Primary Risk Research Articles

Exchange Transfusion in Neonatal Hyperbilirubinemia: Experience of A Tertiary Care Hospital in Dhaka

Background: Hyperbilirubinaemia is a benign condition in newborn babies in some infants may become severe, progressing to kernicterus with substantial risk of neonatal mortality and long-term neurodevelopmental impairments. Among many treatment options exchange transfusion (ET) is the standard method for treatment of severe hyperbilirubinemia.
 Objectives: To investigate the frequency of primary risk factors for neonatal hyperbilirubinemia leading to ET, to evaluate the complications and immediate outcome of ET.
 Methods: This was an observational cross sectional study conducted in Dr. MR Khan Shishu Hospital and ICH, Dhaka. Frequency of primary risk factors for severe neonatal hyperbilirubinemia leading to ET, characteristics of babies undergoing ET, complications and immediate outcome of ET were analyzed among the neonates admitted between January 2017 to February 2021.
 Results: Among 61 neonates 49.18% were male and 50.82% were female, 65.57% of neonates were term and 34.43% pre term. The mean gestational age was 37.00 ± 1.50 weeks and mean birth weight was 2619±50gm. The leading causes of jaundice requiring ET were sepsis 31.17%, ABO incompatibility 24.59%, Rh incompatibility 14.75%, PT LBW with sepsis 14.75%, Infant of diabetic mother (IDM) 6.55%, PT LBW 6.55%, and neonatal sepsis with Down syndrome with congenital hypothyroidism 1.63%. Twenty (32.79%) neonates presented with signs of Kernicterus. Seven neonates (35%) presented with lethargy/poor feeding or hypotonic posture, 4(20%) patients had opisthotonus posture/hypertonia, and 9(45%) had convulsion. Nineteen (31.14%) neonates had complications related to ET. The most frequent complication was bradycardia (16.34%), then Catheter block (9.83%), apnaea (6.55%), cardiac arrest (6.55%), hypothermia (4.92%), NEC after ET (1.64%). Immediate outcome was good in 72.13% patients with smooth recovery, 14.75% had neurological deficit and 1.64% died. Among 20 neonates who presented with signs of Kernicterus 35% patients discharged with good recovery, 45% had neurological deficit.
 Conclusion: The common causes of exchange transfusion in neonatal jaundice were sepsis, ABO incompatibility, PT LBW, and infants of diabetic mothers. Overall outcome was good few developed neurological deficit.
 DS (Child) H J 2022; 38(2): 89-95

Electronic Consultations in a Community Neurology Practice: A Retrospective Study Informing Best Practice

ObjectiveTo describe our practice of electronic consultations (e-consults) and assess safety and risk factors for subsequent face-to-face consultations. Patients and MethodsA retrospective cohort study of all e-consults completed in a community neurology practice between May 5, 2018, and June 31, 2019, was completed. Clinical and demographic variables were compared between the successful and unsuccessful (defined by presence of subsequent face-to-face consultation) cohorts. Hazard ratios (HR) were calculated using Cox regression model. Kaplan-Meier probability analysis (with 95% CIs) of subsequent face-to-face consultation was performed. Case examples highlighting potential harm were summarized. ResultsIn total, 302 e-consults were reviewed. The most frequent referrals were for headache (n=125, 41.4%), dysesthesia (n=40, 13.2%), and abnormal imaging finding (n=27, 8.9%). The most common e-consult questions were for treatment (57.6%) and diagnostic evaluation (48.0%) recommendations. Moreover, 24.8% (n=75) of e-consults were followed by face-to-face consultations, with primary risk factors including female sex (HR, 1.9), referral for headache (HR, 1.7), and final diagnosis of migraine (HR, 2.0) or long-term migraine (HR, 5.0). Potential harm related to delayed diagnosis/treatment was identified in 6 (2.0%) patients with migraine and 4 (1.3%) without migraine presenting to emergency department. ConclusionUtilization of e-consults may safely improve access to neurologic expertise and prevent the need for some visits, which may have required a face-to-face visit. In patients with chronic migraine, e-consults should be considered short-term and followed by face-to-face consultation as soon as access allows. Neurologists performing e-consults should be able to triage patients to face-to-face consultation, particularly when diagnosis is uncertain or the neurologic examination may help guide appropriate testing.

Complex Speciation and Distribution of Iron, Sulfur, and Trace Metals in Coal Mine Soils Reflect Grain- and Sub-Grain-Scale Heterogeneity during Pyrite Oxidative Dissolution

Historical coal mining practices have caused various soil and water hazards, particularly through the dumping of mine waste. The primary environmental risk associated with this waste is the leaching of toxic metals from dumps of spoil or refuse into the subsurface soil or into nearby water resources. The extent of metal release is controlled via the oxidative dissolution of pyrite and potential re-sequestration through secondary Fe oxides. The characterization of the dominant Fe-bearing phase and the distribution of trace metals associated with these phases was determined via electron microscopy, synchrotron-based X-ray micro-fluorescence (μ-XRF) element and redox mapping from shallow mine soils from an impacted watershed in Appalachian Ohio. The dominant Fe-bearing phases were: (1) unweathered to partially weathered pyrite; (2) pseudomorphic replacement of pyrite with Fe(III) oxides; (3) fine-grained Fe oxide surface coatings; and (4) discrete Fe(III) oxide grains. Thicker secondary coatings and larger particles were sulfate rich, whereas smaller grains and thinner coatings were sulfate poor. The discrete Fe oxide grains exhibited the highest concentrations of Cr, Mn, Ni, and Cu, and sub-grain-scale concentration trends (Mn > Cr > Ni > Cu) were consistent with bulk soil properties. Predicting future metal transport requires an understanding of metal speciation and distribution from the sub-grain scale to the pedon scale.

A Glass-Interphase for Highly Reversible and Stable RT-Na/S Batteries

Owing to the high theoretical specific capacity (1165 mA h g-1), high natural abundance, and low redox potential (-2.71 V vs standard hydrogen electrode), sodium metal is considered as an ideal anode material for the next-generation high-energy batteries. Though, a high-temperature variant of the sodium-sulfur batteries has already been commercialized, its compromised safety (due to high-temperature operation, 250 – 300 ⁰C) has triggered the research interest in developing its room-temperature analogue. At room-temperature, the thermodynamic instability of Na metal with the liquid electrolytes often leads to develop a thick and chemically unstable interphase, often called the solid electrolyte interphase (SEI). Upon Na plating/stripping, the SEI grows and dissolves repeatedly, results in consuming both the Na anode and the electrolyte inventory. The Na dendrites, the primary unknown risk associated with Na metal-based batteries, are inclined to develop from the fractured sites of the SEI. The SEI exfoliation can be attributed to weak chemical adhesion between the SEI and the Na metal anode. Functional additives, engineered solvents, and the high concentration electrolytes have often been used to alter the mechanical and electrochemical properties of the SEI. It is apparent that, a stable and durable SEI is the key to creating a secure, dendrite-free, and long-lasting RT-Na/S batteries.More recently, the idea of glass-electrolytes to stabilize the metal anodes is disclosed by the Nobel laureate Prof. J. Goodenough. The glass-electrolyte is used to suppress the dendrite growth and ensured improved safety of the high-energy metal-sulfur batteries. However, the cell experiences a huge interfacial resistance due to metal anode/glass-electrolyte interface.The present work relates to the development of a glass-interphase for RT-Na/S batteries. The interphase is grown directly over the sodium metal anode through a simple and scalable approach. To growth the interphase, a novel organic molecule is used to facilitate the formation of the glass-interphase, and called as “glass-interphase forming additive (GIFA). In general, GIFAs contains the hydrolysable group, which is commonly an amine, acyloxy, alkoxy, or halogen on one side, and one Si atom. It contains organo-functional group, such as epoxide, on other side. The presence of oxide or hydroxide is essential in realizing interaction of GIFA with the sodium metal surface.

Risk Factors Of Anaemia Among Zidovudine-Based Regimen In Patients With Hiv Infection- A Cohort Study.

Anaemia in patients with HIV infection is commonly multifactorial in origin. Nutritional deficiencies and the presence of opportunistic infections as well as HIV infection itself can cause anaemia. HIV medications like zidovudine can also cause anaemia in patients with HIV infection. This study aimed to study the prevalence and risk factors of anaemia in patients with HIV infection on a zidovudine-based HAART regimen. This hospital-based prospective cohort study was done at the ART (anti-retroviral therapy) centre. All adult patients with HIV attending the ART centre were included in the study. After obtaining written informed consent, the patient's demographic data, risk factors, WHO staging, and body mass index (BMI) were noted. Study population was divided into two groups as patients with or without anaemia and compared using appropriate statistical tests. Out of the 202 patients with HIV infection on a zidovudine-based regimen, 52 patients (25.7%) developed anaemia. Anaemia was common in stage 3 or stage 4 of WHO staging (OR-9.94, CI-3.89-25.36) and in patients with low CD4 counts (OR-0.988, CI-0. 982-0.995). Patients with anaemia had significant opportunistic infections. Anaemia is common in patients with HIV on zidovudine-based HAART regimen, which is seen as early as less than 8 weeks. WHO staging, and CD4 count were the primary risk factors for anaemia, which a change of treatment regimen and supportive measures can reverse.

PREDICTING THE RISK FACTORS OF HYPERTENSION AMONG INDIAN OLDER POPULATION: A MACHINE LEARNING APPROACH

Abstract Hypertension, often known as high blood pressure, is a disorder in which the pressure inside the blood arteries remain consistently high. It is a common chronic illness that often occurs along with other morbidities. Risk prediction of hypertension further contributes to the detection, development of interventions, and treatment. The current study used different machine learning models to identify the high-risk factors of developing hypertension using a large-scale survey dataset LASI. A sample of 58,757 collected through the survey aged 45 and above used for model training and testing. We identified 35 risk factors from the literature and then applied feature selection methods to identify only the important ones. Based on the selected features, three models were built i.e., random forest, decision tree, and logistic regression, and the hyper-parameters were optimized on the training set using 10-fold cross-validation. The performance of the models was measured using area under the curve value, precision, recall, and F measure. The random forest classifier outperformed the rest of the two algorithms with an AUC score of 0.64, a precision of 0.65, a recall score of 0.57, and an F1 score of 0.61. Body Mass Index, diabetes, age, type of work, parents having hypertension, and multimorbidity are the primary risk factors for hypertension. The results can be further applied to make algorithms to predict hypertension among an older individuals based on their demographic, health and behavioral factors. Predictive models for hypertension can aid in determining the degree of community interventions required, ensuring a favorable outcome.

THE IMPACT OF A NATIONWIDE PHYSICAL ACTIVITY INTERVENTION FOR DIABETES AND HYPERTENSION PREVENTION

Abstract Increasing physical inactivity is a primary risk factor for diabetes and hypertension, contributing to rising healthcare expenditure and productivity losses. We examined the cost-effectiveness of the National Steps Challenge (NSC), an annual nationwide mHealth intervention to increase physical activity in Singapore. We used a Markov model to assess the long-term impact of increased physical activity from NSC on adults. Conducting NSC yearly for 10 years on a mean cohort size of 654,500 participants is projected to prevent 6,120 diabetes cases (95% credible interval: 3,690 to 9,040), 10,300 hypertension cases (6,260 to 14,700) hypertension cases and 4,950 death cases (3,280 to 7,040), leading to 78,800 QALYs (56,500 to 102,000) gained. From the health system perspective, assuming no differentiation of cost among different physical activity levels within each health state, the healthcare cost savings from the averted cases is estimated to be SGD674 million (239 million to 1.48 billion), with SGD364 million (57.8 million to 1.04 billion) for diabetes and SGD311 million (95.0 million to 690 million) for hypertension. Using a willingness to pay threshold of SGD10,000, NSC was cost-saving at -SGD4,510 (-14,000 to 1,430) per QALY gained. We project that increasing physical activity from a yearly nationwide physical activity intervention delays the incidence of diabetes and hypertension. Our results suggest that the intervention is cost-saving and improves the quality of life. The estimated cost savings are more significant when indirect costs are considered, hence providing important information for decision-making in countries when considering similar large-scale physical activity programmes.

Brief summary on the mechanism, symptoms, epidemiology, management and treatment of osteoarthritis

The most common degenerative joint disorder is osteoarthritis (OA) which impacts hundreds of millions worldwide, with the primary risk factor being age. The disorder is characterized by the breakdown of extracellular matrix (ECM) components, leading to impaired chondrocyte function and cartilage repair. Further, the subsequent inflammation results in pain and even joint disability in severe cases. Conventional treatments focus on symptomatic relief and improvement of joint function, through pharmacological means, physical therapy or surgeries. However, long-term anti-inflammatory or analgesic treatment may result in adverse side effects such as drug dependence. Meanwhile, joint replacement surgery poses risks of permanent disability. This review discusses the underlying mechanisms and risk factors of OA, their relationship to symptoms and disease progression, and current epidemiological trends. Additionally, we focus on new-generation treatments with the application of bioengineering and stem cell therapy. Finally, we address contemporary treatment strategies and the potential for future disease-altering therapies that may be implemented on a large scale.

Barriers to Adherence to Healthy Diet and Recommended Physical Activity Perceived by the Polish Population.

According to the World Health Organization, an unhealthy diet and lack of physical activity constitute the primary global health risks. The purpose of this study was to as-certain the barriers to a healthy diet (HD) and physical activity (PA) as perceived by the Polish population in order to implement public health interventions. A quantitative survey was conducted using the computer-assisted telephone interview technique on a randomly selected representative sample of 2000 Polish citizens aged 18-88 years. The research tool was a questionnaire consisting of two parts: sociodemographic characteristics and examining barriers to an HD (Cronbach's alpha = 0.899) and regular PA (Cronbach's alpha = 0.923). Women constituted more than half of the sample (53.4%), and most of the respondents lived in urban areas (60.5%), considered their financial situation as average (56.9%), and their health as satisfactory (42.3%). Barriers to an HD include the cost of healthy food (43%), lack of motivation (26.7%), and lack of time (25.4%). Barriers to taking up PA include competing priorities (29%), a lack of motivation to exercise (27.3%), feeling of constant fatigue, and lack of energy (24.4%). Limiting factors in the adoption of both an HD and PA are gender (women > men; HD p < 0.01; PA p < 0.001), financial situation (unsatisfactory; HD and PA p < 0.001), health condition (unsatisfactory; HD and PA p < 0.001), type of work (blue-collar workers; HD p < 0.001; PA p < 0.05), and employment status (people running household; HD and PA p < 0.001). The results of this study provide important information about barriers to adopting healthy lifestyle principles. The practical implications of our work can be used by policymakers responsible for intervention strategies and programmes to increase the number of people adhering to recommendations for an HD and PA by removing barriers.

Феномен терапевтического заблуждения: биоэтический аспект

Introduction.The obligatory study of medical drugs during clinical trials conduction can be named as one of the fundamental principles of evidence-based medicine. The article deals with the phenomenon of a therapeutic misconception occurring in volunteers participating in such experiments, who failed to understand the scientific goals of clinical trials and incorrectly expect the therapeutical advantages linked with such a participation. It is analyzed which methodological decisions can cause a therapeutic misconception, and also the main bioethical risks associated with this phenomenon are indicated. Theoretical analysis. It is shown that the procedure of the receipt of informed consent form is the main problematic aspect for an adequate understanding of clinical trials’ goals by its volunteers, and violation of the principle of patient autonomy can be named as a primary bioethical risk. During the COVID-19 pandemic there has been a heterogeneity of therapeutic strategies fixed because of the lack of knowledge about the new pathogen. As a result, the inability to adequately assess the risks of the intended treatment both by a patient and a doctor became a new factor that caused the therapeutic misconception. Conclusion. The procedure for obtaining informed consent form is supposed to be revised, the additional analysis of the methodology of clinical trials should be done to reduce the risk of a therapeutic misconception.

Trioxidized cysteine in the aging proteome mimics the structural dynamics and interactome of phosphorylated serine.

Aging is the primary risk factor for the development of numerous human chronic diseases. On a molecular level, it significantly impacts the regulation of protein modifications, leading to the accumulation of degenerative protein modifications (DPMs) such as aberrant serine phosphorylation (p-Ser) and trioxidized cysteine (t-Cys) within the proteome. The altered p-Ser is linked to abnormal cell signaling, while the accumulation of t-Cys is associated with chronic diseases induced by oxidative stress. Despite this, the potential cross-effects and functional interplay between these two critical molecular factors of aging remain undisclosed. This study analyzes the aging proteome of wild-type C57BL/6NTac mice over 2 years using advanced proteomics and bioinformatics. Our objective is to provide a comprehensive analysis of how t-Cys affects cell signaling and protein structure in the aging process. The results obtained indicate that t-Cys residues accumulate in the aging proteome, interact with p-Ser interacting enzymes, as validated invitro, and alter their structures similarly to p-Ser. These findings have significant implications for understanding the interplay of oxidative stress and phosphorylation in the aging process. Additionally, they open new venues for further research on the role(s) of these protein modifications in various human chronic diseases and aging, wherein exacerbated oxidation and aberrant phosphorylation are implicated.

Risk perception as a barrier to renewable energy finance – a study of debt investors in the Indian context

Purpose This study aims to explore the perceptions of investors regarding the risks associated with funding renewable energy projects in India, as well as the various factors that influence these perceptions. The investigation is limited to debt providers and seeks to pinpoint the primary risks that bankers perceive and the drivers that shape these perceptions. Design/methodology/approach This study draws on interviews and surveys of Indian bank executives, investigating how finance providers perceive risks in the Indian context and the factors driving such perceptions. Qualitative interviews have been used for operationalizing “risk perception” within the renewable energy domain, followed by a quantitative survey and exploratory factor analysis. Findings The authors find that experience and capacity are the most important factors that account for 30% of the overall variance. The second factor, which accounts for 15% of the variance, includes the perceived risks in funding renewable energy projects as compared to infrastructure projects. Among individual risks, the authors find that bankers perceive technological risk to be the lowest (5%) and contractual and regulatory risks as the highest (66%) in renewable energy projects. Research limitations/implications The study contextualizes risk perception toward renewable energy investments in the Indian context by drawing from the risk perception literature and qualitative interviews with senior bankers. It presents empirical evidence on the decision-making behavior of bankers, who are important stakeholders of the renewable energy ecosystem. The main limitation of the study is the relatively small sample, and generalizing the results to the broader population might require a larger sample. This will facilitate the use of confirmatory factor analysis and structural equation modeling, which can facilitate a more comprehensive understanding of risk perceptions in renewables financing. Originality/value Insights gained can be used to provide policy recommendations for improving the financing ecosystem of renewable energy projects. The research significantly contributes to the extant literature within the renewable energy financing domain for emerging economies.

Unraveling the Link: A Comprehensive Literature Review of Type 2 Diabetes and Menopause Onset.

Women with diabetes mellitus (DM), a metabolic endocrine illness, may experience a variety of reproductive problems. The age at menopause onset has been extensively studied as a major predictor of women's health in the future; however, its relationship to diabetes in Indian women has received less attention. This literature review looked at the consequences of diabetes in women as well as the association between diabetes and the age at which menopause begins. The average age at menopause onset among women with type 2 diabetes mellitus (T2DM) has decreased globally. According to one Indian study, the average menopause age dropped to 45 years for 26% of women with T2DM. In the current review, 10 studies indicated that women with T2DM displayed an imbalanced hormonal profile resulting in an extended anovulatory period. Two investigations highlighted the significance of altered body composition of women with T2DM, thereby suggesting obesity as the primary risk factor of ovarian aging and early climacteric symptoms. T2DM may lower the average age at menopause onset; however, further research on Indian women is necessary. There is a need of studies on T2DM in premenopausal women are needed to demonstrate how the changes in body composition impact the age at which menopause begins. Delaying the onset of menopause in women with T2DM necessitates diet and lifestyle interventions to minimize ovarian aging and hormonal imbalance.

Improved Hypertension Risk Assessment with Photoplethysmographic Recordings Combining Deep Learning and Calibration.

Hypertension, a primary risk factor for various cardiovascular diseases, is a global health concern. Early identification and effective management of hypertensive individuals are vital for reducing associated health risks. This study explores the potential of deep learning (DL) techniques, specifically GoogLeNet, ResNet-18, and ResNet-50, for discriminating between normotensive (NTS) and hypertensive (HTS) individuals using photoplethysmographic (PPG) recordings. The research assesses the impact of calibration at different time intervals between measurements, considering intervals less than 1 h, 1-6 h, 6-24 h, and over 24 h. Results indicate that calibration is most effective when measurements are closely spaced, with an accuracy exceeding 90% in all the DL strategies tested. For calibration intervals below 1 h, ResNet-18 achieved the highest accuracy (93.32%), sensitivity (84.09%), specificity (97.30%), and F1-score (88.36%). As the time interval between calibration and test measurements increased, classification performance gradually declined. For intervals exceeding 6 h, accuracy dropped below 81% but with all models maintaining accuracy above 71% even for intervals above 24 h. This study provides valuable insights into the feasibility of using DL for hypertension risk assessment, particularly through PPG recordings. It demonstrates that closely spaced calibration measurements can lead to highly accurate classification, emphasizing the potential for real-time applications. These findings may pave the way for advanced, non-invasive, and continuous blood pressure monitoring methods that are both efficient and reliable.

Germline testing of BRCA1, BRCA2, PALB2 and CHEK2 c.1100delC in 1514 triple negative familial and isolated breast cancers from a single centre, with extended testing of ATM, RAD51C and RAD51D in over 400

BackgroundThe identification of germline pathogenic gene variants (PGVs) in triple negative breast cancer (TNBC) is important to inform further primary cancer risk reduction and TNBC treatment strategies. We therefore investigated...

Forest Fire Risk Mapping Using GIS Based Analytical Hierarchy Process Approach

Turkiye is located in a region sensitive to forest fires due to the Mediterranean climate, vegetation and topography of the south and west coasts. Every year, forest fires for various reasons cause thousands of hectares of forest area to be burned. Fires damage the ecosystem as well as have economic consequences. While the Mediterranean, Aegean and Marmara coasts, where the Mediterranean climate and fire-sensitive tree species are dominant, are at primary risk against forest fires, the forests located on the Black Sea coasts where the Black Sea climate is dominant are less risky in terms of fire. For an effective fight against forest fires, it is crucial to identify zones with fire risk based on various parameters such as forest structures (tree species, crown closure, stand age), topographic features (slope, aspect), climate, and proximity to certain points (such as roads, settlements, agricultural areas). Fire risk data will shed light on the measures that can be taken against fire. In this study, GIS (Geographic Information Systems) based Analytical Hierarchy Process (AHP) method, one of the well know MCDA (Multi-criteria Decision Making Analysis) methods, was used to develop the fire risk map of Mersin Forestry Regional Directorate (FRD) within the Mediterranean region of Turkiye. Then, the accuracy of the fire risk map was evaluated by taking into account the previous fires in the regional directorate. As a result, it was found that 13.87% of the study area was classified as very high, 25.87% high, 24.68% medium, 22.44% low and 13.14% very low risk areas. The results showed that tree species are the most effective risk factor in forest fires, and followed by stand age factor. The accuracy of the fire risk map was evaluated by using the location information of a total of 562 fires in Mersin FRD between 2003-2022 that damaged forest areas. In order to determine the accuracy of the fire risk map, ROC (Receiver Operating Characteristic) curve method was used in ArcGIS environment. As a result, the AUC (Area Under Curve) value was found to be approximately 74%, and these values showed that the fire risk map developed for Mersin FRD was moderately reliable. With this study, it has been demonstrated that it is possible to produce reliable fire risk maps in a short time using the GIS-based AHP method.

Motivation Risks in Teaching Students at Secondary Technical Schools

Motivation has long been of interest to many educational researchers, as it is seen as an essential ingredient in effective teaching and learning. Motivated students are more likely to be eager to learn and more willing to accept the challenges that come with the learning process. In our research, we wanted to specify the attitudes of secondary technical school students towards their studies and to find out what motivates and demotivates them. We aimed to determine potential risks to motivation (demotivators). We hypothesized that students’ intrinsic motivation could be strengthened by teachers if classes were seen as useful, interesting, and inspiring. Having chosen a questionnaire as our research method, we addressed more than 200 secondary technical schools from a public database and asked their management for permission to send a questionnaire on motivation risks to their students. The body of the questionnaire included items asking students to assess 8 potential negative factors, which could represent risks in motivation. Our research sample included 665 responses from 10 technical study programs. The Fuller method of paired comparison was used for our data analysis. The answers from students from various schools, school locations, years of study, and study programs did not show many differences when respondents indicated the primary motivation risks for their study. The impact of risky situations on students’ motivation to study technical subjects was dominantly connected with their cognitive needs, followed by social needs. Surprisingly, in the students’ answers, not much attention was dedicated to the achievement needs.

Oral Microbial Profile Analysis in Patients with Oral and Pharyngeal Cancer Reveals That Tumoral Fusobacterium nucleatum Promotes Oral Cancer Progression by Activating YAP.

The incidence of oral cancer has recently been increasing worldwide, particularly among young individuals and women. The primary risk factors for head and neck cancers, including oral and pharyngeal cancers, are smoking, alcohol consumption, poor oral hygiene, and repeated exposure to mechanical stimuli. However, approximately one-third of the patients with oral and pharyngeal cancers are neither smokers nor drinkers, which points to the existence of other mechanisms. Recently, human microbes have been linked to various diseases, including cancer. Oral pathogens, especially periodontal pathobionts, are reported to play a role in the development of colon and other types of cancer. In this study, we employed a series of bioinformatics analyses to pinpoint Fusobacterium nucleatum as the predominant oral bacterial species in oral and pharyngeal cancer tissue samples. We successfully isolated Fn. polymorphum from the saliva of patients with oral cancer and demonstrated that Fn. polymorphum indeed promoted oral squamous cell carcinoma development by activating YAP in a mouse tongue cancer model. Our research offers scientific evidence for the role of the oral microbiome in oral cancer progression and provides insights that would help in devising preventative strategies against oral cancer, potentially by altering oral bacterial profiles.

Assessing the e-commerce last-mile logistics’ hidden risk hurdles

Due to increasing last-mile logistics complexity, the e-commerce business's last-mile delivery has emerged as an imperative issue that impedes the advancement of contemporary last-mile logistics practices. The paper attempts to identify last-mile logistics associated risk hurdles from e-commerce literature and prioritize them on their significantly affecting logistics operations. The factors were identified by reflecting on the recent literature and internet resources coupled with in-depth brainstorming with experts in the field of Logistics Company including, practitioners, and employers. Two ranking methods namely TODIM (TOmada de Decisao Interativa Multicriterio in Portuguese “interactive and multicriteria decision making” in English) and ARAS (Additive Ratio ASsessment method) are used together to rank order the major risk hurdles and criteria. The results of this study present that lack of visibility (LV), low-efficiency levels (LEL), and unpredictable elements (UE) are ranked as the top three major risk hurdles whereas real-time information on a package’s location (LV1), putting a GPS tracking system to track last- mile journey (OT3) and users wants on time location of their package (LV2) are ranked as top three most significant criteria affecting the practices of modern last-mile logistics in e-commerce businesses. The findings can be used by logistics firms, organizations, and policymakers to better understand the issues and develop strategies to address them, making last-mile delivery a more efficient also better form of awareness for practitioners who are engaged in third-party logistics firms. The novelty of this study is to identify the primary risk hurdles affecting the practices of last-mile logistics and to prioritize them using ranking methods such as TODIM and ARAS. This offers advice for managers and researchers to consider how to handle the logistical uncertainty in e-commerce enterprises.

Clinical efficacy and safety of percutaneous drainage for post-operative fluid collection in patients with bladder cancer undergoing radical cystectomy and urinary diversion.

To evaluate the success rates of percutaneous drainage for fluid collection after radical cystectomy, with emphasis on factors affecting the clinical success, including lesion, patient, and procedure characteristics. In this retrospective study, 31 percutaneous drainage catheters were placed in 29 consecutive patients between January 2021 and September 2023. Most fluid collections formed near the uretero-ileal anastomosis site in the right pelvic cavity (80.6%). The technical success rate was 100%. The primary and final clinical success was 80.6% and 96.9%, respectively. Lymphoceles notably increased the primary clinical failure risk (odds ratio and 95% confidential interval: 22.667 (1.839-279.366), P = .015). Significant differences were observed between transabdominal and transgluteal approaches in terms of fluoroscopic time, dose, and location. Leakage indications on computed tomography prompted differing interventions, but all achieved final clinical success. Percutaneous drainage for post-operative fluid collection is safe and effective in patients with radical cystectomy and urinary diversion.