bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective study of cancer patients’ predictive factors of care in a large, Hungarian tertiary care centre
Authors: Koch Márton , Szabó Éva , Varga Csaba , Soós Viktor , Prenek Lilla , Porcsa Lili , Bellyei Szabolcs , Girán Kyra , Girán János , Kiss István , Pozsgai Éva 
Published: May 2023

ObjectivesTo identify predictive factors of multiple emergency department (ED) visits, hospitalisation and potentially preventable ED visits made by patients with cancer in a Hungarian tertiary care centre.DesignObservational, retrospective study.SettingA large, public tertiary hospital, in Somogy County, Hungary, with a level 3 emergency and trauma centre and a dedicated cancer centre.ParticipantsPatients above 18 years with a cancer diagnosis (International Classification of Diseases, 10th Revision codes of C0000–C9670) who visited the ED in 2018, who had received their diagnosis of cancer within 5 years of their first ED visit in 2018 or received their diagnosis of cancer latest within the study year. Cases diagnosed with cancer at the ED (new cancer diagnosis-related ED visits) were also included, constituting 7.9% of visits.Primary outcome measuresDemographic and clinical characteristics were collected and the predictors of multiple (≥2) ED visits within the study year, admission to inpatient care following the ED visit (hospitalisation), potentially preventable ED visits and death within 36 months were determined.Results2383 ED visits made by 1512 patients with cancer were registered. Predictive factors of multiple (≥2) ED visits were residing in a nursing home (OR 3.09, 95% CI 1.88 to 5.07) and prior hospice care (OR 1.87, 95% CI 1.05 to 3.31). Predictive factors for hospitalisation following an ED visit included a new cancer diagnosis-related visit (OR 1.86, 95% CI 1.30 to 2.66) and complaint of dyspnoea (OR 1.61, 95% CI 1.22 to 2.12).ConclusionsBeing a resident of a nursing home and receiving prior hospice care significantly increased the odds of multiple ED visits, while new cancer-related ED visits independently increased the odds of hospitalisation of patients with cancer. This is the first study to report these associations from a Central-Eastern European country. Our study may shed light on the specific challenges of EDs in general and particularly faced by countries in the region.
Immunotherapy resistance driven by loss of NY-ESO-1 expression in response to transgenic adoptive cellular therapy with PD-1 blockade
Authors: Frankiw Luke , Singh Arun , Peters Cole , Comin-Anduix Begoña , Berent-Maoz Beata , Macabali Mignonette , Shammaie Kiana , Quiros Crystal , Kaplan-Lefko Paula , Baselga Carretero Ignacio , Ribas Antoni , Nowicki Theodore Scott 
Published: May 2023

BackgroundThe tumor antigen NY-ESO-1 has been shown to be an effective target for transgenic adoptive cell therapy (ACT) for the treatment of sarcoma and melanoma. However, despite frequent early clinical responses, many patients ultimately develop progressive disease. Understanding the mechanisms underlying treatment resistance is crucial to improve future ACT protocols. Here, we describe a novel mechanism of treatment resistance in sarcoma involving loss of expression of NY-ESO-1 in response to transgenic ACT with dendritic cell (DC) vaccination and programmed cell death protein-1 (PD-1) blockade.MethodsA HLA-A*02:01-positive patient with an NY-ESO-1-positive undifferentiated pleomorphic sarcoma was treated with autologous NY-ESO-1-specific T-cell receptor (TCR) transgenic lymphocytes, NY-ESO-1 peptide-pulsed DC vaccination, and nivolumab-mediated PD-1 blockade.ResultsPeripheral blood reconstitution with NY-ESO-1-specific T cells peaked within 2 weeks of ACT, indicating rapid in vivo expansion. There was initial tumor regression, and immunophenotyping of the peripheral transgenic T cells showed a predominantly effector memory phenotype over time. Tracking of transgenic T cells to the tumor sites was demonstrated in on-treatment biopsy via both TCR sequencing-based and RNA sequencing-based immune reconstitution, and nivolumab binding to PD-1 on transgenic T cells was confirmed at the tumor site. At the time of disease progression, the promoter region of NY-ESO-1 was found to be extensively methylated, and tumor NY-ESO-1 expression was completely lost as measured by RNA sequencing and immunohistochemistry.ConclusionsACT of NY-ESO-1 transgenic T cells given with DC vaccination and anti-PD-1 therapy resulted in transient antitumor activity. NY-ESO-1 expression was lost in the post-treatment sample in the setting of extensive methylation of the NY-ESO-1 promoter region.Biological/clinical InsightAntigen loss represents a novel mechanism of immune escape in sarcoma and a new point of improvement in cellular therapy approaches.Trial registration numberNCT02775292.
Mapping language literacy at scale: a case study on Facebook
Authors: Lin Yu-Ru , Wu Shaomei , Mason Winter 
Published: May 2023

AbstractLiteracy is one of the most fundamental skills for people to access and navigate today’s digital environment. This work systematically studies the language literacy skills of online populations for more than 160 countries and regions across the world, including many low-resourced countries where official literacy data are particularly sparse. Leveraging public data on Facebook, we develop a population-level literacy estimate for the online population that is based on aggregated and de-identified public posts written by adult Facebook users globally, significantly improving both the coverage and resolution of existing literacy tracking data. We found that, on Facebook, women collectively show higher language literacy than men in many countries, but substantial gaps remain in Africa and Asia. Further, our analysis reveals a considerable regional gap within a country that is associated with multiple socio-technical inequalities, suggesting an “inequality paradox” – where the online language skill disparity interacts with offline socioeconomic inequalities in complex ways. These findings have implications for global women’s empowerment and socioeconomic inequalities.
Outcomes and Histological Variations of Neuroblastoma and Ganglioneuroblastoma with Paraneoplastic Syndromes
Authors: Mina Alexander S. , Nashed Gloria N. , Hermina Andrew M. , Schauwecker Suzanne M. , Phelps Hannah M. , Benedetti Daniel J. , Correa Hernan , Lovvorn Harold N. 
Published: May 2023

Background Neuroblastomas are the most common extracranial solid malignancy in children with variable manifestations and complications depending on the presence of paraneoplastic syndromes. Materials and Methods We performed a single institution retrospective cohort study of all patients less than 18 years old diagnosed with neuroblastoma or ganglioneuroblastoma between January 2002 and July 2022. Patients were identified through the pathology and cancer registry and cross-referenced with pediatric records. Patient demographics, clinical presentation, treatment, and outcomes were collected. A univariate descriptive analysis of the collected data was conducted. Results In our study period, 130 children were diagnosed with neuroblastoma, and 15 were diagnosed with ganglioneuroblastoma. There were 12 children with a paraneoplastic syndrome identified, 8 with NBL and 4 with ganglioneuroblastoma (GNBL). The average age at diagnosis was 22 months. All but 1 underwent resection prior to treatment of paraneoplastic syndrome, and 4 children required neoadjuvant therapy. Neurological complications were the most common with 10 children (83%). The average time from symptom onset to diagnosis was 0.7 months. Eight children had complete resolution of their symptoms after treatment and resection, 2 children recently started treatment within a year, 1 had partial resolution, and 1 died during treatment. The presence of tumor-infiltrating lymphocytes occurred in 4 children with neurologic paraneoplastic syndromes. Six children had neuropil rich tumors. Conclusion The histological profile of paraneoplastic syndromes of neuroblastoma and ganglioneuroblastoma and their treatment across a single institution can be highly variable. The presence of tumor-infiltrating lymphocytes and neuropil may have an impact on paraneoplastic pathology.
Models of care for people with dementia approaching end of life: A rapid review
Authors: Lewis Suzanne , Triandafilidis Zoi , Curryer Cassie , Jeong Sarah Yeun-Sim , Goodwin Nicholas , Carr Sally , Davis Daneill 
Published: May 2023

Background: People with dementia have different care and support needs at their end of life compared to people with other life-limiting illnesses, and general palliative care models may not meet the needs of people with dementia and their carers and families. Some dementia-specific end-of-life care models have been implemented, and a summary of existing models was undertaken to inform development of a local model. Aim: To identify best-practice models of care for people in the advanced and end stages of dementia, and their families and carers. Design: A rapid review with narrative summary of peer-reviewed articles and grey literature was conducted. Data sources: Ten databases were searched for articles published between January 2000 and April 2022. Inclusion criteria were: all care settings; AND the model focuses on people with end-stage or advanced dementia; AND contained multiple components. Results: Nineteen articles or reports, describing twelve dementia-specific models of end-of-life care in a range of care settings were identified for inclusion in the review. There is strong evidence that the principles of best practice palliative care for people with advanced dementia are well known, but limited examples of translation of this knowledge into integrated models of care. The key issues that emerged from the findings were: referral and admission to care, integration of care, sustainability and evaluation. Conclusions: Findings can be used to inform development of improved end-of-life care pathways for people with dementia, but well-designed research studies are needed to evaluate the effectiveness of integrated models of care for this vulnerable population.
Percentiles for paraspinal muscle parameters at the L3 vertebra level in patients undergoing lumbar computed tomography scanning
Authors: Yao Ning , Li Xintong , Huang Pengju , Wang Ling , Cheng Xiaoguang , Yu Aihong 
Published: May 2023

Background Computed tomography (CT) is the gold standard for analyzing muscle parameters. Purpose To clarify sex-specific paraspinal muscle area (PMA), paraspinal muscle index (PMI), and muscle fat infiltration (MFI) percentiles. Material and Methods This was a cross-sectional study of 760 individuals (45% men; age range = 20–92 years; mean age = 53.4 ± 21.1 years) with a body mass index (BMI) in the range of 16.4–38.1 kg/m2. CT scans were retrospectively used to establish PMA, PMI, and MFI at L3 level using a deep-learning (DL) tool. Sex-specific distributions for these parameters were assessed based on associations between age/BMI and individual muscle parameters, after which age- and BMI-specific percentile estimates were determined. The 5th percentile was regarded as the cutoff for PMA/PMI, and the 95th percentile was regarded as the cutoff for MFI. Results Sex-specific PMA, PMI, and MFI cutoffs in the paraspinal muscles group were 52.9 cm2, 15.0 cm2/m2, and 33.3%, respectively, in men, and 33.2 cm2, 9.5 cm2/m2, and 41.2% in women. Age was moderately negatively correlated with PMA and was strongly negatively correlated with PMI, but age was strongly positively correlated with MFI. BMI was moderately positively correlated with PMA/PMI in men and strongly positively correlated in women; BMI was weakly positively correlated with MFI, thus enabling the establishment of age- and BMI-specific cutoff percentiles. Conclusion Sex-specific PMA, PMI, and MFI percentiles and age- and BMI-specific cutoff values for these parameters were successfully established for an outpatient population.
In vitro genotoxicity assessment of biosynthesized zinc oxide nanoparticles
Authors: Demir Abdussamed Yasin , Karadayi Mehmet , Isaoglu Mine , Karadayi Gokce , Gulluce Medine 
Published: May 2023

There are various studies on the toxicological potentials of conventionally synthesized zinc oxide (ZnO) nanoparticles, which are useful tools for many medical applications. However, knowledge about the biologically synthesized ones is still limited. In this study, the potential of producing ZnO nanoparticles via a green synthesis method, which enables safer, environmentally, economical and controlled production by using the Symphoricarpos albus L. plant, was investigated. For this purpose, aqueous extract was obtained from the fruits of the plant and reacted with zinc nitrate precursor. Characterization of the synthesized product was carried out by SEM and EDAX analyzes. In addition, the biosafety of the product was also investigated by using the Ames/ Salmonella, E. coli WP2, Yeast DEL, seed germination, and RAPD test systems. The results obtained from SEM studies showed that spherical nanoparticles with an average diameter of 30 nm were synthesized as a result of the reaction. EDAX findings confirmed that these nanoparticles were composed of Zn and O elements. On the other hand, according to the findings of the biocompatibility tests, the synthesized nanoparticle did not show any toxic and genotoxic effects up to a concentration of 640 μg/ml in any of the test systems. Accordingly, considering the findings of our study, it was concluded that the aqueous extract of S. albus fruits can be used for the green synthesis of ZnO nanoparticles, the products obtained successfully passed the biocompatibility tests in our study, and additionally, more comprehensive biocompatibility tests should be performed before industrial scale production.
A Request for Gender-Affirming Treatment in End-of-Life Care: A Case Study From an Inpatient VA Hospice Program
Authors: Brecher David B. , Romero Melissa S. 
Published: May 2023

Hospice care involves focusing on our patients’ goals of care and good symptom management. This coincides with a focus on their comfort, dignity, and respect. Working with lesbian, gay, bisexual, transgender, queer and/or questioning (LGBTQ+) patients on a hospice service can be challenging for medical staff. Many of these potential challenges relate to lack of training of medical professionals. These patients often receive discriminatory care compared to those who do not identify as LGBTQ+. This case study describes an assigned-male-at-birth Veteran admitted to a Veterans Affairs Community Living Center (CLC) hospice service who, after admission, informed staff of the strong desire to go forward with gender reassignment. Despite a prognosis of 6 months, working with the Veteran to help achieve these goals, supporting the medical plans for providing gender-transition information, and focusing on addressing the Veteran with appropriate pronouns were critical to our medical team’s support for our Veteran at this difficult time.
The clinical and financial impact of remote clinical oncology pharmacist engagement in community-based practices within The US Oncology Network
Authors: Carroll Melissa , Koselke Elizabeth , Howell Josh , Cho Judy , Roman Andrea , Keisler Meredith , Patel Toral , Patel Vimal , Mitchem Tiffany , Yarbro Laura , Hough Shannon 
Published: May 2023

Introduction The integration of clinical oncology pharmacists into multidisciplinary healthcare teams is not well-described in the community practice setting. This study aims to analyze the clinical and financial impact of a remote-based clinical oncology pharmacist in four community oncology practices within The US Oncology Network. Methods Oncology-trained clinical pharmacists electronically reviewed chemotherapy orders for clinical optimization and financial stewardship within four community oncology practices. Each pharmacist was appointed at 0.5 full-time equivalents per practice. Financial, clinical, and workload metrics were tracked to monitor the impact of pharmacist engagement. Results Over 12 months, 5716 order reviews were completed with an intervention rate of 57%. The most common interventions identified by the pharmacists were interventions with clinical impact on the patient (36%), followed by dose rounding (35%) and therapeutic interchange (30%). Overall, interventions improved the cumulative practice margins by $1,455,033 and reduced total medication costs by $5,962,551. The average program return on investment was 415% (range 100–915%). Conclusion Community oncology practices seek to provide high-value care in a lean, resource-constrained model. An oncology clinical pharmacist is a cost-effective and clinically invaluable care team member in community oncology practice. Pharmacists in this setting identified opportunities to improve medication safety and regimen optimization and demonstrated a significant tremendous financial impact on small-scale budgets in community oncology.
Medication-related problems among patients with cervical cancers at oncology centers of University of Gondar comprehensive specialized hospital: A hospital-based retrospective study
Authors: Kefale Belayneh , Engidaw Melaku Tadege , Tesfa Desalegn , Molla Mulugeta , Tegegne Gobezie T. 
Published: May 2023

Introduction Though drugs play indispensable role in the treatment of cervical cancer, they are associated with medication-related problems (MRPs). Hence, the present study was aimed to investigate MRPs among patients with cervical cancer. Methods A hospital-based retrospective study was employed at the oncology center of University of Gondar Comprehensive Specialized Hospital. All patients with cervical cancer diagnosis from January 1, 2016 to December 31, 2020, were included. Stata version 16/MP for Windows was used for description and analysis. Logistic regression analysis was employed. Results A total of 124 patients with cervical cancer were included. Paclitaxel and cisplatin (69.4%) combination were the most widely used treatment regimen. MRPs were found in 59.7% patients, with a mean of 2.22 ± 1.13. Subtherapeutic dose (24.4%), the need for additional drug therapy (22.6%), and adverse drug reactions (22%) were the most prevalent MRPs. Being >50 years (adjusted odds ratio (AOR) = 15.37, 95% confidence interval (CI) = 2.25–105.09, p = 0.005), treated with ≥5 medications (AOR = 7.00, 95% CI = 2.65–18.49, p < 0.001), and being stage III (AOR = 15.43, 95% CI = 2.92–81.47, p = 0.001) and stage IV (AOR = 8.41, 95% CI = 1.35–52.44, p = 0.023) were independent predictors of MRPs. Conclusion More than half of patients with cervical cancer had one or more MRPs. Being older, patients taking polypharmacy, stage III and IV patients were significantly associated with the development of MRPs. As most of the cervical patients experienced one or more MRPs, clinical pharmacy service should be strengthened to optimize drug therapy to reduce unwanted adverse events.
Two mattress suture: A useful technique to prevent bleeding in tunneled catheter insertion
Authors: Khavanin Zadeh Morteza , Chehrehgosha Haleh 
Published: May 2023

Introduction: The implant of tunneled catheters, may be associated with some complications such as bleeding after insertion. We aimed this study to present a modified method for catheter insertion to prevent bleeding after the procedure. Method: The study included the analysis of retrospective results of 5339 tunneled catheter insertion procedures in our center, 5005 of which were performed using the standard method, and in 334 cases, the modified technique was applied. Results: Applying a two-mattress suture was a safe and easy to apply and useful method for tunneled catheter insertion in our center. We reported only one bleeding around the catheter entry site with this modified technique of tunneled catheter removal. While the standard and routine technique was associated with 39 cases of bleeding. Discussion and Conclusion: In our practice, the two-mattress suture procedure is the simplest and best method of central venous catheter insertion in hemodialysis patients and it is associated with less bleeding around the catheter entry site, so, it can be applied over the world.
Chest-to-arm tunneling technique for central venous access devices in neonates
Authors: Rodriguez Perez Carmen , Pezzotti Elena , Risso Francesco Maria 
Published: May 2023

Background: Chest-to-arm (CTA) tunneling technique has been described recently as an alternative option to exit site of the catheter in the infraclavicular area. Method: We report our experience with ultrasound-guided centrally inserted central catheters (CICCs) placed using CTA tunneling in six neonates. All central venous catheters were positioned with ultrasound guidance and real-time tip location. Results: There were no insertion-related complications; all devices were correctly positioned at the first attempt. During the follow-up, we found no catheter-related thrombosis, infections, or catheter malfunction. No tip position-related complications. Only one case of secondary malposition was reported. Conclusion: In our experience, the CTA tunneling technique is reliable, safe, and feasible in the neonate even from the first hours of life, as well as for preterm newborns; it could be a valid alternative to the usual exit site.
Effectiveness and safety of secondary prevention of non-vitamin K oral anticoagulants use by drug type in Asian patients
Authors: Nam Ki-Woong , Kwon Hyung-Min , Lee Yong-Seok , Won Sung-Ho , Moon Hye-Sung 
Published: May 2023

Background: Although widely used in clinical fields, real-world data on the role of warfarin and non-vitamin K oral anticoagulants (NOACs) for the secondary prevention of thromboembolic complications in ischemic stroke patients with nonvalvular atrial fibrillation (NVAF) are scarce. Aims: This retrospective cohort study compared the effectiveness and safety of secondary prevention of NOAC and warfarin in ischemic stroke patients with NVAF. Methods: From the Korean National Health Insurance Service Database, we included 16,762 oral anticoagulants-naive acute ischemic stroke patients with NVAF between July 2016 and June 2019. The main outcomes included ischemic stroke, systemic embolism, major bleeding, and all-cause of death. Results: In total, 1717 warfarin and 15,025 NOAC users were included in the analysis. After 1:8 propensity score matching, during the observation period, all types of NOACs had a significantly lower risk of ischemic stroke and systemic embolism than warfarin (edoxaban: adjusted hazard ratio [aHR], 0.80; 95% confidence interval [CI], 0.68–0.93, rivaroxaban: aHR, 0.82; 95% CI, 0.70–0.96, apixaban: aHR, 0.79; 95% CI, 0.69–0.91, and dabigatran: aHR, 0.82; 95% CI, 0.69–0.97). Edoxaban (aHR, 0.77; 95% CI, 0.62–0.96), apixaban (aHR, 0.73; 95% CI, 0.60–0.90), and dabigatran (aHR, 0.66; 95% CI, 0.51–0.86) had lower risks of major bleeding and all-cause of death. Conclusions: All NOACs were more effective than warfarin in the secondary prevention of thromboembolic complications in ischemic stroke patients with NVAF. Except for rivaroxaban, most NOACs demonstrated a lower risk of major bleeding and all-cause of death than warfarin.