bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of pembrolizumab on T lymphocyte subsets in patients with advanced oral cancer and its therapeutic effect
Authors: Feng Liang , Li Tian-ke , Yin Ke , Zhang Su-xin , Chen Zhong , Bao Yang 
Published: September 2022

Background:
The aim of this study is to investigate changes of peripheral blood lymphocyte subsets before and after treatment with pembrolizumab for advanced oral cancer and its clinical sig-nificance.

Methods:
32 patients with advanced oral cancer who received pembrolizumab treatment were selected as observation group, 30 healthy people during the same period were selected as control group. Before treatment and in cycles 1, 2, 3 and 4 after treatment, fluid cytometry was used to detect changes in levels of lymphocyte subsets in peripheral blood of patients.

Results:
CD3+, CD4+, CD4+/CD8 + indexes of patients with advanced oral cancer before treatment were significantly lower than those in control group (P < .05), CD8 + level was significantly increased (P < .05); After 1 cycle of pembrolizumab treatment, there was no significant difference in changes of lymphocyte subsets compared with before immunotherapy; After 2 and 3 cycles of treatment, CD3+, CD4+, CD4+/CD8 + values were higher than before the treatment (P > .05), CD8 + index was slightly lower than before treatment (P < .05); After fourth cycle of treatment, CD3+, CD4+, CD4+/CD8 + values were significantly improved compared to before treatment (P < .05), CD8 + index was significantly lower than before treatment (P < .05); In treatment process of patients with stable disease (SD)/partial response (PR), the CD3+, CD4+, CD4+/CD8 + values of fourth cycles were higher than before treatment (P < .05), CD8 + index was lower than before treatment (P < .05); During treatment of progressive disease (PD) patients, changes of lymphocyte subsets in fourth cycles were not significantly different from those before treatment (P > .05). This article shows through analysis that expression of programmed cell death ligand 1 (PD-L1) and pathological types have no obvious influence on effect of immunotherapy. Multi-factor analysis shows that it is more meaningful to observe the changes of CD3+, CD4 + and CD8 + at the same time to predict effect of immunotherapy.

Conclusion:
Pembrolizumab can regulate changes of T lymphocyte subsets in patients with advanced oral cancer, improve immune status of patients, there is no obvious adverse reaction. Monitoring changes of lymphocyte subsets during treatment can predict effect of immunotherapy.
Stent retriever thrombectomy in the treatment of basal artery stent thrombosis: Two case reports
Authors: Li Hang , Dai Qinghai , Shu Lingfeng , Wu Tao , Yang Dongyi , Liu Yangyang 
Published: September 2022

Rationale:
Stent thrombosis is a rare but serious complication that requires timely treatment. Catheter thrombectomy is the first-line therapy for this condition; however, it may be challenging for patients with in-stent emboli located in the basilar artery.

Patient concerns:
Herein, we reported 2 cases with stent thrombosis in the vertebrobasilar artery, including their imaging and clinical findings. Both patients were successfully treated with stent retriever thrombectomy.

Diagnosis:
The presence of cerebral infarction was diagnosed by magnetic resonance. Cranial computed tomography excluded cerebral hemorrhage, and basilar artery occlusion was considered in combination with the medical history.

Interventions:
After cerebral angiography confirmed basilar artery occlusion, the stent thrombectomy was used to remove the thrombus.

Outcomes:
The emboli were removed from the stent, and the angiography confirmed that the blood flow in the posterior cerebral circulation was recovered to TICI level 3. Moreover, all symptoms disappeared.

Lessons:
Cerebral vascular stent thrombectomy is a feasible approach for treating cerebral vascular stent thrombosis.
Stress levels of nursing students: A systematic review and meta-analysis
Authors: Zheng Yan-xue , Jiao Jia-Ru , Hao Wen-Nv 
Published: September 2022

Context:
Nursing students experience psychosocial stress in their workplace. Available statistics are at variance, and hence, the need to know the overall prevalence of psychosocial stress among nursing students.

Aims:
This study aimed to determine the prevalence of psychosocial stress among nursing students through meta-analysis.

Materials and methods:
PubMed, Cochrane, Web of Science, CNKI, and China Biomedical Literature Service System were searched for articles. Search terms include “psychosocial stress,” “nursing students.” Articles were included if they used validated psychosocial stress assessment instruments. Of the 15 articles with data on stress prevalence, 8 met all inclusion criteria. Each article was independently reviewed by the authors and relevant data were abstracted. Statistical analysis was done using Revman 4.1.

Results:
Overall, the average score for stress among nursing students was 3.70 (95% confidence interval [CI]: [3.33, 4.06]) based on the analyzed 15 articles with a sample size of 9202.

Conclusion:
This study showed that the stress level of intern nursing students was mainly moderate.
Wingless/integrase-1 signaling in allergic asthma and pediatric lung diseases
Authors: Rai Nooralam , D’Armiento Jeanine 
Published: September 2022

Purpose of review
To provide an update on the current understanding of the role of wingless/integrase-1 (Wnt) signaling in pediatric allergic asthma and other pediatric lung diseases.

Recent findings
The Wnt signaling pathway is critical for normal lung development. Genetic and epigenetic human studies indicate a link between Wnt signaling and the development and severity of asthma in children. Mechanistic studies using animal models of allergic asthma demonstrate a key role for Wnt signaling in allergic airway inflammation and remodeling. More recently, data on bronchopulmonary dysplasia (BPD) pathogenesis points to the Wnt signaling pathway as an important regulator.

Summary
Current data indicates that the Wnt signaling pathway is an important mediator in allergic asthma and BPD pathogenesis. Further studies are needed to characterize the roles of individual Wnt signals in childhood disease, and to identify potential novel therapeutic targets to slow or prevent disease processes.
Navigating diagnostic options for inborn errors of immunity in children: a case-based illustration
Authors: Khan Yasmin W. , Minnicozzi Samantha C. , Lawrence Monica G. 
Published: September 2022

Purpose of review
In recent years, there has been a dramatic increase in the number of recognized inborn errors of immunity (IEI), many of which present in childhood. This review discusses diagnostic approaches for some of the more common presentations of IEI in childhood.

Recent findings
Implementation of newborn screening (NBS) using the T cell receptor excision circle (TREC) assay has led to the timely identification of patients with severe combined immunodeficiency (SCID) as well as both syndromic and nonsyndromic forms of T cell lymphopenia, including DiGeorge syndrome. Improvements in the availability of immunophenotyping assays, genetic testing and advanced diagnostic techniques such as the artificial thymic organoid system can improve diagnostic clarity and impact management plans. Diagnostic improvements in humoral immunodeficiency include development of novel assays to quantify and functionally evaluate polysaccharide vaccine response.

Summary
IEI represent a rapidly growing field, particularly in paediatrics. Use of state-of-the-art diagnostic testing can facilitate rapid identification of IEI, hopefully allowing for initiation of prompt treatment and improved patient outcomes.
Nurse-Reported Staffing Guidelines and Exclusive Breast Milk Feeding
Authors: Lyndon Audrey , Simpson Kathleen Rice , Spetz Joanne , Zhong Jie , Gay Caryl L. , Fletcher Jason , Landstrom Gay L. 
Published: September 2022

Background
Nursing care is essential to overall quality of healthcare experienced by patients and families—especially during childbearing. However, evidence regarding quality of nursing care during labor and birth is lacking, and established nurse-sensitive outcome indicators have limited applicability to maternity care. Nurse-sensitive outcomes need to be established for maternity care, and prior research suggests that the initiation of human milk feeding during childbirth hospitalization is a potentially nurse-sensitive outcome.

Objective
The aim of this study was to determine the relationship between nurse-reported staffing, missed nursing care during labor and birth, and exclusive breast milk feeding during childbirth hospitalization as a nurse-sensitive outcome.

Methods
2018 Joint Commission PC-05 Exclusive Breast Milk Feeding rates were linked to survey data from labor nurses who worked in a selected sample of hospitals with both PC-05 data and valid 2018 American Hospital Association Annual Survey data. Nurse-reported staffing was measured as the perceived compliance with Association of Women’s Health, Obstetric and Neonatal Nurses staffing guidelines by the labor and delivery unit. Data from the nurse survey were aggregated to the hospital level. Bivariate linear regression was used to determine associations between nurse and hospital characteristics and exclusive breast milk feeding rates. Generalized structural equation modeling was used to model relationships between nurse-reported staffing, nurse-reported missed care, and exclusive breast milk feeding at the hospital level.

Results
The sample included 184 hospitals in 29 states and 2,691 labor nurses who worked day, night, or evening shifts. Bivariate analyses demonstrated a positive association between nurse-reported staffing and exclusive breast milk feeding and a negative association between missed nursing care and exclusive breast milk feeding. In structural equation models controlling for covariates, missed skin-to-skin mother–baby care and missed breastfeeding within 1 hour of birth mediated the relationship between nurse-reported staffing and exclusive breast milk feeding rates.

Discussion
This study provides evidence that hospitals’ nurse-reported compliance with Association of Women’s Health, Obstetric and Neonatal Nurses staffing guidelines predicts hospital-exclusive breast milk feeding rates and that the rates are a nurse-sensitive outcome.
Brief Report: Intracellular Cystatin B Levels Are Altered in HIV-Infected Participants With Respect to Neurocognitive Status and Antiretroviral Therapy
Authors: Opsteen Skye , Moylan David , Taiwo Babafemi O. , Robertson Kevin R. , Overton E. Turner , Cutter Gary R. , Sabbaj Steffanie , Heath Sonya L. , Shacka John J. 
Published: September 2022

Abstract:
With advances in HIV treatment, people with HIV (PWH) are living longer but experience aging-related comorbidities, including cognitive deficits, at higher rates than the general population. Previous studies have shown alterations in lysosomal proteins in blood from PWH with severe dementia. However, these markers have not been evaluated in PWH with milder neurocognitive impairment. We sought to determine whether levels of the lysosomal cysteine protease cathepsin B (CatB) and its endogenous inhibitor cystatin B (CysB) were altered in PWH with neurocognitive impairment and whether antiretroviral therapy (ART) further influenced these levels. Peripheral blood mononuclear cells were obtained from the tenofovir arm of a multicenter clinical trial in which ART-naive, HIV+ participants received treatment for 48 weeks (ACTG A5303, NCT01400412). PWH were divided by neurocognitive status (eg, with or without neurocognitive impairment) before ART initiation. Intracellular levels of CatB and CysB were measured in T cells and monocytes by means of flow cytometry. Levels of CysB were significantly decreased in both CD4+ T cells and CD8+ T cells after 48 weeks of ART in HIV+ participants without neurocognitive impairment but not in participants with neurocognitive impairment. Levels of CysB were increased in CD14+ monocytes from the participants with neurocognitive impairment after ART. Levels of CysB and CatB positively correlated regardless of HIV, neurocognitive status, or exposure to ART. These findings suggest that CysB has the potential to provide mechanistic insight into HIV-associated neurocognitive disorders or provide a molecular target for systemic monitoring or treatment of neurocognitive impairment in the context of ART and should be investigated further.
Association Between HIV and Prevalence and Manifestations of Asthma: Analysis of the Multicenter AIDS Cohort Study and Women's Interagency HIV Study
Authors: Drummond M. Bradley , Edmonds Andrew , Ramirez Catalina , Stosor Valentina , Barjaktarevic Igor Z. , Morris Alison , McCormack Meredith C. , Bhatt Surya P. , Alcaide Maria L. , Cribbs Sushma K. , D'Souza Gypsyamber , Bhandari Neha , Kunisaki Ken M. , Huang Laurence , Kassaye Seble G. , Foronjy Robert , Sharma Anjali , Westreich Daniel J. , Adimora Adaora A. 
Published: September 2022

Background:
The association between HIV and asthma prevalence and manifestations remains unclear, with few studies including women.

Setting:
A retrospective observational cohort study from the Multicenter AIDS Cohort Study and Women's Interagency HIV Study.

Methods:
Asthma was defined in 2 ways: (1) self-report and (2) robust criteria requiring all the following: lack of fixed airflow obstruction, presence of wheeze on the St. George's Respiratory Questionnaire (SGRQ), and report of asthma therapies. Estimates of asthma prevalence and asthma-related manifestations were compared by HIV serostatus.

Results:
A total of 1815 men and 2122 women were included. Asthma prevalence did not differ between people with HIV (PWH) and people without HIV regardless of definition: self-report (men, 12.0% vs. 11.2%; women, 24.3% vs. 27.5%) and robust criteria (men, 5.0% vs. 3.4%; women, 12.8% vs. 13.2%). Among men with asthma, worse respiratory symptom burden was reported among those with HIV, regardless of asthma definition. Among women with self-reported asthma, those with HIV had less respiratory symptom burden. Regardless of serostatus, women with robust-defined asthma had similar respiratory symptoms across SGRQ domains and similar frequencies of phlegm, shortness of breath, and wheezing.

Conclusions:
Among PWH and people without HIV, asthma prevalence was 2-fold to 3-fold higher using self-reported definition rather than robust definition. In men and women, HIV was not associated with increased asthma prevalence. In men, HIV was associated with more respiratory symptoms when asthma was self-reported; the relationship was attenuated with the robust criteria. Further studies are needed to explore asthma phenotypes among PWH.
Laboratory Evaluation of the VISITECT Advanced Disease Semiquantitative Point-of-Care CD4 Test
Authors: Lechiile Kwana , Leeme Tshepo B. , Tenforde Mark W. , Bapabi Mbabi , Magwenzi Julita , Maithamako Oitshepile , Mulenga Fredah , Mohammed Terence , Ngidi Julia , Mokomane Margaret , Lawrence David S. , Mine Madisa , Jarvis Joseph N. 
Published: September 2022

Background:
Advanced HIV disease (AHD; CD4 counts <200 cells/µL) remains common in many low- and middle-income settings. An instrument-free point-of-care test to rapidly identify patients with AHD would facilitate implementation of the World Health Organization (WHO) recommended package of care. We performed a laboratory-based validation study to evaluate the performance of the VISITECT CD4 Advanced Disease assay in Botswana.

Setting:
A laboratory validation study.

Methods:
Venous blood samples from people living with HIV having baseline CD4 testing in Gaborone, Botswana, underwent routine testing using flow cytometry, followed by testing with the VISITECT CD4 Advanced Disease assay by a laboratory scientist blinded to the flow cytometry result with a visual read to determine whether the CD4 count was below 200 cells/µL. A second independent investigator conducted a visual read blinded to the results of flow cytometry and the initial visual read. The sensitivity and specificity of the VISITECT for detection of AHD were determined using flow cytometry as a reference standard, and interrater agreement in VISITECT visual reads assessed.

Results:
One thousand fifty-three samples were included in the analysis. The VISITECT test correctly identified 112/119 samples as having a CD4 count <200 cells/µL, giving a sensitivity of 94.1% (95% confidence interval: 88.3% to 97.6%) and specificity of 85.9% (95% confidence interval: 83.5% to 88.0%) compared with flow cytometry. Interrater agreement between the 2 independent readers was 97.5%, Kappa 0.92 (P < 0.001).

Conclusions:
The VISITECT CD4 advanced disease reliably identified individuals with low CD4 counts and could facilitate implementation of the WHO recommended package of interventions for AHD.
Intraoral Approach to Fat Grafting Based on the Mimetic Muscle Unit
Authors: Kim Jin Woo , Lee Jae Hyun , Kim Yong Kyu 
Published: September 2022

Background:
Recently, the concepts of anatomic-based fat grafting and mid-facial anatomy have been studied. However, there is no clear consensus on the optimal fat grafting technique. We aimed to introduce a novel intraoral approach to fat grafting based on mid-facial mimetic muscles, wherein a substantial amount of fat was injected into appropriate locations to increase patient satisfaction and decrease the need for additional surgical techniques.

Methods:
Sixty-four Asian women (mean age, 41.2 y) who had undergone fat grafting through the intraoral approach between 2014 and 2019 were enrolled. We sequentially performed the following steps: fat harvesting, centrifugation, and fat injection. All patients were followed at an outpatient clinic for 6 to 12 months. We obtained photographs of their face before and at 3 and 6 months postoperatively and conducted a 5-point scale questionnaire survey at the 2 time points postoperatively to evaluate the satisfaction of patients and surgeons. We divided the mid-facial areas into malar eminence, infraorbital, and nasolabial fold areas and evaluated the following items: volume consistency, softness, irregularity, and overall satisfaction.

Results:
Patients reported “satisfactory” for the postoperative results. There were only 2 cases of complication among the 64 cases which resolved spontaneously. The highest and lowest satisfaction were reported for the malar eminence and nasolabial fold areas, respectively.

Conclusions:
Fat grafting through the intraoral approach based on the mimetic muscle unit is an effective and safe method for mid-facial rejuvenation.
Estimating the performance of mass testing strategies for COVID-19: a case study for Costa Rica
Authors: Solís Maikol , Pasquier Carlos , Núñez-Corrales Santiago , Madrigal-Redondo Germán , Gatica-Arias Andrés 
Published: September 2022

AbstractDevising effective mass testing strategies to control and suppress COVID-19 pandemic waves make up a complex sociotechnical challenge. It requires a trade-off between performing detection technologies in terms of specificity and sensitivity, and the availability and cost of individual tests per technology. Overcoming this trade-off requires first predicting the level of risk of exposure across the population available. Then selecting testing strategies that match resources to maximize positive case detection and optimize the number of tests and their total cost during sustained mass testing campaigns. In this article, we derive the behavior of four different mass testing strategies, grounded in guidelines and public health policies issued by the Costa Rican public healthcare system. We assume a (privacy-preserving) pre-classifier applied to patient data, Capable of partitioning suspected individuals into low-risk and high-risk groups. We consider the impact of three testing technologies, RT-qPCR, antigen-based testing and saliva-based testing (RT-LAMP). When available, we introduced a category of essential workers. Numerical simulation results confirm that strategies using only RT-qPCR tests cannot achieve sufficient stock capacity to provide efficient detection regardless of prevalence, sensitivity, or specificity. Strategies that harness the power of both pooling and RT-LAMP either maximize stock capacity or detection, efficiency, or both. Our work reveals that investing both in data quality and classification accuracy can improve the odds of achieving pandemic control and mitigation. Future work will concentrate, based on our findings, on constructing representative synthetic data through agent-based modeling and studying the properties of specific pre-classifiers under various scenarios.
The role of peripheral immunity in ALS: a population-based study
Authors: Grassano Maurizio , Manera Umberto , De Marchi Fabiola , Cugnasco Paolo , Matteoni Enrico , Daviddi Margherita , Solero Luca , Bombaci Alessandro , Palumbo Francesca , Vasta Rosario , Canosa Antonio , Salamone Paolina , Fuda Giuseppe , Casale Federico , Mazzini Letizia , Calvo Andrea , Moglia Cristina , Chiò Adriano 
Published: September 2022

AbstractBackgroundSystemic inflammation has been proposed as a relevant mechanism in Amyotrophic Lateral Sclerosis (ALS). Recent evidence shows that an increased inflammatory status correlates with survival in ALS. Still, comprehensive data on ALS patients’ innate and adaptive immune responses and their effect on the clinical phenotype are lacking. Here, we investigate the role and characteristics of systemic immunity in a population-based ALS cohort using readily available hematological indexes that reflect changes in innate and adaptive immunity.MethodsWe collected the complete blood count (CBC) at diagnosis in ALS patients from the Piemonte and Valle d’Aosta Register for ALS (PARALS) from 2007 to 2019. Demographic and clinical data were collected using registry data. Leukocytes populations, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and lymphocyte-to-monocyte ratio (LMR) were derived from CBC. All variables were analyzed for association with clinical features in the entire cohort and then in sex- and age-based subgroups. Logistic, linear and Cox regression models were used as appropriate.ResultsAfter adjustment for relevant covariates, neutrophils (p=0.001) and markers of increased innate immunity (NLR, p=0.008 and SII, p=0.006) were associated with a faster disease progression. Similarly, elevated innate immunity markers correlated with worse pulmonary function and shorter survival. Sex-based differences emerged, as the prognosis in women also correlated with a low lymphocyte (p=0.045) and a decreased LMR (p=0.013). ALS patients with cognitive impairment exhibited lower levels of monocytes (p=0.0415) and, although only in later-onset ALS (age at onset > 70 years), lower lymphocytes (p=0.006) and increased NLR (p=0.021) and SII (p=0.030).Conclusions and RelevanceOur results confirm that a dysregulated systemic immune system participates in ALS progression. More specifically, an elevated innate immune response is associated with faster progression and reduced survival. The immune response varied according to sex and age, thus prompting the speculation that involved immune pathways are patient-specific. Finally, we observed that ALS patients with greater cognitive impairment showed a reduction in monocytes count. Those data revealed that systemic inflammation plays a multifaceted role in ALS: further studies will help translate those findings into clinical practice or targeted treatments.