bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discovery of Perun (G329.9−0.5): a new, young, Galactic SNR
Authors: Smeaton Zachary J , Filipović Miroslav D , Lazarević Sanja , Alsaberi Rami Z E , Ahmad Adeel , Araya Miguel , Ball Brianna D , Bordiu Cristobal , Buemi Carla S , Bufano Filomena , Dai Shi , Haberl Frank , Hopkins Andrew M , Ingallinera Adriano , Jarrett Thomas , Koribalski Bärbel S , Kothes Roland , Kraan-Korteweg Renée C , Leahy Denis , Lundqvist Peter , Maitra Chandreyee , Martin Pierrick , Payne Jeffrey L , Rowell Gavin , Sano Hidetoshi , Sasaki Manami , Soria Roberto , Steyn Nadia , Umana Grazia , Urošević Dejan , Velović Velibor , Vernstrom Tessa , Vukotić Branislav , West Jennifer 
Published: October 2024

ABSTRACT
We present the discovery of possibly the youngest Galactic supernova remnant (SNR) with associated pulsar-wind nebula (PWN), which we name Perun (G329.9−0.5). Perun was serendipitously discovered in the Australian Square Kilometre Array Pathfinder–Evolutionary Map of the Universe survey at 943 MHz, and subsequent follow-up observations were conducted with the Australia Telescope Compact Array observatory at 5500 and 9000 MHz. We combine these with additional radio observations from the MeerKAT, Molonglo Observatory Synthesis Telescope, and Murchison Widefield Array telescopes, infrared (IR) observations from the SpitzerSpace Telescope, and X-ray observations from the Chandra X-ray observatory to perform a multifrequency analysis. The radio morphology shows a small angular size shell (D = 70 arcsec) with a luminous, central PWN. We measure a total spectral index of $\alpha = -0.49\pm 0.05$, which should be typical for a young, composite SNR. Crucial evidence for Perun’s SNR classification comes from the detection of linear fractional polarization at radio frequencies of $\sim$7 per cent–10 per cent with both radial and tangential orientations, similar to the young SNR G1.9+0.3. We use data from the Southern Galactic Plane Survey to perform an H i analysis and estimate a favoured distance range of 6–9 kpc, and thus a favoured age range of $\sim$70–500 yr. We find no high-energy emission in Fermi-Large Area Telescope data. We detect Perun’s outer shell in 24 $\mu$m indicating the possible presence of [O iv] and [Fe iii] emission, also typical for young SNRs. Overall, these observations and analysis confirm Perun as a young, Galactic SNR with a prominent PWN.
Early steroid withdrawal and kidney transplant outcomes in first-transplant and retransplant recipients
Authors: Bae Sunjae , Chen Yusi , Sandal Shaifali , Lentine Krista L , Schnitzler Mark , Segev Dorry L , McAdams DeMarco Mara A 
Published: October 2024

ABSTRACT

Background
Early steroid withdrawal (ESW) is often preferred over conventional steroid maintenance (CSM) therapy for kidney transplant recipients with low immunological risks because it may minimize immunosuppression-related adverse events while achieving similar transplant outcomes. However, the risk–benefit balance of ESW could be less favorable in retransplant recipients given their unique immunological risk profile. We hypothesized that the association of ESW with transplant outcomes would differ between first-transplant and retransplant recipients.

Methods
To assess whether the impact of ESW differs between first and retransplant recipients, we studied 210 086 adult deceased-donor kidney transplant recipients using the Scientific Registry of Transplant Recipients. Recipients who discontinued maintenance steroids before discharge from transplant admission were classified with ESW; all others were classified with CSM. We quantified the association of ESW (vs CSM) with acute rejection, death-censored graft failure and death, addressing retransplant as an effect modifier, using logistic/Cox regression with inverse probability weights to control for confounders.

Results
In our cohort, 26 248 (12%) were retransplant recipients. ESW was used in 30% of first-transplant and 20% of retransplant recipients. Among first-transplant recipients, ESW was associated with no significant difference in acute rejection {adjusted odds ratio (aOR) = 1.04 [95% confidence interval (CI) = 1.00–1.09]}, slightly higher hazard of graft failure [hazard ratio (HR) = 1.09 (95% CI = 1.05–1.12)] and slightly lower mortality [HR = 0.93 (95% CI = 0.91–0.95)] compared with CSM. Nonetheless, among retransplant recipients, ESW was associated with notably higher risk of acute rejection [OR = 1.42 (95% CI = 1.29–1.57); interaction P &lt; .001] and graft failure [HR = 1.24 (95% CI = 1.14–1.34); interaction P = .003], and similar mortality [HR = 1.01 (95% CI = 0.94–1.08); interaction P = .04].

Conclusions
In retransplant recipients, the negative impacts of ESW on transplant outcomes appear to be non-negligible. A more conservatively tailored approach to ESW might be necessary for retransplant recipients.
Engineering of Phycourobilin Synthase: PubS to a Two-Electron Reductase
Authors: Miyake Keita , Iwata Saya , Narikawa Rei 
Published: October 2024

Abstract
Phycourobilin:ferredoxin oxidoreductase (PubS) belongs to the ferredoxin-dependent bilin reductase (FDBR) family and catalyzes the reduction of the C15=C16 double bond, followed by the C4=C5 double bond of biliverdin IXα to produce phycourobilin. Among the diverse FDBR enzymes that catalyze site-specific reduction reactions of bilins, PubS lineage is the only one that reduces the C4=C5 double bond. This family can be broadly divided into four-electron reduction enzymes, which catalyze two successive two-electron reductions, such as PubS, and two-electron reduction enzymes, which catalyze a single two-electron reduction. The crystal structures of diverse FDBRs, excluding PubS, have unraveled that there are two distinct binding modes in the substrate-binding pocket. In this study, we focused on the arginine (Arg) residues that is considered crucial for substrate-binding mode in two-electron reduction enzymes. Through sequence alignment and comparison with the predicted structure of PubS, we identified a residue in PubS that corresponds to the Arg residue in the two-electron reduction enzymes. We further introduced mutations to avoid the steric hindrance associated with changes in the binding mode. Biochemical characterization of these variants showed that we successfully modified PubS from a four-electron reduction enzyme to a two-electron reduction enzyme with the accumulation of radicals. Our results provide insight into the molecular mechanisms of the chromophore binding mode and proton donation from acidic residues.
Digital ulcers in systemic sclerosis are strongly associated with digital arterial disease: a finger-by-finger analysis of finger brachial pressure index measurements
Authors: Blaise Sophie , Boulon Carine , Mangin Marion , Senet Patricia , Lazareth Isabelle , Imbert Bernard , Lapebie François-Xavier , Lacroix Philippe , Seinturier Christophe , Constans Joël , Carpentier Patrick H 
Published: October 2024

Abstract

Objectives
The digital ulcers (DU) of SSc are disabling and frequent. Their pathogenesis involves a capillary microangiopathy and a digital arterial disease that few studies were able to quantify up to now. A multicentre observational study about the predictive value of capillaroscopy in SSc offered us the opportunity to evaluate further the complementary information provided by both capillary and arterial evaluations.

Methods
During the SCLEROCAP study, five out of the nine centres performed a systematic evaluation of the finger brachial pressure index (FBPI) in the last four fingers of both hands at baseline, using the same laser-Doppler device. In the present work, FBPI measurements were compared between fingers with vs without DU or scars, before and after adjusting for the capillaroscopic pattern and systemic factors.

Results
FBPI measurements were performed in 2537 fingers from 326 patients. Active ulcers or scars were found in 10.8% of those fingers, more often on the right hand, and in the second and third fingers. FBPI was lower than 0.70 in 26% of all fingers and in 57.5% of those with ulcers. A strong association was found between a low FBPI and the presence of DU, even after adjusting for capillaroscopic pattern, ulcer location and the patient himself.

Conclusion
These results confirm the importance of digital arterial disease in the pathogenesis of DU of SSc, which is independent from the microangiopathy. FBPI measurements complement the information provided by capillaroscopy and might have an important predictive value for subsequent DU.
The real-world use and effectiveness of avacopan in routine practice for the treatment of ANCA vasculitis. First experiences in Spain
Authors: Draibe Juliana , Espigol-Frigolé Georgina , Cid Maria Cinta , Prados M C , Guillén E , Villacorta J , Vega C , Martins J , daSilva I , Martin-Gomez Mª Adoración , Huerta A , Martinez-Valenzuela L , Morales Enrique 
Published: October 2024

Abstract

Objectives
ANCA-associated vasculitis (AAV) is a group of chronic diseases with relapses that associate organic damage because of the disease and its treatment. Avacopan is a new treatment indicated for AAV. We present the first experiences with avacopan in Spain as part of an Early Access program.

Methods
Patients with AAV who started avacopan between June 2022 and September 2023 were included. For comparison, a historical cohort of patients diagnosed with AAV around the same time and treated without avacopan was also included.

Results
Twenty-nine patients treated with avacopan were analysed. Twelve patients (41.4%) were male, and median age was 56 years. Most patients were ANCA MPO positive (21/29, 72.4%). The most frequently affected organ was the kidney (23/29, 79.31%), with a mean estimated glomerular filtration rate (eGFR) of 23.2 ml/min. Mean follow-up was 456.8 (±181.7) days with a remission rate of 86.2%. eGFR increased from 23.2 (11.2) to 38.38 (18.55) ml/min after 12 months of diagnosis. Two patients had adverse events related to avacopan (severe neutropenia and a gastrointestinal affectation), 13 infections were reported and one death. Patients treated with avacopan received a significantly lower cumulative dose of prednisone at 6 and 12 months (P-values of 0.02 and &lt;0.01, respectively) compared with historical controls. The evolution of GFR at 1 year of follow-up and the incidence of relapse were similar in both groups.

Conclusion
The combination of avacopan with standard immunosuppressive therapy presents a good safety profile and provides added value by contributing to the control of AAV activity, increase GFR and removal of steroids.
Exosomal let‐7b‐5p deriving from parietal epithelial cells attenuate renal fibrosis through suppression of TGFβR1 and ARID3a in obstructive kidney disease
Authors: Song Ahui , Wang Minzhou , Xie Kewei , Lu Jiayue , Zhao Bingru , Wu Wangshu , Qian Cheng , Hong Wenkai , Gu Leyi 
Published: October 2024

AbstractAs renal progenitor cells, parietal epithelial cells (PECs) have demonstrated multilineage differentiation potential in response to kidney injury. However, the function of exosomes derived from PECs has not been extensively explored. Immunofluorescent staining of Claudin‐1 was used to identify primary PECs isolated from mouse glomeruli. Transmission electron microscopy, nanoparticle tracking analysis, and western blotting were used to characterize the properties of PECs‐derived exosomes (PEC‐Exo). The therapeutic role of PEC‐Exo in tubulointerstitial fibrosis was investigated in the unilateral ureteral obstruction (UUO) mouse model and TGF‐β1‐stimulated HK‐2 cells. High‐throughput miRNA sequencing was employed to profile PEC‐Exo miRNAs. One of the most enriched miRNAs in PEC‐Exo was knocked down by transfecting miRNA inhibitor, and then we investigated whether this candidate miRNA was involved in PEC‐Exo‐mediated tubular repair. The primary PECs expressed Claudin‐1, PEC‐Exo was homing to obstructed kidney, and TGF‐β1 induced HK‐2 cells. PEC‐Exo significantly alleviated renal inflammation and ameliorated tubular fibrosis both in vivo and in vitro. Mechanistically, let‐7b‐5p, highly enriched in PEC‐Exo, downregulated the protein levels of transforming growth factor beta receptor 1(TGFβR1) and AT‐Rich Interaction Domain 3A(ARID3a) in tubular epithelial cells (TECs), leading to the inhibition of p21 and p27 to restoring cell cycle. Furthermore, administration of let‐7b‐5p agomir mitigated renal fibrosis in vivo. Our findings demonstrated that PEC‐derived exosomes significantly repressed the expression of TGFβR1 and ARID3a by delivering let‐7b‐5p, thereby alleviating renal fibrosis. This study provides novel insights into the role of PEC‐Exo in the repair of kidney injury and new ideas for renal fibrosis intervention.
Do Obese Patients Have Worse Outcomes in Adult Spinal Deformity Surgeries?
Authors: Maroun Ralph , Daher Mohammad , Sleem Bshara , Nassar Joseph E. , Knebel Ashley , Callanan Tucker C. , Diebo Bassel G. , Sebaaly Amer , Daniels Alan H. 
Published: October 2024

Study Design:
A meta-analysis study.

Objective:
This meta-analysis evaluates the difference in surgical outcomes between obese and nonobese patients undergoing adult spinal deformity (ASD) corrective surgery.

Background:
ASD encompasses a wide range of debilitating spinal abnormalities. Concurrently, obesity is on the rise globally and has been shown to influence the outcomes of ASD management. The relationship between obesity and surgical outcomes in ASD has been the focus of recent studies, yielding various results.

Materials and Methods:
We conducted a comprehensive search of PubMed, Cochrane, and Google Scholar (pages 1–20) through June of 2024. The surgical outcomes assessed included postoperative complications, revision rates, wound infections, thromboembolic events, implant-related complications, and nonhome discharge. Surgical parameters such as operative time, length of stay (LOS), and estimated blood loss (EBL), as well as functional outcomes like the Oswestry Disability Index (ODI) and pain scores were analyzed.

Results:
Nine studies met the inclusion criteria. Nonobese patients exhibited a lower rate of implant-related complications [odds ratio (OR)=0.25; 95% CI: 0.12–0.52, P=0.0002] and nonhome discharge (OR=0.52; 95% CI: 0.32–0.84, P=0.007). In addition, nonobese patients had reduced LOS (MD=−0.29; 95% CI: −0.53 to −0.05, P=0.02) and EBL (SMD=−0.68; 95% CI: −1.19 to −0.18, P=0.008). No statistically significant differences were observed for the remaining outcomes.

Conclusion:
Nonobese patients undergoing ASD corrective surgery are associated with fewer implant-related complications, a lower EBL, shorter LOS, and a higher likelihood of being discharged home compared with their obese counterparts.
Comparison of Patients with and without Predicted Surgical Indication between Clusters of Adult Spine Deformity (ASD) Patients
Authors: Baroncini Alice , Boissiere Louis , Larrieu Daniel , Haddad Sleiman , Pellisé Ferran , Alanay Ahmet , Kleinstueck Frank , Pizones Javier , Bourghli Anouar , Obeid Ibrahim ,   On behalf of the European Spine Study Group (ESSG)
Published: October 2024

Study design.
Multicentric, retrospective analysis of prospectively collected data.

Objective.
To utilize machine-learning (ML) for clustering and management prediction (conservative vs. operative) in surgically treated adult spine deformity (ASD) patients, and to compare the attainment of the Minimum Clinically Important Difference (MCID) between predicted surgical and conservative patients.

Summary of Background Data.
Management choice in ASD is complex. ML can identity patient clusters and predicted treatment, but it is unclear whether patients treated according to the prediction also show better clinical outcomes.

Methods.
ASD patients (2-year follow-up) were divided into groups using k-means clustering. Management choice was predicted among operated patients in each cluster. The MCID for the Oswestry Disability Index (ODI) and the Scoliosis Research Society-22 (SRS-22) was calculated and compared between patients with and without surgical prediction.

Results.
In Cluster 1 (idiopathic scoliosis, n=675, 150 surgeries), 57% of patients had a conservative prediction. Of these, 52% and 49% achieved MCID for ODI and SRS-22, respectively, compared to 68% and 75% for those with surgical predictions (OR=2 and 3.1, respectively).
In Cluster 2 (moderate sagittal imbalance, n=561, 200 surgeries), 12% had a conservative prediction. Of these, 29% and 46% achieved MCID for ODI and SRS-22, respectively, compared to 47% and 56% for those with surgical predictions.
In Cluster 3 (significant sagittal imbalance, n=537, 197 surgeries), 17% had a conservative prediction. Of these, 12% and 15% achieved MCID for ODI and SRS-22, respectively, compared to 37% and 45% for those with surgical predictions (OR=4.2 and 4.5, respectively).

Conclusion.
Patients with a concordant surgical prediction and management had higher odds of achieving the MCID, indicating a good correlation between prediction and clinical outcomes. In Cluster 3, the low percentage of patients with conservative prediction achieving the MCID suggests that machine learning could well identify patients with poor clinical outcomes.
Rescue of COVID-19 Patient Complicated by Spontaneous Pneumothorax and Acute Pulmonary Thromboembolism
Authors: Qu Jiachun , Dai Ruzhen 
Published: October 2024

Abstract
Pulmonary thromboembolism is a common cardiovascular disease, with high morbidity and mortality rates in hospitalized patients. Because of clotting disorders and hypoxemia caused by COVID-19, critically ill patients are highly susceptible to thrombotic complications. A study published in the Journal of the American Medical Association in 2022 showed that the incidence of venous thromboembolism (VTE) in critically ill COVID-19 patients was approximately 10% to 35%, whereas the incidence of VTE in autopsy cases was as high as 60% (JAMA Intern Med 182:1063-1070). Clinicians need increased awareness of VTE in COVID-19 patients, to reduce the risk of deep vein thrombosis and pulmonary thromboembolism and to be alert to life-threatening complications.
Surgical Intensive Care Unit Nurses’ Coping With Moral Distress and Moral Residue
Authors: Booth Adam T. , Christian Becky J. 
Published: October 2024

Background
Moral distress is defined as knowing the right course of action to take but being hindered by institutional constraints.

Objective
The purpose of this study was to explore surgical intensive care unit (SICU) nurses’ experiences of moral distress, moral residue, coping, and perceived quality of patient care.

Method
A descriptive qualitative approach used in-depth, semistructured individual interviews of SICU nurses in a metropolitan, academic medical center until theoretical saturation occurred.

Results
Five themes were identified from 21 interviews. Root causes of moral distress were identified including end-of-life care, conflicts with management, staffing, inadequate resources, communication problems, power differentials between physicians and nurses, and working with incompetent providers. Interviews highlighted the torment experienced by participants, which demonstrated that unacknowledged moral distress impacted their quality of patient care and well-being. Accounts provided insight into patient care that was perceived to be wrong. Well-being was affected as 2 participants sought inpatient psychiatric treatment for moral distress, whereas others were looking for new nursing careers, and many were in school to leave the SICU.

Discussion
This study is unique because it corroborated Epstein and Hamric’s Crescendo Effect framework by providing in-depth analyses of moral distress, moral residue, and the crescendo effect and how these concepts developed within SICU nurses when left unaddressed. Interviews revealed that unacknowledged moral distress created moral residue, which subsequently impacted the quality of patient care and the nurses’ well-being.
Pediatric Resuscitation, Parental Presence, and Provider Perspective
Authors: Lindsay Julie , Hudgins Abbey , Patel Stephine 
Published: October 2024

Background
Varying opinions and practices exist about parental presence during a pediatric resuscitation. In addition, there is a paucity of literature that investigates the perspectives of health care providers about the efficacy of parental presence in these situations.

Objectives
The aim of this study was to gain an understanding of the perspectives of emergency health care providers about parental presence during pediatric resuscitation.

Methods
This pilot study surveyed emergency health care providers about their opinions of parental presence during pediatric resuscitation. All participants were given a survey with closed- and open-ended questions. Data analysis included descriptive statistics for the demographic data and qualitative analysis for the open-ended responses.

Results
A total of 52 emergency services personnel completed the survey. Of the physician respondents, 78.2% (n = 18) were opposed to parental presence during pediatric resuscitation. Common reasons for opposition included the lack of education, interpersonal team communication skills or experience, and discussion concerning end-of-life issues.

Discussion
Utilization of formal education and simulation for parental presence during resuscitation could be helpful for increasing providers’ comfort levels with parental presence.
A New Test for Evaluating the Psychological Impact of COVID-19 in Nurses
Authors: Romero Carolina S. , Gimeno Paloma , Iftimi Adina , De Andrés José , Landoni Giovanni , Catalá Juan , Otero Maria ,   the PSIMCOV Group
Published: October 2024

Introduction
During the COVID-19 pandemic, many health care workers were involved and suffered significant physical and psychological strain, and nursing was one of the main players. Clearly and objectively establishing the psychological impact on nurses during the pandemic is necessary for long-term recovery and to be prepared for new outbreaks in the future.

Aim
The aims of this study were to evaluate the perceived impact on nurses at risk of psychological stress at work during a major health care crisis and determine the psychological impact and its influencing factors.

Methods
An online questionnaire was designed and distributed between April 9 and April 19, 2020, in Spain. The comprehensive self-conducted questionnaire included demographic information and the Psychological Stress and Adaptation at work Score. For the analysis, descriptive statistics, logistic regressions, and receiver operating characteristic curves were determined.

Results
A total of 825 nurses (33% working in intensive care units and emergency departments) answered the questionnaire. A logistic regression analysis revealed that nurses with higher psychological stress scores experienced more physical overload (P = .02), higher psychological overload (P < .01), poor teamwork (P = .02), more distress due to new circumstances (P < .01), more personal impact of how society responded to COVID-19 (P < .01), anticipation of negative future consequences (P < .01), and worse balance between family and work (P < .01). The area under the curve for the cutoff point of Psychological Stress and Adaptation at work Score 40 was 0.82 (95% confidence interval, 0.79-0.91), with 70% sensitivity and 81% specificity. The positive predictive value was 72%, and the negative predictive value was 80%.

Conclusion
Psychological Stress and Adaptation at work Score is a rapid and accurate test for evaluating the psychological well-being of health care staff that can be used when crisis prevents the use of conventional stress diagnosis methods. Higher psychological impact was observed in nurses who worked in the intensive care unit and in the hospital ward.