bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipid nanoparticle-based mRNA vaccines: a new frontier in precision oncology
Authors: Jacob Eden M , Huang Jiaoti , Chen Ming 
Published: August 2024

Abstract
The delivery of lipid nanoparticle (LNP)-based mRNA therapeutics has captured the attention of the vaccine research community as an innovative and versatile tool for treating a variety of human malignancies. mRNA vaccines are now in the limelight as an alternative to conventional vaccines owing to their high precision, low-cost, rapid manufacture, and superior safety profile. Multiple mRNA vaccine platforms have been developed to target several types of cancer, and many have demonstrated encouraging results in animal models and human trials. The effectiveness of these new mRNA vaccines depends on the efficacy and stability of the antigen(s) of interest generated and the reliability of their delivery to antigen-presenting cells (APCs), especially dendritic cells (DCs). In this review, we provide a detailed overview of mRNA vaccines and their delivery strategies and consider future directions and challenges in advancing and expanding this promising vaccine platform to widespread therapeutic use against cancer.
Effect of radiofrequency ablation of genicular nerves on the isokinetic muscle strength of knee joint in patients with osteoarthritis knee: a randomized double-blind sham controlled clinical trial
Authors: Makkar Jeetinder K , Warrier Gayathri , Ghai Babita , Chhabra Monica , Sarkar Pradip K , Goni Vijay G , Khurana Bisman J K 
Published: August 2024

Abstract

Background
This randomized controlled trial evaluated the effect of radiofrequency ablation (RFA) of genicular nerve on muscle strength in osteoarthritis (OA) knee patients with chronic pain.

Methodology
Fifty-four patients with chronic knee OA, experiencing significant pain (visual numeric rating scale [VNRS] &gt;50) and moderate to severe disease (Kellgren Lewis grade ≥2) were enrolled. Group 1 received RFA of genicular nerves of the affected knee while Group 2 received a sham procedure. The primary outcome was change in knee muscle strength evaluated using isokinetic peak torque (IPT) using IsoforceTM isokinetic dynamometer at 3 months. Secondary outcomes included changes in pain scores, function, perceived effect of the treatment and compliance to physiotherapy.

Results
At 3 months, significant difference was observed between IPT of flexor muscle at 60° and 180° between the treatment and the Sham control (P-value = .01). No significant difference was observed in the extensor muscle strength. Within-group analysis revealed a significant increase in the IPT values for both extension and flexion at 60°/sec and 180°/sec evident across various time intervals. Group1 consistently reported lower VNRS scores at all time points. Western Ontario and McMaster Universities Osteoarthritis Index scores of both groups were significantly different at all timepoints, with higher scores indicating reduced functionality in Group2. The Global Perceived Effect and compliance to physiotherapy were higher in Group1 patients at all times of follow up albeit decreasing trend in later periods.

Conclusion
Application of RFA to genicular nerves in chronic OA knee patients resulted in better pain relief, improved functionality, and increased muscle strength at extension and flexion at 3 months follow-up.

Clinical Trial Registry of India — CTRI registration number
CTRI/2020/05/025363.
Imaging of Cerebrovascular Disease in Young Adults: What the Radiologist Needs to Know
Authors: Wang Huijuan , Medvedev Serguei , Zaki-Metias Kaitlin M. , Deptula Lisa , Pearce Eboni , Satei Alexander M. , Mills Nicholas , Pappas George 
Published: August 2024

Cerebrovascular disease (CVD) can result from blood vessel narrowing, rupture, or a hypercoagulable state, which may present on imaging as vascular stenosis, hemorrhage, or occlusion, respectively. As an emerging public health issue with debilitating effects on young adults, recognizing the similarities and differences between CVD in young adults and elderly patients is imperative for optimizing management and patient outcomes. In addition to recognizing key imaging findings for the various causes of CVD, radiologists should be familiar with the clinical presentation, differential diagnoses, and management options for each of these diverse pathologies. For the purposes of this manuscript, young adults are defined as those age 18 to 50 years old.
Pre-existing Diabetes and Stillbirth or Perinatal Mortality
Authors: Blankstein Anna R. , Sigurdson Sarah M. , Frehlich Levi , Raizman Zach , Donovan Lois E. , Lemieux Patricia , Pylypjuk Christy , Benham Jamie L. , Yamamoto Jennifer M. 
Published: August 2024

OBJECTIVE:
Despite the well-recognized association between pre-existing diabetes mellitus and stillbirth or perinatal mortality, there remain knowledge gaps about the strength of association across different populations. The primary objective of this systematic review and meta-analysis was to quantify the association between pre-existing diabetes and stillbirth or perinatal mortality, and secondarily, to identify risk factors predictive of stillbirth or perinatal mortality among those with pre-existing diabetes.

DATA SOURCES:
MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from inception to April 2022.

METHODS OF STUDY SELECTION:
Cohort studies and randomized controlled trials in English or French that examined the association between pre-existing diabetes and stillbirth or perinatal mortality (as defined by the original authors) or identified risk factors for stillbirth and perinatal mortality in individuals with pre-existing diabetes were included. Data extraction was performed independently and in duplicate with the use of prespecified inclusion and exclusion criteria. Assessment for heterogeneity and risk of bias was performed. Meta-analyses were completed with a random-effects model.

TABULATION, INTEGRATION, AND RESULTS:
From 7,777 citations, 91 studies met the inclusion criteria. Pre-existing diabetes was associated with higher odds of stillbirth (37 studies; pooled odds ratio [OR] 3.74, 95% CI, 3.17–4.41, I

2
=82.5%) and perinatal mortality (14 studies; pooled OR 3.22, 95% CI, 2.54–4.07, I

2
=82.7%). Individuals with type 1 diabetes had lower odds of stillbirth (pooled OR 0.81, 95% CI, 0.68–0.95, I

2
=0%) and perinatal mortality (pooled OR 0.73, 95% CI, 0.61–0.87, I

2
=0%) compared with those with type 2 diabetes. Prenatal care and prepregnancy diabetes care were significantly associated with lower odds of stillbirth (OR 0.26, 95% CI, 0.11–0.62, I

2
=87.0%) and perinatal mortality (OR 0.41, 95% CI, 0.29–0.59, I

2
=0%).

CONCLUSION:
Pre-existing diabetes confers a more than threefold increased odds of both stillbirth and perinatal mortality. Maternal type 2 diabetes was associated with a higher risk of stillbirth and perinatal mortality compared with maternal type 1 diabetes.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42022303112.
Evaluation of Statewide Program to Reduce Cesarean Deliveries Among Nulliparous Individuals With Singleton Pregnancies at Term Gestation in Vertex Presentation
Authors: Rosenstein Melissa G. , Chang Shen-Chih , Tucker Curisa M. , Sakowski Christa , Leonard Stephanie A. , Main Elliott K. 
Published: August 2024

OBJECTIVE:
To evaluate the effect of statewide efforts to reduce nulliparous, term, singleton, vertex (NTSV) cesarean delivery rates in California.

METHODS:
This was a population-based study of all NTSV births in California from 2015 to 2019. In 2015, all California hospitals with NTSV cesarean delivery rates above the 23.9% Healthy People 2020 target were invited to join a CMQCC (California Maternal Quality Care Collaborative)–sponsored, 3-year, multifaceted collaborative or a system-level quality collaborative to safely support vaginal birth. We examined the cesarean delivery rate overall and by participation or nonparticipation in a collaborative program. Secondarily, for hospitals that started with an NTSV cesarean delivery rate above 23.9%, we compared patient-level, hospital-level, and obstetric management characteristics between hospitals that met the Healthy People 2020 target (cesarean delivery rate below 23.9%) in 2019 and those that did not.

RESULTS:
There were 758,268 NTSV births at 238 hospitals. Annual mean NTSV cesarean delivery rates decreased among all racial and ethnic groups statewide and among all patients, regardless of payer, maternal age, or body mass index (BMI). The decrease in cesarean delivery was driven largely by a decrease in the frequency of cesarean delivery performed for labor dystocia (14.9% in 2015 to 12.8% in 2019) and from cesarean delivery before the onset of labor (4.2% in 2015 to 3.3% in 2019). For hospitals that started with an NTSV cesarean delivery rate above 23.9%, NTSV cesarean delivery rates among 80 hospitals participating in the CMQCC had a mean±SD decline of 6.9±5.9%, 13 hospitals participating in the system-level collaborative had a 5.0±4.5% decline, and those not participating in any collaborative had a 2.1±6.0% decline. In multivariable analysis, there was no association between meeting the Healthy People target and any of the hospital-level factors or aggregated patient-level characteristics. Rates of induction of labor increased in both groups and were not associated with a change in cesarean delivery rates.

CONCLUSION:
Hospitals in California between 2015 and 2019 with a wide variation in institutional and patient characteristics successfully reduced their NTSV cesarean delivery rates. Reduction in the NTSV cesarean delivery rate at hospitals that started above the Healthy People target was not associated with differences in patient characteristics but rather a reduction in cesarean deliveries for labor dystocia and cesarean deliveries performed before the onset of labor.
Associations of the EAT-Lancet reference diet with metabolic dysfunction–associated steatotic liver disease and its severity: A multicohort study
Authors: Zhang Shunming , Yan Yan , Zeng Xu-Fen , Gu Yeqing , Wu Hongmei , Zhang Qing , Liu Li , Huo Zhenyu , Luo Xiaoqin , Zhang Rui , Sonestedt Emily , Borné Yan , Qi Lu , Huang Tao , Zheng Ming-Hua , Chen Yu-Ming , Niu Kaijun , Ma Le 
Published: August 2024

Background and Aims:
The EAT-Lancet Commission devised a globally sustainable dietary pattern to jointly promote human health and sustainability. However, the extent to which this diet supports metabolic dysfunction–associated steatotic liver disease (MASLD) has not yet been assessed. This study aimed to investigate the association between the EAT-Lancet diet and the risk of MASLD and its severity.

Approach and Results:
This prospective multicohort study included 15,263 adults from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort, 1137 adults from the Guangzhou Nutrition and Health Study (GNHS) cohort, and 175,078 adults from the UK Biobank. In addition, 228 Chinese adults from the Prospective Epidemic Research Specifically of Non-alcoholic Steatohepatitis (PERSONS) with biopsy-proven MASLD were included. An EAT-Lancet diet index was created to reflect adherence to the EAT-Lancet reference diet. The TCLSIH cohort recorded 3010 MASLD cases during 53,575 person-years of follow-up, the GNHS cohort documented 624 MASLD cases during 6454 person-years of follow-up, and the UK Biobank developed 1350 MASLD cases during 1,745,432 person-years of follow-up. In multivariable models, participants in the highest tertiles of the EAT-Lancet diet index had a lower risk of MASLD compared with those in the lowest tertiles (TCLSIH: HR = 0.87, 95% CI: 0.78, 0.96; GNHS: HR = 0.79, 95% CI: 0.64, 0.98; UK Biobank: HR = 0.73, 95% CI: 0.63, 0.85). Moreover, liver-controlled attenuation parameter decreased with increasing the diet index in individuals with biopsy-proven MASLD (β = −5.895; 95% CI: −10.014, −1.775).

Conclusions:
Adherence to the EAT-Lancet reference diet was inversely associated with the risk of MASLD as well as its severity.
Aerobic exercise effects on systolic blood pressure and endothelial inflammation in obese and non-obese elderly women with isolated systolic hypertension
Authors: Koh Suhan , Kim Doyeon , Kim Minkyo , Kim Taekyu 
Published: August 2024

Objectives:
This study aimed to investigate the effects of a 16-week aerobic exercise program on systolic blood pressure, intracellular cell adhesion molecule-1, vascular cell adhesion molecule-1, and oxidized low-density lipoprotein of obese and nonobese elderly women with isolated systolic hypertension.

Methods:
Elderly women aged 70–85 years were recruited and grouped into the normal isolated systolic hypertension (n = 12) and obese isolated systolic hypertension groups (n = 13). The participants followed an aerobic exercise program, using a wireless heart rate monitor to maintain an appropriate heart rate reserve based on the American College of Sports Medicine exercise guidelines. The two-way repeated measures analysis of variance tested group × time interaction. Pearson's correlation and simple regression assessed the influence of each variable, which showed significant differences.

Results:
An interaction effect for systolic blood pressure, intracellular cell adhesion molecule-1, and vascular cell adhesion molecule-1 (P < 0.05) and a main time effect for oxidized low-density lipoprotein (P < 0.05) were observed. A correlation between the rates of change in systolic blood pressure and vascular cell adhesion molecule-1 (P < 0.05) with a 42.8% influence (P < 0.001) and in intracellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 (P < 0.05) with a 21.6% influence (P < 0.05) was observed.

Conclusions:
These findings collectively showed that the 16-week aerobic exercise program effectively lowered blood pressure in patients with isolated systolic hypertension, particularly in the normal group compared to the obese group. Thus, regular aerobic exercise for 16 weeks or more enhances vascular health, potentially improving the healthy life expectancy of elderly women.
INTRAOCULAR PRESSURE AND SAFETY OF VITRECTOMY WITH VITREOUS GAS REPLACEMENT USING LOW-CONCENTRATION NITROUS OXIDE GAS ANESTHESIA
Authors: Noguchi Santaro , Nakakura Shunsuke , Noguchi Asuka , Tabuchi Hitoshi 
Published: August 2024

Purpose:
The aim of this study is to evaluate the efficacy and safety of vitrectomy with vitreous gas replacement using low-concentration nitrous oxide (N2O) gas anesthesia, focusing on intraocular pressure (IOP) changes, pain, anxiety, and safety outcomes.

Methods:
This retrospective study analyzed 133 patients undergoing fluid-air exchange without use of SF6 or C3F8, at Saneikai Tsukazaki Hospital, Japan, from April 2019 to March 2022. Participants were divided into two groups: those receiving low-concentration nitrous oxide gas anesthesia (N2O group) and those receiving local anesthesia with room air inhalation (air group). IOP, pain, anxiety levels, and intraoperative complications were assessed.

Results:
No significant differences were found in IOP changes postoperatively between the N2O and air groups. The N2O group reported significantly lower pain scores and had lower intraoperative systolic blood pressure and heart rate changes compared with the air group. No significant intraoperative or postoperative complications were observed in either group.

Conclusion:
Vitrectomy with fluid-air exchange using low-concentration nitrous oxide gas anesthesia is safe, does not increase IOP, and may offer benefits in reducing intraoperative pain and stabilizing vital signs compared with traditional local anesthesia methods. This approach could be considered a viable option for vitreous surgery requiring fluid-air exchange.
Genetic background and intraoperative haemodynamic instability in patients with pheochromocytoma and paraganglioma: a multicentre retrospective study
Authors: Li Minghao , Zhang Jing , Pang Yingxian , He Yao , Shen Yanting , Wang Jing , Xu Xiaowen , Liu Jiahao , Cheng Kai , Li Zhi , Liu Yujun , Gao Xin , Eisenhofer Graeme , Jiang Jingjing , Liu Longfei 
Published: August 2024

Background:
Perioperative management to maintain intraoperative haemodynamic stability is crucial during surgical treatment of pheochromocytomas and paragangliomas (PPGLs). Although ~70% of PPGLs carry pathogenic variants (PVs) in susceptibility genes, whether intraoperative haemodynamic instability (IHI) is associated with genetic background remains unclear. This study aimed to analyse IHI in patients with PPGL due to PVs in different genes.

Materials and Methods:
This retrospective study recruited 756 patients with abdominal PPGL from two tertiary care centres. Clinical information including sex, age, catecholamine-associated signs and symptoms (CAS), tumour location and size, biochemistry, and perioperative characteristics were collected. Genetic mutations were investigated using next-generation sequencing.

Results:
Among the 671 patients included in the analysis, 61.8% (415/671) had IHI. IHI was significantly associated with genetic background in patients with PPGL. Most (80.9%, 89/110) patients with PPGL due to PVs in HRAS suffered IHI. In contrast, only half (31/62) of patients with PPGL due to PVs in VHL had IHI. In the multivariate regression analysis, compared to those with negative genetic testing results, patients with PPGL due to PVs in HRAS (OR 3.82, 95% CI 2.187–6.679, P<0.001), the other cluster 2 genes (OR 1.95, 95% CI 1.287–2. 569, P<0.05), and cluster 1 genes other than VHL (OR 2.35, 95% CI 1.338–4.111, P<0.05) were independent risk factors for IHI, while PVs in VHL was not independent risk factor (OR 1.09, 95% CI 0.605–1.953, P≥0.05). In addition, age at diagnosis of the primary tumour, presenting of CAS, and tumour size were identified as independent factors for IHI. The nomogram illustrated that genetic background as sharing the largest contribution to IHI, followed by tumour size, age, and presentation of CAS.

Conclusion:
IHI is associated with the genetic background in patients with PPGL. The perioperative management of patients with PPGL can be personalised according to their genetic backgrounds, tumour size, age, and presentation of CAS.
Outcomes of pediatric-focused advanced practice provider fellowship programs: An integrative review
Authors: Koppolu Rajashree , Van Graafeiland Brigit , Hansen Bryan R. 
Published: August 2024

Background:
An increased demand for pediatric-focused advanced practice providers (APPs) exists to address the health care needs of children with medical complexity. Postlicensure advanced practice fellowship programs have been developed to help improve novice provider transition to practice, reducing attrition.

Objectives:
The objectives of this integrative review are to (1) identify outcome measurements of pediatric-focused advanced practice fellowship programs and (2) evaluate the outcome measures to guide future implications for practice.

Data sources:
A systematic integrative literature review was conducted in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses. PubMed, CINAHL, Embase, and Google Scholar were searched in August and September 2022. Articles met inclusion criteria if they included new graduate APPs, reported the intervention of a pediatric fellowship program, and shared outcome measurements. Studies were excluded if they did not directly report on fellowship program outcome measures. Thirteen studies met inclusion criteria and were summarized and appraised for quality using the Johns Hopkins Evidence-Based Practice Model.

Conclusions:
Four themes from the literature included the favorable impact of advanced practice fellowship programs on (a) job satisfaction, (b) retention, (c) clinical and professional performance, and (d) financial outcomes. Variable strategies were used to measure outcomes across programs.

Implications for practice:
Postlicensure pediatric-focused advanced practice fellowship programs seem to improve retention and job satisfaction, increase provider confidence, and bring a favorable return on investment for the organization. Future work should include investment in developing validated, standardized assessment tools to support future development of these programs in the pediatric population.
Severe capsular contracture in a patient with a history of multiple malignancies – Hematoma or neoplasm recurrence?: A case report
Authors: Yuan Yutong , Du Fengzhou , Xiao Yiding , Huang Jiuzuo , Long Xiao 
Published: August 2024

Rationale:
Complications associated with breast implants pose a significant obstacle to improving the quality of life for patients undergoing implant-based breast reconstruction. Due to the intricate nature of their presentation, diagnosis often becomes challenging and perplexing. Herein, we present a case report detailing the diagnostic and therapeutic processes employed in managing implant-related complications in a patient with multiple malignancies who underwent immediate breast reconstruction following mastectomy.

Patent concerns:
The patient, a 48-year-old woman, presented with severe pain and hardening in her left breast. She had previously undergone nipple-sparing mastectomy followed by immediate implant-based breast reconstruction 3 years ago.

Diagnoses:
Upon admission, we suspected a simple diagnosis of capsular contracture. However, upon investigation, she had a medical history of colon cancer, breast cancer, and acute B-lymphoblastic leukemia. Furthermore, she recently experienced nipple hemorrhage.

Interventions:
Considering her clinical manifestations, we postulated the possibility of tumor recurrence along with potential presence of breast implant-associated anaplastic large cell lymphoma. The situation took a new turn, as diagnostic imaging techniques including breast MRI, and ultrasound revealed indications of potential prosthesis rupture and periprosthetic infection.

Outcomes:
Ultimately, en bloc capsulectomy with implant removal was performed, revealing no evidence of implant rupture or infection but rather indicating delayed hematoma formation.

Lessons:
An accurate diagnosis of complications associated with breast prosthesis reconstruction is crucial for effective treatment. The examination and treatment processes employed in this case offer valuable insights toward achieving a more precise diagnosis of prosthesis-related complications, particularly in patients with complex medical histories.
A acute pontine infarction with one-and-a-half syndrome as the manifestation: A case report
Authors: Fu Jing , Yang Hui , Liao Shasha 
Published: August 2024

Rationale:
Sudden ocular dyskinesia is usually associated with ophthalmic diseases and rarely with cerebrovascular diseases. This is a rare case of a patient with a sudden onset of ocular dyskinesia due to occlusion of the anterior inferior cerebellar artery and the spiral modiolar artery. This article describes eye movement disorders associated with cerebrovascular disease, aiming to improve our understanding of cerebrovascular diseases and improve the ability of early diagnosis and differential diagnosis.

Patient concerns:
A 52-year-old man presented with acute pontine cerebral infarction 2 days before presentation. The main symptoms were the inability to adduct and abduct the left eyeball, the ability to abduct but not adduct the right eyeball, and horizontal nystagmus during abduction. Cranial computed tomography in our emergency department suggested cerebral infarction, and magnetic resonance imaging examination after admission confirmed the diagnosis of acute pontine cerebral infarction.

Diagnosis:
This patient was ultimately diagnosed with acute pontine cerebral infarction.

Interventions:
He received aspirin, clopidogrel, and butylphthalide, as well as acupuncture and Chinese herbal medicine.

Outcomes:
After 10 days of treatment, the patient’s paralysis of the eye muscles improved significantly.

Lessons:
Eye movement disorders are sometimes an early warning sign of impending vertebrobasilar ischemic stroke. Patients with acute ischemic stroke who have early detection of oculomotor disturbances should be promptly imaged, as missed diagnosis may lead to serious consequences or even death. It provided us with a new diagnostic idea.