bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment for complete extensor tendon rupture: A case report on extensor pollicis longus tendon transfer and tenodesis procedure to radius for a patient with rheumatoid arthritis
Authors: Kohata Kazuhiro , Miyake Takafumi , Morizaki Yutaka , Sasaki Takahiro , Tanaka Sakae 
Published: March 2024

ABSTRACT
The complete loss of finger extension leads to significant inconvenience in daily life and often requires surgical treatment. Despite some disadvantages, the Boyes method, which uses the flexor digitorum superficialis tendon, is commonly performed for complete extensor rupture. We report the case of a 73-year-old woman living alone diagnosed with a subcutaneous rupture of all extensor tendons from the index to the little finger. The favourable range of motion of her wrist allowed us to perform extensor tenodesis. Additionally, the patient had a dislocated thumb interphalangeal (IP) joint, enabling us to use the extensor pollicis longus tendon for tendon transfer in combination with thumb IP joint fusion. The patient demonstrated favourable finger range-of-motion outcomes at the 6-month postoperative assessment. The case shows that extensor pollicis longus tendon transfer and tenodesis may be a viable treatment option for patients with complete extensor rupture accompanied by thumb IP joint deformity and normal wrist range of motion.
A phase I dose-escalation study of pulsatile afatinib in patients with recurrent or progressive brain cancer
Authors: Juarez Tiffany M , Gill Jaya M , Heng Annie , Carrillo Jose A , Wagle Naveed , Nomura Natsuko , Nguyen Minhdan , Truong Judy , Dobrawa Lucia , Sivakumar Walavan , Barkhoudarian Garni , Kelly Daniel F , Kesari Santosh 
Published: March 2024

Abstract

Background
Afatinib (BIBW2992; Gilotrif®) is a selective and irreversible inhibitor of the epidermal growth factor receptor (ErbB; EGFR) family. It inhibits EGFR, HER2, and HER4 phosphorylation, resulting in tumor growth inhibition and regression. This phase I dose-escalation trial of pulsatile afatinib examined the safety, drug penetration into the central nervous system, preliminary antitumor activity, and recommended phase II dose in patients with progressive or recurrent brain cancers.

Methods
Afatinib was taken orally once every 4 days or once every 7 days depending on dose cohort, until disease progression or unacceptable toxicity.

Results
A total of 24 patients received the investigational agent and were evaluable for safety analyses, and 21 patients were evaluable for efficacy. Dosing was administered at 80 mg every 4 days, 120 mg every 4 days, 180 mg every 4 days, or 280 mg every 7 days. A recommended phase II dose of pulsatile afatinib was established at 280 mg every 7 days as there were no dose-limiting toxicities in any of the dosing cohorts and all toxicities were deemed manageable. The most common drug-related toxicities were diarrhea, rash, nausea, vomiting, fatigue, stomatitis, pruritus, and limb edema. Out of the 21 patients evaluable for efficacy, 2 patients (9.5%) exhibited partial response based on Response Assessment in Neuro-Oncology criteria and disease stabilization was seen in 3 patients (14.3%).

Conclusions
Afatinib taken orally was safe and well-tolerated up to 280 mg every 7 days in brain cancer patients.
Welfare-maximizing patent length in a dynamic general equilibrium model
Authors: Iwaisako Tatsuro 
Published: March 2024

Abstract
This article examines analytically the welfare-maximizing patent length in a dynamic general equilibrium model which is based on a variety expansion R&D-based growth model. The results show that if the elasticity of substitution among the intermediate goods is higher, that is, the price elasticity of demand is higher, the welfare-maximizing patent length is shorter. This article also examines the welfare-maximizing mix of patent length and breadth, and numerically obtains similar results, that is, a higher elasticity of substitution shortens the welfare-maximizing length.
Real-world Experience of Posaconazole Therapeutic Drug Monitoring in Oncology Patients: Clinical Implications of Hypoalbuminemia as a Predictor of Subtherapeutic Posaconazole Levels
Authors: Handley Guy , Greene John , Cannella Anthony P , Velez Ana Paula , Shah Shivan , Pasikhova Yanina 
Published: March 2024

Abstract

Background
Posaconazole maintains broad antifungal activity and is employed for prevention and treatment of invasive fungal infections in oncology patients. Older formulations required therapeutic drug monitoring, and specific plasma drug levels have been recommended. This study evaluated factors associated with subtherapeutic concentrations with the newer delayed-release tablet formulation.

Methods
In this retrospective, single-center cohort study at a national comprehensive cancer center, all oncology patients receiving delayed-release posaconazole at standard dosing of 300 mg orally per day from 06/2021 to 07/2023 with plasma drug concentration evaluation were identified. Demographic, clinical, and laboratory data were evaluated to identify risk factors associated with subtherapeutic drug levels at targets of ≥1.25 µg/mL and ≥1.8 µg/mL.

Results
Of 110 patients identified, 98 met criteria for inclusion in the study. The median time from initiation of posaconazole to drug level assessment was 13 days, and the median concentration was 1.29 µg/mL. Of the 22 patients receiving posaconazole for prophylaxis, 5 (22.7%) failed to achieve concentrations ≥0.7 µg/mL, and of 76 patients receiving posaconazole for treatment, 38 (50%) failed to achieve concentrations of ≥1.25 µg/mL. In multivariable analysis, albumin of ≤3 g/dL and ideal body weight ≥60 kg were found to be associated with subtherapeutic levels. For a higher target of ≥1.8 µg/mL, only albumin ≤3 g/dL was associated with subtherapeutic levels for the variables evaluated.

Conclusions
A higher initial dosing strategy and therapeutic drug monitoring for oncology patients with albumin ≤3 g/dL receiving posaconazole, particularly for the treatment of invasive fungal infection, could be considered.
Sacraments of the Law: Discovering Common Ground of Law and Religion
Authors: Hahn Judith 
Published: March 2024

Abstract
This article proposes to identify ritualization—as the differentiation between the profane and the sacred—as the basic act underlying the creation of norms. In this light, we can perceive ritualization as a common ground of law and religion. This is particularly evident in ‘sacraments’, a specific type of ritual that culminates in the realization of the sacred within the profane. As ‘norm-facts’, sacraments draw the sacred into our everyday world. This connection has been evident since Roman times when ‘sacraments’ denoted performative signs of a juridico-religious nature. If one acknowledges that both religion and law draw not merely on essential ritual processes of generating normative meaning, but also use sacramental action to realize sacred norms within profane contexts, speaking of ‘law and religion’ reaches deeper than identifying the common topics of two separate spheres of the social. We have then in fact discovered an elemental and common foundation of law and religion.
Long-Term Consequences of PTI Activation and Its Manipulation by Root-Associated Microbiota
Authors: Nakano Ryohei Thomas , Shimasaki Tomohisa 
Published: March 2024

Abstract
In nature, plants are constantly colonized by a massive diversity of microbes engaged in mutualistic, pathogenic or commensal relationships with the host. Molecular patterns present in these microbes activate pattern-triggered immunity (PTI), which detects microbes in the apoplast or at the tissue surface. Whether and how PTI distinguishes among soil-borne pathogens, opportunistic pathogens, and commensal microbes within the soil microbiota remains unclear. PTI is a multimodal series of molecular events initiated by pattern perception, such as Ca2+ influx, reactive oxygen burst, and extensive transcriptional and metabolic reprogramming. These short-term responses may manifest within minutes to hours, while the long-term consequences of chronic PTI activation persist for days to weeks. Chronic activation of PTI is detrimental to plant growth, so plants need to coordinate growth and defense depending on the surrounding biotic and abiotic environments. Recent studies have demonstrated that root-associated commensal microbes can activate or suppress immune responses to variable extents, clearly pointing to the role of PTI in root–microbiota interactions. However, the molecular mechanisms by which root commensals interfere with root immunity and root immunity modulates microbial behavior remain largely elusive. Here, with a focus on the difference between short-term and long-term PTI responses, we summarize what is known about microbial interference with host PTI, especially in the context of root microbiota. We emphasize some missing pieces that remain to be characterized to promote the ultimate understanding of the role of plant immunity in root–microbiota interactions.
Exceeding the limit for microscopic image translation with a deep learning-based unified framework
Authors: Dai Weixing , Wong Ivy H M , Wong Terence T W 
Published: March 2024

Abstract
Deep learning algorithms have been widely used in microscopic image translation. The corresponding data-driven models can be trained by supervised or unsupervised learning depending on the availability of paired data. However, general cases are where the data are only roughly paired such that supervised learning could be invalid due to data unalignment, and unsupervised learning would be less ideal as the roughly paired information is not utilized. In this work, we propose a unified framework (U-Frame) that unifies supervised and unsupervised learning by introducing a tolerance size that can be adjusted automatically according to the degree of data misalignment. Together with the implementation of a global sampling rule, we demonstrate that U-Frame consistently outperforms both supervised and unsupervised learning in all levels of data misalignments (even for perfectly aligned image pairs) in a myriad of image translation applications, including pseudo-optical sectioning, virtual histological staining (with clinical evaluations for cancer diagnosis), improvement of signal-to-noise ratio or resolution, and prediction of fluorescent labels, potentially serving as new standard for image translation.
Leakage of old carbon dioxide from a major river system in the Canadian Arctic
Authors: Dasari Sanjeev , Garnett Mark H , Hilton Robert G 
Published: March 2024

Abstract
The Canadian Arctic is warming at an unprecedented rate. Warming-induced permafrost thaw can lead to mobilization of aged carbon from stores in soils and rocks. Tracking the carbon pools supplied to surrounding river networks provides insight on pathways and processes of greenhouse gas release. Here, we investigated the dual-carbon isotopic characteristics of the dissolved inorganic carbon (DIC) pool in the main stem and tributaries of the Mackenzie River system. The radiocarbon (14C) activity of DIC shows export of “old” carbon (2,380 ± 1,040 14C years BP on average) occurred during summer in sampling years. The stable isotope composition of river DIC implicates degassing of aged carbon as CO2 from riverine tributaries during transport to the delta; however, information on potential drivers and fluxes are still lacking. Accounting for stable isotope fractionation during CO2 loss, we show that a large proportion of this aged carbon (60 ± 10%) may have been sourced from biospheric organic carbon oxidation, with other inputs from carbonate weathering pathways and atmospheric exchange. The findings highlight hydrologically connected waters as viable pathways for mobilization of aged carbon pools from Arctic permafrost soils.
Systemic sclerosis-associated pulmonary arterial hypertension is characterized by a distinct peripheral T helper cell profile
Authors: Papadimitriou Theodoros Ioannis , Lemmers Jacqueline M J , van Caam Arjan P M , Vos Jacqueline L , Vitters Elly L , Stinissen Lizan , van Leuven Sander I , Koenders Marije I , van der Kraan P M , Koenen Hans J P M , Smeets Ruben L , Nijveldt Robin , Vonk Madelon C , Thurlings Rogier M 
Published: March 2024

Abstract

Objectives
Systemic sclerosis (SSc) is characterized by multiple clinical manifestations. Vasculopathy is a main disease hallmark and ranges in severity from an exacerbated Raynaud phenomenon to pulmonary arterial hypertension (PAH). The potential involvement of the immune system in SSc-associated vascular abnormalities is not clear. Here, we set out to study SSc-related immune parameters and determine whether and which peripheral T cell subsets associate with vascular severity in SSc patients.

Methods
Peripheral blood and clinical data were collected from 30 SSc patients, 5 patients with idiopathic PAH and 15 age and sex-matched healthy donors (HD). In this cross-sectional cohort, SSc patients with PAH (n = 15) were matched for their age, sex and medication with SSc patients with no signs of PAH (n = 15). Lymphocyte subsets were quantified by multi-colour flow cytometry.

Results
SSc patients exhibited elevated percentages of T peripheral helper cells (Tph), CD4+GZMB+ T cells and decreased levels of Th1 cells compared with HD. Increased presence of both CD4+ and CD8+ exhausted-like (CD28−) T cells, characterized by raised cytokine and cytotoxic signature, was also observed in SSc compared with HD blood. Furthermore, IL-4 expressing CD4+CD8+ T cells were significantly increased in SSc peripheral blood. Interestingly, the presence of PAH in SSc was accompanied by a distinct T helper profile, characterized by raised percentages of Th17 and Tph cells.

Conclusion
SSc patients with severe vasculopathy (presence of PAH) exhibited a distinct T cell profile, suggesting a potential role of auto-immune inflammation in SSc vascular complications.
Risk of diabetes mellitus in systemic lupus erythematosus: systematic review and meta-analysis
Authors: Etchegaray-Morales Ivet , Mendoza-Pinto Claudia , Munguía-Realpozo Pamela , Solis-Poblano Juan Carlos , Méndez-Martínez Socorro , Ayón-Aguilar Jorge , Abud-Mendoza Carlos , García-Carrasco Mario , Cervera Ricard 
Published: March 2024

Abstract

Objective
To investigate the risk of DM and evaluate the impact of SLE therapies on the risk of developing DM in patients with SLE.

Methods
Electronic database searches of PubMed, Embase, Cochrane Library and Web of Science were performed from inception to February 2023. Cohort and cross-sectional studies that analysed the risk of DM in patients with SLE were included. The associations between diabetes and antirheumatic agents, such as antimalarials and glucocorticoids, were analysed in cohort studies. Data were pooled using fixed- or random-effects meta-analysis to estimate pooled odd ratios (OR), relative risks (RR) and 95% confidence intervals (CIs). This study was registered with PROSPERO (CRD42023402774).

Results
A total of 37 studies (23 cross-sectional and 14 cohort studies) involving 266 537 patients with SLE were included. The pooled analyses from cross-sectional studies and cohort studies did not show an increased risk of DM in SLE patients (OR = 1.05, 95% CI 0.87–1.27; P = 0.63 and RR = 1.32, 95% CI 0.93–1.87; P = 0.12, respectively). However, several cohort studies consistently demonstrated a reduced risk of diabetes with antimalarials, while glucocorticoid use has been associated with an increased risk of developing diabetes. Age, sex, hypertension and immunosuppressants have not been identified as risk factors for DM in SLE patients.

Conclusion
Although there was no increased risk of DM in patients with SLE compared with controls, HCQ users or adherents had a decreased risk, whereas glucocorticoid users had an increased risk.
JMJD3 activation contributes to renal protection and regeneration following acute kidney injury in mice
Authors: Yu Chao , Tang Jinhua , Yu Jianjun , Wang Yanjin , Liu Na , Dong Zheng , Zhuang Shougang 
Published: March 2024

AbstractWe have recently demonstrated that Jumonji domain‐containing protein D3 (JMJD3), a histone demethylase of histone H3 on lysine 27 (H3K27me3), is protective against renal fibrosis, but its role in acute kidney injury (AKI) remains unexplored. Here, we report that JMJD3 activity is required for renal protection and regeneration in murine models of AKI induced by ischemia/reperfusion (I/R) and folic acid (FA). Injury to the kidney upregulated JMJD3 expression and induced expression of H3K27me3, which was coincident with renal dysfunction, renal tubular cell injury/apoptosis, and proliferation. Blocking JMJD3 activity by GSKJ4 led to worsening renal dysfunction and pathological changes by aggravating tubular epithelial cell injury and apoptosis in both murine models of AKI. JMJD3 inhibition by GSKJ4 also reduced renal tubular cell proliferation and suppressed expression of cyclin E and phosphorylation of CDK2, but increased p21 expression in the injured kidney. Furthermore, inactivation of JMJD3 enhanced I/R‐ or FA‐induced expression of TGF‐β1, vimentin, and Snail, phosphorylation of Smad3, STAT3, and NF‐κB, and increased renal infiltration by F4/80 (+) macrophages. Finally, GSKJ4 treatment caused further downregulation of Klotho, BMP‐7, Smad7, and E‐cadherin, all of which are associated with renal protection and have anti‐fibrotic effects. Therefore, these data provide strong evidence that JMJD3 activation contributes to renal tubular epithelial cell survival and regeneration after AKI.
Clinical Efficacy of Beta-1 Selective Beta-Blockers Versus Propranolol in Patients With Thyroid Storm: A Retrospective Cohort Study*
Authors: Matsuo Yuichiro , Jo Taisuke , Watanabe Hideaki , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo 
Published: March 2024

OBJECTIVES:Thyroid storm is the most severe manifestation of thyrotoxicosis. Beta-blockers are among the standard treatment regimens for this condition, with propranolol being the historically preferred option. However, 2016 guidelines issued by the Japan Thyroid Association and the Japan Endocrine Society recommend the use of beta-1 selective beta-blockers over nonselective beta-blockers, such as propranolol. Nevertheless, evidence supporting this recommendation is limited. Herein, we aimed to investigate the in-hospital mortality of patients with thyroid storms based on the choice of beta-blockers.DESIGN:Retrospective cohort study.SETTING:The Diagnosis Procedure Combination database, a national inpatient database in Japan.PATIENTS:Patients hospitalized with thyroid storm between April 2010 and March 2022.INTERVENTIONS:Propensity-score overlap weighting was performed to compare in-hospital mortality between patients who received beta-1 selective beta-blockers and those who received propranolol. Subgroup analysis was also conducted, considering the presence or absence of acute heart failure.MEASUREMENTS AND MAIN RESULTS:Among the 2462 eligible patients, 1452 received beta-1 selective beta-blockers and 1010 received propranolol. The crude in-hospital mortality rates were 9.3% for the beta-1 selective beta-blocker group and 6.2% for the propranolol group. After adjusting for baseline variables, the use of beta-1 selective beta-blockers was not associated with lower in-hospital mortality (6.3% vs. 7.4%; odds ratio, 0.85; 95% CI, 0.57–1.26). Furthermore, no significant difference in in-hospital mortality was observed in patients with acute heart failure.CONCLUSIONS:In patients with thyroid storm, the choice between beta-1 selective beta-blockers and propranolol did not affect in-hospital mortality, regardless of the presence of acute heart failure. Therefore, both beta-1 selective beta-blockers and propranolol can be regarded as viable treatment options for beta-blocker therapy in cases of thyroid storm, contingent upon the clinical context.
A Quality Improvement Initiative for Detection of Attention-Deficit/Hyperactivity Disorder in an Urban, Academic Safety Net Hospital
Authors: Roberts Mona Doss , Loubeau J. Krystel , Hasan Syeda , Rabin Megan , Sikov Jennifer , Baul Tithi D. , Brigham Rebecca , Gillooly Melissa , Singh Ruby , Cassidy Kaitlin , Spencer Andrea E. 
Published: March 2024

ABSTRACT:

Objective:
Improve detection of Attention Deficit/Hyperactivity Disorder (ADHD) in a safety net, hospital-based, academic pediatric practice by optimizing screening with the Pediatric Symptom Checklist attention score (PSC-AS) and further evaluation with the Vanderbilt ADHD Diagnostic Rating Scale (VADRS).

Methods:
We implemented a multi-component intervention by (1) optimizing electronic medical record (EMR) features; (2) adjusting clinic operational workflow; and (3) creating a decision-making algorithm for pediatric primary care clinicians (PPCCs). We extracted 4 outcomes manually from the EMR (pediatrician acknowledgment of a positive PSC-AS, documentation of a plan for further evaluation, distribution of VADRS, and completion of at least 1 VADRS). Outcomes were measured monthly in run charts compared to the pre-intervention control period, and implementation was optimized with Plan-Do-Study-Act cycles.

Results:
PPCCs were significantly more likely to acknowledge a positive PSC-AS in the intervention versus control (65.3% vs 41.5%; p < 0.001), although this did not change documentation of a plan (70% vs 67.1%; p-value = 0.565). Significantly more children with a positive PSC-AS were distributed a parent or teacher VADRS in the intervention versus control (30.6% vs 17.7%; p-value = 0.0059), but the percentage of returned VADRS rating scales did not improve (12.9% vs 9.2%; p-value = 0.269).

Conclusion:
Our ADHD detection quality improvement initiative improved use of the PSC-AS to identify attention problems and distribution of VADRS diagnostic rating scales, but additional interventions are needed to improve the completion of ADHD evaluations in primary care to ensure that children are appropriately identified and offered evidence-based care.
A natural language processing algorithm accurately classifies steatotic liver disease pathology to estimate the risk of cirrhosis
Authors: Sherman Marc S. , Challa Prasanna K. , Przybyszewski Eric M. , Wilechansky Robert M. , Uche-Anya Eugenia N. , Ott Ashley T. , McGoldrick Jessica , Goessling Wolfram , Khalili Hamed , Simon Tracey G. 
Published: March 2024

Background:
Histopathology remains the gold standard for diagnosing and staging metabolic dysfunction–associated steatotic liver disease (MASLD). The feasibility of studying MASLD progression in electronic medical records based on histological features is limited by the free-text nature of pathology reports. Here we introduce a natural language processing (NLP) algorithm to automatically score MASLD histology features.

Methods:
From the Mass General Brigham health care system electronic medical record, we identified all patients (1987–2021) with steatosis on index liver biopsy after excluding excess alcohol use and other etiologies of liver disease. An NLP algorithm was constructed in Python to detect steatosis, lobular inflammation, ballooning, and fibrosis stage from pathology free-text and manually validated in >1200 pathology reports. Patients were followed from the index biopsy to incident decompensated liver disease accounting for covariates.

Results:
The NLP algorithm demonstrated positive and negative predictive values from 93.5% to 100% for all histologic concepts. Among 3134 patients with biopsy-confirmed MASLD followed for 20,604 person-years, rates of the composite endpoint increased monotonically with worsening index fibrosis stage (p for linear trend <0.005). Compared to simple steatosis (incidence rate, 15.06/1000 person-years), the multivariable-adjusted HRs for cirrhosis were 1.04 (0.72–1.5) for metabolic dysfunction–associated steatohepatitis (MASH)/F0, 1.19 (0.92–1.54) for MASH/F1, 1.89 (1.41–2.52) for MASH/F2, and 4.21 (3.26–5.43) for MASH/F3.

Conclusions:
The NLP algorithm accurately scores histological features of MASLD from pathology free-text. This algorithm enabled the construction of a large and high-quality MASLD cohort across a multihospital health care system and disclosed an accelerating risk for cirrhosis based on the index MASLD fibrosis stage.