bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mesenchymal Stromal Cell Secretome Is Affected by Tissue Source and Donor Age
Authors: Turlo Agnieszka J , Hammond Dean E , Ramsbottom Kerry A , Soul Jamie , Gillen Alexandra , McDonald Kieran , Peffers Mandy J 
Published: August 2023

Abstract
Variation in mesenchymal stromal cell (MSC) function depending on their origin is problematic, as it may confound clinical outcomes of MSC therapy. Current evidence suggests that the therapeutic benefits of MSCs are attributed to secretion of biologically active factors (secretome). However, the effect of donor characteristics on the MSC secretome remains largely unknown. Here, we examined the influence of donor age, sex, and tissue source, on the protein profile of the equine MSC secretome. We used dynamic metabolic labeling with stable isotopes combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify secreted proteins in MSC conditioned media (CM). Seventy proteins were classified as classically secreted based on the rate of label incorporation into newly synthesized proteins released into the extracellular space. Next, we analyzed CM of bone marrow- (n = 14) and adipose-derived MSCs (n = 16) with label-free LC-MS/MS. Clustering analysis of 314 proteins detected across all samples identified tissue source as the main factor driving variability in MSC CM proteomes. Linear modelling applied to the subset of 70 secreted proteins identified tissue-related difference in the abundance of 23 proteins. There was an age-related decrease in the abundance of CTHRC1 and LOX, further validated with orthogonal techniques. Due to the lack of flow cytometry characterization of MSC surface markers, the analysis could not account for the potential effect of cell population heterogeneity. This study provides evidence that tissue source and donor age contribute to differences in the protein composition of MSC secretomes which may influence the effects of MSC therapy.
Prevalence of Stenocarpella maydis and Stenocarpella macrospora Causing Diplodia Ear Rot in Kentucky
Authors: Anderson Nolan R. , Wise Kiersten A. 
Published: August 2023

Kentucky corn ( Zea mays L.) fields were surveyed in 2019 and 2020 for the presence of Diplodia ear rot (DER) to document the prevalence and distribution of the disease and determine the frequency of DER causal agents Stenocarpella maydis (Berk.) Sutton and Stenocarpella macrospora (Earle) Sutton. In 2019, 92 fields were surveyed, and 125 of 4,600 inspected ears were confirmed to be infected by either causal agent. In 2020, 87 fields were surveyed, and 45 of 4,350 ears examined were confirmed to be infected by either causal agent. Fungi were isolated from corn ears with suspected signs and symptoms of DER, and the causal species was identified based on conidia morphology. S. macrospora was identified in 33.8% of inspected ears in 2019 and 36.9% in 2020, and S. maydis was confirmed in 66.2% of inspected ears in 2019 and 63.1% in 2020. In 2019, ears infected with S. macrospora had greater disease severity than those infected with S. maydis ( P = 0.0245). The incidence of DER was greater in fields with a previous crop rotation of double crop wheat/soybean ( P = 0.0113); however, DER severity was not affected by previous crop rotation ( P = 0.3454). The results from this study emphasize the importance of including both Stenocarpella species in future research and discussions on DER.
Implementation of Specialty Tobacco Use Disorder Services in a Community Health Setting: Support for Enhanced Prescription Practices
Authors: Meredith Lindsay R. , Hurley Brian , Friedman Theodore C. , Lee Martin L. , Rodriguez Luz , Lopez Briana , Mtume Norma , Dixon Tasha , Belani Hrishikesh K. , Hsieh Susan , Ray Lara A. 
Published: August 2023

ObjectivesAlthough public efforts to reduce tobacco use have been successful, millions of US adults currently smoke tobacco. Reducing the public health burden of tobacco use disorder (TUD) and eliminating disparities experienced by underresourced communities requires increased accessibility to services. The goal of this study was to assess whether prescriptions for evidence-based medications for tobacco treatment showed steeper growth rates among community health clinics providing specialty TUD services as compared with treatment as usual.MethodsClinic-wide data on prescriptions for smoking cessation pharmacotherapy at 18 primary care or mental health community clinics operated by Los Angeles County were retrieved for 4 years of an ongoing implementation trial. Specialty services included behavioral counseling and medications for tobacco treatment. Descriptive statistics characterized prescriptions rates across clinics and time. Analyses compared the slopes of the changes between intervention groups across time for primary care and mental health sites.ResultsWithin primary care clinics, the most commonly prescribed smoking cessation medications were nicotine patches, nicotine gum, and varenicline. Throughout the trial, all clinics displayed increased rates of prescribing smoking cessation medications. Analytic results supported overall steeper increases in prescription rates for these medications among clinics randomized to specialty services versus treatment as usual within primary care (P= 0.020) and mental health sites (P= 0.004).ConclusionsThis work provides support for the effectiveness of community-based implementation interventions that promote prescribing smoking cessation medications with the potential to reduce health disparities among communities at greater risk for TUD and its consequences.
High Astigmatism Secondary to Peripheral Ectasia Recurrence in Postpenetrating Keratoplasty Eyes Managed With Miniscleral Contact Lenses
Authors: Law Elizabeth , Moledina Malik , Sexton Ian , Myerscough James 
Published: August 2023

Objectives:
After penetrating keratoplasty (PK) for keratoconus, vision can be impaired by high-degree astigmatism, particularly in those patients with recurrent peripheral ectasia. Scleral contact lenses (CLs) have long been used in the management of keratoconus both in treatment-naive corneas and those postcorneal transplants. We report the use of miniscleral CLs and their related visual and clinical outcomes in a series of patients with post-PK peripheral rim ectasia.

Methods:
In this retrospective case series, 5 patients (7 eyes) presented because of reduced visual acuity with their spectacles/CLs and/or reduced comfort with their existing rigid gas-permeable lenses. All patients in this series underwent PK more than two decades ago for keratoconus (mean 28.7 years±7.2). All patients demonstrated characteristic thinning at the graft–host junction, with anterior chamber deepening. Central corneas had remained clear in all patients inferring high visual potential. Contact lenses used were No 7 Comfort 15 miniscleral and the Onefit MED scleral with 14.5 mm and 15.6 mm diameters, respectively.

Results:
All eyes achieved a best-corrected visual acuity of 6/9 or greater. One case had difficulty with insertion and removal and has since discontinued wearing lens at this time. All others are successfully wearing the lenses regularly.

Conclusion:
Despite advances in CL design, surgical management is still required in some patients. Miniscleral CLs are effective in the refractive management of peripheral ectasia in keratoconic post-PK eyes and should be considered in such eyes before proceeding with repeat surgical intervention.
Carbapenem Appropriateness in a Rural Facility
Authors: Cole Jennifer L. 
Published: August 2023

Objective
Inappropriate carbapenem prescribing leads to increased resistance, secondary infections, serious side effects, and wasted resources. A history of penicillin allergy has been identified as a potential trigger for inappropriate carbapenem prescribing. The PEN-FAST score is a validated tool that provides a high negative predictive value for allergic reaction with low scores. The objectives of this study were to determine the proportion of imipenem/cilastatin and meropenem prescriptions deemed appropriate according to published criteria and to evaluate the proportion of penicillin allergies with a low PEN-FAST score.

Methods
A convenience sample of 100 carbapenem prescriptions (imipenem/cilastatin [n = 50] and meropenem [n = 50]) was evaluated with a retrospective chart review. Objective published criteria were used to assign a score of appropriate, suboptimal, or inappropriate. In patients with a history of penicillin allergy, a PEN-FAST score was retrospectively applied. Indications for use and risk factors for resistant infections were also recorded. Analysis was largely descriptive statistics, with a χ2 used to compare drug cohorts in R Studio.

Results
Prescribing was considered appropriate (25%), suboptimal (20%), and inappropriate (55%) in the combined cohort. Inappropriate prescribing was more common with imipenem/cilastatin (66% vs. 44%, P = 0.03). In 28 patients with a historical penicillin allergy, the PEN-FAST score was 0 (low risk for reaction) in the majority of cases (93%).

Conclusions
Inappropriate carbapenem prescribing is common at the study facility and may benefit from directed antimicrobial stewardship measures. Implementing the PEN-FAST scoring method may be beneficial in a multifaceted intervention.
Worksite Health Promotion and Work Performance
Authors: van der Put Anne C. , Mandemakers Jornt J. , de Wit John B.F. , van der Lippe Tanja 
Published: August 2023

Objective
This work aimed to study whether being aware of the existence of worksite health promotion (WHP), using it, or both are related to employees' task and contextual performance.

Methods
Multilevel cross-sectional data came from the European Sustainable Workforce Survey, with data from more than 11,000 employees in 259 organizations. Generalized structural equation modeling was used to examine two types of WHP: healthy menus and sports facilities.

Results
Awareness of healthy menus and sports facilities was positively associated with task and contextual performance. Healthy menus use was related to both higher task and contextual performance, whereas sports facilities use was only associated with contextual performance. The relation of WHP use was stronger for contextual than for task performance.

Conclusions
Organizations should ensure that employees are aware of the availability of WHP as well as stimulate employees to make use of it.
Successful recanalization of an acute occlusion of the left internal carotid artery and the left cerebral middle artery via the transbrachial approach: A case report
Authors: Xu Chao , Jin Tianyu , Wang Qinpu , Chen Danyu , Ying Jiangxian , Wang Peng 
Published: August 2023

Introduction:
This case study presents an elderly patient with an acute ischemic stroke due to occlusion of the left internal carotid artery (ICA) and the left cerebral middle artery (MCA). The study aimed to evaluate the feasibility and effectiveness of a transbrachial approach for mechanical thrombectomy (MT) in patients with tandem occlusions.

Patient concerns:
The patient presented with stroke symptoms, including severe aphasia, right-sided facial palsy, left gaze deviation and right-sided weakness. The patient had a history of uncontrolled hypertension.

Diagnosis:
Diagnostic tests, including computed tomography and angiography, confirmed the presence of occlusions in both the left ICA and the left MCA.

Interventions:
The patient received MT bridging intravenous thrombolysis. When bilateral iliac arteries were found to be occluded, a puncture via the transbrachial approach was attempted. Angiography suggested an acute occlusion of both the left ICA and the left MCA. The C1 segment was inflated with a pre-dilated balloon and the thrombus in the M1 segment was removed successfully.

Outcomes:
Successful reperfusion was achieved, and the patient had a good outcome at discharge. No access-site complications were encountered.

Conclusion:
Transbrachial approach for MT, especially in those with tandem occlusions, is feasible and could provide an alternative to the transfemoral approach. This approach may be beneficial for patients with occlusions in multiple sites or with iliac artery occlusions. Further research is needed to evaluate the long-term effectiveness of this approach.
Strategies of improving adherence to lipid-lowering therapy in patients with atherosclerotic cardiovascular disease
Authors: Karalis Dean G. 
Published: August 2023

Purpose of review
Lowering LDL-C has been shown to reduce ASCVD events, yet many ASCVD patients do not achieve their guideline-directed LDL-C goals leaving patients at increased risk of another ASCVD event. This review discusses implementation strategies to improve guideline-directed lipid management in patients with ASCVD focusing on the provider, patient, and system level.

Recent findings
At a provider level, under-prescribing of statin intensity due most often to statin intolerance, clinical inertia, insufficient monitoring of LDL-C levels, and the difficulty and cost of prescribing other lipid-lowering therapies such as the PCSK9 inhibitors leads to suboptimal cholesterol management in ASCVD patients. Patients concerns about medication side effects and lack of understanding of their ASCVD risk are causes of poor adherence to their lipid-lowering therapy as are barriers at a system level.

Summary
To improve cholesterol management in ASCVD patients will require an integrated approach targeting the provider, the patient and the system. There is a need for further education of clinicians on the importance of intensive LDL-C lowering in ASCVD patients and greater use of nonstatin LDL-C-lowering therapies for those patients on a maximally tolerated statin who have not achieved their guideline-directed LDL-C goal. This will require shared decision-making with a focus on patient education and patient–clinician communication so that the clinician's goals and aims align with that of the patient.
A new era in cystic fibrosis care: always changing and adapting
Authors: Diener Barry L. , Huertero Fredy , Stables-Carney Teresa , Hoelzer Maureen , Kier Catherine 
Published: August 2023

Purpose of reviewThis review focuses on sharing the current and changing cystic fibrosis (CF) care model. This includes changes in CF care as a chronic disease with availability of new revolutionary, highly effective therapies as well as incorporation of shared decision-making, coproduction of care, quality improvement, telemedicine, and remote patient monitoring.Recent findingsChanges in the CF management, the CF patient population, and CF care team are described as well as how CF care has adapted to these changes.SummaryCF is a chronic, multisystem disease requiring a large specialized multidisciplinary care team for effective treatment. With improvements in CF care and new treatments, people with CF are living longer and healthier lives. As new issues arise, the CF team needs to adapt. This was highlighted by the introduction of highly effective cystic fibrosis transmembrane conductance regulator modulator therapy, which targets the cellular defect in CF, the COVID-19 pandemic, which lead to the incorporation of telehealth and remote patient monitoring into the CF care model, and the partnering with people with CF and families through shared decision-making and coproduction.
Yield of Postmortem Skeletal Surveys in Infants Presenting to Emergency Care With Sudden and Unexpected Death
Authors: Henry M. Katherine , Egbe Teniola I. , White Ammie M. , Servaes Sabah , Andronikou Savvas , Scribano Philip V. , Wood Joanne N. 
Published: August 2023

Objectives
Child abuse should be considered in cases of sudden unexpected infant death (SUID). Postmortem skeletal surveys (PM-SS) are recommended to evaluate for abusive fractures in SUID. Little is known about the yield of PM-SS among infants presenting to emergency care with SUID. Our objectives were to (1) describe the presentation and care of infants with SUID at a tertiary children's hospital emergency department and (2) report PM-SS use and findings.

Methods
We performed a retrospective study of infants younger than 12 months with SUID presenting to an urban emergency department from 2007 to 2019. We describe their presentation and care, including PM-SS performance and findings, referrals to the medical examiner, and reports to child protective services (CPS). We assessed for associations between race, payer, and presentation with reports to CPS.

Results
Of 73 infants with SUID, concern for unsafe sleep was documented in 45 (61.6%) and 71 (97.3%) underwent cardiopulmonary resuscitation by a medical professional. All 73 (100%) underwent PM-SS and were referred to the medical examiner. Twelve definite fractures (11 rib, 1 classic metaphyseal lesion) and 8 possible fractures (7 rib, 1 classic metaphyseal lesion) were identified among 6 (8.2%) infants. Forty-three (58.9%) were reported to CPS. There were no associations between race, payer, age, or history of unsafe sleep and CPS reports.

Conclusions
One in 12 cases of SUID had a possible and/or definite fracture identified on plain radiography. Multicenter studies are needed to compare yield across different postmortem imaging modalities and populations.
Development, Implementation, and Provider Perception of Standardized Critical Event Debriefing in a Pediatric Emergency Department
Authors: Grither Allie , Leonard Kathryn , Whiteley Jill , Ahmad Fahd 
Published: August 2023

Objective
Hot debriefings are communications among team members occurring shortly after an event. They have been shown to improve team performance and communication. Best practice guidelines encourage hot debriefings, but these are often not routinely performed. We aim to describe the development and implementation of a multidisciplinary hot debriefing process in our pediatric emergency department (ED), and its impact on hot debriefing completion and provider perceptions.

Methods
An internal tool and protocol for hot debriefings were developed by integrating responses from a survey of those who work in the ED at our institution and previously published debriefing tools. Charge nurses and pediatric emergency medicine physicians were trained to lead hot debriefings. Surveys on the perception of hot debriefings were administered before and 6 months postimplementation.
Twelve-month baseline data were established by asking physicians who cared for patients who died in the ED or within 48 hours of admission to recall debrief completion. Debriefs were then prospectively tracked for 6 months postimplementation.

Results
Debrief completion for patient deaths in the ED or within 48 hours of admission increased from 23% (5/22) to 75% (12/16) (P < 0.001). When assessing just those deaths within the ED, this number increased from 31% (5/16) to 85% (11/13) (P < 0.001).
There were 98 responses to a baseline survey (response rate, 60.5%). Most who were surveyed felt that debriefs rarely occurred, preferred hot debriefings to cold debriefings, and felt that more hot debriefings should occur. Perceived barriers included lack of time, interest, protocol, trained facilitators, departmental support, and inability to gather the team.
There were 88 responses to a postintervention survey (response rate, 56.8%), 50 of which had participated in a debrief and were included in analysis. Those surveyed felt that debriefs occurred more often and were more often valuable. Most perceived that barriers were significantly reduced. Most respondents felt that hot debriefs helped address systems issues and improved performance.

Conclusions
Implementation of a protocol for physician or charge nurse-led hot debriefings in our pediatric ED resulted in increased completion, perceived barrier reduction, and a uniform approach to address identified issues. Pediatric EDs should consider adoption of a hot debriefing protocol given these benefits.
Impact of Latent M. tuberculosis Infection Treatment on Time to CD4/CD8 Recovery in Acute, Recent, and Chronic HIV Infection
Authors: Grinsztejn Eduarda , Cardoso Sandra Wagner , Velasque Luciane , Hoagland Brenda , dos Santos Desiree Gomes , Coutinho Carolina , Cruz Silva Simone da Costa , Nazer Sandro Coutinho , Ferreira Ana Cristina Garcia , Castilho Jessica , Grinsztejn Beatriz , Veloso Valdilea G. 
Published: August 2023

Introduction:
In people living with HIV, active and latent tuberculosis (TB) coinfections are associated with immune activation that correlate with HIV progression and mortality. We investigated the effect of initiating antiretroviral therapy (ART) during acute (AHI), recent (RHI), or chronic HIV infection (CHI) on CD4/CD8 ratio normalization and associated factors, the impact of latent TB infection treatment, and prior/concomitant TB diagnosis at the time of ART initiation.

Methods:
We included sex with men and transgender women individuals initiating ART with AHI, RHI and CHI between 2013 and 2019, from a prospective cohort in Brazil. We compared time from ART initiation to the first normal CD4/CD8 ratio (CD4/CD8 ≥1) using Kaplan–Meier curves and multivariable Cox proportional hazards models. Sociodemographic and clinical variables were explored. Variables with P-values <0.20 in univariable analyses were included in multivariable analyses.

Results:
Five hundred fifty participants were included, 11.8% classified as AHI and 6.4% as RHI, 46.7% with CHI-CD4 cell counts ≥350 cells/mm3 and 35.1% with CHI-CD4 cell counts <350 cells/mm3. Time to normalization was shortest among AHI patients, followed by RHI and CHI individuals with higher baseline CD4. In the multivariable model, AHI was associated with a six-fold increased likelihood of achieving a CD4/CD8 ratio ≥1 (hazard ratio [HR]: 6.03; 95% confidence interval [CI]: 3.70 to 9.82; P < 0.001), RHI with HR: 4.47 (95% CI: 2.57 to 7.76; P < 0.001), and CHI CD4 ≥350 cells/mm3 with HR: 1.87 (95% CI: 1.24 to 2.84; P = 0.003). Latent TB infection treatment was significantly associated with a higher likelihood of the outcome (HR: 1.79; 95% CI: 1.22 to 2.62; P = 0.003). Previous history or concomitant active TB at ART initiation was associated with a lower likelihood of the outcome (HR: 0.41; 95% CI: 0.16 to 1.02; P = 0.054).

Conclusions:
Initiating ART early during AHI may offer an opportunity to mitigate immune damage. Efforts to implement HIV diagnosis and ART initiation during AHI are critical to amplify ART benefits.