bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global Dynamics of Porcine Enteric Coronavirus PEDV Epidemiology, Evolution, and Transmission
Authors: Zhang Hao , Zou Chuangchao , Peng Ouyang , Ashraf Usama , Xu Qiuping , Gong Lang , Fan Baochao , Zhang Yun , Xu Zhichao , Xue Chunyi , Wei Xiaona , Zhou Qingfeng , Tian Xiaoyan , Shen Hanqin , Li Bin , Zhang Xiangbin , Cao Yongchang 
Published: March 2023

AbstractWith a possible origin from bats, the alphacoronavirus Porcine epidemic diarrhea virus (PEDV) causes significant hazards and widespread epidemics in the swine population. However, the ecology, evolution, and spread of PEDV are still unclear. Here, from 149,869 fecal and intestinal tissue samples of pigs collected in an 11-year survey, we identified PEDV as the most dominant virus in diarrheal animals. Global whole genomic and evolutionary analyses of 672 PEDV strains revealed the fast-evolving PEDV genotype 2 (G2) strains as the main epidemic viruses worldwide, which seems to correlate with the use of G2-targeting vaccines. The evolving pattern of the G2 viruses presents geographic bias as they evolve tachytely in South Korea but undergo the highest recombination in China. Therefore, we clustered six PEDV haplotypes in China, whereas South Korea held five haplotypes, including a unique haplotype G. In addition, an assessment of the spatiotemporal spread route of PEDV indicates Germany and Japan as the primary hubs for PEDV dissemination in Europe and Asia, respectively. Overall, our findings provide novel insights into the epidemiology, evolution, and transmission of PEDV, and thus may lay a foundation for the prevention and control of PEDV and other coronaviruses.
Comparative Genomic and Transcriptomic Analyses Reveal the Impacts of Genetic Admixture in Kazaks, Uyghurs, and Huis
Authors: Pan Yuwen , Wen Jia , Ning Zhilin , Yuan Yuan , Liu Xubing , Yang Yajun , Guan Yaqun , Lu Yan , Mamatyusupu Dolikun , Xu Shuhua 
Published: March 2023

AbstractPopulation admixture results in the combinations of genetic components derived from distinct ancestral populations, which may impact diversity at the genetic, transcriptomic, and phenotypic levels, as well as postadmixture adaptive evolution. Here, we systematically investigated the genomic and transcriptomic diversity in Kazaks, Uyghurs, and Huis—three admixed populations of various Eurasian ancestries living in Xinjiang, China. All three populations showed elevated genetic diversity and closer genetic distance compared with the reference populations across the Eurasian continent. However, we also observed differentiated genomic diversity and inferred different demographic histories among the three populations. Varying ancestry proportions observed in both the global and local aspects corresponded to the population-differentiated genomic diversity, with the most representative signals observed in the genes EDAR, SULT1C4, and SLC24A5. The varying local ancestry partly resulted from the postadmixture local adaptation, with the most significant signals observed in immunity- and metabolism-related pathways. Admixture-shaped genomic diversity further influenced the transcriptomic diversity in the admixed populations; in particular, population-specific regulatory effects were associated with immunity- and metabolism-involved genes such as MTHFR, FCER1G, SDHC, and BDH2. Furthermore, differentially expressed genes between the populations were identified, many of which could be explained by the population-specific regulatory properties, including genes related to health concerns (e.g., AHI1 between Kazak and Uyghurs [P &lt; 6.92 × 10−5] and CTRC between Huis and Uyghurs [P &lt; 2.32 × 10−4]). Our results demonstrate genetic admixture as a driving force in shaping the genomic and transcriptomic diversity of human populations.
Identifying heterogeneity using recursive partitioning: evidence from SMS nudges encouraging voluntary retirement savings in Mexico
Authors: Shah Avni M , Osborne Matthew , Lefkowitz Kalter Jaclyn , Fertig Andrew , Fishbane Alissa , Soman Dilip 
Published: March 2023

Abstract
Individuals regularly struggle to save for retirement. Using a large-scale field experiment (N=97,149) in Mexico, we test the effectiveness of several behavioral interventions relative to existing policy and each other geared toward improving voluntary retirement savings contributions. We find that an intervention framing savings as a way to secure one’s family future significantly improves contribution rates. We leverage recursive partitioning techniques and identify that the overall positive treatment effect masks subpopulations where the treatment is even more effective and other groups where the treatment has a significant negative effect, decreasing contribution rates. Accounting for this variation is significant for theoretical and policy development as well as firm profitability. Our work also provides a methodological framework for how to better design, scale, and deploy behavioral interventions to maximize their effectiveness.
Pneumonia due to antibiotic resistant Streptococcus pneumoniae and Pseudomonas aeruginosa in the HAART era
Authors: Allen S H , Brennan-Benson P , Nelson M , Asboe D , Bower M , Azadian B , Gazzard B , Stebbing J 
Published: March 2023

Abstract
Antibiotic resistance profiles are useful in directing therapeutic strategies during bacterial infections. Patterns of antimicrobial resistance in Streptococcus pneumoniae and Pseudomonas aeruginosa associated pneumonia were investigated in an HIV-1 infected cohort during the era of highly active antiretroviral therapy. The median CD4 count at presentation was significantly lower for cases of P aeruginosa than for S pneumoniae. However, the number of antibiotic resistant cases of P aeruginosa decreased throughout the study period, while the incidence of S pneumoniae remained unchanged. In contrast to pneumococcal pneumonia, we show that antiretrovirals have protected from pneumonia due to antibiotic resistant P aeruginosa. These findings have implications for the treatment of individuals presenting with serious infections in which antibiotic therapy needs to be instituted before identification and sensitivities are known.
How do Campaigns Shape Vote Choice? Multicountry Evidence from 62 Elections and 56 TV Debates
Authors: Le Pennec Caroline , Pons Vincent 
Published: March 2023

AbstractWe use two-round survey data from 62 elections in 10 countries since 1952 to study the formation of vote choice, beliefs, and policy preferences and assess how televised debates contribute to this process. Our data include 253,000 observations. We compare the consistency between vote intention and vote choice of respondents surveyed at different points before, and then again after, the election, and show that 17% to 29% of voters make up their mind during the final two months of campaigns. Changes in vote choice are concomitant to shifts in issues voters find most important and in beliefs about candidates, and they generate sizable swings in vote shares. In contrast, policy preferences remain remarkably stable throughout the campaign. Finally, we use an event study to estimate the impact of TV debates, in which candidates themselves communicate with voters, and of shocks such as natural and technological disasters which, by contrast, occur independently from the campaign. We do not find any effect of either type of event on vote choice formation, suggesting that information received throughout the campaign from other sources such as the media, political activists, and other citizens is more impactful.
Association between erectile dysfunction andHelicobacter pylori, folic acid, vitamin B12, and homocysteine: a cross-sectional study
Authors: Xu Jiangnan , Xu ZhenYu , Pan Huixing , Zhou Zhengdong 
Published: March 2023

AbstractBackgroundPrevious studies have shown that Helicobacter pylori (Hp) infection is associated with erectile dysfunction (ED), but the mechanism is unclear.AimTo assess the relationship between ED and Hp, folic acid (FA), vitamin B12 (B12), and homocysteine (HCY).MethodsThis study included 84 patients with ED and 42 healthy men. We adopted an IIEF-5 score &lt;21 (5-item International Index of Erectile Function) as the diagnostic criterion for ED, and the RigiScan monitoring device was used to preliminarily screen for and rule out psychogenic ED.OutcomesLevels of Hp immunoglobulin G (Hp-IgG) titer, FA, B12, and HCY were compared between the ED group and the non-ED group, and the correlation between the indicators was evaluated.ResultsThe median Hp-IgG titer was higher in the ED group than the control group (32.34 vs 20.88, P &lt; .001). The ED group had lower median levels of B12 (195 vs 338, P &lt; .001) and FA (4.66 vs 10.31, P &lt; .001) and a higher median level of HCY (12.7 vs 8.1, P &lt; .001). Multivariate logistic regression analysis showed that the level of FA (odds ratio, 0.111; 95% CI, 0.031-0.399; P &lt; .001) was an independent risk factor for ED. Specifically, FA level was significantly higher in the moderate ED group than the severe ED group, which had a higher median Hp-IgG titer and lower level of B12; although not significant, this was still a clinical trend. Hp-IgG titer was negatively correlated with levels of FA (r = −0.601, P &lt; .001) and B12 (r = −0.434, P &lt; .001) and with the IIEF-5 score (r = −0.382, P &lt; .001) and positively correlated with HCY (r = 0.69, P &lt; .001).Clinical ImplicationsThe ED group had higher levels of Hp-IgG titer and HCY and lower levels of B12 and FA.Strengths and LimitationsThis study is the first to link Hp infection, FA, B12, and HCY and further explain the relationship between these indicators and the underlying pathologic mechanisms that jointly cause ED. The limitation is that our study was based on Hp-IgG titers, which do not necessarily represent the full extent of Hp infection, despite the avoidance of invasive testing.ConclusionHp infection might lead to decreased FA and B12 and then increased HCY, which might be a mechanism leading to ED. Hp eradication or FA and B12 supplementation might have certain clinical value in the treatment of vascular ED.
Genetic background to attention deficit and hyperactivity disorder and attention deficit and hyperactivity disorder symptoms at the age of 5 years: the role of sleep duration
Authors: Morales-Muñoz Isabel , Paavonen E Juulia , Kantojärvi Katri , Härkänen Tommi , Saarenpää-Heikkilä Outi , Kylliäinen Anneli , Himanen Sari-Leena , Paunio Tiina 
Published: March 2023

Abstract

Study Objectives
We studied the associations between polygenic risk score (PRS) for attention deficit and hyperactivity disorder (ADHD) and (1) ADHD symptoms in 5-year-old children, (2) sleep duration throughout childhood, and (3) the interaction between PRS for ADHD and short sleep duration relative to ADHD symptoms at 5 years.

Methods
This study is based on the population-based CHILD-SLEEP birth cohort (N = 1420 children). PRS was used to quantitate the genetic risk for ADHD. Parent-reported ADHD symptoms at 5 years were obtained from 714 children, using the Strengths and Difficulties Questionnaire (SDQ) and the Five-to-Fifteen (FTF). Our primary outcomes were SDQ-hyperactivity and FTF-ADHD total scores. Parent-reported sleep duration was measured at 3, 8, 18, 24 months, and 5 years in the whole sample and actigraphy-based sleep duration at 2 and 24 months in a subsample.

Results
PRS for ADHD associated with SDQ-hyperactivity (β = 0.214, p = .012) and FTF-ADHD total (β = 0.639, p = .011), and FTF-inattention and hyperactivity subscale scores (β = 0.315, p = .017 and β = 0.324, p = .030), but not with sleep duration at any time point. Significant interactions were found between high PRS for ADHD and parent-reported short sleep throughout childhood in FTF-ADHD total score (F = 4.28, p = .039) and FTF-inattention subscale (F = 4.66, p = .031). We did not find any significant interaction between high PRS for ADHD and actigraphy-based short sleep.

Conclusions
Parent-reported short sleep moderates the association between genetic risk of ADHD and ADHD symptoms in early childhood in the general population, so that children with short sleep, in combination with high genetic risk for ADHD, could be at highest risk for ADHD symptoms.
Effect of oxybutynin and reboxetine on obstructive sleep apnea: a randomized, placebo-controlled, double-blind, crossover trial
Authors: Berger Mathieu , Solelhac Geoffroy , Marchi Nicola A , Dussez Romane , Bradley Brian , Lecciso Gianpaolo , Heiniger Gregory , Bayon Virginie , Van Den Broecke Sandra , Haba-Rubio Jose , Siclari Francesca , Heinzer Raphaël 
Published: March 2023

Abstract

Study Objectives
Although recent investigations combining noradrenergic and antimuscarinic drugs have shown promising short-term results to treat obstructive sleep apnea (OSA), the mid-term effect and optimal dosage remain uncertain. The present study aimed to evaluate the effect of 1 week of 5 mg oxybutynin and 6 mg reboxetine (oxy-reb) on OSA versus placebo.

Methods
We performed a randomized, placebo-controlled, double-blind, crossover trial comparing the effect of 1 week of oxy-reb versus 1 week of placebo on OSA severity. At-home polysomnography was performed at baseline and after each week of intervention.

Results
Fifteen participants (male 66.7%) aged 59 [44–62] years (median [interquartile range]) with a mean body mass index of 33.1 ± 6.6 kg/m2 were included. No significant difference in apnea–hypopnea index (AHI) was observed between conditions (estimated marginal means [95% confidence interval] at baseline: 39.7 [28.5–55.3]; oxy-reb: 34.5 [22.7–52.3]; placebo: 37.9 [27.1–52.9]; p = 0.652), but oxy-reb improved average oxygen desaturation (p = 0.016) and hypoxic burden (p = 0.011) and lowered sleep efficiency (p = 0.019) and rapid eye movement sleep (p = 0.002). Moreover, participants reported reduced sleep quality during the week of oxy-reb compared to the week of placebo (4.7 [3.5; 5.9] vs. 6.5 [5.5; 7.5] on a 0–10 visual analogic scale, respectively; p = 0.001). No significant differences in sleepiness, vigilance, and fatigue were observed. No serious adverse events occurred.

Conclusions
Administration of oxybutynin 5 mg and reboxetine 6 mg did not improve OSA severity assessed by AHI, but did alter sleep architecture and sleep quality. Reduced average oxygen desaturation and hypoxic burden were also observed.

Clinical Trial
ClinicalTrials.gov, https://clinicaltrials.gov, NCT04394143.
Clinician Perspectives on Delivering Medication Treatment for Opioid Use Disorder during the COVID-19 Pandemic: A Qualitative Evaluation
Authors: Lott Aline M. , Danner Anissa N. , Malte Carol A. , Williams Emily C. , Gordon Adam J. , Halvorson Max A. , Saxon Andrew J. , Hagedorn Hildi J. , Sayre George G. , Hawkins Eric J. 
Published: March 2023

Objective
The coronavirus disease 2019 (COVID-19) pandemic necessitated changes in opioid use disorder care. Little is known about COVID-19’s impact on general healthcare clinicians’ experiences providing medication treatment for opioid use disorder (MOUD). This qualitative evaluation assessed clinicians’ beliefs about and experiences delivering MOUD in general healthcare clinics during COVID-19.

Methods
Individual semistructured interviews were conducted May through December 2020 with clinicians participating in a Department of Veterans Affairs initiative to implement MOUD in general healthcare clinics. Participants included 30 clinicians from 21 clinics (9 primary care, 10 pain, and 2 mental health). Interviews were analyzed using thematic analysis.

Results
The following 4 themes were identified: overall impact of the pandemic on MOUD care and patient well-being, features of MOUD care impacted, MOUD care delivery, and continuance of telehealth for MOUD care. Clinicians reported a rapid shift to telehealth care, resulting in few changes to patient assessments, MOUD initiations, and access to and quality of care. Although technological challenges were noted, clinicians highlighted positive experiences, including treatment destigmatization, more timely visits, and insight into patients’ environments. Such changes resulted in more relaxed clinical interactions and improved clinic efficiency. Clinicians reported a preference for in-person and telehealth hybrid care models.

Conclusions
After the quick shift to telehealth-based MOUD delivery, general healthcare clinicians reported few impacts on quality of care and highlighted several benefits that may address common barriers to MOUD care. Evaluations of in-person and telehealth hybrid care models, clinical outcomes, equity, and patient perspectives are needed to inform MOUD services moving forward.
Hyperoxemia During Cardiac Surgery Is Associated With Postoperative Pulmonary Complications
Authors: Douin David J. , Pattee Jack , Scott Benjamin , Fernandez-Bustamante Ana , Prin Meghan , Eckle Tobias , Ginde Adit A. , Clendenen Nathan 
Published: March 2023

OBJECTIVES:
The use of hyperoxemia during cardiac surgery remains controversial. We hypothesized that intraoperative hyperoxemia during cardiac surgery is associated with an increased risk of postoperative pulmonary complications.

DESIGN:
Retrospective cohort study.

SETTING:
We analyzed intraoperative data from five hospitals within the Multicenter Perioperative Outcomes Group between January 1, 2014, and December 31, 2019. We assessed intraoperative oxygenation of adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Hyperoxemia pre and post CPB was quantified as the area under the curve (AUC) of Fio
2 above 0.21 in minutes when the corresponding peripheral oxygen saturation was greater than 92% measured by pulse oximetry. We quantified hyperoxemia during CPB as the AUC of Pao
2 greater than 200 mm Hg measured by arterial blood gas. We analyzed the association of hyperoxemia during all phases of cardiac surgery with the frequency of postoperative pulmonary complications within 30 days, including acute respiratory insufficiency or failure, acute respiratory distress syndrome, need for reintubation, and pneumonia.

PATIENTS:
Twenty-one thousand six hundred thirty-two cardiac surgical patients.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
During 21,632 distinct cardiac surgery cases, 96.4% of patients spent at least 1 minute in hyperoxemia (99.1% pre-CPB, 98.5% intra-CPB, and 96.4% post-CPB). Increasing exposure to hyperoxemia was associated with an increased risk of postoperative pulmonary complications throughout three distinct surgical periods. During CPB, increasing exposure to hyperoxemia was associated with an increased odds of developing postoperative pulmonary complications (p < 0.001) in a linear manner. Hyperoxemia before CPB (p < 0.001) and after CPB (p = 0.02) were associated with increased odds of developing postoperative pulmonary complications in a U-shaped relationship.

CONCLUSIONS:
Hyperoxemia occurs almost universally during cardiac surgery. Exposure to hyperoxemia assessed continuously as an AUC during the intraoperative period, but particularly during CPB, was associated with an increased incidence of postoperative pulmonary complications.
Developing and validating a machine learning ensemble model to predict postoperative delirium in a cohort of high-risk surgical patients
Authors: Neto Paulo C.S. , Rodrigues Attila L. , Stahlschmidt Adriene , Helal Lucas , Stefani Luciana C. 
Published: March 2023

BACKGROUND
Postoperative delirium (POD) has a negative impact on prognosis, length of stay and the burden of care. Although its prediction and identification may improve postoperative care, this need is largely unmet in the Brazilian public health system.

OBJECTIVE
To develop and validate a machine-learning prediction model and estimate the incidence of delirium. We hypothesised that an ensemble machine-learning prediction model that incorporates predisposing and precipitating features could accurately predict POD.

DESIGN
A secondary analysis nested in a cohort of high-risk surgical patients.

SETTING
An 800-bed, quaternary university-affiliated teaching hospital in Southern Brazil. We included patients operated on from September 2015 to February 2020.

PATIENTS
We recruited 1453 inpatients with an all-cause postoperative 30-day mortality risk greater than 5% assessed preoperatively by the ExCare Model.

MAIN OUTCOME MEASURE
The incidence of POD classified by the Confusion Assessment Method, up to 7 days postoperatively. Predictive model performance with different feature scenarios were compared with the area under the receiver operating characteristic curve.

RESULTS
The cumulative incidence of delirium was 117, giving an absolute risk of 8.05/100 patients. We developed multiple machine-learning nested cross-validated ensemble models. We selected features through partial dependence plot analysis and theoretical framework. We treated the class imbalance with undersampling. Different feature scenarios included: 52 preoperative, 60 postoperative and only three features (age, preoperative length of stay and the number of postoperative complications). The mean areas (95% confidence interval) under the curve ranged from 0.61 (0.59 to 0.63) to 0.74 (0.73 to 0.75).

CONCLUSION
A predictive model composed of three indicative readily available features performed better than those with numerous perioperative features, pointing to its feasibility as a prognostic tool for POD. Further research is required to test the generalisability of this model.

TRIAL REGISTRATION
Institutional Review Board Registration number 04448018.8.0000.5327 (Brazilian CEP/CONEP System, available in https://plataformabrasil.saude.gov.br/).
Age and Gender Differences in Fall-Related Factors Affecting Community-Dwelling Older Adults
Authors: SUH Minhee , KIM Da Hye , CHO Insook , HAM Ok Kyung 
Published: March 2023

ABSTRACT

Background
Falls are one of the major adverse events affecting older adults that can result in serious injuries. Hospitalizations and deaths because of fall-related injuries have been increasing. Nevertheless, there is a dearth of studies examining the physical condition and current exercise habits of older adults. Moreover, studies analyzing the role of factors related to fall risk by age and gender in large populations are also scarce.

Purpose
This study was designed to investigate the prevalence of falls among community-dwelling older adults and elucidate the effects of age and gender on the related factors using a biopsychosocial model.

Methods
This cross-sectional study utilized data from the 2017 National Survey of Older Koreans. On the basis of the biopsychosocial model, the biological factors related to falls included chronic diseases, number of medications, visual difficulties, activity of daily living (ADL) dependence, lower-limb muscle strength, and physical performance; psychological factors included depression, cognitive ability, regular smoking, alcohol consumption, nutritional status, and exercise; and the social factors included educational level, annual income, living conditions, and instrumental ADL dependence.

Results
Of the 10,073 older adults surveyed, 57.5% were women and approximately 15.7% had experienced falls. The results of the logistic regression showed that, in men, falls were significantly associated with taking more medications and being able to climb 10 stair steps; in women, falls were significantly associated with poor nutritional status and instrumental ADL dependence; and in both genders, falls were significantly associated with greater depression, ADL dependence, and the presence of more chronic diseases and negatively associated with physical performance.

Conclusions/Implications for Practice
The results suggest that practicing kneeling and squatting is the most effective strategy for reducing fall risk in older adult men and that improving nutritional status and strengthening physical ability is the most effective strategy for reducing fall risk in older adult women.