bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Tele-Stewardship on Rural Antibiotic Prescribing Practices
Authors: Peworchik Matthew , Banerjee Ritu , Katz Sophie E 
Published: October 2024

Abstract

Background
Antibiotic prescribing for children is highest in rural areas. Tele-stewardship allows for implementation of antimicrobial stewardship (AS) via telecommunication with providers. There has been limited research on the effectiveness of tele-stewardship in the outpatient setting. In this study, we address the need for better AS in rural areas by developing, implementing, and evaluating AS interventions using tele-stewardship.

Methods
We employed bundled outpatient AS implementation strategies in rural pediatric primary care (PC) clinics and emergency departments (EDs) affiliated with Vanderbilt University Medical Center (VUMC) using tele-stewardship. The bundle includes (1) patient/guardian educational materials, (2) antibiotic use commitment posters (3) provider education through quarterly teaching pearls on common pediatric infections, communication skills training (DART modules), app-based microlearning modules (QuizTime), and implicit/explicit bias education and (4) quarterly audit and feedback with peer comparison on guideline-concordant antibiotic use. Participants are pediatric prescribers (physician, physician assistant, nurse practitioner). We compared antibiotic prescription data for children &lt;18 years collected during the “baseline” period (Jan-Dec 2022) to the intervention period (Jan-Sept 2023). Two academic urban primary care clinics and one academic urban ED at which the interventions were not implemented were included as “control” sites. The primary outcome is percent of all encounters that result in an antibiotic prescription. Pre- and post-intervention data were analyzed in aggregate (not at the provider-level). Significance was determined via calculating a 95% confidence interval (CI) for the difference of proportions.

Results
To date, there have been 140,077 PC patient encounters (98,409 baseline and 41,065 intervention) and 94,205 ED encounters (61759 baseline and 32,446 intervention) across all sites. Change from baseline to intervention periods in academic PC sites was 0.9 percentage points (95% CI 0.556 to 1.243; 6.6% baseline, 7.5% intervention) while change in rural intervention sites was -1.05 percentage points (95% CI -0.409 to -1.667; 11.8% baseline, 10.75% intervention; Figure 1a). Only 1 of 3 rural EDs had a decrease in percent of encounters with an antibiotic prescription (Figure 1b). Overall the academic ED showed a 3.1 percentage point increase (95% CI 2.430 to 3.769; 18.0% baseline, 21.1% intervention) while the rural sites showed a 1.0 percentage point increase (95% CI -0.817 to 2.817; 24.2% baseline, 25.2% intervention).

Conclusion
Interim analysis shows that bundled implementation strategies using tele-AS led to significantly decreased overall antibiotic use in rural primary care clinics compared to urban academic control sites. The study is ongoing and will continue to evaluate outcomes over a longer intervention period to reduce seasonal bias.
Current situation and trends of radiation therapy in Japan based on the National Database Open Data
Authors: Okazaki Shohei , Murata Masumi , Kitamoto Yoshizumi 
Published: October 2024

Abstract
This study aimed to visualize the current situation and trends in radiation therapy in Japan using open data from the Japanese National Database of Health Insurance Claims and Specific Health Checkups (NDB). We downloaded the NDB open data from the website of Japan’s Ministry of Health, Labor and Welfare and used Python libraries to analyze the receipt data related to radiation therapy from fiscal year 2014 to 2022. The number of radiation therapy plans peaked in 2019, temporarily declined and subsequently showed a gradual increase. Conversely, the total points associated with radiation therapy have consistently increased without any decline. The use of high-precision radiation therapies such as intensity-modulated radiation therapy (IMRT) has increased over time. Significant regional differences exist, with the Chubu and Kyushu regions showing higher total points and receipts per certified radiation oncologist. A correlation was observed between the number of IMRT plans per population and the number of certified radiation oncologists. Males exhibited a sharp peak in their early 70s, while females demonstrated a mild peak from their 40s to 80s. In recent years, the points for males in their early 70s have rapidly increased. We used the NDB open data to illustrate the current situation and trends in radiation therapy in Japan, highlighting reduced costs and workloads. This study underscored the regional differences in radiation therapy and emphasized the need to discuss strategies for meeting future demand.
Development and validation of a prediction model for gastric cancer: a single-center prospective study
Authors: Sun Suyu , Huang Feifei , Xu Xueqin , Xu Ke , Peng Tingting , Bai Wenjing , Huang Chunwei , Hu Xingzhong , Pan Yong 
Published: October 2024

Abstract

Objective
This study aimed to develop and validate a novel nomogram for diagnosing gastric cancer (GC).

Methods
In this prospective analysis, 146 patients of Wenzhou Central Hospital were recruited for a GC group and a benign lesion group and were divided into a training set and an internal validation set in a ratio of 7:3. Clinical and analytical characteristics were collected and analyzed by logistic regression analysis. The performance of the predictive model was evaluated using the receiver operating characteristic curve, calibration curve, and decision curve analysis.

Results
There were 5 variables, namely albumin, carcinoembryonic antigen, carbohydrate antigen 125, creatinine, and small proline-rich protein 2A, that were identified as the final parameters for the developed model. In the training and internal validation sets, the area under the curve of the model was 0.968 and 0.979, respectively, showing good diagnostic performance.

Conclusion
This study developed and validated a new nomogram based on 5 parameters. This model shows good diagnostic performance in distinguishing GC from benign lesion groups and has certain significance in clinical application.
JWST FRESCO: a comprehensive census of H β + [O iii] emitters at 6.8 &lt; z &lt; 9.0 in the GOODS fields
Authors: Meyer R A , Oesch P A , Giovinazzo E , Weibel A , Brammer G , Matthee J , Naidu R P , Bouwens R J , Chisholm J , Covelo-Paz A , Fudamoto Y , Maseda M , Nelson E , Shivaei I , Xiao M , Herard-Demanche T , Illingworth G D , Kerutt J , Kramarenko I , Labbe I , Leonova E , Magee D , Matharu J , Prieto Lyon G , Reddy N , Schaerer D , Shapley A , Stefanon M , Wozniak M A , Wuyts S 
Published: October 2024

ABSTRACT
We present the census of H $\beta$ + [${\rm O\, {\small III}}$] $4960,5008\rm{\mathring{\rm\,A}}$ emitters at $6.8\lt z\lt 9.0$ from the JWST FRESCO survey over 124 arcmin$^2$ in the GOODS-North and GOODS-South fields. Our unbiased spectroscopic search results in 137 spectroscopically confirmed galaxies at $6.8\lt z\lt 9.0$ with observed [${\rm O\, {\small III}}$] fluxes $f_{\rm { [{\rm O\, {\small III}}]}}\gtrsim 1\times 10^{-18}\ \rm {ergs}\ \rm {s}^{-1} \ \rm {cm}^{-2}$. The rest-frame optical line ratios of the median stacked spectrum (median $M_{\rm {UV}}=-19.65^{+0.59}_{-1.05}$) indicate negligible dust attenuation, low metallicity ($12+\log (\rm {O/H})= 7.2-7.7$) and a high ionization parameter $\log _{10}U \simeq -2.5$. We find a factor $\times 1.3$ difference in the number density of $6.8\lt z\lt 9.0$ galaxies between GOODS-South and GOODS-North, which is caused by a single overdensity at $7.0\lt z\lt 7.2$ in GOODS-North. The bright end of the UV luminosity function of spectroscopically confirmed [${\rm O\, {\small III}}$] emitters is in good agreement with HST dropout-selected samples. Discrepancies between the observed [${\rm O\, {\small III}}$] LF, [${\rm O\, {\small III}}$]/UV ratio, and [${\rm O\, {\small III}}$] equivalent widths, and that predicted by theoretical models, suggest burstier star-formation histories and/or more heterogeneous metallicity and ionizing conditions in $z\gt 7$ galaxies. We report a rapid decline of the [${\rm O\, {\small III}}$] luminosity density at $z\gtrsim 6\!-\!7$ which cannot be explained by the evolution of the cosmic star-formation rate density. Finally we find that FRESCO detects in only 2h galaxies likely accounting for $\sim 10-20{{\ \rm per\ cent}}$ of the ionizing budget at $z=7\!-\!8$ (assuming an escape fraction of $10{{\ \rm per\ cent}}$), raising the prospect of directly detecting a significant fraction of the sources of reionization with JWST.
Tracing the Evolutionary History of the Temperature-Sensing Prion-like Domain in EARLY FLOWERING 3 Highlights the Uniqueness of AtELF3
Authors: Zhu Zihao , Trenner Jana , Delker Carolin , Quint Marcel 
Published: October 2024

Abstract
Plants have evolved mechanisms to anticipate and adjust their growth and development in response to environmental changes. Understanding the key regulators of plant performance is crucial to mitigate the negative influence of global climate change on crop production. EARLY FLOWERING 3 (ELF3) is one such regulator playing a critical role in the circadian clock and thermomorphogenesis. In Arabidopsis thaliana, ELF3 contains a prion-like domain (PrLD) that acts as a thermosensor, facilitating liquid–liquid phase separation at high ambient temperatures. To assess the conservation of this function across the plant kingdom, we traced the evolutionary emergence of ELF3, with a focus on the presence of PrLDs. We found that the PrLD, primarily influenced by the length of polyglutamine (polyQ) repeats, is most prominent in Brassicales. Analyzing 319 natural A. thaliana accessions, we confirmed the previously described wide range of polyQ length variation in AtELF3, but found it to be only weakly associated with geographic origin, climate conditions, and classic temperature-responsive phenotypes. Interestingly, similar polyQ length variation was not observed in several other investigated Bassicaceae species. Based on these findings, available prediction tools and limited experimental evidence, we conclude that the emergence of PrLD, and particularly polyQ length variation, is unlikely to be a key driver of environmental adaptation. Instead, it likely adds an additional layer to ELF3's role in thermomorphogenesis in A. thaliana, with its relevance in other species yet to be confirmed.
Genome-wide identification and expression analysis of the ZRT, IRT-like protein (ZIP) family in Nicotiana tabacum
Authors: Duan Zhijie , Soviguidi Deka Reine Judesse , Pan Bangzhen , Lei Rihua , Song Zhongbang , Liang Gang 
Published: October 2024

Abstract
Iron (Fe) and Zinc (Zn) are essential micronutrients for plant growth and development. ZIP (ZRT, IRT-like protein) transporters, known for their role in the regulation of Zinc and Iron uptake, are pivotal in facilitating the absorption, transport, and maintenance of Fe/Zn homeostasis in plants. Nicotiana tabacum has been widely used as a model plant for gene function analysis; however, the tobacco ZIP genes have not been identified systematically. In this study, we have identified a comprehensive set of 32 NtZIP genes, which were phylogenetically categorized into three distinct clades. The gene structures, characterized by their exon/intron organization, and the protein motifs are relatively conserved, particularly among genes within the same clade. These NtZIP genes exhibit an uneven distribution across 12 chromosomes. The gene localization analysis revealed the presence of 11 pairs of homeologous locus genes and 7 pairs of tandem duplication genes within the genome. To further explore the functionality of these genes, real-time quantitative reverse transcription PCR was employed to assess their expression levels in roots subjected to metal deficiency. The results indicated that certain NtZIP genes are specifically upregulated in response to either Fe or Zn deficiency. Additionally, the presence of specific cis-elements within their promoter regions, such as the E-box associated with Fe deficiency response and the ZDRE box linked to Zn deficiency response, was identified. This study lays a foundational groundwork for future research into the biological functions of NtZIP genes in tobacco in micronutrient regulation and homeostasis.
C G composition in transposon-derived genes is increased in FXD with perturbed immune system
Authors: Suganuma Tamaki , Hassan Huzaifa , Gogol Madelaine , Workman Jerry L 
Published: October 2024

Abstract
Increasing incidence of Fragile X disorders (FXD) and of immune-mediated disorders in FXD suggests that additional factors besides FMR1 mutations contribute to the pathogenesis. Here, we discovered that the expression levels or splicing of specific transposon element (TE)-derived genes, regulating purine metabolism and immune responses against viral infections are altered in FXD. These genes include HLA genes clustered in chr6p21.3 and viral responsive genes in chr5q15. Remarkably, these TE-derived genes contain a low A T/C G suggesting base substitutions of A T to C G. The TE-derived genes with changed expression levels contained a higher content of 5′-CG-3′ dinucleotides in FXD compared to healthy donors. This resembles the genomes of some RNA viruses, which maintain high contents of CG dinucleotides to sustain their latent infection exploiting antiviral responses. Thus, past viral infections may have persisted as TEs, provoking immune-mediated disorders in FXD.
Synergistic combination of perphenazine and temozolomide suppresses patient-derived glioblastoma tumorspheres
Authors: Hong Jun Pyo , Choi Ran Joo , Shim Jin-Kyoung , Kim Kibyeong , Kim Ryong Nam , Cho HyeJoung , Kim Seo Jin , Kim Sohyun , Kim Nam Hwa , Park Hun Ho , Moon Ju Hyung , Kim Eui Hyun , Teo Wan-Yee , Chung Seungsoo , Chang Jong Hee , Kang Seok-Gu 
Published: October 2024

Abstract

Background
Glioblastoma (GBM), a primary malignant brain tumor, has a poor prognosis, even with standard treatments such as radiotherapy and chemotherapy. In this study, we explored the anticancer effects of the synergistic combination of perphenazine (PER), a dopamine receptor D2/3 (DRD2/3) antagonist, and temozolomide (TMZ), a standard treatment for GBM, in patient-derived human GBM tumorspheres (TSs).

Methods
The biological effects of the combination of PER and TMZ in GBM TSs were assessed by measuring cell viability, ATP, stemness, invasiveness, and apoptosis. Changes in protein and mRNA expression were analyzed using western blotting and RNA sequencing. Co-administration of PER and TMZ was evaluated in vivo using a mouse orthotopic xenograft model.

Results
The Severance dataset showed that DRD2 and DRD3 expressions were higher in tumor tissues than in the tumor-free cortex of patients with GBM. DRD2/3 knockout by CRISPR/Cas9 in patient-derived human GBM TSs inhibited cell growth and ATP production. The combined treatment with PER and TMZ resulted in superior effects on cell viability and ATP assays compared to those in single treatment groups. Flow cytometry, western blotting, and RNA sequencing confirmed elevated apoptosis in GBM TSs following combination treatment. Additionally, the combination of PER and TMZ downregulated the expression of protein and mRNA associated with stemness and invasiveness. In vivo evaluation showed that combining PER and TMZ extended the survival period of the mouse orthotopic xenograft model.

Conclusions
The synergistic combination of PER and TMZ has potential as a novel combination treatment strategy for GBM.
Waterpipe Size Matters: The Effect of Waterpipe Size on Toxicant Exposures and Subjective Experiences
Authors: Dabroy Danny , Barrientos Steven Alec , Ebrahimi Kalan Mohammed , Alarabi Ahmed , Schug Kevin , Goff Roman , Islam Sabrina , Cobb Caroline O , Ben Taleb Ziyad 
Published: October 2024

Abstract

Introduction
Waterpipe (WP) tobacco smoking remains popular among US young adults, yet specific regulations for WP devices are lacking. This study examines how WP device size (base volume and height) affects smoking behavior, toxicant exposures, and subjective experiences.

Aims and Methods
Thirty-eight individuals who smoke WP aged 21–39 participated in a randomized crossover study. Each completed three 45-min ad libitum smoking sessions using small, medium, and large WP sizes. Saliva nicotine and exhaled carbon monoxide (eCO) were measured before and after smoking. Puff topography was recorded during sessions, and subjective smoking experiences were collected afterwards.

Results
Significant differences were observed in saliva nicotine between the three WP sizes, with higher concentrations for the small WP relative to larger sizes (p &lt; .05). Exhaled CO was significantly higher after smoking the large WP compared to smaller sizes (p &lt; .05). Puff topography revealed significant differences and followed a dose-response pattern, with larger size associated with longer puff duration, greater smoke volume inhaled, and larger puff volume (p &lt; .05). The large WP was associated with enhanced subjective experiences for satisfaction and concentration compared to the small WP (p &lt; .05).

Conclusions
WP size substantially impacts smoking experiences and exposures. Regulation of WP size should be essential in comprehensive tobacco control policies aimed at curbing WP use among young adults. These findings will aid in the developing of WP size-specific standards to regulate the marketing and sales of WP devices. Such regulations should aim to minimize toxicant exposure by controlling the dimensions and design of WP components, which can significantly influence smoking behavior and toxicant intake.

Implications
This study underscores the critical role of waterpipe (WP) size in shaping smoking behavior, experiences, and exposures among young adults.
High Prescription Rate of Medications With Rifampin Drug–drug Interactions in Patients With Diabetic Foot Osteomyelitis: Should Rifabutin Be Included in Clinical Trials for Adjunctive Therapy?
Authors: Mallarino-Haeger Christina , Watson Allison , Mahgoub Umnia , Francis Lily , Heydari Maryam , Choudhary Muaaz , Garcia-Toca Manuel , Patel Manish , Kempker Russell R , Fayfman Maya , Schechter Marcos C 
Published: October 2024

Abstract
Rifampin may improve diabetic foot osteomyelitis outcomes, but its extensive drug–drug interactions could hamper its use. Here, through a review of the medications prescribed to a cohort of 190 persons with diabetic foot osteomyelitis, we show that rifabutin, a rifamycin with fewer drug–drug interactions, would be easier to implement in practice.
Understanding Typology of Preexposure Prophylaxis (PrEP) Persistence Trajectories Among Male PrEP Users in the United States
Authors: Chen Yi-No , Zhou Junlan , Kirkham Heather S , Witt Edward A , Jenness Samuel M , Wall Kristin M , Kamaleswaran Rishi , Naimi Ashley I , Siegler Aaron J 
Published: October 2024

Abstract

Introduction
Understanding longitudinal patterns of preexposure prophylaxis (PrEP) use among men who have sex with men could offer insights for developing efficient and timely interventions to promote PrEP persistence.

Setting
We extracted 2 years of pharmacy fill records for 4000 males who initiated PrEP in 2017 at a national chain pharmacy in the United States.

Methods
Group-based trajectory models were used to develop PrEP trajectory clusters, with periods of use defined based on optimal PrEP seroprotection probabilities (ie, PrEP use frequency ≥4 doses/week). Multinomial logistic regressions were used to evaluate the associations between sociodemographic covariates and identified trajectory group membership.

Results
We identified 4 distinct groups of PrEP persistence trajectories: (1) persistent use of PrEP throughout the period (persistent user), (2) brief use followed by sustained cessation of PrEP use (brief user), (3) PrEP use up to the mid-term followed by sustained cessation of PrEP use (mid-term user), and (4) PrEP use, followed by cessation and subsequent reinitiation (PrEP reinitiator). Persistent users and brief users accounted for 40.1% and 22.9% of the population, respectively, whereas mid-term users and reinitiators accounted for 18.9% and 18.2%, respectively. Older age at PrEP initiation, commercial insurance as the primary payer of PrEP, and use of specialty pharmacy were found to be associated with persistent PrEP use over the other patterns of nonpersistence.

Conclusions
Subgroups of PrEP users could benefit from PrEP persistence interventions that target specific timings of likely PrEP cessation or considerations of reinitiation.
Incidence of Respiratory Syncytial Virus in Community-Dwelling Adults Aged 18–64 Years Over 2 Seasons, 2022–2024, in a North American Community
Authors: Bosch Wendelyn , Speiser Lisa J , Wi Chung-Il , King Katherine S , Natoli Traci L , Ihrke Kathy D , Spiten Matthew J , Binnicker Matthew J , Yao Joseph D , Takahashi Paul Y , Pignolo Robert J , Hidaka Brandon H , Foss Randy M , Pirçon Jean-Yves , Saeedi Pouya , Oujaa Mohamed , Juhn Young J 
Published: October 2024

Abstract

Background
The incidence of respiratory syncytial virus (RSV)–acute respiratory infection (ARI) in community-dwelling adults after the Omicron variant of the COVID-19 pandemic is unknown. Our aim was to assess the incidence of RSV-ARI in adults aged 18 to 64 years over 2 consecutive RSV seasons (October–April 2022–2024) in 4 US states.

Methods
This community-based prospective cohort study comprised 7501 participants in Minnesota, Wisconsin, Florida, and Arizona. We calculated RSV-ARI and RSV–lower respiratory tract disease (LRTD) incidence and attack rates. We reported unadjusted incidence by age group, gender, race and ethnicity, Charlson Comorbidity Index, socioeconomic status, residential state, and rural/urban setting.

Results
Seasons 1 and 2 had 2250 and 2377 ARI episodes, respectively, with an RSV-ARI positivity rate of 5.5% for season 1 and 5.8% for season 2 among those tested. In season 1, the overall incidence of RSV-ARI was 27.71 (95% CI, 22.82–33.34) per 1000 person-years (1.49% attack rate). Almost half (49.0%) had RSV-LRTD, with an incidence of 13.53 (95% CI, 10.19–17.61) per 1000 person-years (0.73% attack rate). In season 2, the RSV-ARI and RSV-LRTD incidence rates were 26.39 (95% CI, 21.73–31.75) per 1000 person-years (1.51% attack rate) and 12.43 (95% CI, 9.31–16.26) per 1000 person-years (0.72% attack rate). RSV-ARI incidence peaked in November 2022 and December 2023.

Conclusions
Our observations suggest that RSV-ARI incidence and seasonal pattern are shifting to prepandemic RSV epidemiology.
High Prevalence of Carbapenem-resistant Klebsiella Pneumoniae in Fecal and Water Samples in Dhaka, Bangladesh
Authors: Kar Sanchita , Kawser Zannat , Sridhar Sushmita , Mukta Sharmin Aktar , Hasan Neamul , Siddik Abu Bakar , Habib Mohammad Tanbir , Slater Damien M , Earl Ashlee M , Worby Colin J , Azad Kasrina , Shamsuzzaman S M , Tanni Nusrat Noor , Khan Raisa Tasnia , Moonmoon Meherunnisa , Qadri Firdausi , Harris Jason B , LaRocque Regina C 
Published: October 2024

Abstract
We evaluated Klebsiella pneumoniae (Kp) gut carriage in healthy, unrelated adults and children living in separate households in Dhaka, Bangladesh. Average Kp prevalence in stool samples ranged from 61% in young children (15/25) to 81% in adults (21/26), with significantly higher abundance in adults (P = .03, t-test). Kp was also prevalent in household water (64%, 21/33) and standing water (85%, 23/27). The presence of Kp in household water was not strongly linked to stool Kp abundance among household members. Antimicrobial resistance was notable: 9% (6/69) of stool and 16% (7/44) of water isolates exhibited multidrug resistance. Carbapenem resistance was observed in 12% of stool isolates (8/69) and 14% of water isolates (6/44). These findings underscore the commonality of Kp in human and environmental reservoirs in Dhaka, Bangladesh, and highlight the emergence of drug-resistant Kp beyond healthcare settings.