bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of order sentence implementation on outpatient antibiotic prescribing for urinary tract infection and skin and soft tissue infection
Authors: Foreman Brennan J. , Westerhof Lindsey , Benzer Jessica , Eid Kristen , Egwuatu Nnaemeka E. , Dumkow Lisa E. 
Published: December 2021

AbstractIntroductionDue to the high volume of outpatient antibiotic prescribing, the Joint Commission now requires antimicrobial stewardship program (ASP) expansion to ambulatory practice settings. Unfortunately, ASP resources in these settings are scarce. The purpose of this study was to determine whether the implementation of antibiotic order sentences alongside education would improve antibiotic prescribing for urinary tract infections (UTI) and skin and soft tissue infections (SSTI).ObjectivesThe primary objective was to compare the proportion of total guideline‐concordant antibiotic prescribing before (pre‐ASP) vs after (post‐ASP) implementing order sentences. Guideline concordance was defined as antibiotic selection, dosing, and duration in accordance with the health system's empiric guidelines. Secondary objectives included comparing patient‐centered outcomes, such as infection‐related revisits and Clostridiodes difficile infections between groups.MethodsThis retrospective, quasi‐experimental study evaluated adult patients treated for uncomplicated UTI or SSTI at an outpatient Family Medicine office between 1 February 2020 and 1 January 2021. The institution's stewardship team provided in‐person education and set prescribing order sentence “favorites” for providers. Patients were excluded who were diagnosed with a complicated UTI, treated only with topical antibiotics, were pregnant, or received care via telephone encounter.ResultsTwo hundred sixty patients were included in this study (pre‐ASP n = 139, post‐ASP n = 121). Total antibiotic appropriateness improved significantly from 24.5% to 39.7% after implementation of order sentences and education (P = .008). Significant improvement was seen for appropriate drug selection (52.5% vs 66.9%, P = .018) and duration (47.5% vs 68.6%, P = .001). There were no differences observed in patient‐centered outcomes between groups.ConclusionImplementing stewardship‐focused order sentences significantly improved outpatient antibiotic prescribing for UTI and SSTI. Tailoring antibiotic order sentences may be a useful tool for ASP expansion into the outpatient setting with limited resources to allocate to stewardship efforts.
Death anxiety among older adults with chronic illnesses during Covid‐19: A qualitative approach
Authors: Özteke Kozan Hatice İrem , Kesici Şahin 
Published: December 2021

AbstractIn the current study, we have investigated death anxiety during the Covid‐19 pandemic among older people with chronic illnesses with qualitative approach. Eighteen older people (10 female, 8 male) participated in the study. Phenomenological research design was used. A semi‐structured interview technique was used with interviews conducted online to collect the data. To analyse the data, both thematic and content analysis were used. The following seven themes were examined: meaning of death before and during Covid‐19; meaning of death during Covid‐19; awareness of life; anxiety toward family members during Covid‐19; effects of Covid‐19 on daily life; future anxiety after Covid‐19; and coping strategies for death anxiety. The participants were mostly afraid of losing their significant others rather than dying. During the pandemic, they have had fears about the manner of death associated with Covid‐19. They were mostly hopeful for the future and spirituality was generally recommended.
Group‐based Acceptance and Commitment Therapy (AHEAD) for adolescents with multiple functional somatic syndromes: A randomised trial
Authors: Kallesøe Karen Hansen , Schröder Andreas , Jensen Jens Søndergaard , Wicksell Rikard K. , Rask Charlotte Ulrikka 
Published: December 2021

AbstractBackgroundEvidence for treatment of adolescents with multiple functional somatic syndromes (FSS) is sparse. This study examined the efficacy of ‘Acceptance and Commitment Therapy for Health in Adolescents’ (AHEAD), a generic group‐based treatment for adolescents with co‐occurrence of multiple FSS.MethodsA randomized trial was conducted at a specialized university hospital clinic. Adolescents (15–19 years) with multiple FSS of at least 1 year's duration were randomly assigned to AHEAD or enhanced usual care (EUC). AHEAD consisted of nine modules (i.e., 27 h) and one follow‐up meeting. Primary outcome was physical health (SF‐36). Various secondary outcomes and treatment targets were included (e.g., symptom severity, symptom impact, and illness perception). A linear mixed‐effects model was used for analysis. Trial‐registration: ClinicalTrials.gov NCT02346071.ResultsNinety‐one patients were included. At 12 months, no significant difference in physical health was identified between groups (mean adjusted difference 1.2 [95% CI −1.6 to 4.0], p = .404). However, different developments over time were seen with an interaction effect between intervention arm and time (χ2(5) = 14.1, p = .0148). AHEAD patients (n = 44) reported a clinically relevant improvement at end of treatment and at 8 and 12 months, while EUC patients (n = 47) displayed a clinically relevant improvement at 12 months. Furthermore, AHEAD patients showed a faster improvement on symptom severity, symptom impact and illness perception. EUC patients received more psychological treatment outside the trial (p ≤ .001) than AHEAD patients. Treatment satisfaction with AHEAD was high in contrast to EUC.ConclusionsCompared with EUC, AHEAD had no additional advantage on the improvement of physical health at the primary endpoint of 12 months. However, a faster improvement of physical health was seen in AHEAD and considerably more psychological treatment was received outside the trial in EUC with clinically meaningful improvements in both groups. The results underpin the importance of an organised and systematic treatment offer for the most severely affected youth.
Scanning electron microscopy as a tool for authentication of biodiesel synthesis from Linum usitatissimum seed oil
Authors: Niazi Anmol , Ahmad Mushtaq , Elnaggar Ashraf Y. , Zafar Muhammad , Sultana Shazia , Rozina  , Majeed Salman , Hussein Enas E. 
Published: December 2021

AbstractUtilization of renewable and alternative energy feedstocks such as nonedible seeds oil to deal with the increasing energy crises and related ecological concerns have gained the attention of researchers. Biodiesel is an efficient and renewable substitute for diesel engine. This work investigates the potential of inexpensive nonedible seed oil of Linum usitatissimum to synthesize biodiesel using iron sulfate green nanocatalyst through the process of transesterification. Flax seed contains about 37.5% oil content estimated through Soxhlet apparatus. Light microscopy revealed that seed size varies from 3.0 to 6.0 cm in length, 2.0 to 3.3 cm in width, and 0.7 to 1.0 mm in diameter. Color of seed varied from yellow to brown. Characterization of biodiesel is performed through GC–MS and FTIR. Scanning electron microscopy was carried out to study the morphological features of seed coat. Catalyst was characterized by scanning electron microscopy, energy diffraction X‐ray, and X‐ray diffraction. The diffraction peaks of Fe3O4 green nanoparticles were found to be in 2θ values, 30.24°, 35.62°, 38.26°, 49.56°, 57.12°, and 62.78°. Fuel properties of biodiesel are also determined and compared with ASTM standards. Linum usitatissimum biodiesel has density 0.8722 (15°C kg/L), kinetic viscosity 5.45 (40°C cSt), flash point (90°C), pour point (−13°C), cloud point (−9°C), sulfur (0.0432% wt), and total acid number (0.245 mg KOH/g). It is concluded that L. usitatissimum seed oil is a highly potential source for biodiesel production to cope with the challenge of present energy demand.
Assessing genetic counselors’ graduate school education and training in congenital heart defects
Authors: Ahmad Aaliya , Fitzgerald‐Butt Sara M. , Ware Stephanie M. , Ison Hannah E. , Elmore Lindsey R. , Helm Benjamin M. 
Published: December 2021

AbstractGenetic counselors are one of the many providers involved in caring for patients with congenital heart defects (CHDs); however, little is known about the cardiovascular genetics training they receive by their graduate programs. To explore the recalled education experiences regarding CHDs by practicing genetic counselors, we surveyed graduates of programs primarily accredited by the American Council on Genetic Counseling (ACGC) about their graduate training in this area, the depth of CHD‐specific education they received, and whether CHDs are a substantial referral indication in their current practice. Genetic counselors were recruited from the National Society of Genetic Counselors and Twitter (n = 112), and participants reflecting multiple specialties and 35 graduate programs completed an online survey which included questions about fieldwork placements and lectures in cardiovascular genetics, exposure to classification schemes regarding cardiac embryology, and education in counseling strategies for CHDs and CHD‐related topics during their graduate training. When asked whether CHDs are a substantial referral indication seen in their current practice, 55% (62/112) responded yes. Most participants (79%, 88/112) recalled receiving some education about CHDs, but 91% (80/88) reported receiving little to no education regarding embryologic classification of CHDs and how to apply classification schemes to their counseling. Both participating prenatal and pediatric GCs reported that CHDs can be a common referral indication, yet they reported receiving limited education on teratogens associated with CHDs, family screening recommendations, and recurrence risk counseling for CHDs. Based on participant responses, the majority of respondents reported receiving sufficient education on syndromes with CHDs which can be beneficial in specialties such as pediatrics. This exploratory study provides insight into opportunities to further support genetic counseling educational opportunities for CHDs. These findings suggest genetic counseling graduate programs could consider implementing education on CHD counseling strategies as a standardized component of the curriculum and that practicing genetic counselors could benefit from educational opportunities and resources with updated information on this topic.
Linearly free graphs
Authors: Huh Youngsik , Lee Jung Hoon 
Published: December 2021

AbstractIn this paper we are interested in an intrinsic property of graphs which is derived from their embeddings into the Euclidean 3‐space . An embedding of a graph into is said to be linear, if it sends every edge to be a line segment. And we say that an embedding of a graph into is free, if is a free group. Lastly a simple connected graph is said to be linearly free if every its linear embedding is free. In the 1980s it was proved that every complete graph is linearly free, by Nicholson. In this paper, we develop Nicholson's arguments into a general notion, and establish a sufficient condition for a linear embedding to be free. As an application of the condition we give a partial answer for a question: How much can the complete graph be enlarged so that the linear‐freeness is preserved and the clique number does not increase? And an example supporting our answer is provided. As the second application it is shown that a simple connected graph of minimal valency at least 3 is linearly free, if it has less than eight vertices. The conditional inequality is strict, because we found a graph with eight vertices which are not linearly free. It is also proved that for the complete bipartite graph is linearly free.
CAR T cell therapy in solid tumors: A review of current clinical trials
Authors: Patel Urvi , Abernathy John , Savani Bipin N , Oluwole Olalekan , Sengsayadeth Salyka , Dholaria Bhagirathbhai 
Published: December 2021

AbstractChimeric antigen receptor (CAR) T cell therapy has made tremendous strides in the arena of hematological malignancies with approved therapies in certain leukemias, lymphomas, and recently myeloma with overall highly favorable response rates. While numerous clinical studies are still ongoing for hematological malignancies, research is developing to translate the feasibility of CAR T therapy in solid organ malignancies. Unfortunately, the majority of diagnosed cancers are primarily solid tumors. Thus, a highly unmet clinical need for further research and development exists in this field. This review article highlights currently active clinical trials and a few pertinent preclinical studies involving CAR T cell therapy in solid tumors while briefly discussing study outcomes and potential key targets that may allow for the feasibility of this therapy option. Finally, we mention critical challenges existing in the solid tumor environment and discuss developing strategies that may potentially overcome the existing barriers to CAR T cell progress in solid tumors.
The challenge of competency assessment of the late‐career practitioner
Authors: Steffany Mary 
Published: December 2021

AbstractJust as the general population of the United States is aging, so, too, is the population of active physicians. Training to become a physician and practice medicine is an arduous process. The competition to gain admission to medical school is fierce, the price tag of medical education is high, and waiting to learn about matching to a residency program is stressful. No wonder that physicians equate their profession with their identity. This sentiment, along with other factors, has resulted in many physicians continuing to practice well beyond the average retirement age. While each individual ages differently, there is evidence that the aging of physicians and length of time since medical school and residency is associated with deficiencies in history‐taking, physical examination, record‐keeping, and the ability to problem‐solve. For late‐career surgeons performing complex surgical procedures, there is a higher mortality rate for patients. Unlike other professions that have a mandatory retirement age, medicine does not. Health systems are grappling with how to fairly assess the competence of late‐career practitioners. This article will explore that challenge from different perspectives, identify best practices, and describe how a risk manager can facilitate stakeholder discussion focused on implementing a competency‐assessment process that is fair and effective.
Awareness about the human papillomavirus (HPV) and HPV vaccine among medical students in Lebanon
Authors: Haddad Sara F. , Kerbage Anthony , Eid Roland , Kourie Hampig R. 
Published: December 2021

AbstractAs a developing country, Lebanon lacks adequate awareness about Human papillomavirus (HPV) among its population, whether working in the medical field or not. Lebanon is traditionally considered conservative with a low incidence of sexually transmitted infections in general, but recently the incidence of HPV infections has significantly increased. The present cross‐sectional study aims to evaluate the level of awareness on HPV and the attitude toward HPV vaccine among Lebanese medical students in a self‐administered questionnaire‐based survey. A total of 1009 answers were collected and analyzed from a population of about 3000 Lebanese medical students. Our study revealed a significant lack of knowledge and awareness on HPV among medical students in Lebanon, with a strikingly low vaccination rate (16.4%) due to many barriers. Education initiatives in medical schools remain crucial to raise awareness on HPV and promote HPV vaccination, especially among medical students, who represent the country's future healthcare providers and policymakers.
Diversity and distribution of thermophilic microorganisms and their applications in biotechnology
Authors: Arbab Safia , Ullah Hanif , Khan Muhammad I. U. , Khattak Muhammad N. K. , Zhang Jiyu , Li Ka , Hassan Inam Ul 
Published: December 2021

AbstractHot springs ecosystem is the most ancient continuously inhabited ecosystem on earth which harbors diverse thermophilic bacteria and archaea distributed worldwide. Life in extreme environments is very challenging so there is a great potential biological dark matter and their adaptation to harsh environments eventually producing thermostable enzymes which are very vital for the welfare of mankind. There is an enormous need for a new generation of stable enzymes that can endure harsh conditions in industrial processes and can either substitute or complement conventional chemical processes. Here, we review at the variety and distribution of thermophilic microbes, as well as the different thermostable enzymes that help them survive at high temperatures, such as proteases, amylases, lipases, cellulases, pullulanase, xylanases, and DNA polymerases, as well as their special properties, such as high‐temperature stability. We have documented the novel isolated thermophilic and hyperthermophilic microorganisms, as well as the discovery of their enzymes, demonstrating their immense potential in the scientific community and in industry.
Stabilization of natural gas foams using different surfactants at high pressure and high temperature conditions
Authors: Bi Weiyu , Zhang Panfeng , Du Xiangrui , Lü Wei , Wang Shitou , Yang Tangying , Ma Liping , Liu Xiaochun , Zhao Haifeng , Ren Shaoran 
Published: December 2021

AbstractNatural gas foam can be used for mobility control and channel blocking during natural gas injection for enhanced oil recovery, in which stable foams need to be used at high reservoir temperature, high pressure and high water salinity conditions in field applications. In this study, the performance of methane (CH4) foams stabilized by different types of surfactants was tested using a high pressure and high temperature foam meter for surfactant screening and selection, including anionic surfactant (sodium dodecyl sulfate), non‐anionic surfactant (alkyl polyglycoside), zwitterionic surfactant (dodecyl dimethyl betaine) and cationic surfactant (dodecyl trimethyl ammonium chloride), and the results show that CH4‐SDS foam has much better performance than that of the other three surfactants. The influences of gas types (CH4, N2, and CO2), surfactant concentration, temperature (up to 110°C), pressure (up to 12.0 MPa), and the presence of polymers as foam stabilizer on foam performance was also evaluated using SDS surfactant. The experimental results show that the stability of CH4 foam is better than that of CO2 foam, while N2 foam is the most stable, and CO2 foam has the largest foam volume, which can be attributed to the strong interactions between CO2 molecules with H2O. The foaming ability and foam stability increase with the increase of the SDS concentration up to 1.0 wt% (0.035 mol/L), but a further increase of the surfactant concentration has a negative effect. The high temperature can greatly reduce the stability of CH4‐SDS foam, while the foaming ability and foam stability can be significantly enhanced at high pressure. The addition of a small amount of polyacrylamide as a foam stabilizer can significantly increase the viscosity of the bulk solution and improve the foam stability, and the higher the molecular weight of the polymer, the higher viscosity of the foam liquid film, the better foam performance.
Targeting DNA repair pathway in cancer: Mechanisms and clinical application
Authors: Wang Manni , Chen Siyuan , Ao Danyi 
Published: December 2021

AbstractOver the last decades, the growing understanding on DNA damage response (DDR) pathways has broadened the therapeutic landscape in oncology. It is becoming increasingly clear that the genomic instability of cells resulted from deficient DNA damage response contributes to the occurrence of cancer. One the other hand, these defects could also be exploited as a therapeutic opportunity, which is preferentially more deleterious in tumor cells than in normal cells. An expanding repertoire of DDR‐targeting agents has rapidly expanded to inhibitors of multiple members involved in DDR pathways, including PARP, ATM, ATR, CHK1, WEE1, and DNA‐PK. In this review, we sought to summarize the complex network of DNA repair machinery in cancer cells and discuss the underlying mechanism for the application of DDR inhibitors in cancer. With the past preclinical evidence and ongoing clinical trials, we also provide an overview of the history and current landscape of DDR inhibitors in cancer treatment, with special focus on the combination of DDR‐targeted therapies with other cancer treatment strategies.
Age‐related differences in self‐report and objective measures of cognitive function in older patients prior to chemotherapy
Authors: Utne Inger , Løyland Borghild , Grov Ellen Karine , Rasmussen Hege Lund , Torstveit Ann Helen , Paul Steven M. , Ritchie Christine , Lindemann Kristina , Vistad Ingvild , Rodríguez‐Aranda Claudia , Miaskowski Christine 
Published: December 2021

AbstractAimEvaluate for differences in demographic and clinical characteristics and subjective and objective measures of cognitive function (CF) between younger older adults (YOA, 60–69 years) and older adults (OA, ≥70 years).DesignCross‐sectional.MethodsOlder oncology patients (n = 139) completed subjective (Attentional Function Index, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) CF scale) and objective (Montreal Cognitive Assessment, Trail Making Test (TMT) A & B) measures of CF prior to chemotherapy. Data were analyzed using parametric and nonparametric tests.ResultsNo differences were found between the two groups for any of the subjective or objective CF measures, except that OA patients had higher TMT B scores. Compared with the general population, OAs had significantly higher EORTC CF scores and YOAs had significantly worse scores for all of the objective tests. Clinically meaningful difference between group differences was found for the TMT B test.
Effect of a ketogenic diet on pain and quality of life in patients with lipedema: The LIPODIET pilot study
Authors: Sørlie Vilde , De Soysa Ann Kristin , Hyldmo Åsne Ask , Retterstøl Kjetil , Martins Catia , Nymo Siren 
Published: December 2021

AbstractBackgroundLipedema is an underdiagnosed condition in women, characterized by a symmetrical increase in subcutaneous adipose tissue (SAT) in the lower extremities, sparing the trunk. The lipedema SAT has been found to be resistant to diet, exercise and bariatric surgery, in regard to both weight loss (WL) and symptom relief. Current experience indicates that a low carbohydrate and high fat (LCHF‐diet) might have a beneficial effect on weight and symptom management in lipedema.ObjectiveTo assess the impact of an eucaloric low carbohydrate, high fat (LCHF)‐diet on pain and quality of life (QoL) in patients with lipedema.MethodsWomen diagnosed with lipedema, including all types and stages affecting the legs, (age 18–75 years, BMI 30–45 kg/m2) underwent 7 weeks of LCHF‐diet and, thereafter 6 weeks of a diet following the Nordic nutrition recommendations. Pain (visual analog scale) and QoL (questionnaire for lymphedema of the limbs), weight and body composition were measured at baseline, week seven and 13.ResultsNine women (BMI: 36.7 ± 4.5 kg/m2 and age: 46.9 ± 7 years) were recruited. The LCHF diet induced a significant WL −4.6 ± 0.7 kg (−4.5 ± 2.4%), p < 0.001 for both, and reduction in pain (−2.3 ± 0.4 cm, p = 0.020). No correlation was found between WL and changes in pain at week seven (r = 0.283, p = 0.460). WL was maintained between week seven and 13 (0.3 ± 0.7 kg, p = 0.430), but pain returned to baseline levels at week 13 (4.2 ± 0.7 cm, p = 0.690). A significant increase in general QoL was found between baseline and week seven (1.0 (95% CI (2.0, 0.001)), p = 0.050) and 13 (1.0 95% CI (2.0, 0.001) p = 0.050), respectively.ConclusionA LCHF‐diet is associated with reduction in perceived pain and improvement in QoL, in patients with lipedema. Larger randomized clinical trials are needed to confirm these findings.