bluuebunny/crossref_metadata_2025_split huggingface dataset:
804. NUTRITIONAL OUTCOMES AND IMPACT OF MALNUTRITION IN A RANDOMIZED COMPARISON BETWEEN STANDARD AND PROLONGED TIME TO SURGERY AFTER NEOADJUVANT CHEMORADIOTHERAPY FOR ESOPHAGEAL CANCER
Authors: Ericson Jessica , Klevebro Fredrik , Sunde Berit , Szabo Eva , Halldestam Ingvar , Smedh Ulrika , Wallner Bengt , Johansson Jan , Johnsen Gjermund , Ahlin Eirik , Johannessen Hans-Olav , Hjortland Geir-Olav , Bartella Isabel , Schröder Wolfgang , Bruns Christiane , Rouvelas Ioannis , Nilsson Magnus 
Published: September 2024

Abstract

Background
Prolonged time to surgery (TTS) after neoadjuvant chemoradiotherapy (nCRT) may enable malnourished oesophageal cancer patients´ nutritional status to recover better, possibly improving outcomes after esophagectomy.

Methods
This is a substudy within a randomised multicenter controlled trial comparing outcomes in esophageal cancer patients after standard TTS of 4-6 weeks to prolonged TTS of 10-12 weeks after nCRT. Patients were categorized as malnourished or non-malnourished at baseline and compared regarding nutritional endpoints.

Results
The mean weight decreased significantly from baseline to the standard TTS (p&lt;0.001) while at the prolonged TTS it had recovered to baseline level (p=0.131), Figure 1. There was no significant difference in postoperative complications between patients malnourished at baseline when allocated to standard compared to delayed surgery (OR: 0.90, 95% confidence interval, CI: 0.29-2.77 and OR 1.13, 95% CI: 0.32-4.00, respectively). Patients malnourished at baseline had a strong trend to worse survival after delayed compared to standard TTS, Hazard ratio (HR) 1.72 (95%, CI: 0.82-3.59, p=0.147). which was less pronounced for non-malnourished patients, HR 1.26 (95% CI:0.82-1.94, p=0.291).

Conclusions
Prolonged TTS led to better weight recovery at time of surgery. Patients malnourished at baseline did not benefit in terms of less postoperative morbidity after delayed surgery and had a stronger trend to detriment in survival from delayed surgery than non-malnourished patients.
807. A REVISED APPROACH TO THE ESOPHAGOGASTRIC JUNCTION: A MODIFIED SIEWERT CLASSIFICATION
Authors: Fonseca Filipa , Cabral Francisco , Ramos Paulo , Monteiro Cecília , Abecasis Nuno , Casaca Rui 
Published: September 2024

Abstract

Background
Esophagogastric junction (EGJ) adenocarcinomas are challenging due to their anatomical and histopathological features and treated either as part of the esophagus or stomach cancers. Siewert (S) and Nishi classifications rely on the tumor’s epicenter to guide treatment decisions, which can lead to diagnostic and therapeutic inconsistencies. Moreover, recent studies helped define the optimal extent of lymphadenectomy for EGJ cancers. Here we present our standardized approach to EGJ cancers that integrates these insights, providing a framework to guide clinical decision-making.

Methods
Our modified classification relies on tumor extent rather than the epicentre, based on endoscopic measurement of the proximal and the distal limits, and the exact location of the EGJ. This approach classifies tumors based on their extent which results into six categories: SI, SI/II, SII, SII/III, SIII, and SI/II/III. Lower esophageal tumors whose distal limit lies between + 1cm and -2cm are classified as I/II. Cardia tumors whose proximal limit falls between those boundaries are II/III. Tumors that span more cephalad than + 1cm and more distally than – 2cm, are I/II/III. For Siewert I, I/II and II tumors, surgical management depends on the extent of esophageal involvement, mainly dictated by the probability of mediastinal basement nodal involvement, as defined by Kurokawa et al (2019). Additionally, a 3-field lymphadenectomy is performed when there is involvement of the cervical or recurrent laryngeal nerve lymph node stations.

Results
In SI, SI/II, and SI/II/III, with esophageal involvement exceeding 4 cm we favor a transthoracic esophagectomy (TTE) with total thoracic lymphadenectomy. If the involvement is between 1-4 cm, a transhiatal esophagectomy (THE) with lower mediastinal lymphadenectomy is performed. In SII, THE is done for 0-1 cm of involvement; absence of esophageal involvement permits a transhiatal extended total gastrectomy (eTG) with abdominal D2 lymphadenectomy and intra-operative margin status assessment via frozen sections.
In SI/II/III and esophageal involvement of more than 4 cm, TTE is required; for esophageal involvement of 1-4 cm, we perform a THE and total gastrectomy with abdominal D2 lymphadenectomy based on distal margin findings.

Conclusion
This proposed modification to the classification of EGJ adenocarcinomas introduces a comprehensive framework that is tailored to the extent of tumor involvement. By addressing the limitations of existing systems and incorporating current insights, this updated classification aims to improve patient categorization and standardize treatment protocols, potentially leading to enhanced clinical outcomes.
“It’s What Would Work for Her”: An Analysis of Adaptations to the Individualized Positive Psychosocial Interaction Program in U.S. Nursing Homes
Authors: Kunkel Miranda C , Talmage Alexis , Noble Molly , Van Haitsma Kimberly , Abbott Katherine M 
Published: September 2024

Abstract

Background and Objectives
The Individualized Positive Psychosocial Interaction (IPPI) program is an adaptable, evidence-based intervention. IPPI trains nursing home care partners to engage residents living with moderate to severe dementia in preference-based, one-to-one interactions using emotion-focused communication. We sought to understand provider-driven adaptations made to the IPPI program and whether the adaptations made were fidelity-consistent.

Research Design and Methods
Data were collected from n = 78 interviews with n = 23 nursing home provider champions who led a quality improvement project to implement the IPPI program with 3–5 residents per care community. Using content analysis, we report quantitative data on the adaptation characteristics according to the Framework for Reporting Adaptations and Modifications-Expanded core modules and participant quotes to illustrate adaptations.

Results
Champions reported 34 adaptations, with an average of 2.6 adaptations per nursing home. The majority of IPPI adaptations pertained to implementation (65%; n = 22), whereas 17% (n = 6) were content and 17% (n = 6) were context. Some adaptations were motivated by the organization (e.g., time constraints), while others were motivated by the recipient (e.g., cognitive capacity). Most adaptations made to the IPPI protocol by care partners were fidelity-consistent (92%; n = 33).

Discussion and Implications
Care partners’ adaptations to the IPPI made the intervention more resident-centric. Future healthcare intervention providers must consider the user perspective and encourage adaptations that further tailor to the user, as long as the adaptations are fidelity-consistent.
Achieving normal pulmonary function following tracheoplasty in infancy
Authors: Harrison Ciara , Harrison Jo , Fricke Tyson A , Konstantinov Igor E 
Published: September 2024

Abstract
Infant long-segment congenital tracheal stenosis (LTS) is rare and presents a challenging clinical scenario. We describe the management of a child who required extracorporeal membrane oxygenation following a respiratory arrest and underwent slide tracheoplasty in infancy for severe LTS and required repeated bronchoscopic reinterventions for recurrent tracheal granulations. At 9 years of age, the child has normal pulmonary function testing and a normal exercise tolerance.
Phlebotomine sand fly (Diptera: Psychodidae) fauna, blood meal source, and detection of Leishmania (Kinetoplastida: Trypanosomatidae) DNA in the Gurupi Biological Reserve, Eastern Amazon, Brazil
Authors: Rodrigues Judson Chaves , Ribeiro-da-Silva Rosa Cristina , Guimarães-e-Silva Antonia Suely , de Oliveira Maxcilene da Silva , Rodrigues Bruno Leite , Pimenta Ronayce Conceição de Jesus Serrão , Galati Eunice Aparecida Bianchi , Pinheiro Valéria Cristina Soares 
Published: September 2024

Abstract
This study was conducted in the Gurupi Biological Reserve (REBIO-Gurupi), the largest area of Amazon rainforest in Maranhão State, Brazil. The objectives were to survey the sand fly (Diptera: Psychodidae) fauna of REBIO-Gurupi, identify blood meal sources, and investigate the presence of Leishmania (Ross, 1903) (Kinetoplastida: Trypanosomatidae) DNA. Individuals were collected using Centers for Disease Control (CDC) light traps and black and white Shannon traps in May and Jun 2022 and Jan 2023. DNA was extracted from female sand flies and subjected to amplification and sequencing of cytochrome b molecular marker (CYTB) for identification of blood meal sources and the first internal transcribed spacer (ITS-1) of ribosomal DNA for Leishmania detection. A total of 514 sand flies individuals were sampled, of which 93 were identified at the genus or series level (9 taxa) and 421 were identified at the species level (24 taxa). Psychodopygus davisi (Root, 1934) (41.1%), Nyssomyia antunesi (Coutinho, 1939) (10.3%), and Psychodopygus (Mangabeira, 1941) Chagasi Series Barretto, 1962 (9.7%) were the most frequently collected. Human (Homo sapiens, Primates, Hominidae) and tapir (Tapirus terrestris, Perissodactyla, Tapiridae) DNA was detected in 10 female sand flies. Leishmania (Leishmania) infantum Cunha and Chagas, 1937 DNA was detected in 2 specimens of Ps. davisi. Given the presence of vectors of Leishmania in REBIO-Gurupi, it is imperative to conduct more comprehensive studies on the interactions among sand flies, Leishmania, and pathogen reservoirs in the area.
Developing a Horizontal Risk Assessment Instrument for incidents of domestic violence victims in Greece: Understanding the landscape and risk factors as identified by the Hellenic Police
Authors: Fotou Eleni , Sebire Jacqueline , Saini Vassiliki , Spanea Efrosyni 
Published: September 2024

ABSTRACT
This article describes the process of developing the Hellenic Risk Assessment Instrument reaching the pilot phase, with particular application to the police. The Risk Assessment tool is designed to assess incidents of domestic violence for recidivism and lethality. In particular, the Hellenic Risk Assessment tool is designed to be applied horizontally, across all frontline national agencies that receive reports of domestic violence and abuse (health, police, social services, specialised network of structures for victim support). First, the legal underpinnings nationally and internationally will be described, and the theoretical background and methodology for the overall project will be discussed. During the first stage of the development, data were collected from the specialised department for domestic violence in the Hellenic Police force for the period from January 2019 until July 2021. The data pertained to six overall parameters, which were selected to identify potential risk markers that might be potentially present in the Greek domestic violence incidents. These include perpetrator variables (age, gender, ethnicity), victim variables (age, gender, ethnicity), incident variables (type of violence, and prevalence). In addition, the number of cases reported before and after a domestic homicide, the number of cases at the times of major sporting events and at during the major holidays were investigated. The results were then analysed and will be presented and cross-referenced with other international findings and were used to create the preliminary version of the risk assessment tool. During the second phase of the development of the tool, focus groups were conducted with police officers who covered various departments (Anti-Racism division, Homicide division, Minors, Domestic Violence), that came into direct or indirect contact with victims of abuse, and could offer significant insight into risk factors and parameters that could potentially lead to recidivism and to lethal violence and be usefully incorporated within the tool as well as give their expert opinion as to its efficacy.
Testing a Motor Score Based on PANSS Ratings: A Proxy for Comprehensive Motor Assessment
Authors: Nadesalingam Niluja , Kyrou Alexandra , Chapellier Victoria , Maderthaner Lydia , von Känel Sofie , Wüthrich Florian , Nuoffer Melanie G , Lefebvre Stephanie , Pavlidou Anastasia , Wobrock Thomas , Gaebel Wolfgang , Cordes Joachim , Langguth Berthold , Falkai Peter , Schneider-Axmann Thomas , Strube Wolfgang , Hasan Alkomiet , Walther Sebastian 
Published: September 2024

Abstract

Background and Hypothesis
Abnormal psychomotor behavior is a core schizophrenia symptom. However, assessment of motor abnormalities with expert rating scales is challenging. The Positive and Negative Syndrome Scale (PANSS) includes 3 items broadly related to hypokinetic motor behavior. Here, we tested whether a sum score of the PANSS items mannerisms and posturing (G5), motor retardation (G7), and disturbance of volition (G13) corresponds to expert ratings, potentially qualifying as a proxy-marker of motor abnormalities.

Study Design
Combining baseline datasets (n = 196) of 2 clinical trials (OCoPS-P, BrAGG-SoS), we correlated PANSS motor score (PANSSmot) and 5 motor rating scales. In addition, we tested whether the cutoff set at ≥3 on each PANSS motor item, ie, “mild” on G05, G07, and G13 (in total ≥9 on PANSSmot) would differentiate the patients into groups with high vs low scores in motor scales. We further sought for replication in an independent trial (RESIS, n = 102), tested the longitudinal stability using week 3 data of OCoPS-P (n = 75), and evaluated the validity of PANSSmot with instrumental measures of physical activity (n = 113).

Study Results
PANSSmot correlated with all motor scales (Spearman-Rho-range 0.19–0.52, all P ≤ .007). Furthermore, the cutoff set at ≥3 on each PANSS motor item was able to distinguish patients with high vs low motor scores in all motor scales except using Abnormal Involuntary Movement Scale (Mann-Whitney-U-Tests: all U ≥ 580, P ≤ .017).

Conclusions
Our findings suggest that PANSSmot could be a proxy measure for hypokinetic motor abnormalities. This might help to combine large datasets from clinical trials to explore whether some interventions may hold promise to alleviate hypokinetic motor abnormalities in psychosis.
Comparison of Surgical and Conservative Treatments for Gartland Type II Supracondylar Humerus Fractures: Evaluation of the Need for Surgical Treatment
Authors: Güneş Zirvecan , Beydemir Ataberk , Mergen Esra Kutsal , Demirkiran Halil Gökhan , Yilmaz Güney , Aksoy Mehmet Cemalettin , Tokgözoğlu Ahmet Mazhar , Yazici Muharrem , Kamaci Saygin 
Published: September 2024

Background:
Supracondylar humerus fractures (SHFs) are common pediatric injuries, with type II fractures being a topic of debate regarding optimal treatment. Our goals are to compare the functional and radiographic outcomes of conservative and surgical treatment of type II SHFs and their subgroups and to identify parameters for determining the optimal treatment option.

Methods:
We retrospectively reviewed a total of 55 patients (23 conservative, 32 surgical) between 2010 and 2020. The mean follow-up was 66 months. Neurovascular status, range of motion, complications, and functional scores (Mayo elbow, Quick DASH) were evaluated. We performed radiographic assessment on initial, postreduction, and final follow-up radiographs using the humerocondylar angle (HCA), Baumann angle, and anterior humeral line (AHL).

Results:
Neither groups nor subgroups showed significant differences in clinical and functional outcomes. HCA was significantly higher in the operative group than in the conservative group. The subgroup analysis revealed that the HCA difference resulted from the difference between the conservative IIb and operative IIb subgroups. None of the patients required a corrective osteotomy, but 1 patient initially treated conservatively underwent operative treatment due to loss of reduction.

Conclusions:
Reconstructing the sagittal, coronal, and rotational alignment in type II SHFs led to good mid-term results in the range of motion and functional scores for the elbow joint, whether conservative or surgical treatment was used. A limited range of remodeling might be expected in the long term.

Level of Evidence:
Level III—retrospective comparative study.
Severe Vulvovaginal Candidiasis Associated With Sodium-Glucose Cotransporter 2 Inhibitors Use in Postmenopausal Women
Authors: Miao Vera Y. , Wijaya Marlene , Fischer Gayle , Saunderson Rebecca B. 
Published: September 2024

Objective
We present a case series of severe vulvovaginal candidiasis in postmenopausal women using sodium-glucose cotransporter-2 inhibitor (SGLT2i) medications for the management of their diabetes mellitus.

Materials and Methods
Twenty-four cases from a private vulvovaginal specialist clinic are described.

Results
All 24 patients were referred with severe and persistent vulvar pruritus, pain, and erythema. Examination findings varied between patients and included erythema, edema, erosions, adherent white discharge, and fissuring, which were extensive and often involved the mons pubis, labia majora, and extended to the perineum and perianal region, mimicking psoriasis and/or irritant dermatitis. The clinical presentation in this postmenopausal group hindered a timely diagnosis, resulting in a delay in appropriate management. Fortunately, all patients improved on oral antifungal treatment, and in those that ceased their SGLT2i medication, there was resolution of the condition.

Conclusions
While candidiasis is reported to occur with SGLT2i, severe genital mycotic infections are not yet a well-recognized adverse effect and may be missed. The presentation in these cases was persistent and severe. Clinicians should have a high index of suspicion in postmenopausal women presenting with vulvar pain, pruritus, and extensive erythema that mimics psoriasis or irritant dermatitis, if they are on SGLT2i therapy.
Cardiometabolic risk factors in women: what's sauce for the goose is not sauce for the gander
Authors: Loh Wann Jia , Watts Gerald F. 
Published: September 2024

Purpose of review
The aim of this review was to discuss cardiometabolic risk factors that affect women.

Recent findings
Recent calls to action to address cardiometabolic risk factors specific to women relate to increasing evidence of sex-specific differences in patient-related, drug-related, and socio-demographic factors leading to sub-optimal care of women.

Summary
Certain aspects of common modifiable cardiovascular risk factors (e.g. smoking, hypertension, dyslipidaemia and diabetes) affect female individuals more adversely. Additionally, there are risk factors or enhancers that particularly affect cardiometabolic health in women [e.g. premature menopause, polycystic ovarian syndrome (PCOS), familial partial lipodystrophy, socio-cultural factors]. Understanding these risk factors may provide insight on how to improve cardiometabolic outcomes in women.
Reducing financial toxicity in bladder cancer care
Authors: Kurnot Jeremy A. , Kaye Deborah R. 
Published: September 2024

Purpose of review
Financial toxicity is a significant concern for many individuals with bladder cancer, which is, overall, the most expensive malignancy, per patient. Financial toxicity, defined as the harmful effects of treatment costs on an individual's quality of life, is associated with worse outcomes and decreased quality of life. Awareness of the objective and subjective factors that contribute to financial toxicity, and ways to mitigate their effects on patients, is essential to reduce the burden of bladder cancer care. This commentary aims to discuss the elements contributing to financial toxicity amongst bladder cancer patients, identify at-risk populations, and review current and potential strategies for mitigating financial burden.

Recent findings
Bladder cancer is becoming more expensive as the use of novel therapies increases. Early data suggest how some of these novel treatments or changes in treatment delivery may impact costs. Potential innovative strategies for cost reduction include blue light cystoscopy, intravesical gemcitabine-docetaxel rather than BCG for high-risk nonmuscle-invasive patients, home BCG therapy, and surveillance guideline optimization. However, there is still much work to be done on the potential impacts of these treatment on financial toxicity. While there is a paucity of data on treatment changes to reduce financial toxicity, and cost data can be hard to access, clinicians can still reduce the financial burden of cancer care. Awareness, financial toxicity screening, cost communication, and/or early referral to financial navigators or other similar resources have the potential to reduce financial burden. Despite mounting evidence, these tools/techniques are largely underutilized.

Summary
Many individuals with bladder cancer face significant financial toxicity, with the potential for this to worsen in the setting of rising treatment costs. Novel diagnostic and treatment modifications may reduce financial toxicity. However, awareness, screening, cost discussions, and utilization of financial navigators are tools/techniques that are currently available and should be used to reduce financial burden.
Identification of proteins’ expression pathway and the effective miRNAs for the treatment of human papillomavirus-induced cervical cancer: in-silico analyses-experimental research
Authors: Monemi Marzieh , Garrosi Lida , Mirzaei Samira , Farhadi Bahar , Ataee Disfani Reza , Zabihi Mohammad Reza , Akhoondian Mohammad , Ghorbani Vajargah Pooyan , Khorshid Alireza , Karkhah Samad 
Published: September 2024

Introduction:
Cervical cancer is the fourth most common cancer in women. The risk factors for cervical cancer include human papillomavirus (HPV) infection, age, smoking, number of pregnancies, use of oral contraceptives, and diet. However, long-term HPV infection appears to be the main risk factor for developing cervical cancer. This in-silico analysis aims to identify the expression network of proteins and the miRNAs that play a role in the development of HPV-induced cervical cancer.

Methods:
The critical proteins and miRNAs were extracted using the DisGeNET and miRBase databases. String and Gephi were applied to the network analysis. The GTEx web tool was utilized to Identify tissue expression levels. The Enrichr website was used to explore the molecular function and pathways of found genes.

Results:
Ten proteins, TP53, MYC, AKT1, TNF, IL6, EGFR, STAT3, CTNNB1, ESR1, and JUN, were identified as the most critical shared gene network among cervical cancer and HPV. Seven miRNAs were found, including hsa-mir-146a, hsa-mir-27, hsa-mir-203, hsa-mir-126, hsa-mir-145, hsa-mir-944, and hsa-mir-93, which have a common expression in cervical cancer and HPV.

Conclusion:
Overall, the gene network, including TP53, MYC, AKT1, TNF, IL6, EGFR, STAT3, CTNNB1, ESR1, and JUN, and Also, hsa-mir-145, hsa-mir-93, hsa-mir-203, and hsa-mir-126 can be regarded as a gene expression pathway in HPV-induced cervical cancer.
Weakly Supervised Vector Quantization for Whole Slide Image Classification
Authors: Shen Dawei , Zhang Yao-zhong , Imoto Seiya 
Published: September 2024

AbstractWhole Slide Images (WSIs) are gigapixel, high-resolution digital scans of microscope slides, providing detailed tissue profiles for pathological analysis. Due to their gigapixel size and lack of detailed annotations, Multiple Instance Learning (MIL) becomes the primary technique for WSI analysis. However, current MIL methods for WSIs directly use embeddings extracted by a pretrained vision encoder, which are not task-specific and often exhibit high variability. To address this, we introduce a novel method, VQ-MIL, which maps the embeddings to a discrete space using weakly supervised vector quantization to refine the embeddings and reduce the variability. Additionally, the discrete embeddings from our methods provides clearer visualizations compared to other methods. Our experiments show that VQ-MIL achieves state-of-the-art classification results on two benchmark datasets. The source code is available athttps://github.com/aCoalBall/VQMIL.