bluuebunny/crossref_metadata_2025_split huggingface dataset:
Triple-negative and Her2-positive breast cancer in women aged 70 and over: prognostic impact of age according to treatment
Authors: Houvenaeghel Gilles , Cohen Monique , Gonçalves Anthony , Berthelot Axel , Chauvet Marie Pierre , Faure Christelle , Classe Jean Marc , Jouve Eva , Sabiani Laura , Bannier Marie , Tassy Louis , Martino Marc , Tallet Agnès , de Nonneville Alexandre 
Published: December 2023

BackgroundElderly breast cancer (BC) patients have been underrepresented in clinical trials whereas ~60% of deaths from BC occur in women aged 70 years and older. Only limited data are available on the prognostic impact of age according to treatment, especially in the triple-negative (TN) and Her2-positive because of the lower frequency of these subtypes in elderly patients. We report herein the results of a multicenter retrospective study analyzing the prognostic impact of age according to treatment delivered in TN and Her2-positive BC patients of 70 years or older, including comparison by age groups.MethodsThe medical records of 31,473 patients treated from January 1991 to December 2018 were retrieved from 13 French cancer centers for retrospective analysis. Our study population included all ≥70 patients with TN or Her2-positive BC treated by upfront surgery. Three age categories were determined: 70-74, 75-80, and &gt; 80 years.ResultsOf 528 patients included, 243 patients were 70-74 years old (46%), 172 were 75-80 years (32.6%) and 113 were &gt;80 years (21.4%). Half the population (51.9%, 274 patients) were TN, 30.1% (159) Her2-positive/hormone receptors (HR)-positive, and, 18% (95) Her2-positive/endocrine receptors (ER)-negative BC. Advanced tumor stage was associated with older age but no other prognostic factors (tumor subtype, tumor grade, LVI). Adjuvant chemotherapy delivery was inversely proportional to age. With 49 months median follow-up, all patient outcomes (overall survival (OS), disease-free survival (DFS), breast cancer-specific survival (BCSS), and recurrence-free survival (RFS)) significantly decreased as age increased. In multivariate analysis, age &gt;80, pT2-3 sizes, axillary macrometastases, lymphovascular involvement, and HR-negativity tumor negatively affected DFS and OS. Comparison between age &gt;80 and &lt;=80 years old showed worse RFS in patients aged &gt; 80 (HR=1.771, p=0.031).ConclusionTN and Her2-positive subtypes occur at similar frequency in elderly patients. Older age is associated with more advanced tumor stage presentation. Chemotherapy use decreases with older age without worse other pejorative prognostic factors. Age &gt;80, but not ≤80, independently affected DFS and OS.
Postoperative adjuvant immunotherapy for high-risk hepatocellular carcinoma patients
Authors: Zhang Wei-Qiao , Zhang Qiao , Tan Li , Guan Zhi-Feng , Tian Feng , Tang Hong-Tao , He Kun , Chen Wei-Qiang 
Published: December 2023

Background and aimStandardized approach to postoperative adjuvant therapy for hepatocellular carcinoma (HCC) remains elusive. This study endeavors to examine the effects of postoperative PD-1 adjuvant therapy on the short-term and long-term prognosis of patients at a heightened risk of post-surgical recurrence.MethodsThe data of HCC patients who underwent hepatectomy at our center from June 2018 to March 2023 were collected from the hospital database. Propensity score matching (PSM) was employed to perform a 1:1 match between the postoperative anti-PD-1 antibody group and the postoperative non-anti-PD-1 antibody group. Kaplan-Meier method was utilized to compare the overall survival (OS) and recurrence-free survival (RFS) between the two groups. Cox regression analysis was conducted to identify the prognostic factors affecting patient outcomes. Subgroup analyses were performed for different high-risk factors.ResultsAmong the 446 patients included in the study, 122 patients received adjuvant therapy with postoperative anti-PD-1 antibodies. After PSM, the PD-1 group had postoperative 1-year, 2-year, 3-year, and 4-year OS rates of 93.1%, 86.8%, 78.2%, and 51.1%, respectively, while the non-PD-1 group had rates of 85.3%, 70.2%, 47.7%, and 30.0%. The PD-1 group had postoperative 1-year, 2-year, 3-year, and 4-year RFS rates of 81.7%, 77.0%, 52.3%, and 23.1%, respectively, whereas the non-PD-1 group had rates of 68.4%, 47.7%, and 25.8% in 1-year, 2-year, 3-year. A multifactorial Cox regression analysis revealed that postoperative PD-1 use was a prognostic protective factor associated with OS and RFS. Subgroup analysis results indicated that HCC patients with high recurrence risks significantly benefited from postoperative anti-PD-1 antibody treatment in terms of OS and RFS.ConclusionFor HCC patients with high-risk recurrence factors and undergoing hepatectomy, postoperative adjuvant therapy with anti-PD-1 antibodies can effectively improve their survival prognosis.
Pediatric autoimmune retinopathy and optic neuropathy: a case report and a review of the literature
Authors: Varma Hersh , Zhang Kevin X. , Shah Veeral S. 
Published: December 2023

PurposeThe purpose of the study was to present a rare case of pediatric bilateral optic neuropathy and retinopathy, which was consistent with a diagnosis of autoimmune retinopathy. We also reviewed the most current literature and phenotypes associated with reported pediatric cases of autoimmune retinopathy.DesignThe design of the study was a case report, with a retrospective case series literature review.SubjectsThis study incorporated data from six subjects, with one presenting as an original case report and five being identified from the English-language literature published to date.Materials and methodsThe materials and methods involved a descriptive analysis of fundus findings, electrophysiologic testing, serum autoantibody testing, optical coherence tomography (OCT), brain MRI scanning, and fluorescein angiography, which were performed where available.Main outcome measuresThe study evaluated the clinical presentation and treatment outcomes of all subjects and followed their visual function over time.ResultsAll six subjects had retinal abnormalities that were documented on imaging, while five out of the six subjects had optic nerve abnormalities. Electrophysiologic testing was performed on three subjects, all of whom recorded abnormal results. An underlying neoplastic disorder was described for four subjects. Serum autoantibody testing results were available for four subjects. The serum testing included using antibodies against a 22-kDa antigen, a 35-kDa optic nerve-derived antigen, a 62-kDa antigen, enolase, recoverin, tubulin, and pyruvate kinase M2. Our subject presented 12 years after resection of a ganglioglioma with asymmetric bilateral vision loss, disc edema in one eye, advanced disc pallor in the fellow eye, and bilateral subtle retinal infiltrates, despite having a normal fluorescein angiogram. OCT demonstrated asymmetric ganglion cell layer thinning, which is consistent with the vision loss. Our subject also had abnormal brain MRI findings of widespread pachymeningeal enhancement, but he had a normal cerebrospinal fluid composition. He was initially treated with high-dose pulse steroids, followed by intravenous immunoglobulin therapy. He experienced partial visual recovery in both eyes.ConclusionsPediatric autoimmune retinopathy and optic neuropathy are rare diseases that can present with unique signs and symptoms. In pediatric patients who present with symptoms of subacute progressive vision loss with negative inflammatory workups, a history of prior neoplasm, and/or clinical findings of progressive retinopathy or optic neuropathy, an autoimmune process should be considered in the differential.
Are lung ultrasound features more severe in infants with bronchiolitis and coinfections?
Authors: De Rose Domenico Umberto , Maddaloni Chiara , Martini Ludovica , Ronci Sara , Pugnaloni Flaminia , Marrocco Gabriella , Di Pede Alessandra , Di Maio Velia Chiara , Russo Cristina , Ronchetti Maria Paola , Perno Carlo Federico , Braguglia Annabella , Calzolari Flaminia , Dotta Andrea 
Published: December 2023

BackgroundThe lung ultrasound (LUS) score can be a useful tool to predict the need for respiratory support and the length of hospital stay in infants with bronchiolitis.ObjectiveTo compare lung ultrasound features in neonates and infants up to three months of age with bronchiolitis to determine whether LUS scores (range 0–36) differ in infants with coinfections or not.MethodsNeonates and infants younger than three months admitted to neonatal units from October 2022 to March 2023, who underwent lung ultrasound evaluation on admission, were included in this retrospective study.ResultsWe included 60 patients who underwent LUS evaluation at admission. Forty-two infants (70.0%) had a single viral infection. Eighteen infants (30.0%) had a coinfection: fifteen infants (25.0%) had more than one virus at PCR; one infant (1.7%) had both a viral coinfection and a viral-bacteria coinfection; two infants (3.3%) had viral-bacteria coinfection. Infants with a single viral infection and those with coinfections had similar LUS scores globally and in different lung zones. An LUS score higher than 8 was identified to significantly predict the need for any respiratory support (p = 0.0035), whereas an LUS score higher than 13 was identified to significantly predict the need for mechanical ventilation (p = 0.024).ConclusionIn our small cohort of neonates and infants younger than three months hospitalized with bronchiolitis, we found no statistically significant differences in the LUS score on admission between patients with a single viral infection and those with multiple infections.
Gastroenterology services for patients with Cystic Fibrosis across Australia and New Zealand: a multi-stakeholder assessment of patients' and professionals’ perspectives
Authors: Katz Tamarah E. , Wakefield Claire E. , Signorelli Christina , Day Andrew S. , Vernon-Roberts Angharad , Ooi Chee Y. 
Published: December 2023

IntroductionGastrointestinal (GI) symptoms are common in individuals with Cystic Fibrosis (CF). International research has highlighted that GI care for this group of patients is lacking. Gastroenterology services to CF clinics across Australasia are yet to be examined. This study aimed to describe the current service delivery model and identify areas for improvement that may lead to positive patient outcomes.Materials and methodsCF clinicians (dietitians, clinical nurse consultants, respiratory consultants), gastroenterologists (GE), and patients or their carers from Australia and New Zealand (NZ) were surveyed online to gather their opinions on CF gastroenterology services provided in their region. Data were analysed using descriptive statistics (frequencies and percentages). Likert scale questions were analysed by grouping responses 1–5 and 6–10, presented alongside the median and interquartile range (IQR). Mann–Whitney U and chi-square tests were used to look at differences between stakeholder groups.ResultsOne hundred and fifty-six health professionals and 172 patients or their carers completed the survey. Results showed that the current GI model of care is predominantly a publicly funded service delivered outside of CF clinic time. GE are largely not integrated into the CF team and report a lack of training opportunities. There is a higher level of dissatisfaction with the current service model in NZ than Australia.DiscussionNo stakeholder group deemed the current CF gastroenterology service model as adequate, leaving opportunity for transformations in this field. Ideally this study will invigorate the need for promotion and integration of GI services that would ultimately benefit the whole CF community.
Implementation and impact of the global access principles at the University of British Columbia: current successes and future challenges
Authors: Gallini Nancy , Hancock Robert E. W. , Lester Richard , Sharp Brett , Wasan Kishor M. 
Published: December 2023

In 2007, the University of British Columbia (UBC) was the first university in Canada to establish and adopt global access (GA) principles. Toward implementing these principles, UBC then identified a set of strategies for providing affordable access to new UBC-developed technologies throughout low- and middle-income countries and among vulnerable populations. In this perspective, we provide an update of UBC’s progress over the past 15 years made on several technologies that fall under the GA principles. The technologies reported on are wide-ranging, including an oral medication for the treatment of leishmaniasis; peptides for potential use against malaria, and various bacterial, viral and fungal infections; a portable vaccine cooler; a diagnostic technology to detect severe sepsis; and an SMS Messaging System to monitor and support patients with HIV, TB and COVID-19. We identify challenges faced by the researchers in implementing the GA principles for these technologies and potential solutions for overcoming them through creative licensing and partnerships with public and private sectors, governments, local companies, and communities. As the UBC example illustrates, universities across the globe have an opportunity to make a significant social impact on improving global health of vulnerable populations and on supporting local infrastructures for sustaining these improvements.
Protective factors enhancing resilience in children of parents with a mental illness: a systematic review
Authors: Van Schoors Marieke , Van Lierde Elke , Steeman Kim , Verhofstadt Lesley L. , Lemmens Gilbert M. D. 
Published: December 2023

ObjectivesA systematic review was conducted to (1) investigate protective factors enhancing resilience in children of parents with a mental illness (COPMI), and (2) examine theoretical and methodological issues in the existing literature.MethodFollowing guidelines for systematic reviews, searches were performed using Web of Science, Pubmed and Embase. After screening 5,073 articles 37 fulfilled inclusion criteria and were extracted for review. Results of the present review indicate that there are several ways to help build resilience in COPMI. More specifically, five protective factors emerged from the reviewed literature: Information, Support, Family functioning and Connectedness, Child coping, and Parenting.DiscussionResearch on protective factors in children confronted with parental mental illness is still scarce and for some factors no clear conclusions can be drawn based on the available evidence. To further our understanding of the building blocks and underlying mechanisms of resilience in COPMI, additional rigorously designed studies are needed.
Magnitude and predictors of pre-diabetes among adults in health facilities of Gondar city, Ethiopia: a cross-sectional study
Authors: Andargie Tsegereda Abebe , Mengistu Berhanu , Baffa Lemlem Daniel , Gonete Kedir Abdela , Belew Aysheshim Kassahun 
Published: December 2023

IntroductionImpaired glucose tolerance currently affects 374 million (7.5%) people worldwide, and by 2030, this number is predicted to affect 454 million (8%). Urban inhabitants have an increased risk of developing pre-diabetes. Thus, the study aimed to assess the magnitude of pre-diabetes and associated factors among adults attending outpatient departments of the health facilities of Gondar, Ethiopia.MethodFrom 3 March to 18 April 2020, an institution-based cross-sectional study was conducted. A systematic random sampling technique was used to select 992 participants. Data were gathered using an interviewer-administered questionnaire, and fasting blood glucose was assessed using capillary blood. Bivariable and multivariable binary logistic regression analyses were fitted to check the association between independent variables and pre-diabetes. Statistical significance was declared at a level of P of &lt;0.05.ResultsThe prevalence of pre-diabetes was 16.6% (95% CIs: 14.3–18.8%). Age [AOR = 3.66, 95% CIs (2.05, 6.52)], a family history of diabetes mellitus [AOR = 3.46, 95% CIs (2.16, 5.52)], waist circumference [AOR = 3.6, 95% CIs (2.26, 5.88)], physical activity [AOR: 5.02, 95% CIs (2.87, 8.77)], dietary diversity [AOR = 3.07, 95% CIs (1.95, 4.84)], and smoking [AOR = 2.9, 95% CI (1.42, 6.05)] were factors associated with pre-diabetes.ConclusionFrom our study, we can conclude that one in six adults in the health facilities have pre-diabetes. Age, family history of diabetes, waist circumference, physical activity, dietary diversity, and smoking were the factors associated with pre-diabetes. Therefore, it is recommended that adults should be educated on modifying their lifestyle, including their diet, and substantial care should be provided for older adults.
The effect of neighborhood social cohesion on life satisfaction in type 2 diabetes mellitus patients: the chain mediating role of depressive symptoms and sleep quality
Authors: Ma Xueping , Bai Wei , Yu Fan , Yang Fan , Yin Jiaxin , Shi Huilian , Niu Yang , Wang Liqun 
Published: December 2023

ObjectiveAlthough most studies have shown that neighborhood social cohesion (NSC) is associated with life satisfaction among patients with type 2 diabetes mellitus (T2DM), it remains unclear how NSC is linked to life satisfaction. The present study aims to examine the potential mediation effect of depressive symptoms and sleep quality on the relationship between NSC and life satisfaction among Chinese individuals with T2DM.MethodsA cross-sectional survey was conducted from August 2019 to November 2020 involving 1747 T2DM patients. The main information was obtained using the Center for Epidemiological Survey Depression Scale (CES-D), self-report sleep quality and life satisfaction questionnaire and NSC scales. Mediation analyses were performed using the PROCESS macro in SPSS.ResultsThe results manifested that the NSC was positively associated with sleep quality (r = 0.219) and life satisfaction (r = 0.214), while negatively correlated with depressive symptoms (r = −0.232). Depressive symptoms were found to be negatively associated with life satisfaction (r = −0.263). NSC influenced life satisfaction through three mediating pathways: (a) depressive symptoms (effect = 0.0081); (b) depressive symptoms and sleep quality (effect = 0.0019); and (c) sleep quality (effect = 0.0015). The total mediating effect accounted for 28.1% of the overall effect.ConclusionOur findings support the hypothesis that depressive symptoms and sleep quality mediated the relationship between NSC and life satisfaction in patients with T2DM. It is important to encourage T2DM patients to participate in social interactions and enhance their level of NSC. Additionally, efforts should be made to actively reduce depressive symptoms and improve sleep quality, so as to improve their life satisfaction.
Economic burden of breast cancer in northern Serbia
Authors: Milovic Marko , Tamas Tatjana , Crnobrnja Veljko , Paut Kusturica Milica 
Published: December 2023

IntroductionBreast cancer is the most common cancer in terms of incidence and mortality among all cancers in women in Vojvodina, the northern region of Serbia. In addition to the effectiveness and safety of therapy, it is important to put emphasis on the cost of treatment, as well as on the optimal allocation of limited resources.ObjectivesThis study aimed to assess the overall economic burden of breast cancer in Vojvodina, as well as the ratio of direct and indirect costs in 2019.Materials and methodsCosts were estimated using Cost of Illness (COI) evaluation, from a social perspective, based on the prevalence of the disease. The total costs included both direct and indirect expenditures. Direct costs associated with breast cancer comprised expenses linked to screening, hospital treatment, outpatient care, and prescribed medications. Indirect costs were estimated using a human capital approach, encompassing expenditures tied to lost productivity arising from sick leave, early retirement, and premature death.ResultsThe total cost of breast cancer in Vojvodina during 2019 was estimated to be 15 million euros. Among the total cost, direct costs accounted for 5 million euros, representing 34% of the overall expenses. Hospital treatment costs accounted for 76% of the direct costs, while screening costs represented 1%. Indirect costs amounted to 10 million euros, constituting 66% of the total cost. The primary driver was attributed to production losses caused by premature retirement, which accounted for 50% of the indirect costs.ConclusionBreast cancer is a huge financial burden on both the health system and society in Vojvodina, accounting for 0.12% GDP. The dominance of indirect costs in total costs, can provide significant guidance to decision-makers in the healthcare system in terms of better allocation of limited resources to breast cancer prevention and early detection strategies.
Dog ownership, glycaemic control and all-cause death in patients with newly diagnosed type 2 diabetes: a national cohort study
Authors: Rådholm Karin , af Geijerstam Peder , Woodward Mark , Chalmers John , Hellgren Margareta , Jansson Stefan , Rolandsson Olov 
Published: December 2023

AimsTo evaluate whether dog ownership from the time of type 2 diabetes diagnosis improved glycaemic control, increased achievement of major guideline treatment goals or reduced the risk of all-cause death.MethodsPatients diagnosed with type 2 diabetes were followed by linkage of four Swedish national registers covering diabetes, dog ownership, socioeconomics, and mortality. Linear regression was used to estimate the mean yearly change in glycated haemoglobin (HbA1c). Cox survival analysis and logistic regression were used to analyse associations between dog ownership and all-cause death and achievement of treatment goals, respectively.ResultsOf 218,345 individuals included, 8,352 (3.8%) were dog-owners. Median follow-up was 5.2 years. Dog-owners had worse yearly change in HbA1c, and were less likely to reach HbA1c, low-density lipoprotein (LDL), and systolic blood pressure (SBP) treatment goals than non-dog-owners (adjusted odds ratios [95% CI] of 0.93 [0.88–0.97], 0.91 [0.86–0.95], and 0.95 [0.90–1.00], respectively). There was no difference in the risk of all-cause death (adjusted hazard ratio [95% CI] 0.92 [0.81–1.04], dog owners versus not).ConclusionOwning a dog when diagnosed with diabetes did not lead to better achievement of treatment goals or reduced mortality, but was in fact associated with a smaller reduction in HbA1c and reduced likelihood of achieving treatment goals.