bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macrophage fate: to kill or not to kill?
Authors: Marrufo Armando M. , Flores-Mireles Ana Lidia 
Published: June 2024

ABSTRACT

Macrophages are dynamic innate immune cells that either reside in tissue, serving as sentinels, or recruited as monocytes from bone marrow into inflamed and infected tissue. In response to cues in the tissue microenvironment (TME), macrophages polarize on a continuum toward M1 or M2 with diverse roles in progression and resolution of disease. M1-like macrophages exhibit proinflammatory functions with antimicrobial and anti-tumorigenic activities, while M2-like macrophages have anti-inflammatory functions that generally resolve inflammatory responses and orchestrate a tissue healing process. Given these opposite phenotypes, proper spatiotemporal coordination of macrophage polarization in response to cues within the TME is critical to effectively resolve infectious disease and regulate wound healing. However, if this spatiotemporal coordination becomes disrupted due to persistent infection or dysregulated coagulation, macrophages’ inappropriate response to these cues will result in the development of diseases with clinically unfavorable outcomes. Since plasticity and heterogeneity are hallmarks of macrophages, they are attractive targets for therapies to reprogram toward specific phenotypes that could resolve disease and favor clinical prognosis. In this review, we discuss how basic science studies have elucidated macrophage polarization mechanisms in TMEs during infections and inflammation, particularly coagulation. Therefore, understanding the dynamics of macrophage polarization within TMEs in diseases is important in further development of targeted therapies.
New discovery of 3.84–3.64 Ga diverse granitoids in eastern Hebei, North China Craton: Petrogenesis and significance
Authors: Dong Chunyan , Liu Shoujie , Nutman Allen P. , Li Pengchuan , Xie Hangqiang , Li Yuan , Liu Dunyi , Wan Yusheng 
Published: June 2024

Abstract
Eoarchean rocks are scarce worldwide, limiting our understanding of Earth’s early history. This contribution presents the field geology, sensitive high-resolution ion microprobe (SHRIMP) U-Pb zircon dating, Nd-Hf-O isotopic analysis, and whole-rock geochemical study of Eoarchean granitoids newly discovered in the Labashan area, eastern Hebei, North China Craton. Eoarchean rocks, including 3838–3754 Ma trondhjemitic gneisses (4 samples), 3786–3773 Ma granodioritic gneisses (4 samples), 3775 Ma quartz monzonite gneiss (1 sample), and 3786–3640 Ma potassic granite gneisses (3 samples), are identified in a tract 1 km long. They are in tectonic contact with 3.4–3.1 Ga supracrustal rocks, with both occurring as enclaves in 2.5 Ga potassic granite. The trondhjemitic gneisses show low (La/Yb)N values (23.4–56.8) and insignificant Eu anomalies (Eu/Eu* = 0.86–1.24). Compared with the trondhjemitic gneisses, the granodioritic gneisses and quartz monzonite gneiss have lower (La/Yb)N ratios (9.2–11.3) and lower Eu/Eu* values (0.62–0.79). The potassic granites have (La/Yb)N ratios of 20.7–55.2 and Eu/Eu* values of 0.75–1.84. Zircon saturation temperatures of the granitoids range from 667 °C to 878 °C. They have whole-rock εNd(t) of −4.6 to 1.0 and tCHUR(Nd) of 4.3–3.6 Ga, and zircon εHf(t) values of −6.9 to 0.4 and tCHUR(Hf) ages of 4.1–3.5 Ga (mainly 4.1–3.8 Ga) and δ18O of 4.6‰–7.5‰ (CHUR—chondritic uniform reservoir). It is speculated that different amounts of low-K mafic rocks and tonalite-trondhjemite-granodiorite rocks with prior crustal residence times were the source of the spectrum of trondhjemitic to granitic compositions at Labashan. Two possible models, magma underplating and convergent plate boundary processes, are explored for the tectonic regime forming these Eoarchean granitoids.
Advances in diagnosis and management of cancer of the esophagus
Authors: Deboever Nathaniel , Jones Christopher M , Yamashita Kohei , Ajani Jaffer A , Hofstetter Wayne L 
Published: June 2024

Abstract
Esophageal cancer is the seventh most common malignancy worldwide, with over 470 000 new cases diagnosed each year. Two distinct histological subtypes predominate, and should be considered biologically separate disease entities.1 These subtypes are esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Outcomes remain poor regardless of subtype, with most patients presenting with late stage disease.2 Novel strategies to improve early detection of the respective precursor lesions, squamous dysplasia, and Barrett’s esophagus offer the potential to improve outcomes. The introduction of a limited number of biologic agents, as well as immune checkpoint inhibitors, is resulting in improvements in the systemic treatment of locally advanced and metastatic esophageal cancer. These developments, coupled with improvements in minimally invasive surgical and endoscopic treatment approaches, as well as adaptive and precision radiotherapy technologies, offer the potential to improve outcomes still further. This review summarizes the latest advances in the diagnosis and management of esophageal cancer, and the developments in understanding of the biology of this disease.
Restrictive use of Restraints and Delirium Duration in the Intensive Care Unit (R2D2-ICU): protocol for a French multicentre parallel-group open-label randomised controlled trial
Authors: Sonneville Romain , Couffignal Camille , Sigaud Florian , Godard Virginie , Audibert Juliette , Contou Damien , Celier Adam , Djibre Michel , Schmidt Julien , Jaquet Pierre , Mekontso Dessap Armand , Bourel Claire , Bellot Romane , Roy Carine , Lamara Fariza , Essardy Fatiha , Timsit Jean-François , Cornic Renaud , Bouadma Lila 
Published: June 2024

IntroductionPhysical restraint (PR) is prescribed in patients receiving invasive mechanical ventilation in the intensive care unit (ICU) to avoid unplanned removal of medical devices. However, it is associated with an increased risk of delirium. We hypothesise that a restrictive use of PR, as compared with a systematic use, could reduce the duration of delirium in ICU patients receiving invasive mechanical ventilation.Methods and analysisThe Restrictive use of Restraints and Delirium Duration in ICU (R2D2-ICU) study is a national multicentric, parallel-group, randomised (1:1) open-label, controlled, superiority trial, which will be conducted in 10 ICUs. A total of 422 adult patients requiring invasive mechanical ventilation for an expected duration of at least 48 hours and eligible for prescription of PR will be randomly allocated within 6 hours from intubation to either the restrictive PR use group or the systematic PR use group, until day 14, ICU discharge or death, whichever comes first. In both groups, PR will consist of the use of wrist straps. The primary endpoint will be delirium or coma-free days, defined as the number of days spent alive in the ICU without coma or delirium within the first 14 days after randomisation. Delirium will be assessed using the Confusion Assessment Method-ICU twice daily. Key secondary endpoints will encompass agitation episodes, opioid, propofol, benzodiazepine and antipsychotic drug exposure during the 14-day intervention period, along with a core outcome set of measures evaluated 90 days postrandomisation.Ethics and disseminationThe R2D2-ICU study has been approved by the Comité de Protection des Personnes (CPP) ILE DE FRANCE III—PARIS (CPP19.09.06.37521) on June 10th, 2019). Participant recruitment started on 25 January 2021. Results will be published in international peer-reviewed medical journals and presented at conferences.Trial registration numberNCT04273360.
Hospital policy of tranexamic acid to reduce transfusion in major non-cardiac surgery (TRACTION): protocol for a phase IV randomised controlled trial
Authors: Houston Brett L , McIsaac Daniel I , Breau Rodney H , Andrews Meghan , Avramescu Sinziana , Bagry Hema , Balshaw Robert F , Daya Jayesh , Duncan Kaitlin , Harle Christopher , Jacobsohn Eric , Kerelska Tina , McIsaac Sarah , Ramsay Tim , Saha Tarit , Perelman Iris , Recio Angela , Solvason Dayna , Szoke Daniel , Tenenbein Marshall , Fergusson Dean A , Zarychanski Ryan 
Published: June 2024

IntroductionTranexamic acid (TXA) is an inexpensive and widely available medication that reduces blood loss and red blood cell (RBC) transfusion in cardiac and orthopaedic surgeries. While the use of TXA in these surgeries is routine, its efficacy and safety in other surgeries, including oncologic surgeries, with comparable rates of transfusion are uncertain. Our primary objective is to evaluate whether a hospital-level policy implementation of routine TXA use in patients undergoing major non-cardiac surgery reduces RBC transfusion without increasing thrombotic risk.Methods and analysisA pragmatic, registry-based, blinded, cluster-crossover randomised controlled trial at 10 Canadian sites, enrolling patients undergoing non-cardiac surgeries at high risk for RBC transfusion. Sites are randomised in 4-week intervals to a hospital policy of intraoperative TXA or matching placebo. TXA is administered as 1 g at skin incision, followed by an additional 1 g prior to skin closure. Coprimary outcomes are (1) effectiveness, evaluated as the proportion of patients transfused RBCs during hospital admission and (2) safety, evaluated as the proportion of patients diagnosed with venous thromboembolism within 90 days. Secondary outcomes include: (1) transfusion: number of RBC units transfused (both at a hospital and patient level); (2) safety: in-hospital diagnoses of myocardial infarction, stroke, deep vein thrombosis or pulmonary embolism; (3) clinical: hospital length of stay, intensive care unit admission, hospital survival, 90-day survival and the number of days alive and out of hospital to day 30; and (4) compliance: the proportion of enrolled patients who receive a minimum of one dose of the study intervention.Ethics and disseminationInstitutional research ethics board approval has been obtained at all sites. At the completion of the trial, a plain language summary of the results will be posted on the trial website and distributed in the lay press. Our trial results will be published in a peer-reviewed scientific journal.Trial registration numberNCT04803747.
Cardiovascular risk and physical activity in Syrians living in England compared with the population of North West England: a cross-sectional study
Authors: Abou Deb George , Hamdallah Hanady 
Published: June 2024

ObjectiveThis study aims to assess the 10-year cardiovascular risk and physical activity among Syrians residing in England and compare them with the North West England population.DesignCross-sectional study.SettingBilingual online questionnaire distributed through social media platforms from 21 June to 23 July 2023.ParticipantsSyrian individuals in England (aged 25–69, migrated post-2010) and residents of North West England within the same age bracket. All participants had no history of cardiovascular disease (CVD).Primary and secondary outcome measuresPrimary outcome measures included differences in QRISK3 score, 10-year relative risk (RR), metabolic equivalent of task (MET) and self-reported physical activity between the two groups. Secondary outcome measures included subgroup analyses based on sex and age.ResultsOf the 273 eligible participants (137 in the Syrian group and 136 in the Northwest England group), the QRISK3 score was twofold higher in the Syrian group (2.20, 5.50) than in the North West England group (1.20, 3.15) (p=0.042). The 10-year RR was approximately three times higher in the Syrian group (p<0.001), while MET was about twice as high in the Northwest England group (p<0.001).ConclusionsDespite relocating to England, Syrians face substantially elevated cardiovascular risks attributed to an unhealthy lifestyle, including smoking, reduced physical activity, increased body mass index and diabetes, coupled with a strong family history of CVD in first-degree relatives under the age of 60. The study underscores the need for early assessment, risk factor identification and tailored interventions for this population. Raising awareness, particularly in the context of smoking, and promoting physical activity are crucial for mitigating cardiovascular risks. The findings emphasise the importance of culturally sensitive interventions to address the unique health challenges of Syrians in the UK.
Performance evaluation of ChatGPT in detecting diagnostic errors and their contributing factors: an analysis of 545 case reports of diagnostic errors
Authors: Harada Yukinori , Suzuki Tomoharu , Harada Taku , Sakamoto Tetsu , Ishizuka Kosuke , Miyagami Taiju , Kawamura Ren , Kunitomo Kotaro , Nagano Hiroyuki , Shimizu Taro , Watari Takashi 
Published: June 2024

BackgroundManual chart review using validated assessment tools is a standardised methodology for detecting diagnostic errors. However, this requires considerable human resources and time. ChatGPT, a recently developed artificial intelligence chatbot based on a large language model, can effectively classify text based on suitable prompts. Therefore, ChatGPT can assist manual chart reviews in detecting diagnostic errors.ObjectiveThis study aimed to clarify whether ChatGPT could correctly detect diagnostic errors and possible factors contributing to them based on case presentations.MethodsWe analysed 545 published case reports that included diagnostic errors. We imputed the texts of case presentations and the final diagnoses with some original prompts into ChatGPT (GPT-4) to generate responses, including the judgement of diagnostic errors and contributing factors of diagnostic errors. Factors contributing to diagnostic errors were coded according to the following three taxonomies: Diagnosis Error Evaluation and Research (DEER), Reliable Diagnosis Challenges (RDC) and Generic Diagnostic Pitfalls (GDP). The responses on the contributing factors from ChatGPT were compared with those from physicians.ResultsChatGPT correctly detected diagnostic errors in 519/545 cases (95%) and coded statistically larger numbers of factors contributing to diagnostic errors per case than physicians: DEER (median 5 vs 1, p<0.001), RDC (median 4 vs 2, p<0.001) and GDP (median 4 vs 1, p<0.001). The most important contributing factors of diagnostic errors coded by ChatGPT were ‘failure/delay in considering the diagnosis’ (315, 57.8%) in DEER, ‘atypical presentation’ (365, 67.0%) in RDC, and ‘atypical presentation’ (264, 48.4%) in GDP.ConclusionChatGPT accurately detects diagnostic errors from case presentations. ChatGPT may be more sensitive than manual reviewing in detecting factors contributing to diagnostic errors, especially for ‘atypical presentation’.
Does electronic data collection perform better than paper-based data collection in health research fieldwork? A participatory action research in Zanzibar
Authors: Othman Omar Juma , Mashayo Eden , Jones Jamison , Shah Kajal , Graham Christine , Yong Ai Chee , Graham Ronnie , Omar Fatma , Chan Ving Fai 
Published: June 2024

IntroductionTechnological advancement in low-resource settings is opening the gateway to implementation of electronic data collection methods that improve data quality. We examined the concerns to use electronic data collection tool in Zanzibar, codeveloped a tool that addressed the concerns and evaluated the process and limitations of incorporating an electronic data collection tool aside from paper-based during a community-based study in Zanzibar.MethodsThe science of improvement Plan-Do-Study-Act model guided this mixed-method participatory action research (PAR). From November 2022 to October 2023, 14 data collection team members participated in (1) a consultative workshop with a fishbone analysis to understand their hesitance to use electronic data collection tools for fieldwork (Plan); (2) developing implementation and evaluation plan for the paper-based method (Do); (3) assessing the proportion of errors and challenges faced using paper-based method (Study); and (4) codeveloping, implementing and assessing an electronic data collection tool (Act).ResultsStakeholders were hesitant to use electronic data collection tools because of fear of lost data due to poor internet, insufficient competency with technology due to lack of training, unfamiliarity with technology in general and fear of lost wages. The study revealed that using a paper-based data collection tool during baseline was time-consuming, with 12.8% of responses being errors (2611 errors out of 20 398 responses). However, once implemented, the electronic data collection application was fast and simple, with minimal errors (0.02%). Overall, there is a need to improve devices’ storage capacity devices and provide more training.ConclusionUsing the PAR approach, we understood the concerns with electronic data collection tools, allowed the team to experience the challenges faced with the paper-based collection method, codeveloped an appropriate solution and changed their attitude towards using technology that could increase accuracy and efficiency of their fieldwork.
Evaluating COVID-19 vaccine effectiveness during pre-Delta, Delta and Omicron dominant periods among pregnant people in the U.S.: Retrospective cohort analysis from a nationally sampled cohort in National COVID Collaborative Cohort (N3C)
Authors: Qin Qiuyuan , Wilkins Kenneth , Jones Sara E , Bradwell Katie Rebecca , Chan Lauren , Sun Jing , Anzalone Jerrod , Zheng Qulu , Liebman Michael , Mariona Federico , Groene Faherty Emily A , Challa Anup P , Hill Elaine , Patel Rena C 
Published: June 2024

ObjectivesTo evaluate the effectiveness of COVID-19 vaccinations (initial and booster) during pre-Delta, Delta and Omicron dominant periods among pregnant people via (1) COVID-19 incident and severe infections among pregnant people who were vaccinated versus unvaccinated and (2) post-COVID-19 vaccination breakthrough infections and severe infections among vaccinated females who were pregnant versus non-pregnant.DesignRetrospective cohort study using nationally sampled electronic health records data from the National COVID Cohort Collaborative, 10 December 2020 –7 June 2022.ParticipantsCohort 1 included pregnant people (15–55 years) and cohort 2 included vaccinated females of reproductive age (15–55 years).Exposures(1) COVID-19 vaccination and (2) pregnancy.Main outcome measuresAdjusted HRs (aHRs) for COVID-19 incident or breakthrough infections and severe infections (ie, COVID-19 infections with related hospitalisations).ResultsIn cohort 1, 301 107 pregnant people were included. Compared with unvaccinated pregnant people, the aHRs for pregnant people with initial vaccinations during pregnancy of incident COVID-19 were 0.77 (95% CI 0.62 to 0.96) and 0.88 (95% CI 0.73 to 1.07) and aHRs of severe COVID-19 infections were 0.65 (95% CI 0.47 to 0.90) and 0.79 (95% CI 0.51 to 1.21) during the Delta and Omicron periods, respectively. Compared with pregnant people with full initial vaccinations, the aHR of incident COVID-19 for pregnant people with booster vaccinations was 0.64 (95% CI 0.58 to 0.71) during the Omicron period. In cohort 2, 934 337 vaccinated people were included. Compared with vaccinated non-pregnant females, the aHRs of severe COVID-19 infections for people with initial vaccinations during pregnancy was 2.71 (95% CI 1.31 to 5.60) during the Omicron periods.ConclusionsPregnant people with initial and booster vaccinations during pregnancy had a lower risk of incident and severe COVID-19 infections compared with unvaccinated pregnant people across the pandemic stages. However, vaccinated pregnant people still had a higher risk of severe infections compared with non-pregnant females.
Implementation factors of non-communicable disease policies and programmes for children and youth in low-income and middle-income countries: a systematic review
Authors: Nguyen Gina T , Gauvreau Cindy , Mansuri Nabeel , Wight Lisa , Wong Bryan , Neposlan Josh , Petricca Kadia , Denburg Avram 
Published: June 2024

IntroductionDespite declared life-course principles in non-communicable disease (NCD) prevention and management, worldwide focus has been on older rather than younger populations. However, the burden from childhood NCDs has mounted; particularly in low-income and middle-income countries (LMICs). There is limited knowledge regarding the implementation of paediatric NCD policies and programmes in LMICs, despite their disproportionate burden of morbidity and mortality. We aimed to understand the barriers to and facilitators of paediatric NCD policy and programme implementation in LMICs.MethodsWe systematically searched medical databases, Web of Science and WHOLIS for studies on paediatric NCD policy and programme implementation in LMICs. Screening and quality assessment were performed independently by researchers, using consensus to resolve differences. Data extraction was conducted within the WHO health system building-blocks framework. Narrative thematic synthesis was conducted.Results93 studies (1992–2020) were included, spanning 86 LMICs. Most were of moderate or high quality. 78% reported on paediatric NCDs outside the four major NCD categories contributing to the adult burden. Across the framework, more barriers than facilitators were identified. The most prevalently reported factors were related to health service delivery, with system fragmentation impeding the continuity of age-specific NCD care. A significant facilitator was intersectoral collaborations between health and education actors to deliver care in trusted community settings. Non-health factors were also important to paediatric NCD policies and programmes, such as community stakeholders, sociocultural support to caregivers and school disruptions.ConclusionsMultiple barriers prevent the optimal implementation of paediatric NCD policies and programmes in LMIC health systems. The low sociopolitical visibility of paediatric NCDs limits their prioritisation, resulting in fragmented service delivery and constraining the integration of programmes across key sectors impacting children, including health, education and social services. Implementation research is needed to understand specific contextual solutions to improve access to paediatric NCD services in diverse LMIC settings.
Sex differences in the intensity of statin prescriptions at initiation in a primary care setting
Authors: Kiss Pauline A J , Uijl Alicia , de Boer Annemarijn R , Duk Tessa C X , Grobbee Diederick E , Hollander Monika , Smits Elisabeth , Sturkenboom Miriam C J M , Peters Sanne A E 
Published: June 2024

Background
Current guidelines for the prevention and management of cardiovascular diseases (CVD) provide similar recommendations for the use of statins in both women and men. In this study, we assessed sex differences in the intensity of statin prescriptions at initiation and in the achievement of treatment targets, among individuals without and with CVD, in a primary care setting.

Methods
Electronic health record data from statin users were extracted from the PHARMO Data Network. Poisson regressions were used to investigate sex differences in statin intensity and in the achievement of treatment targets. Analyses were stratified by age group, disease status and/or CVD risk category.

Results
We included 82 714 individuals (46% women) aged 40–99 years old. In both sexes, the proportion of individuals with a dispensed prescription for high-intensity statin at initiation increased between 2011 and 2020. Women were less likely to be prescribed high-intensity statins as compared with men, both in the subgroups without a history of CVD (risk ratio (RR) 0.69 (95% CI: 0.63 to 0.75)) and with CVD (RR 0.77 (95% CI: 0.74 to 0.81)). Women were less likely than men to achieve target levels of low-density lipoprotein cholesterol following statin initiation in the subgroup without CVD (RR 0.98 (95% CI: 0.97 to 1.00)) and with a history of CVD (RR 0.94 (95% CI: 0.89 to 0.98)).

Conclusion
Compared with men, women were less likely to be prescribed high-intensity statins at initiation and to achieve treatment targets, both in people without and with a history of CVD, and independent of differences in other individual and clinical characteristics.