bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute liver injury following methylprednisolone pulse therapy: 13 cases from a prospectively collected cohort
Authors: Allgeier Julian , Weber Sabine , Todorova Rumyana , Neumann Jens , Gerbes Alexander 
Published: December 2021

Background and aim
Drug-induced liver injury (DILI) remains a challenging diagnosis requiring exclusion of other causes of liver injury, concise medical history taking to identify potential causative medication and creation of a plausible temporal relation to attribute said liver injury to a potentially hepatotoxic agent. In spite of corticosteroids being considered an effective treatment for DILI in some patients, methylprednisolone (MPS) has been associated with liver injury of varying severity.

Methods
We analyzed data of our prospective study on potentially hepatotoxic drugs (NCT 02353455), identified 13 cases of MPS-associated liver injury and performed an analysis of clinical, laboratory and histopathological characteristics. For all available liver biopsy specimens, expert histopathological analysis was performed.

Results
Thirteen patients with a variety of primarily neurologic autoimmune diseases treated with MPS developed subsequent liver injury with a median latency of 5 weeks. Liver injury was severe or required transplantation in six patients. Injury typically occurred after repeated pulsing was hepatocellular and responded swiftly to prednisolone administration. For those patients who received in house-follow up, relapse after discontinuation of immunosuppression was not observed. Histopathological features of MPS-DILI comprised both interface and periportal hepatitis with mixed inflammatory infiltrates, similar to autoimmune hepatitis (AIH) features.

Discussion
MPS-related liver injury can be life-threatening, occurs with considerable latency and after repeat dosing. Regular surveillance of hepatic biochemistry should therefore be routinely performed also after discharge to avoid further MPS-related liver injury during repeat application. Swift response to prednisolone but not histologic features can be helpful to discriminate MPS-DILI from AIH.
“For Years I lived in a Cage. Now the Cage Is Open and I Am Just Learning to Fly.” Perspectives of Cancer Survivors on Psychological Resilience
Authors: Üzar-Özçetin Yeter Sinem , Kovanci Mustafa Sabri 
Published: December 2021

Background
Transitioning from treatment to survivorship engenders several challenges that cancer survivors must learn to manage. These challenges are commonly associated with struggling to manage reentry into postcancer life. Thus, balance is restored after cancer, and postcancer experiences should be considered along with all previous life experiences. This balancing process surrounding cancer causes some cancer survivors’ life to deteriorate, whereas other cancer survivors begin a psychological resilience process.

Objective
The aim of this study was to investigate the way that psychological resilience is experienced by cancer survivors.

Methods
The present descriptive qualitative design study was conducted from August 2019 through January 2020. A total of 12 cancer survivors were sampled from the follow-up clinics of a hospital. Data were collected through semistructured, pilot-tested, face-to-face interviews using an interview guide.

Results
Three main themes were clarified based on the descriptive analysis of the data on cancer survivors’ experiences: “fight vs lose,” “balancing uncertainties,” and “learned to fly.” The results demonstrate the importance and influence of psychological resilience in the overall cancer experience.

Conclusion
This study provides insight into the subjective psychological resilience process of cancer survivors. Nurses may use this knowledge in fostering effective strategies enabling cancer survivors to develop psychological resilience.

Implications for Practice
The results offer a promising resource for nurses to assess and address the risk and protective factors of cancer survivors to identify unique needs and to provide individualized care. In this context, nurses can develop novel approaches and interventions for cancer survivors in accordance with Kumpfer’s resilience framework.
Engaging Patients in Research That Involves Meditation
Authors: Lehto Rebecca H. , Sikorskii Alla , Marshall Katherine , Wyatt Gwen 
Published: December 2021

Background
Studies evaluating the use of meditative practices for supporting symptom management among patients undergoing cancer treatment have increased substantially in recent years. Although meditative practices as adjuncts to promoting health have become mainstream, concerns that such strategies conflict with traditional religious tenets have co-occurred. In the context of a 12-week sequential multiple assignment randomized trial of home-based meditative practices and reflexology delivered to patients with cancer by or with family caregivers to manage symptoms, early attrition was identified in the meditative practices arm.

Objective
Finding religious concerns were factors contributing to attrition; the purpose is to describe adjustments to the training protocol for study recruiters and interveners when enrolling participants and teaching patient-caregiver dyads meditative practices.

Methods
The training protocol for recruiters and interveners was adapted to address religious concerns related to meditative practices.

Results
Since initiation, recruiters and interveners have appreciated the adapted protocol, which has improved their capacity to respond to religious concerns. Participants have responded well to consideration of the practices as mindful movements coordinated with breath.

Conclusions
Given broader application of meditation in symptom management studies, researchers will need to be ready to address religious concerns. It is essential that protocols for introducing meditation are broadly presented to respond to concerns of patients and cancer caregivers regarding perceived conflicts with their specific religious beliefs.

Implications for Practice
As the provision of integrative care options that include meditation training for patients grows, nurses require awareness of potential barriers and strategies to ameliorate religious concerns.
Clostridium difficile Infection Does Not Impact Outcomes in Stroke Patients
Authors: Brown Robert J. , Raabe Michelle , McCullough Louise D. , Zhu Liang , Chokshi Reena V. 
Published: December 2021

Background:
Data are limited for Clostridium difficile infection (CDI) in stroke patients. This study investigates incidence, patient characteristics, clinical features, and outcomes of CDI following stroke, including ischemic stroke (IS), intracerebral hemorrhage (ICH), and aneurysmal subarachnoid hemorrhage (SAH).

Methods:
The hospital database was queried for all patients with IS, ICH, or SAH from 2010 through 2014. Patients who underwent testing for C. difficile testing (CDT) through polymerase chain reaction were assessed. Demographics, risk factors, clinical features, and outcomes were recorded. Fever was defined as temperature >101°F.

Results:
CDT was obtained in 555/4004 patients and was positive in 99, for CDI incidence of 2.5% [SAH 6.5% (26/402) vs. 2.9% in ICH (21/730) and 1.8% in IS (52/2872)]. There were no differences in demographics, severity [ICH score, National Institutes for Health Stroke Scale (NIHSS), Hunt Hess (HH), Glasgow coma scale (GCS)], mechanical ventilation, neurosurgical procedures, stress ulcer prophlyaxis or antibiotic use. Steroid use (P=0.0273) and male sex (P=0.0112) were associated with a positive CDT. On the day of diagnosis, 61% of CDT-positive patients had white blood cell <12, and 71% were afebrile. Length of stay, discharge disposition, mortality, and 3-month and 12-month modified Rankin, were not impacted by CDT results. Two patients with CDI required bowel resection.

Conclusion:
CDI incidence following stroke was low and most common with SAH. Male sex and steroid use were associated with a positive result. Leukocytosis and fever occurred in under half of infected patients. Outcome measures were not impacted by CDI.
High Level of HIV Drug Resistance and Virologic Nonsuppression Among Female Sex Workers in Ethiopia: A Nationwide Cross-Sectional Study
Authors: Arimide Dawit Assefa , Amogne Minilik Demissie , Kebede Yenew , Balcha Taye T. , Adugna Fekadu , Ramos Artur , DeVos Joshua , Zeh Clement , Agardh Anette , Chih-Wei Chang Joy , Björkman Per , Medstrand Patrik 
Published: December 2021

Objective:
To determine viral load (VL) nonsuppression (VLN) rates, HIV drug resistance (HIVDR) prevalence, and associated factors among female sex workers (FSWs) in Ethiopia.

Methods:
A cross-sectional biobehavioral survey was conducted among FSWs in 11 cities in Ethiopia in 2014. Whole blood was collected, and HIVDR genotyping was performed. Logistic regression analysis was performed to identify factors associated with VLN and HIVDR.

Results:
Among 4900 participants, 1172 (23.9%) were HIV-positive and 1154 (98.5%) had a VL result. Participants were categorized into antiretroviral therapy (ART) (n = 239) and ART-naive (n = 915) groups based on self-report. From the 521 specimens (ART, 59; ART-naive, 462) with VL ≥1000 copies/mL, genotyping was successful for 420 (80.6%) and 92 (21.9%) had drug resistance mutations (DRMs). Pretreatment drug resistance (PDR) was detected in 16.5% (63/381) of the ART-naive participants. Nucleoside reverse transcriptase inhibitor (NRTI), non-NRTIs (NNRTIs), and dual-class DRMs were detected in 40 (10.5%), 55 (14.4%), and 35 (9.2%) of the participants, respectively. Among 239 participants on ART, 59 (24.7%) had VLN. Genotyping was successfully performed for 39 (66.1%). DRMs were detected in 29 (74.4%). All 29 had NNRTI, 23 (79.3%) had NRTI or dual-class DRMs. VLN was associated with age 35 years or older, CD4+ T-cell count <350 cells/mm3, and being forced into selling sex. PDR and acquired drug resistance were associated with CD4+ T-cell count <350 cells/mm3 (P < 0.001).

Conclusions:
The high VLN and HIVDR rates among FSWs underscore the need for targeted interventions to improve ART access and virologic monitoring to maximize the benefit of ART and limit the spread of HIV and HIVDR.
New therapies for nontuberculous mycobacterial lung infection
Authors: Chalmers Sarah J. , Aksamit Timothy R. 
Published: December 2021

Purpose of review
Although nontuberculous mycobacterial pulmonary disease is increasing in incidence, outcomes remain less than optimal highlighting the unmet need for developing novel therapies.

Recent findings
Several new antibiotic formulations, novel antibiotics, and novel nonantibiotic treatments have recently demonstrated positive results in treating nontuberculous mycobacterial pulmonary disease.

Summary
Promising novel therapies are currently under investigation fueling much needed interest and enthusiasm in the nontuberculous mycobacterial pulmonary disease space and will hopefully lead to improved understanding and outcomes in this complex disease.
Effects of statin therapy on coronary plaque volume by decreasing CRP/hsCRP levels: A meta-regression of randomized controlled trials
Authors: Gao Darui , Hua Rong , Jiesisibieke Dina , Ma Yanjun , Li Chenglong , Wu Sijing , Ma Qian , Xie Wuxiang 
Published: December 2021

AbstractBackground and aimsSeveral clinical trials have indicated that statins stabilize and reverse atherosclerotic plaque. However, different studies have provided inconsistent findings regarding mechanisms and influencing factors of plaque regression under statin therapy. In this study, meta-analysis and meta-regression were used to determine the effects of statin medications on coronary plaque volume as determined by intravenous ultrasound. Meanwhile, the impact of CRP/hsCRP reduction during statin therapy on plaque regression was investigated.MethodsUp to May 28, 2021, a systematic PubMed, EMBASE, and Cochrane search was performed for randomized controlled trials that assessed treatment effect using total atheroma volume (TAV), percent atheroma volume (PAV), or plaque volume (PV). Only CRP/hsCRP and LDL-C values reported before and after treatment were considered.Results12 studies fulfilled the inclusion criteria and were included in the systematic review. A meta-analysis of 15 statin-treated arms reported a significant reduction in change of TAV/PV (standardized mean difference [SMD]: −0.27, 95% confidence intervals [CI]: −0.42, −0.12), compared with the control arms. Another meta-analysis of 7 trials also found that patients in the intervention group had a significant reduction in change of PAV (SMD: −0.16, 95% CI: −0.29, −0.03), compared with those in the control group. Meta-regression analysis revealed the percent change of CRP/hsCRP statistically influences SMD in change of TAV/PV after adjusting for percent change of LDL-C, age and gender. Meta-regression analysis showed that percent change of CRP/hsCRP statistically influences SMD in change of PAV.ConclusionIn conclusion, statin therapy is beneficial for plaque regression. Statins promote plaque regression through their anti-inflammatory ability.
Excitatory effect of biphasic kHz field stimulation on CA1 pyramidal neurons in slices
Authors: Karnup Sergei , De Groat William , Beckel Jonathan , Tai Changfeng 
Published: December 2021

AbstractBackgroundElectrical stimulation in the kilohertz-frequency range has been successfully used for treatment of various neurological disorders. Nevertheless, the mechanisms underlying this stimulation are poorly understood.ObjectiveTo study the effect of kilohertz-frequency electric fields on neuronal membrane biophysics we developed a reliable experimental method to measure responses of single neurons to kilohertz field stimulation in brain slice preparations.MethodsIn the submerged brain slice pyramidal neurons of the CA1 subfield were recorded in the whole-cell configuration before, during and after stimulation with an external electric field at 2kHz, 5kHz or 10 kHz.ResultsReproducible excitatory changes in rheobase and spontaneous firing were elicited during kHz-field application at all stimulating frequencies. The rheobase only decreased and spontaneous firing either was initiated in silent neurons or became more intense in previously spontaneously active neurons. Response thresholds were higher at higher frequencies. Blockade of glutamatergic synaptic transmission did not alter the magnitude of responses. Inhibitory synaptic input was not changed by kilohertz field stimulation.ConclusionkHz-frequency current applied in brain tissue has an excitatory effect on pyramidal neurons during stimulation. This effect is more prominent and occurs at a lower stimulus intensity at a frequency of 2kHz as compared to 5kHz and 10kHz.
Validation of a Pancreatic Cancer Detection Test in New-Onset Diabetes Using Cell-Free DNA 5-Hydroxymethylation Signatures
Authors: Haan David , Bergamaschi Anna , Guler Gulfem D , Friedl Verena , Ning Yuhong , Reggiardo Roman , Kesling Michael , Collins Micah , Gibb Bill , Pitea Adriana , Hazen Kyle , Bates Steve , Antoine Michael , Fraire Carolina , Lopez Vanessa , Malta Roger , Nabiyouni Maryam , Nguyen Albert , Phillips Tierney , Riviere Michael , Scott Aaron , Nilson Eric , Sheard Judy , Peters Melissa , Chowdhury Shimul , Volkmuth Wayne , Levy Samuel 
Published: December 2021

AbstractBACKGROUNDPancreatic cancer (PaC) has poor (10%) 5-year overall survival, largely due to predominant late-stage diagnosis. Patients with new-onset diabetes (NOD) are at a six-to eightfold increased risk for PaC. We developed a pancreatic cancer detection test for the use in a clinical setting that employs a logistic regression model based on 5-hydroxymethylcytosine (5hmC) profiling of cell-free DNA (cfDNA).METHODScfDNA was isolated from plasma from 89 subjects with PaC and 596 case-control non-cancer subjects, and 5hmC libraries were generated and sequenced. These data coupled with machine-learning, were used to generate a predictive model for PaC detection, which was independently validated on 79 subjects with PaC, 163 non-cancer subjects, and 506 patients with non-PaC cancers.RESULTSThe area under the receiver operating characteristic curve for PaC classification was 0.93 across the training data. Training sensitivity was 58.4% (95% confidence interval [CI]: 47.5– 68.6) after setting a classification probability threshold that resulted in 98% (95% CI: 96.5–99) specificity. The independent validation dataset sensitivity and specificity were 51.9% (95% CI: 40.4–63.3) and 100.0% (95% CI: 97.8–100.0), respectively. Early-stage (stage 1 and 2) PaC detection was 47.6% (95% CI: 23%–58%) and 39.4% (95% CI: 32%–64%) in the training and independent validation datasets, respectively. Sensitivity and specificity in NOD patients were 55.2% [95% CI: 35.7–73.6] and 98.4% [95% CI: 91.3–100.0], respectively. The PaC signal was identified in intraductal papillary mucinous neoplasm (64%), pancreatitis (56%), and non-PaC cancers (17%).CONCLUSIONSThe pancreatic cancer detection assay showed robust performance in the tested cohorts and carries the promise of becoming an essential clinical tool to enable early detection in high-risk NOD patients.
Control Strategies for the Third wave of COVID-19 infection in India: A Mathematical Model Incorporating Vaccine Effectiveness
Authors: Sivadas Namitha A , Panda Pooja , Mahajan Ashutosh 
Published: December 2021

AbstractThe waning effectiveness of the COVID-19 vaccines and the emergence of a new variant Omicron has given rise to the possibility of another outbreak of the infection in India. COVID-19 has caused more than 34 million reported cases and 475 thousand deaths in India so far, and it has affected the country at the root level, socially as well as economically. After going through different control measures, mass vaccination has been achieved to a large extent for the highly populous country, and currently under progress. India has already been hit by a massive second wave of infection in April-June, 2021 mainly due to the delta variant, and might see a third wave in the near future that needs to be controlled with effective control strategies. In this paper, we present a compartmental epidemiological model with vaccinations incorporating the dose-dependent effectiveness. We study a possible sudden outbreak of SARS-CoV2 variants in the future, and bring out the associated predictions for various vaccination rates and point out optimum control measures. Our results show that for transmission rate 30% higher than the current rate due to emergence of new variant or relaxation of social distancing conditions, daily new cases can peak to 250k in March 2022, taking the second dose effectiveness dropping to 50% in the future. Combination of vaccination and controlled lockdown or social distancing is the key to tackling the current situation and for the coming few months. Our simulation results show that social distancing measures show better control over the disease spread than the higher vaccination rates.
Functional properties of the spike glycoprotein of the emerging SARS-CoV-2 variant B.1.1.529
Authors: Wang Qian , Anang Saumya , Iketani Sho , Guo Yicheng , Liu Lihong , Ho David D. , Sodroski Joseph G. 
Published: December 2021

SUMMARYThe recently emerged B.1.1.529 (Omicron) SARS-CoV-2 variant has a highly divergent spike (S) glycoprotein. We compared the functional properties of B.1.1.529 S with those of previous globally prevalent SARS-CoV-2 variants, D614G and B.1.617.2. Relative to these variants, B.1.1.529 S exhibits decreased processing, resulting in less efficient syncytium formation and lower S incorporation into virus particles. Nonetheless, B.1.1.529 S supports virus infection equivalently. B.1.1.529 and B.1.617.2 S glycoproteins bind ACE2 with higher affinity than D614G S. The unliganded B.1.1.529 S trimer is less stable at low temperatures than the other SARS-CoV-2 spikes, a property related to spike conformation. Upon ACE2 binding, the B.1.1.529 S trimer sheds S1 at 37 degrees but not at 0 degrees C. B.1.1.529 pseudoviruses are relatively resistant to neutralization by sera from convalescent COVID-19 patients and vaccinees. These properties of the B.1.1.529 spike glycoprotein likely influence the transmission, cytopathic effects and immune evasion of this emerging variant.
A novel assessment method for COVID-19 humoral immunity duration using serial measurements in naturally infected and vaccinated subjects
Authors: de Boer Jasper , Saade Ursula , Granjon Elodie , Trouillet-Assant Sophie , Saade Carla , Pottel Hans , Zrein Maan 
Published: December 2021

AbstractBackgroundIt is crucial for medical decision-making and vaccination strategies to collect information on sustainability of immune responses after infection or vaccination, and how long-lasting antibodies against SARS-COV-2 could provide a humoral and protective immunity, preventing reinfection with SARS-CoV-2 or its variants. The aim of this study is to present a novel method to quantitatively measure and monitor the diversity of SARS-CoV-2 specific antibody profiles over time.MethodsTwo collections of serum samples were used in this study: A collection from 20 naturally infected subjects (follow-ups to 1 year) and a collection from 83 subjects vaccinated with one or two doses of Pfizer BioNtech vaccine (BNT162b2/BNT162b2) (follow-ups to 6 months). The Multi-SARS-CoV-2 assay, a multiparameter serology test, developed for the serological confirmation of past-infections was used to determine the reactivity of six different SARS-CoV-2 antigens. For each patient sample, 3 dilutions (1/50, 1/400 and 1/3200) were defined as an optimal set over the six antigens and their respective linear ranges, allowing accurate quantitation of the corresponding six specific antibodies. Nonlinear mixed-effects modelling was applied to convert intensity readings from 3 determined dilutions to a single quantification value for each antibody.ResultsMedian half-life for the 20 naturally infected vs 74 vaccinated subjects (two doses) was respectively 120 vs 50 days for RBD, 127 vs 53 days for S1 and 187 vs 86 days for S2 antibodies. Respectively, 90% of the antibody concentration wanes after 398 vs 158 days for RBD, 420 vs 171 days for S1, and 620 vs 225 days for S2 after the second vaccine shot.ConclusionThe newly proposed method, based on a series of a limited number of dilutions, can convert a conventional qualitative assay into a quantitative assay. This conversion helps define the sustainability of specific immune responses against each relevant viral antigen and can help in defining the protection characteristics after an infection or a vaccination.