Modal Group Research Articles

The effect of PSMA PET/CT on clinical decision-making of radical prostatectomy and pelvic lymph node dissection

Objective To evaluate the effect of prostate-specific membrane antigen (PSMA) PET/computed tomography (CT) on clinical decision-making of radical prostatectomy (RP) and pelvic lymph node dissection (PLND) after its utilization in daily clinical practice at an European high-volume cancer center. Materials and methods Patients who had unfavorable intermediate- and high-risk prostate cancer between 2017 and 2021 were included retrospectively and divided into two groups; those who staged using PSMA PET/CT (group 1) and those who staged using conventional modalities (group 2). Clinical decision-making of RP over nonsurgical treatments and f PLND were primary endpoints and evaluated using regression models. Results PSMA PET/CT claimed significantly more N1 (24.2% vs. 11.3%; P = 0.01; OR, 1.97; 95% CI, 1.18–3.28) but insignificantly more M1 disease (9.9% vs. 5.7%; P = 0.42; OR, 1.91; 95% CI, 0.39–9.23), compared with the conventional imaging modalities. miN0 stage was related to more RP decisions compared with cN0 stage (P < 0.001; OR, 1.91; 95% CI, 1.48–2.46). PLND decision-making was significantly driven by positive c\miN stage findings, which were more reliable when it was reported after a PSMA PET/CT examination (P < 0.001; OR, 35.55; 95% CI, 6.74–187.45 for conventional imaging modalities vs. P < 0.001; OR, 91.72; 95% CI, 11.25–747.56 for PSMA PET/CT). Conclusions Patients with no suspicion of lymph node invasion on molecular imaging (PSMA PET/CT) tended to be referred to RP more compared to radiological imaging. Also, the PLND decision was strongly driven by staging findings. Compared with conventional imaging, PSMA PET/CT findings were more reliable during PLND decision-making.

Comparison of the epidemiology of elderly trauma between major trauma centres in Riyadh, Saudi Arabia and Melbourne, Australia.

To review the epidemiology of elderly trauma at the Kind Saud Medical City (KSMC), Riyadh, Saudi Arabia, and carry out risk-adjusted analyses to benchmark outcomes with the Alfred Hospital, Melbourne, Australia, the largest Australasian trauma service. This retrospective study included records of injured patients (≥65 years) from the hospital trauma registries during 2022. Demographic and injury data were extracted. Risk-adjusted endpoints were: inpatient mortality and length of stay, analysed using logistic and median regression. A total of 193 elderly patients were registered on the KSMC registry and 1233 elderly patients were registered on the Alfred Hospital registry. Kind Saud Medical City saw proportionally less major trauma (injury severity score of >12, 24.4% vs. 44.2%, p<0.001) and less females (31.1% vs 44.4%, p<0.001). The modal injury group was low level falls in both centres (≈60%). Discharge destination was different, particularly for patients discharged home (86.5% vs. 56%) or to a rehabilitation facility (0.5% vs. 28.2%). The risk-adjusted length of stay was 4.5 days less at the Alfred Hospital (95% CI: [3.25-5.77] days, p<0.001). The odds of in-hospital death were not significantly different (OR=0.72, 95% CI: [0.36-1.47], p=0.37). Despite the different settings, low level falls were the major cause of injury in older patients. A longer length of stay in the acute hospital was identified for KSMC, however, this may be partly explained by discharge destination practices in the 2 countries.

Deep sediment heterogeneity inferred using very low-frequency features from merchant shipsa).

The very low-frequency noise from merchant ships provides a good broadband sound source to study the deep layers of the seabed. The nested striations that characterize ship time-frequency spectrograms contain unique acoustic features corresponding to where the waveguide invariant β becomes infinite. In this dataset, these features occur at frequencies between 20 and 80 Hz, where pairs of modal group velocities become equal. The goal of this study is to identify these β = ∞ frequencies in ship noise spectrograms and use them to perform statistical inference for the deep layer sound speeds and thicknesses in the New England Mudpatch for a larger number of ships and acoustic arrays over a larger geographical region than previously studied. Marginal probability distributions of the data indicate that using singular points for a feature-based inversion yields an estimate of the sound speed and a limiting value for the thickness of the first deep layer. Heterogeneity is examined by correlating spatial variability of the deep layer sound speeds with ship tracks.

The intersection of bisexuality and gender modality: exploring differences in sexual interest and satisfaction

Background Sexual well-being is crucial for overall health, but research on bisexual individuals’ sexual experiences across gender modalities is limited. This study aims to address this gap by examining differences in sexual interest and satisfaction among bisexual adults of various gender modalities. Objectives To investigate whether there are differences in sexual interest and satisfaction levels among bisexual adults across gender modalities (cisgender men, cisgender women, and transgender/gender diverse individuals). Methods A cross-sectional online survey was conducted with 475 self-identified bisexual adults (161 cisgender men, 228 cisgender women, 86 transgender/gender diverse). Participants completed demographic questionnaires and standardized measures of sexual interest and satisfaction from the PROMIS Sexual Function and Satisfaction Version 2.0. One-way ANOVAs were used to compare scores across gender modality groups. Results Significant differences were found in sexual interest across gender modalities (F(2, 472) = 10.131, p < .001). Cisgender men reported higher sexual interest (M = 52.958) compared to cisgender women (M = 48.563, p < .001) and transgender/gender diverse individuals (M = 50.566, p = .170). No significant differences were found in sexual satisfaction across gender modalities (i(2, 387) = 2.102, p = .124). Conclusions While cisgender bisexual men reported higher levels of sexual interest, sexual satisfaction was comparable across all gender modalities. These findings highlight the need for nuanced understanding of sexual experiences among bisexual individuals and underscore the importance of considering gender modality in research and clinical practice related to sexual health. Implications This study contributes to the limited research on bisexual individuals’ sexual experiences across gender modalities. The findings can inform more inclusive and tailored approaches to sexual health care and support for bisexual individuals of all gender modalities.

Higher-Dimensional Communications Using Multimode Fibers and Compact Components to Enable a Dense Set of Communicating Channels

Higher-dimensional communications are of interest for multiple reasons, including increasing the classical transmission capacity and, more recently, the quantum state transfer through fibers using the many modes within the fiber. For quantum communications, this enables an increase in the number of bits per photon, increasing quantum fidelity, increasing error thresholds and enabling hyperentanglement transfer, among other possibilities. A high-dimensional quantum state transfer can be transported through multimode fiber using the many modes available. However, this transfer of information through multimode optical fiber is limited by attenuation and mode coupling among the various spatial and polarization modes. Here, we consider how this mode coupling impacts the transfer process. We consider the fiber’s modal properties, including orbital angular momentum, modal group numbers, and principal modes. We also investigate and propose input and output optical components, as well as fiber properties, which better mitigate the deleterious effects of mode coupling. We use the WKB approximation to the scaler wave equation as a guidance to quantify this coupling and then implement corrections to this approximation using exact solutions to the scaler wave equation. We consider methods to circumvent this mode coupling using optical fiber designs, holographic optical components and devices that are commercially available today. Some of these components, such as the holographic gratings and lenses, could be implemented using flat optics.

Tuberculin Skin Test Reactivity among Health Care Workers in the Abia State University Teaching Hospital, Aba South-east Nigeria

Background Tuberculosis is one of the infections targeted for eradication and is still under surveillance. Hospital workers in Nigeria take little or no precautions against tuberculosis while attending to patients. Objectives This research aimed to study the prevalence of the reactivity of positive Tuberculin Skin Tests among healthcare workers in a Nigerian University Teaching Hospital. Methods Ethical approval and informed consent were obtained from the participants. Two hundred and ten consented participants were recruited for this study, while 185 contributed till the end. The Tuberculin Skin Test was conducted following the standard operating procedures. The chi-square test was used to compare the variable at a significant level of P &lt; 0.05. Of those who received a BGC vaccine &lt; 3 years, 4.8% were excluded from the analyses. Results Mean ± SD of participants’ age was approximately 30 ± 8 years. Participants comprised 87 (47%) males and 98 (53%) females. The modal age group was 21-25 years. Most participants were clinical medical students, 93(50.3%), while doctors, 7 (3.8%), were second to least. The prevalence of positive reactivity to the Tuberculin Skin Test was 29.9%. There was no significant difference observed regarding sexes and positive reactivity. A significant difference was found in reactivity ≥ 10 mm between those who didn’t receive BCG and those who received BCG vaccine ≥ 10 years before the study. Conclusion Healthcare workers can be potential active TB patients and reservoirs. We recommend highly sensitive and specific periodic TB screening, prophylactic treatment, and re-vaccination of Health Care Workers in Nigeria.

Naso-mucociliary Clearance Time among Patients with Chronic Rhinosinusitis in Ilorin, North-central Nigeria.

The mucociliary clearance system is an important component in the prevention of chronic inflammation of the nasal and paranasal sinus. The study aims to establish the normal values of mucociliary clearance in our region and to study the variation in mucociliary activity in patients with chronic rhinosinusitis in Ilorin, North-central Nigeria. This was a prospective, cross-sectional study using consecutive consenting participants in both the control and study groups carried out at both family medicine and otorhinolaryngology clinics among patients attending the clinics. After ethical approval was sought, informed consent was obtained from patients, a modified version of the validated health questionnaire was filled, semi-structured questionnaires were also filled after which patient undergo anterior rhinoscopy, nasal patency test and spirometry was done. The saccharine test has been used to measure nasal-mucociliary clearance time in the past. All information were entered into SPSS version 20 and analysed descriptively, and results were presented in tables and figures. Consecutive consenting 125 patients with rhinosinusitis (study group) and those without rhinosinusitis (control group) underwent naso-mucociliary clearance test. There were 34 males and 91 females with a male:female ratio of 1:2.6 among the study group and 55 males and 70 females with a male:female ratio of 1:1.3 for the control group. The age range was from 18 to 68 years with 18-40 years constituting the modal age group. The mean age for the studied group was 35.7 years while that of the control group was 33.1 years. The mean naso-mucociliary clearance time among the study group was 35.1 min standard deviation (SD = 12.32 ± 1.63), while among the control group, it was 14.8 min (SD = 5.59 ± 0.43). Compared to the control group, there was a roughly 200% prolonged increase in the duration of naso-mucociliary clearance time among patients with rhinosinusitis. There was also a positive correlation with increasing age. Future studies comparing the pre-operative and post-operative treatment of rhinosinusitis will contribute to knowledge.

Modal group refractive index measurement of few-mode fibers based on time-domain cross-correlation

We propose a measurement method based on the time-domain cross-correlation technique, combined with the cut-back method, enabling the measurement of group refractive indices (n g ) in few-mode fibers (FMF). A Mach–Zehnder interferometric system, equipped with high-precision and extensive range delay devices, is established. The system records off-axis holograms of spatial reference light at various delays interfering with the emitted light from the fiber under test. The interference energy is extracted from these holograms, and a time-domain mode energy curve is developed utilizing the principle of cross correlation. Optimal holograms at each of the curve peaks are used to reconstruct the modal field distribution, effectively separating and accurately identifying each mode within the FMF. By integrating the cut-back method, the n g corresponding to each mode is calculated based on the changes in group delay before and after fiber cutting. The n g of modes in the two-mode fibers was measured and the differential group delay calculated from the measurement agrees with the manufacturer’s specifications. The measured n g of a standard single-mode fiber aligns with the manufacturer’s specifications. Furthermore, the n g of the higher-order modes in four-mode fibers were measured by exciting them at different angles and validating the wave optics theory that the n g of the fiber modes is independent of the excitation angle. This method can simultaneously measure the n g of several modes in a fiber, providing support for the development and application of FMFs.

Біологічна характеристика білого (Hypophthalmichthys molitrix Valenciennes, 1844), строкатого (Hypophthalmichthys nobilis Richardson, 1845) та гібрида товстолобиків (Hypophthalmichthys sp.) як обʼєктів випасної аквакультури в Кременчуцькому водосховищі

Purpose: Determination and analysis of parameters, which characterize the biological and fishery aspects of the formation and exploitation of the commercial stock of silver and bighead carps of the Kremenchuk Reservoir. Methodology. As primary materials, the results of field studies at the Kremenchuk Reservoir carried out in 2019-21 and 2023 have been used. Data collection and processing was carried out in accordance with generally accepted methods. Ichthyological material was collected from catches of commercial fishing nets with mesh sizes a=38-140 mm; in total, during the study period, catches of 2,254 fishing nets were examined, of which 652 individuals of silver and bighead carps as well as their hybrids were analyzed.. Predicted survival rate was assessed based on the annual natural mortality rate, which was determined based on the the Bertalanffy equation parameters. Statistical data processing was carried in MS Excel. Findings. In recent years, the basis of the commercial catches of silver, bighead carps and their hybrids in the Kremenchuk Reservoir was composed of age-7-10 fish, which was due to their predominant catch due to specialized fishing with nets with mesh sizes of a=100-140 mm, which accounted for up to 96.7% of the total catch of these species; the share of native species in the catches of these nets did not exceed 10%. The average annual absolute linear growth of these species in modal age groups was 6.0...9.6 cm, relative - 8.7...14.5%; the weight gains were 1416...3829 g and 28.1...43.5%, respectively, which indicated satisfactory grazing conditions in the Kremenchuk reservoir. The parameters of the Bertalanffy equation, which characterize the growth rate of silver, bighead carps and their hybrids in the Kremenchuk Reservoir, were: K = 1.08 (year-1), L∞ = 115.7 (cm) to = 0.17 (years). Based on the calculated natural mortality rates and 30% removal starting from age-5 fish, the fish return rate from stocking age-1+ fish into the Kremenchuk Reservoir is 10.2%. The peak culmination of ichthyomass of silver, bighead carps and their hybrids falls on age-4-6 fish; the optimal legal length of 55 cm allows ensuring the catch rates of 751 kg per 1,000 stocked age-1+ juveniles. Originality. Original data on the current state of commercial stocks of the main objects of pasture aquaculture in the Kremenchuk Reservoir were obtained from the point of view of the theoretical foundations of the formation and exploitation of their commercial stock. New methodical approaches to the assessment of fish return rate are proposed, as the main criterion for the effectiveness of measures for the artificial reproduction of ichthyofauna. Practical value. It has been established that the conditions for the formation of the commercial stock of the Kremenchuk Reservoir can be considered as satisfactory, i.e. the main limiting factor limiting the growth of their catches is the insufficient stocking volume. The obtained actual coefficients, which characterize the survival of fish seeds, can be used to forecast the volume of stocking and catch of silver, bighead carps and their hybrids. The shortcomings of the organization of modern fishery from the point of view of ensuring the maximum catch per recruitment unit have been established. The advisability of increasing the legal length for silver, bighead carps and their hybrids to 55 cm has been confirmed. Key words: Kremenchuk reservoir, pasture aquaculture, silver carp, bighead carp, organization of fishery.

Colorectal adenoma detection rate using texture and color enhancement imaging versus white light imaging with chromoendoscopy: a propensity score matching study.

Few studies have evaluated the adenoma detection rate (ADR) of colonoscopy with texture and color enhancement imaging (TXI), a novel image-enhancing technology. This study compares the detection of colorectal polyps using TXI to that using white light imaging (WLI). This single-center retrospective study used propensity-matched scoring based on the patients' baseline characteristics (age, sex, indication, bowel preparation, endoscopist, colonoscope type, and withdrawal time) to compare the results of patients who underwent chromoendoscopy using WLI or TXI at the Toyoshima Endoscopy Clinic. The differences in polyp detection rates and the mean number of detected polyps per colonoscopy were determined between the TXI and WLI groups. After propensity score matching, 1970 patients were enrolled into each imaging modality group. The mean patient age was 57.2±12.5years, and 44.5% of the cohort were men. The ADR was higher in the TXI group than in the WLI group (55.0% vs 49.4%, odds ratio: 1.25). High-risk ADR were more common in the TXI group than in the WLI group (17.6% vs 12.8%; OR: 1.45). The mean number of adenomas per colonoscopy (APC) was higher in the TXI group than in the WLI group (1.187 vs 0.943, OR: 1.12). APC with a flat morphology (1.093 vs 0.848, OR: 1.14) and APC of <6mm (0.992 vs 0.757, OR: 1.16) were higher in the TXI group than in the WLI group. Compared to WLI, TXI improved the ADR in patients who underwent chromoendoscopy based on actual clinical data.

Scope of the use of natural and traditional medicine in cancer patients

Rationale: Cancer is the second cause of death in Cuba and the first in Camagüey. To control it, strategies are required regarding the use of medical resources. Natural and Traditional Medicine (NTM) has a group of procedures and modalities that, on the one hand, have been used to treat symptoms related to Cancer, however, these elements have not been generally disclosed. Objective: Show the scope of MNT modalities for the treatment of cancer patients. Material and method: A bibliographic review is carried out with the objective of compiling the MNT modalities that may or may not be used in cancer patients. Results: The modalities that have a favorable scope in the oncological patient. Conclusions: Knowledge of the scope and limitations of MNT modalities in cancer patients is important for their use.

Response reconstruction based on substructural condensation and modal-group superposition

Abstract Increasingly complex civil structures result in an enormous consumption of computational resources in response reconstruction. Moreover, common closely spaced modes (CSMs) also impair reconstruction performance. This study proposed an improved approach that incorporated substructural condensation and modal-group superposition. This method efficiently extrapolated the desired response by dividing the entire finite element model into multiple manageable substructures, which were then condensed and assembled into a super-element model with fewer degrees of freedom (DOFs). The reconstruction response was directly performed on the condensed model by selectively retaining the physically measured DOFs during the condensation process. To address the challenges posed by CSMs, defined modal group responses (MGRs) were extracted from dynamic measurements using empirical mode decomposition. Based on these results, the corresponding MGRs at inaccessible locations were extrapolated using a condensed model. Finally, all the MGRs are superposed to form the desired response. Numerical and experimental tests were conducted to demonstrate the efficiency and accuracy of the proposed approach. The effects of substructural division, measurement noise, and measurement locations on the reconstruction were studied in detail.

Assessing the correlation between the Benign Prostatic Hyperplasia Bother Impact Index and International Prostate Symptom Score after Transurethral Resection of the Prostate

Improvements in Lower Urinary Tract Symptoms (LUTS) and Quality of Life (QoL) are usually the key reasons men seek surgical options for their management. Transurethral Resection of the Prostate (TURP) is an effective surgical option for these patients, and it is increasingly being employed in the management of Benign Prostatic Hyperplasia (BPH) patients. The aim of this study was to evaluate the effect of TURP on the Bother Impact Index (BII) score and International Prostate Symptom Score (IPSS) and assess the correlation between these two parameters three months after TURP. This was a prospective study of 194 men who had TURP between February 2018 and October 2019. On clinical evaluation, all the patients included in the study had moderate to severe LUTS attributable to BPH. Preoperatively, detailed histories were taken of each patient, and the IPSS questionnaire was administered. The mean age of the participants was 66.28 years (Standard Deviation, SD=8.19). The modal age group was the sixth decade. The mean BII score of the patients was 5.73 (SD=0.45), and the mean IPPS of the patients was 25.85 (SD=5.07). The mean BII score 3 months post-TURP was 1.44 (SD±0.91), while the mean IPSS 3 months post-TURP was 2.75 (SD±1.33). There was a strong positive and statistically significant correlation between BII score and IPSS at 3 months post-TURP (r=+0.770, p&lt;0.001).

A Miniaturized Endoscopic Device Integrating Raman Spectroscopy and Laser Speckle Technology Via an Image Fusion Algorithm for Intraoperative Identification and Functional Protection of Parathyroid Glands

Abstract The importance of parathyroid glands (PGs) protection is increasingly recognized by thyroid surgeons in the field of minimally invasive video-assisted thyroidectomy (MIVAT). However, current techniques for intra-operative identification and vascularity assessment of the PGs are contentious and complex. This study presents the design and validation of a miniaturized device for fusion near-infrared autofluorescence (NIRAF) based on Raman spectroscopy and laser speckle contrast imaging (LSCI) via an image fusion algorithm for functional protection of PGs in the MIVAT. Our light source components include an integrated light emitting diode (LED) light source fiber, an NIRAF optical fiber, an acquisition optical fiber, and a laser speckle optical fiber in the endoscopic system to achieve identification and vascularity assessment of PGs using a single endoscopic probe. It has been validated in ex vivo tissue experiments that the fluorescence intensity detected by the device was equivalent to that of the marker indocyanine green (ICG) in visual images and superior to that of the thyroid and all other tissues in the neck. Based on clinical studies, MIVAT using functional fluorescence endoscopy, compared with the White light pattern group, the NIRAF combined with LSCI modality group increased the number of intra-operative confirmations of the PGs (P &amp;lt; 0.001), declined the decrease in parathyroid hormone (PTH) (P &amp;lt; 0.05) and calcium levels (P &amp;lt; 0.05) on the first postoperative day, and reduced the incidence of symptomatic hypocalcemia (P &amp;lt; 0.05). Our device may reduce the incidence of postoperative permanent hypoparathyroidism. Application of an miniaturized functional fluorescence endoscope for real-time and label-free PGs identification and vascularity assessment in MIVAT could be realized.

High-intensity interval training and cardiorespiratory fitness in adults: An umbrella review of systematic reviews and meta-analyses.

High-intensity interval training (HIIT) is characterized by repeated bouts of relatively intense exercise interspersed with recovery periods. Previous studies have evaluated this exercise strategy with various population subgroups, regimens, and comparator groups, limiting the generalizability of findings. We performed a novel umbrella review to generate an up-to-date synthesis of the available evidence regarding the effect of HIIT on cardiorespiratory fitness (CRF) in adults as compared to non-exercise control and traditional continuous forms of exercise such as moderate-intensity continuous training (MICT). An umbrella review was conducted in accordance with the Preferred Reporting Items for Overviews of Reviews guideline. Seven databases (MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science) were searched until February 2024. Systematic reviews with meta-analyses comparing HIIT and active/non-active control conditions were included. Literature search, data extraction, and methodological quality assessment (AMSTAR-2) were conducted independently by two reviewers. Twenty-four systematic reviews with meta-analyses, representing 429 primary studies and 12 967 unique participants, met the inclusion criteria. Most of the systematic reviews received moderate-to-critically low AMSTAR-2 scores. The data showed that HIIT, including the particularly intense variant "sprint interval training" (SIT), significantly increases CRF in adults compared to non-exercise control (standardized mean difference [SMD]: 0.28 to 4.31; weighted mean difference [WMD]: 3.25 to 5.5 mL/kg/min) and MICT (SMD: 0.18 to 0.99; WMD: 0.52 to 3.76 mL/kg/min). This effect was consistently observed across specific groups of individuals (e.g., apparently healthy adults, individuals with overweight/obesity, older adults, and high-level athletes) and HIIT modalities (e.g., low-volume HIIT, whole-body HIIT, home-based HIIT, aquatic HIIT, and short SIT). Existing evidence from systematic reviews consistently supports the effect of HIIT on enhancing CRF in adults when compared to non-exercise control and MICT. Our findings offer a comprehensive basis that may potentially contribute to informing physical activity guidelines aimed at improving CRF in the general population.

Burnout and Job Satisfaction among Lecturers in Public Universities in Enugu State, Nigeria.

There is increasing awareness of burnout and job disaffection among many professions like health profession, teachers, armed personnel and lawyers. However not much has been studied about university lecturers. To obtain the prevalence and determine predictors of burnout and job satisfaction among lecturers in public universities in Enugu State, Nigeria. It was a cross sectional analytical study. The participants were academic staff from University of Nigeria Nsukka and Enugu State University of Technology who met inclusion criteria. They were selected using multistage sampling technique. Data were collected using Oldenberg Burnout Inventory for burnout and Job Descriptive Index for job satisfaction. A total of 392 lecturers were studied: The males were 221 (56.3%), and the modal age group was 41-50 years: 152 (38.8%). The majority were married 303 (77.3%) and had worked for ≤10 years (65.8%). The prevalence of burnout was 57.7%. In general, 150 (38.3%) had a high level of job satisfaction. However, in most facets, < 50% were satisfied. Most socio-demographic variables were not associated with either burnout or job satisfaction. There is significant association between burnout and job satisfaction. Almost all 205 (90.7%) who had burnout had low job satisfaction and this was statistically significant (p value = 0.011). Present work condition, pay, opportunities, supervision were used as predictors to level of burnout. Present condition of work was a significant contributor (p = < 0.001). The prevalence of burnout was high and many had low to moderate job satisfaction. Most socio-demographic variables were not associated with burnout or job satisfaction. There was a negative association between job satisfaction and burnout.

Inflammatory Patterns in the Prostate Gland and Serum Cytokine Activities in Primary Adenocarcinoma of the Prostate in Port Harcourt, Nigeria

Introduction: Chronic inflammation and pro-inflammatory cytokines such as (1L-6 and TNF-α) have been implicated in prostate carcinogenesis and metastasis. This study aims to evaluate serum concentrations of IL-6 and TNF-α, and to determine their association with clinicopathological patterns of prostate cancer in affected patients. Materials and Methods: Ninety (90) patients with histologically diagnosed prostate cancer (PCa), treated at the Urology Division of the University of Port Harcourt Teaching Hospital (UPTH), Nigeria were involved in this study. The enzyme-linked immunosorbent assay (ELISA) technique was used to assay cytokines (IL-6 and TNF-α), and serum PSA. Gleason Scores were categorized as well differentiated (GS of ≤ 6), moderately differentiated (GS = 7), and poorly differentiated (GS 8-10). Results were analyzed with IBM SPSS version 20.0. Pearson’s correlation test was used to determine the correlation between the cytokines (IL-6 and TNF-α) and Gleason Scores. Results: The modal age group with PCa was 60-69 years. The mean age of patients was 68.788.26 years, and the mean serum PSA 93.2478pg/ml. Serum levels of IL-6 and TNF-α were 8.0pg/ml, 11.2pg/ml and (27.0±26.4pg/ml) respectively. Forty-six subjects had poorly differentiated PCa (GS 8-10); 17 moderately differentiated (GS 7); and 27 well differentiated (GS ≤ 6). Mean serum levels of IL-6, TNF-α and PSA (113.1ng/ml) were raised and found highest in those with poorly differentiated PCa. Conclusion: The observed correlation was positive but weak. The patients might have commenced undeclared anti-inflammatory drugs that depressed inflammation. However, a larger sample size would probably confirm the prognostic value of IL-6 and TNF-α in PCa subjects.

A family-centered approach to social needs awareness in the pediatric emergency department

ObjectiveWe aimed to understand family preferences around reporting and receiving health-related social needs (HRSN) information by assessment modality during pediatric emergency department (PED) visits. MethodsFamilies were randomized into paper (control), cell phone, or tablet modality groups by their child's exam room. Nurses alerted families to complete a single HRSN assessment during routine workflow. We used logistic regression and McNemar's test to assess discordance in modality preference. ResultsForty-seven percent of families disclosed at least one HRSN across a total 611 assessments. Disclosure of HRSN was similar by modality. Twenty-three percent of those assigned tablet preferred cell phone (p < 0.001). Two-thirds of families preferred receiving digitally formatted community resources (email or text). There was no difference in preferred timing of HRSN assessment completion. ConclusionsAssessment modality did not appear to influence family HRSN disclosure. Families were generally satisfied with all HRSN assessment modalities but demonstrated a particular preference in using personal cell phones over tablets. Digitally formatted community referrals also pose numerous advantages over conventional paper handouts. InnovationUse of personal cell phones is a novel, streamlined method of HRSN interventions in the clinical setting, performing similar to more conventional modalities, with a preference among families when compared to tablets.

Tissue Microarray Immunohistochemical Staining for Androgen Receptor in Breast Cancer in a Ghanaian Cohort.

Despite the advancement in therapy, breast cancer still remains the most common malignancy in women globally due in part to its heterogeneity. Triple-negative breast cancer (TNBC) represents up to 20% of all breast cancer variants, an aggressive disease with poorer outcomes compared to other breast cancer subtypes. No targeted therapies are currently approved for TNBC, and newer treatment approaches are seriously needed. Androgen receptor (AR), another hormonal receptor, is often expressed in breast cancer, and its role depends on the relative levels of circulating estrogens and androgens. This study aimed to assess the expression of AR in breast cancer in a tertiary hospital in Ghana. Immunohistochemical staining for AR was performed on tissue microarray (TMA) blocks, of which estrogen receptor, progesterone receptor, and Her-2/neu had already been done. 197 cases were suitable for the study. Results from the immunostaining were analyzed using the SPSS version 23 for descriptive statistics and correlations (χ2 and Pearson tests). 197 TMA cases were used. TNBCs constitute 61.9% of the cancers. The majority of these tumors were grade III, ductal carcinoma NST. The mean age was 49.86 ± 14.09, and the modal age group was 40-49 years. Our cases showed 23% AR expression in triple-negative cancers. The study also established that AR is more frequently expressed in low-grade tumors compared to high-grade ones. There is an appreciable level of AR expression in our cases; however, most are quadruple negative. However, AR is more frequently expressed in low-grade tumors than high-grade ones.

Esophageal cancer patient survival: A retrospective study from a tertiary care hospital in Pakistan.

To determine the pattern, tumor characteristics of esophageal cancer (EC) and survival of esophageal carcinoma patients presenting to upper GI Unit at Dr. Ruth K.M. Pfau Civil Hospital Karachi. We conducted a retrospective analysis of histologically confirmed EC patients from 2016 to 2021 at Upper GI Unit - Dr. Ruth K.M. Pfau Civil Hospital, Karachi. Data were collected using a filled Proforma, medical records, pathology reports and surgical notes, and patients or their family members were contacted for informed consent. Statistical analyses were performed using STATA version 16.0. Time to event was measured from the date of diagnosis to the date of the last follow-up or recorded death. Descriptive statistics and survival analyses, including Kaplan-Meier method and log-rank test, were employed. Univariate and multivariate Cox regression analyses were conducted to assess independent predictors of survival. Total 152 patients with a median age of 45 (range 80-15) years were enrolled in this study. Clinical stages-III, IV-A and IV-B were identified in 35.5% (n = 54), 23.7% (n = 36) and 34.2% (n = 52), respectively. Total of 62% (n=94) had died at median follow up of 9.56 months and three years overall survival rate was 10.0%. Univariate survival analysis revealed that patients with clinical stage-II (p-value 0.002) and patients treated with combined surgery plus chemo-radiotherapy (p-value 0.040) was significantly associated with lower risk of mortality among other stages and treatment modality groups. Conversely, patients having metastasis (p value <0.001) and those with vascular involvement >90 degrees (p value <0.001) showed worse survival outcomes. Our study reveals a three years survival rate of 10.0%, emphasizing the formidable challenge of advanced-stage malignancies. Clinical stage, vascular involvement, and metastasis emerged as significant predictors of mortality. Moreover, integrating surgery with chemo-radiotherapy significantly improved three years survival (36.8% vs. 14.2%). Despite single-center limitations, our findings provide crucial regional insights into esophageal carcinoma outcomes.