bluuebunny/crossref_metadata_2025 huggingface dataset:
Attitude and Perception Towards Medical Documentation Among Pre-Intern Doctors in Sri Lanka
Authors: Padeniya A.B , Hathamuna A.I , Abeysinghe W.S.P , Gunawardena A , Mahipala P , Epitakaduwa C , Ranasinghe J.M.S.D , Colambage P , Denuwara H.M.B.H , Marasinghe A , Wijesekara L.J , Weerasinghe K , Wijayarathna N.D.S.K , Jayawickrama W.I.U , Mahesh P.K.B
Published: March 2022

IntroductionA properly documented medical record is a vital component in good clinical care. A medical record lies as a core of health information system in the hospital. Medical document is a record pertaining to clinical assessment, medical care, professional judgment and critical thinking by a health professional in relation to providing patient care. There is a paucity of studies in Sri Lankan literature to assess attitudes and competencies among pre-intern doctors on medical documentation. AimTo describe the Attitude and perception towards medical documentation among pre-intern doctors in Sri Lanka Methods A descriptive cross-sectional study was carried out among 641 pre-interns who were eligible for medical internship in 2020. A pre-tested self-administered questionnaire was used to collect data. The objective of the study was to determine attitude and perception towards medical documentation among pre-intern doctors. Pre-interns who joined for the Good Intern Programme, in year 2020 were invited to participate for the study. Descriptive statistical analyses were done. Results Mean age of the participants was 27.6 (SD 1.4) years and majority of them were females (66.5%). Majority (92.20%) of pre- interns perceived that if a patient leaves against medical advice, it is a duty of the doctor to issue a diagnosis card to the patient. Majority (91.73%) believed that they have to give a diagnosis card even for the simple viral fever. Around 69.42% of pre- interns have got a chance to participate for any training on writing diagnosis cards within last 3 years while majority (74.26%) of them perceived that they have received an adequate training in diagnosis card writing so far. Fifty-eight percent of them specified as they learnt to write diagnosis card by observing it during ward work. Majority (52.26%) of the participants perceived that they have satisfactory level of competency in writing a diagnosis card. Meanwhile majority (88.3%) of participants perceived that they need a training on proper way of writing a diagnosis card prior to the internship.ConclusionThis study highlights the importance of adding training components on medical documentation to undergraduate medical curricula and having refresher trainings prior to the commencement of medical internship.
New insights in amelioration of rhabdomyolysis-induced acute kidney injury by triple effect of Diallyl trisulphide and Sildenafil on apoptosis, NF-κB and NRF-2/HO-1 signaling crosstalk
Authors: Khalil Rania , El-Tanbouly Ghada S.
Published: March 2022

Acute kidney injury is a crucial complication of rhabdomyolysis. Glycerol (Gly) is used for induction of rhabdomyolysis in rats. Diallyl trisulphide (DATS) is a natural product from garlic with reported anti-inflammatory/antioxidant activities. Sildenafil (Sild) is a phosphodiesterase-5 inhibitor, selected in this study for its experimental protective effects in muscle and kidney injuries. Herein, protective effects of DATS and Sild were investigated in rhabdomyolysis-induced acute kidney injury (RIAKI) model. Rats were separated into five groups: Control (saline, i.p.), Gly (10 ml/kg, i.m.), Gly+Sild (5mg/kg, oral), Gly+DATS (10 and 20 mg/kg, i.p.), and tested 24 hrs after injury. Renal and muscle function tests: Serum BUN, creatinine, total CK, CK-MB, in addition to urine creatinine, total protein and albumin were measured. Renal oxidant/antioxidant status and histopathological changes, were also measured. Meanwhile, renal NRF-2, HO-1, IL-1β and IL-6, were assessed by ELISA. Furthermore, inflammation (TNF-α, NF-κBp65, COX-2) and apoptosis (BAX/BCL-2) were examined by immunohistochemistry. The study showed that DATS, in a dose-dependent manner improved RIAKI, through reduction of mortality, renal damage, muscle injury, oxidative stress inflammation and apoptosis, in addition to improvement of kidney function and anti-oxidant defense. DATS prevented nuclear translocation of NF-κBp65 and BAX. Otherwise, DATS elevated nuclear translocation of BCL-2 and expression of NRF-2/HO-1, thus modulating the crosstalk between these pathways. In the meantime, sildenafil, to a reduced extent, monitored the same pathways and proved its muscle/reno-protective actions. Therefore, DATS can be a natural candidate for treatment of acute muscle and kidney injuries, via its verified antioxidant, anti-inflammatory and antiapoptotic potentials.
Relation between the Sense of Strain, Social Control, Differential Associations and Juvenile Delinquency Amongst Adolescents: An Empirical Test of Robert Agnew’s General Strain Theory
Authors: Jurczyk Marcin
Published: March 2022

The main aim of this work was to explore the existing correlation between variables in the scope of the strain (its types), social control, differential associations and illegal and anti-social behaviors demonstrated by youth offenders and high school students’. In total 266 young people were assessed in the age of 16 to 18 years old. This research involved two groups of adolescents: youth offenders and high school students. The results show that strain as the presentation of negative stimuli the most significantly predict an increase in the intensity of behavior violating legal and social norms among youth offenders. Data provide qualified support for the theory. The results could be used in the prevention of criminal behavior, therapy, social rehabilitation, and in criminal and social policy.
Function Study of RNF43 in Colon Cancer and CRISPR Detection of its Mutation
Authors: Wang Zhen , Shi Suping , Bian Chengling , Yan Feihu
Published: March 2022

Purpose
In the present study, we aimed to study the expression levels and functional role of RNF43 in colon cancer, and provid a new theoretical basis and research direction for assessing the risk of colon cancer.
Methods
We used bioinformatics to analysis the expression and effect of RNF43 in colon cancer. Cell proliferation, migration and invasion were detected by CCK-8, Transwell and wound healing experiments. The CRISPR-cas12a was used to detecte the mutation sites of RNF43. Meanwhile, Sanger sequencing was used to recheck.
Results
RNF43 is up-regulated in colon cancer and participated in the signal pathway in tumors. In vitro cell experiments revealed that RNF43 inhibits the proliferation, migration and invasion of colon cancer cells. Finally, rs786205215 and rs1567880628 were found to have higher mutation frequencies and the results of the two detection methods are completely consistent.
Conclusion
Studies have shown that rs786205215 and rs156788062 of RNF43 may be used as indicators for colon cancer risk prediction, and CRISPR-cas12a system can be identified as one of the detection methods of SNP sites.
Deep compressed sensing-based accurate blade vibration reconstruction using sub-sampled tip-timing measurements
Authors: Chen Zhongsheng , Sheng Hao , Liu Chengwu , Xiong Yeping
Published: March 2022

Blade tip-timing (BTT) measurement is seriously sub-sampled due to the restricted number of BTT probes, so that true blade vibration characteristics can hardly be directly extracted. Blade vibration responses are always multi-band which can be considered to be sparse, so compressed sensing (CS) can be used to reconstruct blade vibrations. However, there is often less prior sparse information of multi-band blade vibrations, so that classical reconstruction algorithms are less effective. In order to deal with it, this paper presents an end-to-end deep compressed sensing (DCS)-based blade vibration reconstruction method which is composed of four key operations. First, angular-domain sampling is introduced to adapt complex operation conditions and a Multi-coset BTT measurement model is proposed in angular domain. Then a DCS model of BTT measurements is presented in order domain and a convolutional neural network (CNN) is specially designed. Next, a Simulink model is presented to simulate BTT sampling process under variable speeds and simulations are done to study the effects of the CNN architecture on the reconstruction accuracy. The results demonstrate that convolution layers with ReLU after BN are much beneficial for BTT vibration reconstruction and the proposed method is better than classical algorithms in terms of reconstruction accuracy and speed. In the end, experiments are carried out to validate the DCS-based reconstruction method and true vibration Engine Order can be recovered effectively without prior information. Thus the proposed method may set up a novel direction for BTT signal analysis and blade vibration monitoring.
A Genetic Programming-based Approach for Classifying Pancreatic Adenocarcinoma: the SICED Experience
Authors: D'Angelo Gianni , Scoppettuolo Maria Nunzia , Cammarota Anna Lisa , Rosati Alessandra , Palmieri Francesco
Published: March 2022

Ductal adenocarcinoma of the pancreas is a cancer with a high mortality rate. Among the main reasons for this baleful prognosis is that, in most patients, this neoplasm is diagnosed at a too advanced stage. Clinical oncology research is now particularly focused on decoding the cancer molecular onset by understanding the complex biological architecture of tumor cell proliferation. In this direction, Machine-Learning has proved to be a valid solution in many sectors of the biomedical field, thanks to its ability to mine useful knowledge by biological and genetic data. Since the major risk factor is represented by genetic predisposition, the aim of this study is to find a mathematical model describing the complex relationship existing between genetic mutations of the involved genes and the onset of the disease. To this end, an approach based on evolutionary algorithms (Evolutionary Algorithm) is proposed. In particular, Genetic Programming is used, which allows solving a Symbolic Regression problem through the use of Genetic Algorithms. The identification of these correlations is a typical objective of the diagnostic approach, and is one of the most critical and complex activities in the presence of large amounts of data that are difficult to correlate through traditional statistical techniques. The formula obtained highlights the importance of the complex relationship existing between the different gene's mutations present in the tumor tissue of the group of patients considered.
Evaluation of the Effects of Duloxetine Treatment on Anterior Segment Parameters by Optical Coherence Tomography
Authors: Özer Murat Atabey , Sarı İlker Fatih , koç hakan , yavuz nurçe çilesizoğlu , özen serkan , kulaklı fazıl
Published: March 2022

Purpose: To evaluate the effects of Duloxetine on anterior segment parameters and intraocular pressure(IOP) in open angle eyes.Methods: 38 eyes of 38 patients with fibromyalgia who had open or wide open angles according to the Shaffer classification. Anterior segment optic coherence tomography was performed before and after (month 3) Duloxetine treatment. IOP, central corneal thickness(CCT), corneal endothelial cell density(CECD) and anterior chamber depth(ACD) were also recorded and evaluated. Results: No statistically significant difference was determined in IOP, CCT and CECD(p > 0.05). However, a statistically significant increase was determined in both the temporal and nasal anterior chamber angle, angle opening distance, nasal trabecular-iris space area and ACD values between the baseline and month 3 (p < 0.001). Conclusion: We think that the short term use of Duloxetine does not lead to clinically significant changes despite their statistically significant effects on the anterior chamber parameters.
Performance Analysis of Downlink Multipath Multi-User NOMA-VLC System
Authors: Kumar Ajit , Ghorai Swapan Kumar , Sharan Nishant
Published: March 2022

In the present paper, the performance of non-orthogonal multiple access (NOMA) in a downlink multipath multi-user Visible Light Communication (VLC) system has been evaluated w.r.t bit-error rate (BER), sum rate & outage probability. The results show that the sum rate and BER performance improve with the increase in semi-angle of the LED using both Line-of-sight (LOS) and LOS plus first reflection (L-R1) signals. The simulation results display that there is optimal value of at which minimum BER is achieved. However, the optimal angle of semi-angle varies with the number of users and order of reflection of signal. In case of two-user system with LOS signal, the optimal angle is and for user-1 & user-2 respectively, whereas, for three-user system the optimal angle is for user-1 and it is for each user-2 and user-3. The BER simulation results for L-R1 signal reveal that the successive interference cancellation (SIC) efficiently decodes the signal for two-user system with optimum performance at equals to but as the number of users increases to three, it fails to decode the signal. The results of sum rate vs. offset using LOS signal show that sum rate for two-user system monotonically increases & then decreases with the increase in semi-angle. The optimal angle is for the maximum sum rate which also supports the BER results. The effect of shadowing (blocked LOS signal) shows that the sum rate is zero for lower values of semi-angle of LED. Finally, the outage probability against target rate of far user confirms the key finding results of shadowing.
Naturally aligned cell delivery platform to augment post-infarction neovasculature and ventricular remodeling
Authors: Shin Hye , Thakore Akshara , Tada Yuko , Pedroza Albert , Ikeda Gentaro , Chen Ian , Chan Doreen , Jaatinen Kevin , Kawamura Masashi , Yang Phillip , Wu Joseph , Appel Eric , Fischbein Michael , Woo Y Joseph , Shudo Yasuhiro
Published: March 2022

We demonstrated that joint delivery of human-derived endothelial progenitor cell (EPC) and smooth muscle cell (SMC) sheets mimics the native architecture of structurally mature blood vessels and contributes to limiting ventricular remodeling using a confluent SMC-EPC bi-level cell sheet engineered by cell-sheet technology and transplanted into an athymic rodent model of myocardial infarction. Enhanced vasculogenic potential was observed in vitro when EPCs were stimulated with SMC-conditioned culture medium, augmenting angiogenesis in vivo. Increased structurally mature vessel density, myocardial upregulation of biological adhesion, and vasculature developmental genes in the ischemic border zone myocardium showed interaction between cells and the extracellular matrix. Cell fate tracking experiments featuring xenogeneic transplantation showed transplanted EPCs and SMCs to have elements of the newly formed vasculature. Specialized magnetic resonance imaging of the cell-sheet-transplanted rodents suggested prolonged cell retention. The robust angiogenic effect of the transplanted cell sheets induced reverse ventricular remodeling of the ischemic heart. Bioinformatic analyses indicated that these cell sheets promote transcriptome-wide changes in the left ventricular response to acute ischemia, promote productive remodeling, and prevent pathological ventricular dilation. Thus, the human-derived, spatially arranged SMC-EPC bi-level cell sheet is a promising therapy for increasing myocardial viability and limiting adverse ventricular remodeling after myocardial infarction.
Impact Of Early Supportive Care Assessment On Treatment Decision In Head And Neck Cancer Before Concomitant Chemoradiotherapy
Authors: Cherifi François , Villemin Maud , Bisiaux Frederique , Johnson Alison , Laviec Heidi Solem , Rambeau Audrey
Published: March 2022

Objective: To assess the impact on oncological treatment and supportive care interventions in patients treated with chemoradiation (CRT) for advanced head and neck cancer (HNC) of a global pretherapeutic comprehensive supportive care assessment performed in an outpatient supportive care clinic (OSCC). Methods: In this monocentric prospective observational study, we included all patients considered for CRT (exclusive or post-operative) for advanced HNC from February 2019 to March 2020. The following frailty indicators were assessed: comorbidities (Charlson Index), nutritional status, altered functional ability (ADL and IADL), social precarity (EPICES score), cognitive impairment (MoCA score), addictive habits and pain.Results: OSCC led to a change in treatment for 13.7% of patients, mainly de-escalations. Ninety-three percent of patients had at least one altered domain, including 50% with three or more altered domains. Cognitive function was the most frequently altered domain (66.7%). Altered functional ability was significantly associated with treatment de-escalation after OSCC. Treatment interruptions were significantly associated with treatment de-escalation and social precarity. De-escalation was also associated with a significantly poorer PFS (median of 23.2 mos. vs 8.8 mos., HR=2.18 95%IC[1.02- 4.63] p=0.037)) and a non-significant trend towards worse OS (median 23.3mos. vs not reached (HR = 2.16 95%CI[0.88-5.31] p=0.0836).Conclusion: We strongly encourage the creation of OSCC for patients treated with chemoradiation for HNC. This practice, through an exhaustive assessment, favors therapeutic adaptation, personalized follow-up and optimization of supportive care.
Relationships Among Attitude Toward Leisure, Satisfaction With Leisure Policies, Satisfaction With Leisure Activities, And Happiness In Korean Caregivers For Young Children
Authors: Yoo Jieun
Published: March 2022

This study investigated the effect of attitude toward leisure and satisfaction with leisure policy on satisfaction with leisure activities and level of happiness in Korean caregivers for young children. Data were collected from 864 participants (397 men and 467 women) using the 2018 National Leisure Activity Survey (NLAS). The results showed that there were no significant differences between male and female caregivers in terms of satisfaction with leisure policy, satisfaction with leisure activities, and level of happiness. Women had more positive attitudes toward leisure. Satisfaction with leisure activities mediated the relationship between attitude toward leisure, satisfaction with leisure policy, and level of happiness; there were no significant differences between men and women with regard to the variables. The study suggests that attitude toward leisure and satisfaction with leisure policy promote the happiness of Korean caregivers for young children.
Phenotypic Divergences in Growth and Reproduction Underpin The Invasion of Suckermouth-Amored Catfishes to Lotic and Limnic Habitats in Vietnam
Authors: Duc Dien Tran , Ha Vo Thi , Dang Mai , Sang Huynh Minh , Dinh Khuong V. , Hieu Nguyen Trinh Duc , I.A Stolbunov
Published: March 2022

Suckermouth-amored catfishes (Pterygoplichthys spp.) is one of the most widespread invasive species in Vietnam. However, it is relatively unknown how these species have evolved in divergent adaptations to local conditions varying in habitat types, which is essential for managing their invasion in Vietnam. We addressed this by analyzing a large number of fish (766 phenotypes) collected in lotic (Dinh River) and limnic (Suoi Trau Resevoir) habitats in southern Vietnam during one year. Allometric growth patterns estimated by von Bertalanffy growth functions were \({L}_{t}= 500\left(1-{e}^{-0.71(t-0.44)}\right)\) in Dinh River and \({L}_{t}= 346\left(1-{e}^{-1.01(t-0.62)}\right)\) in Suoi Trau Resevoir. Estimated fish age was 2.9 to 4.2 years old. The percentage of fish with matured ovaries peaked in August (100%) and was lowest in February (< 10%), indicating that these fish breed all year round. The main reproductive season is April-October, with a peak in July-August as indicated by gonado-somatic indices index and monthly changes in the percentage of matured fish. The length at 50% maturity 22.93 and 17.51 cm for females from lotic and limnic habitats, respectively. Lotic fish had the fecundity (5830 ± 546 oocytes/ind.) which was five times larger than that of limnic fish (1042 ± 107 oocytes/ind.). This result was consistent with the larger oocytes of females: 2.94 ± 0.03 and 2.58 ± 0.01 mm for fish from Dinh River and Suoi Trau Resevoir, respectively. The faster growth and bigger fish with higher fecundity in the lotic habitats suggest they can accelerate greater population growth, potentially affecting local communities more than those from limnic habitats. Our study sheds light on substantial phenotypic divergences in reproduction and growth of the armored catfish between lotic and limnetic habitats in Vietnam, which is fundament for arriving at an effective management plan.
Comparison of bedside ultrasonography and bedside chest radiography in neonatal peripherally inserted central catheters：a before and after self-control study
Authors: Wu Liping , Liu Xuexiu , Tao Xiaojun , Xu Ye , Zhang Xianhong , Chen Yanhan
Published: March 2022

The study is a prospective before and after self-control clinical trial.To compare the applications of bedside ultrasonography (US) and bedside chest radiography (CR) in positioning peripherally inserted central venous catheter (PICC) at Neonatal Intensive Care Units (NICUs). A consecutive series of 181 neonate patients were finally enrolled for PICC placement. CR, followed by US, was used to evaluate and readjust the sites of catheter tips. The imaging capability for PICC key structures, fluctuation of the measured data, measurement of tip-to-atrium distance, operation time, infants’ body temperature changes and direct expenses of the two imaging modalities were obtained and compared.The following results are obtained:1.Comparison in viewing PICC key structures: the display rate of catheter tip, SVC-and-right-atrium junction, IVC-and-right-atrium junction and tip-to-atrium distance is 99.47%, 100%, 100% and 99.47% for US and 100%, 98.42%, 97.37% and 95.79% for CR, respectively. 2. Fluctuation of the measured data by US and CR: the tip-to-atrium distance measured by US is 0.631 (0.435-0.820) cm; and that measured by CR is 0.593 (0.210-0.825) cm. US showed narrower range of datum variance. 3. Consistency and correlation between US and CR: for consistency analysis, Kappa coefficient (κ) was 0.843 (P < 0.05), showing their favorable consistency; for correlation analysis, Pearson correlation coefficient (r) was 0.739 (P < 0.05), suggesting a close correlation. 4. Comparison of operation time and infants’ body temperature drop: for a CR exam, the time period taken was significantly longer than that of US（59.7±26.33min vs79.6±28.06min, P < 0.001); and CR operations caused a significant babies’ body temperature drop compared to US (0.14 ± 0.11℃ vs 0.34 ± 0.19℃, P < 0.001). 5. Comparison of the direct expenses: the total cost for CR positioning was significantly higher than that for US (¥153.99 yuan vs. ¥143 yuan, P = 0.026).It can be inferred that US positioning of PICC tip exhibited superior traits to CR. We suggest that US can be used routinely for the neonates’ PICC placement at NICU.
Mapping the contours of an emerging phase out science
Authors: Trencher Gregory , Rinscheid Adrian , Rosenbloom Daniel , Koppenborg Florentine , Truong Nhi , Temocin Pinar
Published: March 2022

Phase-out has emerged as a policy approach to confront multiple sustainability crises. From ozone-depleting substances and hazardous chemicals to fossil fuels and transport technologies, phase-out experiences have been documented by diverse scientific communities. To consolidate this dispersed knowledge and inspire more systematic research, we map the evolution of scientific discussions about phase-out through a systematic literature review. Examining 870 papers published since 1970, we trace the evolving nature of phase-out strategies in terms of targets, geographic and industrial contexts, policy instruments and drivers. This provides a multi-faceted overview of an emerging and rapidly growing ‘phase-out science’ rooted across the full spectrum of scientific enquiry. Evolution of this science is marked by broadening engagement with a growing diversity of targets, contexts, and policies. Our analysis also shows how phase-out policies have recently gained momentum as a tool to tackle climate change, with a particular focus on fossil fuels and associated technologies.
Analysis of the Diversity of Yeast Communities in Xinjiang Honey
Authors: Wei Yumei , Lei Yonghui , Liu Ailing , Zhu Shanshan , Li Yang , Cai Yanli , Sun Yanfei
Published: March 2022

Honey is widely produced in China as a natural health food with high nutritional value. In this study, high-throughput sequencing (HTS) and culture-dependent methods were used to assess the yeast diversity of wild honey from three different regions of Xinjiang. The analysis of HTS data of 26S rDNA NL1F and NL2R region genes revealed the highest number of operational taxonomic units (OTUs) of the yeast genus Zygosaccharomyces in honey, followed by the genera Aureobasidium and Clavispora. Multifloral honey is not only different in yeast structure and composition from monofloral honey, but also more diverse than monofloral honey. Thirty-five yeast strains were obtained by traditional isolation and culture methods, and morphological, physiological and biochemical, and 26S rDNA D1/D2 domain genes were sequenced to identify 11 yeast species, including Zygosaccharomyces siamensis, Aureobasidium pullulans, Naganishia albida, Saccharomyces cerevisiae, Wickerhamomyces anomalus, Rhodotorula glutinis, Pichia kluyveri, Barnettozyma californica, Rhodotorula kratochvilovae, Candia tropicalis, Pichia terricola, and these results are not entirely consistent with those obtained using high-throughput sequencing methods. Different species of honey may have contributed to the diversity of yeast. The results of this study provide basic information on the yeast diversity of native honey in Xinjiang, which will help to develop germ plasm resources of yeast in honey.
lncRNA CHROMR promotes the expression of the CNNM1 gene by adsorbing hsa-miR-1299 to obtain drug resistance in diffuse large B lymphoma cells
Authors: Wei Changyuan , Wang Mingyue , Miao Zhichao
Published: March 2022

Background: Long-chain non-coding RNA (LncRNA) is differentially expressed in diffuse large B cell lines with varying degrees of resistance to rituximab, which plays a regulatory role in the cell cycle, and has a cancer-promoting effect. Methods: This study investigated the role of lncRNA CHROMR in the diffuse large B lymphoma cells producing rituximab resistance and explored its underlying mechanism. We searched the GEO database for lncRNA-related expression data of rituximab resistance in the diffuse large B lymphoma cell line and tested it in cell lines. It was found that CHROMR was differentially expressed in different types of samples, and then the effect of CHROMR in the acquisition of drug resistance of cells was verified through experiments such as cell cycle, cell apoptosis, and cell proliferation. We use bioinformatics analysis to predict that there may be a CHROMR/miR-1299/CNNM1 signaling pathway that enables the diffuse large B lymphoma cells to acquire drug resistance. We first use dual-luciferase analysis to verify the interaction between pathway molecules. We use bioinformatics analysis to predict that there may be a CHROMR/miR-1299/CNNM1 signaling pathway that enables the diffuse large B lymphoma cells to acquire drug resistance. We first use dual-luciferase analysis to verify the interaction between pathway molecules. The cells were co-transfected with or without sh-CHROMR and miR-1299 inhibitor, CHROMR -over and miR-1299 mimic, whose proliferation, apoptosis, and cell cycle were determined subsequently. Results: The results show that restoring the expression of miR-1299 can offset the effects of changes in CHROMR expression. Conclusions: CHROMR promotes the expression of CNNM1 by adsorbing miR-1299 to cause changes in the cell cycle of the diffuse large B lymphoma cells to produce drug resistance.
Development of composite thin-film nanofiltration membranes based on polyethersulfone for water purification
Authors: El-Zahhar Adel , Alghamdi Majed M. , Alshahrani Norah M. , Awwad Nasser S. , Idris Abubakr M.
Published: March 2022

Composite thin-film nanofiltration membranes were prepared by interfacial polymerization of trimesoyl chloride (TMC), polyvinyl pyrolidone (PVP) and montmorilonite (MMT) composite on the porous polyethersulfone (PES) membrane. The effect of preparation parameters were studied as; reaction time, PVP concentration and MMT content. The properties of the prepared composite thin film membranes were analyzed in terms of their chemical structure, surface morphological features, pure water contact angel, zeta potential, pure water permeation flux (PWP) and solutes rejections. The composite thin film membranes had smoother surfaces, different surface functionality and amphoteric surafce with point of zero charges within pH 7-7.5. The PWP was found to increase with increasing MMT content up to 0.10 wt. %. The rejection of crystal violet dye (CV) was studied using the prepared membranes, where the membrane with 0.5 % PVP, 0.10% MMT at reaction time 6 min showed PWP of 18.1 (L/m2.h.bar) and CV rejection of 80.01 %. The rejection of Na2SO4 and MgCl2 was found to increase with MMT content and reached 96% and 35.4 %, respectively. The steady state flux was decreased by 5% with increasing MMT content from 0.10 to 0.12 wt. % reflecting antifouling improvement with MMT.
Clinical Empathy Training: An Explorative Qualitative Study in Search of the Barriers and Facilitators of Implementation
Authors: Barak Luca Claudia , Kuijpers Giliam , Hoeijmakers Lotte , Scheele Fedde
Published: March 2022

Background: Amid concerns about the decline of empathy during clinical training of medical clerks, evidence that empathy improves patient outcomes suggests some potential for teaching empathy in ways that will affect the knowledge, attitude and behaviour of medical clerks. This potential alone cannot, however, guarantee the success of educational innovations to introduce empathy to the medical curriculum. This research aims to investigate an implementation failure of a specific clinical initiative to enhance the empathy skills of clerks, namely the training of clerks to act as ‘MedGezels’ or ‘medical coaches’.Method: We conducted an explorative qualitative study on the basis of interview data collected and analyzed in a manner inspired by grounded theory and viewed through the lens of the readiness for change theory. We conducted semi-structured interviews with the most important stakeholders in the particular case study. Thematic analysis was done based on open and axial coding using ATLAS.ti 9, a qualitative data analyzing software program, which facilitated the emergence of common themes of interest for the study.Results: A total of 13 relevant stakeholders participated as interviewees in our study. The data was collected over a period of 3 months, from April to June 2021. Our analysis generated 6 main themes which can provide insights into why the implementation of the MedGezel educational innovation failed so far. The themes that emerged were: the case for change: why change?; practical necessity; leadership; management and resources; staff culture and the alignment with the corporate strategy. Discussion: The implementation failure is partially explainable as resulting from the personal attitudes and choices of participants who struggled to reconcile a vision that they liked but whose side effects they feared. While participants mentioned management and leadership issues several times, the importance of these was downplayed given that such organizational issues could be easily resolved in practice. What was more important and fatal to the initiative was its lack of alignment with staff culture, despite its alignment with corporate strategy. Conclusion: This investigation into the reasons behind the implementation failure of the MedGezel program produced 6 explanatory themes of which staff culture was most convincing.
How much does effective health facility inspection cost? An analysis of the economic costs of Kenya’s Joint Health Inspection innovations
Authors: Chege Timothy , Wafula Francis , Tama Eric , Khayoni Irene , Ogira Dosila , Gitau Njeri , Goodman Catherine
Published: March 2022

Background: In most low- and middle-income countries, health facility regulation is fragmented, ineffective and under-resourced. The Kenyan Government piloted an innovative regulatory regime involving Joint Health Inspections (JHI) which synthesized requirements across multiple regulatory agencies; increased inspection frequency; digitized inspection tools; and introduced public display of regulatory results. The pilot significantly improved regulatory compliance. Information on costs is essential to consider affordability and value for money. Methods: We calculated the economic costs of three phases: JHI checklist development, start-up activities, and first year of implementation, from the providers’ perspective in three pilot counties. Data collection involved extraction from expenditure records and key informant interviews. The annualized cost of JHI were calculated by adding annualized development and start-up costs to annual implementation costs. National level scale-up costs were also modelled and compared to those of current standard inspections.Results: The total economic cost of the JHI pilot was USD 1,125,600 (2017 USD), with the development phase accounting for 19%, start-up 43% and the first year of implementation 38%. The annualized economic cost was USD 519,287, equivalent to USD 206 per health facility visit and USD 311 per inspection completed. Scale up to the national level, while replacing international advisors with local staff, was estimated to cost approximately USD 4,823,728, equivalent to USD 103 per health facility visit and USD 155 per inspection completed. This compares to an estimated USD 86,997 per year (USD 113 per inspection completed) spent on a limited number of inspections prior to JHI. Conclusion: This is the first study we are aware of costing health facility inspections in sub-Saharan Africa. It has informed debates on appropriate inspection design and potential efficiency gains. It will also serve as an important benchmark for future studies, and a key input into cost-effectiveness analyses.
Understanding Interaction of Engineered Nanomaterials and Dissolved Organic Matters in River Sediments
Authors: Zhang Chen , Tan Xuejun , Yang Xue
Published: March 2022

Engineered nanomaterials (ENMs) would be settled and accumulated in sediments beneath the surface water. Investigation on the interactions between ENMs and dissolved organic matters (DOM) in sediments could assist researchers in better understanding the environmental behaviors of ENMs. This study adopted heating methods to extract DOM from the sediments in a river of Shanghai, China, and titanium dioxide nanoparticles were used as model ENMs. Three-dimensional fluorescence spectra revealed that humic-like substances possessed a better binding ability with ENMs than protein-like substances and fatty acids. Nano-TiO2 could destroy the α-helix structure of proteins. The rapidly diminishing intensity of α-helix bands suggested that secondary structure of protein was distorted, and the nano-TiO2 binding site was amino residues in main peptide chain. X-ray photoelectron spectra further not only demonstrated that protein-like, humic-like substances and fatty acids could adsorb on the surface of nano-TiO2, but also confirmed that phosphonate could combine with nano-TiO2 via P-Ti covalent bond. This study supported comprehensively scientific data and assisted in understanding the environmental behaviors of ENMs, in order to direct the pollution control of river sediments.
Remifentanil Is Associated With Increased Length-Of-Stay After Abdominal Surgery: A Single-Center Retrospective Propensity-Matched Cohort Study
Authors: Chan Steffi Kang Ting , Chong Margaret Yanfong , Ke Yu He , Abdullah Hairil Rizal
Published: March 2022

Perioperative remifentanil infusions have been postulated to help with recovery after surgery due to their rapid offset and predictable metabolism. However, evidence on patients undergoing abdominal surgery suggests an association between intraoperative remifentanil and longer length of stay in the post-anesthetic care unit, increased postoperative pain and analgesic requirement.We retrospectively evaluated 3648 adult patients who underwent major abdominal surgeries from 2013 to 2020 in a tertiary single center. Propensity score matching was conducted to balance 12 specific covariates between the treatment and control groups prior to further statistical analysis. We found that intraoperative remifentanil infusion was associated with an increased average hospital length of stay (10.62 in treatment group vs 10.13 in control group, 95% CI 0.048 - 0.088, P<0.001) and increased length of stay in the high dependency ward (1.89 days in treatment group vs 1.52 days in control group, 95% CI 0.126 - 0.223 P <0.001), but a shorter stay in the intensive care unit (4.03 hours in treatment group vs 7.01 hours in control group, 95% CI -0.509 - 0.452, P <0.001). Consistent with current evidence, there was no significant difference between the treatment and control groups for death in 3 months and 2 years post-surgery.In conclusion, our study suggests that remifentanil may not promote postoperative recovery as expected. Its role in enhancing recovery is debatable and further studies are needed to determine the cost effectiveness of remifentanil use in abdominal surgery.
Health Professionals' Readiness And Its Associated Factors To Implement Telemedicine System At Private Hospitals In Amhara Region, Ethiopia 2021
Authors: Wubante Sisay Maru , Nigatu Araya Mesfin , Jemere Adamu Takele
Published: March 2022

Introduction: in resource-limited settings incorporating the Telemedicine system into the healthcare system enhances exchanging valid health information for practicing evidence-based medicine for the diagnosis, treatment, and prevention of diseases. The successful implementation of a telemedicine system in health care inquires a study of numerous technical, organizational, infrastructure, and human elements.Objective: This study aimed to assess health professionals' readiness and its associated factors to implement a Telemedicine system at private hospitals in Amhara Region, Ethiopia 2021.Method: An institution-based cross-sectional study was conducted among 423 health professionals from March 3 to April 7 2021 at private hospitals in Amhara Region. A self-administered questionnaire was employed to collect the data. The data were analyzed by SPSS version 20 software. Descriptive statistics,bi-variable and multi-variable logistic regression analyses were performed. An adjusted odds ratio (AOR) with 95% CI was used to determine the s association between the independent and the outcome variable. Result: About Two-third (268;65.4%) of health professionals were ready to Telemedicine system.Knowledge (AOR=2.5;95% CI: [1.4, 4.6]), Attitude (AOR=3.2;95% CI: [(1.6,6.2]), computer literacy (AOR=2.2; 95% CI: [1.3, 3.9]), computer training (AOR=2.1;95% CI: [1.1, 4.1]), Computer skill (AOR=1.9;95% CI:[1.1, 3.4]),computer access at office (AOR = 2.1;95% CI: [1.1,3.7],Internet access at office (AOR=2.8;95%CI: [1.6,5.1]),Own personal computer(AOR=3.0;95% CI: [1.5,5.9])and work experience(AOR=3.1;95%CI: [1.4,6.7]) were significantly associated withTelemedicine readiness .Conclusion and Recommendation: In general the overall readiness of health professionals for the Telemedicine system is moderate. Inclusive packages of capacity building are fundamental to increasing the level of, knowledge, attitude, and training among health professionals.
Low Back Pain in Adolescent Elite Rowers and its Association to Skeletal Muscle Changes Detected by Quantitative Magnetic Resonance Imaging
Authors: Marth Adrian Alexander , Auer Timo Alexander , Bertalan Gergely , Gebert Pimrapat , Geisel Dominik , Hamm Bernd , Keller Sarah
Published: March 2022

Objectives:To assess demographic data, training characteristics and low back pain (LBP) in male adolescent elite rowers, visualize structural changes in the lumbar skeletal muscle with quantitative magnetic resonance imaging (qMRI) and correlate findings to reported long- and short-term pain intensity. Methods:In this single-center case series, twenty male elite rowers completed a questionnaire for retrieval of anthropometric data, training characteristics and a standardized back pain questionnaire. Participants then underwent MR imaging, which included the acquisition of T1- and T2-mapping sequences and Dixon-based sequences for the Erector spinae (ES) and Multifidus (MF) muscle. Reported short- and long-term pain intensity was correlated to relaxation times and training characteristics. Results:Short-term pain intensity was associated with shorter T1 relaxation (p = 0.025 and p 0.022 for ES and MF, respectively) and longer T2 relaxation times (p < 0.001 for ES and MF, respectively), while long-term pain intensity was associated to longer T2 relaxation times (p < 0.001 and p = 0.004 for ES and MF, respectively). Conclusion:Competitive adolescent rowers are at risk about developing LBP. qMRI parameters provide insight in structural changes in the lumbar skeletal muscle which are linked to reported short- and long-term pain intensity, indicating that muscular strains can account for LBP.
Enhancing the function of PLGA-collagen scaffold by incorporating TGF-β1 loaded PLGA-PEG-PLGA nanoparticles for cartilage tissue engineering using human dental pulp stem cells
Authors: Ghandforoushan Parisa , Hanaee Jalal , Aghazadeh Zahra , Samiei Mohammad , Navali Amir Mohammad , Khatibi Ali , Davaran Soodabeh
Published: March 2022

Researchers have scrutinized cartilage tissue regeneration to handle the deficiency of cartilage restoration capacity. This investigation proposed to compose an innovative nanocomposite biomaterial that enhances growth factor delivery to the injured cartilage site. Here, we describe the design and development of the biocompatible PLGA-collagen / PLGA-PEG-PLGA nanocomposite scaffold containing TGF-β1. PLGA-PEG-PLGA nanoparticles were employed as a delivery system embedding TGF-β1 as an articular cartilage repair therapeutic agent. This study evaluates various physicochemical aspects of fabricated scaffolds by 1HNMR, FT-IR, SEM, BET, and DLS methods. The physicochemical features of the developed scaffolds, including porosity, density, degradation, swelling ratio, mechanical properties, morphologies, BET, ELIZA, and cytotoxicity were assessed. SEM images displayed suitable cell adhesion and distribution of hDPSCs throughout the scaffolds. The cell viability was investigated with the MTT test. In real-time PCR testing, the expression of Sox-9, collagen type II, and aggrecan genes was monitored. According to the results, h-DPSCs exhibited high adhesion, proliferation, and differentiation on PLGA-collagen/PLGA-PEG-PLGA-TGF-β1 hydrogels compared to the control groups. RT-PCR assay data displayed that TGF-β1 loaded PLGA-PEG-PLGA nanoparticles puts forward chondroblast differentiation in hDPSCs through the expression of chondrogenic genes. Due to its potential for the growth and differentiation of hDPSCc, PLGA-collagen/PLGA-PEG-PLGA-TGF-β1 hydrogel is likely to be a suitable biomaterial for cartilage regeneration.
Osteogenically Induced Human Umbilical Cord Mesenchymal Stem Cell-derived Small Extracellular Vesicles Carrying Distinct microRNA Signature Improve Osteoinductivity of Tissue-engineered Bone
Authors: Zhou Yang , Rong Qiong , Li Shuyi , Liu Shangbin , Wu Wanqiu , Forouzanfar Tim , Wu Gang , Wang Jinheng , Zhou Miao
Published: March 2022

The authors have requested that this preprint be removed from Research Square.
Efficacy of elastodontic devices vs clear aligners in lower dental arch crowding reduction assessed by computer-aid evaluation
Authors: Ortu Eleonora , Pietropaoli Davide , Cova Samuele , Giannoni Mario , Monaco Annalisa
Published: March 2022

Backgroundthis pilot study aim to verify the efficacy of two orthodontic appliances in the treatment of the lower arch crowding in the growing patients.Methodtwenty patients aged 7–15 years were enrolled in the study, and separated into test and control groups. The test group included 10 patients (5 males, 5 females; mean age, 10.4 ± 1.57 years), who were treated with an elastodontic device. The control group included 10 patients (5 males, 5 females; mean age 10.8 ± 1.53 years), who were treated with clear aligners. Dental lower crowding were evaluated at two timepoints with intraorla scans: T0 (before starting therapy) and T1 (after 1 year).Resultsthere was not statistically significant difference between the two groups at T0 and T1 (p < 0.005).Conclusionelastodontic devices and clear aligners can help succesfully the orthodontist in the treatment of the lower crowding. This appliances are comfortably to wear, simply to clean everyday and reduce the number of dentist appointments. Finally, but not in order of importance, these devices have allowed to dentists to continue the orthodontic treatments during the lockdown during the covid 19 pandemic.
Bone Regeneration and Repair: The Negative Influence of Positive Charge
Authors: He Ling , Yao Yingling , Wang Nan , Nan Guoxin
Published: March 2022

Background: Fracture nonunion is a common and challenging complication. Studies have reported that direct current stimulation can promote fracture healing, but there are reports that there are differences in cell density near positive and negative electrodes during direct current stimulation. The purpose of this study is to explore the effect of direct current positive and negative electrodes on the proliferation of osteoblasts and the effect on fracture healing in vivo. Methods: In vitro, MC3T3-E1 cells were stimulated by positive and negative charge to observe cell proliferation and apoptosis. In vivo, after the model of double toes fracture in New Zealand white rabbits was built, positive and negative charge were respectively connected to Kirschner Wires of fractures. DR examination was performed on Day 1, Day 15 and Day 30 to observe the fracture healing. All rabbits were killed after the last examination, the bone tissue samples were analyzed histologically. Results: In vitro, compared to the proliferation rate of cells near negative charge, after 48 hours, the rate near the positive charge decreased significantly(p<0.05), and the apoptosis increased(p<0.05). In vivo, fracture sites connected to the positive charge were not healed and histomorphology analysis showed that the trabecular bone and mineralized bone decreased significantly. Conclusions: Positive charge inhibit the cell proliferation of osteoblasts; the fracture site with positive charge is not favor of fracture healing. The positive charge near the fracture site may be a reason for fracture nonunion.