bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analytical Unreliability of 25 Hydroxy Vitamin D Measurements in Pre-Term Neonates
Authors: Miller Jessica J , Augustin Roy , Sepiashvili Lusia , Singh Ravinder J , Bro Eric , Weishuhn Karen , Kotsopoulos Kirsten , Brennan Joan , Diambomba Yenge , Higgins Victoria , Nichols Matthew , Kulasingam Vathany , Beriault Daniel R , Yip Paul M , Taher Jennifer 
Published: July 2023

Abstract

Background
Vitamin D supplementation is common practice for neonates and infants due to limited stores of vitamin D at birth. Although not commonly encountered, vitamin D toxicity can occur due to over-supplementation. However, toxic concentrations are often not included in method validation experiments, and assays often are not validated in the neonatal population.

Methods
We compared serial 25 hydroxy vitamin D [25(OH)D] measurements in pre-term neonates receiving 25(OH)D supplementation and identified 12 patients wherein concentrations of 25(OH)D were above 50 ng/mL (125 nM) that required additional investigations as the 25(OH)D results did not match the clinical picture. Available samples were compared across 4 immunoassay platforms (LIAISON XL, Roche Cobas e602, Abbott Alinity i, and Siemens Centaur XP) and LC–MS/MS.

Results
Concentrations of 25(OH)D observed on one individual immunoassay platform (LIAISON XL) fluctuated substantially between subsequent blood draws in select neonates with elevated concentrations. Serum samples from these patients showed variable agreement between LC–MS/MS and other immunoassay platforms. These fluctuations were not explained by the presence of 3-epimer-25(OH)D or 24,25(OH)2D.

Conclusions
Although we were unable to identify a cause for the variable elevated results, our findings suggest that neonatal 25(OH)D measurements alone should not be used for assessment of nutritional monitoring, and that clinical correlation and other laboratory parameters including ionized calcium should be considered.
Pharmacist’s knowledge about the safe use of TCS in atopic dermatitis: a pre–post-survey study evaluating the impact of TCS reading module
Authors: Chiew Ping Tan , Ariffin Ahmad Kamal , Jyh Jong Tang , Siddiqui Sania , Zainal Hadzliana 
Published: July 2023

Abstract

Objective
The aim of this study was to assess pharmacists’ knowledge about the safe use of topical corticosteroids (TCS) in the treatment of atopic dermatitis (AD) and to determine whether their knowledge and beliefs can be modified after reading the designed module on TCS use in AD.

Methods
A multicentre cross-sectional survey study was conducted among pharmacists working in the healthcare facilities of Malaysia between February 2018 and April 2019. A total of 310 pharmacists were participated and requested to complete the questionnaire before (pre-test) and 1 week after reading the designed TCS module (post-test).

Results
Pharmacist’s post-module score [median = 8 (interquartile range {IQR} 5–11)] was significantly higher than their pre-module score [median = 5 (IQR1–10; P &lt; 0.001)]. After reading the TCS module, there was a significant increase in correct responses observed to the dispensing activities, application recommendations and side effects associated with the inappropriate use of TCS (P &lt; 0.001). Pharmacists were found highly confident in the use of TCS after reading the designed module with a mean score of 8.0 (95% confidence interval 7.87–8.13) out of 10 measured on the Likert scale.

Conclusion
TCS module has been proven effective in enhancing pharmacists’ knowledge about the safe use of TCS in the treatment of AD.
Essential role of PLD2 in hypoxia-induced stemness and therapy resistance in ovarian tumors
Authors: Muñoz-Galván Sandra , Verdugo-Sivianes Eva M. , Santos-Pereira José M. , Estevez-García Purificación , Carnero Amancio 
Published: July 2023

SummaryHypoxia in solid tumors is a source of chemoresistance that determines poor patient prognosis and relies on the presence of cancer stem cells (CSCs). Here we use ovarian cancer (OC) as a model and a combination of 2D and 3D cell cultures, xenograft models, patient samples, transcriptional databases, iPSCs and ATAC-seq, to address the mechanisms leading to hypoxia-induced CSC generation and chemoresistance. We show that hypoxia activates the expression of the PLD2 gene encoding phospholipase D2. PLD2 overexpression leads to increased CSC-like features, similar to hypoxia, while PLD2 depletion in hypoxia partially suppresses these effects, indicating a role of PLD2 in hypoxia-induced CSC generation in OC. Finally, PLD2 overexpression provokes chemoresistance that is suppressed by combination treatment with PLD2 inhibition. Altogether, our work highlights the HIF-1D-PLD2 axis in hypoxia-induced CSC generation and chemoresistance in OC and proposes an alternative treatment for patients with high PLD2 expression.Statement of SignificanceHypoxia in solid tumors is a major source of chemoresistance and cancer stem cells. We show that hypoxia-induced stemness is mediated by phospholipase D2 in ovarian tumors, generating therapy resistance that is overcome by phospholipase D inhibition. Therefore, we propose an alternative treatment for patients with highPLD2expression.
The impact of physical environment on health-care workers’ well-being in Chinese hospitals during COVID-19 pandemic
Authors: Li Huan , Mahyuddin Norhayati 
Published: July 2023

Purpose
Using a quantitative research method, health-care workers’ (HWs) well-being was taken as the dependent variable while the two independent variables were physical quality and service environment. This study aims to focus on the well-being of HWs in their physical environment.

Design/methodology/approach
This study used a hybrid method that is a combination of literature review and questionnaire survey. This study used quantitative research design which is a systematic study of phenomenon by collecting quantifiable data and performing statistical, mathematical or computational techniques. This study is conducted among HWs, with doctors and nurses at four Chinese government hospitals in the southern city of Changzhou (near Shanghai) as participants.

Findings
A total of 222 responses were obtained from a random sample of HWs from four hospitals in Changzhou City, Jiangsu Province. Three-fifth of the participants (n = 133, 60%) are satisfied with hospital equipment and half (n = 111.50%) of them are satisfied with the modern technology in place. About one-third (n = 67, 30%) are satisfied with ventilation and only one-fifth (n = 44, 20%) are satisfied with hygiene. Most HWs think it was necessary to provide tests for frontline workers.

Originality/value
In the wake of COVID-19 in 2020, HWs are working long hours every day facing high risk of infection and stress. This research investigates the satisfaction level and the difficulties experienced by HWs based on the current physical environment setting during COVID-19 pandemic.
Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation
Authors: Liao Ting‐Wei Ernie , Li Cheng‐Hung , Lin Yenn‐Jiang , Chang Shih‐Lin , Hu Yu‐Feng , Chung Fa‐Po , Chao Tze‐Fan , Liao Jo‐Nan , Yang Hui‐Wen , Lo Men‐Tzung , Chen Shih‐Ann , Lo Li‐Wei 
Published: July 2023

AbstractBackgroundPulmonary vein isolation (PVI) is a cornerstone therapy for paroxysmal atrial fibrillation (PAF). The variations in nonlinear heart rate variability (HRV) between patients with and without recurrences remain unclear. We aimed to characterize the nonlinear HRV before and after PVI in patients with and without recurrence.MethodsTwenty‐five drug‐refractory PAF patients (56.0 ± 9.1 years old, 20 males) who received PVI were enrolled. Holter electrocardiography were performed before, 1–3, and 6–12 months after PVI. After 8.2 ± 2.5 months of follow‐ups after PVI, patients were divided into two groups: the recurrence (n = 8) and non‐recurrence (n = 17) groups. Linear and nonlinear HRV variables were analyzed, including the Poincaré Plot analysis and the Detrended Fluctuation Analysis (DFA).ResultsThe non‐recurrence group, but not the recurrence group, had decreased high‐frequency component (HF), the root mean square of successive RR interval differences (RMSSD), and the Poincaré Plot index SD1 1–3 months after PVI and increased DFAslope2 6–12 months after PVI. The non‐recurrence group's LF/HF ratio and DFAslope1 decreased significantly 1–3 and 6–12 months after PVI, respectively, whereas there was no significant change in the recurrence group after PVI.ConclusionsSignificantly reduced vagal tone 1–3 months after PVI, increased long‐term fractal complexity 6–12 months after PVI, and decreased sympathetic tone as well as short‐term fractal complexity 1–3 and 6–12 months after PVI led to a better AF‐free survival after PVI. These findings suggest that neuromodulation and heart rate dynamics play crucial roles in AF recurrence following PVI.
Portal vein pressure and flow modulation in pediatric liver transplantation
Authors: Sakamoto Seisuke , Shimizu Seiichi , Uchida Hajime , Fukuda Akinari , Kasahara Mureo 
Published: July 2023

AbstractLiver transplantation (LT) has been indicated for smaller and more clinically severe patients in recent years. Small biliary atresia (BA) patients often show portal hypoplasia and sclerotic portal vein (PV), which may make PV reconstruction more difficult during the operation. Among PV complications, intraoperative PV thrombosis can be considered a disaster, and it is important to prevent this catastrophic event by the precise assessment of the PV structure and PVF using radiological imaging before and during LT. However, there are no objective parameters to indicate whether sufficient PVF can be obtained. PV pressure (PVP) and PV flow (PVF) have mainly been studied in adult living donor LT, for the purpose of preventing small‐for‐size syndrome, and PVP has been considered an objective parameter of graft inflow modulation (GIM). In the setting of pediatric LT, GIM is mainly performed to prevent hypoperfusion, and it must be performed before graft implantation. GIM to maximize the PVF of pediatric patients with potentially low PVF in LT consists of the interruption of collateral vessels, the assessment of the usability of the native PV, and technical modifications in PV reconstruction. Reliable objective parameters that represent sufficient PVF before graft implantation are desired. Our recent study proposed that a PVP of ≥25 mmHg before graft implantation can be considered an objective parameter to obtain sufficient PVF (cutoff value: 50 mL/min/100 g of graft weight). Further investigation is needed to determine the best strategy for successful PV reconstruction in pediatric LT.
Trace Elements in Sediment and Urban Water Samples: an Assessment of Metal Pollution
Authors: De Almeida Jéssika Aparecida Santos , Quinaia Sueli Pércio , Nunes Chalder Nogueira , Jansen Aline Bortolanza , De Oliveira Izabelly Izabelly Karol Poncio 
Published: July 2023

In this study, trace elements (Cd, Cr, Cu, Pb and Zn) concentrations were determined by flame atomic absorption spectrometry (FAAS) in environmental compartments (water and superficial sediments) near places of vehicle use and maintenance, aiming to investigate if in these places the trace elements had high concentrations. The content of trace elements found on the samples was compared to the maximum values recommended by resolutions of CONAMA (Conselho Nacional do Meio Ambiente) n. 357 from 2005 for water and n. 454 from 2012 for sediments. Points 11 and 13 were the most critical, with concentrations higher than the recommended for the elements Cu and Pb, either for water or sediment samples. Geoaccumulation index (Igeo) for Cd and Cr in the sediment samples indicated high to extreme contamination in points 5 and 13, while the other elements indicated moderated contamination.
Stats on the desats: alarm fatigue and the implications for patient safety
Authors: Anderson Hannah R , Borgen Alex C , Christnacht Rebecca , Ng Jenny , Weller Joel G , Davison Halley N , Noseworthy Peter A , Olson Rachel , O'Laughlin Danielle , Disrud Levi , Kashou Anthony H 
Published: July 2023

BackgroundPhysiological monitoring systems, like Masimo, used during inpatient hospitalisation, offer a non-invasive approach to capture critical vital signs data. These systems trigger alarms when measurements deviate from preset parameters. However, often non-urgent or potentially false alarms contribute to ‘alarm fatigue,’ a form of sensory overload that can have adverse effects on both patients and healthcare staff. The Joint Commission, in 2021, announced a target to mitigate alarm fatigue-related fatalities through improved alarm management. Yet, no established guidelines are presently available. This study aims to address alarm fatigue at the Mayo Clinic to safeguard patient safety, curb staff burnout and improve the sensitivity of oxygen saturation monitoring to promptly detect emergencies.MethodsA quality improvement project was conducted to combat minimise the false alarm burden, with data collected 2 months prior to intervention commencement. The project’s goal was to decrease the total alarm value by 20% from 55%–85% to 35%–75% within 2 months, leveraging quality improvement methodologies.InterventionsFebruary to April 2021, we implemented a two-pronged intervention: (1) instituting a protocol to evaluate patients’ continuous monitoring needs and discontinuing it when appropriate, and (2) introducing educational signage for patients and Mayo Clinic staff on monitoring best practices.ResultsBaseline averages of red alarms (158.6), manual snoozes (37.8) and self-resolves (120.7); the first postintervention phase showed reductions in red alarms (125.5), manual snoozes (17.8) and self-resolves (107.8). Second postintervention phase recorded 138 red alarms, 13 manual snoozes and 125 self-resolves. Baseline comparison demonstrated an average of 16.92% reduction of alarms among both interventions (p value: 0.25).ConclusionSimple interventions like education and communication techniques proved instrumental in lessening the alarm burden for patients and staff. The findings underscore the practical use and efficacy of these methods in any healthcare setting, thus contributing to mitigating the prevalent issue of alarm fatigue.
Randomised study of bailout intracranial angioplasty following thrombectomy for acute large vessel occlusion (ANGEL-REBOOT): protocol of a multicentre randomised controlled trial
Authors: Gao Feng , Tong Xu , Jia Baixue , Yang Ming , Pan Yuesong , Ren Zeguang , Burgin William Scott , Liu Liping , Zhao Xingquan , Wang Yilong , Wang Yongjun , Miao Zhongrong 
Published: July 2023

RationaleUnsuccessful thrombectomy of acute large vessel occlusions (LVOs) has been associated with unfavourable outcomes. Multiple randomised controlled trials (RCTs) have reported a failure rate of 12%–41% for thrombectomy procedures. Various factors contribute to failed thrombectomy, including technical difficulties in accessing the occlusion, unsuccessful thrombus retrieval, thrombotic reocclusion and pre-existing intracranial atherosclerotic stenosis. Although some studies have explored balloon dilation or permanent stenting as rescue intracranial angioplasty for failed thrombectomy in individual cases, there is currently no evidence from RCTs on this specific topic.AimTo evaluate the potential superiority of bailout angioplasty over standard treatment in cases of unsuccessful recanalisation (eTICI 0 to 2a) or residual severe stenosis (>70%) after thrombectomy in acute LVO patients within 24 hours of stroke onset.DesignThis study is a multicentre, prospective, randomised, controlled clinical trial designed by investigators. It compares bailout angioplasty with standard therapy and follows an open-label treatment approach while maintaining a blinded outcome assessment (PROBE design). Our objective is to allocate 348 patients in a 1:1 ratio to either receive bailout angioplasty as an intervention or standard therapy as a control, following unsuccessful thrombectomy.OutcomeThe main measure of interest is the modified Rankin Scale (mRS) Score, which will be assessed in a blinded manner at 90 (±14) days following randomisation. The primary effect size will be determined using ordered logistic regression to calculate the common OR, representing the shift on the six-category mRS Scale at the 90-day mark. Additionally, the safety outcomes will be evaluated, including symptomatic intracranial haemorrhage within 18–36 hours, severe procedure-related complications and mortality within 90 (±14) days, among others.DiscussionThe ANGEL-REBOOT study aims to generate substantial evidence regarding the efficacy and safety of bailout intracranial angioplasty as a treatment option for patients with LVO who have experienced unsuccessful thrombectomy.Trial registration numberNCT05122286.
Covariant formalism and Noether symmetries on scalar-field cosmologies
Authors: Ribas M. O. , Bonato H. O. , Devecchi F. P. , Constantinidis C. P. 
Published: July 2023

In this work, we investigate a cosmological model in the context of the covariant formalism proposed by Canuto et al. where the notion of atomic and gravitational units is invoked. We consider a minimally coupled scalar field as gravitational source, including a self-interacting potential. It is possible to determine the symmetries associated to the correspondent field theory using the Noether procedure, through the Lie derivative construction. This permits to determine the scale function [Formula: see text], present in the covariant formalism, that maps the physics between descriptions in atomic and gravitational units. In gravitational units it is verified that the Klein–Gordon field behaves as a dark constituent. On the other hand, in atomic units what emerges is an initially accelerated universe, with a later incursion into a decelerated one, mirroring the usual matter/radiation age.
A Single-Cell Taxonomy Predicts Inflammatory Niche Remodeling to Drive Tissue Failure and Outcome in Human AML
Authors: Chen Lanpeng , Pronk Eline , van Dijk Claire , Bian Yujie , Feyen Jacqueline , van Tienhoven Tim , Yildirim Meltem , Pisterzi Paola , de Jong Madelon M.E. , Bastidas Alejandro , Hoogenboezem Remco M. , Wevers Chiel , Bindels Eric M. , Löwenberg Bob , Cupedo Tom , Sanders Mathijs A. , Raaijmakers Marc H.G.P. 
Published: July 2023

Abstract

Cancer initiation is orchestrated by an interplay between tumor-initiating cells and their stromal/immune environment. Here, by adapted single-cell RNA sequencing, we decipher the predicted signaling between tissue-resident hematopoietic stem/progenitor cells (HSPC) and their neoplastic counterparts with their native niches in the human bone marrow. LEPR+ stromal cells are identified as central regulators of hematopoiesis through predicted interactions with all cells in the marrow. Inflammatory niche remodeling and the resulting deprivation of critical HSPC regulatory factors are predicted to repress high-output hematopoietic stem cell subsets in NPM1-mutated acute myeloid leukemia (AML), with relative resistance of clonal cells. Stromal gene signatures reflective of niche remodeling are associated with reduced relapse rates and favorable outcomes after chemotherapy across all genetic risk categories. Elucidation of the intercellular signaling defining human AML, thus, predicts that inflammatory remodeling of stem cell niches drives tissue repression and clonal selection but may pose a vulnerability for relapse-initiating cells in the context of chemotherapeutic treatment.

Significance:
Tumor-promoting inflammation is considered an enabling characteristic of tumorigenesis, but mechanisms remain incompletely understood. By deciphering the predicted signaling between tissue-resident stem cells and their neoplastic counterparts with their environment, we identify inflammatory remodeling of stromal niches as a determinant of normal tissue repression and clinical outcomes in human AML.
See related commentary by Lisi-Vega and Méndez-Ferrer, p. 349.
This article is featured in Selected Articles from This Issue, p. 337
Prevalence, risk factors and outcomes of cardiac disease in cystic fibrosis: a multinational retrospective cohort study
Authors: Frost Freddy , Nazareth Dilip , Fauchier Laurent , Wat Dennis , Shelley James , Austin Philip , Walshaw Martin J. , Lip Gregory Y.H. 
Published: July 2023

BackgroundAlthough people living with cystic fibrosis (PwCF) often have some risk factors for cardiovascular disease, including diabetes and chronic inflammation, little is known about the long-term cardiac risk in this condition. We aimed to determine the characteristics, rates and outcomes for cardiac disease in CF.MethodsWe looked at rates and outcomes for cardiac disease in 5649 adult PwCF in the UK CF Registry and 6265 adult PwCF in TriNetX (a global federated database of electronic healthcare record data). We used propensity matching to compare risk of major adverse cardiac events (MACE) (myocardial infarction, left-sided heart failure and atrial fibrillation) in PwCF against matched non-CF comparators in the general population and other inflammatory diseases.ResultsPwCF had a high prevalence of diabetes but low rates of hypertension and obesity. Some cardiac risk factors (age, diabetes and hypertension) were associated with MACE, but relationships between disease-specific risk factors (lung function and intravenous antibiotic days) were also observed. In propensity score-matched analyses, PwCF had higher risk of MACE than matched general population comparators (hazard ratio (HR) 1.65, 95% CI 1.40–1.95; p<0.001) and an equivalent or higher relative risk compared with other inflammatory conditions considered “high risk” for cardiovascular disease, including systemic lupus erythematosus (HR 0.95, 95% CI 0.82–1.09; p=0.44), rheumatoid arthritis (HR 1.21, 95% CI 1.00–1.48; p<0.001) and HIV (HR 0.93, 95% CI 0.82–1.06; p=0.29).ConclusionsPwCF are at increased risk of adverse cardiac disease events. Future work should focus on defining determinants of cardiovascular risk such that appropriate risk stratification can be employed.
Knockdown of ELF4 aggravates renal injury in ischemia/reperfusion mice through promotion of pyroptosis, inflammation, oxidative stress, and endoplasmic reticulum stress
Authors: Li Li , Wang Shunying , Wang Wenming 
Published: July 2023

Abstract
Background
Renal ischemia/reperfusion (I/R) injury is a major cause of acute kidney injury (AKI). Dysfunction of E74-like ETS transcription factor 4 (ELF4) leads to inflammation. This research intended to look into the function and mechanisms of ELF4 in I/R and oxygen–glucose deprivation/reperfusion (OGD/R) model.

Results
In I/R and OGD/R model, ELF4 expression was downregulated. ELF4 knockout aggravated I/R-induced kidney injury, oxidative stress (OS), endoplasmic reticulum stress (ERS), apoptosis, inflammation, and pyroptosis in mice. In HK-2 cells treated with OGD/R, suppression of ELF4 expression inhibited cell proliferation and promoted cell apoptosis, OS, ERS, inflammation, and pyroptosis. Moreover, ELF4 overexpression led to the opposite results.

Conclusion
ELF4 deficiency aggravated I/R induced AKI, which was involved in apoptosis, OS, ERS, inflammation, and pyroptosis. Targeting ELF4 may be a promising new therapeutic strategy for preventing inflammation after IR-AKI.