bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemoradiotherapy versus radiotherapy in high risk salivary gland cancer
Authors: Shen Yicheng , Shan Jiebo 
Published: July 2024

Abstract
Objective
The aim of this study was to investigate the potential survival benefits associated with chemoradiotherapy (CRT) as opposed to radiotherapy (RT) in patients with resected high-risk salivary gland cancer (SGC), with a specific focus on determining whether these benefits are influenced by the number of high-risk variables.

Methods
Patients who underwent surgical treatment for high-risk SGC were retrospectively enrolled and categorized into either CRT or RT groups. The impact of adjuvant therapy on locoregional control (LRC) and overall survival (OS) was assessed using a multivariable Cox model.

Results
A total of 152 patients were included following propensity score-matching. In comparison to RT, CRT did not demonstrate a significant survival advantage in terms of LRC (p = 0.485, HR: 1.14, 95%CI: 0.36–4.22) and OS (p = 0.367, HR: 0.99, 95%CI: 0.17–3.87) in entire population. But among patients with T3/4 stage, high-grade tumors, and 5 or more positive lymph nodes, the addition of chemotherapy to RT significantly (p = 0.042) correlated with a 15% reduction in the risk of cancer recurrence (95%CI: 4-54%). Conversely, in other subgroups with varying combinations of high-risk variables, CRT did not provide additional survival benefits for LRC and OS compared to RT.

Conclusion
Adjuvant chemotherapy may be considered in conjunction with RT specifically in cases where there is a presence of T3/4 stage, high-grade tumors, and 5 or more metastatic lymph nodes in high-risk SGC.
Efficacy of Interceptor G2, Royal Guard and PermaNet 3.0 against pyrethroid-resistant Anopheles gambiae s.l. from Za-Kpota, southern Benin: an experimental hut trial
Authors: Sovegnon Pierre Marie , Akoton Romaric , Stopard Isaac J. , Churcher Thomas S. , McCall Philip J. , Ranson Hilary , Foster Geraldine M. , Djogbénou Luc Salako 
Published: July 2024

Abstract
Background
The widespread use of insecticide-treated nets (ITNs) has significantly contributed to the reduction in malaria cases and deaths observed across Africa. Unfortunately, this control strategy is threatened by the rapid spread of pyrethroid resistance in malaria vectors. Dual-active-ingredient insecticidal nets are now available to mitigate the impact of pyrethroid resistance. To facilitate evidence-based decisions regarding product selection in specific use settings, data are needed on the efficacy of these different nets against local mosquito populations.

Methods
Two experimental hut trials were performed in Za-Kpota, southern Benin in 2021 to evaluate the performance of Interceptor G2 (BASF), Royal Guard (Disease Control Technologies) and PermaNet 3.0 (Vestergaard Frandsen), all dual-active-ingredient bednets, in comparison to untreated or standard pyrethroid-treated bednets, against free-flying wild Anopheles gambiae mosquitoes. The performance of some of these next-generation nets was compared to the same type of nets that have been in use for up to 2 years. Mosquitoes collected in the huts were followed up after exposure to assess the sublethal effects of treatments on certain life-history traits.

Results
The predominant species in the study site was Anopheles gambiae sensu stricto (An. gambiae s.s.). Both Anopheles coluzzii and An. gambiae s.s. were resistant to pyrethroids (deltamethrin susceptibility was restored by piperonyl butoxide pre-exposure). In the experimental hut trials, the highest blood-feeding inhibition (5.56%) was recorded for the Royal Guard net, relative to the standard PermaNet 2.0 net (44.44% inhibition). The highest 72-h mortality rate (90.11%) was recorded for the Interceptor G2 net compared to the PermaNet 2.0 net (56.04%). After exposure, the risk of death of An. gambiae sensu lato (An. gambiae s.l.) was 6.5-fold higher with the Interceptor G2 net and 4.4-fold higher with the PermaNet 3.0 net compared to the respective untreated net. Lower mosquito mortality was recorded with an aged Interceptor G2 net compared to a new Interceptor G2 net. Oviposition rates were lower in mosquitoes collected from huts containing ITNs compared to those of untreated controls. None of the mosquitoes collected from huts equipped with Royal Guard nets laid any eggs.

Conclusions
The Royal Guard and Interceptor G2 nets showed a potential to significantly improve the control of malaria-transmitting vectors. However, the PermaNet 3.0 net remains effective in pyrethroid-resistant areas.

Graphical Abstract
Commentary on the “A multidisciplinary opioid-reduction pathway for robotic prostatectomy: outcomes at year one”
Authors: Zhu Binbin , Cao Angyang , Chen Yijun 
Published: July 2024

Abstract
Background
Opioid-sparing multimodal analgesia is increasingly emphasized for postoperative pain management. This commentary discusses a study by Manning et al. on an opioid reduction pathway for robotic prostatectomy.

Methods
We reviewed the Manning et al. study, which implemented a multidisciplinary opioid reduction pathway and compared outcomes before and after pathway implementation. Outcomes included opioid use, pain scores, antiemetic use, length of stay, and readmissions.

Results
The study found reduced opioid consumption, lower antiemetic use, shorter length of stay, and similar pain scores after pathway implementation. However, the pre-post-study design has limitations in attributing causality to the pathway itself. Key confounders were not fully accounted for. The clinical significance of the small reduction in length of stay is also questionable.

Conclusions
This commentary highlights important limitations of the Manning et al. study, including the retrospective design, potential confounding factors, small effect size, and lack of long-term outcomes. While the study provides early evidence for a multidisciplinary opioid reduction approach, further rigorous prospective research is needed to confirm the observed benefits and long-term impacts. Additional focus on direct opioid consumption, equivalent analgesia assessment, and clinically meaningful outcomes is warranted.
Survival after thermal ablation versus wedge resection for stage I non-small cell lung cancer < 1 cm and 1 to 2 cm: evidence from the US SEER database
Authors: Yim Shelly , Lin Wei Chan , Liu Jung Sen , Yen Ming Hong 
Published: July 2024

Abstract
Background
This study compared the survival outcomes after thermal ablation versus wedge resection in patients with stage I non-small cell lung cancer (NSCLC) ≤ 2 cm.

Methods
Data from the United States (US) National Cancer Institute Surveillance Epidemiology and End Results (SEER) database from 2004 to 2019 were retrospectively analyzed. Patients with stage I NSCLC and lesions ≤ 2 cm who received thermal ablation or wedge resection were included. Patients who received chemotherapy or radiotherapy were excluded. Propensity-score matching (PSM) was applied to balance the baseline characteristics between patients who underwent the two procedures.

Results
Univariate and Cox regression analyses were performed to determine the associations between study variables, overall survival (OS), and cancer-specific survival (CSS). After PSM, 328 patients remained for analysis. Multivariable Cox regression analysis revealed, compared to wedge resection, thermal ablation was significantly associated with a greater risk of poor OS (adjusted HR [aHR]: 1.34, 95% CI: 1.09–1.63, p = 0.004) but not CSS (aHR: 1.28, 95% CI: 0.96–1.71, p = 0.094). In stratified analyses, no significant differences were observed with respect to OS and CSS between the two procedures regardless of histology and grade. In patients with tumor size 1 to 2 cm, compared to wedge resection, thermal ablation was significantly associated with a higher risk of poor OS (aHR: 1.35, 95% CI: 1.10–1.66, p = 0.004). In contrast, no significant difference was found on OS and CSS between thermal ablation and wedge resection among those with tumor size < 1 cm.

Conclusions
In patients with stage I NSCLC and tumor size < 1 cm, thermal ablation has similar OS and CSS with wedge resection.
The role of national nutrition programs on stunting reduction in Rwanda using machine learning classifiers: a retrospective study
Authors: Munyemana Jacques , Kabano Ignace H. , Uzayisenga Bellancile , Cyamweshi Athanase Rusanganwa , Ndagijimana Emmanuel , Kubana Emmanuel 
Published: July 2024

Abstract
Background

In Rwanda, the prevalence of childhood stunting has slightly decreased over the past five years, from 38% in 2015 to about 33% in 2020. It is evident whether Rwanda's multi-sectorial approach to reducing child stunting is consistent with the available scientific knowledge. The study was to examine the benefits of national nutrition programs on stunting reduction under two years in Rwanda using machine learning classifiers.

Methods
Data from the Rwanda DHS 2015–2020, MEIS and LODA household survey were used. By evaluating the best method for predicting the stunting reduction status of children under two years old, the five machine learning algorithms were modelled: Support Vector Machine, Logistic Regression, K-Near Neighbor, Random Forest, and Decision Tree. The study estimated the hazard ratio for the Cox Proportional Hazard Model and drew the Kaplan–Meier curve to compare the survivor risk of being stunted between program beneficiaries and non-beneficiaries. Logistic regression was used to identify the nutrition programs related to stunting reduction. Precision, recall, F1 score, accuracy, and Area under the Curve (AUC) are the metrics that were used to evaluate each classifier's performance to find the best one.

Results
Based on the provided data, the study revealed that the early childhood development (ECD) program (p-value = 0.041), nutrition sensitive direct support (NSDS) program (p-value = 0.03), ubudehe category (p-value = 0.000), toilet facility (p-value = 0.000), antenatal care (ANC) 4 visits (p-value = 0.002), fortified blended food (FBF) program (p-value = 0.038) and vaccination (p-value = 0.04) were found to be significant predictors of stunting reduction among under two children in Rwanda. Additionally, beneficiaries of early childhood development (p < .0001), nutrition sensitive direct support (p = 0.0055), antenatal care (p = 0.0343), Fortified Blended Food (p = 0.0136) and vaccination (p = 0.0355) had a lower risk of stunting than non-beneficiaries. Finally, Random Forest performed better than other classifiers, with precision scores of 83.7%, recall scores of 90.7%, F1 scores of 87.1%, accuracy scores of 83.9%, and AUC scores of 82.4%.

Conclusion
The early childhood development (ECD) program, receiving the nutrition sensitive direct support (NSDS) program, focusing on households with the lowest wealth quintile (ubudehe category), sanitation facilities, visiting health care providers four times, receiving fortified blended food (FBF), and receiving all necessary vaccines are what determine the stunting reduction under two among the 17 districts of Rwanda. Finally, when compared to other models, Random Forest was shown to be the best machine learning (ML) classifier. Random forest is the best classifier for predicting the stunting reduction status of children under two years old.
Exploring barriers and solutions to consumer involvement in health service research using a nominal group technique
Authors: Ryan Laura , Wenke Rachel , Carlini Joan , Weir Kelly A. , Shapiro Margaret , Baglot Noela , Tobiano Georgia , Sargeant Sally , Hattingh Laetitia 
Published: July 2024

Abstract
Background
Consumer involvement in health research is when patients, their families and caregivers work with researchers on research projects. Despite the growing expectation for health services to facilitate the involvement of consumers in research, the practical integration of this approach is an ongoing process, with limited research conducted into how Australian health services can support this practice. This study explored consumer perspectives on the barriers and solutions to enabling consumer involvement in research within an Australian tertiary hospital and health service, and staff perspectives on the solutions to facilitating consumer involvement. A prior survey had identified barriers to consumer involvement from the staff perspective. The broad aim was to inform the development of a framework to help promote consumer involvement in research within the health service.

Methods
A Nominal Group Technique (NGT) was utilised with groups comprised of health service consumers and staff. Three health consumers were co-researchers in the full life-cycle of this study and are included as authors.

Results
Ten consumers and 14 staff participated across three sessions ranging from one to three hours. For consumers, barriers to their involvement were grouped into seven domains: (1) lack of connection with researchers/research projects, (2) low research literacy, (3) structural barriers, (4) lack of acknowledgement, (5) implementation challenges, (6) inadequate information provision, and (7) representation concerns. Solutions to enabling involvement were grouped into five domains: (1) support to connect with researchers/research projects, (2) adequate information provision, (3) incentive for involvement, (4) acknowledgement, and (5) balanced representation. Staff ideas for solutions were grouped into five domains: (1) support to connect with consumers, (2) support to involve consumers, (3) access to funds to remunerate consumers, (4) more time to involve consumers, and (5) staff training.

Conclusion
Through an NGT methodology, this study delivered a nuanced comprehension of perspectives on involving consumers in research from both health service consumers and staff. These findings serve as a foundation for identifying strategies that foster enhanced and refined relationships between consumers and researchers, advancing the collaborative landscape in health research. The findings from this project offer valuable strategies for researchers to better engage consumers in research and for consumer groups to enhance their involvement. Additionally, these insights could be used by other health services to advocate for essential resources.
Automated prediction of response to neoadjuvant chemotherapy from digitized H&E slides of pre-treatment core needle biopsies in germline BRCA carriers with HER2-negative breast cancer (TBCRC 031).
Authors: Tung Nadine M. , Schnitt Stuart J. , Garber Judy Ellen , Mukhopadhyay Satabhisa , Dasgupta Tathagata , Bunnell Craig A. 
Published: July 2024

605 Background: The INFORM trial, a phase II study of neoadjuvant cisplatin (C) vs doxorubicin-cyclophosphamide (AC) in germline BRCA carriers with HER2-negative breast cancer, demonstrated no difference in response rates between the two arms. The aim of the current study was to determine if quantification of features related to the immune response, proliferative status, and key cell cycle deregulation extracted from digital images of H&E-stained pre-treatment core needle biopsies (CNB) could distinguish patients with a good response to neoadjuvant chemotherapy (NAC) (RCB 0,1) from those with a poor response (RCB 2,3). Methods: CNBs (n=92 with RCB scores available) scanned at 40x on a Hamamatsu Nanozoomer scanner were evaluated using the 4D QPOR platform to generate digital biomarkers as continuous indices measuring immune, proliferation, and key cell cycle deregulation signatures. 96% (88/92) could be analyzed successfully. All biomarkers generated were based on an algorithm that combines statistical physics and tumor biology features to quantify cell cycle aberrations, from H&E whole slide images alone, and were evaluated at their median cut-off to determine if they could identify responders to NAC. Other QPOR indices were analyzed using AUC-ROC to further reduce false positive (FP) and false negative (FN) rates. Pathology review was done on FP and FN cases to determine if they were associated with any specific features. Results: The QPOR Immune Heterogeneity Index (IHI), measuring intra-slide spatial heterogeneity of stromal tumor infiltrating lymphocytes (sTIL), was predictive of RCB 0,1 with greater heterogeneity associated with worse response. IHI identified patients with RCB 0,1 with overall accuracy = 65%, sensitivity = 63%, specificity = 66%, PPV = 62%, NPV = 67%. IHI performed better in predicting RCB 0,1 than pathologist-identified sTIL in the full cohort, TNBC, and BRCA1 sub-cohorts (two sample Wilcoxon test p-value = 0.013, 0.047 and 0.013 respectively, with nonsignificant p-values for sTIL). IHI combined with a proliferative index and a G1S phase deregulation index (CmbI) was predictive of RCB 0,1 with improved accuracy over that of any of these features alone (overall accuracy = 80%, sensitivity = 71%, specificity = 87%, PPV = 83%, NPV = 77%, OR = 16.51 95% CI: 10.05-1.14, kappa = 0.59 (p<0.00001), AUC=0.80 95% CI: 0.71-0.89). CmbI better predicted RCB 0,1 for both AC and C arms (AUC=0.83 95% CI: 0.71-0.96 and 0.77 95% CI: 0.63-0.91, OR = 23.22 95% CI: 148.88-5.10 and 6.47 95% CI: 28.08-1.72, respectively) than IHI alone. Conclusions: QPOR-generated immune, proliferative, and key cell cycle signature indices individually, and more strongly in combination, appear predictive of NAC response in germline BRCA carriers with HER2-negative breast cancers.
Survival outcomes and treatment patterns by tumor subtype (TS) in stage III inflammatory and non-inflammatory breast cancer (BC).
Authors: Leone Jose Pablo , Leone Julieta , Nakhlis Faina , Schlam Ilana , Hirko Kelly , Hazra Aditi , Bellon Jennifer Ruth , Vallejo Carlos Teodoro , Lin Nancy U. , Tolaney Sara M. , Lynce Filipa 
Published: July 2024

607 Background: Inflammatory BC (IBC) is an aggressive form of BC for which trimodality therapy (TMT) is standard. We examined TMT use and compared BC-specific survival (BCSS) and overall survival (OS) between IBC and non-IBC within TS. We also examined survival changes over time. Methods: We evaluated patients (pts) with stage III BC diagnosed 2010 - 2020, using Surveillance, Epidemiology and End Results data. The cohort was categorized as IBC (T4d), and non-IBC. TMT included neoadjuvant systemic therapy (NAST), mastectomy, dissection of ≥6 axillary nodes, and adjuvant radiation (RT). We evaluated BCSS and OS between IBC and non-IBC stratified by TS. Comparisons were made in stratified multivariable Cox models providing adjusted hazard ratios (aHzR) with 95% confidence intervals (CI). Results: We included 3,227 IBC and 44,475 non-IBC pts, with a median follow up of 70 and 68 months, respectively. Median age was 57 years for both. As compared with non-IBC, IBC pts were more often White, single, and had more grade III and less HR+/HER2- (all p<0.001). Individual treatments in IBC vs non-IBC included: mastectomy (73.5% vs 68.1%, p<0.001); dissection of ≥6 axillary nodes (54.9% vs 71.6%, p<0.001); RT (58.4% vs 60%, p=0.07), chemotherapy (87.1% vs 78.7%, p<0.001), NAST (58.4% vs 32.7%, p<0.001); respectively. Overall rate of TMT for IBC was 31.4% and decreased from 33.9% in 2010 to 24.2% in 2020 (p for trend = 0.014). Stage III IBC pts had worse BCSS than non-IBC in each TS (table). Pts with T4 tumors had similar differences but with smaller magnitude (table). We observed improvements in BCSS between 2010-2020 for stage III non-IBC (aHzR=0.98 per year, p<0.001), non-IBC T4 only (aHzR=0.97 per year, p<0.001), and stage III non-IBC treated with TMT (aHzR=0.97 per year, p=0.007). In contrast, there were no improvements in BCSS between 2010-2020 for IBC pts overall (aHzR=1.02 per year, p=0.12) or IBC pts treated with TMT (aHzR=1.03 per year, p=0.25). OS showed similar results to those from BCSS across all analyses. Conclusions: Stage III IBC has worse BCSS and OS than stage III non-IBC within each TS. The rate of TMT for IBC is low and decreased significantly over time, though the completeness of treatment data is a limitation. BCSS and OS did not improve over time for IBC pts, even when treated with TMT; whereas BCSS and OS improved for non-IBC. [Table: see text]
Differentiating pancreatic cancer via cfDNA levels in liquid biopsies.
Authors: Riauka Romualdas , Kupcinskaite-Noreikiene Rita , Grabauskyte Ingrida , Barauskas Giedrius , Gulbinas Antanas , Gruodyte Vakare , Jasukaitiene Aldona , Ignatavicius Povilas 
Published: July 2024

e16344 Background: Pancreatic cancer remains an aggressive and highly lethal disease, exhibiting an overall 5-year survival rate of merely 10%, among the lowest compared to other oncological conditions. The absence of early and effective diagnostic tools hampers the management of pancreatic cancer (PC) patients, leading to compromised quality of life and treatment outcomes. Liquid biopsies, a relatively novel diagnostic method, enable non-invasive sampling of tumor materials. Specific genetic information, particularly changes in circulating free DNA (cfDNA) levels, is believed to forecast poorer tumor differentiation, a more aggressive disease course, faster relapse, and potential use as an early cancer diagnostic marker or for evaluating treatment efficacy. Methods: This study was approved by the Kaunas Regional Bioethics Committee (Approval ID: BE-2-31). Patients with newly diagnosed and histologically confirmed PC, without prior treatment and patients with chronic pancreatitis (control group), admitted to the Department of Surgery at Lithuanian University of Health Sciences Hospital, Kaunas Clinics, between September 2022 and November 2023 were included in this study. Blood samples were obtained from the patients before any treatment procedures commenced. cfDNA was extracted from the collected blood using the QIAmp Circulating Nucleic Acid Kit (Qiagen). The concentration and quality of the extracted cfDNA were determined using the Qubit™ 1X dsDNA High Sensitivity (HS) and Broad Range (BR) Assay Kits (ThermoFisher Scientific, Inc., Waltham, MA, USA). Results: Throughout the study period, 55 patients were included (47 with PC and 8 with chronic pancreatitis). cfDNA levels exhibited significant elevation in PC patients compared to those with chronic pancreatitis (p = 0.037; median (minimum – maximum): 46.5 ng/ml (4 – 768) vs 21.9 ng/ml (8.56 – 138.4) accordingly). The determined cut-off value for cfDNA levels distinguishing PC from chronic pancreatitis was 23.65 ng/ml (Area Under the Curve (AUC) = 0.73, sensitivity = 0.851, specificity = 0.625. Nevertheless, no distinctions in cfDNA levels were noted concerning tumor localization, size, differentiation, spread, or survival rates. Conclusions: Liquid biopsies and alterations in cfDNA levels could aid in distinguishing pancreatic cancer from benign inflammatory diseases like chronic pancreatitis. Nonetheless, further studies and experiments are necessary for comprehensive validation.