bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Utility of SARS-CoV-2 Nucleocapsid Antigenemia: A Meta-analysis
Authors: Damhorst Gregory L , Martin Sydney E , Wilber Eli , Verkerke Hans , Goodman Michael , Lam Wilbur A 
Published: October 2024

Abstract

Background
Studies of the diagnostic performance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid antigen in blood (antigenemia) have reached variable conclusions. The potential utility of antigenemia measurements as a clinical diagnostic test needs clarification.

Methods
We performed a systematic review of Pubmed, Embase, and Scopus through July 15, 2023, and requested source data from corresponding authors.

Results
Summary sensitivity from 16 studies (4543 cases) sampled at ≤14 days of symptoms was 0.83 (0.75–0.89), and specificity was 0.98 (0.87–1.00) from 6 studies (792 reverse transcription polymerase chain reaction–negative controls). Summary sensitivity and specificity for paired respiratory specimens with cycle threshold values ≤33 were 0.91 (0.85–0.95) and 0.56 (0.39–0.73) from 10 studies (612 individuals). Source data from 1779 cases reveal that &gt;70% have antigenemia 2 weeks following symptom onset, which persists in &lt;10% at 28 days. The available studies suffer from heterogeneity, and Omicron-era data are scarce.

Conclusions
Nucleocapsid antigenemia currently has limited utility due to limitations of existing studies and lack of Omicron-era data. Improved study designs targeting potential clinical uses in screening, surveillance, and complex clinical decision-making—especially in immunocompromised patients—are needed.
Recent treatment patterns and real-world survival following first-line anti-PD-L1 treatment for extensive-stage small cell lung cancer
Authors: Shaw Jaime , Pundole Xerxes , Balasubramanian Akhila , Anderson Erik S , Pastel Malaika , Bebb D Gwyn , Jiang Tony , Martinez Pablo , Ramalingam Suresh S , Borghaei Hossein 
Published: October 2024

Abstract

Background
The landscape of small cell lung cancer (SCLC) has changed since the 2019 and 2020 approvals of anti-PD-L1 atezolizumab and durvalumab for first-line (1L) treatment in combination with chemotherapy. We studied treatment patterns and real-world overall survival (rwOS) following 1L-3L therapy.

Patients and Methods
A nationwide electronic health record (EHR)-derived de-identified database was used to describe treatment patterns, characteristics, and survival of patients with extensive-stage (ES)-SCLC by 1L anti-PD-L1 treatment. Patients with ES-SCLC who initiated ≥1 line of systemic therapy from 2013 to 2021, with potential follow-up through 2022, were included.

Results
Among 9952 patients with SCLC, there were 4308 patients with ES-SCLC treated during the study period who met eligibility criteria. Etoposide + platinum (EP) chemotherapy was most common in the 1L, with addition of anti-PD-L1 therapy to most regimens by 2019. Second-line regimens varied by platinum sensitivity status and shifted from topotecan to lurbinectedin over time. Median rwOS following 1L therapy was 8.3 months (95% CI, 7.9-8.8) in those treated with 1L anti-PD-L1 and 8.0 months (95% CI, 7.8-8.2) in those who were not. Following 2L and 3L, median rwOS was 5.6 (95% CI, 4.9-6.3) and 4.9 months (95% CI, 3.4-6.0), respectively, among 1L anti-PD-L1-treated, and 4.5 (95% CI, 4.2-4.9) and 4.0 months (95% CI, 3.7-4.5), respectively, among those who were not.

Conclusion
Despite the introduction of frontline anti-PD-L1 therapy, survival remains dismal among patients with ES-SCLC treated in the real-world setting.
The Critical Lens: It is time to start using the right test for febrile young infants
Authors: Marom Adiel , Papenburg Jesse , Burstein Brett 
Published: October 2024

Abstract
Fever among infants in the first months of life is a common clinical conundrum facing all clinicians who treat children. Most well-appearing febrile young infants have viral illnesses. However, it is critical to identify those at risk of invasive bacterial infections, specifically bacteremia and bacterial meningitis. Clinicians must balance the risks of missing these infections against the harms of over-investigation. Procalcitonin testing is currently the best diagnostic test available to help guide management, and the Canadian Paediatric Society Position Statement on the management of febrile young infants recommends procalcitonin-based risk stratification. However, in many clinical settings, procalcitonin is either unavailable or has a turnaround time that is too long to aid decision-making. Clinicians who care for febrile young infants must have rapid access to procalcitonin results to provide best-evidence, guideline-adherent care. The wider availability of this test is essential to reduce unnecessary invasive testing, hospitalizations, and antibiotic exposure and could reduce system-wide resource utilization.
Navigating Vulnerability and Integration: Refugee Resettlement from Rwanda to Third Countries under the Medical Needs Category
Authors: Bjørkhaug Ingunn , Bækkevold Kine Marie 
Published: October 2024

Abstract
Resettlement is a limited resource available to only a fraction of refugees. Selection criteria, set by the United Nations High Commissioner for Refugees and receiving States, may impose conflicting demands on refugees to exhibit both vulnerability and integration potential to be chosen, a phenomenon termed “promising victimhood”. Drawing on empirical data from interviews with 21 personnel from the United Nations High Commissioner for Refugees and Save the Children International in Rwanda, this article explores how medical needs criteria impact the inclusion or exclusion of refugees for resettlement. It finds that the selection criteria favour refugees with treatable conditions and favourable prognoses, thereby excluding those with chronic or fatal illnesses or patients with poor life expectancy. The article argues that such criteria potentially undermine the humanitarian objectives of the resettlement programme by marginalising some of the most vulnerable individuals. It discusses the implications of these findings for global burden-sharing strategies and calls for strengthening the medical infrastructure in asylum countries. The article concludes by questioning whether resettlement, in its current form, can truly serve as one of the three durable solutions for refugees with medical needs, given that it remains an option for only a select few.
Assessment of the toxic influence of locally formulated pesticides on hepatic and renal biomarkers in male Wistar rats
Authors: Adeyele Esther Itunuoluwa , Ayanyemi Esther Olutomilayo , Akomolafe Rufus Ojo , Sesan Olaoluwa Olukiran , Aladesanmi Omolara Titilayo , Adetutu Aderonke Okoya 
Published: October 2024

Abstract

Background
There is growing concern of the potential damage to vital organs after long term exposure to locally formulated pesticides in rural area of Nigeria. This study was designed to assessed the effects of the individual chemical compound and their combination on the kidney and liver of rats’ model.

Methodology
Fifty-four rats divided into six groups and three sub-groups were exposed to 25, 50 and 75% dose of each of the pesticide’s LD50 for 4 h at 3 days interval in an inhalation chamber for 28 days. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TOT_BIL), creatinine and urea assay showed significant increase at the aforementioned doses in comparison to the control group. The red blood cell counts, hematocrit and hemoglobin concentrations were significantly altered in the rats administered varying doses of the pesticides when compared with the control. Similar result was obtained for the differential white blood cell counts. Histopathological examinations of the liver tissue of rats showed infiltrated sinusoids, traces of karypyknosis, vacuolar degeneration and microvesicular steatosis while that of the renal tissue showed glomeruli atrophy leading to widened Bowman’s spaces as well as few shrunken glomeruli and varied level of degenerative tubular changes to tubular necrosis.

Conclusion
This study established that individual pesticides and their mixture is toxic to the liver and kidney, as evidenced by the elevated markers of renal and liver functions and distortion of the structure of both organs as revealed by their photomicrographs. Therefore, it is a matter of public health significance to regularly monitor pesticide residues in foods and humans in order to assess the food safety risk and population exposure to pesticides.
Medication errors and mitigation strategies in obstetric anesthesia
Authors: Sharpe Emily E. , Corbett Lisa M. , Rollins Mark D. 
Published: October 2024

Purpose of review
Medication administration errors represent a significant yet preventable cause of patient harm in the peripartum period. Implementation of best practices contained in this manuscript can significantly reduce medication errors and associated patient harm.

Recent findings
Cases of medication errors involving unintended intrathecal administration of tranexamic acid highlight the need to improve medication safety in peripartum patients and obstetric anesthesia.

Summary
In obstetric anesthesia, medication errors can include wrong medication, dose, route, time, patient, or infusion setting. These errors are often underreported, have the potential to be catastrophic, and most can be prevented. Implementation of various types of best practice cost effective mitigation strategies include recommendations to improve drug labeling, optimize storage, determine correct medication prior to administration, use non-Luer epidural and intravenous connection ports, follow patient monitoring guidelines, use smart pumps and protocols for all infusions, disseminate medication safety educational material, and optimize staffing models. Vigilance in patient care and implementation of improved patient safety measures are urgently needed to decrease harm to mothers and newborns worldwide.
Novel vaccines against lung cancer
Authors: Baka Sofia , Iraklis George , Papadopoulou Evanthia 
Published: October 2024

Purpose of review
Despite recent advances in immunotherapy treatment for metastatic, early-stage nonsmall cell lung cancer (NSCLC), palliative, adjuvant, neoadjuvant, and perioperative treatment options, further development is needed. Exploring new frontiers of immuno-oncology is necessary. Researchers are interested in a therapeutic vaccination model.

Recent findings
In this paper, we provide a review of the latest lung cancer therapeutic vaccines.
We describe strategies for antigen selection and delivery platforms. As of 5th of August 2024, we have reviewed ongoing clinical trials and results.
We summarize most of the important clinical trials of novel vaccines, the way of action, and available clinical data. We also discuss the pros and cons of various types of therapeutic vaccines.

Summary
Until recently, clinical trial results were mixed regarding the efficacy of therapeutic vaccines in lung cancer.
Developing next-generation sequencing and bioinformatic technologies has helped identify suitable antigens. New personalized vaccines are based on neoantigens specific to unique tumor mutations.
Neoantigens, instead of tumor-associated antigens, better delivery systems and adjuvants will improve antigen presentation and immune system activation.
Combining these therapeutic vaccines with other therapeutic approaches will improve and prolong the response.
Improving Interprofessional Provider Perceptions About Opioid Use Disorder in the Acute Care Setting Through a Blended Educational Simulation Intervention
Authors: Murphy Christine A. , Lakatos Barbara E. , Shelly Colleen E. , Bentain-Melanson Maria , Salvio Genina F. , Ryan Mary Maggie , Weiner Scott G. 
Published: October 2024

BackgroundThe influx of patients in the acute care setting with opioid use disorder (OUD) has outpaced many hospitals’ ability to educate interprofessional staff. This creates distressing experiences for interprofessional staff and patients, leading to moral distress and burnout in staff and poor patient outcomes.ObjectiveThe purpose of this study was to improve interprofessional staff knowledge, attitudes, and perceptions toward working with patients who have OUD using a blended classroom-simulation–based curriculum.MethodsA preintervention and postintervention design was selected. Interprofessional staff (n = 46) participated in a blended classroom-simulation educational intervention focused on the neurobiology of OUD, stigma reduction, pain management, and harm reduction principles, followed by 3 high-fidelity simulation scenarios. Participants completed the Drug and Drug Problems Perceptions Questionnaire to measure staff self-perceived knowledge, skills, and attitudes when working with patients who use drugs before, immediately after, and again 3 and 6 months postintervention.ResultsMost respondents were nurses with an average of 7.6 (SD, 9.6) years of experience. The majority did not have prior training in substance use disorder before (75.6%). There was a statistically significant decrease in mean Drug and Drug Problems Perceptions Questionnaire scores across the total score mean: 55.2 (95% confidence interval, 52.2-58.3) versus 45.5 (95% confidence interval, 43.9-47.1),P< .001. Decreased score indicates improved attitude and perception.DiscussionA curriculum consisting of a blended classroom-simulation intervention was successful at improving several domains regarding perceptions of caring for patients with OUD. This educational intervention can serve as a model for health care systems with goal of improving patient outcomes and staff well-being.
Interarm systolic blood pressure difference is associated with left ventricular concentricity and concentric remodeling
Authors: Paiva Annelise M.G. , Gomes Maria I.C.M. , Gomes Alana C.M. , Gomes Lucca C.M. , Ramalho Saulo R. , Feitosa Audes D.M. , Malachias Marcus V.B. , Brandão Andréa A. , Sposito Andrei C. , Mota-Gomes Marco A. , Nadruz Wilson 
Published: October 2024

Objective:
Interarm systolic blood pressure difference (IASD) values >15 mmHg (IASD > 15) are associated with increased cardiovascular risk, yet the underlying mechanisms remain unclear. This report evaluated whether IASD >15, assessed by different protocols [sequential or simultaneous; based on one or several blood pressure (BP) readings], was associated with adverse left ventricular (LV) remodeling.

Methods:
This cross-sectional study evaluated 605 individuals who underwent clinical and echocardiography evaluation and three pairs of simultaneous arm BP readings. IASD was estimated by seven distinct protocols (three simultaneous and four sequential BP measurements criteria).

Results:
The cohort had a mean age of 53.5 ± 15.4 years, with 51% being women, 23% with LV hypertrophy, 14% with LV concentricity, 69% with normal geometry, 8% with concentric remodeling, 17% with eccentric hypertrophy and 6% with concentric hypertrophy. Multivariable logistic regression revealed that IASD >15 defined by simultaneous measures of the last two pairs of BP readings (IASDsim2) and sequential arm BP readings (right-left-right arm sequence; IASDseq3) were related to LV concentricity (odds ratio [95% CI] = 3.24 [1.02–10.28], P = 0.046 and 2.56 [1.09–6.00], P = 0.030, respectively) and LV concentric remodeling (odds ratio [95% CI]  = 4.12 [1.08–15.78], P = 0.039 and 4.16 [1.61–10.76], P = 0.003, respectively). Conversely, IASD >15 defined by any criteria showed no association with LV hypertrophy.

Conclusion:
Individuals with IASD >15 defined by IASDsim2 and IASDseq3 are associated with adverse LV remodeling, namely LV concentricity and LV concentric remodeling. These findings suggest that both criteria might be potentially used to preferentially assess abnormal IASD in the setting of clinical practice.
Prediction of vaults in eyes with vertical implantable collamer lens implantation
Authors: Shimada Ryuichi , Katagiri Satoshi , Horiguchi Hiroshi , Nakano Tadashi , Kitazawa Yoshihiro 
Published: October 2024

Purpose:
To design formulas for predicting postoperative vaults in vertical implantable collamer lens (ICL) implantation and to achieve more precise predictions using machine learning models.

Design:
Retrospective, observational study.

Setting:
Eye Clinic Tokyo

Methods:
We retrospectively reviewed the medical records of 720 eyes in 408 patients who underwent vertical ICL implantation. The data included age, sex, refractions, anterior segment biometric data, and surgical records. We designed 3 formulas (named V1 to V3 formulas) using multiple linear regression analysis and tested 4 machine learning models.

Results:
Predicted vaults by V1 to V3 formulas were 444.17 ± 93.83 μm, 444.08 ± 98.64 μm, and 444.27 ± 108.81 μm, with a mean absolute error of 127.97 ± 107.92 μm, 126.41 ± 105.86 μm, and 122.90 ± 103.00 μm, respectively. There were no significant differences in error among the V1 to V3 formulas, despite the fact that the V1 and V2 formulas referred to limited parameters (3 and 4, respectively) and the V3 formula referred to all 12 parameters. 2 of 4 machine learning models—Extreme Gradient Boosting and Random Forest Regressor—showed better performance in predicted vaults: 444.52 ± 120.51 μm and 446.00 ± 102.55 μm, and mean absolute error: 118.31 ± 100.55 μm and 118.63 ± 99.34 μm, respectively.

Conclusions:
This is the first study to design V1 to V3 formulas for vertical ICL implantation. The V1 and V2 formulas exhibited good performance despite the limited parameters. In addition, 2 of the 4 machine learning models predicted more precise results.
Clinical utility of extracorporeal shock wave therapy in restoring hand function of patients with nerve injury and hypertrophic scars due to burns: a prospective, randomized, double-blinded study
Authors: Lee Seung Yeol , Cho Yoon Soo , Seo Cheong Hoon , Seo Jisu , Joo So Young 
Published: October 2024

Background:
Joint contractures and nerve injuries are common after hand burns. Extracorporeal shock wave therapy (ESWT) is effective not only for the regeneration of various tissues, including scar tissues, but also for reducing pain and pruritus in patients with burns. Researchers have attempted to explore the effects of ESWT on hand dysfunction caused by nerve injury following burns.

Materials and methods:
The authors evaluated the effects of ESWT (compared to sham stimulation) on hands with nerve injury and hypertrophic scars and, thereby, on hand function. The current study was a double-blind randomized controlled trial involving 120 patients. The ESWT parameters were as follows: energy flux density, 0.05–0.30 mJ/mm2; frequency, 4 Hz; 1000–3000 impulses per treatment; and 12 treatments, one/week for 12 weeks. Outcome measures were as follows: 10-point visual analog scale for pain, Jebsen-Taylor hand function test, grip strength, Purdue Pegboard test, ultrasound measurement of scar thickness, and skin characteristics before and immediately after 12 weeks of treatment.

Results:
No significant intergroup difference was noted after the initial evaluation (P>0.05). More significant improvements were found in the ESWT group than in the sham group in terms of the VAS score (P=0.004), extension ROMs of hand joints (P=0.02), the JTT scores (writing, small, and light) (P<0.001, P<0.001, and P=0.002), and skin characteristics (melanin, skin distensibility, and biologic skin elasticity) (P=0.004, P<0.001, and P<0.001). Other measured outcomes did not differ between the two groups after the treatment.

Conclusion:
The authors identified the clinically beneficial effects of ESWT in promoting hand function, improving scarring, and alleviating scarring-related pain, thereby highlighting its advantages in improving hand function that has been impaired due to nerve injury and hypertrophic scars after burns.
An interview with Pennsylvania State representative Tarik Khan, PhD, FNP-BC
Authors: Chen Leon , Buscemi Charlie P. 
Published: October 2024

ABSTRACT
Nurse practitioners (NPs) take on diverse and essential roles. In an exclusive interview, Representative Tarik Khan, PhD, FNP-BC, highlights the impact NPs can have in the political arena. Transitioning from an NP to a legislator in Pennsylvania, Dr. Khan's journey reflects his commitment to health care reform, driven by hospital closures, lack of patient care access, and the COVID-19 pandemic. Elected in 2022, Dr. Khan leverages his health care background to address a wide range of legislative issues, passing significant bills. He advocates for NPs to engage politically, emphasizing their unique perspective and problem-solving skills. Dr. Khan's story underscores the transformative potential of NPs in shaping public policy and advancing systemic change.
Effects of cardiac telerehabilitation during COVID-19 on cardiac hemodynamic and functional responses and quality of life: a randomized controlled trial
Authors: Dehghani Mostafa , Cheraghi Mostafa , Shakarami Amir , Dehghani Morteza , Namdari Mehrdad 
Published: October 2024

Purpose:
This study aimed to assess the effects of a home-based cardiac telerehabilitation (HBCT) on cardiac hemodynamic and functional responses and health-related quality (HRQOL) of the patients undergoing percutaneous coronary intervention (PCI).

Materials and methods:
In this randomized controlled clinical trial, single-blinded. One hundred-fifty-five patients (mean age: 50.41±7.3 years, 41 women and 39 men) who underwent PCI were randomized into the two groups of intervention and control. The HBCT program included supervised exercise training, walking, phone calls, and a pedometer for 8 weeks. Hemodynamic changes, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), resting heart rate (HRrest), maximum heart rate (HRmax), ejection fraction (EF), and rate pressure product (RPP), and functional parameters including the distance walked and metabolic equivalents (METS), also HRQOL were measured in all patients before and after the 8-week HBCT program.

Results:
Our results showed significant reductions in SBPrest (126.82±9.17 vs. 131.27±10.24; P =0.044), DBPrest (87.4±5.39 vs. 89.17±7.33; P=0.027), HRrest (76.15±3.01 vs. 77.65±4.16; P=0.041), HRmax (143.1±5.24 vs. 147.57±8.63; P=0.011), and RPP (9.64±0.81 vs. 10.07±0.99; P=0.007) and significant elevations in (45.75±4.31 vs. 43.5±5.21; P=0.039), distance walked (514.95±214.5 vs. 368.04±221.43; P=0.019), Mets (7.41±0.84 vs. 6.89±1.28; P=0.018), as well as HRQOL in the MCS (50.62±10.45 vs. 46.25±7.74; P=0.037), and HRQOL in the PCS (46.75±8.73 vs. 42.37±9.99; P=0.040) in the intervention group compared to the control group.

Conclusion:
An HBCT program consisting of supervised exercise training significantly improved hemodynamic response, exercise performance capacity, and HRQOL in patients following PCI.
Squamous cell carcinoma involving the midline of the dorsum of the tongue: a case report
Authors: Sasaki Jun , Aoki Yoshihiko , Ito Yohei , Saito Terumi 
Published: October 2024

Introduction:
Most cases of squamous cell carcinoma (SCC) of the tongue occur on the lateral surface; however, SCC of the dorsum is extremely rare.

Case presentation:
The authors describe the case of a 79-year-old man with SCC involving the midline of the dorsum of the tongue. The lesion was surgically resected. The patient was followed up for 1 year and 6 months, and no recurrence was noted.

Discussion:
SCC of the dorsal midline is even rarer and accounts for less than 1% of tongue carcinomas. SCC involving the dorsum may have a worse prognosis than SCC of the lateral or ventral surface. This report is the first to use submental flap reconstruction to treat cancer of the midline dorsum of the tongue.

Conclusion:
The authors encountered a case of SCC involving the midline of the dorsum of the tongue, which has rarely been reported in the literature. The authors attained a favorable outcome through surgical intervention.