bluuebunny/crossref_metadata_2025_split huggingface dataset:
N-Acetylcysteine and a Specialized Preventive Intervention for Individuals at High Risk for Psychosis: A Randomized Double-Blind Multicenter Trial
Authors: Wasserthal Sven , Muthesius Ana , Hurlemann René , Ruhrmann Stephan , Schmidt Stefanie J , Hellmich Martin , Schultze-Lutter Frauke , Klosterkötter Joachim , Müller Hendrik , Meyer-Lindenberg Andreas , Poeppl Timm B , Walter Henrik , Hirjak Dusan , Koutsouleris Nikolaos , Fallgatter Andreas J , Bechdolf Andreas , Brockhaus-Dumke Anke , Mulert Christoph , Philipsen Alexandra , Kambeitz Joseph 
Published: February 2024

Abstract

Background and Hypothesis
Clinical high risk for psychosis (CHR-P) offers a window of opportunity for early intervention and recent trials have shown promising results for the use of N-acetylcysteine (NAC) in schizophrenia. Moreover, integrated preventive psychological intervention (IPPI), applies social-cognitive remediation to aid in preventing the transition to the psychosis of CHR-P patients.

Study Design
In this double-blind, randomized, controlled multicenter trial, a 2 × 2 factorial design was applied to investigate the effects of NAC compared to placebo (PLC) and IPPI compared to psychological stress management (PSM). The primary endpoint was the transition to psychosis or deterioration of CHR-P symptoms after 18 months.

Study Results
While insufficient recruitment led to early trial termination, a total of 48 participants were included in the study. Patients receiving NAC showed numerically higher estimates of event-free survival probability (IPPI + NAC: 72.7 ± 13.4%, PSM + NAC: 72.7 ± 13.4%) as compared to patients receiving PLC (IPPI + PLC: 56.1 ± 15.3%, PSM + PLC: 39.0 ± 17.4%). However, a log-rank chi-square test in Kaplan–Meier analysis revealed no significant difference of survival probability for NAC vs control (point hazard ratio: 0.879, 95% CI 0.281–2.756) or IPPI vs control (point hazard ratio: 0.827, 95% CI 0.295–2.314). The number of adverse events (AE) did not differ significantly between the four groups.

Conclusions
The superiority of NAC or IPPI in preventing psychosis in patients with CHR-P compared to controls could not be statistically validated in this trial. However, results indicate a consistent pattern that warrants further testing of NAC as a promising and well-tolerated intervention for CHR patients in future trials with adequate statistical power.
How a timely policy contributes to technological capability building: insights from Iran’s biopharmaceutical sector
Authors: Ghorbani Amir , Fartash Kiarash , Bagheri Abolfazl 
Published: February 2024

Abstract
Building technological capabilities is influenced by different factors, notably policies. This paper explains the co-evolution of policies, i.e. policy tools, on the technological capabilities in Iran’s biopharmaceutical sector from 1995 to 2022. By adopting a qualitative research method, we gathered primary data through thirty-nine semi-structured as well as secondary data from reports and statistics. This paper explains technological capabilities enhancement from operational capabilities to innovative capabilities based on our proposed framework, which includes six levels. While the lack of an efficient policy tools, until the mid-2000s, was decisive in the inertia of biopharmaceutical sector capabilities, a proactive policy tools in recent years led to considerable promising results in terms of manufacturing and exporting advanced biosimilar products. Our findings shed light on the role of government support in the acceleration and directionality of technological capabilities building. Achieving advanced levels of technological capabilities requires learning, international collaboration, and export-oriented policies.
Effect of exogenous melatonin on the cellular response of Holstein heifer calves during vaccination
Authors: Martin Allie E , Machado Vinicius S , Rathmann Ryan J , Crossland Whitney L 
Published: February 2024

Abstract
Despite rigorous vaccination protocols, calf morbidity is the primary contributor to economic loss in the calf sector of the dairy industry. Melatonin has modulated immune response in other mature animal species. We hypothesized that exogenous melatonin may improve the cellular response to vaccination in dairy calves. Our objective was to evaluate the effect of exogenous melatonin on polymorphonuclear leukocyte (PMN) function in Holstein heifer calves during immunization. Sixty neonatal Holstein heifers were enrolled by birth cohort (block) and randomized to one of four treatments: control (CON), vaccination of 0.5 mg ovalbumin on days 0 and 21 (VAC), implantation of 24 mg melatonin on day 0 (MEL), or both melatonin and vaccine treatments (MVAC). Jugular blood was collected on days 0, 21, 42, and 63 to measure circulating melatonin, anti-ovalbumin immunoglobulin-G, and PMN function. Calves implanted with melatonin had greater circulating melatonin than non-implanted on day 21 (P &lt; 0.01). Anti-ovalbumin IgG was greater for vaccinated than non-vaccinated calves (P &lt; 0.01). Anti-ovalbumin IgG was greater for MVAC than VAC calves on day 63. Percent of cells and mean florescence intensity of cells performing oxidative burst decreased from day 0 to day 63 (P &lt; 0.01) but were not affected by treatment (P ≥ 0.26). There was a tendency (P = 0.10) for an interaction of melatonin, vaccination, and day for the mean florescence intensity of cells performing phagocytosis where MVAC was greater than all other treatments on d 42. Exogenous melatonin may alter PMN function of calves during vaccination. Further research is needed to define the effect of melatonin on development of antigen-specific IgG during programmed vaccination protocols.
Monogenic lupus: insights into disease pathogenesis and therapeutic opportunities
Authors: Qin Yuting , Ma Jianyang , Vinuesa Carola G. 
Published: February 2024

Purpose of reviewThis review aims to provide an overview of the genes and molecular pathways involved in monogenic lupus, the implications for genome diagnosis, and the potential therapies targeting these molecular mechanisms.Recent findingsTo date, more than 30 genes have been identified as contributors to monogenic lupus. These genes are primarily related to complement deficiency, activation of the type I interferon (IFN) pathway, disruption of B-cell and T-cell tolerance and metabolic pathways, which reveal the multifaceted nature of systemic lupus erythematosus (SLE) pathogenesis.SummaryIn-depth study of the causes of monogenic lupus can provide valuable insights into of pathogenic mechanisms of SLE, facilitate the identification of effective biomarkers, and aid in developing therapeutic strategies.
Preoperative Oswestry Disability Index Should not be Utilized to Determine Surgical Eligibility for Patients Requiring Lumbar Fusion for Degenerative Lumbar Spine Disease
Authors: Issa Tariq Z. , Haider Ameer A. , Lambrechts Mark J. , Sherman Matthew B. , Canseco Jose A. , Vaccaro Alexander R. , Schroeder Gregory D. , Kepler Christopher K. , Hilibrand Alan S. 
Published: February 2024

Study Design.Retrospective cohort study.Objective.To evaluate how preoperative Oswestry Disability Index (ODI) thresholds might affect minimal clinically important difference (MCID) achievement following lumbar fusion.Summary of Background Data.As payers invest in alternative payment models, some are suggesting threshold cutoffs of patient-reported outcomes (PROMs) in reimbursement approvals for orthopedic procedures. The feasibility of this has not been investigated in spine surgery.Materials/Methods.We included all adult patients undergoing one to three-level primary lumbar fusion at a single urban tertiary academic center from 2014 to 2020. ODI was collected preoperatively and one year postoperatively. We implemented theoretical threshold cutoffs at increments of 10. MCID was set at 14.3. The percent of patients meeting MCID were determined among patients “approved” or “denied” at each threshold. At each threshold, the positive predictive value (PPV) for MCID attainment was calculated.Results.A total 1368 patients were included and 62.4% (N=364) achieved MCID. As the ODI thresholds increased, a greater percent of patients in each group reached the MCID. At the lowest ODI threshold, 6.58% (N=90) of patients would be denied, rising to 20.2%, 39.5%, 58.4%, 79.9%, and 91.4% at ODI thresholds of 30, 40, 50, 60, and 70, respectively. The PPV increased from 0.072 among patients with ODI>20 to 0.919 at ODI>70. The number of patients denied a clinical improvement in the denied category per patient achieving the MCID increased at each threshold (ODI>20: 1.96; ODI>30: 2.40; ODI>40: 2.75; ODI>50: 3.03; ODI>60: 3.54; ODI>70: 3.75).Conclusion.Patients with poorer preoperative ODI are significantly more likely to achieve MCID following lumbar spine fusion at all ODI thresholds. Setting a preoperative ODI threshold for surgical eligibility will restrict access to patients who may benefit from spine fusion despite ODI>20 demonstrating the lowest predictive value for MCID achievement.Level of Evidence.3.
Development of a Comprehensive Model for Cancer Symptom Care for Women With Ovarian or Endometrial Cancer
Authors: Christiansen Mille Guldager , Jarden Mary , Colomer-Lahiguera Sara , Eicher Manuela , Bryant-Lukosius Denise , Mirza Mansoor Raza , Pappot Helle , Piil Karin 
Published: February 2024

Background:
Women with ovarian or endometrial cancer experience multiple symptoms during chemotherapy. Specialized cancer nurses possess specific knowledge and competencies to effectively monitor and manage treatment-related toxicities and provide self-management support.

Objective:
To describe the conception and development of a comprehensive cancer symptom model of care in an oncological setting for women diagnosed with ovarian or endometrial cancer.

Methods:
The participatory evidence-based, patient-focused process for guiding the development, implementation, and evaluation of advanced practice nursing roles—the participatory, evidence-based, patient-centered process for advanced practice (PEPPA) framework directed the process. The first 6 steps of this 9-step framework were utilized to incorporate research evidence, engage, and obtain the input of key stakeholders.

Results:
Stakeholders (n = 27) contributed with specific knowledge, perspectives, and feedback to the entire development process, and several needs were identified. Following structured discussions, a new model of cancer symptom care with elements such as symptom management, electronic patient-reported outcomes, and an expanded nursing role in the form of nurse-led consultations was developed.

Conclusions:
We effectively utilized the PEPPA framework to design a new cancer symptom model of care, that was agreed upon by key stakeholders.

Implications for Practice:
This stakeholder-engaged, and evidence-driven process could be used as a template for others wanting to develop a population-specific model of care to improve cancer symptom management.

What is Foundational:
With the expansion of the cancer nursing role, the new model has the potential to improve the quality of cancer care and health outcomes related to symptom management.
Robotic excision of a giant seminal vesicle cyst
Authors: Carbin Danny Darlington , Perry Matthew James Alexander , Abou Chedid Wissam 
Published: February 2024

Abstract
Zinner syndrome is a rare congenital condition characterized by unilateral renal agenesis, ejaculatory duct obstruction, and seminal vesicle cyst. This syndrome is caused by an embryonic malformation of the mesonephric or Wolffian duct. Seminal vesicle cysts are commonly reported, and men with these cysts often present with infertility. This report presents a case of a giant seminal vesicle cyst that was incidentally found while evaluating for bowel symptoms. The seminal vesicle cyst was successfully managed by robot-assisted excision.
Coniochaeta hoffmannii and mutabilis Invasive Fungal Keratitis: A Case Series and Literature Review
Authors: Pegany Roma B. , Wilson Reid L. , Stiefel Hillary , Albert Daniel M. , Chamberlain Winston D. , Redd Travis K. 
Published: February 2024

Purpose:
To describe 2 Coniochaeta species (Coniochaeta hoffmannii and Coniochaeta mutabilis) as rare causes of invasive fungal keratitis resulting in enucleations and to provide a review of ocular infections caused by the genus Coniochaeta and underscore changes to its classification over the past 3 decades, which may clarify previous reports with outdated nomenclature.

Methods:
This is a small case series from a single academic institution (Casey Eye Institute) with a summary of the literature.

Results:
The first case describes a 53-year-old man who had an indolent but persistent anterior chamber reaction after repair of a penetrating nail injury. Cultures from a second penetrating keratoplasty identified C. hoffmannii, which was determined through phenotypic characterization and DNA sequencing. Despite surgical management, cultures were persistently positive for C. hoffmannii. Two years post-injury, he developed a funnel retinal detachment with proliferative vitreoretinopathy and elected for enucleation. The second case describes a 54-year-old woman with poor contact lens hygiene with a presumed filamentous fungal keratitis that remained refractory to topical natamycin. Broad-range polymerase chain reaction of an anterior chamber aspirate identified C. mutabilis. Therapeutic keratoplasty was performed for worsening infection; however, because of intractable pain, she elected for enucleation. Pathology from the enucleation specimen demonstrated persistent, but sparse, fungal elements.

Conclusions:
This is the first case series characterizing ocular infections caused by Coniochaeta, a rare cause of invasive fungal keratitis resulting in devastating outcomes for our patients. Identification of Coniochaeta was initially difficult by traditional culturing techniques, and subsequent molecular diagnostic testing proved useful in detection. Our review of ocular Coniochaeta clarifies previous reports with outdated nomenclature.
Geographic atrophy: current and future therapeutic agents and practical considerations for retinal specialists
Authors: Vakharia Priya , Eichenbaum David 
Published: February 2024

Purpose of review
Geographic atrophy (GA) from age-related macular degeneration (AMD) remains a leading cause of vision loss. The purpose of this review is to summarize currently available intravitreal therapeutics, and discuss pipeline therapeutics that are currently in clinical trials.

Recent findings
The FDA approval of pegcetacoplan and avacincaptad pegol, both approved in 2023, represent the first therapeutics to treat GA. These are delivered via intravitreal injections, and have been shown to slow progression of GA. Both drugs have a risk of new onset neovascular age-related macular degeneration (nAMD). Initial indications seem to be that pegcetacoplan therapy has higher risks of inflammation, vasculitis, and nonarteritic ischemic optic neuropathy (NAION) as compared to avacincaptad pegol, but more real-world data will help to clarify this further. Pipeline therapeutics that we discuss include intravitreal gene therapy, oral anticomplement therapy, and intravitreal injections of a novel glycoprotein.

Summary
Both pegcetacoplan and avacincaptad pegol are FDA approved to treat GA. The decision to treat patients is still complex and nuanced, but the approval of two treatments for GA is a tremendous advance in our field. Future therapeutics may further refine our ability to treat patients more effectively and safely.
Low-frequency (5-Hz) stimulation of ventrolateral periaqueductal gray modulates the descending serotonergic system in the peripheral neuropathic pain
Authors: Park Minkyung , Koh Chin Su , Chang Heesue , Kim Tae Jun , Mun Wonki , Chang Jin Woo , Jung Hyun Ho 
Published: February 2024

Abstract
Neuropathic pain is a type of chronic pain that entails severe prolonged sensory dysfunctions caused by a lesion of the somatosensory system. Many of those suffering from the condition do not experience significant improvement with existing medications, resulting in various side effects. In this study, Sprague–Dawley male rats were used, and long-term deep brain stimulation of the ventrolateral periaqueductal gray was conducted in a rat model of spared nerve injury. We found that 5-Hz deep brain stimulation effectively modulated mechanical allodynia and induced neuronal activation in the rostral ventromedial medulla, restoring impaired descending serotonergic system. At the spinal level, glial cells were still activated but only the 5-HT1a receptor in the spinal cord was activated, implying its inhibitory role in mechanical allodynia. This study found that peripheral neuropathy caused dysfunction in the descending serotonergic system, and prolonged stimulation of ventrolateral periaqueductal gray can modulate the pathway in an efficient manner. This work would provide new opportunities for the development of targeted and effective treatments for this debilitating disease, possibly giving us lower chances of side effects from repeated high-frequency stimulation or long-term use of medication.
Quality Improvement Interventions to Enhance Vaccine Uptake in Cancer Patients: A Systematic Review
Authors: Kazi Basil , Talukdar Zain , Schriefer Jan 
Published: February 2024

ABSTRACT

Introduction:
Cancer patients, because of their compromised immune responses, face a higher risk of preventable infections, leading to increased morbidity and mortality. Despite this, vaccination rates among these patients are suboptimal, and research on effective interventions to improve vaccination rates is limited.

Methods:
We conducted a comprehensive search in PubMed and Cochrane Library for studies investigating quality improvement (QI) interventions targeting vaccine uptake in cancer patients. Two authors independently screened, extracted data, and analyzed studies, resolving any discrepancies through consensus.

Results:
Thirteen studies met the inclusion criteria, published between 2014 and 2022. Seven studies focused on the influenza vaccine, five on the pneumococcal vaccine, and one on both. Twelve studies used multiple interventions, whereas one used a single intervention. Most interventions aimed to enhance patient and family knowledge and identify eligible patients before their appointments. All studies demonstrated improved vaccine uptake after implementing the interventions.

Conclusions:
A variety of QI interventions have effectively increased pneumococcal and influenza vaccine uptake among cancer patients. Future research should address roadblocks to implementation and explore the effect of these interventions on other vaccines.
Effect of telemonitoring and as-needed patient support on positive airway pressure therapy adherence
Authors: Owens Saoirse , Doghramji Karl 
Published: February 2024

ABSTRACT

Background:
Obstructive sleep apnea (OSA) affects patient health and public welfare. Positive airway pressure (PAP) therapy is the preferred treatment of OSA, but therapy adherence rates remain suboptimal. Current literature demonstrates telemonitoring interventions to support improved PAP therapy adherence.

Purpose:
To evaluate the effect of interval telemonitoring of PAP therapy data at 2 and 4 weeks after treatment initiation in patients with moderate-to-severe obstructive sleep apnea with as-needed patient support and troubleshooting by telephone consultation.

Methodology:
Ninety-nine participants were enrolled in this study, 50 in the control group and 49 in the intervention group. Data were analyzed using descriptive and inferential statistics using SPSS 28.0 software. The primary outcome of interest was 90-day PAP adherence.

Results:
Mean PAP adherence scores diverged at 90 days after PAP initiation, with the intervention group having a significantly higher mean score (M = 49.24, SD = 38.18) relative to the control group (M = 36.38, SD = 37.69). Likewise, continued PAP usage at 90 days after therapy initiation diverged between participant groups, with the intervention group having a significantly higher mean score (M = 89.80, SD = 30.58) relative to the control group (M = 72.00, SD = 45.36).

Conclusions:
The intervention resulted in significantly higher mean PAP adherence and a greater percentage of participants demonstrating continued PAP usage at 90 days after therapy initiation but did not result in a statistically significant increase in what is considered and defined as “good PAP adherence” (adherence of ≥70%).

Implications:
Data-triggered telemonitoring protocols offer supplementary support to patients in need and improve PAP adherence.
Prevalence of depression among pregnant women and its correlation with the choice of delivery method
Authors: Vaziri-harami Roya , Kazemi Seyyedeh Neda , Vaziri-harami Saharnaz , Najafiarab Hanieh 
Published: February 2024

Background:
Caesarean section is usually limited to cases where natural vaginal delivery is not possible or poses a serious risk to the foetus and mother. Psychological health of mothers is likely to play an important role in the method of delivery. This study aims to investigate the prevalence of depression in pregnant women and its relationship with the choice of delivery method and other demographic parameters.

Methods:
In this descriptive cross-sectional study, 250 mothers referring to the hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran, were selected, and their demographic information and level of depression was collected using a questionnaire. Statistical analysis was conducted to evaluate the correlation between depression, method of delivery and other associated parameters.

Results:
Among 250 pregnant women, 225 (90%) had no depression, 25 (10%) had mild depression and no moderate or severe depression was reported in any pregnant mother. Also, 146 (58.4%) were willing to have a caesarean section and 104 (41.6%) wanted to have a normal delivery. The choice of delivery method was not significantly associated with depression. Analyzes showed that increasing maternal age is associated with a greater tendency to caesarean delivery. The incidence and higher depression scores of mothers showed a significant association with the history of previous abortions.

Conclusion:
Although in this study no significant association was observed between depression in pregnant mothers and the choice delivery, due to the high prevalence of caesarean section in the country and its progression to higher percentages, it seems that the design and implementation of effective programs and interventions is required.
Skin Expander for Scalp Reconstruction: Reappraisal of a Reconstructive Procedure for Aplasia Cutis Congenita
Authors: Arcuri Francesco , Ardito Emanuela , Bianchi Bernardo 
Published: February 2024

Purpose:
Aplasia cutis congenita (ACC) is a heterogeneous group of congenital disorders characterized by the absence of epidermis, dermis, appendages, subcutaneous tissue, and bone. The aim of the study is to describe a clinical report of ACC of the scalp treated with skin expanders.

Clinical Report:
In October 2019, a 16-year-old female patient underwent scalp expansion with 2 rectangular devices (150 and 250 cm3; Radovan Mentor-Johnson&Johnson). The inflation started 30 days after surgery and continued once every 7 to 10 days to gain 10% of overexpansion. After 3 months, the patient underwent the second surgical step with the expanded scalp transposed to close the defect. Clinical examination 6 months after surgery revealed an acceptable cosmetic result with a hidden surgical scar and hair growth in the previous area of frontoparietal alopecia.

Conclusion:
Skin expander for the reconstruction of extensive ACC defects of the scalp is a valid procedure.