bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fostering Clinical Judgment and Promoting Transition Into First Clinical Rotation Through Active Learning
Authors: York Ashley , Wynn Laura 
Published: June 2024

Abstract
Undergraduate nursing education builds on knowledge obtained from previous semesters to grow critical thinking skills and promote clinical judgment attainment. Transitioning knowledge from the classroom to the clinical setting is often difficult. Students finishing their first semester of courses in a BSN program participated in a novel, interactive classroom activity to help them practice critical thinking, transfer their learning, and develop clinical judgment by applying concepts to patient scenarios. Using an engaging student experience promotes long-term deep learning in hopes that students will remain successful in their progression through the curriculum.
Genetic landscape of atopic dermatitis
Authors: Paternoster Lavinia 
Published: June 2024

Purpose of review
This review summarizes recent advances in identifying genetic risk factors for atopic dermatitis and how these genetic associations are being used to explore the causal relationships between atopic dermatitis and potential risk factors and downstream outcomes.

Recent findings
A recent large-scale GWAS meta-analysis has identified 91 genetic loci associated with atopic dermatitis. Rare variant studies have also identified new gain-of-function or loss-of-function variants implicated in atopic dermatitis, particularly for FLG and STAT6/JAK1. Finally, there has been a surge in utilizing genetic association data to investigate the causal relationships between atopic dermatitis and other traits. Mendelian randomization studies have found that various metabolites and gut microbiota are causal for atopic dermatitis and have causally implicate atopic dermatitis in the development of alopecia areata, diabetes, vascular dementia and some cancers.

Summary
The past year has seen a huge increase in the genes implicated for atopic dermatitis and in the use of genetics to explore causal relationships. The latter requires caution in implementation and interpretation, but is a promising area of research. In the coming years, increasing the ethnic diversity of atopic dermatitis genetic studies would be very welcome and the translation of current genetic findings into new drugs will be an exciting area of development.
Increasing Diversity in Academic Medicine Via a Strategic Intermural Housestaff Leadership Development Program
Authors: Galvan Eva , Ahn Christina E. , Hansen Marissa , Evoh Vanessa , Gebreyohanns Yohanna , Estelle Carolee , Cryer Byron , Yin Helen , Harris Toi Blakley , Collins Chiquita A. , Okorodudu Dale O. 
Published: June 2024

Abstract

Problem
By 2055, the United States will no longer have a single race or ethnic majority. As the nation’s demographics change, the field of medicine must also change to meet the needs of diverse patients.

Approach
In 2013, UT Southwestern Medical Center implemented the Housestaff Emerging Academy of Leaders (HEAL) program, which provides leadership development skills and training to underrepresented in medicine physician residents in preparation for academic medicine careers. Program leaders hypothesized that by providing housestaff with structured mentorship, career coaching, and individualized development plans, HEAL would increase interest in pursuing academic careers and prepare residents for faculty positions. HEAL has since expanded to graduate medical education programs nationwide.

Outcomes
From 2013 to 2018, HEAL included housestaff at UT Southwestern and other Texas medical centers, totaling 392 enrollees. In 2019, the program increased to include housestaff from around the country. The first HEAL USA program had 39 housestaff, which increased to 173 in 2019, including 60 faculty from 31 U.S. academic medical centers. The 2019 HEAL USA preassessment survey (32 trainee responses) revealed that 10 (31%) of the housestaff were “extremely interested” in academic medicine, but only 1 (3%) felt “extremely confident” to pursue an academic medicine career. Postassessment responses to these same items (5 trainee responses) were 3 (60%) and 1 (20%), respectively, with 3 (60%) also feeling “extremely prepared” (1 [20%]) or “very prepared” (2 [40%]) to pursue an academic medicine career. Of 70 evaluable participants who attended at least 2 sessions and have graduated from residency, 47 (67%) have attained academic faculty positions, whereas 23 (33%) have pursued positions at nonacademic centers.

Next Steps
The next steps for HEAL USA will be continued expansion to additional medical centers and effective delivery of career development and leadership training to encourage participants to pursue academic medical careers.
Acyclovir Dosing Practices Across a Multicenter Cohort of Neonatal Intensive Care Units
Authors: Foote Henry P. , Thomassy Haley , Baquero Leonardo , Cayli Mina , Jacobs Elijah , Paladugu Anish , Roy Anisha , Heyward Elizabeth , Clark Reese H. , Hornik Christoph P. , Benjamin Daniel K. , Benjamin Jr Daniel K. , Greenberg Rachel G. 
Published: June 2024

Background:
Acyclovir is the first-line therapy for neonatal herpes simplex virus infections. Therapy can mitigate morbidity and mortality but carries a risk for toxicity. We aimed to compare acyclovir dosing in neonatal intensive care units to published recommendations based on population pharmacokinetic (PopPK) analysis.

Methods:
We performed a multicenter cohort study of infants in neonatal intensive care units managed by the Pediatrix Medical Group from 1997 to 2020. We included all infants who received acyclovir with complete dosing information. Our primary outcome was the proportion of courses with dosing within 80%–120% of the PopPK recommended daily dose and at the recommended dosing frequency. We compared dosing before and after the publication of the 2014 PopPK recommendations using linear probability modeling.

Results:
We identified 6862 infants with complete dosing information across 308 centers. Dosing met PopPK recommendations for 41% of treatment courses for infants <30 weeks postmenstrual age (PMA), 71% for infants 30 to <36 weeks PMA and <1% for infants ≥ 36 weeks PMA. Comparison of dosing from 1997 to 2013 with that from 2015 to 2020 showed a significant increase in dosing meeting PopPK recommendations for infants <30 weeks PMA (P = 0.008) and infants 30 to <36 weeks PMA (P = 0.02) but not infants ≥ 36 weeks PMA (P = 0.29). No significant increase in dosing meeting PopPK recommendations was seen for any PMA group when comparison was limited to more recent years (2008–2013 vs. 2015–2020).

Conclusions:
Dosing meeting PopPK recommendations increased over time for some PMA groups, but dosing different than PopPK recommendations remains common. More research is needed to clarify optimal dosing strategies in these infants.
Health-related quality of life outcomes in children after congenital heart disease surgery in low-middle-income countries: a systematic review and meta-analysis
Authors: Luitel Prajjwol , Yadav Rukesh , Neupane Nischal , Paudel Sujan , Adhikari Niranjan , Punukollu Rachana 
Published: June 2024

Introduction:
Improved treatments for children with congenital heart disease (CHD) have led to a growing interest in long-term functional outcomes such as health-related quality of life (HRQOL). Studies on HRQOL in children with CHD have yielded contradictory results. In this study, we aimed to perform a systematic review and meta-analysis to analyze the effect of surgery on HRQOL outcomes in children with CHD in low-income and middle-income countries.

Methods:
A comprehensive search for articles was performed using the Medline (PubMed), Scopus, and Embase databases from their inception to September 5, 2023. Studies reporting QOL outcomes in children <18 years and published in English were included.

Results:
Of the 1239 records screened, 10 studies, including 1721 participants, were included in the study. The overall QOL was significantly better in the control group than in the children who underwent surgery for CHD (P=0.04, standard mean difference of −0.62, 95% CI: −1.2 to −0.04), and the overall QOL was significantly better in the children with CHD after surgery than before surgery (P=0.05, standard mean difference of −0.56, 95% CI: −1.11 to −0.01).

Conclusion:
The QOL of children from low-income and middle-income countries who undergo surgery for CHD is significantly poorer than that of controls in all dimensions except the emotional domain. Meanwhile, surgery has the greatest impact on improving the physical domain in children with CHD after surgery. Strategies to improve HRQOL in this subgroup of patients should be further investigated.
Knowledge, attitude, practice, and associated factors of health professionals towards cardiopulmonary resuscitation at Ayder Comprehensive Specialized Hospital, 2023, Tigray, Ethiopia
Authors: Hadush Yared , Mulaw Abara , Belay Aregawi , Ayalew Assefa , Bitsa Yihdego , Berhane Haftom 
Published: June 2024

Background:
Cardiopulmonary resuscitation (CPR) is a crucial medical technique that is performed manually to preserve intact brain function. Early initiation of CPR manoeuvres and activation of the chain of survival are key factors in the prognosis of patients with cardiorespiratory arrest (CRA). Inadequacy in any step of CPR due to a lack of knowledge or skill is associated with a poor return of spontaneous circulation and a decreased survival rate.

Objective:
To assess the knowledge, attitude, practice, and factors associated with health towards CPR at Ayder Comprehensive Specialized Hospital 2023.

Methods:
Institution-based cross-sectional study was conducted to assess the knowledge, attitude, and practice of health professionals towards cardiopulmonary CPR in Ayder Comprehensive Specialized Hospital Of Tigray, Ethiopia from 1 May to 30 August 2023. Data were collected using structured questionnaires by Two BSC anaesthesia staff and One MSc. as supervisor. A stratified random sampling technique was used to select the study participants. The Data were entered and analyzed using SPSS version 23. Variables with P value less than 0.20 were fitted into multivariate logistic regression. Descriptive statistics such as frequencies, median, interquartile range, percentages, tables, graphs and charts were used to present the results.

Result:
A total of 262 Of 277 healthcare providers were included in the study, with a response rate of 93.3%. Knowledge, attitude, practice of health professionals towards CPR was 22.5%, 39% and 31.5%, respectively. MSc degree in level of education [adjusted odds ratio (AOR): 8.561 95% CI=2.109–34.746], CPR training (AOR: 2.157, 95%, 1.005, 4.631), and Work experience 6–10years and more than 10 (AOR =0.195, 95% CI, 0.071–0.539) and AOR =0.148 195 95% CI, 0.017, 1.285) were significantly associated with knowledge. The Anaesthetist and Medical doctors were 5.5 times (AOR, 5.50, 95% CI 1.263–23.93) and 2.125 times (AOR: 2.125, 95% CI, 0.865–5.216) respectively more likely to have favourable attitude than the midwives. Regarding to practice participants with CPR training (AOR: 1.804 95% CI=0.925–3.518), good knowledge (AOR: 2.766 95% CI=1.312–5.836) and favourable attitude (AOR: 1.931, 95% CI=0.995–3.749) were significantly associated with safe practice.

Conclusion and recommendation:
The overall level of health professionals, knowledge, attitude, practices, and factors associated towards CPR in Ayder Comprehensive Specialized Hospital at Tigray, Ethiopia were insufficient, favourable and safe enough. Regular CPR training is recommended to increase the knowledge, attitude, and practice of healthcare professionals towards CPR.
Congenital Flexor Contracture of Ulnar Digits Masquerading as Volkmann Ischemic Contracture
Authors: Kumar Rajesh , Saini Parampreet Singh 
Published: June 2024

Abstract
Congenital flexion contracture of ulnar digits is a rare entity with few cases reported in medical literature. This condition is often misdiagnosed as Volkmann ischemic contracture as both have similar presentation. The patient history, physical examination, radiological investigation, and intra-operative findings can differentiate these 2 conditions clearly. A 14-year-old female presented to a tertiary care hospital with flexion deformity of the left long, ring, and little fingers without neurological deficit since she was 3 years old. Patient had decreased handspan with difficulty in grasping daily life objects. Finger flexion deformity was also not aesthetically acceptable due to social stigma. Patient finger contracture was managed with flexor pronator slide (Max-Page) operation. The muscle slide operation was done using concealed medial incision. Aesthetic and functional correction was achieved with no recurrence at subsequent follow-ups.
An AINTEGUMENTA phospho-switch controls bilateral stem cell activity during secondary growth
Authors: Xiao Wei , Yang Ling , Molina David , Chen Houming , Yu Shan , Miao Yingjing , Ripper Dagmar , Deng Shulin , Bayer Martin , De Rybel Bert , Ragni Laura 
Published: June 2024

AbstractPlant stem cells have the remarkable ability to give rise to distinct tissues and organs throughout development. Two concentric cylinders of actively dividing stem cells are the main drivers of radial thickening during secondary growth, each producing distinct vascular cell types towards the inside and the outside. While the molecular mechanisms underlying their initiation have been well studied, it remains unclear how these stem cell layers determine which cell type is generated. Here, we demonstrate that the cross-talk between the ERECTA (ER) receptor pathway and auxin signalling controls the amount and choice of output tissue in these two stem cell regions. Mechanistically, we show that the ER pathway phosphorylates the transcription factor ANTEGUMENTA, thereby modulating bilateral stem cell activity and favouring the differentiation of only one type of cell. Our results thus show that the phosphorylation status of ANT regulates root girth and biomass accumulation by influencing bilateral stem cell production. This highlights the critical role of post-translational modifications in plant growth and development.
Gene-modified NK Cells Expressing CD64 and Pre-loaded with HIV-specific BNAbs Target Autologous HIV-1 Infected CD4+T Cells by ADCC
Authors: Tomescu Costin , Ortiz Adiana Ochoa , Lu Lily D. , Kong Hong , Riley James L. , Montaner Luis J. 
Published: June 2024

AbstractNK cells can efficiently mediate antibody-dependent cellular cytotoxicity (ADCC) of antibody coated target cells via the low-affinity Fc-receptor, CD16, but cannot retain antibodies over time. To increase antibody retention and facilitate targeted ADCC, we genetically modified human NK cells with the high-affinity Fc receptor, CD64, so that we could pre-load them with HIV-specific BNAbs and enhance their capacity to target HIV infected cells via ADCC. Purified NK cells from the peripheral blood of Control Donors or Persons Living with HIV (PLWH) were activated with IL-2/IL-15/IL-21 cytokines and transduced with a lentivirus encoding CD64. High levels of CD64 surface expression were maintained for multiple weeks on NK cells and CD64 transduced NK cells were similar to control NK cells with strong expression of CD56, CD16, NKG2A, NKp46, CD69, HLA-DR, CD38, and CD57. CD64 transduced NK cells exhibited significantly greater capacity to bind HIV-specific BNAbs in short-term antibody binding assay as well as retain the BNAbs over time (1 week antibody retention assay) compared to Control NK cells only expressing CD16. BNAb pre-loaded CD64 transduced NK cells showed a significantly enhanced capacity to mediate ADCC against autologous HIV-1 infected CD4+primary T cells in both a short term 3 hour degranulation assay as well as a 24 hour HIV p24 HIV Elimination Assay when compared to control NK cells. A chimeric CD64 enhanced NK cell strategy (NK EnhancementStrategy, “NuKES”) retaining bound HIV-specific antibody and targeted ADCC represents a novel autologous primary NK cell immuno-therapy strategy against HIV.
A vacuolar invertase geneSlVImodulates sugar metabolism and postharvest fruit quality and resistance in tomato
Authors: Wu Yu , Chen Haonan , Wu Mengbo , Zhou Yuanyi , Yu Chuying , Yang Qihong , Rolland Filip , Van de Poel Bram , Bouzayen Mondher , Hu Nan , Wang Yikui , Liu Mingchun 
Published: June 2024

AbstractSugars act as signaling molecules to modulate various growth processes and enhance plant tolerance to various abiotic and biotic stresses. Moreover, sugars contribute to the post-harvest flavor in fleshy fruit crops. To date, the regulation of sugar metabolism and its effect in plant growth, fruit ripening, postharvest quality and resistance remains not fully understood. In this study, we investigated the role of tomato gene encoding a vacuolar invertase, hydrolyzing sucrose to glucose and fructose.SlVIis specifically expressed during the tomato fruit ripening process. We found that overexpression ofSlVIresulted in increased leaf size and early flowering, while knockout ofSlVIled to increased fruit sucrose content, enhanced fruit firmness, elevated resistance of postharvest fruit toBotrytis cinerea.Moreover, the content of naringenin and total soluble solids was significantly increased inSlVIknockout fruit at postharvest stage. Transcriptome analysis showed a negative feedback regulation triggered by sucrose accumulation inSlVIknockout fruit resulting in a downregulation ofBAM3andAMY2,which are critical for starch degradation. Moreover, genes associated with cell wall, cutin, wax, and flavonoid biosynthesis and pathogen resistance were upregulated inSlVIknockout fruit. Conversely, the expression levels of genes involved in cell wall degradation were decreased in knockout fruit. These results are consistent with the enhanced postharvest quality and resistance. Our findings not only provide new insights into the relationship between tomato fruit sucrose content and postharvest fruit quality, but also suggest new strategies to enhance fruit quality and extend postharvest shelf life.
A holistic quantitative understanding of state transition in plant photosynthesis
Authors: Oung Hui Ming Olivia , Koochak Haniyeh , Krysiak Malgorzata , Svoboda Vaclav , Kirchhoff Helmut 
Published: June 2024

AbstractEfficient and safe harvesting of sunlight by photosynthesis in plant thylakoid membranes requires that both photosystems (PS)I and PSII operate with similar electron turnover rates. This is realized by state transition encompassing the redistribution of light-harvesting complexes II (LHCII) between the spatially separated PSII (mainly in stacked grana thylakoids) and PSI (mainly in unstacked domains). Here, we provide a quantitative holistic view on lateral protein and pigment reorganizations within the thylakoid membrane network induced by state transitions and the role of reversible protein phosphorylation for this process. The data reveals that plants can perfectly balance electron fluxes through both photosystems by the redistribution of a certain pool of hyperphosphorylated LHCII from PSII in stacked to PSI in unstacked thylakoid membranes. Force balance analysis predicts that the photosystems antenna reorganization is not realized by a phosphorylation induced stimulation of lateral mobility of LHCII but likely by vertical unstacking. Shuffling of phospho-LHCII during state transition results in remodeling of the PSI supercomplex landscape but not of the PSII landscape supporting the notion that only a loosely bound pool of LHCIIs is involved in state transition.
Hexa-acylated lipopolysaccharides from the gut microbiota enhance cancer immunotherapy responses
Authors: Beresford-Jones Benjamin S. , Sardar Puspendu , Xia Wangmingyu , Shabana Omar , Suyama Satoshi , Jesus Faustino Ramos Ruben J. , Soderholm Amelia T. , Tourlomousis Panagiotis , Kuo Paula , Evans Alexander C. , Imianowski Charlotte J. , Conti Alberto G. , Wesolowski Alexander J. , Okkenhaug Klaus , Whiteside Sarah K. , Roychoudhuri Rahul , Bryant Clare E. , Cross Justin R. , Pedicord Virginia A. 
Published: June 2024

AbstractImmune checkpoint inhibitors (ICI), such as anti-PD-1, have revolutionized cancer treatment, but they are only effective for a minority of patients. The gut microbiome plays a crucial role in modulating immunotherapy treatment responses, and previous studies correlated lipopolysaccharide (LPS)-producing gut microbes with poorer prognosis. However, LPS from diverse bacterial species have activities ranging from immunostimulatory to inhibitory. By functionally analyzing fecal metagenomes from 112 melanoma patients prior to anti-PD-1 therapy, we found that a subset of LPS-producing bacteria encoding immunostimulatory hexa-acylated LPS was enriched in the microbiomes of clinical responders. We confirmed robust activation of the NF-kB pathway by hexa-acylated LPSin vitro, and this activation was significantly inhibited by penta-acylated LPS in a dose-dependent manner. Importantly, oral administration of hexa-acylated LPS augmented anti-PD-1-mediated anti-tumor immunity in anin vivomouse model of cancer immunotherapy. Microbiome hexa-acylated LPS may therefore represent an accessible predictor and potential enhancer of clinical anti- PD-1 immunotherapy responses.Statement of significanceFunctional rather than taxonomic profiling of patient gut microbiomes reveals hexa-acylated LPS as a novel biomarker of responsiveness and a targetable pathway for enhancing responses to anti-PD-1, informing future studies and current patient treatment.
Autism Prevalence in Chile: Unmet Special Education Needs using Data Linkage and Bayesian Analysis of Three Million School-Aged Children
Authors: Roman-Urrestarazu Andres , Tyson Adele , Gatica-Bahamonde Gabriel , van Kessel Robin , Yang Justin , Mansilla Carola , Zuniga Isabel , Mendez-Fadol Alejanda , Larrain Blanca , Garcia Ricardo , Koch Damaris , Groot Wim , Pavlova Milena , Czabanowska Katarzyna , Ford Tamsin 
Published: June 2024

AbstractPrevalence estimates of autism spectrum disorder (henceforth autism) in Latin America thus far have been limited by a lack of reliable population-level data. We analyzed autism school prevalence across 29 Chilean health service regions for students aged 6–18 years, standardized by age and sex. We validated these results using electronic health records from one of Chile’s largest regional health service, the Servicio de Salud Araucania Sur (SSAS). We then projected Bayesian prevalences, reporting nationally, and by health service, ethnicity, immigration background, and rurality. We found a standardized national school autism prevalence of 0.46% (95% CI, 0.46%-0.47%), with boys having six times higher odds of autism than girls (OR 6.10 [95%CI: 5.82–6.41]). The sex - and age-adjusted clinical prevalence in the SSAS trust was 1.22% (95% CI: 1.16%-1.28%) and the projected Bayesian national autism prevalence was 1.31% (95% Credible Interval: 1.25%-1.38%). Our results indicate a higher autism prevalence than previously reported in the south of the Araucania region with observed disparities in prevalence across sex, ethnic groups, and health services.