bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunosenescence and its related comorbidities in older people living with HIV
Authors: He Xiao-Yan , Wang Xiu-Wen , Li Shuang , Li Na , Li Wei , Hu Yan , Guo Na , Zheng Yong-Tang , Zheng Hong-Yi , Su Bin 
Published: August 2024

Abstract
With the aging of the global population, older people living with HIV (OPLWH) have emerged as a focal point in HIV/AIDS research. Although antiretroviral therapy has demonstrated positive effects in OPLWH, concerns persist regarding overall poor immune reconstitution and elevated rates of age-related comorbidities, such as cardiovascular disease, bone disease, and cognitive impairment. This review aims to elucidate the mechanisms underlying immunosenescence and the interaction of immunosenescence with HIV infection, further exploring its role in the pathogenesis of HIV infection during aging. Aging-induced involution of the immune system, along with chronic inflammation and infection, can induce immunosenescence, leading to immune dysfunction that impairs the effective control of HIV infection. In addition, HIV infection induces immunosenescence through persistent inflammation and immune activation, even under treatment. The combined effects of aging and HIV infection accelerate the progression of immunosenescence in OPLWH, increasing their susceptibility to multiple age-related diseases. The unfavorable prognosis observed among OPLWH is largely attributed to increased levels of immunosenescence. A comprehensive understanding of the relationship between immunosenescence and HIV infection is crucial for developing targeted therapeutic strategies for this vulnerable population.
Perioperative hypothermia and stress jeopardize antimetastatic immunity and TLR-9 immune activation: potential mediating mechanisms (experimental studies)
Authors: Sandbank Elad , Matzner Pini , Eckerling Anabel , Sorski Liat , Rossene Ella , Nachmani Ido , Ben-Eliyahu Shamgar 
Published: August 2024

Background:
The perioperative period often involves stress responses and surgery-induced hypothermia, which were suggested to hinder antimetastatic immunity and promote cancer metastasis. During this critical period, immunotherapies are rarely used, given contraindications to surgery. However, recent preclinical studies support the feasibility of perioperative TLR-9 activation using CpG-C.

Materials and methods:
Herein, we employed hypothermic-stress and normothermic-stress paradigms to assess their impact on perioperative CpG-C immune stimulation and resistance to experimental hepatic metastasis of CT26 colorectal cancer in BALB/c mice.

Results:
Perioperative hypothermic wet-cage stress markedly abrogated CpG-C-induced increase in plasma IL-12 levels, a persistent deleterious effect across different CpG-C doses and administration routes. These effects were not attenuated by blocking glucocorticoids, adrenergic, or opioid signaling, nor by adrenalectomy, suggesting a direct immunosuppressive impact of hypothermia on immunocytes. Indeed, normothermic wet-cage stress, which induced a similar corticosterone response, caused significantly less deleterious effects on IL-12 levels, hepatic NK cell maturation and cytotoxicity, and CT26 metastasis. Additionally, in-vitro exposure of PBMCs to 33°C markedly decreased CpG-C-induced IL-12 production. Last, two normothermic stress paradigms, tilt&light and restraint, did not jeopardize CpG-C-induced IL-12 response nor resistance to CT26 metastases. Interestingly, attenuating glucocorticoid signaling under tilt&light conditions improved CpG-C efficacy.

Conclusions:
Overall, these findings suggest that perioperative hypothermic stress can jeopardize antimetastatic immunity and resistance to metastasis, and prevent perioperative response to immune stimulation and its beneficial antimetastatic impacts, effects that are not mediated through classical neuroendocrine stress responses, but potentially through direct hypothermic impact on leukocytes. These findings may have clinical implications in operated cancer patients, many of whom suffer hypothermic stress.
Tympanic Membrane Regeneration Therapy for Pediatric Tympanic Membrane Perforation
Authors: Kanemaru Shin-ichi , Kita Shin-ichiro , Kanai Rie , Yamaguchi Tomoya , Kumazawa Akiko , Yuki Ryohei , Yoshida Misaki , Miwa Toru , Harada Hiroyuki , Maetani Toshiki 
Published: August 2024

Objective
To evaluate tympanic membrane regeneration therapy (TMRT) for pediatric tympanic membrane perforations (TMPs).

Study Design
Intervention study.

Setting
Research institute hospital.

Patients
In this study, 20 patients with chronic TMP (M/F: 13/7, 13/8 ears, age 0–15 years) treated with TMRT were evaluated. As comparison, 20 pediatric patients with chronic TMP who underwent myringoplasty/tympanoplasty were included.

Interventions
For the TM repair procedure, the edge of the TMP was disrupted mechanically, and gelatin sponge immersed in basic fibroblast growth factor was placed inside and outside the tympanic cavity and covered with fibrin glue. The TMP was examined 4 ± 1 weeks later. The protocol was repeated up to four times until closure was complete.

Main Outcome Measures
Closure of the TMP and hearing improvement were evaluated at 16 weeks after the final regenerative procedure. Adverse events were monitored.

Results
The mean follow-up period was 427.1 days. The TM regenerated in all cases, but pinhole reperforation occurred in two cases, and the final closure rate was 90.5% (19 of 21). Hearing improved to 24.9 ± 7.6 dB on average before surgery and to 13.8 ± 5.4 dB after surgery. The AB gap improved from 12.9 ± 8.0 to 5.2 ± 3.5 dB.
The myringoplasty/tympanoplasty group had significantly lower AB gap improvement compared with the TMRT group. There were no adverse events.

Conclusions
TMRT can be expected to regenerate near-normal TMs with a high closure ratio, resulting in better-hearing improvement compared with the myringoplasty/tympanoplasty group, and is an effective treatment for children with long life expectancy.
Endolymphatic Sac Tumors Associated With von Hippel–Lindau: A Case Report Highlighting Opportunity for Novel Orphan Drug Therapy
Authors: Tan Donald , Fujiwara Rance J.T. , Tan Christopher , Isaacson Brandon , Hunter Jacob B. 
Published: August 2024

Objective
To discuss the potential benefit of belzutifan therapy in a patient with von Hippel–Lindau (VHL) disease–associated endolymphatic sac tumor (ELST).

Patients
Case report.

Interventions
Clinical details of a patient with residual ELST after hearing preservation surgery who initiated belzutifan therapy postoperatively for concurrent renal cell carcinoma, as well as literature review of belzutifan and ELST.

Main Outcome Measures
The patient remained without radiologic evidence of growth of her residual tumor at 17 months post-initiation of belzutifan. It is unknown whether this represents therapeutic drug effect, nonviability of residual tumor, or slow tumor growth not captured radiographically within the duration of follow-up.

Conclusions
Belzutifan could have direct therapeutic benefit in patients with VHL-associated ELST.
Use of glucagon-like-peptide 1 receptor agonist in the treatment of childhood obesity
Authors: Kavarian Patil N. , Mosher Tierra L. , Abu El Haija Marwa 
Published: August 2024

Purpose of reviewPediatric obesity is a growing epidemic. Lifestyle modifications remain central to obesity treatment, however pharmacologic options have gained traction, particularly glucagon-like peptide-1 receptor agonists (GLP-1RA). This review aims to summarize evidence on the use of GLP-1RAs in the management of pediatric obesity, physiological mechanisms of action of GLP-1RAs and their role in appetite regulation and glucose homeostasis and address the challenges and special considerations surrounding GLP-1RA use.Recent findingsRecent studies have highlighted the efficacy of GLP-1RAs, such as exenatide, liraglutide, and semaglutide, in promoting weight loss and improving metabolic parameters in children and adolescents. GLP-1RA's efficacy extends beyond glycemic control to include weight loss mechanisms such as delayed gastric emptying (gastroparesis), and appetite suppression. Semaglutide, the newest GLP-1RA, holds potential for substantial weight loss in adolescents and demonstrates a similar safety and efficacy as seen in adults.SummaryGLP-1RAs may offer a promising adjunct therapy for pediatric obesity, particularly in cases where lifestyle interventions alone are insufficient. However, further research is needed to elucidate long-term safety and efficacy outcomes and to address potential disparities in access to care. Overall, this review highlights the relevance and timeliness of incorporating GLP-1RAs into the comprehensive management of pediatric obesity.
Unraveling the spectrum of airway complications following lung transplantation: a comprehensive overview
Authors: Dhanani Zehra , Criner Rachel , Criner Gerard J. 
Published: August 2024

Purpose of review
This review delves into the intricate landscape of airway complications post lung transplantation. With the rising prevalence of end-stage lung disease and the increasing number of lung transplantation worldwide, understanding and effectively managing airway complications are crucial. Given the nuanced nature of these complications and the array of treatment options available, this review aims to provide a comprehensive overview of how to identify, classify, mitigate risk factors for, and manage these complications.

Recent findings
Several donor, recipient, and surgical risk factors are associated with the increased risk of airway complications. In managing these complications, bronchoscopic interventions, notably balloon dilation and stenting, are pivotal. Although self-expanding metallic stents offer versatility, silicone stents are preferred in certain scenarios for their durability. Emerging techniques such as biodegradable stents and advancing imaging modalities show promise in mitigating complications and improving outcomes.

Summary
These findings underscore the significance of a multidisciplinary approach and personalized treatment algorithms in managing airway complications post lung transplantation. By elucidating specific indications and complications of treatment modalities, this review serves as a valuable resource for optimally managing airway complications. Ongoing research into novel interventions holds promise for further enhancing outcomes in this challenging clinical setting.
Comparison of the effect of use of preoperative mexiletine tablets and control on reducing postoperative pain in patients undergoing abdominal surgery
Authors: Saadat Fakhr Masoud , Jadididavodabadi Abolfazl , Rezvanfar Kiana , Amini Zahra , Amiri Koosha , Narimani Zamanabadi Mahnaz 
Published: August 2024

Objective:
Postoperative pain is a major concern for patients and healthcare providers following abdominal surgery. This study aimed to compare the effectiveness of mexiletine in reducing postoperative pain in patients undergoing abdominal surgery.

Methods:
In this double-blind randomized controlled trial, 34 patients were divided into two groups. One group received 600 mg of mexiletine tablets, while the other group received vitamin C tablets (control) two hours before surgery. Postoperative pain levels were assessed at 6, 12, and 24 h by using the Visual Analog Scale (VAS). Additionally, the amount of narcotics received within the first 24 h after surgery was recorded.

Results:
The results showed that the average postoperative pain score in patients who received mexiletine was significantly lower than in those who received vitamin C tablets (P<0.001). Furthermore, the average amount of narcotics received after surgery was significantly lower in the mexiletine group compared to the control group (P=0.03). Pain scores at 6, 12, and 24 h after surgery were also significantly lower in the mexiletine group (P<0.001).

Conclusion:
Mexiletine was effective in reducing postoperative pain and the need for narcotics in patients undergoing abdominal surgery. This study highlights the potential of mexiletine as a valuable preoperative intervention for postoperative pain management.
Mesenchymal stem cells suppress inflammation by downregulating interleukin-6 expression in intestinal perforation animal model
Authors: Setiawan Eko , Putra Agung , Nabih Dimas Irfan , Ovaditya Shafira Zahra , Rizaldy Rheza 
Published: August 2024

Introduction:
Intestinal perforation has significant fatality due to sepsis contamination and prolonged inflammation. Studies showed that mesenchymal stem cells (MSCs) secreted cytokines and growth factors to reduce inflammation. This study aims to reveal the role of MSCs in controlling inflammation in intestinal perforation wound healing by measuring interleukin-6 (IL-6) and leukocytes in injured tissue.

Materials and methods:
A total of 48 rat models with a 10-mm longitudinal incision at the small intestine were divided into four groups: sham, control, Treatment group 1 (T1) injected with MSC doses of 1.5×106 cells and Treatment group 2 (T2) with 3×106 cells. IL-6 expressions were determined using western blot analysis, whereas the leukocyte infiltrations were assessed using the histopathological examination. All variables were evaluated on day 3 and 7.

Results:
Leukocyte infiltration is significantly lower in T1 and T2 compared to control group in day 3 and 7 (P<0.05), while there were no differences between the two treatment groups. The expression of IL-6 was found to be significantly lower in the T1 and T2 groups compared to the control group on days 3 and 7 (P<0.05), with no significant differences observed between the two treatment groups.

Conclusion:
MSCs administration in rats with intestinal perforation reduced inflammation by controlling leukocyte infiltration and IL-6 expression.
Socio-economic factors and rural-urban differences in patients undergoing emergency laparotomy
Authors: Pouke Anne , Ylimartimo Aura , Nurkkala Juho , Lahtinen Sanna , Koskela Marjo , Vakkala Merja , Kaakinen Timo , Raatiniemi Lasse , Liisanantti Janne 
Published: August 2024

Background:
Emergency laparotomy (EL) is a common surgical procedure with high rates of mortality and complications. Socio-economic circumstances and regional differences have an influence on the utilization of care and outcomes in many diagnostic groups, but there are only a few studies focusing on their effect in EL population. The aim of this study was to examine the socio-economic and regional differences in the rate of EL within one tertiary care hospital district.

Methods:
Retrospective single-center study of 573 patients who underwent EL in Oulu University Hospital between May 2015 and December 2017. The postal code area of each patient’s home address was used to determine the socio-economic status and rurality of the location of residence.

Results:
The age-adjusted rate of EL was higher in patients from low-income areas compared to patients from high-income areas [1.46 ((95% CI 1.27–1.64)) vs. 1.15 (95% CI, 0.96–1.34)]. The rate of EL was higher in rural areas compared to urban areas [1.29 (95% CI 1.17–1.41 vs. 1.42 (1.18–1.67)]. Peritonitis was more common in patients living in low-income areas. There were no differences in operation types or mortality between the groups.

Conclusions:
The study findings suggest that there are socio-economic and regional differences in the need of EL. The patients living in low-income areas had a higher rate of EL and a higher rate of peritonitis. These differences cannot be explained by patient demographics or comorbidities alone.
Management of non-lesional super-refractory status epilepticus: a rare case report
Authors: Albalawi Rawan , Aljthalin Raseel , Khan Sonia , Fouly Raghad , Alshahrani Mohammed , Alsahli Hamoud , Alhashemi Moustafa 
Published: August 2024

Introduction and importance:
Super-refractory status epilepticus is defined as status epilepticus that continues or recurs 24 h or more after the initiation of anesthetic therapy(continuum), a serious medical emergency with a potential for significant morbidity and mortality. Cortisectomy with invasive EEG recording electrocorticography (ECoG) can be a successful treatment option for super-refractory status epilepticus in selected cases after medical management has failed.

Case presentation:
The authors present a case of a young lady who suffered a super-refractory status epilepticus and failed five different anti-seizure medications, coma-producing agents, IVIG. After failure of multiple medical and sedative therapy cortisectomy was done with the use of invasive EEG recording electrocorticography (ECoG) to tailor and localize the epileptogenic zone.

Clinical discussion:
When dealing with status epilepticus (SE) that is refractory to treatment, early surgical intervention should be taken into consideration as a viable option. Although there are only a few published cases of SE treated with epilepsy surgery, these cases have shown positive outcomes. In fact, one study demonstrated a significant improvement in seizure control for patients with SE who underwent surgical treatment using these techniques.

Conclusion:
Cortisectomy, which is a rare and invasive procedure, could be considered as a potential treatment for patients who have not responded to multiple medical and sedative therapies.
Reducing Diarrhea in Critically Ill Patients Receiving Enteral Nutrition Support
Authors: He Mei , Wang Ying , Wang Hui , Wang Mei , Du Mei J. , Xiong Jie , Li Chun L. , Huang Shu , Zhang Xin Y. 
Published: August 2024

Background:
Diarrhea during enteral nutrition may induce various complications and increase the nursing workload.

Local Problem:
The diarrhea rate in our intensive care units (ICUs) was 37.14% from May to July 2021. Nurses reported a moderate to heavy burden regarding care for those with diarrhea.

Methods:
A pre-post implementation design was used to evaluate the impact of evidence-based interventions for diarrhea screening and prevention.

Interventions:
A diarrhea risk screening tool and countermeasures were developed through an extensive literature review. Tools were integrated into the electronic health record system.

Results:
The rate of diarrhea decreased from 37.14% to 17.33% (P = .000). Nurse’s compliance with practice standards increased for diarrhea assessment, risk factor screening, agent choice, and countermeasures provision (P < .05).

Conclusions:
The evidence-based tools developed for this project helped decrease the diarrhea rate in our ICUs.
PSTD Treatment of Joint Forces Operation Combatants
Authors: Semenenko Oleh , Dobrovolskyi Uzef , Yarmolchyk Mariia , Stolinets Serhii , Tarasov Oleh 
Published: August 2024

Abstract
The participation of military personnel in operations like the Anti-Terrorist Operation (ATO)/Joint Forces Operations (JFO) can lead to significant psychological trauma, potentially resulting in posttraumatic stress disorder (PTSD). Understanding the effectiveness of psychotherapy in treating PTSD among ATO/JFO participants is crucial given its profound impact on personal relationships, life scenarios, and overall well-being. This study evaluates how acceptance and commitment therapy can alleviate PTSD symptoms and enhance well-being in Ukrainian military personnel with combat-related PTSD. The main research method was a psychological experiment, and the case study method was used as an auxiliary research method. The study revealed the following: combatants in the ATO/JFO who have been diagnosed with PTSD should be classified as persons with disabilities due to certain limitations in their life activities, namely, the inability to control their behavior, and difficulties in work and communication. This study proves that cognitive-behavioral psychotherapy has a clear advantage in overcoming PTSD in the military, as it allows transforming psychological trauma into posttraumatic growth. Attachment and acceptance therapy, a form of behavioral therapy, has emerged as one of the most effective treatments for PTSD. It focuses on diagnosing and addressing the psychological consequences of war by analyzing the connections among cognition, affect, and behavior. Given the protracted nature of PTSD, the practical significance of the study is to develop effective psychotherapeutic interventions for the expected recovery of ATO/JFO participants affected by combat operations.
The Effect of Nursing Moral Distress on Intent to Leave Employment
Authors: Sheppard Katherine , Smith Catherine , Morgan Merri K. , Wilmoth Donna , Toepp Angela , Rutledge Carolyn , Zimbro Kathie S. 
Published: August 2024

OBJECTIVE
This study explored the impact of moral distress (MD) and respondent characteristics on intent to leave employment.

BACKGROUND
Managing patient care, within organizational constraints, may create physical discomfort or mental peace disturbances such as MD, negatively impacting RN retention.

METHODS
Responses from 948 RNs were collected using an anonymous online survey. The impact of MD on intent to leave employment was explored.

RESULTS
MD was significantly higher among RNs intending to leave employment. System-level and team-level integrity attributes were significant factors predicting intent to leave, controlling for potential confounders. The odds of intending to leave were 147% higher for new graduate RNs, 124% higher for direct care RNs, and 63% higher for 2nd-career RNs. Gender and race were not significant predictors.

CONCLUSION
Exploring root causes contributing to MD frequency and severity is critical to maintain a healthy work environment. Mitigating MD in the work environment may enhance nursing practice and improve patient care. Support for new graduate and 2nd-career RNs can be realized, further reducing turnover for these vulnerable populations of the nursing workforce.
Escape of SARS-CoV-2 variants KP1.1, LB.1 and KP3.3 from approved monoclonal antibodies
Authors: Planas Delphine , Staropoli Isabelle , Planchais Cyril , Yab Emilie , Jeyarajah Banujaa , Rahou Yannis , Prot Matthieu , Guivel-Benhassine Florence , Lemoine Frederic , Enouf Vincent , Simon-Loriere Etienne , Mouquet Hugo , Rameix-Welti Marie-Anne , Schwartz Olivier 
Published: August 2024

ABSTRACTFirst-generation anti-SARS-CoV-2 monoclonal antibodies (mAbs) used for prophylaxis or therapeutic purposes in immunocompromised patients have been withdrawn because of the emergence of resistant Omicron variants. In 2024, two novel mAbs, Pemivibart and Sipavibart, have been approved by health authorities, but their activity against contemporary JN.1 sublineages is poorly characterized. We isolated authentic JN.1.1, KP1.1, LB.1 and KP3.3 viruses and evaluated their sensitivity to neutralization by these mAbs in two target cell lines. Compared to ancestral strains, Pemivibart remained moderately active against JN.1 sub-variants, with a strong increase of 50% Inhibitory Concentration (IC50), reaching up to 3 to 15 μg/ml for KP3.3. Sipavibart neutralized JN.1.1 but lost antiviral efficacy against KP1.1, LB.1 and KP3.3. Our results highlight the need for a close clinical monitoring of Pemivibart and raise concerns about the clinical efficacy of Sipavibart.