bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying desired qualifications, tasks, and organizational characteristics of practice managers—a cross-sectional survey among group practice physicians in Germany
Authors: Schricker Clemens , Strumann Christoph , Steinhäuser Jost 
Published: June 2022

Abstract
Background
The increase of centralization developments in primary and secondary care practices may cause the organizational needs to increase as well, as the practices grow in size. This continuous change is observed in different stages in various countries since, from the perspective of a physician, it is reinforced by the benefits it adds to flexible work configuration, professional exchange and specialization. However, in order to benefit from the joint practice system, the proper managerial skills of practice managers are required, as doctors are not naturally prepared to fulfill such tasks. This study thus aims to gain insight into physicians' views in group practices and acquire a greater understanding of expectations towards practice management and the emerging role of practice managers (PM).

Methods
A cross-sectional study design was employed which utilized an anonymous online questionnaire. In total, 3,456 physicians were invited to participate in the study between February 8th and March 17th 2021 by the Association of Statutory Health Insurance Physicians of Baden-Württemberg, Germany. Bivariate and multivariate analyses were applied to characterize the expectations of physicians towards practice management.

Results
The survey yielded 329 replies (9,5%). 50% of the participating practices already had a PM employed. In general, these practices were larger than practices without a PM. Most physicians (85%) considered a medical background to be essential for the task of a PM. While practices without a PM considered it important for PMs to have medical qualifications, practices with a PM favored qualifications in business administration. 77.2% of physicians preferred to educate and recruit PMs out of their current practice staff. Competence in organizational tasks, such as coordination of tasks and quality management, was considered to be an essential skill of a PM and had the highest agreement levels among those surveyed, followed by staff management of non-physicians, billing, bookkeeping, staff management of physicians and recruiting. Based on multivariate regression analysis, larger practices valued the role of a PM more and were more likely to employ a PM. Notably, the effect that size had on these items was more substantial for generalists than specialists.

Conclusions
The benefits and importance of PMs as well as the potential for delegation are recognized, in particular, by larger practices. The positive feelings that physicians who already employ PMs have towards their contribution to ambulatory care are even more significant. Pre-existing medical support staff has been identified to be the most desirable candidates for taking on the role of PM.
Endotracheal tube microbiome in hospitalized patients defined largely by hospital environment
Authors: Cifuentes Erika Alejandra , Sierra Maria A. , Yepes Andrés Felipe , Baldión Ana Margarita , Rojas José Antonio , Álvarez-Moreno Carlos Arturo , Anzola Juan Manuel , Zambrano María Mercedes , Huertas Monica G. 
Published: June 2022

Abstract
Background
Studies of the respiratory tract microbiome primarily focus on airway and lung microbial diversity, but it is still unclear how these microbial communities may be affected by intubation and long periods in intensive care units (ICU), an aspect that today could aid in the understanding of COVID19 progression and disease severity. This study aimed to explore and characterize the endotracheal tube (ETT) microbiome by analyzing ETT-associated microbial communities.

Methods
This descriptive study was carried out on adult patients subjected to invasive mechanical ventilation from 2 to 21 days. ETT samples were obtained from 115 patients from ICU units in two hospitals. Bacteria isolated from endotracheal tubes belonging to the ESKAPE group were analyzed for biofilm formation using crystal violet quantification. Microbial profiles were obtained using Illumina sequencing of 16S rRNA gene.

Results
The ETT microbiome was mainly composed by the phyla Proteobacteria, Firmicutes and Bacteroidetes. Microbiome composition correlated with the ICU in which patients were hospitalized, while intubation time and diagnosis of ventilator-associated pneumonia (VAP) did not show any significant association.

Conclusion
These results suggest that the ICU environment, or medical practices, could be a key to microbial colonization and have a direct influence on the ETT microbiomes of patients that require mechanical ventilation.
Plastisphere community assemblage of aquatic environment: plastic-microbe interaction, role in degradation and characterization technologies
Authors: Dey Sujata , Rout Ajaya Kumar , Behera Bijay Kumar , Ghosh Koushik 
Published: June 2022

AbstractIt is undeniable that plastics are ubiquitous and a threat to global ecosystems. Plastic waste is transformed into microplastics (MPs) through physical and chemical disruption processes within the aquatic environment. MPs are detected in almost every environment due to their worldwide transportability through ocean currents or wind, which allows them to reach even the most remote regions of our planet. MPs colonized by biofilm-forming microbial communities are known as the ‘‘plastisphere”. The revelation that this unique substrate can aid microbial dispersal has piqued interest in the ground of microbial ecology. MPs have synergetic effects on the development, transportation, persistence, and ecology of microorganisms. This review summarizes the studies of plastisphere in recent years and the microbial community assemblage (viz. autotrophs, heterotrophs, predators, and pathogens). We also discussed plastic-microbe interactions and the potential sources of plastic degrading microorganisms. Finally, it also focuses on current technologies used to characterize those microbial inhabitants and recommendations for further research.
Evaluation of the feasibility of the FAST-M maternal sepsis intervention in Pakistan: a protocol
Authors: Ahmed Sheikh Irfan , Sikandar Raheel , Barolia Rubina , Hanif Khowaja Bakhtawar M. , Memon Kashif Ali , Cheshire James , Dunlop Catherine , Coomarasamy Arri , Sheikh Lumaan , Lissauer David 
Published: June 2022

Abstract
Background
Maternal sepsis is a life-threatening condition, defined by organ dysfunction caused by infection during pregnancy, childbirth, and the postpartum period. It is estimated to account for between one-tenth and half (4.7% to 13.7%) of all maternal deaths globally. An international stakeholder group, including the World Health Organization, developed a maternal sepsis management bundle called “FAST-M” for resource-limited settings through a synthesis of evidence and international consensus. The FAST-M treatment bundle consists of five components: Fluids, Antibiotics, Source identification and control, assessment of the need to Transport or Transfer to a higher level of care and ongoing Monitoring (of the mother and neonate). This study aims to adapt the FAST-M intervention and evaluate its feasibility in Pakistan.

Methods
The proposed study is a mixed method, with a before and after design. The study will be conducted in two phases at the Liaquat University of Medical and Health Sciences, Hyderabad. In the first phase (formative assessment), we will adapt the bundle care tools for the local context and assess in what circumstances different components of the intervention are likely to be effective, by conducting interviews and a focus group discussion. Qualitative data will be analyzed considering a framework method approach using NVivo version 10 (QSR International, Pty Ltd.) software. The qualitative results will guide the adaptation of FAST-M intervention in local context. In the second phase, we will evaluate the feasibility of the FAST-M intervention. Quantitative analyses will be done to assess numerous outcomes: process, organizational, clinical, structural, and adverse events with quantitative comparisons made before and after implementation of the bundle. Qualitative analysis will be done to evaluate the outcomes of intervention by conducting FGDs with HCPs involved during the implementation process. This will provide an understanding and validation of quantitative findings.

Discussion
The utilization of care bundles can facilitate recognition and timely management of maternal sepsis. There is a need to adapt, integrate, and optimize a bundled care approach in low-resource settings in Pakistan to minimize the burden of maternal morbidities and mortalities due to sepsis.
Assessment of freight traffic flows and harmful emissions in euro-mediterranean context: scenario analyses based on a gravity model
Authors: Gattuso Domenico , Cassone Gian Carla , Pellicanò Domenica Savia 
Published: June 2022

AbstractMaritime transport contributes significantly to environmental pollution. The Mediterranean Sea Area is particularly affected by marine emissions from particulate matter, black carbon, nitrogen oxides and sulphur oxides. In addition to international and crossing traffic, the Mediterranean Sea is affected by the freight flows moved between its shores (in the North–South direction and vice versa), but also by transverse freight flows (East–West); these are freights transported through Short Sea Shipping. The Mediterranean Sea is the area where there is the highest concentration of short sea shipping in the EU-27. There are different types of Short Sea transport: container and bulk handling, general cargo ships and Ro-Ro transport. In such scenario, the analysis of trade flows as well as their spatial and geographical distribution, becomes fundamental. The paper proposes a gravity model for estimating trade flows, considering 18 countries boarding the Euro-Mediterranean Sea, in 2019. The proposed gravity model assumes that one of the main factors affecting trade is the economic dimension of a country which is directly related to the volume of imports and exports. In the paper, after a literature review on the gravity models, the illustration of the different phases investigation and construction of the database (specification, calibration and validation) to the definition and implementation of the proposed model is proposed. Scenario analyses are therefore proposed for assessing the environmental impacts generated by maritime transport in the Mediterranean basin as the freight flows vary. The analyses are carried out using a simulation approach which, starting from hypotheses on the economic and social development trends of the countries of the southern shore, made it possible to evaluate the variations in terms of freight flows and environmental impacts in terms of pollution.
Natural time analysis of acoustic emissions before fracture: Results compatible with the Bak-Tang-Wiesenfeld model
Authors: Loukidis A. , Perez-Oregon J. , Pasiou E. D. , Kourkoulis S. K. , Sarlis N. V. , Triantis D. 
Published: June 2022

Abstract
Natural time analysis has been recently applied for the elaboration of data recorded by means of the Acoustic Emission (AE) sensing technique while specimens and structures are mechanically loaded at levels approaching those causing macroscopic fracture. In terms of the variance

, the entropy in natural time S, as well as the entropy in natural time under time reversal

, a complex behavior was observed, which could be understood by the Burridge-Knopoff train model and the Olami-Feder-Christensen earthquake model. Here, the AE data recorded when notched fiber-reinforced concrete specimens were subjected to three-point bending until fracture, are analysed in natural time. The analysis leads to

, S, and

values that are compatible with those obtained by a centrally fed Bak-Tang-Wiesenfeld sandpile model, which was theoretically studied in natural time almost a decade ago.
The influence of stochastic temperature fluctuations in shaping the physiological performance of the California mussel,Mytilus californianus
Authors: Nancollas Sarah J. , Todgham Anne E. 
Published: June 2022

ABSTRACTClimate change is forecasted to increase temperature variability and stochasticity. Most of our understanding of thermal physiology of intertidal organisms has come from laboratory experiments that acclimate organisms to submerged conditions and steady-state increases in temperatures. For organisms experiencing the ebb and flow of tides with unpredictable low tide aerial temperatures, the reliability of reported tolerances and thus predicted responses to climate change requires incorporation of environmental complexity into empirical studies. Using the mussel Mytilus californianus, our study examined how stochasticity of the thermal regime influences physiological performance. Mussels were acclimated to either submerged conditions or a tidal cycle that included either predictable, unpredictable or no thermal stress during daytime low tide. Physiological performance was measured through anaerobic metabolism, energy stores and cellular stress mechanisms just before low tide, and cardiac responses during a thermal ramp. Both air exposure and stochasticity of temperature change were important in determining thermal performance. Glycogen content was highest in the mussels from the unpredictable treatment, but there was no difference in the expression of heat shock proteins between thermal treatments, suggesting that mussels prioritise energy reserves to deal with unpredictable low tide conditions. Mussels exposed to fluctuating thermal regimes had lower gill anaerobic metabolism, which could reflect increased metabolic capacity. Our results suggest that although thermal magnitude plays an important role in shaping physiological performance, other key elements of the intertidal environment complexity such as stochasticity, thermal variability and thermal history are also important considerations for determining how species will respond to climate warming.
Pomniki przyrody i drzewa pomnikowe wybranych gmin powiatu wejherowskiego (województwo pomorskie)
Authors: Antkowiak Wojciech , Grucza Michał 
Published: June 2022

The paper presents results of a survey of natural monuments and monumental trees in the Wejherowo County, Poland. During the field research it was found that there are 106 monuments of nature in the community of Gniewino, Linia, Luzino and Łęczyce. Under monument protection are as follows: 1 climber, 69 individual trees, 3 alleys, 18 groups of trees and 15 erratic boulders. The largest number of monuments of nature is located in the Łęczyce community (51 natural monuments), while the smallest monuments number is located in the area of the Linia community (3 monuments). In total, there are 65 monuments of nature in the State Forests, which constitutes as much as 61% of the total number in the studied area. Along the roads, there are 22 monuments in cemeteries and 19 on private land. Manor parks are rich in monuments of nature. There are a total of 23 monuments in them. All natural monuments should be labeled with the word “NATURE MONUMENT”, while only 72 of them are marked as such. During the research work, 7 monument trees were selected as follows: 4 specimens of the common beech Fagus sylvatica L., 2 specimens of Coast Douglas-fir Pseudotsuga menziesii (Mirb.) Franco and 1 specimen of small-leaved lime Tilia cordata Mill. Due to its impressive size and standing out among other trees of the same genus or species, they should be taken under monument protection.
Factors associated with the diagnosis of COVID-19 among Brazilian health professionals COVID-19 and health professionals
Authors: Gir Elucir , Teles Sheila Araújo , Menegueti Mayra Gonçalves , Reis Renata Karina , de Carvalho Milton Jorge , Botelho Eliã Pinheiro , Milanês Sousa Laelson Rochelle , Campos Coelho Hemilio Fernandes , Ávila Fernanda Maria Pereira , Gimeniz Galvão Marli Teresinha , Nogueira Wynne Pereira , de Oliveira e Silva Ana Cristina 
Published: June 2022

Introduction
Health professionals are on the front lines against the Coronavirus 2019 (COVID-19) pandemic and are at high risk for acquiring the infection. Failures in precautionary measures, inadequacy/scarcity of Personal Protective Equipment (PPE), and lack of social and family distancing may be associated with increased exposure and contamination by the new coronavirus. This study investigated the prevalence of COVID-19 among Brazilian health professionals and associated factors according to demographic and occupational characteristics.

Methods
A cross-sectional, analytical study was conducted using an online survey with 12,086 health professionals from all regions of Brazil. Data were collected using an adaptation of the respondent-driven sampling method for the virtual environment. The outcome variable was the diagnosis of COVID-19. Bivariate and multiple logistic regression analyzes were used to identify an association between the diagnosis of COVID-19 and demographic and occupational variables. Variables were considered statistically significant based on p<0.05.

Results
Most participants were female, from the northeast region, and nursing professionals. A prevalence of 31.95% (95%CI: 31.0%, 32.9%) of COVID-19 was estimated. Following multiple regression analysis, the variables associated with the diagnosis of COVID-19 among health professionals were: male gender, married individuals, professionals who provide care to patients with COVID-19, who work in a field hospital, and those who work in institutions that did not offer enough quality PPE.

Conclusions
The study found a high prevalence of COVID-19 infection, with male professionals being those with greater chances. Inadequate supply or poor quality of PPE offered by health institutions compromises the health of professionals with an increase in positive diagnosis for COVID-19.
Serial T-SPOT.TB responses in Tanzanian adolescents: Transient, persistent and irregular conversions
Authors: Amour Maryam A. , Rees Christiaan A. , Munseri Patricia J. , Said Jamila , Magohe Albert K. , Matee Mecky , Talbot Elizabeth A. , Arbeit Robert D. , Pallangyo Kisali , von Reyn C. Fordham 
Published: June 2022

BackgroundProspective studies of interferon-gamma release assays (IGRA) on healthy subjects in tuberculosis-endemic regions have not examined the long-term variability of serial assays. This issue is relevant to the interpretation of tuberculosis (TB) vaccine trials based on prevention of infection.MethodsT-SPOT.TB assays were performed manually on healthy adolescents during a tuberculosis vaccine trial in Tanzania at 5 intervals over 3 years. Assay results were defined as negative, positive, borderline or invalid. Subsequently, microtiter plates were analyzed by an automated reader to obtain quantitative counts of spot forming cells (SFCs) for the present analysis.Results3387 T-SPOT.TB samples were analyzed from 928 adolescents; manual and automated assay results were 97% concordant. Based on the quantitative results 143 (15%) participants were prevalent IGRA-positives at baseline, were ineligible for further study. Among the remaining IGRA-negative participants, the annual rate of IGRA conversion was 2·9%. Among 43 IGRA converters with repeat assays 12 (28%) were persistent converters, 16 (37%) were transient converters, and 15 (35%) comprised a new category defined as irregular converters (≥2 different subsequent results). ESAT-6 and CFP-10 responses were higher in prevalent than incident positives: 53 vs 36 for CFP-10 (p< 0·007); 44 vs 34 for ESAT-6 (p= 0·12).ConclusionsDefinitions of IGRA conversion, reversion, and persistence depend critically on the frequency of testing. Multiple shifts in categories among adolescents in a TB-endemic country may represent multiple infections, variable host responses in subclinical infection, or assay variation. These findings should to be considered in the design and interpretation of TB vaccine trials based on prevention of infection. Household contact studies could determine whether even transient IGRA conversion might represent exposure to an active case ofM.tuberculosisdisease.
Identification of critical genes and molecular pathways in COVID-19 myocarditis and constructing gene regulatory networks by bioinformatic analysis
Authors: Zhang Fengjun , Yu Cheng , Xu Wenchang , Li Xiao , Feng Junchen , Shi Hongshuo , Yang Jingrong , Sun Qinhua , Cao Xianyi , Zhang Lin , Peng Min 
Published: June 2022

BackgroundThere is growing evidence of a strong relationship between COVID-19 and myocarditis. However, there are few bioinformatics-based analyses of critical genes and the mechanisms related to COVID-19 Myocarditis. This study aimed to identify critical genes related to COVID-19 Myocarditis by bioinformatic methods, explore the biological mechanisms and gene regulatory networks, and probe related drugs.MethodsThe gene expression data of GSE150392 and GSE167028 were obtained from the Gene Expression Omnibus (GEO), including cardiomyocytes derived from human induced pluripotent stem cells infected with SARS-CoV-2 in vitro and GSE150392 from patients with myocarditis infected with SARS-CoV-2 and the GSE167028 gene expression dataset. Differentially expressed genes (DEGs) (adjusted P-Value <0.01 and |Log2 Fold Change| ≥2) in GSE150392 were assessed by NetworkAnalyst 3.0. Meanwhile, significant modular genes in GSE167028 were identified by weighted gene correlation network analysis (WGCNA) and overlapped with DEGs to obtain common genes. Functional enrichment analyses were performed by using the "clusterProfiler" package in the R software, and protein-protein interaction (PPI) networks were constructed on the STRING website (https://cn.string-db.org/). Critical genes were identified by the CytoHubba plugin of Cytoscape by 5 algorithms. Transcription factor-gene (TF-gene) and Transcription factor-microRibonucleic acid (TF-miRNA) coregulatory networks construction were performed by NetworkAnalyst 3.0 and displayed in Cytoscape. Finally, Drug Signatures Database (DSigDB) was used to probe drugs associated with COVID-19 Myocarditis.ResultsTotally 850 DEGs (including 449 up-regulated and 401 down-regulated genes) and 159 significant genes in turquoise modules were identified from GSE150392 and GSE167028, respectively. Functional enrichment analysis indicated that common genes were mainly enriched in biological processes such as cell cycle and ubiquitin-protein hydrolysis. 6 genes (CDK1,KIF20A,PBK,KIF2C,CDC20,UBE2C) were identified as critical genes. TF-gene interactions and TF-miRNA coregulatory network were constructed successfully. A total of 10 drugs, (such as Etoposide, Methotrexate, Troglitazone, etc) were considered as target drugs for COVID-19 Myocarditis.ConclusionsThrough bioinformatics method analysis, this study provides a new perspective to explore the pathogenesis, gene regulatory networks and provide drug compounds as a reference for COVID-19 Myocarditis. It is worth highlighting that critical genes (CDK1,KIF20A,PBK,KIF2C,CDC20, UBE2C) may be potential biomarkers and treatment targets of COVID-19 Myocarditis for future study.