bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asthma in the intensive care unit: A review of patient characteristics and outcomes
Authors: Manyeruke F , Calligaro G L , Raine R , Van-Zyl Smit R N 
Published: August 2023

Background. Most asthma-related deaths occur in low- and middle-income countries, and South Africa (SA) is ranked fifth in global asthma mortality. Little is known about the characteristics and outcome of asthma patients requiring intensive care unit (ICU) admission in SA.
Objectives. To identify and characterise patients with acute severe asthma admitted to the respiratory ICU at Groote Schuur Hospital, Cape Town, SA, in order to evaluate outcomes and identify predictors of poor outcomes in those admitted.
Methods. We performed a retrospective descriptive study of patients with severe asthma admitted to the respiratory ICU at Groote Schuur Hospital between 1 January 2014 and 31 December 2019.
Results. One hundred and three patients (110 admission episodes) were identified with an acute asthma exacerbation requiring ICU admission; all were mechanically ventilated. There was a female preponderance (53.6%; n=59/110), with a median (range) age overall of 33 (13 - 84) years. Of all admissions, 40 (36.4%) were current tobacco smokers and 16 (14.5%) patients with a history of substance abuse. Two thirds (60.0%; n=66/110) of the patients were using an inhaled corticosteroid (ICS). No predictors of mortality were evident in multivariate modelling, although those who died were older, and had higher Acute Physiology and Chronic Health Evaluation (APACHE II) scores and longer duration of admission. Only 59 of the surviving 96 individual patients (61.5%) attended a specialist pulmonology clinic after discharge.
Conclusion. Among patients admitted to the respiratory ICU at Groote Schuur Hospital for asthma exacerbations, there was a high prevalence of smokers and poor coverage with inhaled ICSs. Although mortality was low compared with general ICU mortality, more needs to be done to prevent acute severe asthma exacerbations.
Efficient Adsorption Kinetic Studies of Chromium from Effluents Using Ziziphus mauritiana Leaf Extract Mediated TiO2 Nanoparticles
Authors: Yaseen Zobia , Mehmood Khalid , Ibrahim Muhammad , Yaseen Ammara , Ihsan Ayesha , Raza Ali , Hassan Aakash , Shabir Ghulam , Shabir Tayyaba , Abbas Nasir 
Published: August 2023

Water plays a remarkable role in the natural structure of a living organism as people's bodies comprise 60% water by weight. Water contamination due to negative industrialization and anthropogenic activities is a huge hazard to humanity. The water quality is degraded by the discharge of organic and Inorganic compounds, Pathogens, herbicides, pesticides, drugs, heavy metals, and macroscopic pollutants in the water bodies, leading to a decrease in the oxygen in the water. Heavy metals are well-defined habitat pollutants because of their toxicity and bio accumulative nature. The adsorption method is more appealing to researchers because of its extraordinary potential to remove toxic metals, in which adsorbate are attached to the solid surface of adsorbent through physiochemical interactions. In the current research, the plant leaf extract of Ziziphus mauritiana was subjected to synthesize TiO2. For Chromium removal from an aqueous solution, TiO2 nanoparticles will be used. UV-Visible, FTIR, powder and SEM will be employed to characterize nanoparticle synthesis. Atomic Absorption Spectrophotometer will be employed for heavy metal removal analysis before and after adsorption. pH, dosage rate, concentration, and contact time were among the various experimental activities used. Finally, to improve the results, experimental statistics were applied to all recorded data.
Creation and Adoption of Large Language Models in Medicine
Authors: Shah Nigam H. , Entwistle David , Pfeffer Michael A. 
Published: August 2023

ImportanceThere is increased interest in and potential benefits from using large language models (LLMs) in medicine. However, by simply wondering how the LLMs and the applications powered by them will reshape medicine instead of getting actively involved, the agency in shaping how these tools can be used in medicine is lost.ObservationsApplications powered by LLMs are increasingly used to perform medical tasks without the underlying language model being trained on medical records and without verifying their purported benefit in performing those tasks.Conclusions and RelevanceThe creation and use of LLMs in medicine need to be actively shaped by provisioning relevant training data, specifying the desired benefits, and evaluating the benefits via testing in real-world deployments.
Prospective Associations of Different Combinations of Aerobic and Muscle-Strengthening Activity With All-Cause, Cardiovascular, and Cancer Mortality
Authors: López-Bueno Rubén , Ahmadi Matthew , Stamatakis Emmanuel , Yang Lin , del Pozo Cruz Borja 
Published: August 2023

ImportanceStudies examining the associations of different combinations of intensity-specific aerobic and muscle strengthening activity (MSA) with all-cause and cause-specific mortality are scarce; the few available estimates are disparate.ObjectiveTo examine the prospective associations of different combinations of moderate aerobic physical activity (MPA), vigorous aerobic physical activity (VPA), and MSA with all-cause, cardiovascular (CVD), and cancer mortality.Design, Setting, and ParticipantsThis nationwide prospective cohort study used data from the US National Health Interview Survey. A total of 500 705 eligible US adults were included in the study and followed up during a median of 10.0 years (5.6 million person-years) from 1997 to 2018. Data were analyzed from September 1 to September 30, 2022.ExposuresSelf-reported cumulative bouts (75 weekly minutes) of MPA and VPA with recommended MSA guidelines (yes or no) to obtain 48 mutually exclusive exposure categories.Main Outcomes and MeasuresAll-cause, CVD, and cancer mortality. Participants were linked to the National Death Index through December 31, 2019.ResultsOverall, 500 705 participants (mean [SD] age, 46.4 [17.3] years; 210 803 [58%] female; 277 504 [77%] White) were included in the study. Compared with the reference group (doing no MPA or VPA and less than recommended MSA), the category associated with the lowest hazard ratio (HR) for all-cause mortality was more than 0 to 75 minutes of MPA combined with more than 150 minutes of VPA and 2 or more MSA sessions per week (HR, 0.50; 95% CI, 0.42-0.59). The optimal combinations for CVD and cancer mortality risk reduction were more than 150 to 225 minutes of MPA, more than 0 to 75 minutes of VPA, and 2 or more MSA sessions per week (HR, 0.30; 95% CI, 0.15-0.57), and more than 300 minutes of MPA, more than 0 to 75 minutes of VPA, and 2 or more MSA sessions per week (HR, 0.44; 95% CI, 0.23-0.82), respectively. Adjusted mortality rates represented an approximately 50% lower mortality rate for all-cause and cancer mortality and an approximately 3-fold lower mortality rate for CVD mortality.Conclusions and RelevanceThis cohort study demonstrated that balanced levels of MPA, VPA, and MSA combined may be associated with optimal reductions of mortality risk. Higher-than-recommended levels of MPA and VPA may further lower the risk of cancer and all-cause mortality, respectively.
Effects of Cuff Size on the Accuracy of Blood Pressure Readings
Authors: Ishigami Junichi , Charleston Jeanne , Miller Edgar R. , Matsushita Kunihiro , Appel Lawrence J. , Brady Tammy M. 
Published: August 2023

ImportanceClinical practice guidelines recommend selecting an appropriately sized cuff based on mid-arm circumference prior to measuring blood pressure (BP). To our knowledge, the effect of miscuffing on BP measurement when using an automated BP device has not been quantified.ObjectiveTo determine the effect of using a regular BP cuff vs an appropriately sized BP cuff on automated BP readings.Design, Setting, and ParticipantsThis randomized crossover trial of community-dwelling adults with a wide range of mid-arm circumferences took place between March 16 and October 25, 2021, in Baltimore, Maryland. Participants were recruited via BP screening events at a public food market and a senior housing facility, targeted mailings to prior research participants, placement of study brochures in hypertension clinics at Johns Hopkins University, and referrals from physicians providing hypertension care to adults.InterventionsParticipants underwent 4 sets of triplicate BP measurements, with the initial 3 sets using an appropriate, too-small, or too-large BP cuff in random order; the fourth set of triplicate measurements was always completed with an appropriate BP cuff.Main Outcomes and MeasuresThe primary outcome was the difference in mean BP when measured with a regular BP cuff compared with an appropriate BP cuff. The secondary outcome was the difference in BP when using too-small or too-large BP cuffs vs an appropriate BP cuff across all cuff sizes. Results were also stratified by systolic BP (≥130 mm Hg vs &amp;lt;130 mm Hg) and body mass index (calculated as weight in kilograms divided by height in meters squared; ≥30 vs &amp;lt;30).ResultsA total of 195 adults (mean [SD] age, 54 [16] years; 67 [34%] male; 132 [68%] Black; 100 [51%] with hypertension) were randomized for inclusion. Among individuals requiring a small BP cuff, use of a regular BP cuff resulted in a statistically significant lower BP reading (mean systolic BP difference, −3.6 [95% CI, −5.6 to −1.7] mm Hg). In contrast, among individuals requiring a large or extra-large BP cuff, use of a regular BP cuff resulted in a statistically significant higher BP reading (mean systolic BP difference, 4.8 [95% CI, 3.0-6.6] mm Hg and 19.5 [95% CI, 16.1-22.9] mm Hg, respectively). For the secondary outcome, BP differences with overcuffing and undercuffing by 1 and 2 cuff sizes were greater among those requiring larger BP cuffs. The results were consistent in stratified analyses by systolic BP and body mass index.Conclusions and RelevanceIn this randomized crossover trial, miscuffing resulted in strikingly inaccurate BP measurements. This is particularly concerning for settings where 1 regular BP cuff size is routinely used in all individuals, regardless of arm size. A renewed emphasis on individualized BP cuff selection is warranted.Trial RegistrationClinicalTrials.gov Identifier: NCT04610775
Trends in Delirium and New Antipsychotic and Benzodiazepine Use Among Hospitalized Older Adults Before and After the Onset of the COVID-19 Pandemic
Authors: Reppas-Rindlisbacher Christina , Boblitz Alexa , Fowler Robert A. , Lapointe-Shaw Lauren , Sheehan Kathleen A. , Stukel Therese A. , Rochon Paula A. 
Published: August 2023

ImportanceThe COVID-19 pandemic caused large disruptions to health care for hospitalized older adults. The incidence and management of delirium may have been affected by high rates of COVID-19 infection, staffing shortages, overwhelmed hospital capacity, and changes to visitor policies.ObjectiveTo measure changes in rates of delirium and related medication prescribing during the COVID-19 pandemic among hospitalized older adults.Design, Setting, and ParticipantsThis population-based, repeated cross-sectional study used linked databases to measure rates of delirium and related medication prescriptions among adults aged 66 years or older hospitalized before and during the COVID-19 pandemic (January 1, 2017, to March 31, 2022) in Ontario, Canada.ExposureThe first 2 years of the COVID-19 pandemic (March 1, 2020, to March 31, 2022).Main Outcomes and MeasuresThe main outcomes were weekly rates of delirium per 1000 admitted population and monthly rates of new antipsychotic and benzodiazepine prescriptions per 1000 discharged population. Observed rates were compared with projected rates based on modeling from 3 years before pandemic onset.ResultsAmong 2 128 411 hospitalizations of older adults over the 5-year study period (50.7% female; mean [SD] age, 78.9 [8.3] years), absolute rates of delirium increased from 35.9 per 1000 admitted population during the prepandemic period to 41.5 per 1000 admitted population throughout the pandemic. The adjusted rate ratio (ARR) of delirium during the pandemic compared with the projected rate was 1.15 (95% CI, 1.11-1.19). Monthly rates of new antipsychotic prescriptions increased from 6.9 to 8.8 per 1000 discharged population and new benzodiazepine prescriptions from 4.4 to 6.0 per 1000 discharged population and were significantly higher during the pandemic compared with projected rates (antipsychotics: ARR, 1.28; 95% CI, 1.19-1.38; benzodiazepines: ARR, 1.37; 95% CI, 1.20-1.57). Rates were highest during pandemic waves 1 (March to June 2020), 3 (March to June 2021), and 5 (December 2021 to February 2022) and remained elevated above projected levels throughout the first 2 years of the pandemic.Conclusions and RelevanceIn this repeated cross-sectional study of hospitalized older adults, there was a temporal association between COVID-19 pandemic onset and significant increases in rates of delirium in the hospital and new antipsychotic and benzodiazepine prescriptions after hospital discharge. Rates remained elevated over 2 years. Pandemic-related changes such as visitor restrictions, staff shortages, isolation practices, and reduced staff time at the bedside may have contributed to these trends.
Puzzling out nuclear pore complex assembly
Authors: Penzo Arianna , Palancade Benoit 
Published: August 2023

Nuclear pore complexes (NPCs) are sophisticated multiprotein assemblies embedded within the nuclear envelope and controlling the exchanges of molecules between the cytoplasm and the nucleus. In this review, we summarize the mechanisms by which these elaborate complexes are built from their subunits, the nucleoporins, based on our ever‐growing knowledge of NPC structural organization and on the recent identification of additional features of this process. We present the constraints faced during the production of nucleoporins, their gathering into oligomeric complexes, and the formation of NPCs within nuclear envelopes, and review the cellular strategies at play, from co‐translational assembly to the enrolment of a panel of cofactors. Remarkably, the study of NPCs can inform our perception of the biogenesis of multiprotein complexes in general – and vice versa.
Looking back, looking ahead: Strategic initiatives in AI and NSF's AI Institutes Program
Authors: Donlon James , Goel Ashok 
Published: August 2023

AbstractWe introduce U.S. National Science Foundation's groundbreaking National AI Research Institutes Program. The AI institutes are interdisciplinary collaborations that continue the program's emphasis on tackling larger‐scale, longer‐time horizon challenges in both foundational and use‐inspired AI research, and act as nexus points to address some of society's grand challenges.
Seizure reduction in TSC2‐mutant mouse model by an mTOR catalytic inhibitor
Authors: Dhamne Sameer C. , Modi Meera E. , Gray Audrey , Bonazzi Simone , Craig Lucas , Bainbridge Elizabeth , Lalani Lahin , Super Chloe E. , Schaeffer Samantha , Capre Ketthsy , Lubicka Danuta , Liang Guiqing , Burdette Doug , McTighe Stephanie M. , Gurnani Sarika , Vermudez Sheryl Anne D. , Curtis Daniel , Wilson Christopher J. , Hameed Mustafa Q. , D'Amore Angelica , Rotenberg Alexander , Sahin Mustafa 
Published: August 2023

AbstractObjectiveTuberous sclerosis complex (TSC) is a neurodevelopmental disorder caused by autosomal‐dominant pathogenic variants in either the TSC1 or TSC2 gene, and it is characterized by hamartomas in multiple organs, such as skin, kidney, lung, and brain. These changes can result in epilepsy, learning disabilities, and behavioral complications, among others. The mechanistic link between TSC and the mechanistic target of the rapamycin (mTOR) pathway is well established, thus mTOR inhibitors can potentially be used to treat the clinical manifestations of the disorder, including epilepsy.MethodsIn this study, we tested the efficacy of a novel mTOR catalytic inhibitor (here named Tool Compound 1 or TC1) previously reported to be more brain‐penetrant compared with other mTOR inhibitors. Using a well‐characterized hypomorphic Tsc2 mouse model, which displays a translationally relevant seizure phenotype, we tested the efficacy of TC1.ResultsOur results show that chronic treatment with this novel mTOR catalytic inhibitor (TC1), which affects both the mTORC1 and mTORC2 signaling complexes, reduces seizure burden, and extends the survival of Tsc2 hypomorphic mice, restoring species typical weight gain over development.InterpretationNovel mTOR catalytic inhibitor TC1 exhibits a promising therapeutic option in the treatment of TSC.
On‐Chip Reconstitution of Uniformly Shear‐Sensing 3D Matrix‐Embedded Multicellular Blood Microvessel
Authors: Vo Quoc , Carlson Kaely A. , Chiknas Peter M. , Brocker Chad N. , DaSilva Luis , Clark Erica , Park Sang Ki , Ajiboye A. Seun , Wier Eric M. , Benam Kambez H. 
Published: August 2023

AbstractPreclinical human‐relevant modeling of organ‐specific vasculature offers a unique opportunity to recreate pathophysiological intercellular, tissue‐tissue, and cell‐matrix interactions for a broad range of applications. Here, this work presents a reliable, and simply reproducible process for constructing user‐controlled long rounded extracellular matrix (ECM) embedded vascular microlumens on‐chip for endothelization and co‐culture with stromal cells obtained from human lung. This work demonstrates the critical impact of microchannel cross‐sectional geometry and length on uniform distribution and magnitude of vascular wall shear stress, which is key when emulating in vivo observed blood flow biomechanics in health and disease. In addition, this study provides an optimization protocol for multicellular culture and functional validation of the system. Moreover, this study shows the ability to finely tune rheology of the three‐dimensional natural matrix surrounding the vascular microchannel to match pathophysiological stiffness. In summary, this work provides the scientific community with a matrix‐embedded microvasculature on‐chip populated with all‐primary human‐derived pulmonary endothelial cells and fibroblasts to recapitulate and interrogate lung parenchymal biology, physiological responses, vascular biomechanics, and disease biogenesis in vitro. Such a mix‐and‐match synthetic platform can be feasibly adapted to study blood vessels, matrix, and ECM‐embedded cells in other organs and be cellularized with additional stromal cells.
Hierarchically 3D Fibrous Electrode for High‐Performance Flexible AC‐Line Filtering in Fluctuating Energy Harvesters
Authors: Wu Mingmao , Sun Ke , He Jinfeng , Huang Qinzhui , Zhan Weiqing , Lu Zhixing , Xia Meng‐Chan , Zhang Yu , Lyu Xiaolin , Geng Hongya , Luo Zhong‐Zhen , Zou Zhigang 
Published: August 2023

AbstractIn light of the rapid development of intelligence and miniaturization in electronics, the growing demand for sustainable energy sources gives rise to a plethora of environmental/mechanical energy harvesters. However, the fluctuating nature of these generated energies frequently presents a challenge to their immediate usability. Although electrolytic capacitors can smooth fluctuating energy, lacking miniaturization and flexibility constrain their potential applications. Conversely, electrochemical capacitors (ECs), particularly fiber‐shaped electrochemical capacitors (FSECs), can offer superior flexibility. Nevertheless, the inherent trade‐off between ion transport and charge storage in fibrous electrodes poses a significant obstacle to their filtering capability. Here, a hierarchically 3D fibrous electrode that effectively balances ion transport and charge storage through its unhindered primary framework and intertwined secondary frameworks is presented. The resulting FSEC exhibits an exceptional specific areal capacitance of 1.37 mF cm−2 with a phase angle of −82° at 120 Hz, surpassing that of fiber‐shaped filter capacitors and most non‐fibrous filter ECs previously reported. Additionally, the FSEC displays excellent flexibility and high‐frequency response, rendering it well‐suited for filtering arbitrary ripple voltage and compatible with environmental/mechanical energy harvesters. These results demonstrate a promising approach for designing fibrous high‐frequency response electrodes and a foundation for portable environmental energy harvesting devices.
Smart and Multifunctional Fiber‐Reinforced Composites of 2D Heterostructure‐Based Textiles
Authors: Dulal Marzia , Islam Md Rashedul , Maiti Saptarshi , Islam Mohammad Hamidul , Ali Iftikhar , Abdelkader Amr M. , Novoselov Kostya S. , Afroj Shaila , Karim Nazmul 
Published: August 2023

AbstractSmart and multifunctional fiber reinforced polymer (FRP) composites with energy storage, sensing, and heating capabilities have gained significant interest for automotive, civil, and aerospace applications. However, achieving smart and multifunctional capabilities in an FRP composite while maintaining desired mechanical properties remains challenging. Here, a novel approach for layer‐by‐layer (LBL) deposition of 2D material (graphene and molybdenum disulfide, MoS2)‐based heterostructure onto glass fiber fabric using a highly scalable manufacturing technique at a remarkable speed of ≈150 m min−1 is reported. This process enables the creation of smart textiles with integrated energy storage, sensing, and heating functionalities. This methodology combines gel‐based electrolyte with a vacuum resin infusion technique, resulting in an efficient and stable smart FRP composite with an areal capacitance of up to ≈182 µF cm−2 at 10 mV s−1. The composite exhibits exceptional cyclic stability, maintaining ≈90% capacitance after 1000 cycles. Moreover, the smart composite demonstrates joule heating, reaching from ≈24 to ≈27 °C within 120 s at 25 V. Additionally, the smart composite displays strain sensitivity by altering electrical resistance with longitudinal strain, enabling structural health monitoring. These findings highlight the potential of smart composites for multifunctional applications and provide an important step toward realizing their actual real‐world applications.
Engineering Radioactive Microspheres for Intra‐Arterial Brachytherapy Using Radiation‐Induced Graft Polymerization
Authors: Xu Xiao , Chen Hu , Zhao Zhenwen , Wang Yangjie , He Pan , Cheng Hongwei , Gao Xing , Shi Yesi , Li Yesen , Huang Jinxiong , Peng Yisheng , Chu Chengchao , Zhang Yang , Liu Chao , Li Bo , Mao Jingsong , Ma Hongjuan , Liu Gang 
Published: August 2023

AbstractIntravascular brachytherapy requires advances in radio‐embolization technologies that combine brilliant radiostability efficacy with a facile and green synthesis route. A hybrid‐integrated radioactive microsphere strategy using phosphorylcholine‐modified lutetium‐177 coordinated polymeric microspheres (177Lu‐PCMs) is reported that are fabricated via radiation‐induced graft polymerization for imaging‐guided locoregional intravascular brachytherapy. The underlying formation mechanism of 177Lu‐PCMs is elucidated using first‐principles computations and density functional theory calculations, and 177Lu loading mechanisms are investigated with Near‐edge and extended X‐ray absorption fine structure spectroscopy. The engineered 177Lu‐PCMs exhibit excellent mechanical properties, good hydrophilicity, and controlled sphere diameter. These features provide advantages of ultra‐stable embolic radio‐theranostics, which is demonstrated in different preclinical rodent models and isolated human liver tumor tissues. During locoregional intra‐arterial brachytherapy, 177Lu‐PCMs can be visualized via SPECT to validate the in vivo biodistribution and retention in real time, achieving precise delivery, effective anti‐cancer treatment, and a distinguished safety profile without degradation, ectopic embolization, and adverse reactions. Therefore, this study offer a new avenue for the development of a highly innovative and translational approach for precision intra‐arterial brachytherapy.