bluuebunny/crossref_metadata_2025_split huggingface dataset:
The integration of dermatology experts into primary care to assess and treat patients with skin lesions is cost‐effective: A quasi‐experimental study
Authors: Lovén Maria , Huilaja Laura , Paananen Markus , Torkki Paulus 
Published: December 2024

AbstractBackgroundThe management of patients with skin changes can be challenging in primary healthcare; general practitioners (GPs) often lack the expertise to make accurate assessments and treatment decisions. The standard care pathway for skin changes can result in extended treatment times and costs.ObjectivesThis study was designed to evaluate the cost‐effectiveness of integrating a dermatologist into the primary care setting to assess and treat patients with skin disorders. The primary outcome was the incremental cost‐effectiveness ratio (ICER) for each malignant or pre‐malignant skin disease found and treated. The secondary outcomes included ICER for any treated skin finding, number needed to excise to find malignant or pre‐malignant skin disease, number of hospital referrals required and changes in quality of life (QoL) in the presence and absence of the integration.MethodsThis was a quasi‐experimental cohort study conducted at three primary healthcare centres in Finland. In the two intervention centres, patients with skin findings visited a dermatologist; in the control centre they visited a GP. Cost‐effectiveness was assessed using the incremental cost‐effectiveness ratio (ICER). QoL was assessed with the PROMIS v1.2, calculative EQ‐5D‐3L and PROMIS Anxiety 4a instruments.ResultsIn total, 186 integration and 176 control patients were included. For an additional patient treated for a (pre‐)malignant skin disease, the ICER was €852 lower and with any skin disease €381 lower in the integration group than with standard care. Fewer biopsies were required for each malignant or pre‐malignant skin disease in the integration group compared to the control group (2.1 and 6.5 per patient; p < 0.001) and lower proportion of patients were referred to hospital (8.1 vs. 17.1%, p < 0.001). Patient QoL did not differ between groups.ConclusionsThe integration of dermatological expertise into primary care settings is cost‐effective and can streamline the management of patients with skin conditions without worsening their QoL.
Study on Wax Secretion and Wax‐Secreting System of Mulberry Pest Paurocephala sauteri Enderlein (Hemiptera: Psyllidae)
Authors: Wei Hongxian , Geng Tao , Wu Huazhou , Lou Dezhao , Lu Fuping , Wang Shuchang 
Published: December 2024

ABSTRACTPaurocephala sauteri Enderlein is one of the most important pests of mulberry trees in the tropical and subtropical regions of China. This species by penetrating the veins on the back of leaves and buds of mulberry trees, nymphs and female adults can secrete wax, these wax accumulated on the mulberry leaves significantly affects photosynthesis and silkworm cultivation. Therefore, this study aimed to understand the wax‐secreting system and characteristics of wax secretion, expecting a potential strategy to control the species population. The main findings were as follows: scanning electron microscopy revealed that the nymphs and female adults secrete wax in long tubes with spherical ends, and male adults secrete honeydew. Additionally, the wax‐secreting system of the nymphs and female adults differ, the nymph owned a bending moon‐shaped wax‐secreting system, the wax‐secreting system first instar nymph consisted of one circle of rectangular, depressed cell, whereas the wax‐secreting system of second to fifth instar nymph made up of one circle of rectangular, depressed cell and one circle of round, depressed cell. There were a certain number of white pores inside of this depressed cell. Wax filaments produced by these pores are converted into a dense, tight and hollow the wax tube. Gas chromatography/mass spectrometer showed that the main constituents of P. sauteri wax are hydrocarbons. The wax tube as a water conservation pool during the P. sauteri developmental process. This physiological feature may be a key point for a potential strategy to control P. sauteri, even other secreting insects.
Implications of Large Language Models for Clinical Practice: Ethical Analysis Through the Principlism Framework
Authors: Armitage Richard C. 
Published: December 2024

ABSTRACTIntroductionThe potential applications of large language models (LLMs)—a form of generative artificial intelligence (AI)—in medicine and health care are being increasingly explored by medical practitioners and health care researchers.MethodsThis paper considers the ethical implications of LLMs for medical practitioners in their delivery of clinical care through the ethical framework of principlism.FindingsIt finds that, regarding beneficence, LLMs can improve patient outcomes through supporting administrative tasks that surround patient care, and by directly informing clinical care. Simultaneously, LLMs can cause patient harm through various mechanisms, meaning non‐maleficence would prevent their deployment in the absence of sufficient risk mitigation. Regarding autonomy, medical practitioners must inform patients if their medical care will be influenced by LLMs for their consent to be informed, and alternative care uninfluenced by LLMs must be available for patients who withhold such consent. Finally, regarding justice, LLMs could promote the standardisation of care within individual medical practitioners by mitigating any biases harboured by those practitioners and by protecting against human factors, while also up‐skilling existing medical practitioners in low‐resource settings to reduce global health disparities.DiscussionAccordingly, this paper finds a strong case for the incorporation of LLMs into clinical practice and, if their risk of patient harm is sufficiently mitigated, this incorporation might be ethically required, at least according to principlism.
Indirect Restorations for Increasing the Vertical Dimension of Occlusion
Authors: Thorpe‐Matthisson Lea , Jäggi Marco , Rohr Nadja , Zitzmann Nicola U. , Zaugg Lucia K. 
Published: December 2024

ABSTRACTObjectiveThis article presents a clinical case of erosive tooth wear, in which the vertical dimension of occlusion (VDO) has been restored using defect oriented posterior onlays and anterior veneers respecting minimal invasive treatment approaches.Clinical ConsiderationA 44‐year‐old female with the history of bulimia nervosa and bruxism expressed the desire to improve the aesthetic appearance and reestablishment of function of her worn dentition. After a 3‐month functional therapy to ease myofunctional problems using a Michigan splint, a diagnostic phase revealed the necessity for a full mouth prosthetic rehabilitation. A slight increase of the VDO of 1 mm at the incisal point was determined. Veneered lithium disilicate ceramic restorations of 0.3–0.5 mm in thickness were produced for the incisors and monolithic lithium disilicate restorations of 0.8–1.0 mm in thickness for posterior teeth.ConclusionsFunctional and aesthetic prosthodontic rehabilitation of severely worn teeth can be achieved satisfactory with minimal invasive procedures using defect oriented, indirect lithium disilicate ceramic restorations with increasing the VDO to its original state.Clinical SignificanceIndirect, minimal invasive lithium disilicate ceramic restorations are suitable to restore the VDO of severe dental erosions.
Dyadic interaction of parentification in Chinese families of maternal depression: A qualitative study
Authors: Tam Alan Tsz Lun , Cheung Mei Chun 
Published: December 2024

AbstractThis qualitative study explores the lived experiences of parent–child dyads to understand the occurrence of parentification in Chinese families affected by parental depression. Utilizing purposive sampling, families were recruited from community mental health services in Hong Kong, focusing on parents with major depressive disorder and their adolescent children. Data were collected from 14 families through in‐depth, semistructured interviews with adolescents (n = 8) and parents (n = 12), as well as dyadic interviews (n = 8), and analyzed utilizing thematic analysis. The central theme, “Complementary Dynamic Interaction: Rippled Relationship,” captures the mutual, circular, and reciprocal interactions within parent–adolescent dyads in the context of parental depression. These findings highlight the unique dynamics of parentification in Chinese families affected by parental depression.
The Effect of Natural Disasters on Inbound Tourism: Synthetic Control Evidence From Italy
Authors: Antonaglia Federica , De Simone Elina , Dorato Lorenzo , Gaeta Giuseppe Lucio , Pinto Mauro 
Published: December 2024

ABSTRACTThis study enhances the expanding but still limited body of evidence concerning the influence of natural hazards on tourism. We augment prior scholarly investigations by scrutinizing the repercussions of the 2009 L'Aquila earthquake on incoming tourism, thereby addressing an existing void in the literature regarding the ramifications of extreme events on high‐income nations such as Italy. Moreover, our contribution is novel in its application of the quasi‐experimental Synthetic Control Method within the realm of tourism research. Our findings underscore the enduringly deleterious consequences of the L'Aquila hazard on tourism, persisting over a protracted temporal horizon. In particular, the analysis shows a drop in overnight stays with a pronounced effect on hotel accommodations.
Salivary Proteomics for Detecting Novel Biomarkers of Periodontitis: A Systematic Review
Authors: Corana Matteo , Baima Giacomo , Iaderosa Giovanni , Franco Francesco , Zhang Jianjian , Berta Giovanni Nicolao , Romano Federica , Aimetti Mario 
Published: December 2024

ABSTRACTAimSalivary content is regarded as a powerful diagnostic window for oral and systemic diseases and the proteomic profile could be useful to distinguish between different periodontal conditions. The aim of the present systematic review was to assess distinctive salivary proteins identified through untargeted proteomics in periodontitis patients compared to periodontally healthy and gingivitis subjects, as well as to provide a qualitative methodological assessment of the current literature.MethodsRelevant studies identified from Medline via PubMed, Scopus, Embase, and Cochrane Library databases were retrieved to answer the following PECO question: “In systemically healthy individuals, are there any differences in salivary protein expression profiles assessed in proteomics studies between patients with periodontitis and periodontally healthy or gingivitis subjects?” Moreover, diagnostic utility of the identified markers was sought via a targeted literature search and further quantitative assessment. A modified version of the QUADAOMICS tool was used for the quality assessment of the included studies.ResultsAfter screening 461 relevant articles, a total of 13 studies were selected. The number of identified discriminant salivary proteins ranged from 2 to 4161. However, it was possible to identify proteins that were consistently over‐ or under‐expressed in periodontitis patients in at least 3 studies. Among these, complement C3, profilin‐1, SA100A8, and fibrinogen were consistently reported as increased in periodontitis, while cystatin‐SN and leukocyte elastase inhibitor were more elevated in periodontally healthy controls. Only 4 studies reported diagnostic accuracy measures, with SA100A8 showing an area under the curve of 0.71 (95% CI: 0.66–0.75) in meta‐analysis.ConclusionsUntargeted proteomics techniques identified some key biological molecules which were consistently reported to be over‐ or under‐expressed in periodontitis. These findings could be useful to support novel candidate biomarkers for periodontitis. The high level of heterogeneity in methods and reporting urge to develop standardized protocols to be implemented in this research field (PROSPERO CRD42022299826).
A Common Consumption Pattern in China: Evidence and Mechanism*
Authors: Sun Yucheng , Zhou Xianbo 
Published: December 2024

AbstractUsing a representative sample of Chinese households, this article studies how a non‐rich household's consumption is positively affected by the consumption and income of its rich reference group. Exploiting variations in the levels of the top quantiles of county–year consumption and income distributions, we document two central results. First, non‐rich households consume more when exposed to a reference group with higher consumption and income. Second, the positive effect is the largest in the low tail of the household consumption distribution, which indicates that the common consumption effect can mitigate consumption inequality. Combining the above two findings, we refer to the impacts of a rich reference group on the consumption of non‐rich households as the common consumption effect. We find some supporting evidence that status‐signalling theory, not other classical theories, offers the most likely explanation. Relatively high‐rank non‐rich households are more motivated than low‐rank non‐rich households to signal status to their reference groups by allocating consumption toward more visible goods and services and drawing on loans. Our results hold under several robustness checks, such as controlling for confounders constant at the county level or household level, accounting for sample attrition and relaxing the exclusion restriction.
Bureaucratic prioritizing among clients in the eyes of the public: Experimental evidence from three countries
Authors: Hansen Paw H. , Pedersen Mogens Jin , Willems Jurgen 
Published: December 2024

AbstractIn response to workloads and service demands, frontline workers often prioritize among their clients when delivering public services. This article examines the implications of such bureaucratic prioritization on democratic governance, specifically the public's attitudes toward how frontline workers prioritize among clients. Using data from a pre‐registered, rank‐based conjoint survey experiment conducted among residents (n = 2655) in Denmark, the Netherlands, and New Zealand, we explore two key aspects of bureaucratic prioritization from the public's perspective: (1) citizens' preferences on how teachers should prioritize among students and (2) citizens' beliefs about how teachers do prioritize among students. Our findings reveal general alignments between the public's normative preferences, their descriptive beliefs, and the prioritization tendencies of real‐life teachers as documented in previous research. We discuss the implications of these results in terms of administrative legitimacy and the governance perspective of New Public Service.
Associations of poor water, sanitation, and hygiene and parasite burden with markers of environmental enteric dysfunction in preschool‐age children infected with Schistosoma mansoni in Uganda
Authors: Colt Susannah , Edielu Andrew , Lewander David , Wu Hannah W. , Webb Emily L. , Mawa Patrice A. , Nakyesige Racheal , Ayebazibwe A. Gloria K. , Friedman Jennifer F. , Bustinduy Amaya L. 
Published: December 2024

AbstractBackgroundEnvironmental enteric dysfunction (EED) is an acquired subclinical condition of the small intestine with lasting health implications for nutritional status, linear growth and development among children. EED is characterised by structural and functional changes to the gut barrier. There are no standardised diagnostic criteria, however, a number of biomarkers have been evaluated to capture EED domains. While the causes of EED are not fully understood, risk factors include poor water, sanitation and hygiene conditions and exposure to enteric pathogens. Very few studies have evaluated the impact of schistosomiasis on EED despite repeated intestinal damage from parasite eggs passing across the gut barrier.MethodsIn a cohort of 354 preschool‐aged children aged 12–47 months with Schistosoma mansoni infection recruited from the Lake Albert region of Uganda, we assessed exposure to water, sanitation and hygiene conditions and measured markers from each EED domain: intestinal inflammation (faecal calprotectin), epithelial damage (serum intestinal fatty‐acid binding‐protein), increased permeability (urine lactulose to mannitol ratio and faecal alpha‐1 antitrypsin) and microbial translocation (serum endotoxin core antibody).ResultsIn multivariable linear regression models, we found that children whose drinking water was sourced from Lake Albert had higher concentrations of intestinal fatty‐acid binding‐protein (β = 0.48, 95% CI 0.20–0.76, p < 0.001), and lack of toilet/latrine access was associated with higher concentrations of calprotectin (β = 0.48, 95% CI 0.18–0.78, p < 0.01). Higher schistosomiasis intensity (eggs per gram of stool) was associated with higher calprotectin (β = 0.10, 95% CI 0.02–0.17, p = 0.01), but not with other EED markers.ConclusionsFew studies have investigated schistosomiasis‐related morbidities in very young children infected with schistosomiasis. Our findings from Uganda show that poor water, sanitation and hygiene conditions and heavier schistosomiasis burden are associated with intestinal inflammation and damage, contributing to EED. Improved treatment coverage for preschool‐aged children infected with schistosomiasis may reduce the burden from EED and associated long‐term morbidities.
Seroprevalence and Molecular Detection of Toxoplasma gondii in Wild Boars (Sus scrofa) in Khuzestan Province, Iran
Authors: Boozhmehrani Mohammad Javad , Feiz‐Haddad Mohammad Hossein , Tavalla Mehdi , Nouri Mohammad , Ghoreishi Seyed Morteza 
Published: December 2024

ABSTRACTIntroductionToxoplasma gondii is a parasitic protozoan capable of infecting warm‐blooded animals, including humans, and is the causative agent of toxoplasmosis. Wild boars (Sus scrofa) serve as reservoirs for zoonotic pathogens like T. gondii, which can cause disease in humans if transmitted. This study aimed to assess the seroprevalence and molecular prevalence of T. gondii in wild boars in Khuzestan Province, Iran.MethodsSeroprevalence of T. gondii antibodies was assessed using enzyme‐linked immunosorbent assay (ELISA), employing a commercial kit (Calbiotech), whereas molecular detection was carried out through polymerase chain reaction (PCR) targeting the B1 gene of T. gondii on tissue samples (tongue, muscle, diaphragm and heart). Thirty wild boars were sampled from the regions of Shush, Shushtar, Dezful and Abadan, and both blood and tissue samples were analysed.ResultsIn this study, the seroprevalence of T. gondii antibodies was found to be 83.3% (25/30) among wild boar serum samples using ELISA. Molecular detection through PCR identified T. gondii DNA in 46.7% (14/30) of tissue samples, with the highest detection rates in tongue tissues (64%), followed by muscle (21%) and diaphragm (14%). No positive results were found in heart samples, and no animal had multiple tissues testing positive. All PCR‐positive cases corresponded with positive ELISA results, and a statistically significant difference was observed in parasite prevalence across different tissues (p = 0.002).ConclusionAlthough consumption of wild boar meat is banned in Iran, illegal hunting and consumption remain a concern. The high prevalence of T. gondii in wild boars poses a potential risk for transmission through the illegal consumption of undercooked or raw meat. This study highlights the need for public health interventions to control the illegal trade of wild boar meat and reduce the risk of toxoplasmosis transmission. Further research is recommended to investigate T. gondii distribution in other tissues, including the brain, and to better understand the parasite's epidemiology in this region.
On dynamical parameter space of cubic polynomials with a parabolic fixed point
Authors: Zhang Runze 
Published: December 2024

AbstractThis article focuses on the connectedness locus of the cubic polynomial slice with a parabolic fixed point of multiplier . We first show that any parabolic component, which is a parallel notion of hyperbolic component, is a Jordan domain. Moreover, a continuum called the central part in the connectedness locus is introduced. This is the natural analogue to the closure of the main hyperbolic component of . We prove that is almost a double covering of the filled‐in Julia set of the quadratic polynomial .
LC-AMP-I1, a novel venom-derived antimicrobial peptide from the wolf spider
Lycosa coelestis
Authors: Wang Junyao , Liu Xi , Song Yuxin , Liu Zhonghua , Tang Xing , Tan Huaxin 
Published: December 2024

ABSTRACT

Antibiotic resistance has become a critical concern in recent years, and antimicrobial peptides may function as innovative antibacterial agents to address this issue. In this work, we identified a novel antimicrobial peptide, LC-AMP-I1, derived from the venom of
Lycosa coelestis
, demonstrating substantial antibacterial properties and minimal hemolytic activity. LC-AMP-I1 was subjected to additional assessment for antibacterial efficacy, anti-biofilm properties, drug resistance, stability, and cytotoxicity
in vitro
. It exhibited comparable antibacterial efficacy to melittin against six common clinical multidrug-resistant bacteria, effectively inhibiting biofilm formation and disrupting established biofilms. Additionally, LC-AMP-I1 demonstrated minimal bacterial resistance, excellent stability, negligible mammalian cell toxicity, low hemolytic activity, and appropriate selectivity for both normal and tumor cells. When combined with traditional antibiotics, LC-AMP-I1 exhibited additive or synergistic therapeutic effects. In a neutropenic mouse thigh infection model, LC-AMP-I1 exhibited a therapeutic effect in inhibiting bacterial proliferation
in vivo
. The mechanistic investigation indicated that LC-AMP-I1 could influence bacterial cell membrane permeability at low concentrations and directly disrupt structure-function at high concentrations. The results of this work indicate that LC-AMP-I1 may function as a viable alternative to traditional antibiotics in addressing multidrug-resistant bacteria.
Irregular pulsation on 4D-CTA and quantitative wall enhancement on VW-MRI are associated with symptoms of unruptured intracranial aneurysms
Authors: Zhang Jianjian , Li Xiao , Zhang Jin , Sun Beibei , Wang Lingling , Tian Jiaqi , Mossa-Basha Mahmud , Levitt Michael R , Zhao Bing , Xu Jianrong , Zhou Yan , Zhao Huilin , Zhu Chengcheng 
Published: December 2024

BackgroundUnruptured intracranial aneurysms (IAs) that become symptomatic have been associated with instability.ObjectiveTo investigate the relationship between irregular pulsation on four-dimensional CT angiography (4D-CTA) and aneurysm wall enhancement (AWE) on vessel wall MRI (VW-MRI), and to evaluate their ability to identify symptomatic IAs.MethodsThis retrospective study included consecutive patients with IAs who underwent 4D-CTA and VW-MRI between March 2018 and May 2023. IAs were categorized as asymptomatic and symptomatic. The presence of irregular pulsation was identified on 4D-CTA video. Qualitative and quantitative AWE were evaluated. Univariate and multivariate analyses were used to identify the parameters associated with symptoms.Results192 patients with 216 aneurysms (167 asymptomatic and 49 symptomatic) were included. IAs with irregular pulsation had significantly higher wall enhancement index (WEI) than IAs without irregular pulsation (median (IQR), 0.5 (0.2–1.1) vs 0.2 (0.0–0.6), P<0.001). Symptomatic IAs had significantly higher WEI than asymptomatic IAs (median (IQR), 0.7 (0.3–1.5) vs 0.2 (0.0–0.5), P<0.001), and more irregular pulsations (79.6% vs 25.1%, P<0.001). Both irregular pulsation (OR=6.86; 95% CI 2.62 to 17.96; P<0.001) and WEI (OR=2.56; 95% CI 1.14 to 5.71; P=0.022) were independently associated with symptoms. Combination of irregular pulsation and WEI achieved the highest area under the curve of 0.86 in identifying symptomatic aneurysms compared with irregular pulsation or WEI alone (P<0.001 and P=0.002, respectively).ConclusionIn a large cohort of patients with unruptured IAs who underwent 4D-CTA and VW-MRI, both irregular pulsation and WEI were independently associated with symptoms. Such measures could identify IAs at higher risk of growth or rupture.