bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a hybrid point-of-care ultrasound curriculum for first year medical students in a rural medical education program: a pilot study
Authors: Johnson Joshua I. , Beasley Heather , Southwick Derek , Lords Allie M. , Kessler Ross , Vrablik Michael E. , Baker Russell T.
Published: January 2024

Background

The field of point-of-care ultrasound (POCUS) has advanced in recent decades due to the benefits it holds for medical providers. However, aspiring POCUS practitioners require adequate training. Unfortunately, there remains a paucity of resources to deliver this training, particularly in rural and underserved areas. Despite these barriers, calls for POCUS training in undergraduate medical education are growing, and many medical schools now deliver some form of POCUS education. Our program lacked POCUS training; therefore, we developed and implemented a POCUS curriculum for our first-year medical students.

Methods

We developed a POCUS curriculum for first year medical students in a rural medically underserved region of the United States. To evaluate our course, we measured learning outcomes, self-reported confidence in a variety of POCUS domains, and gathered feedback on the course with a multi-modal approach: an original written pre- and post-test, survey tool, and semi-structured interview protocol, respectively.

Results

Student (n=24) knowledge of POCUS significantly increased (pre-test average score = 55%, post-test average score = 79%, P<0.0001), and the course was well received based on student survey and interview feedback. In addition, students reported increased confidence toward a variety of knowledge and proficiency domains in POCUS use and their future clinical education and practice.

Conclusions

Despite a lack of consensus in POCUS education, existing literature describes many curricular designs across institutions. We leveraged a combination of student initiatives, online resources, remote collaborations, local volunteers, and faculty development to bring POCUS to our institution in a rural and medically underserved region. Moreover, we demonstrate positive learning and experiential outcomes that may translate to improved outcomes in students’ clinical education and practice. Further research is needed to evaluate the psychomotor skills, broader learning outcomes, and clinical performance of students who take part in our POCUS course.
Self-efficacy of medical students in a hybrid curriculum course (traditional and problem-based learning) and associated factors
Authors: Kubrusly Marcos , de Aquino Bianca Oriá Almada , Simonian Thomás Samuel , do Nascimento Oliveira Matheus , Rocha Hermano Alexandre Lima
Published: January 2024

Self-efficacy consists of the judgment of one’s abilities to perform actions required to achieve a given performance, which has been considered predictive of performance. In academics, it means personal convictions in accomplishing a task to a defined degree of quality. Numerous studies have investigated medical students’ self-efficacy in traditional and PBL curricula. However, few studies have addressed the hybrid PBL scenario (Hpbl) that simultaneously contemplates PBL, traditional teaching, and practical activities. An even smaller number have evaluated the factors associated with this entity. With these considerations, we aimed to investigate the self-efficacy belief in the hPBL curriculum and the factors associated with this entity. This quantitative observational cross-sectional study was held between August 2022 and November 2022 in Fortaleza, a city in Northeast Brazil with almost 3 million inhabitants. The medical course has 12 semesters. The first two semesters use traditional teaching and cover the basic cycle, followed by the third to eighth semesters which correspond to the pre-clinical and clinical cycle. From the third semester onwards, traditional teaching and PBL are used simultaneously, which we call a hybrid model of PBL. The scale “Scale of Self-efficacy in Higher Education” was applied, a questionnaire validated for the Portuguese language consisting of 34 questions, with answers on a Likert-type scale with ten points, divided into five dimensions. To verify the association between sociodemographic factors and self-efficacy, simple and multiple linear models with robust errors were used. In total, 412 students participated in this study, most of them women (70.1%). The average age of students was 22.9 years. All domains had medians greater than 8, which means strong self-efficacy. The following factors were associated with higher self-efficacy scores in general after the multivariate analysis: female gender (8.6 vs. 8.3, p-value = 0.014), working (8.8 vs. 8.5, p-value = 0.019) and participating in extracurricular activities (8.7 vs. 8.1, p-value = 0.019). We conclude that medical students studying in hybrid learning models showed strong levels of self-efficacy. In addition, participating in extracurricular activities was associated with higher self-efficacy scores and males presented lower levels of self-efficacy.
Evaluation of a patient-centered communication skills training for nurses (KOMPAT): study protocol of a randomized controlled trial
Authors: Lindig Anja , Mielke Kendra , Frerichs Wiebke , Cöllen Katja , Kriston Levente , Härter Martin , Scholl Isabelle
Published: January 2024

Background

To ensure high quality of nurses’ communication as part of patient-centered care, training of communication skills is essential. Previous studies indicate that communication skills trainings can improve communication skills of nurses and have a positive effect on emotional and psychological burden. However, most show methodological limitations, are not specifically developed for nurses or were developed for oncological setting only.

Methods

This study aims to evaluate the effectiveness of a needs-based communication skills training for nursing professionals and to derive indications for future implementation. A two-armed randomized controlled trial including components from both effectiveness and implementation research will be applied. Additionally, a comprehensive process evaluation will be carried out to derive indications for future implementation. Nurses (n=180) of a university medical center in Germany will be randomized to intervention or waitlist-control group. The intervention was developed based on the wishes and needs of nurses, previously assessed via interviews and focus groups. Outcomes to measure effectiveness were selected based on Kirkpatrick’s four levels of training evaluation and will be assessed at baseline, post-training and at 4-weeks follow-up. Primary outcome will be nurses’ self-reported self-efficacy regarding communication skills. Secondary outcomes include nurses’ communication skills assessed via standardized patient assessment, knowledge about patient-centered communication, mental and work-related burden, and participants’ satisfaction with training.

Discussion

To our knowledge, this is the first study systematically evaluating the effectiveness of a patient-centered communication skills training for nursing professionals in Germany. Results will yield insight whether a needs-based intervention can improve nurses’ self-efficacy regarding communication skills and other secondary outcomes.

Trial registration

Clinical trial registration number: NCT05700929, trial register: ClinicalTrials.gov (date of registration: 16 November 2022).
To capture the child’s interest - nurses experiences of ‘Saga stories in health talks’
Authors: Collan Camilla , Dahl Lina , Henström Maria , Nyström Christine Delisle , Löf Marie , Andermo Susanne
Published: January 2024

Background

As unhealthy lifestyle habits have been found to be established early in life and often track into adulthood, early preventive initiatives are important. ‘Saga Stories in health talks’ is a newly developed material that is intended to be used as a support for nurses at child health care (CHC) centers in their health talks with children and parents in Sweden. The aim of this study is to explore how CHC nurses experience the usability of the ‘Saga Stories in health talks’ material.

Methods

This study used a qualitative design. The material ‘Saga Stories in health talks’ was tested by 33 CHC nurses working in 11 CHC centers in three regions in Sweden. All CHC nurses were invited to participate in the interviews and 17 agreed. The interviews were transcribed and analysed using content analysis.

Results

Three categories and eight sub-categories emerged. The categories were: (1) An appreciated tool suitable for health talks, (2) Illustrations to capture children’s interest in the conversation with families, and (3) Barriers and facilitators. Saga Stories in health talks’ was experienced by the CHC nurses as an appreciated tool with content highly relevant to what should be discussed during the health talks. The CHC nurses described the material as well-designed with illustrations that helped them capture the child’s interest and increase their participation, while still involving the parents. Support from colleagues, the researchers, and managers were seen as important facilitators. Challenges included structural factors such as how and when to best use the material, especially concerning that the 4-year visit contained many other mandatory parts.

Conclusions

This pilot study show that the material ‘Saga Stories in health talks’ was highly appreciated by CHC nurses and facilitated their health talks with families in CHC. Important aspects with the material were the relevant content and the focus on healthy living habits, as well as the child friendly illustrations. These findings can be used when similar material is developed to facilitate health talks with families in other contexts. Our results also highlight the importance to adjust the implementation of a new material with already established practice and routines.
Perspectives of adult patients with mental health disorders on the relationship with nurses: a focus group study
Authors: Coelho Joana , Moreno Poyato Antonio , Roldán Merino Juan , Sequeira Carlos , Sampaio Francisco
Published: January 2024

Background

The relationship between the nurse and the patient with mental health disorder is crucial to the recovery process. Thus, patients with mental health disorders should be active subjects in this relationship by having autonomy and self-determination.

Methods

This study aimed to explore the perspectives of adult patients with mental health disorders on the relationship with nurses. A qualitative, descriptive, and exploratory study was conducted in March 2023, using focus group meetings in an association to support patients with severe mental health disorders in the Northern region of Portugal. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). A total of 8 patients participated in the study. Two focus group meetings were conducted. The inductive method was used, and content analysis of the transcripts was performed. The QDA Miner Lite 4.0 and Microsoft Excel were used for content analysis.

Results

Participants considered the relationship with nurses important for their recovery and expected nurses to provide support and help, being able to identify their needs, thus personalising their care. Attitudinal and communication aspects were also considered crucial for establishing a solid, trusting, and meaningful relationship.

Conclusion

According to the findings nursing care is expected to focus on the patient, his/her preferences, expectations, and the uniqueness of each individual. The results of this study may be useful for the reflection and improvement of nurses in their relational and communication skills and the driving force for nursing students’ awareness of the perspective of the relationship with patients with mental health disorder and its relevance.
Compassionate care of nurses for the elderly admitted to the COVID-19 wards in teaching hospitals of southern Iran
Authors: Faghihi Fereshte , Zarshenas Ladan , Tehranineshat Banafsheh
Published: January 2024

Background

Compassionate care is the main indicator of the quality regarding nursing care. The importance of this care in the recovery process for the elderly hospitalized for COVID-19 has been under-researched in studies. Therefore, this study aimed to determine the compassionate care level of nurses to the elderly hospitalized in the COVID-19 wards of teaching hospitals in the south of Iran.

Methods

This descriptive-analytical study was conducted on 212 nurses working in the COVID-19 wards of teaching hospitals in the south of Iran, who were selected through census in a cross-sectional study. The data were collected using the Tehranineshat et al. nurses’ compassionate care questionnaire and then the data were analyzed using descriptive and analytical statistics along with SPSS software version 22.

Results

The mean score of nurses’ compassionate care was 130.18 ± 9.42, which was at a high level. The highest and lowest scores were related to professional performance (43.17 ± 2.799) and empathic communication dimension (27.76 ± 2.970). No significant relationship was found between variables such as gender, marital status, education, work experience, and job position with the compassionate care score (P > 0.05).

Conclusion

Nurses providing care for hospitalized elderly are recommended to consider all aspects of compassionate care, especially empathic communication, in their educational planning.
Certified Registered Nurse Anaesthetists’ and Critical Care Registered Nurses’ perception of knowledge/power in teamwork with Anaesthesiologists in Sweden: a mixed-method study
Authors: Wising Jenny , Ström Madelene , Hallgren Jenny , Rambaree Komalsingh
Published: January 2024

Efficient teamwork is crucial to provide optimal health care. This paper focuses on teamwork between Anaesthesiologists (ANES), Certified Registered Nurse Anaesthetists’ (CRNA) and Critical Care Registered Nurses (CCRN) working in challenging environments such as the intensive care unit (ICU) and the operating room (OR). Conflicts are common between physicians and nurses, negatively impacting teamwork. Social hierarchies based on professional status and power inequalities between nurses and physicians plays a vital role in influencing teamwork. Foucault was a famous thinker especially known for his reasoning regarding power/knowledge. A Foucauldian perspective was therefore incorporated into this paper and the overall aim was to explore CCRN/CRNA perception of knowledge/power in teamwork with ANES.

Methods A mixed-method approach was applied in this study. Data was collected using a web-based questionnaire containing both closed-end and open-ended questions. A total of 289 CCRNs and CRNAs completed the questionnaire. Data analysis was then conducted through five stages as outlined by Onwuebugzie and Teddlie; analysing quantitative data in SPSS 27.0 and qualitative data with a directed content analysis, finally merging data together in ATLAS.ti v.23.

Results The result reveals a dissonance between quantitative and qualitative data; quantitative data indicates a well-functioning interdisciplinary teamwork between CCRN/CRNA and ANES - qualitative data highlights that there are several barriers and inequalities between the two groups. Medicine was perceived as superior to nursing, which was reinforced by both social and organisational structures at the ICU and OR.

Conclusion Unconscious rules underlying current power structures in the ICU and OR works in favour of the ANES and biomedical paradigm, supporting medical knowledge. To achieve a more equal power distribution between CCRN/CRNAs and ANES, the structural hierarchies between nursing and medicine needs to be addressed. A more equal power balance between the two disciplines can improve teamwork and thereby reduce patient mortality and improve patient outcomes.
Exploring healthcare providers’ perspectives on virtual care delivery: insights into telemedicine services
Authors: Abdelghany Israa K. , AlMatar Ranim , Al-Haqan Asmaa , Abdullah Israa , Waheedi Salah
Published: January 2024

Background

The rapid advancement of technology has led to a concurrent advancement of telemedicine, that is the delivery of medical services over a long distance using technological methods. The consistently growing numbers of COVID-19 cases warranted the use of telemedicine as an alternative method of care-delivery. This study aims to evaluate perceptions of healthcare services provided virtually among healthcare providers (HCPs) in Kuwait and to assess their acceptance and intention to implement such services.

Methods

An exploratory mixed methods design was conducted, where in phase one HCPs’ perceptions towards telemedicine were explored through an online questionnaire and the quantitative data were summarized by descriptive analysis using SPSS. Scores for usefulness and for attitude toward the use of telemedicine were calculated. Then semi-structured interviews were conducted in phase two and the qualitative data were analyzed thematically.

Results

In phase one, 421 HCPs answered the questionnaire. In terms of telemedicine knowledge, 15.4% of HCPs had previously used telemedicine technology and 39% already knew about it. Additionally, 42.3% preferred to use telemedicine, and 88.5% had a moderate to high usefulness score. Telemedicine’s ease of use was perceived positively. Attitude median score was 73 with an IQR of 16 (63–79). Half of the participants intend to use telemedicine.

In phase two, twenty-two interviews were conducted resulting in six themes; HCPs’ acceptance of telemedicine, facilitators and motives for telemedicine implementation, skills and training required to conduct telemedicine, barriers limiting the use of telemedicine, strategies to overcome the barriers, and benefits of telemedicine.

Conclusion

Most of the HCPs favor telemedicine integration into Kuwait’s healthcare system as their perceptions of telemedicine were overall positive, paving the way to develop implementation strategies.
Adaptation of the brainwriting premortem technique to inform the co-creation of COVID-19 testing strategies in underserved communities in South San Diego
Authors: Rabin Borsika A. , Cain Kelli L. , Ayers Lawrence O. , Lomeli Angel , Escoto Arleth , Burola Maria Linda , Aguilar Melanie , Calvillo Stephenie Tinoco , Reyes Breanna , Salgin Linda , Tukey Robert , Laurent Louise C. , Stadnick Nicole A.
Published: January 2024

Introduction

Meaningful engagement of partners in co-creating and refining health-related programs can increase the initial uptake, sustained implementation, broad reach, and effectiveness of these programs. This is especially important for underserved communities where resources are limited and need to be prioritized. Brainwriting premortem is a novel qualitative approach to partner engagement that combines the strengths of individual idea generation with the concept of premortem exercise that addresses failure points prior to the implementation of new programs.

Methods

An adapted form of brainwriting premortem was used to inform iterative refinements to a COVID-19 testing program at a Federally Qualified Health Center (FQHC) in San Diego. Patients and providers from the FQHC participated in interviews at two time points (early- and mid-implementation of the program). Interview data were transcribed, translated, and analyzed using a rapid qualitative approach. Key themes and sub-themes were identified and used to inform refinements to the program.

Results

A total of 11 patients (7 Spanish- and 4 English-speaking) and 8 providers participated in the brainwriting premortem interviews. Key themes related to possible reasons for COVID-19 testing program failure: advertising/sharing information; access to testing; handling of test results; staff and patient safety; patient beliefs and views regarding the SARS-CoV-2 virus; and COVID-19 testing options offered. Proposed solutions were offered for the key failures except for patient beliefs and views regarding the SARS-CoV-2 virus. Additional solutions offered were related to education, physical operations, and recruitment strategies. Real-time changes to the program flow and components were made in response to 7 suggestions from patients and 11 from providers. Changes related to the process of returning results were the most common, and included sending results via email with distinct workflows based on the test result.

Conclusion

The implementation of the adapted brainwriting premortem technique allowed us to incorporate the perspective of key partners in the delivery and iterative refinement of the COVID-19 testing program. This was an effective tool in the context of an FQHC and can be a promising and approach to incorporate iterative input from patients and providers to ensure successful program implementation. Future studies, particularly those requiring rapid response to public health emergencies, should consider the use of this technique.
Morphology-based deep learning enables accurate detection of senescence in mesenchymal stem cell cultures
Authors: He Liangge , Li Mingzhu , Wang Xinglie , Wu Xiaoyan , Yue Guanghui , Wang Tianfu , Zhou Yan , Lei Baiying , Zhou Guangqian
Published: January 2024

Background

Cell senescence is a sign of aging and plays a significant role in the pathogenesis of age-related disorders. For cell therapy, senescence may compromise the quality and efficacy of cells, posing potential safety risks. Mesenchymal stem cells (MSCs) are currently undergoing extensive research for cell therapy, thus necessitating the development of effective methods to evaluate senescence. Senescent MSCs exhibit distinctive morphology that can be used for detection. However, morphological assessment during MSC production is often subjective and uncertain. New tools are required for the reliable evaluation of senescent single cells on a large scale in live imaging of MSCs.

Results

We have developed a successful morphology-based Cascade region-based convolution neural network (Cascade R-CNN) system for detecting senescent MSCs, which can automatically locate single cells of different sizes and shapes in multicellular images and assess their senescence state. Additionally, we tested the applicability of the Cascade R-CNN system for MSC senescence and examined the correlation between morphological changes with other senescence indicators.

Conclusions

This deep learning has been applied for the first time to detect senescent MSCs, showing promising performance in both chronic and acute MSC senescence. The system can be a labor-saving and cost-effective option for screening MSC culture conditions and anti-aging drugs, as well as providing a powerful tool for non-invasive and real-time morphological image analysis integrated into cell production.
DisoFLAG: accurate prediction of protein intrinsic disorder and its functions using graph-based interaction protein language model
Authors: Pang Yihe , Liu Bin
Published: January 2024

Intrinsically disordered proteins and regions (IDPs/IDRs) are functionally important proteins and regions that exist as highly dynamic conformations under natural physiological conditions. IDPs/IDRs exhibit a broad range of molecular functions, and their functions involve binding interactions with partners and remaining native structural flexibility. The rapid increase in the number of proteins in sequence databases and the diversity of disordered functions challenge existing computational methods for predicting protein intrinsic disorder and disordered functions. A disordered region interacts with different partners to perform multiple functions, and these disordered functions exhibit different dependencies and correlations. In this study, we introduce DisoFLAG, a computational method that leverages a graph-based interaction protein language model (GiPLM) for jointly predicting disorder and its multiple potential functions. GiPLM integrates protein semantic information based on pre-trained protein language models into graph-based interaction units to enhance the correlation of the semantic representation of multiple disordered functions. The DisoFLAG predictor takes amino acid sequences as the only inputs and provides predictions of intrinsic disorder and six disordered functions for proteins, including protein-binding, DNA-binding, RNA-binding, ion-binding, lipid-binding, and flexible linker. We evaluated the predictive performance of DisoFLAG following the Critical Assessment of protein Intrinsic Disorder (CAID) experiments, and the results demonstrated that DisoFLAG offers accurate and comprehensive predictions of disordered functions, extending the current coverage of computationally predicted disordered function categories. The standalone package and web server of DisoFLAG have been established to provide accurate prediction tools for intrinsic disorders and their associated functions.
Development of prescribing indicators related to opioid-related harm in patients with chronic pain in primary care—a modified e-Delphi study
Authors: Bansal Neetu , Campbell Stephen M. , Lin Chiu-Yi , Ashcroft Darren M. , Chen Li-Chia
Published: January 2024

Background

Long-term opioid use is associated with dependency, addiction, and serious adverse events. Although a framework to reduce inappropriate opioid prescribing exists, there is no consensus on prescribing indicators for preventable opioid-related problems in patients with chronic pain in primary care in the UK. This study aimed to identify opioid prescription scenarios for developing indicators for prescribing opioids to patients with chronic pain in primary care.

Methods

Scenarios of opioid prescribing indicators were identified from a literature review, guidelines, and government reports. Twenty-one indicators were identified and presented in various opioid scenarios concerning opioid-related harm and adverse effects, drug-drug interactions, and drug-disease interactions in certain disease conditions. After receiving ethics approval, two rounds of electronic Delphi panel technique surveys were conducted with 24 expert panellists from the UK (clinicians, pharmacists, and independent prescribers) from August 2020 to February 2021. Each indicator was rated on a 1–9 scale from inappropriate to appropriate. The score’s median, 30th and 70th percentiles, and disagreement index were calculated.

Results

The panel unanimously agreed that 15 out of the 21 opioid prescribing scenarios were inappropriate, primarily due to their potential for causing harm to patients. This consensus was reflected in the low appropriateness scores (median ranging from 1 to 3). There were no scenarios with a high consensus that prescribing was appropriate. The indicators were considered inappropriate due to drug-disease interactions (n = 8), drug-drug interactions (n = 2), adverse effects (n = 3), and prescribed dose and duration (n = 2). Examples included prescribing opioids during pregnancy, concurrently with benzodiazepines, long-term without a laxative prescription and prescribing > 120-mg morphine milligram equivalent per day or long-term duration over 3 months after surgery.

Conclusions

The high agreement on opioid prescribing indicators indicates that these potentially hazardous consequences are relevant and concerning to healthcare practitioners. Future research is needed to evaluate the feasibility and implementation of these indicators within primary care settings. This research will provide valuable insights and evidence to support opioid prescribing and deprescribing strategies. Moreover, the findings will be crucial in informing primary care practitioners and shaping quality outcome frameworks and other initiatives to enhance the safety and quality of care in primary care settings.
Anti-cancer effects of DHP107 on canine mammary gland cancer examined through in-vitro and in-vivo mouse xenograft models
Authors: Chae Hyung-Kyu , Oh Ye-In , Lim Ga-Hyun , Jung Yun-Chan , Park Seol-Hee , An Ju-Hyun , Park Su-Min , Seo Kyoung-Won , Chu Sung-Nam , Li Qiang , Youn Hwa-Young
Published: January 2024

Background

Canine mammary gland cancer (CMGC) is a common neoplasm in intact bitches. However, the benefit of adjuvant chemotherapy is unclear. The aim of this study was to investigate the anti-proliferative effects of paclitaxel on CMGC in in-vitro and in-vivo settings.

Results

Paclitaxel dose-dependently inhibited viability and induced G2/M phase cell cycle arrest and apoptosis in both primary and metastatic CMGC cell lines (CIPp and CIPm). In animal experiments, the average tumour volume decreased significantly in proportion to the administered oral paclitaxel dose. By examining tumour tissue using a TUNEL assay and immunohistochemical staining with anti-CD31 as a marker of endothelial differentiation, respectively, it was confirmed that oral paclitaxel induced apoptosis and exerted an anti-angiogenetic effect in tumour tissues. Further, downregulation of cyclin D1 in tumour tissues suggested that oral paclitaxel induced cell cycle arrest in tumour tissues in-vivo.

Conclusions

Our results suggest that paclitaxel may have anti-cancer effects on CMGC through cell cycle arrest, induction of apoptosis, and anti-angiogenesis. This study could provide a novel approach to treat CMGC.
Characterization and optimization of 5´ untranslated region containing poly-adenine tracts in Kluyveromyces marxianus using machine-learning model
Authors: Zeng Junyuan , Song Kunfeng , Wang Jingqi , Wen Haimei , Zhou Jungang , Ni Ting , Lu Hong , Yu Yao
Published: January 2024

Background

The 5´ untranslated region (5´ UTR) plays a key role in regulating translation efficiency and mRNA stability, making it a favored target in genetic engineering and synthetic biology. A common feature found in the 5´ UTR is the poly-adenine (poly(A)) tract. However, the effect of 5´ UTR poly(A) on protein production remains controversial. Machine-learning models are powerful tools for explaining the complex contributions of features, but models incorporating features of 5´ UTR poly(A) are currently lacking. Thus, our goal is to construct such a model, using natural 5´ UTRs from Kluyveromyces marxianus, a promising cell factory for producing heterologous proteins.

Results

We constructed a mini-library consisting of 207 5´ UTRs harboring poly(A) and 34 5´ UTRs without poly(A) from K. marxianus. The effects of each 5´ UTR on the production of a GFP reporter were evaluated individually in vivo, and the resulting protein abundance spanned an approximately 450-fold range throughout. The data were used to train a multi-layer perceptron neural network (MLP-NN) model that incorporated the length and position of poly(A) as features. The model exhibited good performance in predicting protein abundance (average R2 = 0.7290). The model suggests that the length of poly(A) is negatively correlated with protein production, whereas poly(A) located between 10 and 30 nt upstream of the start codon (AUG) exhibits a weak positive effect on protein abundance. Using the model as guidance, the deletion or reduction of poly(A) upstream of 30 nt preceding AUG tended to improve the production of GFP and a feruloyl esterase. Deletions of poly(A) showed inconsistent effects on mRNA levels, suggesting that poly(A) represses protein production either with or without reducing mRNA levels.

Conclusion

The effects of poly(A) on protein production depend on its length and position. Integrating poly(A) features into machine-learning models improves simulation accuracy. Deleting or reducing poly(A) upstream of 30 nt preceding AUG tends to enhance protein production. This optimization strategy can be applied to enhance the yield of K. marxianus and other microbial cell factories.
Heterologous production of 3-hydroxypropionic acid in Methylorubrum extorquens by introducing the mcr gene via a multi-round chromosomal integration system based on cre-lox71/lox66 and transposon
Authors: Zhu Liping , Song Yazhen , Ma Shunan , Yang Song
Published: January 2024

Background and aim

Reprogramming microorganisms to enhance the production of metabolites is a part of contemporary synthetic biology, which relies on the availability of genetic tools to successfully manipulate the bacteria. Methylorubrum extorquens AM1 is a platform microorganism used to convert C1 compounds into various value-added products. However, the repertoire of available plasmids to conveniently and quickly fine-tune the expression of multiple genes in this strain is extremely limited compared with other model microorganisms such as Escherichia coli. Thus, this study aimed to integrate existing technologies, such as transposon-mediated chromosomal integration and cre-lox-mediated recombination, to achieve the diversified expression of target genes through multiple chromosomal insertions in M. extorquens AM1.

Results

A single plasmid toolkit, pSL-TP-cre-km, containing a miniHimar1 transposon and an inducible cre-lox71/lox66 system, was constructed and characterized for its multiple chromosomal integration capacity. A co-transcribed mcr-egfp cassette [for the production of 3-hydroxypropionic acid (3-HP) and a reporting green fluorescent protein] was added to construct pTP-cre-mcr-egfp for evaluating its utility in mediating the expression of heterologous genes, resulting in the production of 3-HP with a titer of 34.7–55.2 mg/L by two chromosomal integration copies. Furthermore, in association with the expression of plasmid-based mcr, 3-HP production increased to 65.5–92.4 mg/L.

Conclusions

This study used a multi-round chromosomal integration system based on cre-lox71/lox66 and a transposon to construct a single constructed vector. A heterologous mcr gene was introduced through this vector, and high expression of 3-hydroxypropionic acid was achieved in M. extorquens. This study provided an efficient genetic tool for manipulating M. extorquens, which not only help increase the expression of heterologous genes in M. extorquens but also provide a reference for strains lacking genetic manipulation vectors.
KCNA1 promotes the growth and invasion of glioblastoma cells through ferroptosis inhibition via upregulating SLC7A11
Authors: Wang Weichao , Zhang Yang , Li Xuetao , E Qinzi , Jiang Zuoyu , Shi Qikun , Huang Yu , Wang Jian , Huang Yulun
Published: January 2024

Background

The high invasiveness and infiltrative nature of Glioblastoma (GBM) pose significant challenges for surgical removal. This study aimed to investigate the role of KCNA1 in GBM progression.

Methods

CCK8, colony formation assay, scratch assay, transwell assay, and 3D tumor spheroid invasion assays were to determine how KCNA1 affects the growth and invasion of GBM cells. Subsequently, to confirm the impact of KCNA1 in ferroptosis, western blot, transmission electron microscopy and flow cytometry were conducted. To ascertain the impact of KCNA1 in vivo, patient-derived orthotopic xenograft models were established.

Results

In functional assays, KCNA1 promotes the growth and invasion of GBM cells. Besides, KCNA1 can increase the expression of SLC7A11 and protect cells from ferroptosis. The vivo experiments demonstrated that knocking down KCNA1 inhibited the growth and infiltration of primary tumors in mice and extended survival time.

Conclusion

Therefore, our research suggests that KCNA1 may promote tumor growth and invasion by upregulating the expression of SLC7A11 and inhibiting ferroptosis, making it a promising therapeutic target for GBM.
Signal-to-noise of linear and volume measures of left ventricular and left atrial size
Authors: Duan Yunbo , Amir Nezar , Armstrong Guy P.
Published: January 2024

Background

Serial echocardiographic assessments are common in clinical cardiology, e.g., for timing of intervention in mitral and aortic regurgitation. When following patients with serial echocardiograms, each new measurement is a combination of true change and confounding noise.

The current investigation compares linear chamber dimensions with volume estimates of chamber size. The aim is to assess which measure is best for serial echocardiograms, when the ideal parameter will be sensitive to change in chamber size and have minimal spurious variation (noise). We present a method that disentangles true change from noise. Linear regression of chamber size against elapsed time gives a slope, being the ability of the method to detect change. Noise is the scatter of individual points away from the trendline, measured as the standard error of the slope. The higher the signal-to-noise ratio (SNR), the more reliably a parameter will distinguish true change from noise.

Methods

LV and LA parasternal dimensions and apical biplane volumes were obtained from serial clinical echocardiogram reports. Change over time was assessed as the slope of the linear regression line, and noise was assessed as the standard error of the regression slope. Signal-to-noise ratio is the slope divided by its standard error.

Results

The median number of LV studies was 5 (4–11) for LV over a mean duration of 5.9 ± 3.0 years in 561 patients (diastole) and 386 (systole). The median number of LA studies was 5 (4–11) over a mean duration of 5.3 ± 2.0 years in 137 patients.

Linear estimates of LV size had better signal-to-noise than volume estimates (p < 0.001 for diastolic and p = 0.035 for systolic). For the left atrium, the difference was not significant (p = 0.214). This may be due to sample size; the effect size was similar to that for LV systolic size. All three parameters had a numerical value of signal-to-noise that favoured linear dimensions over volumes.

Conclusion

Linear measures of LV size have better signal-to-noise than volume measures. There was no difference in signal-to-noise between linear and volume measures of LA size, although this may be a Type II error. The use of regression lines may be better than relying on single measurements. Linear dimensions may clarify whether changes in volumes are real or spurious.

Graphical Abstract
NET1 is a critical regulator of spindle assembly and actin dynamics in mouse oocytes
Authors: Wang Shiwei , Wu Xuan , Zhang Mengmeng , Chang Siyu , Guo Yajun , Song Shuang , Dai Shizhen , Wu Keliang , Zeng Shenming
Published: January 2024

Background

Neuroepithelial transforming gene 1 (NET1) is a RhoA subfamily guanine nucleotide exchange factor that governs a wide array of biological processes. However, its roles in meiotic oocyte remain unclear. We herein demonstrated that the NET1-HACE1-RAC1 pathway mediates meiotic defects in the progression of oocyte maturation.

Methods

NET1 was reduced using a specific small interfering RNA in mouse oocytes. Spindle assembly, chromosomal alignment, the actin cap, and chromosomal spreads were visualized by immunostaining and analyzed under confocal microscopy. We also applied mass spectroscopy, and western blot analysis for this investigation.

Results

Our results revealed that NET1 was localized to the nucleus at the GV stage, and that after GVBD, NET1 was localized to the cytoplasm and predominantly distributed around the chromosomes, commensurate with meiotic progression. NET1 resided in the cytoplasm and significantly accumulated on the spindle at the MI and MII stages. Mouse oocytes depleted of Net1 exhibited aberrant first polar body extrusion and asymmetric division defects. We also determined that Net1 depletion resulted in reduced RAC1 protein expression in mouse oocytes, and that NET1 protected RAC1 from degradation by HACE1, and it was essential for actin dynamics and meiotic spindle formation. Importantly, exogenous RAC1 expression in Net1-depleted oocytes significantly rescued these defects.

Conclusions

Our results suggest that NET1 exhibits multiple roles in spindle stability and actin dynamics during mouse oocyte meiosis.
Diagnostic and prognostic potential of long non-coding RNA NORAD in patients with acute deep vein thrombosis and its role in endothelial cell function
Authors: Zhou Kun , Li Na , Qi Jia , Tu Pingping , Yang Yan , Duan Hui
Published: January 2024

Background

Deep venous thrombosis (DVT) is the common clinical cardiovascular disease, and easily develops into post-thrombotic syndrome (PTS). The study aimed to examine the clinical value of long non-coding RNA NORAD gene in the development of DVT and PTS. In vitro, the underlying mechanism was explored.

Methods

Serum levels of lncRNA NORAD gene in 85 DVT cases and 85 healthy individuals were tested. The role of lncRNA NORAD gene in human umbilical vein endothelial cells (HUVECs) proliferation, migration and inflammation was examined. The candidate downstream target gene was predicted via bioinformatic analysis. Gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were done for the function annotation and pathway enrichment.

Results

LncRNA NORAD gene was at high expression in the serum of DVT patients, it can distinguish DVT patients from healthy controls with the area under the curve of 0.919. Elevated expression of lncRNA NORAD gene in PTS patients was detected, DVT cases with high expression of lncRNA NORAD gene were more susceptible to PTS. LncRNA NORAD gene knockdown promoted HUVECs’ proliferation, migration while suppressing cell apoptosis and inflammation. MiR-93-5p served as a target of lncRNA NORAD gene, and its overexpression reversed the role of lncRNA NORAD gene in the biological function of HUVECs. The target genes of miR-93-5p were enriched in HIF-1 signaling, TGF-beta signaling and PI3K-Akt signaling, protein-protein interaction (PPI) network indicated STAT3, MAPK1 to be the key targets.

Conclusions

Upregulation of expression of lncRNA NORAD gene was a potential diagnostic biomarker for DVT and related to the development of PTS. LncRNA NORAD/miR-93-5p axis was involved in the progress of DVT through regulating endothelial cell function.
Hesitancy among Iranian nursing students regarding future career trajectory: a qualitative analysis
Authors: Shafiei Farnoosh , Amini-Rarani Mostafa , Ponnet Koen , Moeeni Maryam
Published: January 2024

Background

The shortage of skilled nurses is a major concern for health systems worldwide. This may be partly due to the hesitancy of some nurses to enter or remain in the nursing career. This shortage consequently reduces the quality of standard patient care, increases patients’ length of stay in a hospital, increases medical costs, and results in patients’ dissatisfaction. This study aimed to explore hesitancy among senior undergraduate nursing students to pursue a career in nursing.

Methods

This qualitative study adopted a thematic analysis approach. The population comprised senior undergraduate nursing students at Isfahan University of Medical Sciences, Iran, who indicated that they were hesitant to pursue a career in nursing. The study sampling was performed from May 2021 till February 2022 and continued until data saturation. Twenty-four interviews were conducted with the selected students. The attributes related to hesitancy among senior undergraduate nursing students to pursue a career in nursing were extracted as themes and sub-themes.

Results

Four themes were identified: academic idiosyncrasies, individual characteristics, poor nursing market regulations (sub-themes: nursing as a tough and intense career, and unfavorable employment contracts), and the peculiarities of the workplace (sub-themes: conflict within work environment, and barriers to professional nursing practice).

Conclusions

The findings of this study showed that senior undergraduate nursing students weigh their future career options from various academic, personal, professional, and work environment dimensions. The findings provide new insights for decision makers to design and implement innovative strategies to promote retention in nursing careers. We recommend to provide academic counseling for all students and applicants of nursing before they enter the nursing education. Furthermore, we suggest to improve study and work environments, and to implement incentive programs to enhance enthusiasm of nursing students for pursuing a nursing career.
Factors affecting the quality of working life among nurses caring for Syrian refugee camps in Jordan
Authors: Oweidat Islam , Omari Abeer , ALBashtawy Mohammed , Al Omar Saleh  , Alrahbeni Tahani , Al-Mugheed Khalid , Alsheikh Ayman Daifallah Ismail
Published: January 2024

Objectives

The global refugee crisis, exacerbated by the Syrian war, has placed tremendous strain on Jordan’s healthcare system and infrastructure, notably impacting nurses working in refugee camps. The aim to identify factors influencing nurses’ Quality of life at work (QWL) and understand their significance in crisis healthcare environments.

Methodology

A cross-sectional study was conducted in multiple healthcare facilities within Syrian refugee camps. A convenient sample of 166 nurses participated, and data were collected using the Brook’s Quality of Nursing Work Life Survey. Data analysis included descriptive and inferential (one-way ANOVA) statistics. Significance level was set at 0.05.

Results

Nurses in this study generally reported a moderate QWL, with an average score of 152.85, indicating that their overall work experience falls into the moderate range. The study found that nurses perceived their work-life/home-life balance (mean score 25.79), work design (mean score 35.71), work context (mean score 71.37), and work world (mean score 19.96) at levels indicative of moderate satisfaction. There were no statistically significant differences in QWL among participating nurses, suggesting that factors other than demographic characteristics may play a more influential role in determining nurses' QWL in the unique context of refugee caregiving.

Conclusion

This study underscores that working within refugee healthcare missions and recommends targeted interventions to enhance their well-being.
"Research ends with publication": a qualitative study on the use of health policy and systems research in Ethiopia
Authors: Morankar Sudhakar , Abraham Gelila , Shroff Zubin , Birhanu Zewdie
Published: January 2024

Background

Decision-making about the design and implementation of health care policies should be supported by research evidence. This article reports on a qualitative study on the experiences of both research institutes and policymakers in Ethiopia in generating and using research evidence to inform health policy decision-making.

Methods

Semi-structured interviews were conducted from January through March 2020, with representatives of research institutes and with policymakers in Ethiopia. The data collected during the interviews were analyzed thematically.

Results

Half of the institutions represented had engaged in health policy and systems research (HPSR). These institutes’ capacities were limited by multiple factors, including unsupportive research environments; the limited number of researchers with extensive experience; high turnover among senior researchers; lack of staff motivation mechanisms; underdeveloped research culture; limited technical and analytical capacity among researchers; lack of core funding for HPSR; ineffective financial management; and, lack of connections with health policy platforms. Research institutes also lacked the capacity in strategic packaging of findings to influence policy decision-making, although some programs have recently improved in this area. Meanwhile, there lacked a culture of using evidence in policymaking settings. In general, we found that policymakers had poor attitudes towards the quality or value of the evidence, and had little capacity to interpret evidence and apply findings to policy options. As a result, much of the research produced by the institutes have only been relevant academically, with little impact on policy. However, respondents reported that the environment is slowly changing, and the recent creation of a Research Advisory Council at the Ministry of Health offers a promising model.

Conclusions

Despite some recent changes, in Ethiopia researchers and policymakers alike often tend to consider health policy and systems research (HPSR) to be not very valuable since the findings generated are rarely used for evidence-informed policy development. Research institutes and researchers need to strengthen their technical, analytical, and administrative capacities (through, among other efforts, seeking more funding for research, and better incentives to attract, retain and build skills among qualified researchers); they also need to improve their understanding of the evidence-to-policy cycle and how to engage effectively with policymakers.