bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmaceuticals in the Water: Emerging Concerns and Innovative
Remediation Solutions
Authors: Ojha Smriti , Tripathi Shivendra Mani , Vishwakarma Pratik Kumar , Mishra Sudhanshu 
Published: October 2023

Abstract:
Pharmaceutical contamination, resulting from the discharge of active pharmaceutical ingredients
(APIs) and other related compounds into the water, has become a growing concern due to
its potential adverse effects on ecosystems and human health. This review article aims to examine the
many facets of pharmaceutical contamination and highlight the most recent developments in its remediation.
The effects of pharmaceuticals, sources, and pathways of pharmaceutical contamination,
as well as the difficulties in detecting and evaluating its toxicities, have been included in the present
manuscript. Nowadays various remediation strategies are employed to mitigate pharmaceutical contamination
in water. Conventional wastewater treatment techniques, including activated sludge processes
and membrane filtration, are effective in removing a portion of the pharmaceutical compounds.
However, advanced oxidation processes such as ozonation and photocatalysis have shown
promising results in enhancing the degradation of recalcitrant APIs. Nanotechnology-based approaches,
such as the use of nanoparticles for adsorption and degradation, and bioremediation methods
utilizing microbial degradation, enzymatic processes, and phytoremediation, offer potential future
directions for efficient and sustainable remediation. This review describes the most recent developments,
current status, and potential research directions with the future prospects of pharmaceutical
pollutants.
Phytochemical Profiling of Borassus flabellifer Haustorium and its
Potential Role in Combating COVID-19-Associated Encephalopathy: A
Computational Perspective
Authors: Mohaideen Noorul Samsoon Maharifa Haja , Srinivasan Hemalatha 
Published: October 2023

Background:
In response to the global outbreak of SARS-CoV-2, researchers have been
conducting extensive investigations into potential drug candidates for combating coronavirus infections. One such focus has been on the ethanolic extract of Borassus flabellifer haustorium. While
various components of Borassus flabellifer have been explored for their pharmaceutical applications,
the potential of the haustorium remains relatively unexplored in this context.

Objective:
This study aimed to assess the phytocompounds from Borassus flabellifer haustorium
using GC MS analysis, evaluate their drug-likeness properties, and perform molecular docking
against crucial proteins involved in SARS-CoV-2 infection, namely the Main protease (6LU7), Spike
trimer (7AD1), and ACE2 receptor (1R42). The goal was to identify promising compounds with
good binding affinity as potential candidates for preventing coronavirus infection.

Methods:
The ethanolic extract of Borassus flabellifer haustorium underwent GC-MS analysis to
identify phytocompounds. Drug-likeness properties of screened compounds were assessed using the
Swiss ADME, followed by molecular docking against COVID-19 protein targets using PyRx.

Results:
The phytocompounds from Borassus flabellifer haustorium namely Phenanthro[1,2-b]furan10,11-dione, 6,7,8,9-tetrahydro-1,6,6-trimethyl-, Ethanone, 1-phenyl-2-(4,5-diphenyl-2-
imidazolylthio)-, and Thiazolo[3.2-a]benzimidazol-3(2H)-one, 2-(4-acetoxybenzylideno)-, exhibit
binding affinities of -7.3, -8.8, and -7.3 for the Main protease, -8, -8.5, and -9.2 for the Spike protein,
and -8, -8.1, and -7.9 for the ACE2 receptor, respectively exhibited favourable interactions with
COVID-19 protein targets. This suggests their potential as promising drug candidates for preventing
coronavirus infection. Despite limited previous exploration, the haustorium emerges as a rich source
of such candidates.

Conclusion:
The study underscores the significance of investigating the haustorium of Borassus
flabellifer identified in this study holds promise as a potential breakthrough treatment for COVID19-associated disease and the need for further investigations and experimental studies is warranted to
validate these findings.
The Impact of Digital Technology on Self-Management in Cancer: Systematic Review
Authors: Lim Dwight Su Chun , Kwok Benedict , Williams Patricia , Koczwara Bogda 
Published: October 2023

Background
Self-management (SM) plays an important role in supporting patients’ adaptation to and management of the symptoms of chronic diseases. Cancer is a chronic disease that requires patients to have responsibility in management. Digital technology has the potential to enhance SM support, but there is little data on what SM skills are most commonly supported by digital technology.

Objective
This review aimed to examine the SM core skills that were enabled and supported by digital interventions in people with cancer and identify any predictors of the effect of digital health intervention on SM core skills.

Methods
Three electronic databases (MEDLINE, Scopus, and CINAHL) were searched for papers, published from January 2010 to February 2022, that reported randomized controlled trials (RCTs) involving patients with cancer or survivors of cancer where a digital technology intervention was evaluated and change in 1 or more SM core skills was a measured outcome.

Results
This systematic review resulted in 12 studies that were eligible to identify which SM core skills were enabled and supported by digital intervention. The total number of participants in the 12 studies was 2627. The most common SM core skills targeted by interventions were decision-making, goal setting, and partnering with health professionals. A total of 8 (67%) out of 12 RCTs demonstrated statistically significant improvement in outcomes including self-efficacy, survivorship care knowledge and attitude, quality of life, increased knowledge of treatment, and emotional and social functioning. A total of 5 (62%) out of 8 positive RCTs used theoretical considerations in their study design; whereas in 1 (25%) out of 4 negative RCTs, theoretical considerations were used. In 3 studies, some factors were identified that were associated with the development of SM core skills, which included younger age (regression coefficient [RC]=–0.06, 95% CI –0.10 to –0.02; P=.002), computer literacy (RC=–0.20, 95% CI –0.37 to –0.03; P=.02), completing cancer treatment (Cohen d=0.31), male sex (SD 0.34 in social functioning; P=.009), higher education (SD 0.19 in social functioning; P=.04), and being a recipient of chemotherapy (SD 0.36 in depression; P=.008). In all 3 studies, there were no shared identical factors that supported the development of SM core skills, whereby each study had a unique set of factors that supported the development of SM core skills.

Conclusions
Digital technology for patients with cancer appears to improve SM core skills including decision-making, goal setting, and partnering with health care partners. This effect is greater in people who are younger, male, educated, highly computer literate, completing cancer treatment, or a recipient of chemotherapy. Future research should focus on targeting multiple SM core skills and identifying predictors of the effect of digital technology intervention.

Trial Registration
PROSPERO CRD42021221922; https://tinyurl.com/mrx3pfax
Digital Cognitive Assessment Tests for Older Adults: Systematic Literature Review
Authors: Cubillos Claudio , Rienzo Antonio 
Published: October 2023

Background
The global health pandemic has affected the increasing older adult population, especially those with mental illnesses. It is necessary to prevent cases of cognitive impairment in adults early on, and this requires the support of information and communication technologies for evaluating and training cognitive functions. This can be achieved through computer applications designed for cognitive assessment.

Objective
In this review, we aimed to assess the state of the art of the current platforms and digital test applications for cognitive evaluation, with a focus on older adults.

Methods
A systematic literature search was conducted on 3 databases (Web of Science, PubMed, and Scopus) to retrieve recent articles on the applications of digital tests for cognitive assessment and analyze them based on the methodology used. Four research questions were considered. Through the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, following the application of inclusion and exclusion criteria, a total of 20 articles were finally reviewed.

Results
Some gaps and trends were identified regarding the types of digital applications and technologies used, the evaluated effects on cognitive domains, and the psychometric parameters and personal characteristics considered for validation.

Conclusions
Computerized tests (similar to paper-and-pencil tests) and test batteries (on computers, tablets, or web platforms) were the predominant types of assessments. Initial studies with simulators, virtual environments, and daily-life activity games were also conducted. Diverse validation methods and psychometric properties were observed; however, there was a lack of evaluations that involved specific populations with diverse education levels, cultures, and degrees of technology acceptance. In addition, these evaluations should consider emotional and usability aspects.
Integrative Approaches to Sleep Management in Skin Disease: Systematic Review
Authors: Kulkarni Vishnutheertha A , Mojica Isaiah , Gamsarian Vahram , Tahjian Michelle , Liu David , Grewal Tjinder , Liu Yuyang , Sivesind Torunn E , Lio Peter 
Published: October 2023

Background
Dermatological conditions, especially when severe, can lead to sleep disturbances that affect a patient’s quality of life. However, limited research exists on the efficacy of treatments for improving sleep parameters in skin conditions.

Objective
The objective was to perform a systematic review of the literature on dermatological conditions and the treatments available for improving sleep parameters.

Methods
A literature review was performed using the PubMed, Ovid MEDLINE, Embase, Cochrane, and ClinicalTrials.gov databases from 1945 to 2021. After filtering based on our exclusion criteria, studies were graded using the SORT (Strength of Recommendation Taxonomy) algorithm, and only those receiving a grade of “2” or better were included.

Results
In total, 25 treatment studies (n=11,025) assessing sleep parameters related to dermatological conditions were found. Dupilumab appeared to be the best-supported and most effective treatment for improving sleep in atopic dermatitis (AD) but had frequent adverse effects. Topical treatments for AD were mostly ineffective, but procedural treatments showed some promise. Treatments for other conditions appeared efficacious.

Conclusions
The evaluation of sleep parameter changes in dermatological treatments is predominantly restricted to AD. Systemic interventions such as dupilumab and procedural interventions were the most efficacious. Sleep changes in other dermatoses were limited by a paucity of available studies. The inclusion of a sleep assessment component to a broader range of dermatological treatment studies is warranted.
A Large Language Model Screening Tool to Target Patients for Best Practice Alerts: Development and Validation
Authors: Savage Thomas , Wang John , Shieh Lisa 
Published: October 2023

Background
Best Practice Alerts (BPAs) are alert messages to physicians in the electronic health record that are used to encourage appropriate use of health care resources. While these alerts are helpful in both improving care and reducing costs, BPAs are often broadly applied nonselectively across entire patient populations. The development of large language models (LLMs) provides an opportunity to selectively identify patients for BPAs.

Objective
In this paper, we present an example case where an LLM screening tool is used to select patients appropriate for a BPA encouraging the prescription of deep vein thrombosis (DVT) anticoagulation prophylaxis. The artificial intelligence (AI) screening tool was developed to identify patients experiencing acute bleeding and exclude them from receiving a DVT prophylaxis BPA.

Methods
Our AI screening tool used a BioMed-RoBERTa (Robustly Optimized Bidirectional Encoder Representations from Transformers Pretraining Approach; AllenAI) model to perform classification of physician notes, identifying patients without active bleeding and thus appropriate for a thromboembolism prophylaxis BPA. The BioMed-RoBERTa model was fine-tuned using 500 history and physical notes of patients from the MIMIC-III (Medical Information Mart for Intensive Care) database who were not prescribed anticoagulation. A development set of 300 MIMIC patient notes was used to determine the model’s hyperparameters, and a separate test set of 300 patient notes was used to evaluate the screening tool.

Results
Our MIMIC-III test set population of 300 patients included 72 patients with bleeding (ie, were not appropriate for a DVT prophylaxis BPA) and 228 without bleeding who were appropriate for a DVT prophylaxis BPA. The AI screening tool achieved impressive accuracy with a precision-recall area under the curve of 0.82 (95% CI 0.75-0.89) and a receiver operator curve area under the curve of 0.89 (95% CI 0.84-0.94). The screening tool reduced the number of patients who would trigger an alert by 20% (240 instead of 300 alerts) and increased alert applicability by 14.8% (218 [90.8%] positive alerts from 240 total alerts instead of 228 [76%] positive alerts from 300 total alerts), compared to nonselectively sending alerts for all patients.

Conclusions
These results show a proof of concept on how language models can be used as a screening tool for BPAs. We provide an example AI screening tool that uses a HIPAA (Health Insurance Portability and Accountability Act)–compliant BioMed-RoBERTa model deployed with minimal computing power. Larger models (eg, Generative Pre-trained Transformers–3, Generative Pre-trained Transformers–4, and Pathways Language Model) will exhibit superior performance but require data use agreements to be HIPAA compliant. We anticipate LLMs to revolutionize quality improvement in hospital medicine.
Empowering Foot Care Literacy Among People Living With Diabetes and Their Carers With an mHealth App: Protocol for a Feasibility Study
Authors: Liew Huiling , Pienkowska Anita , Ang Chin-Siang , Mahadzir Muhammad Daniel Azlan , Goh Kelley Fann Ing , Lodh Nandika , Bojic Iva , Lawate Ashwini , Ong Qi Chwen , Venkataraman Kavita , Car Josip , Ho Andy Hau Yan 
Published: October 2023

Background
Diabetic foot ulcers (DFUs) cause significant morbidity affecting 19% to 34% of people living with diabetes mellitus. DFUs not only impair quality of life but may also result in limb loss and mortality. Patient education has been advocated to raise awareness of proper foot self-care and the necessity of seeking assistance when a foot wound occurs. Modern technologies, including mobile health (mHealth) interventions such as health apps, bring the potential for more cost-effective and scalable interventions.

Objective
This study aims to examine the feasibility and usability of a newly developed mHealth app called Well Feet, which is a diabetes and foot care education app for individuals at risk of developing DFU.

Methods
Well Feet was developed using an evidence-based and expert panel cocreation approach to deliver educational content available in 3 languages (ie, English, Chinese, and Malay) via animation videos and a range of additional features, including adaptive learning. A nonrandomized, single-arm feasibility study using a mixed methods approach with a series of validated questionnaires and focus group discussions will be conducted. In total, 40 patients and carers will be recruited from a tertiary hospital diabetes clinic to receive a 1-month mHealth intervention. The primary outcomes are the usability of the app and a qualitative perspective on user experience. Secondary outcomes include changes in foot care knowledge, self-management behaviors, and quality of life.

Results
Patient recruitment began in July 2023, and the intervention and data collection will be completed by the end of September 2023. This study has been approved by National Healthcare Group Domain Specific Review Board (2022/00614) on February 10, 2023. The expected results will be published in spring 2024.

Conclusions
Through this feasibility study, the Well Feet DFU education app will undergo a comprehensive quantitative and qualitative evaluation of its usability and acceptance for future improvement in its design. With local contextualization, cultural adaptation, and its multilingual functionality, the app addresses a critical aspect of DFU health education and self-management in a multiethnic population. Findings from this study will refine and enhance the features of the app based on user feedback and shape the procedural framework for a subsequent randomized controlled trial to assess the effectiveness of Well Feet.

Trial Registration
ClinicalTrials.gov NCT05564728; https://clinicaltrials.gov/study/NCT05564728

International Registered Report Identifier (IRRID)
DERR1-10.2196/52036
Cosmologies of Asylum: A Lumbung Collaboration Between Trampoline House and Project Art Works
Authors: Carlota Mir  
Published: October 2023

This exposition is a harvest of ‘Massaging The Asylum System’, a year-long collaboration between refugee justice centre Trampoline House (DK) and neurodiverse collective Project Art Works (UK) by co-curator Carlota Mir. As a lumbung practice, harvest refers to artistic recordings of discussions and meetings.

Together, we set out to explore how migrant and neurodivergent communities are affected by social systems of care and control, and we sought ways to massage the asylum system – yes, massage, like a real massage – so that it could become softer and more humane. Bringing together the vision and artistic tools from both organisations, our work became a temporary coalition of dissident bodies.

Organised in a series of concentric circles and islands, the map revisits the ecosystem of the project and its traces: informal encounters, public conversations, art installations, and two workshop series in Copenhagen and Kassel, reflecting a multitude of voices from artists, collective members, facilitators, activists, publics, and the lumbung community.

The collaboration between Trampoline House and Project Art Works was initiated by Carlota Mir and Sara Alberani in the context of documenta fifteen and funded with common resources from the lumbung Collective Pot.

With support from the Danish Arts Foundation and the Italian Council. Publication design: Laura Migueláñez and Orestis Nikolaidis. Thanks to lumbung inter-lokal, Trampoline House and Project Art Works communities for their generosity and the knowledge shared, which has made this harvest possible.
Reepithelialization of Diabetic Skin and Mucosal Wounds Is Rescued by Treatment With Epigenetic Inhibitors
Authors: Yang Bo , Alimperti Stella , Gonzalez Michael V. , Dentchev Tzvete , Kim Minjung , Suh Justin , Titchenell Paul M. , Ko Kang I. , Seykora John , Benakanakere Manju , Graves Dana T. 
Published: October 2023

Wound healing is a complex, highly regulated process and is substantially disrupted by diabetes. We show here that human wound healing induces specific epigenetic changes that are exacerbated by diabetes in an animal model. We identified epigenetic changes and gene expression alterations that significantly reduce reepithelialization of skin and mucosal wounds in an in vivo model of diabetes, which were dramatically rescued in vivo by blocking these changes. We demonstrate that high glucose altered FOXO1–matrix metallopeptidase 9 (MMP9) promoter interactions through increased demethylation and reduced methylation of DNA at FOXO1 binding sites and also by promoting permissive histone-3 methylation. Mechanistically, high glucose promotes interaction between FOXO1 and RNA polymerase-II (Pol-II) to produce high expression of MMP9 that limits keratinocyte migration. The negative impact of diabetes on reepithelialization in vivo was blocked by specific DNA demethylase inhibitors in vivo and by blocking permissive histone-3 methylation, which rescues FOXO1-impaired keratinocyte migration. These studies point to novel treatment strategies for delayed wound healing in individuals with diabetes. They also indicate that FOXO1 activity can be altered by diabetes through epigenetic changes that may explain other diabetic complications linked to changes in diabetes-altered FOXO1-DNA interactions.

Article Highlights
FOXO1 expression in keratinocytes is needed for normal wound healing. In contrast, FOXO1 expression interferes with the closure of diabetic wounds. Using matrix metallopeptidase 9 as a model system, we found that high glucose significantly increased FOXO1-matrix metallopeptidase 9 interactions via increased DNA demethylation, reduced DNA methylation, and increased permissive histone-3 methylation in vitro. Inhibitors of DNA demethylation and permissive histone-3 methylation improved the migration of keratinocytes exposed to high glucose in vitro and the closure of diabetic skin and mucosal wounds in vivo. Inhibition of epigenetic enzymes that alter FOXO1-induced gene expression dramatically improves diabetic healing and may apply to other conditions where FOXO1 has a detrimental role in diabetic complications.
Randomized Trial of the Insulin-Only iLet Bionic Pancreas for the Treatment of Cystic Fibrosis– Related Diabetes
Authors: Sherwood Jordan S. , Castellanos Luz E. , O’Connor Mollie Y. , Balliro Courtney A. , Hillard Mallory A. , Gaston Sarah Grace , Bartholomew Rachel , Greaux Evelyn , Sabean Amy , Zheng Hui , Marchetti Peter , Uluer Ahmet , Sawicki Gregory S. , Neuringer Isabel , El-Khatib Firas H. , Damiano Edward R. , Russell Steven J. , Putman Melissa S. 
Published: October 2023

OBJECTIVE
Cystic fibrosis–related diabetes (CFRD) affects up to 50% of adults with cystic fibrosis and adds significant morbidity and treatment burden. We evaluated the safety and efficacy of automated insulin delivery with the iLet bionic pancreas (BP) in adults with CFRD in a single-center, open-label, random-order, crossover trial.

RESEARCH DESIGN AND METHODS
Twenty participants with CFRD were assigned in random order to 14 days each on the BP or their usual care (UC). No restrictions were placed on diet or activity. The primary outcome was the percent time sensor-measured glucose was in target range 70–180 mg/dL (time in range [TIR]) on days 3–14 of each arm, and key secondary outcomes included mean continuous glucose monitoring (CGM) glucose and the percent time sensor-measured glucose was in hypoglycemic range &lt;54 mg/dL.

RESULTS
TIR was significantly higher in the BP arm than the UC arm (75 ± 11% vs. 62 ± 22%, P = 0.001). Mean CGM glucose was lower in the BP arm than in the UC arm (150 ± 19 vs. 171 ± 45 mg/dL, P = 0.007). There was no significant difference in percent time with sensor-measured glucose &lt;54 mg/dL (0.27% vs. 0.36%, P = 1.0), although self-reported symptomatic hypoglycemia episodes were higher during the BP arm than the UC arm (0.7 vs. 0.4 median episodes per day, P = 0.01). No episodes of diabetic ketoacidosis or severe hypoglycemia occurred in either arm.

CONCLUSIONS
Adults with CFRD had improved glucose control without an increase in CGM-measured hypoglycemia with the BP compared with their UC, suggesting that this may be an important therapeutic option for this patient population.