bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic significance of pre-treatment albumin-bilirubin grade in metastatic urothelial carcinoma receiving pembrolizumab
Authors: Yamashita Shimpei , Wada Takuma , Deguchi Ryusuke , Mashima Nobuyuki , Higuchi Masatoshi , Miyai Haruka , Koike Hiroyuki , Kohjimoto Yasuo , Hara Isao 
Published: June 2023

Abstract

Background
Pre-treatment albumin-bilirubin grade is a useful biomarker for predicting prognosis in patients receiving immune checkpoint inhibitors for advanced malignancies. We evaluated the prognostic impact of pre-treatment albumin-bilirubin grade in patients receiving pembrolizumab for metastatic urothelial carcinoma.

Methods
In this multicenter retrospective study, we calculated pre-treatment albumin-bilirubin scores of 96 patients who received pembrolizumab for metastatic urothelial carcinoma between January 2018 and March 2022. Patients were classified according to albumin-bilirubin grade. Progression-free survival and cancer-specific survival were compared between the groups. To evaluate the prognostic impact of pre-treatment albumin-bilirubin grade, we also performed Cox proportional regression analyses for progression-free survival and cancer-specific survival.

Results
The median pre-treatment albumin bilirubin score was −2.52 (quartile: −2.76 to −2.10), and albumin-bilirubin grade was grade 1 in 37 patients (39%), grade 2a in 30 patients (31%), 2b in 22 patients (23%) and grade 3 in 7 patients (7%). The median progression-free survival and cancer-specific survival were 2 and 7 months, respectively. Progression-free survival and cancer-specific survival were significantly different between the albumin-bilirubin grade groups (P &lt; 0.01 and P &lt; 0.01, respectively) and prognosis became poorer as albumin-bilirubin grade increased. High albumin-bilirubin grade was shown in multivariable Cox proportional analyses to be independently associated with both poor progression-free survival and poor cancer-specific survival.

Conclusions
High pre-treatment albumin-bilirubin grade could be a significant independent predictor of poor prognosis in patients receiving pembrolizumab for advanced urothelial carcinoma.
Accurate age-grading of field-aged mosquitoes reared under ambient conditions using surface-enhanced Raman spectroscopy and artificial neural networks
Authors: Gao Zili , Harrington Laura C , Zhu Wei , Barrientos Luisa M , Alfonso-Parra Catalina , Avila Frank W , Clark John M , He Lili 
Published: June 2023

Abstract
Age-grading mosquitoes are significant because only older mosquitoes are competent to transmit pathogens to humans. However, we lack effective tools to do so, especially at the critical point where mosquitoes become a risk to humans. In this study, we demonstrated the capability of using surface-enhanced Raman spectroscopy and artificial neural networks to accurately age-grade field-aged low-generation (F2) female Aedes aegypti mosquitoes held under ambient conditions (error was 1.9 chronological days, in the range 0–22 days). When degree days were used for model calibration, the accuracy was further improved to 20.8 degree days (approximately equal to 1.4 chronological days), which indicates the impact of temperature fluctuation on prediction accuracy. This performance is a significant advancement over binary classification. The great accuracy of this method outperforms traditional age-grading methods and will facilitate effective epidemiological studies, risk assessment, vector intervention monitoring, and evaluation.
The evening crepuscular host-seeking activity ofAnophelesmosquitoes in northeast Brazil
Authors: Costa-Neta Benedita Maria , de Sousa Francisca Claudia da Silva , de Araújo Eudimara Carvalho , Viana Joany da Costa , Brito Jefferson Mesquita , Silva Francinaldo Soares 
Published: June 2023

AbstractStudies on the timing of anopheline host-seeking are important for understanding mosquito ecology, behaviors, and possible role in disease transmission. To study the evening crepuscular host-seeking activity of anophelines and the effects of moonlight, anopheline mosquitoes were collected with light traps settled in a livestock area in the Brazilian Cerrado region. Traps (Silva traps) were placed next to animal enclosures at 1.5 m asl. The research was divided in 2 experiments: the first experiment (12 nights) comprised 2 trapping periods, one from 6 PM to 7 PM and one from 7 PM to 6 AM, and the second experiment (16 evenings) divided in three 20-min intervals based on the 3 twilight phases (civil: 6–6:20 PM; nautical: 6:20–6:40 PM; and astronomical: 6:40–7 PM). A total of 2,815 anopheline mosquitoes and 9 species were found. The main species were Anopheles triannulatus s.l., An. argyritarsis, An. goeldii, and An. evanse. Host-seeking mosquitoes were more frequently active during the first hour after sunset, with a significant peak in the second 20-min interval. After that, a decrease in the number of individuals was observed from the astronomical twilight onwards. Moonlight did not affect the evening flight activity of anophelines. By using LED-based passive light traps, the evening arrival time of anophelines at blood-feeding sites was demonstrated, and it may be a key time window for malaria vector control interventions.
Survival of adult Amblyomma americanum, Amblyomma maculatum, and Dermacentor variabilis (Acari: Ixodidae) in four habitats in southeastern Virginia
Authors: Bidder Lindsey , Gaff Holly 
Published: June 2023

Abstract
Adult, unfed Amblyomma americanum (Linnaeus), Amblyomma maculatum Koch, and Dermacentor variabilis (Say) ticks were housed inside environmental containers in situ from May through August 2015. The environmental containers were placed in 4 habitats in southeastern Virginia, United States. Two of the habitats were located in low ground and were prone to flooding; the other two consisted of a drier landscape located in a more upland habitat. A Cox Regression survival analysis indicated there was a significant difference in survival among species across all field sites. There was a 50.5-times higher risk of mortality for A. maculatum compared to A. americanum, a 4.3-times higher risk of mortality for A. maculatum compared to D. variabilis, and an 11.9-times higher risk of mortality for D. variabilis compared to A. americanum. There was also significantly higher mortality in field sites prone to flooding than in drier, upland field sites. We concluded that A. americanum was not negatively affected by increased flooding or the variable environmental conditions in southeastern Virginia. Dermacentor variabilis also was successful at remaining in the environment off-host, although increased flooding reduced survival over time. Amblyomma maculatum was more susceptible to mortality during long periods of time off-host in both environments, with high mortality rates in both dry upland and low-ground, flood-prone habitats.
A synthetic lure for Anopheles gambiae (Diptera: Culicidae) based on the attractive plant Parthenium hysterophorus
Authors: Nikbakhtzadeh Mahmood R 
Published: June 2023

Abstract
Sugar is the sole diet for male mosquitoes and a complementary meal for females. Searching for natural sources of sugar is mediated by semiochemicals. Floral nectars, extra floral nectaries, damaged tissues of plants and rotten fruits are the most common sources of sugar in nature. I provide laboratory evidence of the high attraction of Parthenium hysterophorus L., a weed that grows in tropical climates, to Anopheles gambiae Giles. This study has tried to identify the chemicals which might be involved in the chemical attraction of A. gambiae to this plant. Using quantitative GC-MS analysis, α-pinene, camphene, 1-octen-3-ol, β-pinene, cis-β-ocimene, bornyl acetate, α-caryophyllene, hexadecanoic acid, and α-linolenic acid were identified as the main constituents of P. hysterophorus volatiles. Successive olfactory assays helped a better understanding of the more attractive chemicals of P. hysterophorus to A. gambiae which was the basis for testing a possible synthetic blend. Olfactory experiments proved this synthetic blend to be as attractive as Parthenium intact plants for A. gambiae. A minimal blend, consisting of only α-pinene, camphene, and cis-β-ocimene, was also produced and laboratory experiments indicated its relative attraction for A. gambiae. This blend can be tested in the attractive toxic sugar bait stations for sampling, surveillance, or control programs of mosquitoes in tropical Africa, where A. gambiae sensu stricto transfer malaria among residents.
Species Preservation in the Face of Novel Threats: Cultural, Ecological, and Operational Considerations for Preserving Tree Species in the Context of Non-Indigenous Insects and Pathogens
Authors: D’Amato Anthony W , Orwig David A , Siegert Nathan W , Mahaffey Amanda , Benedict Les , Everett Tyler , Daigle John , Johnson Logan , Catanzaro Paul , Cusack Caitlin 
Published: June 2023

Abstract
Non-Indigenous insects and pathogens (NIIP) have functionally eliminated numerous tree species of immeasurable cultural and ecological significance over the past century, with the number of species introductions and associated impacts growing each year. Foresters are often on the frontlines of these impacts, tasked with quickly adapting management plans to recover potential economic losses and maintain future silvicultural options following tree species loss. We highlight that the irreplaceable cultural and ecological values provided by many tree species argues for renewed focus on applying integrated pest management and adaptive strategies in novel ways to sustain these values for future generations. To guide these efforts, we describe a framework for adapting to NIIP centered on three interrelated components: preservation value, preservation approach, and preservation strategy. This framework and emerging species preservation efforts provide an alternative path forward to sustain threatened species and their associated values in an era of increasing change.
Study Implications: The impact of non-indigenous insects and pathogens (NIIP) is one of the greatest challenges facing the long-term stewardship of forests in North America. Species preservation efforts that apply integrated pest management and adaptive strategies to maintain species in the face of NIIP are increasingly needed in foresters’ toolboxes to address these novel threats. Identifying the preservation values (ethical responsibility, cultural integrity, ecological function, genetic conservation) tied to a species preservation effort will help guide how preservation approaches and strategies are applied at stand and landscape scales to sustain species and associated cultural and ecological values into the future.
A systematic review of the association between zinc and anxiety
Authors: Azargoonjahromi Ali 
Published: June 2023

AbstractContextThe incidence of anxiety, which stems from both intrinsic and extrinsic factors, has been increasing worldwide. Various methods by which it can be treated or prevented have been reported thus far. One of the most popular and effective treatments is supplementation therapy. Zinc, which is an essential nutrient found in various plants, animal foods, and supplements, has been shown to be a potential nutrient in anxiety reduction by acting on γ-aminobutyric acid (GABA), glutamatergic, serotonergic, neurogenesis, and immune systems. It can also influence important receptors, such as GPR39. Thus, zinc has received considerable attention with respect to its potential role as a therapeutic or detrimental factor for anxiety; yet, the available evidence needs to be analyzed systematically to reach a convergent conclusion.ObjectiveThe objective was to systematically review any potential connection between adult human anxiety and zinc intake.Data Sources and ExtractionNine original human studies, of which 2 assessed the relationship between zinc consumption and anxiety (based on a questionnaire) and 7 assessed the relationship between serum zinc levels and anxiety, were included based on specific selection criteria. Studies that had been written in English and published in peer-reviewed publications with no restrictions on the date of publication were searched in the Google Scholar and PubMed databases. This project was also reported according to the PRISMA guidelines.Data AnalysisAs per the studies analyzed in this review, there was a noticeable relationship between serum zinc levels and anxiety, which means that patients with anxiety have lower levels of zinc in their serum, as compared with healthy individuals. Furthermore, zinc consumption was inversely associated with anxiety.ConclusionThe results provide plausible evidence for the positive role of zinc in the treatment of patients afflicted with anxiety, albeit with some limitations.
Synergistic toxicity of 2,4-dichlorophenoxyacetic acid and arsenic alters biomarkers in rats
Authors: Demirel Hasan Huseyin , Zemheri-Navruz Fahriye , Kucukkurt İsmail , Arslan-Acaroz Damla , Tureyen Ali , Ince Sinan 
Published: June 2023

Abstract
2,4-dichlorophenoxyacetic acid (2,4-D) and arsenic cause severe and extensive biological toxicity in organisms. However, their interactions and toxic mechanisms in co-exposure remain to be fully elucidated. In this study, 28 four-week-old female rats were divided into four groups and exposed to 100 mg/L arsenic or/and 600 mg/L 2,4-D through drinking water for a period of 28 days. As a result, it was revealed that biochemical indicators (ALT, AST, ALP, blood urea nitrogen, and creatinine) were increased and decreased hormonal parameters (FSH, LH, PG, and E2) in arsenic and 2,4-D and arsenic combination-treated groups. Moreover, increased lipid peroxidation (malondialdehyde level) and decreased antioxidant status (superoxide dismutase and catalase activities) were found in the co-exposure groups compared with the individual-exposure groups. Meanwhile, severe DNA damage was observed in co-exposure groups. Additionally, the levels of apoptotic (Bax, Caspase-3, Caspase-8, Caspase-9, p53, and PARP) and inflammation (NFκB, Cox-2, TNF-α, and TGFβI) indexes in the co-exposure groups were markedly increased, whereas the levels of anti-apoptosis index (Bcl-2) were decreased. It was also observed that co-exposure with 2,4-D and arsenic caused more histopathological changes in tissues. Generally, these results show that co-exposure to 2,4-D and arsenic can seriously cause oxidative stress, DNA damage, apoptosis and inflammation while having toxicological risk for organisms.
Analgesic Effectiveness of Motor-sparing Nerve Blocks for Total Knee Arthroplasty: A Network Meta-analysis
Authors: Hussain Nasir , Brull Richard , Vannabouathong Chris , Robinson Christopher , Zhou Steven , D’Souza Ryan S. , Sawyer Tamara , Terkawi Abdullah Sulieman , Abdallah Faraj W. 
Published: June 2023

Background
The analgesic effectiveness of contemporary motor-sparing nerve blocks used in combination for analgesia in total knee arthroplasty is unclear. This network meta-analysis was conducted to evaluate the analgesic effectiveness of adding single-injection or continuous adductor canal block (ACB) with or without infiltration of the interspace between the popliteal artery and the capsule of the posterior knee (iPACK) to intraoperative local infiltration analgesia (LIA), compared to LIA alone, after total knee arthroplasty.

Methods
Randomized trials examining the addition of single-injection or continuous ACB with or without single-injection block at the iPACK to LIA for total knee arthroplasty were considered. The two primary outcomes were area-under-the-curve pain scores over 24 to 48 h and postoperative function at greater than 24 h. Secondary outcomes included rest pain scores at 0, 6, 12, and 24 h; opioid consumption (from 0 to 24 h and from 25 to 48 h); and incidence of nausea/vomiting. Network meta-analysis was conducted using a frequentist approach.

Results
A total of 27 studies (2,317 patients) investigating the addition of (1) single-injection ACB, (2) continuous ACB, (3) single-injection ACB and single-injection block at the iPACK, and (4) continuous ACB and single-injection block at the iPACK to LIA, as compared to LIA alone, were included. For area-under-the-curve 24- to 48-h pain, the addition of continuous ACB with single-injection block at the iPACK displayed the highest P-score probability (89%) of being most effective for pain control. The addition of continuous ACB without single-injection block at the iPACK displayed the highest P-score probability (87%) of being most effective for postoperative function.

Conclusions
The results suggest that continuous ACB, but not single-injection ACB and/or single-injection block at the iPACK, provides statistically superior analgesia when added to LIA for total knee arthroplasty compared to LIA alone. However, the magnitude of these additional analgesic benefits is clinically questionable.

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The role of gastric ultrasound in anaesthesia for emergency surgery
Authors: Godschalx Vincent , Vanhoof Marc , Soetens Filiep , Van de Putte Peter , Hadzic Admir , Van de Velde Marc , Van Herreweghe Imré 
Published: June 2023

BACKGROUND
The timing and technique of anaesthesia are challenging in patients with a history of recent food intake. The presence of gastric contents increases the risk of aspiration, potentially resulting in acute lung injury, pneumonia, or death. Delayed gastric emptying complicates the estimation of aspiration risk. Surprisingly, there are no fasting guidelines for emergency surgery. Point-of-care gastric ultrasound is a time-efficient, cost-efficient and accurate bedside tool with which to estimate residual gastric content and to guide decision-making in airway management and timing of general anaesthesia. This review summarises the prevailing concepts of ultrasound-guided gastric content assessment for emergency surgery.

METHODS
Medline and Embase databases were searched for studies using ultrasound for the evaluation of gastric content in adults scheduled for emergency surgery.

RESULTS
Five prospective observational studies representing 793 emergency surgery patients showed that the incidence of ‘full stomach’ was between 18 and 56% at the time of induction. Risk factors for a full stomach before emergency surgery were abdominal or gynaecological/obstetric surgery, high body mass index and morphine consumption. No correlation between preoperative fasting time and the presence of a full/empty stomach was found. No deaths due to aspiration were reported.

CONCLUSION
The preoperative presence of gastric content before emergency surgery is high and the estimates used for clinical management are unreliable. This review demonstrates that gastric ultrasound is a valuable tool for evaluating gastric content. A flow chart for medical decision-making using gastric ultrasound before emergency surgery was developed to assist in clinical decision-making. The validity and practical applicability should be assessed in future studies.
Effects of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass on Escitalopram Pharmacokinetics: A Cohort Study
Authors: Schoretsanitis Georgios , Strømmen Magnus , Krabseth Hege-Merete , Helland Arne , Spigset Olav 
Published: June 2023

Background:
Changes in the gastrointestinal physiology after bariatric surgery may affect the pharmacokinetics of medications. Data on the impact of different surgical techniques on the pharmacokinetics of commonly prescribed antidepressants such as escitalopram are limited.

Methods:
This case-only prospective study investigated escitalopram-treated patients who underwent bariatric surgery at hospitals in Central Norway. Escitalopram concentrations were assessed using serial blood samples obtained during a dose interval of 24 hours preoperatively and at 1, 6, and 12 months, postoperatively. The primary outcomes were changes in the area under the time–concentration curve (AUC0-24) with secondary outcomes, including full pharmacokinetic profiling. We performed repeated-measures analysis of variance for the AUC0-24 and secondary outcomes.

Results:
Escitalopram-treated obese patients who underwent sleeve gastrectomy (n = 5) and Roux-en-Y gastric bypass (n = 4) were included. Compared with preoperative baseline, dose-adjusted AUC0-24 values were within ±20% at all time points, postoperatively in the sleeve gastrectomy and oux-en-Y gastric bypass groups, with the largest changes occurring 1 month postoperatively (+14.5 and +17.2%, respectively). No statistically significant changes in any pharmacokinetic variables over time were reported; however, there was a trend toward increased maximum concentrations after surgery (P = 0.069).

Conclusions:
Our findings suggest that bariatric surgery has no systematic effect on the pharmacokinetics of escitalopram. However, because of the substantial interindividual variation, therapeutic drug monitoring can be considered to guide postoperative dose adjustments.
Program Evaluation of Parent Engagement Activities With Postoperative Cardiac Surgery Patients in the Pediatric Cardiac Intensive Care Unit
Authors: Bos Cheryl A. , VanderKooi Marie E. , Spoelstra Sandra L. 
Published: June 2023

Objective: The pediatric cardiac intensive care unit, a department dedicated to caring for cardiac patients, conducted a program evaluation to identify registered nurse (RN) and family perceptions of barriers and facilitators to parent engagement during postoperative care after surgery. Methods: A quasi-experimental presurgical/postsurgical design examined RN data using the Questionnaire of Factors That Influence Family Engagement and parent perception of engagement data via a survey. Results: Nearly half (44.6%) of RNs responded; most were younger (30–49 years old, 44.8%), female (91.4%), and White (94.8%) and held a bachelor's degree (72.4%). Those with more experience (>15 vs. <5 years) had a higher parent engagement score ( p = .021). RNs indicated that workflow (τb = .579, p = .000), unit environment (τb = .572, p = .000), nurse attitude (τb = .520, p = .000), and patient acuity (τb = .519, p = .000) correlated with overall family engagement score. The nine parents (100%) invited responded; most were mothers ( n = 7, 77.8%) and married ( n = 6, 66.7%), and 56% (n = 50) indicated this was not the child's first hospitalization. Parent overall safety score improved (presurgery/postsurgery, Z = −2.000, p = .046). RN barriers for family engagement included lack of written policy. For parents, a facilitator for engagement was safety. Both groups identified collaboration, communication, and shared decision making as a facilitator. Discussion: Results contribute to planning and implementing quality improvement initiatives. Understanding and developing a partnership between parents and RNs, nurturing mutual respect, and enhancing shared decision making improves parent engagement in care and, ultimately, a child's physical and psychological health.
Pilon fractures: Consensus and controversy
Authors: Flores Michael , Ciminero Matthew , Kottmeier Stephen A. , Botros Daniel , Zelle Boris A. , Shearer David W. 
Published: June 2023

Summary:
Pilon fractures are complex injuries that require an individualized approach to treatment to avoid complications and achieve good outcomes. Staged open reduction internal fixation remains the gold standard for most cases to achieve anatomic articular reduction while minimizing soft tissue complications and infection. Careful preoperative planning based on computed tomography dictates the surgical approach for reduction. A subset of cases may be amenable to early definitive or provisional open reduction and internal fixation based on fracture pattern. In some cases of severe articular comminution where reconstruction is not possible, primary ankle arthrodesis may be a good alternative.