bluuebunny/crossref_metadata_2025_split huggingface dataset:
The perfect storm: temporal analysis of air during the world’s most deadly epidemic thunderstorm asthma (ETSA) event in Melbourne
Authors: Price Dwan , Hughes Kira M. , Dona Dulashi Withanage , Taylor Philip E. , Morton David A. V. , Stevanovic Svetlana , Thien Francis , Choi Jason , Torre Paul , Suphioglu Cenk 
Published: August 2023

Background: There have been 26 epidemic thunderstorm asthma (ETSA) events worldwide, with Melbourne at the epicentre of ETSA with 7 recorded events, and in 2016 experienced the deadliest ETSA event ever recorded. Health services and emergency departments were overwhelmed with thousands requiring medical care for acute asthma and 10 people died. Objectives: This multidisciplinary study was conducted across various health and science departments with the aim of improving our collective understanding of the mechanism behind ETSA. Design: This study involved time-resolved analysis of atmospheric sampling of the air for pollen and fungal spores, and intact and ruptured pollen compared with different weather parameters, pollution levels and clinical asthma presentations. Methods: Time-resolved pollen and fungal spore data collected by Deakin Air WATCH Burwood, underwent 3-h analysis, to better reflect the ‘before’, ‘during’ and ‘after’ ETSA time points, on the days leading up to and following the Melbourne 2016 event. Linear correlations were conducted with atmospheric pollution data provided by the Environment Protection Authority (EPA) of Victoria, weather data sourced from Bureau of Meteorology (BOM) and clinical asthma presentation data from the Victorian Agency for Health Information (VAHI) of Department of Health. Results: Counts of ruptured grass pollen grains increased 250% when the thunderstorm outflow reached Burwood. Increased PM10, high relative humidity, decreased temperature and low ozone concentrations observed in the storm outflow were correlated with increased levels of ruptured grass pollen. In particular, high ozone levels observed 6 h prior to this ETSA event may be a critical early indicator of impending ETSA event, since high ozone levels have been linked to increasing pollen allergen content and reducing pollen integrity, which may in turn contribute to enhanced pollen rupture. Conclusion: The findings presented in this article highlight the importance of including ruptured pollen and time-resolved analysis to forecast ETSA events and thus save lives.
Arterial lactate as a risk factor for death in respiratory failure related to coronavirus disease 2019: an observational study
Authors: Maraziti Giorgio , Marchini Laura , Barbieri Greta , Falcone Marco , Corradi Francesco , Graziani Mara , Ghiadoni Lorenzo , Becattini Cecilia 
Published: August 2023

Background: Arterial lactate is a recognized biomarker associated with death in critically ill patients. The prognostic role of arterial lactate in acute respiratory failure due to the novel coronavirus disease 2019 (COVID-19) is unclear. Objectives: We aimed to investigate the prognostic role of arterial lactate levels at admission in patients with COVID-19-related acute respiratory failure. Design and Methods: Cohorts of consecutive patients admitted to nonintensive care units (ICU) at study centers for COVID-19-related respiratory failure were merged into a collaborative database. The prognostic role of lactate levels at admission was assessed for continuous values and values ⩾2.0 mmol/l, and lactate clearance at 24 h through delta-lactate (ΔLac). The study outcome was 30-day in-hospital death. Cox proportional regression model was used to assess independent predictors of the study outcome. Results: At admission, 14.6% of patients had lactate levels ⩾2 mmol/l. In-hospital death at 30 days occurred in 57 out of 206 patients; 22.3% and 56.7% with normal or ⩾ 2 mmol/l lactate at admission, respectively. The median lactate level was 1.0 [interquartile range (IQR) 0.8–1.3] mmol/l and 1.3 (IQR 1.0–2.1) mmol/l in survivors and nonsurvivors, respectively ( p-value < 0.001). After adjusting for age, relevant comorbidities, acidemia, and the severity of respiratory failure, lactate ⩾2.0 mmol/l was associated with in-hospital death (HR 2.53, 95% CI 1.29–4.95, p-value 0.0066), while Δ Lac ⩾0 was not (HR 1.37, 95% CI 0.42–4.49). These results were confirmed in patients with a pO2/FiO2-ratio (P/F ratio) ⩽300 mmHg. Conclusions: In our study, increased arterial lactate at admission was independently associated with in-hospital death at 30 days in non-ICU patients with acute respiratory failure related to COVID-19.
Upregulated Mitochondrial Dynamics Is Responsible for the Procatabolic Changes of Chondrocyte Induced by α2-Adrenergic Signal Activation
Authors: He Jiaying , Qin Wenpin , Zhang Yusong , Yan Jianfei , Han Xiaoxiao , Gao Jialu , Li Qihong , Jiao Kai 
Published: August 2023

Objective Activation of sympathetic tone is important for cartilage degradation in osteoarthritis (OA). Recent studies reported that sympathetic signals can affect the mitochondrial function of target cells. It is unknown whether this effect exits in chondrocytes and affects chondrocyte catabolism. The contribution of mitochondrial dynamics in the activation of α2-adrenergic signal-mediated chondrocyte catabolism was investigated in this study. Design Primary chondrocytes were stimulated with norepinephrine (NE) alone, or pretreated with an α2-adrenergic receptor (Adra2) antagonist (yohimbine) and followed by stimulation with NE. Changes in chondrocyte metabolism and their mitochondrial dynamics were investigated. Results We demonstrated that NE stimulation induced increased gene and protein expressions of matrix metalloproteinase-3 and decreased level of aggrecan by chondrocytes. This was accompanied by upregulated mitochondriogenesis and the number of mitochondria, when compared with the vehicle-treated controls. Mitochondrial fusion and fission, and mitophagy also increased significantly in response to NE stimulation. Inhibition of Adra2 attenuated chondrocyte catabolism and mitochondrial dynamics induced by NE. Conclusions The present findings indicate that upregulation of mitochondrial dynamics through mitochondriogenesis, fusion, fission, and mitophagy is responsible for activation of α2-adrenergic signal-mediated chondrocyte catabolism. The hypothesis that “α2-adrenergic signal activation promotes cartilage degeneration in temporomandibular joint osteoarthritis (TMJ-OA) by upregulating mitochondrial dynamics in chondrocytes” is validated. This represents a new regulatory mechanism in the chondrocytes of TMJ-OA that inhibits abnormal activation of mitochondrial fusion and fission is a potential regulator for improving mitochondrial function and inhibiting chondrocyte injury and contrives a potentially innovative therapeutic direction for the prevention of TMJ-OA.
Digital pathology world tour
Authors: Rizzo Paola Chiara , Caputo Alessandro , Maddalena Eddy , Caldonazzi Nicolò , Girolami Ilaria , Dei Tos Angelo Paolo , Scarpa Aldo , Sbaraglia Marta , Brunelli Matteo , Gobbo Stefano , Marletta Stefano , Pantanowitz Liron , Della Mea Vincenzo , Eccher Albino 
Published: August 2023

Objective Digital pathology (DP) is currently in the spotlight and is rapidly gaining ground, even though the history of this field spans decades. Despite great technological progress, the adoption of DP for routine clinical diagnostic use remains limited. Methods A systematic search was conducted in the electronic databases Pubmed-MEDLINE and Embase. Inclusion criteria were all published studies that encompassed any application of DP. Results Of 4888 articles retrieved, 4041 were included. Relevant articles were categorized as “diagnostic” (147/4041, 4%) where DP was utilized for routine diagnostic workflow and “non-diagnostic” (3894/4041, 96%) for all other applications. The “non-diagnostic” articles were further categorized according to DP application including “artificial intelligence” (33%), “education” (5%), “narrative” (17%) for reviews and editorials, and “technical” (45%) for pure research publications. Conclusion This manuscript provided temporal and geographical insight into the global adoption of DP by analyzing the published scientific literature.
A mixed methods investigation into athletic trainer and dietitian's nutrition practices for sport-related concussion patients
Authors: Weber Rawlins Michelle L , Valovich McLeod Tamara C 
Published: August 2023

Background Nutrients may have implications following concussion, such as inflammation reduction or neuroprotection. The purpose of this study was to describe nutrition practices of athletic trainers (AT) and dietitians for patients regarding sport-related concussion, with respect to prevention, recommendations, and barriers to implementation. Hypotheses Due to the descriptive nature of this study, hypotheses were not warranted. Study Design Mixed methods. Level of Evidence Level 3. Methods A survey was distributed through professional memberships and included multiple-choice and open-ended items about nutritional practices regarding concussions. Participants included 1465 ATs and 51 dietitians accessing the survey (AT: age = 35.7 ± 11.4 years, females = 43.1%; dietitians: age = 31.8 ± 8.17 years, females = 45.1%). Open-ended survey responses regarding nutritional practices for concussion prevention, recommendations, and changes following concussion were analyzed by identifying key words or repeating phrases, theme development and categories into an initial codebook, using the codebook on responses, and coding all responses with the finalized codebook. Barriers to implementation was analyzed with descriptive statistics. Results Themes were identified for prevention strategies, and recommendations and changes following concussion. For concussion prevention, ATs noted overall health, specific target nutrients, barriers and limited research support, while dietitians identified overall health, specific target nutrients, recommendations/guidelines as themes. Post-injury themes for patient recommendations and changes were noted as overall health, specific target nutrients, resources, interprofessional collaboration by ATs, whereas dietitians identified overall health, specific target nutrients, interprofessional collaboration. ATs and dietitians noted numerous barriers including the lack of clinician knowledge and athlete compliance. Conclusions and Clinical Relevance ATs and dietitians are utilizing nutritional practices regarding concussion in numerous ways by focusing on use for whole body, brain health and specific targets such as omega fatty acids, hydration, micronutrients/supplements, and macronutrients. With these findings and the barriers listed by respondents, we can use this information to design focused research to influence evidence-based nutritional practices and concussion.
Application of Innovative Subject Recruitment System for Batch Enrollment: A Pilot Study
Authors: Wi Chung-Il , King Katherine S. , Ryu Euijung , Natoli Traci L. , Miller Ryan P. , Spiten Matthew J. , Borah Bijan J. , Takahashi Paul Y. , Yao Xiaoxi , Noseworthy Peter A. , Pignolo Robert J. , Juhn Young J. 
Published: August 2023

Introduction: Using a digital process that leverages electronic health records (EHRs) can ease many of the challenges presented by the traditional enrollment process for clinical trials. We tested if automated batch enrollment using a technology-enabled subject recruitment system (TESRS) enhances recruitment while preserving representation of research subjects for the study population in our study setting. Methods: An ongoing community-based prospective adult cohort study was used to randomize 600 subjects who were eligible by age and residential address to TESRS (n = 300) and standard mailing method (n = 300), respectively, for 3 months. Then, TESRS was initiated and included automatic identification of patients’ preference for being contacted (online patient portal vs postal mail) from EHRs and automatic sending out of invitation letters followed by completion of a short online survey for checking eligibility and the digital consent process if eligible. We compared (1) median time to consent from invitation sent out per subject and total subjects recruited after a 3-month recruitment period, (2) the estimated study staff’s time, and (3) representation of sociodemographic characteristics (e.g., age, sex, race, SES measured by HOUSES index, and rural residence) between subjects recruited via TESRS and those via traditional mailing methods. Results: Median age of randomized subjects (n = 600) was 63 years with 52.0% female and 89.2% non-Hispanic White. Over a 3-month period, results showed consent rate via TESRS was 13% (39/297) similar to 11% (31/295) via standard mailing. However, recruitment was significantly faster with the TESRS approach (median 7 vs 26 days) given the study staff’s effort. Study staff’s time saved by using TESRS compared to standard mailing approach was estimated at 40 min per subject (equivalent to 200 h for 300 subjects). No significant differences in characteristics of research subjects from the study population were found. Conclusion: Our study demonstrated the utility of TESRS as a subject recruitment digital technology which significantly enhanced the recruitment effort while reducing the study staff burden of recruitment while maintaining the consistency of characteristics of recruited subjects. The strategy and support for implementing and testing TESRS in other study settings should be considered.
Antibiotic Prescription Patterns in Children Under 5 Years of Age With Acute Diarrhea in Quito-Ecuador
Authors: Sánchez Xavier , Calderón Nathali , Solis Olga , Jimbo-Sotomayor Ruth 
Published: August 2023

Background: Diarrheal disease remains a significant cause of child mortality, particularly in regions with limited access to healthcare and sanitation. Inappropriate practices, including unjustified medication prescriptions, pose challenges in the management of acute diarrhea (AD), especially in low- and middle-income countries. Objective: This study analyzed antibiotic prescription patterns and assessed compliance with Integrated Management of Childhood Illness (IMCI) guidelines in children under 5 with AD in the Ministry of Public Health (MOPH) Ambulatory Care Centers of Quito city, Ecuador. Methods: A cross-sectional design was used, collecting electronic health records (EHR) of patients diagnosed with AD from 21 health facilities in District 17D03. A probabilistic and stratified sampling approach was applied. Patient characteristics, prescriber characteristics, treatments, and compliance of IMCI guideline recommendations were evaluated. A stepwise logistic regression analysis examined the association between antibiotic prescription and patient and physician characteristics. Results: A total of 359 children under 5 years of age were included, with 58.77% being girls. 85.24% of the cases of AD were attributed to gastroenteritis and colitis of infectious and unspecified origin. Amebiasis and other protozoal intestinal diseases accounted for 13.37% and 1.11% of the cases, respectively. The completion rates of recording various IMCI parameters varied; parameters such as duration of diarrhea, presence of blood in stool, and evidence of sunken eyes had high completion rates (100%, 100%, and 87.47%, respectively), while parameters like state of consciousness, presence of thirst, and type of diarrhea had low completion rates (0.28%, 0.28%, and 0.84%, respectively). None of the cases had all parameters fully recorded. Antimicrobials were prescribed in 38.72% of the cases. Children aged 3 to 5 years had higher odds of receiving antimicrobial prescription for AD (aOR: 4.42, 95% CI 2.13-9.18, P < .0001) compared to those under 1 year, after adjusting for the number of loose stools per day, gender, and age of the health professional. Conclusion: Variations in IMCI guideline compliance were observed, with no cases fully adhering to the guidelines. Antimicrobial prescription rates were notably high, especially among older children. Further research and specialized interventions are necessary to gain comprehensive insight into the factors underlying non-compliance with the IMCI guidelines.
The association of sociodemographic, nutrition, and sanitation on stunting in children under five in rural area of West Java Province in Indonesia
Authors: Permatasari Tria Astika Endah , Chadirin Yudi , Ernirita  , Elvira Feby , Putri Bella Arinda 
Published: August 2023

Background: The prevalence of stunting in Indonesia has decreased gradually. The strategy to reduce stunting is currently prioritized on improving socio-economic levels, fulfilling food intake, and sanitation conditions. This study aims to analyze the association between sociodemographics, nutrition, and sanitation on stunting in rural West Java Province in Indonesia. Design and methods: A cross-sectional study was conducted in May–August 2022 among 247 mother-children pairs, selected by systematic random sampling from a rural area of West Java Province in Indonesia. The sociodemographic characteristics were measured using a structured questionnaire. The nutritional status of the children under five was assessed by length/height-for-age (HAZ), and was calculated using WHO Anthro software. Sanitation is assessed using observation and interviews with a structured questionnaire. Results: The prevalence of stunting in children under five was 20.7% (5.3% severely stunted and 15.4% stunted). Binary logistic regression analysis using SPSS version 22.0 show that mother’s height as the dominant factor associated with stunting in children under five (AOR = 3.45, 95% CI: 1.12–4.67, p = 0.008). In addition, children’s age (AOR = 0.250, 95% CI: 0.104–0.598, p = 0.002); balanced diet practices (AOR = 1.57, 95% CI: 0.965–2.56, p = 0.069), and building materials (AOR = 1.869, 95% CI: 0.87–4.00, p = 0.108 are also related to stunting in children under five. Conclusions: Efforts to improve maternal nutrition need to be carried out from the period before pregnancy to the first 1000 days of life. Education on healthy home indicators, especially the use of this type of building materials for houses, needs to be done to improve sanitation as an effort to prevent stunting in children under five.
Republication of “Preliminary Experience Using Bioactive Glass Wedges for Cotton Osteotomy”
Authors: Borenstein Todd , Gonzalez Tyler , Krevolin Janet , Den Hartog Bryan , Thordarson David 
Published: August 2023

Background: Medial cuneiform dorsal opening wedge (Cotton) osteotomy is often used for treating forefoot varus in patients undergoing surgery for stage II posterior tibialis tendon dysfunction. The goal of this study was to examine the radiographic outcomes of Cotton osteotomy with bioactive glass wedge to assess for both maintenance of correction and clinical results and complications. We hypothesized that bioactive glass wedges would maintain correction of the osteotomy with low complication rates. Methods: Between December 2015 and June 2016, the charts of 17 patients (10 female and 7 male) who underwent Cotton osteotomy using bioactive glass wedges were retrospectively reviewed. Patient age averaged 56.8 years (range, 16-84). The average follow-up was 6.5 months. Radiographs were reviewed to assess for initial correction and maintenance of correction of medial column sag as well as for union. Charts were reviewed for complications. Results: The medial column sag correction averaged 15.6% on the final postoperative lateral radiograph. Meary angle averaged 19 degrees (3.14-42.8 degrees) preoperatively and 5.5 degrees (0.4-20.7 degrees) at final follow-up. All patients achieved clinical and radiographic union. One patient developed neuropathic midfoot pain and was managed with sympathetic blocks. One patient had a delayed union that healed at 6 months without surgical intervention. No patients required the use of custom orthotics or subsequent surgical procedures. Conclusion: Cotton osteotomy with bioactive glass wedges produced consistent correction of the medial column with low risk. Level of Evidence: Level IV, case series.
Efficacy of endoscopic trans-papillary gallbladder stenting and drainage in acute calculous cholecystitis in high-risk patients: a systematic review and meta-analysis
Authors: Malik Adnan , Malik Muhammad Imran , Amjad Waseem , Javaid Sadia 
Published: August 2023

Background and aims: Acute calculous cholecystitis (ACC) represents about one-third of all surgical emergencies. The gold standard management of ACC is laparoscopic cholecystectomy. Although cholecystectomy is a safe procedure, it may be dangerous and contraindicated in patients with complex comorbidities. Endoscopic transpapillary gallbladder stenting (ETGBS) and drainage had been widely used to manage patients suffering from ACC with comorbidities. Methods: We searched PubMed, SCOPUS, Web of Science, and Cochrane Library for relevant studies assessing the use of ETGBS in patients suffering from ACC with various comorbidities. Risk of bias assessment was performed using the National Institues of Health (NIH) tool. We included the following outcomes: clinical success, technical success, late complications, and pancreatitis. Results: We included seven studies that met our inclusion criteria. We found that the pooled proportion of clinical success, technical success, late complications, and pancreatitis was [91.3%, 95% confidence interval (CI) (86.8%, 95.9%)], [92.8%, 95% CI (89%, 96.5%)], [5.4%, 95% CI (2.9%, 7.9%)], and [3.5%, 95% CI (1.2%, 5.8%)], respectively. Conclusion: We found that an ETGBS was an effective and well-tolerated method for the treatment of cholecystitis, especially in high-risk individuals.
A phase 2 trial of CD24Fc for prevention of graft-versus-host disease
Authors: Magenau John , Jaglowski Samantha , Uberti Joseph , Farag Sherif S. , Riwes Mary Mansour , Pawarode Attaphol , Anand Sarah , Ghosh Monalisa , Maciejewski John , Braun Thomas , Devenport Martin , Lu Susan , Banerjee Bhramori , DaSilva Carolyn , Devine Steven , Zhang Mei-Jie , Burns Linda J. , Liu Yang , Zheng Pan , Reddy Pavan 
Published: August 2023

Abstract
Patients who undergo human leukocyte antigen–matched unrelated donor (MUD) allogeneic hematopoietic stem cell transplantation (HSCT) with myeloablative conditioning for hematologic malignancies often develop acute graft-versus-host disease (GVHD) despite standard calcineurin inhibitor–based prophylaxis in combination with methotrexate. This trial evaluated a novel human CD24 fusion protein (CD24Fc/MK-7110) that selectively targets and mitigates inflammation due to damage-associated molecular patterns underlying acute GVHD while preserving protective immunity after myeloablative conditioning. This phase 2a, multicenter study evaluated the pharmacokinetics, safety, and efficacy of CD24Fc in combination with tacrolimus and methotrexate in preventing acute GVHD in adults undergoing MUD HSCT for hematologic malignancies. A double-blind, placebo-controlled, dose-escalation phase to identify a recommended dose was followed by an open-label expansion phase with matched controls to further evaluate the efficacy and safety of CD24Fc in preventing acute GVHD. A multidose regimen of CD24Fc produced sustained drug exposure with similar safety outcomes when compared with single-dose regimens. Grade 3 to 4 acute GVHD–free survival at day 180 was 96.2% (95% confidence interval [CI], 75.7-99.4) in the CD24Fc expansion cohort (CD24Fc multidose), compared with 73.6% (95% CI, 63.2-81.4) in matched controls (hazard ratio, 0.1 [95% CI, 0.0-0.6]; log-rank test, P = .03). No participants in the CD24Fc escalation or expansion phases experienced dose-limiting toxicities (DLTs). The multidose regimen of CD24Fc was well tolerated with no DLTs and was associated with high rates of severe acute GVHD–free survival after myeloablative MUD HSCT. This trial was registered at ClinicalTrials.gov as #NCT02663622.