bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety Outcomes of Direct Discharge Home From ICUs: An Updated Systematic Review and Meta-Analysis (Direct From ICU Sent Home Study)*
Authors: Lau Vincent I. , Donnelly Ryan , Parvez Sehar , Gill Jivanjot , Bagshaw Sean M. , Ball Ian M. , Basmaji John , Cook Deborah J. , Fiest Kirsten M. , Fowler Robert A. , Mailman Jonathan F. , Martin Claudio M. , Rochwerg Bram , Scales Damon C. , Stelfox Henry T. , Iansavichene Alla , Sy Eric J. 
Published: December 2022

Objective:
To evaluate the impact of direct discharge home (DDH) from ICUs compared with ward transfer on safety outcomes of readmissions, emergency department (ED) visits, and mortality.

Data Sources:
We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature from inception until March 28, 2022.

Study Selection:
Randomized and nonrandomized studies of DDH patients compared with ward transfer were eligible.

Data Extraction:
We screened and extracted studies independently and in duplicate. We assessed risk of bias using the Newcastle-Ottawa Scale for observational studies. A random-effects meta-analysis model and heterogeneity assessment was performed using pooled data (inverse variance) for propensity-matched and unadjusted cohorts. We assessed the overall certainty of evidence for each outcome using the Grading Recommendations Assessment, Development and Evaluation approach.

Data Synthesis:
Of 10,228 citations identified, we included six studies. Of these, three high-quality studies, which enrolled 49,376 patients in propensity-matched cohorts, could be pooled using meta-analysis. For DDH from ICU, compared with ward transfers, there was no difference in the risk of ED visits at 30-day (22.4% vs 22.7%; relative risk [RR], 0.99; 95% CI, 0.95–1.02; p = 0.39; low certainty); hospital readmissions at 30-day (9.8% vs 9.6%; RR, 1.02; 95% CI, 0.91–1.15; p = 0.71; very low-to-low certainty); or 90-day mortality (2.8% vs 2.6%; RR, 1.06; 95% CI, 0.95–1.18; p = 0.29; very low-to-low certainty). There were no important differences in the unmatched cohorts or across subgroup analyses.

CONCLUSIONS:
Very low-to-low certainty evidence from observational studies suggests that DDH from ICU may have no difference in safety outcomes compared with ward transfer of selected ICU patients. In the future, this research question could be further examined by randomized control trials to provide higher certainty data.
Concept of older person autonomy: phenomenological study of the opinion of specialist nurses
Authors: Lima Andreia Maria Novo , da Silva Martins Maria Manuela Ferreira , Ferreira Maria Salomé Martins , Fernandes Carla Sílvia , Schoeller Soraia Dornelles , Coelho Adriana Raquel Neves , Parola Vítor Sérgio Oliveira 
Published: December 2022

Abstract

Background: The concept of autonomy is composed of several components, making it a multidimensional concept. This includes cognitive ability, intellectual ability, emotional intelligence, social situation, and physical ability skills. This study aimed to describe the experiences attributed to the meaning of the concept of autonomy, by specialist nurses.

Methods: A descriptive phenomenological study was carried out, according to the Giorgi method. Eighteen nurses were recruited at a hospital in Portugal. Data were collected through individual interviews.

Results: The 18 specialist nurses work on average as nurses for 16years and are specialist nurses; for an average of 5.9years, most are specialist nurses in rehabilitation nursing. From the data analysis, six themes emerged: ability to do, ability to resolve, decision ability, cognitive ability, social integration, and emotional intelligence.

Conclusions: Most professionals perceive the concept as the ability to perform activities of daily living and the ability to make decisions, especially concerning informed consent. It is necessary to raise awareness of the breadth of this concept since the quality of life and dignity of the elderly person depends on autonomy.
Impact of perioperative chemotherapy in the treatment of patients with gastric cancer
Authors: Fonseca Telma , Coimbra Mariana , Santos-Sousa Hugo , Barbosa Elisabete , Barbosa José 
Published: December 2022

Abstract

Background:
Perioperative chemotherapy (PeriCh) is the current standard of care for stage II/III gastric cancer tumors in Europe. However, when it concerns patients who endure complications during PeriCh it is unclear if it increases the risk of postoperative complications and other poorer surgical outcomes. We aim to demonstrate if there is an association between having complications during PeriCh and postoperative complications and histopathological response.

Methods:
We conducted a retrospective, transversal, and observational study, including all patients with diagnosed gastric cancer who underwent PeriCh followed by surgical resection during the period of eight years.

Results:
We included 80 patients with a median age of 64.0years (min 24, max 78). Eighty-eight-point eight percent ended the chemotherapy regime proposed, with a median duration of 42 days, and were also submitted to gastric resection: 58.8% total gastrectomy and 41.2% distal gastrectomy. Twelve-point five percent of the patients had no complications during the PeriCh period and 16.3% had >2 complications. Twenty-five percent of patients had a histological response of <10% of tumor burden, but in 41.3% only regression of <50% could be obtained. No significant association was found between complications during PeriCh and adverse surgical outcomes (P = .497). Patients with complications during PeriCh had slightly higher median time difference from end of PeriCh until surgery, but with no statistical significance (P = .575).

Conclusions:
In our sample, the existence of association between complications during PeriCh and postoperative complications or histological response was not demonstrated.
Diagnosis of pathological conditions through electronic nose analysis of urine samples: a systematic review and meta-analysis
Authors: Afonso Helga A.S. , Farraia Mariana V. , Vieira Mónica A. , Cavaleiro Rufo João 
Published: December 2022

Abstract
Currently available urinalysis methods are often applied for screening and monitoring of several pathologies. However, traditionally analyzed biomarkers in urinalysis still lack sensitivity and specificity to accurately diagnose some diseases. Several studies have proposed the use of electronic noses (eNoses) for the analysis of volatile organic compounds in urine samples that may, directly or indirectly, correlate with certain pathologies. Hence, the aim of this study was to perform a systematic review and meta-analysis of studies concerning the use of portable electronic noses for diagnosis or monitoring of pathologies through analysis of urine samples. A systematic review of the literature was held according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twenty-four articles met the inclusion criteria and were included in the analysis. The results of the revised studies showed that there are various volatile organic compound profiles, identified through eNose analysis, that may be applied for diagnosis or monitoring of several diseases, such as diabetes, urinary tract infection, inflammatory bowel disease, and kidney disease. A meta-analysis was conducted taking into consideration the data of 10 of the initial 24 articles. The pooled sensitivity, specificity, and diagnostic odds ratio were 84% (95% CI, 0.72–0.92), 85% (95% CI, 0.75–0.91), and 24.17 (95% CI: 7.85–74.41), respectively. The area under the receiver operating characteristic curve was 0.897. These results suggest that eNose technology has adequate diagnostic accuracy for several pathologies and could be a promising screening tool for clinical settings. However, more studies are needed to reduce heterogeneity between results.
Noninvasive Ventilation for Acute Respiratory Failure in Pediatric Patients: A Systematic Review and Meta-Analysis
Authors: Boghi Daniele , Kim Kyung Woo , Kim Jun Hyun , Lee Sang-Il , Kim Ji Yeon , Kim Kyung-Tae , Ambrosoli Andrea , Guarneri Giovanni , Landoni Giovanni , Cabrini Luca 
Published: December 2022

OBJECTIVE:
To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) on the use of noninvasive ventilation (NIV) for acute respiratory failure (ARF) in pediatric patients.

DATA SOURCES:
We searched PubMed, EMBASE, the Cochrane Central Register of Clinical Trials, and Clinicaltrials.gov with a last update on July 31, 2022.

STUDY SELECTION:
We included RCTs comparing NIV with any comparator (standard oxygen therapy and high-flow nasal cannula [HFNC]) in pediatric patients with ARF. We excluded studies performed on neonates and on chronic respiratory failure patients.

DATA EXTRACTION:
Baseline characteristics, intubation rate, mortality, and hospital and ICU length of stays were extracted by trained investigators.

DATA SYNTHESIS:
We identified 15 RCTs (2,679 patients) for the final analyses. The intubation rate was 109 of 945 (11.5%) in the NIV group, and 158 of 1,086 (14.5%) in the control group (risk ratio, 0.791; 95% CI, 0.629–0.996; p = 0.046; I
2 = 0%; number needed to treat = 31). Findings were strengthened after removing studies with intervention duration shorter than an hour and after excluding studies with cross-over as rescue treatment. There was no difference in mortality, and ICU and hospital length of stays.

CONCLUSIONS:
In pediatric patients, NIV applied for ARF might reduce the intubation rate compared with standard oxygen therapy or HFNC. No difference in mortality was observed.
GERD after Peroral Endoscopic Myotomy: Assessment of Incidence and Predisposing Factors
Authors: Rassoul Abu-Nuwar Mohamad , Eriksson Sven E , Sarici Inanc S , Zheng Ping , Hoppo Toshitaka , Jobe Blair A , Ayazi Shahin 
Published: December 2022

BACKGROUND:
Peroral endoscopic myotomy (POEM) is an effective intervention for achalasia, but GERD is a major postoperative adverse event. This study aimed to characterize post-POEM GERD and identify preoperative or technical factors impacting development or severity of GERD.

STUDY DESIGN:
This is a retrospective review of patients who underwent POEM at our institution. Favorable outcome was defined as postoperative Eckardt score of 3 or less. Subjective GERD was defined as symptoms consistent with reflux. Objective GERD was based on a DeMeester score greater than 14.7 or Los Angeles grade C or D esophagitis. Severe GERD was defined as a DeMeester score greater than 50.0 or Los Angeles grade D esophagitis Preoperative clinical and objective data and technical surgical elements were compared between those with and without GERD. Multivariate logistic analysis was performed to identify factors associated with each GERD definition.

RESULTS:
A total of 183 patients underwent POEM. At a mean ± SD follow-up of 21.7 ± 20.7 months, 93.4% achieved favorable outcome. Subjective, objective, and severe objective GERD were found in 38.8%, 50.5%, and 19.2% of patients, respectively. Of those with objective GERD, 24.0% had no reflux symptoms. Women were more likely to report GERD symptoms (p = 0.007), but objective GERD rates were similar between sexes (p = 0.606). The independent predictors for objective GERD were normal preoperative diameter of esophagus (odds ratio [OR] 3.4; p = 0.008) and lower esophageal sphincter (LES) pressure less than 45 mmHg (OR 1.86; p = 0.027). The independent predictors for severe objective GERD were LES pressure less than 45 mmHg (OR 6.57; p = 0.007) and obesity (OR 5.03; p = 0.005). The length of esophageal or gastric myotomy or indication of procedure had no impact on the incidence or severity of GERD.

CONCLUSION:
The rate of pathologic GERD after POEM is higher than symptomatic GERD. A nonhypertensive preoperative LES is a predictor for post-POEM GERD. No modifiable factors impact GERD after POEM.
Aminoacyl-tRNA synthetase evolution within the dynamic tripartite translation system of plant cells
Authors: Sloan Daniel B. , DeTar Rachael A. , Warren Jessica M. 
Published: December 2022

ABSTRACTEukaryotes maintain separate protein translation systems for nuclear and organellar genes, including distinct sets of tRNAs and aminoacyl-tRNA synthetases (aaRSs). In animals, mitochondrial-targeted aaRSs are expressed at lower levels and are less conserved in sequence than cytosolic aaRSs involved in translation of nuclear mRNAs, likely reflecting lower translational demands in mitochondria. In plants, translation is further complicated by the presence of plastids, which share most aaRSs with mitochondria. In addition, plant mitochondrial tRNA pools have a dynamic history of gene loss and functional replacement by tRNAs from other compartments. To investigate the consequences of these distinctive features of translation in plants, we analyzed sequence evolution in angiosperm aaRSs. In contrast to previously studied eukaryotic systems, we found that plant organellar and cytosolic aaRSs exhibit only a small difference in expression levels, and organellar aaRSs are slightlymoreconserved than cytosolic aaRSs. We hypothesize that these patterns result from high translational demands associated with photosynthesis in mature chloroplasts. We also investigated aaRS evolution inSileneae, an angiosperm lineage with extensive mitochondrial tRNA replacement and aaRS retargeting. We predicted positive selection for changes in aaRS sequence resulting from these recent changes in subcellular localization and tRNA substrates but found little evidence for accelerated sequence divergence. Overall, the complex tripartite translation system in plant cells appears to have imposed more constraints on the long-term evolutionary rates of organellar aaRSs compared to other eukaryotic lineages, and plant aaRS protein sequences appear largely robust to more recent perturbations in subcellular localization and tRNA interactions.
Impaired Barrier Integrity of the Skeletal Muscle Vascular Endothelium Drives Progression of Cancer Cachexia
Authors: Kim Young-Mee , Sanborn Mark A. , Wang Xinge , Mancinelli Georgina , Chakraborty Sreeparna , Vijeth Shaluah , Gajwani Priyanka , Grippo Paul , Lee Steve Seung-Young , Valyi-Nagy Tibor , Toth Peter T. , Valyi-Nagy Klara , Rehman Jalees 
Published: December 2022

AbstractCancer patients experience cachexia, which is characterized by extensive skeletal muscle wasting that worsens the quality of life and increases mortality. Currently, there are no approved treatments that can effectively counteract cancer cachexia. Vascular endothelial cells (ECs) are essential for maintaining tissue perfusion, nutrient supply, and preventing inappropriate transmigration of immune cells into the tissue. However, little is known about the role of the muscle vasculature in cancer cachexia. We hypothesized that endothelial dysfunction in the skeletal muscle mediates cancer cachexia. Using transgenic pancreatic ductal adenocarcinoma (PDAC) mice and a tissue clearing and high-resolution 3D-tissue imaging approach, we found that the loss of skeletal muscle vascular density precedes the loss of muscle mass. Importantly, we show that cancer cachexia patients exhibit significantly decreased muscle vascular density and severe muscle atrophy when compared to non-cancer patients. Unbiased single cell transcriptomic analyses of the muscle endothelium unveiled a unique EC population present in cachexia muscles. Increased circulating Activin-A suppresses the expression of the transcriptional co-activator PGC1α in the muscle endothelium, thus disrupting junctional integrity in the vasculature and increasing vascular leakage. Conversely, restoration of endothelial-specific PGC1α prevented the decreased vascular density and muscle loss observed in tumor-bearing mice. Our study suggests that EC-PGC1α is essential for maintaining the integrity of the skeletal muscle vascular barrier and that restoring muscle endothelial function could be a valuable therapeutic approach to prevent or reverse cancer cachexia.
Logical modelling of myelofibrotic microenvironment predicts dysregulated progenitor stem cell crosstalk
Authors: Chapman S. P. , Duprez E. , Remy E. 
Published: December 2022

AbstractPrimary myelofibrosis is an untreatable age-related disorder of haematopoiesis in which a break in the crosstalk between progenitor Haematopoietic Stem Cells (HSCs) and neighbouring mesenchymal stem cells causes HSCs to rapidly proliferate and migrate out of the bone marrow. 90% of patients harbour mutations in driver genes that all converge to overactivate hematopoietic JAK-STAT signalling, which is thought to be critical for disease progression, as well as microenvironment modification induced by chronic inflammation. The trigger to the initial event is unknown but dysregulated thrombopoietin (TPO) and Toll-Like Receptor (TLR) signalling are hypothesised to initiate chronic inflammation which then disrupts stem cell crosstalk. Using a systems biology approach, we have constructed an inter and intracellular logical model that captures JAK-STAT signalling and key crosstalk channels between haematopoietic and mesenchymal stem cells. The aim of the model is to decipher how TPO and TLR stimulation can perturb the bone marrow microenvironment and dysregulate stem cell crosstalk. The model predicted conditions in which the disease was averted and established for both wildtype and ectopically JAK mutated simulations. The presence of TPO and TLR are both required to disturb stem cell crosstalk and result in the disease for wildtype. TLR signalling alone was sufficient to perturb the crosstalk and drive disease progression for JAK mutated simulations. Furthermore, the model predicts the probability of disease onset for wildtype simulations that matches clinical data. These predictions might explain why patients who test negative for the JAK mutation can still be diagnosed with PMF, in which continual exposure to TPO and TLR receptor activation may trigger the initial inflammatory event that perturbs the bone marrow microenvironment and induce disease onset.
Quantifying B-cell Clonal Diversity In Repertoire Data
Authors: Pelissier Aurelien , Luo Siyuan , Stratigopoulou Maria , Guikema Jeroen EJ , Martinez Maria Rodriguez 
Published: December 2022

AbstractThe adaptive immune system has the extraordinary ability to produce a broad range of immunoglobulins that can bind a wide variety of antigens. During adaptive immune responses, activated B cells duplicate and undergo somatic hypermutation in their B-cell receptor (BCR) genes, resulting in clonal families of diversified B-cells that can be related back to a common ancestor. Advances in high-throughput sequencing technologies have enabled the high-throughput characterization of B-cell repertoires, however, the accurate identification of clonally related BCR sequences remains a major challenge. In this study, we compare three different clone identification methods on both simulated and experimental data, and investigate their impact on the characterization of B-cell diversity. We find that different methods may lead to different clonal definitions, which in turn can affect the quantification of clonal diversity in repertoire data. Interestingly, we find the Shannon entropy to be overall the most robust diversity index in regard to different clonal identification. Our analysis also suggests that the traditional germline gene alignment-based method for clonal identification remains the most accurate when the complete information about the sequence is known, but that alignment-free methods may be preferred for shorter read length. We make our implementation freely available as a Python librarycdiversity.
Leveraging a machine learning derived surrogate phenotype to improve power for genome-wide association studies of partially missing phenotypes in population biobanks
Authors: McCaw Zachary R. , Gao Jianhui , Lin Xihong , Gronsbell Jessica 
Published: December 2022

AbstractWithin population biobanks, genetic discovery for specialized phenotypes is often limited by incomplete ascertainment. Machine learning (ML) is increasingly used to impute missing phenotypes from surrogate information. However, imputing missing phenotypes can invalidate statistical inference when the imputation model is misspecified, and proxy analysis of the ML-phenotype can introduce spurious associations. To overcome these limitations, we introduce SynSurr, an approach that jointly analyzes a partially missing target phenotype with a “synthetic surrogate”, its predicted value from an ML-model. SynSurr estimates the same genetic effect as standard genome-wide association studies (GWAS) of the target phenotype, but improves power provided the synthetic surrogate is correlated with the target. Unlike imputation or proxy analysis, SynSurr does not require that the synthetic surrogate is obtained from a correctly specified generative model. We perform extensive simulations and an ablation analysis to compare SynSurr with existing methods. We also apply SynSurr to empower GWAS of dual-energy x-ray absorptiometry traits within the UK Biobank, leveraging a synthetic surrogate composed of bioelectrical impedance and anthropometric traits.
Art therapy is associated with a reduced rate of restrictive practices on an inpatient child and adolescent mental health unit
Authors: Versitano Sarah , Shvetcov Artur , Paton Joy , Perkes Iain 
Published: December 2022

AbstractBackgroundThe elimination of seclusion and restraint, that is, restrictive practices, is a major aim of mental health services globally. The role of art therapy, a predominantly non-verbal mode of creative expression, is under-explored in this context.AimsTo determine whether art therapy service provision was associated with a reduction in restrictive practices on an acute inpatient child and adolescent mental health services (CAMHS) unit.MethodsThe rate (events per 1,000 occupied bed days), frequency (percent of admitted care episodes with incident), duration, and total number of incidents of restrictive practices occurring between July 2015 – December 2021 were analysed in an ABAB design. The rate, frequency and number of incidents of intramuscular injected (IM) sedation, oral PRN (as-needed medication) use, and absconding incidents occurring in conjunction with an episode of seclusion or restraint were also analysed.ResultsThe rate, frequency, duration, and total number of incidents of seclusion, the frequency and total number of incidents of physical restraint, and the rate, frequency and total number of incidents of IM sedation showed a statistically significant decrease during phases of art therapy service provision.ConclusionsArt therapy service provision is associated with reduced use of restrictive practices in inpatient CAMHS.