bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful Pancreatic Cancer Screening Among Individuals at Elevated Risk Using Endoscopic Ultrasound and Magnetic Resonance Imaging
Authors: Raff Joshua Peter , Cook Brennan , Jafri Farrukh Nadeem , Boxer Nicole , Maldonado Jessica , Hopkins Una , Roayaie Sasan , Noyer Charles 
Published: April 2023

Objectives
Guidelines for testing individuals at risk (IAR) for developing pancreatic duct adenocarcinoma (PC) are being advanced from university hospital populations. We implemented a screen-in criteria and protocol for IAR for PC in our community hospital setting.

Methods
Eligibility was based on germline status and/or family history of PC. Longitudinal testing continued, alternating between endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI). The primary objective was to analyze pancreatic conditions and their associations with risk factors. The secondary objective was to evaluate the outcomes and complications resulting from testing.

Results
Over 93 months, 102 individuals completed baseline EUS, and 26 (25%) met defined endpoints of any abnormal findings in the pancreas. Average enrollment was 40 months, and all participants with endpoints continued standard surveillance. Two participants (1.8%) had endpoint findings requiring surgery for premalignant lesions. Increasing age predicted for endpoint findings. Analysis of longitudinal testing suggested reliability between the EUS and MRI results.

Conclusions
In our community hospital population, baseline EUS was effective in identifying the majority of findings; advancing age correlated with a greater chance of abnormalities. No differences were observed between EUS and MRI findings. Screening programs for PC among IAR can be successfully performed in the community setting.
Pancreatic Lineage Cell Differentiation of Bone Marrow Mesenchymal Stromal Cells on Acellular Pancreatic Bioscaffold
Authors: Li Zhao , Du Yue , Wang Xin 
Published: April 2023

Objectives
We evaluated the potential differentiation ability of bone mesenchymal stromal cells (BMSCs) into pancreatic lineage cells on a rat acellular pancreatic bioscaffold (APB) and the effect of differentiated BMSCs in vivo.

Methods
The BMSCs were dynamically or statically cultured with or without growth factor in both culture systems. We assessed the cytological behavior and differentiation. We also evaluated the pancreatic fibrosis and pathological scores.

Results
The proliferation rates of BMSCs were significantly higher in the APB groups. The APB induced BMSCs to express mRNA markers at higher levels. All tested pancreatic functional proteins were also expressed at higher levels in the APB group. The secretion of metabolic enzymes was higher in the APB system. The ultrastructure of BMSCs in the APB group further revealed the morphological characteristics of pancreatic-like cells. For the in vivo study, the pancreatic fibrosis and pathological scores were significantly lower in the differentiated BMSCs group. In addition, in both the in vitro and the in vivo study, growth factor significantly improved proliferation, differentiation, and pancreatic cell therapy.

Conclusions
The APB can promote BMSC differentiation toward pancreatic lineage and pancreatic-like phenotypes, giving it the potential for use in pancreatic cell therapies and tissue engineering.
Early Increases in Posttransplant Pancreatic Enzymes Are Associated With Surgical Complications But Not Graft Failure Among Pancreas Transplant Recipients
Authors: Parajuli Sandesh , Leverson Glen E. , Kaufman Dixon B. , Djamali Arjang , Welch Bridget M. , Sollinger Hans W. , Mandelbrot Didier A. , Odorico Jon S. 
Published: April 2023

Objectives
This study aimed to find the association between immediate postoperative increases in pancreatic enzymes and posttransplant complications among pancreas transplant recipients (PTRs).

Methods
We analyzed all PTRs transplanted at the University of Wisconsin between June 2009 and September 2018. Enzyme levels were presented as a ratio of absolute numbers to the upper limit of normal value, with value >1 considered as abnormal. We specifically evaluated bleeding, fluid collections, and thrombosis complications based on the amylase or lipase ratios on day 1 (Amylase1, Lipase1) and maximum ratios within 5 days of transplant (Amylasemax, Lipasemax). For early complications, we focused on technical complications that occurred within 90 days of transplant. For long-term outcomes, we assessed patient and graft survival, and rejections.

Results
There were a total of 443 PTRs, 287 were simultaneous pancreas and kidney recipients, and 156 were solitary pancreas recipients. Higher Amylase1, Liplase1, Amylasemax, and Lipasemax were associated with an increase in early complications, mainly need for pancreatectomy, fluid collections, bleeding complications, or graft thrombosis, particularly in the solitary pancreas group.

Conclusions
Our finding suggests that cases of early perioperative enzyme increase merit consideration for early imaging investigation to mitigate detrimental outcomes.
Postoperative Poor Oral Intake After Distal Pancreatectomy
Authors: Park Hyeong Min , Park Sang-Jae , Kang Mee Joo , Han Sung-Sik , Kim Sun-Whe 
Published: April 2023

Objectives
Poor oral intake (POI) without an identifiable cause is frequently observed after distal pancreatectomy (DP). This study was designed to investigate the incidence and risk factors of POI after DP, and its impact on the length of hospital stay.

Methods
The prospectively collected data of patients who received DP were retrospectively reviewed. A diet protocol after DP was followed, and POI after DP was defined as the oral intake being less than 50% of the daily requirement and parenteral calorie supply being required on postoperative day 7.

Results
Of the 157 patients, 21.7% (34) experienced POI after DP. The multivariate analysis revealed that the remnant pancreatic margin (head; hazard ratio, 7.837; 95% confidence interval, 2.111–29.087; P = 0.002) and postoperative hyperglycemia >200 mg/dL (hazard ratio, 5.643; 95% confidence interval, 1.482–21.494; P = 0.011) were independent risk factors for POI after DP. The length of hospital stay (median [range]) of the POI group was significantly longer than that of the normal diet group (17 [9–44] vs 10 [5–44] days; P < 0.001).

Conclusions
Patients undergoing pancreatic resection at pancreatic head portion should follow a postoperative diet, and postoperative glucose levels should be strictly regulated.
Regional Growth Velocity and Incidence of Pancreatic Neuroendocrine Neoplasias in Multiple Endocrine Neoplasia Type 1
Authors: Kann Peter Herbert , Scheunemann Adrian , Adelmeyer Jan , Bergmann Simona , Goebel Joachim Nils , Bartsch Detlef K. , Holzer Katharina , Albers Max B. , Manoharan Jerena , Scheunemann Lisann M. 
Published: April 2023

Objectives
Pancreatic neuroendocrine neoplasias (pNENs) in multiple endocrine neoplasia type 1 are predominantly found in the dorsal anlage. Whether their growth velocity and incidence might be related to their location in the pancreas has not been investigated yet.

Methods
We studied 117 patients using endoscopic ultrasound.

Results
Growth velocity could be calculated for 389 pNENs. Increase of largest tumor diameter (% per month) was 0.67 (standard deviation [SD], 2.04) in the pancreatic tail (n = 138), 1.12 (SD, 3.00) in the pancreatic body (n = 100), 0.58 (SD, 1.19) in the pancreatic head/uncinate process—dorsal anlage (n = 130), and 0.68 (SD, 0.77) in the pancreatic head/uncinate process—ventral anlage (n = 12). Comparing growth velocity of all pNENs in the dorsal (n = 368, 0.76 [SD, 2.13]) versus ventral anlage, no significant difference was detected. Annual tumor incidence rate was 0.21 in the pancreatic tail, 0.13 in the pancreatic body, 0.17 in the pancreatic head/uncinate process—dorsal anlage, 0.51 dorsal anlage together, and 0.02 in the pancreatic head/uncinate process—ventral anlage.

Conclusions
Multiple endocrine neoplasia type 1 pNENs are unequally distributed between ventral (low prevalence and incidence) and dorsal anlage. However, there are no regional differences in growth behavior.
KRAS Mutation Testing on Endoscopic Ultrasound-Guided Fine-Needle Aspiration Samples Improves the Diagnostic Accuracy of Pancreatic Cancer
Authors: Yeung Maximus C.F. , Shek Tony W.H. 
Published: April 2023

Objectives
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology was one of the investigations for pancreatic masses. While the specificity approached 100%, its sensitivity remained low because of high rate of indeterminate and false-negative results. Meanwhile, KRAS gene was frequently mutated in up to 90% of pancreatic ductal adenocarcinoma and its precursor lesions. This study aimed to determine whether KRAS mutation analysis could improve the diagnostic sensitivity in EUS-FNA samples for pancreatic adenocarcinoma.

Methods
The EUS-FNA samples from patients with a pancreatic mass obtained between January 2016 and December 2017 were reviewed retrospectively. The cytology results were classified as malignant, suspicious for malignancy, atypical, negative for malignancy, and nondiagnostic. KRAS mutation testing was performed using polymerase chain reaction followed by Sanger sequencing.

Results
A total of 126 EUS-FNA specimens were reviewed. The overall sensitivity and specificity by cytology alone were 29% and 100%, respectively. When KRAS mutation testing was performed in cases with indeterminate and negative cytology, the sensitivity increased to 74.2%, and the specificity remained at 100%.

Conclusions

KRAS mutation analysis, especially when performed in cytologically indeterminate cases, improves the diagnostic accuracy for pancreatic ductal adenocarcinoma. This may reduce the need to repeat invasive EUS-FNA for diagnosis.
The Impact of Preexisting Psychiatric Disorders on Outcomes After Pancreatic Cancer Surgery
Authors: Perry Lauren M. , Kleber Kara T. , Rajasekar Ganesh , Nuño Miriam , Bold Richard J. 
Published: April 2023

Objectives
Comorbid psychiatric illness has been associated with worse outcomes after some major surgical procedures. We hypothesized that patients with preexisting mood disorders would have worse postoperative and oncologic outcomes after pancreatic cancer resection.

Methods
This retrospective cohort study analyzed Surveillance, Epidemiology, and End Results patients with resectable pancreatic adenocarcinoma. A preexisting mood disorder was classified if a patient was diagnosed and/or treated with medication approved for depression/anxiety within 6 months before surgery.

Results
Of 1305 patients, 16% had a preexisting mood disorder. Mood disorders had no impact on hospital length of stay (12.9 vs 13.2 days, P = 0.75), 30-day complications (26% vs 22%, P = 0.31), 30-day readmissions (26% vs 21%, P = 0.1), or mortality (30 days: 3% vs 4%, P = 0.35); only an increased 90-day readmissions rate (42% vs 31%, P = 0.001) was observed. No effect on adjuvant chemotherapy receipt (62.5% vs 69.2%, P = 0.06) or survival (24 months, 43% vs 39%, P = 0.44) was observed.

Conclusions
Preexisting mood disorders influenced 90-day readmissions after pancreatic resection, but not other postoperative or oncologic outcomes. These findings suggest that affected patients should be expected to have outcomes similar to patients without mood disorders.
A Retrospective Real-World Evidence Evaluation of the Characteristics of Exocrine Pancreatic Insufficiency in Patients With Chronic Pancreatitis and Type 2 Diabetes Treated With Pancrelipase in the United States
Authors: Rosenberg Jonathan , Reddy Manchikanti Nagarjuna , Seelam Prafulla , Li Olivia , Twal Janine , Pack Jennifer 
Published: April 2023

Objectives
This retrospective real-world data analysis assessed clinical/health care professional characteristics of gastrointestinal symptom profiles in pancrelipase-treated patients with exocrine pancreatic insufficiency symptoms and chronic pancreatitis (CP) or type 2 diabetes (T2D).

Methods
Data were from the Decision Resources Group Real-World Evidence Data Repository US database. Patients 18 years and older receiving pancrelipase (Zenpep) between index dates August 2015 and June 2020 were included. Gastrointestinal symptoms were assessed 6, 12, and 18 months post-index versus baseline.

Results
A total of 10,656 pancrelipase-treated patients with CP (n = 3215) or T2D (n = 7441) were identified. Significant/sustained reductions in gastrointestinal symptoms were observed in both cohorts after pancrelipase treatment (P < 0.001) versus baseline. Significantly fewer patients with CP compliant with treatment for more than 270 days (n = 1553) reported abdominal pain (P < 0.001) and nausea/vomiting (P < 0.05) versus those compliant for less than 90 days (n = 1115). Significantly fewer patients with T2D compliant with treatment for more than 270 days (n = 2964) reported abdominal pain (P < 0.001) and diarrhea/steatorrhea (P < 0.05) versus those compliant for less than 90 days (n = 2959).

Conclusions
Pancrelipase reduced exocrine pancreatic insufficiency symptoms in patients with CP or T2D, with greater treatment compliance associated with improved gastrointestinal symptom profiles.
Circ_0058058 Drives the Malignant Phenotypes and Immune Evasion of Pancreatic Cancer by the MicroRNA-557–Dependent Regulation of PDL1
Authors: Lin Lin , Xiao Liang , Jin Chang'e , Qin Ying , Deng Haoyuan , Li Meixiang , Lin Huan , Gong Xuehao 
Published: April 2023

Objectives
Pancreatic cancer (PC) is one of the most deadly malignancies in the world. Recently, circular RNAs play crucial roles in PC progression. However, the functions of circ_0058058 in PC are barely known.

Methods
The expression of circ_0058058, microRNA-557-5p (miR-557), and programmed cell death receptor ligand 1 (PDL1) was detected by quantitative real-time polymerase chain reaction. Functional experiments were implemented to disclose the effect of circ_0058058 deficiency on PC cell proliferation, apoptosis, invasion, angiogenesis, and immune escape. The binding relationship between miR-557 and circ_0058058 or PDL1 was identified by dual-luciferase reporter assay and RNA immunoprecipitation assay. In vivo assay was used to disclose the impact of circ_0058058 silencing on tumor formation in vivo.

Results
Circ_0058058 was highly expressed in PC tissues and cell lines. Knockdown of circ_0058058 repressed cell proliferation, invasion, angiogenesis, and immune escape while contributed to apoptosis in PC cells. Mechanically, circ_0058058 worked as a molecular sponge of miR-557 to regulate PDL1 expression. Moreover, circ_0058058 showed a promotional effect on tumor growth in vivo.

Conclusions
Our findings suggested that circ_0058058 served as miR-557 sponge to upregulate PDL1, thereby triggering PC proliferation, invasion, angiogenesis, and immune escape.
Outbreak of leptospirosis amidst COVID’19 in Tanzania: a new threat? Short communication
Authors: Shaikh Omer A. , Azam Umama , Naseem Muhammad U. , Ochani Sidhant , Hasibuzzaman Md. Al , Ullah Kaleem 
Published: April 2023

As the world is still fighting to combat the coronavirus disease 2019 (COVID-19) virus, the United Republic of Tanzania has been confronting yet another bacterial infection called leptospirosis (LS). It is caused by the spirochete bacteria of genus Leptospira, and has been known to infect several people, already claiming a number of lives. It infects 1 million people annually with ~60 000 deaths having a fatality rate of 6.85% worldwide. COVID has profusely burdened the healthcare system worldwide within the past 2 years; it has sabotaged medical management and brought down resources, which has now made it difficult for any country to withstand another pandemic. LS has overburdened the medical care system of Tanzania abjectly; it is now imperative not to overlook environmental factors, like a flood, the presence of rodents, unsatisfactory socioeconomic conditions in areas where dogs reside, substandard wastewater and garbage disposal facilities, or any other factor which might lead to further spread of LS and put Tanzania in jeopardy.
Exploration of Lived Experiences and Measurement of Burnout Among US Clinical Research Nurses
Authors: Johnson Elizabeth , Rainbow Jessica 
Published: April 2023

OBJECTIVE
The aims of this study were to explore the experiences of US clinical research nurses supporting the conduct of clinical trials before and during the COVID-19 pandemic and assess dimensions of burnout among these nurses using the Maslach Burnout Inventory-Human Services Survey.

BACKGROUND
Clinical research nurses are a subspecialty of nursing that supports clinical trial conduct. Postpandemic clinical research nurse well-being, including indicators of burnout, has not been established.

METHODS
A cross-sectional descriptive study via online survey was conducted.

RESULTS
A sample of US clinical research nurses scored overall high for the Maslach category of Emotional Exhaustion, moderate for Depersonalization, and moderate for Personal Achievement. Themes included together or apart, rewarding but challenging, and surviving or thriving.

CONCLUSION
Supportive measures such as workplace appreciation and consistent change communication may benefit clinical research nurse well-being and reduce burnout during times of unpredicted crisis and beyond.
The State of Rest Break Practices Among 12-Hour Shift Hospital Nurses in the United States
Authors: Sagherian Knar , Cho Hyeonmi , Steege Linsey M. 
Published: April 2023

OBJECTIVE
This cross-sectional study aimed to explore the characteristics, content, and context of rest breaks taken by hospital nurses.

BACKGROUND
Nurses often miss, skip, or take interrupted breaks. To improve the quality of breaks and promote within-shift recovery, it is important to understand current rest break practices including break activities and contextual challenges around them.

METHODS
Survey data from 806 nurses were collected between October and November 2021.

RESULTS
Most nurses did not take regular breaks. Rest breaks were often interrupted, spent being worried about work, and rarely resulted in a relaxed state. Common break activities were having a meal or a snack, and browsing the Internet. Regardless of workload, nurses considered patient acuity, staffing, and unfinished nursing tasks when deciding to take breaks.

CONCLUSION
Rest break practices are of poor quality. Nurses mainly consider workload-related factors when taking breaks, which warrants the attention of nursing administration.
The Impact of a Nursing-Led Intervention Bundle With a Bedside Checklist to Reduce Mortality During the Initial COVID-19 Pandemic and Implications for Future Emergencies
Authors: Pugh Suzanne , Chan Florinda , Han Sarah , Lindo Rosalie , Krzewski Dina Giatis , D'Orazi Mary Ann , Narayanajaya Derrik , Gao Ziqi , Norful Allison A. 
Published: April 2023

OBJECTIVE
The study objective was to examine the effectiveness of a bedside checklist enforcing nursing-led interventions in hospitalized COVID-19 patients early in the pandemic.

BACKGROUND
The absence of treatment guidelines for COVID-19 presented challenges to reducing mortality rates early in the pandemic. A bedside checklist and a bundle of nursing-led interventions named “Nursing Back to Basics (NB2B)” were assembled for patient care after a scoping review of evidence.

METHODS
A retrospective analysis was conducted to investigate the impact of the evidence-based interventions randomly implemented based on patient bed assignment. Electronic data (patient demographics, bed assignment and ICU transfers, length of stay, and patient discharge disposition) were extracted and calculated using descriptive statistics, t tests, and linear regression.

RESULTS
Patients receiving the NB2B intervention enforced with a bedside checklist had significantly lower mortality rates (12.3%) compared with those receiving standard nursing care (26.9%).

CONCLUSIONS
Bedside checklists enforcing evidence-based nursing-led interventions may be beneficial as a 1st-line public health emergency response.
Sexuality Transmitted Infections Risk and Interstate Sexual Networks among Men Who Have Sex with Men in New England
Authors: Ibanhes Fernando H. , Fenn Natalie , Le Brazidec Danielle , Napoleon Siena , Predmore Zachary , Skinner Alexandra , Zanowick-Marr Alex , Galipeau Drew , Raifman Julia , Dean Lorraine T. , Chan Philip A. 
Published: April 2023

Abstract
By investigating relationships between sexual mobility and STI risk factors among men who have sex with men, we found that past STI history, number of sexual partners, and substance use are associated with increased odds of interstate sexual encounters, suggesting that interjurisdictional approaches to STI prevention are needed.
Performance of a Provider-Assigned Functional Outcome Score in Critically Ill Children
Authors: Wilson Natalie E. , Su Felice , DaCar Allie , Chang Nathan , Kapphahn Kristopher , Schroeder Alan R. , Tawfik Daniel S. , Knight Lynda , Rasmussen Lindsey 
Published: April 2023

Objectives:
Determine agreement between Pediatric Cerebral Performance Category (PCPC) scores integrated into clinical workflow and traditional investigator-assigned scores.

Design:
Longitudinal study.

Setting:
A single-center quaternary-care academic institution.

Subjects:
Children admitted to the PICU between November 2019 and April 2020.

Interventions:
Providers assigned PCPC scores as part of daily workflow. Investigators assigned scores using retrospective chart review.

Measurements and Main Results:
Of 803 patients admitted to the PICU, 782 survived and were included. Admission and discharge scores were recorded in 95% and 90% of patients, respectively. Agreement between provider- and investigator-assigned scores was excellent, with a weighted kappa of 0.87 (95% CI, 0.84–0.90) and 0.80 (95% CI, 0.76–0.84) for admission and discharge.

Conclusions:
Provider-assigned PCPC scores, documented as standard of care, are largely concordant with retrospective investigator-assigned scores. Measurement of cognitive functional status can be successfully integrated into daily provider workflow for use in the clinical, quality improvement, and research arenas.