Miracle-dz/UniFAR-FTUs huggingface dataset:
The Adoption of a Virtual Reality–Assisted Training System for Mental Rotation: A Partial Least Squares Structural Equation Modeling Approach

Background Virtual reality (VR) technologies have been developed to assist education and training. Although recent research suggested that the application of VR led to effective learning and training outcomes, investigations concerning the acceptance of these VR systems are needed to better urge learners and trainees to be active adopters. Objective This study aimed to create a theoretical model to examine how determining factors from relevant theories of technology acceptance can be used to explain the acceptance of a novel VR-assisted mental rotation (MR) training system created by our research team to better understand how to encourage learners to use VR technology to enhance their spatial ability. Methods Stereo and interactive MR tasks based on Shepard and Metzler’s pencil and paper test for MR ability were created. The participants completed a set of MR tasks using 3D glasses and stereoscopic display and a 6-degree-of-freedom joystick controller. Following task completion, psychometric constructs from theories and previous studies (ie, perceived ease of use, perceived enjoyment, attitude, satisfaction, and behavioral intention to use the system) were used to measure relevant factors influencing behavior intentions. Results The statistical technique of partial least squares structural equation modeling was applied to analyze the data. The model explained 47.7% of the novel, VR-assisted MR training system’s adoption intention, which suggests that the model has moderate explanatory power. Direct and indirect effects were also interpreted. Conclusions The findings of this study have both theoretical and practical importance not only for MR training but also for other VR-assisted education. The results can extend current theories from the context of information systems to educational and training technology, specifically for the use of VR-assisted systems and devices. The empirical evidence has practical implications for educators, technology developers, and policy makers regarding MR training.
Factors Influencing Medical Students’ Experiences and Satisfaction with Blended Integrated E-Learning

Objectives: Blended learning has been presented as a promising learner-centred model that emphasises the learning outcome rather than the process of education, but it can negatively affect learners’ engagement with learning. Subject and Methods: Using a mixed-methods approach, this study aimed to determine the significant predictors of learning satisfaction and to evaluate the experiences of medical students with the different domains of an introduced blended integrated learning approach. Results: The survey was administered to 92 respondents with a mean age of 20.5 years. Male students had significantly higher computer self-efficacy and overall learner satisfaction ratings than their female counterparts. Multiple regression analysis showed that gender (student characteristics), performance expectations (cognitive factors), and learning climate (social environment) were predictors of the perceived satisfaction of learners. Conclusion: Wider integration of blended learning into pre-clinical undergraduate medical education could enhance the shift towards competency-based education and life-long learning among medical students. However, effective implementation would depend largely on student characteristics, as well as environmental and cognitive components of the delivery method.
Prevalence of bullying in the nursing workplace and determinant factors: a nationwide cross-sectional Polish study survey

Objectives In the present study, we aimed to investigate the prevalence of bullying among Polish nurses, and to identify the most common negative acts, as well as individual and work-related risk factors for workplace bullying. Methods Cross-sectional study designed using an online survey. The total study sample was 404 nurses, each having over 6 months of working experience. Data were collected using the Polish version of the Negative Act Questionnaire-Revised. Linear stepwise regression analysis and logistic regression analysis were performed to assess predictors of greater reporting of perceived workplace bullying Results Bullying was experienced by 65.84% of participants. Perceived workplace bullying was associated with sex (p=0.043), age (p=0.003), seniority (p=0.006), number of working hours per week (p=0.010) and position (p=0.029). Logistic regression analysis with the dependent variable of bullying according to Leymann’s rigorous criteria revealed that the model could include four variables: age from 50 to 59, seniority of 11–15 years,>45 working hours per week and a bachelor’s degree in nursing. Conclusions An alarming percentage of nurses were victims of bullying. Among all variables included in the regression model, the most significant predictors of perceived workplace bullying were age, seniority, work overtime and bachelor’s degree education. Bullying prevention and improvement of well-being at work must be addressed as part of an overall strategy to deal with turnover.
Morphometric analysis of fossil bumble bees (Hymenoptera, Apidae, Bombini) reveals their taxonomic affinities

Abstract Bumble bees (Bombus spp.) are a widespread corbiculate lineage (Apinae: Corbiculata: Bombini), mostly found among temperate and alpine ecosystems. Approximately 260 species have been recognized and grouped recently into a simplified system of 15 subgenera. Most of the species are nest-building and primitively eusocial. Species of Bombus have been more intensely studied than any other lineages of bees with the exception of the honey bees. However, most bumble bee fossils are poorly described and documented, making their placement relative to other Bombus uncertain. A large portion of the known and presumed bumble bee fossils were re-examined in an attempt to better understand their affinities with extant Bombini. The taxonomic affinities of fossil specimens were re-assessed based on morphological features and previous descriptions, and for 13 specimens based on geometric morphometrics of forewing shape. None of the specimens coming from Eocene and Oligocene deposits were assigned within the contemporary shape space of any subgenus of Bombus. It is shown that Calyptapis florissantensis Cockerell, 1906 (Eocene-Oligocene boundary, Florissant shale, Colorado, USA) and Oligobombus cuspidatus Antropov, 2014 (Late Eocene, Bembridge Marls) likely belong to stem-group Bombini. Bombus anacolus Zhang, 1994, B. dilectus Zhang, 1994, B. luianus Zhang, 1990 (Middle Miocene, Shanwang Formation), as well as B. vetustus Rasnitsyn & Michener, 1991 (Miocene, Botchi Formation) are considered as species inquirenda. In the Miocene, affinities of fossils with derived subgenera of Bombus s. l. increased, and some are included in the shape space of contemporary subgenera: Cullumanobombus (i.e., B. pristinus Unger, 1867, B. randeckensis Wappler & Engel, 2012, and B. trophonius Prokop, Dehon, Michez & Engel, 2017), Melanobombus (i.e., B. cerdanyensis Dehon, De Meulemeester & Engel, 2014), and Mendacibombus (i.e., B. beskonakensis (Nel & Petrulevičius, 2003), new combination), agreeing with previous estimates of diversification.
Being a Research Mentor: A Qualitative Study.

OBJECTIVES This qualitative study was designed to describe the experiences of mentors for a nursing research fellowship at a southeastern US academic medical center. BACKGROUND Mentoring is an important aspect of nursing and is a key strategy to develop nurse leaders and faculty. Research mentors have been identified as essential for novice researchers to be able to complete clinical studies. However, there has been limited research on the experience of nursing research mentors, despite the emphasis on the critical nature of this role. METHODS Eight mentors for 23 studies over 8 years of a nursing research fellowship participated in a study outlining their experiences as research mentors. RESULTS Common themes emerged from mentors' identification of key components in the research mentoring process and elements necessary for effective support of frontline nurse researchers. CONCLUSIONS Recommendations for developing effective, confident research mentors are drawn from the analyses.
Variation in genes regulating angiogenesis, lymph-angiogenesis and metastasis: associations of three polymorphisms with outcome in patients with colorectal cancer

Biological and clinical findings show that the variation in the angiogenesis, lymph-angiogenesis and metastasis processes may affect patient survival. This study aims to identify new prognostic markers in colorectal cancer by investigating the associations of 381 genetic polymorphisms and haplotypes from 30 angiogenesis, lymph-angiogenesis and metastasis genes in a cohort of colorectal cancer patients from Newfoundland and Labrador. Our results showed that three linked SNPs located in the MMP8 and MMP27 genes were individually associated with overall survival (rs11225388, rs11225389, and rs12365082). By predicting and analyzing the haplotypes from these genes I also found an association between overall survival and an MMP3 haplotype consisting of four polymorphisms. The biological consequences of these three SNPs and the MMP3 haplotype and their relation to the risk of death in colorectal cancer are currently unknown. Future studies are required to replicate these findings in another cohort of colorectal cancer patients.
Rapid progression of type 2 diabetes and related complications in children and young people—A literature review

Type 2 diabetes (T2D) is suggested to progress faster in children and young people vs type 1 diabetes (T1D) in the same age group and T2D in adults. We reviewed the evidence base for this. A literature search was performed of PubMed‐indexed publications between 2000 and 2018, for the terms “pediatric” and “T2D. ” Results were combined and filtered for those relating to “progression. ” Searches of abstract books from Latin American and Asian congresses were performed to include these populations. Pediatric populations were defined as <25 completed years of age. Of the articles and congress abstracts found, 30 were deemed relevant. Dividing the studies into categories based on how T2D progresses, we found the following: (a) yearly beta‐cell function deterioration was shown to be 20% to 35% in children with T2D compared with 7% to 11% in adults with T2D, despite similar disease durations; (b) retinopathy progression was likely dependent on diabetes duration rather than diabetes type; however, nephropathy, neuropathy and probably hypertension progressed faster in youth‐onset T2D vs T1D. Nephropathy progression was similar to adults with T2D, allowing for disease duration. Youth with T2D had a worse cardiovascular (CV) risk profile than youth with T1D, and a faster progression to CV death. (c) Progression to treatment failure was faster in youth‐onset T2D vs adult‐onset T2D. Substantial evidence exists for faster progression of T2D in pediatric patients vs T1D or adult‐onset T2D. New treatments targeting the pathology are needed urgently to address this issue.
Trypsin Treatment Unlocks Barrier for Zoonotic Bat Coronavirus Infection

Overall, our studies demonstrate that proteolytic cleavage is the primary barrier to infection for a subset of zoonotic coronaviruses. Moving forward, the results argue that both receptor binding and proteolytic cleavage of the spike are critical factors that must be considered for evaluating the emergence potential and risk posed by zoonotic coronaviruses. In addition, the findings also offer a novel means to recover previously uncultivable zoonotic coronavirus strains and argue that other tissues, including the digestive tract, could be a site for future coronavirus emergence events in humans. ABSTRACT Traditionally, the emergence of coronaviruses (CoVs) has been attributed to a gain in receptor binding in a new host. Our previous work with severe acute respiratory syndrome (SARS)-like viruses argued that bats already harbor CoVs with the ability to infect humans without adaptation. These results suggested that additional barriers limit the emergence of zoonotic CoV. In this work, we describe overcoming host restriction of two Middle East respiratory syndrome (MERS)-like bat CoVs using exogenous protease treatment. We found that the spike protein of PDF2180-CoV, a MERS-like virus found in a Ugandan bat, could mediate infection of Vero and human cells in the presence of exogenous trypsin. We subsequently show that the bat virus spike can mediate the infection of human gut cells but is unable to infect human lung cells. Using receptor-blocking antibodies, we show that infection with the PDF2180 spike does not require MERS-CoV receptor DPP4 and antibodies developed against the MERS spike receptor-binding domain and S2 portion are ineffective in neutralizing the PDF2180 chimera. Finally, we found that the addition of exogenous trypsin also rescues HKU5-CoV, a second bat group 2c CoV. Together, these results indicate that proteolytic cleavage of the spike, not receptor binding, is the primary infection barrier for these two group 2c CoVs. Coupled with receptor binding, proteolytic activation offers a new parameter to evaluate the emergence potential of bat CoVs and offers a means to recover previously unrecoverable zoonotic CoV strains. IMPORTANCE Overall, our studies demonstrate that proteolytic cleavage is the primary barrier to infection for a subset of zoonotic coronaviruses. Moving forward, the results argue that both receptor binding and proteolytic cleavage of the spike are critical factors that must be considered for evaluating the emergence potential and risk posed by zoonotic coronaviruses. In addition, the findings also offer a novel means to recover previously uncultivable zoonotic coronavirus strains and argue that other tissues, including the digestive tract, could be a site for future coronavirus emergence events in humans.
Comparative dental anatomy in newborn primates: Cusp mineralization

Previous descriptive work on deciduous dentition of primates has focused disproportionately on great apes and humans. To address this bias in the literature, we studied 131 subadult nonhominoid specimens (including 110 newborns) describing deciduous tooth morphology and assessing maximum hydroxyapatite density (MHD). All specimens were CT scanned at 70 kVp and reconstructed at 20.5–39 μm voxels. Grayscale intensity from scans was converted to hydroxyapatite (HA) density (mg HA/cm3) using a linear conversion of grayscale values to calibration standards of known HA density (R2 = .99). Using Amira software, mineralized dental tissues were captured by segmenting the tooth cusps first and then capturing the remainder of the teeth at descending thresholds of gray levels. We assessed the relationship of MHD of selected teeth to cranial length using Pearson correlation coefficients. In monkeys, anterior teeth are more mineralized than postcanine teeth. In tarsiers and most lemurs and lorises, postcanine teeth are the most highly mineralized. This suggests that monkeys have a more prolonged process of dental mineralization that begins with incisors and canines, while mineralization of postcanine teeth is delayed. This may in part be a result of relatively late weaning in most anthropoid primates. Results also reveal that in lemurs and lorises, MHD of the mandibular first permanent molar (M1) negatively correlates with cranial length. In contrast, the MHD of M1 positively correlates with cranial length in monkeys. This supports the hypothesis that natural selection acts independently on dental growth as opposed to mineralization and indicates clear phylogenetic differences among primates.
Effect of Thoracoscopic Talc Poudrage vs Talc Slurry via Chest Tube on Pleurodesis Failure Rate Among Patients With Malignant Pleural Effusions: A Randomized Clinical Trial.

Importance Malignant pleural effusion (MPE) is challenging to manage. Talc pleurodesis is a common and effective treatment. There are no reliable data, however, regarding the optimal method for talc delivery, leading to differences in practice and recommendations. Objective To test the hypothesis that administration of talc poudrage during thoracoscopy with local anesthesia is more effective than talc slurry delivered via chest tube in successfully inducing pleurodesis. Design, Setting, and Participants Open-label, randomized clinical trial conducted at 17 UK hospitals. A total of 330 participants were enrolled from August 2012 to April 2018 and followed up until October 2018. Patients were eligible if they were older than 18 years, had a confirmed diagnosis of MPE, and could undergo thoracoscopy with local anesthesia. Patients were excluded if they required a thoracoscopy for diagnostic purposes or had evidence of nonexpandable lung. Interventions Patients randomized to the talc poudrage group (n = 166) received 4 g of talc poudrage during thoracoscopy while under moderate sedation, while patients randomized to the control group (n = 164) underwent bedside chest tube insertion with local anesthesia followed by administration of 4 g of sterile talc slurry. Main Outcomes and Measures The primary outcome was pleurodesis failure up to 90 days after randomization. Secondary outcomes included pleurodesis failure at 30 and 180 days; time to pleurodesis failure; number of nights spent in the hospital over 90 days; patient-reported thoracic pain and dyspnea at 7, 30, 90, and 180 days; health-related quality of life at 30, 90, and 180 days; all-cause mortality; and percentage of opacification on chest radiograph at drain removal and at 30, 90, and 180 days. Results Among 330 patients who were randomized (mean age, 68 years; 181 [55%] women), 320 (97%) were included in the primary outcome analysis. At 90 days, the pleurodesis failure rate was 36 of 161 patients (22%) in the talc poudrage group and 38 of 159 (24%) in the talc slurry group (adjusted odds ratio, 0.91 [95% CI, 0.54-1.55]; P = .74; difference, -1.8% [95% CI, -10.7% to 7.2%]). No statistically significant differences were noted in any of the 24 prespecified secondary outcomes. Conclusions and Relevance Among patients with malignant pleural effusion, thoracoscopic talc poudrage, compared with talc slurry delivered via chest tube, resulted in no significant difference in the rate of pleurodesis failure at 90 days. However, the study may have been underpowered to detect small but potentially important differences. Trial Registration ISRCTN Identifier: ISRCTN47845793.
Heterogeneous Pattern of Dependence on Anti-Apoptotic BCL-2 Family Proteins upon CHOP Treatment in Diffuse Large B-Cell Lymphoma

Expression of the anti-apoptotic B-cell lymphoma 2 (BCL-2) protein in patients with diffuse large B-cell lymphoma (DLBCL) strongly correlates with resistance to standard therapy with cyclophosphamide, vincristine, doxorubicin, prednisolone, and rituximab (R-CHOP). Although studies focus mainly on the contribution of BCL-2, here we also investigate the contribution of other anti-apoptotic proteins to CHOP-therapy resistance in DLBCL. Functional dynamic BCL-2 homology (BH)3 profiling was applied to DLBCL cell lines upon CHOP treatment or single CHOP compounds. Cell-specific anti-apoptotic dependencies were validated with corresponding BH3-mimetics. We found high expression of anti-apoptotic BCL-2, MCL-1, and BCL-XL in DLBCL cell lines and patients. CHOP treatment resulted in both enhanced and altered anti-apoptotic dependency. Enhanced sensitivity to different BH3-mimetics after CHOP treatment was confirmed in specific cell lines, indicating heterogeneity of CHOP-induced resistance in DLBCL. Analysis of single CHOP compounds demonstrated that similar changes could also be induced by doxorubicin or vincristine, providing evidence for clinical combination therapies of doxorubicin or vincristine with BH3-mimetics in DLBCL. In conclusion, we show for the first time that CHOP treatment induces increased anti-apoptotic dependency on MCL-1 and BCL-XL, and not just BCL-2. These results provide new perspectives for the treatment of CHOP-resistant DLBCL and underline the potential of BH3 profiling in predicting therapy outcomes.
Atrial Fibrillation Post Coronary Artery Graft Surgery: A Review Of Literature

Abstract Atrial fibrillation (AF) is a failure that is observed in heart disease and is also known to be the most common heart rhythm disturbance post coronary artery bypass surgery. Although AF is considered a transient problem, it is usually accompanied with a variety of complications and morbidity for patients and may result in death. In the present study, pre- and post-operative considerable factors which may increase the risk and mortality of AF, and possible treatments have been concisely reviewed.
Epidemiology of Anterior Cruciate Ligament Injury in Italian First Division Soccer Players

Background: The burden of anterior cruciate ligament (ACL) injury in professional soccer players is particularly relevant as it represents a potentially career-threatening injury. Hypothesis: Our hypotheses were that (1) injury incidence rate would be similar to that reported in the literature, (2) we would identify a uniform distribution of the injuries along the season, and (3) injury incidence rate would be similar in high-ranked and lower ranked teams, based on final placement in the league. Study Design: Descriptive epidemiological study. Level of Evidence: Level 4. Methods: Professional male soccer players participating in the Serie A championship league in 7 consecutive seasons (2011-2012 to 2017-2018) were screened to identify ACL injuries through the online football archive transfermarkt.com. Exposure in matches and training were calculated. Results: There were 84 ACL injuries found (mean player age, 25.3 ± 4.2 years). Overall, 25% of ACL injuries were reruptures (15%) or contralateral injuries (10%). ACL incidence rate was 0.4215 per 1000 hours of play during Serie A matches, 0.0305 per 1000 hours of training (rate ratio [RR], 13.8; 95% CI, 8.4-22.7; P < 0.0001), and 0.0618 per 1000 hours of total play. Injury distribution had a bimodal peak, with the highest number of events in October and March. Alternatively, training injuries peaked in June and July. A significantly higher incidence rate was found for the teams ranked from 1st to 4th place compared with those ranked 5th to 20th (0.1256 vs 0.0559 per 1000 hours of play; RR, 2.2; 95% CI, 1.4-3.6; P = 0.0003). A similar finding was found for injury incidence proportion (3.76% vs 1.64%; P = 0.0003). Conclusion: The overall incidence rate of ACL injuries in Italian Serie A was 0.062 per 1000 hours, with a 14-fold risk in matches compared with training. Relevantly, 25% were second injuries. Most injuries occurred in October and March, and an almost 2-fold incidence rate and incidence proportion were noted in those teams ranked in the first 4 positions of the championship league. Clinical Relevance: Knowing the precise epidemiology of ACL injury in one of the most competitive professional football championship leagues could help delineate fields of research aimed to investigate its risk factors.