bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Drug Formulary Exclusions from the Patient’s Perspective: 2023 Update
Authors: Chea Sara , Sydor Anne M. , Popovian Robert 
Published: November 2023

ABSTRACTObjectivePharmacy benefit management companies (PBMs) often determine medication reimbursement, out-of-pocket costs, and access through formularies. Formularies were initially intended to ensure the use of cost-effective medication. Today, formularies are designed to maximize concessions (i.e., rebates, discounts, fees, and other concessions) to PBMs from the biopharmaceutical industry. Formulary exclusions enhance the ability to drive profits through rebate contracting for PBMs. Our 2022 research analyzed whether formulary exclusions benefit patients medically or economically. This update provides an analysis of exclusions based on the 2023 Express Scripts (ESI) national formulary.MethodsWe analyzed ESI’s 2023 national preferred formulary exclusions. ESI is the second-largest PBM in the U.S. and makes its national preferred formulary exclusions list publicly available. We categorized substitutions as equivalent (same active agent used) vs. therapeutic (different active agent). From a patient perspective, we evaluated each exclusion by potential clinical or economic outcomes and compared it to the results from the 2022 analysis.ResultsMore than half (57.4%) of the formulary exclusions had questionable economic or medical benefits or both for patients. The results demonstrate a 9% increase in questionable patient benefits compared with 48.4% in 2022.ConclusionsBecause patient co-pays and deductibles are based on retail prices, some formulary exclusions force patients to pay substantially more for a preferred drug or use a medication with questionable medical benefits for their condition. Exclusions also force prescribers to choose treatments that may have adverse financial or medical outcomes for their patients.
Probing the Evolution of Genes Associated With DNA Methylation inListeria monocytogenes
Authors: Nwaiwu Ogueri , Onyeaka Helen , Rees Catherine 
Published: November 2023

AbstractIn the last decade, there have been increased reports of atypicalListeriaand the discovery of new species. There are public health concerns that new strains may come with increased pathogenicity. Hence, this study aimed to establish the prevalence, evolutionary lineage and ancestry of aListeria monocytogenescollection that includes isolates that harbour a unique set of methylase genes. The addition of methyl groups to DNA can interfere with transcription. Allelic-specific lineage analysis and ribotyping with southern hybridization were carried out after which further phylogenetic analysis was performedin silico. Results show that all the methylase strains belonged to Lineage I and were serotypes 4b or 4d. All designated ancestral strains also belonged to Lineage 1. AListeria monocytogenesplasmid from a serotype 1/2a (Lineage II) contained sequences homologous to that of Lineage I isolates. The methylase nucleotide sequence in the strains studied appears to be highly conserved inListeria monocytogenesand not yet orthologous among other bacterial genera. It is of epidemiological interest and public benefit if wider or continuous surveillance is carried out to ascertain if these rare strains are linked with increased pathogenesis, food type or geographical region.
Context Dependent Perturbation of Allelic Expression Imbalance Reveals Novel Candidate Therapeutic Targets for Metabolic diseases
Authors: Moon Sunjin , Park So-Young 
Published: November 2023

ABSTRACTBackgroundObesity is a pivotal trigger for a spectrum of complex metabolic disorders. By colocalizing cis-eQTLs in adipose tissues from the GTEx consortium and trait-associated SNPs for complex traits from the GWAS Catalog within 3.6 million DNase I hypersensitive sites (DHSs), we systematically identify regulatory variants and genes that exhibit cis effects, as well as potential causal variants within the context of regulatory elements.ResultsOur analysis reveals that 229,504 (26.4%) cis-eQTLs located within DHS reside densely near the transcription start sites, contrasting with those outside of DHS. We observed that genes with higher allelic imbalance have shorter transcript lengths with larger number cis-eQTLs within DHS, and such imbalance genes are predominantly linked to signaling and immune response, whereas those with lower allelic imbalance tend to be involved in metabolism. Our composite colocalization score prioritizes 5,202 DHSs that encompass both cis-eQTLs and trait-associated SNPs, targeting 2,232 protein-coding genes and 523 lncRNAs across complex traits. We highlight the lncRNA SNHG5 as a prime example; it is associated with high-density lipoprotein levels and exhibits low allelic imbalance, and is also down-regulated in adipose tissue from patients with obesity.ConclusionsOur findings underscore the critical role of regulatory context in pinpointing causal variants and refining target genes, offering rich insights into the genetic mechanisms pertinent to obesity and providing valuable resources for the diagnosis and therapeutic targeting of metabolic diseases.
Does diversity facilitate consumer decisions: a comparative perspective based on single-category versus multi-category products
Authors: Dong Xiaosong , Tu Hanqi , Zhu Hanzhe , Liu Tianlang , Zhao Xing , Xie Kai 
Published: November 2023

PurposeThis study aims to explore the opposite effects of single-category versus multi-category products information diversity on consumer decision making. Further, the authors investigate the moderating role of three categories of visitors – direct, hesitant and hedonic – in the relationship between product information diversity and consumer decision making.Design/methodology/approachThe research utilizes a sample of 1,101,062 product click streams from 4,200 consumers. Visitors are clustered using the k-means algorithm. The diversity of information recommendations for single and multi-category products is characterized using granularity and dispersion, respectively. Empirical analysis is conducted to examine their influence on the two-stage decision-making process of heterogeneous online visitors.FindingsThe study reveals that the impact of recommended information diversity on consumer decision making differs significantly between single-category and multiple-category products. Specifically, information diversity in single-category products enhances consumers' click and purchase intention, while information diversity in multiple-category products reduces consumers' click and purchase intention. Moreover, based on the analysis of online visiting heterogeneity, hesitant, direct and hedonic features enhance the positive impact of granularity on consumer decision making; while direct features exacerbate the negative impact of dispersion on consumer decision making.Originality/valueFirst, the article provides support for studies related to information cocoon. Second, the research contributes evidence to support the information overload theory. Third, the research enriches the field of precision marketing theory.
Developing an ecology of disabilities framework: viewing disability inclusively
Authors: Walker Gabriela 
Published: November 2023

PurposeThis study introduces an ecological framework for disabilities meant to provide a new model of viewing and learning about disabilities and special education. This model projects a multi-systemic view of factors that influence a person's life, where people with disabilities are active actors in the development of the world. The increased awareness about interconnectedness, globalization, inter- and trans-disciplinarity, influences on human experience, greening, sustainability, inequality, inequity and lack of opportunities is shifting how people think about potential and growth.Design/methodology/approachThe methodological approach is qualitative, interpretive research.FindingsIn disability studies, the Ecological Model of Disabilities helps reframe this uniqueness as part of the spectrum of human experiences. In special education, the Ecoducation Model helps reframe the learning experience.Research limitations/implicationsThis research is conceptual, but it is also all-inclusive, rendering itself to a wide application in educational settings.Practical implicationsThe Ecoducation Model for Special Education is specific to the education of children and adults with disabilities, and it is directly compatible with the broader Ecological Model of Disabilities. These ecological models can be applied to all levels of the ecological system, and to different ecodemes of population. Nevertheless, the ecological models need to be locally implemented, with general principles tailored to national traditions, laws and resources.Social implicationsAdvocating for the pursuit of individual well-being within the larger society, both models call for practical changes in a multitude of areas, including legislation and policy, training of professional personnel, sufficient financial input in programs designed for the care of children and adults with disabilities, change in societal mentalities to fight discrimination, disempowerment and isolation. Because the scope of ecological frameworks is incommensurate, being both interdisciplinary and transdisciplinary, further research possibilities are countless. The ecological perspective opens the fields of disability studies and special education to new theoretical and empirical possibilities.Originality/valueTwo epistemological models are described as new frameworks in disability studies: the Ecological Model of Disabilities and the Ecoducation Model for Special Education. Both are original models that look into the education and inclusion of the person with disabilities.
Exclusive liquor and cocktail consumption is associated with at‐risk fibrosis among nonheavy alcohol users with metabolic dysfunction‐associated steatotic liver disease
Authors: Ting Peng‐sheng , Lin Wei‐Ting , Huang Chiung‐Kuei , Lin Hui‐Yi , Tseng Tung‐Sung , Chen Po‐Hung 
Published: November 2023

AbstractBackgroundMetabolic dysfunction‐associated steatotic liver disease (MASLD) and alcohol consumption have both increased in recent years, and there is debate as to whether nonheavy alcohol use is safe in MASLD. We analyzed the association between different nonheavy alcohol use patterns and at‐risk liver fibrosis among individuals with MASLD.MethodsWe conducted a cross‐sectional study of 1072 eligible National Health and Nutrition Examination Survey participants with MASLD who reported nonheavy alcohol consumption. We used vibration‐controlled transient elastography to define the primary outcome of at‐risk liver fibrosis as >8.2 kPa (stage F2‐F4). Multivariable logistic regression models were used to determine the association of different alcohol consumption patterns (average drinks/day, drinking days/week, weekly alcohol intake, type of alcoholic beverage) and at‐risk hepatic fibrosis, controlling for demographic/socioeconomic, lifestyle/dietary, and metabolic risk factors.ResultsExclusive liquor or cocktail drinkers had a 5.02‐fold odds of at‐risk fibrosis (95% CI: 1.15–21.95) compared with non‐drinkers when controlling for potential confounders. While consuming an average of 2 drinks/day, ≥3 drinking days/week, or 1–3 drinks/week appeared to have a lower association with at‐risk fibrosis when controlling for demographic/socioeconomic risk factors, the association was not present after controlling for lifestyle/dietary and metabolic risk factors.ConclusionsThere is an association between exclusive liquor/cocktail consumption and at‐risk liver fibrosis in patients with MASLD who report nonheavy alcohol consumption.
Remote ischemic conditioning after stroke: Research progress in clinical study
Authors: Jiang Bin , Wang Xiaojie , Ma Jianping , Fayyaz Aminah , Wang Li , Qin Pei , Ding Yuchuan , Ji Xunming , Li Sijie 
Published: November 2023

AbstractBackground and PurposeStroke is a leading cause of global morbidity and mortality, indicating the necessity and urgency of effective prevention and treatment. Remote ischemic conditioning (RIC) is a convenient, simple, non‐intrusive, and effective method that can be easily added to the treatment regime of stroke patients. Animal experiments and clinical trials have proved the neuroprotective effects of RIC on brain injury including (examples of neuroprotective effects). This neuroprotection is achieved by raising brain tolerance to ischemia, increasing local cerebral blood perfusion, promoting collateral circulations, neural regeneration, and reducing the incidence of hematomas in brain tissue. This current paper will summarize the studies within the last 2 years for the comprehensive understanding of the use of RIC in the treatment of stroke.MethodsThis paper summarizes the clinical research progress of RIC on stroke (ischemic stroke and hemorrhagic stroke (HS)). This paper is a systematic review of research published on registered clinical trials using RIC in stroke from inception through November 2022. Four major databases (PUBMED, WEB OF SCIENCE, EMBASE, and ClinicalTrials.gov) were searched.ResultsForty‐eight studies were identified meeting our criteria. Of these studies, 14 were in patients with acute ischemic stroke with onset times ranging from 6 h to 14 days, seven were in patients with intravenous thrombolysis or endovascular thrombectomy, 10 were in patients with intracranial atherosclerotic stenosis, six on patients with vascular cognitive impairment, three on patients with moyamoya disease, and eight on patients with HS. Of the 48 studies, 42 were completed and six are ongoing.ConclusionsRIC is safe, feasible, and effective in the treatment of stroke. Large‐scale research is still required to explore the optimal treatment options and mechanisms of RIC in the future to develop a breakthrough in stroke prevention and treatment.
Optic nerve pilomyxoid astrocytoma: Intraoperative squash smear cytology of a rare entity
Authors: Tathe Shilpa P. , Parate Sanjay N. 
Published: November 2023

AbstractPilomyxoid astrocytoma [PMA] is a rare, recently described variant of pilocytic astrocytoma with unique clinical and histopathological characteristics. It typically affects the optico‐chiasmatic and hypothalamic region in infants and young children. Though the pilocytic astrocytoma is the commonest tumor of the optic nerve, pilomyxoid astrocytoma arising from the intraorbital part of the optic nerve is extremely rare. To the best of our knowledge, only one case of introrbital optic nerve pilomyxoid astrocytoma has been described in the English literature. We report two cases of pilomyxoid astrocytoma arising from the intraorbital optic nerve, diagnosed on intraoperative squash smear cytology and later confirmed on histopathology. Like in other locations, optic nerve pilomyxoid astrocytoma behaves in an aggressive manner.
The longitudinal impact of type 2 diabetes on brain gyrification
Authors: Crisóstomo Joana , Duarte João V. , Canário Nádia , Moreno Carolina , Gomes Leonor , Castelo‐Branco Miguel 
Published: November 2023

AbstractType 2 diabetes has an effect on brain structure, including cortical gyrification. The significance of these changes is better understood if assessed over time. However, there is a lack of studies assessing longitudinally the effect of this disease with complex aethology in gyrification. While changes in this feature have been associated mainly with genetic legacy, our study allowed to shed light on the effect of the variation of glycaemic profile over time in gyrification in this metabolic disease. In this longitudinal study, we analysed brain anatomical magnetic resonance images of 15 participants with type 2 diabetes and 13 healthy control participants to investigate the impact of this metabolic disease on the gyrification index over a 7‐year period. We observed a significant interaction between time and group in six regions, four of which (left precentral gyrus, left gyrus rectus, left subcentral gyrus and sulci and right inferior temporal gyrus) showed an increase in gyrification in type 2 diabetes and a decrease in the control group and the two others (left pericallosal sulcus and right inferior frontal sulcus) the opposite pattern. The variation of the gyrification was correlated with the variation of the glycaemic profile. Following the interaction, the simple main effect of time in each group separately has shown that in the group with diabetes, there were more regions susceptible to alterations of gyrification. In sum, our results raise credit for the possibility that glycaemic control also might influence gyrification in type 2 diabetes.
Managing understandings of palliative care as more than care immediately before death: Evidence from observational analysis of consultations
Authors: Sansone Holly , Ekberg Stuart , Lord Sarah , Stevenson James , Martinez Katherine , Yates Patsy 
Published: November 2023

AbstractBackgroundEvidence suggests that public, and some professional, understandings of palliative care are limited to care provided immediately before death, which contrasts palliative care's scope as care provided across a range of illness stages.ObjectiveTo examine how clinicians manage patients' understandings of palliative care during initial consultations.DesignInitial palliative care consultations were video‐recorded and analysed using conversation analytic methods.Setting/ParticipantsConsultations were recorded in a specialist palliative care outpatient unit within an Australian public hospital. Participants included 20 newly referred patients and their families, and three palliative care clinicians.ResultsDuring initial consultations, it was observed that specialist palliative care clinicians frequently managed the possibility that patients may understand palliative care as limited to care provided immediately before death. Clinicians used recurrent practices that seemed designed to pre‐empt and contradict patients' possible narrow understandings. When discussing the palliative care inpatient unit, clinicians recurrently explained inpatient care could include active treatment and referred to the possibility of being discharged. These practices contradict possible understandings that future admission to the inpatient unit would be solely for care immediately before death.DiscussionThe findings demonstrate that palliative care clinicians are aware of possible narrow understandings of their discipline among members of the public. The practices identified show how clinicians pre‐emptively manage these understandings to patients newly referred to palliative care.ConclusionsThese findings highlight scope for greater partnership with teams referring patients to palliative care, to assist patients in understanding the range of reasons for their referral.Patient or Public ContributionThe observational method of conversation analysis provides direct insight into matters that are relevant for patients, as raised in their consultations with clinicians. This direct evidence enables analysis of their lived experience, as it occurs, and grounds analysis in observable details of participants' conduct, rather than interpretations of subjective experiences. The patients' contributions, therefore, were to allow observation into their initial palliative care consultations.
The Japanese Urological Association's clinical practice guidelines for urotrauma 2023
Authors: Horiguchi Akio , Shinchi Masayuki , Ojima Kenichiro , Iijima Kazuyoshi , Inoue Koji , Inoue Takamitsu , Kaneko Naoyuki , Kanematsu Akihiro , Saito Daizo , Sakae Tatefumi , Sugihara Toru , Sekine Kazuhiko , Takao Tetsuya , Tabei Tadashi , Tamura Yoshimi , Funabiki Tomohiro , Yagihashi Yusuke , Yanagi Masato , Takahashi Satoru , Nakajima Yosuke 
Published: November 2023

AbstractThe Japanese Urological Association's guidelines for the treatment of renal trauma were published in 2016. In conjunction with its revision, herein, we present the new guidelines for overall urotrauma. Its purpose is to provide standard diagnostic and treatment recommendations for urotrauma, including iatrogenic trauma, to preserve organ function and minimize complications and fatality. The guidelines committee comprised urologists with experience in urotrauma care, selected by the Trauma and Emergency Medicine Subcommittee of the Specialty Area Committee of the Japanese Urological Association, and specialists recommended by the Japanese Association for the Surgery of Trauma and the Japanese Society of Interventional Radiology. The guidelines committee established the domains of renal and ureteral, bladder, urethral, and genital trauma, and determined the lead person for each domain. A total of 30 clinical questions (CQs) were established for all domains; 15 for renal and ureteral trauma and five each for the other domains. An extensive literature search was conducted for studies published between January 1, 1983 and July 16, 2020, based on the preset keywords for each CQ. Since only few randomized controlled trials or meta‐analyses were found on urotrauma clinical practice, conducting a systematic review and summarizing the evidence proved challenging; hence, the grade of recommendation was determined according to the 2007 “Minds Handbook for Clinical Practice Guidelines” based on a consensus reached by the guidelines committee. We hope that these guidelines will be useful for clinicians in their daily practice, especially those involved in urotrauma care.
Evaluation of the antibacterial activity and protein profiling of Nile tilapia (Oreochromis niloticus) epidermal mucus under different feeds and culture systems (biofloc technology and earthen pond)
Authors: Habib Syed Sikandar , Batool Aima Iram , Rehman Muhammad Fayyaz Ur , Naz Saira 
Published: November 2023

AbstractThe mucus layers of fish serve as the main interface between the organism and the environment. They play an important biological and ecological role. The current study focuses on Nile tilapia epidermal mucus reared under different commercial feeds (coded A and B) and environments (biofloc technology and earthen pond systems). Crude protein levels in feed A and B were 30% and 28%, respectively. Water parameters in all culturing systems were suitable for tilapia throughout the study period. The antimicrobial potency of tilapia (n = 5 from each) epidermal mucus was tested in vitro against human and fish pathogenic strains viz. Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Francisella noatunensis, and Aeromonas hydrophila. To determine the antimicrobial activity, zones of inhibition (ZOI) were measured in millimetres and compared with two antibiotics (chloramphenicol and ciprofloxacin). SDS‐PAGE analysis was performed on skin mucus samples of tilapia to determine protein quantity and size (molecular weight). Results of tilapia skin mucus (crude and aqueous) revealed a strong antibacterial effect against all the selected pathogenic strains. However, variation has been observed in the mucus potency and ZOI values between the biofloc and pond tilapia mucus. The crude mucus of tilapia fed on feed A and cultured in the pond exhibited strong antibacterial effects and high ZOI values compared to the mucus of biofloc tilapia, aqueous mucus extracts and positive control chloramphenicol (antibiotic). The SDS‐PAGE results showed that the high molecular weight proteins were found in the collected epidermal mucus of BFT‐B (240 kDa) and EP‐B (230 kDa). Several peptides in fish skin mucus may play a crucial role in the protection of fish against disease‐causing pathogens. Thus, it can be utilized in the human and veterinary sectors as an ‘antimicrobial’ for treating various bacterial infections.