bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Ultrasound-Guided Cannulation for Difficult IV Access in Medical–Surgical Patients: A Quality Improvement Project
Authors: Owen Odaro , Mulkey David C. , Nieves Aldrin 
Published: January 2025

ABSTRACT

Background:
Based on a chart review of 164 patients admitted to our medical–surgical unit over 2 months and who underwent peripheral intravenous (PIV) cannula insertion, difficult intravenous access (DIVA) was found in 35% (57) of patients. Similarly, the first-attempt PIV cannula insertion failure rate was 43% (70 of 164 patients) when nurses used the traditional landmark method of visual inspection and palpation in patients with DIVA.

Purpose:
The purpose of this evidence-based quality improvement (QI) project was to determine if the use of ultrasound-guided peripheral intravenous (USGPIV) cannulation would impact the rate of first-attempt PIV access among acute care adult patients with DIVA in the medical–surgical unit of an urban level 1 trauma center.

Methods:
The timeline for this pilot project was 8 weeks (May 25, 2023, to July 20, 2023). The DIVA Clinical Predictor Tool was used to identify patients at risk for DIVA. Nurses used USGPIV cannulation on eligible patients. Data on first-attempt PIV access were collected from the electronic health record.

Results:
A total of 46 patients (14 in the comparison group and 32 in the implementation group) participated in the project. Results showed a statistically significant improvement in first-attempt success rates from 64.3% (9 out of 14 participants) in the comparison group to 87.5% (28 out of 32 participants) in the implementation group; χ2 (1 df) = 3.34, P = 0.048. This represents a 23.2% improvement in the first-attempt success rate.

Conclusion:
Based on these results, USGPIV cannulation improves the likelihood of first-attempt insertion success in patients with DIVA.
Tranexamic Acid and Heterotopic Ossification Formation Following Elbow Surgery: A Prospective Randomized Controlled Trial
Authors: Avisar Erez , Essa Ahmad , Paul Ryan , Kachko Eric , Rabau Oded , Mattan Rom , Persitz Jonathan 
Published: January 2025

Objectives:
This study investigates whether the intra-operative administration of intravenous tranexamic acid (TXA), known for its hemostatic and potential anti-inflammatory properties, affects the incidence of heterotopic ossification (HO) following surgery for elbow fracture-dislocations.

Methods:

Design: Prospective, randomized clinical trial.

Setting:
Hand and Upper Extremity Surgery Unit.

Patient Selection Criteria:
Patients aged 18 to 75 years with acute traumatic elbow fracture-dislocations requiring surgical management from June 1, 2016, to October 31, 2022, were eligible. Inclusion criteria included traumatic non-pathological elbow fracture-dislocations. Patients were randomized 1:1 to receive either intraoperative TXA or no additional treatment.

Outcome Measures and Comparisons:
The primary outcome was the occurrence of heterotopic ossification (HO), defined by new bone formation observed in radiographic exams during postoperative follow-ups. Secondary outcomes included the presence of clinically relevant HO, reoperation rate due to symptomatic HO, and time to HO reoperation. Compared were patients who received TXA with controls.
Clinicopathologic Characteristics of 40 Cases of Juvenile Conjunctival Nevus
Authors: Zhao Ying , Shi Wangpan , Tie Yateng , Li Xiaorong , Wang Huifang , Ren Dong , Cai Fengmei 
Published: January 2025

Aims:
Limited studies have been conducted on juvenile conjunctival nevus (JCN) in Asian populations. This study aims to investigate the clinical and pathologic characteristics of JCN cases among the Han ethnicity in northwest China, providing insights for pathologists and ophthalmologists in diagnosing this condition.

Methods:
A subset of conjunctival nevi in children and adolescents, characterized by a confluent growth pattern and lack of maturation, was identified and defined as JCN. A retrospective analysis of the clinicopathologic features of these cases was performed.

Results:
The study included 40 patients aged 3–20 years, with a median age of 15.5 years. Six cases involved congenital conjunctival pigmentation. Twenty-four were male patients and 16 were female patients, with a male-to-female ratio of 1.5:1. Microscopically, nevus cells grew confluently within or beneath the epidermis and exhibited moderate cellular atypia. In some cases, the junction of the epithelium and the lamina propria layer was obscured by the integration of nevus cell clusters, mimicking epithelial invasion and potentially leading to a misdiagnosis. Over an average follow-up of 78.5 months, no recurrence or postoperative complications were observed.

Conclusions:
Diagnosing JCN is challenging because of its histologic resemblance to conjunctival melanoma. A systematic analysis of JCN can improve the recognition of its benign nature by pathologists and ophthalmologists, helping to prevent overdiagnosis of conjunctival malignant melanoma in this young population.
Impact of Fluorescence-guided Surgery on splenic preservation: a case of splenic hydatidosis
Authors: Nalawade Kshitija , Bhukebag Prasad , Supe Avinash , Patankar Roy 
Published: January 2025

Abstract
Ecchinococcus granulosus is a parasitic species associated with hydatid disease or Ecchinococcosis. The disease manifests in the form of cysts deposited in various parts of the body. These hydatid cysts are primarily seen in the liver and lungs. The life cycle of this parasite primarily involves dogs as the definitive hosts, whereas sheep and other livestock often serve as intermediate hosts. Humans may end up becoming accidental hosts from infestation occurring due to ingestion of viable cysts. Hydatid disease continues to be a common health problem in many countries. While this condition predominantly affects the liver (50 – 70 %) and lungs (15-30%), spleen is the third most affected organ. Splenic hydatid cyst is a rare parasitic infestation caused by the larval stage (proctoscolex) of the Ecchinococcus tapeworm with an incidence rate of 2 to 5%.
We present a case of a 60-year-old female, who was diagnosed with a large splenic hydatid cyst and was successfully treated using fluorescence-guided laparoscopic surgery. The patient had an uneventful postoperative course. This case highlights the utility of fluorescence-guided surgery in splenic preservation.
Personalized Dosing of Linezolid to Reduce the Risk of Thrombocytopenia: A Systematic Review and Meta-Analysis
Authors: Oda Kazutaka , Tsuruta Takeru , Hanai Yuki , Yamada Tomoyuki , Komatsu Toshiaki , Kondo Shoji , Jono Hirofumi , Saito Hideyuki 
Published: January 2025

Background:
Linezolid-induced thrombocytopenia (LIT) occurs in a dose-dependent manner. There is no consensus regarding personalized dosing of linezolid in the real world. This study investigated the usefulness of personalized dosing for the potential mitigation of LIT compared with standard dosing.

Methods:
A systematic review and meta-analysis were performed using 4 medical electronic databases. Inclusion criteria were original research articles published up to October 23, 2023, whereas nonoriginal articles were excluded. Eligible participants included adults who were administered linezolid. A random-effects model was used to synthesize the results.

Results:
Four studies were eligible for inclusion. There were 208 patients in the personalized dosing (intervention) group and 195 patients in the standard dosing (comparison) group. The odds ratio for the intervention was 0.648 (95% confidence interval: 0.150–2.797), although significant heterogeneity was observed (I
2 = 83.3%). An ad hoc analysis was performed by excluding one study with a significant bias risk in the treatment duration. The odds ratio for the intervention in the ad hoc analysis was 0.356 (95% confidence interval: 0.179–0.708) with little heterogeneity, showing a lower incidence risk of LIT.

Conclusions:
Personalized dosing in linezolid therapy may mitigate the risk of LIT.
Presenteeism caused by health conditions and its economic impacts among Japanese workers in the post-COVID-19 era
Authors: Yoshimoto Takahiko , Matsudaira Ko , Oka Hiroyuki , Kasahara Satoshi , Kokaze Akatsuki , Inoue Shinsuke 
Published: January 2025

Abstract

Objectives
This study investigated the common health conditions leading to presenteeism and the economic impact among Japanese workers in the post-COVID-19 era.

Methods
Between February and March 2023, 10,000 workers responded to a web-based, cross-sectional survey on health problems that interfered with their work, degree of presenteeism, and teleworking status.

Results
Approximately 35.6% of workers faced health problems that impacted their work. The primary health problems leading to presenteeism were low back pain, neck pain/stiff shoulders, and mental illness, which varied slightly with age and work style. The estimated annual costs due to presenteeism per 1000 employees were $488,210 for low back pain, $346,308 for neck pain/stiff shoulders, and $327,137 for mental illness.

Conclusions
Our findings suggest that presenteeism measures, primarily for musculoskeletal pain and mental health problems, are required to increase work productivity.
Antibody–drug conjugates in urothelial carcinoma: current status and future
Authors: Ruder Samuel , Martinez Juana , Palmer Jessica , Arham Abdul Baseet , Tagawa Scott T. 
Published: January 2025

Purpose of review
Antibody–drug conjugates (ADCs) are quickly becoming frontline standard of care in many tumor types, including urothelial carcinoma. This review summarizes recent clinical investigations into the use of ADCs targeting nectin-4, trophoblast cell surface antigen-2 (Trop-2), human epidermal growth factor receptor 2 (HER-2), and other antigens in urothelial carcinoma.

Recent findings
This review covers efficacy and toxicity data of ADCs alone and in combination with immunotherapy; mechanisms of resistance; and preclinical studies that provide biological basis for clinical approaches.

Summary
Enfortumab vedotin and sacituzumab govitecan can be used in an unselected group of patients with urothelial carcinoma whereas HER-2 ADCs have only been administered in those with high expression or amplification. Most are being studied in combination with immune checkpoint inhibitors. Data supports use of enfortumab vedotin in combination with pembrolizumab as first-line therapy in metastatic/unresectable locally advanced urothelial carcinoma. Sacituzumab govitecan may be used as later-line option in these patients. HER-2 therapy is still under investigation but has many recent promising results.
Brachial Plexus Schwannoma
Authors: Alghamdi Abdulaziz M. , Alqazenli Mohamed K. , Alghamdi Arwa , Aletani Tala , Faidah Dania E. , Alkulli Osama A. , Allarakia Yousof F. , Fathi Abdulaziz B. , Fadel Zahir T. 
Published: January 2025

Introduction
Although primary tumors of the brachial plexus (BP) are rare, schwannomas are the most frequently encountered type. This study evaluated the clinicopathological presentation, surgical outcomes, and prognosis of patients with BP schwannomas.

Methods
A systematic review was conducted using PubMed/MEDLINE, Embase, and Cochrane on the 25th of March 2024. All English human studies that reported surgically managed BP schwannomas were included.

Results
This review included 341 patients from 82 studies, with a mean age of 41.49 years and a female majority (55.72%). The most common clinical presentation was swelling, observed in 245 patients (71.85%). Surgical intervention was performed in all cases, with gross total resection (86.80%) being the most common approach. Surgical complications included new motor deficits in 41 (12.02%), sensory deficits in 33 (9.68%), and new-onset pain in 6 cases (1.76%). Prognostic information was available for all the 280 patients. At the last follow-up, only a small number of patients showed no postoperative improvement. Of the 164 patients initially presenting with pain, 3 (1.83%) reported persistent symptoms. In addition, continued sensory deficits were noted in 13 (8.67%) of the 150 cases, and continued motor deficits in 4 (9.30%) of the 43 cases. Furthermore, 14 (19.71%) of 71 postoperative new-onset symptoms persisted at the last follow-up. One (16.67%) of the 6 patients experienced constant pain. Additionally, sensory deficits persisted in 8 (28.57%) of the 28 patients, and motor deficits persisted in 5 (13.51%) of the 37 patients. No local recurrence has been reported.

Conclusions
This systematic review highlights the complexity of BP schwannoma. Despite the occurrence of postoperative complications, the overall prognosis remains favorable with minimal rates of persistent preoperative symptoms and permanent surgical complications. Accurate diagnosis and effective surgical management are necessary to improve the outcomes of patients with this rare, yet clinically significant condition.
Informing ICU Digital Twins: Dynamic Assessment of Cardiorespiratory Failure Trajectories in Patients with Sepsis
Authors: Hou Grace Yao , Lal Amos , Schulte Phillip J. , Dong Yue , Kilickaya Oguz , Gajic Ognjen , Zhong Xiang 
Published: January 2025

Abstract
Understanding clinical trajectories of sepsis patients is crucial for prognostication, resource planning, and to inform digital twin models of critical illness. This study aims to identify common clinical trajectories based on dynamic assessment of cardiorespiratory support using a validated electronic health record data that covers retrospective cohort of 19,177 patients with sepsis admitted to ICUs of Mayo Clinic Hospitals over eight-year period. Patient trajectories were modeled from ICU admission up to 14 days using an unsupervised machine learning two-stage clustering method based on cardiorespiratory support in ICU and hospital discharge status. Of 19,177 patients, 42% were female with a median age of 65 (IQR, 55-76) years, APACHE III score of 70 (IQR, 56-87), hospital length of stay (LOS) of 7 (IQR, 4-12) days, and ICU LOS of 2 (IQR, 1-4) days. Four distinct trajectories were identified: fast recovery (27% with a mortality rate of 3.5% and median hospital LOS of 3 (IQR, 2-15) days), slow recovery (62% with a mortality rate of 3.6% and hospital LOS of 8 (IQR, 6-13) days), fast decline (4% with a mortality rate of 99.7% and hospital LOS of 1 (IQR, 0-1) day), and delayed decline (7% with a mortality rate of 97.9% and hospital LOS of 5 (IQR, 3-8) days). Distinct trajectories remained robust and were distinguished by Charlston comorbidity index, Apache III scores, day 1 and day 3 SOFA (p < 0.001 ANOVA). These findings provide a foundation for developing prediction models and digital twin decision support tools, improving both shared decision-making and resource planning.
The interaction between antithrombin and endothelial heparan sulfate mitigates pulmonary thromboinflammation after trauma and hemorrhagic shock
Authors: del Pilar Huby Vidaurre Maria , Mokhtari Ava K. , Osborn Baron K. , Cotton Bryan A. , Wang Yao-Wei , Xu Yongmei , Arnold Katelyn , Liu Jian , Richter Jillian R. , Cardenas Jessica C. 
Published: January 2025

Abstract

Introduction
Trauma and hemorrhagic shock (T/HS) are associated with multiple organ injury. Antithrombin (AT) has anti-inflammatory and organ protective activity through its interaction with endothelial heparan sulfate containing a 3-O-sulfate modification. Our objective was to examine the effects of T/HS on 3-O-sulfated (3-OS) heparan sulfate expression and determine whether AT-heparan sulfate interactions are necessary for its anti-inflammatory properties.

Methods
Male Sprague Dawley rats underwent laparotomy, gut distension and fixed-pressure hemorrhagic shock (HS) and resuscitation. Liquid chromatography-coupled mass spectrometry analyses were performed to measure pulmonary and plasma heparan sulfate di/tetrasaccharides. Pulmonary mRNA levels were assessed by nCounter panel. Rats were treated with vehicle or surfen (1 mg/kg), a small molecule heparan sulfate antagonist, to block the interaction between AT and endothelial cells prior to T/HS and resuscitated with fresh frozen plasma (FFP), lactated Ringer’s (LR), or AT-supplemented LR. Lung injury was assessed histologically for injury and fibrin deposition and immunostained for myeloperoxidase (MPO). Plasma was assessed for circulating inflammatory biomarkers.

Results
T/HS significantly reduced pulmonary expression of 6-O and 3-O sulfated heparan sulfate, which was associated with reduced pulmonary 6-O- and 3-O-sulfotransferase mRNA levels. Surfen increased fibrin deposition and inflammatory cell infiltration into pulmonary tissue in T/HS rats resuscitated with FFP but had no effect in LR resuscitated rats. Although T/HS and LR resuscitation worsened histologic lung injury compared to sham, regardless of surfen treatment, lung injury was notably improved in FFP resuscitated rodents pre-treated with vehicle but not surfen. Surfen abrogated the anti-inflammatory effects of FFP, indicated by notable increases in circulating levels of multiple pro-inflammatory mediators compared to rats pre-treated with vehicle. Finally, we observed significant increases in pulmonary fibrin and MPO staining in rats pre-treated with surfen followed by resuscitation with LR supplemented with AT compared to vehicle, which was associated with notable increases in lung injury scores.

Conclusions
T/HS causes pronounced reductions in pulmonary expression of 3-OS heparan sulfate, which is essential to AT’s anti-thrombotic and anti-inflammatory activity. Blocking the interaction between AT and the endothelium attenuates the anti-thromboinflammatory and organ protective properties of FFP, suggesting that AT-endothelial anticoagulant function and anti-inflammatory signaling is important for organ protection during T/HS.
Dynamic Muscle Power Training With Elastic Bands Improve Lower Extremity Function and Balance in Older Chronic Stroke Survivors?
Authors: Gambassi Bruno Bavaresco , Lopes de Siqueira André Filipe , Prazeres Jozimar , Seguins Sotão Samir , Furtado Almeida Ana Eugênia Araújo , Bassi Dibai Daniela , Sousa Rêgo Adriana , Furtado Almeida Fabiano de Jesus , Schwingel Paulo Adriano 
Published: January 2025

The present study aims to accomplish 2 primary objectives: (1) to confirm the presence of physical function impairment among older individuals who are survivors of chronic stroke and (2) to investigate the effects of a 12-week regimen of dynamic muscle power training (DMPT) utilizing elastic bands on the physical function of lower limbs (PFLL) and dynamic balance (DB) within this population. The research sample encompassed 2 distinct groups: healthy older adults (HOAG; n = 13) and older chronic stroke survivors (OCSSG; n = 8). An evident divergence in physical function was discernible between the HOAG and OCSSG at the baseline. Furthermore, notable enhancements in both DB and PFLL were evident upon the comparison of baseline measurements with post-intervention results within the OCSSG.
Human Papillomavirus Infection and Cytological Atypia in Female Allogeneic Hematopoietic Stem Cell Transplantation Recipients
Authors: Saco Adela , Carbonell Sara , Rakislova Natalia , Matas Isabel , Alòs Silvia , Hoya Sandra , Suárez-Lledó María , Darecka Katarzyna , Sisuashvili Lia , Marimon Lorena , Vega Naiara , Esteve Roser , Martínez Carmen , Martí Cristina , Glickman Ariel , Balagué Olga , Torne Aureli , Ordi Jaume , del Pino Marta 
Published: January 2025

Background.
Female recipients of allogeneic hematopoietic stem cell transplantation are at high risk of developing human papillomavirus (HPV)-associated lesions and (pre)cancer. We describe the results of a cervical cancer screening program in these women.

Methods.
From 2010 to 2022, 70 female recipients of allogeneic hematopoietic stem cell transplantation in our institution entered a standardized protocol of gynecological evaluation. HPV testing, Papanicolaou smear, and thorough gynecological examinations were conducted in all the women.

Results.
The cumulative prevalence of HPV infection was 21.4% (15/70). Ten of 70 women (14.3%) had a positive HPV test result in the first gynecological evaluation and 5 additional women (7.1%) became positive during follow-up. Thirteen women (18.5%) presented cytohistological lesions (3 high-grade lesions and 10 low-grade lesions). Twenty-nine women (41.4%) showed HPV-negative reactive atypical abnormalities related to the conditioning treatment, which closely mimicked HPV-associated lesions, which spontaneously disappeared during follow-up.

Conclusions.
Gynecological evaluation should be maintained over time, as a significant proportion of these women may become HPV positive during follow-up. Reactive benign, atypical changes related to the treatment, which closely mimic HPV-associated lesions, are a frequent finding in these women. HPV testing is a key tool for the evaluation of these patients, as it allows for identifying women at risk and excluding cytological mimickers.
BioClocks UK: driving robust cycles of discovery to impact
Authors: Rees Hannah , Rzechorzek Nina M. , Hughes Rebecca B. , Dodd Antony N. , Hodge James J. L. , Stevenson Tyler J. , von Schantz Malcolm , Lucas Robert J. , Reece Sarah E. , Kyriacou Charalambos P. , Millar Andrew J. 
Published: January 2025

Chronobiology is a multidisciplinary field that extends across the tree of life, transcends all scales of biological organization, and has huge translational potential. For the UK to harness the opportunities presented within applied chronobiology, we need to build our network outwards to reach stakeholders that can directly benefit from our discoveries. In this article, we discuss the importance of biological rhythms to our health, society, economy and environment, with a particular focus on circadian rhythms. We subsequently introduce the vision and objectives of BioClocks UK, a newly formed research network, whose mission is to stimulate researcher interactions and sustain discovery-impact cycles between chronobiologists, wider research communities and multiple industry sectors.
This article is part of the Theo Murphy meeting issue ‘Circadian rhythms in infection and immunity’.
CLASP1/2 REGULATE IMMUNE SYNAPSE MATURATION IN NATURAL KILLER CELLS
Authors: Pariani Alejandro P. , Huhn Victoria , Maknis Tomás Rivabella , Alonso Victoria , Almada Evangelina , Vena Rodrigo , Favre Cristián , Goldenring James R. , Kaverina Irina , Larocca M. Cecilia 
Published: January 2025

ABSTRACTNatural killer (NK) cells are the first line of defense against viral infections and tumors. Their cytotoxic activity relies on the formation of an immune synapse (IS) with target cells. The lymphocyte function–associated antigen (LFA)-1 plays a central role in NK cell cytotoxicity by modulating NK-IS assembly and maturation. LFA-1 organization at the IS involves a Golgi-dependent mechanism, which has not been completely elucidated. CLIP-associating proteins (CLASP) 1/2 are microtubule plus-tip interacting proteins that control the dynamics of Golgi derived microtubules (GDMTs). In the present study, we found that CLASP1/2 depletion impaired LFA-1 organization at the IS and inhibited the polarization of the centrosome and the lytic granules towards the target cell. Our results also revealed the role of the Golgi apparatus as a microtubule organizing center (MTOC) in these cells. Furthermore, we found that, similarly to what was described in other cell types, NK cells require CLASP1/2 and AKAP350 for efficient nucleation of microtubules at the Golgi. Overall, this study uncovers the role of CLASP1/2 in the maturation of the lytic IS in NK cells, and presents evidence supporting the contribution of GDMTs in this process.Summary sentenceThe Golgi apparatus (GA) functions as a microtubule-organizing center (MTOC) in NK cells. During the recognition of tumoral cells by NK cells, CLASP1/2-mediated stabilization of GA-derived microtubules (GDMTs) facilitates vesicular LFA-1 (LFA-1v) trafficking toward the interaction surface, thereby promoting the immune synapse (IS) maturation.