bluuebunny/crossref_metadata_2025_split huggingface dataset:
Past climate cooling and orogenesis of the Hengduan Mountains have influenced the evolution of Impatiens sect. Impatiens (Balsaminaceae) in the Northern Hemisphere
Authors: Qin Fei , Xue Tiantian , Zhang Xiaoxia , Yang Xudong , Yu Jianghong , Gadagkar Sudhindra R. , Yu Shengxiang 
Published: November 2023

AbstractBackgroundImpatienssect.Impatiensis distributed across the Northern Hemisphere and has diversified considerably, particularly within the Hengduan Mountains (HDM) in southwest China. Yet, the infra-sectional phylogenetic relationships are not well resolved, largely due to limited taxon sampling and an insufficient number of molecular markers. The evolutionary history of its diversification is also poorly understood. In this study, plastome data and the most complete sampling to date were used to reconstruct a robust phylogenetic framework for this section. The phylogeny was then used to investigate its biogeographical history and diversification patterns, specifically with the aim of understanding the role played by the HDM and past climatic changes in its diversification.ResultsA stable phylogeny was reconstructed that strongly supported both the monophyly of the section and its division into seven major clades (Clades I-VII). Molecular dating and ancestral area reconstruction suggest that sect.Impatiensoriginated in the HDM and Southeast China around 11.76 Ma, after which different lineages dispersed to Northwest China, temperate Eurasia, and North America, mainly during the Pliocene and Pleistocene. An intercontinental dispersal event from East Asia to western North America may have occurred via the Bering Land Bridge or Aleutian Islands. The diversification rate was high during its early history, especially with the HDM, but gradually decreased over time both within and outside the HDM. Multiple linear regression analysis showed that the distribution pattern of species richness was strongly associated with elevation range, elevation, and mean annual temperature. Finally, ancestral niche analysis indicated that sect.Impatiensoriginated in a relatively cool, middle-elevation area.ConclusionsWe inferred the evolutionary history of sect.Impatiensbased on a solid phylogenetic framework. The HDM was the primary source or pump of its diversity in the Northern Hemisphere. Orogeny and climate change may have also shaped its diversification rates, as a steady decrease in the diversification rate coincided with the uplift of the HDM and climate cooling. These findings provide insights into the distribution pattern of sect.Impatiensand other plants in the Northern Hemisphere.
Machine-learning vs. logistic regression for preoperative prediction of medical morbidity after fast-track hip and knee arthroplasty—a comparative study
Authors: Michelsen Christian , Jørgensen Christoffer C. , Heltberg Mathias , Jensen Mogens H. , Lucchetti Alessandra , Petersen Pelle B. , Petersen Troels , Kehlet Henrik ,   The Center for Fast-track Hip Knee Replacement Collaborative group, Madsen Frank , Hansen Torben B. , Gromov Kirill , Jakobsen Thomas , Varnum Claus , Overgaard Soren , Rathsach Mikkel , Hansen Lars 
Published: November 2023

Abstract
Background
Machine-learning models may improve prediction of length of stay (LOS) and morbidity after surgery. However, few studies include fast-track programs, and most rely on administrative coding with limited follow-up and information on perioperative care. This study investigates potential benefits of a machine-learning model for prediction of postoperative morbidity in fast-track total hip (THA) and knee arthroplasty (TKA).

Methods
Cohort study in consecutive unselected primary THA/TKA between 2014–2017 from seven Danish centers with established fast-track protocols. Preoperative comorbidity and prescribed medication were recorded prospectively and information on length of stay and readmissions was obtained through the Danish National Patient Registry and medical records. We used a machine-learning model (Boosted Decision Trees) based on boosted decision trees with 33 preoperative variables for predicting “medical” morbidity leading to LOS > 4 days or 90-days readmissions and compared to a logistical regression model based on the same variables. We also evaluated two parsimonious models, using the ten most important variables in the full machine-learning and logistic regression models. Data collected between 2014–2016 (n:18,013) was used for model training and data from 2017 (n:3913) was used for testing.
Model performances were analyzed using precision, area under receiver operating (AUROC) and precision recall curves (AUPRC), as well as the Mathews Correlation Coefficient. Variable importance was analyzed using Shapley Additive Explanations values.

Results
Using a threshold of 20% “risk-patients” (n:782), precision, AUROC and AUPRC were 13.6%, 76.3% and 15.5% vs. 12.4%, 74.7% and 15.6% for the machine-learning and logistic regression model, respectively. The parsimonious machine-learning model performed better than the full logistic regression model. Of the top ten variables, eight were shared between the machine-learning and logistic regression models, but with a considerable age-related variation in importance of specific types of medication.

Conclusion
A machine-learning model using preoperative characteristics and prescriptions slightly improved identification of patients in high-risk of “medical” complications after fast-track THA and TKA compared to a logistic regression model. Such algorithms could help find a manageable population of patients who may benefit most from intensified perioperative care.
Quantification of muscle tone by using shear wave velocity during an anaesthetic induction: a prospective observational study
Authors: Saito Hidehisa , Sugino Shigekazu , Moteki Shoichiro , Kanaya Akihiro , Yamauchi Masanori 
Published: November 2023

Abstract
Objectives
The quantitative assessment of muscle stiffness or weakness is essential for medical care. Shear wave elastography is non-invasive ultrasound method and provides quantitative information on the elasticity of soft tissue. However, the universal velocity scale for quantification has not been developed. The aim of the study is to determine the shear wave velocities of abdominal muscle during anesthetic induction and to identify methods to cancel the effects of confounders for future development in the quantitative assessment of muscle tone using the universal scale.

Methods
We enrolled 75 adult patients undergoing elective surgery with ASA-PS I – III in the period between December 2018 and March 2021. We measured and calculated the shear wave velocity (SWV) before and after opioid administration (i.e., the baseline at rest and opioid-induced rigidity condition), and after muscle relaxant administration (i.e., zero reference condition). The SWV value was adjusted for the subcutaneous fat thickness by our proposed corrections. The SWVs after the adjustment were compared among the values in baseline, rigidity, and relaxation using one-way repeated-measures ANOVA and post hoc Tukey–Kramer test. A p-value of < 0.05 was considered to be statistically significant. UMIN Clinical Trials Registry identifier UMIN000034692, registered on October 30, 2018.

Results
The SWVs in the baseline, opioid-induced rigidity, and muscle relaxation conditions after the adjustment were 2.08 ± 0.48, 2.41 ± 0.60, and 1.79 ± 0.30 m/s, respectively (p < 0.001 at all comparisons).

Conclusion
The present study suggested that the SWV as reference was 1.79 m/s and that the SWVs at rest and opioid-induced rigidity were ~ 10% and ~ 30% increase from the reference, respectively. The SWV adjusted for the subcutaneous fat thickness may be scale points for the assessment of muscle tone.
Interprofessional collaboration in primary care: what effect on patient health? A systematic literature review
Authors: Bouton Céline , Journeaux Manon , Jourdain Maud , Angibaud Morgane , Huon Jean-François , Rat Cédric 
Published: November 2023

Abstract
Background
In a period of change in the organization of primary care, Interprofessional Collaboration (IPC) is presented as one of the solutions to health issues. Although the number of inter-professional interventions grounded in primary care increases in all developed countries, evidence on the effects of these collaborations on patient-centred outcomes is patchy. The objective of our study was to assess the effects of IPC grounded in the primary care setting on patient-centred outcomes.

Methods
We conducted a systematic literature review using the PubMed, Embase, PsycINFO and CINAHL databases from 01/01/1995 to 01/03/2021, according to the PRISMA guidelines. Studies reporting the effects of IPC in primary care on patient health outcomes were included. The quality of the studies was assessed using the revised Downs and Black checklist.

Results
Sixty-five articles concerning 61 interventions were analysed. A total of 43 studies were prospective and randomized. Studies were classified into 3 main categories as follows: 1) studies with patients at cardiovascular risk (28 studies)—including diabetes (18 studies) and arterial hypertension (5 studies); 2) studies including elderly and/or polypathological patients (18 studies); and 3) patients with symptoms of mental or physical disorders (15 studies). The number of included patients varied greatly (from 50 to 312,377). The proportion of studies that reported a positive effect of IPC on patient-centred outcomes was as follows: 23 out of the 28 studies including patients at cardiovascular risk, 8 out of the 18 studies of elderly or polypathological patients, and 11 out of the 12 studies of patients with mental or physical disorders.

Conclusions
Evidence suggests that IPC is effective in the management of patients at cardiovascular risk. In elderly or polypathological patients and in patients with mental or physical disorders, the number of studies remains very limited, and the results are heterogeneous. Researchers should be encouraged to perform studies based on comparative designs: it would increase evidence on the positive effect and benefits of IPC on patient variables.
Rationale, design, and protocol for a hybrid type 1 effectiveness-implementation trial of a proactive smoking cessation electronic visit for scalable delivery via primary care: the E-STOP trial
Authors: Fahey Margaret C. , Wahlquist Amy E. , Diaz Vanessa A. , Player Marty S. , Natale Noelle , Sterba Katherine R. , Chen Brian K. , Hermes Eric D. A. , Carpenter Mathew J. , Dahne Jennifer 
Published: November 2023

Abstract
Background
Cigarette smoking remains the leading cause of preventable disease and death in the United States. Primary care offers an ideal setting to reach adults who smoke cigarettes and improve uptake of evidence-based cessation treatment. Although U.S. Preventive Services Task Force Guidelines recommend the 5As model (Ask, Advise, Assess, Assist, Arrange) in primary care, there are many barriers to its implementation. Automated, comprehensive, and proactive tools are needed to overcome barriers. Our team developed and preliminarily evaluated a proactive electronic visit (e-visit) delivered via the Electronic Health Record patient portal to facilitate evidence-based smoking cessation treatment uptake in primary care, with promising initial feasibility and efficacy. This paper describes the rationale, design, and protocol for an ongoing Hybrid Type I effectiveness-implementation trial that will simultaneously assess effectiveness of the e-visit intervention for smoking cessation as well as implementation potential across diverse primary care settings.

Methods
The primary aim of this remote five-year study is to examine the effectiveness of the e-visit intervention vs. treatment as usual (TAU) for smoking cessation via a clinic-randomized clinical trial. Adults who smoke cigarettes are recruited across 18 primary care clinics. Clinics are stratified based on their number of primary care providers and randomized 2:1 to either e-visit or TAU. An initial baseline e-visit gathers information about patient smoking history and motivation to quit, and a clinical decision support algorithm determines the best evidence-based cessation treatment to prescribe. E-visit recommendations are evaluated by a patient’s own provider, and a one-month follow-up e-visit assesses cessation progress. Main outcomes include: (1) cessation treatment utilization (medication, psychosocial cessation counseling), (2) reduction in cigarettes per day, and (3) biochemically verified 7-day point prevalence abstinence (PPA) at six-months. We hypothesize that patients randomized to the e-visit condition will have better cessation outcomes (vs. TAU). A secondary aim evaluates e-visit implementation potential at patient, provider, and organizational levels using a mixed-methods approach. Implementation outcomes include acceptability, adoption, fidelity, implementation cost, penetration, and sustainability.

Discussion
This asynchronous, proactive e-visit intervention could provide substantial benefits for patients, providers, and primary care practices and has potential to widely improve reach of evidence-based cessation treatment.

Trial registration
NCT05493254.
Blackbox error management: how do practices deal with critical incidents in everyday practice? A qualitative interview study
Authors: Bodek Aljoscha , Pommée Marina , Berger Alexandra , Giraki Maria , Müller Beate Sigrid , Schütze Dania 
Published: November 2023

Abstract
Background
Error management plays a key role in patient safety. It is a systematic approach aimed at identifying and learning from critical incidents by reporting, documenting and analyzing them. Almost nothing is known about the incidents physicians in outpatient care consider to be critical and how they deal with them. We carried out an interview study to explore outpatient physicians’ views on error management, discover what they regard as critical incidents, and find out how error management is put into practice in ambulatory care.

Methods
We conducted 72 semi-structured interviews with physicians from ambulatory practices. We asked participants what they considered to be a critical incident, how they reacted following an incident, how they discussed incidents with their coworkers, and whether they used critical incident reporting systems. The interviews were transcribed verbatim and analyzed using qualitative content analysis.

Results
Interviewed physicians defined the term “critical incident” differently. Most participants reported that they recorded information on incidents and discussed them in their teams. Several physicians reported taking a ‘pay better attention next time-approach’ to the analysis of incidents. Systematic error management involving incident documentation, analysis, preventive measure development, and follow-up, was the exception.

Conclusions
To promote error management, medical training should include teaching on the topic, so that medical professionals can learn about critical incidents and how to deal with them in an open and structured manner. This would help establish the culture of safety that has long been called for internationally.
The patient’s first point of contact (PINPOINT) – protocol of a prospective multicenter study of communication and decision-making during patient assessments by primary care registered nurses
Authors: Sundler Annelie J , Hedén Lena , Holmström Inger K , van Dulmen Sandra , Bergman Karin , Östensson Sofia , Östman Malin 
Published: November 2023

Abstract
Background
A major challenge for primary care is to set priorities and balance demands with available resources. The registered nurses in this study are practice nurses working in primary care offices, playing a large role in initial assessments. The overall objective of this research is to investigate practices of communication and decision-making during nurses’ initial assessment of patients’ health problems in primary care, examine working mechanisms in good practices and develop feasible solutions.

Methods
Project PINPOINT aims for a prospective multicenter study using various methods for data collection and analysis. A purposive sample of 150 patient‒nurse consultations, including 30 nurses and 150 patients, will be recruited at primary care centers in three different geographic areas of southwest Sweden. The study will report on outcomes of communication practices in relation to patient-reported expectations and experiences, communication processes and patient involvement, assessment and decision-making, related priorities and value conflicts with data from patient questionnaires, audio-recorded real-time communication, and reflective interviews with nurses.

Discussion
This research will contribute to the knowledge needed for the guidance of first-line decision-making processes to best meet patient and public health needs. This knowledge is necessary for the development of assessments and decisions to be better aligned to patients and to set priorities. Insights from this research can empower patients and service providers and help understand and enhance feasible person-centered communication strategies tailored to patients’ level of health literacy. More specifically, this research will contribute to knowledge that can strengthen nurses’ communication, assessments, and clinical decision-making in primary care. In the long term, this will contribute to how the competencies of practice nurses and other professionals are organized and carried out to make the best use of the resources within primary care.

Trial registration
ClinicalTrials.gov Identifier: NCT06067672.
The safety of patient management in family medicine in Slovenia during Covid-19: a cross-sectional study
Authors: Gomezelj Maja Cvetko , Miroševič Špela , Tajki Alina Verdnik , Bunc Ksenija Tušek , Van Poel Esther , Willems Sara , Klemenc-Ketiš Zalika 
Published: November 2023

Abstract
Background
During the Covid-19 pandemic, family medicine practices (FMPs) changed to improve safety against new coronavirus infections for both patients and employees. Protocols for treating patients with suspected Sars-Cov-2 infections were established to protect medical staff and other patients from being infected. However, these protocols also led to increased safety risks, such as delays in treating patients with other medical conditions. This exploratory study aimed to investigate safety risks in treating patients in FMPs during the Covid-19 pandemic and to suggest improvements to prevent Covid-19 in FMPs in Slovenia.

Methods
A cross-sectional study was rolled out in FMPs in Slovenia as part of the international Pricov-19 study. Data collection on safety management during the Covid-19 pandemic in FMPs in Slovenia took place from November 2020 until January 2021 using a self-administered online survey for FP working in Slovenia. A chi-square test, ANOVA, independent samples t-test or bivariate correlation test was performed to explore associations regarding the safety of patients’ management variables.

Results
From the 191 participating family physicians (FPs) (15.2% response rate), 54.8% reported having treated patients with fever (not Covid-19) late due to the new protocols at least once, and 54.8% reported patients with urgent conditions having been seen late at least once due to not coming. In the suburbs and rural environments FPs more often reported that at least once patient with a fever (not Covid-19) was seen late due to the protocol (p = 0.017) and more often reported that at least once patient with an urgent condition was seen late due to not coming to their FP (p = 0.017). The larger the practice, the more they reported that at least once a patient with fever (not Covid-19) was seen late due to the protocol (p = 0.012) and the more they reported at least once a patient with an urgent condition was seen late due to not coming to their FP (p = 0.012).

Conclusion
Covid-19 affected the safety of patient management in FMP in Slovenia. The most common problem was foregone care. Therefor, protocols for chronic patient management in the event of epidemics need to be established.
Associations between various types of activity and physical frailty in older Japanese: a cross-sectional study
Authors: Yokote Tsubasa , Yatsugi Harukaze , Chu Tianshu , Liu Xin , Kishimoto Hiro 
Published: November 2023

Abstract
Background
Physical activity is known to help prevent physical frailty, but it is not clear which physical activities practiced alone or in combination are most closely associated with a lower risk of physical frailty. We investigated differences in the associations of exercise habit, social participation, and moderate-to-vigorous physical activity (MVPA) with physical frailty and its components among community-dwelling older Japanese adults.

Subjects and methods
A total of 831 older adults participated in this cross-sectional study. Physical frailty was defined based on the Fried et al. criteria. Exercise habit was defined as exercising ≥ 30 min per day for ≥ 2 days per week for ≥ 1 year. Social participation was defined as participating in community activities ≥ 1/week. MVPA was defined as ≥ 300 min/week of moderate physical activity (MPA) or 150 min/week of vigorous physical activity (VPA). We classified the participants into eight groups according to the presence/absence of these activities, and we performed a logistic regression analysis to investigate the association between different activities, both alone and in combination, and physical frailty.

Results
The prevalence of physical pre-frailty + frailty was 74.8% in the None group, 65.0% in the Exercise habit group, 76.3% in the Social participation group, 56.5% in the MVPA group, 58.7% in the Exercise habit + Social participation group, 44.0% in the Exercise habit + MVPA group, 41.3% in the Social participation + MVPA group, and 38.0% in the All group. Compared to the None group, the groups in which participants were engaged in any combination of two or more types of activity, as well as the MVPA-alone group had significantly lower risks of physical pre-frailty + frailty.

Conclusion
Community-dwelling older Japanese adults who engaged in MVPA or any combination of two or more types of physical activity as defined herein had lower risks of physical pre-frailty and frailty.