bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 62: An Assessment of Cervical Cancer Prevention and Treatment Infrastructure in Belize
Authors: Neibart Shane , Smith Tiffany , Fang Jennifer , Anderson Taylor , Kulkarni Abha , Tsui Jennifer , Hudson Shawna , Peck Gregory , Hanna Joseph , Beer Natalia Largaespada , Einstein Mark
Published: July 2021

Purpose: Belize has among the highest cervical cancer incidence and mortality rates of Latin American and Caribbean countries despite efforts to increase access to prevention and treatment services. This study evaluates the policies, infrastructure, and workforce of the cervical cancer management system in Belize to inform the strengthening of sustainable screening and treatment programs.

Methods: In 2018, health facility assessments were conducted across the 6 districts of Belize at the national pathology facility and 12 public facilities identified by Ministry of Health as critical to cervical cancer control. We used a standardized instrument to assess human resources, physical infrastructure, and existing policies related to cervical cancer management.

Results: The public cervical cancer screening workforce in Belize consists of 75 nurses and physicians (1 per 1,075 screening-eligible women), and 44% (n=33) are members of the outreach workforce who serve rural areas (1 per 2,537 screening-eligible women). All districts have at least 1 screening facility, 50% (n=6) of which perform screening services including visual inspection with acetic acid and cervical cytology 1 day per week. Cervical cancer diagnosis and treatment service availability differ across districts. At the national pathology facility, 38% (n=5) of essential equipment (e.g. microtomes) were available and functional, 23% (n=3) of equipment were available but non-functional, and 38% (n=5) of equipment were unavailable. Regarding essential pathology supplies (e.g. hematoxylin and eosin), 30% (n=6) of supplies were out of stock at the time of assessment and 75% (n=15) were out of stock at one point in the past 12 months.

Conclusion: Public sector cervical cancer management services differ between districts of Belize, with tertiary service availability concentrated in the largest district. Screening, outreach, and pathology are limited by resource availability, and although no standard benchmarks exist for contextualization, this insight into current capacity pinpoints health system components for future investment.

Citation Format: Shane Neibart, Tiffany Smith, Jennifer Fang, Taylor Anderson, Abha Kulkarni, Jennifer Tsui, Shawna Hudson, Gregory Peck, Joseph Hanna, Natalia Largaespada Beer, Mark Einstein. An Assessment of Cervical Cancer Prevention and Treatment Infrastructure in Belize [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 62.
Abstract 66: Screening and Risk Factor Analysis for Oral, Breast and Cervical Cancer amongst Garbage Cleaners of Bangalore, India; An Underserved Community.
Authors: T Chethana , Shetty Punith , Kulkarni Radhika
Published: July 2021

Purpose: According to GLOBOCON 2018, in India oral cancer is the most common cancer among men while breast and cervical cancers are the most common cancers in women. Tobacco is a common and significant risk factor. This study was conducted amongst garbage cleaners of Bangalore, India. This population represents one of the lowest socio-economic classes in India due to poor health literacy and financial poverty. The objectives of this study were to identify the risk factors for oral, breast, and cervical cancer in this population and to identify premalignant and malignant lesions.

Methods: A cross-sectional descriptive study was conducted in Bangalore, India. Validated questionnaires were used to assess risk factors. Over a period of one year, screening programs were conducted once a week in the municipality clinics. The screening included a visual exam of the oral cavity and exfoliative cytology of lesions, clinical breast exam (CBE), and pap smears. Follow up of suspected lesions were referred to higher centers for further management.

Results: Of the 1123 attendees, 81.5% were women, 85% were illiterate. 68 oral premalignant lesions were identified on clinical exam and all of them underwent tobacco cessation counselling. 913/915 women underwent CBE, of which 23 were abnormal and were referred for mammogram. 28 abnormal pap smears were detected; 16 underwent biopsy:1 SCC (treated), 3 HSIL (1 treated/1 refused/1 under follow up), 2 LSIL (under follow up), 10 normal. Multiple logistic regression was done to assess the impact of risk factors on the oral pre-malignant cases. The intercept/constant was statistically significant with tobacco having a positive relationship while gender and age had a marginally positive relationship.

Conclusion: Garbage cleaners represent a high-risk population due to poor health literacy, limited access to health care and hazardous working conditions. This program not only helped to create awareness about these cancers and the implications of tobacco use but also provided opportunity for screening. Imparting knowledge about oral and self-breast exams will help to create a sustainable model. Implementation of tobacco cessation programs would be beneficial.

Citation Format: Chethana T, Punith Shetty, Radhika Kulkarni. Screening and Risk Factor Analysis for Oral, Breast and Cervical Cancer amongst Garbage Cleaners of Bangalore, India; An Underserved Community. [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 66.
Abstract 70: Integrated Cancer Management in Indonesia: Synergism to Achieve a Good Quality Cancer Management 2020-2024
Authors: Gondhowiardjo Soehartati , Permata Tiara Bunga Mayang , Nurhanita  , Khumaessa Novi Elis , Maharani Putri , Nicholas  , Rahmartani Lusi Tania , Octavianus Steven
Published: July 2021

Purpose: Numerous long-term efforts have been established for cancer control by Indonesian government. Still, these efforts seem incapable of keeping up with the increasing number of cancer cases and have not yielded satisfactory outcomes. To further enhance Indonesia's cancer control program, we proposed strategies that mainly focus on prevention and early diagnosis, which consider a promising investment in cancer control. Rather than solely concentrating on treatment plans, which may result in cost-inefficiencies and augmenting its state financial burden.

Methods: A thorough situational analysis for Indonesia's cancer control was performed, including cancer risk factors, screening and early detection, access to cancer care and palliative care, human resource, and cancer registry. The analysis was performed by data collection from literature reviews, site surveys at primary health care, tertiary health care, Indonesia Health Care Insurance, and in-depth interviews with national experts in various professional organizations and NGOs. Based on these findings and analysis, a proposed cancer control program was then formulated by the National Cancer Control Committee (NCCC) and Ministry of Health with WHO-SEAR.

Results: The NCCC has formulated National Cancer Control Program for 2020-2024 with three main visions, increased healthy lifestyle, plenary cancer control and prevention, and effective data-based cancer control, which is well pictured in the 'hour-glass' approach. The strategy mainly focuses on health promotion and primary prevention synergized by other healthcare systems such as cancer care, cancer registry, and palliative care.

Conclusion: Efforts should focus on the three primary cancers in Indonesia, which significantly impact cancer burden, namely breast cancer, cervical cancer, and childhood cancer. Therefore, Indonesia will achieve reasonable cancer control and reduce cancer burden. However, formulating NCCP is crucial to help the country pan out its priorities and action plan in cancer control. Each country should decide its strategy and approach, which is most relevant to their situation.

Citation Format: Soehartati Gondhowiardjo, Tiara Bunga Mayang Permata, Nurhanita, Novi Elis Khumaessa, Putri Maharani, Nicholas, Lusi Tania Rahmartani, Steven Octavianus. Integrated Cancer Management in Indonesia: Synergism to Achieve a Good Quality Cancer Management 2020-2024 [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 70.
Abstract 84: Development and Implementation of a Case-based Virtual Training Program for Oncologic Emergencies in Botswana
Authors: Li Sharon , Qureshi Sadaf , Antony Reena , Wilson Kara , Moumakwa Robert , Lebelonyane Refeletswe , Gaolathe Tendani , Shah Mansi , Popli Pallvi , Chandar Ashwin , Kaur Sukhdeep , Marlink Richard , Mayer Tina , Vuylsteke Peter , Ralefala Tlotlo
Published: July 2021

Purpose: Oncologic emergencies contribute to a large proportion of morbidity and mortality for oncology patients, who present unique medical challenges due to disease and treatment complexities. Emergencies training of medical staff is important, particularly if there is high turnover. We describe the development and implementation of a program to enhance timely recognition and treatment of oncologic emergencies. Due to the COVID19 pandemic, sessions were conducted virtually.

Methods: Healthcare workers who normally care for oncology patients at Princess Marina Hospital (PMH) were invited to participate in a series of weekly virtual case-based lectures. Didactic content was developed between Botswana and Rutgers faculty and fellows to reflect specific management and resources available at PMH. Participation was through live chat case reviews and pre- and post- session questions. Feedback was elicited through Likert-scale surveys.

Results: An average of 19 participants (range 13-29) attended the training sessions. Average make-up per session were as follows: 16% physicians, 26% Medical Officers, 4% Internal Medicine Residents, 32% nurses, 21% other. Healthcare workers from Botswana were invited to participate in content preparation and presentation to their peers; 3 of 8 presentations were by Botswana personnel. Average pre-session test score was 70% (range 40-89%); post-session score was 82% (range 55-97%). In post sessions surveys, average confidence in diagnosis and recognition across emergencies was 84% (range 71-100%); average confidence in management was 81% (range 57-100%).

Conclusions: We describe the successful piloting of a case-based virtual training program in oncologic emergencies, which to our knowledge is the first of its kind. The program was adapted to the Botswana health care setting. Overall, confidence in diagnosis, recognition and management of oncologic emergencies appeared to increase after sessions. Plans are in place to expand the series to more sites within the country, most of which do not have dedicated oncology trained staff.

Citation Format: Sharon Li, Sadaf Qureshi, Reena Antony, Kara Wilson, Robert Moumakwa, Refeletswe Lebelonyane, Tendani Gaolathe, Mansi Shah, Pallvi Popli, Ashwin Chandar, Sukhdeep Kaur, Richard Marlink, Tina Mayer, Peter Vuylsteke, Tlotlo Ralefala. Development and Implementation of a Case-based Virtual Training Program for Oncologic Emergencies in Botswana [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 84.
Abstract 87: Virtual Mentoring of Dentists in Oral Cancer Screening and Tobacco Cessation: An Advanced Level Program
Authors: Nethan Suzanne , John Amrita , Ravi Priyanka , Kumar Vipin , Dhanasekaran Kavitha , Babu Roshni , Hariprasad Roopa
Published: July 2021

Purpose: Oral cancer is the third common cancer in India, the mortality of which can be reduced by early detection. Dentists are ideal for this task and tobacco cessation owing to their forte of work. This paper discusses findings of a Project ECHO (Extension for Community Health Outcome)-based advanced telementoring program in these areas for dentists across India.

Methods: The 14-week long training program in 2018, with weekly, hour-long sessions conducted by our Organization (hub) on Zoom app, had 52 participants (spokes) from across India. Each session comprised of an expert-led didactic, and case discussions by spokes. Participants were evaluated through online, pre- and post-training, and weekly post-session quizzes, along with weekly and post-one-year feedback. Successful spokes attended a hands-on workshop at our organization subsequently.

Results: A notable increase in the overall and per-session mean knowledge score, and confidence in oral cancer screening was seen among the spokes. Many started such services at their respective clinics (and continued till even a year later) and reduced referrals to other healthcare facilities for confirmation of their diagnosis. They also felt motivated to spread community awareness about oral cancer prevention.

Conclusion: The ECHO telementoring model comprising of expert didactics, case discussions by spokes, along with significant interaction between the spokes and experts, is a promising best-practice tool to reduce knowledge and skills disparity regarding oral cancer prevention among dentists situated across different locations. This in turn would enable these most appropriate healthcare providers to contribute towards the overall goal of oral cancer prevention.

Citation Format: Suzanne Nethan, Amrita John, Priyanka Ravi, Vipin Kumar, Kavitha Dhanasekaran, Roshni Babu, Roopa Hariprasad. Virtual Mentoring of Dentists in Oral Cancer Screening and Tobacco Cessation: An Advanced Level Program [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 87.
Abstract 92: Clinical Care and Short-Term Survival Outcomes for Women with Breast Cancer in Gaza, Occupied Palestinian Territory
Authors: Alwaheidi Shaymaa , Sullivan Professor Richard , Davies Dr Elizabeth
Published: July 2021

Purpose: We aimed to provide robust breast cancer survival estimates for Palestinian women in Gaza, and to identify interventions necessary to improve care in this setting.

Methods: We collected detailed clinical and treatment data from the medical records of all women diagnosed with breast cancer from Jan 1, 2017 to Dec 31, 2018 in Gaza. Semi-structured interviews with 11 healthcare providers and 20 patients diagnosed during this period were conducted to examine experiences of giving and receiving cancer care. Women were followed using clinical and death records until 31 December 2019. The one-year crude survival rate was estimated using the Kaplan-Meier method.

Results: 524 new diagnoses of breast cancer (mean age:53, range:23-100) were recorded during the study period, giving a crude annual incidence rate of 27 per 100,000 population. Key prognostic factors were available in most cases -stage (93%), ER, PR, HER2 (82%) and slightly less often for tumour grade (77%) and tumour size (70%). 51% of women underwent mastectomy. By December 31, 2019 24 (5%) of these women had died. The total estimated mean time until death was 11·7 months, and the one-year crude survival rate was 95·4%. Many women reported lack of treatment as the main barrier to effective cancer care, especially those receiving Gosorelin or radiotherapy. This issue was also cited by oncologists who described the difficulty of adhering to treatment protocols for early-stage breast cancer because of radiotherapy not being available in Gaza. Regarding diagnosis, delays were observed in the macroscopic examination of biopsies due to lack of staff, and a severe shortage of immunohistopathology staining kits hindered treatment planning.

Conclusion: Lack of hospital facilities for diagnosis and treatment are barriers to effective cancer care in Gaza. Despite major challenges, Palestinian women with breast cancer have a high short-term survival.

Citation Format: Shaymaa Alwaheidi, Professor Richard Sullivan, Dr Elizabeth Davies. Clinical Care and Short-Term Survival Outcomes for Women with Breast Cancer in Gaza, Occupied Palestinian Territory [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 92.
Abstract 93: Serum miRNA-210 Level in Clear Cell Renal Cell Carcinoma
Authors: Htun Yin Min , Htun Moh Moh , Aung Khin Thida
Published: July 2021

Purpose: Renal cell carcinoma (RCC) is the 12th most common cancer and its incidence is in increasing trend worldwide.

Methods: This study was carried out at Urosurgical ward of Yangon Specialty Hospital including (87) cases of clinically suspected renal cell carcinoma patients. Preoperative serum samples were collected and histologically proven clear cell renal cell carcinoma cases were selected and miRNA level were determined by quantitative reverse-transcriptase polymerase chain reaction.

Results: Clear cell renal cell carcinoma occurred in all age groups ranging from 24 to 82 years. The most commonly affected age group were 41-60 years including 52 patients (56.5%) and male to female ratio was 1.6:1. Serum miRNA-210 level was found to be significantly high in relation to normal and the receiver-operator characteristic (ROC) curve demonstrated the most promising sensitivity and specificity when the miRNA-210 level was set at 8.13 × 103copies/ul. Most of the patients were grade 2 histology followed by grade 3 and grade 4. Grade 1 histology cases were not found in this study. When analyzing with chi squared test, the mean serum miRNA-210 level of the total study population, (8.3057 × 104 copies/µl) was used to categorize the data into two groups in which those having serum miRNA-210 level below mean and those with the mean and above in relation to the low and high grades as well as low and high stages of RCC. There was statistically significant association between miRNA-210 expression of lower grades (grade 1 & 2) and higher grades (grade 3 &4) of clear cell RCC (p = 0.0001). There was also statistically significant association between miRNA-210 expression of lower stages (Stage I & II) and higher stages (Stage III &IV) of RCC (p = 0.005).

Conclusion: The upregulated miRNA-210 expression could estimate prognosis for active surveillance from patients having undergone surgical resection.

Citation Format: Yin Min Htun, Moh Moh Htun, Khin Thida Aung. Serum miRNA-210 Level in Clear Cell Renal Cell Carcinoma [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 93.
Abstract 98: Custom Gene Fusion Assays for the Rapid Diagnosis of Pediatric Cancers in Low-Resourced Settings
Authors: Gastier-Foster Julie , Lutwama Fredrick , Lubega Joseph , Fisher Kevin , Lopez-Terrada Dolores , Roy Angshumoy , Ozuah Nmazuo , Slone Jeremy , Wasswa Peter , Allen Carl , Poplack David
Published: July 2021

Purpose: Risk stratification and molecular targeting have been key to increasing cure rates for pediatric cancers in high-income countries. Precise diagnosis and successful treatment of pediatric cancer in low-resourced settings is often hindered by insufficient pathology infrastructure, including lack of laboratory platforms for molecular analysis. Given the high frequency of gene fusions in pediatric cancers, identifying such fusions would greatly aid cost-effective pediatric cancer diagnosis, risk stratification, and precision medicine in low-resourced settings.

Methods: To allow for implementation of gene fusion detection at Global HOPE sites in Sub-Saharan Africa (SSA), methodologies were reviewed to consider minimal technical expertise required, the ability to utilize samples with sub-optimal RNA quality, and rapid turn-around-time. Literature review, clinical laboratory results, public databases, and large-scale genomic studies were used to obtain exact breakpoint sequence information for gene fusions associated with pediatric and adolescent cancers.

Results: Two custom pediatric gene fusions panels were designed using the NanoString Elements technology. The hematologic malignancy panel was designed to detect 439 breakpoints for 223 non-IGH/TCR fusions reported in ALL, AML, lymphomas, and histiocytosis. The solid tumor panel was designed to detect 204 breakpoints for 436 fusions associated with pediatric sarcomas, brain tumors, and renal malignancies. Each panel was tested using 96 samples with known fusion status at Texas Children's Hospital to determine specificity, sensitivity, precision, and ease of workflow.

Conclusions: The design, testing, and implementation of a rapid assay to detect gene fusions with diagnostic, prognostic, and therapeutic impact would be transformational in the care of pediatric cancer patients in low-resourced settings. The custom designed panels will allow for large-scale fusion detection in 2-3 days with only 15 minutes of technician time after RNA isolation. Additional steps are needed to identify and address any challenges upon initiation in SSA to fully realize the potential of such technology.

Citation Format: Julie Gastier-Foster, Fredrick Lutwama, Joseph Lubega, Kevin Fisher, Dolores Lopez-Terrada, Angshumoy Roy, Nmazuo Ozuah, Jeremy Slone, Peter Wasswa, Carl Allen, David Poplack. Custom Gene Fusion Assays for the Rapid Diagnosis of Pediatric Cancers in Low-Resourced Settings [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 98.
Hypertension as an Unusual Cause of Proliferative Retinopathy: Case Report and Literature Review
Authors: Abu Sbeit Rami Hasan Saleem , Mohammed Osman Abdelzaher , Alamlih Laith Ishaq
Published: July 2021

Malignant hypertensive retinopathy is associated with characteristic fundus findings that typically do not include proliferative retinal vascular changes. We present the case of a 34-year-old patient who had bilateral decreased vision and was found to have malignant hypertension with hypertensive retinopathy changes along with unforeseen bilateral neovascularization and vitreous hemorrhage. Detailed history and extensive systemic and ophthalmic workup failed to reveal an alternative explanation for her proliferative retinopathy. Blood pressure control and panretinal photocoagulation halted further deterioration. Malignant hypertensive retinopathy can rarely cause profound retinal ischemia leading to retinal neovascularization. This case further supports the presence of “proliferative hypertensive retinopathy” that needs to be identified and addressed urgently through collaboration between internists and ophthalmologists.
Familial Optic Disc Pits in 2 Father-Son Pairs: Clinical Features and Genetic Analysis
Authors: Betsch Devin , Orr Andrew , Nightingale Mathew , Gaston Daniel , Gupta Rishi
Published: July 2021

Congenital optic disc pits (ODPs) are well-circumscribed depressions within the optic disc. Thought to arise from anomalous closure of the optic fissure during embryonic development, they are now considered to lie on a broader spectrum of congenital optic disc anomaly (CODA). An increasing number of reports describe clustering of these cases within families, suggesting that inherited genetic elements play a role in disease predisposition. Here, we highlight the clinical features of 2 sets of father-son pairs affected with ODPs and provide preliminary molecular genetic analysis. Subjects underwent complete ophthalmological examination and imaging. In addition, whole-exome sequencing was carried out following informed consent. The resulting datasets were examined for potentially causal genetic variants, both in genes already known to be linked to CODA as well as those likely to lie in the same or similar genetic pathways. In this instance, no unambiguously causal variants were identified. This case series highlights the familial inheritance of ODPs, adding to the existing body of literature supporting an underlying genetic cause for this rare clinical entity. The inclusion here of specific molecular findings raises the hope that the genetic pathophysiology underlying rare entities like ODPs might be clarified in the future by the addition of similarly molecular-documented reports.
Melanoma and Sarcoidosis in Patients Receiving or Not Antineoplastic Therapy
Authors: Gouveris Panagiotis , Zouki Dionysia N. , Sarris Evangelos G. , Kolilekas Likourgos , Tryfonopoulos Dimitrios , Papaxoinis George , Demiri Stamatina
Published: July 2021

Sarcoidosis and sarcoid-like reactions have been associated with many solid tumors including malignant melanoma. There are reports of melanoma patients who develop sarcoidosis without having received any antineoplastic treatment, but there are also melanoma patients who have received immunotherapy or targeted therapy and, therefore, develop drug-associated sarcoidosis. Herein, we describe 2 cases of thoracic sarcoidosis which occurred in asymptomatic patients with known malignant melanoma. The first patient had metastatic disease, and she was under melanoma treatment with BRAF/MEK inhibitors at the time of sarcoidosis diagnosis. The second case involves a patient with early stage melanoma who had received no antineoplastic treatment. In both cases, the thoracic lesions were suspicious for metastatic involvement, and it was the biopsy which gave the diagnosis of granulomatous disease. Sarcoidosis induced by immune checkpoint or BRAF/MEK inhibitors seems to be more frequent in real-world studies than in large phase 3 melanoma trials. Sarcoidosis can mimic metastasis, predominately in mediastinum, representing a diagnostic pitfall. Therefore, biopsies must always be performed to exclude the metastatic spread before initiation of any antineoplastic treatment.
Characteristics Associated with Olfactory and Taste Disorders in COVID-19
Authors: Galmiche Simon , Bruel Timothée , Madec Yoann , Tondeur Laura , Grzelak Ludivine , Staropoli Isabelle , Cailleau Isabelle , Ungeheuer Marie-Noëlle , Renaudat Charlotte , Fernandes Pellerin Sandrine , Hoen Bruno , Schwartz Olivier , Fontanet Arnaud
Published: July 2021

Introduction: Olfactory and taste disorders (OTDs) have been reported in COVID-19 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the mechanisms of which remain unclear. We conducted a detailed analysis of OTDs as part of 2 seroepidemiological investigations of COVID-19 outbreaks. Methods: Two retrospective cohort studies were conducted in a high school and primary schools of Northern France following a COVID-19 epidemic in February-March 2020. Students, their relatives, and school staff were included. Anti-SARS-CoV-2 antibodies were identified using a flow-cytometry-based assay detecting anti-S IgG. Results: Among 2,004 participants (median [IQR] age: 31 [11–43] years), 303 (15.2%) tested positive for SARS-CoV-2 antibodies. OTDs were present in 91 (30.0%) and 92 (30.3%) of them, respectively, and had 85.1 and 78.0% positive predictive values for SARS-CoV-2 infection, respectively. In seropositive participants, OTDs were independently associated with an age above 18 years, female gender, fatigue, and headache. Conclusion: This study confirms the higher frequency of OTDs in females than males and adults than children. Their high predictive value for the diagnosis of COVID-19 suggests that they should be systematically searched for in patients with respiratory symptoms, fever, or headache. The association of OTDs with headache, not previously reported, suggests that they share a common mechanism, which deserves further investigation.
When Anxiety and Depression Coexist: The Role of Differential Diagnosis Using Clinimetric Criteria
Authors: Cosci Fiammetta , Fava Giovanni A.
Published: July 2021

Depressive and anxiety disorders are frequently associated. Depression may be a complication of anxiety and anxiety can complicate depression. The nature of their relationship has been a source of controversy. Reviews generally base their conclusions on randomized controlled trials and meta-analyses that refer to the average patient and often clash with the variety of clinical presentations that may occur when anxiety and depression coexist. The aim of this review was to examine the literature according to profiling of subgroups of patients based on clinimetric criteria, in line with the recently developed concept of medicine-based evidence. We critically reviewed the literature pertaining to the specific presentations of anxiety and depression, outlining the advantages and disadvantages of each treatment approach. The following prototypic cases were presented: depression secondary to an active anxiety disorder, depression in patients with anxiety disorders under treatment, anxious depression, anxiety as a residual component of depression, and demoralization secondary to anxiety disorder. We argue that the selection of treatment when anxiety and depression coexist should take into account the modalities of presentation and be filtered by clinical judgment. Very different indications may ensue when the literature is examined according to this perspective.
Metastasiertes Melanom: Nach der Studie ist vor der Studie
Authors: Maschke Jan
Published: July 2021

Die IMspire150 Studie wurde als Phase III Zulassungsstudie konzipiert und sollte prüfen, ob es bei behandlungsnaiven erwachsenen Patienten mit BRAF-V600-mutierten metastasierten Melanomen (nicht resezierbares klinisches Stadium IIIC-IV, AJCC 2009) einen Unterschied macht, wenn die Erstlinientherapie allein mit der Kombination des BRAF-Inhibitors Vemurafenib (Vem) und dem MEK-Inhibitor Cobimetinib (Cobi) erfolgt oder um den PDL-1 Antikörper Atezolizumab ergänzt wird. Patienten mit unbehandelten oder fortschreitenden Melanom-Hirnmetastasen, anderen aktiven Tumorerkrankungen und schwerwiegenden Autoimmunerkrankungen in der Vorgeschichte wurden ausgeschlossen. Die Randomi­sierung erfolgte 1:1. Der LDH Wert wurde zur Stratifizierung verwendet, Nebenwirkungen wurden gemäß CTCAE 4.0 Kriterien erfasst und als primärer statistischer Endpunkt der Studie wurde das vom Studienarzt bewertete progressionsfreie Überleben (progression-free survival, PFS) gewählt. Die Zwischenanalyse des Gesamtüberlebens der Patienten erfolgte gemäß Protokoll zum Zeitpunkt der Primäranalyse des PFS. Sekundäre Endpunkte waren das PFS, bewertet durch ein unabhängiges Komitee, das objektive Ansprechen, die Dauer des Tumoransprechens, das Gesamtüberleben und die Zeit bis zur Verschlechterung des Gesamtbefindens bzw. der Organfunktionen der Patienten. In den 112 Studienzentren wurden 514 Patienten eingeschlossen (n = 256 Vem/Cobi+Atezolizumab; n = 258 Vem/Cobi); 79% aller Patienten wurden in Europa rekrutiert. In beiden Studienarmen waren ca. 77% der Patienten jünger als 65, hatten einen unauffälligen Allgemeinstatus (ECOG = 0), ca. 94% waren jeweils im Stadium IV (hiervon ca. 60% Stadium M1c) und je 33% hatten einen erhöhten LDH Wert. Zunächst erhielten alle Patienten in beiden Gruppen 2 x tgl. 960mg Vem (2 x tgl. jeweils 4 Tabletten mit 240mg Vem) plus 1 x tgl. 60mg Cobi (1 x tgl. 3 Tabletten mit 20mg Cobi) per os für 21 Tage. Dann wurde Vem bei den Patienten, die in den Atezolizumab-Arm randomisiert worden waren, auf 2 x tgl. 720mg reduziert (3 × 240mg Vem plus je eine Placebotablette), im anderen Arm bei 2 x tgl. 960mg belassen. Cobi wurde zulassungsgemäß in der letzten Woche der 28 Tage dauernden Behandlungszyklen pausiert. In der Atezolizumab-Gruppe erhielten die Patienten an Tag 1 und 15 jeweils 840mg Atezolizumab i.v., in der anderen Gruppe eine Placeboinfusion. Dosismodifikationen und –unterbrechungen waren für Vem und Cobi erlaubt, für Atezolizumab waren allein Behandlungsunterbrechungen erlaubt.
Morphea: LED Technologie sorgt für verbesserte Phototherapie
Authors: Lehmann Percy
Published: July 2021

Ultraviolet A1 (UVA1) phototherapy (spectral range 340–400nm) is a well-established treatment option for various skin diseases such as localized scleroderma. Recent improvements of conventional UVA1 light sources (metal-halide or fluorescent lamps) have brought attention to a new light-emitting diode (LED) technology with remarkable advantages in handling and clinical routine. This study provides a preclinical histological and molecular evaluation of an LED-based UVA1 prototype with a narrower spectral range (360–400nm) for treating localized scleroderma. Scleroderma mouse models and fibroblasts in vitro were exposed to LED-based UVA1 phototherapy or to irradiation with a commercially available metal-halide lamp emitting low-dose (20, 40J/cm2), medium-dose (60J/cm2) and high-dose (80, 100J/cm2) UVA1 light. Both UVA1 light sources affected inflammatory genes (IL-1α and IL-6) and growth factors (TGFß-1 and TGFß-2). Increased collagen type 1 was reduced after UVA1 phototherapy. Matrix metalloproteinase-1 was more enhanced after a medium dose of LED-based UVA1 phototherapy than after conventional treatment. In vivo, dermal thickness and the amount of collagen were reduced after both treatment methods. Remarkably, myofibroblasts were more effectively reduced by a medium dose of LED-based UVA1 phototherapy. The study indicates that LED-based UVA1 phototherapy yields similar or even better results than conventional treatment. In terms of biosafety and patient comfort, LED-based UVA1 phototherapy offers clear advantages over conventional treatment because of the use of a narrower and less harmful UVA1 spectrum, less heat generation and shorter treatment times at the same irradiation intensity. Clinical studies are required to confirm these results in patients with localized scleroderma.
End-of-Life: Patientinnen und Patienten rechtzeitig einbinden
Authors: Zimmermann Tanja
Published: July 2021

Background: Decisions to limit treatment (DLTs) are important to protect patients from overtreatment but constitute one of the most ethically challenging situations in oncology practice. In the Ethics Policy for Advance Care Planning and Limiting Treatment study (EPAL), we examined how often DLT preceded a patient’s death and how early they were determined before (T1) and after (T2) the implementation of an intrainstitutional ethics policy on DLT. Methods: This prospective quantitative study recruited 1.134 patients with haematological/oncological neoplasia in a period of 2×6 months at the University Hospital of Munich, Germany. Information on admissions, discharges, diagnosis, age, DLT, date and place of death, and time span between the initial determination of a DLT and the death of a patient was recorded using a standardised form. Results: Overall, for 21% (n = 236) of the 1.134 patients, a DLT was made. After implementation of the policy, the proportion decreased (26% T1/16% T2). However, the decisions were more comprehensive, including more often the combination of ‘Do not resuscitate’ and ‘no intense care unit’ (44% T1/64% T2). The median time between the determination of a DLT and the patient’s death was similarly short with 6 days at a regular ward (each T1/T2) and 10.5/9 (T1/T2) days at a palliative care unit. For patients with solid tumours, the DLTs were made earlier at both regular and palliative care units than for the deceased with haematological neoplasia. Conclusion: Our results show that an ethics policy on DLT could sensitise for treatment limitations in terms of frequency and extension but had no significant impact on timing of DLT. Since patients with haematological malignancies tend to undergo intensive therapy more often during their last days than patients with solid tumours, special attention needs to be paid to this group. To support timely discussions, we recommend the concept of advance care planning.
Intersexual behaviour and effect of male and female intruders in the Tenerife skink (Chalcides viridanus). Is there any mate guarding?
Authors: Sánchez-Hernández Paula , Suárez-Rancel M. Mercedes , Molina-Borja Miguel
Published: July 2021

Individuals avoid potential competitors accessing mates during reproductive periods staying close to the mate and chasing same-sex intruders. We studied intersexual relationships and the effect of intruders of each sex in male-female pairs of Chalcides viridanus. We analysed: (1) behaviour patterns of each pair member and the time they spent together during three successive days in March, April and May; and (2) interactions of intruder-resident of the same sex, during each of the three months. Sexual and monthly differences appeared in intersexual behaviour as the breeding season progressed. In each month, time together was significantly larger on the third trial day than in the two previous days but did not significantly change between months. Sexes did not significantly differ in intruder-resident behaviours, but male aggressive interactions were significantly larger in May. Intruder females performed higher frequencies of non-agonistic behaviours than residents. We discuss all these results considering the predictions of mate guarding hypothesis.
Molecular diagnostics of the pigeon pea cyst nematode, Heterodera cajani Koshy, 1967, using real-time PCR
Authors: Roubtsova Tatiana V. , Subbotin Sergei A.
Published: July 2021

The pigeon pea cyst nematode, Heterodera cajani, is an important nematode pest of pigeon pea that is present in all major growing regions of this crop in India and reported from Pakistan, Egypt and Myanmar. In this study, a new real-time PCR assay for detection of H. cajani using a species-specific primer and a TaqMan probe was developed. The primers and a probe were designed to amplify the COI gene fragment. The specificity of the primer-probe set was tested in singleplex or multiplex reactions against target and non-target nematodes. In multiplex real-time PCR experiments with the specific and universal primer-probe sets, the signals were simultaneously observed for COI and D3 of 28S rRNA target genes. The results showed that the real-time PCR assay with species-specific primer and probe was sensitive enough to detect H. cajani DNA extracted from 0.003 egg or second-stage juvenile.
Description of Ditylenchus acantholimonis n. sp. (Rhabditida: Anguinidae) from Iran, a morphological and molecular phylogenetic study
Authors: Aliverdi Samira , Pourjam Ebrahim , Pedram Majid
Published: July 2021

Ditylenchus acantholimonis n. sp. is described based on morphological, morphometric and molecular characters. It was isolated from the rhizosphere soil of Acantholimon sp. in Golestan province, Iran, and is mainly characterised by having four lines in the lateral field, a pyriform to bottle-shaped offset pharyngeal bulb, post-vulval uterine sac 36.6-56.1% of the vulva to anus distance long, and a subcylindrical to conical tail with widely rounded tip. It is further characterised by short to medium-sized females, 480-617 μm long, with a fine stylet having small rounded knobs, V = 80.8-83.6, c = 11.0-13.8, c′ = 3.3-4.6, and males with 16.0-17.0 μm long spicules. The new species was morphologically compared with six species having four lines in their lateral field, rounded tail tip and comparable morphometric data namely: D. dipsacoideus, D. emus, D. exilis, D. paraparvus, D. sturhani, and D. solani. It was also compared with two species, D. ferepolitor and D. angustus, forming a maximally supported clade in the 18S tree. The phylogenetic analyses using the maximal number of Anguinidae and several Sphaerularioidea genera based upon partial 18S and 28S rDNA D2-D3 sequences revealed that Ditylenchus is polyphyletic. In the 18S tree, the new species formed a clade with D. ferepolitor (KJ636374) and D. angustus (AJ966483); in the 28S tree it formed a poorly supported clade with D. phyllobios (KT192618) and Ditylenchus sp. (MG865719).
The History and Current Position of the Afghanistan’s Sikh Community
Authors: Bonotto Riccardo
Published: July 2021

The Sikhs in Afghanistan are the descendants of one of the non-Muslim communities that have lived in Afghanistan for centuries. Threatened by political insecurity, terrorist attacks and economic problems that have marked the country for several decades, they began in the 1980s a migratory process that has not stopped since then and has considerably reduced their number today. In this article, I will first present the social and historical origins of the Sikh community in Afghanistan, as well as some aspects that can help us to differentiate them from the international Sikh community. We will then see how the Afghan legislation and different versions of the constitution have addressed non-Muslims in general and the Sikh community in particular since the 1920s. Today, Afghan electoral law saves seats for non-Muslim communities’ representatives (Sikhs and Hindus) in parliament. To conclude, we will see how the diaspora of Afghan Sikhs is organized, by exploring the countries where they have been present for four decades and where we can find members of the second or the third generation, as well as countries like France where their presence is much more recent and is still in the integration phase within the host society.
The Anti-Enlightenment Tradition as a Common Framework of Fascism and the Contemporary Far Right
Authors: Ziegler Tamas Dezso
Published: July 2021

The relationship between far-right political streams and fascism is a recurring topic in scientific literature. However, we find a low number of academic publications which try to create a framework for their similarities. This article uses Zeev Sternhell’s theory of fascism as a tool to measure different interpretations of fascism and the far right. According to its basic statement, there exists an anti-Enlightenment tradition in the Western world, which could serve as a substratum of these streams. This proves two points. Firstly, that there are several political groups which share a very similar political vision, even if their levels of aggression and radicalism are different. This is the reason why many neo-fascist, post-fascist, ‘populist’ and conservative parties have interchangeable rhetorical clichés and ideological patterns. Second, it shows that Western countries could successfully fight the rise of upcoming anti-democratic forces through strengthening the values of the Enlightenment-tradition.
‘The Wife Would Put on a Nice Suit, Hat, and Possibly Gloves’: The Misogynistic Identity Politics of Anders Behring Breivik
Authors: Wilhelmsen Fredrik
Published: July 2021

By analysing the anti-feminist and misogynistic narratives in Anders Behring Breivik’s compendium 2083: A European Declaration of Independence, this article argues that Breivik’s counterjihadist worldview can be located both as a permutation of ‘generic fascism’ and as a form of nonegalitarian ‘identity politics’. First, the article reframes and reformulates Nancy Fraser’s concept of identity politics, as it sets Breivik’s ideology in relation to her theory of a ‘politics of recognition’, arguing that her theories – originally developed to analyse left-wing politics – can be used to identify how questions of identity are at the centre of the dynamics of Breivik’s far-right ideology. The article then goes on to demonstrate how Breivik’s misogynist narratives are plotted into a broader fascist conception of history, where the alleged feminised and Islamised present is described as an estrangement from a glorious past dominated by white, European men. As a result, Breivik’s futural palingenetic vision of a ‘European cultural renaissance’ is not only going to resurrect a white, homogenous, ‘Christian’ society, but also restore patriarchy.
Hidden in plain view: an example from Ptilidium (Ptilidiaceae, Marchantiophyta)
Authors: BAKALIN VADIM , VILNET ANNA , KLIMOVA KSENIA , MA WEN ZHANG , CHOI SEUNG SE , HENTSCHEL JÖRN
Published: July 2021

Ptilidium ciliare is so common in the North Holarctic and hypothetically morphologically uniform that possible diversification may have been overlooked. Previous results however showed the presence of “cryptic” diversity within the species. In the present investigation we show: 1) this diversity is not cryptic, 2) the taxon we describe as P. himalayanum has at least a Sino-Himalayan range, and 3) it occupies a morphologically intermediate position between what has traditionally been treated as P. ciliare and P. pulcherrimum. Both latter taxa are only slightly diverged genetically, and sometimes morphological discrimination is challenging such that both are better treated as varieties or subspecies within a single species.
Madhuca balakrishnanii (Sapotaceae), a new species from Kerala, India
Authors: KUMAR ETTICKAL SUKUMARAN SANTHOSH , SHAILAJAKUMARI SREEDHARAN , SHAREEF SAINUDEEN MUHAMMED
Published: July 2021

Madhuca balakrishnanii (Sapotaceae), a new species from Kerala is here described with photographs. It is most closely similar to M. diplostemon and M. insignis but differs in having long stipules, sparsely hairy pedicels, abaxially hairy inner sepals, shorter corolla tubes with oblong lobes, fairly long densely hairy staminal filaments, shorter styles and ovoid fruits. The IUCN conservation status, ecology, distribution and phenology along with a key for the identification of Madhuca species in the Western Ghats is provided.
New genus and new species of leaf-mimic pygmy grasshoppers from China (Orthoptera: Tetrigidae: Cladonotinae)
Authors: DENG WEI-AN
Published: July 2021

Many species of pygmy grasshoppers (Tetrigidae) exhibit leaf-like appearance, leaf-mimic pygmy grasshoppers mainly characterized by having high pronotal crest (= elevated median carina). A new genus of leaf-mimic Cladonotinae, Deltonotusoides gen. nov., and a new species, Deltonotusoides strictivertex sp. nov. are described from Motuo, Xizang, China.
Exploring the Use of Standardized Soil Moisture as a Drought Indicator
Authors: Leeper Ronald D. , Petersen Bryan , Palecki Michael A. , Diamond Howard
Published: July 2021

Agricultural drought has traditionally been monitored using indices that are based on above-ground measures of temperature and precipitation that have lengthy historical records. However, the period-of-record length for soil moisture networks is becoming sufficient enough to standardize and evaluate soil moisture anomalies and percentiles that are spatially and temporally independent of local soil type, topography, and climatology. To explore these standardized measures in the context of drought, the U.S. Climate Reference Network hourly standardized soil moisture anomalies and percentiles were evaluated against changes in the U.S. Drought Monitor (USDM) status, with a focus on onset, worsening, and improving drought conditions. The purpose of this study was to explore time scales (i.e., 1–6 weeks) and soil moisture at individual (i.e., 5, 10, 20, 50, and 100 cm) and aggregated layer (i.e., top and column) depths to determine those that were more closely align with evolving drought conditions. Results indicated that the upper-level depths (5, 10, and 20 cm, and top layer aggregate) and shorter averaging periods were more responsive to changes in USDM drought status. This was particularly evident during the initial and latter stages of drought when USDM status changes were thought to be more aligned with soil moisture conditions. This result indicates that standardized measures of soil moisture can be useful in drought monitoring and forecasting applications during these critical stages of drought formation and amelioration.