bluuebunny/crossref_metadata_2025_split huggingface dataset:
“It’s a delicate dance”: How informal caregivers experience the role and responsibilities of supporting someone living with a lower-grade glioma
Authors: Rimmer Ben , Balla Michelle , Dutton Lizzie , Burns Richéal , Araújo-Soares Vera , Finch Tracy , Lewis Joanne , Gallagher Pamela , Williams Sophie , Menger Fiona , Sharp Linda 
Published: October 2024

Abstract

Background
People with lower-grade gliomas (LGG) often require long-term support with a condition that causes substantial symptom burden and is likely to progress. Partners, family, and friends often become informal caregivers (IC), but the types of support they provide, and their experiences of this, have not been well investigated. We aimed to understand how ICs experience the role and responsibilities of supporting people with LGG.

Methods
This descriptive qualitative study used semistructured interviews to explore the role and responsibilities of a purposive sample of ICs across the United Kingdom, who currently, or in the past 5 years, support(ed) someone with an LGG. Interviews were audio-recorded and transcribed, and an inductive thematic analysis was conducted.

Results
Nineteen ICs were interviewed (mean age 54.6 years; 5 males/14 females). While most participants spoke about “Being a ‘carer’,” the level of care provided varied. Participants conveyed their experiences with “Adjusting for cognitive difficulties,” “Emotional protection,” “Supporting participation in daily life,” and “Healthcare advocacy.” ICs often felt “abandoned” by healthcare services to provide required care themselves, and reported experiences with “Balancing the challenges of caregiving,” including conflict with work/childcare. Issues around “Maintaining the care recipient’s independence” were interwoven throughout.

Conclusions
ICs of people with LGG provide wide-ranging support to help manage the consequences of the illness. Consideration of ways to help ICs with the challenges of fulfilling this role, particularly, balancing support provision without inhibiting the care recipient’s independence, could help improve outcomes for ICs and people with LGG.
Immune Reconstitution Inflammatory Syndrome in a Patient With Cutaneous Leishmaniasis and HIV: A Diagnostic Challenge for Clinicians Caring for a Migrant Population in the United States
Authors: De La Hoz Alejandro , Gadi Nirupa , Lopez Christina G , Barrera-Godinez Alejandro , Miller Nancy S , Bourque Daniel L , Brem Candice , Ozluk Ekin , Seth Geetika , Kimball Sarah , Taylor Jessica L 
Published: October 2024

Abstract
Migration routes determine exposure to endemic infections. We present a case of complex cutaneous leishmaniasis in a man with HIV infection who migrated to the United States from Haiti, where Leishmania is uncommon, acquiring leishmaniasis while on his journey via South America and Central America. His presentation included hyperpigmented, nonulcerated plaques and nodules on his extremities, chest, back, face, palms, and soles; initially he had no mucosal lesions. Infection with Leishmania panamensis was confirmed via polymerase chain reaction. He was prescribed bictegravir/tenofovir alafenamide/emtricitabine with rapid suppression of HIV and liposomal amphotericin B for diffuse cutaneous leishmaniasis with a limited initial response. He subsequently developed mucosal lesions in the setting of immune reconstitution and was retreated with amphotericin dosed for mucocutaneous disease. A thorough migration history was critical to diagnosis. This case highlights the different presentations of leishmaniasis in people with HIV and the elevated risk for treatment failure.
Effect of Universal Masking on Non–Severe Acute Respiratory Syndrome Coronavirus 2 Healthcare-Associated Respiratory Viral Infections
Authors: Munigala Satish , Ching Patrick R , Wood Helen , Waken R J , Fox Josephine , Gasama Heather , Russell Robert , Yarbrough Melanie L , Warren David K 
Published: October 2024

Abstract

Background
Respiratory viral infections are common and are a major cause of morbidity and mortality. We evaluated the impact of universal masking implemented during the coronavirus disease 2019 (COVID-19) pandemic on other healthcare-associated respiratory viral infections (HA-RIs) in an academic medical center.

Methods
A retrospective cohort study was performed among all inpatients aged ≥18 years admitted between 1 May 2019 and 30 June 2022. Universal masking was implemented in May 2020 at our hospital and state-level mask mandates had been lifted by May 2021. We evaluated and compared the HA-RI rates, adjusted for monthly community-onset viral infections, during the premasking period, universal masking period, and post–community mandate period.

Results
We identified 3015 patients (median age, 58 years; 48.0% males) with a positive respiratory viral test within 14 days prior to, or during, their hospitalization; 441 (14.6%) patients had an HA-RI. Rhinovirus/enterovirus (51.0%), parainfluenza virus (14.3%), coronaviruses (229E, OC43, HKU1, and NL63; 13.2%) and influenza (10.0%) were the predominant HA-RI viruses detected. The monthly HA-RI rate decreased 34.9% (95% confidence interval, 8.8%–51.8%) after the implementation of universal masking (0.71 premasking period vs 0.19 universal masking period vs 0.35 infections per 1000 patient-days in the post–community mandate period) while accounting for a drop in the community-onset respiratory viral infections using a structural time-series model analysis (P &lt; .001), with no significant change in HA-RI rates with the relaxation of community masking mandate.

Conclusions
Implementation of universal masking at our hospital was associated with a significantly reduced incidence of HA-RIs.
Evaluation of Primary Oral Vancomycin Prophylaxis Against Clostridioides difficile Infection During Autologous Stem Cell Transplantation
Authors: Williams Michael J , Atienza Sol , Franzen Erin , Rathod Heena , Mejaki Brittany , Graff Justin , Korman Sandra , Zouine Noah , Gul Zartash , Sana Sherjeel , Medlin Stephen , Buggy Brian P 
Published: October 2024

Abstract

Background
Evaluations of oral vancomycin prophylaxis (OVP) against Clostridioides difficile have been reported in stem cell transplant populations with short follow-up periods. The longest known duration of standardized follow-up post-OVP is 90 days within an allogeneic stem cell transplant population. In 2017, we implemented OVP 125 mg twice daily in autologous stem cell transplant (ASCT) recipients beginning the day of admission and continued until the day of discharge.

Methods
Patients who received an ASCT within our institution between 1 January 2012 and 31 December 2021 were included and separated into 2 groups based on the receipt of OVP. The primary study aim was to measure the incidence of C difficile infection (CDI) during the ASCT admission. A secondary aim was to evaluate for delayed CDI 180 days post-discharge. Other factors evaluated were prior history of CDI, use of systemic antimicrobials, and length of stay.

Results
Overall, 254 patients were evaluated and 58% received OVP, predominantly as primary prophylaxis (95%). Of the 18 patients who developed in-hospital CDI, 6 were in the OVP group versus 12 in the non-OVP cohort (4% vs 11%, P = .03). In the 180-day follow-up period, OVP use did not increase risk of developing CDI after discontinuation while in-hospital length of stay was identified as a significant factor.

Conclusions
The use of OVP significantly reduced the incidence of CDI during the in-hospital ASCT course without increasing CDI post-OVP use. These encouraging results should promote further research into the use of OVP in ASCT.
Opioid use and adverse health effects in breast cancer survivors
Authors: Haque Reina , Chen Lie Hong , Shi Jiaxiao , Gu Zheng , Brady-Rogers Moira , Chlebowski Rowan T , Hechter Rulin C 
Published: October 2024

Abstract

Background
Little information exists on adverse effects related to opioid use in breast cancer survivors following active cancer treatment, and no studies included an age-matched comparison group. Thus, we examined opioid use and risk of falls, fractures, lung problems, and cardiovascular events in breast cancer survivors in the years following active cancer treatment along with a comparison group.

Methods
We conducted a longitudinal cohort study 33 989 breast cancer survivors and 157 609 age-matched women without cancer. Rates of adverse events, and multivariable hazards ratios for association between opioid use and the adverse health effects were calculated.

Results
Women with breast cancer had greater opioid use (60% vs 48%); longer median opioid duration (18 vs 16 days); and were prescribed stronger opioids than the matched cohort over 5.6 median years of follow-up. In multivariable models, the risk of falls was 12% higher (HR, 95% CI, 1.12 [1.07-1.17]), and fracture risk was 56% (HR = 1.56 [1.48-1.65]) greater in women with breast cancer who used opioids vs the matched cohort unexposed to opioids. In an analysis restricted to women with breast cancer, opioid use was strongly associated with the risk of falls (HR = 1.74 [1.63-1.85]); fractures (HR = 2.10 [1.95-2.27]); lung problems (HR = 1.53 [1.43-1.64]); and cardiovascular events (HR = 1.70 [1.39-2.08]) than opioid non-use.

Conclusions
After active cancer treatment, opioid use and high dosage use were common in breast cancer survivors, and were associated with increased risk for falls, lung problems, fractures, and cardiovascular events. Findings underscore the need for careful monitoring of opioid use in these survivors and the exploration of alternative pain management strategies.
Therapeutic targets for gastrointestinal diseases: proteome-wide Mendelian randomization and colocalization analyses
Authors: Zhan Daqin , Yang Zhihao , Li Pengcheng , Pan Jun 
Published: October 2024

Abstract

Purpose
This study was aimed to identify serum proteins linked with gastrointestinal diseases by proteome-wide Mendelian randomization analysis.

Methods
We determined the casual relationship between 732 kinds of circulating proteins and the 24 kinds of gastrointestinal diseases via Mendelian randomization analysis.

Results
Four circulating proteins (FCGR3B, IL-12B, MAPKAPK2, and IL-23R) were associated with the occurrence of ulcerative colitis (UC), and IL23R was also correlated with risk of Crohn's disease (CD). Genetically predicted levels of IL23R were strongly correlated with the risk of UC and CD based on the high supporting evidence of colocalization analysis. Five circulating proteins (NOV, EFEMP1, ADGRE2, LCT, and SEMA3G) were associated with the risk of diverticulosis disease. With high supporting evidence of colocalization, genetically predicted levels of NOV and SEMA3G were inversely correlated with the risk of diverticulosis disease. Five circulating proteins (FUT3, FUT5, CRHBP, SULT2A1, and QPCTL) were associated with the occurrence of cholelithiasis. With high supporting evidence of colocalization, genetically predicted levels of FUT3 and CRHBP were inversely correlated with the risk of cholelithiasis.

Conclusions
The proteome-wide Mendelian randomization investigation identified several circulating proteins associated with the risk of UC, CD, diverticular disease and cholelithiasis, which reinforced the understanding of molecular pathogenesis and design of therapeutic targets.
Peri-operative strategy in resuscitation of unstable injured surgical patients: a primer
Authors: Abdulkhaleq Mamalchi Shahad , Matar Maher , Bass Gary Alan 
Published: October 2024

Abstract

Background
Trauma remains a leading cause of death, both for individuals under 40 in North America, and globally, where it contributes to ~10% of deaths annually. Thoughtful, timely, balanced resuscitation, especially in the peri-operative period for unstable injured surgical patients, is vital for optimizing outcomes. The advanced trauma life support protocol plays a pivotal role in early evaluation and management, emphasizing hemorrhage control and resuscitation strategies.

Objective
This narrative review provides a structured, evidence-based framework aimed at enhancing the educational experience of surgical trainees. It outlines key principles in peri-operative trauma resuscitation, emphasizing timely intervention, goal-directed fluid therapy, and damage control surgery (DCS) to improve patient outcomes.

Methods
A comprehensive Scale for Quality Assessment of Narrative Review Articles -guideline compliant literature search was conducted using PubMed and Google Scholar for English-language articles published between January 2000 and February 2024. The search included relevant medical subject headings terms. Additional studies were identified from reference lists. Extracted data were reviewed and organized using thematic analysis, focusing on historical perspectives, evidence-based practices, and the concept of DCS.

Results
Key findings from the 55 relevant studies selected underscore the importance of balanced fluid and blood product administration, the use of permissive hypotension in hemorrhagic shock, and the application of DCS principles. This review highlights educational strategies that foster a deeper understanding of trauma resuscitation practices, offering practical insights through case studies and technological innovations.

Conclusion
This review serves as an educational resource for surgical trainees, equipping them with a robust understanding of evidence-based trauma resuscitation. By integrating historical context, modern practices, and emerging technologies, the review aims to enhance both the theoretical knowledge and practical skills necessary for managing unstable trauma patients. Emphasis is placed on interdisciplinary teamwork, continuous education, and personalized resuscitation strategies to improve clinical outcomes.
Serial assessment of ultrasound sensitivity and scores in patients with giant cell arteritis before and 3 and 10 days after treatment
Authors: Hansen Morten , Hansen Ib Tønder , Keller Kresten Krarup , Therkildsen Philip , Hauge Ellen-Margrethe , Nielsen Berit Dalsgaard 
Published: October 2024

Abstract

Objectives
The objective of this study was to evaluate the sensitivity and scores of vascular US before and after initiating glucocorticoid (GC) treatment in patients with new-onset giant cell arteritis (GCA).

Methods
Treatment-naïve patients with GCA were prospectively included. 18F-fluorodeoxyglucose (18F-FDG) PET/CT, US and temporal artery (TA) biopsy were performed in all patients. US was repeated 3 and 10 days after GC commencement. Intima-media thickness and presence of halo signs were assessed. Sonographers were unblinded to the clinical data. The OMERACT GCA Ultrasonography score (OGUS) and the halo count (HC) were calculated.

Results
Forty-eight patients were included. Before GC exposure, US sensitivity was 94% (95% CI: 83–99), 73% (95% CI: 58–85), and 71% (95% CI: 56–83) when assessing all vessels, TAs, and large vessels (LVs), respectively. At day 3 and 10, the overall US sensitivity was 92% (95% CI: 78–98, P = 0.16) and 83% (95% CI: 69–92, P = 0.10), respectively. At day 10, the TA-US and LV-US sensitivity was 53% (95% CI: 38–68, P &lt; 0.01) and 60% (95% CI: 44–74, P = 0.13), respectively. The median OGUS decreased from 1.06 (IQR 0.83–1.24) to 0.95 (IQR 0.78–1.14, P &lt; 0.01) and 0.90 (IQR 0.73–1.01, P &lt; 0.001) after 3 and 10 days, respectively. The median HC decreased from 3 (IQR 2–5) to 2 (IQR 1–4, P &lt; 0.01) after 10 days.

Conclusion
The vasculitic US findings expressed by OGUS diminished after 3 days of GC treatment. TA-US sensitivity decreased after 10 days, whereas LV-US was less likely to change, highlighting the importance of LV-assessment. Consistent with the EULAR recommendations, these findings encourage prompt US assessment, preferably within 3 days, to ensure an accurate diagnosis.
Exploring the Interactions Between Psychotic Symptoms, Cognition, and Environmental Risk Factors: A Bayesian Analysis of Networks
Authors: Bosma Minke J , Marsman Maarten , Vermeulen Jentien M , Huth Karoline B S , de Haan Lieuwe , Alizadeh Behrooz Z , Simons Claudia J P , Schirmbeck Frederike 
Published: October 2024

Abstract

Background and Hypothesis
Psychotic disorders (PDs) have huge personal and societal impact, and efforts to improve outcomes in patients are continuously needed. Environmental risk factors (ERFs), especially modifiable risk factors, are important to study because they pose a target for intervention and prevention. No studies have investigated ERFs, cognition, and psychotic symptoms together in a network approach.

Study Design
We explored interactions between 3 important ERFs (tobacco smoking, cannabis use, and childhood trauma), 6 cognitive domains, and 3 dimensions of symptoms in psychosis. From the Genetic Risk and Outcome of Psychosis (GROUP) cohort, we used data from patients, siblings, and healthy controls to construct networks using Bayesian analyses of all 12 variables. We constructed networks of the combined sample and of patients and siblings separately.

Study Results
We found that tobacco smoking was directly associated with cognition and psychotic symptoms. The cognitive variable processing speed was the most central node, connecting clusters of psychotic symptoms and substance use through the variables of positive symptoms and tobacco smoking. Comparing the networks of patients and siblings, we found that networks were relatively similar between patients and siblings.

Conclusions
Our results support a potential central role of processing speed deficits in PDs. Findings highlight the importance of integrating tobacco smoking as potential ERFs in the context of PDs and to broaden the perspective from cannabis discontinuation to smoking cessation programs in patients or people at risk of PDs.
Reproductive safety of STING agonists MSA-2 and manganese-MSA-2
Authors: Cai Ya , He Tian , Yang Tao , Li Yating , Yi Lirong , Li Wenqing , Zhou Peng 
Published: October 2024

Abstract

Background
MSA-2, as an oral molecule for activating STING signaling pathway to cure the tumor entering clinical trials. The toxicity of MSA-2 has aroused wide concern, especially the reproductive toxicity can not be ignored.

Objectives
We synthesized the STING agonist (MSA-2) and its derivative manganese-MSA-2 (MSA-2-Mn) and investigated the reproductive toxicity.

Methods
We evaluated the reproductive effects of MSA-2 and MSA-2-Mn in female mice under the administration alone and on the reproductive system of male mice in the presence or absence of combined radiation.

Results
Results suggested that MSA-2 and MSA-2-Mn have negligible reproductive toxicity in healthy adults. Conclusions: This provides new ideas to enhance the efficacy of immunotherapy, as well as favorable evidence for future systemic dosing in patients of reproductive age and clinical trials of immunotherapy.
CD74+ fibroblasts proliferate upon mechanical stretching to promote angiogenesis in keloids
Authors: Zhang Jingheng , Li Shuyao , Kuang Chunmei , Shen Yunfan , Yu Haibin , Chen Fang , Tang Ruijun , Mao Song , Lv Lu , Qi Min , Zhang Jianglin , Yuan Kai 
Published: October 2024

AbstractThe healing of human skin wounds is susceptible to perturbation caused by excessive mechanical stretching, resulting in enlarged scars, hypertrophic scars, or even keloids in predisposed individuals. Keloids are fibro‐proliferative scar tissues that extend beyond the initial wound boundary, consisting of the actively progressing periphery and the quiescent center. The stretch‐associated outgrowth and enhanced angiogenesis are two features of the periphery of keloids. However, which cell population is responsible for transducing the mechanical stimulation to the progression of keloids remains unclear. Herein, through integrative analysis of single‐cell RNA sequencing of keloids, we identified CD74+ fibroblasts, a previously unappreciated subset of fibroblasts with pro‐angiogenic and stretch‐induced proliferative capacities, as a key player in stretch‐induced progression of keloids. Immunostaining of keloid cryosections depicted a predominant distribution of CD74+ fibroblasts in the periphery, interacting with the vasculature. In vitro tube formation assays on purified CD74+ fibroblasts ascertained their pro‐angiogenic function. BrdU assays revealed that these cells proliferate upon stretching, through PIEZO1‐mediated calcium influx and the downstream ERK and AKT signaling. Collectively, our findings propose a model wherein CD74+ fibroblasts serve as pivotal drivers of stretch‐induced keloid progression, fueled by their proliferative and pro‐angiogenic activities. Targeting the attributes of CD74+ fibroblasts holds promise as a therapeutic strategy for the management of keloids.
Protocol of clinical population pharmacokinetics/pharmacodynamics analysis of alkaloids from the leaves of Alstonia scholaris in acute bronchitis patients
Authors: He Chunying , Cao Weiyi , Zhang Wantong , Zhao Yunli , Luo Xiaodong , Li Rui 
Published: October 2024

Objective:
To validate whether orally administered capsules of alkaloids from the leaves of Alstonia scholaris (CALAS) can improve the clinical indices of acute bronchitis and to investigate the alterations in the relationship between its composition and pharmacodynamic markers, thereby providing a clinical reference for the administration of this medication.

Methods:
This is a prospectively planned, blinded, placebo-controlled, parallel-grouped clinical trial with aggregated population pharmacokinetics/pharmacodynamics (PPK/PPD) data. A total of 55 subjects will be randomly allocated into 4 arms; specifically, 10 of the 55 subjects will be selected randomly for the placebo arm, and will be orally administered placebo (Tid), and 45 subjects will be randomly assigned to CALAS treatment groups (20 mg, 40 mg, and 80 mg Tid, at 15 subjects per group). The medication, presence of cough and phlegm, as well as body temperature of every subject, will be recorded daily during treatment. About 3–4 blood samples will be collected from each subject at the following points for PPK/PPD parameters analysis: at pre-dose (0 h) and post-dose at 15 minutes, 40 minutes, 1 hour, 1.5 hours, 2 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours, 30 hours, and 48 hours after last dosing. All the subjects will be subjected to a laboratory examination and efficacy evaluation on day 8.

Discussion:
A new integrating strategy to explore the relationship among drug components, action pathways, and clinical efficacy will be established through this study. We aim to explore the mechanism of action of CALAS in the treatment of acute bronchitis on the premise of definite active ingredients and reliable clinical efficacy. It is difficult to enroll patients in classic pharmacokinetics research because it adopts an intensive sampling method, and it cannot quantify the variability of pharmacokinetics parameters (intraindividual variation, interindividual variation, and weekly variation). Moreover, the extrapolation and prediction of dosage regimens in different species and populations cannot be achieved. Therefore, the PPK/PPD method, which takes advantage of sparse data (3–5 time points sampling per patient), is adopted to determine the measurable pathologic and physiological factors that can influence dose concentration to guide reasonable dose adjustment toward achieving optimal clinical effects.
Ocular Ultrasound, a neglected tool in the diagnosis of central retinal artery occlusion.
Authors: Sukkarieh Georges , Bonk William , Fisher Yale L , Haddock Luis J. 
Published: October 2024

Purpose:
To discuss the practical utility of ocular ultrasound in central retinal artery occlusion (CRAO).

Methods:
Ocular ultrasound was obtained in 4 patients with CRAO using a 20 MHz Annular Array Probe of the ABSolu (Quantel Medical, Texas, USA) ultrasound machine.

Results:
The causative embolus occluding the central retinal artery was detected on ocular ultrasound imaging in four patients with CRAO.

Conclusion:
Ocular ultrasound, including newer generation, higher frequency ultrasound probes, aids in the detection of the “retrobulbar spot sign”, a finding that seems to be related to embolic central retinal artery occlusion. This sign will orient investigations towards finding an embolic source.