bluuebunny/crossref_metadata_2025_split huggingface dataset:
IL‐21 promoting angiogenesis contributes to the development of psoriasis
Authors: Han Dan , Li Fei , Zhao Yan , Wang Bo , Wang Jingyuan , Liu Bei , Mou Kuanhou , Meng Liesu , Zheng Yan , Lu Shemin , Zhu Wenhua , Zhou Yan 
Published: December 2023

AbstractBackgroundElevated IL‐21 expression which can effectively induce Th17 cell differentiation has been implicated in the pathogenesis of psoriasis, but its role in angiogenesis remains poorly understood.MethodsPASI and PSI score assessment was applied to evaluate the severity of psoriatic lesions. The expression of IL‐21, IL‐21 receptor (IL‐21R), CD31, VEGFA, MMP‐9, and ICAM‐1 in skin was determined by immunohistochemistry or quantitative real‐time polymerase chain reaction. The serum level of IL‐21 was measured by enzyme‐linked immunosorbent assay (ELISA). Then, their correlation was analyzed statistically. Human umbilical vein endothelial cells (HUVECs) cocultured with conditional medium from normal human epidermal keratinocytes (NHEKs) were treated with IL‐21 and/or M5 cocktail (mixture of IL‐1α, IL‐17A, IL‐22, TNF‐α, and oncostatin M). The migration and tube formation of HUVECs were detected, and the levels of VEGFA, MMP‐9, and ICAM‐1 in NHEKs were measured by Western blotting or ELISA.ResultsIncreased IL‐21 and IL‐21R expression was observed in psoriatic sera or skin specimens, with IL‐21R mainly locating in keratinocytes and IL‐21 in immune cells. Pearson analysis showed significantly positive correlation between IL‐21/IL‐21R and erythema scores/microvessel density in psoriatic lesions. Moreover, the expression of proangiogenic genes, VEGFA, ICAM‐1, and MMP‐9 was upregulated in skins of psoriasis. Additionally, in M5 microenvironment, migration and tube formation could be magnified in HUVECs using IL‐21 pre‐treated NHEK medium. Mechanically, the co‐stimulation of IL‐21 and M5 to NEHKs increased the expression of ICAM‐1.ConclusionIL‐21 could regulate keratinocytes to secrete ICAM‐1, thereby promoting angiogenesis in psoriasis.
Prediction Model for Postoperative Pressure Injury in Patients with Acute Type A Aortic Dissection
Authors: Wang Qiuji , Feng Weiqi , Li Wenhui , Li Shan , Wu Qiuyi , Liu Zhichang , Li Xin , Yu Changjiang , Cheng Yunqing , Huang Huanlei , Fan Ruixin 
Published: December 2023

ABSTRACT

OBJECTIVE
To establish a risk assessment model to predict postoperative National Pressure Injury Advisory Panel stage 2 or higher pressure injury (PI) risk in patients undergoing acute type A aortic dissection surgery.

METHODS
This retrospective assessment included consecutive patients undergoing acute type A aortic dissection surgery in the authors’ hospital from September 2017 to June 2021. The authors used LASSO (logistic least absolute shrinkage and selection operator) regression analysis to identify the most relevant variables associated with PI by running cyclic coordinate descent with 10-times cross-validation. The variables selected by LASSO regression analysis were subjected to multivariate logistic analysis. A calibration plot, receiver operating characteristic curve, and decision curve analysis were used to validate the model.

RESULTS
There were 469 patients in the study, including 94 (27.5%) with postoperative PI. Ten variables were selected from LASSO regression: body mass index, diabetes, Marfan syndrome, stroke, preoperative skin moisture, hemoglobin, albumin, serum creatinine, platelet, and d-dimer. Four risk factors emerged after multivariate logistic regression: Marfan syndrome, preoperative skin moisture, albumin, and serum creatinine. The area under the receiver operating characteristic curve of the model was 0.765. The calibration plot and the decision curve analysis both suggested that the model was suitable for predicting postoperative PI.

CONCLUSIONS
This study built an efficient predictive model that could help identify high-risk patients.
Exploring the Association between Hemochromatosis and Lower-Limb Venous Disease
Authors: Parker Christina N. , Finlayson Kathleen J. , Hall Emma J. , Pitman Natasha , Chu Wing Kei , Wallace Daniel F. 
Published: December 2023

ABSTRACT

OBJECTIVE
Chronic venous disease is a circulatory system dysfunction that has the potential to lead to venous leg ulceration. Although research on the influence of specific gene variants on chronic venous disease has been limited, a few studies have reported an association between hemochromatosis and chronic venous disease. However, no studies have looked at the prevalence of lower-limb venous disease and leg ulcers in people with hemochromatosis. This study aimed to review the existing literature for any association between venous disease and hemochromatosis and investigate the prevalence of venous disease and leg ulcers in people with hemochromatosis.

METHODS
Scoping systematic literature review and cross-sectional study surveying people with hemochromatosis.

RESULTS
This scoping systematic literature review included nine articles and indicated a link between hemochromatosis and venous disease/leg ulcers, although further studies are needed to support this link. Analysis of survey results from people with hemochromatosis found a 9.2% prevalence of leg ulcers in those with self-reported hemochromatosis, considerably higher than the 1% to 3% expected, suggesting that hemochromatosis gene variants may be associated with the pathogenesis of chronic venous disease and leg ulcers.

CONCLUSIONS
This is the first known study to complete a review of the literature regarding hemochromatosis and venous leg ulcers and document the association between hemochromatosis and venous disease/leg ulcers. There is a lack of research in this area and hence limited evidence to guide practice.
Psychometric Testing of the Newborn Skin Assessment Attitude Scale in Neonatal ICU Nurses
Authors: Coşkun Adnan Batuhan , Çiğdem Zerrin , Ortabağ Tülay , Bayramlar Kezban 
Published: December 2023

ABSTRACT

OBJECTIVE
To develop a Newborn Skin Assessment Attitude Scale (NSAAS) for neonatal ICU (NICU) RNs.

METHODS
The study was conducted with 326 nurses working in NICUs in three cities in Turkey. The researchers evaluated the content and construct validity and reliability of the scale with item-total score correlation analysis, the test-retest method, and calculating the Cronbach α reliability coefficient.

RESULTS
The content validity index of the scale ranged between 0.87 and 1.00. Prior to exploratory factor analysis and confirmatory factor analysis, the Kaiser-Meyer-Olkin coefficient of the NSAAS was 0.976, and the Bartlett test of sphericity result was χ
2 = 15,337.052 (P < .001). The scale was constructed with 35 items with factor loads greater than 0.40 and three subdimensions. Confirmatory factor analysis showed that the fit indices of the NSAAS were χ
2/df = 3.57, root mean square error of approximation = 0.08, normed fit index = 0.98, non-normed fit index = 0.98, comparative fit index = 0.98, and standardized root mean square residual = 0.05. The overall reliability coefficient of the NSAAS was α = .978. The test-retest coefficients of correlation were r = 0.558 for the overall scale and r = 0.615, r = 0.504, and r = 0.598 for the Awareness, Practice, and Avoidance subdimensions, respectively. In addition, no statistically significant difference was observed when comparing the test-retest mean scores for the total scale and the subdimensions (P > .05).

CONCLUSIONS
The NSAAS can be reliably used for measuring NICU nurses’ attitudes toward newborn skin assessment.
Worse Quality of Life Associated with Hyperextension Varus Tibial Plateau Fracture Pattern
Authors: O’Neill Dillon C. , Sato Eleanor H. , Steffenson Lillia N. , Myhre Luke A. , Higgins Thomas F. , Rothberg David L. , Haller Justin M. , Marchand Lucas S. 
Published: December 2023

OBJECTIVES:
Compare patient reported outcome measures (PROMs) between hyperextension varus tibial plateau (HEVTP) fractures to non-HEVTP fracture patterns

METHODS:

Design:
Retrospective

Setting:
Single academic Level 1 Trauma Center

Patient Selection Criteria:
All patients who underwent fixation of a tibial plateau fracture from 2016-2021 were collected. Exclusion criteria included: inaccurate CPT code, ipsilateral compartment syndrome, bilateral fractures, incomplete medical records, or follow-up less than 10 months.
Outcome Measures and Comparisons: In patients who underwent fixation of a tibial plateau fracture, compare Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), PROMIS Preference (PROPr), and Knee Injury and Osteoarthritis Outcome Score (KOOS) between patients with a HEVTP pattern to those without.

RESULTS:
Two-hundred and seven patients were included, of which 17 (8%) had HEVTP fractures. Compared to non-HEVTP fracture patterns, patients with HEVTP injuries were younger (42.6 vs 51.0, p=0.025), more commonly male (71% vs 44%, p=0.033), and had higher body mass index (32.8 vs 28.0, p=0.05). HEVTP fractures had significantly more ligamentous knee (29% vs 6%, p=0.007) and vascular (12% vs 1%, p=0.035) injuries. PROMIS-PF scores were similar between groups, however, PROMIS-Preference (0.37 vs 0.51, p=0.017) was significantly lower in HEVTP fractures. KOOS pain, activities of daily living, and quality-of-life scores were statistically lower in HEVTP fractures, but only KOOS quality-of-life was clinically relevant (41.7 vs 59.3, p=0.004).

CONCLUSION:
The HEVTP fracture pattern, whether unicondylar or bicondylar, was associated with a higher rate of ligamentous and vascular injuries compared to non-HEVTP fracture patterns. They were also associated with worse health-related quality of life at mid-term follow-up.
Childcare Disruptions and Parental Stress During the COVID-19 Pandemic
Authors: Xu Chuyun , Purdue Eliza Loren , Sege Robert , Sweigart Benjamin , Burstein Dina 
Published: December 2023

ABSTRACT:

Objective:
Families in the United States experienced tremendous disruptions during the COVID-19 pandemic. This study evaluated the relationship of parental stress during the pandemic with interruptions in availability of services (childcare, after-school activities, and medical appointments) for children.

Methods:
We analyzed data from 2 waves of the Measuring the Impact of Violence Against Children and Women During a Pandemic survey
1
to develop a multivariable logistic regression model of the association between caregivers' stress and pandemic-related disruptions in children's lives. Caregivers' past experiences of childhood abuse, recommended stress-relieving activities, and responses to the statement “helping my child(ren) with their education, including remote schoolwork, has been very stressful and/or has resulted in increased tension at home” were included as covariates. Demographic and socioeconomic variables were examined as potential confounders.

Results:
In total, 3479 (73.3%) of 4659 respondents reported feeling stressed since the start of the pandemic. For every one-item increase in the number of COVID disruptions in children's lives, the odds of feeling stressed increased by 20% (OR 1.20: p value < 0.0001, 95% confidence interval [CI], 1.14–1.27). Compared with men, women had 60% higher odds of feeling stressed (odds ratio [OR] 1.60: p value < 0.0001, 95% CI, 1.32–1.93). The covariates listed earlier were all statistically significant.

Conclusion:
Pandemic-related disruptions in children's lives were significantly associated with caregiver stress. Women were more likely to feel stressed than men. Sex, education, marital status, and family income were also associated with parental stress. These results suggest that childcare continuity and parental support should be part of disaster planning.
Levosimendan Relaxes Thoracic Aortic Smooth Muscle in Mice by Inhibiting PKC and Activating Inwardly Rectifying Potassium Channels
Authors: Yang Cai-hong , Qiu Hui-qin , Wang Chan , Tang Ya-ting , Zhang Cheng-rui , Fan Yan-ying , Jiao Xiang-ying 
Published: December 2023

Abstract:
Studies have examined the therapeutic effect of levosimendan on cardiovascular diseases such as heart failure, perioperative cardiac surgery, and septic shock, but the specific mechanism in mice remains largely unknown. This study aimed to investigate the relaxation mechanism of levosimendan in the thoracic aorta smooth muscle of mice. Levosimendan-induced relaxation of isolated thoracic aortic rings that were precontracted with norepinephrine or KCl was recorded in an endothelium-independent manner. Vasodilatation by levosimendan was not associated with the production of the endothelial relaxation factors nitric oxide and prostaglandins. The voltage-dependent K+ channel (KV) blocker (4-aminopyridine) and selective KCa blocker (tetraethylammonium) had no effect on thoracic aortas treated with levosimendan, indicating that KV and KCa channels may not be involved in the levosimendan-induced relaxation mechanism. Although the inwardly rectifying K+ channel (Kir) blocker (barium chloride) and the KATP channel blocker (glibenclamide) significantly inhibited levosimendan-induced vasodilation in the isolated thoracic aorta, barium chloride had a much stronger inhibitory effect on levosimendan-induced vasodilation than glibenclamide, suggesting that levosimendan-induced vasodilation may be mediated by Kir channels. The vasodilation effect and expression of Kir 2.1 induced by levosimendan were further enhanced by the PKC inhibitor staurosporine. Extracellular calcium influx was inhibited by levosimendan without affecting intracellular Ca2+ levels in the isolated thoracic aorta. These results suggest that Kir channels play a more important role than KATP channels in regulating vascular tone in larger arteries and that the activity of the Kir channel is enhanced by the PKC pathway.
Considerations & challenges of mitral valve repair in females: diagnosis, pathology, and intervention
Authors: Deng Mimi Xiaoming , Barodi Batol , Elbatarny Malak , Yau Terrence M. 
Published: December 2023

Purpose of review
Disparities in mitral valve (MV) repair outcomes exist between men and women. This review highlights sex-specific differences in MV disease aetiology, diagnosis, as well as timing and type of intervention.

Recent findings
Females present with more complicated disease: anterior or bileaflet prolapse, leaflet dysplasia/thickening, mitral annular calcification, and mixed mitral lesions. The absence of indexed echocardiographic mitral regurgitation (MR) severity parameters contributes to delayed intervention in women, resulting in more severe symptom burden at time of surgery. The sequelae of chronic MR also necessitate concomitant procedures (e.g. tricuspid repair, arrhythmia surgery) at the time of mitral surgery. Complex MV pathology, greater patient acuity, and more complicated procedures collectively pose challenges to successful MV repair and postoperative recovery. As a consequence, women receive disproportionately more MV replacement than men. In-hospital mortality after MV repair is also greater in women than men. Long-term outcomes of MV repair are comparable after risk-adjustment for preoperative status; however, women experience a greater incidence of postoperative heart failure.

Summary
To address the inequity in MV repair outcomes between sexes, indexed diagnostic measurements, diligent surveillance of asymptomatic MR, increased recruitment of women in large clinical trials, and mandatory reporting of sex-based subgroup analyses are recommended.
Entrectinib-induced tubulointerstitial nephritis: a case report
Authors: Stempler Márk , Dobi Deján , Ledó Nóra 
Published: December 2023

Introduction and importance:
Entrectinib has been approved and increasingly administered for the treatment of non-small cell lung cancer, especially with intracranial metastasis. Although previous clinical studies have confirmed its safety, disproportionality analysis showed unusually high potential adverse renal effects.

Case presentation:
We present a case of a 71-year-old woman with pulmonary adenocarcinoma who developed severe renal function impairment during the treatment with entrectinib. Urinary sediment examination revealed leukocyte casts, while urinary culture was negative, suggesting the presence of possible tubulointerstitial nephritis (TIN). A kidney biopsy was performed, and the diagnosis of TIN was confirmed. The administration of oral methylprednisolone improved renal function.

Clinical discussion:
Protein kinase inhibitors might lead to renal function impairment in several different ways. It is of utmost importance to differentiate between the underlying pathomechanism, which is often challenging. TIN is a potentially reversible condition when treated appropriately.

Conclusion:
In the case of renal function impairment during entrectinib therapy, the possibility of TIN should be considered, and a kidney biopsy should be performed since corticosteroid therapy might improve renal function.
Radiation oncology for the rhinologist
Authors: Levyn Helena , Yang Fan , Lee Nancy Y. 
Published: December 2023

Purpose of review
This comprehensive review explores evolving treatment strategies for sinonasal and nasopharyngeal malignancies. It analyzes the role of adjuvant radiotherapy, the potential of intensity-modulated proton therapy (IMPT), and the relevance of de-escalation strategies nasopharyngeal carcinoma (NPC). Additionally, it discusses hyperfractionation in re-irradiation in NPC.

Recent findings
Adjuvant radiotherapy remains pivotal for sinonasal tumors, improving locoregional control and survival, notably in squamous cell carcinomas, adenocarcinomas, and adenoid cystic carcinomas. IMPT promises enhanced outcomes by sparing healthy tissues, potentially improving patients’ quality of life. For select stage II/T3N0 NPC, radiotherapy alone offers comparable outcomes to concurrent chemoradiotherapy, with fewer adverse events and improved quality of life. Selective neck irradiation in NPC patients with uninvolved necks maintains oncologic outcomes while reducing late toxicity. Hyperfractionation in re-irradiation shows promise in lowering late toxicities and improving overall survival, particularly in undifferentiated sinonasal carcinomas.

Summary
This review underscores the significance of adjuvant radiotherapy and the potential of advanced radiation techniques in optimizing sinonasal and nasopharyngeal malignancy outcomes. It emphasizes evolving de-escalation methods and individualized, evidence-based approaches. Future research will further refine strategies for these challenging malignancies.
Machine learning in the evaluation of voice and swallowing in the head and neck cancer patient
Authors: Srinivasan Yashes , Liu Amy , Rameau Anaïs 
Published: December 2023

Purpose of review
The purpose of this review is to present recent advances and limitations in machine learning applied to the evaluation of speech, voice, and swallowing in head and neck cancer.

Recent findings
Novel machine learning models incorporating diverse data modalities with improved discriminatory capabilities have been developed for predicting toxicities following head and neck cancer therapy, including dysphagia, dysphonia, xerostomia, and weight loss as well as guiding treatment planning. Machine learning has been applied to the care of posttreatment voice and swallowing dysfunction by offering objective and standardized assessments and aiding innovative technologies for functional restoration. Voice and speech are also being utilized in machine learning algorithms to screen laryngeal cancer.

Summary
Machine learning has the potential to help optimize, assess, predict, and rehabilitate voice and swallowing function in head and neck cancer patients as well as aid in cancer screening. However, existing studies are limited by the lack of sufficient external validation and generalizability, insufficient transparency and reproducibility, and no clear superior predictive modeling strategies. Algorithms and applications will need to be trained on large multiinstitutional data sets, incorporate sociodemographic data to reduce bias, and achieve validation through clinical trials for optimal performance and utility.
Host-related indexes in head and neck cancer
Authors: Valero Cristina , León Xavier , Quer Miquel 
Published: December 2023

Purpose of review
Peripheral blood host-related indexes have been widely studied in cancer patients. Several authors have shown the prognostic capacity of these indexes in head and neck cancer. Therefore, there has been an increasing interest in this topic recently.

Recent findings
The main variables analyzed and used to create these host-related indexes are peripheral blood leukocytes – including neutrophils, monocytes and lymphocytes – albumin and hemoglobin levels. Other factors with proven prognostic capacity in some studies are: platelets, C-reactive protein, and BMI. Among all the combined indexes, the neutrophil-to-lymphocyte ratio has been the most accepted and used worldwide. Nonetheless, there are other indexes which group multiple of these factors that have shown better prognostic capacity, and are promising in the near future.

Summary
Host-related indexes are ideal biomarkers to be used on our daily-basis. There is enough evidence to start considering them when assessing patients with head and neck cancer.
Health System and University Leader Learning Collaboratives
Authors: Kapu April 
Published: December 2023

ABSTRACT
This month's column proposes advanced practice nurse (APN), health system, and university leader roundtable discussions to understand and address global healthcare challenges and the evolving role of the APN. Forming international learning collaboratives focused on gaining a comprehensive understanding of the use of APNs and related education, regulatory frameworks, and models for practice can lead to greater utilization and impact to global healthcare. The “PEPPA” framework is discussed as 1 tool to enhance discussion in these collaboratives.
Estimated Costs of Drug-Related Problems Prevented by Pharmacist Prescription Reviews Among Hospitalized Internal Medicine Patients
Authors: Zheng Xiaoying , Shan Xuefeng , Liu Weichu , Gao Diansa , Jiang Huiming , Xue Lifen , Hu Lei , Qiu Feng 
Published: December 2023

Background and Objectives:
Data are lacking on the estimated costs of pharmacist prescription reviews (PPRs) for hospitalized internal medicine patients. This study investigates the estimated costs of drug-related problems (DRPs) prevented by PPRs among hospitalized internal medicine patients.

Methods:
We reviewed all medication orders for patients at an academic teaching hospital in China for 2 years. DRPs were categorized using the Pharmaceutical Care Network Europe classification. The severity of the potential harm of DRPs was assessed by the Harm Associated with Medication Error Classification (HAMEC) tool. The estimated cost of PPRs was calculated.

Results:
A total of 162426 medication orders for 4314 patients were reviewed, and 1338 DRPs were identified by pharmacists who spent 2230 hours performing PPRs. Among the 1080 DRPs that were prospectively intervened upon, 703 were resolved. The HAMEC tool showed that 47.1% of DRPs were assessed as level 2, 30.4% as level 3, 20.6% as level 1, and 0.6% carried a life-threatening risk. Pharmacist interventions contributed to the prevention of DRP errors and a reduction of $339 139.44. This resulted in a mean cost saving of $482.42 per patient at an input cost of $21 495.06 over the 2 years. The benefit-cost ratio was 15.8.

Conclusion:
PPRs are beneficial for detecting potential DRPs and creating potential cost savings among hospitalized internal medicine patients.