bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive analysis of complete chloroplast genome and phylogenetic aspects of ten Ficus species
Authors: Huang Yuying , Li Jing , Yang Zerui , An Wenli , Xie Chunzhu , Liu Shanshan , Zheng Xiasheng 
Published: May 2022

Abstract
Background
The large genus Ficus comprises approximately 800 species, most of which possess high ornamental and ecological values. However, its evolutionary history remains largely unknown. Plastome (chloroplast genome) analysis had become an essential tool for species identification and for unveiling evolutionary relationships between species, genus and other rank groups. In this work we present the plastomes of ten Ficus species.

Results
The complete chloroplast (CP) genomes of eleven Ficus specimens belonging to ten species were determined and analysed. The full length of the Ficus plastome was nearly 160 kbp with a similar overall GC content, ranging from 35.88 to 36.02%. A total of 114 unique genes, distributed in 80 protein-coding genes, 30 tRNAs, and 4 rRNAs, were annotated in each of the Ficus CP genome. In addition, these CP genomes showed variation in their inverted repeat regions (IR). Tandem repeats and mononucleotide simple sequence repeat (SSR) are widely distributed across the Ficus CP genome. Comparative genome analysis showed low sequence variability. In addition, eight variable regions to be used as potential molecular markers were proposed for future Ficus species identification. According to the phylogenetic analysis, these ten Ficus species were clustered together and further divided into three clades based on different subgenera. Simultaneously, it also showed the relatedness between Ficus and Morus.

Conclusion
The chloroplast genome structure of 10 Ficus species was similar to that of other angiosperms, with a typical four-part structure. Chloroplast genome sizes vary slightly due to expansion and contraction of the IR region. And the variation of noncoding regions of the chloroplast genome is larger than that of coding regions. Phylogenetic analysis showed that these eleven sampled CP genomes were divided into three clades, clustered with species from subgenus Urostigma, Sycomorus, and Ficus, respectively. These results support the Berg classification system, in which the subgenus Ficus was further decomposed into the subgenus Sycomorus. In general, the sequencing and analysis of Ficus plastomes, especially the ones of species with no or limited sequences available yet, contribute to the study of genetic diversity and species evolution of Ficus, while providing useful information for taxonomic and phylogenetic studies of Ficus.
The impact of public health interventions on the future prevalence of ESBL-producing Klebsiella pneumoniae: a population based mathematical modelling study
Authors: Salazar-Vizcaya Luisa , Atkinson Andrew , Kronenberg Andreas , Plüss-Suard Catherine , Kouyos Roger D. , Kachalov Viacheslav , Troillet Nicolas , Marschall Jonas , Sommerstein Rami 
Published: May 2022

Abstract
Background
Future prevalence of colonization with extended-spectrum betalactamase (ESBL-) producing K. pneumoniae in humans and the potential of public health interventions against the spread of these resistant bacteria remain uncertain.

Methods
Based on antimicrobial consumption and susceptibility data recorded during > 13 years in a Swiss region, we developed a mathematical model to assess the comparative effect of different interventions on the prevalence of colonization.

Results
Simulated prevalence stabilized in the near future when rates of antimicrobial consumption and in-hospital transmission were assumed to remain stable (2025 prevalence: 6.8% (95CI%:5.4–8.8%) in hospitals, 3.5% (2.5–5.0%) in the community versus 6.1% (5.0–7.5%) and 3.2% (2.3–4.2%) in 2019, respectively). When overall antimicrobial consumption was set to decrease by 50%, 2025 prevalence declined by 75% in hospitals and by 64% in the community. A 50% decline in in-hospital transmission rate led to a reduction in 2025 prevalence of 31% in hospitals and no reduction in the community. The best model fit estimated that 49% (6–100%) of observed colonizations could be attributable to sources other than human-to-human transmission within the geographical setting.

Conclusions
Projections suggests that overall antimicrobial consumption will be, by far, the most powerful driver of prevalence and that a large fraction of colonizations could be attributed to non-local transmissions.
A multivariate multi-step LSTM forecasting model for tuberculosis incidence with model explanation in Liaoning Province, China
Authors: Yang Enbin , Zhang Hao , Guo Xinsheng , Zang Zinan , Liu Zhen , Liu Yuanning 
Published: May 2022

AbstractBackgroundTuberculosis (TB) is the respiratory infectious disease with the highest incidence in China. We aim to design a series of forecasting models and find the factors that affect the incidence of TB, thereby improving the accuracy of the incidence prediction.ResultsIn this paper, we developed a new interpretable prediction system based on the multivariate multi-step Long Short-Term Memory (LSTM) model and SHapley Additive exPlanation (SHAP) method. Four accuracy measures are introduced into the system: Root Mean Square Error, Mean Absolute Error, Mean Absolute Percentage Error, and symmetric Mean Absolute Percentage Error. The Autoregressive Integrated Moving Average (ARIMA) model and seasonal ARIMA model are established. The multi-step ARIMA–LSTM model is proposed for the first time to examine the performance of each model in the short, medium, and long term, respectively. Compared with the ARIMA model, each error of the multivariate 2-step LSTM model is reduced by 12.92%, 15.94%, 15.97%, and 14.81% in the short term. The 3-step ARIMA–LSTM model achieved excellent performance, with each error decreased to 15.19%, 33.14%, 36.79%, and 29.76% in the medium and long term. We provide the local and global explanation of the multivariate single-step LSTM model in the field of incidence prediction, pioneering.ConclusionsThe multivariate 2-step LSTM model is suitable for short-term prediction and obtained a similar performance as previous studies. The 3-step ARIMA–LSTM model is appropriate for medium-to-long-term prediction and outperforms these models. The SHAP results indicate that the five most crucial features are maximum temperature, average relative humidity, local financial budget, monthly sunshine percentage, and sunshine hours.
Survival and predictors of mortality among chronic kidney disease patients on hemodialysis in Amhara region, Ethiopia, 2021
Authors: Workie Sewnet Getaye , Zewale Taye Abuhay , Wassie Gizachew Tadesse , Belew Makda Abate , Abeje Eleni Dagnaw 
Published: May 2022

Abstract
Background
Despite the high economic and mortality burden of chronic kidney disease, studies on survival and predictors of mortality among patients on hemodialysis in Ethiopia especially in the Amhara region are scarce considering their importance to identify some modifiable risk factors for early mortality to improve the patient’s prognosis. So, this study was done to fill the identified gaps. The study aimed to assess survival and predictors of mortality among end-stage renal disease patients on hemodialysis in Amhara regional state, Ethiopia, 2020/2021.

Method
Institution-based retrospective record review was conducted in Felege Hiwot, Gonder, and Gambi hospitals from March 5 to April 5, 2021. A total of 436 medical records were selected using a simple random sampling technique. A life table was used to estimate probabilities of survival at different time intervals. Multivariable cox regression was used to identify risk factors for mortality.

Result
Out of the 436 patients 153 (35.1%) had died. The median survival time was 345 days with a mortality rate of 1.89 per 1000 person-days (95%CI (1.62, 2.22)). Patients live in rural residences (AHR = 1.48, 95%CI (1.04, 2.12)), patients whose cause of CKD was hypertension (AHR = 1.49, 95%CI (1.01, 2.23)) and human immune virus (AHR = 2.22, 95%CI (1.41, 3.51)), and patients who use a central venous catheter (AHR = 3.15, 95%CI (2.08, 4.77)) had increased risk of death while staying 4 h on hemodialysis (AHR = 0.43, 95%CI (0.23, 0.80)) decreases the risk of death among chronic kidney disease patients on hemodialysis.

Conclusions
The overall survival rate and median survival time of chronic kidney disease patients on hemodialysis were low in the Amhara region as compared with other developing Sub–Saharan African counties.
Efficacy and safety of maintenance immune checkpoint inhibitors with or without pemetrexed in advanced non-squamous non-small cell lung cancer: a retrospective study
Authors: Gu Xiaodong , Shi Zhiyong , Shao Lan , Zhang Yuxin , Zhang Yiping , Song Zhengbo , Wang Wenxian , Lou Guangyuan 
Published: May 2022

AbstractBackgroundAdvanced non-squamous non-small cell lung cancer (NS-NSCLC) patients without driver gene mutations are usually treated with immune checkpoint inhibitors (ICIs) plus pemetrexed as maintenance therapy after first-line ICIs plus 4–6 cycles of pemetrexed/platinum. Some patients in the real world receive ICIs monotherapy as maintenance therapy. No clinical study has compared the efficacy and safety of ICIs with or without pemetrexed as maintenance therapy.MethodsWe performed a retrospective study analyzing clinical data of patients with NS-NSCLC who were diagnosed in Zhejiang Cancer Hospital from September 2018 to May 2021 and received maintenance therapy after 4–6 cycles of ICIs plus pemetrexed/platinum. Patients were divided into ICIs plus pemetrexed group and ICIs monotherapy group. Progression Free Survival 1 (PFS1) and PFS2, defined as the interval from the date of initial treatment and maintenance therapy to the date of systemic progression/death or the last follow-up, respectively.ResultsA total of 120 patients received ICIs with or without pemetrexed as maintenance therapy. Eighty-two patients received ICIs plus pemetrexed as maintenance therapy, and 38 patients received ICIs monotherapy. There were no statistically significant difference in median PFS1 between the ICIs monotherapy group and ICIs plus pemetrexed group (12.00 months vs. 12.07 months,P = 0.979). Among patients with PD-L1 TPS < 1%, the median PFS1 was worse with ICIs monotherapy (9.50 months vs. 14.20 months,P = 0.039). Among patients with PD-L1 TPS ≥50% or 1–49%, the median PFS1 in both groups was not statistically significant (P = 0.866,P = 0.589, respectively). Results for median PFS2 were similar to median PFS1, with statistically significantly different only in patients with PD-L1 TPS < 1% (P = 0.008). The 2-year survival rates of the two groups were similar (66.7% vs. 69.5%,P = 0.812). The incidence of fatigue was significantly higher in the ICIs plus pemetrexed group (P = 0.023).ConclusionsICIs with or without pemetrexed can be used as maintenance therapy after first-line ICIs plus 4–6 cycles of pemetrexed/platinum in patients with advanced NS-NSCLC based on PD-L1 expression.
Prevalence of drinking or eating more than usual and associated factors during childhood diarrhea in East Africa: a multilevel analysis of recent demographic and health survey
Authors: Eshetu Habitu Birhan , Fetene Samrawit Mihret , Shewarega Ever Siyoum , Fentie Elsa Awoke , Asmamaw Desale Bihonegn , Teklu Rediet Eristu , Aragaw Fantu Mamo , Belay Daniel Gashaneh , Alemu Tewodros Getaneh , Negash Wubshet Debebe 
Published: May 2022

Abstract
Background
Diarrhea is the second most common cause of death in under-five children. Fluid and food replacement during diarrheal episodes have a paramount effect to avert morbidity and mortality. However, there is limited information about feeding practices. This study aimed to assess the prevalence of drinking or eating more and associated factors during diarrhea among under-five children in East Africa using demographic and health surveys (DHSs).

Methods
Secondary data analysis was done on DHSs 2008 to 2018 in 12 East African Countries. Total weighted samples of 20,559 mothers with their under-five children were included. Data cleaning, coding, and analysis were performed using Stata 16. Multilevel binary logistic regression were performed to identify factors associated with drinking or eating more during diarrheal episodes. Adjusted Odds Ratio (AOR) with a 95% CI, and p-value < 0.05 were used to declare statistical significance.

Results
Prevalence of drinking or eating more than usual during diarrhea disease in East Africa was 26.27%(95% CI: 25.68–26.88). Mothers age > 35 years (AOR: 1.14, 95% CI: (1.03, 1.26), mothers primary education (AOR: 1.17, 95% CI: 1.06,1.28), secondary education (AOR: 1.43,95% CI: 1.27,1.61), and higher education (AOR: 1.42,95% CI: 1.11,1.81), occupation of mothers (agriculture, AOR: 2.2, 95% CI: 1.3–3.6), sales and services, AOR = 1.20, CI:1.07,1.34), manual, AOR =1.28,95% CI: 1.11,1.44), children age 1–2 years (AOR =1.34,95% CI: 1.22,1.46) and 3–4 years (AOR =1.36,95% CI: 1.20,1.55), four and more antenatal visits (AOR: 1.14,95% CI: 1.03,1.27), rich wealth status (AOR:1.27,95% CI: 1.16,1.40), birth in health facility (AOR = 1.19, 95%CI: 1.10, 1.30) and visit health facility (AOR = 1.12, 95%CI: 1.03, 1.22) were associated with drinking or eating more.

Conclusion
The prevalence of drinking or eating more is low in East Africa. Maternal age, occupation, antenatal care visit, marital status, educational status, wealth status, place of delivery, visiting health facility, and child age were significantly associated with drinking or eating more during diarrheal episodes. Health policy and programs should focus on educating mothers, improving the household wealth status, encouraging women to contact health facilities for better feeding practices of children during diarrheal episodes.
Factors of body dissatisfaction among lebanese adolescents: the indirect effect of self-esteem between mental health and body dissatisfaction
Authors: Al-Musharaf Sara , Rogoza Radoslaw , Mhanna Mariam , Soufia Michel , Obeid Sahar , Hallit Souheil 
Published: May 2022

Abstract
Background
Body dissatisfaction (BD) rates are alarmingly high, especially among adolescents, thus. Having a better understanding of correlates associated with BD seems to be an important issue in this developmental context. Furthermore, as adolescence is an essential time in the development of self-perception and self-esteem the current study assesses factors associated with BD among Lebanese adolescents and evaluates the indirect effect of self-esteem between depression/anxiety/stress and BD.

Methods
This is a cross-sectional study among 555 Lebanese adolescents, ages 15–18, who completed an online survey incorporating BD, socioeconomic status, weight and height, physical activity index, Rosenberg Self Esteem Scale, Beirut Distress Scale, Hamilton Anxiety Rating Scale, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index and Global Physical Activity Questionnaire.

Results
The results of a stepwise linear regression, taking the body dissatisfaction score as the dependent variable, showed that higher BMI (B = 0.47), feeling pressured by media/TV to lose weight (Beta = 2.80), higher depression (Beta = 0.39), exercising to lose weight (Beta = 1.84) and following a diet to lose weight (Beta = 1.58) were significantly associated with more body dissatisfaction, whereas higher self-esteem (Beta=-0.11) and more psychological distress (Beta=-0.21) were significantly associated with less body dissatisfaction. Self-esteem played an indirect role in the associations between anxiety and body dissatisfaction and stress and body dissatisfaction.

Conclusions
BD is common among young Lebanese adolescents. Treating adolescents with low self-esteem and psychological issues is crucial in preventing anticipated BD and future eating disorders.
Angiotensin I converting enzyme gene polymorphisms and risk of psychiatric disorders
Authors: Akbari Mohammadarian , Eghtedarian Reyhane , Hussen Bashdar Mahmud , Eslami Solat , Taheri Mohammad , Ghafouri-Fard Soudeh 
Published: May 2022

AbstractAngiotensin-converting enzyme (ACE) as an important enzyme in the renin-angiotensin system facilitates biogenesis of the functionally active product angiotensin II from angiotensin I. ACE gene contains a number of functional polymorphisms which modulate activity of the encoded protein. In the current case–control study, we appraised the association between the rs4359 and rs1799752 polymorphisms and risk of bipolar disorder (type I and type II; BPDI and BPDII), schizophrenia (SCZ) and obsessive–compulsive disorder (OCD). The rs4359 was associated with risk of OCD, BPDI and BPDII in co-dominant and dominant models. The rs1799752 was associated with all assessed psychiatric conditions in four inheritance models except for BPDII whose association was not significant in recessive model. The I allele of rs1799752 was associated with OCD (adjusted FDR q-Value = 4.04E-04), SCZ (adjusted FDR q-Value = 6.00E-06), BPDI (adjusted FDR q-Value = 8.40E-03) and BPDII (adjusted FDR q-Value = 6.00E-06). The effective T allele of rs4359 showed a significant association with disease risk for BPDII group. The estimated haplotypes of these polymorphisms have been distributed differently among patients and controls. Taken together, ACE polymorphisms can be regarded as risk factors for a variety of psychiatric disorders.
Age-related variations in position and morphology of the temporomandibular joint in individuals with anterior openbite and crossbite: a multi-cross-sectional comparative study
Authors: Chen Yanxi , Wang Jingxi , Li Ying , Li Lingfeng , Luo Nan , Wu Yan , Dai Hongwei , Zhou Jianping 
Published: May 2022

Abstract
Background
This study aimed to compare the age-related positional and morphological characteristics of the temporomandibular joint (TMJ) between individuals with anterior openbite or crossbite and controls.

Methods
This multi-cross-sectional comparative study analysed cone-beam computed tomography images of 750 participants, equally divided into the openbite, crossbite, and control groups (OBG, CBG, and CG, respectively). Each group was further divided into five subgroups (8–11 years, 12–15 years, 16–19 years, 20–24 years, and 25–30 years). Measurements of the TMJ included the position of the condyles in their respective fossae and morphology of the condyles and fossae. Data were submitted to statistical analysis. The study adhered to the STROBE Statement checklist for reporting of cross-sectional studies.

Results
Condyles were positioned more posteriorly with increasing age in all groups, and the condylar position was more posterior in the OBG than in the CBG. The articular eminence inclination increased with age in all the groups. There were significant differences in the articular eminence inclination among the three major groups at the age of > 15 years, and the condylar path was flatter in the CBG than in the OBG.

Conclusions
Age-related morphological and positional characteristics of the TMJ differed considerably among OBG, CBG and CG. Contrary to CBG, OBG was found to have relatively posterior condylar position and steeper condylar path.
Effectiveness of end-stage renal disease communication skills training for healthcare personnel: a single-center, single-blind, randomized study
Authors: Fang Ji-Tseng , Chen Shih-Ying , Tian Ya-Chung , Lee Chien-Hung , Wu I-Wen , Kao Chen-Yi , Lin Chung-Chih , Tang Woung-Ru 
Published: May 2022

Abstract
Background
Given that the consequences of treatment decisions for end-stage renal disease (ESRD) patients are long-term and significant, good communication skills are indispensable for health care personnel (HCP) working in nephrology. However, HCP have busy schedules that make participation in face-to-face courses difficult. Thus, online curricula are a rising trend in medical education. This study aims to examine the effectiveness of online ESRD communication skills training (CST) concerning the truth-telling confidence and shared decision-making (SDM) ability of HCP.

Methods
For this single-center, single-blind study, 91 participants (nephrologists and nephrology nurses) were randomly assigned to two groups, the intervention group (IG) (n = 45) or the control group (CG) (n = 46), with the IG participating in ESRD CST and the CG receiving regular in-service training. Truth-telling confidence and SDM ability were measured before (T0), 2 weeks after (T1), and 4 weeks after (T2) the intervention. Group differences over the study period were analyzed by generalized estimating equations.

Results
IG participants exhibited significantly higher truth-telling confidence at T1 than did CG participants (t = 2.833, P = .006, Cohen’s d = 0.59), while there were no significant intergroup differences in the confidence levels of participants in the two groups at T0 and T2. Concerning SDM ability, there were no significant intergroup differences at any of the three time points. However, IG participants had high levels of satisfaction (n = 43, 95%) and were willing to recommend ESRD CST to others (n = 41, 91.1%).

Conclusions
ESRD CST enhanced short-term truth-telling confidence, though it is unclear whether this was due to CST content or the online delivery. However, during pandemics, when face-to-face training is unsuitable, online CST is an indispensable tool. Future CST intervention studies should carefully design interactive modules and control for method of instruction.
Diversity-sensitive measures in German hospitals – attitudes, implementation, and barriers according to administration managers
Authors: Erdsiek Fabian , Aksakal Tuğba , Mader Maria , Idris Munzir , Yılmaz-Aslan Yüce , Razum Oliver , Brzoska Patrick 
Published: May 2022

Abstract
Background
Populations have varying needs and expectations concerning health care that result from diversity characteristics such as a migrant background, gender identity, disability, and age. These needs and expectations must be considered to ensure adequate utilization and quality of health services. Approaches to address diversity do exist, however, little is known about the extent to which they are implemented by health care facilities. The present study aims to examine, which measures and structures hospitals in Germany employ to address diversity, as well as which barriers they encounter in doing so.

Methods
A mixed-mode survey among administration managers of all registered German hospitals (excluding rehabilitation hospitals; n = 1125) was conducted between May and October 2019 using pen-and-paper and online questionnaires. Results were analyzed descriptively.

Results
Data from n = 112 hospitals were available. While 57.1% of hospitals addressed diversity in their mission statement and 59.9% included diversity considerations in quality management, dedicated working groups and diversity commissioners were less prevalent (15.2% each). The majority of hospitals offered multi-lingual admission and exit interviews (59.8%), treatments or therapies (57.1%), but only few had multi-lingual meal plans (12.5%) and seminars or presentations (11.6%). While 41.1% of the hospitals offered treatment and/or nursing exclusively by staff of the same sex, only 17.0% offered group therapies for both sexes separately. According to the managers, the main barriers were a lack of financial resources (54.5%), a lack of incentives from the funding providers (49.1%), and organizational difficulties (45.5%). Other reported barriers were a lack of conviction of the necessity among decision makers (28.6%) and a lack of motivation among staff members (19.6%).

Conclusions
Administration managers from only a small proportion of hospitals participated in our survey on diversity sensitivity. Even hospitals of those who did are currently not adequately addressing the diversity of staff members and patients. Most hospitals address diversity on an ideational level, practical measures are not widely implemented. Existing measures suggest that most hospitals have no overarching concept to address diversity in a broader sense. The main reported barriers relate to economic aspects, a lack of support in organizing and implementing corresponding measures and a lack of awareness or motivation.