bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral histiocytic sarcoma in a cat with mandibular invasion and regional lymph node metastasis
Authors: Ruppert Stephani L , Ferguson Sylvia H , Struthers Jason D , Jones Teela L 
Published: November 2021

Case summary An 11-year-old female spayed domestic medium-hair cat presented for dental prophylaxis, at which time no oral mass was appreciated. Fifteen days after a dental cleaning, a mass expanding the oral mucosa of the rostral mandible was identified. An incisional biopsy revealed that the oral mucosa was infiltrated by neoplastic round-to-spindloid mesenchymal cells arranged in streams and small, dense aggregates consistent with an undifferentiated sarcoma. The patient was managed medically for approximately 6 months following the diagnosis, but, owing to declining health, euthanasia was elected and a post-mortem examination was performed. On post-mortem examination, the previously described neoplastic cells were infiltrating the rostral mandible and had metastasized to the right submandibular lymph node. Immunohistochemistry performed during the postmortem examination found that neoplastic cells were positive for Iba-1, CD18 and CD204, and negative for MUM-1, S100, Melan-A and E-cadherin, favoring a diagnosis of oral histiocytic sarcoma. Although recently recognized in cats, feline oral histiocytic sarcoma is rare, the tumor’s immunohistochemical profile is unstandardized, and the tumor’s behavior and prognosis are unclear. The diagnosis is challenging if small incisional biopsies are submitted and the neoplasm is poorly differentiated. This case report discusses the clinical, macroscopic, microscopic and immunohistochemical features of oral histiocytic sarcoma in a cat with mandibular invasion and submandibular lymph node metastasis. Relevance and novel information Feline primary oral histiocytic sarcoma is rare and tumor behavior and prognosis are unclear. This report broadens the immunohistochemical features of the tumor and recognizes mandibular invasion and submandibular lymph node metastasis.
Oropharynx microbiota transitions in hypopharyngeal carcinoma treatment of induced chemotherapy followed by surgery
Authors: Lau Hui-Ching , Hsueh Chi-Yao , Gong Hongli , Sun Ji , Huang Hui-Ying , Zhang Ming , Zhou Liang 
Published: November 2021

Abstract
Aims
To analyze changes in oropharynx microbiota composition after receiving induced chemotherapy followed by surgery for hypopharyngeal squamous cell carcinoma (HPSCC) patients.

Methods
Clinical data and swab samples of 38 HPSCC patients (HPSCC group) and 30 patients with benign disease (control group, CG) were enrolled in the study. HPSCC group was stratified into two groups: induced chemotherapy group (IC) of 10 patients and non-induced chemotherapy group (nIC) of 28 patients. The microbiota from oropharyngeal membrane was analyzed through 16S rRNA sequencing.

Results
Alpha-diversity (Shannon and Ace indexes) and weighted UniFrac based beta-diversity severely decreased in the HPSCC group when compared with CG. In pre-operative comparisons, PCoA and NMDS analyses showed microbial structures in the IC group were more similar to CG than nIC. Both IC group and nIC group yielded significantly diverse post-operative communities in contrast to their pre-operative counterparts, evident by the decrease in genera Veillonella and Fusobacterium and increase in genera Streptococcus and Gemella. Given that post-operative oropharynx microbiota showed no difference between IC and nIC groups, the IC group showed less accumulation in anaerobic communities. The abundance of genera Fusobacterium, Parvimonas, Actinomyces were enhanced in the advanced stages (III/IV).

Conclusions
Oropharynx microbiota in the HPSCC group presents dysbiosis with low diversity and abundance. Induced chemotherapy is beneficial in adjusting the oropharynx microbial environment leading to fewer amounts of anaerobe accumulation after operation. Higher amounts of Fusobacterium in advanced stages (III/IV) may influence the progression of HPSCC.
20-hydroxyeiscosatetraenoic acid may be as a predictor of malignant middle cerebral artery infarction in patients with massive middle cerebral artery infarction
Authors: Yi Xingyang , Zhou Qiang , Qing Ting , Ming Bing , Lin Jing , Li Jie , Lin Jie 
Published: November 2021

Abstract
Background
Early identification of massive middle cerebral artery infarction (MCAI) at risk for malignant MCAI (m-MCAI) may be useful in selecting patients for aggressive therapies. The aim of this study was to determine whether CYP metabolites may help to predict impending m-MCAI.

Methods
This is a prospective, two-center observational study in 256 patients with acute massive MCAI. Plasma levels of 20-hydroxyeicosatetraenoic acid (20-HETE), epoxyeicosatrienoic acids, and dihydroxyeicosatrienoic acids were measured at admission. Brain computed tomography (CT) was performed at admission and repeated between day 3 and 7, or earlier if there was neurological deterioration. The primary outcome was m-MCAI. The m-MCAI was diagnosed when follow-up brain CT detected a more than two-thirds space-occupying MCAI with midline shift, compression of the basal cisterns, and neurological worsening.

Results
In total of 256 enrolled patients, 77 (30.1%) patients developed m-MCAI. Among the 77 patients with m-MCAI, 60 (77.9%) patients died during 3 months of stroke onset. 20-HETE level on admission was significantly higher in patients with m-MCAI than those without m-MCAI. There was an increase in the risk of m-MCAI with increase of 20-HETE levels. The third and fourth quartiles of 20-HETE levels were independent predictors of m-MCAI (OR: 2.86; 95% CI: 1.16 – 6.68; P = 0.025, and OR: 4.23; 95% CI: 1.35 – 8.26; P = 0.002, respectively).

Conclusions
Incidence of m-MCAI was high in patients with massive MCAI and the prognosis of m-MCAI is very poor. Elevated plasma 20-HETE may be as a predictor for m-MCAI in acute massive MCAI, and it might useful in clinical practice in therapeutic decision making.
Impact of COVID-19 on radiology education in Europe: a survey by the ESR Radiology Trainees Forum (RTF)
Authors:   European Society of Radiology (ESR), Klontzas Michail E. , O’Malley Eoin , Afat Saif , Pozdniakova Viktoria , Pecoraro Martina , Catalano Carlo , Becker Minerva , Reim Martin 
Published: November 2021

Abstract
Background
The ongoing COVID-19 pandemic has significantly affected radiology services around the globe. The impact of the crisis on radiology education in Europe has yet to be determined, in order to identify measures to achieve optimal training of radiologists during pandemics. The aim of this survey was to evaluate the impact of the pandemic on young radiologist members of the European Society of Radiology (ESR).

Methods
A survey consisting of 28 questions was developed and distributed using SurveyMonkey to all ESR European radiologist members in training. The survey sought to collect information on three main themes, ‘demographics’, ‘training level’ and ‘effects of COVID-19’. The responses were statistically analysed with the use of R programming using descriptive statistics.

Results
A total of 249 responses from 34 countries were collected. Specific training on COVID-19 was not offered to 52.2% (130) of the participants. A total of 196 participants were not redeployed to other specialities but only 46.2% of institutions allowed residents to work from home. E-learning was offered at 43% of the departments and most participants (86.2%) were not allowed to switch from clinical work to research. A minority (n = 13) were suspended with (30.8%) or without salary (38.5%) or were forced to take vacation/yearly holiday leave (7.7%) or sick leave (23%). Almost half of the participants did not have access to personal protective equipment and a minority of them had their financial status affected.

Conclusions
The ongoing SARS-CoV-2 outbreak has significantly affected all aspects of postgraduate radiology training across the ESR member countries.
The ethics and management of cannabis use in pregnancy following decriminalisation and licensing for medical use: narrative review
Authors: Towobola Abdulazeez , Towobola Basirat , Nair Bosky , Makwana Arti 
Published: November 2021

Aims and methodAs drug policies pertaining to cannabis use become more liberalised, the prevalence of cannabis use in pregnancy could increase. However, there is limited guidance available for clinicians. This paper presents a narrative review of literature published in the past 16 years (2006–2021) to (a) address the impact of legalisation and decriminalisation on the risks, ethics and support of women who use cannabis during pregnancy and (b) develop guidance for clinicians.ResultsBoth national and international trends suggest increased use of cannabis over the past decade, while the risks of cannabis use for recreational or medicinal purposes in pregnancy remain unmitigated.Clinical implicationsThis review confirmed that the recommendation of cannabinoid-based products for pregnant and breast-feeding women is currently premature. More research is needed to address safety concerns. We discussed navigating ethical concerns and suggest targeted management strategies for clinicians treating pregnant women who choose to use cannabis.
Disparities in Tumor Mutational Burden, Immunotherapy Use, and Outcomes Based on Genomic Ancestry in Non–Small-Cell Lung Cancer
Authors: Brawley Otis W. , Luhn Patricia , Reese-White Deonna , Ogbu Uzor C. , Madhavan Sriraman , Wilson Gerren , Cox Meghan , Ewing Altovise , Hammer Christian , Richie Nicole 
Published: November 2021

PURPOSE In patients with advanced non–small-cell lung cancer (aNSCLC), tumor mutational burden (TMB) may vary by genomic ancestry; however, its impact on treatment outcomes is unclear. This retrospective, observational study describes treatment patterns of patients with aNSCLC by genomic ancestry and electronic health record (EHR)-reported race and/or ethnicity and evaluates differences in TMB, cancer immunotherapy (CIT) access, and treatment outcomes across racial and ancestral groups. METHODS Patients diagnosed with aNSCLC after January 1, 2011, were selected from a real-world deidentified clinicogenomics database and EHR-derived database; continuously enrolled patients were evaluated. Race and/or ethnicity was recorded using variables from the EHR database; genomic ancestry was classified by single-nucleotide polymorphisms on a next-generation sequencing panel. A threshold of 16 mutations per megabase was used to categorize TMB status. RESULTS Of 59,559 patients in the EHR-derived database and 7,548 patients in the clinicogenomics database, 35,016 (58.8%) and 4,392 (58.2%) were continuously enrolled, respectively. CIT use was similar across EHR-reported race groups, ranging from 34.4% to 37.3% for non-Hispanic Asian and non-Hispanic Black patients, respectively. TMB levels varied significantly across ancestry groups ( P < .001); patients of African ancestry had the highest median TMB (8.75 mutations per megabase; interquartile range, 4.35-14.79). In patients who had received CIT, high TMB was associated with improved overall survival compared with low TMB (20.89 v 11.83 months; hazard ratio, 0.60; 95% CI, 0.51 to 0.70) across genomic ancestral groups. CONCLUSION These results suggest that equitable access to next-generation sequencing may improve aNSCLC outcome disparities in racially and ancestrally diverse populations.
Quantile Markov Decision Processes
Authors: Li Xiaocheng , Zhong Huaiyang , Brandeau Margaret L. 
Published: November 2021

Title: Sequential Decision Making Using Quantiles The goal of a traditional Markov decision process (MDP) is to maximize the expectation of cumulative reward over a finite or infinite horizon. In many applications, however, a decision maker may be interested in optimizing a specific quantile of the cumulative reward. For example, a physician may want to determine the optimal drug regime for a risk-averse patient with the objective of maximizing the 0.10 quantile of the cumulative reward; this is the cumulative improvement in health that is expected to occur with at least 90% probability for the patient. In “Quantile Markov Decision Processes,” X. Li, H. Zhong, and M. Brandeau provide analytic results to solve the quantile Markov decision process (QMDP) problem. They develop an efficient dynamic programming procedure that finds the optimal QMDP value function for all states and quantiles in one pass. The algorithm also extends to the MDP problem with a conditional value-at-risk objective.
THE INFLUENCE OF THE COVID-19 PANDEMIC ON ALLOCATION OF ASSETS IN INVESTORS PORTFOLIO
Authors: Bobulský Maroš , Bohdalová Mária 
Published: November 2021

Investing during a pandemic is very challenging. Even in these difficult times, the investor must appropriately allocate assets into his portfolio. In this article, we discuss investing in the stock market. We are interested in creating portfolios of shares that consist of financial assets. The individual methods we use are designed to provide an allocation of funds in between individual shares. In the modern portfolio theory, the Markowitz model (Markowitz, 1952) is being used to solve these problems. The paper's main goal is to propose an efficient, robust approach to solve the Markowitz optimization problem adjusted for periods of a global decline in financial markets. In our research, we focus on robust optimization. Instead of precisely given input parameters, we propose a set of parameters from which we always select the worst possible parameter (so-called worst-case optimization). The robustness of optimization is achieved using so-called filter matrices. These matrices are used to modify historical data directly during optimization. The proposed model modifies the data by using different lengths of historical returns. Our proposed model is then compared with the original Markowitz non-robust model. We compare these two models using the properties of the second derivative of the optimization problem. Our results are visualized for different levels of investor’s risk aversion. We present our methods on historical price data of five randomly selected companies traded on the US market. By comparing the proposed robust approach with the non-robust one, we show that different lengths of historical returns capture volatility changes earlier. The investor can thus reduce his risk aversion and increase his expected returns.
THE RELATIONSHIP BETWEEN JOB SATISFACTION AND INDIVIDUAL PERFORMANCE OF IT EMPLOYEES
Authors: Yanchovska Irina 
Published: November 2021

Purpose – The main purpose of this research paper is to investigate the correlation between job satisfaction of employees in the IT sector and their personal performance. Additionally, the study examines the overall level of employee satisfaction, as well as if job satisfaction levels differ significantly among the studied demographic groups.
Design/methodology/approach – The research is based on quantitative analysis of data collected through a questionnaire containing answers of 126 international respondents from over 25 different IT companies. The research methods used are one-dimensional methods for preliminary analysis, Cronbach alpha for reliability and consistency, one-way ANOVA for mean values comparison and correlation analysis for examining relationships.
Findings – The findings show a moderate statistically significant correlation between job satisfaction and employees’ personal performance, which is bidirectional as influence and presumably depends on other variables like work engagement, motivation, stress or exhaustion, which were not examined in the current study. Additionally, most of the employees in the researched sample define themselves as satisfied with their jobs. Statistically significant variation of the mean job satisfaction levels was observed in two of the examined demographic variables – gender and years in the current position.
Practical implications – The research results can be beneficial for different organizations since job satisfaction is important for employees’ long-term retention, for increasing their commitment and loyalty towards the organization, as well as for the creation of a motivating and productive work environment. Employees’ job satisfaction and their personal performance should always be considered main organizational values and key for achieving excellent business results and market leadership.
Originality/value – The results of the current research are important for validating the position of these researchers, who claim that a positive correlation between an employees’ job satisfaction and their personal performance in the workplace exists and should not be neglected. Additionally, it contributes towards a better understanding of job satisfaction among IT employees.
STUDENTS’ VIEWS ON THE ROLE OF ETHICS EDUCATION FOR THEIR FUTURE MEDICAL PRACTICE
Authors: Leventi Nikoleta , Vodenitcharova Alexandrina , Popova Kristina , Ivanova Kremena , Georgiev Svetlin , Yanakieva Antoniya 
Published: November 2021

INTRODUCTION: Worldwide, in different ways, ethical dilemmas arise in medicine and life sciences. It is critical for medical professionals to respond with confidence when ethical challenges are addressed in their clinical practice. Medical ethics and bioethics education is recognized as an essential course of the medical curriculum. The course aims to provide students with knowledge and competencies on dealing with moral problems.
OBJECTIVES: In this article, we aim to explore students’ views about the importance and role of medical ethics education for their future practice. Their suggestions on specific medical ethics and bioethics topics were also considered, as well as previous knowledge on ethics before they enrolled in university.
METHODS: A paper questionnaire was developed and distributed among first-year foreign medical students from the Faculty of Medicine in the Medical University-Sofia in Bulgaria. All students participated in the study anonymously and voluntarily. The study was conducted during January and February 2020.
RESULTS: Completed questionnaires were received from 366 medical students. Data collected demonstrates that only 19% of the students were taught ethics before enrolling in university and covered topics on philosophy and ethics, civil and human rights. The majority (92%) of the responders believe that the study of medical ethics and bioethics helps medical professionals to improve their skills in identifying ethical problems in their everyday practice. Interesting were the suggestions for topics in medical ethics and bioethics that needed further study during lectures and seminars and included principles of medical ethics and bioethics, ethical behavior in medicine and health care, ethical dimensions of new technologies in health care, ethical dimensions of clinical decisions and patients’ quality of life, ethics and health management.
CONCLUSIONS: Medical ethics education is significant for future physicians, helping them to improve their skills in identifying ethical issues, and base their decisions on fundamental ethical principals in their everyday practice. Attention should be given to topics related to principles of medical ethics, models of patient-physician relationships, new technologies in health care, ethics and health policy.
IS ANYBODY KEEPING THE CODE IN BULGARIA? A STUDY TO EXPLORE LOCAL PARENTS' AWARENESS REGARDING THE INTERNATIONAL CODE FOR THE MARKETING OF BREAST-MILK SUBSTITUTES.
Authors: Serbezova Ivanichka , Lyutakova Daniela 
Published: November 2021

This paper reviews Bulgarian parents’ awareness concerning the existence of the WHO Code for the marketing of breast-milk substitutes and how it can help them optimize their breastfeeding journey. Frequently occurring problems and breaches of the Code in Bulgaria are discussed, and their context explained. We focus on parental attitudes and investigate whether they acknowledge the significant necessity for a Code-compliant prenatal education and postnatal care. We also explore their viewpoints on the implementation of the Code and maximizing compliance with it on a local level. The research findings are presented graphically, and we present tendencies showcased by respondents’ opinions they have expressed in the survey.
OBJECTIVES: Purposes of this research are: (1) to explore parents’ awareness about the WHO Code and their encounter with local prenatal classes in this regard (2) to assess their viewpoints on implementing the Code and if they see it as a significant step towards an optimal breastfeeding experience.
METHODS: The methods we applied include an online-based cross-sectional semi-quantitative questionnaire with closed-ended and open-ended questions, aiming to explore parents’ current knowledge and viewpoints in regard to the Code and its implementation in Bulgaria. The research has been carried out via social media, and it samples parents from a local parent peer support group. Acquired data from closed-ended questions is presented, demonstrating percentages and tendencies.
RESULTS: A total of 463 respondents are included
CONCLUSION: It is a common practice in Bulgaria for prenatal classes not to comply with the WHO Code. Disregarding recommendations and evidence-based medicine, both some experts and companies under the scope of the Code breach its main points. Code-compliant prenatal education is practically almost non-existent with the lack of midwife-led care and classes, predominantly in the private sector, where they are almost entirely, sponsored by those companies. Nearly all parents included in this survey are more than willing and motivated to have access to Code-compliant prenatal education and postnatal care. The lack of such leaves almost no choice for Bulgarian parents actually to have access to code-compliant education and care. This inevitably influences their decision making, attitudes and behavior, potentially leading to lower breastfeeding rates and suboptimal breastfeeding satisfaction and success. Adequate measures must be reinforced to ensure implementation and proper legislation, providing monitoring and enforcement, protecting parents and their babies when they are most vulnerable.
CLINICALLY EVALUATED ACCURACY OF SINGLE GUIDED IMPLANTATIONS WITH TWO DIFFERENT SYSTEMS – PRELIMINARY RESULTS
Authors: Vlahova Angelina , Zlatev Stefan , Pavlov Boyan , Chenchev Ivan , Hadzhigaev Viktor 
Published: November 2021

Introduction: Guided single implant placement ensures an optimal implant position, enables in-surgery immediate loading, and creates a predisposition for predictable treatment results.
Aim: This article aims to present the surgical and loading protocols and assess the accuracy of two guided implant systems.
Materials and methods: Ten patients missing a single molar were included. The semi-guided procedures with the two implant systems – AB Dental and Alpha Bio-Tec, were randomly assigned to each participant. The computer-assisted planning was performed with Implant Studio (3Shape, Denmark). Surgical guides and long-term, temporary, screw-retained restorations were virtually generated within the 3Shape system. Surgical appliances were printed from SG resin (Formlabs, USA), and crowns were milled from Telio CAD (Ivoclar Vivadent, Lichtenstein). Planning accuracy was evaluated based on the crown’s fit and relation to the adjacent teeth and antagonists.
Results and discussion: The patients included for preliminary analysis (6 female and 4 male) were with a mean age of 33.42. The youngest was 24, and the oldest 49 years old. There were no surgical and technical complications for the period of evaluation, which ranged from 1 to 3 months. The crown’s fit was excellent in 8 cases. In two cases, minor adjustments were necessary – 1 in relation to the antagonists and 1 to the adjacent teeth. In one case, a healing screw was placed for 48 hours to facilitate adequate soft-tissue space for the Ti-base.
Conclusion: The preliminary results presented in this report suggest that the clinical and laboratory protocols used for guided implantation and immediate loading are highly efficient.