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Emoji your communication: the effect of employee's use of emojis in digital communication on customers' perceptions of service quality and brand attitude
No full textPediatric high-grade gliomas in patients with neurofibromatosis type 1 — a collaborative cohort study from the SIOPE HGG/DIPG working group
No full textBackground: We assessed clinical features, treatment, and survival of pediatric patients with neurofibromatosis type 1 (NF1) with high-grade glioma (HGG).
Methods: Patients from this retrospective cohort study were identified through an international collaborative effort by the SIOPE HGG/DIPG working group. NF1 was diagnosed based on clinical presentation and confirmed by either a pathogenic germline NF1 gene alteration or the exclusion of mismatch repair deficiency. A control cohort without genetic cancer predisposition was matched in a 2:1-ratio from the HIT-HGG database.
Results: We identified 29 pediatric patients with NF1-associated HGG. Median age at diagnosis of HGG was 11 years. All but 1 tumor arose outside the optic pathway and included circumscribed and diffuse HGG. Molecular analysis in a subset of tumors identified an enrichment of alterations in CDKN2A, TP53, and ATRX. Event-free and overall survival were as poor as in matched sporadic HGG patients. The prognosis was not superior with upfront radiotherapy compared with delayed radiotherapy.
Conclusions: NF1-associated HGGs behave as aggressively as their sporadic counterparts. The relevance of delaying radiotherapy until the time of progression and adjuvant MEK inhibitor treatment needs further investigation
Optical phonons as a testing ground for spin group symmetries
No full textAbstractLattice vibrations are highly sensitive to crystal symmetries and their changes across phase transitions. The latter can modify irreducible (co)representations and corresponding infrared and Raman selection rules of phonons. This concept is established for relativistic magnetic point groups, simultaneously transforming spatial and spin coordinates. However, in altermagnets described by non-relativistic spin groups with disjunct symmetry operations for both vector spaces, the phonon selection rules have remained unexplored. Here, we present a detailed study of the infrared- and Raman-active modes in the collinear antiferromagnet and altermagnet candidate Co2Mo3O8. Comparing to ab initio calculations accurately capturing the eigenfrequencies, we identify all expected phonon modes at room temperature and deduce their selection rules using both symmetry approaches. Importantly, we observe the change of selection rules upon antiferromagnetic ordering, agreeing with the relativistic symmetry approach, while the spin group formalism predicts no changes. Therefore, optical phonons sensing the symmetry of the magnetic order can reveal if relevant magnon-phonon coupling is compatible with the spin-group approach or not
Differences in postoperative outcomes after carotid endarterectomies performed by female versus male surgeons
No full textTo evaluate whether sex of the operating surgeon influences postoperative outcomes after carotid endarterectomy (CEA). We hypothesized that patients treated by female surgeons have lower complication rates or mortality.
Methods: A retrospective, single-center analysis was conducted of all CEA procedures performed between January 2012 and December 2023 by the Clinic of Vascular Surgery of the University Hospital Augsburg. Patient demographics, comorbidities, and operative details were collected from the german national quality assurance database. The primary outcomes included perioperative complications and 30-day mortality. Secondary outcomes included operative time and surgical technique preference. Outcomes were compared between cases performed by male and female surgeons using univariate analysis and multivariable logistic regression.
Results: A total of 1 130 CEA operations met the inclusion criteria. Of these, 905 (80.1%) were performed by male surgeons and 225 (19.9%) by female surgeons. Patient characteristics were comparable between the two groups. Male surgeons more frequently used eversion endarterectomy (OR for eversion by male vs. female surgeon 1.65, 95% CI 1.02-2.67, p = 0.04). The median incision-to-suture operative time was longer under female surgeons (101 minutes [IQR 87-118] vs. 86 [70-106] minutes for male surgeons, p<0.001). The rate of any perioperative complication was 4.4% for female surgeons vs. 6.6% for male surgeons (p = 0.32). Thirty-day mortality was low in both groups (0.4% vs. 0.7%, p = 0.67).
Conclusions: Surgeon sex was not associated with significant differences in perioperative complications or mortality following CEA. Female surgeons had significantly longer operative times, without negatively impacting patient outcomes. These findings support sex equity in vascular surgery
Oncological outcomes with and without axillary lymph node dissection in patients with residual micrometastases after neoadjuvant chemotherapy (OPBC-07/microNAC): an international, retrospective cohort study
No full textBackground
Despite the paucity of outcome data, axillary lymph node dissection (ALND) is increasingly being omitted in patients with positive sentinel lymph nodes after neoadjuvant chemotherapy, particularly in those with low-volume residual disease. We investigated oncological outcomes in patients with breast cancer and residual micrometastases in the sentinel lymph nodes treated with or without ALND.
Methods
OPBC-07/microNAC was a retrospective cohort study, using data obtained from the institutional databases of 84 cancer centres in 30 countries. Patients aged 18 years or older with clinical T1–4, N0–3 breast cancer at diagnosis treated with neoadjuvant chemotherapy followed by surgery between Jan 1, 2013, and May 31, 2023, who were found to have residual micrometastases (metastasis measuring >0·2 mm or >200 cells, not exceeding 2·0 mm in size) on frozen section or on final paraffin sections as determined by sentinel lymph node biopsy, targeted axillary dissection (sentinel lymph node biopsy with single or dual-tracer mapping plus image-guided localisation of the initially biopsy-proven and clipped node), or the marking axillary lymph nodes with radioactive iodine seeds (MARI) procedure were eligible for inclusion. The primary endpoint was the 5-year rate of any axillary recurrence (isolated or combined with local or distant recurrence) stratified by type of axillary surgery. Given the median follow-up, here we report 3-year rates and exploratory 5-year estimates. This study was registered with ClinicalTrials.gov, NCT06529302.
Findings
1585 female patients with ypN1mi disease were analysed, of whom 804 (50·7%) underwent ALND and 781 (49·3%) did not. Of 1585 women, 238 (15·0%) self-identified as Asian, 65 (4·1%) as Black, 200 (12·6%) as Hispanic, 968 (61·1%) as White, and 114 (7·2%) as unknown race and ethnicity. 925 (58·4%) of 1585 women had cT2 tumours, 1054 (66·5%) were node positive, and 1267 (79·9%) received nodal radiotherapy. The median follow-up was 3·1 years (IQR 1·8–5·2). The 3-year rate of any axillary recurrence (isolated or combined with local or distant recurrence) for the entire cohort was 2·0% (95% CI 1·3–2·9), with no statistical difference identified by extent of axillary surgery. However, patients with triple-negative disease who did not receive ALND had significantly higher rates of any axillary recurrence than women treated with ALND (8·7% [95% CI 4·4–15·0] vs 2·4% [95% CI 0·7–6·5], p=0·018). On multivariable analysis, triple-negative breast cancer (hazard ratio 3·83 [95% CI 1·72–8·52]) and omission of nodal radiotherapy (2·62 [1·19–5·73]) but not omission of ALND (0·86 [0·37–2·00]) were independently associated with an increased risk of any axillary recurrence.
Interpretation
Overall, these results do not support ALND for all patients with ypN1mi on sentinel lymph node biopsy treated with nodal radiotherapy; however, tumour biology should be taken into account when considering ALND omission