bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deregulation of the expression of the fractalkine/fractalkine receptor complex in HIV-1–infected patients
Authors: Foussat Arnaud , Bouchet-Delbos Laurence , Berrebi Dominique , Durand-Gasselin Ingrid , Coulomb-L'Hermine Aurore , Krzysiek Roman , Galanaud Pierre , Levy Yves , Emilie Dominique 
Published: July 2002

AbstractFractalkine is the only member of the CX3C chemokine family. Polymorphism of the fractalkine receptor gene may influence the prognosis of human immunodeficiency virus (HIV) infection, but the nature of the cells expressing fractalkine or its receptor in HIV-infected patients remains unknown. We show that, in contrast to HIV-uninfected individuals, a large number of cells expressed fractalkine in T-cell zones of lymph nodes from HIV-infected patients. CD83+ mature and CD123+ plasmacytoid dendritic cells as well as plasma cells are involved in this increased expression of fractalkine. Increased numbers of plasmacytoid dendritic cells and plasma cells were present in T-cell zones of HIV-infected patients. CD83+ dendritic cells were present in similar number in HIV-infected patients and controls, but an increased fraction of these cells produced fractalkine in HIV-infected patients. Many plasma cells in the gut-associated lymphoid tissue from HIV-infected patients also produced fractalkine, whereas few cells produced fractalkine in the gut of controls. The fraction of CD45RO+ and CD45RO− T helper (Th) cells expressing the fractalkine receptor CX3CR1 was higher in HIV-infected patients than in healthy individuals, and these cells were abnormally sensitive to fractalkine stimulation. This increased response correlated with HIV viremia, and it returned to normal levels in patients successfully treated with antiretroviral drugs. The increased expression of the fractalkine/fractalkine receptor complex associated with HIV infection may affect adhesion and migration of Th lymphocytes and their interaction with dendritic cells. Thus, it may influence the equilibrium between depletion and renewal of the Th lymphocyte compartment.
Efficacy and safety of thalidomide in patients with acute myeloid leukemia
Authors: Steins Martin B. , Padró Teresa , Bieker Ralf , Ruiz Sandra , Kropff Martin , Kienast Joachim , Kessler Torsten , Buechner Thomas , Berdel Wolfgang E. , Mesters Rolf M. 
Published: July 2002

AbstractEmerging data suggest an involvement of angiogenesis in the pathophysiology of acute myeloid leukemia (AML). Thus, antiangiogenic therapy could constitute a novel strategy for the treatment of AML. To test this hypothesis, a phase I/II dose-escalating trial was performed to study the safety and efficacy of thalidomide, a putative inhibitor of angiogenesis, in 20 patients with AML. Thirteen patients were assessable for both toxicity and response, tolerating a maximum dose of 200 to 400 mg daily for at least 1 month. Seven patients had to be prematurely withdrawn from drug administration owing to progressive disease and death (3 patients), personal decision (2 patients), or inability to tolerate thalidomide (2 patients). Overall, adverse events were fatigue, constipation, rash, and neuropathy (grade 1 to 2 in most patients). In 4 patients, a partial response, defined as reduction of at least 50% in the blast cell infiltration of the bone marrow accompanied by increases in platelet counts and hemoglobin values, was observed. One additional patient showed a hematologic improvement without fulfilling the criteria of a partial response. The responses lasted a median of 3 months (range, 1-8 months). In parallel, microvessel densities significantly decreased in these 5 patients during treatment with thalidomide (P &lt; .05). This decrease was accompanied by declining plasma levels of basic fibroblast growth factor, one of the most potent angiogenic growth factors. In conclusion, single-agent thalidomide has antiangiogenic and antileukemic activity in AML, although a causal relationship between both effects has still to be proven.
The oxygen debt during routine cardiac surgery: illusion or reality?
Authors: Ganushchak Y M , Maessen J G , de Jong D S 
Published: July 2002

Background: Patients undergoing cardiac surgery with the use of cardiopulmonary bypass (CPB) are often thought to have tissue hypoxia and intraoperative oxygen debt accumulation despite the lack of sufficient data to support this assumption. Methods and results: Oxygen uptake and related parameters, including the plasma lactate and pyruvate concentrations, were studied during the peri-operative period in a group of 15 consecutive patients who underwent coronary artery bypass graft surgery. The actual oxygen uptake (VO2) and delivery (DO2) were compared with the individual expected (computed) oxygen transport values. The mean values of DO2 and VO2were in the range of the expected values. Our results demonstrate a leading role for body temperature in perioperative changes of oxygen consumption rate ( r2 = 0.65, p< 0.001). Plasma lactate and pyruvate did not exceed the physiological range in any patient. However, with initiation of CPB, the lactate to pyruvate (LA/PVA) ratio increased (from 9.87± 2.43 at T1 to 12.08± 1.51 at T2, p< 0.05). The mean value of the LA/PVA ratio was elevated during surgery. Later, upon lowering of the plasma lactate concentration in the postoperative period, the LA/PVA ratio decreased to normal values. Without any other evidence of hypoxia, this increase in the LA/PVA ratio could be explained by washout of lactate from previously hypoperfused tissues and intraoperative decrease of lactate clearance. Conclusion: Systemic oxygenation was not impaired during CPB, or during 18 h after surgery in the studied group of patients.
Hydrodynamics of the new Medos aortic cannula
Authors: Gerdes Anja , Hanke Thorsten , Sievers Hans-H 
Published: July 2002

Background: Postoperative neurologic complications in cardiac surgery patients are considered to be associated with the design of an aortic cannula and its hydrodynamic profile. To gain knowledge about the hydrodynamics of a new cannula type, based on the integration of a helical stator in its tip, was the aim of the present study. Methods: Pressure gradients and back pressures of the new Medos aortic cannula were measured and compared with a commonly used single-stream cannula at varying flow rates in a mock circulation. Additionally, flow visualization was performed by ink injection. Results: Pressure gradients across the Medos cannula were 25.5-31.8% lower at all flow rates measured when compared to the reference cannula. Back pressures of the Medos cannula were 64.1-67.9% lower than reference back pressures. Conclusions: The Medos cannula provides improved hydrodynamic characteristics, probably reducing the risk of atherosclerotic embolism and cerebral malperfusion by avoidance of high back pressures and sandblasting effect.
Integrated care pathways: outcome from inpatient rehabilitation following nontraumatic spinal cord lesion
Authors: Playford E D , Sachs R , Thompson A J 
Published: July 2002

Background: Integrated care pathways (ICPs) map the predicted course of an episode of patient care. They detail the expected interventions during the episode and document departures from the expected pathway (variance). This study describes the use of an ICP to audit the rehabilitation of patients with nontraumatic spinal cord injury admitted between 1997 and 1999. Methods: The ICPs and outcomes of 85 patients with nontraumatic spinal cord injury admitted to the Neurorehabilitation Unit at the National Hospital for Neurology and Neurosurgery, Queen Square, London were analysed. Data extracted included diagnosis, level of the lesion and duration of stay. The numbers and categories of goals and the rates of goal achievement were extracted and the variance patterns analysed. Results: An average of 28 patients were admitted each year. The level of disability on admission and the duration of stay decreased over the three-year period, while the average patient age increased from 48 to 54 years. None of these changes were statistically significant. On average each patient had three new goals set each week. Ninety per cent of all goals were achieved; this was not dependent on the category of goal. Sixteen patients (19%) accounted for 58% of all nonachieved goals. These patients tended to have acute-onset disability. The number of variances fell from 15 to 7 over the three-year period. Conclusions: The pathway enables monitoring of the rehabilitation process. As the Unit becomes more experienced there is a trend to shorter, more focused admissions with fewer variances. Specific groups of patients with particular needs can be identified. Future patients benefit from closure of the ‘audit loop’ and the implementation of clinical change based on information obtained from the ICP.
Between Professional Duty and Ethical Confusion: midwives and selective termination of pregnancy
Authors: Cignacco Eva 
Published: July 2002

This qualitative study describes midwives’ experiences in relation to termination of pregnancy for fetal abnormalities, and their corresponding professional and ethical position. Thirteen midwives working in a university clinic were interviewed about their problems in this respect. The information gathered was evaluated by using qualitative content analysis. The study focused on the emotional experience of the midwives, their professional position, and ethical conflict. In this situation, midwives are faced with a conflict between the woman’s right to self-determination on one hand and the right to life of the child on the other. This conflict causes a high level of emotional stress and, subsequently, professional identity problems. Although questions concerning the child’s right to life are generally suppressed, the ethical principle of the woman’s right to self-determination is rationalized. Although this process of rationalization seems to present a false ethical decision, it enables midwives to continue with their daily professional duties. As far as orientating midwives to the value of these women’s right to self-determination is concerned, it must be assumed that they have made an ethical decision to which they have given insufficient thought. This problem is exacerbated by the fact that midwives are largely excluded from the decision-making process of the parents in question. They cannot therefore help in this process in a valuable and responsible way by providing clear information and proposing objective criteria. In relation to the tasks they are expected to fulfil, these midwives revealed that they were in a state of professional confusion.
Temporal Change in Risk of Metachronous Contralateral Renal Cell Carcinoma: Influence of Tumor Characteristics and Demographic Factors
Authors: Rabbani Farhang , Herr Harry W. , Almahmeed Taghreed , Russo Paul 
Published: July 2002

PURPOSE: To determine the relative risk (RR) of developing a metachronous contralateral renal tumor after an initial diagnosis of renal cell carcinoma (RCC), with stratification by renal tumor characteristics, demographic factors, and follow-up duration, in order to develop an improved risk-based surveillance strategy. PATIENTS AND METHODS: The 1973 to 1997 Surveillance, Epidemiology, and End Results database was used to determine the observed and expected number of metachronous contralateral renal tumors developing after an initial diagnosis of RCC. RESULTS: A total of 43,483 patients had a first diagnosis of RCC. Contralateral RCC developed subsequently in 155 (0.4%) of 40,049 patients with follow-up who had no synchronous diagnosis of RCC, with 10.81 expected cases (RR, 14.3; 95% CI, 12.2 to 16.8). The respective RRs (and 95% CIs) for contralateral RCC for white men and women were 16.0 (11.1 to 22.3) and 13.7 (7.7 to 22.6) at less than 2 years, 8.8 (5.0 to 14.3) and 10.5 (5.0 to 19.3) at 2 to 5 years, 13.5 (8.1 to 21.0) and 5.1 (1.4 to 13.2) at 5 to 10 years, and 13.0 (6.2 to 23.9) and 13.7 (5.0 to 29.9) at ≥ 10 years, respectively. The RRs were significantly higher in black compared with white men for the first 5 years, with the RRs (and 95% CIs) in the former group of 95.3 (58.2 to 146.7) at less than 2 years and 41.9 (16.8 to 86.3) at 2 to 5 years. CONCLUSION: The incidence of metachronous contralateral RCC is stable on long-term follow-up, suggesting that surveillance of the contralateral kidney should remain rigorous on extended follow-up. Black men are at a significantly higher risk of developing contralateral RCC in the first 5 years of follow-up.
Health Care–Related Savings Accounts, Health Care Expenditures, and Tax Expenditures
Authors: Ding Dong , Glied Sherry 
Published: September 2024

ImportanceApproximately 30% of US families with employer-sponsored health insurance, disproportionately drawn from high-income groups, benefit from flexible spending accounts (FSAs) or health savings accounts (HSAs). The combined association through both out-of-pocket spending and premiums of these tax-favored accounts with health care expenditures and tax expenditures remain uncertain.ObjectiveTo compare the health care and health-related tax expenditures among families holding FSAs, HSAs, or neither type of account.Design, Setting, and ParticipantsThis cross-sectional study used family-level data from the Medical Expenditure Panel Survey from January 1, 2011, to December 31, 2019, and conducted regression models, controlling for demographic and socioeconomic characteristics, chronic conditions, prior health care expenditures, and marginal tax rates to analyze how holding tax-favored accounts is associated with families’ health care spending and tax expenditures. The sample was restricted to families included in the survey for 2 years, with no members 65 years or older, and with at least 1 policyholder covered (only) by full-year employer-sponsored insurance. Data were analyzed from December 1, 2023, to April 30, 2024.ExposuresHolding FSAs or HSAs.Main Outcomes and MeasuresOut-of-pocket and insurance-paid health expenditures overall and by service were measured. Health-related tax expenditures were based on tax-excluded insurance premiums and tax-sheltered out-of-pocket expenses.ResultsOf the 17 038 families included in the study sample, 2628 held FSAs (weighted 17%) and 1845 (weighted 13%) held HSAs. In regression-adjusted models, families with FSAs spent a mean of 20% or $2033 (95% CI, $789-$3276) more on health care annually than non–account holding families, largely due to increased insurer-paid expenses. Families with HSAs spent a mean of 44% or $697 (95% CI, $521-$873) more on out-of-pocket expenditures and had insignificantly higher insurance-paid expenditures than families without accounts, resulting in overall expenditures comparable to those of non–account holders. The additional tax expenditures associated with FSAs were a mean of $1306 (95% CI, $536-$2076) annually per family. Both types of funds were associated with significant increases in tax expenditures from additional office-based visits ($445 [95% CI, $244-$645] for FSAs and $174 [95% CI, $11-$336] for HSAs), outpatient visits ($330 [95% CI, $132-$528] for FSAs and $250 [95% CI, $15-$485] for HSAs), dental visits ($180 [95% CI, $126-$233] for FSAs and $165 [95% CI, $104-$226] for HSAs), and vision care ($36 [95% CI, $28-$45] for FSAs and $52 [95% CI, $40-$64] for HSAs).Conclusions and RelevanceParticipation in FSAs is associated with higher health care expenditures and tax expenditures, while HSAs are not associated with reduced expenditures. Tax policy could be better targeted to enhance insurance coverage and health care accessibility.
Community Asset Density and Past-Year Mental Health Symptoms Among Youths
Authors: Szoko Nicholas , Ajith Aniruddh , Kurland Kristen , Culyba Alison J. 
Published: September 2024

ImportanceMany youths experience mental health challenges. Identifying which neighborhood and community factors may influence mental health may guide health policy and practice.ObjectiveTo explore associations between community assets (eg, schools, parks, libraries, and barbershops) and past-year mental health symptoms among youths.Design, Setting, and ParticipantsThis cross-sectional study leveraged 3 datasets, which were linked by 26 zip codes: the Western Pennsylvania Regional Data Center, the Child Opportunity Index 2.0 database, and the Allegheny County Youth Risk Behavior Survey (YRBS). The YRBS was administered during the study period in 2018 to youths across 13 high schools in Allegheny County, Pennsylvania; the study dates were from October 15 to October 19, 2018. Dates of analysis were from August 1, 2023, to July 15, 2024.ExposuresAsset density in each zip code across 8 asset categories (transportation, education, parks and recreation, faith-based entities, health services, food resources, personal care services, and social infrastructure) was calculated.Main Outcomes and MeasuresThe main outcomes were mental health measures included in the past 12 months, which comprised feelings of hopelessness (feeing so sad or hopeless that you stopped doing activities), nonsuicidal self-injury (hurt yourself on purpose without wanting to die), and suicidal ideation (seriously considered attempting suicide). All were operationalized to any or none. Data were analyzed using multivariable generalized linear mixed models and were adjusted for age, sex assigned at birth, race and ethnicity, and identification as sexually or gender diverse.ResultsAmong 6306 students who were eligible for the YRBS based on their enrollment in participating high schools, 4487 students completed surveys, and 2162 were included in the analytic sample (mean [SD] age, 15.8 [1.2] years; 1245 [57.6%] were assigned female sex at birth). Over one-third of the participants (811 [37.5%]) reported past-year feelings of hopelessness; 587 (27.2%), past-year nonsuicidal self-injury; and 450 (20.8%), past-year suicidal ideation. High total asset population density (adjusted odds ratio [AOR], 0.85 [95% CI, 0.75-0.97]; P = .01), as well as population density of transportation assets (AOR, 0.77 [95% CI, 0.66-0.90]; P &amp;lt; .001), educational resources (AOR, 0.78 [95% CI, 0.67-0.92]; P = .002), and health services (AOR, 0.74 [95% CI, 0.60-0.91]; P = .006), were associated with lower odds of past-year hopelessness after adjusting for covariates. There were no correlations between asset density, Child Opportunity Index, and other mental health measures.Conclusions and RelevanceThe findings of this cross-sectional study suggest that access to certain community assets was associated with lower odds of feelings of hopelessness among youths. Ongoing work is needed to characterize other forms of social and cultural capital, which may mitigate negative mental health outcomes among adolescent youths.
Boosting Uniformity and Efficiency of Large‐Area Inverted Organic Photovoltaics Via ZnO Surface Energy Modulation
Authors: Cui Yongting , Li Haojie , Zeng Shumin , Zhang Kai , Wang Hanlin , Liu Siqi , Ye Long , Guo Rui , Hu Xiaotian , Chen Yiwang 
Published: September 2024

AbstractLarge‐area organic photovoltaic modules have a wide range of applications in a number of fields due to their unique advantages. Inverted organic solar cells exhibit better air stability and are suitable for all‐air printing of large‐area modules. However, the mismatch between the surface energy of ZnO and the active layer leads to coffee rings and stick‐slip effects during the printing process, resulting in uneven deposition of the active layer. Additionally, the mismatch in energy levels between the active layer and ZnO degrades device performance. Hence, a phenol series of alcohol solutions is utilized to improve the wettability and surface energy of ZnO, enabling the formation of large‐area homogeneous active layer films. Hydroxyl groups in the phenol series passivate ZnO surface defects and form hydrogen bonds with small molecules of the acceptor, increasing carrier mobility and improving device performances. Based on the PM6: BTP‐eC9 (o‐XY) system, the power conversion efficiency (PCE) reaches 18.80% for small‐area devices and 15.87% for large‐area modules, higher than the forward structure (15.83%). This study offers an effective approach to mitigating large‐area active layer film uniformity issues, advancing the preparation of large‐area organic photovoltaic modules via all‐air printing.
Simultaneous Light‐Triggered Formation of Polymer Networks and Enhancement of Electrohydrodynamic Instabilities in Liquid Crystals for Versatile Energy‐Saving Smart Windows
Authors: Zhang Huimin , Li Junqin , Zhao Yuzhen , He Zemin , Miao Zongcheng , Shen Wenbo 
Published: September 2024

AbstractSmart windows have come to the fore in modern buildings and intelligent information equipment drawing upon their dynamic control over light transmission. Liquid crystals tactfully manipulate light transmission depending on their microcosmic molecular orientations, emerging as new favorite functional materials for smart windows. However, most liquid crystal window technologies require continuous electricity for operation in luminous transparency and still perform a trade‐off between film formation performance and dimming functions. As key components of building structures, windows shall be kept transparent for an extended period. For the convenience of large‐scale processing, polymer matrices are indispensable. Given that, reverse‐operation‐mode dimming films, which are transparent to achieve daylighting in their natural or no power‐input states and become opaque to block sunlight through electric input on demand, are highly desired. Here, by introducing a photolabile amine, the synchronous light‐induced formation of polymer networks and enhancement of electrohydrodynamic instabilities in mesogenic materials is successfully executed. Relying on this creative and effective approach, reverse‐operation‐mode polymer network liquid crystal films having simultaneous modulation capability of visible light and near‐infrared light from solar irradiation are skillfully fabricated, promising applications in versatile energy‐saving smart windows.
Integrated OPECT and Smartphone Colorimetry Dual‐Mode Detection of Okadaic Acid Based on Ce‐MOF Modified MXene@SnO2 Z‐Scheme Heterostructure
Authors: Chi Jingtian , Ju Peng , Bi Fan , Jiang Tiantong , Wen Siyu , Cai Yueyuan , Wang Ling , Qiu Meng 
Published: September 2024

AbstractThe organic photoelectrochemical transistor (OPECT) biosensing relies solely on a singular signal readout inherently, which restrains the precision and dependability nestled within pertinent biological measurements. Herein, a high‐precision magnetic assisted OPECT and smartphone colorimetric (SCL) dual‐mode biosensing platform is first established for detecting harmful algal toxin okadaic acid (OA) by biocatalytic reaction. MXene@SnO2‐Ce‐MOF (MXSnO/Ce‐MOF) Z‐scheme heterojunctions with abundant oxygen vacancies are prepared as photoactive materials. Initially, in the presence of OA, the coupling of trigger DNA (tDNA) to magnetic beads (MBs) via anchor DNA (aDNA) is released through the interaction of the target analyte with the aptamer. Subsequently, the carried tDNA triggers HCR between the two hairpin sequences, producing long double helix chains to capture glucose oxidase (GOx). The obtained GOx supernatant catalyzes glucose to produce H2O2, which can oxidize Ce‐MOF, leading to the alteration of electrode color and a significant decrease in the overall photocurrent of MXSnO/Ce‐MOF. Crucially, the novel OPECT‐SCL biosensor exhibits excellent sensitivity and precision, boasting detection thresholds as low as 42.9 pM and 1.2 nM, respectively, and accomplishes the automated detection of OA within real samples. The proposed OPECT‐SCL dual‐signal measurement model constitutes a sensitive, portable, and precise platform for the quantification of marine toxins.