bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergence of fentanyl‐related deaths in Travis County, Texas and surrounding areas: A retrospective review of postmortem fentanyl‐related drug toxicities from 2020 to 2022
Authors: Ellefsen Kayla N. , Smith Christina R. , Taylor Elizabeth A. , Hall Brad J. 
Published: May 2023

AbstractThe opioid epidemic has affected the United States (US) for decades with fentanyl and its analogs accounting for a recent surge in morbidity and mortality. Currently, there is a relative lack of information characterizing fentanyl‐related fatalities specifically in the Southern US. A retrospective study was conducted to examine all postmortem fentanyl‐related drug toxicities in Travis County, Texas, encompassing Austin (one of the fastest‐growing cities in the US), from 2020 to 2022. Fentanyl contributed to 2.6% and 12.2% of deaths submitted for toxicology between 2020 and 2022, respectively, representing a 375% increase in fentanyl‐related deaths over this 3‐year period (n = 517). Fentanyl‐related fatalities primarily occurred in males in their mid‐30s. Fentanyl and norfentanyl concentrations ranged from 0.58 to 320 ng/mL and 0.53 to 140 ng/mL with mean (median) concentrations of 17.2 ± 25.0 (11.0) and 5.6 ± 10.9 (2.9) ng/mL, respectively. Polydrug use was present in 88% of cases, with methamphetamine (or other amphetamines) (25%), benzodiazepines (21%), and cocaine (17%) representing the most frequently identified concurrent substances. Co‐positivity rates of various drugs and drug classes widely varied over time. Scene investigations reported illicit powder(s) (n = 141) and/or illicit pill(s) (n = 154) in 48% (n = 247) of fentanyl‐related deaths. Illicit oxycodone (44%, n = 67) and illicit “Xanax” (38%, n = 59) pills were frequently reported on scene; however, toxicology only identified oxycodone and alprazolam in 2 and 24 of these cases, respectively. The results of this study provide a better understanding of the fentanyl epidemic in this region creating an opportunity to promote increased awareness, shift focus to harm reduction, and aid in minimizing public health risks.
Preparation of a broad‐specificity antibody against zearalenone and its primary analogues and development of immunoassay of Coicis Semen and related products
Authors: Tian Jiao , Luo Jiaoyang , Qin Jiaan , Wang Yudan , Sun Xinqi , Zhang Jing , Ke Tongwei , Guo Mengyue , Ruan Haonan , An Fang , Yang Meihua 
Published: May 2023

AbstractThe purpose of this study was to prepare a highly sensitive and specific zearalenone (ZEN) monoclonal antibody, which was then used to develop an indirect enzyme‐linked immunosorbent assay (ic‐ELISA) and a colloidal gold immunochromatographic assay (GICA). These techniques were used for the detection of Coicis Semen and related products (Coicis Semen flour, Yimigao, and Yishigao). Immunogens were synthesized by oxime active ester techniques and characterized via ultraviolet spectrophotometry. Immunogens were injected subcutaneously into the abdominal cavities and backs of mice. Using the prepared antibodies, we developed ic‐ELISA and GICA rapid detection methods, which were then applied for the rapid detection of ZEN and its analogues from Coicis Semen and related products. For ic‐ELISA, the half maximal inhibitory concentration (IC50) values for ZEN, α‐zearalenol (α‐ZEL), β‐zearalenol (β‐ZEL), zearalanone (ZAN), α‐zearalanol (α‐ZAL), and β‐zearalanol (β‐ZAL) were determined to be 1.13, 1.69, 2.06, 0.66, 1.20, and 0.94 ng•mL−1, respectively. For GICA, the cutoff values of ZEN, α‐ZEL, β‐ZEL, α‐ZAL, and β‐ZAL on test strips were 0.5 ng•mL−1 in phosphate buffer saline (0.01 M, pH 7.4), while ZAN was found to be 0.25 ng•mL−1. Furthermore, the cutoff values of test strips were between 10 and 20 µg∙kg−1 in Coicis Semen and related products. The results of these two detection methods were in good agreement with results from liquid chromatography‐tandem mass spectrometry. This study provides technical support for the preparation of broad‐specificity monoclonal antibodies against ZEN and lays the foundation for the simultaneous detection of multiple mycotoxins from food and herbal medicines.
Levels of preoperative cerebrospinal fluid pro‐inflammatory mediators and chronic pain after total knee arthroplasty surgery
Authors: Kato Jungo , Murase Reiko , Minoshima Rie , Lu Fanglin , Toramaru Tomoko , Niki Yasuo , Kosugi Shizuko , Morisaki Hiroshi 
Published: May 2023

AbstractBackgroundPatients undergoing total knee arthroplasty (TKA) surgery are at high risk of chronic postsurgical pain (CPSP). Accumulating evidence suggests an active role of neuroinflammation in chronic pain. However, its role in the progression to CPSP following TKA surgery remains unanswered. Here, we examined the associations between preoperative neuroinflammatory states and pre‐ and postsurgical chronic pain in TKA surgery.MethodsThe data of 42 patients undergoing elective TKA surgery for chronic knee arthralgia at our hospital were analyzed in this prospective study. Patients completed the following questionnaires: brief pain inventory (BPI), hospital anxiety and depression scale, painDETECT, and pain catastrophizing scale (PCS). Cerebrospinal fluid (CSF) samples were collected preoperatively and concentrations of IL‐6, IL‐8, TNF, fractalkine, and CSF‐1 were measured by electrochemiluminescence multiplex immunoassay. CPSP severity was ascertained, using the BPI, 6 months postsurgery.ResultsWhile no significant correlation was observed between the preoperative CSF mediator levels and preoperative pain profiles, the preoperative fractalkine level in the CSF showed a significant correlation with CPSP severity (Spearman's rho = −0.525; p = .002). Furthermore, multivariate linear regression analysis revealed that the preoperative PCS score (standardized β coefficient [β]: .11; 95% confidence interval [CI]: 0.06–0.16; p < .001) and CSF fractalkine level (β: −.62; 95% CI: −1.10 to −0.15; p = .012) were independent predictors of CPSP severity 6 months after TKA surgery.ConclusionsWe identified the CSF fractalkine level as a potential predictor for CPSP severity following TKA surgery. In addition, our study provided novel insights into the potential role of neuroinflammatory mediators in the pathogenesis of CPSP.
Antipsychotics and obsessive–compulsive disorder/obsessive–compulsive symptoms: A pharmacovigilance study of the FDA adverse event reporting system
Authors: Burk Bradley G. , DiGiacomo Tilyn , Polancich Shea , Pruett Brandon S. , Sivaraman Soumya , Birur Badari 
Published: May 2023

AbstractObjectiveAntipsychotics have conflicting data with respect to obsessive–compulsive disorder/symptoms (OCD/OCS), with some reporting causality and some reporting treatment benefits. This pharmacovigilance study aimed to investigate reporting of OCD/OCS in association with the use of antipsychotics in comparison to one another, as well as treatment failure using data derived from the FDA Adverse Event Reporting System (FAERS).MethodsData from January 1st, 2010 to December 31st, 2020 on suspected adverse drug reactions (ADRs) including OCD/OCS was obtained. The information component (IC) was used to determine a disproportionality signal, and reporting odds ratio (ROR) calculations were performed via intra‐class analyses to discern differences between the evaluated antipsychotics.ResultsA total of 1454 OCD/OCS cases were utilized in IC and ROR calculations and 385,972 suspected ADRs were used as non‐cases. A significant disproportionality signal was seen with all second generation antipsychotics. Relative to other antipsychotics, only aripiprazole had a significant ROR of 23.87 (95% CI: 21.01–27.13; p < 0.0001). The ROR for antipsychotic treatment failure in those with OCD/OCS was highest with aripiprazole, and lowest with risperidone and quetiapine. Sensitivity analyses were largely in favor of the primary findings. Our analysis appears to implicate the 5‐HT1A receptor or an imbalance between this receptor and the D2‐receptor in antipsychotic treatment‐emergent OCD/OCS.ConclusionsIn contrast to prior reports noting clozapine as the antipsychotic most commonly associated with de novo or exacerbated OCD/OCS, this pharmacovigilance study found aripiprazole was most frequently reported for this adverse effect. While these findings from FAERS offer a unique perspective on OCD/OCS with different antipsychotic agents, due to the inherent limitations of pharmacovigilance studies they should ideally be validated through alternative prospective research studies involving direct comparisons of antipsychotic agents.
What is important to medical students' online learning of dental trauma in medical education
Authors: Yeng Thai 
Published: May 2023

AbstractTraumatic dental injury (TDI), a topic not normally offered in the medical curriculum is made available through the medical school as an online learning course. Online learning provides an educational pathway for cross‐disciplinary learning without any change to the existing curriculum. This research identified important key features that should be included in the design of an online course to provide a positive online learning experience for medical students. Ten important features were identified for medical educators to consider when they develop an online course to introduce dental trauma. These features are (1) prioritising information to TDI, (2) providing specific facts and information to TDI, (3) information must be easily retrieved, (4) providing career‐related information, (5) promoting self‐confidence, (6) promoting learning of new knowledge, (7) easy‐to‐understand content materials, (8) establishing a logical sequence of learning, (9) visual illustrations to complement written text and (10) promoting self‐directed learning.
Sinus inflammation and chronic rhinosinusitis are associated with a diagnosis of new onset asthma in the following year
Authors: Schwartz Brian S. , Pollak Jonathan S. , Bandeen‐Roche Karen , Hirsch Annemarie G. , Lehmann Ashton E. , Kern Robert C. , Tan Bruce K. , Kato Atsushi , Schleimer Robert P. , Peters Anju T. 
Published: May 2023

AbstractBackgroundChronic rhinosinusitis (CRS) and asthma commonly co‐occur. No studies have leveraged large samples needed to formally address whether preexisting CRS is associated with new onset asthma over time.MethodsWe evaluated whether prevalent CRS [identified in two ways: validated text algorithm applied to sinus computerized tomography (CT) scan or two diagnoses] was associated with new onset adult asthma in the following year. We used electronic health record data from Geisinger from 2008 to 2019. For each year we removed persons with any evidence of asthma through the end of the year, then identified those with new diagnosis of asthma in the following year. Complementary log–log regression was used to adjust for confounding variables (e.g., sociodemographic, contact with the health system, comorbidities), and hazard ratios (HRs) and 95% confidence intervals (CI) were calculated.ResultsA total of 35,441 persons were diagnosed with new onset asthma and were compared to 890,956 persons who did not develop asthma. Persons with new onset asthma tended to be female (69.6%) and younger (mean [SD] age 45.9 [17.0] years). Both CRS definitions were associated (HR, 95% CI) with new onset asthma, with 2.21 (1.93, 2.54) and 1.48 (1.38, 1.59) for CRS based on sinus CT scan and two diagnoses, respectively. New onset asthma was uncommonly observed in persons with a history of sinus surgery.ConclusionPrevalent CRS identified with two complementary approaches was associated with a diagnosis of new onset asthma in the following year. The findings may have clinical implications for the prevention of asthma.
Novel application to evaluate endometrial blood flow using transvaginal superb microvascular imaging: A preliminary study describing physiological changes from ovulation to mid‐luteal phase
Authors: Mitao Hiroshi , Yoshizato Toshiyuki , Fujita Tomoyuki , Fukagawa Mayumi , Nakashima Akira , Horinouchi Takashi , Ushijima Kimio 
Published: May 2023

AbstractIntroductionWe aimed to describe physiological changes in endometrial blood flow (minute arterioles running through the endometrium) from ovulation to the mid‐luteal phase using superb microvascular imaging.Material and methodsThe study involved 17 women (median age, 32.5 years; first to third interquartile range, 29.8–40.0 years) with regular menstrual cycles who were managed in our institute from 2020 to 2021. The uterus was delineated at the sagittal section using transvaginal ultrasonography incorporated with superb microvascular imaging. For each participant, a total of 28 cycles were observed; 17 cycles observed within one day of ovulation and the implantation period, 5–7 days (D5–7) after ovulation in the same cycle, and nine cycles in which only ovulation was observed, and two cycles in which only D5–7 was observed. Therefore, 26 and 19 images at ovulation and D5–7, respectively, were acquired. Endometrial blood flow was evaluated by depth of the vascular signal in the endometrium and categorized as follows: signals only in the basal layer of the endometrium (grade 1), reaching up to half the endometrium (grade 2), and covering the whole endometrium (grade 3). Changes in the grade of endometrial blood flow from ovulation to D5–7 after ovulation, and the relationship between the grade of endometrial blood flow and the endometrial thickness on ovulation and D5–7 after ovulation, were analyzed. Statistical significance was set at p < 0.05.ResultsThe endometrial blood flow from ovulation to D5–7 after ovulation during the same menstrual period showed a downgrade in 14 of 17 cycles (82.3%) and no change in the remaining three cycles (17.6%), indicating a decrease in the endometrial blood flow from ovulation to D5–7 after ovulation (p = 0.001). There were differences between the grade of endometrial blood flow and median endometrial thickness on ovulation (grade 1: 5.9 mm, grade 2: 9.1 mm, and grade 3: 11.2 mm); however, no differences in the endometrial thickness were found between the grades on D5–7 after ovulation.ConclusionsIn the normal menstrual cycle, endometrial blood flow decreased from ovulation to the mid‐luteal phase, and the endometrial thickness in the ovulatory phase was related to the endometrial perfusion.
Trends and projections of ovarian cancer incidence in Hong Kong: A population‐based study
Authors: Chen Xiangbo , Du Jianqiang , Wang Xiaoyan , Wu Xiaoming 
Published: May 2023

AbstractIntroductionThis study analyzed the incidence of ovarian cancer in Hong Kong and its association with age, calendar period and birth cohort, made projections through 2030, and attributed differences in new cancer cases to demographic and epidemiologic changes.Material and methodsIncidence data for ovarian cancer were obtained from the Hong Kong Cancer Registry. We employed the age‐period‐cohort modeling approach to investigate the association between ovarian cancer incidence and age in Hong Kong women, with particular emphasis on examining the changing trends of period and cohort effects on incidence. We projected the incidence of ovarian cancer in Hong Kong between 2018 and 2030 and attributed the rise in new cancer cases to epidemiologic and demographic shifts.ResultsBetween 1990 and 2017, a total of 11 182 women were diagnosed with ovarian cancer in Hong Kong. Crude and age‐standardized rates increased from 8.2 and 7.8 per 100 000 person‐years to 16.3 and 11.5 per 100 000 person‐years, respectively. New cases of ovarian cancer rose from 225 in 1990 to 645 in 2017. We observed an increased risk of ovarian cancer throughout the study period and in the post‐1940 birth cohort. The projected incidence rate and new cases of ovarian cancer are expected to continue growing due to demographic and epidemiologic changes such as fertility patterns and lifestyle factors, with an estimated 981 cases in 2030.ConclusionsThe period risk and cohort risk of ovarian cancer among Hong Kong women is increasing. Demographic and epidemiologic changes may continue to increase ovarian cancer incidence and new cases in Hong Kong.
Financial inclusion as a tool for sustainable macroeconomic growth: An integrative analysis
Authors: Chavriya Shubham , Sharma Gagan Deep , Mahendru Mandeep 
Published: May 2023

AbstractDespite extensive research on the relationship between financial inclusion and macroeconomic growth, little is known about the role of financial inclusion as a significant driver of macroeconomic growth in developing countries. Financial inclusion could boost sustainable macroeconomic growth, which has been a key policy goal for governments worldwide because it affects employment, population, inequality, and poverty. This study explores the influence of crucial financial inclusion indicators on developing countries' macroeconomic growth. The study shows that digital finance, financial technologies, financial outreach, financial literacy, demographics access to finance, microfinance and financial stability are the ways through which financial inclusion affects macroeconomic growth. We used the Scopus database to get information from 419 research articles and analyzed those to figure out how financial inclusion affected macroeconomic growth from 2006 to 2020. The study will help policymakers, governments, and marketers develop policies to involve everyone in the financial system, which results in macroeconomic growth.
‘The sword that was broken …’: The detection of recycled iron in the archaeological record
Authors: Bentley McKenzie R. , Gilmour Brian , Pollard A. Mark 
Published: May 2023

AbstractAlthough the recycling of materials such as copper and glass is widely known and generally well understood within archaeological contexts, far less is known about the recycling of iron. Iron recycling is more complex than that of other metals for two reasons. First, normal manufacturing processes, which include forging several components to make a composite object, offer the opportunity to include recycled iron. Second, the material itself is more complex than Cu alloys. The alloys of Fe, depending primarily on C content, are very different in terms of properties and can be interconverted by (normally) removing C such as decarburizing cast iron to make wrought iron. Thus, recycling practices are potentially intimately combined with such processes. These factors, combined with the poor preservation of archaeological iron and the consequent reluctance to carry out extensive studies (which often require destructive analysis via metallography), mean that there are no clear criteria for identifying recycled iron. However, limited historical documentation suggests, at least indirectly, that such recycling was common. This paper is neither comprehensive nor definitive, but merely intends to promote discussion and awareness of iron recycling by hypothesizing several possible mechanisms and providing a few illustrative archaeological examples.
Using natural language processing to support peer‐feedback in the age of artificial intelligence: A cross‐disciplinary framework and a research agenda
Authors: Bauer Elisabeth , Greisel Martin , Kuznetsov Ilia , Berndt Markus , Kollar Ingo , Dresel Markus , Fischer Martin R. , Fischer Frank 
Published: May 2023

Advancements in artificial intelligence are rapidly increasing. The new‐generation large language models, such as ChatGPT and GPT‐4, bear the potential to transform educational approaches, such as peer‐feedback. To investigate peer‐feedback at the intersection of natural language processing (NLP) and educational research, this paper suggests a cross‐disciplinary framework that aims to facilitate the development of NLP‐based adaptive measures for supporting peer‐feedback processes in digital learning environments. To conceptualize this process, we introduce a peer‐feedback process model, which describes learners' activities and textual products. Further, we introduce a terminological and procedural scheme that facilitates systematically deriving measures to foster the peer‐feedback process and how NLP may enhance the adaptivity of such learning support. Building on prior research on education and NLP, we apply this scheme to all learner activities of the peer‐feedback process model to exemplify a range of NLP‐based adaptive support measures. We also discuss the current challenges and suggest directions for future cross‐disciplinary research on the effectiveness and other dimensions of NLP‐based adaptive support for peer‐feedback. Building on our suggested framework, future research and collaborations at the intersection of education and NLP can innovate peer‐feedback in digital learning environments.
Practitioner notesWhat is already known about this topic

There is considerable research in educational science on peer‐feedback processes.
Natural language processing facilitates the analysis of students' textual data.
There is a lack of systematic orientation regarding which NLP techniques can be applied to which data to effectively support the peer‐feedback process.
What this paper adds

A comprehensive overview model that describes the relevant activities and products in the peer‐feedback process.
A terminological and procedural scheme for designing NLP‐based adaptive support measures.
An application of this scheme to the peer‐feedback process results in exemplifying the use cases of how NLP may be employed to support each learner activity during peer‐feedback.
Implications for practice and/or policy

To boost the effectiveness of their peer‐feedback scenarios, instructors and instructional designers should identify relevant leverage points, corresponding support measures, adaptation targets and automation goals based on theory and empirical findings.
Management and IT departments of higher education institutions should strive to provide digital tools based on modern NLP models and integrate them into the respective learning management systems; those tools should help in translating the automation goals requested by their instructors into prediction targets, take relevant data as input and allow for evaluating the predictions.
Pregnenolone sulfate analogues differentially modulate GABAA receptor closed/desensitised states
Authors: Mortensen Martin , Xu Yue , Shehata Mohamed A. , Krall Jacob , Ernst Margot , Frølund Bente , Smart Trevor G. 
Published: May 2023

Background and PurposeGABAA receptors are regulated by numerous classes of allosteric modulators. However, regulation of receptor macroscopic desensitisation remains largely unexplored and may offer new therapeutic opportunities. Here, we report the emerging potential for modulating desensitisation with analogues of the endogenous inhibitory neurosteroid, pregnenolone sulfate.Experimental ApproachNew pregnenolone sulfate analogues were synthesised incorporating various heterocyclic substitutions located at the C‐21 position on ring D. The pharmacological profiles of these compounds were assessed using electrophysiology and recombinant GABAA receptors together with mutagenesis, molecular dynamics simulations, structural modelling and kinetic simulations.Key ResultsAll seven analogues retained a negative allosteric modulatory capability whilst exhibiting diverse potencies. Interestingly, we observed differential effects on GABA current decay by compounds incorporating either a six‐ (compound 5) or five‐membered heterocyclic ring (compound 6) on C‐21, which was independent of their potencies as inhibitors. We propose that differences in molecular charges, and the targeted binding of analogues to specific states of the GABAA receptor, are the most likely cause of the distinctive functional profiles.Conclusions and ImplicationsOur findings reveal that heterocyclic addition to inhibitory neurosteroids not only affected their potency and macroscopic efficacy but also affected innate receptor mechanisms that underlie desensitisation. Acute modulation of macroscopic desensitisation will determine the degree and duration of GABA inhibition, which are vital for the integration of neural circuit activity. Discovery of this form of modulation could present an opportunity for next‐generation GABAA receptor drug design and development.