bluuebunny/crossref_metadata_2025 huggingface dataset:
Language-concordant, patient-centered gynecology oncology symptom screening.
Authors: Reyes Maria Fatima , Rivera Casul Giuliana , Martinez Sarah , Castro Sara , Noor Chelsea Nadiha , Harris Devon , Hacker Michele R. , Shea Meghan , Esselen Katharine
Published: October 2023

85

Background: Patients with advanced gynecologic cancer experience symptoms at diagnosis, on treatment, at recurrence, and at the end of life. There is no standardized screening or interventions for these symptoms. Further, little is known about how primary language affects the screening and treatment of symptoms. Our aim was to understand patients’ preferences when screening for symptoms. The secondary aim was to explore patients’ attitudes using symptom screening tools and to understand obstacles in communication. Methods: Patients with advanced or recurrent gynecologic cancer (ovary, cervix, uterus, vulva), who speak Spanish or English, participated in focus groups facilitated by research staff in a semi-structured discussion on a virtual platform for 1 hour. Spanish language groups were led by native Spanish-speaking research staff. Transcripts of the discussions were translated by certified translators. A validated symptom screening tool and focused gynecologic symptoms screening tool were administered, and feedback elicited. Transcripts were independently reviewed by 3 investigators to identify common themes. Discrepancies were reconciled via consensus. Results: There was a total of 21 participants, 14% were Spanish primary speakers and 85% English speaking. Twenty-nine percent of participants were Black, half of whom identified as Afro-Latinas, 14% Asian, and 5% American Indian. Most patients had ovarian (65%) or uterine cancer (20%). Most patients had recurrent disease (57%), 33% were stage III, 10% were stage IV. Eighty-one percent completed a web-based symptoms survey. Using a symptom screening tool was readily accepted by Spanish- and English-speaking patients. Participants highlighted four important themes: 1) Education and attention to symptoms for early detection of recurrence; 2) mental health and support groups with a noted disparity in access for the Spanish-speaking patients; 3) palliation of treatment-related symptoms; and language concordance between patient; and 4) care team identified by the Spanish-speaking group. Conclusions: Clear communication and education about symptoms are important to patients. Patients experience many mental health symptoms and desire therapy and support groups. Patients want to be screened for symptoms, and there is a strong desire for bilingual resources. Next steps include conducting focus groups with physicians and staff who provide care for this patient population and implementing a screening tool in our clinics.
Cost-effectiveness analysis of bevacizumab biosimilars for metastatic colorectal cancer: A comparative study using real-world data.
Authors: Lu Brandon , Dvorani Erind , Nguyen Lena , Beca Jaclyn M. , Mercer Rebecca , Adamic Andrea , Muñoz Caroline , Arias Jessica , Gavura Scott , Chan Kelvin K.
Published: October 2023

9

Background: MVASI (Amgen) and Zirabev (Pfizer) are two of the earliest bevacizumab biosimilars approved for the first-line treatment of metastatic colorectal cancer (mCRC). While the introduction of biosimilars present an opportunity to alleviate the financial toxicity owing to the escalating costs of novel biologics, biosimilars should be comparatively assessed against the reference biologic in a real-world setting to confirm that they are indeed cost-saving or cost-effective after implementation. In this study, we aimed to confirm and quantify the real-world cost-savings of MVASI and Zirabev relative to originator bevacizumab (Avastin) for patients with mCRC. Methods: We conducted a population-based, retrospective cohort study in Ontario, Canada, where originator and biosimilar bevacizumab are universally publicly funded. Capturing the entire population of Ontario, we assessed all mCRC patients who received originator bevacizumab between January 1, 2008, and August 11, 2019, or biosimilar bevacizumab between August 12, 2019, and March 31, 2021. Biosimilar cases and originator bevacizumab controls were matched 1:4 using propensity score methods to adjust for differences at baseline. We calculated 1-year total patient-level costs (in Canadian dollars) and effects (in life years and quality-adjusted life years (QALY)) from the public health payer’s perspective. The primary outcomes for estimating cost-effectiveness were incremental net monetary benefit (INMB) and incremental net health benefit (INHB), calculated at willingness-to-pay (WTP) thresholds ranging from $50,000-200,000 per life year gained. Sensitivity analyses included a subgroup analysis by biosimilar type (MVASI/Zirabev) and an analysis using a 2-year time horizon. Results: The final propensity score matched cohort included 747 biosimilar cases and 2,945 controls. Bevacizumab biosimilars were associated with an incremental cost of -$6,379 (95% confidence interval (CI): -9,417, -3,537) (i.e., cost-saving) and an incremental effect of 0.0 (95% CI: -0.02, 0.02) life years gained and -0.01 (95% CI: -0.03, 0) QALY gained. INMB and INHB estimates indicated that biosimilar bevacizumab is cost-effective at all WTP thresholds assessed, with results remaining consistent across our biosimilar type subgroups and 2-year sensitivity analyses. Conclusions: Bevacizumab biosimilars demonstrated real-world cost-savings while providing similar survival benefit as originator bevacizumab, confirming the initial expectations of their implementation.
Case-Based Clinical Guidance on Dosing and Management of the Hepatic Artery Infusion Chemotherapy Pump
Authors: Rao Devika , Ellis Carleton S. , Kemeny Nancy , Cercek Andrea
Published: October 2023

Hepatic artery infusion (HAI) delivers localized high-dose floxuridine directly to liver tumors through an implanted pump. While patients are undergoing active treatment, the pump is refilled with chemotherapy alternating with saline every 2 weeks using a specialized noncoring needle. Numerous clinical scenarios influence the dosing of floxuridine, which do not conform to the usual dose modification schema for systemic chemotherapy. This article aims to provide practical clinical management solutions to overcome the common challenges faced by oncologists in the real-world management of HAI pump therapy.
Plasma Methylated DNA Markers for Melanoma Surveillance
Authors: Berger Calise K. , Taylor William R. , Mahoney Douglas W. , Burger Kelli N. , Doering Karen A. , Gonser Anna M. , Cao Xiaoming , Heilberger Justin , Gysbers Brianna J. , Foote Patrick H. , Kottschade Lisa A. , Markovic Svetomir N. , Lehman Julia S. , Katerov Viatcheslav E. , Allawi Hatim T. , Kisiel John B. , Meves Alexander
Published: October 2023

Plasma-based MDMs may offer a cost-effective alternative to imaging for melanoma detection. Early results show 80% sensitivity and 100% specificity against cancer-free controls. Further study needed. #MelanomaResearch #EarlyDetection
Outcomes of the IMMray PanCan-d Test in High-Risk Individuals Undergoing Pancreatic Surveillance: Pragmatic Data and Lessons Learned
Authors: Katona Bryson W. , Worthington Christine , Clay Daniel , Cincotta Hannah , Ahmad Nuzhat A. , Ginsberg Gregory G. , Kochman Michael L. , Brand Randall E.
Published: October 2023

PURPOSE

An effective blood-based test for pancreatic cancer (PC) screening has remained elusive. The IMMray PanCan-d is the first commercially available blood-based test specifically designed for early detection of PC; however, outcomes from its use in clinical practice have not been reported.

METHODS

We performed a blinded spike-in study of 100 individuals who had an IMMray PanCan-d test, including 94 high-risk individuals (HRIs) undergoing PC surveillance and six individuals with known PC. Specimens were processed blindly following the commercial laboratory's standardized operating procedure. Positive predictive value (PPV) and negative predictive value (NPV) were calculated.

RESULTS

Cohort characteristics included a median age of 63 (IQR, 55-70) years, 57% female, 96% non-Hispanic White, 57% with a pathogenic variant in a PC risk gene ( BRCA2 most commonly—18%), and 83% with a family history of PC. Among IMMray PanCan-d results from 94 HRIs undergoing PC surveillance, there was one positive (1%), seven borderlines (7%), 73 negatives (78%), and 13 tests not performed because of low CA19-9 expression (14%). No PC was diagnosed among these HRIs; however, there were two sub-cm pancreatic neuroendocrine tumors, seven clinically diagnosed side branch intraductal papillary mucinous neoplasms ≥1 cm, and a sub-cm solid mass with indeterminate cytology requiring close follow-up; all these individuals had negative IMMray PanCan-d tests. Of the six spiked-in PCs, four (67%) yielded a positive and two (33%) yielded a negative. With an estimated disease prevalence of 2%, the PPV and NPV are 52% and 99%, respectively, if borderline results are considered negative and 12% and 99%, respectively, if borderline tests are considered positive.

CONCLUSION

In clinical practice, IMMray PanCan-d has a robust NPV; however, PPV is dramatically influenced by whether borderline results are characterized as a positive or negative result.
Fighting against Patriarchy with Tweets and Hashtags: Social Media Activism of the Women's Movement and Reactionary Counterpublics
Authors: Yüce Özlem Danacı , Çatalbaş Dilruba
Published: October 2023

This article critically examines social media activism of feminist organizations in Turkey to uncover the strategies and tactics that they deploy in order to mobilize, build networks within and beyond the women's movement, and repel online reactionary publics. It analyzes the use of the Twittersphere by the two leading women's platforms, We Will Stop Femicides (aka KCDP) and Equality for Women (aka EŞİK), in relation to the two important campaigns in recent decades: one about the prevention of femicides and the other on the implementation and, then, reinstatement of the Council of Europe Convention on Violence against Women. Based on in-depth interviews with activists and a quantitative content analysis of the Twitter timelines of the platforms, the authors ascertained five major strategies: insisting on a feminist lexicon; aligning with the ideologically like-minded organized social groups; soliciting support from politicians, celebrities, academics, and the media; forging local and international networks; and disregarding antigender, antifeminist reactive counterpublics and avoiding any direct confrontation with them.
Appear to Disappear: Blackness, Affect, and the Political Imaginary
Authors: Stephens David
Published: October 2023

This article examines the role of affect in making possible or impossible particular political visions. It uses Johari Idusuyi's 2015 protest at a Donald Trump rally to discuss how individual affects and microaggressions culminate in larger political boundaries that prevent the mass coalescing of Black people and white-dominated conservative politics. In response to the aggression of the Trump campaign and its supporters, Idusuyi is seen reading Claudia Rankine's Citizen: An American Lyric. Despite this personal protest, Idusuyi's affective dissent is amplified via its circulation in the media and becomes symbolic of contemporary political incompatibilities. The essay argues that ultimately, Idusuyi's protest challenges racist notions of Black affective life and exposes a foundational incongruency between Blackness and conservative politics.
“We Know Well, but All the Same . . . ”
Authors: Abu El-Haj Nadia
Published: October 2023

In 1984, Edward Said argued that Palestinians had not yet gained “permission to narrate,” that is, a Palestinian national narrative of exile and colonization remained unintelligible in the Euro-American world. Forty years hence, much has changed. And yet, this essay asks, with what political consequences? What if the epistemological-qua-political ground has changed such that this “permission to narrate” turns out to be far less consequential than Said once believed? Tracing a shift in Israeli historical scholarship, and among the Israeli public, vis-à-vis the expulsion of Palestinians during the war of 1948, this essay queries a long-standing anti- and post-colonial commitment to the political salience of counter-histories, of revisiting the archive. Other forms of (epistemological) power have emerged and they do not require the kinds of ideological closures (denial, official or unofficial censorship) that were central to Said’s analysis. Israeli settler-nationhood no longer depends on the suppression of the historical trace, the state secret—on denial. It can just as easily operate through the embrace of a far more brazen and explicit seizure of power: I know very well, but nevertheless.
Immunity priming uncouples the growth–defense trade-off in tomato
Authors: Leibman-Markus Meirav , Schneider Anat , Gupta Rupali , Marash Iftah , Rav-David Dalia , Carmeli-Weissberg Mira , Elad Yigal , Bar Maya
Published: October 2023

Plants have developed an array of mechanisms to protect themselves against pathogen invasion. The deployment of defense mechanisms is imperative for plant survival, but can come at the expense of plant growth, leading to the ‘growth–defense trade-off’ phenomenon. Following pathogen exposure, plants can develop resistance to further attack. This is known as induced resistance, or priming. Here, we investigated the growth–defense trade-off, examining how defense priming via systemic acquired resistance (SAR), or induced systemic resistance (ISR), affects tomato development and growth. We found that defense priming can promote, rather than inhibit, plant development, and that defense priming and growth trade-offs can be uncoupled. Cytokinin response was activated during induced resistance, and found to be required for the observed growth and disease resistance resulting from ISR activation. ISR was found to have a stronger effect than SAR on plant development. Our results suggest that growth promotion and induced resistance can be co-dependent, and that, in certain cases, defense priming can drive developmental processes and promote plant yield.
Plantar Flexor Weakness and Pain Sensitivity Cannot Be Assumed in Midportion Achilles Tendinopathy
Authors: Sara Lauren K. , Gutsch Savannah B. , Hoeger Bement Marie , Hunter Sandra K.
Published: October 2023

Introduction/Purpose

The purpose of this study was to determine the following in persons with midportion Achilles tendinopathy (AT): 1) maximal strength and power; 2) neural drive during maximal contractions and contractile function during electrically evoked resting contractions; and 3) whether pain, neural drive, and contractile mechanisms contribute to differences in maximal strength.

Methods

Twenty-eight volunteers (14 AT, 14 controls) completed isometric, concentric, and eccentric maximal voluntary contractions (MVCs) of the plantar flexors in a Biodex™ dynamometer. Supramaximal electrical stimulation of the tibial nerve was performed to quantify neural drive and contractile properties of the plantar flexors. Pain sensitivity was quantified as the pressure-pain thresholds of the Achilles tendon, medial gastrocnemius, and upper trapezius.

Results

There were no differences in plantar flexion strength or power between AT and controls (isometric MVC: P = 0.95; dynamic MVC: P = 0.99; power: P = 0.98), nor were there differences in neural drive and contractile function (P = 0.55 and P = 0.06, respectively). However, the mechanisms predicting maximal strength differed between groups: neural drive predicted maximal strength in controls (P = 0.02) and contractile function predicted maximal strength in AT (P = 0.001). Although pain did not mediate these relationships (i.e., between maximal strength and its contributing mechanisms), pressure-pain thresholds at the upper trapezius were higher in AT (P = 0.02), despite being similar at the calf (P = 0.24) and Achilles tendon (P = 0.40).

Conclusions

There were no deficits in plantar flexion strength or power in persons with AT, whether evaluated isometrically, concentrically, or eccentrically. However, the mechanisms predicting maximal plantar flexor strength differed between groups, and systemic pain sensitivity was diminished in AT.
Significant Association between a Diagnosis of Hypovitaminosis D and Rotator Cuff Tear, Independent of Age and Sex: A Retrospective Database Study
Authors: ALBRIGHT J. ALEX , TESTA EDWARD J. , BYRNE RORY A. , PORTNOFF BRANDON , DANIELS ALAN H. , OWENS BRETT D.
Published: October 2023

Purpose

As high rates of vitamin D deficiency have been demonstrated in orthopedic patient cohorts, this study aimed to characterize the association between a diagnosis of hypovitaminosis D and primary rotator cuff tear (RCT), primary rotator cuff repair (RCR), and postoperative complications in different sex and age cohorts.

Methods

In this retrospective cohort study using PearlDiver, a nationwide administrative claims database, records for all patients aged 30 to 89 yr who received a diagnosis of hypovitaminosis D between January 1, 2011, and October 31, 2018, were queried. Rates of primary RCT, primary RCR, and postoperative complications including subsequent surgery were calculated within sex- and age-specific cohorts and compared with matched control cohorts using multivariable logistic regression.

Results

Among the 336,320 patients included in the hypovitaminosis D cohort, these patients were significantly more likely to experience an RCT (odds ratio (OR), 2.70; 95% confidence interval (CI), 2.55–2.85) as well as a full-thickness RCT (OR, 2.36; 95% CI, 2.17–2.56) specifically within 2 yr of their diagnosis. Women with hypovitaminosis D were more likely to undergo surgery to address their full-thickness tears (OR, 1.37; 95% CI, 1.09–1.74). There was no difference in the rates of revision RCR or irrigation and debridement. However, women with hypovitaminosis D were significantly more likely to undergo manipulation under anesthesia (OR, 1.16; 95% CI, 1.03–1.31).

Conclusions

Patients diagnosed with hypovitaminosis D were significantly more likely to suffer from a primary RCT and to undergo manipulation under anesthesia within a year of their RCR. Although many risk factors for RCT are unmodifiable, vitamin D deficiency is a readily modifiable risk factor with several treatment regimens demonstrating positive effects on musculoskeletal health.
Is Tranexemic Acid really helpful in major hemorrhage?
Authors: Mansoor Faraz
Published: October 2023

doi: https://doi.org/10.12669/pjms.40.1.8888

How to cite this: Mansoor F. Is Tranexemic Acid really helpful in major hemorrhage? Pak J Med Sci. 2024;40(1):---------. doi: https://doi.org/10.12669/pjms.40.1.8888
Νανοηλεκτρονικές διατάξεις που προσομοιάζουν την λειτουργία νευρωνικών δικτύων
Authors: Κίτσιος Σταύρος
Published: October 2023

Στην εποχή του ταχέως αναπτυσσόμενου Διαδικτύου (IoT), οι επιστημονικές ερευνητικές προσπάθειες οδήγησαν στην ανάπτυξη προηγμένων τεχνολογιών υλικών και λογισμικών για αποτελεσματική επεξεργασία δεδομένων και συνδεσιμότητας μεταξύ τους. Καθώς η ζήτηση για μονάδες επεξεργασίας χαμηλής ενεργειακής απόδοσης συνεχίζει να αυξάνεται, οι περιορισμοί της συμβατικής τεχνολογίας συμπληρωματικών ημιαγωγών οξειδίου μετάλλου (CMOS) απαιτούν νέες προσεγγίσεις αρχιτεκτονικού σχεδιασμού και χρήση καινοτόμων υλικών. Μεταξύ των πολλά υποσχόμενων εναλλακτικών λύσεων, η τεχνολογία μνήμης αντίστασης τυχαίας πρόσβασης (RRAM) έχει αναδειχθεί ως βασικός παράγοντας, προσφέροντας βελτιωμένες υπολογιστικές δυνατότητες όσον αφορά την ικανότητα αποθήκευσης καθώς και άλλες δυναμικές ιδιότητες. Για παράδειγμα, η δομή μετάλλου-μονωτή-μετάλλου (MIM) της RRAM, όταν κατασκευάζεται σε διάταξη διασταυρούμενων συστοιχιών, επιτρέπει την επεξεργασία σε χαμηλές θερμοκρασίες και παρουσιάζει μοναδικές δυνατότητες τρισδιάστατης ολοκλήρωσης. Η διατριβή αυτή εστιάζει στη διερεύνηση της συμπεριφοράς μεταβλητής αντίστασης ενός λεπτού στρώματος SiO2 με ενσωματωμένο το δισδιάστατο υλικό, διθειούχο μολυβδαίνιο (MoS2) σε μια διάταξη μνήμης αγώγιμης γέφυρας (CBRAM). Η προτεινόμενη διάταξη παρουσιάζει αξιοσημείωτα χαρακτηριστικά, συμπεριλαμβανομένης της βελτιωμένης κβαντικής αγωγιμότητας, μειωμένη μεταβλητότητα (variability) που προκύπτει από τον περιορισμένο σχηματισμό στοχαστικών αγώγιμων νημάτων καθώς και συναπτικές ιδιότητες. Συγκεκριμένα, οι διατάξεις παρουσιάζουν διπολική συμπεριφορά χωρίς την ανάγκη ηλεκτροδιαμόρφωσης (electroforming), παρουσιάζοντας εφτά κβαντισμένες καταστάσεις αγωγιμότητας κατά την εφαρμογή συνεχούς τάσης DC και εφτά κβαντισμένες καταστάσεις υπό μετρήσεις παλμών. Επιπλέον, οι διατάξεις παρουσιάζουν βελτιωμένες ιδιότητες αντοχής και συγκράτησης (endurance and retention), καθώς και ενισχυμένη γραμμικότητα στις διαδικασίες ενίσχυσης και καταστολής των συναπτικών χαρακτηριστικών. Αυτά τα χαρακτηριστικά μπορούν να αποδοθούν στο ελεγχόμενο φράγμα διάχυσης των ιόντων Ag που επιτυγχάνεται μέσω του ατομικού πλέγματος των στρωμάτων του MoS2. Επιπλέον, διερευνήθηκε και η κατασκευή επίπεδων διατάξεων μνήμης που χρησιμοποιούν MoS2 ως ενεργό υλικό, χρησιμοποιώντας τεχνικές όπως η λιθογραφία δέσμης ηλεκτρονίων. Οι διατάξεις μνήμης στο επίπεδο παρουσιάζουν πρόσθετους τρόπους για τη διερεύνηση των ηλεκτρονικών ιδιοτήτων και των χαρακτηριστικών μνήμης των διατάξεων που βασίζονται στην ύπαρξη του MoS2, συμβάλλοντας περαι- τέρω στην ανάπτυξη μιας αποτελεσματικής και αξιόπιστης διάταξης μνήμης.
Secondary data analysis of the distribution and determinants of maternal and child health outcomes across Kenya’s 47 counties
Authors: Okungu Vincent
Published: October 2023

Introduction There are 47 semi-autonomous counties in Kenya that are in-charge of financing and delivery of healthcare. Although reports exist that demonstrate how the counties differ in socioeconomic status, disease burden, and health outcomes, such reports often fail to show where the greatest inequities lie, and what actually drives them. This analysis is meant to guide better targeting of resources to achieve a greater impact on maternal and child health outcomes. Methods Secondary data sources were analyzed to determine the variations in inequities in Kenyan counties. The inequities and their distribution in the 47 counties were assessed using a Lorenz curve and principal component analysis (PCA). A regression analysis evaluated the relationship between key outcomes- maternal mortality, under-five mortality, full immunization coverage (DPT3), the incidence of diarrhea, and under-five stunting, as the dependent variables, and years of education for women 15 – 49 years, county health financing per capita, public insurance coverage, population per facility, public nurses/100000, doctors/100000 people, poverty headcount rate, and gender inequality index (GII), as the independent variables. Findings Vaccine coverage (Gini Index 0.063) is the most equitably distributed outcome in the country, followed by under-five mortality (GI=0.124). Maternal mortality has the highest inequity (GI=0.381), followed by the distribution of public sector nurses (GI=0.317). County government funding of health per capita also shows wide variations between counties (GI= 0.230) suggesting different levels of expenditure and prioritization. Vaccine coverage and U-5 mortality are the most evenly distributed across the counties. The key drivers of maternal mortality are education of women of reproductive age (p= 0.001), gender inequality (p=0.002), and congestion at health facilities (0.001). Conclusion Promising approaches and interventions to reduce inequity do exist, which includes UHC whose focus should be on reducing geographical, economic, sociocultural, and gender barriers to healthcare.
Case Report: Surgical reduction for hypertrophied lip using electrocautery
Authors: Durge Khushboo , Salian Shrishti , Subhadarsanee Chitrika
Published: October 2023

Background The lips have a significant role in the aesthetics of the face. People, especially those of the female sex give their lips great attention since they are an essential part of expressing feelings, emotions, and attractiveness. Lip reduction is the surgery to reduce the appearance of larger or fuller than desirable lips. Lip reduction surgery aims to restore normal lip function as well as a harmonic relationship between the top and lower lips and with the rest of the face. Case description A 29-year-old, healthy female reported to the Department of Periodontics with a chief complaint of poor esthetics and a complaint of large lips. The measurements of the lip were made and the treatment option given was lip reduction surgery. Conclusions Inherited genetic traits are the main causes of large lips. The typical strategy advocated in the literature calls for removing a horizontal wedge of soft tissue from the upper and lower lips in order to reduce the labial volume simply. It results in a smaller and more appealing labial complex by reducing lip volume while restoring harmonic relative proportions between the lips.
Family Research and Demographic Analysis – New Insights from the German Family Demography Panel Study (FReDA)
Authors: Bujard Martin , Hank Karsten , Pollak Reinhard
Published: October 2023

This is the Editorial on the Special Issue "Family Research and Demographic Analysis – New Insights from the German Family Demography Panel Study (FReDA)".
Ergonomic comparison of different incontinence products and effects on time and physical demands on carers
Authors: Schneider Wolfgang , Sanaeifar Niuosha
Published: October 2023

Background:

Caregivers are at a high risk of musculoskeletal injuries. Efficiency in handling and changing patients' absorbent incontinence products may reduce the burden of caring.

Aims:

This study aimed to compare various types of absorbent incontinence products from an ergonomic perspective and assess the length of time required for handling these products and the physical demand on caregivers' backs, hands and fingers.

Methods:

A within-subject design was selected for two studies involving 64 experienced nurses. The first study was conducted at a test centre in Germany, while the second was performed at a hospital in France. Objective data, such as the time required to apply or change a product and physical stress on the back and hands/wrists, as well as users' subjective assessment of product handling were investigated.

Findings:

Both objective and subjective assessments showed that elastic slips were superior to other slip products. The traditional and belted slips were the second-best products in the objective and subjective assessments respectively.

Conclusion:

Choice of incontinence product influences the time required and the physical demands associated with handling. Both aspects can be considerably reduced with the use of appropriate absorbent incontinence products.
Transanal irrigation to treat chronic constipation in patients with spinal cord injury: a case study
Authors: Lawrence Debbie
Published: October 2023

This case study explores the benefits of transanal irrigation as a treatment for a patient with a spinal cord injury who was experiencing chronic constipation. In this case, the patient was having episodes of autonomic dysreflexia as a result of the constipation. This condition is unique to patients with spinal cord injury and presents a stroke risk. The article outlines the contraindications and cautions that need to be considered in assessing a patient's suitability for transanal irrigation, and the elements that form part of a holistic assessment by a specialist nurse.
The Divided Mind Model Defended
Authors: Smith Drew
Published: October 2023

At the latter half of the twentieth century, Richard Swinburne proposed a model of the incarnation built upon Freud’s divided mind theory. Over the course of two publications, Tim Bayne has formulated the most robust critique of Swinburne’s model to date. In this paper, I argue that Bayne’s objections rest on key misinterpretations of Swinburne’s work. Moreover, when one properly understands the model, these objections lose their force. I begin by expositing Swinburne’s divided mind model (DM), highlighting its four foundational theses. Next, I respond to Bayne’s objections against DM, demonstrating they rest upon misconceptions of the model.
Wholly Good, Holy God
Authors: Terence Cuneo  , Jada Twedt Strabbing
Published: October 2023

Mark Murphy dedicates Divine Holiness and Divine Action to answering two questions: What is divine holiness? And why does it matter for understanding divine action? According to Murphy, divine holiness consists in God’s having those features that make it appropriate for creatures to be simultaneously attracted to and repelled by God. This account, in turn, affords a novel framework for understanding divine action, one intended to avoid the pitfalls of alternative approaches emphasizing God’s moral goodness or lovingkindness. In this essay, we express agreement with Murphy’s idea that divine holiness is crucial for understanding divine action. But we find ourselves balking at two significant junctures. First, we contend that Murphy’s characterization of divine holiness requires revision, as appeal to attraction and repulsion doesn’t adequately capture attitudes such as awe and reverence that are central to experiences of the holy. And, second, we argue that the ‘holiness framework’ for divine action fails to accomplish its aims, largely because it rejects the claim that God’s perfect moral goodness and lovingkindness ground God’s holiness. We conclude that theorists should instead embrace a framework for action that integrates God’s perfect moral goodness, lovingkindness, and holiness.
The Difference Holiness Makes
Authors: Mark C. Murphy
Published: October 2023

Terence Cuneo & Jada Twedt Strabbing, Samuel Fleischacker, Jonathan Rutledge & Jordan Wessling, and Sameer Yadav have generously engaged with the accounts of divine holiness and its implications offered in my Divine Holiness and Divine Action (2021), criticizing its arguments and in some cases offering attractive alternative accounts. Here I respond to some of their criticisms.
Long-range distributed vibration sensing using phase-sensitive forward optical transmission: publisher’s note
Authors: Chen George Y. , Liu Kuan , Rao Xing , Wang Yuhang , Khalid Mamoona , He Jun , Wang Yiping
Published: October 2023

This publisher’s note contains corrections to Opt. Lett. 48, 4825 (2023)10.1364/OL.500587.
Light blocking and phase modulation based on thermo-plasmonic hotspots in WS2 monolayer
Authors: Maki Hamodi Hayder , Sami Fyath Raad , Hamidi Seyedeh Mehri
Published: October 2023

Here we demonstrate light blocking and phase modulation in nano-plasmonic donate shape rings based on the thermo-plasmonic effect in these structures. For this purpose, we use a laser writing system to fabricate nanohole arrays and cover them with plasmonic gold thin film via a sputtering machine. The chemical vapor deposition method is also used to produce a WS2 layer, which is suitable for light blocking and phase modulation due to the nonlinearity of this two-dimensional material. After theoretically and experimentally evaluating the plasmonic donate-shaped substrate, we use the ellipsometric method to characterize the optical modes of the samples and record the switching manner and light-blocking phenomena under the probe laser excitation set to 980 nm. Our results show phase modulation based on the thermo-plasmonic effect of nano gap in donated double rings and light blocking by thermal expansion of the WS2 layer, which can open new insight into plasmon and two-dimensional material-based devices.
Diverse microtubule-targeted anticancer agents kill cells by inducing chromosome missegregation on multipolar spindles
Authors: Zhou Amber S. , Tucker John B. , Scribano Christina M. , Lynch Andrew R. , Carlsen Caleb L. , Pop-Vicas Sophia T. , Pattaswamy Srishrika M. , Burkard Mark E. , Weaver Beth A.
Published: October 2023

Microtubule-targeted agents are commonly used for cancer treatment, though many patients do not benefit. Microtubule-targeted drugs were assumed to elicit anticancer activity via mitotic arrest because they cause cell death following mitotic arrest in cell culture. However, we recently demonstrated that intratumoral paclitaxel concentrations are insufficient to induce mitotic arrest and rather induce chromosomal instability (CIN) via multipolar mitotic spindles. Here, we show in metastatic breast cancer and relevant human cellular models that this mechanism is conserved among clinically useful microtubule poisons. While multipolar divisions typically produce inviable progeny, multipolar spindles can be focused into near-normal bipolar spindles at any stage of mitosis. Using a novel method to quantify the rate of CIN, we demonstrate that cell death positively correlates with net loss of DNA. Spindle focusing decreases CIN and causes resistance to diverse microtubule poisons, which can be counteracted by addition of a drug that increases CIN without affecting spindle polarity. These results demonstrate conserved mechanisms of action and resistance for diverse microtubule-targeted agents.

Trial registration: clinicaltrials.gov, NCT03393741.
Mammalian cells internalize bacteriophages and use them as a resource to enhance cellular growth and survival
Authors: Bichet Marion C. , Adderley Jack , Avellaneda-Franco Laura , Magnin-Bougma Isabelle , Torriero-Smith Natasha , Gearing Linden J. , Deffrasnes Celine , David Cassandra , Pepin Genevieve , Gantier Michael P. , Lin Ruby CY , Patwa Ruzeen , Moseley Gregory W. , Doerig Christian , Barr Jeremy J.
Published: October 2023

There is a growing appreciation that the direct interaction between bacteriophages and the mammalian host can facilitate diverse and unexplored symbioses. Yet the impact these bacteriophages may have on mammalian cellular and immunological processes is poorly understood. Here, we applied highly purified phage T4, free from bacterial by-products and endotoxins to mammalian cells and analyzed the cellular responses using luciferase reporter and antibody microarray assays. Phage preparations were applied in vitro to either A549 lung epithelial cells, MDCK-I kidney cells, or primary mouse bone marrow derived macrophages with the phage-free supernatant serving as a comparative control. Highly purified T4 phages were rapidly internalized by mammalian cells and accumulated within macropinosomes but did not activate the inflammatory DNA response TLR9 or cGAS-STING pathways. Following 8 hours of incubation with T4 phage, whole cell lysates were analyzed via antibody microarray that detected expression and phosphorylation levels of human signaling proteins. T4 phage application led to the activation of AKT-dependent pathways, resulting in an increase in cell metabolism, survival, and actin reorganization, the last being critical for macropinocytosis and potentially regulating a positive feedback loop to drive further phage internalization. T4 phages additionally down-regulated CDK1 and its downstream effectors, leading to an inhibition of cell cycle progression and an increase in cellular growth through a prolonged G1 phase. These interactions demonstrate that highly purified T4 phages do not activate DNA-mediated inflammatory pathways but do trigger protein phosphorylation cascades that promote cellular growth and survival. We conclude that mammalian cells are internalizing bacteriophages as a resource to promote cellular growth and metabolism.
Thirty-day mortality rates among young adult stroke patients and their characteristics at Kiruddu and Mulago hospitals in Uganda: A prospective observational cohort study
Authors: Nampogo Adrian Mwota , Musubire Abdu Kisekka , Bagasha Peace , Mbalinda Scovia , Moore Shirley , Katabira Elly. T. , Sajatovic Martha , Kaddumukasa Mark
Published: October 2023

Stroke outcomes among young adults in Uganda are unclear. This study therefore determined the clinical characteristics and 30-day outcome among young adults with an acute stroke. In a prospective observational cohort study, 61 young adults with confirmed stroke were followed up for 30 days. Socio-demographic and clinical characteristics were collected using a study questionnaire. Kaplan–Meier curves, and modified Poisson regression were performed for factors associated with the 30-day mortality outcome. A third of the screened stroke survivors, (61/195) were young adults aged between 18 and 50 years. About two-thirds were male. More than half were diagnosed with ischaemic strokes while 42.6% had a haemorrhagic stroke. Nearly half (29/61) were known hypertensives, 43% (26/61) had a history of alcohol consumption with 95% classified as dependent on CAGE assessment. Ten percent had a prior smoking history while 29% of the female gender had a prior history of oral contraception use. Twenty-three percent (14/61) of the young stroke patients died within 30 days of stroke onset (95% CI: 0.01, 0. 901). A history of smoking (adjusted prevalence ratio: aPR;5. 094, 95% CI: 3.712, 6. 990) and stroke severity National Institutes of Health Stroke score (NIHSS) >16; Prevalence ratio (PR) -3. 301, 95%CI: 1. 395, 7. 808) and not drinking alcohol (aPR (adjusted prevalence ratio) -7. 247, 95% CI: 4. 491, 11.696) were associated with 30- day mortality. A third of all stroke survivors were young adults. About 23. 3% died within 30 days of stroke onset. Stroke severity and a history of smoking were associated with mortality. Identifying high risk patients and early outpatient follow up may help reduce the 30-day mortality in our settings.
The epidemiology of fecal carriage of nontyphoidal Salmonella among healthy children and adults in three sites in Kenya
Authors: Muthumbi Esther M. , Mwanzu Alfred , Mbae Cecilia , Bigogo Godfrey , Karani Angela , Mwarumba Salim , Verani Jennifer R. , Kariuki Samuel , Scott J. Anthony G.
Published: October 2023

Background

Despite the importance of non-Typhoidal Salmonella (NTS) disease in Africa, epidemiologic data on carriage and transmission are few. These data are important to understand the transmission of NTS in Africa and to design control strategies.

Method

To estimate the prevalence of stool carriage of NTS in Kenya, we conducted a cross-sectional study in Kilifi, Nairobi, and Siaya, sites with a low, moderate and high incidence of invasive NTS disease, respectively. At each site, we randomly selected 100 participants in each age-group of 0–11 months, 12–59 months, 5–14 years, 15–54 years and ≥55 years. We collected stool, venous blood (for hemoglobin and malaria rapid tests), anthropometric measurements, and administered a questionnaire on Water Access Sanitation and Hygiene (WASH) practices. Stool samples were cultured on selective agar for Salmonella; suspect isolates underwent serotyping and antimicrobial susceptibility testing.

Result

Overall, 53 (3.5%) isolates of NTS were cultured from 1497 samples. Age-adjusted prevalence was 13.1% (95%CI 8.8–17.4) in Kilifi, 0.4% (95%CI 0–1.3) in Nairobi, and 0.9% (95%CI 0–2.0) in Siaya. Prevalence was highest among those aged 15–54 years (6.2%). Of 53 isolates; 5 were S. Enteritidis, 1 was S. Typhimurium. No S. Typhi was isolated. None of the risk factors were associated with carriage of NTS. All isolates were susceptible to all antibiotics tested, including ampicillin, chloramphenicol, ciprofloxacin and co-trimoxazole.

Conclusion

Prevalence of fecal carriage was high in Kilifi, an area of low incidence of invasive NTS disease and was low in areas of higher incidence in Nairobi and Siaya. The age-prevalence, risk factors, geographical and serotype distribution of NTS in carriage differs from invasive disease.
Evaluating the effectiveness of mindfulness alone compared to exercise and mindfulness on fatigue in women with gynaecology cancer (GEMS): Protocol for a randomised feasibility trial
Authors: McCloy Kairen , Hughes Ciara , Dunwoody Lynn , Marley Joanne , Cleland Ian , Cruciani Federico , Saunders Catherine , Gracey Jackie
Published: October 2023

Background

In 2020 Globocan reported nearly 1.4 million new cases of gynaecology cancer worldwide. Cancer related fatigue has been identified as a symptom that can be present for gynaecology cancer patients many years after treatment. The current evidence around the management of this symptom suggests that exercise has the most positive outcome. However, some ambiguity remains around the evidence and whether it can address all areas of fatigue effectively. More recently, other interventions such as mindfulness have begun to show a favourable response to the management of symptoms for cancer patients. To date there has been little research that explores the feasibility of using both these interventions together in a gynaecology cancer population. This study aims to explore the feasibility of delivering an intervention that involves mindfulness and mindfulness and exercise and will explore the effect of this on fatigue, sleep, mood and quality of life.

Methods/Design

This randomised control trial will assess the interventions outcomes using a pre and post design and will also include a qualitative process evaluation. Participants will be randomised into one of 2 groups. One group will undertake mindfulness only and the other group will complete exercise and mindfulness. Both groups will use a mobile application to complete these interventions over 8 weeks. The mobile app will be tailored to reflect the group the participants have drawn during randomisation. Self-reported questionnaire data will be assessed at baseline prior to commencing intervention and at post intervention. Feasibility will be assessed through recruitment, adherence, retention and attrition. Acceptability and participant perspective of participation (process evaluation), will be explored using focus groups.

Discussion

This trial will hope to evidence and demonstrate that combination of two interventions such as mindfulness and exercise will further improve outcomes of fatigue and wellbeing in gynaecology cancer. The results of this study will be used to assess (i) the feasibility to deliver this type of intervention to this population of cancer patients using a digital platform; (ii) assist this group of women diagnosed with cancer to manage fatigue and other symptoms of sleep, mood and impact their quality of life.

Trial registration

NCT05561413.
Exposure to heat stress leads to striking clone-specific nymph deformity in pea aphid
Authors: Jahan Hawa , Khudr Mouhammad Shadi , Arafeh Ali , Hager Reinmar
Published: October 2023

Climatic changes, such as heatwaves, pose unprecedented challenges for insects, as escalated temperatures above the thermal optimum alter insect reproductive strategies and energy metabolism. While thermal stress responses have been reported in different insect species, thermo-induced developmental abnormalities in phloem-feeding pests are largely unknown. In this laboratory study, we raised two groups of first instar nymphs belonging to two clones of the pea aphid Acyrthosiphon pisum, on fava beans Vicia faba. The instars developed and then asexually reproduced under constant exposure to a sub-lethal heatwave (27°C) for 14 days. Most mothers survived but their progenies showed abnormalities, as stillbirths and appendageless or weak nymphs with folded appendages were delivered. Clone N116 produced more deceased and appendageless embryos, contrary to N127, which produced fewer dead and more malformed premature embryos. Interestingly, the expression of the HSP70 and HSP83 genes differed in mothers between the clones. Moreover, noticeable changes in metabolism, e.g., lipids, were also detected and that differed in response to stress. Deformed offspring production after heat exposure may be due to heat injury and differential HSP gene expression, but may also be indicative of a conflict between maternal and offspring fitness. Reproductive altruism might have occurred to ensure some of the genetically identical daughters survive. This is because maintaining homeostasis and complete embryogenesis could not be simultaneously fulfilled due to the high costs of stress. Our findings shine new light on pea aphid responses to heatwaves and merit further examination across different lineages and species.
Prevalence and risk factors of Toxoplasma gondii infection among women with miscarriage and their aborted fetuses in the northwest of Iran
Authors: Zeinali Shiva , Khademvatan Shahram , Jafari Rasool , Vazifekhah Shabnam , Yousefi Elham , Behroozi-Lak Tahereh
Published: October 2023

Toxoplasmosis is a worldwide disease of various animals and human and results from infection with the Toxoplasma gondii parasite. Abortion and congenital defects are important consequences of the T. gondii infection. The aim of this study was to determine the Toxoplasma-induced abortions among women with miscarriage and the presence of T. gondii in their aborted fetuses in Urmia, the northwest of Iran. This cross-sectional study was conducted with 215 women with abortion and their aborted fetuses, from 2020 to 2021. Seroprevalence of anti-Toxoplasma IgG and IgM were determined using the sera of the aforesaid women. Nested PCR was carried out using RE-529 gene sequences, and sequencing was performed using the T. gondii GRA6 gene on the remnant of pregnancy after abortion. The tissue positive samples were then subjected to another PCR on GRA6 gene and sequenced for genotyping. Among 215 serum samples of women with abortion, 70 (32.6%) were positive for anti-Toxoplasma IgG, and three (1.4%) were positive for IgM. The RE-529 sequence of T. gondii was positive in three (1.4%) of the aborted fetuses. The analysis of GRA6 gene indicated that all three positive samples carried a GRA6 allele (GRA6I) of T. gondii type I genotype. Our findings suggest that T. gondii is one of the causative agents of spontaneous abortion in West Azerbijan Province, the northwest of Iran.
Reassessing the genetic variability of Tectona grandis through high-throughput genotyping: Insights on its narrow genetic base
Authors: dos Anjos Isabela Vera , Gilio Thiago Alexandre Santana , Amorim Ana Flávia S. , de Jesus Jeferson Gonçalves , Chimello Antonio Marcos , Takizawa Fausto H. , Araujo Kelly Lana , Neves Leonarda Grillo
Published: October 2023

Teak (Tectona grandis Linn. f.) is considered one of the most expensive hardwoods in the world. The dispersion of the species over the years has taken the teak beyond its first sources of diversity and little is known about the genetic origin and genetic variability. Thus, this study aimed to investigate the genetic diversity and genetic population structure existing in a representative teak germplasm bank collection. DNA was extracted from young leaves and each sample were genotyped by whole genome sequencing at 3 giga bases per sample, the sequences are aligned using the genome, and SNPcalls and quality control were made. To study the population structure of the genotypes, Bayesian variational inference was used via fastStructure, the phylogenetic tree was based on the modified Euclidean distance and the clustering by the UPGMA hierarchical method. Genetic diversity was analyzed based on the pairwise genetic divergence (Fst) of Weir and Cockerham. Genotyping by sequencing resulted in a database of approximately 1.4 million of variations SNPs were used for analysis. It was possible to identify four populations with considerable genetic variability between and within them. While the genetic variability in teak is generally known to be narrow, this study confirmed the presence of genetic variability scale in teak, which is contrary to what was initially expected.