bluuebunny/crossref_metadata_2025_split huggingface dataset:
Collaborative Team Training in Virtual Reality is Superior To Individual Learning For Performing Complex Open Surgery: A Randomised Controlled Trial
Authors: Edwards Thomas C , Soussi Daniella , Gupta Shubham , Khan Sikandar , Patel Arjun , Patil Amogh , Liddle Alexander D , Cobb Justin P , Logishetty Kartik 
Published: August 2023

Objective:
To assess if multiplayer virtual reality (VR) training was superior to single player training for acquisition of both technical and non-technical skills in learning complex surgery.

Summary Background Data:
Superior team-work in the operating room (OR) is associated with improved technical performance and clinical outcomes. VR can successfully train OR staff individually, however VR team training has yet to be investigated.

Method:
Forty participants were randomised to individual or team VR training. Individually-trained participants practiced alongside virtual avatar counterparts, whilst teams trained live in pairs. Both groups underwent five VR training sessions over 6-weeks. Subsequently, they underwent a real-life assessment in which they performed Anterior Approach Total Hip Arthroplasty (AA-THA) surgery on a high-fidelity model with real equipment in a simulated OR. Teams performed together and individually-trained participants were randomly paired up. Videos were marked by two blinded assessors recording the NOTSS, NOTECHS II and SPLINTS scores. Secondary outcomes were procedure time and number of technical errors.

Results:
Teams outperformed individually-trained participants for non-technical skills in the real-world assessment (NOTSS 13.1±1.5 vs 10.6±1.6, P=0.002, NOTECHS-II score 51.7±5.5 vs 42.3±5.6, P=0.001 and SPLINTS 10±1.2 vs 7.9±1.6, P=0.004). They completed the assessment 28.1% faster (27.2 minutes±5.5 vs 41.8 ±8.9, P<0.001), and made fewer than half the number of technical errors (10.4±6.1 vs 22.6±5.4, P<0.001).

Conclusions:
Multiplayer training leads to faster surgery with fewer technical errors and the development of superior non-technical skills.
Living Donor Liver Transplantation for Adults With High Model for End-stage Liver Disease Score: The US Experience
Authors: Rosenthal Benjamin E. , Abt Peter L. , Schaubel Douglas E. , Reddy K. Rajender , Bittermann Therese 
Published: August 2023

Background.
Outcomes after living-donor liver transplantation (LDLT) at high Model for End-stage Liver Disease (MELD) scores are not well characterized in the United States.

Methods.
This was a retrospective cohort study using Organ Procurement and Transplantation Network data in adults listed for their first liver transplant alone between 2002 and 2021. Cox proportional hazards models evaluated the association of MELD score (<20, 20–24, 25–29, and ≥30) and patient/graft survival after LDLT and the association of donor type (living versus deceased) on outcomes stratified by MELD.

Results.
There were 4495 LDLTs included with 5.9% at MELD 25–29 and 1.9% at MELD ≥30. LDLTs at MELD 25–29 and ≥30 LDLT have substantially increased since 2010 and 2015, respectively. Patient survival at MELD ≥30 was not different versus MELD <20: adjusted hazard ratio 1.67 (95% confidence interval, 0.96–2.88). However, graft survival was worse: adjusted hazard ratio (aHR) 1.69 (95% confidence interval, 1.07–2.68). Compared with deceased-donor liver transplant, LDLT led to superior patient survival at MELD <20 (aHR 0.92; P = 0.024) and 20–24 (aHR 0.70; P < 0.001), equivalent patient survival at MELD 25–29 (aHR 0.97; P = 0.843), but worse graft survival at MELD ≥30 (aHR 1.68, P = 0.009).

Conclusions.
Although patient survival remains acceptable, the benefits of LDLT may be lost at MELD ≥30.
Feasibility of Interleukin-6 Receptor Blockade in Cardiac Antibody-mediated Rejection
Authors: Pottebaum April A. , January Spenser E. , Liu Chang , Lavine Steven , Schilling Joel D. , Lavine Kory J. 
Published: August 2023

Background.
Antibody-mediated rejection (AMR) remains a significant cause of heart transplant mortality with few effective therapies.

Methods.
This study aimed to describe initial experience of using interleukin-6 receptor blockade with tocilizumab in the treatment of acute cardiac AMR at Barnes-Jewish Hospital/Washington University Transplant Center from July 2017 to May 2021 (n = 7). Clinical, echocardiographic, and serum alloantibody data were analyzed before and after treatment.

Results.
All participants demonstrated marked improvement in functional status. Echocardiographic data following 4–6 mo of tocilizumab revealed significant improvements in biventricular systolic function for all participants. Consistent reductions in donor-specific HLA or angiotensin type I receptor antibodies were not observed, suggesting that tocilizumab may act downstream of antibody production. No patient experienced drug-related complications that necessitated discontinuation of therapy.

Conclusions.
These findings provide initial insights into the safety and efficacy of interleukin-6 receptor blockade in the treatment of cardiac AMR and support the design of larger prospective studies.
Management of neuropsychiatric symptoms in dementia
Authors: Devanand D.P. 
Published: August 2023

Purpose of review
The purpose is to review the results and clinical implications of recent studies of neuropathology in relation to neuropsychiatric symptoms (NPS) in Alzheimer's disease and related dementias, and discuss new therapeutic approaches based on evidence from clinical trials.

Recent findings
In a large autopsy series from a national consortium, multiple neuropathologies of dementia subtypes were common and increased severity of specific NPS during life was associated with greater severity of neuropathology across diagnoses. Based on three clinical trials, brexpiprazole, which is an antipsychotic with dopamine and serotonin receptor partial agonism properties, was recently approved for the treatment of agitation in Alzheimer's dementia by the U.S. Food and Drug Administration (FDA). Its therapeutic profile indicates modest efficacy with high safety. Brexpiprazole has not been compared to other antipsychotics that are commonly prescribed to treat agitation in dementia, though none of them have been approved for this indication. Other drugs that showed positive results in Phase 2 trials are being tested in Phase 3 trials. These include cannabinoids and drug combinations that inhibit dextromethorphan metabolism peripherally, thereby increasing its bioavailability in the brain. Apathy is common in several types of dementia, and there is initial evidence that treatment with methylphenidate, a psychostimulant, may be efficacious with good tolerability.

Summary
Greater understanding of the associations between NPS and dementia subtypes can improve clinical management of these disorders. In addition to the approval of brexpiprazole to treat agitation in Alzheimer's dementia, there is optimism about other medications based on ongoing clinical trials. Along with short-term improvement, altering the adverse impact on NPS on long-term prognosis remains an important challenge for the field.
SIM-CNN: Self-Supervised Individualized Multimodal Learning for Stress Prediction on Nurses Using Biosignals
Authors: Eom Sunmin , Eom Sunwoo , Washington Peter 
Published: August 2023

AbstractPrecise stress recognition from biosignals is in-herently challenging due to the heterogeneous nature of stress, individual physiological differences, and scarcity of labeled data. To address these issues, we developed SIM-CNN, a self-supervised learning (SSL) method for personalized stress-recognition models using multimodal biosignals. SIM-CNN involves training a multimodal 1D convolutional neural network (CNN) that leverages SSL to utilize massive unlabeled data, optimizing individual parameters and hyperparameters for precision health. SIM-CNN is evaluated on a real-world multimodal dataset collected from nurses that consists of 1,250 hours of biosignals, 83 hours of which are explicitly labeled with stress levels. SIM-CNN is pre-trained on the unlabeled biosignal data with next-step time series forecasting and fine-tuned on the labeled data for stress classification. Compared to SVMs and baseline CNNs with an identical architecture but without self-supervised pre-training, SIM-CNN shows clear improvements in the average AUC and accuracy, but a further examination of the data also suggests some intrinsic limitations of patient-specific stress recognition using biosignals recorded in the wild.
Clinical Presentation of Psychotic Experiences in Patients with Common Mental Disorders Attending the UK Primary Care Improving Access to Psychological Therapies (IAPT) Programme
Authors: Wiedemann Anna , Stochl Jan , Russo Debra , Patel Ushma , Ashford Polly-Anna , Ali Naima , Jones Peter B , Perez Jesus 
Published: August 2023

AbstractBackgroundImproving Access to Psychological Therapies (IAPT) services address anxiety and depression in primary care, but psychotic disorders are typically excluded. Our previous research found that 1 in 4 patients report distressing psychotic experiences (PE) alongside common mental disorders, yet little is known about their clinical presentation and their impact on recovery.MethodsWe used the Community Assessment of Psychic Experiences - Positive Scale (CAPE-P15) to determine the clinical presentation of PE within IAPT settings. We identified different classes (sub- groups) based on the reported frequencies of PE within this population using latent class analysis.ResultsA total of 2,042 IAPT patients completed the CAPE-P15. The mean age was 39.8 (± 15.3) years. We identified five distinct classes of symptom profiles, findings that PE were common, especially self-referential and persecutory ideas. Prevalence and intensity increased across classes, extending to bizarre experiences and perceptual abnormalities (hallucinations) in the fifth and least common class. Perceptual abnormalities were a strong indicator of symptom severity, and patients reporting such experiences were the least likely to achieve recovery by the end of treatment.LimitationsWe collected data from IAPT services that included self-report questionnaires, which may have affected the validity of the reported experiences. We did not collect information on negative PE.ConclusionsPatients seeking treatment for anxiety and depression in primary care commonly experience a wide range of positive PE. Self-referential and persecutory ideation emerged as prevalent experiences; perceptual abnormalities were infrequent. Providing information about prevalence and tailoring therapy may help reduce patient distress.
Data-driven decision support for individualised cardiovascular resuscitation in sepsis: a scoping review and primer for clinicians
Authors: Catling Finneas JR , Nagendran Myura , Festor Paul , Bien Zuzanna , Harris Steve , Faisal A Aldo , Gordon Anthony C , Komorowski Matthieu 
Published: August 2023

AbstractBackgroundWe conducted a scoping review of machine learning systems that inform individualised cardiovascular resuscitation of adults in hospital with sepsis. Our study reviews the resuscitation tasks that the systems aim to assist with, system robustness and potential to improve patient care, and progress towards deployment in clinical practice. We assume no expertise in machine learning from the reader and introduce technical concepts where relevant.MethodsThis study followed thePreferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviewsguidance. MEDLINE, EMBASE, Scopus, ClinicalTrials.gov, arXiv, bioRxiv and medRxiv were systematically searched up to September 2021. We present a narrative synthesis of the included studies, which also aims to equip clinicians with an understanding of the foundational machine learning concepts necessary to interpret them.Results73 studies were included with 80% published after 2018. Supervised learning systems were often used to predict septic shock onset. Reinforcement learning systems were increasingly popular in the last five years, and were used to guide specific dosing of fluids and vasopressors. A minority of studies proposed systems containing biological models augmented with machine learning. Sepsis and septic shock were heterogeneously defined and 63% of studies derived their systems using a single dataset. Most studies performed only retrospective internal validation, with no further steps taken towards translating their proposed systems into clinical practice.ConclusionsMachine learning systems can theoretically match, or even exceed, human performance when predicting patient outcomes and choosing the most suitable cardiovascular treatment strategy in sepsis. However, with some notable exceptions, the vast majority of systems to date exist only as proof of concept, with significant barriers to translation.
Harnessing extracellular vesicles for efficient siRNA deliveryin vitroandin vivo
Authors: Qiu Tao , Zhai Yanhua , Yi Yuan , Wang Xiaoyu , Hu Rui , Niu Shuiqin , Wang Chengcheng , Cui Chuang , He Xinjun , Xu Ke 
Published: August 2023

AbstractTo fulfill the potential of small interference RNA (siRNA) therapeutics, diverse and efficient delivery platforms for siRNA are urgently needed. Extracellular vesicles (EVs) are endogenous, cell secreted nano-vehicles which have been explored for functional siRNA delivery, yet impurities in EVs preparation and lack of efficient siRNA loading method have been limiting its further development into clinical applications. In this work, we have achieved high quality EVs production and an siRNA loading system via EVs. The prepared EV-siRNA system was able to deliver siRNA cargo to model cell lines to silence the expression of targeted genes with high potency. Furthermore, EV-siRNA administration in a tumor xenograft model significantly inhibited tumor growth. Therefore, this study establishes an innovative and efficient EV-siRNA platform for siRNA deliveryin vitroandin vivo.
Prevalence of Comorbidities among United States Adults with asthma and Their Association with Asthma Severity
Authors: Ogbu Chukwuemeka E. , Sarker Pallab , Oparanma Chisa O. , Ogbu Stella C. , Stouras Ioannis , Eze Ebube , Ndugba Chinaenye , Ujah Otobo I. , Kirby Russell S. 
Published: August 2023

AbstractIntroductionThe burden of comorbidities in asthma patients significantly affects management strategies and outcomes. This study aimed to analyze the prevalence and trends of comorbidities among adults with asthma and to investigate their association with persistent asthma.MethodsThe study employed data from the Asthma Call-Back Survey (ACBS) to ascertain the prevalence and trends of comorbidities in adults with asthma. Comorbidities were self-reported binary responses. Asthma severity was categorized as intermittent or persistent based on established methodologies to derive asthma severity in the ACBS. Intermittent asthma includes those with current asthma who are well-controlled without being on long-term control medication (LTCM). Persistent asthma includes those on LTCM, regardless of asthma control status, and those not on LTCM whose asthma is not well controlled or is very poorly controlled. Weighted logistic regression controlling for confounders was used to determine the association of comorbidities and asthma severity.ResultsPrevalence of comorbidities in adults with asthma were as follows: hypertension (38.4%), major depressive disorder (35.2%), diabetes (17.2%), MI (5.3%), Angina/CHD (6.0%), Stroke (5.0%), and Emphysema/Chronic bronchitis/COPD (19.0%). Prevalence of all comorbidities were higher among adults with persistent asthma compared to intermittent asthma. MI, Angina/CHD, obesity, depression, COPD/emphysema/chronic bronchitis, and hypertension were associated with increased odds of persistent asthma. No association was found between diabetes, stroke, and persistent asthma.ConclusionComorbidities are associated with persistent asthma. These findings suggest a need for comprehensive healthcare strategy that address these intertwined health conditions along asthma.
Schisandrin B suppresses colon cancer growth by inducing cell cycle arrest and apoptosis via the CHOP signalling pathway
Authors: Co Vanessa Anna , El-Nezami Hani , Liu Yawen , Twum Bonsra , Dey Priyanka , Cox Paul A , Joseph Shalu , Agbodjan Roland , Sabzichi Mehdi , Draheim Roger , Wan Murphy Lam Yim 
Published: August 2023

AbstractColon cancer is among the most lethal and prevalent malignant tumours in the world, and the lack of effective therapies highlights the need for novel therapeutic approaches. Schisandrin B (Sch B), a lignan extracted from the fruitSchisandra chinensis, has been reported for its anti-cancer properties. However, no studies to date have been done to characterise the exact molecular mechanisms regarding the anti-tumorigenic effect of Sch B in colon cancer. A comprehensive analysis of the molecular mechanism for the anti-tumorigenic effect of Sch B on human colon cancer cells was performed using combination of Raman spectroscopy, RNA-seq, computational docking and molecular biological experiments. Thein vivoefficacy was evaluated by a mouse xenograft model. Sch B reduced cell proliferation and triggered apoptosis in human colon cancer cell lines. Raman spectroscopy, computational, RNA-seq, molecular and cellular studies revealed that Sch B activated unfolded protein responses by interacting with CHOP and upregulating CHOP, which thereby induced apoptosis. CHOP knockdown alleviated the Sch B-induced reduction in cell viability and apoptosis. Sch B reduced colon tumour growthin vivo. Our findings provide essential background for clinical trials examining the effects of Sch B in patients with colon cancer.
Equations describing semi-confluent cell growth (I) Analytical approximations
Authors: Hall Damien 
Published: August 2023

AbstractA set of differential equations with analytical solutions are presented which can quantitatively account for the effects of variable degrees of contact inhibition on cell growth in two- and three-dimensional cultures. The developed equations can be used for comparative purposes when assessing the extent of contribution of higher order effects, such as culture geometry and nutrient depletion, on mean cell growth rate. These equations also offer experimentalists the opportunity to characterize their cell culture growth experiments using a single reductive parameter.
Cadherin Adhesion Complexes Direct Cell Aggregation in the Epithelial Transition of Wnt-Induced Nephron Progenitor Cells
Authors: Der Balint , Bugacov Helena , Briantseva Bohdana-Myroslava , McMahon Andrew P. 
Published: August 2023

AbstractIn the developing mammalian kidney, nephron formation is initiated by a subset of nephron progenitor cells (NPCs). Wnt input activates a β-catenin (Ctnnb1)-driven, transcriptional nephrogenic program. In conjunction, induced mesenchymal NPCs transition through a pre-tubular aggregate to an epithelial renal vesicle, the precursor for each nephron. How this critical mesenchymal-to-epithelial transition (MET) is regulated is unclear. In anin vitromouse NPC culture model, activation of the Wnt pathway results in the aggregation of induced NPCs into closely-packed, cell clusters. Genetic removal of β-catenin resulted in a failure of both Wnt pathway-directed transcriptional activation and the formation of aggregated cell clusters. Modulating extracellular Ca2+levels showed cell-cell contacts were Ca2+-dependent, suggesting a role for cadherin (Cdh)-directed cell adhesion. Molecular analysis identifiedCdh2,Cdh4andCdh11in uninduced NPCs and the up-regulation ofCdh3andCdh4accompanying the Wnt pathway-induced MET. Genetic removal of all four cadherins, and independent removal of α-catenin, which couples Cdh-β-catenin membrane complexes to the actin cytoskeleton, abolished cell aggregation in response to Wnt pathway activation. However, the β-catenin driven inductive transcriptional program was unaltered. Together with the accompanying paper (Bugacovet al., submitted), these data demonstrate that distinct cellular activities of β-catenin - transcriptional regulation and cell adhesion - combine in the mammalian kidney programs generating differentiated epithelial nephron precursors from mesenchymal nephron progenitors.Summary statementOur study highlights the role of Wnt–β-catenin pathway regulation of cadherin-mediated cell adhesion in the mesenchymal to epithelial transition of induced nephron progenitor cells.
Circulating levels of leptin in different phases of the menstrual cycle – a systematic review and meta-analysis
Authors: Panchawagh Suhrud J. , Kumar Pratyush , Srikumar Shabarini , Prajapati Khushi , Sarkar Manali , Abhishek Kumar , Agrawal Poonam , Kaushal G. P. , Martínez Daniel Jesús García , Kalra Swati , Bhutia Euden , Agarwal Aman , Singh Kunika , Sharma Shubhangi , Ashok Tejaswini , Shah Urmil , Shukla Rushikesh , Gupta Sejal , Shaikh Hareem , Soumya K. Sri , S Poorvikha 
Published: August 2023

AbstractLeptin is a peptide hormone synthesized by white adipose tissue. Its principal site of action is in the brainstem and hypothalamus, where it acts to modulate satiety and control of reward and aversion. Leptin deficiency or resistance is associated with dysregulation of cytokine production, increased susceptibility to infections, autoimmune disorders, malnutrition, and inflammatory responses. Studies have shown variation in leptin levels between males and females, and in different phases of the menstrual cycle as well. Our study aims to explain the variation in leptin levels and their physiological role in the menstrual cycle. A total of 1887 records were identified from PubMed, Google Scholar, and Cochrane. We included studies where females were 18-40 years of age, who had achieved menarche, and were on regular menstrual cycles. We excluded studies which were cross-section, pre-prints, or studies where inadequate information was provided. Seven studies were included in the study. We used the standardized mean difference as the outcome measure. Leptin levels varied significantly in the phases of the menstrual cycle as well as during prepubertal, pubertal, and postpubertal phases. The standardized mean difference in leptin levels between the follicular phase and the luteal phase was 2.67 ng/mL (95% CI: 0.16 to 5.19 ng/mL). Fluctuations in leptin levels can cause weight changes and reproductive cycle disturbances. Hence, in cases of infertility with abnormal menstrual cycles, measurement of the physiologic variability in leptin levels may help to diagnose the cause of infertility and appropriate interventions can be started.
Absence of Lipopolysccharide (LPS) expression in Breast Cancer Cells
Authors: de Miranda Noel FCC , Smit Vincent THBM , van der Ploeg Manon , Wesseling Jelle , Neefjes Jacques 
Published: August 2023

AbstractThe association between bacterial activity and tumorigenesis has gained attention in recent years, alongside the well-established link between viruses and cancer. A recent study proposed the presence of intracellular bacteria in cancer cells, particularly in melanomas and breast cancers, with detectable bacterial DNA. The authors suggested that these bacteria contribute to the tumors’ development. We sought to replicate these findings using the same experimental methods on different tissue microarrays. Our investigation included 129 breast cancer samples, but we found no evidence of LPS expression within cancer cells. Instead, LPS immunoreactivity was observed in ducts or immune cells, specifically macrophages. The discrepancies in LPS staining warrant caution in interpreting the reported observations, and further research is needed to elucidate the potential role of intracellular bacteria in cancer development.