bluuebunny/crossref_metadata_2025_split huggingface dataset:
Markers associated with genomic instability, immunogenicity and immune therapy responsiveness in Metaplastic carcinoma of the breast: Expression of γH2AX, pRPA2, P53, PD-L1 and tumor infiltrating lymphocytes in 76 cases
Authors: Voutilainen S. , Heikkilä P. , Bartkova J. , Nevanlinna H. , Blomqvist C. , Bartek J. , Mattson J. 
Published: December 2022

Abstract
Background
Metaplastic breast cancer (MpBC) is an aggressive subtype of breast carcinoma that is often resistant to conventional chemotherapy. Therefore, novel treatment strategies are urgently needed. Immune check point inhibitors have shown activity in programmed death-ligand 1 (PD-L1) – positive metastatic triple negative breast carcinoma (TNBC), which raises the possibility that immunotherapy may also be effective in MpBC as most of the MpBCs are triple negative. The aim of the present study was to assess genomic instability and immunogenicity in tumor specimens of patients with MpBC.

Methods
A total of 76 patients diagnosed with MpBC over a 15-year period were included in the study. We performed immunohistochemical analyses for tumor cell PD-L1, immune cell PD-L1 and p53 on tissue microarrays (TMAs), analyzed stromal and intratumoral tumor infiltrating lymphocytes (TILs) from hematoxylin and eosin-stained (H&E) slides and scored gamma-H2AX (γH2AX) and phosphorylated-RPA2 (pRPA2) from whole tissue sections. We correlated marker expression with clinicopathologic features and clinical outcome.

Results
All tumors expressed γH2AX and pRPA2 with median expressions of 43% and 44%. P53- (68%), tumor cell PD-L1- (59%) and immune cell PD-L1-positivity (62%) were common in MpBCs. Median stromal TIL and intratumoral TIL counts were 5% and 0. The spindle and squamous cell carcinomas expressed the highest levels of PD-L1 and TILs, and carcinoma with mesenchymal differentiation the lowest.

Conclusions
MpBC appears to be an immunogenic cancer with high genomic instability and frequent PD-L1-positivity, implying that check point inhibitors might be effective in MpBC. Expression levels of PD-L1 and TILs varied across different histologic subtypes, suggesting that immunotherapy might be less effective in carcinoma with mesenchymal differentiation.
The quality of life in children with spinal muscular atrophy: a case–control study
Authors: Zamani Gholamreza , Ashrafi Mahmoud Reza , Ghabeli Homa , Akbari Masood Ghahvechi , Mohammadi Mahmoud , Badv Reza Shervin , Hosseinpour Sareh , Haghighi Roya , Pourbakhtyaran Elham , Khosroshahi Nahid , Heidari Morteza 
Published: December 2022

Abstract
Objectives
This study aimed to analyze the health-related quality of life (HRQoL) of patients with spinal muscular atrophy (SMA) based on the type of SMA, demographic and clinical features and compare HRQoL of these patients with a matched healthy control group.

Methods
This was a case–control study of Patients with SMA in Iran. Sixty-six patients with SMA type II and III aged 8–18 years and also 264 healthy age, sex, and socio-economic matched individuals were enrolled. To assess the quality of life, we used the Persian version of the KIDSCREEN-27.

Results
The health-related quality of life between children with type II and type III SMA was not significant in all 5 subscales. However, HRQoL in healthy children was significantly higher than in SMA children in all 5 subscales.

Conclusion
The quality of life in children with SMA was lower than the healthy control group in all subscales, and physical well-being and psychosocial aspects are the main domains of life impaired by SMA disease. However, no significant difference between the quality of life in children with SMA type II and type III was observed.
Risky or protective? Online social support’s impact on NSSI amongst Chinese youth experiencing stressful life events
Authors: Xin Moye , Zhang Lijin , Yang Chengxi , Yang Xueyan , Xiang Meiqiu 
Published: December 2022

Abstract
Background
This study was designed to investigate potential gender differences in the interrelations between different types of stressful life events and non-suicidal self injury (NSSI) among Chinese youth, as well as to test the direct and moderating impacts of online social support on Chinese students’ NSSI engagement under the pressure of different types of stressful life events.

Methods
Based on the data of 2200 students from middle - highschools and universities in Northwestern China, gender difference (male/female binary) in stressful life events, online social support, NSSI and their correlations were analyzed in the study.

Results
Among different types of stressful life events, male students were reported to experience a significantly higher impact of punishment and interpersonal relationship than females. Female students only experienced significantly higher learning pressure than males; Gender difference was not indentified in NSSI among youth; Stressful life events related to punishment could significantly predict NSSI engagement among males. Stressful life events related to learning pressures, interpersonal relationships, and adaption were significantly correlated to NSSI engagement among females; Online social support didn’t had a significant direct effect on youth’s NSSI, although it did significantly moderate the relationship between specific types of stressful life events (i.e., loss, interpersonal relationships, adaption among males and all types among females) and their NSSI.

Conclusion
The present study has provided evidence of specified types of stressful life events being risk factors in affecting youth’s NSSI: For male students, the higher impacts of stressful life events related to punishment they experienced, the more likely they were about to engage in NSSI. For female students, stressful life events related to learning pressure, interpersonal relationships and adaption were all proved as significant predictors and risky factors of female youth’s NSSI; Online social support did not impact on individual’s NSSI engagement directly, but moderated it significantly as a protective factor.
Among the swedish generation of adolescents who experience an increased trend of psychosomatic symptoms. Do they develop depression and/or anxiety disorders as they grow older?
Authors: Giannotta F. , Nilsson K. W. , Åslund C. , Larm P. 
Published: December 2022

Abstract
Background
Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms – somatic, psychological and musculoskeletal – have different impacts on adult mental health.

Methods
One thousand five hundred forty-five Swedish adolescents – aged 13 (49%) and 15 (51%) – completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run.

Results
Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships.

Conclusions
The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.
The relationship between mental health and violence toward women during the COVID-19 pandemic
Authors: Shoaei Najmeh Khatoon , Asadi Neda , Salmani Mahin 
Published: December 2022

AbstractThe COVID-19 pandemic has a number of psychological consequences for societies, especially women. This study was conducted to determine the relationship between mental health and violence toward women during the COVID-19 pandemic in Iran.This study was conducted on during late October to November 2020 (N = 400). Demographic information questionnaire, General Health Questionnaire(GHQ-12) and violence toward women inventory(VTWI) were used.The results showed that violence was higher among employed women. Also, the results showed that VTW was higher in women with 3 children, high school degree, family income under 3 million and women over 40 years old. Findings showed that the mean mental health of women at the COVID-19 pandemic was moderate (15.14 ± 8.8). Also, with increasing psychological and economic violence, their mental health decreases. Therefore, it is suggested that policy makers and planners, apart from the physical effects of the COVID-19 pandemic, pay attention to its psychological dimension, especially for women, and try to allocate funds to maintain and promote mental health and family.
Socioeconomic differences in COVID-19 infection, hospitalisation and mortality in urban areas in a region in the South of Europe
Authors: Fernández-Martínez Nicolás F , Ruiz-Montero Rafael , Gómez-Barroso Diana , Rodríguez-Torronteras Alejandro , Lorusso Nicola , Salcedo-Leal Inmaculada , Sordo Luis 
Published: December 2022

Abstract
Background
To analyse differences in confirmed cases, hospitalisations and deaths due to COVID-19 related to census section socioeconomic variables.

Methods
Ecological study in the 12 largest municipalities in Andalusia (Spain) during the first three epidemic waves of the COVID-19 (02/26/20—03/31/21), covering 2,246 census sections (unit of analysis) and 3,027,000 inhabitants. Incidence was calculated, standardised by age and sex, for infection, hospitalisation and deaths based on average gross income per household (AGI) for the census tracts in each urban area. Association studied using a Poisson Bayesian regression model with random effects for spatial smoothing.

Results
There were 140,743 cases of COVID-19, of which 12,585 were hospitalised and 2,255 died. 95.2% of cases were attributed to the second and third waves, which were jointly analysed. We observed a protective effect of income for infection in 3/12 cities. Almeria had the largest protective effect (smoothed relative risk (SRR) = 0.84 (0.75–0.94 CI 95%). This relationship reappeared with greater magnitude in 10/12 cities for hospitalisation, lowest risk in Algeciras SRR = 0.41 (0.29–0.56). The pattern was repeated for deaths in all urban areas and reached statistical significance in 8 cities. Lowest risk in Dos Hermanas SRR = 0.35 (0.15–0.81).

Conclusions
Income inequalities by geographical area were found in the incidence of COVID-19. The strengths of the association increased when analysing the severe outcomes of hospitalisations and, above all, deaths.
Possible synergic action of non-steroidal anti-inflammatory drugs and glucosamine sulfate for the treatment of knee osteoarthritis: a scoping review
Authors: Veronese Nicola , Ecarnot Fiona , Cheleschi Sara , Fioravanti Antonella , Maggi Stefania 
Published: December 2022

Abstract
Background
Several studies have reported that glucosamine sulfate (GS) can improve knee osteoarthritis (OA) symptomatology. In parallel, the disease-modifying effects of non-steroidal anti-inflammatory drugs (NSAIDs) in knee OA have also been investigated. However, limited literature has reported the combined effect of GS and NSAIDs. The aim of this scoping review is to describe the scope and volume of the literature investigating the potential benefits and synergistic effect of a combination of GS and NSAIDs in patients with knee OA.

Methods
PubMed and Embase were searched for studies published from inception through April 2022, evaluating the effects of the combination of GS and NSAIDs in OA patients, versus either treatment alone. Data are reported narratively.

Results
Five studies were included in this review; 4 were randomized control trials and one was a prospective observational study. The duration of combination treatment was 6 to 12 weeks. The combination was compared to celecoxib in 2 studies, meloxicam in 1, etoricoxib in 1, and a conventional NSAID in 1 (ibuprofen or piroxicam). All 5 studies reported that in patients with knee OA, the combination of GS plus NSAID yielded a significantly greater benefit than single-agent therapy, in terms of outcomes including pain reduction, function, joint stiffness, and markers of inflammatory activity and cartilage degradation.

Conclusion
The 5 studies included in this scoping review all report a significantly greater clinical benefit with a combination of GS plus NSAID compared to either treatment alone. The evidence supports efficacy in reducing pain, improving function, and possibly regulating joint damage. However, further randomized trials with larger sample sizes are warranted to confirm these findings.
A WeChat-based competency and performance checklist in basic surgical skills course for military medical academy undergraduates
Authors: Luo Pengfei , Shui Xianqi , Zhou Yamei , Jiang Xiaoyu , Liu Jia , Sun Yu , Chang Yifan 
Published: December 2022

Abstract
Background
Basic surgical skills (BSS) is a key bridging course for medical students to acquire basic surgical maneuvers and practice animal surgery before clinical rotation, but the complexity of operational procedures and high demands on asepsis may lead to poor performance and frequent error during practice. The current study intended to improve BSS teaching outcomes by implementing smartphone app-based competency and performance checklists for medical academy undergraduates.

Methods
WeChat-based checklists containing competency and performance modules were designed, distributed and collected via smartphone. One hundred seventy-six third-grade undergraduate cadets majoring in clinical medicine or anesthesiology were prospectively enrolled, with 92 set as study group and 84 as control group. Checklists were distributed for self-evaluation before and after each class throughout the semester of autumn 2021-2022. Student age, previous Grade Point Average (GPA), average grades of BSS (including grade-A rate and pass rate), operative time, error rate, and perioperative complications of intestinal anastomosis performed on Beagle dogs between the groups were compared to evaluate the efficacy of the checklists.

Results
The students aged 20.2 ± 0.63 in Group A and 20.3 ± 0.92 in Group B (P = 0.15), with a previous GPA of 2.9 ± 0.61 vs. 2.87 ± 0.58 (P = 0.61). The average operative time on their final lesson of intestinal anastomosis was 192.3 ± 27.18 min vs. 213.8 ± 29.48 min (P < 0.001). All students passed in BSS course, with a final grade of 89.45 ± 4.360 in Group A and 86.64 ± 4.026 in Group B (P < 0.001), in which grade-A rate was 46.7% vs. 26.2% (P = 0.005). For perioperative comorbidities, 4/23 (17.4%) animals in Group A and 5/21 (23.8%) in Group B recorded wound dehiscence or other incision-related complications; no animals died in Group A, and 2 died in Group B due to hemorrhagic shock or sepsis.

Conclusions
The implementation of WeChat-based checklist is a reflection of improved quality of teaching in BSS course that may promote the students’ competency and performance.
The role of Neanderthal introgression in liver cancer
Authors: Taravella Oill Angela M. , Buetow Kenneth H. , Wilson Melissa A. 
Published: December 2022

Abstract
Background
Neanderthal introgressed DNA has been linked to different normal and disease traits including immunity and metabolism—two important functions that are altered in liver cancer. However, there is limited understanding of the relationship between Neanderthal introgression and liver cancer risk. The aim of this study was to investigate the relationship between Neanderthal introgression and liver cancer risk.

Methods
Using germline and somatic DNA and tumor RNA from liver cancer patients from The Cancer Genome Atlas, along with ancestry-match germline DNA from unaffected individuals from the 1000 Genomes Resource, and allele specific expression data from normal liver tissue from The Genotype-Tissue Expression project we investigated whether Neanderthal introgression impacts cancer etiology. Using a previously generated set of Neanderthal alleles, we identified Neanderthal introgressed haplotypes. We then tested whether somatic mutations are enriched or depleted on Neanderthal introgressed haplotypes compared to modern haplotypes. We also computationally assessed whether somatic mutations have a functional effect or show evidence of regulating expression of Neanderthal haplotypes. Finally, we compared patterns of Neanderthal introgression in liver cancer patients and the general population.

Results
We find Neanderthal introgressed haplotypes exhibit an excess of somatic mutations compared to modern haplotypes. Variant Effect Predictor analysis revealed that most of the somatic mutations on these Neanderthal introgressed haplotypes are not functional. We did observe expression differences of Neanderthal alleles between tumor and normal for four genes that also showed a pattern of enrichment of somatic mutations on Neanderthal haplotypes. However, gene expression was similar between liver cancer patients with modern ancestry and liver cancer patients with Neanderthal ancestry at these genes. Provocatively, when analyzing all genes, we find evidence of Neanderthal introgression regulating expression in tumor from liver cancer patients in two genes, ARK1C4 and OAS1. Finally, we find that most genes do not show a difference in the proportion of Neanderthal introgression between liver cancer patients and the general population.

Conclusion
Our results suggest that Neanderthal introgression provides opportunity for somatic mutations to accumulate, and that some Neanderthal introgression may impact liver cancer risk.
Female sex workers and police violence during the Covid-19 health crisis in 2020–2021: results from the EPIC multi-country community-based research program in Argentina
Authors: Aristegui I. , Castro Avila J. , Villes V. , Delabre R. M. , Orellano G. , Aguilera M. , Romero M. , Riegel L. , Kretzer L. , Cardozo N. , Radusky P. D. , Rojas Castro D. ,   EPIC Study Group
Published: December 2022

Abstract
Background
Female sex workers (FSW) have been disproportionately impacted by the Covid-19 crisis. Data show increases of police violence toward key populations (KP), likely a consequence of their role in enforcing health government measures. This study aimed to identify factors associated with police violence experienced by FSW during the Covid-19 crisis in Argentina.

Methods
EPIC is a multi-country, cross-sectional, community-based research program evaluating the impact of Covid-19 among KP. In Argentina, the study was conducted in collaboration with FSW community-based organizations (CBO). Participants completed an online survey (October 2020–April 2021). Police violence was measured as having experienced episodes of violence (physical, verbal, psychological or sexual) by security forces since the start of the health crisis. Factors associated with police violence were assessed in logistic regression models.

Results
Among 173 respondents, median age was 34 [IQR 27–42], 39.3% were transgender women (TW), 78.1% declared sex work as their only income and 71.7% mentioned their financial situation has deteriorated with the health crisis. Nearly half of FSW (44.5%) reported experiencing police violence within the first year of the Covid-19 pandemic, and among them, 76.6% declared more frequent violence episodes since the beginning of the health crisis. After adjustment for age, being a TW (aOR [95% CI] = 2.71 [1.21;6.05]), reporting non-injection drug use (2.92 [1.02;8.36]), having a considerably deteriorated financial situation (3.67 [1.47;9.21]), having had a consultation with a CBO worker for medical care/treatments (5.56 [2.15;14.37]) and declaring fear or experiences of discrimination by physicians/other health workers (2.97 [1.21;7.29]), since the beginning of the Covid-19 health crisis, were independently associated with police violence.

Conclusions
FSW in Argentina have experienced an increase in police violence since the beginning of the health crisis. Belonging to multiple KP (FSW, TW, people who use drugs) increases the likelihood of experiencing police violence, highlighting the need of an intersectional approach to develop interventions to reduce stigma and violence against FSW. CBOs have provided essential support and services during the crisis to FSWs, and other KPs, who may have avoided traditional healthcare structures due to fear or experiences of discrimination.
Analysis of policy responses to COVID-19: a case study in Babol University of Medical Sciences (BUMS), Iran
Authors: Farhadi Zeynab , Salemi Morteza , Jahani Mohammad Ali 
Published: December 2022

Abstract
Background
Preparation and financing of treatments, control of disease by limited resources, are known as the most important challenges encountered by the policy-makers involved in an epidemic outbreak. Therefore, the present study was conducted to analyze the policy responses of Babol University of Medical Sciences (BUMS) to Coronavirus (COVID-19).

Methods
A qualitative study was performed to investigate the policy responses of BUMS to COVID-19 in Babol of January to March, 2021. The statistical population included the experts, pundits, policy-makers and planners involved in four areas of management, treatment, healthcare, and health donation. Data collection was done according to interviews and policy documents, and the obtained data were analyzed based on the Walt and Gilson’s policy triangle.

Results
There are five main themes to names: policy context, policy analysis, policy-making process, actors and stakeholders and 16 sub-themes. After several rounds of revision, the text of the interviews and policy documents were tagged and finally, various issues related to sub-themes were extracted. Also, two sub-themes entitled (improving the policy framework, People’s participation) were obtained from the strategies to reduce the incidence of Covid-19 theme.

Conclusions
(BUMS) was able to use the capacities and skills of experienced physicians, specialists and nurses to respond to patients awaiting treatment. Therefore, most of the policies were aimed at patient care and treatment. The lack of financial resources was compensated by health donors. But the (BUMS) could not use the power of the city government to control traffic and comply with health protocols and prevent infections. It was mainly the formulation and implementation of irregular and unstable policies.