bluuebunny/crossref_metadata_2025 huggingface dataset:
Away From the Nightmare: Sexual Harassment, Leave Intention, and Job Search Behavior
Authors: Chen Kan-Xiang , Lyu Yijing , Ye Yijiao , Liu Xinyu
Published: July 2023

Drawing on social identity theory, we investigated the mechanism underlying the effect of sexual harassment on hospitality employees’ leave intention and job search behavior. The results of a time-lagged survey conducted in six hotels in China revealed that sexual harassment positively undermined hospitality employees’ organizational identification, which further induced their intention to leave the organization and job search behavior. In addition, perceived organizational support moderated the direct link between sexual harassment and organizational identification as well as the indirect link from sexual harassment to leave intention and job search behavior via organizational identification. The theoretical and managerial implications of this study are discussed.
Giottus story—A case study of India’s highly rated crypto exchange
Authors: Gayathri S , Shanmugam Kavitha
Published: July 2023

Giottus is one of India’s most preferred cryptocurrency exchanges, which saw a user growth rate of more than 400% during the pandemic. The platform offers unique and innovative products and secured transactions, making its application interface very user-friendly. This case study elucidates the various factors that enable the immense growth of Giottus exchange in the cryptocurrency market. The case also discusses cryptocurrency’s existing regulatory environment and its challenges. This teaching case also addresses the significant issues that deter the growth of cryptocurrency exchanges in India. It also addresses the future pathway for crypto investments in India and how exchanges like Giottus play an essential role in regulating their market vulnerability.
Unintentionally retained foreign objects (URFOs): Adverse events influenced by the pandemic. A case series and literature review
Authors: Seabra Artur , De Souza Aline Brenner , Artioli Renata Silva , Tagaytayan Raniel , Berends Wilma , Sanders Janelle , Vivas-Buitrago Tito , Hoenig Rigamonti Karen , Rigamonti Daniele
Published: July 2023

Despite being recognized as a preventable serious adverse event more than a century ago, Unintentionally Retained Foreign Objects (URFOs) continue to occur. They, in fact, remain the second most common Sentinel Event (SE) reported to The Joint Commission (TJC). A large private Hospital, after many years of URFO-free practice, experienced four (4) cases of URFOs during a 12-month period (March 9, 2021–March 4, 2022). Three cases occurred in the Operating Room (OR), and one case occurred in Labor & Delivery. All four cases involved the abdomen. The URFO was a sponge in two cases, a retractor wrapped in a pad in one case, and a surgical specimen in one case. Our review confirmed that the characteristics of our cases were similar to those reported by the Joint Commission. The main contributing factor was the closure of the wound without performing the sponge/instrument count. This safety breach resulted from a combination of factors: the inexperience of the nursing staff caused by a dramatic 40% turnover during the pandemic, the lack of assigned responsibility to perform the counting, and the willingness of the surgeon to skip the count. To address the main factors, we implemented a multipronged approach that includes the following: standardization of the protocols of sponge counting, hand-off with shift change, and of double surgical team involvement; assignment of the counting responsibility to two nurses; and education of the new nurses and of independent practitioners about the OR procedures with monitoring of correct implementation.
Lenalidomide plus rituximab for the initial treatment of frail older patients with DLBCL: the FIL_ReRi phase 2 study
Authors: Gini Guido , Tani Monica , Tucci Alessandra , Marcheselli Luigi , Cesaretti Marina , Bellei Monica , Pascarella Anna , Ballerini Filippo , Petrini Mauro , Merli Francesco , Olivieri Attilio , Lanza Francesco , Annibali Ombretta , Zilioli Vittorio Ruggero , Liberati Anna Marina , Tisi Maria Chiara , Arcari Annalisa , Marino Dario , Musuraca Gerardo , Pavone Vincenzo , Fabbri Alberto , Pozzi Samantha , Mannina Donato , Plenteda Caterina , Celli Melania , Luminari Stefano
Published: July 2023

Treatment of diffuse large B-cell lymphoma (DLBCL) in older patients is challenging, especially for those who are not eligible for anthracycline-containing regimens. Fondazione Italiana Linfomi (FIL) started the FIL_ReRi study, a 2-stage single-arm trial to investigate the activity and safety of the chemo-free combination of rituximab and lenalidomide (R2) in ≥70-year-old untreated frail patients with DLBCL. Frailty was prospectively defined using a simplified geriatric assessment tool. Patients were administered a maximum of 6 28-day cycles of 20 mg oral lenalidomide from days 2 to 22 and IV rituximab 375 mg/m2 on day 1, with response assessment after cycles 4 and 6. Patients with partial response or complete response (CR) at cycle 6 were administered lenalidomide 10 mg/d from days 1 to 21 for every 28 cycles for a total of 12 cycles or until progression or unacceptable toxicity. The primary end point was the overall response rate (ORR) after cycle 6; the coprimary end point was the rate of grade 3 or 4 extrahematological toxicity. The ORR was 50.8%, with 27.7% CR. After a median follow-up of 24 months, the median progression-free survival was 14 months, and the 2-year duration of response was 64%. Thirty-four patients experienced extrahematological toxicity according to the National Cancer Institute Common Terminology Criteria for Adverse Events grade ≥3. The activity of the R2 combination was observed in a significant proportion of subjects, warranting further exploration of a chemo-free approach in frail older patients with DLBCL. This trial was registered at EudraCT as #2015-003371-29 and clinicaltrials.gov as #NCT02955823.
In vivo CRISPR/Cas9 screening identifies Pbrm1 as a regulator of myeloid leukemia development in mice
Authors: Li Bin E. , Li Grace Y. , Cai Wenqing , Zhu Qian , Seruggia Davide , Fujiwara Yuko , Vakoc Christopher R. , Orkin Stuart H.
Published: July 2023

CRISPR/Cas9 screening approaches are powerful tool for identifying in vivo cancer dependencies. Hematopoietic malignancies are genetically complex disorders in which the sequential acquisition of somatic mutations generates clonal diversity. Over time, additional cooperating mutations may drive disease progression. Using an in vivo pooled gene editing screen of epigenetic factors in primary murine hematopoietic stem and progenitor cells (HSPCs), we sought to uncover unrecognized genes that contribute to leukemia progression. We, first, modeled myeloid leukemia in mice by functionally abrogating both Tet2 and Tet3 in HSPCs, followed by transplantation. We, then, performed pooled CRISPR/Cas9 editing of genes encoding epigenetic factors and identified Pbrm1/Baf180, a subunit of the polybromo BRG1/BRM-associated factor SWItch/Sucrose Non-Fermenting chromatin–remodeling complex, as a negative driver of disease progression. We found that Pbrm1 loss promoted leukemogenesis with a significantly shortened latency. Pbrm1-deficient leukemia cells were less immunogenic and were characterized by attenuated interferon signaling and reduced major histocompatibility complex class II (MHC II) expression. We explored the potential relevance to human leukemia by assessing the involvement of PBRM1 in the control of interferon pathway components and found that PBRM1 binds to the promoters of a subset of these genes, most notably IRF1, which in turn regulates MHC II expression. Our findings revealed a novel role for Pbrm1 in leukemia progression. More generally, CRISPR/Cas9 screening coupled with phenotypic readouts in vivo has helped identify a pathway by which transcriptional control of interferon signaling influences leukemia cell interactions with the immune system.
The 16S rDNA high-throughput sequencing correlation analysis of milk and gut microbial communities in mastitis Holstein cows
Authors: Jiang Chenxi , Hou Xiaolu , Gao Xiaona , Liu Pei , Guo Xiaoquan , Hu Guoliang , Li Qingqing , Huang Cheng , Li Guyue , Fang Weile , Mai Wanrui , Wu Cong , Xu Zheng , Liu Ping
Published: July 2023

This study aimed to understand the changes in the milk and gut microbiota of dairy cows with mastitis, and to further explore the relationship between mastitis and the microbiota. In this study, we extracted microbial DNA from healthy and mastitis cows and performed high-throughput sequencing using the Illumina NovaSeq sequencing platform. OTU clustering was performed to analyze complexity, multi-sample comparisons, differences in community structure between groups, and differential analysis of species composition and abundance. The results showed that there were differences in microbial diversity and community composition in the milk and feces of normal and mastitis cows, where the diversity of microbiota decreased and species abundance increased in the mastitis group. There was a significant difference in the flora composition of the two groups of samples (P < 0.05), especially at the genus level, the difference in the milk samples was Sphingomonas (P < 0.05) and Stenotrophomonas (P < 0.05), the differences in stool samples were Alistipes (P < 0.05), Flavonifractor (P < 0.05), Agathobacter (P < 0.05) and Pygmaiobacter (P < 0.05). In conclusion, the microbiota of the udder and intestinal tissues of dairy cows suffering from mastitis will change significantly. This suggests that the development of mastitis is related to the endogenous pathway of microbial intestinal mammary glands, but the mechanisms involved need further study.
Conservative management of complete fetal expulsion into the abdominal cavity after silent uterine rupture - case report
Authors: Hruban Lukas , Jouzova Anna , Janku Petr , Weinberger Vit , Seidlova Dagmar , Juren Tomas , Senkyrik Jan , Kadlecova Jana , Hausnerova Jitka , Jandakova Eva
Published: July 2023

Background

Clinically silent uterine rupture with complete fetal expulsion into the abdominal cavity is an extremely rare complication. Diagnosis can be difficult and the risk to the mother and fetus is high. Conservative management has been described only in a few cases of partial expulsion of the fetus so far.

Case presentation

We present a case of 43-year-old tercigravida with a history of previous laparotomic myomectomy and subsequent cesarean section. The subsequent pregnancy was complicated by uterine wall loosening and rupture at the site of the previous uterine scar after myomectomy and complete fetal expulsion into the abdominal cavity. The diagnosis was made at 24 + 6 weeks of gestation. Considering the absence of clinical symptomatology and the good condition of the fetus, a conservative approach was chosen with intensive monitoring of the maternal and fetal conditions. The pregnancy ended by elective cesarean section and hysterectomy at 28 + 0 weeks of gestation. The postpartum course was uneventful and the newborn was discharged to home care 63 days after delivery.

Conclusions

Fetal expulsion into the abdominal cavity after silent uterine rupture of the scarred uterus may be accompanied by minimal symptomatology making early diagnosis difficult. This rare complication must be considered in the differential diagnosis in women after major uterine surgery. In selected cases and under conditions of intensive maternal and fetal monitoring, conservative management may be chosen to reduce the risks associated with prematurity.
The transformation of masculinity orientations and work-related attitudes in men treated for depression (TRANSMODE): study protocol for a mixed-methods observational study
Authors: Krumm Silvia , Krieg Gironimo , Lamp Natalie , Marek Franziska , Nickel Paul , Panzirsch Maria , Stiawa Maja , Beschoner Petra , Brieger Peter , Frasch Karel , Gertzen Marcus , Gündel Harald , Hasan Alkomiet , Jäger Markus , Kling-Lourenco Paulo , Koussemou José Marie , Steber Raimund , Kilian Reinhold
Published: July 2023

Background

Masculinity norms play a crucial role in men’s help-seeking behaviors, service-use, and coping strategies for depression. While previous studies provided evidence for the association between gender role orientations, work related attitudes, stigmatization of men with depression and depressive symptoms, it remains unclear to what extent gender role orientations change over time and whether psychiatric and psychotherapeutic treatment have an impact on these transformations. Additionally, the role of partners in supporting depressed men and the impact of dyadic coping on these processes have not been explored. The aim of this study is to investigate how masculinity orientations and work-related attitudes change over time in men treated for depression, and to examine the role of their partners and dyadic coping in these transformation processes.

Methods

TRANSMODE is a prospective longitudinal mixed-methods study investigating the transformation of masculinity orientations and work-related attitudes in men treated for depression between the ages of 18 and 65 from different settings in Germany. The study will recruit 350 men from various settings for quantitative analysis. By applying a latent transition analysis, the primary outcome are changes in masculine orientations and work-related attitudes over time, measured at four times (t0, t1, t2, t3) with intervals of 6 months. Qualitative interview with a subsample of depressed men selected using latent profile analysis, will be conducted between t0 and t1 (a1) with a follow-up of 12 months (a2). In addition, qualitative interviews with the partners of depressed men will be conducted between t2 and t3 (p1). Qualitative data will be analysed using qualitative structured content analysis.

Discussion

A comprehensive understanding of the transformation processes of masculinity orientations over time including the impact of psychiatric/psychotherapeutic treatment and the role of partners can lead to the development of gender-sensitive depression treatment tailored to the unique needs of men with depression. Thus, the study can promote more effective and successful treatment outcomes and further contribute to reducing the stigma surrounding mental health issues among men and encourage them for mental health service use.

Trial registration

This study is registered in the German Clinical Trail Register (DRKS) and the WHO International Clinical Trials Registry Platform (ICTRP) under registration number DRKS00031065 (Date of registration 06 February 2023).
Are symptoms assessed differently for schizophrenia and other psychoses in legal insanity evaluations of violent crimes?
Authors: Løvgren Pia Jorde , Laake Petter , Narud Kjersti , Reitan Solveig Klæbo , Bjørkly Stål
Published: July 2023

Background

Forensic evaluations of legal insanity include the experts’ assessment of symptoms present at the mental state examination (MSE) and the mental state at the time of offense (MSO). Delusions and hallucinations are most important. We explored how often symptoms were recorded in written forensic reports.

Design

This exploratory, cross-sectional study included 500 reports of legal insanity written in 2009–2018 from cases of violent crimes in Norway. The first author read all reports and coded symptoms recorded from the experts’ assessments of the offenders. Two co-authors repeated this procedure for 50 randomly selected reports. Interrater reliability was calculated with Gwet’s AC1. Generalized Linear Mixed Models with Wald tests for fixed effects and Risk Ratios as effect sizes were used for the statistical analyses.

Results

Legal insanity was the main conclusion in 23.6% of the reports; 71.2% of these were diagnosed with schizophrenia while 22.9% had other psychotic disorders. Experts recorded few symptoms from MSO, but more from MSE, although MSO is important for insanity. We found a significant association between delusions and hallucinations recorded present in the MSO and legal insanity for defendants with other psychotic disorders, but no association for defendants with schizophrenia. The differences in symptom recordings between diagnoses were significant.

Conclusion

Few symptoms were recorded from the MSO. We found no association between presence of delusions or hallucinations and legal insanity for defendants with schizophrenia. This may indicate that a schizophrenia diagnosis is more important to the forensic conclusion than the symptoms recorded in the MSO.
Socio-geographical factors and vulnerability to leptospirosis in South Brazil
Authors: Teles Alessandra Jacomelli , Bohm Bianca Conrad , Silva Suellen Caroline M. , Bruhn Fábio Raphael P.
Published: July 2023

Background

Leptospirosis, caused by the Leptospira bacteria, is an acute infectious disease that is mainly transmitted by exposure to contaminated soil or water, thereby presenting a wide range of subsequent clinical conditions. This study aimed to assess the distribution of cases and deaths from leptospirosis and its association with social vulnerability in the state of Rio Grande do Sul, Brazil, between 2010 and 2019.

Methods

The lethality rates and incidence of leptospirosis and their association with gender, age, education, and skin color were analyzed using chi-square tests. The spatial relationship between the environmental determinants, social vulnerability, and the incidence rate of leptospirosis in the different municipalities of Rio Grande do Sul was analyzed through spatial regression analysis.

Results

During the study period, a total of 4,760 cases of leptospirosis, along with 238 deaths, were confirmed. The mean incidence rate was 4.06 cases/100,000 inhabitants, while the mean fatality rate was 5%. Although the entire population was susceptible, white-colored individuals, males, people of the working-age group, along with less-educated individuals, were more affected by the disease. Lethality was higher in people with dark skin, and the prime risk factor associated with death was the direct contact of the patients with rodents, sewage, and garbage. The social vulnerability was positively associated with the incidence of leptospirosis in the Rio Grande do Sul, especially in municipalities located in the center of the state.

Conclusions

It is evident that the incidence of the disease is significantly related to the vulnerability of the population. The use of the health vulnerability index showed great relevance in the evaluation of leptospirosis cases and can be used further as a tool to help municipalities identify disease-prone areas for intervention and resource allocation.
The impact of an e-newsletter or animated video to disseminate outdoor free-play information in relation to COVID-19 guidelines in New South Wales early childhood education and care services: a randomised controlled trial
Authors: Reilly Kathryn , Jackson Jacklyn , Lum Melanie , Pearson Nicole , Lecathelinais Christophe , Wolfenden Luke , Turon Heidi , Yoong Sze Lin
Published: July 2023

Background

State-based Guidelines were issued for Early Childhood Education and Care (ECEC) services (caring for children 0–6 years) recommending greater time outdoors and inclusion of indoor-outdoor programs to facilitate social distancing to reduce spread of COVID-19. The aim of this 3-arm randomised controlled trial (RCT) was to examine the impact of different dissemination strategies on increasing ECEC service intentions to adopt recommendations from the Guidelines.

Methods

This was a post-intervention only RCT. A sample of eligible ECEC services in New South Wales (n = 1026) were randomly allocated to one of three groups; (i) e-newsletter resource; (ii) animated video resource; or (iii) control (standard email). The intervention was designed to address key determinants of guideline adoption including awareness and knowledge. Following delivery of the intervention in September 2021, services were invited to participate in an online or telephone survey from October-December 2021. The primary trial outcome was the proportion of services intending to adopt the Guidelines, defined as intention to; (i) offer an indoor-outdoor program for the full day; or (ii) offer more outdoor play time. Secondary outcomes included awareness, reach, knowledge and implementation of the Guidelines. Barriers to Guideline implementation, cost of the dissemination strategies and analytic data to measure fidelity of intervention delivery were also captured.

Results

Of the 154 services that provided post-intervention data, 58 received the e-newsletter (37.7%), 50 received the animated video (32.5%), and 46 received the control (29.9%). Services who received the animated video had nearly five times the odds (OR: 4.91 [1.03, 23.34] p = 0.046) than those in the control group, to report having intentions to adopt the Guidelines. There were no statistically significant differences in awareness or knowledge of the Guidelines between either intervention or control services. Development costs were greatest for the animated video. The extent to which the dissemination strategy was viewed in full, were similar for both the e-newsletter and animated video.

Conclusion

This study found potential for the inclusion of interactive strategies to disseminate policy and guideline information within the ECEC setting, in the context of the need for rapid communication. Further research should explore the added benefits of embedding such strategies within a multi-strategy intervention.

Trial registration

Retrospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) on the 23/02/2023 (ACTRN 12,623,000,198,628).
Extensive penile glans and corpus spongiosum necrosis due to catheter traction following laparoscopic radical cystoprostatectomy: a rare case report and literature review
Authors: Akyuz Mehmet , Kayar Ridvan , Mohamed Abdikarim Hussein
Published: July 2023

Background

Penile glans and corpus spongiosum necrosis is an extremely rare urologic condition associated with substantial morbidity.

Case presentation

We report a rare case presenting extensive penile glans and corpus spongiosum necrosis following catheter traction in a 71-year-old male patient who had a laparoscopic radical cystoprostatectomy for muscle-invasive bladder cancer. The patient has no preexisting diabetes mellitus or chronic renal failure. The case was successfully managed with penile preservation. During the procedure, it was observed that the necrosis was not limited to the glans. The necrosis had spread to the entire penile urethra and corpus spongiosum, and an excision of approximately 14 cm of corpus spongiosum was performed.

Conclusion

This is the first case presenting extensive length of penile glans and corpus spongiosum necrosis managed successfully with penile preservation, enabling reaching the best functional and esthetic results reported in the literature. Early detection and urgent imaging with a high index of suspicion ensure a favorable outcome. The main treatment steps are careful evaluation, appropriate therapy, and prompt intervention depending on the severity.
The association of severely worn dentition resulting from betel nut chewing with temporomandibular disorders: a cross-sectional study
Authors: Liu Yundong , Yin Tao , He Mi , Fang Changyun , Peng Shifang
Published: July 2023

Background

Most studies support parafunctions play an important role in temporomandibular disorders (TMD), whereas the association between tooth wear and TMD remains controversial. Betel nut chewing as a parafunction is popular in South and Southeast Asia. We therefore investigated the association of severely worn dentition resulting from betel nut chewing with TMD.

Methods

A cross-sectional analysis of 408 control participants (male: 380, female: 28, 43.62 ± 9.54 years) and 408 participants with betel nut chewing related severely worn dentition (male: 380, female: 28, 43.73 ± 8.93 years) who received dental and TMD checkup according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) in Health Management Center, Xiangya Hospital was performed. Betel nut chewing related severely worn dentition meant all the natural teeth had moderate to severe tooth wear [Tooth Wear Index (TWI) ≥ 2)] including ≥ 2 severe wear teeth (TWI ≥ 3) due to betel nut chewing. Multivariable logistic regression analysis was used.

Results

After adjusting for age, gender, betel nut chewing related severely worn dentition, oral submucosal fibrosis, number of missing teeth, number of dental quadrants with missing teeth, visible third molar and orthodontic history, variables of age, gender and betel nut chewing related severely worn dentition were significant for overall TMD. Multivariable analysis showed betel nut chewing related severely worn dentition was significantly associated with intra-articular TMD [odds ratio and 95% confidence intervals: 1.689 (1.271–2.244), P = 0.001] in a betel nut chewing dose-dependent manner.

Conclusion

Betel nut chewing related severely worn dentition was associated with intra-articular TMD.
Retention of zirconia crowns to titanium bases with straight versus angled screw access channels: an invitro study
Authors: Ibrahim Eman Assem , Khamis Mohamed Moataz , Ezzelarab Salah , Abdelhamid Ahmed M.
Published: July 2023

Background

The aim of this study was to assess the impact of abutments with angled screw access channel on the retention of zirconia crowns.

Methods

Seven implant replicas were inserted in epoxy resin blocks. Fourteen zirconia crowns for central incisor tooth were digitally fabricated and cemented to titanium bases (Ti-bases) with resin cement. Titanium bases were categorized into 2 groups (n = 7). Control group (Group STA) included straight screw access channel abutments. Study group (Group ASC) included angled screw access channel abutments. Following aging (5 °C-55 °C, 60 s; 250,000 cycles, 100 N, 1.67 Hz), the pull-off forces (N) were recorded by using retention test (1 mm/min). Types of failure were defined as (Type 1; Adhesive failure when luting agent predominantly remained on the Ti-base surface (> 90%); Type 2; Cohesive failure when luting agent remained on both Ti-base and crown surfaces; and Type 3; Adhesive failure when luting agent predominantly remained on the crown (> 90%). Statistical analysis was conducted by using (IBM SPSS version 28). Normality was checked by using Shapiro Wilk test and Q-Q plots. Independent t-test was then used to analogize the groups.

Results

Mean ± standard deviation of retention force records ranged from 1731.57 (63.68) N (group STA) to 1032.29 (89.82) N (group ASC), and there was a statistically significant variation between the 2 groups (P < .05). Failure modes were Type 2 for group STA and Type 3 for group ASC.

Conclusions

The retention of zirconia crowns to abutments with a straight screw access channel is significantly higher than abutments with angled screw access channel.
The salivary proteome in relation to oral mucositis in autologous hematopoietic stem cell transplantation recipients: a labelled and label-free proteomics approach
Authors: van Leeuwen S. J. M. , Proctor G. B. , Staes A. , Laheij A. M. G. A. , Potting C. M. J. , Brennan M. T. , von Bültzingslöwen I. , Rozema F. R. , Hazenberg M. D. , Blijlevens N. M. A. , Raber-Durlacher J. E. , Huysmans M. C. D. N. J. M.
Published: July 2023

Background

Oral mucositis is a frequently seen complication in the first weeks after hematopoietic stem cell transplantation recipients which can severely affects patients quality of life. In this study, a labelled and label-free proteomics approach were used to identify differences between the salivary proteomes of autologous hematopoietic stem cell transplantation (ASCT) recipients developing ulcerative oral mucositis (ULC-OM; WHO score ≥ 2) or not (NON-OM).

Methods

In the TMT-labelled analysis we pooled saliva samples from 5 ULC-OM patients at each of 5 timepoints: baseline, 1, 2, 3 weeks and 3 months after ASCT and compared these with pooled samples from 5 NON-OM patients. For the label-free analysis we analyzed saliva samples from 9 ULC-OM and 10 NON-OM patients at 6 different timepoints (including 12 months after ASCT) with Data-Independent Acquisition (DIA). As spectral library, all samples were grouped (ULC-OM vs NON-OM) and analyzed with Data Dependent Analysis (DDA). PCA plots and a volcano plot were generated in RStudio and differently regulated proteins were analyzed using GO analysis with g:Profiler.

Results

A different clustering of ULC-OM pools was found at baseline, weeks 2 and 3 after ASCT with TMT-labelled analysis. Using label-free analysis, week 1–3 samples clustered distinctly from the other timepoints. Unique and up-regulated proteins in the NON-OM group (DDA analysis) were involved in immune system-related processes, while those proteins in the ULC-OM group were intracellular proteins indicating cell lysis.

Conclusions

The salivary proteome in ASCT recipients has a tissue protective or tissue-damage signature, that corresponded with the absence or presence of ulcerative oral mucositis, respectively.

Trial registration

The study is registered in the national trial register (NTR5760; automatically added to the International Clinical Trial Registry Platform).
To disclose or not to disclose: an ethnographic exploration of factors contributing to the (non) disclosure of Ghanaian women’s breast cancer diagnosis to social networks
Authors: Agyemang Linda Serwaa , Wagland Richard , Foster Claire , McLean Chris , Fenlon Deborah
Published: July 2023

Background

Although there may be theoretical support linking positive health outcomes with cancer disclosure to social networks, women from contexts such as Ghana where cancer is not openly talked about may have concerns around breast cancer disclosure. Women may not be able to share their experiences about their diagnosis, which may prevent them from receiving support. This study aimed to obtain the views of Ghanaian women diagnosed with breast cancer about factors contributing to (non) disclosure.

Methods

This study is based on secondary findings from an ethnographic study that employed participant observation and semi-structured face to face interviews. The study was conducted at a breast clinic in a Teaching Hospital in southern Ghana. 16 women diagnosed with breast cancer (up to stage 3); five relatives nominated by these women and ten healthcare professionals (HCPs) participated in the study. Factors contributing to breast cancer (non) disclosure were explored. Data were analysed using a thematic approach.

Results

The analysis indicated that most of the women and family members were very reticent about breast cancer disclosure and were secretive with distant relatives and wider social networks. Whilst remaining silent about their cancer diagnosis helped women protect their identities, prevented spiritual attack, and bad advice, the need for emotional and financial support for cancer treatment triggered disclosure to close family, friends, and pastors. Some women were discouraged from persevering with conventional treatment following disclosure to their close relatives.

Conclusions

Breast cancer stigma and fears around disclosure hindered women from disclosing to individuals in their social networks. Women disclosed to their close relatives for support, but this was not always safe. Health care professionals are well placed to explore women’s concerns and facilitate disclosure within safe spaces to enhance engagement with breast cancer care services.
Temporal and spatial analysis of Plasmodium falciparum genomics reveals patterns of parasite connectivity in a low-transmission district in Southern Province, Zambia
Authors: Fola Abebe A. , Moser Kara A. , Aydemir Ozkan , Hennelly Chris , Kobayashi Tamaki , Shields Timothy , Hamapumbu Harry , Musonda Michael , Katowa Ben , Matoba Japhet , Stevenson Jennifer C. , Norris Douglas E. , Thuma Philip E. , Wesolowski Amy , Moss William J. , Bailey Jeffrey A. , Juliano Jonathan J. ,   the Southern, Central Africa International Center of Excellence for Malaria Research (ICEMR)
Published: July 2023

Background

Understanding temporal and spatial dynamics of malaria transmission will help to inform effective interventions and strategies in regions approaching elimination. Parasite genomics are increasingly used to monitor epidemiologic trends, including assessing residual transmission across seasons and importation of malaria into these regions.

Methods

In a low and seasonal transmission setting of southern Zambia, a total of 441 Plasmodium falciparum samples collected from 8 neighbouring health centres between 2012 and 2018 were genotyped using molecular inversion probes (MIPs n = 1793) targeting a total of 1832 neutral and geographically informative SNPs distributed across the parasite genome. After filtering for quality and missingness, 302 samples and 1410 SNPs were retained and used for downstream population genomic analyses.

Results

The analyses revealed most (67%, n = 202) infections harboured one clone (monogenomic) with some variation at local level suggesting low, but heterogenous malaria transmission. Relatedness identity-by-descent (IBD) analysis revealed variable distribution of IBD segments across the genome and 6% of pairs were highly-related (IBD ≥ 0.25). Some of the highly-related parasite populations persisted across multiple seasons, suggesting that persistence of malaria in this low-transmission region is fueled by parasites “seeding” across the dry season. For recent years, clusters of clonal parasites were identified that were dissimilar to the general parasite population, suggesting parasite populations were increasingly fragmented at small spatial scales due to intensified control efforts. Clustering analysis using PCA and t-SNE showed a lack of substantial parasite population structure.

Conclusion

Leveraging both genomic and epidemiological data provided comprehensive picture of fluctuations in parasite populations in this pre-elimination setting of southern Zambia over 7 years.
Description of pathogenic bacteria in patients with respiratory symptoms associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Colombia
Authors: Zuluaga Nathalia , Martínez David , Hernández Carolina , Ballesteros Nathalia , Castañeda Sergio , Ramírez Juan David , Muñoz Marina
Published: July 2023

Viral respiratory infections may predispose to co-infections with other pathogenic microorganisms. In this study, pathogenic respiratory bacteria were detected using commercial kit Allplex™ Respiratory Panel 4 from nasopharyngeal samples from individuals suffering respiratory symptoms with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients without respiratory symptoms were included as controls. Haemophilus influenzae and Streptococcus pneumoniae were detected from 12 patients (6%) in both, patients with respiratory symptoms (including hospitalized) (n = 6) and individual without symptoms (n = 6). Pathogenic bacteria possibly proliferate due to the limited immune response of patients with SARS-CoV-2, perhaps due to dysbiosis generated by the viral infection.
Machine learning to improve interpretability of clinical, radiological and panel-based genomic data of glioma grade 4 patients undergoing surgical resection
Authors: Dal Bo Michele , Polano Maurizio , Ius Tamara , Di Cintio Federica , Mondello Alessia , Manini Ivana , Pegolo Enrico , Cesselli Daniela , Di Loreto Carla , Skrap Miran , Toffoli Giuseppe
Published: July 2023

Background

Glioma grade 4 (GG4) tumors, including astrocytoma IDH-mutant grade 4 and the astrocytoma IDH wt are the most common and aggressive primary tumors of the central nervous system. Surgery followed by Stupp protocol still remains the first-line treatment in GG4 tumors. Although Stupp combination can prolong survival, prognosis of treated adult patients with GG4 still remains unfavorable. The introduction of innovative multi-parametric prognostic models may allow refinement of prognosis of these patients. Here, Machine Learning (ML) was applied to investigate the contribution in predicting overall survival (OS) of different available data (e.g. clinical data, radiological data, or panel-based sequencing data such as presence of somatic mutations and amplification) in a mono-institutional GG4 cohort.

Methods

By next-generation sequencing, using a panel of 523 genes, we performed analysis of copy number variations and of types and distribution of nonsynonymous mutations in 102 cases including 39 carmustine wafer (CW) treated cases. We also calculated tumor mutational burden (TMB). ML was applied using eXtreme Gradient Boosting for survival (XGBoost-Surv) to integrate clinical and radiological information with genomic data.

Results

By ML modeling (concordance (c)- index = 0.682 for the best model), the role of predicting OS of radiological parameters including extent of resection, preoperative volume and residual volume was confirmed. An association between CW application and longer OS was also showed. Regarding gene mutations, a role in predicting OS was defined for mutations ofBRAFand of other genes involved in the PI3K-AKT-mTOR signaling pathway. Moreover, an association between high TMB and shorter OS was suggested. Consistently, when a cutoff of 1.7 mutations/megabase was applied, cases with higher TMB showed significantly shorter OS than cases with lower TMB.

Conclusions

The contribution of tumor volumetric data, somatic gene mutations and TBM in predicting OS of GG4 patients was defined by ML modeling.
Dose development in sinonasal imaging over the last decade – a retrospective patient study
Authors: Hackenbroch Carsten , Strobel Joachim Rudolf Balthasar , Lorenz Kai Johannes , Beer Meinrad , Schüle Simone
Published: July 2023

Background

Computed tomography (CT) has become the primary imaging modality for visualization of the paranasal sinuses. In this retrospective, single center patient study the radiation dose development in the past 12 years in CT imaging of the paranasal sinuses was assessed.

Methods

The computed tomography dose index (CTDIVol) and dose length product (DLP) of a total of 1246 patients (average age: 41 ± 18 years, 361 females, 885 males) were evaluated, who received imaging of the paranasal sinuses either for chronic sinusitis diagnostic, preoperatively or posttraumatically. Scans were performed on three different CT scanners (Somatom Definition AS, Somatom Definition AS+, Somatom Force, all from Siemens Healthineers) and on one CBCT (Morita) ranging from 2010 to 2022. Reconstruction techniques were filtered back projection and three generations of iterative reconstruction (IRIS, SAFIRE, ADMIRE, all from Siemens Healthineers). Group comparisons were performed using either parametrical (ANOVA) or non-parametrical tests (Kruskal-Wallis Test), where applicable.

Results

Over the past 12 years, there was a 73%, 54%, and 66% CTDIVol reduction and a significant (p < 0.001) 72%, 33%, and 67% DLP reduction in assessing the paranasal sinuses for chronic sinusitis, preoperatively and posttraumatically, respectively.

Conclusion

Technological developments in CT imaging, both hardware and software based, have led to a significant reduction in dose exposure in recent years. Particularly in imaging of the paranasal sinuses, the reduction of radiation exposure is of great interest due to the often young patient age and radiation-sensitive organs in the area of radiation exposure.
Technical violations and infractions are drivers of disengagement from methadone treatment among people with opioid use disorder discharged from Connecticut jails 2014–2018
Authors: Marotta Phillip , Hass Alissa , Viera Adam , Doernberg Molly , Barbour Russell , Grau Lauretta E. , Heimer Robert
Published: July 2023

Background

We investigated the interaction between arrests for technical violations vs. receiving new charges with receiving community-based methadone treatment on time-to reincarceration (TTR) in a cohort of men with opioid use disorder (OUD) released from custody from two Connecticut jails from 2014 to 2018.

Methods

Hazard ratios (HR) were estimated for time to reincarceration for technical violations/infractions, misdemeanors only, felonies only, and both misdemeanors and felonies after adjusting for age, race/ethnicity, and receiving methadone treatment during incarceration or in the community following release. Moderation analyses tested the hypotheses that the benefits of receiving methadone in jail or the community on TTR were significantly different for people with only technical violations and infractions compared to misdemeanor and felony charges.

Results

In the sample of 788 men who were reincarcerated, 29.4% received technical violations with no new charges (n = 232) with the remainder of the sample receiving new charges consisting of 26.9% new misdemeanor charges, 6.5% felony charges, and 37.2% both felony and misdemeanor charges. Compared to men who received new misdemeanor charges, TTR was significantly shorter among those who received technical violations and infractions with no new charges amounting to a 50% increase in TTR (334.5 days, SD = 321.3 vs. 228.1 days, SD = 308.0, p < 0.001; aHR = 1.5, 95% CI = 1.3, 1.8, p < 0.001). TTR of men who resumed methadone and were charged with a new crime was 50% longer than those who resumed methadone and received technical violations/infractions with no new charges. (230.2 days, SD = 340.2 vs. 402.3 days, SD = 231.3; aHR = 1.5, 95%CI = 1.0, 2.2, p = 0.038).

Conclusions

Reducing technical violations may enhance the benefits of providing community-based methadone following release from incarceration on extending the time between incarcerations during the vulnerable time post-incarceration and reduce the burden on correctional systems.
The impact of surgery and age on mortality with primary trachea malignant tumors: a retrospective study based on propensity-score matching analysis
Authors: Ping Chen , Liang Jia , Liu Zhi-Yuan , He Jiang , Zhou Ji-Yao , Cheng Hao , Yuan Guang-Da
Published: July 2023

Purpose

This study aimed to explore the survival significance of surgery and age on the prognosis of patients with primary trachea malignancies.

Methods

The entire cohort of 637 patients with primary malignant trachea tumors was used to perform the main analyses. The data of those patients were from a public database. Overall survival (OS) curves were drawn by the Kaplan-Meier method and compared by the Log-rank test. The univariable and multivariable Cox regression analyses calculated the hazard ratio (HR) and 95% confidence interval (CI) for overall mortality. The propensity-score matching analysis was used to reduce the selection bias.

Results

Age, surgery, histological type, N classification, M classification, marital status, and tumor grading were identified as independent prognostic factors after eliminating confounding factors. The results of the Kaplan-Meier method revealed that patients with age < 65 had a survival advantage over those with age ≥ 65 (HR = 1.908, 95% CI 1.549–2.348, P < 0.001). The 5-year OS rates were 28% and 8% in the group with age < 65 and age ≥ 65, respectively (P < 0.001). Cases with surgery had better survival over patients without surgery (HR = 0.372, 95% CI 0.265–0.522, P < 0.001). Compared with patients who did not undergo operations, patients with surgery had a higher median survival time (20 vs. 174 months). For patients with surgery, young age was considered a survival-promoting factor (HR 2.484; 95% CI 1.238–4.983, P = 0.010).

Conclusion

We suggested that age and surgery were the independent prognostic factors in patients with primary malignant trachea tumors. Besides, age serves as an essential indicator for evaluating the prognosis of postoperative patients.
Treatment of relapsing multiple sclerosis in Hungary – consensus recommendation from the Hungarian neuroimmunology society
Authors: Rajda Cecilia , Rózsa Csilla , Mike Andrea , Lovas Gábor , Mezei Zsolt , Jakab Gábor , Ács Péter , Rum Gábor , Simó Magdolna , Jobbágy Zita , Bíró Zita , Trauninger Anita , Imre Piroska , Mátyás Klotild , Deme István , Illés Zsolt , Csepany Tunde
Published: July 2023

Multiple sclerosis (MS) may impact quality of life, careers and family plans of the affected individuals. The current treatments with disease modifying therapies aim to prevent people with MS (pwMS) from disability accumulation and progression. Different countries have different reimbursement policies resulting in inequalities in patient care among geographical regions. Access to anti-CD20 therapies for relapsing MS is restricted in Hungary because therapy of individual cases only is reimbursed. In the light of the latest research and national guidelines, 17 Hungarian MS experts agreed on 8 recommendations regarding relapsing pwMS using the Delphi round method. Strong agreement (> 80%) was achieved in all except one recommendation after three rounds, which generated a fourth Delphi round. The experts agreed on treatment initiation, switch, follow-up and discontinuation, as well as on special issues such as pregnancy, lactation, elderly population, and vaccination. Well-defined national consensus protocols may facilitate dialogue between policymakers and healthcare professionals and thus contribute to better patient care in the long run.
Mutation-Attention (MuAt): deep representation learning of somatic mutations for tumour typing and subtyping
Authors: Sanjaya Prima , Maljanen Katri , Katainen Riku , Waszak Sebastian M. ,   Genomics England Research Consortium, Ambrose J. C. , Arumugam P. , Bevers R. , Bleda M. , Boardman-Pretty F. , Boustred C. R. , Brittain H. , Brown M. A. , Caulfield M. J. , Chan G. C. , Giess A. , Griffin J. N. , Hamblin A. , Henderson S. , Hubbard T. J. P. , Jackson R. , Jones L. J. , Kasperaviciute D. , Kayikci M. , Kousathanas A. , Lahnstein L. , Lakey A. , Leigh S. E. A. , Leong I. U. S. , Leong F. J. , Maleady-Crowe F. , McEntagart M. , Minneci F. , Mitchell J. , Moutsianas L. , Mueller M. , Murugaesu N. , Need A. C. , O’Donovan P. , Odhams C. A. , Patch C. , Perez-Gil D. , Perez-Gil M. B. , Pullinger J. , Rahim T. , Rendon A. , Rogers T. , Savage K. , Sawant K. , Scott R. H. , Siddiq A. , Siddiq A. , Smith S. C. , Sosinsky A. , Stuckey A. , Tanguy M. , Taylor Tavares A. L. , Thomas E. R. A. , Thompson S. R. , Tucci A. , Welland M. J. , Williams E. , Witkowska K. , Wood S. M. , Zarowiecki M. , Aaltonen Lauri A. , Stegle Oliver , Korbel Jan O. , Pitkänen Esa
Published: July 2023

Background

Cancer genome sequencing enables accurate classification of tumours and tumour subtypes. However, prediction performance is still limited using exome-only sequencing and for tumour types with low somatic mutation burden such as many paediatric tumours. Moreover, the ability to leverage deep representation learning in discovery of tumour entities remains unknown.

Methods

We introduce here Mutation-Attention (MuAt), a deep neural network to learn representations of simple and complex somatic alterations for prediction of tumour types and subtypes. In contrast to many previous methods, MuAt utilizes the attention mechanism on individual mutations instead of aggregated mutation counts.

Results

We trained MuAt models on 2587 whole cancer genomes (24 tumour types) from the Pan-Cancer Analysis of Whole Genomes (PCAWG) and 7352 cancer exomes (20 types) from the Cancer Genome Atlas (TCGA). MuAt achieved prediction accuracy of 89% for whole genomes and 64% for whole exomes, and a top-5 accuracy of 97% and 90%, respectively. MuAt models were found to be well-calibrated and perform well in three independent whole cancer genome cohorts with 10,361 tumours in total. We show MuAt to be able to learn clinically and biologically relevant tumour entities including acral melanoma, SHH-activated medulloblastoma, SPOP-associated prostate cancer, microsatellite instability, POLE proofreading deficiency, and MUTYH-associated pancreatic endocrine tumours without these tumour subtypes and subgroups being provided as training labels. Finally, scrunity of MuAt attention matrices revealed both ubiquitous and tumour-type specific patterns of simple and complex somatic mutations.

Conclusions

Integrated representations of somatic alterations learnt by MuAt were able to accurately identify histological tumour types and identify tumour entities, with potential to impact precision cancer medicine.