bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Novel Giant Magnetoresistance–Enabled Multiplex Polymerase Chain Reaction Assay for the Diagnosis of Invasive Fungal Infection
Authors: Vergidis Paschalis , Ordaya Eloy E , Porter Emma , Sweet Hannah , Wang Wei , Evans Anton F , Zhang Chi , Young Jo-Anne H , Liu Xiaoying 
Published: February 2025

Abstract

Background
Despite advances in clinical microbiology, the diagnosis of invasive fungal infections remains challenging. Giant magnetoresistance (GMR) is a novel technology that enables the detection of trace amounts of cell-free DNA (cfDNA). We evaluated a high-multiplex molecular diagnostic assay coupled with GMR-enabled lab-on-a-chip technology that can detect 18 different fungal species.

Methods
Analytical performance was evaluated in spiked plasma samples. After amplification, cfDNA was digested. Residual single-stranded DNA was flowed over a GMR sensor that was surface-coated with probes specific to different fungal species. After hybridization, magnetic beads bound to the probe complexes produced a GMR signal that was detected by the sensors. Clinical performance was determined using residual serum samples collected before the initiation of antifungal treatment from 20 patients with infection.

Results
The limit of detection of the assay ranged from 5 to 50 copies per polymerase chain reaction (PCR) reaction. Nonspecific signals were not observed in the spiked samples. Fungal cfDNA was detected in 80% of patients with invasive candidiasis (3/4 with candidemia, 5/6 with invasive candidiasis without candidemia), all 3 cases of invasive pulmonary aspergillosis, and all 3 cases of disseminated histoplasmosis. cfDNA was not detected in 2 patients with cryptococcosis (both had negative blood cultures) and 2 patients with Pneumocystis pneumonia.

Conclusions
We developed a novel GMR-enabled multiplex PCR assay detecting fungal pathogens that have been prioritized for public health action. Clinical sensitivity was highest in cases of presumed angioinvasion and dissemination. This technology has the potential for use in the clinical microbiology laboratory setting.
Plasma ctDNA kinetics as a predictor of systemic therapy response for advanced non-small cell lung cancer: a systematic review and meta-analysis
Authors: Leite da Silva Luís F , Saldanha Erick F , de Menezes Júnior Samuel Alonso , Halamy Pereira Leonardo , de Bragança dos Santos João Alexandre R , Buonopane Isabella Romagnoli , de Souza Erito M , de Menezes Caio Ulysses Galvani , Lopes Gilberto 
Published: February 2025

Abstract

Background
Predicting early treatment response in advanced non-small cell lung cancer (NSCLC) is challenging. Longitudinal monitoring of circulating tumor DNA (ctDNA) can track tumor response to treatments like immune checkpoint blockade (ICB) and correlate with outcomes. This meta-analysis evaluated whether ctDNA clearance or decrease is associated with improved survival across various settings in NSCLC.

Methods
A systematic review of MEDLINE, EMBASE, and Cochrane databases (up to April 2024) identified studies evaluating the impact of ctDNA kinetics on survival outcomes in non-curative NSCLC settings. Pooled hazard ratios (HR) for progression-free survival (PFS) and overall survival (OS) were calculated using a random effects model.

Results
We included 32 studies with 3047 NSCLC patients receiving systemic therapies such as targeted therapy (TT), ICB, and chemotherapy. Meta-analysis of 31 studies showed that ctDNA decrease/clearance was linked to improved PFS (HR: 0.32 [0.26, 0.40], I² = 63%, P &lt; .01). Subgroup analysis indicated strong PFS benefits from ctDNA clearance (HR: 0.27 [0.20, 0.36]). Similar improvements were seen across patients undergoing targeted therapy (HR: 0.34) and ICB (HR: 0.33). Analysis of 25 studies revealed a significant association between ctDNA reduction and better OS (HR: 0.31 [0.23, 0.42], I² = 47%, P &lt; .01). Subgroup findings were consistent for both TT (HR: 0.41) and ICB (HR: 0.32). Sensitivity analysis demonstrated that ctDNA clearance/decrease was consistently associated with improved PFS across study designs and ctDNA analysis methods. There was no significant variation in hazard ratios for PFS based on NSCLC subtypes, smoking status, or sex.

Conclusion
Plasma ctDNA kinetics was associated with improved survival outcomes in patients diagnosed with advanced NSCLC undergoing treatment with TT and ICB.
NuSTAR detection of a hot stellar superflare with a temperature of 95 MK in hard X-rays
Authors: Hakamata Tomohiro , Matsumoto Hironori , Odaka Hirokazu , Takasao Shinsuke 
Published: February 2025

Abstract
A search of the hard X-ray archive data of the Nuclear Spectroscopic Telescope Array (NuSTAR) found a transient source, NuSTAR J230059+5857.4, during an observation of 1E 2259+586 on 2013 April 25. A multi-wavelength analysis using X-ray, optical, and infrared data, mostly taken in its quiescent phase, was conducted to identify the origin of NuSTAR J230059+5857.4 and elucidate the phenomena associated with the flare activity. The results indicated that NuSTAR J230059+5857.4 was a stellar flare that occurred on a single M-dwarf, M-dwarf binary, or pre-main-sequence star. NuSTAR J230059+5857.4 exhibited a higher emission measure and higher temperature, $8.60^{+2.15}_{-1.73} \times 10^{54}\:$cm$^{-3}$ and $8.21^{+2.71}_{-1.86}\:$keV, respectively, on average than the nominal values of stellar flares reported in the past. The flare loop size estimated on the basis of the model to balance the plasma and magnetic pressures was larger than the stellar radius by a factor of several. Because, based on solar flare loops, this flare loop scale is excessively large, we conjecture that the observed large emission measure could be attributed to the observation of mutually associated multiple flares simultaneously occurring on the stellar surface, known as sympathetic flares. Thanks to the large effective area of NuSTAR in the hard X-ray band, we are able to conduct a detailed discussion about a temperature variation associated with the flare. Investigation of the temperature variation during the flare revealed that the temperature remained significantly higher than during the quiescent phase even after the count rate dropped to around $5\%$ of the peak. The sustained high temperature over the long duration is consistent with the idea of sympathetic flares. We found that it is essential to use theoretical models to evaluate loops and assess temporal changes in temperature, as done in this study, to determine whether there are multiple flares or not when analyzing flare observation data.
Neuroforecasting reveals generalizable components of choice
Authors: Genevsky Alexander , Tong Lester C , Knutson Brian 
Published: February 2025

Abstract
Accurate forecasts of population-level behavior critically inform institutional choices and public policy. While neuroforecasting research suggests that measurements of group brain activity can improve forecasting accuracy relative to behavior, less is known about how and when brain activity can effectively improve out-of-sample forecasts. We analyzed neural and behavioral data collected in two experiments to forecast choice in more vs. less demographically representative aggregate internet markets in order to test when forecasts based on brain activity generalize better than behavior. In both experiments, while the accuracy of market forecasts based on behavior varied as a function of sample representativeness, market forecasts based on brain activity remained significant regardless of sample representativeness. These findings are consistent with the notion that brain activity associated with early affective responses can generalize across individuals to index aggregate choice more broadly than downstream behavior. Thus, brain activity from limited samples may reveal generalizable components of choice that can improve market forecasts. These findings inform theory regarding which components of individual choice generalize to improve market forecasts and provide insights into mechanisms that underlie the effective application of neuroforecasting.
Retroperitoneal dedifferentiated liposarcoma – diagnostic and surgical challenges: a case report
Authors: Saha Akash , Habibullah Quazi , Rahman Mohammad Mashiur , Bandha Biplob Chandra , Islam Sajib Monirul , Islam Saiful , Das Sagor Kumar , Tonny Jabin Sultana , Rahman Abidur 
Published: February 2025

Introduction:
Primary retroperitoneal liposarcoma is a rare variety of tumors accounting for 0.07%–0.2% of all malignancies. This type of sarcoma often causes diagnostic and therapeutic challenges due to its delayed presentation and anatomical location. Though there are some oncological measures like chemotherapy and radiotherapy still persist, complete surgical resection is the mainstay of treatment. However, the recurrence rate is very high in the case of retroperitoneal sarcomas.

Case presentation:
A 34-year-old male patient presented to our surgery department with abdominal distension, a lumpy feeling in his upper abdomen, and a significant weight loss over the past 3 months. On examination, there was a large intraabdominal mass measuring about 20 × 15 cm in the epigastric, left hypochondriac, umbilical, and left lumber region, which was partially mobile, partly hard, and partly cystic in consistency; the surface was smooth, and the margin was regular. After diagnostic and radiological workup, our primary suspicion was, it might be a case of retroperitoneal liposarcoma. Computed tomography (CT) guided fine needle aspiration tomography (FNAC) reveals, it was a spindle cell sarcoma. However, after six cycles neoadjuvant chemotherapy, resection was performed. Complete resection (R0) was done with extraction of a soft tissue mass of 12.5 kg, followed by adjuvant chemotherapy for three cycles. No recurrence is found after 3-month follow-up.

Conclusion:
Though retroperitoneal sarcoma may challenge the surgeon’s skill, complete marginal clearance along with oncological consultation may delay the recurrence and improve the quality of life of the patients. However, careful and long-term follow-up is required to detect early recurrence and increase the life expectancy of the patients.
Hypertension in chronic kidney disease and future heart failure
Authors: Burnier Michel 
Published: February 2025

Purpose of review
Hypertension and chronic kidney diseases (CKDs) are known risk factors for the development or worsening of heart failure. In last years, several new therapeutic approaches for the management of people with diabetic and nondiabetic CKD and hypertension have been investigated. In this brief review, the most recent findings regarding the ability of SGLT-2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists (nsMRA) and GLP-1 receptor agonists to prevent heart failure in patients with hypertension and CKD will be discussed.

Recent findings
In the last 3 years, several large clinical trials involving very large numbers of CKD patients have been published showing that these new therapeutic approaches significantly reduce the risk of heart failure events and hospitalizations in patients with diabetic and nondiabetic nephropathies and hypertension as well as in patients with heart failure without nephropathy. Moreover, these drugs retard the progression of CKD towards end-stage kidney disease.

Summary
These observations already have a major impact on the management of people with hypertension and CKD. SGLT-2 inhibitors are now recommended as first-line therapy in people with diabetes, CKD and heart failure. The use of nsMRA is increasing and could replace spironolactone over time in heart failure as well as in early CKD stages.
RNA therapeutics in cardiovascular medicine
Authors: Damase Tulsi Ram , Cooke John P. 
Published: February 2025

Purpose of review
RNA therapeutics came to global attention when mRNA-based vaccines provided an answer to the SARS-CoV-2 pandemic. The immense significance of this development notwithstanding, it is important to note that almost a decade prior to the pandemic, RNA drugs had made important inroads toward the amelioration of disease. The first class of RNA therapies to be introduced into clinical use were the antisense oligomers and siRNA drugs which generally induce a therapeutic effect by acting to brake or to modulate mRNA expression. RNA therapeutics is quickly becoming the fourth pillar of pharmacotherapy, and will have broad applications, including for the treatment of cardiovascular disease.

Recent findings
The United States (US) Food and Drug Administration (FDA) has approved several antisense oligomers (ASOs) and siRNA-based drugs to treat disorders associated with cardiovascular disease. In addition, multiple RNA-based drugs are in clinical trials to assess their safety and efficacy in patients with cardiovascular disorders, such as Zodasiran, a siRNA therapy that targets angiopoietin-like protein 3 (ANGPTL3) to reduce LDL cholesterol.

Summary
Because of limitless sequence choice; speed of design; and relative ease of synthesis, RNA drugs will be rapidly developed, will have broad applications, and will be generated at lower cost than other drug types. This review aims to highlight RNA therapies for cardiovascular diseases that are approved, and those that are under clinical evaluation.
Antimicrobials for Neonates: Practitioner Decisions and Diagnostic Certainty
Authors: Spotswood Naomi E. , Grace Erin , Dargaville Peter A. , Beeson James G. , Hickey Leah , Haeusler Gabrielle M. , Bryant Penelope A. , Cooper Celia , Keir Amy K. 
Published: February 2025

Background:
Antimicrobials are frequently prescribed to neonates who require hospital care, but the influences on clinical decision-making and practice variation in this process are ill-understood. We performed a cross-sectional survey of practitioners who prescribe antimicrobials in 3 Australian neonatal units.

Methods:
During two 5-day data capture periods per center, 56 practitioners reported their general confidence in antimicrobial decision-making for neonates. Then, 4 questionnaires evaluated diagnostic certainty and influences on antimicrobial decision-making for 68 antimicrobial courses and 11 infection evaluations where antimicrobials were not prescribed.

Results:
Self-reported guideline use at antimicrobial commencement was high (26/31, 84%). Clinical risk factors, clinical signs and laboratory tests contributed variably to decisions to start and cease antimicrobials. Consultation with a colleague contributed to 14/31 (45%) decisions to commence antimicrobials and 13/34 (38%) decisions to cease them. The most frequent responses to questions regarding the likelihood of infection and the possibility of an alternative diagnosis were “some possibility” and “some likelihood.” Team concordance in responses ranged from 14% to 50%. While practitioners in roles that denoted more clinical experience had greater general confidence in antimicrobial decision-making, this difference was not observed in real-world clinical situations where infection was not microbiologically confirmed.

Conclusions:
Clinical, laboratory, practitioner, team and center-based factors each influence antimicrobial prescribing decisions. Clinical uncertainty and differing guidelines likely contribute to practice variation. Future work to inform stewardship efforts should include improved guideline consistency, roles of diagnostic aids and a better understanding of the medicocultural contributors to neonatal antimicrobial prescribing.
The Certification Ranking of Stroke Treatment Centers Is Unclear to the General Public
Authors: Preciado Michael V. , Wilson Jennifer E. , Alejandro-White Jose , Denbow Maria , Olson DaiWai M. 
Published: February 2025

ABSTRACT

BACKGROUND: Certified stroke treatment centers are classified based on their available resources to treat stroke including an Acute Stroke Ready Hospital (ASRH), a primary stroke center (PSC), a Thrombectomy-Capable Stroke Center (TCSC), and comprehensive stroke centers (CSCs). These hospitals all provide varying levels of care with CSCs being the most able to treat all types and complexities of stroke. This undergraduate nursing-led study explored the public's preference for treatment at different certified stroke treatment centers. METHODS: This study was a prospective nonrandomized observational survey of English-speaking adults at a plasma donation center in the Southwest United States. Subjects completed a 2-minute survey asking whether they would drive to the hospital or call 911 during a suspected stroke, and at which type of hospital they would prefer to be treated. RESULTS: Of 249 respondents, 204 (81.9%) indicated that they would call 911 for hospital transport, and 45 (18.1%) would drive their family member to a hospital. Most respondents (95/248, 38.3%) would prefer treatment at a PSC, 90 (36.3%) preferred an ASRH, 52 (21.0%) preferred a CSC, and 11 (4.4%) preferred a TCSC. There was no association between transportation preference and hospital preference dichotomized as CSC or PSC versus ASRH or TCSC (χ2 = 0.021, P = .885), nor CSC versus other (χ2 = 0.944, P = .331). CONCLUSION: Most respondents did not select CSC as the preferred treatment site, and 1 in 5 would drive rather than call 911. This indicates a knowledge gap regarding stroke center classification that warrants increased education.
Implementation of a Low-risk Algorithm for Outpatient Management of Febrile Pediatric Patients With Sickle Cell Disease
Authors: Erno Jason , Noisette Laurence , Bergmann Shayla , Diaz Charyse , Depriest Brittany , Nietert Paul J. , Hudspeth Michelle 
Published: February 2025

Background:
Splenic dysfunction in children with sickle cell disease (SCD) increases the risk of serious bacterial infections; therefore, families are instructed to seek medical care in the presence of fever. Recurrent hospital admissions of patients with SCD cause financial and resource burdens on caregivers and the health care system, contributing to a lower quality of life in this patient population. Recent studies have documented a reduction of the incidence of bacterial infections among these patients managed on an outpatient basis with no association of increased morbidity and mortality. We decided to establish a partnership between our pediatric hematology/oncology division and pediatric emergency medicine division to initiate an algorithm to identify low-risk patients eligible for outpatient management.

Procedure:
We conducted a retrospective review of patients with SCD younger than 18 years of age, followed at the Comprehensive Care Sickle Cell Center at the Medical University of South Carolina (MUSC), who presented to our Pediatric Emergency Department (ED) with a temperature ≥101°F from July 1, 2018 to June 30, 2020.

Results:
The mean length of stay and age at admission were nearly equal between pre-implementation and post-implementation of the algorithm. The admission rates from the study for were 55.2% and 43.6% pre-implementation and post-implementation, respectively. Patients revisited the ED within 72 hours in 6.7% of patients in pre-implementation and 5.9% of patients in post-implementation. There were no patient deaths.

Conclusions:
Our pathway helps standardize the treatment of febrile pediatric patients with SCD. Although the decrease in admissions did not reach statistical significance, the > 10% decrease in admissions was likely meaningful to reduce health care burdens for patients and families.
Nurses' Role in the Birth Experience
Authors: Raposo Nicholas M. , Jurgens Corrine Y. 
Published: February 2025

Abstract

Background:
Intrapartum nurses are integral to the birth experience, yet their unique influence on this patient-reported outcome is not clear. The purpose of this review is to synthesize and highlight characteristics and practices of intrapartum nursing care associated with the birth experience.

Methods:
A search was conducted in February and March 2024 in CINAHL, PubMed, and Scopus with keywords birth experience, birth satisfaction, and nurse. Publication date was unrestricted, as no similar review was identified. Original, peer-reviewed publications in English were included. Publications that explored mediators of the birth experience, made unclear associations, or validated instruments were excluded. The Johns Hopkins Research Evidence Appraisal Tool was used for quality assessment. Findings were presented through Maslow's hierarchy of needs.

Results:
Twenty-five publications were included. They were published between 1989 and 2021 and present national and international data on a range of birth experience outcomes. Most publications were good or high quality. Characteristics and practices of intrapartum nursing care associated with the birth experience were those that fulfilled patients' physiological, safety, love, esteem, and self-actualization needs throughout labor and birth.

Discussion:
Fulfilled needs set the stage for positive birth experiences, whereas unfulfilled needs were associated with negative birth experiences. Findings can be used to support intrapartum nurses in optimizing birth experience outcomes.
In a Flash
Authors: Beck Cheryl Tatano 
Published: February 2025

Abstract

Purpose:
To describe women's experiences of surviving an amniotic fluid embolism (AFE) as written in their online stories.

Study Design and Methods:
In this qualitative descriptive study, 50 stories of AFE that women posted on the AFE Foundation website were analyzed using Braun and Clarke's thematic analysis.

Results:
In this sample, 35 women had emergency cesarean births, 12 had vaginal births, and 3 did not mention the type of birth. In 35 of the stories, women's ethnicity could be determined. Thirty-three women were White and one each were Black and Asian. Twenty-eight mothers were primiparas and 22 were multiparas. Five themes were identified: In a Flash, Heartbreaking Loss of Memory, Arduous Trek Towards Physical Recovery, Struggling Mentally with the Aftermath of a Traumatic Birth, and It Takes a Village and Then Some.

Clinical Implications:
The five themes identified from survivors' stories of AFE provide a firsthand account of surviving this catastrophic complication of childbirth and its prolonged aftermath. Nursing interventions based on these findings can be designed to help women heal from AFE.
Edutech-Based Formative Assessment and Teaching Competencies in Nursing Education
Authors: Shin Sujin , Hong Eunmin , Lee Miji , Lee Minjae 
Published: February 2025

Background:
The integration of education and technology (Edutech) has become significant in education.

Purpose:
To explore the current state of formative assessment in nursing education and factors influencing technological pedagogical content knowledge (TPACK) competencies.

Methods:
A total of 216 novice nurse educators with <5 years of teaching experience in South Korea were surveyed online.

Results:
Among these participants, 27.3% used EFA (Edutech-based formative assessment), highlighting its benefits in providing immediate feedback and accessibility, yet faced insufficient time, technical issues and insufficient digital literacy as significant barriers. Completion of nursing education courses in a graduate program, EFA experience, and age were associated with TPACK competencies.

Conclusion:
Implementing Edutech improves assessment processes and highlights the critical need for comprehensive technological training and support to improve digital literacy and TPACK competencies. Effective educational strategies tailored to the diverse technological abilities of nurse educators are needed for enhancing overall teaching quality.