bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraductal papillary mucinous neoplasm of the accessory pancreatic duct in the pancreas uncinate process: A case report
Authors: Guo Tao , Liu Ya , Yang Zhu , Li Jing , You Kun , Zhao Dejun , Chen Sujuan , Li Cong , Yang Pei , Hu Hongqiang , Zhang Hao 
Published: June 2023

Rationale:
Intraductal papillary mucinous neoplasms (IPMN) of the accessory pancreatic duct (APD) are very rare and their clinical significance is not known. Here, we describe a case of IPMN originating in a branch of the duct of APD within the uncinate process of the pancreas, which initially presented with acute pancreatitis.

Patient concerns:
A 70-year-old man visited our medical center presenting with acute pancreatitis around the head and uncinate process of the pancreas.

Diagnoses:
Computer tomography scans revealed the presence of a 35-mm cystic mass-like lesion within the pancreas uncinate process communicating with a branch of the APD. The patient was diagnosed with APD-IPMN in the pancreas uncinate process accompanied by acute pancreatitis.

Interventions:
Conservative management of the acute pancreatitis relieved his symptoms, while duodenum-preserving partial pancreatic head resection (DPPHR-P) was performed to treat the APD-IPMN. Intraoperative exploration showed the presence of severe adhesions within the uncinate process of the pancreas and that the tumor’s “peduncle” – a branch of the duct of APD – was saddling just at the front of the main pancreatic ducts. Thus, surgical removal of the tumor required special handling of the region between the main duct (MD) and APD to protect the integrity of the main pancreatic ducts. Finally, a 35*30*15 mm IPMN was successfully removed and the MD was preserved combined with ligation from the root of the APD of the pancreas. The drainage volume of the ventral tube increased by around 20-fold in 24 hours on the fourth day after surgery. The presence of high amylase levels in the drainage discharge (40713.5 U/L) led to the diagnosis of postoperative pancreatic fistula (POPF). The drainage volume remained high for 3 days.

Outcomes:
The patient was discharged and POPF was successfully managed through endoscopic pancreatic duct stenting.

Lessons:
APD-IPMN in the pancreas uncinate process has its own characteristics of localized pancreatitis, and MD-preserving DPPHR-P not only protects the exocrine and endocrine functions of the pancreas, but it also protects the physiological and anatomical integrity. The appearance of POPF after DPPHR-P may be managed by endoscopic pancreatic duct stenting.
A rare presentation of Sintilimab-induced swelling along the vessels: Case report
Authors: Liu Liqiong , Yu Yang , Xia Juan , Ning Yanting 
Published: June 2023

Rationale:
Immune-related adverse events are occasionally reported in Sintilimab treatment. This study reports a forward and reverse swelling case along the vein after infusion of Sintilimab. At present, swelling along the vascular direction during peripheral infusion are limitedly reported at home and abroad, especially when choosing a vein with thick, elastic, and good blood return.

Patient concerns:
A 56-year-old male who suffered from esophageal cancer and liver cancer and received albumin-bound paclitaxel and nedaplatin chemotherapy in combination with Sintilimab immunotherapy appeared swelling along the vessel after infusion of Sintilimab. The patient was punctured 3 times.

Diagnoses:
Sintilimab-induced vascular edema may be a side effect resulted from a combination of variables such as relatively poor vascular function of the patient, chemical extravasation, allergic skin reactions, venous valves, vascular intima, and diameter stenosis. Sintilimab rarely causes vascular edema only when drug allergic reaction is the underlying factor. As only a few cases of vascular edema caused by Sintilimab have been reported, causes to such a drug-induced vascular edema remained unclear.

Interventions:
The swelling was controlled by an intravenous specialist nurse according to delayed extravasation treatment and the doctor anti-allergy treatment, but the uncertainty of repeated puncture and symptom diagnosis caused pain and anxiety to the patient and his family.

Outcomes:
The symptom of swelling was gradually relieved after the anti-allergic treatment. The patient completed the following drug infusion without discomfort after the third puncture. When the patient was discharged the next day, swelling in his both hands disappeared, and the patient had no anxiety or discomfort.

Lessons:
The side effects of immunotherapy may accumulate over time. Early identification and appropriate nursing management are the keys to minimizing patients’ pain and anxiety. To effectively treat symptoms, nurses could benefit from quickly identifying the source of swelling.
Diagnostic accuracy of circulating exosomal circRNAs in malignances: A meta-analysis and systematic review
Authors: Yuan Xia , Mao Ye , Ou Shuangyan 
Published: June 2023

Background:
Pathogenesis of malignant tumors are often accompanied by aberrant expression of circular RNAs (circRNAs), indicating the potential diagnostic value of circRNAs in tumors. CircRNAs have been found to be enriched, stable and ubiquitous in serum and plasma exosomes. The study aims at evaluating the diagnostic performance of circulating (plasma and serum) exosomal circRNA in different types of cancer by synthesis of published data.

Methods:
A comprehensive literature search was conducted in PubMed, Embase, Medline and the Web of Science databases to identify potentially eligible studies published before April 2021. We conducted the meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations.

Results:
Eleven articles comprising 21 studies were included, and a total of 1609 cases and 1498 controls were evaluated. Six types of cancer were involved in these studies, including lung cancer, hepatocellular carcinoma, colorectal cancer, gastric cancer, multiple myeloma and osteosarcoma. The pooled sensitivity and specificity were 0.72 (95% confidence interval [CI], 0.62–0.81) and 0.83 (95% CI, 0.78–0.88), respectively. Summary receiver operating characteristic curve was constructed and the pooled value of area under curve was 0.86 (95% CI, 0.83–0.89), indicating a favorable diagnostic efficacy of circulating exosomal circRNAs in malignancies.

Conclusions:
In conclusion, our study evaluated the diagnostic power of circulating exosomal circRNAs in 6 types of cancer by synthesis of published data comprising 21 studies from eleven articles. The pooled analysis provided the evidence supporting circulating exosomal circRNAs as a promising noninvasive diagnostic biomarkers for malignancies.
Stability Changes in Fall-Prone Individuals With Parkinson Disease Following Reactive Step Training
Authors: Monaghan Andrew S. , Hooyman Andrew , Dibble Leland E. , Mehta Shyamal H. , Peterson Daniel S. 
Published: June 2023

Background and Purpose:
Poor reactive steps may lead to falls in people with Parkinson disease (PwPD). However, whether reactive steps can be improved in PwPD at risk for falls or whether step training reduces falls remains unclear. This study aimed to determine whether 2 weeks of reactive step training result in (1) immediate and retained improvements in stepping and (2) fewer prospective falls in PwPD at fall risk.

Methods:
Twenty-five PwPD (70.52 years ± 7.15; Hoehn & Yahr range 1-3) at risk for falls completed a multiple baseline, open-label, uncontrolled pre-/postintervention study. Stepping performance was assessed at 2 baseline assessments (B1 and B2) followed by a 2-week, 6-session training protocol. Stepping was assessed immediately (P1) and 2 months after training (P2). Primary outcomes were anterior-posterior margin of stability (MOS), step length, and step latency during backward stepping. Fall frequency was measured for 2 months before and after training.

Results:
MOS during backward steps was significantly larger (better) after training (P < 0.001, d = 0.83), and improvements were retained for 2 months (P = 0.04, d = 0.66). Step length was not statistically significant different after training (P = 0.13, d = 0.46) or at follow-up (P = 0.08, d = 0.62), although effect sizes were medium and large, respectively. Step latency improved after initial exposure (P = 0.01, d = 0.60) but not following training (P = 0.43, d = 0.35). Twelve participants experienced fewer falls after training than before (10 = no change, 5 = increase; P = 0.12). Greater improvements in MOS were related to fewer falls (P = 0.04).

Discussion and Conclusions:
Two weeks of reactive step training resulted in immediate and retained improvements in some reactive stepping outcomes in PwPD at risk for falls and may reduce fall risk. Reactive step training may be a viable approach to reduce falls in PwPD.
Fluid Balance and Its Association With Mortality and Health-Related Quality of Life: A Nonprespecified Secondary Analysis of the Life After Pediatric Sepsis Evaluation
Authors: Stenson Erin K. , Banks Russell K. , Reeder Ron W. , Maddux Aline B. , Zimmerman Jerry , Meert Kathleen L. , Mourani Peter M. ,   for the Life After Pediatric Sepsis Evaluation (LAPSE) Investigators
Published: June 2023

OBJECTIVES:
To evaluate the association between fluid balance (FB) and health-related quality of life (HRQL) among children at 1 month following community-acquired septic shock.

DESIGN:
Nonprespecified secondary analysis of the Life After Pediatric Sepsis Evaluation. FB was defined as 100 × [(cumulative PICU fluid input – cumulative PICU fluid output)/PICU admission weight]. Three subgroups were identified: low FB (< 5%), medium FB (5%–15%), and high FB (> 15%) based on cumulative FB on days 0–3 of ICU stay. HRQL was measured at ICU admission and 1 month after using Pediatric Quality of Life Inventory 4.0 Generic Core or Infant Scales or the Stein-Jessop Functional Status Scale. The primary outcome was a composite of mortality or greater than 25% decline in HRQL 1 month after admission compared with baseline.

SETTING:
Twelve academic PICUs in the United States.

PATIENTS:
Critically ill children between 1 month and 18 years, with community-acquired septic shock who survived to at least day 4.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Two hundred ninety-three patients were included of whom 66 (23%) had low FB, 127 (43%) had medium FB, and 100 (34%) had high FB. There was no difference in Pediatric Risk of Mortality Score 3 (median 11 [6, 17]), age (median 5 [1, 12]), or gender (47% female) between FB groups. After adjusting for potential confounders and comparing with medium FB, higher odds of mortality or greater than 25% HRQL decline were seen in both the low FB (odds ratio [OR] 2.79 [1.20, 6.57]) and the high FB (OR 2.16 [1.06, 4.47]), p = 0.027. Compared with medium FB, low FB (OR 4.3 [1.62, 11.84]) and high FB (OR 3.29 [1.42, 8.00]) had higher odds of greater than 25% HRQL decline.

CONCLUSIONS:
Over half of the children who survived septic shock had low or high FB, which was associated with a significant decline in HRQL scores. Prospective studies are needed to determine if optimization of FB can improve HRQL outcomes.
Society for Healthcare Epidemiology of America Compendium updates 2022
Authors: Septimus Edward J. 
Published: June 2023

Purpose of review
Healthcare-associated infections (HAIs) are a leading cause of preventable harm in US hospitals. Hospitals are required to conduct surveillance and report selected HAIs, including central line-associated bloodstream infections, catheter-associated urinary tract infections, colon and abdominal hysterectomy surgical-site infections, methicillin-resistant Staphylococcus aureus bacteremia, and Clostridioides difficile infections, to the CDC's National Healthcare Safety Network.

Recent findings
Up until the COVID-19 pandemic, there was significant progress in reducing HAIs. However, the pandemic resulted in extraordinary challenges for infection prevention in hospitals. Increases in HAIs were observed throughout 2020 and 2021. The Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals has recently been updated and provides common sense evidenced-based strategies to reduce HAIs.

Summary
The purpose of this review is to highlight important changes since the 2014 Compendium.
The present and future of blood virome in allogeneic hematopoietic cell transplant recipients
Authors: Hosszu-Fellous Krisztina , Zanella Marie-Celine , Kaiser Laurent , Neofytos Dionysios 
Published: June 2023

Purpose of review
Allogeneic hematopoietic cell transplantation (allogeneic HCT) is a highly effective therapy for a broad range of hematological diseases and its use is increasing worldwide. Despite advances in antiviral prophylaxis and treatment, viral infections are still one of the leading causes of post-HCT morbidity and mortality. In this patient population, metagenomic next-generation sequencing (mNGS) revealed a much larger diversity of viruses than previously suspected via the targeted screening approach. In the context of profound immunosuppression, these viral infections may cause transient viremia or protracted replication and potentially be associated with yet unrecognized or unspecific clinical manifestations. On the contrary, by constantly interacting with the immune system, viral infections may have a significant impact on posttransplant outcomes. Here, we review the latest advances in research assessing the role of the blood virome in the development of post-HCT complications.

Recent findings
Research efforts are under way to uncover the potential role of several previously undetected viruses in the development of allogeneic HCT complications and their impact on transplant outcomes.

Summary
The identification of viral actors impacting post-HCT morbidity and survival is key to optimize monitoring and infection prevention/treatment strategies.
The HLA-II immunopeptidome of SARS-CoV-2
Authors: Weingarten-Gabbay Shira , Chen Da-Yuan , Sarkizova Siranush , Taylor Hannah B. , Gentili Matteo , Pearlman Leah R. , Bauer Matthew R. , Rice Charles M. , Clauser Karl R. , Hacohen Nir , Carr Steven A. , Abelin Jennifer G. , Saeed Mohsan , Sabeti Pardis C. 
Published: June 2023

ABSTRACTTargeted synthetic vaccines have the potential to transform our response to viral outbreaks; yet the design of these vaccines requires a comprehensive knowledge of viral immunogens, including T-cell epitopes. Having previously mapped the SARS-CoV-2 HLA-I landscape, here we report viral peptides that are naturally processed and loaded onto HLA-II complexes in infected cells. We identified over 500 unique viral peptides from canonical proteins, as well as from overlapping internal open reading frames (ORFs), revealing, for the first time, the contribution of internal ORFs to the HLA-II peptide repertoire. Most HLA-II peptides co-localized with the known CD4+ T cell epitopes in COVID-19 patients. We also observed that two reported immunodominant regions in the SARS-CoV-2 membrane protein are formed at the level of HLA-II presentation. Overall, our analyses show that HLA-I and HLA-II pathways target distinct viral proteins, with the structural proteins accounting for most of the HLA-II peptidome and non-structural and non-canonical proteins accounting for the majority of the HLA-I peptidome. These findings highlight the need for a vaccine design that incorporates multiple viral elements harboring CD4+ and CD8+ T cell epitopes to maximize the vaccine effectiveness.
Adolescents’ knowledge of pain medication – can a specific teaching program in primary school improve knowledge and attitudes toward the use of pain medication?
Authors: Andreucci Alessandro , Olesen Anne Estrup , Merrild Camilla , Hardardóttir Heidur , Al-Janabi Nabil , Bruun Malene Kjær , Larsen Rikke Møller , Rathleff Michael Skovdal 
Published: June 2023

AbstractObjectivesThe aim of this study was to investigate how a specifically designed teaching program for adolescents on the subject of “pain medication” affects their knowledge and attitudes regarding pain medication.MethodsThis prospective interventional study used both quantitative and qualitative methods. The teaching intervention was co-developed with end-users. Adolescents completed a questionnaire at 3 time points: 1) at baseline before the teaching intervention, 2) immediately after the intervention and 3) at follow-up after approximately 1-2 months, depending on the schools’ availability. A qualitative component with interviews on a subsample of participants was carried out between baseline and the 1-2 months follow-up.ResultsNine classes, corresponding to 181 adolescents with a median age of 14 were exposed to the teaching intervention. 22% used pain medication at least once a week at baseline. Their baseline knowledge regarding the mechanism of action, side effects, dosage, and alternative methods to treat pain was low. Their levels of knowledge improved after the teaching intervention and we observed higher levels of knowledge and less uncertainty. However, despite the immediate positive effect, the retainment of knowledge was slightly reduced at the 1–2-month follow-up.DiscussionOur intervention increased the overall knowledge on pain medication and reduced the adolescents’ uncertainty. However, the retainment of knowledge was reduced after 1–2-month follow-up. Future interventions carried out on a longer time-span and with the inclusion of parents and delivery of online material might be designed to improve retainment of knowledge.
A randomized controlled safety and feasibility trial of floatation-REST in anxious and depressed individuals
Authors: Garland McKenna M. , Wilson Raminta , Thompson Wesley K. , Stein Murray B. , Paulus Martin P. , Feinstein Justin S. , Khalsa Sahib S. 
Published: June 2023

AbstractBackgroundReduced Environmental Stimulation Therapy via floatation (floatation-REST) is a behavioral intervention designed to attenuate exteroceptive sensory input to the nervous system. Pilot studies in anxious and depressed individuals demonstrated that single sessions of floatation- REST are safe, well-tolerated, and associated with acute anxiolysis. However, there is not sufficient evidence of the feasibility of floatation-REST as a repeated intervention.MethodsWe randomized 75 individuals with anxiety and depression to six sessions of floatation-REST in different formats (pool-REST or pool-REST preferred) or an active comparator (chair-REST). Feasibility was assessed via adherence rate to the assigned intervention, tolerability via duration of REST utilization and overall study dropout rate, and safety via incidence of serious or non-serious adverse events.ResultsSix-session adherence was 85% for pool-REST, 89% for pool-REST preferred, and 74% for chair-REST. Dropout rates did not differ significantly between the treatment conditions.Mean session durations were consistently above 50 minutes, and when allowed to choose the duration and frequency, participants opted to float for an average of 75 minutes. There were no serious adverse events associated with any intervention. Positive experiences were endorsed more commonly than negative ones and were also rated at higher levels of intensity.ConclusionsTaken together, six sessions of floatation-REST appear feasible, well-tolerated, and safe in anxious and depressed individuals. Floatation-REST induces positively-valenced experiences with few negative effects. Larger randomized controlled trials evaluating markers of clinical efficacy are warranted.Clinical Trial Registration IdentifierNCT03899090
OICNet: A Neural Network for Online EEG Source Separation using Independent Component Analysis
Authors: Yeh Po-Ting , Tsai Arthur C. , Hsieh Chia-Ying , Yang Chia-Cheng , Wei Chun-Shu 
Published: June 2023

AbstractOnline source separation of EEG signals plays a crucial role in understanding and interpreting brain dynamics in real-time applications such as brain-computer interfaces (BCIs). In this paper, we propose OICNet, a novel neural network designed specifically for online EEG source separation using independent component analysis, aiming to address the challenges of real-time computational efficiency and reliable extraction of independent components from EEG data streams. The OICNet is trained on a loss function that integrates non-Gaussianity measurement and an orthogonality constraint to achieve effective decomposition of multi-channel EEG signals. We conducted comprehensive evaluation of OICNet on both task-related and task-free EEG datasets with comparison against conventional and network-based ICA counterparts. The results demonstrate that OICNet outperforms existing methods in terms of accuracy and computational efficiency. Overall, OICNet provides high-efficiency real-time EEG source separation capabilities and paves the way for advancements in deep-learning EEG processing in real-world BCI applications.
Miniaturized CAR knocked onto CD3ε extends TCR function with CAR specificity under control of endogenous TCR signaling cascade
Authors: Manske Katrin , Dressler Lisa , Fräßle Simon P. , Effenberger Manuel , Tschulik Claudia , Cletiu Vlad , Benke Eileen , Wagner Michaela , Schober Kilian , Müller Thomas R. , Busch Dirk H. , Stemberger Christian , Germeroth Lothar , Poltorak Mateusz P. 
Published: June 2023

AbstractImmunotherapy using TCR and especially CAR transgenic T cells is a rapidly advancing field with the potential to become standard of care for the treatment of multiple diseases. While all current FDA approved CAR T cell products are generated using lentiviral gene transfer, extensive work is put into CRISPR/Cas mediated gene delivery to develop the next generation of safer and more potent cell products. One limitation of all editing systems is the size restriction of the knock-in cargo. Targeted integration under control of an endogenous promotor and/or signaling cascades opens the possibility to reduce CAR gene size to absolute minimum. Here we demonstrate that a first-generation CAR payload can be reduced to its minimum component - the antigen-binding domain - by targeted integration under control of the CD3ε promoter generating a CAR-CD3ε fusion protein that exploits the endogenous TCR signaling cascade. Miniaturizing CAR payload in this way results in potent CAR activity while simultaneously retaining the primary antigen recognition function of the TCR. Introducing CAR-specificity using a CAR binder only while maintaining endogenous TCR function may be an appealing design for future autologous CAR T cell therapies.
Lysine 117 on ataxin-3 modulates toxicity inDrosophilamodels of Spinocerebellar Ataxia Type 3
Authors: Blount Jessica R. , Patel Nikhil C. , Libohova Kozeta , Harris Autumn L. , Tsou Wei-Ling , Sujkowski Alyson , Todi Sokol V. 
Published: June 2023

ABSTRACTAtaxin-3 (Atxn3) is a deubiquitinase with a polyglutamine (polyQ) repeat tract whose abnormal expansion causes the neurodegenerative disease, Spinocerebellar Ataxia Type 3 (SCA3; also known as Machado-Joseph Disease). The ubiquitin chain cleavage properties of Atxn3 are enhanced when it is ubiquitinated at lysine (K) at position 117. K117-ubiqutinated Atxn3 cleaves poly-ubiquitin more rapidly in vitro compared to its unmodified counterpart and this residue is also important for Atxn3 roles in cell culture and inDrosophila melanogaster. How polyQ expansion causes SCA3 remains unclear. To gather insight into the biology of disease of SCA3, here we posited the question: is K117 important for toxicity caused by Atxn3? We generated transgenicDrosophilalines that express full-length, human, pathogenic Atxn3 with 80 polyQ with an intact or mutated K117. We found that K117 mutation mildly enhances the toxicity and aggregation of pathogenic Atxn3 inDrosophila. An additional transgenic line that expresses Atxn3 without any K residues confirms increased aggregation of pathogenic Atxn3 whose ubiquitination is perturbed. These findings suggest Atxn3 ubiquitination as a regulatory step of SCA3, in part by modulating its aggregation.