bluuebunny/crossref_metadata_2025_split huggingface dataset:
THEMIS2 Impairs Antitumor Activity of NK Cells by Suppressing Activating NK Receptor Signaling
Authors: Deborah Elfira Amalia , Nabekura Tsukasa , Shibuya Kazuko , Shibuya Akira 
Published: April 2024

Abstract
NK cells are cytotoxic innate lymphocytes that play a critical role in antitumor immunity. NK cells recognize target cells by using a repertoire of activating NK receptors and exert the effector functions. Although the magnitude of activation signals through activating NK receptors controls NK cell function, it has not been fully understood how these activating signals are modulated in NK cells. In this study, we found that a scaffold protein, THEMIS2, inhibits activating NK receptor signaling. Overexpression of THEMIS2 attenuated the effector function of human NK cells, whereas knockdown of THEMIS2 enhanced it. Mechanistically, THEMIS2 binds to GRB2 and phosphorylated SHP-1 and SHP-2 at the proximity of activating NK receptors DNAM-1 and NKG2D. Knockdown of THEMIS2 in primary human NK cells promoted the effector functions. Furthermore, Themis2-deficient mice showed low metastatic burden in an NK cell–dependent manner. These findings demonstrate that THEMIS2 has an inhibitory role in the antitumor activity of NK cells, suggesting that THEMIS2 might be a potential therapeutic target for NK cell–mediated cancer immunotherapy.
Cutting Edge: First Lung Infection Permanently Enlarges Lymph Nodes and Enhances New T Cell Responses
Authors: Stolley J Michael , Scott Milcah C , O’Flanagan Stephen D , Künzli Marco , Matson Courtney A , Weyu Eyob , Langlois Ryan A , Vezys Vaiva , Masopust David 
Published: April 2024

Abstract
Humans experience frequent respiratory infections. Immunology and vaccinology studies in mice are typically performed in naive specific pathogen-free animals responding to their very first respiratory challenge. We found that the first respiratory infection induces lifelong enlargement of the lung-draining mediastinal lymph nodes (medLNs). Furthermore, infection-experienced medLNs supported better naive T cell surveillance and effector responses to new unrelated infections that exhibited more biased accumulation and memory establishment within the lung. Moreover, we observed that weight loss induced by influenza infection was substantially reduced in mice that had recovered from a previous unrelated respiratory viral challenge. These data show that the lack of infectious history and corresponding medLN hypoplasia in specific pathogen-free mice alter their immune response to lung infections. Preclinical vaccination and immunology studies should consider the previous infectious experience of the model organism.
Preoperative cross-matching in major elective surgical procedures in children: An audit of department’s transfusion practices
Authors: Raju Rajkiran Srinivas , Mahadevaiah Shubha Attibele , Devi Shanthala A. M. 
Published: April 2024

Abstract:

AIMS:
To determine the utilization of cross-matched packed red blood cell (PRBC) concentrate in children posted for major elective operative procedures. To evaluate the efficacy of a simple preoperative “screening criteria” for ordering preoperative cross-match.

MATERIALS AND METHODS:
Data were retrieved from online surgery scheduling system prospectively over a 4-month period (January–April 2022). The number of units cross-matched and those utilized were assessed. A screening criterion was devised in consultation with stakeholders for ordering blood. The utilization of PRBCs was reassessed after implementation of these criteria and reaudited (July–October 2022). A subset analysis of A1 (tunneled catheter placements) and A2 (core pediatric surgical procedures) groups was done to analyze blood utilization.

RESULTS:
Initial audit showed poor PRBC utilization with 46 units unused of the 54 cross-matched units, and most of these were from A1 group (3 of 29 units and 5 out of 25 units utilized in A1 and A2 groups, respectively). Reaudit after introducing cutoff criteria showed sharp decline (79.3%) in the number of cross-matched units and the number of units returned (84.6% decrease) in A1 group and the number of units returned unused dropped by 50% in the A2 group. There was visible reversal of indicators of utilization (cross-match to transfusion ratio dropped from 6.75 to 1.73 and TI increased from 0.163 to 0.613), indicating optimal utilization.

CONCLUSION:
This pilot audit clearly demonstrates the gap between requisition and utilization of cross-matched PRBCs. Formulating an effective screening criterion avoids unnecessary cross-matching and wastage of resources and maximizes utilization.
Evaluating the effectiveness of three communication modes in promoting repeat voluntary donation behavior in first-time blood donors at a tertiary care blood center in North India
Authors: Mahajan Anshu , Akhtar Naveen , Sharma Salve , Sidhu Meena 
Published: April 2024

Abstract:

INTRODUCTION:
Due to rapid technological advancements, several new methods such as telephone (TP), e-mail, social media, WhatsApp (WA), and Short Message Services are being used as effectively among blood centers worldwide for postdonation communication with blood donors’ education and motivation to recruit and retain them as repeat and regular voluntary nonremunerated blood donors. The present study was aimed at determining the effectiveness of WA, TP, and personal communications (PCs) as modes of communication to recruit and retain first-time replacement blood donors to become repeat and regular voluntary blood donors.

MATERIALS AND METHODS:
This 1-year observational prospective study was conducted in the Post Graduate Department of Immunohematology and Blood Transfusion in Government Medical College and Hospital, Jammu. Three hundred first-time blood donors selected for the study were divided into three groups comprising 100 blood donors each as per the mode of communication strategy adopted, namely postdonation PC, TP, and WA groups.

RESULTS:
The repeat donation rate was highest in the TP group (61%), followed by the WA group (47%) and PC group (37%). The mean repeat donation was found to be significant in the TP group (P = 0.007) and WA group (P = 0.021) as compared PC group while there was no significant difference between the TP group and WA groups (0.751).

CONCLUSION:
In our study, it was found that of the three communication modes, namely personal, TP, and WA, telephonic communication with a repeat donation rate of 61% was the most effective mode of communication in for motivating and converting first-time blood donors into repeat regular voluntary blood donors.
Thick tiny hearts and tangled vessels: Navigating the complexity of a neonate with hepatic arteriovenous malformation, hypertrophic cardiomyopathy, and persistent pulmonary hypertension
Authors: Thakur Shaifalika , Kishore Sunil , Ahmar Rizwan , Kumar Rakesh 
Published: April 2024

ABSTRACT
Congenital hepatic arteriovenous malformation (HAVM) is an uncommonly encountered condition in clinical practice. This condition often presents as isolated hepatomegaly, congestive cardiac failure or anemia. Here, we discuss a case of a full-term neonate who was admitted to the neonatal care unit for birth asphyxia and neonatal sepsis and was consecutively diagnosed with HAVM and hypertrophic cardiomyopathy, along with persistent pulmonary hypertension.
Prevalence and prognostic significance of iron deficiency anemia among heart failure patients: A prospective observational study
Authors: Qureshi Naeem , Kumar Abhishek , Muneer Kader 
Published: April 2024

ABSTRACT

Background:
Patients with chronic heart failure (CHF) frequently have associated iron deficiency, which may or may not be associated with anemia. Studies to ascertain the impact of repleting iron in patients with CHF and various other prognostic markers are lacking in Indian patients and the Indian context.

Objectives:
The objective is to study the prevalence of iron deficiency anemia in patients with CHF and its prognostic significance in predicting major adverse cardiovascular events (MACEs) during 6 months of follow-up along with the role of other clinical and demographic variables.

Methodology:
A prospective, observational, hospital-based study conducted in a government tertiary medical center in south India on patients admitted with the diagnosis of CHF. Full demographic and clinical characterization and all relevant laboratory investigations including iron profile were done per protocol. The incidence of a MACE (rehospitalization for heart failure or death) and its association with iron deficiency was studied at the end of a 6-month follow-up.

Results:
A total of 388 patients were followed for 6 months. Out of those, 211 patients (54%) developed composite outcomes. Old age, coronary artery disease, atrial fibrillation, previous heart failure history, chronic kidney disease, and reduced left ventricular ejection fraction were independent predictors of composite outcome. The prevalence of anemia in the study population was 71%, and iron deficiency was 63% (20% absolute and 43% relative). Iron deficiency without anemia was also an independent predictor of the composite outcome.

Conclusions:
This study highlights the underestimated and neglected burden of iron deficiency in CHF patients in India. It also suggests further large-scale studies to characterize this easily treatable condition better and consider routine testing of iron profiles in future Indian guidelines.
Perplexities in anticoagulation management of prosthetic heart valve in pregnancy
Authors: Yadav Sangeeta , Pradhan Mandakini 
Published: April 2024

ABSTRACT
The presence of prosthetic heart valve in pregnancy causes significant risk to mother and fetus and poses a great management challenge. There is a high risk of valve thrombosis necessitating uninterrupted anticoagulation which may lead to increased risk of maternal and fetal bleeding as well as embryopathy. There is no anticoagulation strategy that is entirely safe and difficult decisions need to be taken. No single approach fits all patients and patient care needs to be individualized. Preconception counseling and evaluation by the multidisciplinary team taking in account all the associated risk factors helps in providing a balanced comprehensive approach for the best possible outcome.
Rotavirus and adenovirus in children evaluated for viral gastroenteritis at a single healthcare center in the Eastern Province of Saudi Arabia: A perspective of two decades
Authors: Alqurayn Ahmed K. , Obeid Obeid E. , Alkharsah Khaled R. 
Published: April 2024

BACKGROUND:
The aim of this study was to determine the distribution of rotavirus and adenovirus in pediatric patients evaluated for viral gastroenteritis in a hospital in the Eastern Province of Saudi Arabia for 22 years.

MATERIALS AND METHODS:
This was a retrospective study based in a secondary healthcare center in Saudi Arabia. Laboratory and demographic data were collected from hospital records for all pediatric patients (up to 14 years old) evaluated for viral gastroenteritis by rotavirus/adenovirus antigen detection kit from January 2000 to December 2022. Data were analyzed utilizing SPSS version 28.0. Categorical data were presented as frequency and percentages, whereas mean and standard deviations were computed for continuous variables. Chi-square test and t-test were used to determine statistical significance.

RESULTS:
The overall yields of antigen detection were 13.6% for rotavirus and 2.6% for adenovirus. Coinfection with both viruses was documented in 0.5% of the study population. Rotavirus was persistently detected in the past two decades with varying frequency, but the detection of adenovirus showed intervals of at least three consecutive years of zero confirmed cases. Before 2013, when the rotavirus vaccine was introduced in Saudi Arabia, rotavirus was much more prevalent than adenovirus (30% compared to 3.8% in 2010), but they became equally prevalent a decade after the introduction of the vaccine. Rotavirus gastroenteritis showed three different peaks in the year, in March, July, and December. Each peak was followed by a gradual decrease in prevalence before the next peak. Adenovirus, in contrast, was detected consistently around the year at rates between 2% and 5%.

CONCLUSION:
Rotavirus and adenovirus gastroenteritis have changed in prevalence in the past two decades. We found distinct seasonal patterns associated with rotavirus and adenovirus gastroenteritis. The utilization of virological testing for pediatric gastroenteritis with syndromic testing panels is to be encouraged to improve the knowledge of the true prevalence of enteric viruses.
Epidemiological characteristics of Klebsiella ozaenae infection and its antibiotic susceptibility: Experience of a tertiary care hospital in the Eastern Province of Saudi Arabia
Authors: AlJindan Reem 
Published: April 2024

BACKGROUND:Klebsiellaozaenae(K.ozaenae), a forgotten pathogen that normally colonizes the upper respiratory mucosa, can be associated with severe and invasive infections. The objectives of this study were to determine the frequency of isolation ofK.ozaenaeat the microbiology laboratory in a tertiary hospital and the scope of diseases associated with it and to characterize its antimicrobial susceptibility pattern.MATERIALS AND METHODS:This cross-sectional study analyzed the retrospective data, from 2002 to 2021, on cases with laboratory-confirmed isolation ofK.ozaenaeat a tertiary care hospital. The primary outcome was to identify the scope ofK.ozaenaeinfections and their antimicrobial susceptibility patterns.K.ozaenaeisolation was done by cultivation on microbiological culture media, whereas its identification and antimicrobial susceptibility pattern were performed using either Microscan or Vitek automated systems. Data was gathered and analyzed in Excel. The percentage of resistance was calculated as the number of resistant isolates from the total isolates multiplied by 100. Similarly, the percentage of sensitivity was calculated as the number of sensitive isolates from total isolates multiplied by 100.RESULTS:K.ozaenaewas detected in 59 cases during the study period.K.ozaenaewas associated with urinary tract infections (39%), nasal infections (18.6%), other respiratory tract infections including sinusitis, bronchiectasis, and pneumonia (16.9%), and wound infections (15.3%). It was also associated with invasive infections such as bacteremia (3.4%) and abscesses (3.4%).K.ozaenaeshowed susceptibility to multiple antibiotic classes, but was resistant to ampicillin, piperacillin, nalidixic acid, and nitrofurantoin.K.ozaenaeisolates from urinary tract infections had higher antibiotic resistance percentage than isolates from other infections, particularly to amoxicillin/clavulanic acid (P= 0.007, 95% confidence interval [CI]: 1.84–375), ciprofloxacin (P< 0.0001, 95% CI: 4.6–111.2), and trimethoprim/sulfamethoxazole (P< 0.001, 95% CI: 3.1–63.6).CONCLUSION:Our data show thatK.ozaenaeis a pathogen with a spectrum of diseases wider than expected and a unique antibiotic susceptibility pattern in urinary tract infections.
Hypertension clinical pathway: Experience of Aseer region, Saudi Arabia
Authors: Assiri Ali M.M. , Al-Khaldi Yahia M. , Kaabi Abdu A.A. , Alshehri Ibrahim A.M. , Al-Shahrani Mohammad A.S. , Almalki Abdullah A. 
Published: April 2024

BACKGROUND:Hypertension (HTN) is a common chronic health problem with many complications and high morbidity rates. This study aimed to describe the HTN pathway, to assess the performance of screening and registration programs, to explore the challenges and suggest solutions for those challenges.MATERIALS AND METHODS:This study was conducted in primary care centers in the Aseer region, Saudi Arabia, at the end of 2022. The study consisted of three parts namely: Screening for HTN, registration of known hypertensive patients and opinions of representatives of Primary Healthcare Centers (PHCs) on challenges to the implementation of HTN pathway and suggestions for overcoming these challenges. Three Google forms were developed by the investigators to achieve the objectives of this study. The first two forms were completed by doctors and nurses at each PHC and reviewed by the leader of HTN pathway, and the third form completed by a representative of each PHC. SPSS version 26 was used for data management and analysis. Chi-square test was used to determine association between categorical variables; binary logistic regression analysis was performed to determine the correlates of being hypertensive and having good control of HTN.RESULTS:A total of 159,243 individuals were screened for HTN, 55% of whom were females and 94% were Saudis. The prevalence of HTN was 13%; 70% were overweight or obese and 14% had diabetes. The total registered number of patients was 55,628; 50% had good HTN control. Major challenges were inadequate health coaches, care coordinators, laboratory and radiology facilities, lack of coordination with hospitals, and ineffective appointment system.CONCLUSION:This study revealed that the current HTN pathway was successful with regard to screening and registration of patients with HTN. Many challenges need an executive plan with SMART objectives to optimize the care for HTN patients in the region.
Significant differences in the length and weight measurements of Jordanian infants compared to the World Health Organization 2006 growth standards
Authors: Bataineh Lina , Al-Qerem Walid , Jarab Anan , Alasmari Fawaz , Eberhardt Judith 
Published: April 2024

BACKGROUND:
In 2006, the World Health Organization (WHO) introduced new growth standards based on data derived globally from optimally nourished breastfed infants. The aim of this study was to assess the effects of implementing WHO growth standards on the growth patterns of Jordanian infants. In addition, it was to ascertain the necessity of establishing country-specific growth standards and charts tailored to Jordanian infants.

MATERIALS AND METHODS:
The data of 102,846 infants (50.1% boys, 49.9% girls) aged 0–24 months, from 115 primary healthcare centers across the country were retrieved from a National E-health Program. Weight and length measurements were analyzed, and age- and sex-specific z-scores were calculated relative to the WHO growth standards. Data was analyzed using SPSS version 26. Mann–Whitney U test was performed to determine significant differences between the measurements for boys and girls in terms of age, length, and weight.

RESULTS:
Jordanian infants exhibited significantly shorter length-for-age measurements than WHO standards with mean z-scores of −0.56 and −0.38, for boys and girls, respectively. Weight-for-age measurements showed a good fit and were comparable to the WHO growth standards for boys (mean z score = −0.05) and girls (mean z score = 0.04). Notably, Jordanian infants displayed higher weight-for-length measurements, with mean z-scores of 0.51 for boys and 0.47 for girls.

CONCLUSION:
The availability of Jordanian-specific growth standards will improve the accuracy of assessing infant growth and enhance the monitoring and evaluation of their health and development.
Isolation and detection of bacterial species on mitis salivarius bacitracin agar from the plaque samples of caries active children
Authors: Bansal Kalpana , Shamoo Azeema , Atif Mohammad , Batra Priyam , Chaudhry Rama 
Published: April 2024

Background:
In cariology studies, mitis-salivarius-bacitracin (MSB) agar has been commonly considered as the selective medium for Streptococcus
mutans growth. The present study was the part of a funded project (a noninferiority randomized controlled trial) which compared the efficacy of a plant extract-based mouth rinse with that of a fluoride mouth rinse on the S.
mutans counts of the children.

Aim:
This study aimed to identify the frequency of detection of S.
mutans and nonstreptococcal bacterial species from the dental plaque of caries active children using a combined technique of anaerobic culture and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry.

Settings and Methods:
Caries-active children (8–12 years old) were enrolled from a pediatric dental outpatient department at a tertiary care hospital. From each participant, dental plaque samples were collected from carious surfaces under sterilized conditions and then subjected to anaerobic culture. After 48 h of incubation, the bacterial colonies were isolated by sub-culture and identified by the MALDI-TOF.

Results:
In all, 13 different bacterial species were isolated from the MSB agar medium. Other than S.
mutans species, colonies of bacterial species such as Veillonella
dispar,
Streptococcus
anginosus, Veillonella
parvula, and Streptococcus
gordonii were also frequently observed from the medium.

Conclusions:
The study concluded that several bacterial strains, both streptococcal and nonstreptococcal, could be isolated from the MSB agar medium; hence, this medium should no longer be considered selective medium for the culture of S.
mutans in clinical and epidemiological studies.
Correlation between the middle phalanx of the third finger skeletal maturation staging system and insulin-like growth factor-1 levels among Indian children – A 3-year longitudinal study
Authors: Veena R. , Alle Rajkumar S. , Shanbhog Raghavendra , Prashant Akila 
Published: April 2024

Introduction:Tracking insulin-like growth factor-1 (IGF-1) level alongside the middle phalanx of the third finger (MP3) staging modification could provide valuable insights into the relationship between hormonal factors and skeletal maturation during different stages of growth. Longitudinal studies indeed play a crucial role in understanding these complex relationships over time, allowing for a more comprehensive assessment of how IGF-1 might serve as a marker for pubertal growth stages.Methodology:The present longitudinal prospective cohort study was done among 26 boys and 26 girls. For each child, once in every 6 months for 3 years, blood samples (to estimate IGF-1 level) and X-rays of the left hand middle finger were taken. DRG IGF-1 600 Human Enzyme-Linked Immunosorbent Assay kit was used for the quantitative measurement of IGF1 from serum. The MP3 stages of the middle phalanx of the middle finger were evaluated using a modified MP3 system. The collected data were subjected to suitable descriptive and inferential statistics.Results:The mean IGF1 levels were significantly higher in girls compared to boys across all the stages of MP3 skeletal maturity indicators. However, in both boys and girls, IGF-1 levels showed increasing trends from Stage F to H where it peaked and showed deceleration to Stage I (P< 0.05).Conclusion:The observed increase in serum IGF-1 levels during pubertal stages, followed by a decline in late puberty, aligning with the stages of skeletal maturation, suggests a close relationship between hormonal changes and bone development.