bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimation of Mycophenolic Acid Exposure in Chinese Renal Transplant Patients by a Joint Deep Learning Model
Authors: Shao Kun , Jia Yichen , Lu Jiaqian , Zhang Wei , Chen Bing , Chen Dehua , An Huimin , Zhou Quan , Rong Ruiming , Zhu Tongyu , Zhou Peijun 
Published: September 2022

Background:
To predict mycophenolic acid (MPA) exposure in renal transplant recipients using a deep learning model based on a convolutional neural network with bilateral long short-term memory and attention methods.

Methods:
A total of 172 Chinese renal transplant patients were enrolled in this study. The patients were divided into a training group (n = 138, Ruijin Hospital) and a validation group (n = 34, Zhongshan Hospital). Fourteen days after renal transplantation, rich blood samples were collected 0–12 hours after MPA administration. The plasma concentration of total MPA was measured using an enzyme-multiplied immunoassay technique. A limited sampling strategy based on a convolutional neural network–long short-term memory with attention (CALS) model for the prediction of the area under the concentration curve (AUC) of MPA was established. The established model was verified using the data from the validation group. The model performance was compared with that obtained from multiple linear regression (MLR) and maximum a posteriori (MAP) methods.

Results:
The MPA AUC0–12 of the training and validation groups was 54.28 ± 18.42 and 41.25 ± 14.53 µg·ml−1·h, respectively. MPA plasma concentration after 2 (C2), 6 (C6), and 8 (C8) hours of administration was the most significant factor for MPA AUC0–12. The predictive performance of AUC0–12 estimated using the CALS model of the validation group was better than the MLR and MAP methods in previous studies (r2 = 0.71, mean prediction error = 4.79, and mean absolute prediction error = 14.60).

Conclusions:
The CALS model established in this study was reliable for predicting MPA AUC0–12 in Chinese renal transplant patients administered mycophenolate mofetil and enteric-coated mycophenolic acid sodium and may have good generalization ability for application in other data sets.
Predictive Algorithm for Thiopurine-Induced Hepatotoxicity in Inflammatory Bowel Disease Patients
Authors: van Moorsel Sofia A. W. , Deben Debbie S. , Creemers Rob H. , Winkens Bjorn , Bus Paul , Pierik Marieke J. , Simsek Melek , de Boer Nanne K. H. , van Bodegraven Adriaan A. , Wong Dennis R. 
Published: September 2022

Background:
Approximately 25% of patients with inflammatory bowel disease (IBD) discontinue azathioprine (AZA) or mercaptopurine (MP) therapy within 3 months of treatment initiation because of adverse drug reactions. Of these side-effects, about half are because of hepatotoxicity. The aim of this study was to validate and (subsequently) optimize a previously reported predictive algorithm for thiopurine-associated hepatotoxicity by increasing the number of patients with IBD benefitting from conventional thiopurine therapy.

Methods:
This multicenter observational study included consecutive thiopurine-naive patients with IBD who received AZA or MP treatment. The primary outcome was hepatotoxicity within 12 weeks. The patients with and without hepatotoxicity were compared. Four determinants, namely, age, sex, body mass index (BMI), and 6-methylmercaptopurine ribonucleotide concentrations 1 week after treatment initiation (T = 1) were used to validate and optimize 2 (1 dichotomous and 1 continuous) algorithms using multivariable logistic regression analysis.

Results:
Of 229 patients, 21 (9%) developed hepatotoxicity and 93% of the patients received MP with a median dose of 0.7 mg/kg (95% confidence interval 0.3–1.4 mg/kg). A difference in BMI was found between with and without hepatotoxicity groups (median 27.6 versus 24.2, P = 0.022). Specificities of 68% (Algorithm 1) and 77% (Algorithm 2) and sensitivities of 56% (Algorithm 1) and 50% (Algorithm 2) were obtained.

Conclusions:
Both algorithms demonstrated limited predictive accuracy for thiopurine-induced hepatotoxicity in the validation cohort. Relevant factors contributing to this outcome were changes in thiopurine prescription behavior over time, with more MP prescriptions at relatively lower dosages of MP.
Impact of a 12-minute educational video prior to initial consultation in a Mature Women’s Health and Menopause Clinic
Authors: Bouteaud Jeanne , Shaltout Ola , Christakis Marie K. , Murtaza Fahmeeda , Wolfman Wendy , Shirreff Lindsay 
Published: September 2022

Abstract

Objectives
Assess acceptability of a 12-minute educational video before menopause clinic consultation and evaluate its impact on knowledge and treatment certainty.

Methods
This was a pre-post intervention study among new patients with vasomotor symptoms (VMS) referred to a menopause clinic in Toronto, Canada. Participants completed electronic questionnaires before and after viewing a 12-minute online video covering menopause facts and VMS treatments. Participants’ demographic information and referring provider type were recorded. A 19-item true/false knowledge quiz and validated Decision Conflict Scale (DCS) were administered before and after viewing the video along with a validated Acceptability questionnaire after the video. Demographic information and acceptability were summarized descriptively and independent samples t tests compared knowledge and DCS total and subscores before and after viewing the education module. Multivariable analysis was used to identify factors associated with achieving treatment certainty.

Results
Seventy-one participants completed pre- and postintervention questionnaires. Mean age was 51.4 ± 6.0 years and most were White (58/71, 81.7%), had a university degree (24/71, 63.3%) and household income >$90,000 (53/71, 74.6%). After the video, there was significant increase in knowledge score (12.7 ± 2.1 vs. 16.9 ± 1.8, P < 0.001) and decrease in all DCS scores (total and five subscores) compared with preintervention scores (P < 0.001). Acceptability was high with 62/71 (87.3%) respondents indicating the tool was useful. Findings were independent of level of education, household income, and referring physician type.

Conclusion
In a study of predominantly university-educated White women, a 12-minute education module on menopause and VMS treatment was acceptable, there was improved knowledge and decision certainty about VMS treatment.
Radiation-induced Cell Death and Its Mechanisms
Authors: Jiao Yunfei , Cao Fangyu , Liu Hu 
Published: September 2022

Abstract
With rapid technical advances, ionizing radiation has been put into wider application in ordinary living, with the worst cytological effect on the human body being cell death. Moreover, according to the Nomenclature Committee on Cell Death, the method of radiation-induced cell death, usually classified as interphase and proliferative death, undergoes more detailed classifications oriented by its molecular mechanism. Elaborating its mode and molecular mechanism is crucial for the protection and treatment of radiation injury, as well as the radiotherapy and recovery of tumors. Varying with the changes of the radiation dose and the environment, the diverse targets and pathways of ionizing radiation result in various cell deaths. This review focuses on classifications of radiation-induced cell death and its molecular mechanism. We also examine the main characteristics of ionizing radiation-induced cell death. The modes of radiation-induced cell death can be classified as apoptosis, necrosis, autophagy-dependent cell death, pyroptosis, ferroptosis, immunogenic cell death, and non-lethal processes. Once the dose is high enough, radiation effects mostly appear as destructiveness (“destructiveness” is used to describe a situation in which cells do not have the opportunity to undergo a routine death process, in which case high-dose radiation works like a physical attack). This breaks up or even shatters cells, making it difficult to find responses of the cell itself. Due to diversities concerning cell phenotypes, phases of cell cycle, radiation dose, and even cellular subregions, various methods of cell death occur, which are difficult to identify and classify. Additionally, the existence of common initial activation and signaling molecules among all kinds of cell deaths, as well as sophisticated crossways in cellular molecules, makes it more laborious to distinguish and classify various cell deaths.
Monitoring Length of Stay of Acute Myocardial Infarction Patients: A Times Series Analysis Using Statistical Process Control
Authors: Pakdil Fatma , Beazoglou Hannah 
Published: September 2022

Goal:
Given that length of stay (LOS) of acute myocardial infarction (AMI) patients has a significant impact on the utilization of hospital resources and the health status of communities, this study focused on how best to monitor LOS of AMI patients admitted to U.S. hospitals by employing statistical process control (SPC).

Methods:
Data were abstracted from the Healthcare Cost and Utilization Project Nationwide Readmissions Database between 2010 and 2016. A total of 1,491 patients were examined in the study. Patients who were admitted to nonfederal government (public) hospitals in metropolitan areas of at least 1 million residents with the primary diagnosis of AMI were abstracted. They were excluded if they developed AMI secondary to an interventional procedure or surgery, died during their index hospitalization, and were admitted and discharged on the same day. Patients were also excluded if they were discharged to short-term hospitals, nursing facilities, intermediate care facilities, home healthcare, or against medical advice. Individual moving range (I-MR) charts were used to monitor LOS of individual AMI patients in each subgroup from 2010 to 2016.

Principal Findings:
The results showed I-MR charts could be used to indicate statistically out-of-control signals on LOS. Specifically, I-MR charts showed that LOS decreased between 2010 and 2016. LOS appeared to be longer at teaching hospitals compared to nonteaching hospitals and varied by gender. Female patients appeared to stay longer than male patients in the hospitals.

Practical Applications:
The application of SPC and control charts can facilitate improved decision-making in healthcare organizations. This study shows the value of integrating control charts in administrative and medical decision-making processes. It may also help healthcare providers and managers achieve higher quality and lower cost of care.
The Role of the Leader in Fostering Employee Resilient Behaviors
Authors: Caniëls Marjolein C.J. , Stynen Dave 
Published: September 2022

ObjectiveThis study aims to uncover the relationship between leadership behaviors (servant and resilient), leaders’ psychological capital, and employee resilient behaviors over time, and we assess whether employee resilient behaviors and employee psychological capital mediate this relationship.MethodsBased on dyadic 3-wave data collected from 111 unique leader-follower pairs, we use time-lagged path analysis to test our hypotheses.ResultsServant leadership and leaders’ psychological capital may strengthen employees’ psychological capital, which in turn may foster resilient behaviors in employees over time. Resilient leadership was, however, negatively related to employee psychological capital on the short term but positively related to employee resilient behaviors over a 6-week time window.ConclusionsEnacting servant leadership and resilient behavior and through their psychological capital leaders can foster resilient behaviors in employees.
Environmental Factors at the Periconceptional Period and the Occurrence of Cleft Lip and Palate in a Midwest Brazil Population
Authors: Silvestre Carla Meliso R. , Silva Ageo M. C. , Ferreira da Silva Renata Cristina Giroto , Bittencourt Walkiria S. , Borba Alexandre Meireles , Fernandes Vander , da Silva Cristhiane A. L. 
Published: September 2022

Objective
To investigate the association between periconceptional environmental exposures and the occurrence of cleft lips and palates.

Methods
This case-control study analyzed 150 mothers of children with cleft lips and palates living in the same city as 250 mothers whose children did not present with this malformation (controls). Environmental exposure data were gathered through a questionnaire (Latin American Collaborative Study of Congenital Malformations methodology).

Results
Multivariate analysis revealed that monthly income below minimum wage, having another malformed child, other diseases in the first gestational trimester (urinary infection), use of pesticides in home gardens, and pesticide use in farms close to the home were risk factors associated with the malformation, whereas taking vitamins was a protective factor.

Conclusion
Maternal and paternal exposure to pesticides is associated with cleft lip and palate in Mato Grosso State, Brazil.
Perceived Adequacy of Infection Control Practices and Symptoms of Anxiety Among In-Person Elementary School Educators in Ontario
Authors: Smith Peter M. , Oudyk John , Cedillo Leonor , Inouye Kimiko , Potter Guy , Mustard Cameron 
Published: September 2022

Objective
The aim of this study was to examine the association between the perceived adequacy of infection control practices (ICPs) and symptoms of anxiety among educators in Ontario, Canada.

Methods
Data from 4947 educators were collected in December 2020. Modified Poisson models assessed the association between adequacy of ICPs and moderate or severe anxiety symptoms, adjusting for a range of covariates.

Results
Approximately 60% of respondents reported moderate or severe anxiety symptoms. Two-thirds (66.5%) of the sample had less than half of their ICP needs met. Respondents with less than half their ICP needs met were more than three times more likely to have moderate or severe anxiety, compared with respondents with their ICP needs met.

Conclusion
Findings highlight the importance of adequate administrative and engineering controls in schools, not only to minimize risk of infection, but also for educator's mental health.
Workplace Infection Control Measures and Perceived Organizational Support During the COVID-19 Pandemic in Japan
Authors: Mori Takahiro , Nagata Tomohisa , Ando Hajime , Hino Ayako , Tateishi Seiichiro , Tsuji Mayumi , Matsugaki Ryutaro , Fujino Yoshihisa , Mori Koji ,   and for the CORoNaWork project
Published: September 2022

ObjectiveWe investigated whether workplace infection control measures during the COVID-19 pandemic could increase perceived organizational support (POS).MethodsThis prospective cohort study was conducted in Japan from December 2020 to December 2021 using a questionnaire survey. There were 18,560 respondents at follow-up; we investigated 4971 who rated low POS at baseline. The participants were asked a single question about POS and nine about workplace infection control measures. We determined the odds ratios (ORs) of high POS at follow-up using multilevel logistic regression analysis.ResultsThe groups of 5 to 6 (OR = 1.29, 95% confidence interval = 1.05–1.57,P= 0.014) and 7 to 9 workplace infection control measures (OR = 1.54, 95% confidence interval, 1.28–1.85,P< 0.001) had significantly higher ORs than the group with 0 to 2 measures.ConclusionsHealth support for employees through workplace infection control measures can increase POS.
Novel Use of Botulinum Toxin in Long-Standing Adductor-Related Groin Pain: A Case Series
Authors: Creuzé Alexandre , Fok-Cheong Thomas , Weir Adam , Bordes Philippe , Reboul Gilles , Glize Bertrand , de Seze Mathieu 
Published: September 2022

Background:
Adductor-related groin pain (ARGP) is the most common groin injury in athletes. If conservative treatment fails, then adductor tenotomy to relieve tension can be considered. The use of botulinum toxin A (BoNT-A) has shown good results in other musculoskeletal pathologies.

Objective:
Assess the effectiveness of BoNT-A injections in ARGP in cases where usual treatment has failed.

Design:
Retrospective cohort study.

Setting:
Orthopedic Medicine and Rehabilitation Unit, University of Bordeaux.

Participants:
Fifty patients treated by BoNT-A injection in ARGP after failure of medical and/or surgical treatment were included in this study.

Interventions:
One or several adductor muscles were injected with BoNT-A, according to clinical evaluation using ultrasound and electrical stimulation guidance. Patients were followed up at 1, 3, 6, and 12 months.

Main Outcome Measures:
The primary assessment criterion was the improvement of Hip and Groin Outcome Score subscales at day 30. Secondary outcomes included pain intensity and impact on sport, work, and quality of life (QoL), the Blazina scale, and side effects.

Results:
All the first 50 injected patients (45 male and 5 female patients) were included. A significant improvement was noted regarding the majority of Hip and Groin Outcome Score subscales at day 30 (P < 0.05). Pain intensity and its impacts were both significantly reduced (P < 0.001): less sport and professional disability and lower impact on QoL. Severity of symptoms assessed by the Blazina scale was significantly reduced (P < 0.001). The improvements remained significant until 1-year postinjection.

Conclusions:
BoNT-A is promising as a new treatment for ARGP but should be fully assessed in a randomized controlled trial.
Characterizing Asbestos Hazard Emergency Response Act (AHERA) Compliance in New Jersey: 2008-2017
Authors: Lefkowitz Daniel , Fontus Helga , Vermeychuk James , Centifonti Gary , McGreevy Katharine 
Published: September 2022

Context:
The Asbestos Hazard Emergency Response Act (AHERA) became a law in 1986, and the US Environmental Protection Agency (USEPA) was mandated to promulgate rules to regulate the inspection, management, and abatement of asbestos-containing building materials (ACBM) in schools. This study describes 10 years (2008-2017) of AHERA compliance site inspection data conducted by the New Jersey Department of Health (NJDOH).

Objectives:
To establish the level to which inspected NJ schools comply with AHERA regulations, to characterize compliance deficiencies including those that may lead to increased asbestos exposure risk to students and school employees, and to determine whether age, type, and geographic location of school impacted the likelihood of noncompliance.

Design:
Information collected during 456 unique inspections between 2008 and 2017 was analyzed.

Setting and Participants:
Inspections were conducted at public and private schools in New Jersey. These included elementary, middle, and high schools, as well as charter and vocational/technical schools.

Main Outcome Measures:
Descriptive statistics and multiple logistic regression modeling of 3 factors, school type, geographical region, and school age.

Results:
NJDOH inspectors found damage to friable ACBM in 50% (n = 229) of the schools and fiber release episodes in 27% of inspections (n = 121). The case of schools failing to attach warning labels on or immediately adjacent to ACBM was the most frequently noted compliance deficiency over the 10-year period. The modeling output showed that compliance was associated with the type of school and geographical region.

Conclusions:
Inspected schools during the 10-year period were in serious noncompliance with AHERA regulations. This included deficiencies that demonstrate a potential exposure to asbestos such as missing ACBM in management plans, damaged ACBM, lack of protection of short-term workers and custodial staff, and the identification of fiber release episodes. Modeling results of specific school characteristics can help direct limited resources to mitigate potential asbestos exposures.
Synthetic CT in Musculoskeletal Disorders
Authors: Lombardi Alecio F. , Ma Ya-Jun , Jang Hyungseok , Jerban Saeed , Du Jiang , Chang Eric Y. , Chung Christine B. 
Published: September 2022

Abstract
Repeated computed tomography (CT) examinations increase patients' ionizing radiation exposure and health costs, making an alternative method desirable. Cortical and trabecular bone, however, have short T2 relaxation times, causing low signal intensity on conventional magnetic resonance (MR) sequences. Different techniques are available to create a “CT-like” contrast of bone, such as ultrashort echo time, zero echo time, gradient-echo, and susceptibility-weighted image MR sequences, and artificial intelligence. This systematic review summarizes the essential technical background and developments of ultrashort echo time, zero echo time, gradient-echo, susceptibility-weighted image MR imaging sequences and artificial intelligence; presents studies on research and clinical applications of “CT-like” MR imaging; and describes their main advantages and limitations. We also discuss future opportunities in research, which patients would benefit the most, the most appropriate situations for using the technique, and the potential to replace CT in the clinical workflow.
Scaling rules for pandemics: Estimating infected fraction from identified cases for the SARS-Cov-2 Pandemic
Authors: Ma Mingyang , Zsolway Mary , Tarafder Ayush , Doniach Sebastian , Bhanot Gyan 
Published: September 2022

ABSTRACTUsing a modified form of the SIR model, we show that, under general conditions, all pandemics exhibit certain scaling rules. Using only daily data for symptomatic, confirmed cases, these scaling rules can be used to estimate: (i) reff, the effective pandemic R-parameter; (ii) ftot, the fraction ofexposedindividuals that were infected (symptomatic and asymptomatic); (iii) Leff,the effective latency, the average number of days an infected individual is able to infect others in the pool of susceptible individuals; and (iv) α, the probability of infection per contact between infected and susceptible individuals. We validate the scaling rules using an example and then apply our method to estimate reff, ftot, Leffand α for the first phase of the SARS-Cov-2, Covid-19 pandemic for several countries where there was a well separated first peak in identified infected daily cases after the outbreak of the pandemic in early 2020. Our results are general and can be applied to any pandemic.
Controllable self-replicating RNA vaccine delivered intradermally elicits predominantly cellular immunity
Authors: Amano Tomokazu , Yu Hong , Amano Misa , Leyder Erica , Badiola Maria , Ray Priyanka , Kim Jiyoung , Ko Akihiro C. , Achour Achouak , Weng Nan-ping , Kochba Efrat , Levin Yotam , Ko Minoru S.H. 
Published: September 2022

SummaryIntradermal delivery of self-replicating RNA (srRNA) is a promising vaccine platform. Considering that human skin temperature is around 33°C, lower than core body temperature of 37°C, we have developed an srRNA that functions optimally at skin temperature and is inactivated at or above 37°C as a safety switch. This temperature-controllable srRNA (c-srRNA), when tested as an intradermal vaccine against SARS-CoV-2, functions when injected naked without lipid nanoparticles. Unlike most currently available vaccines, c-srRNA vaccines predominantly elicit cellular immunity with little or no antibody production. Interestingly, c-srRNA-vaccinated mice produced antigen-specific antibodies upon subsequent stimulation with antigen protein. Antigen-specific antibodies were also produced when B-cell stimulation using antigen protein was followed by c-srRNA booster vaccination. Using c-srRNA, we have designed a pan-coronavirus booster vaccine that incorporates both spike receptor binding domains as viral surface proteins and evolutionarily conserved nucleoproteins as viral non-surface proteins, from both SARS-CoV-2 and MERS-CoV. It can thereby potentially immunize against SARS-CoV-2, SARS-CoV, MERS-CoV, and their variants. c-srRNA may provide a route to activate cellular immunity against a wide variety of pathogens.