bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Preventive Services and Self-Management Practices Among Adult Cancer Survivors in the United States Over Time
Authors: Findley Patricia A. , Wiener R. Constance , Shen Chan , Dwibedi Nilajana , Sambamoorthi Usha
Published: November 2021

The objective of this research was to determine if the engagement/participation in health promotion activities of cancer survivors in the United States (US) changed between 2006 and 2015. We pooled two independent cross-sectional data of cancer survivors using Medical Expenditure Panel Surveys from 2006 (N = 791; weighted N = 9,532,674) and 2015 (N = 1067; weighted N = 15,744,959). Health promoting activities consisted of past year influenza immunization, routine physical examination, and dental visit. Self-care included maintaining normal weight, not smoking, and engagement in recommended vigorous physical activity. We conducted unadjusted and adjusted logistic regression analyses to examine the change in engagement in health promoting activities over time. We found rates of annual influenza immunization (66.8% vs 70.3%), dental visit (71.8% vs 70.3%), and normal weight (33.9% vs 33.5%) did not change from 2006 to 2015. The percent with physical examination (90.8% vs 93.8%; P = .03) and non-smokers increased (87.9% vs 91.2; P = .04). Between 2006 and 2015, despite guidelines and recommendations for personalized cancer survivorship health plans, health promoting activities among cancer survivors did not change significantly.
Pediatric Home Tracheostomy Care: The Importance of Knowledge Assessment
Authors: Boonjindasup Wicharn , Syananondh Kusuma , Somboon Prapasri , Sritippayawan Suchada
Published: November 2021

Assessment of caregiver knowledge is an essential part of home healthcare education for pediatric tracheostomy care, however, there is a paucity of evidence in long term. This study aims to determine how caregiver knowledge and misconceptions, as assessed by our knowledge test, changed over a 12-month period following our educational program and whether the test score was associated with any demographics of the caregivers and children with tracheostomy. A prospective cohort study was undertaken to evaluate the knowledge at 3 timepoints after tracheostomy education: baseline (T1), 6 months (T2), and 12 months (T3). Test scores were analyzed for trend and relationship with demographics. Items for which less than 80% caregivers gave correct responses at T1 were considered common misconceptions. Fifty-four caregivers were enrolled. Out of a maximum score of 25, the median (IQR) scores were 22 (21-23), 23 (22-24), and 23 (22-25), at T1, T2, and T3, respectively. The scores at T2 and T3 were significantly higher than at T1 ( P ≤ .01). One common misconception “how to manage when suction got less secretion than expected” was found at all timepoints. Caregivers of children with >2 comorbidities scored slightly higher than those of children with 0 to 2 comorbidities ( P = .01). In conclusion, our caregivers achieved high knowledge scores which increased over the 12-month study period potentially because of repeated assessment and practical experience. Common misconceptions and a factor associated with the knowledge were also identified. These advantages highlighted the importance of knowledge assessment for quality improvement.
Cognitive workload, complications and visual outcomes of phacoemulsification cataract surgery: Three-dimensional versus conventional microscope
Authors: Kelkar Aditya , Kelkar Jai , Chougule Yogesh , Bolisetty Mounika , Singhvi Priyanka
Published: November 2021

Purpose

To compare the surgical workload, complications, and visual outcomes using the three-dimensional visualization system with the conventional microscope in phacoemulsification cataract surgery.

Design

Prospective, non-randomized, open-label interventional study.

Methods

All patients underwent phacoemulsification cataract surgery using the three-dimensional visualization system or conventional microscope.

Results

Of the 203 eyes, 80 underwent surgery with the three-dimensional system while 123 underwent with the conventional microscope. No difference was noted in the total surgical duration, complication rates, and visual outcomes between the two groups. However, capsulorhexis was significantly faster using the conventional microscope while posterior chamber intraocular lens insertion was quicker using the three-dimensional system. In terms of cognitive workload comparison, no difference was seen in the surgeons’ heart rate, oxygen saturation levels, and surgery task load index total workload score and workload score for all six dimensions of the questionnaire, between the three-dimensional system and conventional microscope groups. As compared to baseline, the heart rate increased significantly during all surgical steps and at the end in both groups. When compared to baseline, the oxygen saturation levels were significantly raised during capsulorhexis, irrigation, and aspiration and posterior chamber intraocular lens insertion and at the end of the surgery in the three-dimensional group and during incision and at the end of the surgery in the conventional microscope group.

Conclusions

The duration of surgery, complications, and visual acuity outcomes remain unaffected while performing phacoemulsification cataract surgeries with the three-dimensional viewing system when compared to the conventional microscopes. Moreover, the surgeons’ cognitive workload too remains unaffected while utilizing this revolutionary three-dimensional surgical technology.
Screening of Important Factors in the Early Sepsis Stage Based on the Evaluation of ssGSEA Algorithm and ceRNA Regulatory Network
Authors: Huang Liou , Wu Chunrong , Xu Dan , Cui Yuhui , Tang Jianguo
Published: November 2021

Background:

Sepsis is a dysregulated host response to pathogens. Delay in sepsis diagnosis has become a primary cause of patient death. This study determines some factors to prevent septic shock in its early stage, contributing to the early treatment of sepsis.

Methods:

The sequencing data (RNA- and miRNA-sequencing) of patients with septic shock were obtained from the NCBI GEO database. After re-annotation, we obtained lncRNAs, miRNA, and mRNA information. Then, we evaluated the immune characteristics of the sample based on the ssGSEA algorithm. We used the WGCNA algorithm to obtain genes significantly related to immunity and screen for important related factors by constructing a ceRNA regulatory network.

Result:

After re-annotation, we obtained 1708 lncRNAs, 129 miRNAs, and 17 326 mRNAs. Also, through the ssGSEA algorithm, we obtained 5 important immune cells. Finally, we constructed a ceRNA regulation network associated with SS pathways.

Conclusion:

We identified 5 immune cells with significant changes in the early stage of septic shock. We also constructed a ceRNA network, which will help us explore the pathogenesis of septic shock.
Enacting assessment for learning in the induction phase of physical education teaching
Authors: Tolgfors Björn , Quennerstedt Mikael , Backman Erik , Nyberg Gunn
Published: November 2021

In many countries, assessment for learning (AfL) is recommended in both policy and research as a concept that should be integrated into the teaching of physical education (PE) in schools. AfL is also part of physical education teacher education (PETE) programs in several countries and, consequently, something future PE teachers are expected to practice in their teaching. In a previous study ( Tolgfors et al., 2021 ), we showed how AfL was transmitted and transformed between a university course and a school placement course within Swedish PETE. In the current study, we have more closely followed three of the preservice teachers who took part in our initial study into their first year of PE teaching. The purpose of this follow-up study is thus to explore how AfL is enacted in the induction phase of PE teaching. The more specific research question is: how is AfL enacted in beginning teachers’ PE practices under the contextual conditions provided at the schools where they are employed? The data were generated through Stimulated Recall interviews and follow-up interviews via the online meeting software Zoom. The analysis was based on Braun et al.’s (2011) contextual dimensions of policy enactment and Bernstein’s (1996) pedagogic device. Our findings illustrate how AfL is generally enacted through (1) progression and (2) “rich tasks.” However, the contextual dimensions of each school provide different conditions that either support or hinder the use of AfL in PE. AfL is accordingly enacted in different ways in the induction phase of PE teaching.
The victims, villains and heroes of ‘panic buying’: News media attribution of responsibility for COVID-19 stockpiling
Authors: Phillips Tarryn , Vargas Carmen , Graham Melissa , Couch Danielle , Gleeson Deborah
Published: November 2021

Societies often respond to a crisis by attributing blame to some groups while constructing others as victims and heroes. While it has received scant sociological attention, ‘panic buying’ is a critical indicator of such public sentiment at the onset of a crisis, and thus a crucial site for analysis. This article traces dynamics of blame in news media representations of an extreme period of panic buying during COVID-19 in Australia. Analysis reveals that lower socio-economic and ethnically diverse consumers were blamed disproportionately. Unlike wealthier consumers who bulk-bought online, shoppers filling trollies in-store were depicted as selfish and shameful, described using dehumanising language, and portrayed as ‘villains’ who threatened social order. Supermarkets were cast simultaneously as ‘victims’ of consumer aggression and ‘heroes’ for their moral leadership, trustworthiness and problem-solving. This portrayal misunderstands the socio-emotional drivers of panic buying, exacerbates stigma towards already disadvantaged groups, and veils the corporate profiteering that encourages stockpiling.
A Meta-Analysis of How Country-Level Factors Affect Web Survey Response Rates
Authors: Daikeler Jessica , Silber Henning , Bošnjak Michael
Published: November 2021

A major challenge in web-based cross-cultural data collection is varying response rates, which can result in low data quality and non-response bias. Country-specific factors such as the political and demographic, economic, and technological factors as well as the socio-cultural environment may have an effect on the response rates to web surveys. This study evaluates web survey response rates using meta-analytical methods based on 110 experimental studies from seven countries. Three dependent variables, so-called effect sizes, are used: the web response rate, the response rate to the comparison survey mode, and the difference between the two response rates. The meta-analysis indicates that four country-specific factors (political and demographic, economic, technological, and socio-cultural) impact the magnitude of web survey response rates. Specifically, web surveys achieve high response rates in countries with high population growth, high internet coverage, and a high survey participation propensity. On the other hand, web surveys are at a disadvantage in countries with a high population age and high cell phone coverage. This study concludes that web surveys can be a reliable alternative to other survey modes due to their consistent response rates and are expected to be used more frequently in national and international settings.
Construction of a circRNA-miRNA-mRNA Regulated Pathway Involved in EGFR-TKI Lung Adenocarcinoma Resistance
Authors: Dai Chenyue , Liu Bing , Li Shaolei , Hong Yang , Si Jiahui , Xiong Ying , Wu Nan , Ma Yuanyuan
Published: November 2021

Objectives: Epidermal growth factor receptor-tyrosine kinase inhibitors are widely used for lung epidermal growth factor receptor-positive lung adenocarcinomas, but acquired resistance is inevitable. Although non-coding RNAs, such as circular RNA and microRNA, are known to play vital roles in epidermal growth factor receptor-tyrosine kinase inhibitor resistance, comprehensive analysis is lacking. Thus, this study aimed to explore the circular RNA-microRNA-messenger RNA regulatory network involved in epidermal growth factor receptor-tyrosine kinase inhibitor resistance. Methods: To identify differentially expressed genes between the epidermal growth factor receptor-tyrosine kinase inhibitor sensitive cell line PC9 and resistant cell line PC9/ epidermal growth factor receptor-tyrosine kinase inhibitor resistance(PC9/ER), circular RNA, microRNA and messenger RNA microarrays were performed. Candidates were then identified to construct a circular RNA-microRNA-messenger RNA network using bioinformatics. Additionally, Gene Oncology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were conducted to evaluate the network messenger RNA, setting up a protein-protein interaction network for hub-gene identification. Afterwards, RNA immunoprecipitation was performed to enrich microRNA, and quantitative real-time PCR was used to estimated gene expression levels. Results: In total, 603, 377, and 1863 differentially expressed circular RNA, microRNA, messenger RNAs, respectively, were identified using microarray analysis, constructing a circular RNA-microRNA-messenger RNA network containing 18 circular RNAs, 17 microRNAs and 175 messenger RNAs. Moreover, Gene Oncology and Kyoto Encyclopedia of Genes and Genomes pathway analyses showed that the most enriched biological process terms and pathways were related to epidermal growth factor receptor-tyrosine kinase inhibitor resistance, including Wnt and Hippo signaling pathways. Based on the competing endogenous RNA and protein-protein interaction network, circ-0007312 was showed to interact with miR-764 and both circ-0003748 and circ-0001398 were shown to interact with miR-628; both these microRNAs targeted MAPK1. Furthermore, circ-0007312, circ-0003748, circ-0001398, and MAPK1 were up-regulated, whereas miR-764 and miR-628 were downregulated in PC9/ER cells as compared to parental PC9 cells. We also found that circ-0007312 and miR-764 were positively expressed in plasma. Conclusions: Our original study associated with mechanism of target therapy in lung cancer provided a systematic and comprehensive regulation of circular RNA, microRNA and messenger RNA in epidermal growth factor receptor-tyrosine kinase inhibitor resistance. It was found that circ-0007312- miR-764-MAPK1, circ-0003748-miR-628-MAPK1, and circ-0001398-miR-628-MAPK1 axis may play key roles in epidermal growth factor receptor-tyrosine kinase inhibitor resistance.
Radiosensitizing Effect of Bromelain Using Tumor Mice Model via Ki-67 and PARP-1 Inhibition
Authors: Mekkawy Mai H. , Fahmy Hanan A. , Nada Ahmed S. , Ali Ola S.
Published: November 2021

Recent reports have shown that bromelain (BL), a pineapple extract, acts as an adjuvant therapy in cancer treatment and prevention of carcinogenesis. The present study was designed to investigate the possible mechanisms by which BL could radiosensitize tumor cells in vitro and in a mouse tumor model. BL has shown a significant reduction in the viability of the radioresistant human breast carcinoma (MCF-7) cell line using cell proliferation assay. The in vivo study was designed using the Ehrlich model in female albino mice, treated with BL (6 mg/kg b. wt., intraperitoneal, once daily for 10 days) 1 hour before exposure to a fractionated dose of gamma radiation (5 Gy, 1 Gy for 5 subsequent days). The radiosensitizing effect of BL was evident in terms of a significant reduction in tumor volume, poly ADP ribose polymerase-1 (PARP-1), the proliferation marker Ki-67 and nuclear factor kappa activated B cells (NF-κB) with a significant elevation in the reactive oxygen species (ROS) content and lipid peroxidation (LPO) in tumor cells. The present findings offer a novel insight into the radiosensitizing effect of BL and its potential application in the radiotherapy course.
Pedestrian Deaths During the COVID-19 Pandemic
Authors: Redelmeier Donald A. , Zipursky Jonathan S.
Published: November 2021

The COVID pandemic provides a natural experiment examining how a 50–60% reduction in pedestrian activity might lead to a reduction in pedestrian deaths. We assessed whether the reduction in pedestrian deaths was proportional to a one-to-one matching presumed in statistics correlating mobility with fatality. The primary analysis examined New York (largest city in US), and the validation analysis examined Toronto (largest city in Canada). We identified pedestrian activity in each location from the Apple Mobility database, normalized to the baseline in January 2020. We calculated monthly pedestrian deaths from the Vision Zero database in each city with baseline data from 3 prior years. We found a large initial reduction in pedestrian deaths during the lockdown in New York that was transient and not statistically significant during the summer and autumn despite sustained reductions in pedestrian activity. Similarly, we found a large initial reduction in pedestrian deaths during the lockdown in Toronto that was transient and not sustained. Together, these data suggest the substantial reductions in pedestrian activity during the COVID pandemic have no simple correlation with pedestrian fatality counts in the same locations. An awareness of this finding emphasizes the role of unmeasured modifiable individual factors beyond pedestrian infrastructure or other structural contributors.
Analysis on the escape phenomenon of oil mist from turbine lower guide bearing based on VOF model
Authors: Pang Jiayang , Liu Huizi , Liu Xiaobing , Ren Minghui , Zhang Pan , Yu Zhishun
Published: November 2021

To analyze the cause and mechanism of oil mist escaping from the lower guide bearing during the operation of a turbine, the oil-gas mixture in the lower guide bearing was numerically simulated by using the VOF two-phase flow model and the SST turbulence model. The influences of different sealing clearances and speeds on the flow field and the oil-gas distribution in the oil tank were studied, and the escaping characteristics of oil mist were analyzed. The results show that increasing the clearance of the labyrinth seal will reduce the pressure difference between the inside and outside of the oil tank and reduce the driving force for the escape of the oil mist. However, increasing the clearance will increase the turbulence of the flow field, the number and volume of bubbles in the lubricating oil, which will lead to the uneven distribution of oil and gas and reduce the motion stability of the lower guide bearing. The change of speed will affect the normal use of the shaft-collar pump. High speed will aggravate the generation of bubbles in the oil tank and increase the possibility of cavitation in the lower guide bearing structure. In engineering practices, it is necessary to comprehensively consider factors such as oil mist escape phenomenon, economic benefits, process manufacturing and assembly, and adopt the lower guide bearing structure with a suitable labyrinth seal clearance.
A neural network-based model predictive controller for displacement tracking of piezoelectric actuator with feedback delays
Authors: Du Zhangming , Zhou Chao , Cao Zhiqiang , Wang Shuo , Cheng Long , Tan Min
Published: November 2021

Piezoelectric actuators are widely used in micro/nanoscale robotic manipulators. Due to its hysteresis and dynamic-related nonlinearity, accurate displacement tracking control of piezoelectric actuator is challenging. Besides, in some low-cost practical systems with low sampling rate, transmission delay causes mismatches between feedback and real displacement, further increasing the challenge in tracking control. In this article, a neural network-based model predictive controller (MPC) is proposed for precise tracking control of piezoelectric actuator’s displacement in situation where feedback is slow and delayed. The prediction model is based on a nonlinear-autoregressive-moving-average-with-exogenous-inputs framework, which outputs entire prediction horizon of future displacement in a single time, and is fulfilled by a multilayer feedforward neural network. An extended Kalman filter-based estimation for displacement is introduced to relieve the influence of feedback delays so as to improve dynamic performance of the controller. Another neural network is trained to provide initial values for MPC to reduce computation costs and improve performance in dynamic tracking. In a series of tracking experiments, the effectiveness of proposed controller is verified.
The Promotive Effect of the Active Ingredients of Atractylodes macrocephala on Intestinal Epithelial Repair Through Activating Ca2+ Pathway
Authors: Ren Yan , Jiang Wenwen , Luo Chunli , Zhang Xiaohan , Huang Mingjin
Published: November 2021

Atractylodes macrocephala ( AM) is a famous traditional Chinese medicine for intestinal epithelial restitution through activating Ca2+ channels. However, the roles of specific AM compositions in intestinal epithelial restitution are sparse. Therefore, this study aimed to compare the concrete effects of the 4 active ingredients (atractylon, β-eudesmol, atractylenolide II, atractylenolide III) of AM and their combination on intestinal epithelial repair and the Ca2+ pathway in intestinal epithelial cell (IEC-6) cells. First, the best combination of the 4 ingredients with an optimal mixing ratio of atractylon: β-eudesmol: atractylenolide II: atractylenolide III = 1:2:2:2 was demonstrated by a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide orthogonal experiment. Subsequently, enzyme-linked immunosorbent assay was used to measure anti-inflammatory cytokine levels, the migratory ability was evaluated by cell scratch experiments, cell cycle analysis and [Ca2+]cyt concentration in cells were detected by flow cytometry, and the expression of the Ca2+ pathway-related genes was detected by immunofluorescence staining, quantitative polymerase chain reaction and whole blood assays. Our result showed that atractylon, β-Eudesmol, atractylenolide II, and atractylenolide III showed different abilities to promote the IEC-6 cells proliferation, migration, and the expression of anti-inflammatory cytokines interleukin (IL)-2, IL-10, and ornithine decarboxylase, as well as the intracellular [Ca2+]cyt concentration through stromal interaction molecule 1 transposition to activate Ca2+ pathway. Thereinto, atractylenolide III was the main active ingredient of AM for pro-proliferation and anti-inflammation, and the combination of 4 AM ingredients performed better beneficial effects on IEC-6 cells. Therefore, our study suggested that atractylenolide III was the active ingredient of AM for intestinal epithelial repair through activating the Ca2+ pathway, and the 4 ingredients of AM have a synergy in intestinal epithelial repair.
The Therapeutic Potential of Saw Palmetto Extract in Urological Disorders
Authors: Liu Meng , Yin Huirong , Wang Fang , Tian Ying
Published: November 2021

Saw palmetto extract (SPE) has been widely used as a therapeutic remedy for urinary dysfunction in western countries. Furthermore, as an herb drug, it can be used as an alternative therapy for benign prostatic hyperplasia (BPH) due to its safety and minimum adverse effects. Reportedly, SPE improves the urinary symptoms, which mainly depend on anti-androgenic effects and effects on autonomic receptors in the lower urinary tract. However, the mechanisms of action responsible for the therapeutic roles of SPE have not been fully elucidated. Relevant studies indicate that SPE has some positive effects on the treatment of urological diseases in animals, and clinical trials are ongoing. In this review, we summarize the pharmacological properties and discuss the possible therapeutic mechanisms of SPE in urological diseases, including anti-androgenic effects, effects on autonomic receptors in the lower urinary tract, anti-inflammatory activity, anti-proliferative and pro-apoptotic effects, and highlight a potential therapeutic approach in the clinical treatment of patients with BPH, prostate cancer, chronic prostatitis (CP) and erectile dysfunction (ED).
The Impact of Banking Competition on Firm Credit Risk and Leverage
Authors: Feng Chengxiao , Li Zhubo , Peng Zhen
Published: November 2021

A firm’s default risk is closely related to its macrofinancial stability. As financial reform deepens, banking competition may ease firms’ credit constraints, encouraging them to increase their leverage and default risks. This study uses contingent claims analysis to examine firms’ asset–liability ratio and default distance. We find that companies have low leverage and low overall default risks. Moreover, a pro-cyclical effect exists between leverage and economic growth. As banking competition becomes more intense, the default risk decreases, but firms’ leverage ratio rises significantly. The impact is more prominent for highly leveraged firms. Our findings also indicate that utilizing the contingent claims analysis method to measure firms’ leverage and default risks provides more accurate results. Moreover, we provide empirical evidence of the impact of banking competition on firms’ leverage and credit risks. The results suggest that enhancing financial competition has a positive effect on easing credit constraints and reducing default risks.
The Implementation of Mindfulness-Based Programs in the Swedish Healthcare System—A Qualitative Study
Authors: Andermo Susanne , Crane Rebecca , Niemi Maria
Published: November 2021

Background:

As the provision of Mindfulness-Based Programs (MBPs) in health care settings progresses, more research is needed to develop guidelines and structures for implementation in various contexts. This study is part of a larger project were MBP provision in Sweden is explored.

Objective:

The objective is to provide knowledge for the next steps of MBP implementation both in Sweden and internationally. The specific aim of the study is to explore how MBP teachers and other relevant stakeholders experience the implementation of MBP.

Methods:

Qualitative in-depth interviews were conducted with 15 MBP providers and 2 other stakeholders from a range of health care settings in Sweden.

Results:

The results, presented in 3 themes, provide insights into the factors that are crucial for facilitating or hindering MBP implementation; (1) MBP teachers and their training, including the importance of champion individuals and the benefit and shortcomings of various forms of MBP; (2) Patients and patient referrals, including patient characteristics and referral pathways; (3) Organizational prerequisites to successful implementation, highlighting the importance of financial factors and managers’ and colleagues’ knowledge and acceptance of MBP; and (4) the need for structural changes, including future recommendations on quality assessment and guidelines.

Conclusion:

This study highlights the need for national guidelines for MBP provision and teacher training pathways, as well as improved availability of teacher training. Also, the benefit of a stepped-care model of MBP provision is indicated by the findings. Finally, increasing awareness of MBPs among referrers, managers, and the public may enable successful implementation.
Emotional Health Status of Postgraduate Students of Periodontics in India During COVID Health Crisis—A Questionnaire-Based Study
Authors: Pasupuleti Mohan Kumar , Penmetsa Gautami S , Gottumukkala Sruthima NVS , Vintha Jaswitha , Santosh Vamsi E , Meghana G
Published: November 2021

Dental students, especially postgraduate students present a higher risk of getting infected because of their close contact with the patients during this pandemic. The objectives of the study include (a) the reasons for postgraduate students’ altered emotional status during coronavirus (COVID-19) infection. (b) To assess the kind of infection protocols adopted. (c) To assess the impacts of postgraduate students’ emotional status on treating patients with periodontal problems during the COVID-19 lockdown period from March 2020 to December 2020. The emotional status of postgraduate students was assessed in 2 phases that are at the initial phase of COVID infection and lockdown and the second phase when the lockdown was prolonged. Questionnaires were distributed to the Postgraduate students of periodontics all over India to assess their level of awareness of COVID infection, type of infection control measures followed during the pandemic period, as well as the outpatient turnout during the lockdown period. Results of this study stated that more than 80% of students addressed the decline in the number of patients to surgical clinics, 76.3% of postgraduates were worried about themselves and their families due to the pandemic situation. Surprisingly, 74.3% of them even worried about losing their expertize or skills due to a long lockdown period. Dental postgraduates all over India are willing to treat their patients during the period of a pandemic but in strict compliance with infection control guidelines. This study assessed the emotional responses of the postgraduates during the pandemic through the questionnaire and concluded that all the professionals are ready to resume their clinical activities with adequate guidelines provided.
Disconnection in Information Exchange During Pediatric Trauma Transfers: A Qualitative Study
Authors: Sauers-Ford Hadley S , Aboagye James B , Henderson Stuart , Marcin James P , Rosenthal Jennifer L
Published: November 2021

Pediatric patients experiencing an emergency department (ED) visit for a traumatic injury often transfer from the referring ED to a pediatric trauma center. This qualitative study sought to evaluate the experience of information exchange during pediatric trauma visits to referring EDs from the perspectives of parents and referring and accepting clinicians through semi-structured interviews. Twenty-five interviews were conducted (10 parents and 15 clinicians) and analyzed through qualitative thematic analysis. A 4-person team collaboratively identified codes, wrote memos, developed major themes, and discussed theoretical concepts. Three interdependent themes emerged: (1) Parents’ and clinicians’ distinct experiences result in a disconnect of information exchange needs; (2) systems factors inhibit effective information exchange and amplify the disconnect; and (3) situational context disrupts the flow of information contributing to the disconnect. Individual-, situational-, and systems-level factors contribute to disconnects in the information exchanged between parents and clinicians. Understanding how these factors’ influence information disconnect may offer avenues for improving patient–clinician communication in trauma transfers.
Qualitative Needs Assessment for the Development of Chronic Pain Group Medical Visits
Authors: Wile Kevin A. , Roy Siddhartha , Stuckey Heather , Zimmerman Eric , Bailey David , Parascando Jessica A. , Reedy-Cooper Alexis
Published: November 2021

Group medical visits (GMVs) for patients with chronic pain are becoming more accessible and have been shown to be successful in furthering patient education on multidisciplinary, nonopioid interventions. Unfortunately, evidence suggests that many group visit models lack sustainability due to recruitment issues and retention rates. Additionally, most of the studies surrounding GMVs are located in primarily urban health centers, potentially limiting their generalizability. This study aims to identify patient interest in and barriers to GMVs for chronic pain and to explore how chronic pain impacts daily lives for GMV content optimization in a nonurban population. Nineteen participants age 18 to 65 years participated in semistructured phone interviews to generate a thematic analysis. Participants received their care from family practitioners at a suburban multiclinic academic medical group and were being prescribed at least 50 morphine milligram equivalents (MME) at the time of recruitment. Analysis generated two themes: (1) Participants expressed specific interest in GMVs with few barriers identified, and (2) Pain has a negative impact on mental health and most aspects daily life, creating a foundation for discussion in GMVs. Findings support significant patient interest in group medical visits for chronic pain, but careful planning is necessary to address patient needs, expectations, and barriers in order to ensure GMV sustainability.
TSEBRA: transcript selector for BRAKER
Authors: Gabriel Lars , Hoff Katharina J. , Brůna Tomáš , Borodovsky Mark , Stanke Mario
Published: November 2021

Background

BRAKER is a suite of automatic pipelines, BRAKER1 and BRAKER2, for the accurate annotation of protein-coding genes in eukaryotic genomes. Each pipeline trains statistical models of protein-coding genes based on provided evidence and, then predicts protein-coding genes in genomic sequences using both the extrinsic evidence and statistical models. For training and prediction, BRAKER1 and BRAKER2 incorporate complementary extrinsic evidence: BRAKER1 uses only RNA-seq data while BRAKER2 uses only a database of cross-species proteins. The BRAKER suite has so far not been able to reliably exceed the accuracy of BRAKER1 and BRAKER2 when incorporating both types of evidence simultaneously. Currently, for a novel genome project where both RNA-seq and protein data are available, the best option is to run both pipelines independently, and to pick one, likely better output. Therefore, one or another type of the extrinsic evidence would remain unexploited.

Results

We present TSEBRA, a software that selects gene predictions (transcripts) from the sets generated by BRAKER1 and BRAKER2. TSEBRA uses a set of rules to compare scores of overlapping transcripts based on their support by RNA-seq and homologous protein evidence. We show in computational experiments on genomes of 11 species that TSEBRA achieves higher accuracy than either BRAKER1 or BRAKER2 running alone and that TSEBRA compares favorably with the combiner tool EVidenceModeler.

Conclusion

TSEBRA is an easy-to-use and fast software tool. It can be used in concert with the BRAKER pipeline to generate a gene prediction set supported by both RNA-seq and homologous protein evidence.
LPI-HyADBS: a hybrid framework for lncRNA-protein interaction prediction integrating feature selection and classification
Authors: Zhou Liqian , Duan Qi , Tian Xiongfei , Xu He , Tang Jianxin , Peng Lihong
Published: November 2021

Background

Long noncoding RNAs (lncRNAs) have dense linkages with a plethora of important cellular activities. lncRNAs exert functions by linking with corresponding RNA-binding proteins. Since experimental techniques to detect lncRNA-protein interactions (LPIs) are laborious and time-consuming, a few computational methods have been reported for LPI prediction. However, computation-based LPI identification methods have the following limitations: (1) Most methods were evaluated on a single dataset, and researchers may thus fail to measure their generalization ability. (2) The majority of methods were validated under cross validation on lncRNA-protein pairs, did not investigate the performance under other cross validations, especially for cross validation on independent lncRNAs and independent proteins. (3) lncRNAs and proteins have abundant biological information, how to select informative features need to further investigate.

Results

Under a hybrid framework (LPI-HyADBS) integrating feature selection based on AdaBoost, and classification models including deep neural network (DNN), extreme gradient Boost (XGBoost), and SVM with a penalty Coefficient of misclassification (C-SVM), this work focuses on finding new LPIs. First, five datasets are arranged. Each dataset contains lncRNA sequences, protein sequences, and an LPI network. Second, biological features of lncRNAs and proteins are acquired based on Pyfeat. Third, the obtained features of lncRNAs and proteins are selected based on AdaBoost and concatenated to depict each LPI sample. Fourth, DNN, XGBoost, and C-SVM are used to classify lncRNA-protein pairs based on the concatenated features. Finally, a hybrid framework is developed to integrate the classification results from the above three classifiers. LPI-HyADBS is compared to six classical LPI prediction approaches (LPI-SKF, LPI-NRLMF, Capsule-LPI, LPI-CNNCP, LPLNP, and LPBNI) on five datasets under 5-fold cross validations on lncRNAs, proteins, lncRNA-protein pairs, and independent lncRNAs and independent proteins. The results show LPI-HyADBS has the best LPI prediction performance under four different cross validations. In particular, LPI-HyADBS obtains better classification ability than other six approaches under the constructed independent dataset. Case analyses suggest that there is relevance between ZNF667-AS1 and Q15717.

Conclusions

Integrating feature selection approach based on AdaBoost, three classification techniques including DNN, XGBoost, and C-SVM, this work develops a hybrid framework to identify new linkages between lncRNAs and proteins.
Holstein Friesian dairy cattle edited for diluted coat color as a potential adaptation to climate change
Authors: Laible G. , Cole S.-A. , Brophy B. , Wei J. , Leath S. , Jivanji S. , Littlejohn M. D. , Wells D. N.
Published: November 2021

Background

High-producing Holstein Friesian dairy cattle have a characteristic black and white coat, often with large proportions of black. Compared to a light coat color, black absorbs more solar radiation which is a contributing factor to heat stress in cattle. To better adapt dairy cattle to rapidly warming climates, we aimed to lighten their coat color by genome editing.

Results

Using gRNA/Cas9-mediated editing, we introduced a three bp deletion in the pre-melanosomal protein 17 gene (PMEL) proposed as causative variant for the semi-dominant color dilution phenotype observed in Galloway and Highland cattle. Calves generated from cells with homozygous edits revealed a strong color dilution effect. Instead of the characteristic black and white markings of control calves generated from unedited cells, the edited calves displayed a novel grey and white coat pattern.

Conclusion

This, for the first time, verified the causative nature of the PMEL mutation for diluting the black coat color in cattle. Although only one of the calves was healthy at birth and later succumbed to a naval infection, the study showed the feasibility of generating such edited animals with the possibility to dissect the effects of the introgressed edit and other interfering allelic variants that might exist in individual cattle and accurately determine the impact of only the three bp change.
Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China
Authors: Wang Shucai , Zhao Jiazheng , Wang Chanchan , Zhang Ning
Published: November 2021

Background

The diagnosis of malignant pericardial effusion (MPE) is often associated with a poor prognosis, but due to the complexity and unspecific nature of MPE patients' clinical manifestations, imaging often performs an essential role in diagnosis and prognosis.

Methods

Patients diagnosed with MPE between 2013 and 2018 at one tumor hospital were included and followed up. The data covered the basic clinical features, imaging findings, treatments and prognosis of patients with MPE, and the factors that may have affected the prognosis were explored.

Results

A total of 216 patients with MPE were included with the median age of 60 years. The most common primary cancer type was lung cancer (73.6%), the most common symptom was dyspnea (62.9%) and the most common abnormal electrocardiogram finding was sinus tachycardia (42.1%). The median survival time of the 216 patients with MPE was 13.7 months. The factors affecting prognosis were echocardiographic fluid signs (HR = 2.37, P = 0.010), electrocardiographic evidence of sinus tachycardia (HR = 1.76, P = 0.006) and echocardiographic evidence of cardiac tamponade (HR = 3.33, P < 0.001).

Conclusions

MPE has complex clinical manifestations and an unsatisfactory prognosis. Echocardiographic fluid signs, electrocardiographic evidence of sinus tachycardia, and echocardiographic evidence of cardiac tamponade are independent risk factors affecting prognosis.
Self-management perspectives of elderly patients with multimorbidity and practitioners - status, challenges and further support needed?
Authors: Breckner Amanda , Roth Catharina , Glassen Katharina , Wensing Michel
Published: November 2021

Background

Patients with multimorbidity (here defined as three or more chronic conditions) require constant treatment and care. Furthermore, they have to manage their health and diseases in daily life. Offering support to patients’ medical self-management is an important task of primary care. The aim of this study was to explore, what further support is needed from the perspective of patients’ and primary care practitioners.

Methods

A qualitative study using individual semi-structed interviews with 17 patients with multimorbidity and 7 practitioners (4 primary care physicians and 3 practice assistants) was conducted in Germany. Data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA.

Results

The three broad themes: current status, challenges and further support emerged. Patients reported on unfulfilled needs regarding role or emotional management, like coping with loneliness, loss of independence and, changing habits. The importance of social contact was highlighted by patients and practitioners. Patients articulated further support from their primary care practitioners on coping with the disease. Practitioners’ wished for further support in aspects of social participation, public transport, and community resources.

Conclusion

Challenges regarding self-management of elderly patients with multimorbidity may be addressed by harnessing social support and community initiatives.
Identification of transcriptomics biomarkers for the early prediction of the prognosis of septic shock from pneumopathies
Authors: Shi Songchang , Pan Xiaobin , Feng Hangwei , Zhang Shujuan , Shi Songjing , Lin Wei
Published: November 2021

Background

Identifying the biological subclasses of septic shock might provide specific targeted therapies for the treatment and prognosis of septic shock. It might be possible to find biological markers for the early prediction of septic shock prognosis.

Methods

The data were obtained from the Gene Expression Omnibus databases (GEO) in NCBI. GO enrichment and KEGG pathway analyses were performed to investigate the functional annotation of up- and downregulated DEGs. ROC curves were drawn, and their areas under the curves (AUCs) were determined to evaluate the predictive value of the key genes.

Results

117 DEGs were obtained, including 36 up- and 81 downregulated DEGs. The AUC for the MME gene was 0.879, as a key gene with the most obvious upregulation in septic shock. The AUC for the THBS1 gene was 0.889, as a key downregulated gene with the most obvious downregulation in septic shock.

Conclusions

The upregulation of MME via the renin-angiotensin system pathway and the downregulation of THBS1 through the PI3K–Akt signaling pathway might have implications for the early prediction of prognosis of septic shock in patients with pneumopathies.
Impact of socio-economic factors on Tuberculosis treatment outcomes in north-eastern Uganda: a mixed methods study
Authors: Nidoi Jasper , Muttamba Winters , Walusimbi Simon , Imoko Joseph F. , Lochoro Peter , Ictho Jerry , Mugenyi Levicatus , Sekibira Rogers , Turyahabwe Stavia , Byaruhanga Raymond , Putoto Giovanni , Villa Simone , Raviglione Mario C. , Kirenga Bruce
Published: November 2021

Background

Tuberculosis (TB) is a major public health problem and at 48%, Karamoja in North-Eastern Uganda has the lowest treatment success rate nationally. Addressing the social determinants of TB is crucial to ending TB. This study sought to understand the extent and ways in which socio-economic factors affect TB treatment outcomes in Karamoja.

Methods

We conducted a convergent parallel mixed methods study in 10 TB Diagnostic and Treatment Units. The study enrolled former TB patients diagnosed with drug-susceptible TB between April 2018 and March 2019. Unit TB and laboratory registers were reviewed to identify pre-treatment losses to follow-up. Four focus group discussions with former TB patients and 18 key informant interviews with healthcare workers were conducted. Principle component analysis was used to generate wealth quintiles that were compared to treatment outcomes using the proportion test. The association between sociodemographic characteristics and TB treatment outcomes was evaluated using the chi-square test and multiple logistic regression.

Results

A total of 313 participants were randomly selected from 1184 former TB patients recorded in the unit TB registers. Of these, 264 were contacted in the community and consented to join the study: 57% were male and 156 (59.1%) participants had unsuccessful treatment outcomes. The wealthiest quintile had a 58% reduction in the risk of having an unsuccessful treatment outcome (adj OR = 0.42, 95% CI 0.18–0.99, p = 0.047). People who were employed in the informal sector (adj OR = 4.71, 95% CI 1.18–18.89, p = 0.029) and children under the age of 15 years who were not in school or employed (adj OR = 2.71, 95% CI 1.11–6.62, p = 0.029) had significantly higher odds of unsuccessful treatment outcome. Analysis of the pre-treatment loss to follow-up showed that 17.2% of patients with pulmonary bacteriologically confirmed TB did not initiate treatment with a higher proportion among females (21.7%) than males (13.5%). Inadequate food, belonging to migratory communities, stigma, lack of social protection, drug stock-outs and transport challenges affected TB treatment outcomes.

Conclusions

This study confirmed that low socio-economic status is associated with poor TB treatment outcomes emphasizing the need for multi- and cross-sectoral approaches and socio-economic enablers to optimise TB care.
Pedicle screw accuracy in thoracolumbar fractures- is routine postoperative CT scan necessary?
Authors: Aigner R. , Bichlmaier C. , Oberkircher L. , Knauf T. , König A. , Lechler P. , Ruchholtz S. , Frink M.
Published: November 2021

Background

While several studies report on accuracy rates of pedicle screws, risk factors associated with inaccurate pedicle screw positioning in patients with thoracolumbar fractures are reported rarely. CT scan as a routine postoperative control is advocated by various authors, however its necessity remains unclear.

Methods

Two hundred forty-five patients were included in this retrospective study. Percutaneous dorsal instrumentation was most commonly performed (n = 201). Classification of Zdichavsky et al. and Rao et al. were used to classify screw misplacement and anterior perforation was further evaluated according to the extent of perforation (< 2 mm; > 2 mm). Multivariate analysis was performed to identify risk factors for misplacement of screws.

Results

One thousand sixty-eight pedicle screws were inserted in 245 patients. Misplacement was found in 51 screws (4.8%) in 42 patients (17.1%) according to the classification of Zdichavsky et al. and in 75 screws (7.0%) in 64 patients (26.1%) according to the classification of Rao et al.. An anterior perforation of the vertebral cortex was found in 56 screws (5.2%). Multivariate analysis showed fracture location in the upper thoracic (p = 0.048) and lumbar spine (p = 0.013) to be the only independent predictors for screw misplacement. In addition a significant correlation between pedicle diameter and the occurrence of screw malposition was found (p = 0.003). No consequences were drawn from postoperative routine CT in asymptomatic patients.

Conclusion

An overall low rate of screw misplacement was found with fracture location in the upper thoracic and lumbar spine being the only factors independently associated with the risk of screw misplacement. No consequences were drawn from postoperative routine CT in asymptomatic patients. Therefore its use has to be discussed critically.