Shallow WGS of individual CTCs identifies actionable targets for informing treatment decisions in metastatic breast cancer.

BACKGROUND: We report copy-number profiling by low-pass WGS (LP-WGS) in individual circulating tumour cells (CTCs) for guiding treatment in patients with metastatic breast cancer (MBC), comparing CTC results with mutations detected in circulating tumour DNA (ctDNA) in the same blood samples. METHODS: Across 10 patients with MBC who were progressing at the time of blood sampling and that had >20 CTCs detected by CellSearch®, 63 single cells (50 CTCs and 13 WBCs) and 16 cell pools (8 CTC pools and 8 WBC pools) were recovered from peripheral blood by CellSearch®/DEPArray™ and sequenced with Ampli1 LowPass technology (Menarini Silicon Biosystems). Copy-number aberrations were identified using the MSBiosuite software platform, and results were compared with mutations detected in matched plasma cfDNA analysed by targeted next-generation sequencing using the Oncomine™ Breast cfDNA Assay (Thermo Fisher). RESULTS: LP-WGS data demonstrated copy-number gains/losses in individual CTCs in regions including FGFR1, JAK2 and CDK6 in five patients, ERBB2 amplification in two HER2-negative patients and BRCA loss in two patients. Seven of eight matched plasmas also had mutations in ctDNA in PIK3CA, TP53, ESR1 and KRAS genes with mutant allele frequencies (MAF) ranging from 0.05 to 33.11%. Combining results from paired CTCs and ctDNA, clinically actionable targets were identified in all ten patients. CONCLUSION: This combined analysis of CTCs and ctDNA may offer a new approach for monitoring of disease progression and to direct therapy in patients with advanced MBC, at a time when they are coming towards the end of other treatment options.

Longitudinal monitoring of circulating tumour DNA improves prognostication and relapse detection in gastroesophageal adenocarcinoma.

BACKGROUND: Gastroesophageal adenocarcinoma (GOA) has poor clinical outcomes and lacks reliable blood markers. Here we present circulating tumour DNA (ctDNA) as an emerging biomarker. METHODS: Forty patients (17 palliative and 23 curative) were followed by serial plasma monitoring. Primary tumour DNA was analysed by targeted next-generation sequencing to identify somatic single-nucleotide variants (SNVs), and Nanostring nCounter® to detect copy number alterations (CNAs). Patient-specific SNVs and CNA amplifications (CNAamp) were analysed in plasma using digital droplet PCR and quantitative PCR, respectively. RESULTS: Thirty-five patients (13 palliative, 22 curative) had ≥1 SNVs and/or CNAamp detected in primary tumour DNA suitable for tracking in plasma. Eighteen of 35 patients (nine palliative, nine curative) had ≥1 ctDNA-positive plasma sample. Detection of postoperative ctDNA predicted short RFS (190 vs 934 days, HR = 3.7, p = 0.028) and subsequent relapse (PPV for relapse 0.83). High ctDNA levels (>60.5 copies/ml) at diagnosis of metastatic disease predicted poor OS (90 vs 372 days, HR = 11.7 p < 0.001). CONCLUSION: Sensitive ctDNA detection allows disease monitoring and prediction of short OS in metastatic patients. Presence of ctDNA postoperatively predicts relapse and defines a 'molecular relapse' before overt clinical disease. This lead time defines a potential therapeutic window for additional anticancer therapy.

Evaluation of Three Methods for CPR Training to Lifeguards: A Randomised Trial Using Traditional Procedures and New Technologies.

Background and objectives: When the drowning timeline evolves and drowning occurs, the lifeguard tries to mitigate the event by applying the last link of the drowning survival chain with the aim of treating hypoxia. Quality CPR (Cardiopulmonary Resuscitation) and the training of lifeguards are the fundamental axes of drowning survival. Mobile applications and other feedback methods have emerged as strong methods for the learning and training of basic CPR in the last years so, in this study, a randomised clinical trial has been carried out to compare the traditional method as the use of apps or manikins with a feedback system as a method of training to improve the quality of resuscitation. Materials and Methods: The traditional training (TT), mobile phone applications (AP) and feedback manikins (FT) are compared. The three cohorts were subsequently evaluated through a manikin providing feedback, and a data report on the quality of the manoeuvres was obtained. Results: Significant differences were found between the traditional manikin and the manikin with real-time feedback regarding the percentage of compressions with correct depth (30.8% (30.4) vs. 68.2% (32.6); p = 0.042). Hand positioning, percentage correct chest recoil and quality of compressions exceeded 70% of correct performance in all groups with better percentages in the FT (TT vs. FT; p < 0.05). Conclusions: As a conclusion, feedback manikins are better learning tools than traditional models and apps as regards training chest compression. Ventilation values are low in all groups, but improve with the feedback manikin.

Plasma cell-free DNA (cfDNA) as a predictive and prognostic marker in patients with metastatic breast cancer.

BACKGROUND: Breast cancer (BC) is the most common cancer in women, and despite the introduction of new screening programmes, therapies and monitoring technologies, there is still a need to develop more useful tests for monitoring treatment response and to inform clinical decision making. The purpose of this study was to compare circulating cell-free DNA (cfDNA) and circulating tumour cells (CTCs) with conventional breast cancer blood biomarkers (CA15-3 and alkaline phosphatase (AP)) as predictors of response to treatment and prognosis in patients with metastatic breast cancer (MBC). METHODS: One hundred ninety-four female patients with radiologically confirmed MBC were recruited to the study. Total cfDNA levels were determined by qPCR and compared with CELLSEARCH® CTC counts and CA15-3 and alkaline phosphatase (AP) values. Blood biomarker data were compared with conventional tumour markers, treatment(s) and response as assessed by RECIST and survival. Non-parametric statistical hypothesis tests were used to examine differences, correlation analysis and linear regression to determine correlation and to describe its effects, logistic regression and receiver operating characteristic curve (ROC curve) to estimate the strength of the relationship between biomarkers and clinical outcomes and value normalization against standard deviation to make biomarker values comparable. Kaplan-Meier estimator and Cox regression models were used to assess survival. Univariate and multivariate models were performed where appropriate. RESULTS: Multivariate analysis showed that both the amount of total cfDNA (p value = 0.024, HR = 1.199, CI = 1.024-1.405) and the number of CTCs (p value = 0.001, HR = 1.243, CI = 1.088-1.421) are predictors of overall survival (OS), whereas total cfDNA levels is the sole predictor for progression-free survival (PFS) (p value = 0.042, HR = 1.193, CI = 1.007-1.415) and disease response when comparing response to non-response to treatment (HR = 15.917, HR = 12.481 for univariate and multivariate analysis, respectively). Lastly, combined analysis of CTCs and cfDNA is more informative than the combination of two conventional biomarkers (CA15-3 and AP) for prediction of OS. CONCLUSION: Measurement of total cfDNA levels, which is a simpler and less expensive biomarker than CTC counts, is associated with PFS, OS and response in MBC, suggesting potential clinical application of a cheap and simple blood-based test.

Effectiveness of the application of massage therapy and kinesitherapy by parents on premature neonates: A research protocol.

AIM: The study aims to analyse the efficacy of massage therapy and kinesitherapy applied by parents of premature infants admitted to hospital. BACKGROUND: Premature newborns suffer early somatic deprivation that has adverse effects on their growth and development and that also has a negative impact on the emotional state of their parents. Massage therapy and kinesitherapy is beneficial in alleviating somatic deficit and facilitates the bond between parents and newborns. DESIGN: A quasi-experimental community intervention trial will be conducted in a neonatology unit. METHODS: This study will compare the benefits of a 15-min massage protocol applied by parents with the usual medical and nursing care given by neonatal units for premature babies. The evaluation of neuromotor development will take place through the Spanish Premie-Neuro scale. The determination of weight, size, and head circumference will be based on the unit's usual procedures. DISCUSSION: If the implementation of a massage therapy and kinesitherapy protocol is effective in promoting the growth and development of hospitalized premature infants, the results of this study could give an impetus for the inclusion of somatic stimulation in the usual nursing care given for preterm infants. IMPACT: Prematurity and its associated morbidity pose a major global public health problem. Somatic and kinaesthetic stimulation has beneficial effects on anthropometric and neuromotor development in preterm infants. The results will have a positive impact on premature neonates and their families, both during the hospitalization, and a positive socio-economic effect throughout their lives (education, work, disability). TRIAL REGISTRATION: NCT03704012.

Effects of Massage Therapy and Kinesitherapy to Develop Hospitalized Preterm Infant's Anthropometry: A Quasi-Experimental Study.

PURPOSE: The aim of this study was to analyze the efficacy of massage therapy and kinesitherapy on the anthropometric development of hospitalized preterm infants applied by parents. DESIGN AND METHODS: A prospective quasi-experimental study was designed. Hospitalized preterm infants received a daily 15-minute session of massage therapy and kinesitherapy. The control group received regular medical and nursing care. RESULTS: The massage therapy and kinesitherapy protocol significantly improved the anthropometric parameters studied: weight (895.7 ±â€¯547.9 vs 541.8 ±â€¯536.2; p < 0.001) size (5.5 ±â€¯4.3 vs. 3.0 ±â€¯3.1; p < 0.001) and head circumference (4.2 ±â€¯3.2 vs 2.4 ±â€¯2.6; p < 0.001). CONCLUSIONS: The implementation of a massage therapy and kinesitherapy protocol is beneficial for the anthropometric development of hospitalized preterm infants. PRACTICE IMPLICATIONS: An easy to administer and cost-effective intervention such as massage therapy and kinesitherapy can improve the anthropometric development of preterm infants and reduce growth-related morbidity in the short, medium, and long term.

Analysis of peripheral central venous access ports at the forearm: An observational study.

The aim of this study was to analyse the characteristics of central venous catheters with brachial-implanted reservoirs and the complications associated with their use over a 4-years period. This observational study was carried out in an onco-haematological day hospital in Spain. Information was collected about 125 catheters inserted in patients requiring intravenous chemotherapy. There were more catheters implanted in women than men and the mean age was 58.6 years. Seventy of the implanted catheters were made of polyurethane and 55 of silicone. Left laterality prevailed with a mean catheter dwell-time of 347.1 days. A total of 164 complications were registered, 124 of them came from blood draws, where the most frequent complication was "inability to withdraw, ability to infuse". Forty complications were associated with the administration of treatments. Furthermore, there were 21 catheter removals, caused by several other complications different from those mentioned before. Statistically significant differences were found when associating types of catheters, laterality, blood draws and administration of treatments. Results showed how silicone ports would be more appropriate for patients who carry these types or ports than polyurethane because they reduce the number of complications causes by thrombosis.

Rehabilitation and early mobilization in the critical patient: systematic review.

[Purpose] To review the literature that examines rehabilitation and early mobilization and that involves different practices (effects of interventions) for the critically ill patient. [Materials and Methods] A PRISMA-Systematic review has been conducted based on different data sources: Biblioteca Virtual en Salud, CINHAL, Pubmed, Scopus, and Web of Science were used to identify randomized controlled trials, crossover trials, and case-control studies. [Results] Eleven studies were included. Early rehabilitation had no significant effect on the length of stay and number of cases of Intensive Care Unit Acquired Weaknesses. However, early rehabilitation had a significant effect on the functional status, muscle strength, mechanical ventilation duration, walking ability at discharge, and health quality of life. [Conclusion] Rehabilitation and early mobilization are associated with an increased probability of walking more distance at discharge. Early rehabilitation is associated with an increase in functional capacity and muscle strength, an improvement in walking distance and better perception of the health-related quality of life. Cycloergometer and electrical stimulation can be used to maintain muscle strength. Further research is needed to establish stronger evidences.

Next Generation Sequencing of Circulating Cell-Free DNA for Evaluating Mutations and Gene Amplification in Metastatic Breast Cancer.

BACKGROUND: Breast cancer tissues are heterogeneous and show diverse somatic mutations and somatic copy number alterations (CNAs). We used a novel targeted next generation sequencing (NGS) panel to examine cell-free DNA (cfDNA) to detect somatic mutations and gene amplification in women with metastatic breast cancer (MBC). METHODS: cfDNA from pretreated patients (n = 42) and 9 healthy controls were compared with matched lymphocyte DNA by NGS, using a custom 158 amplicon panel covering hot-spot mutations and CNAs in 16 genes, with further validation of results by droplet digital PCR. RESULTS: No mutations were identified in cfDNA of healthy controls, whereas exactly half the patients with metastatic breast cancer had at least one mutation or amplification in cfDNA (mean 2, range 1-6) across a total of 13 genes. Longitudinal follow up showed dynamic changes to mutations and gene amplification in cfDNA indicating clonal and subclonal response to treatment that was more dynamic than cancer antigen 15-3 (CA15-3). Interestingly, at the time of blood sampling disease progression was occurring in 7 patients with erb-b2 receptor tyrosine kinase 2 (ERBB2) gene amplification in their cfDNA and 3 of these patients were human epidermal growth factor receptor 2 (HER2) negative at diagnosis, suggesting clonal evolution to a more aggressive phenotype. Lastly, 6 patients harbored estrogen receptor 1 (ESR1) mutations in cfDNA, suggesting resistance to endocrine therapy. Overall 9 of 42 patients (21%) had alterations in cfDNA that could herald a change in treatment. CONCLUSIONS: Targeted NGS of cfDNA has potential for monitoring response to targeted therapies through both mutations and gene amplification, for analysis of dynamic tumor heterogeneity and stratification to targeted therapy.

MODPATH-RW: A Random Walk Particle Tracking Code for Solute Transport in Heterogeneous Aquifers.

Random walk particle tracking (RWPT) is a discrete particle method that offers several advantages for simulating solute transport in heterogeneous geological systems. The formulation is a discrete solution to the advection-dispersion equation, yielding results that are not influenced by grid-related numerical dispersion. Numerical dispersion impacts the magnitude of concentrations and gradients obtained from classical grid-based solvers in advection-dominated problems with relatively large grid Péclet numbers. Accurate predictions of concentrations are crucial for reactive transport studies, and RWPT has been recognized for its potential benefits for this kind of application. This highlights the need for a solute transport program based on RWPT that can be seamlessly integrated with industry-standard groundwater flow models. This article presents a solute transport code that implements the RWPT method by extension of the particle tracking model MODPATH, which provides the base infrastructure for interacting with several variants of MODFLOW groundwater flow models. The implementation is achieved by developing a method for determining the exact cell-exit position of a particle undergoing simultaneous advection and dispersion, allowing for the sequential transfer of particles between flow model cells. The program is compatible with rectangular unstructured grids and integrates a module for the smoothed reconstruction of concentrations. In addition, the program incorporates parallel processing of particles using the OpenMP library, enabling faster simulations of solute transport in heterogeneous systems. Numerical test cases involving different applications in hydrogeology benchmark the RWPT model with well-known transport codes.

Identifying Barriers to the Acquisition of Knowledge about Skin Integrity Impairment in Nursing Students: An Educational Intervention.

BACKGROUND: Wound healing competence is implied in the nursing profession, but there is no standardized content regulation for wound care in university curricula. The primary objective of this study was to identify the barriers to the acquisition of knowledge about skin integrity impairment. METHODS: A quasi-experimental pre-test and post-test study with an ad hoc questionnaire involved 304 students (control: 165; intervention: 139) from June to July 2023. A 10-h educational intervention focused on skin integrity assessment and treatment was conducted. RESULTS: The control group, scoring 17 ± 0.22 out of a maximum of 61, achieved a significantly lower final test score (p < 0.001) compared to the wound care educational intervention group, with the pre-test group scoring 30 ± 0.76 and the post-test group scoring 43 ± 0.61. The educational intervention in wound care program improved nursing students' knowledge of prevention, assessment/diagnosis, treatment, lower limb wounds, and wound bed preparation by replacing the number of "Don't know" answers in the post-test group with correct answers. CONCLUSIONS: The barriers identified to the acquisition of knowledge about skin integrity impairment in nursing studies are the following: the transversality of teaching, the teaching and evaluation system, and the variability in the training of professionals and teachers in charge of their education. The educational intervention can be used to consolidate knowledge and to enhance students' self-confidence in caring for patients with wounds.

Cytotoxicity and concentration of silver ions released from dressings in the treatment of infected wounds: a systematic review.

Introduction: Silver-releasing dressings are used in the treatment of infected wounds. Despite their widespread use, neither the amount of silver released nor the potential in vivo toxicity is known. The aim of this study was to evaluate the cytotoxic effects and the amount of silver released from commercially available dressings with infected wounds. Methods: The review was conducted according to the PRISMA statement. The Web of Science, PubMed, Embase, Scopus, and CINAHL databases were searched for studies from 2002 through December 2022. The criteria were as follows: population (human patients with infected wounds); intervention (commercial dressings with clinical silver authorized for use in humans); and outcomes (concentrations of silver ions released into tissues and plasma). Any study based on silver-free dressings, experimental dressings, or dressings not for clinical use in humans should be excluded. According to the type of study, systematic reviews, experimental, quasi-experimental, and observational studies in English, Spanish, or Portuguese were considered. The quality of the selected studies was assessed using the JBI critical appraisal tools. Studies that assessed at least 65% of the included items were included. Data were extracted independently by two reviewers. Results: 740 articles were found and five were finally selected (all of them quasi-experimental). Heterogeneity was found in terms of study design, application of silver dressings, and methods of assessment, which limited the comparability between studies. Conclusion: In vivo comparative studies of clinical dressings for control of infection lack a standardized methodology that allows observation of all the variables of silver performance at local and systemic levels, as well as evaluation of its cytotoxicity. It cannot be concluded whether the assessed concentrations of released silver in commercial dressings for the topical treatment of infected wounds are cytotoxic to skin cells. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351041, PROSPERO [CRD42022351041].

Serial Postoperative Circulating Tumor DNA Assessment Has Strong Prognostic Value During Long-Term Follow-Up in Patients With Breast Cancer.

PURPOSE: Here, we report the sensitivity of a personalized, tumor-informed circulating tumor DNA (ctDNA) assay (Signatera) for detection of molecular relapse during long-term follow-up of patients with breast cancer. METHODS: A total of 156 patients with primary breast cancer were monitored clinically for up to 12 years after surgery and adjuvant chemotherapy. Semiannual blood samples were prospectively collected, and analyzed retrospectively to detect residual disease by ultradeep sequencing using ctDNA assays, developed from primary tumor whole-exome sequencing data. RESULTS: Personalized Signatera assays detected ctDNA ahead of clinical or radiologic relapse in 30 of the 34 patients who relapsed (patient-level sensitivity of 88.2%). Relapse was predicted with a lead interval of up to 38 months (median, 10.5 months; range, 0-38 months), and ctDNA positivity was associated with shorter relapse-free survival (P < .0001) and overall survival (P < .0001). All relapsing triple-negative patients (n = 7/23) had a ctDNA-positive test within a median of 8 months (range, 0-19 months), while the 16 nonrelapsed patients with triple-negative breast cancer remained ctDNA-negative during a median follow-up of 58 months (range, 8-99 months). The four patients who had negative tests before relapse all had hormone receptor-positive (HR+) disease and conversely, five of the 122 nonrelapsed patients (all HR+) had an occasional positive test. CONCLUSION: Serial postoperative ctDNA assessment has strong prognostic value, provides a potential window for earlier therapeutic intervention, and may enable more effective monitoring than current clinical tests such as cancer antigen 15-3. Our study provides evidence that those with serially negative ctDNA tests have superior clinical outcomes, providing reassurance to patients with breast cancer. For select cases with HR+ disease, decisions about treatment management might require serial monitoring despite the ctDNA-positive result.

Multiprocessing for the Particle Tracking Model MODPATH.

Particle tracking has several important applications for solute transport studies in aquifer systems. Travel time distribution at observation points, particle coordinates in time and streamlines are some practical results providing information of expected transport patterns and interaction with boundary conditions. However, flow model complexity and simultaneous displacement of multiple particle groups leads to rapid increase of computational requirements. MODPATH is a particle tracking engine for MODFLOW models and source code displays potential for parallel processing of particles. This article addresses the implementation of this feature with the OpenMP library. Two synthetic aquifer applications are employed for performance tests on a desktop computer with increasing number of particles. Speed up analysis shows that dynamic thread scheduling is preferable for highly heterogeneous flows, providing processing adaptivity to the presence of slow particles. In simulations writing particles position in time, thread exclusive output files lead to higher speed up factors. Results show that above a threshold number of particles, simulation runtimes become independent of flow model grid complexity and are controlled by the large number of particles, then parallel processing reduces simulation runtimes for the particle tracking model MODPATH. Article impact statement: Parallel particles processing for MODPATH using the OpenMP library.

Analysis of Knowledge of Smoking-Related Diseases in Spanish Nursing Students.

Smoking causes significant morbidity and mortality worldwide, mainly in developed countries. In addition, it is the cause of numerous diseases in the body, despite the fact that the prevalence of tobacco use is decreasing. Nursing students, as future professionals, should be aware of action plans for cessation and information designed for smokers. To determine the level of knowledge among nursing students about smoking-related diseases and analyze the prevalence of student who smoke at the University of Leon, Spain, a descriptive cross-sectional study was carried out in which students were given an anonymous questionnaire, which was previously validated, during the 2021-2022 academic year. In a sample of 477 (79.5%) nursing students, a smoking prevalence of 17.6% was obtained. In addition, students' knowledge about the diseases directly caused by tobacco consumption and others associated with exposure to environmental smoke was assessed, and in both cases (8.03 points of 9 for consumption and 5.24 of 6 to exposure), scores were obtained that allow us to state that students do not know for sure the types of diseases that are related to tobacco use and passive smoking. In spite of this, it is necessary to continue to reduce the prevalence of smoking through different programs implemented in schools and universities, as it is also necessary to improve teaching plans when explaining smoking-related diseases, so that students, in the future, will be able to advise patients correctly.

Implications of gut and oral microbiota in neuroinflammatory responses in Alzheimer's disease.

A diverse and stable microbiota promotes a healthy state, nevertheless, an imbalance in gut or oral bacterial composition, called dysbiosis, can cause gastrointestinal disorders, systemic inflammatory states and oxidative stress, among others. Recently, gut and oral dysbiosis has been linked to Alzheimer's disease (AD), which is considered the most common form of dementia and a public health priority due to its high prevalence and incidence. The aim of this review is to highlight the implications of gut and oral microbiota in the neuroinflammation characteristic of AD pathology and the subsequent cognitive impairment. It is a systematic review of the current literature obtained by searching the PubMed, Web of Science and Scopus databases. The characteristic intestinal dysbiosis in AD patients leads to increased permeability of the intestinal barrier and activates immune cells in the central nervous system due to translocation of microbiota-derived metabolites and/or bacteria into the circulation leading to increased neuroinflammation and neuronal loss, thus generating the cognitive impairment characteristic of AD. The presence in the central nervous system of Porphyromonas gingivalis can cause an increased neuroinflammation and beta-amyloid peptide accumulation.

Analysis of cardiovascular risk factors for the viability of cornea donors: a case-control study.

OBJECTIVE: The main objective of the study was to evaluate the influence of arterial hypertension, diabetes, dyslipidaemia, smoking, alcoholism and COPD (chronic obstructive pulmonary disease) on the viability of the extracted tissue as well as the donor. DESIGN: Observational case-control study. SETTING: Regional hospital in Northern Spain. PARTICIPANTS: 1517 corneas were registered. INTERVENTIONS: Patients' medical history was reviewed after corneal donation and evaluation. Previous medical information (age, sex and cardiovascular risk factors (CVRFs)) and data related to the donor (type of donor), the corneal tissue and its evaluation, and the viability of the implant were collected. RESULTS: A total of 1517 corneas were registered and 81.5% of the donors presented at least one CVRF. In relation to the viability of the donor, it was observed that having suffered from COPD reduced the viability of the donor (no COPD: 93.8% vs COPD: 88%; OR=0.49; 95% CI: 0.28 to 0.84) while alcohol consumption increased it (drinker or ex-drinker: 95.8% vs non-drinker: 92.5%; OR=1.84; 95% CI: 1.01 to 3.33). Regarding tissue viability, decreased viability was observed in the presence of COPD (no COPD: 72.5% vs COPD: 64; OR=0.67; 95% CI: 0.47 to 0.96) and diabetes mellitus (no diabetes: 72.9% vs diabetes: 67.2%; OR=0.76; 95% CI: 0.58 to 0.99). As regards the viability of the implant, a total of 1039 corneas (68.9%) were suitable, observing decreased viability when suffering from COPD (no COPD: 69.8% vs COPD: 60.7%; OR=0.67; 95% CI: 0.47 to 0.94) and increased when having an active smoking habit (no habit: 65.3% vs habit: 74.1%; OR=1.52; 95% CI: 1.21 to 1.91). CONCLUSIONS: Through this study, it can be concluded that in the absence of absolute exclusion criteria for donors, the assessment of how CVRF, alcoholism and COPD may affect the donor provides details about the quality of the tissue to be obtained.

Comparison of phenomics and cfDNA in a large breast screening population: the Breast Screening and Monitoring Study (BSMS).

To assess their roles in breast cancer diagnostics, we aimed to compare plasma cell-free DNA (cfDNA) levels with the circulating metabolome in a large breast screening cohort of women recalled for mammography, including healthy women and women with mammographically detected breast diseases, ductal carcinoma in situ and invasive breast cancer: the Breast Screening and Monitoring Study (BSMS). In 999 women, plasma was analyzed by nuclear magnetic resonance (NMR) and Ultra-Performance Liquid Chromatography-Mass Spectrometry (UPLC-MS) and then processed to isolate and quantify total cfDNA. NMR and UPLC-MS results were compared with data for 186 healthy women derived from the AIRWAVE cohort. Results showed no significant differences between groups for all metabolites, whereas invasive cancers had significantly higher plasma cfDNA levels than all other groups. When stratified the supervised OPLS-DA analysis and total cfDNA concentration showed high discrimination accuracy between invasive cancers and the disease/medication-free subjects. Furthermore, comparison of OPLS-DA data for invasive breast cancers with the AIRWAVE cohort showed similar discrimination between breast cancers and healthy controls. This is the first report of agreement between metabolomics and plasma cfDNA levels for discriminating breast cancer from healthy subjects in a true screening population. It also emphasizes the importance of sample standardization. Follow on studies will involve analysis of candidate features in a larger validation series as well as comparing results with serial plasma samples taken at the next routine screening mammography appointment. The findings here help establish the role of plasma analysis in the diagnosis of breast cancer in a large real-world cohort.

Presenteeism and mental health of workers during the COVID-19 pandemic: a systematic review.

Background: A large number of workers attend work despite being ill. Attending work during sickness can have a number of consequences for the worker (e.g., worsening of physical and mental condition), for co-workers, and for the company, and for service users. Objectives: The aim of this study was to assess the factors influencing presenteeism and mental health of workers during the COVID-19 pandemic. Methods: A systematic review following the PRISMA format was conducted in the PubMed, Scopus, Web of Science (WoS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and ScienceDirect electronic databases in January 2023, using the following key words: Presenteeism, Mental Health, and COVID-19. The eligibility criteria applied were original articles published in English, Spanish, French, German, and Portuguese, workers during the COVID-19 pandemic (data collection date: January 01, 2020 - January 01, 2023), and articles assessing at least one measure of presenteeism and mental health status. Methodological quality was assessed using the critical appraisal tools of the Joanna Briggs Institute. The followed protocol is listed in the International Prospective Register of Systematic Reviews (PROSPERO) with code CRD42023391409. Results: A total of 25 studies were included in this review recruiting a total of 164,274 participants. A number of factors influencing mental health and sickness presenteeism were identified: (1) mental health-related factors (burnout [in 4 studies], stress [in 9 studies], depression [in 1 study], fear of COVID-19 [in 1 study], no well-being [in 2 studies], etc.); (2) individual factors (health status [in 1 study], being young [in 1 study], workers who experienced interrupted medical care [in 2 studies], having a chronic disease [in 1 study], etc.); (3) factors related to the situation caused by COVID-19 (confinement, symptoms, loss of contract, risk of bankruptcy, etc. [in 1 study each one]); and (4) factors derived from working conditions (organisational support [in 1 study], patient care [in 1 study], work functioning or task performance impairment [in 4 studies], work fatigue [in 2 studies], safety climate [in 1 study], workload [in 1 study], etc.). Conclusion: Identifying the key determinants of presenteeism and understanding the phenomena and origins of sickness presenteeism will help to create a safe working environment and optimal organisational systems to protect vulnerable workers in a pandemic context. Systematic review registration: The unique identifier is CRD42023391409.

Applying the Modified Ten-Group Robson Classification in a Spanish Tertiary Hospital.

BACKGROUND: Caesarean section is necessary to save the lives of mothers and newborns at times, but it is important to perform it only when it is essential due to all the risks involved. This study aimed to examine the rate of caesarean sections performed at a tertiary hospital using the Robson classification to detect methods for the detection of and/or reduction in these caesarean section rates. METHODS: A descriptive, cross-sectional study of a retrospective database was carried out. RESULTS: A total of 10,317 births were assessed. The Robson classification was used to assess these interventions and verify whether the indication for performed caesarean sections was appropriate. In total, 2036 births by caesarean section were performed in the whole sample. The annual caesarean section rate varied between 18.67% and 21.18%. CONCLUSIONS: Caesarean sections increased by about 20% in 2021 compared to 2020 even though the trend over the years of study was decreasing. Vaginal delivery after caesarean section is a reasonable and safe option. Caesarean section rates could be improved, mostly in Robson's Group 2. The Robson classification facilitated progress in the implementation of measures aimed at improving care and adjusting caesarean section rates.