bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of ERCP simulator training on early ERCP learning curves of novice trainees: a cohort study
Authors: van der Wiel Sophia Elisabeth , Rauws Erik , Van Gool Stijn , Wang Dong , Hu Bing , Kylanpaa Leena , Webster George J.M. , James Martin , Koch Arjun Dave , Bruno Marco 
Published: August 2023

Abstract
Background and study aim Simulator-based training has been extensively studied in training gastroduodenoscopy and colonoscopy and shown to significantly improve learning curves of novices. Data on simulator-based training in endoscopic retrograde cholangiopancreatography (ERCP) are scarce. We aimed to determine the impact of 2-day intensive hands-on simulator training on the course of the learning curve of novice trainees.
Methods We conducted a prospective cohort study using a validated mechanical ERCP simulator (Boškoski-Costamagna ERCP Trainer). Six trainees were allocated to the simulation course program (SG). Each of these trainees were paired with an endoscopy trainee starting regular ERCP training at the same center who had no exposure to a simulation course program (control group; CG). The course included lectures, live ERCP demonstrations, and hands-on ERCP training to educate trainees in basic techniques related to cannulation, stent placement, stone extraction and stricture management. After the course, both the SG and CG started formal ERCP training in their respective centers. The Rotterdam Assessment Form for ERCP was used to register each performed ERCP. Simple moving average was applied to create learning curves based on successful common bile duct (CBD) cannulation. Outcomes were plotted against a historical cohort (HC).
Results Thirteen trainees were included, six trainees in the SG and seven trainees in the CG, with a total of 717 ERCPs. Mean successful ERCP cannulation rate was higher for the simulator group at baseline compared to both CG and HC, 64% versus 43% and 42%, respectively. Differences became less explicit after 40 ERCPs, but persisted until a median of 75 ERCPs.
Conclusions We demonstrate that 2-day hands-on simulator-based ERCP training course has a positive effect on the learning curves of ERCP trainees and should be considered an integral part of the training curricula for ERCP to develop skills prior to patient-based training.
Impact of income inequality on climate change in Asia: the role of human capital
Authors: Oanh Tran Thi Kim , Ha Nguyen Thi Hong 
Published: August 2023

AbstractApplying different regression estimators on balanced panel data, this article examines the impact of human capital and income inequality on climate change in Asian countries during the period 2007–2020. Results by the GMM estimator confirm that increases in income inequality and investments in human capital exacerbate environmental degradation in Asian countries. However, among the three variables that represent human capital, only HC3 (Gross enrollment ratio for tertiary school) plays a role in reducing the impact of income inequality on emissions of carbon dioxide. In addition, the study also provides evidence on the impact of other factors on CO2 emissions such as renewable energy, economic growth, population, output in the agricultural and services sectors, trade openness, government expenditure and total investment in the economy. Besides, some important policy implications have been suggested to aim at securing sustained economic growth in Asia.
Toward a One Health Surveillance System in Cuba: Co-Productive Stakeholder Engagement
Authors: Valle Damarys de las Nieves Montano , García Oshin Ley , Hernandez Beatriz Delgado , Abreu Marian Irian Percedo , Pérez Dianelys Quiñones , Silva Laura Cunha , Carmo Luís Pedro , Berezowski John , Zamora Pastor Alfonso , Dürr Salome 
Published: August 2023

Abstract
We advocate for a holistic approach to building resilience against health hazards in Cuba by improving cross-sectoral and transdisciplinary collaboration. As a step in this direction, we conducted participatory workshops to design two One Health Surveillance Systems (OHSS): (i) for Influenza viruses with zoonotic/pandemic potential and (ii) for Antimicrobial Resistance (AMR). We engaged multiple stakeholders and used a Constellation Analysis (CA) tool to identify and visualize the elements of the ongoing veterinary and public health surveillance systems that are currently in place for AMR and Influenza. The stakeholders also delivered innovative insights regarding their views on the future OHSS. The participatory workshops consisted of four stages: (1) description of the case studies and their impact in Cuba; (2) validation of pre-designed CAs; (3) focus group discussions about the future OHSS; and (4) listing and discussing essential action points to develop and implement an OHSS. The workshops encompassed several group discussions and plenary sessions. The discussions were guided by a set of questions and supported by the CA tool. In both studies, we found that the transdisciplinary approach of the CA was suitable for encouraging group and plenary discussions. Stakeholder engagement is essential for the co-production of viable solutions to address complex health problems. Overall, this case illustrates how transdisciplinary research enables rapid co-production of knowledge among stakeholders that can inform both policy and practice.

Information
© The Authors 2023
An interrupted time series analysis of the cardiovascular health benefits of a coal coking operation closure
Authors: Yu Wuyue , Thurston George D 
Published: August 2023

Abstract
With the widespread implementation of air pollution mitigation strategies for health and climate policy, there is an emerging interest in accountability studies to validate whether a reduction of air pollution exposure, in fact, produces the human health benefits estimated from past air pollution epidemiology. The closure of a coal coking plant provides an ideal ‘natural’ experiment opportunity to rigorously evaluate the health benefits of air pollution emissions reductions. In this study, we applied an interrupted time series model to test the hypothesis that the substantial reduction in air pollution induced by the closure of the Shenango, Inc. coke plant in Pittsburgh, PA during January, 2016 was followed by immediate and/or longer-term cumulative local cardiovascular health benefits. We observed a 90% decrease in nearby SO2 levels, as well as significant reductions in coal-related fine particulate matter constituents (sulfate and arsenic), after the closure. Statistically significant cardiovascular health benefits were documented in the local population, including a 42% immediate drop (95% CI: 33%, 51%) in cardiovascular emergency department (ED) visits from the pre-closure mean. A longer-term downward trend was also observed for overall emergency visits at −0.14 (95% CI: −0.17, −0.11) visits per week rate of decrease after the closure, vs. a rise of 0.17 (95% CI: 0.14, 0.20) visits per week before. Similarly, inpatient cardiovascular hospitalizations per year showed a decrease after closure (−27.97 [95% CI: −46.90, −9.04], as compared with a 5.09 [95% CI: −13.84, 24.02] average increase in cases/year over the prior three years). Our study provides clear evidence that this intervention lowering fossil fuel-associated air pollution benefited public health in both the short and longer term, while also providing validation of the past use of observational air pollution epidemiology effect estimates in policy analyses.
Transient conduction disturbances acutely after pulsed-field cavotricuspid isthmus ablation: a case report
Authors: Andrikopoulos George , Tampakis Konstantinos , Sykiotis Alexandros , Pastromas Sokratis 
Published: August 2023

Abstract

Background
Cavotricuspid isthmus pulsed-field ablation has been recently described to be safely performed despite initial reports on coronary arterial spasm while conduction disturbances as a complication of cavotricuspid isthmus ablation are rare and have been reported exclusively for radiofrequency catheter ablation.

Case summary
A 64-year-old female patient with mechanical prosthetic valves underwent atrial fibrillation ablation using the pentaspline pulsed-field ablation catheter. At the end of the uneventful pulmonary vein isolation, an atrial tachycardia depended to the cavotricuspid isthmus occurred. A single pulsed-field application at the cavotricuspid isthmus resulted in right bundle branch block combined with posterior fascicular hemiblock and PR prolongation that resolved spontaneously within 12 h.

Discussion
This is the first report of transient conduction disturbances as a complication of cavotricuspid isthmus pulsed-field ablation. Although the underlying mechanism, either single or miscellaneous, was not verified, this case highlights that caution should be taken when the pentaspline pulsed-field ablation catheter is used for cavotricuspid isthmus ablation.
A case report of repeat clipping for recurrent severe mitral regurgitation from both sides of the clip: those who run after two hares may catch both
Authors: Iwaya Takuma , Amaki Makoto , Kanzaki Hideaki , Izumi Chisato 
Published: August 2023

Abstract

Background
Recurrent mitral regurgitation (MR) can occur even after successful transcatheter edge-to-edge mitral valve repair (TEER). While some reports show the utility of repeat clipping for recurrent MR, the results are unsatisfactory. We describe a patient who underwent repeat clipping for MR that recurred from both sides of the original clip.

Case summary
An 89-year-old male was admitted to our hospital with congestive heart failure. Transthoracic and transoesophageal echocardiograms (TTE/TEE) revealed severe MR due to A2 (middle segment of the anterior leaflet) prolapse. Because of his high operative risk, we performed TEER. An NTW clip was placed between A2 and P2 (middle scallop of the posterior leaflet), markedly reducing MR to mild. Six months after TEER, he complained of dyspnoea, and severe MR was evident from both sides of the clip. Although the risk of iatrogenic mitral stenosis was considered, we assessed that there might be a chance to succeed in repeat clipping if the additional two clips were placed only in the P2 beside the original clip following a careful review of TEE images. We challenged repeat clipping. After we placed NT clips on each side of the original NTW clip, MR was reduced to mild without creating iatrogenic mitral stenosis, and his symptoms subsequently improved.

Discussion
Anatomical features such as no valve thickening at the leaflet’s grasping site and the presence of posterior leaflet indentation may increase the likelihood of a successful repeat clipping outcome. Repeat clipping should be considered after careful anatomical assessment, even in patients with challenging anatomy.
Endemicity of Pseudomonas aeruginosa producing IMP-18 and/or VIM-2 MBLs from the high-risk clone ST111 in Central America
Authors: Deshpande Lalitagauri M , Vega Silvio , Tinoco Juan Carlos , Castanheira Mariana 
Published: August 2023

Abstract

Background
Pseudomonas aeruginosa is an important cause of serious nosocomial infections. Despite the overall genetic diversity of this species, highly conserved clonal complexes (CCs) have been observed among MDR isolates. Many of these CCs are associated with MBL-producing isolates.

Objectives
To evaluate five P. aeruginosa isolates from Central America that carried IMP-18- and/or VIM-2-encoding genes from the SENTRY Antimicrobial Surveillance Program (2017–2018).

Methods
Susceptibility testing was performed by broth microdilution (CLSI). WGS was performed using MiSeq (Illumina) and MinION (Oxford Nanopore). Assembled contigs from short and long reads were combined for in silico screening of resistance genes, MLST, core genome (cg)MLST and SNP analysis.

Results
The P. aeruginosa isolates were collected in Panama and Mexico from patients with urinary tract infections or pneumonia. Isolates were categorized as XDR (CLSI/EUCAST). All isolates belonged to ST111 but carried different combinations of resistance-encoding genes. Transposon-associated MBL genes, blaIMP-18 and/or blaVIM-2, were chromosomally located. blaIMP-18 was detected in an In1666 integron whereas blaVIM-2 was embedded in an In59-like integron. Isolates were closely related based on cgMLST (average allele distance 2–34) and SNP analysis (5–423 different SNPs).

Conclusions
MBL-producing ST111 P. aeruginosa have become endemic in Panama and may have spread to Mexico via clonal dissemination. Recombination events are apparent in the evolution of this CC. Surveillance is warranted to track the expansion and movement of this clone.
Stability-Indicating Densitometric Analysis of Evogliptin Tartrate in Bulk and Tablet Dosage Form
Authors: Srivastava Shruti , Dhaneshwar Suneela , Kawathekar Neha 
Published: August 2023

Abstract

Background
Evogliptin tartrate is a novel dipeptidyl peptidase (DPP-4) inhibitor very recently introduced into the market as an oral hypoglycemic drug.

Objective
The literature review has revealed no reports of stability-indicating analytical methods so far for evogliptin tartrate. Thus, the goal of this study was to develop and validate a stability-indicating high-performance thin-layer chromatography (HPTLC) method for evogliptin tartrate in bulk and tablet dosage form.

Method
For the study, precoated plates of silica gel 60F254 were used as stationary phase and acetonitrile–water–formic acid (30:8:2, v/v/v) was used as a developing system. The densitometric scanning was performed at 270 nm, and the method was validated as per International Council for Harmonisation (ICH) guidelines for accuracy, precision, limit of detection (LOD), and limit of quantitation (LOQ). Evogliptin was subjected to forced degradation studies and was exposed to various stress conditions such as acid/base hydrolysis, oxidation, thermal stress, and UV light.

Results
The developed method furnished compact spots of evogliptin (Rf 0.62 ± 0.05) and was linear in the concentration range of 1–5 µg/spot. The lowest detection and quantitation values were found to be 0.331 and 1.003 µg/spot, respectively, and % recovery was found to be 101.09. The low RSD values (below 2%) for intra-day (% RSD 1.86) and inter-day (% RSD 1.43) precision studies demonstrated the preciseness of the developed method.

Conclusions
All the validation parameters were found to be within the acceptable range prescribed by ICH guidelines, indicating that the developed method was accurate, precise, selective, and reproducible. A total of five degradation products were resolved under various stress conditions.

Highlights
The proposed method has a promising application commercially for identification, routine quantitative determination, and monitoring of stability of the evogliptin tartrate in bulk and tablet dosage forms to guarantee its safety, efficacy, and quality. Moreover, the developed method will also help in formulation development and in determining the appropriate storage conditions.
Spontaneous Pneumomediastinum Secondary to Undiagnosed Asthma in Military Adult
Authors: Klamfoth Jeanette , Koroscil Matthew 
Published: August 2023

ABSTRACT
Spontaneous pneumomediastinum (SPM) is a rare but described complication of exercise-induced bronchoconstriction (EIB), more commonly observed in children with asthma. We present a 23-year-old active duty military male and avid distance runner who developed progressive radiating retrosternal chest pain preceded by wheezing and coughing paroxysm. A chest computed tomography revealed extensive pneumomediastinum. SPM results from increased intrathoracic pressure with alveolar rupture and subsequent tracking of air between fascial planes. Like most cases of SPM, our patient remained hemodynamically stable and responded well to conservative therapies with complete resolution. After thorough evaluation, undiagnosed asthma was determined to be the inciting etiology. The patient is now well controlled and symptom free on a daily low-dose inhaled corticosteroid without SPM reoccurrence. In young adult patients presenting with SPM, EIB and asthma should be considered on the differential diagnosis as appropriate medical therapy will improve symptoms and reduce risk of reoccurrence.
New-onset severe eosinophilic granulomatosis with polyangiitis following the third dose of mRNA COVID-19 vaccine: A case report
Authors: Mahdi Salah , Joudeh Anwar I , Raman Krishnamoorthy Sundara , Faqih Samia Ait , Alhatou Mohammed Ibrahim , Wadiwala Muhammad Faisal , Akhtar Mohammed , Lutf Abdo Qaid Ahmed 
Published: August 2023

ABSTRACT
Eosinophilic granulomatosis with polyangiitis (EGPA) is a complex multifactorial disease that results in multisystemic inflammation of the small- and medium-sized arteries. The exact pathogenesis of this syndrome is poorly understood, but it is postulated to result from a combination of eosinophilic dysfunction, genetic predisposition, and the development of autoantibodies after exposure to an unknown stimulus. We describe a case of new-onset EGPA following the third dose of the Pfizer-BioNTech mRNA vaccine in an infection-naive middle-aged man with a background history of allergic respiratory symptoms. The patient developed acute onset of mononeuritis multiplex, pauci-immune glomerulonephritis, and leucocytoclastic vasculitis 10 days after receiving the booster dose. His laboratory markers including eosinophil count, antineutrophil cytoplasmic antibodies, and renal function tests improved markedly after the initiation of pulse steroid therapy and rituximab infusion. However, his peripheral muscle weakness and neuropathic pain did not respond to the initial therapy but improved later with intravenous cyclophosphamide and intravenous immunoglobulin. To the best of our knowledge, this is the fourth case report of post-coronavirus disease 2019 vaccination precipitation of EGPA. All reported cases including our report were in patients with previous allergic manifestations who received mRNA-based coronavirus disease 2019 vaccines, and all the patients developed mononeuritis multiplex at presentation. Despite the few reported cases of post-vaccination autoimmune phenomena, the temporal association between vaccination administration and disease onset does not indicate causality, given the mass vaccination programmes employed. However, the novel use of the mRNA platform in vaccine delivery necessitates vigilant monitoring by the scientific committee.
Incidence and Prevalence of Hepatitis C Virus Among HIV-Negative Gay and Bisexual Men Using HIV Pre-exposure Prophylaxis (PrEP): A Systematic Review and Meta-analysis
Authors: Traeger Michael W , Harney Brendan L , Sacks-Davis Rachel , van Santen Daniela K , Cornelisse Vincent J , Wright Edwina J , Hellard Margaret E , Doyle Joseph S , Stoové Mark A 
Published: August 2023

Abstract

Background
Gay and bisexual men using HIV pre-exposure prophylaxis (PrEP) are at increased risk for sexually transmissible infections. Hepatitis C virus (HCV) risk among PrEP users is less clear. We explored HCV prevalence and incidence among cohorts of gay and bisexual men using PrEP and sources of heterogeneity across studies.

Methods
This was a systematic review and meta-analysis of open-label PrEP studies to April 2022 reporting HCV prevalence at baseline or incidence during follow-up among gay and bisexual men using PrEP. Pooled prevalence and incidence estimates were calculated using random-effects meta-analysis, and subgroup analyses were performed by study- and country-level characteristics, including availability of HCV direct-acting antiviral (DAA) therapy at time of study.

Results
Twenty-four studies from 9 countries were included, with a total sample of 24 733 gay and bisexual men. Pooled HCV antibody baseline prevalence was 0.97% (95% CI, 0.63%–1.31%), and pooled HCV RNA baseline prevalence was 0.38% (95% CI, 0.19%–0.56%). Among 19 studies reporting HCV incidence, incidence ranged from 0.0 to 2.93/100 person-years (py); the pooled estimate was 0.83/100py (95% CI, 0.55–1.11). HCV incidence was higher in 12 studies that began follow-up before broad DAA availability (1.27/100py) than in 8 studies that began follow-up after broad DAA availability (0.34/100py) and higher in studies in Europe compared with North America and Australia.

Conclusions
Early reports of high HCV incidence among PrEP-using cohorts likely reflect enrollment of individuals based on specific risk-based eligibility criteria for smaller studies and enrollment before DAA scale-up. In contexts where both DAAs and PrEP have been implemented at scale, studies report lower HCV incidence. PrEP-specific HCV testing guidelines should be guided by local epidemiology.
Biologics to treat anaphylaxis
Authors: Yang Barbara C. 
Published: August 2023

Purpose of review
The purpose of this literature review was to review the latest use of biologics in the management of anaphylaxis. The methodology was to highlight both the nonbiologic management of anaphylaxis and the biologic management and how they can be used in conjunction with each other.

Recent findings
As the phenotypes and endotypes of anaphylaxis are better portrayed, it furthers our understanding of the mechanisms of anaphylaxis. New applications of existing biologics to the prevention of anaphylaxis are described.

Summary
Anaphylaxis is a potentially life-threatening acute hypersensitivity reaction affecting up to 16.8% of the U.S. population. Acute management entails swift identification, removal of the causative agent, and the prevention of cardiovascular collapse, firstly with epinephrine. Adjunctive treatments such as antihistamines work to prevent anaphylaxis from recurring. Biologic management of anaphylaxis involves the use of large-molecule drugs such as monoclonal antibodies. Omalizumab, an IgG1 monoclonal antibody targeting unbound IgE, is the most prevalent and widely studied biologic in the prevention of anaphylaxis. Other monoclonal antibodies in development or approved for other indications, such as ligelizumab, quilizumab, MEDI4212, and dupilumab, may also have potential for preventing anaphylaxis through various mechanisms.