bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining Corneal Tissue Exportation Fee and Its Impact on Equitable Allocation
Authors: Machin Heather , Sutton Gerard , Baird Paul N. 
Published: September 2021

Abstract:
Although an estimated 23% of all global corneal transplants occur because corneal tissue is moved from one nation to another (export and import), the fee structures, fees charged, and use of reimbursement or profit models, to support this practice, have not been evaluated. This article describes the fee structures and determines whether they support or hinder the equitable allocation of corneal tissue.

Methods:
We conducted grounded theory semistructured interviews, purposively inviting participants until themed saturation was met. Sentiment analysis was used to determine opinion.

Results:
We interviewed n = 92 global eye tissue and eye bank professionals. We determined that corneal tissue, which is exported, costs between US $100 and US $6000 or is provided as gratis. Collectively, interviewees indicated that, globally, there were no fixed fee structures in place, and the fee was influenced by multiple factors on both export and import sides. They indicated that ultimately corneas were allocated based on the importers' ability to pay the price determined by the exporting eye bank.

Discussion:
Allocation of corneal tissue, which is exported, is influenced by the fees charged by the exporters to meet their bottom line and the funds available to importers. Therefore, export allocation is not equitable, with those who can pay a higher fee, prioritized. Steps to guide and support exporters with the development of fee structures that promote equitable allocation are essential. This will assist both export and import eye bank development, corneal tissue access development, and those awaiting a corneal transplant.
Bronchoscopy and Pathology Findings in an Unusual Case of Allergic Bronchopulmonary Mycosis
Authors: Li Yongqun , Zhang Caiyun , Zhang Chunyang 
Published: September 2021

Abstract
The diagnosis of allergic bronchopulmonary mycosis (ABPM) is usually made on clinical, serologic, and roentgenographic findings. However, the indicators in such diagnostic criteria still lack specificity, which results in a high rate of misdiagnosis. A 47-year-old woman was diagnosed with “tuberculosis” or “pneumonia” for 10 years and after thoracoscopic right upper lung resection the following chest CT showed right lung atelectasis. Brown sputum was seen in the right bronchus via bronchoscopy. Reviewing the surgical pathology specimen, the bronchi were found to be generally cystic dilated, and a large amount of mucus was retained and formed a mucus plug. The final diagnosis of the case was ABPM. The current diagnostic criteria of ABPM do not emphasize the role of bronchoscopy and pathological examination, but bronchoscopy and pathological examination still have important value for some atypical cases with suspected ABPM.
Addressing Lesbian, Gay, Bisexual, Transgender, and Queer Health in Physical Therapy Education
Authors: Morton Ryan C. , Ge Weiqing , Kerns Lucy , Rasey Jacob 
Published: September 2021

Introduction.
The objectives were to determine doctor of physical therapy (DPT) student comfort level, attitudes, and preparedness to address lesbian, gay, bisexual, transgender, and queer (LGBTQ+) health in the United States.

Methods.
The research design was a cross-sectional nonexperimental national survey of DPT students in the United States The survey was administered online using SurveyGizmo. Participants included 1,015 DPT students.

Results.
Most respondents (91.7%, n = 931) reported that they felt comfortable treating patients who identify as lesbian, gay, and bisexual and 75.7% (n = 768) indicated that they felt comfortable treating patients who identify as transgender. An overwhelming majority (96.7%, n = 982) agreed that it was the responsibility of all health care providers to care for patients who identify as LGBTQ+. Conversely, only 20.6% (n = 209) agreed that their entry-level DPT programs had prepared them to care for patients who identify as LGBTQ+. About two-thirds of the respondents (66.0%, n = 670) indicated that they were interested in receiving further education about LGBTQ+ health. Ordinal logistic regression analysis indicated that some demographical factors, including age, gender, number of years in a physical therapy program, and respondent's sexual orientation, had impacts on some of the responses with statistical significance.

Discussion.
Doctor of physical therapy students reported high comfort level and positive attitudes toward patients who identify as LGBTQ+ but feel underprepared by their entry-level DPT programs to treat this population and demonstrate an interest in more training.

Conclusion.
Improvements in education on LGBTQ+ health are needed in entry-level DPT programs to provide high-quality graduates as workforce in the health care system.
Introducing the American Society for Bone and Mineral Research multistakeholder group secondary fracture prevention recommendations: Nurse practitioners play an important role
Authors: Alexander Ivy M. , Bowka Linda , Hannafon Freda , Lake Anne , Williams Kathy , Woodburn Marcia 
Published: September 2021

ABSTRACT
Sequelae after an osteoporosis-related fracture include significant morbidity and mortality. Preventing repeat fractures is an important aspect of mitigating these sequelae. As highlighted in the American Society for Bone and Mineral Research multistakeholder coalition's Secondary Fracture Prevention: Consensus Clinical Recommendations, nurse practitioners play an important role in secondary fracture prevention. With a focus on education, longitudinal relationships with patients, and expertise in coordinating and managing care, nurse practitioners are uniquely qualified to run Fracture Liaison Services and help close the gap to care in secondary fracture prevention.
Emerging clinical perspectives in cystic fibrosis liver disease
Authors: Athwal Varinder S. , Scott Jennifer A. , Fitzpatrick Emer , Rowland Marion 
Published: September 2021

Purpose of review
Liver disease (CFLD) as a complication of cystic fibrosis is recognized as a more severe disease phenotype in both children and adults. We review recent advances in understanding the disease mechanism and consider the implications of new strategies for the diagnosis and management of cystic fibrosis in those with evidence of clinically significant liver disease.

Recent findings
Evidence suggests that the prevalence of CFLD has not declined with the introduction of newborn screening. Furthermore, children with CFLD, who have been diagnosed with cystic fibrosis following newborn screening continue to have a much higher mortality rate compared with those with no liver disease. There is further data suggesting noncirrhotic obliterative portal venopathy as the predominant pathological mechanism in the majority of children and young adults receiving a liver transplantation. Little progress has been made in developing an accurate noninvasive test for early diagnosis or monitoring disease progression in CFLD. The benefit of new modulator therapies is not well understood in those with established CFLD, whereas the risk of hepatotoxicity as a complication of treatment must be carefully monitored.

Summary
Better understanding of the pathophysiology of CFLD would allow a standardized approach to diagnosis, with the potential to improve outcomes for those with CFLD.
Plasma and urine biomarkers in chronic kidney disease: closer to clinical application
Authors: Zabetian Azadeh , Coca Steven G. 
Published: September 2021

Purpose of review
Chronic kidney disease (CKD) is a silent disease, causing significant health and economic burden worldwide. It is of strong clinical value to identify novel prognostic, predictive, and pharmacodynamic biomarkers of kidney function, as current available measures have limitations. We reviewed the advances in biomarkers in CKD over the preceding year.

Recent findings
The most frequently studied prognostic plasma biomarkers during recent year were plasma TNFR1, TNFR2, KIM1 and urinary MCP-1 and EGF. New biomarkers such as plasma WFDC2, MMP-7, EFNA4, EPHA2 may also have potential to serve as prognostic biomarkers. There is a shortage of data on biomarkers that are predictive of response to treatments. Data on novel biomarkers to serve as pharmacodynamic biomarkers are limited, but there are emerging data that plasmaTNFR1, TNFR2, KIM-1 are not only prognostic at baseline, but can also contribute to time-updated response signals in response to therapy.

Summary
Data continue to emerge on applicable biomarkers for prognostic clinical risk stratification, prediction of therapeutic response and assessment of early efficacy of interventions. Although more studies are needed for refinement and specific clinical utility, there seems to be sufficient data to support clinical implementation for some biomarkers.
Lifestyle interventions for preventing and ameliorating CKD in primary and secondary care
Authors: Kelly Jaimon T. , Su Guobin , Carrero Juan-Jesus 
Published: September 2021

Purpose of review
Despite the growth in chronic kidney disease (CKD) epidemics, evidence-based lifestyle recommendations for primary prevention of CKD are limited by reliance on observational studies and predominantly pilot clinical trials.

Recent findings
Emerging data have shown lifestyle modification strategies for primary CKD prevention with the most evidence favoring a healthy dietary pattern (rich in fruit, vegetables, potassium and have a higher plant-based to animal protein ratio), and diet low in sodium, being physically active, avoiding tobacco smoking, moderating alcohol consumption and maintaining a healthy body weight. The way these behavioral interventions can be implemented in practice should consider their synergistic benefit as well as mechanisms to facilitate long-term behavior change. Sustaining long-term behavior change remains a challenge in practice, particularly due to a lack of healthcare resources and behavior relapse. Some suggestions to mitigate this include ensuring adequate time is spent in intervention codesign and planning, utilizing adaptive trial/intervention designs with regular intervention tailoring for intervention dose, intensity, duration, and modality.

Summary
A number of modifiable lifestyle behaviors consistently associate with developing CKD in the community. The current evidence base, despite its inherent limitations, may inform both public health recommendations and clinical practice.
Role of gut–kidney axis in renal diseases and IgA nephropathy
Authors: Monteiro Renato C. , Berthelot Laureline 
Published: September 2021

Purpose of review
Growing evidence show the importance of gut/kidney axis in renal diseases. Advances in gut microbiome sequencing, associated metabolites, detection of gut permeability and inflammation provide new therapeutic strategies targeting gut for kidney diseases and particularly for Immunoglobulin A (IgA) nephropathy (IgAN).

Recent findings
The diversity and composition of gut flora have been recently deeply explored in kidney diseases. Modulation and depletion of microbiota in animal models allowed the understanding of molecular mechanisms involved in the crosstalk between gut, immune system and kidney. New clinical trials in order to positively modulate microbiota result in improvement of gastrointestinal disorders and inflammation in patients suffering with kidney diseases.

Summary
The investigation of gut alterations in kidney diseases open new therapeutic strategies. In IgAN, targeted treatments for intestinal inflammation and modifications of gut microbiota seem promising.
Hemiplegic-Migraine–like Attacks as First Manifestation of Diffuse Leptomeningeal Glioneuronal Tumor: A Case Report
Authors: Fetta Anna , Pruccoli Jacopo , Biasucci Giacomo , Parisi Roberto , Toni Francesco , Melchionda Fraia , Cordelli Duccio M. 
Published: September 2021

Background:
Diffuse leptomeningeal glioneuronal tumor (DLGNT) is a low-grade tumor characterized by diffuse leptomeningeal infiltrates. Symptoms are usually secondary to hydrocephalus. Hemiplegic migraine (HM)-like episodes have never been associated with DLGNT, but they have been reported with different inflammatory and tumoral entities involving leptomeninges.

Observations:
We report the case of a 10-year-old boy with recurrent episodes of right hyposthenia, aphasia, and headache lasting hours to days with complete remission. The electroencephalogram during the attack showed diffuse slower activity on the left hemisphere, which improved together with the symptoms. DLGNT was discovered during a follow-up magnetic resonance imaging and confirmed by biopsy.

Conclusions:
This is the first report of HM-like attacks in DLGNT. We discuss the pathogenetic hypotheses of our case and previously reported cases of “symptomatic” HM with leptomeningeal involvement.
Antifungal Therapy in Pediatric Acute Lymphoblastic Leukemia: A Single-center Experience
Authors: Yigit Metin , Arman Bilir Özlem , Kanik Yüksek Saliha , Kaçar Dilek , Özbek Namik Y. , Yarali Hüsniye N. 
Published: September 2021

Introduction:
Invasive fungal infections (IFIs) are significant causes of morbidity and mortality in leukemia patients. This study investigated antifungal treatment and prophylaxis features according to leukemia risk groups and treatment phases in pediatric acute lymphoblastic leukemia (ALL) patients who received Berlin-Frankfurt-Munster-based protocols.

Materials and Methods:
We retrospectively examined ALL patients’ data between the ages of 1 and 18 and treated them with Berlin-Frankfurt-Munster-ALL protocols between June 2013 and December 2016.

Results:
A total of 446 febrile neutropenic attacks in 85 children were evaluated. Seventy-two patients received antifungals in 151 infection attacks, while 13 patients did not receive any antifungal treatment during chemotherapy. Empirical, preemptive, or proven treatments were given to 74.8%, 21.2%, and 4% of patients, respectively. The frequency of antifungal therapy increased linearly and significantly from the standard-risk group to the intermediate-risk (IR) group, high-risk (HR) group, and relapsed group. IR patients needed more antifungal therapy while receiving induction, whereas HR patients needed more throughout the induction and HR consolidation blocks than other phases. During induction, IR patients received antifungal therapy similar to HR patients’ treatment in the induction and HR consolidation blocks.

Conclusions:
Antifungal therapy requirements increased as the severity and intensity of chemotherapy increased for all leukemia risk groups. The requirement of antifungal therapy for IR patients receiving induction was similar to that of HR patients; further studies are needed to evaluate the potential advantages of using primary antifungal prophylaxis in IR patients.
The Use of Sunitinib as Maintenance Therapy in a Pediatric Patient With a Poorly Differentiated Thymic Carcinoma
Authors: Romanos-Sirakis Eleny , Doan Andrew , Bittman Mark E. , Webb Ryan L. , Williamson Alex K. , Edelman Morris , Hanson Derek , Riely Gregory J. , Fein Levy Carolyn 
Published: September 2021

Background:
Thymic carcinomas are rare aggressive mediastinal tumors with a median survival of 2 years.

Observation:
We present a pediatric patient who was diagnosed with metastatic thymic carcinoma and showed continuous improvement of his primary mass and lung metastases with a regimen of cisplatin/docetaxel followed by long-term maintenance therapy with sunitinib for over 5 years.

Conclusions:
This report demonstrates a long-term positive treatment effect using chemotherapy followed by sunitinib in an advanced thymic carcinoma. We are not aware of other reports of pediatric patients with metastatic thymic carcinoma treated with sunitinib maintenance who maintained a durable response for this prolonged period of time.
Impact of State Nurse Practitioner Regulations on Potentially Inappropriate Medication Prescribing Between Physicians and Nurse Practitioners
Authors: Tzeng Huey-Ming , Raji Mukaila A. , Chou Lin-Na , Kuo Yong-Fang 
Published: September 2021

Background:
The American Geriatrics Society regularly updates the Beers Criteria for Potentially Inappropriate Medication (PIM) to improve prescribing safety.

Purpose:
This study assessed the impact of nurse practitioner (NP) practices on PIM prescribing across states in the United States and compared the change in PIM prescribing rates between 2016 and 2018.

Methods:
We used data from a random selection of 20% of Medicare beneficiaries (66 years or older) from 2015 to 2018 to perform multilevel logistic regression. A PIM prescription was classified as initial or refill on the basis of medication history 1 year before a visit. PIM use after an outpatient visit was the primary study outcome.

Results:
We included 9 000 224 visits in 2016 and 9 310 261 in 2018. The PIM prescription rate was lower in states with full NP practice and lower among NPs than among physicians; these rates for both physicians and NPs decreased from 2016 to 2018.

Conclusions:
Changes could be due to individual state practices.
Heart Weight Is an Independent Factor Associated With, But Is a Poor Predictor for, Sudden Cardiac Death
Authors: Garland Jack , Kesha Kilak , Glenn Charley , Stables Simon , Ondruschka Benjamin , Lohner Larissa , Tse Rexson 
Published: September 2021

Abstract
An enlarged heart can cause electrical instability and impaired contractility, leading to fatal arrhythmia and acute heart failure, and is associated with sudden cardiac death. However, there is limited postmortem evidence on whether heart weight is an independent factor associated with sudden cardiac death. This 18-month retrospective study examined 108 adult heart weights in which all the hearts were weighed after dissection, blood and blood clots removed, rinsed in water, and pat dried. The multivariate logistic regression analysis showed heart weight was an independent factor associated with sudden cardiac death. However, after normalization, the heart weight was a poor predictor of sudden cardiac death with an area under the curve less than 0.7 in the plotted receiver operating characteristic curve.
Detecting Preanalytical Errors Using Quality Indicators in a Hematology Laboratory
Authors: Alshaghdali Khalid , Alcantara Tessie Y. , Rezgui Raja , Cruz Charlie P. , Alshammary Munif H. , Almotairi Yasser A. , Alcantara Jerold C. 
Published: September 2021

Background and Objectives:
Monitoring laboratory performance continuously is crucial for recognizing errors and fostering further improvements in laboratory medicine. This study aimed to review the quality indicators (QIs) and describe the laboratory errors in the preanalytical phase of hematology testing in a clinical laboratory.

Methods:
All samples received in the Hematology Laboratory of the Maternity and Pediatric Hospital in Hail for 3 years were retrospectively reviewed and evaluated for preanalytical issues using a set of QIs. The rate of each QI was compared to the quality specifications cited in the literature.

Results:
A total of 95002 blood samples were collected for analysis in the hematology laboratory from January 2017 through December 2019. Overall, 8852 (9.3%) were considered to show preanalytical errors. The most common were “clotted specimen” (3.6%) and “samples not received” (3.5%). Based on the quality specifications, the preanalytical QIs were classified generally as low and medium level of performance. In contrast, the sigma-based performance level indicates acceptable performance on all the key processes. Further analysis of the study showed a decreasing rate of preanalytical errors from 11.6% to 6.5%.

Conclusions:
Preanalytical errors remain a challenge to hematology laboratories. The errors in this case were predominantly related to specimen collection procedures that compromised the specimen quality. Quality indicators are a valuable instrument in the preanalytical phase that allows an opportunity to improve and explore clinical laboratory process performance and progress. Continual monitoring and management of QI data are critical to ensure ongoing satisfactory performance and to enhance the quality in the preanalytical phase.
Cross-species parallels in babbling: animals and algorithms
Authors: ter Haar Sita M. , Fernandez Ahana A. , Gratier Maya , Knörnschild Mirjam , Levelt Claartje , Moore Roger K. , Vellema Michiel , Wang Xiaoqin , Oller D. Kimbrough 
Published: September 2021

A key feature of vocal ontogeny in a variety of taxa with extensive vocal repertoires is a developmental pattern in which vocal exploration is followed by a period of category formation that results in a mature species-specific repertoire. Vocal development preceding the adult repertoire is often called ‘babbling’, a term used to describe aspects of vocal development in species of vocal-learning birds, some marine mammals, some New World monkeys, some bats and humans. The paper summarizes the results of research on babbling in examples from five taxa and proposes a unifying definition facilitating their comparison. There are notable similarities across these species in the developmental pattern of vocalizations, suggesting that vocal production learning might require babbling. However, the current state of the literature is insufficient to confirm this suggestion. We suggest directions for future research to elucidate this issue, emphasizing the importance of (i) expanding the descriptive data and seeking species with complex mature repertoires where babbling may not occur or may occur only to a minimal extent; (ii) (quasi-)experimental research to tease apart possible mechanisms of acquisition and/or self-organizing development; and (iii) computational modelling as a methodology to test hypotheses about the origins and functions of babbling.This article is part of the theme issue ‘Vocal learning in animals and humans’.
The vocal development of the pale spear-nosed bat is dependent on auditory feedback
Authors: Lattenkamp Ella Z. , Linnenschmidt Meike , Mardus Eva , Vernes Sonja C. , Wiegrebe Lutz , Schutte Michael 
Published: September 2021

Human vocal development and speech learning require acoustic feedback, and humans who are born deaf do not acquire a normal adult speech capacity. Most other mammals display a largely innate vocal repertoire. Like humans, bats are thought to be one of the few taxa capable of vocal learning as they can acquire new vocalizations by modifying vocalizations according to auditory experiences. We investigated the effect of acoustic deafening on the vocal development of the pale spear-nosed bat. Three juvenile pale spear-nosed bats were deafened, and their vocal development was studied in comparison with an age-matched, hearing control group. The results show that during development the deafened bats increased their vocal activity, and their vocalizations were substantially altered, being much shorter, higher in pitch, and more aperiodic than the vocalizations of the control animals. The pale spear-nosed bat relies on auditory feedback for vocal development and, in the absence of auditory input, species-atypical vocalizations are acquired. This work serves as a basis for further research using the pale spear-nosed bat as a mammalian model for vocal learning, and contributes to comparative studies on hearing impairment across species.This article is part of the theme issue ‘Vocal learning in animals and humans’.