bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dialysis initiation for patients with decompensated cirrhosis when liver transplant is unlikely
Authors: Bansal Amar D. , Patel Arpan A. 
Published: December 2023

Purpose of review
The purpose of this review is to describe an approach that emphasizes shared decision-making for patients with decompensated cirrhosis and acute kidney injury when liver transplantation is either not an option, or unlikely to be an option.

Recent findings
When acute kidney injury occurs on a background of decompensated cirrhosis, outcomes are generally poor. Providers can also be faced with prognostic uncertainty. A lack of guidance from nephrology and hepatology professional societies means that providers rely on expert opinion or institutional practice patterns.

Summary
For patients who are unlikely to receive liver transplantation, the occurrence of acute kidney injury represents an opportunity for a goals of care conversation. In this article, we share strategies through which providers can incorporate more shared decision-making when caring for these patients. The approach involves creating prognostic consensus amongst multidisciplinary teams and then relying on skilled communicators to share the prognosis. Palliative care consultation can be useful when teams need assistance in the conversations.
Molecular profiling in the management of hepatocellular carcinoma
Authors: Soliman Nadine , Saharia Ashish , Abdelrahim Maen , Connor Ashton A. 
Published: December 2023

Purpose of review
The purpose of this review is to both summarize the current knowledge of hepatocellular carcinoma molecular biology and to suggest a framework in which to prospectively translate this knowledge into patient care. This is timely as recent guidelines recommend increased use of these technologies to advance personalized liver cancer care.

Recent findings
The main themes covered here address germline and somatic genetic alterations recently discovered in hepatocellular carcinoma, largely owing to next generation sequencing technologies, and nascent efforts to translate these into contemporary practice.

Summary
Early efforts of translating molecular profiling to hepatocellular carcinoma care demonstrate a growing number of potentially actionable alterations. Still lacking are a consensus on what biomarkers and technologies to adopt, at what scale and cost, and how to integrate them most effectively into care.
Community Mental Health Services for Frequent Emergency Department Users
Authors: Samosh Jonathan , Agha Ayda , Pettey Donna , Sylvestre John , Aubry Tim 
Published: December 2023

Purpose of Study:
This study aimed to investigate the perceived outcomes and mechanisms of change of a community mental health service combining system navigation and intensive case management supports for frequent emergency department users presenting with mental illness or addiction.

Primary Practice Setting:
The study setting was a community mental health agency receiving automated referrals directly from hospitals in a midsize Canadian city for all individuals attending an emergency department two or more times within 30 days for mental illness or addiction.

Methodology and Sample:
Qualitative interviews with 15 program clients. Focus groups with six program case managers. Data were analyzed using pragmatic qualitative thematic analysis.

Results:
Participants generally reported perceiving that the program contributed to reduced emergency department use, reduced mental illness symptom severity, and improved quality of life. Perceived outcomes were more mixed for outcomes related to addiction. Reported mechanisms of change emphasized the importance of positive working relationships between program clients and case managers, as well as focused efforts to develop practical skills.

Implications for Case Management Practice:
Community mental health services including intensive case management for frequent emergency department users presenting with mental illness or addiction were perceived to effectively address client needs while reducing emergency department resource burden. Similar programs should emphasize the development of consistent and warm working relationships between program clients and case managers, as well as practical skills development to support client health and well-being.
Necrotizing fasciitis: an update on epidemiology, diagnostic methods, and treatment
Authors: Allaw Fatima , Wehbe Saliba , Kanj Souha S. 
Published: December 2023

Purpose of review
The aim of this review is to discuss the latest evidence of epidemiology, diagnostic methods, and treatment of necrotizing soft tissue infections (NSTIs) with a particular focus on necrotizing fasciitis (NF).

Recent findings
NSTIs have been historically referred to as NF but encompass a broader range of infections, with variable rates ranging from 0.86 to 32.64 per 100 000 person-years, influenced by factors such as climate and seasonal variations. They have diverse microbiological profiles categorized into different types based on the involved pathogens, including polymicrobial or monomicrobial infections caused by organisms such as group A streptococcus (GAS), Staphylococcus aureus, some Gram-negative pathogens, and filamentous fungi following trauma and natural disasters. Diagnosis relies on clinical symptoms and signs, laboratory markers, and imaging. However, the gold standard for diagnosis remains intraoperative tissue culture. Treatment involves repeated surgical debridement of necrotic tissues in addition to intravenous antibiotics. Adjuvant therapies with intravenous immunoglobulin (IVIG) and hyperbaric oxygen therapy (HBOT) might have a role. Soft tissue reconstruction may be necessary following surgery.

Summary
Prompt diagnosis and proper medical and surgical management of NSTI will improve outcomes.
Does imaging of the ischemic penumbra have value in acute ischemic stroke with large vessel occlusion?
Authors: Seners Pierre , Baron Jean-Claude , Olivot Jean-Marc , Albers Gregory W. 
Published: December 2023

Purpose of review
In this review, we summarize current evidence regarding potential benefits and limitations of using perfusion imaging to estimate presence and extent of irreversibly injured ischemic brain tissue (‘core’) and severely ischemic yet salvageable tissue (‘penumbra’) in acute stroke patients with large vessel occlusion (LVO).

Recent findings
Core and penumbra volumes are strong prognostic biomarkers in LVO patients. Greater benefits of both intravenous thrombolysis and endovascular therapy (EVT) are observed in patients with small core and large penumbra volumes. However, some current definitions of clinically relevant penumbra may be too restrictive and exclude patients who may benefit from reperfusion therapies. Alongside other clinical and radiological factors, penumbral imaging may enhance the discussion regarding the benefit/risk ratio of EVT in common clinical situations, such as patients with large core – for whom EVT's benefit is established but associated with a high rate of severe disability –, or patients with mild symptoms or medium vessel occlusions – for whom EVT's benefit is currently unknown. Beyond penumbral evaluation, perfusion imaging is clinically relevant for optimizing patient's selection for neuroprotection trials.

Summary
In an emerging era of precision medicine, perfusion imaging is a valuable tool in LVO-related acute stroke.
In-vivo diagnosis of cerebral amyloid angiopathy: an updated review
Authors: Raposo Nicolas , Périole Charlotte , Planton Mélanie 
Published: December 2023

Purpose of review
Sporadic cerebral amyloid angiopathy (CAA) is a highly prevalent small vessel disease in ageing population with potential severe complications including lobar intracerebral hemorrhage (ICH), cognitive impairment, and dementia. Although diagnosis of CAA was made only with postmortem neuropathological examination a few decades ago, diagnosing CAA without pathological proof is now allowed in living patients. This review focuses on recently identified biomarkers of CAA and current diagnostic criteria.

Recent findings
Over the past few years, clinicians and researchers have shown increased interest for CAA, and important advances have been made. Thanks to recent insights into mechanisms involved in CAA and advances in structural and functional neuroimaging, PET amyloid tracers, cerebrospinal fluid and plasma biomarkers analysis, a growing number of biomarkers of CAA have been identified. Imaging-based diagnostic criteria including emerging biomarkers have been recently developed or updated, enabling accurate and earlier diagnosis of CAA in living patients.

Summary
Recent advances in neuroimaging allow diagnosing CAA in the absence of pathological examination. Current imaging-based criteria have high diagnostic performance in patients presenting with ICH, but is more limited in other clinical context such as cognitively impaired patients or asymptomatic individuals. Further research is still needed to improve diagnostic accuracy.
Postdischarge telephone follow-up among chronic disease patients discharged from a vascular surgery service: a best practice implementation project
Authors: Sousa Pedro , Cardoso Daniela , Vrbová Tereza , Apóstolo João , Santos Margarida , Manso Gracinda , Mourão Daniel , Ferreira Goreti , Monteiro Manuela , Manata Jacinta , Vaz Alexandre , Klugarová Jitka , Klugar Miloslav 
Published: December 2023

ABSTRACT

Objectives:
To improve postdischarge telephone follow-up in the context of chronic disease management (peripheral artery disease), in a vascular surgery service.

Introduction:
Patients with chronic diseases, such as peripheral artery disease, present a higher risk of complications and greater constraints regarding their adherence to treatment, leading to an increasing mortality rate and decreased functional capacity. Comprehensive discharge planning plus postdischarge telephone follow-up may reduce 30-day re-hospitalization rates.

Methods:
The project used the JBI audit and feedback methodological approach to implement the best available evidence into practice. Two audit criteria were used: existence of comprehensive discharge planning and timely telephone follow-up. A baseline audit was conducted, followed by analysis of barriers, which led to the implementation of several strategies, namely, a targeted training program, the development of educational resources and standardized procedures for the discharge process, and postdischarge telephone follow-up.

Results:
Results from the baseline and first follow-up audits showed improvement for both criteria. Compliance for criterion 1 (comprehensive discharge planning, including postdischarge telephone follow-up) increased from 0% to 40.7%, and for criterion 2 (patient is followed up by telephone within 2 weeks of discharge) increased from 0% to 44.4%. These two criteria sustained improvements in the second follow-up audit: compliance increased to 45% (criterion 1) and 60% (criterion 2).

Conclusions:
This implementation project contributed to the optimization of the chronic disease management, including improved compliance with discharge planning and early postdischarge telephone follow-up.
Breastfeeding support and avoiding inappropriate breast milk substitute marketing in a neonatal ward in the Czech Republic: a best practice implementation project
Authors: Kantorová Lucia , Poloková Andrea , Sýkora Michal , Vrbová Tereza , Klugar Miloslav , Klugarová Jitka 
Published: December 2023

ABSTRACT

Objectives:
The aim of this implementation project was to improve breastfeeding support, and more specifically, to increase compliance with the Baby-Friendly Hospital Initiative (BFHI) and the requirements of the International Code of Marketing of Breastmilk Substitutes (the Code).

Introduction:
The Ten Steps to Successful Breastfeeding of the BFHI have been shown to improve breastfeeding outcomes at target hospitals. The Code is a minimum standard for the regulation of marketing practices related to breastfeeding support.

Methods:
We used the JBI evidence implementation model to identify a group of stakeholders in a hospital in the Czech Republic and carried out a best practice implementation project from January 2021 to May 2022. After conducting a baseline audit, the clinical team and external breastfeeding experts discussed challenges and devised an implementation plan using the JBI Getting Research into Practice framework. Follow-up audits were undertaken from January to December 2021 and in May 2022.

Results:
Compliance improved across all audited criteria, namely, to fully comply with the Code (0% to 100%); to have a written infant feeding policy (0% to 100%); to ensure staff have skills to support breastfeeding (0% to 100%); to discuss breastfeeding with pregnant women (0% to 100%); to facilitate skin-to-skin contact (67.86% to 83.58%); to support and provide help with breastfeeding (67.86% to 82.09%); to not provide fluids other than breast milk (50% to 58.21%); to practice rooming-in (57.14% to 61.19%); to respond to infant cues (50% to 64.18%); to provide information about community support services (32.14% to 62.69%); and to coordinate discharge and ongoing care (0% to 100%).

Conclusions:
Breastfeeding support requires a sustained long-term effort before it can become fully established. The involvement of national-level policy makers is needed.
Parsing digital or analogue TCR performance through piconewton forces
Authors: Akitsu Aoi , Kobayashi Eiji , Feng Yinnian , Stephens Hannah M. , Brazin Kristine N. , Masi Daniel J. , Kirpatrick Evan H. , Mallis Robert J. , Duke-Cohan Jonathan S. , Booker Matthew A. , Cinella Vincenzo , Feng William W. , Holliday Elizabeth L. , Lee Jonathan J. , Zienkiewicz Katarzyna J. , Tolstorukov Michael Y. , Hwang Wonmuk , Lang Matthew J. , Reinherz Ellis L. 
Published: December 2023

Abstractαβ T-cell receptors (TCRs) recognize aberrant peptides bound to major histocompatibility complex molecules (pMHCs) on unhealthy cells, amplifying specificity and sensitivity through physical load placed on the TCR-pMHC bond during immunosurveillance. To understand this mechanobiology, TCRs stimulated by abundantly and sparsely arrayed epitopes (NP366-374/Dband PA224-233/Db, respectively) followingin vivoinfluenza A virus infection were studied with optical tweezers. While certain NP repertoire CD8 T lymphocytes require many ligands for activation, others are digital, needing just few. Conversely, all PA TCRs perform digitally, exhibiting pronounced bond lifetime increases through sustained, energizing volleys of structural transitioning. Optimal digital performance is superiorin vivo,correlating with ERK phosphorylation, CD3 loss, and activation marker upregulationin vitro. Given neoantigen array paucity, digital TCRs are likely critical for immunotherapies.One Sentence SummaryQuality of ligand recognition in a T-cell repertoire is revealed through application of physical load on clonal T-cell receptor (TCR)-pMHC bonds
Identification of a targetable ST2-expressing fibroblast subset driving Peutz-Jeghers syndrome polyposis
Authors: Domènech-Moreno Eva , Lim Wei-Wen , Brandt Anders , Lemmetyinen Toni T , Viitala Emma W , Mäkelä Tomi P , Cook Stuart A , Ollila Saara 
Published: December 2023

AbstractPeutz-Jeghers syndrome (PJS) is associated with early-onset and recurring gastrointestinal hamartomatous polyposis caused by hereditary inactivating mutations in the tumor suppressor gene LKB1 (STK11). Due to lack of efficient prophylactic therapies PJS patients require regular surgical interventions and have an increased risk of cancer. LKB1-deficient fibroblasts have been identified as drivers of polyposis, but a safely druggable target remains to be identified. Here we investigate tumorigenic mechanisms in PJS polyps using single-cell RNA sequencing of predisposed and tumor tissue and identified a ST2-expressing crypt top fibroblast (CTF) cluster enriched in polyps. The relevance of CTFs was supported by the fast polyposis following deletion of Lkb1 in CTFs. The transcriptional signature characterizing the ST2+ fibroblasts (ST2-CTFs) was enriched in inflammation-associated fibroblasts, and PJS polyposis was exacerbated by inflammation. Cell-cell communication analysis identified the ST2-CTF signature gene interleukin 11 (IL-11) as an upstream regulator of the ST2-CTFs, and consistently, reprogramming toward ST2 fibroblasts in vitro was dependent on IL-11. Importantly, a neutralizing IL-11 antibody efficiently reduced the tumor burden in a PJS mouse model. In summary, our results reveal ST2+ tumorigenic fibroblasts as drivers of PJS polyposis and identify IL-11 as the key mediator and a potential therapeutic target in PJS.
Whole-genome screening for near-diagnostic genetic markers for white oak species identification in Europe
Authors: Kremer Antoine , Delcamp Adline , Lesur Isabelle , Wagner Stefanie , Christian Rellstab , Guichoux Erwan , Leroy Thibault 
Published: December 2023

AbstractContextIdentifying species in the European white oak complex has been a long standing concern in taxonomy, evolution, forest research and management.Quercus petraea, Q. robur, Q. pubescensandQ. pyrenaicaare part of this species complex in western temperate Europe and hybridize in mixed stands, challenging species identification.AimsOur aim was to identify diagnostic single nucleotide polymorphisms (SNPs) for each of the four species that are suitable for routine use and rapid diagnosis in research and applied forestry.MethodsWe first scanned existing whole-genome and target-capture data sets in a reduced number of samples (training set) to identify candidate diagnostic SNPs, ie genomic positions being characterized by a reference allele in one species and by the alternative allele in all other species. Allele frequencies of the candidates SNPs were then explored in a larger, range-wide sample of populations in each species (validation step).ResultsWe found a subset of 38 SNPs (ten forQ. petraea, seven forQ. pubescens, nine forQ. pyrenaicaand twelve forQ. robur) that showed near-diagnostic features across their species distribution ranges withQ. pyrenaicaandQ. pubescensexhibiting the highest and lowest diagnosticity, respectively.ConclusionsWe provide a new, efficient and reliable molecular tool for the identification of the speciesQ. petraea, Q. robur, Q. pubescensandQ. pyrenaica, which can be used as a routine tool in forest research and management. This study highlights the resolution offered by whole-genome sequencing data to design diagnostic marker sets for taxonomic assignment, even for species complexes with relatively low differentiation.
Optimizingex-vitroone-step RUBY-equipped hairy root transformation in drug- and hemp-type Cannabis
Authors: Ajdanian Ladan , Niazian Mohsen , Torkamaneh Davoud 
Published: December 2023

AbstractUsing synthetic biology techniques to engineer secondary metabolic pathways through hairy root transformation is one of the most advanced approaches used in research. In this study, we optimized anex-vitroone-step hairy root transformation of theRUBYsystem in both drug- and hemp-type cannabis, shedding light on its potential applications in secondary metabolite production. Three different strains ofA. rhizogenesincluding (A4, ARqual, and K599) were used. Significant variation in HR induction and transformation efficiency (TE) was observed based onA. rhizogenesstrains and seed types. Drug-type seedlings exhibited the highest hairy root induction, increasing by 58.8% compared to hemp-type seedlings. Also, the A4 strain consistently demonstrated the highest transformation efficiency (75%) irrespective of genotype, while the ARqual strain yielded the lowest one (8.33%). In conclusion, our study is the first to present anex-vitroone-step transformation of both hemp- and drug-type cannabis. In comparison to the in vitro method, our ex-vitro method is simpler, faster, and has a lower risk of contamination, making it an excellent choice for the efficient production of secondary metabolites in cannabis using the CRISPR/Cas system.
Subfamily C7 Raf-like kinases MRK1, RAF26, and RAF39 regulate immune homeostasis and stomatal opening inArabidopsis thaliana
Authors: Dias Márcia Gonçalves , Doss Bassem , Rawat Anamika , Siegel Kristen R. , Mahathanthrige Tharika , Sklenar Jan , Derbyshire Paul , Dharmasena Thakshila , Cameron Emma , Zipfel Cyril , Menke Frank L.H. , Monaghan Jacqueline 
Published: December 2023

SummaryThe calcium-dependent protein kinase CPK28 is a regulator of immune homeostasis in multiple plant species. Here, we used a proteomics approach to uncover CPK28-associated proteins. We found that CPK28 associates with subfamily C7 Raf-like kinases MRK1, RAF26, and RAF39, and trans-phosphorylates RAF26 and RAF39. Metazoan Raf kinases function in mitogen-activated protein kinase (MAPK) cascades as MAPK kinase kinases (MKKKs). Although Raf-like kinases share some features with MKKKs, we found that MRK1, RAF26, and RAF39 are unable to trans-phosphorylate any of the 10 Arabidopsis MKKs. We show that MRK1, RAF26, and RAF39 localize to the cytosol and endomembranes, and we define redundant roles for these kinases in stomatal opening, immune-triggered reactive oxygen species (ROS) production, and resistance to a bacterial pathogen. Overall, our study suggests that C7 Raf-like kinases associate with and are phosphorylated by CPK28, function redundantly in stomatal immunity, and possess substrate specificities distinct from canonical MKKKs.
Perineuronal nets and the neuronal extracellular matrix can be imaged by genetically encoded labeling of HAPLN1in vitroandin vivo
Authors: Lemieux Sakina P. , Lev-Ram Varda , Tsien Roger Y. , Ellisman Mark H. 
Published: December 2023

AbstractNeuronal extracellular matrix (ECM) and a specific form of ECM called the perineuronal net (PNN) are important structures for central nervous system (CNS) integrity and synaptic plasticity. PNNs are distinctive, dense extracellular structures that surround parvalbumin (PV)-positive inhibitory interneurons with openings at mature synapses. Enzyme-mediated PNN disruption can erase established memories and re-open critical periods in animals, suggesting that PNNs are important for memory stabilization and conservation. Here, we characterized the structure and distribution of several ECM/PNN molecules around neurons in culture, brain slice, and whole mouse brain. While specific lectins are well-established as PNN markers and label a distinct, fenestrated structure around PV neurons, we show that other CNS neurons possess similar extracellular structures assembled around hyaluronic acid, suggesting a PNN-like structure of different composition that is more widespread. We additionally report that genetically encoded labeling of hyaluronan and proteoglycan link protein 1 (HAPLN1) reveals a PNN-like structure around many neuronsin vitroandin vivo. Our findings add to our understanding of neuronal extracellular structures and describe a new mouse model for monitoring live ECM dynamics.