bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges and support needs among persons with a migration background who use drugs in four European metropolitan cities
Authors: Pouille Aline , De Ruysscher Clara , van Selm Lena , van Amsterdam Jan , van den Brink Wim , Busz Machteld , Perez Gayo Roberto , Atzemis Marios , Vanderplasschen Wouter ,   the SEMID-EU consortium, Moura Joanna , Bakker Ingrid , Perez Roberto , Baghdadi Sultan , Köhlein Ralf , Leicht Astrid , Lovera Mathieu , Detrez Victor , Avril Elisabeth 
Published: November 2024

Abstract
Background
Persons who migrate for economic reasons, along with asylum seekers and refugees, face multiple personal experiences and societal inequalities that increase the risk of mental health problems and substance dependency, compounded by intersectional social and economic vulnerabilities. The precarious situation and limited access to care of persons with a migration background who use drugs (PMWUD) in Europe raises concern. Therefore, this qualitative study explores the challenges and support needs of a sample of PMWUD in vulnerable situations living in Amsterdam, Athens, Berlin and Paris.

Methods
This study employed a community-based participatory approach. Through semi-structured interviews with PMWUD (n = 99), we identified (service) needs of a diversity of PMWUD in Europe. Participants were recruited through a combination of community gatekeepers, venue-based sampling, and snowball sampling. Trained community researchers conducted the interviews, which focused on participants’ living situation, substance use, physical and mental health, and employment opportunities.

Results
Despite substantial heterogeneity among the PMWUD, several common themes emerged across all groups. Participants frequently mentioned early childhood adversity, limited social networks leading to loneliness, medical, psychological, and substance use issues, histories of personal violence or poverty, homelessness, lack of necessary documents for health care, social security, and employment, and encounters with the criminal justice system. These intertwined and mutually reinforcing factors simultaneously functioned as barriers to care and support, alongside other barriers such as linguistic and cultural differences, and stigma and discrimination. Due to social exclusion, migration, and substance dependence, participants had limited reliable social networks. Therefore, they often had to rely on accessible and low-threshold services. Harm reduction services played a significant role in providing support to PMWUD. Most PMWUD indicated that basic needs for hygiene and food were met thanks to local organizations. Differences in housing opportunities and access to harm reduction services were identified in each city.

Conclusion
Structural barriers toward treatment and care, often related to administrative requirements, stand in the way of appropriate care for PMWUD. Linguistically and culturally sensitive outreach activities with limited practical requirements could break down social and treatment barriers.
The cell adhesion molecule CD44 acts as a modulator of 5-HT7 receptor functions
Authors: Borsdorf Saskia , Zeug Andre , Wu Yuxin , Mitroshina Elena , Vedunova Maria , Gaitonde Supriya A. , Bouvier Michel , Wehr Michael C. , Labus Josephine , Ponimaskin Evgeni 
Published: November 2024

Abstract
Background
Homo- and heteromerization of G protein-coupled receptors (GPCRs) plays an important role in the regulation of receptor functions. Recently, we demonstrated an interaction between the serotonin receptor 7 (5-HT7R), a class A GPCR, and the cell adhesion molecule CD44. However, the functional consequences of this interaction on 5-HT7R-mediated signaling remained enigmatic.

Methods
Using a quantitative FRET (Förster resonance energy transfer) approach, we determined the affinities for the formation of homo- and heteromeric complexes of 5-HT7R and CD44. The impact of heteromerization on 5-HT7R-mediated cAMP signaling was assessed using a cAMP responsive luciferase assay and a FRET-based cAMP biosensor under basal conditions as well as upon pharmacological modulation of the 5-HT7R and/or CD44 with specific ligands. We also investigated receptor-mediated G protein activation using BRET (bioluminescence resonance energy transfer)-based biosensors in both, homo- and heteromeric conditions. Finally, we analyzed expression profiles for 5-HT7R and CD44 in the brain during development.

Results
We found that homo- and heteromerization of the 5-HT7R and CD44 occur at similar extent. Functionally, heteromerization increased 5-HT7R-mediated cAMP production under basal conditions. In contrast, agonist-mediated cAMP production was decreased in the presence of CD44. Mechanistically, this might be explained by increased Gαs and decreased GαoB activation by 5-HT7R/CD44 heteromers. Unexpectedly, treatment of the heteromeric complex with the CD44 ligand hyaluronic acid boosted constitutive 5-HT7R-mediated cAMP signaling and receptor-mediated transcription, suggesting the existence of a transactivation mechanism.

Conclusions
Interaction with the hyaluronan receptor CD44 modulates both the constitutive activity of 5-HT7R as well as its agonist-mediated signaling. Heteromerization also results in the transactivation of 5-HT7R-mediated signaling via CD44 ligand.
Evidence of rustrela virus-associated feline staggering disease in Sweden since the 1970s
Authors: Thilén Emma , Rubbenstroth Dennis , Tengstrand Sofia , Pfaff Florian , Wensman Jonas Johansson , Ley Cecilia 
Published: November 2024

Abstract
Background
Staggering disease (SD) is a severe neurological disease that has been regularly reported in Swedish cats since the beginning of the 1970s. The aetiology of SD has been debated, but novel rustrela virus (RusV) was recently suggested as the causative agent in Swedish cases dating from 2017 onwards. However, whether RusV was associated with earlier cases of feline SD in Sweden remained unknown. Further, presence of RusV in extraneural tissues of RusV-infected cats and viral transmission routes for RusV are still unknown. Therefore, we investigated the presence of RusV in nervous tissue of historical cases of plausible feline SD in Sweden, dating back to the 1970s, as well as the presence of RusV in selected extraneural tissues.
Formalin-fixed, paraffin-embedded brain and spinal cord from 14 encephalitic cats matching the criteria for SD based on clinical and pathological records, and five non-encephalitic control cats were screened for the presence of RusV antigen and RNA using immunohistochemistry (IHC) and reverse transcription-quantitative polymerase chain reaction (RT-qPCR), respectively. Extraneural presence of RusV antigen was investigated by IHC in four known RusV-positive cats. Morphologic changes were evaluated using light microscopy. In addition, the 14 encephalitic cats were tested for Borna disease virus 1 (BoDV-1) RNA by RT-qPCR.

Results
Morphologic findings compatible with SD were confirmed in 13 of 14 encephalitic cats. All 13 cats were RusV-positive by IHC and 12 of them also by RT-qPCR. One encephalitic cat, morphologically and clinically untypical of SD, as well as all control cats tested negative for RusV RNA and showed either negative or uncertain RusV immunolabeling. There was no firm evidence of extraneural presence of RusV. All encephalitic cats were negative for BoDV-1.

Conclusions
We show that RusV has infected cats in Sweden as far back as the 1970s, whereas BoDV-1 was not detected in any of the investigated cats. This further strengthens RusV as the causative agent of feline SD. Our findings suggest that RusV is strongly neurotropic in cats and that the cat may represent a dead-end host. Further investigations into the pathogenesis of RusV-associated meningoencephalomyelitis in cats are warranted, including disease transmission, pathophysiologic responses and mechanisms of neuronal dysfunction.
Deep learning-based Emergency Department In-hospital Cardiac Arrest Score (Deep EDICAS) for early prediction of cardiac arrest and cardiopulmonary resuscitation in the emergency department
Authors: Deng Yuan-Xiang , Wang Jyun-Yi , Ko Chia-Hsin , Huang Chien-Hua , Tsai Chu-Lin , Fu Li-Chen 
Published: November 2024

Abstract
Background
Timely identification of deteriorating patients is crucial to prevent the progression to cardiac arrest. However, current methods predicting emergency department cardiac arrest are primarily static, rule-based with limited precision and cannot accommodate time-series data. Deep learning has the potential to continuously update data and provide more precise predictions throughout the emergency department stay.

Methods
We developed and internally validated a deep learning-based scoring system, the Deep EDICAS for early prediction of cardiac arrest and a subset of arrest, cardiopulmonary resuscitation (CPR), in the emergency department. Our proposed model effectively integrates tabular and time series data to enhance predictive accuracy. To address data imbalance and bolster early prediction capabilities, we implemented data augmentation techniques.

Results
Our system achieved an AUPRC of 0.5178 and an AUROC of 0.9388 on on data from the National Taiwan University Hospital. For early prediction, our system achieved an AUPRC of 0.2798 and an AUROC of 0.9046, demonstrating superiority over other early warning scores. Moerover, Deep EDICAS offers interpretability through feature importance analysis.

Conclusion
Our study demonstrates the effectiveness of deep learning in predicting cardiac arrest in emergency department. Despite the higher clinical value associated with detecting patients requiring CPR, there is a scarcity of literature utilizing deep learning in CPR detection tasks. Therefore, this study embarks on an initial exploration into the task of CPR detection.
Upregulation of CD244 promotes CD8+ T cell exhaustion in patients with alveolar echinococcosis and a murine model
Authors: Wang Maolin , Deng Bingqing , Jiang Tiemin , Duolikun Adilai , Li Yinshi , ainiwaer Abidan , Kang Xuejiao , Zheng Xuran , Rousu Zibigu , Yu Qian , Li Jing , Wang Hui , Zhang Chuanshan , Aji Tuerganaili , Shao Yingmei 
Published: November 2024

Abstract
Background
In patients with alveolar echinococcosis (AE), CD8+ T cells undergo functional exhaustion, which accelerates the malignant progression of AE. However, the role of inhibitory receptor CD244 in mediating CD8+ T cell exhaustion remains elusive.

Methods
CD244 expression on exhausted CD8+ T cells in the close liver tissue (CLT) of AE patients was analyzed using single-cell RNA sequencing data. Immunohistochemistry and immunofluorescence were employed to detect CD244 expression. Flow cytometry was used to assess the impact of CD244 on differentiation and effector function of CD8+ T cells in patients with AE, in vitro and in vivo models. Reactive oxygen species (ROS) and oxygen consumption rate (OCR) were measured to evaluate the influence of CD244 on mitochondrial function of CD8+ T cells.

Results
CD244+CD8+ T cells in the CLT of AE patients exhibit a more terminal differentiation phenotype, with reduced secretion of IFN-γ and TNF-α. In vitro studies revealed that CD8+ T cells from CD244-deficient mice produced higher levels of IFN-γ, TNF-α and Granzyme B. In vivo studies revealed that CD244 deficiency enhanced the secretion capacity of IFN-γ and TNF-α by CD8+ T cells, inhibiting the growth of metacestodes. Moreover, CD244 deficiency leads to a decrease in ROS levels in liver CD8+ T cells, while significantly increasing their adenosine triphosphate (ATP)-linked oxygen consumption rate.

Conclusions
CD244 facilitates AE disease progression by mediating immune exhaustion in CD8+ T cells.

Graphical abstract
Prognostic effects of glycaemic variability on diastolic heart failure and type 2 diabetes mellitus: insights and 1-year mortality machine learning prediction model
Authors: Yang Zhenkun , Li Yuanjie , Liu Yang , Zhong Ziyi , Ditchfield Coleen , Guo Taipu , Yang Mingjuan , Chen Yang 
Published: November 2024

Abstract
Background
Diastolic heart failure (DHF) and type 2 diabetes mellitus (T2DM) often coexist, causing increased mortality rates. Glycaemic variability (GV) exacerbates cardiovascular complications, but its impact on outcomes in patients with DHF and T2DM remains unclear. This study examined the relationships between GV with mortality outcomes, and developed a machine learning (ML) model for long-term mortality in these patients.

Methods
Patients with DHF and T2DM were included from the Medical Information Mart for Intensive Care IV, with admissions (2008–2019) as primary analysis cohort and admissions (2020–2022) as external validation cohort. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to evaluate the associations of GV with 90-day, 1-year, and 3-year all-cause mortality. The primary analysis cohort was split into training and internal validation cohorts, then developing ML models for predicting 1-year all-cause mortality in training cohort, which were validated using the internal and external validation cohorts.

Results
2,128 patients with DHF and T2DM were included in primary analysis cohort (meidian age 71.0years [IQR: 62.0–79.0]; 46.9% male), 498 patients with DHF and T2DM were included in the external validation cohort (meidian age 75.0years [IQR: 67.0–81.0]; 54.0% male). Multivariate Cox proportional hazards models showed that high GV tertiles were associated with higher risk of 90-day (T2: HR 1.45, 95%CI 1.09–1.93; T3: HR 1.96, 95%CI 1.48–2.60), 1-year (T2: HR 1.25, 95%CI 1.02–1.53; T3: HR 1.54, 95%CI 1.26–1.89), and 3-year (T2: HR 1.31, 95%CI: 1.10–1.56; T3: HR 1.48, 95%CI 1.23–1.77) all-cause mortality, compared with lowest GV tertile. Chronic kidney disease, creatinine, potassium, haemoglobin, and white blood cell were identified as mediators of GV and 1-year all-cause mortality. Additionally, GV and other clinical features were pre-selected to construct ML models. The random forest model performed best, with AUC (0.770) and G-mean (0.591) in internal validation, with AUC (0.753) and G-mean (0.599) in external validation.

Conclusion
GV was determined as an independent risk factor for short-term and long-term all-cause mortality in patients with DHF and T2DM, with a potential intervention threshold around 25.0%. The ML model incorporating GV demonstrated strong predictive performance for 1-year all-cause mortality, highlighting its importance in early risk stratification management of these patients.
Determinants of non-adherence to antibiotic treatment guidelines in hospitalized adults with suspected community-acquired pneumonia: a prospective study
Authors: Markussen Dagfinn Lunde , Wathne Jannicke Slettli , Ritz Christian , van Werkhoven Cornelis H. , Serigstad Sondre , Bjørneklett Rune Oskar , Ulvestad Elling , Knoop Siri Tandberg , Jenum Synne , Grewal Harleen M. S. 
Published: November 2024

Abstract
Background
Antimicrobial resistance (AMR) is a global health threat with millions of deaths annually attributable to bacterial resistance. Effective antimicrobial stewardship programs are crucial for optimizing antibiotic use. This study aims to identify factors contributing to deviations from antibiotic treatment guidelines in hospitalized adults with suspected community-acquired pneumonia (CAP).

Methods
We conducted a prospective study at Haukeland University Hospital's Emergency Department in Bergen, Norway, from September 2020 to April 2023. Patients were selected from two cohorts, with data on clinical and microbiologic test results collected. We analysed adherence of antibiotic therapy to guidelines for the choice of empirical treatment and therapy duration using multivariate regression models to identify predictors of non-adherence.

Results
Of the 523 patients studied, 479 (91.6%) received empirical antibiotic therapy within 48 h of admission, with 382 (79.7%) adhering to guidelines. However, among the 341 patients included in the analysis of treatment duration adherence, only 69 (20.2%) received therapy durations that were consistent with guideline recommendations. Key predictors of longer-than-recommended therapy duration included a C-reactive protein (CRP) level exceeding 100 mg/L (RR 1.37, 95% CI 1.18–1.59) and a hospital stay longer than two days (RR 1.22, 95% CI 1.04–1.43). The primary factor contributing to extended antibiotic therapy duration was planned post-discharge treatment. No significant temporal trends in adherence to treatment duration guidelines were observed following the publication of the updated guidelines.

Conclusion
While adherence to guidelines for the choice of empirical antibiotic therapy was relatively high, adherence to guidelines for therapy duration was significantly lower, largely due to extended post-discharge antibiotic treatment. Our findings suggest that publishing updated guidelines alone is insufficient to change clinical practice. Targeted stewardship interventions, particularly those addressing discharge practices, are essential. Future research should compare adherence rates across institutions to identify factors contributing to higher adherence and develop standardized benchmarks for optimal antibiotic stewardship.
Trial registration NCT04660084.
Depth use of wild Atlantic salmon post-smolts migrating through fjords
Authors: Bjerck Helge B. , Urke Henning A. , Haugen Thrond O. , Alfredsen Jo Arve , Kristensen Torstein 
Published: November 2024

AbstractJuvenile Atlantic salmon (Salmo salar), known as post-smolt as they enter the sea, undergo an arduous migration from their natal rivers to their feeding grounds in the North Atlantic Ocean. It has become increasingly important to understand how post-smolts use the fjord environment as they migrate in order to properly assess the potential threats posed by large-scale salmon farming. Chief among these threats is the increased numbers of ectoparasitic salmon lice (Lepeophtheirus salmonis) inhabiting the water column, which are known to have specific depth preferences based on light, temperature, and salinity. Here, we present data on the depth use of wild Atlantic salmon post-smolts migrating through fjords. We aimed to investigate to what extent depth use varied throughout the fjord and from year to year. Using acoustic telemetry, tagged fish from four rivers in two fjords in western Norway were monitored as they migrated towards the open sea during two consecutive years. We found that post-smolts predominantly migrated in the top three meters of the water column throughout the length of both fjord systems. Among 61 successful migrants and 7013 detections, 98% of detections were in the top three meters of the water column. This corresponds well with past findings showing similar depth use in hatchery-reared smolt and in adult Atlantic salmon kelts returning to their feeding grounds after spawning. We found little evidence of a consistent diel pattern in depth use. Our results support assumptions of representative sampling when trawling the upper portion of the water column for post-smolts in order to estimate sea lice infection rates and may improve the precision of efforts to model salmon lice infection risk. The results may also be valuable in evaluating other threats to wild salmon.
Percutaneous management of chronic total occlusion of the portal vein: a retrospective analysis of technical aspects and outcomes
Authors: Dulcetta Ludovico , Marra Paolo , Muglia Riccardo , Carbone Francesco Saverio , Viganò Mauro , Di Giorgio Angelo , D’Antiga Lorenzo , Fagiuoli Stefano , Sironi Sandro 
Published: November 2024

Abstract
Background
Chronic total occlusion (CTO) of the portal vein is one of the main causes of portal hypertension, which may result in life-threatening complications often managed by interventional radiology (IR). The aim of this study is to report the innovative experience with percutaneous revascularization therapy in the management of portal vein CTO in paediatric and adult patients.

Materials and methods
From January 2020 to December 2023 consecutive paediatric and adult patients with severe portal hypertension resulting from portal vein CTO who underwent attempts at percutaneous recanalization were retrospectively reviewed. Technical aspects including the percutaneous approach, portal vein stenting, transjugular intrahepatic portosystemic shunt (TIPS) creation, varices embolization and clinical outcomes including adverse events and control of portal hypertension were analyzed. Technical success was defined as at least partial restoration of the portal vein patency at the final angiogram. Clinical success was defined as the improvement of clinical-laboratory signs of portal hypertension and control for variceal bleeding.

Results
Fifteen patients (median age = 21 years, range = 59 years; 10 males; 5 children) with portal vein CTO underwent a total of 25 percutaneous revascularization procedures. Nine patients (60%; 5 children, 4 adults) were liver transplant recipients. All patients except one had cavernous transformation of the extra-hepatic portal vein, involving the spleno-mesenteric confluence in 5 cases. Technical success was achieved in 13/15 (87%) patients of whom 8 had portal revascularization through the placement of an extra-hepatic stent; indeed, in six cases, a TIPS was performed to achieve sustained portal vein patency. Embolization of varices and/or cavernoma was performed in 12 patients. Adverse events occurred in 2/15 (splenic artery perforation and hemoperitoneum, one each) managed without sequelae. Technical success led to clinical success in all the 13/15 (87%) cases, with a median follow-up of 20 months (IQR 4–34 months).

Conclusion
CTO can be managed effectively by interventional radiology. Restored portal flow physiology alone is possible in most patients, while TIPS may be required in a small proportion of them, to prolong portal vein patency and control portal hypertension.
Exploring the diverse nature of business processes in organisations in Industry 4.0/5.0
Authors: Szelągowski Marek , Berniak-Woźny Justyna , Sliż Piotr , Potoczek Natalia , Napieraj Aneta , Podobińska-Staniec Marta , Senkus Piotr 
Published: November 2024

AbstractThe article investigates the differentiation of business processes in contemporary organisations based on their dynamics (predictability). It presents and summarises research on the nature of business processes in Industry 4.0/5.0 conducted by researchers from 7 Polish universities. The study combines a systematic literature review based on the SCOPUS database and a survey of 466 respondents with an analysis of 12,573 processes. Filling the cognitive gap in Industry 4.0/5.0 organisations, the study reveals that nearly 60% of all BPs are semi-structured processes. At the same time, it shows a strong relationship between the importance of processes for the organisation and the dynamics of their execution. This finding highlights the importance of adaptability and flexibility in organisational dynamics, reflecting the nuanced nature of most BPs. The article presents original research on a diverse sample of Polish enterprises based on the simplified Business Processes Nature Assessment Framework. The presented research results indicate the need to update the essential elements of the BPM concept, such as BPM Lifecycle, BPM implementation method, or BPM maturity assessment, to consider various assessment criteria and implementation methods depending on the nature of BPs. The study contributes to advancing both theoretical knowledge and practical applications in the field of BPM, providing valuable insights for scholars, practitioners, and policymakers alike.