bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracellular Vesicle Secretion by Leukemia Cells In Vivo Promotes CLL Progression by Hampering Antitumor T-cell Responses
Authors: Gargiulo Ernesto , Viry Elodie , Morande Pablo Elías , Largeot Anne , Gonder Susanne , Xian Feng , Ioannou Nikolaos , Benzarti Mohaned , Kleine Borgmann Felix Bruno , Mittelbronn Michel , Dittmar Gunnar , Nazarov Petr V. , Meiser Johannes , Stamatopoulos Basile , Ramsay Alan G. , Moussay Etienne , Paggetti Jérôme 
Published: September 2022

Abstract

Small extracellular vesicle (sEV, or exosome) communication among cells in the tumor microenvironment has been modeled mainly in cell culture, whereas their relevance in cancer pathogenesis and progression in vivo is less characterized. Here we investigated cancer–microenvironment interactions in vivo using mouse models of chronic lymphocytic leukemia (CLL). sEVs isolated directly from CLL tissue were enriched in specific miRNA and immune-checkpoint ligands. Distinct molecular components of tumor-derived sEVs altered CD8+ T-cell transcriptome, proteome, and metabolome, leading to decreased functions and cell exhaustion ex vivo and in vivo. Using antagomiRs and blocking antibodies, we defined specific cargo-mediated alterations on CD8+ T cells. Abrogating sEV biogenesis by Rab27a/b knockout dramatically delayed CLL pathogenesis. This phenotype was rescued by exogenous leukemic sEV or CD8+ T-cell depletion. Finally, high expression of sEV-related genes correlated with poor outcomes in CLL patients, suggesting sEV profiling as a prognostic tool. In conclusion, sEVs shape the immune microenvironment during CLL progression.

Significance:
sEVs produced in the leukemia microenvironment impair CD8+ T-cell mediated antitumor immune response and are indispensable for leukemia progression in vivo in murine preclinical models. In addition, high expression of sEV-related genes correlated with poor survival and unfavorable clinical parameters in CLL patients.
See related commentary by Zhong and Guo, p. 5.
This article is highlighted in the In This Issue feature, p. 1
A new bee species of the genus Dasypoda Latreille (Hymenoptera, Apoidea) from Northwest Africa with comparative remarks on the subgenus Microdasypoda Michez
Authors: RADCHENKO VLADIMIR G. , GHISBAIN GUILLAUME , MICHEZ DENIS 
Published: September 2022

North Africa, with its vast array of ecosystems and reliefs, constitutes a remarkable place to explore and describe the diversity of wild bees. In this paper, a new bee species of the genus Dasypoda Latreille (Hymenoptera, Apoidea, Melittidae), D. schwarzi Radchenko et Michez sp. nov., is described from the Atlas Mountains area (Morocco and Tunisia). This species belongs to the subgenus Microdasypoda Michez and is phenotypically related to D. brevicornis Pérez, but differs from all other species of this subgenus by the structure of the male genitals, the metasomal sterna, and by its overall hair colour. A detailed comparative diagnosis of D. schwarzi with the other four species of this subgenus is provided, as well as a key to the males of Microdasypoda, and a correction to the diagnosis of the subgenus. This new species is the fortieth described Dasypoda species and should be looked for in other mountain regions of Northwest Africa, such as in the Algerian Atlas where it could be present.
The health of mothers of children with a life-limiting condition: A qualitative interview study
Authors: Fisher Victoria , Atkin Karl , Fraser Lorna K 
Published: September 2022

Background: The number of children with a life-limiting condition is increasing. The mothers of these children commonly provide extensive care at home for their child and are at a higher risk of poor health than other mothers. The impact of this is rarely explored from mothers’ perspectives. Aim: To explore mothers’ accounts of their physical and mental health, experiences of accessing healthcare and who they think should support their health. Design: Qualitative semi-structured interviews were conducted and analysed using thematic analysis. Setting/participants: Thirty mothers of children with a life-limiting condition were recruited via three UK children’s hospices and social media. Results: Mothers felt that their health concerns could be misunderstood by professionals, describing untimely and inappropriate support that failed to recognise the nature of caring for a child with a life-limiting condition. This led to mothers’ reluctance in addressing these concerns. Mothers felt unable to prioritise their own needs, relative to those of their child and worried about who would look after their child if they did become unwell. They described stress as a result of battles with services rather than as a result of caregiving. Mothers valued feeling recognised as caregivers, which made it easier to look after their health alongside their child’s. Hospice support was particularly valuable in this respect. Conclusions: A more unified system that recognises not only the unique set of challenges presented to mothers caring for a child with a life-limiting condition, but the value of palliative care services in supporting these mothers, is required.
Influence of the area of the aqueduct and region of interest on quantification of stroke volume in healthy volunteers using phase-contrast cine magnetic resonance imaging
Authors: Zhang Hongri , Yang Haixin , Duan Weike , Li Xiaopan , Wang Yixin , Cogswell Petrice M , Elder Benjamin D 
Published: September 2022

Background Phase-contrast cine magnetic resonance imaging (PC-MRI) has been used to measure cerebrospinal fluid (CSF) flow dynamics, but the influence of the area of the aqueduct and region of interest (ROI) on quantification of stroke volume (SV) has not been assessed. Purpose To assess the influence of the area of the ROI in quantifying the aqueductal SV measured with PC-MRI within the cerebral aqueduct. Material and Methods Nine healthy volunteers (mean age = 29.6 years) were enrolled in the study, and brain MRI examinations were performed on a 3.0-T system. Quantitative analysis of the aqueductal CSF flow was performed using manual ROI placement. ROIs were separately drawn for each of the 12 phases of the cardiac cycle, and changes in aqueduct size during the cardiac cycle were determined. The SV was calculated using 12 different aqueductal ROIs and compared with the SV calculated using a fixed ROI size. Results There was variation in the size of the aqueduct during the cardiac cycle. In addition, the measured SV increased with a greater area of the ROI. A significant difference in the calculated SVs with the 12 variable ROIs was observed compared with that using a fixed ROI throughout the cardiac cycle. Conclusion To establish reliable reference values for the SV in future studies, a variable ROI should be considered.
Caregiver Observations of Infant Well-Being Before and After Cleft Lip Surgery
Authors: Rosenberg Janine M. , Bellucci Claudia Crilly , Edwards Todd C. , Heike Carrie L. , Leroux Brian G. , Jones Salene M. , Stueckle Laura P. , Patrick Donald L. , Albert Meredith , Aspinall Cassandra L. , Kapp-Simon Kathleen A. 
Published: September 2022

Objective To evaluate the sensitivity to change of daily ratings of the comfort (COMF) and behavioral/emotional health (BEH) domains of the Infants with Clefts Observation Outcomes Instrument (iCOO) at 3 time points, and to assess the association of post-surgical interventions on iCOO ratings. Design The COMF and BEH domains were completed by caregivers before (T0), immediately after (T1), and 2-months after (T2) cleft lip (CL) surgery. Analyses included descriptive statistics, correlations, t-tests, and generalized estimating equations. Participants Caregivers ( N  =  140) of infants with CL with/without cleft palate. Main Outcome Measures The COMF and BEH domain scores of the iCOO: Scale (SCALE), a summary of observable signs; and Global Impression (IMPR), a single item measuring caregivers’ overall impression. Results Daily COMF and BEH SCALE and IMPR scores changed significantly during T1 ( P's < 0.001) but not T0 or T2. Day 1 and 7 T0 scores were significantly higher than Day 1 and 7 T1 scores ( P's <0.001 to <0.012) but similar at T2 ( P's > 0.05). After CL surgery, the combined use of immobilizers and nasal stents and the use of multiple feeding methods with treatment for gastroesophageal reflux were associated with lower daily scores in COMF and BEH SCALE and IMPR ( P's: 0.040 to <0.001). Conclusions COMF and BEH iCOO scores were sensitive to daily changes in infant well-being following CL surgery. Future studies should further investigate impact of post-surgical treatments on infant well-being.
Catheter-related complications in onco-hematologic children: A retrospective clinical study on 227 central venous access devices
Authors: Annetta Maria Giuseppina , Celentano Davide , Zumstein Lucrezia , Attinà Giorgio , Ruggiero Antonio , Conti Giorgio , Pittiruti Mauro 
Published: September 2022

Background: The use of central venous access devices (CVADs) is of paramount importance to safely deliver antiblastic and support therapies in children with cancer. Though, in pediatric patients, as much as in adults, CVADs are potentially associated with severe complications which may result in unscheduled interruption of therapy, hospitalization, increased morbidity/mortality, and increased cost of care. Methods: We have reviewed retrospectively our experience with CVADs in children with solid tumors and hematologic diseases, with the purpose of verifying if the adoption of well-defined insertion and maintenance bundles might be effective in reducing catheter-related complications, and in particular catheter-related thrombosis. Results: A total of 227 CVADs were analyzed: 175 peripherally inserted central catheters (PICCs), 50 centrally inserted central catheters (CICCs), and 2 femorally inserted central catheters. All CVADs were non-valved, non-cuffed power injectable polyurethane catheters; 81% were tunneled. Median dwelling time of CVADs was 172 days, for a total number of 39,044 catheter days. A very low incidence of both symptomatic catheter-related thrombosis (0.9%) and catheter-related blood stream infection (0.56 episodes per 1000 catheter days) was found. Unscheduled removal or guidewire replacement because of mechanic complications occurred in 15.7% of CVADs. There was no difference in terms of complications between PICCs and CICCs or between tunneled and non-tunneled catheters. Conclusions: Our experience with CVADs in oncologic and hematologic children suggests that catheter-related complications may be minimized by the adoption of appropriate insertion and maintenance bundles.
Dual Institutional Experience with Transcarotid Artery Revascularization
Authors: George Mitchell J , Husman Regina , Dakour-Aridi Hanaa , Tanaka Akiko , Madison Mackenzie , Motaganahalli Raghu , Leckie Katherin , Wang S Keisin 
Published: September 2022

Introduction Transcarotid artery revascularization (TCAR) is a hybrid open and endovascular technique to treat carotid stenosis. The purpose of this study is to present a large cohort of patients who underwent TCAR at 2 high-volume TCAR health systems. Methods This study was a retrospective chart review of all instances of TCAR within the Memorial Hermann Health System and Indiana University Health, from December 2015-January 2022, using the ENROUTE Neuroprotection Device (Silk Road Medical, Sunnyvale, CA). We report patient demographics, intraoperative metrics, 30-day results and long-term results. Results In all, 750 patients underwent TCAR in the designated time period. Average patient age was 73 years, with 68% being male. Overall, 53.9% of patients had coronary artery disease, 45.4% had diabetes, and 36.9% were symptomatic. Technical success was achieved in 98.8% of patients with conversion to open endarterectomy in 1.1%. Average reverse flow time was 9.1 minutes with length of stay greater than 1 day 38%. Ipsilateral stroke rate within 30 days was 2.3% and long-term cumulative stroke rate was 3.0%. Death within 30 days occurred in 1.2% of patients and in 5.9% over long-term follow up. In all, 1% of patients required reintervention. Conclusions TCAR is a safe and effective treatment modality for carotid artery stenotic disease. Its outcomes are similar to historical results associated with carotid endarterectomy, long considered the gold standard.
Concurrent valve replacement and caesarean section for rheumatic mitral valve disease with refractory heart failure in late pregnancy
Authors: Pande Swaraj N , Munuswamy Hemachandren , Rath Durga P , Prasad Sreevathsa KS , Baghel Jyoti , Pillai Ajith A , Parida Satyen , Mondal Nivedita , Keepanasseril Anish 
Published: September 2022

Objective To assess clinical characteristics and outcomes of women who underwent concurrent valve replacement with caesarean section for severe rheumatic mitral valve disease with refractory heart failure. Methods All women admitted to a single centre from 2011 to 2020 with severe rheumatic mitral valve disease, having recurrent episodes of pulmonary edema on optimal medical therapy and contraindication to percutaneous balloon mitral valvotomy, who underwent concurrent valve replacement (for native valve disease) along with caesarean section, were included. Results Among 1300 pregnancies with rheumatic heart disease, six underwent the concurrent procedure. All had replacement of mitral valve except one who had both aortic and mitral valve replacements, between 33 and 39 weeks of gestation. There were no maternal deaths, and there was one neonatal loss from late-onset sepsis. Conclusion Pregnant women with severe rheumatic mitral valve disease with refractory heart failure, unsuitable for minimal access interventions, can be considered for a concurrent valve replacement with caesarean section.
Gender disparity and stigma experience of patients with chronic hepatitis B virus infection: A prospective cross-sectional study from a hospital in Nigeria
Authors: Adekanle Olusegun , Komolafe Akinwumi Oluwole , Ijarotimi Oluwasegun , Olowookere Anu Samuel , Ndububa Dennis A 
Published: September 2022

Backgound Hepatitis B virus (HBV) infected persons often suffer stigma. Stigma can come from the society or be self-induced. This study assessed the gender differences and stigma experience of patients with HBV. Methods Prospective cross-sectional design with a qualitative element using a pretested interviewer administered questionnaire and an in-depth oral interview of HBV infected patients. Quantitative data obtained were entered into SPSS version 20 and analyzed using simple descriptive and inferential statistics, while content analysis was used for the qualitative data. Results Total of 242 respondents answered the quantitative questionnaire. There were 142(58.7%) males and 100 (41.3%) females; age range was 18–72 years with mean (SD) of 35.4(10.7) years. Overall stigma rate was 23.1%. Stigma resulted from a positive HBsAg test, and the experience was unaffected by other markers of HBV infection. Stigma was higher in the domain of disease transmission for both single and married respondents and was particularly higher among males than females. Stigma among females affected pre-marital engagements and also caused marital disharmony among married respondents. In-depth oral interview of 23 HBV infected respondents revealed that many exhibited self-stigma, had wrong knowledge of HBV infection modes, complications, and interpretation of HBV internet information which aggravated stigma reactions. Conclusions Stigma of HBV is high and majorly in the domain of disease transmission. It is higher in males than females. Enlightenment campaign targeting singles and married couples and HBV infection modes is advocated.
Fertility desire of HIV-positive men and women in public health hospitals
Authors: Tilahun Wassie Semahegn , Marye Yimam Shimels , Birhanu Fentaw Tesfaye 
Published: September 2022

Objective: Despite the increased emphasis on antiretroviral therapy and other healthcare services for HIV-infected individuals, issues of fertility desire have received relatively little attention. In particular, little is known about actual fertility desire and determinants of fertility desires among HIV-infected women and men receiving antiretroviral therapy. Methods: A cross-sectional study was conducted among HIV-positive individuals in public health hospitals of Addis Ababa City from 1 October to 30 November 2021. A pretested structured questionnaire was used to collect the data with a consecutive sampling technique. EpiData 4.6.2 and SPSS 25 were used for data entry and analysis. Bivariate and multivariable logistic regression analyses were done to identify factors associated with fertility desire. An adjusted odds ratio with a 95% confidence interval was computed for data interpretation. A p value of ⩽0.05 was considered to be statistically significant. Result: Among 400 participants, 55% (95% confidence interval = 50%, 60%) have future fertility desire. Factors like age less than 35 years (adjusted odds ratio = 24.03, 95% confidence interval = 9.99, 57.83), a secondary education level (adjusted odds ratio = 2.78, 95% confidence interval = 1.21, 6.40), being married (adjusted odds ratio = 2.89, 95% confidence interval = 1.39, 5.99), being employed (adjusted odds ratio = 3.12, 95% confidence interval = 1.56, 6.24), being diagnosed with HIV in the past 1 year (adjusted odds ratio = 4.02, 95% confidence interval 2.07, 7.80) or past 2–4 years (adjusted odds ratio = 9.80, 95% confidence interval = 3.89, 26.02) have a significant association with future fertility desire. Respondents using contraceptives were 90.9% less likely to have future fertility desire (adjusted odds ratio = 0.09, 95% confidence interval = 0.05, 0.18). Conclusion: The magnitude of future fertility desire was founded high. Further research on this topic should include qualitative studies to provide a deeper understanding of people living with HIV fertility desires.
Tunneled hemodialysis catheter insertion: Above, within, or below the right atrium—Where is the tip?
Authors: Auer Jonas , Braun Joachim , Lenk Julian , Gollrad Johannes , Ro Sa-Ra , Hamm Bernd , de Bucourt Maximilian 
Published: September 2022

Background One major challenge when inserting a tunneled, cuffed central venous catheter (CVC) for hemodialysis under fluoroscopy is to accurately place the catheter tip by assessing its position in relation to the cardiac silhouette to approximate the right atrium (RA). Purpose To investigate whether a weighted mean calculated from published results for two two-dimensional landmark reference distances may be useful in assessing CVC tip positions in relation to the RA. Material and Methods Central venous catheter tip positions attained under fluoroscopic imaging during insertion using the cardiac silhouette as approximation were retrospectively related to two reference distances (carina to cranial RA border and craniocaudal RA extent), which were used to group catheter tip locations above (1), within (2), or below (3) the RA (henceforth referred to as landmark technique approximation, LTA). The LTA-derived catheter tip locations were validated by correlation with postinterventional computed tomography (CT) datasets acquired shortly after implantation (if available). Results Based on LTA, 45 catheter tips (10.6%) were above, 179 (42.2%) within, and 200 (47.2%) below the RA. Postinterventional CT ( n = 57; 13.4%) visualized 26.3% above, 66.7% within, and 7.0% below the RA. Conclusion The LTA reference distances appear to lead to a rather low categorization of the CVC tips, or the tips have been placed rather low in the study population. Validation using postinterventional CT indicated an underestimation of the RA in the LTA. Patient characteristics with a higher risk of false estimation through LTA have been defined.
Management and Scheduling of Spine Surgery in a Level 1 Trauma Center in the Setting of the COVID-19 Pandemic: Feasibility and Considerations for Reimplementation of Elective Spine Surgery
Authors: Crawford Zachary , Elson Nora C. , Kanhere Arun , Thomson Cameron , Sabbagh Ramsey , Nasser Rani , Guanciale Anthony F. 
Published: September 2022

Introduction Determination of what constitutes necessary surgery in the setting of acute hospital resource strain during the COVID-19 pandemic is an unprecedented challenge for healthcare systems. Over the past two years during the COVID-19 pandemic, there have been many changes in reviews of medically necessary spine surgery. There continues to be no clear guidelines on recommendations and further discussion is necessary to continue to provide appropriate and high-level care during future pandemics. Significance This review critically appraises and evaluates current barriers to medically necessary spine surgery during the COVID-19 pandemic and evaluates future decision making to maintain spine surgery during future pandemics or limitations in medical care. Results Multiple studies included in this review have shown that while various orthopaedic surgeries may be considered elective, medically necessary spine surgery will need to continue during settings of limited medical care. This review discussed multiple methods and recommendations to limit transmission of virus from patients to providers and providers to patients. Conclusion Continued medically necessary spine surgery in the setting of the COVID-19 pandemic and future pandemics should continue while limiting risk of transmission to continue providing high-level medical care and allowing hospitals to maintain financial responsibility.
Driving Environment Uncertainty-Aware Motion Planning for Autonomous Vehicles
Authors: Tang Xiaolin , Yang Kai , Wang Hong , Yu Wenhao , Yang Xin , Liu Teng , Li Jun 
Published: September 2022

AbstractAutonomous vehicles require safe motion planning in uncertain environments, which are largely caused by surrounding vehicles. In this paper, a driving environment uncertainty-aware motion planning framework is proposed to lower the risk of position uncertainty of surrounding vehicles with considering the risk of rollover. First, a 4-degree of freedom vehicle dynamics model, and a rollover risk index are introduced. Besides, the uncertainty of surrounding vehicles' position is processed and propagated based on the Extended Kalman Filter method. Then, the uncertainty potential field is established to handle the position uncertainty of autonomous vehicles. In addition, the model predictive controller is designed as the motion planning framework which accounts for the rollover risk, the position uncertainty of the surrounding vehicles, and vehicle dynamic constraints of autonomous vehicles. Furthermore, two edge cases, the cut-in scenario, and merging scenario are designed. Finally, the safety, effectiveness, and real-time performance of the proposed motion planning framework are demonstrated by employing a hardware-in-the-loop experiment bench.