bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing HIV-related stigma in school children in Northern Uganda: Study protocol for an arts-based population health intervention and stepped-wedge cluster-randomized controlled trial
Authors: Mendelsohn Joshua B. , Fournier Bonnie , Caron-Roy Stephanie , Maina Geoffrey , Strudwick Gillian , Ojok Santo , Lim Hyun June , Sanches Marcos , Logie Carmen H. , Sommerfeldt Susan , Nykiforuk Candace , Harrowing Jean , Adyanga Francis Akena , Hakiigaba Jussy Okello , Bilash Olenka
Published: May 2022

BackgroundHIV-related stigma negatively impacts HIV prevention, care, and treatment particularly children and adolescents in sub-Saharan Africa. Interventions that are culturally-grounded and relevant to address the root causes of stigma may reduce the stigma experienced by HIV positive and affected young people. This study in a post-conflict, rural setting in Omoro District, Uganda, will create and evaluate a transformative education and arts-based HIV-related stigma intervention rooted in local cultural knowledge to reduce stigma and improve HIV prevention and care for those living with HIV. The study will employ a mixed-methods, stepped-wedge cluster-randomized controlled trial, and community-based participatory research approach. The intervention will be delivered to children and youth in schools by Elders, with the support of teachers, through the transfer of local cultural knowledge and practices. The arts-based intervention aims to re-establish the important cultural and social role of Elders within a community that has suffered the loss of inter-generational transfer of cultural knowledge due to a 25-year civil war.MethodsA formative research phase consisting of interviews with students, teachers and Elders will inform the intervention and provide data for study objectives. Workshops will then be delivered to Elders and teachers in participating schools to build capacity for transformative, arts-based, educational workshops with students in the classroom. Government-funded schools located in Omoro District will be randomized into 3 blocks, each comprised of two primary and two secondary schools (n=1800 students). Schools will be randomly allocated to sequences of 8-week time periods in which they will crossover from control to the intervention condition. A process evaluation will be implemented throughout the study to evaluate intervention development, implementation, and effects.DiscussionThis study will generate comprehensive, in-depth research and evaluation data that will be integrated to inform an effective and sustainable protocol for implementing arts-based HIV-stigma interventions for young people in school settings. Findings will have widespread implications in post-conflict settings for HIV prevention, treatment and care.Trial registrationClinicalTrials.gov NCT04946071 (June 30, 2021; https://clinicaltrials.gov/ct2/show/NCT04946071)
Lentivirus-mediated siRNA knockdown of METTL3 is involved in Alzheimer's disease
Authors: Wang Yun , Liu Zhen , Wang Min , Liu Zengqiang , Bi Jianzhong , Han Min
Published: May 2022

Alzheimer's disease is the most common form of dementia in older people. The pathogenesis of AD is still uncertain, although it appears autophagy abnormalities are involved. In recent years, epigenetics, including RNA N6-methyladenosine (m6A) methylation, has been shown to be involved in the pathogenesis of neurodegeneration. However, how RNA methylation may be involved in the pathogenesis of AD is still unclear. Our previous RNA m6A methylation high-throughput sequencing analysis found that some hippocampal genes showed elevated methylation in AD mouse models, but that some genes showed declining methylation. Genes showing different methylation patterns tended to be related to autophagy. The focus of this study is to examine possible mechanisms by which m6A RNA methylation may be involved in AD. SH-SY5Y cells treated with Aβ25−35 were used as AD models, and untreated SH-SY5Y cells were used as controls. We first detected the expression of methylase in the two groups of cells. The results showed that the protein expression of METTL3 in the AD cell group was higher than that in the control group, while FTO expression showed no statistically significant differences. We then used lentivirus-mediated METTL3 RNA knockouts to observe the expression of Parkin protein in each group of cells. Results showed that expression of the Parkin protein in the AD cell group was increased compared to the control group, while the expression levels of Parkin protein in AD cells with METTL3 RNA knockout decreased. Additionally, mitochondrial structural changes were observed using transmission electron microscopy. These results showed that the mitochondrial structure in an AD cell model with METTL3 RNA knockout was improved compared to the AD cell model alone. Taken together, our findings suggest that RNA m6A methylation is involved in the AD process.
Creation and Evaluation of a Participatory Child Abuse and Neglect Workshop for Medical Students
Authors: Giannakas Christos , Manta Aspasia , Livanou Maria Effrosyni , Daniil Vasiliki , Paraskeva Angeliki , Georgiadou Maria-Konstantina , Griva Nefeli , Papaevangelou Vassiliki , Tsolia Maria , Leventhal John M. , Soldatou Alexandra
Published: May 2022

Background
Since child abuse and neglect (CAN) is prevalent worldwide, medical students should acquire basic knowledge, skills, and confidence in identifying and addressing CAN. Significant educational efforts have been previously described, but none has focused on participatory methods to teach medical students CAN.
Purpose
To: 1) develop a participatory educational workshop in CAN for medical students, 2) gather, train, and establish a peer-to-peer teaching group, and 3) assess the effectiveness of the workshop in gain of knowledge and improvement of self-confidence for participants.
Methods
A two-hour workshop was created with role-playing, the use of dolls and peer-to-peer teaching. A 15-item knowledge and a 9-item self-confidence questionnaire were used before, right after, and six months after the workshops.
Results
Nine workshops in two academic pediatric departments with a total attendance of 300 6th year medical students were conducted. For the 69 students who completed the questionnaires at all three times, there were statistically significant gains in knowledge right after (p < .001) and six months after (p < .0001) the workshops. Similarly, self-confidence increased right after (p < .0001) and six months after (p < .001) the workshops. Self-selection bias testing indicated that these 69 students who completed all three questionnaires were representative of those who completed the pre-testing and the testing right after.
Conclusions
We successfully established a thriving peer-to-peer teaching group to conduct nine participatory workshops that improved the participants’ knowledge and self-confidence in CAN. This feasible and novel active learning approach may help address inadequacies in medical curricula.
Ranking group members by assessment performance in environmental decision-making
Authors: Srđe Zorica , Ilić Milica , Ždero Senka , Srdje Bojan
Published: May 2022

Group multi-criteria decision-making in environment-related problems is faced with important aspects such as competencies of the members of the group, demonstrated consistencies while making judgments, compatibilities with derived group decisions, etc. In this paper, we present an approach and methodology for evaluating the quality of group members based on their consistencies and deviations from the group decision. While individually making decisions, members of the group demonstrate how consistent they are. Once their decision is aggregated into a group decision, it is possible to assess individual deviations of decisions from the group decision. The members of the group can be treated as alternatives in the multi-criteria environment where criteria for assessing their 'quality' are performance indicators such as Euclidean distance, minimum violation, conformity, and Spearman's rank coefficient. Preference schemes applied to sets of performance indicators offer manipulations that may eventually lead to justified exclusion of odd (e.g. consistency - inferior) members and further changes in deriving the group decisions. An example is presented in which importance for society is assessed for six endangered Ramsar sites in the northern part of Serbia. Ramsar sites are considered as environmental systems and assessed by seven experts using AHP. Based on their consistency and deviation parameters as criteria, evaluation of the quality of members in the group is performed by the TOPSIS multi-criteria method. The discussion part of this article is devoted to the possible use of the DEMATEL method and entropy concept in supporting the group decision-making processes.
The Short-term Efficacy of High Flow Nasal Oxygen Therapy on Cardiovascular Surgical Patients: A Randomized Crossover Trial
Authors: Deguchi Shiho , Kusaka Yusuke , Nakano Shoko , Umegaki Osamu
Published: May 2022

BackgroundOxygen therapy after extubation in the intensive care unit (ICU) is essential in order to maintain adequate oxygenation, especially in patients who have undertaken cardiovascular surgery. In such cases, a Venturi mask (VM) has been routinely used as an oxygen therapy in the ICU. Recently, however, the high flow nasal cannula (HFNC) has become available, and this device can deliver up to 60 L/min of humidified oxygen. The aim of this study is to evaluate the short-term efficacy between HFNC and VM in cardiovascular surgical patients. MethodsForty patients who underwent cardiovascular surgery in 2015 were randomized to either protocol A (HFNC followed by VM) or protocol B (VM followed by HFNC). After 60-minutes of use with either device, arterial blood gas analysis was performed, and the PaO2/FiO2 ratio (PFR) was calculated. Simultaneously, physiological data (respiratory rate, heart rate, mean arterial pressure, continuous cardiac index, and mixed venous oxygen saturation) were recorded. During this procedure, FiO2 and gas flow were maintained at a fixed rate. These variables were compared by using the paired t-test, and a p value < 0.05 was considered significant. All data were expressed as mean (standard deviation).ResultsThirty-five patients (17 from protocol A and 18 from protocol B) were enrolled, and 5 patients were excluded from analysis in accordance with the exit criteria. PFR was significantly higher in the HFNC group than in the VM group [265.9 (81.4) vs. 238.7 (68.5), p=0.002]. Moreover, PaCO2 was significantly lower in the HFNC group than in the VM group [33.8 (3.5) vs. 34.7 (2.9), p=0.033]. As for physiological data, the respiratory rate was significantly lower in the HFNC group than in the VM group [18 (4) vs. 21 (4), p=0.006], and no significant differences were seen in any of the other parameters.ConclusionsCompared to VM, HFNC ameliorated oxygenation function and decreased patients’ effort in breathing. HFNC also had little influence on their hemodynamic state when switched from VM. Therefore, HFNC can be used safely in cardiovascular surgical patients.Trial registrationThis trial was registered with the UMIN Clinical Trials Registry (ID UMIN000016572, February 18th, 2015, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000019231).
A risk signature with two autophagy‐related genes for predicting prognosis of triple negative breast cancer
Authors: Yu Bing , Xing Zhimei , Tian Xiaoxuan , Feng Rui
Published: May 2022

Background
Triple negative breast cancer (TNBC) constitutes the most aggressive molecular subtype among breast tumors. Recent studies have shown that autophagy plays a dual role for TNBC.
Results
We first examined the role of differentially expressed autophagy-related genes in TNBC using high-throughput RNA-seq data from The Cancer Genome Atlas (TCGA). Cox regression analyses showed that EIF4EBP1 and NPAS3 correlated with prognosis in TNBC patients. Multivariate Cox regression analysis showed that expression of these two genes accurately predicted the risk of disease progression in TNBC samples in TCGA and GSE31519 dataset. A nomogram was developed by integrating the risk signature with clinicopathological factor, i.e., TNM stage. ROC curve and calibration plot suggested the nomogram could accurately predict 1-, 2- and 3-year survival rate of TNBC patients. The expression of EIF4EBP1 and NPAS3 also influenced the drug sensitivity of TNBC cell lines.
Conclusion
In conclusion, the risk signature EIF4EBP1 and NPAS3 as autophagy-related genes could serve as an independent prognostic factor for TNBC patients.
Robust osteogenic efficacy of 2a-heteroarylalkyl vitamin D analogue AH-1 in VDR(R270L) hereditary vitamin D-dependent rickets model rats
Authors: Nishikawa Miyu , Murose Naruhiro , Mano Hiroki , Yasuda Kaori , Isogai Yasuhiro , Kittaka Atsushi , Takano Masashi , Ikushiro Shinichi , Sakaki Toshiyuki
Published: May 2022

Active vitamin D form 1a,25-dihydroxtvitamin D3 (1,25(OH)2D3) plays pivotal roles in calcium homeostasis and osteogenesis via its transcription regulation effect via binding to vitamin D receptor (VDR). Mutated VDR often causes hereditary vitamin D-dependent rickets (VDDR) type II, and patients with VDDR-II are hardly responsive to physiological doses of 1,25(OH)2D3. Current therapeutic approaches, including high doses of oral calcium and supraphysiologic doses of 1,25(OH)2D3, have limited success and fail to improve the quality of life of affected patients. Thus, various vitamin D analogues have been developed as therapeutic options. In our previous study, we generated genetically modified rats with mutated Vdr(R270L), an ortholog of human VDR(R274L) isolated from the patients with VDDR-II. The significant reduced affinity toward 1,25(OH)2D3 of rat Vdr (R270L) enabled us to evaluate biological activities of exogenous VDR ligand without 1a-hydroxy group such as 25(OH)D3. In this study, 2α-[2-(tetrazol-2-yl)ethyl]-1α,25(OH)2D3 (AH-1) exerted much higher affinity for Vdr(R270L) in in vitro ligand binding assay than both 25(OH)D3 and 1,25(OH)2D3. A robust osteogenic activity of AH-1 was observed in Vdr(R270L) rats. Only a 40-fold lower dose of AH-1 than that of 25(OH)D3 was effective in ameliorating rickets symptoms in Vdr(R270L) rats. Therefore, AH-1 may be promising for the therapy of VDDR-II with VDR(R274L).
Developing and evaluating a SAFER model to screen for diabetes complications among people experiencing homelessness: A pilot study protocol
Authors: Scott Sara , Grewal Eshleen K. , Tariq Hamna , Campbell David JT
Published: May 2022

Background - Diabetes management combined with housing instability intersect, forcing individuals to triage competing needs and critical stressors, such as safety and shelter, with fundamental diabetes self-management tasks like attending healthcare appointments to screen for the complications of diabetes, leaving individuals overwhelmed and overburdened. We aim to address this disjuncture found within our current healthcare delivery system by providing point-of-care screening opportunities in a more patient-centered approach.Method - We describe a pilot study of a novel clinical intervention which provides timely, comprehensive, and accessible screening for diabetes complications to people experiencing homelessness. We will assess the reach, effectiveness, adoption, implementation, and maintenance, as per the RE-AIM framework, of a SAFER model of care (i.e., Screening for A1C, Feet, Eyes, and Renal function). A trained nurse will provide this screening within a homeless shelter. During these encounters, eligible participants will be screened for microvascular complications (neuropathy, nephropathy, retinopathy) and have their A1C measured, all at the point-of-care, using bedside tools and novel technology. Effectiveness, our primary objective, will be evaluated using a pre-post design, by comparing the rate of completion of full microvascular screening during the study period with individuals’ own historical screening in the 2-year period prior to enrollment. The other domains of the RE-AIM framework will be assessed using process data, chart reviews, patient surveys and qualitative semi-structured interviews with service providers and participants. This study will be conducted in a large inner-city homeless shelter within a major urban Canadian city (Calgary, Canada).Discussion - Currently, screening for diabetes complications is often inaccessible for individuals experiencing homelessness, which places heavy burdens on individuals, and ultimately, on already strained emergency and acute care services when complications go undetected at earlier stages. The SAFER intervention will modify the current standard of care for this population in a way that is less fragmented, more person-focused, and timely, with the goal of ultimately improving the rate of screening in an acceptable fashion to identify those requiring specialist referral at earlier stages.
Acceleration of Esophageal Wound Healing by Anisotropically Aligned Smooth Muscle Cell-Laden Nanofibrous Patch
Authors: Yeo Miji , Yoon Jung Won , Park Gyu Tae , Shin Sung-Chan , Song Young-Cheol , Cheon Yong-Il , Lee Byung-Joo , Kim Geun Hyung , Kim Jae Ho
Published: May 2022

Background
Esophageal tissue engineering is proposed to repair damaged esophagus, which requires peristalsis via directional alignment and movement of smooth muscle. Cell electrospinning (CE) is an effective technique to produce aligned muscle tissues by directly encapsulating living cells into micro/nanofibers. Mesenchymal stem cells (MSCs) can differentiate into smooth muscle cells (SMCs) in response to treatment with transforming growth factor-β1. In this study, we investigated the phenotypic changes of MSCs and MSC-derived SMCs via CE, and evaluated the therapeutic effect of SMC-patch for esophageal wound model.
Methods
MSCs and SMCs were fabricated with 2 wt % alginate and 3 wt % PEO, and the cell-laden bioink was printed and electrospun onto PCL scaffolds for random and anisotropic alignment, respectively. In in vivo test, the SMC-patch was construct by CE and the rat’s esophageal wound model was developed by tissue punching. The SMC-patch was transplanted with sutures in the esophageal defect.
Results
Cell electrospinning resulted in more aligned and elongated forms of MSCs and SMCs than bioprinting. SMCs aligned via cell electrospinning exhibited upregulated expression of SMC-specific markers (alpha-smooth muscle actin, calponin, SM22α, and desmin), SMC-associated extracellular matrix proteins (fibronectin, collagen types I and IV), and connexin 43, the principal gap junction protein in SMCs. The electrospun SMC was fabricated in a patch form and transplanted into a rat esophageal wound model. Transplantation of the smooth muscle patch promoted muscle regeneration and vascularization in esophageal wounds.
Conclusion
Taken together, these results suggest that transforming growth factor-β1-induced differentiation of MSCs to SMCs and anisotropic alignment of SMCs can be applied to engineer smooth muscle tissues and treat gastrointestinal perforation.
Hyperglycemia and glycemic variability associated with glucocorticoids in women without pre-existing diabetes undergoing (neo) adjuvant taxane chemotherapy for early-stage breast cancer
Authors: Mortimer Joanne , Mahin Dana , Lavasani Sayeh Moazami , Cristobal Leon , Patel Niki Tank , Sedrak Mina , Stewart Daphne , Waisman James , Yuan Yuan , Yu Wai , Samoa Raynald , Ruel Nora , Lee Hayley , Kil Sung
Published: May 2022

Purpose: Glucocorticoids administered with chemotherapy cause hyperglycemia even in the non-diabetes setting. The prevalence of hyperglycemia and glycemic variability among breast cancer patients without diabetes are not well known, especially across different race/ethnicities. Methods: A retrospective cohort study was conducted involving early-stage breast cancer patients without diabetes who have received dexamethasone prior to (neo) taxane adjuvant chemotherapy between August 2017-December 2019. Random blood glucose levels were extracted, and steroid-induced hyperglycemia (SIH) was defined as a random glucose level of >140 mg/dL. Multivariate proportional hazards model was used to identify risk factors for SIH.Results: Of 100 total patients, the median age was 53 years (IQR: 45-63.5). Forty-five percent were non-Hispanic white, 28% Hispanic, 19% Asian, and 5% African American. The incidence of SIH was 67%, and glycemic fluctuations were highest in those with glucose levels >200 mg/dL. Non-Hispanic white remained as a significant predictor for time to SIH with a hazard ratio of 2.5 (95% CI: 1.04, 5.95, p=0.039). SIH was transient in over 90% patients, and only 7 patients remained hyperglycemic after glucocorticoid and chemotherapy completion.Conclusions: Pre-taxane dexamethasone-induced hyperglycemia in 67% of patients with the greatest glycemic lability in women with blood glucose level > 200 mg/dL. Non-Hispanic white had a higher risk of developing SIH. SIH patients should be monitored using a continuous glucose monitoring or self-monitoring of blood glucose devices. Diagnostic tests for diabetes such as HbA1c, oral glucose tolerance test, fasting plasma glucose, and endocrinology consultation should also be recommended.
Influence of Abrasive Deburring in Tool Wear Measurement in Microslots of Inconel 718
Authors: Paiva Gabriel , Silva Márcio Bacci da , de Oliveira Déborah
Published: May 2022

Micromilling is a machining process used in the fabrication of microscopic components and features. Tool wear in micromilling can be indirectly measured through the dimensions of the microslot, however the presence of burrs may cause imprecisions in this measurement. Inconel 718 is a nickel-based superalloy that is frequently reported to exhibit large burrs when micromilled. The abrasive deburring method is a simple, versatile and inexpensive technique for removing burrs in microcomponents. Thus, this work aims to evaluate the influence of abrasive deburring in tool wear measurement on precision features of Inconel 718. Four samples, each one with 12 microslots 400 𝜇m wide and 40 𝜇m deep, were deburred with silicon carbide sandpaper sheets with mesh sizes 800, 1200, 2000 and 3000 during a fixed time of 30 seconds and a constant spindle speed of 120 rpm. The results showed that the presence of burrs leads to values of tool wear with greater standard deviations in comparison with the deburred samples. Moreover, the chosen deburring method proved to be efficient in reducing burr heights in microslots of Inconel 718, without any significant damage to the surface quality of the samples, favoring the indirect wear measurement.
Research Trends on Ash Stabilization in the Pavement during 2002-2021
Authors: Hatami Amir Mostafa , Sabour Mohammad Reza , Joshaghani Alireza
Published: May 2022

Incineration ashes should be disposed of appropriately considering environmental issues. Ash stabilization in the pavement is an effective approach to reduce environmental impact and proper disposal. This study aimed to achieve a bibliometric analysis of “ash stabilization in pavement” research during 2002-2021, considering language, chronological trends, source types, subject areas, document types, affiliations, journals, countries, and author keywords. Also, Social Network Analysis was used for trends mapping and global collaborations determination among countries. The results exposed that the number of publications has been significantly increased by more than fourteenfold over the studied period. The United States, by 383 publications, was the leading country, followed by India and China. The most independent rate of the publications belonged to India, by 93.0%. The “Construction and Building Materials” published the most related articles, followed by “Journal Of Materials in Civil Engineering” and “Road Materials and Pavement Design.” Amongst the top ten productive institutes and organizations, four affiliations were from China, and three were from the United States. “Fly ash,” “compressive strength,” “durability,” “geopolymer,” “strength,” and “resilient modulus” had the most growth rate in recent years, based on the author keywords analysis. Besides, the increase of emerging keywords, “pervious concrete,” “reclaimed asphalt pavement,” and “lateritic soil” are noteworthy in the second half period.
Serum lipidomics reveals novel biomarkers by UHPLC-HRMS to assist the discrimination between colorectal adenoma and cancer
Authors: Chen Hongwei , Zhang Jiahao , Zhou Hailin , Zhu Yifan , Liang Yunxiao , Zhu Pingchuan , Zhang Qisong
Published: May 2022

Background: The mechanisms of colorectal adenoma (CA) transforming colorectal cancer (CRC) remain unclear, and there are still lacking biomarkers to distinguish CA from CRC. Hence, this study aimed to explore underlying the mechanisms of CA canceration and novel biomarkers to differentiate CA from CRC. Methods: An ultrahigh performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS) method was employed to measure global lipid profiles of 100 serum samples from CA and CRC patients. Univariate and multivariate statistical analysis were applied to select the differential lipids between two groups. Combining constituent ratio analysis and performance evaluation analysis by the receiver operating characteristic (ROC) curve explored the mechanisms of CA canceration and lipid markers to discriminate CA and CRC.Results: Serum lipid profiles presented obvious differences between CA and CRC. Totally 85 differential lipids (P < 0.05 and fold change > 1.5) were discovered and mainly involved in fatty acid (FA), phosphatidylcholine (PC), and triacylglycerol (TAG) metabolism with ratio > 63%. 7 lipids served as the putative biomarkers with the area under the curve (AUC) > 0.800. Among them, a lipid panel containing four lipids was selected as the potential biomarkers with excellent performance (AUC = 0.971) and the highest selected frequency to distinguish CA from CRC based on SVM classification model.Conclusions: The lipid panel could act as the potential biomarkers aiding the early diagnosis of CRC. Metabolic dysregulation of FAs, PCs, and TAGs should be involved in CA canceration, which provides new clues to understand its underlying mechanisms.
Dynamic link between economic growth, tourism, inward FDI, environmental degradation in ASEAN countries: A fresh look at an old problem
Authors: Noor Sameena , Azam Muhammad , Nawaz Muhamad Atif , Awan Abdul Majid
Published: May 2022

This study aims to investigate the linkage among tourism, foreign direct investment (FDI), environmental degradation by carbon dioxide (CO2) emissions and economic growth in five countries from Association of Southeast Asian Nations (ASEAN) over 1995–2018. The outcomes of pooled mean group (PMG) estimator reveal that inward FDI and international tourism arrivals have a significantly positive influence on economic growth both in the short-run and the long-run. The association between growth and CO2 emissions is found negative and significant. The Granger causality result reveals that there is bidirectional causality between FDI and growth, tourism, and growth and FDI and tourism. A unidirectional causal link is found between CO2 emissions and growth, tourism and population and population and CO2 emissions. These findings suggest enhance more inward FDI, control environmental pollution, but also necessary to attract more tourists towards these countries, which in turn, generate revenue and boost up economic growth and development.
Deformation failure and acoustic emission characteristics of continuous graded waste rock cemented backfill under uniaxial compression
Authors: Chen Guan , Ye Yicheng , Yao Nan , Fu Fanghui , Hu Nanyan , Zhang Zhen
Published: May 2022

In order to study the effect of aggregate particle size on damage and failure of cemented backfill, uniaxial compression tests were carried out on waste rock cemented backfill with different Talbol particle size gradations using YZW-30A rock direct shearing instrument. The characteristic parameters of acoustic emission (AE) of the specimens during loading process were monitored, and the damage evolution and failure mode of waste rock cemented backfill with different particle size gradations were discussed. The results show that: With the increase of Talbol particle size gradation index n, the uniaxial compressive strength of backfill body first increased and then decreased, and the failure mode of backfill body gradually changed from shear failure to tensile failure. The cracks on the surface of specimens are more and damage is more serious with the increase of the gradation index n. With the increase of the Talbol gradation index n, AE energy rate is more active, and the cumulative AE energy rate is higher. The AE energy rate increases rapidly in the plastic development stage, and reaches maximum value before and after the peak stress, which can be used as the precursor to judge the failure of waste rock cemented backfill. According to the test results, the damage model and constitutive equations of waste rock cemented backfill with different Talbol particle size gradations are established, which can provide engineering guidance for filling mined-out areas with waste rock to ensure safe production of mines.
Cultural Adaptation and Validation of the SPICT-ESTM Instrument to Identify Palliative Care Needs in Chilean Older Adults
Authors: Farfán-Zúñiga Ximena , Zimmermann-Vildoso Melissa
Published: May 2022

INTRODUCTION: Chile presents a scenario of an aging population and increased life expectancy, leading to many older adults (OA) needing palliative care (PC) during the course of their illness. The SPICT-ESTM is an instrument used to clinically evaluate patients with advanced chronic illness (ACI) to detect PC needs. Validating this instrument in Chile will allow for early detection of OA at risk of clinical decline who require this care.OBJECTIVE: adapt and validate the SPICT-ESTM instrument to identify PC needs among OA in Chile.METHODOLOGY: study following quantitative design – cross-sectional, descriptive, and developed in three stages: cultural adaptation by expert judgment; preliminary test of the SPICT-ESCH instrument to evaluate reliability and application of the SPICT-ESCH in 292 patients, to determine internal consistency and stability of the instrument. This study was done between January 2019 and July 2021. Participants in the study were nurses and OA from 5 health centers in Santiago, Chile. This study was approved by the Ethics Committee of Universidad de los Andes.RESULTS: in the cultural adaptation with content validity, following expert judgment, all items were kept. Semantic modifications were made on only three of them. A Cronbach’s Alpha of 0.84 and a Lawshe coefficient of 84% were achieved, ranking this as an acceptable tool for application. The pilot for the new version in Chile, SPICT-ESCH, determined stability and consistency over time, with a Pearson correlation coefficient (ρ) of 0.9167 (p<0.0001). In the final application of the instrument, to fortify the psychometric evaluation (n=292) we identified 53.4% positive SPICT-ESCH. The logistical model via OR (<0.001) showed that the items predicted the positivity of the instrument. The internal consistency obtained was 0.8662, confirming a correlation and intercorrelation between items. 100% of nurses evaluated the SPICT-ESCH as a useful and feasible instrument. CONCLUSION: SPICT-ESCH includes all the relevant indicators for adequate clinical identification of PC needs among the Chilean OA population, who could Benefit from the early introduction of palliative support contributing to their quality of life.
Peri-conceptional folic acid supplementation: A Cross-Sectional study to Assess the Awareness, Knowledge, Use and Associated Factors Among Pregnant Women Attending Antenatal Care in a Secondary Health Care Facility, Southwest Region, Cameroon
Authors: Alemajo Confidence Atemnkeng , Halle-Ekane Gregory Edie , Nkengasong Elvis Ajabmoh , Asongalem Emmanuel Acha
Published: May 2022

Background
Neural tube defects(NTDs) are among the most common birth defects, contributing to miscarriages, infant mortality, severe congenital abnormalities and serious disabilities. The protective effect of peri-conceptional folic acid (PFA) supplementation in reducing the risk of NTDs and other adverse pregnancy outcomes has been scientifically confirmed.
Methods
A cross sectional study was conducted using a structured questionnaire administered to 393 pregnant women seeking routine antenatal care between February to April 2020. Multivariate logistic regression was used to model factors associated with awareness, knowledge, and use of PFA.
Results
Approximately 55% of women reported that they had heard of folic acid and only 6.1% had knowledge of folic acid (its benefit in preventing birth defects and the appropriate time to start using it). However, only 5.1% reported that they started using folic acid before pregnancy. Folic acid awareness showed a significant relationship with university education and above (OR = 4.30, 95% CI [2.60, 7.30], P < 0.001). There was also a significant difference in the odds of knowledge among those with university education and above (OR = 5.06, 95% CI [1.65, 19.0], P = 0.0076). There was a statistically significant difference in the odds of being aware and having knowledge of folic acid between women who had a history of folic acid education from a health care provider before pregnancy compared to those who did not, (OR = 23.7, 95% CI [4.84, 430], P = 0.002), (OR = 12.0, 95% CI [4.31, 35.1], P < 0.001) respectively. Even though women who planned their pregnancy (OR = 4.89, 95% CI [0.84, 93.9]), received pre-conceptional folic acid education (OR = 5.11, 95% CI [1.47, 18.7], and had a history of an unsuccessful pregnancy (OR = 2.61, 95% CI [0.86, 8.65], had higher odds of folic acid use, these relationships were not statistically significant.
Conclusion
These results supports the fact that women with a high level of education and those with pre-conceptional education from a health care provider are more likely to be aware and have knowledge of folic acid, though this does not translate into use. Antenatal and population based health educational strategies and campaigns by health care providers targeting pregnant and child bearing age women, especially those with low levels of educational may improve use.
Human umbilical cord-derived mesenchymal stem cells ameliorate experimental colitis by normalization of gut microbiota
Authors: Yang Fan , Ni Beibei , Liu Qiuli , He Fangping , Li Li , Zhong Xuemei , Zheng Xiaofan , Lu Jianxi , Chen Xiaoyan , Lin Huizhu , Xu Ruixuan , He Yizhan , Zhang Qi , Zou Xiaoguang , Chen Wenjie
Published: May 2022

Background Crohn's disease (CD) is a chronic nonspecific inflammatory bowel disease. Current CD therapeutics cannot fundamentally change the natural course of CD and therefore it is of great significance to find new treatment strategy for CD. Preclinical and clinical studies have shown that mesenchymal stromal cells (MSCs) are a promising therapeutic approach, However，the mechanism of MSC alleviating CD and how MSC affects gut microbes is still unclear and needs to be further elucidated. MethodsWe used 2,4,6-trinitrobenzenesulfonic acid (TNBS) to induce experimental colitis in mice, and analyzed the microbiota in the fecal samples, which come from the control group, the TNBS group and the TNBS+MSC group with fecal 16S rDNA sequencing. Subsequent analysis of alpha and beta diversity were all performed based on the rarified data. PICRUStII analysis was subsequently performed from 16S rRNA gene sequences to infer gut microbiome functions. ResultsMSCs treatment improved the TNBS-induced colitis by increasing survival rates, relieving symptoms. A distinct bacterial signature was found in the TNBS group that differed from the TNBS+MSC group and controls. MSC alleviated the increased activities of sulfur and riboflavin metabolism.Meanwhile some metabolisms such as biosynthesis of amino acids，lysine biosynthesis, sphingolipid metabolism，secondary bile acid biosynthesis were decreased in the TNBS group when compared with the control group and the TNBS+MSC group.ConclusionsMSC treatment could modulate the dysregulated metabolism pathways in mice with colitis, restoring the abnormal microbiota function to a normal situation as the control group.
Domains of competence in midwifery students:A basis for developing a competence assessment tool for Iranian undergraduate midwifery students
Authors: Firoozehchian Firoozeh , Zareiyan Armin , Geranmayeh Mehrnaz , Moghadam Zahra Behboodi
Published: May 2022

Background:Given the growing importance of competence-based midwifery education, this study was conducted to explain the domains of clinical competence in midwifery students. Methods: Qualitative approach and conventional content analysis were used in the design of the present study. The research setting included midwifery and nursing schools and hospitals and health centers affiliated to Tehran and Guilan universities of medical sciences in Iran. The target population consisted of undergraduate midwifery students in the fourth to eighth semesters of school, midwives working in hospitals and health centers, midwifery faculty members, and obstetricians. The participants were selected through purposive maximum variation sampling, which continued until data saturation. After in-depth semi-structured interviews, the content of the interviews was analyzed according to the steps proposed by Zhang & Wildemuth. Results: Twenty-four people participated in this study, including seven midwifery students, seven midwives, nine midwifery and reproductive and sexual health faculty members, and one obstetrician. The participants were aged 20-56 years and their mean age was 39.75 years. Their level of education varied from midwifery student to PhD. The mean work experience of the participants was 13.62 years and the mean duration of the interviews was 48 minutes. The analysis of the data obtained from the experiences of the participants led to the formation of the four categories of ethical and professional function in midwifery, holistic midwifery care, effective interaction, and personal and professional development, along with ten subcategories. Conclusion: The findings of the present study showed that clinical competence in midwifery students involves different domains that correspond well overall to the general definitions of clinical competence in different sources. These findings can be used as a basis for the design and psychometric assessment of a clinical competence assessment tool for undergraduate midwifery students.
Towards Precision Home Visiting: Results at Six Months Postpartum from a Randomized Pilot Implementation Trial to Assess the Feasibility of a Precision Approach to Family Spirit
Authors: Ingalls Allison , Rebman Paul , Martin Lisa , Kushman Elizabeth , Leonard Amanda , Cisler Aimee , Gschwind Ingrid , Brayak Amanda , Amsler Ann Marie , Haroz Emily E.
Published: May 2022

Background: Shared implementation challenges at scale in early childhood home visiting have led researchers to explore precision home visiting as a promising service delivery mechanism to better address families’ unique needs and build greater program efficiencies. This randomized controlled pilot study aimed to assess the acceptability of a precision approach to one home visiting model, Family Spirit® and explore potential differences between Precision Family Spirit (PFS) and Standard Family Spirit (Standard FS) on participant-home visitor relationship and maternal outcomes. Methods: Participants (N=60) were at least 14 years old, pregnant or within two months postpartum, and enrolled in Family Spirit. Four sites in Michigan were randomized 1:1 to deliver PFS (up to 17 core lessons plus up to 13 additional lessons as needed) or Standard FS (home visiting services as usual). Primary (program acceptability, participant satisfaction, home visitor-participant relationship quality, retention, adherence) and secondary (knowledge, quality of life, difficulty with parenting problems, substance use, depression, stress) outcomes at 6 months postpartum are presented. PFS participants only were assessed during home visits on a subset of secondary measures that informed which lessons they should receive. Results: Mothers in both groups reported positive program acceptability, satisfaction, and home visitor-participant relationships at 6 months postpartum. However, open-ended feedback from Standard FS participants indicates that some lesson content may not be applicable to all participants. At six months, retention was 82.3% for PFS and 66.7% for Standard FS, and adherence was 30.1% for PFS and 20.6% for Standard FS. Conclusions: Preliminary findings indicate that precision home visiting may be acceptable and feasible, yet more research is needed to understand its impact as an implementation strategy. Trial registration: ClinicalTrials.gov NCT03975530 (first posted on 05/06/2019)
“We start where we are”: A qualitative study of barriers and pragmatic solutions to the assessment and reporting of implementation strategy fidelity
Authors: Akiba Christopher F , Powell Byron J , Pence Brian W , Muessig Kate , Golin Carol E. , Go Vivian
Published: May 2022

Background: Fidelity measurement of implementation strategies is underdeveloped and underreported, and the level of reporting is decreasing over time. Failing to properly measure the factors that affect the delivery of an implementation strategy may obscure the link between a strategy and its outcomes. Barriers to assessing and reporting implementation strategy fidelity among researchers are not well understood. The aims of this qualitative study were to identify barriers to fidelity measurement and pragmatic pathways towards improvement. Methods: We conducted in-depth interviews among researchers conducting implementation trials. We utilized a theory-informed interview approach to elicit the barriers and possible solutions to implementation strategy fidelity assessment and reporting. Reflexive-thematic analysis guided coding and memo-writing to determine key themes regarding barriers and solutions. Results: Twenty-two implementation researchers were interviewed. Participants agreed that implementation strategy fidelity was an essential element of implementation trials and that its assessment and reporting should improve. Key thematic barriers focused on (1) a current lack of validated fidelity tools with the need to assess fidelity in the short term, (2) the complex nature of some implementation strategies, (3) conceptual complications when assessing fidelity within mechanisms-focused implementation research, and (4) structural issues related to funding and publishing. Researchers also suggested pragmatic solutions to overcome each barrier. Respondents reported using specification and tracking data in the short term until validated tools become available. Participants suggested that researchers with strategy-specific content expertise lead the way in identifying core components and setting fidelity requirements for them. Addressing the third barrier, participants provided examples of what pragmatic prospective and retrospective fidelity assessments might look like along a mechanistic pathway. Finally, researchers described approaches to minimize costs of data collection, as well as more structural accountability like adopting and enforcing reporting guidelines or changing the structure of funding opportunities. Discussion: We propose short- and long-term priorities for improving the assessment and reporting of implementation strategy fidelity and the quality of implementation research. Conclusions: A better understanding of the barriers to implementation strategy fidelity assessment may pave the way toward pragmatic solutions.
Perceiving the landscape of fear for a semi-sessile ecosystem engineer - induced defensive and facilitative responses in mussels can be related to dose and origin of chemical cues
Authors: Capelle Jacob
Published: May 2022

Phenotypic plasticity in defensive traits (inducible defences) are energetically costly and are a trade off between growth and safety. Mussels live in high risk environments and, being semi-sessile perceive information on this environment via chemical cues. We hypothesize that in a natural situation different cues are simultaneously present in a dose that informs about density and type of predator. First, it is identified if the magnitude of the induced defense of the mussels is directly related to the degree of the dose of the chemical. Second, it is investigated if there is a difference in response to stimuli from different origin, as perceived by the mussel via chemical cues released. Chemical cues from an increasing number of predators, injured/dead conspecifics, aggregating mussels at high turbulence, and a combination of these factors are all observed. A toolkit was developed to quickly assess effects of the presence of various cues using formation and subsequent detachment of byssus treads as inducible defence. Results show that mussels can distinguish between chemical cues released by different predators and threats, and adjust their defensive response accordingly, but also respond to cues that give rise to facilitation (i.e. aggregation). Results further suggest that mussels react to risk relative to the threat it poses. A higher density of crabs evoked an increase in byssal thread production and the presence of sea stars only evoked an inducible defence in combination with crushed mussels. Energy allocation to deal with a threat is thereby increased only when the treat is immediate.
The value of hemodynamic parameters of uterine spiral arteries in predicting Gestational Diabetes Mellitus in first trimester
Authors: Wang Lei , Chen Ping , Mao Xiaoyuan , Ren Min
Published: May 2022

Purpose Early diagnosis of GDM and targeted blood glucose control treatment are crucial to improve maternal and infant health and to reduce the incidence of adverse pregnancy events. There is a lack of simple, effective and accurate screening methods that can be performed before 14 weeks of gestation. This study aimed to investigate the value of hemodynamic parameters of spiral artery in predicting GDM at 11 ~ 13 + 6 weeks of gestation. Methods To investigate the value of hemodynamic parameters of uterine spiral artery in predicting GDM in first trimester. We conducted a prospective case–control study, involving 1054 singleton pregnancies in our obstetric clinic of Shanghai First Maternal and Infant Hospital from January 2020 to June 2021. According to the follow-up results, they were divided into normal group (938 cases) and GDM group (116 cases). All pregnant women examined by Doppler ultrasonography in first-trimester to measure uterine spiral arterial hemodynamic parameters, including pulsation index (PI), resistance index (RI), peak systolic flow velocity (PSV) and mean diastolic velocity(MDV). The hemodynamic parameters of the GDM group and normal group were compared, and ROC curve was drawn to evaluate the efficacy of uterine spiral artery PI in predicting GDM. Results The PI value of uterine spiral artery in GDM group was higher than that in normal group (0.88 ± 0.16 vs. 0.63 ± 0.17), and the difference was statistically significant (t = 14.932, P < 0.05). The PSV and RI in GDM group were slightly lower than those in normal group, but the differences were not statistically significant (P > 0.05). The area under ROC curve of spiral artery PI for predicting GDM was 0.861 (95%CI: 0.827–0.895, P < 0.05), and PI 0.675 was the optimal threshold. The sensitivity and specificity of spiral artery PI for predicting GDM were 90.5% and73.3%, respectively. Conclusions: The changes of uterine spiral artery hemodynamic parameters at first-trimester of pregnancy may be related to the occurrence of GDM, and the PI value of uterine spiral artery has certain value in predicting GDM.