bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a pulmonary rehabilitation program combined with cognitive training on exercise tolerance and cognitive functions among Tunisian male patients with chronic obstructive pulmonary disease: A randomized controlled trial
Authors: Tabka Oussama , Sanaa Imen , Mekki Marwa , Acheche Amal , Paillard Thierry , Trabelsi Yassine
Published: September 2023

Background

Cognitive impairment has been well described in patients with Chronic Obstructive Pulmonary Disease (COPD) in addition to cardiorespiratory disability. To reduce this impairment, researchers have recommended the use of single or combined exercise training. However, the combined effect of cognitive training (CT) and pulmonary rehabilitation (PR) program on selective cognitive abilities in patients with COPD has not been fully evaluated. Therefore, we aimed to assess the impact of PR combined with CT on 6 minutes walking test (6MWT) and cognitive parameters in Tunisian males’ patients with COPD.

Methods

Thirty-nine patients with COPD were randomly assigned to an intervention group ( n = 21, age = 65.3 ± 2.79) and a control group ( n = 18, age = 65.3 ± 3.2). The intervention group underwent PR combined with CT, and the control group underwent only PR, three times per week for 3 months. The primary outcomes were 6MWT (6 minutes walking test -6MWT-parameters) and cognitive performance, as evaluated by Montreal cognitive assessments (MOCA) and P300 test. Secondary outcomes were patient’s characteristics and spirometric data. These tests were measured at baseline and after 3 months of training programs.

Results

Results showed a significant improvement of the 6MWT distance after the rehabilitation period in both groups ( p < .001). Moreover, both groups showed significant improvement ( p < .001) in cognitive performance including MOCA score and P300 test latency in three midline electrodes. However, the improvement in cognitive performance was significantly greater in the PR+CT group than the PR group.

Conclusion

In conclusion, although PR alone improves 6MWT parameters and cognitive function, the addition of CT to PR is more effective in improving cognitive abilities in patients with COPD. This combined approach may provide clinicians with a complementary therapeutic option for improving cognitive abilities in patients with COPD.
Study on the tensile mechanical property of wool bundle fibers through fracture sounds detected by acoustic emission
Authors: Lu Di , Yu Weidong
Published: September 2023

This study deals with the prediction of the mechanical properties of wool bundle fibers and the characterization of the fracture performance of fiber fracture sound. Acoustic emission detection was used to record the fracture sound of wool fibers. According to the fracture sounds, the tensile properties of the bundle fibers were obtained. Acoustic emission provided a convenient method for obtaining fibers breaking elongation distribution. Based on the fiber bundle model and fiber breaking distribution, the fracture strength and elongation of bundle fibers could be predicted. Meanwhile, based on the correlation between the amplitude of fiber fracture sound and fiber breaking strength, the single fiber breaking strength could be predicted and the tensile properties of bundle fibers could also be obtained. The prediction results based on bundle fiber fracture sound were more similar to the measured results. Besides, the number of fibers within the bundle increased, the fiber interaction was also enhanced, and the bundle fiber strength prediction results were affected. This work was considered to have the potential of being used in the prediction of mechanical properties of natural fiber composites.
Perceptions of Facilitators and Barriers to Smoking Cessation Among Patients and Providers in a Cancer Center: A Single Institution Qualitative Exploratory Study
Authors: Shenton Luke M. , Perera Udara , Leader Amy , Klassen Ann C.
Published: September 2023

Purpose:

Cancer patients who remain tobacco users have poorer outcomes, including increased mortality and decreased treatment tolerance; however, cessation post-diagnosis is challenging. Our formative research explored cessation-related perspectives among patients and staff at one National Cancer Institute-designated cancer center, to inform improving cessation services within oncology care.

Methods:

Using a descriptive phenomenological approach, a purposive sample of current cancer patients (n = 13) and cancer center physicians and cessation program staff (n = 9) were recruited to complete one-on-one audio-recorded in-depth qualitative interviews, to explore experiences providing or receiving cessation support, and perspectives on patients’ readiness and needs regarding cessation. Thematic coding utilized Green’s predisposing, enabling, and reinforcing framework to identify factors having positive, negative, or mixed impact on delivery of best-practices cessation services (ie, 5As) and patient cessation success.

Results:

Patients identified cancer diagnosis as a wake-up call, existing health problems, persistent healthcare providers, cost of cigarettes, and societal disapproval of smoking as factors facilitating quitting. Futility of quitting after a cancer diagnosis, cost and logistics of program participation, clinician time constraints, and lifetime addiction made quitting harder. Family, friends, stigma and motivation, and pharmacotherapies played mixed roles. Patients felt survivor-focused cessation programs, including stress management, could better enable quitting. Provider-anticipated problems with implementing cessation counseling included so-called “therapeutic nihilism” (ie, pessimism regarding cessation post-diagnosis), lack of training and standardized approaches, and time and documentation burden. Clinicians saw both policies and peer clinician “champions” as potentially increasing prioritization of cessation within oncology.

Conclusions:

Findings highlight unmet needs for patients and providers regarding provision of effective cessation care. Despite survival benefit, cessation is still not standard within cancer care. Our results show that many patients would benefit from standardized programs where they are routinely asked about cessation. Providers would benefit from both structural enhancements and professional education to ensure that evidence-based cessation services tailored to cancer patients, are offered throughout treatment and survivorship.
Effect of Moxibustion Combined With Cisplatin on Tumor Microenvironment Hypoxia and Vascular Normalization in Lewis Lung Cancer Mice
Authors: Mao Ni , Wu Xiaobo , Wang Chaofeng , Mao Huijuan , Wei Jianzi
Published: September 2023

Purpose:

This study was developed to evaluate the effects of moxibustion on tumor microenvironmental hypoxia in a murine model of Lewis lung carcinoma (LLC).

Methods:

Twenty-four tumor-bearing mice were randomized into tumor group (T), tumor + cisplatin group (TC), tumor + moxibustion group (TM), and tumor + cisplatin + moxibustion group (TMC) (n = 6/group). Six age-matched C57BL/6 mice were employed as control group (Ctrl). A tumor model was established by implanting LLC cells into the right flank of each mouse. Animals in the TM group received moxibustion treatment at the ST36 (bilateral) and GV4 acupoints on the day of visible tumor formation. Moxibustion treatment was performed every other day for a total of 7 sessions. Animals in the TC group were intraperitoneally injected with cisplatin (3 mg/kg) on day 3 after visible tumor formation, and this treatment was performed every 3 days for 4 times. Animals in the TMC group underwent combined moxibustion and chemotherapy treatment, following the same conditions as outlined above. Following treatment, the concentrations of hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), CD31, and Ki67 were measured using ELISA, Western blot, and immunohistochemical staining.

Results:

Compared to the tumor group, treatment in the TM, TC, and TCM groups resulted in varying reductions in tumor growth ( P < .001 or P < .05), while tumor microenvironmental hypoxia was alleviated as evidenced by the downregulation of HIF-1α, VEGFA, and CD31( P < .001- P < .05).

Conclusion:

Our results suggest that a combined approach of moxibustion and cisplatin can alleviate intratumoral hypoxia, promote vascular normalization, and slow the growth of LLC tumors in mice.
Force loss and distribution of load in the hands of patients with cubital tunnel syndrome
Authors: Garkisch Angelina , Rohmfeld Kristina , Fischer Dagmar-Christiane , Prommersberger Karl-Josef , Mühldorfer-Fodor Marion
Published: September 2023

Manugraphy with three different cylinder sizes was used to quantify the contribution of fingers, thumb and palm to grip force in patients with unilateral cubital tunnel syndrome. Forces in the affected and contralateral hands differed by up to 29%. Although grip force is usually maximal when gripping small handles, ulnar nerve palsy resulted in similar absolute grip forces using the 100-mm and 200-mm cylinders. The contact area between the affected hand and the cylinders was reduced by 5%–9%. We noted a high correlation between the contact area and grip force, visible atrophy and permanently impaired sensibility. The load distribution differed significantly between both hands for all cylinder sizes. When gripping large objects, the main functional impairment in cubital tunnel syndrome is weakness in positioning and stabilizing the thumb. Weak intrinsic finger muscles are responsible for loss of force when gripping small objects. 

Level of evidence: III
From Loan-Financed to Privatised Infrastructure? Tracing China's Turn Towards Public–Private Partnerships in Africa
Authors: van Wieringen Kjeld , Zajontz Tim
Published: September 2023

Waning debt sustainability has challenged the debt-financed, infrastructure-led global expansion of Chinese capital. This article traces the gradual shift in the financial governance of the Belt and Road Initiative towards public–private partnerships (PPPs). We first document China's domestic PPP experience and its failure to check the unsustainable indebtedness of sub-national governments. We then conceptualise China's “turn” towards PPPs in Africa as an attempt at “metagoverning” its current growth model. Analysing official Chinese sources, we discern dominant Chinese narratives that present PPPs as panaceas for African debt problems. However, Chinese risk perceptions and empirical examples, such as the Nairobi Expressway, the Tanzania–Zambia Railway, and the Congolese Kolwezi–Kasumbalesa toll road, reveal that China's experimentation with PPPs in Africa engenders new challenges, including popular contestation, controversies over financial terms and corruption. Furthermore, contrary to the official Chinese narrative, profit imperatives behind PPP investments and potential financial complications that were widespread in China's domestic PPP experience risk adding to the financial burdens of African governments and populations.
The Sarawak Myelofibrosis (SaMy) experience: Demographics and outcome of myelofibrosis patients in Sarawak, Malaysia
Authors: Tang Andy Sing Ong , Leong Tze Shin , Wong Qi Ying , Tan Xin Yee , Ko Ching Tiong , Ngew Kok Yew , Teh Erik Kah Jin , Chew Lee Ping
Published: September 2023

Introduction: Myelofibrosis is a rare disease. There is currently no published data reporting the demographics and outcome of myelofibrosis patients in Malaysia. We aimed to study the demographics, clinical characteristics, and outcome of our patients in Sarawak. Materials and methods: This non-interventional, retrospective, and multi-center study was conducted on secondary data of medical records collected at four Sarawak Public Hospitals. All adult myelofibrosis patients diagnosed between January 2001 and December 2021 were included. Results: A total of 63 patients (male 31) with myelofibrosis were included—47 (74.6%) primary and 16 (25.4%) secondary myelofibrosis. Eleven had antecedent polycythaemia vera, whereas five transformed from essential thrombocythaemia. The combined annual incidence rate was 0.182 per 100,000 population. The period prevalence per 100,000 population over the entire study duration was 2.502. The median age was 59.0 years (33.0–93.0). Majority had high-risk (34/63(54.0%)) and intermediate-2 risk disease (19/63(30.2%)). JAK2V617F mutation was identified in 52 patients (82.5%), followed by CALR mutation in 6 (9.5%) and negative for both mutations in 5 (7.9%). Hydroxyurea was used as first-line therapy in 41/63 (65.1%), followed by interferon (8/63(12.7%)) and ruxolitinib (4/63(6.3%)). Out of 46 patients who received second-line therapy, 18 (39.1%) were switched to ruxolitinib and 9 (19.6%) to interferon. The median age of survival for overall patients was 6.8 years. The use of ruxolitinib in myelofibrosis patients showed a better overall 5-year survival compared to the no ruxolitinib arm, despite no statistical significance ( p = 0.34). Patients who had good performance status had lower hazard of death than patients who had poor performance status (high-risk (95% confidence intervals): 0.06(0.013–0.239), p < 0.001). Patients with intermediate risk disease had better overall survival compared to those in high-risk group (95% confidence intervals): 0.24(0.082–0.695), p = 0.009). Conclusion: This registry provides a real-world overview of myelofibrosis patients in our state and highlights the key insight into the unmet clinical need.
Comparison Between High School Youth and College Freshmen Toward Their Psychological Disorders Under the Influence of Sleep Hygiene During COVID-19 Pandemic
Authors: Zhang Ziyu , Ren Xuanyu , Gao Yue , Nie Lirong , Chen Qiqi , Zhi Xinyue
Published: September 2023

Objective:

Adolescents experience the critical period for physical and psychological growth. Few studies focus on the influence of sleep hygiene on the psychological health of adolescence aging from high school to freshmen year. Also, the influence from the COVID-19 pandemic has a public health significance.

Methods:

A total of 698 students from high schools and colleges were included in the manuscript, and a cross-sectional procedure was conducted, objective to make an epidemiological comparison of the social phobia/depression prevalence, and discuss the effects of potential determinants.

Results:

Psychological problems including social phobia and depression were prevalent especially among the high school students, with the female gender showing higher possibilities. Current results also indicated that the association between sleep status and the occurrence of social phobia is most obvious among high school students, while relatively higher MMR risks was found both for high school students showing symptoms of social phobia and college freshmen with depressive symptoms. Moreover, the interaction between social phobia and depression was obvious for both populations.

Conclusions:

Psychological problems including social phobia symptoms and depression are more prevalent among the high school females when compared with their male and freshemen peers. Sgnificant influencial factors for the risk of psychological problems among 2 populations are different, but media multitasking status should be paid attention to for both.
Invasive Coronary Assessment in a 9-Year-Old With Anomalous Aortic Origin of the Left Coronary Artery
Authors: Przybycien Thomas S. , Doan Tam T. , Qureshi Athar M. , Reaves-O’Neal Dana , Binsalamah Ziyad , Molossi Silvana
Published: September 2023

A previously healthy nine-year-old boy with anomalous aortic origin of the left coronary artery (AAOLCA) with high-risk anatomy demonstrated negative stress on magnetic resonance imaging. Invasive cardiac catheterization for intracoronary flow measurement was performed and demonstrated compromised coronary flow during pharmacologic stress and significant stenosis on angiography. The patient underwent surgical intervention with normalization of coronary flow upon postoperative evaluation. Invasive intracoronary flow determination with angiography under provocative stress is emerging as a critical data point for risk stratification and management decision-making in high-risk AAOLCA patients with negative noninvasive perfusion studies.
A District Level Analysis of the Status of Financial Inclusion in Assam, India: Implications for Social Development Policies and Programmes
Authors: Kazi Muktazur Rahman , Shemim Akila
Published: September 2023

In recent years, India has placed a greater emphasis on the issue of financial inclusion. The purpose of this research is to assess the current status of financial inclusion in the various districts of Assam, India. A financial inclusion index is developed for each district in Assam by using data pertaining to three key dimensions of financial inclusion: banking penetration, availability of banking services and usage of banking services. The findings indicate that despite several initiatives to provide financial services to all, the success of financial inclusion in Assam is still far from satisfactory. Significant disparities exist in the extent of financial inclusion across the districts in Assam. While a few districts have achieved considerable success, the achievements of the majority of districts are unsatisfactory. The regression analysis indicates that literacy has a significant effect on such disparities in financial inclusion. The study argues that to enhance the efficacy and success of financial inclusion, all stakeholders need to make a concerted effort with a social development perspective.
ALL Repair and Reconstruction: Techniques From the SANTI Study Group
Authors: Hopper Graeme P. , Vieira Thais Dutra , Carrozzo Alessando , Monaco Edoardo , Claes Steven , Saithna Adnan , Helito Camilo P. , Cavaignac Etienne , Sonnery-Cottet Bertrand ,   the SANTI Study Group††
Published: September 2023

Background:

Combining an anterior cruciate ligament (ACL) reconstruction with an anterolateral ligament (ALL) reconstruction results in significant advantages including reduced graft rupture rates, a lower risk of reoperation for secondary meniscectomy, improved knee stability, and higher rates of return to preinjury levels of sport.

Indications:

The previously reported indications for combined ACL and ALL reconstruction are as follows: ACL reconstruction revision; high-grade pivot shift test; long-term ACL rupture; young patients; pivoting activities; concomitant medial meniscus repair, and, specifically, regarding the ALL repair, it must be an acute surgery (within 15 days from injury).

Technique Description:

Several modern techniques have been described to repair and reconstruct the ALL. This technical note details a number of these techniques performed by the Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group.

Results:

First, we describe a combined ACL reconstruction and double-bundle ALL reconstruction using hamstring autograft. Secondly, we describe a single-bundle ALL reconstruction using gracilis autograft. Thirdly, we describe an ALL reconstruction technique using a knotless soft anchor, which provides shallow fixation and prevents tunnel convergence. Finally, we describe a technique for ALL repair.

Conclusion:

Several techniques have been described to repair and reconstruct the ALL, all offering significant advantages over an isolated ACL reconstruction.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Lateral Extra-Articular Tenodesis in Skeletally Immature Patients: The Modified Ellison Technique
Authors: Röhm Julian , Devitt Brian M. , Feller Julian A.
Published: September 2023

Background:

Anterior cruciate ligament (ACL) rupture is an increasingly common injury in the young population. Unfortunately, reinjury rates in this population following ACL reconstruction (ACLR) are also very high. As such, lateral extra-articular procedures have been proposed to augment ACLR and shown to reduce reinjury rates. Most techniques use a strip of iliotibial band (ITB) fixed proximally on the distal femur in close proximity to the lateral femoral epicondyle, which in the skeletally immature patient may be closely associated with the distal femoral physis. In addition, there is also a risk of convergence with the femoral tunnel for the ACLR. The modified Ellison technique avoids both of these risks given it is a distally based tenodesis with its fixation point on the proximal tibial epiphysis. The purpose of this video is to describe a modified Ellison technique in a skeletally immature patient.

Indications:

Primary ACLR in skeletally immature patients at high risk of ACL graft rerupture due to their young age, a positive family history of ACL rupture in a first-degree relative, previous contra-lateral ACL rupture, generalized joint hypermobility, high-grade pivot-shift test, and participating in pivoting sports.

Technique Description:

The modified Ellison technique is a distally based lateral extra-articular procedure. A 1-cm strip of ITB is detached from Gerdy’s tubercle, passed beneath the lateral collateral ligament, and reattached back to from where it was removed. The fixation is within the proximal epiphysis of the tibia.

Results:

In a high-risk adult population, the modified Ellison technique has been shown to have a low ACL graft reinjury rate at 2 years following an ACLR. Biomechanical studies have demonstrated that a modified Ellison technique closely restores native knee kinematics following simulated anterolateral complex injury.

Discussion/Conclusion:

The modified Ellison technique is a safe and reproducible lateral extra-articular procedure in skeletally immature patients when performed in combination with an ACLR.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
The trace-element compositions of amphibole, magnetite and ilmenite as potential exploration guides to metamorphosed Proterozoic Cu–Zn±Pb±Au±Ag volcanogenic massive sulfide deposits in Colorado, USA
Authors: Spry Paul G. , Berke Edward H. , Layton-Matthews Dan , Voinot Alexandre , Heimann Adriana , Teale Graham S. , von der Handt Anette
Published: September 2023

Orthoamphibole, clinoamphibole and magnetite are common minerals in altered rocks associated spatially with Palaeoproterozoic volcanogenic massive sulfide (VMS) deposits in Colorado, USA and metamorphosed to the amphibolite facies. These altered rocks are dominated by the assemblage orthoamphibole (anthophyllite/gedrite)–cordierite–magnetite±gahnite±sulfides. Magnetite also occurs in granitoids, banded iron formations, quartz garnetite, and in metallic mineralisation consisting of semi-massive pyrite, pyrrhotite, chalcopyrite, and sphalerite with subordinate galena, gahnite and magnetite; amphibole also occurs in amphibolite. The precursor to the anthophyllite/gedrite–cordierite assemblages was probably the assemblage quartz–chlorite formed from hydrothermal ore-bearing fluids (~250° to 400°C) associated with the formation of metallic minerals in the massive sulfide deposits.

Element–element variation diagrams for amphibole, magnetite and ilmenite based on LA-ICP-MS data and Principal Component Analysis (PCA) for orthoamphiboles and magnetite show a broad range of compositions which are primarily dependent upon the nature of the host rock associated spatially with the deposits. Although discrimination plots of Al/(Zn+Ca) vs Cu/(Si+Ca) and Sn/Ga vs Al/Co for magnetite do not indicate a VMS origin, the concentration of Al+Mn together with Ti+V and Sn vs Ti support a hydrothermal rather than a magmatic origin for magnetite. Principal Component Analyses also show that magnetite and orthoamphibole in metamorphosed altered rocks and sulfide zones have distinctive eigenvalues that allow them to be used as prospective pathfinders for VMS deposits in Colorado. This, in conjunction with the contents of Zn and Al in magnetite, Zn and Pb in amphibole, ilmenite and magnetite, the Cu content of orthoamphibole and ilmenite, and possibly the Ga and Sn concentrations of magnetite constitute effective exploration vectors.
Genome-wide analysis of the P450 gene family in tea plant (Camellia sinensis) reveals functional diversity in abiotic stress
Authors: Shen Chuan , Li Xia
Published: September 2023

Background

Cytochrome P450 (Cytochrome P450s) genes are involved in the catalysis of various reactions, including growth, development, and secondary metabolite biosynthetic pathways. However, little is known about the characteristics and functions of the P450 gene family in Camellia sinensis (C. sinensis).

Results

To reveal the mechanisms of tea plant P450s coping with abiotic stresses, analyses of the tea plant P450 gene family were conducted using bioinformatics-based methods. In total, 273 putative P450 genes were identified from the genome database of C. sinensis. The results showed that P450s were well-balanced across the chromosomes I to XV of entire genome, with amino acid lengths of 268–612 aa, molecular weights of 30.95–68.5 kDa, and isoelectric points of 4.93–10.17. Phylogenetic analysis divided CsP450s into 34 subfamilies, of which CYP71 was the most abundant. The predicted subcellular localization results showed that P450 was distributed in a variety of organelles, with chloroplasts, plasma membrane,,and cytoplasm localized more frequently. The promoter region of CsP450s contained various cis-acting elements related to phytohormones and stress responses. In addition, ten conserved motifs (Motif1-Motif10) were identified in the CsP450 family proteins, with 27 genes lacking introns and only one exon. The results of genome large segment duplication showed that there were 37 pairs of genes with tandem duplication. Interaction network analysis showed that CsP450 could interact with multiple types of target genes, and there are protein interactions within the family. Tissue expression analysis showed that P450 was highly expressed in roots and stems. Moreover, qPCR analysis of the relative expression level of the gene under drought and cold stress correlated with the sequencing results.

Conclusions

This study lays the foundation for resolving the classification and functional study of P450 family genes and provides a reference for the molecular breeding of C. sinensis.
Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions
Authors: Omotoso Olabode , Teibo John Oluwafemi , Atiba Festus Adebayo , Oladimeji Tolulope , Paimo Oluwatomiwa Kehinde , Ataya Farid S. , Batiha Gaber El-Saber , Alexiou Athanasios
Published: September 2023

Introduction

Cancer is a significant public health challenge globally, with nearly 2000 lives lost daily in Africa alone. Without adequate measures, mortality rates are likely to increase. The major challenge for cancer care in Africa is equity and prioritization, as cancer is not receiving adequate attention from policy-makers and strategic stakeholders in the healthcare space. This neglect is affecting the three primary tiers of cancer care: prevention, diagnosis, and treatment/management. To promote cancer care equity, addressing issues of equity and prioritization is crucial to ensure that everyone has an equal chance at cancer prevention, early detection, and appropriate care and follow-up treatment.

Methodology

Using available literature, we provide an overview of the current state of cancer care in Africa and recommendations to close the gap.

Results

We highlight several factors that contribute to cancer care inequity in Africa, including inadequate funding for cancer research, poor cancer education or awareness, inadequate screening or diagnostic facilities, lack of a well-organized and effective cancer registry system and access to care, shortage of specialized medical staff, high costs for screening, vaccination, and treatment, lack of technical capacity, poor vaccination response, and/or late presentation of patients for cancer screening. We also provide recommendations to address some of these obstacles to achieving cancer care equity. Our recommendations are divided into national-level initiatives and capacity-based initiatives, including cancer health promotion and awareness by healthcare professionals during every hospital visit, encouraging screening and vaccine uptake, ensuring operational regional and national cancer registries, improving healthcare budgeting for staff, equipment, and facilities, building expertise through specialty training, funding for cancer research, providing insurance coverage for cancer care, and implementing mobile health technology for telemedicine diagnosis.

Conclusion

Addressing challenges to cancer equity holistically would improve the likelihood of longer survival for cancer patients, lower the risk factors for groups that are already at risk, and ensure equitable access to cancer care on the continent. This study identifies the existing stance that African nations have on equity in cancer care, outlines the current constraints, and provides suggestions that could make the biggest difference in attaining equity in cancer care.
Which surgical approach is more favorable for pheochromocytoma of different sizes (< 6 cm vs. ≥ 6 cm)? A single retrospective center experience
Authors: Wan Shun , Li Kunpeng , Wang Chenyang , Chen Siyu , Wang Huabin , Luo Yao , Li Xiaoran , Yang Li
Published: September 2023

Background

To compare the surgical effects of lateral transperitoneal approach (LTA) and posterior retroperitoneal approach (PRA) for pheochromocytoma of different sizes.

Methods

Data on patients with pheochromocytoma from 2014 to 2023 were collected from our hospital. According to different surgical approaches and tumor size, all patients were divided into four groups: tumor size < 6 cm for LTA and PRA and tumor size ≥ 6 cm for LTA and PRA. We compared these two surgical methods for pheochromocytoma of different sizes.

Results

A total of 118 patients with pheochromocytoma underwent successful laparoscopic surgery, including PRA group (n = 80) and LTA group (n = 38). In tumor size < 6 cm, the outcomes were no significant difference in LTA and PRA. In tumor size ≥ 6 cm, there was a significant difference in operation time (214.7 ± 18.9 vs. 154.3 ± 8.2, P = 0.007) and intraoperative blood loss (616.4 ± 181.3 vs. 201.4 ± 45.8, P = 0.037) between LTA and PRA.

Conclusion

LTA and PRA were performed safely with similar operative outcomes in patients with pheochromocytoma size < 6 cm. While both LTA and PRA were executed with a commendable safety profile and comparable operative results in patients afflicted by pheochromocytomas < 6 cm, the PRA technique distinctly showcased advantages when addressing large-scale pheochromocytomas (≥ 6 cm). Notably, this manifested in reduced operative time, diminished intraoperative blood loss, decreased hospitalization expenses, and a paucity of procedural complications.
Nonexistence of interior bubbling solutions for slightly supercritical elliptic problems
Authors: Ben Ayed Mohamed , El Mehdi Khalil
Published: September 2023

In this paper, we consider the Neumann elliptic problem $(\mathcal{P}_{\varepsilon})$
(

P
ε

)
: $-\Delta u +\mu u = u^{(({n+2})/({n-2}))+\varepsilon}$
−
Δ
u
+
μ
u
=

u

(
(
n
+
2
)
/
(
n
−
2
)
)
+
ε

, $u>0$
u
>
0
in Ω, ${\partial u}/{\partial \nu}=0$
∂
u
/
∂
ν
=
0
on ∂Ω, where Ω is a smooth bounded domain in $\mathbb{R}^{n}$

R
n

, $n\geq 4$
n
≥
4
, ε is a small positive real, and μ is a fixed positive number. We show that, in contrast with the three dimensional case, $(\mathcal{P}_{\varepsilon})$
(

P
ε

)
has no solution blowing up at only interior points as ε goes to zero. The proof strategy consists in testing the equation by appropriate vector fields and then using refined asymptotic estimates in the neighborhood of bubbles, we obtain equilibrium conditions satisfied by the concentration parameters. The careful analysis of these balancing conditions allows us to obtain our results.
Research progress on the role of extracellular vesicles in neurodegenerative diseases
Authors: Li Zhengzhe , Wang Xiaoling , Wang Xiaoxing , Yi Xiaomei , Wong Yin Kwan , Wu Jiyang , Xie Fangfang , Hu Die , Wang Qi , Wang Jigang , Zhong Tianyu
Published: September 2023

Neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, and Huntington’s disease, affect millions of people worldwide. Tremendous efforts have been put into disease-related research, but few breakthroughs have been made in diagnostic and therapeutic approaches. Extracellular vesicles (EVs) are heterogeneous cell-derived membrane structures that arise from the endosomal system or are directly separated from the plasma membrane. EVs contain many biomolecules, including proteins, nucleic acids, and lipids, which can be transferred between different cells, tissues, or organs, thereby regulating cross-organ communication between cells during normal and pathological processes. Recently, EVs have been shown to participate in various aspects of neurodegenerative diseases. Abnormal secretion and levels of EVs are closely related to the pathogenesis of neurodegenerative diseases and contribute to disease progression. Numerous studies have proposed EVs as therapeutic targets or biomarkers for neurodegenerative diseases. In this review, we summarize and discuss the advanced research progress on EVs in the pathological processes of several neurodegenerative diseases. Moreover, we outline the latest research on the roles of EVs in neurodegenerative diseases and their therapeutic potential for the diseases.
Words Re(en)visioned
Authors: Negrín Diana
Published: September 2023

This chapter suggests the theoretical and practical opportunities that are to be found in the “third perspective” that Black geographic theory and Mesoamerican Indigenous linguistic concepts offer. The chapter argues for the importance of cross-border theorizing that centers the transformative and decolonizing value of languages in their written, spoken, and sung forms.
Rendering Gentrification and Erasing Race
Authors: Corbin C.N.E.
Published: September 2023

The City of Oakland, California, released the West Oakland Specific Plan (WOSP) in 2014. The plan, which was said to be the “guiding framework for realizing the vision of a healthy, vibrant West Oakland,” was both celebrated and contested based on the spaces it depicted. The visual discourse analysis in this chapter examines Appendix A, the design guidelines for the WOSP, and questions the representations illustrated. Studying the WOSP provides a unique opportunity to deconstruct municipal images while illuminating how historical environmental and racialized discourses continue to be (re)produced in current environmental agendas and municipal plans. This chapter argues that the West Oakland Specific Plan portrays an eco-friendly city while erasing the Black population from the historically African American district of West Oakland as it rebrands the municipality as a white and green city.
“Need Black Joy?”
Authors: Kenyatta Matthew Jordan-Miller
Published: September 2023

Currently, geography offers few original terms to spotlight the meaningful interactions between race, place, and taste: how Blackness travels as a global cultural identity through digital technology. Using multiple methods, this chapter mines and maps a three-year longitudinal dataset of over twelve hundred events, announced online by marketing start-up Black Book LA (BBLA), to sketch the dimensions of everyday dynamic forms of cultural gatherings constituting Blackness as distinctive temporal urbanisms in the metropolitan city-region of Los Angeles. The findings suggest that Black cultural geographies are quantum: cosmopolitan, dispersed, complex, and often financially accessible. It repositions two popular yet undertheorized concepts—Afrotech and Black joy–as key traits and technologies of Black public spheres especially relevant for this digitally augmented era. It argues for three spatial understandings of Black joy that motivate new language in Black studies, geography, and information technology, or what the chapter refers to as “Afrotechtonics.”
Today Like Yesterday, Tomorrow Like Today
Authors: Brand Anna Livia
Published: September 2023

This chapter explores Black place-making as the life-giving work of making freedom geographically. In contrast to white Cartesianism, it considers Black life and landscapes as intrinsically linked to ancestral temporalities, acts of resistance, and everyday inhabitance. Through a study of post-Katrina New Orleans and a critique of urban planning visions for rebuilding the city, this chapter first examines how urban planning works as whiteness to delineate a future without Black geographies. The majority of the chapter explores how thinking in the fourth dimension, at the intersection of space and time, can help secure and emplace an incommensurate Black future that is unfettered and dense with love. To consider Blackness as geographically and temporally expansive, the chapter pairs image and text to render a Black landscape as it might be drawn from the perspectives of the porch and second lines, where all geographies are Black and Black residents are home.
Perceived Social Support and Anxiety among Chronic Hepatitis-C Patients
Authors: Hafeez Muhammad , Hafeez Qurat Ul Ain , Siddiqi Fuad Ahmad
Published: September 2023

Objective: To study the relationship of perceived social support (PSS) and anxiety among patients of Chronic Hepatitis C (CHC).

Methods: It is a cross sectional survey conducted from March 2021 to December 2021 in different hospitals of Islamabad and Rawalpindi. Sampling was done through purposive and snowball technique. Self-administered and standardized questionnaires were used. To analyze perceived social support and anxiety, perceived social support “scale” and Beck anxiety inventory were used in patients of Hepatitis C. Patients Polymerase Chain Reaction (PCR) positive HCV patients between the ages 31 to 50 years were included. Patients with comorbid conditions and other than 31 to 50 years of age were excluded from the study.

Results: Out of 250, males were 185(74%) and females 65(26%). Ages were between 31 to 50 years. PSS in both males and females was 49.8 and 49 (p=0.63%) with anxiety level 44.63 and 56.18 (p=0.00) respectively. There was no significant gender differences on PSS but women had significantly higher on anxiety (M = 56.18, SD = 11.36) with moderate effect size (>.05). PSS had significant negative correlation with anxiety (r = -.31, p < .05).

Conclusion: Anxiety is more common in females and perceived social support has negative correlation with anxiety in patients of Chronic Hepatitis C.

doi: https://doi.org/10.12669/pjms.39.6.7412

How to cite this: Hafeez M, Hafeez QA, Siddiqi FA. Perceived Social Support and Anxiety among Chronic Hepatitis-C Patients. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7412

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
An initial experience of using dual energy contrast enhanced mammography at a tertiary care hospital in Pakistan
Authors: Zeeshan Sana , Shafqat Gulnaz , Ali Danish , Vohra Lubna
Published: September 2023

Objective: Contrast enhanced mammography (CEM), a relatively new and promising modality, combines mammography (MMG) with an iodinated contrast material to illuminate neovascularity within the breast; analogous to magnetic resonance imaging (MRI). CEM improves the overall sensitivity of MMG; reduces the need for unnecessary biopsies and follow-up imaging and can be considered a reasonable substitute for MRI. In Pakistan, CEM was recently introduced and to assess its usability a study was conducted on five patients before making it available as a regular investigation.

Case presentations: Four out of the five patients had a clinical suspicion of malignancy with two patients having heterogeneously dense breasts and two with dense breasts. All enhancing lesions were concordant on biopsy and had similar corresponding findings on additional imaging such as ultrasound (US) and/or MRI. CEM in all four cases of biopsy proven malignancy facilitated surgical planning. The fifth patient underwent CEM for screening and was found to have no enhancing lesion.

Conclusion: In low-middle-income countries (LMICs) where breast MRI is not readily available and expensive for the populace, CEM can be a reliable alternative. The initial experience with CEM at our hospital shows better visualization of malignant lesions in dense and heterogeneously dense breasts with an easy-to-perform technique and a shorter imaging time while facilitating surgical decision-making in terms of breast conservation.

doi: https://doi.org/10.12669/pjms.39.6.7607

How to cite this: Zeeshan S, Shafqat G, Ali D, Vohra L. An initial experience of using dual energy contrast enhanced mammography at a tertiary care hospital in Pakistan. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7607

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The cognitive remediation of attention in HIV-associated neurocognitive disorders (HAND): A meta-analysis and systematic review
Authors: Zondo Sizwe
Published: September 2023

Background: Despite medical advances in Highly Active Antiretroviral Therapy (HAART), patients living with HIV continue to be at risk for developing HIV-associated neurocognitive disorders (HAND). The optimization of non-HAART interventions, including cognitive rehabilitation therapy (CRT), shows promise in reversing the impact of HAND. No data exist indicating the efficacy of CRT in remediating attention skills following neuroHIV. This paper presents a meta-analysis of randomised and non-randomised controlled trials (RCTs) to remediate attention skills following HIV CRT.

Methods: The database search included literature from Google Scholar, ERIC, Cochrane Library, ISI Web of Knowledge, PubMed, PsycINFO, and grey literature published between 2013 and 2022. Inclusion criteria included studies with participants living with HIV who had undergone CRT intervention to remediate attention skills following neuroHIV. Exclusion criteria included case studies, non-human studies, and literature reviews. To assess study quality, including, randomisation, allocation concealment, participant and personnel blinding, the Cochrane Collaboration ratings system was applied.

Results: A total of 14 studies met the inclusion criteria (n = 532). There were significant pre- to post-intervention between-group benefits due to CRT in the experimental group relative to control conditions for the remediation of attention skills following HIV acquisition (Hedges g = 0.251, 95% CI = 0.005 to 0.497; p < 0.05). No significant effects (p > 0.05) were demonstrated for subgroup analysis.

Conclusions: To the author's knowledge, this is the first meta-analysis that exclusively analyses the remediation of attention skills in the era of HAART and neuroHIV, where all studies included participants diagnosed with HIV. The overall meta-analysis effect indicates the efficacy of CRT in remediating attention skills in HIV and HAND. It is recommended that future cognitive rehabilitation protocols to remediate attention skills should be context and population-specific and that they be supplemented by objective biomarkers indicating the efficacy of the CRT.

Registration: Protocols.io (01/03/2023).
The discourse of organizational resilience before and after the global pandemic
Authors: Harsanto Budi , Firmansyah Egi Arvian
Published: September 2023

Background: Over the past decade, there has been a surge in public and academic discussions about organizational resilience, particularly in the wake of the coronavirus disease (COVID-19) pandemic. It is essential to understand the changes in the discourse of organizational resilience before and after the pandemic. This study aims to understand how the concept of organizational resilience evolved before and after the pandemic.

Methods: This study is qualitative in nature, employing discourse analysis techniques on scholarly documents on organizational resilience. Our analysis considers the global context of organizational resilience discussions and highlights the most frequently discussed industries, such as tourism and hospitality, manufacturing, and healthcare. The documents were searched on Scopus academic databases with the key search term of organizational AND resilience.

Results: Our findings indicate that themes related to "response to external threats" and "supply chain vulnerabilities and disruptions" have gained significant attention post-pandemic. Meanwhile, discussions around "preparedness and organizational reliability" and "coping with occupational and job demands" have remained consistent before and after the pandemic.

Conclusions: This study contributes to the academic understanding and practical application of organizational resilience evolution by discourse before and after the pandemic. It highlights the significance of being prepared for external threats and managing supply chain disruptions while recognizing the importance of preparedness and organizational reliability.
A cross sectional study to assess prevalence of internet addiction and its relationship with personality traits and associated psychiatric conditions in undergraduate medical students of an Indian university
Authors: Chadha Yatika , Patil Ragini
Published: September 2023

Background: In India, 622 million internet users were found out of which our nationally representative data suggest that about 20% to 40% of college students in India are at risk for internet addiction (IA). Therefore, the research on its addiction is on the rise and is an established concern.

Objectives: To study the prevalence of internet addiction in undergraduate medical graduates associating its impact, on personality traits and psychiatric conditions like depression, anxiety and stress.

Methods: It is a cross sectional study based on undergraduate medical students of Jawaharlal Nehru Medical College, Wardha. It is a convenience based sampling method and a Krejcie-Morgan Formula is used. Using this, the sample size came out to be 300. Clearance from the ethics committee will be obtained. An informed consent from the students will be taken, thereafter they will be asked to fill socio demographic data and then will be subjected to the following questionnaires:

1)Young’s Internet addiction test

2) DASS 21

3)Brief Big Five inventory scale

Results: We will be able to determine the prevalence of internet addiction among medical students after we have the results from the aforementioned questionnaires, their personality traits and development of psychiatric co- morbidities like depression, anxiety and stress.

Conclusions: We’ll be able to know the prevalence of internet addiction in medical students, their personality traits and the development of psychiatric co- morbidities like depression, anxiety and stress.