bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transauricular vagus nerve stimulation in preventing post-traumatic stress disorder in emergency trauma surgery patients in China: a study protocol for a multicenter, double-blind, randomised, controlled trial
Authors: Zhang Jun , Shen Qi-hong , Lin Xinru , Liu Tieshuai , Li Yu , Yu Yunyun , Liang Jingwen , Yu Xin , Chen Gang 
Published: January 2025

IntroductionThe incidence of post-traumatic stress disorder (PTSD) in emergency trauma surgery patients is 24%, emphasising the urgent need for effective early interventions and treatments. Transauricular vagus nerve stimulation (ta-VNS) modulates the autonomic nervous system by stimulating the nucleus tractus solitarius while affecting PTSD-related neural networks, including the prefrontal cortex, hippocampus and amygdala, potentially offering new options for PTSD prevention and treatment. This study aims to evaluate the efficacy and safety of ta-VNS in preventing PTSD in emergency trauma surgery patients.Methods and analysisThis multicentre, double-blind, randomised controlled study aims to evaluate the incidence of PTSD in emergency trauma surgery patients receiving either ta-VNS or sham stimulation. A total of 350 participants will be randomly assigned to receive either active or sham stimulation. The active group will undergo electrical stimulation of the left cymba conchae at 30 Hz with a pulse width of 250 µs, using a 30 s on/30 s off cycle. The intensity will start at 0.4 V, increasing in 0.4 V increments until a tingling sensation is detected, and will be adjusted to the highest tolerable level without causing pain. The initial intervention will begin once informed consent is obtained and randomisation is completed in the preoperative preparation room, continuing until the surgery is finished. For the four postoperative days, the intervention will be administered two times per day in 2-h sessions each morning and evening. The sham stimulation group will follow a similar procedure without actual stimulation. The primary outcome is the incidence of PTSD evaluated on postoperative day 30, with secondary outcomes including recovery quality, sleep quality, and adverse events.Ethics and disseminationThe protocol received approval from Sir Run Run Shaw Hospital, affiliated with Zhejiang University School of Medicine, on 15 October 2024 (approval number: 20240562). The study will adhere to the Declaration of Helsinki guidelines, and written informed consent will be obtained from all participants. Results will be submitted to a peer-reviewed journal for publication.Trial registration numberChina Clinical Trial Registration Center (ChiCTR2400080342). Trial details:https://www.chictr.org.cn/showproj.html?proj=217809
Instruments for assessing healthcare professionals’ knowledge, attitudes and practices regarding deprescribing: a scoping review protocol
Authors: Modesto Ana Carolina Figueiredo , Lopes Luis Phillipe Nagem , Neiva Pantuzza Laís Lessa , Moura Mariana Del Grossi , de Oliveira Jardel Corrêa , Lopes Luciane Cruz 
Published: January 2025

ObjectiveTo map instruments for assessing healthcare professionals’ knowledge, attitudes and practices regarding deprescribing.IntroductionDeprescribing is essential for improving patient outcomes by managing polypharmacy, reducing fall risks and decreasing medication costs. However, there is a limited exploration of healthcare professionals’ perspectives about deprescribing.Methods and analysisStudies involving healthcare professionals directly involved in the medication use process (nurses, pharmacists and physicians) will be included, while those in which it is not possible to identify the professional will be excluded. Any definition of deprescribing, as well as any stage of the deprescribing process, will be included, and those without a clear definition of deprescribing will be excluded. Studies employing instruments for assessing the knowledge, attitudes and practices of healthcare professionals regarding deprescribing, whether validated or not, will be included. Studies focusing on deprescribing algorithms will be excluded. Studies in any healthcare setting will be included. Data will be presented as absolute and relative frequencies, a world heatmap, heatmaps, bar plots or as a word cloud when appropriate.Ethics and disseminationThe findings from this review will be discussed with stakeholders and healthcare professionals directly involved in deprescribing processes. Additionally, the results will be disseminated through publications and conference presentations.Protocol registrationhttps://osf.io/tgjyc/
Modifiable factors for irritable bowel syndrome: evidence from Mendelian randomisation approach
Authors: Liu Di , Cao Meiling , Wu Shanshan , Jiang Yiwen , Cao Weijie , Lin Tengfei , Li Fuxiao , Sha Feng , Yang Zhirong , Tang Jinling 
Published: January 2025

BackgroundThe potential modifiable factors influencing irritable bowel syndrome (IBS) have not been thoroughly documented. We aimed to systematically investigate the modifiable factors associated with IBS, while accounting for the impact of unobserved confounders and coexisting disorders.MethodsGenetic correlation and Mendelian randomisation (MR) analyses were integrated to identify potential modifiable factors and coexisting disorders linked to IBS. Subsequently, multiresponse MR (MR2) was employed to further examine these associations. Summary-level genome-wide association data were used. Modifiable factors and coexisting disorders (ie, gastrointestinal and psychiatric disorders) were identified based on evidence from cohort studies and meta-analysis. In all analyses, IBS was the primary outcome, while in the MR2analysis, coexisting disorders were also treated as outcomes alongside IBS.ResultsMost identified modifiable factors and coexisting disorders exhibited genetic correlations with IBS. MR analyses revealed strong causation between IBS and multisite chronic pain (OR=2.20, 95% CI 1.82 to 2.66), gastro-oesophageal reflux disease (OR=1.31, 95% CI 1.23 to 1.39), well-being spectrum (OR=0.17, 95% CI 0.13 to 0.21), life satisfaction (OR=0.31, 95% CI 0.25 to 0.38), positive affect (OR=0.30, 95% CI 0.24 to 0.37), neuroticism score (OR=1.20, 95% CI 1.16 to 1.25) and depression (OR=1.50, 95% CI 1.37 to 1.66). Additionally, smoking, alcohol frequency, college or university degree, intelligence, childhood maltreatment, frailty index, diverticular disease of the intestine and schizophrenia were suggestively associated with IBS. Robust associations were found between multisite chronic pain and both IBS and coexisting disorders.ConclusionsOur study identified a comprehensive array of potential modifiable factors and coexisting disorders associated with IBS, supported by genetic evidence, including genetic correlation and multiple MR analyses. The presence of multisite chronic pain may offer a promising avenue for the concurrent prevention of IBS and its coexisting disorders.
Associations of infection burden with Kawasaki disease in a population-based setting during 30 years
Authors: Mofors Johannes , Rudolph André , Schiller Bodil , Elinder Göran , Sonesson Sven-Erik , Eliasson Håkan , Bergman Gunnar , Wahren-Herlenius Marie 
Published: January 2025

ObjectivesThe objective of this study was to investigate the role of infections in the pathogenesis of Kawasaki disease.MethodsThe investigation was a nationwide epidemiological case-control study, comprising all cases of Kawasaki disease diagnosed in Sweden 1987–2018. Controls were randomly sampled from the general population, matched on sex, age, and area of residency. Data on infections were obtained from the Swedish National Patient Register, which prospectively collects data on all Swedish residents. Infections were classified by organ system, infectious agent and by temporal proximity to Kawasaki disease diagnosis date. Prescription of antibiotics and infections in family members were also considered in separate analyses.ResultsThe study comprised n=1774 (61% male) cases and n=17 731 controls. Overall, a history of infections was associated with Kawasaki disease with an OR of 2.3 (95% CI 2.0 to 2.5). Respiratory, skin, urogenital and gastrointestinal tract infections were all associated with Kawasaki disease. Temporal stratification revealed a prominent clustering of infections during the weeks before a Kawasaki diagnosis, but also higher frequencies of infections several months preceding Kawasaki disease with OR ranging from 5.1 (95% CI 3.6 to 7.1) 15–28 days to 1.3 (95% CI 1.1 to 1.6) 181–365 days prior Kawasaki disease. A dose–response relationship was observed, with repeated infections associating with higher ORs of Kawasaki.ConclusionsThe findings suggest that infections are closely linked with Kawasaki disease, and with a wider temporal association than previously known. Further, the data imply that many different agents may induce the disease.
Words That Don't Translate into English
Authors: Yaffe Philip 
Published: January 2025

Each "Communication Corner" essay is self-contained; however, they build on each other. For best results, before reading this essay and doing the exercise, go to the first essay "How an Ugly Duckling Became a Swan," then read each succeeding essay.
The better you become as a good expository (non-fiction) writer, the more you appreciate just how challenging (and rewarding) it is to produce good expository text. Most treatises on good writing seem to presume that you are writing for native speakers of the language in which you are writing. However, often this is not the case. If you are not a polyglot, poor translation could lead to poor outcomes.
Puerarin Attenuates Podocyte Damage in Mice With Diabetic Kidney Disease by Modulating the AMPK/Nrf2 Pathway
Authors: Xue Song , Fan Wei , Li Qingping , Huang Hong , Tang Yibo , Wu Min 
Published: January 2025

Background: This study aimed to investigate the potential mechanisms of puerarin in alleviating diabetic nephropathy (DKD) in mice.Method: The DKD model was induced by multiple low‐dose injections of streptozotocin (STZ) and a high‐sugar and high‐fat diet in male C57BL/6J mice. After confirming the onset of DKD, mice were given irbesartan, distilled water, or different concentrations of puerarin (40 and 80 mg/kg/d) by gavage for 8 weeks. HE staining and PAS staining were adopted to assess the pathological changes in the kidney tissues. Meanwhile, the levels of superoxide dismutase, catalase, creatinine, and cystatin C in the serum and the urine albumin and creatinine were measured, and the renal indices as well as the urinary albumin‐to‐creatinine ratio (UACR) were calculated. The changes of podocin and protein expression levels associated with AMPK/Nrf2 signaling pathway were evaluated by western blot.Results: Puerarin significantly reduced the level of fasting blood glucose, renal index, glomerular mesangial expansion index, renal function, and oxidative stress induced by STZ (p < 0.05). The pathological injuries in kidney tissues were also alleviated. Furthermore, we demonstrated that the expression level of podocin and protein related to the AMPK/Nrf2 signaling pathway was also decreased significantly by the treatment of puerarin. At the same time, the efficacy of puerarin in the treatment of DKD was better than that of irbesartan, and the treatment effect of the high‐dose group (80 mg/kg/d) was also significantly better than that of the low‐dose group (40 mg/kg/d).Conclusion: Puerarin could attenuate the severity of DKD and protect the podocyte in mice in a dose‐dependent way. Also, it might be performed by regulating the AMPK/Nrf2 pathway. These findings may provide a theoretical basis for updating the clinical management of DKD.
Topographic Evaluation of Inflammatory Periapical Lesions in the First Molar’s Region Using CBCT
Authors: Kazemipoor Maryam , Foroughipour Fatemeh , Safi Yaser 
Published: January 2025

Background: Investigating the pattern of extension in the periapical (PA) inflammatory lesions is important in the treatment plan and prognosis of treatment.Introduction: This study evaluated the topography of PA inflammatory lesions in the first molars using cone‐beam computed tomography (CBCT).Methods: In this descriptive study, 197 CBCT images about patients in the age group of 14–77 years were analyzed. The maximum extension of the PA lesion in the three orthogonal planes related to the regions of maxillary and mandibular first molars was measured and reported in millimeters. Measurements were compared based on age, gender, dental arch, and root type. Statistical analysis was performed using percentages, repeated measure ANOVA, paired t‐tests, and Pearson correlation coefficient. The significant level was set at 0.05.Results: The highest total mean lesion extensions were in the vertical plane followed by the buccolingual and mesiodistal plane. There was a statistically significant difference between the extension of the PA lesion in the vertical and mesiodistal (p < 0.001), vertical and buccolingual (p  = 0.001), as well as the mesiodistal and buccolingual planes (p  = 0.027). In the maxilla and mandible, the highest mean lesion extension was in the vertical, buccolingual, and mesiodistal plane, respectively. According to the root type, there was only a statistically significant difference in lesion extension in the buccolingual plane and between the mesial and distobuccal roots (p  = 0.030).Conclusion: Given the limitations of the present study, regarding the extension of the PA lesion in the first molar region, the bone structure of the maxilla and mandible follows a precise and delicate pattern. In this regard, future studies in different communities and races should be designed to address this issue in different communities. In addition, CBCT is a reliable imaging method to evaluate the extension of the PA lesion both morphologically and morphometrically.
Registered Nurse Scope of Practice in Australian Primary Healthcare Settings: A Retrospective Longitudinal Study
Authors: Nguyen Van N. B. , Brand Gabrielle , Collison Lisa , Griffin Ken , Moses Samantha , Morphet Julia 
Published: January 2025

Background: Registered nurses (RNs) play an important role in providing primary healthcare (PHC) services. Longitudinal evidence on how the RN scope of practice in these settings has evolved over the years is currently missing and is critical in understanding how Australian government health policies have shaped the reality of nursing practice.Aim: To explore the scope of practice of RNs in Australian PHC workplace in both metropolitan and rural areas and among those with and without postgraduate qualifications during 2015–2019.Methods: Longitudinal survey data were retrospectively retrieved, collated and analysed using variate and bivariate analyses in SPSS Version 27.0. Composite items were used to combine survey items into seven key areas of nursing practice.Results: Majority of the 3882 participants were female (n = 3782, n = 97.4%), worked in general practice (n = 2916, 75.1%) and in metropolitan areas (n = 2145, 55.3%) and had completed a short course (n = 2470, 63.6%). A total of 904 participants (23.3%) completed at least one postgraduate degree. There was no significant and substantial difference in the frequency, and preference for frequency, of seven PHC practice areas by participants in different workplace localities, with or without a formal postgraduate degree as well as throughout the 5‐year survey period.Conclusion: The findings on the scope of practice by the RN participants might be explained by the interplay of interprofessional, organisational and institutional factors (more than individual factors).Implications for Nursing Management: Multilayer strategies targeting interprofessional, organisational, institutional and individual factors should be in place to enable RNs to work to their full capacity and advanced level of education. RNs also need to be included in major policy‐ and decision‐making that affects them to ensure their job satisfaction, retention in practice and contribution to patient health outcomes in PHC are sustained.
Intralesional Steroid Injections for Management of Granulomatous Mastitis: A Systematic Review of Treatment Protocols and Clinical Outcomes
Authors: Vercoe J. , Sedaghat N. , Brennan M. E. 
Published: January 2025

Introduction: Although idiopathic granulomatous mastitis (GM) of the breast is a benign condition, it can be locally aggressive and frequently chronic, causing significant pain and distress to the patient. Treatment often involves multiple disciplines including general practice, breast surgery/physicians, rheumatology and/or immunology. Traditional options for treatment include observation, oral steroids, methotrexate and/or surgery, all with variable outcomes. A more recent alternative treatment option involves intralesional steroid injections.Methods: Using PRISMA methodology, a systematic review of intralesional steroid injection for the management of GM was conducted. Medline, PubMed, Embase and Cochrane databases were searched for original studies reporting treatment protocols and clinical outcomes, published up to the end of September 2023.Results: Nine eligible studies reported outcomes in 474 patients undergoing treatment of GM with intralesional injections. All studies reported success (improvement in clinical and/or imaging appearance) with intralesional injections. Studies that had a comparison group showed statistically significantly fewer side effects compared to oral steroids or surgical management. The recurrence rate was less for intralesional injections than for other treatments in all studies except one. No studies included patient‐reported outcomes.Conclusion: There is consistent evidence for the safety, efficacy and low recurrence rate with intralesional steroid injections for GM. The existing literature is heterogenous with respect to injection protocols, and the optimal protocol is unclear. Future research should compare the various steroid agents and dose/frequency of administration. Future studies should include cost analysis and patient‐reported outcomes to ensure that the treatment is cost‐effective and acceptable to people with idiopathic GM.
In Situ RAS:RAF Binding Correlates with Response to KRASG12C Inhibitors in KRASG12C-Mutant Non–Small Cell Lung Cancer
Authors: Kato Ryoji , Solanki Hitendra S. , Ozakinci Hilal , Desai Bina , Gundlapalli Harika , Yang Yu Chi , Aronchik Ida , Singh Mallika , Johnson Joseph , Marusyk Andriy , Boyle Theresa A. , Haura Eric B. 
Published: January 2025

Abstract

Purpose:
Therapeutic efficacy of KRASG12C(OFF) inhibitors (KRASG12Ci) in KRASG12C-mutant non–small cell lung cancer (NSCLC) varies widely. The activation status of RAS signaling in tumors with KRASG12C mutation remains unclear, as its ability to cycle between the active GTP-bound and inactive GDP-bound states may influence downstream pathway activation and therapeutic responses. We hypothesized that the interaction between RAS and its downstream effector RAF in tumors may serve as indicators of RAS activity, rendering NSCLC tumors with a high degree of RAS engagement and downstream effects more responsive to KRASG12Ci compared with tumors with lower RAS–RAF interactions.

Experimental Design:
We developed a method for measuring in situ RAS binding to RAF in cancer samples using proximity ligation assays (PLA) designed to detect panRAS–CRAF interactions.

Results:
The panRAS–CRAF PLA signal correlated with levels of both RAS-GTP and phosphorylated ERK protein, suggesting that this assay can effectively assess active RAS signaling. We found that elevated panRAS–CRAF PLA signals were associated with increased sensitivity to KRASG12Ci in KRASG12C-mutant NSCLC cell lines, xenograft models, and patient samples. Applying a similar PLA approach to measure the interactions between EGFR and its adapter protein growth factor receptor–bound protein 2 as a surrogate for EGFR activity, we found no relationship between EGFR activity and response to KRASG12Ci in the same samples.

Conclusions:
Our study highlights the importance of evaluating in situ RAS–RAF interactions as a potential predictive biomarker for identifying patients with NSCLC most likely to benefit from KRASG12Ci. The PLA developed for quantifying these interactions represents a valuable tool for guiding treatment strategies.
Unlocking the Potential of CAR-NK Cell Therapy: Overcoming Barriers and Challenges in the Treatment of Myeloid Malignancies
Authors: Zhang Anqi , Yang Xingcheng , Zhang Yicheng , Yu Xiaoxuan , Mu Wei , Wei Jia 
Published: January 2025

Abstract
Myeloid malignancies include various types of cancers that arise from the abnormal development or proliferation of myeloid cells within the bone marrow. Chimeric antigen receptor (CAR) T cell treatments, which show great potential for B cell and plasma cell cancers, face major challenges when used for myeloid malignancies. CAR natural killer (NK) cell–based immunotherapy encounters several challenges in treating myeloid cancers, including (i) poor gene transfer efficiency and expansion platforms in vitro, (ii) limited proliferation and persistence in vivo, (iii) antigenic heterogeneity, and (iv) an immunosuppressive tumor microenvironment. Despite these hurdles, “off-the-shelf” CAR-NK treatments showed encouraging results, marked by enhanced proliferation, prolonged persistence, enhanced tumor infiltration, and improved adaptability. This review offers a summary of the biological traits and cellular sources of NK cells along with a discussion of contemporary CAR designs. Furthermore, it addresses the challenges observed in preclinical research and clinical trials related to CAR-NK cell therapy for myeloid cancers, suggesting enhancement strategies.
Use of Claims to Assess Outcomes and Treatment Effects in the Evolut Low Risk Trial
Authors: Butala Neel M. , Lalani Christina , Tale Archana , Song Yang , Kolte Dhaval , Baron Suzanne , Strom Jordan , Cohen David J. , Yeh Robert W. 
Published: January 2025

BACKGROUND:

Food and Drug Administration–mandated postmarket studies for transcatheter aortic valve replacement in low-risk populations plan to use passively collected registry data linked to claims for long-term follow-up out to 10 years. Therefore, it is critically important to understand the validity of these claims-based end points. We sought to evaluate the ability of administrative claims with
International Classification of Diseases-Tenth Revision
(
ICD-10
) codes to identify trial-adjudicated end points and reproduce treatment comparisons of aortic valve replacement in the Evolut Low Risk Trial.

METHODS:

We linked Evolut Low Risk trial patients to the Medicare Provider Analysis and Review database. We calculated sensitivity, specificity, positive predictive value, negative predictive value, and
κ
agreement statistic of claims to detect clinical end points through 2 years in trial patients. We additionally compared end points across treatment arms using trial-adjudicated outcomes versus claims-based outcomes.

RESULTS:

Trial-adjudicated deaths were perfectly identified by claims. Claims had good performance in identifying trial-adjudicated disabling stroke (sensitivity 68.8%, specificity 99.0%, positive predictive value 64.7%, negative predictive value 99.1%,
κ
=0.66) and pacemaker placement (sensitivity 85.2%, specificity 98.4%, positive predictive value 90.4%, negative predictive value 97.5%,
κ
=0.86), but more modest performance in identifying trial-adjudicated myocardial infarction (
κ
=0.46) and vascular complications (
κ
=0.45). There was no difference between treatment arms for the primary end point of death or disabling stroke using trial data (hazard ratio, 0.83 [95% CI, 0.41–1.68]) or claims data (hazard ratio, 0.89 [95% CI, 0.43–1.81]; interaction
P
=0.71).

CONCLUSIONS:
Claims-based end points performed well in ascertaining death, disabling stroke, and pacemaker placement and were able to reproduce principal trial findings. These results support the selective use of claims-based end points for transcatheter aortic valve replacement postmarketing surveillance.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02701283.