Gender Distribution Research Articles

Gender distribution in publishing in five leading optometry journals.

To explore gender distribution in authorship and citation parameters of articles published in five optometry journals included in the Ophthalmology category of Journal Citation Reports. The Scopus database was used to retrieve all citable articles published in 2011 and 2021 in Optometry and Vision Science, Ophthalmic and Physiological Optics, Clinical Experimental Optometry, Contact Lens and Anterior Eye, and Eye and Contact Lens. Gender of the first, last and single authors of all articles, and citation parameters of articles published in 2011 up to May 2023 were determined. Gender of the editor-in-chief and members of the editorial board of these journals was investigated (May 2023). Only one journal had a female editor-in-chief and three journals had more males than females in their editorial board. In 2011 and 2021, respectively, 40.1% and 48.0% of articles had female as the first authors (  = 5.77; p = 0.02), and 32.7% and 39.6% had female as the last authors (  = 4.61; p = 0.03). Gender parity was observed in one journal for the first author and none for the last author in 2011, and in three journals for the first author and one for the last author in 2021. Regarding combinations of male (M) and female (F) first and last authorship positions, the authors of articles in 2011 were MM (44.5%), FM (22.8%), FF (17.3%) and MF (15.4%), and MM (34.6%), FM (25.8%), FF (22.1%) and MF (17.5%) in 2021. Differences between 2011 and 2021 were statistically significant (  = 9.80; p = 0.02). The proportion of authorship combinations did not show statistically significant differences among journals in 2011 or in 2021. Neither citation nor self-citation were influenced by gender. Gender disparities persist in optometry journals, with females being under-represented in senior and leadership positions. Increasing the awareness of gender disparity in authorship is a necessary step towards ensuring fairness in science in general, and optometry in particular.

An assessment of the probability of patients experiencing bone pain for early prioritization to the rehabilitation clinic

Background: As a result of DEXA and risk factor-based evaluation, which rank patients according to their osteoporosis risk, risk assessment instruments such as the Osteoporosis Self-assessment Tool, Risk Assessment Instrument, and Simple Calculated Risk Estimation were created. Aims: In two phases, the precision of evaluation instruments will be assessed: pre-test, post-test, and pre-diagnostic DEXA will be utilised to determine the accuracy of the assessment tools and pre-test, respectively. Methods: From September to November 2021, this study examines osteoporosis patients at Prince Rashid bin Al-Hasan Military Hospital in Jordan. Bayes' theorem and osteoporosis screening methodologies are utilised to calculate the post-test probability of patients. Evaluation of AUROC and performance metrics will be conducted utilising a ROC curve. The term of the investigation is 2021-2021. Results: The gender distribution of the 206 patients examined in the study was 5.87:1. AUCs SEMs for the binary logistic regression models incorporating independent variables (OST, ORAI, and BAQ) varied in response to the probability of FRAX≥3% versus <3%. FRAX% exhibited the following sensitivity indices: 0.02, 75%, 41.36%, 66.36%, and 41.03%. The innovative quotient (BAQ), which represents the ratio of body weight to age, had respective pre-test probabilities of 0.789±0.033, 0.484±0.042, and 0.254±0.037. Conclusion: The research examined the probability of BLR_BAQ after the test was conducted using OST and ORAI references. Significant AUROCs were observed for all three osteoporosis instruments; however, the performance of the post-test probabilities for FRAX≥3% of the BLR_BAQ model was subpar, as evidenced by both the standards and ORAI inference.

Screening of voluntary blood donors for beta-thalassemia trait in an endemic area in Northwest India for 15 years: Results and future directions after screening more than 300 thousand donors

Abstract: BACKGROUND: North-West India has a high prevalence of the Thalassemia, and the Beta Thalassemia Trait often remains undetected in the population. Recognizing the need to address this public health issue, we initiated “Blood the Lifeline” project in 2006 with the aim to eradicate Thalassemia through proactive measures, including screening of voluntary blood donors. AIM: The primary aim of this study was to screen voluntary blood donors in an endemic area in northwestern India for Thalassemia trait. The study aimed to determine its prevalence, identify gender and ethnic group-wise distributions, and assess the implications for future interventions. METHODS: The screening program was conducted from January 2006 till December 2022. Voluntary blood donors were recruited from the target area and underwent Thalassemia trait screening. The screening process involved High Performance Liquid Chromatography using VARIANT II fully automated HPLC system to identify Thalassemia trait. Data regarding the total number of cases screened, gender distribution, ethnic group-wise distribution, and positive and negative cases were collected and analyzed. Screening Process: EDTA Pilot tube from each donor was collected and analyzed within 24 hrs of collection. RBC Counts, Hb Concentration, MCV, MCH, RDW-SD were noted to differentiate between Iron Deficiency Anaemia & thalassemia trait & following Criteria’s were taken into account: Total RBC Count: > 5.0 x 106 / micro-liter, Hb: < 11.7 g/dl, MCV: < 77 fl, MCH: < 28 pg & RDW-SD: < 45 fl. A combination of Formulas like Mentzer’s index= MCV/RBC <13; Shine and Lal Index (S&L) = MCV × (MCH/100) < 1530; Green & King (MCV2) × RDW]/ (Hb × 100) < 65 were used for screening. All the above formulas were introduced into the Blood Bank Software to exclude out the blood units requiring screening & confirmation. If any of the samples were positive on initial screening, then confirmatory test was done by demonstrating the elevation of concentration of HbA2 by HPLC VARIANT II fully automated analyser. RESULTS: A total of 377,503 voluntary blood donors for a 16 year period were screened and data was analysed .The Mean Hemoglobin of positive donors was 12.1 gm/dl; Mean RBC Count was 6.24 m/cu mm, MCV 67.79 fl, MCH 21.04 pg, RDW-SD 42.11fl & HbA2 was 7.48%. The majority of positive cases were found in the Sindhi (16.68%), Punjabi (10.32%), and Muslim (9.81%) ethnic groups. The Rajasthani population accounted for 6.01% of positive cases. CONCLUSION: This comprehensive screening program revealed a relatively high prevalence of Thalassemia trait in 2.29% of the screened population. The communities with higher prevalence (Sindhi, Punjabi, and Muslim) were educated about the disease and a targeted screening program will be further carried out in these ethnic groups. The data helped in planning genetic counseling, carrier screening, and pre-marital screening programs to reduce the transmission of Thalassemia in these populations. By focusing efforts on specific groups and locations with higher prevalence, a community based approach to prevent the birth of children with Thalassemia major is being implemented. It is also being used for analyzing the implications of different local policies pertaining to Thalassemia trait in the region. Collaborative efforts between healthcare organizations, community leaders, and governmental agencies are crucial to address the burden of Thalassemia and work towards its eradication. The results of this study serve as a foundation for future initiatives aimed at minimizing the impact of Thalassemia at a community level.

COVID-19 pandemic amplified mortality rates among adolescents with bipolar disorder through family-related factors

BACKGROUND Recently, a growing number of adolescents have been afflicted with mental disorders, with annual morbidity rates on the rise. This trend has been exacerbated by the global coronavirus disease 2019 (COVID-19) pandemic, leading to a surge in suicide and self-harm rates among this demographic. AIM To investigate the impact of the COVID-19 pandemic on adolescent bipolar disorder (BD), along with the underlying factors contributing to heightened rates of suicide and self-harm among adolescents. METHODS A comprehensive statistical analysis was conducted utilizing clinical interviews and self-reports obtained from patients or their guardians. Diagnostic criteria for BDs were based on the Diagnostic and statistical manual of mental disorders, international classification of diseases-11, and the National institute of mental health research domain criteria. Statistical analyses were performed using SPSS 26.0 software, with significance set at P < 0.05. RESULTS A cohort of 171 adolescents diagnosed with BD between January 1, 2018, and December 31, 2022, was included in the analysis. The gender distribution was 2.8:1 (female to male), with ages ranging from 11 to 18 years old. Major factors contributing to adolescent BDs included familial influences, academic stress, genetic predisposition and exposure to school-related violence. Notably, a significant increase in suicide attempts and self-harm incidents was observed among adolescents with BD during the COVID-19 pandemic. Statistical analysis indicated that the pandemic exacerbated familial discord and heightened academic stress, thereby amplifying the prevalence of suicidal behavior and self-harm among adolescents. CONCLUSION The COVID-19 pandemic has exacerbated familial tensions and intensified the incidence of suicide and self-harm among adolescents diagnosed with BD. This study underscores the urgent need for societal, familial and educational support systems to prioritize the well-being of adolescents and offers valuable insights and guidelines for the prevention, diagnosis and treatment of adolescent BDs.

Elevated Biomarkers of Inflammation and Vascular Dysfunction Are Associated with Distal Sensory Polyneuropathy in People with HIV

Distal sensory polyneuropathy (DSP) is a disabling, chronic condition in people with HIV (PWH), even those with viral suppression of antiretroviral therapy (ART), and with a wide range of complications, such as reduced quality of life. Previous studies demonstrated that DSP is associated with inflammatory cytokines in PWH. Adhesion molecules, essential for normal vascular function, are perturbed in HIV and other conditions linked to DSP, but the link between adhesion molecules and DSP in PWH is unknown. This study aimed to determine whether DSP signs and symptoms were associated with a panel of plasma biomarkers of inflammation (d-dimer, sTNFRII, MCP-1, IL-6, IL-8, IP-10, sCD14) and vascular I integrity (ICAM-1, VCAM-1, uPAR, MMP-2, VEGF, uPAR, TIMP-1, TIMP-2) and differed between PWH and people without HIV (PWoH). A cross-sectional study was conducted among 143 participants (69 PWH and 74 PWoH) assessed by studies at the UC San Diego HIV Neurobehavioral Research Program. DSP signs and symptoms were clinically assessed for all participants. DSP was defined as two or more DSP signs: bilateral symmetrically reduced distal vibration, sharp sensation, and ankle reflexes. Participant-reported symptoms were neuropathic pain, paresthesias, and loss of sensation. Factor analyses reduced the dimensionality of the 15 biomarkers among all participants, yielding six factors. Logistic regression was used to assess the associations between biomarkers and DSP signs and symptoms, controlling for relevant demographic and clinical covariates. The 143 participants were 48.3% PWH, 47 (32.9%) women, and 47 (33.6%) Hispanics, with a mean age of 44.3 ± 12.9 years. Among PWH, the median (IQR) nadir and current CD4+ T-cells were 300 (178–448) and 643 (502–839), respectively. Participants with DSP were older but had similar distributions of gender and ethnicity to those without DSP. Multiple logistic regression showed that Factor 2 (sTNFRII and VCAM-1) and Factor 4 (MMP-2) were independently associated with DSP signs in both PWH and PWoH (OR [95% CI]: 5.45 [1.42–21.00], and 15.16 [1.07–215.22]), respectively. These findings suggest that inflammation and vascular integrity alterations may contribute to DSP pathogenesis in PWH, but not PWoH, possibly through endothelial dysfunction and axonal degeneration.

Anterolateral versus anteromedial plate osteosynthesis of midshaft humeral fractures; is there a difference in the rates of iatrogenic radial nerve palsy?

The anterolateral (AL) and anteromedial (AM) surfaces of the humerus are typically used for plate placement during plate osteosynthesis of midshaft humeral fractures via the anterolateral approach. The purpose of this study was to determine if a significant difference exists in the rates of iatrogenic radial nerve palsy (IRNP) following either AL or AM humeral fracture plating. The research question is stated as follows: is anteromedial plating of humeral fractures associated with lower rates of IRNP when compared with anterolateral plating? This multicenter prospective randomized study was undertaken following ethical review and approval with eligible patients who had midshaft humeral fractures or nonunions randomized into 2 groups, viz AL plate osteosynthesis group and AM plate osteosynthesis group. Following diagnostic and preoperative evaluation, patients had open plate osteosynthesis through the anterolateral approach with plate placement according to their study groups. Post-operatively, they were assessed for IRNP while obtained data was analyzed with SPSS version 23 and inter-group differences with P values less than 0.05 were considered statistically significant. Eighty-five eligible patients participated in the study with 43 patients in Group A (AL plate osteosynthesis group) and 42 patients in Group B (AM plate osteosynthesis group). The observed inter-group differences with regard to gender distribution, mean age and clinical diagnosis; acute fracture (AF) versus nonunion were not statistically significant. Furthermore, four (9.3%) patients amongst the 43 patients in Group A (AL plate osteosynthesis group) developed IRNP while two (4.8%) patients amongst the 42 patients in Group B (AM plate osteosynthesis group) had IRNP. The inter-group difference with regard to rates of IRNP was not statistically significant (P = 0.694). This study found that (in contrast to previous studies) there was no significant difference in the rates of IRNP following either open anterolateral or anteromedial plate osteosynthesis of midshaft humeral fractures through the anterolateral approach. Orthopaedic surgeons should therefore remain cautious when obtaining consent for surgery as well as when performing internal fixation of midshaft humeral fractures to limit medicolegal disputes that may arise from IRNP.

ANALYSIS OF SUPPORTING AND HINDER FACTORS IN IMPROVING HUMAN RESOURCE COMPETENCE AT PALANGKA RAYA UNIVERSITY

This study provides a concise overview of Palangka Raya University (UPR), a state university founded in 1963. UPR, operating as a Public Service Agency, has implemented strategic changes in response to financial management adjustments, particularly focusing on elevating the quality of higher education lecturers. The research evaluates UPR's performance over the last five years, resulting in the identification of five key business strategies. Examining UPR's human resources, the study outlines the organizational structure, emphasizing teaching staff and education personnel. In 2022, an analysis of lecturers' academic positions, space class, and gender distribution highlights the diversity within the university. Additionally, education personnel are scrutinized based on gender, age, years of service, and rank, providing a comprehensive insight into UPR's human resources landscape. Descriptive analysis pinpoints supporting factors, such as the competency certification process and research roadmaps, and inhibiting factors, including a lack of leadership synergy and lecturer awareness. Budgetary constraints, insufficient person-in-charge roles, and a lack of specific strategies are identified as obstacles. The research concludes with actionable recommendations to enhance human resource quality at UPR, emphasizing skills development, government support, reward systems, and the cultivation of professional attitudes and personality maturity. These strategies aim to foster a more productive and inclusive work environment in alignment with UPR's vision of producing competitive and morally grounded human resources.

Exploring Online Communication in Self-Identified Autistic Adolescents.

Social media sites provide autistic youth a familiar space to interact that is devoid of many of the challenges that accompany face-to-face interactions. As such, it is important to determine whether the linguistic profiles observed during online interactions are consistent with face-to-face interactions. This preliminary study took a step in this direction by examining gender differences observed in autistic adolescents in an online forum to determine whether they are consistent with the emerging body of research investigating linguistic gender differences in autistic adolescents. We analyzed the entries of self-identified autistic adolescents in an online forum to determine whether autistic girls (n = 99) and boys (n = 94) differ in their use of linguistic features as a proportion of total words produced. Transcriptions were coded across discourse, lexical, and semantic features and compared to previous research investigating linguistic gender differences in autistic people. Exploratory comparisons were also made to linguistic gender differences in neurotypical people. Of the linguistic features we examined, three out of four of the gendered usage patterns observed in the online forum language samples were consistent with previous research on face-to-face communication for autistic adolescents. Only one feature out of 12 occurred in the same gender distribution as previous research on neurotypical communication. Autistic girls and boys demonstrate largely consistent gender differences in their language use across in-person and online communication contexts. Interestingly, most of the significant gender differences previously reported in neurotypical communicators were not seen in this sample of autistic adolescents, suggesting that perhaps autistic individuals may linguistically express gender characteristics to a different extent or in a different manner than neurotypical individuals.

Impact of Patient Demographics and Injury Patterns on the Choice and Success of Proximal Femur Fracture Surgeries

Background: Understanding the influence of patient demographics and injury patterns on the choice and success of surgical interventions for stable extracapsular fractures of the proximal femur is crucial for optimizing treatment outcomes.
 Methods: This comparative study analyzed 50 patients undergoing CRIF with either Gamma Nail or PFN, focusing on how demographics, injury patterns, and socio-economic status impacted surgical choice and outcomes.
 Results: No significant differences were observed in age and socio-economic status between the two groups. Gender distribution and the mode of injury showed slight variations but did not substantially influence the surgical choice. Both Gamma Nail and PFN were utilized across a diverse patient population, suggesting the need for individualized surgical planning.
 Conclusion: The choice of surgical technique for treating stable extracapsular fractures of the proximal femur is multifaceted, influenced by a combination of technical, demographic, and injury-related factors.
 Keywords: Extracapsular fractures, proximal femur, Gamma Nail, Proximal Femoral Nail, patient demographics, injury patterns.

Seasonal Variation of Malaria Infections among Outpatients Attending Muhammad Abdullahi Wase Teaching Hospital Kano State, Nigeria

Malaria is a serious public health problem in Sub-saharan Africa including Nigeria, with the potential to increase significantly in response to seasonal changes. The aim of the study was to determine the influence of seasonal variations on the prevalence of malaria infection among outpatient attending Muhammad Abdullahi Wase teaching hospital Kano state, Nigeria. The objectives were to establishing the correlation between malaria infections and seasonal variations, and also determining the prevalence during different seasons, and evaluating the gender distribution of infection. The study was carried out from January to December, 2019, involving the use of microscopic examination of 840 blood samples using thick and thin film methods. Out of 840 patients examined (57.1%) had a malaria infection. Wet season had the highest prevalence rate of malaria infection (33.2%) than dry season (23.9%).There was a statistically significant differences (P<0.05) in the prevalence rate of malaria infection in relation to season. In relation to the gender females had higher (31.9%) prevalence rate of malaria infection than males (25.2%) and there was no significant difference in the prevalence rate of the infection in relation to sex (P>0.05). Concerning age groups, patients aged 26-30 years had the highest prevalence rate (9.04%), while those aged 40 and above had the lowest. However, the variation in prevalence among age groups was not statistically significant (P>0.05).This study confirmed that malaria infection still remains an important public health problem in the study area. Therefore, full implementation of adequate public health measures need to be undertaken to mitigate the endemicity of the disease, such as the Roll Back Malaria control Strategies as well as health education and environmental modifications are advocated is recommended.

Causes of Traumatic Spinal Cord Injury with Gender Distribution and Most Commonly Affected Age Group

Background: Spinal cord injury (SCI) has significant consequences, especially for young adults, requiring comprehensive support. Additionally, non-traumatic SCI is under-researched in Pakistan, highlighting the need for further investigation. Managing readmissions post-discharge remains a global challenge for SCI patients. This study conducted at Paraplegic Centre Peshawar aims to find the traumatic causes of spinal cord injury with gender and age distribution. Methods: A retrospective study was conducted at Paraplegic Center in Hayatabad and Prime Teaching Hospital, Peshawar. Over two months, 1843 patients were recruited from hospital records with permission from the department head. Data collection forms were designed to include age, gender, and cause of SCI, ensuring confidentiality by excluding personal identifiers. SPSS-V19 was used for data analysis. Results: Our study included 1843 patient records, with males comprising 80.7% and females 19.3%. Among different age groups, individuals aged 30 and older represented the highest proportion at 52.7%. The primary causes of spinal cord injury were falls from height (46.3%) and firearm injuries (25.9%). Paraplegic injuries were more prevalent, accounting for 87.9% of cases compared to quadriplegic injuries at 12.1%. These findings shed light on the demographics and patterns of spinal cord injuries, providing valuable insights for healthcare management and prevention strategies. Conclusion: Falls are major cause of spinal cord injury (SCI). Mean age patients suffers are 26. frequency of SCI is more in males then females. Paraplegia is more common then quadriplegia. The socioeconomic impact of SCI is eminence because it is affecting the youth population. It is important to understand the epidemiological features of SCIs which could lead to plan appropriate cost-effective prevention strategy in order to reduce the SCI prevalence and incidence in our community. 

Antimicrobial Resistance Patterns of Urine Culture in Tertiary Care Teaching Hospital Islamabad, Pakistan

Background: Urine cultures are performed in laboratories to identify any bacteria or other microorganisms present in urine samples. The purpose of this study was to investigate the microorganisms growing resistant to antibiotics in the urine culture and their antibiotics susceptibility testing. Methods: For this investigation, the Microbiology Department's hospital management information systems records provided the culture and sensitivity data of the uropathogens found in urine samples. Urine samples collected midstream were prepared for microscopy and culture, and the organisms were identified using globally accepted methods. The Kirby-Bauer disk diffusion method was used to determine antibiotic susceptibility in accordance with hospital clinical and laboratory standards as well as international protocols. In this investigation, the information and data were assessed using descriptive statistics. Results: A total number of 207 urine culture data were extracted from the hospital management information system records of which, 116 samples showed positive bacterial growth. Candida had positive growth in 16.4%. Out of positive samples gender-wise, females were in the majority 66.4% and males were 33.6%. Escherichia coli bacteria frequently isolated in positive samples 58/116 (50%), whereas, Enterococcus spp were positive in 17 patients out of 116 (14.7 %). Gram-negative rods were positive in 16 patients out of 116 (13.8%), Klebsiella spp were positive in 4 patients out of 116(3.4%) and Pseudomonas aeruginosa were least positive in only 2 patients out of 116 positive samples (1.7 %).    Conclusion: In our study according to gender distribution female frequency was higher than males. Escherichia coli bacteria were the most common isolate in positive samples, whereas, Enterococcus spp were observed. Vancomycin was most sensitive in all urine cultures against all organisms and Erythromycin was most resistant in urine culture. Antimicrobial resistance is a serious subject on national and international levels that needs continued surveillance and resolute management.

Functional outcomes in intradural extramedullary spinal tumors

Background: Intradural extramedullary (IDEM) spinal cord tumors account for approximately two-thirds of benign intraspinal neoplasms. These are amenable to gross total excision but can have variable functional outcomes, which plays a key role in assessing their impact on a patient’s quality of life. Understanding the functional outcomes associated with these tumors is crucial for healthcare professionals to devise appropriate treatment plans and provide comprehensive care. Methods: In this study, we retrospectively reviewed the outcomes of 130 patients with IDEM tumors who underwent surgery in the past six years between January 2017 and December 2022 at a single institution. Patient demographics, symptoms, and tumor characteristics (anatomical and pathological) in all operated spinal IDEM tumors were analyzed. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel grading. The back pain was assessed using the Denis pain scale (DPS). Results: The age range, gender distribution, presentation, histopathology, and tumor characteristics were analyzed. The histopathological outcomes of the study were as follows: 56 cases of schwannoma, 37 cases of meningiomas, 16 patients of neurofibroma, six cases of epidermoid cyst, five cases each of ependymoma and dermoid cyst, three cases of arachnoid cyst, two cases of metastasis, and one case of paraganglioma. Pain was the most common symptom (38.5%), followed by weakness in limbs (31.5%), paresthesia/numbness (22.3%), and sphincter disturbance (7.7%). Complete total resection was seen in 93% of cases, with 7% undergoing subtotal excision. The complications encountered were – four cases of surgical site infection and one case each of cerebrospinal fluid leak, pseudomeningocele, and epidural hematoma. In our series, 49.3% of patients had significantly good improvement in functional outcomes as per improvement in Frankel score, and 43% of patients had good functional improvement. Significant functional improvement was noted at immediate postoperative follow-up, 2-week follow-up, and six-month follow-up periods. Reoccurrence was seen in 7 cases (5.4%). The DPS score mean values showed a significant decrease over the follow-up duration as compared to preoperative mean values. Significantly poor outcome was seen in IDEM tumours present anteriorly. Conclusion: The IDEM tumors are usually benign and are readily detected by contrast-enhanced magnetic resonance imaging scans. These have variable functional outcomes in different centers. Assessing this functional outcome is an essential aspect of managing IDEM spinal tumors. It was observed through our study that the ventral location of the tumor, thoracic tumors, and poor preoperative neurological status of the patient correspond with poorer postoperative functional outcomes. Furthermore, a significant decrease in the pain symptoms with improvement of Frankel score was seen postoperatively, thus this being suggestive of a significant improvement of functional outcome after surgery. This study helps to conclude that the morbidity associated with the resection of IDEM tumors is not as significant as originally thought to be.

Family model and family-gender roles in the assessments of modern youth

Modern trends in changing the marriage and family attitudes of  modern youth are characterized by the transformation of gender roles. Based on  a questionnaire survey of modern youth, social attitudes of young people were  obtained regarding the gender distribution of roles in the sphere of decision-making, financial security of the family, parenthood, organization of everyday  life and a favorable climate in the family, as well as the assessment of these areas  in the parental family. Data indicate an egalitarianization of the family model,  but in relation to the sphere of family provision, this trend is less pronounced.  Young people more often name love as the reasons for starting a family, followed  by socio-psychological comfort and having children.

Abstract CT193: Phase 1 clinical trial evaluating the safety, tolerability, and immunogenicity of AST-021p, a novel cancer vaccine targeting HSP90-derived epitopes in advanced solid tumor patients (CornerStone-002)

Abstract Background: AST-021p is an "off-the-shelf" therapeutic cancer vaccine composed of two peptides, AST-021p4 and AST-021p5, derived from MHC class II-specific epitopes of Hunam HSP90 protein. Both peptides serve as antigenic determinants for HSP90 and act as a tumor-associated antigen (TAA) inducing activation of type 1 helper T cells (Th1). Th1 cell immunologically elicited by AST-021p secrete cytokines, including IFN-γ, and activate local antigen presenting cells (APC) enhancing cross priming at the tumor site. This immunological activity, through the mechanism of cross priming, sequentially leads to the activation of cytotoxic T cells and epitope spreading. In preclinical studies using the MMTV neu gene overexpressing mouse model, the administration of the HSP90 peptide vaccine, AST-021p, significantly inhibited tumor growth. Based on these scientific rationales, The first-in-human (FIH) study was conducted to evaluate the safety, tolerability, and immunogenicity of AST-021p in advanced solid tumor patients have no treatment option. Methods: Phase 1 study (CornerStone-002, NCT No.: 04864418) was conducted on patients with recurrent or metastatic solid tumors for whom applicable standard treatment options were unavailable (patient enrollment period: June 9, 2021, to June 14, 2023). Four-dose cohorts of AST-021p (Cohort 1: 1.2mg, Cohort 2: 2.4mg, Cohort 3: 3.6mg, Cohort 4: 4.8mg) received three vaccinations at 2-week intervals (Priming immunization) followed by boosting immunization with 4-week interval based on PI's discretion. Enrolling one patient initially in the lowest dose cohort, Cohort 1 (1.2mg), dose escalation occurred sequentially after confirming safety and tolerability. Subsequently, each dose cohort (Cohort 2: 2.4mg, Cohort 3: 3.6mg, Cohort 4: 4.8mg) enrolled six patients each for vaccination. Antigen-specific immune response was assessed by IFNγ ELISPOT using PBMCs from the subjects at baseline, 4 weeks, and 8 weeks. Results: During the study period, a total of 22 patients were enrolled (Cohort 1: 1, Cohort 2: 6, Cohort 3: 8, Cohort 4: 7). The median age of the patients was 66, with a gender distribution of 14 males and 8 females. Among the 22 patients, 20 completed the priming immunization with 3 vaccinations, and 7 of them proceeded with the boosting immunization. A total of 75 adverse events were reported in 21 patients (95.5%). Adverse drug reactions (ADRs) occurred in 15 patients (68.2%), accounting for 92 cases. The most common ADR was injection site reaction (ISR), observed in 15 patients (68.2%), with 35 cases and all reactions were graded as 1 or 2. Serious adverse events (SAEs), including gastrointestinal hemorrhage, vomiting, and aspiration, were observed in 3 patients (13.6%), totaling 3 cases. However, these events were unrelated to AST-021p. Conclusions: This study, as the first-in-human (FIH) administration of the AST-021p, demonstrated safety and tolerability across all four dose groups. Plus, optimal immunogenic dose (OID) and recommended phase 2 dose (RP2D) were confirmed based on AST-021p-specific immunogenicity and safety. Citation Format: Eun Joo Kang, Kyoungmin Lee, In Ho Kim, Ju Won Kim, Jwa Hoon Kim, Soohyeon Lee, Jiwon Lee, Kabsoo Shin, Sejun Park, Joori Kim, Hyun Won Shin, Kyong Hwa Park. Phase 1 clinical trial evaluating the safety, tolerability, and immunogenicity of AST-021p, a novel cancer vaccine targeting HSP90-derived epitopes in advanced solid tumor patients (CornerStone-002) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr CT193.

Impact of Home-Based Work during the COVID-19 Pandemic on Mental and Physical Health in a German Population-Based Sample.

Background: The COVID-19 outbreak necessitated physical distancing, as part of secondary prevention, at a personal and professional level. Working from home (WFH) became increasingly important. In this study, the impact of the COVID-19 pandemic restrictions on physical and mental health is investigated, compared with pre-pandemic data, and with employees who WFH and are on-site. Methods: Data from the German Saxon longitudinal study population were used. Attitudes towards WFH as well as mental and physical health assessments during the COVID-19 pandemic were examined. Comparisons were made with corresponding pre-pandemic scores and between employees WFH and on-site in 2022. Results: In total, 319 participants with equal gender distribution were included. Of those, 86 worked from home stating better organizability of their work, more time for partnership, less stress, and greater work satisfaction. Compared to pre-pandemic data, the D-score, PHQ-4, G-Score, and PHQ-SSS-8 showed a significant increase. No difference in physical or mental health between employees WFH and on-site was observed. Conclusion: In general, COVID-19 restrictions had a negative impact on mental and physical health. Although WFH is well accepted, it did not show significant health benefits.

Comparison of revision rates and epidemiological data of a single total knee arthroplasty system of different designs (cruciate retaining, posterior stabilized, mobile bearing, and fixed bearing): a meta-analysis and systematic review of clinical trials and national arthroplasty registries.

This study aimed to meta-analyze epidemiological data, revision rates, and incidences of different designs of a single Total Knee Arthroplasty System and compare these factors across different countries. A systematic review was conducted on clinical studies and arthroplasty registries of ATTUNE TKA from 1999 to 2020. The main endpoints analyzed were revision rates and epidemiological data. The average age of patients was 67.8years, with a gender distribution of 60% female and 40% male. The pooled average BMI was 29.4kg/m2. Eight clinical studies showed a pooled revision rate per 100 observed CY of 0.5 (n = 1343 cases). Cumulative revision rates after 1, 3, and 5years varied among registries, with the Swiss registry having the highest revision data (after 5years: 6.3%) and the American registry having the lowest revision data (after 5years: 1.7%). A comparison of the revision rates of mobile bearing and fixed bearing (41,200 cases) as well as cruciate retaining and posterior stabilized (n = 123,361 cases) showed no significant advantage in the first 5years after implantation. In conclusion, pooled data from 41,200 cases of TKA with a single Total Knee Arthroplasty System in two arthroplasty registries revealed that there was no significant difference in revision rates between the mobile bearing and fixed bearing design within the first 5years after implantation. In addition, a comparison of the revision rates in n = 123,361 cases showed no significant advantage for cruciate retaining or posterior stabilized in the first 5years after implantation.

Gender-based division of household labor: a study of selected districts of Bangladesh

PurposeAs women perform most household chores and other nonproductive work, gender-based division of labor in the home has now been identified as a barrier to gender equality. The objective of this study is to assess the effects of gender distribution of housework especially for women and investigate the factors influencing the total hours spent on house chores in Bangladesh.Design/methodology/approachThis study adopted a quantitative approach based on survey data obtained from 200 households in the Madaripur and Gopalganj districts of Bangladesh. To analyze the obtained data, the partial least squares (PLS) regression was used.FindingsAccording to this study, demographic and socioeconomic factors of women, and gender are influencing the total hours spent in housework. Women were observed to have a positive relationship with empowerment but a negative relationship with social perception. Social perception was further observed to have a significant impact on the total number of hours expended by women on house chores.Practical implicationsThe study suggests that the importance of sharing the burden of household work be taught in schools and community-based awareness programs so that it becomes ingrained as a social and cultural practice. Furthermore, the government should conduct a proper assessment that recognizes unpaid housework by women as an important factor in inclusive sustainable development.Originality/valueIssues of inequality in the division of labor in household activities are barely recognized in Bangladesh. Therefore, this study collected primary data to assess the effects of gender on the distribution of housework. The findings of the study will help policymakers and academicians to better understand the gender-based division of household labor.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-03-2023-0195.

Infants of mothers with early remitted clinical depression and mothers with no postpartum depression: Adaptive functioning in the second year of life.

Whether and how remitted clinical depression in postpartum motherhood contributes to poor infant adaptive functioning is inconclusive. The present longitudinal study examines adaptive functioning in infants of mothers diagnosed as clinically depressed at 5 months but remitted at 15 and 24 months. Fifty-five U. S. mothers with early, remitted clinical depression and 132 mothers without postpartum depression completed the Vineland Adaptive Behavior Scales about their infants at 15 and 24 months. Between groups, mothers were equivalent in age, ethnicity, marital status, and receptive vocabulary (a proxy for verbal intelligence), and infants were equivalent in age and distribution of gender. Controlling for maternal education and parity, mothers with early, remitted clinical depression and mothers with no postpartum depression rated their infants similarly on communication, daily living skills, and socialization. Mothers with early, remitted clinical depression rated their infants poorer in motor skills. Girls were rated more advanced than boys in communication at 24 months and daily living skills at 15 and 24 months. Rated infant adaptive behavior skills increased from 15 to 24 months. With exceptions, adaptive functioning in infants may be robust to early, remitted maternal depression, and adaptive functioning presents a domain to promote positive development in this otherwise vulnerable population.

Acute Graft versus Host Disease in Beta Thalassemia Patients Following Allogeneic Haematopoietic Stem Cell Transplantation.

To analyse the frequency, risk factors, and clinical symptoms of acute graft-versus-host disease (aGvHD) in patients with beta-thalassemia major after allogeneic haematopoietic stem cell transplantation (HSCT). Descriptive study. Place and Duration of the Study: Department of Clinical Haematology, Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan, from January 2017 to December 2021. Data were obtained from patients diagnosed with bone and tissue malignancies (BTM) who had undergone haematopoietic stem cell transplantation (HSCT) and experienced aGVHD. Patients who experienced initial graft failure and individuals who underwent subsequent bone marrow transplantation were excluded. Total of 117 patients diagnosed with BTM underwent fully matched HSCT, including 76 (65%) males, and 41 (35%) females. The median age of the patients undergoing transplantation was 7.34±7.32 years and the donors' median age was 7.6±9.85 years. Among the donors, 53 (45.3%) were males and 64 (54.7%) were females. Gender disparity was observed in 46 (39.3%) instances as a female donor matched with a male recipient. A total of 106 individuals underwent bone marrow harvest (BMH); with 5 (4.3%) patients receiving peripheral blood stem cells (PBSC) and 6 (5.2%) patients receiving both BMH and PBSC. Acute GvHD was observed in 50 (42.7%) patients, including 30 (60%) males and 20 (40%) females. Grade I GvHD occurred in 32 (27.3%) individuals, Grade II GvHD in 16 (13.7%) patients, and Grade III GvHD in one (0.8%) patient. It had no statistically significant association with recipient/donor age, gender disparity, the source of the graft source, the dose of stem cells, or the presence of thymoglobulin (TG). Acute GvHD was observed in high frequency in Beta-thalassemia patients receiving morrow harvesting proportional to their gender distribution. Associated factors were GvHD prophylaxis measure, mucositis and, CMV reactivation. Beta thalassemia major patients, Acute graft versus host disease, Allogeneic haematopoietic stem cell.