bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care conundrum in the emergency department: The gap between clinician awareness and patient expectations surrounding advance directives
Authors: Manfredi Rita A. , Riley Jessica , Lunsford Beverly 
Published: August 2024

AbstractObjectivesClinicians in the emergency department (ED) frequently encounter seriously ill patients at a time when advance directives may be pivotal in improved clinician decision‐making. The objectives of this study were to identify the prevalence of advanced directives in ED patients, as well as patterns of advance care discussions between patients and providers. This study describes patients' perceptions and expectations of such serious illness discussions in an emergency care setting with the expectation of including patients as strategic members of the care team.MethodsTrained research assistants in two emergency departments surveyed patients over age 65, or their caregivers, from July 2016 to August 2018. Patients were verbally administered a standard survey tool related to advance directives and advance care planning.Results497 out of 877 patients completed surveys (59.4%). 50% of patients reported having an advance care planning document. The large majority (92%) of patients with an advance directive had not been asked about it during their ED visit. When questioned about their personal preferences, 79% of patients thought emergency physicians should be aware of their wishes regarding life‐sustaining treatments and end‐of‐life care. Paradoxically, only 38% expressed a desire to discuss advance care plans with an ED clinician.ConclusionsOlder patients expect emergency clinicians to be aware of their care preferences, yet most are not asked about these care preferences in the ED. The large gap between patient preference and reality suggests the need for more targeted discussion by ED clinicians and translation of patient perspectives into system healthcare improvements. Future studies should explore barriers to advance care planning in the ED as well as patient preferences for these conversations to support a true healthcare learning system.
A multiple applications study of motile microorganisms past a vertical surface with double‐diffusive binary base fluid
Authors: Madhusudhana Rao Battina , Durgaprasad Putta , Dharmaiah Gurram , Dinarvand Saeed , Gupta Saurav 
Published: August 2024

AbstractThis study investigates the various uses of density of motile microorganisms in the context of the flow of a binary base fluid with double diffusion past a vertical surface. The research aims to comprehend the interactions between motile microorganisms and the fluid dynamics, as well as the heat and mass transport mechanisms in this system. The analysis involves mathematically constructing the governing equations, transforming them into dimensionless nonlinear ordinary differential equations using similarity transformations, and numerically solving them using the MATLAB bvp4c solver. An analysis of the influence of several parameters on the profiles of velocity, temperature, concentration, nanoparticle concentration, and density of motile microorganisms is conducted using graphical representation. The findings demonstrate that boosting the thermophoresis parameter intensifies the temperature profile. In addition, an increase in the nanofluid Schmidt number results in a larger concentration of nanoparticles, whereas a higher bioconvection Lewis number reduces the density of the motile microorganism profile. These findings may find use in biomedical engineering as well as industrial processes that include enhancing the efficiency of mass transfer and bioconvection. Numeric simulation prophesies 99.9% for both shear stress and heat transfer rate intensification for Prandtl values are noticed.
A study on the pressure‐driven flow of magnetized non‐Newtonian Casson fluid between two corrugated curved walls of an arbitrary phase difference
Authors: Mujahid Maham , Abbas Zaheer , Rafiq Muhammad Yousuf 
Published: August 2024

AbstractPressure‐driven movement is a fundamental concept with numerous applications in various industries, scientific disciplines, and fields of engineering. Its proper execution is vital for promoting revolutionary innovations and providing solutions in numerous sectors. Therefore, this article scrutinizes the pressure‐driven flow of magnetized Casson fluid between two curved corrugated walls. The geometry of the channel is represented mathematically in an orthogonal curvilinear coordinate system. The corrugation grooves are described by sinusoidal functions with phase differences between the corrugated curved walls. The boundary perturbation method is used to find the analytical solution for the velocity field and volumetric flow rate, taking the corrugation amplitude as the perturbation parameter. The results show that the peak of the velocity increases with the radius of curvature and the width of the channel for a constant pressure gradient. The velocity exhibited a declining trend due to an increase in the Casson fluid parameter. For a sufficiently large corrugation wavenumber, the flow rate decreases, and the phase difference becomes irrelevant. However, the reduction in flow can be minimized by decreasing the channel radius of curvature. In general, a smooth curved channel will give the maximum flow rate for a large corrugation wavenumber. The model can be used to simulate blood flow in arteries with varying geometries and magnetic fields, aiding in the study of cardiovascular diseases and the design of medical devices like stents.
Honey bee larval toxicity study designs: Applicability of the current study protocols and endpoints as a predictor of pesticide hazard for pollinators
Authors: De Souza Daiana A. , Feken Max , Tomé Hudson V. V. , Schmehl Daniel R. 
Published: August 2024

Abstract
The assessment of pesticide risks to bees in North America currently relies in part on Tier 1 honey bee laboratory toxicity studies to support the registration and registration review processes for crop protection chemicals. For immature stages, the studies follow two standardized test designs recommended by the Organization for Economic Cooperation (OECD), evaluating acute (seven-day single-dose, TG OECD 237) and chronic (22-day repeated-dose, GD OECD 239) toxicity in bee larvae. In this article, we aim to evaluate the current approach for generating and interpreting honey bee larval toxicity data, enhancing pesticide risk assessment for pollinators. First, by considering that the repeated-dose larval study covers all stages of honey bee brood development up to adult emergence, we compared endpoints (larval LD/ED50 and LC/EC50 values) from seven-day acute exposure studies with the 22-day chronic exposure studies. Our goal was to identify the study design offering greater sensitivity in assessing pesticide toxicity to immature bees. Our second objective involved analyzing available weight data from emerged adults and comparing it to survival endpoints (e.g., NOEL and LD50) to determine if the weight after adult emergence would accurately represent a sensitive indicator of pesticide effects on developing honey bees. Our analysis determined that the use of a single 22-day chronic exposure study adequately covers all immature stages and that the toxicity values based on cumulative dose are more accurate and representative measures of exposure for immature bees than using endpoints based on estimated daily doses. Furthermore, our analysis suggests that measuring the weight of emerged adults was a more sensitive indicator than mortality of treatment-related effects in 22% of the compounds included in our analysis. Here we also discuss the importance of standardized protocols for proper collection of weight after emergence and the need for further discussion on the relevance of this parameter at risk assessment scheme. Integr Environ Assess Manag 2024;20:2283–2293. © 2024 Pollinator Research Task Force. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).
Key Points
A meta-data assessment was conducted to evaluate the current approach for generating and interpreting honey bee larval toxicity data. The chronic larval study tends to provide a more robust screening-level risk determination than the acute larval study design. The weight after adult emergence from chronic exposure larval study may be an indicator of pesticide effects on growth. Standardized protocols for measuring the weight of emerged adults are needed.
Notable correlation between serum epidermal growth factor values and inflammatory status in patients with COVID‐19
Authors: Pérez Héctor José , Crombet Tania 
Published: August 2024

AbstractIntroductionDespite its crucial role in Epidermal Growth Factor Receptor (EGFR) activation, and the resulting impact on the health‐disease process, epidermal growth factor (EGF) is an underexplored molecule in relation to how its serum concentrations relate to other analytes and clinical variables in pathological contexts.ObjectiveTo clarify the possible correlation between EGF and clinical and analytical variables in the context of COVID‐19.MethodsCross‐sectional observational and analytical study, in patients with virological and clinical diagnosis of COVID‐19, selected by simple random sampling, admitted between August and September 2021. UMELISA‐EGF commercial kits were used.ResultsDifferences in overall EGF values were observed between groups (566.04 vs. 910.53 pg/ml, p = .0430). In COVID‐19 patients, no notable correlations were observed for neutrophil, platelet, triglyceride or liver enzyme values (p > .05). Significant correlations were observed with the neutrophil‐lymphocyte indicator (r = 0.4711, p = .0128) as well as with the platelet‐lymphocyte index (r = 0.4553, p = .0155). Statistical results of multivariate regression analysis suggest NLR (β = .2232, p = .0353) and PLR (β = .2117, p = .0411) are predictors of inflammation in patients with COVID‐19.ConclusionsSerum EGF concentrations in COVID‐19 correlate positively with prognostic inflammatory markers of severity and could presumably act as an independent risk factor for the development of inflammation in response to new severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2).
Eighty‐six cases of clinical characteristics and outcomes of systemic lupus erythematosus‐associated macrophage activation syndrome: A meta‐analysis study
Authors: Wang Jingya , Rong Wei , Yan Haotian 
Published: August 2024

AbstractObjectiveTo improve our understanding of systemic lupus erythematosus (SLE)‐macrophage activation syndrome (MAS).MethodsA systematic review was performed, to retrieve all those papers on patients with SLE‐MAS, in individual or aggregated form. The data in each of these medical records were extracted and analyzed to identify the characteristics of SLE‐MAS.ResultsA total of 86 SLE‐MAS patients were included (25 males and 61 females. The mean (±standard error of the mean) age was 31.21 ± 1.694 years. MAS occurred as the initial presentation of SLE in 47 people (54.65%) and during the course of SLE in 39 (45.35%). A coinfection was reported in 23 (26.74%) patients. The mean Lupus Erythematosus Disease Activity Index 2000 (SLEDAI‐2K) score was 16.54 ± 0.9462. Overall, 10 patients (11.63%) died. The SLEDAI‐2K score was higher in patients with MAS as an initial manifestation of SLE than in those where MAS occurred during the course of SLE. The proportion of patients receiving steroid pulse therapy was lower in patients with coinfections. The deceased group demonstrated lower platelet and ferritin levels. Multiple regression analysis revealed that age and thrombocytopenia were independent factors associated with poor prognosis. In receiver operating characteristic analysis, a platelet count cutoff value of ≤47 × 109/L was a predictor of poor outcome.ConclusionsSLE‐MAS patients demonstrated high lupus activity, and lupus activity was especially higher in patients with MAS as an initial manifestation. Lupus activity was the predominant trigger of lupus MAS. Thrombocytopenia was an independent factor for poor prognosis.
Screening significance of systemic immune‐inflammation index (SII) and systemic inflammation response index (SIRI) in coronary heart disease of symptomatic youth
Authors: Wang Chunxiao , Yan Weihong , Ren Mengmeng , Zhong Lin 
Published: August 2024

AbstractBackgroundThe incidence of coronary heart disease (CHD) in youth is rapidly increasing but difficultly recognized in the early stage.Methods and ResultsIn this retrospective study, 194 CHD patients under the age of 45 who previously experienced chest pain symptoms and 170 non‐CHD patients were included and demographic data were collected. Systemic inflammation index (SII) and systemic inflammation response index (SIRI) were increased in young CHD patients (p < 001). Spearman's correlation analysis showed that both SII and SIRI were negatively correlated with HDL and positively correlated with hypertension, Gensini score, and hsTnI. Logistic regression analysis indicated that SII and SIRI were independently associated with the presence of CHD in youth with chest pain symptoms. The area under the ROC curve (AUC) of the SII model for young CHD patients was 0.805 (0.728−0.869), and the sensitivity and specificity were 0.65 and 0.823, respectively. Meanwhile, the AUC for the SIRI model was 0.812 (0.739−0.872), and the sensitivity and specificity were 0.673 and 0.8022. The calibration curves of both SII and SIRI models are in good agreement with the actual curves. And the decision curves of both models indicated their clinical practicality.ConclusionSII and SIRI are independent risk factors for CHD in young adults, which can quickly and effectively identify CHD patients among young adults who have previously experienced chest pain symptoms.
One‐carbon metabolism biomarkers and upper gastrointestinal cancer in the Golestan Cohort Study
Authors: Inoue‐Choi Maki , Freedman Neal D. , Etemadi Arash , Hashemian Maryam , Brennan Paul , Roshandel Gholamreza , Poustchi Hossein , Boffetta Paolo , Kamangar Farin , Amiriani Taghi , Norouzi Alireza , Dawsey Sandy , Malekzadeh Reza , Abnet Christian C. 
Published: August 2024

AbstractIncidence of esophageal and gastric cancer has been linked to low B‐vitamin status. We conducted matched nested case–control studies of incident esophageal squamous cell carcinoma (ESCC; 340 case–control pairs) and gastric cancer (GC; 352 case–control pairs) within the Golestan Cohort Study. The primary exposure was plasma biomarkers: riboflavin and flavin mononucleotide (FMN) (vitamin B2), pyridoxal phosphate (PLP) (B6), cobalamin (B12), para‐aminobenzoylglutamate (pABG) (folate), and total homocysteine (tHcy); and indicators for deficiency: 3‐hydroxykyurenine‐ratio (HK‐r for vitamin B6) and methylmalonic acid (MMA for B12). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression adjusting for matching factors and potential confounders. High proportions of participants had low B‐vitamin and high tHcy levels. None of the measured vitamin B levels was associated with the risk of ESCC and GC, but elevated level of MMA was marginally associated with ESCC (OR = 1.42, 95% CI = 0.99–2.04) and associated with GC (OR = 1.53, 95% CI = 1.05–2.22). Risk of GC was higher for the highest versus lowest quartile of HK‐r (OR = 1.95, 95%CI = 1.19–3.21) and for elevated versus non‐elevated HK‐r level (OR = 1.59, 95% CI = 1.13–2.25). Risk of ESCC (OR = 2.81, 95% CI = 1.54–5.13) and gastric cancer (OR = 2.09, 95%CI = 1.17–3.73) was higher for the highest versus lowest quartile of tHcy. In conclusion, insufficient vitamin B12 was associated with higher risk of ESCC and GC, and insufficient vitamin B6 status was associated with higher risk of GC in this population with prevalent low plasma B‐vitamin status. Higher level of tHcy, a global indicator of OCM function, was associated with higher risk of ESCC and GC.
Genomic mutation patterns and prognostic value in de novo and secondary acute myeloid leukemia: A multicenter study from China
Authors: Dou Xi , Dan Chunli , Zhang Duanzhong , Zhou Hongjing , He Renke , Zhou Guangyu , Zhu Yu , Fu Nan , Niu Ben , Xu Shuangnian , Liao Yi , Luo Zhangqin , Yang Lihua , Zhang Haiguo , Xu Yizhi , Zhan Qian , Chen Wei , Yang Zesong , Tang Xiaoqiong , Zhang Hongbin , Xiao Qing , Chen Jianbin , Liu Lin , Wang Yi , Pei Li , Wang Li 
Published: August 2024

AbstractAcute myeloid leukemia (AML) can manifest as de novo AML (dn‐AML) or secondary AML (s‐AML), with s‐AML being associated with inferior survival and distinct genomic characteristics. The underlying reasons for this disparity remain to be elucidated. In this multicenter study, next‐generation sequencing (NGS) was employed to investigate the mutational landscape of AML in 721 patients from June 2020 to May 2023.Genetic mutations were observed in 93.34% of the individuals, with complex variations (more than three gene mutations) present in 63.10% of them. TET2, ASXL1, DNMT3A, TP53 and SRSF2 mutations showed a higher prevalence among older individuals, whereas WT1 and KIT mutations were more commonly observed in younger patients. BCOR, BCORL1, ZRSR2, ASXL1 and SRSF2 exhibited higher mutation frequencies in males. Additionally, ASXL1, NRAS, PPMID, SRSF2, TP53 and U2AF1 mutations were more common in patients with s‐AML, which PPM1D was more frequently associated with therapy‐related AML (t‐AML). Advanced age and hyperleukocytosis independently served as adverse prognostic factors for both types of AML; however, s‐AML patients demonstrated a greater number of monogenic adverse prognostic factors compared to dn‐AML cases (ASXL1, PPM1D, TP53 and U2AF1 in s‐AML vs. FLT3, TP53 and U2AF1 in dn‐AML). Age and sex‐related gene mutations suggest epigenetic changes may be key in AML pathogenesis. The worse prognosis of s‐AML compared to dn‐AML could be due to the older age of s‐AML patients and more poor‐prognosis gene mutations. These findings could improve AML diagnosis and treatment by identifying potential therapeutic targets and risk stratification biomarkers.
Circulating vascular endothelial growth factor receptor‐3, a pro‐lymphangiogenic and pro‐angiogenic mediator, is decreased in pre‐eclampsia
Authors: Palei Ana C. , Kaihara Julyane N. S. , Cavalli Ricardo C. , Sandrim Valeria C. 
Published: August 2024

AbstractObjectiveTo compare circulating levels of vascular endothelial growth factor receptor 3 (VEGFR‐3) in women with pregnancy‐induced hypertension (PIH) and in non‐pregnant (NP) and healthy pregnant (HP) women.MethodsWe conducted a case–control study including PIH (n = 135), HP (n = 68), and NP (n = 49) women from southeastern Brazil. PIH were diagnosed according to international guidelines, and defined as gestational hypertension (GH, n = 61) or pre‐eclampsia (n = 74). VEGFR‐3 was measured in plasma using ELISA.ResultsPlasma VEGFR‐3 was increased in HP (1207 pg/mL) compared with NP (133 pg/mL) women; however, PIH (729 pg/mL) patients exhibited lower levels than HP women (both p < 0.05). In addition, plasma VEGFR‐3 was decreased in pre‐eclampsia compared with GH (537 versus 980 pg/mL; p < 0.05). When pre‐eclampsia was classified according to different clinical presentations, plasma VEGFR‐3 was further decreased in the cases identified as pre‐eclampsia with severe features, preterm pre‐eclampsia, and pre‐eclampsia accompanied by small for gestational age (all p < 0.05).ConclusionOur data indicate reduced circulating VEGFR‐3 levels in patients with PIH, specifically in those diagnosed with pre‐eclampsia. Moreover, decreased VEGFR‐3 was associated with adverse clinical outcomes in pre‐eclampsia. These findings expand previous evidence of reduced VEGFR‐3 expression in pre‐eclampsia. Future studies should investigate whether it can be used as a predictive biomarker and/or therapeutic target for pre‐eclampsia.
Enhanced diclofenac adsorption and degradation using iron‐loaded modified spent bleaching earth carbon in the presence of clofibric acid: mechanistic insights and toxicity assessment
Authors: Zhang Liwen , Song Xue , Zhang Jie , Chen Yue , Liu Yongde , Zhao Jihong , Deng Fanbao , Yan Guihua 
Published: August 2024

AbstractBACKGROUNDThe presence of pharmaceutical active substances such as diclofenac (DCF) and clofibric acid (CA) in aquatic environments poses significant ecological threats. Existing treatments have not fully explored the impact of CA on DCF removal efficiency. This research introduces nZVI/CTAB‐SBE@C, a novel adsorbent developed from industrial spent bleaching earth (SBE), modified with cetyltrimethylammonium bromide (CTAB) and nano zero‐valent iron (nZVI), enhancing both adsorption and degradation of DCF and CA.RESULTSThis study investigated the impact of CA on the removal capabilities of nZVI/CTAB‐SBE@C for DCF in a coexisting system. Systematic examinations were conducted on the effects of various parameters, including reaction time, dosage, temperature, actual wastewater, humic acid content and coexisting ions. Results indicated that the presence of CA significantly enhanced the DCF removal efficiency, achieving an optimal rate of 87.3% under conditions of reaction time 2 h, adsorbent dosage 5 g L−1 and temperature 25 °C. Moreover, interactions between Al3+ ions and the adsorbent matrix notably improved removal efficiencies for both DCF and CA. Analysis revealed that CA facilitated new degradation pathways for DCF, including hydroxylation and decarboxylation reactions. Additionally, the presence of CA reduced the toxicity of degradation intermediates, enhancing environmental safety compared to systems containing only DCF.CONCLUSIONThis study effectively transforms industrial waste into the efficient nZVI/CTAB‐SBE@C adsorbent. The presence of CA not only boosts DCF removal efficiency but also promotes its safer degradation, thereby reducing the ecological impact of contaminants. © 2024 Society of Chemical Industry (SCI).
Application of principles learned in a prevention‐focused pediatric dental residency curriculum to professional practice
Authors: Ramos‐Gomez Francisco , Kinsler Janni J. , Wang Yan , Parkinson Stephanie , Pike Nancy 
Published: August 2024

AbstractPurposeThis study examined whether pediatric dentists who participated in a pediatric dental residency program focusing on disease prevention and management training and screening for social determinants of health (SDOH) were applying these principles to their professional practice upon graduation.MethodsUsing a cross‐sectional study design, a one‐time‐only online survey was disseminated to 75 pediatric dentists who graduated from the University of California, Los Angeles's training program between 2012 and 2022. The 21‐item survey included questions on demographics, patient population characteristics, and application of preventive dentistry and SDOH to their professional practice. Descriptive statistics and bivariate analyses were used to assess survey items.ResultsThe survey response rate was 64%. Over two‐thirds (67%) of alumni reported accepting Medicaid, 34% saw patients in a medically underserved area and all reported seeing children with special needs in their practice. Strategies used to address SDOH in their practice included providing anticipatory guidance (98%) and educating families on oral disease prevention and screening for SDOH (96%). Alumni accepting patients with Medicaid/public health insurance were more likely to address SDOH in their practice, such as assisting patients with filling out Medicaid paperwork (p < 0.05), conducting outreach to underserved communities (p < 0.05), and using interpreters in their practice (p < 0.01) in comparison with alumni not accepting patients with Medicaid/public health insurance.ConclusionThis study demonstrated that a pediatric dental residency program may be successful in training residents to educate children, families, and special needs patients on disease prevention and management in an ethical and culturally sensitive manner and screen for SDOH during patient visits.