bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting futility of upfront surgery in perihilar cholangiocarcinoma: Machine learning analytics model to optimize treatment allocation
Authors: Ratti Francesca , Marino Rebecca , Olthof Pim B. , Pratschke Johann , Erdmann Joris I. , Neumann Ulf P. , Prasad Raj , Jarnagin William R. , Schnitzbauer Andreas A. , Cescon Matteo , Guglielmi Alfredo , Lang Hauke , Nadalin Silvio , Topal Baki , Maithel Shishir K. , Hoogwater Frederik J.H. , Alikhanov Ruslan , Troisi Roberto , Sparrelid Ernesto , Roberts Keith J. , Malagò Massimo , Hagendoorn Jeroen , Malik Hassan Z. , Olde Damink Steven W.M. , Kazemier Geert , Schadde Erik , Charco Ramon , de Reuver Philip R. , Groot Koerkamp Bas , Aldrighetti Luca ,   The Perihilar Cholangiocarcinoma Collaboration Group
Published: August 2023

Background:
While resection remains the only curative option for perihilar cholangiocarcinoma, it is well known that such surgery is associated with a high risk of morbidity and mortality. Nevertheless, beyond facing life-threatening complications, patients may also develop early disease recurrence, defining a “futile” outcome in perihilar cholangiocarcinoma surgery. The aim of this study is to predict the high-risk category (futile group) where surgical benefits are reversed and alternative treatments may be considered.

Methods:
The study cohort included prospectively maintained data from 27 Western tertiary referral centers: the population was divided into a development and a validation cohort. The Framingham Heart Study methodology was used to develop a preoperative scoring system predicting the “futile” outcome.

Results:
A total of 2271 cases were analyzed: among them, 309 were classified within the “futile group” (13.6%). American Society of Anesthesiology (ASA) score ≥ 3 (OR 1.60; p = 0.005), bilirubin at diagnosis ≥50 mmol/L (OR 1.50; p = 0.025), Ca 19-9 ≥ 100 U/mL (OR 1.73; p = 0.013), preoperative cholangitis (OR 1.75; p = 0.002), portal vein involvement (OR 1.61; p = 0.020), tumor diameter ≥3 cm (OR 1.76; p < 0.001), and left-sided resection (OR 2.00; p < 0.001) were identified as independent predictors of futility. The point system developed, defined three (ie, low, intermediate, and high) risk classes, which showed good accuracy (AUC 0.755) when tested on the validation cohort.

Conclusions:
The possibility to accurately estimate, through a point system, the risk of severe postoperative morbidity and early recurrence, could be helpful in defining the best management strategy (surgery vs. nonsurgical treatments) according to preoperative features.
Centralization and democratization: Managing crisis communication in health care delivery
Authors: Hayirli Tuna C. , Stark Nicholas , Hardy James , Peabody Christopher R. , Kerrissey Michaela J. 
Published: August 2023

Background
Communication is an essential organizational process for responding to adversity. Managers are often advised to communicate frequently and redundantly during crises. Nonetheless, systematic investigation of how information receivers perceive organizational communication amid crises has remained lacking.

Purpose
The aim of this study was to characterize features of effective internal crisis communication by examining how information-sharing processes unfolded during the initial stage of the COVID-19 pandemic.

Methodology
Between June and August 2020, we conducted 55 semistructured interviews with emergency department workers practicing in a variety of roles. We analyzed interview transcripts following constructivist constant comparative methods.

Results
Our findings revealed that at the onset of COVID-19 pandemic response, emergency department workers struggled with immense fear and anxiety amid high uncertainty and equivocality. Frequent and redundant communication, however, resulted in information delivery and uptake problems, worsening anxiety, and interpersonal tension. These problems were ameliorated by the emergence of contextual experts who centralized and democratized communication. Centralization standardized information received across roles, work schedules, and settings while decoupling internal communication from turbulence in the environment. Democratization made information accessible in a way that all could understand. It also ensured information senders’ receptiveness to feedback from information receivers. Centralization and democratization together worked to reduce sensed uncertainty and equivocality, which reduced anxiety and interpersonal tension.

Conclusion
Establishing frequent and redundant communication strategies does not necessarily address the anxiety and interpersonal tension produced by uncertainty and equivocality in crises.

Practice Implications
Centralization and democratization of crisis communication can reduce anxiety, improve coordination, and promote a safer workplace and patient care environment.
Clinical characteristics of neutropenic patients under antithyroid drug: Twelve-year experience in a medical center
Authors: Tseng Chih-Hsueh , Tseng Chi-Lung , Chen Harn-Shen , Chen Pei-Lung , Huang Chun-Jui 
Published: August 2023

Background:
Thionamide-induced agranulocytosis (TiA) is a rare adverse event with a reported incidence of approximately 0.1% to 1.75%. Prompt recognition of TiA is critical to reduce the mortality rate. However, the differential diagnosis between cases of TiA and non-TiA neutropenia can be challenging due to the potential simultaneous involvement of other causes of neutropenia, such as concomitant chemotherapy, liver dysfunction, or infection. The aim of the present study was to investigate the possible factors associated with the development of TiA.

Methods:
This was a retrospective cohort study of patients treated with antithyroid drugs (ATDs) in Taipei Veterans General Hospital, Taipei, Taiwan, from 2006 to 2018. Patients who developed a neutropenic event during treatment with ATDs were identified from their medical records. The diagnosis of TiA was based on the following: (1) development of neutropenia during treatment or within 7 days after previous exposure to the same ATDs; (2) complete resolution of neutropenia within 1 month after discontinuation of the culprit drug with an absolute neutrophil count (ANC) >1500/μL; and (3) exclusion of other causes of neutropenia. The incidence and risk factors of TiA were analyzed and compared with those of non-TiA neutropenia.

Results:
Among 6644 patients treated with ATDs, 66 (mean age: 53 ± 15 years; 16.2% men) developed a neutropenic event and 20 were diagnosed with TiA (incidence: 0.3%). In the univariate analysis, compared with non-TiA neutropenia, TiA was associated with a lower Charlson Comorbidity Index, shorter treatment duration, lower cumulative ATD dosage, higher ATD dosage, higher ANC, and higher levels of free T4 at the time of the neutropenic event. In the multivariate logistic regression analysis, after adjusting for age, gender and the time to neutropenia, the cumulative ATD dose to neutropenia and ATD dosage at the time of the neutropenic event, Charlson Comorbidity Index, free T4 levels (odds ratio [OR], 4.44; 95% CI, 1.48-13.25), and ANC (OR, 1.00; 95% CI, 1.00-1.01) remained independently associated with TiA.

Conclusion:
Patients with TiA were more likely to have higher levels of free T4 and ANC at the time of the neutropenic event vs those with non-TiA neutropenia.
Urokinase administration for intraventricular hemorrhage in adults: A retrospective analysis of hemorrhage volume reduction and clinical outcomes
Authors: Li Chi-Ruei , Yang Meng-Yin , Cheng Wen-Yu , Tseng Huan-Chin , Lin Yi-Ying , Liu Yu-Hao , Shen Chiung-Chyi , Yen Chun-Ming 
Published: August 2023

Background:
Intraventricular hemorrhage (IVH) is a type of ventricular bleeding that results in significant morbidity and mortality. Multiple studies have investigated the use of urokinase in IVH treatment. The use of urokinase may lead to higher rates of hematoma resolution and lower mortality rates. However, further studies are required to determine efficacy of urokinase administration. This study examined the association between urokinase use, IVH volume reduction, and clinical outcomes.

Methods:
In total, 94 adult patients with hypertensive intracerebral hemorrhage with ventricular extension or primary IVH were enrolled between 2015 and 2021. Participants were categorized into two groups: “EVD combined with fibrinolysis” and “EVD only.” The primary objective was to assess the reduction of IVH severity. Additionally, the study evaluated the functional outcomes and shunt dependency rate as secondary outcomes. Non-contrast computed tomography scans were obtained to measure the severity of IVH using the mGRAEB score. The main outcomes were the association among urokinase administration, reduced IVH severity, and functional outcomes.

Results:
There were no significant differences in the reduction rate of mGRAEB scores within a 7-day period (−50.0 [−64.4 to −32.5] % vs −44.2 [−59.3 to −7.9] %; p = 0.489). In addition, investigation of the third and fourth ventricles showed similar findings between the two groups. Urokinase treatment was not associated with significant differences in the modified Rankin Scale (5.0 (4.0–5.0) vs. 4.5 (4.0-5.0), p = 0.674) or shunt dependency rate (33.3% vs 39.3%, p = 0.58).

Conclusion:
This study found that intraventricular urokinase use in patients with IVH was not associated with reduced IVH severity. In addition, urokinase use was not associated with better functional outcomes or minor shunt dependency rates.
Views of Multiple Sclerosis Patients About Key Elements for a Decision Aid: A Qualitative Study
Authors: Robles-Sanchez Miguel-Angel , Moharra Montse , Bosch-Farré Cristina , Hernández-Leal María José , Montalban Xavier , Sastre-Garriga Jaume , Ramió-Torrentà Lluís , Bertran-Noguer Carme 
Published: August 2023

ABSTRACT

BACKGROUND: Patients with multiple sclerosis (MS) may experience decisional conflict during treatment choice. Shared decision making (SDM), whereby patients and health professionals, primarily nurses, collaborate in making decisions, reduces this decisional conflict. It requires understanding large amounts of information and may be complex, especially when decisions affect patients' autonomy and quality and prolongation of life. Patient decision aids are tools in facilitating SDM. This study aimed to identify the key elements from the perspective of patients with relapsing-remitting MS to create a patient decision aid in the Spanish sociocultural context. METHODS: This is a qualitative study using focus groups led by a clinical nurse specialist. Semistructured interviews included healthcare needs and demands, the SDM process, and general characteristics of a peer support program. After the transcription of interview recordings, data were analyzed by thematic analysis and a constructivist naturalistic approach. RESULTS: Patients with MS (27) from Spain participated in 4 focus groups of 90 to 120 minutes each. Three overarching themes were identified: information access to sufficient high-quality data; knowledge of available treatment options, including efficacy, adverse effects, frequency, administration route, and the impact on daily life; decision-making role, engaged versus nonengaged patients. The former require support in facilitating their active involvement in decisions, whereas the latter prefer more passive health models. CONCLUSION: The needs identified by patients with relapsing-remitting MS regarding treatment choice in the Spanish setting align with those reported by other studies. The identified themes provide valuable information to design and develop a virtual patient decision aid jointly by clinical MS nurses and patients according to the International Patient Decision Aid Standards Collaboration criteria. This aid will help improve understanding between nurses and patients during SDM and facilitate the process.
Social Regulation of the Neural Threat Response Predicts Subsequent Markers of Physical Health
Authors: Lin Jingrun , Namaky Nauder , Costello Meghan , Uchino Bert N. , Allen Joseph P. , Coan James A. 
Published: August 2023

ABSTRACT

Objective
Social support has been linked to a vast range of beneficial health outcomes. However, the physiological mechanisms of social support are not well characterized. Drawing on functional magnetic resonance imaging and health-related outcome data, this study aimed to understand how neural measures of “yielding”—the reduction of brain activity during social support—moderate the link between social support and health.

Methods
We used a data set where 78 participants around the age of 24 years were exposed to the threat of shock when holding the hand of a partner. At ages 28 to 30 years, participants returned for a health visit where inflammatory activity and heart rate variability were recorded.

Results
Findings showed a significant interaction between dorsal anterior cingulate cortex–related yielding and perceived social support on C-reactive protein levels (β = −0.95, SE = 0.42, z = −2.24, p = .025, 95% confidence interval = −1.77 to −0.12). We also found a significant interaction between hypothalamus-related yielding and perceived social support on baseline heart rate variability (β = 0.51, SE = 0.23, z = 2.19, p = .028, 95% confidence interval = 0.05 to 0.97).

Conclusions
Greater perceived social support was associated with lower C-reactive protein levels and greater baseline heart rate variability among individuals who were more likely to yield to social support in the dorsal anterior cingulate cortex and hypothalamus years earlier. The current study highlights the construct of yielding in the link between social support and physical health.
Particulate matter concentration in Davao City airshed and its trend over the years
Authors: Anunciado Marife B. 
Published: August 2023

AbstractDavao City airshed was selected for air quality mapping using particulate matter (PM) concentrations. PM data were taken from the regulatory office, Environmental Management Bureau XI, from 2016 to 2021 to understand annual variation and determine trends that may be attributed to seasonal changes in the region. PM concentrations were spatially interpolated using Inverse distance weighting (IDW) feature, an interpolation technique of ArcGIS. PM concentration and distribution over the years showed no similar patterns, both for PM10and PM2.5. No annual similarities of PM concentration were observed, and distribution varies yearly. No seasonal trends were shown on the interpolated maps for PM. However, there was an overall PM concentration decrease and distribution covered fewer affected areas over time. PM concentration in 2016 were generally at a level within the defined limit of NAAQGV except for some AQMS locations and years but sparingly exceeding the NAAQGV limit over time. Results show that PM emissions were lower suggesting a possible success on the regulation policies in the Davao City airshed through reduction or better management of air pollutant emissions.
Sensitization of meningeal afferents to locomotion-related meningeal deformations in a migraine model
Authors: Blaeser Andrew S , Zhao Jun , Sugden Arthur U , Carneiro-Nascimento Simone , Andermann Mark L , Levy Dan 
Published: August 2023

ABSTRACTMigraine headache is hypothesized to involve the activation and sensitization of trigeminal sensory afferents that innervate the cranial meninges. To better understand migraine pathophysiology and improve clinical translation, we used two-photon calcium imaging via a closed cranial window in awake mice to investigate changes in the responses of meningeal afferent fibers using a preclinical model of migraine involving cortical spreading depolarization (CSD). A single CSD episode caused a seconds-long wave of calcium activation that propagated across afferents and along the length of individual afferents. Surprisingly, unlike previous studies in anesthetized animals with exposed meninges, only a very small afferent population was persistently activated in our awake mouse preparation, questioning the relevance of this neuronal response to the onset of migraine pain. In contrast, we identified a larger subset of meningeal afferents that developed augmented responses to acute three-dimensional meningeal deformations that occur in response to locomotion bouts. We observed increased responsiveness in a subset of afferents that were already somewhat sensitive to meningeal deformation before CSD. Furthermore, another subset of previously insensitive afferents also became sensitive to meningeal deformation following CSD. Our data provides new insights into the mechanisms underlying migraine, including the emergence of enhanced meningeal afferent responses to movement-related meningeal deformations as a potential neural substrate underlying the worsening of migraine headache during physical activity.
ProjectSVR: Mapping single-cell RNA-seq data to reference atlases by supported vector regression
Authors: Gao Jianing , Guo Shipeng , Zhang Yuanwei 
Published: August 2023

AbstractThe rapid accumulation of public single-cell RNA-seq (scRNA-seq) data and advances in integration algorithms make it possible to build the organ and body-scale cell atlases after overcoming the batch effect originating from different studies, donors, and sequence platforms. However, projecting the query cells onto the carefully constructed reference atlas to rapidly interpret cell states remains challenging. Here, we present ProjectSVR (https://github.com/jarninggau/ProjectSVR), a machine learning-based algorithm for mapping the query cells onto well-constructed reference embeddings. We demonstrate the effectiveness of ProjectSVR in multiple case studies of different tissue and experimental design, including (1) interpreting the decidual immune microenvironment from recurrent pregnancy loss (RPL) patients, (2) resolving the tumor-infiltrated T cell states from patients receiving anti-PD1 treatment, (3) mapping the genetic-perturbed mouse germ cells to integrated mouse testicular cell atlas (mTCA) for inferring their arrested developmental stage, and (4) evaluating in vitro induced meiosis by via mapping the induced germ cells onto mTCA. Taken together, our results show that ProjectSVR is a useful tool for reference mapping and make the scRNA-seq data analysis more convenient when well-annotated atlases emerge.
Pseudomonas Putida Dynamics of Adaptation under Prolonged Resource Exhaustion
Authors: Gross Jonathan , Katz Sophia , Hershberg Ruth 
Published: August 2023

AbstractMany non-sporulating Bacterial species survive prolonged resource exhaustion, by entering a state termed long-term stationary phase (LTSP). Here, we performed LTSP evolutionary experiments on the bacteriumPseudomonas putida, followed by whole genome sequencing of evolved clones. We show thatP. putidais able to persist and adapt genetically under LTSP. We observed a gradual accumulation of mutations within the evolvingP. putidapopulations. Within each population, independently evolving lineages are established early on and persist throughout the four-month-long experiment. Mutations accumulate in a highly convergent manner, with similar loci being mutated across independently evolving populations. Across populations, mutators emerge, that due to mutations within mismatch repair genes developed a much higher rate of mutation than other clones with which they co-existed within their respective populations. While these general dynamics of the adaptive process are quite similar to those we previously observed in the model bacteriumEscherichia coli, the specific loci that are involved in adaptation only partially overlap betweenP. putidaandE. coli.Significance statementBacteria often face conditions of prolonged nutrient limitation, following periods of growth. One strategy for dealing with this challenge is entry into a state termed long-term stationary phase (LTSP), in which a small minority of cells within a population can survive and persist, by recycling the remains of their deceased brethren. Here, we broaden our understanding of adaptation under LTSP, by studying it in the bacteriumPseudomonas putida. We show that many of the dynamics of LTSP genetic adaptation are quite general, as reflected by great similarity to what was previously observed in the model bacteriumEscherichia coli. However, the specific loci that are involved in adaptation substantially vary betweenP. putidaandE. coli.
Propagation of neuronal micronuclei regulates microglial states
Authors: Yano Sarasa , Asami Natsu , Kishi Yusuke , Kubotani Hikari , Hattori Yuki , Kitazawa Ayako , Hayashi Kanehiro , Kubo Ken-ichiro , Saeki Mai , Maeda Chihiro , Akiyama Kaito , Okajima-Takahashi Tomomi , Sato Ban , Gotoh Yukiko , Nakajima Kazunori , Ichinohe Takeshi , Nagata Takeshi , Chiba Tomoki , Tsuruta Fuminori 
Published: August 2023

AbstractMicroglia, resident immune cells in the central nervous system, undergo morphological and functional changes in response to signals from the local environment and mature into various homeostatic states. However, niche signals underlying microglial development and maturation remain largely unknown. In this study, we show that neuronal micronuclei propagate microglia, followed by changing microglial states during the postnatal period. We discovered that neurons passing through a dense region of the developing neocortex give rise to micronuclei and release them into the extracellular space. Moreover, neuronal micronuclei were incorporated into microglia and affected morphological changes. Loss of thecGASgene alleviates effects on micronucleus-dependent morphological changes. Notably, neuronal micronuclei-harboring microglia exhibit unique transcriptome signatures. These results demonstrate that neuronal micronuclei serve as niche signals that produce novel microglial states. Our findings provide a potential mechanism for regulating the microglial state in the early-postnatal neocortex.
IN VIVOISOLATION OF A QUIESCENT MELANOMA POPULATION WITH INVASIVE PROPERTIES UNVEILS A TRANSCRIPTIONAL REPROGRAMMING DRIVEN BY THE TUMOR NICHE
Authors: Fiorenza Lotti , Marine Meliksetyan , Marco Malferrari , Nicolò Quaresima , Stefania Rapino , Velia Mollo , Ilaria Ferrarotto , Thalia Vlachou , Daniela Bossi , Giuseppe Pelicci Pier , Lucilla Luzi , Luisa Lanfrancone 
Published: August 2023

ABSTRACTMelanoma is a heterogeneous tumor composed of many interacting cellular populations and highly plastic melanoma cells that pass through distinct cell states to adapt to the surrounding microenvironment. Slow cycling is a transient state that defines a minor population of cells with cancer-initiating features. These cells are enriched upon drug therapy and can trigger cancer relapse and metastasis dissemination when they acquire proliferative potential. This population is still not entirely characterized.Here we provide evidence of the existence of a slow cycling melanoma population isolatedin vivofrom melanoma PDXs using the H2B-GFP system. These cells display a highly invasive phenotype and are able to dynamically respond to cancer microenvironmental stimuli. Single cell transcriptomic analysis unveils a significant transcriptional heterogeneity of GFP-retaining slow cycling cells, defining a quiescent subpopulation of cells. These cells show a different phenotype in primary tumors and matched metastases, suggesting that tumor niche pressure drives a transcriptional reprogramming of quiescent cells during melanoma progression.