bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protecting the integrity of survey research
Authors: Jamieson Kathleen Hall , Lupia Arthur , Amaya Ashley , Brady Henry E , Bautista René , Clinton Joshua D , Dever Jill A , Dutwin David , Goroff Daniel L , Hillygus D Sunshine , Kennedy Courtney , Langer Gary , Lapinski John S , Link Michael , Philpot Tasha , Prewitt Ken , Rivers Doug , Vavreck Lynn , Wilson David C , McNutt Marcia K 
Published: March 2023

Abstract
Although polling is not irredeemably broken, changes in technology and society create challenges that, if not addressed well, can threaten the quality of election polls and other important surveys on topics such as the economy. This essay describes some of these challenges and recommends remediations to protect the integrity of all kinds of survey research, including election polls. These 12 recommendations specify ways that survey researchers, and those who use polls and other public-oriented surveys, can increase the accuracy and trustworthiness of their data and analyses. Many of these recommendations align practice with the scientific norms of transparency, clarity, and self-correction. The transparency recommendations focus on improving disclosure of factors that affect the nature and quality of survey data. The clarity recommendations call for more precise use of terms such as “representative sample” and clear description of survey attributes that can affect accuracy. The recommendation about correcting the record urges the creation of a publicly available, professionally curated archive of identified technical problems and their remedies. The paper also calls for development of better benchmarks and for additional research on the effects of panel conditioning. Finally, the authors suggest ways to help people who want to use or learn from survey research understand the strengths and limitations of surveys and distinguish legitimate and problematic uses of these methods.
Explaining Types of Military Defections during Major Anti-authoritarian Protests
Authors: Neu Kara Kingma 
Published: March 2023

Abstract
Military defections during major anti-authoritarian protests have received significant attention. Yet instances of military disloyalty, commonly termed defections, often actually involve different parts of the military organization. Middle- and high-ranking officers may unite to defect, or they may fragment, with some defecting and others remaining loyal. In this article, I draw on the existing scholarship’s insights to argue that a dictator that uses control of internal security forces marginalizes all officers and increases the likelihood of united defections, whereas a dictator that uses military politicization marginalizes only some officers and increases the likelihood of fragmented defections. I assess and find support for these relationships statistically, using data on types of defections across a large N sample of all major anti-authoritarian protests from 1960 to 2011. I also illustrate the relationships using two brief comparative cases, Chile (1988) and El Salvador (1979).
Viral intra-host evolutionary dynamics revealed via serial passage of Japanese encephalitis virus in vitro
Authors: Sun Bangyao , Ni Ming , Liu Haizhou , Liu Di 
Published: March 2023

Abstract
Analyses of viral inter- and intra-host mutations could better guide the prevention and control of infectious diseases. For a long time, studies on viral evolution have focused on viral inter-host variations. Next-generation sequencing has accelerated the investigations of viral intra-host diversity. However, the theoretical basis and dynamic characteristics of viral intra-host mutations remain unknown. Here, using serial passages of the SA14-14-2 vaccine strain of Japanese encephalitis virus (JEV) as the in vitro model, the distribution characteristics of 1,788 detected intra-host single-nucleotide variations (iSNVs) and their mutated frequencies from 477 deep-sequenced samples were analyzed. Our results revealed that in adaptive (baby hamster kidney (BHK)) cells, JEV is under a nearly neutral selection pressure, and both non-synonymous and synonymous mutations represent an S-shaped growth trend over time. A higher positive selection pressure was observed in the nonadaptive (C6/36) cells, and logarithmic growth in non-synonymous iSNVs and linear growth in synonymous iSNVs were observed over time. Moreover, the mutation rates of the NS4B protein and the untranslated region (UTR) of the JEV are significantly different between BHK and C6/36 cells, suggesting that viral selection pressure is regulated by different cellular environments. In addition, no significant difference was detected in the distribution of mutated frequencies of iSNVs between BHK and C6/36 cells.
Formation of Interpersonal Competencies Through Interprofessional Simulation
Authors: Rojas Reyes Jennifer , Macias Inzunza Lylian , Baeza Contreras Marcela , Arévalo Valenzuela Carolina , Munilla González Viviana 
Published: March 2023

Abstract

AIM
The aim of this study was to analyze the process of interpersonal competencies formation in nursing and medical students who participated in a standardized interprofessional clinical simulation.

BACKGROUND
Interprofessional education in health sciences has had an important impact on the development of relational qualities centered on the patient.

METHOD
The study followed a qualitative interpretive approach with students. Students who participated in clinical simulation activities were asked about their experiences and their learning process with respect to interpersonal competencies. A thematic analysis of the data was performed

RESULTS
Three themes emerged: 1) approaching the practice with uncertainty and fear of new relationships, 2) reflecting on decisions while recognizing distinctive roles, and 3) recognizing the human sense of practice while developing skills for caring and curing.

CONCLUSION
Students underwent this process and learned about empathy, communication, critical reflexive thinking, and teamwork.
Development of Cultural Competence: The Effects of a Virtual Exchange Between US and Omani Nursing Students
Authors: Emerson Christie , Keen Diane 
Published: March 2023

Abstract
Development of cultural competence is essential for nurses to meet the needs of patients, families, and communities. Immersion experiences abroad have been shown to facilitate the development of cultural competence in nursing students; not all students are able to participate in these experiences. Virtual exchange is an alternative type of immersion experience that requires no travel and few resources. The purpose of this study was to examine the effects of a virtual exchange between bachelor of science in nursing students in the United States and the Sultanate of Oman on the development of cultural competence.
Implementation of Lung-Protective Ventilation in Patients With Acute Respiratory Failure*
Authors: Grissom Colin K. , Lanspa Michael J. , Groat Danielle , Jacobs Jason R. , Carpenter Lori , Kuttler Kathryn G. , Leither Lindsay , Peltan Ithan D. , Brown Samuel M. , Srivastava Rajendu 
Published: March 2023

OBJECTIVES:
We implemented a computerized protocol for low tidal volume ventilation (LTVV) to improve management and outcomes of mechanically ventilated patients with, and without, the acute respiratory distress syndrome (ARDS).

DESIGN:
Pragmatic, nonrandomized stepped wedge type II hybrid implementation/effectiveness trial.

SETTING:
Twelve hospitals in an integrated healthcare system over a 2-year period.

PATIENTS:
Patients greater than or equal to 18 years old who had initiation of mechanical ventilation in the emergency department or ICU. We excluded patients who died or transitioned to comfort care on the day of admission to the ICU. We defined a subgroup of patients with ARDS for analysis.

INTERVENTIONS:
Implementation of ventilator protocols for LTVV in the ICU.

MEASUREMENTS AND MAIN RESULTS:
Our primary clinical outcome was ventilator-free days (VFDs) to day 28. Our primary process outcome was median initial set tidal volume. We included 8,692 mechanically ventilated patients, 3,282 (38%) of whom had ARDS. After implementation, set tidal volume reported as mL/kg predicted body weight decreased from median 6.1 mL/kg (interquartile range [IQR], 6.0–6.8 mL/kg) to 6.0 mL/kg (IQR, 6.0–6.6 mL/kg) (p = 0.009). The percent of patients receiving LTVV (tidal volume ≤ 6.5 mL/kg) increased from 69.8% (n = 1,721) to 72.5% (n = 1,846) (p = 0.036) after implementation. The percent of patients receiving greater than 8 mL/kg initial set tidal volume was reduced from 9.0% (n = 222) to 6.7% (n = 174) (p = 0.005) after implementation. Among patients with ARDS, day 1 positive end-expiratory pressure increased from 6.7 to 8.0 cm H2O (p < 0.001). We observed no difference in VFD (adjusted odds ratio, 1.06; 95% CI, 0.91–1.24; p = 0.44), or in secondary outcomes of length of stay or mortality, either within the main cohort or the subgroup of patients with ARDS.

CONCLUSIONS:
We observed improved adherence to optimal ventilator management with implementation of a computerized protocol and reduction in the number of patients receiving tidal volumes greater than 8 mL/kg. We did not observe improvement in clinical outcomes.
Latest incidence and electrocardiographic predictors of atrial fibrillation: a prospective study from China
Authors: Wei Yong , Zhou Genqing , Wu Xiaoyu , Lu Xiaofeng , Wang Xingjie , Wang Bin , Wang Caihong , Shen Yahong , Peng Shi , Ding Yu , Xu Juan , Cai Lidong , Chen Songwen , Yang Wenyi , Liu Shaowen 
Published: March 2023

Abstract

Background:
China bears the biggest atrial fibrillation (AF) burden in the world. However, little is known about the incidence and predictors of AF. This study aimed to investigate the current incidence of AF and its electrocardiographic (ECG) predictors in general community individuals aged over 60 years in China.

Methods:
This was a prospective cohort study, recruiting subjects who were aged over 60 years and underwent annual health checkups from April to July 2015 in four community health centers in Songjiang District, Shanghai, China. The subjects were then followed up from 2015 to 2019 annually. Data on sociodemographic characteristics, medical history, and the resting 12-lead ECG were collected. Kaplan–Meier curve was used for showing the trends in AF incidence and calculating the predictors of AF. Associations of ECG abnormalities and AF incidence were examined using Cox proportional hazard models.

Results:
This study recruited 18,738 subjects, and 351 (1.87%) developed AF. The overall incidence rate of AF was 5.2/1000 person-years during an observation period of 67,704 person-years. Multivariable Cox regression analysis indicated age (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.06–1.09; P < 0.001), male (HR, 1.30; 95% CI: 1.05–1.62; P = 0.018), a history of hypertension (HR, 1.55; 95% CI: 1.23–1.95; P < 0.001), a history of cardiac diseases (HR, 3.23; 95% CI: 2.34–4.45; P < 0.001), atrial premature complex (APC) (HR, 2.82; 95% CI: 2.17–3.68; P < 0.001), atrial flutter (HR, 18.68; 95% CI: 7.37–47.31; P < 0.001), junctional premature complex (JPC) (HR, 3.57; 95% CI: 1.59–8.02; P = 0.002), junctional rhythm (HR, 18.24; 95% CI: 5.83–57.07; P < 0.001), ventricular premature complex (VPC) (HR, 1.76; 95% CI: 1.13–2.75, P = 0.012), short PR interval (HR, 5.49; 95% CI: 1.36–22.19; P = 0.017), right atrial enlargement (HR, 6.22; 95% CI: 1.54–25.14; P = 0.010), and pacing rhythm (HR, 3.99; 95% CI: 1.57–10.14; P = 0.004) were independently associated with the incidence of AF.

Conclusions:
The present incidence of AF was 5.2/1000 person-years in the studied population aged over 60 years in China. Among various ECG abnormalities, only APC, atrial flutter, JPC, junctional rhythm, short PR interval, VPC, right atrial enlargement, and pacing rhythm were independently associated with AF incidence.
Detection of Speech-Language Delay in the Primary Care Setting: An Electronic Health Record Investigation
Authors: Frelinger Catherine , Gardner Rebecca M. , Huffman Lynne C. , Whitgob Emily E. , Feldman Heidi M. , Bannett Yair 
Published: March 2023

Abstract:

Objective:
The purpose of this study is to determine the rate and age at first identification of speech-language delay in relation to child sociodemographic variables among a pediatric primary care network.

Methods:
We analyzed a deidentified data set of electronic health records of children aged 1- to 5-years-old seen between 2015 and 2019 at 10 practices of a community-based pediatric primary health care network. Primary outcomes were numbers (proportions) of patients with relevant ICD-10 visit-diagnosis codes and patient age (months) at first documentation of speech-language delay. Regression models estimated associations between outcomes and patient characteristics, adjusting for practice affiliation.

Results:
Of 14,559 included patients, 2063 (14.1%) had speech-language delay: 68.4% males, 74.4% with private insurance, and 96.1% with English as a primary household language. Most patients (60%) were first identified at the 18- or 24-month well-child visit. The mean age at first documentation was 25.4 months (SD = 9.3), which did not differ between practices reporting the use of standardized developmental screener and those using surveillance questionnaires. Regression models showed that males were more than twice as likely than females to be identified with speech-language delay (adjusted odds ratio [aOR] = 2.05, 95% CI: [1.86–2.25]); publicly insured were more likely than privately insured patients to be identified with speech-language delay (aOR = 1.48, 95% CI: [1.30–1.68]). Females were older than males at first identification (+1.2 months, 95% CI: [0.3–2.1]); privately insured were older than military insured patients (private +3.3 months, 95% CI: [2.2–4.4]).

Conclusion:
Pediatricians in this network identified speech-language delays at similar rates to national prevalence. Further investigation is needed to understand differences in speech-language delay detection across patient subgroups in practices that use developmental screening and/or surveillance.
ECHO (Extension for Community Healthcare Outcomes) Autism STAT: A Diagnostic Accuracy Study of Community-Based Primary Care Diagnosis of Autism Spectrum Disorder
Authors: Sohl Kristin , Levinstein Leeore , James Alexandra , Greer Sophia , Boles Katrina , Curran Alicia Brewer , Mahurin Melissa , Mazurek Micah O. , Nanclares Valeria 
Published: March 2023

ABSTRACT

Objective:
Children can be reliably diagnosed with autism spectrum disorder (ASD) by a highly trained clinician as early as 12 to 24 months of age, but recent estimates indicate that the average age of diagnosis is 4.4 years. We hypothesized that trained primary care physicians and practitioners can reliably and accurately diagnose children 14 to 48 months with unambiguous symptoms of ASD.

Methods:
Through this diagnostic accuracy study, 20 patients diagnosed with ASD by clinicians trained through the ECHO (Extension for Community Healthcare Outcomes) Autism STAT program participated in an independent gold-standard evaluation at a regional autism center. Caregiver perceptions of the diagnostic process were also assessed.

Results:
Of the 20 patients who received a diagnosis of ASD by a trained clinician and completed the study, 19 diagnoses were confirmed by a gold-standard evaluation. Caregivers indicated that undergoing diagnosis in their local community rather than an autism specialty center was helpful (4.8/5 on a 5-point Likert scale, n = 19). Results of this study demonstrate that primary care clinicians can be trained to reliably diagnose ASD in children 14 to 48 months with unambiguous symptoms.

Conclusion:
Diagnosis in the primary care setting may lead to earlier diagnosis and quicker connection to evidence-based therapies and interventions. Given the potential impact of increasing access to high-quality diagnostic services, the role of primary care clinicians in the diagnosis of ASD should be further evaluated.
Use of a Three-dimensional Smartphone Scanner in the Quantitative Analysis of Repaired Unilateral Cleft Lip during the Coronavirus Disease Pandemic
Authors: Sari Kartika P. , Saputro Iswinarno D. , Hariani Lynda 
Published: March 2023

Background:
Cleft lip, a major craniofacial abnormality, is highly prevalent among people with low socioeconomic status in Indonesia. Direct two-dimensional measurement of the affected region is the gold standard for surgical preparation; however, its compliance and usability are limited in pediatric patients. Modern smartphones, including iPhones, are equipped with high-resolution cameras, which can record images and videos of a face. Here, we investigated whether a three-dimensional (3D) smartphone scanner can be used for the facial measurements of patients with unilateral cleft lip.

Methods:
Twelve facial measurements were acquired after cleft lip surgery in three female and seven male patients (aged 11–29 months) with unilateral cleft lip using direct anthropometry and a 3D smartphone scanner. The accuracy and precision of the 3D smartphone scanner were assessed through comparative analyses (t test and Bland–Altman plot).

Results:
The anthropometric data obtained using the 3D smartphone scanner matched the direct measurement data. The linear measurements did not differ significantly between two-dimensional and 3D modalities (P > 0.05). The intraobserver reliabilities of the two-dimensional smartphone scanner of the first and second observers were high (intraclass correlation coefficient 0.876–0.993 and Cronbach alpha 0.920–0.998) and moderate to high (intraclass correlation coefficient 0.839–0.996 and Cronbach alpha 0.940–0.996), respectively. Inter-observer data showed an intraclass correlation coefficient of 0.876–0.981 and a Cronbach α of 0.960–0.997.

Conclusion:
The 3D smartphone scanner is effective, efficient, economical, quick, and feasible for facial measurements of patients with unilateral cleft lip and is a viable alternative to direct two-dimensional measurements.
Xenogeneic cross-circulation for physiological support and recovery of ex vivo human livers
Authors: Wu Wei Kelly , Ukita Rei , Patel Yatrik J. , Cortelli Michael , Trinh Vincent Q. , Ziogas Ioannis A. , Francois Sean A. , Mentz Meredith , Cardwell Nancy L. , Talackine Jennifer R. , Grogan William M. , Stokes John W. , Lee Youngmin A. , Kim Jinho , Alexopoulos Sophoclis P. , Bacchetta Matthew 
Published: March 2023

Background and Aims:
The scarcity of suitable donor livers highlights a continuing need for innovation to recover organs with reversible injuries in liver transplantation.

Approach and Results:
Explanted human donor livers (n = 5) declined for transplantation were supported using xenogeneic cross-circulation of whole blood between livers and xeno-support swine. Livers and swine were assessed over 24 hours of xeno-support. Livers maintained normal global appearance, uniform perfusion, and preservation of histologic and subcellular architecture. Oxygen consumption increased by 75% (p = 0.16). Lactate clearance increased from −0.4 ± 15.5% to 31.4 ± 19.0% (p = 0.02). Blinded histopathologic assessment demonstrated improved injury scores at 24 hours compared with 12 hours. Vascular integrity and vasoconstrictive function were preserved. Bile volume and cholangiocellular viability markers improved for all livers. Biliary structural integrity was maintained.

Conclusions:
Xenogeneic cross-circulation provided multisystem physiological regulation of ex vivo human livers that enabled functional rehabilitation, histopathologic recovery, and improvement of viability markers. We envision xenogeneic cross-circulation as a complementary technique to other organ-preservation technologies in the recovery of marginal donor livers or as a research tool in the development of advanced bioengineering and pharmacologic strategies for organ recovery and rehabilitation.
REAL WORLD STUDY COMPARING PHAKIC VERSUS PSEUDOPHAKIC EYES IN DIABETIC MACULAR EDEMA TREATED WITH DEXAMETHASONE IMPLANT
Authors: Mathis Thibaud , Rezkallah Amina , Ricard Cécile , Vartin Cristina , Abukhashabah Amro , Devin François , Kodjikian Laurent 
Published: March 2023

Purpose:
Dexamethasone implant (DEX-implant) is one treatment choice in diabetic macular edema. However, steroid-induced cataract is a common complication when treating a chronic disease and could lead to vision loss. Because of the lack of studies specifically focused on the functional outcomes according to the lens status, the authors therefore aim to analyze the effectiveness and safety of DEX-implant treatment for diabetic macular edema in phakic versus pseudophakic eyes.

Methods:
This multicenter, retrospective study conducted in France included eyes of consecutive patients who had received a DEX-implant for diabetic macular edema.

Results:
A total of 328 eyes were included: 158 eyes (48.2%) were phakic, 167 eyes (50.9%) were pseudophakic and three were unknown. According to the lens status, mean change in best-corrected visual acuity from baseline was never significantly different between phakic and pseudophakic eyes (likelihood ratio test, P = 0.09) nor in the change in central macular thickness (likelihood ratio test, P = 0.79) in multivariate analysis. Cataract surgery was performed in 63 phakic eyes (39.9%) during the study period with a mean delay of 8.1 months (CI95% [6.59–9.69]). The mean change in best-corrected visual acuity between phakic eyes who underwent cataract surgery and those who did not, was not significantly different during the follow-up at each visit. The risk of ocular hypertension was not statistically different between phakic and pseudophakic subsets (P = 0.9).

Conclusion:
The authors showed here that phakic eyes treated with DEX-implant for diabetic macular edema did not have a significant difference in visual gain in comparison to pseudophakic eyes, with a comparable safety profile.
WHEN THE PICTURE MASKS THE DIAGNOSIS - AN ATYPICAL AND SEVERE GIANT CELL ARTERITIS CASE REPORT
Authors: Moleiro Ana Filipa , Vilares-Morgado Rodrigo , Falcão-Reis Fernando , Torres-Costa Sónia 
Published: March 2023

Purpose:
The purpose of this study was to describe an atypical and severe case of giant cell arteritis (GCA).

Methods:
This was a case report description.

Results:
The authors report the case of a 76-year-old man who presented with severe and progressive bilateral visual loss. On presentation at the ophthalmology emergency room, the patient's right eye (OD) displayed aqueous flare, hyphema, rubeosis iridis, and dense posterior capsular opacification. After YAG laser capsulotomy, vitreous densifications, intraretinal hemorrhages, cotton wool spots, retinal ischemia, and vasculitis were observed in the fundoscopy. The patient's left eye (OS) also presented intraretinal hemorrhages and cotton wool spots around the temporal arcades. The diagnostic workup excluded infectious diseases, demyelinating diseases, and ocular ischemic syndrome due to carotid obstruction. Proteinogram revealed a monoclonal gammopathy, suggesting a possible hematologic condition. High-dose corticotherapy was initiated, which improved the vitreous densifications and enabled the visualization of the pale optic disk. The remaining study did not confirm the diagnosis of hematologic disease. During follow-up, bilateral VA deteriorated, with the development of progressive pallor in the OS optic disk. Follow-up fluorescein angiography demonstrated progressive retinal and choroidal ischemia. Finally, owing to high clinical suspicion, temporal artery Doppler ultrasound was performed, confirming the diagnosis of GCA.

Conclusion:
GCA may present multiple ocular features. The knowledge of these different presentations, including retinal and choroidal ischemia or uveitis, is critical for timely diagnosis and treatment initiation. Since patients with GCA often present with vision loss, ophthalmologists may be the first medical doctors who contact with these patients, being on the frontline of GCA diagnosis.