bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing ethylenediaminetetraacetic acid (EDTA) interference in EDTA contaminated samples – selectivity in reporting analytes
Authors: Kalaria Tejas , Ford Clare , Gama Rousseau 
Published: November 2022

Background The widely accepted practice of not reporting any results from ethylenediaminetetraacetic acid (EDTA) contaminated samples necessitates repeat phlebotomy and could delay clinical management decisions. EDTA, however, interferes variably or not at all in assays. EDTA concentration in contaminated samples, like serum indices, therefore, could be used to selectively report the result of analytes not affected at measured EDTA concentration. Methods A serum pool, level 1 and level 3 internal quality control materials were spiked with tripotassium-EDTA to create samples with EDTA concentration up to 6.0 mmol/L. EDTA and 45 common and critically important analytes were measured on Abbott Architect to identify EDTA concentrations for analytes where the change in concentration exceeded their respective reference change value (RCV) for unidirectional change at 95% probability. Results Serum potassium increased and calcium decreased exceeding RCV at 0.17 mmol/L EDTA. Alkaline phosphatase (ALP) decreased exceeding RCV at EDTA >1.86 mmol/L. The decrease in iron did not exceed a wide RCV of 61.9% until maximum spiked EDTA but exceeded the desirable specification for allowable total error (30.7%) at EDTA >1.86 mmol/L. The small decrease in magnesium did not exceed RCV. EDTA up to the concentration in blood collection tubes did not affect the results of any other measured analyte. Conclusions Only serum potassium, calcium, ALP and iron studies, of the 45 analytes studied, should not be reported in EDTA contaminated samples. EDTA concentration cut-offs for selective reporting would further facilitate reporting of these analytes in EDTA contaminated samples.
The Fight to End Neoliberal Madness in Honduras
Authors: Pine Adrienne 
Published: November 2022

While limited in numbers, unionized workers at the two psychiatric hospitals in Honduras have had an important impact in the evolving struggle to improve conditions in their facilities and their country. In the 57 years since the union was formed, its members have modified their strategies in response to major political changes, including the implementation of neoliberal policies led by international financial institutions, and the 2009 coup. The union has fought to achieve better conditions for workers and patients while facing serious challenges, including a context of institutional psychiatry that has dramatically failed to meet the mental health care needs of the Honduran population over the past century and neoliberal policies that have increased structural vulnerability, trauma, and the incidence of associated embodied manifestations—including mental illness—among Hondurans while increasing stigma against the mentally ill and drastically weakened the infrastructure and quality of health care through defunding and privatization. Aunque limitados en número, los trabajadores sindicalizados en los dos hospitales psiquiátricos de Honduras han tenido un impacto importante en la lucha progresiva por mejorar las condiciones en las instalaciones y su país. En los 57 años transcurridos desde la formación del sindicato, sus miembros han modificado sus estrategias en respuesta a los principales cambios políticos, incluyendo la implementación de políticas neoliberales liderada por instituciones financieras internacionales, y el golpe de estado de 2009. La lucha militante del sindicato por mejorar las condiciones para los trabajadores y los pacientes ha enfrentado serios desafíos. Estos incluyen un contexto de psiquiatría institucional que ha fracasado dramáticamente, probándose incapaz de satisfacer las necesidades de atención de salud mental de la población hondureña durante el siglo pasado, así como las políticas neoliberales que han aumentado la vulnerabilidad estructural, el trauma y la incidencia de manifestaciones somáticas asociadas (como las enfermedades mentales) entre los hondureños. Al mismo tiempo el neoliberalismo ha aumentado el estigma contra los enfermos mentales, mientras que la infraestructura y la calidad de la atención a la salud se han debilitado drásticamente a raíz de la desfinanciación y la privatización.
Improving actuation strain and breakdown strength of natural rubber dielectric elastomers incorporated with AlN with silane grafting
Authors: Ruan Mengnan , Li Bo , Guo Dandan , Nie Weixing , Wang Shenao , Liu Zhifeng 
Published: November 2022

In this study, dielectric elastomers offering intrinsically good integrated performances are achieved by introducing AlN particles grafted with γ-methacryloxypropyl trimethoxy silane (KH570). The C=C of KH570 participated in the vulcanization of NR, which could increase the dispersions and interfacial interactions. By incorporating 10 phr AlN-KH570 fillers, the dielectric and mechanical properties of the composite are increased compared with the pristine DEA, and the breakdown strength remains above 93.9 kV/mm. Correspondingly, the actuation strain of 10 phr AlN-KH570/NR composite is 7 times higher than that of pristine DEA under the same driving voltage. Consequently, the AlN particles developed here are promising candidates as dielectric in actuators, and their excellent electromechanical properties could be applied in future industrial applications of DEs.
A Review of Current and Emerging Therapeutic Options for Hemophagocytic Lymphohistiocytosis
Authors: Summerlin Jenna , Wells Drew A. , Anderson Mary Kate , Halford Zachery 
Published: November 2022

Objective: To provide an overview of clinical sequelae and emerging treatment options for hemophagocytic lymphohistiocytosis (HLH). Data Sources: A literature search was conducted using the search terms “hemophagocytic lymphohistiocytosis,” “hemophagocytic syndrome,” “macrophage activation syndrome,” and “treatment” on Ovid and PubMed from January 1, 2017, through September 28, 2022. Study Selection and Data Extraction: Relevant clinical trials, meta-analyses, case reports, review articles, package inserts, and guidelines to identify current and emerging therapeutic options for the management of HLH. Data Synthesis: Genetic disorders and secondary causes may trigger HLH in both children and adults. Notable improvements in the diagnosis of HLH were seen with implementation of the HLH-2004 standard diagnostic criteria; however, timely and accurate identification of HLH remain significant barriers to optimal management. Multiagent immunochemotherapy are the backbone of aggressive therapy for acutely ill patients with HLH. Relevance to Patient Care and Clinical Practice: The global coronavirus 2019 (COVID-19) pandemic and emerging immune effector cell therapies have served to highlight the concerns with immune dysregulation and subsequent HLH precipitation. Without prompt identification and treatment, HLH can be fatal. Historically, the clinician’s armamentarium for managing HLH was sparse, with etoposide-based protocols serving as the standard of care. Relapsed or refractory disease portends a poor prognosis and requires additional treatment options. Second- or subsequent-line options now include hematopoietic stem cell transplantation, emapalumab, alemtuzumab, anakinra, ruxolitinib, and tocilizumab. Conclusions: Improvements in diagnostic methods and novel immunosuppressive treatment strategies, including noncytotoxic immunochemotherapy, have transformed the therapeutic landscape. Unfortunately, many unanswered questions remain. Additional studies are required to optimize dosing, schedules, treatment sequences, and indications for novel treatment options.
Palliative radiation therapy as a treatment for feline urinary bladder masses in four cats
Authors: Yoon Paula , Murakami Keiko , Athanasiadi Ilektra , Rancilio Nicholas J 
Published: November 2022

Case series summary Urinary bladder masses in four cats were treated with palliative radiation therapy (RT). Three cats were previously diagnosed with chronic kidney disease (CKD): International Renal Interest Society (IRIS) stage 2 in two cats and IRIS stage 3 in one cat. One cat had a diagnosis of hyperthyroidism and inflammatory bowel disease. Three cats had urinary tract infections diagnosed by urine culture and susceptibility testing prior to or during treatment. All patients had urine cytospin cytology performed; one case showed suspect urothelial carcinoma and three had no cytological evidence of neoplasia. All clients declined further sampling from the bladder masses. Therefore, cytologic/histologic diagnosis in all cases was not available. An abdominal ultrasound was performed in all cats, which revealed urinary bladder mass(es) prior to referral for RT. Three cats had pretreatment thoracic radiographs, which revealed no evidence of pulmonary metastasis. An abdominal CT was performed in all cases and one case had thoracic CT performed for staging. The thoracic CT showed a focal lesion of unknown etiology in the right caudal lung lobe. Palliative RT was performed with four weekly 6 Gy fractions (24 Gy in total). The urinary signs in all cats resolved over the course of RT: after the first RT treatment in two cats and after the second RT treatment in two cats. There were two Veterinary Radiation Therapy Oncology Group grade 1 gastrointestinal and one grade 2 genitourinary acute RT side effects. Relevance and novel information This is the first report in the literature of a standardized RT protocol as a treatment option for feline urinary bladder masses.
No evidence of pulmonary hypertension revealed in an echographic evaluation of right-sided hemodynamics in hyperthyroid cats
Authors: Lachance Laury , Conversy Bérénice , Wiggen Kelly , Pavard Christophe , Reinero Carol , Masseau Isabelle 
Published: November 2022

Objectives Hyperthyroidism is a common endocrinopathy affecting middle-aged to elderly cats, with multisystemic repercussions. Hyperthyroid humans show decreased lung compliance and increased cardiac output with subsequent left heart failure leading to pulmonary capillary congestion. Prognosis worsens with the development of increased pulmonary vascular pressures (ie, pulmonary hypertension [PH]) in hyperthyroid humans. The effect of excess thyroid hormone concentration on pulmonary arterial hemodynamics is unknown in cats. Assessing pulmonary vascular pressures in veterinary medicine relies heavily on echocardiographic measurements performed at the level of the heart and pulmonary trunk. This study investigated right-sided cardiac and pulmonary arterial hemodynamics in hyperthyroid cats using echocardiography. Methods Echocardiographic examinations of hyperthyroid cats identified through a bi-institutional database search were reviewed for the determination of systolic pulmonary arterial pressure (PAP) and 20 other metrics. Values were compared with those of a healthy cat group using non-parametric statistical analyses. Results Systolic PAP could not be determined in 23/26 hyperthyroid and 13/14 healthy cats owing to unmeasurable tricuspid regurgitation flow velocity. Hyperthyroid cats were roughly twice as old ( P <0.001) and had 2–4-fold higher respiratory rates ( P <0.001) than healthy cats. Hyperthyroid cats showed an increase in acceleration time-to-ejection time ratio of pulmonary flow (1.4-fold, P = 0.001), pulmonary artery velocity time integral (1.2–1.6-fold, P = 0.001), maximal pulmonary velocity (1.3–1.7-fold, P = 0.002), stroke volume (1.5-fold, P = 0.001) and cardiac output (1.6-fold, P <0.001) vs healthy cats. None of the other echocardiographic metrics reached statistical significance. Conclusions and relevance Systolic PAP estimation proved unsuitable as a sole measurement for the assessment of PH in hyperthyroid cats owing to the frequent inability to interrogate tricuspid regurgitant flow velocity. Hyperthyroid cats have altered echocardiographic measures of pulmonary hemodynamics dissimilar to those reported in hyperthyroid humans. Differential effects of thyrotoxic cardiomyopathy on ventricular systolic function may underlie species differences.
Denial and Diagnosis of Methamphetamine Dependence Severity
Authors: Rice Myra , Dean Andy C , Suh Jaymee , London Edythe D 
Published: November 2022

Introduction: Denial, or lack of awareness of problems related to substance misuse, is a common feature of drug use disorders and can affect engagement in treatment and recovery. This study tested for association of denial with severity of symptoms used in the diagnosis of Methamphetamine Dependence. Methods: This secondary analysis used data from 69 participants (52.2% male) who met criteria for the diagnosis of Methamphetamine Dependence on the Structured Clinical Interview for DSM-IV (SCID). The association between diagnostic severity, determined from a SCID summary score (8 items), and denial, measured by the University of Rhode Island Change Assessment Scale (URICA) Precontemplation score, was tested by Pearson correlation. In post hoc t-tests, participants who differed on individual SCID items were compared on the Precontemplation score. The additional URICA subscales (Contemplation, Maintenance, Action) were also tested on a secondary basis. Results: SCID summary scores were negatively correlated with URICA Precontemplation scores ( P = .003). Post-hoc tests revealed that participants who denied continued methamphetamine use despite persistent or recurrent problems (SCID item 6) had significantly higher Precontemplation scores than those who endorsed these problems ( t = 3.066, P = .003). In contrast, positive correlations were observed between diagnostic severity and greater openness/willingness to change on the URICA (eg, Maintenance, r = .26; P = .01). Conclusions: The findings highlight the importance of a patient’s insight regarding their addiction in clinical diagnosis. Because minimizing the impact of methamphetamine use may preclude or delay treatment, it is advised that self-report be supplemented to improve accuracy of diagnosis.
Technology-Supported University Teaching Models in China During the Pandemic: National Survey and Future Prospects
Authors: Wang (汪潇潇) Xiaoxiao , Guo (郭双双) Shuangshuang 
Published: November 2022

Highlights The Ministry of Education Research Center for Online Education conducted a national survey of university administrators of learning and teaching. The survey results showed that (a) the universities in eastern China had developed and introduced more massive open online courses (MOOCs) than those in the central and western regions; (b) of the various measures for blended learning, the universities tended to focus on supporting hardware development before providing training and incentive measures to teachers; and (c) the universities had widely used hybrid learning approaches. In relation to hybrid learning, Tsinghua University explored infrastructure upgrades, teacher training, and the optimal use of the rain classroom and its clone class, and launched the global hybrid classroom and global open courses. In the future, it will be necessary to further promote education equity in line with national policies and provide and perfect incentives to improve the quality of blended learning and expand hybrid learning while improving interaction through technology.
Downregulation of miR-451 in cholangiocarcinoma help the diagnsosi and promotes tumor progression
Authors: Guo Dengfang , Wang Qingling , Huang Jiancheng , Hu Zhanglin , Chen Chun , Zhang Chun , Lin Feng 
Published: November 2022

Abstract
Background
Cholangiocarcinoma is a kind of invasive malignant tumor followed by hepatocellular carcinoma. miR-451 was suggested to function as regulator in various human tumors, but its role in mediating tumor progression and predicting the prognosis of cholangiocarcinoma remains unknown. The clinical significance and biological function of miR-451 in cholangiocarcinoma were assessed in this study.

Results
The tissue and serum expression of miR-451 was decreased in cholangiocarcinoma compared with corresponding normal samples. The downregulation of miR-451 was associated with the progressive TNM stage and positive lymph node metastasis of patients. miR-451 was identified to be an indicator of the diagnosis and prognosis of cholangiocarcinoma distinguishing cholangiocarcinoma patients from healthy volunteers and predicting the poor outcome of patients. miR-451 also served as a tumor suppressor negatively regulating the cellular processes of cholangiocarcinoma.

Conclusions
miR-451 played a vital role in the early detection and risk prediction of cholangiocarcinoma. miR-451 also suppressed the progression of cholangiocarcinoma, which provides a potential therapeutical target for cholangiocarcinoma treatment.
Serum marker and CT characteristics of coronary calcified nodule assessed by intravascular ultrasound
Authors: Li Jing , Li Jing , Jian Zhijie , Wu Jianhua , Yang Jian , Guo Ning , Huang Xin 
Published: November 2022

Abstract
Background
Calcified nodule (CN) is a type of potentially vulnerable plaque. Its formation mechanism remains unknown. This study was to assess serum marker and computed tomography angiography (CTA) characteristics of CN validated by intravascular ultrasound (IVUS).

Methods
Patients who underwent coronary CTA followed by invasive coronary angiography and IVUS were retrospectively analyzed. Serum levels of alkaline phosphatase (ALP), gamma-glutamyltransferase, and calcium were collected.

Results
IVUS detected 128 de novo calcified lesions in 79 patients with coronary artery disease (CAD). CNs were identified in 11.4% (9/79) of patients and 9.4% (12/128) of lesions. Compared with patients with non-nodular calcified plaques, CN patients had higher serum level of ALP (82.00 vs 65.00 U/L, P = 0.022) and total plaque volume (673.00 vs 467.50 mm3, P = 0.021). Multivariable analyses revealed that serum ALP level and total plaque volume were independently associated with the prevalence of CN in CAD patients with calcified plaques. At lesion level, the CN group had a higher frequency of moderate to heavy calcification on angiography (75.00% vs 40.52%, P = 0.017). In terms of CTA characteristics, plaques with CN had a more severe diameter stenosis (79.00% vs 63.00%, P = 0.007), higher plaque burden (85.40% vs 77.05%, P = 0.005), total plaque density (398.00 vs 283.50 HU, P = 0.008), but lower lipid percentage (14.65% vs 19.75%, P = 0.010) and fiber percentage (17.90% vs 25.65%, P = 0.011). Mean plaque burden is an independent predictor of the prevalence of CN in calcified plaques (odds ratio = 1.102, 95% confidence interval: 1.025–1.185, P = 0.009). The AUC is 0.753 (95% confidence interval: 0.615–0.890, P = 0.004). When using 84.85% as the best cutoff value, the diagnostic sensitivity and specificity of mean plaque burden for predicting the presence of CN within calcified plaques were 66.7% and 80.2%, respectively.

Conclusions
CN had different CTA imaging features from non-nodular coronary calcification. The presence of a CN was associated with a higher serum ALP level and plaque burden.
Feasibility of a protocol for deprescribing antihypertensive medication in older patients in Dutch general practices
Authors: Hassan Dimokrat , Versmissen Jorie , Hek Karin , van Dijk Liset , van den Bemt Patricia M. L. A. 
Published: November 2022

Abstract
Background
Older patients using antihypertensive medication may experience Adverse Drug Events (ADEs), and thus benefit from deprescribing. The lack of a practical protocol may hamper deprescribing. Therefore, we aimed to develop a deprescribing protocol, based on a review of literature, combined with a feasibility test in a small number of patients.

Methods
A deprescribing protocol for general practitioners was drafted and tested in older patients using multiple antihypertensive medication in a single arm intervention. Patients were included if they were 75 years or older, were using two or more antihypertensives, had at least one ADE linked to antihypertensive medication and deprescribing was considered to be safe by their general practitioner. The primary outcome was the percentage of patients for whom one or more antihypertensive drugs were stopped or reduced in dose after 12 months of follow up while maintaining safe blood pressures. Secondary outcomes were the proportion of patients reporting no ADEs after 12 months and the number of deprescribed antihypertensives. Patient’s opinions on deprescribing and enablers and barriers for study participation were also collected.

Results
Nine general practitioners included 14 patients to deprescribe antihypertensive medication using the deprescribing protocol. After 12 months antihypertensive drug use was lowered in 11 patients (79%). These patients had a mean systolic blood pressure increase of 16 mmHg and a mean diastolic blood pressure increase of 8 mmHg. Nine patients (64%) reported experiencing no ADEs anymore after twelve months. The mean number of deprescribed antihypertensives was 1.1 in all patients and 1.4 (range: 0.5 to 3.5) in patients who successfully lowered their medication.
At baseline, being able to use less medication was the most frequently mentioned enabler to participate in this study. The most frequently mentioned positive experience at the end of the study was using less medication, which was in line with the most mentioned enabler to participate in this study.

Conclusion
A protocol for deprescribing antihypertensives in older patients was considered feasible, as it resulted in a substantial degree of safe deprescribing in this pilot study. Larger studies are needed to demonstrate the effect and safety of deprescribing antihypertensives in older patients.
Comparison of the duration of viral RNA shedding and anti-SARS-CoV-2 spike IgG and IgM antibody titers in COVID-19 patients who were vaccinated with inactivated vaccines or not: a retrospective study
Authors: Xu Chuancai , He Zhisong , Lei Wei , Chen Li , Shen Dan , Wang Xiaofei , Xu Deyu , Xu Ying , Huang Jian’an 
Published: November 2022

Abstract
Background
At present, the role of inactivated vaccines in viral RNA shedding among Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) breakthrough infections is still unknown.

Methods
We collected data of 147 coronavirus disease 2019 (COVID-19) patients with mild-to-moderate illness who were hospitalized in the Third People’s Hospital of Yangzhou from 7 to 20 August 2021 and analyzed the differences in symptoms and laboratory tests among fully vaccinated (FV), partially vaccinated (PV) and unvaccinated (UV) patients.

Results
The median duration of viral RNA shedding was shorter in the FV (12 [IQR, 9.5–14] days) and PV (13 [IQR, 9–16.75] days) groups than in the UV group (15 [IQR, 11.75–17.25] days) (adjusted P < 0.001 and adjusted P = 0.23, respectively). The median titers of SARS-CoV-2-specific IgG and IgM were significantly higher in the FV (12.29 S/co [IQR, 2.08–63.59] and 0.3 S/co [IQR, 0.05–2.29], respectively) and PV (0.68 S/co [IQR, 0.14–28.69] and 0.12 S/co [0.03–5.23], respectively) groups than in the UV group (0.06 S/co [IQR, 0.03–0.47] and 0.04 S/co [IQR, 0.02–0.07]) (adjusted P < 0.001 and adjusted P = 0.008, respectively).

Conclusions
Inactivated vaccines may shorten viral RNA shedding in breakthrough infected patients who have mild-to-moderate illness and may improve the ability of the host to generate specific antibodies to infection.