bluuebunny/crossref_metadata_2025 huggingface dataset:
Nomograms combining clinical factors and apparent diffusion coefficient to predict downstaging and progression-free survival after concurrent chemoradiotherapy in patients with cervical cancer
Authors: Fan Jiawei , Li Wenfei , Cheng Mengyu , Wang Zhehan , Wang Zhanqiu , Chen Tao , Gu Tao
Published: November 2024

Background

Concurrent chemoradiotherapy (CCRT) is used as the primary treatment modality for currently limited cervical cancer and lacks non-invasive quantitative parameters to assess clinical outcomes of treatment for cervical cancer treatment.

Purpose

To develop nomograms based on clinical prognostic factors and apparent diffusion coefficient (ADC) in predicting downstaging and progression-free survival (PFS) after CCRT for cervical cancer.

Material and Methods

X-tile was used to calculate the optimal threshold for ΔADCmean(%) for prognostic stratification. Kaplan–Meier curves were used to calculate the difference in PFS between high- and low-risk groups. Univariate and multivariate Cox proportional risk regression models were used to identify clinical and radiological risk factors for prognosis and construct a prognostic nomogram model.

Results

ΔADCmean(%) was significantly correlated with tumor downstaging; the area under the receiver operating characteristic curve (AUC) was 0.868. X-tile showed that the optimal threshold for ΔADCmean(%) to diagnose prognosis was 40.8. Kaplan–Meier curves showed that the low-risk population in the training group had significantly longer PFS within 3 years ( P < 0.001). Multivariate Cox regression showed that ΔADC (%) is independent risk factor for PFS. The C-index of ΔADC(%) predicting 3-year PFS in the training set is 0.761 and the C-index of the nomogram model is 0.862.

Conclusion

ΔADCmean(%) is a non-invasive biomarker for predicting tumor downstaging in cervical cancer after CCRT. The nomograms based on ΔADCmean(%) predict PFS of patients with cervical cancer with moderate accuracy.
Exploring the Impact of Regional Environment and Institutional Factors on Operation Period of Nursing Facilities in Taiwan
Authors: Wang Charlotte , Chang Ching-Yun , Chen Chen-Fen
Published: November 2024

This study examines factors influencing the operational durations of nursing facilities in Taiwan. It departs from previous closure-focused research by analyzing the duration of facility operation. A Cox regression model was employed to assess the impact of regional, governmental, and individual institutional factors on 199 facilities across diverse areas in Taiwan from 2011 to 2019. Results demonstrate closure hazards associated with rising property prices, particularly for rented facilities, with metropolitan locations exhibiting superior survival rates and lower institutional appraisal grades significantly increasing closure. Additionally, operator background, facility type, and bed occupancy emerged as influential factors. These findings underscore the financial vulnerability of rented facilities to market fluctuations and the challenges associated with adjusting resident fees. Furthermore, the study highlights the unique challenges faced by facilities in low-density areas regarding resident access to resources. Policymakers should closely monitor regional factors and consider proactively implementing early warning systems to address these challenges.
“Not Having Family, not Having Insurance, not Having Money, Experiencing lots of Pain”: Fears About Cancer Among Older Latino Men
Authors: Carrion Iraida V. , Bonano Crystal , Estapé Jorge , Estapé Tania
Published: November 2024

Cancer among older adults is pervasive, placing excessive strain on the individual, caregivers, and wider society. Focusing on cancer among older immigrant Latino men is critical to identifying knowledge gaps, diagnosis and treatment while providing insights to improving cancer care to this growing population. As such, this article presents the multifactorial experience of fears and beliefs about cancer and cancer prevention of 57 older immigrant Latino men based on qualitative responses. From the results emerged three significant sub-themes that provided crucial insight into the thought processes that influence decision-making in regard to cancer for this population. A major concern is the financial impacts of cancer and treatment without insurance. Factors regarding their ability to continuing providing for their families if they were to undergo treatment, and their families’ future financial security once they were gone provide valuable insights to improving cancer care information among older immigrant Latino men.
3D printed sodium alginate/gelatin/tannic acid/calcium chloride scaffolds laden bone marrow mesenchymal stem cells to repair defective thyroid cartilage plate
Authors: Li Jingzhi , Chen Yuelin , Wei Mengru , Tang Ying , Zhou Li , Quan Xiaoxuan , Ma Ruina , Hou Nan
Published: November 2024

Due to the absence of blood vessels, cartilage exhibits extremely limited self-repair capacity. Currently, repairing laryngeal cartilage defects, resulting from conditions such as laryngeal tumors, injury, and congenital structural abnormalities, remains a significant challenge in the Department of Otolaryngology, Head and Neck Surgery. Previous research has often focused on enhancing the mechanical properties of synthetic materials. However, their low biological activity and weak cell adhesion necessitate compensatory measures. This study aims to capitalize on the advantages of natural materials in cartilage tissue engineering. Sodium alginate, gelatin, tannic acid, and calcium chloride were utilized to prepare bioinks through cross-linking for application in 3D printing cartilage scaffolds. Bone marrow mesenchymal stem cells with multidirectional differentiation potential were chosen as seed cells, with appropriate growth factors incorporated to promote their differentiation into cartilage during in vitro culture. The scaffold laden cells was subsequently implanted into rabbit thyroid cartilage plate defects at the appropriate time. HE staining, toluidine blue staining, Masson staining, and collagen type II staining were employed to assess cartilage defect repair at 4, 8, and 12 weeks, respectively. Results demonstrated that scaffolds made from natural materials could emulate the mechanical properties of fresh cartilage with commendable biocompatibility. Stained sections further confirmed the efficacy of the composite hydrogel scaffolds identified in this study in promoting rabbit thyroid cartilage plate restoration. In summary, this study successfully fabricated a natural material scaffold for rabbit laryngeal cartilage tissue engineering, thereby furnishing a new idea and experience for the clinical application of laryngeal cartilage defect reconstruction.
Prepared for service? A mixed-methods study on psychosocial support in the UK public library, with a focus on staff perceptions and training
Authors: Taylor Charlotte A , Simon Anoush
Published: November 2024

This mixed-methods study considers the ways in which the public library is increasingly supporting the mental, emotional and social – or ‘psychosocial’ – needs of individuals within its local communities; reflecting on an emerging body of US research which is exploring this topic. This research aimed to determine how prepared UK public library services are to support the psychosocial needs of users, with a focus on staff perceptions, confidence and training. The research identified the psychosocial services and relevant staff training currently taking place in Southeast England, through an online survey with public library staff. This data provided a background of understanding, before in-depth, semi-structured interviews were completed with nine public library staff within one library service, to uncover staff perceptions and attitudes around this area of work. The quantitative and qualitative data revealed findings which largely reflected the research that has taken place in the US. Public library staff are committed to delivering psychosocial support by providing information, signposting, delivering library groups and activities, and showing compassion to users. However, staff experience feelings of uncertainty around this work, particularly when responding to users with complex needs or those in crisis, and they have a strong desire for more targeted training in this area. This paper concludes that this aspect of modern public library work necessitates the development of targeted staff training and further research in this area.
Antiproliferative and Apoptotic Potential of Chicoric Acid, a Major Phytoconstituent of Cichorium intybus, against Colon Cancer Cells: A Possible Inhibition of CDC25 Phosphatases
Authors: Alotaibi Modhi O. , Verma Mahima , Fatima Shireen , Alotaibi Nahaa M. , Alshammari Nawaf , Saeed Mohd , Alharbi F. K. , Ansari Irfan Ahmad
Published: November 2024

Background:

Over the years, plants have been utilized worldwide for the treatment of cancer in the traditional system of medicine, notably in the majority of developing nations. The use of chemotherapeutic drugs is frequently associated with lethal side effects when treating cancer. Therefore, the panacea to the vicious side effects linked to synthetic pharmaceuticals is the alternative usage of widely accessible and affordable therapeutic approaches. Chicoric acid, a major constituent of Cichorium intybus, has recently been shown to exhibit antioxidant, anti-inflammatory, antidiabetic, antiviral, neuroprotective, hepatoprotective, and anticancer properties.

Purpose:

Except for a few preliminary studies, no detailed study on the chemotherapeutic efficacy of chicoric acid against cancer cells has been done till now. Therefore, the aim of this study is to assess the potential of chicoric acid against colon cancer cells.

Methods:

Different in vitro assays like MTT, DAPI staining, rhodamine staining, H2DCFDA staining, caspase activity, and cell analysis were performed on colon cancer HCT116 cells to assess their growth inhibitory properties.

Results:

According to the results, chicoric acid dose-dependently suppressed the growth of colon cancer HCT116 cells by inducing cell cycle arrest at G0/G1 phase and apoptosis via both intrinsic and extrinsic pathways. In silico findings unveiled the cell cycle regulatory capacity of chicoric acid through binding CDC25 phosphatases, implying its potential as an antiproliferative agent capable of suppressing cell growth.

Conclusion:

Collectively, the results suggested strong chemopreventive potential of chicoric acid against colon cancer cells. Thus, chicoric acid may turn out to be an excellent anticancer agent, which may be explored in the future for the therapeutic drug development against cancer.
Assessment of Midwives’ Knowledge and Application of the Modified WHO Partograph at Ga South Public Health Facilities, Greater Accra, Ghana
Authors: Asirifi Vivian Hickson , Sutherland Edward Kofi , Afakorzi Stephen Henry
Published: November 2024

Background

The partograph, one of the vital tools available for the midwife, was originally developed from Friedman’s 1954 Cervicograph by Philpott and Castle in 1972. It was later modified and adopted by the WHO as a universal ‘gold standard’ tool for recording and monitoring progress in labour and providing interventions in cases of abnormal labour. The goal of this study was to assess the level of knowledge of midwives and their utilisation of the modified WHO partograph at the Ga South Municipality in the Greater Accra Region of Ghana.

Methodology

An institution-based quantitative cross-sectional study was conducted within the municipality from February to March 2019. One hundred and ten (110) midwives were recruited using the census approach. Data were collected using a structured self-administered questionnaire. STATA statistical software version 14 was used for descriptive analysis and results were reported in the form of percentages and frequencies using charts and tables. Pearson’s Chi-Square estimation was also performed to test the association between selected variables with a p value <.05 as the threshold for statistical significance.

Results

Of the 110 participants, 105 (95.5%) of the midwives could properly describe the partograph and 104 (94.5%) understood that it was used as a tool for vital decision-making, while 92 (83.6%) indicated that partograph contributes in reducing maternal and new-born deaths. Almost all participants, 109 (99.09%) knew all the parameters of the partograph and were also aware that plotting the partograph begins at a cervical dilation of 4 cm. Also, while a good number of participants 103 (93.64%) knew that cervical dilation on the partograph is carried out every four hours during the active phase of labour, 110 (100%) indicated that progress of labour is assessed by the degree of cervical dilation and descent of the presenting part. Routine usage of the partograph was recorded among the majority of midwives, 102 (92.7%), to record and monitor the progress of labour in expectant women. Bivariate analysis showed a significant association between the use of the modified WHO partograph and the knowledge of midwives on Ghana Health Service (GHS) policies ( p = .045). There was, however, no positive association determined among age ( p = .66), rank ( p = .77), years of professional experience ( p = 1.00), place of work ( p = .51), work shift and highest qualification ( p = 1.00) as far as knowledge and use of the WHO modified partograph are concerned.

Conclusion

The findings of the study underscore the desirable level of knowledge and usage of the partograph among study participants. This affirms that the knowledge and usage of the partograph within the facilities in Ga South health facilities hold the prospect of enhancing the safety of expectant mothers.
Community Leaders’ Perceptions of the Unique Service Barriers and Facilitators Among Immigrant Families With Young Children in the Rural U.S.–Mexico Border Region
Authors: Lopez Anayeli , Finno-Velasquez Megan , Sepp Sophia , Mendoza Vanessa , Corkill Marianna , Salazar Pérez Michelle
Published: November 2024

The present descriptive phenomenological study examines the unique service access barriers and facilitators of immigrant families along the rural U.S.–Mexico border from the perspectives of agency and government representatives. Twenty-three semi-structured interviews were conducted with nine local/state government officials and 14 community agency leaders using purposive and snowball sampling. A phenomenological thematic analysis approach was utilized to analyze data from individual interviews. Findings reveal that unique barriers experienced by immigrant families in the U.S.–Mexico border region include rurality, border checkpoints, and U.S. Customs and Border Patrol presence, which have placed mobility limitations on immigrant families, cutting them off from central service providers. Programs and policies aimed at engagement of mixed-status families in areas along the U.S.–Mexico border need to create mechanisms to better reach these families.
Implementing Resourcefulness Training© with Parent Caregivers of Children Dependent on Medical Technology During the COVID-19 Pandemic: Lessons Learned from a Randomized Controlled Trial
Authors: Toly Valerie Boebel , Russell Katie N. , Shi Sophie , Zauszniewski Jaclene A.
Published: November 2024

Parent caregivers of children requiring life-saving medical technology (e.g., mechanical ventilation) report higher levels of stress and poorer health than other caregivers, often neglecting health-promoting behaviors for themselves. This article describes an iterative implementation science strategy used to improve intervention delivery for a randomized controlled trial testing a telehealth, cognitive-behavioral resourcefulness intervention with this population during the COVID-19 pandemic. This process consisted of reflective team meetings and content analysis. Initial adjustments were made after content analysis of pilot study materials before intervention delivery including an intervention script, checklist, online daily log, Health Insurance Portability and Accountability Act (HIPAA)-compliant texting option, training material access, and fidelity checks. In vivo adjustments were implemented in four areas: recruitment/engagement, participation and use of resources, in-person delivery, and virtual delivery. Our efforts to streamline intervention delivery were enhanced by incorporating an iterative implementation science strategy including analysis and adjustment of intervention delivery procedures to decrease participant burden and promote intervention adherence. Reflective team meetings and a collaborative, problem-solving approach to resolve the various barriers and challenges with the randomized controlled trial were integral components of intervention delivery. This study informs future intervention research by providing details of barriers faced, pragmatic adjustments made to intervention implementation, and lessons learned (NCT0410524; www.clinicaltrials.gov).
Association Between Coagulation Fibrinolysis Markers and Severity in Patients with COVID-19
Authors: Iwamoto Takuya , Hatayama Yuki , Yamashita Noriko , Ichikawa Hitomi , Kawamura Koji
Published: November 2024

Introduction

Thrombosis is a major complication of COVID-19. D-dimer (DD) is an important coagulation fibrinolysis marker in COVID-19 and has been extensively studied. However, very little is known about the role of other fibrinolysis markers, plasmin-plasmin inhibitor complex (PIC), and fibrin monomer complex (FMC) in COVID-19. This study investigated and compared the associations of DD, PIC, and FMC with COVID-19 severity.

Methods

Archived plasma samples from patients with COVID-19 (n = 50) were assessed for DD, FMC, and PIC levels. We compared the levels between patients with mild (n = 36) and moderate (n = 14) COVID-19 and evaluated their correlation with other COVID-19 severity markers, including lactate dehydrogenase (LD), serum albumin (Alb), C-reactive protein (CRP), and neutrophil-lymphocyte ratio (NLR).

Results

Patients with moderate COVID-19 had significantly higher DD and PIC levels than those with mild disease, while FMC levels were comparable. DD and PIC levels significantly correlated with LD, Alb, and NLR. Additionally, PIC levels significantly correlated with CRP levels. However, FMC levels correlated only with Alb but not with LD, NLR, or CRP.

Conclusions

COVID-19 severity was significantly associated with PIC and DD levels but not with FMC levels. PIC was the variable with the most clearly significant difference between patients with moderate disease and those with mild disease, highlighting its potential as an indicator of coagulation and fibrinolysis imbalance in patients with COVID-19. Further studies with larger sample sizes and more diverse severity groups are required to confirm these findings.
Occurrence of Eosinophilic Granulocytes in the Decidua of Placentas With Perinatal Clinical Findings
Authors: Feist Henning , Schaumann Nora
Published: November 2024

Introduction:

Inflammatory and immunologic homeostasis in the basal plate of the placenta is essential for the fetal development and growth, since the fetus immunologically constitutes a semi-allograft. Bone marrow derived eosinophilic granulocytes are usually not found in the basal plate.

Materials and Methods:

We retrospectively analyzed the occurrence of eosinophilic granulocytes in the basal plate of singleton placentas and investigated clinical and pathologic-anatomic associations.

Results:

In 5 singleton placentas (0.3% of all investigated cases from the archive) eosinophilic granulocytes were detectable. All these cases also displayed chronic deciduitis. Two cases had a clinical history of substitution therapy with methadone, in 2 instances the mothers had a history of atopic diseases, and 1 mother had a SARS-CoV-2-infection during pregnancy.

Conclusions:

The infiltration of eosinophilic granulocytes in the decidua is a rare feature of placentas with perinatal clinical findings. Strikingly, all 5 affected cases also presented with chronic deciduitis. This may hint at a contribution of the eosinophilic infiltrate to a non-infectious pathologic inflammatory process with an increased risk for perinatal complications.
An Adaptation of Stay Play Talk for Young Children Who Exhibit Social Withdrawal
Authors: Taylor Abby L. , Hemmeter Mary Louise , Ledford Jennifer , Granger Kristen L. , Hoepfner Anna C , Basler Sarah J.
Published: November 2024

Promoting positive relationships with peers is an important support for children who exhibit social withdrawal. Children who show extreme shyness or are identified as self-isolating are at risk for developing internalizing conditions, which can also lead to poor social and academic outcomes. These children may benefit from targeted support to develop relationships with peers. Identifying effective social interventions that support children who exhibit internalizing behaviors such as social withdrawal in preschool classrooms is a critical need. A nonconcurrent multiple baseline across three focal children design was used to test the effects of an adapted version of Stay, Play, Talk (SPT) that included peer choice on the estimated duration of social play for young children who were socially withdrawn. A functional relation was found between the implementation of SPT with peer choice and focal children’s social play. This study demonstrates that SPT with peer choice may be an effective and socially valid intervention for increasing the social play of preschoolers who are socially withdrawn in classrooms. More research is needed to better understand to what extent this adapted SPT intervention impacts children’s social networks, broader social-emotional development, and specific internalizing behaviors when implemented over a longer period.
Healing through tradition: the role of Indigenous Elder support in child and youth mental health in Canada
Authors: Doucette Madeline , Bove Carrie A , Hill (Yelthlaanaas Raven Clan) Sunni
Published: November 2024

The current mental health care system in Canada, with its focus on Western biomedical and individualistic approaches, does not support Indigenous holistic views of wellness and silences Indigenous knowledges through colonial ideologies. This research identifies the vital support that mental health services must include to create culturally relevant and safe services: Elders. Elders provide holistic approaches to mental wellness that consider cultural, individual, family, and community needs to promote healing. To explore the roles of Elders in mental health services, a comprehensive narrative review was conducted. All 22 included studies were conducted by Indigenous scholars or with Indigenous communities. Findings were organized into three themes: (a) Elders are knowledge keepers: sharing wisdom; (b) need for cultural-based teachings, ceremonies, and land-based healing led by Elders; and (c) Importance of relationships for increasing youth’s mental wellness. Barriers were identified that prevent Elder involvement, and recommendations for mental health programmes are provided.
Morbid symptoms: a feminist dialectics of global patriarchy in crisis
Authors: Johnston Melissa , Meger Sara
Published: November 2024

This article offers insights into the nature of patriarchy as a structuring condition of global order, and – significantly – the process of change that has enabled its endurance. We are, today, witnessing the emergence of multiple challenges to the existing order and the tying of the political campaigns of these challenges to an agenda of anti-feminism (what we term ‘patriarchal backlash’). We argue that current ructions cannot be understood in a linear sense of feminist progress and regression, nor can these patriarchal challenges to the existing order be understood in isolation from one another. We propose a feminist dialectical approach to theorising patriarchy as a structuring condition of global order and as a useful methodological tool to understand change and transformation. Rather than seeing feminist movements or instances of patriarchal backlash as ‘outside agitators’ to patriarchy, we view them as necessary internal contradictions within patriarchy and the driving engine for its transformation. We propose here feminist dialectics as providing the conceptual tools to understand patriarchy’s variation over time and across space and its endurance as an ordering condition of the international.
Do residents support LGBTIQ+ tourism development? Insights from Ho Chi Minh, Vietnam
Authors: Muñoz Kyrie Eleison , Chen Li-Hsin , Pham Thi Phuong Thao
Published: November 2024

This research note addresses the need for more studies on residents’ attitudes towards LGBTIQ + tourism amid the growing attention towards recognizing LGBTIQ + rights in Southeast Asia. The findings provide novel and emerging empirical evidence on the impact of host-tourist interactions and place image on residents’ attitudes and support for LGBTIQ + tourism in Ho Chi Minh City, Vietnam. The findings provide important insights for scholars, practitioners, and policymakers to advance LGBTIQ + tourism development and LGBTIQ + rights.
What is inclusion? Children perspective on education at primary schools in rural Afghanistan
Authors: Trani Jean-Francois , Gettinger Kate , Kaplan Ian , Wang Zijing , Rfat Mustafa , Zhu Yiqi , Hashim Rawab , Bakhshi Parul
Published: November 2024

Inclusive education remains a distant goal in Afghanistan threatened by issues of discrimination based on gender, disability, ethnicity, cultural beliefs and socioeconomic status. To promote more inclusive practices, we conducted 120 participatory workshops in three rounds, including 1187 volunteer children aged 9 to 12 years old from grades three, four and five in 40 primary rural schools of Badakhshan, Ghazni and Takhar provinces of Afghanistan between 2018 and 2021. Children described inclusion as the combination of allowing all children to access school and to effectively learn. Children were able to meaningfully define the state of education while articulating coherently what motivates them, their teachers, and parents and what actions need to be taken to improve the whole school system. In a political context limiting girls’ education, children voiced their need for a school environment that is enriching, supportive and adapted to their needs and expectations to keep motivated and engaged.
Do Metrics of Temporal Glycemic Variability Reveal Abnormal Glucose Rates of Change in Type 1 Diabetes?
Authors: Richardson Robert
Published: November 2024

Background:

We aimed to identify the normal range of glucose rates of change (RoC) observed in health and assess whether existing metrics of temporal glycemic variability (GV-timing), such as mean absolute glucose change (MAG) and continuous overlapping net glycemic action (CONGA), are predictive of abnormally rapid RoC in type 1 diabetes (T1D).

Methods:

We identified the normal range of RoC over one-hour intervals from continuous glucose monitoring (CGM) data of healthy individuals. Rapidly rising glucose was defined as RoC values above percentiles 99% (level 1, L1) or 99.9% (level 2, L2), and rapidly falling glucose as below 1% (L1) or 0.1% (L2). The percentage of time these thresholds are exceeded in a given individual is referred to as time in fluctuation (TIF). In a separate CGM dataset of 736 T1D individuals, we calculated TIF-L1 and TIF-L2, and compared them against corresponding values of MAG and CONGA.

Results:

The extremum percentiles of RoC observed in health are 0.1%: −80 mg/dL/h, 1%: −50 mg/dL, 99%: +56 mg/dL/h, and 99.9%: +89 mg/dL/h. The T1D individuals spend significantly more TIF at rates exceeding these thresholds (TIF-L1: median, 16.7% [interquartile range, 12.7-21.5], TIF-L2: 5.0% [3.1-7.8]) than healthy individuals (TIF-L1: 1.4% [0.6-2.8], TIF-L2: 0.0% [0.0-0.2]). Both MAG and CONGA are highly correlated with TIF-L1 and TIF-L2 ( r > .95 in each pairwise comparison).

Conclusions:

Individuals with T1D spend significant time with glucose RoC exceeding those observed in health. Existing GV-timing metrics are strongly correlated with time with abnormal RoC. Incorporation of a GV-timing metric in clinical practice is recommended.
Caffeic Acid Phenethyl Ester Suppresses Cytokine- and Chemotherapy-Induced Inflammation in Triple-Negative Breast Cancer via NF-κB Signalling
Authors: Fosu Kwadwo , Quarshie Jude Tetteh , Offei Nicholas Awuku , Serwaa Alberta , Tuah Bernardine , Sobo Augustine Kojo , Kotei Amon Justum Nii , Nketiah Sarpong Kwabena Amofa , Aikins Anastasia Rosebud
Published: November 2024

Background: Triple-negative breast cancer (TNBC) remains a significant clinical challenge due to its aggressive nature and lack of targeted therapies. In TNBC, inflammation contributes to tumour progression by promoting cell proliferation, survival, and migration. It may be triggered by cytokines such as TNF-α or chemotherapeutic agents such as doxorubicin (DOX). Thus, identifying agents that suppress inflammation in TNBC is of prime interest. Caffeic acid phenethyl ester (CAPE) is a naturally occurring anti-inflammatory compound that exhibits selective cytotoxicity against some cancer cells. However, its impact on cytokine or chemotherapy induced inflammation in TNBC has not yet been explored. Aim: This study aimed to investigate the effects of CAPE on TNF-α- or DOX-induced inflammation and metastatic markers in TNBC. Methods: The effects of CAPE and DOX on TNBC cell viability and migration were assessed using the MTT and wound healing assays, respectively. The effect of CAPE on the expression of pro-inflammatory cytokines, epithelial-mesenchymal transition (EMT) markers, and tumour invasion markers was evaluated using RT-qPCR. Results: CAPE inhibited TNF-α-induced proliferation and migration of TNBC cells. CAPE also suppressed TNF-α- and DOX-induced upregulation of NF-κB-regulated pro-inflammatory genes, IL-1B, IL-6, IL-8, and TNF-α, corroborating the evidence that CAPE suppresses NF-κB signalling. Additionally, CAPE suppressed EMT in TNF-α–stimulated and DOX-treated cells by downregulating vimentin and VCAM1. Furthermore, CAPE reduced the expression of the cancer invasion markers MMP2 and MMP9. Conclusions: We demonstrated the anticancer potential of CAPE and its ability to suppress cytokine and chemotherapy-induced inflammation. This study offers novel insights into the role of CAPE in suppressing inflammation and metastasis markers in TNBC, specifically in the context of TNF-α and DOX-induced NF-κB signalling. These findings underscore the urgent need to further study CAPE as a possible adjuvant for treating patients with TNBC, especially those undergoing chemotherapy.
Using machine learning to assist decision making in the assessment of mental health patients presenting to emergency departments
Authors: Higgins Oliver , Wilson Rhonda L. , Chalup Stephan K.
Published: November 2024

Objective

The objective of this study was to assess the predictability of admissions to a MH inpatient ward using ML models, based on routine data collected during triage in EDs. This research sought to identify the most effective ML model for this purpose while considering the practical implications of model interpretability for clinical use.

Methods

The study utilised existing data from January 2016 to December 2021. After data pre-processing, an exploratory analysis revealed the non-linear nature of the dataset. Six different ML models were tested: Random Forest, XGBoost, CatBoost, k-Nearest Neighbours (kNN), Explainable Boosting Machine (EBM) using InterpretML, and Support Vector Machine using Support Vector Classification (SVC). The performance of these models was evaluated using various metrics including the Matthews Correlation Coefficient (MCC).

Results

Among the models evaluated, the CatBoost model achieved the highest MCC score of 0.1952, demonstrating superior balanced accuracy and predictive power, particularly in correctly identifying positive cases. The InterpretML model also performed well, with an MCC score of 0.1914. While CatBoost showed strong predictive capabilities, its complexity poses challenges for clinical interpretation. Conversely, the InterpretML model, though slightly less powerful, offers better transparency and is more practical for clinical use.

Conclusion

The findings suggest that the CatBoost model is a compelling choice for scenarios prioritising the detection of positive cases. However, the InterpretML model's ease of interpretation makes it more suitable for clinical application. Integrating explanation methods like SHAP with non-linear models could enhance model transparency and foster clinician trust. Further research is recommended to refine non-linear models within decision support systems, explore multi-source data integration, understand clinician attitudes towards ML, and develop real-time data collection systems. This study highlights the potential of ML in predicting MH admissions from ED data while stressing the importance of interpretability, ethical considerations, and ongoing validation for successful clinical implementation.
Artificial intelligence-powered dentistry: Probing the potential, challenges, and ethicality of artificial intelligence in dentistry
Authors: Rahim Abid , Khatoon Rabia , Khan Tahir Ali , Syed Kawish , Khan Ibrahim , Khalid Tamsal , Khalid Balaj
Published: November 2024

Introduction

Healthcare amelioration is exponential to technological advancement. In the recent era of automation, the consolidation of artificial intelligence (AI) in dentistry has rendered transformation in oral healthcare from a hardware-centric approach to a software-centric approach, leading to enhanced efficiency and improved educational and clinical outcomes.

Objectives

The aim of this narrative overview is to extend the succinct of the major events and innovations that led to the creation of modern-day AI and dentistry and the applicability of the former in dentistry. This article also prompts oral healthcare workers to endeavor a liable and optimal approach for effective incorporation of AI technology into their practice to promote oral health by exploring the potentials, constraints, and ethical considerations of AI in dentistry.

Methods

A comprehensive approach for searching the white and grey literature was carried out to collect and assess the data on AI, its use in dentistry, and the associated challenges and ethical concerns.

Results

AI in dentistry is still in its evolving phase with paramount applicabilities relevant to risk prediction, diagnosis, decision-making, prognosis, tailored treatment plans, patient management, and academia as well as the associated challenges and ethical concerns in its implementation.

Conclusion

The upsurging advancements in AI have resulted in transformations and promising outcomes across all domains of dentistry. In futurity, AI may be capable of executing a multitude of tasks in the domain of oral healthcare, at the level of or surpassing the ability of mankind. However, AI could be of significant benefit to oral health only if it is utilized under responsibility, ethicality and universality.
The use of telehealth technology for lifestyle modification among patients with hypertension in Nigeria and Ghana
Authors: Echieh Chidiebere Peter , Dele-Ojo Bolade Folasade , Ahmad Oseni Tijani Idris , Blankson Paa-Kwesi , Duodu Fiifi , Tayo Bamidele O , Alabi Biodun Sulyman , Sarpong Daniel F , Amoakoh-Coleman Mary , Boima Vincent , Ogedegbe Gbenga
Published: November 2024

Introduction

Sedentary lifestyle and consumption of an unhealthy diet are significantly associated with hypertension in Nigeria and Ghana. Increasing the uptake of physical activity and diet rich in fruits and vegetables has been a challenge in the region. This study aimed at assessing the effect of a mobile health intervention (mhealth) on physical activity, and fruits and vegetables intake in patients with hypertension in Nigeria and Ghana

Methods

The study was a quasi-experimental study conducted in Mamprobi Hospital (MH) in Ghana, and State University Teaching Hospital (EKSUTH) in Nigeria. One hundred and sixteen consenting adult patients with hypertension were consecutively recruited and given regular reminders on physical activity and intake of fruits and vegetables via mobile app (mnotify®) for six months. All participants were followed up for six months and data collected at Baseline, three months and six months. Analysis was done using Stata 14 software (StataCorp. College Station, TX) assuming an alpha level of 0.05. Ethical approval was obtained from both countries and ethical standards were followed.

Results

A total of 116 (53 from Ghana and 63 from Nigeria) patients with hypertension participated in the study. Respondents had a mean age of 61.0 ± 9.1 years, and were mostly females (64.7%). There was an increase in the level of physical activity which was significant by the third month ( p < 0.0001) but became insignificant by the 6th month ( p = 0.311). Fruits and vegetables intake also improved at 3 months ( p = 0.054) and significantly at 6 months ( p = 0.002).

Conclusion

The study found the use of telehealth as an effective tool for the delivery of adjunct therapy for lifestyle modification in the management of hypertension in Nigeria and Ghana. It is therefore recommended that telehealth be incorporated into the management of hypertension and other chronic diseases for better health outcome.
Improving Access and Timeliness of Employee Annual Exams
Authors: Davis Katie E. , Huntsman-Jones Carrie E. , Wixom Lyndsay , Twitchell Joshua Dean , Clifton Jennifer , West Morgan
Published: November 2024

Background

Access to preventive healthcare improves health outcomes and reduces risk of chronic disease. Annual examinations were integrated into an underutilized clinic at the University of Utah to improve access to preventive care.

Methods:

Nurse practitioners conducted these examinations, which included history, physical examination, age-based screenings, and immunizations. The service was part of a wellness program offering health premium discounts for participants. With employee permission, visit documentation was shared with primary care providers (PCPs) or used to help establish a PCP. Human resources received monthly reports of participating employees identification numbers, validating participation in order to receive premium discount.

Results:

In 2023, 373 examinations were performed, including 719 preventive services and screenings, with 143 referrals for specialty and primary care. Patient satisfaction remained high throughout implementation.

Conclusion/Application to Practice:

This initiative effectively increased access to preventive care for employees, demonstrating the feasibility of offering annual examinations in worksite clinics. The program addresses common barriers to preventive care such as long wait times, PCP shortages, and travel time to appointments.
Effects of Conditioned Media From Human Umbilical Cord-Derived Mesenchymal Stem Cells on Tenocytes From Degenerative Rotator Cuff Tears in an Interleukin 1β–Induced Tendinopathic Condition
Authors: Lee Min Ji , Park Kyungtaek , Yeon Lee Seung , Jang Kwi-Hoon , Won Sungho , Hyunchul Jo Chris
Published: November 2024

Background:

Evidence suggests that mesenchymal stem cells (MSCs) are safe for treating different tendinopathies. Synovial fluid is a pooled environment of biomarkers from the inflammatory and degenerative joint cavity. Understanding the effects of synovial fluid on MSCs is important, as it is the first microenvironment that administered MSCs encounter. Several studies have reported that exposure to osteoarthritic synovial fluid–activated MSCs increased the release of soluble factors; however, the paracrine effects of shoulder synovial fluid–stimulated umbilical cord-derived MSCs (SF-UC-MSCs) on tendinopathy have yet to be investigated.

Purpose:

To assess the effects of the conditioned media from SF-UC-MSCs on tenocytes from degenerative rotator cuff tears in an interleukin-1β (IL-1β)–induced tendinopathic condition.

Study Design:

Controlled laboratory study.

Methods:

UC-MSCs were isolated and cultured from healthy, full-term deliveries by cesarean section. Tenocytes were isolated and cultured from patients with degenerative rotator cuff tears. Conditioned media were obtained from UC-MSCs stimulated with synovial fluid. To evaluate the gene expression of proinflammatory and anti-inflammatory cytokines, enzymes and their inhibitors, matrix molecules, and growth factors, the tenocytes were cultured with IL-1β and 50% of the conditioned media from the SF-UC-MSCs; quantitative, real-time, reverse transcriptase polymerase chain reaction was also performed. A prostaglandin E2 (PGE2) assay was performed to investigate the PGE2 level secreted by the tenocytes. Western blotting was performed to examine protein synthesis of collagen type I and III. Cell viability, senescence, and apoptosis assays were also performed.

Results:

The conditioned media from the SF-UC-MSCs interfered with the inflammatory gene expression on tenocytes induced by IL-1β, but it increased the gene expression of tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-3. Meanwhile, the conditioned media decreased the PGE2 level on cells induced by IL-1β. It did increase the type I/III ratio of gene expression and protein synthesis, mainly through the induction of type I collagen. Conditioned media of SF-UC-MSCs reversed senescence and apoptosis induced by IL-1β.

Conclusion:

Study findings indicated that the conditioned media from SF-UC-MSCs had anti-inflammatory effects and cytoprotective effects on IL-1β–treated tenocytes from degenerative rotator cuff tears.

Clinical Relevance:

UC-MSCs have useful potential for the treatment of tendinopathy in practice.
Antivascular Endothelial Growth Factor Injections for the Chronic Treatment of Macula-off, Fovea-on Diabetic Tractional Retinal Detachment With Vitreous Hemorrhage
Authors: Yuan Melissa , Hoyek Sandra , Kim Leo A. , Chaaya Celine , Patel Nimesh
Published: November 2024

Purpose: To evaluate the use of antivascular endothelial growth factor (anti-VEGF) as treatment for tractional retinal detachments (TRDs) involving the macula. Methods: A case report was evaluated. Results: A 40-year-old man with a medical history notable for congenital heart disease and proliferative diabetic retinopathy presented with decreased vision. Surgery was not feasible for medical reasons, and panretinal photocoagulation was limited by retinal traction and hemorrhage. Despite initial progression of bilateral macula-off, foveal-on TRDs, the patient received intravitreal (IVT) bevacizumab regularly every 8 to 12 weeks. After initial improvement, both eyes remained anatomically stable with attached foveas over more than 1.5 years of follow-up. Conclusions: In cases in which surgery is not possible, macula-involving TRDs with neovascularization can be managed successfully with repeated IVT anti-VEGF injection monotherapy.
Conflict-mediation, consensus-building, and co-production: Three models of co-governance in China’s neighborhood regeneration
Authors: Zhao Nannan , He Shenjing , Liu Yuting , Rui Guangye , Wang Shifu
Published: November 2024

Existing literature on co-governance has extensively discussed how the state interacts with various actors beyond the government to promote urban development. In China, the discourse and practice of co-governance illustrate different trajectories from the West. As the urban development strategies in China shifted from property-led expansion to inner-city neighborhood regeneration, the importance of multiscalar participation in governing community affairs has been increasingly emphasized, moving beyond the government-market dichotomy and emphasizing negotiation and collaboration among the government, market participants, stakeholders, and the public. Based on practical experience and participatory action research in Guangdong province, we identify three models of co-governance in recent neighborhood regeneration practices: (1) the state-led co-creation model for conflict-mediation purposes, which primarily relies on local government and party organization to mediate inherited conflicts and rebuild local trust for promoting the regeneration agenda; (2) the professional-led place-making model for consensus-building purposes, which focuses on reshaping daily habits and beautifying public spaces to achieve consensus-based aspirations for neighborhood development; and (3) the co-production model, driven by society-community partnership, which reflects the emergence of new commons, encompassing dynamic reconfigurations on both socio-economic and institutional dimensions. Through case studies in Guangzhou and Foshan, specifically in the Enninglu, Keyuan, and Dongfeng neighborhoods, we illustrate how local governments enhance the inclusiveness and effectiveness of neighborhood governance by engaging various third-party actors, such as local enterprises, community planners, and residents’ self-help groups. Local governments are skillfully avoiding direct confrontation with residents by incorporating community planners and empowering social actors to promote co-production among multiscalar participants. By examining the emergence, functioning, and dilemmas of different co-governance models in China’s latest neighborhood regeneration practices, this study enriches the existing framework of the state-market-society landscape, demonstrating the plurality of the state’s governance intentions and highlighting the political space in which grassroots governance is constituted.
Hydroxylbastnäsite-(La), an ‘old new’ bastnäsite-group mineral
Authors: Pekov Igor V. , Zubkova Natalia V. , Kasatkin Anatoly V. , Chukanov Nikita V. , Koshlyakova Natalia N. , Ksenofontov Dmitry A. , Škoda Radek , Britvin Sergey N. , Kirillov Anatoly S. , Zaitsev Anatoly N. , Kuznetsov Aleksey M. , Pushcharovsky Dmitry Yu.
Published: November 2024

Hydroxylbastnäsite-(La), the OH- and La-dominant member of the bastnäsite group, in fact known for many years, was studied in detail and has been approved by the IMA–CNMNC as a new mineral species with the ideal, end-member formula La(CO3)(OH). The holotype originates from the Vuoriyarvi (another spelling: Vuorijärvi) alkaline-ultrabasic complex, Northern Karelia, and the cotype from the Mochalin Log REE deposit, Potaniny Mts, South Urals, both in Russia. At Vuoriyarvi, hydroxylbastnäsite-(La) occurs as clusters (up to 1 mm) of light brown, honey-yellow or colourless hexagonal tabular to short-prismatic crystals up to 0.15 mm associated with fluorite and ancylite-(Ce) in cavities of calcite–dolomite carbonatites. At Mochalin Log, hydroxylbastnäsite-(La) forms light brown grains up to 0.2 mm included in massive aggregates of other LREE minerals: bastnäsite-(Ce), bastnäsite-(La), percleveite-(Ce), percleveite-(La), biraite-(Ce), biraite-(La), törnebohmite-(La), ferriperbøeite-(Ce), allanite-(Ce), etc. Dmeas is 4.75(2) and Dcalc is 4.778 g cm–3 (holotype). Hydroxylbastnäsite-(La) is optically uniaxial (+), ω = 1.76(1) and ε = 1.86(1) (holotype). The chemical composition (wt.%, electron microprobe, CO2 and H2O calculated: holotype/cotype) is: CaO 0.23/0.00, SrO 0.07/0.00, La2O3 39.47/39.58, Ce2O3 33.51/31.99, Pr2O3 1.03/1.51, Nd2O3 1.95/2.38, F 0.76/3.33, CO2 20.49/20.34, H2O 3.77/2.58, –O=F 0.32/1.40, total 100.96/100.31. The empirical formulae, calculated based on the sum of metal cations of 1 apfu and one CO3 group pfu, are (La0.52Ce0.44Nd0.02Pr0.01Ca0.01)Σ1.00(CO3)[(OH)0.90F0.09]Σ0.99 (holotype) and (La0.53Ce0.42Nd0.03Pr0.02)Σ1.00(CO3)[(OH)0.62F0.38]Σ1.00 (cotype). Hydroxylbastnäsite-(La) is hexagonal, P6̅, unit-cell parameters (from powder XRD data, holotype/cotype) are: a = 12.537(3)/12.533(1), c = 9.968(2)/9.908(1) Å, V = 1356.8(5)/1347.9(3) Å3 and Z = 18. Strong reflections of the powder XRD pattern [d,Å(I)(hkl)] are (holotype): 4.98(39)(002), 3.616(88)(300), 2.926(100)(302), 2.089(41)(330), 2.052(46)(304) and 1.927(40)(332). The crystal structure of holotype hydroxylbastnäsite-(La) was refined by the Rietveld method, Rwp = 0.0071, Rp = 0.0050, Robs = 0.0466. It is isostructural to hydroxylbastnäsite-(Ce) and synthetic bastnäsite-type hydroxyl-carbonates REE3+(CO3)(OH) (REE = La–Er), but differs from fluorine-dominant bastnäsites which adopt the space group P6̅2c.