bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacist-driven renal dose optimization practice—outcomes of a retrospective study in ambulatory care settings
Authors: Parakkal Sainul Abideen , Hakeem Faisal Ahmed , Madathil Hafees , Nemr Habib Shaker , Ghamdi Fuad Hamed 
Published: June 2022

Abstract

Objectives
Previous studies indicate a higher prevalence of inappropriate drug usage in patients with renal disease in ambulatory care settings and a higher rate of non-compliance with the renal dose adjustment protocol. This study aimed to investigate the number of renal dose adjustments recommended by pharmacists in ambulatory care settings, acceptance rate by the physicians and medications involved.

Methods
This two-year retrospective study was conducted in an ambulatory care pharmacy in a Saudi Arabian tertiary care hospital. Based on the renal protocol at the study site, the pharmacists recommended dose adjustments for inappropriate medication orders, and the outcomes were documented electronically. A quantitative descriptive analysis of this practice was performed by retrieving the pharmacists’ documentation from electronic health records. Only protocol-compliant recommendations with proper documentation were included in the study.

Key findings
A total of 302 renal dose adjustments were recommended by pharmacists for 269 patients involving 47 medications, with an average of 1.12 recommendations per patient. The average monthly recommendation was 12.58 (median: 11; SD: 5.174; 95% Confidence Interval (CI), 12 to 13.16). Of the 302 recommendations, 219 (72.52%) were accepted by the physician, and 71 (23.51%) were not. The most common medications accepted for renal dosage adjustment included levofloxacin (8.94%), metformin (5.29%), amoxicillin-clavulanate (5.29%), cetirizine (4.97%), diclofenac (4.64%), ciprofloxacin (3.97%) and nitrofurantoin (3.31%).

Conclusions
The pharmacist’s renal dose recommendations have a high acceptance rate in ambulatory care. This study demonstrated that ambulatory care pharmacists play a substantial clinical role in reducing inappropriate drug use in patients with renal disease.
Staphylococcus aureus-Associated Glomerulonephritis and Chronic Granulomatous Disease in an Adolescent Male
Authors: Parzen-Johnson Simon , Dalal Vidhi , Jhaveri Ravi 
Published: June 2022

Abstract
Staphylococcus-associated glomerulonephritis (GN) is an uncommon diagnosis in pediatric patients. Empiric therapy with steroids alone could potentially worsen the underlying infectious process in these patients, leading to worse clinical outcomes. An adolescent male diagnosed with GN was subsequently found to have chronic granulomatous disease with a Staphylococcus aureus liver abscess. His GN improved with antibiotics alone. This case illustrates the need to consider chronic infection, and primary immunodeficiency, in the differential diagnosis for new-onset GN.
Acute cerebellar ischaemic stroke secondary to arterial thoracic outlet syndrome
Authors: Sokhal Balamrit Singh , Mohammadi Leila , Weerathunga Janaka , Rajagopalan Sriram 
Published: June 2022

Abstract
Arterial thoracic outlet syndrome comprises a collection of symptoms due to compression of the neurovascular structures of the thoracic outlet. Cervical ribs are rare congenital abnormalities that are a cause of thoracic outlet syndrome, leading to upper limb complications depending on the compressed structure. Management tends to be surgical in the form of rib resection. We report a case of arterial thoracic outlet syndrome secondary to a cervical rib in a 45-year-old male who presented with left-sided cerebellar stroke caused by subclavian artery thrombosis. Medical management in the form of anticoagulation was favoured. Oedema in the recent peri-infarct zone due to reperfusion may have caused compression of the fourth ventricle due to anatomical proximity, with the risk of further neurological compromise and coning. At follow-up appointments, the patient had no residual upper limb or neurological symptoms.
Hydrofluoric Acid, an Unexpected Surprise
Authors: Meaney Colleen , Perdue Matthew , Umar Mohamad , Walker Jerimiah 
Published: June 2022

ABSTRACT
We report the case of a 37-year-old man presenting with pain out of proportion to the exam with hydrofluoric acid burns to his upper extremities after he spilled a wheel-stripping compound on his forearms while working at his powder coating business. His burns initially appeared mild and superficial, but over the course of several days, these evolved from simple erythema to significant partial thickness tissue destruction and ulceration. He required substantial topical, intradermal, and intravenous therapies to control the unseen burning process during his index visit to the emergency department. We transferred the patient to a burn center given the location of his burns and the causative agent. The burn center clinicians observed him over the course of two nights and then discharged him with instructions to come for multiple follow-up visits during the subsequent month. Following nonoperative management, he had an uneventful recovery with full function retained in the affected extremities. Hydrofluoric acid burns require prompt treatment with calcium to neutralize the burning process, despite a potentially benign initial appearance. The emergency clinician should use an aggressive diagnostic and therapeutic approach to patients presenting with pain out of proportion to their exam, as this finding is associated with various serious underlying pathology.
Reliability and limitations of inferring birth radii in the Milky Way disc
Authors: Lu Yuxi(Lucy) , Buck Tobias , Minchev Ivan , Ness Melissa K 
Published: June 2022

ABSTRACT
Recovering the birth radii of observed stars in the Milky Way is one of the ultimate goals of Galactic Archaeology. One method to infer the birth radius and the evolution of the interstellar medium (ISM) metallicity assumes a linear relation between the ISM metallicity with radius at any given look-back time. Here, we test the reliability of this assumption by using four zoom-in cosmological hydrodynamic simulations from the NIHAO-UHD project. We find that one can infer precise birth radii only when the stellar disc starts to form, which for our modelled galaxies happens ∼10 Gyr ago, in agreement with recent estimates for the Milky Way. With a current day measurement of ISM metallicity gradient of −0.05 dex and a dispersion of 0.03 dex, the intrinsic uncertainty in inferring Rbirth is ∼0.6 kpc. At later times, the linear correlation between the ISM metallicity and radius increases, as stellar motions become more ordered and the azimuthal variations of the ISM metallicity start to drop. The formation of a central bar and perturbations from mergers can increase this uncertainty in the inner and outer disc, respectively.
DNA G-quadruplex structure participates in regulation of lipid metabolism through acyl-CoA binding protein
Authors: Xiang Lijun , Niu Kangkang , Peng Yuling , Zhang Xiaojuan , Li Xiaoyu , Ye Ruoqi , Yu Guoxing , Ye Guojun , Xiang Hui , Song Qisheng , Feng Qili 
Published: June 2022

Abstract
G-quadruplex structure (G4) is a type of DNA secondary structure that widely exists in the genomes of many organisms. G4s are believed to participate in multiple biological processes. Acyl-CoA binding protein (ACBP), a ubiquitously expressed and highly conserved protein in eukaryotic cells, plays important roles in lipid metabolism by transporting and protecting acyl-CoA esters. Here, we report the functional identification of a G4 in the promoter of the ACBP gene in silkworm and human cancer cells. We found that G4 exists as a conserved element in the promoters of ACBP genes in invertebrates and vertebrates. The BmACBP G4 bound with G4-binding protein LARK regulated BmACBP transcription, which was blocked by the G4 stabilizer pyridostatin (PDS) and G4 antisense oligonucleotides. PDS treatment with fifth instar silkworm larvae decreased the BmACBP expression and triacylglycerides (TAG) level, resulting in reductions in fat body mass, body size and weight and growth and metamorphic rates. PDS treatment and knocking out of the HsACBP G4 in human hepatic adenocarcinoma HepG2 cells inhibited the expression of HsACBP and decreased the TAG level and cell proliferation. Altogether, our findings suggest that G4 of the ACBP genes is involved in regulation of lipid metabolism processes in invertebrates and vertebrates.
Identification of flexible Pif1–DNA interactions and their impacts on enzymatic activities
Authors: Li Jinghua , Ma Jianbing , Kumar Vikash , Fu Hang , Xu Chunhua , Wang Shuang , Jia Qi , Fan Qinkai , Xi Xuguang , Li Ming , Liu Haiguang , Lu Ying 
Published: June 2022

Abstract
Flexible regions in biomolecular complexes, although crucial to understanding structure–function relationships, are often unclear in high-resolution crystal structures. In this study, we showed that single-molecule techniques, in combination with computational modeling, can characterize dynamic conformations not resolved by high-resolution structure determination methods. Taking two Pif1 helicases (ScPif1 and BsPif1) as model systems, we found that, besides a few tightly bound nucleotides, adjacent solvent-exposed nucleotides interact dynamically with the helicase surfaces. The whole nucleotide segment possessed curved conformations and covered the two RecA-like domains of the helicases, which are essential for the inch-worm mechanism. The synergetic approach reveals that the interactions between the exposed nucleotides and the helicases could be reduced by large stretching forces or electrostatically shielded with high-concentration salt, subsequently resulting in reduced translocation rates of the helicases. The dynamic interactions between the exposed nucleotides and the helicases underlay the force- and salt-dependences of their enzymatic activities. The present single-molecule based approach complements high-resolution structural methods in deciphering the molecular mechanisms of the helicases.
An automatic integrative method for learning interpretable communities of biological pathways
Authors: Beebe-Wang Nicasia , Dincer Ayse B , Lee Su-In 
Published: June 2022

Abstract
Although knowledge of biological pathways is essential for interpreting results from computational biology studies, the growing number of pathway databases complicates efforts to efficiently perform pathway analysis due to high redundancies among pathways from different databases, and inconsistencies in how pathways are created and named. We introduce the PAthway Communities (PAC) framework, which reconciles pathways from different databases and reduces pathway redundancy by revealing informative groups with distinct biological functions. Uniquely applying the Louvain community detection algorithm to a network of 4847 pathways from KEGG, REACTOME and Gene Ontology databases, we identify 35 distinct and automatically annotated communities of pathways and show that they are consistent with expert-curated pathway categories. Further, we demonstrate that our pathway community network can be queried with new gene sets to provide biological context in terms of related pathways and communities. Our approach, combined with an interpretable web tool we provide, will help computational biologists more efficiently contextualize and interpret their biological findings.
Does a Bevacizumab-based regime have a role in the treatment of children with diffuse intrinsic pontine glioma? A systematic review
Authors: Evans Mia , Gill Ria , Bull Kim S 
Published: June 2022

Abstract

Background
There are no effective treatments for diffuse intrinsic pontine glioma (DIPG); median survival is 11.2 months. Bevacizumab has the potential to improve quality of life (QOL) and survival in DIPG but has never been evaluated systematically. The aim of this review was to assess Bevacizumab’s role in the treatment of DIPG.

Methods
MEDLINE, EMBASE, Scopus, and Web of Science were searched for relevant studies using terms developed from alternatives for Bevacizumab and DIPG. One reviewer screened titles and abstracts, then two reviewers screened full texts. Data were extracted into tables and quality assessed using methodological index for non-randomized studies and JBI tools.

Results
Searching revealed 1001 papers; after deduplication 851 remained. After screening of titles and abstracts, then 28 full texts, 11 studies were included. Four studies reported a median overall survival longer than historical data, however, two found no significant impact of Bevacizumab. Five studies reported a radiological response in a proportion of participants and two reported no response. Three studies, evaluating clinical response, reported improvement in a proportion of patients. Three studies, evaluating QOL, reported stability or improvement. Four studies, evaluating steroid use, reported reductions in the proportion of patients receiving steroids. In radiation necrosis treatment, Bevacizumab led to clinical improvement in 6/12 patients in 2 studies and permitted a reduction in steroid use in most patients.

Conclusions
Insufficient evidence means the role of Bevacizumab in the treatment of DIPG is unclear. However, Bevacizumab may be beneficial to some patients. The review highlights the need for further research in this area.
Assessment of clinical consultations in an academic occupational medicine clinic
Authors: Spilchuk V , House R , Holness D Linn 
Published: June 2022

Abstract

Background
Occupational medicine clinical consultation services are relatively under-recognized and under-utilized in Canada.

Aims
To describe clinical consultations in a university-affiliated general occupational medicine clinic.

Methods
All of the charts of patients seen in referral to our general occupational medicine clinic over a 2-year period were reviewed to extract information to provide a descriptive summary of the nature of these consultations. We evaluated patient demographic factors and work- and exposure-related information, as well as the source of referral and the nature of the presenting clinical problem.

Results
The 131 patients had a mean (SD) age of 50.6 (14.0) years, 55% were men and 62% were referred by their family physicians. They presented with a broad spectrum of clinical problems, with neurological problems (29%) and multisystem problems (24%) being the most prevalent. The patients worked in a variety of occupational sectors, with manufacturing and the service sector being the most frequent. Seventy-two per cent of patients came for investigation of an occupational problem and 28% came for an environmental issue. Only 36% of patients were found to have their presenting problem due to an exposure, which highlights the need for in-depth clinical assessment before making a causal attribution.

Conclusions
This study provides information about the nature of clinical problems seen in an academic general occupational medicine referral clinic. The results might assist in increasing awareness and utilization of occupational medicine clinical services, which are beneficial for patient education, diagnosis and management.
Evaluating Diversity in Randomized Clinical Trials of Dolutegravir-Based Antiretroviral Therapy Regimens: Pooled 48-Week Analyses by Race, Sex, and Regional Subgroups
Authors: Rawlings M Keith , Letang Emilio , Quercia Romina , Grove Richard , DeMasi Ralph , Min Sherene , Vannappagari Vani , Zolopa Andrew , van Wyk Jean , Smith Kimberly 
Published: June 2022

Abstract

Background
In HIV clinical trials, proportions of Black and female participants achieving virologic suppression (VS) are often lower compared with White and male participants. As the antiretroviral therapy (ART) landscape continues to evolve, addressing existing challenges in clinical trial diversity will be critical to effectively translate results into clinical practice. Here, we pooled data to evaluate the efficacy and safety of dolutegravir (DTG)-containing regimens by race, sex, and regional subgroups.

Methods
Three pooled analyses were conducted using 48-week results from phase 3/3b trials: DTG 3-drug vs non-DTG-containing 3- or 4-drug regimens in ART-naive participants (ARIA, FLAMINGO, SINGLE, SPRING-2), DTG-containing 2-drug vs 3-drug regimens in ART-naive participants (GEMINI-1, GEMINI-2), and DTG 3-drug vs non-DTG-containing 3- or 4-drug regimens in ART-experienced participants (SAILING, DAWNING). Proportions of participants with VS, safety, and change from baseline in CD4+ cell count were analyzed.

Results
Proportions of participants achieving VS were high among those receiving DTG vs comparator regimens. Proportions of participants achieving VS were generally lower in Black (vs non-Black), female (vs male), and US (vs non-US) subgroups. No new safety signals emerged from any subgroup in pooled analyses.

Conclusions
These analyses confirm that, across subgroups, DTG has robust efficacy and a good safety profile at week 48 relative to comparator regimens. Achieving VS may vary by participant characteristics, highlighting the urgent need for enrollment to reflect the demographics of global HIV populations more accurately. Future studies should strive to support participants throughout the trial to ensure optimal representation, inclusion, and retention.
Management of Histoplasmosis by Infectious Disease Physicians
Authors: Mazi Patrick B , Arnold Sandra R , Baddley John W , Bahr Nathan C , Beekmann Susan E , McCarty Todd P , Polgreen Philip M , Rauseo Adriana M , Spec Andrej 
Published: June 2022

Abstract

Background
The Infectious Diseases Society of America (IDSA) guidelines for the management of histoplasmosis were last revised 15 years ago. Since those guidelines were compiled, new antifungal treatment options have been developed. Furthermore, the ongoing development of immunomodulatory therapies has increased the population at increased risk to develop histoplasmosis.

Methods
An electronic survey about the management practices of histoplasmosis was distributed to the adult infectious disease (ID) physician members of the IDSA’s Emerging Infections Network.

Results
The survey response rate was 37% (551/1477). Only 46% (253/551) of respondents reported seeing patients with histoplasmosis. Regions considered endemic had 82% (158/193) of physicians report seeing patients with histoplasmosis compared to 27% (95/358) of physicians in regions not classically considered endemic (P &lt; 0.001). Most ID physicians follow IDSA treatment guidelines recommending itraconazole for acute pulmonary (189/253 [75%]), mild-moderate disseminated (189/253 [75%]), and as step-down therapy for severe disseminated histoplasmosis with (232/253 [92%]) and without (145/253 [57%]) central nervous system involvement. There were no consensus recommendations observed for survey questions regarding immunocompromised patients.

Conclusions
Though there are increased reports of histoplasmosis diagnoses outside regions classically considered endemic, a majority of ID physicians reported not seeing patients with histoplasmosis. Most respondents reported adherence to IDSA guidelines recommending itraconazole in each clinical situation. New histoplasmosis guidelines need to reflect the growing need for updated general guidance, particularly for immunocompromised populations.
Jerusalem
Authors: Whittaker Jason 
Published: June 2022

Abstract
In the century since Parry set it to music, ‘Jerusalem’ has become emblematic of a conventional view of Englishness as a rural vision of a green and pleasant land. Yet when William Blake wrote the stanzas to his Preface to Milton, he had recently been tried for sedition and even Parry, having composed his music during the First World War, was appalled by the jingoism and nationalism of those who had commissioned him, instead giving the copyright to the suffragettes. Over the following century the hymn has been used by conservatives nostalgic for a lost empire and radicals committed to a socialist vision for Britain. This book explores the ways in which ‘Jerusalem’ has been used to create often conflicting narratives of Englishness, from royal celebrations to sporting events, from the 1920s exhibition of empire to protests against the poll tax in the 1990s, and from boosting the morale of a country suffering during war to dividing that nation during the vote for Brexit.
SWOLLEN TAPETUM AND STERILITY 1 is required for tapetum degeneration and pollen wall formation in rice
Authors: Yuan Guoqiang , Zou Ting , He Zhiyuan , Xiao Qiao , Li Gongwen , Liu Sijing , Xiong Pingping , Chen Hao , Peng Kun , Zhang Xu , Luo Tingting , Zhou Dan , Yang Shangyu , Zhou Fuxin , Zhang Kaixuan , Zheng Kaiyou , Han Yuhao , Zhu Jun , Liang Yueyang , Deng Qiming , Wang Shiquan , Sun Changhui , Yu Xiumei , Liu Huainian , Wang Lingxia , Li Ping , Li Shuangcheng 
Published: June 2022

Abstract
The pollen wall is important for protecting the male gametophyte and for fertilization. The lipid components of the pollen wall are mainly synthesized and transported from the sporophytic tapetum. Although several factors related to lipid biosynthesis have been characterized, the molecular mechanisms underlying lipid biosynthesis during pollen development in rice (Oryza sativa L.) remain elusive. Here, we showed that mutation in the SWOLLEN TAPETUM AND STERILITY 1 (STS1) gene causes delayed tapetum degradation and aborted pollen wall formation in rice. STS1 encodes an endoplasmic reticulum (ER)-localized protein that contains domain of unknown function (DUF) 726 and exhibits lipase activity. Lipidomic and transcriptomic analyses showed that STS1 is involved in anther lipid homeostasis. Moreover, STS1 interacts with Polyketide Synthase 2 (OsPKS2) and Acyl-CoA Synthetase 12 (OsACOS12), two enzymes crucial in lipidic sporopollenin biosynthesis in pollen wall formation, suggesting a potentially lipidic metabolon for sporopollenin biosynthesis in rice. Collectively, our results indicate that STS1 is an important factor for lipid biosynthesis in reproduction, providing a target for the artificial control of male fertility in hybrid rice breeding and insight into the function of DUF726-containing protein in plants.
At the nexus of science, engineering, and medicine: Pasteur's quadrant reconsidered
Authors: Pettigrew Roderic I , Cooke John P 
Published: June 2022

Abstract
There has been a sea change in the scientific world, advanced even more rapidly by the recent compounded public crises. Accelerated discovery, and impact from such discoveries have come from convergence approaches across disciplines, sectors, institutions, and the multiple communities seeking the common goal of innovations that transform. The classic simultaneous pursuit of fundamental understanding and application has been termed Pasteur's quadrant, where use-inspired basic research occurs. In the classic schematic developed by Donald Stokes, three quadrants represent research approaches using a 2D plane in which the vertical dimension represents the quest for understanding (basic research) and the horizontal dimension represents the consideration of use (applied research). The three outer quadrants are Bohr's (pure basic research), Edison's (pure applied research), and Pasteur's (use-inspired basic research). Viewing each of these axes as a continuum, we label the previously unnamed but contributory cell as the Innominate quadrant, where a nonzero amount of discovery and applied research also has value in generating scientific tools, novel processes or products that inform the other quadrants. More importantly, a reimagined Pasteur's quadrant schema shows a third dimension of Transformations over Time, occurring through a continuous fluid interchange among the quadrants. Transformative innovations may originate from any single quadrant. While work in Pasteur's quadrant has been shown to be highly productive, a dynamic fluid interchange among the quadrants is often involved and generates transformative advances at a faster rate. This should inform how we fund science, engineering, and medicine and educate the next generation of innovators.