bluuebunny/crossref_metadata_2025 huggingface dataset:
House officers’ specialist career choices and motivators for their choice– a sequential mixed-methods study from Malaysia
Authors: Nadarajah Anuradha , Shankar Pathiyil Ravi , Jayaraman Sivakumaran , Sreeramare Chandrashekhar
Published: June 2022

Background
Shortage and maldistribution of medical specialists hamper healthcare quality. The specialist career choices of house officers determine the composition healthcare system. We studied house officers’’ specialist career choices and motivators for their choice.
Methods
An exploratory sequential mixed-methods study was done. We conducted online in-depth interviews among seven house officers using an interview guide developed based on a literature review. The transcripts were analyzed thematically. A 33-item questionnaire was developed, and the main and sub-themes were identified as motivators for specialist career choice. An online survey was done among a random sample of 185 house officers. Content validation of motivators for specialist choice was done using exploratory factor analysis. First, the second and third choices for a specialist career were identified. Multinomial logistic regression analyses were done to determine the socio-demographic factors and motivators associated with the first choice.
Results
Two major themes were identified from the in-depth interviews with house officers. Perceptions about specialist training opportunities were positive as they gain a wide range of clinical competencies through well-structured, comprehensive training programs under existing specialist training pathways. However, the limited availability of Malaysian local university training opportunities and challenges of ‘on-contract’ to pursue specialist training were the main challenges. The motivational factors for first-choice specialty were related to ‘work schedule’, ‘patient care characteristics’, ‘specialty characteristics’, ‘personal factors’, ‘past work experience’, ‘training factors’, and ‘career prospects.’ Overall Cronbach’s alpha for the questionnaire on motivators was 0.85. Exploratory factor analyses retained 26 out of 33 items in seven constructs with a 64.9% variance. House officers’ first choices were specialties related to medicine (40.5%), surgery (31.5%), primary care (14.6%), and acute care (13.5%). On multivariate analysis, “younger age”, “health professional in the family”, “work schedule and personal factors”, “career prospects” and “specialty characteristics” were associated with the first choice.
Conclusions
Specialties related to medical and surgical disciplines were the most preferred disciplines. Motivators for the first choice varied by discipline. The information motivational factors are helpful to develop policies to encourage more doctors to choose specialties with a shortage of doctors and to provide career specialty guidance.
Structure of fish assemblages with the bioinvasion of Clarias gariepinus in a river in the Guapimirim Environmental Protection Area, southeastern Brazil.
Authors: Dumith Michelle Torres , Santos Alejandra FGN
Published: June 2022

The African sharptooth catfish (Clarias gariepinus) is the most important catfish species for aquaculture. It has great capacity to endure several stressing factors, such as adverse environmental conditions, as well as a broad feeding flexibility. Notwithstanding, the presence of this alien fish in the Guapimirim Environmental Preservation Area, in Southeast of Brazil, may generate negative impacts on the community of native fish. In 2018, during dry and rainy seasons, samples from the fish community were collected in thirty-two sites of the Guapi-Macacu River, and the abiotic variables (salinity, pH, temperature, turbidity, dissolved oxygen, and transparency) were assessed to diagnose which factors influence in the distribution of the alien fish along the river. Moreover, species within the ichthyofauna were evaluated as bioindicators to identify possible alterations in the community. Multivariate analyzes indicated that the African sharptooth catfish dominates the buffer zone of the environmental protection area, benefiting from higher levels of dissolved oxygen and temperature. However, C. gariepinus still do not dominate the most protected area of Guapimirim, where a higher percentage of native fish species dwell. The alterations in abiotic factors, related to the increase in the temperature, may significantly contribute to the domination of this invading alien fish in this protected area, being necessary the constant monitoring of some key species, as well as the population of the invading species in this environmental preservation area.
Thermochemical Recovery from the Sustainable Economy Development Point of View – LCA Based Reasoning for EU Legislation Changes
Authors: Tomic Tihomir , Slatina Iva , Schneider Daniel Rolph
Published: June 2022

The EU legislation put the focus on the material recovery of waste while energy recovery is not elaborate enough and all thermochemical conversion technologies are classified in the same category regardless of the final products, which can hamper overall sustainability. Therefore, this research analyses technologies for recovery of plastic waste to review the existing EU legislation and technology classifications. Most important LCA impact categories from the legislation point of view were identified and used in the analysis. As alternative thermochemical recovery technologies are not widely used, their inventories were modelled based on an extensive literature review. Results show that pyrolysis of plastic waste has 46%, 90%, and 55%, while gasification up to 24%, 8%, and 91%, lower global warming, abiotic depletion, and cumulative energy demand related impacts respectively, compared to incineration with CHP generation. Incineration-based scenarios show lower impacts only in the acidification potential category which is dependent on energy mixes of substituted energy vectors which are quickly changing due to the energy transition. Thus, alternative thermochemical recovery technologies can help in reaching sustainable development goals by lowering environmental impacts and import dependence. But, before considering new investments, the substitution of less environmentally sustainable fuels in facilities like cement kilns needs to be looked upon. Results of this analysis provide levelised results for environmental and resource sustainability based on which current legislative views on individual thermochemical recovery technologies may be re-examined.
Person-Centered Care Research in Ghana: a Scoping Review Protocol
Authors: Amoh Gordon , Addo Alex Kweku , Odiase Osamuedeme , Tahir Peggy , Getahun Monica , Aborigo Raymond , Essuman Akye , Yawson Alfred E , Essuman Vera Adobea , Afulani Patience A
Published: June 2022

Background: Person-centered care (PCC) is provision of care that is respectful of and responsive to in­dividual patient preferences, needs, and values, and ensures that patient values guide all clinical decisions. While there is a large body of evidence on the benefits of PCC in high-income countries, little research exists on PCC in Ghana and Sub-Saharan Africa at large. Most studies on PCC have focused on maternity care as part of the global movement of respectful maternity care. The few studies on patient experiences and health system responsiveness beyond maternal health also highlight gaps in patient experience and satisfaction, as well as discrimination in health facilities which leads to the most vulnerable having the poorest experiences. This scoping review aims to systematically map the extent of literature focused on PCC in Ghana by identifying patient expectations and preferences, barriers and facilitators, and interventions regarding PCC in Ghana.Methods: This protocol will be guided by the Arksey and O’Malley methodological framework and recommendations by Levac, Colquhoun and O'Brien. A comprehensive search strategy will be used to search for published articles in PubMed, EMBASE, Web of Science, and the African Journals Online (AJOL) from their inception to December 2021. Grey literature and reference lists of included studies will also be searched. Two independent reviewers will perform the literature search, eligibility assessments, and study selection. Any disagreements will be resolved through discussion with a third reviewer. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram for the scoping reviews (PRISMA-ScR) will be used to outline the study selection process. Extracted data from the included articles will be synthesised and reported under key concepts derived from the outcomes of the scoping review.Discussion: The findings from this proposed scoping review on documented person-centeredness of care and patient expectations and preferences regarding PCC will be useful information for policymakers to consider in rolling out healthcare strategies that are driven by patient interest. Also, identification of various barriers and facilitators and evidence of effective PCC interventions will have implications on policy, practice, and further research in Ghana.Scoping review registration: OSF Registration DOI 10.17605/OSF.IO/ZMDH9
Pilonidal cyst with malignant degeneration: a case report
Authors: Bonilla Sergio Cervera , Marin Manuela Ramirez , Buendia Margarita Tamayo , Cortes Maddy Mejia , Gonzalez Rocio Mariño , Lopez Liliana Cuevas
Published: June 2022

Introduction: Pilonidal cyst is a frequent surgical pathology with low risk of malignancy. Here, we present a case of a chronic pilonidal cyst with transformation to skin squamous cell carcinoma. Case presentation: A 67-year-old male patient with a chronic presentation of injury in the sacrococcygeal region with occasional bleeding that got worse with progressive growth and purulent discharge. Initially was treated as a soft tissue infection with oral antibiotics but did not solve. A skin biopsy reported a squamous cell carcinoma, extension studies showed no secondary disease of the lesion. The patient was treated as if he was diagnosed a squamous cell carcinoma of the anal margin. Treatment was initiated with Nigro protocol chemoradiotherapy and wide local resection of the lesion with oncological margins of 1 cm with success.Discussion: The pilonidal cyst is an episodic inflammatory disease in the sacrococcygeal zone that usually responses to antibiotic treatment and surgery if it’s necessary, malignant degeneration is rare, might it be related with chronic inflammation that affects repair mechanisms and create a predisposition for malignancy. The optimal treatment is in bloc surgical resection with tumor-free margins and complementary treatment depends on the histology.Conclusion: This is an uncommon case of a Pilonidal cyst with transformation to skin squamous cell carcinoma managed with Nigro protocol chemoradiotherapy and wide local resection. This case will give surgeons another tool to treat this condition.
Arrhenius equation construction and nitrate source identification of denitrification at the Lake Taihu sediment−water interface with 15N isotope
Authors: Ma Qiuxia , Pang Min , Pang Yong , Zhang Lu , Huang Zhilin
Published: June 2022

Total nitrogen in Taihu Lake, China has gradually decreased since 2015 while the total phosphorus concentration has exhibited an increasing trend, indicating an asynchronous change. The dominant nitrogen removal process in freshwater ecosystems is denitrification which primarily occurs at the sediment–water interface. In this study, 15N isotope incubation experiments were attempted to analyze the effect of water temperature on denitrification, to construct the regional denitrification Arrhenius equations considering water temperature, and to identify the nitrate source of denitrification in Lake Taihu sediments. The results indicated that the potential N2 production rates and denitrification rates generally decreased in the west to east direction, which was significantly positively correlated with the nitrate concentration of overlying water by Pearson correlation coefficient analysis (P < 0.05). In addition, when the water temperature was lower than 30°C, the rates of the potential N2 production and denitrification were higher with an increase in water temperature, but when the water temperature was overhigh, denitrification was inhibited. The ratio of the total denitrification rate of nitrate from the water column in the sediment to the total denitrification rate during the incubation experiment was above 0.5 at each sampling site. This indicated that the denitrification in the Lake Taihu sediment primarily occurred at the expense of nitrate from the water column. The research results of Arrhenius equation construction and nitrate source identification of denitization can be applied to improve the accuracy of water quality model of Taihu Lake, which is of great significance to improve Taihu Lake water quality, and can act as a reference for the water environment treatment of other shallow eutrophic lakes in China and abroad.
Antibiotic allergy and blood eosinophils percent could be prognostic indicators of glioma
Authors: SUN QIAN , Cao Liming , WANG HUAN , Wang Weiliang , Li Xue , Shi Jing , Liang Hongsheng , Zhang Yiwei , Lv Zhonghua
Published: June 2022

Introduction: To estimate the effect of antibiotic allergy and blood eosinophil percentage (EOS%) on glioma prognosis and to conduct a nomogram model for glioma patients.Methods: We conducted a retrospective cohort study with 656 glioma patients to estimate the associations between antibiotic allergy, EOS% and glioma prognosis by Kaplan-Meier and Cox regression analysis. Stratified analyses were performed according to tumor grade. We constructed a nomogram with age at diagnosis, gender, tumor grade, antibiotic allergy, EOS% to predict the survival probabilities of glioma.Results: During 12 months follow-up, a total of 227 patients were alive and 318 patients died. Antibiotic allergy and EOS% >1.65 conferred a survival advantage on glioma patients. In the stratified analysis by tumor grade, antibiotic allergy was significantly associated with the prognosis of the prognosis of low-grade gliomas (HR = 0.36, 95%CI: 0.13–0.97) and high-grade gliomas (HR = 0.58, 95%CI: 0.36–0.93) in the univariate Cox regression analysis. However, after adjusting for confounding factors in the multivariate Cox regression analysis, antibiotic allergy was only significantly associated with high-grade gliomas (HRadj = 0.50, 95%CI: 0.30–0.82); the relationship between EOS% and glioma prognosis was restricted to low-grade gliomas (HRadj = 0.50, 95%CI: 0.30–0.82). The C-index of nomogram was 0.74.Conclusion: Antibiotic allergy was a protective prognosis factor of high-grade gliomas, EOS% >1.65 was a protective prognosis factor of low-grade gliomas. The nomogram with antibiotic allergy and EOS% could effectively predict the survival probability of glioma.
Influence of the direct and indirect effects of landscape fragmentation, via microclimate change, on animal locomotion
Authors: Tigreros Natasha , Kozhoridze Giorgi , Davidowitz Goggy , Ziv Yaron
Published: June 2022

Context Intensive use of agricultural land often modifies the landscape by dividing continuous natural habitat into smaller and more isolated patches. While it is widely recognized that landscape fragmentation is a main cause of species extinction, less is known about how this impacts the function of organisms that do persist in the modified environment. Understanding these effects is complicated by the fact that fragmentation can affect organisms directly but also indirectly, by altering the patch microclimatic conditions. Objectives We tested the hypothesis that fragmentation-induced microclimate change might be an important mechanism driving changes in animal locomotion in an agricultural landscape. Methods We used satellite image analysis, behavioral assays, and patch analyses, to disentangling the direct and indirect effects of fragmentation on the locomotor behavior of a darkling beetle, Zophosis punctata (Tenebrionidae), in the Southern Judea Lowlands in Israel. Results We found that fragmentation in an agricultural ecosystem may lead to changes in the thermal conditions of natural habitat patches. Importantly, such fragmentation-related increases in patch temperature played an important role in explaining variation in beetle locomotion across an agricultural landscape. Specifically, beetles from highly fragmented landscapes, which included warmer habitat patches, showed high locomotor intermittence –frequent pausing events during locomotion. Conclusions This study shows that the potential consequences of landscape fragmentation on the organism function are likely to be underestimated when fragmentation-related microclimate change is ignored. Intermittent locomotion, as opposite to steady locomotion, may provide various physiological and fitness benefits in fragmented landscapes, like mitigating performance limitations imposed by extreme thermal conditions.
Facilitators and Barriers to the Implementation of New Critical Care Practices during COVID-19: A Multicenter Qualitative Study using the Consolidated Framework for Implementation Research (CFIR)
Authors: Silver Santana , Jones Kayla Christine , Redmond Sarah , George Emily , Zornes Sarah , Barwise Amelia , Leppin Aaron , Dong Yue , Harmon Lori A. , Kumar Vishakha K. , Kordik Christina , Walkey Allan , Drainoni Mari-Lynn
Published: June 2022

Background
The COVID-19 pandemic produced unprecedented demands and rapidly changing evidence and practices within critical care settings. The purpose of this study was to identify factors and strategies that hindered and facilitated effective implementation of new critical care practices and policies in response to the pandemic.
Methods
We used a cross-sectional, qualitative study design to conduct semi-structured in-depth interviews with critical care leaders across the United States. The interviews were audio-taped and professionally transcribed verbatim. Guided by the Consolidated Framework for Implementation Research (CFIR), three qualitative researchers used rapid analysis methods to develop relevant codes and identify salient themes.
Results:
Among the 17 hospitals that agreed to participate in this study, 31 clinical leaders were interviewed. The CFIR-driven rapid analysis of the interview transcripts generated 12 major themes, which included six implementation facilitators (i.e., factors that promoted the implementation of new critical care practices) and six implementation barriers (i.e., factors that hindered the implementation of new critical care practices). These themes spanned the five CFIR domains (Intervention Characteristics, Outer Setting, Inner Setting, Characteristics of Individuals, and Process) and 11 distinct CFIR constructs. Salient facilitators to implementation efforts included staff resilience, commitment, and innovation, which were supported through collaborative feedback and decision-making mechanisms between leadership and frontline staff. Major identified barriers included lack of access to reliable and transferable information, available resources, uncollaborative leadership and communication styles.
Conclusions:
Through applying the CFIR to organize and synthesize our qualitative data, this study revealed important insights into implementation determinants that influenced the uptake of new critical care practices during COVID-19. As the pandemic continues to burden critical care units, clinical leaders should consider emulating the effective change management strategies identified. The cultivation of streamlined, engaging, and collaborative leadership and communication mechanisms not only supported implementation of new care practices across sites, but it also helped reduce salient implementation barriers, particularly resource and staffing shortages. Future critical care implementation studies should seek to capitalize on identified facilitators and reduce barriers.
Identification of Arsenic Spatial Distribution by Hydrogeochemical Processes Represented by Different Ion Ratios in the Hohhot Basin, China
Authors: Ren Yu , Cao Wengeng , Li Zeyan , Pan Deng , Wang Shuai
Published: June 2022

The Hohhot Basin, a typical inland basin of the Yellow River Basin in China, generally has high concentrations of arsenic (As) in its shallow groundwater, while the factors dominating the distribution of high arsenic levels remain to be further identified. An analysis of the ratio of hydrogeochemical compositions can help to reveal the spatial characteristics of the shallow groundwater environmental conditions and the distribution of high arsenic water (As > 10µg/L). In this study, a total of 170 samples of shallow groundwater in the Hohhot Basin were collected and water samples with As > 10µg/L accounted for 29.4% of the total. Based on the slope changes of the cumulative frequency curves of (HCO3−+CO32−)/SO42−, Ca2+/(HCO3−+CO32−), Ca2+/Mg2+ and Na+/Ca2+, the groundwater in the study area can be categorized into six different zones according to the environmental characteristics including redox condition, surface water recharge intensity and cation exchange level. The result shows that the groundwater in the front of the piedmont alluvial plain and platform is in a weak reducing condition with high lateral recharge intensity, fast runoff, and weak cation exchange. In the Dahei River alluvial plain, which serves as the groundwater discharge zone, the groundwater runoff is sluggish with poor lateral recharge, sufficient exchange between cations in the groundwater and the aquifer matrix, and enhanced reducibility. The degree of oxidation increased in the groundwater near the Hasuhai Lake and the drainage canal, which adverse to the arsenic enrichment. High arsenic groundwater is mainly distributed in aquifers of (HCO3−+CO32−)/SO42 > 10, Na+/Ca2+>13, and Ca2+/(HCO3−+CO32−) < 0.1, which represent the strong reducing condition, low surface water recharge intensity and strong cation exchange condition. Reductive dissolution of iron oxide, strong evaporation and concentration process, and competition from phosphate in aquifers jointly lead to the release of arsenic into groundwater.
A genome-wide screen reveals new regulators of the 2-cell-like cell state
Authors: Defossez Pierre-Antoine , Gupta Nikhil , Yakhou Lounis , Albert Julien Richard , Miura Fumihito , Ferry Laure , Kirsh Olivier , Azogui Anaelle , Yamaguchi Kohsuke , Laisné Marthe , Domrane Cécilia , Bonhomme Frédéric , Sarkar Arpita , Delagrange Marine , Ducos Bertrand , Cristofari Gael , Ito Takashi , Greenberg Maxim
Published: June 2022

In mammals, only the zygote and blastomeres of the early embryo are fully totipotent. This totipotency is mirrored in vitro by mouse "2-cell-like cells" (2CLCs), which appear at low frequency in cultures of Embryonic Stem cells (ESCs). Because totipotency is incompletely understood, we carried out a genome-wide CRISPR KO screen in mouse ESCs, searching for mutants that reactivate the expression of Dazl, a robust 2-cell-like marker. Using secondary screens, we identify four mutants that reactivate not just Dazl, but also a broader 2-cell-like signature: the E3 ubiquitin ligase adaptor SPOP, the Zinc Finger transcription factor ZBTB14, MCM3AP, a component of the RNA processing complex TREX-2, and the lysine demethylase KDM5C. Functional experiments show how these factors link to known players of the 2 cell-like state. These results extend our knowledge of totipotency, a key phase of organismal life.
Interactions between carbon nanotubes and external structures of SARS-CoV-2 using molecular docking and molecular dynamics
Authors: Lobato Júlio Cesar Mendes , Arouche Tiago da Silva , Nero Jordan Del , Filho Tarciso Andrade , Borges Rosivaldo dos Santos , Neto Antonio Maia de Jesus Chaves
Published: June 2022

Molecular modeling techniques are used to describe the process of interaction between nanotubes and the main structures of the Covid-19 virus: the envelope protein, the main protease, and the Spike glycoprotein. Molecular docking studies show that the ligands have interaction characteristics capable of adsorbing the structures. Molecular dynamics simulations provide information on the mean squared deviation of atomic positions ​​between 0.5 and 3.0 Å. The Gibbs free energy model and solvent accessible surface area approaches are used. Through the results obtained through molecular dynamics simulations, it is noted that the zigzag nanotube prefers to interact with E-pro, M-pro, and S-gly, respectively. Molecular couplings and free energy showed that the S-gly active site residues strongly interact with zigzag, chiral, and armchair nanotubes, in this order. The interactions demonstrated in this manuscript may predict some promising candidates for virus antagonists, which may be confirmed through experimental approaches.
How surface acting affects turnover intention among family doctors in rural China: The mediating role of emotional exhaustion and the moderating role of occupational commitment
Authors: Wang Anqi , Tang Changhai , Zhou Lifang , Lv Haiyuan , Song Jia , Chen Zhongming , Yin Wenqiang
Published: June 2022

Background: Family doctors in rural China are the main force for primary health care. It is critical to stabilize the Chinese healthcare system and improve the quality of primary health care by understanding family doctors’ turnover intention. Surface acting is an important strategy of emotional labor, and few studies have focused on the effect of emotional labor on turnover intention among family doctors. The aim of this study with Conservation of Resources theory is to explore how the surface acting of family doctors in rural areas affects turnover intention through emotional exhaustion and to investigate what role occupational commitment plays in this relationship.Methods: 953 valid data were collected by an anonymous self-administered questionnaire survey in December 2021 in Shandong Province, China. Cronbach’s α and confirmatory factor analysis (CFA) were used to estimate reliability and structural validity, respectively. The PROCESS macro in SPSS was performed to analyze mediating and moderated mediation effects of surface acting, emotional exhaustion, occupational commitment, and turnover intention.Results: Reliability and validity indicated that measurement instruments were acceptable. Surface acting had a direct positive effect on turnover intention (β= 0.481, 95%CI: [0.420, 0.543]). Emotional exhaustion partially mediated the effect of surface acting on turnover intention (indirect effect: 0.214, 95%CI: [0.175, 0.256]). Occupational commitment moderated the effect of emotional exhaustion on turnover intention (β= -0.065, 95%CI: [-0.111, -0.019]), and moderated the indirect effect of surface acting on turnover intention via emotional exhaustion (index of moderated mediation: -0.035).Conclusions: Emotional exhaustion partially mediates the relationship between surface acting and turnover intention among family doctors in rural China, and occupational commitment moderates the direct effect of emotional exhaustion on turnover intention and further moderates the mediating effect. It is suggested that engagement and diversion strategies are used to reduce the practice of surface acting. Also, pre-service education and external resources are provided to increase family doctors’ occupational commitment and minimize the incidence of emotional exhaustion and turnover intention.
Odor Identification Quantitatively by Odorant Receptor Vectors
Authors: Kawai Kosei , Morishita Shin
Published: June 2022

A new concept of odorant receptor vectors composed of the half maximal effective concentration (EC50) of each receptor to odorant molecules was proposed. Odors are mainly subjective and qualitative evaluation has been per-formed until now. Therefore, we attempted to quantitatively express the direct association between odorant receptors and odor molecules in this study. The degree of similarity evaluated by taking inner product of the odorant receptor vectors was verified by comparing with the results by sensory evaluation tests published in past literatures in the form of correlation coefficient. A multi-layered artificial neural network whose input was the elements of prescribed odorant receptor vector was also introduced to identify odorant molecules in the output layer. As a result, the inner product of proposed odorant receptor vector might evaluate the degree of similarity quantitatively among various odorants. Further, it might be possible to identify odorant molecules by the artificial neural network using EC50 of receptors to various odorants.
The Development of an Instructional Model of Holographic Standardized Patient-based Education for Enhancing Clinical Reasoning skill in Undergraduate Healthcare Education
Authors: Kang Yong Joon , KANG YUN , Hong Hyeonmi , Lee Woosuck
Published: June 2022

Objective
The use of holographic standardized patient (HSP) with mixed reality can provide students with the opportunity to enhance clinical reasoning skills. This is still relatively new, so there is a lack of guidelines for educators. Thus, we aimed to develop the instructional model of HSP-based education, for enhancing clinical reasoning skills in undergraduate healthcare education, which could systematically guide educators in designing and implementing HSP-based teaching and learning activities appropriately.
Results
The instructional model developed in this study has six steps: (1) Consider the situation, (2) Collect cues and information, (3) Identify problems and issues with potential causes, (4) Action plan with rationale, (5) Expected outcomes, and (6) Reflection. It includes the teaching and learning activities required in each stage.
OMFSurgery: Analyzing the use of social media applications in Oral and Maxillofacial Surgery resident training
Authors: Seifert Lukas Benedikt , Becker Philipp , Pabst Andreas , Sander Anna Katharina , Schneider Josephine , Schorn Lara , Zeller Alexander , Hoffmann Jürgen , Thiem Daniel
Published: June 2022

Background: Despite its increasing popularity, to our knowledge the use of social media applications (SM) for residents’ training in Oral and Maxillofacial Surgery (OMFS) has not been investigated yet. The aim of this study was to evaluate the use of SM applications by OMFS residents for post-graduate training in Germany.Methods: For explorative assessment, an online questionnaire containing 27 questions about the current use of SM for resident training was sent to OMFS residents in Germany.Results: Sixty-four colleagues participated to the study. Thirty-four participants (54%) responded to regularly use those platforms mainly for OMFS-related content. YouTube (65%, n = 37), Instagram (48%, n = 27), ResearchGate (25%, n = 14) and WhatsApp (16%, n = 9) were the most popular platforms. (Surgical) videos (97%, n = 59), pictures and graphics (82%, n = 50) were the mainly accessed contents. Forty-four participants (69%) stated that SM substantially contributed to their OMFS training. Dentoalveolar surgery and implantology (66%, n = 35) and aesthetic facial surgery (55%, n = 29) content contributed most to OMFS resident training. Fifty-one participants (80%) recommended an official SM account of the DGMKG.Conclusions: SM is frequently used by OMFS residents for the consumption of training-related content. There is an imbalance toward dentoalveolar and facial aesthetic surgery regarding the presented content. Academic institutions and societies should complement their educational activities to not miss this emerging educational innovation. Official SM content by academic institutions and societies could contribute to the existing educational activities.
The association between score of plant-based diet and non-alcoholic fatty liver disease in adults
Authors: Fallah Azadeh , abdolazimi Hamid , Darabi Zahra , Talenezhad Nasir , Mirzavandi Farhang , Rahimpour Shahab , Hosseinzadeh Mahdieh
Published: June 2022

Background: Plant-based diet as resource of antioxidants and anti-inflammatory phytochemicals, that was considered to protect against onset and development of NAFLD.Aim: To investigate the association between plant-based diet and NAFLD in adults.Methods: The present case control study was conducted on 240 individuals (120 with NAFLD and 120 control) aged 20–69 years. Provided recommendations by the American College of Gastroenterology and the American Gastroenterological Association were used for NAFLD diagnosis. Dietary intake was assessed using 178-food item food frequency questionnaire. Also, plant-based diet score was evaluated based on 18 food groups classified into animal foods, healthy and unhealthy plant foods. A multiple logistic regression model was used to examine the relationship between fatty liver disease and tertiles of PDI. Results: The results of this study showed that we did not observe any association between tertiles of plant-based diet index (PDI) and NAFLD in crude model (OR: 1.29, 95%CI:0.66 – 2.52, P:0.44) and after adjustment for confounders including age, energy intake, physical activity, body mass index (OR:0.76, 95%CI: 0.31 – 1.86, P:0.52). Also, there were not any association of tertiles of healthy PDI (hPDI) (OR:1.14, 95%CI: 0.50 – 2.60, P:0.74) and unhealthy PDI (uhPDI) (OR:0.89, 95%CI:0.36–2.18, P: 0.79) with NAFLD after full adjustment for potential confounders. Conclusion: There was not any association of PDI, hPDI, and uPDI with NAFLD in adults. More research needs to examine whether this specific diet may impact and improve NAFLD.
A cross-sectional analysis from the PAC-19QoLReg on the association between Quality of Life (QoL) of long COVID-19 patients and their disease duration
Authors: Jandhyala Ravi , Lin Yuhui
Published: June 2022

Background: The COVID-19 pandemic has been recognized for its long-term detrimental effects on the human population. The aim of this study was to report on the quality of life (QoL) from the interim analysis of COVID-19 positive patients registry data (PAC-19QoLReg) at baseline.Method: Self-declared patients who received COVID-19 positive diagnosis and/or had exhibited symptoms of lagged effects from post-COVID-19 for a duration of at least 28 days were recruited into the PAC-19QoLReg in December 2020 via social media, broadcasting platforms community forums and by word-of-mouth.Results: At primary recruitment, a total of 107 participants were recruited into the study. However, this interim data reports on N=74 long COVID-19 patients who have completed their baseline PAC-19QoL; Survey 1. The generalized linear model (GLM) Poisson regression was applied in this study to examine the association between exposure duration to COVID-19 and PAC-19QoL scores. The finalized model was adjusted for truncation time and age at recruitment. Truncation time was considered for its contribution in the delayed effects to complete the questionnaire upon recruitment, and such postponement varied among participants. The findings demonstrate that all participants were likely to recover in their QoL scores with increasing time since being diagnosed with COVID-19. The model underwent an elective statistical adjustment with the UK-only participants, and with truncation time at 0-14 and beyond 14 days. Participants who took >14 days to complete the survey were likely to recover in QoL scores than <=14 days. Conclusion: Findings from this study suggests a disproportional impact on patients by gender, age, and study country was observed, emphasizing that an awareness of patient-specific factors can assist clinicians in identifying those who may be at risk for diminished QoL as they progress. Furthermore, psychological adaptation to disease symptoms upon COVID-19 diagnosis was observed among the participants Trial registration: ClinicalTrials.gov Identifier NCT04586413 (14/10/2020)
Safety and efficacy of low-dose rt-PA with tirofiban to treat acute non-cardiogenic stroke: A single-center controlled study
Authors: Liang Zhigang , Zhang Junliang , Huang Shuangfeng , Yang Shaowan , Xu Luyao , Xiang Wei , Zhang Manman
Published: June 2022

Background and Purpose
The recanalization rate after intravenous thrombolysis (IVT) is not enough and there is still the possibility of re-occlusion. We aim to investigate the effectiveness and safety of infusing tirofiban after IVT.
Methods
We performed a prospective controlled study of 60 patients with acute non-cardiogenic ischemic stroke who were hospitalized in Yantai Yuhuangding Hospital from January 2018 to December 2019. The patients were divided into 2 groups: those who received tirofiban for 24 hours after IVT (rt-PA + T group) and those who did not receive postprocedural intravenous tirofiban (rt-PA group). The rt-PA + T group received low-dose rt-PA (0.6 mg/kg). The rt-PA group received standard dose rt-PA (0.9 mg/kg). The main outcome measure were safety, included the symptomatic intracranial hemorrhage (sICH), any ICH, severe systemic bleeding, and mortality. The secondary outcome measure is curative efficacy which were evaluated by the 7d-NIHSS score and functional outcomes at 90 days. During hospitalization, the deterioration of neurological function was recorded.
Results
All patients completed the follow-up with complete data, there were 30 patients in each of groups. The general characteristics between the two group patients had no statistically significant differences. Compared with the rt-PA + T group and the rt-PA group, in terms of safety, the rates of the sICH, severe systemic bleeding, and mortality in both groups were 0, and there was no statistically significant difference in the rates of any ICH between the two groups (10.0% vs 3.3%, P = 0.306). In terms of efficacy, the rate of the early neurological deterioration events (END) was no statistical significance (0 vs 6.6%, P = 0.246). There was no significant difference in the NHISS score between the two groups before the IVT, and also at 24h, however, the 7d-NIHSS score was lower in the rt-PA + T group compared with the rt-PA group (2.33 ± 1.85 vs 4.80 ± 4.02, P = 0.004). At 90 days, 83.3% of patients in the rt-PA + T group had favorable functional outcomes compared with 60.0% of patients in the rt-PA group (P = 0.045).
Conclusion
Low-dose rt-PA combined with tirofiban in acute non-cardiogenic ischemic stroke did not increase the risk of ICH, and mortality, and it was associated with neurological improvement.
Trial Registration:
The trial has been registered at the ChiCTR and identified as ChiCTR1800014666 (28/01/2018).
Comparative analysis and definition of types of reference resolution
Authors: kalman guljamal
Published: June 2022

This article describes new methods of solving reference resolution. The main method used here is, first of all, the method of solving by reference types, carrying out a theoretical study of methods for solving reference relations. Second, by a formal analysis of all types of references in Kazakh and Russian, English, a comparative study of all types of references in the three languages is conducted. For the Kazakh language, the absence of certain types and the definition of anaphoric and cataphoric relations in the language, taking into account the linguistic features. The purpose of solving reference resolution in this method is to highlight previously undeveloped and fully solved methods, and to search the literature for methods of solving reference types and convenient ways of solving reference resolution using methods of theoretical investigation, formal analysis, and verification of developed research papers in the field. A comparison of the eight methods of solving reference resolution among themselves in this study with the new method of solution is shown in Table 7. And by relating the nine reference types to the eight methods that conducted this theoretical research work, we can see that the complete solution of the reference types can only be solved in our method. The article studies the function of pronouns in the word and taking into account the linguistic features of Kazakh Russian and English, from which we can extract specific types of reference types by eliminating interlingual differences.
Application of intracardiac echocardiography in the radiofrequency ablation of atrial fibrillation
Authors: xue feng , Sun Yunjuan , lin ling , Zhang Fangfang , Zhu Shasha , Guo Xiao , Wang Shuhuan , Liu Ming , Hui Jie , Jiang tingbo
Published: June 2022

Background Intracardiac echocardiography (ICE) has been used in the radiofrequency ablation of arrhythmia since 1994. This study investigated the efficacy and safety of ICE assiting the ablation of atrial fibrillation.Methods From May 2020 to February 2021, 100 patients with atrial fibrillation underwent radiofrequency ablation assisted by ICE and three-dimensional mapping system. They were enrolled in ICE group. In the same period, 100 patients with atrial fibrillation who only received radiofrequency ablation assisted by three-dimensional mapping system were enrolled in control group. The patients were followed up and the fluoroscopy times, complications and success rates were compared. Results 1. The X-ray fluoroscopy times in ICE group was significantly shorter than that in control group. In ICE group there was no pericardial tamponade during atrial septal puncture. But in control group there were three cases of pericardial tamponade during atrial septal puncture; 2. The injury of vagus nerve around esophagus in ICE group was significantly less than that in control group; 3. There was no significant difference in the success rate between the two groups. Conclusions ICE can significantly increase the safety of the radiofrequency ablation of atrial fibrillation.
Improved complete portal 4-port robotic lobectomy for lung cancer: ‘Hamamatsu Method KAI’
Authors: Funai Kazuhito , Kawase Akikazu , Takanashi Yusuke , Mizuno Kiyomichi , Shiiya Norihiko
Published: June 2022

Background: Robotic-assisted thoracic surgery has been widely used in the treatment of lung cancer. We devised a new port arrangement at robot-assisted thoracoscopic surgery for lung cancer, the “Hamamatsu method” to provide a good cranial field of view using the da Vinci Xi surgical system, last year. It consists of four robot ports and one assist port, while our video-assisted thoracoscopic lobectomy is performed with four ports.Methods: By combining the access port and camera port of “Hamamatsu Method”, we devised the 4-port “Hamamatsu Method KAI” equivalent to the conventional 5-port method without changing the operability. Then, in order to prove the safety of “Hamamatsu Method KAI,” the bleeding volume, drain placement period, operation time, and console time were compared with the conventional 5-port case.Results: In 18 cases of lung cancer who underwent anatomical lung resection by “Hamamatsu Method KAI,” there was no significant difference in bleeding volume, drain placement period, operation time, and console time compared with the conventional 5-port case. No thoracotomy conversion case was detected.Conclusions: Robotic surgery should not ideally increase the number of wounds than thoracoscopic surgery to preserve the minimal invasiveness advantage. Furthermore, patients are generally more sensitive to wound size and number than what surgeons assume. Therefore, we devised a method to reduce the number of ports without degrading the robotic surgery quality. The improved 4-port “Hamamatsu Method KAI” method combines the access port with the camera port and helps ensure minimal invasiveness while maintaining the same feasibility as the original method.
Herb-Symptom analysis of Erchen Decoction combined Xiebai Powder prescription and its mechanism of action in treating chronic obstructive pulmonary disease
Authors: Ye Hua , He Beibei , Yu Ziwei , Feng Yifan , Wen Chuanbiao , Feng Quansheng
Published: June 2022

Background
In this study, Herb-Symptom analysis of Erchen Decoction combined Xiebai Powder (ECXB) prescription was conducted based on the SymMap platform, and the synergistic mechanism of this prescription in the treatment of chronic obstructive pulmonary disease (COPD) was explored by network pharmacology and molecular docking method.
Methods
The SymMap platform was used to collect information related to Traditional Chinese Medicine (TCM) symptoms and Modern Medicine (MM) symptoms prescribed by ECXB, and the “Herb-TCM Symptoms” network and “Herb-MM symptoms” network were drawn for Herb-Symptom analysis. TCMSP database was used to screen the active ingredients and corresponding targets of ECXB. GeneCards database was used to screen Chronic obstructive pulmonary disease related targets, which were mapped to the predicted targets of ECXB to obtain the action targets of ECXB in the treatment of Chronic obstructive pulmonary disease. Cytoscape software was used to construct the “Drug-ingredient-target” network. Protein-protein Interaction (PPI) network was analyzed by STRING database, and the core targets were obtained. DAVID database was used for Gene Ontology (GO) analysis and Kyoto Encyclopedia of Gene and Genome (KEGG) pathway enrichment analysis.
Results
Herb-Symptom analysis showed that ECXB prescription drugs had similar symptoms with COPD patients. Network pharmacology obtained 170 active ingredients with 137 corresponding targets, and 7002 Chronic obstructive pulmonary disease action targets were obtained. 120 ECXB treating chronic obstructive pulmonary disease joint action targets were obtained by intersection mapping, among which the core targets include MAPK8, ESR1, TP53, MAPK3, JUN, RELA, MAPK1, and AKT1. The GO enrichment analysis results indicated that ECXB mainly participates in response to drug, response to nutrient levels, response to extracellular stimulus, response to oxygen levels, and other biological processes. The pathway analysis showed that ECXB treating Chronic obstructive pulmonary disease by regulating hepatitis B, pathways in cancer, TNF signaling pathway, and so on.
Conclusions
This study analyzed the medication rule of ECXB prescription in the treatment of COPD from a new perspective, and found that the symptoms of TCM treatment with ECXB prescription were similar to those of Modern medicine treatment, and that ECXB could treat COPD through multi-component, multi-target, and multi-pathway synergistic effects, providing a scientific basis for further study on the mechanism of ECXB treatment of chronic obstructive pulmonary disease. It also provides new ideas for drug development.
UGP2, a novel target gene of TP53, inhibits endothelial cells apoptosis and atherosclerosis
Authors: He Xin , Chen Juan-Jiang , Hu Xiu-Mei , Wu Chang-Meng , Zhang Ru-Yi , Yang Biao , Zheng Lei , Wang Qian
Published: June 2022

Dysfunction of the endothelial lining of lesion-prone areas of the arterial vasculature is an important contributor to the pathobiology of atherosclerotic cardiovascular disease. Recent studies have indicated that UDP-glucose pyrophosphorylase 2(UGP2) is implicated in cell proliferation and survival. Here we investigated the anti-apoptosis and anti-atherogenic effect of UGP2 in vitro and in vivo.Here, we explored the effects and mechanisms of UGP2 on apoptosis in endothelial cells by flow cytometer and Western blot analyses. And we engineered ldlr−/−ugp2+/− double-deficient mice to evaluated the apoptosis levels in atherosclerotic lesion. A microarray analysis showed that the expression of UGP2 was reduced in human atherosclerotic plaques. In vitro experiments revealed that TP53 interacted with the promotor region of the UGP2 gene, which upregulated UGP2 expression. Augmentation of UGP2 expression downregulated ROS levels, the expressions of Cleaved caspase-3 and apoptosis levels in endothelial cells, and this inhibitory effects of UGP2 on cell apoptosis could be significantly abolished by H2O2. In vivo experiments using ldlr−/−ugp2+/− mice fed a Western high-fat diet demonstrated that UGP2 deficiency promoted atherosclerosis, and increased the levels of ROS, expressions of Cleaved caspase-3 and apoptosis cells in atherosclerotic lesions. Thus, our results provide evidence for UGP2 as a novel target gene of TP53 contributes to anti-apoptosis effect linking to ROS homeostasis differ from canonical pathway, and we suggested that UGP2 could act as potential therapeutic targets to ameliorate atherosclerosis-related diseases.