Nintedanib in Combination With Chemotherapy in the Treatment of Non-small Cell Lung Cancer: A Systematic Review and Meta-Analysis.

Lung cancer remains a major global health challenge, contributing to substantial morbidity and mortality rates. Nintedanib, a tyrosine kinase inhibitor, has demonstrated potential as a treatment for lung cancer. We aim to evaluate nintedanib's efficacy in treating patients with non-small cell lung cancer (NSCLC), depending on the available evidence. Our search for relevant articles was conducted on PubMed, Cochrane Library, Scopus, and Web of Science for randomized controlled trials (RCTs) that involved adult patients with NSCLC up to August 15, 2023. These trials compared the combination of nintedanib and chemotherapy to either placebo plus chemotherapy or chemotherapy alone. Our main outcomes include progression-free survival (PFS) and overall survival (OS). We utilized the Review Manager Software V.5.4 (The Cochrane Collaboration) to analyze all relevant data. Three identified trials, which included 2270 patients, fulfilled the inclusion criteria. Our analysis showed significantly improved PFS (hazard ratio (HR) = 0.79; 95% confidence interval (CI) 0.71-0.88, P < 0.0001) in patients receiving nintedanib compared to placebo. However, OS was not statistically significant (HR = 0.96; 95% CI 0.88-1.05, P = 0.35). In conclusion, a combination of nintedanib and chemotherapy in treating patients with NSCLC was associated with improved PFS than chemotherapy alone but not with improved OS. Further clinical trials assessing nintedanib in the setting of NSCLC are necessary before any further recommendations can be made.

Green synthesis of copper oxide nanoparticles using Ficus elastica extract for the electrochemical simultaneous detection of Cd2+, Pb2+, and Hg2.

In this paper, for the first time, we report the use of a new carbon paste electrode based on a low-cost pencil graphite powder modified with polyaniline (PANI) and green synthesized copper oxide nanoparticles using Ficus elastica extract as a sensor for Cd2+, Pb2+, and Hg2+. The elaborated electrode was characterized by FT-IR spectroscopy, field-emission gun scanning electron microscopy (FEG-SEM), energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), and simultaneous thermal analysis (TGA/DSC). The electrochemical behavior of the sensor was evaluated using cyclic voltammetry (CV) and electrochemical impedance spectroscopy techniques. According to CV, as well as square wave voltammetry (SWV) results, it was found that the CuONPs/PANI-CPE sensor was able to determine very low concentrations of Cd2+, Pb2+, and Hg2+ in HCl (0.01 M) either in single metal or in multi-metal solutions with a high sensitivity. Furthermore, Cd2+, Pb2+, and Hg2+ simultaneous detection on CuONPs/PANI-CPE achieved very low limits of detection (0.11, 0.16, and 0.07 µg L-1, respectively). Besides, the designed sensor displayed a good selectivity, reproducibility, and stability. Moreover, CuONPs/PANI-CPE enabled us to determine with high accuracy Cd2+, Pb2+, and Hg2+ traces in environmental matrices.

Determination of Heavy Metal Levels and Health Risk Assessment of Raw Cow Milk in Guelma Region, Algeria.

During the recent decades, adverse effects of unexpected contaminants, such as heavy metals on raw cow milk quality, have threatened human health. The objective of this study was to determine heavy metal levels in raw milk collected from autochthonous bovine breeds in the eastern region of Algeria. Eighty-eight pooled milk samples were analyzed using atomic absorption spectrometry for Pb, Cd, Cr, Cu, Ni, Fe, and Zn, and dietary risks were estimated for infants, children, and adults with minimum, average, and maximum milk consumption scenarios. Results revealed that Pb (0.94 ± 0.49 mg/kg), Cd (0.03 ± 0.01 mg/kg), and Cu (0.14 ± 0.08 mg/kg) levels in all analyzed samples were higher than their corresponding maximum residue levels (MRLs). The task hazard quotient (THQ) values suggest potential risk for infants in the three scenarios from Pb, Cd, and Cr; for children in the three scenarios from Pb and in the high scenario from Cr; and for adults in the medium and high scenarios from Pb. The hazard index (HI) values were higher than 1, and the contributions of each metal to the overall HI followed a descending order of Pb, Cr, Cd, Ni, Zn, Cu, and Fe with values of 68.19%, 15.39%, 6.91%, 4.94%, 3.42%, 0.88%, and 0.28%, respectively. Our results indicated that there may be a potential risk of heavy metals, especially Pb, for infants through raw cow milk consumption. Moreover, data actualization and continuous monitoring are necessary and recommended to evaluate heavy metal effects in future studies.

Programmed vs. Thirst-Driven Drinking during Prolonged Cycling in a Warm Environment.

We compared the effect of programmed (PFI) and thirst-driven (TDFI) fluid intake on prolonged cycling performance and exercise associated muscle cramps (EAMC). Eight male endurance athletes (26 ± 6 years) completed two trials consisting of 5 h of cycling at 61% V˙O2peak followed by a 20 km time-trial (TT) in a randomized crossover sequence at 30 °C, 35% relative humidity. EAMC was assessed after the TT with maximal voluntary isometric contractions of the shortened right plantar flexors. Water intake was either programmed to limit body mass loss to 1% (PFI) or consumed based on perceived thirst (TDFI). Body mass loss reached 1.5 ± 1.0% for PFI and 2.5 ± 0.9% for TDFI (p = 0.10). Power output during the 20 km TT was higher (p < 0.05) for PFI (278 ± 41 W) than TDFI (263 ± 39 W), but the total performance time, including the breaks to urinate, was similar (p = 0.48) between conditions. The prevalence of EAMC of the plantar flexors was similar between the drinking conditions. Cyclists competing in the heat for over 5 h may benefit from PFI aiming to limit body mass loss to <2% when a high intensity effort is required in the later phase of the race and when time lost for urination is not a consideration.

Impact of Mild Hypohydration on 100 m Front Crawl Performance and Starting Block Peak Force Production in Competitive University-Level Swimmers.

Unstructured, ad libitum drinking may predispose some athletes to start exercise already slightly hypohydrated (decreased body water). The impact of pre-exercise mild hypohydration on subsequent swimming performance is still unknown. Hence, the goal of this study was to examine its effect on peak force production on the starting block and 100 m front crawl swimming performance in competitive university-level swimmers. At least one hour after having been passively exposed to heat where a body mass loss of 1.5% was induced or euhydration (normal body water) maintained, nine participants (age: 22 ± 2 years) underwent an assessment of their peak force production on the starting block and 100 m front crawl performance. One hour following hypohydration, rectal temperature had returned to baseline in each condition. Urine osmolality and specific gravity were higher (p < 0.05) with hypohydration than euhydration (995 ± 65 vs. 428 ± 345 mOsmol/kg; 1.027 ± 0.003 vs. 1.016 ± 0.007 g/mL) prior to exercise testing, as was perceived thirst. Swimming performance (p = 0.86) and peak force production (p = 0.72) on the starting block did not differ between the hypohydration and euhydrated condition (63.00 ± 4.26 vs. 63.09 ± 4.52 s; 1322 ± 236 vs. 1315 ± 230 N). The current results indicate that mild hypohydration, which may occur with ad libitum drinking, does not impede peak force production on the starting block and 100 m front crawl performance in university-level competitive swimmers. Planned drinking is not required prior to such an event.

Bone Turnover Markers and Lean Mass in Pubescent Boys: Comparison Between Elite Soccer Players and Controls.

The aim of this study was to examine the relationship between bone mass and bone turnover markers with lean mass (LM) in pubescent soccer players. Two groups participated in this study, which included 65 elite young soccer players who trained for 6-8 hours per week and 60 controls. Bone mineral density; bone mineral content in the whole body, lower limbs, lumbar spine, and femoral neck; biochemical markers of osteocalcin; bone-specific alkaline phosphatase; C-telopeptide type I collagen; and total LM were assessed. Young soccer players showed higher bone mineral density and bone mineral content in the whole body and weight-bearing sites (P < .001). Indeed, the total LM correlated with whole-body bone mineral density and bone mineral content (P < .001). There were significant differences within the bone formation markers and osteocalcin (formation)/C-telopeptide type I collagen (resorption) ratio between young soccer players compared with the control group, but no significant difference in C-telopeptide type I collagen was observed between the 2 groups. This study showed a significant positive correlation among bone-specific alkaline phosphatase, osteocalcin, and total LM (r = .29; r = .31; P < .05) only for the young soccer players. Findings of this study highlight the importance of soccer practice for bone mineral parameters and bone turnover markers during the puberty stage.

Email Between Patient and Provider: Assessing the Attitudes and Perspectives of 624 Primary Health Care Patients.

BACKGROUND: Email between patients and their health care providers can serve as a continuous and collaborative forum to improve access to care, enhance convenience of communication, reduce administrative costs and missed appointments, and improve satisfaction with the patient-provider relationship. OBJECTIVE: The main objective of this study was to investigate the attitudes of patients aged 16 years and older toward receiving email communication for health-related purposes from an academic inner-city family health team in Southern Ontario. In addition to exploring the proportion of patients with a functioning email address and interest in email communication with their health care provider, we also examined patient-level predictors of interest in email communication. METHODS: A cross-sectional study was conducted using a self-administered, 1-page survey of attitudes toward electronic communication for health purposes. Participants were recruited from attending patients at the McMaster Family Practice in Hamilton, Ontario, Canada. These patients were aged 16 years and older and were approached consecutively to complete the self-administered survey (N=624). Descriptive analyses were conducted using the Pearson chi-square test to examine correlations between variables. A logistic regression analysis was conducted to determine statistically significant predictors of interest in email communication (yes or no). RESULTS: The majority of respondents (73.2%, 457/624) reported that they would be willing to have their health care provider (from the McMaster Family Practice) contact them via email to communicate health-related information. Those respondents who checked their personal email more frequently were less likely to want to engage in this electronic communication. Among respondents who check their email less frequently (fewer than every 3 days), 46% (37/81) preferred to communicate with the McMaster Family Practice via email. CONCLUSIONS: Online applications, including email, are emerging as a viable avenue for patient communication. With increasing utility of mobile devices in the general population, the proportion of patients interested in email communication with their health care providers may continue to increase. When following best practices and appropriate guidelines, health care providers can use this resource to enhance patient-provider communication in their clinical work, ultimately leading to improved health outcomes and satisfaction with care among their patients.

Full genome sequence analysis of a newly emerged QX-like infectious bronchitis virus from Sudan reveals distinct spots of recombination.

Infectious bronchitis virus (IBV) infection continues to cause economically important diseases in poultry while different geno- and serotypes continue to circulate globally. Two infectious bronchitis viruses (IBV) were isolated from chickens with respiratory disease in Sudan. Sequence analysis of the hypervariable regions of the S1 gene revealed a close relation to the QX-like genotype which has not been detected in Sudan before. Whole genome analysis of IBV/Ck/Sudan/AR251-15/2014 isolate by next generation sequencing revealed a genome size of 27,646 nucleotides harbouring 13 open reading frames: 5'-1a-1b-S-3a-3b-E-M-4b-4c-5a-5b-N-6b-3'. Highest nucleotide sequence identity of 93% for the whole genome was found with the Chinese IBV strain Ck/CH/LHLJ/140906, the Italian IBV isolate ITA/90254/2005 and the 4/91 vaccine strain. Phylogenetic analysis of the S1 gene revealed that the IBV/Ck/Sudan/AR251-15/2014 isolate clustered together with viruses of the GI-19 lineage. Recombination analysis gave evidence for distinct patterns of origin of RNA in the Sudanese isolate in multiple genes. Several sites of recombination were scattered throughout the genome suggesting that the Sudan-QX-like strain emerged as a unique recombinant from multiple recombination events of parental viruses from 4/91, H120 and ITA/90254/2005 genotypes. The Sudanese QX-like isolate is plausibly genetically different from IBV strains previously reported in Africa and elsewhere.