bluuebunny/crossref_metadata_2025_split huggingface dataset:
Readability of Online Materials Related to Vocal Cord Leukoplakia
Authors: Shneyderman Matthew , Snow Grace E. , Davis Ruth , Best Simon , Akst Lee M. 
Published: August 2021

ObjectivesTo assess readability and understandability of online materials for vocal cord leukoplakia.Study DesignReview of online materials.SettingAcademic medical center.MethodsA Google search of “vocal cord leukoplakia” was performed, and the first 50 websites were considered for analysis. Readability was measured by the Flesch Reading Ease Score (FRES), Flesch‐Kincaid Grade Level (FKGL), and Simple Measure of Gobbledygook (SMOG). Understandability and actionability were assessed by 2 independent reviewers with the PEMAT‐P (Patient Education Materials Assessment Tool for Printable Materials). Unpaired t tests compared scores between sites aimed at physicians and those at patients, and a Cohen’s kappa was calculated to measure interrater reliability.ResultsTwenty‐two websites (17 patient oriented, 5 physician oriented) met inclusion criteria. For the entire cohort, FRES, FKGL, and SMOG scores (mean ± SD) were 36.90 ± 20.65, 12.96 ± 3.28, and 15.65 ± 3.57, respectively, indicating that materials were difficult to read at a >12th‐grade level. PEMAT‐P understandability and actionability scores were 73.65% ± 7.05% and 13.63% ± 22.47%. Statistically, patient‐oriented sites were more easily read than physician‐oriented sites (P <. 02 for each of the FRES, FKGL, and SMOG comparisons); there were no differences in understandability or actionability scores between these categories of sites.ConclusionOnline materials for vocal cord leukoplakia are written at a level more advanced than what is recommended for patient education materials. Awareness of the current ways that these online materials are failing our patients may lead to improved education materials in the future.
Graft-versus-host disease: a disorder of tissue regeneration and repair
Authors: Chakraverty Ronjon , Teshima Takanori 
Published: August 2021

Abstract
Regenerative failure at barrier surfaces and maladaptive repair leading to fibrosis are hallmarks of graft-versus-host disease (GVHD). Although immunosuppressive treatment can control inflammation, impaired tissue homeostasis leads to prolonged organ damage and impaired quality of life. In this Blood Spotlight, we review recent research that addresses the critical failures in tissue regeneration and repair that underpin treatment-resistant GVHD. We highlight current interventions designed to overcome these defects and provide our assessment of the future therapeutic landscape.
CoSTA: unsupervised convolutional neural network learning for spatial transcriptomics analysis
Authors: Xu Yang , McCord Rachel Patton 
Published: August 2021

Abstract
Background
The rise of spatial transcriptomics technologies is leading to new insights about how gene regulation happens in a spatial context. Determining which genes are expressed in similar spatial patterns can reveal gene regulatory relationships across cell types in a tissue. However, many current analysis methods do not take full advantage of the spatial organization of the data, instead treating pixels as independent features. Here, we present CoSTA: a novel approach to learn spatial similarities between gene expression matrices via convolutional neural network (ConvNet) clustering.

Results
By analyzing simulated and previously published spatial transcriptomics data, we demonstrate that CoSTA learns spatial relationships between genes in a way that emphasizes broader spatial patterns rather than pixel-level correlation. CoSTA provides a quantitative measure of expression pattern similarity between each pair of genes rather than only classifying genes into categories. We find that CoSTA identifies narrower, but biologically relevant, sets of significantly related genes as compared to other approaches.

Conclusions
The deep learning CoSTA approach provides a different angle to spatial transcriptomics analysis by focusing on the shape of expression patterns, using more information about the positions of neighboring pixels than would an overlap or pixel correlation approach. CoSTA can be applied to any spatial transcriptomics data represented in matrix form and may have future applications to datasets such as histology in which images of different genes are from similar but not identical biological sections.
A common gene drive language eases regulatory process and eco-evolutionary extensions
Authors: Verma Prateek , Reeves R. Guy , Gokhale Chaitanya S. 
Published: August 2021

AbstractBackgroundSynthetic gene drive technologies aim to spread transgenic constructs into wild populations even when they impose organismal fitness disadvantages. The extraordinary diversity of plausible drive mechanisms and the range of selective parameters they may encounter makes it very difficult to convey their relative predicted properties, particularly where multiple approaches are combined. The sheer number of published manuscripts in this field, experimental and theoretical, the numerous techniques resulting in an explosion in the gene drive vocabulary hinder the regulators’ point of view. We address this concern by defining a simplified parameter based language of synthetic drives.ResultsEmploying the classical population dynamics approach, we show that different drive construct (replacement) mechanisms can be condensed and evaluated on an equal footing even where they incorporate multiple replacement drives approaches. Using a common language, it is then possible to compare various model properties, a task desired by regulators and policymakers. The generalization allows us to extend the study of the invasion dynamics of replacement drives analytically and, in a spatial setting, the resilience of the released drive constructs. The derived framework is available as a standalone tool.ConclusionBesides comparing available drive constructs, our tool is also useful for educational purpose. Users can also explore the evolutionary dynamics of future hypothetical combination drive scenarios. Thus, our results appraise the properties and robustness of drives and provide an intuitive and objective way for risk assessment, informing policies, and enhancing public engagement with proposed and future gene drive approaches.
Non-specific pain and 30-day readmission in acute coronary syndromes: findings from the TRACE-CORE prospective cohort
Authors: Chen Jinying , Kiefe Catarina I. , Gagnier Marc , Lessard Darleen , McManus David , Wang Bo , Houston Thomas K. 
Published: August 2021

Abstract
Background
Patients with acute coronary syndromes often experience non-specific (generic) pain after hospital discharge. However, evidence about the association between post-discharge non-specific pain and rehospitalization remains limited.

Methods
We analyzed data from the Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) prospective cohort. TRACE-CORE followed patients with acute coronary syndromes for 24 months post-discharge from the index hospitalization, collected patient-reported generic pain (using SF-36) and chest pain (using the Seattle Angina Questionnaire) and rehospitalization events. We assessed the association between generic pain and 30-day rehospitalization using multivariable logistic regression (N = 787). We also examined the associations among patient-reported pain, pain documentation identified by natural language processing (NLP) from electronic health record (EHR) notes, and the outcome.

Results
Patients were 62 years old (SD = 11.4), with 5.1% Black or Hispanic individuals and 29.9% women. Within 30 days post-discharge, 87 (11.1%) patients were re-hospitalized. Patient-reported mild-to-moderate pain, without EHR documentation, was associated with 30-day rehospitalization (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.14–3.62, reference: no pain) after adjusting for baseline characteristics; while patient-reported mild-to-moderate pain with EHR documentation (presumably addressed) was not (OR: 1.23, 95% CI: 0.52–2.90). Severe pain was also associated with 30-day rehospitalization (OR: 3.16, 95% CI: 1.32–7.54), even after further adjusting for chest pain (OR: 2.59, 95% CI: 1.06–6.35).

Conclusions
Patient-reported post-discharge generic pain was positively associated with 30-day rehospitalization. Future studies should further disentangle the impact of cardiac and non-cardiac pain on rehospitalization and develop strategies to support the timely management of post-discharge pain by healthcare providers.
Developing and evaluating online COVID-centric advance care planning training and information resources for nursing staff and family members in nursing homes: the necessary discussions study protocol
Authors: Harding Andrew , Preston Nancy , Doherty Julie , Cousins Emily , Varey Sandra , McCann Adrienne , Dening Karen Harrison , Finucane Anne , Carter Gillian , Mitchell Gary , Brazil Kevin 
Published: August 2021

Abstract
Background
Nursing home residents are typically older adults with high levels of chronic illness and impairment. As such, they are particularly susceptible to severe complications and mortality from COVID-19. Since all nursing home residents are at increased risk, nursing home care staff need to know what residents would want to happen should they become infected with COVID-19. This study aims to develop and evaluate advance care planning (ACP) COVID-centric online training and information resources for nursing home staff and family members of residents, to improve care at the end of life during a COVID-19 outbreak. Based on the findings we will develop implementation guidelines for nursing homes to ensure wider impact and application during the pandemic and beyond.

Methods
The content of the training and information resources will be based on a rapid review of literature and guidance on ACP in the context of COVID-19 and consultation with the study expert reference group. An integrated communications company will then work alongside the research team to design the online training and information resources. To evaluate the resources, we will employ a multiple case study design where a nursing home (defined as an institutional setting in which nursing care is provided to older adults on-site 24 h a day) will be the unit of analysis or ‘case’. The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will guide the evaluation of implementation of the training and information resources. We will recruit and interview staff and family members from between 6 and 9 nursing homes across Northern Ireland, England and Scotland and gather quantitative data from a feedback survey included in the training and information resources.

Discussion
The Necessary Discussions study is very timely given the challenging experiences of nursing homes, their staff, residents and their family members during the COVID-19 pandemic. It meets a key need and addresses an important gap in research and practice. The training and information resources will be ‘COVID-centric’, but they will also have a longstanding relevance for future ACP practice in UK care homes.

Trial registration
ISRCTN registry (ID 18003630) on 19.05.21
Case report: pulmonary nocardiosis caused by Nocardia exalbida in an immunocompetent patient
Authors: Abe Seitaro , Tanabe Yoshinari , Ota Takeshi , Fujimori Fumio , Youkou Akira , Makino Masato 
Published: August 2021

Abstract
Background
Nocardiosis is known as an opportunistic infection in immunocompromised hosts, but it occasionally has been reported in immunocompetent patient. The Nocardia exalbida is first-reported in 2006 from Japan, and a few cases of have been reported in only immunocompromised host, and the characteristic is still unclear. We herein describe the first case of pulmonary nocardiosis caused by N. exalbida in an immunocompetent patient.

Case presentation
A77 -year-old Japanese man was admitted to our hospital on November 2, 2018. He was a lifelong non-smoker with no childhood history of respiratory disease. He had a medical history of dyslipidemia. One month before this admission fevers, sputum, mild cough were developed and he was evaluated in a clinic near our hospital. His diagnosis was community acquired pneumonia within his right middle lobe. He was treated with ceftriaxone 1 g/day intravenously for a week, however his symptoms relapsed a few days later. So, the physician retried ceftriaxone for another 3 days, but his symptoms did not improve. He was referred to our hospital. He was treated with sitafloxacin as an outpatient for a week, however his symptoms got worse. The chest CT showed consolidation and atelectasis in his right middle lobe. Low density area was scattered in consolidation, and right pleural effusion was observed.
The patient was diagnosed with pulmonary abscess and he was admitted. Administration of piperacillin/tazobactam improved his condition. We switched antibiotics to amoxicillin/clavulanate, and he was discharged. After 2 weeks, he relapsed and was admitted again. After administration of piperacillin/tazobactam for 3 weeks, we perform bronchoscopy and Nocardia species were cultured from samples of the bronchial wash. The isolates were identified as N. exalbida using 16S rRNA gene sequencing. We prescribed Trimethoprim / Sulfamethoxazole (TMP/SMX) for 4 months. Then we switched to minocycline for renal dysfunction caused from TMP-SMX for 1 more month. After 5 months therapy, Consolidation on CT disappeared, and Nocardiosis was cured.

Conclusion
we reported the first case of pulmonary nocardiosis caused by N. exalbida in an immunocompetent patient. N. exalbida infection might be associated with a good response to treatment.
Clinical and virological outcomes with baloxavir compared with oseltamivir in pediatric patients aged 6 to < 12 years with influenza: an open-label, randomized, active-controlled trial protocol
Authors: Ishiguro Nobuhisa , Morioka Ichiro , Nakano Takashi , Furukawa Masashi , Tanaka Shintaro , Kinoshita Masahiro , Manabe Atsushi 
Published: August 2021

Abstract
Background
Children with influenza virus infections are prone to complications and are common sources of influenza transmission. Baloxavir marboxil inhibits cap-dependent endonuclease and was approved for influenza treatment in adolescent, adult, and pediatric patients in Japan. The miniSTONE-2 study included pediatric patients with influenza (1 to < 12 years) and demonstrated similar median times to alleviation of signs and symptoms of influenza with a single dose of baloxavir granules (weight < 20 kg: 2 mg/kg, ≥ 20 kg: 40 mg) and oseltamivir. Although the baloxavir dose in miniSTONE-2 was higher than the Japanese-approved dose, baloxavir exposure in miniSTONE-2 was similar to Japanese pediatric patients who receive the Japanese-approved dose. This study will be the first randomized active-controlled study in pediatric patients with influenza using the Japanese-approved dose of baloxavir.

Methods
This is a multicenter, open-label, randomized, active-controlled trial in which 200 Japanese subjects aged 6 to < 12 years with influenza virus infection are randomly allocated (2:1) to a single dose of baloxavir at the approved dose in Japan (weight ≥ 10 to < 20 kg: 10 mg, ≥ 20 to  < 40 kg: 20 mg, ≥ 40 kg: 40 mg) or oseltamivir twice daily for 5 days. The primary clinical endpoint is the time to illness alleviation of influenza, from administration of baloxavir or oseltamivir until the following criteria were met and sustained for at least 21.5 h (24 h—10%): cough and nasal discharge/nasal congestion rated as absent or mild axillary body temperature < 37.5 °C. The primary analysis population is the intention-to-treat infected population, which includes all pediatric subjects who receive at least one dose of study drug and have confirmed influenza virus infection by reverse transcription-polymerase chain reaction. The safety population includes all subjects who receive at least one dose of study drug.

Discussion
No comparative studies have been conducted to confirm the efficacy and safety of baloxavir versus a comparator in pediatric patients with influenza infection in Japan. The outcomes from this trial will provide evidence on the efficacy and safety of baloxavir as an antiviral treatment option for Japanese pediatric patients with influenza infection. Trial registration Japan Registry of Clinical Trials: jRCTs011200011. Registered November 2020. (https://rctportal.niph.go.jp/en/).
Sero-epidemiology and associated factors of HIV, HBV, HCV and syphilis among blood donors in Ethiopia: a systematic review and meta-analysis
Authors: Melku Mulugeta , Ambachew Sintayehu , Enawgaw Bamlaku , Abebe Molla , Abebe Zegeye , Deressa Tekalign , Damtie Debasu , Biadgo Belete , Tessema Belay , Geremew Demeke , Kebede Asemarie , Woldu Berhanu , Teklu Takele , Shiferaw Elias 
Published: August 2021

Abstract
Background
Transfusion transmissible infections (TTIs) remain a major public health problem in developing countries including Ethiopia. In Ethiopia, comprehensive information about sero-epidemiology of major TTIs is lacking at the national level. Therefore, this systematic review and meta-analysis was aimed at providing the pooled estimate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors in Ethiopia.

Methods
Relevant studies published until May 31, 2019 were searched through PubMed/Medline, EMBASE, SCOPUS, HINARI, Cochrane database library, Web of Science, Google Scholar and Google. The methodological quality of articles was assessed using Joanna Brigg’s Institute critical appraisal checklist for prevalence and analytical studies. The pooled sero-epidemiology of HIV, HBV, HCV and syphilis were determined using the random-effects model. Heterogeneity between the studies was assessed using the I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics.

Results
A total of 7921 articles were retrieved, and 7798 were screened for eligibility after duplicates removed. Forty-nine full-text articles were assessed for eligibility; of which 45 were eligible for qualitative and quantitative synthesis: categorized as 36, 34, 31 and 23 studies for estimations of HBV, HIV, HCV and syphilis, respectively. In the random-effects model, the pooled sero-epidemiology of HBV, HIV, HCV and syphilis was 5.20, 2.83, 0.93 and 1.50%, respectively. Moreover, being a male blood donor was significantly associated with HBV and syphilis infection, whereas being a replacement blood donor was significantly associated with a high burden of HIV, HBV and HCV infections.

Conclusion
The pooled sero-epidemiology of major TTIs among blood donors was high. Therefore, there is a need to design prevention and control strategies in a comprehensive approach to reduce the burden.
A vein-viewing application enabled detecting abdominal wall varices related to the presence of non-treated gastroesophageal varices: a cross-sectional study
Authors: Hoshino Yoshiki , Sugihara Takaaki , Ikeda Suguru , Matsuki Yukako , Nagahara Takakazu , Okano Jun-ichi , Isomoto Hajime 
Published: August 2021

Abstract
Background
Gastroesophageal varices (GOV) are a life-threatening complication in chronic liver disease. A method for non-invasively predicting GOV is crucial for management. This study aimed to determine whether a vein-viewing application can detect abdominal wall varices (AWV) and elucidate the relationship between AWV and GOV.

Methods
One-hundred patients with chronic liver diseases were prospectively enrolled. All the patients underwent esophagogastroduodenoscopy within three months of the enrollment. Unmanipulated images (UI) and vein-weighted images (VWI) were taken for assessing AWV by a vein-viewing application on iPhone. Two doctors independently evaluated both image types. We defined the grading of both UI and AWV as grade 0 (non-detectable), grade 1 (slightly detectable), and grade 2 (distinct).

Results
The causes of liver diseases among the 71 men and 29 women (median age, 70.5 yr) included Hepatitis B (n = 19), Hepatitis C (n = 21), alcoholism (n = 33), primary biliary cholangitis (n = 3), autoimmune hepatitis (n = 4) and others (n = 20). GOV was indicated in ﻿60﻿ patients, and half of them had not been treated previously (non-treated). VWI could significantly visualize AWV than UI (72% vs. 24%, p = 0.0005). The presence of cirrhosis (chronic hepatitis vs. cirrhosis = 64.6% vs. 91.4%, p = 0.004) and GOV (52.3% vs. 74.3%, p = 0.032) were significantly higher in the VWI-AWV grade 2 group. Multivariate analysis demonstrated that VWI-AWV grade 2 was an independent factor related to the presence of non-treated GOV [OR = 3.05 (1.24–7.53), p = 0.016].

Conclusions
The vein-viewing application non-invasively detected AWV related to the presence of cirrhosis and GOV, and VWI-AWV grade 2 was an independent factor related to the presence of non-treated GOV.
Borderline personality disorder and adolescent suicide attempt: the mediating role of emotional dysregulation
Authors: Mirkovic Bojan , Delvenne Véronique , Robin Marion , Pham-Scottez Alexandra , Corcos Maurice , Speranza Mario 
Published: August 2021

Abstract
Background
Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). In addition, recent research in the adolescent population has shown that suicidal behaviours have been associated with maladaptive strategies of emotion regulation.

Methods
This study examined the relative contributions of emotional dysregulation to suicide attempt history in a clinical sample of borderline adolescents. Data were analyzed from 85 participants of the Collaborative European Research Network on Borderline Personality Disorder. Participants completed measures of BPD traits and symptoms, suicide behaviours, emotional dysregulation, attachment styles and lifetime depressive disorders.

Results
In an SEM model, lifetime depressive disorders and insecure attachment styles have a significant direct effect on lifetime suicide attempt, but only lifetime depressive disorders have an indirect effect through emotion dysregulation. The results suggest that emotional dysregulation has a mediating role in suicide attempts among BPD adolescents.

Conclusions
These findings call for the development of interventions targeting the role of emotion dysregulation in effectively predicting and preventing suicidality in borderline adolescents.