bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relación entre los servicios de urgencia y las unidades de cuidados intensivos
Authors: Tobar Almonacid Eduardo 
Published: September 2023

Los servicios de urgencia (SU) constituyen un elemento central para la atención inicial del paciente ambulatorio que requiere de una evaluación médica de forma no programada, de carácter urgente o emergente. Las unidades de cuidados intensivos (UCI), por su parte, cumplen un rol central en la atención sanitaria compleja de la actualidad, concentrando personal, equipamiento e infraestructura, que permiten implementar terapias de soporte vital ante condiciones de riesgo, susceptibles de ser estabilizadas y/o resueltas. El SU y la UCI comparten algunos elementos a considerar y desafíos que afrontar. El sistema sanitario chileno enfrenta un contexto marcado por el cambio demográfico, con un incremento en las enfermedades crónicas no transmisibles y un patrón de causas de mortalidad que se asemeja a los países desarrollados. Entre los desafíos comunes que enfrentan ambos servicios clínicos, se encuentran el fortalecimiento continuo de la calidad y seguridad de la atención de sus pacientes, y el propiciar la continuidad de la atención. Es necesario recordar que ambos servicios clínicos son complementarios, y lo que sucede en uno impacta en el funcionamiento del otro. Para una adecuada gestión hospitalaria, y considerando como objetivo el mayor bienestar de nuestros pacientes y familias, es fundamental un funcionamiento armónico, y coordinado entre ambas unidades.
Whole-Exome Sequencing Identifies Mutation Profile and Mutation Signature-Based Clustering Associated with Prognosis in Appendiceal Pseudomyxoma Peritonei
Authors: Lin Yu-Lin , Zhu Jun-Qi , Ma Rui-Qing , Meng Wei , Wang Zi-Yue , Li Xin-Bao , Ma Ru , Wu He-Liang , Xu Hong-Bin , Gao Ying , Li Yan 
Published: September 2023

Abstract

Pseudomyxoma peritonei (PMP) is a rare malignant clinical syndrome with little known about the global mutation profile. In this study, whole-exome sequencing (WES) was performed in 49 appendiceal PMP to investigate mutation profiles and mutation signatures. A total of 4,020 somatic mutations were detected, with a median mutation number of 56 (1–402). Tumor mutation burden (TMB) was generally low (median 1.55 mutations/Mb, 0.12–11.26 mutations/Mb). Mutations were mainly enriched in the function of cancer-related axonogenesis, extracellular matrix–related processes, calcium signaling pathway, and cAMP signaling pathway. Mutations in FCGBP, RBFOX1, SPEG, RTK-RAS, PI3K-AKT, and focal adhesion pathways were associated with high-grade mucinous carcinoma peritonei. These findings revealed distinct mutation profile in appendiceal PMP. Ten mutation signatures were identified, dividing patients into mutation signature cluster (MSC) 1 (N = 28, 57.1%) and MSC 2 (N = 21, 42.9%) groups. MSC (P = 0.007) was one of the four independent factors associated with 3-year survival. TMB (P = 0.003) and microsatellite instability (P = 0.002) were independent factors associated with MSC 2 grouping. Taken together, our findings provided a broader view in the understanding of molecular pathologic mechanism in appendiceal PMP and may be critical to developing an individualized approach to appendiceal PMP treatment.

Implications:
This work describes exhaustive mutation profile of PMP based on WES data and derives ten mutation signatures, which divides patients into two clusters and serve as an independent prognostic factor associated with 3-year survival.
Peritumoral Immune-suppressive Mechanisms Impede Intratumoral Lymphocyte Infiltration into Colorectal Cancer Liver versus Lung Metastases
Authors: Ye Jian , Guo Weihua , Wang Chongkai , Egelston Colt A. , D'Apuzzo Massimo , Shankar Geereesh , Fakih Marwan G. , Lee Peter P. 
Published: September 2023

Abstract

Patients with microsatellite stable (MSS) colorectal cancer with liver metastases are resistant to immune checkpoint inhibitor (ICI) therapy, while about one-third of patients with colorectal cancer without liver metastases, particularly those with lung-only metastases, respond to ICI. We analyzed primary colorectal cancer tumors and major metastatic sites (liver, lung, peritoneal) using multiplex immunofluorescence and whole-slide spatial analyses to identify variations in immune contexture and regional localization within the tumor microenvironment. While levels of T and B cells within peritumoral regions were similar, their levels were significantly lower within the tumor core of liver and peritoneal metastases compared with lung metastases. In contrast, antigen-presenting cells (APC) and APC–T cell interactions were more abundant in all regions of lung metastases. We also identified an abundance of lymphoid aggregates throughout lung metastases, but these were present only within peritumoral regions of liver and peritoneal metastases. Larger lymphoid aggregates consistent with features of tertiary lymphoid structures were observed within or adjacent to primary tumors, but not metastatic lesions. Our findings were validated using NanoString GeoMx DSP, which further showed that liver metastases had higher expression of immune-suppressive markers, while lung metastases showed higher proinflammatory activity and T-cell activation markers. Peritoneal metastases demonstrated higher expression of cancer-associated fibroblast–related proteins and upregulated PD-1/PD-L1 signaling molecules. Our results demonstrate that functional status and spatial distribution of immune cells vary significantly across different metastatic sites. These findings suggest that metastatic site–dependent immune contexture may underlie discordant responses to ICI therapy in patients with MSS colorectal cancer.

Significance:
Our results demonstrate that functional status and spatial distribution of immune cells vary significantly across different metastatic sites in MSS colorectal cancer. These findings suggest that metastatic site–dependent immune contexture may underlie discordant responses to ICI therapy in patients with MSS colorectal cancer.
China’s Transition to Collective Labor Relations: Top-Down and Bottom-Up Mechanisms
Authors: Kai Chang 
Published: September 2023

Abstract
The article analyzes the development, characteristics, and tendency of China’s labor relations and the labor movement in recent years. It points out that China has begun the transition from individual labor relations to collective labor relations with the strike wave in the summer of 2010 as the main turning point. In the process of transformation, there are two kinds of forces and two ways to accomplish the labor movement. One is the top-down labor union movement led by the authorities within the system; the other is the bottom-up labor movement formed spontaneously by workers outside the system. The article particularly analyzes the emergence of, and mutual relationship between these two types of transition, as well as their influence and significance on China’s labor relations.
Full-Circumference Prosthetic Grafts for Replacing a Retrohepatic Inferior Vena Cava Segment During Hepatectomy for Tumor
Authors: Suzuki Kaori , Takahashi Yuki , Shiozawa Toshimitsu , Matsuo Kenichi , Shimizu Hiroaki , Tanaka Kuniya 
Published: September 2023

Background Although hepatectomy including inferior vena cava (IVC) resection is becoming more common, some details remain uncertain such as use of artificial materials to replace a tumor-involved, damaged, or narrowed retrohepatic IVC segment. Methods Surgical outcomes of 12 patients who underwent hepatectomy with IVC resection including reconstruction using synthetic tubular grafts were investigated to clarify safety and feasibility. Results Operative time (median, 573 min; range, 268 to 774) and the blood loss (1076 mL; 155 to 2960) were acceptable. In-hospital mortality was 8% (1/12), and morbidity was 42% (5/12). Among the 12 patients, 2 were planned to undergo IVC reconstruction without an artificial graft. In one patient, prosthetic repair was adopted because of massive bleeding from the IVC wall during dissection of tumor from the IVC. In the other, severe stricture became evident during attempted direct closure of the partially resected IVC wall. Discussion Ongoing experience has increased our acceptance of combined liver and IVC resection. We believe that segmental IVC resection and reconstruction with a prosthetic tubular graft could be chosen more frequently in managing liver tumors suspected to involve the IVC.
Competitive dynamics of lead firms and their systems suppliers in the automotive industry
Authors: Yeung Godfrey 
Published: September 2023

Lead firms play a dominant role in the governance structure of conventional global production network (GPN) analyses but this framework is not fully applicable in sectors where (new) regulations, technologies and subsequent market changes have a disruptive effect on its governance structure. This paper proposes an analytical framework to examine how disruptive effects of industrial megatrends in forms of new regulations and technologies and the subsequent market changes could alter the competitive dynamics between lead firms and their tier-I suppliers. Although lead firms are becoming more specialized and highly efficient in specific product segments, they may not always have inter-firm control over their tier-I suppliers. GPN boundaries become more permeable when there is an external shock, such as new regulations or massive shifts in consumer demand, or the entrance of an entirely new lead firm, possibly due to a technological breakthrough or innovative use of existing technologies in a product. This external shock could have disruptive effects on the GPN, from the exit of current lead firms to the entrance of new tier-I suppliers or lead firms. Consequently, a reconstituted GPN with a newly established boundary is then produced. Applying the analytical framework to the automotive industry, it is argued that selected (and new) systems suppliers with expertise in micro-electronics are not only in a prime position to capture the value generated by the increasingly stringent regulatory environment on safety and environmental standards, but also more resilient than the incumbent automakers to three emerging megatrends: electrification, digitalization and autonomous driving. JEL: F23, L14, L20, L62
The Effects of Interpersonal Violence on Sleep Following the COVID-19 Stay-at-Home Order
Authors: Schober Daniel J. , Bruce Douglas , Lewis Taylor , Keller Allison , Lippert Julia F. , Singh Meha , Matzke Hannah , Prachand Nikhil 
Published: September 2023

Purpose Lack of sleep is a harm that can lead to chronic diseases ranging from diabetes to heart disease. We examined the exposure to interpersonal violence and its association with sleep, following the COVID-19 stay-at-home order. Design Cross-sectional. Setting Surveys were completed online and via paper-and-pencil in English and Spanish (N = 2049; RR = 68.4%). Subjects Respondents were 18+ and residing in Chicago. Measures The Chicago Department of Public Health’s “2022 Healthy Chicago Survey COVID-19 Social Impact Survey”. Analysis We developed two weighted models. Model 1 examined the effects of neighborhood violence on meeting the national sleep recommendation. Model 2 examined the effects of violence in the home among friends or family on meeting the sleep recommendation, incorporating additional predictors: victimization, stress, gender, race/ethnicity, household income, and general health. Odds ratios were estimated using multivariate logistic regression. Results Exposure to neighborhood violence and sleep was not significant, but knowing a friend or family member who experienced violence or mistreatment in their home affected the odds of meeting the sleep recommendation (OR = .61, 95% CI = .44-.84). Non-Hispanic Blacks had 52% lower odds of meeting sleep recommendations (OR = .48, 95% CI = .37-.63). Conclusion Addressing the harms to sleep that followed COVID-19 should engage diverse stakeholders in implementing culturally responsive interventions to promote adequate sleep and prevent chronic disease.
Building Consensus on Domains of Wellness Using Finnish and International Expert Panels: A Delphi-Method Study
Authors: Kauppi Krista , Roos Eira , Borg Patrik , Torkki Paulus 
Published: September 2023

Purpose The paper investigates whether we can build consensus on wellness domains and create a more universal conceptual framework for wellness. Design A modified ranking type of Delphi method. Participants Two separate panels consisting of 23 Finnish and 11 international experts. Methods Panels were asked to rate the importance of 61 systematic review-based wellness domains and to eventually form a wellness model in both panels. The similarities between the resulting models were investigated and a new conceptual framework for wellness was created. Results The Finnish model included 8 themes and 20 domains, and the international model 5 themes and eleven domains. Eight of the eleven domains were an exact match for the Finnish model (namely mental health, cognitive health, exercise, nutrition, community, life satisfaction, meaningfulness, work-life balance). There were also 2 similar domains that could be found in both models (namely self-care and lifestyle habits, social networks). A new conceptual framework for wellness was created based on these ten domains. Conclusion The lack of consensus on the wellness construct has made it difficult to find comparable measures that could assess and improve the level of wellness of individuals, organizations, and society. This study offers a conceptual framework that can be further validated and turned into a more universal measurement instrument.
The prevalence of sexually transmitted infections and their association with knowledge, attitudes, and practice in male street children in Indonesia
Authors: Nilasari Hanny , Indriatmi Wresti , Irawan Yudo , Budiono Santoso Edy , Silviana Andiati , Waworuntu Wiendra 
Published: September 2023

Background Street children’s level of knowledge, attitudes, and practice (KAP) regarding sexually transmitted infections (STIs) and HIV-related diseases remains a challenge since it is difficult to reach all key populations. This study aims to provide an overview of the findings of STI cases and their association with the KAP of street children in Jakarta and Banten. Methods We conducted a cross-sectional study on 259 male street children (aged 10 –21 years old). We collected the data through questionnaire interviews, history taking, physical examination, and specimen collection for STI and HIV testing. Results 5.8% ( n = 15) STI cases were discovered, consisting of Hepatitis B ( n = 6), Hepatitis C ( n = 1), HIV ( n = 2), Chlamydia ( n = 3), Syphilis ( n = 1), and Gonorrhea ( n = 1). Buskers (44.4%) and other occupations like helping parents sell their wares, parking lot attendants, shoe shiners, or gathering (44.8%) dominated the sociodemographic characteristics. Condomless sex predominated risky sexual behavior, despite some subjects already having good knowledge. Conclusion Sociodemographic characteristics and the KAP of street children in Indonesia are varied. The association between the KAP level and STI cases in street children is challenging to describe. Further studies covering more areas in Indonesia are required.
Outcome of critically ill patients with systemic lupus erythematosus from a medical intensive care unit in Southern India
Authors: Bhargav Arvind , Ramanathan Venkateswaran , Ramadoss Ramu , Kavadichanda Chengappa , Mariaselvam Christina M , Negi Vir S , Thabah Molly M 
Published: September 2023

Objective Systemic lupus erythematosus (SLE) has become the most prevalent autoimmune condition requiring admission in the intensive care units (ICU) in the last two decades. Here we analysed the clinical outcomes of SLE patients admitted to our ICU between 2011 and 2021, and studied the prognostic role of high-density lipoprotein (HDL) and procalcitonin in those enrolled after August 2019. Methods Systemic lupus erythematosus (ACR/SLICC 2012) were enrolled, 72 retrospectively and 30 prospectively. Data on indications for ICU admission, complications, infections, and disease activity were recorded. Outcome was mortality at 90 days (prospective) whereas in the retrospective analysis outcome was hospital discharge or death in hospital. Serum HDL and procalcitonin (PCT) was estimated in the prospectively enrolled 30 patients and compared with 30 non ICU-SLE patients. Results Indications for ICU admissions were respiratory causes in 78/102 (76.5%) patients; for haemodynamic monitoring and for invasive procedures in the remaining. Pneumonia was the primary reason for mechanical ventilation, followed by diffuse alveolar haemorrhage (DAH). Eighty-three (81.3%) patients died; infections ( n = 54) and SLE related causes ( n = 29). APACHE-II >16 ( p = .026), lymphopenia ( p = .021), infection ( p = .002), creatinine >1.3 mg/dL ( p = .023), and hypotension requiring vasopressor support ( p = .006) emerged as significant predictors of non-survival on multivariable analysis. HDL (mg/dL) day 1 was significantly lower in SLE-ICU patients compared to non ICU-SLE (31.8 ± 14.3 vs 38.8 ± 11.4 mg/dl); p = .045. On day 1, PCT (ng/mL) in SLE-ICU was significantly higher when compared to non-ICU SLE; median (IQR): 0.53 (0.26–5.27) versus 0.13 (0.05–0.47), p < .001), respectively. It was also significantly higher on day 5 in SLE-ICU than non-ICU SLE (median (IQR): 4.18 (0.20–14.67) versus 0.10 (0.08–0.46), p = .004. Conclusion The mortality of SLE patients admitted to the ICU in this study is high, and infections were the principal reason for death. Baseline low HDL and higher procalcitonin are potential biomarkers to identify critically ill SLE patients.
Scutellarin Protects Myocardial Ischemia-Reperfusion Injury ERK1/2-CREB Regulated Mitophagy
Authors: Wang Wei-Wei , Liu Xiao-Lei , Ding Yu , Chen Ya-Di , Ma Dan , Bu Rui , Bao Tian-Hao 
Published: September 2023

Objectives Scutellarin, which is obtained from Erigeron breviscapus Hand-Mazz (EBHM), is a flavonoid that has demonstrated the ability to safeguard neural stem cells from hypoxia-induced damage and prevent cell apoptosis. The aim of this study was to investigate the beneficial impacts of Scutellarin on mitophagy in both in vivo and in vitro models of myocardial ischemia-reperfusion (I/R) injury. Materials and Methods Prior to inducing models of myocardial I/R injury, mice were administered either Scutellarin (50 mg/kg/day) or a vehicle for seven consecutive days. The mice underwent I/R injury (30 min of left anterior descending (LAD) coronary artery ligation followed by 120 min of reperfusion). Myocardial injury markers were assessed by the enzyme-linked immunosorbent assay (ELISA). The size of the myocardial infarction was measured via 2,3,5-triphenyl tetrazolium chloride triazole staining, and the protein expression of LC3 and caspase-3 was determined through Western blot analysis. In vitro experiments were conducted utilizing cultured H9C2 cells subjected to an oxygen-glucose deprivation/reoxygenation model to investigate the underlying mechanism(s) of Scutellarin’s positive effects (50 µM). Results It shows that Scutellarin treatment reduced the size of the myocardial infarctions and decreased the levels of myocardial injury markers. Western blot analysis showed that protein expression of caspase-3 was decreasing and the ratio of LC3Ⅱ to LC3Ⅰ was increasing in the Scutellarin group. In vitro, Scutellarin decreased oxidative stress markers, stabilized mitochondrial membrane potential (∇Ψm), decreased mitochondrial permeability transition pore (mPTP) opening rate, promoted mitochondrial fusion, inhibited mitochondrial fission, and increased adenosine triphosphate (ATP) production and cell viability. Scutellarin increased the commitment of mitophagy by regulating Pink and Parkin, while apoptosis decreased. cAMP-response element-binding protein (CREB) and extracellular signal-regulated kinases 1 and 2 (ERK1/2) phosphorylation were also modulated by Scutellarin. Conclusion The myocardial protective effect of Scutellarin may be associated with the phosphorylation of CREB and ERK1/2.
Peripapillary retinal nerve fiber layer thickness as a diagnostic tool for pseudophakic cystoid macular edema
Authors: Rabina Gilad , Shtayer Chen , Shemesh Rachel , Mimouni Michael , Gal-Or Orly , Nemet Arie Y. , Geffen Noa , Segal Ori 
Published: September 2023

PurposeTo investigate the effects of pseudophakic cystoid macular edema (PCME) on retinal nerve fiber layer (RNFL) thickness before and after treatment using optical coherence tomography (OCT).methodsA retrospective, observational study of consecutive patients diagnosed with PCME after cataract surgery. Patients underwent macular and RNFL OCT imaging at time of diagnosis and during follow up. OCT was performed for both the study eye and the contralateral healthy eye which served as control. All patients were followed for a period of at least 6 months.ResultsOverall, 40 eyes of 40 patients with a mean age of 71.1 ± 8.1 years of which 45% (n = 18) were of male gender were included in this study. At presentation, the central thickness in the PCME eye was significantly higher than in the contralateral eye (515.7 ± 127.9μm versus 238.1 ± 41.8μm, p < 0.001). Similarly, all macular measurements were significantly higher in the PCME eye compared to the contralateral eye (p < 0.001 for all). In terms of RNFL measurements, the PCME eyes had greater global (p < 0.001), superonasal (p = 0.001) and superotemporal (p = 0.005) thickness values. PCME eyes demonstrated a significant decrease in thickness for all macular and RNFL parameters following resolution of CME (p < 0.05 for all).ConclusionsPCME patients presents with greater global, superotemporal and superonasal RNFL thickness in comparison to the other healthy eye. After resolution of PCME, there is significant thinning of RNFL. Peripapillary RNFL thickness may serve as an additional parameter for diagnosis and follow-up of PCME.
Declining trends in telehealth utilization in the ongoing COVID-19 pandemic
Authors: Shilane David , Lu Ting’an Heidi 
Published: September 2023

Introduction Telehealth is an important complement to in-person healthcare, with opportunities to overcome barriers to healthcare and improve health equity. Telehealth utilization increased sharply at the onset of the COVID-19 pandemic. This study assessed trends in telehealth utilization for the years 2020 through 2022, both overall and in subgroups. Methods We gathered data from the 2020–2022 National Health Interview Survey. The rates of telehealth utilization were calculated overall and within subgroups based on demographic factors, health conditions, healthcare utilization, challenges of ability, and social needs. Adjusted multivariable logistic regression models of telehealth utilization assessed the yearly trends. We also analyzed the ratios of subgroup utilization relative to the overall rates. Results A total of 69,581 patients were identified with complete information. The overall rates of telehealth utilization were 36.2% for 2020, 38.9% for 2021, and 31.3% for 2022. The reduction in telehealth utilization for 2022 was large and statistically significant (OR: 0.64 (95% CI: 0.62–0.67), p < 0.001). Subgroup analyses showed corresponding reductions in 2022 for essentially all patient subgroups. Telehealth was utilized at higher rates by patients with chronic conditions, challenges of ability, and other kinds of medical utilization. Ratio analyses showed evidence of widening disparities for patients of older age, in rural areas, and by geographic region, limited education, and of low income. Discussion The study demonstrates declining rates of telehealth utilization are occurring with widening gaps among patient subgroups. Addressing these disparities may be critical to improving equity in telehealth and healthcare overall.