bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries
Authors: Fudim Marat , Zhong Lin , Patel Kershaw V. , Khera Rohan , Abdelmalek Manal F. , Diehl Anna Mae , McGarrah Robert W. , Molinger Jeroen , Moylan Cynthia A. , Rao Vishal N. , Wegermann Kara , Neeland Ian J. , Halm Ethan A. , Das Sandeep R. , Pandey Ambarish 
Published: November 2021

Background
Nonalcoholic fatty liver disease (NAFLD) and heart failure (HF) are increasing in prevalence. The independent association between NAFLD and downstream risk of HF and HF subtypes (HF with preserved ejection fraction and HF with reduced ejection fraction) is not well established.

Methods and Results

This was a retrospective, cohort study among Medicare beneficiaries. We selected Medicare beneficiaries without known prior diagnosis of HF. NAFLD was defined using presence of 1 inpatient or 2 outpatient claims using
International Classification of Diseases, Ninth Revision, Clinical Modification
(
ICD‐9‐CM
), claims codes. Incident HF was defined using at least 1 inpatient or at least 2 outpatient HF claims during the follow‐up period (October 2015–December 2016). Among 870 535 Medicare patients, 3.2% (N=27 919) had a clinical diagnosis of NAFLD. Patients with NAFLD were more commonly women, were less commonly Black patients, and had a higher burden of comorbidities, such as diabetes, obesity, and kidney disease. Over a mean 14.3 months of follow‐up, patients with (versus without) baseline NAFLD had a significantly higher risk of new‐onset HF in unadjusted (6.4% versus 5.0%;
P
<0.001) and adjusted (adjusted hazard ratio [HR] [95% CI], 1.23 [1.18–1.29]) analyses. Among HF subtypes, the association of NAFLD with downstream risk of HF was stronger for HF with preserved ejection fraction (adjusted HR [95% CI], 1.24 [1.14–1.34]) compared with HF with reduced ejection fraction (adjusted HR [95% CI], 1.09 [0.98–1.2]).

Conclusions
Patients with NAFLD are at an increased risk of incident HF, with a higher risk of developing HF with preserved ejection fraction versus HF with reduced ejection fraction. The persistence of an increased risk after adjustment for clinical and demographic factors suggests an epidemiological link between NAFLD and HF beyond the basis of shared risk factors that requires further investigation.
One-Year Outcome After Endovascular Treatment for Acute Basilar Artery Occlusion
Authors: Li Fengli , Sang Hongfei , Song Jiaxing , Guo Zhangbao , Liu Shuai , Luo Weidong , Yuan Junjie , Qiu Zhongming , Huang Jiacheng , Chen Luming , Li Linyu , Wu Deping , Zi Wenjie , Nogueira Raul Gomes , Shuai Jie , Yang Qingwu ,   for the BASILAR Investigators
Published: November 2021

Background and Purpose:
The BASILAR registry, a nationwide prospective nonrandomized study conducted in China, enrolled consecutive patients with acute basilar artery occlusion receiving endovascular treatment or conventional-treatment from January 2014 to May 2019. This article aimed to report the results of clinical follow-up at one year among these patients.

Methods:
The primary outcome was the modified Rankin Scale at one year, assessed as a common odds ratio using ordinal logistic regression analysis adjusted for prespecified prognostic factors. Secondary outcomes included the modified Rankin Scale-based outcome group at one year (0–1, 0–2, or 0–3) and all-cause death.

Results:

Of the 829 patients enrolled in the original BASILAR registry, one-year data were available for 785 patients (94.7%). The distribution of outcomes on the modified Rankin Scale favored endovascular treatment over conventional-treatment (adjusted common odds ratio, 4.50 [95% CI, 2.81–7.29];
P
<0.001). The cumulative one-year mortality rate was 54.6% in the endovascular treatment group versus 83.5% in the conventional-treatment group (adjusted odds ratio, 4.36 [95% CI, 2.69–7.29];
P
<0.001).

Conclusions:
The beneficial effect of endovascular treatment on functional outcome at one year in patients with acute basilar artery occlusion is similar to that reported at 90 days in the original study.

REGISTRATION:

URL:
http://www.chictr.org.cn
; Unique identifier: ChiCTR1800014759.
Rabbit microbiota across the whole body revealed by 16S rRNA gene amplicon sequencing
Authors: Hu Xiaofen , Wang Fei , Yang Shanshan , Yuan Xu , Yang Tingyu , Zhou Yunxiao , Li Yong 
Published: November 2021

Abstract
Background
Rabbit can produce meat, fur and leather, and serves as an important biomedical animal model. Understanding the microbial community of rabbits helps to raise rabbits healthily and better support their application as animal models.

Results
In this study, we selected 4 healthy Belgium gray rabbits to collect the microbial samples from 12 body sites, including skin, lung, uterus, mouth, stomach, duodenum, ileum, jejunum, colon, cecum, cecal appendix and rectum. The microbiota across rabbit whole body was investigated via 16S rRNA gene amplicon sequencing. After quality control, 46 samples were retained, and 3,148 qualified ASVs were obtained, representing 23 phyla and 264 genera. Based on the weighted UniFrac distances, these samples were divided into the large intestine (Lin), stomach and small intestine (SSin), uterus (Uter), and skin, mouth and lung (SML) groups. The diversity of Lin microbiota was the highest, followed by those of the SSin, Uter and SML groups. In the whole body, Firmicutes (62.37%), Proteobacteria (13.44%) and Bacteroidota (11.84%) were the most predominant phyla. The relative abundance of Firmicutes in the intestinal tract was significantly higher than that in the non-intestinal site, while Proteobacteria was significantly higher in the non-intestinal site. Among the 264 genera, 35 were the core microbiota distributed in all body sites. Sixty-one genera were specific in the SML group, while 13, 8 and 1 were specifically found in the Lin, SSin and Uter groups, respectively. The Lin group had the most difference with other groups, there were average 72 differential genera between the Lin and other groups. The functional prediction analysis showed that microbial function within each group was similar, but there was a big difference between the intestinal tracts and the non-intestinal group. Notably, the function of microorganism in uterus and mouth were the most different from those in the gastrointestinal sites; rabbit’s coprophagy of consuming soft feces possibly resulted in little differences of microbial function between stomach and large intestinal sites.

Conclusion
Our findings improve the knowledge about rabbit microbial communities throughout whole body and give insights into the relationship of microbial communities among different body sites in health rabbits.
Characterization of wall-associated kinase/wall-associated kinase-like (WAK/WAKL) family in rose (Rosa chinensis) reveals the role of RcWAK4 in Botrytis resistance
Authors: Liu Xintong , Wang Zicheng , Tian Yu , Zhang Shiya , Li Dandan , Dong Wenqi , Zhang Changqing , Zhang Zhao 
Published: November 2021

Abstract
Background
Wall-associated kinase (WAK)/WAK-like (WAKL) is one of the subfamily of receptor like kinases (RLK). Although previous studies reported that WAK/WAKL played an important role in plant cell elongation, response to biotic and abiotic stresses, there are no systematic studies on RcWAK/RcWAKL in rose.

Results
In this study, we identified a total of 68 RcWAK/RcWAKL gene family members within rose (Rosa chinensis) genome. The RcWAKs contained the extracellular galacturonan-binding domain and calcium-binding epidermal growth factor (EGF)-like domain, as well as an intracellular kinase domains. The RcWAKLs are missing either calcium-binding EGF-like domain or the galacturonan-binding domain in their extracellular region. The phylogenetic analysis showed the RcWAK/RcWAKL gene family has been divided into five groups, and these RcWAK/RcWAKL genes were unevenly distributed on the 7 chromosomes of rose. 12 of RcWAK/RcWAKL genes were significantly up-regulated by Botrytis cinerea-inoculated rose petals, where RcWAK4 was the most strongly expressed. Virus induced gene silencing of RcWAK4 increased the rose petal sensitivity to B. cinerea. The results indicated RcWAK4 is involved in the resistance of rose petal against B. cinerea.

Conclusion
Our study provides useful information to further investigate the function of the RcWAK/RcWAKL gene family and breeding research for resistance to B. cinerea in rose.
Determinants of migraine headache among regular undergraduate students, of Wollo University, Dessie, Ethiopia: cross–sectional study
Authors: Birkie Mengesha , Endris Mohammed , Asnakew Sintayehu 
Published: November 2021

Abstract
Background
The prevalence of migraine headaches varied from 2.4 to 48.5% worldwide among university students. As per the knowledge of the investigators, the study of migraine headaches is not done in this study area. Hence, this study aimed to assess determinates of migraine headaches among regular undergraduate students, of Wollo University, Dessie, Ethiopia, 2020.

Method
Institution-based cross-sectional study design was conducted from November 15–30 /2020 by using a self-administered questionnaire among 371 regular undergraduate students at Wollo University. A multistage sampling technique was employed to represent our study population. Identity migraine test, Migraine Disability Assessment Questionnaire, perceived stress scale, and Oslo social support scale was used. Descriptive statistics, binary and multiple logistic regression were employed. The adjusted odds ratio at a 95% confidence interval and level of significance (p-value < 0.05) was used to interpret the findings.

Results
From 371 participants, the prevalence of migraine headache in this study was 34% (95% CI: 29.2, 38.5). Variables statistically associated with migraine headache, were a family history of headache (AOR = 3.83, CI: 2.313, 6.366), suicidal thoughts in the past 3 months (AOR = 10.76, CI: 2.117, 54.74), and had low perceived stress 62.6% (AOR = 0.374, CI: 0.205, 0.683).

Conclusion
In this study, the prevalence of migraine headaches was very high. Family history of headache, suicidal thoughts, and low perceived stress were determinates for migraine headache. So special emphasis shall be given to those participants who had high perceived stress, a family history of migraine headache, and suicidal thoughts.
A cross-sectional study of mental health and suicidality among trans women in São Paulo, Brazil
Authors: Reis Arianne , Sperandei Sandro , de Carvalho Paula Galdino Cardin , Pinheiro Thiago Félix , de Moura Ferdinando Diniz , Gomez José Luis , Porchat Patrícia , Bastos Francisco Inácio , McFarland Willi , Wilson Erin C. , Veras Maria Amélia 
Published: November 2021

Abstract
Background
Trans women have been shown to experience disproportionately poor outcomes in physical and mental health. Although it is common to talk about the violence against trans people, little is still known about mental health outcomes and experiences of suicidality among trans women, particularly in developing countries. This study aims to investigate risk factors and associations with mental health, suicide ideation and suicide attempts among trans women in the largest metropolitan area in Brazil.

Methods
Trans women living in São Paulo were recruited between May 2017 and July 2019 using the long-chain peer referral method Respondent-Driven Sampling. Multivariate regression models were used to investigate the associations with K10 score classification (logistic) and suicidal ideation/suicide attempt (ordinal logistic).

Results
A total of 763 trans women were included in the study. Over one quarter (26.5%) of trans women had been diagnosed with anxiety in the past, and close to one in five (19.1%) trans women had received a diagnosis of depression. More than two in five (41.9%) trans women had moderate to severe psychological distress. More than half of all participating trans women reported having previously either experienced suicidal ideation or attempted to take their own lives (25.0 and 31.2% respectively). In multivariate regression, moderate to severe psychological distress was associated with homelessness, income, current sex work, use of stimulant drugs, history of physical abuse, depression diagnosis and access to mental health treatment. Suicidal ideation and suicide attempts were associated with race/skin color, living arrangements, marital status, current sex work, history of sexual violence, depression and PTSD diagnoses, access to mental health treatment and psychological distress.

Conclusions
This study showed that there is a significant association between mental health conditions, lack of treatment for these conditions and suicidality among trans gender women. Findings point to the need for a structural transformation in Brazil that enables a reduction in the social inequality and violence that impact the mental health of trans women. A number of recommendations to achieve this are provided.
First steps towards international competency goals for residency training: a qualitative comparison of 3 regional standards in anesthesiology
Authors: Buléon Clément , Eng Reuben , Rudolph Jenny W. , Minehart Rebecca D. 
Published: November 2021

Abstract
Background
Competency-based medical education (CBME) has revolutionized approaches to training by making expectations more concrete, visible, and relevant for trainees. Designing, applying, and updating CBME requirements challenges residency programs, which must address many aspects of training simultaneously. This challenge also exists for educational regulatory bodies in creating and adjusting national competencies to standardize training expectations. We propose that an international approach for mapping residency training requirements may provide a baseline for assessing commonalities and differences. This approach allows us to take our first steps towards creating international competency goals to enhance sharing of best practices in education and clinical work.

Methods
We chose anesthesiology residency training as our example discipline. Using two rounds of content analysis, we qualitatively compared published anesthesiology residency competencies for the European Union (The European Training Requirement), United States (ACGME Milestones), and Canada (CanMEDS Competence By Design), focusing on similarities and differences in representation (round one) and emphasis (round two) to generate hypotheses on practical solutions regarding international educational standards.

Results
We mapped the similarities and discrepancies between the three repositories. Round one revealed that 93% of competencies were common between the three repositories. Major differences between European Training Requirement, US Milestones, and Competence by Design competencies involved critical emergency medicine. Round two showed that over 30% of competencies were emphasized equally, with notable exceptions that European Training Requirement emphasized Anaesthesia Non-Technical Skills, Competence by Design highlighted more granular competencies within specific anesthesiology situations, and US Milestones emphasized professionalism and behavioral practices.

Conclusions
This qualitative comparison has identified commonalities and differences in anesthesiology training which may facilitate sharing broader perspectives on diverse high-quality educational, clinical, and research practices to enhance innovative approaches. Determining these overlaps in residency training can prompt international educational societies responsible for creating competencies to collaborate to design future training programs. This approach may be considered as a feasible method to build an international core of residency competency requirements for other disciplines.
Barriers and facilitators of using mobile devices as an educational tool by nursing students: a qualitative research
Authors: Nikpeyma Nasrin , Zolfaghari Mitra , Mohammadi Aeen 
Published: November 2021

Abstract
Background
Although the use of mobile devices can facilitate the learning process, there may be barriers to using them for learning purposes. This study aimed to identify and investigate the barriers and facilitators of using mobile devices as an educational device from the perspective of nursing students.

Methods
This qualitative descriptive study was conducted in 2020 on undergraduate nursing students of the Nursing and Midwifery Faculty, Tehran University of Medical Sciences. A total of 22 undergraduate nursing students were selected by purposive sampling with maximum variability. Inclusion criteria were Undergraduate nursing education, having mobile devices, and willingness to participate in research. Data were collected through semi-structured individual interviews for 45–75 min in the proposed environment of students until the data were saturated. Data analysis was performed manually using the framework analysis method with the steps: familiarization, identifying a thematic framework, indexing, Charting and Synthesis, Mapping, and Interpretation. Trustworthiness was determined by methods of Credibility, Dependability, Conformability, and Transferability.

Results
The majority of participants (45.45%) were 21 years old, 63.63% were women, and 36.36% studied in the 8th semester. Findings from the analysis of interviews showed that barriers to the use of mobile devices were classified into 4 main categories (barriers related to mobile devices, barriers related to Internet access, barriers related to information literacy, cultural-environmental barriers) and 15 subcategories, and facilitating the use of mobile devices was divided into 2 main categories (easy to use mobile devices and easy access to information) and 6 subcategories.

Conclusion
The results of this study help educational managers and curriculum planners to adapt to technological change, to focus on the many benefits of mobile devices as an educational tool, and to plan to overcome barriers to mobile device use, and use mobile devices to teach theoretical topics and clinical nursing skills effectively.
Development of a model of medication review for use in clinical practice: Bristol medication review model
Authors: McCahon D. , Denholm R. E. , Huntley A. L. , Dawson S. , Duncan P. , Payne R. A. 
Published: November 2021

Abstract
Background
Medication review is a core aspect of medicine optimisation, yet existing models of review vary substantially in structure and content and are not necessarily easy to implement in clinical practice. This study aimed to use evidence from the existing literature to identify key medication review components and use this to inform the design of an improved review model.

Methods
A systematic review was conducted (PROSPERO: CRD42018109788) to identify randomised control trials of stand-alone medication review in adults (18+ years). The review updated that by Huiskes et al. (BMC Fam Pract. 18:5, 2017), using the same search strategy implemented in MEDLINE and Embase. Studies were assessed using the Cochrane risk of bias tool. Key review components were identified, alongside relevant clinical and health service outcomes. A working group (patients, doctors and pharmacists) developed the model through an iterative consensus process (appraisal of documents plus group discussions), working from the systematic review findings, brief evidence summaries for core review components and examples of previous models, to agree on the main purpose of the review model, overarching model structure, review components and supporting material.

Results
We identified 28 unique studies, with moderate bias overall. Consistent medication review components included reconciliation (26 studies), safety assessment (22), suboptimal treatment (19), patient knowledge/preferences (18), adherence (14), over-the-counter therapy (13) and drug monitoring (10). There was limited evidence from studies for improvement in key clinical outcomes. The review structure was underpinned by patient values and preferences, with parallel information gathering and evaluation stages, feeding into the final decision-making and implementation. Most key components identified in the literature were included. The final model was considered to benefit from a patient-centred, holistic approach, which captured both patient-orientated and medication-focused problems, and aligned with traditional consultation methods thus facilitating implementation in practice.

Conclusions
The Bristol Medication Review Model provides a framework for standardised delivery of structured reviews. The model has the potential for use by all healthcare professionals with relevant clinical experience and is designed to offer flexibility of implementation not limited to a particular healthcare setting.
Diagnostic value of routine chest tube tip culture in surgery for noninfectious lung disease
Authors: van Schelt Martijn , Jenniskens Kevin , Rentenaar Rob J. , Bronsveld Inez 
Published: November 2021

Abstract
Background
Evaluation of the diagnostic value of routine chest tube tip culture for detection of postoperative infection after surgery for noninfectious lung disease.

Methods
Included subjects were patients who underwent lung surgery between January 1st 2013 and January 1st 2018 in University Medical Centre Utrecht and of whom a chest tube tip was cultured. Postoperative outcomes included pneumonia, surgical site infection, and empyema within 30 days after surgery. Univariable analysis for diagnostic accuracy of chest tube tip culture results predicting these postoperative outcomes was performed, as well as multivariable analysis using penalized firth logistic regression.

Results
Patients developed one or more postoperative infections in 42 out of 210 (20%) lung surgeries. Pneumonia, surgical site infection, and empyema were found in 36 (17%), 8 (4%), and 2 (1%) cases respectively. Chest tube tip culture had a sensitivity of 31%, a specificity of 83%, a positive predictive value of 32%, and a negative predictive value of 83% for postoperative infections. In the subgroup of patients who did not have evidence of postoperative infection at the time of chest tube removal, the drain tip culture’s positive and negative predictive value changed to 18% and 92% respectively. Adding additional variables to chest tube tip culture in a prediction model resulting in only limited improvement in diagnostic performance.

Conclusions
We found insufficient diagnostic performance to support the practice of routine chest tube tip culture after surgery for noninfectious lung disease. Therefore, routine chest tube tip culture is not advisable and should be omitted to unburden the healthcare process and prevent low value care together with extra costs.