bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to embrace sepsis pathways and antibiotic prescribing decision support in the emergency department: Observations from a retrospective single site clinical audit
Authors: Herd Sarah H , Allen Penny L , Reed Lucy J , O'Hern Jennifer A , Fraser Jessica , Flanagan Katie L 
Published: April 2023

AbstractObjectiveTo compare clinician documentation of sepsis for infective presentations in the ED against a formal sepsis pathway in the ED and to assess appropriateness of the initial parenteral antibiotic prescription for adult patients in ED.MethodsA retrospective, clinical audit of adult patients who received at least one parenteral antibiotic in ED over a 10‐week period in 2018. Documented initial clinical impression was compared with an approved sepsis pathway. Antibiotic appropriateness was assessed using National Antimicrobial Prescribing Survey definitions. Assessment was carried out by an infectious diseases pharmacist, with input from an infectious diseases physician.ResultsTwo hundred and nineteen infective presentations were included in the analysis. There was a discordance between the initial documented clinical impression compared with the classification when a sepsis pathway was applied. An initial documented clinical impression of sepsis and septic shock was present in 38 (60.3%) of the presentations compared to 63 presentations when a formal sepsis pathway was applied as a screening tool. There was a significant difference in the proportion of patients in each diagnostic group (infection, sepsis and septic shock) according to documented clinical impression versus sepsis pathway classification (P = 0.0002). There were 386 prescriptions for antibiotics as part of the initial management. Antibiotic appropriateness for the initial prescription was assessed as 63.7% appropriate, 27.2% inappropriate and 9.1% not assessable.ConclusionOur observations demonstrate that use of a formal sepsis pathway may improve the screening and early diagnosis of sepsis and septic shock and that there is a need for antibiotic prescribing guidance in the ED.
Comparison the effect of valerian and gabapentin on RLS and sleep quality in hemodialysis patients: A randomized clinical trial
Authors: Hajizadeh Iman , Jamshidi Mahdieh , Kazemi Majid , Kargar Hossein , Sadeghi Tabandeh 
Published: April 2023

AbstractIntroductionThis study aimed to compare the effect of valerian and gabapentin on restless legs syndrome (RLS) and sleep quality in HD patients.MethodsIn this cross over clinical trial study, 40 HD patients allocated into a valerian and gabapentin group. In the first phase of the study, Group A received valerian and Group B received gabapentin 1 h before bedtime for 1 month. In the second phase, the two groups' treatment regimen was swapped. After a 1‐month washout period, the same process was repeated on the crossover groups.ResultsAfter the first phase, the mean score of RLS was lower in the gabapentin group. But there was no statistically significant difference between the two groups in terms of sleep quality score before and after the first and second interventions.ConclusionGabapentin is more effective than valerian in improving RLS, but both are equally effective in improving sleep quality.
A novel device and system concept for therapeutic plasma exchange in rats
Authors: Ciorpac Mitică , Caratașu Cezar‐Cătălin , Szilagyi Andrei , Mihai Cosmin‐Teodor , Nistor Ionut , Iliescu Radu , Tamba Bogdan Ionel 
Published: April 2023

AbstractIntroductionTherapeutic plasma exchange (TPE) has been developed more than 100 years ago in an animal model and adapted to humans 30 years later. Since then, the TPE research on animal models is lacking, mainly due to difficulties raised by the scaling of the plasmapheresis unit so that the animal's cardiovascular parameters are not considerably affected.MethodsThe system concept of a novel TPE device with continuous hemodynamic monitoring in small rodent models has been used.ResultsA continuum TPE unit for rats has been developed, able to produce up to 95% plasma exchange rate without any TPE‐related hemodynamic impairment, monitored up to 35 days after the procedure.ConclusionThe TPE unit for rats was able to produce 95% plasma exchange rate in non‐anesthetized animals, enabling a full translation of the human TPE into an animal model. The newly developed plasmapheresis unit enable a wide range of more accurate preclinical evaluation, with cardiac parameters monitoring, using small rodents in awaken state.
The effect of the time from diagnosis to induction therapy on prognosis in patients with acute leukemia undergoing leukapheresis for symptomatic hyperleukocytosis
Authors: Pınar İbrahim Ethem , Özkocaman Vildan , Ersal Tuba , Dağtekin Mehmet Emin , Yalçın Cumali , Orhan Bedrettin , Candar Ömer , Çubukçu Sinem , Güllü Koca Tuba , Gürsoy Vildan , Özkalemkaş Fahir 
Published: April 2023

AbstractIntroductionOur study investigated leukapheresis's effect on delayed induction therapy outcomes in patients with acute leukemia presenting with symptomatic hyperleukocytosis.MethodsThis retrospective cohort study included 30 adult patients diagnosed with acute leukemia who underwent leukapheresis for leukostasis. The patients were divided into the first 24 h and >24 h groups, according to the time from diagnosis to induction therapy (TDT).ResultsThere was no significant difference between the TDT groups regarding complete remission (CR), 4‐week mortality, and overall survival (OS) at a median follow‐up of 409 days. Tumor lysis syndrome, disseminated intravascular coagulation, and hemoglobin levels were significant in early mortality. In univariate analysis, age, hemoglobin levels, patients' eligibility for intensive chemotherapy, and achieving CR were critical factors for OS.ConclusionThe study findings suggest that waiting for the clinical and laboratory results may be a safe and reasonable approach before assigning patients the best treatment option with leukapheresis.
Structural, physicochemical, and functional properties of insoluble dietary fiber derived from okara by Viscozyme®L
Authors: Zhang Gaopeng , Hao Manyi , He Ying , Ahmad Ishtiaq , Ding Yuting , Lyu Fei 
Published: April 2023

AbstractThe endogenous components of okara can affect the extraction and modification of insoluble dietary fiber (IDF). This study was intended to investigate the effect of extraction and purification of IDFs from okara affected by the endogenous components and composite enzyme Viscozyme®L. After that, the physicochemical, functional, and structural characteristics of IDFs were analyzed. The results showed that with the purification of degreasing, deproteinizing and destarching, Viscozyme®L can accurately act on the cell wall of okara, leading to the increase in specific surface area of IDF and the formation of honeycomb‐like structure. In accordance with the X‐ray diffraction and Fourier‐transform infrared spectrum investigations, relative crystallinity decreased and certain cellulose components were reallocated and changed into soluble dietary fiber. Moreover, the modified IDF showed improved water‐holding capacity (10.73–11.59 g/g), oil‐holding capacity (5.37–6.60 g/g), and swelling capacity (8.99–12.37 mL/g), leading to improved adsorption capacities of glucose (maximum: 39.60 mg/g), cholesterol (14.54–33.56 mg/g at pH 7; 10.94–19.37 mg/g at pH 2), and cholate and better cation‐exchange capacity. The outcomes demonstrated the potential for the acquired IDFs, particularly the high‐purity modified‐IDFs T3 and T4, to be exploited as functional fiber components in the food sector.Practical ApplicationThis study advances the understanding of the internal mechanism of modified insoluble dietary fiber (IDF) with different purities in okara. The obtained high‐purity modified IDF can be employed as a functional fiber raw material in the manufacture of functional foods, and can also be utilized to assist in the treatment of some illnesses due to its well‐established in vivo function.
Effectiveness, safety, initial optimal dose, and optimal maintenance dose range of basal insulin regimens for type 2 diabetes: A systematic review with meta‐analysis
Authors: Luo Yingying , Xia Jun , Zhao Zhan , Chang Yaping , Bee Yong Mong , Nguyen Khue Thy , Lim Soo , Yabe Daisuke , McGill Margaret , Kong Alice Pik Shan , Chan Siew Pheng , Deodat Marisa , Deerochanawong Chaicharn , Suastika Ketut , Xu Chenchen , Chen Liming , Chen Wei , Li Xiaoying , Zhao Weigang , Yao Xiaomei , Ji Linong 
Published: April 2023

AbstractAimsTo investigate the effectiveness, safety, optimal starting dose, optimal maintenance dose range, and target fasting plasma glucose of five basal insulins in insulin‐naïve patients with type 2 diabetes mellitus.MethodsMEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched from January 2000 to February 2022. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was adopted. The registration ID is CRD42022319078 in PROSPERO.ResultsAmong 11 163 citations retrieved, 35 publications met the planned criteria. From meta‐analyses and network meta‐analyses, we found that when injecting basal insulin regimens at bedtime, the optimal choice in order of most to least effective might be glargine U‐300 or degludec U‐100, glargine U‐100 or detemir, followed by neutral protamine hagedorn (NPH). Injecting glargine U‐100 in the morning may be more effective (ie, more patients archiving glycated hemoglobin < 7.0%) and lead to fewer hypoglycemic events than injecting it at bedtime. The optimal starting dose for the initiation of any basal insulins can be 0.10–0.20 U/kg/day. There is no eligible evidence to investigate the optimal maintenance dose for basal insulins.ConclusionsThe five basal insulins are effective for the target population. Glargine U‐300, degludec U‐100, glargine U‐100, and detemir lead to fewer hypoglycemic events than NPH without compromising glycemic control.
Evaluation of statewide restrictions on e‐cigarette nicotine strength—United States, 2017–2022
Authors: Ali Fatma Romeh M. , Schillo Barbara , Crane Elisha , Seaman Elizabeth L. , King Brian A. 
Published: April 2023

AbstractAimsTo evaluate statewide policies restricting e‐cigarette nicotine strength.DesignA difference‐in‐difference regression analysis was used to compare e‐cigarette sales in states that restrict nicotine strength with states with no restrictions. Because flavor restrictions might affect sales and nicotine strength, states with flavor restrictions were also assessed.Setting and casesUnited States e‐cigarette retail sales data during January 2017 to March 2022 were licensed from Information Resources Incorporated. States with restrictions included Massachusetts (restricted maximum nicotine strength to 3.5% and nontobacco flavored e‐cigarette sales in December 2019); Utah (restricted nicotine strength to 3.6% in September 2021); and Rhode Island, New York and Washington (restricted nontobacco flavor sales in October 2019, May 2020 and October 2019 to January 2020, respectively). These were compared with data from 34 states with no e‐cigarette nicotine strength or flavor restrictions.MeasurementsWeighted mean nicotine strength and total unit sales. Total unit sales per 1000 state population were summed into 4‐week periods by state. Models controlled for emergency responses, state demographics, tobacco control policies, time and state fixed effects.FindingsRestricting both nicotine strength and flavors in Massachusetts was associated with a 2.04 percentage point (pp) reduction in mean nicotine strength and 86.76‐unit reduction in monthly unit sales per 1000 persons compared with states with no restrictions (all P < 0.01). Restricting nicotine strength only in Utah was associated with a 1.77 pp (P < 0.01) reduction in mean nicotine strength; however, there was no impact on unit sales. Restricting nontobacco flavor sales only in Rhode Island, New York and Washington slightly reduced mean nicotine strength (0.21, 0.62 and 0.19 pp, respectively) and sales (36.66, 34.51 and 16.37 units, respectively) (all P < 0.01).ConclusionsUnited States statewide policies restricting e‐cigarette nicotine strength appear to be associated with reductions in average nicotine strength in sales within that state; however, there appears to be no impact on unit sales. When these policies are implemented along with flavor restrictions; reductions in average nicotine strength occur in addition to reduced unit sales.
Pricing Liquidity Risk in the Korean Corporate Bond Market*
Authors: Kim Eunji , Jang Ga‐Young , Kim Soo‐Hyun 
Published: April 2023

AbstractThis study investigates the pricing of liquidity risk in the Korean corporate bond market. We use three different liquidity factors — namely, aggregate market liquidity, liquidity innovation, and predicted liquidity. The empirical results show that, while a liquidity premium exists in the Korean corporate bond market when measured by the market liquidity factor, a liquidity discount occurs when measured by the predicted liquidity factor. Drawing on prior studies, we further describe that the lower (higher) returns for portfolios with a high sensitivity to unexpected liquidity shocks may be attributable to the infrequent (frequent) trading of AAA(A)‐rated bonds in the Korean market. Finally, our findings suggest that while a liquidity premium exists in expectation, investors are penalized for taking predicted liquidity risks in the Korean corporate bond market.
Working for Nico
Authors: Robb Larkins Erika 
Published: April 2023

SummaryOver the course of the last decade, I have conducted fieldwork on the militarization of Rio de Janeiro and on the security industry that developed in response to the 2014 World Cup and 2016 Olympics. This fictional short story follows two different imagined security laborers, Nico and Valesca, reflecting the racial, gendered, and class tensions I saw play out between police and military operators from different regions during my research. Working alongside Nico and Valesca, a fictional narrator seeks to navigate fraught power dynamics in a highly masculine setting.
Ex‐vivo ureteroscopy, laser lithotripsy, and stone basketing extraction of deceased donor kidney stones during machine perfusion preservation
Authors: Kunkel Gregory , Sorokin Igor , Oster Michela , Van Horn Christine , Movahedi Babak , Pang‐Yen Fan , Martins Paulo N. 
Published: April 2023

AbstractThe incidence of nephrolithiasis in kidney donors is rare. The timing and treatment of nephrolithiasis in deceased donor kidneys are not well established. While some programs have proposed ex‐situ rigid or flexible ureteroscopy treatment before transplantation, we report on two cases of kidney stones in the same deceased donor that we treated by flexible ureteroscopy and laser lithotripsy performed during the storage time on a hypothermic perfusion machine. Two deceased donor kidneys were found to have multiple kidney stones discovered on preprocurement CT imaging. The right kidney had less than five 2–3 mm stones, whereas the left had five to ten 1 mm stones with a single 7 mm stone. Both organs were placed on a hypothermic perfusion machine and maintained at a temperature of 4°C. An ex‐vivo flexible ureteroscopy with laser lithotripsy and basket extraction was performed while the kidneys were maintained on Lifeport* perfusion machine. The cold ischemia time was 16.9 and 23.1 h. After 12 months of observational follow‐up, neither recipient had nephrolithiasis, UTI, or other urologic complications. The creatinine values now are 1.17 and 2.44 mg/dL (103.4 and 215.7 μmol/L), respectively. Ex‐vivo flexible ureteroscopy with laser lithotripsy and stone removal on machine‐perfused kidneys appears to be safe and offers a good option to treat graft nephrolithiasis and prevent posttransplant complications. Ureteroscopy serves as a minimally invasive treatment option with direct stone removal. Performing this while on machine perfusion minimizes the ischemic time of the kidney and resultant complications or delays in graft function.
‘Them’ in an abnormal world: Media construction and responsibility attribution of left‐behind children in rural China
Authors: Huang Wan , Zou Wenxue 
Published: April 2023

AbstractLeft‐behind children who live away from their migrant parents in rural China have received widespread media attention, especially around their vulnerability and delinquency. To examine the media construction of this population and responsibility attribution for the incidents occurring to them, we used the phronetic iterative approach to analyse 348 news reports published byThe Paper, one of China's leading digital media outlets. Our findings revealed that the media constructed a stereotypical portrayal of these children and their families. Moreover, structural inequalities existing in social policies were shifted into personal responsibility in media discourses. This study offers empirical support for the role of news media in shaping public perceptions through their construction and framing processes. We highlight the need to identify structural factors that affect media portrayals of rural families and call for more social support for left‐behind children.
Spatially multicellular variability of intervertebral disc degeneration by comparative single‐cell analysis
Authors: Lin Peng , Yan Pulin , Zhu Jun , Huang Sha , Wang Zhong , Hu Ou , Jin Huaijian , Li Yangyang , Zhang Liang , Zhao Jianhua , Chen Lin , Liu Bing , He Jian , Gan Yibo , Liu Peng 
Published: April 2023

AbstractPrevious studies have revealed cellular heterogeneity in intervertebral discs (IVDs). However, the cellular and molecular alteration patterns of cell populations during degenerative progression remain to be fully elucidated. To illustrate the cellular and molecular alteration of cell populations in intervertebral disc degeneration (IDD), we perform single cell RNA sequencing on cells from four anatomic sites of healthy and degenerative goat IVDs. EGLN3+ StressCs, TGFBR3+ HomCs and GPRC5A+ RegCs exhibit the characteristics associated with resistance to stress, maintaining homeostasis and repairing, respectively. The frequencies and signatures of these cell clusters fluctuate with IDD. Notably, the chondrogenic differentiation programme of PROCR+ progenitor cells is altered by IDD, while notochord cells turn to stemness exhaustion. In addition, we characterise CAV1+ endothelial cells that communicate with chondrocytes through multiple signalling pathways in degenerative IVDs. Our comprehensive analysis identifies the variability of key cell clusters and critical regulatory networks responding to IDD, which will facilitate in‐depth investigation of therapeutic strategies for IDD.
Multiple abnormal peripheral blood gene expression assay results are correlated with subsequent graft loss after kidney transplantation
Authors: Heilman Raymond L. , Fleming James N. , Mai Martin , Smith Byron , Park Walter D. , Holman John , Stegall Mark D. 
Published: April 2023

AbstractBackgroundThe aim of this study was to correlate peripheral blood gene expression profile (GEP) results during the first post‐transplant year with outcomes after kidney transplantation.MethodsWe conducted a prospective, multicenter observational study of obtaining peripheral blood at five timepoints during the first post‐transplant year to perform a GEP assay. The cohort was stratified based on the pattern of the peripheral blood GEP results: Tx‐all GEP results normal, 1 Not‐TX had one GEP result abnormal and >1 Not‐TX two or more abnormal GEP results. We correlated the GEP results with outcomes after transplantation.ResultsWe enrolled 240 kidney transplant recipients. The cohort was stratified into the three groups: TX n = 117 (47%), 1 Not‐TX n = 59 (25%) and >1 Not‐TX n = 64 (27%). Compared to the TX group, the >1 Not‐TX group had lower eGFR (p < .001) and more chronic changes on 1‐year surveillance biopsy (p = .007). Death censored graft survival showed inferior graft survival in the >1 Not‐TX group (p < .001) but not in the 1 Not‐TX group. All graft losses in the >1 Not‐TX group occurred after 1‐year post‐transplant.ConclusionsWe conclude that a pattern of persistently Not‐TX GEP assay correlates with inferior graft survival.
Firm‐specific pay premiums and the gender wage gap in Europe
Authors: Hennig Jan‐Luca , Stadler Balazs 
Published: April 2023

AbstractWe study how firm premia influence the gender wage gap for 21 European countries. We use a quadrennial harmonized matched employer–employee dataset to estimate gender‐specific firm premia. Subsequently, we decompose the firm‐specific wage premia differential into within‐ and between‐firm components. On average, the former accounts mainly for the decline in the pay gap between 2002 and 2014. We pay particular attention to the development of each component by age group, and find that the between‐firm component is associated with an increase in the gender pay gap over age. The decomposition of firm premia allows us to investigate how institutional settings relate to each component. We associate the within‐firm component with collective bargaining at the national and firm levels, and the between‐firm component with family policies. Decentralized wage bargaining is associated with a larger within‐firm pay gap, whereas family policies incentivizing women to return to employment after family formation are linked to a smaller between‐firm component.
Tocilizumab‐related hypertriglyceridemia is independent of key molecules regulating lipid metabolism
Authors: Ferraz‐Amaro Iván , Santos‐Concepción Sergio , Castro Javier , Hernández‐Hernández María V. , Tejera‐Segura Beatriz , Luna Cristina , Delgado‐Frias Esmeralda , Díaz‐González Federico 
Published: April 2023

AbstractIntroductionTocilizumab (TCZ) treatment is associated with dyslipidaemia, including a rise in triglycerides through a mechanism poorly understood. Three molecules play key roles in the regulation of triglyceride metabolism: apolipoprotein C‐III (ApoC‐III), angiopoietin‐like protein 4(ANGPLT4) and lipoprotein lipase (LPL). The aim of this work was to analyse whether the changes in triglycerides shown by TCZ‐treated RA patients could stem from the dysregulation that can occur in these regulatory molecules.MethodsTwenty‐seven RA patients included in the TOCRIVAR study who received TCZ (8 mg/kg IV/q4w) were evaluated at baseline and at Weeks 12, 24 and 52 of treatment. ANGPTL4, ApoC‐III and LPL, a complete lipid profile and RA disease activity, were analysed at baseline and at each visit. Multivariable linear mixed models were performed to study changes over time in lipids and regulatory molecules.ResultsAfter 24 weeks of TCZ treatment, HDL cholesterol, apolipoprotein A1 and triglycerides increased, whereas lipoprotein (a) decreased significantly from baseline values. However, 1 year after TCZ, no significant differences in lipid pattern were observed with respect to baseline. Serum ANGPTL4 and Apo‐CIII levels decreased gradually over time, both being significantly lower than baseline values at Week 52. LPL concentration did not change significantly during TCZ treatment. Remarkably, the elevation of triglycerides at Week 24 maintained its statistical significance after adjusting for the changes in ApoC‐III, ANGPTL4 and LPL.ConclusionIn TCZ‐treated RA patients basal serum levels of ANGPLT4 and ApoC‐III, but not LPL, decreased significantly. However, the elevation of triglycerides after TCZ was not related to changes in these regulatory molecules.