bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heme oxygenase-1 increases intracellular iron storage and suppresses inflammatory response of macrophages by inhibiting M1 polarization
Authors: Tang Xueyou , Li Yunqin , Zhao Jing , Liang Li , Zhang Kang , Zhang Xiaofeng , Yu Hong , Du Huahua 
Published: October 2023

Abstract
Heme oxygenase-1 (HO-1) catalyzes the first and rate-limiting enzymatic step of heme degradation, producing carbon monoxide, biliverdin, and free iron. Most iron is derived from aged erythrocytes by the decomposition of heme, which happened mainly in macrophages. However, the role of HO-1 on iron metabolism and function of macrophage is unclear. The present study investigated the effect of HO-1 on iron metabolism in macrophages, and explored the role of HO-1 on inflammatory response, polarization, and migration of macrophages. HO-1 inducer Hemin or HO-1 inhibitor zinc protoporphyrin was intravenously injected to C57BL/6 J mice every 4 d for 28 d. We found that HO-1 was mainly located in the cytoplasm of splenic macrophages of mice. Activation of HO-1 by Hemin significantly increased iron deposition in the spleen, up-regulated the gene expression of ferritin and ferroportin, and down-regulated gene expression of divalent metal transporter 1 and hepcidin. Induced HO-1 by Hemin treatment increased intracellular iron levels of macrophages, slowed down the absorption of extracellular iron, and accelerated the excretion of intracellular iron. In addition, activation of HO-1 significantly decreased the expression of pro-inflammatory cytokines including interleukin (IL)-6, IL-1β, and inducible nitric oxide synthase, but increased the expression of anti-inflammatory cytokines such as IL-10. Furthermore, activation of HO-1 inhibited macrophages to M1-type polarization, and increased the migration rate of macrophages. This study demonstrated that HO-1 was able to regulate iron metabolism, exert anti-inflammatory effects, and inhibit macrophages polarization to M1 type.
Bivalent Vaccine Effectiveness Among Adults Aged ≥65 Years During the BA.5-Predominant Period in Japan: The VENUS Study
Authors: Mimura Wataru , Ishiguro Chieko , Terada-Hirashima Junko , Matsunaga Nobuaki , Maeda Megumi , Murata Fumiko , Fukuda Haruhisa 
Published: October 2023

Abstract

Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron BA.5 became prevalent in July 2022 in Japan. Bivalent messenger RNA (mRNA) vaccines were approved as booster doses for individuals who received the primary series or booster dose by monovalent vaccines. We aimed to assess the effectiveness of bivalent vaccines in Japanese adults aged ≥65 years.

Methods
We conducted a population-based cohort study using data collected from January 2019 to February 2023 in Japan. We included individuals aged ≥65 years in a municipality who received the first or second booster dose of monovalent mRNA vaccines. We estimated the effectiveness of the second or third booster dose of bivalent mRNA vaccines during the Omicron BA.5–predominant period (July–December 2022), compared with ≥90 days after the booster dose of monovalent vaccines. We used a Cox proportional hazard regression model with vaccination status as a time-dependent covariate.

Results
A total of 81 977 individuals aged ≥65 years (mean [standard deviation] age, 78.3 [7.4] years; 33 487 male [40.8%]) were included in the study cohort. Among them, 57 396 were vaccinated with the second or third dose of bivalent vaccines (BA.1 or BA.4/5). The effectiveness against coronavirus disease 2019 (COVID-19) was estimated to be 57.9% (95% confidence interval, 52.7%–62.5%) for ≥14 days after the second or third bivalent booster dose, compared with 90 days after the first or second monovalent booster dose.

Conclusions
The study showed that the bivalent mRNA vaccines as the second and third doses would provide protection against COVID-19 among adults ≥65 years in Japan.
Exploring the Systemic Structures That Affect Access to Physical Therapist Services for Non-Indigenous Black People in Australia
Authors: Rusinga Adelaide , Setchell Jenny , Jang Sarah , Costa Nathalia 
Published: October 2023

Abstract

Objective
Physical therapy is generally considered to be a white profession in Western nations. Australia’s increasingly diverse population, driven largely by growth in immigration, invites Australian health systems to be responsive to factors that may impact on non-white Australian population’s access to health care. Here, the authors sought to explore non-Indigenous Black people’s perspectives of physical therapy in Australia.

Methods
Eligible participants (n = 12) took part in semistructured, in-depth interviews and were prompted to discuss their experiences and perceptions of physical therapy. Interview data were analyzed using critical discourse analysis, underpinned by critical race theory.

Results
Participants were on average 29.4 years (SD = 12.9) from diverse cultural and linguistic backgrounds. Participants described mostly positive experiences with physical therapists, but they noted that it was not widely accessed by their communities, with 2 key discourses underpinning these discussions. Discourse 1, “physiotherapy is a solution for white people,” established physical therapy as primarily accessed by and welcoming of white people. “Whiteness” and the perpetuation of Western norms in physical therapy resulted in little consideration of other cultural practices. Participants’ discussions also pointed to the intersections of systemic racism and social inequities such as low income and language barriers, impacting Black people’s engagement with physical therapy. Discourse 2, “physiotherapists are white,” was mostly concerned with how the perceived “whiteness” of professionals and lack of Black physical therapists impacts cultural safety and comfort when accessing physical therapy.

Conclusion
Our results suggest that Westernization and whiteness persist among discourses surrounding physical therapy. Such discourses are likely to inform Black people’s perceptions and experiences of physical therapy. Our analyses suggest avenues to enhance the cultural diversity of the profession and improve physical therapy accessibility for Black people in Australia by providing culturally appropriate material, including critical reflexivity, epistemic and cultural humility in the curricula, recruiting staff from diverse backgrounds, and providing outreach services to underserved populations.

Impact
These findings highlight the need for increased cultural safety and diversity within the physical therapy profession to improve equity.
Multi-Dimensional Screening: Buyer-Optimal Learning and Informational Robustness
Authors: Deb Rahul , Roesler Anne-Katrin 
Published: October 2023

Abstract
A monopolist seller of multiple goods screens a buyer whose type vector is initially unknown to both but drawn from a commonly known prior distribution. The seller chooses a mechanism to maximize her worst-case profits against all possible signals from which the buyer can learn about his values for the goods. We show that it is robustly optimal for the seller to bundle goods with identical demands (these are goods that can be permuted without changing the buyer’s prior type distribution). Consequently, pure bundling is robustly optimal for exchangeable prior distributions. For exchangeable priors, pure bundling is also optimal for the seller in the information environment (with the reverse timing) where an information designer, with the objective of maximizing consumer surplus, first selects a signal for the buyer, and then the seller chooses an optimal mechanism in response. We derive a formal relationship between the seller’s problem in both information environments.
Advancement of anti‐LAG‐3 in cancer therapy
Authors: Li Yunong , Ju Mingyi , Miao Yuxi , Zhao Lin , Xing Lijuan , Wei Minjie 
Published: October 2023

AbstractImmune checkpoint inhibitors have effectively transformed the treatment of many cancers, particularly those highly devastating malignancies. With their widespread popularity, the drawbacks of immune checkpoint inhibitors are also recognized, such as drug resistance and immune‐related systematic side effects. Thus, it never stops investigating novel immune checkpoint inhibitors. Lymphocyte Activation Gene‐3 (LAG‐3) is a well‐established co‐inhibitory receptor that performs negative regulation on immune responses. Recently, a novel FDA‐approved LAG‐3 blocking agent, together with nivolumab as a new combinational immunotherapy for metastatic melanoma, brought LAG‐3 back into focus. Clinical data suggests that anti‐LAG‐3 agents can amplify the therapeutic response of other immune checkpoint inhibitors with manageable side effects. In this review, we elucidate the intercellular and intracellular mechanisms of LAG‐3, clarify the current understanding of LAG‐3 in the tumor microenvironment, identify present LAG‐3‐associated therapeutic agents, discuss current LAG‐3‐involving clinical trials, and eventually address future prospects for LAG‐3 inhibitors.
Safety of allergen immunotherapy in children
Authors: Schmidlin Kristin A. , Bernstein David I. 
Published: October 2023

Purpose of review
The current review discusses allergen immunotherapy (AIT) safety in children.

Recent findings
AIT is a well tolerated and effective treatment for pediatric allergic conditions. While mostly well tolerated, severe reactions and near fatal reactions may occur with subcutaneous immunotherapy (SCIT) once in every 160 000 visits. Sublingual immunotherapy (SLIT) is associated more with local side effects, but severe systemic reactions, including anaphylaxis, have been rarely reported. Providing informed consent, recognizing risk factors for severe systemic reactions, such as severe or uncontrolled asthma, and mitigating the risk of severe reactions are important components to improving the safety of AIT.

Summary
Overall, AIT is well tolerated in children, and data suggest that the incidence of systemic reactions in children receiving SCIT is no less than mixed populations of adult and pediatric patients. SLIT carries less risk for systemic reactions, and local oral site-application reactions are usually mild and resolve within 15 days of treatment.
Positive Intraoperative Cultures in Cup Revisions of THA: What Happens to the Stem?
Authors: Ottink Karsten D. , Dorleijn Desirée M. J. , Spierenburg Willemijn , Ploegmakers Joris J. W. , Zijlstra Wierd P. , Ettema Harmen E. , ten Have Bas L. E. F. , Jutte Paul C. , Wouthuyzen-Bakker Marjan ,   on behalf of the Northern Infection Network Joint Arthroplasty (NINJA)
Published: October 2023

Abstract

Background
Positive intraoperative cultures (PICs) are encountered in some patients undergoing revision of the acetabular cup after a previous THA. It is unknown whether PIC of the cup indicates whether the stem is infected as well and what happens to the stem during follow-up.

Questions/purposes
(1) What proportion of patients undergoing THA who undergo cup revision have PICs? (2) What is the survival of the stem during follow-up in cup revisions with PICs versus that of those with negative cultures? (3) Does antibiotic treatment of PIC of the cup prevent revision THA during follow-up?

Methods
In this retrospective, comparative multicenter study, five surgeons at four centers performed 338 acetabular cup revisions between January 2015 and December 2017. After evaluating the data, we excluded one patient because of an incomplete dataset and 77 patients because fewer than three intraoperative cultures were obtained during surgery, leaving 260 patients for analysis. Follow-up was 2 years. Patients were stratified into three cohorts: no PIC, one PIC, and two or more PICs.

Results
The proportion of patients with one or more PIC was 15% (39 of 260). A total of 8% (21 of 260) had one and 7% (18 of 260) had two or more PICs. Stem survival was lower in patients with two or more PICs, but stem revision for periprosthetic joint infection was similar between groups. Two-year survival, which was defined as freedom from revision for any cause or infection, was 97% (95% confidence interval 95% to 99%) in the group without PICs, 100% (95% CI 95% to 100%) in the group with one PIC, and 86% (95% CI 68% to 100%; p = 0.08) in the group with two or more PICs. None of the patients in the no PIC and one PIC groups were treated with antibiotics. In the two or more PICs cohort, 12 of 18 patients were treated. The stem survived in one of 12 patients treated with antibiotics versus two of six patients who were not treated with antibiotics.

Conclusion
When treated with antibiotics, more than two PICs isolated during cup revision surgery do not have a major impact on survival of the stem during follow-up. A larger cohort of patients with PICs during cup revision might confirm these findings.

Level of Evidence
Level III, therapeutic study.
Sixty years of the Bruce protocol: reappraising the contemporary role of exercise stress testing with electrocardiographic monitoring
Authors: Vilela Eduardo M. , Oliveira Cátia , Oliveira Cláudia , Torres Susana , Sampaio Francisco , Primo João , Ribeiro José , Teixeira Madalena , Oliveira Marco , Bettencourt Nuno , Viamonte Sofia , Fontes-Carvalho Ricardo 
Published: October 2023

Abstract
The cardiovascular response to exercise has long been a focus of interest. Over a century ago, the first descriptions of electrocardiographic changes occurring during exercise highlighted the possible relevance of this dynamic assessment. In this background, the inception of the Bruce protocol circa 60 years ago allowed for a major leap in this field by providing a standardized framework with which to address this issue, by means of an integrated and structured methodology. Since then, exercise stress testing with electrocardiographic monitoring (ExECG) has become one of the most widely appraised tests in cardiovascular medicine. Notably, past few decades have been profoundly marked by substantial advances in the approach to cardiovascular disease, challenging prior notions concerning both its physiopathology and overall management. Among these, the ever-evolving presentations of cardiovascular disease coupled with the development and implementation of several novel diagnostic modalities (both invasive and noninvasive) has led to a shifting paradigm in the application of ExECG. This technique, however, has continuously shown to be of added value across various momentums of the cardiovascular continuum, as depicted in several contemporary guidelines. This review provides a pragmatical reflexion on the development of ExECG, presenting a comprehensive overview concerning the current role of this modality, its challenges, and its future perspectives.
Stroke Phase Is Essential for Pneumonia in Dysphagia Patients After Cerebral Infarction
Authors: Ke Zi , Liu Wei , Chen Fuyan , Ge Wenyi , Bao Yiru , Wen Jian , Liu Yang , Li Xingping , Fan Xiaonong , Wu Bangqi 
Published: October 2023

Background:
The risk of pneumonia increases after stroke, especially in poststroke dysphagia patients. Propensity score matching (PSM) is a statistical method in SPSS, which can be used to balance the difference between the 2 groups of known factors. Nasogastric tube feeding is an important factor of stroke-associated pneumonia. However, few studies have used PSM to eliminate the effect of confounding factor.

Methods:
Our research was a retrospective case-control study. Retrospective review of the patient database between December 1, 2019, and June 30, 2022, to identify consecutive dysphagia patients after cerebral infarction during hospitalization. An 1:1 PSM in SPSS 25.0 was used to balance nasogastric tube feeding between patients with and without pneumonia. The characteristics of these 2 groups were analyzed. Univariate and binary logistic regression analyses were used to screen the risk factors of dysphagia after cerebral infarction.

Results:
After 1:1 PSM, 198 subjects met our criteria and were included in the analysis. Age [odds ratio (OR)=1.047, 95% CI: 1.013-1.081, P=0.006], stroke phase (acute stroke) (OR=5.931, 95% CI: 1.133-31.054, P=0.035), admission National Institutes of Health Stroke Scale score (OR=1.058, 95% CI: 1.004-1.115, P=0.034), and length of hospital stay (OR=1.025, 95% CI: 1.001-1.049, P=0.042) had statistically significant correlation with pneumonia in patients with dysphagia after cerebral infarction.

Conclusion:
In clinical practice, for the prevention of pneumonia in patients with dysphagia after cerebral infarction, we should pay more attention to admission National Institutes of Health Stroke Scale score, age, and stroke phase, especially in acute cerebral infarction patients.
The Covert Impact of Chiari Network and Eustachian Valves on Stroke
Authors: Al-Sabbagh Mohammed Q. , Eswaradass Prasanna 
Published: October 2023

Background:
The role of Chiari network (CN) and Eustachian valves (EVs) in cardioembolic strokes is still unclear. There is inconsistency in the literature regarding clinical approach to these lesions to reduce stroke risk. We aimed to describe clinical presentation, neuroimaging and cardioimaging features, as well as management approaches for CN and EV in stroke context.

Review Summary:
A systemic search was carried out using PubMed and Web of Science following PRISMA guidelines, Supplemental Digital Content 1 (http://links.lww.com/NRL/A123). We retrieved 4 case-control studies, 2 cross sectional studies as well 8 case reports, with a total of 883 patients with a mean age of 44.6 years (±13.8). The combined prevalence of EV/CN in stroke-related patent foramen ovale (PFO) patients was 50% (95% CI: 31-68). With isolated prevalence for EV and CN of 43% (95% CI: 25-63), 18% (95% CI: 12-25), respectively. Patients with history of stroke had higher prevalence of EV/CN compared with controls odds ratio=2.45 (95% CI: 1.2-5, P<0.01). All case-control and cross-sectional studies defined EV/CN by transesophageal echocardiography or intracardiac cardiography. In the 8 case reports, 7 cases were diagnosed by transesophageal echocardiography, while only 1 case was diagnosed postmortem.

Conclusion:
EV/CN are relatively common findings in stroke patients with PFO. While it appears that presence of EV/CN with a PFO increases the risk of cardioembolic stroke, they remain underrecognized. EV/CN should be considered as high-risk PFO features. There is a scarcity of research emphasizing their role in clinical decision making, especially PFO closure and antithrombotic therapy choice.
Impact of Frailty on Inpatient Outcomes of Acute Traumatic Spinal Cord Injury
Authors: Chu Hongyu , Chen Liang , Li Jun , Li Jianjun , Yang Degang , Yang Mingliang , Du Liangjie , Wang Maoyuan , Gao Feng 
Published: October 2023

Objectives:
Spinal cord injury (SCI) is any spinal cord injury or affliction that results in temporary or permanent impairment of motor or sensory function. This study determined the prevalence of frailty and its impact on in-hospital outcomes of patients admitted with acute traumatic SCI (TSCI).

Methods:
This retrospective study extracted data of adults 18 to 85 years with acute TSCI from the US Nationwide Inpatient Sample (NIS) 2016 to 2018. Frailty status were assessed by the 11-factor modified Frailty Index (mFI-11) through claim codes. Patients with an mFI ≥3 were classified as frail. Associations between study variables and in-hospital mortality, discharge status, prolonged length of stay, severe infection, and hospital costs were determined by univariate and multivariable regression analyses.

Results:
A total of 52,263 TSCI patients were identified, where 12,203 (23.3%) patients were frail. After adjusting for relevant confounders, frailty was independently associated with increased risk for in-hospital mortality [adjusted odds ratio (aOR) = 1.25, 95% CI:1.04-1.49], unfavorable discharge (aOR =1.15, 95% CI: 1.09-1.22), prolonged length of stay (aOR =1.32, 95% CI: 1.24-1.40), and severe infection (aOR =2.52, 95% CI: 2.24-2.83), but not hospital cost. Stratified analyses revealed frailty was associated with higher unfavorable discharge and severe infection regardless of age, Charlson Comorbidity Index, and injury level.

Conclusions:
In acute TSCI, frailty is independently associated with increased risk for adverse inpatient outcomes in terms of in-hospital mortality, prolonged hospital stays, unfavorable discharge, and particularly severe infection.
MR Imaging Patterns and Prognosis in Powassan Virus Encephalitis
Authors: Finelli Pasquale F. 
Published: October 2023

Background:
Powassan virus (POWV) encephalitis is an arbovirus infection and the only tick-borne encephalitis serogroup which is present in mainland North America. The magnetic resonance (MR) imaging described with POWV encephalitis is varied, nonspecific, and limited in number, and as such, imaging patterns and outcomes with this arbovirus infection are not well appreciated.

Methods:
A case report and literature review of the MR imaging associated with POWV encephalitis and correlate of the MR pattern with outcome is considered.

Results:
The cerebellar dominant MR imaging pattern was identified in 50% of POWV encephalitis cases and was associated with a 60% fatality rate. POWV encephalitis with prominent cerebellar involvement on MR imaging responded to intravenous steroid.

Conclusions:
A cerebellar dominant MR pattern in POWV encephalitis was common, associated with a poor prognosis, and recognition could change management from supportive to life-saving.
Uric Acid Nephropathy Secondary to Generalized Tonic-Clonic Seizures
Authors: Simon Amanda , Nguyen Dan , Newman Blake , Arain Amir 
Published: October 2023

Introduction:
Acute kidney injury is a well-known complication of generalized tonic-clonic seizures, most commonly due to rhabdomyolysis. Elevated serum uric acid resulting in uric acid nephropathy is an overlooked cause of acute kidney injury in these patients, with only a few published case reports.

Case Report:
In the first case, a 23-year-old male was admitted with status epilepticus. His kidney function worsened and he developed anuria. He had a serum uric acid level of 20.7 mg/dL and required multiple sessions of hemodialysis. In the second case, a 32-year-old male was admitted with acute kidney injury after experiencing a breakthrough seizure. He had a serum uric acid level of 20.4 mg/dL and was treated with rasburicase with recovery of renal function. In the third case, a 29-year-old male was admitted with status epilepticus. His renal function deteriorated. His serum uric acid level was 19.5 mg/dL. He required hemodialysis and rasburicase.

Conclusion:
Uric acid nephropathy is a rare complication of generalized tonic-clonic seizures, which is poorly recognized by healthcare providers. We advocate for Nephrology consultation early in a patient’s hospitalization to discuss the use of rasburicase to avoid the associated morbidity of renal replacement therapies.