bluuebunny/crossref_metadata_2025_split huggingface dataset:
The five types of glomerulonephritis classified by pathogenesis, activity and chronicity (GN-AC)
Authors: Romagnani Paola , Kitching A Richard , Leung Nelson , Anders Hans-Joachim 
Published: May 2023

ABSTRACT
Glomerulonephritis (GN) is a diverse group of immune-mediated disorders. Currently, GN is classified largely by histological patterns that are difficult to understand and teach, and most importantly, do not indicate treatment choices. Indeed, altered systemic immunity is the primary pathogenic process and the key therapeutic target in GN. Here, we apply a conceptual framework of immune-mediated disorders to GN guided by immunopathogenesis and hence immunophenotyping: (i) infection-related GN require pathogen identification and control; (ii) autoimmunity-related GN, defined by presence of autoantibodies and (iii) alloimmunity-related GN in transplant recipients both require the suppression of adaptive immunity in lymphoid organs and bone marrow; (iv) autoinflammation-related GN, e.g. inborn errors of immunity diagnosed by genetic testing, requires suppression of single cytokine or complement pathways; and (v) Monoclonal gammopathy-related GN requires B or plasma cell clone-directed therapy. A new GN classification should include disease category, immunological activity to tailor the use of the increasing number of immunomodulatory drugs, and chronicity to trigger standard chronic kidney disease care including the evolving spectrum of cardio-renoprotective drugs. Certain biomarkers allow diagnosis and the assessment of immunological activity and disease chronicity without kidney biopsy. The use of these five GN categories and a therapy-focused GN classification is likely to overcome some of the existing hurdles in GN research, management and teaching by reflecting disease pathogenesis and guiding the therapeutic approach.
CKD therapy to improve outcomes of immune-mediated glomerular diseases
Authors: Anders Hans-Joachim , Fernandez-Juarez Gema M , Vaglio Augusto , Romagnani Paola , Floege Jürgen 
Published: May 2023

ABSTRACT
The management of immunoglobulin A nephropathy, membranous nephropathy, lupus nephritis, anti-neutrophil cytoplasmic antibody–associated vasculitis, C3 glomerulonephritis, autoimmune podocytopathies and other immune-mediated glomerular disorders is focused on two major treatment goals, preventing overall mortality and the loss of kidney function. Since minimizing irreversible kidney damage best serves both goals, the management of immune-mediated kidney disorders must focus on the two central pathomechanisms of kidney function decline, i.e., controlling the underlying immune disease process (e.g. with immunotherapies) and controlling the non-immune mechanisms of chronic kidney disease (CKD) progression. Here we review the pathophysiology of these non-immune mechanisms of CKD progression and discuss non-drug and drug interventions to attenuate CKD progression in immune-mediated kidney disorders. Non-pharmacological interventions include reducing salt intake, normalizing body weight, avoiding superimposed kidney injuries, smoking cessation and regular physical activity. Approved drug interventions include inhibitors of the renin–angiotensin–aldosterone system and sodium–glucose cotransporter-2. Numerous additional drugs to improve CKD care are currently being tested in clinical trials. Here we discuss how and when to use these drugs in the different clinical scenarios of immune-mediated kidney diseases.
Complement inhibitors for kidney disease
Authors: Wooden Benjamin , Tarragon Blanca , Navarro-Torres Mariela , Bomback Andrew S 
Published: May 2023

ABSTRACT
A refined understanding of the role of complement in the pathogenesis of glomerular and other kidney diseases has, over the past two decades, been matched by the development of novel, complement-targeting therapies. As we increasingly recognize the important role that complement activation across all three pathways—classical, lectin and alternative—plays in glomerular lesions both rare (e.g. C3 glomerulopathy) and common (e.g. immunoglobulin A nephropathy), we can identify avenues for precise, targeted approaches to modifying the natural history of these kidney diseases. In this review, we survey the evidence on using complement inhibition from the earliest, small-scale studies focusing on C5-targeting agents to more recent, large, multicenter, randomized trials utilizing complement blockade higher up in the complement pathway at the level of C3. We conclude by examining where the field of complement targeting therapy may be headed in light of these studies.
Preventing infections in immunocompromised patients with kidney diseases: vaccines and antimicrobial prophylaxis
Authors: Windpessl Martin , Kostopoulou Myrto , Conway Richard , Berke Ilay , Bruchfeld Annette , Soler Maria Jose , Sester Martina , Kronbichler Andreas 
Published: May 2023

ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic revealed that our understanding of infectious complications and strategies to mitigate severe infections in patients with glomerular diseases is limited. Beyond COVID-19, there are several infections that specifically impact care of patients receiving immunosuppressive measures. This review will provide an overview of six different infectious complications frequently encountered in patients with glomerular diseases, and will focus on recent achievements in terms of vaccine developments and understanding of the use of specific antimicrobial prophylaxis. These include influenza virus, Streptococcus pneumoniae, reactivation of a chronic or past infection with hepatitis B virus in cases receiving B-cell depletion, reactivation of cytomegalovirus, and cases of Pneumocystis jirovecii pneumonia in patients with anti-neutrophil cytoplasmic antibody–associated vasculitis. Varicella zoster virus infections are particularly frequent in patients with systemic lupus erythematosus and an inactivated vaccine is available to use as an alternative to the attenuated vaccine in patients receiving immunosuppressants. As with COVID-19 vaccines, vaccine responses are generally impaired in older patients, and after recent administration of B-cell depleting agents, and high doses of mycophenolate mofetil and other immunosuppressants. Strategies to curb infectious complications are manifold and will be outlined in this review.
Flora Annie Steel
Authors: Nielsen Danielle 
Published: May 2023

During her lifetime, Flora Annie Webster Steel (b. 1847–d. 1929) was one of the most popular Anglo-English writers of the fin de siècle. She was born in Harrow, England, the sixth child and second daughter of George Webster, a government employee, and Isabella MacCallum, an heiress to a fortune derived from Jamaican plantation holdings. When George Webster’s financial mismanagement required the family to move to Scotland, it prevented the young Flora from having any formal educational opportunities. She was largely self-taught and highly valued education. She married Indian Civil Service member Henry Steel when she was twenty years old and spent the next twenty-two years in India, primarily in the northern Punjab region. While living in the subcontinent, she served as the first female Inspector of Schools, organized girls’ and women’s secular education, worked with John Lockwood Kipling to preserve Indian handcrafts, and collected Indian folk tales. These folktales were first published in Anglo-Indian periodicals for readers in the subcontinent and later collected and published in Britain in the collections Tales from the Punjab and Wide Awake Stories with Richard Carnac Temple. While in India, she and Grace Gardiner co-authored The Complete Indian Housekeeper and Cook, a domestic manual intended to help newly-arrived British women manage their households. After returning permanently to Scotland in 1889, Steel used her Indian experiences to support what would become a prolific writing career, publishing short story collections such as In the Permanent Way, and Other Stories; newspaper columns on The Woman Question, marriage, and late in life, suffrage; novels; and histories of India. Referred to, often derisively, as “the female Kipling,” she continues to be most recognized for her novel On the Face of the Waters, which portrayed the Indian Uprising of 1857, though scholarly interest in her other writing is increasing. Her interest in Indian history is also evident in her series of novels, Prince of Dreamers, King-errant, Mistress of Men, and The Builder, detailing specific moments in the Mughal Dynasty, Dramatic History of India: 29 playlets, and non-fiction work like India, illustrated by Mortimer Menpes, and India Through the Ages: A Popular and Picturesque History of Hindustan. Her posthumously published autobiography, The Garden of Fidelity: Being the Autobiography of Flora Annie Steel, 1847–1929, concluded her writing career.
A Bundle of the Top 10 OPAT Publications in 2022
Authors: Childs-Kean Lindsey M , Beieler Alison M , Coroniti Ann-Marie , Cortés-Penfield Nicolás , Keller Sara C , Mahoney Monica V , Rajapakse Nipunie S , Rivera Christina G , Yoke Leah H , Ryan Keenan L 
Published: May 2023

Abstract
Outpatient parenteral antimicrobial therapy (OPAT) has become more common in clinical settings. Correspondingly, OPAT-related publications have also increased; the objective of this article was to summarize clinically meaningful OPAT-related publications in 2022. Seventy-five articles were initially identified, with 54 being scored. The top 20 OPAT articles published in 2022 were reviewed by a group of multidisciplinary OPAT clinicians. This article provides a summary of the “top 10” OPAT publications of 2022.
The ameliorative effects of quercetin and curcumin against subacute nephrotoxicity of fipronil induced in Wistar rats
Authors: Uzunhisarcikli Meltem , Apaydin Fatma Gokce , Bas Hatice , Kalender Yusuf 
Published: May 2023

Abstract
Fipronil is a phenylpyrazole insecticide that is widely used in agricultural, veterinary, and public health fields for controlling a wide variety of insect species and it is an environmentally potent toxic substance. Curcumin and quercetin, which are well-known natural antioxidants, are widely used to prevent the harmful effects of free radicals on biological systems. The present study aimed to determine the potential ameliorative effects of quercetin and/or curcumin on fipronil-induced nephrotoxicity in rats. Curcumin (100 mg/kg of body weight), quercetin (50 mg/kg of body weight), and fipronil (3.88 mg/kg of body weight) were administered to male rats by intragastric gavage for 28 consecutive days. In the present study, body weight, kidney weight, the renal function markers (blood urea nitrogen, creatinine, and uric acid levels) in the blood, antioxidant enzyme activities, and malondialdehyde level as markers of oxidative stress, and histological changes of the renal tissue were evaluated. The levels of serum blood urea nitrogen, creatinine, and uric acid were significantly increased in fipronil-treated animals. Additionally, while superoxide dismutase, catalase, glutathione-S-transferase, and glutathione peroxidase activities were decreased in the kidney tissue of rats treated with fipronil, malondialdehyde level was significantly increased. Histopathological analyses showed that the glomerular and tubular injury occurred in the renal tissue of fipronil-treated animals. Also, the supplementation of quercetin and/or curcumin with fipronil significantly improved fipronil-induced alterations in renal function markers, antioxidant enzyme activities, malondialdehyde levels, and histological features of renal tissue.
TRPA1deficiency aggravates dilated cardiomyopathy by promotingS100A8expression to induceM1macrophage polarization in rats
Authors: Zhao Mengmeng , Zheng Zihui , Pan Wei , Zhang Jishou , Yin Zheng , Wei Cheng , Xu Yao , Wan Jun , Wang Menglong 
Published: May 2023

AbstractTransient receptor potential ankyrin 1 (TRPA1) plays an important role in different cardiovascular diseases. However, the role of TRPA1 in dilated cardiomyopathy (DCM) remains unclear. Here, we aimed to investigate the role of TRPA1 in DCM induced by doxorubicin (DOX) and explore its possible mechanisms. GEO data were used to explore the expression of TRPA1 in DCM patients. DOX (2.5 mg/kg/week, 6 weeks, i.p.) was used to induce DCM. Bone marrow‐derived macrophages (BMDMs) and neonatal rat cardiomyocytes (NRCMs) were isolated to explore the role of TRPA1 in macrophage polarization, cardiomyocyte apoptosis, and pyroptosis. In addition, DCM rats were treated with the TRPA1 activator, cinnamaldehyde to explore the possibility of clinical translation. TRPA1 expression was increased in left ventricular (LV) tissue in DCM patients and rats. TRPA1 deficiency aggravated the cardiac dysfunction, cardiac injury, and LV remodeling in DCM rats. In addition, TRPA1 deficiency promoted the M1 macrophage polarization, oxidative stress, cardiac apoptosis, and pyroptosis induced by DOX. RNA‐seq results showed that TRPA1 knockout promoted the expression of S100A8, an inflammatory molecule that belongs to the family of Ca2+‐binding S100 proteins, in DCM rats. Furthermore, S100A8 inhibition attenuated M1 macrophage polarization in BMDMs isolated from TRPA1 deficiency rats. Recombinant S100A8 promoted the apoptosis, pyroptosis, and oxidative stress in primary cardiomyocytes stimulated with DOX. Finally, TRPA1 activation via cinnamaldehyde alleviated the cardiac dysfunction and reduced S100A8 expression in DCM rats. Taken together, these results suggested that TRPA1 deficiency aggravates DCM by promoting S100A8 expression to induce M1 macrophage polarization and cardiac apoptosis.
Characteristics and Outcomes of Very Elderly Patients Admitted to Intensive Care: A Retrospective Multicenter Cohort Analysis*
Authors: Rai Sumeet , Brace Charlotte , Ross Paul , Darvall Jai , Haines Kimberley , Mitchell Imogen , van Haren Frank , Pilcher David 
Published: May 2023

OBJECTIVES:
To characterize and compare trends in ICU admission, hospital outcomes, and resource utilization for critically ill very elderly patients (≥ 80 yr old) compared with the younger cohort (16–79 yr old).

DESIGN:
A retrospective multicenter cohort study.

SETTING:
One-hundred ninety-four ICUs contributing data to the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database between January 2006 and December 2018.

PATIENTS:
Adult (≥ 16 yr) patients admitted to Australian and New Zealand ICUs.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Very elderly patients with a mean ± sd age of 84.8 ± 3.7 years accounted for 14.8% (232,582/1,568,959) of all adult ICU admissions. They had higher comorbid disease burden and illness severity scores compared with the younger cohort. Hospital (15.4% vs 7.8%, p < 0.001) and ICU mortality (8.5% vs 5.2%, p < 0.001) were higher in the very elderly. They stayed fewer days in ICU, but longer in hospital and had more ICU readmissions. Among survivors, a lower proportion of very elderly was discharged home (65.2% vs 82.4%, p < 0.001), and a higher proportion was discharged to chronic care/nursing home facilities (20.1% vs 7.8%, p < 0.001). Although there was no change in the proportion of very elderly ICU admissions over the study period, they showed a greater decline in risk-adjusted mortality (6.3% [95% CI, 5.9%–6.7%] vs 4.0% [95% CI, 3.7%–4.2%] relative reduction per year, p < 0.001) compared with the younger cohort. The mortality of very elderly unplanned ICU admissions improved faster than the younger cohort (p < 0.001), whereas improvements in mortality among elective surgical ICU admissions were similar in both groups (p = 0.45).

CONCLUSIONS:
The proportion of ICU admissions greater than or equal to 80 years old did not change over the 13-year study period. Although their mortality was higher, they showed improved survivorship over time, especially in the unplanned ICU admission subgroup. A higher proportion of survivors were discharged to chronic care facilities.
Attitudes and Beliefs Toward Thymectomy in the Myasthenia Gravis Patient Registry
Authors: Hamedani Ali G. , McPherson Tarrant O. , Aban Inmaculada , Lee Ikjae , Kupersmith Mark J. , Wolfe Gil I. , Kaminski Henry J. 
Published: May 2023

Abstract

Objectives:
To evaluate patient attitudes and beliefs toward thymectomy for myasthenia gravis (MG).

Methods:
The Myasthenia Gravis Foundation of America administered a questionnaire to the MG Patient Registry, an ongoing longitudinal survey of adult MG patients. Questions assessed reasons for or against thymectomy and how hypothetical scenarios would have affected their decision.

Results:
Of 621 respondents, 190 (31%) reported a history of thymectomy. Of those who underwent thymectomy for nonthymomatous MG, 97 (51.6%) ranked symptom improvement as most important and 100 (53.2%) ranked reducing medication as least important. Among 431 nonthymectomy patients, the most frequent reason for not undergoing thymectomy was that their doctor did not discuss it (152 of 431 = 35.2%) and 235 (56.8%) said that they would have considered it more strongly if their doctor spent more time discussing it.

Conclusions:
Thymectomies are motivated more by symptoms than by medication, and a lack of neurologist discussion is the most common barrier to thymectomy.
Neonatal Fc Receptor Inhibitor Therapeutics in Neuromuscular Disease
Authors: Jaffry Mustafa , Menkes Daniel L. , Shaikh Anam , Mandava Kranthi , Kothari Om , Jaffry Kazim , Souayah Nizar 
Published: May 2023

Abstract
The Neonatal Fc Receptor (FcRn) is integral to a wide variety of processes including IgG recycling, serum albumin turnover, and bacterial opsonization. Thus, targeting FcRn will increase antibody degradation including pathogenic IgGs. FcRn inhibition provides a novel therapeutic mechanism by which autoantibody titers are reduced resulting in clinical improvement and disease abatement. The FcRn targeting mechanism is similar to that of intravenous immunoglobulin (IVIg) in which saturated FcRn facilitates accelerated pathogenic IgG degradation. Recently, the FcRn inhibitor efgartigimod was approved for the treatment of myasthenia gravis. Subsequently, clinical trials of this agent have been conducted for numerous inflammatory conditions involving pathogenic autoantibodies. These disorders include the Guillain–Barre syndrome, chronic inflammatory demyelinating polyneuropathy, and inflammatory myositis. Other disorders traditionally treated with IVIg may also benefit from FcRn inhibition in certain contexts. This manuscript discusses the mechanism of FcRn inhibition, preclinical data, and the results of clinical trials of this agent for a wide range of neuromuscular diseases.
Exploring the Interprofessional Contributions of Spiritual Health Practitioners to Prevent Compassion Fatigue in Nurses
Authors: Hildebrand Amy , Reimer-Kirkham Sheryl , Quinn Barry 
Published: May 2023

Background
Few studies in academic literature involve the application of a spiritual health intervention for the purpose of mitigating compassion fatigue in nurses.

Objectives
The purpose of this qualitative study was to explore the perspectives of Canadian spiritual health practitioners (SHPs) in their support for nurses to prevent compassion fatigue.

Method
Interpretive description was utilized for this research study. Sixty-minute interviews with 7 individual SHPs were conducted. Data were analyzed with NVivo 12 software (QSR International, Burlington, Massachusetts). Thematic analysis identified common themes that allowed data from interviews, a pilot project on psychological debriefing, and a literature search to be compared, contrasted, and compiled.

Results
The 3 main themes were found. The first theme highlighted the underlying issue of how spirituality is ranked or viewed within health care and the impact of leadership integrating spirituality in their practice. The second theme related to SHPs' perception of nurses' compassion fatigue and lack of connection to spirituality. The final theme explored the nature of SHP support to mitigate compassion fatigue before and during the COVID-19 pandemic.

Discussion
Spiritual health practitioners are positioned in a unique role to be facilitators of connectedness. They are professionally trained to provide a type of in situ nurturing for patients and health care staff through spiritual assessments, pastoral counseling, and psychotherapy. The COVID-19 pandemic has revealed an underlying desire for in situ nurturing and connectedness in nurses due to an increase in existential questioning, unusual patient circumstances, and social isolation leading to disconnectedness. Organizational spiritual values are recommended to be exemplified by those in leadership to create holistic, sustainable work environments.
The Outcome of Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension during the COVID-19 Pandemic
Authors: Serati Alireza , Keshmiri Mohammad Sadegh , Shafaghi Shadi , Mohammad Majid Malek , Kashani Babak Sharif , Naghashzadeh Farah , Mohamadifar Arezoo , Shafaghi Masoud , Noorali Sima , Hajimoradi Maryam , Astani Bahamin , Aghdasi Sina , Riahi Mahsa , Alavi Sima , Malek Rayka , Movahed Mohammad Reza 
Published: May 2023

Background:
The coronavirus 2019 (COVID-19) has affected the lives of many people worldwide. Patients with chronic underlying morbidities are vulnerable to get the severe form of the infection. The goal of this study was to evaluate the outcome of patients with pulmonary arterial hypertension during the COVID-19 pandemic in Iran.

Methods:
This cross-sectional study was conducted at a large tertiary center for pulmonary artery hypertension (PAH) patients. The primary end point was the prevalence of SARS-CoV-2 infection in PAH patients. The secondary end points were investigating the severity and mortality of COVID-19 infection in PAH patients during the COVID-19 pandemic.

Results:
Totally 75 patients were enrolled in the study from December 2019 to October 2021 and 64% were female. The mean ± SD age was 49 ± 16 years. The prevalence of COVID-19 in PAH/chronic thromboembolic pulmonary hypertension patients was 44%. About 66.7% of patients had comorbidities, which was a prognostic factor for COVID-19 infection in PAH patients (P < 0.001). Fifty-six percent of infected patients were asymptomatic. The most reported symptoms in symptomatic patients were fever (28%) and malaise (29%). Twelve percent of patients were admitted with severe symptoms. The mortality rate in infected individuals was 3.7%.

Conclusions:
COVID-19 infection in PAH/chronic thromboembolic pulmonary hypertension patients seems to be associated with high mortality and morbidity. More scientific proof is needed to clarify different aspect of COVID-19 infection in this population.