bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the COVID-19 vaccine cause a disease flare in patients with primary Sjögren’s syndrome? A Cross-Sectional Study
Authors: Al Darwish Lama A. , Khalayli Naram M. , A. Almajzoub Rahaf , Kudsi Maysoun 
Published: September 2024

Background:
Data regarding the efficacy of the COVID-19 (coronavirus disease) vaccine is limited in rheumatic disease patients. We aimed to study the post-COVID-19 vaccine disease exacerbation prevalence and characteristics in a sample of Primary Sjogren Syndrome (PSS) patients in Syria.

Patients and Methods:
We evaluated 32 PSS (Primary Sjogren Syndrome) patients. The pattern of vaccine received was evaluated, and the ESSDAI (Sjögren’s syndrome disease activity index). Activity score was used to assess the disease activity before and after vaccination. 32 patients had the first and second COVID-19 vaccine, 21 received a third dose, and 20 received the mRNA (Messenger ribonucleotide antibody vaccine) vaccine. The mean age of patients was 52 years, 22 patients were female, with a median disease duration of 7 years.

Results:
Respectively PSS flare was reported by 18 after the first vaccine dose, 15 after the second vaccine dose, and 13 after the third vaccine dose, typically appearing as musculoskeletal symptoms such as arthralgia/arthritis, without changing their medication. Eight patients discontinued the drug during vaccination. Seven patients used analgesics. Side effects were significantly higher in the mRNA vaccine group and in the first and second doses of the vaccine. There was no statistically significant difference in PSS exacerbation according to the pattern of vaccines.

Conclusion:
Our study highlights increased PSS flare risk post-COVID-19 vaccination, especially in high disease activity patients. Most flares were mild, mainly musculoskeletal symptoms. Side effects were higher with mRNA vaccines and initial doses. Despite risks, vaccination is recommended, prioritizing stable disease states for PSS patients.
Long-term impact of scheduled regular endoscopic interventions for patients with primary sclerosing cholangitis
Authors: Özdirik Burcin , Veltzke-Schlieker Wilfried , Nicklaus Jule Marie , Berger Hilmar , Schmidt Daniel , Leonhardt Silke , Penndorf Volker , Adler Andreas , Müller Tobias , Wree Alexander , Tacke Frank , Sigal Michael 
Published: September 2024

Background:Primary sclerosing cholangitis (PSC) is associated with biliary obstructions that can require endoscopic retrograde cholangiopancreatography (ERCP). While the beneficial effects of ERCP are well documented, follow-up interventional strategies are less defined, and their long-term impact is debated.Methods:We evaluated the outcome of a scheduled program of ERCP-guided interventions that have been developed and implemented at our tertiary liver center for more than 20 years. Within our center, follow-up ERCPs were performed at regular intervals to treat previously detected morphological stenosis independent of clinical symptoms. We calculated the transplant-free survival (TFS) of patients who were enrolled in the scheduled ERCP program and compared it to patients who received follow-up ERCPs only on clinical demand. Moreover, we documented the occurrence of hepatic decompensation, recurrent cholangitis episodes, hepatobiliary malignancies, and endoscopy-related adverse events.Results:In our retrospective study, we included 201 patients with PSC who all received an ERCP. In all, 133 patients received scheduled follow-up ERCPs and 68 received follow-up ERCPs only on demand. The rates of TFS since initial diagnosis (median TFS: 17 vs. 27 y;P= 0.020) and initial presentation (median TFS: 16 vs. 11 y;P= 0.002) were higher in patients receiving scheduled versus on-demand ERCP. Subgroup analysis revealed that progression in cholangiographic findings between the first and second ERCP was associated with a poorer outcome compared to patients without progression (17 y vs. undefined;P= 0.021).Conclusion:In conclusion, we report the outcome data of a scheduled follow-up ERCP program for patients with PSC in an experienced high-volume endoscopy center. Our data suggest the initiation of multicenter randomized controlled prospective trials to explore the full potential of regular endoscopic follow-up treatment as a strategy to prevent disease progression in patients with PSC.
Treatment mechanism and outcome decoupling effects in cognitive therapy, mindfulness-based stress reduction, and behavior therapy for chronic pain
Authors: Gerhart James , Burns John W. , Thorn Beverly , Jensen Mark , Carmody James , Keefe Francis 
Published: September 2024

Abstract
Findings suggest that cognitive therapy (CT), mindfulness-based stress reduction (MBSR), and behavior therapy (BT) for chronic pain produce improvements through changes in putative mechanisms. Evidence supporting this notion is largely based on findings showing significant associations between treatment mechanism variables and outcomes. An alternative view is that treatments may work by reducing or decoupling the impact of changes in mechanism variables on changes in outcomes. We examined the degree to which relationships between previous changes in potential treatment mechanisms and subsequent changes in outcomes changed as treatment progressed and vice versa. Cognitive therapy, MBSR, BT, and treatment as usual (TAU) were compared in people with chronic low back pain (N = 521). Eight individual sessions were administered with weekly assessments of putative treatment mechanisms and outcomes. Lagged analyses revealed mechanism × session number interactions and outcome × session number interactions, such that associations between mechanism and outcome variables were strong and significant in the first third of treatment, but weakened over time and became nonsignificant by the last third of treatment. These effects were similar across treatment conditions but did not emerge among people undergoing TAU. Results suggest that during the course of CT, MBSR, and BT, the links between changes in treatment mechanism variables became decoupled from subsequent changes in outcomes and vice versa. Thus, starting by midtreatment and continuing into late treatment, participants may have learned through participation in the treatments that episodes of maladaptive pain-related thoughts and/or spikes in pain need not have detrimental consequences on their subsequent experience.
Implementation of a Novel Seizure Assessment Tool for Unified Seizure Evaluation Improves Nurse Response
Authors: Cubria Thanh , Nairon Emerson B. , Landers Jami , Joseph Sonia , Chandra Mishu , Denbow Maria E. , Hays Ryan , Olson DaiWai M. 
Published: September 2024

ABSTRACT

BACKGROUND: Ictal and postictal testing is an essential aspect of clinical care when diagnosing and treating seizures. The epilepsy monitoring unit (EMU) has standard operating procedures for nursing care during and after seizure events, but there is limited interrater reliability. Streamlining ictal and postictal testing processes may enhance care consistency for patients in the EMU unit. The purpose of this study was to create an ictal and postictal seizure assessment tool that would increase the consistency of nursing assessment for EMU patients. METHODS: This prospective study had 4 phases: baseline assessment, instrument development, staff education, and field testing. During baseline assessment, an advanced practice provider and an epilepsy fellow graded nurse ictal and postictal assessment via survey questions. After instrument development, education, and implementation, the same survey was administered to determine if nursing consistency in assessing seizure events improved. The tool used in this study was created by a team of clinical experts to ensure consistency in the assessment of seizure patients. RESULTS: A total of 58 first seizure events were collected over a 6-month intervention period; 27 in the pretest and 31 in the posttest. Paired t test analyses revealed significant improvement in the clinical testing domains of verbal language function (P < .005), motor function (P < .0005), and item assessment order (P < .005) postintervention. There was nonsignificant improvement in the domains of responsiveness (feeling [P = .597], using a code word [P = .093]) and visual language function (P = .602). CONCLUSION: The data captured in this study support the need for this instrument. There is strong need to increase consistency in assessing seizure events and to promote continued collaboration among clinical teams to enhance care to EMU patients. Validation of this instrument will further improve team collaboration by allowing nurses to contribute to their fullest extent.
Effects of Ankle-Foot Orthoses on Gait Parameters in Children with Diplegic Cerebral Palsy Based on Kinect Analysis: A Preliminary Study
Authors: Suharti Amien , Yusviani Hafizia Asri , Alifprilia Savira Widha , Nadhif Muhammad Hanif , Utama Fakhri Rekha 
Published: September 2024

ABSTRACT

Introduction
An objective, child-friendly tool is needed for physical rehabilitation intervention and evaluation of cerebral palsy children with permanent neuromotor disorders affecting movement and postures and causing gait deviation.

Materials and Methods
This study describes the feature of gait parameters in children with spastic cerebral palsy (SCP) using Microsoft Kinect and compares several spatiotemporal gait parameters before and after the use of ankle-foot orthoses (AFOs). The parameters measured were cadence and stride length. The types of orthotic devices used were hinged ankle-foot orthosis (HAFO) and supramalleolar orthosis (SMO).

Results
The gait analysis results showed different effects in stride length and cadence on each subject after using the orthotic devices. The effects also were significantly different between each patient (P < 0.050).

Conclusions
Kinect v2.0 may be more valid and comfortable for evaluating gait AFOs in cerebral palsy children.

Clinical Relevance
Improvement gait in cerebral palsy after use AFO could be evaluated by Kinect v2.0 as an objective tool and friendly for children.
Tumor-informed circulating tumor DNA in urothelial carcinoma: a promising novel biomarker
Authors: Ben-David Reuben , Mehrazin Reza , Attalla Kyrollis , Wiklund Peter , Sfakianos John P. 
Published: September 2024

Purpose of review
Tumor-informed circulating tumor DNA (ctDNA) is an emerging biomarker in urothelial carcinoma. Recent clinical trials have investigated the integration of ctDNA into clinical decision-making in patients with muscle-invasive bladder cancer, their findings suggest that ctDNA may potentially revolutionize the way we stratify patients to different treatment modalities.

Recent findings
ctDNA informed from TURBT specimens was found to be prognostic of disease outcomes among patients with localized nonmetastatic bladder cancer. Detectable precystectomy ctDNA status was associated with worse survival outcomes. Additionally, ctDNA status was predictive of adverse disease on radical cystectomy, including the likelihood of disease upstaging, lymph node involvement, and having a locally advanced disease (≥pT3a). In the postcystectomy minimal residual disease (MRD) period, ctDNA status may refine patient selection to adjuvant therapy, and if validated by ongoing clinical trials, patients with undetectable postcystectomy ctDNA status may forgo adjuvant treatment, regardless of pathological stage. On the contrary, patients with pre or postcystectomy detectable ctDNA status may benefit from treatment intensification.

Summary
The integration of ctDNA in clinical decision-making has the potential to revolutionize the way we manage urothelial carcinoma by refining patient selection to different treatment modalities. This approach could ultimately lead to personalization of oncological care, with the potential to reduce both treatment-related and financial toxicity.
Belatacept Versus Tacrolimus for Kidney Transplant Recipients of Deceased Donors With Acute Kidney Injury: US National Database Study
Authors: Yamauchi Junji , Raghavan Divya , Jweehan Duha , Oygen Suayp , Marineci Silviana , Hall Isaac E. , Molnar Miklos Z. 
Published: September 2024

Background.
It is unclear whether kidney grafts from deceased donors with acute kidney injury (AKI) are more vulnerable to calcineurin inhibitor nephrotoxicity, and whether de novo use of belatacept is more beneficial than tacrolimus for recipients of these types of kidney transplants.

Methods.
In this retrospective cohort study using the US Organ Procurement and Transplantation Network database, we created 1:4 matches with highly similar characteristics for recipients of AKI-donor kidneys receiving belatacept versus tacrolimus for initial maintenance immunosuppression and compared outcomes for graft function, patient and graft survival, and rejection.

Results.
The matched cohort consisted of 567 and 2268 recipients administered belatacept and tacrolimus, respectively. Posttransplant estimated glomerular filtration rate was significantly higher in the belatacept group at 6 mo (58.2 ± 24.2 versus 54.6 ± 21.6 mL/min/1.73 m2, P < 0.001); however, the between-group difference did not reach statistical significance at 12 mo (57.2 ± 24.3 versus 55.7 ± 22.2 mL/min/1.73 m2, P = 0.057). Median follow-up periods were 3.2 and 3.1 y for patient and graft survival, respectively. There were no significant differences between belatacept versus tacrolimus for mortality (hazard ratio 1.18 [95% confidence interval, 0.95-1.47], P = 0.14) or death-censored graft failure (hazard ratio 1.17 [0.85-1.61], P = 0.33). Rejection rate within 12 mo was significantly higher in the belatacept group (13% versus 7%, P < 0.001).

Conclusions.
In this matched cohort study, initial use of belatacept for AKI-donor kidney recipients was associated with small benefits in early graft function when compared with tacrolimus. Although rejection risk was significantly higher in recipients administered belatacept, patient and graft survival were not significantly different between groups.
A Third COVID-19 Vaccine Dose in Kidney Transplant Recipients Induces Antibody Response to Vaccine and Omicron Variants but Shows Limited Ig Subclass Switching
Authors: Lee Jenny M. , Sachithanandham Jaiprasath , Lee John S. , Shapiro Janna R. , Li Maggie , Sitaris Ioannis , Peralta Stephanie R. , Wouters Camille , Cox Andrea L. , Segev Dorry L. , Durand Christine M. , Robien Mark , Tobian Aaron A.R. , Karaba Andrew H. , Blankson Joel N. , Werbel William A. , Pekosz Andrew , Klein Sabra L. 
Published: September 2024

AbstractSolid organ transplant recipients (SOTRs) suffer more frequent and more severe infections due to their compromised immune responses resulting from immunosuppressive treatments designed to prevent organ rejection. Pharmacological immunosuppression can adversely affect immune responses to vaccination. A cohort of kidney transplant recipients (KTRs) received their third dose of ancestral, monovalent COVID-19 vaccine in the context of a clinical trial and antibody responses to the vaccine strain, as well as to Omicron variants BA.1 and BA.5 were investigated and compared with healthy controls. Total IgG and live virus neutralizing antibody titers were reduced in KTRs compared to controls for all variants. KTRs displayed altered IgG subclass switching, with significantly lower IgG3 antibodies. Responses in KTRs were also very heterogeneous, with some individuals showing strong responses but a significant number showing no Omicron-specific neutralizing antibodies. Taken together, immune responses after COVID-19 vaccination in KTRs were not only lower than healthy controls but highly variable, indicating that simply increasing the number of vaccine doses alone may not be sufficient to provide greater protection in this population.ImportanceThis study addresses the challenges faced by kidney transplant recipients (KTRs) in mounting effective immune responses against COVID-19. By evaluating the antibody responses to a third dose of monovalent mRNA COVID-19 vaccine and its effectiveness against Omicron subvariants (BA.1 and BA.5), this study reveals significant reductions in both binding and neutralizing antibodies in KTRs compared to healthy controls. The research highlights altered IgG subclass switching and heterogeneous responses within the KTR population. Reduced recognition of variants, coupled with differences in IgG subclasses, decreases both the quality and quantity of protective antibodies after vaccination in KTRs. These findings underscore the need for tailored vaccination strategies for immunosuppressed populations such as KTRs. Alternative formulations and doses of COVID-19 vaccines should be considered for people with severely compromised immune systems, as more frequent vaccinations may not significantly improve the response, especially regarding neutralizing antibodies.
The influence of visual attention on letter recognition and reading acquisition in Arabic
Authors: Ghandour Alaa , Trouche Emmanuel , Guillo Dominique , Valdois Sylviane 
Published: September 2024

AbstractThe present study sets out to explore the cognitive underpinnings of reading acquisition in Arabic. Previous studies have identified phonological awareness and rapid automatized naming as early predictors. However, the graphic complexity of Arabic letters imposes particular constraints on the visual system, which should mobilize visual attention. To test this hypothesis, 101 Arabic-speaking children who just began their formal reading instruction in Arabic were administered tests of syllable and word reading. Their nonverbal reasoning, vocabulary, phonological awareness, rapid automatized naming and letter knowledge were measured. Their visual attention was estimated through tasks of visual attention span. We found that phonological awareness, visual attention span and letter knowledge were associated with reading outcomes. However, regression analyses showed that the relationship between visual attention span and reading disappeared when letter knowledge was taken-into-account. We used structural equation modeling to examine the direct and indirect effects of visual attention span to reading. Results showed that phonological awareness and letter knowledge were significant and independent predictors of reading while visual attention span contributed only indirectly through its influence on letter knowledge. Our findings suggest that beginning readers rely on visual attention to identify and discriminate visually-complex Arabic letters. In turn, more efficient letter identification in children with higher visual attention facilitates reading acquisition. These findings support the cognitive models of word recognition that include visual attention as a component of the reading system. They open new perspectives for cross-language studies, suggesting that visual attention might contribute differently to reading depending on the orthographic system. They also provide a foundation for innovative teaching methodologies in Arabic language education.
In vivoImaging and Pharmacokinetics of Percutaneously Injected Ultrasound and X-ray Imageable Thermosensitive Hydrogel loaded with Doxorubicin versus Free Drug in Swine
Authors: Delgado Jose F. , Negussie Ayele H. , Varble Nicole A. , Mikhail Andrew S. , Arrichiello Antonio , Borde Tabea , Saccenti Laetitia , Bakhutashvili Ivane , Owen Joshua W. , Morhard Robert , Karanian John W. , Pritchard William F. , Wood Bradford J. 
Published: September 2024

AbstractIntratumoral injections often lack visibility, leading to unpredictable outcomes such as incomplete tumor coverage, off-target drug delivery and systemic toxicities. This study investigated an ultrasound (US) and x-ray imageable thermosensitive hydrogel based on poloxamer 407 (POL) percutaneously delivered in a healthy swine model. The primary objective was to assess the 2D and 3D distribution of the hydrogel within tissue across three different needle devices and injection sites: liver, kidney, and intercostal muscle region.Secondly, pharmacokinetics of POL loaded with doxorubicin (POLDOX) were evaluated and compared to free doxorubicin injection (DOXSoln) with a Single End Hole Needle. Utilizing 2D and 3D morphometrics from US and x-ray imaging techniques such as Computed Tomography (CT) and Cone Beam CT (CBCT), we monitored the localization and leakage of POLDOX over time. Relative iodine concentrations measured with CBCT following incorporation of an iodinated contrast agent in POL indicated potential drug diffusion and advection transport. Furthermore, US imaging revealed temporal changes, suggesting variations in acoustic intensity, heterogeneity, and echotextures. Notably, 3D reconstruction of the distribution of POL and POLDOX from 2D ultrasound frames was achieved and morphometric data obtained. Pharmacokinetic analysis revealed lower systemic exposure of the drug in various organs with POLDOX formulation compared to DOXSoln formulation. This was demonstrated by a lower area under the curve (852.1 ± 409.1 ng/mL·h vs 2283.4 ± 377.2 ng/mL·h) in the plasma profile, suggesting a potential reduction in systemic toxicity. Overall, the use of POL formulation offers a promising strategy for precise and localized drug delivery, that may minimize adverse effects. Dual modality POL imaging enabled analysis of patterns of gel distribution and morphology, alongside of pharmacokinetics of local delivery. Incorporating hydrogels into drug delivery systems holds significant promise for improving the predictability of the delivered drug and enhancing spatial conformability. These advancements can potentially enhance the safety and precision of anticancer therapy.
Incidence of postoperative acute kidney injury is higher in men than women after colorectal surgery – PROSACC: a posthoc analysis of a global, multicenter, randomized controlled trial
Authors: Frithiof Robert , Enlund Mats , Franzén Stephanie 
Published: September 2024

ABSTRACTPostoperative acute kidney injury (AKI) is a common postoperative complication. Approximately 7% of the general, elective, non-cardiac surgical population develop AKI after surgery. The female sex was previously believed to be associated with higher incidence of AKI however more recent literature implies that men have higher risk for AKI. Estrogen has been suggested to have renoprotective properties. We therefore aimed to analyze AKI incidence after colorectal cancer resection surgery in men and women on a global, multicenter, level.In Sweden and China, a total pf 3255 patients were included in this posthoc analysis based on the CAN-trial (Cancer and Anesthesia: Survival After Radical Surgery - a Comparison Between Propofol or Sevoflurane Anesthesia). Presence of AKI was defined according to KDIGO (Kidney Disease: Improving Global Outcome) criteria for changes in plasma creatinine compared with preoperative values.After colorectal surgery, 8% of the patients had developed AKI within 10 postoperative days. Within the 4–10-day postoperative timeframe, twice as many men as women (8% vs 4%) had developed AKI and women had a significantly lower likelihood of developing AKI (OR 0.4 [0.2-0.8], p=0.009). In general, the cumulative proportion of developing AKI within 10 days postoperatively was significantly higher in men than women (p=0.037). Moreover, older patients (60+ years) had significantly higher incidence of AKI than those younger than 60 years. This trend was evident in both men and women.To our knowledge, this is the first ever global, multicenter, randomized controlled trial reporting a sex-difference in AKI incidence after colorectal surgery. Our posthoc analysis reinforces the notion that the male sex is a risk factor for postoperative AKI.