bluuebunny/crossref_metadata_2025_split huggingface dataset:
Solid organ transplantation originating from uncontrolled donation after circulatory death in Europe: a narrative review
Authors: Pionnier Yann , Darius Tom , Penaloza Andrea , Steenebruggen Francoise , Dupriez Florence , Neyrinck Arne , Genbrugge Cornelia 
Published: December 2024

AbstractHuman organ transplantation has begun in the 1960s with donation after circulatory death. At that time this was named non heart beating donation, later donation after cardiac death and nowadays it is named donation after circulatory death. Currently, we are facing a significant shortage of transplant organs in Europe and worldwide. To increase the graft acceptance from donation after controlled or uncontrolled circulatory death, preceding regional normothermic perfusion by an extracorporeal circulation before organ procurement or ex-situ machine perfusion are frequently implemented in clinical practice as organ assessment and reconditioning techniques. Due to these advancements more organs can be potentially transplanted, even after out-of-hospital cardiac arrest (OHCA). First line actors like emergency physicians and pre-hospital paramedics must be aware of such programs to recognize and refer patients for donation in OHCA situations. This review provides an overview of organs transplanted from uncontrolled donation after circulatory death (uDCD) and emphasize the role of the emergency physician in the organ donation cascade. Outcome of uDCD has a lower effectiveness than donation after brain death (DBD) and controlled donation after circulatory death (cDCD) for short term graft survival. However, observational studies illustrate that long term outcome from uDCD is comparable to graft outcome from cDCD and DBD. We summarize the studies reporting the procured organ rate and functional outcome of organs originated from uDCD. European databases indicate a high incidence of OHCA, where resuscitation efforts are initiated but the rate of return of spontaneous circulation (ROSC) remains limited. These patients represent a substantial potential pool of organ donors for uDCD programs. However, these programs tend to overestimate the number of potential donors. While organ procurement from uDCD has yielded favorable outcomes, further research is required to accurately assess the associated costs and benefits and to establish clear donor selection guidelines. Furthermore, the use of new technologies like extracorporeal Cardiopulmonary Resuscitation (E-CPR) for organ donation should be investigated from both medical and economical perspectives. Emergency departments must also explore the feasibility of implementing these programs.
Adherence to national trauma triage criteria in Norway: a cross-sectional study
Authors: Hoås Einar Frigstad , Majeed Waleed Mohammed , Røise Olav , Uleberg Oddvar 
Published: December 2024

Abstract
Background
Norwegian hospitals employed individual trauma triage criteria until 2015 when nationwide criteria were implemented. There is a lack of empirical evidence regarding adherence to Norwegian national criteria for activation of the trauma team (NTrC) and the decision-making processes regarding trauma team activation (TTA) within Norwegian trauma hospitals. The objectives of this study were to investigate institutional adherence to the NTrC and to investigate similarities and differences in the decision-making process leading to TTA in Norwegian trauma hospitals.

Methods
A digital semi-structured questionnaire regarding adherence to criteria, TTA decision-making and criteria documentation was distributed to all Norwegian trauma hospitals (n = 38) in the spring of 2022. Contact details of trauma coordinators and registrars were provided by the Norwegian Trauma Registry secretariat. Follow-up telephone interviews were conducted at the investigator’s discretion in cases of non-respondents or need to clarify answers.

Results
Thirty-eight trauma hospitals were invited to answer the survey, where 35 hospitals responded (92%), making 35 the denominator of the results. Thirty-four (97.1%) hospitals stated that they followed NTrC. Thirty-three (94.3%) of the responding hospitals provided documentation of their criteria in use, of which twenty-eight (80%) of responding hospitals adhered to the NTrC. Three (8.6%) hospitals employed a tiered TTA approach with different sized teams. In addition four hospitals (11.4%) used specialized teams to meet the needs of defined patient groups (e.g. geriatric patients, traumatic brain injury). Twenty-one (60%) of the responding hospitals had written guidelines on who could perform TTA and in 18 hospitals (51.4%) TTA could be performed by pre-hospital personnel. Twenty-three (65.7%) of the hospitals documented which criteria that were used for TTA.

Conclusion
There is good adherence to the national criteria for activation of the trauma team among Norwegian trauma hospitals after implementation of national guidelines. Individual hospitals argue the use of certain local criteria and trauma team activation decision-making processes to increase their precision in specific patient populations and demographics. Further steps should be done to reduce the variation in TTA decision-making processes among hospitals and improve documentation quality.
Process evaluation of an individually tailored complex intervention to improve activities and participation of older nursing home residents with joint contractures (JointConEval): a mixed-methods study
Authors: Thalhammer Regina , Nguyen Natalie , Meyer Gabriele , Skudlik Stefanie , Müller Martin , Beutner Katrin 
Published: December 2024

Abstract
Background
Older people with joint contractures in nursing homes often experience severe restrictions in their activities and participation. The effectiveness of an individually tailored complex intervention to improve residents’ activities and participation by incorporating the biopsychosocial perspective into nursing care using a structured facilitator approach could not be established in the JointConEval cluster-randomised controlled trial. This process evaluation aimed to systematically identify factors influencing implementation and effectiveness.

Methods
The mixed-methods process evaluation analysed recruitment, implementation, mechanisms of impact, and context. Qualitative data was generated in semi-structured focus groups and in individual interviews with facilitators, nursing and social care staff, residents, relatives and guardians. Quantitative data was recorded with facilitators and 20% of nursing and social care staff using standardised documentation forms and questionnaires. Qualitative data was analysed using qualitative thematic content analysis, while the quantitative data was analysed descriptively. An interpretation was performed by combining and comparing the qualitative and quantitative results after the separate analyses.

Results
The implementation was realised as planned, but the intervention did not always reach the nursing home staff, which hindered the planned change in attitude and behaviour. The attitude of the facilitators was mainly in line with the intervention. However, the intervention reached only half the residents. We identified various key influencing factors related to the context, setting and implementation agents. Nursing homes lacking facilitator support from staff or management or experiencing staff shortages and facing organisational weaknesses had difficulties in achieving the desired behavioural changes and positive primary outcomes.

Conclusions
The complex intervention was delivered as planned with several factors affecting the implementation. A key influencing factor was the organisational structure and leadership of the nursing homes, which had an impact on the behaviour and motivation of the implementation agents. The findings highlight challenges in achieving behavioural changes among nursing staff in the context of long-term care in Germany. We recommend a systematic organisational context analysis for similar complex interventions in long-term care, involving stakeholders and improving leadership participation for more effective implementation.

Trial registration
DRKS (German Clinical Trials Register), number DRKS00015185. Registered on 1 August 2018, https://drks.de/search/en/trial/DRKS00015185. Universal Trial Number U1111-1218–1555.
The efficacy and safety of stepwise oral food challenge in children with hen’s egg allergy
Authors: Ogata Mika , Kido Jun , Yoshida Takanobu , Nishi Natsuko , Shimomura Sachiko , Hirai Nami , Mizukami Tomoyuki , Yanai Masaaki , Nakamura Kimitoshi 
Published: December 2024

Abstract
Background
Oral food challenge (OFC) is the gold standard for diagnosing food allergies (FAs) but carries the risk of anaphylactic reaction. Stepwise OFC, starting with a low dose of allergen and progressing to medium and full doses, is effective in determining a tolerable dose. We retrospectively evaluated the results of a stepwise OFC for hen’s egg (HE) to demonstrate its safety and efficacy. We discuss whether early low-dose administration of HE induces early immune tolerance in HE allergy.

Methods
We included 2,058 children (median, 2.6 years) who underwent HE-OFC between 2017 and 2021 at two institutes in Japan. The target challenge dose of OFC was classified as low (less than 1/8 of a cooked egg), medium (1/8 or more but less than 1/2), or full (1/2 or more). If the low-dose OFC was negative, subjects were allowed to consume the same dose of HE and underwent medium-dose OFC within 12 months. Even if positive, individuals were recommended to consume previously-tolerated amounts of HE and repeat OFC at the same dose within 12 months. We evaluated the correlation between their OFC results and response.

Results
A total of 526 (25.6%) children presented positive reactions. There were no cases of anaphylactic shock. Higher serum egg white (EW)- (P < 0.001) and ovomucoid (OVM)- specific IgE (P < 0.001) (sIgE) levels were associated with positive OFC. The low-dose OFC group had more positive reactions (P < 0.001), younger children (P < 0.001), higher EW-sIgE (P < 0.001) and OVM-sIgE (P < 0.001), and more histories of anaphylaxis (P = 0.014). OFC-positive children were younger than OFC-negative children, particularly in low-dose OFC (P = 0.010). OFC results between complete and partial elimination of HE groups across all EW- or OVM-sIgE classes were similar (P > 0.05).

Conclusions
Stepwise OFC is safe and effective in diagnosing HE allergy and facilitates the earlier introduction of HE in children. This study suggests the limited potential of early consumption of lower doses of HE to induce earlier immune tolerance, such that other strategies to induce earlier tolerance in infants with HE allergy should be considered.
Radiation-induced exosomal miR-21 enhances tumor proliferation and invasiveness in breast cancer: implications for poor prognosis in radiotherapy patients
Authors: Kim Kyungmin , Jung Kyung Oh , Oh Sera , Kim Young-Hwa , Lee Seok-Yong , Hong Seongje , Cho Su Han , Kim Hyejin , Rhee Siyeon , Cheon Gi Jeong , Kang Keon Wook , Chung June-Key , Youn Hyewon 
Published: December 2024

AbstractRadiotherapy is widely used as an effective non-surgical strategy to control malignant tumors. However, recurrence is one of common causes of treatment failure even after the effective radiotherapy. In this study, we focused on the effects of radiation-induced exosomal miR-21 on the tumor microenvironment to investigate the causes of recurrence. Analysis of the TCGA database revealed that breast cancer patients with high levels of miR-21 have significantly reduced overall survival when treated with radiotherapy compared to those who did not receive radiotherapy, indicating a high hazard ratio for miR-21 in patients undergoing this treatment. Additionally, exosomal miR-21 is found to be highly expressed in the serum of breast adenocarcinoma patients. To explore how miR-21 induces poor prognosis in irradiated breast cancer, we irradiated 4T1 cell line with low or high doses of radiation, and examined the impact of secreted exosomal miR-21 on breast cancer cell and tumor microenvironment. After 10 Gy irradiation, 4T1 cells secreted 2.20 ± 0.10 times more exosomes and exhibited a 1.85 ± 0.01-fold increase in exosomal miR-21 levels. Treatment with exosomes from 10 Gy-irradiated cancer cells led to enhanced tumor cell proliferation, wound healing, and migration. The survival rate of 10 Gy-irradiated tumor cells incubated with 10 Gy-derived exosomes increased by 2.83-fold. Moreover, the growth of subcutaneous tumors treated with 10 Gy exosomes (n = 13) was significantly faster compared to tumors treated with 0 Gy exosomes (n = 10, P < 0.05). In summary, our study revealed high-dose irradiation-induced exosomes were found to enhance tumor proliferation and invasiveness via the transfer of exosomal miR-21. Based on these findings, we suggest that radiation-induced exosomal miR-21 may contribute to a poorer prognosis of breast cancer patients undergoing radiotherapy.
Functional limitations and firearm purchases among low-income U.S. military veterans
Authors: Testa Alexander , Tsai Jack 
Published: December 2024

Abstract
Objectives
Functional limitations may be associated with firearm ownership among veterans by amplifying perceptions of vulnerability and the need for security, yet their role remains underexplored despite emerging research on health-related factors influencing firearm acquisition in this group. This study examines the relationship between the number of functional limitations and recent firearm purchasing among a sample of low-income US military veterans.

Methods
Data are from the National Veteran Homeless and Other Poverty Experiences (NV-HOPE) study, which surveyed US veterans in households under 300% of the US federal poverty level. The survey was conducted in December 2022 and January 2023 (n = 1,008). Functional limitations were assessed based on self-reported assistance needed in daily tasks. Multiple logistic regression was used to analyze the association between functional limitations and firearm purchases in the past year, adjusting for demographic and socioeconomic factors. Analyses were conducted in Stata v. 18, and statistical significance was determined at the p < 0.05 threshold.

Results
5.5% of respondents reported purchasing a firearm in the past year. Increased functional limitations were positively associated with recent firearm purchases (Adjusted Odds Ratio [aOR] = 1.14, 95% Confidence Interval [CI] = 1.03, 1.26). Sensitivity using Firth Logit for rare events confirmed the robustness of this finding.

Discussion
Veterans experiencing a greater number of functional limitations are more likely to report recently purchasing a firearm. These findings underscore the importance of addressing health needs among firearm-owning veterans through VA programs that support disabled veterans and their caregivers.
Deciphering the role of exosomal derived regulatory noncoding RNAs as potential biomarkers for diabetic retinopathy: a systematic review
Authors: Nandalal Santosh , Venkatesan Harshitha , Haridoss Madhumitha , Ramachandran Krithika , Lenin Raji Rajesh 
Published: December 2024

AbstractAbout one-third of individuals with diabetes develop diabetic retinopathy (DR), with one-tenth experiencing vision-threatening conditions such as diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR). Current treatments only show recovery in 50% of cases, and the disease often remains asymptomatic. Therefore, novel early detection methods and new biomarkers are crucial. Our study aims to summarise evidence on the role of altered exosomal regulatory noncoding RNAs in DR, based on human studies. Observational studies delineating the different exosomal noncoding RNAs in DR were searched systematically from inception to June 2024 in PubMed-MEDLINE and SCOPUS databases. Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) 2020 guidelines was used to conduct this systematic review (Prospero ID: CRD42023406724). We synthesised data from 13 human studies that assessed the expression of exosomal regulatory ncRNAs from individuals with DR. Among the 13 studies, nine focused on miRNA, while three examined lncRNA and one on circRNA. Although no common genes were identified across the studies, the review underscores the critical roles of exosomal noncoding RNAs in the pathogenesis of diabetic retinopathy, highlighting their potential as therapeutic targets. Future studies should aim for a unified approach in terms of sample selection, RNA analysis, and appropriate controls for a comprehension of exosomal expression patterns for early diagnosis of DR.
GATA1 activates HSD17B6 to improve efficiency of cisplatin in lung adenocarcinoma via DNA damage
Authors: Shao Xingxing , Hou Hailang , Chen Huijie , Xia Wan , Geng Xinpu , Wang Jindao 
Published: December 2024

Abstract
Background
Lung adenocarcinoma (LUAD) is the most common histological type of non-small cell lung cancer (NSCLC). Platinum-based chemotherapy, such as cisplatin chemotherapy, is the cornerstone of treatment for LUAD patients. Nevertheless, cisplatin resistance remains the key obstacle to LUAD treatment, for its mechanism has not been fully elucidated.

Methods
HSD17B6 mRNA expression data were accessed from TCGA-LUAD database and differential expression analysis was performed. Enrichment analysis of HSD17B6 was conducted by GSEA, and its upstream transcription factors were predicted by hTFtarget. mRNA and protein expression levels of HSD17B6 and GATA1 were assayed by qRT-PCR and WB, and the binding relationship between them was verified by chromatin immunoprecipitation assay and dual luciferase reporter assay. Cell viability and IC50 value of cisplatin-treated cells were measured by cell counting kit-8 assay. Cell cycle was assayed by flow cytometry. DNA damage level and DNA damage marker γ-H2AX expression were assayed by comet assay and western blot, respectively.

Results
HSD17B6 was lowly expressed in LUAD tissues and cells and mainly enriched in homologous recombination and mismatch repair pathways. As cell function experiments revealed, overexpression of HSD17B suppressed malignant phenotypes and cisplatin resistance in LUAD cells through DNA damage. Bioinformatics analysis revealed that GATA1 is the upstream regulator of HSD17B6, which was markedly reduced in LUAD tissues and cells. ChIP and dual luciferase reporter assays ascertained the binding of GATA1 to HSD17B6. Knockdown of GATA1 attenuated the effect of overexpression of HSD17B6 on LUAD cell behaviors and cisplatin resistance.

Conclusion
Transcription factor GATA1 could activate HSD17B6 to inhibit cisplatin resistance in LUAD through DNA damage, suggesting that GATA1/HSD17B6 axis may be a potential therapeutic target for chemotherapy resistance in LUAD patients.
Hck promotes IL-1β-induced extracellular matrix degradation, inflammation, and apoptosis in osteoarthritis via activation of the JAK-STAT3 signaling pathway
Authors: Yan Zhenzhong , Ji Lin 
Published: December 2024

AbstractWe investigated role of haematopoietic cell kinase (Hck) in osteoarthritis (OA) and to explore the underlying mechanisms driving its effects. An OA animal model was established and after OA induction, rats received intra-articular injections of lentivirus twice a week for four weeks. Rats were divided into four groups: control (healthy rats without OA), OA model (rats with induced OA), OA + Len-si-NC (OA rats treated with a non-targeting control lentivirus), and OA + Len-si-Hck (OA rats treated with lentivirus targeting Hck). Blood samples were collected, and serum cytokine levels were measured using ELISA. Afterward, the rats were sacrificed for histological analysis and TUNEL assay. In vitro, IL-1β-treated human chondrocytes were transfected with Hck, and the effects on cell viability, apoptosis, ECM degradation, and JAK-STAT3 signaling were assessed. Colivelin, a JAK-STAT3 agonist, was used to confirm the pathway’s involvement. Results indicated increased Hck expression in the cartilage tissues of OA rats and in IL-1β-stimulated chondrocytes. Silencing Hck in vivo reduced IL-6 and TNF-α levels, apoptosis, and preserved cartilage structure. In vitro, Hck knockdown in IL-1β-treated chondrocytes resulted in enhanced cell viability, reduced apoptosis, and decreased ECM degradation. Notably, the expression of MMP3 and MMP13 was significantly lowered, while collagen II and aggrecan levels were restored. Additionally, Hck knockdown inhibited JAK-STAT3 activation, which was evident from reduced levels of phosphorylated JAK1 and STAT3. The addition of colivelin reversed these effects, confirming that Hck mediates its effects through the JAK-STAT3 pathway. Overall, our findings indicate that Hck is critical in OA progression by promoting inflammation, apoptosis, and ECM degradation through the JAK-STAT3 signaling pathway activation.
Investigating the causal relationship between immune factors and ankylosing spondylitis: insights from a Mendelian Randomization study
Authors: Geng Ziming , Tong Yang , Chen Yang , Wang Jian , Liu Ziwen , Miao Jun , Li Ruihua 
Published: December 2024

Abstract
Background
Despite previous studies indicating a close relationship between immune system and ankylosing spondylitis (AS), the causal relationship between them remains unclear.

Methods
Genome-wide association data were utilized to explore the causal link between 731 immune cells and AS using a bidirectional two-sample MR approach. The data included immune cell data from Orrù et al.’s study and AS data from the FinnGen consortium. Cochran’s Q test and leave-one-out checked instrument variable (IV) heterogeneity. IVW was the primary method for causal analysis, with MR-Egger and MR-PRESSO addressing horizontal pleiotropy. FDR correction was applied to both analysis directions to rectify multiple testing errors.

Results
In our study, 22 immune phenotypes out of 731 were casually linked to AS. After excluding 5 less robust features, 17 immune factors remained, with 4 being protective and the rest posing risks. Through FDR correction, we found a significant causal relationship between HLA DR on CD14- CD16+ monocyte and AS (OR (95%CI) = 0.70(0.60 ~ 0.83), P = 2.06*10−5). In the reverse analysis with AS as exposure, potential effects on 34 immune features were discovered. After correction, we confirmed significant causal relationships between AS and two immune features, namely CD20- B cell %lymphocyte (OR (95%CI) = 1.16(1.08–1.25), P = 1.91*10−5) and CD20- B cell %B cell (OR (95%CI) = 1.17(1.09–1.26), P = 1.50*10−5).

Conclusions
Our study identified various features associated with AS in different types of immune cells. These findings provide important clues and a theoretical basis for further understanding the pathogenesis of AS, guiding clinical treatment, and drug design.