriptions of the acceptability, relevance and usefulness of the specific interventions reflected to a high degree the objective visual observations made by means of the SFC and ward walkthrough. Patient engagement was demonstrated by several suggestions about how to adapt the interventions. There is potential to obtain valuable input from patients when adapting Safewards in practice. This study also presents many examples of practical work with these interventions and the effects it can have on patients’ experiences of care.
Detection and management of localized prostate cancer in Nigeria: barriers and facilitators according to patients, caregivers and healthcare providers
Authors: Tolani Musliu Adetola , Agbo Christian A. , Paciorek Alan , Umar Shehu S. , Ojewola Rufus W. , Mohammed Faruk , Kaninjing Ernie , Ahmed Muhammed , DeBoer Rebecca
Published: August 2024

Background

Prostate cancer mortality rates are high in Nigeria. While prostate cancer is highly curable with early detection and effective multidisciplinary management, the quality of care is suboptimal in this setting. Sustainable delivery of high-quality care for patients with localized prostate cancer is needed to save more lives. To inform future interventions to improve care, this study aimed to identify barriers and facilitators that influence prostate cancer detection and management in Nigeria.

Methods

Six focus group discussions (FGDs), stratified by stakeholders were conducted with a purposive sample of prostate cancer patients (n = 19), caregivers (n = 15), and healthcare providers (n = 18), in two academic tertiary hospitals in northern and southern Nigeria. A discussion guide organized based on the socio-ecological model was used. FGDs were recorded, transcribed, and analysed using the framework technique.

Results

Barriers and facilitators were identified at the individual, interpersonal, and organizational levels. Barriers to detection included limited knowledge and misperceptions among patients, caregivers, and community-based non-specialist healthcare providers, and limitations of centralized opportunistic screening; while facilitators included the potential for religious institutions to encourage positive health-seeking behaviour. Barriers to management included non-uniformity in clinical guideline usage, treatment abandonment amidst concerns about treatment and survival, absence of patient interaction platforms and follow-up support systems, difficulty in navigating service areas, low health insurance coverage and limited financial resource of patients. Facilitators of management included the availability of resource stratified guidelines for prostate cancer management and the availability of patient peers, caregivers, nurses, and medical social workers to provide correct medical information and support patient-centred services. Participants also provided suggestions that could help improve prostate cancer detection and management in Nigeria.

Conclusion

This study identified multiple determinants affecting the detection and management of localized prostate cancer. These findings will inform the refinement of implementation strategies to improve the quality of prostate cancer care in Nigeria.
Seminal plasma removal for medium-term preservation of ram sperm at 5 °C
Authors: Neila-Montero Marta , Alvarez Mercedes , Riesco Marta F. , Soriano-Úbeda Cristina , Montes-Garrido Rafael , Palacin-Martinez Cristina , de Paz Paulino , Anel Luis , Anel-Lopez Luis
Published: August 2024

This study aimed to investigate if washing ram sperm from seminal plasma (SP) could be an effective tool to extend sperm lifespan in medium-term preservation in liquid form to optimize ovine artificial insemination protocols. To this end, in Experiment 1 SP was added to a sperm model without previous contact with this substance (ram epididymal sperm) at the beginning or the end of a 48-hour preservation protocol at 5 °C (n = 13). Sperm motility and kinetic parameters and sperm functionality in terms of sperm viability, apoptosis, mitochondrial activity and reacted acrosomes were assessed after 6 h of storage at 15 °C (standard liquid preservation method) and 24 and 48 h at 5 °C. Extended sperm showed better results after 48 h when stored in the absence than in the presence of SP in most sperm quality parameters. Moreover, the final SP supplementation of this experimental group resulted in the highest sperm motility and kinetic parameters, viability and mitochondrial activity. These results suggested that initial SP deprivation could be beneficial in a medium-term ram sperm preservation protocol in liquid form, as well as a final supplementation. Therefore, we conducted Experiment 2 to evaluate the effect of SP removal from freshly ejaculated ram semen under the same storage conditions as in Experiment 1 (n = 12). Surprisingly, SP withdrawal impaired sperm functionality, leading to increased apoptosis and decreased mitochondrial activity after 24 and 48 h at 5 °C. Conversely, SP supplementation at the end of the preservation protocol of the ejaculate processed as usual had a positive effect on sperm quality and fertility. To summarize, SP absence was beneficial for a medium-term preservation protocol (up to 48 h at 5 °C) of ram epididymal sperm, but the same preservation protocol for ram ejaculated sperm revealed a possible failure of the SP removal method in avoiding the sperm-SP interaction effect. Meanwhile, SP supplementation of ram semen at the end of the preservation protocol increased in vitro sperm quality and fertility after artificial insemination.
Adipocytes promote metastasis of breast cancer by attenuating the FOXO1 effects and regulating copper homeostasis
Authors: Chen Xiu , Zhang Heda , Fang Zheng , Wang Dandan , Song Yuxin , Zhang Qian , Hou Junchen , Yang Sujin , Xu Di , Fei Yinjiao , Zhang Wei , Zhang Jian , Tang Jinhai , Li Lei
Published: August 2024

Background

Obesity and the forkhead box O1(FOXO1) affect the survival of breast cancer patients, but the underlying mechanism remains unclear. We aimed to investigate the role of FOXO1 in obesity-associated-breast cancer.

Methods

We screened 383 breast disease patients from the first affiliated hospital with Nanjing Medical University in 2020. We performed wound healing, transwell, matrigel assays to assess the metastatic ability of cancer cells. We adopted mRNAs sequencing to select the differentially expressed transcripts in breast cancer. We applied immunohistochemistry, western blot, tissue microarrays to assess the level of FOXO1 and epithelial-mesenchymal transition (EMT) pathways. We conducted bioinformatic analysis to investigate interactions between FOXO1 and miR-135b. We used fluorescence in situ hybridization, RT-qPCR to confirm the characteristics of circCNIH4. We conducted luciferase reporter assay, rescue experiments to investigate interactions between circCNIH4 and miR-135b.

Results

Obesity was positively correlated with the incidence and progression of breast cancer. Adipocytes enhanced the migration of breast cancer and attenuated the effects of FOXO1. MiR-135b was a binding gene of FOXO1 and was regulated by circCNIH4. CircCNIH4 exhibited antitumor activity in vitro and in vivo.

Conclusion

Adipocytes might accelerate the progression of breast cancer by modulating FOXO1/miR-135b/ circCNIH4 /EMT axis and regulating copper homeostasis.
Enhancing mutation detection in multiple myeloma with an error-corrected ultra-sensitive NGS assay without plasma cell enrichment
Authors: Kim Jin Ju , Kim Soo-Jeong , Lim Seoyoung , Lee Seung-Tae , Choi Jong Rak , Shin Saeam , Hwang Doh Yu
Published: August 2024

Background

Risk stratification in multiple myeloma (MM) patients is crucial, and molecular genetic studies play a significant role in achieving this objective. Enrichment of plasma cells for next-generation sequencing (NGS) analysis has been employed to enhance detection sensitivity. However, these methods often come with limitations, such as high costs and low throughput. In this study, we explore the use of an error-corrected ultrasensitive NGS assay called positional indexing sequencing (PiSeq-MM). This assay can detect somatic mutations in MM patients without relying on plasma cell enrichment.

Method

Diagnostic bone marrow aspirates (BMAs) and blood samples from 14 MM patients were used for exploratory and validation sets.

Results

PiSeq-MM successfully detected somatic mutations in all BMAs, outperforming conventional NGS using plasma cells. It also identified 38 low-frequency mutations that were missed by conventional NGS, enhancing detection sensitivity below the 5% analytical threshold. When tested in an actual clinical environment, plasma cell enrichment failed in most BMAs (14/16), but the PiSeq-MM enabled mutation detection in all BMAs. There was concordance between PiSeq-MM using BMAs and ctDNA analysis in paired blood samples.

Conclusion

This research provides valuable insights into the genetic landscape of MM and highlights the advantages of error-corrected NGS for detecting low-frequency mutations. Although the current standard method for mutation analysis is plasma cell-enriched BMAs, total BMA or ctDNA testing with error correction is a viable alternative when plasma cell enrichment is not feasible.
Nest site selection and fidelity of European pond turtle (Emys orbicularis) population of Babat Valley (Gödöllő, Hungary)
Authors: Kiss István , Erdélyi Gergő , Szabó Borbála
Published: August 2024

Background

The conservation of aquatic and semiaquatic turtles requires knowledge of the area and vegetation structure of habitat used for nesting, and nesting migration route. We aimed to survey the effects of habitat features to the nest site selection, nesting success, and test the possibility of nest site fidelity. Our study was carried out at 10 different nesting areas, with special emphasis on data from returning females in a pond system in Hungary between 2014 and 2017.

Results

Most nesting attempts were found in closed sand steppes, uncharacteristic dry and semi-dry grasslands habitat patches. The principal component analysis (PCA) showed that increased sandy soil cover, sunlight and slope were important variables in nest site choice. The increasing PCA first axis score significantly increased the chance of an emergence. The degradation of open steppe vegetation, occurrence of weeds, invasive and disturbance tolerant species have a negative effect on the selection of nest sites. We observed that 96.55% of nests were located within 20 m south of a pine forest at preferred nest site at pond 5, which provided the right incubation temperature through partial shading. The returning females nested significantly closer to the northern pine forest than the single clutch females. Most probably the returning females already has the necessary experience to select the right nesting site. The individually marked females did not choose new nesting areas during the monitored years which suggests nesting area fidelity, but we did not find nest site fidelity.

Conclusion

The maintenance of mosaic habitat structure, slowing down the succession process at the nesting area should be basic priorities in European pond turtle conservation programs. We suggested a spatial and temporal scheduling of land management and agricultural work to the local farmers. If the actual nest site is in an agricultural area, all work should be avoided throughout the year. Agricultural machinery should avoid the migration routes of adult turtles and emerged hatchlings during the concerned period. Under strong predation pressure, predator control should be carried out, and use nest protection.
High expression of L-GILZ transcript variant 1 (GILZ TV 1) is associated with increased 30-day sepsis mortality, and a high expression ratio possibly contraindicates hydrocortisone administration
Authors: Rusev Stefan , Thon Patrick , Dyck Birte , Ziehe Dominik , Rahmel Tim , Marko Britta , Palmowski Lars , Nowak Hartmuth , Ellger Björn , Limper Ulrich , Schwier Elke , Henzler Dietrich , Ehrentraut Stefan Felix , Bergmann Lars , Unterberg Matthias , Adamzik Michael , Koos Björn , Rump Katharina
Published: August 2024

Background

Sepsis presents a challenge due to its complex immune responses, where balance between inflammation and anti-inflammation is critical for survival. Glucocorticoid-induced leucine zipper (GILZ) is key protein in achieving this balance, suppressing inflammation and mediating glucocorticoid response. This study aims to investigate GILZ transcript variants in sepsis patients and explore their potential for patient stratification and optimizing glucocorticoid therapy.

Methods

Sepsis patients meeting the criteria outlined in Sepsis-3 were enrolled, and RNA was isolated from whole blood samples. Quantitative mRNA expression of GILZ transcript variants in both sepsis patient samples (n = 121) and the monocytic U937 cell line (n = 3), treated with hydrocortisone and lipopolysaccharides, was assessed using quantitative PCR (qPCR).

Results

Elevated expression of GILZ transcript variant 1 (GILZ TV 1) serves as a marker for heightened 30-day mortality in septic patients. Increased levels of GILZ TV 1 within the initial day of sepsis onset are associated with a 2.2-[95% CI 1.2–4.3] fold rise in mortality, escalating to an 8.5-[95% CI 2.0–36.4] fold increase by day eight. GILZ TV1 expression is enhanced by glucocorticoids in cell culture but remains unaffected by inflammatory stimuli such as LPS. In septic patients, GILZ TV 1 expression increases over the course of sepsis and in response to hydrocortisone treatment. Furthermore, a high expression ratio of transcript variant 1 relative to all GILZ mRNA TVs correlates with a 2.3-fold higher mortality rate in patients receiving hydrocortisone treatment.

Conclusion

High expression of GILZ TV 1 is associated with a higher 30-day sepsis mortality rate. Moreover, a high expression ratio of GILZ TV 1 relative to all GILZ transcript variants is a parameter for identifying patient subgroups in which hydrocortisone may be contraindicated.
Production of rare ginsenosides by biotransformation of Panax notoginseng saponins using Aspergillus fumigatus
Authors: Yang Lian , Lin Dongmei , Li Feixing , Cui Xiuming , Lou Dengji , Yang Xiaoyan
Published: August 2024

Panax notoginseng saponins (PNS) are the main active components of Panax notoginseng. But after oral administration, they need to be converted into rare ginsenosides by human gut microbiota and gastric juice before they can be readily absorbed into the bloodstream and exert their effects. The sources of rare ginsenosides are extremely limited in P. notoginseng and other medical plants, which hinders their application in functional foods and drugs. Therefore, the production of rare ginsenosides by the transformation of PNS using Aspergillus fumigatus was studied in this research. During 50 days at 25 ℃ and 150 rpm, A. fumigatus transformed PNS to 14 products (1–14). They were isolated by varied chromatographic methods, such as silica gel column chromatography, Rp-C18 reversed phase column chromatography, semi-preparative HPLC, Sephadex LH-20 gel column chromatography, and elucidated on the basis of their 1H-NMR, 13C-NMR and ESIMS spectroscopic data. Then, the transformed products (1–14) were isolated and identified as Rk3, Rh4, 20 (R)-Rh1, 20 (S)-Protopanaxatriol, C-K, 20 (R)-Rg3, 20 (S)-Rg3, 20 (S)-Rg2, 20 (R)-R2, Rk1, Rg5, 20 (S)-R2, 20 (R)-Rg2, and 20 (S)-I, respectively. In addition, all transformed products (1–14) were tested for their antimicrobial activity. Among them, compounds 5 (C-K) and 7 [20 (S)-Rg3] showed moderate antimicrobial activities against Staphylococcus aureus and Candida albicans with MIC values of 6.25, 1.25 μg/mL and 1.25, 25 μg/mL, respectively. This study lays the foundation for production of rare ginsenosides.

Graphical abstract
Human-De Brazza’s monkey conflict in Kafa Biosphere Reserve, Kafa Zone South West, Ethiopia
Authors: Haile Melaku , Gadisa Tsegaye , Gutema Tariku Mekonnen
Published: August 2024

Background

Human-wildlife conflict (HWC) is any interaction between humans and wildlife that arises when wildlife necessities encroach on those of the human population. It affects all areas where animal and peoples cohabit regardless of geography or climatic circumstances; but the burden is great in developing nations. De Brazza’s monkey (DM) (Cercopithecus neglectus) is one of the most unusual species in the group of Old-World monkeys commonly known as guenons. The De Brazza’s monkey is distributed in different parts of African forests from Guinea to Ethiopia. This study was conducted in Kafa Biosphere Reserve, Kafa Zone, South West Ethiopia, to assess the causes of human wildlife conflict in the area. The methods used were, household questionnaire, focus group discussion and direct field observation from June 2022 to May 2023.

Results

The study revealed that the major causes of human De Brazza’s monkey conflicts were; habitat destruction 52.9%, (n = 72), human proximity to natural forest, 25.7%, (n = 35) and increasing of its population size 8.1 %, (n = 11). These monkeys’ raids crop usually early in the morning 42.6%, (n = 58), and late evening 29.4%, (n = 40). Maize was the most damaged crop by De Brazza’s monkey followed by coffee. The study also confirmed that guarding was the most common method used to protect crops from crop raiding wildlife in the area. Majority 66.2%, (n= 90) of the informants had negative attitude but 22.1%, (n = 30) had positive attitude towards De Brazza’s monkey conservation.

Conclusion

The study discovered that, in contrast to olive baboons and grivet monkeys in the area, De Brazza's monkeys were not previously identified as crop raiders; however, they are currently causing damage to crops, especially maize and coffee crops. This could be due to habitat destruction and human proximity to the forest boundary. Thus, the conflict between humans and De Brazza's monkeys is escalating. As such, we recommended more research on the population status of the monkeys and strategies for coexist in the area.
Translation and cultural adaption of the control preference scale across various care settings in a Danish hospital
Authors: Knudsen Bettina Mølri , Steffensen Karina Dahl
Published: August 2024

Background

In recent decades, there has been a growing emphasis on involving patients in healthcare decision-making, driven by political, ethical, and research considerations. Although patient involvement is associated with improved health outcomes, understanding patient preferences regarding their role in decision-making is crucial for effective interventions. The Control Preferences Scale (CPS) measures patient preferences along a continuum from passive to active participation. However, its application in Denmark necessitates translation and cultural adaptation.

Methodology

This study aimed to translate and culturally adapt the CPS for Danish use across diverse healthcare settings: acute care, cancer care, elective surgery, chronic medical treatment, and parental involvement in pediatric care. Following a cross-sectional design, the translation process was systematically planned and executed using Beaton’s guidelines, including the five stages: forward and back translation, synthesis, expert review, and pre-testing.

Results

The translation and adaption process was carried out successfully. Few linguistic challenges were identified and resolved by the expert review. The findings of the pre-testing indicated high acceptability and usability of the adapted CPS among 152 Danish patients and parents. The collaborative role emerged as the most preferred across settings (69.8%), with passive roles more prevalent among cancer patients (30%) and parents waiting with their child to see a pediatrician (23.3%). Notable, more women preferred collaborative or active roles (83.9%) than men (73.9%). The content validity assessment yielded positive feedback, affirming the relevance and comprehensiveness of the CPS.

Conclusions

In summary, the adaptation and validation of the CPS for Danish use proved successful, providing a valuable tool for assessing patient’s role preferences in healthcare decision-making. However, future studies are recommended to ensure construct validity and reliability through psychometric testing.
Combined treatment with vitamin C, hydrocortisone and thiamine does not attenuate morbidity and mortality of septic sheep
Authors: Baljinnyam Tuvshintugs , Fukuda Satoshi , Niimi Yosuke , Prough Donald , Enkhbaatar Perenlei
Published: August 2024

Background

Sepsis is associated with a highest mortality rate in the ICU. Present study tests the efficacy of combined therapy with vitamin C, hydrocortisone and thiamine (combined therapy) in the ovine model of sepsis induced by Pseudomonas aeruginosa. In this study, sepsis was induced in sheep by instillation of Pseudomonas aeruginosa (1 × 1011 CFU) into the lungs via bronchoscope, under anesthesia. Nine hours after injury, intravenous infusion of vitamin C (0.75 g every 6 h), hydrocortisone (25 mg every 6 h), and thiamine (100 mg every 12 h) or saline was given to the treatment and control groups. Cardiopulmonary variables were recorded.

Results

The survival rate was 16.7% in control and 33.3% in treatment groups. In the control group, mean arterial pressure dropped from 93.6 ± 8.6 to 75.5 ± 9.7 mmHg by 9 h, which was not affected by the combined therapy. Pulmonary dysfunction was not attenuated by the combined therapy either. The combined therapy had no effect on increased extravascular lung water content and fluid effusion into thoracic cavity. The bacterial number in the bronchoalveolar lavage fluid was significantly increased in the treatment group than the control group. The blood bacterial number remained comparable between groups.

Conclusions

Combined vitamin C, hydrocortisone, and thiamine did not attenuate severity of ovine sepsis.
Changes in the treatment landscape of metastatic hormone-sensitive prostate cancer: A multicenter study.
Authors: Urabe Fumihiko , Kimura Takahiro
Published: August 2024

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Background: A multicenter database was utilized to examine the current treatment landscape and clinical outcomes among patients with metastatic hormone-sensitive prostate cancer (mHSPC) following approval of upfront androgen receptor signaling inhibitors (ARSIs). Methods: We retrospectively analyzed patients with mHSPC who commenced treatment between February 2018 and June 2023. The Kaplan–Meier method was used to assess oncological outcomes, including time to castration-resistant prostate cancer (CRPC), progression-free survival 2 (PFS2, duration from initial treatment to tumor progression during second-line treatment), cancer-specific survival (CSS), and overall survival (OS). Cox regression analyses were performed to determine the impact of treatment choices on oncological outcomes. In addition, the incidence rate of adverse events was assessed. Results: In total, 829 patients were analyzed; 42.5% received ARSIs with androgen deprivation therapy (ADT), 44.0% received combined androgen blockade (CAB), and 13.5% received ADT alone. Analysis of annual treatment choice trends revealed an increasing preference for ARSIs with ADT. Kaplan–Meier curves and multivariate Cox regression analyses indicated higher rates of CRPC and shorter PFS2 in patients treated with CAB versus ARSIs with ADT. By contrast, CSS and OS were not significantly different between the ARSI with ADT group and the CAB group. Grade 3–4 adverse events occurred in 1.9% of patients receiving CAB and 6.0% of those receiving ARSIs with ADT. Conclusions: For patients with mHSPC, initial treatment with ARSIs in combination with ADT resulted in a longer time to CRPC and longer PFS2 compared to CAB. Although CAB and ADT alone were associated with fewer adverse events, ARSIs with ADT should be considered a first-line treatment option given its superior oncological outcomes.
Single centre real world data on disease profile and outcome of 700 patients with penile cancer treated with curative intent at an Indian cancer centre.
Authors: Prakash Gagan , Arora Amandeep , Pal Mahendra , Menon Santosh , Murthy Vedang , Misra Ankit , Maitre Priyamvada , Gujela Ajit , Tummala Manoj , Chandankhede Uday , Mohan Anand , Bonkar Dethe Shraddha , Ringe-Katdare Aparna , Agrawal Archi , Joshi Amit , Prabhash Kumar , Noronha Vanita , Bakshi Ganesh
Published: August 2024

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Background: Globocan 2022 reported that there are close to 10000 newly diagnosed penile cancer (PeCa) patients annually in India, which contributes to around 27% of the world’s burden of this disease. With the rarity of this male genitourinary cancer globally and absence of level I evidence on most aspects of the disease, real world data from a single Centre assumes importance and this retrospective study highlights the clinico-demographic profile, oncological outcome and surgical complications in patients treated with a curative intent. Methods: We retrospectively reviewed our prospectively maintained institutional database for patients with PeCa treated with curative intent from 2013 to 2021. Data was collected for demographic variables, clinico-pathological characteristics, post-operative complications and oncological outcomes. Descriptive data were expressed as mean / median / proportions. The Kaplan Meier method was used to calculate the cancer specific survival (CSS) of the patients, stratified by pN status. Results: From 2013 to 2021, 700 patients were treated for PeCa at our centre with curative intent, with a median age of 54 years (IQR 44-62) and a mean BMI of 24.1 kg/m2. Around 40% of the patients had history of tobacco use. The clinico-pathological features and Clavian Dindo complication rates are summarized in the table. With a median follow-up of 42 months, the CSS for cN0 patients under observation for their groins was 97.3%.CSS for patients with pN0, pN1, pN2 and pN3 was 90.6%, 79.4%, 71.4% and 55%. Amongst pN3, 24.3% received adjuvant chemo alone, 23.7% received adjuvant RT/CTRT alone while 33.7% received both adjuvant chemo and RT.CSS of pelvic nodal pN3 patients was 35% compared to 71% of inguinal perinodal extension pN3. Conclusions: Our series, one of the largest reported from a single centre, highlights the real world oncological outcome of PeCa patients. We reemphasize the importance of addressing inguinal nodes early and adequately and the worser outcome of pN3 due to pelvic node involvement compared to pN3 due to extra nodal extension of inguinal nodes. [Table: see text]
PD-1 blockade with camrelizumab after chemoradiotherapy in nasopharyngeal carcinoma.
Authors: Ma Jun , Sun Ying , Liang Ye-Lin , Liu Xu , Shen Liangfang , Hu Guangyuan , Zou Guorong , Zhang Ning , Chen Chuanben , Chen Xiaozhong , Zhu Xiao-Dong , Yuan Yawei , Yang Kunyu , Jin Feng , Hong Shu-Bin , Zhao Hongyun , Li Ji-Bin
Published: August 2024

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Background: Approximately 30% of locoregionally advanced nasopharyngeal carcinoma (NPC) experience disease relapse despite definitive chemoradiotherapy. The programmed death-1 (PD-1) blockade camrelizumab has demonstrated considerable value in recurrent/metastatic NPC, while its role in locoregionally advanced NPC is worth exploring. Methods: We conducted a randomized, open-label, phase 3 trial to evaluate adjuvant camrelizumab in locoregionally advanced NPC after definitive chemoradiotherapy. Patients with T4N1M0 or T1-4N2-3M0 NPC who have undergone induction chemotherapy and concurrent chemoradiotherapy were randomized in a 1:1 ratio to receive adjuvant camrelizumab (200mg intravenously once every 3 weeks for up to 12 cycles; Camrelizumab group) or observation ( Standard-therapy group). The primary endpoint was event-free survival (freedom from randomization to locoregional recurrence, distant metastasis, or death from any cause). The secondary endpoint included locoregional recurrence-free survival, distant metastasis-free survival, overall survival, safety, and quality of life. Results: A total of 226 patients were randomized to the Camrelizumab group and 224 to Standard-therapy group. At a median follow-up of 37 months, the 3-year event-free survival was 86.9% in the Camrelizumab group and 77.4% in the Standard-therapy groups (stratified hazard ratio, 0.61; 95% confidence interval [CI], 0.38 to 0.96; P = 0.03). Grade 3 or 4 adverse events were reported in 11.2% patients in the Camrelizumab group and 3.2% of those in the Standard-therapy group. The most common adverse event of grade 3 or 4 was leukopenia (4.9% and 1.4%, respectively). There was no meaningful deterioration in quality of life associated with the use of adjuvant camrelizumab. Conclusions: Adjuvant PD-1 blockade with camrelizumab significantly improved event-free survival, with mild toxicity, highlighting its compelling role in the management of locoregionally advanced NPC. (DIPPER,ClinicalTrials.gov numberNCT03427827). Clinical trial information: NCT03427827 . [Table: see text]
Health disparity viewed from public historic cancer mortality data in the US: Advocacy for gastrointestinal cancers, for tailored prevention measures, and for inter-agency population data harmonization.
Authors: Zhang Tingting , Hung Tony
Published: August 2024

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Background: We searched public datasets released by CDC to answer the question ”Can we have a bird’s-eye view of health disparity in cancer care in the US?” By looking into historic data, we hope to identify not only health disparity reflected by the different cancer mortality rates for major cancer types, but also signs of missing data. Methods: We analyzed 2016-2020 US Cancer Statistics (USCS) cancer burden data to assess cancer disparity as reflected by rates of death in different races or ethnicities. Since the 2022 AACR report on cancer in Asian Americans raised concerns, we then looked into the “Single Race 15” grouping for the underlying cause-of-death data in WONDER@CDC to count liver cancer deaths (ICD10: C22) 2018-2021 among 6 Asian minority groups with population data from 2021 Census ACS data. 2020 GLOBOCAN estimated liver cancer mortality data were also compared. With anecdotal stories suggesting immigrants may seek end-of-life care in the birth country to access culture-concordant services, we looked into how cancer deaths abroad was reported. Results: Gastrointestinal (GI) cancers emerged as an area of cancer health disparity from USCS data. 5 GI cancers (colon and rectum, pancreas, liver and bile duct, stomach, and esophagus) contributed to 1/4 of US cancer deaths, and cancers in the pancreas, liver and bile duct, and esophagus still have poor outcomes. Black non-hispanic Americans are more likely to die from cancers of colon/rectum or pancreas. All minority races or ethnicities are more likely to die from cancers in liver and bile duct, or stomach than white non-Hispanic Americans. Cancers in colon and rectum, liver and bile duct, or stomach also cause high numbers of death in US under-50 population. Liver cancer mortality of US East Asian alone groups shown in the table were lower than GLOBOCAN estimated ASR of 16.1, with the greatest discrepancy in the Chinese (9.1 vs 17.2). Difference between the Vietnamese and Asian Indians may reflect that liver cancer is #1 cause of death in Vietnam, or HepB infection is low in India. Census data excluded expat US citizens, and consulate reports of death abroad have neither cause of death nor race/ethnicity data. Conclusions: We identified gastrointestinal cancers as a focus for cancer health disparity advocacy. Divergent risks for liver cancer in Asian Americans call for tailored prevention measures. Cross-agency death abroad data harmonisation to include race/ethnicity information will complete views of cancer mortality data in US. [Table: see text]
Retrieval-augmented large language models for clinical trial screening.
Authors: He Jianqiao , Gai Shanglei , Ho Si Xian , Chua Shi Ling , Oo Viviana , Zaw Ma Wai Wai , Tan Daniel Shao-Weng , Tan Ryan
Published: August 2024

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Background: Clinical trial screening is currently manual and laborious. We tested several large language models enhanced with retrieval-augmented generation (RAG-LLM) to assess their performance on this task. Methods: We extracted eligibility criteria of 184 oncology trials with FDA approval notifications between 8 January 2020 and 18 January 2024, as well as information on cancer staging and performance status scoring for the RAG-LLM vector database. A medical oncologist and 2 senior clinical trial coordinators developed a test set of 975 synthetic patient profiles which included primary site, stage, prior therapy, tumor mutations and one additional clinical feature. Each profile was paired with one of the 184 trials and annotated for ground-truth eligibility and the reason for it. This process was repeated for another validation set of 240 longer and more challenging profiles paired with 8 ongoing trials. We developed RAG-LLMs with 4 leading LLMs (Zephyr-7B, Med42, GPT 3.5, GPT4) and evaluated their accuracy in determining trial eligibility as well as retrieval-augmented generation assessment (RAGAs) metrics. A response was deemed accurate only if it correctly assigned both trial eligibility and the reason for assignment. Results: GPT4 performed best and achieved an accuracy of 95.18% and 80.00% on the test and validation set respectively with a mean inference time of 10.95 seconds. It also demonstrated the highest answer relevancy, context relevancy and faithfulness (Table). Conclusions: Our results demonstrate potential for RAG-LLMs to assist with trial screening at scale. Further evaluation in real-world cohorts utilizing electronic records and full protocol data with tracking of impact on trial enrolment can be explored within secure firewalls. [Table: see text]