bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma levels of autophagy regulator Rubicon are inversely associated with acute coronary syndrome
Authors: Grazide Marie-Hélène , Ruidavets Jean-Bernard , Martinet Wim , Elbaz Meyer , Vindis Cécile 
Published: January 2024

BackgroundThe discovery of novel biomarkers that improve current cardiovascular risk prediction models of acute coronary syndrome (ACS) is needed for the identification of very high-risk patients and therapeutic decision-making. Autophagy is a highly conserved catabolic mechanism for intracellular degradation of cellular components through lysosomes. The autophagy process helps maintain cardiac homeostasis and dysregulated autophagy has been described in cardiovascular conditions. Rubicon (Run domain Beclin-1-interacting and cysteine-rich domain-containing protein) is a key regulator of autophagy with a potential role in cardiac stress.ObjectivesThe aims of the present study were to assess whether changes in circulating Rubicon levels are associated with ACS and to evaluate the added value of Rubicon to a clinical predictive risk model.Methods and resultsThe study population included ACS patients (n = 100) and control subjects (n = 99) at high to very high cardiovascular risk but without known coronary event. Plasma Rubicon levels were measured in the whole study population by enzyme-linked immunosorbent assay. Multivariate logistic regression analyses established that Rubicon levels were inversely associated with ACS. A receiver operating characteristic curve analysis demonstrated that the addition of Rubicon improved the predictive performance of the model with an increased area under the curve from 0.868 to 0.896 (p = 0.038).ConclusionsPlasma levels of the autophagy regulator Rubicon are associated with ACS and provide added value to classical risk markers for ACS.
A Bayesian network-based approach for identifying risk factors and predicting ischemic stroke in infective endocarditis patients
Authors: Yuan Boyi , Wang Chaobin , Fan Zexin , Liu Chun , Fang Libo , Ma Lin , Zou Wenlong , Yuan Guobin , Liu Guangzhi 
Published: January 2024

ObjectiveThis study aimed to seek the risk factors and develop a predictive model for ischemic stroke (IS) in patients with infective endocarditis (IE) utilizing a Bayesian network (BN) approach.MethodsData were obtained from the electronic medical records of all adult patients at three hospitals between 1 January 2018, and 31 December 2022. Two predictive models, logistic regression and BN, were used. Patients were randomly assigned to the training and test sets in a 7:3 ratio. We established a BN model with the training dataset and validated it with the testing dataset. The Bayesian network model was built by using the Tabu search algorithm. The areas under the receiver operating characteristic curve (AUCs), calibration curve, and decision curve were used to evaluate the prediction performance between the BN and logistic models.ResultsA total of 542 patients [mean (SD) age, 49.6 (15.3) years; 137 (25.3%) female] were enrolled, including 151 (27.9%) with IS and 391 (72.1%) without IS. Hyperlipidemia, hypertension, age, vegetation size (&gt;10 mm), S. aureus infection, and early prosthetic valve IE were closely correlated with IS. The BN models outperformed the logistic regression in training and testing sets, with accuracies of 76.06% and 74.1%, AUC of 0.744 and 0.703, sensitivities of 25.93% and 20.93%, and specificities of 96.27% and 90.24%, respectively.ConclusionThe BN model is more efficient than the logistic regression model. Therefore, BN models may be suitable for the early diagnosis and prevention of IS in IE patients.
Impact of clinical variables on outcomes in refractory cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation
Authors: Demers Simon-Pierre , Cournoyer Alexis , Dagher Olina , Noly Pierre-Emmanuel , Ducharme Anique , Ly Hung , Albert Martin , Serri Karim , Cavayas Yiorgos Alexandros , Ben Ali Walid , Lamarche Yoan 
Published: January 2024

BackgroundIn the past two decades, extracorporeal resuscitation (ECPR) has been increasingly used in the management of refractory cardiac arrest (CA) patients. Decision algorithms have been used to guide the care such patients, but the effectiveness of such decision-making tools is not well described. The aim of this study was to compare the rate of survival with a good neurologic outcome of patients treated with ECPR meeting all criteria of a clinical decision-making tool for the initiation of ECPR to those for whom ECPR was implemented outside of the algorithm.MethodsAll patients who underwent E-CPR between January 2014 and December 2021 at the Montreal Heart Institute were included in this retrospective analysis. We dichotomized the cohort according to adherence or non-adherence with the ECPR decision-making tool, which included the following criteria: age ≤65 years, initial shockable rhythm, no-flow time &lt;5 min, serum lactate &lt;13 mmol/L. Patients were included in the “IN” group when they met all criteria of the decision-making tool and in the “OUT” group when at least one criterion was not met.Main outcomes and measuresThe primary outcome was survival with intact neurological status at 30 days, defined by a Cerebral Performance Category (CPC) Scale 1 and 2.ResultsA total of 41 patients (IN group, n = 11; OUT group, n = 30) were included. A total of 4 (36%) patients met the primary outcome in the IN group and 7 (23%) in the OUT group [odds ratio (OR): 1.88 (95% CI, 0.42–8.34); P = 0.45]. However, survival with a favorable outcome decreased steadily with 2 or more deviations from the decision-making tool [2 deviations: 1 (11%); 3 deviations: 0 (0%)].Conclusion and relevanceMost patients supported with ECPR fell outside of the criteria encompassed in a clinical decision-making tool, which highlights the challenge of optimal selection of ECPR candidates. Survival rate with a good neurologic outcome did not differ between the IN and OUT groups. However, survival with favorable outcome decreased steadily after one deviation from the decision-making tool. More studies are needed to help select proper candidates with refractory CA patients for ECPR.
Integrating EQUIP competency-based training into a university curriculum: a qualitative inquiry with students and faculty at Makerere University in Uganda
Authors: Ndeezi Morris , Pedersen Gloria A. , Alipanga Benjamin , Luberenga Ibrahim , Kohrt Brandon A. , Kasujja Roscoe 
Published: January 2024

IntroductionCompetency-based training has gained prominence in clinical psychology education, emphasizing practical skills acquisition. The EQUIP competency-based approach, recognized for its effectiveness in in-service training, raises questions about its feasibility and utility in pre-service education.MethodsFaculty and supervisors were trained in and applied EQUIP competency-based assessment and techniques with current graduate students. A cohort comprising 15 graduate students, 12 faculty members, and supervisors from Butabika National Referral Mental Health and Teaching Hospital participated in focus group discussion and key informant interviews. Qualitative data was collected from 1st August 2022 to 4th August 2022. Thematic analysis identified three central themes.FindingsThe first theme reveals participants’ recognition of EQUIP’s feasibility in standardizing competence levels and addressing curriculum gaps. An extended training period, approximately 15 h, was identified as crucial to enhance educators’ and supervisors’ confidence in implementing the approach. The second theme emphasizes the pivotal role of role-play in competency-based training, transforming initial apprehension into constructive learning. Lastly, feedback emerged as a crucial component, with participants highlighting its role in fostering self-assuredness and refining skills.ConclusionThe study emphasizes the importance of robust training in competency-based methodologies. The EQUIP approach’s potential in clinical psychology education is evidenced by its alignment with research outcomes. Beyond this, the study advocates for longitudinal research to assess sustained engagement with EQUIP resources and their long-term impact. This research not only advances the discourse on competency-based training but also sets the stage for continuous improvements in clinical psychology education.
Residential surrounding greenness is not associated with incident breast cancer in young women in Ontario, Canada
Authors: Waddingham Claudia M. , Villeneuve Paul J. , Le Provost Blandine , Parent Marie-Élise , Brook Jeffrey R. , Lavigne Eric , Harris Shelley A. 
Published: January 2024

ObjectivesEnvironmental exposures play an important role in the development of breast cancer. The incidence of breast cancer is increasing in young women, and its etiology differs from that of older women. Epidemiological studies have provided mixed evidence about whether proximity to urban greenness reduces the risk of breast cancer, but few studies have evaluated this risk in younger women.MethodsWe investigated associations between residentially-based measures of greenness and breast cancer among participants of the Ontario Environmental Health Study (OEHS). The OEHS was a case–control study of Ontario women, 18–45 years of age, who provided questionnaire data between 2013 and 2015. The study included 465 cases diagnosed with a pathologically confirmed primary diagnosis of breast cancer, and 242 population-based controls. Residentially-based measures of greenness, the Normalized Difference Vegetation Index (NDVI) and tree coverage percentage, at 100-, 250-, 500-, and 1,000-m buffers, were assigned to the residential histories of the women. Odds ratios and their 95% confidence intervals (CIs) were estimated using logistic regression, adjusted for potential confounders including traffic-related air pollution [nitrogen dioxide (NO2)].ResultsWe found no evidence that an increase in NDVI or tree coverage were significantly associated with breast cancer. The adjusted odds ratio of breast cancer in relation to an interquartile range increase (IQR) in the NDVI (500-m buffer) was 0.86 (95% CI = 0.59–1.13). Similarly, the odds ratio of breast cancer among those in the highest quartile of tree coverage (500-m buffer) relative to the lowest was 1.11 (95% CI = 0.59–2.07). Risk estimates for both measures of greenness did not vary substantially across different buffer distances. Exposure to NO2 was an important confounder in these associations.ConclusionsOur findings do not support the hypothesis that residential greenness reduces the risk of breast cancer among young women, while highlighting the importance of adjusting for air pollution.
Plasmodium falciparum remains the dominant parasite affecting children despite decades of implementing vector control in two villages of Wolaita Zone, Southwest Ethiopia
Authors: Elias Shimels , Massebo Fekadu 
Published: January 2024

BackgroundMalaria is still a significant public health concern, and its prevention and control measures have different impacts in different areas. This study assesses the prevalence of malaria and the effectiveness of routine malaria control programmes such as indoor residual spray (IRS) in two Ethiopian villages.MethodsThe Kebeles (villages) were purposefully selected based on their malaria prevalence rates. A parasitology survey was conducted in Fango-Gelchecha pre- and post-IRS implementation, whereas in Shochora-Abela it was only conducted post-IRS implementation. The IRS was implemented as part of the routine malaria control programme in August 2017. Every fourth house from the village registration list was systematically selected, resulting in a sample of 300 households per village. A total of 3,075 individuals were enrolled for malaria testing using microscopy.ResultsAfter three to four months of application of IRS in August 2017, 59 malaria cases were confirmed, resulting in an overall prevalence of 1.9% (95% CI: 1.5–2.5). Of the positive cases, 18 cases (0.59%: 95% CI: 1.3–1.8) were from Shochora-Abela village, and 41 cases (1.33%: 95% CI: 1.1–1.3) were from Fango-Gelchecha. About age categories, the prevalence of malaria was 10.1% (95% CI: 5.9–15.9) among children under five, 4.7% (95% CI: 3.3–6.4) in children aged 5–14, and only 0.32% (95% CI: 0.13–0.67) in the age group 15 and above. Overall, P. falciparum was the dominant malaria parasite, accounting for 69.5% (95% CI: 56.1–80.8), while P. vivax malaria accounted for 30.5% (95% CI: 19.2–43.8). The malaria prevalence in Fango-Gelchecha village was 3.1% (95% CI: 2.3–4.0) before IRS and 2.6% (95% CI: 1.8–3.5) after IRS application. In the village of Shochora-Abela, the prevalence of malaria post-IRS was 1.2% (95% CI: 0.7–1.9), but the prevalence prior to IRS was not evaluated.ConclusionsPlasmodium falciparum is the predominant parasite in the villages, mainly affecting children under five. Therefore, protecting young children should be the top priority for reducing infection burdens.
Phylogenetic conservation of Trop-2 across species—rodent and primate genomics model anti-Trop-2 therapy for pre-clinical benchmarks
Authors: Guerra Emanuela , Trerotola Marco , Relli Valeria , Lattanzio Rossano , Boujnah Khouloud , Travali Nicole , Moschella Antonino , Todaro Paolo , Pierdomenico Laura , Di Pietro Roberta , Tinari Nicola , Alberti Saverio 
Published: January 2024

A phylogenetic conservation analysis of Trop-2 across vertebrate species showed a high degree of sequence conservation, permitting to explore multiple models as pre-clinical benchmarks. Sequence divergence and incomplete conservation of expression patterns were observed in mouse and rat. Primate Trop-2 sequences were found to be 95%–100% identical to the human sequence. Comparative three-dimension primate Trop-2 structures were obtained with AlphaFold and homology modeling. This revealed high structure conservation of Trop-2 (0.66 ProMod3 GMQE, 0.80–0.86 ± 0.05 QMEANDisCo scores), with conservative amino acid changes at variant sites. Primate TACSTD2/TROP2 cDNAs were cloned and transfectants for individual ORF were shown to be efficiently recognized by humanized anti-Trop-2 monoclonal antibodies (Hu2G10, Hu2EF). Immunohistochemistry analysis of Macaca mulatta (rhesus monkey) tissues showed Trop-2 expression patterns that closely followed those in human tissues. This led us to test Trop-2 targeting in vivo in Macaca fascicularis (cynomolgus monkey). Intravenously injected Hu2G10 and Hu2EF were well tolerated from 5 to 10 mg/kg. Neither neurological, respiratory, digestive, urinary symptoms, nor biochemical or hematological toxicities were detected during 28-day observation. Blood serum pharmacokinetic (PK) studies were conducted utilizing anti-idiotypic antibodies in capture-ELISA assays. Hu2G10 (t1/2 = 6.5 days) and Hu2EF (t1/2 = 5.5 days) were stable in plasma, and were detectable in the circulation up to 3 weeks after the infusion. These findings validate primates as reliable models for Hu2G10 and Hu2EF toxicity and PK, and support the use of these antibodies as next-generation anti-Trop-2 immunotherapy tools.
Adverse events of neoadjuvant combination immunotherapy for resectable cancer patients: a systematic review and meta-analysis
Authors: Feng Yuqian , Guo Kaibo , Jin Huimin , Jiang Jing , Wang Menglei , Lin Shengyou 
Published: January 2024

BackgroundNeoadjuvant combination immunotherapy is changing the treatment landscape for patients with cancer. Exploring the incidence of immune-related adverse events (irAEs) in relation to this novel approach may provide valuable insights for future clinical investigations.MethodsThis review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, Cochrane Library, American Society of Clinical Oncology (ASCO), and European Society of Medical Oncology (ESMO) websites were searched for all relevant literature from their inception to November 24, 2023. We then extracted the required data from the included studies and used the R software to analyze the pooled incidence of irAEs. Subgroup analyses examined the pooled incidence of irAEs according to cancer and combination types using a random-effects model.ResultsSixteen studies involving 501 patients were included in the meta-analysis. Considering the heterogeneity of the study design, we analyzed the randomized controlled studies (RCTs) and the single-arm studies separately. In RCTs, the incidence of any-grade irAEs was 95.0% (95% confidence interval [CI] 87.3-99.3) and that of grade ≥3 irAEs was 24.0% (95% CI 13.7-36.0). In single-arm studies, the incidence of any-grade irAEs was 89.4% (95% CI 75.0-98.0) and grade ≥3 irAEs was 20.3% (95% CI 8.7-35.2). In both RCTs and single arms, the most common any- grade irAEs were rash and fatigue, while the most common grade ≥3 irAEs was abnormal liver function and colitis. Due to irAEs, 9.4% of patients in RCTs and 6.9% of patients in single-arm studies did not complete the prescribed neoadjuvant treatment cycle.ConclusionThis study comprehensively summarized the incidence of irAEs in neoadjuvant combination immunotherapy. The occurrence of irAEs varies depending on the cancer and combination types. Our meta-analysis provides clinicians with essential guidance for the management of patients with cancer.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42023387969.
Lactobacillus rhamnosus ameliorates acne vulgaris in SD rats via changes in gut microbiota and associated tryptophan metabolism
Authors: Huang Yukun , Huang Yaxin , Xia Dengmei , Liu Lu , Xiong Xia , Ouyang Yongliang , Deng Yongqiong 
Published: January 2024

BackgroundThe depletion of beneficial bacteria in the gut has been found in patients with acne vulgaris, and in previous studies, the supplement of Lactobacillus rhamnosus led to the improvement of adult acne. Nevertheless, the potential mechanism of L. rhamnosus in the amelioration of acne vulgaris has not been elucidated yet.MethodsTo mimic the human intestinal environment, a pseudo-germ-free rat model was used, and then gut microbiota from healthy individuals and acne patients were transplanted into rats. The effects of L. rhamnosus and tryptophan (Trp) metabolites on a rat acne model were investigated by gavage. Then, 16S rRNA analysis and targeted measurement of metabolites were performed to discover the differences in gut microbiota and metabolites between groups. Finally, HaCaT cells pretreated with Cutibacterium acnes were employed to validate the effect and mechanism of Trp metabolites on acne.ResultsL. rhamnosus significantly improved acne-like symptoms in rats by suppressing the level of inflammatory cytokines such as IL-1β, IL-6, and TNF-α. L. rhamnosus induced an increase in the production of indole-3-acetic acid (IAA) and indole via targeted Trp metabolic analyses. Furthermore, L. rhamnosus promoted bacterial diversity and also enhanced the Firmicutes/Bacteroidota (F/B) ratio, which was positively related to both IAA and indole. Finally, the roles of IAA and indole in alleviating acne vulgaris were confirmed both in vitro and in vivo, which could be reversed by AhR inhibitors.ConclusionOur study demonstrated that L. rhamnosus could exert its therapeutic effects on acne vulgaris by modulating the gut microbiota and regulating associated Trp metabolites.
Museum-based art activities to stay young at heart? Results of a randomized controlled trial
Authors: Cami Margot , Planta Océane , Matskiv Jacqueline , Plonka Alexandra , Gros Auriane , Beauchet Olivier 
Published: January 2024

BackgroundHealth benefits have been reported with art activities. Heart rate is a biomarker of health state. The aim of this randomized controlled trial (RCT) was to compare the changes in heart rate over a 3 month-period in older adults participating in art-based activities at the Montreal Museum of Fine Arts (MMFA, Quebec, Canada) and in their control counterparts.Methods/designParticipants (mean age 71.0 ± 5.1; 84.9% female) were a subset of older community dwellers recruited in a RCT in two parallel groups (n = 28 in the intervention group and n = 25 in the control group) who had their heart rate recorded. They attended weekly participatory MMFA-based art activities over a 3-month period. Heart rate was collected via the smart watch Fitbit Alta HR at baseline (M0) and at 3 months (M3). The outcomes were mean heart rate per hour for the full day, including active and inactive hours.ResultsHeart rate for full day (p = 0.018) and active hours (p = 0.028) were slower in the intervention group compared to the control group. Decrease in mean heart rate for full day between M0 and M3 in the intervention group was higher than in the control group (p = 0.030). The linear regression showed that MMFA-based art activities decreased full day heart rate (Coefficient of regression Beta = −6.2 with p = 0.010).ConclusionMMFA-based art activities significantly decreased full day heart rate, suggesting a health benefit in older community dwellers who participated in the RCT.Clinical trial registration: NCT03679715.
Stable closure of acute and chronic wounds and pressure ulcers and control of draining fistulas from osteomyelitis in persons with spinal cord injuries: non-interventional study of MPPT passive immunotherapy delivered via telemedicine in community care
Authors: Sams-Dodd Jeanette , Belci Maurizio , Bandi Surendra , Smith Damian , Sams-Dodd Frank 
Published: January 2024

BackgroundMicropore particle technology (MPPT) is a topical wound treatment. It is a passive immunotherapy, acting via the skin and wound microbiome without the use of antimicrobial action. In a general patient population, it removed wound infections 60% and initiated tissue regeneration 50% quicker than antibiotics and antiseptics. As MPPT supports the immune system, the aim was to confirm that MPPT is also effective in immunocompromised individuals. People with spinal cord injury (SCI) are immunodeficient due to their injury and not an underlying disease and recruit 50% fewer immune cells to an injury. The study, therefore, determined the efficacy, safety, health economics, and sustainability of MPPT in acute and chronic wounds and pressure ulcers in this patient population.MethodsPressure ulcers in SCI persons are an orphan indication, patient variability is high, and ICH E10 excludes comparators due to ethical concerns. The study design was, therefore, a single-arm, non-interventional, observational, post-market surveillance study of MPPT for treating wounds and pressure ulcers and removing soft tissue infection in connection with draining fistulas in SCI persons. The study was based on telemedicine in community care.ResultsThe study included 44 wounds. All acute and chronic grade 1–4 wounds and pressure ulcers reached stable closure. In wounds acting as fistulas draining from an underlying, primary focus of infection, e.g., osteomyelitis, MPPT removed the soft tissue infection in approx. 2.5 months and supported regeneration, considerably reducing fistula sizes. Compared to standard care, per-wound cost savings were 51 to 94% depending on wound grade and age, and substantial nursing resources were freed up. The telemedicine approach was well received by participants and supported independence and self-care. The use of antimicrobials, plastics, and synthetic polymers was essentially eliminated. MPPT did not require bed rest.ConclusionThe study confirmed that MPPT is safe and effective in treating acute and chronic wounds in immunocompetent and immunocompromised individuals, including wounds with antimicrobial-resistant infections. MPPT also removes soft tissue infections caused by an underlying primary focus of infection, such as osteomyelitis. Non-healing wounds currently represent an unmet clinical need. The findings suggest that a therapy acting via the microbiome without antimicrobial actions is effective.