bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P6-01-03: Tumor-infiltrating lymphocytes (TILs) and 21-gene recurrence score in 1,883 patients with ER+/HER2- breast cancer
Authors: Ahn Sung Gwe , Jang Ji Soo , Kook Yoonwon , Baek Seung Ho , Lee Sae Byul , Bae Soong June , Jeong Joon 
Published: March 2023

Abstract
Background: In ER+/HER2- breast cancer, several lines of evidence suggest that tumors with high level of tumor-infiltrating lymphocytes (TILs) have a greater chance of obtaining a pathological complete response (pCR) after neoadjuvant chemotherapy. In addition, high 21-gene recurrence score (RS) is associated with an increasing rate of pCR in luminal tumors. We investigated the relationship between TIL and RS in 1,883 patients with early ER+HER2- breast cancer.
Method: In 1,883 ER+ breast cancer patients with 21-gene assay, TIL level was evaluated. Correlation between continuous TIL and RS was investigated. Logistic-regression analysis was performed to identify risk factors for high RS (26). The cut-off for high TIL was 50%. Recurrence-free survival (RFS) was investigated.
Results: A weak positive correlation between TIL level and RS was observed (correlation coefficient=0.283, p&lt; 0.001) in all patients. Average TIL level of the high RS tumors was significantly higher. Two parameters were positively correlated in both two groups classified by age 50 years (correlation coefficient=0.281 in the age 50; correlation coefficient=0.288 in the age&gt;50). Either continuous TILs or binary high TIL level was demonstrated to be an independent factor for high RS. When all patients were divided into 4 groups using TIL and RS (low-RS/low-TIL, low-RS/high-TIL, high-RS/low-TIL, and high-RS/high-TIL), the RFS was worst in the low-TIL/high-RS group (p&lt; 0.001).
Conclusions: Our findings show that TIL level is correlated with RS in ER+ breast cancer regardless of age and suggest that high TIL level can be regarded as a risk factor for high RS. Multigene assay could be integrated in designing clinical trials evaluating immune-check point blockades in luminal breast cancer.
Recurrence-free survival according to RS and TIL
Table 1. 5-years RFS according to TIL and RS
Citation Format: Sung Gwe Ahn, Ji Soo Jang, Yoonwon Kook, Seung Ho Baek, Sae Byul Lee, Soong June Bae, Joon Jeong. Tumor-infiltrating lymphocytes (TILs) and 21-gene recurrence score in 1,883 patients with ER+/HER2- breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-01-03.
Abstract P6-05-21: Quality of Life and Perspectives of Older Adults with Early & Locally Advanced Breast Cancers Undergoing Pre-operative Therapy
Authors: Ma Jun , Zhang Zewen , Tan Jasmine Yun Ting , Ong Whee Sze , Kamis Sulastri , Tan Benita Kiat Tee , Tan Veronique Kiak Mien , Kanesvaran Ravindran , Tan Tira Jing Ying 
Published: March 2023

Abstract
Background: Breast cancer (BC) is the commonest diagnosed cancer in Singaporean women. Increasingly, non-metastatic BC are treated aggressively with neoadjuvant therapy (NAT). Early identification and addressing supportive care needs of NAT treated patients is important for effective cancer care whilst maintaining optimal physical, psychological and social function. This project aims to explore the longitudinal trends of quality of life (QOL) of BC patients enrolled in a NAT program. Methods: This was a prospective cohort study of females aged 21 diagnosed with non-metastatic BC, referred to the NAT program at the SingHealth network of acute hospitals. The Functional Assessment of Cancer Therapy-Breast (FACT-B) was used as a health related QOL measure prior to NAT, within 2 months post definitive breast surgery and at 1-year post diagnosis. In older adults (OA) ≥65 years, the Attitude scale, Now vs Later as well as Health Outcome tool were also performed at baseline. Here we report pre-NAT baseline FACT-B and questionnaire results of OA patients recruited into the NAT program between Jun 2020 and Jun 2021. Results: Pre-NAT median FACT-B scores was 117 (IQR 102-126) for the entire cohort (n=119) and 116 (IQR 104-126) for OA (n=22). OA had significantly lower median Social Wellbeing score at baseline compared to patients &lt; 65 years (p=0.01), while Physical, Emotional, and Functional Wellbeing were not significantly different. More than 50% of OA favoured QOL over quantity of life on the Attitude Scale. 68% of patients would rather have QOL now than 1 year later with half expecting their QOL to reduce by 50% in this time period. When the time scale was extended to 5 years, 64% would rather have QOL 5-years from now instead of QOL now with close to 80% expecting their QOL to be lower in 5 years than presently. Of the 4 outcomes, maintaining independence scored the highest, followed by keeping alive, then reducing/eliminating pain and other symptoms. Conclusion: Our study suggests that OA with BC report similar QOL to younger patients at baseline prior to NAT. Majority of OA patients favoured QOL over quantity of life, and viewed the ability to maintain independence as more important than survival prolongation representing their unique attitude towards cancer treatment and outcomes.
Citation Format: Jun Ma, Zewen Zhang, Jasmine Yun Ting Tan, Whee Sze Ong, Sulastri Kamis, Benita Kiat Tee Tan, Veronique Kiak Mien Tan, Ravindran Kanesvaran, Tira Jing Ying Tan. Quality of Life and Perspectives of Older Adults with Early & Locally Advanced Breast Cancers Undergoing Pre-operative Therapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-21.
Comparing Severely Injured Trauma Patients Admitted to Investor-Owned versus Public and Not-For-Profit Hospitals Reveals Opportunities for Improvement in the US
Authors: Hernandez Jennifer , Spector Chelsea L. , Quintero Luis A. , Shatawi Zaineb , Rosenthal Andrew , Curcio Gary , Buicko Jessica L. , Parreco Joshua P. 
Published: March 2023

Background Non-elderly trauma patients represent the largest portion of preventable years of life loss in the US. The purpose of this study was to compare outcomes in patients admitted to investor-owned vs public and not-for-profit hospitals across the US. Material and Methods The Nationwide Readmissions Database 2018 was queried for trauma patients with an Injury Severity Score greater than 15 and age 18-65 years. The primary outcome was mortality; secondary outcomes were prolonged length of stay (LOS) greater than 30 days, readmission within 30 days, and readmission to a different hospital. Patients admitted to investor-owned hospitals were compared to public and not-for-profit hospitals. Univariable analysis was performed using chi-squared tests. Multivariable logistic regression was performed for each outcome. Results 157 945 patients were included with 11.0% (n = 17 346) admitted to investor-owned hospitals. The overall mortality rate and prolonged LOS were similar for both groups. The overall readmission rate was 9.2% (n = 13 895), with the rate in investor-owned hospitals at 10.5% (n = 1,739, P < .001). Multivariable logistic regression revealed investor-owned hospitals had an increased risk of readmission (OR 1.2 [1.1-1.3] P < .001) and readmission to a different hospital (OR 1.3 [1.2-1.5] P < .001). Discussion Severely injured trauma patients have similar rates of mortality and prolonged length of stay in investor-owned vs public and not-for-profit hospitals. However, patients admitted to investor-owned hospitals have an increased risk of readmission and readmission to different hospitals. Efforts to improve outcomes after trauma must consider hospital ownership and readmission to different hospitals.
Emergency General Surgery Procedures in Older Adults: Where You Live Matters!
Authors: Dhillon Navpreet K. , Kufera Joseph , Ghneim Mira 
Published: March 2023

Background Neighborhood location and its built environment are important social determinants of health that impact health outcomes. Older adults (OAs) represent the fastest growing population in the United States with many requiring emergency general surgery procedures (EGSPs). The aim of this study was to evaluate whether neighborhood location, represented by zip code, influences mortality and disposition in OAs undergoing EGSPs in Maryland. Methods A retrospective review was undertaken of hospital encounters in the Maryland Health Services Cost Review Commission from 2014 to 2018 of OAs undergoing EGSPs. Older adults residing in the 50 most affluent (MANs) and 50 least affluent (LANs) neighborhoods based on zip codes were compared. Data collected included demographics, all patient-refined (APR)-severity of illness (SOI), APR-risk of mortality (ROM), Charlson Comorbidity Index, complications, mortality, and discharge to a higher level of care. Results Of the 8661 OAs analyzed, 2362 (27.3%) resided in MANs and 6299 (72.7%) in LANs. Older adults in LANs were more likely to undergo EGSPs, had higher APR-SOI and APR-ROM, and experienced more complications, discharge to higher level of care, and mortality. Living in LANs was independently associated with discharge to higher level of care (OR 1.56, 95% CI: 1.38-1.77, P < .001) and increased mortality (OR 1.35, 95% CI: 1.07-1.71, P = .01). Discussion Mortality and quality of life in OAs undergoing EGSPs are dependent on environmental factors likely determined by neighborhood location. These factors need to be defined and incorporated in predictive models of outcomes. Public health opportunities to improve outcomes for those who are socially disadvantaged are necessary.
The efficacy of online parenting interventions in addressing emotional problems in children and adolescents: A meta-analysis of randomized controlled trials
Authors: David Oana A , Fodor Liviu A , Dascăl Marina D , Miron Ionela S 
Published: March 2023

Background: Parenting interventions offer opportunities for reducing emotional problems in children and adolescents, based on addressing parental risk and protective factors. Online parenting interventions were developed more recently to increase access to interventions for parents, and the aim of this systematic review and meta-analysis is to investigate their efficacy. Methods: We conducted a meta-analysis pooling studies that tested online parenting interventions having as outcome emotional problems in children/adolescents. We considered as secondary outcome parent mental health and moderation effects for the type of population, intervention characteristics, and risk of bias. Results: Thirty-one studies met the inclusion criteria and were included in the meta-analysis. For child/adolescent emotional problems, at post-intervention, 13 studies were pooled, yielding an ES of g = −0.26 (95% CI [−0.41, −0.11]; p < .001) favoring the online parental interventions over wait-list, while at follow-up five RCTs were pooled, yielding an ES of g = −0.14 (95% CI [−0.25, –0.02]; p = .015) favoring the parental online interventions over wait-list. Moderation analyses suggest that longer online parenting programs are more effective in improving child emotional problems. Conclusions: Online parent programs have positive effects on reducing emotional symptoms in children and adolescents. Future research will need to develop and investigate the efficacy of the programs that can personalize their contents and delivery methods.
Portuguese Physical Literacy Assessment Questionnaire (PPLA-Q) for Adolescents: Validity and Reliability of the Psychological and Social Modules using Mokken Scale Analysis
Authors: Mota João , Martins João , Onofre Marcos 
Published: March 2023

We examined the construct validity and reliability of the previously developed Psychological and Social modules of the Portuguese Physical Literacy Assessment Questionnaire (PPLA-Q) using Mokken Scale Analysis in a sample of 508 Portuguese adolescents in public schools in Lisbon. We used a retest subsample ( n = 73) to calculate the Intraclass Correlation Coefficient. Eight PPLA-Q scales can be interpreted as moderate-to-strong Mokken scales (H = .47–.66) with good total-score reliability (ρ = .83–.94), and moderate-to-excellent test-retest reliability (ICC95%CI = .51–.95); four scales had an interpretable invariant item ordering. All but the Physical Regulation scale functioned similarly across sex. Scale-scores correlated as expected, with low-to-moderate correlations across domains supporting convergent and discriminant validity. These results support the construct validity and reliability of the PPLA-Q to assess the psychological and social domains of physical literacy in Portuguese adolescents (15–18 years) enrolled in physical education.
The New Normal – Virtual and Hybrid Presentations: Developing Content, Designing Slides, and Delivery Guidelines
Authors: Gartner-Schmidt Jacqueline 
Published: March 2023

Objective To outline best practices for virtual and hybrid presentation effectiveness. Methods Retrospective review of recommendations from world experts in how to develop a solid story, design slides that visually communicate, and improve delivery skills that connect with the audience. Virtual and hybrid presenting is not as strongly dependent on all the new technical and software means as supposed. Presentation basics remain critical. Result Best practice in presentation effectiveness will statistically decrease the incidence of and risk factors for Nodding-off Episodes per Lecture (NOELs). Conclusion The future of presenting is here, and it is mostly online. Mastering the presentation basics and understanding the limitations and opportunities for this new virtual/hybrid presentation space will allow presenters the reach and influence their message deserves.
Multiple sclerosis versus cerebral small vessel disease in MRI: a practical approach using qualitative and quantitative signal intensity differences in white matter lesions
Authors: Yuzkan Sabahattin , Balsak Serdar , Cinkir Ufuk , Kocak Burak 
Published: March 2023

Background Multiple sclerosis (MS) and cerebral small vessel disease (CSVD) are relatively common radiological entities that occasionally necessitate differential diagnosis. Purpose To investigate the differences in magnetic resonance imaging (MRI) signal intensity (SI) between MS and CSVD related white matter lesions. Material and Methods On 1.5-T and 3-T MRI scanners, 50 patients with MS (380 lesions) and 50 patients with CSVD (395 lesions) were retrospectively evaluated. Visual inspection was used to conduct qualitative analysis on diffusion-weighted imaging (DWI)_b1000 to determine relative signal intensity. The thalamus served as the reference for quantitative analysis based on SI ratio (SIR). The statistical analysis utilized univariable and multivariable methods. There were analyses of patient and lesion datasets. On a dataset restricted by age (30–50 years), additional evaluations, including unsupervised fuzzy c-means clustering, were performed. Results Using both quantitative and qualitative features, the optimal model achieved a 100% accuracy, sensitivity, and specificity with an area under the curve (AUC) of 1 in patient-wise analysis. With an AUC of 0.984, the best model achieved a 94% accuracy, sensitivity, and specificity when using only quantitative features. The model's accuracy, sensitivity, and specificity were 91.9%, 84.6%, and 95.8%, respectively, when using the age-restricted dataset. Independent predictors were T2_SIR_max (optimal cutoff=2.1) and DWI_b1000_SIR_mean (optimal cutoff=1.1). Clustering also performed well with an accuracy, sensitivity, and specificity of 86.5%, 70.6%, and 100%, respectively, in the age-restricted dataset. Conclusion SI characteristics derived from DWI_b1000 and T2-weighted-based MRI demonstrate excellent performance in differentiating white matter lesions caused by MS and CSVD.
Access to a dementia-friendly garden on behavioural and psychological symptoms of dementia, falls and psychotropic medication use in residents of an aged care home in Melbourne, Australia
Authors: Lai Rhoda , Foladkar Mouhamed , Dhaliwal Gurnik , Kibria Anika , Gualano Rosa C , Healy Madeleine L 
Published: March 2023

Objective Residents of care homes need access to outdoors. This may improve behavioural and psychological symptoms of dementia (BPSD) and quality of life in residents living with dementia. Barriers including lack of accessibility and increased falls risk, which may be mitigated using dementia-friendly design. This prospective cohort study followed a group of residents in the first 6 months after the opening of a new dementia-friendly garden. Method Nineteen residents participated. The Neuropsychiatric Inventory – Nursing Home Version (NPI-NH) and psychotropic medication use were collected at baseline, 3 and 6 months. The facility's falls rate during this time and feedback from staff and residents' next of kin were collected. Results Total NPI-NH scores decreased, though not significantly. Feedback was positive overall; the falls rate decreased. Usage of the garden was low. Conclusions Despite its limitations, this pilot study adds to the literature about the importance of access to the outdoors for people who are experiencing BPSD. Staff remain concerned about falls risk despite the dementia-friendly design, and many residents do not access outdoors frequently. Further education may help to remove barriers to encouraging residents to access the outdoors.
Profiling of Immunomodulatory Genes and Quantification of CD25+ Cells in Different Types of Early Pregnancy Loss
Authors: Ozer Erdener , Kanit Naz , Cevizci Mustafa Cuneyt , Cagliyan Erkan , Mifsud William 
Published: March 2023

Introduction: Maternal regulatory T (Treg) cells play a pivotal role in establishing general immune homeostasis in the decidua for maintenance of pregnancy. We aimed in this study to investigate the relationship between mRNA expression of immunomodulatory genes and CD25+ Treg cells with early pregnancy losses. Methods: Our study included 3 groups of early pregnancy losses including sporadic spontaneous abortions, recurrent spontaneous abortions, sporadic spontaneous abortions post IVF treatment and the control group. We performed RT-PCR for analyzing mRNA expression levels of 6 immunomodulatory genes and CD25 immunohistochemistry for quantification of Treg cells. Results: Only FOXP3, CD274 (PDL1), and TGFβ1 mRNA expression levels were significantly decreased in the miscarriage groups in comparison to the control group, whereas there was no significant mRNA expression change of CD4, IL2RA, and IL10. We also found significantly lower number of CD25+ cells in the miscarriages. Conclusion: We conclude that decreased expression of FOXP3 and PD-L1 may play a significant role in the pathogenesis of spontaneous abortion cases whereas decreased expression of TGFβ1 gene may be associated with the occurrence of early loss in IVF-treated pregnancies. Additional immunoprofiling of Treg cell population is needed to quantify Treg cells in early pregnancy losses.
Trabeculectomy in first trimester of pregnancy: A case report
Authors: Kumar Harsh , Singh Swati , Taneja Surbi 
Published: March 2023

Purpose Glaucoma management in pregnancy is a challenging task for the ophthalmologist. With limited studies due to ethical concerns, the exact management protocols are not well established. Surgery has been mentioned as an option in 2nd trimester and is avoided in 1st trimester due to the detrimental effect on organogenesis of fetus and the harmful effects of anaesthesia. Methods A 26 year old woman with advanced glaucomatous damage underwent trabeculectomy without antifibrotic agent in first trimester of pregnancy. Results The intraocular pressures (IOP) were well controlled during pregnancy with no need of addiitional antiglaucoma medications. She delivered a healthy baby at term with no congenital abnormality. Conclusion Trabeculectomy without antifibrotic agents can be done in first trimester of pregnancy in cases where IOP cannot be controlled with topical antiglaucoma drugs that are considered safe during this period. This is the first report in literature on trabeculectomy in first trimester of pregnancy.
Prevalence of significant pathology on MRI of brain and orbits in patients presenting with visual disturbance
Authors: Whitlow S. , Haughey A. , O’Connor J. , Killeen RP. 
Published: March 2023

Purpose The aim of our study was to determine the frequency and variety of abnormalities detected on MRI studies of the brain and orbits (MRBO), in patients referred for investigation of visual disturbance from a tertiary ophthalmology centre in Ireland. A secondary objective was to assess the various imaging pathologies identified in this cohort of patients. Methods The inclusion criteria were patients who underwent an Magnetic resonance imaging (MRI) brain or MRI brain and orbits over a 12-month period for investigation of first episode of visual disturbance, who were over 18 years of age, with visual disturbance of unknown aetiology. Statistical analysis was performed to calculate the percentage of abnormalities and corresponding 95% confidence interval (CI). Additionally, logistic regression was used to investigate any association between age, gender and the pathologies which presented. Results 135 MRI brain and orbit examinations fulfilled the inclusion criteria. Abnormalities were identified on 86 of the 135 examinations (63.7%; 95% CI: 55.3% to 71.3%). Nonspecific T2 hyperintensities were identified on 28 (20.7%) of the examinations, 13 (9.6%) examinations showed images suggestive of demyelination and 11 (8.1%) showed optic neuropathy. The logistic regression analysis showed no evidence of an association between age (p = 0.223), gender (p = 0.307) and abnormalities in this study. Conclusion This represents a relatively high detection rate of abnormalities on MRBO when compared with similar studies and shows the important role MRI has in patients with a visual disturbance.
Alcohol Use Disorder and Associated Factors Among Elderly in Ethiopia
Authors: Wolde Asrat 
Published: March 2023

Background: The aim of this study was to investigate the magnitude and associated factors of alcohol use disorder among the elderly living in 3 towns in South West Ethiopia. Method: Cross-sectional community-based study was done among 382 elderly people aged 60 or more from February to March 2022 in South West Ethiopia. The participants were selected by a systematic random sampling method. Alcohol use disorder, quality of sleep, cognitive impairment, and depression were assessed by using AUDIT, Pittsburgh Sleep Quality Index, Standardized Mini Mental State Examination, and geriatric depression scale, respectively. Also, suicidal behavior, elder abuse, and other clinical and environmental factors were assessed. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a P-value less than .05 in the final fitting model were stated as independent predictors of alcohol use disorder (AUD). Result: The magnitude of alcohol use disorder, current alcohol use, and life-time alcohol use among the elderly was 27.5%, 52.4%, and 89.3%, respectively. Also, 7%, 23%, 8.9%, and none of the elderly had nicotine, khat, inhalants, and cannabis use disorder, respectively. Furthermore, AUD was associated with cognitive impairment (AOR, 95% CI; 2.79 (1.47-5.30)), poor sleep quality (AOR, 95% CI; 3.27 (1.23-8.69)), chronic medical illness (AOR, 95% CI; 2.12 (1.20-3.74)), and suicidal ideation (AOR, 95% CI; 5.27 (2.21-12.60)). Conclusion: Problematic alcohol use was higher among the elderly, and cognitive impairment, poor sleep quality, having chronic medical illness, and suicidal ideation were risk factors for AUD. Therefore, community level screening for AUD and comorbid risk factors among this particular age group and managing them is crucial to prevent further complications due to AUD.