bluuebunny/crossref_metadata_2025 huggingface dataset:
Transformative Trends: Generative AI’s Impact on Biochemistry and Clinical Chemistry
Authors: Salami Siamak
Published: August 2024

The Article Abstract is not available.
A review of the therapeutic effects of polyphenols on non-alcoholic fatty liver disease: Focus on oxidative stress
Authors: Soleimani Ali Akbar , Sarajar Behnam Omidi , Aliabadi Masoume , Azmon Marzyeh , Meshkani Reza
Published: August 2024

A substantial body of research suggests that polyphenols may have health benefits, particularly in metabolic disorders associated with obesity, such as non-alcoholic fatty liver (NAFLD), type 2 diabetes, and cardiovascular disease. Given the importance of oxidative stress in the pathogenesis of metabolic disorders, significant emphasis has recently been placed on the characteristics of polyphenols in obesity-related problems. This narrative review summarizes the current knowledge on the inhibitory effects of polyphenols, including curcumin, resveratrol, baicalin, nobiletin, and quercetin, on oxidative stress, with a focus on the role of the Nrf2 pathway. This review compiles the data from articles showing that the aforementioned polyphenols improve health in metabolic diseases by regulating Nrf2 and its target proteins involved in reducing oxidative stress. However, due to the limitations of in vitro and in vivo investigations, as well as the lack of long-term human clinical trial studies, further high-quality research is required to definitively demonstrate the clinical usefulness of polyphenols for the prevention and management of NAFLD.
Effectiveness of hydroalcoholic extract of Nasturtium Officinale on sleep quality, asthma control and quality of life in asthmatic patients: a randomized controlled trial
Authors: Abbasi Reza , Zarei Ezzat , Shakerinasab Nasrin , Eftekhari Mahdieh , Sadeghi Hossein , Fazel Ali , Doustimotlagh Amir-Hossein , Bazarganipour Fatemeh
Published: August 2024

Objectives: Considering the role of oxidants in asthma, airway inflammation, and the anti-inflammatory effects of Nasturtium officinale extract, this study aimed to investigate the impact of the hydroalcoholic extract of Nasturtium officinale on sleep quality, asthma control, and quality of life in asthmatic patients.
Methods: This parallel group randomized clinical trial was conducted in Yasuj, Iran. It included 60 patients who randomly received either Nasturtium officinale hydroalcoholic extract (500 mg daily, for four weeks, orally plus routine care) or a placebo (500 mg capsule containing flour daily, for four weeks, orally plus routine care). To achieve the study objectives, lung function (FEV1, FVC, PEF, FEF 25-75%, and FEV1/FVC), quality of life as measured by the 12-item Short Form Health Survey (SF-12), sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI), and asthma control as examined by the Asthma Control Test (ACT) were assessed at baseline and one-month follow-up.
Results: In total, 48 patients (22 patients in the intervention group and 26 patients in the control group) completed the study. The analyses showed no significant differences between the two groups regarding changes in lung function, quality of life, sleep quality, and status of asthma control within a one-month follow-up.
Conclusion: The findings suggest that the hydroalcoholic extract of Nasturtium Officinale does not appear to improve sleep quality, asthma control, and quality of life in asthmatic patients in the short term.
Prevalence of cardiomyopathy following pacemaker insertion in an iranian population; a cross-sectional study
Authors: Dehghani-Tafti Faezeh , Hossaini Seyed Mostafa Seyed , Jafari-Naeimi Mohammad , Chaleshi Danial , Lojje Hossein
Published: August 2024

Objectives: This study aimed to determine the prevalence of pacemaker-induced cardiomyopathy in patients with pacemaker implantation and to identify the associated risk factors.
Methods: This cross-sectional study examined all patients who were implanted with a pacemaker at Afshar Hospital Yazd in 2019 and wore it for two to three years. A new EF test was performed for all patients and compared with the old EF. If a reduction in EF of more than 10% was observed, or the EF was less than 50% due to another reason, it was considered HF. All data were analyzed using SPSS, version 22.
Results: One hundred eleven patients participated in this study, 52 (46.8%) men and 59 (53.2%) women. The results showed that ejection fraction (EF) was more than 50% in 93 patients (83.8%). The mean EF decreased from 62.1 to 36.2% over three years. Statistical analysis showed that there is a significant association between diabetes and the incidence of cardiomyopathies in these patients (p = 0.016), but there was no association with hypertension. The mean length of the QRS wave in the electrocardiogram was significantly longer in the group with cardiac pacemakers than in the other patients (P = 0.49).
Conclusions: We concluded that 22.5% of referring patients with implantation of a right ventricular pacemaker will develop cardiomyopathy within 2-3 years.
Survival benefit of ICD implantation for primary prevention in dilated cardiomyopathy
Authors: Akrami Alimoahammad , Dehghani-Tafti Faezeh , Razavi Ratki Seyed Kazem , Mohammadi Mohsen , Sarebanhassanabadi Mohammadtaghi , Malekpoor Maliheh , Ghiasi Hafezi Najmeh , Hossaini Tezerjani Seyed Mostafa Seyed
Published: August 2024

Objectives: Dilated cardiomyopathy (DCM) represents a significant cause of heart failure unrelated to ischemic heart disease, posing a high risk of sudden cardiac death (SCD) due to low left ventricular ejection fraction (LVEF). This study evaluates the survival benefits of implantable cardiac defibrillators (ICDs) for primary prevention in DCM patients.
Methods: We enrolled 52 symptomatic non-ischemic cardiomyopathy patients (LVEF ≤ 35%, NYHA class II-III) eligible for ICD implantation in Afshar Hospital, Yazd, Iran, from 2014 to 2015. Exclusion criteria included those with ischemic indications or requiring cardiac resynchronization therapy. We divided patients into ICD recipients and those on a waiting list, collected the baseline data (age, functional class, LVEF), then followed up with patients to assess mortality rates.
Results: Among 45 patients, 64.5% received ICDs while 35.5% were on the waiting list. The mean age was 57±13 years, predominantly male (67.3%). The ICD group had a significantly lower mortality rate (17.3%) than the waiting list group (42.7%, p = 0.54). Although age and functional class did not significantly predict outcomes, lower LVEF was a crucial factor for long-term survival. Despite some studies suggesting no survival benefit in non-ischemic heart failure, our findings highlight the efficacy of ICDs in reducing mortality among DCM patients.
Conclusions: ICD implantation in DCM patients substantially reduces all-cause mortality compared to those awaiting the procedure, underscoring the importance of timely ICD deployment for primary prevention in this population.
Asessment of blood urea nitrogen to creatinine ratio as a predictor of mortality in ST-elevation myocardial infarction patients undergoing thrombolytic therapy: a cross-sectional study
Authors: Bodagh Haleh , Ghanivash Amin , Yousefzadeh Asma , Banisefid Erfan , Bodagh Mohammad bagher , Khiavi Shila Mosadeghi , Hamzehzadeh Sina , Seifimansour Sina , Parizad Razieh
Published: August 2024

Objectives: Given the increasing number of ST-elevation myocardial infarction (STEMI) and the related healthcare expenses and medical outcomes, as well as the frequent occurrence of kidney problems in this patient population, the current research aims to explore the effect of blood urea nitrogen to creatinine (BUN/Cr) ratio on the in-hospital mortality (IHM) of STEMI patients undergoing thrombolytic therapy.
Methods: This study is a cross-sectional analytical study conducted in 2021 at Shahid Madani Hospital, affiliated with Tabriz University of Medical Science, which investigated the relationship between the BUN/Cr ratio and IHM in patients with STEMI who received thrombolytic treatment between 2017 and 2019. Patients with other causes of ST elevation, those undergoing dialysis, or those with incomplete medical records were excluded. Data were collected from patient medical records. The primary outcome was in-hospital mortality, with secondary outcomes including the occurrence of heart failure and the need for blood transfusion—chi-square tests for categorical and t-tests for continuous variables. A p-value of less than 0.05 was considered statistically significant.
Results: A total of 398 patients were diagnosed with STEMI and treated with thrombolytic 330 (82.9%) patients were men. High BUN and Cr had a significant correlation with high mortality rates (P <0.01). However, BUN/Cr didn’t have a substantial relationship with IHM and one-year mortality (P-value = 0.46). The most common in-hospital complication was heart failure (HF), and a higher need for blood transfusion was significantly related to high rates of BUN/Cr (P <0.01).
Conclusions: While high BUN and Cr levels were significantly associated with increased mortality rates, the BUN/Cr ratio was not significantly related to IHM. These results suggest that although elevated BUN and creatinine indicate poor prognosis, the BUN/Cr ratio may not be a standalone predictor of in-hospital mortality. Further research is needed to validate these findings and identify other factors affecting patient outcomes.
Abstract Introduction of a novel pathogenic variant (c.1684G>A) in the SOX5 gene associated with Lamb– Shaffer syndrome in a family from north of Iran
Authors: Amirfiroozy Akbar , Jalali Hossein , Khoshaeen Atefeh , Mahdavi Mohammad Reza , Mahdavi Mahan
Published: August 2024

So far, different types of SOX5 variants have been reported in patients with LAMSHF syndrome, which are mainly clustered in the HMG domain. The LAMSHF syndrome has a broad variety of clinical manifestations such as developmental delay, speech delay, intellectual disability, and behavioral disturbances. In this article, we aim to present three cases with Lamb–Shaffer syndrome who are heterozygotes for a novel variant (c.1684G>A) in the SOX5 gene in a family from the north of Iran. A 38-year-old male case with moderate mental retardation and strabismus, with a head circumference size of 56 cm, was tested for genetic diagnosis. The results of wholeexome sequencing (WES) indicated the c.1684G>A pathogenic variant (NM_006940.6) in the SOX5 gene in a heterozygote state. Family analysis showed that the proband’s sister and father, who have similar symptoms, also carry the detected variant. Like the previous cases, the presented cases with a missense variant in the HMGdomain also have a mild phenotype. The introduction of new patients, especially with new pathogenic variants, is fundamental to increasing our knowledge about the disease and possible genotype–phenotype correlations.
Alkaptonuria and Ochronotic Arthropathy: The Path to Pain-Free Mobility
Authors: Poursalehian Mohammad , Barzegar Mohammadreza , Razzaghof Mohammadreza , Mortazavi Seyed Mohammad Javad
Published: August 2024

This article discusses a case of ochronotic arthropathy, a manifestation of alkaptonuria. Alkaptonuria is characterized by the accumulation of homogentisic acid [HGA] in tissues, leading to a distinctive blue-black pigmentation and early joint degeneration. A 68-year-old female patient, with a history of alkaptonuria, presented with progressive hip pain and was eventually treated with an elective total hip replacement. Due to vertebral calcifications, the operation was performed under general anesthesia. Pre- and post-operative care was guided by the patient’s comorbidities and potential complications related to alkaptonuria, including potential cardiac and respiratory issues. Following surgery, the patient exhibited significant improvements in hip joint functionality. The paper also discusses the challenges in diagnosing alkaptonuria, the absence of definitive treatment, and the potential of dietary restrictions and symptomatic treatments. Moreover, it addresses surgical considerations for ochronotic arthropathy and emphasizes the role of regular calcium and vitamin D intake in maintaining bone quality. The success of the hip replacement surgery in this case suggests a potential intervention for managing ochronotic arthropathy in alkaptonuria patients.
Recurrent Facial Palsy in an Adolescent - Case Report
Authors: Garg Anantika , Shamsi Sumaiya , Khan Wamique
Published: August 2024

Introduction: Recurrent facial nerve paralysis is an unusual occurrence.
Main Symptoms: Recurrent facial palsy, oro-facial swelling, and a fissured tongue.
Main Diagnosis: Lower Motor Neuron Palsy. No definitive therapy is available, and frequent recurrences are common.
Conclusion: Idiopathic recurrent Lower Motor Neuron facial palsy with atypical presentations can be indicative of Melkerson-Rosenthal syndrome.
A Case of Anti-IgLON5 Disease with Aplastic Anemia and review of the literature
Authors: Tafakhori Abbas , Ebadi Seyyed Reza , Amirifard Hamed , Karima Saeed , Hasani Arian , Esmaeili Nazanin
Published: August 2024

Anti-IgLON5 is a neurological condition with neurodegenerative and autoimmune etiology. A 64-year-old man with a 2-year history of aplastic anemia presented with symmetrical parkinsonism, fluctuating consciousness, supranuclear gaze palsy, mild fasciculation, and muscular atrophy. He had disturbances in his sleep cycle and brain MRI. CSF analysis was positive for the IgLON5 antibody. We initiated immunotherapy with high-dose methylprednisolone, intravenous immunoglobulin, and rituximab. The patient showed a mild to moderate response to treatment. We reviewed 29 published case reports regarding anti-Iglon-5 and examined the clinical manifestation. None of the cases showed aplastic anemia, which was the main presentation in our case. All of the patients experienced sleep disturbances, while other symptoms were heterogeneous. Anti-Iglon-5 is usually diagnosed late, leading to a weak prognosis. This study helped us establish a better understanding of the correlation between antiIglon5 disease and other autoimmune disorders like anemia.
An uncommon cause of intra-abdominal sepsis: A case report
Authors: Abouhamzeh Kosar , Salahshour Faeze , Zangi Mahdi , Mirbagheri Somayeh , Eftekhari Mohammad
Published: August 2024

The abdomen is the second most common site for sepsis. This potentially lifethreatening condition necessitates finding the source and providing prompt medical and/or surgical treatment. This presentation reveals an uncommon cause of intraabdominal sepsis. A 43-year-old woman presented to the emergency department with abdominal pain, tachycardia, tachypnea, and generalized abdominal tenderness. The evaluation of the laboratory tests showed an elevation in white blood cell count and liver enzymes. Ultrasonography of the liver revealed the presence of hydatid cysts, and the abdominopelvic computed tomography scan with contrast displayed multiple pyogenic cysts in her liver, one of which had ruptured into the peritoneum. She underwent surgery, received antimicrobial agents, and was successfully discharged without experiencing any complications. One clinical presentation of a hepatic hydatid cyst could be intra-abdominal sepsis, which requires emergency surgery along with antibiotic and anti-helminthic drugs.
Complicated progress of Granulomatosis with polyangiitis - A Case Presentation and Review of literature
Authors: Tabatabae Matineh Sadat , Mortazi Mostafa
Published: August 2024

Granulomatosis with polyangiitis, previously known as Wegener’s, is a necrotizing vascular disease that affects small blood vessels and may cause damage to the respiratory tract and kidneys. In this article, we report on a 50-year-old male with a complicated disease process who experienced rare bladder and renal complications and several adverse drug reactions. Despite using drug alternatives, the side effects remained mostly the same. Therefore, by studying different cases and articles, we establish the relation between these findings and the specifications of granulomatosis with polyangiitis. This case underscores the complexity of managing this condition and the need for personalized treatment strategies.
Cesarean scar choriocarcinoma following a cesarean scar molar pregnancy: A case report
Authors: Tarafdari Azadeh , Ghashghaee Sanaz , Mansouri Zeinab , Parsaei Mohammadamin
Published: August 2024

Gestational choriocarcinoma, a rare variant of gestational trophoblastic disease, typically arises from abnormal trophoblastic cell proliferation post-pregnancy, often associated with a hydatidiform mole. While most choriocarcinoma cases develop within the uterine cavity, an exceedingly rare manifestation occurs within a previous cesarean section scar. In our study, a 31-year-old woman with a history of hydatidiform mole presented with amenorrhea and spotting. Initial assessments revealed elevated beta-human chorionic gonadotropin (βhCG) levels and a heteroechoic mass at her prior cesarean section scar in sonographic examination. Histopathologic findings and the metastatic workup categorized the patient as FIGO stage I, indicating no metastasis. Due to the absence of metastasis, adjuvant chemotherapy was omitted. Total abdominal hysterectomy confirmed choriocarcinoma. Post-surgery, βhCG levels notably decreased, remaining negative during the two-year follow-up with no reported symptoms. Our findings suggest that surgical resection and meticulous βhCG monitoring may be a promising treatment strategy for non-metastatic choriocarcinoma.
Occupational Morbidities and Health-Seeking Behavior among Automobile Mechanics in the Western Region of Nigeria
Authors: Adeiza Ozomata Ebenezer
Published: August 2024

Background: Automobile mechanic work is associated with illnesses and injuries. These occupational diseases can result in sickness absence, economic loss, disability, or death of these workers. This study assessed self-reported health problems and health-seeking behavior of automobile mechanics in Surulere, Lagos State.
Methods: A cross-sectional study was used in this study carried out in December 2014. A systematic sampling method was employed to select 120 respondents from various workshops within their Local Government Area and were interviewed using a structured questionnaire. Data entry and analysis were done using epi-info3.5.1
Results: About 27.5% of the respondents reported at least one work-related illness or injury. Five percent of the respondents had musculoskeletal disease. About 11.5% of the respondents reported having cuts and crushing injuries. Most (86.7%) of these workers do not have health workers available around their workplaces. Slightly less than half (48.3%) visit health facilities between 6 to 15 minutes of estimated walking distance. Most (70%) respondents visit health facilities when ill or injured; 33.3% patronize traditional healers/ herbs/ prayer houses (spiritualists); 25% patronize patent medicine vendors and practice self-medication. The level of education of the workers was inversely significantly associated with the occurrence of occupational injury or illness.
Conclusion: High work-related morbidities were managed by a few available health workers who were majoring in the patent medicine vendor category. The importance of level of education in the control of workplace injuries and illnesses was demonstrated by this study.
Factors Influencing Access to Sexual and Reproductive Health Information among Adolescents Aged 12-19 Years in Mukono Municipality Schools: A Cross-Sectional Study
Authors: Namyalo Josephine , Sentumbwe Dissan , Patience Nakalega Annet , Kobusingye Jacqueline , Otieno Emmanuel
Published: August 2024

Background: Adolescent sexual and reproductive health is one of the essential health care services that promote a adolescent’s health. Complications of unwanted pregnancies lead to school dropouts’, disability and mortality.  However, many adolescents 12-19 years face barriers to reproductive health information about their health and rights. And are unable to access services needed to protect their health. This study aimed to assess factors influencing access to Sexual and Reproductive Health Information among adolescents aged 12-19 years in Mukono municipality schools, Uganda.
Methods: Analytical cross-sectional survey and simple random sampling were used to select 384 participants between July and December 2022 in Mukono municipality. A Self-administered structured was used to collect data. Data was analyzed using descriptive statistics, chi-square test, and a modified Poisson regression model.
Results: Findings showed the mean age of participants was 16.1 (S.D + 2) years. The proportion of access to information was 80.27%. Significant factors strongly associated with access to sexual and reproductive health information were being Moslem (OR: 0.284 (0.089-0.912)], going to hospital [OR: 2.350 (1.143-4.828)], distance 3-5 Kms from home to nearest health facility [OR: 0.41 (0.176-0.912)].  
Conclusion: Two of every ten participants had access to Sexual Reproductive Health and Rights information. Significant determinants were radio media and print newspapers. Stakeholders should advocate for adolescents’ increased access to healthcare information to avert the upsurge in related diseases. Policy makers should review and monitor new guidelines for Adolescent and School health inclusive of sexuality and reproductive health. Thus, improve health equity for all.
Human Immunodeficiency Virus Co-Infection among Sickle Cell-Exposed Children in Kisumu County, Western Kenya
Authors: Adel Ottoman , Lihana Raphael , Rono Betsy
Published: August 2024

Globally, the high prevalence of infectious diseases, particularly HIV, and the possible interaction with sickle cell disease, has been of great public health concern. Kenya experiences a significant burden of HIV. Kisumu County in particular, exhibits unique epidemiological burden characterized by unprecedented high mortality 50%-90% among children with sickle cell disease,. This is coupled with high prevalence 17.5% of HIV/AIDS among its population, and high malaria endemicity with prevalence of 19%. The overarching aim of this study was to assess the HIV co-infection among sickle cell-exposed children in Kisumu County. The study adopted a retrospective systematic review. Study population comprised of the sickle cell-exposed children in Kisumu County with a sample size of 173. The study used both purposive and simple random sampling techniques. Majority 99.2% of the sample size participated. The prevalence of HIV among sickle cell-exposed children was 4.65% in Kisumu County. Majority 76.3% sickle cell-exposed children had hemoglobinopathies for sickle cell disease. Age was not statistically significant factor p-value= 0.414 complicating co-infection. A paltry one quarter 49 (28.48%) had attained fifth anniversary with close to a third 47 (27.33%) being only 7 months to one and half years old. Viral load was statistically significant p-value=0.046 in β-thalassemia co-infection. The study recommends enhancement of HIV screening and prevention efforts in this vulnerable population
Practicality of Student-Centered Assessment/Learning using Mathematics Modeling Process Worksheets to Improve the Quality of Education
Authors: Riyanto Bambang
Published: August 2024

It is necessary to consider reforms to improve the quality of education through assessment/learning. The problem formulation of this research is how to design student-centered assessment/learning using practical mathematical modeling process worksheets to improve the quality of education? This research uses a development research approach developed by Akker, Gravemeijer, McKenney and Nieveen. This development research consists of 3 steps, namely analysis, design and evaluation. In the analysis step, student analysis, curriculum, mathematical modeling and real world problems are implemented. Second step, design and product. In the final step, researchers used a formative evaluation design consisting of self-evaluation, one-to-one, expert review, small group, and field test. Data were analyzed using descriptive analysis methods: (1) walk through, analysis based on solutions and student comments in small groups to obtain student-centered assessment/learning using mathematical modeling process worksheets using the best practical transportation context to improve the quality of education; (2) analyzing the results of the review of small group results. Based on the results of the small group worksheet, the mathematical modeling process is practical for improving the quality of education. Students commented that this mathematical modeling process worksheet was interesting, confusing but challenging and had never been found in their classrooms. Students can solve problems on process worksheets even though the mathematization process has not yet appeared, because students only solve them using informal methods. So, this is a golden opportunity to implement in order to improve the quality of education through assessment/learning. So, a practical mathematical modeling process worksheet is obtained to implement student-centered assessment/learning in order to improve the quality of education.
Consumptive Behavior of Students Examined from the Perspective of E-Wallet Application Usage
Authors: Mahdiyah Mahdiyah , Putri Fildzah Rudyah , Dahlia Mutiara
Published: August 2024

The purpose of this research is to identify the consumptive behaviour of students from the perspective of e-wallet application usage. The research data is analyzed using the quantile regression method, which is a more specific regression method that can provide different estimator values at various quantile positions of the data. The respondents used in this study were 212 students. The results of the research show that the use of e-wallet applications is positively correlated with the consumptive behaviour of students. The relationship between the effect of using e-wallets and the consumptive behaviour of students varies at different quantile distribution levels. A larger regression coefficient value indicates a greater role of e-wallet usage in students' consumptive behaviour. The most significant role of e-wallet usage is seen at the 0.25, 0.75, 0.10, 0.50, and 0.90 quantiles in the distribution of students' consumptive behaviour. The variation in the results of this analysis demonstrates the flexibility of quantile regression and makes it more complex.
Organoleptical Test And Acceptance Of Gummy Candy With The Addition Of Turmeric Acid
Authors: Melati Denis
Published: August 2024

Abstract. Technological developments have an impact on people's awareness of the importance of maintaining a healthy body by optimizing natural resources as functional food. Functional food is food and drink that is often consumed by the public because it contains bioactive compounds that are beneficial for health. Gummy candy is a type of jelly-like soft candy made from a mixture of sugar and the purpose of this study was to determine the acceptability of gummy candies with the addition of turmeric and tamarind as functional foods. This study used an experimental method with organoleptic tests on the resulting functional food products. There were 3 treatments in this study namely P1 (100% mineral water: 0% sour turmeric), P2 (81.5% mineral water: 18.5% sour turmeric) and P3 (63% mineral water: 37% sour turmeric). Based on the Friedman rank test, and carried out with the Wilcoxon test, it was found that the tamarind turmeric substitution had a significant effect on the color and texture parameters with a value (p = 0.00), but was not significantly different in the aroma parameter with a value (p = 0.81) and taste with a value (p = 0.16) on organoleptic gummy candy. It can be concluded that P3 got superior scores compared to P1 and P2 on the color and aroma parameters, while P1 excelled on the texture and taste parameters. The addition of tamarind turmeric will affect the organoleptic acceptability of Gummy candies.
About TESOL in Context
Authors: TESOL in Context Journal Coordinator
Published: August 2024

This includes the ACTA's mission statement and objectives.
MET Exon 14 Skipping Mutations in Non–Small-Cell Lung Cancer: Testing Considerations and Clinical Outcomes a 3 years screening experience
Authors: Loyaux Romain , Dhiab Rym Ben , Garinet Simon , Bastide Mathilda , Léonard-Goyet Sophie , Fabre Elizabeth , Mansuet-Lupo Audrey , Gibault Laure , Jouveshomme Stéphane , Giroux-Leprieur Etienne , Leroy Karen , Wislez Marie , Blons Hélène
Published: August 2024

Background
MET exon 14 skipping is an oncogenic driver observed in 1 to 4% of non-small cell lung cancer (NSCLC). MET exon 14 mutations affect splice sites and are highly heterogeneous which makes them difficult to detect. Because of the approval of capmatinib for patients with MET exon 14 mutated tumors and the related poor response to immunotherapy (ICI) for a subset of patients with MET mutated tumors, MET screening has become mandatory for first line treatment decision.
Methods
Here we report our testing experience based on 1143 consecutive NSCLC addressed for molecular diagnosis. Two strategies using either DNA sequencing (NGS) and fragment analysis or DNA-RNA sequencing (NGS) were developed and validated to accurately detect MET exon 14 alterations including large deletions. For patients with MET tumors (n = 46), demographic characteristics, treatments and outcomes were obtained from medical records and discussed.
Results
46 MET exon 14 alterations were identified, 4 were not called by DNA sequencing and rescued by fragment analysis or RNA sequencing. Sixty-seven percent tumors had a high PD-L1 expression > 50% and 42% of cases had co-occurring alterations, mainly TP53 mutations (24%) and PIK3CA mutations (9%). Response to MET inhibitors (Crizotinib and Capmatinib) was evaluated for 15 patients. The ORR (Objective Response Rate) and the median of PFS (Progression Free Survival) were 44% and 5.5 months [1.6–18.2 months] respectively. Thirteen patients were treated by immunotherapy, ORR and median PFS (Progression Free Survival) median were 30% and 4 months [0.7–55.5 months] respectively. The response to immunotherapy was not correlated with PD-L1 status but smokers seemed to better respond to ICIs.
Conclusions
This study highlights that a multimodal approach may be necessary to detect MET exon 14 mutations as large deletions may not be detected by DNA sequencing. Targeted DNA-ARN sequencing strategies broadly interrogate the diverse druggable genomic variations and permits direct detection of altered splicing or gene fusions. Because patients with MET exon 14 mutated tumors, demonstrate low response to immunotherapy despite high PDL1 and because MET exon 14 is druggable the detection of MET mutations is mandatory to optimize treatment.
Surface Elemental Characterization of Indian Punch-Marked Coins of 600 to 200 BCE Era
Authors: Upadhyay Amit Kumar , Giri Neeraj Kumar , Prakash Rajiv , Mishra Hirdyesh
Published: August 2024

In the present work, X-ray diffraction [XRD] and x-ray photoelectron spectroscopic [XPS] techniques are used for surface elemental analysis and chemical composition of nine series of imperial punch-marked coins [PMC] of 600 to 200 BCE stored in the Numismatic Society of India at BHU, Varanasi. These coins were selected based on the Gupta-Hardakar classification system of the Mahajanpada and Janpada periods. PMCs are considered the oldest coins in India. They are among the most common coinages globally and are frequently found in hoards. XRD results show four prominent diffraction peaks, whereas XPS spectral analysis of these nine series of imperial punch-marked coins at different surface positions shows a non-uniform distribution revealed by the elemental analysis, which shows different element percentages in each coin. In XPS, Silver is found in dominant, along with copper, lead and a few other elements in very low percentages and gold in Janpada PMC only. In XRD, silver is found in the crystal fcc phase at the surface of PMCs. XPS data shows that the percentage of silver found decreases with the increase of lead and copper in the varying series. The results show a high degree of metallurgical understanding and alloying techniques between the sixth and third centuries BCE. It also demonstrates that the coins were issued at different times when technology was advancing. Numerous issues were raised by the decreasing silver content, including the state of the economy, the growth in coin demand for exchange, and the preservation of weight standards.
Gender Distribution of Presbyopia and its Effect on Vision Related Quality of Life in a Nigerian Population
Authors: Eze Ugochukwu A , Babalola Olufemi E , Ndife Thelma I , Momoh-Jimoh Abdulrazak , Umar Murtala M , Bature Mustapha , Bello Shahir
Published: August 2024

Aim –
To highlight the gender specific characteristics and impact of presbyopia on vision related quality of life among the participants
Methodology –
This was a cross sectional analytical survey in which 1047 persons ≥ 35 years were examined in a multistage random sampling with probability proportional to size. Near and distance visual acuity was assessed, anterior and posterior segment examinations and near refraction done. Participants who could not read N8 at 40cm with distance correction in place were adjudged presbyopic and offered near spectacles where applicable. Data was entered into a standard pre tested questionnaire which contained sections on demographic variables, distant and near vision examination, and visual function (VF 14)
Results –
One thousand and forty out of 1082 enumerated participants were examined (96.7% response rate which was considered high) with a mean age of participants of 48.2 years ± 8.194 SD (age range of 35–87 years). A significantly higher prevalence of presbyopia was noted in females relative to males (87.9% versus 82.9%) (P = 0.041) and a relatively higher diopteric power (p = 0.000), were obtained. Presbyopia had a significant negative impact on quality of life in the study population with 82.7%, 79.1% and 70.8 of participants reporting difficulty in reading prints, threading needles and operating mobile phones, respectively. Women were more likely to be unsatisfied with their vision related quality of life.
Conclusion –
Women had significantly higher prevalence of presbyopia, higher diopteric need per age group, and were more likely to be unsatisfied with their near vision. This should be borne in mind by stakeholders in planning for refraction and optical services within populations.
Plant derivative extracts' (Brahmastra) spectral characterization and their impact on Lipaphis erysimi and natural enemies in oilseed-mustard under organic farming conditions
Authors: Singh Subash , Sidhu Mehra S.
Published: August 2024

Rapeseed- mustard (gobhi sarson) crop is a vital source of edible oil and is vulnerable to more than three dozen insect pests in India. Among them, the mustard aphid Lipaphis erysimi (Kalt.) is a major pest on rapeseed mustard. In the current investigations, the plant derivative extract (Brahmastra (BA)) was characterized, the composition of active ingredients from individual components was identified, and their role is correlated with field efficacy. The BA was employed at 7.5, 10.0 and 12.5 litres ha− 1 against L. erysimi on gobhi sarson under organic farming conditions. All treatments were applied two times. We found that active ingredients such as phytols act as antifeedants and metabolite inhibitors, while Nimbin, a triterpenoid, might provide fungicidal activity. Other components include ryenosin, copaene, caryophyllene, and naphthalene, which are attractive and antibacterial. BA employed at 12.5 litres ha− 1 was found to be most effective against mustard aphids, offering the highest per cent reduction over control (PROC), i.e., 38.1–67.2 and 38.4–58.9% during 2020-21 and 2021-22, respectively, with the non-significant coccinellid population in all treatments. BA employed at 12.5 litres ha− 1 registered the highest seed yield (20.5 and 17.3 q ha− 1) as against control (16.8 and 15.4 qha− 1) for two consecutive years. The economic returns were more elevated in Brahmastra at 12.5 litres (235 USD ha-1) over the other treatments in gobhi sarson. The possible active ingredients identified using GC-MS and FTIR studies are attributed to control the mustard aphids. The plant derivative extract brahmastra emerged as an innovative pest management system, and its effects on non-target organisms or natural enemies is minimal.
Diagnosis and Management of Cervical Pregnancy with Placental Implantation: A Case Report and Literature Review
Authors: Lv Fengqing , Zhang Jingyi , Zou Xiaojie , Bai Yiyun , Liu Dan
Published: August 2024

Introduction:
Cervical pregnancy (CP) is a rare form of ectopic pregnancy (EP) that occurs in the cervical canal. Diagnosis and treatment are particularly challenging when the lesion is large and presents without typical symptoms. We report a case of a 16+-week CP patient with placenta accreta.
Case Presentation:
A 39-year-old woman presented with amenorrhea for four months but no associated symptoms. Doppler ultrasound revealed an enlarged uterus and a mixed echogenic mass in the lower uterine segment extending to the cervix, accompanied by rich blood flow signals. His serum β-HCG concentration was 576.68 mIU/ml. Following multidisciplinary evaluation, exploratory laparotomy under general anesthesia revealed a significantly enlarged cervix with prominent vascular networks. The patient underwent total abdominal hysterectomy with bilateral salpingectomy, with an intraoperative blood loss of 600 ml. Pathological examination confirmed the presence of placental villi in the cervix, consistent with CP. Postoperative recovery was uneventful, with serum β-HCG levels normalizing within a week, and no abnormalities were detected in follow-up assessments over six months.
Conclusion
This case underscores the diagnostic and therapeutic complexities associated with CP, especially when patients present with large lesions and atypical symptoms. Comprehensive clinical history, imaging findings, and serum HCG levels are crucial for accurate diagnosis and effective clinical decision-making. The successful management of this case highlights the importance of a multidisciplinary approach in addressing such rare and challenging conditions.
Renal involvement in solid cancers: epidemiological, clinical and histological characteristics study of 154 onconephrology patients.
Authors: Gueutin Victor , Cardineau Aurore , Mathian Alexis , Lanot Antoine , Comoz Francois , Brocheriou Isabelle , Izzedine Hassan
Published: August 2024

Background
Onconephrology is a growing discipline that aims to improve the management of patients with cancer and kidney disease. If renal histology is an essential key, the anatomopathological data remain weak although essential to this complex management.
Methods
Patients with active cancer who had a renal biopsy (RB) between 2015 and 2020 were included, and their clinicobiological and histological data were analyzed retrospectively.
Results
Our cohort consisted of 154 patients (83 women) with a mean age of 58 years. One hundred twelve patients presented with proteinuria, 95 with acute renal failure, and 59 with arterial hypertension. Histologically, interstitial fibrosis was found in 74% of RBs, tubular atrophy in 55.1%, arteriolar hyalinosis in 58.4%, and fibrous endarteritis in 54.4%. Regarding the main acute lesions, thrombotic microangiopathy (TMA) was found in 29.9% of biopsies, acute tubular necrosis (ATN) in 51.3%, and acute interstitial nephritis in 24.8%. The etiological diagnosis most often made was the nephrotoxicity of anticancer drugs (87 patients), followed by a functional cause (15 patients) and renal disease unrelated to cancer (13 patients). Sixty-seven patients presented with at least 2 associated diagnoses reflecting the complexity of kidney damage in cancer. Different clusters were found, highlighting that immunotherapy and anti-VEGF were the most commonly involved drugs.
Conclusions
During onconephrology practice, renal toxicity of treatments is the most common etiology. Several mechanisms can be involved, underscoring the importance of renal biopsy and the complexity of its management. Chronic histological lesions were very common.
Assessment of High-Sensitivity C-Reactive Protein (hs-CRP) Changes Following One Anastomosis Gastric Bypass (OAGB) in Patients with Obesity: A Prospective Cohort Study
Authors: Mehrnia Nriman , Jaliliyan Ali , Mosavari Hesam , Khalili Pantea , Heidari Fatemeh , Mohammadi Manizhe Amir , Teimoury Taher , Fakhri Elham , Moradi Mohammad , Hosseininasab Ali , Kermansaravi Mohammad , Eghbali Foolad
Published: August 2024

Background
Obesity, characterized by excessive adipose tissue, is associated with chronic low-grade inflammation and elevated inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP). This inflammation is linked to obesity-associated medical problems, including cardiovascular diseases. One Anastomosis Gastric Bypass (OAGB) has emerged as an effective metabolic and bariatric surgical procedure to address severe obesity and its associated inflammatory state. This study aims to evaluate the changes in hs-CRP levels following OAGB in patients with obesity.
Methods
In this prospective cohort study, 71 participants with BMI > 35 kg/m², with or without obesity-associated medical problems, underwent OAGB. The hs-CRP levels were measured at baseline, one day, five days, thirty days, and six months post-surgery.
Results
The median baseline hs-CRP level was 8.5 mg/L, initially increasing post-surgery to 19 mg/L, but significantly decreased to 3.5 mg/L at six months (p < 0.001). Significant reductions in weight and BMI were also observed, with median total weight loss (%TWL) of 29% and excess weight loss (%EWL) of 68.2% over six months. Pre-operative hs-CRP levels were the only significant predictor of CRP reduction post-surgery.
Conclusion
OAGB significantly reduces systemic inflammation by decreasing hs-CRP levels, alongside substantial weight loss. These findings support OAGB as a beneficial intervention for mitigating inflammation and improving metabolic conditions in patients with obesity. Further long-term studies are warranted to evaluate the sustained impact of OAGB on inflammatory markers and obesity-associated medical problems.
Identification of Essential Topics and Procedural Skills for Inclusion in a Contextualised Undergraduate Anaesthesia and Critical Care Clerkship in Rwanda: Results of a Modified Delphi Process
Authors: Forbes Callum , Nzobele Bruce Mutembe , Alayande Barnabas Tobi , Nizeyimana Françoise , Mvukiyehe Jean Paul , Booth Jocelyn M. , Woldegiorgis Selam Degu , Pierre Benoucheca , Littlejohn James , Tabaie Sheida , Bekele Abebe , McClain Craig David , Nyirigira Gaston , Group n/a The African Anaesthesia Education Delphi
Published: August 2024

Introduction: Low anaesthesia workforce numbers contribute to shortfalls in access to surgical care globally. Investment in contextualised education and training can help address this issue. We undertook a modified Delphi study to identify physician anaesthesiologist consensus on themes, topics, and skills for inclusion in undergraduate anaesthesia and critical care (ACC) medical school curricula in sub-Saharan Africa (SSA) and Rwanda.
Methods: A list of ACC topics/skills was compiled through grey literature review, guiding survey development for a 3-round Delphi process. The first two rounds solicited responses from physician anaesthesiologists across SSA. The final round included only Rwandan physician anaesthesiologists. Respondents rated topics/skills on a 4-point Likert scale from 1 (“exclude from the curriculum”) through 4 (“essential for inclusion”). Item-level Content Validity Index (I-CVI, the proportion of respondents rating a topic/skill as 3 or 4) was used for stratification. A first-round I-CVI threshold of 80% and 70% for subsequent rounds was used to define consensus for inclusion. Excluded topics/skills were considered for re-inclusion in subsequent rounds; 50% agreement was set as threshold for re-inclusion. The first round also sought consensus regarding aims, objectives, and delivery methodology.
Results: A total of 147 topics/skills across 12 domains were identified for initial survey inclusion.
Fifty-one respondents from 12 countries completed round one. Ninety-six (65.3%) topics/skills met consensus threshold. One additional skill (“pain assessment”) was incorporated into round two following suggestions from respondents. The clerkship outcome ranked as most important and achievable was to ‘inspire students to undertake anaesthesia specialty training’ (n=25, 49.0% and n=26, 51.0% respectively). Thirty-six respondents from 12 countries completed round two. Eighty (82.5%) topics/skills met consensus threshold. Seventeen Rwandan specialists completed round three. Seventy-eight (97.5%) topics/skills met consensus threshold. From 67 previously excluded topics/skills, 14 (20.9%) met re-inclusion threshold.
Discussion and conclusion: A modified Delphi process identified 92 essential topics/skills for inclusion in a Rwandan undergraduate ACC clerkship. Experts prioritised ‘inspiring students’ over ‘achieving clinical competence’ for undergraduates. A similar Delphi approach may be useful for educational content development in other settings across the African continent and for other specialties.
Heart Failure Recurrence Prevention: Patient Knowledge, Attitudes, and Practices in Yancheng City
Authors: He Yanhong , Dong Zhifeng , Gu Xingjun , Xu Jiaoyan , Li Xinli
Published: August 2024

To investigate the knowledge, attitudes, and practices (KAP) concerning the prevention of heart failure recurrence among patients. A cross-sectional study was conducted at the Third People's Hospital of Yancheng City from September 1, 2023, to December 31, 2023, employing a self-administered KAP questionnaire. The study included 421 heart failure patients, of whom 230 (54.6%) were male. Median scores for knowledge, attitudes, and practices were 12.00 [10.00, 13.00] (possible range: 1-18), 20.00 [19.00, 21.00] (possible range: 5-25), and 16.00 [15.00, 17.00] (possible range: 5-22), respectively. Pearson’s correlation analysis indicated a positive correlation between knowledge and attitude scores (r=0.183, P<0.001), as well as between knowledge and practice scores (r=0.169, P<0.001). A higher attitude score was significantly associated with a higher practice score (r=0.245, P<0.001), as supported by structural equation modelling. Multivariate logistic regression revealed that attitude score (OR = 1.238), suburban residence (OR = 2.524), monthly household income exceeding 5000 Yuan (OR = 3.539), BMI less than 20 kg/m2 (OR = 2.155, P = 0.029), BMI between 20-24 kg/m2 (OR = 2.387), and BMI between 25-29 kg/m2 (OR = 4.063) were independently linked to proactive practices (all P<0.05). Additionally, Structural Equation Modelling (SEM) elucidated the intricate relationship between sociodemographic factors and KAP dimensions. Despite positive attitudes and proactive prevention efforts, heart failure patients exhibit a knowledge gap. Tailored educational interventions by healthcare providers could effectively bridge this gap, leveraging patients' positive attitudes and proactive behaviours to reinforce preventive measures.