bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Unique Multi- and Interdisciplinary Cardiology-Renal-Endocrine Clinic: A Description and Assessment of Outcomes
Authors: Dubrofsky Lisa , Lee Jason F. , Hajimirzarahimshirazi Parisa , Liu Hongyan , Weisman Alanna , Lawler Patrick R. , Farkouh Michael E. , Udell Jacob A. , Cherney David Z. 
Published: February 2022

Background: Patients with diabetes and co-existing chronic kidney disease and/or cardiovascular disease have complex medical needs with multiple indications for different guideline-directed medical therapies and require high health care resource utilization. The Cardiac and Renal Endocrine Clinic (C.a.R.E. Clinic) is a multi- and interdisciplinary clinic offering a unique care model to this population to overcome barriers to optimal care. Objective: To describe the patient characteristics and clinical data of consecutive patients seen in the C.a.R.E. Clinic between 2014 and 2020, with a focus on the feasibility, strengths, and challenges of this outpatient care model. Design: Single-center retrospective cohort study. Setting: The C.a.R.E. Clinic is a multi- and interdisciplinary clinic at Toronto General Hospital in Toronto, Canada. Patients: We reviewed the charts of all 118 patients who had been referred to the C.a.R.E. Clinic with type 2 diabetes mellitus, co-existing renal disease, and/or cardiovascular disease. Measurements: Demographic data, medication data, clinic blood pressure measurements, and laboratory data were assessed at the first and last available clinic visit. Methods: Data were extracted via manual chart review of paper and electronic medical records. Results: First and last attended clinic visit data were available for descriptive analysis in 74 patients. There was a significant improvement in low-density lipoprotein (LDL) cholesterol (1.9 mmol/L vs 1.5 mmol/L, P < .01), hemoglobin A1C (7.5% vs 7.1%, P = .02), and the proportion of patients with blood pressure at target (52.7% vs 36.5%, P = .04), but not body mass index (29.7 kg/m² vs 29.6 kg/m², P = .15) between the last and first available clinic visits. There was higher uptake in evidence-based medication use including statins (93.2% vs 81.1%, P = .01), SGLT-2i (35.1% vs 4.1%, P < .01), and GLP-1 receptor agonists (13.5% vs 4.1%, P = .02), while RAAS inhibitor use was already high at baseline (81.8% vs 78.4%, P = .56). There remains a significant opportunity for therapy with sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists. Limitations: This is a retrospective chart review lacking a control group, therefore clinical improvements cannot be causally attributed to the clinic alone. New evidence and changes to guideline-recommended therapies also contributed to practice changes during this time period. Conclusions: A multi- and interdisciplinary clinic is a feasible and potentially effective way to improve evidence-based and patient-centered care for patients with diabetes, kidney, and cardiovascular disease.
Indocyanine-based near-infrared lymphography for real-time detection of lymphatics in a cat with multiple mast cell tumours
Authors: Arz Raphael , Seehusen Frauke , Meier Valeria S , Nolff Mirja C 
Published: February 2022

Case summary An 11-year-old female domestic shorthair cat was presented with cutaneous mast cell tumours (MCTs) localised at the right temporal region, the left buccal region and on the third digit of the right thoracic limb. Staging was negative and locoregional lymph nodes appeared normal, based on clinical findings. During surgery, real-time indocyanine green (ICG)-based lymphography was performed to detect the cutaneous draining pattern of all the primary MCTs. ICG was injected intracutaneously in four quadrants around each tumour, and a clear lymphogram was visible shortly after injection. Using near-infrared lymphography (NIR-L) for guidance, all lymphadenectomies were performed in 12 mins or less, with a maximal incision length of 3.5 cm. The smallest resected node was 0.9 cm in diameter. All MCTs were classified as low-grade cutaneous MCT. All four ICG-positive lymph nodes were considered premetastatic or metastatic. The only ICG-negative resected node was also negative for tumour cells. No complications related to NIR-L were recorded. Relevance and novel information This is the first description of NIR-L in a cat with MCT. Application was straightforward and ICG enrichment only occurred in the metastatic nodes, suggesting correct identification of lymphatic draining patterns. Of note, as previously described in dogs, we did detect nodal metastasis, despite low-grade primary tumours. The clinical relevance should be evaluated in future studies.
Preliminary testing of eye gaze interfaces for controlling a haptic system intended to support play in children with physical impairments: Attentive versus explicit interfaces
Authors: Castellanos-Cruz Javier L. , Gómez-Medina María F. , Tavakoli Mahdi , Pilarski Patrick , Adams Kim D 
Published: February 2022

Introduction Children with physical impairments may face challenges to play because of their motor impairments, which could lead to negative impacts in their development. The objective of this article was to compare two eye gaze interfaces that identified the desired toy a user wanted to reach with a haptic-enabled telerobotic system in a play activity. Methods One of the interfaces was an attentive user interface predicted the toy that children wanted to reach by observing where they incidentally focused their gaze. The other was an explicit eye input interface determined the toy after the child dwelled for 500 ms on a selection point. Five typically developing children, an adult with cerebral palsy (CP) and a child with CP participated in this study. They controlled the robotic system to play a whack-a-mole game. Results The prediction accuracy of the attentive interface was higher than 89% in average, for all participants. All participants did the activity faster with the attentive interface than with the explicit interface. Conclusions Overall, the attentive interface was faster and easier to use, especially for children. Children needed constant prompting and were not 100% successful at using the explicit interface.
Expanding Knowledge and Changing Attitudes About Poverty: An Interactive, Interprofessional Approach
Authors: Marrast Lyndonna M. , Chim Christine , Tocco Jack , Coletti Daniel J. , Nouryan Christian , Block Lauren , Martinez Johanna 
Published: February 2022

Background: Poverty negatively affects the lives and health of the poor. However, health professionals often have limited personal experience and receive little formal education on surviving under conditions of poverty in the United States, which may contribute to suboptimal patient care and outcomes. Purpose: We conducted a 3-h, interactive, experiential poverty simulation workshop with an interprofessional group of pre-professional health students to increase their comprehension about the realities of poverty. Method: As part of the evaluation, participants completed a self-assessment of their attitudes and skills using a Likert scale and open-ended questions; a reflection prompt about how the workshop might affect their professional practice; and a pre- and post-assessment questionnaire. Discussion: Participants’ attitudes about low-income patients became more favorable; they gained awareness and expressed empathy through the role-play experience. Our analysis revealed increased understanding of social determinants of health, of life challenges that patients face outside of healthcare, and that solutions must be collaborative as the challenges facing poor patients are multifactorial. Conclusion: The workshop allowed interprofessional students to learn from and with each other about the experiences of poor patients. Future sessions should emphasize interprofessional skill-building and action, potentially in virtual formats.
Patterns of Lumbar Spine Malalignment Leading to Revision Surgery for Proximal Junctional Kyphosis: A Cluster Analysis of Over- Versus Under-Correction
Authors: Lafage Renaud , Passias Peter , Sheikh Alshabab Basel , Bess Shay , Smith Justin S. , Klineberg Eric , Kim Han Jo , Elysee Jonathan , Shaffrey Christopher , Burton Douglas , Hostin Richard , Mundis Gregory , Schwab Frank , Lafage Virginie ,   On behalf of the International Spine Study Group
Published: February 2022

Study Design Retrospective cohort study. Objective Investigate the patterns of fused lumbar alignment in patients requiring revision surgery for proximal junctional kyphosis (PJK). Methods Fifty patients (67.8 yo, 76% female) with existing thoraco-lumbar fusion (T10/12 to pelvis) and indicated for surgical correction for PJK were included. To investigate patterns of radiographic alignment prior to PJK revision, unsupervised 2-step cluster analysis was run on parameters describing the fused lumbar spine (PI-LL) to identify natural independent groups within the cohort. Clusters were compared in terms of demographics, pre-operative alignment, surgical parameters, and post-operative alignment. Associations between pre- and post-revision PJK angles were investigated using a Pearson correlation analysis. Results Analysis identified 2 distinct patterns: Under-corrected (UC, n = 12, 32%) vs over-corrected (OC, n = 34, 68%) with a silhouette of .5. The comparison demonstrated similar pelvic incidence (PI) and PJK angle but significantly greater deformity for the UC vs OC group in terms of PI-LL, PI-LL offset, pelvic tilt, and sagittal vertebral axis. The surgical strategy for PJK correction did not differ between the 2 groups in terms of approach, American Society of Anesthesiologists grade, decompression, use of osteotomy, interbody fusion, or fusion length. The post-revision PJK angle significantly correlated with the amount of PJK correction within the OC group but not within the UC group. Conclusions This study identified 2 patterns of lumbar malalignment associated with severe PJK: over vs under corrected. Despite the difference in PJK etiology, both patterns underwent the same revision strategy. Future analysis should look at the effect of correcting focal deformity alone vs correcting focal deformity and underlying malalignment simultaneously on recurrent PJK rate.
Psychological Resilience and Cognitive Function Among Older Military Veterans
Authors: McDaniel Justin T. , Hascup Erin R. , Hascup Kevin N. , Trivedi Mehul , Henson Harvey , Rados Robert , York Mary , Albright David L. , Weatherly Taryn , Frick Kaitlyn 
Published: February 2022

The purpose of this study was to explore the association between psychological resilience and cognitive function in military veterans. We obtained public-use data from the Health and Retirement Study (HRS) for this cross-sectional study of military veterans aged 52 to 101 years ( n = 150). We estimated a multivariable linear regression model in which cognitive function served as the dependent variable and psychological resilience served as the independent variable. After controlling for demographics, health conditions, and health behaviors, veterans who had higher psychological resilience scores had better cognitive function (b = 0.22, p = 0.03). Our findings suggest that psychological resilience may be associated with cognitive function among veterans. These findings highlight the importance of assessing psychological resilience in gerontological social work practice.
Genome variation in tick infestation and cryptic divergence in Tunisian indigenous sheep
Authors: Ahbara Abulgasim M. , Khbou Médiha Khamassi , Rhomdhane Rihab , Sassi Limam , Gharbi Mohamed , Haile Aynalem , Rekik Mourad , Rischkowsky Barbara , Mwacharo Joram M. 
Published: February 2022

Abstract
Background
Ticks are obligate haematophagous ectoparasites considered second to mosquitos as vectors and reservoirs of multiple pathogens of global concern. Individual variation in tick infestation has been reported in indigenous sheep, but its genetic control remains unknown.

Results
Here, we report 397 genome-wide signatures of selection overlapping 991 genes from the analysis, using ROH, LR-GWAS, XP-EHH, and FST, of 600 K SNP genotype data from 165 Tunisian sheep showing high and low levels of tick infestations and piroplasm infections. We consider 45 signatures that are detected by consensus results of at least two methods as high-confidence selection regions. These spanned 104 genes which included immune system function genes, solute carriers and chemokine receptor. One region spanned STX5, that has been associated with tick resistance in cattle, implicating it as a prime candidate in sheep. We also observed RAB6B and TF in a high confidence candidate region that has been associated with growth traits suggesting natural selection is enhancing growth and developmental stability under tick challenge. The analysis also revealed fine-scale genome structure indicative of cryptic divergence in Tunisian sheep.

Conclusions
Our findings provide a genomic reference that can enhance the understanding of the genetic architecture of tick resistance and cryptic divergence in indigenous African sheep.
Analysis of global Aeromonas veronii genomes provides novel information on source of infection and virulence in human gastrointestinal diseases
Authors: Liu Fang , Yuwono Christopher , Tay Alfred Chin Yen , Wehrhahn Michael C. , Riordan Stephen M. , Zhang Li 
Published: February 2022

Abstract
Background
Aeromonas veronii is a Gram-negative rod-shaped motile bacterium that inhabits mainly freshwater environments. A. veronii is a pathogen of aquatic animals, causing diseases in fish. A. veronii is also an emerging human enteric pathogen, causing mainly gastroenteritis with various severities and also often being detected in patients with inflammatory bowel disease. Currently, limited information is available on the genomic information of A. veronii strains that cause human gastrointestinal diseases.
Here we sequenced, assembled and analysed 25 genomes (one complete genome and 24 draft genomes) of A. veronii strains isolated from patients with gastrointestinal diseases using combine sequencing technologies from Illumina and Oxford Nanopore. We also conducted comparative analysis of genomes of 168 global A. veronii strains isolated from different sources.

Results
We found that most of the A. veronii strains isolated from patients with gastrointestinal diseases were closely related to each other, and the remaining were closely related to strains from other sources. Nearly 300 putative virulence factors were identified. Aerolysin, microbial collagenase and multiple hemolysins were present in all strains isolated from patients with gastrointestinal diseases. Type III Secretory System (T3SS) in A. veronii was in AVI-1 genomic island identified in this study, most likely acquired via horizontal transfer from other Aeromonas species. T3SS was significantly less present in A. veronii strains isolated from patients with gastrointestinal diseases as compared to strains isolated from fish and domestic animals.

Conclusions
This study provides novel information on source of infection and virulence of A. veronii in human gastrointestinal diseases.
Out of hospital cardiac arrest in Western Sydney—an analysis of outcomes and estimation of future eCPR eligibility
Authors: Chandru Pramod , Mitra Tatum Priyambada , Dhanekula Nitesh Dutt , Dennis Mark , Eslick Adam , Kruit Natalie , Coggins Andrew 
Published: February 2022

AbstractBackgroundRefractory out of hospital cardiac arrest (OHCA) is associated with extremely poor outcomes. However, in selected patients extracorporeal cardiopulmonary resuscitation (eCPR) may be an effective rescue therapy, allowing time treat reversible causes. The primary goal was to estimate the potential future caseload of eCPR at historically 'low-volume' extracorporeal membrane oxygenation (ECMO) centres.MethodsA 3-year observational study of OHCA presenting to the Emergency Department (ED of an urban referral centre without historical protocolised use of eCPR. Demographics and standard Utstein outcomes are reported. Further, an a priori analysis of each case for potential eCPR eligibility was conducted. A current eCPR selection criteria (from the 2-CHEER study) was used to determine eligibly.ResultsIn the study window 248 eligible cardiac arrest cases were included in the OHCA registry. 30-day survival was 23.4% (n = 58). The mean age of survivors was 55.4 years. 17 (6.8%) cases were deemed true refractory arrests and fulfilled the 2-CHEER eligibility criteria. The majority of these cases presented within “office hours” and no case obtained a return of spontaneous circulation standard advanced life support.ConclusionsIn this contemporary OHCA registry a significant number of refractory cases were deemed potential eCPR candidates reflecting a need for future interdisciplinary work to support delivery of this therapy.
The association between continuous renal replacement therapy as treatment for sepsis-associated acute kidney injury and trend of lactate trajectory as risk factor of 28-day mortality in intensive care units
Authors: Wang Zichen , Zhang Luming , Xu Fengshuo , Han Didi , Lyu Jun 
Published: February 2022

AbstractBackgroundSepsis has high incidence and fatality rates in intensive care units, often leading to renal failure. The effectiveness of continuous renal replacement therapy (CRRT) in sepsis-associated acute kidney injury (S-AKI) patients is currently uncertain.AimJoint model was used to determine the association between CRRT and the lactate trajectory trend and how it correlated to 28-day mortality for S-AKI patient in ICU.MethodsA retrospective study was applied to patients with sepsis and AKI, which were extracted from the MIMIC-III public database, with the endpoint being 28-day mortality. Every lactate level measurement within 28 days was observed and calculated using logarithms. Joint model combined the longitudinal analysis of the natural logarithm of the lactate level [log(lactate)] in longitudinal submodel and Cox regression by trajectory function, demonstrating the effects of CRRT on 28-day survival and log(lactate) changes, and its final relationship with the event status.ResultsAmong the 717 S-AKI patients, 157 received CRRT. CRRT was not associated with 28-day mortality. After adjustments, the relationship between CRRT use and log(lactate) elevation was statistically significant. The parameter estimation of CRRT and log(lactate) indicated that using CRRT will increase log(lactate) by 0.041 in S-AKI patients. The joint model also instigated a fixed association between changes in the lactate level and the event result, revealing an exp value of (0.755) = 2.12, indicating that an increase of one unit in log(lactate) will increase the risk of 28-day mortality 2.12-times.ConclusionThere was no significant association between CRRT use and 28-day survival in S-AKI patients, and JM showed that CRRT use might be associated with elevation of longitudinal lactate levels. Therefore, additional attention should be paid to other treatments to control lactate levels when providing renal support for patients with S-AKI.
Danish feasibility study of a new innovation for treating alcohol disorders in primary care: the 15-method
Authors: Schøler Peter Næsborg , Søndergaard Jens , Barfod Sverre , Nielsen Anette Søgaard 
Published: February 2022

Abstract
Background
The 15-method: a new brief intervention tool for alcohol problems in primary care has shown promising results in Sweden for mild to moderate alcohol use disorders. The present study evaluated the 15-method’s usability, organizational integration, and overall implementation feasibility in Danish general practice in preparation for a large-scale evaluation of the method’s effectiveness in identifying and treating alcohol problems in general practice.

Methods
Five general practices in the Central and Southern Region of Denmark participated: seven general practitioners (GPs), eight nurses. Participants received a half day of training in the 15-method. Testing of implementation strategies and overall applicability ran for 2 months. A focus group interview and two individual interviews with participating GPs along with five individual patient interviews concluded the study period.

Results
Results indicate that implementation of the 15-method is feasible in Danish general practice. The healthcare professionals and patients were positive about the method and its possibilities. The method was considered a new patient centered treatment offer and provided structure to a challenging topic. An interdisciplinary approach was much welcomed. Results indicate that the method is ready for large scale evaluation.

Conclusions
Implementation of the 15-method is considered feasible in Danish general practice and large-scale evaluation is currently being planned.
Functional dentition is a modifier of the association between vitamin D and the frailty index among Chinese older adults: a population-based longitudinal study
Authors: Dai Miao , Yue Jirong , Zhang Jingyi , Wang Hui , Wu Chenkai 
Published: February 2022

Abstract
Backgrounds
Although vitamin D and dentition status are each associated with frailty, their combined effects on frailty have not been studied. This study aimed to evaluate the combined effects of vitamin D and dentition status on frailty in old Chinese adults.

Methods
Baseline data were obtained from the 2011–2012 wave of the Chinese Longitudinal Healthy Longevity Survey. A total of 1074 participants ≥65 years who were non-frail or prefrail at baseline were included; follow-up was conducted in the 2014 wave. Frailty was assessed by a 40-item frailty index (FI) and classified into frail (FI > 0.21), prefrail (FI: 0.1–0.21), and non-frail (FI ≤0.1). Vitamin D was assessed by 25-Hydroxyvitamin D (25(OH)D) and categorized into quartiles and dichotomies (normal: ≥50 nmol/L vs. low: < 50 nmol/L). The presence of ≥20 natural teeth was defined as functional dentition, otherwise as non-functional dentition. We used bivariate logistic regression and restricted cubic splines to examine the association between vitamin D, dentition status, and frailty. We created a multiplicative interaction between vitamin D and dentition status to test for their combined effect.

Results
A total of 205 (19.1%) incident frailty were identified during the 3-year follow-up. Participants with the lowest quartile of plasma 25(OH) D were more likely to be frail (odds ratio [OR] 2.45, 95% confidence interval [CI]: 1.38 to 4.35) than those in the highest quartile. Older adults with the lowest quartile of 25(OH) D and non-functional dentition had the highest odds of frailty (OR = 3.67, 95% CI: 1.02 to 13.12). We also observed that a lower vitamin D level was associated with an increased risk of frailty with a threshold of 40.37 nmol/L using restricted cubic spline models. However, vitamin D levels were not significantly associated with frailty among participants with functional dentition.

Conclusions
Low vitamin D levels were associated with an increased risk of frailty in older adults. Functional dentition modified the association of vitamin D with frailty.