International Literature Data Research Articles

ESR Essentials: Imaging in colorectal cancer-practice recommendations by ESGAR.

Colorectal cancer (CRC) is a significant global health concern. Diagnostic imaging, using different modalities, has a pivotal role in CRC, from early detection (i.e., screening) to follow-up. The role of imaging in CRC screening depends on each country's approach: if an organized screening program is in place, the role of CT colonography (CTC) is limited to the study of either individuals with a positive stool test unwilling/unable to undergo colonoscopy (CC) or in patients with incomplete CC. Although CC is the most common modality to diagnose CRC, CRC can be also incidentally detected during a routine abdominal imaging examination or at the emergency room in patients presenting with intestinal occlusion/subocclusion or perforation. Staging is a crucial aspect of CRC management, guiding treatment decisions and providing valuable prognostic information. An accurate local staging is mandatory in both rectal and colon cancer to drive the appropriate therapeutic workflow. Important limitations of US, CT, and MR in N-staging can be partially solved by FDG PET/CT. Distant staging is usually managed by CT, with MR and FDG PET/CT which can be used as problem-solving techniques. Follow-up is performed according to the general recommendations of the oncological societies. CLINICAL RELEVANCE STATEMENT: It is essential to summarize each phase of colorectal cancer workup, differentiating the management for colon and rectal cancer supported by the main international guidelines and literature data, with the aim to inform the community on the best practice imaging in colorectal cancer. KEY POINTS: • Colorectal cancer is a prevalent disease that lends itself to imaging at each stage of detection and management. • Various imaging modalities can be used as adjuncts to, or in place of, direct visualization methods of screening and are necessary for evaluating metastatic disease. • Reevaluation of follow-up strategies should be considered depending on patients' individual risk of recurrence.

Efficacy and Safety of Fondaparinux Versus Enoxaparin in The Management of Unstable Angina and NSTEMI

Background: Unstable angina (UA) and Non-ST elevation myocardial infarction (NSTEMI) impose significant health and economic burden on Bangladesh. Anticoagulants are recommended as standard therapy by various clinical practice guidelines. Recent studies have shown fondaparinux's superiority over enoxaparin in patients with UA & NSTEMI, especially in bleeding reduction. The description of this finding has not yet been documented in any study from Bangladesh. This study aimed to evaluate the efficacy and safety of fondaparinux compared with enoxaparin in the management of UA & NSTEMI. Methods: This prospective observational study included 177 patients (fondaparinux=87, enoxaparin=90) with UA and NSTEMI admitted to the Department of Cardiology of Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh. The primary outcome was to determine whether fondaparinux was non-inferior to enoxaparin in preventing the composite of death, new myocardial infarction, and refractory ischemia, readmission in the hospital for heart failure within six months after anticoagulant therapy. The primary safety outcome was to evaluate the rates of major bleeds in the two groups. Results: The minor (6.9% versus 20%, p=0.002) and major (0% versus 3.3%, p=0.002) bleeding events were less frequently observed with Fondaparinux than enoxaparin. Myocardial ischemia (3.4% vs. 14.4%, p=0.011) and recurrent ischemia (11.5% vs. 24.4%, p=0.025) were less frequent in Fondaparinux than in the enoxaparin group. Fondaparinux was associated with a reduced number of deaths in 3 months (6.2% vs. 12.5%) and 6 months (5.1% vs. 13.3%) without any statistical significance (p>0.05). In the fondaparinux group, 20.7% of patients experienced a composite event within 6 months, compared with 40% of patients in the enoxaparin group (OR:0.659, 95% CI 0.500-0.867, p=0.005). Conclusion: Similarly, to recently published data in international literature, fondaparinux proved superior to enoxaparin for the Bangladeshi population, with a significant reduction of combined events and bleeding in patients with UA & NSTEMI. Bangladesh Heart Journal 2024; 39(1): 31-37

Chromosomal abnormalities in children with acute lymphoblastic leukemia

Acute lymphoblastic leukemia is the most conventional cancer in children and teenagers. In adults, this pathology is much less common. The paper presents the results of a retrospective analysis of chromosomal aberrations in clinically identified 1269 feeble children with acute lymphoblastic leukemia for the period from January 2013 to January 2023. The average age of the patients was 10.2±1.69 years. The material for the study was bone marrow and blood cells obtained from a puncture biopsy of the sternum and peripheral vein. Cytogenetic studies were carried out using the generally accepted standard method using GTG banding. The results of the analysis showed the absence of genomic and chromosomal mutations in 215 (17%) children; translocation t(1;19)(q23;p13) was detected in 75 (6%) children; in 221 (17.5%) children - t(4;11)(q21;q23); in 234 (18.5%) children - t(9;22)(q34;q11); 88 (7%) - t(12;21)(p33;q22) and 139 (11%) patients had translocations between other chromosomes. Hyperdiploid translocations were detected in 139 (11%) children. No sick children with hypodiploid cells were found. No metaphase cells were obtained from 152 patients (12%). In sick children, a relatively low frequency of optimistic predicting chromosomal abnormalities, namely t(12;21)(p13;q22) and hyperdiploid, has been established. The pervasiveness of chromosomal aberrations with a negative treatment prediction, such as t(9;22)(q34;q11.2), is consistent with the accessible international scientific literature data. The results obtained indicate the importance of cytogenetic studies in the diagnosis and predictions of children with ALL.

Is work hours' flexibility really a solution to morning peak period congestion? Comparative analysis between Paris and San Francisco

According to transport economics theory, the effect of flexible hours should be that workers spread out their starting times with the result that rush-hour travel conditions improve. But is this really what happens regardless of territorial contexts and transport systems? Paris and San Francisco region are facing serious congestion and are also the French and American cities with their countries' largest share of workers with flexible hours. In those contexts, do employees with the possibility of flexible working hours in fact avoid peak-time travel? Drawing on an international literature review and data from the national household travel surveys for the Paris region and the Metropolitan Area of San Francisco, we reveal new findings that may even appear paradoxical. Far from leading to staggered workplace arrival times, in Paris, flexible hours are associated with a significantly higher probability of arrival at work during the morning peak period. In San Francisco, flexibility has no significant impact on peak period. In an era of flexible schedules, our research tempers the idea of any systematic impact of flexibilisation oriented toward desynchronisation. It reveals that the impact of flexible hours depends on territorial dynamics, where the “social distribution of flexibility” plays an important role.

HPV-associated cervical cancer: Current status and prospects

Every year, 570,000 new cases of cervical cancer (CC) are diagnosed in the world, and 311,000 people die from this disease. CC is the fourth most common type of cancer and therefore the fourth leading cause of cancer death in women worldwide. Numerous data on the occurrence and development of cervical cancer indicate an association in most cases (up to 90 %) with human papillomaviruses (HPV) of high carcinogenic risk (HCR).CC prevention strategies are based on screening, and deaths from this oncopathology can be prevented through vaccination and treatment with early detection of the disease.In this review, much attention is paid to current issues of detection and prevention of HPV-associated pathologies, and cervical cancer in particular, aiming to summarize and analyze the latest international literature data on this issue. As a result of this study, it was shown that for countries implementing the National program of vaccination against HPV of high carcinogenic risk, a decrease in the incidence of both cervical pathologies of varying severity and other cancers associated with the HPV carriage was registered.While effective implementation of actual experience and future advances in human papillomavirus vaccine prophylaxis may make it possible for all countries to move to the high levels of vaccination coverage required to eliminate HPV-associated pathologies, the results also suggest that the path to complete cervical cancer elimination as a global public health problem can be extremely difficult due to a number of existing limitations.

Appraisal of published guidelines in European countries addressing the clinical care of childhood sexual abuse: protocol for a systematic review

IntroductionChildhood sexual abuse (CSA) is a global public health problem with potentially severe health and mental health consequences. Healthcare professionals (HCPs) should be familiar with risk factors and potential indicators...

Impact of Geographical Diversification on Credit Risk of Microfinance Organizations in Armenia

This paper analyzes the existence of relationship between credit risk and the geographical diversification of financial institutions, originating from emerging countries. Due to economic unstable situation in the world caused by Covid-19, credit portfolios of banks and MFIs caused negatively which in some situations can lead to default. In the current situation, it became necessary to discover new approaches to credit risk management and new researches to be done. For this purpose, financial indicators of MFIs operating in Armenia were evaluated and Pearson analysis of MFIs data, risks & profitability efficiency calculation was made to take out impact of diversification of MFIs on credit risk reduction. Both international literature and practical data of MFIs operating in Armenia were identified. Another research was made for taking out the number of branches and credit risk correlation. Our findings show that geographic diversification is statistically significant with the expansion of gross loans. In contrast, empirical results suggest that the geographical diversification of MFIs does not have a significant correlation with the size of the credit risk reserve, which means that the representation of MFIs in different regions in the form of branches will not always lead to credit risk reduction, and in some cases may lead to operational risks and additional costs. We adopt cost funding and assets size variables impact assessment evaluation through instrumental variables method. Our results confirm the endogenous nature of those variables with risk level of MFIs.

The role of the euro as an international currency for Polish private and public sectors - selected issues

The paper discusses the usage of the euro as a parallel currency in Poland. The aim is to assess the importance of the euro as an international currency for Polish residents, with particular emphasis on reserve and investment currency. The main stress is put on the assessment of the use of euro-denominated bank deposits and loans. The paper is based on the international literature and statistical data. Main sources of necessary data were taken from publications delivered by European Central Banka and National Bank of Poland.

Fractional treatment of rosacea by LBO 532 nm laser with “one shot” procedure: A preliminary study

Rosacea is a chronic skin disease prevalently affecting the center of the face. The permanent erythema of skin face represents its typical sign. Further common features are face flushing, telangiectasias, and inflammatory presence of oedema, papules and pustules. The aim of this study was to investigate the use of LBO 532nm laser in the treatment of this disease. Ten subjects of both sex and middle age affected by rosacea in erithemato/teleangectatic stage were treated by a LBO 532nm laser single session. Discomfort evaluation during and after the treatment, one session results as well as incidence of the side effects were evaluated, with 6 months follow up. Positive results were obtained after only one session in total safety with minimal patients discomfort and without undesired effects during treatment. The study confirmed International literature data suggesting the use of laser and light devices as elective treatment of this disease. IPL, dye lasers and 532nm laser are the devices more used and the last seems to represent the gold standard for 1,2,3 phototypes. This clinical trial, with the limitations due to the small number of patients, indicated that “one session LBO 532nm laser treatment” represents an interesting and innovative approach in the therapy of the erythemato/telangectatic rosacea.

Economic evaluation of endovascular treatment for acute ischaemic stroke in Thailand

ObjectivesEndovascular therapy (EVT) has proven to be clinically effective in treating large vessel occlusion acute ischaemic stroke (AIS), either alone or in combination with intravenous alteplase. Despite this, there is...

APPROACHES TO RATIONAL NUTRITION OF THE POPULATION OF INDUSTRIALIZED REGIONS EXPOSED TO AEROGENIC IMPACT OF AROMATIC HYDROCARBONS

In the process of sustainable development of regions, negative consequences arise in the form of (1) depletion of natural and energy resources, (2) reduction of biological diversity, (3) violation of the stability of ecosystems, and (4) pollution of environmental objects, including atmospheric air. The constant prolonged chronic aerogenic impact of aromatic hydrocarbons on the human body can make a significant contribution to the formation of additional morbidity and mortality in the population. The ability to neutralize and correct the effect of these compounds is ensured not only by continuous monitoring of the quality of atmospheric air and its impact on human health but also by specifically selected food rations. The analysis of modern theoretical data of international and Russian scientific literature was conducted within the methodological approaches to organizing food for the population in conditions of chemical pollution of atmospheric air. We searched for scientific information in bibliographic and abstract databases. Besides, we presented the average long-term data on (1) the content of benzene and phenol in the atmospheric air and blood in children living under conditions of high chemical aerogenic load with these substances; (2) the state of the antioxidant and conjugation-elimination functions of the benzene biotransformation system; (3) the assessment of the secretion of proteolytic digestive enzymes; and (4) the state of liver cells and excretory-concentration function of the biliary tract. There are examples of food products, the systematic inclusion of which in the diet accelerates the modification and elimination of chemicals; moreover, it has a membrane-stabilizing, hepatoprotective, and antioxidant effect. Acceleration of biotransformation and elimination of toxic substances can be done by including food products with a high content of fiber and pectins in the diet. The acceleration of the metabolism of toxic substances can be carried out by including in the diet foods with a high content of fiber and pectins, polyunsaturated fatty acids, and antioxidant vitamins. The importance of the availability of special diets for all groups of the population living in industrially developed regions under conditions of aerogenic chemical load, including aromatic hydrocarbons, is shown to minimize the negative impact of human-made chemicals and prevent diseases caused by an increased level of atmospheric air pollution.

Assessing survival and prescription of injury establishment in forensic medical practice (literature review)

Determining the prescription of organ and tissue damage in forensic practice is of pivotal role in establishing an objective picture of the facts and circumstances. Nowadays, when the latest research methods and modern laboratory and instrumental equipment appear, there is a need to improve forensic diagnostics to establish the prescription of injuries. Although experts and scientists are trying to invent new methods and techniques for diagnosing the age of injury, this area of research will not lose relevance, given the complexity of solving problems. The purpose of this work is to analyze literature data on the use of various diagnostic methods in forensic practice to establish the prescription of injuries and assessing survival. In our study we analyzed scientific papers and data of international scientific literature on the problem of various diagnostic methods in forensic practice to establish the prescription of injuries and assessing survival. Methods used: scientific research, analytical and generalizing. The authors cite publications that set out the methods and criteria to address this issue. In particular, promising areas of application of histological, immunohistochemical methods, postmortem computed tomography are shown. The issues of establishing the prescription of cranio-cerebral injuries are considered. The role of manifestations of the body's systemic response to trauma, in particular, the neuroendocrine system, is also shown. Examples of the use of non-ischemic heart disease to diagnose the duration of dying are given. The role of tropopnin I, creatine kinase, brain natriuretic peptide (NT-pro BNP) in the diagnosis of the duration of the traumatic process is shown. Based on a review of the literature, the authors conclude that new methods and criteria for assessing survival and prescription of injuries in forensic practice in order to unify the results of the study and avoid diagnostic errors are promising.

Special Education Teachers’ Experiences on Assessment Activities

The purpose of this research is to determine what kinds of processes are covered in assessment activities aimed at assessing students with special needs by special education teachers working in special education schools. Eleven special education teachers working in special education schools at different levels participated in the study. The study employed the phenomenological method, a qualitative research approach. The research data were collected through semi-structured interviews. The collected data were analyzed by content analysis. The themes obtained as a result of the analyses are as follows: “Assessment processes of special education teachers”, “The effect of the type and level of disability on the assessment activities”, “Stakeholders with whom special education teachers collaborate in the assessment process”, and “Special education teachers’ self-development goals on assessment”. The obtained findings are discussed in light of the national and international literature data, and several suggestions for practice are presented.

The Results of the Study of Microbiologic Pattern of the Urinary Tract Infection in Children from Kyiv and Kyiv Region

The article presents the results of a retrospective analysis of the species composition of microbial pathogens of the urinary tract infection according to the results of urine culture and their sensitivity to antibiotics of different classes in children with the active stage of the disease (mainly with pyelonephritis), who were treated in the nephrology unit of Kyiv Children’s City Hospital № 1 in 2009–2014. A consistently high sensitivity (94.1 %) and low resistance (3.2 %) of Escherichia coli strains to a modern derivative of nitrofuran — furazidin K (Furamag) has been shown compared with other classes of antibacterial agents. The findings correspond with the international literature data and allow us to recommend this drug for empiric therapy of uncomplicated infections of the urinary system in children.

Modern vector in treatment of patients with lung cancer: tyrosine kinase inhibitors in epidermal growth factor receptor mutations (literature review)

Tumor molecular profiling in patients with non-small cell lung cancer (NSCLC) is used to identify driver mutations, which lead to premature carcinogenesis in more than 80% of adenocarcinoma cases, including epidermal growth factor receptor (EGFR) mutations. Identification of specific somatic aberrations allows to personalize treatment. Personalization of treatment resulted in improvement of NSCLC outcomes. The aim of our study was to consider scientific data on modern concepts of treatment of patients with non-small cell lung cancer with previously detected oncogenic mutations, especially EGFR mutation. In our study we analyzed scientific papers and data of international scientific literature on the problem of lung cancer treatment. Methods used: scientific research, analytical and generalizing. Different drugs are used in treatment of lung cancer. Choice of treatment scheme depends on type and presence of mutations. Patients with advanced non-small-cell lung cancer and detected mutation in the EGFR can be treated with tyrosine kinase inhibitors (TKIs). Nowadays three first generation drugs are recommended by FDA: afatinib, erlotinib, gefitinib. They showed good clinical benefit. Most patients with metastatic NSCLC typically show disease progression after approximately 9 to 13 months of erlotinib, gefitinib, or afatinib therapy. The first and only commercially available third-generation EGFR TKI is оsimertinib - an oral drug, which selectively inhibits both EGFR-TKI and EGFR T790M resistance mutations. Nowadays scientists are in active investigation of mechanisms of acquired resistance to TKIs, but little is known yet. Clinical success can be observed in patients who were treated with TKIs. EGFR T790M is a mutation that leads to acquired resistance to EGFR TKI therapy. Its incidence is approximately 60% after disease progression on TKI drugs (erlotinib, gefitinib, or aphatinib). Third-generation EGFR TKIs demonstrate high efficacy, but acquired resistance development cannot be avoided. Mechanisms of acquired resistance to these agents are still investigated.

Understanding the role of local educational departments in school collaboration for improvement: Two districts in China

As improving low-performing schools has become a critical strategy to achieve educational equity in China, local educational departments have implemented various school collaboration programs. Drawing on international literature and empirical data from in-depth interviews and policy documents in two Chinese urban districts, this multiple-case qualitative study examines local educational departments’ roles in the school collaboration implementation. Our analysis shows that both local educational departments set clear district-wide expectations of school collaborations. While various strategies were implemented to improve low-performing schools, limited opportunities were provided for school-based educators to contribute to decision-making processes. Both districts relied more on structural changes to create conditions to improve teaching and learning, and lacked long-term investments in building professional capacity and fostering data-use cultures. Finally, local educational departments’ goals of equity and school improvement were sometimes overshadowed by other political and economic priorities. This study offers new evidence on the leadership roles that local educational departments play in Chinese school reform implementation, thus responding to a scarcity of district-level empirical research in Chinese literature. It also expands the existing international research base that is largely Western-focused and not necessarily applicable to all countries, especially developing countries where school improvement efforts are often situated in conflicting policy systems.

The new prospects of the inhalation therapy for bronchial asthma

Based on the latest new international literature data, the article considers the possibilities of fixed combinations of long-acting β2-agonist, long-acting muscarinic antagonist and inhaled corticosteroids in achieving the control of bronchial asthma (BA). Clinical advantages for a fixed combination of indacaterol, glycopyrronium and mometasone furoate one dosing regimen in the therapy of BA are presented based on the results of recently completed randomized clinical trials IRIDIUM and ARGON.

Comparative analysis of sanitation systems for resource recovery: Influence of configurations and single technology components

Resource recovery and emissions from sanitation systems are critical sustainability indicators for strategic urban sanitation planning. In this context, sanitation systems are the most often structured using technology-driven templates rather than performance-based sustainability indicators. In this work, we answer two questions: Firstly, can we estimate generic resource recovery and loss potentials and their uncertainties for a diverse and large set of sanitation systems? And secondly, can we identify technological aspects of sanitation systems that indicate a better overall resource recovery performance? The aim is to obtain information that can be used as an input into any strategic planning process and to help shape technology development and system design for resource recovery in the future. Starting from 41 technologies, which include novel and conventional options, we build 101,548 valid sanitation system configurations. For each system configuration we quantify phosphorus, nitrogen, total solids, and water flows and use that to calculate recovery potentials and losses to the environment, i.e. the soil, air, or surface water. The four substances cover different properties and serve as a proxy for nutrient, organics, energy, and water resources. For modelling the flows ex-ante, we use a novel approach to consider a large range of international literature and expert data considering uncertainties. Thus all results are generic and can therefore be used as input into any strategic planning process or to help guide future technology development. A detailed analysis of the results allows us to identify factors that influence recovery and losses. These factors include the type of source, the length of systems, and the level of containment in storage and treatment. The factors influencing recovery are related to interactions of different technologies in a system which shows the relevance of a modelling approach that allows to look at all possible system configurations systematically. Based on our analysis, we developed five recommendations for the optimization of resource recovery: (i) prioritize short systems that close the loop at the lowest possible level; (ii) separate waste streams as much as possible, because this allows for higher recovery potentials; (iii) use storage and treatment technologies that contain the products as much as possible, avoid leaching technologies (e.g. single pits) and technologies with high risk of volatilization (e.g. drying beds); (iv) design sinks to optimise recovery and avoid disposal sinks; and (v) combine various reuse options for different side streams (e.g. urine diversion systems that combine reuse of urine and production of biofuel from faeces).

Global Agruciltural Responsibility

Today global agriculture is confronted in several areas with various interests in environmental protection. The global food economy will face major challenges in the coming decades. There is a need to use new technologies that can increase productivity while preserving natural resources and biodiversity, in a climate-friendly way and by maintaining site-specific ecosystem services. The purpose of this study is to explore the potential role of agroforestry systems in the sustainable development of global food production. In order to achieve this goal, we carried out the systematic processing of international and domestic literature and secondary data.

Early experience with self-expanding flexible stent for the treatment of atherosclerotic diseases in the popliteal artery

Introduction: The incidence of peripheral arterial diseases and the rate of chronic limb-threatening ischaemia are increasing year by year. Minimally invasive peripheral interventions have gradually replaced traditional operations. Earlier steno-occlusion of the popliteal artery was an indication for femoropopliteal bypass below the knee. Nowadays, endovascular procedures are also used, but the indication of the stent placement into the popliteal artery is controversial. Aim: We have been using Jaguar stent for the treatment of popliteal artery steno-occlusion since January 2016. The aim of our study was to evaluate the efficacy of this treatment. Method: We included patients who underwent popliteal artery angioplasty with Jaguar stent placement between 1 January 2016 and 31 December 2017 in our department. During the one-year follow-up, we examined the popliteal stent patency, amputation-free survival and risk factors that influence stent patency. Statistical analysis: For the comparison of mean values, two-sided t-tests were used. Categorical data were analyzed by using chi-square test. Results: 33 patients underwent popliteal or femoropopliteal endovascular intervention with Jaguar stent placement into the popliteal artery. Postoperative complications that required surgical treatment occurred in 2 patients. At the end of the follow-up, the primary patency of the popliteal stents was 58.1%, the secondary patency was 74.2% and amputation-free survival was 96.8%. Conclusion: Compared with international data, the primary patency of the Jaguar stents in our study is relatively lower, but amputation-free survival is much better, and in most cases there is less operative strain compared with traditional operations. Orv Hetil. 2020; 161(15): 588–593.