bluuebunny/crossref_metadata_2025_split huggingface dataset:
ADP-dependent glucokinase (ADPGK) is not critical for the activation of human macrophages by LPS
Authors: Geiger Benjamin , Wang Bei-Tzu , Munteanu Bogdan , Riedel Jens , Zezina Ekaterina , Biesemann Nadine , Schmoll Dieter 
Published: August 2022

Background:
Activated immune cells show an enhanced glucose metabolism, suggesting that the inhibition of this pathway selective in immune cells could be a potential approach to combat inflammatory diseases. We studied here whether ADP-dependent glucokinase (ADPGK), a glucose-phosphorylating enzyme predominantly expressed in immune cells, could be a suitable target for the inhibition of macrophage activation.

Methods:
The regulation and role of ADPGK in human primary macrophages differentiated from blood monocytes was studied using Real-time quantitative PCR (RT-qPCR), gene silencing, whole-cell MALDI-mass spectrometry (MS) imaging as well as immune-based and enzymatic medium analyzes.

Results:
The expression of ADPGK was induced in response to the activation of toll-like receptors (TLRs). The most robust effect was observed with the TLR4 ligand Lipopolysaccharide (LPS) leading to an approximately 4-fold increase of ADPGK RNA levels. For this induction, the activation of p38 MAPK and IKKε was important. Silencing of ADPGK expression using siRNAs had neither an effect on LPS-induced expression and release of proinflammatory cytokines nor on cellular ATP levels and lactate production. Untargeted metabolic cell profiling by whole-cell MALDI-MS imaging did not reveal any metabolic regulations after ADPGK down-regulation suggesting no specific metabolic pathway involvement.

Conclusions:
ADPGK neither catalyzes a rate-limiting step of glucose metabolism in LPS-activated macrophages nor is required for the proinflammatory phenotype of these cells in vitro. Our data do not indicate that ADPGK inhibition could be a pharmacological approach to modulate immunometabolism.
Severe infections in recipients of cancer immunotherapy: what intensivists need to know
Authors: Joseph Adrien , Lafarge Antoine , Mabrouki Asma , Abdel-Nabey Moustafa , Binois Yannick , Younan Romy , Azoulay Elie 
Published: August 2022

Purpose of review
Given the increased number of cancer patients admitted in the ICU and the growing importance of immunotherapy in their therapeutic arsenal, intensivists will be increasingly confronted to patients treated with immunotherapies who will present with complications, infectious and immunologic.

Recent findings
Apart from their specific immunologic toxicities, cancer immunotherapy recipients also have specific immune dysfunction and face increased infectious risks that may lead to intensive care unit admission.

Summary
Chimeric antigen receptor T-cell therapy is associated with profound immunosuppression and the risks of bacterial, fungal and viral infections vary according to the time since infusion.
Immune checkpoint blockers are associated with an overall favorable safety profile but associations of checkpoint blockers and corticosteroids and immunosuppressive drugs prescribed to treat immune-related adverse events are associated with increased risks of bacterial and fungal infections.
The T-cell engaging bispecific therapy blinatumomab causes profound B-cell aplasia, hypogammaglobulinemia and neutropenia, but seems to be associated with fewer infectious adverse events compared with standard intensive chemotherapy.
Lastly, intravesical administration of Bacillus Calmette-Guérin (BCG) can lead to disseminated BCGitis and severe sepsis requiring a specific antibiotherapy, often associated with corticosteroid treatment.
Bone marrow fibrocytes: villain or white knight in thyroid-associated ophthalmopathy?
Authors: Proctor Erin S. , Smith Terry J. 
Published: August 2022

Purpose of review
We attempt to provide an historical perspective on progress made in understanding the pathogenesis of thyroid-associated ophthalmopathy (TAO), focusing on the roles of orbital fibroblasts (OF) in the diseased orbit (termed GD-OF) and how these cells differ from those residing in the healthy orbit. GD-OF comprise both residential OF and those apparently derived from CD34+ fibrocytes.

Recent findings
CD34+ fibrocytes of the monocyte lineage putatively traffic to the TAO orbit from bone marrow. We believe that these fibroblastic cell populations dictate the activity and severity of TAO. Their impact on disease may be moderated by Slit2, a neuron axon guidance repellent synthesized by and released from residential CD34- OF. Approximately 50% of patients with GD develop clinically meaningful TAO. Relatively few require systemic medical and surgical therapies, while milder disease can be managed with conservative, local care. Determining the intrinsic properties of GD-OF and their expression of Slit2 may explain why some patients with GD develop severe, vision-threatening TAO while others virtually escape any of its manifestations. Such insights should allow for improved and better-tolerated therapies.

Summary
Identifying unique characteristics of fibrocytes and GD-OF subsets reveals their apparent roles in tissue activation, inflammation, and remodeling associated with TAO. Better understanding of these cells, their origins, behavior, and factors modulating their activities remains necessary for the development of more targeted, effective, and safe treatments.
Chlamydia Vaccination: Parent Opinions and Implications for Future Promotion Programs
Authors: Footman Alison , Kanney Nita , Niccolai Linda M. , Zimet Gregory D. , Overton Edgar Turner , Davies Susan L. , Van Der Pol Barbara 
Published: August 2022

Background
Chlamydia vaccines are currently under development and have the potential to lower the incidence of infection and disease, which are highest among adolescents and young adults. Ideally, a chlamydia vaccine would be administered to adolescents before sexual debut, a time when parents are the primary vaccine decision makers. This study explores parent opinions about an adolescent chlamydia vaccine to understand barriers and facilitators to uptake.

Methods
Semistructured interviews were conducted with parents of adolescents. Topics included conversations parents have with their children about chlamydia, opinions on chlamydia vaccine development, and vaccine characteristics, such as efficacy and cost. Interviews were analyzed using a thematic analysis approach.

Results
From March to April 2021, 21 interviews were completed. Few parents discuss chlamydia with their children and sex education was seen as limited. Overall, 16 parents indicated that a chlamydia vaccine is needed. However, there were mixed opinions about vaccinating their own children, related to the need to vaccinate at a young age, vaccine efficacy, and confusion about benefits of vaccination. Finally, healthcare provider recommendations were seen as important before deciding to vaccinate a child.

Conclusions
Although parents think that chlamydia vaccines are needed, lack of awareness about infections and potential benefits of vaccination could serve as barriers to uptake. Healthcare provider recommendations can help to improve knowledge and vaccine uptake. However, there is a need for multilevel approaches to improve chlamydia awareness and ensure that vaccination initiation and completion rates remain high.
Estimating Chlamydia and Gonorrhea Burden Among US Army Soldiers From Military Health System Data: Mind the Gap
Authors: Jordan Nikki N. , Gaydos Joel C. , Garges Eric C. 
Published: August 2022

Background
Reporting systems are commonly used for chlamydia and gonorrhea surveillance and community burden assessments. Estimates are conservative given high proportions of asymptomatic cases and underreporting. The military's unified health system, which includes laboratory and medical encounter data, could offer insight into surveillance gaps and improve burden analyses.

Methods
Confirmed chlamydia and gonorrhea cases reported among active component soldiers were merged with laboratory and medical encounter records indicative of infection to identify incident cases during 2015–2019. Case capture across data systems was assessed, and reported case rates were compared with those derived from the enhanced 3-source database. Attributable medical encounters for total cases were extrapolated using average visits for the subset of cases with supporting encounter data. Multivariable generalized linear models were generated to characterize infections.

Results
Approximately 83% and 76% of respective chlamydia and gonorrhea cases were identified through reporting, compared with 87% and 67% through laboratory records, and 58% for both through medical encounters. Rates from enhanced 3-source surveillance peaked at 2844 chlamydia and 517 gonorrhea cases per 100,000 person-years in 2019, reflecting 17% and 28% increases in respective rates compared with reported rates. Overall, 3163 cases of chlamydia and/or gonorrhea per 100,000 person-years were detected in 2019, affecting 13,004 soldiers and requiring an estimated 21,690 medical encounters. Soldiers who were younger, female, racial/ethnic minorities, nonmarried, enlisted, less educated, and Southern residents had significantly higher risk.

Conclusion
Integration of laboratory and medical encounter data substantially improved burden estimation over reporting alone. Rates generated remain conservative because they only reflect documented cases. Increasing rates support prevention prioritization, particularly among young soldiers.
Monkeypox and Herpes Simplex Virus Type 2 Coinfection: Case Report of Perianal Lesions in HIV-Positive Patient
Authors: Zlámal Milan , Bartovská Zofia , Burantová Anna , Zákoucká Hana , Jiřincová Helena , Chmel Martin , Holub Michal 
Published: August 2022

Abstract
We report a case of monkeypox and herpes simplex type 2 coinfection in an HIV-positive male patient who has sex with men. This case report describes a diagnostic approach for papular rash in the anal area of the male patient who has sex with men with a history of sexually transmitted disease. This is also the first documented case of monkeypox in the Czech Republic, which was confirmed after a retrospective review of swab samples from a previously hospitalized HIV-positive patient.
Building Consensus for a Shared Definition of Adverse Events: A Case Study in the Profession of Dentistry
Authors: Franklin Amy , Kalenderian Elsbeth , Hebballi Nutan , Delattre Veronique , Etoule Jini , White Joel , Vaderhobli Ram , Stewart Denice , Kent Karla , Yansane Alfa , Walji Muhammad 
Published: August 2022

Background
To achieve high-quality health care, adverse events (AEs) must be proactively recognized and mitigated. However, there is often ambiguity in applying guidelines and definitions. We describe the iterative calibration process needed to achieve a shared definition of AEs in dentistry. Our alignment process includes both independent and consensus building approaches.

Objective
We explore the process of defining dental AEs and the steps necessary to achieve alignment across different care providers.

Methods
Teams from 4 dental institutions across the United States iteratively reviewed patient records after identification of charts using an automated trigger tool. Calibration across teams was supported through negotiated definition of AEs and standardization of evidence provided in review. Interrater reliability was assessed using descriptive and κ statistics.

Results
After 5 iterative cycles of calibration, the teams (n = 8 raters) identified 118 cases. The average percent agreement for AE determination was 82.2%. Furthermore, the average, pairwise prevalence and bias-adjusted κ (PABAK) was 57.5% (κ = 0.575) for determining AE presence. The average percent agreement for categorization of the AE type was 78.5%, whereas the PABAK was 48.8%. Lastly, the average percent agreement for categorization of AE severity was 82.2% and the corresponding PABAK was 71.7%.

Conclusions
Successful calibration across reviewers is possible after consensus building procedures. Higher levels of agreement were found when categorizing severity (of identified events) rather than the events themselves. Our results demonstrate the need for collaborative procedures as well as training for the identification and severity rating of AEs.
Critical Care Clinicians’ Experiences of Patient Safety During the COVID-19 Pandemic
Authors: Rosen Amanda , Carter Danielle , Applebaum Jo R. , Southern William N. , Brodie Daniel , Schwartz Joseph , Cornelius Talea , Shelton Rachel C. , Yip Natalie H. , Pincus Harold A. , Hwang Calvin , Cooke Joseph , Adelman Jason S. 
Published: August 2022

Objective
It is unknown how hospital- and systems-level factors have impacted patient safety in the intensive care unit (ICU) during the COVID-19 pandemic. We sought to understand how the pandemic has exacerbated preexisting patient safety issues and created novel patient safety challenges in ICUs in the United States.

Methods
We performed a national, multi-institutional, mixed-methods survey of critical care clinicians to elicit experiences related to patient safety during the pandemic. The survey was disseminated via email through the Society of Critical Care Medicine listserv. Data were reported as valid percentages, compared by COVID caseload and peak of the pandemic; free-text responses were analyzed and coded for themes.

Results
We received 335 survey responses. On general patient safety, 61% felt that conditions were more hazardous when compared with the prepandemic period. Those who took care of mostly COVID-19 patients were more likely to perceive that care was more hazardous (odds ratio, 4.89; 95% CI, 2.49–9.59) compared with those who took care of mostly non–COVID-19 or no COVID-19 patients. In free-text responses, providers identified patient safety risks related to pandemic adaptations, such as ventilator-related lung injury, medication and diagnostic errors, oversedation, oxygen device removal, and falls.

Conclusions
Increased COVID-19 case burden was significantly associated with perceptions of a less safe patient care environment by frontline ICU clinicians. Results of the qualitative analysis identified specific patient safety hazards in ICUs across the United States as downstream consequences of hospital and provider strain during periods of the COVID-19 pandemic.
Teamwork Before and During COVID-19: The Good, the Same, and the Ugly…
Authors: Rehder Kyle J. , Adair K. Carrie , Eckert Erin , Lang Richard W. , Frankel Allan S. , Proulx Joshua , Sexton J. Bryan 
Published: August 2022

Objectives
The COVID 19 pandemic placed unprecedented strain on healthcare systems and workers, likely also impacting patient safety and outcomes. This study aimed to understand how teamwork climate changed during that pandemic and how these changes affected safety culture and workforce well-being.

Methods
This cross-sectional observational study of 50,000 healthcare workers (HCWs) in 3 large U.S. health systems used scheduled culture survey results at 2 distinct time points: before and during the first year of the COVID 19 pandemic. The SCORE survey measured 9 culture domains: teamwork climate, safety climate, leadership engagement, improvement readiness, emotional exhaustion, emotional exhaustion climate, thriving, recovery, and work-life balance.

Results
Response rate before and during the pandemic was 75.45% and 74.79%, respectively. Overall, HCWs reporting favorable teamwork climate declined (45.6%–43.7%, P < 0.0001). At a facility level, 35% of facilities saw teamwork climate decline, while only 4% saw an increase in teamwork climate. Facilities with decreased teamwork climate had associated decreases in every culture domain, while facilities with improved teamwork climate maintained well-being domains and saw improvements in every other culture domain.

Conclusions
Healthcare worker teamwork norms worsened during the COVID-19 pandemic. Teamwork climate trend was closely associated with other safety culture metrics. Speaking up, resolving conflicts, and interdisciplinary coordination of care were especially predictive. Facilities sustaining these behaviors were able to maintain other workplace norms and workforce well-being metrics despite a global health crisis. Proactive team training may provide substantial benefit to team performance and HCW well-being during stressful times.
Airway-Associated Complications With and Without Primary Tracheotomy in Oral Squamous Cell Carcinoma Surgery
Authors: Riekert Maximilian , Rempel Vadim , Keilwerth Stefanie , Zöller Joachim E. , Kreppel Matthias , Schick Volker C. 
Published: August 2022

Purpose:
This study analyzes postoperative airway management, tracheotomy strategies, and airway-associated complications in patients with oral squamous cell carcinoma in a tertiary care university hospital setting.

Material and Methods:
After institutional approval, airway-associated complications, tracheotomy, length of hospital stay (LOHS), and length of intensive care unit stay were retrospectively recorded. Patients were subdivided in primarily tracheotomized and not-primarily tracheotomized. Subgroup analyses dichotomized the not-primarily tracheotomized patients into secondary tracheotomized and never tracheotomized. Associations were calculated using regression analyses. A multivariate regression model was used to determine risk factors for secondary tracheotomy.

Results:
A total of 207 patients were included. One hundred fifty-three patients (73.9%) were primarily tracheotomized. Primarily tracheotomized patients showed longer LOHS [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.01–1.07, P=0.008] but decreased need for reventilation within the intensive care unit stay (OR 0.39, 95% CI 0.15–0.99, P=0.05) compared with not-primarily tracheotomized patients. Within the not-primarily tracheotomized patients, secondary tracheotomized during the hospital stay was needed in 15 of 54 patients (27.8%). In secondary tracheotomized patients, airway management due to respiratory failure was required in 6/15 (40%) patients resulting in critical airway situations in 3/6 (50%) patients. Multivariate regression model showed secondary tracheotomy-associated with bilateral neck dissection (OR 5.93, 95% CI 1.22–28.95, P=0.03) and pneumonia (OR 16.81, 95% CI 2.31–122.51, P=0.005).

Conclusion:
Primary tracheotomy was associated with extended LOHS, whereas secondary tracheotomy was associated with increased complications rates resulting in extended length of intensive care unit stay. Especially in not-primarily tracheotomized patients, careful individualized patient evaluation and critical re-evaluation during intensive care unit stay is necessary to avoid critical airway events.
Excess mortality in Cyprus during the COVID-19 pandemic and its lack of association with vaccination rates
Authors: Lytras Theodore , Athanasiadou Maria , Demetriou Anna , Stylianou Despina , Heraclides Alexandros , Kalakouta Olga 
Published: August 2022

AbstractBackgroundIt has been claimed that COVID-19 vaccination is associated with excess mortality during the COVID-19 pandemic, a claim that contributes to vaccine hesitancy. We examined whether all-cause mortality has actually increased in Cyprus during the first two pandemic years, and whether any increases are associated with vaccination rates.MethodsWe calculated weekly excess mortality for Cyprus between January 2020 and June 2022, overall and by age group, using both a Distributed Lag Nonlinear Model (DLNM) adjusted for mean daily temperature, and the EuroMOMO algorithm. Excess deaths were regressed on the weekly number of confirmed COVID-19 deaths and on weekly first-dose vaccinations, also using a DLNM to explore the lag-response dimension.Results552 excess deaths were observed in Cyprus during the study period (95%CI: 508–597) as opposed to 1306 confirmed COVID-19 deaths. No association between excess deaths and vaccination rates was found overall and for any age group except 18-49 years, among whom 1.09 excess deaths (95%CI: 0.27–1.91) per 10,000 vaccinations were estimated during the first 8 weeks post-vaccination. However, detailed cause-of-death examination identified just two such deaths potentially linked to vaccination, therefore this association is spurious and attributable to random error.ConclusionsExcess mortality was moderately increased in Cyprus during the COVID-19 pandemic, primarily as a result of laboratory-confirmed COVID-19 deaths. No relationship was found between vaccination rates and all-cause mortality, demonstrating the excellent safety profile of COVID-19 vaccines.
How Efficient is the k-means Clustering to Analyze the CT images of Pyogenic and Amoebic Liver Abscess?
Authors: Chattopadhyay Subhagata 
Published: August 2022

AbstractLiver abscesses are well-delineated pus-filled lesions. Two common types are Amoebic liver abscesses (ALA), caused by protozoa called entamoeba histolytica while several pus-forming bacteria cause pyogenic liver abscesses (PLA). Both cause debilitating morbidities and are diagnosed by pus culture-sensitivity tests. A contrast CT abdomen shows well-demarcated lesions in the liver. The telemedicine practice is on the rise where image processing is becoming a part and parcel of teleradiology to fill the gap between the number of radiologists versus the large patient pool. Cluster-based image segmentation is a useful step in grouping the image into the desired number of clusters. The k-means clustering (k-MC) technique is one popular method, used in this study on ALA and PLA contrast CT images. it observes that with the desired 2-clusters – a) normal liver tissue and b) the pus-filled tissue) parameters, the algorithm gives better results in PLA.
The Maine Vein of Marshall Ethanol Experience: Learning Curve, Efficacy, and Safety
Authors: Leyton-Mange Jordan S , Tandon Kunal , Sze Edward Y , Carpenter Charles M , Sesselberg Henry W 
Published: August 2022

AbstractBackgroundThe marginal benefit of ethanol infusion into the VOM as an adjunct to atrial fibrillation ablation has shown promise in a single randomized study and case series from very experienced centers. However, adoption has not been widespread and the impact on real-world outcomes outside of leading centers is not established.ObjectiveTo understand the learning curve, and explore procedural outcomes and safety with VOM ethanol infusion from a large single medical center.MethodsAll atrial ablation cases wherein VOM ethanol infusion was attempted were identified from the time of the program’s inception in 2019 at Maine Medical Center (Portland, ME). Our technical approach, procedural success and efficacy rates, and complications were adjudicated from the medical record.ResultsThe overall VOM ethanol infusion success was 90%. Infusion success rates improved and fluoroscopy utilization decreased with experience. Arrhythmia recurrence was 86% after a mean follow-up of 9.5 months, with an arrhythmia-freedom probability of 80% at 12 months. Complications occurred in 5.4% of patients, including a 3.1% risk of delayed tamponade.ConclusionIn our single center experience, VOM ethanol infusion was feasible with a high technical success rate and excellent arrhythmia freedom in follow-up. These positive results are balanced against a concerning rate of delayed tamponade.