bluuebunny/crossref_metadata_2025_split huggingface dataset:
Growth in emergency department self-harm or suicidal ideation presentations in young people: Comparing trends before and since the COVID-19 first wave in New South Wales, Australia
Authors: Sara Grant , Wu Jianyun , Uesi John , Jong Nancy , Perkes Iain , Knight Katherine , O’Leary Fenton , Trudgett Carla , Bowden Michael 
Published: March 2022

Introduction: Self-harm presentations in children and young people have increased internationally over the last decade. The COVID-19 pandemic has the potential to worsen these trends. Objective: To describe trends in emergency department self-harm or suicidal ideation presentations for children and young people in New South Wales before and since the COVID-19 pandemic. Methods: We studied presentations for self-harm or suicidal ideation by 10- to 24-year-olds to New South Wales emergency departments, using interrupted time series analysis to compare annualised growth before COVID (2015 to February 2020) and since COVID (March 2020 to June 2021). Subgroup analyses compared age group, gender, triage category, rurality and disadvantage. Time series decomposition via generalised additive models identified long-term, seasonal and short-term trends. Results: Self-harm or suicidal ideation presentations by young people in New South Wales increased by 8.4% per annum pre-COVID. Growth accelerated since COVID, to 19.2% per annum, primarily due to increased presentations by females aged 13–17 years (47.1% per annum since COVID, from 290 per 10,000 in 2019 to 466 per 10,000 in 2021). Presentations in males aged 10–24 years did not increase since COVID (105.4 per 10,000 in 2019, 109.8 per 10,000 in 2021) despite growing 9.9% per annum before COVID. Presentation rates accelerated significantly in socio-economically advantaged areas. Presentations in children and adolescents were strongly linked to school semesters. Conclusion: Emergency department self-harm or suicidal ideation presentations by New South Wales young people grew steadily before COVID. Understanding the sustained increase remains a priority. Growth has increased since COVID particularly for adolescent females, but not among adolescent males. Surprisingly, the largest post-COVID increases in annual growth occurred in socio-economically advantaged and urban regions. The COVID-19 pandemic appears to have added new challenges, particularly in females in the developmentally critical early adolescent and teenage years.
Dying in times of COVID-19: Experiences in different care settings – An online questionnaire study among bereaved relatives (the CO-LIVE study)
Authors: Yildiz Berivan , Korfage Ida J , Witkamp Erica FE , Goossensen Anne , van Lent Liza GG , Pasman H Roeline , Onwuteaka-Philipsen Bregje D , Zee Masha , van der Heide Agnes 
Published: March 2022

Background: The COVID-19 pandemic and restricting measures have affected end-of-life care across different settings. Aim: To compare experiences of bereaved relatives with end-of-life care for a family member or friend who died at home, in a hospital, nursing home or hospice during the pandemic. Design: An open observational online survey was developed and disseminated via social media and public fora (March–July 2020). Data were analyzed using descriptive statistics and logistic regression analyses. Participants: Individuals who lost a family member or friend in the Netherlands during the COVID-19 pandemic. Results: The questionnaire was filled out by 393 bereaved relatives who lost a family member or friend at home ( n =  68), in a hospital ( n =  114), nursing home ( n =  176) or hospice ( n =  35). Bereaved relatives of patients who died in a hospital most often evaluated medical care (79%) as sufficient, whereas medical care (54.5%) was least often evaluated as sufficient in nursing homes. Emotional support for relatives was most often evaluated as sufficient at home (67.7%) and least often in nursing homes (40.3%). Sufficient emotional support for relatives was associated with a higher likelihood to rate the place of death as appropriate. Bereaved relatives of patients who died at a place other than home and whose care was restricted due to COVID-19 were less likely to evaluate the place of death as appropriate. Conclusion: End-of-life care during the COVID-19 pandemic was evaluated least favourably in nursing homes. The quality of emotional support for relatives and whether care was restricted or not were important for assessing the place of death as appropriate.
Dysbiosis index to evaluate the fecal microbiota in healthy cats and cats with chronic enteropathies
Authors: Sung Chi-Hsuan , Marsilio Sina , Chow Betty , Zornow Kailee A , Slovak Jennifer E , Pilla Rachel , Lidbury Jonathan A , Steiner Jörg M , Park So Young , Hong Min-Pyo , Hill Steve L , Suchodolski Jan S 
Published: March 2022

Objectives Previous studies have identified various bacterial taxa that are altered in cats with chronic enteropathies (CE) vs healthy cats. Therefore, the aim of this study was to develop a targeted quantitative molecular method to evaluate the fecal microbiota of cats. Methods Fecal samples from 80 client-owned healthy cats and 68 cats with CE were retrospectively evaluated. A panel of quantitative PCR (qPCR) assays was used to measure the fecal abundance of total bacteria and seven bacterial taxa: Bacteroides, Bifidobacterium, Clostridium hiranonis, Escherichia coli, Faecalibacterium, Streptococcus and Turicibacter. The nearest centroid classifier algorithm was used to calculate a dysbiosis index (DI) based on these qPCR abundances. Results The abundances of total bacteria, Bacteroides, Bifidobacterium, C hiranonis, Faecalibacterium and Turicibacter were significantly decreased, while those of E coli and Streptococcus were significantly increased in cats with CE ( P <0.027 for all). The DI in cats with CE was significantly higher compared with healthy cats ( P <0.001). When the cut-off value of the DI was set at 0, it provided 77% (95% confidence interval [CI] 66–85) sensitivity and 96% (95% CI 89–99) specificity to differentiate the microbiota of cats with CE from those of healthy cats. Fifty-two of 68 cats with CE had a DI >0. Conclusions and relevance A qPCR-based DI for assessing the fecal microbiota of cats was established. The results showed that a large proportion of cats with CE had an altered fecal microbiota as evidenced by an increased DI. Prospective studies are warranted to evaluate the utility of this assay for clinical assessment of feline CE.
Gut microbiome and diabetic retinopathy
Authors: Jabbehdari Sayena , Sallam Ahmed B. 
Published: March 2022

During the last decades, the incidence of diabetes and a variety of complications such as diabetic retinopathy (DR) and cardiovascular diseases have been increased exponentially. Gut bacterial composition -microbiota – has been associated with the pathobiology of many inflammatory and metabolic disorders such as diabetes. Gut microbiota plays a crucial role in preserving the metabolic and immune homeostasis, protecting against pathogens and regulating host immunity; however, gut microbiome ecosystem can be altered by lifestyle, cigarette smoking, dietary patterns, and oxidative stress. Herein, we present a hypothesis on the potential complex association between gut microbiota and DR as one of the microvascular complications of diabetes.
Identifying higher risk subgroups of health care workers for priority vaccination against COVID-19
Authors: Haq Mohsina , Rehman Asif , Haq Momina , Haq Hala , Rajab Hala , Ahmad Junaid , Ahmed Jawad , Anwar Saeed , Ahmad Sajjad , Haq Najib Ul 
Published: March 2022

Background: Health care workers (HCWs) are exposed to high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to close contact with infected patients in hospital. The objective of this study was to estimate the seroprevalence and to identify the exposure risk of various subgroups among HCWs to prioritize them for early vaccination. Methods: This was a multicentre cross-sectional study conducted between 15 and 29 June 2020. A total of 987 HCWs were recruited randomly from two major tertiary-care hospitals of Peshawar city, Pakistan. The HCWs included doctors, nurses, paramedics and hospital support staff. The US Food and Drug Administration (FDA)–approved kit was used for the detection of SARS-CoV-2 antibodies. Results: Overall, 310 (31.4%) HCWs were seropositive for SARS-CoV-2 antibodies (95% confidence interval, CI: 28.5–34.4). Seroprevalence was higher in males (33.5%) and in age group 51–60 years (40.9%). Seropositivity increased with increasing age from 8.3% in age group ⩽20 to 40.9% in 51–60 years of age group ( p < 0.05). The highest seroprevalence was identified in paramedical staff (42·5%, 95% CI: 36.6–48.6) followed by nursing staff (38·8%, 95% CI: 32.1–45.7). In logistic regression, being a male HCW led to higher risk of seropositivity (odds ratio, OR: 1.50, 95% CI: 1·06–2.13. p < 0.05) compared with female staff members. The odds of seropositivity was higher in nurses (OR: 3·47, 95% CI: 1.99–6.05. p < 0.01), paramedical staff (OR: 3·19, 95% CI: 1.93–5.28. p < 0.01) and hospital support staff (OR: 2·47, 95% CI: 1.29–4.7. p < 0.01) compared with consultants. Conclusion: Overall, our results concluded that nursing and paramedical staff are at higher risk and should be vaccinated on priority.
How Changes in Treatment Guidelines Affect the Standard of Care: Ethical Opinions Using the Chicago 4.0 Classification for Esophageal Motility Disorders as Example
Authors: Herbella Fernando A. M. , Patti Marco G. , Filho Roberto Maia , Serodio Aluisio M. B. , Adão Diego , Bastos Isis Boll de Araujo , Soares Flaviana Rampazzo , Wagar Chip 
Published: March 2022

Background: Traditionally, guidelines issued by medical societies have provided a standard of care for the treatment of disease processes, establishing clear pathways, and limiting litigation. A major ethical dilemma may occur when an update in guidelines may lead to an instant change in the standard of care. Methods: We present a hypothetical clinical scenario of esophagogastric obstruction outflow obstruction (EGJOO) where guidelines were changed, and we asked the opinion of experts in different areas—surgeons, ethicists, and lawyers. Results: Each group of experts presented their opinion on ethical issues relevant to the clinical case. Conclusions: The clinical case presented and the guidelines for the treatment of primary esophageal motility disorders based on the Chicago classification 4.0, represent a current issue that the world of medicine has to face. While guidelines are usually particularly useful for practitioners, they must be based on irrevocable principles. They must be the result of a rigorous scientific analysis of available data by a group of real experts, and opinions should be avoided if not based on evidence. The level of evidence should be clearly stated, stressing the weakness of some recommendations when present. Conflicts of interest of the Authors of the guidelines should be not only declared, but carefully analyzed in order to avoid biases. Finally, radical changes in a short period of time should be avoided as they expose the practitioners to poor outcomes and litigation.
Competency Assessment for Laparoscopic Anti-Reflux Surgery: Design and Delphi Review, a Collaboration With the American Foregut Society
Authors: Turner Simon R. , Louie Brian E. , Dunst Christy , Molena Daniela , Bédard Eric L. R. 
Published: March 2022

Background: Laparoscopic anti-reflux surgery, including hiatus hernia repair, is a common operation performed by both general and thoracic surgeons and an important learning objective for surgical trainees. This study aimed to design a competency assessment instrument for laparoscopic anti-reflux surgery. Method: A comprehensive competency assessment instrument was designed by a process of logical analysis by 4 expert thoracic surgeons with an interest in foregut surgery, and then reviewed informally by a panel of experts. The instrument was then further assessed and refined using a modified Delphi process. The Delphi questionnaire was distributed to all members of the Fellowship Training Committee of the American Foregut Society (n = 21). Results: A first draft of the competency assessment instrument included 32 steps in 4 categories. The first round of the Delphi review was completed by 14 respondents (response rate 66.7%). A total of 3 rounds of Delphi review were performed. Ultimately, 25 items were retained from the original instrument and 1 modified and 4 new items were added. The final instrument has 30 steps in 4 categories. Conclusions: An international and inter-specialty consensus was established on the key components of assessing competence to perform anti-reflux surgery. The resulting instrument could be used to guide competency based assessments of general and thoracic surgeons and trainees.
Dynamic contrast enhanced MRI for the evaluation of lung perfusion in idiopathic pulmonary fibrosis
Authors: Torres Luis A. , Lee Kristine E. , Barton Gregory P. , Hahn Andrew D. , Sandbo Nathan , Schiebler Mark L. , Fain Sean B. 
Published: March 2022

BackgroundThe objective of this work was to apply quantitative and semiquantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) methods to evaluate lung perfusion in idiopathic pulmonary fibrosis (IPF).MethodsIn this prospective trial 41 subjects, including healthy control and IPF subjects, were studied using DCE-MRI at baseline. IPF subjects were then followed for 1 year; progressive IPF (IPFprog) subjects were distinguished from stable IPF (IPFstable) subjects based on a decline in percent predicted forced vital capacity (FVC % pred) or diffusing capacity of the lung for carbon monoxide (DLCO% pred) measured during follow-up visits. 35 out of 41 subjects were retained for final baseline analysis (control: n=15; IPFstable: n=14; IPFprog: n=6). Seven measures and their coefficients of variation (CV) were derived using temporally resolved DCE-MRI. Two sets of global and regional comparisons were made: controlversusIPF groups and controlversusIPFstableversusIPFproggroups, using linear regression analysis. Each measure was compared with FVC % pred,DLCO% pred and the lung clearance index (LCI % pred) using a Spearman rank correlation.ResultsDCE-MRI identified regional perfusion differences between control and IPF subjects using first moment transit time (FMTT), contrast uptake slope and pulmonary blood flow (PBF) (p≤0.05), while global averages did not. FMTT was shorter for IPFprogcompared with both IPFstable(p=0.004) and control groups (p=0.023). Correlations were observed between PBF CV andDLCO% pred (rs= −0.48, p=0.022) and LCI % pred (rs= +0.47, p=0.015). Significant group differences were detected in age (p<0.001),DLCO% pred (p<0.001), FVC % pred (p=0.001) and LCI % pred (p=0.007).ConclusionsGlobal analysis obscures regional changes in pulmonary haemodynamics in IPF using DCE-MRI in IPF. Decreased FMTT may be a candidate marker for IPF progression.
Prevalence and characteristics of progressive fibrosing interstitial lung disease in a prospective registry
Authors: Hambly Nathan , Farooqi M. Malik , Dvorkin-Gheva Anna , Donohoe Kathryn , Garlick Kristopher , Scallan Ciaran , Chong Sy Giin , MacIsaac Sarah , Assayag Deborah , Johannson Kerri A. , Fell Charlene D. , Marcoux Veronica , Manganas Helene , Morisset Julie , Comes Alessia , Fisher Jolene H. , Shapera Shane , Gershon Andrea S. , To Teresa , Wong Alyson W. , Sadatsafavi Mohsen , Wilcox Pierce G. , Halayko Andrew J. , Khalil Nasreen , Cox Gerard , Richeldi Luca , Ryerson Christopher J. , Kolb Martin 
Published: March 2022

BackgroundProgressive fibrosing interstitial lung disease (PF-ILD) is characterised by progressive physiological, symptomatic and/or radiographic worsening. The real-world prevalence and characteristics of PF-ILD remain uncertain.MethodsPatients were enrolled from the Canadian Registry for Pulmonary Fibrosis between 2015 and 2020. PF-ILD was defined as a relative forced vital capacity (FVC) decline ≥10%, death, lung transplantation or any two of: relative FVC decline ≥5% and <10%, worsening respiratory symptoms or worsening fibrosis on computed tomography of the chest, all within 24 months of diagnosis. Time-to-event analysis compared progression between key diagnostic subgroups. Characteristics associated with progression were determined by multivariable regression.ResultsOf 2746 patients with fibrotic ILD (mean±sdage 65±12 years; 51% female), 1376 (50%) met PF-ILD criteria in the first 24 months of follow-up. PF-ILD occurred in 427 (59%) patients with idiopathic pulmonary fibrosis (IPF), 125 (58%) with fibrotic hypersensitivity pneumonitis (HP), 281 (51%) with unclassifiable ILD (U-ILD) and 402 (45%) with connective tissue disease-associated ILD (CTD-ILD). Compared with IPF, time to progression was similar in patients with HP (hazard ratio (HR) 0.96, 95% CI 0.79–1.17), but was delayed in patients with U-ILD (HR 0.82, 95% CI 0.71–0.96) and CTD-ILD (HR 0.65, 95% CI 0.56–0.74). Background treatment varied across diagnostic subtypes, with 66% of IPF patients receiving antifibrotic therapy, while immunomodulatory therapy was utilised in 49%, 61% and 37% of patients with CHP, CTD-ILD and U-ILD, respectively. Increasing age, male sex, gastro-oesophageal reflux disease and lower baseline pulmonary function were independently associated with progression.ConclusionsProgression is common in patients with fibrotic ILD, and is similarly prevalent in HP and IPF. Routinely collected variables help identify patients at risk for progression and may guide therapeutic strategies.
The effect of oxygen and carbon dioxide cross-sensitivity sensor error in the Eco Medics Exhalyzer D device on measures of conductive and acinar airway function
Authors: Bozier Jack , Jeagal Edward , Robinson Paul D. , Prisk G. Kim , Chapman David G. , King Gregory G. , Thamrin Cindy , Rutting Sandra 
Published: March 2022

IntroductionThe multiple breath nitrogen washout (MBNW) test provides important clinical information in obstructive airways diseases. Recently, a significant cross-sensitivity error in the O2and CO2sensors of a widely used commercial MBNW device (Exhalyzer D, Eco Medics AG, Duernten, Switzerland) was detected, which leads to overestimation of N2concentrations. Significant errors in functional residual capacity (FRC) and lung clearance index (LCI) have been reported in infants and children. This study investigated the impact in adults, and on additional important indices reflecting conductive (Scond) and acinar (Sacin) ventilation heterogeneity, in health and disease.MethodsExisting MBNW measurements of 27 healthy volunteers, 20 participants with asthma and 16 smokers were reanalysed using SPIROWARE V 3.3.1, which incorporates an error correction algorithm. Uncorrected and corrected indices were compared using paired t-tests and Bland–Altman plots.ResultsCorrection of the sensor error significantly lowered FRC (mean difference 9%) and LCI (8–10%) across all three groups.Scondwas higher following correction (11%, 14% and 36% in health, asthma and smokers, respectively) with significant proportional bias.Sacinwas significantly lower following correction in the asthma and smoker groups, but the effect was small (2–5%) and with no proportional bias.DiscussionThe O2and CO2cross-sensitivity sensor error significantly overestimated FRC and LCI in adults, consistent with data in infants and children. There was a high degree of underestimation ofScondbut minimal impact onSacin. The presence of significant proportional bias indicates that previous studies will require reanalysis to confirm previous findings and to allow comparability with future studies.
Effectiveness of high cardiorespiratory fitness in cardiometabolic protection in prediabetic rats
Authors: Thonusin Chanisa , Pantiya Patcharapong , Sumneang Natticha , Chunchai Titikorn , Nawara Wichwara , Arunsak Busarin , Siri-Angkul Natthaphat , Sriwichaiin Sirawit , Chattipakorn Siriporn C. , Chattipakorn Nipon 
Published: March 2022

Abstract
Background
Caloric restriction and exercise are lifestyle interventions that effectively attenuate cardiometabolic impairment. However, cardioprotective effects of long-term lifestyle interventions and short-term lifestyle interventions followed by weight maintenance in prediabetes have never been compared. High cardiorespiratory fitness (CRF) has been shown to provide protection against prediabetes and cardiovascular diseases, however, the interactions between CRF, prediabetes, caloric restriction, and exercise on cardiometabolic health has never been investigated.

Methods
Seven-week-old male Wistar rats were fed with either a normal diet (ND; n = 6) or a high-fat diet (HFD; n = 30) to induce prediabetes for 12 weeks. Baseline CRF and cardiometabolic parameters were determined at this timepoint. The ND-fed rats were fed continuously with a ND for 16 more weeks. The HFD-fed rats were divided into 5 groups (n = 6/group) to receive one of the following: (1) a HFD without any intervention for 16 weeks, (2) 40% caloric restriction for 6 weeks followed by an ad libitum ND for 10 weeks, (3) 40% caloric restriction for 16 weeks, (4) a HFD plus an exercise training program for 6 weeks followed by a ND without exercise for 10 weeks, or (5) a HFD plus an exercise training program for 16 weeks. At the end of the interventions, CRF and cardiometabolic parameters were re-assessed. Then, all rats were euthanized and heart tissues were collected.

Results
Either short-term caloric restriction or exercise followed by weight maintenance ameliorated cardiometabolic impairment in prediabetes, as indicated by increased insulin sensitivity, improved blood lipid profile, improved mitochondrial function and oxidative phosphorylation, reduced oxidative stress and inflammation, and improved cardiac function. However, these benefits were not as effective as those of either long-term caloric restriction or exercise. Interestingly, high-level baseline CRF was correlated with favorable cardiac and metabolic profiles at follow-up in prediabetic rats, both with and without lifestyle interventions.

Conclusions
Short-term lifestyle modification followed by weight maintenance improves cardiometabolic health in prediabetes. High CRF exerted protection against cardiometabolic impairment in prediabetes, both with and without lifestyle modification. These findings suggest that targeting the enhancement of CRF may contribute to the more effective treatment of prediabetes-induced cardiometabolic impairment.