bluuebunny/crossref_metadata_2025_split huggingface dataset:
What we can and cannot learn from SARS-CoV-2 and animals in metagenomic samples from the Huanan market
Authors: Débarre Florence 
Published: December 2023

Abstract
While the exact context of the emergence of SARS-CoV-2 remains uncertain, data accumulated since 2020 have provided an increasingly more precise picture of Wuhan’s Huanan Seafood Wholesale Market, to which the earliest clusters of human cases of Covid-19 were linked. After the market closed on January 1st 2020, teams from the Chinese Center for Disease Control and Prevention collected environmental samples, and sequenced them. Metagenomic sequencing data from these samples were shared in early 2023. These data confirmed that non-human animals susceptible to SARS-CoV-2 were present in the market before it closed, but also that these animals were located in the side of the market with most human cases, and in a corner with comparatively more SARS-CoV-2-positive environmental samples. The environmental samples were however collected after abundant human-to-human transmission had taken place in the market, precluding any identification of a non-human animal host. Jesse Bloom recently investigated associations between SARS-CoV-2 and non-human animals, concluding that the data failed to indicate whether non-human animals were infected by SARS-CoV-2, despite this being an already acknowledged limitation of the data. Here I explain why a correlation analysis could not confidently conclude which hosts(s) may have shed SARS-CoV-2 in the market, and I rebut the suggestion that such analyses had been encouraged. I show that Bloom’s investigation ignores the temporal and spatial structure of the data, which led to incorrect interpretations. Finally, I show that criteria put forward by Bloom to identify the host(s) that shed environmental SARS-CoV-2 would also exclude humans. Progress on the topic of SARS-CoV-2’s origin requires a clear distinction between scientific studies and news articles (mis)interpreting them.
To have or not to have a penis? Phally polymorphism in minute, hermaphroditic gastropods from the Vertiginidae family
Authors: Książkiewicz Zofia , Sulikowska-Drozd Anna , von Proschwitz Ted , Rybak Michał 
Published: December 2023

Abstract
Phally polymorphism in snails offers an excellent opportunity to study the evolutionary basis of sexual polymorphism in animals. Phally polymorphism occurs when two or three sexual morphs co-occur in populations of hermaphroditic organisms. Euphallics have a fully developed and functional penis, hemiphallics have a reduced and non-functional penis, while aphallics have no penis. All morphs can self-fertilize, but only euphallics can donate sperm during copulation. In this study, we investigated the geographical pattern of phally polymorphism in minute Vertigo species by testing snails from Polish and Swedish populations. Considering the principle of resource allocation, we checked whether sexual morph reflects the size of the shell. Although the Swedish Vertigo snails tend to be smaller than the Polish ones, our results show no clear geographical pattern of sexual morph balance in the studied populations. Aphallics of V. angustior were bigger than the euphallics; conversely to V. substriata, where euphallics were bigger than aphallics. Such a result suggests a species-specific resource allocation towards the given sexual function. Since hemiphallics of V. antivertigo were smaller than euphallics, we discuss the possible trade-off when faced with resource depletion and the failure of attaining sexual maturity of euphallics.
State-related Electroencephalography Microstate Complexity during Propofol- and Esketamine-induced Unconsciousness
Authors: Liang Zhenhu , Tang Bo , Chang Yu , Wang Jing , Li Duan , Li Xiaoli , Wei Changwei 
Published: December 2023

Background
Identifying the state-related “neural correlates of consciousness” for anesthetics-induced unconsciousness is challenging. Spatiotemporal complexity is a promising tool for investigating consciousness. The authors hypothesized that spatiotemporal complexity may serve as a state-related but not drug-related electroencephalography (EEG) indicator during an unconscious state induced by different anesthetic drugs (e.g., propofol and esketamine).

Methods
The authors recorded EEG from patients with unconsciousness induced by propofol (n = 10) and esketamine (n = 10). Both conventional microstate parameters and microstate complexity were analyzed. Spatiotemporal complexity was constructed by microstate sequences and complexity measures. Two different EEG microstate complexities were proposed to quantify the randomness (type I) and complexity (type II) of the EEG microstate series during the time course of the general anesthesia.

Results
The coverage and occurrence of microstate E (prefrontal pattern) and the duration of microstate B (right frontal pattern) could distinguish the states of preinduction wakefulness, unconsciousness, and recovery under both anesthetics. Type I EEG microstate complexity based on mean information gain significantly increased from awake to unconsciousness state (propofol: from mean ± SD, 1.562 ± 0.059 to 1.672 ± 0.023, P < 0.001; esketamine: 1.599 ± 0.051 to 1.687 ± 0.013, P < 0.001), and significantly decreased from unconsciousness to recovery state (propofol: 1.672 ± 0.023 to 1.537 ± 0.058, P < 0.001; esketamine: 1.687 ± 0.013 to 1.608 ± 0.028, P < 0.001) under both anesthetics. In contrast, type II EEG microstate fluctuation complexity significantly decreased in the unconscious state under both drugs (propofol: from 2.291 ± 0.771 to 0.782 ± 0.163, P < 0.001; esketamine: from 1.645 ± 0.417 to 0.647 ± 0.252, P < 0.001), and then increased in the recovery state (propofol: 0.782 ± 0.163 to 2.446 ± 0.723, P < 0.001; esketamine: 0.647 ± 0.252 to 1.459 ± 0.264, P < 0.001).

Conclusions
Both type I and type II EEG microstate complexities are drug independent. Thus, the EEG microstate complexity measures that the authors proposed are promising tools for building state-related neural correlates of consciousness to quantify anesthetic-induced unconsciousness.

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Relevance of Protein Intake for Weaning in the Mechanically Ventilated Critically Ill: Analysis of a Large International Database
Authors: Hartl Wolfgang H. , Kopper Philipp , Xu Lisa , Heller Luca , Mironov Maxim , Wang Ruiyi , Day Andrew G. , Elke Gunnar , Küchenhoff Helmut , Bender Andreas 
Published: December 2023

OBJECTIVES:
The association between protein intake and the need for mechanical ventilation (MV) is controversial. We aimed to investigate the associations between protein intake and outcomes in ventilated critically ill patients.

DESIGN:
Analysis of a subset of a large international point prevalence survey of nutritional practice in ICUs.

SETTING:
A total of 785 international ICUs

PATIENTS:
A total of 12,930 patients had been in the ICU for at least 96 hours and required MV by the fourth day after ICU admission at the latest.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We modeled associations between the adjusted hazard rate (aHR) of death in patients requiring MV and successful weaning (competing risks), and three categories of protein intake (low: < 0.8 g/kg/d, standard: 0.8–1.2 g/kg/d, high: > 1.2 g/kg/d). We compared five different hypothetical protein diets (an exclusively low protein intake, a standard protein intake given early (days 1–4) or late (days 5–11) after ICU admission, and an early or late high protein intake). There was no evidence that the level of protein intake was associated with time to weaning. However, compared with an exclusively low protein intake, a standard protein intake was associated with a lower hazard of death in MV: minimum aHR 0.60 (95% CI, 0.45–0.80). With an early high intake, there was a trend to a higher risk of death in patients requiring MV: maximum aHR 1.35 (95% CI, 0.99–1.85) compared with a standard diet.

CONCLUSIONS:
The duration of MV does not appear to depend on protein intake, whereas mortality in patients requiring MV may be improved by a standard protein intake. Adverse effects of a high protein intake cannot be excluded.
Child exposure to organophosphate and pyrethroid insecticides measured in urine, wristbands, and household dust and its implications for child health in South Africa: A panel study
Authors: Veludo Adriana Fernandes , Röösli Martin , Dalvie Mohamed Aqiel , Stuchlík Fišerová Petra , Prokeš Roman , Přibylová Petra , Šenk Petr , Kohoutek Jiří , Mugari Mufaro , Klánová Jana , Huss Anke , Figueiredo Daniel Martins , Mol Hans , Dias Jonatan , Degrendele Céline , Fuhrimann Samuel 
Published: December 2023

Background:
Children in agricultural areas are exposed to organophosphate (OP) and pyrethroid (PYR) insecticides. This explorative study investigated child exposure to OPs and PYRs, comparing temporal and spatial exposure variability within and among urine, wristbands, and dust samples.

Methods:
During spraying season 2018, 38 South African children in two agricultural areas (Grabouw/Hex River Valley) and settings (farm/village) participated in a seven-day study. Child urine and household dust samples were collected on days 1 and 7. Children and their guardians were wearing silicone wristbands for seven days. Intraclass correlation coefficients (ICCs) evaluated temporal agreements between repeated urine and dust samples, Spearman rank correlations (Rs) evaluated the correlations among matrices, and linear mixed-effect models investigated spatial exposure predictors. A risk assessment was performed using reverse dosimetry.

Results:
Eighteen OPs/PYRs were targeted in urine, wristbands, and dust. Levels of chlorpyrifos in dust (ICC = 0.92) and diethylphosphate biomarker in urine (ICC = 0.42) showed strong and moderate temporal agreement between day 1 and day 7, respectively. Weak agreements were observed for all others. There was mostly a weak correlation among the three matrices (Rs = −0.12 to 0.35), except for chlorpyrifos in dust and its biomarker 3,5,6-trichloro-2-pyridinol in urine (Rs = 0.44). No differences in exposure levels between living locations were observed. However, 21% of the urine biomarker levels exceeded the health-risk threshold for OP exposure.

Conclusions:
Observed high short-term variability in exposure levels during spraying season highlights the need for repeated sampling. The weak correlation between the exposure matrices points to different environmental and behavioral exposure pathways. Exceeding risk thresholds for OP should be further investigated.
Risk of alcohol-associated liver disease in the offspring of parents with alcohol-associated liver disease: A nationwide cohort study
Authors: Jepsen Peter , West Joe , Kann Anna Emilie , Kraglund Frederik , Morling Joanne , Crooks Colin , Askgaard Gro 
Published: December 2023

Background and Aims:
Offspring of patients with alcohol-associated liver disease (ALD) may have a higher risk of ALD. We examined their risk of ALD and survival with ALD.

Approach and Results:
We used Danish nationwide registries to identify the offspring of patients diagnosed with ALD in 1996–2018 and 20:1 matched comparators from the general population. They were followed for ALD diagnosis through 2018. We used landmark competing risk analysis to estimate the age-specific absolute and relative 10-year risks of ALD. ALD was diagnosed in 385 of 60,707 offspring and 2842 of 1,213,357 comparators during 0.7 and 14.0 million person-years of follow-up, respectively, yielding an incidence rate ratio of 2.73 (95% CI: 2.44–3.03). The risk of being diagnosed with ALD within the next 10 years peaked at age 55 years for offspring and age 57 years for comparators with 10-year risks of 1.66% (95% CI: 1.16–2.30) in offspring and 0.81% (95% CI: 0.68–0.97) in comparators at these ages. Offspring were younger at ALD diagnosis than comparators (median age of 47.4 vs. 48.9 years), yet slightly more of them had developed cirrhosis (60.3% vs. 58.7%). Survival after ALD diagnosis was similar in offspring and comparators, adjusted hazard ratio=1.03 (95% CI: 0.88–1.21), so on average offspring died younger due to their younger age at diagnosis.

Conclusions:
Offspring of patients with ALD had a low but increased risk of ALD. Screening offspring for chronic liver disease may be unnecessary, but other interventions to mitigate alcohol-associated harm should be considered.
Medication Errors in Pediatric Emergency Departments
Authors: Alsabri Mohammed , Eapen Diane , Sabesan Vaishnavi , Tarek Hassan Zeyad , Amin Mody , Elshanbary Alaa Ahmed , Alhaderi Ayman , Elshafie Emad , Al-sayaghi Khaled M. 
Published: December 2023

ObjectiveThis systematic review aims to investigate the prevalence, preventability, and severity of medication errors in pediatric emergency departments (P-EDs). It also aims to identify common types of medication errors, implicated medications, risk factors, and evaluate the effectiveness of interventions in preventing these errors.MethodsA systematic review analyzed 6 primary studies with sample sizes ranging from 96 to 5000 pediatric patients in P-EDs. The review followed Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and included observational studies and randomized controlled trials involving patients aged 18 years and younger. Comprehensive searches in biomedical databases were conducted, and conflicts in record screening were resolved by a third reviewer using systematic review software.ResultsMedication errors in P-EDs are prevalent, ranging from 10% to 15%, with dosing errors being the most common, accounting for 39% to 49% of reported errors. These errors primarily stem from inaccurate weight estimations or dosage miscalculations. Inadequate dosing frequency and documentation also contribute significantly to medication errors. Commonly implicated medications include acetaminophen, analgesics, corticosteroids, antibiotics, bronchodilators, and intravenous fluids. Most errors are categorized as insignificant/mild (51.7% to 94.5%) or moderate (47.5%). Risk factors associated with medication errors in P-EDs include less experienced physicians, severely ill patients, and weekend/specific-hour ordering. Human factors such as noncompliance with procedures and communication failures further contribute to medication errors. Interventions such as health information technology solutions like ParentLink and electronic medical alert systems, as well as structured ordering systems, have shown promise in reducing these errors, although their effectiveness varies.ConclusionsOverall, this systematic review provides valuable insights into the complexity of medication errors in the P-ED, emphasizes the need for targeted interventions, and offers recommendations to enhance medication safety and reduce preventable errors in this critical health care setting.
The Perceived Meaning of Traumatic Brain Injury for Older Adults: A Longitudinal-Multiple Case Study
Authors: Jung Wonkyung , Vogel Mia , Figuracion Karl Cristie F , Byun Eeeseung , Thompson Hilaire 
Published: December 2023

Abstract

Purpose
The aim of this study was to explore the perceived meaning of traumatic brain injury (TBI) over the first-year postinjury among older adults and to explore if and how meaning changes.

Design
A longitudinal multiple-case study design was used.

Methods
Semistructured face-to-face interviews were completed at 1 week and 1, 3, 6, and 12 months postinjury. Transcripts were analyzed using inductive thematic analysis.

Results
Fifty-five interviews were conducted with 12 participants. Four themes were identified: gratitude, vulnerability and dependence, slowing down and being more careful, and a chance for reflecting on life. Most participants’ perceptions of their TBI remained either consistently positive or negative over the first-year postinjury.

Clinical Relevance
Nurses should elicit and support patients’ positive illness perceptions regarding their brain injury, which can contribute to a higher quality of life. For those patients with negative illness perceptions, nurses should provide resources in order to support coping and resilience following brain injury.

Conclusions
This study is the first study to explore individual perceptions over time of the meaning made from experiencing TBI among older adults. Findings can serve as a foundation for tailored supportive interventions among older adults following TBI to maximize quality of life.
MEAN ARTERIAL PRESSURE/NOREPINEPHRINE EQUIVALENT DOSE INDEX AS AN EARLY MEASURE FOR MORTALITY RISK IN PATIENTS WITH SHOCK ON VASOPRESSORS
Authors: Yang Jie , Zou Xia , Wang Ruoran , Kang Yan , Ou Xiaofeng , Wang Bo 
Published: December 2023

ABSTRACTPurpose:We aimed to investigate the association between the early mean arterial pressure (MAP)/norepinephrine equivalent dose (NEQ) index and mortality risk in patients with shock on vasopressors and further identify the breakpoint value of the MAP/NEQ index for high mortality risk.Methods:Based on the Medical Information Mart for Intensive Care IV database, we conducted a retrospective cohort study involving 19,539 eligible intensive care unit records assigned to three groups (first tertile, second tertile, and third tertile) by different MAP/NEQ indexes within 24 h of intensive care unit admission. The study outcomes were 7-, 14-, 21-, and 28-day mortality. A Cox model was used to examine the risk of mortality following different MAP/NEQ indexes. The receiving operating characteristic curve was used to evaluate the predictive ability of the MAP/NEQ index. The restricted cubic spline was applied to fit the flexible correlation between the MAP/NEQ index and risk of mortality, and segmented regression was further used to identify the breakpoint value of the MAP/NEQ index for high mortality risk.Results:Multivariate Cox analysis showed that a high MAP/NEQ index was independently associated with decreased mortality risks. The areas under the receiving operating characteristic curve of the MAP/NEQ index for different mortality outcomes were nearly 0.7. The MAP/NEQ index showed an L-shaped association with mortality outcomes or mortality risks. Exploration of the breakpoint value of the MAP/NEQ index suggested that a MAP/NEQ index less than 183 might be associated with a significantly increased mortality risk.Conclusions:An early low MAP/NEQ index was indicative of poor prognosis in patients with shock on vasopressors.
Integrating Causal Discovery and Clinically-Relevant Insights to Explore Directional Relationships between Autistic Features, Sex at Birth, and Cognitive Abilities
Authors: Francis Sunday , Tseng Angela , Rawls Eric , Conelea Christine , Grissom Nicola , Kummerfeld Erich , Ma Sisi , Jacob Suma 
Published: December 2023

AbstractPrevalence in autism spectrum disorder (ASD) diagnosis has long been strongly male-biased. Yet, consensus has not been reached on mechanisms and clinical features that underlie sex-based discrepancies. Whereas females may be under-diagnosed because of inconsistencies in diagnostic/ascertainment procedures (sex-biased criteria, social camouflaging), diagnosed males may have exhibited more overt behaviors (e.g., hyperactivity, aggression) that prompted clinical evaluation. Applying a novel network-theory-based approach, we extracted data-driven, clinically-relevant insights from a large, well-characterized sample (Simons Simplex Collection) of 2175 autistic males (Ages = 8.9±3.5 years) and 334 autistic females (Ages = 9.2±3.7 years). Exploratory factor analysis (EFA) and expert clinical review reduced data dimensionality to 15 factors of interest. To offset inherent confounds of an imbalanced sample, we identified a subset of males (N=331) matched to females on key variables (Age, IQ) and applied data-driven CDA using Greedy Fast Causal Inference (GFCI) for three groups (All Females, All Males, and Matched Males). Structural equation modeling (SEM) extracted measures of model fit and effect sizes for causal relationships between sex, age, and, IQ on EFA-selected factors capturing phenotypic representations of autism across sensory, social, and restricted and repetitive behavior domains. Our methodology unveiled sex-specific directional relationships to inform developmental outcomes and targeted interventions.
Assessing Sociodemographic Factors Associated with Household Hardships during the COVID-19 Pandemic in Manhiça, Mozambique using Data Collected between April 2021 and February 2022
Authors: Nhacolo Ariel Q. , Muir Jonathan A. , Madewell Zachary J. , Keiri Fatima , Sacoor Charfudin N. , Jamisse Edgar L. , Xerinda Elisio G. , Matsena Teodimiro , Hunguana Aura M. , Bassat Quique , Whitney Cynthia G. , Mandomando Inácio M. , Cunningham Solveig A. 
Published: December 2023

AbstractBackgroundCOVID-19 resulted in vast disruption to life in the 21stcentury. To quell the disease spread, national governments implemented several containment measures like state of emergency, curfews, and lockdowns that likely created hardships for households. To improve knowledge of the negative consequences of these lockdowns, we examine the extent to which the pandemic period was associated with hardships at the household level and assess factors associated with household vulnerability to these hardships.MethodsWe conducted a cross-sectional survey between April 2021 and February 2022 among households residing in the district of Manhiça through a survey questionnaire fielded in the Health and Demographic Surveillance System (HDSS) operating in Manhiça, Mozambique. Logistic regression was used to analyze associations between the head of household and household characteristics with specific household hardships (business closure, food price increase, household member detained, input inflation, job loss).ResultsHouseholds headed by individuals with lower education and employed in non-agricultural occupations as well as households that were larger in size or poorer in asset ownership compared to other households were generally at greater risk of experiencing a larger variety of hardships. Conversely, households that owned “distance demolishing technologies” such as motorcycles were less likely to experience these hardships, presumably as they were able to transcend local conditions.ConclusionsThese results identify at-risk groups according to a social determinants of vulnerability framework and will help inform future policies and practices that aim to mitigate the negative consequences of COVID-19 as well as future disease outbreaks.