bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mesenchymal Stem Cells-Derived Exosomes Alleviate Acute Lung Injury by Inhibiting Alveolar Macrophage Pyroptosis
Authors: Liu Peipei , Yang Shengnan , Shao Xuecheng , Li Chen , Wang Zai , Dai Huaping , Wang Chen 
Published: February 2024

Abstract
Acute lung injury (ALI) is an important pathological process of acute respiratory distress syndrome, yet there are limited therapies for its treatment. Mesenchymal stem cells-derived exosomes (MSCs-Exo) have been shown to be effective in suppressing inflammation. However, the effects of MSCs-Exo on ALI and the underlying mechanisms have not been well elucidated. Our data showed that MSCs-Exo, but not exosomes derived from MRC-5 cells (MRC-5-Exo), which are human fetal lung fibroblast cells, significantly improved chest imaging, histological observations, alveolocapillary membrane permeability, and reduced inflammatory response in ALI mice model. According to miRNA sequencing and proteomic analysis of MSCs-Exo and MRC-5-Exo, MSCs-Exo may inhibit pyroptosis by miRNAs targeting caspase-1-mediated pathway, and by proteins with immunoregulation functions. Taken together, our study demonstrated that MSCs-Exo were effective in treating ALI by inhibiting the pyroptosis of alveolar macrophages and reducing inflammation response. Its mechanism may be through pyroptosis-targeting miRNAs and immunoregulating proteins delivered by MSCs-Exo. Therefore, MSCs-Exo may be a new treatment option in the early stage of ALI.
Novel Management of Ocular Surface Inflammation in Patients With Ocular Graft-Versus-Host Disease in the Setting of Cataract Surgery
Authors: Roca Daniela , Jain Sandeep , Mun Christine , Akbar Sarwar Monazzah , Shorter Ellen , Ortiz-Morales Gustavo , Tarib Imane , De La Cruz Jose 
Published: February 2024

Purpose:
To report the outcomes of cataract surgery in patients with ocular graft-versus-host disease (oGVHD) using a novel preoperative immunomodulatory regimen in a collaborative subspecialty care setting.

Methods:
Retrospective case series of patients with oGVHD who underwent cataract surgery using a novel preoperative immunomodulatory regimen in a collaborative care setting. A preoperative regimen consisting of pooled human immune globulin 1%, autologous serum 50%, and methylprednisolone 1% eye drops was prescribed. Outcome measures included visual acuity (VA), ocular surface disease index (OSDI) score, lissamine green staining, and complications with a minimum of 2 years of follow-up.

Results:
Thirty-five eyes from 20 patients with oGVHD were studied. The mean age was 59 years (range 30–70 years). A healthy comparison group included 35 eyes from 24 patients with a mean age of 63 years (range 44–74 years). At the 2-year follow-up, the mean corneal staining score was 2.3/15, the mean OSDI score was 37.5, and the mean VA was 20/30 (logarithm of the minimal angle of resolution 0.17). The global complication rate was 2.8% at the last follow-up with no difference versus a healthy comparison group.

Conclusions:
A collaborative care model improving ocular surface health before cataract surgery with dry eye and cataract subspecialists can optimize outcomes in patients with oGVHD.
Lower Functional Status and Sternal Precaution Noncompliance May Not Be Related to Dehiscence Post-Median Sternotomy
Authors: Shoemaker Michael J. , Van Dam Ashley , Erickson Katelyn , Gregory Jared , Ureste Gabrielle , Preston Katelyn , Griswold Amy 
Published: February 2024

Introduction:
The purpose of this study was to examine the relationship between functional status, compliance with sternal precautions, and aseptic osseous postoperative incision complications.

Review of Literature:
Although there is limited research on upper extremity use and noncompliance with sternal precautions and sternal motion, there is a paucity of literature on functional status and noncompliance with sternal precautions and their effect on actual sternal complications, specifically aseptic osseous dehiscence.

Methods:
A retrospective medical record review was performed on 113 patients with an incisional complication following median sternotomy. Functional status was assessed using the AM-PAC “6-Clicks” Basic Mobility Short Form and initial gait distance. Compliance to sternal precautions was assessed using clinical documentation to determine the percentage of therapy sessions requiring cues. Propensity score matching was performed to select matched comparator records for those with aseptic osseous dehiscence. A descriptive, in-depth chart review was then performed to determine other possible clinical factors contributing to complication.

Results:
Eight of 113 patients had aseptic osseous dehiscence. Initial AM-PAC “6-Clicks” score (U = 4.375, P = .036), initial gait distance (U = 7.252, P = .007), and number of ventilator days (U = 2.790, P = .005) were significantly different in the aseptic osseous group compared to other complication types. However, the number of ventilator days was the only variable that remained significant (U = 52.5, P = .028) between those with aseptic osseous dehiscence and the 8 matched comparators. The in-depth chart review revealed that the aseptic osseous group had respiratory complications in 5 of 8 records as compared with 2 of 8 records in the comparator group.

Discussion and Conclusion:
The findings of this study suggest that confounding clinical factors besides functional status and compliance to sternal precautions could have contributed to aseptic osseous dehiscence following median sternotomy. Respiratory complications postoperatively may be a key confounding factor in aseptic osseous dehiscence. Therefore, the effect of functional status and noncompliance to traditional sternal precautions remains unclear.
Importance of age at 2nd implantation and interimplant interval to the outcome of bilateral prelingually deafened pediatric cochlear implantation
Authors: Chen Shih-Lung , Zhang Bang-Yan , Lee Yi-Chieh , Lin Chia-Chen , Sun Yu-Sheng , Chan Kai-Chieh , Wu Che-Ming 
Published: February 2024

Background:
In Taiwan, the number of cases of sequential bilateral pediatric cochlear implantation (CI) is increasing but data regarding its effectiveness and impact of the reimbursement policy are lacking. We examined the speech perception and quality of life (QOL) of bilateral prelingually deaf children who underwent sequential CI, considering the effects of age at the time of second implantation and interimplant interval.

Methods:
We enrolled 124 Mandarin-speaking participants who underwent initial cochlear implant (CI1) in 2001-2019 and a second CI (CI2) in 2015-2020. Patients were followed up for ≥2 years and were categorized into groups based on age at the time of CI2 implantation (<3.5, 3.6-7, 7.1-10, 10.1-13, and 13.1-18 years) and interimplant interval (0.5-3, 3.1-5, 5.1-7, 7.1-10, and >10 years). We evaluated speech perception, device usage rates, and QOL using subjective questionnaires (Speech, Spatial, and Qualities of Hearing and Comprehension Cochlear Implant Questionnaire).

Results:
Speech perception scores of CI2 were negatively correlated with ages at the time of CI1 and CI2 implantation and interimplant interval. Older age and a longer interimplant interval were associated with higher nonuse rates for CI2 and worse auditory performance and QOL. Among individuals aged >13 years with interimplant intervals >10 years, up to 44% did not use their second ear. Patients aged 7.1 to 10 years had better speech perception and higher questionnaire scores than those aged 10.1 to 13 and 13.1 to 18 years. Furthermore, patients aged 10.1 to 13 years had a lower rate of continuous CI2 usage compared to those aged 7.1 to 10 years.

Conclusion:
Timely implantation of CI2 is essential to achieve optimal outcomes, particularly among sequentially implanted patients with long-term deafness in the second ear and no improvement with hearing aids following CI1 implantation. For CI2 implantation, an upper limit of age of 10 years and interimplant interval of 7 years are essential to prevent suboptimal outcomes. These data can provide useful information to implant recipients, their families, and medical and audiological professionals, enabling a comprehensive understanding of the benefits and potential impacts of the timing of CI2 implantation.
Systemic Occupational Health Needs of Gender-Based Violence Advocates
Authors: Haen Lisa Sophia , McGown Molly , Taylor Simone , Conroy Lorraine , Velonis Alisa 
Published: February 2024

Objective
This study explores occupational health burdens faced by domestic and sexual violence advocates, many of which intensified during the COVID-19 pandemic. It identifies key stressors and offers advocate-driven recommendations to improve their wellbeing, addressing the lack of system-level interventions in the occupational health literature.

Methods
Semistructured interviews were conducted with 22 advocacy professionals. Thematic content analysis guided transcript coding, and researchers shared initial results with participants in two member checking sessions to validate the preliminary findings.

Results
Advocates experienced logistical, emotional, and systemic stressors, including loss of peer support and unempathetic workplace cultures. Recommendations prioritize advocate wellbeing and call for systemic changes.

Conclusions
Advocates’ occupational stressors highlight the need for system-level solutions to enhance their occupational wellbeing, particularly during large-scale emergencies. Collaborative efforts among employers, funders, and staff are essential to address system deficiencies.
Nonsurgical salvage options for locally recurrent prostate cancer after primary definitive radiotherapy: A systematic review and meta-analysis
Authors: Yang Jie , Xiong Xingyu , Liao Xinyang , Zheng Weitao , Xu Hang , Yang Lu , Wei Qiang 
Published: February 2024

Objective:
To conduct a meta-analysis to provide the latest evidence of nonsurgical local salvage options in the first-line radiotherapy failure setting for localized prostate cancer patients.

Background:
Recurrence of localized prostate cancer after primary radiotherapy (RT) remains a clinical challenge. There is no consensus on optimal nonsurgical local salvage therapies, which mainly consist of cryotherapy (CRYO), high-intensity focused ultrasound (HIFU), high/low-dose-rate brachytherapy (HDR/LDR), and stereotactic body radiotherapy (SBRT).

Methods:
Our study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We systematically searched PubMed, Web of Science, Cochrane Library and ClinicalTrials.gov up to September 2023 to identify potentially relevant studies. The risk of bias was assessed using the European Association of Urology (EAU) items. Biochemical recurrence-free survival (bRFS) and genitourinary/gastrointestinal toxicities were the outcomes of interest. Pooled rates with 95% confidence intervals (CIs) were evaluated.

Results:
A total of 99 studies comprising 8440 patients were included. The pooled rate of 1-year biochemical control (BC) was highest for LDR (0.88, 95%CI 0.72-0.95) and lowest for SBRT (0.68, 95%CI 0.49-0.83). The pooled rate of 5-year BC was highest for CRYO (0.52, 95%CI 0.33-0.69) and lowest for HDR (0.23, 95%CI 0.08-0.51). HIFU presented the worst outcome of grade ≥3 genitourinary toxicities (GU3), with a rate of 0.22 (95%CI 0.12-0.3). Conversely, CRYO (0.09, 95%CI 0.04-0.14), HDR (0.05, 95%CI 0.02-0.07), LDR (0.10, 95%CI 0.06-0.14) and SBRT (0.06, 95%CI 0.03-0.09) presented low rates of GU3. All subgroups induced a quite low incidence of grade ≥3 gastrointestinal toxicities (GI3).

Conclusions:
Nonsurgical salvage therapies are promising modalities for prostate cancer in the local radiorecurrence setting. Based on the preliminary evidence from this study, CRYO and SBRT might present a relatively steady efficacy of BC with acceptable treatment-related toxicities.
Suitability of the MP1000 system for robot-assisted partial nephrectomy: A multicenter randomized controlled noninferiority trial
Authors: Gao Yu , Yang Yang , Niu Shaoxi , He Wang , Tao Jin , Guo Shengjie , Li Hongzhao , Ma Xin , Huang Jian , Ai Xing , Zhou Fangjian , Zhang Xuepei , Zhang Xu 
Published: February 2024

Purpose:
This study aimed to compare the safety and effectiveness of the MP1000 surgical system with the da Vinci® Si robot system in robot-assisted partial nephrectomy (RAPN) through a prospective, single-blinded, randomized control trial.

Materials and Methods:
A total of 62 patients who were scheduled to undergo RAPN were randomly assigned to either the da Vinci® Si robot or MP1000 group. A noninferiority test was conducted with a non-inferior intermediate value of 10%. The study compared installation and operation times, estimated blood loss, warm ischemia time, postoperative surgical margin, rate of conversion to open surgery, eGFR level, complications, and other safety indicators between the two groups.

Results:
All procedures were successfully completed without the need for conversion to open or laparoscopic surgery, and no major complications were observed during the process. The test of noninferiority was achieved. There were no significant differences in median installation time, operation time, complication rate at 3 months, rate of positive surgical margin, and eGFR level at 3 months between the groups. Additionally, no evidence of recurrence was found on imaging in both groups. No difference in National Aeronautics and Space Administration task load index results for ergonomic considerations. A limitation of this study was its small sample size.

Conclusions:
The MP1000 system is a suitable platform for RAPN with safety and effectiveness comparable with da Vinci® Si system.
Concomitant tricuspid valve surgery in patients undergoing left ventricular assist device: a systematic review and meta-analysis
Authors: Luo Yuxiang , Leng Jiajie , Shi Rui , Jiang Yingjiu , Chen Dan , Wu Qingchen , Tie Hongtao 
Published: February 2024

Introduction:
This study aims to investigate the effect of concomitant tricuspid valve surgery (TVS) during left ventricular assist device (LVAD) implantation due to the controversy over the clinical outcomes of concomitant TVS in patients undergoing LVAD.

Methods:
A systematic literature search was performed in PubMed and EMbase from the inception to Aug 1st, 2023. Studies comparing outcomes in adult patients undergoing concomitant TVS during LVAD implantation (TVS group) and those who did not (no-TVS group) were included. The primary outcomes were right heart failure (RHF), right ventricular assist device (RVAD) implantation and early mortality. All meta-analyses were performed using random-effects models, and a two-tailed P<0.05 was considered significant.

Results:
21 studies were included, and 16 of them were involved in the meta-analysis, with 660 patients in the TVS group and 1291 in the no-TVS group. Patients in the TVS group suffered from increased risks of RHF (risk ratios [RR]=1.31, 95% confidence interval [CI]: 1.01-1.70, P=0.04; I
2=38%, p

H
=0.13), RVAD implantation (RR=1.56, 95%CI: 1.16-2.11, P=0.003; I

2
=0%, p

H
=0.74), and early mortality (RR=1.61, 95%CI: 1.07-2.42, P=0.02; I

2
=0%, p

H
=0.75). Besides, the increased risk of RHF holds true in patients with moderate to severe tricuspid regurgitation (RR=1.36, 95%CI: 1.04-1.78, P=0.02). TVS was associated with a prolonged cardiopulmonary bypass time. No significant differences in acute kidney injury, re-operation requirement, hospital length of stay, or intensive care unit stay were observed.

Conclusions:
Concomitant TVS failed to show benefits in patients undergoing LVAD, and it was associated with increased risks of RHF, RVAD implantation, and early mortality.
Microvascular abnormalities induced by hand-transmitted vibration reflects in finger systolic blood pressure: a cross-sectional study in China
Authors: Yan Maosheng , Zheng Hanjun , Liu Qian , Xiao Bin , Wang Chengmin , Jia Yanxia , Pan Siyu 
Published: February 2024

Objective
Local vibration can cause microcirculatory abnormalities such as blood stasis and symmetrical intermittent digital artery vasospasm. Finger SBP (FSBP) measurement is a potential way of assessing vascular components. This study aims to comprehensively investigate the relationship between the occurrence of the vibration-induced white finger (VWF) and changes in FSBP and then set the application value of FSBP measurements in the early diagnosis of VWF.

Methods
All samples were judgmental sampling from one factory. Totally 50 patients with VWF were the case group, while 50 without occupational hand-transmitted vibration exposure were the control group. FSBP measurements and epidemiological feature investigations were taken.

Results
There were significant reductions in FSBP level and %FSBP index at both 10 °C and 30 °C in fingers reported VWF (P < 0.05). The %FSBP abnormal rate of the index, ring and little finger in the VWF group was higher than the control (44.00% vs. 18.00%, 78.00% vs. 26.00%, 64.00% vs. 8.00%). The %FSBP of the ring and little finger had a relatively high application value (area under curve = 0.902, 0.737), while their standard regression coefficients were −0.23 and −0.412. The diagnostic cutoff value of the ring finger was 77.60%, while the sensitivity and specificity were 86.67%.

Conclusion
FSBP measurements were proven helpful in monitoring and diagnosing VWF prospectively and proved to have great application value in our study. %FSBP of the ring finger was the appropriate diagnostic index in FSBP measurements, while its abnormal value could be set as 80.00%.
Clinically significant macular edema in an underserved population: Association with demographic factors and hemoglobin A1c
Authors: Parimi Vamsi , Elsner Ann E. , Gast Thomas J. , Chen Zhongxue , Baskaran Karthikeyan , Alhamami Mastour A. , Litvin Taras V. , Ozawa Glen Y. , Cuadros Jorge A. 
Published: February 2024

SIGNIFICANCE
Suspected clinically significant macular edema (SCSME) from exudates differed among ethnic groups in our underserved population. African American and Asian subjects had higher prevalence than Hispanics and non-Hispanic Caucasians, from the same clinics. Men had higher prevalence than women. Highly elevated blood glucose was frequent and associated with SCSME.

PURPOSE
We investigated the association between the presence of SCSME from exudates and hemoglobin A1c (HbA1c), as well as demographic factors such as age, sex, and ethnic group. Our population was underserved diabetic patients from the same geographic locations. Ethnic groups were White Hispanic, non-Hispanic Caucasian, African American, and Asian, with a high proportion of underrepresented minorities.

METHODS
In a diabetic retinopathy screening study at four community clinics in Alameda County, California, nonmydriatic 45° color fundus images were collected from underserved diabetic subjects following the EyePACS imaging protocol. Images were analyzed for SCSME from exudates by two certified graders. Logistic regression assessed the association between SCSME from exudates and age, sex, ethnic group, and HbA1c.

RESULTS
Of 1997 subjects, 147 (7.36%) had SCSME from exudates. The mean ± standard deviation age was 53.4 ± 10.5 years. The mean ± standard deviation HbA1c level was 8.26 ± 2.04. Logistic regression analysis indicated a significant association between presence of SCSME from exudates and HbA1c levels (p<0.001), sex (p=0.027), and ethnicity (p=0.030). African Americans (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.06 to 2.50; p=0.025) and Asians (OR, 1.63; 95% CI, 1.05 to 2.54; p=0.029) had a higher risk than Hispanics. After adjusting for ethnicity, sex, and age, the odds of developing SCSME from exudates increased by 26.5% with every 1% increase in HbA1c level (OR, 1.26; 95% CI, 1.18 to 1.36; p<0.001).

CONCLUSIONS
In our underserved population, many diabetic patients had very high HbA1c values. Ethnic background (African American > Asians > Hispanics), sex (male > female), and HbA1c level were strong indicators for identifying who is at increased risk of developing SCSME from exudates.
Brief Report: Mapping Colorectal Distribution of Cell-Free and Cell-Associated HIV Surrogates Following Simulated Anal Intercourse to Aid Rectal Microbicide Development
Authors: Weld Ethel D. , Ogasawara Ken , Fuchs Edward J. , Louissaint Nicolette , Caffo Brian , Hendrix Craig W. 
Published: February 2024

Background:
Anal sex remains the greatest HIV transmission risk for men who have sex with men and carries substantial population attributable risk among women. Despite a growing array of HIV preexposure prophylaxis (PrEP) options, rectal microbicides remain desirable as on-demand, nonsystemic PrEP. Rectal microbicide product development for PrEP requires understanding the spatiotemporal distribution of HIV infectious elements in the rectosigmoid to optimize formulation development.

Setting:
Outpatient setting with healthy research participants.

Methods:
Six healthy men underwent simulated receptive anal sex with an artificial phallus fitted with a triple-lumen catheter in the urethral position. To simulate ejaculation of HIV-infected semen, autologous seminal plasma laden with autologous blood lymphocytes from apheresis labeled with 111Indium-oxine (cell-associated) and 99mTechnetium-sulfur colloid (cell-free) as HIV surrogates was injected into the rectal lumen through the phallic urethra. Spatiotemporal distribution of each radioisotope was assessed using single-photon emission computed tomography/CT over 8 hours. Analysis of radiolabel distribution used a flexible principal curve algorithm to quantitatively estimate rectal lumen distribution.

Results:
Cell-free and cell-associated HIV surrogates distributed to a maximal distance of 15 and 16 cm, respectively, from the anorectal junction (∼19 and ∼20 cm from the anal verge), with a maximal signal intensity located at 6 and 7 cm, respectively. There were no significant differences in any distribution parameters between cell-free and cell-associated HIV surrogates.

Conclusions:
Cell-free and cell-associated HIV surrogate distribution in the rectosigmoid can be quantified with spatiotemporal pharmacokinetic methods. These results describe the ideal luminal target distribution to guide rectal microbicide development.