bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a novel predictive model for postpancreatectomy hemorrhage using lasso-logistic regression: an international multicenter observational study of 9631 pancreatectomy patients
Authors: Duan Yunjie , Du Yongxing , Mu Yongrun , Guan Xiao , He Jin , Zhang Jianwei , Gu Zongting , Wang Chengfeng 
Published: July 2024

Background:
Hemorrhage following pancreatectomy represents a grave complication, exerting a significant impact on patient prognosis. The formulation of a precise predictive model for postpancreatectomy hemorrhage risk holds substantial importance in enhancing surgical safety and improving patient outcomes.

Materials and methods:
This study utilized the patient cohort from the American College of Surgeons National Surgical Quality Improvement Program database, who underwent pancreatectomy between 2014 and 2017 (n=5779), as the training set to establish the Lasso-logistic model. For external validation, a patient cohort (n=3852) from the Chinese National Multicenter Database of Pancreatectomy Patients, who underwent the procedure between 2014 and 2020, was employed. A predictive nomogram for postpancreatectomy hemorrhage was developed, and polynomial equations were extracted. The performance of the predictive model was assessed through the receiver operating characteristic curve, calibration curve, and decision curve analysis.

Results:
In the training and validation cohorts, 9.0% (520/5779) and 8.5% (328/3852) of patients, respectively, experienced postpancreatectomy hemorrhage. Following selection via lasso and logistic regression, only nine predictive factors were identified as independent risk factors associated with postpancreatectomy hemorrhage. These included five preoperative indicators [BMI, American Society of Anesthesiologists (ASA) ≥3, preoperative obstructive jaundice, chemotherapy within 90 days before surgery, and radiotherapy within 90 days before surgery], two intraoperative indicators (total operation time, vascular resection), and two postoperative indicators (postoperative septic shock, pancreatic fistula). The new model demonstrated high predictive accuracy, with an area under the receiver operating characteristic curve of 0.87 in the external validation cohort. Its predictive performance significantly surpassed that of the previous five postpancreatectomy hemorrhage risk prediction models (P<0.001, likelihood ratio test).

Conclusion:
The Lasso-logistic predictive model we developed, constructed from nine rigorously selected variables, accurately predicts the risk of PPH. It has the potential to significantly enhance the safety of pancreatectomy surgeries and improve patient outcomes.
Complicated Pleural Infection is Associated With Prolonged Recovery and Reduced Functional Ability
Authors: Meggyesy Austin M. , Wilshire Candice L. , Bograd Adam J. , Chiu Shih Ting , Gilbert Christopher R. , Rahman Najib M. , Bedawi Eihab O. , Vallieres Eric , Gorden Jed A. 
Published: July 2024

Background:
Management of complicated pleural infections (CPIs) had historically been surgical; however, following the publication of the second multicenter intrapleural sepsis trial (MIST-2), combination tissue plasminogen (tPA) and dornase (DNase) offers a less invasive and effective treatment. Our aim was to assess the quality of life (QOL) and functional ability of patients’ recovery from a CPI managed with either intrapleural fibrinolytic therapy (IPFT) or surgery.

Methods:
We identified 565 patients managed for a CPI between January 1, 2013 and March 31, 2018. There were 460 patients eligible for contact, attempted through 2 phone calls and one mailer. Two questionnaires were administered: the Short Form 36-Item Health Survey (SF-36) and a functional ability questionnaire.

Results:
Contact was made in 35% (159/460) of patients, and 57% (90/159) completed the survey. Patients had lower QOL scores compared to average US citizens; those managed with surgery had higher scores in physical functioning (surgery: 80, IPFT: 70, P=0.040) but lower pain scores (surgery: 58, IPFT: 68, P=0.045). Of 52 patients who returned to work, 48% (25) reported an impact on their work effectiveness during recovery, similarly between management strategies (IPFT: 50%, 13/26 vs. surgery: 46%, 12/26; P=0.781).

Conclusion:
Patients with a CPI had a lower QOL compared with average US citizens. Surgically managed patients reported improved physical functioning but worse pain compared with patients managed with IPFT. Patients returned to work within 4 weeks of discharge, and nearly half reported their ability to work effectively was impacted by their recovery. With further research into recovery timelines, patients may be appropriately counselled for expectations.
Reduction in Unindicated Cervical Cancer Screening in Adolescents in a Large Health Care System
Authors: Geng Bertie , Oliveira Carlos R. , Hosier Hillary , Sheth Sangini S. , Vash-Margita Alla 
Published: July 2024

Objectives/Purpose
Evidence-based guidelines recommend against screening for cervical cancer (Pap testing) in average-risk adolescents <21 years old. Despite this, many still undergo unindicated screenings with subsequent detrimental reproductive health and economic consequences. Our aim was to reduce unindicated cervical cancer screening in individuals <21 years old in a large health care system by utilizing an electronic provider notification.

Methods
Starting in July 2020, a Best Practice Advisory (BPA) appeared in the electronic medical record (EMR) if providers ordered Pap testing on individuals <21 years old. This BPA reiterated that screening was not indicated for average-risk adolescents and prompted users to choose an indication if they wanted to proceed.
A retrospective chart review, pre/post intervention study was performed comparing individuals <21 years old with Pap testing performed before and after intervention (January 2019–June 2020 and July 2020–June 2021, respectively). Patient characteristics were extracted from the EMR and analyzed using Fisher exact tests, Kruskal-Wallis tests, and logistic regression.

Results
There were 140 subjects included: 106 preintervention and 34 postintervention. There were no differences in baseline characteristics. Neither Pap nor human papillomavirus testing results differed between the groups. Preintervention, 6.6% of cytology tests were indicated compared to 20.6% postintervention (p = .042). The proportion of indicated human papillomavirus testing did not differ preintervention and postintervention at 65% and 45%, respectively (p = .295). The overall reduction in unindicated cervical cancer screening postintervention was 13.9% (95% CI = 4.0–23.7).

Conclusions
We demonstrated that incorporating a BPA to the EMR reduces unindicated cervical cancer screening.
Effects of Aromatherapy on Physical and Psychological Symptoms in Cancer Patients
Authors: Liu Yantong , Xu Mengmeng , Tian Qi , Yu Shuanghan , Cao Minglu , Zhao Wei , Han Yujie , Wang Ziqi , Zhang Wei 
Published: July 2024

BackgroundNumerous physical and psychological symptoms experienced by cancer patients seriously affect their normal lives. Many academics and medical professionals have attempted to use aromatherapy in this situation to help cancer patients manage their physical and emotional problems.ObjectiveTo systematically investigate the efficacy of aromatherapy on physical and psychological symptoms in cancer patients.MethodsA systematic review and meta-analysis of randomized controlled trials was performed. Four electronic databases were searched. The review process followed a registered priori review protocol and was reported using Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Data extraction and quality assessment were performed in parallel.ResultsTwenty-six studies with 2912 subjects were included. Meta-analysis showed that aromatherapy significantly improved sleep quality, fatigue, anxiety, and depression. We performed a subgroup analysis according to the different plant or animal aromatics contained in the oil, which found that lavender oil significantly reduced preoperative anxiety. In addition, aromatherapy massage was superior to inhaled aromatherapy in reducing anxiety. Moreover, cancer patients who used aromatherapy reduced the frequency of vomiting in 24 hours.ConclusionsAromatherapy is a useful treatment for improving sleep quality and reducing symptoms of fatigue, anxiety, and depression in cancer patients, as well as the frequency of vomiting over 24 hours.Implications for PracticeHealthcare providers can use aromatherapy to alleviate psychological and physical symptoms in cancer patients. The use of lavender oil and massage is recommended in clinical settings to improve anxiety symptoms in cancer patients.
Internal Audit to Monitor the Injected Activity in PET/CT Using Control Charts
Authors: Russo Sara , Almeida Pedro , Lúcio Teresa , Oliveira Luís , Conde Isabel , Aleixo Ana , Matos Ana Sofia 
Published: July 2024

Background and Objective:
In an effort to limit the risks associated with medical radiation exposure, the last century witnessed the development of dose control mechanisms, recommended by the International Commission on Radiological Protection. This organization recommends the optimization of radiation protection to provide the highest level of safety that may reasonably be achievable. Adhering to the “as low as reasonably achievable” principle, the purpose of this study was to monitor the 18F-FDG injected activity in PET and optimize the radiation protection through an internal audit process. This monitoring allows the identification of opportunities for improvement in patient care and safety, as well as to establish a periodic review of the medical unit reference levels.

Methods:
The methodology is based on short run Quesenberry (Q) statistics and normalized nonconstant sample size (Z-chart) control charts. Anonymized data from 512 patients were selected from a set of 18F-FDG PET/CT (Siemens, Biograph 6) examinations performed during 10 months. The analyzed variable was the ratio between the 18F-FDG injected activity (MBq) and patient weight (kg).

Results:
Mean injected 18F-FDG activity was 347.811 ± 64.967 MBq corresponding to a mean effective dose of 6.608 ± 1.234 mSv. The ratio between the 18F-FDG injected activity and the body mass of patients was reduced from 5.243 ± 0.716 to 5.171 ± 0.672 MBq/kg during the statistical data analysis. The study demonstrates that control charts can be a useful tool to signal situations where patients receive an activity significantly different from the standard practice in a medical unit.

Conclusion:
The use of joint control charts is a suitable tool for detecting nonoptimized radiopharmaceutical administration. This analysis provides opportunities to evaluate and improve the quality of practice in nuclear medicine. This methodology constitutes an internal audit that may help health care professionals to make appropriate decisions to ensure all patients receive the safest and most appropriate care.
Diagnostic criteria for amyotrophic lateral sclerosis
Authors: Timmins Hannah C. , Thompson Alexandra E. , Kiernan Matthew C. 
Published: July 2024

Purpose of review
The present review will discuss the evolution of diagnostic criteria for amyotrophic lateral sclerosis (ALS) and biomarker considerations.

Recent findings
To address the limitations of existing ALS diagnostic criteria, a consortium of key stakeholders developed the Gold Coast consensus criteria (GCC). The GCC has similar or greater sensitivity compared with the revised El Escorial (rEEC) and Awaji criteria (AC), particularly for atypical phenotypes, maintained across disease duration, severity, and site of onset. In addition to improving diagnostic sensitivity, using the GCC in clinical trials may promote an increased enrolment of up to 50% of ALS patients who do not currently meet the full diagnostic eligibility requirements of the rEEC. Future inclusion of genetic biomarkers may mitigate some limitations of the GCC, to further improve diagnostic utility. In advance of such a process, validation of these biomarkers will be required before inclusion as additional criteria.

Summary
The GCC are simpler to use than previous consensus criteria, with demonstrated greater sensitivity and, enabling an earlier and more definitive ALS diagnosis, thereby facilitating wider enrolment into clinical trials. Broader implementation of the GCC in clinical trial settings is currently underway, globally.
The Prevalence of Skin Tears in an Acute Care Hospital
Authors: Werth Sherry Lynn , Justice Rachel 
Published: July 2024

PURPOSE:
The purpose of this quality improvement project was to determine the prevalence of skin tears (STs) within an acute care hospital.

PARTICIPANTS AND SETTING:
The setting was a 676-bed Midwestern urban teaching hospital with Magnet designation in the United States. All adult, children, and neonatal patients were assessed during the data collection period with the exclusion of the mother/baby unit and patients who were unsafe to move, actively dying, off the unit during the survey assessment, or those who declined participation.

APPROACH:
ST prevalence data were collected concurrently with the quarterly Pressure Injury Prevalence Survey over a period of 12-months (beginning the third quarter of 2017 through the second quarter of 2018) by the Pressure Injury Prevalence Survey Skin Care Champions using the revised Payne-Martin classification system for STs. A data collection form developed by the Wound, Ostomy, and Continence nurse was also completed for the patients with ST(s).

OUTCOMES:
The prevalence of STs was 2.92% (46/1576 patients). Twenty-one patients were women and 25 were men, with a mean age of 69.90 years (age range: 8 days-96 years). The majority of STs were found on the extremities (60 STs, 86.96%) and hospital-acquired (30 patients, 65.22%). Thirty STs (43.48%) were category III according to the revised Payne-Martin classification system for STs with major risk factors identified as frail skin (n = 34), advanced age (n = 30), and impaired mobility (n = 24).

IMPLICATIONS FOR PRACTICE:
STs are a common finding in the acute care setting spanning all age groups and are frequently overlooked by health care providers. This project provides a strategy to determine ST prevalence in a health care setting. Additional studies should focus on risk factor assessment and prevention strategies as these may decrease the incidence of this painful wound.
Spatially explicit predictions of food web structure from regional-level data
Authors: Dansereau Gabriel , Barros Ceres , Poisot Timothée 
Published: July 2024

Knowledge about how ecological networks vary across global scales is currently limited given the complexity of acquiring repeated spatial data for species interactions. Yet, recent developments in metawebs highlight efficient ways to first document possible interactions within regional species pools. Downscaling metawebs towards local network predictions is a promising approach to using the current data to investigate the variation of networks across space. However, issues remain in how to represent the spatial variability and uncertainty of species interactions, especially for large-scale food webs. Here, we present a probabilistic framework to downscale a metaweb based on the Canadian mammal metaweb and species occurrences from global databases. We investigated how our approach can be used to represent the variability of networks and communities between ecoregions in Canada. Species richness and interactions followed a similar latitudinal gradient across ecoregions but simultaneously identified contrasting diversity hotspots. Network motifs revealed additional areas of variation in network structure compared with species richness and number of links. Our method offers the potential to bring global predictions down to a more actionable local scale, and increases the diversity of ecological networks that can be projected in space.
This article is part of the theme issue 'Connected interactions: enriching food web research by spatial and social interactions'.
On formal limitations of causal ecological networks
Authors: Damos Petros T. 
Published: July 2024

Causal multivariate time-series analysis, combined with network theory, provide a powerful tool for studying complex ecological interactions. However, these methods have limitations often underestimated when used in graphical modelling of ecological systems. In this opinion article, I examine the relationship between formal logic methods used to describe causal networks and their inherent statistical and epistemological limitations. I argue that while these methods offer valuable insights, they are restricted by axiomatic assumptions, statistical constraints and the incompleteness of our knowledge. To prove that, I first consider causal networks as formal systems, define causality and formalize their axioms in terms of modal logic and use ecological counterexamples to question the axioms. I also highlight the statistical limitations when using multivariate time-series analysis and Granger causality to develop ecological networks, including the potential for spurious correlations among other data characteristics. Finally, I draw upon Gödel’s incompleteness theorems to highlight the inherent limits of fully understanding complex networks as formal systems and conclude that causal ecological networks are subject to initial rules and data characteristics and, as any formal system, will never fully capture the intricate complexities of the systems they represent.
This article is part of the theme issue ‘Connected interactions: enriching food web research by spatial and social interactions’.
Societies with fission–fusion dynamics as complex adaptive systems: the importance of scale
Authors: Madsen Anastasia , de Silva Shermin 
Published: July 2024

In this article, we argue that social systems with fission–fusion (FF) dynamics are best characterized within a complex adaptive systems (CAS) framework. We discuss how different endogenous and exogenous factors drive scale-dependent network properties across temporal, spatial and social domains. Importantly, this view treats the dynamics themselves as objects of study, rather than variously defined notions of static ‘social groups’ that have hitherto dominated thinking in behavioural ecology. CAS approaches allow us to interrogate FF dynamics in taxa that do not conform to more traditional conceptualizations of sociality and encourage us to pose new types of questions regarding the sources of stability and change in social systems, distinguishing regular variations from those that would lead to system-level reorganization.
This article is part of the theme issue ‘Connected interactions: enriching food web research by spatial and social interactions’.
Programming aliphatic polyester degradation by engineered bacterial spores
Authors: Cui Ziyu , Kawada Masamu , Hui Yue , Sim Seunghyun 
Published: July 2024

ABSTRACTEnzymatic degradation of plastics is a sustainable approach to addressing the growing issue of plastic accumulation. The primary challenges for using enzymes as catalysts are issues with their stability and recyclability, further exacerbated by their costly production and delicate structures. Here, we demonstrate an approach that leverages engineered spores that display target enzymes in high density on their surface to catalyze aliphatic polyester degradation and create self-degradable materials. Engineered spores display recombinant enzymes on their surface, eliminating the need for costly purification processes. The intrinsic physical and biological characteristics of spores enable easy separation from the reaction mixture, repeated reuse, and renewal. Engineered spores displaying lipases completely degrade aliphatic polyesters and retain activity through four cycles, with full activity recovered through germination and sporulation. Directly incorporating spores into polyesters results in robust materials that are completely degradable. Our study offers a straightforward and sustainable biocatalytic approach to plastic degradation.
Blocking the ability of huntingtin to bind membranes: a therapeutic strategy for Huntington’s disease
Authors: Siriwardhana Chathuranga , Adegbuyiro Adewale , Sedighi Faezeh , Stonebraker Alyssa R. , Leonard Sharon , Beasley Maryssa , Skeens Adam , Mertz Blake , Geldenhuys Werner , Legleiter Justin 
Published: July 2024

AbstractThe ordered aggregation of proteins into amyloid fibrils is a hallmark of numerous neurodegenerative diseases. A common strategy in developing therapeutics for amyloid-based diseases relies on preventing or manipulating the aggregation process. However, many amyloid-forming proteins and their aggregates bind and damage organelle and cellular membranes. As such, blocking the ability of these proteins from directly interacting with membranes represents a unique therapeutic strategy. Using a mutant huntingtin (htt) protein associated with Huntington’s disease (HD) as a model system, the viability of this strategy was evaluated. Screening over 1200 compounds for their ability to block htt binding to lipid vesicles, two compounds, Ro90-7501 (Ro) and Benzamil (Ben), were identified and validated. Despite directly interacting with htt, neither compound prevented fibril formation. Molecular dynamics simulations suggested each compound has a unique mechanism of action, consistent with experimental data. Importantly, both compounds ameliorated phenotype in aC. elegansmodel of HD.
Cell state and transcription factor modulation during extended ex vivo CD8+T-cell expansion
Authors: Lui Yuan , Jenkins Edward , Ng Emily Zhi Qing , Kotowski Mateusz , Mullin Sydney J , Clarke Joseph , Davis Simon J , Santos Ana Mafalda , Sharma Sumana 
Published: July 2024

AbstractAdoptive cell therapy is becoming a cornerstone of tumour immunotherapy. It relies on the relatively long-term (> 2 week) ex vivo expansion of T cells either in the form of tumour-infiltrating cells, or bulk cells modified with the expression of heterologous signalling proteins, e.g., chimeric antigen receptors. However, relatively little is known about the developmental trajectories of T cells under these conditions at the system level, or whether the pathways governing these trajectories could be manipulated for clinical advantage. Using bulk RNA-seq analysis of T cells expanded and rested over a 17-day period, we produce a resource revealing how gene expression changes as cells transition through distinct cellular states over the course of activation and ex vivo expansion. By integrating this resource with published single-cell RNA-seq data, we identify a member of the AP1 transcription factor (TF) family, FOSL1, that primes CD8+T-cells towards an effector/killing phenotype. Remarkably, FOSL1 over-expression during T-cell expansion produced ‘super engager-like’ T-cells, evidenced by their gene-expression signatures and enhanced cancer-cell killing capacity. This establishes proof-of-principle for the rational engineering of T cells via TF modification during ex vivo expansion, offering a route to improving adoptive T-cell therapy.