bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blocking CTLA‐4 promotes pressure overload‐induced heart failure via activating Th17 cells
Authors: Shang An‐Qi , Yu Chang‐Jiang , Bi Xin , Jiang Wei‐Wei , Zhao Ming‐Luan , Sun Yu , Guan Hong , Zhang Zhi‐Ren 
Published: August 2024

AbstractTargeting cytotoxic T‐lymphocyte‐associated antigen‐4 (CTLA‐4) with specific antibody offers long‐term benefits for cancer immunotherapy but can cause severe adverse effects in the heart. This study aimed to investigate the role of anti‐CTLA‐4 antibody in pressure overload‐induced cardiac remodeling and dysfunction. Transverse aortic constriction (TAC) was used to induce cardiac hypertrophy and heart failure in mice. Two weeks after the TAC treatment, mice received anti‐CTLA‐4 antibody injection twice a week at a dose of 10 mg/kg body weight. The administration of anti‐CTLA‐4 antibody exacerbated TAC‐induced decline in cardiac function, intensifying myocardial hypertrophy and fibrosis. Further investigation revealed that anti‐CTLA‐4 antibody significantly elevated systemic inflammatory factors levels and facilitated the differentiation of T helper 17 (Th17) cells in the peripheral blood of TAC‐treated mice. Importantly, anti‐CTLA‐4 mediated differentiation of Th17 cells and hypertrophic phenotype in TAC mice were dramatically alleviated by the inhibition of interleukin‐17A (IL‐17A) by an anti‐IL‐17A antibody. Furthermore, the C‐X‐C motif chemokine receptor 4 (CXCR4) antagonist AMD3100, also reversed anti‐CTLA‐4‐mediated cardiotoxicity in TAC mice. Overall, these results suggest that the administration of anti‐CTLA‐4 antibody exacerbates pressure overload‐induced heart failure by activating and promoting the differentiation of Th17 cells. Targeting the CXCR4/Th17/IL‐17A axis could be a potential therapeutic strategy for mitigating immune checkpoint inhibitors‐induced cardiotoxicity.
Activation of the G protein‐coupled sulfakinin receptor inhibits blood meal intake in the mosquito Aedes aegypti
Authors: Jiang Linlong , Xie Xiao Bing , Zhang Lei , Tang Yu , Zhu Xiaojing , Huang Yuqi , Hong Yue , Hansson Bill S. , Cui Zong Jie , Han Qian 
Published: August 2024

AbstractLittle is known about the blood‐feeding physiology of arbovirus vector Aedes aegypti although this type of mosquito is known to transmit infectious diseases dengue, Zika, yellow fever, and chikungunya. Blood feeding in the female A. aegypti mosquito is essential for egg maturation and for transmission of disease agents between human subjects. Here, we identify the A. aegypti sulfakinin receptor gene SKR from the A. aegypti genome and show that SKR is expressed at different developmental stages and in varied anatomical localizations in the adult mosquito (at three days after eclosion), with particularly high expression in the CNS. Knockingdown sulfakinin and sulfakinin receptor gene expression in the female A. aegypti results in increased blood meal intake, but microinjection in the thorax of the sulfakinin peptide 1 and 2 both inhibits dose dependently blood meal intake (and delays the time course of blood intake), which is reversible with receptor antagonist. Sulfakinin receptor expressed ectopically in mammalian cells CHO‐K1 responds to sulfakinin stimulation with persistent calcium spikes, blockable with receptor antagonist. These data together suggest that activation of the Gq protein‐coupled (i.e., calcium‐mobilizing) sulfakinin receptor inhibits blood meal intake in female A. aegypti mosquitoes and could serve as a strategic node for the future control of A. aegypti mosquito reproduction/population and disease transmission.
Prediction of Length of Stay After Colorectal Surgery Using Intraoperative Risk Factors
Authors: Huisman Daitlin Esmee , Ingwersen Erik Wouter , Luttikhold Joanna , Slooter Gerrit Dirk , Kazemier Geert , Daams Freek ,   LekCheck Study Group
Published: August 2024

Objective:
The primary objective of this study was to develop a length of stay (LOS) prediction model.

Background:
Predicting the LOS is crucial for patient care, planning, managing expectations, and optimizing hospital resources. Prolonged LOS after colorectal surgery is largely influenced by complications, and an accurate prediction model could significantly benefit patient outcomes and healthcare efficiency.

Methods:
This study included patients who underwent colorectal surgery in 14 different hospitals between January 2016 and December 2020. Two distinct random forest models were developed: one solely based on preoperative variables (preoperative prediction model [PP model]) and the other incorporating both preoperative and intraoperative variables (intraoperative prediction model [IP model]). Both models underwent validation using 10-fold cross-validation. The discriminative power of the model was assessed using the area under the curve (AUC), and calibration was evaluated using a calibration curve. The 2 developed models were compared using DeLong test.

Results:
A total of 2140 patients were included in the analysis. After internal validation, the PP model achieved an AUC of 0.75 (95% confidence interval [CI]: 0.73–0.77), and the IP model achieved an AUC of 0.84 (95% CI: 0.82–0.85). The difference in discrimination between the 2 models was statistically significant (DeLong test, P < 0.001). Both models exhibited good calibration.

Conclusions:
Incorporating intraoperative parameters enhances the accuracy of the predictive model for LOS after colorectal surgery. Improving LOS prediction can assist in managing the increasing number of patients and optimizing the allocation of healthcare resources.
Expanding access to postpartum contraception
Authors: Cooper Michelle , Black Kirsten , Cameron Sharon 
Published: August 2024

Purpose of review
Women are particularly vulnerable to unintended pregnancy in the 12 months following a birth. Improving access to postpartum contraception within maternity settings can prevent unintended and closely spaced births, improving the health of mother and child. This review will summarize the recent research in postpartum contraception (PPC), building on existing knowledge and developments in this field.

Recent findings
Current models of postpartum contraceptive provision may not adequately meet women's needs. The COVID-19 pandemic led to changes in postpartum contraceptive provision, with an increasing emphasis placed on maternity services. Antenatal contraceptive discussion is associated with increased postpartum contraceptive planning and uptake of methods after birth. Digital health interventions may be a useful tool to support information about contraception. The most effective long-acting reversible contraceptive (LARC) methods, such as the intrauterine device (IUD) and implant, can be challenging to provide in the maternity setting because of availability of trained providers. Postpartum IUD insertion remains relatively under-utilized, despite evidence supporting its safety, efficacy and cost-effectiveness.

Summary
Antenatal information needs to be partnered with access to the full range of methods immediately after birth to reduce barriers to PPC uptake. Training and education of maternity providers is central to successful implementation of PPC services.
Unveiling the uncommon: a case report of avascular necrosis in the triquetrum bone without trauma
Authors: Sallameh Jafar , Mansour Majd , Mansour Abdallah N. , Afif Ali , Klayshe Abdalkareem , Shahin Emad 
Published: August 2024

Introduction and importance:
Avascular necrosis (AVN) is a rare occurrence in the carpal region, especially in the triquetrum bone, which presents a diagnostic puzzle due to its infrequency and lack of trauma history. This case study explores the signs, diagnosis, and treatment of AVN in a healthy 22-year-old individual, emphasizing the need for early identification using suitable imaging methods.

Case presentation:
A 22-year-old patient complained of persistent wrist pain, specifically on the ulnar side, without any history of injury. Clinical examination revealed tenderness without signs of inflammation, with normal sensation and movement. Initial X-ray results were inconclusive, prompting further investigation with MRI, which showed a decrease in signal intensity in the triquetrum bone, leading to the diagnosis of AVN.

Clinical discussion:
The development of AVN involves compromised blood flow, often due to various factors. While AVN affecting carpal bones is uncommon, the triquetrum bone’s robust blood supply typically protects against such conditions. However, this case highlights an exceptional occurrence. Gelberman’s classification underscores the triquetrum’s vascular nature, explaining why AVN is rare in this bone. MRI plays a crucial role in detecting AVN, especially when symptoms do not align with X-ray findings.

Conclusion:
Avascular necrosis should be considered in carpal bones, even without a history of trauma, with a focus on MRI for early detection. Although AVN of the triquetrum is rare, this case underscores the importance of timely recognition and conservative management. Further research is necessary to establish optimal treatment strategies for this unusual presentation.
Nurse Well-Being and Patient-Specific Outcomes
Authors: Pryor Stacy , Hanson Ardis , Chan Janet , Brunner Hope , Letourneau Rayna , Menon Usha 
Published: August 2024

Background:
The health and well-being of the nursing workforce has received recent attention due to nurse attrition and the critical nurse shortages projected across the country. A nurse’s well-being may impact patient outcomes.

Purpose:
The purpose of this scoping review was to assess the association between nurse well-being factors and specific patient outcomes.

Methods:
The preferred reporting items for systematic reviews and meta-analyses (PRISMA) PRISMA Scoping Review protocol and 2020 reporting guidelines were utilized in this review.

Results:
Staffing, environment, physical health, and mental health of nurses were correlated to specific adverse patient outcomes among the 97 articles included in the final review. The majority of the articles reported significant findings.

Conclusions:
Patient outcomes were reviewed as discrete events in the articles examined. With mixed results found on key patient outcomes, future research requires more in-depth investigation into the role nurse well-being has on patient outcomes.
A Case for Open Pedagogy in Nursing Education
Authors: Petrovic Kristin , Perry Beth , Walsh Pamela 
Published: August 2024

Background:
Open pedagogy increases access to equitable nursing education with its commitment to the scholarship of “teaching and learning” and critically framed, student-centered, relational, and open knowledge principles.

Purpose:
This study examined the operation of and factors that nurture and challenge the practice of open pedagogy in an undergraduate digital distance nursing education program.

Methods:
An exploratory qualitative methodology was used to examine linkages between open pedagogy and a nursing education program in an open digital distance Canadian university. A critical realist research paradigm provided the framework for the study.

Results:
Our findings shed light on how open pedagogy is practiced in relation to its 5 principles and delve into the major themes of nurse educator agency, course design, and institutional structure.

Conclusions:
The study addresses a dearth in the literature by exploring the potential of open pedagogy to increase access to meaningful and critically framed nursing education.
Qualitative Analysis of an Integrated Curricular Strategy to Develop Health Policy Advocacy
Authors: Cropley Stacey , Hughes Monica , Belcik Kim 
Published: August 2024

Background:
Baccalaureate nursing programs have primarily taught policy advocacy using knowledge related to social and health policy and political systems. Creative curricular strategies have not been widely implemented to prepare nursing students to address health policy advocacy.

Purpose:
A qualitative study explored the impact of an innovative intervention to integrate leadership competencies with population health policy advocacy in an undergraduate nursing curriculum.

Method:
The intervention consisted of a 5-part, unfolding assignment across leadership and population health courses. A phenomenological theoretical approach was used to understand and describe students’ perceptions about the intervention and impact on student readiness to engage in health policy advocacy through narrative survey responses.

Results:
Student understanding of policy processes improved postintervention. Students recognized that systems level thinking and developing policy solutions for population health issues were important attainable activities for nurses. This study demonstrates the significance of providing integrated curricula to develop student engagement in policy advocacy.

Conclusion:
Nurse educators should explore innovative policy advocacy curricula to prepare baccalaureate graduates to address health equity.
Socioeconomic Disadvantage, Neighborhood Belonging, and Inflammation Among Adolescents
Authors: Chen Michelle A. , Chen Edith , Gallivan Shanti U. , Brody Elizabeth J. , Passarelli Veronica , Miller Gregory E. 
Published: August 2024

ABSTRACT

Objective
Childhood socioeconomic disadvantage is associated with a host of adverse health outcomes across the lifespan. However, there is increasing interest in identifying factors that may promote resilience to disadvantage’s effects on health. One promising candidate in this regard is a sense of neighborhood belonging, which could offset health risks by providing a sense of connection to others, as well as a sense of belonging to a community larger than oneself.

Methods
In a sample of 245 adolescents (age: mean [standard deviation] = 15.98 [0.54] years; sex: 64.1% female; race: 41.6% White, 37.6% Black/African American, 9.8% Other; ethnicity: 68.6% non-Hispanic), we examined neighborhood belonging as a moderator of the relationship between socioeconomic disadvantage (measured on a 0- to 5-point scale, mean [standard deviation] = 1.21 [1.36]) and low-grade inflammation (measured via a composite of circulating inflammatory biomarkers including IL-6, IL-8, IL-10, TNF-α, CRP, and suPAR). Covariates included age, sex, race/ethnicity, and pubertal status.

Results
Neighborhood belonging buffered the relationship between socioeconomic disadvantage and low-grade inflammation, a key mechanistic pathway to multiple chronic diseases. Specifically, there was a positive relationship between socioeconomic disadvantage and low-grade inflammation among individuals with low neighborhood belonging, but not among individuals with high neighborhood belonging.

Conclusions
These findings suggest that neighborhood belonging is one type of social connection factor that can mitigate the relationship between socioeconomic disadvantage and low-grade inflammation in youth.
Consequences of low-level viremia among women with HIV in the United States
Authors: Aldredge Amalia , Mehta C. Christina , Lahiri Cecile D. , Schneider Michael F. , Alcaide Maria L. , Anastos Kathryn , Plankey Michael , French Audrey L. , Floris-Moore Michelle , Tien Phyllis C. , Dionne Jodie , Dehovitz Jack , Collins Lauren F. , Sheth Anandi N. 
Published: August 2024

Objective:
Investigate the outcomes of women with HIV (WWH) with low-level viremia (LLV).

Design:
The prevalence of LLV and potential clinical sequelae, such as virologic failure and non-AIDS comorbidity (NACM) development, are poorly characterized among WWH.

Methods:
We analyzed data from the Women's Interagency HIV Study among WWH enrolled from 2003 to 2020 who reported antiretroviral therapy use at least 1 year followed by an HIV-1 viral load less than 200 copies/ml. Consecutive viral load measurements from four semi-annual visits were used to categorize women at baseline as having: virologic suppression (all viral load undetectable), intermittent LLV (iLLV; nonconsecutive detectable viral load up to 199 copies/ml), persistent LLV (pLLV; at least two consecutive detectable viral load up to 199 copies/ml), or virologic failure (any viral load ≥200 copies/ml). Adjusted hazard ratios quantified the association of virologic category with time to incident virologic failure and multimorbidity (≥2 of 5 NACM) over 5-year follow-up.

Results:
Of 1598 WWH, baseline median age was 47 years, 64% were Black, 21% Hispanic, and median CD4+ cell count was 621 cells/μl. After excluding 275 women (17%) who had virologic failure at baseline, 58, 19, and 6% were categorized as having virologic suppression, iLLV, and pLLV, respectively. Compared with WWH with virologic suppression, the adjusted hazard ratio [aHR; 95% confidence interval (CI)] for incident virologic failure was 1.88 (1.44–2.46) and 2.51 (1.66–3.79) for iLLV and pLLV, respectively; and the aHR for incident multimorbidity was 0.81 (0.54–1.21) and 1.54 (0.88–2.71) for iLLV and pLLV, respectively.

Conclusion:
Women with iLLV and pLLV had an increased risk of virologic failure. Women with pLLV had a trend towards increased multimorbidity risk.
Outcomes of Adult Right Graft Living Donor Liver Transplantation Utilizing the Robotic Platform-integrated Real-time Indocyanine Green Fluorescence Cholangiography Compared to the Open Approach
Authors: Raptis Dimitri A. , Vashist Yogesh K. , Kulkarni Rugved , Alabbad Saleh , Elsheikh Yasser , Alnemary Yasir , Malagò Massimo , Broering Dieter C. 
Published: August 2024

Objective:
This study aimed to assess short-term biliary outcomes in adult living donor liver transplants using right grafts, comparing robotic surgery with real-time indocyanine green fluorescence cholangiography for optimal hilar plate transection, against the conventional open approach.

Background:
Determining the optimal transection plane through the hilar plate is crucial in donor hepatectomies, impacting outcomes significantly.

Methods:
From 2011 to 2023, a total of 839 right graft living donor hepatectomies were performed, with 414 (49%) performed via the open approach and 425 (51%) utilizing the robotic platform.

Results:
The magnetic resonant cholangiopancreatography predictions correlated moderately with the actual count of graft ducts (r=0.57, P<0.001). Out of all 839 right donor hepatectomies, 321 (44%) were single duct grafts, of which 193/425 (49%) were retrieved with the robotic while 128/414 (38%) were with the open approach (OR: 1.58, 95% CI: 1.16–2.14), P=0.003). Overall, 50 (6%) of the donors developed a biliary complication during their hospital stay, of whom 38 (9%) were grafts retrieved with the open, while 13 (3%) with the robotic approach (OR: 0.31, 95% CI: 0.15–0.61, P<0.001). Similarly, 63 (15%) of the adult recipients developed a biliary complication of any severity when grafts were retrieved with the open approach compared to 35 (8%) with the robotic approach (OR: 0.50, 95% CI: 0.31–0.79), P=0.002).

Conclusions:
The robotic platform with integrated real-time indocyanine green fluorescence cholangiography during right donor hepatectomy offers improved safety for the donor by accurately addressing the right hilar corridor, resulting in fewer graft ducts and fewer complications for the donor and recipient when compared to the standard open approach.
Optimal Treatment Strategies for cT2 Staged Adenocarcinoma of the Esophagus and the Gastroesophageal Junction
Authors: Wirsik Naita M. , Kooij Cezanne D. , Dempster Niall , Crnovrsanin Nerma , Donlon Noel E. , Uzun Eren , Bhanot Kunal , Nienhüser Henrik , Polette Daniela , Kewani Kammy , Grimminger Peter , Reim Daniel , Seyfried Florian , Fuchs Hans F. , Gisbertz Suzanne S. , Germer Christoph-Thomas , Ruurda Jelle P. , Klevebro Fredrik , Schröder Wolfgang , Nilsson Magnus , Reynolds John V. , Van Berge Henegouwen Mark I. , Markar Sheraz , Van Hillegersberg Richard , Schmidt Thomas , Bruns Christiane J. 
Published: August 2024

Objective:
To evaluate outcomes after primary surgery (PS) or neoadjuvant treatment followed by surgery (NAT/S) in cT2 staged adenocarcinomas of the esophagus (EAC) and gastroesophageal junction (GEJ), a multinational high-volume center study was undertaken.

Background:
The optimal treatment approach with either NAT/S or PS for clinically staged cT2cNany or cT2N0 EAC and GEJ remains unknown due to the lack of randomized controlled trials.

Methods:
A retrospective analysis of prospectively maintained databases from 10 centers was performed. Between January 2012 and August 2023, 645 patients who fulfilled inclusion criteria of GEJ Siewert type I, II, or EAC with cT2 status at diagnosis underwent PS or NAT/S with curative intent. The primary endpoint was overall survival (OS).

Results:
In the cT2cNany cohort, 192 patients (29.8%) underwent PS and 453 (70.2%) underwent NAT/S. In all cT2cN0 patients (n = 333), NAT/s remained the more frequent treatment (56.2%). Patients undergoing PS were in both cT2 cohorts older (P < 0.001) and had a higher American Society of Anesthesiologists classification (P < 0.05). R0 resection showed no differences between NAT/S and PS in both cT2 cohorts (P > 0.4).
Median OS was 51.0 months in the PS group (95% CI: 31.6–70.4) versus 114.0 months (95% CI: 53.9–174.1) in the NAT/S group (P = 0.003) of cT2cNany patients. For cT2cN0 patients, NAT/S was associated with longer OS (P = 0.002) and disease-free survival (P = 0.001). After propensity score matching of the cT2N0 patients, survival benefit for NAT/S remained (P = 0.004). Histopathology showed that 38.1% of cT2cNany and 34.2% of cT2cN0 patients were understaged.

Conclusions:
Due to the unreliable identification of cT2N0 disease, all patients should be offered a multimodal therapeutic approach.
Machine Learning-Based Algorithm for the Early Prediction of Postoperative Hypocalcemia Risk After Thyroidectomy
Authors: Muller Olivier , Bauvin Pierre , Bacoeur Ophélie , Michailos Théo , Bertoni Maria-Vittoria , Demory Charles , Marciniak Camille , Chetboun Mikael , Baud Grégory , Raffaelli Marco , Caiazzo Robert , Pattou Francois 
Published: August 2024

Objective:
We used machine learning to develop and validate a multivariable algorithm allowing the accurate and early prediction of postoperative hypocalcemia risk.

Background:
Postoperative hypocalcemia is frequent after total thyroidectomy. An early and accurate individualized prediction of the risk of hypocalcemia could guide the selective prescription of calcium supplementation only to patients most likely to present with hypocalcemia after total thyroidectomy.

Methods:
This retrospective study enrolled all patients undergoing total thyroidectomy in a single referral center between November 2019 and March 2022 (derivation cohort) and April 2022 and September 2022 (validation cohort). The primary study outcome was postoperative hypocalcemia (serum calcium under 80 mg/L). Exposures were multiple clinical and biological variables prospectively collected and analyzed with various machine learning methods to develop and validate a multivariable prediction algorithm.

Results:
Among 610/118 participants in the derivation/validation cohorts, 100 (16.4%)/26 (22%) presented postoperative hypocalcemia. The most accurate prediction algorithm was obtained with random forest and combined intraoperative parathyroid hormone measurements with 3 clinical variables (age, sex, and body mass index) to calculate a postoperative hypocalcemia risk for each patient. After multiple cross-validation, the area under the receiver operative characteristic curve was 0.902 (0.829–0.970) in the derivation cohort, and 0.928 (95% CI: 0.86; 0.97) in the validation cohort. Postoperative hypocalcemia risk values of 7% (low threshold) and 20% (high threshold) had, respectively, a sensitivity of 92%, a negative likelihood ratio of 0.11, a specificity of 90%, and a positive of 7.6 for the prediction of postoperative hypocalcemia.

Conclusions:
Using machine learning, we developed and validated a simple multivariable model that allowed the accurate prediction of postoperative hypocalcemia. The resulting algorithm could be used at the point of care to guide clinical management after total thyroidectomy.