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S2 Open Access 2012
Radical prostatectomy versus observation for localized prostate cancer.

T. Wilt, M. K. Brawer, Karen M. Jones et al.

BACKGROUND The effectiveness of surgery versus observation for men with localized prostate cancer detected by means of prostate-specific antigen (PSA) testing is not known. METHODS From November 1994 through January 2002, we randomly assigned 731 men with localized prostate cancer (mean age, 67 years; median PSA value, 7.8 ng per milliliter) to radical prostatectomy or observation and followed them through January 2010. The primary outcome was all-cause mortality; the secondary outcome was prostate-cancer mortality. RESULTS During the median follow-up of 10.0 years, 171 of 364 men (47.0%) assigned to radical prostatectomy died, as compared with 183 of 367 (49.9%) assigned to observation (hazard ratio, 0.88; 95% confidence interval [CI], 0.71 to 1.08; P=0.22; absolute risk reduction, 2.9 percentage points). Among men assigned to radical prostatectomy, 21 (5.8%) died from prostate cancer or treatment, as compared with 31 men (8.4%) assigned to observation (hazard ratio, 0.63; 95% CI, 0.36 to 1.09; P=0.09; absolute risk reduction, 2.6 percentage points). The effect of treatment on all-cause and prostate-cancer mortality did not differ according to age, race, coexisting conditions, self-reported performance status, or histologic features of the tumor. Radical prostatectomy was associated with reduced all-cause mortality among men with a PSA value greater than 10 ng per milliliter (P=0.04 for interaction) and possibly among those with intermediate-risk or high-risk tumors (P=0.07 for interaction). Adverse events within 30 days after surgery occurred in 21.4% of men, including one death. CONCLUSIONS Among men with localized prostate cancer detected during the early era of PSA testing, radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation, through at least 12 years of follow-up. Absolute differences were less than 3 percentage points. (Funded by the Department of Veterans Affairs Cooperative Studies Program and others; PIVOT ClinicalTrials.gov number, NCT00007644.).

1675 sitasi en Medicine
S2 Open Access 2001
Cancer Statistics, 2001

R. Greenlee, Mary B. Hill-Harmon, Taylor Murray et al.

Each year the American Cancer Society compiles estimates of the number of new cancer cases and deaths expected in the US in the current year and the most recent data on cancer incidence, mortality, and survival. An estimated 1,268,000 new cases of cancer will be diagnosed in the year 2001 and an estimated 553,400 Americans will die from cancer. Overall cancer incidence and death rates have continued to decrease in men and women since the early 1990s, and the decline in overall cancer mortality has been greater in recent years. Despite reductions in age‐adjusted rates of cancer death, the total number of recorded cancer deaths in the US continues to increase, due to an aging and expanding population. Large disparities in cancer incidence and mortality across racial/ethnic groups continue. Black men and women experience higher incidence of cancer and poorer survival than white men and women. The disparity in survival reflects both diagnosis of cancer at later disease stages, and poorer survival within each stage of diagnosis.

3402 sitasi en Medicine
DOAJ Open Access 2025
Time-Domain Simulation of Coupled Motions for Five Fishing Vessels Moored Side-by-Side in a Harbor

Xuran Men, Jinlong He, Bo Jiao et al.

With the rapid development and accelerated utilization of marine resources, multi-body floating systems have become extensively used in practical applications. This study examines the coupled motions of a side-by-side anchoring system for five fishing vessels in a harbor using ANSYS-AQWA. The system is connected by hawsers and equipped with fenders to reduce collisions between the vessels. It is designed to operate in the sheltered wind-wave combined environment within Ningbo Zhoushan Port, China. Considering the diverse types and quantities of fishing vessels in the anchorage area, this paper proposes a mixed arrangement of three large-scale fishing vessels in the middle and two small-scale vessels on both sides. The time-domain analysis is performed on this system under the combined effects of wind and waves, calculating the motion responses of the five fishing vessels along with the mechanical loads at the hawsers, fenders, and moorings. The results indicate that the maximum loads on these mechanical components remain well within the safe working limits, ensuring reliable operation. In addition, the impact of varying wind-wave angles on the coupled motions of the fishing vessel system are studied. As the wind-wave angle increases, the surge motion of the fishing vessels gradually decreases, while the sway motion intensifies. The forces on the hawsers, fenders, and mooring system exhibit distinct characteristics at different angles.

Naval architecture. Shipbuilding. Marine engineering, Oceanography
DOAJ Open Access 2024
Characterization of suicidal behavior in Coquimbo, Chile, between 2018 and 2020

Patricia Paz-Soto, Larry Games-Díaz, Muriel Ramírez-Santana

Introduction Suicidal behavior is a public health problem worldwide. The World Health Organization estimated 700 000 deaths for the year 2021. Objective This study aimed to estimate the prevalence of suicidal behavior and describe its related factors in the Coquimbo Region, Chile, between 2018 and 2020. Methods 2190 suicide attempt notifications from the regional epidemiological surveillance system were analyzed, corresponding to 1781 people, along with 217 reports from the Forensic Medical Service of people who died by suicide. Results The overall suicide rate for the region during that period was 9.79 deaths per 100 000 inhabitants. The 2018 rates were standardized according to available information, with direct methods for the regional rate (9.55 per 100 000 inhabitants) and indirect methods for the communes. Rural communes presented higher rates than urban ones. Women showed a higher risk of attempts (OR 1.28; 95% CI 1.23 to 1.33) and a lower risk of suicide compared to men (0.086; 0.06 to 0.13). Young people had a higher risk of suicide attempts and a lower risk of suicide compared to older people. The increased suicide rates in older people (70 to 79 years) during 2020 are noteworthy. Basic education level is a risk variable for suicide (2.21; from 1.15 to 4.23), compared to having higher education. Previous suicide attempts and psychiatric pathology are risk factors. Conclusions Suicide prevalence and related factors are similar to those reported in other studies and national reports, highlighting rurality and higher risk in older male adults. In contrast to suicides, attempts are more frequent in women and young people. A history of mental health problems, previous attempts, and family violence are risk factors for both outcomes. Knowing the patterns of suicidal behavior in the population is fundamental for its prevention.

Medicine, Medicine (General)
DOAJ Open Access 2024
Relationship between addictions and obesity, physical activity and vascular aging in young adults (EVA-Adic study): a research protocol of a cross-sectional study

Sara Vicente-Gabriel, Sara Vicente-Gabriel, Cristina Lugones-Sánchez et al.

BackgroundBehavioral and substance addictions are prevalent health problems that, alongside obesity, are linked to reduced physical activity and increased sedentary time. Similarly, arterial stiffness and vascular aging are processes that begin gradually at an early age and are closely associated with morbidity and mortality from cardiovascular diseases. The main objective of this study is to analyze how addictions are related to obesity and body fat distribution, physical activity, sedentary time, arterial stiffness and vascular aging, as well as sleep quality, cognitive function and gender differences in young adults aged between 18 and 34 years.MethodsThis cross-sectional descriptive observational study will analyze data from 500 subjects (250 men and 250 women) aged 18–34 without cardiovascular disease, selected by simple random sampling with replacement from the urban population of the city center of Salamanca (34,044 people aged 18–34, with 18,450 women and 15,594 men). Behavioral and substance addictions, as well as sleep quality and cognitive impairment will be assessed using questionnaires. The Pittisburg Sleep Quality Index (PSQI) will be used to measure sleep quality and the Ford questionnaire will be used to measure insomnia in response to stress. For obesity, weight, height, waist and hip circumference, body composition will be measured with the Inbody 230® impedance meter. For physical activity and sedentary time, we will use the Actigraph® accelerometer alongside the international physical activity questionnaire (IPAQ) and the Marshall questionnaire. The Sphygmocor System® will be used for pulse wave analysis and carotid-femoral pulse wave velocity (cfPWV), while the Vasera VS-2000® will measure cardio ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Vascular aging will be calculated with the 10th and 90th percentiles of cfPWV or baPWV. Demographic, analytical variables will be collected, as will data to assess vascular, cardiac, renal, and brain injury.DiscussionAddictions are on the rise in today’s society, affecting the mental health and well-being of those who suffer from them, generating important social problems such as job loss, family dysfunction, debt and social isolation. Together with obesity, they are prevalent health problems in young adults and are associated with lower physical activity and higher sedentary time. Meanwhile, arterial stiffness and vascular aging are processes that begin gradually at an early age and determine morbidity and mortality caused by cardiovascular diseases. The results of this project will allow us to understand the situation regarding behavioral and substance addictions in young adults. Better understanding of these addictions will in turn facilitate the development of more effective prevention strategies and intervention programs, which can then reduce the negative impact at both the individual and societal levels.Clinical trial registration[ClinicalTrials.gov], identifier [NCT05819840].

Public aspects of medicine
DOAJ Open Access 2024
Incidence of side effects of antituberculosis drugs and their related factors in northern Iran: a retrospective cohort study

Kheradmand, Motahareh, Afshari, Mahdi, Aarabi, Mohsen et al.

Background: Antituberculosis drugs may cause mild, moderate or severe adverse drug reactions (ADR) leading to poor compliance. Description of the pattern of ADR and their related factors can help tuberculosis (TB) control program as part of the WHO programs. This study aims to investigate the incidence of ADR and associated factors among TB patients in northern Iran. Methods: This is a retrospective cohort study. The required information, including year of diagnosis, age, gender, residence area, nationality, HIV co-morbidity, history of anti TB treatment and ADR, was obtained from the Deputy of Health, Mazandaran University of Medical Sciences, Iran. All data were analyzed using SPSS version 21 software. Results: Out of 3903 TB patients, 136 (3.5%) experienced major ADR. The incidence of ADR for men and women as well as for those with and without previous treatment history were 3.9% vs. 3.3% and 5.3% vs. 3.4%, respectively (p>0.05). Multiple logistic regression models showed a higher chance of ADR among those aged over 59 compared with those aged under 29 (OR=2.63, 95% confidence interval: 1.54–4.49). Conclusions: Age over 59 can be considered a risk factor for ADR with anti-TB drug administration.

Medicine, Public aspects of medicine
DOAJ Open Access 2023
THE ROLE OF FEMALE ENTREPRENEURSHIP IN DEVELOPING COUNTRIES (SYRIAN WOMEN ENTREPRENEURSHIP AS A LIFESTYLE)

Gafar ALMHAMAD, Vilmos LAKATOS2

This study examines the effect of female business projects and their impact on women's economic and social empowerment through increasing women's contribution to income, their role in family decision-making, improving their standard of living, self-esteem, and self-confidence, eliminating poverty and unemployment that rural women suffer from. The gender gap in entrepreneurship persists despite the increasing number of public policies and institutional resources intended to promote women-led enterprises. A qualitative method was used to review the literature related to Women Entrepreneurship in Syria. The economic contribution of women in Syria is characterized by its diversity between agriculture, trade, and government jobs. However, the Syrian crisis has heavily affected the level of entrepreneurship. Data shows that the business performance index decreased to 41.6% in 2018, making Syria rank 174 out of 190 countries surveyed. Even though Syria has witnessed a great improvement in the level of women's development in parallel with the development of the level of women's education and their entry into the labour market within the public and private sectors alike, still the most recent Gender Empowerment Measure (GEM) shows the relative gender gap in entrepreneurship index rate is currently at 0.2. The percentage of entrepreneurship was limited to 1% of working women, compared to 4.9% of men, meaning there are approximately five male entrepreneurs for every female entrepreneur which clearly highlight the need for support.

Business, Finance
DOAJ Open Access 2023
Preventative health assessments and indigenous people of Australia: a scoping review

Kim Usher, Kim Usher, Debra Jackson et al.

Given that Indigenous populations globally are impacted by similar colonial global legacies, their health and other disaprities are usually worse than non-indigenous people. Indigenous peoples of Australia have been seriously impacted by colonial legacies and as a result, their health has negatively been affected. If Indigenous health and wellbeing are to be promoted within the existing Australian health services, a clear understanding of what preventive health means for Indigenous peoples is needed. The aim of this scoping review was to explore the available literature on the uptake/engagement in health assessments or health checks by Indigenous Australian peoples and to determine the enablers and barriers and of health assessment/check uptake/engagement. Specifically, we aimed to: investigate the available evidence reporting the uptake/engagement of health checks/assessments for Australian Indigenous; assess the quality of the available evidence on indigenous health checks/assessments; and identify the enablers or barriers affecting Indigenous persons’ engagement and access to health assessment/health checks. A systematic search of online databases (such as Cinhl, Scopus, ProQuest health and medicine, PubMed, informit, google scholar and google) identified 10 eligible publications on Indigenous preventive health assessments. Reflexive thematic analysis identified three major themes on preventive health assessments: (1) uptake/engagement; (2) benefits and limitations; and (3) enablers and barriers. Findings revealed that Indigenous peoples’ uptake and/or engagement in health assessments/check is a holistic concept varied by cultural factors, gender identity, geographical locations (living in regional and remote areas), and Indigenous clinical leadership/staff’s motivational capacity. Overall, the results indicate that there has been improving rates of uptake of health assessments by some sections of Indigenous communities. However, there is clearly room for improvement, both for aboriginal men and women and those living in regional and remote areas. In addition, barriers to uptake of health asessments were identified as length of time required for the assessment, intrusive or sensitive questions and shame, and lack of access to health services for some. Indigenous clinical leadership is needed to improve services and encourage Indigenous people to participate in routine health assessments.

Public aspects of medicine

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