bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Political Economy of Macroeconomic Policy in India
Authors: Gupta Surupa 
Published: September 2024

Abstract
India’s macroeconomic policy has largely been driven by the need to create a stable environment for economic development and poverty reduction. In the immediate period after Independence, the concern for economic development led to policies that gave the government a central role in investment and production. By the 1970s, trade policy grew more protectionist trade policies and policies governing domestic and foreign investors more restrictive. A gradual reversal began after 1980 and in 1991, the Indian government undertook comprehensive liberalization of trade, investment and exchange rate policies, opening up most sectors to both domestic and foreign private investment. These new policies set the GDP growth rate on a higher path after 1980, reducing poverty on the one hand and increasing inequality on the other. This chapter shows that the executive enjoyed substantial autonomy in policymaking during the first 3 decades after Independence and embraced fiscal conservatism. However, the rise of diverse sectoral interests has led to a decline in autonomy. Policy-making during the more recent decades is marked by societal and sectoral demands, resulting in sharp increases in fiscal deficits. Higher levels of economic growth have allowed politicians the option of avoiding difficult reform decisions required to tame those deficits. At the same time, achieving higher growth rates in the future—a pre-requisite for continued economic development—will require sectoral reforms thus far thwarted by domestic politics. Overall, preferences of domestic businesses and large farm owners continue to shape most policies.
Novel immunotherapeutic approaches in gastric cancer
Authors: Yang Meng , Lin Wuhao , Huang Jiaqian , Mannucci Alessandro , Luo Huiyan 
Published: September 2024

Abstract
Gastric cancer is a malignant tumor that ranks third in cancer-related deaths worldwide. Early-stage gastric cancer can often be effectively managed through surgical resection. However, the majority of cases are diagnosed in advanced stages, where outcomes with conventional radiotherapy and chemotherapy remain unsatisfactory. Immunotherapy offers a novel approach to treating molecularly heterogeneous gastric cancer by modifying the immunosuppressive tumor microenvironment. Immune checkpoint inhibitors and adoptive cell therapy are regarded as promising modalities in cancer immunotherapy. Food and Drug Administration-approved programmed death-receptor inhibitors, such as pembrolizumab, in combination with chemotherapy, have significantly extended overall survival in gastric cancer patients and is recommended as a first-line treatment. Despite challenges in solid tumor applications, adoptive cell therapy has demonstrated efficacy against various targets in gastric cancer treatment. Among these approaches, chimeric antigen receptor-T cell therapy research is the most widely explored and chimeric antigen receptor-T cell therapy targeting claudin18.2 has shown acceptable safety and robust anti-tumor capabilities. However, these advancements primarily remain in preclinical stages and further investigation should be made to promote their clinical application. This review summarizes the latest research on immune checkpoint inhibitors and adoptive cell therapy and their limitations, as well as the role of nanoparticles in enhancing immunotherapy.
Ejectosome of Pectobacterium bacteriophage ΦM1
Authors: Eruera Alice-Roza , Hodgkinson-Bean James , Rutter Georgia L , Hills Francesca R , Kumaran Rosheny , Crowe Alexander J M , Jadav Nickhil , Chang Fangfang , McJarrow-Keller Klemens , Jorge Fátima , Hyun Jaekyung , Kim Hyejin , Ryu Bumhan , Bostina Mihnea 
Published: September 2024

Abstract
Podophages that infect gram-negative bacteria, such as Pectobacterium pathogen ΦM1, encode tail assemblies too short to extend across the complex gram-negative cell wall. To overcome this, podophages encode a large protein complex (ejectosome) packaged inside the viral capsid and correspondingly ejected during infection to form a transient channel that spans the periplasmic space. Here, we describe the ejectosome of bacteriophage ΦM1 to a resolution of 3.32 Å by single-particle cryo-electron microscopy (cryo-EM). The core consists of tetrameric and octameric ejection proteins which form a ∼1.5-MDa ejectosome that must transition through the ∼30 Å aperture created by the short tail nozzle assembly that acts as the conduit for the passage of DNA during infection. The ejectosome forms several grooves into which coils of genomic DNA are fit before the DNA sharply turns and goes down the tunnel and into the portal. In addition, we reconstructed the icosahedral capsid and hybrid tail apparatus to resolutions between 3.04 and 3.23 Å, and note an uncommon fold adopted by the dimerized decoration proteins which further emphasize the structural diversity of podophages. These reconstructions have allowed the generation of a complete atomic model of the ΦM1, uncovering two distinct decoration proteins and highlighting the exquisite structural diversity of tailed bacteriophages.
Advancing rheumatology with natural language processing: insights and prospects from a systematic review
Authors: Omar Mahmud , Naffaa Mohammad E , Glicksberg Benjamin S , Reuveni Hagar , Nadkarni Girish N , Klang Eyal 
Published: September 2024

Abstract

Objectives
Natural language processing (NLP) and large language models (LLMs) have emerged as powerful tools in healthcare, offering advanced methods for analysing unstructured clinical texts. This systematic review aims to evaluate the current applications of NLP and LLMs in rheumatology, focusing on their potential to improve disease detection, diagnosis and patient management.

Methods
We screened seven databases. We included original research articles that evaluated the performance of NLP models in rheumatology. Data extraction and risk of bias assessment were performed independently by two reviewers, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to evaluate the risk of bias.

Results
Of 1491 articles initially identified, 35 studies met the inclusion criteria. These studies utilized various data types, including electronic medical records and clinical notes, and employed models like Bidirectional Encoder Representations from Transformers and Generative Pre-trained Transformers. High accuracy was observed in detecting conditions such as RA, SpAs and gout. The use of NLP also showed promise in managing diseases and predicting flares.

Conclusion
NLP showed significant potential in enhancing rheumatology by improving diagnostic accuracy and personalizing patient care. While applications in detecting diseases like RA and gout are well developed, further research is needed to extend these technologies to rarer and more complex clinical conditions. Overcoming current limitations through targeted research is essential for fully realizing NLP’s potential in clinical practice.
Expiratory muscle strength training reduces oxidative stress and systemic inflammation in men with obstructive sleep apnea syndrome: a double-blinded, randomized parallel trial
Authors: Erturk Nurel , Celik Adem , Kahraman Yaman Sevim , Yaman Huseyin , Unal Ferhat , Calik Kutukcu Ebru 
Published: September 2024

Abstract

Study Objectives
This study aimed to evaluate and compare the effects of high and low-intensity expiratory muscle strength training (EMST) on disease severity, systemic inflammation, oxidative stress, respiratory muscle strength, exercise capacity, symptoms, daytime sleepiness, fatigue severity, and sleep quality in male patients with obstructive sleep apnea syndrome (OSAS).

Methods
Thirty-one male patients diagnosed with moderate OSAS were included in this double-blind, randomized, parallel study. Patients were randomized into two groups: High-EMST and Low-EMST groups. EMST was used at home 7 days/week, once a day, for 25 breaths, 12 weeks. Respiratory muscle strength was measured using a mouth pressure device. Disease severity (Apnea–Hypopnea Index [AHI]) and, respiratory sleep events by polysomnography, total oxidant level(TOS), total antioxidant level(TAS), oxidative stress index (OSI), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels by blood serum were evaluated.

Results
The percentage of AHI change in the high-EMST group(50.8%) was significantly higher than in the low-EMST group(6.3%; p = .002, d = 1.31). In general, as MEP increased by one unit, AHI decreased by 0.149 points (b = −0.149; CR = −3.065; p = .002), and as AHI increased by one unit, ODI increased by 0.746 points (b = 0.746; CR = 10.604; p &lt; .001). TOS, OSI, TNF-α and IL-6 levels decreased at similar rates in both groups.

Conclusions
EMST significantly reduces systemic inflammation and oxidative stress while improving expiratory muscle strength in male patients with moderate OSAS. High-EMST is more effective in enhancing the severity of disease than low-EMST. EMST is a practical, effective, and promising treatment for pulmonary rehabilitation in patients with moderate OSAS.

Clinical Trials
Effect of EMST systemic inflammation and oxidative stress in patients with moderate OSAS, https://clinicaltrials.gov/study/NCT05242406, with the number NCT05242406.
Development and Preliminary Validation of Stigma Measures for Care Partners of Persons Who Are d/Deaf or Hard of Hearing
Authors: Wallhagen Margaret I. , Kraemer John D. , Saalim Khalida , Adams Elizabeth Troutman , Stelmach Rachel D. , West Jessica S. , Chung Jenny Jae Won , Nyblade Laura 
Published: September 2024

Objectives:
A great deal of literature documents the significant demands, both physical and psychosocial, that care partners experience when providing care to persons with a range of health conditions. There is, however, far less research available on care partners of adult persons who are d/Deaf or hard of hearing (d/DHH). In response to this gap, the authors developed measures of d/DHH stigma among care partners as part of the work of the Lancet Commission on Hearing Loss’ Measures, Models, and Stigma Reduction Subgroup. The measures examined in this article are part of a larger set of parallel measures to enable comparison of stigma measurement across groups.

Design:
The present study describes the preliminary validation of five stigma scales specifically tailored for use to assess the prevalence and effect of stigma on the care partners of adult people who are d/DHH in the United States. Care partners in this context are defined broadly and can include spouses, partners, adult children, siblings, and friends of persons who are d/DHH. The scales describe the care partner’s own assessment of how the person who is d/DHH experiences and perceives stigma as well as the care partner’s own internalized, experienced, and perceived stigma as a result of their association with a person who is d/DHH. This latter set of three scales describes secondary stigma, or the stigma a person experiences related to their association with a member of a stigmatized group. Measures were developed through a process that included a literature review, Delphi groups with people who became d/DHH after they developed spoken language, cognitive interviews, and a pretest. An online, self-administered preliminary validation survey was conducted with 151 care partners.

Results:
Results support the internal reliability of each of the five stigma scales (ordinal α’s all greater than 0.9) and that each scale is assessing a single factor.

Conclusions:
Additional testing is needed to confirm the validity of these measures. After further validation, they can be used to assess the prevalence and effect of stigma on care partners of persons who are d/DHH and to evaluate the success of interventions developed to address stigma and its effects both on the care partner and the person who is d/DHH and receiving the care.
Intramedullary Cylindrical Grafting for Nonunions of the Proximal Fifth Metatarsal
Authors: Seiça Emanuel Cortesão , Domingos Rui , Mendes Daniel , Vide João , Sousa Manuel Resende 
Published: September 2024

Fractures affecting the proximal fifth metatarsal constitute 25% of all metatarsal fractures, being particularly prevalent in sports due to stress-related incidents. Recognizing fracture patterns and implementing precise management are pivotal to mitigate potential complications, given the proclivity for suboptimal bone healing, and high incidence of nonunions (up to 4% in zone 2/3 fractures). Various methods for graft collection and application have been outlined, ranging from inlay grafts to the straightforward application of bone grafts at the nonunion site. However, the use of inlay grafts may pose challenges in size accuracy and donor site morbidity. We present and describe a novel grafting technique, which we describe as intramedullary bone grafting, exposing its capacity to promote bone healing by filling the medullary canal with cancellous bone. Developed for the treatment of delayed unions or nonunions in zone 2 and 3 fractures of the proximal fifth metatarsal, this innovative technique amalgamates the advantages of both inlay grafting and cancellous grafting. Employing a compacted cylindrical graft, tailored to match the reamed canal’s dimensions, replaces the entire medulla, facilitating the bone healing process. The technique establishes an intramedullary bone bridge across the nonunion site without compromising cortical bone integrity, extending significantly above and below the site. This presents a possible alternative to conventional methods. Furthermore, we illustrate a case involving a professional athlete with a Torg-3 fracture nonunion in zone 3, who underwent this grafting technique alongside anatomic plate fixation. Following a 4-month follow-up, a CT scan revealed complete bone healing, yielding a painless and functionally restored foot. This success enabled the athlete to resume regular practice.

Level of Evidence:
Level IV.
Sleep Disturbances and Dry Eye Symptoms and Signs, Systemic Conditions, and Inflammatory Markers in the Dry Eye Assessment and Management Study
Authors: Huang Alan , Augello Patrick , Asbell Penny , Ying Gui-shuang ,   The DREAM Research Group
Published: September 2024

Purpose:
To investigate the association between sleep disturbances, dry eye disease (DED) severity, and DED risk factors.

Methods:
We conducted a secondary analysis of the Dry Eye Assessment and Management (DREAM) study, a randomized trial of 535 patients with moderate-to-severe DED. Participants self-reported sleep disturbances at baseline. DED symptoms were assessed using the Ocular Surface Disease Index and Brief Ocular Discomfort Index. DED signs were assessed using tear film break-up time, Schirmer test, corneal and conjunctival staining, tear osmolarity, and meibomian gland dysfunction assessment. Immune cells were assessed using conjunctival impression cytology. Outcomes were compared between participants with ongoing and no history of sleep disturbances, adjusting for confounders.

Results:
The mean age was 58 years, and 81% were women. Ongoing sleep disturbances (n = 113) were significantly associated with older age (mean 60.5 vs. 57.4; P = 0.03), smoking (39.8% vs. 28.7%; P = 0.02), and DED treatment. Systemic conditions associated with sleep disturbances included thyroid dysfunction (26.5% vs. 15.7% P = 0.007), irritable bowel (18.6% vs. 5.4%; P < 0.0001), osteoarthritis (38.9% vs. 21.6%; P = 0.0007), and depression (30.1% vs. 11.5%; P < 0.0001). Sleep disturbances were associated with lower conjunctival staining scores (2.46 vs. 2.77; P = 0.03) and higher concentrations of dendritic cells in ocular surface white blood cells (12.0% vs. 8.1%; P = 0.01).

Conclusions:
Sleep disturbances were associated with older age, smoking history, systemic diseases, and higher dendritic cell concentration among patients with moderate-to-severe DED. These findings support further investigation of sleep disturbances as a comorbidity of patients with DED. Additional research is needed to understand the mechanisms behind this relationship.
A Novel Shielding Device for Cardiac Cath Labs
Authors: Smith Lancer , Caffrey Emily , Wilson Charles 
Published: September 2024

Abstract
This research evaluates the effectiveness of a large specialized cardiac catheterization laboratory shielding device (SCCLSD) placed perpendicular to the patient compared to traditional shielding methods in reducing occupational exposure to scattered x rays, contributing to the ongoing enhancement of radiation safety in the cardiac catheterization laboratory (CCL) setting. An experimental setup involving an anthropomorphic phantom on the catheterization table simulated radiation scatter from a patient. Measurements were taken systematically at various grid points and heights in the CCL using a Fluke 451P ion chamber while mimicking a real interventional scenario. In-air peak exposure rates were analyzed at head, chest, and waist heights in the anteroposterior (AP) position. Results demonstrated that the SCCLSD provided a superior radiation shadow and effective whole-body radiation exposure reduction compared to conventional shielding devices. Considering that conventional shielding requires staff to wear lead aprons, an effective dose equivalent correction factor was applied for exposure measurements without the SCCLSD. Even after the correction factor, the SCCLSD continued outperforming lead aprons and offered whole-body protection, including the head and arms, which is typically neglected with conventional shielding. The SCCLSD also reduces exposure to the eyes, aligning with lower occupational exposure recommendations from ICRP and NCRP. However, proper CCL staff positioning is important in maximizing the effectiveness of the SCCLSD. Future research avenues may explore exposure rates at different C-arm angles to more completely assess the SCCLSD’s impact on occupational exposure.
The conotoxin Contulakin-G reverses hypersensitivity observed in rodent models of cancer-induced bone pain without inducing tolerance or motor disturbance
Authors: Martin Laurent F. , Almuslim Moyad , Ismail Khaled A. , Ibrahim Mohab M. , Moutal Aubin , Cheng Kevin , Stratton Harrison J. , Price Theodore J. , Vanderah Todd W. , Olivera Baldomero M. , Khanna Rajesh , Patwardhan Amol 
Published: September 2024

Abstract
As the incidence and survival rates of patients with cancer continues to grow, an increasing number of people are living with comorbidities, which often manifests as cancer-induced bone pain (CIBP). The majority of patients with CIBP report poor pain control from currently available analgesics. A conotoxin, Contulakin-G (CGX), has been demonstrated to be an antinociceptive agent in postsurgical and neuropathic pain states via a neurotensin receptor 2 (NTSR2)-mediated pathway. However, the efficacy and side effect profile of CGX have never been assessed in CIBP. Here, we evaluated CGX's antinociceptive potential in a rodent model of CIBP. We hypothesized that CGX engages the NTSR2 pathway, providing pain relief with minimal tolerance and motor side effects. Our results demonstrated that CGX intrathecal injection in mice with CIBP attenuated both spontaneous pain behaviors and evoked mechanical hypersensitivity, regardless of their sex. Furthermore, the antinociceptive effect of CGX was dependent upon expression of NTSR2 and the R-type voltage-gated calcium channel (Cav2.3); gene editing of these targets abolished CGX antinociception without affecting morphine antinociception. Examination of the side effect profile of CGX demonstrated that, unlike morphine, chronic intrathecal infusion maintained antinociception with reduced tolerance in rats with CIBP. Moreover, at antinociceptive doses, CGX had no impact on motor behavior in rodents with CIBP. Finally, RNAScope and immunoblotting analysis revealed expression of NTSR2 in both dorsal and ventral horns, while Cav2.3 was minimally expressed in the ventral horn, possibly explaining the sensory selectivity of CGX. Together, these findings support advancing CGX as a potential therapeutic for cancer pain.
A retrospective analysis on the effectiveness of cytokine hemadsorption in patients with severe coronavirus disease 2019
Authors: Tran Tuan DM , Thanh Tu Kim , Duy Luong Thai , Lam Dieu Ha 
Published: September 2024

Background:
An increase in systemic inflammation due to hyperimmune activation leads to severe coronavirus disease 2019 (COVID-19) disease, acute respiratory distress syndrome, multiple organ failure, and ultimately death. Extracorporeal blood purification using hemadsorption to reduce excessive inflammatory cytokine was suggested as an effective treatment for patients with severe COVID-19. We investigated the effectiveness of intermittent cytokine hemadsorption with a HA330 cartridge in patients with severe COVID-19.

Methods:
We gathered data from severe COVID-19 patients who underwent hemadsorption using Jafron® (HA330) between October and December 2021. We assessed pre- and post-hemadsorption inflammatory cytokine levels, treatment complications, and mortality. Statistical significance was set at P < 0.05.

Results:
Of the total 40 patients, 13 (32.5%) were males with a mean age of 63.6 years. In patients who survived (n = 23), a 2-fold decrease in interleukin-6 (IL-6, P = 0.0433), a 3-fold decrease in procalcitonin (P = 0.0163), a 2.5-fold decrease in C-reactive protein (CRP, P = 0.0080), a 2.5-fold increase in D-dimer (P = 0.0337), and a 1.3-fold increase in white blood cell (WBC) (P = 0.0102) were observed before and after cytokine hemadsorption. In patients who died (n = 17), a 2-fold increase in WBC (P = 0.0022) was observed with no significant changes in other parameters. Except for a few cases of platelet transfusion, catheter occlusion, hypotension, and hematoma, no other complications were observed. A low rate of mortality (33.3%) was observed in patients who received 3 sessions of hemadsorption.

Conclusion:
Intermittent hemadsorption reduced inflammatory factors and improved outcomes of patients with severe COVID-19. Cytokine hemadsorption can be an effective therapeutic option for establishing inflammatory equilibrium. Our study was a non-comparator and single-center observational study. Larger studies like RCTs are warranted.