bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic De-Escalation Practices in the Intensive Care Unit: A Multicenter Observational Study
Authors: Patanwala Asad E , Abu Sardaneh Arwa , Alffenaar Jan-Willem C , Choo Chui Lynn , Dey Alexandra L , Duffy Eamon J , Green Sarah E , Hills Thomas E , Howle Lisa M , Joseph Jessica A , Khuon Maxkirivan C , Koppen Cassandra S , Pang Francis , Park Jung Yeun , Parlicki Mark A , Shah Isha S , Tran Kylie , Tran Priscilla , Wills Mardi A , Xu Jessica H , Youssef Marian ,   ADEPT Study Investigators and Collaborators
Published: August 2024

Background: There is little known about antibiotic de-escalation (ADE) practices in the intensive care unit (ICU). Objective: The objective was to determine the proportion of patients who received ADE within 24 hours of actionable cultures and identify predictors of timely ADE. Methods: Multicenter cohort study in ICUs of 15 hospitals in Australia and New Zealand. Adult patients were included if they were started on broad-spectrum antibiotics within 24 hours of ICU admission. The ADE was defined as switching from a broad-spectrum agent to a narrower-spectrum agent or antibiotic cessation. The primary outcome was ADE within 24 hours of an actionable culture, where ADE was possible. Results: The 446 patients included in the study had a mean age of 63 ± 16 years, 60% were male, 32% were mechanically ventilated, and 19% were immunocompromised. Of these, 161 (36.1%) were not eligible for ADE and 37 (8.3%) for whom ADE within 24 hours of actionable culture could not be determined. In the remaining 248 patients, ADE occurred ≤24 hours in 60.5% (n = 150/248) after actionable cultures. In the multivariable logistic regression analysis, ADE was less likely to occur within 24 hours for patients with negative cultures (odds ratio [OR] = 0.48, 95% confidence interval [CI] = 0.25-0.92, P = 0.03). Conclusion and Relevance: Timely ADE may not occur in 40% of patients in the ICU and is less likely to occur in patients with negative cultures. Timely ADE can be improved, and patients with negative cultures should be targeted as part of antimicrobial stewardship efforts.
Docetaxel-induced severe neuropathy, a case of breast cancer with GTSP1 polymorphism
Authors: Değerli Ezgi 
Published: August 2024

Introduction Breast cancer, the most prevalent cancer among women, often requires chemotherapy with docetaxel being a key agent. However, docetaxel-inducted peripheral neuropathy (DIPN) can adversely impact patients’ quality of life. This case discusses an unusual instance of severe DIPN leading to wheelchair dependence in a 35-years old woman undergoing neoadjuvant treatment for locally advanced breast cancer. Case Following anthracycline and cyclophosphamide cycles without neurological symptoms, docetaxel administration resulted in progressive neuropathy. Despite dose reduction, the patient developed severe paraesthesias, foot weakness, and eventually wheelchair dependence. Management and outcome Docetaxel's microtubule-stabilizing mechanism, vital for cell division, may disrupt axonal structures, causing sensory and motor neuropathy. While rare, severe motor neuropathy, leading to wheelchair dependence, poses a significant challenge. The frequency of DIPN varies, with docetaxel exhibiting lower neuropathy rates than other taxanes. Risk factors include age, diabetes mellitus, cumulative dose, and genetic polymorphisms in GSTP1 and ABCB1. In our case, despite the patient being young, fit and without diabetes, severe DIPN occured, suggesting a potential genetic predisposition. Genetic variations, such as GSTP1 polymorphisms have been associated with DIPN. Our patient carried GSTP1 (I1e105Val) mutations, emphasizing the need for further research to establish their role as risk factors. Discussion This case underscores the importance of recognizing severe DIPN, even in atypical patient profiles. Genetic factors, like GSTP1 polymorphisms, may contribute to DIPN risk. Large-scale studies are crucial to establishing the significance of these genetic variations in DIPN susceptibility.
Anterior chamber retained lens fragments: A novel approach with Nd:Yag laser
Authors: Meduri Alessandro , Oliverio Giovanni William , De Luca Laura , Borroni Davide , Frisina Rino , Aragona Pasquale 
Published: August 2024

The retention of lenticular fragments (LF), either cortical or nuclear, in the anterior chamber after cataract surgery are a rare but important complication that may lead to patient discomfort and visual decrease. In this multicenter case series, we report the use of Neodymium:Yag laser to fragment LF effectively in twenty patients. Methods Multicenter retrospective case series of nd:Yag laser fragmentation of LF in twenty eyes at different clinics discovered after cataract surgery performed through phacoemulsification and implant of intraocular lens (IOL). Conclusion Early nd:Yag laser procedure is a good option to use for retained lenticular fragments in the anterior chamber after cataract extraction, to reduce damages to the endothelium caused by the LF, to lower patient discomfort to re-enter surgery, to minimize costs of surgical re-intervention and to avoid possible inflammatory complications given by the retained fragments that may not be reabsorbed properly and may even present several years after primary surgery leading to damages to endothelium caused by the lenticular fragments and visual disturbances.
Nine Human Leukocyte Antigen (HLA) Class I Alleles are Omnipotent Against 11 Antigens Expressed in Melanoma Tumors
Authors: Georgopoulos Apostolos P , James Lisa M , Sanders Matthew 
Published: August 2024

Objective: Host immunogenetics (Human Leukocyte Antigen, HLA) play a critical role in the human immune response to melanoma, influencing both melanoma prevalence and immunotherapy outcomes. Beneficial outcomes hinge on the successful binding of epitopes of melanoma antigens to HLA Class I molecules for an effective engagement of cytotoxic CD8+ lymphocytes and subsequent elimination of the cancerous cell. This study evaluated the binding affinity and immunogenicity of HLA Class I to melanoma tumor antigens to identify alleles best suited to facilitate elimination of melanoma antigens. Methods: In this study, we used freely available software tools to determine in silico the binding affinity and immunogenicity of 2462 reported HLA Class I alleles to all linear nonamer epitopes of 11 known antigens expressed in melanoma tumors (TRP2, S100, Tyrosinase, TRP1, PMEL(17), MAGE1, MAGE4, CTA, BAGE, GAGE/SSX2, Melan). Results: We identified the following 9 HLA Class I alleles with very high immunogenicity and binding affinity against all 11 melanoma antigens: A*02:14, B*07:10, B*35:10, B*40:10, B*40:12, B*44:10, C*07:11, and C*07:13, and C*07:14. Conclusion: These 9 HLA alleles possess the potential to aid in the elimination of melanoma both by themselves and by enhancing the beneficial effect of immune checkpoint inhibitors.
Dual drivers of bilingual semantic accent: Semantic relations and input limitations
Authors: Malt Barbara C. , Yang Xingjian 
Published: August 2024

Research question: Second language (L2) learners may have a “semantic accent,” using L2 words differently from a native speaker. The current studies investigate how learning conditions and the need to use different semantic dimensions may constrain the acquisition of L2 meanings. Approach: In Experiment 1, we asked whether first language (L1) Mandarin speakers would successfully learn English carry and hold with intensive input in a laboratory training procedure. In Experiment 2, we asked whether the difficulties observed were due to differing semantic dimensions per se or to the need to move from a larger number of fine-grained native distinctions to a smaller number of broader English meanings. Data and analysis: Word definitions and label choice after training were scored for consistency with native performance. Conclusions: Experiment 1 supported the idea that intensive input helps, but Experiment 2 suggested that any kind of semantic difference from L1 is challenging even with intensive input. Originality: The current study clarifies the contributions of learning conditions and L1-L2 semantic differences in semantic accent. Implications: Reducing semantic accent may require instruction in specific L1-L2 differences and cultivation of metacognitive sensitivity to the potential for differences.
Composite waste-based aramid aerogel separators
Authors: Bulbul Hale , Yanilmaz Meltem , Kim Juran 
Published: August 2024

Lithium ion batteries are one of the most promising electrochemical energy storage systems. They generally consist of four components: anode, cathode, electrolyte, and separator. The separators are crucial for batteries since they prevent physical contact of electrodes and thus short circuit. In this study, reutilization of aramid fabric was highlighted by transforming it into a high value product: battery separator. A waste aramid fabric was used to synthesize aramid aerogels by deprotonation, sol-gel, and freeze-drying processes and then investigated as lithium ion battery separators. Aramid fabric was collected from a scrap plant of an industrial automotive company. Nanoclay or TiO2 nanoparticles were added into this waste-based aramid aerogel matrix in the sol-gel stage to further enhance the performance of the separators. The samples were characterized by scanning electron microscope (SEM), linear sweep voltammetry, electrochemical impedance spectroscopy (EIS) and galvanostatic charge/discharge tests. A uniform and bead-free morphology was observed for all samples with over 60% porosity. Electrolyte uptake and ionic conductivity test results showed that addition of TiO2 nanoparticles increased electrolyte uptake and ionic conductivity up to 365% and 2.2 mS/cm, respectively. The cells prepared by using nanocomposite aramid aerogels with TiO2 exhibited excellent cycling performance with a capacity of around 160 mAh/g in 200 cycles.
Are Psychological Variables and Time Since Surgery Related to Rotator Cuff Strength and Functional Performance in Cadets After Shoulder Stabilization Surgery?
Authors: Casper Preston C. , Benedict Timothy , Morris Jamie , McHenry Paige , Dummar Max , Crowell Michael S. 
Published: August 2024

Background: Traumatic shoulder instability is a common injury in the general population and the military. Surgical stabilization surgery reduces recurrence rates compared with nonsurgical management. Time since surgery is generally the primary measure of return to sport. There is a gap in knowledge on psychological variables and time since surgery and their relationship to rotator cuff strength and functional performance. Hypothesis: It was hypothesized that, after shoulder stabilization surgery, psychological factors and time since surgery will be associated positively with objective physical performance tests, that physical performance will differ significantly between postsurgery cadets and healthy controls, and that surgical stabilization of the nondominant arm will demonstrate greater range of motion deficits than surgical intervention on the dominant arm. Study Design: Case-control study. Level of Evidence: Level 4. Methods: The 52 participants (26 postsurgical [6-24 months after surgery] and 26 healthy controls) were all military cadets. Outcome measures were patient-reported outcomes, range of motion, isometric strength, and functional performance. Results: No significant relationships existed between time since surgery and psychological factors to rotator cuff strength or functional performance. Significant differences were found between groups in self-reported outcomes, including the Shoulder Instability Return to Sport After Injury scale, Single Assessment Numeric Evaluation, Numeric Pain Rating Scale, quickDASH, flexion and external rotation (ER), and ER limb symmetry. Those who received dominant-sided shoulder surgery demonstrated a greater mean active range of motion deficit than those who received nondominant-sided surgery. Both groups demonstrated a significant loss in ER, but dominant-sided surgical participants also demonstrated significant flexion loss. Conclusion: Time since surgery and psychological variables did not demonstrate a relationship to rotator cuff strength and functional performance. Significant differences existed between the stabilization surgical participants and healthy controls in all patient-reported outcomes. Surgical participants with dominant-sided shoulder surgery demonstrated a greater mean motion deficit when compared with those who received nondominant-sided surgery.
Maintaining healthy lifestyle through fitness app use: A parallel mediation model from a nationwide survey
Authors: Zhang Min , Li Xiaojing 
Published: August 2024

Objective Adolescents face various health challenges due to academic pressures and sedentary lifestyles. Establishing healthy habits during this critical period is essential for long-term well-being. With the widespread use of fitness apps, understanding their impact on adolescent health behaviors and the underlying mechanisms is crucial. Guided by social support theory and social comparison theory, this study examined the influence of WeRun, a fitness app within WeChat, on adolescents’ adoption of healthy lifestyles. It investigated the correlation between WeRun usage and healthy behaviors, as well as the underlying mechanisms driving this relationship. Methods A cross-sectional survey was conducted across 31 provinces and metropolitans in China, utilizing a random cluster sampling approach targeting high school and freshman students aged 15–24 ( N = 1312). A parallel mediation model was employed to test the hypotheses. Results The analysis showed that WeRun use positively predicted both social support and social comparison. Meanwhile, both social support and social comparison were positively associated with healthy lifestyles. Additionally, WeRun use could not directly predict healthy lifestyles. However, WeRun use indirectly predicted healthy lifestyles via social support and social comparison. Conclusions The study's findings revealed the pivotal roles of social support and social comparison as mediating variables in the relationship between adolescents’ WeRun usage and adoption of healthy lifestyles. The results contributed to the current comprehension of the mechanisms linking app utilization to health-promoting behaviors. Furthermore, it provided valuable insights for promoting adolescent health and informed improved design strategies for fitness apps.
Efficacy of Platelet-rich Fibrin for the Treatment of Grade II Furcation Defects in Mandibular Molars
Authors: Hong Cam Le Ngoc , Pham Thuy Anh Vu 
Published: August 2024

Aim: To evaluate the efficacy of platelet-rich fibrin (PRF) in the treatment of grade II furcation mandibular molars. Materials and Methods: We enrolled 12 patients with 24 mandibular class II furcation defects in this randomized clinical trial with a split-mouth design. These defects were treated with either open flap debridement (OFD) in conjunction with PRF (test group) or only OFD (control group). We recorded and assessed clinical parameters (probing pocket depth [PPD], gingival recession [GR], and vertical and horizontal clinical attachment level [VCAL and HCAL, respectively]), radiographic parameters (bone defect fill [%BF]), and microbiological parameters at baseline and 6 months after treatment. Results: After treatment, PPD, VCAL, HCAL, BF, and microbiological parameters were significantly reduced in both groups. All clinical and radiographic parameters showed significant improvement at the sites that had been treated with PRF and OFD compared with those that had been treated with OFD alone. Among 24 furcation defects in both groups, 10 showed a significantly improved clinical condition and 14 remained at the initial grade. There were no more severe conditions recorded after treatment. Conclusion: Within the limitation of this article, we have demonstrated the effectiveness of PRF in the regenerative treatment of grade II furcation defects.
Borderline Developmental Dysplasia of the Hip With Osseous Impingement as Distinct From Femoroacetabular Impingement and Developmental Dysplasia of the Hip
Authors: Zhang Jia , Li Zhongyao , Wu Yidong , Yu Kangkang , Gan Lu , Liu Yujie , Xu Chengfeng , Li Chunbao 
Published: August 2024

Background: Borderline developmental dysplasia of the hip (BDDH) accompanied by cam deformity and subspinous impingement has been found to benefit from arthroscopic surgery. However, the research comparing BDDH combined with osseous impingement to femoroacetabular impingement (FAI) without borderline dysplasia remains limited. Purpose/Hypothesis: To compare the clinical symptoms, intraoperative findings, and outcomes of hip arthroscopy in patients with BDDH and osseous impingement versus cam-type FAI. It was hypothesized that BDDH with osseous impingement could be classified as a distinct entity between FAI and developmental dysplasia of the hip (DDH). Study Design: Cohort study; Level of evidence, 3. Methods: Data were collected from patients 18 to 50 years old who underwent primary hip arthroscopy between September 2016 and October 2020. Patients were divided based on preoperative lateral center-edge angle (LCEA) into 2 groups: (1) BDDH group (LCEA 18°-25°; n = 67); and (2) cam-type FAI group without BDDH (FAI group; LCEA 25°-40° and alpha angle >55°; n = 145). Disparities in symptoms, preoperative examination, intraoperative findings and procedures, and patient-reported outcome (PRO) scores were compared. Results: Follow-up was available for 61 (91.0%) patients in the BDDH group and 125 (86.2%) patients in the FAI group. The incidence of cam deformity in BDDH patients was 91.8%. The preoperative characteristics and intraoperative findings were similar between the groups; however, preoperative internal and external hip rotation, Tönnis angle, femoroepiphyseal acetabular roof index, labral size, capsule thickness, and percentage of ligamentum teres tear were significantly higher in the BDDH group than the FAI group, and the percentage of pain aggravating factor, cam deformity, and anterior inferior iliac spine types 2 and 3 were also significantly different between groups ( P < .05 for all). The percentage of intraoperative minimal acetabuloplasty, subspinous decompression, labral repair, ligamentum teres debridement, and capsular closure was significantly higher in the BDDH group than the FAI group, while the percentage of femoroplasty was higher in the FAI group ( P < .05). Pre- to postoperative improvement on PRO scores was seen in both groups. Conclusion: Given the differences in etiology and surgical procedures between the 2 conditions, it is suggested that BDDH with osseous impingement be classified as an entity distinct from FAI and DDH (and separate from BDDH without impingement) while excluding joint instability.
Prefrontal Metabolite Alterations in Individuals with Posttraumatic Stress Disorder: A 7T Magnetic Resonance Spectroscopy Study
Authors: Reid Meredith A. , Whiteman Sarah E. , Camden Abigail A. , Jeffirs Stephanie M. , Weathers Frank W. 
Published: August 2024

Background Evidence from animal and human studies suggests glutamatergic dysfunction in posttraumatic stress disorder (PTSD). The purpose of this study was to investigate glutamate abnormalities in the dorsolateral prefrontal cortex (DLFPC) of individuals with PTSD using 7T MRS, which has better spectral resolution and signal-to-noise ratio than lower field strengths, thus allowing for better spectral quality and higher sensitivity. We hypothesized that individuals with PTSD would have lower glutamate levels compared to trauma-exposed individuals without PTSD and individuals without trauma exposure. Additionally, we explored potential alterations in other neurometabolites and the relationship between glutamate and psychiatric symptoms. Methods Individuals with PTSD (n = 27), trauma-exposed individuals without PTSD (n = 27), and individuals without trauma exposure (n = 26) underwent 7T MRS to measure glutamate and other neurometabolites in the left DLPFC. The severities of PTSD, depression, anxiety, and dissociation symptoms were assessed. Results We found that glutamate was lower in the PTSD and trauma-exposed groups compared to the group without trauma exposure. Furthermore, N-acetylaspartate (NAA) was lower and lactate was higher in the PTSD group compared to the group without trauma exposure. Glutamate was negatively correlated with depression symptom severity in the PTSD group. Glutamate was not correlated with PTSD symptom severity. Conclusion In this first 7T MRS study of PTSD, we observed altered concentrations of glutamate, NAA, and lactate. Our findings provide evidence for multiple possible pathological processes in individuals with PTSD. High-field MRS offers insight into the neurometabolic alterations associated with PTSD and is a powerful tool to probe trauma- and stress-related neurotransmission and metabolism in vivo.
Potential harms resulting from patient–clinician real-time clinical encounters using video-based telehealth: A Making Healthcare Safer rapid evidence review
Authors: Rosen Michael , Stewart C Matthew , Kharrazi Hadi , Sharma Ritu , Vass Montrell , Zhang Allen , Bass Eric B 
Published: August 2024

Objectives To review the evidence on harms associated with patient–clinician real-time encounters using video-based telehealth and determine the effectiveness of any related patient safety practices (PSPs), which are interventions, strategies, or approaches intended to prevent or mitigate unintended consequences of healthcare delivery and improve patient safety. Methods We searched PubMed, EMBASE, and Cochrane to identify eligible studies published from 2012 to 2022, supplemented by grey literature search. Outcomes of interest included adverse events and other specified harms (i.e., preventable hospitalizations, inappropriate treatment, missed or delayed diagnoses, duplication of services, privacy breaches). Findings Our search retrieved 7155 citations, of which 23 studies (including six randomized controlled trials [RCTs]) were eligible for review. Fourteen studies reported on adverse events or unintended effects of telehealth conducted in diverse settings. Adverse events such as death, reoperation, infection, or major complications were infrequent in both telehealth and usual care groups. Thirteen studies examined preventable hospitalizations or emergency department (ED) visits and reported mixed findings. Of the six RCTs, three showed no difference in risk of hospitalization or ED visits for telehealth compared to usual care and three showed reduced risk for patients receiving telehealth. We found no studies on the effectiveness of PSPs in reducing harms associated with real-time telehealth. Conclusions Telehealth was not inferior to usual care in terms of hospitalizations or ED visits. No studies evaluated a specific PSP. More research is needed to improve understanding of harms associated with real-time use of telehealth and how to prevent or mitigate those harms.