bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital readmission for acute kidney injury is independently associated with de novo end-stage renal disease after liver transplantation
Authors: Bittermann Therese , Kathawate Ranganath G. , Schaubel Douglas E. , Lewis James D. , Goldberg David S. 
Published: August 2024

End-stage renal disease (ESRD) after liver transplantation (LT) is associated with high morbidity and mortality. The consequences of hospitalizations for post-LT acute kidney injury (AKI) are poorly understood. Using linked Medicare claims and transplant registry data, we analyzed adult liver alone recipients not receiving pretransplant dialysis between January 1, 2007, and December 31, 2016. Covariate-adjusted Cox proportional hazards models stratified by center evaluated factors associated with AKI readmission during the first post-LT year, and whether AKI readmission was associated with de novo early (<1 y) or late (≥1 y) ESRD post-LT. The cohort included 10,559 patients and was 64.5% male, 72.5% White, 8.1% Black, and 14.0% Hispanic with median age 62 years. Overall, 2875 (27.2%) patients had ≥1 AKI hospitalization during the first year. Estimated glomerular filtration rate at LT was associated with AKI readmission (adjusted HR: 1.16 per 10 mL/min/1.73m2 decrease; p<0.001). The adjusted HR for early ESRD in patients with ≥1 AKI readmission <90 days post-LT was 1.90 (p<0.001). The adjusted HRs for late ESRD with 1 and ≥2 prior AKI readmissions were 1.57 and 2.80, respectively (p<0.001). AKI readmissions in the first post-LT year impact over one-quarter of recipients. These increase the risk of subsequent ESRD, but may represent an opportunity to intervene and mitigate further renal dysfunction.
Severe Pneumonia in PICU Admissions: The Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN) Observational Cohort Study, 2020–2022*
Authors: Wong Judith Ju Ming , Abbas Qalab , Wang Justin Qi Yuee , Xu Wei , Dang Hongxing , Phan Phuc Huu , Guo Liang , Lee Pei Chuen , Zhu Xuemei , Angurana Suresh Kumar , Pukdeetraipop Minchaya , Efar Pustika , Yuliarto Saptadi , Choi Insu , Fan Lijia , Hui Alvin Wun Fung , Gan Chin Seng , Liu Chunfeng , Samransamruajkit Rujipat , Cho Hwa Jin , Ong Jacqueline Soo May , Lee Jan Hau ,   on behalf of the Pediatric Acute and Critical Care Asian Network (PACCMAN)
Published: August 2024

OBJECTIVES:
Mortality from pneumonia is three times higher in Asia compared with industrialized countries. We aimed to determine the epidemiology, microbiology, and outcome of severe pneumonia in PICUs across the Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN).

DESIGN:
Prospective multicenter observational study from June 2020 to September 2022.

SETTING:
Fifteen PICUs in PACCMAN.

PATIENTS:
All children younger than 18 years old diagnosed with pneumonia and admitted to the PICU.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Clinical, microbiologic, and outcome data were recorded. The primary outcome was PICU mortality. Univariate and multivariable logistic regression was performed to investigate associations between PICU mortality and explanatory risk factors on presentation to the PICU. Among patients screened, 846 of 11,778 PICU patients (7.2%) with a median age of 1.2 years (interquartile range, 0.4–3.7 yr) had pneumonia. Respiratory syncytial virus was detected in 111 of 846 cases (13.1%). The most common bacteria were Staphylococcus species (71/846 [8.4%]) followed by Pseudomonas species (60/846 [7.1%]). Second-generation cephalosporins (322/846 [38.1%]) were the most common broad-spectrum antibiotics prescribed, followed by carbapenems (174/846 [20.6%]). Invasive mechanical ventilation and noninvasive respiratory support was provided in 438 of 846 (51.8%) and 500 of 846 (59.1%) patients, respectively. PICU mortality was 65 of 846 (7.7%). In the multivariable logistic regression model, age (adjusted odds ratio [aOR], 1.08; 95% CI, 1.00–1.16), Pediatric Index of Mortality 3 score (aOR, 1.03; 95% CI, 1.02–1.05), and drowsiness (aOR, 2.73; 95% CI, 1.24–6.00) were associated with greater odds of mortality.

CONCLUSIONS:
In the PACCMAN contributing PICUs, pneumonia is a frequent cause for admission (7%) and is associated with a greater odds of mortality.
Characterization of the genomic landscape of HIV-associated lymphoma reveals heterogeneity across histological subtypes
Authors: Hybel Trine Engelbrecht , Sørensen Emma Frasez , Enemark Marie Hairing , Hemmingsen Jonas Klejs , Simonsen Anita Tranberg , Lauridsen Kristina Lystlund , Møller Michael Boe , Pedersen Court , Pedersen Gitte , Obel Niels , Larsen Carsten Schade , d’Amore Francesco , Hamilton-Dutoit Stephen , Stougaard Magnus , Vase Maja Ølholm , Ludvigsen Maja 
Published: August 2024

Objective:
Individuals with HIV experience an increased risk of lymphoma, making this an important cause of death among people with HIV. Nevertheless, little is known regarding the underlying genetic aberrations, which we therefore set out to characterize.

Design:
We conducted next-generation panel sequencing to explore the mutational status of diagnostic lymphoma biopsies from 18 patients diagnosed with lymphoma secondary to HIV infection.

Methods:
Ion Torrent next-generation sequencing was performed with an AmpliSeq panel on diagnostic lymphoma biopsies from HIV-associated B-cell lymphomas (n = 18), comprising diffuse large B-cell lymphoma (n = 9), classic Hodgkin lymphoma (n = 6), Burkitt lymphoma (n = 2), follicular lymphoma (n = 1), and marginal zone lymphoma (n = 1). The panel comprised 69 lymphoid and/or myeloid-relevant genes, in which either the entire coding sequence or a hotspot region was sequenced.

Results:
Among the 18 lymphomas, we detected 213 variants. The number of detected mutations ranged from 4 to 41 per tumor distributed among 42 genes, including both exonic and intronic regions. The most frequently mutated genes included KMT2D (67%), TNFAIP3 (50%), and TP53 (61%). Notably, no gene was found to harbor variants across all the HIV-associated lymphomas, nor did we find subtype-specific variants. While some variants were shared among patients, most were unique to the individual patient and were often not reported as malignant genetic variants in databases.

Conclusion:
Our findings demonstrate genetic heterogeneity across histological subtypes of HIV-associated lymphomas and thus help elucidate the genetics and pathophysiological mechanisms underlying the disease.
VASCULAR ENDOTHELIAL DYSFUNCTION IMPROVEMENTS IN PATIENTS WITH UREMIA USING PENTOXIFYLLINE-SUPPRESSING NLRP3 EXPRESSIONS AND HMGB1 RELEASE
Authors: Li Ruikun , Zhang Xue , Xu Yuanqin , Feng Tao 
Published: August 2024

ABSTRACT
This study aimed to investigate the protective effect of pentoxifylline (PTX) on vascular endothelial dysfunction in uremia. The human aortic endothelial cells (HAECs) required for the experiments were all obtained from the National Collection of Authenticated Cell Cultures (Salisbury, UK). The permeability of HAECs was assessed. Each group had six samples. Compared with the healthy volunteer group, HAEC proliferation in the 20% uremia group was significantly inhibited after 72 h (P < 0.001), co-localization of nucleotide-binding domain, leucine-rich repeat-containing receptor family pyrin domain-containing 3 (NLRP3) and apoptosis-associated speck-like (ASC) protein induced by uremic serum was enhanced (P < 0.01) and high mobility group box 1 (HMGB1) release was increased (0.594 ± 0.057, P = 0.03). The co-immunoprecipitation of NLRP3, ASC, and HMGB1 induced by uremic toxin was also enhanced (P < 0.01), and PTX inhibited this phenomenon. The expression of NLRP3 (0.810 ± 0.032, P = 0.02) and caspase-1 (0.580 ± 0.041, P = 0.03) was increased, whereas the expression of ZO-1 (0.255 ± 0.038, P = 0.03) and VE-cadherin (0.0546 ± 0.053, P = 0.02) was decreased in the uremia group; compared with the healthy volunteer group, treated with PTX (NLRP3, 0.298 ± 0.042, P = 0.03; caspase-1, 0.310 ± 0.021, P = 0.03; ZO-1, 0.412 ± 0.028, P = 0.02; VE-cadherin, 0.150 ± 0.034, P = 0.02) and MCC950 (NLRP3, 0.432 ± 0.022, P = 0.03; caspase-1, 0.067 ± 0.031, P > 0.05; ZO-1, 0.457 ± 0.026, P = 0.03; VE-cadherin, 0.286 ± 0.017, P = 0.03) these lessened this trend. Pentoxifylline promoted the HAEC permeability mediated by uremic toxins (1.507 ± 0.012, P = 0.02). In conclusion, PTX enhances the release of HMGB1, which is dependent on NLRP3 activation, and consequently exerts positive effects on interconnecting proteins, ultimately leading to an improvement in vascular permeability.
PANAXADIOL SAPONIN ALLEVIATES LPS-INDUCED CARDIOMYOPATHY SIMILAR TO DEXAMETHASONE VIA IMPROVING MITOCHONDRIAL QUALITY CONTROL
Authors: Yang Zhaoyun , Gao Yan , Li Dongyang , Zhao Lijing , Du Yanwei 
Published: August 2024

ABSTRACT
Septic cardiomyopathy is linked to a dysregulation in mitochondrial integrity and elevated mortality rates, for which an efficacious treatment remains elusive. PDS is a panaxadiol saponin extracted from ginseng stem and leaf. This study identified the protective effects of PDS and DEX in LPS-induced cardiomyopathy and explored the mechanism of them treating LPS-induced cardiomyopathy from the perspectives of mitochondrial quality control. DEX and PDS enhance antioxidant defense by degrading Keap1 to activate Nrf2; activate mitochondrial occurrence protein PGC-1α and fusion protein OPA1, Mfn1, and Mfn2 expression; and inhibit phosphorylation of mitochondrial fission protein Drp1, aiming to maintain normal structure and function of mitochondrial, thereby preserving oxidative phosphorylation capacity. In summary, our findings highlighted the protective efficacy of PDS and DEX in maintaining mitochondrial in LPS-induced cardiomyopathy, and mechanism improving mitochondrial quality control at least in part by promoting Nrf2 activation.
TARGETED TEMPERATURE MANAGEMENT AT 36°C IMPROVES SURVIVAL AND PROTECTS TISSUES BY MITIGATING THE DELETERIOUS INFLAMMATORY RESPONSE FOLLOWING HEMORRHAGIC SHOCK
Authors: Choi Arom , Woo Ji Sun , Park Yoo Seok , Kim Ju Hee , Chung Yong Eun , Lee Sojung , Beom Jin Ho , You Je Sung 
Published: August 2024

ABSTRACT
Hemorrhagic shock (HS) is a life-threatening condition with high mortality rates despite current treatments. This study investigated whether targeted temperature management (TTM) could improve outcomes by modulating inflammation and protecting organs following HS. Using a rat model of HS, TTM was applied at 33°C and 36°C after fluid resuscitation. Surprisingly, TTM at 33°C increased mortality, while TTM at 36°C significantly improved survival rates. It also reduced histological damage in lung and kidney tissues, lowered serum lactate levels, and protected against apoptosis and excessive reactive oxygen species production. TTM at 36°C inhibited the release of high mobility group box 1 protein (HMGB1), a key mediator of inflammation, and decreased proinflammatory cytokine levels in the kidneys and lungs. Moreover, it influenced macrophage behavior, suppressing the harmful M1 phenotype while promoting the beneficial M2 polarization. Cytokine array analysis confirmed reduced levels of proinflammatory cytokines with TTM at 36°C. These results collectively highlight the potential of TTM at 36°C as a therapeutic approach to improve outcomes in HS. By addressing multiple aspects of injury and inflammation, including modulation of macrophage responses and cytokine profiles, TTM at 36°C offers promising implications for critical care management after HS, potentially reducing mortality and improving patient recovery.
Impact of Intrapatient Immunosuppression Variability in Liver Transplantation Outcomes: A Systematic Review and Meta-analysis
Authors: Lattimore Sherene , Chambers Anastasia , Angeli-Pahim Isabella , Shrestha Abhishek , Eke Benjamin O. , Pomputius Ariel , Bylund Carma , Gregory Megan E. , Zarrinpar Ali 
Published: August 2024

Background.To investigate the impact of intrapatient variability (IPV) in the levels of immunosuppressant drugs on health outcomes after liver transplantation.Methods.A comprehensive systematic review and meta-analysis were conducted, examining literature from MEDLINE/PubMed, Embase, Web of Science, Cochrane Reviews, and Cochrane CENTRAL.Results.The analysis focused on acute rejection, graft survival, acute kidney injury, and cancer risk as health outcomes. Of 2901 articles screened, 10 met the inclusion criteria. The results indicate a 19% reduction in the risk of acute rejection in patients with lower IPV (RR = 0.81; 95% confidence interval, 0.66-0.99), although 6 studies found no significant association between high IPV and acute rejection. Contrasting results were observed for graft survival, with 1 study indicating worse outcomes for high IPV, whereas another reported no significant difference. High IPV was consistently associated with acute kidney injury across 3 studies. One study suggested a link between high IPV and hepatocellular carcinoma, although a meta-analysis for these outcomes was not feasible.Conclusions.These findings point to a marginal but statistically significant association between high IPV and an increased risk of acute rejection, highlighting the importance of precise management of immunosuppressive drugs in liver transplant recipients to enhance patient outcomes.
Impact of Dialysis Time on Long-term Outcomes in HLA-identical Living Donor Kidney Transplant Recipients
Authors: Ferreira Evelyn S. , Requião-Moura Lucio , Nakamura Mônica R. , Foresto Renato Demarchi , Medina Pestana José , Tedesco-Silva Hélio 
Published: August 2024

Background.
Dialysis vintage is associated with worse outcomes after kidney transplantation. The reasons behind this observation include immunological and nonimmunological risk factors. To mitigate the influence of immunological factors, we examined the association between time on dialysis and clinical outcomes in a cohort of HLA-identical kidney transplant recipients.

Methods.
This retrospective study included 13 321 kidney transplant recipients between 1999 and 2016, of whom 589 were HLA identical followed for at least 5 y. Patient and graft survivals were compared according to dialysis time (<12 or >12 mo) using the log-rank test and Cox regression analysis. We compared surgical complications, cytomegalovirus infection, acute rejection, disease recurrence, and the trajectories of estimated glomerular filtration rate (eGFR).

Results.
Median time on dialysis was 15 mo; 9.2% of patients received preemptive transplants, and 55.3% of patients were on dialysis for >12 mo. After a median follow-up time of 154 mo, there were no differences in unadjusted and adjusted patient and graft survivals (1, 5, 10, and 15 y) between the 2 groups. There were no differences in the incidence of surgical complications (6.2% versus 3.1%), acute rejection (6.1% versus 7.7%), cytomegalovirus infection (7.6% versus 4.0%), and disease recurrence (4.2% versus 4.0%), respectively. There were no differences in mean eGFR during 5 y or in the proportion of patients with an eGFR <30 mL/min at 5 y (9.9% versus 9.2%).

Conclusions.
In this low immunological risk cohort of HLA-identical kidney transplant recipients, we did not observe any association between dialysis vintage on patient survival and graft survival.
G2019S Mutation of Leucine-Rich Repeat Kinase 2 Is a Cause of Lewy Body Dementia in Patients With North African Ancestors
Authors: Segers Kurt , Benoit Florence , Levy Sophie , Martinet Valérie , Schulz Joachim G. , Bertrand Frédéric , De Bourgoing Gabrielle , Tatillo Chiara , Praet Jean-Philippe , Vandernoot Isabelle , Desmyter Laurence , Peyrassol Xavier , Kehagias Pashalina , Smits Guillaume , Dumoulin Baptiste , Besse-Hammer Tatiana , Dachy Bernard , Surquin Murielle 
Published: August 2024

Background:
Mutations in the LRRK2 gene are the most common genetic cause of Parkinson disease but are believed to play no significant role in Lewy body disease (LBD).

Objectives:
As the frequency of G2019S LRRK2 mutation is extremely high in North African patients with Parkinson disease, we postulate that the high prevalence of LBD in North Africa might be due to the same mutation because LBD and Parkinson disease share many clinical, pathological, and genetic features.

Methods:
We screened patients with LBD or prodromal LBD for the G2019S mutation of LRRK2.

Results:
A total of 162 patients were tested for the mutation, which was present in 5 of the 47 patients with North African ancestors. This is a much higher prevalence (10.6%) than in healthy North African subjects (1.45%) but lower than in North African patients with Parkinson disease (36% to 39%). Carriers tended to develop more often orthostatic hypotension and swallowing problems.

Conclusions:
Where previous studies in European and North American patients found no link between LRRK2 mutations and LBD, we found an LRRK2 mutation associated with Lewy body disease, namely the G2019S mutation that might be restricted to patients with North African ancestors. Our study illustrates the need to introduce ethnic diversity as stratifying factor in the analysis of genetic causes of neurodegenerative disorders. The current development of disease-modifying drugs modulating LRRK2 kinase activity could justify to screen North African patients with LBD for the G2019S LRRK2 mutation.
Interpreting Histopathology Reports of Temporal Artery Biopsies Positive for Giant Cell Arteritis (GCA): A Single-Center Retrospective Study
Authors: McDonald Heather , Phillips Christian , Shah Minj , Margolin Edward 
Published: August 2024

Background:
The gold standard for diagnosing giant cell arteritis (GCA) is temporal artery biopsy (TAB). However, specific histopathologic findings on biopsy reports are rarely considered in the context of the patient's clinical presentation. The purpose of this study was to analyze the correlation of specific biopsy findings with the clinical presentation of patients with GCA.

Methods:
Retrospective chart review of patients with a clinical and histopathologic diagnosis of GCA at a single tertiary care neuro-ophthalmology practice from January 2014 to September 2023. Histopathologic findings on TAB were recorded for each patient, along with clinical history, examination, and treatment. Continuous variables were reported as mean values with standard deviations (SD), while categorical variables were described as percentages. Correlation coefficients with P-values were used to evaluate the relationship between biopsy findings and clinical data.

Results:
A total of 53 patients were included. TAB specimens ranged in length from 0.6 to 3.4 cm, with a statistically significant correlation coefficient between specimen length and total number of positive findings on the biopsy report. A positive correlation coefficient that approached statistical significance was found between the presence of lymphocytes in the biopsy and permanent vision loss (R = 0.253, P-value 0.054), which occurred in 27 patients. Patients were treated with steroids prebiopsy for an average of 9 days; there was no statistically significant correlation between the duration of steroid treatment and the presence of specific histopathologic findings other than involvement of the intima.

Conclusions:
The results of this study demonstrate that (1) longer temporal artery biopsy specimens are significantly correlated with a higher number of findings on biopsy reports; (2) the presence of arterial stenosis, eosinophils, and lymphocytes correlated with permanent vision loss or degree of vision loss; and (3) the duration of steroid treatment had a significant inverse correlation with intimal involvement but did not affect other histopathologic findings seen with GCA. This retrospective observational study provides clinicians with an approach to understanding the nuances of the histopathologic findings on their patient's TAB report.
Does Electroencephalography Seizure Duration Account for an Adequate Treatment of Magnetic Seizure Therapy for Schizophrenia?
Authors: Jiang Jiangling , Li Jin , Xu Yuanhong , Zhang Bin , Sheng Jianhua , Liu Dengtang , Wang Wenzheng , Yang Fuzhong , Guo Xiaoyun , Li Qingwei , Zhang Tianhong , Tang Yingying , Jia Yuping , Wang Jijun , Li Chunbo 
Published: August 2024

Objectives
A seizure lasting >15 s has been considered to indicate treatment for magnetic seizure therapy (MST), a modification of electroconvulsive therapy (ECT), without much validation. This study aimed to investigate whether this seizure duration was suitable for the treatment of schizophrenia.

Methods
Altogether, 34 and 33 in-patients with schizophrenia received 10 sessions of MST and ECT, respectively. Clinical symptoms were assessed using the Positive and Negative Symptom Scale at baseline and at the 4-week follow-up. Electroencephalogram (EEG) was monitored during each MST or ECT treatment using bifrontal electrodes.

Results
The proportion of participants who achieved the 15-second threshold was only 28.6% in the MST group, with a significant difference between responders and nonresponders. For patients receiving MST, the average EEG seizure duration correlated with the percentage of Positive and Negative Symptom Scale reduction (t
(32) = 2.51, P = 0.017, uncorrected; t
(32) = 2.00, P = 0.055, corrected with clinical characteristics). The average EEG seizure duration predicted the clinical response at a trend level (Z = 1.76, P = 0.078) with an optimal cutoff of 11.3 seconds. All patients in the ECT group achieved the 15-second threshold. However, their average EEG seizure duration was uncorrelated with clinical improvement.

Conclusions
The duration of EEG seizures may be associated with the antipsychotic effects of MST. This association may have been influenced by various clinical and technical factors. More research is needed to define the specific criteria for adequate MST in schizophrenia in order to achieve personalized dosing.
Context-Dependent Modulations of Subthalamo-Cortical Synchronization during Rapid Reversals of Movement Direction in Parkinson’s Disease
Authors: Winkler Lucie , Butz Markus , Sharma Abhinav , Vesper Jan , Schnitzler Alfons , Fischer Petra , Hirschmann Jan 
Published: August 2024

AbstractThe role of beta band activity in cortico-basal ganglia interactions during motor control has been studied extensively in resting-state and for simple movements, such as button pressing. However, little is known about how beta oscillations change and interact in more complex situations involving rapid changes of movement in various contexts.To close this knowledge gap, we combined magnetoencephalography (MEG) and local field potential recordings from the subthalamic nucleus (STN) in Parkinson’s disease patients to study beta dynamics during initiation, stopping, and rapid reversal of rotational movements. The action prompts were manipulated to be predictable vs. unpredictable.We observed movement-related beta suppression at motor sequence start, and a beta rebound after motor sequence stop in STN power, motor cortical power, and STN-cortex coherence. Despite involving a brief stop of movement, no clear rebound was observed during reversals of turning direction. On the cortical level, beta power decreased bilaterally following reversals, but more so in the hemisphere ipsilateral to movement, due to a floor effect on the contralateral side. In the STN, power modulations varied across patients, with patients revealing brief increases or decreases of high-beta power. Importantly, cue predictability affected these modulations. Event-related increases of STN-cortex beta coherence were generally stronger in the unpredictable than in the predictable condition.In summary, this study reveals the influence of movement context on beta oscillations in basal ganglia-cortex loops when humans change ongoing movements according to external cues. We find that movement scenarios requiring higher levels of caution involve enhanced modulations of subthalamo-cortical beta synchronization. Further, our results confirm that beta oscillations reflect the start and end of motor sequences better than movement changes within a sequence.Significance StatementBeta synchrony between motor cortex and the subthalamic nucleus is intensified when instructional cues within a continuous motor sequence become less predictable, calling for more cautious behavior.