bluuebunny/crossref_metadata_2025 huggingface dataset:
Buffering against exposure to mental health misinformation in online communities on Facebook: the interplay of depression literacy and expert moderation
Authors: Bizzotto Nicole , de Bruijn Gert-Jan , Schulz Peter Johannes
Published: August 2023

Background

The proliferation of health misinformation on social media is a growing public health concern. Online communities for mental health (OCMHs) are also considered an outlet for exposure to misinformation. This study explored the impact of the self-reported volume of exposure to mental health misinformation in misinformation agreement and the moderating effects of depression literacy and type of OCMHs participation (expert vs. peer-led).

Methods

Participants (n = 403) were recruited in Italian-speaking OCMHs on Facebook. We conducted regression analyses using PROCESS macro (moderated moderation, Model 3). Measures included: the Depression Literacy Questionnaire (Griffiths et al., 2004), the self-reported misinformation exposure in the OCMHs (3 items), and misinformation agreement with the exposure items (3 items). Whether participants were members of expert or peer-led OCMHs was also investigated.

Results

The final model explained the 12% variance in the agreement. There was a positive and significant relationship between misinformation exposure and misinformation agreement (β = 0.3221, p < .001), a significant two-way interaction between misinformation exposure and depression literacy (β = − 0.2179, p = .0014 ), and between self-reported misinformation exposure and type of OCMH (β = − 0.2322, p = .0254), such that at higher levels of depression literacy and in case of participation to expert-led OCMHs, the relationship misinformation exposure-misinformation agreement was weaker. Finally, a three-way interaction was found (β = 0.2497, p = .0144) that showed that depression literacy moderated the positive relationship between misinformation exposure and misinformation agreement such that the more misinformation participants were exposed to, the more they agreed with it unless they had higher levels of depression literacy; this, however, occurred only if they participated in peer-led groups.

Conclusions

Results provide evidence that the more members reported being exposed to mental health misinformation, the more they tended to agree with it, however this was only visible when participants had lower depression literacy and were participating in peer-led OCMHs. Results of this study suggest that both internal factors (i.e., high depression literacy) and external factors (the type of online community individuals were participating in) can buffer the negative effects of misinformation exposure. It also suggests that increasing depression literacy and expert community moderation could curb the negative consequences of misinformation exposure related to mental health. Results will guide interventions to mitigate the effects of misinformation in OCMHs, including encouraging health professionals in their administration and implementing health education programs.
Are there differences in the patient-reported medication-related problems among asthma and allergy patients? A community pharmacy survey in Finland
Authors: Heikkilä Juha Markus , Bergman Paula , Jantunen Juha , Salimäki Johanna , Pohjanoksa-Mäntylä Marika , Kauppi Paula
Published: August 2023

Background

A medication-related problem is an event involving medication that interferes with desired health outcomes. Those are largely studied among asthma patients, but little is known about medication-related problems among allergy patients. The objective of this study was to determine the most common patient-reported medication-related problems among asthma patients compared to allergy patients during the self-management of diseases. The other objective was to identify how demographic variables and the received treatment information influence reported problems.

Methods

A nationwide survey was conducted in Finnish community pharmacies (n = 785) in September 2016. The survey targeted patients buying prescription medicines for asthma or allergy.

Results

Responses were received from 46% of targeted pharmacies from 956 respondents. At least one medication problem was reported by 24% of asthma patients and 12% of allergy patients. The most common problems among asthma patients were having problems taking medicines on time (16%), problems in the administration technique (7%) and in the use of the inhaler (4%). Among allergy patients, 10% reported problems remembering to take medicines on time. Severe asthma and allergy increased the risk for medication-related problems (OR 1.20, 95% CI 1.04–1.40 and OR 1.17, 95% CI 1.0–1.37). A higher age and less education were associated with fewer reported medication-related problems among both patient groups.

Conclusions

Asthma patients reported more medication-related problems than allergy patients. Among both investigated patient groups, remembering to take medicines on time was the most common. Health care professionals should educate younger patients but also older and less educated asthma and allergy patients to recognize and, to solve medication-related problems. In addition, severe asthma patients still need medication counseling.
Association between white blood cell count to hemoglobin ratio and risk of in-hospital mortality in patients with lung cancer
Authors: Gao Tingting , Wang Yurong
Published: August 2023

Background

The objective of this study was to investigate the association between white blood cell count to hemoglobin ratio (WHR) and risk of in-hospital mortality in patients with lung cancer.

Methods

In this retrospective cohort study, the medical records of patients with lung cancer were retrieved from the electronic ICU (eICU) Collaborative Research Database between 2014 and 2015. The primary outcome was in-hospital mortality. The secondary outcome was the length of stay in intensive care unit (ICU). The cut-off value for the WHR was calculated by the X-tile software. The Cox model was applied to assess the association between WHR and in-hospital mortality among patients with lung cancer and the linear regression model was used to investigate the association between WHR and length of ICU stay. Subgroup analyses of age (< 65 years or >  = 65 years), Acute Physiology and Chronic Health Evaluation (APACHE) score (< 59 or >  = 59), gender, ventilation (yes or no), and vasopressor (yes or no) in patients with lung cancer were conducted.

Results

Of the 768 included patients with lung cancer, 153 patients (19.92%) died in the hospital. The median total follow-up time was 6.88 (4.17, 11.23) days. The optimal cut-off value for WHR was 1.4. ICU lung cancer patients with WHR >  = 1.4 had a significantly higher risk of in-hospital mortality [Hazard ratio: (HR): 1.65, 95% confidence interval (CI): 1.15 to 2.38, P = 0.007) and length of stay in ICU (HR: 0.63, 0.01, 95% CI: 1.24 to 0.045, P = 0.045). According to the subgroup analysis, WHR was found to be associated with in-hospital mortality in patients with higher APACHE score (HR: 1.60, 95% CI: 1.06 to 2.41, P = 0.024), in male patients (HR: 1.87, 95% CI: 1.15 to 3.04, P = 0.012), and in patients with the treatment of ventilation (HR: 2.33, 95% CI: 1.49 to 3.64, P < 0.001).

Conclusion

This study suggests the association between WHR and risk of in-hospital mortality in patients with lung cancer and length of stay, which indicates the importance of attention to WHR for patients with lung cancer.
An evaluation of the relationship between clinical requirements and tests of competence in a competency-based curriculum in dentistry
Authors: Marchan Shivaughn M. , Coldero Larry G. , Smith William A.J.
Published: August 2023

Background

The development of competencies in dentistry is a complicated process that calls for the development of not just cognitive and psychomotor abilities but also behaviors and attitudes that change as technical proficiency increases and meaningful patient encounters occur. This study examined the relationship between the number of clinical requirements completed by dental students and subsequent performance on tests of competence. The null hypothesis stated there would be no significant linear relationship different from zero between absolute clinical requirements and grades attained in various tests of clinical competence.

Methods

Retrospective assessment data for 81 students were used in this analysis. Data included the amounts of clinical requirements completed for operative dentistry, endodontics, periodontics, and fixed prosthodontics together with data on the respective performance in tests of competence. Correlation was ascertained between grades for tests of competence and the corresponding clinical requirements using a non-parametric Spearman’s Rho test at an alpha level of 0.05.

Results

Fixed prosthodontics and posterior endodontics were the least common procedures completed by dental students. Statistically significant weak correlations were found between the amounts of clinical requirements performed for posterior endodontic(p = 0.005) and operative procedures (p = 0.006) and associated performance in tests of competence. A moderate correlation was found between the number of fixed prosthodontic procedures completed and associated performance in tests of competence. This latter correlation, however, was not statistically significant (p = 0.654). A significant weak correlation was found between requirements completed for periodontics and the associated test of competence (p = 0.04). A highly statistically significant moderate correlation was found between clinical requirements for anterior endodontics and the associated performance in the tests of competence (p < 0.001).

Conclusion

The null hypothesis was rejected since a positive correlation was found between the absolute clinical requirements completed and grades in tests of competence. However, only a weak to moderate degree of correlation was found between the completion of clinical requirements and performance in tests of competence for common clinical procedures that new dental graduates should be able to perform.
Transition to professional practice: Perspectives of new nursing graduates of Nepal
Authors: Gautam Sital , Poudel Anju , Paudyal Kalpana , Prajapati Mangal Maya
Published: August 2023

Background

Internationally, the transition from student nurse to practicing nurse is recognized as being the most stressful period. Yet very little is known about how new nursing graduates perceive this transition in Nepal. The study aimed to explore new nursing graduates’ perceptions of the transition to professional practice.

Methods

A qualitative descriptive methodology was used. In-depth semi-structured interviews were conducted with 10 purposively recruited participants from two private hospitals in Nepal. Data were analyzed using inductive thematic analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used to report the findings of this study.

Results

New nursing graduates perceived the transition to professional practice as an intense experience. Inductive thematic analysis yielded four intrinsically linked themes that encompassed new nursing graduates’ transition experiences: ‘getting hit by reality’, ‘losing confidence’, ‘feeling unsupported’, and ‘gathering strengths.’ The theme ‘getting hit by reality’ included three sub-themes: ‘gap between theory and practice,’ ‘no protective shield,’ and ‘plethora of responsibilities’, which explains nurses’ initial encounter with real-world practice. The theme ‘losing confidence’ contained three sub-themes: ‘being fearful,’ ‘being ignored,’ and ‘being accused,’ which describes how nurses started losing confidence as they confronted the real side of the profession. The theme ‘feeling unsupported’ included two sub-themes: ‘left without guidance,’ and ‘limited support from seniors,’ which explains how nurses perceived their work environment. The theme ‘gathering strength’ contained two sub-themes: ‘reflecting’ and ‘asking for help,’ which describes how nurses coped with the challenges related to the transition.

Conclusion

To facilitate the transition to practice, educational institutions must impart to students a realistic understanding of the transition process, address the theory-practice gap, and collaborate with hospitals. Similarly, hospitals should have realistic expectations from new nurses, assign work according to their capabilities, and allow them sufficient time for role integration. Likewise, well-conceived detailed orientation, mentorship or preceptorship programs, and regular professional development programs are vital to easing the transition. Furthermore, establishing and maintaining a supportive work culture, which promotes equity, respect, and safety among employees, is crucial for positive transition experiences.
ITC-6102RO, a novel B7-H3 antibody-drug conjugate, exhibits potent therapeutic effects against B7-H3 expressing solid tumors
Authors: Shin Seol Hwa , Ju Eun Jin , Park Jin , Ko Eun Jung , Kwon Mi Ri , Lee Hye Won , Son Ga Won , Park Yun-Yong , Kim Yeon Joo , Song Si Yeol , Lee Sangkwang , Seo Beom Seok , Song Jin-A , Lim Sangbin , Jung Doohwan , Kim Sunyoung , Lee Hyangsook , Park Seok Soon , Jeong Seong-Yun , Choi Eun Kyung
Published: August 2023

Background

The B7-H3 protein, encoded by the CD276 gene, is a member of the B7 family of proteins and a transmembrane glycoprotein. It is highly expressed in various solid tumors, such as lung and breast cancer, and has been associated with limited expression in normal tissues and poor clinical outcomes across different malignancies. Additionally, B7-H3 plays a crucial role in anticancer immune responses. Antibody-drug conjugates (ADCs) are a promising therapeutic modality, utilizing antibodies targeting tumor antigens to selectively and effectively deliver potent cytotoxic agents to tumors.

Methods

In this study, we demonstrate the potential of a novel B7-H3-targeting ADC, ITC-6102RO, for B7-H3-targeted therapy. ITC-6102RO was developed and conjugated with dHBD, a soluble derivative of pyrrolobenzodiazepine (PBD), using Ortho Hydroxy-Protected Aryl Sulfate (OHPAS) linkers with high biostability. We assessed the cytotoxicity and internalization of ITC-6102RO in B7-H3 overexpressing cell lines in vitro and evaluated its anticancer efficacy and mode of action in B7-H3 overexpressing cell-derived and patient-derived xenograft models in vivo.

Results

ITC-6102RO inhibited cell viability in B7-H3-positive lung and breast cancer cell lines, inducing cell cycle arrest in the S phase, DNA damage, and apoptosis in vitro. The binding activity and selectivity of ITC-6102RO with B7-H3 were comparable to those of the unconjugated anti-B7-H3 antibody. Furthermore, ITC-6102RO proved effective in B7-H3-positive JIMT-1 subcutaneously xenografted mice and exhibited a potent antitumor effect on B7-H3-positive lung cancer patient-derived xenograft (PDX) models. The mode of action, including S phase arrest and DNA damage induced by dHBD, was confirmed in JIMT-1 tumor tissues.

Conclusions

Our preclinical data indicate that ITC-6102RO is a promising therapeutic agent for B7-H3-targeted therapy. Moreover, we anticipate that OHPAS linkers will serve as a valuable platform for developing novel ADCs targeting a wide range of targets.
Diagnostic value of CT and MRI combined with serum LDH, NSE, CEA, and MYCN in pediatric neuroblastoma
Authors: Hao Jumei , Sang Jing , Xu Xiajuan , Bao Aihua
Published: August 2023

Background

To analyze the diagnostic value of computed tomography (CT), magnetic resonance imaging (MRI) combined with serum lactate dehydrogenase (LDH), neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), and N-myc (MYCN) in the diagnosis of pediatric neuroblastoma.

Methods

Fifty-two children diagnosed with neuroblastoma were selected as the neuroblastoma group. During the same period, 52 children who visited our hospital with abdominal distension, diarrhea, constipation, and vomiting but were finally excluded from neuroblastoma were selected as the control group. CT and MRI were performed on all children.

Results

Fifty-two cases of neuroblastoma of the central nervous system were confirmed by pathological examination. The levels of LDH, NSE, CEA, and MYCN in the neuroblastoma group were clearly higher than those in the control group (P < 0.05). The results of CT and MRI combined with serum LDH, NSE, CEA, and MYCN were false positive in 10 cases and false negative in 6 cases, which were consistent with the pathological results. The sensitivity of CT and MRI combined with serum LDH, NSE, CEA, and MYCN in the diagnosis of neuroblastoma was notably higher than that of the three alone (P < 0.05).

Conclusion

The imaging findings of CT and MRI in children with central nervous system neuroblastoma were definitely characteristic. MRI had higher diagnostic value than CT. The diagnostic value of CT and MRI combined with serum LDH, NSE, CEA, and MYCN was improved to some extent.
Targeting FSCN1 with an oral small-molecule inhibitor for treating ocular neovascularization
Authors: Bai Wen , Ren Jun-Song , Xia Min , Zhao Ya , Ding Jing-Juan , Chen Xi , Jiang Qin
Published: August 2023

Background

Ocular neovascularization is a leading cause of blindness and visual impairment. While intravitreal anti-VEGF agents can be effective, they do have several drawbacks, such as endophthalmitis and drug resistance. Additional studies are necessary to explore alternative therapeutic targets.

Methods

Bioinformatics analysis and quantitative RT-PCR were used to detect and verify the FSCN1 expression levels in oxygen-induced retinopathy (OIR) and laser-induced choroidal neovascularization (CNV) mice model. Transwell, wound scratching, tube formation, three-dimensional bead sprouting assay, rhodamine-phalloidin staining, Isolectin B4 staining and immunofluorescent staining were conducted to detect the role of FSCN1 and its oral inhibitor NP-G2-044 in vivo and vitro. HPLC–MS/MS analysis, cell apoptosis assay, MTT assay, H&E and tunnel staining, visual electrophysiology testing, visual cliff test and light/dark transition test were conducted to assess the pharmacokinetic and security of NP-G2-044 in vivo and vitro. Co-Immunoprecipitation, qRT-PCR and western blot were conducted to reveal the mechanism of FSCN1 and NP-G2-044 mediated pathological ocular neovascularization.

Results

We discovered that Fascin homologue 1 (FSCN1) is vital for angiogenesis both in vitro and in vivo, and that it is highly expressed in oxygen-induced retinopathy (OIR) and laser-induced choroidal neovascularization (CNV). We found that NP-G2-044, a small-molecule inhibitor of FSCN1 with oral activity, can impede the sprouting, migration, and filopodia formation of cultured endothelial cells. Oral NP-G2-044 can effectively and safely curb the development of OIR and CNV, and increase efficacy while overcoming anti-VEGF resistance in combination with intravitreal aflibercept (Eylea) injection.

Conclusion

Collectively, FSCN1 inhibition could serve as a promising therapeutic approach to block ocular neovascularization.
Influenza a virus regulates interferon signaling and its associated genes; MxA and STAT3 by cellular miR-141 to ensure viral replication
Authors: Alalem Mai , Dabous Emad , Awad Ahmed M. , Alalem Nedaa , Guirgis Adel A. , El-Masry Samir , Khalil Hany
Published: August 2023

The antiviral response against influenza A virus (IAV) infection includes the induction of the interferon (IFN) signaling pathway, including activation of the STATs protein family. Subsequently, antiviral myxovirus resistance (MxA) protein and other interferon-stimulated genes control virus replication; however, the molecular interaction of viral-mediated IFN signaling needs more investigation. Host microRNAs (miRNAs) are small non-coding molecules that posttranscriptionally regulate gene expression. Here, we sought to investigate the possible involvement of miR-141 in IAV-mediated IFN signaling. Accordingly, the microarray analysis of A549 cells transfected with precursor miR-141 (pre-miR-141) was used to capture the potentially regulated genes in response to miR-141 overexpression independent of IAV infection. The downregulation of targeted genes by miR-141, in addition to viral gene expression, was investigated by quantitative real-time PCR, western blot analysis, and flow cytometric assay. Our findings showed a significant upregulation of miR-141 in infected A549 cells with different strains of IAV. Notably, IAV replication was firmly interrupted in cells transfected with the miR-141 inhibitor. While its replication significantly increased in cells transfected with pre-miR-141 confirming the crucial role of miRNA-141 in supporting virus replication. Interestingly, the microarray data of miR-141 transduced A549 cells showed many downregulated genes, including MxA, STAT3, IFI27, and LAMP3. The expression profile of MxA and STAT3 was significantly depleted in infected cells transfected with the pre-miR-141, while their expression was restored in infected cells transfected with the miR-141 inhibitor. Unlike interleukin 6 (IL-6), the production of IFN-β markedly decreased in infected cells that transfected with pre-miR-141, while it significantly elevated in infected cells transfected with miR-141 inhibitor. These data provide evidence for the crucial role of miR-141 in regulating the antiviral gene expression induced by IFN and IL-6 signaling during IAV infection to ensure virus replication.
Mid-term results of endoscopic mitral valve repair and insights in surgical techniques for isolated posterior prolapse
Authors: Squiccimarro Enrico , Margari Vito , Kounakis Georgios , Visicchio Giuseppe , Pascarella Clemente , Rotunno Crescenzia , Carbone Carmine , Paparella Domenico
Published: August 2023

Background

The adoption of minimally invasive techniques to perform mitral valve repair surgery is increasing. This is enhanced by the compelling evidence of satisfactory short-term results and lower major morbidity. We analyzed mid-term follow-up results of our experience, and further compared two techniques: isolated leaflet resection and neochord implantation for posterior leaflet prolapse.

Methods

Data for all consecutive endoscopic mitral valve repairs via video-assisted right anterior mini-thoracotomy were analyzed between December 2012 and September 2021. The early and mid-term follow-up results were ascertained. The main outcome was the incidence of mortality and the recurrence of significant mitral regurgitation during follow-up which were summarized by the Kaplan-Meier estimator and compared between treatment arms using the stratified log-rank test. Secondary outcomes were the early-postoperative results including 30-days mortality and the occurrence of major complications.

Results

A total of 309 patients were included. Along with ring annuloplasty, 136 (44.4%) patients received posterior leaflet resection (122 isolated) whereas 97 (31.1%) underwent posterior leaflet chords implantation (88 isolated). Forty-nine patients had annuloplasty alone. In-hospital mortality was 1.0%. Mean follow-up was 28.8 ± 22.0 months (maximum 8.3 years). Kaplan–Meier survival rate at 5 years was 97.3 ± 1.0%, mitral regurgitation ($$\ge$$3+) or valve reoperation free-survival at 5 years was estimated as 94.5 ± 2.3%. Subgroup time-to-event analysis for the indexed outcomes showed no statistical significance between the techniques.

Conclusions

Endoscopic mitral valve repair is safe and associated with excellent short- and mid-term outcomes. No differences were found between leaflet resection and gore-tex chords implantation for posterior leaflet prolapse.
GTM-decon: guided-topic modeling of single-cell transcriptomes enables sub-cell-type and disease-subtype deconvolution of bulk transcriptomes
Authors: Swapna Lakshmipuram Seshadri , Huang Michael , Li Yue
Published: August 2023

Cell-type composition is an important indicator of health. We present Guided Topic Model for deconvolution (GTM-decon) to automatically infer cell-type-specific gene topic distributions from single-cell RNA-seq data for deconvolving bulk transcriptomes. GTM-decon performs competitively on deconvolving simulated and real bulk data compared with the state-of-the-art methods. Moreover, as demonstrated in deconvolving disease transcriptomes, GTM-decon can infer multiple cell-type-specific gene topic distributions per cell type, which captures sub-cell-type variations. GTM-decon can also use phenotype labels from single-cell or bulk data to infer phenotype-specific gene distributions. In a nested-guided design, GTM-decon identified cell-type-specific differentially expressed genes from bulk breast cancer transcriptomes.
Statistical modeling of gut microbiota for personalized health status monitoring
Authors: Zhu Jinlin , Xie Heqiang , Yang Zixin , Chen Jing , Yin Jialin , Tian Peijun , Wang Hongchao , Zhao Jianxin , Zhang Hao , Lu Wenwei , Chen Wei
Published: August 2023

Background

The gut microbiome is closely associated with health status, and any microbiota dysbiosis could considerably impact the host’s health. In addition, many active consortium projects have generated many reference datasets available for large-scale retrospective research. However, a comprehensive monitoring framework that analyzes health status and quantitatively present bacteria-to-health contribution has not been thoroughly investigated.

Methods

We systematically developed a statistical monitoring diagram for personalized health status prediction and analysis. Our framework comprises three elements: (1) a statistical monitoring model was established, the health index was constructed, and the health boundary was defined; (2) healthy patterns were identified among healthy people and analyzed using contrast learning; (3) the contribution of each bacterium to the health index of the diseased population was analyzed. Furthermore, we investigated disease proximity using the contribution spectrum and discovered multiple multi-disease-related targets.

Results

We demonstrated and evaluated the effectiveness of the proposed monitoring framework for tracking personalized health status through comprehensive real-data analysis using the multi-study cohort and another validation cohort. A statistical monitoring model was developed based on 92 microbial taxa. In both the discovery and validation sets, our approach achieved balanced accuracies of 0.7132 and 0.7026, and AUC of 0.80 and 0.76, respectively. Four health patterns were identified in healthy populations, highlighting variations in species composition and metabolic function across these patterns. Furthermore, a reasonable correlation was found between the proposed health index and host physiological indicators, diversity, and functional redundancy. The health index significantly correlated with Shannon diversity ($$\rho = 0.07$$

ρ
=
0.07

) and species richness ($$\rho = 0.44$$

ρ
=
0.44

) in the healthy samples. However, in samples from individuals with diseases, the health index significantly correlated with age ($$\rho = 0.12$$

ρ
=
0.12

), species richness ($$\rho = 0.46$$

ρ
=
0.46

), and functional redundancy ($$\rho = - 0.16$$

ρ
=
-
0.16

). Personalized diagnosis is achieved by analyzing the contribution of each bacterium to the health index. We identified high-contribution species shared across multiple diseases by analyzing the contribution spectrum of these diseases.

Conclusions

Our research revealed that the proposed monitoring framework could promote a deep understanding of healthy microbiomes and unhealthy variations and served as a bridge toward individualized therapy target discovery and precise modulation.
Prevalence of subclinical systolic dysfunction in Takayasu’s arteritis and its association with disease activity: a cross-sectional study
Authors: de Lourdes Castro de Oliveira Figue Maria , Costa Maria Carolina Moura , Costa Maria Clara Moura , Lobo Paulo Rocha , Sanches Leonardo Vinicius , Martins Kátia Maria Alves , Sousa Anna Paula Mota Duque , Pedreira Ana Luisa Souza , Barreto Santiago Mittermayer
Published: August 2023

Background

Takayasu’s arteritis (TA) is a vasculitis that affects the aorta and its branches and causes stenosis, occlusion, and aneurysms. Up to 60% of TA patients are associated with cardiac involvement which confers a poor prognosis. Global longitudinal strain (GLS) analysis is an echocardiographic technique that can detect the presence of subclinical systolic dysfunction. Hence, this study aimed to describe the prevalence of subclinical systolic dysfunction in patients with TA using the GLS method and to correlate this finding with disease activity using the ITAS-2010 (Indian Takayasu Activity Score).

Methods

Thirty patients over 18 years of age who met the American College of Rheumatology (ACR) 1990 criteria for TA were included. The sample was submitted for medical record review, clinical and echocardiographic evaluation, and application of ITAS-2010. The cutoff for systolic dysfunction was GLS > – 20%.

Results

Of the 30 patients analyzed, 25 (83.3%) were female, and the mean age was 42.6 years (± 13.2). The median time since diagnosis was 7.5 years [range, 3–16.6 years], and the type V angiographic classification was the most prevalent (56.7%). Regarding echocardiographic findings, the median ejection fraction (EF) was 66% [61–71%] and the GLS was − 19.5% [-21.3 to -15.8%]. Although half of the participants had reduced GLS, only two had reduced EF. Eleven patients (33.%) met the criteria for activity. An association was found between disease activity and reduced GLS in eight patients (P = 0.02) using the chi-square test.

Conclusion

GLS seems to be an instrument capable of the early detection of systolic dysfunction in TA. The association between GLS and disease activity in this study should be confirmed in a study with a larger sample size.
Increasing Quality and Efficiency of the Radiotherapy Treatment Planning Process by Constructing and Implementing a Workflow-Monitoring Application
Authors: Heilemann Gerd , Georg Dietmar , Dobiasch Matthias , Widder Joachim , Renner Andreas
Published: August 2023

PURPOSE

To demonstrate how the efficiency of the treatment planning processes of a university radiation oncology department (2,500 new patients/year) could be improved by constructing and implementing a workflow-monitoring application.

METHODS

A web-based application was developed in house, which enhanced the process management tools of the clinic's oncology information system. The application calculates the days left for the next task in the treatment planning process and visualizes the information on a browser-based whiteboard. Workflow monitoring considers tumor types (breast, prostate, lung, etc) and treatment techniques and is backward planned from the planned start of treatment. The effect of introducing this application was analyzed over four phases: (1) baseline data without the workflow-monitoring application, (2) after introducing workflow visualization via a browser-based whiteboard, (3) after upgrading the whiteboard and introducing backend rules, and (4) after updating these rules on the basis of data from the previous phase.

RESULTS

Implementing the workflow-monitoring application and the introduced measures significantly reduced delays and, consequently, stress and a negative working atmosphere in the treatment planning process. Most notably, the amount of last-minute physics checks (on the day of the treatment start) could be reduced by 50%.

CONCLUSION

The study showed what measures can help organize and prioritize the treatment planning workflow. The increased efficiency is believed to improve the quality and reduce the risk of human error.
Implementation of Brachytherapy for Patients With Cervical Cancer in Ethiopia: A 3-Year Practice Report
Authors: Kibret Yitbarek M. , Tigeneh Wondemagegnehu , Jemal Ahmedin , Kantelhardt Eva J.
Published: August 2023

PURPOSE

Although cervical cancer is the second most commonly diagnosed cancer in Ethiopia, brachytherapy (BT) was not a component in patient treatment until 2015. The purpose of this study was to identify the patterns of utilization as well as to describe the practice of BT in Ethiopia.

MATERIALS AND METHODS

A retrospective descriptive data analysis of 138 patients with cervical cancer treated with a curative potential using BT from 2015 to 2018 at Tikur Anbassa Specialized Hospital, which housed the only BT facility in Ethiopia during the study period.

RESULTS

During the first 3-year period of BT service commencement, each year n = 37, n = 36, and n = 65 patients with cervical cancer were treated, respectively, with curative intention treatment. The median age of these 138 patients was 50 years (range, 22-75). All the patients were in International Federation of Gynecology and Obstetrics stage Ib–IIIb group, and stage IIb (66.4%) was the predominant. Majority (79%) of the patients were treated primarily with radiotherapy (RT), while 21% received RT after surgery. More than half of these patients (62%) received a total RT dose of 82 Gy in equivalent dose in 2 Gy fractions (EQD2), while the rest received a dose ranging from 76 to 86 Gy. Concurrent cisplatin with RT was given only for 36% of the patients for undocumented reasons. The overall treatment time including both external-beam RT and BT was greater than 8 weeks in 21% of the patients.

CONCLUSION

The utilization of BT service increased gradually and BT enabled the delivery of a higher RT dose to patients with cervical cancer (mostly stage IIB). However, there was protracted treatment duration and low concurrent chemotherapy utilization.
Organizational Impact of Immunotherapies in Advanced Cancers in France
Authors: Grumberg Valentine , Chouaïd Christos , Gaudin Anne-Françoise , Le Tourneau Christophe , Marabelle Aurélien , Bongiovanni-Delarozière Isabelle , Cotté François-Emery , Borget Isabelle
Published: August 2023

PURPOSE

In 2020, the French National Authority for Health ( Haute Autorité de Santé) published a methodologic guide called organizational impact (OI) cartography to define and structure assessment of the OI of health technologies. As immunotherapies are associated with extended survival and improved quality of life in advanced cancer, we aimed to identify OIs that immunotherapies had on health care systems and professionals. To our knowledge, we suggest the first implementation for OI assessment on the basis of the cartography.

METHODS

A literature review was conducted, and interviews with health care professionals (HCPs) were performed to identify OIs of immunotherapies. They were asked if immunotherapies had OIs classified into three macrocriteria, namely, impact on the care process (six criteria), impact on capacities and skills required (six criteria), and impact on society (four criteria). If an OI was mentioned for a criterion, information on its impact (minor/moderate/major) and its timing was collected. We considered that an OI existed when 75% of HCPs mentioned an impact for a given criterion.

RESULTS

Overall, 27 HCPs were interviewed. For 12 of 16 criteria, most HCPs mentioned an impact, whereas the literature identified impacts for 11 criteria. Four criteria (skills and transfer between HCPs, scheduling capabilities, and social relationship) had consensus among HCPs and a high impact; two criteria (rhythm or care duration, working/living conditions) showed consensus but a moderate impact; two criteria (funding and scheduling capabilities cross-structure) had a high impact but no consensus. For eight criteria (as environment or inequity), there was no consensus and moderate impact.

CONCLUSION

The introduction of immunotherapies for advanced cancer has had an important OI in France, regarding capacities and skills. Further research using qualitative analysis of interviews will provide more information regarding OI.
Outcome of Patients With Early-Stage Mismatch Repair Deficient Colorectal Cancer Receiving Neoadjuvant Immunotherapy: A Systematic Review
Authors: Chakrabarti Sakti , Grewal Udhayvir Singh , Vora Kruti Bhagirath , Parikh Aparna Raj , Almader-Douglas Diana , Mahipal Amit , Sonbol Mohamad (Bassam) B.
Published: August 2023

PURPOSE

We conducted a systematic review to evaluate the outcome of patients with early-stage (stages I-III) mismatch repair deficient (dMMR) colorectal cancer (CRC) receiving neoadjuvant immunotherapy (NIT) with immune checkpoint inhibitor (ICI)–based regimens.

METHODS

MEDLINE, Scopus, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched for publications reporting the outcome of patients with early-stage dMMR CRC receiving NIT. The primary outcome measures were the complete response (CR) rate (clinical CR [cCR] or pathologic CR [pCR]) and the incidence of grade 3 or higher toxicities.

RESULTS

The search identified 37 publications that included 423 patients with colon (n = 326, 77%) and rectal (n = 97,23%) cancers aged 19-82 years; most patients had stage III CRC (88%). Approximately 67% of patients received monotherapy with anti–PD-1 agents; the rest received dual ICIs (ipilimumab plus nivolumab). The CR rate (pCR + cCR) in the overall population was 72% (305 of 423). The R0 resection and pCR rates were 99.3% and 70% among the patients undergoing surgery, respectively. Only four (0.9%) patients had primary resistance to NIT. After median follow-up periods ranging from 4 to 27 months, 3 (0.7%) patients progressed after an initial response. Grade 3 or higher toxicities were uncommon (6.3%), rarely delaying planned surgery.

CONCLUSION

NIT in patients with early-stage dMMR CRC is associated with a high response rate, low primary resistance to immunotherapy and cancer recurrence rate, and an excellent safety profile. The findings of the present systematic review support further investigation of NIT in patients with early-stage dMMR CRC, with a particular emphasis on the organ-preserving potential of this strategy.
Transcriptomic Signatures Associated With Outcomes in Recurrent Prostate Cancer Treated With Salvage Radiation, Androgen-Deprivation Therapy, and Enzalutamide: Correlative Analysis of the STREAM Trial
Authors: Bitting Rhonda L. , Wu Yuan , Somarelli Jason A. , Proudfoot James A. , Liu Yang , Davicioni Elai , George Daniel J. , Armstrong Andrew J.
Published: August 2023

PURPOSE

Men with rising prostate-specific antigen (PSA) after radical prostatectomy (RP) may progress despite radiation and androgen-deprivation therapy (ADT). Tissue-based transcriptomic signatures can identify who may benefit from a more aggressive systemic approach.

METHODS

We performed a retrospective analysis of a prospective phase II multicenter trial of enzalutamide, ADT, and salvage radiotherapy in men with rising PSA after RP. Tumor tissue was analyzed using the Decipher platform for gene expression, including a novel prostate subtyping classifier, PTEN loss, homologous recombination deficiency (HRD), and ADT response. Cox models were used to associate signature scores with progression-free survival (PFS).

RESULTS

Of the 38 men enrolled, 31 had tissue with sufficient-quality RNA for genomic analysis. Luminal differentiated (LD) subtype tumors had the longest 3-year PFS at 89% compared with 19% in the luminal proliferating subtype. Men with signatures of PTEN loss (hazard ratio [HR], 1.32; 95% CI, 1.07 to 1.64; P = .01) or HRD (HR, 1.21; 95% CI, 1.05 to 1.39; P = .009) had worse PFS, while those with higher ADT response signature scores (HR, 0.75; 95% CI, 0.61 to 0.94; P = .01) were associated with improved PFS. Analysis of these signatures in a large cohort (n = 5,330) of RP samples from patients with biochemical recurrence found that these signatures provide complementary information related to outcomes with salvage radiation.

CONCLUSION

Despite aggressive systemic therapy with salvage radiation, nearly 50% of high-risk men relapse within 3 years. We show that LD and higher ADT sensitivity tumors had favorable outcomes. Those with a luminal proliferating subtype, PTEN loss, and/or HRD signatures had poor outcomes despite ADT/radiation and enzalutamide and may benefit from alternative approaches.
Thinking Out to In: Psychological Considerations and Strategies for Optimal Sport and Exercise Performance
Authors: Mellano Kathleen T.
Published: August 2023

Apply It!

By reading this article, you will learn how:

• To choose or design a task that is challenging but presents some opportunity for success.

• Working in groups can foster or inhibit motivation and how to pair people based on skill level and existing relationships.

• To set aside a few mindful minutes before engaging in sport or exercise to warm-up mentally; similar to how one physically warms-up.
The Use of Botulinum Toxin in Medicine: Safety and Efficacy Based on the Latest Research
Authors: Jaremek Anna , Kępa Joanna , Kandefer Norbert , Wyszkowski Michał , Grabarczyk Aleksandra , Pawlak Anna , Grad Sylwia , Gregorek Małgorzata , Gregorek Paweł
Published: August 2023

Introduction and aim of the study: Botulinum toxin, produced by anaerobic bacteria of the Clostridium botulinum family, is one of the most potent organic compounds known to man. Despite its toxicity, it has found widespread use in medicine. From applications in aesthetic medicine, through the treatment of various disease entities, botulinum toxin has become an extremely valuable tool in the hands of doctors. The aim of this study is to review the latest research on the use of botulinum in medicine, with an emphasis on its safety and effectiveness.
 
Methodology: The review work is mainly based on articles searched in the Pubmed and Google Scholar databases in the years 2016-2023. The study was conducted by reviewing keywords such as "botulin", "botulin toxin", "botulin treatment", "botulin aesthetic".
Current state of knowledge: Botulinum is used in the treatment of such disease entities as hyperhidrosis, cervical dystonia, migraines, neurogenic bladder, as well as in the treatment of scars and wrinkles. The use of botulinum in medicine is safe, provided that it is used by qualified specialists and in appropriate doses. An area that requires further research is the impact of long-term botulinum therapy on the antibodies produced against the toxin. Additionally, an important area for further research is patient monitoring, appropriate dose adjustment and frequency of administration, which in turn can increase the effectiveness of treatment.
Summary: Botulinum toxin is an effective tool in medicine, which has many applications. However, as with any drug, it requires appropriate use and understanding of potential side effects. Further research and education are key to fully exploiting its potential and assessing the risk associated with long-term use.
Treatment methods for patients suffering from acute lymphoblastic leukemia (all) - a brief review
Authors: Czudy Zuzanna , Pawęska Wojciech , Radwański Jan , Dominik Hanna , Polatowska Marika , Gadomska Anna , Kurek Justyna , Gorzyński Rafał , Garstka Michał , Molczyk-Sieńczak Justyna
Published: August 2023

Introduction and purpose: Acute lymphoblastic leukemia is a medical condition with underlying abnormal proliferation of cells of the lymphoid system which are blocked at an early stage of differentiation. As a result of impaired lymphocyte maturation, the proliferation and accumulation of immature blastic cells, derived from tumor-transformed bone marrow precursor cells, develop in the bone marrow. The infiltration of the bone marrow by leukemic cells results in failure of normal hematopoiesis, with subsequent anemia, thrombocytopenia and neutropenia. Acute lymphoblastic leukemia is among the most aggressive proliferative diseases, and survival time is a few to several weeks without appropriate treatment.Materials and methods: The literature available on PubMed was reviewed using the words “acute lymphoblastic leukemia ”, “ALL”, “acute lymphoblastic leukemia treatment”.Summary: Acute lymphoblastic leukemia was managed with a chemotherapeutic drug combination for several years, with median overall survival of approximately 80% for all newly diagnosed cases. Patients with higher-risk relapses receive more intensive treatment, while patients with more favorable outcomes can avoid more toxic effects. Multicenter randomized controlled trials conducted by international collaborative efforts are helping to advance overall survival by exploring novel treatments. Hope for the future of leukemia therapy is defining the underlying molecular trails in the pathogenesis of the disease and clarifying host pharmacogenetic factors further. If successful, these efforts will allow the identification of new genes with candidate proteins for targeted therapies.
Suciedad y orden. Reformas sanitarias borbónicas en la Nueva Granada, 1760-1810. Segunda edición
Authors: Alzate Echeverri Adriana María
Published: August 2023

Las reformas sanitarias borbónicas formaban parte de un proyecto que buscaba “civilizar” a los vasallos, convertirlos en sujetos sanos, obedientes y productivos, con base en ciertas prácticas ligadas al canon definido por los valores ilustrados. En el Virreinato de la Nueva Granada, las reformas sanitarias comprendieron la organización y el saneamiento del espacio urbano, el desplazamiento de los cementerios fuera de las ciudades, el establecimiento de me canismos más eficaces para luchar contra las epidemias, la reestructuración de la institución hospitalaria, la renovación de los estudios médicos y la puesta en circulación más intensa de libros relacionados con la salud. Este libro estudia los dos primeros aspectos. El texto explica las más importantes estrategias instauradas en Virreinato de la Nueva Granada con el fin de llevar a cabo estas reformas, los objetivos alcanzados, el conjunto de resistencias que genera ron y la variada literatura que produjeron. Fue esta una obra pionera, que abrió importantes caminos de reflexión sobre el tema y que impulsó debates en Colombia e Hispanoamérica.
O JUS COGENS COMO MECANISMO DE PROTEÇÃO DOS DIREITOS HUMANOS: O IMPACTO DA VOZ DISSIDENTE DO JUIZ ANTÔNIO AUGUSTO CANÇADO TRINDADE - DOI: 10.12818/P.0304-2340.2022v81p123
Authors: Stoppioni Edoardo , de Oliveira Biazatti Bruno
Published: August 2023

Jus cogens ou normas peremptórias são aquelas normas de direito internacional aceitas e reconhecidas pela comunidade internacional dos Estados como um todo como aquelas das quais nenhuma modificação, derrogação ou revogação é permitida, exceto por outra norma de mesma natureza. Em sua essência, as normas de jus cogens protegem os valores mais fundamentais da comunidade internacional e, em decorrência disso, são hierarquicamente superiores a outras normas internacionais e nacionais e são universalmente aplicáveis. O jus cogens possui papel de destaque no processo de humanização do direito internacional promovido por Antônio Augusto Cançado Trindade, já que a sua forte carga axiológica e hierarquização inerente se revelam úteis ferramentas para a desconstrução de elementos voluntaristas e a consolidação de normas e procedimentos voltados para a proteção da humanidade. Contudo, enquanto juiz internacional, Cançado Trindade fez uso do jus cogens de maneira diferenciada quando serviu na Corte Interamericana de Direitos Humanos (CtIADH) e depois na Corte Internacional de Justiça (CIJ). Por meio da análise de seus votos individuais, o presente artigo visa demonstrar como o jus cogens foi percebido e utilizado por Cançado Trindade dependendo do tribunal internacional no qual atuou. Enquanto na CtIADH o brasileiro encontrou larga receptividade ao seu projeto de humanização, resultando numa significativa expansão material, horizontal e vertical do jus cogens para fins de proteção dos direitos humanos, o cenário muito díspar da CIJ, onde o voluntarista do direito internacional clássico ainda persistente, motivou Cançado Trindade a modificar a sua abordagem, agora usando o jus cogens como parte de uma estratégia argumentativa contra- -hegemônica.