bluuebunny/crossref_metadata_2025_split huggingface dataset:
The imbalance of pulmonary Th17/Treg cells in BALB/c suckling mice infected with respiratory syncytial virus-mediated intestinal immune damage and gut microbiota changes
Authors: Liu Jiling , Huang Yixuan , Liu Nian , Qiu Huan , Zhang Xiaoyan , Liu Xiaojie , He Maozhang , Chen Mingwei , Huang Shenghai 
Published: May 2024

ABSTRACT

The immune response induced by respiratory syncytial virus (RSV) infection is closely related to changes in the composition and function of gastrointestinal microorganisms. However, the specific mechanism remains unknown and the pulmonary-intestinal axis deserves further study. In this study, the mRNA levels of ROR-γt and Foxp3 in the lung and intestine increased first and then decreased. IL-17 and IL-22 reached the maximum on the third day after infection in the lung, and on the second day after infection in the small intestine and colon, respectively. RegⅢγ in intestinal tissue reached the maximum on the third day after RSV infection. Moreover, the genus enriched in the RSV group was
Aggregatibacter
, and
Proteus
was reduced. RSV infection not only causes Th17/Treg cell imbalance in the lungs of mice but also leads to the release of excessive IL-22 from the lungs through blood circulation which binds to IL-22 receptors on the intestinal surface, inducing RegⅢγ overexpression, impaired intestinal Th17/Treg development, and altered gut microbiota composition. Our research reveals a significant link between the pulmonary and intestinal axis after RSV infection.

IMPORTANCE
RSV is the most common pathogen causing acute lower respiratory tract infections in infants and young children, but the complex interactions between the immune system and gut microbiota induced by RSV infection still requires further research. In this study, it was suggested that RSV infection in 7-day-old BALB/c suckling mice caused lung inflammation and disruption of Th17/Treg cells development, and altered the composition of gut microbiota through IL-22 induced overexpression of RegⅢγ, leading to intestinal immune injury and disruption of gut microbiota. This research reveals that IL-22 may be the link between the lung and gut. This study may provide a new insight into the intestinal symptoms caused by RSV and other respiratory viruses and the connection between the lung and gut axis, as well as new therapeutic ideas for the treatment of RSV-infected children.
Intact stalked crinoids from the late Aptian of NE Spain offer insights into the Mesozoic Marine Revolution in the Tethys
Authors: García-Penas Álvaro , Baumiller Tomasz K. , Aurell Marcos , Zamora Samuel 
Published: May 2024

Abstract
Stalked crinoids were common in shallow-marine habitats in the geologic past but are today restricted to the deep sea. The timing of the shift in their bathymetric distribution has been discussed in the context of the Mesozoic Marine Revolution (MMR), one of the most important episodes of change in marine ecosystems of the Phanerozoic, which is generally thought to have begun sometime in the Late Triassic. However, the record of Cretaceous stalked crinoids is poor, consisting primarily of disarticulated ossicles for which the provenance is often difficult to determine, hampering interpretations of the habitat in which they lived. Here, we report on well-preserved isocrinids from the Aptian and use a multidisciplinary approach involving sedimentological, isotopic, and paleontological data to demonstrate that they inhabited a shallow lagoon subject to salinity variations. This suggests that their absence from such environments today is not a function of physicochemical factors and reinforces the idea that predation pressure may have played a critical role in their bathymetric distribution. The influence of predation is supported by the first Early Cretaceous record of a regenerating arm.
Early and extended erythropoietin monotherapy after hypoxic ischaemic encephalopathy: a multicentre double-blind pilot randomised controlled trial
Authors: Garegrat Reema , Londhe Atul , Manerkar Swati , Fattepur Sudhindrashayana , Deshmukh Laxmikant , Joshi Amol , Chandriah Savitha , Kariyappa Mallesh , Devadas Sahana , Ethirajan Theranirajan , Srivasan Kalaivani , Kamalarathnam Chinnathambi , Balachandran Anitha , Krishnan Elango , Sahayaraj Deepthy , Bandiya Prathik , Shivanna Niranjan , Burgod Constance , Thayyil Ashwini , Alocious Annie , Lanza Marianna , Muraleedharan Pallavi , Pant Stuti , Venkateswaran Harini , Morales Maria Moreno , Montaldo Paolo , Krishnan Vaisakh , Kalathingal Thaslima , Joshi Anagha Rajeev , Vare Ajay , Patil G C , Satyanathan Babu Peter , Hapat Pavan , Deshmukh Abhishek , Shivarudhrappa Indramma , Annayappa Manjesh Kurupalya , Baburaj Mythili , Muradi Christina , Fernandes Esprance , Thale Nishad , Jahan Ismat , Shahidullah Mohammed , Choudhury Sadeka Moni , Dey Sanjoy Kumer , Neogi Sutapa B , Banerjee Rupsa , Rameh Vanessa , Alobeidi Farah , Grant Ellen , Juul Sandra E , Wilson Martin , Vita Enrico De , Pressler Ronit , Bassett Paul , Shankaran Seetha , Thayyil Sudhin 
Published: May 2024

ObjectiveTo examine the feasibility of early and extended erythropoietin monotherapy after hypoxic ischaemic encephalopathy (HIE).DesignDouble-blind pilot randomised controlled trial.SettingEight neonatal units in South Asia.PatientsNeonates (≥36 weeks) with moderate or severe HIE admitted between 31 December 2022 and 3 May 2023.InterventionsErythropoietin (500 U/kg daily) or to the placebo (sham injections using a screen) within 6 hours of birth and continued for 9 days. MRI at 2 weeks of age.Main outcomes and measuresFeasibility of randomisation, drug administration and assessment of brain injury using MRI.ResultsOf the 154 neonates screened, 56 were eligible; 6 declined consent and 50 were recruited; 43 (86%) were inborn. Mean (SD) age at first dose was 4.4 (1.2) hours in erythropoietin and 4.1 (1.0) hours in placebo. Overall mortality at hospital discharge occurred in 5 (19%) vs 11 (46%) (p=0.06), and 3 (13%) vs 9 (40.9%) (p=0.04) among those with moderate encephalopathy in the erythropoietin and placebo groups. Moderate or severe injury to basal ganglia, white matter and cortex occurred in 5 (25%) vs 5 (38.5%); 14 (70%) vs 11 (85%); and 6 (30%) vs 2 (15.4%) in the erythropoietin and placebo group, respectively. Sinus venous thrombosis was seen in two (10%) neonates in the erythropoietin group and none in the control group.ConclusionsBrain injury and mortality after moderate or severe HIE are high in South Asia. Evaluation of erythropoietin monotherapy using MRI to examine treatment effects is feasible in these settings.Trial registration numberNCT05395195.
Cat-scratch disease: a rare cause of osteomyelitis
Authors: Domingos Grilo Ricardo , Madureira Miguel , Reis Melo Ana , Tavares Margarida 
Published: May 2024

Cat-scratch disease is a zoonosis caused byBartonella henselae, characterised by regional lymphadenopathy. Rarer presentations, such as osteomyelitis, can occur.We present an adolescent girl with severe right lumbar pain and fever, without animal contacts or recent travels. On examination, pain on flexion of torso, movement limitation and marked lordosis were noted, but there were no inflammatory signs, palpable masses or lymph nodes. Serological investigations revealed elevated inflammatory markers. Imaging revealed a paravertebral abscess with bone erosion. Several microbiological agents were ruled out. After a second CT-guided biopsy, PCR forBartonella sppwas positive. At this point, the family recalled having a young cat some time before. Cat-scratch disease was diagnosed, and complete recovery achieved after treatment with doxycycline and rifampicin.Cat-scratch disease is a challenging diagnosis in the absence of typical features. However,B. henselaemust be investigated if common pathogens are ruled out and response to therapy is poor.
Improved accuracy of spectral-domain optical coherence tomography and optical coherence tomography angiography for monitoring myopic macular neovascularisation activity
Authors: Ng Danny Siu-Chun , Chen Li Jia , Chan Leo Ka Yu , Tang Fang Yao , Teh Wee-Min , Zhou Linbin , Chan Fiona , Lin Eleanor Sui Sum , Yuen Ka Wai , Chu Wai Kit , Mohamed Shaheeda , Tsang Chi Wai , Zhang Xinyuan , Yam Jason C , Pang Chi-Pui , Lai Timothy Y Y 
Published: May 2024

Background/aimsTo evaluate the diagnostic accuracy of spectral-domain optical coherence tomography (SD OCT) combined with OCT angiography (OCTA) for myopic myopic macular neovascularisation (MNV) activity.MethodsBoth eyes of patients with myopic MNV diagnosed with fluorescein angiography (FA), SD OCT and OCTA were assessed by unmasked investigators. The images were deidentified and randomised before graded by masked investigators, who determined the presence of active myopic MNV by using SD OCT together with OCTA without FA and by FA alone, respectively. The findings of masked investigators were compared with unmasked investigators.Results213 eyes of 110 patients comprising 499 imaging episodes were eligible for grading. For diagnosing new-onset myopic MNV without FA, combined use of SD OCT and OCTA had a sensitivity of 0.94, specificity of 0.84 and area under the curve (AUC) of 0.92. FA had a sensitivity of 0.52 (p<0.01), specificity of 0.80 (p=0.38) and AUC of 0.66 (p<0.01). For recurrent myopic MNV, the combination of SD OCT and OCTA had a sensitivity of 0.98, specificity of 0.78 and AUC of 0.88. FA had a sensitivity of 0.50 (p=0.04), specificity of 0.76 (p=0.85) and AUC of 0.63 (p=0.01). Myopic traction maculopathy was more frequently associated with recurrent myopic MNV (p<0.01).ConclusionSD OCT with dense volumetric scan was highly sensitive for diagnosing myopic MNV. The addition of OCTA improved the diagnostic specificity without FA. Monitoring of the longitudinal changes on SD OCT and judicious use of FA is a reliable surveillance strategy for myopic MNV.
Adoption by clinicians of electronic order communications in NHS secondary care: a descriptive account
Authors: Coleman Jamie J , Atia Jolene , Evison Felicity , Wilson Lydia , Gallier Suzy , Sames Richard , Capewell Andrew , Copley Richard , Gyves Helen , Ball Simon , Pankhurst Tanya 
Published: May 2024

BackgroundDue to the rapid advancement in information technology, changes to communication modalities are increasingly implemented in healthcare. One such modality is Computerised Provider Order Entry (CPOE) systems which replace paper, verbal or telephone orders with electronic booking of requests. We aimed to understand the uptake, and user acceptability, of CPOE in a large National Health Service hospital system.MethodsThis retrospective single-centre study investigates the longitudinal uptake of communications through the Prescribing, Information and Communication System (PICS). The development and configuration of PICS are led by the doctors, nurses and allied health professionals that use it and requests for CPOE driven by clinical need have been described.Records of every request (imaging, specialty review, procedure, laboratory) made through PICS were collected between October 2008 and July 2019 and resulting counts were presented. An estimate of the proportion of completed requests made through the system has been provided for three example requests. User surveys were completed.ResultsIn the first 6 months of implementation, a total of 832 new request types (imaging types and specialty referrals) were added to the system. Subsequently, an average of 6.6 new request types were added monthly. In total, 8 035 132 orders were requested through PICS. In three example request types (imaging, endoscopy and full blood count), increases in the proportion of requests being made via PICS were seen. User feedback at 6 months reported improved communications using the electronic system.ConclusionCPOE was popular, rapidly adopted and diversified across specialties encompassing wide-ranging requests.
Prospective evaluation of artificial intelligence (AI) applications for use in cancer pathways following diagnosis: a systematic review
Authors: Macheka Sheba , Ng Peng Yun , Ginsburg Ophira , Hope Andrew , Sullivan Richard , Aggarwal Ajay 
Published: May 2024

The role of artificial intelligence (AI) in cancer care has evolved in the face of ageing population, workforce shortages and technological advancement. Despite recent uptake in AI research and adoption, the extent to which it improves quality, efficiency and equity of care beyond cancer diagnostics is uncertain to date. Henceforth, the objective of our systematic review is to assess the clinical readiness and deployability of AI through evaluation of prospective studies of AI in cancer care following diagnosis.We undertook a systematic review to determine the types of AI involved and their respective outcomes. A PubMed and Web of Science search between 1 January 2013 and 1 May 2023 identified 15 articles detailing prospective evaluation of AI in postdiagnostic cancer pathway. We appraised all studies using Risk of Bias Assessment of Randomised Controlled Trials and Risk of Bias In Non-randomised Studies-of Interventions quality assessment tools, as well as implementational analysis concerning time, cost and resource, to ascertain the quality of clinical evidence and real-world feasibility of AI.The results revealed that the majority of AI oncological research remained experimental without prospective clinical validation or deployment. Most studies failed to establish clinical validity and to translate measured AI efficacy into beneficial clinical outcomes. AI research are limited by lack of research standardisation and health system interoperability. Furthermore, implementational analysis and equity considerations of AI were largely missing.To overcome the triad of low-level clinical evidence, efficacy-outcome gap and incompatible research ecosystem for AI, future work should focus on multicollaborative AI implementation research designed and conducted in accordance with up-to-date research standards and local health systems.
Unmasking mental health symptoms in female professional football players: a 12-month follow-up study
Authors: Bilgoe Sharaisha Chanita , Janse van Rensburg Dina Christina (Christa) , Goedhart Edwin , Orhant Emmanuel , Kerkhoffs Gino , Gouttebarge Vincent 
Published: May 2024

ObjectiveTo calculate the prevalence rates of mental health symptoms among female professional football players over a 12-month period and to explore the associations of severe injury and related surgery with mental health symptoms among female professional footballers.MethodsAn observational prospective cohort study was conducted over a 12-month follow-up period by distributing an electronic questionnaire three times. The questionnaire was based on validated screening tools for assessing mental health symptoms.ResultsA total of 74 female professional football players participated in this study. Mental health symptoms ranged from 1% for substance misuse to 65% for sport-psychological distress at baseline, from 6% for anxiety to 53% for sport-psychological distress 6 months postbaseline and from 3% for substance misuse to 55% for sport-psychological distress 12 months postbaseline. The prevalence of disordered eating remained between 15% and 20% over the 12-month period. Only one of the associations was statistically significant. Female professional football players were nearly twice as likely to report sport-related psychological distress following every surgery.ConclusionsThe substantial prevalence of mental health symptoms among female professional football players emphasises the need for increased attention, awareness and interventions. Additionally, female professional football players are nearly twice as likely to report sport-related psychological distress after each surgery. Sports medicine physicians and mental health professionals working in female football should provide standard care, which involves identifying, monitoring and implementing tailored interventions for mental health symptoms.
Healthcare professional views about a prehospital redirection pathway for stroke thrombectomy: a multiphase deductive qualitative study
Authors: Day Jo , Simmonds Rosemary L , Shaw Lisa , Price Christopher I , McClelland Graham , Ford Gary A , James Martin , White Phil , Stein Ken , Pope Catherine 
Published: May 2024

BackgroundMechanical thrombectomy for stroke is highly effective but time-critical. Delays are common because many patients require transfer between local hospitals and regional centres. A two-stage prehospital redirection pathway consisting of a simple ambulance screen followed by regional centre assessment to select patients for direct admission could optimise access. However, implementation might be challenged by the limited number of thrombectomy providers, a lack of prehospital diagnostic tests for selecting patients and whether finite resources can accommodate longer ambulance journeys plus greater central admissions. We undertook a three-phase, multiregional, qualitative study to obtain health professional views on the acceptability and feasibility of a new pathway.MethodsOnline focus groups/semistructured interviews were undertaken designed to capture important contextual influences. We purposively sampled NHS staff in four regions of England. Anonymised interview transcripts underwent deductive thematic analysis guided by the NASSS (Non-adoption, Abandonment and Challenges to Scale-up, Spread and Sustainability, Implementation) Implementation Science framework.ResultsTwenty-eight staff participated in 4 focus groups, 2 group interviews and 18 individual interviews across 4 Ambulance Trusts, 5 Hospital Trusts and 3 Integrated Stroke Delivery Networks (ISDNs). Five deductive themes were identified: (1) (suspected) stroke as a condition, (2) the pathway change, (3) the value participants placed on the proposed pathway, (4) the possible impact on NHS organisations/adopter systems and (5) the wider healthcare context. Participants perceived suspected stroke as a complex scenario. Most viewed the proposed new thrombectomy pathway as beneficial but potentially challenging to implement. Organisational concerns included staff shortages, increased workflow and bed capacity. Participants also reported wider socioeconomic issues impacting on their services contributing to concerns around the future implementation.ConclusionsPositive views from health professionals were expressed about the concept of a proposed pathway while raising key content and implementation challenges and useful ‘real-world’ issues for consideration.
Urinary proteomic signature of mineralocorticoid receptor antagonism by spironolactone: evidence from the HOMAGE trial
Authors: Yu Yu-Ling , Siwy Justyna , An De-Wei , González Arantxa , Hansen Tine , Latosinska Agnieszka , Pellicori Pierpaolo , Ravassa Susana , Mariottoni Beatrice , Verdonschot Job AJ , Ahmed Fozia , Petutschnigg Johannes , Rossignol Patrick , Heymans Stephane , Cuthbert Joe J , Girerd Nicolas , Clark Andrew L , Verhamme Peter , Nawrot Tim S , Janssens Stefan , Cleland John G , Zannad Faiez , Diez Javier , Mischak Harald , Ferreira João Pedro , Staessen Jan A 
Published: May 2024

ObjectiveHeart failure (HF) is characterised by collagen deposition. Urinary proteomic profiling (UPP) followed by peptide sequencing identifies parental proteins, for over 70% derived from collagens. This study aimed to refine understanding of the antifibrotic action of spironolactone.MethodsIn this substudy (n=290) to the Heart ‘Omics’ in Ageing Study trial, patients were randomised to usual therapy combined or not with spironolactone 25–50 mg/day and followed for 9 months. The analysis included 1498 sequenced urinary peptides detectable in ≥30% of patients and carboxyterminal propeptide of procollagen I (PICP) and PICP/carboxyterminal telopeptide of collagen I (CITP) as serum biomarkers of COL1A1 synthesis. After rank normalisation of biomarker distributions, between-group differences in their changes were assessed by multivariable-adjusted mixed model analysis of variance. Correlations between the changes in urinary peptides and in serum PICP and PICP/CITP were compared between groups using Fisher’s Z transform.ResultsMultivariable-adjusted between-group differences in the urinary peptides with error 1 rate correction were limited to 27 collagen fragments, of which 16 were upregulated (7 COL1A1 fragments) on spironolactone and 11 downregulated (4 COL1A1 fragments). Over 9 months of follow-up, spironolactone decreased serum PICP from 81 (IQR 66–95) to 75 (61–90) µg/L and PICP/CITP from 22 (17–28) to 18 (13–26), whereas no changes occurred in the control group, resulting in a difference (spironolactone minus control) expressed in standardised units of −0.321 (95% CI 0.0007). Spironolactone did not affect the correlations between changes in urinary COL1A1 fragments and in PICP or the PICP/CITP ratio.ConclusionsSpironolactone decreased serum markers of collagen synthesis and predominantly downregulated urinary collagen-derived peptides, but upregulated others. The interpretation of these opposite UPP trends might be due to shrinking the body-wide pool of collagens, explaining downregulation, while some degree of collagen synthesis must be maintained to sustain vital organ functions, explaining upregulation. Combining urinary and serum fibrosis markers opens new avenues for the understanding of the action of antifibrotic drugs.Trial registration numberNCT02556450.
von Meyenburg complexes are more frequently associated with cholangiocarcinoma
Authors: Jain Dhanpat , Khandakar Binny , Ni Pu , Kenney Barton , Qin Lihui , Deshpande Vikram , Fiel Maria Isabel 
Published: May 2024

AimThere is some evidence that von Meyenburg complexes (VMCs) can progress to cholangiocarcinoma (CC). This study aimed to evaluate the prevalence of VMCs in CC cases.MethodsAll hepatic resections and explants with intra-hepatic CC (I-CC) and hilar-CC (H-CC) from 1985 to 2020 were studied. Hepatic resections (n=68) for benign lesions or metastatic colonic carcinoma and 15 cases with cirrhosis without any cancer were used as controls.ResultsA total of 118 cases of CC (88 I-CC, 30 H-CC) were identified. Of these, 61 (52%) patients had no known background liver disease, and 20 (17%) had cirrhosis. Associated liver disorders included metabolic dysfunction-associated steatohepatitis (23), chronic viral hepatitis B or C (13), biliary disease (primary or secondary sclerosing cholangitis) (8), polycystic kidney disease (6), cryptogenic cirrhosis (5) and others miscellaneous disorders (7). VMCs were present in 34 (39%) of 88 I-CC cases and 7 (23%) of 30 H-CC cases. VMCs were present within the tumour (20 cases), outside the cancer (21 cases) or at both locations (10 cases). VMCs with dysplasia/carcinoma in situ were seen in 19 of 41 (46%) cases with CC and VMCs. In addition, bile duct adenomas were identified in 6 (5%) of CC. 7% of controls showed the presence of VMCs compared with 35% of CC cases (p<0.05).ConclusionsVMCs are seen far more frequently in patients with CC than in the control group. The findings support the hypothesis that VMCs could represent a precursor of CC or a marker for a higher risk of developing CC.