bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal study of patients with discrepant results in CLIFT and a solid-phase dsDNA antibody assay: does a gold standard dsDNA assay exist?
Authors: Trujillo Aguilera Antonio , Bernardo Serrano Raquel , Navas Ana , Alcaide Molina Juan , Alvarez Romero Paula , Jurado Roger Aurora 
Published: October 2023

ObjectiveAntidouble-stranded DNA (dsDNA) antibodies are essential for diagnosis and follow-up of systemic lupus erythematous (SLE). To ensure the best diagnostic approach, most healthcare laboratories opt for a combination of highly sensitive methods, such as solid-phase immunoassays, and highly specific methods, such as theCrithidia luciliaeindirect immunofluorescence test (CLIFT). Even so, discordant results are common, thus hindering the diagnostic process. Therefore, this study aimed to characterise a cohort of patients with discrepant results for a dsDNA fluorescence enzyme immunoassay (FEIA) and CLIFT during 2016–2018 and to follow patients up until December 2021.MethodsWe performed an observational, longitudinal and retrospective study on 417 samples from 257 patients who had been referred for suspected connective tissue diseases or followed up after diagnosis. All of them were positive for antinuclear antibodies (ANAs) using an indirect immunofluorescence assay (IFA) on Hep-2 cells, the entry criterion in our laboratory, and positive for FEIA dsDNA. Samples were then tested with CLIFT according to our routine protocol, which includes CLIFT testing after FEIA dsDNA results ≥10 UI/ml. After the assessment of data quality, the final analysis was based on 222 patients.ResultsEighty-three patients (37.4%) had positive results in both tests and met the diagnostic criteria for SLE. However, 139 patients (62.6%) had discrepant results (FEIA+, CLIFT–). Of these, 58 patients (41.7%) had a diagnosis of SLE, with 47 (33.8%) having been previously diagnosed and under treatment. The remaining 11 patients (7.9%) had a new diagnosis of SLE, which was made up within 4 years of the initial screening. A total of 81 of the 139 patients (57.5%) with discrepant results did not meet lupus criteria during the follow-up period.ConclusionsThe study showed that CLIFT could be negative in both treated and newly diagnosed SLE, thus underlining the importance of follow-up of dsDNA-positive results using solid-phase tests. Therefore, quantitative tests such as FEIA could add value to the diagnosis and management of patients with suspected SLE.
Comparative dose–response study of intrathecal hyperbaric ropivacaine for cesarean delivery in preterm singleton versus twin pregnancies
Authors: Zhu Miao , Liu Ju-Jun , Shen Yan-Ping , Pan Zheng-Bin , Lv Chang-Cheng , Chen Wen-Din , Qian Xiaowei 
Published: October 2023

IntroductionPreviously, we demonstrated that patients with full-term singletons and preterm twins require similar dose of intrathecal hyperbaric ropivacaine. However, these findings may be attributable to enrolled patients with preterm twin pregnancies. In this study, we aimed to determine the intrathecal dose requirements of hyperbaric ropivacaine for twins and singletons at equal gestational ages.MethodsWe enrolled 75 patients with preterm singletons and 75 patients with preterm twins scheduled for cesarean delivery under combined spinal-epidural anesthesia in this two-arm parallel, randomized, double-blind, dose–response study. Patients with singletons and twins were randomly assigned to receive one of five different doses of hyperbaric ropivacaine: 10, 12, 14, 16, or 18 mg. A probit regression model was used to determine the dose effective in 50% of patients (ED50) and dose effective in 90% of patients (ED90) values. The relative median potency was calculated to compare the ED50between patients with twins and singletons.ResultsIntrathecal ropivacaine ED50and ED90(with 95% CI) in patients with preterm singletons were 9.9 (7.2 to 11.5) mg and 16.8 (14.5 to 22.9) mg, respectively. In patients with preterm twins, these values were 9.2 (95% CI 6.4 to 10.8) mg and 15.6 (95% CI 13.6 to 20.6) mg. Between patients with preterm twins and preterm singletons, the relative potency (ED50ratios) was 0.933 (95% CI 0.72 to 1.15).ConclusionsDuring preterm gestation, intrathecal hyperbaric ropivacaine dose requirements for scheduled cesarean delivery were not different between patients with twins and singletons.Trial registration numberChiCTR2100051382.
Techniques for Enhancing Security in Industrial Control Systems
Authors: Varadharajan Vijay , Tupakula Uday , Karmakar Kallol Krishna 
Published: October 2023

Increasingly Industrial Control Systems (ICS) systems are being connected to the Internet to minimise the operational costs and provide additional flexibility. These control systems such as the ones used in power grids, manufacturing and utilities operate continually and have long lifespans measured in decades rather than years as in the case of Information Technology (IT) systems. Such industrial control systems require uninterrupted and safe operation. However, they can be vulnerable to a variety of attacks, as successful attacks on critical control infrastructures could have devastating consequences to the safety of human lives as well as a nation’s security and prosperity. Furthermore, there can be a range of attacks that can target ICS and it is not easy to secure these systems against all known attacks let alone unknown ones. In this paper, we propose a software enabled security architecture using Software Defined Networking (SDN) and Network Function Virtualisation (NFV) that can enhance the capability to secure industrial control systems. We have designed such an SDN/NFV enabled security architecture and developed a Control System Security Application (CSSA) in SDN Controller for enhancing security in ICS by achieving real time situational awareness and dynamic policy-driven decision making across the network infrastructure. In particular, CSSA can be used for establishing secure path for end-to-end communication between devices and also deal against certain specific attacks namely denial of service attacks, from unpatched vulnerable control system components and securing the communication flows from the legacy devices that do not support any security functionality. We also discuss how CSSA provides reliable paths for safety critical messages in control systems. We discuss the prototype implementation of the proposed architecture and the results obtained from our analysis.
Effect of Kinnow (Citrus nobilis × C. deliciosa) Peel Oil Coating on the Shelf Stability and Antioxidant Potential of Cheddar Cheese
Authors: Nadeem Muhammad , Qureshi Tahir Mahmood , Sarfraz Sahar , Ur-Rehman Salim , Rehman Abdul , Malik Faiqa , Iqbal Aqsa , Ahmad Naushad , Nawaz Asad , Siddeeg Azhari 
Published: October 2023

Kinnow peel oil has been reported to possess antimicrobial and antioxidant activities due to presence of many bioactive compounds. Therefore, the experiments reported in this research paper aimed to investigate the shelf stability and antioxidant potential of Cheddar cheese coated with Kinnow peel oil at various concentrations (0.2%, 0.4%, and 0.6%). The physicochemical characteristics, microbial counts, antioxidant potential, and sensory acceptability of Cheddar cheese were evaluated during ripening (up to 9 months, 4°C). The titratable acidity (%), pH, moisture (%), fat (%), protein contents (%), and soluble nitrogen (SN, %) of Cheddar cheese investigated in the present study showed significant

p

<

0.05

variations among treatments during ripening. The maximum plate counts (8.36 Log cfu·g−1) were observed in control cheese (T0) ripened for 3 months whereas T3 (9 months ripened) showed the minimum counts (5.04 Log cfu·g−1) among all the treatments. The maximum (3.76 Log cfu·g−1) yeast and mold counts were observed in T0 cheese ripened for 9 month whereas the respective samples of T3 showed the lowest values (2.89 Log cfu·g−1) among all the treatments. The surfaces of Cheddar cheese coated with 0.6% Kinnow peel (T3) did not show any visible signs of yeast and molds. The maximum (366.56 mg GAE/100 g) total phenolic contents were observed in T3 ripened for 6 months. The maximum values (1995.02 mM TE/100 g) of DPPH radical scavenging activity were observed in T3 ripened for 6 months. Similarly, T3 obtained the highest sensory scores among all the treatments. Hence, it was concluded that Kinnow peel oil significantly improved antioxidant potential, sensory perception, and shelf stability of Cheddar cheese.
XPO1-Mediated mRNA Export of Genome Maintenance Regulators Drives Chemotherapy Resistance in Aggressive Lymphoma
Authors: Knittel Gero , Reinhardt Hans Christian 
Published: October 2023

Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoid malignancy and displays vast genetic and transcriptomic heterogeneity. Current treatment guidelines recommend first-line chemoimmunotherapy consisting of an anthracycline backbone, which produces cure rates of approximately 65%. However, the remaining patients will face relapsed or refractory disease, which, even in the era of chimeric antigen receptor T cells, is difficult to treat. In this issue of Cancer Research, Marullo and colleagues investigate the biological underpinnings of the tumor-suppressive activity of the newly approved XPO1 inhibitor selinexor in the treatment of lymphoma. In a translational effort covering genomic and biochemical approaches, combined with in vivo validation experiments and a phase I clinical trial, they demonstrate that upon DNA damage, XPO1 selectively exports transcripts encoding proteins involved in genome maintenance via the RNA-binding proteins THOC4 and eIF4E. Pharmacologic interception of this export process enhances chemosensitivity in various lymphoma models, and combined selinexor plus chemoimmunotherapy displays a favorable toxicity profile and early evidence of efficacy in patients.
See related article by Marullo et al., p. 101
Population-specific Mutation Patterns in Breast Tumors from African American, European American, and Kenyan Patients
Authors: Tang Wei , Zhang Flora , Byun Jung S. , Dorsey Tiffany H. , Yfantis Harris G. , Ajao Anuoluwapo , Liu Huaitian , Pichardo Margaret S. , Pichardo Catherine M. , Harris Alexandra R. , Yang Xiaohong R. , Figueroa Jonine D. , Sayed Shahin , Makokha Francis W. , Ambs Stefan 
Published: October 2023

Abstract

Women of African descent have the highest breast cancer mortality in the United States and are more likely than women from other population groups to develop an aggressive disease. It remains uncertain to what extent breast cancer in Africa is reminiscent of breast cancer in African American or European American patients. Here, we performed whole-exome sequencing of genomic DNA from 191 breast tumor and non-cancerous adjacent tissue pairs obtained from 97 African American, 69 European American, 2 Asian American, and 23 Kenyan patients. Our analysis of the sequencing data revealed an elevated tumor mutational burden in both Kenyan and African American patients, when compared with European American patients. TP53 mutations were most prevalent, particularly in African American patients, followed by PIK3CA mutations, which showed similar frequencies in European American, African American, and the Kenyan patients. Mutations targeting TBX3 were confined to European Americans and those targeting the FBXW7 tumor suppressor to African American patients whereas mutations in the ARID1A gene that are known to confer resistance to endocrine therapy were distinctively enriched among Kenyan patients. A Kyoto Encyclopedia of Genes and Genomes pathway analysis could link FBXW7 mutations to an increased mitochondrial oxidative phosphorylation capacity in tumors carrying these mutations. Finally, Catalogue of Somatic Mutations in Cancer (COSMIC) mutational signatures in tumors correlated with the occurrence of driver mutations, immune cell profiles, and neighborhood deprivation with associations ranging from being mostly modest to occasionally robust. To conclude, we found mutational profiles that were different between these patient groups. The differences concentrated among genes with low mutation frequencies in breast cancer.

Significance:
The study describes differences in tumor mutational profiles between African American, European American, and Kenyan breast cancer patients. It also investigates how these profiles may relate to the tumor immune environment and the neighborhood environment in which the patients had residence. Finally, it describes an overrepresentation of ARID1A gene mutations in breast tumors of the Kenyan patients.
White Matter Hyperintensity Volume and Poststroke Cognition: An Individual Patient Data Pooled Analysis of 9 Ischemic Stroke Cohort Studies
Authors: de Kort Floor A.S. , Coenen Mirthe , Weaver Nick A. , Kuijf Hugo J. , Aben Hugo P. , Bae Hee-Joon , Bordet Régis , Cammà Guido , Chen Christopher P.L.H. , Dewenter Anna , Duering Marco , Fang Rong , van der Giessen Ruben S. , Hamilton Olivia K.L. , Hilal Saima , Huenges Wajer Irene M.C. , Kan Cheuk Ni , Kim Jonguk , Kim Beom Joon , Köhler Sebastian , de Kort Paul L.M. , Koudstaal Peter J. , Lim Jae-Sung , Lopes Renaud , Mok Vincent C.T. , Staals Julie , Venketasubramanian Narayanaswamy , Verhagen Charlotte M. , Verhey Frans R.J. , Wardlaw Joanna M. , Xu Xin , Yu Kyung-Ho , Biesbroek J. Matthijs , Biessels Geert Jan 
Published: October 2023

BACKGROUND:
White matter hyperintensities (WMH) are associated with cognitive dysfunction after ischemic stroke. Yet, uncertainty remains about affected domains, the role of other preexisting brain injury, and infarct types in the relation between WMH burden and poststroke cognition. We aimed to disentangle these factors in a large sample of patients with ischemic stroke from different cohorts.

METHODS:

We pooled and harmonized individual patient data (n=1568) from 9 cohorts, through the Meta VCI Map consortium (
www.metavcimap.org
). Included cohorts comprised patients with available magnetic resonance imaging and multidomain cognitive assessment <15 months poststroke. In this individual patient data meta-analysis, linear mixed models were used to determine the association between WMH volume and domain-specific cognitive functioning (
Z
scores; attention and executive functioning, processing speed, language and verbal memory) for the total sample and stratified by infarct type. Preexisting brain injury was accounted for in the multivariable models and all analyses were corrected for the study site as a random effect.

RESULTS:

In the total sample (67 years [SD, 11.5], 40% female), we found a dose-dependent inverse relationship between WMH volume and poststroke cognitive functioning across all 4 cognitive domains (coefficients ranging from −0.09 [SE, 0.04,
P
=0.01] for verbal memory to −0.19 [SE, 0.03,
P
<0.001] for attention and executive functioning). This relation was independent of acute infarct volume and the presence of lacunes and old infarcts. In stratified analyses, the relation between WMH volume and domain-specific functioning was also largely independent of infarct type.

CONCLUSIONS:
In patients with ischemic stroke, increasing WMH volume is independently associated with worse cognitive functioning across all major domains, regardless of old ischemic lesions and infarct type.
Long term stability of lactate in uncentrifuged sodium fluoride/potassium oxalate blood collection tubes
Authors: Stevic Ivan , Bolsover Jade , Moore Rick , Bhayana Vipin 
Published: October 2023

Background Delayed time from collection to centrifugation may cause erroneously high lactate levels in vitro (from continued blood cell metabolism under anaerobic conditions in the collection tube) if not collected in appropriate collection devices, consequently increasing the risk for inappropriate patient care or harm. We undertook a study to determine the turnaround time for lactate testing in a tertiary care setting and also performed short- and long-term lactate stability studies in blood collected in sodium fluoride/potassium oxalate (NaF/KOx) collection tubes. Methods The hospital lab information system was mined for 6 months to determine patient samples that may have exceeded the time from collection-to-receival in lab of 15-min. Lactate stability was evaluated in unspun NaF/KOx collection tubes at 15 min intervals for to 2 h; and separately at 2, 6, 12, 24, and 48-h post-collection. Results A total of 8,929 plasma samples were collected in 6 months, and 1/3 were not received in the lab within 15 min from collection. In NaF/KOx additive, lactate levels had minor increases over 2 h, and incremental increases at an average rate of 0.0035 mmol/L/h over 48 h with maximum increase of 9.8% at 48 h. However, the average change across all time points were within local allowable performance goals (at ≤4 mmol/L ± 0.5 mmol/L; at >4 mmol/L ± 12%). Conclusion A small proportion of lactate specimens may experience delay in processing. Although lactate levels may incrementally increase over 48-h at room temperature in unspun NaF/KOx collection tubes, the changes may not be clinically impactful.
Enhancing Self-Reported Assessment of Working Conditions in Policing: Revisiting the Psychometric Properties and Applications of the Police Stress Questionnaire
Authors: Rabbing Lillis , Lau Bjørn , Fostervold Knut Inge , Blenkinsopp John , Bjørkelo Brita 
Published: October 2023

Objectives Policing is recognized as a highly stressful occupation, encompassing stressors not commonly encountered in other fields. In response, police-specific stress scales have been developed and used when studying police work. Despite changes in the composition of police personnel, most studies examining police working conditions focus on sworn police officers (SPO), excluding employees without police education (EWPE). To advance research and practice on stress in the police, align results, and increase the possibilities for comparisons across studies using police-specific measures (PSMs) we conducted a psychometric evaluation of the two scales in the Police Stress Questionnaire (PSQ). We examined whether adding “Not Applicable” to the response scales would reduce vulnerability and make the PSQ more robust. Method Based on a survey with a randomised sample ( N = 560) of SPO and EWPE in the Norwegian Police, we tested the original factor structures of the PSQ through Confirmatory Factor Analysis including tests of factor structures from previous studies. Results For all models, the indicators of fit indicated a poor fit with either our whole or stratified sample. The response choice ‘Not Applicable’ provided extended information for SPOs and EWPEs on the PSQ. Conclusions To promote aligning results and enabling comparisons across studies using the PSQ, we suggest treating the PSQ scales as formative indexes, rather than reflective scales. Adding “Not Applicable” to the response scale offers an influential elaboration of the PSQ with beneficial and extended information. Generalised studies of stress in the police should include the entire population working there.
Neighborhood Environment and Epigenetic Age: A Scoping Review
Authors: Jackson Pamela , Kempf Mirjam-Colette , Goodin Burel R. , A. Hidalgo Bertha , Aroke Edwin N. 
Published: October 2023

Background: Interest in how the neighborhood environment impacts age-related health conditions has been increasing for decades. Epigenetic changes are environmentally derived modifications to the genome that alter the way genes function—thus altering health status. Epigenetic age, a biomarker for biological age, has been shown to be a useful predictor of several age-related health conditions. Consequently, its relation to the neighborhood environment has been the focus of a growing body of literature. Objective: We aimed to describe the scope of the evidence on the relationship between neighborhood environmental characteristics and epigenetic age. Methods: Using scoping review following methods established by Arksey and O’Malley, we first defined our research questions and searched the literature in PubMed, PsycINFO, and EMBASE. Next, we selected the literature to be included, and finally, we analyzed and summarized the information. Results: Nine articles met the inclusion criteria. Most studies examined deprivation as the neighborhood characteristic of interest. While all studies were observational in design, the articles included diverse participants, including men and women, adults and children, and multiple ethnicities. Results demonstrated a relationship between the neighborhood environment and epigenetic age, whether the characteristic of interest is socioeconomic or physical. Conclusions: Overall, studies concluded there was a relationship between neighborhood characteristics and epigenetic age, whether the characteristic of interest was socioeconomic or physical. However, findings varied based on how the neighborhood characteristic and/or epigenetic age was measured. Furthermore, a paucity of investigations on physical characteristics was noticeable and warrants increased attention.
Association of MOUD ECHO Participation on Expansion of Buprenorphine Prescribing in Rural Primary Care
Authors: Salvador Julie G. , Myers Orrin B. , Bhatt Snehal R. , Jacobsohn Vanessa , Lindsey Larissa , Alkhafaji Rana S. , Rishel Brakey Heidi , Sussman Andrew L. 
Published: October 2023

Background: Lack of access to buprenorphine to treat Opioid Use Disorder is profound in rural areas where over half of small and remote rural counties have no buprenorphine prescriber. To increase prescribing, an online, Medication of Opioid Use Disorder (MOUD) Extensions for Community Healthcare Outcomes (ECHO) was developed that addressed known barriers to the startup and expansion of treatment. The objective of the present study was to determine the relationship between participating in MOUD ECHO sessions and prescribing of buprenorphine for OUD in rural primary care. Methods: Using non-random, rolling-recruitment from Feb 2018 to October of 2021, all rural primary care clinics in New Mexico were contacted via phone call and fax to recruit providers (Physicians, Nurse Practitioners, and Physician Assistants) who had no or limited buprenorphine experience to enroll in this study. Participation in the MOUD ECHO was tracked across the 12 week series. Start-up and expansion of buprenorphine treatment was measured every 3 months for up to 2 years using 5 implementation benchmarks spanning training completion, obtaining licensure, prescribing and adding patients. Using a dose-response intention to treat type analysis, associations between number of sessions and benchmark achievement were analyzed using logistic regression. Results: Eighty providers were enrolled, mostly female (66%) white (82%), non-Hispanic (82%), and mostly nurse practitioners (51%) or MDs (38%). Achievement of prescribing benchmarks at 6 months was significantly increased by attendance at MOUD ECHO sessions including obtaining training and licensure Odds Ratio (OR = 1.24; P = .001); starting to prescribe (OR = 1.31; P = .004), and adding patients (OR = 1.14; P = .025). Conclusions: This study provides compelling evidence that MOUD ECHO participation may significantly increase the number of providers implementing this treatment and adding patients onto their panels. The dose-response approach helps address current gaps in ECHO research that call for more rigorous examination of the ECHO model’s impact on provider practice improvements.