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Introduction: The radiotherapy workflow involves the collaboration of multiple professionals and the execution of several steps to results in an effective treatment. In this study, we described the clinical implementation of an electronic checklist, developed to standardize the process of the chart review prior to the first treatment fraction by the radiation therapists (RTTs). Materials and Methods: A customized electronic checklist was developed based on the recommendations of American Association of Physicists in Medicine (AAPM) Task Groups 275 and 315 and integrated into the Record and Verify System (RVS). The checklist consisted of 16 items requiring binary (yes/no) responses, with mandatory completion and review by RTTs prior to treatment. The utility of the checklist and its impact on workflow were assessed by analysing checklist reports, and by soliciting feedback to RTTs through an anonymized survey. Results: During the first trial phase, from June to November 2023, 285 checklists were completed with a 98% compilation rate and 94.4% review rate. Forty errors were detected, mainly due to missing signed treatment plans and absence of Beam’s Eye View documentation. Ninety percent of detected errors were fixed before the treatment start. In 4 cases, the problem could not be fixed before the first fraction, resulting in a suboptimal first treatment. The feedback survey showed that RTTs described the checklist as useful, with minimal impact on workload, and supported its implementation. Discussion: The introduction of a customized electronic checklist improved the detection and correction of errors, thereby enhancing patient safety. The positive response from RTTs and the minimal impact on workflow underscore the value of the checklist as standard practice in radiotherapy departments.

Vegetarian diets are plant-based diets including all the edible foods from the Plant Kingdom, such as grains, legumes, vegetables, fruits, nuts, and seeds. Dairy and eggs can be added in small amounts in the lacto-ovo-vegetarian subtype, or not at all in the vegan subtype. The abundance of non-processed plant foods—typical of all well-planned diets, including vegetarian ones—can provide the body with numerous protective factors (fiber, phytocompounds), while limiting the intake of harmful nutrients like saturated fats, heme-iron, and cholesterol. The beneficial effects on health of this balance have been reported for many main chronic diseases, in both observational and intervention studies. The scientific literature indicates that vegetarians have a lower risk of certain types of cancer, overall cancer, overweight-obesity, type 2 diabetes, dyslipidemia, hypertension, and vascular diseases. Since the trend of following a vegetarian diet is increasing among citizens of developed countries, the knowledge in the field will benefit from further studies confirming the consistency of these findings and clarifying the effects of vegetarian diets on other controversial topics.

Inflammation and cancer are diseases caused by genetic and environmental factors as well as altered microbiota. Diet plays a role, with leguminous such as beans (Phaseolus vulgaris, Vicia faba), chickpeas (Cicer arietinum), lentils (Lens culinaris), peas (Pisum sativum) and soybeans (Glycine max), known to prevent such diseases. Processing of food leguminous yields aqueous side streams. These products are nothing short of water extracts of leguminous, containing albumin, globulin, saponins, and oligosaccharides. This review analysed the most recent findings on the anticancer activities of legume-soluble nutrients. Albumin from chickpeas and peas inhibits the pro-inflammatory mediator interleukins, while soy Bowman–Birk Inhibitor inhibits serine proteases. The peptide vicilin activates peroxisome proliferator-activated receptor, mediating triglyceride metabolism. Soyasaponins promote apoptosis of cancer cells by activating caspases and by enhancing the concentration of intracellular calcium. Soyasapogenol regulates specific protein pathways, leading to apoptosis. Oligosaccharides such as raffinose and stachyose promote the synthesis of short chain fatty acids, balancing the intestinal microbiota, as result of their prebiotic activity. Verbascoside also modulate signalling pathways, leading to apoptosis. In closing, water extracts of leguminous have the potential to be efficient anticancer ingredients, by means of numerous mechanisms based on the raw material and the process.

PURPOSEAn understanding of the cultural and context-specific perceptions of the causes of cancer is an important prerequisite for designing effective primary health prevention and early detection strategies. We aimed to use the Murdock Ill Health Theoretical Model to conceptualize views on illness causation among dysphagia-suffering patients undergoing diagnostic workup for esophageal cancer (EC) in Tanzania.METHODSAt the end of a structured interview on lifestyle habits, patients with suspected EC were asked about beliefs on the reasons behind their illness through (1) a set of questions with fixed binary answers, whose determinants were analyzed using logistic regression, and (2) a single question with free-text answers. Responses were coded using a hierarchy of natural and supernatural (godly and social constructs) causes.RESULTSAmong 322 patients interviewed between November 2015 and December 2019, we found complex and varied views about the origins of their illness. Overall, 49% of patients attributed illness to natural causes and 39% to supernatural causes. Natural causes ranged from infection, use of alcohol and tobacco, other ailments, and the environment. The supernatural causes included attributing illness to God, curses, and spells from personal acquaintances. Belief in supernatural causes was more common in the less educated and those who sought help first via a traditional healer.CONCLUSIONThe results underscore the need for increased community awareness of biomedical causes of ill health and patient-based participatory research to inform prevention programs. The results also highlight the importance of building health systems that support a series of health-seeking behaviors that acknowledge both biomedical and local traditional healing belief systems.

Introduction Breast cancer is increasing in sub-Saharan Africa (SSA), and most women are diagnosed at a late stage. This leads to increased suffering for the patients and challenging care situations for nurses. Limited resources in healthcare, lack of oncology training, and low health literacy in society result in even more demanding situations for nurses. Objective The objective was to explore nurses’ experiences of caring women for with breast cancer in Tanzania. Methods The study employed a descriptive qualitative design. Fifteen nurses, working in oncology units in three major hospitals in Tanzania were interviewed using a semistructured interview guide. The participants had a minimum of 6 months experience of caring for breast cancer patients. Purposive sampling was used. Data were analyzed by qualitative content analysis. Results Two main themes emerged: Challenges in caring for breast cancer patients and Nurses’ psychological distress . The late diagnosis was very challenging for the nurses. Low health literacy regarding breast cancer disease and treatment, patients’ financial difficulties, minimal oncology nursing education, and technology in healthcare systems were also major challenges. The nurses experienced psychological distress, lost hope, and faced ethical dilemmas while providing cancer care. Conclusion The findings of this study conclude that nurses face emotional distress and ethical dilemmas while caring for patients with breast cancer. Late diagnosis, lack of infrastructure and resources, and low health literacy among patients, family, and healthcare providers have a great impact on the stress that the nurses experience.

Key Clinical Message Primary SCC of the breast is a very rare disease. Metastasis from elsewhere should be excluded first. The tumor is a very aggressive with poor prognosis. No standard treatment approaches are available. Managed by surgical excision followed by chemotherapy and radiotherapy. Abstract Primary squamous cell carcinoma of the breast is an exceedingly rare disease, and its management is still unclear. A‐65‐year‐old lady presented with a progressive swelling of her right breast that started spontaneously. Other potential primary sites were ruled out. She was kept on a neo‐adjuvant chemotherapy (AC‐T protocol) of doxorubicin, adriamycin, and paclitaxel. Later, she was underwent modified radical mastectomy with axillary lymph node dissection. Her post‐operative recovery was uneventful. Currently, she is followed up at oncology outpatient clinic.

Objective To ascertain how the COVID-19 pandemic was perceived by oncology patients and community health workers (CHWs) and whether this contributed to disruptions in cancer care.Design Cross-sectional study using (1) structured telephone interviews with patients and (2) structured questionnaires completed by CHWs.Setting Outpatient and community care at Kilimanjaro Christian Medical Centre’s Cancer Care Centre (KCMCCCC), Northern Tanzania.Participants 300 oncology patients (158 men and 142 women) who had attended KCMCCCC between January and April 2020 and 78 CHWs (16 men and 62 women) in the KCMC regional palliative care network who conducted home visits to patients with cancer during the period January to April 2020.Primary outcome measures For patients, missed appointments and fear of COVID-19 more than postponement of their treatment. For CHWs, no primary outcome (a broad range of questions on perception of the pandemic were asked).Results 30% of patients said they missed appointments due to the pandemic, the most commonly cited reasons being financial problems (37%) and fear of acquiring COVID-19 infection during travel and/or in the hospital (37%). Only 12.7% of patients said they feared COVID-19 more than postponement of cancer treatment. 88% of CHWs noticed differences in delivering home care since the start of the pandemic, with 58% saying they had noticed more patients dying and 74% saying that more patients were relying on local healers. 31% of CHWs said they feared home visits because of COVID-19 and 46% perceived patients feared home visits due to COVID-19. However, 92% felt home visits should continue.Conclusion These results indicated that while there was a significant degree of disruption and fear around the COVID-19 pandemic, the majority of patients and CHWs did not fear of COVID-19 more than disruption to cancer care. This highlights the importance to these groups of maintaining access to vital cancer services.

Aquafaba and liluva are names used to define the processing water of food legumes. Large volumes of liluva are generated by frozen pea manufacturers (blanching water) and tofu producers (tofu whey). Studies have shown the potential of aquafaba and liluva in food applications as texture improvers and sources of bioactive substances and prebiotics. Nonetheless, no information on consumer perception of these new food ingredients is available. Therefore, this study investigated consumer expectations of steam blanching pea water (SBPW) and tofu whey (TW), correlating it with their actual sensory qualities and functional properties. Specifically, liluva was used as a source of prebiotics and hydrocolloids in 3D-printed mashed potatoes to enhance their rheology and printability. A preliminary survey showed a limited understanding of SBPW and TW as food ingredients, with only 43% and 38% of subjects willing to try TW and SBPW, respectively, with most subjects unsure on whether they wanted to or not (34% tofu whey and 49% liluva). Once the actual sensory test was conducted, TW-added mashed potato received favorable scores for all sensory attributes (appearance, aroma, taste, and texture). In contrast, SBPW-added mashed potato had a negative score on the color, as all nine focus group subjects described the color as gray. Overall, TW enhanced the printability of mashed potatoes due to its emulsifying ability and possibly coagulants derived from tofu making, and it was more appreciated sensory-wise, resulting in being the most preferred out of three samples (SBPW, TW, and control). Therefore, emphasizing consumer education may be key when expanding these innovative food ingredients to other food areas.

Introduction Cancer is a disease of public importance in Tanzania. Considering a limited health care system with few cancer centers and low health literacy in general, people are diagnosed at late stage and face difficulties in accessing care for their cancer. All these challenges affect the caring situation for the nurses who meet the patients at the cancer care centers. Objective This study aimed to explore the journey of cancer care experienced by patients with cancer. Research questions: How do patients experience the quality of care at the cancer care centers? How do patients experience the family’s and the community's role? Methods Semi-structured qualitative interviews were carried out with 15 patients treated for colorectal-, breast-, or prostate cancer in three cancer care centers in Tanzania. A purposive sampling was used. Qualitative content analysis according to Graneheim and Lundman was employed. Results Three main themes and six sub-themes emerged. The main themes were e xperiences of cancer care services, the role of the family, community challenges and cancer care. The sub-themes were communication, resource allocation at the cancer care centers, fmily's denial, family challenges, limitations of primary care and misconceptions, and accessibility of cancer service and the health care system. The findings show that patients experienced incapacitated health care facilities for cancer care, misconceptions in the community and challenges for the families. Conclusions The quality of cancer care in Tanzania needs to be improved, patients face challenges in all levels of health care facilities, including families, and the community at large. The distance to oncology care, economic hardship, and lack of knowledge in the community including families, lead to late diagnosis and suffering for the patients. There is a great need for education regarding cancer within healthcare, as well as in the community, to change the situation for patients with cancer.

ABSTRACT: In the present study, we investigated a possible relationship between the immune response and the oxidative stress (OS) state trend in a group of 12 chickens after intraocular administration of an attenuated Mycoplasma gallisepticum (MG) vaccine. Blood samples were collected at the vaccination time (T0), after 14 (T1) and 21 d (T2). White blood cell count (WBC), differential leucocyte count, and anti-MG antibodies titer (S/P) were studied as immune response indexes. As plasmatic OS biomarkers levels, we considered malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), reactive oxygen metabolites derived compounds (d-ROMs), the ferric reducing ability of plasma (FRAP), and superoxide anion (O2−). After antigenic stimulation, it was observed a significant decrease in monocythemia and a significant increase in thrombocythemia, S/P, MDA, and SOD. Furthermore, subjects with high d-ROMs levels at T0 tended to develop higher cellular mobilization with increases in WBC and lymphocytes accompanied by lower antibody release. It was also observed that the antioxidant components FRAP and SOD were moderately positively correlated to the entity of antibody response.

BackgroundThe purpose of this study was to assess willingness of advanced cancer patients to receive palliative care and its determinants at Cancer Care Centre in Kilimanjaro Christian Medical Centre Northern Tanzania.ObjectiveThe purpose of this study was to assess willingness of advanced cancer patients to receive palliative care and its determinants at Cancer Care Centre in Kilimanjaro Christian Medical Centre Northern Tanzania.MethodsThis was an institution-based cross-sectional study and the target population was all advanced cancer patients attending care at Cancer care Centre in Northern Tanzania. Data was collected using a structured questionnaire and analysed using Stata for windows 15. A descriptive analysis was conducted to summarize the data using mean standard deviation, while categorical data was summarized using frequency and percentages. Both bivariate and multivariate logistic regression analysis was used to determine the predictors associated with willingness to receive palliative care.ResultsThe results showed that more than half of the respondents had willingness to accept palliative care. The degree of willingness PC among advanced cancer patients was high 60.6% (95%CI: 55.8-65.3). The predictors which remained significant associated with willingness to receive palliative care in multivariate analysis were the knowledgeable of palliative care [AOR: 2.86; 95%CI: 1.69-4.85] and high perceived benefits of palliative care [AOR: 3.58; 95%CI: 2.12-6.04].ConclusionWillingness to accept palliative care services was more than half of the patients just 60.6% among patients with advanced cancer from the study site. Advanced age of a patient, occupations, better knowledge, and perceived benefits for palliative care was the significant predictor for patients' willingness to accept palliative care.

PURPOSECancer is a growing problem in Africa, and delays in receiving timely cancer care often results in poorer outcomes. The purpose of this study was to identify the patient and health-system factors associated with delayed cancer care in adults living in the Northern Zone of Tanzania.PATIENTS AND METHODSBetween July 2018 and July 2019, we surveyed adult patients presenting to an oncology clinic in Northern Tanzania. Delayed presentation was defined as 12 weeks or longer from initial symptoms to presentation for cancer care. Multivariate Poisson regression and adjusted relative risk (aRR) were used to identify factors predicting delayed presentation.RESULTSAmong 244 adult patients with cancer who completed the survey, 78% (n = 191) had delayed presentation. Patient-related factors associated with delayed presentation included lower educational attainment (P = .03), increased travel time (P = .05), lack of cancer knowledge (P < .05), and fear of cancer and cancer treatments (P < .05) on multivariate analysis. On analysis of aRR, patients without private car and those with health insurance had higher risk of delayed presentation (aRR: 1.27; 95% CI, 1.02 to 1.32 and aRR: 1.15; 95% CI, 1.01 to 1.32). There was a strong association with increased number of visits before presentation at the cancer center and delayed presentation (P = .0009).CONCLUSIONCancer awareness and prevention efforts targeting patients and community-level health care workers are key to reduce delays in cancer care in Northern Tanzania.

PURPOSEChallenges to breast cancer control in low-and middle-income countries exist because of constrained access to care, including pathology services. Immunohistochemistry (IHC)–based estrogen receptor (ER) analysis is limited-nonexistent because of few and inadequately staffed and equipped pathology laboratories. We have identified Nw-hydroxy-L-Arginine (NOHA) as a blood-based biomarker to distinguish ER status in US patients with breast cancer. Here, we examine NOHA's clinical utility as an ER IHC alternative in Tanzanian patients.MATERIALS AND METHODSFollowing informed consent, 70 newly diagnosed, known or suspected patients with breast cancer were enrolled at Kilimanjaro Christian Medical Center; basic, deidentified clinical and sociodemographic data were collected. For each, a needle prick amount of blood was collected on a Noviplex plasma card and stored at −80°C. Plasma cards and unstained tumor pathology slides were shipped regularly to US laboratories for NOHA, histologic and IHC analysis. NOHA and IHC assay operators were blinded to each other's result and patient clinical status. Paired NOHA and IHC results were compared.RESULTSSlides from 43 participants were available for pathological analysis in the United States. Of those with confirmed malignancy (n = 39), 44%, 51%, 5% were ER-positive, ER-negative, and ER inconclusive, respectively. NOHA levels were available among 33 of 43 of those with pathological data and showed distinct threshold levels correlating 100% to tumor ER IHC and disease categorization where a level below 4 nM, from 4 to 8 nM, and above 8 nM signified ER-negative, ER-positive, and no cancer, respectively.CONCLUSIONThe results are consistent with findings from US patients and suggest NOHA's clinical utility as an accessible IHC replacement in determining ER status among low-and middle-income country patients with breast cancer, promising to extend access to cost-efficient, available hormonal agents and improve outcomes.

Peanuts contain nutritionally relevant levels of protein, yet are poorly digestible. Fermentation is a promising technique to boost legume protein quality, but its effect on the protein quality of raw peanuts has not been investigated. This study aimed to assess the impact of fermentation on the in vitro protein digestibility and free amino acid profile of cooked peanut slurry (peanut to water ratio 1:1). Cultures used were Propionibacterium freudenreichii subsp. globosum and a commercial fresh cheese culture that contained Lactococcus lactis subsp. cremoris, lactis, lactis biovar diacetylactis, and Leuconostoc, fermenting at 38 °C for 48 h. Samples fermented with the combination of cultures showed higher protein digestibility, as well as softer texture. Significant increases were observed only in the sample fermented with the fresh cheese culture. While the fresh cheese culture improved the free amino acid profile after fermentation, the combination of the cultures decreased all free amino acid concentrations except for glutamine, alanine, and proline. The observed increases in in vitro protein digestibility and the free amino acid profile may be attributed to the proteolytic activities of the cultures.

With the growing demand for sustainable practises, the food industry is increasingly adopting circular economy approaches. One example is recycling the symbiotic culture of bacteria and yeast (SCOBY) used in kombucha fermentation to create value-added products. However, consumer acceptance of such novel products remains unclear. To address this, the present study examined consumer attitudes towards ice cream made with SCOBY as an ingredient and how this affected their intention to consume it. Drawing on the theory of planned behaviour (TPB) and additional constructs such as emotions and food neophobia, an online survey was conducted with New Zealand consumers (N = 170). Results showed that the TPB constructs significantly predicted the intention to consume SCOBY ice cream. Moreover, by adding emotions to the constructs, the model’s explanatory power was enhanced. Attitudes, subjective norms, and emotions were the main predictors of intention, which in turn was found to be the main predictor of behaviour. Participants’ beliefs about the safety and taste of SCOBY ice cream were significantly correlated with their intention and behaviour, as were the opinions of nutritionists/dietitians, friends, and family. The model accounted for 21.7% of the variance in behaviour and 57.4% of the variance in intention. These findings can be used to plan marketing strategies related to waste-to-value-added products such as SCOBY ice cream.

Background Phoenician and Punic expansions have been protagonists of intense trade networks and settlements in the Mediterranean Sea. Aims The maternal genetic variability of ancient Punic samples from the Sardinian necropolis of Tharros was analysed, with the aim to explore genetic interactions and signatures of past population events. Subjects and methods The mtDNA HVS-I and coding region SNPs were analysed in 14 Punic samples and 74 modern individuals from Cabras and Belvì (for which the HVS-II region was also analysed). The results were compared with 5,590 modern Euro-Mediterranean sequences and 127 ancient samples. Results While contemporary groups fall within the genetic variability of other modern Sardinians, our Punic samples reveal proximity to present-day North-African and Iberian populations. Furthermore, Cabras and Belvì cluster mainly with pre-Phoenician groups, while samples from Tharros project with other Punic Sardinian individuals. Conclusion This study provides the first preliminary insights into the population dynamics of the Punic site of Tharros. While the number of currently available samples does not allow definitive investigation of the connection with indigenous Sardinian groups, our results seem to confirm internal migratory phenomena in the central-western Mediterranean and female participation in the Punic mobility.

Copyright of Nuova Rivista Storica is the property of Societa Editrice Dante Alighieri s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A new Early Silurian cephalopod from the Italian side of the Carnic Alps is reported on the basis either of newly collected material or museum specimens. The genus Serpaglioceras gen. nov. and the species S. forojuliense sp. nov. are described. The material described originates from the Pterospathodus celloni biozone.

Numerous remains of ceramic vessels were discovered during the archaeological excavations carried out in 2012 at the site of Glavice near Stara Povljana on the island of Pag. Some of these finds can be attributed to the Late Middle Ages and Early Modern Period (indicated also by the finds of Venetian coins), and others are clearly dated to the prehistoric period, predominantly Iron Age. The aforementioned remains were discovered around and even within the heavily damaged dry stone structures, which, although they cannot be precisely dated to either prehistoric or later periods, indicate the longevity of use of this site for habitation. Due to the context of these finds it is highly possible that the prehistoric settlement was organized on the plateau below the nearby hill and adjacent to the arable field, which is considered to be atypical for the area and indicates a possible change in settlement placement patterns. Therefore, in this paper we shall analyse fragments of prehistoric vessels, their consistency, typology and decorations, and place them in the context of prehistoric finds in the wider territory as well as evaluate the importance of this site in the overall distribution of prehistoric settlements on the island of Pag.

PURPOSE A trend of increasing incidence of colorectal cancer (CRC) has been observed in northern Tanzania. Studies have shown a six-fold increase in CRC in the past decade, with 90% of patients presenting in late stages, with resultant high morbidity and mortality rates. In this study, we aimed to document the burden of CRC in the northern zone of Tanzania from 1998 to 2018, focusing on patient presentation, clinical features, and treatment at a tertiary hospital. METHODS Pathological and clinical records for all patients from 1998 to 2018 were identified and reviewed. Records of patients whose CRC was diagnosed histologically were retrospectively reviewed. RESULTS Approximately 313 CRC cases were documented. The majority age group (29.1%) was between 50 and 64 years (mean [standard deviation], 54.28 [16.75] years). However, together, the age groups of patients younger than 50 years was 41.5% (n = 130). Of 174 patients with complete records, most (29.3%) were between 35 and 49 years of age. The median age was 52 (interquartile range, 40-67) years. Men accounted for 62.1% of patients and were mostly from the Kilimanjaro region. More than half (54.7%) presented > 3 months after symptom debut; 62.6% first sought care at lower-level health facilities. Most (64.9%) presented as emergencies, necessitating colostomy for fecal diversion as the initial surgical procedure in 60.3% of patients. Colonoscopy was performed for 38.6% of the study participants. Most tumors (72.7%) originated from the sigmoid and rectum. Adenocarcinoma was the most prevalent histologic type. CONCLUSION High proportions of young individuals with CRC pose great concern and a need for further appraisal. Furthermore, late emergency presentation and low colonoscopy rates highlights underlying system challenges and need for education campaigns.

Cannabis sativa products have historically been used for healing purposes; now their biological properties are supported with scientific evidence, but modern research has not yet fully developed its therapeutic potential. This study focuses on the cultivar of C. sativa called strawberry to understand the biological and medical potentials of hydroalcoholic extracts from two different parts of the plant: leaves and inflorescences. Two biological assets were investigated including antioxidant and antimicrobial potential. Additionally, quantitative determination of phenolic and terpenophenol compounds was conducted. The antimicrobial action was highlighted for the hydroalcoholic extract from inflorescences, especially against Escherichia coli and Bacillus subtilis. Among the dermatophytes’ strains, the most sensitive was Arthroderma currey. These effects could be related albeit partially to the pattern of the phenolics detected, among which the most prominent one was benzoic acid. On the other hand, antioxidant and antimicrobial effects of the extracts could be also mediated by the main terpenophenolics identified and quantified, namely cannabidiolic acid and cannabidiol. Collectively, the present data point to the potential use of the inflorescences from the C. sativa cultivar strawberry as a valuable plant material for the development of bioactive extracts with antioxidant and antimicrobial effects

Disease- and treatment-mediated immunodeficiency might render SARS-CoV-2 vaccines less effective in patients with hematologic diseases. We performed a prospective non-interventional study to evaluate humoral response after one and two doses of mRNA-1273, BNT162b2, or ChAdOx1 nCoV-19 vaccine in 118 patients with different malignant or non-malignant hematologic diseases from three Croatian treatment centers. An electrochemiluminescent assay was used to measure total anti-SARS-CoV-2 S-RBD antibody titers. After one vaccine dose, 20/66 (33%) achieved seropositivity with a median antibody titer of 6.1 U/mL. The response rate (58/90, 64.4%) and median antibody titer (>250 U/mL) were higher after two doses. Seropositivity varied with diagnosis (overall p < 0.001), with the lowest rates in lymphoma (34.6%) and chronic lymphocytic leukemia (52.5%). The overall response rate in chronic myeloproliferative neoplasms (CMPN) was 81.3% but reached 100% in chronic myeloid leukemia and other non-myelofibrosis CMPN. At univariable analysis, age > 67 years, non-Hodgkin’s lymphoma, active treatment, and anti-CD20 monoclonal antibody therapy increased the likelihood of no vaccine response, while hematopoietic stem cell recipients were more likely to respond. Age and anti-CD20 monoclonal antibody therapy remained associated with no response in a multivariable model. Patients with the hematologic disease have attenuated responses to SARS-CoV-2 vaccines, and significant variations in different disease subgroups warrant an individualized approach.

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Combination doxycycline/macrocyclic lactone (ML) protocols have been shown to provide a more rapid adulticidal and microfilaricidal effect than either MLs or doxycycline alone, although female worms were reported to have a higher tolerance to treatments compared to male worms. The present study aimed to evaluate how ABC transporters may be involved in the synergic effect of the combination treatment. Adult worms of D. immitis were treated in vitro for 24 hours with doxycycline (DOXY), ivermectin (IVM) and a combination of both, and changes in the modulation of ABC transporter genes were measured. Levels of doxycycline inside different treatment media, post-treatment, were determined through HPLC analysis. Results Quantitative RT-PCR analysis showed the presence of changes in the modulation of ABC transporter genes evaluated in this study. In particular, in female worms, the combination treatment induced a substantial increase in gene expressions, especially of Dim-pgp-10 and Dim-haf-4; whereas in male worms, the greatest increase in gene expression was observed for Dim-pgp-10 and Dim-pgp-11 when treated with DMSO + IVM and DMSO + DOXY/IVM. HPLC analysis of the DOXY concentrations in the media after in vitro treatments of male worms showed a slight difference between the DMSO + DOXY samples and the combination (DMSO + DOXY + IVM), while no difference was observed among females. Conclusions Further studies are required to explain whether the modulation of cellular efflux plays a role, even partially, in the adulticide effect of doxycycline/macrocyclic lactone combinations in heartworm-infected dogs. To the authors’ knowledge, this is the first study to evaluate P-gp expression in adult D. immitis.

PURPOSE: Cancer is a growing public health concern in low-income countries (LICs). From 14 million new patient cases identified worldwide each year, 8 million are diagnosed in LICs. The fatality rate is 75% in LICs compared with 46% in high-income countries. Causes are low literacy levels, lack of awareness and knowledge about cancer, and limited education of health care professionals that leads to late detection and diagnosis. In Tanzania, cancer incidence will double to 60,000 in 2030. The referral hospital of Northern Tanzania established a new cancer unit in December 2016 to meet these needs. However, there is limited knowledge about perceptions of health care professionals toward cancer care in LICs. This study aims to understand attitudes and perspectives of those professionals and the treatment-related challenges in a newly established center to assist future efforts in this field. METHODS: A qualitative method approach using in-depth interviews was chosen to achieve inductive conceptualization. Analysis of data was performed according to qualitative content analysis. RESULTS: Eleven interviews were conducted. Five main categories were found: training and education of staff, availability of financial support, challenges in management, interests in future developments, and job satisfaction. Subcategories elaborated in more detail within the main categories. CONCLUSION: Limitations in staffing, training, and education were major concerns. The importance of sustainable funding and the needed cooperation of the government with international aid were identified as key points. The involvement of different stakeholders requires guidance by health care management. Health care professionals expressed their satisfaction with the possibilities of treating cancer and the rewarding feedback from patients. Misconceptions and poor knowledge by patients were mentioned as reasons for delayed health-seeking behavior. Screening and awareness programs were seen as useful interventions.

Introduction Temporary ileostomy is a valuable aid in reducing the severity of complications related to rectal cancer surgery. However, it is still unclear what is the best timing of its closure in relation to the feasibility of an adjuvant treatment, especially considering patient-reported outcomes and health system costs. The aim of the study is to compare the results of an early versus late closure strategy in patients with indication to adjuvant chemotherapy after resection for rectal cancer.Methods and analysis This is a prospective multicentre randomised trial, sponsored by Rete Oncologica Piemonte e Valle d’Aosta (Oncology Network of Piedmont and Aosta Valley-Italy). Patients undergone to rectal cancer surgery with temporary ileostomy, aged >18 years, without evidence of anastomotic leak and with indication to adjuvant chemotherapy will be enrolled in 28 Network centres. An early closure strategy (between 30 and 40 days from rectal surgery) will be compared with a late one (after the end of adjuvant therapy). Primary endpoint will be the compliance to adjuvant chemotherapy with and without ileostomy. Complications associated with stoma closure as well as quality of life, costs and oncological outcomes will be assessed as secondary endpoints.Ethics and dissemination The trial will engage the Network professional teams in a common effort to improve the treatment of rectal cancer by ensuring the best results in relation to the most correct use of resources. It will take into consideration both the patients’ point of view (patient-reported outcome) and the health system perspective (costs analysis). The study has been approved by the Ethical Review Board of Città della Salute e della Scienza Hospital in Turin (Italy). The results of the study will be disseminated by the Network website, medical conferences and peer-reviewed scientific journals.Trial registration number NCT04372992.

Chitin is a widely available polysaccharide, biodegradable, insoluble in most solvents and with low antigenic properties. Chitin nanoparticles such as nano whiskers and nanofiber (CHNF) can form a stable and uniform dispersion. The nanoparticle suspension shows the properties of crude chitin as well as the properties of high aspect ratio, high surface area, low density, and hydroxyl group, N-acetyl group and the residual amine group on its surface can also be chemically modified. This review describes nanochitin preparation technologies and food applications. Specifically, the role of nanochitin in modulating fat-soluble bioavailability and saltiness perception was investigated. Fat-soluble vitamins incorporated into CHNF are less available for digestion. Whereas hyaluronic acid and cancer-treatment drugs can be delivered through the skin to targeted locations via chitin nanogels. Interestingly, CHNF enhances saltiness perception via ionic binding with taste receptors. At pH < 7, the amino group chelates chloride, thus releasing sodium for interaction with salt receptors. This mechanism may allow salt reduction in food formulations. Furthermore, nanochitins express surfactant properties and strengthen composite food packaging (starch- or gelatin-based, gelatin nanocomposite, nanocellulose/nanochitin membranes coating F-SiO2 suspensions). This paper can help build a better understanding of the opportunities of nanochitin as functional food ingredient.

Background: 14.9 million women (≥15 years) in Tanzania are at risk of developing cervical cancer. Limited cancer care facilities, prevention programs and sparse knowledge among community members and healthcare workers contribute to late-stage presentation leading to a high mortality rate. Objective: This study aims to scientifically accompany prevention and awareness campaigns (PrevACamp) in northern Tanzania in its real-world settings to obtain (1) a better understanding about cervical cancer and HPV knowledge amongst female PrevACamp participants and (2) to determine the prevalence of pre-cancerous lesions among women undergoing cervical cancer VIA screening. Method: Cross-sectional survey among PrevACamp attendees in two regions in Northern Tanzania. Two data collections tools were used: Questionnaires and clinical data from VIA screening. Data were collected from October 2017 to March 2019. Results: 2,192 PrevACamp attendees were interviewed and 2,224 received VIA screening. There was significant nescience on cervical cancer regardless of education level, resident status, or number of children as well as nescience on HPV in all age groups, especially in urban areas and misconceptions about cancer. Screening revealed VIA positivity rate of 3.1%. Conclusion: There is an alarming lack of knowledge about cervical cancer and, to a lesser Extent, about HPV among the study participants. Having health insurance influenced the level of knowledge significantly. Outreach programs in rural areas appear to target the population in need of health education. Low positive VIA screening results are paralleled with lower HIV rates among the women. We assume that the high density of primary health care coverage in northern Tanzania contributes to these findings..

One percent of the global population requires a gluten-free diet. With concurrent global warming and population growth, it is increasingly necessary to optimize the use of ingredients from resilient crops, such as tapioca. Tapioca flour is used in low proportions in bread due to its lack of gluten. Sourdough fermentation can enhance the nutritional value of bread but also causes a sour taste. Propionibacterium freudenreichii subsp. globosum can reduce food acidity while synthesizing several nutrients, such as vitamin B12. Aquafaba is a known hydrocolloid and prebiotic. Therefore, the objective of this study was to test the sourdough fermentation of a composite bread based on tapioca and brown rice flour, cultured with Lactobacillus lactis and Propionibacterium freudenreichii subsp. globosum enriched in aquafaba. The bread quality was measured instrumentally (hardness, volume, moisture content) and with a semi-trained sensory panel (focus group). The co-fermentation of the Lactobacillus lactis and Propionibacterium freudenreichii subsp. Globosum produced palatable bread, improving the appearance, taste, and texture in comparison to the yeast-leavened recipe. This co-fermentation also enabled shorter production times, reducing it from 1 h to 30 min. The addition of the aquafaba further improved the bread appearance, texture, and volume, although a bitter tasting crust was reported. The co-fermentation of the tapioca–brown rice composite flour with Lactobacillus lactis and Propionibacterium freudenreichii subsp. globosum produced acceptable bread, which could provide a climate-resilient solution to food sustainability. The aquafaba addition further enhanced such improvements and the baking performance, offering sustainability in terms of nutrition, sensory quality, and price.

Grain-based food is a staple of the human diet [...]

Importance: Tumor Treating Fields (TTFields) are an anti-mitotic treatment approved for treating newly diagnosed and recurrent glioblastoma, and mesothelioma. TTFields in glioblastoma comprise alternating electric fields (200 kHz) delivered continuously, ideally for ≥18 h/day, to the tumor bed via transducer arrays placed on the shaved scalp. When applied locoregionally to the tumor bed and combined with systemic temozolomide chemotherapy, TTFields improved overall survival vs. temozolomide alone in patients with newly diagnosed glioblastoma. Improved efficacy outcomes with TTFields were demonstrated, while maintaining a well-tolerated and manageable safety profile. The most commonly-reported TTFields–associated adverse events (AEs) are beneath-array dermatologic events. Since survival benefit from TTFields increases with duration-of-use, prevention and management of skin AEs are critical to maximize adherence. This paper describes TTFields-associated dermatological AEs and recommends prevention and management strategies based on clinical trial evidence and real-world clinical experience.Observations: TTFields–associated skin reactions include contact dermatitis (irritant/allergic), hyperhidrosis, xerosis or pruritus, and more rarely, skin erosions/ulcers and infections. Skin AEs may be prevented through skin-care and shifting (~2 cm) of array position during changes. TTFields–related skin AE management should be based on clinical phenotype and severity. Depending on diagnosis, recommended treatments include antibiotics, skin barrier films, moisturizers, topical corticosteroids, and antiperspirants. Water-based lotions, soaps, foams, and solutions with minimal impact on electrical impedance are preferred with TTFields use over petroleum-based ointments, which increase impedance.Conclusions: Early identification, prophylactic measures, and symptomatic skin AE management help patients maximize TTFields usage, while maintaining quality-of-life and optimizing therapeutic benefit.Implications for practice: TTFields confer a survival benefit in patients with glioblastoma that correlates positively with duration of daily use. Skin events (rash) are the primary treatment-related AE that can limit duration of use. The recommendations described here will help healthcare professionals to recognize, prevent, and manage dermatologic AEs associated with TTFields treatment. These recommendations may improve cutaneous health and support adherence to therapy, both of which would maximize treatment outcomes.

The present study investigates the effects of incorporating oat bran (OB) into Chinese steamed bread (CSB). Different levels (5%, 10% and 15%) of OB were used to replace wheat flour in the manufacture of CSB. The rheological properties of the dough were measured (water absorption (WA), development time, mixing tolerance, extensibility and stickiness). The addition of OB significantly increased WA, development time and stickiness, whereas decreased extensibility of dough. The physical properties of CSB were determined using specific volume, loaf height, moisture, and texture analysis. The nutritional quality of the bread was also analysed using an in vitro digestion method mimicking intestinal digestion. The results illustrated that the incorporation of OB into wheat flour decreases specific volume and softness of CSB. The addition of OB decreased the glycaemic response of steamed bread. This study illustrates the potential addition of OB to improve the nutritional quality of CSB. Keywords:: Oat bran, Dough rheology, Glycaemic response

Background: Archaeological data provide evidence that Italy, during the Iron Age, witnessed the appearance of the first communities with well defined cultural identities. To date, only a few studies report genetic data about these populations and, in particular, the Piceni have never been analysed. Aims: To provide new data about mitochondrial DNA (mtDNA) variability of an Iron Age Italic population, to understand the contribution of the Piceni in shaping the modern Italian gene pool and to ascertain the kinship between some individuals buried in the same grave within the Novilara necropolis. Subjects and methods: In a first set of 10 individuals from Novilara, we performed deep sequencing of the HVS-I region of the mtDNA, combined with the genotyping of 22 SNPs in the coding region and the analysis of several autosomal markers. Results: The results show a low nucleotide diversity for the inhabitants of Novilara and highlight a genetic affinity of this ancient population with the current inhabitants of central Italy. No family relationship was observed between the individuals analysed here. Conclusions: This study provides a preliminary characterisation of the mtDNA variability of the Piceni of Novilara, as well as a kinship assessment of two peculiar burials.

Background: Environmental conditions and past migratory events may have shaped genetic heterogeneity of clinically relevant enzymes involved in the phase I metabolism of the most common therapeutic drugs. Aim: To investigate the genetic variability of CYP2D6, CYP2B6, CYP2C19 and CYP2C9 across the Italian Peninsula, by sampling only ancestrally and geographically homogeneous individuals from northern, central and southern Italy. Subjects and methods: A total of 25 SNPs were genotyped in 174 unrelated Italian individuals by means of multiplex PCR and minisequencing reactions. CYP2D6 genotypic data were used to predict phenotypes and the phylogenetic relationships among reconstructed haplotypes were represented by means of a Median Joining Network. Results: Pairwise Fisher Exact tests revealed significant differences between northern and southern Italy in the distribution of CYP2C19 genotypes, with the CYP2C19*2 allele appearing over-represented in northern Italy. Likewise, significant differences in the distribution of CYP2D6 genotypes (*4/*3, *4/*4 and *6/*4) responsible for the poor metabolizer phenotype were observed in northern with respect to both central and southern Italy. Conclusions: The north–south structuring pattern showed by CYP2D6 and CYP2C19 underline how a deeper knowledge of the geographic distribution of alleles may improve clinical practice and help to avoid hypothetical bias in drug trials.

It is good to have an up-to-date review of the worldwide situation for neonates. A key part of Sustainable Development Goals is the ‘Every Newborn Action Plan’ to ensure that all newborns have the opportunity to survive and thrive. This paper summarises the main points in the World Health Organization’s ‘Roadmap on human resource strategies to improve newborn care in health facilities in low- and middle-income countries.

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Vegetable pasta is a premium product, and its consumption may deliver health benefits by increasing vegetable intake. This study investigated the replacement of semolina with juice, puree, and pomace of spinach and red cabbage. The effect of replacement on chemical composition, cooking performance (cooking loss, swelling index, water absorption), texture quality (elasticity, firmness), and colour was evaluated. The cooking loss of pasta made with spinach juice and spinach puree at 1 g/100 g substitution was the same as the control, while all other samples had a higher cooking loss. Spinach pasta had a higher breaking force but lower breaking distance in the tensile test than the control, while red cabbage pasta had a lower breaking force and breaking distance. Spinach juice fortified pasta was firmer than the control. Red cabbage juice pasta was less firm than other forms of fortified pasta at 1 g/100 g substitution level. Spinach and red cabbage juice are better colorants than puree or pomace as they change the colour of the pasta more dramatically at the same substitution level. Cooking performance and texture quality of spinach juice pasta were better than other samples, which indicates a premium pasta product for the food industry.