bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for severe adult-onset asthma: a multi-factor approach
Authors: Toppila-Salmi Sanna , Lemmetyinen Riikka , Chanoine Sebastien , Karjalainen Jussi , Pekkanen Juha , Bousquet Jean , Siroux Valérie 
Published: July 2021

Abstract
Background
The aim was to identify risk factors for severe adult-onset asthma.

Methods
We used data from a population-based sample (Adult Asthma in Finland) of 1350 patients with adult-onset asthma (age range 31–93 years) from Finnish national registers. Severe asthma was defined as self-reported severe asthma and asthma symptoms causing much harm and regular impairment and ≥ 1 oral corticosteroid course/year or regular oral corticosteroids or waking up in the night due to asthma symptoms/wheezing ≥ a few times/month. Sixteen covariates covering several domains (personal characteristics, education, lifestyle, early-life factors, asthma characteristics and multiple morbidities) were selected based on the literature and were studied in association with severe asthma using logistic regressions.

Results
The study population included 100 (7.4%) individuals with severe asthma. In a univariate analysis, severe asthma was associated with male sex, age, a low education level, no professional training, ever smoking, ≥ 2 siblings, ≥ 1 chronic comorbidity and non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD) (p < 0.05), and trends for association (p < 0.2) were observed for severe childhood infection, the presence of chronic rhinosinusitis with nasal polyps, and being the 1st child. The 10 variables (being a 1st child was removed due to multicollinearity) were thus entered in a multivariate regression model, and severe asthma was significantly associated with male sex (OR [95% CI] = 1.96 [1.16–3.30]), ever smoking (1.98 [1.11–3.52]), chronic comorbidities (2.68 [1.35–5.31]), NERD (3.29 [1.75–6.19]), and ≥ 2 siblings (2.51 [1.17–5.41]). There was a dose–response effect of the total sum of these five factors on severe asthma (OR [95% CI] = 2.30 [1.81–2.93] for each one-unit increase in the score).

Conclusions
Male sex, smoking, NERD, comorbidities, and ≥ 2 siblings were independent risk factors for self-reported severe asthma. The effects of these factors seem to be cumulative; each additional risk factor gradually increases the risk of severe asthma.
Literacy as part of professional knowing in a Swedish dental education
Authors: Lindberg Viveca , Jounger Sofia Louca , Christidis Maria , Christidis Nikolaos 
Published: July 2021

Abstract
Background
Academic reading and writing are seen as self-evident literacy competences in most contemporary higher educations, however, whether students also are introduced to professional literacy of relevance for dentistry during their education is a question. The purpose of this study is to analyze one of the Swedish dental programmes, with respect to its design, in relation to possible content of relevance for academic and professional literacy. Secondarily, to identify and analyze Swedish dental students’ writing in an academic setting, i.e. what these students are expected to read and write, and how they write.

Methods
Data, for this ethnographically inspired case-study, was produced by observations and audio-recordings of lectures, copies of teachers’ handouts and of volunteering students’ notes, and a multiple-choice-test. Data-analysis was made in five steps, starting with macro-level data, i.e. curriculum and syllabuses, followed by the syllabuses for the two observed modules, the teacher-provided material, analysis of the students’ notes, while in the fifth and final step, the results from the previous steps were compared, to find patterns of what students were expected to read and write, and what in the teacher-provided multimodal material that was emphasized in teachers’ talk.

Results
This study showed that students were engaged in several types of literacy events, such as reading, finding and watching videos on their learning platform, writing, and following instructions. The study also showed that there is a recurrent academic content comprised of anatomy, physiology and pathology, while the professional content comprised of patient communication and anamnesis. Further, an integrated content was found and was initiated in teacher-constructed PowerPoints and by student-questions. Note-taking patterns varied between individual students, but the general pattern for this group of students were the use of complementary notes. This type of note-taking was used to make available further descriptions of the teacher-constructed text in PowerPoints, but also an independent text describing pictures shown on teachers’ PowerPoints or the blackboard.

Conclusion
Findings from the present study reveal that students either copy text from teachers’ PowerPoint-slides, re-formulate text from teachers’ PowerPoint-slides, or write complementing text to teachers’ PowerPoint-slides. Further, the students individually choses type of note-taking based on situation. The study also revealed that the academic literacy – in the two modules during the fifth and sixth semesters of a dental education analyzed – mainly has a professional basis for reading, writing, and communication purposes. The study also showed that academic and professional literacy are closely connected through recurrent integration.
Creation of a novel simple heat mapping method for curriculum mapping, using pathology teaching as the exemplar
Authors: Clark Ryan , Bell Sarah , Roccisana Jennifer , Oien Karin A. , Sneddon Sharon F. 
Published: July 2021

Abstract
Background
The undergraduate five-year MBChB programme at the University of Glasgow has a high volume of pathology teaching integrated into the course. The ability to better understand what pathology is taught and when, so as to build a picture of the types and depth of pathology topics covered across the programme stages is crucial, especially in a spiral curriculum. A novel method of curriculum mapping, known as curriculum heat mapping, was developed as a way to visualise where and when topics are taught, in an easier to understand format.

Methods
This method involved comparing the Glasgow curriculum to a pre-determined standard of what should be taught. In this case, The Royal College of Pathologists’ ‘Pathology Undergraduate Curriculum’ was used as a comparison of what a graduating doctor should know about pathology.

Results
Following the developed template, heat maps showcasing the range of pathology topics covered, and where they are covered, were developed for local use.
These heat maps provided a clear visual representation of where and when topics are taught, and how they cluster.

Conclusions
Heat mapping is a novel low-cost, high-input method of curriculum mapping. It requires a person to input the data which can take a long time for large curricula. There are no other upfront financial costs. It can be used in any area with a curriculum and an external or internal comparator. Examples of gold standard external comparators include validated national or international curricula.
Heat mapping can help integrated, spiral curriculum programmes to identify where core topics are taught throughout their course. The heat maps themselves successfully demonstrate the required information and are easy to interpret. The process of mapping, as well as the final heat map, can yield important information. This includes information about trends within the curriculum, areas for potential improvement in sessional design and a clearer understanding of the depth to which each topic is covered in each lecture.
Overall, it is a viable novel method, which has been successful locally and is easily transferable to other areas such as pharmacology.
Factors influencing the patient safety climate in intensive care units: cross-sectional study
Authors: de Lima Silva Nunes Ranielle , de Camargo Silva Ana Elisa Bauer , de Lima Juliana Carvalho , Carvalho Dayse Edwiges , Bernardes Cristina Alves , Sousa Tanielly Paula , Gimenes Fernanda Raphael Escobar , Pires Ana Claudia Andrade Cordeiro 
Published: July 2021

Abstract
Background
Measuring the patient safety climate of a health service provides important information about the safety status at a given time. This study aimed to determine the factors influencing the patient safety climate in Intensive Care Units.

Methods
An analytical and cross-sectional study conducted in 2017 and 2018 in two adult Intensive Care Units of a Brazilian Teaching Hospital. The Safety Attitudes Questionnaire instrument was applied with the multidisciplinary teams to determine the factors influencing the patient safety climate. Data were double entered into a database and processed using the R (version 3.5.0) statistical software. Position, central tendency and dispersion measures were taken and absolute and relative frequencies, mean and confidence intervals were calculated for the quantitative variables. Linear regression was performed to verify the effect of variables on the SAQ domains. Variables with a p-value of less than 0.25 were selected for multivariate analysis.

Results
A total of 84 healthcare providers participated in the study. The mean Safety Attitudes Questionnaire score was 59.5, evidencing a negative climate. The following factors influenced the safety climate: time since course completion, professional category, type of employment contract, complementary professional training, and weekly workload.

Conclusions
The factors identified indicate items for planning improvements in communication, teamwork, work processes, and management involvement, aiming to ensure care safety and construct a supportive safety climate.
Psychometric properities of the Polish version of clinical learning environment inventory
Authors: Bodys-Cupak Iwona 
Published: July 2021

Abstract
Background
Clinical experience is a crucial activity for nursing students. The way students` perceive clinical placement exerts an immense influence on the learning process. This study aims to test the psychometric properties of a 19-item version of the Clinical Learning Environment Inventory under Polish clinical conditions.

Method
For this study, Discriminant validity and Cronbach’s alpha reliabilities were computed. In order to measure content validity, the criterion validity Generalized Self Efficacy Scale and the Life Orientation Test - Revised were used.

Results
Cronbach’s Alpha for the Clinical Facilitator Support of Learning Scale and the Satisfaction with Clinical Placement scale is 0.949 and 0.901, respectively. The Spearman’s rank correlation coefficient indicates the existence of a positive correlation between the students’ satisfaction with clinical placement and their [overall] life optimism. Age correlates negatively with perceived teacher support and positively with satisfaction with clinical placement. The sense of self-efficacy correlates negatively with their satisfaction with clinical placement. Clinical Learning Environment Inventory − 19 could be a useful tool to evaluate the quality of the clinical learning process in Polish conditions.
Metagenome-wide association study of gut microbiome revealed potential microbial marker set for diagnosis of pediatric myasthenia gravis
Authors: Liu Peng , Jiang Yiqi , Gu Shanshan , Xue Yinping , Yang Hongxia , Li Yongzhao , Wang Yaxuan , Yan Congya , Jia Pei , Lin Xiaoting , Qi Guoyan 
Published: July 2021

Abstract
Background
Myasthenia gravis (MG) is an acquired immune-mediated disorder of the neuromuscular junction that causes fluctuating skeletal muscle weakness and fatigue. Pediatric MG and adult MG have many different characteristics, and current MG diagnostic methods for children are not quite fit. Previous studies indicate that alterations in the gut microbiota may be associated with adult MG. However, it has not been determined whether the gut microbiota are altered in pediatric MG patients.

Methods
Our study recruited 53 pediatric MG patients and 46 age- and gender-matched healthy controls (HC). We sequenced the fecal samples of recruited individuals using whole-genome shotgun sequencing and analyzed the data with in-house bioinformatics pipeline.

Results
We built an MG disease classifier based on the abundance of five species, Fusobacterium mortiferum, Prevotella stercorea, Prevotella copri, Megamonas funiformis, and Megamonas hypermegale. The classifier obtained 94% area under the curve (AUC) in cross-validation and 84% AUC in the independent validation cohort. Gut microbiome analysis revealed the presence of human adenovirus F/D in 10 MG patients. Significantly different pathways and gene families between MG patients and HC belonged to P. copri, Clostridium bartlettii, and Bacteroides massiliensis. Based on functional annotation, we found that the gut microbiome affects the production of short-chain fatty acids (SCFAs), and we confirmed the decrease in SCFA levels in pediatric MG patients via serum tests.

Conclusions
The study indicated that altered fecal microbiota might play vital roles in pediatric MG’s pathogenesis by reducing SCFAs. The microbial markers might serve as novel diagnostic methods for pediatric MG.
Identification of autophagy-related risk signatures for the prognosis, diagnosis, and targeted therapy in cervical cancer
Authors: Meng Dan , Jin Hua , Zhang Xing , Yan Wenjing , Xia Qianqian , Shen Siyuan , Xie Shuqian , Cui Mengjing , Ding Bo , Gu Yun , Wang Shizhi 
Published: July 2021

Abstract
Background
To rummage autophagy-related prognostic, diagnostic, and therapeutic biomarkers in cervical cancer (CC).

Methods
The RNA-sequence and clinical information were from the TCGA and GTEx databases. We operated Cox regression to determine signatures related to overall survival (OS) and recurrence-free survival (RFS) respectively. The diagnostic and therapeutic effectiveness of prognostic biomarkers were further explored.

Results
We identified nine (VAMP7, MTMR14, ATG4D, KLHL24, TP73, NAMPT, CD46, HGS, ATG4C) and three risk signatures (SERPINA1, HSPB8, SUPT20H) with prognostic values for OS and RFS respectively. Six risk signatures (ATG4C, ATG4D, CD46, TP73, SERPINA1, HSPB8) were selected for qPCR. We screened five prognostic signatures(ATG4C, CD46, HSPB8, MTMR14, NAMPT) with diagnostic function through the GEO database. Correlation between our models and treatment targets certificated the prognostic score provided a reference for precision medicine.

Conclusions
We constructed OS and RFS prognostic models in CC. Autophagy-related risk signatures might serve as diagnostic and therapeutic biomarkers.
Identification and validation of lncRNAs involved in m6A regulation for patients with ovarian cancer
Authors: Zheng Jianfeng , Guo Jialu , Cao Benben , Zhou Ying , Tong Jinyi 
Published: July 2021

AbstractBackgroundBoth N6-methyladenosine (m6A) modification and lncRNAs play an important role in the carcinogenesis and cancer inhibition of ovarian cancer (OC). However, lncRNAs involved in m6A regulation (LI-m6As) have never been reported in OC. Herein, we aimed to identify and validate a signature based on LI-m6A for OC.MethodsRNA sequencing profiles with corresponding clinical information associated with OC and 23 m6A regulators were extracted from TCGA. The Pearson correlation coefficient (PCC) between lncRNAs and 23 m6A regulators (|PCC|> 0.4 and p < 0.01) was calculated to identify LI-m6As. The LI-m6As with significant prognostic value were screened based on univariate Cox regression analysis to construct a risk model by LASSO Cox regression. Gene Set Enrichment Analysis (GSEA) was implemented to survey the biological functions of the risk groups. Several clinicopathological characteristics were utilized to evaluate their ability to predict prognosis, and a nomogram was constructed to evaluate the accuracy of survival prediction. Besides, immune microenvironment, checkpoint, and drug sensitivity in the two risk groups were compared using comprehensive algorithms. Finally, real-time qPCR analysis and cell counting kit-8 assays were performed on an alternative lncRNA, CACNA1G-AS1.ResultsThe training cohort involving 258 OC patients and the validation cohort involving 111 OC patients were downloaded from TCGA. According to the PCC between the m6A regulators and lncRNAs, 129 LI-m6As were obtained to perform univariate Cox regression analysis and then 10 significant prognostic LI-m6As were identified. A prognostic signature containing four LI-m6As (AC010894.3, ACAP2-IT1, CACNA1G-AS1, and UBA6-AS1) was constructed according to the LASSO Cox regression analysis of the 10 LI-m6As. The prognostic signature was validated to show completely opposite prognostic value in the two risk groups and adverse overall survival (OS) in several clinicopathological characteristics. GSEA indicated that differentially expressed genes in disparate risk groups were enriched in several tumor-related pathways. At the same time, we found significant differences in some immune cells and chemotherapeutic agents between the two groups. An alternative lncRNA, CACNA1G-AS1, was proven to be upregulated in 30 OC specimens and 3 OC cell lines relative to control. Furthermore, knockdown of CACNA1G‐AS1 was proven to restrain the multiplication capacity of OC cells.ConclusionsBased on the four LI-m6As (AC010894.3, ACAP2-IT1, CACNA1G-AS1, and UBA6-AS1), the risk model we identified can independently predict the OS and therapeutic value of OC. CACNA1G‐AS1 was preliminarily proved to be a malignant lncRNA.
High burden of anemia among pregnant women in Tanzania: a call to address its determinants
Authors: Sunguya Bruno F. , Ge Yue , Mlunde Linda , Mpembeni Rose , Leyna Germana , Huang Jiayan 
Published: July 2021

Abstract
Background
Anemia in pregnancy is behind a significant burden of maternal mortality and poor birth outcomes globally. Efforts to address it need evidence on trends and its pertinent factors as they vary from one area to another.

Methods
We pooled data of 23,203 women of reproductive age whose hemoglobin levels were measured from two Tanzania Demographic and Health Surveys (TDHS). Of them, 2,194 women were pregnant. Analyses employed descriptive analyses to determine the burden of anemia, its characteristics, and severity; GIS mapping to determine the regional changes of anemia between 2005 and 2015; and logistic regression to determine the remaining determinants of anemia among pregnant women using Stata 15.

Results
The burden of anemia among pregnant women in Tanzania has remained unprecedently high, and varies between regions. There was no significant decline of anemia in general between the two periods after adjusting for individual, households, reproductive, and child characteristics [AOR = 0.964, 95% CI = 0.774–1.202, p = 0.747). Anemia is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. It is more likely to be prevalent among those within large families, with no formal education, food insecurity, lack of health insurance, had no antimalaria during pregnancy, and had low frequency of ANC attendance. On the other hand, delivery in a health facility may be potentially protective against anemia.

Conclusions
Anemia in pregnancy remained persistently high and prevalent among 57% of pregnant women in Tanzania. Efforts to address anemia are crucial and need to be focused in regions with increasing burden of anemia among pregnant women. It is imperative to address important risk factors such as food insecurity, strengthening universal health coverage, empowering women of reproductive age with education and especially nutritional knowledge and advocating for early antenatal booking, attendance, and facility delivery.
Optimizing the maximum reported cluster size in the spatial scan statistic for survival data
Authors: Lee Sujee , Moon Jisu , Jung Inkyung 
Published: July 2021

Abstract
Background
The spatial scan statistic is a useful tool for cluster detection analysis in geographical disease surveillance. The method requires users to specify the maximum scanning window size or the maximum reported cluster size (MRCS), which is often set to 50% of the total population. It is important to optimize the maximum reported cluster size, keeping the maximum scanning window size at as large as 50% of the total population, to obtain valid and meaningful results.

Results
We developed a measure, a Gini coefficient, to optimize the maximum reported cluster size for the exponential-based spatial scan statistic. The simulation study showed that the proposed method mostly selected the optimal MRCS, similar to the true cluster size. The detection accuracy was higher for the best chosen MRCS than at the default setting. The application of the method to the Korea Community Health Survey data supported that the proposed method can optimize the MRCS in spatial cluster detection analysis for survival data.

Conclusions
Using the Gini coefficient in the exponential-based spatial scan statistic can be very helpful for reporting more refined and informative clusters for survival data.
Factors associated with opioid overdose during medication-assisted treatment: How can we identify individuals at risk?
Authors: Au Vivian Y. O. , Rosic Tea , Sanger Nitika , Hillmer Alannah , Chawar Caroul , Worster Andrew , Marsh David C. , Thabane Lehana , Samaan Zainab 
Published: July 2021

AbstractBackgroundDue to the loss of tolerance to opioids during medication-assisted treatment (MAT), this period may represent a time of heightened risk for overdose. Identifying factors associated with increased risk of overdose during treatment is therefore paramount to improving outcomes. We aimed to determine the prevalence of opioid overdoses in patients receiving MAT. Additionally, we explored factors associated with opioid overdose during MAT and the association between length of time enrolled in MAT and overdose.MethodsData were collected prospectively from 2360 participants receiving outpatient MAT in Ontario, Canada. Participants were divided into three groups by overdose status: no history of overdose, any lifetime history of overdose, and emergency department visit for opioid overdose in the last year. We used a multivariate multinomial regression model to assess demographic and clinical factors associated with overdose status.ResultsTwenty-four percent of participants reported a lifetime history of overdose (n = 562), and 8% reported an emergency department (ED) visit for opioid overdose in the last year (n = 179). Individuals with a recent ED visit for opioid overdose were in treatment for shorter duration (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.87, 0.97,p = 0.001). Individuals with a lifetime or recent history of overdose were more likely to be younger in age (OR 0.93, 95% CI 0.89, 0.98,p = 0.007 and OR 0.84, 95% CI 0.77, 0.92,p < 0.001, respectively), report more physical symptoms (OR 1.02, 95% CI 1.01, 1.03,p = 0.005 and OR 1.03, 95% CI 1.01, 1.05,p = 0.005, respectively), and had higher rates of non-prescription benzodiazepine use (OR 1.87, 95% CI 1.32, 2.66,p < 0.001 and OR 2.34, 95% CI 1.43, 3.81,p = 0.001, respectively) compared to individuals with no history of overdose.ConclusionsA considerable number of patients enrolled in MAT have experienced overdose. Our study highlights that there are identifiable factors associated with a patient’s overdose status that may represent areas for intervention. In particular, longer duration in MAT is associated with a decreased risk of overdose.