bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential protein expression in endothelial cells exposed to serum from patients with acute graft‐vs‐host disease, depending on steroid response
Authors: Martinez‐Sanchez Julia , Palomo Marta , Pedraza Alexandra , Moreno‐Castaño Ana Belén , Torramade‐Moix Sergi , Rovira Montserrat , Salas María Queralt , Cid Joan , Escolar Gines , Penack Olaf , Carreras Enric , Diaz‐Ricart Maribel 
Published: April 2023

AbstractGraft‐versus‐host disease (GVHD) is a complication of allogeneic haematopoietic cell transplantation. Endothelial injury is crucial as pathophysiological substrate for GVHD. GVHD first‐line treatment is high‐dose corticosteroids, although some patients are steroid‐refractory. Through the present study, we compared the endothelial proteomic profiles in response to serum from steroid‐refractory acute GVHD (SR‐aGVHD) and steroid‐sensitive acute GVHD (SS‐aGVHD) patients. Blood samples from SR‐aGVHD (n = 4) and SS‐aGVHD (n = 8) patients were collected at aGVHD diagnosis. Endothelial cell cultures were exposed (48 h) to patients' serum. Protein extraction and proteomic analysis were performed. Differences were statistically evaluated by multivariate analysis. Forty‐four proteins contributed to separate all samples into the two study groups, among which 15 participated significantly (p < 0.05), 10 exhibiting a fold change >1.2. Differentially expressed proteins were mainly associated with oxidative phosphorylation (Cytochrome C oxidase subunit 6B1, CX6B1), inflammation and angiogenesis (Apolipoprotein D, APOD), cell survival (Rapamycin‐insensitive companion of mTOR, RICTR), and oxidative stress (Riboflavin kinase, RIFK). This pilot study used a novel approach to distinguish the aGVHD response to steroid treatment. The proteins differentially expressed could constitute potential biomarkers for steroid‐treatment response. These findings signify a step forward to identify the mechanisms of response to steroids, of high clinical relevance considering the SR‐aGVHD elevated mortality.
From Market Liberalism to Public Intervention: Digital Sovereignty and Changing European Union Digital Single Market Governance
Authors: Heidebrecht Sebastian 
Published: April 2023

AbstractAgainst the backdrop of the ever‐increasing importance of digital services, the European Union (EU) is promoting deepening of its digital single market (DSM). Whilst the single market has often been portrayed as the Trojan horse of neoliberalism, recent rhetoric on digital sovereignty indicates a desire for more control over the digital sphere. A historical case study of key elements of the DSM, namely digital services regulation and data protection, shows that EU governance has become less market‐liberal and more public‐interventionist. In response to challenges associated with the digital economy, policy goals have been broadened to include further objectives in addition to competitiveness. Stakeholders and public authorities rather than business actors have become more important in governance processes, and more market‐correcting instruments have been introduced. These reforms have been made by adding more interventionist elements and also by redirecting the role of the European Commission to overseeing very large online platforms.
Philosophy and the real reasons for action: G. H. von Wright's understanding explanations
Authors: Ahlskog Jonas 
Published: April 2023

AbstractAccording to the received view, philosophy of action took a justified turn towards causalism because anti‐causalists failed the causalist challenge about efficacious reasons. This paper contests that view by examining the ways in which Georg Henrik von Wright responded to causalism in his later philosophy. First, von Wright attacked the subjectivism of causalism by arguing for an objectivist view that construes reasons not as subjective mental states but as external facts of the agent's situation. Second, von Wright fundamentally disagreed with the view of philosophical inquiry that underpinned causalism. For von Wright, the task of philosophy was conceptual: to explicate what one is looking for when one is looking for the real reasons for action. In contrast, for causalists the task was ontological: to determine what kind of item in the world the real reason for action is. Examining von Wright's account contributes to contemporary assessments of the metaphilosophical dimension of the reasons/causes debate.
SPIRITUAL INTELLIGENCE: PROCESSING DIFFERENT INFORMATION OR PROCESSING INFORMATION DIFFERENTLY?
Authors: Dorobantu Marius , Watts Fraser 
Published: April 2023

AbstractThis article introduces the concept of spiritual intelligence in terms of a natural human ability to take a different perspective on reality rather than an extraordinary ability to engage with a different/supernatural reality. From a cognitive perspective, spiritual intelligence entails a re‐balancing of the two main modes of human cognition, with a prioritization of the holistic‐intuitive mind over the conceptual one. From the psychological and phenomenological perspectives, it involves a different kind of engagement with information: slower, more participatory, less objectifying, and not focused entirely on problem solving. The article ends with a reflection on the theological implications of the proposed model and how such an account of spiritual intelligence as knowing differently might relate to theological anthropology and the theology of the spirit and the spiritual.
Assessing prevalence of missed laboratory-confirmed sexually transmitted infections among women in Kingston, Jamaica: results from a secondary analysis of the Sino-Implant clinical trial
Authors: Zia Yasaman , Wiener Jeffrey , Snead Margaret Christine , Papp John , Phillips Christi , Flowers Lisa , Medley-Singh Natalie , Costenbader Elizabeth C , Hylton-Kong Tina , Kourtis Athena P 
Published: April 2023

ObjectivesTo assess potentially missed sexually transmitted infections (STIs), we compared clinically diagnosed STIs to laboratory-confirmed diagnoses of gonorrhoea (GC), chlamydia (CT) and trichomonas (Tvag).DesignSecondary analysis of a randomised controlled trial.SettingWe used data and specimens previously collected for the Sino-Implant Study in Kingston, Jamaica.ParticipantsThe Sino-Implant Study randomised 414 women to receive a levonorgestrel implant at either baseline or 3 months post-enrolment to evaluate unprotected sex after implant initiation. This analysis used 254 available vaginal swab samples.Outcome measuresClinically diagnosed STIs were determined from medical records by assessing clinical impressions and prescriptions. Laboratory-confirmed STIs included GC, CT and Tvag tested by Aptima Combo 2 for CT/GC and Aptima Tvag assays (Hologic, San Diego, California, USA). Log-binomial regression models fit with generalised estimating equations were used to estimate associations of clinically diagnosed STIs with laboratory-confirmed diagnoses and demographic and behavioural characteristics.ResultsOverall, 195 (76.8%) women had laboratory-confirmed STI (CT, GC or Tvag) while only 65 (25.6%) women had clinically diagnosed cervicitis and/or vaginitis during the study period. Clinical diagnosis missed 79.7% of laboratory-confirmed STIs: 85% of GC (n=17/20), 78.8% of CT (n=141/179) and 80.0% of Tvag (n=180/225). Hormonal contraceptive use in the month prior to the study visit was significantly associated with clinical diagnosis at any time point (prevalence ratio (PR): 1.65, 95% CI 1.07 to 2.54). As age increased, clinically missed infections significantly decreased (PR: 0.98 per year increase, 95% CI 0.97 to 1.00).ConclusionsThe prevalence of laboratory-confirmed STIs was much higher than what was captured by clinical diagnosis. GC, CT and Tvag were not accurately detected without lab confirmation. Missed diagnoses decreased with older age. Increased laboratory capacity and refinement of the syndromic approach are needed to protect the health of sexually active Jamaican women.Trial registration numberNCT01684358.
Minimizing ICU Neurological Dysfunction with Dexmedetomidine-induced Sleep (MINDDS): protocol for a randomised, double-blind, parallel-arm, placebo-controlled trial
Authors: Shelton Kenneth T , Qu Jason , Bilotta Federico , Brown Emery N , Cudemus Gaston , D’Alessandro David A , Deng Hao , DiBiasio Alan , Gitlin Jacob A , Hahm Eunice Y , Hobbs Lauren E , Houle Timothy T , Ibala Reine , Loggia Marco , Pavone Kara J , Shaefi Shahzad , Tolis George , Westover M. Brandon , Akeju Oluwaseun 
Published: April 2023

IntroductionDelirium, which is prevalent in postcardiac surgical patients, is an acute brain dysfunction characterised by disturbances in attention, awareness and cognition not explained by a pre-existing neurocognitive disorder. The pathophysiology of delirium remains poorly understood. However, basic science and clinical studies suggest that sleep disturbance may be a modifiable risk factor for the development of delirium. Dexmedetomidine is a α-2A adrenergic receptor agonist medication that patterns the activity of various arousal nuclei similar to sleep. A single night-time loading dose of dexmedetomidine promotes non-rapid eye movement sleep stages N2 and N3 sleep. This trial hypothesises dexmedetomidine-induced sleep as pre-emptive therapy for postoperative delirium.Methods and analysisThe MINDDS (Minimizing ICU Neurological Dysfunction with Dexmedetomidine-induced Sleep) trial is a 370-patient block-randomised, placebo-controlled, double-blinded, single-site, parallel-arm superiority trial. Patients over 60 years old, undergoing cardiac surgery with planned cardiopulmonary bypass, will be randomised to receive a sleep-inducing dose of dexmedetomidine or placebo. The primary outcome is the incidence of delirium on postoperative day 1, assessed with the Confusion Assessment Method by staff blinded to the treatment assignment. To ensure that the study is appropriately powered for the primary outcome measure, patients will be recruited and randomised into the study until 370 patients receive the study intervention on postoperative day 0. Secondary outcomes will be evaluated by in-person assessments and medical record review for in-hospital end points, and by telephone interview for 30-day, 90-day and 180-day end points. All trial outcomes will be evaluated using an intention-to-treat analysis plan. Hypothesis testing will be performed using a two-sided significance level (type I error) of α=0.05. Sensitivity analyses using the actual treatment received will be performed and compared with the intention-to-treat analysis results. Additional sensitivity analyses will assess the potential impact of missing data due to loss of follow-up.Ethics and disseminationThe Partners Human Research Committee approved the MINDDS trial. Recruitment began in March 2017. Dissemination plans include presentations at scientific conferences, scientific publications and popular media.Trial registration numberNCT02856594.
Protocol of a randomised controlled trial of real-time continuous glucose monitoring in neonatal intensive care ‘REACT’
Authors: Beardsall Kathryn , Thomson Lynn , Guy Catherine , van Weissenbruch Mirjam M , Iglesias Isabel , Muthukumar Priya , Somisetty Sateesh Kumar , Bond Simon , Petrou Stavros , Dunger David 
Published: April 2023

IntroductionHyperglycaemia is common in the very preterm infant and has been associated with adverse outcomes. Preventing hyperglycaemia without increasing the risk of hypoglycaemia has proved challenging. The development of real-time continuous glucose monitors (CGM) to inform treatment decisions provides an opportunity to reduce this risk. This study aims to assess the feasibility of CGM combined with a specifically designed paper guideline to target glucose control in the preterm infant.Methods and analysesThe Real Time Continuous Glucose Monitoring in Neonatal Intensive Care (REACT) trial is an international multicentre randomised controlled trial. 200 preterm infants ≤1200 g and ≤24 hours of age will be randomly allocated to either real-time CGM or standard care (with blinded CGM data collection). The primary outcome is time in target 2.6–10 mmol/L during the study intervention assessed using CGM. Secondary outcomes include efficacy relating to glucose control, utility including staff acceptability, safety outcomes relating to incidence and prevalence of hypoglycaemia and health economic analyses.Ethics and disseminationThe REACT trial has been approved by the National Health Service Health Research Authority National Research Ethics Service Committee East of England (Cambridge Central); Medical Ethics Review Committee, VU University Medical Centre, Amsterdam, The Netherlands and the Research Ethics Committee, Sant Joan de Déu Research Foundation, Barcelona, Spain. Recruitment began in July 2016 and will continue until mid-2018. The trial has been adopted by the National Institute of Health Research Clinical Research Network portfolio (ID: 18826) and is registered with anInternational Standard Randomised Control Number (ISRCTN registry ID: 12793535). Dissemination plans include presentations at scientific conferences, scientific publications and efforts at stakeholder engagement.Trial registration numberISRCTNNCT12793535Pre-results.
Protocol for assessment of sleep quality and duration in the Treatment In Morning versus Evening (TIME) study: a randomised controlled trial using online patient-reported outcome measures
Authors: Rogers Amy , Morrison Ian , Rorie David A , Mackenzie Isla S , MacDonald Thomas M 
Published: April 2023

IntroductionWe will use the existing online mechanisms of the Treatment in Morning versus Evening (TIME) study to collect patient-reported outcome measures of sleep quality to determine whether nocturnal dosing of antihypertensives affects sleep quality, when compared with morning dosing.The TIME study aims to determine if morning or evening dosing of antihypertensive medications is more effective in preventing heart attacks and strokes. The cardiovascular end points in TIME are identified by individual-level linkage to routinely collected hospital admissions and mortality data; these data are supplemented with participant-completed follow-up questionnaires, administered online.This substudy will provide information regarding the relative acceptability of morning and evening dosing of antihypertensives that will be essential should the TIME study results prompt doctors to consider advising particular dosing times to their patients.Methods and analysisTIME participants are aged over 18 years and prescribed at least one antihypertensive drug, taken once a day. They are self-enrolled and consented on the secure TIME website (www.timestudy.co.uk) and then randomised to dosing time. Study follow-up is conducted by automated email. Average participant follow-up is expected to be 4 years. Participants in the sleep substudy are asked to complete an online sleep quality questionnaire at baseline, after 3 months and annually. This includes a Pittsburgh Sleep Quality Index (PSQI), a Hospital Anxiety and Depression Scale and an Epworth Sleepiness Scale. The primary outcome of the TIME Sleep substudy is sleep quality as measured by the PSQI. Secondary outcomes include sleep quantity and duration, and an analysis of any association between sleep quality and the main outcome measures of the TIME study (heart attack, stroke and vascular death).Ethics and disseminationEthical approval has been obtained from the Tayside Committee on Medical Research Ethics (MREC reference: 11/AL/0309), and results will be published in a peer-reviewed journal.Protocol version9 (approved 19 July 2017).Trial registration numberUKCRN ID: 17071. ISRCTN:NCT18157641. Pre-results.
Clinical and ultrasonographic predictors for achieving minimal disease activity in patients with psoriatic arthritis: the UPSTREAM (Ultrasound in PSoriatic arthritis TREAtMent) prospective observational study protocol
Authors: Canzoni Marco , Piga Matteo , Zabotti Alen , Scirè Carlo Alberto , Carrara Greta , Olivieri Ignazio , Iagnocco Annamaria 
Published: April 2023

IntroductionPsoriatic arthritis (PsA) occurs in 10%–15% of people with psoriasis and accounts for 10%–20% of early arthritis clinics referral. Only a few prognostic factors of therapeutic response in patients with PsA have been identified. In the last years, the role of imaging has grown up and the European League Against Rheumatism recognised that ultrasound (US) has higher sensitivity than clinical examination to detect inflammatory disease activity. The aims of the Ultrasound in PSoriatic arthritis TREAtMent (UPSTREAM) study are to integrate clinic and US in order to inform whether US has provide an added prognostic value in PsA.Methods and analysisUPSTREAM is an observational prospective cohort study enrolling patients with PsA having clinically active joint disease and starting a new course of therapy. The primary objective is to evaluate the additional value of US over clinical examination in detecting patients achieving minimal disease activity after 6 months. Data will be obtained at baseline and at standard clinical follow-up visits. Patient’s clinical assessment will be performed according to the core set proposed by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis-Outcome Measures in Rheumatology. Sonographic evaluations will be performed by expert sonographers in 42 joints, 36 tendons, 12 entheses and 2 bursae, according to a score that will be purposely developed for PsA by the US Study Group of the Italian Society for Rheumatology. The UPSTREAM study will identify clinical and US predictors of response to treatment in patients with PsA and active peripheral arthritis starting a new course of therapy.Ethics and disseminationEthic approval for this study has been obtained from the institutional review board (IRB)/independent ethics committee (IEC) Comitato Etico Lazio 1 (Prot. N 198 02-02-2017) and then locally from the IRB/IEC of each participating centre. Results will be published in relevant scientific journals and be disseminated in international conferences. Fully anonymised data will be accessible from authors upon request.Trial registration numberNCT03330769.
Exploration and characterisation of the phenotypic and genetic profiles of patients with early onset schizophrenia associated with autism spectrum disorder and their first-degree relatives: a French multicentre case series study protocol (GenAuDiss)
Authors: Fernandez Arnaud , Dor Emmanuelle , Maurin Thomas , Laure Gaelle , Menard Marie-Line , Drozd Małgorzata , Poinso Francois , Bardoni Barbara , Askenazy Florence , Thümmler Susanne 
Published: April 2023

IntroductionEarly-onset schizophrenia (EOS) is a rare and severe condition. A higher rate of neurodevelopmental abnormalities, such as intellectual or communication impairments as well as attention deficit hyperactivity disorder, is observed in EOS compared with adult-onset schizophrenia. Early signs of autism spectrum disorders (ASD) are present in about 30% of patients. Genetic abnormalities, including copy number variations, are frequent in neurodevelopmental disorders and have been associated to ASD physiopathology. Implicated genes encode proteins involved in brain development, synapses morphology and plasticity and neurogenesis. In addition, an increasing number of genetic abnormalities are shared by EOS and ASD, underlying the neurodevelopmental hypothesis of EOS.The main objective of our study is to identify disease-causing genetic mutations in a cohort of patients affected by both EOS and ASD. Special attention will be paid to genes involved in neurodevelopmental pathways.Methods and analysisWe describe a multicentric study in a paediatric population. The study started in April 2014. Inclusion criteria are: age 7–22 years, diagnosis of EOS with comorbid ASD and IQ >50; Parents and siblings are also enrolled. We perform psychiatric assessments (Mini International Neuropsychiatric Interview, Kiddie Schedule for Affective Disorders and Schizophrenia -Present and Lifetime Version, Positive and Negative Syndrome Scale and Scale for the Assessment of Negative Symptoms) together with neurocognitive evaluations (IQ, Trail Making Test A/B and verbal fluency). Then, we study variants of the coding part of DNA (exome), using next-generation sequencing process on trio (mother, father and child). Bioinformatics tools (RVIS and PolyPhen-2) are used to prioritise disease-causing mutations in candidate genes. The inclusion period will end in November 2019.Ethics and disseminationThe study protocol was approved by the Local Ethic Committee and by the French National Agency for Medicines and Health Products Safety. All patients signed informed consent on enrolment in the study. Results of the present study should help to unravel the molecular pathology of EOS, paving the way for an early therapeutic intervention.Trial registration numberNCT0256552
‘Organisation of delivery of care in operating suite recovery rooms within 48 hours postoperatively and patient outcomes after adult non-cardiac surgery: a systematic review’
Authors: Lloyd Courtney , Ludbrook Guy , Story David , Maddern Guy 
Published: April 2023

ContextPostoperative recovery rooms have existed since 1847, however, there is sparse literature investigating interventions undertaken in recovery, and their impact on patients after recovery room discharge.ObjectiveThis review aimed to investigate the organisation of care delivery in postoperative recovery rooms; and its effect on patient outcomes; including mortality, morbidity, unplanned intensive care unit (ICU) admission and length of hospital stay.Data sourcesNCBI PubMed, EMBASE and Cumulative Index to Nursing and Allied Health Literature.Study selectionStudies published since 1990, investigating health system initiatives undertaken in postoperative recovery rooms. One author screened titles and abstracts, with two authors completing full-text reviews to determine inclusion based on predetermined criteria. A total of 3288 unique studies were identified, with 14 selected for full-text reviews, and 8 included in the review.Data extractionEndNote V.8 (Clarivate Analytics) was used to manage references. One author extracted data from each study using a data extraction form adapted from the Cochrane Data Extraction Template, with all data checked by a second author.Data synthesisNarrative synthesis of data was the primary outcome measure, with all data of individual studies also presented in the summary results table.ResultsFour studies investigated the use of the postanaesthesia care unit (PACU) as a non-ICU pathway for postoperative patients. Two investigated the implementation of physiotherapy in PACU, one evaluated the use of a new nursing scoring tool for detecting patient deterioration, and one evaluated the implementation of a two-track clinical pathway in PACU.ConclusionsManaging selected postoperative patients in a PACU, instead of ICU, does not appear to be associated with worse patient outcomes, however, due to the high risk of bias within studies, the strength of evidence is only moderate. Four of eight studies also examined hospital length of stay; two found the intervention was associated with decreased length of stay and two found no association.PROSPERO registration numberThis protocol is registered on the International Prospective Register of Systematic Reviews (PROSPERO) database, registration numberNCT42018106093.