Isopp 2023

The proceedings contain 109 papers. The topics discussed include: dose intensity of palbociclib and initial body weight dosage: implications on progression free survival in 220 patients with ER+/HER2-negative metastatic breast cancer;characteristics of Nirmatrelvir/Ritonavir (Paxlovid) recipients and clinical interventions by oncology pharmacists at a tertiary outpatient cancer center;safe handling of non-carcinogenic drugs in the Ghent University Hospital: development, implementation and communication of hospital-specific guidelines;case series: use of olaparib in uncommon locations in patients with impaired homologous recombination;real-world data evaluation of medicines used in special situations in oncohematology: a retrospective study from a comprehensive cancer institution;Dostarlimab in the treatment of recurrent endometrial cancer: real life experience;medication-related osteonecrosis of the jaws and CDK4/6 inhibitors in breast cancer;and efficacy and safety outcomes of generic imatinib in adults with chronic myeloid leukemia (CML) following the switch from branded imatinib.

The impact of dynamic adaptive teaching model on surgical education.

Objective To investigate the impact of dynamic adaptive teaching model on surgical education. Methods Due to the COVID-19 pandemic in 2020, we adopted dynamic adaptive teaching model in the Department of Breast Surgery, Peking Union Medical College Hospital, which divided the whole curriculum into several individual modules and recombined different modules to accommodate to student's levels and schedules. Meanwhile, adaptive strategy also increased the proportion of online teaching and fully utilized electronic medical resources. The present study included quantitative teaching score (QTS) recorded from January 2020 to June 2020, and used the corresponding data from 2019 as control. The main endpoint was to explore the impact of dynamic adaptive teaching model on overall QTS and its interaction effect with trainer's experience and student category. Results Totally, 20 trainers and 181 trainees were enrolled in the present study. With implementation of dynamic adaptive strategy, the overall QTS decreased dramatically (1.76+/-0.84 vs. 4.91+/-1.15, t=4.85, P=0.005). The impact was consistent irrespective of trainers' experience (high experience trainers: 0.85+/-0.40 vs. 2.12+/-0.44, t=4.98, P=0.004;medium experience trainers: 0.85+/-0.29 vs. 2.06+/-0.53, t=4.51, P=0.006;and low experience trainers: 0.10+/-0.16 vs. 0.44+/-0.22, t=2.62, P=0.047). For resident (including graduate) and undergraduate student teaching, both QTS was lower with dynamic strategy (residents: 0.18+/-0.34 vs. 0.97+/-0.14, t=4.35, P=0.007;undergraduate students 1.57+/-0.55 vs. 3.77+/-1.24, t=3.62, P=0.015), but dynamic strategy was effective for post-doc student subgroup and reached comparable QTS as traditional model (0.00+/-0.00 vs. 0.17+/-0.41, t=1.00, P=0.363). Conclusions Dynamic adaptive teaching strategy could be a useful alternative to traditional teaching model for post-doc students. It could be a novel effective solution for saving teaching resources and providing individualized surgical teaching modality.Copyright © 2023, Peking Union Medical College Hospital. All rights reserved.

Breastfeeding in emergencies with assessment of recent humanitarian crises and the Covid-19 pandemic.

The world is becoming a place where the number of emergencies and humanitarian crises is increasing rapidly due to economic inequality and the gap between developed and underdeveloped countries, as well as climate changes leading to disruption of the natural balance and development of natural disasters. The most vulnerable groups of the population including women and children always are affected by disasters. The younger the child, the more vulnerable he/she is, especially if not naturally fed or having a mother or parents. Various humanitarian organizations have been involved in a number of crises, with the World Health Organization and UNICEF and other United Nations-related organizations leading the way. In the care of mothers, infants and young children, most important is to ensure appropriate nutrition because otherwise it can result in life-threatening health conditions. The lack of protection, support and promotion of natural nutrition (breastfeeding) and its disruption and undermining by uncritical and uncontrolled donations and distribution of infant formula are the biggest challenge due to the lack of information of mothers, those who provide support in emergencies from both governmental and non-governmental sector, without cross-sectoral cooperation, thus causing uncoordinated and sometimes harmful interventions. Therefore, it is recommended that governments issue guidelines on infant and young child nutrition prior to the occurrence of an emergency, and crisis management regulations in which the issue of infant and young child nutrition will be given due consideration.Copyright © 2020 Croatian Paediatric Society. All rights reserved.

Perinatal aspects of sars-cov-2 infection during pregnancy: A potential cause for concern

Ever since the beginning of COVID-19 pandemic, uncertainty regarding clinical presentation and differences among various subpopulations exist. With more than 209,870,000 confirmed cases and more than 4,400,000 deaths worldwide, we are facing the new era of health crisis which will undoubtedly impair global health, economic and social circumstances. In the past year, numerous genetic mutations which code SARS-CoV-2 proteins led to the occurrence of new viral strains, with higher transmission rates. Apart from the implementation of vaccination, the effect of SARS-CoV-2 on pregnancy outcome and maternal fetal transmission remains an important concern. Although neonates diagnosed with COVID-19 were mostly asymptomatic or presented with mild disease, the effect on early pregnancy is yet to be evident. While positive finding of SARS-CoV-2 RNA in some samples such as amniotic fluid, placental tissue, cord blood and breast milk exists, additional research should confirm its association with transplacental transmission.Copyright © 2022, Dr. Mladen Stojanovic University Hospital. All rights reserved.

SARS-CoV-2 in Pregnancy, Birth and Puerperium. Guideline of the DGGG and DGPM (S2k-Level, AWMF Registry Number 015/092, March 2022)

Objective This S2k guideline of the German Society for Gynecology and Obstetrics (DGGG) and the German Society of Perinatal Medicine (DGPM) contains consensus-based recommendations for the care and treatment of pregnant women, parturient women, women who have recently given birth, and breastfeeding women with SARS-CoV-2 infection and their newborn infants. The aim of the guideline is to provide recommendations for action in the time of the COVID-19 pandemic for professionals caring for the above-listed groups of people. Methods The PICO format was used to develop specific questions. A systematic targeted search of the literature was carried out using PubMed, and previously formulated statements and recommendations issued by the DGGG and the DGPM were used to summarize the evidence. This guideline also drew on research data from the CRONOS registry. As the data basis was insufficient for a purely evidence-based guideline, the guideline was compiled using an S2k-level consensus-based process. After summarizing and presenting the available data, the guideline authors drafted recommendations in response to the formulated PICO questions, which were then discussed and voted on. Recommendations Recommendations on hygiene measures, prevention measures and care during pregnancy, delivery, the puerperium and while breastfeeding were prepared. They also included aspects relating to the monitoring of mother and child during and after infection with COVID-19, indications for thrombosis prophylaxis, caring for women with COVID-19 while they are giving birth, the presence of birth companions, postnatal care, and testing and monitoring the neonate during rooming-in or on the pediatric ward.Copyright © 2023. Thieme. All rights reserved.

Psychological considerations when attending for mammography screening

The pandemic led to a pause in routine breast screening in the UK, with up to one million not being offered appointments (Breast Cancer Now, Almost one million women in UK miss vital breast screening due to COVID-19, 2022). However, according to a Nuffield report, even before this, breast cancer screening in the UK had yet to reach its 'optimal performance standard of 80%' (Nuffield, Cancer screening-quality watch, 2022). In usual times, this has meant that with screening rates in excess of 70%, over two million women have been screened annually in the UK. However, breast cancer is also the most common cancer in women in the UK (Office for National Statistics, Cancer registration statistics, 2017), with 85% survival 5 years after diagnosis (Office for National Statistics, Cancer survival in England - adults diagnosed 2019) and it remains clear that screening can help reduce breast cancer mortality (Office for National Statistics, Cancer registration statistics, 2017). So why would 25% or more fail to accept an invitation for a routine mammogram which may ultimately help save their lives? This chapter considers a range of psychological factors relevant to understanding this phenomenon and hopefully bring about a positive change. © Springer Nature Switzerland AG 2015, 2022. All rights reserved.

Gene Editing/Gene Therapies: CHALLENGE TO DEVELOP GMP COMPLIANT MANUFACTURING PROCESS FOR COXSACKIE VIRUS TYPE B3

Background & Aim: Gene therapies has become recognized for its remarkable clinical benefits in a variety of medical applications, in particular recent approval of an Ad vector-based COVID-19 vaccines have attracted recent global attention. Here, we present key considerations for GMP compliant process development for Coxsackie virus type B3 (CVB3), an oncolytic virus designed for clinical trial in triple-negative breast cancer. Methods, Results & Conclusion(s): CVB3 is a non-enveloped, linear single-strand RNA virus with a size of approximately 27-33 um in diameter. From the initial type using the zonal rotor centrifuge to the advanced type using the tangential flow filtration system and ion chromatograph, we considered the points of the design concept in constructing the manufacturing process. The final design system is constructed as a closed and single-use manufacturing system in which all processes from upstream large-scale cell culture to downstream target purification and concentration steps. In brief, HEK293 cell suspension extended in 3L serum-free medium infected with CVB3, up to 3.6 times 10 to 7 of TCID50 /mL before going to downstream steps, made total 150 mL of final products as 8.43 times 10 to 7 of TCID50/mL concentration. Although further quality control challenges remain that is removal of product-related impurities such as human cellular proteins and residual DNA/RNA to increase virus purity, this concept is effectively applicable even for other types of viruses as GMP manufacturing processes, and would be also important for technology transfer to future commercial production.Copyright © 2023 International Society for Cell & Gene Therapy

DIAGNOSIS OF MEDICAL CONDITIONS IN PATIENTS USING MACHINE LEARNING MODELS

A variety of patient care and intelligent health systems can benefit from the implementation of artificial intelligence as a tool to aid caregivers. Machine learning and deep learning are two types of AI that are increasingly being used in the medical industry. Artificial intelligence methods require a large amount of clinical data from a range of imaging modalities for correct disease diagnosis. In addition, AI has greatly enhanced the quality of hospital stays, allowing patients to be released sooner and complete their recoveries at home. This article aims to provide the information on the field of AI subset i.e., machine learning-based disease detection with information that will aid them in making better decision making. This helps the researchers to classify the medical conditions in patients with a prominent dataset.

Short Term Outcome of Management of Early Breast Cancer Patients in COVID-19 Era. Ain Shams University Experience

Introduction: COVID-19 implied that a great number of infected individuals were hospitalized and possibly admitted to intensive care units. Cancer centers have rapidly changed models of care by delaying non-urgent surgeries. Breast surgeries were delayed for early breast cancer patients forcing clinicians to potentially alter treatment recommendations by neoadjuvant chemotherapy until appropriate conditions were established. Aim of the work: to assess conservative breast cancer surgery after neo-adjuvant therapy in early breast cancer patients in COVID-19 era as regard surgical outcome, complications and early recurrence comparing results with previous results when patients underwent primary conservative breast surgery. Patients and Methods: This is a cohort study that was conducted 52 patients with early breast cancer stage I and II a. Patients were divided into two groups (A) and (B). Group A included 26 patients who underwent primary conservative breast surgery. Group B included 26 patients who underwent conservative breast surgery after neo-adjuvant therapy during COVID-19 era. Results: Intra-operative re-excision was done in 5 patients (19.2%) in group A and 3 patients (11.5%) in group B. Two patients (7.7%) in group A and 1 patient (3.8%) in group B were converted to modified radical mastectomy. Sentinel lymph node (SLN) was done in all 26 patients in group A while only 25 patients in group B with 1 patient undergoing axillary dissection from the start. SLN was positive in 8 patients (30.8%) in group A & 6 (24 %) patients in group B. Consequently, 8 patients (30.8%) in group A and 7 patients (26.9%) in group B underwent axillary dissection. Conclusion: Conservative breast cancer surgery after neo-adjuvant therapy in early breast cancer patients in COVID-19 era has comparable results to primary conservative breast surgery. Thus, the obligatory decision to delay primary surgery during COVID-19 era by giving neoadjuvant chemotherapy was effective. Copyright © Celsius Publishing House.

Nutrition Strategies Pre-infection, during, and Post-infection with Coronavirus Disease

Coronavirus disease is a serious viral infection that is characterized by severe inflammation and lymphopenia. The virus attacks many organs causing acute respiratory distress and malfunctioning of the organs leading to death. Through strengthening of the innate immune system, a balanced diet plays a critical role in defense against bacterial and viral diseases. A healthy diet before, during and after an infection can lessen the severity of the symptoms and speed up the recovery of damaged cells. Due to the Mediterranean diet's high concentration of bioactive polyphenols, which have antioxidant, anti-inflammatory, and antithrombic properties, numerous studies have suggested that it is a preventative dietary strategy against many diseases including coronavirus disease. Nutrition and herbal plants play a key role to enhance the immunity of people to protect and fight against coronavirus. Diet rich in antioxidants and phytochemicals represents perfect barrier to the virus through elevation of the innate immunity of the body. In addition, gut microbiota including prebiotics, probiotics, and synbiotics were found to enhance immunity to reduce the symptoms of the disease during infection. Protein-rich foods and honey bee products reported significant role during and post-coronavirus infection. This review presents updated information from original pre-clinical and clinical researches, and review articles as well to expose the nutritive strategies including breastfeeding benefits to infants pre-infection, during, and post-infection with coronavirus.Copyright © 2023, Scientific Foundation SPIROSKI. All rights reserved.

Reducing your risk cancer-focused health events to meaningfully engage the medically underserved and diminish future cancer disparities

Lack of access to cancer prevention education, early screening, and timely treatment, particularly in low socioeconomic, underserved communities, are cited as substantial barriers to improving survivorship. Outreach educational efforts with on-site screenings offered in partnership with community groups are known to be valuable in encouraging community members' uptake of healthy behaviors and adherence to screening recommendation. To create more engaging events, a community-academic partnership, We Engage 4 Health (WE4H), co-created 11 unique 4-panel comic-style stories designed to be read aloud together as attendees visit each event table. These colorful stories are shared on boards that stand on each table and are offered in both English and Spanish at this time. Many tables also have an accompanying hands-on activity. Together, they lead to meaningful "low stakes" discussions which support understanding of seemingly complex health information. Story topics include the cause of cancer (Cells Gone Wrong), cancer risk factors (Reducing Your Risk), the role of primary care in cancer screening (Primary Care for Prevention), the purpose of research (short Research Ready) and details about specific cancer types (Combatting Colon Cancer, Blocking Breast Cancer, Looking for Lung Cancer, Silencing Skin Cancer, Hindering HPV, and Professional Prostate Protection) and COVID-19 (Take Your Best Shot FAQs). A health passport is used to facilitate table visitation and survey collection at each table enables meaningful evaluation of the event as well as provides the community hosts and their partners baseline cancer data to inform future programing. In 2022, WE4H and the University of Cincinnati Cancer Center partnered with three different communities to co-host pilot events that served over 100 adult residents. Community, research interns and university students volunteered to work the tables at the event and received training prior. Post event surveys and discussions indicated that community partners appreciated the different take on a health fair event. Most volunteers indicated that they would enjoy volunteering again. Attendees indicated that they liked the graphic-style story format used and most preferred it to text and text with graphics approaches. Taken together, the data indicates that Reducing Your Risk events are useful in meaningfully engaging hard to reach, at risk attendees. Additional in-person and virtual events are being planned for 2023 as an approach to reach the medically underserved throughout our region.

The mediating effects of socio-behavioral factors on the needs for help among Asian American breast cancer survivors

Background: Breast cancer survivors often report their high needs for help during the transition to cancer survivorship. During the COVID-19 pandemic, technology-based programs are increasingly popular because of their high flexibility and accessibility in delivering information and coaching/support to address the current needs for help among cancer survivors. Yet, little is known about how socio-behavioral factors influence the effects of a technology-based intervention on the needs for help of racial/ethnic minority breast cancer survivors, especially Asian American breast cancer survivors. Purpose(s): The purpose of this secondary analysis was to examine the multiple socio-behavioral factors (including attitudes, self-efficacy, perceived barriers, and social influences related to breast cancer survivorship) mediated the effects of a technology-based intervention on the needs for help among Asian American breast cancer survivors. Method(s): This analysis was conducted with the data from 199 Asian American breast cancer survivor women who were recruited from January 2017 to June 2020 through online and offline communities/groups. The needs for help were measured using the Support Care Needs Survey-34 Short Form (SCNS) with five domains on psychological, information, physical, support, and communication needs. Mediation analysis was conducted using the PROCESS macro within SPSS. The analysis determined the mediating effects of four socio-behavioral mediators on the needs for help at pre-test [T0 ], post 1-month [T1 ], and post 3-months [T2 ] of a technology-based intervention. Result(s): Overall, all the mediators had statistically significant mediation effects on all types of needs for help (p < .05) at different points. Attitudes and social influence presented statistically significant mediation effects on the total needs for help score over 3 months (T0 , T1 , and T2 ). Perceived Barriers had mediation effects on all types of needs for help over 1 month (T0 , T1 ). Self-efficacy mediated the effects on all types of needs for help only at post 1 month (T1 ). Conclusion(s): The findings supported that all the socio-behavioral factors (attitudes, self-efficacy, perceived barriers, and social influences) mediated the effects of a technology-based intervention on the needs for help of Asian American breast cancer survivors. Future research and practice should consider socio-behavioral factors to reduce their needs for help during their survivorship process.

Face masks as sources of cross-contamination during food preparation

Amid the COVID-19 pandemic, mask-wearing has become a common practice in the foodservice industry to prevent the spread of respiratory diseases. Like kitchen utensils, a mask may serve as a vehicle for cross-contamination of pathogens during food handling. The objective of this study was to quantify cross-contamination between tasks of handling contaminated chicken and chopping lettuce. Chicken breasts were inoculated with a high or a low level of nonpathogenic Escherichia coli surrogates (ca. 6 or 4 log CFU/ml) and sliced for 1, 5, or 10 min. During slicing, duplicate, single-use medical masks were touched each minute. One mask was immediately sampled, but the second mask was used to contaminate lettuce by touching the mask each minute while chopping the lettuce for 5 min. E. coli were enumerated from the second mask and lettuce. Masks touched while slicing both high- and low-inoculated chicken showed significant contamination (0.8-4.9 log CFU/cm2) after each slicing scenario of 1, 5, or 10 min (P > 0.05). Lettuce was significantly contaminated regardless of inoculation level (1.0-3.2 log CFU/g). Slicing time was a significant factor in some cases (P < 0.05), whereas inoculation level was not (P > 0.05). Data indicate masks can be a source of cross-contamination if not replaced appropriately.

Sensitizing breast cancers to immune checkpoint inhibitors through CD27 agonism and vaccination against tumor-associated antigen

Project objective: Despite the recent revolution in immune checkpoint inhibitors (ICIs), only modest improvement in overall survival and likely caused by not enough potent cellular immunity among BC patients. Our lab has been focus on inducing cellular immunity against HER2+ BC through vaccination against the tumor-associated antigen HER2. Approximately 20 years ago, we performed an experimental pilot study by administrating HER2 peptide and recombinant protein pulsed dendritic cells (DC vaccine) to six patients with refractory HER2+ advanced or metastatic (stage II (>= 6 +LN), III, or stage IV) BC. We followed the patients on 2019 found that all of the six patients were still alive, 18 years after vaccination. Their blood sample were analyzed with cytometry by time-offlight (CyTOF) and found there is a significantly increased presence of CD27 expressing memory T cells in response to HER2 peptide stimulation. Recent report on the SARS-CoV2 mRNA vaccine also suggested that CD27 expressing memory T cells plays a critical role in long-lasting cellular immunity against SARS-CoV2 infection. Therefore, we hypothesized that CD27 plays a critical role in cellular immunity against BC, and the stimulation of CD27 expressing T cells with mAb targeting CD27 significantly increase the cellular immunity triggered by vaccination against tumor-associated antigen. Result(s): We recapitulate the rise of CD27+ antigen specific T cells among the vaccinated patients using a transgenic mouse model expressing human CD27. When combined the adenoviral-vector based HER2 (Ad-HER2) vaccination with a single dose of human aCD27 antibody (Varlilumab), we found there is a robust increase in the HER2 specific T cells compared to vaccination alone, especially CD27+CD44+ memory CD4 T cells, even after 120 days post vaccination. Using an ICIinsensitive syngeneic HER2+ BC models, we found 50% of mice in the combination group of aCD27 antibody plus Ad-HER2 showed total tumor regression by the end of study. When combined with anti-PD1 antibody, the combination of AdHER2 and Varlilumab leads to total tumor regression in 90% of tumor bearing mice with syngeneic HER2+ BC, indicating that the vaccination against tumor associated antigen HER2 plus anti-CD27 antibody sensitized ICI-insensitive HER2+ BC toward ICI. Conclusion(s): Our data demonstrates that the administration of anti-CD27 antibody significantly increase the long term presence of CD27+ antigen specific memory T cells after vaccination against tumor associated antigen HER2. As consequence, combination of anti-CD27 with HER2 sensitized the immune unresponsive breast cancer toward anti-PD1 antibody. Our study suggests that the vaccination against tumor-associated antigen with mAb targeting CD27 leads to the robust cellular immunity, which is required for successful ICIs against breast cancer.

Perinatal SARS-CoV-2 infection and vaccination: new insight

Cumulative data regardingCOVID-19 infection during pregnancy have demonstrated the ability of SARS-CoV-2 to infect the placenta. However, the mechanisms of SARS-CoV-2 placental viral entry are yet to be defined. SARS-CoV-2 infects cells by binding to the ACE2 receptor. However, SARS-CoV-2 cell entry also requires co-localization of spike protein cleavage by the serine protease TMPRSS2. However, the co-expression of ACE2 and TMPRSS2 in placental cells is debated, raising the question of whether potential non-canonical molecular mechanismsmay be involved in SARS-CoV-2 placental cells' viral entry. Although published data regarding the ability of the SARS-CoV- 2 to infect the fetus are contradicting, the placenta appears to be an immunological barrier to active SARS-CoV-2 infection and vertical transmission;however, the mechanism is unclear. Our experiments demonstrated the ability of the SARS-CoV-2 virus to directly infect the placenta and induce transcriptomic responses in COVID-positive mothers. These transcriptomic responses were characterized by differential expression of specific mRNAs and miRNAs associated with SARS-CoV-2 infection, with induction of specific placental miRNAs that can inhibit viral replication. Failure in such mechanisms may be associated with vertical transmission. Since the start of the COVID-19 pandemic, the COVID-19 mRNA vaccines have been widely used to reduce the morbidity and mortality of SARS-CoV-2 infection. Historically, non-live vaccines have not caused any harm to pregnant mothers;however, it is unclear whether our current understanding of the effects of non-live vaccines serves as a reliable precedent owing to the novel technology used to create these mRNA vaccines. Since there are no definitive data on the possible biodistribution of mRNA vaccines to the placenta, the likelihood of vaccine mRNA reaching the fetus remains uncertain. Little has been reported on the tissue localization of the lipid nanoparticles (LNPs) after intramuscular (IM) administration of the mRNA vaccine. The biodistribution of LNPs containing the mRNA vaccine has been investigated in animal models but not humans. In the murine model, the vaccine LNPs were rapidly disseminated to several organs, including the heart, liver, kidney, lung, and spleen, following IM administration. However, no traditional pharmacokinetic or biodistribution studies have been performed with the mRNA vaccines, including possible biodistribution to breast milk or the placenta.

The relationship between inflammatory diet score and cancer-specific outcomes: Systematic review and meta-analysis

Cancer remains one of the most prevalent diseases in the United States and a leading cause of death. Large prospective studies have found significant correlations between dietary intake and cancer. Chronic inflammation promotes pro-cancer inflammatory environments and nutrition can influence inflammation, with the intake of certain food items increasing inflammatory biomarkers. The objective of this research was to explore the relationship between inflammatory diet score measured by the Dietary Inflammatory index and all-cause mortality, cancer-specific mortality, and cancer recurrence among cancer survivors. Web of Science, Medline, CINHAL, and PsycINFO databases were searched to collect potentially eligible sources that focus on dietary inflammation and cancer outcomes. All sources were uploaded to Covidence software and screened by two independent blinded reviewers. The quality of the sources was assessed using the Newcastle Ottawa scale and relevant data was extracted and transferred to the Comprehensive Meta Analysis software and a random effects model was used to perform meta-analysis. Of the 1444 studies imported into the Covidence software, 13 passed all the screening stages and were included in the final analysis. Eight studies reported on pre-diagnosis diet while five others reported on postdiagnosis diet. Five studies reported on colorectal cancer, four on breast cancer, two on ovarian cancer, one on endometrial cancer and one on prostate cancer. Meta-analysis of the studies found that being in the highest postdiagnosis DII score indicating pro-inflammatory diet significantly increased the risk of all-cause death among cancer survivors by 33.5% (HR = 1.335, 95% CI = 1.049, 1.698, n = 6). Analysis did not show a statistically significant association between DII score and cancer mortality or recurrence (HR = 1.097, 95% CI = 0.939, 1.281, n = 6). Analysis by cancer subtype found a significant correlation between postdiagnosis DII score and all-cause mortality among the breast cancer survivors (HR = 1.335, 95% CI = 1.041, 1.711, n = 3) though there were no significant associations between DII and the outcomes of interest from the other cancer types. The meta-analysis concludes that being in the highest postdiagnosis DII score group significantly increased the risk of all-cause death among cancer survivors. This suggests that risk of all-cause mortality could be reduced for cancer survivors by consuming more anti-inflammatory food components and reducing consumption of pro-inflammatory foods. These findings also warrant more research in this field to clarify the relationship between dietary inflammation as measured by the DII and cancer outcomes, particularly cancer-specific mortality.

Empirical Review of Various Thermography-based Computer-aided Diagnostic Systems for Multiple Diseases

The lifestyle led by today's generation and its negligence towards health is highly susceptible to various diseases. Developing countries are at a higher risk of mortality due to late-stage presentation, inaccessible diagnosis, and high-cost treatment. Thermography-based technology, aided with machine learning, for screening inflammation in the human body is non-invasive and cost-wise appropriate. It requires very little equipment, especially in rural areas with limited facilities. Recently, Thermography-based monitoring has been deployed worldwide at various organizations and public gathering points as a first measure of screening COVID-19 patients. In this article, we systematically compare the state-of-the-art feature extraction approaches for analyzing thermal patterns in the human body, individually and in combination, on a platform using three publicly available Datasets of medical thermal imaging, four Feature Selection methods, and four well-known Classifiers, and analyze the results. We developed and used a two-level sampling method for training and testing the classification model. Among all the combinations considered, the classification model with Unified Feature-Sets gave the best performance for all the datasets. Also, the experimental results show that the classification accuracy improves considerably with the use of feature selection methods. We obtained the best performance with a features subset of 45, 57, and 39 features (from Unified Feature Set) with a combination of mRMR and SVM for DB-DMR-IR and DB-FOOT-IR and a combination of ReF and RF for DB-THY-IR. Also, we found that for all the feature subsets, the features obtained are relevant, non-redundant, and distinguish normal and abnormal thermal patterns with the accuracy of 94.75% on the DB-DMR-IR dataset, 93.14% on the DB-FOOT-IR dataset, and 92.06% on the DB-THY-IR dataset. [ FROM AUTHOR] Copyright of ACM Transactions on Intelligent Systems & Technology is the property of Association for Computing Machinery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Benefits of Breastfeeding on Child and Postpartum Psychological Health of the Mother

Ab s t r ac t Aim: The aim of this study was to summarize different types of benefits that have been observed in the baby's development and the mother's psychological health during the postpartum period. Background(s): Breastfeeding is a natural process that plays a vital role in the physical as well as mental health of the mother and child. Breast milk is rich in contents such as proteins, fats, and vitamins, which are responsible for building the immune system of the baby. Lactation helps in decreasing the prevalence of infant mortality rate. It enhances the development of the physical health of the children. Breastfeeding protects the mother from many systemic conditions like endometrial cancer, ovarian cancer, breast cancer, etc. It has been observed that with an increase in healthy breastfeeding practices, there is a decline in the cases of maternal mental health issues reported mainly in the postpartum period. Review result: The authors have explained various types of advantages of breastfeeding on the child's and mother's health, their mechanism of action, effects on the baby, and mother-child relationship. Conclusion(s): The mother's mental health plays a crucial role in a healthy infant, and breastfeeding is key to it. The role of breastfeeding is therefore considered a boon for the mother because if there is a decrease in health issues in the child, the mother's mental condition improves automatically. Therefore, breastfeeding should be promoted at the national level. Clinical significance: Breastfeeding not only helps in reducing maternal stress and postpartum depression but also improves the physical health of the child and mother during the postpartum period. The clinicians should teach mothers about the importance and also the correct positions of breastfeeding. "Breastfeeding week" is celebrated every year from August 1 to August 7, as implemented by the Indian government.Copyright © The Author(s). 2023 Open Access.

Human Milk Bank in Croatia: initial experiences.

Donated human milk is the best substitute for breast milk in the case when the mother cannot feed her baby. Human milk banks provide safe and high quality donated human milk. That was the reason why the Human Milk Bank was established in the Croatian Tissue and Cell Bank at the Zagreb University Hospital Centre in January 2020. The Bank works in accordance with the Law on the Application of Human Tissues and Cells. In this paper, we present the results of the Bank work since from its opening until June 2020. Due to logistic reasons caused by the COVID-19 epidemic and the earthquake in Zagreb, the Human Milk Bank did not collect milk for 43 days. Milk was donated by 31 mothers. Their median age was 31 years and 81% of them had high education level. In 52% of cases, mothers started donating milk three months after giving birth. Most donors donated milk only once (45%). The median period of donation was 46 days. The majority (52%) of donors gave birth for the first time, in the expected term of childbirth (94%), birth weight was >2500 g. Only three of donors' children (9%) were in intensive care. A total of 175.5 L of milk were collected (mean 5.7 L per donor), of which 151.5 L met the requirements of input quality control, and 141 L were pasteurized. A critical number of viable aerobic and facultative bacteria were identified in 32.6% of milk pools prepared for pasteurization, and 8.9% after pasteurization. For clinical use, 78.7 L were dispensed in three neonatal intensive care units. The Human Milk Bank has already shown the importance of its activities during the first months of operation. In order to be able to meet the needs for donated human milk at the national level, it is necessary to constantly inform mothers about the importance of human milk and to promote its donation.Copyright © 2020 Croatian Paediatric Society. All rights reserved.