bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of toxicity after neoadjuvant chemoradiotherapy for locally advanced gall bladder cancer
Authors: Loyal Anushree , Chopra Supriya , Goel Mahesh , Mehta Shaesta , Patil Prachi , Patkar Shraddha , Shrivastava Shyam , Engineer Reena 
Published: April 2024

Background:
The present study evaluated the correlation of hepatobiliary toxicity and radiation dose received in patients undergoing neoadjuvant chemoradiotherapy (NACRT) for locally advanced unresectable gall bladder cancers (LAGBC).

Methods:
Twenty-six patients with LAGBC, treated with NACRT (55–57 Gy/25 fractions/5 weeks and weekly gemcitabine 300 mg/m2) within a phase II study, were included. Whenever feasible, surgery was performed after NACRT. Acute and late hepatobiliary toxicity was recorded. Treatment scans were retrieved to delineate central porto-hepatobiliary system (CPHBS), resected liver surface, segment IV B and V, and duodenum. The doses received by these structures were recorded and correlated with toxicity.

Results:
Of 26 patients, 20 (77%) had partial or complete response and 12 (46%) had R0 resection. At the median follow-up of 38 months, overall survival was 38%. Eight (30%) patients had post-treatment toxicity, of which most common was biliary toxicity (30%). A correlation was observed between the biliary leak and V45Gy CPHBS >50 cm3 (P = 0.070). Higher toxicity was observed in those with metallic stents (P = 0.072).

Conclusion:
The incidence of the biliary leak was 46%. CPHBS dose was found to correlate with biliary leaks. Restricting V45Gy CPHBS <50 cm3 and using plastic stent may facilitate a reduction in hepatobiliary toxicity in patients undergoing NACRT and surgery.
Access to HER2-targeted therapy at a tertiary care center in India
Authors: Nair Nita S , Gupta Sudeep , Ghosh Jaya , Desai Sangeeta , Parmar Vani , Shet Tanuja , Chitkara Garvit , Siddique Shabina , Badwe Rajendra A 
Published: April 2024

Background:
In a previous retrospective audit from our institution we reported that patients had limited access to HER2-targeted therapy due to financial constraints. Subsequently, the advent of biosimilar versions of trastuzumab and philanthropic support has potentially changed this situation. Herein, we reanalyzed and reported access to HER2-targeted therapy in a more recent cohort of patients.

Methods:
Medical records of new breast cancer patients registered in one calendar year were retrospectively reviewed, supplemented by online pharmacy data to extract information on receptor status, use of HER2-targeted therapy, and other relevant variables. Since not all HER2 immunohistochemistry (IHC) 2+ tumors underwent fluorescent in-situ hybridization (FISH) testing, we estimated the probable HER2 amplified from this group based on a FISH amplified fraction in those HER2 2+ tumors who did undergo FISH.

Results:
Between January 2016 and December 2016, 4717 new BC patients were registered at our institution, of whom 729 (20.04%) had HER2 IHC 3+ tumors while 641 (17.62%) had HER2 IHC 2+ tumors. The final number of HER2 overexpressing/amplified tumors was estimated to be 928 (729 HER2 IHC 3+, 105 known FISH amplified, and 94 estimated FISH amplified), of whom 831 received treatment at our institution. Overall 474 (57.03%, 95% confidence interval [CI] 53.6–60.4) of these 831 patients received trastuzumab for durations ranging from 12 weeks to 12 months in the (neo)adjuvant setting or other durations in metastatic setting compared to 8.61% (95% CI 6.2–11.6) usage of HER2-targeted therapy in the 2008 cohort.

Conclusion:
Access to HER2-targeted therapy has substantially increased among patients treated at a public hospital in the past decade, likely due to the advent of biosimilars, the use of shorter duration adjuvant regimens, and philanthropic support. However, further efforts are required to achieve universal access to this potentially life-saving treatment.
Survival outcomes with 12 weeks of adjuvant or neoadjuvant trastuzumab in breast cancer
Authors: Ghosh Joydeep , Joy Phillip Deepa S , Ghosh Jaya , Bajpai Jyoti , Gulia Seema , Parmar Vani , Nair Nita , Joshi Shalaka , Sarin Rajiv , Budrukkar Ashwini N , Wadasadawala Tabassum , Desai Sangeeta B , Shet Tanuja , Patil Asawari , Sawant Sheela P , Dhir Aruna A , Kembhavi Seema , Popat Palak , Hawaldar Rohini , Kembhavi Yogesh , Perumal Prema , Banavali Shripad D , Badwe Rajendra A , Gupta Sudeep 
Published: April 2024

Background:
There is limited access to 1 year of adjuvant trastuzumab in resource-constrained settings. Most randomized studies have failed to prove non-inferiority of shorter durations of adjuvant trastuzumab compared to 1 year However, shorter durations are often used when 1 year is not financially viable. We report the outcomes with 12 weeks of trastuzumab administered as part of curative-intent treatment.

Methods:
This is a retrospective analysis of patients treated at Tata Memorial Centre, Mumbai, a tertiary care cancer center in India. Patients with human epidermal growth factor receptor (HER2)-positive early or locally advanced breast cancer who received 12 weeks of adjuvant or neoadjuvant trastuzumab with paclitaxel and four cycles of an anthracycline-based regimen in either sequence, through a patient assistance program between January 2011 and December 2012, were analyzed for disease-free survival (DFS), overall survival (OS), and toxicity.

Results:
A total of 102 patients were analyzed with a data cutoff in September 2019. The median follow-up was 72 months (range 6–90 months), the median age was 46 (24–65) years, 51 (50%) were postmenopausal, 37 (36%) were hormone receptor-positive, and 61 (60%) had stage-III disease. There were 37 DFS events and 26 had OS events. The 5-year DFS was 66% (95% Confidence Interval [CI] 56–75%) and the OS was 76% (95% CI 67–85%), respectively. Cardiac dysfunction developed in 11 (10.7%) patients.

Conclusion:
The use of neoadjuvant or adjuvant 12-week trastuzumab-paclitaxel in sequence with four anthracycline-based regimens resulted in acceptable long-term outcomes in a group of patients, most of whom had advanced-stage nonmetastatic breast cancer.
Determining PD-L1 expression in head and neck squamous cell carcinoma using immunohistochemistry
Authors: Mishra Prabha S , Sidhu Avnit , Dwivedi Gunjan , Mulajker Deepak S , Awasthi Shivali 
Published: April 2024

Background:
Advanced head and neck squamous cell carcinoma (HNSCC) has limited treatment options. Programmed death-ligand1 (PD-L1) expressed by tumor cells interacts with PD-1 receptor on T lymphocytes leading to immune evasive response and survival advantage. Therapy with immune check-point inhibitors target PD-1/PD-L1 blockade inducing tumor regression. Immunohistochemistry (IHC) for PD-L1 expression enables patient selection for immunotherapy and may be considered a potential predictor of clinical response.

Methods:
A retrospective analysis of IHC for PD-L1 expression using manual laboratory developed technique (LDT) with antibody clone 22C3 (Dako) in 93 cases of HNSCC. PD-L1 expression was correlated with age, gender, tumor site, grade and stage.

Results:
PD-L1 IHC was performed in 93 cases and immunopositivity was noted in 59 (63.4%) cases. High expression with combined proportion score (CPS) ≥50 was seen in 15 (16.1%) cases and low expression with CPS ≥1 expression was seen in 44 (47.3%) cases. An almost-perfect interobserver agreement was noted by two pathologists for PD-L1 IHC expression (Cohen’s kappa coefficient = 0.910). No statistically significant correlation was noted between PD-L1 score and patient demographics, tumor site, grade or stage.

Conclusion:
Detection of PD-L1 status by IHC enables identification of HNSCC patients eligible for future targeted immunotherapy.
Safety profile of G-CSF in chemotherapy-induced neutropenia
Authors: Deb Uttiya , Mukhopadhyay Sandip , Banerjee Sanatan , Biswas Supreeti 
Published: April 2024

Background:
Granulocyte-colony stimulating factor (G-CSF) is used in cancer patients to treat chemotherapy-induced neutropenia (CIN). However, G-CSF poses few risks. Despite the regular use of G-CSF in CIN management, there is a paucity of published data on its safety profile in the management of CIN in India. Hence, the present study was designed to demonstrate the safety profile of G-CSF in patients with CIN.

Methods:
A prospective observational study was conducted over a period of 5 months enrolling 100 cancer patients aged from 18 years to 70 years. Patients with a diagnosis of CIN who received G-CSF were included. Patients were followed up for 15 days. Adverse events (AEs) were graded according to US National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The system organ class and preferred term of Medical Dictionary for Regulatory Activities (MedDRA) were used for reporting the AEs. Causality assessment was done by using the WHO-Uppsala Monitoring Centre scale.

Results:
The most frequently reported AEs were musculoskeletal and connective tissue disorders which included bone pain, myalgia, arthralgia, and pain in the extremity. Other AEs reported were general disorders and administration site conditions, and gastrointestinal disorders. The highest grade of toxicity reported was of grade 3 among all AEs. The majority of AEs had a “probable” type of causality relationship with G-CSF.

Conclusion:
G-CSF has a safety profile consistent with previous G-CSF studies.
Comparison of Root Canal Morphology in Intraoral Periapical Radiographs and Cone-Beam Computed Tomography: An In vitro Study
Authors: Sil Shiladitya , Ghosh Subhankar , Saha Nilanjana , Ghosh Suryoday 
Published: April 2024

Backgrounds and Objectives:
Intraoral periapical radiographs (IOPAR) are routinely used to fulfill the preoperative, par-operative and postoperative imaging needs in endodontic treatment. IOPAR is not a sensitive tool for identification of complex root canal morphology with failure rates of up to 34%. Cone-beam computed tomography (CBCT) provides three-dimensional imaging and has been recommended when endodontic imaging needs cannot be met by IOPAR. There is a need to understand which anatomic parameters are better viewed in CBCT and which on IOPAR. Hence, this study is planned to compare the root canal morphology on IOPAR and CBCT and correlate with chemically cleared tooth.

Methods:
One hundred recently extracted teeth were collected and subjected to IOPAR and CBCT scanning. A total of six root canal morphologies were compared in both the imaging modalities and with the teeth itself after making it chemically transparent.

Results:
CBCT and IOPAR showed a good agreement in detection of fractured tooth roots with P < 0.005. However, CBCT was better than IOPAR in detection of the number of accessory canals, ramifications, and obliterations in the root canal and fractures with P < 0.005. IOPAR showed reduced artifacts with P < 0.005. During working length measurement, both CBCT and IOPAR showed increased values than the cleared teeth although CBCT was more accurate.

Conclusion:
We can conclude from this study CBCT is more accurate in detection of root canal morphologies in comparison to IOPAR.
The Quality and Reliability of Information in YouTube Videos on Occupational Health and Safety
Authors: Erdoğan Ayşegül , Kaya Erhan , Şahin Musa , Kurt Burk , Gökmen Rasim 
Published: April 2024

Abstract

Background:
Education is very important to prevent occupational injuries and accidents, which are almost all completely preventable. The aim of this study was to evaluate training videos on this subject on the YouTube platform.

Methods:
Six search terms related to occupational health and safety (OHS) were scanned on May 31, 2021. After the application of exclusion criteria, a total of 176 videos were included for final analysis using the parameters of country origin, source of the video, content, number of views, comments, likes, dislikes, and video duration. The Global Quality Scale (GQS) and modified DISCERN tools were used to evaluate the quality and reliability of the videos in this analytical cross-sectional study.

Results:
According to the GQS score, 111 (63.1%) videos were of low quality. Statistically significant differences were found between the low-, moderate-, and high-quality groups with respect to video length, likes, dislikes, comments, likes per day, dislikes per day, comments per day, video category, and the DISCERN scores (P < 0.05). The vast majority of videos contained low-quality information. A large number of videos were uploaded on OHS content from independent users and the USA.

Conclusion:
There is a clear need for professionals to play a more active role in uploading and sharing high-quality information on Internet platforms on the subject of OHS.
Association of Anthropometric Adiposity Indices and Hand Grip Strength among Male Industrial Workers in Chennai, Tamil Nadu, India: A Cross-Sectional Study
Authors: Priyadarshini R. Durga , Beatrice D. Annette 
Published: April 2024

Abstract

Background:
Hand Grip Strength (HGS), a basic, non-invasive measure of musculoskeletal function is found to be a risk marker for cardiovascular diseases, respiratory diseases, diabetes, metabolic syndrome, and cancer. Considering the importance and paucity of studies among industrial workers, we aim to study the association between anthropometric adiposity indices and the HGS of industrial workers.

Materials and Methods:
The study is a descriptive, cross-sectional study. Anthropometric measurements and HGS of 198 male industrial workers between 21 and 60 years of age, employed at metal manufacturing industries in Chennai, Tamil Nadu, India were assessed.

Statistical Analysis:
Descriptive and inferential statistics were done using “R” statistical software.

Results:
The mean age of male industrial workers was 39.51 ± 12.20 years. The majority of the workers were found to be obese (64%) and the mean body fat percentage was 27.69 ± 5.13%. The mean HGS of the worker’s dominant hand was found to be 35.80 ± 8.93 kg and of their non-dominant hand was 35.0 ± 8.67 kg. When compared to the normative values of HGS for Indians, results revealed significantly higher HGS of both dominant and non-dominant hands of workers between the age group of 21–30 years and 51–60 years. Multiple linear regression analysis revealed that body weight [β(s.e) =0.27 (0.05), P < 0.000], body fat [β(s.e) = −0.52 (0.14), P < 0.000) and WHR [β(s.e) = −28.81 (11.9), P = 0.017] independently predicted the HGS of dominant hand. In non-dominant hand, body weight [β(s.e) = 0.26 (0.05), P < 0.000] and body fat [β(s.e) = −0.60 (0.13), P < 0.000] independently predicted HGS.

Conclusions:
Body fat, body weight, and Waist-to-Hip ratio (WHR) were found to have a significant influence on the HGS of industrial workers. Strategies aimed to reduce overall body fat and abdominal obesity may prove beneficial in improving HGS and nutritional status thereby reducing the risk of non-communicable diseases.
Dental Erosion—An Occupational Hazard among Battery Manufacturing Industry Workers in Hyderabad, India
Authors: Kalyani Suma , Reginald B. Ajay , Reddy B. Siva , Samatha Meda 
Published: April 2024

Abstract

Background and Objective:
Dental erosion is a condition that results from exposure of the enamel and dentin to non-bacterial acids of extrinsic and intrinsic origin, causing mineral loss on the surface of the tooth. Occupational exposure to sulfuric acid fumes has been described in association with dental erosion in battery manufacturing industry workers. Hence, this study aimed to assess the dental erosion among battery factory workers in HBL Power Systems Ltd, Hyderabad.

Materials and Methods:
The sample consisted of 90 battery factory workers (62 males and 28 females). Demographic data with regard to age, gender, and length of exposure were recorded. Clinical examination was done to assess dental erosion using the tooth wear index given by Smith and Knight. Data were statistically analyzed by using Fisher exact test. P <0.05 was considered statistically significant.

Results:
Among 90 workers examined, 43.3% showed prevalence of erosion with higher occurrence rate in females (54%) than males (38.7%). 66.6% of affected workers had erosion score of 1, and 33.4% showed erosion score of 2 and 3. We also observed statistically significant highest prevalence and increased severity of dental erosion in workers with prolonged duration of employment (>11 years).

Conclusion:
The present study revealed increased prevalence of dental erosion among battery factory workers. Hence, it highlights the importance of protective measures with efficient surveillance and monitoring in the workplace environment.
Emotional Intelligence and Occupational Stress Among Nursing Professionals in Tertiary Care Hospitals of Bangalore: A Multicentric, Cross-Sectional Study
Authors: Regy Minitta M. , Ramesh Naveen 
Published: April 2024

Abstract

Background:
Nursing profession requires strength and resilience not just physically, but emotionally as well which requires them to adapt in stressful situations that they are often exposed to in their work environment.

Objective:
To determine the prevalence and associated factors of emotional intelligence (EI) and occupational stress (OS) among the nursing professionals from selected tertiary care hospitals in Bangalore, India.

Methods:
This was a multi-centric, cross-sectional study done among nurses with more than 1year of work experience and they were randomly selected from four tertiary care hospitals in Bangalore. The EI and OS were assessed using the Emotional intelligence scale (EIS) and Occupational Stress Index (OSI). Data was collected, both online and offline, owing to the ongoing COVID-19 pandemic. The data was analyzed using SPSS v21.0 to calculate the mean, associations, and regression.

Results:
Out of the total 294, the mean age of the study participants was 27±4.92years. A total of 75 (25.5%) nurses had poor EI and 245 (83.3%) had moderate OSI. None of the participants had high OSI. There was a significant association between the severity grades of EI and OSI (P = 0.010) and a binary logistic regression showed that those staff with high EI had a lesser odd (OR 0.531, 95% CI 0.282-0.999) of developing occupational stress as compared to those with low EI.

Conclusion:
EI plays a significant role in reversing the effect of one’s occupational stress. Thereby, the training curriculum should include skills and measures of resilience to facilitate their EI improvement.
Rate and Causes of 30-day Unplanned Readmission/Return Following Head and Neck Surgery at a Tertiary Care Center in Saudi Arabia
Authors: Merdad Mazin , Alqutub Abdulsalam , Mogharbel Ahmed , Alghamdi Abdullah A. , Alsulami Omar , Awadh Mohammed , Alsulami Ahmed S. 
Published: April 2024

Abstract

Background:
Identifying and targeting common preventable causes of 30-day hospital readmissions could help improve survival rates and reduce the healthcare burden.

Objective:
To determine the rate and causes of unplanned hospital return/readmission to the Outpatient Department (OPD) or Emergency Department (ED) within 30 days after discharge following head and neck surgery (HNS) at a tertiary hospital in Western Saudi Arabia.

Methods:
This retrospective study included all adult patients (aged ≥18 years) who had undergone HNS at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 2015 and December 2022 and returned to the OPD or ED within 30 days of being discharged.

Results:
Of 1041 patients who had undergone HNS, 84 (8.1%) returned to the hospital within 30 days after discharge: 63 (6.1%) to the OPD and 21 (2.0%) to the ED. A total of 9 (0.9%) patients were readmitted as inpatients, most commonly for infections (33.3%) and neurological symptoms, including weakness and seizures (22.2%). For OPD visits, common causes were wound swelling (25.4%) and neurological symptoms (17.5%). For ED returns, frequent causes were neurological symptoms (23.8%) and surgical site bleeding (19.1%). Readmission was associated with intensive care unit (ICU) admission during the primary hospital stay (P = 0.003) and higher preoperative baseline health burdens when examined using the American Society of Anesthesiology score (P = 0.022), the Cumulative Illness Rating Scale (P = 0.007), and the Charlson Comorbidity Index (CCI) (P = 0.006).

Conclusion:
The rate of 30-day unplanned hospital return following head and neck surgery was 6.1% and 2.0% through the OPD and the ED, respectively; 0.9% were readmitted as inpatients. Common causes of return included wound swelling, infections, bleeding, and neurological symptoms.
Prescribing Trends of Renin-Angiotensin System Inhibitors and Mortality among Acute Coronary Syndrome Patients: Insights from the Malaysian National Cardiovascular Disease Registry
Authors: Suki Siti Zaleha , Zuhdi Ahmad Syadi Mahmood , Yahya Abqariyah , Adnan Wan Ahmad Hafiz Wan Md , Zaharan Nur Lisa 
Published: April 2024

Abstract

Background:
Despite guideline recommendations, suboptimal prescription rates of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been observed in patients with acute coronary syndrome.

Objective:
This study aimed to examine the temporal trends, variations, and mortality outcomes among acute coronary syndrome patients prescribed ACEIs/ARBs in the multi-ethnic population of Malaysia.

Methodology:
This retrospective study utilized data from the Malaysian National Cardiovascular Disease–Acute Coronary Syndrome registry, encompassing consecutive patient records from 2008 to 2017 (N = 60,854). Ten-year temporal trends of on-discharge ACEIs/ARBs prescription were examined. Demographics, clinical characteristics and 1-year all-cause mortality outcomes were compared between patients prescribed and not prescribed ACEIs/ARBs.

Results:
The 10-year prescription rate of on-discharge ACEIs/ARBs was 52.8% (n = 32,140), with a significant decline over the years [linear trend test, P = 0.008; SD = 0.03; SE = 0.001; 95% CI = 0.55-0.64]. Patients aged ≥65 years (aOR = 0.79; 95% CI = 0.73–0.86) were less likely to be prescribed ACEIs/ARBs than those aged <65 years. In addition, patients with comorbid diabetes mellitus (DM) (aOR = 0.85; 95% CI = 0.79–0.92) and chronic kidney disease (CKD) (aOR = 0.34; 95% CI = 0.30–0.40) were significantly less likely to receive ACEIs/ARBs. IPW-adjusted survival analysis revealed a 38% lower 1-year all-cause mortality rate in patients prescribed on-discharge ACEIs/ARBs (HR = 0.62; 95% CI = 0.56–0.69; P < 0.001).

Conclusion:
Acute coronary syndrome patients with concomitant DM and CKD were less likely to receive on-discharge ACEIs/ARBs in Malaysia. Suboptimal prescription rates of ACEIs/ARBs persisted over the 10-year period, despite improved 1-year survival in ACS patients prescribed ACEIs/ARBs.