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Background: There is a dearth of data on eczema from the African continent despite the purported increasing burden. Objectives: To describe the prevalence of eczema at Kiambu Level 5 Hospital and patient skincare. Methods: A descriptive retrospective cross-sectional research design was performed describing the period between 2016 and 2020. Data analysis was done using STATA Version 13. Geospatial mapping of patient residence was also conducted. Results: Eczema was the most common skin condition diagnosed with a prevalence of 25.5%. Majority of the patients favored the use of non-conventional products such as bar soap and milking jelly as routine skincare products. Geospatial mapping demonstrated a higher prevalence of eczema in the urban areas and also revealed access to a specialist as a contributor to health-seeking behavior. Limitations: Subtypes of eczema were not described and this data only reflects 1 facility serving an entire county. Conclusion: The prevalence of eczema in Kiambu Level 5 Hospital mirrors the increasing global burden of eczema. Urban environments have a higher density of eczema in Kiambu. More research is needed to decipher the impact of the preferred non-conventional skin care products on eczema.

Abstract Breast conserving treatment typically involves surgical excision of tumor and adjuvant radiotherapy targeting the breast area or tumor bed. Accurately defining the tumor bed is challenging and lead to irradiation of greater volume of healthy tissues. Preoperative stereotactic body radiotherapy (SBRT) which target tumor may solves that issues. We conducted a systematic literature review to evaluates the early toxicity and cosmetic outcomes of this promising treatment approach. Secondary we reviewed pathological complete response (pCR) rates, late toxicity, patient selection criteria and radiotherapy protocols. We retrieved literature from PubMed, Scopus, Web of Science, Cochrane, ScienceDirect, and ClinicalTrials.gov. The study adhered to the PRISMA 2020 guidelines. Ten prospective clinical trials (7 phase II, 3 phase I), encompassing 188 patients (aged 18–75 years, cT1-T3 cN0-N3 cM0, primarily with ER/PgR-positive, HER2-negative status,), were analyzed. Median follow-up was 15 months (range 3–30). Treatment involved single-fraction SBRT (15-21Gy) in five studies and fractionated (19.5–31.5Gy in 3 fractions) in the rest. Time interval from SBRT to surgery was 9.5 weeks (range 1–28). Acute and late G2 toxicity occurred in 0–17% and 0–19% of patients, respectively, G3 toxicity was rarely observed. The cosmetic outcome was excellent in 85–100%, fair in 0–10% and poor in only 1 patient. pCR varied, showing higher rates (up to 42%) with longer intervals between SBRT and surgery and when combined with neoadjuvant systemic therapy (up to 90%). Preoperative SBRT significantly reduce overall treatment time, enabling to minimalize volumes. Early results indicate excellent cosmetic effects and low toxicity. Graphical abstract

Apresenta-se no presente trabalho uma análise minuciosa do Capítulo XXII do tratado De regula aliza libellus de Girolamo Cardano, onde consta a sua reformulação e putativa demonstração da regra dos sinais. Mostra-se que, embora seu resultado é pontualmente interessante, é globalmente inconsistente, sendo a raiz da invalidez do argumento centrada na atribuição de valores negativos a comprimentos e áreas. Mostra-se também como o seu argumento depende de dois princípios gerais extra-matemáticos.

Abstract The Oil and Gas (O&G) sector is facing unprecedented challenges regarding greenhouse gas (GHG) emissions, urging rapid decarbonization actions in line with global imperatives. This comprehensive review article delves into the crucial role of industry standards in spearheading transformative efforts. It synthesizes findings from a literature review, offering insights into real-world implementation cases within the O&G industry, and integrates perspectives from specialists through qualitative research. Key standards from the International Organization for Standardization (ISO), notably TC 301 and ISO 50001, are highlighted for their pivotal role in promoting energy management systems as essential tools for GHG mitigation. These standards not only advocate for energy-saving practices but also emphasize structured energy management to effectively reduce greenhouse gas (GHG) emissions. Additionally, the influential ISO/TC 67 orchestrates a comprehensive suite of standards tailored for the O&G industry, facilitating its adaptation to evolving technological and environmental landscapes. Complementary collaborative initiatives such as IPIECA, OGCI, and IOGP emerge as vital forces in promoting operational and strategic solutions. Through this review study, the intertwined relationship between energy management and GHG emission reductions is elucidated, underscoring how industry standards and collective efforts can drive the O&G sector towards a more sustainable future in alignment with global environmental ambitions.

Few studies have considered household interventions for reducing endocrine disrupting chemical (EDC) exposures. We conducted a secondary analysis of a randomized controlled trial, originally designed to reduce lead exposure, to evaluate if the intervention lowered EDC exposures in young children. Study participants were children from the Cincinnati, Ohio area (n = 250, HOME Study). Prenatally, families received a housing intervention that included paint stabilization and dust mitigation, or as a control, injury prevention measures. At 24-months, we measured organophosphate esters (OPEs) and phthalates or their metabolites in dust and urine. We measured perfluoroalkyl substances (PFAS) in dust and serum at 24- and 36-months, respectively. We assessed associations between dust and biomarker EDCs using Spearman correlations, characterized EDC mixtures via principal components analysis, and investigated treatment effects using linear regression. To mitigate selection bias, we fit statistical models using inverse probability of retention weights. Correlations between dust EDCs and analogous biomarkers were weak-to-moderate (ρ’s ≤ 0.3). The intervention was associated with 23 % (95 % CI: −38, −3) lower urinary DEHP metabolites and, in a per-protocol analysis, 34 % lower (95 % CI: −55, −2) urinary MBZP. Additionally, among Black or African American children, the intervention was associated with lower serum concentrations of several PFAS (e.g., −42 %; 95 % CI: −63, −8 for PFNA). Household interventions that include paint stabilization and dust mitigation may reduce childhood exposures to some phthalates and PFAS in Blacks/African Americans. These findings highlight the need for larger studies with tailored and sustained housing interventions.

IntroductionRadiation induced lymphopenia (RIL) deteriorate survival and diminishes the benefit of immune checkpoint inhibitors in combined treatment of lung cancer. Given the inconsistent data across various studies on the predictors of RIL, we aim to methodically elucidate these predictors and formulate a practical guide for clinicians.MethodsWe conducted observational cohort study in four tertiary cancer centers. Patients with non-small cell lung cancer and small cell lung cancer, without lymphopenia grade >1, who underwent standalone radiotherapy (RT) in minimum 15 fractions were eligible. Dose-volume parameters of structures and clinical factors were comprehensively analyzed using various predictors selection methods and statistical models (Linear Regressors, Elastic Net, Bayesian Regressors, Huber Regression, regression based on k-nearest neighbors, Gaussian Process Regressor, Decision Tree Regressor, Random Forest Regressor, eXtreme Gradient Boosting, Automated Machine Learning) and were ranked to predict lymphocytes count nadir (alc_nadir).ResultsTwo hundred thirty eight patients (stage I-3.4%, II-17.6%, III-75.2%, IV-3.8%) who underwent RT to median dose of 60 Gy were analyzed. Median alc_nadir was 0.68K/mm3. The 60 feature sets were evaluated in 600 models (RMSE 0.27-0.41K/mm³). The most important features were baseline lymphocyte count (alc_1), mean lung_dose, lung v05, lung v10, heart v05 and effective dose to immune cells (edic). In patients with alc_1 ≤ 2.005K/mm3, median alc_nadir predictions were 0.54K/mm3 for lung_v05p > 51.8% and 0.76K/mm3 for lung_v05p ≤ 51.8%. Lymphopenia was rare in patients with alc_1 > 2.005K/mm3.DiscussionRIL was most severe in patients with low early lymphocyte counts, primarily triggered by low RT doses in the heart and lungs.

Abstract Background Paucity and low evidence-level data on proton therapy (PT) represent one of the main issues for the establishment of solid indications in the PT setting. Aim of the present registry, the POWER registry, is to provide a tool for systematic, prospective, harmonized, and multidimensional high-quality data collection to promote knowledge in the field of PT with a particular focus on the use of hypofractionation. Methods All patients with any type of oncologic disease (benign and malignant disease) eligible for PT at the European Institute of Oncology (IEO), Milan, Italy, will be included in the present registry. Three levels of data collection will be implemented: Level (1) clinical research (patients outcome and toxicity, quality of life, and cost/effectiveness analysis); Level (2) radiological and radiobiological research (radiomic and dosiomic analysis, as well as biological modeling); Level (3) biological and translational research (biological biomarkers and genomic data analysis). Endpoints and outcome measures of hypofractionation schedules will be evaluated in terms of either Treatment Efficacy (tumor response rate, time to progression/percentages of survivors/median survival, clinical, biological, and radiological biomarkers changes, identified as surrogate endpoints of cancer survival/response to treatment) and Toxicity. The study protocol has been approved by the IEO Ethical Committee (IEO 1885). Other than patients treated at IEO, additional PT facilities (equipped with Proteus®ONE or Proteus®PLUS technologies by IBA, Ion Beam Applications, Louvain-la-Neuve, Belgium) are planned to join the registry data collection. Moreover, the registry will be also fully integrated into international PT data collection networks.

Abstract As global declines in seagrass populations continue to cause great concern, long-term assessment of seagrass meadows show promise in furnishing valuable clues into fundamental causes of seagrass loss and drivers of environmental change. Here we report two long-term records of seagrass presence in western Gulf of Mexico coastal waters (Laguna Madre) that provided insight into their rapid decline in a relatively pristine ecosystem. Coincident with unprecedented increases in water depth starting in 2014 (14–25 mm y−1), monthly measurements at a deep edge fixed station revealed that two ubiquitous seagrass species (Halodule wrightii and Syringodium filiforme) vanished altogether in just five years; a subsequent basin-wide assessment revealed that seagrasses disappeared at 23% of 144 sentinel stations. Models that incorporate differing sea level rise scenarios and water depth thresholds reveal potential global losses of seagrass habitat (14,000 km2), with expansion into newly created shallow habitats constrained by altered natural shorelines.

Bone metastases (BMs) are the most common cause of cancer-related pain and radiation therapy plays a key role in treating pain caused by it. The half-body irradiation (HBI) is a modality that can be used to treat patients with multiple painful BMs. In the modern era, concerns about toxicity and the availability of new agents requiring robust bone marrow function have limited the use of HBI in advanced cancer. Concerns about HBI toxicity stem from outdated techniques; modern methods like volumetric modulated arc therapy (VMAT) and helical tomotherapy now allow safer irradiation of complex target volumes. We conducted a systematic review to present updated information about HBI efficacy and potential toxicity. Pain relief usually occurs very quickly 2–3 weeks after HBI. The overall pain response rate was high in all the series, accounting for a median of 84 % (75.6–89 %), with a median of 36 % complete pain response. The toxicity is usually limited to G1/G2, with very rare G3 cases. More than 50 % of patients can reduce analgesic intake after HBI. Additionally, with modern radiotherapy techniques, quality of life is improved in most patients. HBI is a safe and effective method and should once again be reconsidered for more frequent use.