bluuebunny/crossref_metadata_2025_split huggingface dataset:
Image-Guided VATS in the Hybrid Operation Room Facilitates Early Diagnosis and Concurrent Treatment of Subcentimeter Nonpalpable Lung Nodules
Authors: Partlow Jamie , Thomas Sabrina , Nicolini Michael , Greeno Sarah , Schroeder Carsten 
Published: February 2024

Objective: As lung cancer screening increases, the detection of small, nonpalpable lung lesions is on the rise. The hybrid operation room (OR), which combines percutaneous or endobronchial fiducial placement with on-table computed tomography (CT) and fluoroscopic guidance, improves localization and facilitates the diagnosis and treatment of smaller, nonpalpable lung nodules with greater accuracy. Methods: In 35 consecutive months, 55 veterans underwent 60 image-guided video-assisted thoracic surgery procedures for lesion resection. Of the cases, 36% were found during lung cancer screening. All patients received their care in the hybrid OR, where cone-beam CT scan technology was used to place an average of 1.6 fiducials percutaneously ( n = 55) or via augmented navigational bronchoscopy ( n = 5). Results: A total of 66 lesions were resected. The median lesion size was 8 mm with an interquartile range of 6 to 14. The patients underwent nonanatomical resection with lymph node dissection using radiologic guidance. When indicated, an anatomical resection was subsequently performed. Of 47 total non-small cell lung cancer lesions, 83% were diagnosed at stage IA1 or IA2. The median surgical margin was 15 mm; the margin was usually 1.5 times as wide as the lesion. Conclusions: The hybrid OR technology gives a 3-dimensional assessment of the small lung lesions, allowing for a tissue-saving resection while achieving good surgical margins. During lung cancer screening, smaller, nonpalpable lung nodules are frequently found. This technology allows resection of subcentimeter lesions, which would otherwise be unresectable at this early stage, possibly improving survival.
Antegrade femoral lengthening and simultaneous hemiepiphysiodesis for congenital femoral deficiency
Authors: Georgiadis Andrew G , Albright Patrick D , Huser Aaron J , Novotny Susan A , Dahl Mark T 
Published: February 2024

Purpose: Congenital femoral deficiency is characterized by limb length discrepancy and genu valgum. Lengthening of the femur along its anatomic axis increases valgus alignment by medial knee translation. Pairing limb lengthening with simultaneous medial distal femoral hemiepiphysiodesis can simultaneously correct two limb deformities. Methods: All skeletally immature patients with congenital femoral deficiency who underwent antegrade femoral lengthening and concomitant guided growth over a 4-year period were reviewed. Length and alignment data were quantified during lengthening, consolidation, and for 1 year after guided growth implants were removed or the patient reached skeletal maturity. Digital simulation was performed for all lengthenings to assess the mechanical alignment that would have been achieved had lengthening been performed without medial distal femoral hemiepiphysiodesis. Results: Nine patients (five males, four females, mean age = 12.3 ± 1.9 years) underwent 10 antegrade intramedullary femoral lengthenings with simultaneous medial distal femoral hemiepiphysiodesis. All had improvement in valgus alignment (average improvement in mechanical axis deviation was 18 ± 11 mm, average change in limb alignment was 6 ± 5°). In simulated lengthenings without guided growth, all limbs would have experienced increased lateral mechanical axis deviation of 5 ± 3 mm. The hemiepiphysiodesis implant and lengthening device were explanted simultaneously in 7 of 10 lengthenings. Conclusion: Simultaneous medial distal femoral hemiepiphysiodesis with antegrade femoral lengthening for ongenital femoral deficiency can minimize the number of surgical episodes for the skeletally immature patient. The lengthening device and guided growth construct can be removed simultaneously in a majority of cases, saving children one or two additional surgical treatments.
Added value of video edutainment on android handsets in home visits to improve maternal and child health in Bauchi State, Nigeria: Secondary analysis from a cluster randomised controlled trial
Authors: Ansari Umaira , Omer Khalid , Aziz Amar , Gidado Yagana , Mudi Hadiza , Jamaare Ibrahim Sabo , Andersson Neil , Cockcroft Anne 
Published: February 2024

Objective A trial of evidence-based health promotion home visits to pregnant women and their spouses in northern Nigeria found significant improvements in maternal and child health outcomes. This study tested the added value for these outcomes of including video edutainment in the visits. Methods In total, 19,718 households in three randomly allocated intervention wards (administrative areas) received home visits including short videos on android handsets to spark discussion about local risk factors for maternal and child health; 16,751 households in three control wards received visits with only verbal discussion about risk factors. We compared outcomes between wards with and without videos in the visits, calculating the odds ratio (OR) and 95% confidence interval (95%CI) of differences, in bivariate and then multivariate analysis adjusting for socio-economic differences between the video and non-video wards. Results Pregnant women from video wards were more likely than those from non-video wards to have discussed pregnancy and childbirth often with their husbands (OR 2.22, 95%CI 1.07–4.59). Male spouses in video wards were more likely to know to give more fluids and continued feeding to a child with diarrhoea (OR 1.61, 95%CI 1.21–2.13). For most outcomes there was no significant difference between video and non-video wards. The home visitors who shared videos considered they helped pregnant women and their spouses to appreciate the information about risk factors. Conclusion The lack of added value of the videos in the context of a research study may reflect the intensive training of home visitors and the effective evidence-based discussions included in all the visits. Further research could rollout routine home visits with and without videos and test the impact of video edutainment added to home visits carried out in a routine service context.
Impact of Initiating a GLP1 Agonist and/or SGLT2 Inhibitor Therapy on De-Escalation and Discontinuation of Insulin and Diabetes Control When Managed by an Interprofessional Collaborative Team
Authors: Champion Megan , Wills Avila Gabriel , Garcia Angelica E. , Álvarez Delgado Faviola M. , Valdez Connie A. 
Published: February 2024

Background: An FQHC in Denver, Colorado developed and implemented an interprofessional care model to collaboratively manage type 2 diabetes mellitus (T2DM). Utilizing the 340B program, the team protocolized ADA Guidelines to promote the early adoption of first-line medications, glucagon-like peptide1 receptor agonists (GLP1 RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) to improve patient outcomes. Objectives: To assess the impact of interprofessional collaborative management versus standard care on early initiation of a SGLT2i and/or GLP1 RA as first-line therapies to enhance (1) deprescribing of insulin, (2) reducing overbasalization of insulin through insulin de-escalation, and (3) effectively lowering A1C levels in adult primary care patients with T2DM. Methods: This was a retrospective chart review of adult patients with T2DM who were initiated on a GLP1 RA and/or a SGLT2i. To determine the effects of initiating GLP1 RA and/or SGLT2i therapy on insulin usage and glycemic control, the total daily dose (TDD) of insulin before initiation was compared with the most recent TDD post-initiation to evaluate deprescribing. To determine the impact on overbasalization, pre-initiation and post-initiation insulin doses were evaluated. The effectiveness of GLP1 RA and/or SGLT2i in lowering A1C levels was determined by comparing the A1C prior to initiation with the A1C postinitiation. To evaluate the influence of interprofessional collaborative care on insulin deprescribing, overbasalization, and diabetes control, relevant measures were compared between patients receiving collaborative care versus standard care. Results: Of the 60 total patients treated with insulin, 46.6% were deprescribed insulin, with a majority in the interprofessional collaborative group (93.1%) compared to standard care (6.9%). A total of 78.3% of patients benefited from a reduction in A1C following the initiation of a GLP1 RA and/or SGLT2i. The greatest A1C reduction was −2.9% in the group receiving metformin in addition to a GLP1 RA and a SGLT2i. Patients who received interprofessional collaborative care had an average A1c reduction of −2.9% compared to—1.1% with standard care. Conclusion: Most patients initially overbasalized on insulin experienced a reduction in overbasalization after initiating GLP1 RA and/or SGLT2i. There was a notable A1C reduction, de-escalation, and deprescribing of insulin in patients receiving interprofessional collaborative care.
Correlation between early intracranial pressure and cerebral perfusion pressure with 28-day intensive care unit mortality in patients with hemorrhagic stroke
Authors: Zhang Yang , Zhu Shuaijie , Hu Yan , Guo Heng , Zhang Jin , Hua Tianfeng , Zhang Zhongheng , Yang Min 
Published: February 2024

Introduction: Hemorrhagic stroke may cause changes in intracranial pressure (ICP) and cerebral perfusion pressure (CPP), which may influence the prognosis of patients. The aim of this study was to investigate the relationship between early ICP, CPP, and 28-day mortality in the intensive care unit (ICU) of patients with hemorrhagic stroke. Patients and methods: A retrospective study was performed using the Medical Information Mart for Intensive Care (MIMIC-IV) and the eICU Collaborative Research Database (eICU-CRD), including hemorrhagic stroke patients in the ICU with recorded ICP monitoring. The median values of ICP and CPP were collected for the first 24 h of the patient’s monitoring. The primary outcome was 28-day ICU mortality. Multivariable Cox proportional hazards models were used to analyze the relationship between ICP, CPP, and 28-day ICU mortality. Restricted cubic regression splines were used to analyze nonlinear relationships. Results: The study included 837 patients with a 28-day ICU mortality rate of 19.4%. Multivariable analysis revealed a significant correlation between early ICP and 28-day ICU mortality (HR 1.08, 95% CI 1.04–1.12, p < 0.01), whereas early CPP showed no correlation with 28-day ICU mortality (HR 1.00, 95% CI 0.98–1.01, p = 0.57), with a correlation only evident when CPP < 60 mmHg (HR 1.99, 95% CI 1.14–3.48, p = 0.01). The study also identified an early ICP threshold of 16.5 mmHg. Discussion and conclusion: Early ICP shows a correlation with 28-day mortality in hemorrhagic stroke patients, with a potential intervention threshold of 16.5 mmHg. In contrast, early CPP showed no correlation with patient prognosis.
Scleral remodeling during myopia development in mice eyes: a potential role of thrombospondin-1
Authors: Chen Junhan , Ikeda Shin-ichi , Yang Yajing , Zhang Yan , Ma Ziyan , Liang Yifan , Negishi Kazuno , Tsubota Kazuo , Kurihara Toshihide 
Published: February 2024

Abstract
Background
Scleral extracellular matrix (ECM) remodeling plays a crucial role in the development of myopia, particularly in ocular axial elongation. Thrombospondin-1 (THBS1), also known as TSP-1, is a significant cellular protein involved in matrix remodeling in various tissues. However, the specific role of THBS1 in myopia development remains unclear.

Method
We employed the HumanNet database to predict genes related to myopic sclera remodeling, followed by screening and visualization of the predicted genes using bioinformatics tools. To investigate the potential target gene Thbs1, we utilized lens-induced myopia models in male C57BL/6J mice and performed Western blot analysis to detect the expression level of scleral THBS1 during myopia development. Additionally, we evaluated the effects of scleral THBS1 knockdown on myopia development through AAV sub-Tenon’s injection. The refractive status and axial length were measured using a refractometer and SD-OCT system.

Results
During lens-induced myopia, THBS1 protein expression in the sclera was downregulated, particularly in the early stages of myopia induction. Moreover, the mice in the THBS1 knockdown group exhibited alterations in myopia development in both refraction and axial length changed compared to the control group. Western blotting analysis confirmed the effectiveness of AAV-mediated knockdown, demonstrating a decrease in COLA1 expression and an increase in MMP9 levels in the sclera.

Conclusion
Our findings indicate that sclera THBS1 levels decreased during myopia development and subsequent THBS1 knockdown showed a decrease in scleral COLA1 expression. Taken together, these results suggest that THBS1 plays a role in maintaining the homeostasis of scleral extracellular matrix, and the reduction of THBS1 may promote the remodeling process and then affect ocular axial elongation during myopia progression.
Hypothesis of a CD137/Eomes activating axis for effector T cells in HPV oropharyngeal cancers
Authors: Baudouin Robin , Tartour Eric , Badoual Cécile , Hans Stéphane 
Published: February 2024

AbstractChronic Human Papilloma Virus (HPV) infection is supplanting alcohol and tobacco intoxications as the leading cause of oropharyngeal cancer in developed countries. HPV-related squamous cell carcinomas of the oropharynx (HPV + OSC) present better survival and respond better to radiotherapy and chemotherapy. Regulatory T cells (TREG) are mainly described as immunosuppressive and protumoral in most solid cancers. However, TREG are paradoxically associated with a better prognosis in HPV + OSCs. The transcription factor FoxP3 is the basis for the identification of TREG. Among CD4 + FoxP3 + T cells, some have effector functions. A medical hypothesis is formulated here: the existence of a CD137 (4.1BB)-Eomesodermin (Eomes) activated pathway downstream of TCR-specific activation in a subpopulation of CD4 + FoxP3 + T cells may explain this effector function. Evidence suggest that this axis may exist either in CD4 + FoxP3 + T cells or CD8 + T cells. This pathway could lead T cells to strong antitumor cytotoxic activity in a tumor-specific manner. Furthermore, CD137 is one of the most expected targets for the development of agonist immunotherapies. The identification of CD137 + Eomes + FoxP3+/- T cells could be a key element in the selective activation of the most anti-tumor cells in the HPV + OSC microenvironment.
Anti-CD38 targeted nanotrojan horses stimulated by acoustic waves as therapeutic nanotools selectively against Burkitt’s lymphoma cells
Authors: Vighetto Veronica , Conte Marzia , Rosso Giada , Carofiglio Marco , Sidoti Abate Federica , Racca Luisa , Mesiano Giulia , Cauda Valentina 
Published: February 2024

AbstractThe horizon of nanomedicine research is moving toward the design of therapeutic tools able to be completely safe per se, and simultaneously be capable of becoming toxic when externally activated by stimuli of different nature. Among all the stimuli, ultrasounds come to the fore as an innovative approach to produce cytotoxicity on demand in presence of NPs, without invasiveness, with high biosafety and low cost. In this context, zinc oxide nanoparticles (NPs) are among the most promising metal oxide materials for theranostic application due to their optical and semi-conductor properties, high surface reactivity, and their response to ultrasound irradiation. Here, ZnO nanocrystals constitute the stimuli-responsive core with a customized biomimicking lipidic shielding, resembling the composition of natural extracellular vesicles. This core–shell hybrid structure provides high bio- and hemocompatibility towards healthy cells and is here proofed for the treatment of Burkitt’s Lymphoma. This is a very common haematological tumor, typically found in children, for which consolidated therapies are so far the combination of chemo-therapy drugs and targeted immunotherapy. In this work, the proposed safe-by-design antiCD38-targeted hybrid nanosystem exhibits an efficient selectivity toward cancerous cells, and an on-demand activation, leading to a significant killing efficacy due to the synergistic interaction between US and targeted hybrid NPs. Interestingly, this innovative treatment does not significantly affect healthy B lymphocytes nor a negative control cancer cell line, a CD38- acute myeloid leukemia, being thus highly specific and targeted. Different characterization and analyses confirmed indeed the effective formation of targeted hybrid ZnO NPs, their cellular internalization and the damages produced in Burkitt’s Lymphoma cells only with respect to the other cell lines. The presented work holds promises for future clinical applications, as well as translation to other tumor types.
Graphical abstract
Triage implementation in resource-limited emergency departments: sharing tools and experience from the Pacific region
Authors: Mitchell Rob , White Libby , Elton Leigh , Luke Cliff , Bornstein Sarah , Atua Vincent 
Published: February 2024

AbstractAccording to the World Health Organization’s (WHO) Emergency Care Systems Framework, triage is an essential function of emergency departments (EDs). This practice innovation article describes four strategies that have been used to support implementation of the WHO-endorsed Interagency Integrated Triage Tool (IITT) in the Pacific region, namely needs assessment, digital learning, public communications and electronic data management.Using a case study from Vila Central Hospital in Vanuatu, a Pacific Small Island Developing State, we reflect on lessons learned from IITT implementation in a resource-limited ED. In particular, we describe the value of a bespoke needs assessment tool for documenting triage and patient flow requirements; the challenges and opportunities presented by digital learning; the benefits of locally designed, public-facing communications materials; and the feasibility and impact of a low-cost electronic data registry system.Our experience of using these tools in Vanuatu and across the Pacific region will be of interest to other resource-limited EDs seeking to improve their triage practice and performance. Although the resources and strategies presented in this article are focussed on the IITT, the principles are equally relevant to other triage systems.
Using body sensors for evaluating the impact of smart cycling technologies on cycling experiences: a systematic literature review and conceptual framework
Authors: Boot Mario , Ulak Mehmet Baran , Geurs Karst T. , Havinga Paul J. M. 
Published: February 2024

AbstractDigital technologies in, on, and around bicycles and cyclists are gaining ground. Collectively called Smart Cycling Technologies (SCTs), it is important to evaluate their impact on subjective cycling experiences. Future evaluations can inform the design of SCTs, which in turn can help to realize the abundant benefits of cycling. Wearable body sensors and advanced driver assistance systems are increasingly studied in other domains, however evaluation methods integrating such sensors and systems in the field of cycling research were under-reviewed and under-conceptualized. This paper therefore presents a systematic literature review and conceptual framework to support the use of body sensors in evaluations of the impact of SCTs on perceptions, emotions, feelings, affect, and more, during outdoor bicycle rides. The literature review (n = 40) showed that there is scarce research on this specific use of body sensors. Moreover, existing research designs are typically not tailored to determine impact of SCTs on cycling experience at large scale. Most studies had small sample sizes and explored limited sensors in chest belts and wristbands for evaluating stress response. The evaluation framework helps to overcome these limitations, by synthesizing crucial factors and methods for future evaluations in four categories: (1) experiences with SCTs, (2) experience measurements, (3) causal analysis, (4) confounding variables. The framework also identifies which types of sensors fit well to which types of experiences and SCTs. The seven directions for future research include, for example, experiences of psychological flow, sensors in e-textiles, and cycling with biofeedback. Future interactions between cyclists and SCTs will likely resemble a collaboration between humans and artificial intelligence. Altogether, this paper helps to understand if future support systems for cyclists truly make cycling safer and more attractive.
Control-FREEC viewer: a tool for the visualization and exploration of copy number variation data
Authors: Crippa Valentina , Fina Emanuela , Ramazzotti Daniele , Piazza Rocco 
Published: February 2024

Abstract
Background
Copy number alterations (CNAs) are genetic changes commonly found in cancer that involve different regions of the genome and impact cancer progression by affecting gene expression and genomic stability. Computational techniques can analyze copy number data obtained from high-throughput sequencing platforms, and various tools visualize and analyze CNAs in cancer genomes, providing insights into genetic mechanisms driving cancer development and progression. However, tools for visualizing copy number data in cancer research have some limitations. In fact, they can be complex to use and require expertise in bioinformatics or computational biology. While copy number data analysis and visualization provide insights into cancer biology, interpreting results can be challenging, and there may be multiple explanations for observed patterns of copy number alterations.

Results
We created Control-FREEC Viewer, a tool that facilitates effective visualization and exploration of copy number data. With Control-FREEC Viewer, experimental data can be easily loaded by the user. After choosing the reference genome, copy number data are displayed in whole genome or single chromosome view. Gain or loss on a specific gene can be found and visualized on each chromosome. Analysis parameters for subsequent sessions can be stored and images can be exported in raster and vector formats.

Conclusions
Control-FREEC Viewer enables users to import and visualize data analyzed by the Control-FREEC tool, as well as by other tools sharing a similar tabular output, providing a comprehensive and intuitive graphical user interface for data visualization.