bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design, development, and deployment of an indication- and kidney function-based decision support tool to optimize treatment and reduce medication dosing errors
Authors: Hirsch Jamie S , Brar Rajdeep , Forrer Christopher , Sung Christine , Roycroft Richard , Seelamneni Pradeep , Dabir Hemala , Naseer Ambareen , Gautam-Goyal Pranisha , Bock Kevin R , Oppenheim Michael I 
Published: June 2021

AbstractDelivering clinical decision support (CDS) at the point of care has long been considered a major advantage of computerized physician order entry (CPOE). Despite the widespread implementation of CPOE, medication ordering errors and associated adverse events still occur at an unacceptable level. Previous attempts at indication- and kidney function-based dosing have mostly employed intrusive CDS, including interruptive alerts with poor usability. This descriptive work describes the design, development, and deployment of the Adult Dosing Methodology (ADM) module, a novel CDS tool that provides indication- and kidney-based dosing at the time of order entry. Inclusion of several antimicrobials in the initial set of medications allowed for the additional goal of optimizing therapy duration for appropriate antimicrobial stewardship. The CDS aims to decrease order entry errors and burden on providers by offering automatic dose and frequency recommendations, integration within the native electronic health record, and reasonable knowledge maintenance requirements. Following implementation, early utilization demonstrated high acceptance of automated recommendations, with up to 96% of provided automated recommendations accepted by users.
Kimura’s disease: a rare cause of chronic neck lymphadenopathy
Authors: Kok Kenneth Y Y , Lim Edwin C C 
Published: June 2021

AbstractKimura’s disease is a rare chronic inflammatory disorder of unknown etiology which typically presents with subcutaneous nodules in the head and neck region and is frequently associated with regional lymphadenopathy or salivary gland enlargement. Peripheral blood eosinophilia and elevated serum immunoglobulin E levels are constant features of the disease. We present herein a 31-year-old male patient who presented with chronic neck lymphadenopathy. Kimura’s disease was diagnosed on fine needle aspiration cytology, the patient initially decided not to have further intervention. He presented 6 years later with lymphadenopathy and was treated with surgery. The diagnosis of Kimura’s disease was confirmed on histopathology. This patient had the disease for 6 years and did not have the typical features of peripheral eosinophilia and raise serum IgE level.
Diagnostic Evaluation of Hypoglycemia Due To an Insulinoma in a Deployed Infantryman: Significance of Neuroglycopenia and the Role of the Military Health System
Authors: Olatunbosun Samuel T , Alaketu Ayodeji F , McDermott Joseph H , Elsayed von Bayreuth Al M 
Published: July 2021

ABSTRACT
Insulinoma, the prototype of endogenous hyperinsulinemic hypoglycemia, is a very rare condition, with an incidence of four cases per million person-years. Its rate of occurrence in the U.S. military population is unknown. Two cases of insulinomas involving active duty service members have been published. However, there has been no reported case of an insulinoma in a deployed service member. We report the case of a 21-year-old infantryman with clinical hypoglycemia of insidious onset, manifesting with overt neuroglycopenic symptoms during his deployment as a combatant soldier, and the ultimate diagnosis of an insulinoma as the underlying cause. The series of multiple clinical evaluations and the unique circumstances leading to the formal evaluation of the patient’s hypoglycemia and treatment are chronicled. The significance of neuroglycopenia and the diagnostic approach to any suspected case of hypoglycemia, the potential challenges and opportunities, and educational aspects of evaluation and management of the insulinoma are elaborated. The potential role of the Military Health System in facilitating the detection and treatment of this rare condition in the service member is discussed as well.
An inventory of atomic species in the atmosphere of WASP-121b using UVES high-resolution spectroscopy
Authors: Merritt Stephanie R , Gibson Neale P , Nugroho Stevanus K , de Mooij Ernst J W , Hooton Matthew J , Lothringer Joshua D , Matthews Shannon M , Mikal-Evans Thomas , Nikolov Nikolay , Sing David K , Watson Chris A 
Published: June 2021

ABSTRACT
Ultrahot Jupiters (UHJs) present excellent targets for atmospheric characterization. Their hot dayside temperatures (T ≳ 2200 K) strongly suppress the formation of condensates, leading to clear and highly inflated atmospheres extremely conducive to transmission spectroscopy. Recent studies using optical high-resolution spectra have discovered a plethora of neutral and ionized atomic species in UHJs, placing constraints on their atmospheric structure and composition. Our recent work has presented a search for molecular features and detection of Fe i in the UHJ WASP-121b using Very Large Telescope (VLT)/UV–Visual Echelle Spectrograph (UVES) transmission spectroscopy. Here, we present a systematic search for atomic species in its atmosphere using cross-correlation methods. In a single transit, we uncover potential signals of 17 atomic species that we investigate further, categorizing five as strong detections, three as tentative detections, and nine as weak signals worthy of further exploration. We confirm previous detections of Cr i, V i, Ca i, K i, and exospheric H i and Ca ii made with the High Accuracy Radial velocity Planet Searcher (HARPS) and the Echelle SPectrograph for Rocky Exoplanets and Stable Spectroscopic Observations (ESPRESSO), and independently re-recover our previous detection of Fe i at 8.8σ using both the blue and red arms of the UVES data. We also add a novel detection of Sc ii at 4.2σ. Our results further demonstrate the richness of UHJs for optical high-resolution spectroscopy.
Endoscopic Third Ventriculostomy With “Rescue” Fourth Ventriculocisternostomy: 2-Dimensional Operative Video
Authors: Goldberg Jacob L , Carnevale Joseph A , Rapoport Benjamin , Garton Andrew L A , Bander Evan , Souweidane Mark M 
Published: June 2021

Abstract
This case of endoscopic third ventriculostomy (ETV) and flexible endoscopy for lysis of fourth ventricle adhesions for obstructive hydrocephalus illustrates a key anatomical variant (anastomosis of posterior communicating arteries) that increases the difficulty of ETV and should be recognized preoperatively. The video further demonstrates flexible endoscopy for lysis of a fourth ventricular web and excellent third and fourth ventricular anatomy. This patient presented with normal pressure hydrocephalus-like symptoms and magnetic resonance imaging suggestive of a fourth ventricular outflow obstruction. An ETV would be an ideal intervention with a high chance of success
1
and avoiding a ventriculoperitoneal shunt or a more invasive suboccipital craniectomy for fourth ventricle exploration; however, variant anatomy and resultant medialization of the bilateral posterior communicating arteries put their location directly beneath the tuber cinereum. After discussing the risks and benefits of the proposed procedure, the patient consented to proceeding with the surgery. Patient is not identifiable either by clinical vignette or through this operative video, which is entirely intraventricular. The care rendered was standard (nonexperimental). The patient did sign consent for filming and production of the educational video submitted.
Here, we present operative video from our ETV, demonstrating an inability to confirm adequate fenestration and subsequent flexible endoscopy for fourth ventriculocisternostomy.
The efficacy of systemic glucocorticosteroids for pain in rheumatoid arthritis: a systematic literature review and meta-analysis
Authors: McWilliams Daniel F , Thankaraj Divya , Jones-Diette Julie , Morgan Rheinallt , Ifesemen Onosi S , Shenker Nicholas G , Walsh David A 
Published: June 2021

Abstract

Objectives
Glucocorticosteroids (GCs) are recommended to suppress inflammation in people with active RA. This systematic review and meta-analysis aimed to quantify the effects of systemic GCs on RA pain.

Methods
A systematic literature review of randomized controlled trials (RCTs) in RA comparing systemic GCs to inactive treatment. Three databases were and spontaneous pain and evoked pain outcomes were extracted. Standardized mean differences (SMDs) and mean differences were meta-analysed. Heterogeneity (I2, tau statistics) and bias (funnel plot, Egger’s test) were assessed. Subgroup analyses investigated sources of variation. This study was pre-registered (PROSPERO CRD42019111562).

Results
A total of 18 903 titles, 880 abstracts and 226 full texts were assessed. Thirty-three RCTs suitable for the meta-analysis included 3123 participants. Pain scores (spontaneous pain) decreased in participants treated with oral GCs; SMD = −0.65 (15 studies, 95% CI −0.82, −0.49, P &lt;0.001) with significant heterogeneity (I2 = 56%, P =0.0002). Efficacy displayed time-related decreases after GC initiation. Mean difference visual analogue scale pain was −15 mm (95% CI −20, −9) greater improvement in GC than control at ≤3 months, −8 mm (95% CI −12, −3) at &gt;3–6 months and −7 mm (95% CI −13, 0) at &gt;6 months. Similar findings were obtained when evoked pain outcomes were examined. Data from five RCTs suggested improvement also in fatigue during GC treatment.

Conclusion
Oral GCs are analgesic in RA. The benefit is greatest shortly after initiation and GCs might not achieve clinically important pain relief beyond 3 months. Treatments other than anti-inflammatory GCs should be considered to reduce the long-term burden of pain in RA.
Growth indices, intestinal histomorphology, and blood profile of rabbits fed probiotics- and prebiotics-supplemented diets
Authors: Nwachukwu Chinwe Uchechi , Aliyu Karimat Imam , Ewuola Emmanuel Olubisi 
Published: June 2021

Abstract
In a 12-week feeding trial, 32 rabbits (Chinchilla × New Zealand White; 56 days old; 691 ± 1 g body weight) were used to investigate the effect of pro- and prebiotics as growth enhancer on the growth performance, intestinal mucosal development, hematological and serum biochemical responses of rabbits. The dietary Biotronic® prebiotics and Biovet®-YC probiotics were added at 400 mg/kg and 50 mg/kg, respectively. The rabbits were housed individually and randomly assigned to four dietary treatments (n = 8/group; 50:50 bucks to does) including a control diet (diet 1), diet 2 (control + Biotronic® prebiotics), diet 3 (control + Biovet®-YC probiotics) and diet 4 (control + symbiotics [Biotronic® prebiotics and Biovet®-YC probiotics]). Body weight (BW), average daily gain (ADG), dry matter intake (DMI), and feed conversion ratio (FCR) were monitored. Five rabbits per treatment were used for organ assessment and intestinal histomorphology after feeding trial. Blood samples were collected for hematological and serum biochemical analysis. Results showed that supplementation of Biotronic® prebiotics and symbiotics in rabbit diet significantly (P &lt; 0.05) increased final BW and ADG compared to Biovet®-YC probiotic and control diets. Kidney, lung, esophagus, gastro-intestinal tract, small and large intestines were significantly (P &lt; 0.05) influenced by dietary treatments. Ileal mucosal assessment revealed that villus height (VH), villus width, villus density, crypt depth (CD), and VH:CD ratio of rabbits fed Biotronic® prebiotic and symbiotic diets were similar and significantly (P &lt; 0.05) higher than those rabbits fed control and Biovet®-YC probiotic diets. Packed cell volume of rabbits fed symbiotic and control diets was significantly (P &lt; 0.05) higher than those fed Biotronic® prebiotic and Biovet®-YC probiotic diets. This study suggests that Biotronic® prebiotics and its combination with Biovet®-YC probiotics are good alternative growth promoting feed additives in rabbit nutrition. They improved performance, intestinal development and blood profiles and aid feed digestion, nutrient absorption and utilization in rabbits.
The relationship between falling and fear of falling among community-dwelling elderly
Authors: Chen Wei-Cheng , Li Yang-Tzu , Tung Tao-Hsin , Chen Chieh , Tsai Ching-Yao 
Published: June 2021

Abstract
Researchers have repeatedly examined the relationship between a previous experience of a fall and subsequent fear of falling (FOF); however, few studies have investigated the effects of falling along various timelines among older adults. The objective of this study was to determine whether experiencing a fall in the previous month or the previous year led to FOF among the elderly.
The National Health and Aging Trends Study (NHATS) in the U.S. collected information indicative of basic trends in the behavior of individuals aged 65 years and older. In the current study, we applied multiple logistic regression analysis of results from round 7 of the NHATS with the aim of identifying the risk factors associated with FOF among 5559 participants aged 65 years or older.
FOF was reported by 48.8% of those who experienced a fall in the previous year and 46.8% experienced a fall in the previous month. The results of regression analysis revealed that after adjusting for sex, age, related chronic disease, activities of daily living, and instrumental activities of daily living, FOF was significantly associated with experiencing a fall during the previous month (OR = 2.29, 95% CI: 1.78–2.95) or during the previous year (OR = 2.60, 95% CI: 2.16–3.14).
Our results indicate that experiences of falling during the previous month or the previous year were both significantly associated with a fear of falling, and caregivers should keep this in mind when dealing with community-living elderly individuals.
Effect of inflammatory bowel disease and related medications on COVID-19 incidence, disease severity, and outcome: the Israeli experience
Authors: Richter Vered , Bermont Anton , Cohen Daniel L , Broide Efrat , Shirin Haim 
Published: June 2021

Objectives
The coronavirus disease 2019 (COVID-19) pandemic raised concerns among inflammatory bowel disease (IBD) patients fearing an increased risk of infection and poor outcomes. We aimed to evaluate the incidence of COVID-19 among IBD patients; its influence on disease severity and outcome; its relationship to medication use and how the pandemic affected IBD management.

Methods
An anonymous questionnaire was posted online to members of the Israel Crohn’s Disease and Ulcerative Colitis Foundation (November 2020–January 2021). The questionnaire addressed the course of IBD disease and COVID-19 infection over the past year.

Results
Total 2152 IBD patients completed the questionnaire. Of which 104 (4.8%) had been infected with COVID-19, significantly lower than the ‘expected’ infected cases among the Israeli population (P = 0.033). The median age of participants was 39 years; 60.5% were female. Most patients (75.6%) had no comorbidities other than IBD. No correlation was found between IBD type or disease severity and COVID-19 infection. Most IBD patients reported mild COVID-19 disease, regardless of the type of IBD medications. Multivariable logistic regression analysis revealed that younger age, elevated BMI and diabetes were independent risk factors for COVID-19 infection. IBD treatment methods including 5-aminosalicylic acid, smoking and hypertension were protective factors. In total 25.2% of COVID-19 patients discontinued their IBD treatment, compared to 8.5% of non-COVID-19-infected patients. IBD flares were significantly higher in those who discontinued treatment (P < 0.001).

Conclusions
IBD patients do not have an increased risk for COVID-19, regardless of IBD activity or treatment. Patients should be encouraged to continue effective IBD therapy, including biologics and steroids, to minimize active IBD.
Breath biomarkers of insulin resistance in pre-diabetic Hispanic adolescents with obesity
Authors: Khan Mohammad S. , Cuda Suzanna , Karere Genesio M. , Cox Laura , Bishop Andrew C. 
Published: June 2021

ABSTRACTBackgroundInsulin Resistance (IR) affects a quarter of the world’s adult population and is a major factor in the pathogenesis of cardio-metabolic disease. Non-invasive sampling of exhaled breath contains metabolic markers indicative of underlying systemic metabolic abnormality.MethodIn this pilot study, we implemented a non-invasive breathomics approach, combined with random forest machine learning, to investigate metabolic markers from pre-diabetic Hispanic adolescents with obesity as indicators of abnormal metabolic regulation.FindingsExhaled breath collection using the ReCIVA breathalyzer is feasible in an adolescent population. We have identified a signature of breath metabolites (breath-IR model) which correlates with Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (R = 0.95,p<0.001). A strong correlation was also observed between the breath-IR model and the blood glycemic profile (fasting insulin R=0.91,p<0.001 and fasting glucose R=0.80,p<0.001). Among tentatively identified metabolites, limonene, undecane, and 2,7-dimethyl-undecane, significantly cluster individuals based on HOMA-IR (p=0.003,p=0.002, andp<0.001, respectively). Our breath-IR model differentiates between adolescents with and without IR with an area under the receiver operating characteristic curve of 0.87, after cross-validation.InterpretationIdentification of a breath metabolite signature indicative of IR in prediabetic Hispanic adolescents with obesity provides evidence of the utility of exhaled breath metabolomics for assessing systemic metabolic dysregulation. A simple and non-invasive breath-based test has utility as a diagnostic tool for monitoring IR progression, potentially allowing for earlier detection of IR and implementation of early interventions to prevent onset of type 2 diabetes mellitus.FundingThis study was funded by The Healthy Babies Project, Texas Biomedical Research Institute, San Antonio, TX.
Resurgence of SARS-CoV-2 in India: Potential role of the B.1.617.2 (Delta) variant and delayed interventions
Authors: Salvatore Maxwell , Bhattacharyya Rupam , Purkayastha Soumik , Zimmermann Lauren , Ray Debashree , Hazra Aditi , Kleinsasser Michael , Mellan Thomas , Whittaker Charlie , Flaxman Seth , Bhatt Samir , Mishra Swapnil , Mukherjee Bhramar 
Published: June 2021

AbstractIndia has seen a surge of SARS-CoV-2 infections and deaths in early part of 2021, despite having controlled the epidemic during 2020. Building on a two-strain, semi-mechanistic model that synthesizes mortality and genomic data, we find evidence that altered epidemiological properties of B.1.617.2 (Delta) variant play an important role in this resurgence in India. Under all scenarios of immune evasion, we find an increased transmissibility advantage for B.1617.2 against all previously circulating strains. Using an extended SIR model accounting for reinfections and wanning immunity, we produce evidence in support of how early public interventions in March 2021 would have helped to control transmission in the country. We argue that enhanced genomic surveillance along with constant assessment of risk associated with increased transmission is critical for pandemic responsiveness.One Sentence SummaryAltered epidemiological characteristics of B.1.617.2 and delayed public health interventions contributed to the resurgence of SARS-CoV-2 in India from February to May 2021.
Glycoproteome remodelling in MLL-rearranged B-cell precursor acute lymphoblastic leukemia
Authors: Oliveira Tiago , Zhang Mingfeng , Joo Eun Ji , Abdel-Azim Hisham , Chen Chun-Wei , Yang Lu , Chou Chih-Hsing , Qin Xi , Chen Jianjun , Alagesan Kathirvel , Almeida Andreia , Jacob Francis , Packer Nicolle H , von Itzstein Mark , Heisterkamp Nora , Kolarich Daniel 
Published: June 2021

AbstractB-cell precursor acute lymphoblastic leukemia (BCP-ALL) with mixed-lineage leukemia gene rearrangement (MLL-r) is a poor-prognosis subtype for which additional therapeutic targets are urgently needed. Currently no multi omics data set for primary MLL r patient cells exists that integrates transcriptomics, proteomics and glycomics to gain an inclusive picture of theranostic targets.MethodsWe have integrated transcriptomics, proteomics and glycomics to i) obtain the first inclusive picture of primary patient BCP-ALL cells and identify molecular signatures that distinguish leukemic from normal precursor B-cells and ii) better understand the benefits and limitations of the applied technologies to deliver deep molecular sequence data across major cellular biopolymers.ResultsMLL-r cells feature an extensive remodelling of their glycocalyx, with increased levels of Core 2-type O-glycans and complex N-glycans as well as significant changes in sialylation and fucosylation. Notably, glycosaminoglycan remodelling from chondroitin sulfate to heparan sulfate was observed. A survival screen, to determine if glycan remodelling enzymes are redundant, identified MGAT1 and NGLY1, essential components of the N-glycosylation/degradation pathway, as highly relevant within this in vitro screening. OGT and OGA, unique enzymes that regulate intracellular O-GlcNAcylation, were also indispensable. Transcriptomics and proteomics further identified Fes and GALNT7-mediated glycosylation as possible therapeutic targets. While there is overall good correlation between transcriptomics and proteomics data, we demonstrate that a systematic combined multi-omics approach delivers important diagnostic information that is missed when applying a single omics technology.ConclusionsApart from confirming well-known MLL-r BCP-ALL glycoprotein markers, our integrated multi-omics workflow discovered previously unidentified diagnostic/therapeutic protein targets.Graphical abstract