bluuebunny/crossref_metadata_2025_split huggingface dataset:
Death of a Simulated Patient
Authors: Murphy Glenn , Sweeney Amy 
Published: May 2023

Abstract
Dosage calculation errors impact patient safety. A creative teaching strategy for undergraduate nursing students in the nursing skills laboratory incorporated a simulated patient who had died. The patient received three incorrect medication dosages. The objective of the learning activity was for students to calculate the medication dosages and determine which error most likely resulted in the patient’s death. Students were highly engaged in this activity. Faculty observed student learning in the cognitive and affective domains. This innovative teaching strategy encouraged students to evaluate dosage calculations in a safe learning environment.
Socioeconomic Inequality in Hearing Impairment Among Working-Age Australians: Evidence From a Cross-Sectional and Longitudinal Analyses
Authors: Nure Alam Mohammad , Dawes Piers , Sinha Kompal 
Published: May 2023

Objectives:
The objective of this study was to analyze the spatial and temporal association between socioeconomic gradient in hearing impairment among working-age Australians.

Design:
We modeled the cross-sectional and longitudinal associations between individual- and area-level socioeconomic status (SES) and hearing impairment among working-age Australians using longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey for 10,719 working-age adults aged between 15 and 64 years surveyed between 2008 and 2018. Associations between self-reported hearing impairment and education, income, employment status, and area-level SES were estimated using a multivariate logistic regression model and Cox proportional hazards regression, controlling for age, sex, and a range of other sociodemographic factors.

Results:
Among 10,719 participants, the prevalence of hearing impairment was higher among individuals with lower income, occupational status and socioeconomic disadvantage. The odds ratio (OR) of those with the lowest income quintile versus highest income quintile (OR = 2.10, 95% confidence interval [CI] = 1.40 to 3.14); for blue-collar occupation versus white-collar (OR = 1.92, 95% CI = 1.39 to 2.66) and most disadvantaged area quintile versus most advantaged area quintile (OR = 1.76, 95% CI = 1.10 to 2.83) were associated with higher odds of prevalence of hearing impairment. For the 10,046 participants without hearing loss at baseline, income quintile 1 versus quintile 5 (hazard ratio [HR] = 1.44, 95% CI = 1.33 to 1.56), ≤ year 11 versus ≥ bachelor’s degree (HR = 2.15, 95% CI = 1.98-2.34) blue-collar occupation versus white collar (HR = 1.15, 95% CI = 1.07 to 1.25) and most disadvantaged area quintile versus most advantaged quintile (HR = 1.49, 95% CI = 1.37 to 1.63) was positively associated with incident hearing impairment.

Conclusions:
Lower individual-level and area-level SES was associated with an increased risk of prevalence and incidence of hearing impairment among working-age Australians. These findings are particularly concerning since working-age Australians are mostly not eligible for socially subsidized hearing-related health care in Australia. This lack of access to affordable hearing services could exacerbate the negative consequences of hearing impairment and increase social inequality.
Refractive Outcomes With New Generation Formulas for Intraocular Lens Power Calculation in Radial Keratotomy Patients
Authors: Ferrara Silvia , Crincoli Emanuele , Savastano Alfonso , Savastano Maria Cristina , Catania Fiammetta , Rizzo Stanislao 
Published: May 2023

Purpose:
Radial keratotomies (RKs) are responsible for corneal irregularities resulting in biometric errors and lower best-corrected visual acuity (BCVA) due to lower-order and higher-order optical aberrations. The aim of the study was to compare performances of new and old generation formulas in a population of RK patients.

Methods:
RK patients who underwent phacoemulsification with intraocular lens (IOL) implantation were retrospectively recruited. Inclusion criteria were availability of preoperative and 6-month postoperative BCVA assessment, topography, and tomography. Documented refraction instability, corneal ectasia, and previous ocular surgery except for RK were exclusion criteria. Mean prediction error (ME), mean absolute prediction error (MAE), and incidence of MAE > 0.25D were calculated for SRK-T, Barrett True K, EVO 2.0, Kane, and PEARL-DGS.

Results:
Twenty-seven patients with a mean baseline BCVA of 0.32 ± 0.18 logMAR and a mean corneal root mean square (RMS) value of 1.59 ± 0.91 μm were included. EVO 2.0, Kane, and PEARL-DGS showed a significantly lower MAE and lower ME compared with all other formulas (P < 0.001 and P < 0.001) and a significant lower incidence of MAE >0.25D (P < 0.001). Significant differences were still detected when using 3-mm mean keratometry for IOL calculation.

Conclusions:
PEARL-DGS, Kane, and EVO 2.0 formulas show superior accuracy in IOL power calculation compared with SRK-T and Barrett True K in RK patients, with no significant differences between the 3.
Substance Use Among Physician Assistant Students: A National Study on the Prevalence of Alcohol, Tobacco, Illicit Substances, and Medication Use
Authors: Carim Charles A. , Keller Nicole E. , Greene Gabriel G. , Pitchford Kandi D. , Solh Tia M. , Miller Paul M. 
Published: May 2023

Introduction
The purpose of this study was to discover the substance use prevalence among physician assistant students (PA-S) compared with the age-relevant general US population and to examine the frequency of stress, burnout, anxiety, and depression during the didactic and clinical phases, while accounting for the impact of the COVID-19 pandemic.

Methods
A 20-item survey instrument was created. Self-reported data included demographics, anxiety, burnout, tobacco, illicit substances, and prescription medication use. Outcome-based inventories included a modified Perceived Stress Scale, Patient Health Questionnaire-2 (PHQ-2), and Alcohol Use Disorder Identification Test–Concise. The survey was emailed to all US programs (∼270 programs; ∼25,000 students), with 54 programs approving dissemination to their students (n∼4,760).

Results
Of the 1432 responses (30% response rate, 96% completion rate), the final validated sample was 1378 students (56.1% didactic, 43.8% clinical). When compared with the national population, PA-S prevalence for tobacco (5.2%) and illicit substance use (9.9%) were notably lower; alcohol (53.5%) was comparable; and prescription medication (7.0%) is only reported for PA students due to the lack of a national comparison. A higher frequency of substance use was observed during the didactic (52.5%) vs clinical (47.5%) phases. Stress was the dominant factor in both phases (93.5% didactic, 86.1% clinical). Respondents reported that the COVID-19 pandemic had minimal impact on reported rates, other than alcohol.

Discussion
Although PA-S substance use prevalence is at or below the national population, PA programs are encouraged to review their policies and provide conversations and resources for students who may have one or more risk factors and experience a negative effect from current substance use.
The Role of Mentoring in Recruiting and Retaining Minority Physician Assistant Faculty
Authors: Radcliffe-Henry Erica , Obisesan Olawunmi 
Published: May 2023

Introduction
The physician assistant profession (PA) is experiencing a proliferation of PA programs nationally, creating a demand for PA faculty to educate and train future PA clinicians. Current data show that the number of minority PA educators is insufficient to train a diverse PA workforce. Previous studies have explored the high turnover rate of minority PA faculty, their retention, and attrition. Guided by the social-ecological model (SEM), the purpose of this phenomenological study was to explore the lived experiences of Black and Hispanic minority PA faculty in PA education to gain further insights about the specific role that mentoring has played in their recruitment and retention.

Methods
Qualitative data were collected from a purposive sample of 6 minority PA faculty using semi-structured telephone interviews.

Results
This study's findings identified specific SEM constructs—specifically individual, interpersonal, and institutional levels of mentoring—that may influence minority PA faculty recruitment and retention efforts. The participants in this study identified several recruitment and retention factors, including formal and informal mentoring, support, and guidance. Challenges related to lack of pedagogical training and lack of administrative support for meaningful professional development were reportedly overcome by the assistance of colleagues within and outside of their programs.

Discussion
The findings of this study provide insights necessary to inform professional practice initiatives among PA program leaders and institutional leadership to engage in dialogue and coordinate efforts involving the implementation of effective professional development and mentoring structures.
Prevalence of and Risk Factors for Emergency Department Visits After Outpatient Gynecologic Surgery
Authors: Chaves Katherine F. , Novoa Victoria Arruga Novoa y , Apple Annie , Hassoun Jenine , Alamri Lamia A. , Zhao Zhiguo , Yunker Amanda 
Published: May 2023

ABSTRACT
Outpatient gynecologic surgeries are very common; in 2014 alone, 500,000 procedures were performed with 70% and 85% of hysterectomies and oophorectomies, respectively, performed in the outpatient setting. Although risk factors for overnight or prolonged admission after outpatient hysterectomy have been studied, less is known about the postoperative emergency department (ED) burden generated by other outpatient gynecologic surgeries.
The objective of this retrospective cohort study was to identify the incidence of ED visits within 30 days of outpatient gynecologic surgery and to identify risk factors for these visits. This study included all adult patients undergoing scheduled outpatient gynecologic surgery for a benign condition at the Vanderbilt University Medical Center (VUMC), a tertiary academic medical institution, between January 2018 and September 2019. Demographic data, as well as comorbidities, surgical history, and surgical outcomes data, were obtained from the electronic medical record. Primary procedure performed was characterized into 1 of 4 categories: hysterectomy, other intra-abdominal nonprolapse surgery, prolapse surgery without hysterectomy, or other nonprolapse vulvovaginal procedure. The primary study outcome was evaluation in the VUMC ED within 30 days of surgery. Logistic regression models were used to evaluate associations between potential risk factors and the risk of an ED visit.
A total of 2373 surgeries met the inclusion criteria, with 109 patients (5%) visiting the VUMC ED for a total of 125 visits within 30 days of surgery. After adjustment for potential confounders, younger age (adjusted odds ratio [aOR], 1.2; 95% confidence interval [CI], 1.1–1.3; P < 0.001), history of abdominal surgery (aOR, 1.7; 95% CI, 1.1–2.6; P = 0.02), cardiopulmonary comorbidities (aOR, 1.9; 95% CI, 1.2–3.0; P = 0.004), undergoing hysterectomy (aOR, 2.0; 95% CI, 1.1–3.8; P = 0.03), and a vulvovaginal surgical route as opposed to abdominal surgical route (aOR, 2.4; 95% CI, 1.2–5.1; P = 0.02) were all related to an increased risk of visiting the emergency room. Patients who visited the ED were more likely to have undergone hysterectomy (26% vs 20%, P = 0.05) and less likely to have undergone prolapse surgery (4% vs 12%, P = 0.05). The median time to first ED presentation was 7 days following surgery and surgical site pain (n = 52 [42% of visits]), nausea and/or vomiting (n = 18 [14%]), and fever (n = 15 [12%]) were the most common chief complaints. Of the 125 visits, 45 (36%) resulted in admission, and 36 of these (80%) were surgery related.
The results of this study demonstrate that although ED visits after outpatient gynecologic surgery are uncommon, younger patients with underlying cardiopulmonary comorbidities and/or a history of abdominal surgery are at greater risk.
Trends in Long-Term Ventilation Care in U.K. Children and Young People—Further Consideration Required for Pediatric Critical Care Services
Authors: Wilkinson Kathy , Freeth Heather , Mahoney Nicholas , Iles Richard , Juniper Mark 
Published: May 2023

OBJECTIVES:
The objective was to compare specific data from the 2020 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report “Balancing the Pressures” with two previous U.K. studies and to examine changes in the pediatric population requiring long-term ventilation (LTV) as well as the types delivered. We believe that the new data presented will facilitate future service planning.

DESIGN:
A subset of confidential enquiry data derived from a study by a nationally funded quality improvement organization (NCEPOD: www.ncepod.org.uk) was compared with two previous U.K. datasets.

SETTING:
Healthcare providers across England, Wales, and Northern Ireland—inpatient and community settings.

PATIENTS:
Children and young people (CAYP) 0–16 years old receiving LTV between April 1, 2016, and March 31, 2018.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
When comparing the NCEPOD data with that last published in the United Kingdom, the number of CAYP requiring LTV more than doubled between 2008 and 2018 (933–2,093). There has also been a particular increase in the proportion of children that were under two when they were commenced on LTV (26–39.2%). Children are now more likely than previously to be receiving LTV to manage upper airway obstruction and CNS conditions. There has also been an approximate doubling of those receiving LTV over the whole 24-hour period (9.4–18.4%).

CONCLUSIONS:
The increased numbers and changing characteristics of babies and children requiring LTV over the last 3 decades in the United Kingdom have implications for all healthcare sectors but particularly for providers of critical care services.
Whole blood transfusion in the treatment of acute hemorrhage, a systematic review and meta-analysis
Authors: van der Horst Robert A. , Rijnhout Tim W.H. , Noorman Femke , Borger van der Burg Boudewijn L.S. , van Waes Oscar J.F. , Verhofstad Michael H.J. , Hoencamp Rigo 
Published: May 2023

BACKGROUND
Whole blood (WB) transfusion received renewed interest after recent armed conflicts. The effectiveness as compared with blood component transfusion (BCT) is, however, still topic of debate. Therefore, this study investigated the effect of WB ± BCT as compared with BCT transfusion on survival in trauma patients with acute hemorrhage.

METHODS
Studies published up to January 16, 2023, including patients with traumatic hemorrhage comparing WB ± BCT and BCT were included in meta-analysis. Subanalyses were performed on the effectiveness of WB in the treatment of civilian or military trauma patients, patients with massive hemorrhage and on platelet (PLT)/red blood cell (RBC), plasma/RBC and WB/RBC ratios. Methodological quality of studies was interpreted using the Cochrane risk of bias tool. The study protocol was registered in PROSPERO under number CRD42022296900.

RESULTS
Random effect pooled odds ratio (OR) for 24 hours mortality in civilian and military patients treated with WB as compared with BCT was 0.72 (95% confidence interval [CI], 0.53–0.97). In subanalysis of studies conducted in civilian setting (n = 20), early (4 hours, 6 hours, and emergency department) and 24 hours mortality was lower in WB groups compared with BCT groups (OR, 0.65; 95% CI, 0.44–0.96 and OR, 0.71; 95% CI, 0.52–0.98). No difference in late mortality (28 days, 30 days, in-hospital) was found. In military settings (n = 7), there was no difference in early, 24 hours, or late mortality between groups. The WB groups received significant higher PLT/RBC (p = 0.030) during early treatment and significant higher PLT/RBC and plasma/RBC ratios during 24 hours of treatment (p = 0.031 and p = 0.007). The overall risk of bias in the majority of studies was judged as serious due to serious risk on confounding and selection bias, and unclear information regarding cointerventions.

CONCLUSION
Civilian trauma patients with acute traumatic hemorrhage treated with WB ± BCT as compared to BCT had lower odds on early and 24-hour mortality. In addition, WB transfusion resulted in higher PLT/RBC and plasma/RBC ratios.

LEVEL OF EVIDENCE
Systematic Review and Meta-Analysis; Level III.
Genomic regions and candidate genes affect root anatomical traits in diverse rice accessions
Authors: Fonta Jenna E. , Vejchasarn Phanchita , Hanlon Meredith T. , McCouch Susan R. , Brown Kathleen M. 
Published: April 2023

AbstractRoot anatomical traits show significant variation among rice,Oryza sativaL., genotypes and are of interest for improving adaptation to a variety of edaphic, hydrological and nutritional environments in which rice is grown. However, they are difficult to measure and the genetic controls of these traits are not well understood in rice. We conducted genome-wide association (GWA) analyses using moderate- and high-density SNP panels on a diverse rice population to identify genomic regions and candidate genes that control root anatomical traits. We identified 28 genomic regions for metaxylem vessel area and number, root cross-sectional area, stele area, and aerenchyma area. One genomic region associated with metaxylem vessel number and two regions associated with three root thickness-related traits, stele area, root cross-sectional area and metaxylem vessel area, were supported by chromosome-specific GWA using a high-density SNP panel and are regarded as highly significant regions controlling trait variation. Candidate genes in these regions were related to cell differentiation, elongation and division, and secondary cell wall formation. For genomic regions identified in theindicasubpopulation, haplotype variation and root anatomical phenotypes were associated with geographic distributions of the accessions, notably the presence of alternate alleles conferring larger diameter roots, stele, and metaxylem vessels in accessions from theindica 2andindica 3subgroups originating largely in south and southeast Asia. The identification of genomic regions and candidate genes related to root anatomical traits in a diverse panel of rice varieties deepens our understanding of trait variation and genetic architecture and facilitates the incorporation of favorable alleles into breeding populations.Key messageGenomic regions and candidate genes associated with root anatomical traits were identified inOryza sativausing genome-wide association analyses.
RNAvigate: Efficient exploration of RNA chemical probing datasets
Authors: Irving Patrick S. , Weeks Kevin M. 
Published: April 2023

AbstractChemical probing technologies enable high-throughput examination of diverse structural features of RNA including local nucleotide flexibility, RNA secondary structure, protein- and ligand-binding, through-space interaction networks, and multi-state structural ensembles. Performing these experiments, by themselves, does not directly lead to biological insight. Instead, deep understanding of RNA structure-function relationships typically requires evaluating a system under structure- and function-altering conditions, linking these data with additional information, and visualizing multi-layered relationships. Current platforms lack the broad accessibility, flexibility, and efficiency needed to iterate on integrative analyses of these diverse, complex data. Here, we share the RNA visualization and graphical analysis toolset RNAvigate, a straightforward and flexible Python library. RNAvigate currently automatically parses twenty-one standard file formats (primary sequence annotations, per- and inter-nucleotide data, and secondary and tertiary structures) and outputs eighteen plot types. These features enable efficient exploration of nuanced relationships between chemical probing data, RNA structure, and motif annotations across multiple experimental samples. Compatibility with Jupyter Notebooks enables non-burdensome, reproducible, transparent and organized sharing of multi-step analyses and data visualization strategies. RNAvigate simplifies examination of multi-layered RNA structure information and accelerates discovery and characterization of RNA-centric functions in biology.
Performance ofqpAdm-based screens for genetic admixture on admixture-graph-shaped histories and stepping-stone landscapes
Authors: Flegontova Olga , Işıldak Ulaş , Yüncü Eren , Williams Matthew P. , Huber Christian D. , Kočí Jan , Vyazov Leonid A. , Changmai Piya , Flegontov Pavel 
Published: April 2023

AbstractqpAdmis a statistical tool that is often used for testing large sets of alternative admixture models for a target population. Despite its popularity,qpAdmremains untested on two-dimensional stepping-stone landscapes and in situations with low pre-study odds (low ratio of true to false models). We tested high-throughputqpAdmprotocols with typical properties such as number of source combinations per target, model complexity, model feasibility criteria, etc. Those protocols were applied to admixture-graph-shaped and stepping-stone simulated histories sampled randomly or systematically. We demonstrate that false discovery rates of high-throughputqpAdmprotocols exceed 50% for many parameter combinations since: 1) pre-study odds are low and fall rapidly with increasing model complexity; 2) complex migration networks violate the assumptions of the method, hence there is poor correlation betweenqpAdm p-values and model optimality, contributing to low but non-zero false positive rate and low power; 3) although admixture fraction estimates between 0 and 1 are largely restricted to symmetric configurations of sources around a target, a small fraction of asymmetric highly non-optimal models have estimates in the same interval, contributing to the false positive rate. We also re-interpret large sets ofqpAdmmodels from two studies in terms of source-target distance and symmetry and suggest improvements toqpAdmprotocols: 1) temporal stratification of targets and proxy sources in the case of admixture-graph-shaped histories; 2) focused exploration of few models for increasing pre-study odds; dense landscape sampling for increasing power and stringent conditions on estimated admixture fractions for decreasing the false positive rate.Article SummaryProliferation in the archaeogenetic literature of protocols for detection of admixed groups based a so-calledqpAdmalgorithm became disconnected from performance testing: the only extensive study ofqpAdmon simulated data showed that it performs well under an unrealistically simple demographic scenario. We found that false discoveries of gene flows byqpAdmon a collection of random admixture-graph-shaped histories and on complex stepping-stone landscapes are very common and provide guidelines for design ofqpAdmprotocols in archaeogenetic studies.