bluuebunny/crossref_metadata_2025_split huggingface dataset:
HIV Phylogenetic Clusters Point to Unmet HIV Prevention, Testing and Treatment Needs Among Men Who Have Sex with Men in Kenya
Authors: Cholette François , Lazarus Lisa , Macharia Pascal , Walimbwa Jeffrey , Kuria Samuel , Bhattacharjee Parinita , Musyoki Helgar , Mugambi Mary , Ongaro Martin K. , Olango Kennedy , Musimbi Janet , Emmanuel Faran , Isac Shajy , Pickles Michael , Becker Marissa L. , Mishra Sharmistha , McKinnon Lyle R. , Blanchard James , Ho John , Henry Omari , Fabia Rissa , Sandstrom Paul , Lorway Robert , Shaw Souradet Y. 
Published: August 2024

Abstract

Background
The HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study’s objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.
Methods
Dried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.
Results
Of the 2,450 participants (baseline and endline), 453 (18%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 8%), likely due to most study participants being virally suppressed (87%). Among these sequences, 13 (36%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 77%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 85%).
Conclusions
Our findings suggest that GBMSM in Kenya who seek partners through different venues –physical hotspots or online – may have unique and unmet HIV prevention, testing, and treatment needs. Consequently, consideration by programs as to the needs of diverse GBMSM in Kenya across venues is required in order to address their unmet HIV prevention, testing and treatment needs.
Exploring Opioid Management Challenges in Chronic Non-Tumor Pain: Findings from a Mixed-Methods Study among General Practitioners
Authors: Brinkmöller Sabrina , Poß-Doering Regina , Balzer Alexandra , Paul Cinara , Wurmbach Viktoria S. , Zugaj Marco , Wensing Michel , Straßner Cornelia 
Published: August 2024

Abstract

Background: Germany has seen a significant increase in opioid prescriptions, particularly for high-potency opioids, despite limited evidence of their long-term efficacy for chronic non-tumor pain. 87% of these prescriptions are written by general practitioners. The high classified S3-LONTS guideline provides comprehensive recommendations for responsible opioid management. However, there is little insight into the implementation of these recommendations in primary care. This study explores the extent to which these recommendations are considered in general practice.
Methods: A mixed-methods study comprising an online survey and telephone interviews with general practitioners was conducted to assess the implementation of four key recommendations: 1) Setting realistic treatment goals, 2) Using long-acting opioids, 3) Adhering to fixed intake schedules, and 4) Considering opioid reduction or discontinuation in responsive patients. Questionnaire data were analyzed descriptively and through correlation analysis, while interviews were analyzed using an inductive-deductive method based on Kuckartz.
Results: A total of n=131 completed questionnaires and n=21 interviews were analyzed. The survey identified several gaps in implementing recommendations: nearly 50% of general practitioners did not set individualized, realistic treatment goals, half preferred combining long-acting opioids with fixed intervals and short-acting opioids on demand, about 16% used short-acting opioid monotherapy on demand, considered a treatment error. Over half did not discuss reducing or discontinuing opioids after six months of effective pain relief. Qualitative analysis revealed barriers such as general practitioners being inadequately informed, prioritizing personal experience over guidelines, lacking a structured approach to opioid management, and being reluctant to deprescribe opioids due to concerns about compromising treatment success.
Conclusion: Barriers to implementing evidence-based opioid management for chronic non-tumor pain in primary care may contribute to opioid overuse and misuse. Structured treatment programs, peer exchanges about guidelines in quality circles, and a stronger emphasis on guideline importance in (continuing) medical training could enhance the integration of evidence-based recommendations into routine care and reduce concerns about therapy success.
Axillary lymph node dissection is not required for breast cancer patients with minimal axillary residual disease after neoadjuvant chemotherapy
Authors: Muslumanoglu Mahmut , Mollavelioglu Baran , Cabioglu Neslihan , Emiroglu Selman , Tukenmez Mustafa , Karanlık Hasan , Ozmen Tolga , Yılmaz Ravza , Comert Rana Gunoz , Onder Semen , Bayram Aysel , Simsek Duygu Has , Oflas Melis , Ibis Kamuran , Aydıner Adnan , Ozmen Vahit , Igci Abdullah 
Published: August 2024

Abstract

Background
Sentinel lymph node biopsy(SLNB) is widely used in patients who receive neoadjuvant chemotherapy(NAC). Still, axillary lymph node dissection(ALND) is recommended for patients with any axillary residual disease after NAC. The necessity of ALND in patients with minimal axillary disease is unclear. We aim to investigate regional recurrence rates in patients with limited axillary residual disease after NAC underwent SLNB + image-tailored axillary surgery and adjuvant radiotherapy (RT).
Methods
Patients with clinical stages were T1-3 and N1 at the time of diagnosis, clinically good or complete axillary response after NAC, and limited axillary residue (≤ 3 pathological lymph nodes) with favorable response to NAC in the final pathological examination were included in the study. All patients underwent SLNB + image-tailored axillary surgery. Peripheral lymphatic radiotherapy was applied, and no further surgery was performed in patients with compatible radiology and pathology results.
Results
Our study, which evaluated 139 patients with a median age of 47 years, found that the median number of excised lymph nodes was 4. Notably, 46% of patients had between 1 and 3 lymph nodes excised, while 45% had between 4 and 6. Only 9% of patients had ≥ 7 lymph nodes. 83(60%) of the patients underwent breast-conserving surgery (BCS), and 56(40%) underwent mastectomy. The study's median follow-up period was 44 months. During this duration, one breast recurrence (0.7%), one supraclavicular recurrence (0.7%), and six systemic recurrences (4.3%) were observed. No axillary recurrence occurred within the follow-up period.
Conclusions
Patients presenting with pathological-suspicious ≤ 3 lymph nodes on imaging and showing a good response to NAC can be considered suitable candidates for SLNB + image-tailored axillary surgery, followed by adjuvant RT instead of ALND.
IL-17 Expression Negatively Correlates with γδ T-Cell Accumulation in Human Psoriasis Lesions: A Novel Implication for Disease Pathogenesis
Authors: Sevgin Kubra , Ozkanli Seyma , Hekimoglu Gulam , Yesilay Gamze , Yucel Nurullah , Canbaz Halime Tuba , Seker Muzaffer 
Published: August 2024

Abstract

Psoriasis, an inflammatory autoimmune disease, arises from intricate interactions between the immune system and epithelium. Recent reports have suggested new roles for gamma delta (γδ) T-cells in addition to immune surveillance, however, it remains to be determined whether the mechanisms identified in psoriasis murine models have a similar role in humans. The present study aimed to examine the relationship between IL-17 mRNA level and the γδ T-cell proliferation and to clarify their function in the psoriatic human samples. The study involved 20 patients diagnosed with psoriasis and 16 control subjects. Expression of the IL-17 gene was measured in formalin-fixed paraffin-embedded (FFPE) tissues by qRT-PCR method. TCRγδ+ immunofluorescence staining was performed to measure the proliferation and distribution of γδ T-cells in the same samples. In psoriatic lesion biopsies, TCRγδ+ T-cell percentage was found higher than the control samples. Additionally, psoriasis patients exhibited elevated levels of IL-17 gene expression. In addition, this study showed a weak negative correlation between γδ T-cell proliferation and IL-17 gene expression in psoriatic skin samples, highlighting the novel effector functions of these cells in psoriasis pathogenesis.
The Beverage Quality Index and Type 2 Diabetes Risk in Women: A Prospective Analysis of the Mexican Teachers’ Cohort
Authors: Stern Dalia , Cejudo Maria G. Jacobo , Monge Adriana , Khandpur Neha , Voortman Trudy , Geleijnse Johanna 
Published: August 2024

Abstract

BACKGROUND Individual beverages have shown divergent associations with type 2 diabetes. Whether overall beverage quality affects diabetes risk is unknown. Therefore, we estimated the association of a previously developed Beverage Quality Index (BQI) with incidence of diabetes in Mexican women.METHODS We included 77 484 female participants from the Mexican Teachers’ Cohort without diabetes at baseline (2006–2008). At baseline, diet was assessed using a 140-item food-frequency questionnaire. The BQI included 7 components (coffee, milk, juices, sugar-sweetened beverages [SSBs], alcohol, sugar added to beverages, and energy from beverages), with a total theoretical score ranging from 0 to 70. A higher score represents a healthier beverage intake pattern. Data on diabetes incidence were available through 2018 from self-reports or cross-linkage with administrative data. We used multivariable Cox proportional-hazard models adjusted for potential confounders.RESULTS Participants' mean (SD) baseline age was 45.9 (7.2) years, and BQI score was 37.3 (8.6), ranging from 9.8 to 69.3. During a median follow-up of 7.6 years, 4521 participants developed diabetes. After multivariable adjustment, when comparing extreme categories (≥55 vs. <25), a higher BQI was suggestively associated with lower diabetes incidence (HR: 0.87; 95% CI: 0.71, 1.06), but the estimation was imprecise. However, restricted cubic spline analysis showed no association between the BQI and diabetes incidence (p-nonlinearity = 0.20).CONCLUSIONS In a cohort of Mexican women, the BQI for overall beverage quality showed no consistent association with diabetes incidence. Further research on beverage quality indices for Mexican populations, including those with high SSBs intake, is warranted.
Morphodynamics Evolution of the Urban Beaches of Rio de Janeiro, Brazil city.
Authors: Silva Agenor Cunha , Pinto Camille Brito , Vargas Ruan , Dias Fábio Ferreira 
Published: August 2024

Abstract

This article deals with morphodynamics and sedimentation on urban sandy beaches. It focuses on the relationship between depositional dynamics on the beaches of Arpoador, Ipanema and Leblon, in the south zone of the city of Rio de Janeiro, Brazil. The coast morphological evolution described here is a function of sedimentation processes and the width variation on the beaches sand strip. Sediments are evaluated from eighteen beach samples collected from six transect beach profiles to verify the predominant sediment types. Coastal morphodynamics is described based on depositional processes on the morphological beach’s evolution. The morphology evolution is depicted from historical satellite images. Meteorological and oceanographic data reflect the depositional dynamics of beaches under different climatic conditions. Granulometric analysis is used here to determine the grain size, standard deviation, skewness values, and kurtosis. The areas of erosion and deposition of the beaches are shown by maps with the points most susceptible to the negative effects of storms and climate change. The depositional dynamics that occur at the same time alternately between the studied beaches is also analysed to improve the understanding of the depositional processes. On some occasions, the reduction of sand on Arpoador beach occurs at the same time as the accumulation of sand in the area in front of Jardim de Alah beach. On some occasions, the channel connecting the Rodrigo de Freitas Lagoon with the sea is closed. It is hoped that a better understanding of the depositional processes discussed here can be used to facilitate the management and preservation of urban beaches.
Clinical Utility of Multimodal Imaging to Assess Macular Changes in Usher Syndrome: A Transversal Study
Authors: Sabage Josmar , Sabage Luís Expedito , Yamaguti Elisabete Honda , Moreira-Neto Carlos Augusto , Mazzo Alessandra , Lourençone Luiz Fernando Manzoni 
Published: August 2024

Abstract

Purpose
Usher syndrome (USH) is an autosomal recessive disorder that presents with varying degrees of visual loss related to Retinitis Pigmentosa. In most of the developing countries, initial diagnosis is based on clinical criteria and supported by multimodal imaging. The objective of this study is to identify changes in retinal morphology through retinal imaging that could be a diagnostic parameter of disease’s progression.
Methods
a transversal study was conducted to examine patients referred with a presumed clinical diagnosis of USH using visual acuity, campimetry, retinography and quantitative OCT and OCTA parameters. Eyes were divided into two groups according to visual acuity (BCVA): Group 1 BCVA > 0.5 and Group 2 BCVA < 0.5, allowing comparative analysis between eyes with different degrees of visual loss from the disease.
Results
The final sample consisted of 18 patients. Group 1 showed an increased central macular thickness (p = 0.003, µd 64µm), a decrease in FAZ area and perimeter (p = 0.002, µd -0,43 mm2; p = 0,004 µd -1,45mm); an increase in central, internal and total macular vessel perfusion density (p = 0.002, µd 9.57%; p = 0.001, µd 10.24%; p = 0.001, µd 10.40%). This study compared the difference between the quantitative values between OD and OS, finding a mean difference in FAZ’s circularity index of -0.05µm (p = 0.024).
Conclusion
The OCT and OCTA parameters exhibit notable alterations in USH, which vary based on the patient's visual acuity. Evaluation of retinal quantitative parameters presented in this study can be used as tools for monitoring the evolution and future studies in treatment of USH, especially its complications.
Correlation between peripheral blood circulating tumor cell level and tumor response in advanced hepatocellular carcinoma patients treated with immunotherapy and molecular targeted therapy
Authors: Zhou Jiangmin , Xiong Huifang , Chen Dong , Zhang Zhiwei , Wang Wei , Wu Biao 
Published: August 2024

Abstract

Background
Circulating tumor cells (CTCs) are closely associated with hepatocellular carcinoma (HCC) progression, but the value of CTCs in systemic treatment remains to be explored.
Methods
One hundred and twenty-five patients with advanced HCC who underwent systemic treatment were included in the study. Five millilitre peripheral blood were drawn before treatment, one month, three months, six months, and one year after systemic treatment. isolation by size of epithelial tumor cells (ISET) is used to capture circulating tumor cells. The tumor response to systemic treatment was assessed by modified response evaluation criteria in solid tumors criteria (mRECIST). The correlation between the dynamic change of peripheral blood CTCs level and tumor response to systemic treatment was analysis.
Results
The objective response rate (ORR) and disease control rate (DCR) were 39.2% (49/125) and 82.4% (103/125) respectively. Dynamic CTCs analysis showed that the CTCs levels of patients with (progressive disease) PD status continued to be at a high level and gradually increased. The CTCs levels of patients in complete response (CR), partial response (PR), and stable disease (SD) status gradually decreased as treatment continued. Patients with higher initial CTCs levels have worse tumor treatment response. Patients with less than 15 initial CTCs, less than 13 CTCs in the first month, and less than 10 CTCs in the third month are more likely to achieve objective response and have a better response to tumor treatment. The PFS and OS were better than those of patients with more than 15 initial CTCs, more than 13 CTCs in the first month, and more than 10 CTCs in the third month.
Conclusions
The number of CTCs in peripheral blood is closely related to tumor treatment response in patients with advanced HCC. Detecting the number of CTCs in patients has important clinical significance in predicting tumor treatment response and evaluating patient prognosis.
Pneumonitis in older lung cancer patients after radiotherapy (POLCAR): A prospective study to develop a scoring instrument that helps identify radiation pneumonitis in elderly patients with lung cancer
Authors: Rades Dirk , Zwaan Inga , Ohlen Daphne Schepers-von , Bohnet Sabine , Janssen Stefan , Timke Carmen , Kristiansen Charlotte , Duma Marciana-Nona , Keerl Silke , Bartscht Tobias , Yu Nathan , Werner Elisa M. 
Published: August 2024

Abstract

Background: Pneumonitis caused by radiotherapy for lung cancer may be missed, since it often occurs only several months later. In a previous trial including patients of any age, a symptom-based scoring system was tested to facilitate the correct diagnosis of radiation pneumonitis. Since elderly lung cancer patients have a greater risk of developing this complication, a separate scoring system particularly for this age group appears reasonable. This trial investigates such a specific tool for elderly patients irradiated for lung cancer.
Methods: Patients with lung cancer patients aged ≥65 years will be included in this prospective multi-center trial and complete paper-based questionnaires (symptom-based scoring system). Patients indicate and rate symptoms potentially caused by pneumonitis, namely cough, dyspnea, and fever, once a week during and up to 24 weeks following their radiotherapy course. If symptomatic (grade ≥2) pneumonitis is confirmed by corresponding diagnostic procedures, patients receive prednisolone whenever possible. The total score of the symptom-based scoring system, which ranges between 0 and 9 points, is correlated to pneumonitis (yes or no). The discriminative power of the scoring system is evaluated by calculating the area under the receiver operating characteristic curve (AUC). Optimality is defined as a cut-off score with sensitivity ≥90% and specificity ≥80%. In addition, the Youden index (sensitivity + specificity – 1) will be applied. Fifty-nine patients (18 with and 41 without pneumonitis) are required in the full analysis set. Assuming that 5% of the patients will not qualify for this set, 62 patients should be enrolled. In addition, patient satisfaction with the scoring system is evaluated. If the dissatisfaction rate is >20%, the score needs modifications; if the dissatisfaction rate is >40%, the scoring system is considered not useful.
Discussion: If the optimal cut-off score facilitates the diagnosis of radiation pneumonitis and its discrimination from other lung diseases in elderly patients with lung cancer, it will contribute to the development of a mobile application for identification of radiation pneumonitis, which can be used by the patients at home.
Trial registration: clinicaltrials.gov (NCT06480734; URL: https://clinicaltrials.gov/show/NCT06480734); protocol version 1.2, registered on 27th of June, 2024.
Abbreviated MRI Screening in Turkish Women Aged 40-69 With Dense Breasts: A Prospective Feasibility Study
Authors: Yirgin Inci Kizildag , Cabioglu Neslihan , Dursun Memduh , Can Omur , Sener Aziz , Vatandas Gulcin , Aykuter Gonul , Yilmaz Ravza , Ozaydin Ayse Nilufer , Gurdal Sibel Ozkan , Ozcinar Beyza , Akyurt Nuran , Ozmen Vahit , Kayhan Arda , Aribal Erkin 
Published: August 2024

Abstract

Background
Survival time and quality of life increase with the early diagnosis of breast cancer. We aim to investigate the feasibility of abbreviated protocol (AP) breast magnetic resonance imaging (MRI) screening in women with dense breasts in a screening program in a middle-income country.
Methods
The study included 649 women selected randomly from 1285 women with type C and D breasts in a screening program, of which 238 underwent an abbreviated breast MRI screening (AP-MRI). The AP-MRI consisted of dynamic series during the first and second post-contrast phases, in addition to axial T1W and axial T2W-fat sat (TRIM) sequences. The reference standard for the study was based on pathology results obtained from biopsies and normal screening mammography results within two years.
Results
MRI scans of 201 women (84.4%) displayed normal or benign findings (BIRADS-1 and 2). An additional 25 women (10.5%) were recommended for MRI or ultrasound (USG) follow-up (BI-RADS-3) and did not show any progression in the two-year follow-up. The remaining 12 women (5%) were recommended a biopsy (BIRADS-4), of which five were reclassified as BIRADS-3 after a second-look ultrasound. Subsequently, a biopsy of the remaining seven patients. did not reveal any malignancies. They all had a negative two-year follow-up. The main challenges encountered were scheduling AP-MRI screening and compliance of women.
Conclusion
This study highlights that supplemental AP-MRI screening may not offer universal benefits for all women with dense breasts. The use of AP breast MRI could potentially lead to overdiagnosis and unnecessary biopsies, primarily due to false positive findings on MRI scans.
Sensitive Infant Care Tunes a Frontotemporal Interbrain Network in Adolescence
Authors: Schwartz Linoy , Hayut Olga , Levy Jonathan , Gordon Ilanit , Feldman Ruth 
Published: August 2024

Abstract

Caregiving plays a critical role in children's cognitive, emotional, and psychological well-being. In the current longitudinal study, we investigated the enduring effects of early maternal behavior on processes of interbrain synchrony in adolescence. Mother-infant naturalistic interactions were filmed when infants were 3 months old and interactions were coded for maternal sensitivity and intrusiveness using the Coding Interactive Behavior. In early adolescence (Mean = 12.30, SD = 1.25), mother-adolescent interbrain synchrony was measured using hyperscanning EEG during a naturalistic interaction of positive valance. Consistent with prior hyperscanning research, we focused on interbrain connections within the right frontotemporal network. Results indicate that maternal sensitivity in early infancy was longitudinally associated with interbrain synchrony in the right frontotemporal network. Post-hoc comparisons highlighted enhancement of mother-adolescent frontal-frontal connectivity, a connection implicated in parent-child social communication. In contrast, maternal intrusiveness in infancy linked with attenuation of interbrain synchrony in the right frontotemporal network. Sensitivity and intrusiveness are key maternal social orientations that are individually stable in the mother-child relationship from infancy to adulthood and foreshadow children's positive and negative social-emotional outcomes, respectively. Our findings are the first to demonstrate that these two maternal orientations play a role in enhancing or attenuating the child's frontotemporal interbrain network that sustains social communication and affiliation. Results suggest that the long-term impact of the mother's sensitive and intrusive style may relate, in part, to its effects on tuning the child's interbrain network to sociality.