Reirradiation for diffuse intrinsic pontine glioma: prognostic radiomic factors at progression.

PURPOSE: Diffuse intrinsic pontine glioma (DIPG) is a lethal pediatric brain tumor. Radiation therapy (RT) is the standard treatment, with reirradiation considered in case of progression. However, the prognostic factors for reirradiation are not well understood. This study aims to investigate the outcomes of DIPG patients undergoing reirradiation and identify clinical and radiomic prognostic factors. METHODS: We conducted a retrospective analysis of patients with DIPG who underwent reirradiation at our institution between January 2016 and December 2023. Using PyRadiomics, we extracted radiomic features of tumors at the time of progression from FLAIR MRI images and collected clinical data. We used the least absolute shrinkage and selection operator (lasso) for Cox's proportional hazard model with leave-one-out cross-validation to select optimal prognostic factors for survival after reirradiation. RESULTS: The study included 18 patients who underwent reirradiation at first progression, receiving a total dose of 20 Gy or 24 Gy in 2­Gy fractions. Reirradiation was well tolerated, with no severe toxicity. Most patients (78%) showed neurological improvement after treatment. Median survival after progression was 29.2 weeks. The Cox model demonstrated a concordance of 0.81 (95% CI: 0.75-0.88), revealing that tumor sphericity and structural gray-level heterogeneity in FLAIR MRI images were associated with longer survival of reirradiated patients. CONCLUSION: Reirradiation is a safe and effective approach for patients with DIPG. MRI-based radiomic models could be helpful in predicting survival after reirradiation.

Revisiting the role of radiotherapy in the treatment of neuroblastoma 4S: 30 years of institutional experience and systematic review.

Background and purpose: Neuroblastoma 4S is a rare subtype of metastatic neuroblastoma found in children younger than 12 months, characterized by liver, skin, or bone marrow metastases. While the prognosis for patients is generally favorable, rapid progression of liver metastases can lead to life-threatening organ insufficiency. In such cases, immediate treatment with chemotherapy or radiotherapy is necessary. Given the recent decline in radiotherapy utilization, this study aims to reassess its role, evaluating its effectiveness and toxicity. Materials and methods: We conducted a systematic review and an institutional retrospective analysis to assess the use of radiotherapy for hepatomegaly in patients with neuroblastoma 4S. The study included data from 164 patients from the literature and 16 patients from our institutional cohort. We extracted and analyzed data on short- and long-term outcomes, as well as reports of radiotherapy-induced toxicity. Results: Our institutional data showed that 81 % of patients responded to low-dose radiotherapy administered at a median dose of 450 cGy in three fractions, resulting in liver shrinkage and symptom resolution. Based on the systematic review, 1-year survival rate was 80 %, while 5-year survival rate was 75 %. No serious toxicity was observed with the current low-dose radiotherapy; however, one case of induced secondary malignancy was reported. Conclusion: Radiation therapy is an effective treatment modality for hepatomegaly in patients with neuroblastoma 4S, with a success rate of about 80 %. Despite being administered to infants, a low dose of 450-600 cGy does not result in toxicity related to the kidneys, liver, or posture defects.

The rise of negative portrayals of radiation oncology: A textual analysis of media news.

BACKGROUND AND PURPOSE: There has been growing concern about the media's negative portrayal of radiation oncology in recent years. Our study shows changes in media sentiment toward radiotherapy over the years, identifies prevalent themes, and analyzes their shifts over time. MATERIALS AND METHODS: We analyzed articles about radiation oncology published in The New York Times since the journal's inception in 1851. Initially, we collected 30 427 articles containing the keywords "radiation" or "radiotherapy" up to July 2023. In the next step, we selected 342 articles on radiation oncology using keyword searches, prompting the Chat GPT language model and manual assessment. Ultimately, we created a codebook summarizing the media topics related to radiotherapy and categorized the articles into these categories. RESULTS: Our analysis identified ten distinct categories representing media themes related to radiation oncology: five negative, three positive, and two neutral. Our findings indicate a rising negative sentiment toward radiotherapy. In the 21st century, over 50% of articles negatively described radiation oncology. The media coverage has shifted its focus away from describing scientific breakthroughs and the implementation of new techniques and toward treatment errors, toxicity, and ineffectiveness. CONCLUSION: The increasing negative media sentiment surrounding radiation oncology may influence public perceptions and impact patients' decisions. Radiation oncologists should remain vigilant about this situation, ensuring the dissemination of accurate information and addressing negative portrayals.

Challenges in Job Seeking and the Integration of Ukrainian War Refugee Healthcare Workers Into the Polish Healthcare System: Facebook Content Analysis.

Objectives: The full-scale Russian invasion of Ukraine resulted in a refugee crisis. The terms of employment of Ukrainian Refugee background Medical Professionals (UKR-MPs) in the Polish healthcare system were liberalised. The aim of the study was to identify challenges in job seeking and the integration of Ukrainian war refugee healthcare workers into the Polish healthcare system. Methods: A qualitative, descriptive study based on content thematic analysis of Facebook content. We analyzed 1,700 posts published on two public Facebook groups intended for UKR-MPs. Results: The most common problems encountered by UKR-MPs were: 1) lack of easy-to-understand information about the list of documents necessary to apply for a work permit, 2) lack of feedback from those responsible for handling individual cases, and 3) long waiting time for the decision issued by the Ministry of Health. Conclusion: Despite the promptly implemented solutions enabling access to the job market by UKR-MPs, the refugees have encountered considerable administrative difficulties, as well as those arising from insufficient knowledge of the regulations on working as medical professionals in Poland under the EU law.

Social media literacy among nursing students during the COVID-19 pandemic - does year of study matter? A nationwide cross-sectional study.

INTRODUCTION AND OBJECTIVE: Research to date indicates that student competencies in various dimensions of social media use vary depending on, for example, the field of study or stage of education. The aim of the study was assessment of social media literacy in a group of undergraduate nursing students, based on the year of study. MATERIAL AND METHODS: Respondents: 679 nursing students from 11 Polish medical universities who began or continued their education during the COVID-19 pandemic. First-year students (N = 397, 58.73%) and women (N = 589, 87.13%) constituted the largest group. The Perceived Social Media Literacy Scale was used. Statistical analysis used the Kruskal-Wallis one-way analysis-of-variance-by-ranks to analyse differences in PSML scores, and Dunn's test to analyse differences in PSML scores between individual years of study (α= 0.05). RESULTS: The level of social media literacy between students differed significantly (p < 0.001). Students rated their technical competency the highest (H = 29.722, p < 0.001), social relationships (H = 20.946, p < 0.001) and informational awareness (H = 21.054, p < 0.001) the lowest. The lowest scores in the self-assessment of social media literacy were noted among first-year students (M = 55.85, Max = 70.0; p < 0.001), and the highest among second-year students (M = 60.99, Max = 70.0; p < 0.001). CONCLUSIONS: Nursing students rated their competency lowest in the sphere related to verifying the content of messages appearing on social media, which may have a significant impact on their professional competencies. Differences in the level of social media literacy among students of different years of study should be taken into account when designing training in this field.

How Psychological Variables Maybe Correlated with Willingness to Get COVID-19 Vaccine: A Nationwide Cross-Sectional Study of Polish Novice Nurses.

INTRODUCTION: Nurses became the largest medical group exposed to direct contact with the SARS-CoV-2 virus. In this study, we aimed to assess the readiness and motivation for vaccination, as well as the use of sources of information and attitudes toward vaccination depending on the psychological profile. MATERIAL AND METHODS: A cross-sectional online survey study was conducted. The study included 145 novice nurses from 8 medical universities who completed 3-year undergraduate studies. Women constituted 97.2% of the respondents (N = 141). The Generalized Anxiety Disorder 7-Item Scale, General Self-Efficacy Scale, Brief Resilient Coping Scale, and an original questionnaire were used. Variables were analyzed with descriptive statistics methods. A p-value of <0.05 was considered statistically significant. RESULTS: Among the participants, 73.1% had already been vaccinated against COVID-19 (N = 106). The participants were divided into two groups: G1 (N = 98), characterized by a lower level of anxiety with higher self-efficacy and resilient coping, and G2 (N = 47), with a higher level of anxiety with poorer self-efficacy and resilient coping. The analysis of the potential correlation of psychological pattern with the decision to vaccinate was not statistically significant (p = 0.166). CONCLUSION: Psychological variables may be correlating with motivation, attitudes toward vaccination, and the choice of reliable sources of information about vaccination. Our study demonstrates the key role of two psychological variables, self-efficacy and resilient coping, in this context.

Attitudes toward COVID-19 Vaccination on Social Media: A Cross-Platform Analysis.

During the COVID-19 pandemic, social media content analysis allowed for tracking attitudes toward newly introduced vaccines. However, current evidence is limited to single social media platforms. Our objective was to compare arguments used by anti-vaxxers in the context of COVID-19 vaccines across Facebook, Twitter, Instagram, and TikTok. We obtained the data set of 53,671 comments regarding COVID-19 vaccination published between August 2021 and February 2022. After that, we established categories of anti-vaccine content, manually classified comments, and compared the frequency of occurrence of the categories between social media platforms. We found that anti-vaxxers on social media use 14 categories of arguments against COVID-19 vaccines. The frequency of these categories varies across different social media platforms. The anti-vaxxers' activity on Facebook and Twitter is similar, focusing mainly on distrust of government and allegations regarding vaccination safety and effectiveness. Anti-vaxxers on TikTok mainly focus on personal freedom, while Instagram users encouraging vaccination often face criticism suggesting that vaccination is a private matter that should not be shared. Due to the differences in vaccine sentiment among users of different social media platforms, future research and educational campaigns should consider these distinctions, focusing more on the platforms popular among adolescents (i.e., Instagram and TikTok).

Impact of Anxiety on Readiness for COVID-19 Vaccination among Polish Nursing Undergraduate Students: Nationwide Cross-Sectional Study.

The COVID-19 pandemic had a huge impact on the mental health of people around the world, and it increased the level of fear of infection and anxiety about the consequences of the disease caused by the SARS-CoV-2 virus. We examined the relationship between the level of anxiety among nursing students and their knowledge about COVID-19 vaccination. In addition, we explored the correlations among the level of anxiety, knowledge about vaccination, and the willingness to vaccinate against COVID-19. A total of 790 undergraduate nursing students participated in the study. The results demonstrated that the level of anxiety among the surveyed nursing students was low; 40% of the study participants did not report any anxiety at all, 30% reported mild anxiety, 20% reported moderate anxiety, and 9% reported severe anxiety. At the time of the study, 77.2% of the participants were already vaccinated against COVID-19. Student knowledge about vaccination against COVID-19 was high and anxiety levels were low, with no direct correlation between the knowledge of vaccination and the severity of anxiety.

Perceiving the Role of Communication Skills as a Bridge between the Perception of Spiritual Care and Acceptance of Evidence-Based Nursing Practice-Empirical Model.

Decision making using evidence-based practice (EBP) is generally universally accepted by nurses. Such acceptance may affect the personnel's behaviour towards patients, which is also demonstrated by taking into consideration the patient's preferences, including the patient's spiritual needs, in the care plan. The provision of such care requires the development of an attitude of approval and an adequate level of communicative competence, which will enable the actual implementation of the EBP. The purpose of our study was to assess the perception of spirituality and the nurse's role in providing spiritual care, as well as the perception of the significance of communication skills in the approval of EBP in professional practice. A multi-centre cross-section study was conducted on a population of 1176 participants (459 undergraduate (bachelor's programme, BP) and 717 postgraduate students (master's programme, MP)) from 10 medical universities in Poland. Three tools were used in the study to evaluate the participants' approach: Evidence-Based Practice Competence Questionnaire (EBP-COQ), The Spirituality and Spiritual Care Rating Scale (SSCRS), and Communication Skills Attitude Scale (CSAS). Structural equation modelling was used for the analysis. An analysis of structural equations revealed the presence of positive relationships of the attitude to spiritual care and the role of communicative competences with the approach to EBP regardless of the cohort. A significant difference was found related to the influence of age on the attitude towards learning communicative competences. The approval in this respect was observed to decrease with age in the MP group. Increasing approval of EBP requires strengthening the approach to activity-centred spiritual care, with the simultaneous development of a positive attitude towards learning communicative competences. The model reveals the need to integrate a humanistic approach with EBP, which can be achieved by planning different interventions in different groups of recipients: nurses, academic teachers and students.

Social Media Sharing of Articles About Measles in a European Context: Text Analysis Study.

BACKGROUND: Despite the existence of an effective vaccine, measles still threatens the health and lives of many Europeans. Notably, during the COVID-19 pandemic, measles vaccine uptake declined; as a result, after the pandemic, European countries will have to increase vaccination rates to restore the extent of vaccination coverage among the population. Because information obtained from social media are one of the main causes of vaccine hesitancy, knowledge of the nature of information pertaining to measles that is shared on social media may help create educational campaigns. OBJECTIVE: In this study, we aim to define the characteristics of European news about measles shared on social media platforms (ie, Facebook, Twitter, and Pinterest) from 2017 to 2019. METHODS: We downloaded and translated (into English) 10,305 articles on measles published in European Union countries. Using latent Dirichlet allocation, we identified main topics and estimated the sentiments expressed in these articles. Furthermore, we used linear regression to determine factors related to the number of times a given article was shared on social media. RESULTS: We found that, in most European social media posts, measles is only discussed in the context of local European events. Articles containing educational information and describing world outbreaks appeared less frequently. The most common emotions identified from the study's news data set were fear and trust. Yet, it was found that readers were more likely to share information on educational topics and the situation in Germany, Ukraine, Italy, and Samoa. A high amount of anger, joy, and sadness expressed within the text was also associated with a higher number of shares. CONCLUSIONS: We identified which features of news articles were related to increased social media shares. We found that social media users prefer sharing educational news to sharing informational news. Appropriate emotional content can also increase the willingness of social media users to share an article. Effective media content that promotes measles vaccinations should contain educational or scientific information, as well as specific emotions (such as anger, joy, or sadness). Articles with this type of content may offer the best chance of disseminating vital messages to a broad social media audience.

"Vaccinate, Do Not Hesitate!". Vaccination Readiness against COVID-19 among Polish Nursing Undergraduate Students: A National Cross-Sectional Survey.

COVID-19 vaccination raises numerous concerns among the public, and also among medical personnel including nurses. As nurses play a crucial role in the process of vaccination, it is important to recognize the attitudes of students of nursing, nurses in spe, toward COVID-19 vaccination, as well as to define the factors influencing students' pro-vaccine choices. The study was conducted between March and April 2021 at all medical universities in Poland educating nurses in spe. The study included 793 first-degree students from 12 universities. The results revealed that the vast majority of students of nursing (77.2%) were vaccinated against COVID-19, as 61.2% received an mRNA vaccine and 16% a viral vector vaccine. Every other person in the non-vaccinated group declared their intention to get a vaccination. A trend was observed whereby people co-living with persons from the risk group, who are at risk of a severe form of COVID-19, showed greater willingness to get a vaccine. The study results identified the role of universities in increasing the vaccination rate among students, both in terms of education about vaccinations and in shaping pro-vaccine attitudes among students, as well as organizing vaccinations on university campuses to facilitate the process.

Characteristics of Antivaccine Messages on Social Media: Systematic Review.

BACKGROUND: Supporters of the antivaccination movement can easily spread information that is not scientifically proven on social media. Therefore, learning more about their posts and activities is instrumental in effectively reacting and responding to the false information they publish, which is aimed at discouraging people from taking vaccines. OBJECTIVE: This study aims to gather, assess, and synthesize evidence related to the current state of knowledge about antivaccine social media users' web-based activities. METHODS: We systematically reviewed English-language papers from 3 databases (Scopus, Web of Science, and PubMed). A data extraction form was established, which included authors, year of publication, specific objectives, study design, comparison, and outcomes of significance. We performed an aggregative narrative synthesis of the included studies. RESULTS: The search strategy retrieved 731 records in total. After screening for duplicates and eligibility, 18 articles were included in the qualitative synthesis. Although most of the authors analyzed text messages, some of them studied images or videos. In addition, although most of the studies examined vaccines in general, 5 focused specifically on human papillomavirus vaccines, 2 on measles vaccines, and 1 on influenza vaccines. The synthesized studies dealt with the popularity of provaccination and antivaccination content, the style and manner in which messages about vaccines were formulated for the users, a range of topics concerning vaccines (harmful action, limited freedom of choice, and conspiracy theories), and the role and activity of bots in the dissemination of these messages in social media. CONCLUSIONS: Proponents of the antivaccine movement use a limited number of arguments in their messages; therefore, it is possible to prepare publications clarifying doubts and debunking the most common lies. Public health authorities should continuously monitor social media to quickly find new antivaccine arguments and then create information campaigns for both health professionals and other users.

What Arguments against COVID-19 Vaccines Run on Facebook in Poland: Content Analysis of Comments.

Social media allow anti-vaxxers to quickly spread misinformation and false statements. This situation may lead to an increase in vaccine hesitancy. We wanted to characterize what arguments against COVID-19 vaccines run on Facebook in Poland. We analyzed Facebook comments related to the five events of the introduction of COVID-19 vaccines-announcements of the efficacy of the Pfizer-BioNTech (09.11.2020), Moderna (16.11.2020), and AstraZeneca (23.11.2020) vaccines, registration of the Pfizer-BioNTech vaccine by the European Medicines Agency (21.12.2020), and the first vaccination in Poland (27.12.2020). We collected the comments from fanpages of the biggest Polish media and then established their main anti-vaccine themes. We found that the negative arguments about COVID-19 vaccines can be divided into 12 categories. Seven of them are universal and also apply to other vaccines but five are new and COVID-19' specific. The frequency of arguments from a given category varied over time. We also noticed that, while the comments were mostly negative, the reactions were positive. Created codebook of anti-vaccine COVID-19 arguments can be used to monitor the attitude of society towards COVID-19 vaccines. Real-time monitoring of social media is important because the popularity of certain arguments on Facebook changes rapidly over time.

Novel de novo mutation affecting two adjacent aminoacids in the EED gene in a patient with Weaver syndrome.

Overgrowth, macrocephaly, accelerated osseous maturation, variable intellectual disability, and characteristic facial features are the main symptoms of Weaver syndrome, a rare condition caused by mutations in EZH2 gene. Recently, in four patients with Weaver-like symptoms without mutations in EZH2 gene, pathogenic variants in EED were described. We present another patient clinically diagnosed with Weaver syndrome in whom WES revealed an EED de novo mutation affecting two neighboring aminoacids, NM_003797.3:c.917_919delinsCGG/p.(Arg306_Asn307delinsThrAsp) located in one allele (in cis). Our observation, together with previous reports suggests that EED gene testing is warranted in patients with the overgrowth syndrome features and suspicion of Weaver syndrome with normal results of EZH2 gene sequencing.