bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a compulsory clinical pharmacist‐led medication deprescribing intervention in high‐risk seniors in the emergency department
Authors: Jovevski Joshua J. , Smith Cole R. , Roberts Justin L. , Dev Sharmistha , Iloabuchi Tochukwu C. , Gruber Erica A. , Williams Maxwell J. , Slaven James E. , Mitchell Alice M. 
Published: February 2023

AbstractObjectivesThe objective of this study was to assess the impact of an emergency department (ED) deprescribing intervention for geriatric adults. We hypothesized that pharmacist‐led medication reconciliation for at‐risk aging patients would increase the 60‐day case rate of primary care provider (PCP) deprescribing of potentially inappropriate medications (PIMs).MethodsThis was a retrospective, before‐and‐after intervention pilot study conducted at an urban Veterans Affairs ED. In November 2020, a protocol utilizing pharmacists to perform medication reconciliations for patients 75 years or older who screened positive using an Identification of Seniors at Risk tool at triage was implemented. Reconciliations focused on identifying PIMs and providing deprescribing recommendations to patients' PCPs. A preintervention group was collected between October 2019 and October 2020, and a postintervention group was collected between February 2021 to February 2022. The primary outcome compared case rates of PIM deprescribing in the preintervention group to the postintervention group. Secondary outcomes include per‐medication PIM deprescribing rate, 30‐day PCP follow‐up visits, 7‐ and 30‐day ED visits, 7‐ and 30‐day hospitalizations, and 60‐day mortality.ResultsA total of 149 patients were analyzed in each group. Both groups were similar in age and sex, with an average age of 82 years and 98% male. The case rate of PIM deprescribing at 60 days was 11.1% preintervention compared to 57.1% postintervention (p < 0.001). Preintervention, 91% of PIMs remained unchanged at 60 days compared to 49% (p < 0.05) postintervention. Regardless of PIM identification, the 30‐day primary care follow‐up rate increased postintervention: 31.5% and 55.7% (p < 0.0001), respectively. There was no improvement in 7‐ or 30‐day subsequent ED visits, hospitalization, or mortality.ConclusionsPharmacist‐led medication reconciliation in high‐risk geriatric patients was associated with an increase both in the rate of PIM deprescribing and in post‐ED primary care engagement.
Protease allergens as initiators–regulators of allergic inflammation
Authors: Soh Wai Tuck , Zhang Jihui , Hollenberg Morley D. , Vliagoftis Harissios , Rothenberg Marc E. , Sokol Caroline L. , Robinson Clive , Jacquet Alain 
Published: February 2023

AbstractTremendous progress in the last few years has been made to explain how seemingly harmless environmental proteins from different origins can induce potent Th2‐biased inflammatory responses. Convergent findings have shown the key roles of allergens displaying proteolytic activity in the initiation and progression of the allergic response. Through their propensity to activate IgE‐independent inflammatory pathways, certain allergenic proteases are now considered as initiators for sensitization to themselves and to non‐protease allergens. The protease allergens degrade junctional proteins of keratinocytes or airway epithelium to facilitate allergen delivery across the epithelial barrier and their subsequent uptake by antigen‐presenting cells. Epithelial injuries mediated by these proteases together with their sensing by protease‐activated receptors (PARs) elicit potent inflammatory responses resulting in the release of pro‐Th2 cytokines (IL‐6, IL‐25, IL‐1β, TSLP) and danger‐associated molecular patterns (DAMPs; IL‐33, ATP, uric acid). Recently, protease allergens were shown to cleave the protease sensor domain of IL‐33 to produce a super‐active form of the alarmin. At the same time, proteolytic cleavage of fibrinogen can trigger TLR4 signaling, and cleavage of various cell surface receptors further shape the Th2 polarization. Remarkably, the sensing of protease allergens by nociceptive neurons can represent a primary step in the development of the allergic response. The goal of this review is to highlight the multiple innate immune mechanisms triggered by protease allergens that converge to initiate the allergic response.
Opioid prescribing patterns following common general surgery procedures in the Bay of Plenty, New Zealand
Authors: Mclaughlin Scott , Overell James , Rossaak Jeremy 
Published: February 2023

AbstractBackgroundGlobal increases in opioid prescribing and misuse have prompted calls for closer regulation. Opioid prescription following surgery may lead to long term opioid use. A study was conducted evaluating opioid prescriptions on hospital discharge following common general surgery operations in the Bay of Plenty.MethodsRetrospective observational study over a two‐year period in two regional New Zealand hospitals. Six hundred and eleven patients aged 18–64 years were assessed. Patients with complications, readmission, and a prescription of opioids in the preceding 3 months were excluded.ResultsA total of 460 patients (165 Laparoscopic Cholecystectomy (LC), 200 Laparoscopic Appendicectomy (LA) and 95 Open Inguinal Hernia Repair (OIHR)) were included in analysis. Opioids were prescribed to 53% of LC, 55% of LA, and 60% of OIHR patients, with a mean of 75.8 Morphine Milligram Equivalents (MMEs), 75.3 MMEs, and 82.8 MMEs respectively. Seven percent of patients (18/254) received a second opioid prescription within 3 months, and of those only 1.6% (4/254) received a further prescription between 3 and 6 months from discharge. Opioid prescribing did not correlate with operation, ethnicity, age, length of stay, or gender, except for males receiving a more MMEs than females following LC (mean 102.0 MMEs versus 65.4 MMEs, P = 0.017).ConclusionThis study shows a rate of opioid prescribing lower than the USA, and greater than seen in an Australian setting. Substantial amounts of opioids were prescribed following uncomplicated surgery, with significant variability. Improvements in training in post‐operative opioid prescribing are needed. Fortunately, rates of ongoing opioid use were low.
Association of serum albumin to globulin ratio with outcomes in acute ischemic stroke
Authors: Wang Anxin , Zhang Yijun , Xia Guangxin , Tian Xue , Zuo Yingting , Chen Pan , Wang Yongjun , Meng Xia , Han Xinsheng 
Published: February 2023

AbstractBackgroundSerum albumin to globulin ratio (A/G) has been widely used as a representative biomarker for assessing inflammation and nutrition status. However, in patients with acute ischemic stroke (AIS), the predictive value of serum A/G has rarely been reported. We aimed to evaluate whether serum A/G is associated with prognosis in stroke.MethodsWe analyzed data from the Third China National Stroke Registry. The patients were categorized into quartile groups according to the serum A/G at admission. Clinical outcomes included poor functional outcomes (modified Rankin Scale [mRS] score of 3–6 or 2–6) and all‐cause mortality at 3 months and1 year. Multivariable logistic regressions and Cox proportional hazards regressions were used to evaluate the association of serum A/G with the risk of poor functional outcomes and all‐cause mortality.ResultsA total of 11, 298 patients were included in this study. After adjustment for confounding factors, patients in the highest serum A/G quartile had a lower proportion of mRS score 2–6 (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.76–1.00) and mRS score 3–6 (OR, 0.87; 95% CI, 0.73–1.03) at 3 months follow‐up. At 1 year follow‐up, there was a significant association between higher serum A/G and mRS score 3–6 (OR, 0.68; 95% CI, 0.57–0.81). We also found that the highest serum A/G was related to decreased risk of all‐cause mortality (hazard ratio [HR], 0.58; 95% CI, 0.36–0.94) at 3 months follow‐up. Similar results were found at 1‐year follow‐up.ConclusionsLower serum A/G levels were associated with poor functional outcomes and all‐cause mortality at 3 months and 1‐year follow‐up in patients with acute ischemic stroke.
Ensuring no patient is lost along the way – a single‐centre experience of the clinical genetics referral pathways for Lynch syndrome
Authors: El‐Shakankery Karim Hussien , Balogh Petra , Grantham Marianne , Minicozzi Anna , Diamantis Nikolaos 
Published: February 2023

AbstractLynch syndrome (LS), caused by heterozygous germline mutation in one of the key mismatch repair (MMR) genes, is the primary cause of inherited colorectal cancer (CRC). LS also increases susceptibility to several other cancers. It is estimated that just 5% of patients with LS are aware of their diagnosis. Therefore, in an attempt to increase the identification of cases within the UK population, the 2017 NICE guidelines recommend offering immunohistochemistry for MMR proteins or microsatellite instability (MSI) testing to all people with CRC when first diagnosed. Following identification of MMR deficiency, eligible patients should be assessed for underlying causes, including potential referral to the genetics service and/or germline LS testing (if appropriate). In our regional centre for CRC, we audited local pathways to identify what proportion of patients are being correctly referred, in line with national guidelines. Reflecting on these results, we highlight our practical concerns by identifying the pitfalls and issues faced with the recommended referral pathway. We also propose possible solutions to improve the efficacy of the system for both referrers and patients. Finally, we discuss the ongoing interventions that national bodies and regional centres are implementing to improve and further streamline this process.
Diabetes is a significant and independent predictor for tacrolimus immediate release and LCP‐tacrolimus conversion ratios
Authors: Coffman Kelsey , Patel Neha , Bartlett Felicia , Newman Jessica , Patel Shikha , Sprague Taylor , Rao Nikhil , Andrade Erika , Casey Michael J. , Rohan Vinayak , DuBay Derek , Taber David 
Published: February 2023

AbstractDiabetes (DM) is a common comorbidity in transplant patients with known effects on gastrointestinal (GI) motility and absorption; however, DM's impact on immediate release (IR) tacrolimus to LCP‐tacrolimus (LCP) conversion ratios has not been studied. This multivariable analysis of a retrospective longitudinal cohort study included kidney transplant recipients converted from IR to LCP between 2019 and 2020. The primary outcome was IR to LCP conversion ratio based on DM status. Other outcomes included tacrolimus variability, rejection, graft loss, and death. Of the 292 patients included, 172 patients had DM and 120 did not. The IR:LCP conversion ratio was significantly higher with DM (67.5% ± 21.1% no DM vs. 79.8% ± 28.7% in DM; P < .001). In multivariable modeling, DM was the only variable significantly and independently associated with IR:LCP conversion ratios. No difference was observed in rejection rates. Graft (97.5% no DM vs. 92.4% in DM; P = .062) and patient survival (100% no DM vs. 94.8% in DM; P = .011) were lower with DM. The presence of DM significantly increased the IR:LCP conversion ratio by 13%–14%, compared to patients without DM. On multivariable analysis, DM was the only significant predictor of conversion ratios, potentially related to GI motility or absorption differences.
Optical coherence tomography for presurgical delineation of basal cell carcinomas on the face—A comparison with histopathology
Authors: Holm K. B. E. , Nielsen L. J. , Lock‐Andersen J. , Behrendt N. , Svensson M. S. , Themstrup L. , Jemec G. B. E. 
Published: February 2023

AbstractBackgroundTo minimize the risk of incomplete excision of basal cell carcinomas (BCC) the macroscopic tumor margins should be adequately defined. Optical coherence tomography (OCT) is a non‐invasive imaging tool that can provide structural and vascular information about skin cancer lesions. The study objective was to compare the presurgical delineation of facial BCC by clinical examination, histopathology, and OCT imaging in tumors undergoing full excision.MethodsTen patients with BCC lesions on the face were examined clinically, with OCT and histopathology at 3‐mm intervals, from the clinical lesion border and beyond the resection line. The OCT scans were evaluated blinded and a delineation estimate of each BCC lesion was made. The results were compared to the clinical and histopathologic results.ResultsOCT evaluations and histopathology were in agreement in 86.6% of the collected data points. In three cases the OCT scans estimated a reduction of the tumor size compared to the clinical tumor border set by the surgeon.ConclusionThe results of this study support the notion that OCT can have a role in the clinical daily practice by aiding clinicians in delineating BCC lesions before surgery.
Preexisting mental health disorders and risk of opioid use disorder in young people: A case‐control study
Authors: Marshall Tyler , Olson Karin , Youngson Erik , Abba‐Aji Adam , Li Xin‐Min , Vohra Sunita , Lewanczuk Richard 
Published: February 2023

AbstractAimOpioid use disorder (OUD) is a leading cause of preventable mortality amongst young people worldwide. Early identification and intervention of modifiable risk factors may reduce future OUD risk. The aim of this study was to explore whether the onset of OUD is associated with preexisting mental health conditions such as anxiety and depressive disorders in young people.MethodsA retrospective, population‐based case‐control study was conducted from 31 March 2018 until 01 January 2002. Provincial administrative health data were collected from Alberta, Canada. Cases: Individuals 18–25 years on 01 April 2018, with a previous record of OUD. Controls: Individuals without OUD were matched to cases, on age/sex/index date. Conditional logistic regression analysis was used to control for additional covariates (e.g., alcohol‐related disorders, psychotropic medications, opioid analgesics, and social/material deprivation).ResultsWe identified N = 1848 cases and N = 7392 matched controls. After adjustment, OUD was associated with the following preexisting mental health conditions: Anxiety disorders, aOR = 2.53 (95% CI = 2.16–2.96); depressive disorders, aOR = 2.20 (95% CI = 1.80–2.70); alcohol‐related disorders, aOR = 6.08 (95% CI, 4.86–7.61); anxiety and depressive disorders, aOR = 1.94 (95% CI = 1.56–2.40); anxiety and alcohol‐related disorders, aOR = 5.22 (95% CI = 4.03–6.77); depressive and alcohol‐related disorders, aOR = 6.47 (95% CI = 4.73–8.84); anxiety, depressive and alcohol‐related disorders, aOR = 6.09 (95% CI = 4.41–8.42).DiscussionPreexisting mental health conditions such as anxiety and depressive disorders are risk factors for future OUD in young people. Preexisting alcohol‐related disorders showed the strongest association with future OUD and demonstrated an additive risk when concurrent with anxiety/depression. As not all plausible risk factors could be examined, more research is still needed.
Timing and magnitude of drought impacts on carbon uptake across a grassland biome
Authors: Felton Andrew J. , Goldsmith Gregory R. 
Published: February 2023

AbstractAlthough drought is known to negatively impact grassland functioning, the timing and magnitude of these impacts within a growing season remain unresolved. Previous small‐scale assessments indicate grasslands may only respond to drought during narrow periods within a year; however, large‐scale assessments are now needed to uncover the general patterns and determinants of this timing. We combined remote sensing datasets of gross primary productivity and weather to assess the timing and magnitude of grassland responses to drought at 5 km2 temporal resolution across two expansive ecoregions of the western US Great Plains biome: the C4‐dominated shortgrass steppe and the C3‐dominated northern mixed prairies. Across over 700,000 pixel‐year combinations covering more than 600,000 km2, we studied how the driest years between 2003–2020 altered the daily and bi‐weekly dynamics of grassland carbon (C) uptake. Reductions to C uptake intensified into the early summer during drought and peaked in mid‐ and late June in both ecoregions. Stimulation of spring C uptake during drought was small and insufficient to compensate for losses during summer. Thus, total grassland C uptake was consistently reduced by drought across both ecoregions; however, reductions were twice as large across the more southern and warmer shortgrass steppe. Across the biome, increased summer vapor pressure deficit (VPD) was strongly linked to peak reductions in vegetation greenness during drought. Rising VPD will likely exacerbate reductions in C uptake during drought across the western US Great Plains, with these reductions greatest during the warmest months and in the warmest locations. High spatiotemporal resolution analyses of grassland response to drought over large areas provide both generalizable insights and new opportunities for basic and applied ecosystem science in these water‐limited ecoregions amid climate change.
RECONCEIVING THE PRACTICE OF HISTORY: FROM REPRESENTATION TO TRANSLATION
Authors: Seth Sanjay 
Published: February 2023

ABSTRACTArguing that history is not the application of a rigorous method to sources bequeathed to us from the past but rather a practice of coding that constructs “the past” in particular ways, this article seeks to delineate the key elements of this coding. Modern history treats past objects and texts as the objectified remains of humans who endowed their world with meaning and purpose while constrained by the social circumstances characterizing their times. This time of theirs is dead, and it can only be represented, not resurrected; the past is only ever the human past, and it does not include ghosts, gods, spirits, or nature. If, as argued here, “the past” does not exist independently of the means by which it is known and represented, then the many different modes of historicity that human beings developed and deployed before the modern form of history became dominant cannot be measured against “the” past in an effort to compare their accuracy or adequacy in representing it. The concluding section of this article asks what we are doing when we write the history of those who did not share the presumptions of the modern discipline but who had their own mode(s) of historicity. What, it asks, is the character and status of the knowledge produced when we write histories of premodern and non‐Western pasts?
2022 KLEIN LECTURE PARENTAL EDUCATION AND INVENTION: THE FINNISH ENIGMA
Authors: Aghion Philippe , Akcigit Ufuk , Hyytinen Ari , Toivanen Otto 
Published: February 2023

AbstractWhy is invention strongly positively correlated with parental income not only in the United States but also in Finland, which displays low income inequality and high social mobility? Using data on 1.45 M Finnish individuals and their parents, we find the following: (i) the positive association between parental income and off‐spring probability of inventing is greatly reduced when controlling for parental education; (ii) instrumenting for the parents having an MSc degree using distance to nearest university reveals a large causal effect of parental education on offspring probability of inventing; and (iii) the causal effect of parental education has been markedly weakened by the introduction in the early 1970s of a comprehensive schooling reform.
Self‐management experiences of haemodialysis patients with self‐regulatory fatigue: A phenomenological study
Authors: Tao Yuxiu , Liu Tongcun , Li Ping , Lv Aili , Zhuang Kaipeng , Ni Chunping 
Published: February 2023

AbstractAimTo understand the real experiences of self‐management in haemodialysis patients with self‐regulatory fatigue, and to explore the influencing factors and coping strategies for patients with decreased self‐management.DesignA qualitative study was carried out using the phenomenological analysis method.MethodsFrom 5 January to 25 February, 2022, semi‐structured interviews were conducted with 18 haemodialysis patients in Lanzhou, China. Thematic analysis of the data was performed using the NVivo 12 software based on the 7 steps of Colaizzi's method. The study reporting followed the SRQR checklist.ResultsFive themes and 13 sub‐themes were identified. The main themes were difficulties in fluid restrictions and emotional management, hard to adhere to long‐term self‐management, uncertainty about self‐management, influencing factors are complex and diverse and coping strategies should be further improved.ConclusionThis study revealed the difficulties, uncertainty, influencing facts and coping strategies of self‐management among haemodialysis patients with self‐regulatory fatigue. A targeted program should be developed and implemented according to the characteristics of patients to reduce the level of self‐regulatory fatigue and improve self‐management.ImpactSelf‐regulatory fatigue has a significant impact on the self‐management behaviour of haemodialysis patients. Understanding the real experiences of self‐management in haemodialysis patients with self‐regulatory fatigue enables medical staff to correctly identify the occurrence of self‐regulatory fatigue in time and help patients adopt positive coping strategies to keep effective self‐management behaviour.Patient or Public contributionHaemodialysis patients who met the inclusion criteria were recruited to participate in the study from a blood purification centre in Lanzhou, China.
Efficacy of adjunctive measures in peri‐implant mucositis. A systematic review and meta‐analysis
Authors: Gennai Stefano , Bollain Juan , Ambrosio Nagore , Marruganti Crystal , Graziani Filippo , Figuero Elena 
Published: February 2023

AbstractAimTo answer the following PICO question: In systemically healthy humans with peri‐implant mucositis, what is the efficacy of patient‐performed or administered (by prescription) measures used adjunctively to submarginal instrumentation, as compared to submarginal instrumentation alone or combined with a negative control, in terms of reducing bleeding on probing (BOP), in randomized controlled clinical trials (RCTs) with at least 3 months of follow‐up?Materials and MethodsThree databases were searched until April 2022. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) and predictive intervals were calculated.ResultsSixteen parallel RCTs corresponding to 14 studies with low/moderate risk of bias were included. Test groups showed greater reductions in BOP (%) than control groups (nstudies = 16; npatients = 650; WMD = 14.25%; 95% CI [9.06–19.45]; p < .001; I2 = 98.7%). The greatest WMD in BOP reductions (%) were obtained by antiseptics (ns = 5; np = 229; WMD = 22.72%; 95% CI [19.40–26.04]; p < 0.001; I2 = 94.8%), followed by probiotics (ns = 6; np = 260; WMD = 12.11%; 95% CI [3.20–21.03]; p = .008; I2 = 93.3%) and systemic antibiotics (ns = 3; np = 101; WMD = 5.97%; 95% CI [1.34–10.59]; p = .012; I2 = 58.1%). Disease resolution was scarcely reported (n = 6).ConclusionsSignificant clinical improvements can be obtained when professional submarginal instrumentation is combined with patient‐performed or administered (by prescription) adjunctive measures, although a complete disease resolution may not be achieved.