bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing catheter-associated urinary tract infections in the cardiac intensive care unit with a coordinated strategy and nursing staff empowerment
Authors: Gupta Poonam , Thomas Mincy , Mathews Leena , Zacharia Nidhu , Fayiz Ibrahim Ashraf , Garcia Ma Leni , Simbulan Cherlyn , Attia Mohamed Fatma , El Hassan Mawahib 
Published: May 2023

BackgroundCatheter-associated urinary tract infection (CAUTI) is one of the most common hospital-acquired infections. The use of urinary catheters is associated with several complications and increased mortality and morbidity. At the coronary intensive care unit (CICU) of a tertiary cardiac care facility, the CAUTI rate was 7.6/1000 catheter days in January 2017. In collaboration with the Institute for Healthcare Improvement, we implemented evidence-based practices in the form of bundles based on the value improvement methodology to eliminate CAUTIs in the CICU.MethodsThis initiative aimed to reduce the CAUTI rate using a multifaceted approach. The key interventions were empowering front-line nurses for automatic stop orders and ensuring compliance to the catheter insertion and maintenance bundles. We used a model for improvement and tested the changes using small plan–do–study–act cycles. Surveillance methods and CAUTI definitions proposed by the National Healthcare Safety Network were used to monitor the outcomes. Monthly rates of CAUTIs 24 months before the intervention were compared with those 44 months after the intervention using an independent t-test. Statistical significance was set at p<0.05.ResultsThe rate of CAUTIs dropped from 7.6 per 1000 catheter days in January 2017 to 0 from October 2021 to August 2022. The unit had achieved 280 calendar days free of CAUTI untill August 2022.ConclusionsBehavioural changes, including empowerment of nurses and adherence to all elements of the care bundle, led to significant and sustained improvement in reducing the CAUTI rate in the adult CICU.
Dapagliflozin in people with chronic kidney disease
Authors: Sylvester Rochelle D , Khong Teck K 
Published: May 2023

AbstractCommentary on:Heerspink HJL, Stefánsson BV, Correa-Rotter R,et al. Dapagliflozin in patients with chronic kidney disease.N Engl J Med2020;383:1436–46.Series Editor:Dr Teck Khong, DTB Associate Editor, Clinical Pharmacology, St George’s, University of London, UK
A narrative review of heart failure with preserved ejection fraction in breast cancer survivors
Authors: Yogeswaran Vidhushei , Wadden Elena , Szewczyk Warren , Barac Ana , Simon Michael S , Eaton Charles , Cheng Richard K , Reding Kerryn W 
Published: May 2023

Advances in breast cancer (BC) treatment have contributed to improved survival, but BC survivors experience significant short-term and long-term cardiovascular mortality and morbidity, including an elevated risk of heart failure with preserved ejection fraction (HFpEF). Most research has focused on HF with reduced ejection fraction (HFrEF) after BC; however, recent studies suggest HFpEF is the more prevalent subtype after BC and is associated with substantial health burden. The increased HFpEF risk observed in BC survivors may be explained by treatment-related toxicity and by shared risk factors that heighten risk for both BC and HFpEF. Beyond risk factors with physiological impacts that drive HFpEF risk, such as hypertension and obesity, social determinants of health (SDOH) likely contribute to HFpEF risk after BC, impacting diagnosis, management and prognosis.Increasing clinical awareness of HFpEF after BC and screening for cardiovascular (CV) risk factors, in particular hypertension, may be beneficial in this high-risk population. When BC survivors develop HFpEF, treatment focuses on initiating guideline-directed medical therapy and addressing underlying comorbidities with pharmacotherapy or behavioural intervention. HFpEF in BC survivors is understudied. Future directions should focus on improving HFpEF prevention and treatment by building a deeper understanding of HFpEF aetiology and elucidating contributing risk factors and their pathogenesis in HFpEF in BC survivors, in particular the association with different BC treatment modalities, including radiation therapy, chemotherapy, biological therapy and endocrine therapy, for example, aromatase inhibitors. In addition, characterising how SDOH intersect with these therapies is of paramount importance to develop future prevention and management strategies.
Fixed dose combination therapies in primary cardiovascular disease prevention in different groups: an individual participant meta-analysis
Authors: Dagenais Gilles R , Pais Prem , Gao Peggy , Roshandel Gholamreza , Malekzadeh Reza , Joseph Philip , Yusuf Salim 
Published: May 2023

ObjectiveTo evaluate the effects of fixed dose combination (FDC) medications on cardiovascular outcomes in different age groups in an individual participant meta-analysis of three primary prevention randomised trials.MethodsParticipants at intermediate risk (17.7% mean 10-year Framingham Cardiovascular Risk Score), randomised to FDC of two or more antihypertensives and a statin with or without aspirin, or to their respective control, were followed up for 5 years. Age groups were <60, 60–65 and ≥65 years. The primary outcome was cardiovascular death, myocardial infarction, stroke or revascularisation. Cox proportional HRs and 95% CIs were computed within each age group.ResultsThe primary outcome risk was reduced by 37% (3.3% in FDC vs 5.2% in control (HR 0.63; 95% CI 0.54 to 0.74)) in the total population of 18 162 participants with larger benefits in older groups (HR 0.58; 95% CI 0.42 to 0.78, 60 to 65 years) and (HR 0.57; 95% CI 0.47 to 0.70, ≥65 years), as were their numbers needed to treat to avoid one primary outcome: 53 and 33, respectively. The primary outcome risk was reduced in the two oldest groups with FDC with aspirin (n=8951) by 54% and 54%, and without aspirin (n=12 061) by 34% and 38%. Dizziness, the most frequent FDC adverse effects, was higher in participants aged <65 years. Aspirin was not associated with significant bleeding excess.ConclusionsIn participants with intermediate cardiovascular risk, FDCs produce larger cardiovascular benefits in older individuals, which appear greater with aspirin.Trial registration numberHOPE-3,NCT00468923; TIPS-3,NCT016464137; PolyIran,NCT01271985.
Prognostic implications of the immunohistochemical expression of perilipin 1 and adipophilin in high-grade liposarcoma
Authors: Kawaguchi Kengo , Kohashi Kenichi , Mori Taro , Yamamoto Hidetaka , Iwasaki Takeshi , Kinoshita Izumi , Susuki Yosuke , Furukawa Hiroshi , Endo Makoto , Matsumoto Yoshihiro , Nakashima Yasuharu , Oda Yoshinao 
Published: May 2023

AimsLiposarcoma is a malignant soft tissue tumour with adipocytic differentiation. Dedifferentiated liposarcoma (DDLS) and myxoid liposarcoma (MLS) are classified as high-grade liposarcomas. Lipid droplet-associated protein (also known as perilipin 1 (PLIN1)) is the predominant perilipin and has utility as a specific marker of adipogenic differentiation. Adipose differentiation-related protein (also known as adipophilin (ADRP)) is ubiquitously expressed in a range of tissues. High ADRP expression is reportedly a poor prognostic factor in several cancer types. However, no previous studies have examined the association between PLIN1 or ADRP expression and prognosis in sarcoma. This study therefore aimed to evaluate the association between PLIN1 or ADRP expression and prognosis in liposarcoma.MethodsIn total, 97 primary resection specimens (53 MLS and 44 DDLS) were examined in this study. PLIN1 and ADRP expression was evaluated by immunohistochemistry. Survival analyses were performed for MLS and DDLS.ResultsOf the 53 MLS specimens, 15 (28.3%) exhibited high PLIN1 expression. PLIN1 expression was not observed in DDLS specimens. High PLIN1 expression was significantly associated with increased disease-free survival (DFS) among patients with MLS (p=0.045). Distinct ADRP expression was observed in 13 of 53 (24.5%) MLS specimens and 5 of 44 (11.4%) DDLS specimens. High ADRP expression was associated with shorter overall survival (OS) in MLS (p=0.042) and DFS and shorter OS in DDLS (p=0.024 and p<0.001, respectively).ConclusionsPLIN1 and ADRP expression is associated with poor prognosis in high-grade liposarcoma.
Landscape of cancer biomarker testing in England following genomic services reconfiguration: insights from a nationwide pathologist survey
Authors: Taniere Phillipe , Nicholson Andrew G , Gosney John R , Montero Fernandez Maria Angeles , Bury Danielle , Moore David Allan , Verghese Eldo , Soomro Irshad , Joseph Leena , Bhatt Nidhi , Viola Patrizia , Bains Rozinder , Lanctot Adrienne G , Ryan Jacqueline 
Published: May 2023

AimsCancer diagnostics have been evolving rapidly. In England, the new National Health Service Genomic Medicine Service (GMS) provides centralised access to genomic testing via seven regional Genomic Laboratory Hubs. The PATHways survey aimed to capture pathologists’ experience with current diagnostic pathways and opportunities for optimisation to ensure equitable and timely access to biomarker testing.MethodsA nationwide survey was conducted with consultant pathologists from regional laboratories, via direct interviews based on a structured questionnaire. Descriptive analysis of responses was undertaken using quantitative and qualitative methods.ResultsFifteen regional centres completed the survey covering a median population size of 2.5 (1.9–3.6) million (each for n=12). The median estimated turnaround time (calendar days) for standard molecular markers in melanoma, breast and lung cancers ranged from 2 to 3 days by immunohistochemistry (excluding NTRKfus in breast and lung cancers, and PD-L1 in melanoma) and 6–15 days by real-time-PCR (excluding KIT for melanoma), to 17.5–24.5 days by next-generation sequencing (excludingPIK3CAfor breast cancer). Tests were mainly initiated by pathologists and oncologists. All respondents discussed the results at multidisciplinary team (MDT) meetings. The GMS roll-out was perceived to have high impact on services by 53% of respondents, citing logistical and technical issues. Enhanced education on new pathways, tissue requirements, report interpretation, providing patient information and best practice sharing was suggested for pathologists and other MDT members.ConclusionOur survey highlighted the role of regional pathology within the evolving diagnostic landscape in England. Notable recommendations included improved communication and education, active stakeholder engagement, and tackling informatics barriers.
Prognosis of immune checkpoint inhibitors-induced myocarditis: a case series
Authors: Coustal Cyrille , Vanoverschelde Juliette , Quantin Xavier , Lesage Candice , Michot Jean-Marie , Lappara Ariane , Ederhy Stephane , Assenat Eric , Faure Maxime , Issa Nahema , Lambotte Olivier , Puyade Mathieu , Dereure Olivier , Tosi Diego , Rullier Patricia , Serre Isabelle , Larcher Romaric , Klouche Kada , Chanques Gérald , Vernhet-Kovacsik Hélène , Faillie Jean-Luc , Agullo Audrey , Roubille François , Guilpain Philippe , Maria Alexandre Thibault Jacques 
Published: May 2023

BackgroundImmune checkpoint inhibitors (ICI) have transformed cancer treatment over the last decade. Alongside this therapeutic improvement, a new variety of side effects has emerged, called immune-related adverse events (irAEs), potentially affecting any organ. Among these irAEs, myocarditis is rare but life-threatening.MethodsWe conducted a multicenter cross-sectional retrospective study with the aim of better characterizing ICI-related myocarditis. Myocarditis diagnosis was based on the recent consensus statement of the International Cardio-Oncology Society.ResultsTwenty-nine patients were identified, from six different referral centers. Most patients (55%) were treated using anti-programmed-death 1, rather than ICI combination (35%) or anti-programmed-death-ligand 1 (10%). Transthoracic echocardiography was abnormal in 52% of them, and cardiac magnetic resonance showed abnormal features in 14/24 patients (58%). Eleven patients (38%) were classified as severe. Compared with other patients, they had more frequently pre-existing systemic autoimmune disease (45% vs 6%, p=0.018), higher troponin level on admission (42-fold the upper limit vs 3.55-fold, p=0.001), and exhibited anti-acetylcholine receptor autoantibodies (p=0.001). Seven patients (24%) had myocarditis-related death, and eight more patients died from cancer progression during follow-up. Twenty-eight patients received glucocorticoids, 10 underwent plasma exchanges, 8 received intravenous immunoglobulins, and 5 other immunosuppressants. ICI rechallenge was performed in six patients, with only one myocarditis relapse.DiscussionThe management of ICI-related myocarditis may be challenging and requires a multidisciplinary approach. Prognostic features are herein described and may help to allow ICI rechallenge for some patients with smoldering presentation, after an accurate evaluation of benefit–risk balance.
Genetic dissection ofHLA-DRB1*15:01and XL9 region variants in Japanese patients with systemic lupus erythematosus: primary role forHLA-DRB1*15:01
Authors: Kawasaki Aya , Kusumawati Premita Ari , Kawamura Yuka , Kondo Yuya , Kusaoi Makio , Amano Hirofumi , Kusanagi Yasuyoshi , Itoh Kenji , Fujimoto Takashi , Tamura Naoto , Hashimoto Hiroshi , Matsumoto Isao , Sumida Takayuki , Tsuchiya Naoyuki 
Published: May 2023

ObjectiveMajor histocompatibility complex strongly contributes to susceptibility to systemic lupus erythematosus (SLE). In the European populations,HLA-DRB1*03:01andDRB1*15:01are susceptibility alleles, butC4locus was reported to account for the association ofDRB1*03:01. With respect toDRB1*15:01, strong linkage disequilibrium with a variant rs2105898T in the XL9 region, located betweenDRB1andDQA1and regulates HLA-class II expression levels, was reported; however, the causative allele remains to be determined. Leveraging the genetic background of the Japanese population, whereDRB1*15:01andDRB1*15:02are commonly present and onlyDRB1*15:01is associated with SLE, this study aimed to distinguish the genetic contribution ofDRB1*15:01and XL9 variants.MethodsAmong the XL9 variants, two (rs2105898 and rs9271593) previously associated variants in the European populations and two (rs9271375 and rs9271378) which showed a trend towards association in a Japanese Genome-Wide Association Study were selected. Associations of the XL9 variants andHLA-DRB1were examined in 442 Japanese SLE patients and 779 controls. Genotyping of the XL9 variants was performed by TaqMan SNP Genotyping Assay and direct sequencing.HLA-DRB1alleles were determined by PCR-reverse sequence-specific oligonucleotide probes.ResultsAmong the XL9 variants, associations of rs2105898T and rs9271593C were replicated in the Japanese population. However, these associations became no longer significant when conditioned onDRB1*15:01. In contrast, the association ofDRB1*15:01remained significant after conditioning on the XL9 variants.ConclusionIn the Japanese population,HLA-DRB1*15:01was found to be primarily associated with SLE, and to account for the apparent association of XL9 region.
Influence of the saturation effect on the Zeeman and hfs spectra
Authors: Sobolewski Ł. M. , Kwela J. 
Published: May 2023

Abstract
The technique of laser absorption spectroscopy is widely used in the study of the atomic structure. In order to thoroughly analyze the recorded structure of complex atoms, the effect of saturation must be taken into account. In the current paper we present a method of analysis of Zeeman and hyperfine structures spectra obtained with the use of laser spectroscopy, which allows to take into account the effect of saturation.

Graphic abstract
Preclinical Evidence of an Allogeneic Dual CD20xCD22 CAR to Target a Broad Spectrum of Patients with B-cell Malignancies
Authors: Aranda-Orgilles Beatriz , Chion-Sotinel Isabelle , Skinner Jordan , Grudman Steven , Mumford Ben , Dixon Chantel , Postigo Fernandez Jorge , Erler Piril , Duchateau Phillipe , Gouble Agnes , Galetto Roman , Poirot Laurent 
Published: May 2023

Abstract
Despite the remarkable success of autologous chimeric antigen receptor (CAR) T cells, some patients relapse due to tumor antigen escape and low or uneven antigen expression, among other mechanisms. Therapeutic options after relapse are limited, emphasizing the need to optimize current approaches. In addition, there is a need to develop allogeneic “off-the-shelf” therapies from healthy donors that are readily available at the time of treatment decision and can overcome limitations of current autologous approaches. To address both challenges simultaneously, we generated a CD20xCD22 dual allogeneic CAR T cell. Herein, we demonstrate that allogeneic CD20x22 CAR T cells display robust, sustained and dose-dependent activity in vitro and in vivo, while efficiently targeting primary B-cell non–Hodgkin lymphoma (B-NHL) samples with heterogeneous levels of CD22 and CD20. Altogether, we provide preclinical proof-of-concept data for an allogeneic dual CAR T cell to overcome current mechanisms of resistance to CAR T-cell therapies in B-NHL, while providing a potential alternative to CD19 targeting.
Outcomes After Development of Ventricular Arrhythmias in Single Ventricular Heart Disease Patients With Fontan Palliation
Authors: Giacone Heather M. , Chubb Henry , Dubin Anne M. , Motonaga Kara S. , Ceresnak Scott R. , Goodyer William R. , Hanisch Debra , Trela Anthony V. , Boramanand Nicole , Lencioni Erin , Boothroyd Derek , Graber-Naidich Anna , Wright Gail , Haeffele Christiane , Hollander Seth A. , McElhinney Doff B. , Ma Michael , Hanley Frank L. , Chen Sharon 
Published: May 2023

Background:
With the advent of more intensive rhythm monitoring strategies, ventricular arrhythmias (VAs) are increasingly detected in Fontan patients. However, the prognostic implications of VA are poorly understood. We assessed the incidence of VA in Fontan patients and the implications on transplant-free survival.

Methods:
Medical records of Fontan patients seen at a single center between 2002 and 2019 were reviewed to identify post-Fontan VA (nonsustained ventricular tachycardia >4 beats or sustained >30 seconds). Patients with preFontan VA were excluded. Hemodynamically unstable VA was defined as malignant VA. The primary outcome was death and heart transplantation. Death with censoring at transplant was a secondary outcome.

Results:

Of 431 Fontan patients, transplant-free survival was 82% at 15 years post-Fontan with 64 (15%) meeting primary outcome of either death (n=16, 3.7%), at a median 4.6 (0.4–10.2) years post-Fontan, or transplant (n=48, 11%), at a median of 11.1 (5.9–16.2) years post-Fontan. Forty-eight (11%) patients were diagnosed with VA (90% nonsustained ventricular tachycardia, 10% sustained ventricular tachycardia). Malignant VA (n=9, 2.0%) was associated with younger age, worse systolic function, and valvular regurgitation. Risk for VA increased with time from Fontan, 2.4% at 10 years to 19% at 20 years. History of Stage 1 surgery with right ventricular to pulmonary artery conduit and older age at Fontan were significant risk factors for VA. VA was strongly associated with an increased risk of transplant or death (HR, 9.2 [95% CI, 4.5–18.7];
P
<0.001), with a transplant-free survival of 48% at 5-year post-VA diagnosis.

Conclusions:
Ventricular arrhythmias occurred in 11% of Fontan patients and was highly associated with transplant or death, with a transplant-free survival of <50% at 5-year post-VA diagnosis. Risk factors for VA included older age at Fontan and history of right ventricular to pulmonary artery conduit. A diagnosis of VA in Fontan patients should prompt increased clinical surveillance.
Subclinical Cardiovascular Disease in US Adults With and Without Diabetes
Authors: Fang Michael , Wang Dan , Tang Olive , McEvoy John William , Echouffo‐Tcheugui Justin B. , Christenson Robert H. , Selvin Elizabeth 
Published: May 2023

Background
We characterized the burden and prognostic value of subclinical cardiovascular disease (CVD) assessed by cardiac biomarkers among adults with and without diabetes in the general US population.

Methods and Results
We measured hs‐cTnT (high‐sensitivity cardiac troponin T) and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) in stored serum samples from the 1999 to 2004 National Health and Nutrition Examination Survey. Among US adults without a history of CVD (n=10 304), we estimated the prevalence of elevated hs‐cTnT (≥14 ng/L) and NT‐proBNP (≥125 pg/mL) in those with and without diabetes. We examined the associations between elevated hs‐cTnT and NT‐proBNP with all‐cause and CVD mortality after adjustment for demographics and traditional CVD risk factors. The crude prevalence of subclinical CVD (elevated hs‐cTnT or NT‐proBNP) was ≈2 times higher in adults with (versus without) diabetes (33.4% versus 16.1%). After age adjustment, elevated hs‐cTnT, but not elevated NT‐proBNP, was more common in those with diabetes, overall and across age, sex, race and ethnicity, and weight status. The prevalence of elevated hs‐cTnT was significantly higher in those with longer diabetes duration and worse glycemic control. In persons with diabetes, elevated hs‐cTnT and NT‐proBNP were independently associated with all‐cause mortality (adjusted hazard ratio [HR], 1.77 [95% CI, 1.33–2.34] and HR, 1.78 [95% CI, 1.26–2.51]) and CVD mortality (adjusted HR, 1.54 [95% CI, 0.83–2.85] and HR, 2.46 [95% CI, 1.31–4.60]).

Conclusions
Subclinical CVD affects ≈1 in 3 US adults with diabetes and confers substantial risk for mortality. Routine testing of cardiac biomarkers may be useful for assessing and monitoring risk in persons with diabetes.
Toward Operational Real-Time Identification of Frontal Boundaries Using Machine Learning
Authors: Justin Andrew D. , Willingham Colin , McGovern Amy , Allen John T. 
Published: May 2023

Abstract
We present and evaluate a deep learning first-guess front-identification system that identifies cold, warm, stationary, and occluded fronts. Frontal boundaries play a key role in the daily weather around the world. Human-drawn fronts provided by the National Weather Service’s Weather Prediction Center, Ocean Prediction Center, Tropical Analysis and Forecast Branch, and Honolulu Forecast Office are treated as ground-truth labels for training the deep learning models. The models are trained using ERA5 data with variables known to be important for distinguishing frontal boundaries, including temperature, equivalent potential temperature, and wind velocity and direction at multiple heights. Using a 250-km neighborhood over the contiguous U.S. domain, our best models achieve critical success index scores of 0.60 for cold fronts, 0.43 for warm fronts, 0.48 for stationary fronts, 0.45 for occluded fronts, and 0.71 using a binary classification system (front/no front), whereas scores over the full unified surface analysis domain were lower. For cold and warm fronts and binary classification, these scores significantly outperform prior baseline methods that utilize 250-km neighborhoods. These first-guess deep learning algorithms can be used by forecasters to locate frontal boundaries more effectively and expedite the frontal analysis process.

Significance Statement
Fronts are boundaries that affect the weather that people experience daily. Currently, forecasters must identify these boundaries through manual analysis. We have developed an automated machine learning method for detecting cold, warm, stationary, and occluded fronts. Our automated method provides forecasters with an additional tool to expedite the frontal analysis process.