bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of frequency and types of drug interactions in intensive care units: a cross-sectional study
Authors: Baghaei Rahim , Torabzadeh Aysan , Sorayya Hamid , Alinejad Vahid 
Published: November 2023

Background:
Drug interactions can cause adverse reactions, from treatment inefficiency to serious treatment complications in the patient. Due to the complexity of drug therapy and the simultaneous use of several drugs and different drug groups, patients hospitalized in intensive care units are exposed to more drug interactions. Therefore, this study was conducted to investigate the frequency of drug interactions in patients hospitalized in the ICU.

Methods:
In this cross-sectional study, the files of 300 patients hospitalized in the ICU were examined. Drug interactions were determined using Lexicomp software and the book drug iteration facts. Data analysis was done using SPSS 21 software.

Findings:
The findings showed that there were a total of 1121 cases of interference. Two hundred thirty-one (77%) patients had moderate interference, 94 (31.3%) patients had mild interference, and 67 patients (22.3%) had severe interference. One hundred eight patients had B-type interference, 223 C-type interference, 116 D-type interference, and 6 X-type interference, so most of the interactions are C-type interference. One hundred eighty-six patients had pharmacokinetic interference and 201 patients had pharmacodynamics interference. The highest interaction was between two drugs, heparin and aspirin with 58 cases.

Conclusion:
This study highlights the alarming frequency and types of drug interactions observed in ICU. The high prevalence of drug interactions emphasizes the need for improved medication management and vigilance in these critical care settings. Polypharmacy and certain drug combinations were identified as major contributing factors to the occurrence of drug interactions, which calls for regular medication reviews and cautious prescribing practices.
Capillary regression leads to sustained local hypoperfusion by inducing constriction of upstream transitional vessels
Authors: Bonney Stephanie K. , Nielson Cara D. , Sosa Maria J. , Shih Andy Y. 
Published: November 2023

ABSTRACTIn the brain, a microvascular sensory web coordinates oxygen delivery to regions of neuronal activity. This involves a dense network of capillaries that send conductive signals upstream to feeding arterioles to promote vasodilation and blood flow. Although this process is critical to the metabolic supply of healthy brain tissue, it may also be a point of vulnerability in disease. Deterioration of capillary networks is a hallmark of many neurological disorders and how this web is engaged during vascular damage remains unknown. We performedin vivotwo-photon microscopy on young adult mural cell reporter mice and induced focal capillary injuries using precise two-photon laser irradiation of single capillaries. We found that ∼63% of the injuries resulted in regression of the capillary segment 7-14 days following injury, and the remaining repaired to re-establish blood flow within 7 days. Injuries that resulted in capillary regression induced sustained vasoconstriction in the upstream arteriole-capillary transition (ACT) zone at least 21 days post-injury in both awake and anesthetized mice. This abnormal vasoconstriction involved attenuation of vasomotor dynamics and uncoupling from mural cell calcium signaling following capillary regression. Consequently, blood flow was reduced in the ACT zone and in secondary, uninjured downstream capillaries. These findings demonstrate how capillary injury and regression, as often seen in age-related neurological disease, can impair the microvascular sensory web and contribute to cerebral hypoperfusion.SIGNIFICANCEDeterioration of the capillary network is a characteristic of many neurological diseases and can exacerbate neuronal dysfunction and degeneration due to poor blood perfusion. Here we show that focal capillary injuries can induce vessel regression and elicit sustained vasoconstriction in upstream transitional vessels that branch from cortical penetrating arterioles. This reduces blood flow to broader, uninjured regions of the same microvascular network. These findings suggest that widespread and cumulative damage to brain capillaries in neurological disease may broadly affect blood supply and contribute to hypoperfusion through their remote actions.
Prediction of donor heart acceptance for transplant and its clinical implications – results from the Donor Heart Study
Authors: Wayda Brian , Weng Yingjie , Zhang Shiqi , Luikart Helen , Pearson Thomas , Wood R. Patrick , Nieto Javier , Nicely Bruce , Geraghty PJ , Belcher John , Nguyen John , Neidlinger Nikole , Groat Tahnee , Malinoski Darren , Zaroff Jonathan , Khush Kiran K. 
Published: November 2023

AbstractBackgroundDespite a shortage of potential donors for heart transplant in the United States (US), most potential donor hearts are discarded. We evaluated predictors of donor heart acceptance in the US and applied modern analytic methods to improve prediction.MethodsWe included anationwide(2005 – 2020) cohort of potential heart donors in the US (n = 73,948) from the Scientific Registry of Transplant Recipients and a more recent (2015 – 2020) rigorously phenotyped cohort of potential donors from the Donor Heart Study (DHS; n = 4,130). We identified predictors of acceptance for heart transplant in both cohorts using multivariate logistic regression, incorporating time-interaction terms to characterize their varying effects over time. We fit models predicting acceptance for transplant in a 50% training subset of the DHS using multiple machine learning algorithms and compared their performance in the remaining 50% (test) subset.ResultsPredictors of donor heart acceptance were similar in thenationwideandDHScohorts. Among these, older age has become increasingly predictive of discard over time while other factors – including those related to drug use, infection, and mild cardiac diagnostic abnormalities - have become less influential. A random forest model (area under the curve 0.90, accuracy 0.82) outperformed other prediction algorithms in the test subset and was used as the basis of a novel web-based prediction tool.ConclusionsPredictors of donor heart acceptance for transplantation have changed significantly over the last two decades, likely reflecting evolving evidence regarding their impact on post-transplant outcomes. Real-time prediction of donor heart acceptance, using our web-based tool, may improve efficiency during donor management and heart allocation.Clinical PerspectivePredictors of donor heart acceptance for transplantation have changed significantly over the last two decades. Donor age has become increasingly influential while several other factors have become less so - likely reflecting the lack of evidence regarding their impact on post-transplant outcomes. Our web-based tool can enable real-time prediction of donor heart acceptance, and thereby improve efficiency during donor management and heart allocation.
Distinct pathway-based effects of blood pressure and body mass index on cardiovascular traits: comparison of novel Mendelian Randomization approaches
Authors: Sobczyk Maria K , Richardson Tom G , Leyden Genevieve M , Gaunt Tom R 
Published: November 2023

AbstractBackgroundMendelian randomization (MR) leverages genetic variants as instrumental variables to determine causal relationships in epidemiology. However, challenges persist due to heterogeneity arising from horizontal pleiotropy. On the other hand, exploration of the biological underpinnings of such heterogeneity across variants can enhance our understanding of disease mechanisms and inform therapeutic strategies. Here, we introduce a new approach to instrument partitioning based on enrichment of Mendelian disease categories and compare it to a method based on genetic colocalisation in contrasting tissues.MethodsWe employed one-sample and two-sample MR methodologies using blood pressure (BP) exposure SNPs grouped by proximity to Mendelian disease genes affecting the renal system or vasculature, or body mass index (BMI) variants related to mental health and metabolic Mendelian disorders. We then compared the causal effects of Mendelian-partitioned SNPs on cardiometabolic outcomes with subsets inferred from gene expression colocalisation in kidney, artery (for BP), adipose, and brain tissues (for BMI). Additionally, we assessed whether effects from these groupings could emerge by chance using random SNP subset sampling.ResultsOur findings suggest that the causal relationship between systolic BP and coronary heart disease is predominantly driven by SNPs associated with vessel- related Mendelian diseases over renal. However, kidney-oriented SNPs showed more pronounced effect size in the colocalization-based analysis, hinting at a multifaceted interplay between pathways in the disease aetiology. We consistently identified a dominant role of Mendelian vessel and coloc artery exposures in driving the negative effect of diastolic BP on left ventricular stroke volume and positive effect of systolic BP on type 2 diabetes. We also found higher causal estimates for metabolic versus mental health SNPs when dissecting BMI pathway contribution to atrial fibrillation risk using Mendelian disease. In contrast, brain variants yielded higher causal estimates than adipose in the colocalization method.ConclusionsThis study presents a novel approach to dissecting heterogeneity in MR by integrating clinical phenotypes associated with Mendelian disease. Our findings emphasize the importance of understanding tissue-/pathway- specific contributions in interpreting causal relationships in MR. Importantly, we advocate caution in interpreting pathway-partitioned effect size differences without robust statistical validation.
The implications of using maternity care deserts to measure progress in access to obstetric care: A mixed-integer optimization analysis
Authors: Meredith Meghan E. , Steimle Lauren N. , Radke Stephanie M. 
Published: November 2023

AbstractBackgroundLack of access to risk-appropriate maternity services, particularly for rural residents, is thought to be a leading contributor to disparities in maternal morbidity and mortality. There are several existing measures of access to obstetric care in the literature and popular media. In this study, we explored how current measures of obstetric access inform the number and location of additional obstetric care facilities required to improve access.MethodsWe formulated two facility location optimization models to determine the number of new facilities required to minimize the number of reproductive-aged women who lack access to obstetric care. We define regions with a lack of access as either maternity care deserts, designated by the March of Dimes to be counties with no obstetric care facility or obstetric providers, or regions further than 50 miles from critical care obstetric (CCO) services. We gathered information on hospitals with obstetric services from Georgia Department of Public Health public reports and estimated the female reproductive-age population by census block group using the American Community Survey.ResultsOut of the 1,910,308 reproductive-aged women who live in Georgia, 104,158 (5.5%) live in maternity care deserts, 150,563 (7.9%) reproductive-aged women live further than 50 miles from CCO services, and 38,202 (2.0%) live in both maternity care desert and further than 50 miles from CCO services. Our optimization analysis suggests that at least 56 new obstetric care facilities (a 67% increase) would be required to eliminate maternity care deserts in Georgia. However, and the expansion of 8 facilities would ensure all women in Georgia live within 50 miles of CCO services.ConclusionsCurrent measures of access to obstetric care may not be sufficient for evaluating access and planning action toward improvements. In a state like Georgia with a large number of small counties, eliminating maternity care deserts would require a prohibitively large number of new obstetric care facilities. This work suggests that additional measures and tools are needed to estimate the number and type of obstetric care facilities that best match practical resources to meet obstetric care needs.
The impact of cirrhosis on the inflammatory milieu before and long-term after hepatitis C virus elimination by direct-acting antiviral therapy
Authors: Witte Moana , Oltmanns Carlos , Tauwaldt Jan , Schmaus Hagen , Mischke Jasmin , Grabert Gordon , Bretthauer Mara , Deterding Katja , Maasoumy Benjamin , Wedemeyer Heiner , Kacprowski Tim , Kraft Anke R.M. , Cornberg Markus 
Published: November 2023

AbstractBackground and AimsChronic hepatitis C virus (HCV) infection can lead to cirrhosis, development of hepatocellular carcinoma (HCC) and several extrahepatic manifestations. A sustained virological response (SVR) is achieved with direct-acting antivirals (DAA) in over 95% of the patients, but sequelae do not improve in all patients, suggesting permanent biological alterations induced by HCV infection. Therefore, we investigated the influence of chronic HCV infection, viral elimination and cirrhosis on inflammatory immune mediators.Approach and ResultsIn 102 chronic HCV patients, 46 with and 56 without cirrhosis, 92 soluble immune mediators (SIM) were measured in plasma samples at therapy start, end of treatment and long-term follow-up (median 96 weeks). 39 HBsAg positive persons with HBeAg negative infection served as controls.At baseline, 42 SIM were altered in chronic HCV patients (adj.p <0.05). Notably, patients with cirrhosis displayed a higher frequency and severity of alterations. At long-term follow-up, the SIM profile of the non-cirrhotic patients recovered to the level of the control group, while 41 SIM remained altered in cirrhotic patients. 33 of these SIM correlated with elastography, among them SIM linked to carcinogenesis as e.g. HGF, IL8 and IL6 (KEGG Pathways hsa05202, hsa05200).ConclusionsHCV-related changes in the inflammatory milieu can persist even after HCV elimination, specifically in cirrhotic patients. These changes are closely associated with liver damage and carcinogenesis. Our findings underscore the need for HCV elimination before extensive liver injury occurs and suggest further investigation of the relationship between persistent inflammatory milieu changes and long-term sequelae after HCV elimination.Graphical Abstract
Assessments of Effectiveness of Technologies Utilizations in VIHSCM Among Selected Health Facilities in Tanzania Mainland
Authors: Mollel Henry A. , Mushi Lawrencia D. , Nkwera Richard V. 
Published: November 2023

AbstractIntroductionTanzania has adopted various technologies for Vaccine and Immunization Health Supply Chain Management to improve the availability, access, and utilization of immunization programs. However, questions remain regarding the effectiveness of the technologies in Vaccine and Immunization Health Supply Chain Management. This study assesses the effectiveness of technology on vaccine and immunization supply chain management in selected health facilities in Tanzania.MethodsThis study adopted an exploratory descriptive cross-sectional design. The study collected data using structured questionnaires from health facilities that adopted VIHSCM technologies in Arusha, Mwanza, and Mbeya regions, Tanzania. Data were analyzed using descriptive statistics and cross-tabulations with the aid of the Statistical Package of Social Sciences 23rdEdition (SPSS).ResultsThe study findings showed that 56.7% of the surveyed Health facilities had either TiMR, DHIS2, or GOTHOMIS technology used for vaccine and immunization supply chain management. The study shows that 51.4% of respondents at health facilities agreed that the adopted technologies were very effective, 45.9% were moderately effective and 2.7% said the technologies were less effective. The results asserted that 18.9 % of the adopted technologies were effective in the Management of immunization services, 37.8 % asserted that technology utilizations have Increased access to the vaccine, 2.7% said that technology utilizations assisted in monitoring vaccine temperature, 24.3% said that technologies utilizations assisted in vaccines at their respective health facilities, 5.4 % said that technologies utilizations assisted in the Maintaining the quality of Vaccines.ConclusionThis study concluded that technology plays a substantial role in improving the availability and quality of vaccines and immunization services in health facilities. Also, the study suggested that increase the use of technologies to capitalize the VIHSCM effectiveness.
Optimal referral rewards for poverty-alleviating products based on the structural equation interpretation
Authors: Zou Fei , Zhou Yanju 
Published: November 2023

PurposeThe goal of this study is to investigate the mediating effect of referral rewards on consumer willingness to recommend poverty-alleviating products and to identify the most effective referral rewards for incentivizing consumers to recommend poverty-alleviating products.Design/methodology/approachTournament rewards and piece-rate rewards are designed based on the theory of indebtedness, the related literature and the actual background. SPSS 26.0 and AMOS 17.0 are used to analyze the structural equation model.FindingsAccording to the structural equation analysis, the following findings were found: under the tournament reward condition, social image, feelings of indebtedness and perceived reward value negatively affect consumer willingness to recommend. Under the piece-rate reward condition, social image and feelings of indebtedness significantly negatively affect consumer recommendation willingness, while perceived reward value significantly positively affects consumer recommendation willingness. The mean recommendation willingness of the tournament reward group is significantly lower than that of the control group. In contrast, the mean recommendation willingness of the piece-rate rewards group is significantly higher than that of the control group.Originality/valueBased on the study findings, the authors propose that enterprises apply piece-rate rewards to incentivize consumers to recommend poverty-alleviating products when designing such rewards. In this way, the sale of poverty-alleviating products can be improved.
Time-varying connectedness and causality between oil prices and G7 economies exchange rates. Evidence from the COVID-19 and Russia-Ukraine crises
Authors: Thai Hung Ngo 
Published: November 2023

Purpose
This study aims to attempt to investigate the time-varying causality and price spillover effects between crude oil and exchange rate markets in G7 economies during the COVID-19 and Russia–Ukraine crises.

Design/methodology/approach
This study uses time-varying Granger causality test and spillover index.

Findings
This study finds a time-varying causality between exchange rate returns and oil prices, implying that crude oil prices have the predictive power of the foreign exchange rate markets in G7 economies in their domain. Furthermore, the total spillover index is estimated to fall significantly around COVID-19 and war events. However, this index is relatively high – more than 57% during the first wave of COVID-19 and decreasing slightly during the Russia–Ukraine conflict.

Practical implications
This outcome supports the hypothesis that the majority of the time-varying interaction between exchange rates and oil prices takes place in the short term. As a result, the time-varying characteristics provide straightforward insight for investors and policymakers to fully understand the intercorrelation between oil prices and the G7 exchange rate markets.

Originality/value
First, this study has reexamined the oil–exchange rate nexus to highlight new evidence using novel time-varying Granger causality model recently proposed by Shi et al. (2018) and the spillover index proposed by Diebold and Yilmaz (2012). These approaches allow the author to improve understanding of time-varying causal associations and return transmission between exchange rates and oil prices. Second, compared to past papers, this paper has used data from December 31, 2019, to October 31, 2022, to offer a fresh and accurate structure between the markets, which indicates the unique experience of the COVID-19 outbreak and Russia–Ukraine war episodes. Third, this study analyzes a data set of seven advanced economies (G7) exhibiting significant variations in their economic situations and responding to global stress times.
Moving towards a comprehensive view of the spatial processes in seed dispersal networks: Embracing metacommunities
Authors: Vidal Mariana Morais 
Published: November 2023

AbstractThe current biodiversity crisis requires efficient approaches to address the ongoing impoverishment of natural communities and the depletion of ecosystem services and functions. In this sense, identifying key species that promote the functioning of ecological processes can be strategic to guide actions aiming at the conservation and restoration of biodiversity. Node‐level metrics in interaction networks can be helpful to identify those key species, as they measure the role each species plays in organizing the interactions. Moreover, ecological correlates of species structural roles may vary between local and global networks of interactions, reflecting distinct mechanisms acting at different spatial scales. By studying local seed dispersal networks and one global meta‐network combining those local networks, Moulatlet et al. identified the most important traits explaining bird species centrality at varying spatial scales. They found that body mass was the main trait explaining centrality at the local scale, whereas range size was the main predictor of species centrality at the global scale. In this contribution, besides assessing local interaction networks, Moulatlet et al. adopt a biogeographical perspective to seed dispersal systems, extending our knowledge about the possible mechanisms that underlie the organization of interacting assemblages when changing the spatial scale of observation. Future efforts on this field could include an intermediate scale, comprising the level of metacommunities, shedding light on the interplay between local and spatial processes, both embedded in biogeographical realms, when determining the organization of interactions and the ecological correlates of species roles.