bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients with naproxen‐induced liver injury display T‐cell memory responses toward an oxidative (S)‐O‐desmethyl naproxen metabolite but not the acyl glucuronide
Authors: Thomson Paul , Fragkas Nik , Kafu Laila M. , Aithal Guruprasad P. , Lucena M. Isabel , Terracciano Luigi , Meng Xiaoli , Pirmohamed Munir , Brees Dominique , Kullak‐Ublick Gerd A. , Odermatt Alex , Hammond Thomas , Kammüller Michael , Naisbitt Dean J. 
Published: July 2023

AbstractBackgroundExposure to nonsteroidal anti‐inflammatory drugs (NSAIDs) such as ibuprofen (IBU) and naproxen (NAP) is associated with idiosyncratic drug‐induced liver injury (DILI). Carboxylate bioactivation into reactive metabolites (e.g., acyl glucuronides, AG) and resulting T‐cell activation is hypothesized as causal for this adverse event. However, conclusive evidence supporting this is lacking.MethodsIn this work, we identify CD4+ and CD8+ T‐cell hepatic infiltration in a biopsy from an IBU DILI patient. Lymphocyte transformation test and IFN‐γ ELIspot, conducted on peripheral blood mononuclear cells (PBMCs) of patients with NAP‐DILI, were used to explore drug‐specific T‐cell activation. T‐cell clones (TCC) were generated and tested for drug specificity, phenotype/function, and pathways of T‐cell activation. Cells were exposed to NAP, its oxidative metabolite 6‐O‐desmethyl NAP (DM‐NAP), its AG or synthesized NAP‐AG human‐serum albumin adducts (NAP‐AG adduct).ResultsCD4+ and CD8+ T‐cells from patients expressing a range of different Vβ receptors were stimulated to proliferate and secrete IFN‐γ and IL‐22 when exposed to DM‐NAP, but not NAP, NAP‐AG or the NAP‐AG adduct. Activation of the CD4+ TCC was HLA‐DQ‐restricted and dependent on antigen presenting cells (APC); most TCC were activated with DM‐NAP‐pulsed APC, while fixation of APC blocked the T‐cell response. Cross‐reactivity was not observed with structurally‐related drugs.ConclusionOur results confirm hepatic T‐cell infiltrations in NSAID‐induced DILI, and show a T‐cell memory response toward DM‐NAP indicating an immune‐mediated basis for the adverse event. Whilst bioactivation at the carboxylate group is widely hypothesized to be pathogenic for NSAID associated DILI, we found no evidence of this with NAP.
The impact of delay and prehospital factors on acute appendicitis severity in New Zealand children: a national prospective cohort study
Authors: Elliott Brodie M. , Bissett Ian P. , Harmston Christopher ,   STRATA Collaborative
Published: July 2023

AbstractBackgroundAppendicitis is the most common reason children undergo acute general surgery but international, population‐level disparities exist. This is hypothesised to be caused by preoperative delay and differential access to surgical care. The impact of prehospital factors on paediatric appendicitis severity in New Zealand is unknown.MethodsA prospective, multicentre cohort study with nested parental questionnaire was conducted by a national trainee‐led collaborative group. Across 14 participating hospitals, 264 patients aged ≤16 years admitted between January and June 2020 with suspected appendicitis were screened. The primary outcome was the effect of prehospital factors on the American Association for the Surgery of Trauma (AAST) anatomical severity grade.ResultsOverall, 182 children had confirmed appendicitis with a median age of 11.6. The rate of complicated appendicitis rate was 38.5% but was significantly higher in rural (44.1%) and Māori children (54.8%). Complicated appendicitis was associated with increased prehospital delay (47.8 h versus 20.1 h; P < 0.001), but not in‐hospital delay (11.3 h versus 13.3 h; P = 0.96). Multivariate analysis revealed increased anatomical severity in rural (OR 4.33, 95% CI 1.78–7.25; P < 0.001), and Māori children (OR 2.39, 95% CI 1.24–5.75; P = 0.019), as well as in families relying on external travel sources or reporting unfamiliarity with appendicitis symptomology.ConclusionPrehospital delay and differential access to prehospital determinants of health are associated with increased severity of paediatric appendicitis. This manifested as increased severity of appendicitis in rural and Māori children. Understanding the pre‐hospital factors that influence the timing of presentation can better inform health‐system improvements.
Exploring the experiences and perspectives of women on oral health during pregnancy: A qualitative study in Tasmania, Australia
Authors: Wilson Annika , Hoang Ha , Crocombe Leonard , Bridgman Heather , Bettiol Silvana 
Published: July 2023

AbstractObjectiveTo explore women's oral health experiences and barriers to dental care and identify potential strategies to improve oral health during pregnancy.MethodsA qualitative descriptive study design was used. Purposively elected antepartum and postpartum women ≥18 years of age from Tasmania, Australia, were recruited using maximum variation sampling. Semi‐structured interviews were conducted, and all qualitative data were analysed using an inductive thematic approach.ResultsFifteen women were interviewed with a mean ± SD age of 32.3 ± 4.5 years. Three key themes were generated from the data that described women's perceived changes in their oral health during pregnancy; barriers to oral health care during and after pregnancy; and perceived strategies to improve access to care. Most women acknowledged the importance of maintaining good oral health but reported a decline in their oral health status during pregnancy. Women also identified several barriers to dental care, including treatment costs, competing maternal priorities, limited oral health knowledge and negative perceptions towards dentistry. The provision of preventative oral health care by ANC providers was also limited. Community awareness, patient education resources and assessment tools could support the promotion of oral health care. Women also perceived that interprofessional collaboration between antenatal and dental providers played a key role in promoting oral health.ConclusionThis study explored women's varied oral health experiences and perceptions during pregnancy and highlighted critical barriers and enablers to dental care. Policy‐level strategies that promote interprofessional collaboration between antenatal and dental providers and expand dental care access are suggested to overcome barriers to oral health for women during pregnancy.
Predisposing factors of non‐syndromic cleft lip and cleft palate in the northern Thai population: A 10‐year retrospective case–control study
Authors: Charoenvicha Chirakan , Wongkawinwoot Karn , Sirikul Wachiranun , Khwanngern Krit , Sirimaharaj Wimon 
Published: July 2023

AbstractThe most common congenital anomaly is orofacial cleft, which is categorized into two main types: cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO). One of the most accepted etiologies is multifactorial (gene–environment). This study aimed to identify the amendable risk factors of an orofacial cleft in Northern Thailand. A retrospective case–control study in Maharaj Nakorn Chiang Mai Hospital was conducted from 2011 to 2020. One hundred and seventeen cases of CL/P and CPO were included. Forty‐nine normal children were enrolled in a time‐matched control group. Exploratory survey data on maternal exposures were collected. Multivariate logistic regression was used to estimate the adjusted association between maternal exposures and CL/P, and CPO occurrence. Multivariate analysis identified three predisposing factors that increased the risk of CL/P and CPO. The first factor was caffeine consumption with a total amount of 560 mg/week (adjusted OR: 7.59; 95% CI: 2.48–23.23; p < 0.001). The second factor was any smoker or passive smoking (adjusted OR: 8.47; 95% CI: 1.63–43.92; p = 0.011). The third factor was a low socioeconomic status (income of lower than 270 USD/month; adjusted OR: 4.05; 95% CI: 1.07–15.27; p = 0.039). From the 10‐year study in Northern Thailand: caffeine consumption, exposure to cigarette smoke, and low socioeconomic status were identified as associated negative factors for orofacial clefts. We propose that preconceptional counseling for risk reduction should be emphasized in reducing the mother's exposure to these factors. Future investigations in large multicenter populations are suggested.
Patient satisfaction with stoma care and their expectations on mobile apps for supportive care
Authors: van der Storm Sebastiaan L. , Hensen Nikita , Schijven Marlies P. 
Published: July 2023

AbstractAimSelf‐efficacy in stoma care is essential, as it reduces morbidity and psychosocial problems. Mobile applications (apps) may optimise patients' self‐efficacy. This article investigates patients' satisfaction with stoma care, their attitudes towards a supporting app aiming to promote self‐efficacy and evaluate which functionalities are desired.MethodA survey was sent to members of the two stoma‐related patient associations in the Netherlands. Associations between patient characteristics, satisfaction concerning received stoma care, and willingness to use an app were evaluated.ResultsThe survey was completed by 1868 patients. Overall satisfaction was scored as 6.6, with shortfalls reported in the preoperative information provision, stoma site selection, and postoperative care. Patients of older age, who were unaware of getting a stoma, had an ileostomy, a low quality of life or psychosocial problems, were less satisfied. An app was expected to be of added value by 59.4% of the patients having a stoma for less than three years, compared to the significantly lower 43.8% expectation rate of the remaining study population (p < 0.001). Moreover, patients with a high frequency of physical or psychosocial problems expressed higher levels of interest.ConclusionPatients were only moderately satisfied with their received stoma care. A supportive app is most likely beneficial for patients who had a stoma for less than three years, were in an acute situation, and/or have stoma‐related problems. Most patients prefer information via internet or on paper, although apps may offer additional benefits. It is important to acknowledge digital literacy and to council patients appropriately about the benefits and help them to use apps.
Clinical significance of para‐carinal air cysts in patients with pleuroparenchymal fibroelastosis: The relationship with pneumomediastinum and pneumothorax
Authors: Yamakawa Hideaki , Sato Shintaro , Ohta Hiroki , Takatsuka Makiko , Kusano Kenji , Kawabe Rie , Oba Tomohiro , Akasaka Keiichi , Amano Masako , Araya Jun , Sasaki Hiroki , Matsushima Hidekazu 
Published: July 2023

AbstractBackgroundPara‐tracheal or para‐carinal air cysts (PACs) are often asymptomatic and usually detected incidentally by methods such as computed tomography. Their clinical significance is unclear in patients with pleuroparenchymal fibroelastosis (PPFE).MethodsWe evaluated the clinical significance of PACs in PPFE and their relationship with pneumomediastinum or pneumothorax.ResultsIn total, 50 patients had PPFE and 34 (68%) had PACs. Most PACs were para‐carinal (n = 30). A para‐tracheal air cyst was detected in only nine patients, which included five patients having both para‐carinal and para‐tracheal air cysts. Overall median survival was 24.7 months. Survival was not significantly different between the patients with [PACs(+)] and without PACs (P = 0.268). A high frequency (64%) of the complication of pneumomediastinum or pneumothorax occurred in the overall population during follow‐up. Pneumomediastinum/pneumothorax occurred significantly more frequently in patients with PACs(+) than in those without (76.5% vs. 37.5%; P = 0.012). PACs(+) was the only significant risk factor for pneumomediastinum/pneumothorax.ConclusionsOur data showed that PACs commonly occur in patients with PPFE, and most PACs were para‐carinal air cysts. Additionally, PACs(+) was a significant risk factor for pneumomediastinum/pneumothorax; therefore, clinicians should be more aware of these complications during follow‐up examination, particular in PACs(+) patients with PPFE.
Posaconazole and midostaurin in patients with FLT3‐mutated acute myeloid leukemia: Pharmacokinetic interactions and clinical facts in a real life study
Authors: Menna Pierantonio , Marchesi Francesco , Cattaneo Chiara , Candoni Anna , Delia Mario , Nadali Gianpaolo , Vatteroni Alessandra , Pasciolla Crescenza , Perrone Salvatore , Verga Luisa , Armiento Daniele , Del Principe Maria Ilaria , Fracchiolla Nicola S. , Salvatorelli Emanuela , Lupisella Santina , Terrenato Irene , Busca Alessandro , Minotti Giorgio , Pagano Livio 
Published: July 2023

AbstractMidostaurin is used in combination with chemotherapy to treat patients with newly diagnosed FLT3‐mutated acute myeloid leukemia. Chemotherapy‐induced neutropenia exposes these patients to a significant risk of invasive fungal infections (IFIs). International guidelines recommend primary antifungal prophylaxis with posaconazole (PCZ) but nested analysis of a phase III trial showed that strong PCZ inhibition of CYP3A4 diminished midostaurin metabolism and increased midostaurin plasma levels; however, midostaurin‐related adverse events (AEs) were only moderately exacerbated. We conducted a prospective multicenter real‐life study to evaluate (i) how often concerns around PCZ‐midostaurin interactions made the hematologist prescribe antifungals other than PCZ, (ii) how remarkably PCZ increased midostaurin plasma levels, and (iii) how significantly PCZ‐midostaurin interactions influenced hematologic and safety outcomes of induction therapy. Although the hematologists were blinded to pharmacokinetic findings, as many as 16 of 35 evaluable patients were prescribed antifungal prophylaxis with micafungin, weak CYP3A4 inhibitor, in place of PCZ (p < 0.001 for deviation from guidelines). In the 19 patients managed as per guidelines, PCZ‐midostaurin interactions were more remarkable than previously characterized, such that at the end of induction therapy midostaurin minimum plasma concentration (Cmin) was greater than three times higher than reported; moreover, midostaurin Cmin, maximum plasma concentration, and area under the curve were more than or equal to four times higher with PCZ than micafungin. Hematologic outcomes (complete remission and duration of severe neutropenia) and safety outcomes (midostaurin‐related any grade or grade ≥3 AEs) were nonetheless similar for patients exposed to PCZ or micafungin, as was the number of breakthrough IFIs. In waiting for randomized phase III trials of new prophylaxis regimens, these findings show that PCZ should remain the antifungal of choice for the midostaurin‐treated patient.
Mausoleum or museum: Engaging the significance of cultural museum collections for heritage tourism in the 21st century
Authors: Ezenagu Ngozi 
Published: July 2023

AbstractTangible and intangible elements of culture are the primary sustenance of heritage tourism. They include traditional dance, folklore, songs, arts and craft, indigenous technologies, festivals, rituals, and rites. All these are cultural products designed to embody different activities. They constitute some of the major attractions of present‐day cultural museums. Although these objects are imbued with functional roles through which they interact with society, yet within the confines of cultural museums, they are seemingly lifeless; needing the curator to narrate their relevance. Their functional role in the community seems lost as no opportunity is given or created to display their cultural relevance to amuse curious museum visitors. This raises some questions, is the museum a mausoleum of cultural products? How can mere narration of lifeless objects satisfy visitors' curiosity and taste for a new experience? To answer these salient questions, this paper employed desktop research design using two case studies, the Osun Osogbo sacred grove in Osun state and the palace of the Oba of Benin Nigeria, to explore the significance of cultural museums in promoting heritage tourism through the functional role of its collections. The study found that living heritage negates their original community role upon entry into the modern museum. The paper concludes that the significance of cultural museum collections can be revived by decolonizing the Eurocentric paradigm and indigenizing curatorial practices of western‐modeled museums in Nigeria.
What distribution models of alligator weed in its native and invaded ranges tell us about its invasion story and biological control
Authors: Sánchez‐Restrepo Andrés F. , Reche Vanina A. , Cabrera Nora , Pan Xiaoyun , Pratt Paul , Sosa Alejandro J. 
Published: July 2023

AbstractEcological niche models of species occurrence have gained interest in biological control programs to improve efficiency, reduce risks, and to inform when and how control agents may be released and/or surveyed. Alligator weed, Alternanthera philoxeroides (Mart.) Griseb. (Amaranthaceae), is an amphibious aquatic plant native to southern South America that has invaded several countries around the world. In this study, our aim was to quantify the current and to model the future alligator weed geographical distributions in its native range in South America, and in its introduced range (USA, the country where biological control of the weed was first implemented). Additionally, we modelled the current and potential distribution of its biocontrol agent Agasicles hygrophila Selman & Vogt (Coleoptera: Chrysomelidae), released in the USA in 1964, and other potential biocontrol agents, including the flea beetles Disonycha argentinensis Jacoby and Systena sp. In total, 19438 occurrence records of alligator weed, 253 of A. hygrophila, 48 of D. argentinesis, and 19 of Systena sp. were compiled. Niche models predicted expanded distributions of alligator weed, particularly in northern regions of South America. However, the models of the flea beetles A. hygrophila, D. argentinensis, and Systena sp. did not predict geographic range expansion and the future scenarios are similar to current distributions. Our study predicts an increase in the suitable areas for alligator weed in South America in future scenarios of global warming, whereas these new areas would not be as favourable for the biocontrol agents historically used.
A general framework to quantify and compare ecological impacts under temporal dynamics
Authors: Volery Lara , Vaz Fernandez Margarida , Wegmann Daniel , Bacher Sven 
Published: July 2023

AbstractBiodiversity is diminishing at alarming rates due to multiple anthropogenic drivers. To mitigate these drivers, their impacts must be quantified accurately and comparably across drivers. To enable that, we present a generally applicable framework introducing fundamental principles of ecological impact quantification, including the quantification of interactions between multiple drivers. The framework contrasts biodiversity variables in impacted against those in unimpacted or other reference situations while accounting for their temporal dynamics through modelling. Properly accounting for temporal dynamics reduces biases in impact quantification and comparison. The framework addresses key questions around ecological impacts in global change science, namely, how to compare impacts under temporal dynamics across stressors, how to account for stressor interactions in such comparisons, and how to compare the success of management actions over time.
Structural asymmetry in biotic interactions as a tool to understand and predict ecological persistence
Authors: Allen‐Perkins Alfonso , García‐Callejas David , Bartomeus Ignasi , Godoy Oscar 
Published: July 2023

AbstractA universal feature of ecological systems is that species do not interact with others with the same sign and strength. Yet, the consequences of this asymmetry in biotic interactions for the short‐ and long‐term persistence of individual species and entire communities remains unclear. Here, we develop a set of metrics to evaluate how asymmetric interactions among species translate to asymmetries in their individual vulnerability to extinction under changing environmental conditions. These metrics, which solve previous limitations of how to independently quantify the size from the shape of the so‐called feasibility domain, provide rigorous advances to understand simultaneously why some species and communities present more opportunities to persist than others. We further demonstrate that our shape‐related metrics are useful to predict short‐term changes in species' relative abundances during 7 years in a Mediterranean grassland. Our approach is designed to be applied to any ecological system regardless of the number of species and type of interactions. With it, we show that is possible to obtain both mechanistic and predictive information on ecological persistence for individual species and entire communities, paving the way for a stronger integration of theoretical and empirical research.
European Academy of Neurology guidelines on the treatment of cluster headache
Authors: May Arne , Evers Stefan , Goadsby Peter J. , Leone Massimo , Manzoni Gian Camillo , Pascual Julio , Carvalho Vanessa , Romoli Michele , Aleksovska Katina , Pozo‐Rosich Patricia , Jensen Rigmor H. ,   European Academy of Neurology Task Force
Published: July 2023

AbstractBackground and PurposeCluster headache is a relatively rare, disabling primary headache disorder with a major impact on patients' quality of life. This work presents evidence‐based recommendations for the treatment of cluster headache derived from a systematic review of the literature and consensus among a panel of experts.MethodsThe databases PubMed (Medline), Science Citation Index, and Cochrane Library were screened for studies on the efficacy of interventions (last access July 2022). The findings in these studies were evaluated according to the recommendations of the European Academy of Neurology, and the level of evidence was established using GRADE (Grading of Recommendations Assessment, Development, and Evaluation).RecommendationsFor the acute treatment of cluster headache attacks, there is a strong recommendation for oxygen (100%) with a flow of at least 12 L/min over 15 min and 6 mg subcutaneous sumatriptan. Prophylaxis of cluster headache attacks with verapamil at a daily dose of at least 240 mg (maximum dose depends on efficacy and tolerability) is recommended. Corticosteroids are efficacious in cluster headache. To reach an effect, the use of at least 100 mg prednisone (or equivalent corticosteroid) given orally or at up to 500 mg iv per day over 5 days is recommended. Lithium, topiramate, and galcanezumab (only for episodic cluster headache) are recommended as alternative treatments. Noninvasive vagus nerve stimulation is efficacious in episodic but not chronic cluster headache. Greater occipital nerve block is recommended, but electrical stimulation of the greater occipital nerve is not recommended due to the side effect profile.