bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmental Drivers of Gulf Coast Tick (Acari: Ixodidae) Range Expansion in the United States
Authors: Flenniken J Matthew , Tuten Holly C , Rose Vineer Hannah , Phillips Victoria C , Stone Chris M , Allan Brian F 
Published: July 2022

Abstract
In the United States, the Gulf Coast tick (Amblyomma maculatum Koch) is a species of growing medical and veterinary significance, serving as the primary vector of the pathogenic bacterium, Rickettsia parkeri (Rickettsiales: Rickettsiaceae), in humans and the apicomplexan parasite, Hepatozoon americanum, in canines. Ongoing reports of A. maculatum from locations outside its historically reported distribution in the southeastern United States suggest the possibility of current and continuing range expansion. Using an ecological niche modeling approach, we combined new occurrence records with high-resolution climate and land cover data to investigate environmental drivers of the current distribution of A. maculatum in the United States. We found that environmental suitability for A. maculatum varied regionally and was primarily driven by climatic factors such as annual temperature variation and seasonality of precipitation. We also found that presence of A. maculatum was associated with open habitat with minimal canopy cover. Our model predicts large areas beyond the current distribution of A. maculatum to be environmentally suitable, suggesting the possibility of future northward and westward range expansion. These predictions of environmental suitability may be used to identify areas at potential risk for establishment and to guide future surveillance of A. maculatum in the United States.
WHERE DOES RESPONSIBILITY LIE? ANALYSING LEGAL AND REGULATORY RESPONSES TO FLAWED CLINICAL DECISION SUPPORT SYSTEMS WHEN PATIENTS SUFFER HARM
Authors: Prictor Megan 
Published: July 2022

Abstract
Clinical decision support systems (CDSSs) are digital healthcare information systems that apply algorithms to patient data to generate tailored recommendations. They are designed to support, but neither dictate nor execute, clinical decisions. CDSSs can introduce new risks, both by design features that heighten clinician burden and by outright errors that generate faulty recommendations for care. In the latter instance, if such unintercepted recommendations were to result in harm to the patient, novel legal questions emerge. Does legal responsibility for this harm lie with the clinician, the software developer or both? What is the clearest path to a remedy? Further, how does the Australian regulatory framework provide for oversight and redress? This article analyses the potential forms of legal redress in negligence, contract and under statutory consumer law, for the patient and the clinician. It also examines the Australian regulatory framework, specifically in relation to the Australian Competition and Consumer Commission and the Therapeutic Goods Administration, and reflects on the framework’s adequacy to protect patients and clinicians. It finds that the regulatory approach and the contour of legal risk still centre upon the clinician’s duty to exercise decisional autonomy and to intercept flawed recommendations generated by algorithmic errors within CDSSs.
Prediction of radiographic progression during a treat-to-target strategy by the sequential application of MRI-proven bone marrow oedema and power-Doppler grade ≥2 articular synovitis in rheumatoid arthritis: Retrospective observational study
Authors: Takatani Ayuko , Tamai Mami , Ohki Nozomi , Okamoto Momoko , Endo Yushiro , Tsuji Sousuke , Shimizu Toshimasa , Umeda Masataka , Fukui Shoichi , Sumiyoshi Remi , Nishino Ayako , Koga Tomohiro , Kawashiri Shin-ya , Iwamoto Naoki , Igawa Takashi , Ichinose Kunihiro , Arima Kazuhiko , Nakamura Hideki , Origuchi Tomoki , Uetani Masataka , Kawakami Atsushi 
Published: July 2022

ABSTRACT

Objectives
To investigate the appropriate timing, useful findings and combination of magnetic resonance imaging (MRI) and ultrasound (US) for predicting the radiographic progression in early rheumatoid arthritis (RA).

Methods
Forty-four active RA patients, who examined by both of MRI and US in the symptomatic wrist and finger joints, were recruited in Nagasaki University Hospital from 2010 to 2017 and treated by the treat-to-target therapeutic strategy for 1 year. MRI was evaluated by RA MRI scoring and US by Outcomes Measures in Rheumatology Clinical Trial, respectively. Plain radiographs were assessed by the Genant-modified Sharp score for the symptomatic side in the same manner as MRI and US. Radiographic progression was defined as an annual increase ≥0.75 at 1 year. Factors associated with radiographic progression were analysed. Also, the optimal combination of MRI and US at each timepoint was considered.

Results
Logistic regression model revealed that MRI-proven bone marrow oedema at baseline and 6 months and joint counts of power-Doppler grade ≥2 articular synovitis at 3 or 6 months were significantly associated with radiographic progression at 1 year.

Conclusion
This study may suggest the favourable timing and combination of MRI and US at each point to predict radiographic progression in patients with early-stage RA.
The bioimpedance phase angle may be associated with frailty in rheumatoid arthritis patients: Results from a prospective, cohort study
Authors: Matsumoto Yoshinari , Tada Masahiro , Yamada Yutaro , Mandai Koji , Hidaka Noriaki , Koike Tatsuya 
Published: July 2022

ABSTRACT

Objectives
This study investigated whether the phase angle (PhA) on bioelectrical impedance analysis is related to frailty in rheumatoid arthritis (RA) patients.

Methods
Data from a prospective cohort study of RA patients were analysed. The PhA was assessed by the bioelectrical impedance analysis method, and frailty was assessed by the Kihon Check List (KCL) annually. The cut-off value of the PhA for frailty was calculated by receiver-operating characteristic analysis. The relationships between the PhA and frailty were evaluated by logistic regression analysis. The relationships between the change in PhA and frailty status and the KCL score were evaluated by analysis of covariance and multiple regression analysis.

Results
A total of 170 patients (81.2% female, 66.2 ± 13.1 years) were included in the analysis. A PhA of less than the cut-off for frailty was significantly associated with frailty (odds ratio: 4.75, 95% confidence interval: 1.86, 12.17). The change in the PhA was significantly associated with the change in the KCL score (β = −0.15). In robust patients, there was a significant difference in the rate of change of the PhA between the group that became pre-frail in the next year and the group that remained robust.

Conclusions
The PhA may be associated with frailty in RA patients.
Family caregiver constructs and outcome measures in neuro-oncology: A systematic review
Authors: Boele Florien , Hertler Caroline , Dirven Linda , Piil Karin , Sherwood Paula 
Published: July 2022

Abstract

Background
As a first step to reach consensus on the key constructs and outcomes in neuro-oncology caregiver research, we performed a systematic review to evaluate the constructs that are being evaluated in research studies and how these have been assessed.

Methods
All peer-reviewed publications with primary data reporting on outcomes of family caregivers of adult primary brain tumor patients were eligible. Electronic databases PubMed/Medline, Embase, Web of Science, Emcare, Cochrane Library, and PsycINFO were searched up to September 2021. Using Covidence, title and abstract screening, full-text review, and data extraction were done by two researchers independently, with a third guiding consensus. Constructs as reported in each study, and how these were assessed were the primary result.

Results
Searches yielded 1090 unique records, with 213 remaining after title/abstract screening. Of these, 157 publications met inclusion criteria, comprising 120 unique studies. These originated from 18 countries and were published between 1996 and 2022. Most were observational (75%) cross-sectional (61%) studies, reporting on quantitative methods (62%). Twenty-seven different constructs were assessed and mapped along the Caregiver Health Model (CGHM) categories, namely, caregiver health, needs, tasks, beliefs and attitudes, and environment. Seventeen questionnaires were used &gt;2 times to measure the same construct, with the vast majority of questionnaires only used across one or two studies.

Conclusions
Neuro-oncology caregiving research is a field gaining traction, but lags behind in clear definition of key constructs, and consistency in assessment of these constructs. Developing consensus or guidance will improve comparability of studies, meta-analyses, and advance the science more quickly.
Anlotinib Combined with Toripalimab as Second-Line Therapy for Advanced, Relapsed Gastric or Gastroesophageal Junction Carcinoma
Authors: Jiang Man , Zhang Chuantao , Hu Yabin , Li Tianjun , Yang Guangjie , Wang Guanqun , Zhu Jingjuan , Shao Changfeng , Hou Helei , Zhou Na , Liu Kewei , Zhang Xiaochun 
Published: July 2022

Abstract
Our study aimed to explore the efficacy and safety of anlotinib–toripalimab combination therapy as a second-line treatment for advanced relapsed gastric or gastroesophageal junction carcinoma (GC/GEJC). In this single arm, single-center extension clinical trial, patients with advanced relapsed GC/GEJC received toripalimab (240 mg, intravenously over 60 minutes, once every 2 weeks) plus anlotinib (12 mg/day, orally, 2 weeks on and 1 week off, every 3 weeks) as second-line therapy. There were 29 patients who achieved partial response, and the ORR was 32.3% (95% CI, 26.6%-38.5%). Grade 3 treatment-related adverse events (TRAEs) were recorded in 7 participants (11.3%), all of which were manageable. The PFS and OS were 4.0 and 11.1 months, respectively. Patients with programmed death-ligand 1 (PD-L1) positive expression showed numerically longer OS than the negative ones although the difference was not significantly. The tumor mutational burden-high (TMB-H) group showed a significantly better OS (P = .05) than the TMB-Low (TMB-L) group. Next-generation sequencing (NGS) revealed that fibroblast growth factor receptor 2 (FGFR2) mutations positively correlated with target lesion reduction (odds ratio [OR] = 0.14; P = .02). The new regimen increased tumor-infiltration of CD8+ T and CD3+ T cells. Furthermore, a patient-derived organoid (PDO) study indicated that anlotinib could promote an immune-supportive tumor microenvironment. As conclusion, the anlotinib-toripalimab combination showed promising efficacy and favorable safety as a second-line treatment for advanced, relapsed GC/GEJC. The PD-L1 expression, TMB, and FGFR2 mutation are potential biomarkers for predicting the efficacy of this regimen (ClinicalTrials.gov registration number: NCT04713059).
An analysis of the recent US dietary guidelines process in light of its federal mandate and a National Academies report
Authors: Achterberg Cheryl , Astrup Arne , Bier Dennis M , King Janet C , Krauss Ronald M , Teicholz Nina , Volek Jeff S 
Published: July 2022

Abstract
The US Dietary Guidelines for Americans is an enormously influential policy that has guided US nutrition programs since 1980. During these last 40 years, some researchers have expressed concern that the guidelines are based on an insufficiently rigorous assessment of the scientific evidence, a view that was largely substantiated by a Congressionally mandated 2017 report by the National Academies of Sciences, Engineering, and Medicine, which identified a need for enhanced transparency, greater scientific rigor, and updates to the scientific methodology for the DGA process. This paper traces the history of these ideas and contextualizes the DGA within the law and regulations that govern its process. The paper also discusses how recent iterations of the Dietary Guidelines have not fully adhered to these guiding documents, which has resulted in diminished independence of the expert committee in charge of evaluating the science for the DGA and a continued lack of a fully rigorous scientific process for producing consistent and trustworthy guidelines for the public.
N-Acetylcysteine (NAC) in Schizophrenia Resistant to Clozapine: A Double-Blind, Randomized, Placebo-Controlled Trial Targeting Negative Symptoms
Authors: Neill Erica , Rossell Susan L , Yolland Caitlin , Meyer Denny , Galletly Cherrie , Harris Anthony , Siskind Dan , Berk Michael , Bozaoglu Kiymet , Dark Frances , Dean Olivia M , Francis Paul S , Liu Dennis , Phillipou Andrea , Sarris Jerome , Castle David J 
Published: July 2022

Abstract

Background and Hypothesis
Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, yet a significant proportion of individuals on clozapine continue to experience disabling symptoms, despite being treated with an adequate dose. There is a need for adjunct treatments to augment clozapine, notably for negative and cognitive symptoms. One such potential agent is the glutathione precursor N-acetylcysteine (NAC).

Study Design
A randomized double-blind, multi-center, placebo-controlled trial for clozapine patients with enduring psychotic symptoms (n = 84) was undertaken to investigate the efficacy of adjunctive NAC (2 g daily) for negative symptoms, cognition and quality of life (QoL). Efficacy was assessed at 8, 24, and 52 weeks.

Study Results
NAC did not significantly improve negative symptoms (P = .62), overall cognition (P = .71) or quality of life (Manchester quality of life: P = .11; Assessment of quality of life: P = .57) at any time point over a 1-year period of treatment. There were no differences in reported side effects between the groups (P = .26).

Conclusions
NAC did not significantly improve schizophrenia symptoms, cognition, or quality of life in treatment-resistant patients taking clozapine. This trial was registered with “Australian and New Zealand Clinical Trials” on the 30 May, 2016 (Registration Number: ACTRN12615001273572).
Ants (Hymenoptera: Formicidae) from Miocene Ethiopian amber: filling gaps in the geological record of African terrestrial biota
Authors: Perrichot Vincent , Boudinot Brendon E , Engel Michael S , Xu Chunpeng , Bojarski Błażej , Szwedo Jacek 
Published: July 2022

Abstract
The Early Miocene (16–23 Mya) amber of Ethiopia constitutes a new source of fossil ants for Africa, where they are otherwise poorly documented. Here we report a diversified assemblage of six subfamilies and at least 19 genera that are still predominantly alive in the Afrotropics today. In this first account, a particular reference is made to the subfamily Dolichoderinae, with the description of two new species: Technomyrmex svojtkai Perrichot & Engel sp. nov. and Ravavy goldmani Boudinot & Perrichot sp. nov. The first is illustrated and described based on synchrotron-radiation microcomputed tomography, and the second represents the first fossil record for the tribe Bothriomyrmecini and Ravavy, a Malagasy and Afrotropical genus that was hitherto monotypic. The ant composition in Ethiopian amber is congruent with the global pattern emerging across ants and showing a Neogene diversification almost exclusively within extant genera.
Could X-ray Predict Long-term Complications in Patients with Diabetic Foot Osteomyelitis?
Authors: Tardáguila-García Aroa , García-Álvarez Yolanda , Sanz-Corbalán Irene , López-Moral Mateo , Molines-Barroso Raúl J. , Lázaro-Martínez José Luis 
Published: July 2022

ABSTRACT

OBJECTIVE:
To analyze the association between radiologic changes on plain X-rays in patients with diabetic foot osteomyelitis and the development of complications at the 1-year follow-up.

METHODS:
A prospective, observational study was conducted involving 115 patients with diabetic foot osteomyelitis. X-ray features that were evaluated during 1-year follow-up visits included affected bone marrow, active periosteal reaction, sequestrum, cortical disruption, and other types of signs. Researchers analyzed the association between the presence of X-ray changes and complication development, such as bone or soft tissue infections, ulcer recurrence, reulceration, amputation, death, and other diabetic foot disease-related events.

RESULTS:
During follow-up, of 115 patients included in the study, 33 patients (28.7%) showed radiologic changes, and 85 (73.9%) developed complications. The presence of radiologic changes after ulcer healing had a significant association with complication development during the 1-year follow-up in addition to those found at different follow-up visits. Patients who showed radiologic changes had higher percentages of complications during the 1-year follow-up, and patients without radiologic changes had lower percentages of complications.

CONCLUSIONS:
The presence of radiologic changes is related to the development of complications in patients who suffer from diabetic foot osteomyelitis.
The 2021 Update on Pressure Injuries: A Review of the Literature
Authors: Saindon Kelley , Nguyen Tran D. , Berlowitz Dan R. 
Published: July 2022

GENERAL PURPOSE
To provide a review of the recent literature on the epidemiology and treatment of pressure injuries (PIs).

TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant will:
1. Identify risk factors for developing PIs.
2. Differentiate factors that could affect the healing of PIs.
3. Select strategies that have an impact on the development of PIs.

ABSTRACT
Keeping up with the literature on pressure injuries is always a challenge for busy clinicians. In this article, the authors summarize six important articles published in 2021. Articles cover a range of topics including epidemiology, treatment, precision medicine, nurse staffing, and patient preferences for care. For each article, a description of the study results is provided along with a comment on why the results are important. This information is intended to help clinicians incorporate new data into their clinical practice.
Can Rater Training Improve the Quality and Accuracy of Workplace-Based Assessment Narrative Comments and Entrustment Ratings? A Randomized Controlled Trial
Authors: Kogan Jennifer R. , Dine C. Jessica , Conforti Lisa N. , Holmboe Eric S. 
Published: July 2022

Purpose
Prior research evaluating workplace-based assessment (WBA) rater training effectiveness has not measured improvement in narrative comment quality and accuracy, nor accuracy of prospective entrustment-supervision ratings. The purpose of this study was to determine whether rater training, using performance dimension and frame of reference training, could improve WBA narrative comment quality and accuracy. A secondary aim was to assess impact on entrustment rating accuracy.

Method
This single-blind, multi-institution, randomized controlled trial of a multifaceted, longitudinal rater training intervention consisted of in-person training followed by asynchronous online spaced learning. In 2018, investigators randomized 94 internal medicine and family medicine physicians involved with resident education. Participants assessed 10 scripted standardized resident–patient videos at baseline and follow-up. Differences in holistic assessment of narrative comment accuracy and specificity, accuracy of individual scenario observations, and entrustment rating accuracy were evaluated with t tests. Linear regression assessed impact of participant demographics and baseline performance.

Results
Seventy-seven participants completed the study. At follow-up, the intervention group (n = 41), compared with the control group (n = 36), had higher scores for narrative holistic specificity (2.76 vs 2.31, P < .001, Cohen V = .25), accuracy (2.37 vs 2.06, P < .001, Cohen V = .20) and mean quantity of accurate (6.14 vs 4.33, P < .001), inaccurate (3.53 vs 2.41, P < .001), and overall observations (2.61 vs 1.92, P = .002, Cohen V = .47). In aggregate, the intervention group had more accurate entrustment ratings (58.1% vs 49.7%, P = .006, Phi = .30). Baseline performance was significantly associated with performance on final assessments.

Conclusions
Quality and specificity of narrative comments improved with rater training; the effect was mitigated by inappropriate stringency. Training improved accuracy of prospective entrustment-supervision ratings, but the effect was more limited. Participants with lower baseline rating skill may benefit most from training.
A Blueprint for Increasing Ethnic and Racial Diversity in U.S. Residency Training Programs
Authors: Butler Paris D. , Fowler Jessica C. , Meer Elana , Rosen Ilene M. , Reyes Iris M. , Berns Jeffrey S. 
Published: July 2022

Problem
People who identify as African Americans, Latinos, or from indigenous backgrounds, are dramatically underrepresented in the U.S. physician workforce. It is critical for academic health centers to recognize racial and ethnic diversity at the residency level and implement changes to enhance diversity among trainees.

Approach
The Office of Graduate Medical Education (GME) at the University of Pennsylvania Health System (UPHS) developed a multipronged approach to enhance diversity and inclusion (D&I) among residency trainees. The approach included the development of an underrepresented in medicine (UIM) professional network; UIM-focused visiting clerkship programs; holistic review implementation by selection committees; and targeted outreach to UIM candidates, overseen by an associate designated institutional official for UIM Affairs. The authors reported demographic data on residency applicants invited for interviews and matching for all programs at UPHS from 2014–2015 (baseline) to 2020–2021. They also reported data on maximum ranking number programs reached to fill their positions and the average United States Medical License Examination (USMLE) Step 1 scores of matched candidates. Finally, they discussed the implications for leaders who wish to enhance D&I at academic health centers.

Outcomes
During the baseline year (2014–2015), UIMs represented 12.1% of interviewees and 8.7% of all matched candidates into UPHS residency programs. Over the successive 6 years after incremental implementation of the approach, UIM representation steadily increased. In 2020–2021, UIMs represented 23.2% of interviewees and 26.4% of matched candidates. Programs’ maximum rank number to fill and USMLE Step 1 scores of matched candidates remained relatively unchanged.

Next Steps
The UPHS Office of GME incorporated a purposeful approach to enhance the D&I of its residents. Across 6 years of implementation, UIM representation among resident matches tripled while quantitative program and candidate metrics remained unchanged. Similar efforts should be given further consideration for implementation and evaluation nationwide.