bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification and classification of principal features for analyzing unwarranted clinical variation
Authors: McOwiti Apollo O. , Tao Wei , Tao Cui 
Published: November 2023

AbstractRationale, Aims, and ObjectiveUnwarranted clinical variation (UCV) is an undesirable aspect of a healthcare system, but analyzing for UCV can be difficult and time‐consuming. No analytic feature guidelines currently exist to aid researchers. We performed a systematic review of UCV literature to identify and classify the features researchers have identified as necessary for the analysis of UCV.MethodsThe literature search followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. We looked for articles with the terms ‘medical practice variation’ and ‘unwarranted clinical variation’ from four databases: Medline, Web of Science, EMBASE and CINAHL. The search was performed on 24 March 2023. The articles selected were original research articles in the English language reporting on UCV analysis in adult populations. Most of the studies were retrospective cohort analyses. We excluded studies reporting geographic variation based on the Atlas of Variation or small‐area analysis methods. We used ASReview Lab software to assist in identifying articles for abstract review. We also conducted subsequent reference searches of the primary articles to retrieve additional articles.ResultsThe search yielded 499 articles, and we reviewed 46. We identified 28 principal analytic features utilized to analyze for unwarranted variation, categorised under patient‐related or local healthcare context factors. Within the patient‐related factors, we identified three subcategories: patient sociodemographics, clinical characteristics, and preferences, and classified 17 features into seven subcategories. In the local context category, 11 features are classified under two subcategories. Examples are provided on the usage of each feature for analysis.ConclusionTwenty‐eight analytic features have been identified, and a categorisation has been established showing the relationships between features. Identifying and classifying features provides guidelines for known confounders during analysis and reduces the steps required when performing UCV analysis; there is no longer a need for a UCV researcher to engage in time‐consuming feature engineering activities.
Bone mineral density and the risk of incident dementia: A meta‐analysis
Authors: Lary Christine W. , Ghatan Samuel , Gerety Meghan , Hinton Alexandra , Nagarajan Archana , Rosen Clifford , Ross Ryan D. , Bennett David A. , DeStefano Anita L. , Ikram Mohammad A. , Rivadeneira Fernando , Kiel Douglas P. , Seshadri Sudha , Beiser Alexa 
Published: November 2023

AbstractBackgroundIt is not known whether bone mineral density (BMD) measured at baseline or as the rate of decline prior to baseline (prior bone loss) is a stronger predictor of incident dementia or Alzheimer's disease (AD).MethodsWe performed a meta‐analysis of three longitudinal studies, the Framingham Heart Study (FHS), the Rotterdam Study (RS), and the Rush Memory and Aging Project (MAP), modeling the time to diagnosis of dementia as a function of BMD measures accounting for covariates. We included individuals with one or two BMD assessments, aged ≥60 years, and free of dementia at baseline with follow‐up available. BMD was measured at the hip femoral neck using dual‐energy X‐ray absorptiometry (DXA), or at the heel calcaneus using quantitative ultrasound to calculate estimated BMD (eBMD). BMD at study baseline (“baseline BMD”) and annualized percentage change in BMD prior to baseline (“prior bone loss”) were included as continuous measures. The primary outcome was incident dementia diagnosis within 10 years of baseline, and incident AD was a secondary outcome. Baseline covariates included age, sex, body mass index, ApoE4 genotype, and education.ResultsThe combined sample size across all three studies was 4431 with 606 incident dementia diagnoses, 498 of which were AD. A meta‐analysis of baseline BMD across three studies showed higher BMD to have a significant protective association with incident dementia with a hazard ratio of 0.47 (95% CI: 0.23–0.96; p = 0.038) per increase in g/cm2, or 0.91 (95% CI: 0.84–0.995) per standard deviation increase. We observed a significant association between prior bone loss and incident dementia with a hazard ratio of 1.30 (95% CI: 1.12–1.51; p < 0.001) per percent increase in prior bone loss only in the FHS cohort.ConclusionsBaseline BMD but not prior bone loss was associated with incident dementia in a meta‐analysis across three studies.
Social determinants of health and incident postoperative delirium: Exploring key relationships in the SAGES study
Authors: Arias Franchesca , Dufour Alyssa B. , Jones Richard N. , Alegria Margarita , Fong Tamara G. , Inouye Sharon K. 
Published: November 2023

AbstractBackgroundExamining the associations of social determinants of health (SDOH) with postoperative delirium in older adults will broaden our understanding of this potentially devastating condition. We explored the association between SDOH factors and incident postoperative delirium.MethodsA retrospective study of a prospective cohort of patients enrolled from June 18, 2010, to August 8, 2013, across two academic medical centers in Boston, Massachusetts. Overall, 560 older adults age ≥70 years undergoing major elective non‐cardiac surgery were included in this analysis. Exposure variables included income, lack of private insurance, and neighborhood disadvantage. Our main outcome was incident postoperative delirium, measured using the Confusion Assessment Method long form.ResultsOlder age (odds ratio, OR: 1.01, 95% confidence interval, CI: 1.00, 1.02), income <20,000 a year (OR: 1.12, 95% CI: 1.00, 1.26), lack of private insurance (OR: 1.19, 95% CI: 1.04, 1.38), higher depressive symptomatology (OR: 1.02, 95% CI: 1.01, 1.04), and the Area Deprivation Index (OR: 1.02, 95% CI: 1.01, 1.04) were significantly associated with increased risk of postoperative delirium in bivariable analyses. In a multivariable model, explaining 27% of the variance in postoperative delirium, significant independent variables were older age (OR 1.01, 95% CI 1.00, 1.02), lack of private insurance (OR 1.18, 95% CI 1.02, 1.36), and depressive symptoms (OR 1.02, 95% CI 1.00, 1.03). Household income was no longer a significant independent predictor of delirium in the multivariable model (OR:1.02, 95% CI: 0.90, 1.15). The type of medical insurance significantly mediated the association between household income and incident delirium.ConclusionsLack of private insurance, a social determinant of health reflecting socioeconomic status, emerged as a novel and important independent risk factor for delirium. Future efforts should consider targeting SDOH factors to prevent postoperative delirium in older adults.
Nutritional screening and assessment tools for patients with cirrhosis based on the Global Leadership Initiative on Malnutrition criteria
Authors: He Yumei , Hu Ling , Wu Shiyan , Li Lu , Zhong Ke , Li Jiazhen , Liu Na , Sun Xiaobin , Wang Qiong , Sun Chao , Wu Liping 
Published: November 2023

AbstractBackgroundMalnutrition is highly prevalent and associated with complications and mortality in patients with cirrhosis.MethodsThis was a prospective observational study. Patients with cirrhosis were screened using the Nutritional Risk Screening 2002, the Royal Free Hospital‐Nutritional Prioritizing Tool and the Skeletal Muscle Index. Then, the sensitivity, specificity, positive and negative predictive values, and consistency with the Global Leadership Initiative on Malnutrition criteria results were calculated. We also analysed the association between nutritional status and short‐term prognosis.ResultsWe enrolled 125 patients with cirrhosis, of whom 59.20% and 60.00% were malnourished based on the Global Leadership Initiative on Malnutrition criteria and Skeletal Muscle Index. Some 53.60% and 65.60%, respectively, were classified medium‐to‐high nutritional risk by Nutritional Risk Screening 2002 and the Royal Free Hospital‐Nutritional Prioritizing Tool. The Royal Free Hospital‐Nutritional Prioritizing Tool had the best predictive value, and it was more sensitive and had a better negative predictive value than the Nutritional Risk Screening 2002 Tool. The Skeletal Muscle Index also had good sensitivity and predictive value. The Royal Free Hospital‐Nutritional Prioritizing Tool, Skeletal Muscle Index and Global Leadership Initiative on Malnutrition criteria showed high concordance. The 3‐ and 6‐month mortality rates were significantly higher for patients with moderate‐to‐high nutritional risk or malnutrition, regardless of the tool.ConclusionsWhen assessing cirrhosis with the Global Leadership Initiative on Malnutrition criteria, the Royal Free Hospital‐Nutritional Prioritizing Tool is best for nutritional screening and the Skeletal Muscle Index is also a good nutritional assessment tool.
Evaluating the Usability of the Wellness School Assessment Tool Whole School, Whole Community, Whole Child (WellSAT WSCC): A School Wellness Policy Assessment Tool*
Authors: Connolly Katherine , Koslouski Jessica B. , Chafouleas Sandra M. , Schwartz Marlene B. , Edmondson Bonnie , Briesch Amy M. 
Published: November 2023

AbstractBACKGROUNDAdoption of the Whole School, Whole Community, Whole Child (WSCC) model has been slowed by a lack of available tools to support implementation. The Wellness School Assessment Tool (WellSAT) WSCC is an online assessment tool that allows schools to evaluate the alignment of their policies with the WSCC model. This study assesses the usability of the WellSAT WSCC.METHODSUsing a convergent mixed methods design, we collected qualitative and quantitative data from 5 school‐based participants with roles in development and evaluation of policy. Participants explored the platform while engaging in a think‐aloud procedure and scored a sample policy using the platform. They also completed the System Usability Scale and responded to open‐ended questions about the usability of the platform.RESULTSParticipants rated the WellSAT WSCC as an above‐average user experience, but data suggested several areas for improvement, including improved instructions, enhanced visual design of the platform, and guidance for subsequent policy changes.CONCLUSIONThe WellSAT WSCC provides an above‐average user experience but can be improved to increase user experience. These improvements increase the potential for greater use to facilitate integration of the WSCC model into school policy.
Sig‐Wasserstein GANs for conditional time series generation
Authors: Liao Shujian , Ni Hao , Sabate‐Vidales Marc , Szpruch Lukasz , Wiese Magnus , Xiao Baoren 
Published: November 2023

AbstractGenerative adversarial networks (GANs) have been extremely successful in generating samples, from seemingly high‐dimensional probability measures. However, these methods struggle to capture the temporal dependence of joint probability distributions induced by time‐series data. Furthermore, long time‐series data streams hugely increase the dimension of the target space, which may render generative modeling infeasible. To overcome these challenges, motivated by the autoregressive models in econometric, we are interested in the conditional distribution of future time series given the past information. We propose the generic conditional Sig‐WGAN framework by integrating Wasserstein‐GANs (WGANs) with mathematically principled and efficient path feature extraction called the signature of a path. The signature of a path is a graded sequence of statistics that provides a universal description for a stream of data, and its expected value characterizes the law of the time‐series model. In particular, we develop the conditional Sig‐ metric that captures the conditional joint law of time series models and use it as a discriminator. The signature feature space enables the explicit representation of the proposed discriminators, which alleviates the need for expensive training. We validate our method on both synthetic and empirical dataset and observe that our method consistently and significantly outperforms state‐of‐the‐art benchmarks with respect to measures of similarity and predictive ability.
Mothers' sociodemographic factors and use of health professionals for child feeding advice
Authors: House Eve , Xu Huilan , Taki Sarah , Denney‐Wilson Elizabeth , Baur Louise , Wen Li M. 
Published: November 2023

AbstractThis study examined sociodemographic factors associated with mothers seeking child feeding advice from health professionals (HPs). Cross‐sectional analysis of survey data from linked randomized controlled trials was conducted. Surveys asked which sources of feeding information mothers used when their child was 6 months and 5 years old. Logistic regression was used to examine associations between sociodemographic characteristics and use of information from HPs. Here, 947 and 405 mothers completed 6‐month and 5‐year surveys, respectively. At 6 months, multiparous mothers were less likely to seek advice from child and family health nurses (CFHNs) (adjusted odds ratio [AOR]: 0.558, 95% confidence interval [95% CI]: 0.416–0.749) and other HPs (AOR: 0.706, 95% CI: 0.542–0.919), unmarried mothers were less likely to seek advice from other HPs (AOR: 0.582, 95% CI: 0.342–0.990). At 5 years, mothers with household income ≥$80,000 p.a. were less likely to seek advice from CFHNs (AOR: 0.514, 95% CI: 0.302–0.875) and working mothers less likely to seek advice from general practitioners (GPs) (AOR: 0.581, 95% CI: 0.374–0.905). Mothers born in Australia were less likely to seek information from CFHNs (AOR: 0.462, 95% CI: 0.257–0.833) and GPs (AOR: 0.431, 95% CI: 0.274–0.677). There was a greater likelihood that multiparous mothers (AOR: 2.114, 95% CI: 1.272–3.516) and mothers of children whose fathers had not attended university (AOR: 2.081, 95% CI: 1.256–3.449) had never sought advice from CFHNs, and that mothers who had not attended university (AOR: 1.769, 95% CI: 1.025–3.051), multiparous (AOR: 1.831, 95% CI: 1.105–3.035) and employed (AOR: 2.058, 95% CI: 1.135–3.733) mothers had never sought advice from other HPs. Understanding sociodemographic factors associated with seeking child feeding advice from HPs may inform priorities for engaging families in health promotion.
Between teacher candidates’ reflection and teacher educators’ evaluation: Fluctuations in epistemic (a)symmetry in feedback conversations
Authors: Turan Pınar , Yiğitoğlu Aptoula Nur 
Published: November 2023

AbstractEvidence‐based reflective practices are promoted in all recent frameworks for language teacher education (LTE). Through dialogic evidence‐based feedback sessions, reflectional sequences make trainees join a virtuous cycle in which they reconsider and readjust their methods of teaching. However, research into how mentor and trainees orient to this evidence in interaction remains scarce. With this need in mind, this study investigates post‐observation conversations (POCs) in a language teaching practicum. The recordings of 17 video‐mediated POCs are sequentially and functionally analyzed using multimodal conversation analysis. The data suggests that the fluctuations in knowledge (a)symmetries serve as a catalyst for the progression of reflection‐ and evaluation‐oriented sequences. The mentors strategically downgrade their epistemic position to index the trainees’ experiential knowledge and invite reflection. However, when mentors initiate evaluation‐oriented sequences, they systematically insert their epistemic primacy to limit any potential resistance that would challenge their epistemic authority to evaluate. The video medium also creates unique multimodal opportunities for their mutual orientation to evidence. The findings are conducive to expanding research into reflective practice in LTE and have pedagogical and research implications for our understanding of the sequential and relational organization of epistemics in feedback conversations.
Heat tolerance of a tropical–subtropical rainforest tree species Polyscias elegans: time‐dependent dynamic responses of physiological thermostability and biochemistry
Authors: Zhu Lingling , Scafaro Andrew P. , Vierling Elizabeth , Ball Marilyn C. , Posch Bradley C. , Stock Frederike , Atkin Owen K. 
Published: November 2023

Summary
Heat stress interrupts physiological thermostability and triggers biochemical responses that are essential for plant survival. However, there is limited knowledge on the speed plants adjust to heat in hours and days, and which adjustments are crucial.
Tropical–subtropical rainforest tree species (Polyscias elegans) were heated at 40°C for 5 d, before returning to 25°C for 13 d of recovery. Leaf heat tolerance was quantified using the temperature at which minimal chl a fluorescence sharply rose (Tcrit). Tcrit, metabolites, heat shock protein (HSP) abundance and membrane lipid fatty acid (FA) composition were quantified.
Tcrit increased by 4°C (48–52°C) within 2 h of 40°C exposure, along with rapid accumulation of metabolites and HSPs. By contrast, it took > 2 d for FA composition to change. At least 2 d were required for Tcrit, HSP90, HSP70 and FAs to return to prestress levels.
The results highlight the multi‐faceted response of P. elegans to heat stress, and how this response varies over the scale of hours to days, culminating in an increased level of photosynthetic heat tolerance. These responses are important for survival of plants when confronted with heat waves amidst ongoing global climate change.
Plant litter loss exacerbates drought influences on grasslands
Authors: Chen Wanjie , Jiang Lin , Jia Ruoyu , Tang Bo , Jiang Hongzhi , Wang Yang , Lu Xiaoming , Su Jishuai , Bai Yongfei 
Published: November 2023

Summary
Plant litter is known to affect soil, community, and ecosystem properties. However, we know little about the capacity of litter to modulate grassland responses to climate change.
Using a 7‐yr litter removal experiment in a semiarid grassland, here we examined how litter removal interacts with a 2‐yr drought to affect soil environments, plant community composition, and ecosystem function.
Litter loss exacerbates the negative impacts of drought on grasslands. Litter removal increased soil temperature but reduced soil moisture and nitrogen mineralization, which substantially increased the negative impacts of drought on primary productivity and the abundance of perennial rhizomatous graminoids. Moreover, complete litter removal shifted plant community composition from grass‐dominated to forb‐dominated and reduced species and functional group asynchrony, resulting in lower ecosystem temporal stability.
Our results suggest that ecological processes that lead to reduction in litter, such as burning, grazing, and haying, may render ecosystems more vulnerable and impair the capacity of grasslands to withstand drought events.
Complete pathway elucidation and heterologous reconstitution of (+)‐nootkatone biosynthesis from Alpinia oxyphylla
Authors: Deng Xiaomin , Ye Ziling , Duan Jingyu , Chen Fangfang , Zhi Yao , Huang Man , Huang Minjian , Cheng Weijia , Dou Yujie , Kuang Zhaolin , Huang Yanglei , Bian Guangkai , Deng Zixin , Liu Tiangang , Lu Li 
Published: November 2023

Summary
(+)‐Nootkatone is a natural sesquiterpene ketone widely used in food, cosmetics, pharmaceuticals, and agriculture. It is also regarded as one of the most valuable terpenes used commercially. However, plants contain trace amounts of (+)‐nootkatone, and extraction from plants is insufficient to meet market demand. Alpinia oxyphylla is a well‐known medicinal plant in China, and (+)‐nootkatone is one of the main components within the fruits.
By transcriptome mining and functional screening using a precursor‐providing yeast chassis, the complete (+)‐nootkatone biosynthetic pathway in Alpinia oxyphylla was identified.
A (+)‐valencene synthase (AoVS) was identified as a novel monocot‐derived valencene synthase; three (+)‐valencene oxidases AoCYP6 (CYP71BB2), AoCYP9 (CYP71CX8), and AoCYP18 (CYP701A170) were identified by constructing a valencene‐providing yeast strain. With further characterisation of a cytochrome P450 reductase (AoCPR1) and three dehydrogenases (AoSDR1/2/3), we successfully reconstructed the (+)‐nootkatone biosynthetic pathway in Saccharomyces cerevisiae, representing a basis for its biotechnological production.
Identifying the biosynthetic pathway of (+)‐nootkatone in A. oxyphylla unravelled the molecular mechanism underlying its formation in planta and also supported the bioengineering production of (+)‐nootkatone. The highly efficient yeast chassis screening method could be used to elucidate the complete biosynthetic pathway of other valuable plant natural products in future.
Relationship between suicide ideation and attempts, bully victimization, dating violence, and depressive symptoms among Black and Hispanic youth
Authors: Opara Ijeoma , Weerakoon Sitara M. , Brooks Stephens Jasmin R. , Choe Taylor , Gunn John F. , Thrasher Shawndaya S. 
Published: November 2023

AbstractBackgroundSuicide rates among Black and Hispanic youth have been increasing over the past decade in the United States. The objective of this study was to identify risk factors for suicide ideation and attempt among Black and Hispanic youth in the United States using intersectionality theory and minority stress theory as a framework.MethodsData from the CDC Youth Risk Behavior Surveillance System (YRBSS; 2015–2019) were analyzed and delimited to include only Black and Hispanic youth.ResultsAbout 37% of the subsample identified as Black and 63% of the subsample identified as Hispanic; mean age was 16 years (SE = 0.02). Weighted multivariate logistic regressions were used to explore associations between suicide ideation and attempt, depressive symptoms, bullying, dating violence, and being threatened with a weapon. Black and Hispanic youth who had depressive symptoms, experienced bullying, dating violence, or threatened with a weapon all had increased odds of having suicide ideation and suicide attempt. Hispanic youth had the higher odds of suicide ideation and attempt than Black youth. Girls in the study also had elevated odds of suicide ideation.ConclusionThis study adds to the literature on risk factors of suicide in Black and Hispanic youth and bringing to awareness the gender disparities in suicide ideation and attempt among youth.
Chinese children show racial and skin‐tone salience but little color evasion
Authors: Gao Dan , van Geel Mitch , Liu Junsheng , Mesman Judi 
Published: November 2023

AbstractChildren may notice racial differences (i.e., show racial and/or skin‐tone salience), but deliberately avoid mentioning such differences (i.e., color evasion) with increasing age. This contradiction may be due to prevailing egalitarian social norms about race. Color evasion is understudied among children in China. In a sample of 155 Chinese children (71 girls and 84 boys) aged 7–11 years from urban regions of China, we collected measures of children's racial and/or skin‐tone salience and color evasion as well as their attitudes toward light‐skinned East Asian, tan‐skinned East Asian, and White groups. Analyses revealed that racial differences were salient to Chinese children, and that they showed little color evasion. Skin tone was most salient in children's categorization performance. We found a preference hierarchy where light‐skinned East Asian people were favored most, and White people least. Color evasion was negatively related to Chinese children's positive attitudes toward White people. The findings emphasize the importance of social contexts in shaping children's racial attitudes.