bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical inertia in onychomycosis treatment: results from the Illuminating Dialogues and Insights in Onychomycosis Management (IDIOM) survey
Authors: Tsunemi Yuichiro , Otsuka Atsushi , Nonaka Yusuke 
Published: October 2024

AbstractOnychomycosis is a fungal infection of the nail that can serve as a reservoir for tinea infections in other parts of the body and can be transmitted to other individuals. As the disease progresses, it can lead to functional impairment, such as difficulties in walking, and negatively impact the psychosocial aspects of quality of life. Onychomycosis treatment, especially topical, is long‐term, and adequate follow‐up is essential for cure. However, the realities and issues of patient‐physician communication after treatment initiation, including patients' perception of efficacy, treatment satisfaction, and reconsideration of the treatment approach, remain unclear. Therefore, this study aimed to examine the realities and issues associated with onychomycosis treatment, focusing on topical therapies, through a web‐based survey of patients with onychomycosis and dermatologists. The duration of topical treatment was prolonged, with 30.5% of patients undergoing topical therapy for more than 2 years. Of these, 54.5% had not perceived clear efficacy. In addition, 93.7% of all patients with onychomycosis expressed a desire to change their treatment if it was ineffective. However, only 29.9% of patients receiving topical treatment discussed changing their treatment with their physicians, and only 7.3% ultimately changed their treatment. These findings indicate that the review of treatment strategies was insufficient. Furthermore, the satisfaction rate among patients treated with oral medications was higher than that of patients treated with topical medication. Despite dermatologists' awareness of low patient satisfaction with topical treatments, approximately 40% recommended alternative topical therapies when the initial topical treatment was ineffective. These results suggest clinical inertia in the treatment of onychomycosis stemming from a lack of appropriate intensification of treatment. In managing onychomycosis, the patient and dermatologist must share a common understanding of the importance of regular evaluation and the optimization of treatment regimens during treatment and must work side by side toward a cure.
Distinct microbial communities supported by iron oxidation
Authors: Burkartová Kateřina , Hlaváček Antonín , Skoblia Sergej , Falteisek Lukáš 
Published: October 2024

AbstractMicrobial biostalactites and streamers commonly grow at iron seepages in abandoned mines worldwide. This study addresses the diversity and composition of these simple prokaryotic communities, which thrive in pH ranges from 2.4 to 6.6 across six different mines. Our analysis of 85 communities reveals that a pH of approximately 3.2 is a critical threshold where alpha and beta diversity change discretely. Below this pH, the average number of ASVs per sample is 2.91 times lower than above this boundary. Autotrophs, heterotrophs, and symbionts of eukaryotes originate from nearly non‐overlapping species pools in the two habitat types that differ only in pH. Communities below pH 3.2 further divide into two distinct groups, differing in diversity, taxonomic, and functional composition. Both types of communities coexist within the same stalactites, likely corresponding to zones where the capillary structure of the stalactite is either perfused or clogged. These findings indicate that microbial community structure can be significantly influenced by the intricate spatial organization of the ecosystem, rather than solely by measurable environmental parameters.
Ambulance offload performance, patient characteristics and disposition for patients offloaded to different areas of the emergency department
Authors: Mallows James L , Salter Mark D , Chapman Mitchell 
Published: October 2024

AbstractObjectiveAmbulance transfer of care (TOC) is a key performance indicator for New South Wales EDs, with 90% of ambulances to be offloaded within 30 min of arrival. Nepean Hospital ED has a number of strategies to improve TOC, including ambulatory areas where patients can be offloaded immediately. Offload data are supplied by ambulance and there is no study into its accuracy. The aim is to audit the accuracy of ambulance data of TOC compared to times recorded in the Nepean ED information system, and to examine TOC and patient demographics for different offload destinations.MethodsA retrospective observational study was performed for patients presenting by ambulance between 1 July and 31 December 2022. TOC was calculated from FirstNet and compared to ambulance data using a paired‐sample t test. Patients were categorised by offload destination within the ED and examined for age, TOC, disposition and specialty team if admitted.ResultsTOC for ambulance and ED data was 60.8% versus 64.1%, respectively (difference 3.33%, P < 0.001). Patients offloaded to acute care were older, with 61.9% being >65 years; had a TOC of 37.3% compared to the resuscitation and ambulatory areas with TOC close to 90%; and were likely to be admitted with a 63.8% admission rate and 24.1% of admissions being under the geriatric service.ConclusionPatients arriving by ambulance requiring an acute care bed were likely to be elderly and frail, and suffered substantial ambulance offload delays. Delays to ambulance offload for these patients is likely driven by acute care bed availability and access block.
Involved‐field high‐dose chemoradiotherapy with respiratory motion management for esophageal squamous cell carcinoma
Authors: Matsuda Masaki , Komiyama Takafumi , Marino Kan , Aoki Shinichi , Akita Tomoko , Sano Naoki , Suzuki Hidekazu , Saito Masahide , Nemoto Hikaru , Onishi Hiroshi 
Published: October 2024

AbstractBackgroundWe investigated the clinical outcomes of involved‐field high‐dose (≥66 Gy) chemoradiotherapy (CRT) combined with respiratory motion management for esophageal squamous cell carcinoma (ESCC).MethodsPatients who underwent definitive CRT for histologically confirmed ESCC in our department between 2012 and 2018 were retrospectively analyzed. Respiratory motion management strategies included breath‐holding (63%) and mask immobilization (29%) based on individual measurements of respiratory tumor motion using radiographic fluoroscopy with endoscopically placed clip markers as landmarks. We evaluated patient characteristics, treatment efficacy, failure patterns, and toxicities.ResultsWe enrolled 35 patients with a prescribed dose of 66–70 Gy in 33–35 fractions. The overall response rate within 6 months post‐CRT was 94.3%; the median follow‐up period for survivors was 43 months. The 2‐year overall survival (OS), progression‐free survival, and locoregional failure‐free survival rates were 51.4%, 42.9%, and 42.9%, respectively. A significant difference in OS was observed between patients with and without esophageal fistulas after CRT (p = 0.002, log‐rank test). Disease failure occurred in 16 patients (45.7%), including one (2.9%) with out‐of‐field regional nodal failure. Major grade 3 or higher toxicities included decreased white blood cell count (48.6%), neutrophil count (34.3%), and esophageal stenosis (31.4%). No grade 3 or higher cardiopulmonary toxicities were observed. Bronchial/tracheal tumor compression and a higher radiotherapy dose (70 Gy) were significantly correlated with esophageal fistulas.ConclusionInvolved‐field high‐dose CRT with respiratory motion management may be a feasible treatment option for ESCC. However, a comprehensive assessment of esophageal fistula risk is required to identify suitable candidates.
Substance use and psychiatric phenotypes of youth experiencing homelessness: A cluster analysis
Authors: Burke Colin W. , Lanni Sylvia , Hoeppner Bettina B. , Ducharme Peter , Wilens Timothy E. 
Published: October 2024

AbstractBackground and ObjectivesDue to the complex interactions of psychopathology, psychosocial stressors, and risk behaviors, characterizing high‐risk phenotypic groups of transitional‐age youth experiencing homelessness (TAY‐EH) for targeted interventions remains difficult. We aimed to uncover specific phenotypes of TAY‐EH based upon psychiatric and substance use disorder (SUD) diagnoses, and to assess relationships between these phenotypes and negative outcomes including suicidality and high‐risk behaviors.MethodsParticipants (N = 140; 57% male, 54% Black) were individuals aged 16–25 years accessing support at a psychosocial agency in the U.S. Northeast. Data were gathered via structured assessment. Cluster analysis identified sub‐groups of TAY‐EH with differing diagnostic patterns. Bivariate analyses examined associations between cluster membership and target outcomes.ResultsA four‐cluster solution was identified. Cluster 1 (Co‐occurring; N = 33) was characterized by high levels of comorbidity (i.e., major depressive disorder (MDD), SUD, and notable levels of other diagnoses). Clusters 2 (MDD alone; N = 47) and 3 (SUD alone; N = 18) were characterized by single diagnoses. Cluster 4 (None; N = 42) was characterized by low levels of psychopathology. Clusters differed significantly on several variables including suicidality, adverse childhood experiences, and social connectedness. Comorbid MDD and SUD were most strongly associated with high‐risk behaviors and suicidality.Discussion and ConclusionsThese results highlight the importance of diagnosis and targeted interventions for co‐occurring MDD and SUD to address the crisis of early mortality and other negative outcomes among TAY‐EH.Scientific SignificanceThis study is the first to identify specific high‐risk psychiatric and psychosocial phenotypes among the highly complex group of TAY‐EH based upon structured diagnostic assessments.
COVID‐19 Vaccine mRNA Biodistribution: Maternal and Fetal Exposure Risks
Authors: Zhong Connie , Cohen Koral , Lin Xinhua , Schiller Emily , Sharma Surendra , Hanna Nazeeh 
Published: October 2024

ABSTRACTSARS‐CoV‐2 infection during pregnancy has severe consequences on maternal and neonatal health. Presently, vaccination stands as a critical preventive measure for mitigating infection‐related risks. Although the initial clinical trials for the COVID‐19 vaccines excluded pregnant women, subsequent investigations have indicated mRNA vaccinations' effectiveness and short‐term safety during pregnancy. However, there is a lack of information regarding the potential biodistribution of the vaccine mRNA during pregnancy and lactation. Recent findings indicate that COVID‐19 vaccine mRNA has been detected in breast milk, suggesting that its presence is not confined to the injection site and raises the possibility of similar distribution to the placenta and the fetus. Furthermore, the potential effects and responses of the placenta and fetus to the vaccine mRNA are still unknown. While potential risks might exist with the exposure of the placenta and fetus to the COVID‐19 mRNA vaccine, the application of mRNA therapies for maternal and fetal conditions offers a groundbreaking prospect. Future research should leverage the unique opportunity provided by the first‐ever application of mRNA vaccines in humans to understand their biodistribution and impact on the placenta and fetus in pregnant women. Such insights could substantially advance the development of safer and more effective future mRNA‐based therapies during pregnancy.
Application of instrumental neutron activation analysis (INAA) to ceramics and clay sources for the late period (c. 950 years BP) in the Southern Argentine Puna: Interweaving sources, objects and practices
Authors: Gasparotti Leticia , Plá Rita , Arévalo Victoria 
Published: October 2024

AbstractThe study of the raw materials used in the production of ceramic objects involves studying the materiality of the objects themselves while providing insights into the factors that guided the choice of a particular resource over another. Simultaneously, this article focuses on the social contexts in which these objects were produced. We present the results obtained through an instrumental neutron activation analysis (INAA) of ceramics from the Corral Alto site (Antofagasta de la Sierra, Catamarca) of Argentina. The results suggest that most ceramic pieces were locally manufactured, contrasting with earlier periods and coinciding with the emergence of new ways of dwelling in the Southern Argentine Puna.
Characterization of historical mortar from Huilongguan temple site in Wudang Mountain, Hubei province, China
Authors: Wei Guofeng , Zhang Jiahui , An Zhao , Kang Yuhu 
Published: October 2024

AbstractAs the royal Taoist buildings of the Ming dynasty (1368–1644 CE), the Huilongguan temple site of Wudang Mountain represents the highest level of art and architecture of that era. Thanks at least in part to the quality and durability of building mortar materials, the part buildings of the Huilongguan temple site are still well preserved after 500 years of erosion by wind and rain. The present study conducted muti‐analytical techniques to explore the characterization of eight mortars from the Huilongguan temple site. The results indicate that the material formulae of these mortars from construction phases I–IV of the Ming dynasty were all sticky rice as the organic additive incorporated into the magnesian lime base, which originated from the calcination of dolomitic limestone. The contents of Ca carbonate in the studied mortar samples are about 39–66%; the design of mortar groundmass presents differences due to various building purposes. Different from sharp‐edged rhombohedral calcite crystals of pure lime mortar, irregular nano‐scale calcite crystals were found in the studied samples due to sticky rice slurry regulating the growth of Ca carbonate as an inhibitor and template, which formed more compact organic–inorganic composite microstructures.
Population pharmacokinetics of tacrolimus whole blood and peripheral blood mononuclear cell concentrations in stable kidney‐transplanted patients
Authors: Agergaard Katrine , Thiesson Helle C. , Carstens Jan , Staatz Christine E. , Järvinen Erkka , Nielsen Flemming , Christensen Heidi Dahl , Juhl‐Sandberg Rikke , Brøsen Kim , Stage Tore Bjerregaard , Andersen Dorte Terp , Kjellsson Maria C. , Bergmann Troels K. 
Published: October 2024

AimTherapeutic drug monitoring of tacrolimus based on whole blood drug concentrations is routinely performed. The concentration of tacrolimus in peripheral blood mononuclear cells (PMBCs) is likely to better reflect drug exposure at the treatment target site. We aimed to describe the relationship between tacrolimus whole blood and PBMC concentrations, and the influence of patient characteristics on this relationship by developing a population pharmacokinetic model.MethodsWe prospectively enrolled 63 stable adult kidney‐transplanted patients and collected dense (12‐h, n = 18) or sparse (4‐h, n = 45) pharmacokinetic profiles of tacrolimus. PBMCs were isolated from whole blood (Ficoll density gradient centrifugation), and drug concentrations in whole blood and PBMCs were analysed using liquid chromatography‐mass spectrometry. Patient genotype (CYP3A4/5, ABCB1, NR1I2) was assessed with PCR. Population pharmacokinetic modelling and statistical evaluation was performed using NONMEM.ResultsTacrolimus whole blood concentrations were well described using a two‐compartment pharmacokinetic model with a lag‐time and first‐order absorption and elimination. Tacrolimus PBMC concentrations were best estimated from whole blood concentrations with the use of a scaling factor, the ratio of whole blood to PBMC concentrations (RC:PBMC), which was the extent of tacrolimus distribution into PBMC. CYP3A5*1 non‐expressors and NR1I2‐25 385T allele expressors demonstrated higher RC:PBMC ratios of 42.4% and 60.7%, respectively.ConclusionTacrolimus PBMC concentration could not be accurately predicted from whole blood concentrations and covariates because of significant residual unexplained variability in the distribution of tacrolimus into PBMCs and may need to be measured directly if required for future studies.
Parental control and adolescent social anxiety: A focus on emotional regulation strategies and socioeconomic influences in China
Authors: Fu Wangqian , Zhang Weida , Dong Yuhan , Chen Guanyu 
Published: October 2024

AbstractAn individual's social adaptation, which is influenced by both internalizing and externalizing factors, depends on social anxiety. We proposed that the connection between parental psychological control and social anxiety among middle school students was mediated by negative emotion response‐focused strategies and moderated by socioeconomic status (SES). We collected data from 1343 Chinese students from 12 to 16 years old (M = 13.3, SD = 0.96) by applying the questionnaire of parental psychological control scale, social anxiety scale and negative emotion response‐focused strategies scale. The findings demonstrated that parental psychological control, including father and mother psychological control, was positively associated with social anxiety and that the relationship between parental psychological control and children's social anxiety was mediated by negative emotion response‐focused strategies. Meanwhile, SES played a moderating role in the relationship between children's negative emotion response‐focused strategies and social anxiety. The findings also suggest that we should pay more attention to the psychological status and social interaction of children with lower SES.
A systematic assessment of robustness in CNS safety pharmacology
Authors: Reiber Maria , Stirling Helen , Ahuis Tim P. , Arias Washington , Aulehner Katharina , Dreßler Ute , Kas Martien J. H. , Kela Johanna , Kerker Kimberly , Kuosmanen Tarja , Lorenz Helga , Pennington Alexander T. , von Rüden Eva‐Lotta , Schauerte Heike , Seiffert Isabel , Talbot Steven R. , Torturo Christina , Virtanen Sami , Waldron Ann‐Marie , Ramboz Sylvie , Potschka Heidrun 
Published: October 2024

Background and PurposeIrwin tests are key preclinical study elements for characterising drug‐induced neurological side effects. This multicentre study aimed to assess the robustness of Irwin tests across multinational sites during three stages of protocol harmonisation. The projects were part of the Enhanced Quality in Preclinical Data framework, aiming to increase success rates in transition from preclinical testing to clinical application.Experimental ApproachFemale and male NMRI mice were assigned to one of three groups (vehicle, MK‐801 0.1 and 0.3 mg kg−1). Irwin scores were assessed at baseline and multiple times following intraperitoneal injection of MK‐801 using local protocols (Stage 1), shared protocols with harmonised environmental design (Stage 2) and fully harmonised Irwin scoring protocols (Stage 3).Key ResultsThe analysis based on the four functional domains (motor, autonomic, sedation and excitation) revealed substantial data variability in Stages 1 and 2. Although there was still marked overall heterogeneity between sites in Stage 3 after complete harmonisation of the Irwin scoring scheme, heterogeneity was only moderate within functional domains. When comparing treatment groups versus vehicle, we found large effect sizes in the motor domain and subtle to moderate effects in the excitation‐related and autonomic domains.Conclusion and ImplicationsThe pronounced interlaboratory variability in Irwin datasets for the CNS‐active compound MK‐801 needs to be carefully considered when making decisions during drug development. While environmental and general study design had a minor impact, the study suggests that harmonisation of parameters and their scoring can limit variability and increase robustness.
A retrospective study on patient satisfaction and Oral Health‐Related Quality of Life with fixed 4‐ or 6‐implant supported prostheses over 3‐7 years
Authors: Chen Wenjia , Zhou Yi , Pang Lijiao , Pu Rui , He Fuming , Yang Haiping 
Published: October 2024

AbstractObjectivesTo compare patients' satisfaction and oral health‐related quality of life (OHRQoL) in edentulous patients treated by All‐on‐4 and All‐on‐6 implant‐supported fixed prostheses rehabilitation over 3–7 years.MethodsAll patients (n = 125) were divided into short‐term (3–5 years, n = 71) and long‐term (5–7 years, n = 54) follow‐up groups. Patients' satisfaction was examined in a cross‐sectional survey. OHRQoL and psychological impact were evaluated using the Oral Health Impact Profile (OHIP). Comparison of All‐on‐4 and All‐on‐6, including OHIP values, satisfaction scores, treatment duration and complications, were analyzed using the Chi‐square test and the Mann–Whitney U test. Potential influence of patient‐related factors on patient‐reported outcome measures (PROMs) were analyzed via the Mann–Whitney U test, the Kruskal–Wallis test and multiple regression analyses. Power calculation was conducted in R Studio.ResultsBoth All‐on‐4 and All‐on‐6 follow‐up groups showed high scores in total satisfaction and PROMs, including chewing comfort, aesthetics, cleanability, and stability, with no significant difference (p > 0.05). Meanwhile, no significant differences were observed in the OHIP scores between two groups in both follow‐up durations (p > 0.05). However, in patients with 3–5 years follow‐up, All‐on‐4 group had significantly lower phonetic satisfaction scores than All‐on‐6 group (p < 0.05). Additionally, during both follow‐up periods, All‐on‐4 patients exhibited notably superior psychological effect in contrast to All‐on‐6 patients (p < 0.05).ConclusionsEdentulous patients treated by four or six implant‐supported fixed prostheses showed same high satisfaction in oral health‐related quality of life in both 3–5 years and 5–7 years follow‐ups.
An Unexpected Finding of a PTPN11 Germline Mutation in a Patient With a Melanocytic Lesion With a Somatic MAP2K1 Mutation. Coincidence or Not?
Authors: van der Woude Sven , Klein Wassink‐Ruiter J. S. , Kluiver Joost , de Jonge Marthe , Diercks Gilles F. H. 
Published: October 2024

ABSTRACTMelanocytic tumors are a diverse group of lesions and are traditionally classified based on a combination of clinical presentation as well as histological examination. More recently, molecular diagnostics has become an increasingly important part of differentiating different melanocytic lesions in the current WHO standards. This molecular testing, however, can result in unexpected findings. In this report, we describe that molecular testing of a clinical atypical melanocytic lesion showed a mutation in the MAP2K1 gene as well as an unexpected germline mutation in PTPN11, indicative of Noonan syndrome. Based on these findings we concluded that the patient had a MAP2K1 associated melanocytic lesion with Noonan syndrome as an incidental finding. Melanomas are classically not associated with Noonan syndrome. However, we hypothesized that the germline mutations of PTPN11 and the somatic second hit mutation in the MAP2K1 genes might be involved in the formation of the aforementioned lesion. As they are both part of the RAS‐MAPK pathway. Furthermore, with the expansion of molecular diagnostics in melanomas, we expect to find an increase in unexpected (germline) mutations.
Begutachtung von arbeitsbedingten Hauterkrankungen und Hautkrebserkrankungen
Authors: Skudlik Christoph 
Published: October 2024

ZusammenfassungDie Begutachtung arbeitsbedingter Hauterkrankungen zählt zu den dermatologischen Kernkompetenzen. Als Gutachter nimmt der Hautarzt im Zuge seiner Funktion als neutraler Sachverständiger eine andere Rolle ein als in seiner Funktion als therapeutisch tätiger Arzt. Um die Gleichbehandlung der zu begutachtenden Personen zu gewährleisten, ist bei der Begutachtung arbeitsbedingter Hauterkrankungen einschließlich der Hautkrebserkrankungen die Bamberger Empfehlung als wissenschaftlich fundierte Beurteilungsgrundlage zugrunde zu legen. Neben der dermatologischen Fachexpertise ist für den Gutachter die Kenntnis der versicherungsrechtlichen Rahmenbedingungen und Rechtsbegriffe unabdingbar. Mit ihrer qualifizierten Gutachtertätigkeit bereiten Dermatologen Entscheidungen der Sozialgerichtsbarkeit und der Sozialversicherungsträger vor und leisten damit einen wichtigen Beitrag zur sozialen Sicherheit.