bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Interruption Management Education Bundle
Authors: Schroers Ginger , Pfieffer Jill , Andersen Bridget , O'Rourke Jenny 
Published: December 2023

Background:
Interruptions and distractions are pervasive in health care settings, increase risks for errors, and decrease task efficiency. Researchers recommend the use of strategies to mitigate their negative effects.

Purpose:
The purpose was to assess the feasibility and acceptability of (1) an education bundle that included an interruption management strategy and (2) simulated scenarios with embedded interruptions and distractions.

Methods:
Nineteen undergraduate nursing students participated in this repeated-measures, multimethods feasibility study. Data on interruption management behaviors were collected across 3 timepoints via direct observation of individual-simulated medication administration. Participants’ perceptions of the education bundle were explored via semistructured interviews.

Results:
Participants described the simulated scenarios as realistic and interruption management strategy as easy to use and remember. Participants voiced increased confidence in handling interruptions after learning the strategy. The strategy averaged 4 seconds to apply.

Conclusions:
Findings support the feasibility and acceptability of the bundle and need for studies to investigate the impact of the strategy on errors and task durations.
Student Perception of Diversity, Equity, and Inclusion Curricular Threads on Nursing Practice
Authors: Dowling Tomeka , Toll Crystal , Whitlow Malinda , Hicks Frank D. 
Published: December 2023

Background:
Compassionate, inclusive, and equitable nursing care begins with integrating concepts of diversity, equity, and inclusion (DEI) and social determinants of health (SDOH) into curricula.

Problem:
Little is known about RN to BSN students' perception of applying these concepts in practice. The purpose of this pilot project was to assess RN to BSN students' perceptions of DEI-SDOH curricular threads in their nursing practice.

Approach:
Students were surveyed to assess their perceptions about the impact DEI-SDOH curricular content had on their ability to assess and address DEI-SDOH in practice, level of confidence in talking about DEI-SDOH, addressing breaches in DEI, and the influence of DEI-SDOH in nursing.

Outcomes:
Respondents indicated DEI-SDOH curricula promoted self-examination, critical examination of health care systems, and increased DEI-SDOH competence.

Conclusion:
DEI-SDOH curricula build upon professional experiences, strengthen assessment and application competence, and equip nurses with confidence to address DEI-SDOH as an effective strategy to reduce health disparities.
Relationship of Social Deprivation Among Living Kidney Donor–Recipient Pairs
Authors: Bilen Yara , Schold Jesse D. , Arrigain Susana , Buchalter R. Blake , Huml Anne M. 
Published: December 2023

Background.
Living kidney transplant is the most effective renal replacement therapy for patients with end-stage kidney disease. Community-level factors contribute to pervasive socioeconomic and racial disparities in access to living donor kidney transplantation. Little is known about social and environmental conditions between living donors and recipients. Further understanding of these relationships may enhance opportunities for transplantation.

Methods.
From 2010 to 2020, 59 575 living kidney donor–recipient pairs (≥18 y old) were identified using the Scientific Registry of Transplant Recipients. Living donors and recipients were geocoded to area-level social deprivation index (SDI). The primary outcome was difference between recipient and donor SDI. We used multivariable logistic regression to examine recipient and donor characteristics association with residence in different SDI communities.

Results.
Living kidney donation occurs across all strata of social deprivation; including when donors, recipients or both reside in more disadvantaged communities. Donor–recipient race combination and biological relationship are associated with differences in SDI. When compared with White recipients of White donors, Black and Hispanic recipients were more likely to reside in more disadvantaged areas (odds ratio = 2.41 [2.19-2.66] and 1.97 [1.78-2.19]). Recipients in anonymous and paired donations were more likely to reside in areas of more disadvantage than their donors (odds ratio = 1.27 [1.15-1.40] and 1.32 [1.23-1.41] compared with biological); attenuating socioeconomic disparities in access to living donor transplantation.

Conclusions.
Findings illustrate the social and environmental relationships between living kidney donor–recipient pairs that are important to develop targeted approaches and address barriers to living kidney transplantation. Best practices from areas of high deprivation with successful living kidney transplantation can be shared.
Early Metabolic Measures Predict Long-term Insulin Independence in Recipients of Total Pancreatectomy and Islet Autotransplantation
Authors: Nanno Yoshihide , Hodges James S. , Freeman Martin L. , Trikudanathan Guru , Schwarzenberg Sarah J. , Downs Elissa M. , Ramanathan Karthik , Pruett Timothy L. , Beilman Gregory J. , Chinnakotla Srinath , Hering Bernhard J. , Bellin Melena D. 
Published: December 2023

Background.
Although diabetes after total pancreatectomy and islet autotransplantation (TP-IAT) is one of the biggest concerns for TP-IAT recipients and physicians, reliable prediction of post-TP-IAT glycemic control remains unestablished. This study was conducted to identify early predictors of insulin independence and goal glycemic control by hemoglobin A1c (HbA1c) ≤ 6.5% after TP-IAT.

Methods.
In this single-center, retrospective study, patients who underwent TP-IAT (n = 227) were reviewed for simple metabolic markers or surrogate indices of β-cell function obtained 3 mo after TP-IAT as part of standard clinical testing. Long-term metabolic success was defined as (1) insulin independence and (2) HbA1c ≤ 6.5% 1, 3, and 5 y after TP-IAT. Single- and multivariate modeling used 3-mo markers to predict successful outcomes.

Results.
Of the 227 recipients, median age 31 y, 30% male, 1 y after TP-IAT insulin independence, and HbA1c ≤ 6.5% were present in 39.6% and 72.5%, respectively. In single-predictor analyses, most of the metabolic markers successfully discriminated between those attaining and not attaining metabolic goals. Using the best model selected by random forests analysis, we accurately predicted 1-y insulin independence and goal HbA1c control in 77.3% and 86.4% of the patients, respectively. A simpler “clinically feasible” model using only transplanted islet dose and BETA-2 score allowed easier prediction at a small accuracy loss (74.1% and 82.9%, respectively).

Conclusions.
Metabolic testing measures performed 3 mo after TP-IAT were highly associated with later diabetes outcomes and provided a reliable prediction model, giving valuable prognostic insight early after TP-IAT and help to identify recipients who require early intervention.
Safety and efficacy of orally administered full-spectrum medicinal cannabis plant extract 0.08% THC (NTI-164) in children with autism spectrum disorder: An open-label study
Authors: El-Sukkari Dima , Sharma Kanan , Fleiss Bobbi , Braganza Dion L. , Crichton Alison , Fahey Michael C. 
Published: December 2023

AbstractAutism spectrum disorder (ASD) is commonly associated with debilitating comorbidities impacting the well-being of affected children and their families. Some children with ASD experience behavioural difficulties that do not respond well to current medications and may also experience unwanted side effects. Therefore, it is crucial to develop alternative, safe and effective therapies. The improved understanding of the endocannabinoid system, together with emerging evidence for the therapeutic effects of cannabis derivatives in neurodevelopment disorders, has led to an exploration of their use in ASD.This open-label study assessed the efficacy and safety of a novel oil-based full-spectrum medicinal cannabis plant extract 0.08% THC (NTI-164) in treating 14 children with ASD symptoms (13.4 years, range 10-17). Data on the safety profile of NTI-164 was collected through biochemical analysis, vital signs, and parent and participant reports. The efficacy was assessed through a dose-escalation protocol using a broad range of validated clinical behavioural assessments and parent and child-reported questionnaires.Following four weeks of treatment with NTI-164, 93% of participants demonstrated significant overall improvement in ASD-related symptoms compared to baseline with transient side effects that did not interfere with their general functioning. In addition, targeted behavioural problems were rated as much improved or very much improved in 46% of the treated patients. More than half of caregivers and children also reported decreased anxiety symptoms.The findings from this study suggest that NTI-164 is well-tolerated and safe, with potential clinical benefits in improving disruptive behaviours and reducing anxiety in children with ASD-related symptoms. Future longitudinal and well-controlled studies are warranted to develop evidence-based clinical therapies and further evaluate the therapeutic benefit of full- spectrum cannabis extracts in managing ASD core and associated comorbid symptoms in this group of children.Trial registration numberACTRN12621000760875
The immunosuppressive Tuberculosis-associated microenvironment inhibits viral replication and promotes HIV-1 latency in CD4+ T cells
Authors: Cronin Samantha , de Vries-Egan Anneke , Vahlas Zoï , Czernikier Alejandro , Melucci Claudia , Gerber Pehuén Pereyra , O’Neil Thomas , Gloss Brian , Sharabas Mayssa , Turk Gabriela , Verollet Christel , Balboa Luciana , Palmer Sarah , Duette Gabriel 
Published: December 2023

Author SummaryMycobacterium tuberculosis(Mtb), the causative agent of tuberculosis (TB), is the most common coinfection among people living with HIV-1. This coinfection alters the efficacy of the immune response against both HIV-1 andMtb, and is associated with accelerated HIV-1 disease progression and reduced survival. Enhanced HIV-1 replication in macrophages induced byMtbcoinfection may contribute to the worsened clinical outcomes observed in HIV-1/TB coinfected individuals. However, the impact of the HIV-1/TB coinfection on HIV-1 replication and latency in CD4+ T cells remains poorly studied.In this study, we used the acellular fraction of tuberculous pleural effusion (TB-PE) as a proxy for the microenvironment generated byMtbinfection. Using this physiologically relevant fluid, we investigated whether viral replication and HIV-1 latency in CD4+ T cells are affected by a TB-associated microenvironment. Interestingly, our results revealed that TB-PE shaped the transcriptional profile of CD4+ T cells impairing T cell receptor-dependent cell activation and decreased HIV-1 replication. Moreover, this immunosuppressive TB microenvironment promoted viral latency and inhibited HIV-1 reactivation in CD4+ T cells from people living with HIV-1. This study indicates that the immune response induced by TB may contribute to the persistence of the viral reservoir by silencing HIV-1 expression in individuals coinfected with both pathogens, allowing the virus to persist undetected by the immune system and increasing the size of the HIV-1 latent reservoir in cells at the site of the coinfection.
Predictors of abnormal Thompson score in term neonates in a tertiary hospital in Zimbabwe
Authors: Khan N. , Mugwagwa E. , Cortina-Borja M. , Catherall E. , Fitzgerald F. , Chimhuya S. , Chimhini G. , Gannon H. , Crehan C. , Mangiza M. , Heys M. 
Published: December 2023

AbstractBackgroundNeonatal encephalopathy, abnormal neurological function in a baby born at term is a key cause of neonatal death. In the absence of adequate training and brain imaging or monitoring in low-resource settings, clinical risk scores, such as Thompson score, have been useful to predict risk of neonatal encephalopathy. A clearer understanding of the clinical and maternal predictors of abnormal values of Thompson score would be beneficial to identify term neonates with suspected neonatal encephalopathy.MethodsA scoping review of the literature identified a set ofa priorineonatal and maternal variables associated with neonatal encephalopathy in low-resource settings. Next, a prospective study of all neonates born at term admitted to Sally Mugabe Central Hospital in Zimbabwe between October 2020 and December 2022 (n=6,054) was conducted. A predictive statistical model for abnormal (>10) Thompson score (range 0-22) was developed.ResultsIn total 45 articles were identified from three databases and 10 articles were selected. 45 candidate predictors were identified −36 from the available literature and 9 from clinical data and experience. 4.06% (n=246) of neonates had an abnormal Thompson score of 10 or more on admission and 90.65% (n=223) of these neonates had an Apgar score less than 7 at 5 mins (p<0.001). 24 possible predictors were selected as the most important of which nine factors were identified as the most useful in predicting which neonates are at risk of abnormal Thompson score. These predictors and their adjusted odds ratios are: low Apgar score at 5min (OR= 0.46, 95%CI=(0.42, 0.51)), low neonatal heart rate at admission (OR=0.977, 95%CI=(0.97, 0.985)), temperature lower than 36.5°C (OR=1.64, 95%CI=(1.18, 2.28)), abnormal head shape (OR=2.12, 95%CI=(1.51, 2.97)), resuscitation received (OR=3.95, 95%CI=(1.69, 11.01)), neonatal encephalopathy as an admission reason (OR= 2.47, 95%CI=(1.37, 4.32)), risk factors of sepsis other than premature rupture of membrane and offensive liquor (OR=2.04, 95%CI=(1.1, 3.67)), respiratory distress as an admission reason (OR=2.48, 95%CI=(1.59, 3.96)), and other admission reasons (OR=1.81, 95% CI=(1.12, 2.97)). The main admission reasons in ‘Other’ category include low birthweight, meconium aspiration and hypoxic ischaemic encephalopathy and congenital abnormality.ConclusionIn resource-poor settings where it may be not possible to clinically assess all admitted neonates, those with the identified risk factors should be prioritised for a Thompson score assessment. Local clinical guidelines should incorporate these factors into the clinical management of at-risk neonates and assess their impact on clinical care and neonatal outcomes.
Genomic determinants of response and resistance to inotuzumab ozogamicin in B-cell ALL
Authors: Zhao Yaqi , Short Nicholas J , Kantarjian Hagop M , Chang Ti-Cheng , Ghate Pankaj S , Qu Chunxu , Macaron Walid , Jain Nitin , Thakral Beenu , Phillips Aaron H , Khoury Joseph , Garcia-Manero Guillermo , Zhang Wenchao , Fan Yiping , Yang Hui , Garris Rebecca S , Nasr Lewis F , Kriwacki Richard W , Roberts Kathryn G , Konopleva Marina , Jabbour Elias J , Mullighan Charles G 
Published: December 2023

ABSTRACTInotuzumab ozogamicin (InO) is an antibody-drug conjugate that delivers calicheamicin to CD22-expressing cells. In a retrospective cohort of InO treated patients with B-cell acute lymphoblastic leukemia, we sought to understand the genomic determinants of response to InO. AcquiredCD22mutations were observed in 11% (3/27) of post-InO relapsed tumor samples. There were multipleCD22mutations per sample and the mechanisms of CD22 escape included protein truncation, protein destabilization, and epitope alteration. Hypermutation by error-prone DNA damage repair (alternative end-joining, mismatch repair deficiency) drove CD22 escape. Acquired loss-of-function mutations inTP53,ATMandCDKN2Awere observed, suggesting compromise of the G1/S DNA damage checkpoint as a mechanism of evading InO-induced apoptosis. In conclusion, genetic alterations modulating CD22 expression and DNA damage response influence InO efficacy. The escape strategies within and beyond antigen loss to CD22-targeted therapy elucidated in this study provide insights into improving therapeutic approaches and overcoming resistance.KEY POINTSWe identified multiple mechanisms of CD22 antigen escape from inotuzumab ozogamicin, including protein truncation, protein destabilization, and epitope alteration.Hypermutation caused by error-prone DNA damage repair was a driver of CD22 mutation and escape.VISUAL ABSTRACT
Mechanisms underlying exercise intolerance in Long COVID: an accumulation of multi-system dysfunction
Authors: Jamieson Alexandra , Saikhan Lamia Al , Alghamdi Lamis , Howes Lee Hamill , Purcell Helen , Hillman Toby , Heightman Melissa , Treibel Thomas , Orini Michele , Bell Robert , Scully Marie , Hamer Mark , Chaturvedi Nishi , Montgomery Hugh , Hughes Alun D. , Astin Ronan , Jones Siana 
Published: December 2023

AbstractThe pathogenesis of exercise intolerance and persistent fatigue which can follow an infection with the SARS-CoV-2 virus (’Long COVID’) is not fully understood.Cases were recruited from a Long COVID clinic (N=32; 44±12y; 10(31%)men), and age/sex- matched healthy controls (HC) (N=19; 40±13y; 6(32%)men) from University College London staff and students. We assessed exercise performance, lung and cardiac function, vascular health, skeletal muscle oxidative capacity and autonomic nervous system (ANS) function. Key outcome measures for each physiological system were compared between groups using potential outcome means(95% confidence intervals) adjusted for potential confounders. Long COVID participant outcomes were compared to normative values.When compared to HC, cases exhibited reduced Oxygen Uptake Efficiency Slope (1847(1679,2016) vs (2176(1978,2373) ml/min, p=0.002) and Anaerobic Threshold (13.2(12.2,14.3) vs 15.6(14.4,17.2) ml/Kg/min, p<0.001), and lower oxidative capacity on near infrared spectroscopy (τ: 38.7(31.9,45.6) vs 24.6(19.1,30.1) seconds, p=0.001). In cases, ANS measures fell below normal limits in 39%.Long COVID is associated with reduced measures of exercise performance and skeletal muscle oxidative capacity in the absence of evidence of microvascular dysfunction, suggesting mitochondrial pathology. There was evidence of attendant ANS dysregulation in a significant proportion. These multi-system factors might contribute to impaired exercise tolerance in Long COVID sufferers.Key PointsThe pathogenesis of exercise intolerance and persistent fatigue which can follow an infection with the SARS-CoV-2 virus (’Long COVID’) is not fully understood.We show that Long COVID is associated with reduced measures of exercise performance in line with previous work.In Long COVID cases, we observed reduced skeletal muscle oxidative capacity in the absence of evidence of microvascular dysfunction, suggesting mitochondrial pathology.We also observed evidence of attendant autonomic nervous system (ANS) dysregulation in a significant proportion of Long COVID cases.These multi-system factors might contribute to impaired exercise tolerance in Long COVID sufferers.
Graph-Based Patient Representation for Multimodal Clinical Data: Addressing Data Heterogeneity
Authors: Ghanvatkar Suparna , Rajan Vaibhav 
Published: December 2023

ABSTRACTPatient data comprises of different modalities like clinical notes, lab results, and radiological investigations. Predictive modeling on this patient data is challenging due to the heterogeneity among patients and modalities captured, such as no ECG recordings for a few patients. Ensuring model applicability to all admitted patients requires addressing three key factors: i) handling modalities at disparate time-scales (e.g., once in a few hours medication and 125 Hz ECG need to be handled by same model), ii) handling missing modality (e.g., ECG not recorded), and iii) modeling temporal interactions between modalities over time (e.g., the ECG fluctuation triggered some lab test order). Existing literature often doesn’t simultaneously address these requirements. Therefore, we propose a novel patient representation approach inspired by clinical workflows, representing each patient as a graph. We categorize patient data into two main components: observations and care team actions, allowing cross-modality temporal interaction when actions consider the previous observations. We define observation nodes to capture modality-specific data within the time between two actions, and action nodes capture data of the actions undertaken, with edges to capture the temporal dependencies. To address missing modalities and time-scale disparities, we define node types for different modalities and use modality-specific representation for the nodes; implying a missing modality is equivalent to a missing node type in the graph. Aligned with clinical workflows, this patient-graph representation aims to enhance the practicality of predictive systems for various healthcare tasks, from mortality risk assessment to medication recommendations, thereby improving clinical decision support.
Using passive telemetry and environmental variables to predict Silver Carp (Hypophthalmichthys molitrix)movement cues on the northwestern edge of their invasion front
Authors: LaBrie Lindsey A. P. , Wesner Jeff S. 
Published: December 2023

AbstractSilver carpHypophthalmichthys molitrix, are a highly mobile aquatic invasive species in the United States. The James River, South Dakota, USA, is a tributary of the Missouri River and is considered the northwestern leading edge of their invasion front. Understanding silver carp movement patterns on the cusp of this invasion is key to combatting the northwestward expansion of the species. We used passive telemetry to observe large-scale movement patterns of silver carp in the James River, South Dakota. Fifty silver carp were implanted with acoustic transmitter tags in June 2021, and movement data was recorded over a 1.5-year period. Most individuals exhibited site fidelity and stayed within the James River throughout the duration of the study. We used environmental data (i.e., temperature, dissolved oxygen, daily mean discharge, the change in discharge over 24 h and 48 h) and movement data collected from passive telemetry receivers to understand and predict silver carp movement cues in the James River. Daily mean discharge (“flow”) was the most important predictor of silver carp movement in the James River. As flow increased, the probability of movement increased from 59% (95% CrI: 34% to 81%) at 1.5 m3/s to 94% (95% CrI: 80 to 99%) at 100 m3/s. In this study, silver carp exhibited a high propensity for movement within the James River, especially during periods of high flow. To prevent further northwestward expansion of these fish, silver carp movements must continue to be monitored and removal and prevention of further range expansion must be prioritized.
Phospholipase D1 Produces Phosphatidic Acid at Sites of Secretory Vesicle Docking and Fusion
Authors: Bills Broderick L. , Hulser Megan L. , Knowles Michelle K. 
Published: December 2023

ABSTRACTPhospholipase D1 (PLD1) activity is essential for the stimulated exocytosis of secretory vesicles where it acts as a lipid-modifying enzyme to produces phosphatidic acid (PA). PLD1 localizes to the plasma membrane and secretory vesicles, and PLD1 inhibition or knockdowns reduce the rate of fusion. However, temporal data resolving when and where PLD1 and PA are required during exocytosis is lacking. In this work, PLD1 and production of PA are measured during the trafficking, docking, and fusion of secretory vesicles in PC12 cells. Using fluorescently-tagged PLD1 and a PA-binding protein, cells were imaged using TIRF microscopy to monitor the presence of PLD1 and the formation of PA throughout the stages of exocytosis. Single docking and fusion events were imaged to measure the recruitment of PLD1 and the formation of PA. PLD1 is present on mobile, docking, and fusing vesicles and also colocalizes with Syx1a clusters. Treatment of cells with PLD inhibitors significantly reduces fusion, but not PLD1 localization to secretory vesicles. Inhibitors also alter the formation of PA; when PLD1 is active, PA slowly accumulates on docked vesicles. During fusion, PA is reduced in cells treated with PLD1 inhibitors, indicating that PLD1 produces PA during exocytosis.