bluuebunny/crossref_metadata_2025_split huggingface dataset:
The advantages of standardizing exhaled breath-alcohol concentration to a reference respiratory gas—water vapor
Authors: Lindberg Lars , Jones Alan Wayne 
Published: November 2022

Abstract
Measuring the concentration of alcohol (ethanol) in exhaled breath (BrAC) provides a rapid and non-invasive way to determine the co-existing concentration in arterial blood (A-BAC). The results of breath-alcohol testing are used worldwide as evidence of excessive drinking, such as when traffic offenders are prosecuted. Two types of breath-alcohol analyzer are in common use; hand-held instruments used as preliminary screening tests of sobriety and more sophisticated evidential instruments, the results of which are accepted as evidence for prosecution of drunken drivers. Most evidential breath-alcohol analyzers are designed to capture the last portion of a prolonged exhalation, which is thought to reflect the alcohol concentration in substantially alveolar air. The basic premise of breath-alcohol analysis is that there is a physiological relationship between A-BAC and BrAC and close agreement between the two analytical methods. This article reviews the principles and practice of breath-alcohol analysis and introduces the concept of standardizing the results to a secondary physiological gas (water vapor), which therefore serves as an internal standard. The measured BrAC is thus adjusted to an alveolar air water content of 43.95 mg l−1 at 37 °C. This has several advantages, and means that a sample of breath can be captured without the person having to blow directly into the instrument. Adjusting the breath-alcohol concentration to water vapor concentration also compensates for variations in temperature of the expired air. The contact-free method of sampling breath means that a mouthpiece is unnecessary and the test subject does not need to make a continuous end exhalation.
Adaptive survival movement strategy to local epidemic outbreaks in cyclic models
Authors: Menezes J , Moura B , Rangel E 
Published: November 2022

Abstract
We study the generalised rock-paper-scissors game with five species whose organisms face local epidemic outbreaks. As an evolutionary behavioural survival strategy, organisms of one out of the species move in the direction with more enemies of their enemies to benefit from protection against selection. We consider that each organism scans the environment, performing social distancing instead of agglomerating when perceiving that the density of sick organisms is higher than a tolerable threshold. Running stochastic simulations, we study the interference of the adaptive movement survival strategy in spatial pattern formation, calculating the characteristic length scale of the typical spatial domains inhabited by organisms of each species. We compute how social distancing trigger impacts the chances of an individual being killed in the cyclic game and contaminated by the disease. The outcomes show that the species predominates in the cyclic game because of the organisms’ local adaptation. The territory occupied by the species grows with the proportion of individuals learning to trigger the social distancing tactic. We also show that organisms that perceive large distances more properly execute the adaptive strategy, promptly triggering the social distancing tactic and choosing the correct direction to move. Our findings may contribute to understanding the role of adaptive behaviour when environmental changes threaten biodiversity.
Drugs and Conditions That May Mimic Hemolysis
Authors: Jones Andrew D , Sapatnekar Suneeti , Bakdash Suzanne 
Published: November 2022

Abstract

Objectives
Visual inspection of posttransfusion plasma for hemolysis is a key laboratory method in the investigation of possible acute hemolytic transfusion reactions (AHTRs). Many substances and physiologic conditions can mimic hemolysis in vitro. Isolated reports describe specific cases of interference, but a comprehensive listing is lacking.

Methods
Using an illustrative case, we summarize available literature on substances and conditions that may mimic hemolysis in vitro. We further describe other substances and conditions that may discolor plasma but are unlikely to be mistaken for hemolysis on visual inspection.

Results
At least 11 substances and conditions have been reported to discolor plasma, in colors ranging from orange to red to brown, including relatively common therapies (eg, eltrombopag, hydroxocobalamin, iron dextran). Other substances are unlikely to be encountered in everyday practice but may mimic hemolysis in particular patient populations. Additional substances may cause plasma discoloration, ranging from blue to green to white, and are associated with a wide variety of therapies and conditions.

Conclusions
An awareness of the possible preanalytic confounding factors that may mimic hemolysis can aid in the workup of a suspected AHTR. Review of the medical record, use of ancillary testing, and consideration for nonimmune causes of hemolysis can aid in ruling out AHTR.
Developing the ‘Caring Being’ in Social Work: Reflections on my Grandmother’s Life
Authors: Pawar Manohar 
Published: November 2022

Abstract
The article is a personal story about my grandmother and how she experienced care in her old age. By sharing my grandmother’s life story about caring and reflecting on it, I inductively develop a thesis on caring and argue that caring is an asymmetrical phenomenon, and we can do better. The discussion includes the role of caring in social work practice and how to inculcate a focus on caring among workers so that they may contribute to creating caring communities. First, it exposes the complex phenomenon of dispossession at both personal and political levels and its implications for caring for elderly people. Secondly, it suggests the need for basic technology transfer. Thirdly, it points out the significance of emotional and material care and commitment to caring and challenges to sustaining it, and the need for innovations to enhance human caring. Fourthly, it emphasises the best interests of elderly people when choosing the place and space for caring arrangements. Finally, to creating caring communities, it suggests implications for integrating reason and emotion, and altering the professional values-base and policies. Social workers and similar professionals can contribute to caring communities to meet the challenging needs of growing ageing populations in the world.
Validation of ASCL1 and LHX8 Methylation Analysis as Primary Cervical Cancer Screening Strategy in South African Women with Human Immunodeficiency Virus
Authors: Vink Frederique J , Meijer Chris J L M , Lissenberg-Witte Birgit I , Visser Cathy , Duin Sylvia , Snyman Leon C , Richter Karin L , van der Merwe Frederick H , Botha Matthys H , Steenbergen Renske D M , Dreyer Greta 
Published: November 2022

Abstract

Background
Compared with women who are human immunodeficiency virus (HIV) negative, women with human immunodeficiency virus (WWH) have a higher human papillomavirus (HPV) prevalence and increased cervical cancer risk, emphasizing the need for effective cervical cancer screening in this population. The present study aimed to validate methylation markers ASCL1 and LHX8 for primary screening in a South African cohort of WWH.

Methods
In this post hoc analysis within the DIAgnosis in Vaccine And Cervical Cancer Screen (DiaVACCS) study, a South African observational multicenter cohort study, cervical scrape samples from 411 HIV-positive women were analyzed for hypermethylation of ASCL1 and LHX8 genes, HPV DNA, and cytology. Sensitivities, specificities, and positive and negative predictive values of primary methylation-based, HPV-based and cytology-based screening were calculated for the detection of cervical intraepithelial neoplasia of grade 3 or higher.

Results
Single markers ASCL1 and LHX8 resulted in a good performance for the detection of cervical intraepithelial neoplasia of grade 3 or higher, with sensitivities of 85.9% (95% confidence interval [CI], 78.2%–93.6%) and 89.7% (83.0%–96.5%), respectively, and specificities of 72.9% (67.3%–78.5%) and 75.0% (69.5%–80.5%). Combining markers ASCL1 and LHX8 resulted in a lower sensitivity compared with HPV testing (84.6% vs 93.6%, respectively; ratio, 0.90 [95% CI, .82–.99]) and a higher specificity (86.7% vs 78.3%; ratio 1.11 [1.02–1.20]) and reduced the referral rate from 46.8% to 33.4%. ASCL1/LHX8 methylation had a significantly higher sensitivity than cytology (threshold, high-grade intraepithelial squamous lesion or worse), (84.6% vs 74.0%, respectively; ratio, 1.16 [95% CI, 1.01–1.32]) and similar specificity (86.7% vs 91.0%; ratio, 0.95 [.90–1.003]).

Conclusions
Our results validate the accuracy of ASCL1/LHX8 methylation analysis for primary screening in WWH, which offers a full-molecular alternative to cytology- or HPV-based screening, without the need for additional triage testing.
The Geographic Distribution of Dimorphic Mycoses in the United States for the Modern Era
Authors: Mazi Patrick B , Sahrmann John M , Olsen Margaret A , Coler-Reilly Ariella , Rauseo Adriana M , Pullen Matthew , Zuniga-Moya Julio C , Powderly William G , Spec Andrej 
Published: November 2022

Abstract

Background
The dimorphic mycoses (DMs) of the United States—Histoplasma, Coccidioides, and Blastomyces—commonly known as endemic mycoses of North America (in addition to Paracoccidioides) are increasingly being diagnosed outside their historical areas of endemicity. Despite this trend, the maps outlining their geographic distributions have not been updated in more than half a century using a large, nationwide database containing individual-patient–level data.

Methods
This was a retrospective analysis of &gt;45 million Medicare fee-for-service beneficiaries from 1 January 2007 through 31 December 2016. Diagnoses of histoplasmosis, coccidioidomycosis, and blastomycosis were defined by International Classification of Diseases, Ninth/10th Revision, codes. The primary outcome was the incidence of histoplasmosis, coccidioidomycosis, and blastomycosis for each US county. Clinically meaningful thresholds for incidence were defined as 100 cases/100 000 person-years for histoplasmosis and coccidioidomycosis and 50 cases/100 000 person-years for blastomycosis.

Results
There were 79 749 histoplasmosis, 37 726 coccidioidomycosis, and 6109 blastomycosis diagnoses in unique persons from 2007–2016 across 3143 US counties. Considering all US states plus Washington, DC, 94% (48/51) had ≥1 county above the clinically relevant threshold for histoplasmosis, 69% (35/51) for coccidioidomycosis, and 78% (40/51) for blastomycosis.

Conclusions
Persons with histoplasmosis, coccidioidomycosis, and blastomycosis are diagnosed in significant numbers outside their historical geographic distributions established &gt;50 years ago. Clinicians should consider DM diagnoses based on compatible clinical syndromes with less emphasis placed on patients' geographic exposure. Increased clinical suspicion leading to a subsequent increase in DM diagnostic testing would likely result in fewer missed diagnoses, fewer diagnostic delays, and improved patient outcomes.
Adaptation in Outbred Sexual Yeast is Repeatable, Polygenic and Favors Rare Haplotypes
Authors: Linder Robert A , Zabanavar Behzad , Majumder Arundhati , Hoang Hannah Chiao-Shyan , Delgado Vanessa Genesaret , Tran Ryan , La Vy Thoai , Leemans Simon William , Long Anthony D 
Published: November 2022

AbstractWe carried out a 200 generation Evolve and Resequence (E&R) experiment initiated from an outbred diploid recombined 18-way synthetic base population. Replicate populations were evolved at large effective population sizes (&gt;105 individuals), exposed to several different chemical challenges over 12 weeks of evolution, and whole-genome resequenced. Weekly forced outcrossing resulted in an average between adjacent-gene per cell division recombination rate of ∼0.0008. Despite attempts to force weekly sex, roughly half of our populations evolved cheaters and appear to be evolving asexually. Focusing on seven chemical stressors and 55 total evolved populations that remained sexual we observed large fitness gains and highly repeatable patterns of genome-wide haplotype change within chemical challenges, with limited levels of repeatability across chemical treatments. Adaptation appears highly polygenic with almost the entire genome showing significant and consistent patterns of haplotype change with little evidence for long-range linkage disequilibrium in a subset of populations for which we sequenced haploid clones. That is, almost the entire genome is under selection or drafting with selected sites. At any given locus adaptation was almost always dominated by one of the 18 founder's alleles, with that allele varying spatially and between treatments, suggesting that selection acts primarily on rare variants private to a founder or haplotype blocks harboring multiple mutations.
A molecular brake that modulates spliceosome pausing at detained introns contributes to neurodegeneration
Authors: Meng Dawei , Zheng Qian , Zhang Xue , Piao Xuejiao , Luo Li , Jia Yichang 
Published: November 2022

Abstract
Emerging evidence suggests that intron-detaining transcripts (IDTs) are a nucleus-detained and polyadenylated mRNA pool for cell to quickly and effectively respond to environmental stimuli and stress. However, the underlying mechanisms of detained intron (DI) splicing are still largely unknown. Here, we suggest that post-transcriptional DI splicing is paused at the B act state, an active spliceosome but not catalytically primed, which depends on Smad Nuclear Interacting Protein 1 (SNIP1) and RNPS1 (a serine-rich RNA binding protein) interaction. RNPS1 and B act components preferentially dock at DIs and the RNPS1 docking is sufficient to trigger spliceosome pausing. Haploinsufficiency of Snip1 attenuates neurodegeneration and globally rescues IDT accumulation caused by a previously reported mutant U2 snRNA, a basal spliceosomal component. Snip1 conditional knockout in the cerebellum decreases DI splicing efficiency and causes neurodegeneration. Therefore, we suggest that SNIP1 and RNPS1 form a molecular brake to promote spliceosome pausing, and that its misregulation contributes to neurodegeneration.
Anti-rituximab antibodies demonstrate neutralizing capacity, associate with lower circulating drug levels and earlier relapse in lupus
Authors: Wincup Chris , Dunn Nicky , Ruetsch-Chelli Caroline , Manouchehrinia Ali , Kharlamova Nastya , Naja Meena , Seitz-Polski Barbara , Isenberg David A , Fogdell-Hahn Anna , Ciurtin Coziana , Jury Elizabeth C 
Published: November 2022

Abstract

Objectives
High rates of anti-drug antibodies (ADA) to rituximab have been demonstrated in patients undergoing treatment for SLE. However, little is known with regard to their long-term dynamics, impact on drug kinetics and subsequent implications for treatment response. In this study, we aimed to evaluate ADA persistence over time, impact on circulating drug levels, assess clinical outcomes and whether they are capable of neutralizing rituximab.

Methods
Patients with SLE undergoing treatment with rituximab were recruited to this study (n = 35). Serum samples were collected across a follow-up period of 36 months following treatment (n = 114). Clinical and laboratory data were collected pre-treatment and throughout follow-up. ADA were detected via electrochemiluminescent immunoassays. A complement dependent cytotoxicity assay was used to determine neutralizing capacity of ADA in a sub-cohort of positive samples (n = 38).

Results
ADA persisted over the 36-month study period in 64.3% of patients undergoing treatment and titres peaked earlier and remained higher in those who had previously been treated with rituximab when compared with than those who were previously treatment naive. ADA-positive samples had a significantly lower median drug level until six months post rituximab infusion (P = 0.0018). Patients with persistent ADA positivity showed a significant early improvement in disease activity followed by increased rates of relapse. In vitro analysis confirmed the neutralizing capacity of ADA to rituximab.

Conclusions
ADA to rituximab were common and persisted over the 36-month period of this study. They associated with earlier drug elimination, an increased rate of relapse and demonstrated neutralizing capacity in vitro.
An Examination of Suicidal Behavior among Black College Students with Exposure to Police Violence
Authors: Szlyk Hannah , Motley Robert , Joe Sean , Nonas-Barnes Lucy , Azasu Enoch 
Published: November 2022

Abstract
There is limited research about suicidal behaviors among Black emerging adults (peak age of suicide risk) who report exposure to police violence. The current study applies an integrated approach to examine individual, immediate environment, and community-based risk and protective factors of suicide among Black college students who reported previous exposure to police violence. A purposive sample of Black college students (N = 300) was analyzed using bivariate analyses and binary logistic regression. Outcome variables investigated were lifetime suicidal ideation and suicide attempt. Twenty-eight percent of participants reported lifetime suicidal ideation and 14 percent reported lifetime attempts. Female students were significantly more likely to report lifetime suicidal ideation and recent symptoms of anxiety and to engage in emotional social support than male peers. Logistic regression results demonstrated that higher income and greater depression symptoms were associated with lower reporting of lifetime suicidal ideation. Reporting of more grit, the trait of perseverance and passion for long-term goals, was associated with a lower reporting of both lifetime suicidal ideation and suicide attempt. Findings have implications for how social workers in higher education are encouraged to address suicidal behavior among Black students, including the cultivation of grit.
Trends in outcomes of pregnancy in patients with congenital heart disease
Authors: Cutshall Andrew , Gourdine Ashlee , Bender Whitney , Karuppiah Arunthevaraja 
Published: November 2022

Purpose of review
This review aims to analyze the trends in the management of pregnant patients with congenital heart disease (CHD).

Recent findings
The literature that this article reviews specifically highlights the importance of multidisciplinary and specialized care, the unique and variable physiologic differences within the umbrella of CHD in pregnancy, and recommendations for obstetric and anesthetic care in the prenatal and peripartum period.

Summary
The findings that this article summarizes have profound implications for clinical practice and management of the patient with CHD, including the optimization of preoperative screening, facilitation of ideal prenatal care to include qualified specialists and resources, and recommendations for optimal anesthetic management during labor and delivery.
Perceptions of motivating factors and barriers to precepting
Authors: Boyce Delaney J. , Shifrin Megan M. , Moses Shelley R. , Moss Colleen R. 
Published: November 2022

ABSTRACT

Background:
Advanced practice registered nurses (APRNs) and physician assistants (PAs) are integral to health care delivery in the United States. However, the cultivation of APRNs and PAs relies heavily on the model of precepting. Advanced practice registered nurses and PAs frequently precept students or new hires, yet limited data are available to describe the motivations, incentives, and barriers associated with precepting.

Purpose:
The purpose of this mixed-method, cross-sectional study was to better understand APRN and PA preceptors' perceived levels of support during precepting, facilitating factors, and barriers to the precepting process.

Methods:
An electronic survey was distributed via REDCap to a convenience sample of APRN and PA preceptors at an academic medical center. Data collected from the survey were analyzed using both descriptive statistics and qualitative thematic analysis.

Results:
One hundred fifty-four participants completed the survey. Motivating factors for precepting included “giving back” to the profession, and barriers included inadequate time to precept while in the clinical role. Participants indicated that financial incentives, heightened communication, protected teaching time, preceptor training, meaningful recognition, and organizational support could enhance the precepting process.

Conclusion:
This study demonstrated that altruistic intentions frequently motivate APRN and PA preceptors, however, navigating multiple clinical responsibilities while precepting serves as a barrier to the precepting process. Preceptor training, ongoing education, dedicated time for precepting, enhanced communication, and organizational or professional incentives may optimize the APRN and PA precepting process.

Implications:
Further research should focus on how to optimally incorporate education, professional development, support, and incentives into the APRN and PA preceptor role.
Change in First-year Intravascular Ultrasound Results Predicts Adverse Events in Heart Transplant Recipients: Implications for Clinical Trial Endpoints
Authors: Seguchi Osamu , Azarbal Babak , Mirocha James , Youn Jong-Chan , Passano Elizabeth , Patel Jignesh , Kobashigawa Jon 
Published: November 2022

Background.
Heart transplantation (HTx) is an established therapeutic option for patients with advanced heart failure who are refractory to conventional guideline-directed treatments. This study aimed to reassess whether intravascular ultrasound variables could predict adverse events after HTx in the modern era.

Methods.
One hundred primary HTx recipients with available serial intravascular ultrasound examination results of the left anterior descending artery 4–8 wk and 1 y after HTx were enrolled, with an average follow-up duration of 5.7 y. The primary endpoint was a composite of all-cause death, nonfatal major adverse cardiac events, and angiographic cardiac allograft vasculopathy.

Results.
Forty-three patients developed primary endpoints. The baseline maximal intimal thickness was independently associated with the primary endpoint (hazard ratio, 8.24; 95% confidential interval [CI], 3.21-21.21; P < 0.001), and the optimal cutoff value was 0.64 mm. A change in the plaque atheroma volume in a proximal 20-mm segment from the left anterior descending artery bifurcation >1.05 mm3/mm (hazard ratio, 2.75; 95% CI, 1.28-5.89; P = 0.009) and a change in the first-year maximal intimal thickness >0.27 mm (hazard ratio, 2.63; 95% CI, 1.05-6.56; P = 0.04) were independent predictors of the primary endpoint 1 y after intravascular ultrasonography.

Conclusions.
The aforementioned important clinical implications of intravascular ultrasound parameters are useful predictors of outcomes, which may be considered endpoints in modern clinical HTx trials.