bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-depth analysis of Klebsiella aerogenes resistome, virulome and plasmidome worldwide
Authors: Morgado Sergio , Fonseca Érica , Freitas Fernanda , Caldart Raquel , Vicente Ana Carolina 
Published: March 2024

AbstractKlebsiella aerogenes is an emergent pathogen associated with outbreaks of carbapenem-resistant strains. To date, studies focusing on K. aerogenes have been small-scale and/or geographically restricted. Here, we analyzed the epidemiology, resistome, virulome, and plasmidome of this species based on 561 genomes, spanning all continents. Furthermore, we sequenced four new strains from Brazil (mostly from the Amazon region). Dozens of STs occur worldwide, but the pandemic clones ST93 and ST4 have prevailed in several countries. Almost all genomes were clinical, however, most of them did not carry ESBL or carbapenemases, instead, they carried chromosomal alterations (omp36, ampD, ampG, ampR) associated with resistance to β-lactams. Integrons were also identified, presenting gene cassettes not yet reported in this species (blaIMP, blaVIM, blaGES). Considering the virulence loci, the yersiniabactin and colibactin operons were found in the ICEKp10 element, which is disseminated in genomes of several STs, as well as an incomplete salmochelin cluster. In contrast, the aerobactin hypervirulence trait was observed only in one ST432 genome. Plasmids were common, mainly from the ColRNAI replicon, with some carrying resistance genes (mcr, blaTEM, blaNDM, blaIMP, blaKPC, blaVIM) and virulence genes (EAST1, senB). Interestingly, 172 genomes of different STs presented putative plasmids containing the colicin gene.
Real-world evidence of constipation and laxative use in the Korean population with chronic kidney disease from a common data model
Authors: Kim Kipyo , Kim Ji-Eun , Kim Jae Ho , Ahn Seong Hee , Jung Chai Young , Hwang Seun Deuk , Lee Seoung Woo , Song Joon Ho 
Published: March 2024

AbstractConstipation is a highly prevalent gastrointestinal disorder in patients with chronic kidney disease (CKD). However, our understanding of its epidemiology and management in CKD is limited. We aimed to explore real-world data on constipation and laxative use in patients with CKD in a nationwide population-based cohort from the Korean Health Insurance Review and Assessment-National Patient Sample database. This study analyzed retrospective health claims data in Korea from 2012 to 2017 that were transformed into the Observational Medical Outcomes Partnership Common Data Model. The pooled proportion of constipation diagnoses was 30.5% in all patients with CKD and 15.9%, 16.5%, 17.4%, 29.9%, and 43.3% in patients with CKD stages 1–5, respectively, suggesting a higher prevalence in advanced CKD. Patients receiving peritoneal dialysis or hemodialysis had the highest prevalence of constipation, while transplant recipients showed a prevalence comparable to that of patients with early CKD. Patients with CKD had a significantly higher risk of constipation than age- and sex-matched non-CKD individuals (range of odds ratio [OR]:1.66–1.90). Laxative prescribing patterns differed by CKD severity. Osmotic agents were prescribed in more than half of patients with advanced CKD, while magnesium salts and bulking agents were prescribed less frequently. The CKD patients with constipation were more likely to be prescribed constipation-inducing medications, including antipsychotic and neurological medications. Our findings provide real-world constipation and laxative prescription status in the Korean CKD population, revealing a significantly higher risk of constipation and different laxative prescribing patterns in patients with CKD.
Insurance Coverage for Gender-Affirming Voice and Communication Services: An In-Depth Analysis in a Midwestern U.S. State
Authors: Dubey Ishita , Stryker Shanna D. , Madzia Jules L. , Pickle Sarah , Dion Gregory R. , McKenna Victoria S. 
Published: March 2024

Purpose:
The aim of this study was to explore the gap between the need for gender-affirming voice and communication services (GAVCS) and insurance coverage within one state.

Method:
An electronic, cross-sectional survey of transgender/gender-diverse (TGD) adults assessed the incidence of insurance and cost barriers to GAVCS. Then, policies from 22 major insurers were reviewed using a web-based search and telephone inquiries. Finally, a tool was developed for clinicians to share available coverage for GAVCS by insurer.

Results:
Over half (53%) of 115 respondents reported vocal incongruence, but only 19.1% had pursued GAVCS. Of those who had not, 57% reported cost and/or insurance coverage were barriers (most of whom were commercially insured). Less than half of major Ohio insurance plans mentioned GAVCS coverage, and of those who did, less than half would consider covering it on a case-by-case basis. Creation of a tool that explained coverage across insurance companies was helpful, but challenging and labor-intensive.

Conclusions:
TGD individuals often experience a mismatch between their gender identity and societal perceptions of their voice, which can worsen dysphoria and compromise safety. GAVCS align voice with gender identity but are inconsistently covered by health insurance and can be costly, particularly for individuals who face socioeconomic marginalization. Inconsistent transparency in communicating coverage criteria further exacerbates access to GAVCS. Poor insurance coverage of GAVCS is an important barrier to accessing this evidence-based care, and more transparency and consistency in coverage is critical.
Intensive Care Treatment of Pulmonary Embolism: An Update Based on the Revised AWMF S2k Guideline
Authors: Janssens Uwe 
Published: March 2024

AbstractAcute pulmonary embolism (PE) remains a significant cause of morbidity and requires prompt diagnosis and management. The prognosis of affected patients depends on the clinical severity. Therefore, risk stratification is imperative for therapeutic decision-making. Patients with high-risk PE need intensive care. These include patients who have successfully survived resuscitation, with obstructive shock or persistent haemodynamic instability. Bedside diagnostics by means of sonographic procedures are of outstanding importance in this high-risk population. In addition to the treatment of hypoxaemia with noninvasive and invasive techniques, the focus is on drug-based haemodynamic stabilisation and usually requires the elimination or reduction of pulmonary vascular thrombotic obstruction by thrombolysis. In the event of a contraindication to thrombolysis or failure of thrombolysis, various catheter-based procedures for thrombus extraction and local thrombolysis are available today and represent an increasing alternative to surgical embolectomy. Mechanical circulatory support systems can bridge the gap between circulatory arrest or refractory shock and definitive stabilisation but are reserved for centres with the appropriate expertise. Therapeutic strategies for patients with intermediate- to high-risk PE in terms of reduced-dose thrombolytic therapy or catheter-based procedures need to be further evaluated in prospective clinical trials.
Inhalativer Konsum in Drogenkonsumräumen als wichtiges Element von
Harm Reduction
Authors: Grabski Meryem , Stöver Heino , Michels Ingo Ilja , Förster Stefan 
Published: March 2024

Zusammenfassung
Ziel der Studie Während die schadensminimierende Wirkung von
Drogenkonsumräumen (DKR) bei injizierendem Drogengebrauch gut belegt ist, gibt
es momentan wenige Nachweise über die schadensminimierende Wirkung bei
nicht-injizierendem Drogengebrauch in DKR. Dies ist aber aktuell von großer
Wichtigkeit: zum einen bringt die Alterung der DKR-Population mit sich, dass
viele Konsument*innen wegen ihrer durch chronischen Konsum von nicht regulierten
Drogen geschädigten Venen nicht mehr intravenös Nutzen können. Zum anderen wird
europaweit und auch in Deutschland ein Anstieg vom Konsum gerauchter
Stimulanzien, wie Crack, beobachtet. Generell gilt der nicht- injizierende
Konsum als risikoärmer, aber dies ist im Kontext von DKR bis jetzt nicht
untersucht worden. Seit 2011 wird der Konsum von Substanzen in den
Inhalationsräumen der vier DKR in Frankfurt am Main systematisch erfasst. Durch
sein Volumen und die Länge der systematischen Erfassung ist dieser Datensatz
besonders geeignet, die Entwicklungen des nicht- injizierenden Konsums in DKR
und die schadensminimierende Wirkung dieser Konsumform zu untersuchen.
Methodik Wir untersuchen die Nutzung von Inhalationsplätzen und die
Nutzung von nicht -injizierend und injizierend konsumierter Substanzen. Zudem
werden Notfalldaten zu injizierendem und nicht- injizierendem Gebrauch
verglichen.
Ergebnisse Inhalationsplätze werden insgesamt viel und vermehrt genutzt.
Nicht- injizierend werden vor allen Dingen Heroin und Crack konsumiert. Heroin
ist nach einem sprunghaften Anstieg ab 2015 die am meisten nicht-injizierend
genutzte Substanz. Den stärksten Anstieg von nicht-injizierend genutzten
Substanzen in den letzten zwei Jahren hatte Crack. Der injizierende Gebrauch
nimmt insgesamt ab, es ist aber noch die bei weitem häufigste Konsumform.
Notfalldaten zeigen, dass die Nutzung von nicht- injizierenden Methoden zur
Drogeneinnahme im Vergleich zu injizierenden Methoden in Verbindung mit deutlich
weniger Notfällen steht. Dies ist auch nach statistischer Anpassung für die
Häufigkeit der Konsumform der Fall.
Schlussfolgerung Die Bereitstellung von Inhalationsplätzen bietet die
Möglichkeit zum weniger riskanten Konsum von gerauchten Substanzen und kann den
Umstieg vom injizierenden zum weniger riskanten inhalativen oder intranasalen
Konsum erleichtern. Sollte der Konsum von Drogen wie Crack weiter ansteigen,
könnte die gezielte Ausrichtung von DKR auf die Bedarfe von Konsument*innen eine
der wichtigsten gesunderhaltenden Maßnahmen sein.
Structural factors influencing the clinical performance of 0.025-inch guidewires for pancreatobiliary endoscopy: An experimental study
Authors: Koga Takehiko , Tsuchiya Naoaki , Ishida Yusuke , Kitaguchi Takanori , Matsumoto Keisuke , Fukuyama Makoto , Kojima Satoki , Kojima Norihiro , Hirai Fumihito 
Published: March 2024

Abstract
Background and study aims To develop a pancreatobiliary endoscopic guidewire with good clinical performance, an understanding of its structure is necessary. This study aimed to investigate the structural factors influencing the clinical performance of pancreatobiliary endoscopic guidewires.
Methods Eight types of 0.025-inch guidewires were evaluated. The following structural properties were measured: tip length, tip deflection height, tip weight (TW), ratio of tip core weight to TW, shaft coating type (flat or uneven), outer diameter, and core wire diameter (CWD). Four performance tests were conducted to evaluate shaft stiffness as bending force (BF), shaft lubricity as friction force (FF), torque response as torque response rate (TRR), and seeking ability as total insertion success (TIS) in a technical test using a 3D bile duct model. The correlation coefficients of each variable were analyzed.
Results The BF and CWDs were strongly correlated, as well as the FF and CWDs and BF. Among the guidewires with similar CWDs, the guidewires with uneven coating had significantly lower FF than those with flat coating. The TRR was strongly correlated with the CWDs; furthermore, guidewires with lower FF had better TRR. TIS was strongly correlated with the TRR, TWs, and ratio of the tip core weight to TW.
Conclusions CWD affects shaft stiffness; CWD and coating type affect shaft lubricity and torque response. Because TRR and TW are correlated with seeking ability, an appropriate combination of core wire thickness, TW, and coating design is required to develop a guidewire with good seeking ability.
Quantification of interstitial cells of Cajal and fibrosis during gastric per-oral endoscopic myotomy and its association with clinical outcomes
Authors: Yang Dennis , Hasan Muhammad Khalid , Bani Fawwaz BahaAldeen , Farooq Aimen , Zhang Yiyang , Khan Hafiz M , Brar Tony S , Singh Sanmeet , Viana Artur , Singh Gurdeep , Kadkhodayan Kambiz , Arain Mustafa A , Cosgrove Natalie , Jain Deepanshu , Inayat Irteza , Singh Charanjeet 
Published: March 2024

Abstract
Background and study aims Alterations to interstitial cells of Cajal (ICC) and collagen fibrosis have been implicated in the pathogenesis of gastroparesis. We aimed to evaluate the feasibility and safety of pyloric muscle sampling during gastric peroral endoscopic myotomy (G-POEM) and the association between pyloric ICC density and degree of fibrosis with clinical outcomes.
Patients and methods This was a single-center prospective study
of gastroparetic patients who underwent G-POEM and intraprocedural pyloric muscle biopsies
between January 2022 and April 2023. ICC count was estimated using CD117 stain and trichome
for collagen fibrosis. Clinical response to G-POEM was defined as an improvement of ≥ 1 point
on the Gastroparesis Cardinal Symptom Index.
Results Fifty-six patients (median age 60 years, 71.4% women)
underwent G-POEM (100% technical success; 71.4% clinical response). ICC depletion (<
10/high-power field) and fibrosis were encountered in 70.4% and 75% of the cases,
respectively. There was no difference in mean ICC count between G-POEM responders vs.
non-responders (7±3.6 vs. 7.7±3.3; P= 0.9). There was no
association between ICC density or degree of fibrosis with the etiology of gastroparesis,
duration of symptoms, gastric emptying rate, or pyloric impedance planimetry. Patients who did
not respond to G-POEM had a significantly higher degree of moderate/severe fibrosis when
compared with those who responded (81.3% vs. 25%; P =
0.0002).
Conclusions Pyloric muscle biopsies during G-POEM was feasible and safe. ICC depletion and pyloric muscle fibrosis are common in gastroparetic patients. The degree of fibrosis may be related to pyloric dysfunction and clinical response to G-POEM. Additional studies are needed to confirm these results.
SFM Fetal Therapy Practice Guidelines: Fetal Interstitial Laser
Authors: Sharma K. Aparna , KV Seneesh , Chawla Latika , Rana Anubhuti 
Published: March 2024

AbstractFetal laser therapy was first used in complicated monochorionic pregnancies such as twin-to-twin transfusion syndrome or twin-reversed arterial perfusion sequence. There are some other less common indications such as amniotic band syndrome, chorioangiomas, lower urinary tract obstructions, sacrococcygeal teratomas, and fetal thoracic masses. These practice guidelines discuss the indications, contraindications, and risks of the procedure along with information for patients and draft consent form.
Delayed Commissuroplasty Increases Interincisal Distance in Buccogingival Cancer Patients Treated with Free Flap Reconstruction of the Oral Commissure
Authors: Hung Shao Yu , Hanba Curtis , Chang Tommy Nai-Jen , Chen Yan-Lin , Lu Johnny Chuieng-Yi 
Published: March 2024

Abstract
Background Oral cavity cancers requiring excision of the oral commissure and free flap reconstruction often requires commissuroplasty to manage oral incontinence. We aimed to evaluate the implications of primary versus delayed commissuroplasty on drooling, and interincisal distance outcomes in this cohort.
Methods A retrospective query of head and neck cancer patients operated by a single surgeon from 2017 to 2020 was performed. Patients were included if they underwent free flap reconstruction of the oral commissure, had an immediate or delayed commissuroplasty, and had 2 years of follow-up data including Thomas-Stonell and Greenberg drooling rating scales and interincisal distance measurements.
Results Thirty-five patients were included in the review. Twelve patients received immediate commissuroplasty and 23 patients had delayed commissuroplasty. Interincisal distance was similar at baseline, although significantly varied between immediate and delayed commissuroplasty groups at 1 month and 2 years postoperative. Drooling scores were significantly elevated in the group treated with delayed commissuroplasty, but eventually normalized after staged surgery and follow-up. Patients treated with adjunct radiation therapy had lower interincisal distance than patients who did not have radiation.
Conclusion Delayed commissuroplasty increased interincisal distance and normalize drooling in patients who required full-thickness excision of the buccal mucosa and oral commissure and free tissue reconstruction. The presented data can help to educate patients on expected postoperative outcomes and likely advocates for a second-stage procedure after completion of adjunct radiotherapy to achieve optimal commissural placement and oral competence.
Chinese university faculty supervisors’ academic identity construction in online profiles
Authors: Zhou-min Yuan , Hao Wang , Li Yang 
Published: March 2024

AbstractFaculty supervisor profiles on the graduate school webpages of universities offer an explicit assertion of self-representation regarding the author’s academic identity, from which potential graduates can gain official information about their future faculty supervisors. Though scholars’ identity construction on blogs or homepages has drawn sufficient attention, supervisors’ identity construction on graduate school webpages across authors’ status, gender, and disciplines in the Chinese context has not been sufficient. Based on the analysis of moves and processes, this study explores academic identity construction across authors’ status, gender, and disciplines. Professor/Ph.D. faculty supervisors (PPSs) generally tend to use more moves than associate professors/master supervisors (APMs); different relational and material processes are used most frequently for scholars of different statuses. For gender, male academics use more words than females for move and process items. For disciplinary differences, art scholars pay close attention to education, achievement and community service, presenting more relational processes, while history and telecommunications scholars concentrate on their research directions and main publications. The results are further discussed with reference to status advantage, women’s dilemma, and disciplinary culture in the Chinese academic community.
Cavity tuning and beam commissioning of the radio-frequency quadrupole linac for a transportable neutron source
Authors: Li H. P. , Wang F. Y. , Su H. Q. , Liu C. , Pan W. L. , Kong G. Q. , Chen Y. Q. , Yang K. S. , Wang Z. Y. , Wang S. 
Published: March 2024

A transportable, compact, accelerator-based neutron source is under development at Xi’an Jiaotong University. At the heart of the linear accelerator is a radio-frequency quadrupole (RFQ) unit that has been designed to accelerate a proton beam from 30 keV to 2.5 MeV with a peak current of 12 mA and a duty factor of 3%. Recently, the manufacturing of the RFQ cavity has been completed. Cavity tuning, including field unevenness, resonant frequency, and rf coupling coefficient, was carried out after finishing brazing and assembly. The quadrupole perturbative component was controlled within ±2.0%, and the two dipole components were about ±2.5%. The value of the intrinsic Q was 9609, 89% of that of the theoretical simulation. We have completed the installation of the RFQ experimental setup and performed beam commissioning experiments. The output beam current reached 10.6 mA with a transmission efficiency of 93.8%.
Navigating the EU Health Claim Regulation
Authors: Shortt Colette 
Published: March 2024

Abstract
The Health Claim Regulation (HCR) is the legal framework used by food businesses to highlight the benefits of their food products on labels or in promotional communications in the European Union (EU). The rules aim to ensure consumer protection from misleading health claims and to promote fair competition, the free circulation of foods bearing health claims and innovation. There are different authorisation procedures managed by the European Commission (EC) for distinct types of claims and considerable guidance is available both on the presentation of the dossier and the scientific aspects of substantiation of the health claim. While thousands of health claims have been submitted by applicants, only a small percentage have been authorised and the rate of submission has slowed dramatically from the early years of the HCR’s introduction. Nevertheless, applicants have been successful and health claims have been authorised in each health claim type. More recently, the introduction of the Transparency Regulation has impacted the submission process in significant ways, and it remains to be seen if this change will encourage or deter applicants from submitting. While the HCR has been in place for 16 years, there are still many outstanding items, such as nutrition profiling and “on hold” claims that affect businesses. In addition, authorities often take different views on the flexibility that can be applied to authorised health claim wording. This makes implementation of authorised health claims across the EU often complex for businesses to manage. However, despite these issues, the HCR has made strides to protect consumers from misleading claims and provided a robust framework for the scientific evaluation of health claims which is highly regarded worldwide.

Information
© The Author 2023
Waste Management: Landfill Selection Using Gis and Analytical Hierarchy Process
Authors: Shukor A. A. H. M. , Ishak N. M. , Salleh S. A. , Othman F. 
Published: March 2024

Abstract
The widespread use of landfilling as a convenient waste management method has become unsustainable due to the rapid development causing a surge in waste generation, threatening the lifespan of existing landfills. The closure of landfills presents waste management challenges, necessitating more extensive garbage disposal facilities to accommodate the growing urban population. However, poor site selection methods can have a negative impact on both the environment and human health, which goes against the objectives of sustainable development goal (SDG). Methods like Geographic Information System (GIS) and Multi-Criteria Decision Analysis (MCDA) facilitate decision-making processes. This integration reduces analysis time and costs enhances accuracy and minimizes errors. The Analytical Hierarchy Process (AHP) provides a framework to validate judgments and derive measurable values in decision-making involving theories and concepts. In this study, several criteria were used to create a final suitability map which is the distance from the residential area, distance from the plantation area, distance from the main road, distance from waterways, type of soil, slope, and land cover. The results indicate that distance from residential has the highest weightage of importance, which is 27%. It also found that the highly suitable new landfill area is located at Batu in Kuala Langat, Pulau Carey, and Bukit Rotan in Kuala Selangor.