bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integration of dental therapists in safety net practice increases access to oral health care in Minnesota
Authors: Khan Mishal , Catalanotto Frank , Singhal Astha , Revere F. Lee 
Published: June 2024

AbstractObjectivesThis study evaluates the impact of introducing dental therapists (DTs) into Children's Dental Services (CDS), a large non‐profit organization in Minnesota. The aim is to assess the effect of DTs in improving access and reducing dental care costs in Minnesota by analyzing the trends in dental care delivery and procedures performed by CDS dentists and therapists.MethodsUsing 2009 to 2021 data from CDS, the study compares trends in patient volume, types of procedures, salary data and payments by dentists, DTs, and registered dental hygienists (RDH). Return on investment (ROI) trends are calculated using salary and revenues for each provider type.ResultsAfter introducing DTs at CDS and implementing mobile clinics, the number of patients served and volume increased steadily, demonstrating increased access. DTs provided an increasing proportion of fluorides, sealants, and extractions through 2020. Interestingly 2021, there was a decrease for DTs, possibly due to Covid related workforce shortages. ROI analysis showed that DTs' ROI dramatically rose, eventually surpassing dentists, while RDHs maintained a constant ROI. Dentists' ROI also initially increased after adopting DTs in the practice.ConclusionIntegrating DTs at CDS improved access by expanding mobile clinics, increasing patient volume, and redistributing procedures, while demonstrating a positive return on investment. Results suggest that adopting the DT model may be a promising practice for other organizations seeking to improve access to dental care, increase operational efficiency, and boost the dental care team's ROI.
Educating long‐term care staff on older adult oral health: Maine's oral team‐based initiative vital access to education (MOTIVATE) program
Authors: Crittenden Jennifer A. , Nelligan Labrini I. , O'Connell Denise , Brennan Leonard 
Published: June 2024

AbstractIntroductionThe oral health status of older adults in the United States is a public health crisis and a silent epidemic. Maine's Oral Team‐Based Initiative Vital Access to Education (MOTIVATE) Program is an innovative interprofessional oral health program aimed at enhancing oral health education and practice of interprofessional health care teams in nursing homes. Using a blended learning model, a combination of in‐person and online learning, this program provides a foundation from which to implement evidenced based oral care in nursing homes.MethodsLearning outcomes were assessed via a three‐part timed series survey. A set of self‐report assessment items measured skills implemented at baseline and post‐training.ResultsLearning domain scores increased over time from baseline to post‐training. Confidence in providing oral healthcare and role clarity in providing oral health care improved over time. Staff identified using new skills in daily oral care and communication across the interprofessional team.DiscussionThe MOTIVATE program is an effective collaborative‐based model for developing oral health competencies and promoting evidence‐based oral health care in nursing homes.
Update on heme biosynthesis, tissue‐specific regulation, heme transport, relation to iron metabolism and cellular energy
Authors: Belot Audrey , Puy Herve , Hamza Iqbal , Bonkovsky Herbert L. 
Published: June 2024

AbstractHeme is a primordial macrocycle upon which most aerobic life on Earth depends. It is essential to the survival and health of nearly all cells, functioning as a prosthetic group for oxygen‐carrying proteins and enzymes involved in oxidation/reduction and electron transport reactions. Heme is essential for the function of numerous hemoproteins and has numerous other roles in the biochemistry of life. In mammals, heme is synthesised from glycine, succinyl‐CoA, and ferrous iron in a series of eight steps. The first and normally rate‐controlling step is catalysed by 5‐aminolevulinate synthase (ALAS), which has two forms: ALAS1 is the housekeeping form with highly variable expression, depending upon the supply of the end‐product heme, which acts to repress its activity; ALAS2 is the erythroid form, which is regulated chiefly by the adequacy of iron for erythroid haemoglobin synthesis. Abnormalities in the several enzymes of the heme synthetic pathway, most of which are inherited partial enzyme deficiencies, give rise to rare diseases called porphyrias. The existence and role of heme importers and exporters in mammals have been debated. Recent evidence established the presence of heme transporters. Such transporters are important for the transfer of heme from mitochondria, where the penultimate and ultimate steps of heme synthesis occur, and for the transfer of heme from cytoplasm to other cellular organelles. Several chaperones of heme and iron are known and important for cell health. Heme and iron, although promoters of oxidative stress and potentially toxic, are essential cofactors for cellular energy production and oxygenation.
Long‐term outcome of hepatitis delta in different regions world‐wide: Results of the Hepatitis Delta International Network
Authors: Wranke Anika , Lobato Cirley , Ceausu Emanoil , Dalekos George N. , Rizzetto Mario , Turcanu Adela , Niro Grazia A. , Keskin Onur , Gherlan George , Abbas Minaam , Ingiliz Patrick , Muche Marion , Buti Maria , Jachs Mathias , Vanwolleghem Thomas , Cornberg Markus , Abbas Zaigham , Yurdaydin Cihan , Dörge Petra , Wedemeyer Heiner ,   the Hepatitis Delta International Network
Published: June 2024

AbstractBackground and AimsChronic hepatitis delta represents a major global health burden. Clinical features of hepatitis D virus (HDV) infection vary largely between different regions worldwide. Treatment approaches are dependent on the approval status of distinct drugs and financial resources.MethodsThe Hepatitis Delta International Network (HDIN) registry involves researchers from all continents (Wranke, Liver International 2018). We here report long‐term follow‐up data of 648 hepatitis D patients recruited by 14 centres in 11 countries. Liver‐related clinical endpoints were defined as hepatic decompensation (ascites, encephalopathy and variceal bleeding), liver transplantation, hepatocellular carcinoma or liver‐related death.ResultsPatient data were available from all continents but Africa: 22% from Eastern Mediterranean, 32% from Eastern Europe and Central Asia, 13% from Central and Southern Europe, 14% from South Asia (mainly Pakistan) and 19% from South America (mainly Brazil). The mean follow‐up was 6.4 (.6–28) years. During follow‐up, 195 patients (32%) developed a liver‐related clinical event after 3.5 (±3.3) years. Liver cirrhosis at baseline and a detectable HDV RNA test during follow‐up were associated with a worse clinical outcome in multivariate regression analysis while patients receiving interferon alfa‐based therapies developed clinical endpoints less frequently. Patients from South Asia developed endpoints earlier and had the highest mortality.ConclusionsThe HDIN registry confirms the severity of hepatitis D and provides further evidence for HDV viraemia as a main risk factor for disease progression. Hepatitis D seems to take a particularly severe course in patients born in Pakistan. There is an urgent need to extend access to antiviral therapies and to provide appropriate education about HDV infection.
Association between low maternal serum aflatoxin B1 exposure and adverse pregnancy outcomes in Mombasa, Kenya, 2017–2019: A nested matched case–control study
Authors: Osoro Eric , Awuor Abigael O. , Inwani Irene , Mugo Cyrus , Hunsperger Elizabeth , Verani Jennifer R. , Nduati Ruth , Kinuthia John , Okutoyi Lydia , Mwaengo Dufton , Maugo Brian , Otieno Nancy A. , Mirieri Harriet , Ombok Cynthia , Nyawanda Bryan , Agogo George O. , Ngere Isaac , Zitomer Nicholas C. , Rybak Michael E. , Munyua Peninah , Njenga Kariuki , Widdowson Marc‐Alain 
Published: June 2024

AbstractWe examined the association between serum aflatoxin B1‐lysine adduct (AFB1‐lys) levels in pregnant women and adverse pregnancy outcomes (low birthweight, miscarriage and stillbirth) through a nested matched case–control study of pregnant women enroled at ≤28 weeks' gestation in Mombasa, Kenya, from 2017 to 2019. Cases comprised women with an adverse birth outcome, defined as either delivery of a singleton infant weighing <2500 g, or a miscarriage, or a stillbirth, while controls were women who delivered a singleton live infant with a birthweight of ≥2500 g. Cases were matched to controls at a ratio of 1:2 based on maternal age at enrolment, gestational age at enrolment and study site. The primary exposure was serum AFB1‐lys. The study included 125 cases and 250 controls. The median gestation age when serum samples were collected was 23.0 weeks (interquartile range [IQR]: 18.1–26.0) and 23.5 (IQR: 18.1–26.5) among cases and controls, respectively. Of the 375 tested sera, 145 (38.7%) had detectable serum AFB1‐lys: 36.0% in cases and 40.0% in controls. AFB1‐lys adduct levels were not associated with adverse birth outcomes on multivariable analysis. Mid‐upper arm circumference was associated with a 6% lower odds of adverse birth outcome for every unit increase (p = 0.023). Two‐fifths of pregnant women had detectable levels of aflatoxin midway through pregnancy. However, we did not detect an association with adverse pregnancy outcomes, likely because of low serum AFB1‐lys levels and low power, restricting meaningful comparison. More research is needed to understand the public health risk of aflatoxin in pregnant women to unborn children.
Integrated organismal responses induced by projected levels of CO2 and temperature exposures in the early life stages of lake sturgeon
Authors: Belding Luke D. , Thorstensen Matt J. , Quijada‐Rodriguez Alex R. , Bugg William S. , Yoon Gwangseok R. , Loeppky Alison R. , Allen Garrett J. P. , Schoen Alexandra N. , Earhart Madison L. , Brandt Catherine , Ali Jennifer L. , Weihrauch Dirk , Jeffries Kenneth M. , Anderson W. Gary 
Published: June 2024

AbstractAtmospheric CO2 and temperature are rising concurrently, and may have profound impacts on the transcriptional, physiological and behavioural responses of aquatic organisms. Further, spring snowmelt may cause transient increases of pCO2 in many freshwater systems. We examined the behavioural, physiological and transcriptomic responses of an ancient fish, the lake sturgeon (Acipenser fulvescens) to projected levels of warming and pCO2 during its most vulnerable period of life, the first year. Specifically, larval fish were raised in either low (16°C) or high (22°C) temperature, and/or low (1000 μatm) or high (2500 μatm) pCO2 in a crossed experimental design over approximately 8 months. Following overwintering, lake sturgeon were exposed to a transient increase in pCO2 of 10,000 μatm, simulating a spring melt based on data in freshwater systems. Transcriptional analyses revealed potential connections to otolith formation and reduced growth in fish exposed to high pCO2 and temperature in combination. Network analyses of differential gene expression revealed different biological processes among the different treatments on the edges of transcriptional networks. Na+/K+‐ATPase activity increased in fish not exposed to elevated pCO2 during development, and mRNA abundance of the β subunit was most strongly predictive of enzyme activity. Behavioural assays revealed a decrease in total activity following an acute CO2 exposure. These results demonstrate compensatory and compounding mechanisms of pCO2 and warming dependent on developmental conditions in lake sturgeon. Conserved elements of the cellular stress response across all organisms provide key information for how other freshwater organisms may respond to future climate change.
Power and place: Uncovering the politics of global medical education
Authors: Rashid Mohammed Ahmed , Grant Janet 
Published: June 2024

AbstractContextPolitics is characterised by power relations, and the deployment of power is inescapably political. In an increasingly globalised and interconnected modern world, politics is shaping the field of medical education more than ever before. Global frameworks that classify peoples and places are political tools that are fundamentally shaped by hegemonic knowledge systems. Despite this, they continue to form the basis for global thinking and practices, including in medical education. Political analysis can help to expose and challenge such thinking.ApproachTo better understand impacts of globalisation in medical education, we explore the previously under‐examined political dimensions that underpin it, focusing particularly on deconstructing power relations. We situate our analysis of global medical education in political terms, including through examination of ideology, economics, market and the enduring effects of colonialism. We interrogate the construct of the Global South (GS), considering the geopolitical and historical ideas that have enabled it to be widely propagated. We go on to examine the consequences of the GS construct in medical education and consider what this tells us about how power is enacted in the field.ConclusionsIn analysing the politics of global medical education, we shed light on how power is exerted and draw attention to forces that permit and enable trends, policies and positions. Notwithstanding the emancipatory rhetoric that has been associated with the GS construct, we highlight its reductive potential and argue that it can lead to an oversimplification of power relations and vested interests. Given the growing recognition that educational approaches do not transfer well across countries and cultures, we encourage the medical education community to consider why ideas from more dominant countries continue to be imitated so routinely. In doing so, we urge them to use political lenses to recognise the influence of multiple complex and interconnected forces of global power that shape all aspects of medical education.
The human colon: Evidence for degenerative changes during aging and the physiological consequences
Authors: Baidoo Nicholas , Sanger Gareth J. 
Published: June 2024

AbstractBackgroundThe incidence of constipation increases among the elderly (>65 years), while abdominal pain decreases. Causes include changes in lifestyle (e.g., diet and reduced exercise), disease and medications affecting gastrointestinal functions. Degenerative changes may also occur within the colo‐rectum. However, most evidence is from rodents, animals with relatively high rates of metabolism and accelerated aging, with considerable variation in time course. In humans, cellular and non‐cellular changes in the aging intestine are poorly investigated.PurposeTo examine all available studies which reported the effects of aging on cellular and tissue functions of human isolated colon, noting the region studied, sex and age of tissue donors and study size. The focus on human colon reflects the ability to access full‐thickness tissue over a wide age range, compared with other gastrointestinal regions. Details are important because of natural human variability.We found age‐related changes within the muscle, in the enteric and nociceptor innervation, and in the submucosa. Some involve all regions of colon, but the ascending colon appears more vulnerable. Changes can be cell‐ and sublayer‐dependent. Mechanisms are unclear but may include development of “senescent‐like” and associated inflammaging, perhaps associated with increased mucosal permeability to harmful luminal contents.In summary, reduced nociceptor innervation can explain diminished abdominal pain among the elderly. Degenerative changes within the colon wall may have little impact on symptoms and colonic functions, because of high “functional reserve,” but are likely to facilitate the development of constipation during age‐related challenges (e.g., lifestyle, disease, and medications), now operating against a reduced functional reserve.
A game‐theoretic systematics of conservation and management of spatial ecosystem services
Authors: Drechsler Martin 
Published: June 2024

AbstractSince many ecosystem services involve spatial scales beyond farm size, their preservation and management in agricultural systems depend on the interaction of the landowners. For the analysis of such interactive land use a generic dynamic land‐use model is developed that considers different payoff structures in a systematic manner and relates land‐use dynamics to these payoff structures. A landowner's own payoff depends on the land use on neighboring land parcels. The landowners’ payoffs are interpreted in a game‐theoretic manner which allows for a game‐theoretic classification of the different land‐use dynamics generated by the model. The model is analyzed to determine the proportion, spatial aggregation and temporal turnover of land‐use measures. The model results are applied to a number of cases from literature in which the management of ecosystem services involves a regional scale, including pollinator conservation, pest control, and coordination incentives for the conservation of species in fragmented landscapes. Four main domains of model behavior are identified and related to the payoff structures (type of game), characterized by the proportions and temporal turnover of land‐use measures, and by whether the system has one or two stable equilibria. An important determinant of the land‐use dynamics is the spatial heterogeneity of the landowners' payoffs which. It affects the domain and the location in the domain by which the land‐use dynamics are characterized.
The role of metabolic and bariatric surgery on the obesity pandemic in Latin America: A review of current practices and future directions
Authors: Castellanos Luis D. , Anselmetti Paola , Acosta G Arnaldo J , Tomey Daniel , Araujo‐Contreras Robert , Puche Emiro , Elzein Steven , Graham Yitka , Mahawar Kamal , Marshall Skye , Abou‐Mrad Adel , Oviedo Rodolfo J. 
Published: June 2024

SummaryLatin America faces a significant public health challenge due to the high prevalence of obesity and its associated diseases. Metabolic and bariatric surgery is effective and safe to treat obesity when other treatments fail; however, its implementation in Latin America remains unsatisfactory. This review explores the current status, challenges, and innovations of metabolic and bariatric surgery in Latin America. We searched peer‐reviewed journals in English and Spanish for relevant articles published between 1998 and 2023. We found that more than 20% of the Latin American population is affected by obesity. Unfortunately, only a limited number of patients have access to metabolic and bariatric surgery due to high cost, limited availability, and shortage of specialists. The review found that ongoing clinical trials are being conducted in Brazil, Mexico, Chile, and Venezuela, indicating some regional progress. However, published studies remain low in number compared with other regions. Furthermore, we summarized the clinical outcomes, risks, and perioperative assessments associated with metabolic and bariatric surgery. We discussed potential strategies to enhance the availability and affordability of this intervention. This review emphasizes the significance of metabolic and bariatric surgery in addressing the obesity pandemic, specifically for Latin America, and proposes directions for future research and innovation.
The endocrinologist gap: Managing diabetes patients in absence of a specialist
Authors: Ahmed Nabeel , Ingelmo Pablo 
Published: June 2024

AbstractThe treatment of pediatric patients with diabetes is frequently orchestrated within a multidisciplinary framework at tertiary, specialized institutions. In situations where emergent surgery is indicated or when a procedure is scheduled in a facility devoid of an endocrinology service, the onus of managing perioperative glycemic levels may rest with the attending anesthesiologist. The objective of this review is to furnish a comprehensive examination of the anesthetic considerations and perioperative governance of pediatric patients with diabetes. Furthermore, this paper delineates a streamlined protocol for perioperative glycemic control, tailored to both major and minor surgical interventions.
Characteristics of board‐certified pediatric dermatologists accepting Medicaid
Authors: Tessier‐Kay Madeleine , Beltrami Eric , Sinha Shivani , Feng Hao 
Published: June 2024

AbstractA current shortage of pediatric dermatologists limits access to dermatologic care among the pediatric population, yet comprehensive and updated data are lacking regarding access among the pediatric Medicaid population. This cross‐sectional study characterized Medicaid acceptance among actively practicing board‐certified pediatric dermatologists in the United States and revealed that of the 352 physicians compiled, 275 (78.1%) accept Medicaid. Significant differences in Medicaid acceptance status were observed based on practice type, region of practice, practice county median household income, and density of pediatric dermatologists. While the majority of practicing board‐certified pediatric dermatologists accept Medicaid, our findings suggest that differences in access to Medicaid‐accepting pediatric dermatologists exist based on practice type, geographic location, and density of pediatric dermatologists per county.
Significant improvement of a nevus spilus‐type congenital melanocytic nevus with oral selumetinib
Authors: Berna R. , Hasbun T. , Adams D. , Moon A. T. , Treat J. R. 
Published: June 2024

AbstractGiant congenital melanocytic nevi (GCMN) can be cosmetically significant and can lead to melanoma. There is no standard pharmacologic treatment for GCMN. We present the case of an 8‐year‐old female with kaposiform lymphangiomatosis caused by an NRAS mutation whose nevus spilus‐type GCMN improved on oral selumetinib.
Neonatal Sweet syndrome with associated rectovestibular fistula and review of the literature
Authors: Abdelwahab Rewan M. , Coias Jennifer L. , Tollefson Megha M. 
Published: June 2024

AbstractAn otherwise healthy 4‐week‐old term female of Japanese heritage presented with a 1‐week history of asymptomatic progressive, generalized skin lesions. The lesion morphology, distribution, and dermatopathology result was consistent with Sweet syndrome. The patient was found to have a congenital type H rectovestibular fistula. This case highlights the rare association of rectovestibular fistula in neonatal Sweet syndrome which has only been described in neonates of Japanese heritage.
“An Alpha Wouldn't Spare an Emotion on a Woman”: A directed qualitative analysis of dark triad outcomes in women's relationships with Red Pill men
Authors: Zapcic Ian 
Published: June 2024

AbstractThe Dark Triad (DT) is a set of personality traits consisting of subclinical psychopathy, narcissism, and Machiavellianism. Separately, The Red Pill (TRP) is a seduction community part of an online men's movement that advocates incorporating DT traits and behaviors in romantic or sexual relationships with women. This study investigates the potential presence of DT influences in relationships with TRP‐affiliated men as described by former romantic partners. Using a directed content analysis of six semi‐structured interviews, four thematic categories emerged: relationship development, coaxing, outward appearances, and DT‐associated Internet behaviors. TRP men consistently displayed self‐interest and willingness to use manipulation to meet their needs, portraying themselves to their partners and the world as successful while callously disregarding partners' emotions in their pursuit of sex or social desirability. Participants' experiences of TRP men's behaviors aligned with prior knowledge regarding DT‐associated romantic and sexual relationships. This research may be used to inform future research connecting DT personalities and maladaptive social groups, as well as generating prevention strategies among relationship‐based practitioners.