bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastrostomy management by the nursing team in a hospital in São Paulo, Brazil: a best practice implementation project
Authors: Vicente Michele Coelho , Sanches Mariana Bucci , Fabri Jeferson Castelani , Cunha Gilmar Faustino da , Carvalho Leonardo de Souza , Püschel Vilanice Alves de Araujo 
Published: September 2024

ABSTRACT

Introduction:
The efficient and effective management of gastrostomy patients should be based on best practices.

Objective:
This project aimed to improve gastrostomy management in a semi-intensive care unit of a private hospital in São Paulo, Brazil.

Methods:
This study followed the JBI Evidence Implementation Framework. The JBI approach to evidence implementation is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted to measure current practices against recommended best practices. Feedback from the audit was used to identify barriers and design implement strategies to improve practice. A follow-up audit was then conducted to measure changes in compliance with best practices.

Results:
The baseline audit involved an evaluation of 33 nurses and 90 nursing technicians, as well as 10 gastrostomy patients. The follow-up audit evaluated 37 nurses and 80 nursing technicians, as well as 10 gastrostomy patients. The follow-up audit revealed that compliance increased to 90% for three of the eight criteria. For the remainder, it varied between 20% and 50%.

Conclusion:
The baseline audit and feedback strategy led to improved compliance in five of the eight criteria. Future audits will be necessary to maintain these results.

Spanish abstract:

http://links.lww.com/IJEBH/A259
A systematic review and meta-analysis of the association between neglected tropical diseases and malnutrition: more research needed on diseases other than intestinal parasites, leishmaniasis and leprosy
Authors: Loglo Aloysius , Aniagyei Wilfred , Vivekanandan Monika Mira , Agbanyo Abigail , Asamoah Evans Adu , Phillips Richard Odame , Annan Reginald , Engel Barbara , Simmonds Rachel E 
Published: September 2024

Background: According to the WHO, neglected tropical diseases (NTDs) affect over 2 billion people worldwide. While the links between nutrition and many diseases have become clear over recent decade, NTDs have lagged behind and the linkage with nutrition is largely unknown. We conducted this systematic review with meta-analysis to determine current knowledge on the association between NTDs and malnutrition.
Methodology: PubMed, Embase, Scopus and African Journal online databases were searched using predefined search terms. We included all original articles with a case-control design and at least one NTD. The studies had to compare nutritional parameters between infected cases and control participants. Articles that did not report original data were excluded. The quality of the studies was assessed using the Newcastle-Ottawa scale. Pooled estimates were conducted using the random-effects model. The publication bias of studies was determined by funnel plots. Q and I2 statistics were used to assess the heterogeneity of the studies.
Results: After screening 1294 articles, only 16 qualified for the systematic review and 12 for meta-analysis. These predominately had a focus on soil-transmitted helminthiasis (ascariasis, hookworm diseases, trichuriasis) and schistosomiasis, with a minority concerning leishmaniasis and leprosy. Pooled estimates showed an association between intestinal parasites and stunting in children (OR= 1.38, 95%CI: 1.14-1.66, I2 = 0%, tau^2 = 0). We also identified a moderate association established between serum iron deficiency (OR=4.67, 95%CI: 1.91-11.44, tau^2 =0) and intestinal parasites.
Conclusions/Significance: Of the 20 NTDs, the links between diet and disease have been explored for only four. There is a paucity of data from low and middle-income countries and least developed countries where the NTD burden is high. Therefore, more research into the role of malnutrition in NTDs other than intestinal parasites, leishmaniasis and leprosy is needed.
Targeting cancer-associated glycosylation for adoptive T cell therapy of gastro-intestinal and gynecological cancers
Authors: Zingg Andreas , Ritschard Reto , Thut Helen , Buchi Mélanie , Holbro Andreas , Oseledchyk Anton , Heinzelmann Viola , Buser Andreas , Binder Mascha , Zippelius Alfred , Mantuano Natalia Rodrigues , Matter Matthias , Läubli Heinz 
Published: September 2024

AbstractCAR-T cell therapy has provided a significant improvement for patients with chemotherapy-resistant B cell malignancies. However, CAR-T cell treatment of patients with solid cancers has been more difficult, in part because of the heterogeneous expression of tumor-specific cell surface antigens. Here, we describe the generation of a fully human CAR targeting altered glycosylation in secretory epithelial cancers. The expression of the target antigen – the truncated, sialylated O-glycan sialyl-Thomsen-Nouveau antigen (STn) – was studied with a highly STn-specific antibody across various different tumor tissues. Strong expression was found in a high proportion of gastro-intestinal cancers including pancreatic cancers and in gynecological cancers, in particular ovarian and endometrial tumors. T cells expressing anti-STn CAR were testedin vitroandin vivo.Anti-STn CAR-T cells showed activity in mouse models as well as in assays with primary ovarian cancer samples. No significant toxicity was observed in mouse models, although some intraluminal expression of STn was found in gastro-intestinal mouse tissue. Taken together, this fully human anti-STn CAR construct shows promising activity in preclinical tumor models supporting its further evaluation in early clinical trials.
Diagnostic Validity of Drinking Behaviour for Identifying Alcohol Use Disorder: Findings from a Nationally Representative Sample of Community Adults and an Inpatient Clinical Sample
Authors: Garber M.L. , Samokhvalvov A. , Chorny Y. , LaBelle O. , Rush B. , Costello J. , MacKillop J. 
Published: September 2024

ABSTRACTBackground and AimsAlcohol consumption is an inherent feature of alcohol use disorder (AUD), and drinking characteristics may be diagnostically informative. This study had three aims: (1) to examine the classification accuracy of several drinking quantity/frequency indicators in a large representative sample of U.S. community adults; (2) to extend the findings to a clinical sample of adults; and (3) to examine potential sex differences.DesignThis retrospective study utilized receiver operating characteristic (ROC) curves to evaluate area under the curve (AUC). Optimal cut-offs were identified using the Youden Index. Diagnostic validity was evaluated using accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).MeasurementsIndex tests included measures of quantity/frequency (e.g., drinks/drinking day, largest drinks/drinking day, number of drinking days, and heavy drinking frequency). The reference standard was AUD status as determined via a clinical interview (community sample) or a symptom checklist (clinical sample).Setting and ParticipantsTwo samples were examined: A large, nationally representative random sample of U.S. community adults who reported past-year drinking (N=25,778, AUD=20%) and a consecutive drinking clinical sample from a Canadian mental health and addictions inpatient treatment centre (N=1,341, AUD=82%).FindingsAll drinking indicators performed much better than chance at classifying AUD (AUCs=0.60-0.92,ps<.0001). Heavy drinking frequency indicators performed optimally in both the community (AUCs=0.78-0.87; accuracy=0.72-0.80) and clinical (AUC=0.85-0.92; accuracy =0.77-0.89) samples. Collectively, the most discriminating drinking behaviors were heavy drinking episodes and exceeding NIAAA drinking low-risk guidelines. No substantive sex differences in optimal cut-offs or variable performance were observed.ConclusionsDrinking patterns performed well at classifying AUD in both a nationally representative and large inpatient sample, robustly identifying AUD at rates much better than chance and above accepted benchmarks, with limited differences by sex. Findings broadly support the potential utility of quantitative drinking indicators as being diagnostically informative in clinical settings.
A next generation CRISPR diagnostic tool to survey drug resistance in Human African Trypanosomiasis
Authors: Antón Elena Pérez , Dujeancourt-Henry Annick , Rotureau Brice , Glover Lucy 
Published: September 2024

AbstractThe WHO aims to eliminate thegambienseform of human African trypanosomiasis (HAT) by 2030. With the decline of reported cases, maintaining efficient epidemiological surveillance is essential, including the emergence of drug-resistant strains. We have developed new highly specific diagnostic tools using Specific High-Sensitivity Reporter Enzymatic UnLOCKing (SHERLOCK) technology for monitoring the presence of drug-resistant genotypes that (1) are already circulating, such as the AQP2/3(814)chimera providing resistance to pentamidine and melarsoprol, or (2) could emerge, such asTbCPSF3 (N232H), associated to acoziborole resistance in lab conditions. The melarsoprol - pentamidineAQP2/3(814)SHERLOCK assay detected RNA from both cultured parasites and field isolated strains from gHAT patients in relapse following treatment. The acoziboroleCPSF3(SNV)SHERLOCK assay discriminated between wild-typeCPSF3RNA andCPSF3with a single A-C mutation that confers resistance to acoziborolein vitro.
Deriving Imaging Biomarkers for Primary Central Nervous System Lymphoma Using Deep Learning
Authors: Zhu Joshua , Destito Michela , Dhanireddy Chitanya , Hager Tommy , Hossain Sajid , Chadha Saahil , Sritharan Durga , Dhawan Anish , Kandala Keervani , Pedersen Christian , Anzalone Nicoletta , Calimeri Teresa , De Momi Elena , Spadea Maria Francesca , Aboian Mariam S. , Aneja Sanjay 
Published: September 2024

AbstractPurposePrimary central nervous system lymphoma (PCNSL) is typically treated with chemotherapy, steroids, and/or whole brain radiotherapy (WBRT). Identifying which patients benefit from WBRT following chemotherapy, and which patients can be adequately treated with chemotherapy alone remains a persistent clinical challenge. Although WBRT is associated with improved outcomes, it also carries a risk of neuro-cognitive side effects. This study aims to refine patient phenotyping for PCNSL by leveraging deep learning (DL) extracted imaging biomarkers to enable personalized therapy.MethodsOur study included 71 patients treated at our institution between 2009-2021. The primary outcome of interest was overall survival (OS) assessed at one-year, two-year, and median cohort survival cutoffs. The DL model leveraged an 8-layer 2D convolutional neural network which analyzed individual slices of post-contrast T1-weighted pre-treatment MRI scans. Survival predictions were made using a weighted voting system related to tumor size. Model performance was assessed with accuracy, sensitivity, specificity, and F1 scores. Time-dependent AUCs were calculated and C-statistics were computed to summarize the results. Kaplan-Meier (KM) survival analysis assessed differences between low and high-risk groups and statistically evaluated using the log-rank test. External validation of our model was performed with a cohort of 40 patients from an external institution.ResultsThe cohort’s average age was 65.6 years with an average OS of 2.80 years. The one-year, two-year, and median OS models achieved AUCs of 0.73 (95% C.I., 0.60-0.85), 0.70 (95% C.I., 0.58-0.82), and 0.73 (95% C.I., 0.58-0.82) respectively. KM survival curves showcased discrimination between low and high-risk groups in all models. External validation with our one-year model achieved AUC of 0.64 (95% C.I., 0.63-0.65) and significant risk discrimination. A sub-analysis showcased stable model performance across different tumor volumes and focality.ConclusionsDL classifiers of PCNSL MRIs can stratify patient phenotypes beyond traditional risk paradigms. Given dissensus surrounding PCNSL treatment, DL can augment risk stratification and treatment personalization, especially with regards to WBRT decision making.
Association of air pollution from a landfill site with primary care consultation
Authors: Jordan Kelvin P , Muller Sara , Usman Muhammad , Bailey James , Burton Claire , Lawton Sarah A , Mallen Christian D , Mason Kayleigh J , Wathall Simon , van der Windt Danielle A 
Published: September 2024

AbstractBackgroundWaste landfill sites are associated with gaseous emissions and this air pollution can cause unpleasant smells (“malodour”). This causes concerns about its impact on the health of the local population. This study assessed change in general practice consultation behaviour during a period of increased complaints associated with air pollution at a UK landfill site.MethodsThe study period was October 2020 to December 2021. The age-sex standardised prevalence and incidence of consultations for mental health, respiratory, and other symptoms hypothesised to be impacted by the air pollution issues were determined and compared between: i) 6 practices located close to the landfill site (zone A), ii) 6 practices located a mid-distance from the site (zone B), iii) 6 practices located further away and expected to have had less impact (zone C).ResultsWhilst there was an increased consultation for mental health problems in practices nearest to the landfill site compared to those furthest away, consultation frequencies for respiratory and other potentially associated symptoms were lower and likelihood of consultation was consistently highest in practices located in zone B.ConclusionThis study did not show clear evidence of an increase in recorded primary healthcare contacts for conditions and symptoms hypothesised to be connected to air pollution. It highlighted the challenges of examining the impact of air pollution on the health of local populations. Since this study focussed on coded consultations in primary care and not symptoms present in the general population, an impact on the health of individuals cannot be ruled out.How this fits inAir pollution from waste landfill sites may impact on the health of the local population.We did not find consistent evidence of increased healthcare consultations to general practices which were nearest to such pollution.This study highlights the challenges in examining the impact of air pollution on health.Symptoms may still be increased in the general population and an impact on the health of individuals cannot be ruled out.
Association of Item-Level Responses to Cognitive Function Index with Tau Pathology and Hippocampal volume in The A4 Study
Authors: Demirsoy Idris , Ghanbarian Elham , Khorsand Babak , Nallapu Bhargav T. , Ezzati Ali 
Published: September 2024

AbstractBackgroundAlzheimer’s Disease (AD) has a lengthy asymptomatic preclinical phase during which individuals may show pathological signs like β-amyloid (Aβ) pathology and tau tangles without noticeable objective cognitive impairments. Subjective cognitive impairment reports may offer valuable and early insights into individuals’ cognitive functioning and serve as indicators of early stages of cognitive decline.ObjectiveTo investigate the associations of the item-level response to Cognitive Function Index (CFI) by participant and study partner with tau pathology and adjusted hippocampal volume (HVa).MethodParticipants were 339 cognitively unimpaired, Aβ positive, individuals enrolled in the Anti-Amyloid Asymptomatic Alzheimer’s (A4) Study who underwent tau-PET imaging. Participants and their study partners assessed subjective changes in cognition and function over the past year using the 15-item CFI questionnaire. For each CFI item, the relationship among tau, HVa, and CFI reports was investigated.ResultParticipants were on average 72.38 (SD = 4.87) years old, 58.1% were female, and 23.6% were tau positive. Higher tauMTLwas significantly associated with participant report of decline on three CFI items including depending on written notes, seeing a doctor for memory concern, and feeling lost while navigating. Higher tauMTLwas associated with study partner report of decline on two different items: needing help from others to remember appointments/occasions and asking same questions. Additionally, HVa was linked to challenges with driving for participants and noticeable memory decline for study partners.ConclusionWe showed that early changes reported on specific items of the CFI are associated with higher tauMTLand lower HVa in Aβ+ participants. Different CFI items were associated with tau and hippocampal volume for participants and study partners, highlighting the importance of both perspective.
Comparative Risk of the Onset of Atrial Fibrillation after Icosapent Ethyl versus Omega-3 –Acid-Ethyl-Esters Adjuvant to Statins
Authors: Sarker Jyotirmoy , Kim Michael , Patton Samantha , Radwański Przemysław B. , Munger Mark A. , Kim Kibum 
Published: September 2024

ABSTRACTBackgroundIcosapent ethyl (ICP), an ethyl ester of eicosapentaenoic acid (EPA), and omega-3 acid ethyl esters (DHA/EPA), comprised of ethyl esters of EPA and doxosahexaenoic acid (DHA), are approved as adjunctive therapy to statins for reducing adverse cardiovascular events (CV) in patients with CV risks. However, there are concerns regarding a potential association between ICP and atrial fibrillation (AF). This study evaluated the incidence of AF onset between ICP and DHA/EPA when used as adjuvant therapy with statins.Methods and ResultsThis retrospective study utilized administrative healthcare claims to analyze adult AF-naïve patients from one year preceding their first prescription for ICP or DHA/EPA. These patients were followed for two years, spanning from2013-2021. AF incidence was assessed during active treatment with either ICP or DHA/EPA as adjunct statin therapy. A propensity score (PS) matched cohort controlled for baseline characteristics and the effect of calendar year on the use of ICP or DHA/EPA. The cumulative incidence of AF was estimated using a product-limit estimator and compared between groups using a Cox proportional hazards regression model. The PS-matched cohort included 17,638 participants with a mean age 56 years, predominantly male (65.7% ICP vs. 64.5% DHA/EPA). Over two years, the cumulative incidence of AF from ICP and DHA/EPA was 5.32% and 3.99% respectively, resulting in a HR of 1.242 (95% CI: 1.061 to 1.455).ConclusionsIn adult AF-naïve patients, ICP, when compared to DHA/EPA in conjunction with statin therapy, was associated with a significantly higher significant risk of developing AF.RESEARCH PERSPECTIVEWhat is New?Does icopasent ethyl (ICP), an ethyl ester of eicosapentaenoic acid (EPA) and omega-3 acid ethyl esters comprised of ethyl esters of EPA and doxosahexaenoic acid (DHA) in atrial fibrillation (AF)-naïve patients taking statins increase the incidence of AF?Over two years, the cumulative incidence of AF from ICP and DHA/EPA was 5.32% and 3.99% respectively, resulting in a HR of 1.242 (95% CI: 1.061 to 1.455).In adult AF-naïve patients, ICP, when compared to DHA/EPA in conjunction with statin therapy was associated with a higher significant risk of developing AF.What Question Should be Addressed Next?What should be considered as clinical and demographic factors in identifying patients at risk of atrial fibrillation prior to being prescribed ICP or DHA/EPA agents.Investigation into the underlying mechanism of the increase in atrial fibrillation with marine omega-3 ethyl esters should continue.Understanding AF outcomes from ICP or DHA/EPA use including AF burden, need for AF medical or electrophysiological interventions, and health-care total costs.
A longitudinal study of depressive symptom trajectories and risk factors in congestive heart failure
Authors: Gallucci Julia , Ng Justin , Secara Maria T. , Jones Brett D.M. , Hawco Colin , Husain M. Omair , Husain Nusrat , Chaudhry Imran B. , Voineskos Aristotle N. , Husain M. Ishrat 
Published: September 2024

AbstractBackgroundDepression is prevalent among patients with congestive heart failure (CHF) and is associated with increased mortality and healthcare utilization. However, most research has focused on high-income countries, leaving a gap in knowledge regarding the relationship between depression and CHF in low-to-middle-income countries (LMICs). This study aimed to delineate depressive symptom trajectories and identify potential risk factors for poor outcomes among CHF patients.MethodsLongitudinal data from 783 patients with CHF from public hospitals in Karachi, Pakistan was analyzed. Depressive symptom severity was assessed using the Beck Depression Inventory (BDI). Baseline and 6-month follow-up BDI scores were clustered through Gaussian Mixture Modeling to identify distinct depressive symptom subgroups and extract trajectory labels. Further, a random forest algorithm was utilized to determine baseline demographic, clinical, and behavioral predictors for each trajectory.ResultsFour depressive symptom trajectories were identified: ‘good prognosis,’ ‘remitting course,’ ‘clinical worsening,’ and ‘persistent course.’ Risk factors associated with persistent depressive symptoms included lower quality of life and the New York Heart Association (NYHA) class 3 classification of CHF. Protective factors linked to a good prognosis included less disability and a non-NYHA class 3 classification of CHF.ConclusionsBy identifying key characteristics of patients at heightened risk of depression, clinicians can be aware of risk factors and better identify patients who may need greater monitoring and appropriate follow-up care.Clinical PerspectiveWhat is new?To the best of our knowledge, this is the first study to use machine learning techniques to investigate depressive symptom trajectories in CHF patients from an LMIC.Four distinct depressive symptom trajectories were identified, ranging from good prognosis to persistent depressive symptoms.This study highlights protective and risk factors associated with these trajectories based on patients’ demographics and clinical presentations at baseline.What are the clinical implications?Personalized interventions based on identified protective factors for high-risk CHF patients could enhance both mental health and cardiovascular outcomes.Early detection and management of depression, particularly in patients with poor quality of life or advanced heart failure, may help reduce healthcare utilization and mortality.This study emphasizes the importance of routine depression screening in CHF patients, especially in LMICs, to enhance overall patient care and outcomes.