Glioblastoma Survival Outcomes at a Tertiary Hospital in Appalachia: Factors Impacting the Survival of Patients Following Implementation of the Stupp Protocol

Glioblastoma is a fatal brain cancer with low median and yearly survival rates. The standard of care for treating glioblastoma is gross total resection (GTR) coupled with the Stupp protocol, but various factors influence the interventions undertaken and survival achieved. As health disparities exist in rural areas, survival in these areas need to be assessed in order to understand which factors detract from the successes of these standard medical interventions. We retrospectively determined the impact of age of diagnosis, number of lesions, the molecular marker O6-methylguanine methyltransferase (MGMT), extent of surgery, and completion of the Stupp protocol on survival among patients treated at West Virginia University Hospitals. We found that an age of diagnosis under 60 years, having the MGMT gene methylated, having a unifocal tumor, receiving GTR, adhering to the Stupp protocol, and undergoing a treatment course of GTR followed by the Stupp protocol significantly increased survival. Lastly, we compared our findings to a pre-Stupp study done in West Virginia in 1996. This comparison showed that although overall median survival has not increased, all interventions involving GTR have resulted in a significantly higher survival. We conclude that we can serve our patient population by offering GTR to all adult glioblastoma patients when no contraindications exist and ensuring that patients follow the Stupp protocol. After discharge, the Stupp protocol may not be followed/completed for a variety of reasons. In the future, we aim to assess these reasons and analyze other significant interventional and socioeconomic factors which influence survival

Islamic financial technology acceptance: An empirical study in Jordan

The present research endeavors to comprehend the determinants that impact the inclination to utilize financial technology within the context of Islamic banking clientele. The study undertakes an examination of various determinants that may exert an influence on the consumer's intention. These determinants encompass financial risk, legal risk, security risk, operational risk, consumer innovativeness, perceived ease of use, and perceived usefulness. The technology acceptance model is employed as the theoretical framework for the research. The requisite data for hypothesis testing is collected through the administration of an online survey to consumers of Islamic banks who possess a high degree of adaptability and proficiency in utilizing financial technology. The study employs the methodology of structural equation modelling with partial least squares to assess the proposed relationships among a sample of 399 participants. The results indicate that the acceptance of Islamic Financial technology services is contingent upon the perceived ease of use, perceived usefulness, and consumer innovativeness. In contrast, it is observed that various other factors, namely financial risk, legal risk, security risk, and operational risk, do not hold significant sway in shaping the level of acceptance of Islamic Financial technology among users of Islamic banking services. The concept of Technology Acceptance Model (TAM) is expanded within the realm of Islamic financial technology, and it is utilized to examine the impact of a novel factor, specifically consumer innovativeness. The untested nature of consumer innovativeness makes this paper a valuable resource for policymakers, academics, and researchers in the future

Dialogues artistiques avec les passés de l'Égypte

De l’architecture aux arts décoratifs et de la peinture au théâtre, ce recueil de textes traite d’œuvres dialoguant avec le patrimoine égyptien dans toutes ses composantes. La notion « d’égyptianisme » se trouve ainsi examinée dans la plus large variété de ses acceptions artistiques, architecturales et critiques, dans le monde occidental comme en Égypte. Les textes révèlent un historicisme artistique de veine égyptienne qui ne se cantonnerait ni à la référence antique, ni au monde occidental : nombreux sont les peintres, les sculpteurs, les cinéastes, les architectes… d’Égypte à avoir intégré des représentations du passé national – pharaonique, copte, médiéval, ottoman, et désormais khédivial ou nassérien – dans leur pratique artistique. À l’encontre de l’image habituelle de l’Égyptomanie, c’est un panorama plus riche et plus diversifié qui prend corps ici à travers divers médias et contextes nationaux. Le présent recueil trouve sa source dans un colloque international organisé à la faveur de la venue à Paris de l’exposition « Le théorème de Néfertiti : itinéraire de l’œuvre d’art, la création des icônes » présentée à l’Institut du monde arabe en 2013. Ce colloque s’est tenu les 26 et 27 juin 2013 en partenariat avec Mathaf : Arab Museum of Modern Art (Doha) sous l’intitulé « L’Égypte en ses miroirs ; art, architecture et critique, à demeure et au-delà (XIXe-XXe siècles) »

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries