bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic Prescribing Practices for Upper Respiratory Tract Infections Among Primary Care Providers: A Descriptive Study
Authors: Chandra Deb Liton , McGrath Brenda M , Schlosser Levi , Hewitt Austin , Schweitzer Connor , Rotar Jeff , Leedahl Nathan D , Crosby Ross , Carson Paul 
Published: June 2022

Abstract

Background
Most antibiotics are prescribed in the ambulatory setting with estimates that up to 50% of use is inappropriate. Understanding factors associated with antibiotic misuse is essential to advancing better stewardship in this setting. We sought to assess the frequency of unnecessary antibiotic use for upper respiratory infections (URIs) among primary care providers and identify patient and provider characteristics associated with misuse.

Methods
Unnecessary antibiotic prescribing was assessed in a descriptive study by using adults ≥18 years seen for common URIs in a large, Upper Midwest, integrated health system, electronic medical records from June 2017 through May 2018. Individual provider rates of unnecessary prescribing were compared for primary care providers practicing in the departments of internal medicine, family medicine, or urgent care. Patient and provider characteristics associated with unnecessary prescribing were identified with a logistic regression model.

Results
A total of 49 463 patient encounters were included. Overall, antibiotics were prescribed unnecessarily for 42.2% (95% confidence interval [CI], 41.7–42.6) of the encounters. Patients with acute bronchitis received unnecessary antibiotics most frequently (74.2%; 95% CI, 73.4–75.0). Males and older patients were more likely to have an unnecessary antibiotic prescription. Provider characteristics associated with higher rates of unnecessary prescribing included being in a rural practice, having more years in practice, and being in higher volume practices such as an urgent care setting. Fifteen percent of providers accounted for half of all unnecessary antibiotic prescriptions.

Conclusions
Although higher-volume practices, a rural setting, or longer time in practice were predictors, unnecessary prescribing was common among all providers.
Different Clinical Presentations of Human Rhinovirus Species Infection in Children and Adults in Mexico
Authors: Galindo-Fraga Arturo , Guerra-de-Blas Paola del Carmen , Ortega-Villa Ana M , Mateja Allyson , Ruiz Quiñones Jesus Arturo , Ramos Cervantes Pilar , Ledesma Barrientos Fernando , Ortiz-Hernández Ana A , Llamosas-Gallardo Beatriz , Ramírez-Venegas Alejandra , Valdéz Vázquez Rafael , Noyola Chepitel Daniel , Moreno-Espinosa Sarbelio , Powers John H , Guerrero M Lourdes , Ruiz-Palacios Guillermo M , Beigel John H ,   for the Mexican Emerging Infectious Diseases Network
Published: June 2022

Abstract

Background
Human rhinoviruses (HRVs) are a common cause of influenza-like illness, with the ability to infect the upper and lower respiratory tracts. In this study we aim to describe the clinical and molecular features of HRV infection in Mexican children and adults.

Methods
We performed a hospital-based, 4-year multicenter prospective observational cohort study of patients with influenza-like illness. Participants who tested positive for HRV were included. We described demographic, clinical, and laboratory characteristics and the association between HRV types, illness severity, and clinical outcomes.

Results
Of the 5662 subjects recruited, 1473 (26%) had HRV; of those, 988 (67.1%) were adults (≥18 years) and 485 (32.9%) were children. One hundred sixty-seven (11.33%) samples were sequenced; 101 (60.5%) were rhinovirus species A (HRV-A), 22 (13.2%) were rhinovirus species B (HRV-B), and 44 (26.3%) were rhinovirus species C (HRV-C). Among children and adults, 30.5% and 23.5%, respectively, were hospitalized (non–intensive care unit [ICU]). The odds of HRV-C are higher than HRV-A for participants in the ICU (compared to outpatient) and when platelets, lymphocytes, white blood cells, and lactate dehydrogenase are increased. The odds of HRV-C are higher than HRV-A and HRV-B with shortness of breath. The odds of HRV-A are higher than HRV-B, and the odds of HRV-B are higher than HRV-C, when mild symptoms like muscle ache and headache occur.

Conclusions
Rhinoviruses are a common cause of influenza-like illness. It is necessary to improve the surveillance, testing, and species identification for these viruses to understand different clinical presentations and risk factors associated with worse outcomes.
Clinical Trials Registration. NCT01418287.
Comparative Lessons in Sectional Title Laws: Mitigating Urban Inequality in South Africa
Authors: Ti Edward S W 
Published: June 2022

Abstract
Urban inequality in South Africa is a formidable problem that is linked to the injustices of its historical apartheid past. This paper identifies sectional titles, a form of property ownership where proprietors wholly own their apartment unit while co-owning the land and common property, as critical to providing more affordable housing. Sectional title schemes mitigate urban inequality by giving a greater proportion of the country the opportunity to own legally secure, well-located dwellings while serving as a platform where communal living could take place. Two suggestions how sectional title legislation can further alleviate aspects of urban inequality are made (1) Permitting a supermajority of sectional owners to terminate a sectional scheme prevents holdout and allows urban land to be redeveloped, providing an increase in housing. (2) Municipalities could consider mandating ethnic integration in sectional schemes to counter the organic formation of mono-racial residential enclaves which remain in present-day South Africa.
The State of American Federalism 2021–2022: Federal Courts, State Legislatures, and the Conservative Turn in the Law
Authors: Konisky David M , Nolette Paul 
Published: June 2022

Abstract
Contemporary American politics features intense political polarization and closely contested battles over the direction of public policy. Conservatives and liberals alike have used the many venues in the American federal system to try to gain an advantage. In this article, we suggest that a key feature of contemporary American federalism is the institutional advantage that conservatives have achieved due to recent shifts in the ideological conservatism of the federal judiciary and growing Republican dominance in state legislatures. We assess the consequences of these developments, focusing on efforts to weaken federal administrative agencies’ authority and discretion, challenge individual voting rights and institutional control over elections, expand conservative approaches to personal liberties in areas such as abortion, religious practice, and gun rights, and to preempt local policy authority. These developments have the effect of consolidating authority in the hands of Republican-controlled state governments and in some cases bringing about national-level policy changes via state initiatives, and with important implications for American society, politics, and federalism.
TOX promotes follicular helper T cell differentiation in patients with primary Sjögren’s syndrome
Authors: Liu Suying , Yang Yanlei , Zeng Liuting , Wang Li , He Chengmei , Chen Zhilei , Sun Jinlei , Lyu Taibiao , Wang Mu , Chen Hua , Zhang Fengchun 
Published: June 2022

Abstract

Objectives
Whether naive CD4+ T cells are dysregulated and associated with the overactivation of CD4+ T cells in primary SS (pSS) remains unclear. We aimed to explore the role and underlying mechanism of naive CD4+ T cells in pSS.

Methods
We examined the activation, proliferation and differentiation of naive CD4+ T cells from pSS patients and healthy controls. Differentially expressed genes were identified using RNA sequencing, and were overexpressed or silenced to determine the gene regulating follicular helper T (Tfh) cells. Assay for transposase-accessible chromatin with high-throughput sequencing (ATAC-seq) with chromatin immunoprecipitation with high-throughput sequencing (ChIP-seq) was performed to explore the epigenetic mechanism. Naive CD4+ T cells were treated with pSS-related cytokines to explore the upstream signalling pathway.

Results
pSS naive CD4+ T cells had higher potentials of activation, proliferation and differentiation towards Tfh cells. Thymocyte selection-associated high mobility group box protein (TOX) was upregulated in pSS naive CD4+ T cells and promoted T cell activation and Tfh cell polarization. TOX silencing in pSS naive CD4+ T cells downregulated B cell lymphoma 6 (BCL6) expression and altered levels of multiple Tfh-associated genes. ChIP-seq analysis implied that TOX bound to the BCL6 locus, where there were accessible regions found by ATAC-seq. IFN-α induced TOX overexpression, which was attenuated by Janus kinase (JAK) and signal transducer and activator of transcription 1 (STAT1) inhibitors.

Conclusion
Our data suggest that TOX in pSS naive CD4+ T cells is upregulated, which facilitates Tfh cell differentiation. Mechanistically, IFN-α induces TOX overexpression in naive CD4+ T cells through JAK–STAT1 signalling and TOX regulates BCL6 expression. Therefore, IFN-α-JAK–STAT1 signalling and TOX might be potential therapeutic targets in pSS.
STUDY OF EFFECTIVENESS OF SHELTERING FROM RADIATION EXPOSURE DUE TO ACCIDENTAL RELEASE OF RADIOACTIVITY
Authors: Singh Ashish Kumar , Dey Riya , Deokar U V , Ganesh G , Kulkarni M S , Anand S 
Published: June 2022

Abstract
Sheltering is one of the important protective actions as a part of emergency response during the early phases of an accident—mostly precautionary in nature. Sheltering via structural shielding reduces the direct exposure from plume/cloud shine and ground shine doses as well as the airborne radioactivity concentration and hence inhalation dose. The present study was aimed at estimating the shielding factor in the case of Indian houses for external exposure pathways using the FLUKA Monte Carlo based radiation transport code. Furthermore, the dose reduction factor due to exposure from the inhalation pathway was estimated using an indoor aerosol model. These factors were assessed for the three major types of dwellings, and they provided important inputs for decision-making for sheltering or evacuation in case of any sudden release of radionuclides into the environment.
Placebo Response in Trials of Negative Symptoms in Schizophrenia: A Critical Reassessment of the Evidence
Authors: Czobor Pál , Kakuszi Brigitta , Bitter István 
Published: June 2022

Abstract

Background
Summarizing evidence from clinical trials of patients with schizophrenia with predominant or prominent negative symptoms (NS), a prior meta-analysis reported a large placebo effect in negative symptoms (Cohen’s d = 2.909). Assuming that such an effect was clinically not plausible, we performed a critical re-assessment and an update of the previous results with newly available data from add-on and monotherapy studies.

Study Design
Random-effect meta/regression analysis of trials that focused on predominant or prominent NS; and adopted a double-blind, randomized, placebo-controlled design. The final pooled meta-analytic database, based on the available add-on and monotherapy studies combined, included 24 publications containing data on a total of 25 studies (21 add-on, 4 monotherapy).

Study Results
The pooled overall estimate for the placebo effect from the primary analysis for all included studies had a medium effect size, with a Cohen’s d value of 0.6444 (SE = 0.091). The estimates were similar in the add-on and monotherapy studies. Meta-regression indicated that the high placebo response was significantly associated with clinical trial characteristics, including the high ratio of patients assigned to active vs. placebo treatment and short trial duration.

Conclusions
These results represent a major downward correction for a current effect size estimate of the placebo response in the negative symptoms of schizophrenia. Our findings also pinpoint certain clinical trial characteristics, which may serve as important predictors of the placebo response. The knowledge of these factors can have important implications for drug development and trial design for new drugs for negative symptoms of schizophrenia.
Identification of diverse viruses associated with grasshoppers unveils the parallel relationship between host phylogeny and virome composition
Authors: Xu Yao , Jiang Jingyi , Lin Xiaoju , Shi Wangpeng , Cao Chuan 
Published: June 2022

Abstract
Grasshoppers (Orthoptera: Acridoidea) are one of the most dangerous agricultural pests. Environmentally benign microbial pesticides are increasingly desirable for controlling grasshopper outbreaks in fragile ecosystems. However, little is known about natural pathogens infecting this pest. Here we profile the rich viral communities in forty-five grasshopper species and report 302 viruses, including 231 novel species. Most of the identified viruses are related to other insect viruses, and small RNA sequencing indicates that some are targeted by host antiviral RNA interference (RNAi) pathway. Our analysis of relationships between host phylogeny and virus diversity suggests that the composition of viromes is closely allied with host evolution. Overall, this study is a first extensive exploration of viruses in grasshoppers and provides a valuable comparative dataset of both academic and applied interest.
The autophagy‐related degradation of MDA5 by Tembusu virus nonstructural 2B disrupts IFNβ production
Authors: Wu Zhen , Hu Tao , Chen Weiqiong , Cheng Yao , Wang Mingshu , Jia Renyong , Zhu Dekang , Liu Mafeng , Zhao Xinxin , Yang Qiao , Wu Ying , Zhang Shaqiu , Huang Juan , Mao Sai , Ou Xumin , Gao Qun , Sun Di , Cheng Anchun , Chen Shun 
Published: June 2022

AbstractDuck Tembusu virus (TMUV) is a serious avian pathogen causing a decline in egg production, but the mechanism of the virus that breaks through the innate immune system is poorly understood. Here, we show that TMUV inhibits poly(I:C)‐induced interferon (IFN) production. Because poly(I:C) transfection can specifically activate the MDA5 pathway in duck primary cells, we found that infection with TMUV can specifically target MDA5 and lead to its degradation. MDA5 downregulation could be blocked by the autophagy inhibitor 3‐methyladenine (3‐MA) but not a proteasome inhibitor, strongly implicating MDA5 degradation as an autophagy‐related degradation pathway. Pretreatment with 3‐MA enhanced the expression of MDA5 and inhibited TMUV replication. To screen TMUV proteins that degraded MDA5, the TMUV replicon and MDA5‐Flag were cotransfected into cells, and the western blot analysis showed that nonstructural 2B (NS2B) can degrade MDA5 in a dose‐dependent manner. Dual‐luciferase assays indicate that NS2B alone inhibits MDA5‐ or poly(I:C)‐mediated IFN production. NS2B binds MDA5 in the presence of 3‐MA. The deletion of the amino acids of NS2B from residues 51 to 92 (hydrophilic area) restored the expression of MDA5 and relieved the MDA5‐mediated IFNβ production inhibition by NS2B, indicating that the hydrophilic area of NS2B is important for its interaction with host innate immunity.
Clinical and Dermoscopic Evaluation of Trichloroacetic Acid 20% Versus Long-Pulsed 1064-nm Nd-YAG Laser in the Treatment of Keratosis Pilaris
Authors: Hassan Akmal S. , Abdel Aziz Mai , Saadi Dina G. 
Published: June 2022

BACKGROUND
Keratosis pilaris (KP) is a common disorder of keratinization with different therapeutic modalities; however, none of them is completely satisfactory.

OBJECTIVE
Assess and compare the efficacy of trichloroacetic acid (TCA) 20% and long-pulsed 1,064-nm Nd:YAG laser in the treatment of KP.

MATERIALS AND METHODS
Twenty patients with symmetrically distributed areas of KP were enrolled in this study. In each patient, 2 symmetrical KP areas were randomly assigned to receive 4 sessions of either long-pulsed Nd:YAG laser or TCA 20%. Clinical evaluation by Investigator Global Assessment (IGA) was done by 2 blinded physicians after treatment. Dermoscopic assessment was done at baseline and at the end point of the study.

RESULTS
Investigator Global Assessment of laser-treated area showed that 2 patients (10%) had moderate improvement, 10 patients (50%) had marked improvement, and 8 patients (40%) had excellent improvement. Investigator Global Assessment of TCA-treated area showed that 9 patients (45%) had marked improvement and 11 patients (55%) had excellent improvement. Dermoscopic score of KP showed a significant reduction with both modalities. The IGA and reduction in dermoscopic scores were comparable between the 2 modalities.

CONCLUSION
Both long-pulsed 1,064-nm Nd:YAG laser and 20% TCA are effective in the treatment of KP.

CLINICAL TRIAL REGISTRATION:
Name of the trial register: clinicaltrial.gov. Registration number: NCT04797663.
Employee silence in health care: Charting new avenues for leadership and management
Authors: Montgomery Anthony , Lainidi Olga , Johnson Judith , Creese Jennifer , Baathe Fredrik , Baban Adriana , Bhattacharjee Anindo , Carter Madeline , Dellve Lotta , Doherty Eva , Jendeby Mimmi Kheddache , Morgan Karen , Srivastava Manjari , Thompson Neill , Tyssen Reidar , Vohra Veena 
Published: June 2022

Issue
Health care management is faced with a basic conundrum about organizational behavior; why do professionals who are highly dedicated to their work choose to remain silent on critical issues that they recognize as being professionally and organizationally significant? Speaking-up interventions in health care achieve disappointing outcomes because of a professional and organizational culture that is not supportive.

Critical Theoretical Analysis
Our understanding of the different types of employee silence is in its infancy, and more ethnographic and qualitative work is needed to reveal the complex nature of silence in health care. We use the sensemaking theory to elucidate how the difficulties to overcoming silence in health care are interwoven in health care culture.

Insight/Advance
The relationship between withholding information and patient safety is complex, highlighting the need for differentiated conceptualizations of silence in health care. We present three Critical Challenge points to advance our understanding of silence and its roots by (1) challenging the predominance of psychological safety, (2) explaining how we operationalize sensemaking, and (3) transforming the role of clinical leaders as sensemakers who can recognize and reshape employee silence. These challenges also point to how employee silence can also result in a form of dysfunctional professionalism that supports maladaptive health care structures in practice.

Practice Implications
Delineating the contextual factors that prompt employee silence and encourage speaking up among health care workers is crucial to addressing this issue in health care organizations. For clinical leaders, the challenge is to valorize behaviors that enhance adaptive and deep psychological safety among teams and within professions while modeling the sharing of information that leads to improvements in patient safety and quality of care.
Traditional Chinese medicine injections with activating blood circulation, equivalent effect of anticoagulation or antiplatelet, for acute myocardial infarction
Authors: Li Xiang , Lou Yan , Shang Ju-Ju , Liu Hong-Xu , Chen Jia-Ping , Zhou Hui-Wen 
Published: June 2022

Abstract

Background
In spite of a growing number in the use of percutaneous coronary intervention (PCI) in China, the mortality of acute myocardial infarction (AMI) has not decreased. Traditional Chinese medicine injections for Activating Blood Circulation (TCMi-ABC), equivalent effect of anticoagulation or antiplatelet, are widely used in China; however, the improvement of fatality towards AMI is unclear. Therefore, we intend to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of TCMi-ABC in treatment with AMI.

Methods
Based on the “National Medical Products Administration of China,” TCMi-ABC with AMI treatment indication will be selected, including Danhong injection, Sodium Tanshinone IIA Sulfonate injection, Danshen Chuanxiongqin injection, and Puerarin injection. Randomized controlled studies will be searched from as follows: PubMed, Embase, the CENTRAL in Cochrane Library, Chinese Biomedical Literature Database (SinoMed), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang Data Knowledge Service Platform. Two researchers will work independently on literature selection, data extraction, and quality assessment. The outcomes focus on the effects of TCMi-ABC on fatality of patients with AMI in hospitalization and in the long term, the incidence of malignant arrhythmia, left ventricular ejection fraction, and adverse events. RevMan 5.4.1 software was used for mate analysis.

Results
This study will conduct a comprehensive literature search and provide a systematic synthesis of current published data to explore the efficacy and safety of TCMi-ABC for AMI.

Conclusion
This study will provide high-quality evidence for treatment of AMI with TCMi-ABC in terms of efficacy and safety, which may help clinicians make a better complementary treatment schedule of patients with AMI.
The role of statins in patients with early diabetic nephropathy
Authors: Zhao Xi , Zhou Shu Chun , Wang Xiu Fang , Liao Hong Wu 
Published: June 2022

Abstract

Background:
Little is known about the renoprotective effects of statins on the regulation of urinary oxidative stress markers and proteinuria in patients with diabetic nephropathy. Therefore, we conducted this protocol of systematic review and meta-analysis to evaluate the role of statins in patients with early diabetic nephropathy.

Methods:
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines to conduct this study. The electronic databases EMBASE, PUBMED, CINAHL, and Web of Science will be searched from the earliest available time to July 2022. The population is defined as participants with early diabetic nephropathy. The Intervention groups are given any one of the statins, such as simvastatin or rosuvastatin. The control groups are treated with angiotensin-converting enzyme inhibitor or placebo alone. The primary outcome is estimated glomerular filtration rate; secondary outcome is serological indicators including triglyceride, cholesterol, C-reactive protein, and complications. The Jadad scale will be used to assess the methodological quality of each study included in this meta-analysis.

Result & Conclusion:
We hypothesized that statins would have a positive renoprotective effect in such patients.

OSF registration number:
10.17605/OSF.IO/ESMWR.