bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of postoperative outcomes of minimally invasive distal pancreatectomy for left-sided pancreatic tumors based on the modified frailty index: A retrospective cohort study
Authors: Park Yejong , Hwang Dae Wook , Lee Jae Hoon , Song Ki Byung , Jun Eunsung , Lee Woohyung , Kwak Bong Jun , Kim Song Cheol 
Published: August 2023

Background:
This study compared the postoperative outcomes of minimally invasive distal pancreatectomy (MIDP) for left-sided pancreatic tumors based on the modified frailty index (mFI).

Materials and Methods:
This retrospective study included 2,212 patients who underwent MIDP for left-sided pancreatic tumors between 2005 and 2019. Postoperative outcomes, including complications (morbidity and mortality), were analyzed using mFI, and the participants were divided into two groups: frail (n=79) and nonfrail (n=2,133). A subanalysis of 495 MIDPs for pancreatic ductal adenocarcinoma was conducted to compare oncological outcomes.

Results:
Clinically relevant postoperative pancreatic fistula was significantly higher in the frail group than in the nonfrail group. A significant between-group difference was observed in overall complications with Clavien−Dindo classification grade ≥III. Furthermore, the proportion of all complications before readmission was higher in the frail group than in the nonfrail group. Among all readmitted patients, the frail group had a higher number of grade ≥IV patients requiring intensive care unit treatment. The frail group’s 90-day mortality was 1.3%; the difference was statistically significant (nonfrail: 0.3%, P=0.021). In the univariate and multivariate logistic regression analyses, mFI ≥0.27 (odds ratio 3.231, 95% confidence interval 1.889−5.523, P<0.001), extended pancreatectomy, body mass index ≥30 kg/m2, male sex, and malignancy were risk factors for Clavien–Dindo classification grade ≥III.

Conclusion:
mFI is a potential preoperative tool for predicting severe postoperative complications, including mortality, in patients who have undergone MIDP for left-sided tumors.
Digital solutions and the future of recovery after critical illness
Authors: Rose Louise , Cox Christopher E. 
Published: August 2023

Purpose of review
Digital technologies may address known physical and psychological barriers to recovery experienced by intensive care survivors following hospital discharge and provide solutions to care fragmentation and unmet needs. The review highlights recent examples of digital technologies designed to support recovery of survivors of critically illness.

Recent findings
Despite proliferation of digital technologies supporting health in the community, there are relatively few examples for intensive care survivors. Those we identified included web-based, app-based or telemedicine-informed recovery clinics or pathways offering services, including informational resources, care planning and navigation support, medication reconciliation, and recovery goal setting. Digital interventions supporting psychological recovery included apps providing adaptive coping skills training, mindfulness, and cognitive behavioural therapy. Efficacy data are limited, although feasibility and acceptability have been established for some. Challenges include difficulties identifying participants most likely to benefit and delivery in a format easily accessible to all, with digital exclusion a resultant risk.

Summary
Digital interventions supporting recovery comprise web or app-based recovery clinics or pathways and digital delivery of psychological interventions. Understanding of efficacy is relatively nascent, although several studies demonstrate feasibility and acceptability. Future research is needed but should be mindful of the risk of digital exclusion.
Acute heart failure in elderly patients admitted to the emergency department with acute dyspnea: a multimarker approach diagnostic study
Authors: Taheri Omide , Mauny Frédéric , Ray Patrick , Puyraveau Marc , Dubart Alain-Eric , Chenevier-Gobeaux Camille , Seronde Marie-France , Mebazaa Alexandre , Martin Bérenger , Pretalli Jean-Baptiste , Desmettre Thibaut ,   for the READ Study group
Published: August 2023

Background and importance
Diagnosing acute heart failure (AHF) is difficult in elderly patients presenting with acute dyspnea to the emergency department.

Objectives
To assess the diagnostic accuracy of NT-proBNP, high-sensitivity cardiac troponin-I (Hs-cTnI), soluble ST2 (ST2), galectin-3 and CD146 alone and in combination for diagnosing AHF in elderly patients presenting with acute dyspnea to the emergency department.

Design, settings and participants
This was a prospective, multicenter study performed between September 2016 and January 2020, including elderly patients presenting with acute dyspnea to the emergency department of 6 French hospitals.

Intervention
Measurement of NT-proBNP, hs-cTnI, ST2, galectin-3 and CD146.

Outcome measure and analysis
The reference standard, AHF, was adjudicated by two independent physicians based on ED and hospitalization clinical, biological (excluding biomarkers), radiological and echocardiography data (performed by a cardiologist in the cardiology department specifically for this study). Three exploratory methods (two using a cross-sectional approach with logistic regression and counting all biomarker combinations, and one using a sequential approach with gray zone optimizations) were applied to create comprehensive combinations of the 5 biomarkers for measuring diagnostic accuracy.

Main results
Two hundred thirty-eight patients (median age of 85 years, IQR = 8) were analyzed, and 110 (46%) were diagnosed with AHF. The accuracies of NT-proBNP, CD146, hs-cTnI, galectin-3, and ST2 were 0.72 [95% confidence interval (CI) 0.66–0.77], 0.63 (95% CI 0.57–0.69), 0.59 (95% CI 0.53–0.65), 0.55 (95% CI 0.49–0.61) and 0.51 (95% CI 0.45–0.57), respectively. Regardless of the approach used or how the 5 biomarkers were combined, the best accuracy for diagnosing AHF (0.73, 95% CI 0.67–0.78) did not differ from that of NT-proBNP alone.

Conclusion
In this study, NT-proBNP alone exhibited the best diagnostic accuracy for diagnosing AHF in elderly patients presenting with acute dyspnea to the emergency departments. None of the other biomarkers alone or combined improved the accuracy compared to NT-proBNP, which is the only biomarker to use in this setting.
Assessing study methodological quality and integrating this data into meta-analysis
Authors: Stone Jennifer C. , Habibi Nahal , Aromataris Edoardo 
Published: August 2023

Purpose of review
Results of meta-analyses are frequently used to inform clinical practice guidelines and healthcare policy. However, healthcare recommendations derived from these meta-analyses may not be trustworthy if based on the results of biased studies. This literature review aims to provide an up-to-date summary of the state-of-the-art methods for integrating methodological quality data into meta-analyses, also known as bias adjustment, as well as the strengths and weaknesses of current methods. This is essential to ensure meta-analyses are conducted in a way that produces trustworthy and valid results.

Recent findings
This literature review outlines the various bias adjustment methods and some of the advantages and limitations of each. Quality effects modelling has emerged as a promising option, with few limitations and ease of application for meta-analysts.

Summary
This paper outlines what systematic reviewers can expect from different bias adjustment methods, which will be helpful in minimizing the impact of bias on study results and increasing the validity and reliability of findings from meta-analysis.
Factors associated with CD4 cell count recovery among males and females with advanced HIV disease
Authors: Kouamou Vinie , Gundidza Patricia , Ndhlovu Chiratidzo Ellen , Makadzange Azure Tariro 
Published: August 2023

Objective:
HIV/AIDS mortality remains significantly high in Sub-Saharan Africa, mostly driven by opportunistic infections and advanced HIV disease (AHD). This study aimed to assess CD4 cell count recovery following ART initiation and factors associated with immune reconstitution.

Methods:
We conducted a prospective cohort study between 2015-2016. HIV-infected adults (≥18 years) with AHD (CD4 cell count ≤100 cells/mm3) receiving care at 20 outpatient HIV treatment facilities in Harare, Zimbabwe were enrolled. CD4 cell count recovery (CD4 cell count >200 cells/mm3) was assessed following 12-month ART initiation and factors associated with immune reconstitution were investigated using Logistic regression analysis. All statistical analyses were performed on SPSS v23.

Results:
1320 participants were enrolled and 56.4% were males. The median (IQR) age was 37 (32–43) years. Tuberculosis was seen in 16.0%. Of the 739 participants that had CD4 cell count at 12 months, CD4 cell count recovery above 200 cells/mm3 was observed in 163 (22.1%) participants. Median (IQR) CD4 cell count at 12-months increased to 127 (75–190) cells/mm3 from 31 (14 – 55) at baseline. Factors associated with CD4 cell count recovery were younger age at baseline (OR≥40/<40 = 0.58, 95%CI: 0.40–0.85, P = 0.005), sex (ORfemale/male = 2.07, 95%CI:1.44–2.99,P < 0.0001) and baseline CD4 cell count (OR≥50/<50 = 1.60, 95%CI:1.10–2.33,P = 0.013).

Conclusion:
A significant proportion (77.9%) of patients seeking care with AHD in a resource limited setting failed to recover a CD4 cell count >200 cells/mm3. Male sex, older age and low CD4 cell count at ART initiation were factors associated with poor immune reconstitution. Better differentiated care deliveries targeting this vulnerable population are critical for improving clinical outcomes and quality of life of the patients.
Introduction to the special issue: challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs
Authors: Forbes Kathryn , Basáñez Maria-Gloria , Hollingsworth T. Déirdre , Anderson Roy M. 
Published: August 2023

Twenty neglected tropical diseases (NTDs) are currently prioritised by the World Health Organization for eradication, elimination as a public health problem, elimination of transmission or control by 2030. This issue celebrates progress made since the 2012 London Declaration on NTDs and discusses challenges currently faced to achieve these goals. It comprises 14 contributions spanning NTDs tackled by intensified disease management to those addressed by preventive chemotherapy. Although COVID-19 negatively affected NTD programmes, it also served to spur new multisectoral approaches to strengthen school-based health systems. The issue highlights the needs to improve impact survey design, evaluate new diagnostics, understand the consequences of heterogeneous prevalence and human movement, the potential impact of alternative treatment strategies and the importance of zoonotic transmission.
This article is part of the theme issue ‘Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs’.
How important is the spatial movement of people in attempts to eliminate the transmission of human helminth infections by mass drug administration?
Authors: Collyer Benjamin S. , Truscott James E. , Mwandawiro Charles S. , Njenga Sammy M. , Anderson Roy M. 
Published: August 2023

Human mobility contributes to the spatial dynamics of many infectious diseases, and understanding these dynamics helps us to determine the most effective ways to intervene and plan surveillance. In this paper, we describe a novel transmission model for the spatial dynamics of hookworm, a parasitic worm which is a common infection across sub-Saharan Africa, East Asia and the Pacific islands. We fit our model, with and without mobility, to data obtained from a sub-county in Kenya, and validate the model's predictions against the decline in prevalence observed over the course of a clustered randomized control trial evaluating methods of administering mass chemotherapy. We find that our model which incorporates human mobility is able to reproduce the observed patterns in decline of prevalence during the TUMIKIA trial, and additionally, that the widespread bounce-back of infection may be possible over many years, depending on the rates of people movement between villages. The results have important implications for the design of mass chemotherapy programmes for the elimination of human helminth transmission.
This article is part of the theme issue ‘Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs’.
Reproducibility matters: intra- and inter-sample variation of the point-of-care circulating cathodic antigen test in two
Schistosoma mansoni
endemic areas in Uganda
Authors: Kabbas-Piñango Elías , Arinaitwe Moses , van Dam Govert J. , Moses Adriko , Namukuta Annet , Nankasi Andrina Barungi , Mwima Nicholas Khayinja , Besigye Fred , Prada Joaquin M. , Lamberton Poppy H. L. 
Published: August 2023

Over 240 million people are infected with schistosomiasis. Detecting
Schistosoma mansoni
eggs in stool using Kato–Katz thick smears (Kato-Katzs) is highly specific but lacks sensitivity. The urine-based point-of-care circulating cathodic antigen test (POC-CCA) has higher sensitivity, but issues include specificity, discrepancy between batches and interpretation of trace results. A semi-quantitative G-score and latent class analyses making no assumptions about trace readings have helped address some of these issues. However, intra-sample and inter-sample variation remains unknown for POC-CCAs. We collected 3 days of stool and urine from 349 and 621 participants, from high- and moderate-endemicity areas, respectively. We performed duplicate Kato-Katzs and one POC-CCA per sample. In the high-endemicity community, we also performed three POC-CCA technical replicates on one urine sample per participant. Latent class analysis was performed to estimate the relative contribution of intra- (test technical reproducibility) and inter-sample (day-to-day) variation on sensitivity and specificity. Within-sample variation for Kato-Katzs was higher than between-sample, with the opposite true for POC-CCAs. A POC-CCA G3 threshold most accurately assesses individual infections. However, to reach the WHO target product profile of the required 95% specificity for prevalence and monitoring and evaluation, a threshold of G4 is needed, but at the cost of reducing sensitivity.

This article is part of the theme issue ‘Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs’.
Modernizing the design and analysis of prevalence surveys for neglected tropical diseases
Authors: Diggle Peter J , Fronterre Claudio , Gass Katherine , Hundley Lee , Niles-Robin Reza , Sampson Annastacia , Morice Ana , Scholte Ronaldo Carvalho 
Published: August 2023

Current WHO guidelines set prevalence thresholds below which a neglected tropical disease can be considered to have been eliminated as a public health problem, and specify how surveys to assess whether elimination has been achieved should be designed and analysed, based on classical survey sampling methods. In this paper, we describe an alternative approach based on geospatial statistical modelling. We first show the gains in efficiency that can be obtained by exploiting any spatial correlation in the underlying prevalence. We then suggest that the current guidelines' implicit use of a significance testing argument is not appropriate; instead, we argue for a predictive inferential framework, leading to design criteria based on controlling the rates at which areas whose true prevalence lies above and below the elimination threshold are incorrectly classified. We describe how this approach naturally accommodates context-specific information in the form of georeferenced covariates that have been shown to be predictive of disease prevalence. Finally, we give a progress report of an ongoing collaboration with the Guyana Ministry of Health Neglected Tropical Disease programme on the design of an IDA (ivermectin, diethylcarbamazine and albendazole) Impact Survey of lymphatic filariasis to be conducted in Guyana in early 2023.
This article is part of the theme issue ‘Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs’.
From serological surveys to disease burden: a modelling pipeline for Chagas disease
Authors: Ledien Julia , Cucunubá Zulma M. , Parra-Henao Gabriel , Rodríguez-Monguí Eliana , Dobson Andrew P. , Adamo Susana B. , Castellanos Luis Gerardo , Basáñez María-Gloria , Nouvellet Pierre 
Published: August 2023

In 2012, the World Health Organization (WHO) set the elimination of Chagas disease intradomiciliary vectorial transmission as a goal by 2020. After a decade, some progress has been made, but the new 2021–2030 WHO roadmap has set even more ambitious targets. Innovative and robust modelling methods are required to monitor progress towards these goals. We present a modelling pipeline using local seroprevalence data to obtain national disease burden estimates by disease stage. Firstly, local seroprevalence information is used to estimate spatio-temporal trends in the Force-of-Infection (FoI). FoI estimates are then used to predict such trends across larger and fine-scale geographical areas. Finally, predicted FoI values are used to estimate disease burden based on a disease progression model. Using Colombia as a case study, we estimated that the number of infected people would reach 506 000 (95% credible interval (CrI) = 395 000–648 000) in 2020 with a 1.0% (95%CrI = 0.8–1.3%) prevalence in the general population and 2400 (95%CrI = 1900–3400) deaths (approx. 0.5% of those infected). The interplay between a decrease in infection exposure (FoI and relative proportion of acute cases) was overcompensated by a large increase in population size and gradual population ageing, leading to an increase in the absolute number of Chagas disease cases over time.
This article is part of the theme issue ‘Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs’.
A modelling analysis of a new multi-stage pathway for classifying achievement of public health milestones for leprosy
Authors: Davis Emma L. , Crump Ron E. , Medley Graham F. , Solomon Anthony W. , Pemmaraju Venkata Ranganadha Rao , Hollingsworth T. Déirdre 
Published: August 2023

Several countries have come close to eliminating leprosy, but leprosy cases continue to be detected at low levels. Due to the long, highly variable delay from infection to detection, the relationship between observed cases and transmission is uncertain. The World Health Organization's new technical guidance provides a path for countries to reach elimination. We use a simple probabilistic model to simulate the stochastic dynamics of detected cases as transmission declines, and evaluate progress through the new public health milestones. In simulations where transmission is halted, 5 years of zero incidence in autochthonous children, combined with 3 years of zero incidence in all ages is a flawed indicator that transmission has halted (54% correctly classified). A further 10 years of only occasional sporadic cases is associated with a high probability of having interrupted transmission (99%). If, however, transmission continues at extremely low levels, it is possible that cases could be misidentified as historic cases from the tail of the incubation period distribution, although misleadingly achieving all three milestones is unlikely (less than 1% probability across a 15-year period of ongoing low-level transmission). These results demonstrate the feasibility and challenges of a phased progression of milestones towards interruption of transmission, allowing assessment of programme status.
This article is part of the theme issue ‘Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs’.
A Computational Model of Hippocampus: A Unified Theory About Engram and Sharp-Ware Ripples
Authors: Zishuo ZHENG 
Published: August 2023

AbstractThe hippocampus is key to memory encoding, consolidation, and retrieval. Previous work shows that neurons in the hippocampus fire in sequence to encode spatial information. The same group of cells will replay in memory consolidation, coupled with ripples, spindle, and slow waves. As for episodic memory, engram cells have been proposed to explain the encoding and transformation of episodic memory. Another universe theory about memory is the cognitive map theory. Here I use cognitive map theory as the bridge to overcome the gap between spatial and episodic memory. I believe spatial memory is a highly compressed case of episodic memory. In addition, I propose the hypothesis that engram can trigger sharp-wave ripples. I use a spike neural network-based computational model to verify this hypothesis. In conclusion, I believe engram cells and sharp-wave ripples are two different phenomena under a unified memory system.
Local CpG-Stat3siRNA treatment improves antitumor effects of immune checkpoint inhibitors
Authors: Zhang Chunyan , Huang Rui , Ren Lyuzhi , Song JiEun , Kortylewski Marcin , Swiderski Piotr , Forman Stephen , Yu Hua 
Published: August 2023

ABSTRACTImmune checkpoint blockade (ICB) therapy has significantly benefited patients with several types of solid tumors and some lymphomas. However, many of the treated patients do not have durable clinical response. It has been demonstrated that rescuing exhausted CD8+T cells is required for ICB-mediated antitumor effects. We recently developed an immunostimulatory strategy based on silencing STAT3 while stimulating immune responses by CpG, ligand for Toll-like receptor 9 (TLR9). The CpG-small interfering RNA (siRNA) conjugates efficiently enter immune cells, silencing STAT3 and activating innate immunity to enhance T-cell mediated antitumor immune responses. In the present study, we demonstrate that blocking STAT3 through locally delivered CpG-Stat3siRNA enhances the efficacies of the systemic PD-1 and CTLA4 blockade against mouse A20 B cell lymphoma. In addition, locally delivered CpG-Stat3siRNA combined with systemic administration of PD-1 antibody significantly augmented both local and systemic antitumor effects against mouse B16 melanoma tumors, with enhanced tumor-associated T cell activation. Overall, our studies in both B cell lymphoma and melanoma mouse models demonstrate the potential of combinatory immunotherapy with CpG-Stat3siRNA and checkpoint inhibitors as a therapeutic strategy for B cell lymphoma and melanoma.