bluuebunny/crossref_metadata_2025 huggingface dataset:
Medication adherence in geriatric patients attending medical outpatient department
Authors: Odubanjo Oluremi A. , Tipping Brent , Greenstein Lara S.
Published: October 2024

Background: Adherence to medication represents a challenge in managing chronic conditions in the geriatric population. This study assessed adherence rates and factors affecting adherence of geriatric patients attending the Helen Joseph Hospital outpatient department.Methods: This was a prospective cross-sectional study of 130 patients aged 65 years and older, with at least two chronic conditions. Participants were administered a survey incorporating the Medication Adherence Rating Scale and the Adherence Barrier Questionnaire to identify medication adherence and patient-specific barriers to adherence, respectively. These instruments are reliable and valid.Results: Descriptive statistics and logistic regression were used for analysis. Most patients were female (63%) with a mean age of 72 (67–78) years. Common comorbidities included type 2 diabetes mellitus (63%), hypertension (98%), dyslipidaemia (92%) and congestive cardiac failure (38%). Polypharmacy was prevalent, affecting 53% of the participants. Despite 96% of participants being adherent, all had at least one barrier to adherence, with the majority (65%) having more than one barrier. The main barriers were forgetfulness (59%), fear of side effects (39%), problems with taking the medications (26%) and believing medications are poisonous (22%). Although most participants accessed the pharmacy easily, only 83% reported consistent medication availability and 11% could not afford to collect their medication.Conclusion: Polypharmacy is common in the population. Despite high adherence rates, barriers such as believing medications are poisonous remain significant. A good patient–doctor relationship improves adherence.Contribution: Understanding the barriers to adherence in older adults with polypharmacy and multimorbidity can assist practitioners improve patient care.
CONTEMPORARY URBAN AND CENTER-PERIPHERY STRUCTURE
Authors: Silva Marlon Lima da , Rodrigues Jovenildo Cardoso
Published: October 2024

The contemporary urban phenomenon has challenged studies that seek to establish generalizations about spatial structuring, leading to continual questioning of center-periphery models. The proliferation of shopping malls towards the "peripheries" represents an important indicator capable of promoting this debate. Thus, the article analyzes the spatial structuring logic of Brazil's shopping center sector, particularly its expansion into the Brazilian Amazon. To that end, it raises two questions: Is the Brazilian center-periphery model still able to explain shopping centers' spatia distribution, considering the regions and hierarchy of the cities in which they are located? Based on the hierarchy and intra-urban space of its cities, how does this spatial distribution take place in the Brazilian Amazon? The sector's data is mapped based on information from the Brazilian Association of Malls and the Regic/IBGE/2018 study. On the intra-urban scale, it establishes three locational types (central, pulverized, fragmented) based on the uses within a 1 km radius of the malls. The study concludes that the center-periphery model has not lost its explanatory validity. However, it must be improved to capture the complexity of contemporary spatial structuring, dialoguing on multiple scales, and different socio-spatial formations. Keywords: Contemporary Urban, Center, Periphery, Shopping Mall, Brazilian Amazon.
MEDIUM-SIZED CITIES AND THE EXPRESSIONS OF HIERARCHY-HETARARCHY IN THE BRAZILIAN URBAN SYSTEM
Authors: Fernandes Jefferson Santos , Catelan Márcio José Veríssimo
Published: October 2024

Amid the complex web of contemporary interurban relations, there is an urgent need for analytical perspectives that advance the understanding of spatial interactions beyond the traditional hierarchical pattern. To this end, the proposal of urban heterarchy contributes to a reading of the movement and the leap of scales in the urban network's structure within a context of strong spatial restructuring promoted by capitalism in the light of globalization. In this work, the roles and functions of medium-sized cities are favored, to recognize the expressions of urban heterarchy in the territory. Namely, the economic sectors through which these cities establish flows and interact with other urban centers at multiple spatial scales. To this end, the trade balance (exports and imports), air network, and shopping malls were selected as analytical dimensions, whose economic logic reveals the changes in the ongoing urban structuring. Keywords: Medium-sized Cities, Urban Hierarchy-Hetararchy, Exports and Imports, Airports, Shopping Malls.
PROBLEMS OF METHOD IN GEOGRAPHY, THROUGH SARTREAN STRABISMUS
Authors: Marandola Junior Eduardo
Published: October 2024

Method's reflection is revisited owing to the problematic horizon of coloniality that traces scientific Geography, which questions the validity of its tradition in view of the need to re-discuss its bases. The paper resorts to the Knowledge-Existence dialectic, as placed in its práxis by the thought of Jean-Paul Sartre, as a strategy to problematize the epistemological and ontological issues that are involved in the challenges of contemporary Geography. Keywords: Existentialism; Práxis; Coloniality; Epistemology of Geography.
ANALYSIS OF LOCAL ADVANTAGES IN THE MAIN CEREAL BAR INDUSTRIES OF THE STATE OF SAO PAULO
Authors: Cano Fernando Camillo Santos
Published: October 2024

The state of São Paulo is home to an articulated network of local advantages (services, technologies, transportation, labor, and markets) responsible for attracting the main Brazilian production of cereal bars. This plot is based on an urban network with metropolises, large and medium-sized cities that are holders of large population contingents, which still represent important markets. To understand the search for these attractive spaces, the article investigated the locational factors of the main cereal industries in the state of São Paulo. Therefore, the following methodological procedures were adopted: a) literature review based on classical and contemporary authors in the subject; b) documentary and statistical survey; c) field research. In the domestic market, it was found that there are few, but large industries, that hegemonically dominate the production of cereal bars. In the case of the present research, the following industries were investigated: Kobber Alimentos Ltda. (Diadema), Nestle do Brasil Bebidas e Alimentos Ltda. (Caçapava) and Trio Alimentos Ltda. (Sorocaba). The cities above contemplate the spatial cutting of the research, having as a time frame the last two decades (2000 to 2020). This qualitative and semi-structured research is based on Santos (1996), who highlighted the importance of form-content and how this relationship dialectically influences space. Keywords: Local advantages, Manufacture Deconcentration, Cereal Bar Industry, State of São Paulo.
RECENT COASTLINE TRENDS ON THE EAST MARGIN OF THE MIDDLE PARÁ ESTUARY
Authors: Guimarães Diandra Karina Martins , El-Robrini Maâmar , Rosário Renan Peixoto , Menezes Rafael Alexandre Alves
Published: October 2024

The main objective of this article is to quantify the erosion and accretion rates on the eastern margin of the middle Pará Estuary within 32 years (1987, 1993, 1999, 2004, 2008, 2013, and 2019) with the use of remote sensing and data Digital Shoreline Analysis System (DSAS) extension. These methodological procedures recently applied in the Amazon region are effective in the search for intended results. To calculate with significant accuracy the rates of CL changes, select the parameters Net Shoreline Movement (NSM), Linear Regression Rate (LRR), and End Point Rate (EPR) to obtain the variations. In the middle estuary, the rates showed a tendency towards CL retreat in the onshore direction, with an average rate of -38 m and an average accretion rate of 22.97 m prevailing on Mosqueiro Island, related to average rates of variation of -0.58 m/ year (EPR) and -0.54 m/year (LRR) and in Santo Antônio do Tauá with LRR and EPR parameters identifying average rates of variation of -1.67 m/year (LRR) and -1.55 m/year (EPR). Only on Colares island, there was a tendency to accretion, with an average erosion rate of -96.29 m and an average accretion rate of 116.49 m, where the maximum accretion and erosion rates are 405.61 m and -396.87 m, respectively. Keywords: Eastern Amazon, Coastal Dynamics, Estuarine Environment, LANDSAT.
FIRES IN BRAZILIAN BIOMES
Authors: Souza Amaury de , Jesús Villar-Hernández Bartolo de , Oliveira Júnior José Francisco de , Abreu Marcel Carvalho de , Oliveira Ana Paula Garcia , Nunes Raquel Soares Casaes , Fakhruddin Muhammad
Published: October 2024

Increasingly, forest fires are occurring in large parts of the world due to warmer weather, more frequent and severe droughts and continuous changes in land use. In Brazil, the weakening of environmental public policies has further aggravated forest fires with widespread impacts throughout the country. This study aimed to evaluate the association between short-term variations in fire focis by precipitation, temperature in biomes in the state of Mato Grosso do Sul (MS) – Midwest Brazil. Generalized additive negative binomial regression models with distributed nonlinear lag terms were adjusted with daily counts of fire focis as results and total daily precipitation and other meteorological variables as predictors, adjusting for seasonality and trend. In general, higher precipitation was associated with fewer fire focis, with higher relative risks for the cerrado biome for the dry cutting and for higher temperatures the number of fire focis with higher relative risk for the pantanal biome. Stronger associations were observed in dry cutting (winter/spring). It was found that higher temperatures are associated with more fire focis. Fire focis are strongly associated with precipitation and temperature variation, but in opposite directions. Higher precipitation can become more clearly associated with fewer fire focis and higher temperature to more fire focis. If we maintain the burning culture to clear pastures and planting areas, the burnings will become increasingly uncontrollable. Keywords: Hot Spots, Precipitation, Temperature, Weather, Risk Assessement, Regression Models, Fire Foci, Burned Area.
CLIMATE, TROPICALITY OF THE BRAZILIAN CENTRAL PLATEAU, AND TUBERCULOSIS LOAD
Authors: Brandao Erlayne , Borsato Victor da Assunção , Steinke Ercília Torres , Evangelista Maria do Socorro Nantua
Published: October 2024

The current literature has pointed out an influence of climatic and environmental aspects on tuberculosis (TB) burden. Among the main influences, the effects of climate stand out. The present study aims to identify whether the tropicality of the Brazilian Central Plateau increases TB burden in the Federal District, Brazil. This is an ecological study carried out with 1,291 new TB cases notified to the Notifiable Diseases Information System of the State Health Department of the Federal District. We studied the participation of air masses and the cases of tuberculosis during the summers from 2006 to 2017. For the rhythmic analysis, we considered the summer of 2006, as it was the year with the highest frequency of TB cases. We used Pearson's correlation test. The most frequent types in the summers were the continental Equatorial mass, with a 77.5% frequency, and the Atlantic Tropical mass, 13.8%. We observed no correlation between the performance of atmospheric systems and TB cases; that is, meterological variables showed no contribution to the greater burden of TB in the Federal District. Keywords: Tuberculosis. Climate. Air Masses. Climate Changes. Effects of Climate Change.
SERRA DA CAPIVARA/PI NATIONAL PARK AND THE PRACTICE OF ECOTOURIST ACTIVITY
Authors: Barros Juliana Ramalho , Aguiar Junior Paulo Roberto Ferreira de , Santos Mayra Nayara Nair dos , Santos Nicali Bleyer Ferreira dos
Published: October 2024

Ecotourism faces the challenge of balancing environmental and cultural preservation with sustainable development and local income generation. Since the Stockholm Conference in 1972, environmental conservation has gained relevance on government schedule. The establishment of Conservation Units (CUs) has led to the implementation of administrative and political mechanisms to safeguard specific ecosystems. These spaces not only protect the environment but also enable indirect use through tourism, with an emphasis on ecotourism. This study aims to evaluate whether the ecotourism practices adopted in the Serra da Capivara National Park (PNSC), located in Piauí, align with the theoretical framework that underpins this tourism segment. Using a Case Study methodology, which includes visits to PNSC, literature review, and photographic documentation, it was found that this Integral Conservation Unit is in line with the guidelines advocated by ecotourism. Keywords: Conservation Unit; Serra da Capivara National Park; Ecotourism.
Navigating the complex landscape of crawling-type gastric adenocarcinomas: Insights and implications for clinical practice
Authors: Yu Hai-Bo , Jia Ke-Feng , Wang Xing-Fen , Li Bao-Yu , Xin Qi
Published: October 2024

In this editorial, we comment on an article by Xu et al . This article describes a case of crawling-type gastric adenocarcinoma (CRA) distinguished by its rare occurrence and diagnostic complexity. We reviewed the detailed case-report findings showcasing clinical, pathological, and molecular characteristics of CRA that shed light on its elusive nature and challenges for early detection and treatment. This case underscored the significance of advanced diagnostic tools such as endoscopic submucosal dissection. Emphasis was placed on the molecular peculiarities of CRA, including the higher mutation rates of genes such as TP53 and RHOA and the notable absence of HER2 amplification, differentiating it from more conventional forms of gastric adenocarcinoma. In this editorial, we advocate for a multidisciplinary approach to effectively manage this rare subtype and highlight the necessity for precision in both diagnostic and therapeutic strategies. Moreover, a heightened awareness urging the adoption of advanced diagnostic techniques and collaborative approaches is necessary among clinicians and researchers. We aim to contribute to the ongoing discourse in gastrointestinal oncology, emphasizing the importance of recognizing and addressing the complexities associated with rare cancer subtypes such as CRA.
Practical hints for the diagnosis of mixed neuroendocrine-non-neuroendocrine neoplasms of the digestive system
Authors: Mattiolo Paola
Published: October 2024

In this editorial, a comment on the article by Díaz-López et al published in the recent issue of the 2024 is provided. We focus on the practical implications critical for providing a correct and complete diagnosis of mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) in the gastrointestinal system. The diagnosis of MiNEN begins with the recognition of neuroendocrine features in one component of a biphasic tumor. The non-neuroendocrine counterpart can be virtually represented by any neoplastic type, even though the most frequent histologies are glandular and squamous. However, qualification of the neuroendocrine component requires histological and immunohistochemical confirmation. Neuroendocrine tumors are characterized by a peculiar architectural organization and bland nuclei with granular “salt and pepper” chromatin. Although neuroendocrine carcinomas have multiple and variable presentations, they typically show a solid or organoid architecture. The histological aspect needs to be confirmed by immunohistochemistry, and a diagnosis is confirmed whenever the expression of keratin and neuroendocrine markers is observed. Once both histopathological and immunohistochemical features of neuroendocrine neoplasms are identified, it is important to consider the three major pitfalls of MiNEN diagnostics: (1) Entrapment of neuroendocrine non-neoplastic cells within the tumor mass; (2) Differential diagnosis with amphicrine neoplasms; and (3) Differential diagnosis of tumors that partially express neuroendocrine markers. According to the current guidelines for diagnosing digestive MiNEN, each component must represent at least 30% of the entire neoplastic mass. Although the high-grade histopathological subtype frequently determines disease prognosis, both components can significantly affect prognosis. Thus, if one of the components, either neuroendocrine or non-neuroendocrine, does not fulfill the volumetric criteria, the guidelines still encourage reporting it. These strict criteria are essential for correctly recognizing and characterizing digestive MiNENs. This task is essential because it has prognostic relevance and substantial potential value for guiding further studies in this field. In the future, systematic analyses should be performed to validate or reconsider the current 30% cutoff value.
Endoscopic diagnosis and management of gallbladder carcinoma in minimally invasive era: New needs, new models
Authors: Deqing La-Cuo , Zhang Jun-Wen , Yang Jian
Published: October 2024

Gallbladder cancer (GBC) is a rare and lethal malignancy; however, it represents the most common type of biliary tract cancer. Patients with GBC are often diagnosed at an advanced stage, thus, unfortunately, losing the opportunity for curative surgical intervention. This situation leads to lower quality of life and higher mortality rates. In recent years, the rapid development of endoscopic equipment and techniques has provided new avenues and possibilities for the early and minimally invasive diagnosis and treatment of GBC. This editorial comments on the article by Pavlidis et al . Building upon their work, we explore the new needs and corresponding models for managing GBC from the endoscopic diagnosis and treatment perspective.
Advances in the diagnosis and treatment of MET-variant digestive tract tumors
Authors: Zhang Chen , Dong Hu-Ke , Gao Jian-Ming , Zeng Qi-Qi , Qiu Jiang-Tao , Wang Jia-Jia
Published: October 2024

The receptor tyrosine kinase encoded by the MET gene plays an important role in various cellular processes such as growth, survival, migration and angiogenesis, and its abnormal activation is closely related to the occurrence and development of various tumors. This article reviews the recent advances in diagnosis and treatment of MET-variant digestive tract tumors. In terms of diagnosis, the application of next-generation sequencing technology and liquid biopsy technology makes the detection of MET variants more accurate and efficient, providing a reliable basis for individualized treatment. In terms of treatment, MET inhibitors such as crizotinib and cabotinib have shown good efficacy in clinical trials. In addition, the combination of immunotherapy and MET inhibitors also demonstrated potential synergies, further improving the therapeutic effect. However, the complexity and heterogeneity of drug resistance mechanisms are still one of the difficulties in current research. In the future, it is necessary to further deepen the understanding of the mechanism of MET variation and explore new combination treatment strategies to improve the overall survival rate and quality of life of patients. The diagnosis and treatment of MET-variant digestive tract tumors are moving towards precision and individualization, and have broad application prospects.
Effect of colorectal cancer stem cells on the development and metastasis of colorectal cancer
Authors: Deng Run-Zhi , Zheng Xin , Lu Zhong-Lei , Yuan Ming , Meng Qi-Chang , Wu Tao , Tian Yu
Published: October 2024

The relevant mechanism of tumor-associated macrophages (TAMs) in the treatment of colorectal cancer patients with immune checkpoint inhibitors (ICIs) is discussed, and the application prospects of TAMs in reversing the treatment tolerance of ICIs are discussed to provide a reference for related studies. As a class of drugs widely used in clinical tumor immunotherapy, ICIs can act on regulatory molecules on cells that play an inhibitory role - immune checkpoints - and kill tumors in the form of an immune response by activating a variety of immune cells in the immune system. The sensitivity of patients with different types of colorectal cancer to ICI treatment varies greatly. The phenotype and function of TAMs in the colorectal cancer microenvironment are closely related to the efficacy of ICIs. ICIs can regulate the phenotypic function of TAMs, and TAMs can also affect the tolerance of colorectal cancer to ICI therapy. TAMs play an important role in ICI resistance, and making full use of this target as a therapeutic strategy is expected to improve the immunotherapy efficacy and prognosis of patients with colorectal cancer.
Current clinical trials on gastric cancer surgery in China
Authors: Zhang Shun , Hu Ren-Hao , Cui Xi-Mao , Song Chun , Jiang Xiao-Hua
Published: October 2024

Gastric cancer (GC) is the leading diagnosed malignancy worldwide, especially in China. Radical surgery is the cornerstone of GC treatment. We reviewed previous clinical trials and aimed to provide an update on the factors related to the surgical treatment of GC. The number of registered clinical trials in the field of GC surgery is rapidly increasing. With the development and popularization of endoscopic, laparoscopic, and robotic techniques, GC surgery has gradually entered a new era of precise minimally invasive surgery. Postoperative quality of life has become a major issue in addition to surgical oncological safety. Although great progress has been made in clinical research on GC in China, there are still deficiencies. Many studies enrolled large numbers of patients, but the research data were not of high quality. The characteristics of GC in China include a high incidence, large population, and large proportion of patients with advanced GC, which provides sufficient reason for studying this disease. There is still a need for well-designed, large, randomized clinical trials to improve our knowledge of the surgical treatment of GC.
Pattern of colorectal surgery and long-term survival: 10-year experience from a single center
Authors: Zhu De-Xiang , Chen Miao , Xu Dong-Hao , He Guo-Dong , Xu Ping-Ping , Lin Qi , Ren Li , Xu Jian-Min
Published: October 2024

BACKGROUND

The incidence of colorectal cancer (CRC) has increased in recent decades, and ranks fourth among males and third among females in China. Surgical resection remains the most important treatment modality for curative intent in CRC. Several studies found that surgeon volumes and specialization appeared to be associated with improved overall survival (OS). Moreover, numerous reports have suggested that specialization and minimally invasive surgery have gained increased popularity in CRC surgery. However, few studies have specifically examined the role and long-term survival of all stage CRC in a real-world study.

AIM

To evaluate the effect of surgeon specialization on survival changes and minimally invasive surgery utilization in a real world study.

METHODS

A retrospective analysis on the association between surgeon specialization and OS between 2008 and 2013 in Zhongshan Hospital CRC database was performed. Standard demographic, clinicopathologic, surgical and follow-up data were obtained from the CRC database. Surgeon specialty was categorized as colorectal surgeon (CS) and general surgeon (GS). CRC patients who underwent primary surgical resection were enrolled.

RESULTS

A total of 5141 CRC patients who underwent primary surgical resection between 2008 and 2013 were evaluated, 1748 (34.0%) of these by CS. The percentage of minimally invasive procedures in the CS group showed an increasing trend. There was no benefit associated with surgeon specialization for stage I, II and IV patients. Surgeon specialization exhibited a significant association with OS solely among stage III patients, with 5-year OS rates of 76% and 67% for the CS and GS groups, respectively (P < 0.01). Further analyses found that surgeon specialization was significantly associated with survival only in stage III rectal patients, and the 5-year OS rate in the CS group and GS group was 80% and 67%, respectively (P < 0.01).

CONCLUSION

Surgeon specialization is associated with improved OS after primary surgery in stage III rectal patients. An appropriate surgical technique, perioperative program and adjuvant therapy may contribute to survival benefit in these patients.
BIRC3 induces the phosphoinositide 3-kinase-Akt pathway activation to promote trastuzumab resistance in human epidermal growth factor receptor 2-positive gastric cancer
Authors: Li Shu-Liang , Wang Pei-Yao , Jia Yang-Pu , Zhang Zhao-Xiong , He Hao-Yu , Chen Peng-Yu , Liu Xin , Liu Bang , Lu Li , Fu Wei-Hua
Published: October 2024

BACKGROUND

Trastuzumab-targeted therapy is currently the standard of care for advanced human epidermal growth factor receptor 2 (HER2)-positive gastric cancer. However, the emergence of resistance to trastuzumab poses significant challenges.

AIM

To identify the key genes associated with trastuzumab resistance. These results provide a basis for the development of interventions to address drug resistance and improve patient outcomes.

METHODS

High-throughput sequencing and bioinformatics were used to identify the differentially expressed pivotal gene BIRC3 and delineate its potential function and pathway regulation. Tumor samples were collected from patients with HER2-positive gastric cancer to evaluate the correlation between BIRC3 expression and trastuzumab resistance. We established gastric cancer cell lines with both highly expressed and suppressed levels of BIRC3 , followed by comprehensive in vitro and in vivo experiments to confirm the involvement of BIRC3 in trastuzumab resistance and to elucidate its underlying mechanisms.

RESULTS

In patients with HER2-positive gastric cancer, there is a significant correlation between elevated BIRC3 expression in tumor tissues and higher T stage, tumor node metastasis stage, as well as poor overall survival and progression-free survival. BIRC3 is highly expressed in trastuzumab-resistant gastric cancer cell lines, where it inhibits tumor cell apoptosis and enhances trastuzumab resistance by promoting the phosphorylation and activation of the phosphoinositide 3-kinase-Akt (PI3K-AKT) pathway in HER2-positive gastric cancer cells, both in vivo and in vitro .

CONCLUSION

This study revealed a robust association between high BIRC3 expression and an unfavorable prognosis in patients with HER2-positive gastric cancer. Thus, the high expression of BIRC3 stimulated PI3K-AKT phosphorylation and activation, stimulating the proliferation of HER2-positive tumor cells and suppressing apoptosis, ultimately leading to trastuzumab resistance.
Impact and mechanism study of dioscin on biological characteristics of colorectal cancer cells
Authors: Cai Xie-Xiao , Huang Zhen-Feng , Tu Fu-Yang , Yu Jie
Published: October 2024

BACKGROUND

Colorectal cancer (CRC) is a considerable global health issue. Dioscin, a compound found in several medicinal plants, has shown potential anticancer effects.

AIM

To find the relationship between CRC cells (HCT116) and diosgenin and clarified their mechanisms of action.

METHODS

CRC cell line HCT116 was cultured by dividing cells into control and dioscin groups (dioscin + Jagged 1 group; Jagged 1 group, 5 μg/mL; and dioscin group, 2.5 μg/mL). The dioscin groups were given different concentrations of dioscin. Cell Counting Kit-8 was chosen for testing cell viability in different groups. Flow cytometry was established to undiscover the apoptosis rate of human liver cancer cell line 11. Real-time PCR as well as Western blot analyses were applied to reveal the expression levels of caspase-3, Notch, and other proteins. Transwell and scratch experiments were conducted to assess cell migration and invasion abilities.

RESULTS

This study indicated that dioscin restricted the growth of HCT116 cells, boosted cell apoptosis, and rose the Bax /Bcl-2 ratio as well as the expression of Caspase-3 . Dioscin also inhibited physiological activities, for instance cell migration, and significantly reduced the expression levels of proteins for instance Notch1 (P < 0.05). Dioscin partially reversed the effects of Jagged 1.

CONCLUSION

Dioscin exerts a certain inhibitory effect on HCT116, and its mechanism of action may be linked, with the inhibition of the Notch1 signaling pathway.
Effects of invigorating-spleen and anticancer prescription on extracellular signal-regulated kinase/mitogen-activated protein kinase signaling pathway in colon cancer mice model
Authors: Wang Wei , Wang Jing , Ren Xiu-Xiu , Yue Hai-Long , Li Zheng
Published: October 2024

BACKGROUND

Colon cancer (CC) is one of the most common malignant tumors in the gastrointestinal system. Overall, CC had the third highest incidence but the second highest mortality rate globally in 2020. Nowadays, CC is mainly treated with capecitabine chemotherapy regimen, supplemented by radiotherapy, immunotherapy and targeted therapy, but there are still limitations, so Chinese medicine plays an important role.

AIM

To investigate the effects of invigorating-spleen and anticancer prescription (ISAP) on body weight, tumor inhibition rate and expression levels of proteins in extracellular-signal-regulated kinase (ERK)/mitogen-activated protein kinase (MAPK) signaling pathway in CC mice model.

METHODS

The CC mice model were established and the mice were randomly divided into 5 groups, including the control group, capecitabine group, the low-dose, medium-dose and high-dose groups of ISAP, with 8 mice in each group, respectively. After 2 weeks of intervention, the body weight and tumor inhibition rate of mice were observed, and the expression of RAS , ERK , phosphorylated ERK (p-ERK ), C-MYC and matrix metalloproteinase 2 (MMP2) proteins in the tissues of tumors were detected.

RESULTS

Compared with the control group, the differences of body weight before and after treatment was much smaller in the groups of ISAP, with the smallest difference in the high-dose group of ISAP, while the capecitabine group had the greatest difference, indicating ISAP had a significant inhibiting effect on the growth of transplanted tumor in mice. The expression of RAS protein was decreased in the low- and medium-dose groups of ISAP, and the change of p-ERK was significant in the medium- and high- dose groups of ISAP. MMP2 protein expression was significantly decreased in both the low-dose and medium-dose groups of ISAP. There were no significant changes in ERK in the ISAP group compared to the capecitabine group, while RAS, MMP2, and C-MYC protein expression were reduced in the ISAP group. The expression level of C-MYC protein decreased after treated with ISAP, and the decrease was the most significant in the medium-dose group of ISAP.

CONCLUSION

ISAP has a potential inhibiting effect on transplanted tumor in mice, and could maintain the general conditions, physical strength and body weight of mice. The expression levels of RAS , p-ERK , MMP2 and c-myc were also decreased to a certain extent. By inhibiting the expression of upstream proteins, the expression levels of downstream proteins in ERK/MAPK signaling pathway were significantly decreased. Therefore, it can be concluded that ISAP may exert an anti-tumor effect by blocking the ERK/MAPK signaling pathway and inhibiting the expression of MMP2 and c-myc proteins.
Prognostic value of neutrophil-to-lymphocyte ratio in gastric cancer patients undergoing neoadjuvant chemotherapy: A systematic review and meta-analysis
Authors: Wei Zhen-Hua , Tuo Min , Ye Chen , Wu Xiao-Fan , Wang Hong-Hao , Ren Wen-Zhen , Liu Gao , Xiang Tian
Published: October 2024

BACKGROUND

In recent studies, accumulating evidence has revealed a strong association between the inflammatory response and the prognosis of many tumors. There is a certain correlation of neutrophil-to-lymphocyte ratio (NLR) with the prognosis in gastric cancer (GC) patients undergoing neoadjuvant chemotherapy (NAC). However, the existing research results have remained controversial.

AIM

To explore the relationship between NLR ratio and prognosis of GC patients receiving NAC.

METHODS

A thorough systematic search was performed in databases such as PubMed, Embase, Web of Science, and Cochrane Library, the search is available until February 29, 2024, and studies exploring the interaction of NLR with clinical outcomes were collected. Relevant studies meeting pre-defined inclusion and exclusion criteria were carefully chosen. The outcomes included progression-free survival (PFS), relapse-free survival, disease-free survival (DFS), and overall survival (OS). The hazard ratio (HR) and its corresponding 95% confidence interval (CI) were utilized for estimation.

RESULTS

Our analysis encompassed 852 patients and incorporated data from 12 cohort studies. The comprehensive analysis revealed a significant association of high NLR with reduced OS (HR = 1.76; 95%CI: 1.22-2.54, P = 0.003), relapse-free survival (HR = 3.73; 95%CI: 1.74-7.96, P = 0.0007), and PFS (HR = 2.32; 95%CI: 1.42-3.81, P = 0.0008) in patients. However, this correlation in disease-free survival was not significant. NLR demonstrated its crucial role in effectively predicting the OS of GC patients undergoing NAC at different detection times, ages, regions, and NLR thresholds.

CONCLUSION

In GC patients receiving NAC, an elevated NLR is strongly associated with reduced OS and PFS. NLR has become an effective biomarker for patient prognosis evaluation, providing valuable insights for the treatment strategies of NAC in GC patients.
From biomarker discovery to combined therapies: Advancing hepatocellular carcinoma treatment strategies
Authors: Kong Mo-Wei , Yu Yang , Wan Ying , Gao Yu , Zhang Chun-Xiang
Published: October 2024

This editorial reviews advances in hepatocellular carcinoma (HCC) treatment, focusing on a triple therapy approach and biomarker discovery. Zhang et al discuss the synergistic potential of transarterial chemoembolization combined with tyrosine kinase inhibitors and PD-1 inhibitors. Meanwhile, Li et al identify protein tyrosine phosphatase non-receptor II (PTPN2) as a biomarker for poor prognosis and immune evasion in HCC. The studies highlight the importance of combined therapies and biomarkers in improving HCC treatment efficacy and patient outcomes, with PTPN2 emerging as a potential therapeutic target. This article supplements the aforementioned studies with more recent research advancements, focusing on the molecular mechanisms and clinical applications of biomarkers.
Advancing Automotive Light-weighting:
Material–Process–Microstructure–Performance (MP2) Relationships of Supercritical
Foam Injection of PP–Graphene Nanocomposite Foams and
Over-molding
Authors: Pradeep Sai Aditya , Deshpande Amit Makarand , Shah Bhavik , Khan Saida , Farahani Saeed , Sternberg James , Li Gang , Pilla Srikanth
Published: October 2024

Vehicle light-weighting constitutes a critical component in the automotive
sector’s drive to improve fuel economy and reduce greenhouse gas emissions.
Among the various options for lightweight materials, thermoplastic foams are
distinguished by their durability, low weight, and environmental sustainability.
This study explores the manufacturing of novel graphene-filled polypropylene
(PP) foam, employing supercritical nitrogen as an eco-friendly substitute
instead of conventional chemical foaming agents, and investigated the role of
over-molding a solid skin over a foamed core on the flexural strength of the
molded component. Our approach is broken down into four distinct
investigations—Study I investigated the effect of different graphene content by
weight percentage (wt.%), namely 0.1%, 0.5%, and 1%, on flexural properties and
foam morphology obtained for 15 wt.% reduction of the PP thermoplastic, thereby
helping identify an optimum graphene loading wt.%. Study II broadened the wt.%
reduction horizon for PP to 5 wt.%, 10 wt.%, and 15 wt.%, systematically
analyzing the impact of the optimal graphene loading and comparing their cell
morphology and flexural properties. This improvement in microstructure and
mechanical properties was confirmed in the case of graphene addition to 10 wt.%
and 15 wt.% reduction, where cell size was reduced by ~100% for 10 wt.%
reduction samples and cell density improved from 4.37 × 105
cell/cm3 to 5.42 × 106 cell/cm3 for the
same when compared to baseline PP foams. Study III serves as a demonstrator for
a novel hybrid over-molding process designed to improve flexural properties.
Over-molding with solid PP was performed over a foamed PP core, generating a
composite foam with improved flexural strength and a class-A surface finish and
noticeably improved flexural strength from 23.4 MPa to 27.3 MPa, achieving an
overall 10 wt.% reduction. This is significant since it translated to a 16%
improvement in flexural strength over baseline PP foams and a flexural modulus
equivalent to solid PP. Study IV investigated the impact of this light-weighting
to assess the potential energy savings over a typical passenger vehicle’s life
cycle. The study demonstrates a viable route to achieve sustainable vehicle
light-weighting and highlights the role supercritical fluid-assisted foamed
thermoplastic nanocomposites may occupy in the vanguard of sustainable material
development.
Passenger Car Air Spring Suspension: Open-System Modeling and
Experimental Verification
Authors: Ahmed Saad Anwar , Hupfeld Jan , Rajput Brijesh
Published: October 2024

Air suspension systems are increasingly in demand in high-end cars due to their
ability to vary ride height based on vehicle loads, road conditions, and speeds.
This trend has driven manufacturers to enhance the performance of these systems.
Predicting and optimizing the performance of the air spring system for various
vehicle loads and conditions has become essential. The performance of an air
suspension system is typically measured by its ability to suspend the vehicle
within a specified target time. Therefore, it is necessary to model the air
spring system—including the air spring, compressor, pneumatic lines, and
valves—and integrate it with the vehicle. This modeling helps in predicting
performance and optimizing the system. Additionally, a validated system model
enables other important calculations, such as sizing the valves, pneumatic
hoses, and compressors.

In this study, a complete air spring system model has been developed alongside a
15-degrees-of-freedom car chassis to achieve the highest possible accuracy
regarding leveling times while maintaining reasonable simulation times. The air
spring components were validated with actual measurements, and the system was
subsequently validated using an experimental setup. The system’s performance was
simulated and then compared with actual vehicle measurements, resulting in
simulation outcomes that were comparable to the measurements.
Breast cancer imaging-clinical experience with two-dimensional-shear wave elastography: A retrospective study
Authors: Chervenkov Lyubomir , Georgiev Aleksandar , Doykov Mladen , Velikova Tsvetelina
Published: October 2024

BACKGROUND

Breast cancer morbidity has been increasing worldwide, but treatments are improving. The therapeutic response depends on the stage at which the disease is diagnosed. Therefore, early diagnosis has never been more essential for successful treatment and a reduction in mortality rates. Radiology plays a pivotal role in cancer detection, and advances in ultrasound (US) palpation have shown promising results for breast cancer imaging. The addition of two-dimensional-shear wave elastography (2D-SWE) US in the routine breast imaging exam can increase early cancer detection and promote better surveillance.

AIM

To evaluate the clinical applications of 2D-SWE US in breast cancer detection and its combination with other imaging modalities.

METHODS

The 200 consecutive female patients aged 50-80 were examined to evaluate palpable breast lesions. All patients underwent mammography, bright mode (B-mode) US, and 2D-SWE followed by US-guided biopsy in two consecutive sessions.

RESULTS

Combining B-mode and shear wave US imaging with x-ray mammography revealed 100% of the suspicious lesions, resulting in greater sensitivity, specificity, and negative predictive value. The result improves compared to either B-mode or 2D-SWE alone (P = 0.02).

CONCLUSION

Combining 2D-SWE with conventional US and x-ray techniques improves the chance of early cancer detection. Including 2D-SWE in regular breast imaging routines can reduce the need for biopsies and improve the chance of early cancer detection and survivability with the proper line of therapy.
Exertional heat stroke with pronounced presentation of microangiopathic hemolytic anemia: A case report
Authors: Xiang Chu-Han , Zhang Xi-Mu , Liu Jie , Xiang Jun , Li Lei , Song Qing
Published: October 2024

BACKGROUND

Exertional heat stroke (EHS) is a critical condition arising from prolonged physical exertion in high temperatures that typically presents with normal hemoglobin levels. However, atypical presentations can also occur, leading to significant complications such as hemolytic anemia and organ dysfunction.

CASE SUMMARY

This case report describes a male patient who experienced moderate-to-severe anemia that was difficult to correct, with a confirmed diagnosis of microangiopathic hemolytic anemia accompanying multiple organ dysfunction syndrome, indicative of critical EHS. Despite intensive resuscitation efforts, the patient’s condition deteriorated, necessitating admission to the intensive care unit for advanced management.

CONCLUSION

This case highlights the importance of recognizing atypical presentations of EHS, particularly that with significant hemolytic anemia and concurrent organ failure. Clinicians should maintain a high level of suspicion for these complications in patients displaying symptoms of heat-related illness, especially when caused by strenuous activity, as early diagnosis and intervention are crucial to improve patient outcomes.
Hypoparathyroidism with situs inversus totalis: A case report
Authors: Yang Mao , Pu Sheng-Lan , Li Ling , Ma Yu , Qin Qin , Wang Yan-Xia , Huang Wen-Long , Hu Hong-Ya , Zhu Mei-Feng , Li Chun-Zhu
Published: October 2024

BACKGROUND

Hypoparathyroidism (HP) is a rare endocrine disorder, while situs inversus totalis (SIT) is a rare condition in which the internal organs are positioned in a mirrored pattern compared to their usual positions. This case illustrates some potential shared mechanisms between HP and SIT, highlighting the importance of accurate identification and prompt first emergency, offering insights for future research.

CASE SUMMARY

This report discusses a case of a middle-aged patient with adolescent-onset HP with concurrent SIT. The patient experienced recurrent episodes of increased neuromuscular excitability (manifesting as spasms in the hands and feet and laryngospasms) and even periods of unconsciousness. Initially, these symptoms led to a misdiagnosis of epilepsy. Nevertheless, upon thorough examination and treatment in the general medicine ward, the correct diagnosis was established. Corresponding treatment resulted in improved management of the patient’s symptoms.

CONCLUSION

Co-occurrence of HP and SIT may be associated with genetic mutations, chromosomal anomalies, or hereditary factors, as may other similar conditions.
Successful management of infection and macrophage activation syndrome patient using low-dose etoposide: A case report
Authors: Gao Shu-Pei , Luo Xiao-Fang , Kosari Mohammadreza , Li Wen-Juan , Yang Liu , Tu Wei , Zhong Ji-Xin
Published: October 2024

BACKGROUND

Macrophage activation syndrome (MAS), a sub-type of hemophagocytic lymphohistiocytosis (HLH) secondary to autoimmune rheumatic diseases, is a critical and potentially fatal condition characterized by an excessive inflammatory response. Despite the established efficacy of the HLH-2004 guideline in diagnosing and treating HLH over the years, ongoing discussion persists regarding its application, especially for HLH secondary to complicated conditions, such as autoimmune rheumatic diseases combined with severe infection. Etoposide (VP-16), a topoisomerase II inhibitor that effectively induces DNA damage and subsequent apoptosis in hyperactivated immune cells, has been widely used for the treatment of HLH. However, its suppressive effect on immune system may also cause potential exacerbation of infection in autoimmune rheumatic disease-induced HLH patients complicated with severe infection. Therefore, the use of VP-16 in such cases was inconclusive.

CASE SUMMARY

In this case study, we propose a potentially effective strategy for managing a patient diagnosed with secondary HLH complicated with systemic lupus erythematosus (SLE) and chronic coronavirus disease 2019 infection. Our approach involves early administration of low-dose VP-16 (100 mg twice a week, 300 mg in total), combined with methylprednisolone, cyclophosphamide, and cyclosporine A. The administration of etoposide effectively led to improvements in various indices of HLH.

CONCLUSION

Low dose etoposide proves to be an effective approach in alleviating HLH while mitigating the risk of infection.
Cystic ductal adenocarcinoma of pancreas complicated with neuroendocrine tumor: A case report and review of literature
Authors: Zou Dong-Mei , Shu Zeng-Yi , Cao Xu
Published: October 2024

BACKGROUND

Difficulties in making an accurate preoperative diagnosis of cystic pancreatic lesions pose a challenge for radiologists. It would be helpful to report rare cases and review the literature.

CASE SUMMARY

In the present report, a case of a patient with a pancreatic cystic lesion initially misdiagnosed as a pseudocyst by radiologist was documented, which was later pathologically confirmed as pancreatic ductal adenocarcinoma with neuroendocrine tumor. However, subsequent literature review yielded no previous reports of pancreatic ductal adenocarcinoma with neuroendocrine tumors and cystic lesions. Therefore, literature on the imaging diagnosis of pancreatic cystic lesions was instead reviewed and discussed.

CONCLUSION

Careful evaluation of the characteristics revealed by multimodal imaging techniques, medical history, laboratory examination data and follow-up observations, is critical to the diagnosis and treatment of pancreatic cystic disease. We provide valuable insights into the diagnosis of pancreatic cystic disease through a rare case report and literature review.