bluuebunny/crossref_metadata_2025 huggingface dataset:
Gestão em enfermagem para a obtenção de selos de qualidade hospitalar: uma revisão integrativa
Authors: Laborda Yasmin Tainá Corrêa , Rodrigues Antônio José Paulo da Silva , Lopes Graciana de Sousa , Rubem Luisa Magalhães , Reis Fabricia Seixas dos , Laborda Emilly Beatriz Corrêa , Silva Bárbara Margarida Gurgel da , Silva Vitória Diniz Bezerra Lucio da , Souza Laina Emely Silva , Lima Lucas Albuquerque de
Published: January 2022

Objetivo: Discutir sobre o processo de Gestão relacionado a Acreditação Hospitalar, Comparar a evolução dos cuidados após a exigência e implantação de protocolos de qualidade e descrever a importância do Enfermeiro no processo de Acreditação. Métodos: Trata-se de uma revisão integrativa da literatura, realizada dentro das bases: SciELO e BDENF, realizada por meio da junção de quatro descritores em saúde: Gestão da Qualidade, Acreditação Hospitalar, Enfermagem, Gestão em Saúde, sendo selecionado 13 artigos após as etapas de seleção. Resultados: Os protocolos visam garantir a segurança em geral em uma unidade hospitalar, gerando uma atenção mais detalhada para cada procedimento, e demonstrou a capacidade do Enfermeiro em administrar cada etapa necessária para o alcance da certificação hospitalar. Considerações finais: Após a implantação de protocolos houve melhorias na qualidade dos cuidados ao paciente e redução dos riscos para todos que circulam no hospital, e apresentou que a Gestão de Enfermagem é essencial para a instituição que almeja padrões de excelência reconhecidos nacionalmente e internacionalmente.
Values and value orientations of a digital leader in the digital economy era
Authors: Karpova E. G. , Gurenko E. S.
Published: January 2022

The article examines the values and value orientations of a modern leader in the digital economy, in particular, the characteristics, skills and competencies, which distinguish a “digitalˮ leader from a “traditionalˮ leader and guarantee him/her success in business. The research is based on the results of a survey in which 120 people of different age categories and different managerial ranks (in Russia and abroad) participated to identify their priority personal and professional values and assess how these values influence their managerial decisions and the actions they take to transform of their business caused by digital change and the pandemic crisis and to achieve success. The findings of the study have to help understand to current and future leaders, what they have to do, what qualities and skills they have to develop to remain successful in today’s realities.
Social media as dialogue platforms for citizens and authorities of the Central Federal District's entities
Authors: Zotov V. V. , Gubanov A. V.
Published: January 2022

This study examines the role of social and network resources in building dialogue with citizens on the example of subjects of the Central Federal District of regional government bodies. The study is based on monitoring the network space of public communications formed around the accounts of the authorities of the subjects of the Central Federal District. The data obtained were compared with the results of similar monitoring in 2019, as well as the results of a sociological survey on civic engagement of the population on social networks.

As a general rule, the presence of two key network resources in each of the regions was noted – the personal accounts of the head of the region and the official pages of governments (administrations). These resources act as a network “showcase”, are efficiently administered and are consistently filled with well-developed content. Monitoring data make it possible to confirm the presence in the network space of public communications of a fully developed pool of government accounts in popular social media users among domestic Internet users of social media. But at the same time, a decrease in user involvement in the socio-network space of public communications around government accounts is observed for all regions under study.

The information field of each region of the Central Federal District is unique, its actual structure depends on a number of objective factors, such as the level of penetration of various social networks into the audience of Internet users, the activity of large network actors (bloggers, media, popular public), the features of network interaction of ordinary users. Ultimately, the totality of external conditions should predetermine the model of behavior of authorities in social networks.

The introduction of the “Incident Management” system has had a positive impact on the situation, through which citizens’ appeals are not only accepted and processed, but also sent to target authorities, which are obliged to provide a response to the applicant via social networks.

The conclusion of the study presents the authors’ recommendations, which, in our opinion, will optimise the operation of the network of official accounts of the entities of the Central Federal District.
Media image of the Russian Orthodox Church and the challenge of the pandemic
Authors: Zimova N. S. , Fomin E. V.
Published: January 2022

In the digital age, social media have become especially relevant in creating the image of the Russian Orthodox Church. They have their own characteristics and provide a different image of Orthodoxy in comparison to traditional media.

The article presents the results of a study of the media image of the Russian Orthodox Church during the coronavirus lockdown in Russia from January 3 to April 30, 2020. We used a social media analysis system “Kribrum”. At the first stage, content on the Russian Orthodox Church and coronavirus was analysed, and the top 35 influential media were compiled. Taking into account the political attitude of the media, they were divided into state (conservative), neutral (without an editorial agenda); oppositional (liberal). The rating did not include Orthodox media, which indicates the low influence of the Church on the consciousness of users. The basis of the information space is formed by non-religious and opposition media with high ratings.

 At the second stage, with using the method of content analysis, the image of the Russian Orthodox Church and its constituent elements were analysed – the image of the Orthodox faith, the Patriarch, priests, believers. Two poles are highlighted, between which the images of the Russian Orthodox Church are built. In the state media, the Russian Orthodox Church is presented as a state institution, a patriotic organisation uniting all Orthodox Christians. It performs a psychological function and helps believers to survive the period of a pandemic through prayers. Oppositional (liberal) media show the Russian Orthodox Church as an archaic, self-serving and pro-government organisation that has turned out to be unable to prepare for a pandemic and to make the right decisions so that believers do not get coronavirus. Rhetorical, technical and analytical (social technologies) methods of framing the image of the Russian Orthodox Church are revealed.

It can be argued that the Internet is dominated by a stereotypical negative and distorted image of the Russian Orthodox Church. This leads to a violation of the understanding of the social functions of the Church and a decrease in its role in public life.
Structure-based relaxation analysis reveals C-terminal [1-13C]glycine-d2 in peptides has long spin-lattice relaxation time that is applicable to in vivo hyperpolarized magnetic resonance studies
Authors: Kondo Yohei , Saito Yutaro , Seki Tomohiro , Takakusagi Yoichi , Morimoto Jumpei , Nonaka Hiroshi , Miyanishi Koichiro , Mizukami Wataru , Negoro Makoto , Elhelaly Abdelazim Elsayed , Hyodo Fuminori , Matsuo Masayuki , Raju Natarajan , Swenson Rolf , Krishna Murali C. , Yamamoto Kazutoshi , Sando Shinsuke
Published: January 2022

Dissolution-dynamic nuclear polarization (d-DNP) is a state-of-the-art technology that can dramatically enhance the detection sensitivity of nuclear magnetic resonance (NMR). DNP NMR has been applied to small molecules with stable isotopes and has been used to obtain metabolic and physiological information in vivo. However, the hyperpolarized state exponentially decays back to the thermal equilibrium state, depending on the spin-lattice relaxation time (T1). This signal decay has remained a major problem associated with this technology. Therefore, DNP NMR molecular probes useful for in vivo analysis have been limited to naturally occurring small molecules that inherently show long T1. While peptides are promising targets for DNP NMR studies, because of the limitation in T1, DNP NMR molecular probes applicable in vivo have been limited to amino acids or dipeptides. Herein we propose a 13C-labeling strategy to utilize the C-terminal [1-13C]Gly-d2 residue for realizing long T1 in peptides. Structure-based T1 relaxation analysis of amino acids and peptides revealed that (1) T1 does not decrease monotonically with increasing molecular weight and (2) T1 is not significantly affected by a side chain on the neighboring amino acid residue. These findings suggest that the C-terminal [1-13C]Gly-d2 residue affords sufficiently long T1 for biological uses, even in oligopeptides, and allowed us to develop 13C-b- casomorphin-5 (Tyr-Pro-Phe-Pro-[1-13C]Gly-d2, T1 = 24 ± 4 s at 3 T in H2O) and 13C-glutathione (g-Glu-Cys-[1-13C]Gly-d2, T1 = 58 ± 3 s at 3 T in H2O) as DNP NMR probes with long T1. We succeeded in in vivo detection of enzymatic conversions of these two probes. These results demonstrate the utility of our strategy and would contribute to further expansion of the substrate scope for DNP applications.
SOCIO-GEOGRAPHICAL SPACE OF A SMALL CITY (ON THE EXAMPLE OF THE CITIES OF THE TVER REGION)
Authors: Лебедев Павел Сергеевич , Смирнов Илья Петрович
Published: January 2022

В статье рассматривается социально-географическое пространство шести малых городов Тверской области: Бежецка, Торопца, Конакова, Бологого, Кашина и Калязина. Дается краткий обзор вариантов использования понятия «социально-географическое пространство». В фокусе исследования находятся особенности размещения основных «якорных» точек - мест социальной активности горожан. Сравнение позволяет проследить закономерности размещения точек притяжения для «новых» и исторических городов. По результатам исследования составлены схемы, характеризующие это расположение. Отдельно отмечено, что модель размещения, свойственная для «новых» городов, обнаружена в Калязине - городе, утратившем часть своего исторического ядра в результате создания Угличского водохранилища.

The article examines the socio-geographical space of six small towns of the Tver region: Bezhetsk, Toropets, Konakov, Bologogo, Kashin and Kalyazin. An overview of the use cases of the concept of «socio-geographical space» is given. The features of the placement of the main «anchor» points - places of social activity of citizens are investigated. The comparison allows us to trace the patterns of the placement of points of attraction in new and historical cities. According to the results of the study, the schemes characterizing this location have been compiled. It is noted that the placement model typical for new cities was found in Kalyazin - a city that lost part of its historical core as a result of the creation of the Uglich reservoir.
Tri-Wheels Stair Climbing Trolley
Authors:   Faculty of Innovative Design and Technology, Universiti Sultan Zainal Abidin, Malaysia, Norain ​Muhammad Syafiq , Yew Been Seok ,   Faculty of Innovative Design and Technology, Universiti Sultan Zainal Abidin, Malaysia
Published: January 2022

Buildings with no lift and escalator facilities make it difficult for users to lift heavy loads from the ground floor to the upper floor. Human labor is the solution. There is a need to develop a mechanism that can lift loads while traveling through stairs to reduce the ergonomic constraint that may lead to the risk of developing musculoskeletal disorders (MSD). This work presents the tri-wheels stair climbing trolley for this purpose. The tri-wheels stair climbing trolley consists of two pairs of quasi-planetary wheel frames to hold three wheels at both sides, a frame, a movable base, and a manual hand winch. The trolley frame is made from malleable hollow steel, and mild steel is used for the wheel frames due to its high strength and toughness. Physical testing was done on the designed trolley, and it was found that it can carry the maximum load, which is 20kg, and tri-wheels design can climb the stair up and down smoothly without causing damage to the trolley and stair.
A Mechanistic Overview of the Cellular Pathology and Prion-Like Propagation of α-Synuclein in Parkinson's Disease: A Narrative Review
Authors: Ives Rowan
Published: January 2022

Introduction: Prions are quaternary protein complexes made up of misfolded protein isoforms (PrPSc) that are able to aggregate and self-replicate in the absence of nucleic acids. They do this by incorporating and inducing the misfolding of normally-folded protein isoforms (PrPC) in a template-directed fashion, before fragmenting and continuing to propagate at increasingly greater concentrations in cells. Parkinson’s disease (PD) is a disease affecting the central nervous system (CNS), primarily characterised by a marked loss of dopaminergic neurons from the pars compacta of the substantia nigra in the midbrain (snPC). Lewy bodies (LBs) and Lewy neurites (LNs) are protein inclusions made primarily of the protein α-synuclein (α-Syn) and are implicated in defective neural signalling and neuronal cell death in PD. LBs/LNs have been hypothesised to cause symptoms of PD via propagation throughout the CNS in a prion-like mechanism.
Methods: A narrative literature review was conducted to synthesise current and past research surrounding the prion-like propagation of α-Syn in PD, and models connecting cellular pathology to pathophysiology. Results were critically analysed and implications were determined.
Results: α-Syn is a conformationally flexible protein normally involved in presynaptic regulation and dopamine homeostasis. In PD, α-Syn takes on a pathogenic, β-sheet rich conformation resulting from random cellular events or inoculation, that acts in a prion-like manner, inducing the misfolding of normal protein isoforms. Pathogenic α-Syn is propagated between neurons via exosomal secretion and leads to neurotoxicity by loss-of-function causing disruption of dopamine homeostasis, and proteasomal saturation and inhibition. Due to prion-like propagation, and differential susceptibility of neurons to pathogenic α-Syn-mediated neurotoxicity, models of PD progression and symptomatology have been suggested with differing degrees of success.
Discussion: This narrative review aims to build on previous knowledge by clearly describing and evaluating the mechanisms of prion-like propagation and neurotoxicity of pathogenic α-Syn in PD, comparing them to traditional prion mechanisms observed for PrPSc, and models of PD which connect cellular pathology with pathophysiology.
Conclusion: This review provides insight into the cellular mechanisms behind PD and can be used to propel research in this areas via identification of future areas of inquiry and pharmacological targets, among others.
EFFECT OF INLET AIR COOLING ON THE GAS TURBINE PERFORMANCE USING EVAPORATOR AND VAPOUR ABSORPTION COOLERS AT THE HQ-2 DAUR SSGCL GAS COMPRESSION STATION
Authors: Ali Qurban
Published: January 2022

A gas turbine is a device that converts the energy of fuel into mechanical energy and is used to derive several types of rotating equipment. One of the major drawbacks of a gas turbine is that the performance (power output and thermal efficiency) of a gas turbine decreases instantly with the rise of ambient temperature. At Daur SSGCL Gas Compression Station, gas turbines are used to derive centrifugal type gas compressors to raise the pressure of natural gas where ambient temperature varies between 70 to 500C which decreases the performance of gas turbines. Inlet air cooling is a method through which the effect of ambient temperature on the performance of gas turbines can be decreased. This technique of cooling intake air increases the performance of gas turbines by increasing air density. There are various types of inlet air cooling but, in this study, two types of inlet air cooling techniques are discussed, one of which is wetted media evaporative type and the other one is vapour absorption type. The Evaporative type inlet air cooling technique is suitable for sites with high ambient temperature and low relative humidity and vapour absorption type is used for a wide range of ambient air temperature. In this study, thermodynamic models of the gas turbine have been developed without inlet air cooling (base case/cycle) with inlet air cooling for analyzing the effects of ambient conditions (temperature and relative humidity) on the performance of the gas turbine. The simulated results obtained from Engineering Equation Solver with inlet air cooling systems (vapour absorption and wetted media evaporator cooler) are compared without inlet air cooling (base cycle) gas turbine. On comparison of results of a gas turbine with inlet air cooling systems to without inlet air cooling at ambient conditions, T_0=298.15K (250C) and ∅=60% it is found that gas turbine with evaporator cooler produces 289kW more power than base case/cycle and 390kW more output power with vapour absorption inlet air cooling.
Concepções da profissionalidade na fase de consolidação da carreira docente em Matemática
Authors: Barbosa Daiana Estrela Ferreira , Soares Luís Havelange
Published: January 2022

O artigo apresenta os resultados de uma pesquisa que teve como principal objetivo analisar as concepções que o professor de Matemática, inserido na faixa dos quatro aos dez anos de carreira, tem sobre sua profissionalidade. A investigação de natureza qualitativa foi desenvolvida com quatro professores de Matemática que lecionam na Educação Básica e que se encontravam no período de profissão estabelecido para o estudo. Os dados obtidos foram coletados a partir de entrevistas semiestruturadas realizadas, individualmente, com os participantes, após a caracterização do grupo feita com a aplicação de um questionário. Na análise dos dados, selecionamos as falas que sugeriram possíveis entendimentos sobre a temática e os seus aspectos significativos, que serviram para delinear três eixos principais para a discussão. As concepções dos professores participantes indicam uma estabilidade na profissão. Eles se encontram mais confiantes e seguros de suas ações pedagógicas. Pensando nos alunos, eles procuram realizar uma aula interessante, atrativa e motivadora, mesmo com a consciência de que existem dificuldades, seja no processo ensino aprendizagem, seja na representação e valorização docente, citando principalmente, o baixo salário como fator preponderante.
O jogo de papéis como recurso lúdico colaborativo à interpretação e solução de problemas matemáticos
Authors: Santos Dias Audrey Rodrigues , Assis Alice
Published: January 2022

O presente artigo é fruto de uma pesquisa de mestrado que investigou de que maneira o uso de cinco “jogos de papéis”, com alunos do 5º ano do Ensino Fundamental, contribuiu para que esses alunos interpretassem e resolvessem problemas envolvendo as quatro operações matemáticas. O “jogo de papéis” corresponde a uma brincadeira em que a criança assume uma determinada função social (médico, professor, vendedor, entre outros), representando suas ações e comportamentos. Nessa pesquisa, foram aplicadas as brincadeiras “feira”, “banco”, “papelaria”, “lanchonete” e “mercado”. Neste artigo, em particular, os instrumentos de análise foram constituídos: pela transcrição de momentos de intervenção da professora na forma de diálogo com os alunos; pelas transcrições das videogravações das aulas em que essas brincadeiras foram aplicadas e pelas respostas dos alunos à Atividade Diagnóstica Final. Os dados foram analisados qualitativamente mediante Análise de Conteúdo. As seguintes categorias de análise foram estabelecidas a priori: Tradução/Interpretação do problema; Planejamento de estratégias para solução; Execução; e Avaliação. Essas categorias foram definidas a partir dos referenciais teóricos que nortearam esta pesquisa. Os resultados mostraram que a utilização desses “jogos de papéis” contribuiu para a interpretação e a solução de problemas envolvendo as quatro operações matemáticas, por parte dos alunos.
Diagnóstico da aprendizagem por meio da atividade de situações problema discente em modelagem Matemática dos estudantes de licenciatura em Matemática da Universidade Federal de Amazonas
Authors: Wakiyama Yachiko Nascimento , Mendoza H´éctor José García
Published: January 2022

Apresenta-se este estudo sobre a formação de habilidades, no processo de determinação e construção de modelos matemáticos, no âmbito da Educação Matemática, fundamentado na Teoria da Atividade. O objetivo é diagnosticar a aprendizagem por meio da Atividade de Situações Problema Discente em Modelagem Matemática dos estudantes da Licenciatura em Matemática da Universidade Federal de Amazonas. A pesquisa está fundamentada na teoria de formação por etapas das ações mentais e dos conceitos de Galperin; no ensino problematizador de Majmutov e; na direção da Atividade de Estudo de Talízina. Os instrumentos aplicados foram uma prova pedagógica e um questionário. O modelo de controle do Esquema da Base Orientadora Completa da Ação permitiu criar critérios para analisar a aprendizagem. Os resultados revelam que a maioria dos estudantes possui uma orientação falha, necessitando de (re)elaboração de uma base orientadora da ação adequada para formação de habilidade em determinar modelos matemáticos diante de situações problemas.
A Geometria para pessoas com deficiência nas publicações do Seminário Internacional de Pesquisa em Educação Matemática (SIPEM 2000-2018)
Authors: Silva Carla Raianny Gonçalves , Brito Mirian Ferreira
Published: January 2022

O presente artigo foi construído com objetivo de identificar e apresentar artigos relacionados à geometria para pessoas com deficiência publicados nas sete edições do Seminário Internacional de Pesquisa em Educação Matemática (SIPEM) no período 2000-2018. Dessa maneira, utilizamos a pesquisa qualitativa e documental como opção de estudos, assim como o estado do conhecimento para analisar livros, cadernos e anais da I a VII edição do SIPEM. Os resultados mostraram a existência de 1.221 publicações, das quais quarenta e cinco relacionando matemática/geometria à deficiência e, desses 45, quatro articularam geometria e deficiência. Os resultados também mostraram diminuta quantidade de artigos concernentes às temáticas de nosso estudo. Sob outra ótica, entretanto, mostraram de igual modo novas possibilidades de estudos e, consequentemente, de publicações que podem envolver geometria e/ou seus conteúdos noutras perspectivas, seja das já descritas nos quatro artigos, seja de outros ainda não publicados.
Switch Otomatis Untuk Supplay Listrik Di Rumah
Authors: Susanto Sambasari  , Yudi Ananto
Published: January 2022

Dengan sering terjadinya pemadaman listrik secara bergantian di perumahan, ini akan berakibat tergangunya segala aktifitas dan penerangan yang berhubungan dengan pengunaan listrik, juga akan berakibat rusaknya alat-alat yang mempergunakan listrik. Dengan menyediakan generator set (genset) sebagai back-up dalam penyedian supplay listrik, namun masih mengalami proses pemadaman, karena saat start-up genset membutuhkan waktu, juga saat koneksinya rentan terjadi kesalahan, maka dibutuhkan suatu sistem yang dapat secara otomatis men-switch power dari master ke back-up, juga start-up genset tanpa proses pemadaman listrik.

Berlatar belakang masalah di atas, dilakukan penelitian bagaimana mendesain suatu switch (saklar) secara otomatis untuk membangkitkan genset dengan bantuan baterai, apabila terjadi pemadaman listrik dari PLN, dengan waktu yang relatif singkat, peralatan listrik di rumah masih tetap bekerja. Sehingga peralatan yang memerlukan listrik begitupun penerangan masih tetap bekerja dan tidak cepat rusak.

Dari hasil penelitian dan perancangan automatic transfer switch untuk kelistrikan rumah didapat bahwa sistem ini telah berjalan dengan baik, Sistem perpindahan secara otomatis dari PLN ke Genset atau sebaliknya hanya perlu waktu 5 menit dan proses pemadaman listrik hanya 0,3 detik. Fungsi Automatic Main Failure (AMF) menghidupkan genset secara otomatis ketika supplay atau pasokan arus listrik dari PLN terhenti.
Risk of Guillain–Barré syndrome after vaccination against human papillomavirus: a systematic review and meta-analysis, 1 January 2000 to 4 April 2020
Authors: Boender T Sonia , Bartmeyer Barbara , Coole Louise , Wichmann Ole , Harder Thomas
Published: January 2022

Background

Guillain–Barré syndrome (GBS) is a rare autoimmune disease that can follow viral infections and has in a few cases been linked to vaccinations. Pre-licensure clinical trials did not observe an association between human papillomavirus (HPV) vaccination and GBS, a post-marketing study from 2017 reported an increased relative risk.

Aim

We assessed the risk of GBS after HPV vaccination through a systematic literature review and meta-analysis.

Methods

We searched Embase, MEDLINE and Cochrane for studies reporting on the risk of GBS after HPV vaccination in individuals aged ≥ 9 years, published between 1 January 2000 and 4 April 2020, excluding studies without a comparator group. Seven studies reporting relative effect sizes were pooled using random-effects meta-analysis. We assessed quality of evidence using the GRADE approach. Study protocol was registered (PROSPERO No. #CRD42019123533).

Results

Of 602 identified records, we included 25 studies. Based on over 10 million reports, cases of GBS were rare. In 22 studies no increased risk was observed, while in three studies a signal of increased risk of GBS after HPV vaccination was identified. Meta-analysis yielded a pooled random-effects ratio of 1.21 (95% CI: 0.60–2.43); I2 = 72% (95% CI: 36–88). This translates to a number needed to harm of one million to be vaccinated to generate one GBS case. Quality of evidence was very low.

Conclusions

The absolute and relative risk of GBS after HPV vaccination is very low and lacks statistical significance. This is reassuring for the already implemented vaccination programmes and should be used in respective communication activities.
Variability in detection of SARS-CoV-2-specific antibody responses following mild infection: a prospective multicentre cross-sectional study, London, United Kingdom, 17 April to 17 July 2020
Authors: Pallett Scott JC , Jones Rachael , Abdulaal Ahmed , Pallett Mitchell A , Rayment Michael , Patel Aatish , Denny Sarah J , Mughal Nabeela , Khan Maryam , Rosadas de Oliveira Carolina , Pantelidis Panagiotis , Randell Paul , Toumazou Christofer , O’Shea Matthew K , Tedder Richard , McClure Myra O , Davies Gary W , Moore Luke SP
Published: January 2022

Introduction

Immunoassays targeting different SARS-CoV-2-specific antibodies are employed for seroprevalence studies. The degree of variability between immunoassays targeting anti-nucleocapsid (anti-NP; the majority) vs the potentially neutralising anti-spike antibodies (including anti-receptor-binding domain; anti-RBD), particularly in mild or asymptomatic disease, remains unclear.

Aims

We aimed to explore variability in anti-NP and anti-RBD antibody detectability following mild symptomatic or asymptomatic SARS-CoV-2 infection and analyse antibody response for correlation with symptomatology.

Methods

A multicentre prospective cross-sectional study was undertaken (April–July 2020). Paired serum samples were tested for anti-NP and anti-RBD IgG antibodies and reactivity expressed as binding ratios (BR). Multivariate linear regression was performed analysing age, sex, time since onset, symptomatology, anti-NP and anti-RBD antibody BR.

Results

We included 906 adults. Antibody results (793/906; 87.5%; 95% confidence interval: 85.2–89.6) and BR strongly correlated (ρ = 0.75). PCR-confirmed cases were more frequently identified by anti-RBD (129/130) than anti-NP (123/130). Anti-RBD testing identified 83 of 325 (25.5%) cases otherwise reported as negative for anti-NP. Anti-NP presence (+1.75/unit increase; p < 0.001), fever (≥ 38°C; +1.81; p < 0.001) or anosmia (+1.91; p < 0.001) were significantly associated with increased anti-RBD BR. Age (p = 0.85), sex (p = 0.28) and cough (p = 0.35) were not. When time since symptom onset was considered, we did not observe a significant change in anti-RBD BR (p = 0.95) but did note decreasing anti-NP BR (p < 0.001).

Conclusion

SARS-CoV-2 anti-RBD IgG showed significant correlation with anti-NP IgG for absolute seroconversion and BR. Higher BR were seen in symptomatic individuals, particularly those with fever. Inter-assay variability (12.5%) was evident and raises considerations for optimising seroprevalence testing strategies/studies.
Increased risk of infection with SARS-CoV-2 Omicron BA.1 compared with Delta in vaccinated and previously infected individuals, the Netherlands, 22 November 2021 to 19 January 2022
Authors: Eggink Dirk , Andeweg Stijn P , Vennema Harry , van Maarseveen Noortje , Vermaas Klaas , Vlaemynck Boris , Schepers Raf , van Gageldonk-Lafeber Arianne B , van den Hof Susan , Reusken Chantal BEM , Knol Mirjam J
Published: January 2022

Infections with the Omicron SARS-CoV-2 variant are rapidly increasing worldwide. Among 174,349 SARS-CoV-2-infected individuals (≥ 12 years), we observed an increased risk of S gene target failure, predictive of the Omicron variant, in vaccinated (odds ratio (OR): 3.6; 95% confidence interval (CI): 3.4–3.7) and previously infected individuals (OR: 4.2; 95% CI: 3.8–4.7) compared with infected naïve individuals. This suggests vaccine- or infection-induced immunity against SARS-CoV-2 infections is less effective against the Omicron than the Delta variant.
Reduced risk of hospitalisation among reported COVID-19 cases infected with the SARS-CoV-2 Omicron BA.1 variant compared with the Delta variant, Norway, December 2021 to January 2022
Authors: Veneti Lamprini , Bøås Håkon , Bråthen Kristoffersen Anja , Stålcrantz Jeanette , Bragstad Karoline , Hungnes Olav , Storm Margrethe Larsdatter , Aasand Nina , Rø Gunnar , Starrfelt Jostein , Seppälä Elina , Kvåle Reidar , Vold Line , Nygård Karin , Buanes Eirik Alnes , Whittaker Robert
Published: January 2022

We included 39,524 COVID-19 Omicron and 51,481 Delta cases reported in Norway from December 2021 to January 2022. We estimated a 73% reduced risk of hospitalisation (adjusted hazard ratio: 0.27; 95% confidence interval: 0.20–0.36) for Omicron compared with Delta. Compared with unvaccinated groups, Omicron cases who had completed primary two-dose vaccination 7–179 days before diagnosis had a lower reduced risk than Delta (66% vs 93%). People vaccinated with three doses had a similar risk reduction (86% vs 88%).
A MULTICENTRIC STUDY ON BREAST CANCER IN ULTRA YOUNG WOMEN: I – A CLINICAL AND EPIDEMIOLOGIC PICTURE
Authors: Yoshimura Adriana Akemi , Mattar André , Mota Bruna S. , Fristachi Carlos Elias , Pessoa Eduardo Carvalho , Andrade Felipe Eduardo , Tosello Giuliano , Vespoli Heloísa Maria De Luca , Oliveira Junior8 Idam de , Borges João Bosco Ramos , Filassi José Roberto , Gebrim Luiz Henrique , Piccinilli Marina Filie Haddad , Vieira René Aloisio Costa , Tarriconi Junior Vicente , Barros Alfredo Carlos Simões Dornellas de
Published: January 2022

Introduction: A substantial number of young women (YW) is affected by breast cancer (BC), an important cause of death in young age. The definition of a YW in a BC context varies in the literature. Considering specific characteristics, such as reproductive factors and hereditary risk, we defined ultra young women (UYW) as women aged 30 years or less. Despite the fact that specialized centers are increasingly providing assistance to UYW with BC, important aspects of the disease in this age remain controversial. Objective: Evaluate clinical and epidemiological characteristics of BC in UYW in the State of São Paulo. Methods: We conducted a multicentric, observational, retrospective study of consecutive BC in UYW patients in nine Services. Only patients with infiltrating BC aged 30 years or less were included. The following data were collected: age, body mass index, parity, hormonal contraception use, history of breast/ovarian cancer in the family, pathological tumor category and clinical staging. Frequency parameters were estimated. The research protocol was approved by the Ethics Committee of all collaborative centers. An informed consent was waived. Results: The study population included 293 patients. Age varied between 19 and 30 years (mean 27.3; median 28). Considering body weight, we found that 37.1% of the patients were overweight or obese. 58.6% were current or past HC users. Nulliparity was referred in 44.4%. 246 cases reported family history of BC which was verified in first degree relatives in 37.9%, while 66 patients referred BC in any member of the family. Only 33 patients went through a multigene testing panel: pathogenic inherited variants were detected in 37.5%. Remarkably, locally advanced tumors were diagnosed in 57.1%. Tumor sizes at diagnosis were: T1-11.8%, T2-33.8%, T3-31.6% T4-19.9% and T4d-2.9%. Clinical axillary lymph nodes evaluation revealed: N0-35%, N1-42.8%, N2-18.7%, and N3-3.5%. Systemic metastases at diagnosis were observed in 29 cases, that were classified as stage IV “de novo” (9.8%). The metastases sites were multiple in 31% and the clinical staging in the diagnosis are later. Conclusion: An unfavorable picture was observed in UYW with BC. We found a high rate of advanced neoplasias, with adverse clinical prognostic factors. To change the present-day scenario, we need to educate the population, enhancing BC awareness and self-body attention since adolescence, besides stimulating the adoption of a healthy lifestyle.
IMMUNOHISTOCHEMICAL PROFILE STRATIFIED IN AGE RANGE IN11,326 PATIENTS FROM THE BRAZILIAN UNIFIED HEALTH SYSTEM (SUS) IN SÃO PAULO
Authors: Santos Catharine Coelho , Farabotti Camila Santos , Gomes Pedro Santos , Gebrim Luiz Henrique , Mattar André Santos
Published: January 2022

Introduction: The development of breast cancer is heterogeneous and there are variations in its morphologic and biological characteristics. Several risk factors for breast cancer have already been identified, including the age group. It is wellestablished that the incidence of breast cancer increases from the age of 65. Older patients are more likely to have tumors which are positive estrogen receptors (ER) and progesterone receptors (RP) and, HER2 negative, which are associated with better outcomes. In contrast, younger patients with triple-negative breast cancer and HER2 positive are associated with reduced survival and poor prognosis. Objectives: To evaluate immunohistochemical profiles stratified by age group in patients diagnosed with breast cancer at Pérola Byington Hospital. Methods: A retrospective cross-sectional study was carried out at the Referral Center for Women’s Health - Hospital Pérola Byington– São Paulo (SP), Brazil. The data were removed from the collection system during the period of January 2011 to December 2018. Such women were stratified through the subtype histochemical analysis and evaluated in relation to their age at diagnosis. Results: We analyzed the immunohistochemical profile of 11,326 patients treated at Hospital Pérola Byington from January 2011 to December 2018. Lumum tumors A corresponded to 2,629 cases and among these 7.3% were under 40 years old, 23.1% between 40 and 50 years old and 60.5% were over 50 years old. The rate of tumors lumen B was 3,494 cases, with 10.1% in patients under 40, 24.2% between 40 and 50 years old and 65.6% over 50 years old. Acheampong et al. carried out a study on the incidence of molecular subtypes in the USA between 2010 and 2016 and concluded that from the 32,0124 women included, 72.6% were classified as luminal A, 11.2% luminal B, 4.8% overexpression of HER2 and 11.3% tumors. Conclusions: Based on the molecular markers, we classified the subtypes into four breast carcinomas: luminal B was the most frequent, followed by luminal A. The subtypes showed no significant difference in relation to their histological type nor age. Thus, the correlation between histological diagnosis and immunohistochemistry can improve the treatment and survival of women with breast cancer and, consequently, improve the therapeutic response of patients.
PREVALENCE OF VARIANTS OF UNCERTAIN SIGNIFICANCE IN TESTS REQUESTED FOR BREAST CANCER PATIENTS IN A PRIVATE SERVICE
Authors: Heinzen Rebeca Neves , Meyer Maria Eduarda , Pizatto Liliane Raupp Gomes , Freitas Adriana Magalhães de Oliveira
Published: January 2022

Introduction: The genetic mutations test among breast cancer (BC) patients is one of the steps for the diagnosis in the majority of the patients. To identify and manage patients with hereditary predisposition to cancer is also a competence of the breast surgeon. The development of Next Generation Sequence (NGS) has allowed the reduction of the tests’ cost as well as the expansion of the analyzed genes, besides BRCA 1 and 2, and the inclusion of new genes of high and moderate penetrance. There is a concern about the impact of these results because there is not a well-established conduct for all the mutations as well as for the increase of the diagnoses of variant of uncertain significance (VUS) diagnosed in the panels, mostly in patients that did not receive a formal genetic counseling. Studies show that the larger number of analyzed genes is related to a better chance of detecting VUS, reaching 40%, but they are not conduct modifiers. The literature shows that approximately 90% of VUS are reclassified as benign. Objectives: To assess prevalence of VUS in multigenic panels requested by the non-geneticist physician, in private office, performed on patients with BC diagnosis. Methods: A retrospective cross-sectional study was conducted based in data from invasive BC patients or in situ or with high risk for neoplasia that attended a private office and were subjected to multigenic panels requested by the non-geneticist physician from January 2019 to January 2020. Statistical analysis frequency measurements were analyzed in Excel Office®. Results: 147 patients underwent the genetic test of 83 genes with NGS technology. Only one was a male. Among the tests performed, 48 were negative for pathogenic variants and 23 were positive for pathogenic mutations in 22 (15%) patients, the most common being in BRCA2 gene (7 cases), followed by MUTHY (6 cases). 137 VUS occurred in 77 (52.4%) patients, the most common of these being in gene POLE and RECQL4. Conclusions: The data found in our population match the literature, showing more than half of the patients with VUS. This demonstrates the importance of test interpretation as well as inpatient correct orientation.
EXPRESSION OF miRNAS SUGGESTS A POTENTIAL ROLE IN BREAST CANCER
Authors: Carvalho Tamyres MIngorance , Jukoski Tayana Schultz , Brasil Guillermo Ortiz , Kuroda Flavia , Ribeiro Enilze M. S. F.
Published: January 2022

Introduction: MicroRNAs (miRNAs) are regulators of gene expression in biological processes, mainly repressing translation or degrading messenger RNA (mRNA) from their target genes. Their deregulation is associated with a wide variety of diseases, including cancer. Breast cancer (BC) is the most common cancer among women worldwide. Understanding the mechanisms involved in this pathology is essential for the discovery of new diagnostic and prognostic markers. Objectives: Investigate the differential expression of selected miRNAs in luminal A (LA) and triple-negative breast cancer (TNBC). Methods: We evaluated the expression of miR-320a, miR-4433b-5p, miR-142-5p, and miR-150-5p in 31 BC samples (19 LA and 12 TNBC) and 29 adjacent non-tumor breast cancer (NT). The miRNAs were selected after in silico study. RT-qPCR was the method of choice, using RNU48 as endogenous control, and the BT-474 cell line was used as a calibrator between plates. The 2−ΔΔCt method was used to estimate miRNA expression level. Individual receiver operating characteristic (ROC) curves were calculated based on RQ values to investigate the diagnostic value of miRNAs. Results: miR-142-5p, miR-150-5p, miR-320a, and miR-4433b-5p were downregulated in BC compared to NT samples. All studied miRNAs were able to discriminate between BC and NT samples with sensitivity and sensibility (AUC – Area under curve >0.7 and p <0.05). A panel including all miRNAs improved the AUC to identify TNBC patients compared to NT (AUC=0.9240, sensitivity 94.44%, specificity 100%). We found no difference comparing miRNAs between LA and TNBC BC subtypes. There was no association between expression levels and prognostic parameters (age, histological grade, size of the tumor, axillary lymph node status). Conclusions: Our data suggest that downregulation of miR-142-5p, miR-150-5p, miR-320a, and miR-4433b-5p can be involved in BC for not repressing the expression of target genes. Functional studies will contribute to elucidate their involvement in BC.
RECURRENCE PROFILE AND PROGNOSIS IN A NEGATIVE SENTINEL LYMPH NODE BREAST CANCER PATIENTS COHORT TREATED AT HOSPITAL DO SERVIDOR ESTADUAL DE SÃO PAULO
Authors: Vasconcelos Raissa Naiara Alves Barros , Antonini Marcelo , Cabral Samira Marcondes , Cardoso Mariana Soares , Solino Matheus de Paula
Published: January 2022

Introduction: Breast cancer is the main cause of death by cancer among brazilian women and its incidence increases annually. Due to screening e new technologies, diagnosis without axillary metastasis is increasing. Objectives: This study aimed at evaluating locoregional recurrences, distant metastasis, prognostic factors associated to those outcomes and its impact on deaths among breast cancer patients treated in a public hospital of São Paulo. Methods: It is a retrospective cohort study that included 342 T1-3N0 breast cancer patients with negative sentinel lymph node biopsy submitted to primary surgery between March 2014 and March 2019 at Hospital do Servidor Público Estadual (HSPE). Primary outcomes were locoregional recurrence rate, distant metastasis rate, mortality, disease free survival and overall survival. Secondary outcomes were the association between primary outcomes and prognostic factors established in the literature. Results: During 1.5 to 6.4 years of follow-up (median time 3.3 years), there was 3.8% locoregional recurrence cases, 4.1% distant metastasis and 3.8% deaths. Locoregional recurrence free survival in three years was 94.4% and metastasis free survival was 95.6%. Overall survival in three years was 97.2%. It was observed an association between locoregional recurrence histological subtype and hormonal therapy, distant metastasis, histological subtype and tumor grade, deaths and tumor grade. The results evidence that locoregional recurrences increases distant metastasis, but do not reduce overall survival. On the other hand, distant metastasis decreases overall survival. Conclusions: This study showed that breast cancer patients without axillary metastasis treated at HSPE presentedconsistent locoregional recurrence, metastasis and mortality patterns in the literature. Further studies with more participants and longer follow-up are necessary to evaluate the relative risk of each prognostic factor included in the present research.
IMPACT OF LOCAL RECURRENCE ON PATIENTS WITH BREAST CANCER DIAGNOSIS SUBMITTED TO CONSERVATIVE SURGERY AT HOSPITAL PÚBLICO DO SERVIDOR ESTADUAL
Authors: Cabral Samira Marcondes , Antonini Marcelo , Vasconcelos Raissa Naiara Barros , Cardoso Mariana Soares , Solino Matheus de Paula
Published: January 2022

Introduction: Breast cancer is a major cause of mortality in Brazil and worldwide. It is a heterogeneous disease with specific molecular subtypes, which are associated with different prognosis and responses to treatment. Objectives: The present study aimed at assessing the incidence of local recurrence in patients undergoing conservative surgery and its impact on overall survival. As a secondary outcome, there are the prognostic factors of local recurrence in addition to the relationship with systemic metastasis. Methods: It is a retrospective cohort including 500 patients submitted to conservative surgical treatment, from March 2014 to March 2019 at Hospital do Servidor Público Estadual de São Paulo. Results: The results are compatible with the literature, with local recurrence in 4% of patients and more relapses with triple-negative subtype; 367 patients had hormonal treatment: five (1.4%) relapsed and 51 patients did not use hormonal treatment, four (7.8%) relapsed. This shows a higher percentage of recurrence in the group without adjuvant hormone therapy when compared to the group that underwent treatment (p=0.016); 7.4% of patients developed metastasis, which was more prevalent in patients diagnosed with triple-negative subtype cancer and pure Her. This group had an estimated probability of survival significantly lower (72.3%) than the group without metastases (98%) (p <0.001). In this cohort, disease-free survival was 93.4% and overall survival was 96% over a median of three years of follow-up. Other prognostic factors, established in the literature, such as age, lymph node involvement, tumor size, in addition to systemic treatment and radiotherapy had no significant difference between patients who did or did not relapse. Conclusion: In this cohort, patients diagnosed with breast cancer and who underwent conservative surgery, evolving with local recurrence, did not present a higher risk of death, and we found tumor biology as a risk factor for locoregional recurrences. Patients who evolved with systemic metastases showed a reduction in the overall survival rate.