bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proximal splenic artery embolization for treatment of refractory ascites, a single‐center experience
Authors: Mustafa Abdul Rehman , Atta Raneem , P. Goodman Russell , Wu Vincent , Irani Zubin , Zurkiya Omar , Bethea Emily D. , Yamada Kei , Wehrenberg‐Klee Eric P. 
Published: September 2024

AbstractAimRefractory ascites from portal hypertension can be managed with regular large‐volume paracentesis (LVP) or transjugular intrahepatic portosystemic shunt (TIPS). Large‐volume paracentesis is clinically unsatisfactory and many patients are ineligible or relatively contraindicated for TIPS or Denver shunt. Proximal splenic artery embolization (PSAE) using coils or plugs reduces but does not completely stop splenic arterial inflow, differing from distal splenic artery embolization techniques. By reducing splenic arterial inflow, splenic vein outflow is also decreased, lowering portal pressure and thus treating refractory ascites.MethodsIn this institutional review board‐approved single‐center retrospective study, electronic medical records were reviewed to obtain demographics and baseline clinical and laboratory data, paracentesis data before and after PSAE, PSAE procedural details, and follow‐up imaging up to 12 months post‐PSAE. Mixed‐effects models were used for statistical analysis.ResultsTen patients with LVP‐dependent ascites meeting inclusion criteria underwent PSAE for refractory ascites from 2017 to 2024. Prior to PSAE, four patients had TIPS, three had liver transplants, and the remaining three were neither TIPS nor transplant candidates. In the month before PSAE, patients averaged 3.8 ± 1.7 paracentesis sessions, draining a total of 20.84 ± 10.39 L of fluid monthly. Post‐PSAE, the number of paracentesis sessions decreased to 2.1 ± 2.7, 1.0 ± 1.7, 0.4 ± 1.1, and 0.0 ± 0.0 at 1, 3, 6, and 12 months, respectively (p = 0.03). Corresponding ascitic volume drained decreased to 8.7 ± 10.3, 2.7 ± 6.4, 2.0 ± 5.4, and 0.0 ± 0.0 L (p = 0.01). Over the 12‐month follow‐up period, 6 of 10 patients became LVP‐independent.ConclusionProximal splenic artery embolization can improve refractory ascites in certain patients with portal hypertension, thus providing safe and effective treatment as an alternative to TIPS.
The association of ultra‐processed food intake with adolescent metabolic dysfunction‐associated steatotic liver disease in the NHANES
Authors: Buytaert Maarten , Declercq Dimitri , Depoorter Fleur , Cosijn Zerlina , Devisscher Lindsey , Raevens Sarah , Verhelst Xavier , Van Vlierberghe Hans , Geerts Anja , De Bruyne Ruth , Lefere Sander 
Published: September 2024

SummaryIntroductionMetabolic dysfunction‐associated steatotic liver disease (MASLD) has become a major public health concern. A thorough analysis of the link between ultra‐processed food (UPF) intake and MASLD in the adolescent population is lacking.MethodsAdolescent participants of the National Health and Nutrition Examination Survey (NHANES) pre‐pandemic cohort were included. Different controlled attenuation parameter (CAP) cut‐offs were used to assess MASLD. The percentage energy intake of UPF, categorized according to the NOVA classification, to total energy intake was taken as the main outcome marker. Structural equation modelling (SEM) was used to better quantify the causal connection between UPF and liver steatosis.ResultsUPF consumption constituted a median 75% (62–86) of total energy intake. There was no significant correlation between UPF intake and CAP (ρ = 0.061, p = 0.091). The median proportion UPF intake was not associated with steatosis severity. SEM similarly yielded a weak and non‐significant correlation of 0.078. In participants with MASLD, total energy intake was significantly higher (p < 0.001) and sugar‐containing beverage (SCB) consumption showed a non‐significant trend towards higher consumption.ConclusionsNo clinically relevant association between UPF intake and MASLD in adolescents could be demonstrated. Our results nonetheless suggest that total energy intake and consumption of SCBs are important contributors to paediatric obesity and MASLD.
RNA technology and nanocarriers empowering in vivo chimeric antigen receptor therapy
Authors: Cai Jingsheng , Chen Shaoyi , Liu Zheng , Li Haoran , Wang Peiyu , Yang Fan , Li Yun , Chen Kezhong , Sun Ming , Qiu Mantang 
Published: September 2024

AbstractThe remarkable success of mRNA‐based coronavirus 2019 (COVID‐19) vaccines has propelled the advancement of nanomedicine, specifically in the realm of RNA technology and nanomaterial delivery systems. Notably, significant strides have been made in the development of RNA‐based in vivo chimeric antigen receptor (CAR) therapy. In comparison to the conventional ex vivo CAR therapy, in vivo CAR therapy offers several benefits including simplified preparation, reduced costs, broad applicability and decreased potential for carcinogenic effects. This review summarises the RNA‐based CAR constructs in in vivo CAR therapy, discusses the current applications of in vivo delivery vectors and outlines the immune cells edited with CAR molecules. We aim for the conveyed messages to contribute towards the advancement of in vivo CAR application.
Immunomodulatory and anti‐inflammatory properties of immunoglobulin G antibodies
Authors: Hematianlarki Marjan , Nimmerjahn Falk 
Published: September 2024

SummaryAntibodies provide an essential layer of protection from infection and reinfection with microbial pathogens. An impaired ability to produce antibodies results in immunodeficiency and necessitates the constant substitution with pooled serum antibodies from healthy donors. Among the five antibody isotypes in humans and mice, immunoglobulin G (IgG) antibodies are the most potent anti‐microbial antibody isotype due to their long half‐life, their ability to penetrate almost all tissues and due to their ability to trigger a wide variety of effector functions. Of note, individuals suffering from IgG deficiency frequently produce self‐reactive antibodies, suggesting that a normal serum IgG level also may contribute to maintaining self‐tolerance. Indeed, the substitution of immunodeficient patients with pooled serum IgG fractions from healthy donors, also referred to as intravenous immunoglobulin G (IVIg) therapy, not only protects the patient from infection but also diminishes autoantibody induced pathology, providing more direct evidence that IgG antibodies play an active role in maintaining tolerance during the steady state and during resolution of inflammation. The aim of this review is to discuss different conceptual models that may explain how serum IgG or IVIg can contribute to maintaining a balanced immune response. We will focus on pathways depending on the IgG fragment crystallizable (Fc) as pre‐clinical data in various mouse model systems as well as human clinical data have demonstrated that the IgG Fc‐domain recapitulates the ability of intact IVIg with respect to its ability to trigger resolution of inflammation. We will further discuss how the findings already have or are in the process of being translated to novel therapeutic approaches to substitute IVIg in treating autoimmune inflammation.
Object play in Tajikistan: Infants engage with objects despite bounds on play
Authors: Karasik Lana B. , Schneider Joshua L. , Kuchirko Yana A. , Dodojonova Rano 
Published: September 2024

AbstractObject play is a ubiquitous context for learning. Existing knowledge on infant object interaction has relied on Euro‐American samples and observations confined to laboratory playrooms or families' homes, where object play is typically observed indoors and in rooms brimming with toys. Here we examined infants' everyday object play in Tajikistan, where spaces are uniquely laid out and homes are not child‐centered and toy‐abundant. The restrictive gahvora cradling practice in Tajikistan may indirectly shape how infants access and engage with objects. We documented how much time infants spent in object play, the types and diversity of objects they contacted, and the locations of play—indoors or outside. We observed 59 infants (12–24 months) during a 45‐min naturalistic observation when infants were out of the gahvora. Infants engaged with objects 50% of the time. Despite a lack of object diversity, object interactions were frequent and dispersed throughout observations. Walkers tended to divide their object interactions between time spent indoors and outside, but pre‐walkers mostly interacted with objects indoors. Caregivers inadvertently shape infants' opportunities for exploration and play through culturally guided childrearing practices. And infants make due: they take it upon themselves to move, explore, and engage—gleaning culturally relevant routines.
Longitudinal interactions between maternal depression symptoms and familial stressful life events on child anxiety symptoms at 5 years of age
Authors: Valdes Viviane , Craighead Linda W. , Nelson Charles A. , Bosquet Enlow Michelle 
Published: September 2024

AbstractIn the current study we identified salient parental factors for child anxiety symptoms by considering the role of stressful life events, maternal anxiety symptoms, maternal depressive symptoms, and maternal neuroticism. Families (N = 399) in an urban area in the United States were participants in a longitudinal study beginning in infancy. Mothers completed measures of stressful life events (Revised Life Events Questionnaire at all visits), maternal anxiety and depressive symptoms (State–Trait Anxiety Inventory and Beck Depression Inventory, respectively, at infancy between 5 and 12 months, at 2 years, and at 3 years), maternal neuroticism (NEO Five–Factor Inventory at infancy), and child anxiety symptoms (Child Behavior Checklist 1.5–5 at 5 years). Linear mixed models (LMMs) were used in analyses. Maternal depressive symptoms from infancy through 3 years were associated with child anxiety symptoms; other main effects modeled (stressful life events, maternal anxiety symptoms, maternal neuroticism) were not associated with child anxiety symptoms. There was a significant interaction effect between stressful life events and maternal depression. Stressful events from infancy through 5 years of age increased risk for child anxiety symptoms at 5 years if the child's mother had a mild mood disturbance or depression, but not for children with non–depressed mothers.
Young People Transitioning From Child and Adolescent to Adult Mental Health Services: A Qualitative Systematic Review
Authors: Rosina Robyn , McMaster Rose , Lovecchio Victoria , Wu Chiung‐Jung 
Published: September 2024

ABSTRACTTo critically synthesise the literature on the lived experience of young adults about their transition to adult mental health services including the perspectives of key people in their world: parents, carers and clinicians. Young people within child and adolescent mental health services are usually required to transition to adult mental health services at the age of 18, despite evidence showing cognitive and emotional development impacted by childhood trauma, illness and adverse life events. This qualitative systematic review searched relevant electronic databases, policy documents, grey literature and theses examining original qualitative peer‐reviewed studies published from 2009 to 2022 in English. The process utilised the PRISMA guidelines and the quality of papers assessed by the JBI critical appraisal tool. Nine papers met the criteria for inclusion in the review. The results indicate that qualitative research listening to the voices of young people transitioning to adult mental health services is a rarity. Even fewer papers examine the perspectives of key people in their lives: this review has critically synthesised the literature on the lived experience of young adults about their transition to adult mental health services including the perspectives of key people in their world: parents, carers and clinicians. The main themes identified include: age 18 is not a helpful trigger to transition; young people want more individualised planning; parents want more involvement and clinicians open up about a challenging nexus with adult mental health services.
Nurses' Perspectives on Fostering Therapeutic Relationships While Working With Clients Who Display Conflict Behaviour
Authors: Overpelt Nick , Kool‐Goudzwaard Nienke , Stringer Barbara , van Meijel Berno 
Published: September 2024

ABSTRACTTherapeutic relationships are critical in the treatment of mental health disorders. Some clients experiencing mental health disorders display conflict behaviour—for example, suicidal or self‐harming behaviour, threats of or actual aggression, and various psychotic behaviours—which presents significant challenges for care professionals. In inpatient mental health units, where interactions with mental health nurses are frequent, managing conflict behaviour is crucial to maintaining care quality and fostering therapeutic progress. This study aims to describe nurses' perspectives on fostering therapeutic relationships while working with clients who display conflict behaviour. Qualitative research was conducted in a specialised treatment setting for such clients by means of individual semi‐structured interviews and a focus group interview with nurses. The results show that the nurses' primary focus is on cooperating with clients and colleagues. Regardless of conflict behaviour, nurses consistently invite clients to cooperate. To do so, they must manage their own emotions and expectations, emphasise the clients' responsibility and reduce the opportunities for conflict behaviour. The unit structure helps nurses by reducing ambiguity regarding treatment policies and inconsistencies in nurse–client interactions and allows nurses and clients to experience feelings of safety. To work with conflict behaviour, nurses need to feel valued and supported by their colleagues and have adequate time and resources. In conclusion, this study shows how nurses foster therapeutic relationships with clients who display conflict behaviour by focusing on cooperation, structure and safety.
Reasons Explaining High Emergency Department Use in Patients With Mental Illnesses: Different Staff Perspectives
Authors: Fleury Marie‐Josée , Ferland Francine , Farand Lambert , Grenier Guy , Imboua Armelle , Gaida Firas 
Published: September 2024

ABSTRACTFor patients with mental illnesses (MIs), emergency departments (EDs) are often the entry point into the healthcare system, or their only resort for quickly accessing mental health treatment. A better understanding of the various barriers justifying high ED use among patients with MIs may help recommend targeted interventions that better meet their needs. This explorative qualitative study aimed to identify such barriers and the solutions brought forth to reduce ED use based on the perspectives of clinicians and managers working in EDs, other hospital departments or the community sector. Interviews were conducted between April 2021 and February 2022; 86 mental health professionals (22% were nurses) from four large urban ED sites in Quebec (Canada) were interviewed. Barriers were identified in relation to patient profiles, healthcare system and organisational features and professional characteristics. The key barriers that were found to explain high ED use were patients having serious MIs (e.g., psychotic disorders) or social issues (e.g., poverty), lack of coordination and patient referrals between EDs and other health services, insufficient access to mental health and addiction services and inadequacy of care. Very few solutions were implemented to improve care for high ED users. Better deployment of ED interventions in collaboration with outpatient care may be prioritised to reduce high ED use for patients with MIs. Improvements to the referral and transfer processes to outpatient care, particularly through care plans and case management programs, may be implemented to reduce high ED use and improve outpatient care among patients with multiple health and social needs.
Cyclosporine and hypertension
Authors: Curtis John J. 
Published: September 2024

AbstractTransplant physicians frequently encounter hypertension as a clinical problem since the widespread use of cyclosporine was established in 1983. While hypertension had been a problem before cyclosporine, this immunosuppressive agent is capable of causing a different form of post‐transplant hypertension. Cyclosporine‐induced hypertension doesn't appear to be mediated by the renin‐angiotensin system and may be associated with vascular volume expansion. The current study observes 50 kidney transplant patients documented to have hypertension while on cyclosporine therapy. Follow‐up of these patients suggests that the hypertensive state does not resolve with time as long as cyclosporine blood levels are maintained.
Ten‐ to 20‐year follow‐up of 123 consecutive HLA‐identical living‐related kidney transplants from the pre‐cyclosporine era
Authors: Fabrega Alfredo , Matas Arthur J. , Payne William D. , Fryd David S. , Dunn David L. , Sutherland David E. R. , Najarian John S. 
Published: September 2024

AbstractWe studied the long‐term morbidity and mortality of 123 consecutive HLA‐ID living‐related kidney transplants performed at a single institution more than 10 years ago. Type I diabetes was the cause of renal failure in 39% of patients; mean age at transplant was 32 ± 12 yr (range 2–64). Immunosuppression consisted of prednisone and Imuran; most patients received ALG perioperatively. For nondiabetics, 10‐, 15‐, and 20‐yr actuarial patient survival was 85%, 75%, and 68%; for diabetics. 10‐ and 15‐yr survival was 65% and 34% (p = 0.0015). Cardiovascular complications were the main cause of death in diabetics, affecting mostly males; sepsis, malignancy, and graft loss were the main cause of death in nondiabetics. Graft survival paralleled patient survival; 76% of grafts lost were due to patient death. Graft survival at 10 and 15 yr was 81% and 73% for nondiabetics; for diabetics, it was 63% and 24%, respectively (p = 0.0031). When death as a cause of graft loss was excluded, there was no difference between diabetics and nondiabetics. Mean serum creatinine at 10 yr was 1.4 ± 0.5. Thirty‐two patients (26%) had one or more acute rejection episodes, most of them occurring within the 1st yr posttransplant. Only 7 grafts have been lost either to acute (4) or chronic (3) rejection. Twenty‐four percent of the patients had no complications. Cardiovascular complications (28%) were the major cause of morbidity and mortality, affecting mostly diabetic males. Sepsis was also a significant problem (19.5%), CMV being the most common pathogen. Malignancy occurred in 12.2% of cases, affecting most frequently the skin. Liver dysfunction, mainly of viral etiology, was the cause of 2 deaths and contributed to several others. Nontraumatic osteonecrosis occurred in 4.9% of the patients; it tended to present in young patients soon after their transplant. We conclude that the long‐term results of HLA‐ID transplantation are excellent when compared to other options in patients with ESRD. Mortality due to the underlying disease (diabetes) and morbidity due to the immunosuppression remain as major obstacles to the long‐term survival and successful rehabilitation of these patients.
Hepatitis C infection in allogeneic bone marrow transplant recipients
Authors: Ljungman P. , Duraj V. , Magnius L. , Aschan J. , Lönnqvist B. , Ringdén O. , Gahrton G. 
Published: September 2024

AbstractAntibodies to hepatitis C virus (HCV) were determined 2 years after allogeneic bone marrow transplantation (BMT) in 83 long‐term survivors. Seven of 8 patients who seroconverted had signs of acute hepatitis which was more frequent than in patients who did not seroconvert (p < 0.01). Patients who seroconverted had received more platelet transfusions than those who did not (p = 0.013). The importance of HCV infection for long‐term liver function was determined in 69 of the 83 patients who were disease‐free during follow‐up and from whom sera were available. One patient was seropositive before BMT. Eight patients seroconverted to HCV after BMT. The median follow‐up time from BMT was 6.4 yr (range 2.9–7.3 yr) among the patients who seroconverted to HCV and 5.9 yr (range 2.3–9.6 yr) among the patient who did not seroconvert. Seven of 8 patients who seroconverted to HCV had persistent liver function abnormalities at the time of last follow‐up compared to 5 of 61 patients without evidence of HCV infection (p = 0.0001). Two of these patients had biopsy‐verified chronic active hepatitis. We conclude that HCV infection was a major cause of persistent liver abnormalities after allogeneic BMT.
Ganciclovir therapy for viral disease in liver transplant recipients
Authors: Stratta Robert J. , Shaefer Mark S. , Markin Rodney S. , Cushing Kathleen A. , Donovan Jeremiah P. , Wood R. Patrick , Langnas Alan N. , Reed Elizabeth C. , Woods Gail L. , Zetterman Rowen K. , Sorrell Michael F. , Pillen Todd J. , Shaw Byers W. 
Published: September 2024

AbstractWith current immunosuppressive regimens, viral disease has become an important source of morbidity after orthotopic liver transplantation. Over a 5‐year period, we retrospectively analyzed 422 liver transplants in 370 recipients (242 adults, 128 children) under cyclosporine and prednisone immunosuppression. A total of 108 patients (29.2%) received intravenous ganciclovir for viral disease, including 103 for cytomegalovirus (CMV) disease and 5 for Epstein‐Barr virus (EBV) disease. A total of 132 episodes of CMV disease (103 initial, 29 relapse) were treated with ganciclovir, including 22 patients with primary CMV disease. Opportunistic viral hepatitis was the most common clinical presentation of viral disease while recurrent disease often involved extra‐hepatic sites (especially pulmonary). The majority of cases of viral disease (both initial and relapse) were confined to single organ involvement (81.0%), at which time ganciclovir therapy was begun at a dose of 5 mg/kg twice daily for 2 weeks (with dosage adjustments for renal dysfunction). The initial diagnosis of CMV disease was made at a mean time after transplantation of 38 days, with a mean duration of ganciclovir therapy of 16 d. A prompt and lasting response, characterized by clinical improvement and negative viral cultures, was documented in 74 cases (71.8%). Fourteen additional patients were successfully retreated with ganciclovir for CMV relapse, so that CMV disease was ultimately controlled in 85.4% of cases. EBV disease was diagnosed at a mean time of 124 d after transplantation, with a mean duration of ganciclovir therapy of 39 d. Four cases (80%) were successfully treated. Overall patient survival after ganciclovir therapy is 79.0% with a mean follow‐up of 24 months. Adverse drug effects included significant leukopenia and thrombocytopenia in 7 patients (6.5%), with 2 requiring drug withdrawal. Conclusion: ganciclovir is a safe and effective agent for the treatment of viral disease in liver transplantat recipients. The availability of ganciclovir has resulted in successful treatment of viral disease without dramatic reductions in immunosuppression, thus permitting successful rescue of the patient and allograft with an acceptably low incidence of toxicity and viral relapse.