bluuebunny/crossref_metadata_2025_split huggingface dataset:
Avacopan for the Treatment of Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis
Authors: Alihosseini Christopher , Kopelman Hannah , Zaino Mallory , Feldman Steven R. 
Published: March 2023

Objective: To review the safety and efficacy of avacopan for the treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Data Sources: A systematic review of the literature was performed using the terms avacopan OR tavneos OR CCX168 OR ANCA-associated vasculitis in PubMed and Google Scholar. Articles between January 2016 and January 2023 were considered for inclusion. Bibliographies and ClinicalTrials.gov were also searched for completion. Study Selection and Data Extraction: Relative English language and human studies related to pharmacology, clinical trials, and safety were included. Data Synthesis: The 52-week ADVOCATE and 12-week CLEAR clinical trials evaluated the safety and efficacy of avacopan. The remission rate was 65.7% and 54.9% in the avacopan and placebo group, respectively, in the ADVOCATE trial. The Birmingham Vasculitis Activity Score improved by ≥50% in 86.4% of avacopan treated patients and 70% of prednisone treated patients in the CLEAR trial. Relevance to Patient Care and Clinical Practice in Comparison With Existing Drugs: Glucocorticoids in combination with cyclophosphamide, azathioprine, and/or rituximab have been a mainstay of ANCA-associated vasculitis treatment. However, short- and long-term medication-related adverse effects risk negative outcomes for patients. Avacopan may provide equivalent to better treatment with fewer side effects due to a reduction, if not elimination, of glucocorticoids. Conclusions: Avacopan used in isolation or combination is safe and effective for ANCA-associated vasculitis.
Efficacy and tolerance of LV5FU2-carboplatin chemotherapy in patients with advanced pancreatic ductal adenocarcinoma after failure of standard regimens
Authors: Chaigneau Thomas , Aguilera Munoz Lina , Oger Caroline , Gourdeau Clémence , Hentic Olivia , Laurent Lucie , Muller Nelly , Dioguardi Burgio Marco , Gagaille Marie-Pauline , Lévy Philippe , Rebours Vinciane , Hammel Pascal , de Mestier Louis 
Published: March 2023

Background: Chemotherapy options in patients with advanced pancreatic ductal adenocarcinoma (PDAC) after failure of standard chemotherapies are limited. Objectives: We aimed to report the efficacy and safety of the leucovorin and 5-fluorouracil (LV5FU2) and carboplatin combination in this setting. Design: We performed a retrospective study including consecutive patients with advanced PDAC who received LV5FU2–carboplatin between 2009 and 2021 in an expert center. Methods: We measured overall survival (OS) and progression-free survival (PFS), and explored associated factors using Cox proportional hazard models. Results: In all, 91 patients were included (55% male, median age 62), with a performance status of 0/1 in 74% of cases. LV5FU2–carboplatin was mainly used in third (59.3%) or fourth line (23.1%), with three (interquartile range: 2.0–6.0) cycles administered on average. The clinical benefit rate was 25.2%. Median PFS was 2.7 months (95% CI: 2.4–3.0). At multivariable analysis, no extrahepatic metastases ( p = 0.083), no ascites or opioid-requiring pain ( p = 0.023), <2 prior treatment lines ( p < 0.001), full dose of carboplatin ( p = 0.004), and treatment initiation >18 months after initial diagnosis ( p < 0.001) were associated with longer PFS. Median OS was 4.2 months (95% CI: 3.48–4.92) and was influenced by the presence of extrahepatic metastases ( p = 0.058), opioid-requiring pain or ascites ( p = 0.039), and number of prior treatment lines (0.065). Prior tumor response under oxaliplatin did not impact either PFS or OS. Worsening of preexisting residual neurotoxicity was infrequent (13.2%). The most common grade 3–4 adverse events were neutropenia (24.7%) and thrombocytopenia (11.8%). Conclusion: Although the efficacy of LV5FU2–carboplatin appears limited in patients with pretreated advanced PDAC, it may be beneficial in selected patients.
Excellent Clinical Long-Term Outcomes of Kidney Transplantation From Small Pediatric Donors (Age ≤ 5 Years) Despite Early Hyperfiltration Injury
Authors: Burkhalter Felix , Holzmann Yvonne , Georgalis Argyrios , Wehmeier Caroline , Hirt-Minkowski Patricia , Hoenger Gideon , Hopfer Helmut , Guerke Lorenz , Steiger Juerg , Schaub Stefan , Amico Patrizia 
Published: March 2023

Background: The use of small pediatric donors (age ≤ 5 years and body weight < 20kg) for adult transplant recipients is still regarded controversially in terms of early complications, long-term outcomes, and development of hyperfiltration injury due to body size mismatch. Objective: To investigate long-term outcomes of adult renal allograft recipients receiving a kidney from small pediatric donor (SPD) in terms of kidney function and early features of hyperfiltration injury such as histological changes and proteinuria. Design: Retrospective, single center study. Settings: Transplant center of the University Hospital of Basel, Switzerland. Patients: Adult renal allograft recipients receiving a kidney from a small pediatric donor at our center between 2005 and 2017. Methods: The outcome of 47 transplants from SPD were compared with 153 kidney transplants from deceased-standard criteria donors (SCD) occurring during the same time period. Incidence of clinical signs of hyperfiltration injury (eg, proteinuria) was investigated. According to our policy, surveillance biopsies were taken at 3 and 6 months post-transplant and were evaluated in terms of signs of hyperfiltration injury. Results: At a median follow-up of 2.3 years post-transplant, death-censored graft survival of SPD was comparable to transplants from SCD (94% vs 93%; P = .54). Furthermore, allograft function at last follow-up (estimated glomerular filtration rate–Modification of Diet in Renal Disease) was significantly higher in pediatric transplant (80 vs 55 ml/min/1.73 m2, P = .002). We found histological signs of early hyperfiltration injury in 55% of SPD. There was an equally low proteinuria in both groups during follow-up. Limitations: It is a single center and retrospective observational study with small sample size. The outcomes were investigated in a well-selected population of recipients with low body mass index, low immunological risk, and well-controlled hypertension and was not compared with equal selected group of recipients. Conclusions: Early histological and clinical signs of hyperfiltration injury in SPD is frequent. Despite the hyperfiltration injury, there is an equal allograft survival and even superior allograft function in SPD compared with SCD during follow-up. This observation supports the concept of high adaptive capacity of pediatric donor kidneys.
Unravelling Lifelong Learning in Multi-Generational Workforce Using Text Mining
Authors: Gupta Jaya , Misra Pooja 
Published: March 2023

Accelerated structural transformations characterize the workplace post-pandemic. A lifelong learning ecosystem must be built to ensure a smooth and inclusive transition since generational diversity is ubiquitous in contemporary organizations. The present phenomenological qualitative study attempts to explore generational diversity from the lens of lifelong learning construct across the three prominent generations, X, Y, and Z, present in the workforce. The data collected from 24 semi-structured telephonic interviews were analyzed using text mining and topic modeling. The results suggest differences and similarities among the members of different generations. The topics derived waxed and waned across generations. While the drive to engage in continuous learning varied across generational cohorts, the preferred mode for engaging in it was similar. The study provides insights that could help enhance the effectiveness of human resource management practices and firms’ competitiveness during tough times. Further, the findings contribute to the existing literature by adopting machine learning as a tool to extract and decode the latent topics across the three generational cohorts.
Sprinting in a Marathon: Nursing Staff and Nurse Leaders Make Meaning of Practicing in COVID-19 Devoted Units Pre-Vaccine
Authors: McAndrew Natalie S. , Rosa William E. , Moore Kaylen M. , Christianson Jacqueline , AbuZahra Tala , Mussatti Megann , McCracken Colleen , Newman Amy R. , Calkins Kelly , Breakwell Susan , Klink Katie , Guttormson Jill 
Published: March 2023

Objective To describe the lived experience of nursing staff and nurse leaders working in COVID-19 devoted units (intensive care or medical unit) prior to vaccine availability. Research Design Qualitative phenomenological design with a focus group approach. Methods The study team recruited a convenience sample of nursing staff (nurses, and nursing assistants/nurse technicians) and nurse leaders (managers, assistant nurse managers, clinical nurse specialists, and nurse educators) at an academic medical center in the midwestern United States. Focus groups and individual interviews were conducted to encourage participants to describe their (1) experiences as nursing professionals, (2) coping strategies, and (3) perspectives about supportive resources. Moral distress was measured with the moral distress thermometer and qualitative data were analyzed with Giorgi-style phenomenology. Results We conducted 10 in-person focus groups and five one-on-one interviews ( n  =  44). Seven themes emerged: (1) the reality of COVID-19: we are sprinting in a marathon; (2) acute/critical care nurse leaders experience unique burdens; (3) acute/critical care staff nurses experience unique burdens; (4) meaning of our lived experience; (5) what helped us during the pandemic; (6) what hurt us during the pandemic; and (7) we are not okay. Participants reported a moderate level of moral distress ( M  =  5.26 SD  =  2.31). They emphasized that peer support was preferred over other types of support offered by the healthcare organization. Participants expressed positive feedback about the focus group experience and commented that group processing validated their experiences and helped them “feel heard.” Conclusion These findings affirm the need for trauma-informed care and grief support for nurses, interventions that increase meaning in work, and efforts to enhance primary palliative communication skills. Study findings can inform efforts to tailor existing interventions and develop new, more comprehensive resources to meet the psychosocial needs of nursing staff and nurse leaders practicing during a pandemic.
Contact Mechanism of Rail Grinding with Open-Structured Abrasive Belt Based on Pressure Grinding Plate
Authors: Wu Zhiwei , Fan Wengang , Qian Chang , Hou Guangyou 
Published: March 2023

AbstractThe current research of abrasive belt grinding rail mainly focuses on the contact mechanism and structural design. Compared with the closed structure abrasive belt grinding, open-structured abrasive belt grinding has excellent performance in dynamic stability, consistency of grinding quality, extension of grinding mileage and improvement of working efficiency. However, in the contact structure design, the open-structured abrasive belt grinding rail using a profiling pressure grinding plate and the closed structure abrasive belt using the contact wheel are different, and the contact mechanisms of the two are different. In this paper, based on the conformal contact and Hertz theory, the contact mechanism of the pressure grinding plate, abrasive belt and rail is analyzed. Through finite element simulation and static pressure experiment, the contact behavior of pressure grinding plate, abrasive belt and rail under single concentrated force, uniform force and multiple concentrated force was studied, and the distribution characteristics of contact stress on rail surface were observed. The results show that under the same external load, there are three contact areas under the three loading modes. The outer contour of the middle contact area is rectangular, and the inner contour is elliptical. In the contact area at both ends, the stress is extremely small under a single concentrated force, the internal stress is drop-shaped under a uniform force, and the internal stress under multiple concentration forces is elliptical. Compared with the three, the maximum stress is the smallest and the stress distribution is more uniform under multiple concentrated forces. Therefore, the multiple concentrated forces is the best grinding pressure loading mode. The research provides support for the application of rail grinding with open-structured abrasive belt based on pressure grinding plate, such as contact mechanism and grinding pressure mode selection.
Development of glycan-targeted nanoparticles as a novel therapeutic opportunity for gastric cancer treatment
Authors: dos Santos Sofia Nascimento , Junior Dino Seigo Gushiken , Pereira Jhonatas Pedrosa Marim , Iadocicco Natália Miranda , Silva André Henrique , do Nascimento Tatielle , Dias Luís Alberto Pereira , de Oliveira Silva Flávia Rodrigues , Ricci-Junior Eduardo , Santos-Oliveira Ralph , Bernardes Emerson Soares 
Published: March 2023

AbstractChemotherapy resistance remains a major cause of therapeutic failure in gastric cancer. The combination of genetic material such as interference RNAs (iRNAs) to silence cancer-associated genes with chemotherapeutics has become a novel approach for cancer treatment. However, finding the right target genes and developing non-toxic, highly selective nanocarrier systems remains a challenge. Here we developed a novel sialyl-Tn-targeted polylactic acid—didodecyldimethylammonium bromide nanoparticle (PLA-DDAB) nanoparticles (NPs) loaded with dsRNA targeting ST6GalNac-I and/or galectin-3 genes. Using single photon emission computed tomography (SPECT), we have demonstrated that 99mtechnetium radiolabeled sialyl-Tn-targeted nanoparticles can reach the tumor site and downregulate ST6GalNAc-I and galectin-3 RNA expression levels when injected intravenously. Furthermore, using an in vivo gastric tumor model, these nanoparticles increased the effectiveness of 5-FU in reducing tumor growth. Our findings indicate that cancer-associated glycan-targeted NPs loaded with dsRNA targeting ST6GalNAc-I and/or galectin-3 in combination with standard chemotherapy, have the potential to become a novel therapeutic tool for gastric cancer.
Comparative chloroplast genomics of 34 species in subtribe Swertiinae (Gentianaceae) with implications for its phylogeny
Authors: Yang Lucun , Deng Shengxue , Zhu Yongqing , Da Qilin 
Published: March 2023

Abstract
Background
Subtribe Swertiinae, a medicinally significant and highly speciose Subtribe of family Gentianaceae. Despite previous extensive studies based on both morphology and molecular data, intergeneric and infrageneric relationships within subtribe Swertiinae remain controversial.

Methods
Here, we employed four newly generated Swertia chloroplast genomes with thirty other published genomes to elucidate their genomic characteristics.

Results
The 34 chloroplast genomes were small and ranged in size from 149,036 to 154,365 bp, each comprising two inverted repeat regions (size range 25,069–26,126 bp) that separated large single-copy (80,432–84,153 bp) and small single-copy (17,887–18,47 bp) regions, and all the chloroplast genomes showed similar gene orders, contents, and structures. These chloroplast genomes contained 129–134 genes each, including 84–89 protein-coding genes, 37 tRNAs, and 8 rRNAs. The chloroplast genomes of subtribe Swertiinae appeared to have lost some genes, such as rpl33, rpl2 and ycf15 genes. Comparative analyses revealed that two mutation hotspot regions (accD-psaI and ycf1) could serve as effective molecular markers for further phylogenetic analyses and species identification in subtribe Swertiinae. Positive selection analyses showed that two genes (ccsA and psbB) had high Ka/Ks ratios, indicating that chloroplast genes may have undergone positive selection in their evolutionary history. Phylogenetic analysis showed that the 34 subtribe Swertiinae species formed a monophyletic clade, with Veratrilla, Gentianopsis and Pterygocalyx located at the base of the phylogenetic tree. Some genera of this subtribe, however, were not monophyletic, including Swertia, Gentianopsis, Lomatogonium, Halenia, Veratrilla and Gentianopsis. In addition, our molecular phylogeny was consistent with taxonomic classification of subtribe Swertiinae in the Roate group and Tubular group. The results of molecular dating showed that the divergence between subtrib Gentianinae and subtrib Swertiinae was estimated to occur in 33.68 Ma. Roate group and Tubular group in subtribe Swertiinae approximately diverged in 25.17 Ma.

Conclusion
Overall, our study highlighted the taxonomic utility of chloroplast genomes in subtribe Swertiinae, and the genetic markers identified here will facilitate future studies on the evolution, conservation, population genetics, and phylogeography of subtribe Swertiinae species.
The construction of patient quality management model in oral post anesthesia care unit in China: a grounded theory approach
Authors: Zhang Qi , Tang Heshu , Yao Zhiqing , Han Wei 
Published: March 2023

Abstract
Background
Nowadays, people have paid more and more attention to the quality of physical and mental health recovery after oral surgery anesthesia. As a remarkable feature of patient quality management, it can effectively reduce the risk of postoperative complications and pain in Post Anesthesia Care Unit (PACU). However, the patient management model in oral PACU remains unknown, especially in China. The purpose of this study is to explore the management elements of patient quality management in the oral PACU and to construct the management model.

Methods
Strauss and Corbin’s grounded theory method was used to explore the experiences of three anesthesiologists, six anesthesia nurses and three administrators working in oral PACU. Twelve semi-structured interviews were conducted using face-to-face in a tertiary stomatological hospital from March to June, 2022. The interviews were transcribed and thematically analysed according to QSR NVivo 12.0 qualitative analysis tool.

Results
Three themes and ten subthemes were identified through an active analysis process, including three of the core team members: stomatological anesthesiologists, stomatological anesthesia nurses and administrators, three of the main functions: education and training, patient care and quality control and four of the team operation processes: analysis, plan, do, check.

Conclusion
The patient quality management model of the oral PACU is helpful for the professional identity and career development of stomatological anesthesia staff in China, which can accelerate the professional development of oral anesthesia nursing quality. According to the model, the patient’s pain and fear will decrease, meanwhile, safety and comfort will increase. It can make contributions to the theoretical research and clinical practice in the future.
APC mutation correlated with poor response of immunotherapy in colon cancer
Authors: Li Bing , Zhang Guoliang , Xu Xuejie 
Published: March 2023

Abstract
Objective
APC (adenomatous polyposis coli) gene mutation is a central initialization in colon cancer tumorigenesis. However, the connection between APC gene mutation and immunotherapy efficacy for colon cancer remains unknown. This study aimed to explore the impact of APC mutation on immunotherapy efficacy for colon cancer.

Methods
Colon cancer data from The Cancer Genome Atlas (TCGA) and Memorial Sloan Kettering Cancer Center (MSKCC) were used for the combined analysis. Survival analysis was performed to evaluate the association between APC mutation and immunotherapy efficacy in colon cancer patients. The expressions of immune check point molecules, tumor mutation burden (TMB), CpG methylation level, tumor purity (TP), microsatellite instability (MSI) status and tumor-infiltrating lymphocyte (TIL) in the two APC status were compared to evaluate the associations between APC mutation and immunotherapy efficacy indicators. Gene set enrichment analysis (GSEA) was performed to identify signaling pathways related to APC mutation.

Results
APC was the most frequently mutated gene in colon cancer. The survival analysis demonstrated that APC mutation was correlated with a worse immunotherapy outcome. APC mutation was associated with lower TMB, lower expression of immune check point molecules (PD-1/PD-L1/PD-L2), higher TP, lower MSI-High proportion and less CD8 + T cells and follicular helper T cells infiltration. GSEA indicated that APC mutation up-regulated mismatch repair pathway, which may play a negative role in evoking an antitumor immune response.

Conclusion
APC mutation is associated with worse immunotherapy outcome and inhibition of antitumor immunity. It can be used as a negative biomarker to predict immunotherapy response.
Isolated massive histiocytes renal interstitial infiltration: a case report of an unexpected cause of acute kidney injury in a kidney transplant recipient
Authors: Martins Luis E. M. , Moyses-Neto Miguel , Costa Roberto S. , Traina Fabiola , Romao Elen A. 
Published: March 2023

Abstract
Background
Acute kidney injury is a frequent cause of hospital readmission in kidney transplant recipients (KTR), usually associated with infections and graft rejection. Herein, we report a case of an unusual cause of acute kidney injury in a KTR (massive histiocytes renal interstitial infiltration).

Case presentation
A 40-year-old woman was submitted to a second kidney transplant. One year after surgery, she presented asthenia, myalgia, and fever, haemoglobin 6.1 g/dL; neutrophils: 1.3 × 109/µL; platelets: 143 × 109/µL; blood creatinine 11.8 mg/dL, requiring dialysis. A kidney biopsy revealed diffuse histiocytic infiltration, which was assumed due to dysregulated immunological activation triggered by infections. The patient had multiple infections, including cytomegalovirus infection (CMV), aspergillosis, bacteraemia, and urinary tract infections, which could trigger the immune response. Haemophagocytic lymphohistiocytosis (HLH) was ruled out. The present case highlights the occurrence of isolated massive renal interstitial infiltration of histiocytes that does not meet the criteria for HLH or other related pathologies.

Conclusions
Renal histiocyte activation and infiltration may have been initiated by an immunological mechanism similar to what occurs in HLH and infectious processes. The present case highlights the occurrence of isolated massive renal interstitial infiltration of histiocytes that does not meet the criteria for HLH or other related pathologies.