bluuebunny/crossref_metadata_2025 huggingface dataset:
Discordant pathologic diagnoses of myelodysplastic neoplasms and their implications for registries and therapies
Authors: Gorak Edward J. , Otterstatter Michael , Al Baghdadi Tareq , Gillis Nancy , Foran James M. , Liu Jane Jijun , Bejar Rafael , Gore Steven D. , Kroft Steven H. , Harrington Alexandra , Saber Wael , Starczynowski Daniel , Rollison Dana E. , Zhang Ling , Moscinski Lynn , Wilson Steffanie , Thompson Jason , Borchert Christine , Sherman Seth , Hebert Donnie , Walker Mary Ellen , Padron Eric , DeZern Amy E. , Sekeres Mikkael A.
Published: August 2023

Myelodysplastic neoplasms (MDS) are a collection of hematopoietic disorders with widely variable prognoses and treatment options. Accurate pathologic diagnoses present challenges because of interobserver variability in interpreting morphology and quantifying dysplasia. We compared local clinical site diagnoses with central, adjudicated review from 918 participants enrolled in the ongoing National Heart, Lung, and Blood Institute National MDS Natural History Study, a prospective observational cohort study of participants with suspected MDS or MDS/myeloproliferative neoplasms (MPNs). Locally, 264 (29%) were diagnosed as having MDS, 15 (2%) MDS/MPN overlap, 62 (7%) idiopathic cytopenia of undetermined significance (ICUS), 0 (0%) acute myeloid leukemia (AML) with <30% blasts, and 577 (63%) as other. Approximately one-third of cases were reclassified after central review, with 266 (29%) diagnosed as MDS, 45 (5%) MDS/MPN overlap, 49 (5%) ICUS, 15 (2%) AML with <30%, and 543 (59%) as other. Site miscoding errors accounted for more than half (53%) of the local misdiagnoses, leaving a true misdiagnosis rate of 15% overall, 21% for MDS. Therapies were reported in 37% of patients, including 43% of patients with MDS, 49% of patients with MDS/MPN, and 86% of patients with AML with <30% blasts. Treatment rates were lower (25%) in cases with true discordance in diagnosis compared with those for whom local and central diagnoses agreed (40%), and receipt of inappropriate therapy occurred in 7% of misdiagnosed cases. Discordant diagnoses were frequent, which has implications for the accuracy of study-related and national registries and can lead to inappropriate therapy. This trial was registered at www.clinicaltrials.gov as #NCT05074550.
A significant proportion of classic Hodgkin lymphoma recurrences represents clonally unrelated second primary lymphoma
Authors: van Bladel Diede A. G. , Stevens Wendy B. C. , Kroeze Leonie I. , de Groen Ruben A. L. , de Groot Fleur A. , van der Last-Kempkes Jessica L. M. , Berendsen Madeleine R. , Rijntjes Jos , Luijks Jeroen A. C. W. , Bonzheim Irina , van der Spek Ellen , Plattel Wouter J. , Pruijt Johannes F. M. , de Jonge-Peeters Susan D. P. W. M. , Velders Gerjo A. , Lensen Chantal , van Bladel Esther R. , Federmann Birgit , Hoevenaars Brigiet M. , Pastorczak Agata , van der Werff ten Bosch Jutte , Vermaat Joost S. P. , Nooijen Peet T. G. A. , Hebeda Konnie M. , Fend Falko , Diepstra Arjan , van Krieken J Han J. M. , Groenen Patricia J. T. A. , van den Brand Michiel , Scheijen Blanca
Published: August 2023

Despite high cure rates in classic Hodgkin lymphoma (cHL), relapses are observed. Whether relapsed cHL represents second primary lymphoma or an underlying T-cell lymphoma (TCL) mimicking cHL is underinvestigated. To analyze the nature of cHL recurrences, in-depth clonality testing of immunoglobulin (Ig) and T-cell receptor (TCR) rearrangements was performed in paired cHL diagnoses and recurrences among 60 patients, supported by targeted mutation analysis of lymphoma-associated genes. Clonal Ig rearrangements were detected by next-generation sequencing (NGS) in 69 of 120 (58%) diagnoses and recurrence samples. The clonal relationship could be established in 34 cases, identifying clonally related relapsed cHL in 24 of 34 patients (71%). Clonally unrelated cHL was observed in 10 of 34 patients (29%) as determined by IG-NGS clonality assessment and confirmed by the identification of predominantly mutually exclusive gene mutations in the paired cHL samples. In recurrences of >2 years, ∼60% of patients with cHL for whom the clonal relationship could be established showed a second primary cHL. Clonal TCR gene rearrangements were identified in 14 of 125 samples (11%), and TCL-associated gene mutations were detected in 7 of 14 samples. Retrospective pathology review with integration of the molecular findings were consistent with an underlying TCL in 5 patients aged >50 years. This study shows that cHL recurrences, especially after 2 years, sometimes represent a new primary cHL or TCL mimicking cHL, as uncovered by NGS-based Ig/TCR clonality testing and gene mutation analysis. Given the significant therapeutic consequences, molecular testing of a presumed relapse in cHL is crucial for subsequent appropriate treatment strategies adapted to the specific lymphoma presentation.
CryoGrid-PIXUL-RNA: high throughput RNA isolation platform for tissue transcript analysis
Authors: Schactler Scott A. , Scheuerman Stephen J. , Lius Andrea , Altemeier William A. , An Dowon , Matula Thomas J. , Mikula Michal , Kulecka Maria , Denisenko Oleg , Mar Daniel , Bomsztyk Karol
Published: August 2023

Background

Disease molecular complexity requires high throughput workflows to map disease pathways through analysis of vast tissue repositories. Great progress has been made in tissue multiomics analytical technologies. To match the high throughput of these advanced analytical platforms, we have previously developed a multipurpose 96-well microplate sonicator, PIXUL, that can be used in multiple workflows to extract analytes from cultured cells and tissue fragments for various downstream molecular assays. And yet, the sample preparation devices, such as PIXUL, along with the downstream multiomics analytical capabilities have not been fully exploited to interrogate tissues because storing and sampling of such biospecimens remain, in comparison, inefficient.

Results

To mitigate this tissue interrogation bottleneck, we have developed a low-cost user-friendly system, CryoGrid, to catalog, cryostore and sample tissue fragments. TRIzol is widely used to isolate RNA but it is labor-intensive, hazardous, requires fume-hoods, and is an expensive reagent. Columns are also commonly used to extract RNA but they involve many steps, are prone to human errors, and are also expensive. Both TRIzol and column protocols use test tubes. We developed a microplate PIXUL-based TRIzol-free and column-free RNA isolation protocol that uses a buffer containing proteinase K (PK buffer). We have integrated the CryoGrid system with PIXUL-based PK buffer, TRIzol, and PureLink column methods to isolate RNA for gene-specific qPCR and genome-wide transcript analyses. CryoGrid-PIXUL, when integrated with either PK buffer, TRIzol or PureLink column RNA isolation protocols, yielded similar transcript profiles in frozen organs (brain, heart, kidney and liver) from a mouse model of sepsis.

Conclusions

RNA isolation using the CryoGrid-PIXUL system combined with the 96-well microplate PK buffer method offers an inexpensive user-friendly high throughput workflow to study transcriptional responses in tissues in health and disease as well as in therapeutic interventions.
Development of SNP and InDel markers by genome resequencing and transcriptome sequencing in radish (Raphanus sativus L.)
Authors: Li Yadong , Luo Xiaobo , Peng Xiao , Jin Yueyue , Tan Huping , Wu Linjun , Li Jingwei , Pei Yun , Xu Xiuhong , Zhang Wanping
Published: August 2023

Background

Single nucleotide polymorphisms (SNPs) and insertions/deletions (InDels) are the most abundant genetic variations and widely distribute across the genomes in plant. Development of SNP and InDel markers is a valuable tool for genetics and genomic research in radish (Raphanus sativus L.).

Results

In this study, a total of 366,679 single nucleotide polymorphisms (SNPs) and 97,973 insertion-deletion (InDel) markers were identified based on genome resequencing between ‘YZH’ and ‘XHT’. In all, 53,343 SNPs and 4,257 InDels were detected in two cultivars by transcriptome sequencing. Among the InDel variations, 85 genomic and 15 transcriptomic InDels were newly developed and validated PCR. The 100 polymorphic InDels markers generated 207 alleles among 200 Chinese radish germplasm, with an average 2.07 of the number of alleles (Na) and with an average 0.33 of the polymorphism information content (PIC). Population structure and phylogenetic relationship revealed that the radish cultivars from northern China were clustered together and the southwest China cultivars were clustered together. RNA-Seq analysis revealed that 11,003 differentially expressed genes (DEGs) were identified between the two cultivars, of which 5,020 were upregulated and 5,983 were downregulated. In total, 145 flowering time-related DGEs were detected, most of which were involved in flowering time integrator, circadian clock/photoperiod autonomous, and vernalization pathways. In flowering time-related DGEs region, 150 transcriptomic SNPs and 9 InDels were obtained.

Conclusions

The large amount of SNPs and InDels identified in this study will provide a valuable marker resource for radish genetic and genomic studies. The SNPs and InDels within flowering time-related DGEs provide fundamental insight into for dissecting molecular mechanism of bolting and flowering in radish.
Bacteriophage cocktail application for Campylobacter mitigation - from in vitro to in vivo
Authors: Peh Elisa , Szott Vanessa , Reichelt Benjamin , Friese Anika , Rösler Uwe , Plötz Madeleine , Kittler Sophie
Published: August 2023

Background

Effective strategies are urgently needed to control Campylobacteriosis, one of the most important foodborne gastrointestinal diseases worldwide. Administering bacteriophages (phages) is under evaluation as a possible intervention strategy in primary poultry production to reduce the public health risk of human infection. A major challenge is the translation of results from small-scale animal studies to large broiler flocks. In this study, the in vitro lytic activity of 18 Campylobacter-specific group II phages and 19 group III phages were examined singly, and in different combinations from the same group and from both groups using a planktonic killing assay. Based on these results, a combination of phage NCTC 12,673 (group III) and vB_CcM-LmqsCPL1/1 (group II) was selected for in vivo application in a seeder bird model to study its effectiveness under conditions as close as possible to field conditions. One hundred eighty Ross 308 broiler chickens were divided into a control and a treatment group. Ten days post hatch, seeder birds were orally inoculated with the C. jejuni target strain. Phages were administered via drinking water at a total concentration of 107 PFU/mL four, three, and two days before necropsy.

Results

Combining group II and group III phages resulted in significantly higher in vitro growth inhibition against the C. jejuni target strain BfR-CA-14,430 than single application or combinations of phages from the same group. The results of the animal trial showed that the application of the two phages significantly reduced Campylobacter counts in cloacal swabs. At necropsy, Campylobacter counts in colonic content of the treatment group were significantly reduced by 2 log10 units compared to the control group.

Conclusions

We demonstrated that combining phages of groups II and III results in significantly increased lytic activities. The in vitro results were successfully translated into practical application in a study design close to field conditions, providing new data to apply phages in conventional broiler flocks in the future. Phage application reduced the fecal Campylobacter excretion and Campylobacter concentrations in the colon of broilers.
Investigating the evolution and predicting the future outlook of antimicrobial resistance in sub-saharan Africa using phenotypic data for Klebsiella pneumoniae: a 12-year analysis
Authors: Aruhomukama Dickson , Nakabuye Hellen
Published: August 2023

Background

Antimicrobial resistance (AMR) is a major public health challenge, particularly in sub-Saharan Africa (SSA). This study aimed to investigate the evolution and predict the future outlook of AMR in SSA over a 12-year period. By analysing the trends and patterns of AMR, the study sought to enhance our understanding of this pressing issue in the region and provide valuable insights for effective interventions and control measures to mitigate the impact of AMR on public health in SSA.

Results

The study found that general medicine patients had the highest proportion of samples with AMR. Different types of samples showed varying levels of AMR. Across the studied locations, the highest resistance was consistently observed against ceftaroline (ranging from 68 to 84%), while the lowest resistance was consistently observed against ceftazidime avibactam, imipenem, meropenem, and meropenem vaborbactam (ranging from 92 to 93%). Notably, the predictive analysis showed a significant increasing trend in resistance to amoxicillin-clavulanate, cefepime, ceftazidime, ceftaroline, imipenem, meropenem, piperacillin-tazobactam, and aztreonam over time.

Conclusions

These findings suggest the need for coordinated efforts and interventions to control and prevent the spread of AMR in SSA. Targeted surveillance based on local resistance patterns, sample types, and patient populations is crucial for effective monitoring and control of AMR. The study also highlights the urgent need for action, including judicious use of antibiotics and the development of alternative treatment options to combat the growing problem of AMR in SSA.
Critical illness at the emergency department of a Tanzanian national hospital in a three-year period 2019–2021
Authors: Mboya Erick A. , Ndumwa Harrieth P. , Amani Davis E. , Nkondora Paulina N. , Mlele Victoria , Biyengo Happines , Mashoka Ramadhan , Haniffa Rashan , Beane Abi , Mfinanga Juma , Sunguya Bruno F. , Sawe Hendry R. , Baker Tim
Published: August 2023

Background

Critically ill patients have life-threatening conditions requiring immediate vital organ function intervention. But, critical illness in the emergency department (ED) has not been comprehensively described in resource-limited settings. Understanding the characteristics and dynamics of critical illness can help hospitals prepare for and ensure the continuum of care for critically ill patients. This study aimed to describe the pattern and outcomes of critically ill patients at the ED of the National Hospital in Tanzania from 2019 to 2021.

Methodology

This hospital-records-based retrospective cohort study analyzed records of all patients who attended the ED of Muhimbili National Hospital between January 2019 and December 2021. Data extracted from the ED electronic database included clinical and demographic information, diagnoses, and outcome status at the ED. Critical illness in this study was defined as either a severe derangement of one or more vital signs measured at triage or the provision of critical care intervention. Data were analyzed using Stata 17 to examine critical illnesses’ burden, characteristics, first-listed diagnosis, and outcomes at the ED.

Results

Among the 158,445 patients who visited the ED in the study period, 16,893 (10.7%) were critically ill. The burden of critical illness was 6,346 (10.3%) in 2019, 5,148 (10.9%) in 2020, and 5,400 (11.0%) in 2021. Respiratory (18.8%), cardiovascular (12.6%), infectious diseases (10.2%), and trauma (10.2%) were the leading causes of critical illness. Most (81.6%) of the critically ill patients presenting at the ED were admitted or transferred, of which 11% were admitted to the ICUs and 89% to general wards. Of the critically ill, 4.8% died at the ED.

Conclusion

More than one in ten patients attending the Tanzanian National Hospital emergency department was critically ill. The number of critically ill patients did not increase during the pandemic. The majority were admitted to general hospital wards, and about one in twenty died at the ED. This study highlights the burden of critical illness faced by hospitals and the need to ensure the availability and quality of emergency and critical care throughout hospitals.
Altered intrinsic brain activity and functional connectivity in COVID-19 hospitalized patients at 6-month follow-up
Authors: Li Ruili , Liu Guangxue , Zhang Xiaodong , Zhang Miao , Lu Jie , Li Hongjun
Published: August 2023

Background

Although most patients can recover from SARS-CoV-2 infection during the short-term, the long-term effects of COVID-19 on the brain remain explored. Functional MRI (fMRI) could potentially elucidate or otherwise contribute to the investigation of the long COVID syndrome. A lower fMRI response would be translated into decreased brain activity or delayed signal transferring reflecting decreased connectivity. This research aimed to investigate the long-term alterations in the local (regional) brain activity and remote (interregional) functional connection in recovered COVID-19.

Methods

Thirty-five previously hospitalized COVID-19 patients underwent 3D T1weighed imaging and resting-state fMRI at 6-month follow-up, and 36 demographic-matched healthy controls (HCs) were recruited accordingly. The amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) was used to assess the regional intrinsic brain activity and the influence of regional disturbances on FC with other brain regions. Spearman correlation analyses were performed to evaluate the association between brain function changes and clinical variables.

Results

The incidence of neurosymptoms (6/35, 17.14%) decreased significantly at 6-month follow-up, compared with COVID-19 hospitalization stage (21/35, 60%). Compared with HCs, recovered COVID-19 exhibited higher ALFF in right precuneus, middle temporal gyrus, middle and inferior occipital gyrus, lower ALFF in right middle frontal gyrus and bilateral inferior temporal gyrus. Furthermore, setting seven abnormal activity regions as seeds, we found increased FC between right middle occipital gyrus and left inferior occipital gyrus, and reduced FC between right inferior occipital gyrus and right inferior temporal gyrus/bilateral fusiform gyrus, and between right middle frontal gyrus and right middle frontal gyrus/ supplementary motor cortex/ precuneus. Additionally, abnormal ALFF and FC were associated with clinical variables.

Conclusions

COVID-19 related neurological symptoms can self heal over time. Recovered COVID-19 presented functional alterations in right frontal, temporal and occipital lobe at 6-month follow-up. Most regional disturbances in ALFF were related to the weakening of short-range regional interactions in the same brain function.
Ovarian cyst torsion in Prader-Willi Syndrome
Authors: Zhao Ji-cun , Huang Heng , Gong Hong-lei , Zhao Qing-kai , Wu He
Published: August 2023

Background

Prader-Willi syndrome (PWS) is a genetic disorder involving multiple systems, with an incidence of about 1/10000–25000. Ovarian torsion (OT) is not commonly found in children. Ovarian cyst acts as one of the primary factors resulting in OT. While ovarian cyst torsion with Prader-Willi Syndrome has not been reported before.

Case presentation

A 12-years old female was admitted to Emergency Department of our hospital with the chief complaint of abdominal pain. The outcomes of physical examination revealed the height of 150 cm, weight of 103 kg, BMI of 45.77 kg/m2. The patient manifested the special facial features, an obese body, with the abdomen distended into a spherical shape. The fat accumulation in the abdomen significantly embarrassed the palpation. The abdominal CT scan indicated a huge cystic mass in the abdominal cavity, sized about 138 mm × 118 mm. According to medical history, the patient was born with low crying and hypotonia, who has developed the uncontrollable eating behavior since 3-years old. These abnormalities led to a speculation of PWS syndrome, so a genetic test was performed and finally confirmed it, concluding a torsion of ovarian cyst with PWS. With the multidisciplinary consultation, a careful treatment strategy containing the control of blood pressure and blood sugar, coenzyme Q10 was administrated to nourish the myocardium and the application of Growth Hormone was developed. All the above preoperative treatments have brought great benefits to patients. Thus promising the successful completion of operation. The postoperative follow-up till now indicated that the abdominal incision was well healed, without operative complications.

Conclusions

This may be the first case report. In the treatment of ovarian cyst torsion, PWS syndrome requires fully consideration, as the latter can lead to multisystem abnormalities, especially the relation to perioperative management, and even fatalities. Genetic testing should be conducted early when PWS was suspected, accompanied with adequate preparation for the perioperative period, the follow-ups of patients should be maintained for a long time after surgery.
Development and psychometric evaluation of the mental readiness for military transition scale (MT-Ready)
Authors: Romaniuk Madeline , Fisher Gina , Sunderland Matthew , Batterham Philip J.
Published: August 2023

Background

The transition to civilian life following separation from military service is associated with increased risk of mental health disorders, suicide, and poor adjustment. No measure currently enables pre-separation screening to assess mental readiness for transition and identify personnel most at risk of poor outcomes. The Mental Readiness for Military Transition Scale (MT-Ready) was developed to identify psychosocial factors predictive of post-separation psychological adjustment and mental health.

Methods

Phase I was a qualitative study including transitioned veterans (n = 60), partners of transitioned veterans (n = 20) and mental health clinicians (n = 20) which enabled development of candidate items that were subsequently piloted with a current serving Australian Defence Force (ADF) sample (n = 19). Phase II included evaluation of the factor structure, psychometric properties, and scale refinement of the initial pool of 50 items with a convenience sample of transitioning ADF personnel (n = 345). Analyses included exploratory factor analysis, evaluation of test-retest reliability, internal consistency, convergent, divergent, discriminant and predictive validity. Receiver Operating Characteristic Curve Analysis was also conducted to determine an optimal cut-off score.

Results

Exploratory factor analysis resulted in a 15-item, three-factor solution that explained 62.2% of the variance: Future focus and optimism; Anger and perceived failure; Civilian connections and social support. Reliability and convergent, divergent, and discriminant validity was established. Receiver Operating Characteristic Curve Analysis determined a cut-off score of 55. MT-Ready scores significantly differentiated those reporting adjusting versus not adjusting to civilian life 3.7 months post-separation, and predicted post-separation outcomes including symptoms of Posttraumatic Stress Disorder, depression, anxiety, psychological adjustment and quality of life.

Conclusions

This evaluation provides promising evidence the MT-Ready is a valid, reliable measure of mental readiness for transition, with predictive capability and considerable potential to assist prevention of poor post-separation outcomes among military personnel.
Workplace violence and burnout among Chinese nurses during the COVID-19 pandemic: does the sense of coherence mediate the relationship?
Authors: Fei Yeping , Yang Silan , Zhu Zhihong , Lv Mengmeng , Yin Yan , Zuo Man , Chen Yiping , Sheng Han , Zhang Shenya , Zhang Mingmin
Published: August 2023

Background

Workplace violence has always been a critical issue worldwide before and after the COVID-19 pandemic, which can lead to burnout and turnover. In addition, the burnout and mental stress of nurses during the COVID-19 period have been widely described. To our knowledge, no studies have examined the mediating effect of the sense of coherence on the relationship between workplace violence and burnout among Chinese nurses over time. Therefore, this study aimed to explore the relationship between workplace violence and burnout among Chinese nurses and how the sense of coherence mediates the association.

Methods

Using a convenience sampling method, 1190 nurses from 4 tertiary grade-A comprehensive hospitals were investigated between September 2021 and December 2021 in 3 provinces of China. The Workplace Violence Scale, Burnout Inventory, and Sense of Coherence scale were used to collect data. Data analysis was conducted using descriptive statistics, Pearson correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis.

Results

The mean total scores for workplace violence and burnout were 1.67 ± 1.08 and 47.36 ± 18.39, respectively. Workplace violence was significantly negatively correlated with the sense of coherence (r = -0.25) and positively correlated with burnout (r = 0.27). Additionally, a higher level of workplace violence was associated with higher burnout (β = 1.13, 95% CI: 0.68 ~ 1.56). A higher sense of coherence was also associated with lower burnout (β = -0.98, 95% CI: -1.03 ~ -0.92). Workplace violence showed an effect on burnout through a sense of coherence. The direct, indirect and total effects were 1.13, 1.88 and 3.01, respectively. The mediating effect of the sense of coherence accounted for 62.45% of the relationship between workplace violence and burnout.

Conclusion

We found that the sense of coherence mediated most workplace violence on burnout. It is imperative for hospital managers to improve nurses’ sense of coherence to reduce the occurrence of burnout during COVID-19. Future intervention studies should be designed to strengthen nurses’ sense of coherence.
Growing relevance of reports of adolescent cyberbullying victimization among adult outpatients
Authors: Iffland Benjamin , Bartsch Lena M. , Kley Hanna , Neuner Frank
Published: August 2023

In the general population, prevalence rates of cyberbullying victimization have continuously increased over the past decades. However, the extent to which these increasing numbers affect clinical populations seeking treatment in outpatient services remains an open question. The present study sought to examine whether the increase of cyberbullying victimization is also reflected by increased reports of cyberbullying victimization in a clinical outpatient population. In addition, we assessed the incremental contribution of experiences of cyberbullying in the prediction of psychological symptoms when controlling for histories of childhood maltreatment and offline peer victimization. For this purpose, we analyzed routine data from N = 827 outpatients who had sought treatment at a University outpatient clinic for psychotherapy between 2012 and 2021 in a cross-sectional study design. Analyses showed that 8.3% of the patients born in the years 1980 to 2002 indicated the experience of cyberbullying victimization in their adolescence. The rate of reported cyberbullying victimization increased from 1 to 3% in patients born in the years 1980 to 1987 to 24% in patients born in the year 2000. A logistic regression revealed that patients born in the years 1995–2002 were up to nineteen times as likely to report cyberbullying victimization as patients born in the years 1980–1982. In addition, hierarchical multiple regression analyses indicated that cyberbullying victimization significantly accounted for an incremental proportion of variance (1%) in the prediction of psychological symptom distress after controlling for child maltreatment and offline peer victimization. In conclusion, this retrospective survey indicates an increase of the clinical relevance of cyberbullying victimization both in frequency of and potential contribution to etiology. Raising attention to cyberbullying in clinical care and research seems to be justified and warranted.
A randomized controlled pilot study assessing feasibility and safety of a wilderness program for childhood, adolescent, and young adult cancer survivors: the WAYA study
Authors: Jong Miek C. , Dahlqvist Heléne , Lown E. Anne , Schats Winnie , Beckman Lars , Jong Mats
Published: August 2023

Background

The majority of childhood, Adolescent and Young Adult (AYA) cancer survivors suffers from long-lasting health issues following cancer treatment. It is therefore critical to explore effective health promotion strategies to address their needs. Exposure to nature is a promising approach to support the needs of young cancer survivors. This study investigated whether it is feasible to conduct a randomized controlled trial (RCT) of a wilderness program for childhood and AYA cancer survivors.

Methods

Eligible participants were aged 16–39 years, had a cancer diagnosis, and met minimal criteria. Seventy-one individuals expressed interest and 59 were randomized to either a wilderness or a holiday program. The wilderness program involved an 8-day expedition including backpacking, sea kayaking, gorge climbing, camping, bush-craft skills, and mindfulness-practices. It was followed by a 4-day basecamp after 3 months. The comparison was an 8-day holiday program at a Spa-hotel followed by a 4-day holiday program at the same hotel after 3 months. Primary outcome was study feasibility and safety.

Results

Ultimately, 19 AYAs participated in the wilderness and 23 in the holiday program. All completed the study at one-year follow-up. Participants were mostly female (70%) and represented diverse cancers. Clinical characteristics were similar between study arms excepting greater age at cancer diagnosis in the wilderness program (age 19.1 vs. 12.5; p = 0.024). Program adherence and data completeness was high (> 90%) in both arms. Adverse Effects (AEs) in the wilderness vs. the holiday program were similar (Relative Risk: 1.0, 95% Confidence Interval 0.8–1.3). The most frequent AE was tiredness, all were mild to moderate in severity, and serious AEs were not reported. Nature connectedness significantly increased over time in the wilderness program participants, but not in the holiday program (p < 0.001). No differences were found between the two study arms regarding quality of life, self-esteem, or self-efficacy.

Conclusion

It is feasible to conduct a RCT and a supervised wilderness adventure is equally safe for childhood and AYA cancer survivors as a holiday program. This pilot study lays the foundation for a larger RCT to investigate the effectiveness of wilderness programs on the health of young cancer survivors.

Trial registration date and number

18/02/2021, NCT04761042 (clinicaltrials.gov).
Vaccination as a social practice: towards a definition of personal, community, population, and organizational vaccine literacy
Authors: Lorini Chiara , Del Riccio Marco , Zanobini Patrizio , Biasio Roberto Luigi , Bonanni Paolo , Giorgetti Duccio , Ferro Valerio Allodola , Guazzini Andrea , Maghrebi Olfa , Lastrucci Vieri , Rigon Lisa , Okan Orkan , Sørensen Kristine , Bonaccorsi Guglielmo
Published: August 2023

Background

A comprehensive and agreed-upon definition of vaccine literacy (VL) could support the understanding of vaccination and help policy-makers and individuals make informed decisions about vaccines.

Methods

To shed some light on this debate and provide clarity, a scoping review was conducted to collect, summarize, and analyse available definitions of VL. Based on the findings of the scoping review, a new and comprehensive definition was proposed by a panel of experts.

Results

Fifty-three articles were included, and two of them appeared to be the milestones around which the other definitions were grouped. The new definition proposed by the panel of experts included not only the personal perspective, but also the community, population, and organizational perspectives. Moreover, due to the increasing complexity of the social context with respect to the ability to navigate, understand, and use information and services, the definition of organizational vaccine literacy and the attributes of a vaccine literate healthcare organization have been proposed.

Conclusion

The new definition can contribute to the overall paradigm of health literacy and its distinct component of vaccine literacy, possibly improving the implementation of public health strategies to allow vaccination to be understood as a social practice by the entire community. This study describes the conceptual foundations, the competencies, and the civic orientation to be considered when developing measurement tools devoted to assessing VL at the different levels and in different contexts.
Does prophylactic antibiotics post pediatric pyeloplasty reduce the incidence of febrile UTIs?
Authors: Sheth Kunj , Puttmann Kathleen , Nichols Paige , King Jordon C. , Zhu Huirong , Ryan Sheila , Gabrielson Andrew T. , Wang Ming-Hsien
Published: August 2023

Purpose

The use of postoperative prophylactic antibiotics in pediatric upper urinary tract reconstruction remains controversial. In this study, we examined whether low dose antibiotics administered following pediatric pyeloplasty reduce the incidence of febrile urinary tract infections at our institution. As a secondary outcome, in those patients with infection, additional analysis was performed to better quantify which patient population benefits the most from low dose prophylactic antibiotics.

Methods

Institutional review board approval (IRB) was obtained. All methods were carried out in accordance with relevant guidelines and regulations. A retrospective study was performed in patients who underwent pyeloplasty (2011–2017) at our institution. Surgical approach (laparoscopic versus robotic assisted versus open, with or without internal JJ ureteral stent) were based on surgeon preference. Patients of 8 fellowship trained pediatric urologists were included in the study period. Patients with prior history of urologic interventions or other congenital genitourinary tract abnormalities were excluded. Demographics (age, gender, ethnicity, insurance status), prior history of culture proven urinary tract infection, surgical details (administration of perioperative antibiotics), and postoperative outcomes including; 1) re-admission 30 days post-surgery, 2) any urine cultures collected due to suspected urinary tract infection.

Results

A total of 209 patients (149 boys, 60 girls) met our inclusion criteria with 55/209 (26%) receiving postoperative prophylactic antibiotics. The average age was 6 years (range: 2 months-18 years). Indwelling ureteral stent was used in 176 (84%) patients. Eleven patients (5%) had a culture-proven urinary tract infection within 30-days postoperatively. No significant differences were seen in postoperative complications or incidence of urinary tract infection when comparing surgical approaches, +/- ureteral stent, or the use of antibiotics. Secondary analysis noted statistically significant increase in post-operative urinary tract infection in younger children (2.8 v. 6.2 years, p = 0.02), those patients who had a positive preoperative urine culture (8/11, p = 0.01) and those with public health insurance (p = 0.038).

Conclusion

The incidence of postoperative urinary tract infection following pyeloplasty in our cohort was relatively low. There was a higher incidence of urinary tract infection in patients less than 3 years old. The use of antibiotics in patients post pyeloplasty did not appear to affect the incidence of post-operative urinary tract infection, however, they may have a role in children who have not yet potty trained and in patients with positive preoperative urine culture.
Update of students’ and lecturers’ perspectives on online learning in dental education after a five-semester experience due to the SARS-CoV-2 (COVID-19) pandemic: insights for future curriculum reform
Authors: Schlenz Maximiliane Amelie , Wöstmann Bernd , Krämer Norbert , Schulz-Weidner Nelly
Published: August 2023

Background

The coronavirus disease (COVID-19) pandemic has accelerated digital transformation in dental education, resulting in a shift from face-to-face teaching to online learning. While online learning could be a common strategy in various fields, the challenge for dental education is that it depends on the requirements of clinical experience to achieve competence in performing the dental treatment. This cross-sectional study aimed to analyse students’ and lecturers’ perceptions towards online learning after five semesters of experience using a questionnaire survey.

Methods

Since the spring term of 2020, the theoretical part of the curriculum has been conducted in the form of online learning using a combination of synchronous and asynchronous formats. In the following semesters, more theoretical content was shifted back from online learning to face-to-face courses. Preclinical and clinical students enrolled in the dental curriculum during the spring term 2022 semester and all lecturers with at least one year of teaching experience in face-to-face and online learning formats were asked to fill out an online questionnaire regarding the aspects of handling, didactic benefit, motivation, and overall assessment.

Results

Students and lecturers rated the implementation of online learning as mostly positive, but pointed out that established ‘face-to-face’ learning could not be replaced. Moreover, the students reported personal benefits in terms of daily planning. Lecturers also benefitted as their experience increased in online teaching. For future curriculum, students demanded 49.5% (25.1) ((mean (standard deviation) of theoretical part in terms of online learning), while lecturers demanded only 34.1% (24.1).

Conclusions

Despite having no prior need for online learning, students and lecturers showed a positive perspective on online learning which should be considered in the implementation and planning of future dental education. However, in terms of practical training, it cannot replace face-to-face education in dentistry.
An ontology-based approach for modelling and querying Alzheimer’s disease data
Authors: Taglino Francesco , Cumbo Fabio , Antognoli Giulia , Arisi Ivan , D’Onofrio Mara , Perazzoni Federico , Voyat Roger , Fiscon Giulia , Conte Federica , Canevelli Marco , Bruno Giuseppe , Mecocci Patrizia , Bertolazzi Paola ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: August 2023

Background

The recent advances in biotechnology and computer science have led to an ever-increasing availability of public biomedical data distributed in large databases worldwide. However, these data collections are far from being “standardized” so to be harmonized or even integrated, making it impossible to fully exploit the latest machine learning technologies for the analysis of data themselves. Hence, facing this huge flow of biomedical data is a challenging task for researchers and clinicians due to their complexity and high heterogeneity. This is the case of neurodegenerative diseases and the Alzheimer’s Disease (AD) in whose context specialized data collections such as the one by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) are maintained.

Methods

Ontologies are controlled vocabularies that allow the semantics of data and their relationships in a given domain to be represented. They are often exploited to aid knowledge and data management in healthcare research. Computational Ontologies are the result of the combination of data management systems and traditional ontologies. Our approach is i) to define a computational ontology representing a logic-based formal conceptual model of the ADNI data collection and ii) to provide a means for populating the ontology with the actual data in the Alzheimer Disease Neuroimaging Initiative (ADNI). These two components make it possible to semantically query the ADNI database in order to support data extraction in a more intuitive manner.

Results

We developed: i) a detailed computational ontology for clinical multimodal datasets from the ADNI repository in order to simplify the access to these data; ii) a means for populating this ontology with the actual ADNI data. Such computational ontology immediately makes it possible to facilitate complex queries to the ADNI files, obtaining new diagnostic knowledge about Alzheimer’s disease.

Conclusions

The proposed ontology will improve the access to the ADNI dataset, allowing queries to extract multivariate datasets to perform multidimensional and longitudinal statistical analyses. Moreover, the proposed ontology can be a candidate for supporting the design and implementation of new information systems for the collection and management of AD data and metadata, and for being a reference point for harmonizing or integrating data residing in different sources.
Understanding the impact of tuberous sclerosis complex: development and validation of the TSC-PROM
Authors: Müller Annelieke R. , Luijten Michiel A. J. , Haverman Lotte , de Ranitz-Greven Wendela L. , Janssens Peter , Rietman André B. , ten Hoopen Leontine W. , de Graaff Laura C. G. , de Wit Marie-Claire , Jansen Anna C. , Gipson Tanjala , Capal Jamie K. , de Vries Petrus J. , van Eeghen Agnies M.
Published: August 2023

Background

Tuberous sclerosis complex (TSC) is a rare and complex genetic disorder, associated with tumor growth in various organ systems, epilepsy, and a range of neuropsychiatric manifestations including intellectual disability. With improving patient-centered care and targeted therapies, patient-reported outcome measures (PROMs) are needed to measure the impact of TSC manifestations on daily functioning. The aim of this study was to develop a TSC-specific PROM for adults that captures the impact of TSC on physical functions, mental functions, activity and participation, and the social support individuals with TSC receive, called the TSC-PROM.

Methods

COSMIN methodology was used to develop a self-reported and proxy-reported version. Development and validation consisted of the following studies: PROM development, content validity, structural validity, internal consistency, and construct validity. The International Classification of Functioning and Disability was used as a framework. Content validity was examined by a multidisciplinary expert group and cognitive interview study. Structural and construct validity, and internal consistency were examined in a large cohort, using confirmatory factor analysis, hypotheses testing, and Cronbach’s alpha.

Results

The study resulted in an 82-item self version and 75-item proxy version of the TSC-PROM with four subscales (physical functions 18 and 19 items, mental functions 37 and 28 items, activities and participation 13 and 14 items, social support 13 items, for self version and proxy version respectively). Sufficient results were found for structural validity with sufficient unidimensionality for each subscale. With regard to construct validity, 82% of the hypotheses were met for the self version and 59% for the proxy version. The PROM showed good internal consistency (Cronbach’s alpha 0.78–0.97).

Conclusions

We developed a PROM for adults with TSC, named TSC-PROM, showing sufficient evidence for reliability and validity that can be used in clinical and research settings to systematically gain insight into their experiences. It is the first PROM in TSC that addresses the impact of specific TSC manifestations on functioning, providing a valuable, patient-centered addition to the current clinical outcomes.
Adverse childhood and adulthood experiences and risk of new-onset cardiovascular disease with consideration of social support: a prospective cohort study
Authors: Wang Wanxin , Liu Yifeng , Yang Yuwei , Jiang Weiqing , Ni Yanyan , Han Xue , Lu Ciyong , Guo Lan
Published: August 2023

Background

The relationship between adverse childhood experiences (ACEs) and adverse adulthood experiences (AAEs) and their association with incident cardiovascular disease (CVD) have not been extensively studied. Considering social support, we evaluated the complex relations of ACEs and AAEs with incident CVD.

Methods

This prospective cohort study used data from the 2014 life course survey and the 2015 and 2018 surveys of the China Health and Retirement Longitudinal Study, a national survey of Chinese adults aged ≥ 45 years from 28 provinces across China. The study population included 5836 individuals (mean [SD] age, 59.59 [8.22] years, 49.7% were males). Information on ACEs, AAEs, young adulthood social support, health behavior factors, health status factors, and demographics was measured. Cox regression models, the difference method to estimate the mediation proportion, and the additive and multiplicative interactions were performed. Subgroup and sensitivity analyses were also conducted.

Results

During follow-up, 789 incident cases of CVD occurred. The fully adjusted model, including demographics, health behaviors, health status factors (e.g., depressive symptoms), and social support as control variables, demonstrated that the overall number of ACEs (Hazard ratio [HR]: 1.11, 95% CI: 1.08 to 1.14) and AAEs (HR: 1.19, 95% CI: 1.16 to 1.22) were associated with an increased risk of incident CVD. A dose–response relationship existed between the number of ACEs or AAEs and incident CVD risk. The overall AAEs were found to mediate 17.7% (95% CI: 8.2 to 34.2%) of the association between ACEs and incident CVD. Moreover, a significant additive interaction between ACEs and AAEs was detected (RERI [95% CI]: 0.32 [0.09 to 0.56]). Compared with adults without exposure to both ACE and AAE, those with exposure to both at least one ACE and one AAE indicator had the highest risk of incident CVD (HR: 1.96, 95% CI: 1.72 to 2.23).

Conclusions

Exposure to ACEs or AAEs was independently associated with an increased risk of incident CVD among Chinese middle-aged and older adults in a dose–response manner, and the overall AAEs partially mediated the association between ACEs and incident CVD. Preventive measures aimed at addressing either ACEs or AAEs alone may not significantly reduce the risk of CVD later in life. The necessity of a comprehensive life-course health strategy targeting the prevention of adversity merits increased attention.
Upregulation of SLUG expression in canine mammary gland tumors and its prognostic significance
Authors: Cheon Soo-Bin , Kim Wan Hee
Published: August 2023

Background

SLUG (also known as snai2), which is a transcription factor in epithelial–mesenchymal transition (EMT), plays an important role in tumorigenesis. Several human studies have revealed that SLUG expression downregulates E-cadherin activity to induce metastasis and invasion of tumor cells, and its association with tumor mechanisms is under constant evaluation. In clinical veterinary medicine, one study revealed upregulated SLUG expression in canine oral squamous cell carcinoma. However, the association between canine mammary gland tumors (MGT), the most common neoplasm in intact female dogs, and SLUG has not been investigated yet. Therefore, this study aimed to evaluate the differences in SLUG expression among canine normal mammary gland tissue and MGTs using immunohistochemistry. In addition, its prognostic significance was evaluated by analyzing the correlation with the Ki-67 proliferation index and various clinicopathological features.

Results

SLUG expression increased substantially from normal mammary gland tissues to MGTs, especially showing the strongest expression in malignant MGT than in benign MGT. Negative SLUG expression was observed in mostly normal mammary gland tissues, whereas all tissues in malignant MGT showed positive SLUG expression. Furthermore, positive SLUG expression was associated with higher Ki-67 index, larger tumor size (> 3 cm), and metastasis. Kaplan–Meier survival curve analysis revealed that positive SLUG expression was significantly associated with poor overall and disease-free survival.

Conclusions

These results indicate that SLUG is upregulated in canine MGTs and positive SLUG expression is positively correlated with poor prognosis. Thus, SLUG protein can be a novel biomarker and therapeutic target for canine patients with MGT.