bluuebunny/crossref_metadata_2025 huggingface dataset:
Proches aidantes immigrantes vivant au Canada : accompagner malgré la distance
Authors: Savoie Elda , Lanteigne Isabel , Albert Hélène , Savoie Lise
Published: September 2024

Cet article découle d’une étude qualitative menée au Canada auprès de 100 proches aidantes francophones, dont dix qui ont immigré et qui accompagnent leurs familles habitant dans le pays d’origine. Réalisée à partir d’entretiens semi-dirigés, cette recherche permet de comprendre la complexité que revêt le fait d’être proche aidante dans un contexte transnational. Il en ressort que vivre au loin tout en continuant à soutenir ses proches comporte des défis particuliers. Le care , comme choix théorique, contribue à saisir des formes d’oppression qui souvent taisent la parole et l’expérience de certains groupes marginalisés. Trois thèmes centraux décrivent leur expérience de soutien et d’accompagnement et permettent d’en apprécier la complexité, notamment les défis financiers, la gestion à distance et le sentiment de culpabilité qui les habite. Enfin, cette étude met en lumière le besoin de recherche portant sur la proche aidance à distance en contexte francophone minoritaire au Canada.
Santé au travail : ce que l’on sait et ce qui est ignoré
Authors: Gosselin Anne , Counil Émilie
Published: September 2024

Les statistiques l’attestent : les personnes étrangères sont surreprésentées dans les secteurs où les conditions de travail sont réputées dégradées et pénibles. Cette ségrégation professionnelle les expose davantage aux discriminations et au déclassement dont les effets sur la santé sont, bien souvent, passés sous silence. Qu’ils soient minorés par les personnes concernées ou ignorés par les travaux de recherche, les enjeux propres aux risques professionnels et à la santé au travail des étrangers constituent, en effet, un objet d’étude qu’il reste à défricher tant subsistent de nombreux angles morts.
Corps cassés : le regard d’un médecin du travail
Authors: Chappart Pascaline , X
Published: September 2024

La Docteure X suit près de 2500 salarié·es du secteur du nettoyage, mais aussi de l’hôtellerie. Elle observe, quotidiennement, les conséquences dramatiques, tant médicales que sociales, de l’externalisation du travail dans ces domaines d’activité. D’année en année, les cadences infernales brisent un peu plus les corps de ces travailleuses et travailleurs. Et, comme elle l’observait en aparté, on ne les nomme pas « les invisibles » par hasard.
La lutte oubliée des travailleuses immigrées de l’Insa de Lyon en 1979
Authors: Doré Lison
Published: September 2024

En 1979, à l’Institut national des sciences appliquées (Insa) de Lyon, une quarantaine de femmes de ménage immigrées, employées par une agence de sous-traitance, mènent une grève illimitée. Cette mobilisation, point de rencontre de plusieurs forces militantes, dialogue avec les protestations contre les débats législatifs en cours (loi Bonnet) et visibilise les oppressions combattues par des femmes immigrées, travailleuses en lutte trop longtemps tombées dans l’oubli.
La souveraineté à l’épreuve de l’Europe
Authors: Spector Céline
Published: September 2024

Cette contribution entend défendre l’émergence d’une forme de souveraineté européenne. Pour des raisons géopolitiques d’abord, au regard des menaces créées par la résurgence des empires. Et pour des raisons politiques ensuite : afin que l’intégration européenne puisse créer des obligations positives, telles que la protection sociale et environnementale, un régime fiscal, voire une défense commune, sans mettre en péril la démocratie, il est impératif de concevoir une souveraineté républicaine à l’échelle de l’Union – ce que l’on nommera, dans le sillage de Montesquieu, une « République fédérative européenne ».
La souveraineté budgétaire dans l’Union européenne
Authors: Martucci Francesco
Published: September 2024

Dans le système constitutionnellement intégré formé par l’Union et les États membres, la souveraineté budgétaire se déploie dans une subtile interaction entre les niveaux européen et nationaux. Si la politique budgétaire demeure de la compétence des États membres, ces derniers l’exercent dans le cadre du Semestre européen, dont la vocation, originellement disciplinaire, est désormais davantage d’orienter les politiques économiques nationales. Plutôt qu’un fédéralisme budgétaire, il faut y voir un pluralisme constitutionnel financier.
Le rejet de la constitution européenne, ou la fin d’un rêve politique
Authors: Levade Anne
Published: September 2024

Avec vingt ans de recul, le rejet de la constitution européenne ne peut se résumer à la chronique d’une mort annoncée. Le traité établissant une constitution pour l’Europe était l’aboutissement d’un projet au long cours dont l’ambition était résolument constitutionnelle et, par conséquent, politique. Son échec est d’abord celui d’un rêve politique européen qui est durablement brisé mais aussi le symptôme d’une crise du modèle de l’État de droit démocratique.
Penser la résilience climatique dans les organisations : un enjeu de « durabilité »
Authors: Benoit Benjamin , Maurel Christophe
Published: September 2024

L’innovation du modèle d’affaires ou business model (BM) joue un rôle important. Adoptant une perspective historique et privilégiant le prisme du pilotage organisationnel, cette contribution s’intéresse à un concept sur lequel il y a encore peu de consensus mais une nécessité de réflexion tant les organisations publiques et privées y sont confrontées, celui de la résilience climatique organisationnelle. Proposant des définitions de la résilience organisationnelle et de la résilience climatique organisationnelle, cette recherche souligne le mouvement de fond qui est à l’œuvre et se traduit par l’essor de textes réglementaires, d’outils comptables et de dispositifs de reporting durable qui permettent d’identifier et de tracer les enjeux qui sont à l’œuvre. Si la dimension technique des outils et des modalités d’évaluation est interrogée, il faut aussi souligner l’importance des jeux d’acteurs et de leur engagement.
Optimized Received Signal Strength-Based Radio Map Interpolation for Indoor Positioning Systems
Authors: Khoo Hui Wen , Ng Yin Hoe , Tan Chee Keong
Published: September 2024

The most viable strategy to establish a dependable indoor positioning system is by employing the received signal strength (RSS) based fingerprinting technique, which encompasses both the offline and online phases. The offline phase involves constructing a radio map, which can be arduous in vast indoor environments. To tackle this, radio map interpolation is often used to interpolate RSS by utilizing the RSS recorded at a coarser level of known reference points (RPs). This paper proposes a novel RSS-based radio map interpolation to enhance the existing inverse distance weighting (IDW) interpolation technique. The method divides the deployment area into zones and optimizes the density of known RPs in each zone based on the number of access points (APs) with average RSS exceeding the threshold. It allocates higher RP density for the zones with poor AP coverage and reduces it for well-covered zones. Results demonstrates that the proposed method achieves substantial improvements over the baseline IDW scheme in average positioning error of up to 6.58% at the floor level and 3.77% overall.
The Gut Microbiota characterization of a World-Class Mountain Trail runner during a complete competition season: a case report
Authors: Álvarez-Herms J , Burtscher M , González-Benito A , Corbi F , Odriozola-Martínez A
Published: September 2024

In the present case study, the gut microbiota (GM) profile of a male Elite Mountain Runner (34 years, 171cm, 59 kg, VO2max: 92 mL·min−1 ·kg−1) was analyzed over 5 months competitive period (6 samples). The GM diversity increased through the season coinciding higher levels to the peak performance and shorter and longer race (42 vs. 172 km) produced different phenotypic GM changes. Shorter race promoted the elevation of protective bacteria related to positive benefits (higher production of short-chain fatty acids (SCFAs), lactate resynthesis, mucin degraders). In contrast, longer race promoted an elevation of opportunistic pathogenic bacteria while reducing protective commensal bacteria. The present findings indicate that a higher resilience of the GM after competitions may support rapid recovery from maximal exercise. The GM analyses pre- and post-competition could represent a rapid indicator for the (patho)physiological impact of exercise and provide information on gut health and recovery time needed.
Multi-drug resistant tuberculosis: A moral dilemma
Authors: Ogunbanjo Gboyego A. , Knapp van Bogaert Donna
Published: September 2024

No abstract available.
Saving the history of the defeated and the lost - ethical dilemmas in the midst of the AIDS epidemic
Authors: Cameron D.
Published: September 2024

No abstract available.
FaMEC - the first three years
Authors: De Villiers Pierre
Published: September 2024

No abstract available.
Men who behave voilently ask for help
Authors: Jobson Roy
Published: September 2024

No abstract available.
General Practice in Ireland
Authors: Couper I.
Published: September 2024

This article reports on the way general practice functions in the Republic of Ireland, based on a personal experience of working in that context. It describes the health care system in Ireland and the way that general practice fits in, the role of hospitals in relation to this, and the system of training for the general practice.
Nomenclature: Appropriateness of Primary Health Care Physician
Authors: Mhlongo S.W.P.
Published: September 2024

No abstract available.
Monitoring of Human Rights in the Health Sector
Authors: Pillay K. , De Villiers M.R.
Published: September 2024

Monitoring of human rights in the health sector is of crucial importance to ensure the effective realisation of these rights, especially in the light of human rights i6uses in the history of our country. Monitoring means comprehensive efforts to collect appropriate data to determine whether performance of institutions or individuals conforms to accepted human rights standards. Monitoring can take place by means of a number of strategies and at different levels, considering certain'' preconditions for monitoring. This article outlines information on mechanisms for monitoring of human rights. Furthermore it seeks to raise relevant issues that warrant further consideration in order to inform an effective approach to the monitoring of human rights in the health sector.
Redefining 'unity' - is there a third way?
Authors: De Villiers Pierre J.T.
Published: September 2024

No abstract available.
Rural Medicine in Namibia: The story of Frans at Opuwo
Authors: Kellerman Gerda
Published: September 2024

No abstract available.
The Hand Patient: Ganglion of the Flexor tendon sheath
Authors: Mennen Ulrich
Published: September 2024

No abstract available.
Qualitative research across boundaries of language: The representation of lived experiences
Authors: Calvert G.
Published: September 2024

Background: Qualitative methodology has a growing importance in primary care research, reflected in projects submitted for the degree of MFamMed at The Medical University of Southern Africa (Medunsa). These projects were completed in multilingual settings and sought highly subjective information.This paper aimed to demonstrate how researchers handled issues of language within their work.Methods: All dissertations successfully submitted for the degree of MFamMed at Medunsa between 1993 and 2000 were examined.Those using a predominantly qualitative methodology were subject to content analysis.Results: Researchers acknowledged issues of language and developed a range of strategies to ensure the faithful representation of their subjects' beliefs and attitudes in the language of the final dissertation.Conclusions: Working across boundaries of language presents a potential threat to the faithful representation of qualitative data. Examination of these examples of qualitative research point to some ways in which loss of meaning may be minimised.The paper calling for a close examination of issues of language in research of this nature.
Subacute parkinsonism induced by immune checkpoint inhibitors
Authors: Silva Lénia , Laranjinha Inês , Casais Cláudia , Samões Raquel
Published: September 2024

Immune checkpoint inhibitors can trigger immune-related side effects, and while neurological involvement is rare, it can be serious. A woman with treatment-refractory intestinal T-cell lymphoma was initiated pembrolizumab and developed a daily fever and parkinsonian syndrome 2 weeks later. The investigation revealed only mild slowing of the background activity on electroencephalogram and slightly elevated cell count and protein levels in her cerebrospinal fluid. Immunotherapy was discontinued, and the patient recovered after 5 days of methylprednisolone. Minor neurological symptoms recurred after the rechallenge with pembrolizumab. Subacute parkinsonian syndromes should be considered a potential neurological event related to immune checkpoint inhibitors.
Flaxseed Oil, Casitose, and Its Combination Diets Increase Antioxidant Activity and Upregulates Aging-related Genes in Drosophila melanogaster
Authors: Jayaraj Indhuja , Sathyamurthy Vijaya Harini , Sankar Sudharsan , Ramasamy Selvaraj , Velraja Supriya , Parvathi Venkatachalam Deepa
Published: September 2024

Background:

Nutrigenomics refers to the study of how diet influences the genomic expression and function of an organism. Diet is a significant factor that impacts metabolism, aging, and lifespan. Long-term dietary patterns can influence the risk of age-related diseases, including diabetes, cardiovascular diseases, hypertension, and cancer. While research in Drosophila melanogaster has focused on areas such as calorie restriction, high-sugar and high-fat diets, micronutrients, and disease-specific nutritional interventions, the effects of different combinations of macronutrients have not been adequately studied. This study aimed to analyze the impact of individual macronutrients, specifically flaxseed oil (a source of fat) and casitose (hydrolyzed milk protein), as well as their combinations, on longevity, antioxidant activity, and the expression of aging-related genes in D. melanogaster.

Methods:

The study examined the in vivo effects of different concentrations of flaxseed oil (120 μl, 240 μl, 480 μl, and 960 μl), casitose (125 mg, 250 mg, 500 mg, and 1000 mg), and their combinations with a base diet on longevity, antioxidant activity, and the expression of aging-related genes, namely manganese superoxide dismutase (Mn-SOD or SOD1) and copper–zinc SOD (Cu-Zn SOD or SOD2) in D. melanogaster.

Results:

The study found that flaxseed oil, casitose, and their combinations increased lipid peroxidation (LPO) activity, leading to the production of reactive oxygen species. However, these substances also enhanced the activity of the antioxidant enzymes SOD and catalase, which help combat-free radicals. Furthermore, the gene expression of SOD1 and SOD2 was upregulated, suggesting a potential mechanism for the observed improvements in lifespan. Interestingly, high doses of flaxseed oil (960 μl) were associated with decreased lifespan in the flies.

Conclusion:

The findings indicate that the optimal levels of flaxseed oil, casitose, or their combination can increase lifespan in Drosophila by upregulating the expression of the antioxidant enzymes SOD1 and SOD2. This provides insights into the potential of targeted nutrient combinations as a dietary approach to combat aging-related diseases.
Neurobiological Definition of Intelligence: A Neuroscience Review
Authors: Aghanouri Reza
Published: September 2024

Intelligence is a complex cognitive trait that has long intrigued researchers across disciplines. Recent advances in neuroscience have provided insights into the neurobiological underpinnings of intelligence. This review examines the neurobiological definition of intelligence, focusing on the neural processes and brain regions associated with cognitive functions such as reasoning, problem-solving, memory, and learning. Key findings include: (I) prefrontal cortex plays a crucial role in higher cognitive functions such as decision-making, planning, and working memory, with larger prefrontal cortex volume correlating with better fluid intelligence performance; (II) parietal cortex is implicated in mathematical reasoning and spatial processing, essential for problem-solving and abstract thinking; (III) hippocampus, critical for memory formation and retrieval, is linked to intelligence through its role in cognitive task performance; and (IV) neuroimaging studies reveal that higher intelligence scores are associated with increased connectivity between brain regions, suggesting more efficient information processing. Understanding the neurobiological basis of intelligence can provide valuable insights into human cognition and inform interventions to enhance cognitive functioning. Further research is needed to unravel the complexities of intelligence and its neural substrates.
Impact of Hyperhomocysteinemia on Cytokine and Matrix Metalloproteinases Contents in Rat Skeletal Muscle
Authors: Kravchenko Olha , Nataliia Raksha , Oleksandra Kostiuk , Oleksandra Liashevska , Oksana Tiron , Oleksandr Maievskyi
Published: September 2024

Background:

High levels of homocysteine (Hcy) in the blood (hyperhomocysteinemia [HHcy]) are associated with many pathologies, including atherosclerosis, coronary heart disease, stroke, neurological disorders, and a decrease in muscle mass and strength. The present study aimed to evaluate the levels of pro- and anti-inflammatory cytokines and matrix metalloproteinases (MMPs) in skeletal muscle of rats with experimental HHcy.

Methods:

HHcy in rats of two age groups was induced by intragastric administration of D, L-thiolactone Hcy for 8 weeks. The criterion for the development of pathological conditions was a blood Hcy level above 15 mmol L−1. Cytokine and MMP levels in muscle homogenate were determined by enzyme-linked immunosorbent assay.

Results:

The findings of the study on the content of pro-inflammatory cytokines in skeletal muscles of rats with hyperhomocysteinemia indicated the following. For immature rats, the greatest reduction in tumor necrosis factor-α and interleukin-8 (IL-8) content was observed, whereas, for mature individuals, the most pronounced decline in IL-1b was evident in skeletal muscle tissue under the pathology state. The content of anti-inflammatory interferon-γ was also reduced in the muscles of both age groups by 30% compared to the control, besides a decrease in the content of collagenase MMP-1 was also observed.

Conclusions:

The presence of HHcy is associated with metabolic changes in skeletal muscles, which can result in a depletion of cytokines and a slowing down of proteolytic remodeling. This, in turn, can lead to the development of muscular abnormalities, including dysfunction, weakness, and muscle degeneration.
Association of Serum Biomarkers with C-X-C Motif Chemokine Receptor 3 Gene Polymorphism and Severity of Coronavirus-2019 Infection
Authors: Adiga Usha Sachidananda , Adiga Sachidananda Narasimha , Rai Tirthal Rathnakar
Published: September 2024

Background:

Polymorphisms in the C-X-C motif chemokine receptor 3 (CXCR3) gene may impact the immune system’s reaction to infections such as coronavirus disease-19 (COVID-19). Nevertheless, a detailed analysis of the precise influence of CXCR3 gene polymorphisms on COVID-19 has not yet been conducted. This study aims to determine the genotype distribution of three specific CXCR3 gene polymorphisms (rs770806154, rs776323716, and rs778526136) and their potential association with the severity of COVID-19.

Methods:

One hundred COVID-19 patients were enrolled after the study protocol was approved by institutional ethical clearance. Selection of single-nucleotide polymorphisms was based on the bioinformatics analysis; CXCR-3 receptor (rs770806154, rs776323716, and rs778526136) polymorphism was analyzed by sequencing. D-dimer, ferritin, and erythrocyte sedimentation rate were estimated by Cobas C-311. Chi-square analysis was used to find the association of gene polymorphisms with the severity of infection and clinical parameters. P <0.05 was considered statistically significant.

Results:

Significant deviations from Hardy–Weinberg equilibrium for all three gene variations were observed and a significant association of CXCR3 (rs778526136) gene polymorphism with D-dimer levels and COVID-19 severity was observed. However, the other genotypes had no significant association with disease severity.

Conclusion:

A significant association was observed between the severity of COVID-19 and CXCR3 (rs778526136 variant) gene polymorphisms. The lower severity of COVID-19 is linked to the rs778526136 mutant genotype, indicating a protective effect. Hence, emphasizing the possibility that genetic factors could affect the course of COVID-19 and genetic screening could thus help in controlling COVID-19 severity.
Accuracy of Noninvasive Intracranial Pressure Monitoring in Patients with Subarachnoid Hemorrhage
Authors: Seddighi Amir Saied , Seddighi Afsoun , Zali Alireza
Published: September 2024

Background:

Subarachnoid hemorrhage (SAH) can lead to elevated intracranial pressure (ICP), which poses significant risks of morbidity and mortality. Monitoring ICP is crucial for the early detection and management of these complications in patients with aneurysmal SAH (aSAH). Traditional invasive ICP monitoring techniques, while effective, carry risks associated with infection and other complications. The Schmidt method, a noninvasive ICP monitoring technique, has emerged as a potential alternative to provide reliable measurements without the inherent risks of invasive methods.

Methods:

From January 2018 to December 2023, the authors performed both invasive (intraventricular catheters) and noninvasive (Schmidt method) ICP monitoring in patients with aSAH and Hunt and Hess (H and H) scores of 3–5. Patients requiring emergent craniotomy, with serious medical comorbidities or coagulopathies, or with noncompliance were excluded from the study. The accuracy and efficacy of the Schmidt method were evaluated by comparing the results of noninvasive monitoring with the results of invasive ICP monitoring.

Results:

Out of 238 cases with aSAH referred to our neurosurgical center, 105 had H and H scores of 3–5. Noninvasive ICP monitoring using the Schmidt method was performed in 86 cases (48 females, 38 males; mean age 68 ± 8 years). The mean ICP measured by the invasive method was 15.2 ± 6.2 mmHg, whereas the mean ICP measured by the noninvasive method was 16.6 ± 5.4 mmHg. The calculated root mean square error was 3.6 mmHg, and the average Pearson correlation between the estimated and real waveforms was 0.96.

Conclusion:

The findings of this study suggest that the application of the Schmidt method is a reliable and accurate approach for the assessment of ICP in patients with SAH, potentially eliminating the need for invasive ICP monitoring and reducing the associated risks.
Unveiling bone marrow cryptococcosis in an immunocompetent child: A rare case presentation
Authors: Singh Shalini , Hajra Subhajit , Kumar Vinod , Balasubramanian Priyavadhana
Published: September 2024

Cryptococcal infection is less common in immunocompetent hosts and almost always occurs in the setting of HIV disease. Disseminated Cryptococcosis in a child is a fatal condition and often requires a prompt diagnosis and appropriate antifungal therapy to improve patient outcomes. Here, we present a case of bone marrow Cryptococcal infection in a 4-year-old female child. She presented clinically with fever, abdominal pain, and hepatosplenomegaly for a duration of two and a half months. A bone marrow aspiration and trephine biopsy was performed with a suspicion of haemato-lymphoid malignancy. However, bone marrow aspirate smears revealed bone marrow Cryptococcosis which was later confirmed by special stains. She was treated with liposomal amphotericin B (3 mg/kg) and flucytosine (100 mg/kg/day). A comprehensive approach including clinical symptoms, examination findings, imaging studies, and laboratory tests is crucial in establishing an early diagnosis of Cryptococcosis, particularly with atypical presentations.
Foreign body pulmonary vessel embolism and granulomatosis in intravenous drug abuse: An autopsy study
Authors: Kaur Manveen , Punia RPS , Mohamedali Rasheeda , Chatterjee Debajyoti , Bhagat Ranjeev , Aggarwal Phiza , Handa Uma , Singh Amandeep
Published: September 2024

The abuse of illicit drugs causes a myriad of systemic complications. Intravenous (IV) injection of such drugs poses various additional threats, primarily due to the use of excipient materials in them. Pulmonary artery embolism with foreign material and granulomatosis may be encountered in the lungs on histopathological examination in such cases. In this study, we aimed to analyze the histopathological findings in lungs in postmortem specimens with suspected IV drug abuse. This was a retrospective study of 5 years in which 15 cases of known or suspected history of drug abuse were assessed. The clinical details were compiled, and the hematoxylin and eosin (H and E)-stained microscopic slides were retrieved from the archives for reviewing the histopathological features in lungs submitted for postmortem analysis. All the cases were male, aged 21 to 36 years (median: 27 years). Gross examination revealed edematous lungs in four cases (26.6%). On microscopic examination of the lungs, all the cases (100%) showed the presence of basophilic irregular structures to rod-like pale crystalline refractile material, which was accompanied by a granulomatous reaction in the lumen of the pulmonary arteries. Four of these cases (26.6%) showed birefringence on polarizing microscopy. The use of illicit drugs is becoming widespread, especially among young individuals. IV drug abuse increases the rate of morbidity and mortality by affecting primarily the pulmonary vasculature, particularly pulmonary arteries. An acquaintance with the various patterns of pulmonary involvement in IV drug abuse is essential to arrive at an accurate pathological diagnosis and provide a possible cause of death in such cases.
Potential predictor of prognosis in breast carcinoma: Tumor budding
Authors: Usta İnci , Yalta Tülin D. , Can Nuray , Süt Necdet , Taştekin Ebru , Puyan Fulya Ö. , Usta Ufuk , Erdoğan Ezgi G. , Demirtaş Elif M. , Bağış Merve , Özcan Erkan , Çiçin İrfan
Published: September 2024

Background:

Breast cancer is the most common cancer in women, with invasive breast carcinoma of no special type (IBC-NST) accounting for the majority of cases.

Aim:

This study aimed to evaluate the relationship between tumor budding (TB), which is the earliest histological indicator of tumor spread and represents epithelial–mesenchymal transition, and prognostic factors as well as the effect of TB on survival in patients with IBC-NST, thereby demonstrating its potential prognostic value.

Materials and Methods:

This study included 278 cases of breast resection diagnosed with IBC-NST from 2014 to 2019. Total tumor buds were counted in 10 high-power fields of a hematoxylin and eosin–stained section with the most infiltrative area at 400× magnification. The cutoff value for TB was obtained using receiver operating characteristic analysis for mortality and recurrence risk; this cutoff value was used to classify TB into two categories: low and high grades. The relationship between TB and prognostic factors and the effect of TB on the survival of patients were investigated.

Results:

This study revealed a statistically significant relationship between high-grade TB and increased tumor size, advanced pathological primary tumor (pT) category, lymph node metastasis, lymphatic invasion, blood vessel invasion, increased recurrence, and mortality as well as reduced overall and disease-free survival.

Conclusion:

TB in breast carcinomas may have significant predictive value for prognosis. It emerges as a simple, reproducible, and cost-effective histological marker. With the standardization of evaluation criteria, TB may be readily integrated into routine pathological examination, thereby increasing its value in clinical patient management.
The NF1 gene mutations and co-mutations in lung adenocarcinomas with brain metastasis
Authors: Kahraman-Cetin Nesibe , Akin Dilara , Orenay-Boyacioglu Seda , Boyacioglu Olcay , Erdogdu Ibrahim Halil , Oktay Esin , Meteoglu Ibrahim
Published: September 2024

Background:

The co-occurrence of lung adenocarcinoma and brain metastasis remains a significant cause of morbidity and mortality despite advancements in cancer treatment. The activity of neurofibromin, the product of Neurofibromatosis Type 1 gene (NF1), is crucial in regulating the RAS/MAPK pathway. The NF1 somatic mutations are significant in conditions such as melanoma, lung cancer, breast cancer, neuroblastoma, and central nervous system tumors.

Objective:

Therefore, this research aims to uncover the profile of NF1 mutations and co-mutations in patients with brain metastases from lung adenocarcinoma, shedding light on their role in the pathophysiology of metastatic lung cancer.

Materials and Methods:

In this study, a total of 131 (31 females, 90 males) patients diagnosed with metastatic lung adenocarcinoma who were examined in the Molecular Pathology Laboratory between 2019 and 2022 were retrospectively analyzed. The NF1 somatic mutations and co-mutations were evaluated using the NGS lung panel on the MiniSEQ NGS platform.

Results:

The average age of the 131 patients (31 females, 90 males) retrospectively examined in the study was 62.05 years. The ages of the cases included in the study followed a normal distribution according to Kolmogorov–Smirnov test (P = 0.200). Lymph node metastasis was detected in 48 patients (36.6%), while distant organ metastasis was observed in 81 patients (61.83%). Metastases were more frequently seen in males. No statistically significant difference was found between metastases and gender (P > 0.05). Distant organ metastasis (n = 26, 19.8%) and NF1 mutations (n = 8/26, 30.77%) were most commonly observed in the brain. The most common NF1 pathogenic variants in brain metastases were c.2325 + 3A > G (p.M1205fs*12) (n = 6/26, 23.07%) and c.1400C > T (p.T4671) (n = 5/26, 19.23%). There was no statistically significant relationship observed between patients’ age, gender, brain metastasis, and NF1 mutation types (respectively, P = 0.98, P = 0.63, and P = 0.87). The mutations that showed the most association with NF1 mutations in brain metastases were PTEN and TP53.

Conclusions:

Somatic NF1 mutations and co-mutations can play a critical driving force in metastatic lung adenocarcinoma and may contribute to treatment resistance. The mutational landscape of somatic NF1 mutations and co-mutations can provide new insights into the pathophysiology of metastatic lung cancer, especially those that have metastasized to the brain.
The effect of different clinical recycling methods on load deflection properties of super-elastic and thermal nickel–titanium orthodontic arch wires: A comparative assessment
Authors: Shukla Priti , Kapoor Sudhir , Jaiswal Raj Kumar , Sharma Vipul Kumar , Shashtri Dipti , Bhagchandani Jitendra
Published: September 2024

INTRODUCTION:

Repeated clinical use of arch wires requires sterilization and may result in alteration of the properties of the wires as they get subjected to corrosion and cold working. Therefore, the present study aimed to assess the effects of different clinical recycling methods on the load-deflection properties of super-elastic and thermal nickel–titanium orthodontic arch wires.

MATERIALS AND METHODS:

A total of 50 0.014” round nickel–titanium orthodontic wires [Group I: super-elastic nickel–titanium (n = 25) and Group II: thermal nickel–titanium wires (n = 25)] were tested for changes in their load deflection properties after three different recycling methods, that is, dry heat sterilization, autoclave, and cold sterilization. For each group, five wires as received from the manufacturer were taken as control (T0), and the rest of the 20 wires were placed intra-orally for a duration of one cycle of clinical use (T1). Five wires out of these were subjected to 3-point bending tests, and the rest of the wires were subjected to different recycling methods. Load deflection properties of recycled wires were measured with an Instron universal testing machine. The results were tabulated, and the data were analyzed by analysis of variance (ANOVA) with the Tukey post hoc test.

RESULTS:

Statistically, no significant difference was found in the super-elastic group between samples recycled by dry heat, autoclave, and cold sterilization when compared with as-received super-elastic NiTi up to 2.5 mm of deflection. A highly significant difference was found between as-received thermal NiTi group (83.51 ± 6.49 N/mm) and samples recycled by dry heat (53.73 ± 4.72 N/mm), autoclave (45.38 ± 4.37 N/mm), and cold sterilization (48.44 ± 3.12 N/mm) at 0.5 mm of deflection.

CONCLUSION:

Among thermal NiTi, any of the sterilization methods could opt at all deflections. For super-elastic NiTi, at higher deflections or in cases of crowding of more than 2.5 mm, cold sterilization should be the method of choice, whereas any sterilization method can be used at deflections less than 2.5 mm.
Cephalometric differences in grades II and IV adenoid hypertrophy: A cross-sectional study
Authors: Hammood Afnan R. , Saloom Hayder F.
Published: September 2024

OBJECTIVES:

This study aims to determine whether there were cephalometric changes between grades II and IV adenoid hypertrophy.

METHODS AND MATERIALS:

A cross-sectional study was conducted on 120 6–12-year-old patients selected from the ear, nose, and throat department at Imam Al-Hussein Medical City in Karbala. Patients were classified into three groups (each = 40) based on endoscopic findings: control, grade II, and grade IV. The findings were confirmed with cephalometric radiographs. Specific cephalometric points were identified to measure sella-nasion-point A (SNA), sella-nasion-point B (SNB), point A-nasion-point B (ANB), sella-nasion-pogonion (SNPog), sella nasion plane-palatal plane (SNPP), palatal plane-mandibular plane (PPMP), sella nasion plane-mandibular plane (SNMP), saddle, articular, gonial angles, and the y-axis. Additionally, superior-posterior airway space (SPAS), posterior air way space (PAS), mandibular plane-hyoid bone (MP-H), third cervical vertebra-hyoid bone (C3-H), total anterior facial height (TAFH), total posterior facial height (TPFH), upper anterior facial height (UAFH), lower anterior facial height (LAFH), and the Jarabak ratio were measured.

RESULTS:

Analysis of variance (ANOVA) and Welch tests indicated statistically significant differences (P < 0.05) among the three groups in SNA, SNB, SNPog, PPMP, SNMP, gonial angle, y-axis, SPAS, PAS, MP-H, and the Jarabak ratio. Tukey’s honestly significant difference (HSD) and Games-Howell tests indicated a statistically significant difference between grade II and grade IV in SNA, SNMP, y-axis, SPAS, PAS, MP-H, and Jarabak ratio.

CONCLUSION:

The present study demonstrated that craniofacial changes start to occur at the moderate adenoid enlargement throughout the downward backward mandibular rotation. More changes would become evident at the severe stage; therefore, an urgent medical intervention and the establishment of nasal breathing by orthodontic treatment with breathing activity would be needed.
Effect of transcutaneous electrical nerve stimulation therapy on condylar position and myofascial pain in patients with temporomandibular joint disorders—A pilot clinical trial
Authors: Rebekah R , Navaneethan R , Nagachandran KS
Published: September 2024

OBJECTIVE:

Temporomandibular joint disorders (TMD) are a type of disorder that affects the temporomandibular joint, muscles, and nerves leading to persistent facial pain. Transcutaneous electrical nerve stimulation (TENS) therapy is an alternative treatment for pain relief in TMD patients. The aim of the study was to assess the condylar position changes and pain levels occurring in TMD patients after TENS therapy.

MATERIALS AND METHODOLOGY:

According to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) criteria, a total of seven patients with TMD were included in this study. Routine diagnostic investigations were taken for each patient along with joint vibration analysis (JVA), electromyography (EMG), and a cone beam computed tomography (CBCT) at rest position. Using the Dolphin software (version 11.95), the temporomandibular joint spaces were measured on the CBCT for the right and left sides individually for each patient. These patients were then subjected to TENS therapy, and an EMG reading was taken post-TENS therapy to evaluate the effect on muscle strain. A CBCT was taken after the TENS therapy to assess its effect on the condylar position. The statistical significance of the pre- and post-temporomandibular joint spaces and the EMG readings post-TENS therapy were assessed using paired t-tests, respectively.

RESULTS:

There was a change in the anterior, middle, and posterior dimensions observed radiographically, before and after TENS. However, the results were found to be statistically significant only in the anterior region on the right joint space (P = 0.03) and posterior region of the left joint space (P = 0.04).

CONCLUSION:

TENS therapy has been found to bring about a change in the condylar position and pain intensities by relieving inadvertent muscle activity in the temporomandibular region. Therefore, further studies with larger sample sizes and control are required to fully ascertain the role of inadvertent muscle activity on the TMJ.
Evaluation of surface roughness, cytotoxicity, and antibacterial effects of silver nanoparticle coating on copper nickel titanium orthodontic arch wires – in vitro study
Authors: Anishya Daphane , Jain Ravindra K.
Published: September 2024

BACKGROUND:

Surface roughness of arch wires directly impacts their corrosion behavior, friction resistance, and plaque accumulation, which may hinder tooth movement and lead to dental caries.

OBJECTIVES:

The study aims to synthesize vanillin-mediated silver nanoparticles (AgNPs), characterize them, assess surface roughness and cytotoxicity of arch wires after silver nanoparticle coating, and test their antibacterial properties.

MATERIALS AND METHODS:

Nine copper–nickel–titanium arch wires (CuNiTi) were cut into equal pieces. Three were sent for surface roughness assessment, three for cytotoxicity, and three for antibacterial testing. Dip coating of wires was done using the sol–gel thin film method. The surface roughness (Ra) before and after coating was evaluated using scanning electron microscopy and atomic force microscopy. Cytotoxicity testing was done with a (3- (4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay using gingival fibroblasts. Statistical analysis was done using SPSS software. Antibacterial activity against S. mutans was tested using the Agar-well diffusion method.

RESULTS:

The CuNiTi wires were coated successfully, and the coating appeared homogeneous. The mean Ra after coating (297.3+/- 30.4 nm) was significantly less than that before coating (339.7+/-49.2 nm). AgNPs showed minimal cytotoxicity against human gingival fibroblasts at different concentrations. Optical microscopy showed over 90% viability between 12.5 and 100 µg/ml. At 100 µg/ml, only 80% of cells remained viable. AgNP coating is biocompatible at concentrations up to 75 µg/ml. There was a significant intergroup difference in the zone of inhibition (antibacterial activity) noted with higher values in noncoated wires. (P value <0.007).

CONCLUSION:

AgNPs coated on CuNiTi arch wires showed reduced surface roughness and minimal cytotoxic effects on human gingival cells and good antibacterial activity against S. mutans compared to noncoated arch wires.
Determinants of decision-making in biopsy of PI-RADS 3 transition zone lesions
Authors: Wee Nicole Kessa , Tan Cher Heng , Choo Zhen Wei , Lee Chau Hung
Published: September 2024

Introduction:

Cancer rates for Prostate Imaging-Reporting and Data System (PI-RADS) 3 lesions are low. We aimed to determine the clinical and magnetic resonance imaging (MRI) parameters that can provide risk stratification for PI-RADS 3 transition zone (TZ) lesions to guide decision for biopsy, which can improve the cost-effectiveness of resource utilisation.

Methods:

The MRI scans of all patients who underwent MRI–ultrasound fusion targeted biopsy from 1 May 2016 to 31 December 2022 were retrospectively assessed by two board-certified abdominal radiologists. The following data were collected and analysed serum prostate-specific antigen, Prostatic Health Index (PHI), prostate volume, histological results, lesion size, location, diffusion-weighted imaging (DWI) parameter scores and overall PI-RADS score.

Results:

Two hundred and fourteen TZ lesions were included. Among 131 PI-RADS 3 lesions, those with marked restricted diffusion (DWI score ≥4), diameter ≥1 cm, prostrate-specific antigen density (PSAD) ≥0.11 and PHI ≥34 were more likely to contain clinically significant prostate cancer (csPCa; P = 0.04, 0.02, 0.049 and 0.05, respectively), with areas under the receiver operating characteristics curve of 0.9, 0.76, 0.84 and 0.80, respectively. Apical lesions were more likely to contain csPCa compared to midgland or basal lesions (P = 0.01).

Conclusion:

Clinical parameters (PSAD and PHI) and MRI features (lesion size, DWI score, lesion location) can be used to risk stratify PI-RADS 3 TZ lesions and guide decision for targeted biopsy.
Clinical Features of Behçet’s Disease Uveitis
Authors: Yalçindag Nilüfer , Oklar Murat
Published: September 2024

Behçet’s disease (BD) is a chronic, multisystemic vasculitis first described by Professor Hulusi Behçet in 1937. It is characterized by recurrent inflammatory attacks affecting multiple organs, with uveitis being a significant and severe complication that can lead to blindness. BD typically emerges between the ages of 20 and 30 years, with a higher prevalence in males and rare occurrences in children. The prevalence and severity of BD and its ocular symptoms tend to diminish with age. In Turkey, BD is a leading cause of noninfectious uveitis, and its prevalence varies across different regions. Ocular involvement, seen in up to 90% of BD patients, often appears 2–4 years after disease onset and may be the initial sign in 10%–20% of cases. BD uveitis is characterized by recurrent nongranulomatous panuveitis and retinal vasculitis, typically affecting both eyes. Diagnostic tools such as fluorescein angiography (FA), optical coherence tomography (OCT), and laser flare photometry (LFP) are essential for monitoring disease activity and guiding treatment. FA is crucial for identifying occlusive and leaky vasculitis, while OCT helps in detecting macular complications and visualizing retinal infiltrates and their sequelae. LFP quantitatively evaluates intraocular inflammation. Recognizing the ocular manifestations of BD early is vital for accurate diagnosis and effective management. This review highlights the clinical features, diagnostic tools, and importance of early diagnosis in managing BD uveitis.
“Don’t miss the globe” – Study of diagnostic accuracy of computed tomography in detecting open globe injury
Authors: George Georgina , Monteiro Berton C. , Noronha Dilon D. , Mijar Mahesh , Karanth Krishna K. S.
Published: September 2024

PURPOSE:

The purpose is to determine the computed tomography (CT) characteristics of open globe injury and establish the relative accuracy and reliability of various features on CT. Second, to assess the significance of a difference in the anterior chamber depths (ACDs) on CT in cases of open globe injury.

METHODS:

The diagnostic database of our radiology department was retrospectively reviewed to obtain details of patients with a history of blunt or penetrating injury to the orbit between September 2018 and March 2021. A total of 190 patients (144 males and 46 females) were included. A radiologist analyzed the CT scans without prior knowledge of ophthalmologic findings or surgical outcomes. Operative and ophthalmic examination findings were considered the gold standard for comparison.

RESULTS:

Out of 190 injured globes, the final clinical diagnosis confirmed 54 (28.4%) open globe injuries and 136 (71.5%) closed globe injuries. Between the two groups, intraocular hemorrhage, lens dislocation, lens injury or absence, intraocular foreign body, intraocular air, wall/contour defect, and ACD change were considered statistically significant (P < 0.05). The average sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in diagnosing open globe injury were 71.3%, 98.5%, 83.6%, 95.75%, and 94.9%, respectively.

CONCLUSION:

Globe contour deformity or defect, intraocular hemorrhage, and a change in ACD were the three most predictive signs of open globe injury. CT is of valuable help in a multi-trauma setting and in an uncooperative patient for ophthalmological examination to draw attention to globe injury. However, CT examination alone is insufficient in detecting all cases of open globe injury. There is a need for a more collaborative approach among emergency physicians, ophthalmologists, and radiologists.
Cataract surgery with corneal endothelial pathology
Authors: Chaudhari Isha , Mehta Jodhbir S.
Published: September 2024

It is not uncommon for Fuch’s endothelial corneal dystrophy (FECD) patients to present with a co-existent cataract. Surgeons are often faced with a choice between simultaneous and staged corneal and cataract surgery. Descemet’s membrane endothelial keratoplasty (DMEK) has been found to have better visual outcomes as compared to Descemet’s stripping endothelial keratoplasty (DSEK) and penetrating keratoplasty and is currently the preferred surgery for FECD. Endothelial cell count and pachymetry cutoffs were earlier used for decision-making. Various other investigations such as Scheimpflug imaging and confocal microscopy are now used to prognosticate the outcome when performing cataract surgery only. Triple DMEK has the advantage of a definite treatment in a single sitting. Whereas, a staged approach with DMEK followed by cataract surgery has a better visual outcome. This is due to variable refractive changes in the cornea post-DMEK or DSEK that can lead to inaccurate intraocular lens (IOL) power calculation. Even though the graft detachment rates and rebubbling rates have been found to be comparable in triple DMEK versus a staged surgery, in view of increasing patient demands and expectations for a spectacle-independent outcome, a staged surgery is now preferable. Conventionally, surgeons favored the use of only monofocal lenses; however, the use of premium IOLs, especially extended depth of focus lenses, is now increasing. In this review, we will discuss the various advantages and disadvantages of a simultaneous and staged approach and pearls on decision-making in FECD with cataracts.