bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting adverse cardiovascular events in emergency department patients with bupropion overdose
Authors: Simpson Michael D. , Campleman Sharan , Brent Jeffrey , Wax Paul , Manini Alex F. ,   the Toxicology Investigators Consortium
Published: June 2024

AbstractObjectivesBupropion toxicity can lead to adverse cardiovascular events (ACVE), but delayed onset of toxicity makes risk stratification difficult. This study aimed to validate previously defined predictors of ACVE and identify novel predictors among patients presenting to the emergency department (ED) after bupropion overdose.MethodsThis secondary analysis of prospective data from the Toxicology Investigators Consortium Core Registry analyzed adult acute or acute‐on‐chronic bupropion exposures from 2015 to 2018. The primary outcome was ACVE (any of the following: myocardial injury, shock, ventricular dysrhythmia, or cardiac arrest). Potential predictors of ACVE included previously derived predictors in the overall drug overdose population (prior cardiac disease, initial serum bicarbonate < 20 mEq/L, and initial QTc ≥ 500 ms), exposure circumstances, and initial serum lactate value. Candidate predictors were evaluated using univariate analysis and multivariable regression modeling. Receiver operator characteristic curves were used to derive optimal cutoff points for novel predictors, and prognostic test characteristics were calculated.ResultsOf 355 patients analyzed, ACVE occurred in 34 (9.6%) patients. Initial serum bicarbonate < 20 mEq/L (adjusted odds ratio [aOR] 4.42, 95% confidence interval [CI] 1.94–10.0) and initial QTc ≥ 500 ms (aOR 2.52, 95% CI 1.01–6.09) independently predicted ACVE. Exposure circumstances did not predict ACVE. Initial serum lactate > 5.2 mmol/L independently predicted ACVE (aOR 12.2, 95% CI 2.50–75.2) and was 90.7% specific with 80.3% negative predictive value.ConclusionsMetabolic acidosis and QTc prolongation were validated as predictors of ACVE in ED patients with bupropion overdose. Serum lactate elevation was strongly predictive of ACVE in this study and warrants further investigation.
Salamander loss alters montane stream ecosystem functioning and structure through top‐down effects
Authors: Alonso A. , Bosch J. , Pérez J. , Rojo D. , Boyero L. 
Published: June 2024

AbstractAmphibians are among the most endangered taxa worldwide, but little is known about how their disappearance can alter the functioning and structure of freshwater ecosystems, where they live as larval stages. This is particularly true for urodeles, which often are key predators in these ecosystems. The fire salamander (Salamandra salamandra) is a common predator in European fresh waters, but the species is declining due to habitat loss and the infection by fungal pathogens. We studied the consequences of fire salamander loss from three montane streams, by comparing two key ecosystem processes (periphyton accrual and leaf litter decomposition) and the structure of three communities (periphytic algae, aquatic hyphomycetes and invertebrates) using stream enclosures with and without salamander larvae. Salamander loss did not cause changes in invertebrate abundance or community structure, except for one stream where abundance increased in the absence of salamander larvae. However, salamander loss led to lower periphyton accrual, changes in algal community structure and slower leaf litter decomposition, with no associated changes in fungal communities or microbial decomposition. The changes observed may have been caused by release of salamander predatory pressure on invertebrates, which could have promoted their grazing on periphyton, in contrast to their preference for leaf shredding in the presence of salamander. Our study demonstrates an important role of salamander larvae in montane streams through top‐down control of lower trophic levels and thus in regulating key stream ecosystem processes. Our results highlight the need for improving protection measures for amphibians to prevent these alterations on ecosystem structure and function.
Guidelines for non‐surgical root canal treatment
Authors: Peters Ove A. , Rossi‐Fedele Giampiero , George Roy , Kumar Kiran , Timmerman Aovana , Wright Patricia P. 
Published: June 2024

AbstractGuidelines were developed by the Australian Society of Endodontology Inc. with the intent to describe relevant aspects of contemporary evidence‐based root canal treatment. The document aims to support clinicians by describing a Standard of Practice in the Australian context. The presented guidelines refer to Competence criteria and Quality standards for the main steps in root canal treatment. While the intent is not to replace individual clinical decision‐making, it is envisaged that these periodically reviewable guidelines may help to improve clinical outcomes.
Repeatability of vibration‐controlled transient elastography versus magnetic resonance elastography in patients with cirrhosis: A prospective study
Authors: Siddiqi Harris , Huang Daniel Q. , Mittal Nikita , Nourredin Nabil , Bettencourt Ricki , Madamba Egbert , Amangurbanova Maral , Hernandez Christie , Sirlin Claude , Yin Meng , Loomba Rohit 
Published: June 2024

SummaryBackground and AimsMagnetic resonance elastography (MRE) and vibration‐controlled transient elastography (VCTE) have the potential to assess disease progression; however, repeatability data in people with cirrhosis are lacking. We aimed to assess the effect of disease severity on measurement variability and contribute to the evidentiary basis for the qualification of repeating liver stiffness measurements (LSM) in practice and research.MethodsThis prospective study included 49 adult participants (58.3% female) with cirrhosis who underwent same‐day repeat LSM examinations. The primary outcome was the same‐day, same‐operator repeatability coefficient% (RC%) and the within‐case coefficient of variation (wCV) for each modality. Secondary outcomes include the intra‐class correlation coefficient (ICC). The relationship between measurement variability (interquartile for VCTE, standard deviation for MRE) and disease severity (mean liver stiffness) was evaluated by linear regression with the coefficient of determination R2 reported.ResultsSame‐day repeat MRE and VCTE exams were prospectively conducted in 33 and 45 participants, respectively. The RC% appeared 82% higher for VCTE versus MRE (38% vs. 21%), with consistent findings in head‐to‐head analyses. The wCV for VCTE and MRE was 14% and 8% respectively, indicating VCTE has 75% higher within‐subject measurement variation than MRE. ICC was excellent for LSM by VCTE (0.92) and MRE (0.96). Measurement variability increased with mean liver stiffness for VCTE (R2 = 0.78) and MRE (R2 = 0.93).ConclusionBoth VCTE and MRE demonstrated increased measurement variability with disease severity. However, MRE outperformed VCTE in terms of technical repeatability in patients with cirrhosis. These repeatability estimates may improve the qualification of NITs in practice.
Assessing the anticholinergic cognitive burden classification of putative anticholinergic drugs using drug properties
Authors: Phutietsile Geofrey Oteng , Fotaki Nikoletta , Nishtala Prasad S. 
Published: June 2024

AimsThis study evaluated the use of machine learning to leverage drug absorption, distribution, metabolism and excretion (ADME) data together with physicochemical and pharmacological data to develop a novel anticholinergic burden scale and compare its performance to previously published scales.MethodsExperimental and in silico ADME, physicochemical and pharmacological data were collected for antimuscarinic activity, blood–brain barrier penetration, bioavailability, chemical structure and P‐glycoprotein (P‐gp) substrate profile. These five drug properties were used to train an unsupervised model to assign anticholinergic burden scores to drugs. The model performance was evaluated through 10‐fold cross‐validation and compared with the clinical Anticholinergic Cognitive Burden (ACB) scale and nonclinical Anticholinergic Toxicity Scores (ATS) scale, which is based primarily on muscarinic binding affinity.ResultsIn silico software (ADMET Predictor) used for screening drugs for their blood–brain barrier (BBB) penetration correctly identified some drugs that do not cross the BBB. The mean area under the curve for the unsupervised and ACB scale based on the five selected variables was 0.76 and 0.64, respectively. The unsupervised model agreed with the ACB scale on the classification of more than half of the drugs (49 of 88) agreed on the classification of less than half the drugs in the ATS scale (12 of 25).ConclusionsOur findings suggest that the commonly used ACB scale may misclassify certain drugs due to their inability to cross the BBB. By contrast, the ATS scale would misclassify drugs solely depending on muscarinic binding affinity without considering other drug properties. Machine learning models can be trained on these features to build classification models that are easy to update and have greater generalizability.
Acromegaly management in the Nordic countries: A Delphi consensus survey
Authors: Arlien‐Søborg Mai C. , Dal Jakob , Heck Ansgar , Stochholm Kirstine , Husted Eigil , Feltoft Claus Larsen , Rasmussen Åse Krogh , Feldt‐Rasmussen Ulla , Andreassen Mikkel , Klose Marianne Christina , Nielsen Torben Leo , Andersen Marianne Skovsager , Christensen Louise Lehmann , Krogh Jesper , Jarlov Anne , Bollerslev Jens , Nermoen Ingrid , Oksnes Marianne , Dahlqvist Per , Olsson Tommy , Berinder Katarina , Hoybye Charlotte , Petersson Maria , Akerman Anna‐karin , Wahlberg Jeanette , Ekman Bertil , Engstrom Britt Eden , Johannsson Gudmundur , Ragnarsson Oskar , Olsson Daniel , Sigurjónsdóttir Helga Ágústa , Fougner Stine Lyngvi , Matikainen Niina , Vehkavaara Satu , Metso Saara , Jaatinen Pia , Hämäläinen Päivi , Rintamäki Reeta , Yliaska Iina , Immonen Heidi , Mäkimattila Sari , Cederberg‐Tamminen Henna , Viukari Marianna , Nevalainen Pasi , Nuutila Pirjo , Schalin‐Jäntti Camilla , Burman Pia , Jørgensen Jens Otto Lunde 
Published: June 2024

AbstractObjectiveAcromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow‐up exist. However, not all recommendations are strictly evidence‐based. To evaluate consensus on the treatment and follow‐up of patients with acromegaly in the Nordic countries.MethodsA Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow‐up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert‐type scale (1−7). Consensus was defined as ≥80% of panelists rating their agreement as ≥5 or ≤3 on the Likert‐type scale.ResultsConsensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first‐generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first‐generation SSA and pegvisomant as second‐ or third‐line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.ConclusionThis consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence‐based data.
Emergence of artificial intelligence for automating cone‐beam computed tomography‐derived maxillary sinus imaging tasks. A systematic review
Authors: Shujaat Sohaib , Alfadley Abdulmohsen , Morgan Nermin , Jamleh Ahmed , Riaz Marryam , Aboalela Ali Anwar , Jacobs Reinhilde 
Published: June 2024

AbstractCone‐beam computed tomography (CBCT) imaging of the maxillary sinus is indispensable for implantologists, offering three‐dimensional anatomical visualization, morphological variation detection, and abnormality identification, all critical for diagnostics and treatment planning in digital implant workflows. The following systematic review presented the current evidence pertaining to the use of artificial intelligence (AI) for CBCT‐derived maxillary sinus imaging tasks. An electronic search was conducted on PubMed, Web of Science, and Cochrane up until January 2024. Based on the eligibility criteria, 14 articles were included that reported on the use of AI for the automation of CBCT‐derived maxillary sinus assessment tasks. The QUADAS‐2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool was used to evaluate the risk of bias and applicability concerns. The AI models used were designed to automate tasks such as segmentation, classification, and prediction. Most studies related to automated maxillary sinus segmentation demonstrated high performance. In terms of classification tasks, the highest accuracy was observed for diagnosing sinusitis (99.7%), whereas the lowest accuracy was detected for classifying abnormalities such as fungal balls and chronic rhinosinusitis (83.0%). Regarding implant treatment planning, the classification of automated surgical plans for maxillary sinus floor augmentation based on residual bone height showed high accuracy (97%). Additionally, AI demonstrated high performance in predicting gender and sinus volume. In conclusion, although AI shows promising potential in automating maxillary sinus imaging tasks which could be useful for diagnostic and planning tasks in implantology, there is a need for more diverse datasets to improve the generalizability and clinical relevance of AI models. Future studies are suggested to focus on expanding the datasets, making the AI model's source available, and adhering to standardized AI reporting guidelines.
Tracing the influence of prenatal risk factors on the offspring retina: Focus on development and putative long‐term consequences
Authors: Baptista Filipa I. , Ambrósio António F. 
Published: June 2024

AbstractBackgroundPregnancy represents a window of vulnerability to fetal development. Disruptions in the prenatal environment during this crucial period can increase the risk of the offspring developing diseases over the course of their lifetime. The central nervous system (CNS) has been shown to be particularly susceptible to changes during crucial developmental windows. To date, research focused on disruptions in the development of the CNS has predominantly centred on the brain, revealing a correlation between exposure to prenatal risk factors and the onset of neuropsychiatric disorders. Nevertheless, some studies indicate that the retina, which is part of the CNS, is also vulnerable to in utero alterations during pregnancy. Such changes may affect neuronal, glial and vascular components of the retina, compromising retinal structure and function and possibly impairing visual function.MethodsA search in the PubMed database was performed, and any literature concerning prenatal risk factors (drugs, diabetes, unbalanced diet, infection, glucocorticoids) affecting the offspring retina were included.ResultsThis review collects evidence on the cellular, structural and functional changes occurring in the retina triggered by maternal risk factors during pregnancy. We highlight the adverse impact on retinal development and its long‐lasting effects, providing a critical analysis of the current knowledge while underlining areas for future research.ConclusionsAppropriate recognition of the prenatal risk factors that negatively impact the developing retina may provide critical clues for the design of preventive strategies and for early therapeutic intervention that could change retinal pathology in the progeny.
Time to prerandomization seizure count design sufficiently assessed the safety and tolerability of perampanel for the treatment of primary generalized tonic–clonic seizures
Authors: Kerr Wesley T. , Ngo Leock Y. , Zhu Liang , Patten Anna , Cheng Jocelyn Y. , Reddy Advith S. , French Jacqueline A. 
Published: June 2024

AbstractObjectiveStatic assignment of participants in randomized clinical trials to placebo or ineffective treatment confers risk from continued seizures. An alternative trial design of time to exceed prerandomization monthly seizure count (T‐PSC) has replicated the efficacy conclusions of traditionally designed trials, with shorter exposure to placebo and ineffective treatment. Trials aim to evaluate efficacy as well as safety and tolerability; therefore, we evaluated whether this T‐PSC design also could replicate the trial's safety and tolerability conclusions.MethodsWe retrospectively applied the T‐PSC design to analyze treatment‐emergent adverse events (TEAEs) from a blinded, placebo‐controlled trial of perampanel for primary generalized tonic–clonic seizures (NCT01393743). The safety analysis set consisted of 81 and 82 participants randomized to perampanel and placebo arms, respectively. We evaluated the incidences of TEAEs, treatment‐related TEAEs, serious TEAEs, and TEAEs of special interest that occurred before T‐PSC relative to those observed during the full‐length trial.ResultsOf the 67 and 59 participants who experienced TEAEs in the perampanel and placebo arms during full‐length trial, 66 (99%) and 54 (92%) participants experienced TEAEs with onset occurring before T‐PSC, respectively. When limited to treatment‐related TEAEs, 55 of 56 (98%) and 32 of 37 (86%) participants reported treatment‐related TEAEs that occurred before T‐PSC in the perampanel and placebo arms, respectively. There were more TEAEs after T‐PSC with placebo as compared to perampanel (Fisher exact odds ratio = 8.6, p = .035), which resulted in overestimation of the difference in TEAE rate. There was a numerical reduction in serious TEAEs (3/13 occurred after T‐PSC, one in placebo and two in perampanel).SignificanceAlmost all TEAEs occurred before T‐PSC. More treatment‐related TEAEs occurred after T‐PSC for participants randomized to placebo than perampanel, which may be due to either a shorter T‐PSC or delayed time to TEAE for placebo.
Out of the frying pan into the fire: Predicted warming in alpine streams suggests hidden consequences for aquatic ectotherms
Authors: Shackleton M. E. , Siebers A. R. , Suter P. J. , Lines O. , Holland A. , Morgan J. W. , Silvester E. 
Published: June 2024

AbstractThermal regimes of aquatic ecosystems are predicted to change as climate warming progresses over the next century, with high‐latitude and high‐elevation regions predicted to be particularly impacted. Here, we have modelled alpine stream water temperatures from air temperature data and used future predicted air temperature trajectories (representative concentration pathway [rcp] 4.5 and 8.5) to predict future water temperatures. Modelled stream water temperatures have been used to calculate cumulative degree days (CDDs) under current and future climate conditions. These calculations show that degree days will accumulate more rapidly under the future climate scenarios, and with a stronger effect for higher CDD values (e.g., rcp 4.5: 18–28 days earlier [CDD = 500]; 42–55 days earlier [CDD = 2000]). Changes to the time to achieve specific CDDs may have profound and unexpected consequences for alpine ecosystems. Our calculations show that while the effect of increased CDDs may be relatively small for organisms that emerge in spring–summer, the effects for organisms emerging in late summer–autumn may be substantial. For these organisms, the air temperatures experienced upon emergence could reach 9°C (rcp 4.5) or 12°C (rcp 8.5) higher than under current climate conditions, likely impacting on the metabolism of adults, the availability of resources, including food and suitable oviposition habitat, and reproductive success. Given that the movement of aquatic fauna to the terrestrial environment represents an important flux of energy and nutrients, differential changes in the time periods to achieve CDDs for aquatic and terrestrial fauna may de‐couple existing predator–prey interactions.
Microstructure and mechanical properties of pressure‐less sintered B4C–SiC–ZrB2–LaB6 ceramic composites
Authors: Zhang Yaning , Huang Xingyu , Wang Dong , Wei Boxin , Wang Yujin , Ran Songlin 
Published: June 2024

AbstractThe effect of LaB6 on the densification and microstructure of pressure‐less sintered 0.4B4C–0.4SiC–0.2ZrB2 ternary ceramic with eutectic composition was investigated. The Vickers hardness, bending strength, and fracture toughness of the quaternary ceramic were discussed based on the microstructural characteristics. The densification of the 0.4B4C–0.4SiC–0.2ZrB2 ceramic was enhanced with increasing LaB6 content from 0 to 70 mol% (the proportion to B4C–SiC–ZrB2). When the LaB6 content was 50 mol%, the densification rate of the composite ceramic reached a peak. The 0.27B4C–0.27SiC–0.13ZrB2–0.33LaB6 quaternary composite ceramic has reached a density of over 95% after being sintered at 2 100°C for 1 h. The B4C and SiC phases had refined grains of 1–3 µm with intragranular structures in the as‐sintered ceramics. The hardness and strength reached 17.9 ± .8 GPa and 307 ± 38 MPa, respectively. Crack deflection and branching were ascribed to the improved fracture toughness of 3.78 ± .26 MPa·m1/2. This study provides new ideas for fabricating dense non‐oxide ceramic composites with enhanced properties.
Resilience in family caregivers of Asian older people with dementia: An integrative review
Authors: Duangjina Thitinan , Hershberger Patricia E. , Gruss Valerie , Fritschi Cynthia 
Published: June 2024

AbstractAimTo identify factors associated with resilience in family caregivers of Asian older people with dementia based on Luthar and Cicchetti's definition of resilience.DesignIntegrative review of resilience in family caregivers of Asian older people with dementia reported by studies with quantitative and qualitative research designs.Data SourcesDatabases used for the literature search included CINAHL, PubMed, EMBASE, PsycINFO and Google Scholar.Review MethodsA total of 565 potentially relevant studies published between January 1985 and March 2024 were screened, and 27 articles met the inclusion criteria.ResultsFamily caregivers were most commonly adult children of care recipients, female and providing care in their home. Two themes emerged from the review: factors associated with adversity (dementia severity, caregiver role strain, stigma, family stress, female gender, low income and low education) and factors associated with positive adaptational outcomes (positive aspect of caregiving, social support and religiosity/spirituality).ConclusionIn our review of Asian research, four new factors—caregiver role strain, stigma, family stress and positive aspects of caregiving—emerged alongside those previously identified in Western studies. A paradigm shift was observed from a focus on factors associated with adversity to factors associated with positive adaptational outcomes, particularly after the issuance of the WHO's 2017 global action plan for dementia. However, a gap remains between WHO policy recommendations and actual research, with studies often neglecting to address gender and socioeconomic factors.ImpactThe review findings will broaden healthcare providers' understanding of resilience in dementia caregivers and use them to develop comprehensive programmes aimed at reducing factors associated with adversity and enhancing those associated with positive adaptational outcomes. This approach can be customized to incorporate Asian cultural values, empowering caregivers to navigate challenges more effectively.No Patient or Public ContributionThis paper is an integrative review and does not include patient or public contributions.