bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Restrictions on the Beach Tourism Destination Development as an Effort for Environmental Preservation
Authors: Pawestri A. , Wahyuliana I. , Nugroho L. D. 
Published: May 2023

Abstract
Tourism development on the one hand provides an increase in economic value, on the other hand, it raises environmental problems. Especially in beach tourist destinations. The emergence of many rides, redundant buildings in addition to core buildings such as prayer rooms and toilets, increases environmental problems and reduces comfort. This research aims, firstly, that the need to maintain and preserve the environment is one of human rights and secondly a form of restriction on the development of the development of beach tourist destinations to maintain environmental sustainability and the authenticity of tourist destinations. To answer these problems, this research uses normative legal research methods with a complementary statutory approach, concept approach and case approach. The research results obtained, first, tourism development must maintain environmental sustainability. Because a good living environment is part of human rights as a whole. Protecting and preserving the environment is also an obligation. Second, in the development of tourism, especially in beach tourism destinations, it is very necessary to pay attention to the principles of sustainable tourism development, one of the pillars is environmental preservation. By not carrying out excessive development, maintaining authenticity, to avoid long-term damage. So there needs to be restrictions on development.
Building Smart People In Overcoming Poverty In The Kendeng Mountain Area, Banyumas Regency
Authors: Tobirin T , Harsanto BT , Wahyuningrat W , Indiahono D 
Published: May 2023

Abstract
This article examines the Gunung Kendeng Area as a poor area, where the village does not have a source of village income, depending on its residents managing the village, as a result of which it is less than optimal in development and public services. The focus of this research is collaboration in developing villages through participatory roles in new perspectives in managing villages. This research method uses participatory action research with an approach and assistance to villagers. The data collection method is an in-depth Focus Group Discussion (FGD) interview, and data analysis using interactive analysis. The results of this study show that the Gunung Kendeng Area is a Janggolan Village Area that does not have village cash land and the original income of the village is minimal. However, rural communities have potential with high participation rates, a spirit of mutual aid, good social care, and organized social networks. Awareness to build networks and cooperation between stakeholders began to be established in poverty reduction.
Placing biofabrication into the context of human disease modeling
Authors: Zhang Yu Shrike , Alvarez Mario Moisés , Trujillo-de Santiago Grissel 
Published: May 2023

Abstract
The field of biofabrication has seen tremendous advances in the past decade. More recently, the emerging role of biofabrication in allowing faithful generation of models of human tissues in their healthy and diseased states has been demonstrated and has rapidly expanded. These biomimetic models are potentially widely applicable in a range of research and translational areas including but not limited to fundamental biology studies as well as screening of chemical compounds, such as therapeutic agents. The United States Food and Drug Administration Modernization Act 2.0, which now no longer requires animal tests before approving human drug trials, will likely further boost the field in the years to come. This Special Issue, with a collection of 11 excellent research articles, thus focuses on showcasing the latest developments of biofabrication towards human disease modeling, spanning from 3D (bo)printing to organ-on-a-chip as well as their integration.
Comparison of Different Modeling Approaches for Prescription Opioid Use and Its Association With Adverse Events
Authors: Kurteva Siyana , Abrahamowicz Michal , Beauchamp Marie-Eve , Tamblyn Robyn 
Published: May 2023

AbstractPrevious research linking opioid prescribing to adverse drug events has failed to properly account for the time-varying nature of opioid exposure. This study aimed to explore how the risk of opioid-related emergency department visits, readmissions, or deaths (composite outcome) varies with opioid dose and duration, comparing different novel modeling techniques. A prospective cohort of 1,511 hospitalized patients discharged from 2 McGill-affiliated hospitals in Montreal, 2014–2016, was followed from the first postdischarge opioid dispensation until 1 year after discharge. Marginal structural Cox proportional hazards models and their flexible extensions were used to explore the association between time-varying opioid use and the composite outcome. Weighted cumulative exposure models assessed cumulative effects of past use and explored how its impact depends on the recency of exposure. The patient mean age was 69.6 (standard deviation = 14.9) years; 57.7% were male. In marginal structural model analyses, current opioid use was associated with a 71% increase in the hazard of opioid-related adverse events (adjusted hazard ratio = 1.71, 95% confidence interval: 1.21, 2.43). The weighted cumulative exposure results suggested that the risk cumulates over the previous 50 days of opioid consumption. Flexible modeling techniques helped assess how the risk of opioid-related adverse events may be associated with time-varying opioid exposures while accounting for nonlinear relationships and the recency of past use.
Managing DNACPR Recommendations in Residential Care: Towards Improved Training for Social Care and Capacity Professionals
Authors: Fitton Emily , Kuylen Margot , Wyllie Aaron , Michalowski Sabine , Bhatt Vivek , Martin Wayne 
Published: May 2023

Abstract
The use of ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) recommendations has come under scrutiny during the COVID-19 pandemic, and the Care Quality Commission (CQC) has issued a call for new standards, guidance and training. One group for whom new training is required is ‘capacity professionals’ working in and with residential care facilities. These professionals (including Independent Mental Capacity Advocates and Best Interests Assessors) typically have a social work background and have specialist training regarding the 2005 Mental Capacity Act, the provisions of which have a direct relevance to DNACPR recommendations. We report on a survey and focus groups that probed the experiences of this professional group during the pandemic. We recruited 262 participants by approaching civil society organisations in which capacity professionals are well represented; twenty-two participated in follow-on focus groups. We used manifest content analysis and descriptive statistics to analyse the results. Our findings contribute to an emerging picture of what transpired in residential care homes during the first year of the pandemic and help to provide an empirical and normative basis for the development of the new guidance and training for which the CQC has called.
Immune checkpoint inhibitors and their interaction with proton pump inhibitors–related interstitial nephritis
Authors: Miao Jing , Herrmann Sandra M 
Published: May 2023

ABSTRACT
Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy and outcomes, leading to an expanding use in millions of patients worldwide. However, they can cause a spectrum of immune-related adverse events (irAEs). Essentially, any organs can be affected by irAEs, which have emerged as therapy-limiting side effects. In the kidneys, ICI-associated acute interstitial nephritis (ICI-AIN) leads to acute kidney injury (AKI) in 2%–5% of patients on ICI therapy. AKI associated with ICI therapy pathologically presents with AIN in nearly 90% of the cases, but the pathophysiology of ICI-AIN remains to be defined. The generation of autoreactive T cells in patients receiving AIN-inducible drugs, such as proton pump inhibitors (PPIs), is one of the leading theories, supported by a higher incidence of ICI-AIN in patients on these AIN-inducible drugs. In this review, we will discuss our understanding of the incidence, potential pathophysiological mechanisms, clinical presentations, risk factors, diagnosis, and management of PPI-related AIN and its interaction with ICI therapy.
Safety and efficacy of pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) in patients with glomerular diseases who received rituximab
Authors: Sciascia Savino , Rilat Maria Letizia Antonietta , Fenoglio Roberta , Foddai Silvia Grazietta , Radin Massimo , Cecchi Irene , Cinnirella Giacoma , Crosasso Paola , Guidetti Maria Gabriella , Barinotti Alice , Baldovino Simone , Menegatti Elisa , Roccatello Dario 
Published: May 2023

ABSTRACT

Background
Patients on B-cell-depleting agents may have a suboptimal response to vaccination, placing them at a higher risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or suffering from a more severe prognosis. Indeed, available data on pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) in subjects with glomerular diseases (GDs) who received rituximab are limited.

Methods
We conducted a prospective study analysing the safety and efficacy of tixagevimab/cilgavimab for pre-exposure prophylaxis in patients with GDs who received rituximab in the previous 12 months. The rates of symptomatic infections and hospitalizations were compared with those for patients with GD treated with rituximab who refused to receive tixagevimab/cilgavimab.

Results
Tixagevimab/cilgavimab was administered to 22 patients (12 females, mean age 58.4 ± 19.6 years) with GD diagnoses including membranous nephropathy, lupus nephritis, anti-neutrophil cytoplasmic antibody–associated vasculitis and focal segmental glomerulosclerosis. No patient treated with tixagevimab/cilgavimab experienced symptomatic infection with SARS-CoV-2 during the follow-up (mean observation time of follow-up was 112 ± 23 days), while 11 of 28 controls (39.3%) reported a symptomatic infection (P = .0001), requiring hospitalization in 2 cases. Reported adverse events were mild, namely self-limiting headache [4], discomfort at the injection site [3], flu-like symptoms/myalgia [3] and fever [1]. No serious adverse events (e.g. cardiac events, anaphylaxis) were reported.

Conclusion
Pre-exposure prophylaxis with tixagevimab/cilgavimab seems safe and lowered the risk of symptomatic SARS-CoV-2 infection by ≈40% in vaccinated subjects with GD who received anti-CD20 therapy. Possible applications in the subset of patients who need immunosuppressive therapy, especially with rituximab, in a pandemic setting might be envisaged.
Can we reverse arterial stiffness by intervening on CKD-MBD biomarkers?
Authors: Vervloet Marc G 
Published: May 2023

ABSTRACT
The increased cardiovascular risk of chronic kidney disease may in part be the consequence of arterial stiffness, a typical feature of kidney failure. Deranged homeostasis of minerals and hormones involved (CKD-MBD), are also strongly associated with this increased risk. It is well established that CKD-MBD is a main driver of vascular calcification, which in turn worsens arterial stiffness. However, there are other contributors to arterial stiffness in CKD than calcification. An overlooked possibility is that CKD-MBD may have detrimental effects on this potentially better modifiable component of arterial stiffness. In this review, the individual contributions of short-term changes in calcium, phosphate, PTH, vitamin D, magnesium, and FGF23 to arterial stiffness, in most studies assessed as pulse wave velocity, is summarized. Indeed, there is evidence from both observational studies and interventional trials that higher calcium concentrations can worsen arterial stiffness. This, however, has not been shown for phosphate, and it seems unlikely that, apart from being a contributor to vascular calcification and having effects on the microcirculation, phosphate has no acute effect on large artery stiffness. Several interventional studies, both by infusing PTH and by abrupt lowering PTH by calcimimetics or surgery, virtually ruled out direct effects on large artery stiffness. A well-designed trial using both active and nutritional vitamin D as intervention found a beneficial effect for the latter. Unfortunately, the study had a baseline imbalance and other studies did not support its finding. Both magnesium and FGF23 do not seem do modify central arterial stiffness.
Relative apical sparing in cardiac amyloidosis is not always explained by an amyloid gradient
Authors: De Gaspari Monica , Sinigiani Giulio , De Michieli Laura , Della Barbera Mila , Rizzo Stefania , Thiene Gaetano , Iliceto Sabino , Perazzolo Marra Martina , Mele Donato , Basso Cristina , Cipriani Alberto 
Published: May 2023

Abstract

Aims
Myocardial longitudinal strain (LS) by two-dimensional (2D) speckle-tracking echocardiography has a diagnostic and prognostic role in cardiac amyloidosis (CA). Typically, the apical segments of the left ventricle (LV) are less affected by LS abnormalities, a finding called relative apical sparing (RELAPS). Whether a variable burden of CA might explain the RELAPS remains unknown.
We aimed to evaluate the extent, distribution, and deposition pattern of amyloid in autopsy hearts of CA patients and to correlate the histopathology findings with 2D echocardiography.

Methods and results
This is a retrospective study of whole heart specimens of CA patients who died and underwent autopsy and 2D echocardiography. Amyloid burden quantification was assessed by histomorphometry in each segment at different LV levels. The LS analysis results were compared with the amyloid burden and the base-to-apex distribution.
Histopathology investigation of 27 hearts with CA [immunoglobulin light chains (AL) 17 cases and transthyretin (ATTR) 10 cases] demonstrated an amyloid base-to-apex gradient. In 11 CA patients with 2D echocardiography, analysis of LS and histological amyloid burden allowed to identify different patterns: RELAPS (8 cases, 73%), with (2) or without (6) amyloid gradient, normal or mildly reduced LS with diffuse low amyloid (2, 18%), and severely reduced LS with diffuse high amyloid (1, 9%).

Conclusion
The typical RELAPS pattern at echocardiography is not always explained by a base-to-apex gradient of amyloid burden at histopathology, suggesting that RELAPS might be an epiphenomenon of complex interactions among amyloid infiltration, myocardial structure, and adaptation.
Bacterial extracellular electron transfer in plant and animal ecosystems
Authors: Stevens Eric , Marco Maria L 
Published: May 2023

Abstract
Extracellular electron transfer (EET) is a bioelectrochemical process performed by electrochemically active bacteria (EAB) found in host-associated environments, including plant and animal ecosystems and fermenting plant- and animal-derived foods. Through direct or mediated electron transfer pathways, certain bacteria use EET to enhance ecological fitness with host-impacting effects. In the plant rhizosphere, electron acceptors support the growth of EAB such as Geobacter, cable bacteria, and some clostridia that can result changing iron and heavy metal uptake by plants. In animal microbiomes, EET is associated with diet-derived iron in the intestines of soil-dwelling termites, earthworms, and beetle larvae. EET is also associated with the colonization and metabolism of some bacteria in human and animal microbiomes, such as Streptococcus mutans in the mouth, Enterococcus faecalis and Listeria monocytogenes in the intestine, and Pseudomonas aeruginosa in the lungs. During the fermentation of plant tissues and bovine milk, lactic acid bacteria like Lactiplantibacillus plantarum and Lactococcus lactis may use EET to increase their growth and food acidification, as well as decrease environmental oxidation–reduction potential. Thus, EET is likely an important metabolic pathway for host-associated bacteria and has implications for ecosystem function, health and disease, and biotechnological applications.
Association Between Serum GDF15 Concentration and Total Mortality in Community-Dwelling Japanese Older Populations: The Involvement of Renal Dysfunction
Authors: Fujita Yasunori , Shinkai Shoji , Taniguchi Yu , Miura Yuri , Tanaka Masashi , Ohsawa Ikuroh , Kitamura Akihiko , Ito Masafumi 
Published: May 2023

Abstract

Background
Serum growth differentiation factor 15 (GDF15) is associated with age-related adverse outcomes. However, renal function has not been thoroughly evaluated in studies addressing the association between GDF15 and mortality. We aimed to clarify whether GDF15 is associated with total mortality after carefully controlling renal function markers.

Methods
We divided 1 801 community-dwelling Japanese older adults into quartiles according to their serum GDF15 concentrations. The correlation of GDF15 with renal function and inflammation markers was assessed by calculating Spearman correlation coefficients. Cumulative survival rates of the quartiles were estimated. In a Cox regression analysis adjusted for confounders, the association between GDF15 and mortality was evaluated. The discriminative capacity of GDF15 for the prediction of mortality was assessed with receiver-operating characteristic analysis.

Results
GDF15 was correlated with cystatin C (r = 0.394), β2-microglobulin (r = 0.382), C-reactive protein (r = 0.124), and interleukin-6 (r = 0.166). The highest GDF15 quartile showed poor survival compared to the others. Older adults with higher GDF15 were associated with an increased mortality risk, independent of demographics and clinically relevant variables (hazard ratio [95% confidence interval]: 1.98 [1.09–3.59]). This significant association disappeared when additionally adjusted for cystatin C (1.65 [0.89–3.05]) or β2-microglobulin (1.69 [0.91–3.12]). The ability to predict mortality was approximately comparable between GDF15 (area under the curve: 0.667), cystatin C (0.691), and β2-microglobulin (0.715).

Conclusions
Serum GDF15 is associated with total mortality in older Japanese after adjustment for major confounders. The increased mortality risk in older adults with higher GDF15 may be partly attributed to decreased renal function.
The Infectious Diseases Specialist, At Risk of Extinction
Authors: Reece Rebecca , Beckwith Curt G 
Published: May 2023

Abstract
The results of the Infectious Diseases (ID) fellowship match over the past decade have raised concerns that the future of our specialty is in peril, despite the unprecedented demand for ID expertise as exemplified by the COVID-19 pandemic. While there was a modest increase in ID fellowships applicants attributable to the pandemic, the disappointing 2023 match results indicate that the increase was short-lived. Multiple factors contribute to low interest in ID including but not only low salaries relative to other specialties. Solutions to grow the ID workforce are urgently needed and are critical to the public health of this nation.
Application of metagenomic next-generation sequencing in the diagnosis and resistome analysis of community-acquired pneumonia pathogens from bronchoalveolar lavage samples
Authors: Chen Shenglin , Hou Chenrui , Kang Yutong , Li Dan , Rong Jianrong , Li Zhenjun 
Published: May 2023

Abstract

Aims
To perform a prospective diagnostic study exploring the clinical utility of metagenomic next-generation sequencing (mNGS) in diagnosing community-acquired pneumonia (CAP), and revealing resistome differences in bronchoalveolar lavage fluid (BALF) from CAP patients with varying severity of admission base on Pneumonia Patient Outcomes Research Team (PORT) risk classes.

Methods and results
We compared the diagnostic performances of mNGS and conventional testing for the detection of pathogens in BALF from 59 CAP patients, and performed resistome differences analysis of metagenomic data from 59 BALF samples, namely, 25 from CAP patients with PORT score I (I group), 14 from CAP patients with PORT score II (II group), 12 from CAP patients with PORT score III (III group), and 8 from CAP patients with PORT score IV (IV group). The diagnostic sensitivities of mNGS and conventional testing for the detection of pathogens in BALF in patients with CAP were 96.6% (57/59) and 30.5% (18/59), respectively. There was a significant difference in the overall relative abundance of resistance genes between the four groups (P = 0.014). The results of principal coordinate analysis based on Bray–Curtis dissimilarities showed that there were significant differences in the composition of resistance genes among the I, II, III, and IV groups (P = 0.007). A large number of antibiotic resistance genes, such as those affiliated with multidrug, tetracycline, aminoglycoside, and fosfomycin resistance, were enriched in the IV group.

Conclusions
In conclusion, mNGS has a high diagnostic value in CAP. There were significant differences present in microbiota resistance to antibiotics in BALF from CAP patients in different PORT risk classes, which should attract enough attention.
Regional Anesthesia and Acute Pain Management for Adult Patients with Burns
Authors: Wardhan Richa , Fahy Brenda G 
Published: May 2023

Abstract
Patients with burns suffer from excruciating pain, thus presenting unique challenges to the hospital staff involved in their care. Any hospital system may be involved in managing smaller and less serious burns, but patients with more complicated issues are often transferred to a burn center. This article will review the pathophysiological evolution of pain immediately after burn injury to emphasize the role of complex inflammatory pathways involved in the progression of burn pain. This review also focuses on managing acute pain using a combined multimodal and regional pain management approach. Finally, we attempt to address the continuum from acute to chronic pain management and the strategies used to minimize and manage the progression to chronic pain. Chronic pain remains a debilitating outcome of burn injury, and this article discusses efforts to mitigate this complication. Available options for pain treatment are important to discuss, as current drug shortages may limit medications that can be used.
Structural Change within the Services Sector and the Future of Cost Disease
Authors: Duernecker Georg , Herrendorf Berthold , Valentinyi Ákos 
Published: May 2023

Abstract
In his seminal work, Baumol observed that developed economies suffer from cost disease, i.e., aggregate productivity growth falls because structural change reallocates production to services with low productivity growth. We document that cost disease importantly contributed to the productivity growth slowdown in the postwar U.S. To assess how severe cost disease may become, we build a model of structural change among the goods sector and broad services sectors. Calibrating the model to the postwar U.S. implies that broad categories of services are substitutes and the services with low productivity growth do not take over production. Simulating the calibrated model forward implies that future cost disease will be less severe than the past one.