bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-led home-based follow-up after surgery for colorectal cancer: the protocol of the prospective, multicentre FUTURE-primary implementation study
Authors: Voigt Kelly Raquel , Wullaert Lissa , Höppener Diederik J , Schreinemakers Jennifer M J , Doornebosch Pascal G , Verseveld Maria , Peeters Koen , Verhoef Cornelis , Husson Olga , Grünhagen Dirk
Published: October 2023

Introduction

Colorectal cancer (CRC) is the third most common type of cancer in the Netherlands. Approximately 90% of patients can be treated with surgery, which is considered potentially curative. Postoperative surveillance during the first 5 years after surgery pursues to detect metastases in an early, asymptomatic and treatable stage. Multiple large randomised controlled trials have failed to show any (cancer-specific) survival benefit of intensive postoperative surveillance compared with a minimalistic approach in patients with CRC. This raises the question whether an (intensive) in-hospital postoperative surveillance strategy is still warranted from both a patient well-being and societal perspective. A more modern, home-based surveillance strategy could be beneficial in terms of patients’ quality of life and healthcare costs.

Methods and analysis

The multicentre, prospective FUTURE-primary study implements a patient-led home-based surveillance after curative CRC treatment. Here, patients are involved in the choice regarding three fundamental aspects of their postoperative surveillance. First regarding frequency, patients can opt for additional follow-up moments to the minimal requirement as outlined by the current Dutch national guidelines. Second regarding the setting, both in-hospital or predominantly home-based options are available. And third, concerning patient–doctor communication choices ranging from in-person to video chat, and even silent check-ups. The aim of the FUTURE-primary study is to evaluate if such a patient-led home-based follow-up approach is successful in terms of quality of life, satisfaction and anxiety compared with historic data. A successful implementation of the patient-led aspect will be assessed by the degree in which the additional, optional follow-up moments are actually utilised. Secondary objectives are to evaluate quality of life, anxiety, fear of cancer recurrence and cost-effectiveness.

Ethics and dissemination

Ethical approval was given by the Medical Ethics Review Committee of Erasmus Medical Centre, The Netherlands (2021-0499). Results will be presented in peer-reviewed journals.

Trial registration number

NCT05656326.
Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK: a mixed-methods study
Authors: King Emma , France Emma , Malcolm Cari , Kumar Simita , Dick Smita , Kyle Richard G , Wilson Philip , Aucott Lorna , Turner Stephen , Hoddinott Pat
Published: October 2023

Objectives

To identify and prioritise interventions, from the perspectives of parents and health professionals, which may be alternatives to current unscheduled paediatric urgent care pathways.

Design

FLAMINGO (FLow of AdMissions in chIldren and youNG peOple) is a sequential mixed-methods study, with public and patient involvement (PPI) throughout. Data linkage for urgent admissions and three referral sources: emergency department, out of hours service and general practice, was followed by qualitative interviews with parents and professionals. Findings were presented and discussed at a stakeholder intervention prioritisation event.

Setting

National Health Service in Scotland, UK.

Participants

Quantitative data: children with urgent medical admission to hospital from 2015 to 2017. Qualitative interviews: parents and health professionals with experiences of urgent short stay hospital admissions of children. PPI engagement was conducted with nine parent–toddler groups and a university-based PPI advisory group. Stakeholder event: parents, health professionals and representatives from Scottish Government, academia, charities and PPI attended.

Results

Data for 171 039 admissions which included 92 229 short stay admissions were analysed and 48 health professionals and 21 parents were interviewed. The stakeholder event included 7 parents, 12 health professionals and 28 other stakeholders. Analysis and synthesis of all data identified seven interventions which were prioritised at the stakeholder event: (1) addressing gaps in acute paediatric skills of health professionals working in community settings; (2) assessment and observation of acutely unwell children in community settings; (3) creation of holistic children’s ‘hubs’; (4) adoption of ‘hospital at home’ models; and three specialised care pathways for subgroups of children; (5) convulsions; (6) being aged <2 years old; and (7) wheeze/bronchiolitis. Stakeholders prioritised interventions 1, 2 and 3; these could be combined into a whole population intervention. Barriers to progressing these include resources, staffing and rurality.

Conclusions

Health professionals and families want future interventions that are patient-centred, community-based and aligned to outcomes that matter to them.
Nursing support for breathlessness in patients with cancer: a scoping review
Authors: Kako Jun , Morikawa Miharu , Kobayashi Masamitsu , Kanno Yusuke , Kajiwara Kohei , Nakano Kimiko , Matsuda Yoshinobu , Shimizu Yoichi , Hori Megumi , Niino Mariko , Suzuki Miho , Shimazu Taichi
Published: October 2023

Objective

To identify nursing support provided for the relief of breathlessness in patients with cancer.

Design

A scoping review following a standard framework proposed by Arksey and O’Malley.

Study selection

Electronic databases (PubMed, CINAHL, CENTRAL and Ichushi-Web of the Japan Medical Abstract Society Databases) were searched from inception to 31 January 2022. Studies reporting on patients with cancer (aged ≥18 years), intervention for relief from breathlessness, nursing support and quantitatively assessed breathlessness using a scale were included.

Results

Overall, 2629 articles were screened, and 27 were finally included. Results of the qualitative thematic analysis were categorised into 12 nursing support components: fan therapy, nurse-led intervention, multidisciplinary intervention, psychoeducational programme, breathing technique, walking therapy, inspiratory muscle training, respiratory rehabilitation, yoga, acupuncture, guided imagery and abdominal massage.

Conclusions

We identified 12 components of nursing support for breathlessness in patients with cancer. The study results may be useful to understand the actual state of nursing support provided for breathlessness in patients with terminal cancer and to consider possible support that can be implemented.
Prevalence of questionable health behaviours in Serbia and their psychological roots: protocol for a nationally representative survey
Authors: Knezevic Goran , Lazarević Ljiljana , Purić Danka , Zupan Zorana , Žeželj Iris
Published: October 2023

Introduction

We will launch a national survey in Serbia to document the prevalence of two types of questionable health behaviours: (1) intentional non-adherence to medical recommendations and (2) use of traditional, complementary and alternative medicine practices, as well as the relation between the two. We will also investigate their psychological roots, including (a) ‘distal’ predictors such as HEXACO personality traits (plus Disintegration) and thinking dispositions (rational/experiential thinking and cognitive reflexivity), and (b) ‘proximal’ predictors under the umbrella ‘irrational mindset’ (set of unfounded beliefs consisting of conspiratorial thinking, superstition, magical health beliefs as well as selected cognitive biases), which have more content-wise overlap with the health behaviours.

Methods and analysis

In this cross-sectional study, a research agency will collect data from a nationally representative sample (n=1043; age 18–75 years; estimated start/end—June/November 2023) recruited online (approximately, 70% of the sample, aged 18–54; 11 years) and face-to-face (approximately, 30% of the sample, aged 55–75 years). Participants will complete a battery of tests assessing questionable health behaviours, basic personality traits, thinking dispositions, irrational mindset, sociopolitical beliefs, sociodemographic and health-related variables. Prevalence rates will be calculated using descriptive statistics. To explore the relation between (psychological) predictors and questionable health behaviours, we will use hierarchical regression and partial mediation models (path analysis or full SEM models).

Ethics and dissemination

Ethical Committees of the Faculty of Philosophy in Belgrade (#935/1), Faculty of Special Education and Rehabilitation (#139/1) and Faculty of Media and Communications (#228) approved the protocol. Only participants who provide informed consent will participate in the study. A research report based on the study results will be submitted to peer-reviewed journals and results will be made available to stakeholders through reports on the project websitehttps://reasonforhealth.f.bg.ac.rs/en/and disseminated via social media.

Trial registration number

NCT05808660
Impact of strategies to mitigate misinformation in diverse settings and populations: a protocol for a living evidence synthesis
Authors: Wilson Michael , Vélez Marcela , Lavis John
Published: October 2023

Introduction

Misinformation refers to inadvertent misleading information that the public may be exposed and share without intent to cause harm, and can delay or prevent effective care, affect mental health, lead to misallocation of health resources and/or create or exacerbate public-health crises. There are many strategies to address misinformation, but there is a need to evaluate their effects. Our objective is to synthesise and routinely update evidence to assess the impact of strategies to mitigate health-related misinformation in diverse settings, and populations.

Methods and analysis

We will search seven databases in May 2023 with planned updates at 6 and 9 months, which will be supplemented with searches for grey literature and reference lists of included studies and contacting experts. Two reviewers will independently screen all search results for studies that evaluate one or more approaches to addressing health-related misinformation. One researcher will conduct data extraction and risk of bias assessments, which will be reviewed by a second reviewer for accuracy. We will include experimental, quasi-experimental and observational studies for any populations, settings and diseases without language or publication restrictions. We will conduct quantitative analysis if meta-analytical pooling is possible. If pooling is not possible, we will synthesise quantitative data according to outcomes and interventions addressed, and present a narrative summary of findings disaggregated by sex and/or gender, irrespective of whether differences were found.

Ethics and dissemination

There are no individuals or protected health information involved and no safety issues identified. Results will be published through the Global Commission on Evidence and COVID-END websites, in a peer-reviewed journal, as well as through plain-language materials.

PROSPERO registration number

CRD42023421149.
An improved design for a zero-tillage experimental plot drill
Authors: Beres B.L. , Simmill S. , Taylor W. , Dyck R.J. , Hubert J.
Published: October 2023

Adoption of conservation farming practices such as zero tillage when planting field research plots is essential to the replication of on-farm practices. The problem is that most drill options fail to meet expectations as they are not built to the scale required, compromise the need for uniformity of plant emergence within plot areas, lack portability, or have been designed and equipped in a manner that is not relevant to farm-scale seeder technologies and practices. Agronomists and Technicians at Agriculture and Agri-Food Canada engaged with engineering expertise to design and build two prototype drills that are now in full operation.
Silver, cobalt and nickel mineralogy and geochemistry of shale ore in the sediment-hosted stratiform Nowa Sól copper–silver deposit, SW Poland
Authors: Bieńko Tomasz , Wierchowiec Jan , Pietrzela Alicja
Published: October 2023

The Nowa Sól deposit is a part of the newly discovered Northern Copper Belt and is situated some 30 km NW of the Lubin–Sieroszowice mining district (the so-called New Copper District) in SW Poland. The ore horizon spans across the upper part of the Lower Permian (Rotliegend) terrestrial redbeds and the lower part of the Upper Permian (Zechstein) marine rocks. It comprises three lithotypes: sandstone, shale and carbonate.

The high-grade shale ore has polymetallic characteristics and is a crucial host for by-product metals such as Ag, Co and Ni (studied in this paper), but also Mo, V and Re. The results of bulk-rock and electron microprobe as well as mineralogical (optical and scanning electron microscope) data of the mineralized, organic-rich shale ore from the Nowa Sól deposit are presented. This thin stratigraphic horizon, ranging from 0.06 to 0.59 m, shows notable concentrations of critical metals, including on average 15.9 wt% Cu, 715 grams per tonne (g t
-1
) Ag, 318 g t
-1
Co and 345 g t
-1
Ni. It constitutes less than 10% of the total ore mass, but accounts for 36% of the Ag, 40% of the Ni and 42% of the Co found within the deposit.

The ore sulfides in the mineralized shale in the Nowa Sól deposit include chalcocite, djurleite and bornite, accompanied by digenite, covellite, tennantite, galena, sphalerite and pyrite. The Ag content within the Cu sulfides exhibits a linear decrease: chalcocite > djurleite > bornite. Three primary Ag minerals are identified within the shale ore, namely native Ag, Ag amalgam and stromeyerite. Two types of Ag amalgam are observed: Hg-rich and Hg-poor. Cobaltite and gersdorffite represent the primary Co and Ni minerals, occurring as micrometre-sized inclusions within chalcocite and djurleite. Textural observations suggest that the Ag, Co and Ni mineralization postdates the major phase of Cu sulfide precipitation. It is shown that in the Nowa Sól deposit, the Kupferschiefer horizon has acted as a geochemical barrier for the above-mentioned metals during protracted time, from early syndepositional to late epigenetic stage of basin evolution.

Supplementary material:
The supplementary material contains the results of the electron microprobe analyses and the specific experimental conditions employed for these analyses – available at
https://doi.org/10.6084/m9.figshare.c.6873631
The Harz Mountains (Germany) – Cadomia meets Avalonia and Baltica: U–Pb ages of detrital and magmatic zircon as a key for the decoding of Pangaea's central suture
Authors: Linnemann Ulf , Zweig Maren , Zieger-Hofmann Mandy , Vietor Tim , Zieger Johannes , Haschke Jessica , Gärtner Andreas , Mende Katja , Krause Rita , Knolle Friedhart
Published: October 2023

U–Pb ages of detrital (
n
= 2391) and magmatic (
n
= 170) zircon grains from the Harz Mountains were obtained by LA-ICP-MS for provenance studies and absolute age dating. Results point to a complete closure of the Rheic Ocean at
c.
419 Ma. A narrow Rhenish Seaway then re-opened in Emsian to mid-Devonian time (
c.
390–400 Ma). Devonian sedimentary rocks of the Harz Mountains were deposited on the northwestern (Rheno-Hercynian) and on the southeastern (Saxo-Thuringian) margins of the Rhenish Seaway. A new U–Pb zircon age from a plagiogranite (329 ± 2 Ma) within a harzburgite makes the existence of oceanic lithosphere in the Rhenish Seaway probable. The Rhenish Seaway was completely closed by Serpukhovian time (
c.
328 Ma). Existence of a terrane in the seaway is not supported by the new data. Provenance studies and spatial arrangement allow reconstruction of the thin- to thick-skinned obduction style of the Harz Mountains onto the southeastern margin of East Avalonia (Rheno-Hercynian Zone) during the Variscan orogeny. Detrital zircon populations define Rheno-Hercynian and Saxo-Thuringian nappes. Intrusion of the granitoid plutons of the Harz Mountains occurred in a time window of
c.
300 to 295 Myr and constrained the termination of Variscan deformation.
The Mwesia Beds of northern Malawi in relation to the Tanganyika Problem
Authors: Chindebvu Elizabeth Gomani , Jacobs Louis L. , Juwayeyi Yusuf M. , Perez Myria L. , Polcyn Michael J. , Simfukwe Harrison H. , Vineyard Diana P. , Winkler Dale A.
Published: October 2023

In this paper, we trace the saga of the rocks and fossils discovered along Stevenson Road, northern Malawi. Fish and bivalves discovered along the road were proclaimed the first fossils of Central Africa. In the late nineteenth and early twentieth centuries, they became a large part of the ‘Tanganyika Problem’, the notion of whether a Jurassic incursion of the sea left fossils in what is now Malawi and relict marine invertebrates in Lake Tanganyika. Later studies clarified both the geology and zoology of the region, but no more informative fossils were found in Malawi until 2016 when a specimen of
Eunotosaurus
was discovered by a herdsman in the original nineteenth century fossil locality. He presented the fossil to the Cultural and Museum Centre Karonga, the public face of geoheritage in Malawi. That specimen constrains the upper age limit of the site to approximately 259 Ma (Late Permian). The Tanganyika Problem is now largely of historical interest, yet in a more current multidisciplinary context – the timing and mechanisms of the evolutionary transition of clades from the marine realm into freshwater biomes open new questions about historical biogeography in a geological context.
Non-intrusive Human Vital Sign Detection Using mmWave Sensing Technologies: A Review
Authors: Wu Yingxiao , Ni Haocheng , Mao Changlin , Han Jianping , Xu Wenyao
Published: October 2023

Non-invasive human vital sign detection has gained significant attention in recent years, with its potential for contactless, long-term monitoring. Advances in radar systems have enabled non-contact detection of human vital signs, emerging as a crucial area of research. The movements of key human organs influence radar signal propagation, offering researchers the opportunity to detect vital signs by analyzing received electromagnetic (EM) signals. In this review, we provide a comprehensive overview of the current state-of-the-art in millimeter-wave (mmWave) sensing for vital sign detection. We explore human anatomy and various measurement methods, including contact and non-contact approaches, and summarize the principles of mmWave radar sensing. To demonstrate how EM signals can be harnessed for vital sign detection, we discuss four mmWave-based vital sign sensing (MVSS) signal models and elaborate on the signal processing chain for MVSS. Additionally, we present an extensive review of deep learning-based MVSS and compare existing studies. Finally, we offer insights into specific applications of MVSS (e.g., biometric authentication) and highlight future research trends in this domain.
HARR: Learning Discriminative and High-Quality Hash Codes for Image Retrieval
Authors: Ma Zeyu , Wang Siwei , Luo Xiao , Gu Zhonghui , Chen Chong , Li Jinxing , Hua Xian-Sheng , Lu Guangming
Published: October 2023

This article studies deep unsupervised hashing, which has attracted increasing attention in large-scale image retrieval. The majority of recent approaches usually reconstruct semantic similarity information, which then guides the hash code learning. However, they still fail to achieve satisfactory performance in reality for two reasons. On the one hand, without accurate supervised information, these methods usually fail to produce independent and robust hash codes with semantics information well preserved, which may hinder effective image retrieval. On the other hand, due to discrete constraints, how to effectively optimize the hashing network in an end-to-end manner with small quantization errors remains a problem. To address these difficulties, we propose a novel unsupervised hashing method called
HARR
to learn discriminative and high-quality hash codes. To comprehensively explore semantic similarity structure, HARR adopts the Winner-Take-All hash to model the similarity structure. Then similarity-preserving hash codes are learned under the reliable guidance of the reconstructed similarity structure. Additionally, we improve the quality of hash codes by a bit correlation reduction module, which forces the cross-correlation matrix between a batch of hash codes under different augmentations to approach the identity matrix. In this way, the generated hash bits are expected to be invariant to disturbances with minimal redundancy, which can be further interpreted as an instantiation of the information bottleneck principle. Finally, for effective hashing network training, we minimize the cosine distances between real-value network outputs and their binary codes for small quantization errors. Extensive experiments demonstrate the effectiveness of our proposed HARR.
Interventional Pulmonology: Extending the Breadth of Thoracic Care
Authors: Gesthalter Yaron B. , Channick Colleen L.
Published: October 2023

Interventional pulmonary medicine has developed as a subspecialty focused on the management of patients with complex thoracic disease. Leveraging minimally invasive techniques, interventional pulmonologists diagnose and treat pathologies that previously required more invasive options such as surgery. By mitigating procedural risk, interventional pulmonologists have extended the reach of care to a wider pool of vulnerable patients who require therapy. Endoscopic innovations, including endobronchial ultrasound and robotic and electromagnetic bronchoscopy, have enhanced the ability to perform diagnostic procedures on an ambulatory basis. Therapeutic procedures for patients with symptomatic airway disease, pleural disease, and severe emphysema have provided the ability to palliate symptoms. The combination of medical and procedural expertise has made interventional pulmonologists an integral part of comprehensive care teams for patients with oncologic, airway, and pleural needs. This review surveys key areas in which interventional pulmonologists have impacted the care of thoracic disease through bronchoscopic intervention.
Antinociceptive effect of the calcitonin gene-related peptide receptor antagonist BIBN4096BS in mice with bacterial cystitis
Authors: Montalbetti Nicolas , Dalghi Marianela G. , Parakala-Jain Tanmay , Clayton Dennis , Apodaca Gerard , Carattino Marcelo D.
Published: October 2023

Afferent C fibers release neuropeptides including calcitonin gene-related peptide (CGRP). Here, we show that the specific CGRP receptor antagonist, BIBN409BS, ameliorates lower urinary tract symptoms and pelvic allodynia in mice inoculated with uropathogenic E. coli. Using fluorescent in situ hybridization, we identified a population of suburothelial fibroblasts in the lamina propria that expresses the canonical CGRP receptor. Our findings indicate that CGRP contributes to the transmission of nociceptive information arising from the bladder.
Angiotensin II hypertension along the female rat tubule: predicted impact on coupled transport of Na+ and K+
Authors: Edwards Aurélie , Ralph Donna L. , Mercado Adriana , McDonough Alicia A.
Published: October 2023

We used a computational model of the renal tubule to assess the impact of 2-wk angiotensin II (ANG II) infusion on the handling of Na+ and K+ in female rats. ANG II strongly stimulates distal Na+ reabsorption and K+ secretion. Simulations indicate that substantial downregulation of proximal tubule NHE3 is needed to reestablish Na+ balance at 2 wk. Proximal adaptations challenge K+ homeostasis, and regulation of distal NCC and specific K+ channels likely limit urinary K+ losses.
Defining the molecular fingerprint of bladder and kidney fibroblasts
Authors: Apodaca Gerard
Published: October 2023

Fibroblasts are integral to the organization and function of all organs and play critical roles in pathologies such as fibrosis; however, we have limited understanding of the fibroblasts that populate the bladder and kidney. In this review, I describe how transcriptomics is leading to a revolution in our understanding of fibroblast biology by defining the molecular fingerprint (i.e., transcriptome) of universal and specialized fibroblast types, revealing gene signatures that allows one to resolve fibroblasts from other mesenchymal cell types, and providing a new comprehension of the fibroblast lineage. In the kidney, transcriptomics is giving us new insights into the molecular fingerprint of kidney fibroblasts, including those for cortical fibroblasts, medullary fibroblasts, and erythropoietin (EPO)-producing Norn fibroblasts, as well as new information about the gene signatures of kidney myofibroblasts and the transition of kidney fibroblasts into myofibroblasts. Transcriptomics has also revealed that the major cell type in the bladder interstitium is the fibroblast, and that multiple fibroblast types, each with their own molecular fingerprint, are found in the bladder wall. Interleaved throughout is a discussion of how transcriptomics can drive our future understanding of fibroblast identification, diversity, function, and their roles in bladder and kidney biology and physiology in health and in disease states.
Chloroquine impairs maximal transdiaphragmatic pressure generation in old mice
Authors: Saldarriaga Carlos A. , Alatout Mayar H. , Khurram Obaid U. , Gransee Heather M. , Sieck Gary C. , Mantilla Carlos B.
Published: October 2023

Recent findings suggest that autophagy plays a role in the development of aging-related neuromuscular dysfunction; however, the contribution of autophagy impairment to the maintenance of diaphragm force generation in old age is unknown. This study shows that in old mice, chloroquine administration decreases maximal transdiaphragmatic pressure generation. These chloroquine effects suggest a susceptibility to impairments in autophagy in old age.
Adaptability to eccentric exercise training is diminished with age in female mice
Authors: Baumann Cory W. , Deane Colleen S. , Etheridge Timothy , Szewczyk Nathaniel J. , Willis Craig R. G. , Lowe Dawn A.
Published: October 2023

The ability to adapt to exercise training may help prevent and combat sarcopenia. Here, we demonstrate young mouse muscles get stronger whereas older mouse muscles become weaker after repeated bouts of eccentric contractions, and that numerous genes were differentially expressed between age groups following training. These results highlight that molecular and functional plasticity is not fixed in skeletal muscle with advancing age, and the ability to handle or cope with physical stress may be impaired.
Classification of Brain Tumor Images Using CNN
Authors: Gupta Manali , Sharma Sanjay Kumar , Sampada G. C.
Published: October 2023

A brain tumor is a serious malignant condition caused by unregulated as well as aberrant cell partitioning. Recent advances in deep learning have aided the healthcare business, particularly, diagnostic imaging for the diagnosis of numerous disorders. The most frequent and widely utilized machine learning model for image recognition is probably task CNN. Similarly, in our study, we categorize brain MRI scanning images using CNN and data augmentation and image processing techniques. We compared the performance of the scratch CNN model with that of pretrained VGG‐16 models using transfer learning. Even though the investigation is carried out on a small dataset, the results indicate that our model’s accuracy is quite successful and has extremely low complexity rates, achieving 100 percent accuracy compared to 96 percent accuracy for VGG‐16. Compared to existing pretrained methods, our model uses much less processing resources and produces substantially greater accuracy.
Instructional Leadership Practices and Challenges: The Case of Primary School Principals in Liban Jawi Woreda of West Shoa Zone
Authors: Feyisa Lucho Begi , Edosa Kitessa Chemeda
Published: October 2023

This study was conducted to assess the practices and challenges of instructional leadership in primary schools of Liban Jawi Woreda of the West Shoa Zone. In order to address this objective of the study, a descriptive survey design was employed. About 114 teachers, seven principals, six vice principals, and one vice head of Woreda Education Office (WEO) participated in the study. Questionnaires, interviews, and document analysis were data gathering tools. The results showed that most of the problems instructional leaders have a communication gap with the stakeholders on issues related to the vision, mission, and goals of the schools and had problems in relation to lack of educational management profession. It was concluded that instructional leaders have a gap in taking a measure to overcome problems. Therefore, the study mainly recommended that Ministry of Education (MOE) and other stakeholders should give training to instructional leaders to overcome their leadership knowledge and skills, and also principals should create communication channels to overcome communication problems.
Efficacy of Periarticular Infiltration with Dexamethasone and Bupivacaine plus Adductor Canal Block Relative to That of Adductor Canal Block Alone for Patients Undergoing Total Knee Arthroplasty: A Retrospective Case-Matched Study
Authors: Yuenyongviwat Varah , Wuttiworawanit Bunyaporn , Panichnantho Nipat , Hongnaparak Theerawit , Iamthanaporn Khanin
Published: October 2023

Purpose. Periarticular infiltration (PI) is a common procedure during total knee arthroplasty (TKA) for postoperative pain management. This retrospective, case-matched study aimed to evaluate the effectiveness of PI with dexamethasone and bupivacaine in combination with an adductor canal block (ACB) and compare it with that of ACB alone in reducing postoperative pain in patients with TKA. Methods. Data were collected from 66 patients who underwent TKA performed by a single surgeon. Thirty-three of them received ACB + PI, and 33 received ACB alone. However, both groups underwent identical surgical techniques and postoperative care protocols. The pain scores and fentanyl consumption of the two groups were compared. Results. The ACB + PI group had significantly lower pain scores than the ACB alone group at 8, 16, 24, and 48 hours postoperatively (

p
=
0.033

, 0.004, 0.038, and 0.049, respectively). The percentage of patients requiring fentanyl as a rescue medication was significantly higher for the ACB alone group (90.9%) than for the ACB + PI group (69.7%,

p
=
0.03

). The total fentanyl consumption was also lower for the ACB + PI group (

p
<
0.001

). Conclusion. The periarticular injection of the combination of dexamethasone and bupivacaine plus ACB was more effective than ACB alone in reducing postoperative pain and fentanyl consumption in patients undergoing TKA. Further studies comparing different doses of dexamethasone or other cocktail regimens may provide additional insights into this approach.
Odontogenic Keratocysts: Presentation and Surgical Outcome in a Sample of Sudanese Patients
Authors: Mohamed Alaa Ayman , Babiker Abdualhameed Abbas , Khalfallah Mazin Salah , Eltohami Yousif Idris
Published: October 2023

Background. Odontogenic keratocyst (OKC) is a benign intraosseous lesion relatively frequent in the oral cavity. It has a locally aggressive behavior and exhibits a high propensity to recur after treatment. The present study aimed to investigate the clinicoradiographic presentations and outcomes of surgical treatment of OKC at Khartoum Teaching Dental Hospital. Material and Methods. Fifty-five cases of OKC files at the Department of Oral and Maxillofacial Surgery in Khartoum Teaching Hospital between 2012 and 2022 were reviewed and studied using a descriptive prospective cross-sectional study. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 27. Results. Out of 55 cases studied, the mean age at the time of diagnosis was 30 ± 17.6 years; of them, 28 (50.9%) were males and 27 (49.1%) were females. The most common clinical manifestation was swelling (34.9%), followed by pain (28.0%). Sixty-five percent of the OKCs were located in the posterior mandible, and multilocular radiolucency (73.6%) was the most prevalent radiological finding. Enucleation with Carnoy’s solution (CS) (55.2%) was the most common surgical modality that was used in more than half the patients, and only six patients had a recurrence. Marsupialization and segmental resection had no recurrence, while marginal resection and curettage had the highest recurrence rate of 20%. Patients with consanguineous parents had a higher recurrence rate (15%) compared with patients who had nonconsanguineous parents (8.6%). None of the patients died or had a malignant transformation. Conclusion. The most common location for the cyst was the mandible, and multilocular radiolucency was the most prevalent radiological finding. Enucleation with CS was the most commonly used surgical modality, used in more than half of the patients, with only six patients experiencing recurrence.
BCL-xL Targeting to Induce Apoptosis and to Eliminate Chemotherapy-Induced Senescent Tumor Cells: From Navitoclax to Platelet-Sparing BCL-xL PROTACs
Authors: Skwarska Anna , Konopleva Marina
Published: October 2023

Restoring apoptotic cell death is a critical goal for cancer therapy. One of the primary mechanisms by which cancer cells evade death and maintain survival in the face of stress signals is by overexpression of prosurvival B-cell lymphoma 2 (BCL2) family members such as BCL2, BCL-xL, and MCL1, which suppress the intrinsic (mitochondrial) pathway of apoptosis through complex protein and membrane interactions. While these antiapoptotic proteins have been validated as potent therapeutic targets, synthesis of their inhibitors remained challenging for decades mainly due to the presence of a difficult to target, highly hydrophobic groove on the surface. The groove serves as a binding site for the BH3 domain of corresponding proapoptotic partners, which leads to their sequestration and prevents apoptosis. In 2008, a Cancer Research article by Tse and colleagues, led by Dr. Steven Elmore from Abbott Laboratories, reported the discovery of the first orally bioavailable BCL2/BCL-xL inhibitor, navitoclax (ABT-263), marking the onset of an era of “BH3 mimetics” in cancer therapeutics and changing the therapeutic landscape especially for leukemia. Here, we reflect on how this landmark study fueled development of small-molecule BH3 mimetics like venetoclax and seek to indicate new strategies and future directions for improving the clinical activity of navitoclax for hematologic malignancies.

See related article by Tse and colleagues, Cancer Res 2008;68:3421–3428.
Influence of Half-life and Smoking/Nonsmoking Ratio on Biomarker Consistency between Waves 1 and 2 of the Population Assessment of Tobacco and Health Study
Authors: Ashley David L. , Zhu Wanzhe , Bhandari Deepak , Wang Lanqing , Feng Jun , Wang Yuesong , Meng Lei , Xia Baoyun , Jarrett Jeffery M. , Chang Cindy M. , Kimmel Heather L. , Blount Benjamin C.
Published: October 2023

Background:

Biomarkers of exposure are tools for understanding the impact of tobacco use on health outcomes if confounders like demographics, use behavior, biological half-life, and other sources of exposure are accounted for in the analysis.

Methods:

We performed multiple regression analysis of longitudinal measures of urinary biomarkers of alkaloids, tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons, volatile organic compounds (VOC), and metals to examine the sample-to-sample consistency in Waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) Study including demographic characteristics and use behavior variables of persons who smoked exclusively. Regression coefficients, within- and between-person variance, and intra-class correlation coefficients (ICC) were compared with biomarker smoking/nonsmoking population mean ratios and biological half-lives.

Results:

Most biomarkers were similarly associated with sex, age, race/ethnicity, and product use behavior. The biomarkers with larger smoking/nonsmoking population mean ratios had greater regression coefficients related to recency of exposure. For VOC and alkaloid metabolites, longer biological half-life was associated with lower within-person variance. For each chemical class studied, there were biomarkers that demonstrated good ICCs.

Conclusions:

For most of the biomarkers of exposure reported in the PATH Study, for people who smoke cigarettes exclusively, associations are similar between urinary biomarkers of exposure and demographic and use behavior covariates. Biomarkers of exposure within-subject consistency is likely associated with nontobacco sources of exposure and biological half-life.

Impact:

Biomarkers measured in the PATH Study provide consistent sample-to-sample measures from which to investigate the association of adverse health outcomes with the characteristics of cigarettes and their use.
Supplementary Table 1 from Peritumoral Immune-suppressive Mechanisms Impede Intratumoral Lymphocyte Infiltration into Colorectal Cancer Liver versus Lung Metastases
Authors: Ye Jian , Guo Weihua , Wang Chongkai , Egelston Colt A. , D'Apuzzo Massimo , Shankar Geereesh , Fakih Marwan G. , Lee Peter P.
Published: October 2023

Detailed summary of CRC specimens and patient overall survival.
Supplementary Figure 5 from Peritumoral Immune-suppressive Mechanisms Impede Intratumoral Lymphocyte Infiltration into Colorectal Cancer Liver versus Lung Metastases
Authors: Ye Jian , Guo Weihua , Wang Chongkai , Egelston Colt A. , D'Apuzzo Massimo , Shankar Geereesh , Fakih Marwan G. , Lee Peter P.
Published: October 2023

Distribution of lymphocytes in the cancer island, stroma and necrosis tissue within tumorcore and inner invasive region.
FIGURE 6 from Peritumoral Immune-suppressive Mechanisms Impede Intratumoral Lymphocyte Infiltration into Colorectal Cancer Liver versus Lung Metastases
Authors: Ye Jian , Guo Weihua , Wang Chongkai , Egelston Colt A. , D'Apuzzo Massimo , Shankar Geereesh , Fakih Marwan G. , Lee Peter P.
Published: October 2023

Analysis of immune cells between paired primary and liver metastases. A, Representative images of the tumor core from two individual patient's paired primary colorectal cancer and metastatic liver tumors. B, Correlations of CD4 and CD8 T cells in the paired primary and liver metastases. R2 were calculated with the density of immune cells in different histologic regions.
FIGURE 5 from Peritumoral Immune-suppressive Mechanisms Impede Intratumoral Lymphocyte Infiltration into Colorectal Cancer Liver versus Lung Metastases
Authors: Ye Jian , Guo Weihua , Wang Chongkai , Egelston Colt A. , D'Apuzzo Massimo , Shankar Geereesh , Fakih Marwan G. , Lee Peter P.
Published: October 2023

Distribution of LA and TLS across colorectal cancer sites. A, Representative images of primary colorectal cancer tumor. Numbered insets show higher magnification. The second inset magnifies the same area seen in Fig. 1B. B, Representative images of primary and metastatic colorectal cancer tumors stained with mIF Panel 4. The boxes highlight the LA in the primary and metastatic tumors. C, Percentage of tumor specimens with intratumoral LA in primary and metastatic tumors. Statistical significance was determined by χ2 test. D, The number and percentage of area of LA in the metastatic tumor calculated in five individual compartments. E, Correlations of LA and various immune cells. PCC were calculated from the density LA and sporadic immune cells in different histologic regions from primary and metastatic colorectal cancer tumors from mIF Panel 4.
FIGURE 1 from Peritumoral Immune-suppressive Mechanisms Impede Intratumoral Lymphocyte Infiltration into Colorectal Cancer Liver versus Lung Metastases
Authors: Ye Jian , Guo Weihua , Wang Chongkai , Egelston Colt A. , D'Apuzzo Massimo , Shankar Geereesh , Fakih Marwan G. , Lee Peter P.
Published: October 2023

Metastatic colorectal cancer tumor specimens and cell population evaluated by mIF. A, Kaplan–Meier curve of overall survival in patients with colorectal cancer with metastases in liver (n = 17), lung (n = 12), and peritoneum (n = 8). Numbers below each x axis indicate the number of patients at risk and those in parentheses are the number of events. Statistical significance was determined by log-rank test (B). Representative images showing four panels of mIF staining from consecutive sections of a colorectal cancer primary tumor. C, Cell lineages identified by hierarchical gating of lineage and functional biomarkers during image analysis of mIF staining. D, Representative images of a colorectal cancer lung metastasis showing manual segmentation of five compartments (tumor core, inner invasive margin, outer invasive margin, juxta tumor, and distal tissue) and tissue segmentation by machine learning algorithm (cancer island, stroma, and necrosis).
Pigmented Onychomatricoma Presenting as Pachymelanonychia Striata: A Case Report and Review of Literature
Authors: Grover Chander , Gaurav Vishal , Sharma Sonal , Sinha Surabhi
Published: October 2023

Introduction: Onychomatricoma is a fibroepithelial tumor derived from the nail matrix and onychodermis. Many clinical and histological variants have been described. Pigmented onychomatricoma is a rare variant which presents as longitudinal pachymelanonychia. Case Presentation: We report the details of a 41-year-old female who presented with blackening and thickening involving more than half of the left middle fingernail for the past 10 years. Dorsal plate onychoscopy revealed longitudinal parallel white, gray, and black bands, while onychoscopy of the distal free edge demonstrated a thickened nail plate with “wood worm” cavities. The histopathological examination of the excised tumor revealed a pigmented onychomatricoma. Conclusions: Onychomatricoma is one of the nail tumors presenting as pachyonychia striata apart from onychocytic matricoma and onychocytic carcinoma. A pigmented onychomatricoma may closely mimic fungal melanonychia, pigmented onychopapilloma, pigmented ungual Bowen’s disease, and ungual melanoma. Noninvasive techniques like onychoscopy and imaging studies like ultrasonography and magnetic resonance imaging are helpful in differentiating it from pigmented ungual Bowen’s disease and ungual melanoma, even though diagnostic confirmation requires an excisional biopsy.
Post-Traumatic Stress Disorder in Patients with Alopecia Areata: A Survey Study in the USA
Authors: Drake Lara , Li Sara J. , Reyes-Hadsall Sophia , Lee Karen , Huang Kathie , Mostaghimi Arash
Published: October 2023

Introduction: Alopecia areata (AA) is an autoimmune condition that results in nonscarring hair loss. AA is comorbid with mental health disorders including anxiety and depression. This study aimed to evaluate the presence of post-traumatic stress disorder (PTSD) in relation to hair loss in patients with AA. Methods: A cross-sectional national survey was distributed using the National Alopecia Areata Foundation’s (NAAF) email list. This study was approved by the Mass General Brigham Institutional Review Board. Participants were asked to complete the PTSD Checklist for the DSM-5 (PCL-5), a validated screening tool for PTSD in the context of their AA. Results: Of the 1,449 completed surveys (completion rate 79.6%), most respondents were female (83.8%) and white (76.6%) with an average age of 50.6 ± 15.6 years. Respondents had AA for an average of 17.7 ± 15.8 years, with 91.4% experiencing current active hair loss. A total of 33.9% of respondents screened positively for PTSD, with an average score of 48.8 ± 12.3 on the PCL-5 in participants who screened positively. Participants with alopecia totalis have the highest average PCL-5 score of 30.1 ± 19.2, followed by participants with alopecia universalis with an average score of 26.0 ± 19.9, and lastly patchy AA with an average score of 24.5 ± 18.3 (p = 0.003). Feelings of intrusion and avoidance were the predominant reported symptoms. Total PTSD scores were significantly higher in respondents who were younger and identified as Black or African American and Hispanic when compared to white and non-Hispanic respondents, respectively. Conclusion: These findings identify that one in 3 patients with AA in this cohort meet the screening criteria for PTSD specifically relating to their hair loss experience. These results further highlight the mental health comorbidities associated with AA and emphasize that these symptoms may persist even after hair regrowth. Limitations include the nonrandomized NAAF population with most participants being white females. Future studies should confirm these findings in other patient populations. Finally, respondent’s baseline mental health was not assessed; therefore, a causal relationship between AA and PTSD cannot be deduced.
Feasibility of Noninvasive Assessment of Cardiac Output during Exercise in Healthy Adults by a Novel Elaboration on Systolic Time Intervals
Authors: Kim Chul-Ho , Cierzan Bradley S. , Patel Nisha , Borlaug Barry A. , Johnson Bruce D.
Published: October 2023

Background: Although assessment of cardiovascular hemodynamics during exercise can provide clinical insights, it is challenging to acquire it in clinical settings. Objectives: Accordingly, this preliminary study was to determine whether a novel elaboration on systolic time interval measures (eSTICO) method of quantifying cardiac output and stroke volume was comparable to those obtained using a validated soluble gas (open circuit CO measure [OpCircCO]) method or calculation based on oxygen consumption (oxygen consumption-based CO [VO2CO]) during exercise. Methods: For the present study, 14 healthy subjects (male: n = 12, female: n = 2) performed incremental exercise on a recumbent cycle ergometer. At rest and during exercise, cardiac output (CO) was obtained via the eSTICO method, while the OpenCircCO and VO2CO measures were obtained at the last minute of each workload. Results: At peak, there was no difference between eSTICO and OpCircCO (12.39 ± 3.06 vs. 13.96 ± 2.47 L/min, p > 0.05), while there was a slight difference between eSTICO and VO2CO (12.39 ± 3.06 vs. 14.28 ± 2.55 L/min, p < 0.05). When we performed correlation analysis with all subjects and all measures of CO at all WL, between eSTICO and OpenCircCO, there was a good relationship (r = 0.707, p < 0.001) with a Bland and Altman agreement analysis demonstrating a −1.6 difference (95% LoA: −6.3–3.5). Between eSTICO and VO2CO, we observed an r = 0.865 (p < 0.001) and a Bland and Altman agreement analysis with a −1.2 difference (95% LoA: −4.8–2.4). Conclusion: A novel exploitation of cardiac hemodynamics using systolic timing intervals may allow a relatively good assessment of CO during exercise in healthy adults.
Aktuelle Ansätze zur neoadjuvanten Immuntherapie des resektablen nicht kleinzelligen Lungenkarzinoms
Authors: Parekh Jay , Parikh Kaushal , Reuss Joshua E. , Friedlaender Alex , Addeo Alfredo
Published: October 2023

Zweck der Übersichtsarbeit: Seit Jahrzehnten ist das nicht kleinzellige Lungenkarzinom (non-small cell lung cancer, NSCLC) im Frühstadium potenziell heilbar, weist aber eine inakzeptabel hohe Rückfallrate auf. Jüngste Ergebnisse: Die Anti-PD-(L)1-Immuncheckpoint-Blockade (ICB) hat die Behandlung des fortgeschrittenen NSCLC revolutioniert. Mit den jüngsten Zulassungen im perioperativen Bereich ist sie nun in der Lage, das systemische Behandlungsparadigma für das lokalisierte und lokal fortgeschrittene NSCLC zu verändern.