bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre-therapy Laparoscopic Jejunostomy Provides Safe, Reliable Nutrition for Trimodality GEJ Cancer Care
Authors: Sillcox Rachel , Mohammadi Daniel , Czerwonko Matias , Oelschlager Brant K. 
Published: August 2024

Background: Patients with locally advanced GEJ cancer may have severe obstruction and irreversible malnutrition requiring intervention such as TPN, stenting, or enteral access. Laparoscopic jejunostomy (LJ) is a reliable method of supplementing nutrition but is not widely used for fear of complications. At our institution we place LJ tubes preoperatively in such patients and aimed to evaluate their effectiveness. Methods: A retrospective review of patients undergoing neoadjuvant chemo-radiation and laparoscopic transhiatal esophagectomy (LTHE) from 2013 to 2022 was performed. Nutritional markers, weight, and height were recorded, LJ associated complications were recorded from placement time to removal. Thirty-day complications after LTHE were recorded using Clavien-Dindo classification. Results: Of 165 patients who underwent LTHE, twenty patients (12.1%) had LJ placement prior to neoadjuvant therapy due to obstructive symptoms and a median [IQR] weight loss of 13.6 kg [9.07, 16.74] despite dietary modification. LJs were placed a median [IQR] of 103.5 [93.3, 116.8] days prior to LTHE. Median [IQR] weight gain from LJ placement to LTHE was 2.09 kg [0.1, 5.03], P = .01. There were no major complications and 3 (15%) minor complications. There were no unplanned feeding interruptions greater than 48 hours or disruptions in neoadjuvant treatment. There was 1 (5%) 30-day complication after LTHE and there was no mortality. The median [IQR] hospital stay was 7 days [6.5, 9]. Conclusion: Jejunostomy feeding tube prior to neoadjuvant treatment consistently reverses weight loss with minor, manageable complications. Reliable pre-therapy nutrition in obstructed patients is associated with excellent esophagectomy results and should be considered the adjuvant nutritional treatment of choice.
Mitigation of checkpoint inhibitor–induced autoimmune hemolytic anemia through modulation of purinergic signaling
Authors: Dei Zotti Flavia , Qiu Annie , D’Agati Vivette D. , Jagnarine Shwatina , Kyritsis Emmalene , Miller Anabel , Tredicine Maria , Fliginger Daysha , Stone Elizabeth F. , Panch Sandhya , Hudson Krystalyn E. 
Published: August 2024

Abstract
Immune checkpoint inhibitors (ICPis) have revolutionized cancer immunotherapy but also can induce autoimmune hemolytic anemia (AIHA), a severe disease with high mortality. However, the cellular and molecular mechanism(s) of AIHA secondary to ICPi therapy (ICPi-AIHA) are unclear, other than being initiated through decreased checkpoint inhibition. Herein, we report ICPi-AIHA in a novel mouse model that shows similar characteristics of known human ICPi-AIHA (eg, autoantibodies, hemolysis, and increased mortality). During ICPi-AIHA, there is the simultaneous reduction of 2 regulatory T-cell populations (FoxP3+ and Tr1 [type 1 regulatory cells]) and an increase in inflammatory T helper cell 17 (TH17). Moreover, a novel CD39+CD73–FoxP3–CD25– CD4+ T-cell subset (ie, CD39 single positive [CD39SP]) emerges, and early increases in CD39SP predict AIHA development; CD39 is an ectonuclease that breaks down adenosine triphosphate (ATP). Additionally, we found that boosting ATPase activity by injecting recombinant apyrase mitigates AIHA development and significant CD39SP reductions, both suggesting a functional role for CD39 and demonstrating a novel therapeutic approach. Importantly, CD39SP are detectable in multiple mouse models developing AIHA and in patients with AIHA, demonstrating applicability to idiopathic and secondary AIHA. Highlighting broader autoimmunity relevance, ICPi-treated NZB mice experienced accelerated onset and severity of lupus, including AIHA. Moreover, ICPi treatment of healthy B6 animals led to detectable CD39SP and development of autoantibodies against multiple autoantigens including those on red blood cells and platelets. Together, our findings provide further insight into the cellular and molecular mechanisms of ICPi-AIHA, leading to novel diagnostic and therapeutic approaches with translational potential for use in humans being treated with ICPi.
Anticancer activity of quantum size carbon dots: opportunities and challenges
Authors: Bhattacharya Tanima , Preetam Subham , Mukherjee Sohini , Kar Sanjukta , Roy Debanjan Singha , Singh Harshita , Ghose Arak , Das Tanmoy , Mohapatra Gautam 
Published: August 2024

AbstractResearch into the anticancer activity of quantum-sized carbon dots (CDs) has emerged as a promising avenue in cancer research. This CDs delves into the opportunities and challenges associated with harnessing the potential of these nanostructures for combating cancer. Quantum-sized carbon dots, owing to their unique physicochemical properties, exhibit distinct advantages as potential therapeutic agents. Opportunities lie in their tunable size, surface functionalization capabilities, and biocompatibility, enabling targeted drug delivery and imaging in cancer cells. However, we include challenges, a comprehensive understanding of the underlying mechanisms, potential toxicity concerns, and the optimization of synthesis methods for enhanced therapeutic efficacy. A succinct summary of the state of the research in this area is given in this review, emphasizing the exciting possibilities and ongoing challenges in utilizing quantum-sized carbon dots as a novel strategy for cancer treatment.
RING finger protein 5 protects against acute myocardial infarction by inhibiting ASK1
Authors: Wan Hong , Zhang Jianqing , Liu Zhen , Dong Bizhen , Tao Zhangqian , Wang Guanglin , Wang Chihua 
Published: August 2024

Abstract
Background
Myocardial infarction (MI) is a major disease with high morbidity and mortality worldwide. However, existing treatments are far from satisfactory, making the exploration of potent molecular targets more imperative. The E3 ubiquitin ligase RING finger protein 5 (RNF5) has been previously reported to be involved in several diseases by regulating ubiquitination-mediated protein degradation. Nevertheless, few reports have focused on its function in cardiovascular diseases, including MI.

Methods
In this study, we established RNF5 knockout mice through precise CRISPR-mediated genome editing and utilized left anterior descending coronary artery ligation in 9-11-week-old male C57BL/6 mice. Subsequently, serum biochemical analysis and histopathological examination of heart tissues were performed. Furthermore, we engineered adenoviruses for modulating RNF5 expression and subjected neonatal rat cardiomyocytes to oxygen-glucose deprivation (OGD) to mimic ischemic conditions, demonstrating the impact of RNF5 manipulation on cellular viability. Gene and protein expression analysis provided insights into the molecular mechanisms. Statistical methods were rigorously employed to assess the significance of experimental findings.

Results
We found RNF5 was downregulated in infarcted heart tissue of mice and NRCMs subjected to OGD treatment. RNF5 knockout in mice resulted in exacerbated heart dysfunction, more severe inflammatory responses, and increased apoptosis after MI surgery. In vitro, RNF5 knockdown exacerbated the OGD-induced decline in cell activity, increased apoptosis, while RNF5 overexpression had the opposite effect. Mechanistically, it was proven that the kinase cascade initiated by apoptosis signal-regulating kinase 1 (ASK1) activation was closely regulated by RNF5 and mediated RNF5’s protective function during MI.

Conclusions
We demonstrated the protective effect of RNF5 on myocardial infarction and its function was dependent on inhibiting the activation of ASK1, which adds a new regulatory component to the myocardial infarction associated network and promises to enable new therapeutic strategy.
Initial non-adherence to lipid-lowering medication: a systematic literature review
Authors: Cooke Catherine E. , Robertson Teisha 
Published: August 2024

Abstract
Background
The impact on cardiovascular health is lost when a patient does not obtain a newly prescribed lipid-lowering medication, a situation termed “initial medication nonadherence” (IMN). This research summarizes the published evidence on the prevalence, associated factors, consequences, and solutions for IMN to prescribed lipid-lowering medication in the United States.

Methods
A systematic literature search using PubMed and Google Scholar, along with screening citations of systematic reviews, identified articles published from 2010 to 2021. Studies reporting results of IMN to lipid-lowering medications were included. Studies that evaluated non-adult or non-US populations, used weaker study designs (e.g., case series), or were not written in English were excluded.

Results
There were 19 articles/18 studies that met inclusion and exclusion criteria. Estimates of the prevalence of IMN to newly prescribed lipid-lowering medications ranged from 10 to 18.2% of patients and 1.4–43.8% of prescriptions (n = 9 studies). Three studies reported prescriber and patient characteristics associated with IMN. Hispanic ethnicity, Black race, lower Charlson Comorbidity Index score and no ED visits or hospitalization were associated with IMN. Lipid lowering prescriptions from primary care providers were also associated with IMN. Four studies described patient-reported reasons for IMN, including preference for lifestyle modifications, lack of perceived need, and side effect concerns. Four intervention studies reported mixed results with automated calls, live calls, or letters. One study reported worse clinical outcomes in patients with IMN: higher levels of low-density lipoprotein and greater risk of emergency department visits.

Conclusions
Up to one-fifth of patients fail to obtain a newly prescribed lipid-lowering medication but there is limited information about the clinical consequences. Future research should assess outcomes and determine cost-effective approaches to address IMN to lipid-lowering therapy.
Evaluating the health outcomes of aging in place: the role of medicaid aging waiver program on U.S. older adults
Authors: Zai Xianhua 
Published: August 2024

AbstractThe Medicaid Aging Waiver program (MAW) subsidizes the cost of long-term care (LTC) at home or in communities to satisfy older people’s increasing desire to age in place. The MAW program might be health improving for older people by allowing them to age at home. However, less quality and quantity of home-based care comparing to nursing home care could offset some of the potential benefits. I use policy expenditure across states over time linked with detailed health information from the Health and Retirement Study (HRS) to identify the associated effects of MAWs on health outcomes of older adults who are at risk of needing LTC and who are resources constrained to be potentially eligible for Medicaid. Overall, the findings suggest that the MAW program is beneficial to health: a $1,000 increase in MAW spending for each older person results is associated with a 1.4 percent improvement in self-reported health status, a 1.5 percent reduction in functional mobility limitations, a 1.6 percent decrease in Instrumental Activities of Daily Living (IADL) limitations, and a 1.7 percent improvement in negative psychological feelings. For older people who are most likely not eligible for MAWs, such as those who are wealthy or in good health and do not require LTC, these health-improving effects have not been observed.
Estimating the risk of gastrointestinal illness associated with drinking tap water in Norway: a prospective cohort study
Authors: Hyllestad Susanne , Lyngstad Trude Marie , Lindstrøm Jonas Christoffer , White Richard Aubrey , Andreassen Monica , Svendsen Camilla 
Published: August 2024

Abstract
Background
The delivery of safe drinking water has high public health relevance, as reflected in the Sustainable Development Goals (SDG6). Several precautionary actions have reduced the burden associated with infectious diseases in high-income countries; however, pollution in source waters, inadequate disinfection, and premise plumbing, along with an increased awareness that intrusion in the drinking water distribution system, represents risk factors for gastrointestinal illness linked to consume of drinking water. Sporadic cases of waterborne infections are expected to be underreported since a sick person is less likely to seek healthcare for a self-limiting gastrointestinal infection. Hence, knowledge on the true burden of waterborne diseases is scarce. The primary aim with the present study was to estimate the risk of gastrointestinal illness associated with drinking tap water in Norway.

Methods
We conducted a 12-month prospective cohort study where participants were recruited by telephone interview after invitation based on randomised selection. A start up e-survey were followed by 12 monthly SMS questionnaires to gather information on participants characteristics and drinking tap water (number of 0.2L glasses per day), incidence, duration and symptoms associated with gastrointestinal illness. Associations between the exposure of drinking tap water and the outcome of risk of acute gastrointestinal illness (AGI) were analysed with linear mixed effects models. Age, sex, education level and size of the drinking water supply were identified as potential confounders and included in the adjusted model.

Results
In total, 9,946 persons participated in this cohort study, accounting for 11.5% of all invited participants. According to the data per person and month (99,446 monthly submissions), AGI was reported for 5,508 person-months (5.5 per 100 person-months). Severe AGI was reported in 819 person-months (0.8 per 100 person-months). Our study estimates that 2–4% of AGI in Norway is attributable to drinking tap water.

Conclusions
This is the largest cohort study in Norway estimating the burden of self-reported gastrointestinal infections linked to the amount of tap water drunk in Norway. The data indicate that waterborne AGI is not currently a burden in Norway, but the findings need to be used with caution. The importance of continued efforts and investments in the maintenance of drinking water supplies in Norway to address the low burden of sporadic waterborne cases and to prevent future outbreaks needs to be emphasised.
Achilles’ heel: elderly COVID-19 vaccination policy in China
Authors: Deng Ziru , Grépin Karen A. 
Published: August 2024

Abstract
Background
Despite high overall COVID-19 vaccine coverage, the continuously low elderly vaccination rate in mainland China remains a dangerous threat as the country shifts away from its zero-Covid policy. This retrospective study uses the Multiple Streams Framework to examine how macro-level factors may explain poor elderly vaccination outcomes.

Methods
We performed a thematic analysis of qualitative data obtained from 95 official press conferences from October 20, 2020, to February 27, 2023, vaccination-related policy documents, and media coverage, using both inductive and deductive coding approaches.

Results
Our findings suggest that in the problem stream, elderly vaccination was not a “focusing event” during the initial vaccine rollout, resulting in delayed outreach to this population. Additionally, ideologically driven complacency and discrepancies in top-down implementation undermined elderly vaccination in the political stream. In the policy stream, precautious and ambiguous statements, inconsistent policy content, radical shifting media messages, and less age-friendly digital technologies also affected elderly vaccination.

Conclusions
The poor convergence of the three streams led the elderly to be the Achilles’ heel of China’s COVID-19 containment strategy. Future studies should focus on priority identification, adoption of enforcement measures, and timely and effective policy dissemination. The empirical lessons from China can inform and optimize elderly vaccination policy design and implementation in the post-pandemic era.
A decade of change towards Value-Based Health Care at a Dutch University Hospital: a complexity-informed process study
Authors: van Engen Veerle , Buljac-Samardzic Martina , Baatenburg de Jong Rob , Braithwaite Jeffrey , Ahaus Kees , Den Hollander-Ardon Monique , Peters Ingrid , Bonfrer Igna 
Published: August 2024

Abstract
Background
While healthcare organizations in several countries are embracing Value-Based Health Care (VBHC), there are limited insights into how to achieve this paradigm shift. This study examines the decade-long (2012–2023) change towards VBHC in a pioneering Dutch university hospital.

Method
Through retrospective, complexity-informed process research, we study how a Dutch university hospital’s strategy to implement VBHC evolved, how implementation outcomes unfolded, and the underlying logic behind these developments. Data include the hospital’s internal documents (n = 10,536), implementation outcome indicators (n = 4), a survey among clinicians (n = 47), and interviews with individuals contributing to VBHC at the hospital level (n = 20).

Results
The change towards VBHC is characterized by three sequential strategies. Initially, the focus was on deep change through local, tailored implementation of multiple VBHC elements. The strategy then transitioned to a hospital-wide program aimed at evolutionary change on a large scale, emphasizing the integration of VBHC into mainstream IT and policies. Recognizing the advantages and limitations of both strategies, the hospital currently adopts a “hybrid” strategy. This strategy delicately combines deep and broad change efforts. The strategy evolved based on accumulated insights, contextual developments and shifts in decision-makers. The complexity of change was downplayed in plans and stakeholder communication. By the end of 2023, 68 (sub)departments engaged in VBHC, enabled to discuss patients’ responses to Patient Reported Outcomes Measures (PROMs) during outpatient care. However, clinicians’ use of PROMs data showed limitations. While pioneers delved deeper into VBHC, laggards have yet to initiate it.

Conclusions
VBHC does not lend itself to linear planning and is not easily scalable. While there appears to be no golden standard for implementation, blending local and larger-scale actions appears advantageous. Local, deep yet harmonized and system-integrated changes culminate in large scale transformation. Embracing complexity and focusing on the ultimate aims of (re)institutionalization and (re)professionalization are crucial.
Integrating knowledge graphs into machine learning models for survival prediction and biomarker discovery in patients with non–small-cell lung cancer
Authors: Fang Chao , Arango Argoty Gustavo Alonso , Kagiampakis Ioannis , Khalid Mohammad Hassan , Jacob Etai , Bulusu Krishna C. , Markuzon Natasha 
Published: August 2024

AbstractAccurate survival prediction for Non-Small Cell Lung Cancer (NSCLC) patients remains a significant challenge for the scientific and clinical community despite decades of advanced analytics. Addressing this challenge not only helps inform the critical aspects of clinical study design and biomarker discovery but also ensures that the ‘right patient’ receives the ‘right treatment’. However, survival prediction is a highly complex task, given the large number of ‘omics; and clinical features, as well as the high degree of freedom that drive patient survival. Prior knowledge could play a critical role in uncovering the complexity of a disease and understanding the driving factors affecting a patient’s survival. We introduce a methodology for incorporating prior knowledge into machine learning–based models for prediction of patient survival through Knowledge Graphs, demonstrating the advantage of such an approach for NSCLC patients. Using data from patients treated with immuno-oncologic therapies in the POPLAR (NCT01903993) and OAK (NCT02008227) clinical trials, we found that the use of knowledge graphs yielded significantly improved hazard ratios, including in the POPLAR cohort, for models based on biomarker tumor mutation burden compared with those based on knowledge graphs. Use of a model-defined mutational 10-gene signature led to significant overall survival differentiation for both trials. We provide parameterized code for incorporating knowledge graphs into survival analyses for use by the wider scientific community.
Healthcare workers’ perceptions and user experiences of biometric technology in the selected healthcare facilities in Zambia
Authors: Hamapa Arnold M. , Zulu Joseph M. , Khondowe Oswell , Hangulu Lydia 
Published: August 2024

Abstract
Background
Biometric recognition, using traits like fingerprints, faces, and irises, has advanced significantly, enabling accurate identification. Despite progress, implementation in Zambian healthcare is limited. This study explored healthcare workers’ and patients' perceptions and experiences regarding biometric technology in Zambian healthcare settings, offering insights for informed decision-making and product design.

Methods
This phenomenological study explored the perceptions and experiences of healthcare workers and end-users (patients) concerning biometric technology in four healthcare facilities in Lusaka Province: Chilenje, Chawama, Kanyama (first-level hospitals), and Railways Urban Clinic. These facilities were purposefully selected for their active use of biometric services and involvement with the National Health Insurance Management Authority (NHIMA). The study included 20 healthcare workers and 16 patients. Face-to-face interviews with healthcare workers and patients, and focus group discussions with users, lasting 35 to 65 min, were conducted. Interviews were audio-recorded, transcribed verbatim, coded with Nvivo version 12, and analyzed using inductive thematic analysis.

Results
Facilitators included efficient system integration, investment in biometric equipment, workflow transformation, and patient recognition of benefits. Barriers included infrastructure limitations, technical challenges, patient resistance and misconceptions, and accessibility challenges for individuals with disabilities.

Conclusion
This study highlights the transformative potential of biometric identification systems in healthcare, emphasizing benefits in efficiency and data integrity. Successful integration requires addressing facilitators like education and infrastructure and mitigating barriers such as cultural resistance and technological limitations. Stakeholders, including policymakers and healthcare providers, can use these insights to align efforts with Sustainable Development Goals for improved healthcare access and reduced inequalities. Considering user perspectives is crucial for effective implementation, and continuous improvement can enhance healthcare delivery and patient outcomes.