bluuebunny/crossref_metadata_2025 huggingface dataset:
P20.03.A PREDICTING THE CLINICAL PHENOTYPE INNF2 RELATED SCHWANNOMATOSIS PATIENTS USING NEW GENETIC SCORES
Authors: Paterra R , Borghi A , Rosati N , Ibba M , Menicatti D , Moscatelli M , Vetrano I , Saini M , Nazzi V , Silvani A , Eoli M
Published: September 2023

BACKGROUND

NF2 related Schwannomatosis (NF2 -SCHW MIM # 101000) is a rare autosomal dominant familial cancer syndromes caused by mutations in the NF2 gene, mainly due to NF2 point mutations or intragenic deletions. NF2 patients. In 95% of patients, bilateral vestibular schwannomas are present, but NF2 -SCHW patients can develop other tumors and show ophthalmic and dermatological signs. Several studies established a genotype-phenotype correlations; the UK NF2 Reference Group proposed a Genetic Severity Score (GSS) based on the type and location of NF2 germline variant observed. Catasus et al. after validation of the score in a Spanish cohort suggested a new score based also on a functional assay of Merlin and its downstream pathways (FGSS). Recently Teranish et al. used targeted deep sequencing to predict functional prognosis in those patients.

MATERIAL AND

methods 70 patients (median age 40) were identified by scanning the electronic NF2-SCHW patient database at Fondazione IRCCS C. Besta, where the patients had undergone full neurological, ophthalmic, and audiological assessment. The median follow-up was 14 yrs. Clinical diagnosis was established following the Updated diagnostic criteria and nomenclature for neurofibromatosis type 2 and schwannomatosis”. All patients underwent NF2, SMARCB1 and LZTR1 mutational screening by NGS and MPLA analysis using blood DNA or the tissue of two different tumors when available.NF2 gene germline pathogenic were found in 45 subjects (64%), in most cases NF2 point mutations, but in 4 cases and whole gene deletions was observed and in 2 a ring NF2 chromosome was identified, in four cases a mosaic NF2-SCH was identified and in 21 (30%) patients no pathogenic variant was found. We assessed NF2-SCHW clinical phenotype in relation to the UK GSS and FGSS to validate their use as clinical and research tools, despite the significant phenotypic variability observed.

RESULTS

The disease outcome differed significantly depending both on clinicaland genetic factors. Among these factors,” Age of symptom onset” “Truncating”, “Mosaic”, and “whole gene deletion” had the most significant effects on functional disability. Conclusion GSS and FGSS showed significant correlation with several measures, allowing stratification of patients with severe and mild disease but not with moderate phenotype. Furthermore, we provided evidence on correlation between whole NF2 deletion extent and phenotype severity. Large cohorts of NF2-SCHW patients are needed to identify more accurate scores, becoming useful tools for patient management.
P20.04.B DIAGNOSIS AND TREATMENT OF PERIPHERAL AND CRANIAL NERVE TUMORS WITH EXPERT RECOMMENDATIONS: AN EUROPEAN NETWORK FOR RARE CANCERS (EURACAN) INITIATIVE
Authors: Pellerino A , Verdijk R , Nichelli L , Andratschke N , Idbaih A , Goldbrunner R
Published: September 2023

BACKGROUND

The 2021 WHO classification of the CNS Tumors identifies as “Peripheral nerve sheath tumors” (PNST) some entities with specific clinical and anatomical characteristics, histological and molecular markers, imaging findings, and aggressiveness.

MATERIAL AND METHODS

The Task Force has reviewed the evidence of diagnostic and therapeutic interventions, which is particularly low due to the rarity, and drawn recommendations accordingly.

RESULTS

Tumor diagnosis is primarily based on hematoxylin and eosin-stained sections and immunohistochemistry. Molecular analysis is not essential to establish the histological nature of these tumors, although genetic analyses on DNA extracted from PNST (neurofibromas/schwannomas) is required to diagnose mosaic forms of NF1 and SPS. MRI is the gold-standard to delineate the extension with respect to adjacent structures. Gross-total resection is the first choice, and can be curative in benign lesions; however, the extent of resection must be balanced with preservation of nerve functioning. Radiotherapy can be omitted in benign tumors after complete resection and in NF-related tumors, due to the theoretic risk of secondary malignancies in a tumor-suppressor syndrome. Systemic therapy should be considered in incomplete resected plexiform neurofibromas/MPNSTs. MEK inhibitor selumetinib can be used in NF1 children ≥2 years with inoperable/symptomatic plexiform neurofibromas, while anthracycline-based treatment is the first choice for unresectable/locally advanced/metastatic MPNST. Clinical trials on other MEK1-2 inhibitors alone or in combination with mTOR inhibitors are under investigation in plexiform neurofibromas and MPNST, respectively.

CONCLUSION

Given the heterogeneity and rarity of these tumors, there is a paucity of well-powered clinical trials, thus it is not possible to generate evidence-based treatment recommendations for non-surgical modalities. However, some clinical trials have been reported on targeted therapies in plexiform neurofibromas of NF1 patients or in heterogenous cohorts of soft-tissue tumors, including MPNSTs, with initial data of efficacy that need to be further investigated.
P21.05.B CAPTURING EVOLVING DEFINITIONS OF 12 SELECT RARE CNS TUMORS: A TIMELY REPORT FROM CBTRUS AND NCI-CONNECT
Authors: Price M , Neff C , Kruchko C , Waite K , Cioffi G , Barnholtz-Sloan J , Cordeiro B , Cimino P J , Gilbert M R , Armstrong T S , Ostrom Q
Published: September 2023

BACKGROUND

Histopathology-specific incidence, prevalence, and survival are essential population-based cancer statistics that describe cancer burden. The National Cancer Institute’s Comprehensive Oncology Network Evaluating Rare CNS Tumors (NCI-CONNECT) aims to improve understanding of tumor biology and patient outcomes for 12 selected rare brain and other central nervous system (CNS) tumor types to improve approaches to care and treatment. These types included atypical teratoid/rhabdoid tumor, brainstem and midline gliomas, choroid plexus tumors, ependymomas, high grade meningiomas, gliomatosis cerebri, medulloblastoma, oligodendrogliomas, pineal region tumors, pleomorphic xanthoastrocytomas, CNS embryonal tumors, NEC/NOS and primary CNS sarcoma. The analysis aimed to estimate the incidence (new cases per year), prevalence (currently living cases), and survival rates for these selected rare brain and other CNS tumor types.

MATERIAL AND METHODS

The Central Brain Tumor Registry of the United States (CBTRUS) data, which contains data from the Centers for Disease Control and Preventions National Program of Cancer Registries (NPCR) and National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) data, from 2008-2019 were used to calculate average annual age-adjusted incidence rates (AAAIR) per 100,000 population overall and by sex, race/ethnicity, and age. Incidence time trends were calculated for diagnosis years 2004-2019. NPCR survival data from 2001-2018 were used to calculate relative survival (RS) estimates. Estimated prevalence counts as of December 31, 2019 were estimated using incidence from CBTRUS and overall survival rates from SEER.

RESULTS

Overall AAAIR for all 12 subtypes combined was 1.51 per 100,000 population, with the highest subtype-specific incidence in ependymomas (AAAIR=0.41/100,000). Overall, most subtypes were more common in males and people who are non-Hispanic White. Incidence of all subtypes varied by age. Ependymomas were most prevalent with 19,339 cases; followed by oligodendrogliomas with 15,070 cases. Time trends in incidence varied by subtype, with significant decreases in incidence of gliomatosis cerebri, CNS embryonal tumor, and primary CNS sarcoma. RS for all subtypes combined at 1, 5, and 10 years was 86.6%, 71.9%, and 65.3%, respectively. Ependymomas had the highest RS (1-year=96.1%, 5-years=90.6%, 10-years=86.6%) and primary CNS sarcomas had the lowest RS (1-year=48.2%, 5-years=7.7%, 10-years=5.2%).

CONCLUSION

Incidence, prevalence, and survival patterns for these 12 selected rare cancer subtypes varied significantly by type. Population based data are critical to guiding effective design of and accrual expectations for clinical trials in rare cancers.
P21.07.B THE LHSC/WESTERN BRAIN TUMOUR TISSUE BANK: A GLOBAL RESOURCE
Authors: Megyesi J , Wang R , White M , Ranger A , Ramsay D , Zhang Q
Published: September 2023

BACKGROUND

A brain tumour tissue bank can serve as an important source of tissue for neuro-oncology research. The London Health Sciences (LHSC) / Western Brain Tumour Tissue Bank (BTTB) provides high-quality brain tumour tissue specimens that are used globally for neuro-oncology research. The LHSC / Western BTTB was established approximately 35 years ago. The objectives of this study were to: 1) establish an up-to-date accounting of the brain tumour specimens in the BTTB; 2) compare the quality control measures used to assess specimen quality against those used in other comparable tissue banks; 3) determine the scope of tissue distribution globally.

MATERIAL AND METHODS

The records of the BTTB were reviewed with the assistance of the BTTB coordinator. Number and type of brain tumour specimens were recorded. The quality control measures used in the BTTB were compared with the published literature. The location of laboratories to which brain tumour tissue had been distributed was determined.

RESULTS

Since 1995 there have been 1536 adult brain tumour specimens collected in the BTTB. There are approximately 3 vials per case, not including paraffin blocks. This includes 713 primary intra-axial central nervous system tumours, 229 meningeal tumours, and 285 metastatic tumours. Since 1995 there have been 223 pediatric brain tumour specimens collected in the BTTB. This includes 53 pilocytic astrocytomas, 32 medulloblastomas, and 27 ependymomas. The quality control measures used in the BTTB appear to exceed those used by other brain tumour tissue banks as determined by literature review. The BTTB has sent tissue specimens to neuro-oncology laboratories around the globe and numerous publications have resulted from experiments using the brain tumour tissue supplied by the BTTB.

CONCLUSION

The LHSC / Western BTTB has collected a large and diverse number of high quality brain tumour specimens since its founding. It serves as a global resource, and the supplied tissue has led to many research publications in neuro-oncology.
P22.04.B THE VALUE OF A NURSE CARE COORDINATOR WORKING WITH YOUNG BRAIN TUMOR PATIENTS IN THE NEUROSURGICAL OUTPATIENT CLINIC
Authors: Bruun-Pedersen M , Guldager R , Nordentoft S M J , Skjøth-Rasmussen J
Published: September 2023

BACKGROUND

When young people between 18-35 are diagnosed with a brain tumor, it often has significant impact on their lives. In that period the young person is often in their process of building their lives, with little to no mental preparation on perspectives towards end of life. The aim of this study is to measure the value of a Nurse Care Coordinator, working with young brain tumor patients in the Neurosurgical Outpatient Clinic.

MATERIAL AND METHODS

The Nurse Care Coordinators function is to support and guide the young patients, from getting the diagnosis with a brain tumor and through their disease and treatment. The Nurse Care Coordinator meets the young patient and relatives several times from before surgery, and for as long as needed, depending on the patients’ individual situation. The relation and interactions with the young patients are very individually approached. However, the fundamental approach to all young patients includes regular weekly phone calls, which eventually become monthly conversations or personal meetings in the Outpatient Clinic, all depending on the topic and young patient’s preferences. Areas where the Nurse Care Coordinator can assist the young patients includes general overviews of their disease and treatment course, assist where barriers may arise and ensuring correct rehabilitation for the young patients, offering an elaborating conversation on the diagnosis, or discuss solutions with external parties on behalf of the patient. To measure the value of the Nurse Care Coordinator, young patients (n=20) were provided with a questionnaire with four Likert scale items. In addition, they received a phone call from a Research Nurse, asking the open-ended question; “What is your opinion of the function of a Nurse Care Coordinator, and what are the areas where the Nurse Care Coordinator could carry out her role better or differently?”

RESULTS

Both the quantitative results from the questionnaire and the open-ended qualitative responses from the young patients, showed that the function of the Nurse Care Coordinator provided both value and meaning to the young patients. Responses included references to the perception of safety (as opposed to anxiety), a sense of familiarity and comfort (during chaotic and unfamiliar processes), and a constructive approach to patient enquiry (providing help and effective assistance).

CONCLUSION

The role of a Nurse Care Coordinator has increased focus on the young patients with a brain tumor in the Neurosurgical Clinic. It has also contributed to a higher degree of multidisciplinary workflows around the young patients and great satisfaction for the young patients.
Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021–July 2022
Authors: Plumb Ian D , Mohr Nicholas M , Hagen Melissa , Wiegand Ryan , Dumyati Ghinwa , Harland Karisa K , Krishnadasan Anusha , Gist Jade James , Abedi Glen , Fleming-Dutra Katherine E , Chea Nora , Lee Jane , Barter Devra , Brackney Monica , Fridkin Scott K , Wilson Lucy E , Lovett Sara A , Ocampo Valerie , Phipps Erin C , Marcus Tiffanie M , Smithline Howard A , Hou Peter C , Lee Lilly C , Moran Gregory J , Krebs Elizabeth , Steele Mark T , Lim Stephen C , Schrading Walter A , Chinnock Brian , Beiser David G , Faine Brett , Haran John P , Nandi Utsav , Chipman Anne K , LoVecchio Frank , Talan David A , Pilishvili Tamara
Published: September 2023

Background

Protection against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019 [COVID-19]) can limit transmission and the risk of post-COVID conditions, and is particularly important among healthcare personnel. However, lower vaccine effectiveness (VE) has been reported since predominance of the Omicron SARS-CoV-2 variant.

Methods

We evaluated the VE of a monovalent messenger RNA (mRNA) booster dose against COVID-19 from October 2021 to June 2022 among US healthcare personnel. After matching case-participants with COVID-19 to control-participants by 2-week period and site, we used conditional logistic regression to estimate the VE of a booster dose compared with completing only 2 mRNA doses >150 days previously, adjusted for multiple covariates.

Results

Among 3279 case-participants and 3998 control-participants who had completed 2 mRNA doses, we estimated that the VE of a booster dose against COVID-19 declined from 86% (95% confidence interval, 81%–90%) during Delta predominance to 65% (58%–70%) during Omicron predominance. During Omicron predominance, VE declined from 73% (95% confidence interval, 67%–79%) 14–60 days after the booster dose, to 32% (4%–52%) ≥120 days after a booster dose. We found that VE was similar by age group, presence of underlying health conditions, and pregnancy status on the test date, as well as among immunocompromised participants.

Conclusions

A booster dose conferred substantial protection against COVID-19 among healthcare personnel. However, VE was lower during Omicron predominance, and waning effectiveness was observed 4 months after booster dose receipt during this period. Our findings support recommendations to stay up to date on recommended doses of COVID-19 vaccines for all those eligible.
Biomarker Testing Trends in Patients With Metastatic Colorectal Cancer Who Live in Rural Areas and Urban Clusters in the US
Authors: Lewis Mark A , Stansfield Lindsay , Kelton John M , Lieu Christopher H
Published: September 2023

Background

There is a paucity of data on biomarker testing rates in rural populations with metastatic colorectal cancer (mCRC). To assess biomarker testing practices, oncologists in rural areas and urban clusters in the US were surveyed.

Materials and Methods

A web-based survey was administered to oncologists spending ≥40% of their time practicing in rural areas or urban clusters and who had treated ≥2 patients with stage IV mCRC in the prior month.

Results

Ninety-nine oncologists completed the quantitative survey and 17 the qualitative interview. Among respondents, 97% reported ordering biomarker tests. Oncologists reported testing for KRAS, NRAS, BRAF, HER2, and mismatch repair deficiency/microsatellite instability in 72%, 65%, 63%, 56%, and 66% of patients with metastatic disease, respectively. Forty-one percent reported performing reflex testing. The most cited testing barriers were lack of insurance coverage, insufficient tissue samples, and long turnaround times.

Conclusion

Further assessment of rural testing practices is needed.
Development and initial validation of the menstrual sensitivity index
Authors: Handy Ariel B , Seidman Laura C , Payne Laura A
Published: September 2023

Objective

The present study sought to develop and perform the initial validation of a scale assessing sensitivity to menstrual pain and symptoms.

Methods

Data were taken from a larger parent study in which participants were recruited from a nationwide sample of individuals via the UniVox platform (www.univoxcommunity.com). In that study, participants were stratified by age and self-reported menstrual pain. Participants in the parent study completed 2 online surveys, one at baseline and one at a 3-month follow up. Participants who provided complete responses to the potential scale items, as well as a variety of validated questionnaires, were included in the present analyses. Final item selection was determined by factor analyses, and measures of validity and reliability were examined.

Results

Factor analyses support an 8-item scale assessing menstrual sensitivity. This scale, the Menstrual Sensitivity Index, demonstrates excellent internal consistency, good item–total correlations, and good total score test–retest reliability. Convergent validity emerged for menstrual- and pain-specific measures, and divergent validity emerged for anxiety sensitivity, anxiety, depression, nonmenstrual bodily pain, and premenstrual symptoms.

Conclusions

Menstrual sensitivity is a unique construct that reflects women’s attunement to and fear of menstrual symptoms, and the Menstrual Sensitivity Index is a valid and reliable measure of this construct. This scale could be useful in advancing research and clinical work targeting menstrual pain.
Evaluating the risk of sepsis attributing to obesity: a two-sample Mendelian randomization study
Authors: Hu Jing , Gan Quan , Zhou Dong , Xia Xing , Xiang Wei , Xiao Rong , Tang Jing , Li Jie
Published: September 2023

Background

Sepsis is a reaction to infection with high morbidity and mortality. It has been noted that patients with obesity were more likely to suffer from sepsis. However, the causality remains elucidating, as reverse causality and residual confounding could not be largely mitigated in conventional observational studies.

Objective

To evaluate the risk of sepsis attributed to obesity phenotypes including body mass index (BMI), waist circumstance (WC), and WC adjusted for BMI (WCadjBMI) in a causal way.

Methods

We conducted a two-sample Mendelian randomization (MR) study using large-scale genome-wide association study summary data with sample sizes ranging from 231 353 to 486 484. The inverse-weighted variance (IVW) was conducted as the primary approach. We also used the weighted median and MR-Egger for causal inference. A sensitivity analysis was conducted to evaluate the reliability of the MR estimates.

Results

IVW detected that genetic liability for increased BMI [odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.20–1.63, P = 1.52 × 10–5] and WC (OR = 1.02, 95% CI = 1.01–1.03, P = 4.28 × 10−3) predicted a higher risk of sepsis. No evidence was observed for a causal effect of WCadjBMI on sepsis risk (OR = 1.01, 95% CI = 1.00–1.02, P = 0.08). Sensitivity analysis did not identify any bias in the MR results.

Conclusion

This MR study showed that obesity contributed to an increased risk of sepsis, indicating that obesity management might be beneficial for reducing sepsis risk.

Key messages What is already known on this topic—Observational studies have reported the association between obesity and sepsis, but the causality has not been determined. What this study adds—This Mendelian randomization study demonstrated that obesity-related phenotypes, including body mass index and Waist circumstance, causally increased the risk of sepsis. How this study might affect research, practice, or policy—The findings of our study might have an implication for clinicians that obesity management might be a promised strategy for reducing the risk of sepsis.
Accuracy of Video-Based Gait Analysis Using Pose Estimation During Treadmill Walking Versus Overground Walking in Persons After Stroke
Authors: John Kristen , Stenum Jan , Chiang Cheng-Chuan , French Margaret A , Kim Christopher , Manor John , Statton Matthew A , Cherry-Allen Kendra M , Roemmich Ryan T
Published: September 2023

Objective

Video-based pose estimation is an emerging technology that shows significant promise for improving clinical gait analysis by enabling quantitative movement analysis with little costs of money, time, or effort. The objective of this study is to determine the accuracy of pose estimation-based gait analysis when video recordings are constrained to 3 common clinical or in-home settings (ie, frontal and sagittal views of overground walking and sagittal views of treadmill walking).

Methods

Simultaneous video and motion capture recordings were collected from 30 persons after stroke during overground and treadmill walking. Spatiotemporal and kinematic gait parameters were calculated from videos using an open-source human pose estimation algorithm and from motion capture data using traditional gait analysis. Repeated-measures analyses of variance were then used to assess the accuracy of the pose estimation-based gait analysis across the different settings, and the authors examined Pearson and intraclass correlations with ground-truth motion capture data.

Results

Sagittal videos of overground and treadmill walking led to more accurate measurements of spatiotemporal gait parameters versus frontal videos of overground walking. Sagittal videos of overground walking resulted in the strongest correlations between video-based and motion capture measurements of lower extremity joint kinematics. Video-based measurements of hip and knee kinematics showed stronger correlations with motion capture versus ankle kinematics for both overground and treadmill walking.

Conclusion

Video-based gait analysis using pose estimation provides accurate measurements of step length, step time, and hip and knee kinematics during overground and treadmill walking in persons after stroke. Generally, sagittal videos of overground gait provide the most accurate results.

Impact

Many clinicians lack access to expensive gait analysis tools that can help identify patient-specific gait deviations and guide therapy decisions. These findings show that video-based methods that require only common household devices provide accurate measurements of a variety of gait parameters in persons after stroke and could make quantitative gait analysis significantly more accessible.
Double-crosslinked PNIPAM-based hydrogel dressings with adjustable adhesion and contractility
Authors: Cao Yu , Wang Longfei , Zhang Xiumei , Lu Yi , Wei Yan , Liang Ziwei , Hu Yinchun , Huang Di
Published: September 2023

Rapid post-wound closure is necessary to avoid wound infection and promote scar-free healing when skin trauma occurs. In this study, new types of hydrogel dressings with adjustable contractility were fabricated based on N-isopropyl acrylamide/sodium alginate/graphene oxide (P/SA/GO). Then, the chitosan (CS) solution was used as a bridging polymer to achieve tissue adhesion to the hydrogel. The results show that the hydrogel based on poly(N-isopropyl acrylamide) (PNIPAM) not only has the ability to self-shrink but also can adjust the rate of shrinkage through near-infrared thermal stimulation. At the same time, high adhesion strength (7.86 ± 1.22 kPa) between the tissue and the dressing is achieved through the introduction of bridging polymers (CS), and the coating area of the bridging polymer can be adjusted to achieve regional adhesion. The mouse total skin defects experiments have shown that sutures-free wound closure in the early stages of wound healing could be obtained by adjusting the material temperature. Besides, the dressings can promote scar-free wound healing by reducing inflammatory cell infiltration and collagen deposition. These results indicate that double-crosslinked PNIPAM-based hydrogel dressings with adjustable adhesion and contractility proposed in this study provide a candidate material for achieving trackless wound healing.
Minimum Wage Employment Effects and Labour Market Concentration
Authors: Azar José , Huet-Vaughn Emiliano , Marinescu Ioana , Taska Bledi , von Wachter Till
Published: September 2023

This paper shows that more highly concentrated labour markets experience more positive employment effects of the minimum wage. In the most concentrated labour markets, employment rises following a minimum wage increase. The paper establishes its main findings by studying the effects of local minimum wage increases on a key low-wage retail sector, and using data on labour market concentration that covers the entirety of the U.S. with fine spatial variation at the occupation level. The results carry over to the fast-food sector and the entire low-wage labour market and are robust to using proxies of labour market concentration available for a broader range of industries, such as the number of establishments and population density. A model of oligopsonistic competition can explain these effects: there is more room to increase wages in high-concentration areas where wages tend to be further below marginal productivity. These findings provide evidence supporting monopsonistic wage setting as an explanation for the near-zero minimum wage employment effect documented in prior work.
The developmental trajectory of sleep in children with Smith-Magenis syndrome compared to typically developing peers: a 3-year follow-up study
Authors: Agar Georgie , Oliver Chris , Spiller Jayne , Richards Caroline
Published: September 2023

Study Objectives

To determine the trajectory of: (i) objective sleep parameters and (ii) caregiver-reported sleep questionnaire scores over 3 years in children with Smith-Magenis syndrome (SMS) compared to age-matched typically developing (TD) controls. We also aimed to (iii) describe individual profiles of change in sleep parameters over time.

Methods

Week-long, overnight actigraphy and questionnaire data from 13 children with SMS and 13 age-matched TD children were collected at Time 1 and Time 2 (3 years later). Independent samples t-tests, paired samples t-tests, and Bayesian analyses were used to compare sleep parameters and sleep questionnaire scores between groups at each time point and compare data within groups to assess change over time.

Results

Sleep parameters were consistently more disrupted in the SMS group than the TD group, with significantly reduced sleep efficiency, increased wake after sleep onset and earlier get up times at both time points. This was mirrored in the questionnaire data, with children with SMS evidencing higher scores for overall sleep disturbance, night waking, and daytime sleepiness. While TD sleep parameters demonstrated expected developmental changes over 3 years, in the SMS group sleep parameters and variability between and within children remained largely stable. However, some children with SMS showed substantial variation in sleep parameters over time. Questionnaire scores remained stable over 3 years in both groups.

Conclusions

Overall, sleep disturbance appears to be a stable feature of SMS, indicative of a divergent sleep trajectory compared to TD peers. Proactive intervention approaches should be considered for poor sleep in SMS.
Adaptations to a statewide walking program: Use of iterative feedback cycles between research and delivery systems improves fit for over 10 years
Authors: Frazier Mary C , Balis Laura E , Armbruster Shannon D , Estabrooks Paul A , Harden Samantha M
Published: September 2023

FitEx is an 8-week, group-based physical activity and fruit and vegetable consumption program co-created and implemented with the Cooperative Extension System. Effectiveness and delivery personnel perceptions of the program are promising; however, ongoing adaptations are required to continuously meet shifting needs of both researchers and delivery systems. We applied the APDER iterative cycles of implementation over 15 years to understand dynamic and ongoing adaptations as well as implications for FitEx sustainability. Each year, an IRPP between delivery (FitEx deliverers) and research (FitEx developers) systems shared feedback on program core elements and strategies for adaptation through regular team meetings, emails, and evaluations. While the core elements (delivering to groups, goal setting, feedback, and self-monitoring) of FitEx remained consistent, changes were made to address logistical factors, emergent research questions, and technological advancements. For example, program deliverers suggested decreasing training time and making program content available on demand rather than through traditional in-person training. Using APDER with a long-standing IRPP allowed the delivery system to provide feedback to program developers to co-create ongoing adaptations and data-driven decisions. Future work in response to shifting needs includes Fitbit integration and technological updates to the usability of the FitEx platform. Our aim is to report the 15+ years of applying the Assess, Plan, Do, Evaluate, Report (APDER) process with an integrated research–practice partnership (IRPP) for co-creation of ongoing adaptations of FitEx and to share methods for capturing relevant data for decision-making to integrate health promotion programs in community settings.
Identification and Fungicide Screening of Fungal Species Associated with Walnut Anthracnose in Shaanxi and Liaoning Provinces, China
Authors: Fan Kun , Qi Yu-Kun , Fu Li , Li Li , Liu Xing-Hong , Qu Jian-Lu , Li De-Wei , Dong Ai-Xin , Peng Yi-Ji , Wang Qing-Hai
Published: September 2023

Walnut is cultivated around the world for its precious woody nut and edible oil. Recently, walnut infected by Colletotrichum spp. resulted in a great yield and quality loss. In August and September 2014, walnut fruits with anthracnose were sampled from two commercial orchards in Shaanxi and Liaoning provinces, and five representative isolates were used in this study. To identify the pathogen properly, four genes per region (internal transcribed spacer, glyceraldehyde-3-phosphate dehydrogenase, actin, and chitin synthase) were sequenced and used in phylogenetic studies. Based on multilocus phylogenetic analysis, five isolates clustered with Colletotrichum fioriniae, including its ex-type, with 100% bootstrap support. The results of multilocus phylogenetic analyses, morphology, and pathogenicity confirmed that C. fioriniae was one of the walnut anthracnose pathogens in China. All 13 fungicides tested inhibited mycelial growth and spore germination. Flusilazole, fluazinam, prochloraz, and pyraclostrobin showed the strongest suppressive effects on the mycelial growth than the others, the average EC50 values ranged from 0.09 to 0.40 μg/ml, and there was not any significant difference (P < 0.05). Pyraclostrobin, thiram, and azoxystrobin were the most effective fungicides on spore germination (P < 0.05), and the EC50 values ranged from 0.01 to 0.44 μg/ml. Pyraclostrobin, azoxystrobin, fluazinam, flusilazole, mancozeb, thiram, and prochloraz exhibited a good control effect on walnut anthracnose caused by C. fioriniae, and preventive activities were greater than curative activities. Pyraclostrobin at 250 a.i. μg/ml and fluazinam at 500 a.i. μg/ml provided the highest preventive and curative efficacy, and the values ranged from 81.3 to 82.2% and from 72.9 to 73.6%, respectively. As a consequence, mancozeb and thiram could be used at the preinfection stage, and pyraclostrobin, azoxystrobin, flusilazole, fluazinam, and prochloraz could be used at the early stage for effective prevention and control of walnut anthracnose caused by C. fioriniae. The results will provide more significant instructions for controlling the disease effectively in northern China.
Cost-per-Response Analysis of Pure Hypochlorous Acid Among Patients with Chronic Venous Leg Ulcers: A Health Economic Analysis
Authors: Niezgoda Jeffrey A. , Niezgoda Jonathan A. , Niezgoda Kathleen M. , Mallow Peter J.
Published: September 2023

OBJECTIVE

To estimate the total cost-per-wound healing response (CPR) and the per-day CPR of patients with chronic leg ulcers treated with pure hypochlorous acid (pHA) as part of their overall would healing regimen.

METHODS

The authors developed a deterministic decision-tree model to estimate the incremental CPR for pHA. The analysis was performed using clinical data from a published single-arm prospective study. The outcome of interest was re-epithelialization at 90 days. Economic data for pHA were based on public prices of pHA per dressing change from the wound care center perspective. The following time points were assessed: 90, 60, and 30 days. Dressing changes occurred every 2.5 days. Sensitivity analysis was performed to gauge the robustness of the results.

RESULTS

A total of 31 patients (68% women) with 31 lesions (average age of wound, 29 months; range, 1-240 months) were included in the clinical study. Re-epithelialization occurred in 23 lesions (74%) at 90 days, 17 (55%) at 60 days, and 3 (10%) at 30 days. The total CPRs were $75.69, $68.27, and $193.44, and the per-day CPRs were $0.84, $1.13, and $6.45 at 90, 60, and 30 days, respectively. The sensitivity analysis revealed that CPRs ranged from $0.63 to $1.12 per day at 90 days.

CONCLUSIONS

Incorporating pHA into standard wound healing protocols is a minimal added expense and may yield a substantial economic savings of $2,695 at 90 days.
Epidemiology trends and progress in breast cancer survival: earlier diagnosis, new therapeutics
Authors: Amato Ottavia , Guarneri Valentina , Girardi Fabio
Published: September 2023

Purpose of review

In this review we will critically appraise the latest evidence on breast cancer (BC) survival trends and discuss how these may reflect breakthroughs in early diagnosis and treatment approaches. We will address the wide global inequalities in BC survival and review the ongoing initiatives aimed at improving cancer control worldwide.

Recent findings

BC outcomes have improved in high-income countries during the last decades, following the implementation of strategies for early detection and optimal multimodality treatment. Novel therapeutics, such as anti-HER2 targeted treatments, have also contributed to the progress in BC survival. However, BC mortality is still high in low-income countries, due to the lack of optimal healthcare infrastructures. In the context of marked inequities in BC management across world regions, international collaborations such as the Global Breast Cancer Initiative and the Global Initiative for Cancer Registry Development work to foster capacity-building in developing countries, tackle the burden of BC and deliver the Sustainable Development Goals by 2030.

Collection of robust, high-quality data from population-based cancer registries is crucial to drive and refine public health interventions. Population-based data are also the litmus paper to evaluate the real-world impact of clinical advances and monitor progress.
Recurrence Risk Stratification for Women With FIGO Stage I Uterine Endometrioid Carcinoma Who Underwent Surgical Lymph Node Evaluation
Authors: Ghanem Ahmed I. , Bhatnagar Aseem , Elshaikh Muneer , Hijaz Miriana , Elshaikh Mohamed A.
Published: September 2023

Objective:

The aim of this study was to estimate the recurrence risk based on the number of prognostic factors for patients with stage I uterine endometrioid carcinoma (EC) who underwent surgical lymph node evaluation (SLNE) and were managed with observation.

Methods:

We queried our database for women with FIGO-2009 stage I EC who underwent surgical staging including SLNE. Multivariate analysis with stepwise model selection was used to determine independent risk factors for 5-year recurrence-free survival (RFS). Study groups based on risk factors were compared for RFS, disease-specific survival, and overall survival.

Results:

A total of 706 patients were identified: median age was 60 years (range, 30 to 93 y) and median follow-up was 120 months. Median number of examined lymph nodes was 8 (range, 1 to 66). 91% were stage IA, 75% had grade 1 and lymphovascular space invasion was detected in 6%. Independent predictors of 5-year RFS included age 60 years and above (P=0.038), grade 2 (P=0.003), and grade 3 (P<0.001) versus grade 1. Five-year RFS for group 0 (age less than 60 y and grade 1) was 98% versus 92% for group 1 (either: age 60 y and older or grade 2/3) versus 84% for group 2 (both: age 60 y and above and grade 2/3), respectively (P<0.001). Five-year disease-specific survival was 100% versus 98% versus 95%, (P=0.012) and 5-year overall survival was 98% versus 90% versus 81%, for groups 0, 1, and 2, respectively (P<0.001).

Conclusions:

In patients with stage I EC who received SLNE and no adjuvant therapy, only age 60 years and above and high tumor grade were independent predictors of recurrence and can be used to quantify individualized recurrence risk, whereas lymphovascular space invasion was not an independent prognostic factor in this cohort.
Social Distancing in the COVID-19 Pandemic
Authors: Liu Jianghong , Ouyang Na , Mizrahi Alina , Kornides Melanie L.
Published: September 2023

Social distancing has reemerged as a public health measure for containing the spread of COVID-19. This integrative review aims to analyze the historical use of social distancing, the current application during COVID-19, individual factors that affect social distancing practices, and consequential health outcomes. We analyzed relevant literature from searches conducted on Scopus, PubMed, and PsycINFO. We found that resources, culture, age, gender, and personality are associated with the degree to which people practice social distancing. Furthermore, social distancing changes our lifestyles and behavior and results in multifaceted health outcomes, including decreased physical activity and sunlight exposure, increased weight gain, and impaired sleep quality. On the positive side, social distancing has been linked to reduced crime rates and environmental damage, as well as better social and family ties. Future interventions may be utilized to increase adherence to social distancing practices and to mitigate the negative health effects of social distancing.
TESTOSTERONE-INDUCED CENTRAL SEROUS CHORIORETINOPATHY MIMICKING A CHOROIDAL MASS
Authors: Kornblau Ilyse S. , Pritchett David Y. , Wilson Matthew W.
Published: September 2023

Purpose:

The purpose of this study was to describe a case of supplemental testosterone-induced central serous chorioretinopathy (CSCR) mimicking a choroidal mass in a 63-year-old man.

Methods:

This is a case report on a 63-year-old male patient on self-prescribed supplemental testosterone with CSCR mimicking a choroidal mass.

Results:

A 63-year-old man presented with new-onset vision loss, subretinal fluid, and choroidal mass in his left eye. IV fluorescein angiography showed an enhancing choroidal mass involving the fovea. B-scan ultrasonography revealed diffuse choroidal thickening. Given concern for a diffuse uveal melanoma, the lesion was biopsied showing nondiagnostic rare, atypical melanocytes. Four months after initial presentation, the patient was diagnosed with polycythemia vera. Fourteen months after diagnosis, he admitted to testosterone supplementation. On cessation of the testosterone supplement, the lesion progressively flattened to a chorioretinal scar with subretinal fluid resolution and returned to normal choroidal thickness over the next 14 months.

Conclusion:

Testosterone supplementation has been linked to erythrocytosis and polycythemia vera. In the retina, testosterone supplementation has been linked to CSCR and both central and branch retinal artery and vein occlusions. This case report demonstrates the importance of inquiring about all prescribed and over-the-counter medications in patients presenting with retinal lesions of unknown origin.
Efficacy and Safety of Hyperbaric Oxygen Therapy in Fistulizing Crohn’s Disease
Authors: Dokmak Amr , Sweigart Benjamin , Orekondy Nayantara S. , Jangi Sushrut , Weinstock Joel V. , Hamdeh Shadi , Kochar Gursimran S. , Shen Bo , Levy Alexander N.
Published: September 2023

Background:

Hyperbaric oxygen therapy (HBOT) delivers 100% oxygen in a pressurized chamber, increasing tissue oxygen levels and regulating inflammatory pathways. Mounting evidence suggests that HBOT may be effective for inflammatory bowel disease. Our systematic review and meta-analysis aimed to quantify the efficacy and safety of HBOT in fistulizing Crohn’s disease (CD).

Methods:

A systematic review was conducted using the EMBASE, Web of Science, Pubmed, and Cochrane Library databases according to the “Preferred Reporting Items for Systematic Reviews and Meta-analyses” criteria. Study bias was assessed using the Cochrane Handbook guidelines.

Results:

Sixteen studies with 164 patients were included in the analysis. For all fistula subtypes, the pooled overall clinical response was 87% (95% CI: 0.70-0.95, I
2 = 0) and the pooled clinical remission was 59% (95% CI: 0.35-0.80, I
2 = 0). The overall clinical response was 89%, 84%, and 29% for perianal, enterocutaneous, and rectovaginal fistulas, respectively. On meta-regression, hours in the chamber and the number of HBOT sessions were not found to correlate with clinical response. The pooled number of adverse events was low at 51.7 per 10,000 HBOT sessions for all fistula types (95% CI: 16.8-159.3, I
2 = 0). The risk of bias was observed across all studies.

Conclusion:

HBOT is a safe and potentially effective treatment option for fistulizing CD. Randomized control trials are needed to substantiate the benefit of HBOT in fistulizing CD.
Prognostic value of cell division cycle-associated protein-3 in prostate cancer
Authors: Gu Peng , Zhang Minhao , Chen Xinhua , Du Jie , Chen Lu , He Xiaoliang , Li Meilin
Published: September 2023

Background:

The study was aimed to explore cell division cycle-associated protein-3 (CDCA3) expression and its correlation with clinicopathological characteristics, and identification of co-expressed genes of CDCA3 in prostate cancer (PCa).

Methods:

Data for CDCA3 mRNA expression in PCa were obtained from The Cancer Genome Atlas database. Furtherly, CDCA3 protein expression was examined by immunohistochemistry in 80 cases, including 20 normal prostate samples and 60 PCa samples. Then we used “survival” package to obtain the differentially expressed CDCA3 mRNA associated with prognosis of PCa patients. “pROC” package was used to analyze receiver operating characteristic of CDCA3. We used chi-square test, Kruskal–Wallis test and Wilcoxon rank sum test to identify clinicopathological parameters that correlated with CDCA3 expression. In order to determine the effects of CDCA3 expression and clinicopathological parameters on survival, univariate cox regression analysis was performed. Finally, the co-expressed genes of CDCA3 in PCa were explored by search tool for the retrieval of interacting genes, Kyoto encyclopedia of genes and genomes enrichment analysis and Spearman correlation analysis.

Results:

In this study, we found that CDCA3 expression was increased in PCa. PCa patients with higher CDCA3 expression had poor outcomes. In terms of receiver operating characteristic, CDCA3 had an area under the curve of 0.857. High CDCA3 expression was positively correlated with advanced T stage, N stage, Gleason score, and served as an independent predictor of progress free interval in PCa patients. Then 20 proteins closely related to CDCA3 were screened through STRING website. Functional enrichment analysis revealed that, Kyoto encyclopedia of genes and genomes pathway was mainly enriched in cell cycle, including 6 genes, BUB1, CCNA2, CDK1, CDC20, TTK, and CCNB2.

Conclusion:

CDCA3 is significantly associated with the prognosis of PCa, which may be an indicator of the diagnosis and prognosis of PCa and a new therapeutic target.
Methylprednisolone or dexamethasone? How should we choose to respond to COVID-19?: A systematic review and meta-analysis of randomized controlled trials
Authors: Li Zhengning , Xue Yuan , Li Laodong , Li Chaoqian
Published: September 2023

Background:

Methylprednisolone (MP) and dexamethasone (DXM) are commonly prescribed hormone drugs for treating coronavirus pandemic disease 2019 (COVID-19) patients, but conflicting results from previous studies and meta-analyses on their efficacy and safety necessitate further investigation. Therefore, in this study, we conducted a systematic review and meta-analysis of randomized controlled trials to enhance the level of evidence and compare the efficacy and safety of MP and DXM in COVID-19 patients.

Methods:

We conducted a comprehensive search of PubMed, Web of Science, Embase, and Cochrane Library databases to retrieve randomized clinical trials. Our primary outcome measure was all-cause mortality, with secondary outcomes including admission to the intensive care unit, length of hospital stay, mechanical ventilation, and adverse events.

Results:

This study analyzed six randomized controlled trials involving 1403 patients (MP group: 704; DXM group: 699). The results of the analysis showed no significant differences in mortality rates, admission to intensive care units, hospitalization time, mechanical ventilation, or adverse events between the MP and DXM groups (P > .05). However, a significant difference was observed in the incidence of hyperglycemia between these 2 groups (RR = 1.78, 95% CI [1.09, 2.89], P = .02, I
2 = 78%).

Conclusion:

The results of this meta-analysis showed that there was no difference in mortality, ICU admission rate, hospital stay, mechanical ventilation, or adverse events between MP and DXM in the treatment of COVID-19. The incidence of hyperglycemia with methylprednisolone was higher than that with dexamethasone.