bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective evaluation of cystatin C in the assessment of kidney dysfunction and survival in liver transplant candidates
Authors: Gonzalez Stevan A. , Shankar Nagasri , Mehta Ashwini , Garcia-Saenz-de-Sicilia Mauricio , Klintmalm Goran B. , Trotter James F. , Asrani Sumeet K. , Fischbach Bernard V. , Duarte-Rojo Andres 
Published: September 2024

Kidney dysfunction is associated with decreased survival in liver transplant (LT) candidates, yet serum creatinine (sCr) is a poor surrogate for glomerular filtration rate (GFR) in this population. Serum cystatin C (CysC) may provide a more accurate assessment of kidney function and predict outcomes. We performed a multicenter prospective cohort study of consecutive candidates for LT. CysC was obtained at LT evaluation (n = 244), and a subset underwent simultaneous I125-iothalamate clearance for measured GFR (mGFR) assessment (n = 137). Patients were followed to assess the need for pre-LT renal replacement therapy, simultaneous liver and kidney transplant, and survival. Estimated GFR (eGFR) based on MDRD-4, GRAIL, Royal Free Hospital Cirrhosis GFR, and the CKD-EPI equations was assessed for bias, precision, and accuracy in reference to mGFR. Receiver operator characteristic (AUROC) and competing risk survival analyses were performed. CysC more accurately discriminated mGFR than sCr at thresholds of ≤60 and ≤30 mL/min/1.73 m2 with AUROC 0.92 (p = 0.005) and 0.96 (p=0.01), respectively. All eGFR equations overestimated GFR, especially among females (p < 0.05). The GRAIL equation demonstrated the least bias, while CKD-EPI-cystatin C was associated with the greatest precision and lowest frequency of GFR overestimation. Among 165 recipients of LT, CysC discriminated pre-LT renal replacement therapy and the need for simultaneous liver and kidney transplant with AUROC of 0.70 and 0.85, respectively. Cumulative incidence of death, accounting for LT as a competing event, increased with CysC (p = 0.002) but was not observed with sCr overall or among subgroups (p = NS). CysC more accurately predicts thresholds of mGFR than sCr in candidates for LT. Elevated CysC discriminates pre-LT renal replacement therapy and simultaneous liver and kidney transplant and is strongly associated with survival in contrast with sCr. CysC is a promising tool to improve prognostication among candidates for LT.
Quintuplet pregnancy: a case report from Pakistan
Authors: Qayyum Sardar Noman , Alamgir Eman , Alamgir Iqra , Khan Gulmeena Aziz , Alamgir Unsa , Rehan Muhammad , Noori Samim 
Published: September 2024

Introduction and importance:
Quintuplet pregnancies are exceptionally rare outcomes of fertility treatments, that is clomiphene citrate therapy. These high-order multiple pregnancies carry significant risks for both maternal and neonatal health, necessitating specialized care to manage complications effectively.

Case presentation:
A 26-year-old woman, gravida three para two, presented with preterm labor at 32 weeks gestation following clomiphene citrate self-medication. Diagnosed with quintuplets, she underwent an emergency cesarean section at Allied-1 Hospital, Faisalabad, delivering five neonates alive. Unfortunately, all five neonates succumbed to death due to perinatal asphyxia, three within 24 h and two on the third day.

Clinical discussion:
Higher-order multiple pregnancies, such as quintuplets, are associated with increased risks of obstetric complications, including pre-eclampsia, gestational diabetes, and fetal growth restriction. Preterm birth further exacerbates the risk of neonatal complications like respiratory distress syndrome, perinatal asphyxia, and death. The patient’s care highlights the challenges of managing such pregnancies in resource-limited settings, emphasizing the need for specialized antenatal and neonatal care facilities.

Conclusion:
This case highlights the critical need for advanced medical care in managing high-order multiple pregnancies. The outcomes reflect the significant challenges posed by preterm labor and neonatal complications in quintuplet pregnancies. There is the need for enhanced antenatal care, healthcare infrastructure, and multidisciplinary teams for the efficient management of high-order multiple pregnancies in Pakistan, where neonatal and maternal mortality rates are surprisingly high.
Examining Unusual Patterns of Cancer and Environmental Concerns: The Importance of Community Input and Engagement
Authors: Foster Stephanie L. , Condon Suzanne K. , Lavery Amy M. , Etheredge Alisha A. , Kennedy Brian S. , Svendsen Erik R. , Breysse Patrick N. 
Published: September 2024

Context:
In fiscal year 2019, the Department of Health and Human Services (DHHS) received an appropriation from Congress specifically to update guidelines for investigating community cancer concerns. This resulted in the DHHS directing the Centers for Disease Control and Prevention (CDC) to fulfill this responsibility.

Program:
The CDC and the Agency for Toxic Substances and Disease Registry (ATSDR) provide guidance to state, tribal, local, and territorial (STLT) health departments and play important roles in supporting STLT programs in addressing community cancer concerns.

Implementation:
The updated guidelines offer enhancements addressing limitations and challenges regarding the process for investigating cancer clusters as expressed by STLT programs responsible for responding to inquiries and by communities impacted by unusual patterns of cancer. Additionally, the updated guidelines offer new tools and approaches associated with scientific advancements. Issues associated with improving communications and community engagement were a priority. Details in the updated guidelines provide suggestions for building and maintaining trust; provide resources via additional tools, templates, and methodology to facilitate sharing of information; provide suggestions for identifying agency and community points of contacts; and provide suggestions for establishing a community advisory committee.

Conclusion:
Enhancements to the previous guidelines were included to address advancements in statistical approaches and methods for understanding exposure pathways and also to respond to limitations described in the previous guidelines. Furthermore, these enhancements ensure communities have a voice in the process and offer methods to enhance transparency throughout the investigative process. Ultimately, the 2022 Guidelines are designed to ensure that community engagement, community input, and communication remains paramount to the process of assessing unusual patterns of cancer and environmental concerns.
Discovery of Natural Products for Cancer Prevention
Authors: Blanco Carcache Peter J. , Clinton Steven K. , Kinghorn A. Douglas 
Published: September 2024

Abstract“Cancer chemoprevention” is a term referring to the slowing or reversal of this disease, using nontoxic natural or synthetic compounds. For about 50 years, there has been a strong scientific interest in discovering plant-derived compounds to prevent cancer, and strategies for this purpose using a concerted series ofin vitro,ex vivo, andin vivolaboratory bioassays have been developed. Five examples of the more thoroughly investigated agents of this type are described herein, which are each supported by detailed literature reports, inclusive of ellagic acid, isoliquiritigenin, lycopene,trans-resveratrol, and sulforaphane. In addition, extracts of the plants avocado (Persea americana), noni (Morinda citrifolia), açai (Euterpe oleracea), and mangosteen (Garcinia mangostana) have all shown inhibitory activity in anin vivoorex vivobioassay using a carcinogen and germane to cancer chemoprevention, and selectedin vitro–active constituents are described for each of these 4 species.
Mapping the Landscape of Those Left Behind When a Person With Dementia Dies
Authors: Baker Zachary G. , Han SeungYong , Sefcik Justine S. , Petrovsky Darina V. , Ma Kris Pui Kwan , Smith Matthew Lee , Bacsu Juanita-Dawne R. , Rahemi Zahra , Saenz Joseph 
Published: September 2024

Introduction:
People with dementia can have many family and friends who might be affected by their deaths. Pursuing the long-term aim of understanding how dementia deaths affect close family and friends, this project lays groundwork through estimates of who those close family and friends are, with special attention to race and ethnicity.

Method:
Regression models estimated associations between dementia, race/ethnicity, and close family and friend network size, controlling for age, sex, education, marital status, and household wealth for 1386 deceased people with dementia from the Health and Retirement Study (2004 to 2018).

Results:
Persons with dementia had an average of 9.4 close family and friends at death. But patterns of close family and friends were different among non-Latino Black (10.8), Latino (9.9), and non-Latino White (9.2) people with dementia at death. Notably, non-Latino White persons with dementia had the fewest close family (3.7), followed by non-Latino Black (5.1), and Latino (7.7) persons with dementia.

Discussion:
Knowing who might be affected by dementia deaths is the first step to explore how dementia-related deaths impact close family and friends. Future work can now sample bereaved family and friends of people with dementia to explore their experiences and develop culturally appropriate supports.
FcγR- and CD9-dependent synapse engulfing microglia in the thalamus drives cognitive impairment following cortical brain injury
Authors: Matoba Ken , Kochi Takahiro , Mreyoud Yassin R , Badrani Jana H. , Patel Hency , Tsujioka Hiroshi , Yamashita Toshihide , Crossman David K. , Niwa Minae , Kano Shin-ichi 
Published: September 2024

AbstractVarious states of microglia appear in neuroinflammation, but their impact on brain function and behavior is not fully understood. Here we report that synapse engulfing microglia in the thalamus are crucial for cognitive impairment after cortical brain injury. Region-specific manipulations of reactive microglia in the chronic phase of injuries showed that microglial changes in the thalamus, but not in the hippocampus, impaired recognition memory. Single-cell RNA-sequencing analysis revealed the enrichment of synapse engulfing microglia in the thalamus, which developed in a CD9-dependent manner and caused synaptic loss and recognition memory deficits. In the thalamus, the blood-brain barrier was disrupted, and extravasated γ-immunoglobulins (IgG) co-localized with synapse engulfing microglia. Fcγ receptor III blockade in the thalamus reduced synapse engulfing microglia, synapse loss, and recognition memory deficits. These findings demonstrate that the induction of synapse engulfing microglia in the thalamus by extravasated IgG/FcγRIII and CD9 signals causes recognition memory deficits after cortical brain injury.
Adaptive immunity shapes innate and epithelial cell landscapes by silencing tonic IFN-γ in innate lymphoid cells during homeostasis
Authors: Mejri Ousséma , Ma Li , Aoudi Amneh , Labiad Ossama , Mondot Stanislas , Igalouzene Ramdane , Codan Clément , Hernandez-Vargas Hector , Rousseaux Noémi , Lapaque Nicolas , Paul Stéphane , Walzer Thierry , Marie Julien C. , Soudja Saïdi 
Published: September 2024

AbstractDuring homeostasis, innate and epithelial cells undergo continuous maturation, shaped by microbial, molecular and cellular interactions. While these cells influence adaptive immunity during steady-state conditions, the reciprocal homeostatic role of adaptive immune cells in the maturation and function of innate and epithelial cells remains underexplored. Here, through computational approaches and murine models, we establish that adaptive immunity shapes innate immune and epithelial homeostatic landscapes. Mechanistically, adaptive immunity acts as a brake on type 1 polarization and diversification of innate lymphocytes (ILCs). Without adaptive immunity, the innate cellular interactions within the mesenteric lymph nodes are dominated by an interferon-gamma (IFNγ) signaling network. Moreover, the innate immune and epithelial cells follow distinct phenotypic and functional trajectories, including ILCs acquiring myeloid markers, monocytes adopting an inflammatory path, and colonic epithelial cells expressing altered antimicrobial peptides and losing Paneth-like features. Depleting ILCs, abolishing IFNγ signaling, or restoring adaptive immunity reduces these IFNγ-driven changes. Thus, our findings highlight a homeostatic function of adaptive immunity in modulating innate and epithelial cell communication, diversity, composition, function, and differentiation, notably by limiting ILC-derived IFNγ.
Using machine learning to forecast peak health care service demand in real-time during the 2022-23 winter season: a pilot in England, UK
Authors: Morbey Roger A , Todkill Dan , Moura Phil , Tollinton Liam , Charlett Andre , Watson Conall H. , Elliot Alex J 
Published: September 2024

AbstractDuring winter months, there is increased pressure on health care systems in temperature climates due to seasonal increases in respiratory illnesses. Providing real-time short-term forecasts of the demand for health care services helps managers plan their services.During the Winter of 2022-23 we piloted a new forecasting pipeline, using existing surveillance indicators which are sensitive to increases in respiratory syncytial virus (RSV). Indicators including telehealth cough calls and ED bronchiolitis attendances, both in children under 5 years. We utilised machine learning techniques to train and select models that would best forecast the timing and intensity of peaks up to 28 days ahead. Forecast uncertainty was modelled usings a novel gamlss approach which enabled prediction intervals to vary according to the level of the forecast activity.The winter of 2022-23 was atypical because the demand for healthcare services in children was exceptionally high, due to RSV circulating in the community and increased concerns around invasive Group A streptococcal (GAS) infections. However, our short-term forecasts proved to be adaptive forecasting a new higher peak once the increasing demand due to GAS started. Thus, we have demonstrated the utility of our approach, adding forecasts to existing surveillance systems.
SARS-CoV-2, the human placenta, and adverse perinatal outcomes
Authors: Linn Rebecca L. , Forkpa Markolline , Leite Rita , Guerrero Jessenia C. , Reyes Maria C. , Schwartz Lauren E. , Simmons Rebecca A. , Parry Samuel , Golden Thea N. 
Published: September 2024

AbstractThe relationship among timing and severity of COVID-19 during pregnancy, placental pathology, and adverse pregnancy outcomes is not well understood. We conducted a prospective cohort study of 497 pregnant patients with COVID-19 whose placentas underwent systematic pathologic examination. The main exposure was timing of COVID-19 during pregnancy (first or second versus third trimester). The primary outcome was composite placental pathology that included high grade maternal vascular malperfusion or greater than 25 percent perivillous fibrin deposition. There were 63 patients who had the composite placental pathology outcome. In adjusted analyses that controlled for maternal age, parity, active infection at delivery, interval from time of diagnosis to delivery and COVID-19 variant, timing of COVID-19 during pregnancy was not associated with risk of the composite placental pathology outcome. Among secondary COVID-19 related exposures we investigated, severity of disease and treatment for COVID-19 were associated with risk of the composite placental pathology outcome. In addition, patients with COVID-19 in the first nine months of the pandemic had the highest rate of the composite placental pathology outcome. In this large cohort, placental vascular pathology was common among COVID-19 cases but was unrelated to timing of COVID-19 during pregnancy or adverse pregnancy outcomes. These findings suggest that uncomplicated COVID-19 during pregnancy does not require intensive fetal surveillance or detailed pathologic examination of the placenta after delivery.
Pelvic Stability During Total Hip Arthroplasty: A Comparison of Traction and Standard Surgical Tables Using Augmented Reality Navigation
Authors: Ima Musashi , Kabata Tamon , Inoue Daisuke , Yanagi Yu , Iyobe Takahiro , Fujimaru Naoya , Demura Satoru 
Published: September 2024

AbstractBackgroundTotal hip arthroplasty enhances quality of life by improving joint function. However, the success of this procedure heavily relies on precise acetabular cup positioning, which is insufficient using traditional placement guidelines. This insufficiency is evidenced by the persistent occurrence of dislocations, highlighting the critical need for enhanced pelvic alignment accuracy. Standard surgical tables present challenges in maintaining consistent pelvic positioning during the procedure, making it difficult to achieve optimal alignment.PurposeThis study aimed to evaluate the effectiveness of a traction surgical table in stabilizing pelvic movements during total hip arthroplasty and compare it with the use of a standard surgical table.MethodsThis retrospective study assessed 88 total hip arthroplasties performed using the AR-HIP (Zimmer Biomet Japan, Tokyo, Japan) system for real-time pelvic navigation. Procedures were performed using either a standard surgical table (n=48) or a traction surgical table (n=40). Pelvic alignment was monitored at multiple surgical stages, and stability was statistically analyzed to compare the efficacy of the two table types.ResultsThe traction table significantly stabilized anteroposterior pelvic movements across all critical surgical stages (p<0.05), except during anterior capsular release. In contrast, procedures performed on the standard table exhibited less stability in anteroposterior pelvic movements, suggesting the superior performance of the traction table.ConclusionsCompared with the standard table, the use of the traction table in total hip arthroplasty effectively controls anteroposterior pelvic movements and improves acetabular cup alignment. However, lateral pelvic stability remains uncontrolled using both table types, indicating a need for further technological advancements in surgical practice to improve the outcomes of total hip arthroplasty.
Resource Recovery from Wastewater By Directing Microbial Metabolism Toward Production of Value-added Biochemicals
Authors: Zhou Xueyang , Manna Bharat , Lyu Boyu , Lear Gavin , Kingsbury Joanne M. , Singhal Naresh 
Published: September 2024

AbstractTransitioning wastewater treatment from mere pollutant removal to resource recovery necessitates exploiting the metabolic capabilities of microbial communities. Studies suggest that under low-oxygen conditions, microbes activate oxygen-responsive regulons that suppress the tricarboxylic acid (TCA) cycle, diverting carbon flux towards biosynthetic pathways and accumulating valuable organic metabolites. We hypothesized that dynamically altering dissolved oxygen levels in activated sludge would disrupt aerobic metabolic equilibrium, enhancing the production of valuable biochemicals like amino acids and fatty acids. To test this, batch experiments were conducted with activated sludge under constant aeration and rapid cycling between oxygen-rich and oxygen-poor states. Fluctuating oxygen concentrations between 0 and 2 mg/L significantly increased valuable biochemical production compared to constant aeration (P<0.05). Continuous oxygen perturbations increased free amino acids by 35.7±7.6% and free fatty acids by 76.4±13.0%, while intermittent perturbations with anoxic periods enhanced free amino acids by 42.4±8.1% and free fatty acids by 39.3±7.7%. Notably, 14 standard amino acids showed significant increases, and most fatty acids had carbon chain lengths between C12-C22. Mechanistically, compared to stable oxygen, oxygen perturbations activated the FNR and ArcA regulons, resulting in lower relative abundances of TCA cycle enzymes such as malate dehydrogenase, isocitrate dehydrogenase, and 2-oxoglutarate dehydrogenase, while higher relative abundances of amino acid (ilv cluster) and fatty acid (acc cluster) biosynthetic enzymes. Our findings demonstrate that introducing controlled oxygen fluctuations in wastewater treatment can enhance the biochemical value of activated sludge with minimal process modifications, facilitating resource recovery.Abstract Figure
Identification of the orphan GPR25 as a receptor of the chemokine CXCL17
Authors: Hu Wen-Feng , Yu Jie , Wang Juan-Juan , Sun Ru-Jiao , Zheng Yong-Shan , Zhang Teng , Liu Ya-Li , Xu Zeng-Guang , Guo Zhan-Yun 
Published: September 2024

AbstractC-X-C motif chemokine ligand 17 (CXCL17) is a small secretory protein primarily expressed in mucosal tissues and likely functions as a chemoattractant, but its receptor is still controversial. In the present study, we identified the rarely studied orphan G protein-coupled receptor 25 (GPR25) as a receptor of CXCL17 via prediction by the newly developed AlphaFold 3 algorithm and validation by the NanoBiT-based β-arrestin recruitment assay. In the β-arrestin recruitment assay, recombinant human CXCL17 could activate human GPR25 in transfected human embryonic kidney (HEK) 293T cells with an EC50value around 100 nM, but it had no activation effect on 17 other tested G protein-coupled receptors (GPCRs). Deletion of three conserved C-terminal residues of human CXCL17 almost abolished its activity, and alanine replacement of W95 or R178 of human GPR25, two conserved residues in the predicted orthosteric ligand binding pocket, almost abolished its response towards CXCL17. These results are consistent with the AlphaFold 3-predicted binding model in which the highly conserved C-terminal fragment of CXCL17 inserts into the orthosteric ligand binding pocket of the receptor GPR25. According to the expression pattern of CXCL17 and GPR25 shown at the Human Protein Atlas, CXCL17 might be an endogenous agonist of GPR25 in human and other mammals, but this hypothesis needs to be tested in future studies via more assays. The present deorphanization paves the way for further functional characterization of the orphan receptor GPR25 and the orphan ligand CXCL17.