bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying the EHA/EBMT grading for ICAHT after CAR-T: comparative incidence and association with infections and mortality
Authors: Rejeski Kai , Wang Yucai , Hansen Doris K. , Iacoboni Gloria , Bachy Emmanuel , Bansal Radhika , Penack Olaf , Müller Fabian , Bethge Wolfgang , Munoz Javier , Mohty Razan , Bücklein Veit L. , Barba Pere , Locke Frederick L. , Lin Yi , Jain Michael D. , Subklewe Marion 
Published: January 2024

Abstract
Cytopenias represent the most common side effect of CAR T-cell therapy (CAR-T) and can predispose for severe infectious complications. Current grading systems, such as the Common Terminology Criteria for Adverse Events (CTCAE), neither reflect the unique quality of post–CAR-T neutrophil recovery, nor do they reflect the inherent risk of infections due to protracted neutropenia. For this reason, a novel EHA/EBMT consensus grading was recently developed for Immune Effector Cell-Associated HematoToxicity (ICAHT). In this multicenter, observational study, we applied the grading system to a large real-world cohort of 549 patients treated with BCMA- or CD19-directed CAR-T for refractory B-cell malignancies (112 multiple myeloma [MM], 334 large B-cell lymphoma [LBCL], 103 mantle cell lymphoma [MCL]) and examined the clinical sequelae of severe (≥3°) ICAHT. The ICAHT grading was strongly associated with the cumulative duration of severe neutropenia (r = 0.92, P &lt; .0001), the presence of multilineage cytopenias, and the use of platelet and red blood cell transfusions. We noted an increased rate of severe ICAHT in patients with MCL vs those with LBCL and MM (28% vs 23% vs 15%). Severe ICAHT was associated with a higher rate of severe infections (49% vs 13%, P &lt; .0001), increased nonrelapse mortality (14% vs 4%, P &lt; .0001), and inferior survival outcomes (1-year progression-free survival: 35% vs 51%, 1-year overall survival: 52% vs 73%, both P &lt; .0001). Importantly, the ICAHT grading demonstrated superior capacity to predict severe infections compared with the CTCAE grading (c-index 0.73 vs 0.55, P &lt; .0001 vs nonsignificant). Taken together, these data highlight the clinical relevance of the novel grading system and support the reporting of ICAHT severity in clinical trials evaluating CAR-T therapies.
Regression algorithms-driven mechanical properties prediction of angle bracket connection on cross-laminated timber structures
Authors: Wu Zhe , Chen Lin , Xiong Haibei 
Published: January 2024

AbstractThe construction of structures using cross-laminated timber (CLT) has grown in popularity as a result of its environmentally friendly and high-strength characteristics. The primary function of angle bracket connections is to resist the force of CLT structures under horizontal forces, which is essential to ensure the seismic resilience and ductility of CLT structures. A regression algorithms-driven method for predicting the mechanical performance of angle bracket connections is introduced in this study. As input parameters, the geometric dimensions of the angle bracket connector, the connection method of the connector with the wall and floor slabs, and the properties of the CLT panel are utilized to predict the yield load, the maximal load, the initial stiffness, and the ductility ratio of the angle bracket connection. Prediction models were developed using the collected data from 110 angle bracket experiments, and each prediction model's performance was discussed in depth. Lastly, the permutation importance and SHapley Additive exPlanations (SHAP) value analysis were used to interpret the prediction models. The results showed that the extreme gradient boosting (XGB) algorithm could accurately predict the maximum and yielding load of the angle bracket connection, with R2 reaching 0.968 and 0.939. Furthermore, in predicting the initial stiffness of the angle bracket, the XGB algorithm performed the best with an average ratio of predicted to actual values of 0.985. The results indicated that this study proposed an accurate and efficient method for angle bracket connection to predicting its mechanical properties and confirmed the trustworthiness and feasibility of the prediction models.
Evaluation of the causal effects of blood metabolites on irritable bowel syndrome: Mendelian randomization
Authors: Zeng Yu , Liu Huabing , Pei Zhihui , Li Rui , Liu Zuihui , Liao Chuanwen 
Published: January 2024

AbstractBackgroundIrritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by abdominal pain, discomfort, and changes in bowel habits. The mechanism underlying IBS remains unclear, and little evidence exists for clarifying the causal relationship between blood metabolites and IBS.MethodsWe conducted a Mendelian randomization (MR) study using two samples. Exposure data for 7824 Europeans were extracted from a genome-wide association study (GWAS) on metabolite levels. The IBS GWAS data from the GWAS database were used for the initial analysis. The primary analysis of causal relationships was conducted using inverse-variance weighting (IVW) with MR-Egger and weighted medians as supplementary analyses. Sensitivity analyses were performed using a combination of the Cochran’s Q test, MR-Egger intercept test, Mendelian randomization pleiotropy residual sum and outlier, and leave-one-out analysis. For significant associations, replication and meta-analyses were performed using additional independent IBS case GWAS data released by the FinnGen Consortium R9. To identify the metabolites, score regression, confounding analysis, and reverse MR were performed to further assess the causal relationships between the metabolites.ResultsAfter rigorous screening, we identified four known metabolites to be associated with IBS (stearate, odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.59–0.92; arginine, OR: 1.36, 95% CI: 1.07–1.74; 1-palmitoylglycerol, OR:1.49, 95% CI: 1.07–2.07; 1-palmitoylglycerophosphoinositol, OR: 0.84, 95% CI: 0.71–0.99).ConclusionsMR analysis revealed a causal relationship between the four metabolites and IBS, providing preliminary evidence for the pathogenesis of IBS. Our results provide novel insights into the potential biomarkers of IBS.
Endoscopic gastrointestinal bypass anastomosis using deformable self-assembled magnetic anastomosis rings (DSAMARs) in a pig model
Authors: Zhang Miaomiao , Mao Jianqi , Ma Jia , Xu Shuqin , Lyu Yi , Yan Xiaopeng 
Published: January 2024

Abstract
Background
To investigate the feasibility of a deformable self-assembled magnetic anastomosis ring (DSAMAR), designed and developed by us, for endoscopic gastrointestinal bypass anastomosis.

Methods
Ten experimental pigs were used as model animals. The DSAMAR comprises 10 trapezoidal magnetic units, arranged in a straight line under the constraint of a guide wire. When the desired anastomosis site is reached under the guidance of an endoscope, the catheter pushes the magnetic unit along the guide wire. The linear DSAMAR can be assembled into a circular DSAMAR. Two DSAMARs were inserted, one at the end of the duodenum and the other into the stomach successively. They attracted each other and compressed the wall of the stomach and duodenum to establish gastrointestinal bypass anastomosis. The experimental pigs were euthanized 4 weeks after the operation, and the gastrointestinal bypass anastomosis specimens were obtained. The anastomosis formation was evaluated by the naked eye and histology.

Results
Gastrointestinal bypass anastomosis with DSAMARs was successfully performed. The average operation time under an endoscope was 70.30 ± 19.05 min (range: 43–95 min). The DSAMARs were discharged through the anus 10–17 days after surgery. There were no complications such as gastrointestinal bleeding, perforation, anastomotic fistula, and gastrointestinal obstruction during and after the operation. Gastroscopy and gross specimen of the anastomosis showed a well-formed magnetic anastomosis. Histological observation showed good continuity of the serous membrane and the mucosa of magnetic anastomosis.

Conclusion
The DSAMAR is a safe and feasible device for fashioning gastrointestinal bypass anastomosis in this animal model.
Improving health literacy through group antenatal care: results from a cluster randomized controlled trial in Ghana
Authors: Lori Jody R. , Kukula Vida Ami , Liu Liya , Apetorgbor Veronica E.A. , Ghosh Bidisha , Awini Elizabeth , Lockhart Nancy , Amankwah Georgina , Zielinski Ruth , Moyer Cheryl A. , Williams John 
Published: January 2024

Abstract
Background
Although the majority of Ghanaian women receive antenatal care (ANC), many exhibit low health literacy by misinterpreting and incorrectly operationalizing ANC messages, leading to poor maternal and newborn health outcomes. Prior research in low-resource settings has found group antenatal care (G-ANC) feasible for women and providers. This study aims to determine the effect of G-ANC on increasing maternal health literacy. We hypothesized that pregnant women randomized into G-ANC would exhibit a greater increase in maternal health literacy than women in routine, individual ANC.

Methods
A 5-year cluster randomized controlled trial was conducted in 14 rural and peri-urban health facilities in the Eastern Region of Ghana. Facilities were paired based on patient volume and average gestational age at ANC enrollment and then randomized into intervention (G-ANC) vs. control (routine, individual ANC); 1761 pregnant women were recruited. Data collection occurred at baseline (T0) and post-birth (T2) using the Maternal Health Literacy scale, a 12-item composite scale to assess maternal health literacy. Logistic regression compared changes in health literacy from T0 to T2.

Results
Overall, women in both the intervention and control groups improved their health literacy scores over time (p < 0.0001). Women in the intervention group scored significantly higher on 3 individual items and on overall composite scores (p < 0.0001) and were more likely to attend 8 or more ANC visits.

Conclusion
While health literacy scores improved for all women attending ANC, women randomized into G-ANC exhibited greater improvement in overall health literacy post-birth compared to those receiving routine individual care. Life-saving information provided during ANC must be presented in an understandable format to prevent women and newborns from dying of preventable causes.

Trial Registry
Ethical approval for the study was obtained from the Institutional Review Boards of the University of Michigan (HUM#00161464) and the Ghana Health Service (GHS-ERC: 016/04/19).
The role of dairy consumption in the relationship between wealth and early life physical growth in India: evidence from multiple national surveys
Authors: George Franciosalgeo , Rajeev L Naga , Bandyopadhyay Sulagna , Baby Jeswin , Sinha Srishti , Sachdev Harshpal Singh , Kurpad Anura V , Thomas Tinku 
Published: January 2024

Abstract
Introduction
Prevalence of undernutrition continues to be high in India and low household wealth is consistently associated with undernutrition. This association could be modified through improved dietary intake, including dairy consumption in young children. The beneficial effect of dairy on child growth has not been explored at a national level in India. The present analyses aimed to evaluate the direct and indirect (modifying association of household level per adult female equivalent milk and milk product consumption) associations between household wealth index on height for age (HAZ) and weight for age (WAZ) in 6-59 months old Indian children using data from of nationally representative surveys.

Methods
Two triangulated datasets of two rounds of National Family Health Survey, (NFHS-3 and 4) and food expenditure (National Sample Survey, NSS61 and 68) surveys, were produced by statistical matching of households using Non-Iterative Bayesian Approach to Statistical Matching technique. A Directed Acyclic Graph was constructed to map the pathways in the relationship of household wealth with HAZ and WAZ based on literature. The direct association of wealth index and its indirect association through per adult female equivalent dairy consumption on HAZ and WAZ were estimated using separate path models for each round of the surveys.

Results
Wealth index was directly associated with HAZ and WAZ in both the rounds, but the association decreased from NFHS-3 (βHAZ: 0.145; 95% CI: 0.129, 0.16) to NFHS-4 (βHAZ: 0.102; 95%CI: 0.093, 0.11). Adult female equivalent milk intake (increase of 10gm/day) was associated with higher HAZ (β_NFHS-3=0.001;95% CI: 0, 0.002; β_NFHS-4=0.002;95% CI: 0.002, 0.003) but had no association with WAZ. The indirect association of wealth with HAZ through dairy consumption was 2-fold higher in NFHS-4 compared to NFHS-3.

Conclusions
The analysis of triangulated survey data shows that household level per- adult female equivalent dairy consumption positively modified the association between wealth index and HAZ, suggesting that regular inclusion of milk and milk products in the diets of children from households across all wealth quintiles could improve linear growth in this population.
DAIR in treating chronic PJI after total knee arthroplasty using continuous local antibiotic perfusion therapy: a case series study
Authors: Zenke Yukichi , Motojima Yasuhito , Ando Kohei , Kosugi Kenji , Hamada Daishi , Okada Yasuaki , Sato Naohito , Shinohara Daichi , Suzuki Hitoshi , Kawasaki Makoto , Sakai Akinori 
Published: January 2024

Abstract
Background
Antimicrobial agents are administered via intramedullary antibiotic perfusion (iMAP)/intrasoft tissue antibiotic perfusion (iSAP) to infected lesions to control osteoarticular and soft tissue infections. Continuous local antibiotic perfusion (CLAP) has been reported to be useful. This study aimed to investigate the outcomes of DAIR combined with CLAP for chronic PJI after total knee arthroplasty performed at our hospital.

Subjects and methods
Six patients (male; one case, female; five cases, mean age 79.5 years (70–94)) underwent CLAP for chronic PJI after TKA at our hospital between July 2020 and June 2022. They were followable for at least one year after surgery. Seven months (17–219), with a mean follow-up of 24.3 months (12–36). In addition to direct debridement and insert exchange, systemic antimicrobial treatment, and CLAP with gentamicin were performed using NPWT. We investigated the organisms causing the inflammation, the duration of iMAP/iSAP implantation, the maximum daily dose of GM, the maximum GM blood concentration, and the presence or absence of GM-induced adverse events.

Result
Two of six patients had a recurrence of infection at five weeks and five months after initial CLAP and required repeat CLAP treatment, but all patients could preserve their components. The organisms responsible for the flare-ups were MSSA in three cases: ESBL-producing E. coli, mixed MSSA and streptococcal infection, Klebsiella pneumonia in one case each, and unknown pathogens in one case. CLAP therapy for all patients was administered eight times in 6 cases: iMAP, mean: 10.0 days (5–16); iSAP, mean: 19.3 days (15–28); GM dose, mean: 162.5 mg/day (80–240); and GM blood concentration, mean: 1.4 µg/mL (0.2-5.0). Adverse events included one case of reversible acute kidney injury during CLAP in a patient with recurrent infection.

Summary
DAIR with CLAP for chronic post-TKA infection can be a useful treatment option to preserve components and allow the infection to subside, provided the implant is not markedly loosened.
The association between plain water intake and periodontitis in the population aged over 45: a cross-sectional study based on NHANES 2009–2014
Authors: Li Xianxian , Wang Lili , Yang Luming , Liu Xianghong , Liu Henglang , Mu Yandong 
Published: January 2024

Abstract
Background
Numerous studies have demonstrated the impact of beverage consumption on overall health and oral health. Specifically, high consumption of sugar-sweetened beverages and coffee has been associated with an increased risk of metabolic disorders and periodontitis. Conversely, high intake of plain water has been linked to various health benefits, including weight management and reduced energy intake. However, no previous studies have explored the potential association between plain water intake and the risk of periodontitis.

Objectives
Our objective was to investigate the relationship between plain water consumption and periodontitis in a middle-aged and elderly population.

Methods
The present cross-sectional study was conducted among participants aged ≥ 45 in the 2009–2014 National Health and Nutrition Examination Surveys. Multivariable regression analysis, subgroup analysis and smooth fitting tests were conducted to explore the independent relationship between plain water intake and periodontitis.

Results
A total of 5,882 participants were enrolled,62.02% have periodontitis. Periodontitis patients have lower plain water intake. The multivariable regression tests showed that the risk of periodontitis decreased with increased plain water intake quartiles (Q4 OR = 0.78; 95%CI 0.62–0.96) after fully adjustment. Subgroup analysis and interaction tests showed that gender, age, smoking, diabetes, hypertension or BMI does not significantly interact with the association. However, the relation was significant in males (Q4 OR = 0.64; 95%CI 0.47–0.86) but not in females (Q4 OR = 0.97;95% CI 0.71–1.31). In the smoothed curve fits stratified by gender, the curve for male participants displayed as a U-shape, with an optimal plain water intake at 1200 ml/day. For males drinking plain water less than 1200 ml/day, the risk of periodontitis decreased by 24% with each increase of 500 ml plain water intake (OR = 0.76, 95%CI 0.66–0.87, p < 0.001).

Conclusions
Together, the results showed that plain water intake is negatively associated with periodontitis risk in US middle aged and elderly population. Further studies are needed to investigate the mechanism unites this association. Attention should be given to adequate plain water intake when considering dietary suggestions to the population at high risk of developing periodontitis, especially for men.
Challenges of using evidence in managerial decision-making of the primary health care system
Authors: Hedayatipour Marjan , Etemadi Sina , Hekmat Somayeh Noori , Moosavi Alisadat 
Published: January 2024

AbstractBackgroundManagerial Evidence-Based Decision-Making [EBDM] in the primary is a systematic approach that directs the decision-maker in a conscientious, explicit, and judicious utilization of reliable and best evidence based on the professional experiences and preferences of stakeholders and patients from various sources. This study aimed to investigate the challenges primary healthcare managers encounter while undertaking decision-making processes.MethodA systematic review was conducted in 2022 with the aim of identifying and collecting all qualitative articles pertaining to evidence-based decision-making in the primary healthcare system. To achieve this, a meticulous search was conducted using the relevant keywords, including primary health care and evidence-based decision making, as well as their corresponding synonyms, across the databases Web of Science, Scopus, and Pubmed. Importantly, there were no limitations imposed on the timeframe for the search. To carefully analyze and consolidate the findings of this systematic review, the meta-synthesis approach was employed.ResultsA total of 22 articles were assessed in this systematic review study. The results revealed the main categories including evidence nature, EBDM barriers, utilizing evidence, decision-makers ability, organizational structure, evidence-based, EBDM support, communication for EBDM, evidence sides, EBDM skill development, public health promotion, and health system performance improvement.ConclusionThe primary healthcare system is crucial in improving health outcomes and ensuring access to healthcare services for all individuals. This study explored the utilization of evidence-based EBDM within the primary healthcare system. We identified five key dimensions: causal, contextual, and intervening conditions, strategies, and consequences of EBDM as a core phenomenon. The findings will help policymakers and administrators comprehend the importance of evidence-based decision-making, ultimately leading to enhanced decision quality, community well-being, and efficiency within the healthcare system. EBDM entails considering the best reliable evidence, and incorporating community preferences while also exploiting the professional expertise and experiences of decision-makers. This systematic review has the potential to provide guidance for future reforms and enhance the quality of decision-making at the managerial level in primary healthcare.
RNA-seq reveals multifaceted gene expression response to Fab production in Escherichia coli fed-batch processes with particular focus on ribosome stalling
Authors: Vazulka Sophie , Schiavinato Matteo , Tauer Christopher , Wagenknecht Martin , Cserjan-Puschmann Monika , Striedner Gerald 
Published: January 2024

Abstract
Background
Escherichia coli is a cost-effective expression system for production of antibody fragments like Fabs. Various yield improvement strategies have been applied, however, Fabs remain challenging to produce. This study aimed to characterize the gene expression response of commonly used E. coli strains BL21(DE3) and HMS174(DE3) to periplasmic Fab expression using RNA sequencing (RNA-seq). Two Fabs, Fabx and FTN2, fused to a post-translational translocation signal sequence, were produced in carbon-limited fed-batch cultivations.

Results
Production of Fabx impeded cell growth substantially stronger than FTN2 and yields of both Fabs differed considerably. The most noticeable, common changes in Fab-producing cells suggested by our RNA-seq data concern the cell envelope. The Cpx and Psp stress responses, both connected to inner membrane integrity, were activated, presumably by recombinant protein aggregation and impairment of the Sec translocon. The data additionally suggest changes in lipopolysaccharide synthesis, adjustment of membrane permeability, and peptidoglycan maturation and remodeling. Moreover, all Fab-producing strains showed depletion of Mg2+, indicated by activation of the PhoQP two-component signal transduction system during the early stage and sulfur and phosphate starvation during the later stage of the process. Furthermore, our data revealed ribosome stalling, caused by the Fabx amino acid sequence, as a contributor to low Fabx yields. Increased Fabx yields were obtained by a site-specific amino acid exchange replacing the stalling sequence. Contrary to expectations, cell growth was not impacted by presence or removal of the stalling sequence. Considering ribosome rescue is a conserved mechanism, the substantial differences observed in gene expression between BL21(DE3) and HMS174(DE3) in response to ribosome stalling on the recombinant mRNA were surprising.

Conclusions
Through characterization of the gene expression response to Fab production under industrially relevant cultivation conditions, we identified potential cell engineering targets. Thereby, we hope to enable rational approaches to improve cell fitness and Fab yields. Furthermore, we highlight ribosome stalling caused by the amino acid sequence of the recombinant protein as a possible challenge during recombinant protein production.