bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Probiotic Clostridium butyricum Therapy with Survival and Response to Immune Checkpoint Blockade in Patients with Lung Cancer
Authors: Tomita Yusuke , Ikeda Tokunori , Sakata Shinya , Saruwatari Koichi , Sato Ryo , Iyama Shinji , Jodai Takayuki , Akaike Kimitaka , Ishizuka Shiho , Saeki Sho , Sakagami Takuro 
Published: July 2020

Abstract
Gut dysbiosis caused by antibiotics impairs response to immune checkpoint blockade (ICB). Gut microbiota is becoming an attractive therapeutic target for cancer. The Clostridium butyricum MIYAIRI 588 strain is a probiotic therapy used to improve symptoms related to antibiotic-induced dysbiosis in Japan. We hypothesized that probiotic Clostridium butyricum therapy (CBT) may affect the therapeutic efficacy of ICBs. We retrospectively evaluated 118 patients with advanced non–small cell lung cancer treated with ICBs at Kumamoto University Hospital (Kumamoto-shi, Kumamoto, Japan). Survival analysis comparing patients given CBT before and/or after ICB was conducted using univariate analyses and Cox proportional hazards regression models using propensity score. Propensity score analyses confirmed that probiotic CBT significantly prolonged progression-free survival (PFS) and overall survival (OS). Probiotic CBT significantly associated with longer PFS and OS even in patients who received antibiotic therapy. This study suggests that probiotic CBT may have a positive impact on therapeutic efficacy of ICB in patients with cancer.
See articles by Hakozaki et al., p. 1243, and Peng et al., p. 1251
Tenascin-C Orchestrates an Immune-Suppressive Tumor Microenvironment in Oral Squamous Cell Carcinoma
Authors: Spenlé Caroline , Loustau Thomas , Murdamoothoo Devadarssen , Erne William , Beghelli-de la Forest Divonne Stephanie , Veber Romain , Petti Luciana , Bourdely Pierre , Mörgelin Matthias , Brauchle Eva-Maria , Cremel Gérard , Randrianarisoa Vony , Camara Abdouramane , Rekima Samah , Schaub Sebastian , Nouhen Kelly , Imhof Thomas , Hansen Uwe , Paul Nicodème , Carapito Raphael , Pythoud Nicolas , Hirschler Aurélie , Carapito Christine , Dumortier Hélène , Mueller Christopher G. , Koch Manuel , Schenke-Layland Katja , Kon Shigeyuki , Sudaka Anne , Anjuère Fabienne , Van Obberghen-Schilling Ellen , Orend Gertraud 
Published: July 2020

AbstractInherent immune suppression represents a major challenge in the treatment of human cancer. The extracellular matrix molecule tenascin-C promotes cancer by multiple mechanisms, yet the roles of tenascin-C in tumor immunity are incompletely understood. Using a 4NQO-induced oral squamous cell carcinoma (OSCC) model with abundant and absent tenascin-C, we demonstrated that tenascin-C enforced an immune-suppressive lymphoid stroma via CCL21/CCR7 signaling, leading to increased metastatic tumors. Through TLR4, tenascin-C increased expression of CCR7 in CD11c+ myeloid cells. By inducing CCL21 in lymphatic endothelial cells via integrin α9β1 and binding to CCL21, tenascin-C immobilized CD11c+ cells in the stroma. Inversion of the lymph node-to-tumor CCL21 gradient, recruitment of T regulatory cells, high expression of anti-inflammatory cytokines, and matrisomal components were hallmarks of the tenascin-C–instructed lymphoid stroma. Ablation of tenascin-C or CCR7 blockade inhibited the lymphoid immune-suppressive stromal properties, reducing tumor growth, progression, and metastasis. Thus, targeting CCR7 could be relevant in human head and neck tumors, as high tenascin-C expression and an immune-suppressive stroma correlate to poor patient survival.
Adverse Events Associated With Laser Use in the Upper Airway
Authors: Tong Jane Y. , Pasick Luke J. , Benito Daniel A. , Sataloff Robert T. 
Published: July 2020

ObjectiveSurgical lasers are used extensively in head and neck surgery. Laser use in the upper airway offers many advantages but also presents risks to patients and operators that are not reported comprehensively. This study aims to summarize device malfunctions, patient complications, and subsequent interventions related to laser use in the upper airway.MethodsThe US Food and Drug Administration’s Manufacturer and User Facility Device Experience database was queried for reports of surgical laser adverse events from January 2010 to March 2020. Data were extracted from reports pertaining to the upper airway.ResultsSixty‐two reports involving upper airway laser use in an operating room were identified, from which 95 events were extracted. Of these, 40 (42.1%) were adverse events to patients, 2 (2.1%) adverse events to operators, and 53 (55.8%) device malfunctions. Dislodgement of laser fiber in the airway (23 [57.5%]), burn (8 [20%]), and scar (5 [12.5%]) were the most common adverse events to patients. Two incidents of eye exposure through unfiltered microscope lenses were the only adverse events to operators. Fiber break (26 [49.1%]) and flare (12 [22.6%]) were the most common device malfunctions.DiscussionSurgical lasers have demonstrated utility in head and neck surgery but are associated with risks. This study discusses adverse events and device malfunctions associated with airway laser surgery and emphasizes shortcomings in current reporting.Implications for PracticeStandardized reporting and multi‐institutional research are needed to better understand adverse events related to surgical laser use and to allow accurate estimation of their prevalence.
Gender-Specific Correlates of Alcohol Use Among College Students in Kerala, India
Authors: Raveendranathan Dhanya , Jaisoorya T. S. , Nair B. Sivasankaran , Menon Priya G. , Rani Anjana , Thennarasu K. , Murthy Pratima 
Published: July 2020

Background: Studies of alcohol use among college students in India have reported a male preponderance, but a recent large study suggested that alcohol use is increasing in young females. This increase in use among the young females is of concern as they experience poorer outcomes and a higher risk for addiction. Hence, we aimed to examine the gender-specific correlates of alcohol use among college students in the district of Ernakulum, Kerala. Methods: From 58 colleges, 5,784 students completed a self-administered questionnaire that assessed use of alcohol, use of tobacco and illicit drugs, psychological distress, suicidality, symptoms of attention deficit hyperactivity disorder, and history of sexual abuse. Results: Of the questionnaires, 342 had incomplete responses and had to be discarded, and the rest (n = 5,442, 94.1%) were analyzed. lifetime alcohol use was reported by 39% males and 12.6% females. In the multivariable logistic regression analysis using a full model, male students using alcohol compared to male non-users were older, non-Muslim, had poor academic performance, and used other substances. Female users, compared to female non-users, were non-Muslim, had urban residence, used tobacco, and had higher psychological distress, higher suicidal thoughts, and higher lifetime exposure to sexual abuse. Conclusion: Gender-specific differences extend across sociodemographic and psychological domains. Incorporation of these may improve the effectiveness of public health strategies addressing alcohol use.
Factors Affecting the Psychological Well-being of Health Care Workers During an Epidemic: A Thematic Review
Authors: Philip Joel , Cherian Vinu 
Published: July 2020

Background: Health care workers (HCWs) constitute a vulnerable group in terms of physical, mental, and emotional health setbacks during an epidemic. An in-depth understanding of the effects of epidemics on HCWs is of utmost importance, in order to put in place measures for their well-being. The purpose of the review was to compile, compare, and contrast the available information so as to produce a lucid picture of how HCWs are impacted during an epidemic, and the factors that affect their mental health. Methods: A literature search of MEDLINE and Google Scholar databases was conducted to uncover research pertaining to four major epidemic outbreaks over the last two decades. The search was carried out at three levels using pertinent key words. The records thus identified were narrowed down at three further levels, that is, by screening of the title, abstract, and full text, to obtain articles most relevant to the subject matter. Data extraction was done using a spreadsheet to compile the relevant data. Data synthesis was done by studying those factors found to affect psychological well-being of HCWs and separating them into suitable sub-groups. Recommendations to mitigate the psychological impact were proposed. Results: Thirteen factors were identified, which were grouped under the broad categories of socio-demographic variables, individual characteristics, social characteristics, and psychological constructs. Conclusion: Epidemics have a profound impact on psychological well-being of HCWs. There is a pressing need to address the issue of the psychological health of this vulnerable group.
Pravastatin attenuates atherosclerosis after myocardial infarction by inhibiting inflammatory Ly6Chigh monocytosis in apolipoprotein E knockout mice
Authors: Chen Yufei , Zhang Hongqi , Hu Liang , Shi Haiming , Liu Xiaojin , Jia Jianguo , Sun Shengjia , Ou Yang , Luo Xinping , Zhou Guomin , Shen Wei 
Published: July 2020

Objective To evaluate the protective effect of pravastatin on atherosclerotic development and inflammatory monocyte subset in atherosclerotic apolipoprotein E (ApoE)−/− mice after myocardial infarction (MI). Methods Male ApoE−/− mice (8 weeks old) were fed a high-fat diet for 14 weeks throughout the experiment. A MI model was produced using 18-week-old ApoE−/− mice. They were randomly divided into three groups: sham group, MI group, and MI+Pra group (40 mg/kg/day pravastatin). After 4 weeks (at the end of the study period), the mice were sacrificed and cardiac function was evaluated by echocardiography. Aortic lesion areas were evaluated using oil red O staining. Plaque macrophage in aortic sinus was analyzed by immunofluorescence staining. Flow cytometry was used to explore the proportions of monocyte subsets in the blood, spleen, and bone marrow． Results Pravastatin improved cardiac function and reduced lesion areas. It also attenuated the supply of monocytes in spleen, especially the inflammatory Ly6Chigh monocyte subset. Pravastatin also subsequently reduced macrophage accumulation in atherosclerotic lesions. Conclusions MI accelerated chronic atherosclerosis progress. Pravastatin suppressed atherosclerotic development and inhibited inflammatory monocytosis after MI in ApoE−/− mice.
Impact of increased serum 8-hydroxy-2′-deoxyguanosine levels on extent of coronary artery lesions in elderly patients with type 2 diabetes
Authors: Zhao Yajie , Liang Wei , Tian Shuya , Shen Linhui , Yang Hui 
Published: July 2020

Objective Patients with type 2 diabetes (T2DM) are prone to cardiovascular disease, and both conditions are linked to oxidative DNA damage, which produces 8-hydroxy-2′-deoxyguanosine (8-OHdG). We investigated the impact of 8-OHdG on coronary heart disease (CHD) in elderly patients with T2DM. Methods We assessed the demographic, clinical, and biochemical characteristics of 147 patients with T2DM (mean age 73.29 ± 8.19 years) with or without CHD. Serum 8-OHdG was detected by enzyme-linked immunosorbent assay. CHD was diagnosed as ≥50% stenosis in at least one main branch of the coronary arteries determined by coronarography, evaluated by Gensini score. Results Serum 8-OHdG, number of stenotic branches, and Gensini score were all significantly increased in the CHD group. After adjustment for various factors, the number of stenotic branches and Gensini score remained positively correlated with 8-OHdG levels in the CHD group. Coronary artery lesions were significantly more severe in the CHD compared with the non-CHD group when 8-OHdG levels were >0.523 ng/mL. The number of stenotic branches and Gensini score were significantly independently associated with 8-OHdG levels in patients with T2DM. Conclusions 8-OHdG is a marker of oxidative DNA damage, and is highly associated with the extent of coronary artery lesions in ageing patients with T2DM. Trial registration: Registration number: 1.0/20170720; date of registration 26/07/2016 (retrospectively registered).
Giving nurses a voice during ethical conflict in the Intensive Care Unit
Authors: McAndrew Natalie S , Hardin Joshua B 
Published: July 2020

Background: Ethical conflict and subsequent nurse moral distress and burnout are common in the intensive care unit (ICU). There is a gap in our understanding of nurses’ perceptions of how organizational resources support them in addressing ethical conflict in the intensive care unit. Research question/objectives/methods: The aim of this qualitative, descriptive study was to explore how nurses experience ethical conflict and use organizational resources to support them as they address ethical conflict in their practice. Participants and research context: Responses to two open-ended questions were collected from critical care nurses working in five intensive care units at a large, academic medical center in the Midwestern region of the United States. Ethical considerations: This study was approved by the Institutional Review Board at the organization where the study took place. Findings: Three main interwoven themes emerged: nurses perceive (1) intensive care unit culture, practices, and organizational priorities contribute to patient suffering; (2) nurses are marginalized during ethical conflict in the intensive care unit; and (3) organizational resources have the potential to reduce nurse moral distress. Nurses identified ethics education, interprofessional dialogue, and greater involvement of nurses as important strategies to improve the management of ethical conflict. Discussion: Ethical conflict related to healthcare system challenges is intrinsic in the daily practice of critical care nurses. Nurses want to be engaged in discussions about their perspectives on ethical conflict and play an active role in addressing ethical conflict in their practice. Organizational resources that support nurses are vital to the resolution of ethical conflict. Conclusion: These findings can inform the development of interventions that aim to proactively and comprehensively address ethical conflict in the intensive care unit to reduce nurse moral distress and improve the delivery of patient and family care.
Pre‐hospital emergency response to terrorist attacks: A scoping review
Authors: Amiresmaili Mohammadreza , Talebian Ali , Miraki Sadegh 
Published: July 2020

Background:Terrorist incidents are on the rise in the world, and many countries have been involved so far. Unfortunately, many innocent people fall victim to such incidents every year. The pre‐hospital emergency, as one of the most important organs in the management and service of the victims, plays a vital role in these events.Objectives:This scoping review aimed to evaluate the performance and preparedness of the pre‐hospital emergency in the world for such Terrorist incidents.Methods:In order to access the documents and scientific evidence relevant to the purpose of our research, selected keywords were searched in PubMed, Scopus, and Web of Science databases. Finally, we collected the required information through a pre‐designed data extraction form that designed based on the purpose of this study.Results:The initial search, with the specified search strategies, resulted into 794 documents (263, 488, and 43 documents from PubMed, Scopus, and Web of Science databases, respectively). Finally, eight papers were selected through the full text of the selected articles, three of which were qualitative and three were quantitative, and two were mix‐methods (qualitative/quantitative). Our findings show that published papers have so far emphasized four main axes, namely, preparation, training and practice, effective communication, and the proper triage and transmission of these four axes.Conclusion:A few studies have been done in this area and more studies should be done in different areas and sectors, and given that terrorist incidents are on rise and the pre‐hospital emergency organization as one of the most important organizations is not well prepared to respond these events although it has a vital role to play, they need to be more prepared to effectively manage these incidents.
Specialist Palliative Care Activity at an Acute Care Tertiary Hospital and Its Representation in Administrative Data
Authors: Stubbs Joanne M. , Assareh Hassan , Achat Helen M. , Greenaway Sally , Muruganantham Poorani 
Published: July 2020

Objective: To quantify and examine specialist palliative care (SPC) in-hospital activity and compare it to routinely collected administrative data on palliative care (PC). Methods: All patients discharged from a large acute care tertiary hospital in New South Wales, Australia, between July 1 and December 31, 2017, were identified from the hospital’s data warehouse. Administrative data were supplemented with information from the electronic medical record for hospital stays which were assigned the PC additional diagnosis code (Z51.5); had a “palliative care” care type; or included SPC consultation. Results: Of 34 653 hospital stays, 524 were coded as receiving PC—based on care type (43%) and/or diagnosis code Z51.5 (100%). Specialist palliative care provided 1717 consultations over 507 hospital stays. Patients had 2 (median; interquartile range: 1-4) consultations during an average stay of 15.3 days (SD 15.78; median 10); the first occurred 7.0 days (SD 12.13; median 3) after admission. Of patient stays with an SPC consultation, 70% were assigned the PC Z51.5 code; 60% were referred for symptom management; 68% had cancer. One hundred forty-one patients were under a palliative specialist—either from initial hospital admission (49.6%) or later in their stay. Conclusions: Palliative care specialists provide expert input into patient management, benefitting patients and other clinicians. Administrative data inadequately capture their involvement in patient care, especially consultations, and are therefore inappropriate for reporting SPC activity. Exclusion of information related to SPC activity results in an incomplete and distorted representation of PC services and fails to acknowledge the valuable contribution made by SPC.
Long-term outcomes of intrathecal baclofen in ambulatory multiple sclerosis patients: A single-center experience
Authors: Abbatemarco Justin R , Griffin Austin , Jones Noble G , Hartman Jennifer , McKee Keith , Wang Zhini , Nagel Sean J , Machado Andre G , Bethoux Francois 
Published: July 2020

Background: Intrathecal baclofen (ITB) is traditionally reserved for non-ambulatory patients. Objective: To investigate outcomes of ITB in ambulatory multiple sclerosis (MS) patients. Methods: Changes in outcome measures were estimated by a mixed effect model, while the complication rate was calculated using a logistic regression. Predictors of non-ambulatory status were identified by Cox model. Results: In all, 256 patients received an ITB test injection and 170 underwent ITB surgery. Aggregate Modified Ashworth Scale (MAS) scores for the ambulatory ITB cohort decreased from 13.5 ± 6.96 to 4.54 ± 4.18 at 5 years ( p < 0.001). There was no significant change in walking speed 1 year post ITB surgery (0.45 m/second ± 0.30 vs 0.38 m/second ± 0.39, p = 0.80) with 77.8% of patients remaining ambulatory which decreased to 41.7% at year 5. Longer MS disease duration (hazard ratio (HR): 1.04; 95% confidence interval (CI): 1.01–1.07; p = 0.018) and lower hip flexor strength (HR: 0.40; 95% CI: 0.27–0.57; p < 0.001) predicted non-ambulatory status after surgery. Complications were more likely in the ambulatory cohort (odds ratio (OR): 3.30, 95% CI: 2.17–5.02; p = 0.017). Conclusion: ITB is effective for ambulatory MS patients without compromising short-term walking speed, although a higher complication rate was observed in this cohort.
Using phecode analysis to characterize co-occurring medical conditions in autism spectrum disorder
Authors: Failla Michelle D , Schwartz Kyle L , Chaganti Shikha , Cutting Laurie E , Landman Bennett A , Cascio Carissa J 
Published: July 2020

Individuals with autism spectrum disorder experience a significant number of co-occurring medical conditions, yet little is known about these conditions beyond prevalence. Using large-scale de-identified medical records, we can use a novel phecode-based tool to characterize co-occurring conditions in autism spectrum disorder. We hypothesized that individuals with autism spectrum disorder experience an increased burden of co-occurring conditions as measured by presence, frequency, and duration of visits related to co-occurring conditions. Secondarily, we hypothesized that age at first encounter for autism spectrum disorder (early, <5; late, >5) would be associated with different co-occurring conditions. The International Classification of Diseases, Ninth Revision, codes were extracted from a large anonymized electronic medical center database for 3097 individuals with autism spectrum disorder and 3097 matched controls. Co-occurring conditions were characterized using a novel tool (pyPheWAS) to examine presence, frequency, and duration of each condition. We identified several categories of co-occurring conditions in autism spectrum disorder: neurological (convulsions, sleep disorders); psychiatric (anxiety disorders, adjustment/conduct disorders), as well as constipation, hearing loss, and developmental delays. Our work confirms individuals with autism spectrum disorder are under a significant medical burden, with increased duration and frequency of visits associated with co-occurring conditions. Adequate management of these conditions could improve quality of life for individuals with autism spectrum disorder. Lay abstract People with autism spectrum disorder often have a number of other medical conditions in addition to autism. These can range from constipation to epilepsy. This study uses medical record data to understand how frequently and how long people with autism have to be seen by a medical professional for these other medical conditions. This study confirmed that people with autism often have a number of other medical conditions and that they have to go see a medical professional about those conditions often. We also looked to see if children diagnosed with autism after age 5 years might have different medical conditions compared to children diagnosed earlier. Children diagnosed later had more conditions like asthma, hearing loss, and mood disorders. This work describes how much medical care people with autism get for different medical conditions and the burden of seeking additional medical care for people with autism and their families.