bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross-sectional study examining household factors associated with SARS-CoV-2 seropositivity in low-income children in Los Angeles
Authors: Doctor Jason N , Berg Anders H , Knight Tara K , Kadono Mika , Stewart Emily , Sonik Rajan , Hochman Michael , Sood Neeraj 
Published: May 2023

ObjectivesThis study aims to quantify the degree to which an underserved, Hispanic population in Los Angeles is impacted by SARS-CoV-2, and determine factors associated with paediatric seropositivity.DesignCross-sectional.SettingAltaMed, a Federally Qualified Health Center in Los Angeles.ParticipantsA random sample of households who had received healthcare at AltaMed Medical Group was invited to participate. Households with at least one adult and one paediatric participant between 5 and 17 years of age were eligible to participate. Consented participants completed a survey on social determinants of health and were tested for antibodies using Abbott Architect SARS-CoV-2-IgG and SARS-CoV-2-IgM tests.Primary outcome measureSeropositive status.ResultsWe analysed 390 adults (mean age in years, 38.98 (SD 12.11)) and 332 paediatric participants (11.26 (SD 3.51)) from 196 households. Estimated seropositivity was 52.11% (95% CI 49.61% to 55.19%) in paediatric participants and 63.58% (95% CI 60.39% to 65.24%) in adults. Seropositivity was 11.47% (95% CI 6.82% to 14.09%) lower in paediatric participants, but high relative to other populations. A household member with type 2 diabetes (OR 2.94 (95% CI 1.68 to 5.14)), receipt of food stamps (OR 1.66 (95% CI 1.08 to 2.56)) and lower head-of-household education (OR 1.73 (95% CI 1.06 to 2.84)) were associated with paediatric seropositivity.ConclusionsSARS-CoV-2 seropositivity is high in Hispanic children and adolescents in Los Angeles. Food insecure households with low head-of-household education, and at least one household member with type 2 diabetes, had the highest risk. These factors may inform paediatrician COVID-19 mitigation recommendations.Trial registration numberNCT04901624.
Intraoperative evaluation of sentinel lymph nodes in patients with breast cancer treated with systemic neoadjuvant therapy
Authors: Huerta-Rosario Mariela , Mir Mariam , Quispe-Vicuña Carlos , Hwang Helena , Sarode Venetia , Peng Yan , Fang Yisheng , Leitch Marilyn , Sahoo Sunati 
Published: May 2023

AimsTouch preparation (TP) and frozen section (FS) are the two methods routinely used in the intraoperative evaluation (IOE) of sentinel lymph nodes (SLNs) to detect metastases in patients with breast cancer. Both methods are extremely sensitive and specific in the primary surgery (non-neoadjuvant systemic therapy (non-NST)) setting. Since NST introduces unique challenges in the IOE of SLNs, the aim was to determine the accuracy of TP and FS in the IOE of SLNs in the NST setting and compare the results with the non-NST setting and to examine factors that contribute to any differences.MethodsWe analysed 871 SLNs from 232 patients (615 SLNs from NST and 256 SLNs from non-NST settings) between 2016 through 2019.ResultsIn the NST group, TP alone (n=366) had a sensitivity of 45.7% and specificity of 99.7%; FS alone (n=90) had a sensitivity of 83.3% and specificity of 100%. When both TP and FS (n=135) were used, the sensitivity was 80.3% and the specificity was 98.6%.In the non-NST group, TP alone (n=193) had a sensitivity of 66.7% and specificity of 100%; FS alone (n=22) had a sensitivity and specificity of 100%; and combined TP and FS (n=34) had a sensitivity and specificity of 100% and 96%, respectively.ConclusionsEvaluating SLNs intraoperatively in the NST setting can be challenging secondary to therapy-related changes. In the NST setting, FS has higher sensitivity and specificity compared with TP for the IOE of SLNs and should be the preferred method.
Do not attempt cardiopulmonary resuscitation documentation: a quality improvement project
Authors: Haire Ellen , Bralesford Catherine , Botting Joanna , Beasant Elizabeth , Taubert Mark 
Published: May 2023

ObjectivesThis quality improvement project looked at enhancing do not attempt cardiopulmonary resuscitation (DNACPR) documentation in a Welsh National Health Service trust.MethodsA full clinical review cycle was carried out, evaluating 50 DNACPR forms in each data collection, totalling 100 forms. The all Wales DNACPR audit template was used to ensure standardised audit criteria. After completion of the first data collection, several changes were introduced: a new version national form was adopted by the trust; a series of education events was launched to improve understanding of the all Wales DNACPR policy. Electronic learning resources, such as the TalkCPR videos and electronic staff record modules, were widely disseminated.ResultsThe evaluation of data demonstrated consistency in completion of forms. The introduction of the new national form in phase 2 of the audit resulted in clearer documentation of discussions held with patients and their significant others and documented reasons why and when conversations had not taken place.ConclusionDocumentation of DNACPR discussions in the trust demonstrably improved in several domains. A central electronic record for advance and future care plans, accessible by all relevant healthcare providers, patients and carers, may be an effective way of improving further on the current paper-based model.
Single-Cell Evolutionary Analysis Reveals Drivers of Plasticity and Mediators of Chemoresistance in Small Cell Lung Cancer
Authors: Wollenzien Hannah , Afeworki Tecleab Yohannes , Szczepaniak-Sloane Robert , Restaino Anthony , Kareta Michael S. 
Published: May 2023

Abstract

Small cell lung cancer (SCLC) is often a heterogeneous tumor, where dynamic regulation of key transcription factors can drive multiple populations of phenotypically different cells which contribute differentially to tumor dynamics. This tumor is characterized by a very low 2-year survival rate, high rates of metastasis, and rapid acquisition of chemoresistance. The heterogeneous nature of this tumor makes it difficult to study and to treat, as it is not clear how or when this heterogeneity arises. Here we describe temporal, single-cell analysis of SCLC to investigate tumor initiation and chemoresistance in both SCLC xenografts and an autochthonous SCLC model. We identify an early population of tumor cells with high expression of AP-1 network genes that are critical for tumor growth. Furthermore, we have identified and validated the cancer testis antigens (CTA) PAGE5 and GAGE2A as mediators of chemoresistance in human SCLC. CTAs have been successfully targeted in other tumor types and may be a promising avenue for targeted therapy in SCLC.

Implications:
Understanding the evolutionary dynamics of SCLC can shed light on key mechanisms such as cellular plasticity, heterogeneity, and chemoresistance.
FH Variant Pathogenicity Promotes Purine Salvage Pathway Dependence in Kidney Cancer
Authors: Wilde Blake R. , Chakraborty Nishma , Matulionis Nedas , Hernandez Stephanie , Ueno Daiki , Gee Michayla E. , Esplin Edward D. , Ouyang Karen , Nykamp Keith , Shuch Brian , Christofk Heather R. 
Published: May 2023

Abstract

Fumarate accumulation due to loss of fumarate hydratase (FH) drives cellular transformation. Germline FH alterations lead to hereditary leiomyomatosis and renal cell cancer (HLRCC) where patients are predisposed to an aggressive form of kidney cancer. There is an unmet need to classify FH variants by cancer-associated risk. We quantified catalytic efficiencies of 74 variants of uncertain significance. Over half were enzymatically inactive, which is strong evidence of pathogenicity. We next generated a panel of HLRCC cell lines expressing FH variants with a range of catalytic activities, then correlated fumarate levels with metabolic features. We found that fumarate accumulation blocks de novo purine biosynthesis, rendering FH-deficient cells reliant on purine salvage for proliferation. Genetic or pharmacologic inhibition of the purine salvage pathway reduced HLRCC tumor growth in vivo. These findings suggest the pathogenicity of patient-associated FH variants and reveal purine salvage as a targetable vulnerability in FH-deficient tumors.

Significance:
This study functionally characterizes patient-associated FH variants with unknown significance for pathogenicity. This study also reveals nucleotide salvage pathways as a targetable feature of FH-deficient cancers, which are shown to be sensitive to the purine salvage pathway inhibitor 6-mercaptopurine. This presents a new rapidly translatable treatment strategy for FH-deficient cancers.
This article is featured in Selected Articles from This Issue, p. 1949
Maternal Embryonic Leucine Zipper Kinase is Associated with Metastasis in Triple-negative Breast Cancer
Authors: Xie Xuemei , Chauhan Gaurav B. , Edupuganti Ramakrishna , Kogawa Takahiro , Park Jihyun , Tacam Moises , Tan Alex W. , Mughees Mohd , Vidhu Fnu , Liu Diane D. , Taliaferro Juliana M. , Pitner Mary Kathryn , Browning Luke S. , Lee Ju-Hyeon , Bertucci François , Shen Yu , Wang Jian , Ueno Naoto T. , Krishnamurthy Savitri , Hortobagyi Gabriel N. , Tripathy Debu , Van Laere Steven J. , Bartholomeusz Geoffrey , Dalby Kevin N. , Bartholomeusz Chandra 
Published: May 2023

AbstractTriple-negative breast cancer (TNBC) has high relapse and metastasis rates and a high proportion of cancer stem-like cells (CSC), which possess self-renewal and tumor initiation capacity. MELK (maternal embryonic leucine zipper kinase), a protein kinase of the Snf1/AMPK kinase family, is known to promote CSC maintenance and malignant transformation. However, the role of MELK in TNBC metastasis is unknown; we sought to address this in the current study. We found that MELK mRNA levels were higher in TNBC tumors [8.11 (3.79–10.95)] than in HR+HER2− tumors [6.54 (2.90–9.26)]; P &lt; 0.001]. In univariate analysis, patients with breast cancer with high-MELK–expressing tumors had worse overall survival (P &lt; 0.001) and distant metastasis-free survival (P &lt; 0.01) than patients with low-MELK–expressing tumors. In a multicovariate Cox regression model, high MELK expression was associated with shorter overall survival after adjusting for other baseline risk factors. MELK knockdown using siRNA or MELK inhibition using the MELK inhibitor MELK-In-17 significantly reduced invasiveness, reversed epithelial-to-mesenchymal transition, and reduced CSC self-renewal and maintenance in TNBC cells. Nude mice injected with CRISPR MELK-knockout MDA-MB-231 cells exhibited suppression of lung metastasis and improved overall survival compared with mice injected with control cells (P &lt; 0.05). Furthermore, MELK-In-17 suppressed 4T1 tumor growth in syngeneic BALB/c mice (P &lt; 0.001). Our findings indicate that MELK supports metastasis by promoting epithelial-to-mesenchymal transition and the CSC phenotype in TNBC.Significance:These findings indicate that MELK is a driver of aggressiveness and metastasis in TNBC.
Desmoplastic Reaction Associates with Prognosis and Adjuvant Chemotherapy Response in Colorectal Cancer: A Multicenter Retrospective Study
Authors: Hu Qingru , Wang Yiting , Yao Su , Mao Yun , Liu Liu , Li Zhenhui , Chen Yonghe , Zhang Shenyan , Li Qian , Zhao Yingnan , Fan Xinjuan , Cui Yanfen , Zhao Ke , Liu Zaiyi 
Published: May 2023

Desmoplastic reaction (DR) is one of many tumor–host interactions and is associated with the overall survival (OS) of patients with colorectal cancer. However, the clinical significance of DR requires further study in large multicenter cohorts and its predictive value in adjuvant chemotherapy (ACT) response remains unclear. Here, a total of 2,225 patients with colorectal cancer from five independent institutions were divided into primary (N = 1,012 from two centers) and validation (N = 1,213 from three centers) cohorts. DR was classified as immature, middle, or mature depending on the presence of myxoid stroma and hyalinized collagen bundles at the invasive front of the primary tumor. OS among different subgroups were compared, and the correlations of DR type with tumor-infiltrating lymphocytes (TILs) within stroma, tumor stroma ratio (TSR), and Stroma AReactive Invasion Front Areas (SARIFA) were also analyzed. In the primary cohort, patients with mature DR had the highest 5-year survival rate. These findings were confirmed in validation cohort. In addition, for stage II colorectal cancer, patients classified as non-mature DR would benefit from ACT compared with surgery alone. Furthermore, immature and middle DR were more associated with high TSR, less distribution of TILs within stroma and positive SARIFA compared with mature. Taken together, these data suggest that DR is a robust-independent prognostic factor for patients with colorectal cancer. For patients with stage II colorectal cancer, non-mature DR could be a potential marker for recognizing high-risk patients who may benefit from ACT.

Significance:
DR has the potential to identify patients with high-risk colorectal cancer and predict the efficacy of adjuvant chemotherapy in patients with stage II colorectal cancer. Our findings support reporting DR types as additional pathologic parameters in clinical practice for more precise risk stratification.
Enhancing Seasonal Forecast Skills by Optimally Weighting the Ensemble from Fresh Data
Authors: Brajard Julien , Counillon François , Wang Yiguo , Kimmritz Madlen 
Published: May 2023

Abstract
Dynamical climate predictions are produced by assimilating observations and running ensemble simulations of Earth system models. This process is time consuming and by the time the forecast is delivered, new observations are already available, making it obsolete from the release date. Moreover, producing such predictions is computationally demanding, and their production frequency is restricted. We tested the potential of a computationally cheap weighting average technique that can continuously adjust such probabilistic forecasts—in between production intervals—using newly available data. The method estimates local positive weights computed with a Bayesian framework, favoring members closer to observations. We tested the approach with the Norwegian Climate Prediction Model (NorCPM), which assimilates monthly sea surface temperature (SST) and hydrographic profiles with the ensemble Kalman filter. By the time the NorCPM forecast is delivered operationally, a week of unused SST data are available. We demonstrate the benefit of our weighting method on retrospective hindcasts. The weighting method greatly enhanced the NorCPM hindcast skill compared to the standard equal weight approach up to a 2-month lead time (global correlation of 0.71 vs 0.55 at a 1-month lead time and 0.51 vs 0.45 at a 2-month lead time). The skill at a 1-month lead time is comparable to the accuracy of the EnKF analysis. We also show that weights determined using SST data can be used to improve the skill of other quantities, such as the sea ice extent. Our approach can provide a continuous forecast between the intermittent forecast production cycle and be extended to other independent datasets.
Readmission and Disposition in Patients With Malignant Bowel Obstructions Following Gastrostomy Tube
Authors: Yu Jingjing , Sullivan Brittany G. , Nguyen Ninh T. , Hohmann Samuel F. , Harris Alyssa H. , Micic Dejan , Turaga Kiran K. , Senthil Maheswari , Eng Oliver S. 
Published: May 2023

Background Patients with peritoneal carcinomatosis (PC) can develop malignant bowel obstructions (MBOs) requiring inpatient admission and nasogastric tube decompression. Palliative decompressive gastrostomy tubes (G-tubes) may affect patient disposition, allowing for self-management and reduction in inpatient services. Therefore, we sought to assess disposition and inpatient readmission rates in patients admitted with PC and MBO following G-tube placement. Methods The Vizient® Clinical Data Base was queried for inpatient admissions from October 2018 to May 2022 utilizing ICD-10 codes to identify patients admitted with PC and bowel obstruction, with or without G-tube placement. Demographics and hospital outcomes were recorded. Descriptive statistics and multivariate logistic regression analysis were performed. Results From 750 patients, 59 (7.9%) had a G-tube placed. Compared to patients without G-tubes, those with G-tubes had lower rates of disposition to home (32.2% vs 70.0%, P < .001) and higher rates of disposition to hospice (home: 30.5% vs 7.8%, P < .001, facility: 10.2% vs 3.9%, P = .02). There was no significant difference in the rate (17.3% vs 22.3%, P = .40) or risk (OR = 1.44, 95% CI .69-3.01) of 30-day readmissions with G-tubes. However, palliative care consultation (OR 33.77, 95% CI 19.16-59.52) and G-tube placement (OR 5.82, 95% CI 2.56-13.25) were independent predictors for hospice. Discussion Placement of G-tubes in patients with PC and MBO was associated with higher rates of disposition to hospice but there is no difference in 30-day readmission rates compared to those without G-tubes. Further prospective studies are needed to understand the role of G-tube placement in patients with MBO in relation to outcomes and disposition.
Factors that Influence Preferences for Defined Benefit Plans Versus Defined Contribution Plans
Authors: Ryan Michael P. , Cude Brenda J. 
Published: May 2023

The majority of public sector employees in the United States still have access to defined benefit (DB) retirement plans, with some retaining a choice between a defined benefit plan and a defined contribution (DC) plan when hired. This research was based on a survey assessing individuals’ financial literacy, risk tolerance, and time orientation and the influence those three variables had on preferences for DB versus DC plans. Greater financial skill and risk tolerance were associated with a preference for DC plans, while a time orientation focused on the present was associated with a preference for DB plans. This research could benefit employers as they determine retirement plan options that they choose to offer employees. Employers who offer both plan types may benefit from informing employees about the factors associated with preferences for each plan type as greater awareness of such factors could improve employee satisfaction and increase retention. JEL Codes: J32, H75, G53, G32
High precision localisation of the sources of noise of a bent-axis motor
Authors: Xu Chen , Xiangming Meng , Qinghong Gong , Hui Huang , Shumei Chen , Heng Du , Yuzheng Li , Xiufang Lin 
Published: May 2023

The hydraulic motor will generate noise in operation and it has fluid-structure coupling and compact internal structure. The sound intensity measurement is difficult to distinguish the noise sources of motor. In this paper, a high-precision localization method for noise sources of bent-axis motor is studied to improve the resolution of the sound intensity images to locate noise sources accurately. Firstly, the structural characteristics of the motor are analyzed, and the sound intensity images are obtained through the experiment. Then the high-resolution optimization method based on compressed sensing is designed according to the characteristics of the sound intensity field. Finally, the sound intensity images with high resolution are constructed. The high-resolution images can distinguish the position of the prominent points, and the error is less than 0.4 dB. The identification distance of noise sources can reach 30 mm, and it breaks through the highest resolution of the traditional sound intensity test.
Characteristics of a good nurse as perceived by nurses
Authors: Abedin Samireh , Khademi Zahra , Kamalzadeh Hesamaddin , Beigi Broujeni Razieh 
Published: May 2023

Background Nursing is a humanitarian and social field that provides health services. It combines science and art and has a rich history. Despite fundamental changes in the provision of medical services and nursing education, the concept of “good nurse” is still unclear. Purpose The purpose of this article is to investigate the characteristics of a good nurse from the nurses’ perspective. Research design and method A qualitative study was applied using conventional content analysis. The participants were 30 nurses that selected with purposive sampling method. Data were collected through unstructured interviews and simultaneously analyzed via the conventional content analysis approach of Graneheim and Lundman. Ethical considerations This study was approved by the Research Ethics Committee of Hormozgan University of Medical Sciences, Iran. Findings The study revealed that personal characteristics (Adherence to ethical and human principles, Physical health, Attractive appearance, and Ability to communicate properly); and professional characteristics (knowledge - clinical skill - nursing roles) are essential to being a good nurse. Conclusion Coming to know the distinctive features of a good nurse as perceived by nurses themselves creates an opportunity for nurses to rethink their profession and to reflect on the characteristics of the good nurse.
Associations Between Certificate of Need Policies and Hospice Quality Outcomes
Authors: Gaines Arlen G. , Cagle John G. 
Published: May 2023

Background Certificate of need (CON) laws are state-based regulations requiring approval of new healthcare entities and capital expenditures. Varying by state, these regulations impact hospices in 14 states and DC, with several states re-examining provisions. Aim This cross-sectional study examined the association of CON status on hospice quality outcomes using the hospice item set metric (HIS). Design Data from the February 2022 Medicare Hospice Provider and General Information reports of 4870 US hospices were used to compare group means of the 8 HIS measures across CON status. Multiple regression analysis was used to predict HIS outcomes by CON status while controlling for ownership and size. Results Approximately 86% of hospices are in states without a hospice CON provision. The unadjusted mean HIS scores for all measures were higher in CON states (M range 94.40-99.59) than Non-CON (M range 90.50-99.53) with significant differences in all except treatment preferences. In the adjusted model, linear regression analyses showed hospice CON states had significantly higher HIS ratings than those from Non-CON states for beliefs and values addressed (β = .05, P = .009), pain assessment (β = .05, P = .009), dyspnea treatment (β = .08, P < .001) and the composite measure (β = .09, P < .001). Treatment preferences, pain screening, dyspnea screening, and opioid bowel treatment were not statistically significant ( P > .05). Conclusion The study suggests that CON regulations may have a modest, but beneficial impact on hospice-reported quality outcomes, particularly for small and medium-sized hospices. Further research is needed to explore other factors that contribute to HIS outcomes.