bluuebunny/crossref_metadata_2025_split huggingface dataset:
Markers of Natural Killer Cell Exhaustion in HIV/HCV Coinfection and Their Dynamics After HCV Clearance Mediated by Direct-Acting Antivirals
Authors: Osegueda Ariel , Polo Maria Laura , Baquero Lucia , Urioste Alejandra , Ghiglione Yanina , Paz Silvia , Poblete Gabriela , Gonzalez Polo Virginia , Turk Gabriela , Quiroga Maria Florencia , Laufer Natalia 
Published: November 2023

Abstract

Background
Liver fibrosis is a leading cause of morbimortality in people with HIV/hepatitis C virus (HCV). Natural killer (NK) cells are linked with amelioration of liver fibrosis; however, NK cells from individuals coinfected with HIV/HCV with cirrhosis display impaired functionality and high PD-1 expression. Here, we aimed to study PD-1, TIGIT, and Tim3 as potential exhaustion markers in NK cells from persons coinfected with HIV/HCV with mild and advanced liver fibrosis. We also evaluated the role of PD-1 expression on NK cells after HCV clearance by direct-acting antivirals (DAAs).

Methods
Peripheral blood mononuclear cells were isolated from individuals coinfected with HIV/HCV (N = 54; METAVIR F0/F1, n = 27; F4, evaluated by transient elastography, n = 27). In 26 participants, samples were collected before, at the end of, and 12 months after successful DAA treatment. The frequency, immunophenotype (PD-1, TIGIT, and Tim3 expression), and degranulation capacity (CD107a assay) of NK cells were determined by flow cytometry.

Results
Unlike PD-1, Tim3 and TIGIT were comparably expressed between persons with mild and advanced fibrosis. Degranulation capacity was diminished in NK/TIGIT+ cells in both fibrosis stages, while NK/PD-1+ cells showed a lower CD107a expression in cirrhotic cases. Twelve months after DAA treatment, those with advanced fibrosis showed an improved NK cell frequency and reduced NK/PD-1+ cell frequency but no changes in CD107a expression. In individuals with mild fibrosis, neither PD-1 nor NK cell frequency was modified, although the percentage of NK/CD107a+ cells was improved at 12 months posttreatment.

Conclusions
Although DAA improved exhaustion and frequency of NK cells in cirrhotic cases, functionality was reverted only in mild liver fibrosis, remarking the importance of an early DAA treatment.
Is electrostrain &gt;1% in oxygen deficient Na0.5Bi0.5TiO3 a composition effect?
Authors: Tina Getaw Abebe , Muleta Gudeta Jafo , Adhikary Gobinda Das , Ranjan Rajeev 
Published: November 2023

Abstract
For over two decades Na0.5Bi0.5TiO3 (NBT) -based lead-free piezoelectrics have attracted attention due to its ability to exhibit large electric-field driven strain. Compared to the popular Pb(Zr, Ti)O3 (PZT)-based piezoelectrics, which exhibit electrostrain of about 0.3%, the derivatives of NBT-based lead-free piezoelectrics at the ergodic—non ergodic relaxor crossover exhibit larger electric-field driven strain ∼0.45%. In recent years, there has been a concerted effort to increase the maximum electrostrain in lead-free piezoceramics. Recent reports suggest that oxygen deficient NBT- based piezoceramics can exhibit electrostrain ∼1%. In this paper we explore this phenomenon and show that the ultra high electric field driven strain measured is primarily a consequence of reducing the thickness of the disc dimension below 500 microns and not an exclusive effect of the composition.
Green bonds and carbon emissions
Authors: Flammer Caroline 
Published: November 2023

Abstract
This paper examines the relationship between green bonds (that is, bonds whose proceeds are committed to financing green projects) and carbon emissions at the aggregate level. Using data for US states, I find that the issuance of $1,000 of green bonds per capita is associated with a subsequent decrease in state-level emissions by 0.9–1.4 per cent. I obtain similar magnitudes using cross-country data. These results are stronger for green bonds that are certified by independent third parties, suggesting that certification is an important governance mechanism in the green bond market.
Factors that predict the safe recovery of missing and abducted children
Authors: Reifel Kerri L , Sundberg-Alley Madison , McCaulley Karen L , Hayne Anita S 
Published: November 2023

Abstract
Over 2,000 children were reported as ‘critically missing’ to a federal law enforcement agency’s crisis watch unit between the years of 2014 and 2020. The present study examines characteristics from these cases to determine what factors may exist to help predict their safe recovery. Most children in the sample (89%) were recovered alive. Several factors that serve as predictors for a safe recovery were revealed, including being a multiple-victim incident; being reported last seen at school; the victim/offender relationship; and initial incident classification of abduction, as opposed to missing. A significant interaction between age and presence of Autism Spectrum Disorder (ASD) suggests that young victims with ASD are less likely to be recovered alive. Operational considerations for law enforcement are provided.
Deep Learning Models for Predicting Hearing Thresholds Based on Swept-Tone Stimulus-Frequency Otoacoustic Emissions
Authors: Liu Yin , Gong Qin 
Published: November 2023

Objectives:
This study aims to develop deep learning (DL) models for the quantitative prediction of hearing thresholds based on stimulus-frequency otoacoustic emissions (SFOAEs) evoked by swept tones.

Design:
A total of 174 ears with normal hearing and 388 ears with sensorineural hearing loss were studied. SFOAEs in the 0.3 to 4.3 kHz frequency range were recorded using linearly swept tones at a rate of 2 Hz/msec, with stimulus level changing from 40 to 60 dB SPL in 10 dB steps. Four DL models were used to predict hearing thresholds at octave frequencies from 0.5 to 4 kHz. The models—a conventional convolutional neural network (CNN), a hybrid CNN-k-nearest neighbor (KNN), a hybrid CNN-support vector machine (SVM), and a hybrid CNN-random forest (RF)—were individually built for each frequency. The input to the DL models was the measured raw SFOAE amplitude spectra and their corresponding signal to noise ratio spectra. All DL models shared a CNN-based feature self-extractor. They differed in that the conventional CNN utilized a fully connected layer to make the final regression decision, whereas the hybrid CNN-KNN, CNN-SVM, and CNN-RF models were designed by replacing the last fully connected layer of CNN model with a traditional machine learning (ML) regressor, that is, KNN, SVM, and RF, respectively. The model performance was evaluated using mean absolute error and SE averaged over 20 repetitions of 5 × 5 fold nested cross-validation. The performance of the proposed DL models was compared with two types of traditional ML models.

Results:
The proposed SFOAE-based DL models resulted in an optimal mean absolute error of 5.98, 5.22, 5.51, and 6.06 dB at 0.5, 1, 2, and 4 kHz, respectively, superior to that obtained by the traditional ML models. The produced SEs were 8.55, 7.27, 7.58, and 7.95 dB at 0.5, 1, 2, and 4 kHz, respectively. All the DL models outperformed any of the traditional ML models.

Conclusions:
The proposed swept-tone SFOAE-based DL models were capable of quantitatively predicting hearing thresholds with satisfactory performance. With DL techniques, the underlying relationship between SFOAEs and hearing thresholds at disparate frequencies was explored and captured, potentially improving the diagnostic value of SFOAEs.
15 Years of Spinal Fusion Outcomes in Children with Cerebral Palsy
Authors: Badin Daniel , Shah Suken A. , Narayanan Unni G. , Cahill Patrick J. , Marrache Majd , Samdani Amer F. , Yaszay Burt , Hunsberger Joann B. , Marks Michelle C. ,   HARMS Study Group, Sponseller Paul D. 
Published: November 2023

Study Design.
Retrospective Multicenter Study

Objective.
We reviewed 15-year trends in operative factors, radiographic and quality-of-life outcomes, and complication rates in children with cerebral palsy (CP) related scoliosis who underwent spinal fusion.

Summary of Background Data.
Over the past 2 decades, significant efforts have been made to decrease complications and improve outcomes of this population.

Methods.
We retrospectively reviewed a multicenter registry of pediatric CP patients who underwent spinal fusion from 2008 to 2020. We evaluated baseline and operative, hospitalization, and complication data as well as radiographic and quality-of-life outcomes at a minimum 2-year follow-up.

Results.
Mean estimated blood loss and transfusion volume declined from 2.7±2.0 L in 2008 to 0.71±0.34 L in 2020 and 1.0±0.5 L in 2008 to 0.5±0.2 L in 2020, respectively, with a concomitant increase in antifibrinolytic use from 58% to 97% (all, P<0.01). Unit rod and pelvic fusion use declined from 33% in 2008 to 0% in 2020 and 96% in 2008 to 79% in 2020, respectively (both, P<0.05). Mean postoperative intubation time declined from 2.5±2.6 days to 0.42±0.63 days (P<0.01). No changes were observed in pre- and post-operative coronal angle and pelvic obliquity, operative time, frequency of anterior/anterior-posterior approach, and durations of hospital and intensive care unit stays. Improvements in the Caregiver Priorities and Child Health Index of Life with Disabilities postoperatively did not change significantly over the study period. Complication rates, including reoperation, superficial and deep surgical site infection, and gastrointestinal and medical complications remained stable over the study period.

Conclusions.
Over the past 15 years of CP-scoliosis surgery, surgical blood loss, transfusion volumes, duration of postoperative intubation, and pelvic fusion rates have decreased. However, the degree of radiographic correction, the rates of surgical and medical complications (including infection), and health-related quality-of-life measures have broadly remained constant.

Level of Evidence.
3
Repeated Levosimendan Infusions in the Management of Advanced Heart Failure: Review of the Evidence and Meta-analysis of the Effect on Mortality
Authors: Silvetti Simona , Pollesello Piero , Belletti Alessandro 
Published: November 2023

Abstract:
In the latest years, several studies described the impact of repetitive/intermittent i.v. levosimendan treatment in the management of advanced heart failure. For this updated review, we systematically searched the literature for clinical trials, registries, and real-world data and identified 31 studies that we commented in a narrative review: 3814 patients were described, of whom 1744 were treated repetitively with levosimendan. On the basis of the nature of the study protocols and of the end points, out of those studies, we further selected 9 that had characteristics, making them suitable for a meta-analysis on mortality. This short list describes data from 680 patients (of whom 399 received repeated doses of levosimendan) and 110 death events (of which 50 occurred in the levosimendan cohort). In the meta-analysis, repetitive/intermittent therapy with i.v. levosimendan was associated with a significant reduction in mortality at the longest time point available: 50 of 399 (12.5%) versus 60 of 281 (21.4%) in the control arms, with a risk ratio of 0.62 (95% confidence interval, 0.42–0.90; P < 0.01). In a sensitivity analysis, removing each trial and reanalyzing the remaining data set did not change the trend, magnitude, or significance of the results. A visual inspection of the funnel plot did not suggest publication bias. The results provide a very strong rationale for continuing to investigate the repetitive use of levosimendan in patients with advanced heart failure by properly powered regulatory clinical trials. Meanwhile, it seems that the use of repetitive/intermittent i.v. levosimendan infusions has become one of the few effective options for preserving the hemodynamic and symptomatic balance in such patients.
High Fatality Rates in Pediatric Multisystem Inflammatory Syndrome: A Multicenter Experience From the Epicenter of Brazil’s Coronavirus Pandemic
Authors: Almeida Flávia Jacqueline , Jarovsky Daniel , Almeida Farias Camila Giuliana , Ramos Nantes de Castilho Taisa Roberta , Gara Caetano Thiago , Manzoni Ribeiro Borsetto Cibele Cristina , Simões Aguiar Andressa , Serafini de Araújo Carolina , Badue Pereira Maria Fernanda , de Sousa Marques Heloisa Helena , Silva Clovis Artur , Ribeiro de Matos Tannure Andressa , Prado Rogério , Becker Mau Luciana , Andrade Alvares Paula , de Siqueira Antônio Carlos , Paro Scremin Gustavo , Otsuka Marcelo , Volpe Arnoni Mariana , Machado Rissoni Laporte Roberta , Altruda de Moraes Costa Carlesse Fabianne , Ejzenberg Fernanda , Naaman Berezin Eitan , Palazzi Sáfadi Marco Aurélio 
Published: November 2023

Background:
Brazil´s case fatality rate (CFR) of pediatric multisystem inflammatory syndrome in children and adolescents (MIS-C) is among the highest worldwide. Despite these concerns, limited hospital-based and comprehensive pediatric data have been published on MIS-C in Brazilian children.

Methods:
We performed a descriptive analysis of the MIS-C scores in 16 public and private hospitals providing secondary and tertiary care in the metropolitan area of São Paulo, Brazil. Clinical and demographic information were systematically extracted from the electronic medical records of each patient. Logistic regression analysis was performed to identify the combined effects of MIS-C phenotype, disease severity and comorbidity as dependent variables.

Results:
A total of 101 patients met the MIS-C criteria and were evaluated. The median age was 67 months, 60% were male, 28.7% were black or afrodescendant and 62.3% were admitted to public hospitals. Underlying medical conditions were observed in 16.8% of patients and were associated with a longer duration of hospitalization. A Kawasaki disease-like phenotype was observed in 43.5% of patients, and they demonstrated a trend of lower median age. Children with severe MIS-C were older (median age 91 months vs. 36 months) and had a nonspecific phenotype, more cardiovascular and respiratory involvement and kidney injury; 73.3% required intensive care, 20.8% required mechanical ventilation and 35.6% required inotropic support. Four deaths occurred (CFR = 3.9%), three of which were in healthy participants.

Conclusion:
We identified a lower median age, particularly among children with Kawasaki disease-like phenotypes, those with a significant need for intensive care, and a high CFR in MIS-C. Our findings confirmed the increased severity of the disease in the selected Brazilian population.
A multiomic investigation of lung adenocarcinoma molecular subtypes
Authors: Liang Kung-Hao , Luo Yung-Hung , Wang Mong-Lien , Chiou Shih-Hwa , Chen Yuh-Min , Hsu Han-Shui 
Published: November 2023

Background:
Lung adenocarcinoma—an aggressive and life-threatening malignancy—is a type of non–small-cell lung cancer. Despite medical advancements, the prognosis of lung adenocarcinoma remains unfavorable, likely because of its heterogeneous nature. Furthermore, few subtype-specific treatments are available for lung adenocarcinoma. This study was conducted to explore the molecular subtypes of lung adenocarcinoma.

Methods:
We performed a joint analysis of transcriptome and proteome data from East Asian patients with lung adenocarcinoma (nonsmokers, 86.5%).

Results:
Four novel subtypes were identified based on distinct molecular characteristics: subtypes I, II, III, and IV. In patients with subtype I lung adenocarcinoma, eukaryotic translation initiation factor 4 gamma 1 activates cell proliferation; inhibiting this factor suppresses tumor growth, and reducing its level induces autophagy. Subtype II is characterized by Kristen rat sarcoma viral oncogene homolog-activating oncogenesis; the onset age of this subtype is the lowest among all subtypes. Subtype III manifests as an advanced disease at diagnosis; it is characterized by a core serum response-related oncogenic signature, which indicates poor overall survival in Western patients with lung cancer. Subtype IV is more common in men than in women; it has astroglial characteristics. A Connectivity Map analysis revealed that the oncogenic expression patterns corresponding to subtypes I, II, III, and IV can be reversed by the inhibitors of Inhibitor of κB (IκB) kinase (eg, withaferin A), mammalian target of rapamycin (eg, everolimus), Src proto-oncogene (Src) (eg, saracatinib), and Transforming Growth Factor (TGF)-β/Smad (eg, LY-364947), respectively.

Conclusion:
This study introduced an innovative multiomics data analysis pipeline. Using this approach, we successfully identified four molecular subtypes of lung adenocarcinoma and their candidate therapeutic agents. The newly identified subtypes can be combined with the current biomarkers to generate a comprehensive roadmap for treatment decision-making.
Somatic PIK3CA Variants Are Associated With Eccrine Angiomatous Hamartomas
Authors: Bricknell Lana , Richmond Christopher M. , Das Gupta Romi , Payton Diane , Phua Yun , Kimble Roy M. 
Published: November 2023

Objectives:
Eccrine angiomatous hamartoma (EAH) is a rare vascular anomaly with mixed eccrine and vascular components, typically identified in children. While benign, EAH can cause significant morbidity and be difficult to treat. The aims of this case series were to identify all patients with EAH that have been seen at the Queensland Children’s Hospital and describe their phenotypic and somatic genotypic details, in an effort to contribute to the limiting understanding and literature surrounding this condition.

Methods:
Individuals with EAH were retrospectively identified through engagement in a multidisciplinary vascular anomaly clinic in a tertiary Australian children’s hospital. All individuals had a previous histological diagnosis of EAH. High-read-depth sequencing of a panel of 27 genes known to be associated with vascular anomalies was undertaken on affected tissue. Samples were rereviewed by a senior pathologist and geneticist for this study.

Results:
Five cases of EAH were identified. All were associated with 1 of 3 somatic PIK3CA variants (c.1633G>A;p.Glu545Lys, c.1624G>A;p.Glu542Lys, and c.3140A>G;p.Histo1047Arg) in low allele fractions. These variants have previously been reported in a range of tumors and vascular anomalies, including PIK3CA-related overgrowth spectrum, but not in EAH.

Conclusion:
Occurrence of somatic PIK3CA variants in EAH provides evidence for a novel gene-disease association and is plausibly the cause of EAH in some individuals. This finding expands the phenotypic spectrum of PIK3CA, contributes to understanding of the pathophysiology of this rare condition, and may avail molecularly targeted therapy in the future.
The Perceived Intersection of Parenting and Physician Assistant Training Among Current Physician Assistant Students
Authors: Neary Stephanie , Smith Nöel E. , Henderson Derek C. , Ruggeri Mary 
Published: November 2023

Introduction
Despite recent advancements in policies supporting pregnancy and parenting-related resources for physician assistant (PA) students, there remains a paucity of data on the perceptions of family planning or available resources during training. The purpose of this study was to explore the perceptions of support for, and impact on, family planning and parenting, including lactation, among PA students.

Methods
This cross-sectional study used data collected from the American Academy of Physician Associates Student Survey between January and March 2023. Descriptive and inferential statistics were performed.

Results
A total of 557 students (557/1353; 41.2%) completed the survey. Less than 15% of students (14.4%) believed their program provides resources to support parental leave, and many students (52.1%) remained unsure whether resources exist(ed). There was a significant difference for PA students (P = .005) by gender in whether family planning affected the decision to pursue PA training over another profession, with female students proportionately affected more than male students. Medical school was the most often considered aside from PA training. Most PA students (311/548; 56.8%) also felt pressure to wait until after training to have children. In addition, multiple students (26/554; 4.7%) admitted to being asked questions they believed were biased or inappropriate regarding pregnancy or parenting during the interview process for, or after beginning, PA school.

Discussion
Programs should seek opportunities to support students through all stages of family planning. Support will require both cultural and structural shifts beginning with peer stigma and extending through admissions interview question audits, faculty training, university policies, and accreditation requirements.
Self-disclosure in Adult Patients With Cancer
Authors: Lee Hyungran , Jeong Younhee 
Published: November 2023

Background
Health-related self-disclosure has been studied in various aspects, as has self-disclosure of cancer patients. However, any theoretical models that comprehensively include self-disclosure events, factors associated with self-disclosure, and the outcomes of self-disclosure of cancer patients have not yet been presented.

Objective
The purpose of this study was to explore the relationships between self-disclosure, perception toward cancer, intention for self-disclosure, level and range of self-disclosure, social support, and well-being in adult patients with cancer.

Methods
Data were collected from adult cancer patients via an online survey using self-report questionnaires and analyzed using structural equation modeling. The data from 359 participants were included in the final analysis.

Results
Positive intention for self-disclosure was a significant predictor of both self-disclosure level and range, whereas negative perception toward cancer significantly decreased self-disclosure level. The self-disclosure level significantly improved both social support and well-being, whereas the self-disclosure range did not present a significant impact on social support and well-being.

Conclusion
Self-disclosure is closely associated with social support and well-being, and self-disclosure can be promoted by improving negative perceptions and positive intentions about self-disclosure. In addition, to improve the social support and well-being of cancer patients, it suggests increasing the self-disclosure depth level rather than widening the range of self-disclosure.

Implications for Practice
The results of this study can be used as evidence for the development of nursing intervention programs to reduce negative perceptions toward cancer and improve positive intentions and levels of self-disclosure among cancer patients.