bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying factors that affect the use of health information technology in the treatment and management of hypertension
Authors: Faezi Aysan , Afshar Hadi lotfnezhad , Rahimi Behlol
Published: December 2022

Background: We conducted this study with the aim of Identifying factors that affect the use of health information technology in the treatment and management of hypertension.
Methods: This is a descriptive-analytic study conducted in 2022. To obtain relevant articles, databases including Scopus, Web of Science, IEEE, and PubMed were searched and the time period was between 2013 and 2022. Based on the review of similar articles, a five-point Likert scale checklist was developed in the second phase. The statistical population of the present study was specialist physicians (n=40) and patients (n=384). In order to analyze the data, SPSS Statistics 24 was used. We used descriptive measures to show the data on the two affecting categories on the checklist, followed by a One-Way ANOVA.
Results: As a result of the review literature process, 50 papers were screened, that based we can distinguish motivational and inhibitory factors affecting the use of health information technology in hypertension management. Indeed, Motivational factors and inhibitory factors can be classified into five groups: organizational, economic, technical, personal, and legal/moral factors. Based on the results of the survey, the factors that were identified as most influential on patient and specialist physicians' motivation and inhibitory to use of health information technology to manage and treat hypertension.
Conclusion: Utilizing technologies for hypertension management can be improved by identifying motivating and inhibiting factors. This approach can improve the acceptability of these technologies, save costs, reduce long-term complications of hypertension, and improve patient quality of life.
Psychometric properties of a standardized protocol of muscle strength assessment by hand-held dynamometry in healthy adults: A reliability study
Authors: Morin Marika , Hébert Luc J. , perron Marc , Petitclerc Émilie , Lake Shanna-Rose , Duchesne Elise
Published: December 2022

Background Maximal isometric muscle strength (MIMS) assessment is a key component of physiotherapists’ work. Hand-held dynamometry (HHD) is a simple and quick method to obtain quantified MIMS values that have been shown to be valid, reliable, and more responsive than manual muscle testing. However, the lack of MIMS reference values for several muscle groups in healthy adults with well-known psychometric properties limits the use and the interpretation of these measures obtained with HHD in clinic. Objective To determine the intra- and inter-rater reliability, standard error of measurement (SEM) and minimal detectable change (MDC) of MIMS torque values obtained with HHD. Methods Intra and Inter-rater Reliability Study. The MIMS torque of 17 muscle groups was assessed by two independent raters at three different times in 30 healthy adults using a standardized HHD protocol using the MEDup™ (Atlas Medic, Québec, Canada). Participants were excluded if they presented any of the following criteria: 1) participation in sport at a competitive level; 2) degenerative or neuromusculoskeletal disease that could affect torque measurements; 3) traumatic experience or disease in the previous years that could affect their muscle function; and 4) use of medication that could impact muscle strength (e.g., muscle relaxants, analgesics, opioids) at the time of the evaluation. Intra- and inter-rater reliability were determined using two-way mixed (intra) and random effects (inter) absolute agreement intraclass correlation coefficients (ICC: 95% confidence interval). SEM and MDC were calculated from these data. Results Intra- and inter-rater reliability were excellent with ICC (95% confidence interval) varying from 0.90 to 0.99 (0.85–0.99) and 0.89 to 0.99 (0.55–0.995), respectively. Absolute SEM and MDC for intra-rater reliability ranged from 0.14 to 3.20 Nm and 0.38 to 8.87 Nm, respectively, and from 0.17 to 5.80 Nm and 0.47 to 16.06 Nm for inter-rater reliability, respectively. Conclusions The excellent reliability obtained in this study suggest that the use of such a standardized HHD protocol is a method of choice for MIMS torque measurements in both clinical and research settings. And the identification of the now known metrological qualities of such a protocol should encourage and promote the optimal use of manual dynamometry.
Evaluation of SPECT imaging: a multi-center and multi-vendor phantom study
Authors: Gonçalves Maria Inês Rebelo , Parafita Rui , Costa Mauro , Geão Ana , Pereira Edgar , Vieira Lina
Published: December 2022

Background: Single-photon emission computed tomography (SPECT) is a nuclear medicine (NM) imaging method sensitive for the evaluation and quantification of physiological processes in patients. However, there are different factors that affect qualitatively and quantitatively the SPECT images and, consequently, the reliability of the data. There is a degree of variability underlying the intrinsic performance of systems from the same or different manufacturers. In addition, the different configurations of the gamma cameras (GC) and the acquisition and reconstruction protocols used may lead to heterogeneity of results. This study compared SPECT images acquired in three GC from three NM centers, using the Jaszczak and NEMA IEC Body phantoms, filled with homogeneous solution of technetium-99m. Acquisitions were performed in each GC, following the protocols used in clinical practice of the respective NM center, and the images were analyzed and compared in terms of spatial resolution, sensitivity, noise, contrast, and contrast recovery (CR). Subsequently, the processing and reconstruction parameters were harmonized to assess their impact on the standardization of results.
Results: With the clinical protocols, the images acquired with the three GC showed small differences in spatial resolution, noise, and contrast, with the greatest difference being observed in the quantitative accuracy, since the CR has achieved variabilities of 0.17 and 0.28, for different activity concentrations. This intersystem variability was reduced to 0.09 and 0.08 after reconstruction algorithm standardization. However, this change increased the differences in the contrast percentage.
Conclusion: GC from different manufacturers showed the greatest heterogeneity of results, however, by eliminating possible sources of variation it is possible to reduce the differences between systems. It was demonstrated the need to include different parameters for the evaluation and comparison of SPECT images, so that procedures can be established between the different NM centers to ensure a trade-off between the various parameters assessed here, as the improvement of some usually leads to the deterioration of others.
Significance of upper paratracheal lymph node resection in stage IB right lung cancer
Authors: Wang Feng , Yu Xiangyang , Han Yi , Zhang Lanjun , Liu Shuku
Published: December 2022

Objective
The aim of this study was to investigate the effect of upper paratracheal lymph node (2R lymph node) resection on the prognosis of stage IB right lung cancer
Methods
We retrospectively collected data of 339 patients with stage IB right lung cancer who underwent radical surgery from 1999 to 2009. The prognostic factors were evaluated by Cox proportional hazard regression model. Propensity score matching (PSM) was applied to adjust the confounding factors. The Kaplan-Meier method was applied to evaluate overall survival (OS) and recurrence-free survival (RFS).
Results
For all 339 cases included in the study, Univariate and multivariate analysis showed that smoking and family history of malignant tumors were prognostic factors for OS. Age and family history of malignant tumors were prognostic factors for RFS. Resection of the 2R lymph node was not statistically associated with OS and RFS. All cases were separated into two groups based on whether the 2R lymph nodes were resected. The results of survival analysis after PSM also suggest that the resection of 2R lymph node is not statistically associated with OS and RFS (P > 0.05).
Conclusions
For stage IB right lung cancer, upper paratracheal lymph node resection was not statistically associated with OS or RFS. 2R lymph node resection may not be necessary for early-stage NSCLC.
A prior knowledge-informed traceableNeutral Network modeling only using regular laboratory results to assist early diagnosis for tuberculosis: a multiple-center study in China
Authors: LIANG Yu-fang , Zheng Hua-rong , Huang Da-wei , Nai Jing , Wang Yan , Cui Wei-qun , Feng Li-na , Li Xu-sheng , Fan Meng-guang , Luo Yi-fei , Chen Chao , Wang Qing-tao , Zhou Rui
Published: December 2022

Background:To construct a knowledge-informed traceable artificial intelligence (AI)-based model to assist early diagnosis for tuberculosis (TB).Methods:60729 cases were extracted from January 1, 2014, to December 31, 2021, in Beijing Hepingli Hospital. Beijng Jishuitan Hospital was used as an independently external testing set. Only using routine laboratory results, six models based on Neutral Network (NN) algorithm combined with clinical prior knowledge were designed for TB screening and differentials were set up. Our TB model was not only quantitatively evaluated by means of metrology, but also validated by an independently external testing set from Beijing Jishuitan Hospital, and by on-site clinical validation in 37 hospitals.Results:For disease screening, our NN algorithm overall performed better than the other algorithms for diseases & healthy control (HC), and TB & non-TB models. Taking an example for the TB& non-TB model, the AUC, ACC, SPE and SEN were 0.9240, 0.7703, 0.7664 and 0.8958 respectively. For disease differentials, The AUC was 0.8035 for pulmonary tuberculosis (PTB) & other pulmonary diseases (OPD) model; the AUC was 0.7761 for tuberculosis（TB）& extrapulmonary tuberculosis（EPTB）model. For an on-site clinical validation in Baoding No.2 Central Hospital, the average accuracy was stable, achieving 93% for TB& non-TB model.Conclusions:A knowledge-informed AI-based model only based on regular laboratory results offers a more convenient, effective, and highly accurate early diagnosis tool for TB.
Analysis of remote sensing monitoring of atmospheric ozone in Japan for the past 12 years
Authors: Lei Shengtong , Ju Tianzhen , Li Bingnan , Xia Xuhui , Huang Cheng , Zhang Jiaming , Li Chunxue
Published: December 2022

It is ozone pollution great significance to the study of photochemical smog to understand the present situation of ozone pollution in Japan and provide theoretical basis for solving ozone pollution problem. Based on remote sensing data from OMI satellites, MK and Slope trend analysis, Hurst index analysis, the potential source contribution factor algorithm, Kendall correlation analysis, and the random forest regression model were used in this paper to investigate ozone column concentrations in Japan from 2010 through 2021. The results showed that ozone column concentration have shown a significant latitudinal trend over the past 12 years, ozone column concentration have increased with latitude, the spatial distribution patterns have remained consistent from month to month, and the slope has showen a lower upward trend over the years (slope = 0.0052). The interannual maximum and minimum ozone column concentrations are in 2021 (387.57 DU) and 2015 (241.27 DU), respectively. The monthly maximum and minimum values occur in February (443.03 DU) and December (234.04 DU). Spring (352.94 DU) > winter (336.01 DU) > summer (306.78 DU) > autumn (296.30 DU). Column ozone concentrations have increased in 69.82% of Japan over the past 12 years. In 2022, the maximum, minimum, and mean ozone column concentrations based on random forest forecasts are 372DU, 278DU, and 334DU, respectively. pollution sources in Japan are largely derived from pollutants that are transported across borders from the seas around the country or from other countries in the world, with the largest potential source areas being located in the Kanto region. Ozone is negatively correlated with precipitable water and air temperature, positively correlated with nitrogen dioxide and the rising index, and uncorrelated with air pressure. The contribution of population and GDP to ozone is small.
The construction and analysis of ceRNA and tumor-infiltrating immune cell networks in the distant metastasis of lung adenocarcinoma
Authors: liu Jun , zhu Yun , Guo Yuntao , Tang Shuainan , Fu Guolong , Zhang Tongsong , Song Haiping , Zhao Dezhi , Wang Licheng , Jiang Xin
Published: December 2022

Lung adenocarcinoma (LUAD) is the most common lung cancer with a high rate of distant metastasis. The potential mechanism of competitive endogenous RNA (ceRNA) and tumor-infiltrating immune cells in LUAD distant metastasis is still unclear. RNA profiles of LUAD were downloaded from the cancer genome atlas (TCGA) including primary LUADs without or with distant metastasis. The miRNA-mRNA and lncRNA-miRNA interaction information were downloaded to establish the distant metastasis-specific ceRNA network. The algorithm “cell type identification by estimating relative subsets of RNA transcripts (CIBERSORT)” was used to estimate their immune cells. The Pearson correlation analysis was utilized to compare the prognostic biomarker in the ceRNA network and immune cell proportion. We established the two nomograms of metastasis-related ceRNA networks and immune cells. The Receiver Operating Characteristic (ROC) and the calibration curves indicated acceptable accuracy and discrimination of the nomogram. Based on the correction analysis between metastasis-related ceRNA and immune cells, along with external validation, NR3C2, PIK3R1, PTPN13, SPRY2 and mast cells resting were found to be associated with each other and constitute the potential regulation networks. Our data identify prognostic ceRNAs and immune cells and provide two prediction nomograms. Besides, the potential regulatory networks among NR3C2, PIK3R1, PTPN13, SPRY2 and mast cells resting are also uncovered, which may take part in the distant metastasis of LUAD.
Diversity under a magnifier lens: The case of Typhlotanaidae in N Atlantic
Authors: Gellert Marta , Błażewicz Magdalena , Mamos Tomasz , Bird Graham J.
Published: December 2022

Research focusing on ‘stout-bodied’ typhlotanaids collected from several sites around Iceland and adjacent northern seas has resulted in the description of 15 species new to science, as well as the creation of eight new genera. Typhlotanais eximius Hansen, 1913 was redescribed and transferred to a new genus, while Typhlotanais crassus and Peraeospinosus adipatus are transferred to the genus Larsenotanais. The morphological and the molecular data were combined to consolidate and confirm the validity of the results obtained from both approaches. The polyphyletic nature of Typhlotanaidae and its serious underestimation was emphasized. Molecular analysis revealed that the ’stout-bodied‘ Typhlotanaidae are monophyletic. Depth, temperature, and salinity were identified as the main environmental parameters determining the distribution of this group of Typhlotanaidae. Several species were clearly associated with shelf and upper bathyal of Iceland. The Greenland-Iceland-Faroe ridge is shown to be a distinct zoogeographical barrier for typhlotanaids inhabiting the deeper slope and abyssal around Iceland.
A structural equation model analysis of the relationship between expectant fathers' fear of COVID-19 and their fear of childbirth: The mediating role of maternal fear of childbirth
Authors: Mortazavi Forough , Nikbakht Roya , Mehrabadi Maryam , Shahhosseini Zohreh
Published: December 2022

Background
Pregnancy and childbirth may provoke various emotional responses in expectant fathers including excessive fear of childbirth. It is not unreasonable to assume that fear of contracting the virus during the COVID-19 pandemic, may have intensified fathers' fear of childbirth. This study aims to determine the mediating role of the expectant mothers’ fear of childbirth in the relationship between expectant fathers’ fear of COVID-19 and their fear of childbirth.
Methods
This cross-sectional study was conducted on 270 pregnant women and their spouses attending health centers from Aug 2021 to April 2022. Fathers’ fear of childbirth scale (FFCS), Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-A), and Fear of COVID-19 Scale (FCV-19S) were used to collect data. To examine the relationships between variables and to develop the final model, we used the structural equation model (SEM).
Results
The prevalence of severe fear of childbirth in fathers and their female spouses were 40.9% and 22.4%, respectively. The mean score and standard deviation of fear of childbirth in the fathers and their female spouses were 49.2±17.1 and 62.5±29.4, respectively. Results showed that fathers’ fear of COVID-19 was directly (B=0.44, p=0.004) and indirectly (B=0.13, p=0.015) associated with fathers’ fear of childbirth. Also, women’s fear of childbirth was positively associated with fathers’ fear of childbirth (B=0.45, p=0.030). In the final model, the values of χ2/df, CFI, PCFI, RMSEA, and SRMR were equal to 2.32, 0.94, 0.76, 0.07, and 0.06, respectively.
Conclusions
The findings of the present study indicate that mothers’ fear of childbirth has a mediating role in the relationship between fathers’ fear of COVID and fear of childbirth. Therefore, to alleviate fathers’ fear of childbirth, interventions to reduce fathers’ fear of COVID-19 and women’s fear of childbirth should be developed and implemented. The impact of fathers’ mental health on the fear of childbirth in expectant couples should be further investigated.
Temporally Complex Inflammatory Networks in an Animal Model Reveal Signatures for Interstitial Cystitis and Bladder Pain Syndrome Phenotype
Authors: Shah Ashti M. , Vodovotz Yoram , Yoshimura Naoki , Chermansky Christopher J. , Fitzgerald Jocelyn , Tyagi Pradeep
Published: December 2022

Introduction and Objective
Interstitial cystitis and bladder pain syndrome (IC/BPS) presents with symptoms of debilitating bladder pain and is typically a diagnosis of exclusion. Patients with Hunner’s lesions and tissue inflammation on bladder biopsy have an increased likelihood of therapeutic success with anti-inflammatory drugs. However, identification of this subgroup remains difficult due to the invasive nature of biopsies and the lack of surrogate biomarkers of IC/BPS. We modeled the dynamic evolution of inflammation in an experimental IC/BPS rodent model using computational biological network analysis of inflammatory mediators (cytokines and chemokines) in the urine. The use of biological network analysis allows us to identify urinary proteins that could be causative drivers of inflammation and potential prognostic biomarkers that could serve as therapeutic targets for the treatment of IC/BPS.
Methods
Rats subjected to cyclophosphamide (CYP) injection (150 mg/kg) were used as an experimental model for acute IC/BPS (n=8). Urine from each void was collected from the rats over a 12-hour period and was assayed for 14 inflammatory mediators using Luminex™. Time-interval principal component analysis (TI-PCA) and dynamic network analysis (DyNA), two biological network algorithms, were used to identify biomarkers of inflammation characteristic of IC/BPS over time.
Results
Compared to vehicle-treated rats, nearly all inflammatory mediators were elevated significantly (p<0.05) in the urine of CYP treated rats. TI-PCA highlighted that GRO-KC, IL-5, IL-18, and MCP-1 account for the greatest variance in inflammatory response. At early time points, DyNA indicated a positive correlation between IL-4 and IL-1b and between TNFa and IL-1b. Analysis of TI-PCA and DyNA at later timepoints showed the emergence of IL-5, IL-6, and IFNg as additional key mediators of inflammation. Furthermore, DyNA network complexity rose and fell before peaking at 9.5 hours following CYP treatment. This pattern of inflammation mimics the fluctuating severity of inflammation coinciding with IC/BPS flares.
Conclusions
Computational analysis of inflammation networks in experimental IC/BPS analysis expands on the previously accepted inflammatory signatures of IC by adding IL-5, IL-18, and MCP-1 to the prior studies implicating IL-6 and GRO as IC/BPS biomarkers. This analysis supports a complex evolution of inflammatory networks suggestive of the rise and fall of inflammation characteristic of IC/BPS flares.
Investigating the short- and long-term impacts of pain from surgical castration on affective states in piglets
Authors: Neary Jessica Michelle , Ali Ahmed B.A. , Jacobs Leonie
Published: December 2022

Surgical castration of male piglets is a routine procedure performed to improve meat quality. Pain due to castration can last for up to 4 days, negatively impacting animal welfare. The objective of this study was to assess the impact of surgical castration and practical pain alleviation methods during and after castration on piglets’ short and long-term affective states and activity. Piglets were surgically castrated (n = 22), castrated with analgesics (n = 21), or sham-handled (n = 22) at 3 days of age. Data on piglets’ activity, tails, and grimaces were collected for 1, 6, and 24 hours after castration treatments. An attention bias test was performed in week 1 (n = 31) and 12 (n = 33) to assess anxiety (an affective state), with feed (positive stimulus) and loud bangs and flashing lights (negative stimuli) presented simultaneously. Latency to eat, behavioral responses, and activity were recorded during the test. Castration treatment and sampling timepoint impacted activity levels hours after treatments. Piglets’ behavior and activity at week 1 suggest a negative impact of surgical castration on anxiety. Impacts of castration treatments observed in week 1 were no longer detected in week 12. Results confirm that surgical castration negatively impacts affective states of 1-week-old piglets, but results did not support a long-term impact detectable at 12 weeks of age. As this is the first study assessing the relationship between painful procedures and piglet affective state, more research is needed to better understand the impacts on these and other measures of pig affect.
Swiss medical schools’ experiences with online teaching during the COVID-19 pandemic. Swiss perspectives in light of international experiences
Authors: Gogollari Artemisa , Mitchell Sharon , Guttormsen Sissel
Published: December 2022

Background In a short amount of time, because of the pandemic, all universities had to switch to digital learning and teaching (DLT). The advantages and obstacles of DLT are well reported in research. Although, present solutions to the obstacles are not optimal. To ensure a sustainable DLT implementation, the needs of institutions, educators and students should be aligned. Objective This paper aims at identifying and describing the experiences made at the Swiss medical schools after having to suddenly switch from on-site to on-line teaching; in particular, the experienced issues, needs, and solution approaches shall be investigated. Methods Initially, we conducted a literature review from which we seek to derive themes and subthemes regarding the central aspects of the transition from on-site to on-line teaching. Then, we conducted a semi-structured interviews with people responsible for the medical curricula at the Swiss Medical Schools. We used a purposive sampling method and invited key persons at the following Swiss Medical Schools: Basel, Bern, Freiburg, Geneva, Lausanne, Zürich, and also the ETHZ. The interviews were conducted in English, audio-recorded, transcribed verbatim. Subsequently the data collected was organized, stored and analysed with the software Nvivo. We used a qualitative, deductive, content analysis to explore faculty experiences. Results Twenty-four articles met the eligibility criteria and were included for full text screening. Of the included articles, 15 reported on DLT in general and nine articles reported on DLT during the Pandemic. The thematic analysis of the interviews resulted in four overall themes, requirements, obstacles, facilitators and advantages. Results are organized by theme linked to specific characteristics of stakeholders. Curriculum managers shared their perspectives during interviews that institutions were relatively unprepared for the quick transition from onsite to online at the onset of the pandemic. Conclusions Our research reports a lack of institutional structures, communication, digital competences and literacy, teaching strategies, as well as a theoretical foundation for DLT implementation. A conceptual DLT framework adapted to the Swiss universities going beyond the current situation is needed.
Identification key genes influence cell cycle process in glioma by bioinformatics analysis
Authors: Zhang Huikai , Zhou Long , Li Zhiyang , Wei Hangyu , Lei Pan , Chen Qianxue , Cai Qiang
Published: December 2022

The aim of the present study was to identify key genes that influence cell cycle in gliomas by bioinformatics analysis, these genes may play an important role in tumorigenesis. We downloaded GSE50161 and GSE4290 from the gene expression omnibus (GEO) dataset and then with the using of GEO Diver web tool, 1882 differential expressed genes (DEGs) included 662 up-regulated genes and 1220 down-regulated genes were identified between 117 glioma samples and 13 normal brain tissue samples. Subsequently, the top 50 genes with the most significant difference were selected to construct protein-protein interaction (PPI) network, and functional enrichment analysis was carried out. Most of these genes such as WEE1, CDK1, PBK, CCNB2, NUSAP1, MELK, KIAA0101, TOP2A and CAMK2A had been shown to be involved in cell cycle process. Then Gene Ontology (GO) and Kyoto Encyclopedia were performed. Protein-protein interaction (PPI) networks and pathway analysis were also conducted. Furthermore, CDK1, TPO2A, NUSAP1, PBK and CHEK1 genes were identified with the higher degrees in protein-protein interaction network and enriched in cell cycle. We verified these genes in GSE4290. Further on, overall survival analysis showed the prognostic value of these genes and we confirmed the low expression of CAMK2A and CDK1 in glioma tissues on TCGA and the Human Protein Atlas database. In conclusion, these genes associated with the cell cycle process such as CAMK2A, CDK1, PBK, WEE1 and CHEK1 may play an important role in the occurrence and development of glioma.
“If only I had”, patients’ experiences during early oncology trials
Authors: IJsselt Maaike E. A. van Sasse van , Biessen Diane A.J. van der , Puffelen Andrea J. van , Robbrecht Debbie G.J. , Oldenmenger Wendy H
Published: December 2022

Purpose
Until today, it is not clear why patients decide to continue with Early Clinical Trial (ECT) participation. Therefore, the aim of this study is to explore to which extent the self-determination theory of Ryan and Deci, according to the ECT enrollment phase, corresponds to the motivations of participants during ECT’s.
Methods
This study has a qualitative design. Data were collected using semistructured interviews and were deductively analyzed in Nvivo12 using the thematic analysis approach of Braun and Clarke.
Results
As a result of the deductive analysis performed, six themes and twenty subthemes emerged which matched the three personal needs: competence, relatedness, and autonomy (n = 12). “Competence” included the following themes: mixed future expectations, treatment expectations, and control of the outcome. “Relatedness” included the theme altruistic motivation. “Autonomy” included the themes; to live and act in harmony as well as mental and physical burden.
Conclusion
Participants felt they tried everything and that they were treated to the limit. This not only gives the motivation to continue participating but also a sense of altruism. Despite different burdens, side-effects, and the feeling of being a test subject, the participants will not easily choose to stop participation in order to prevent saying afterwards: "If only I had".
Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: A qualitative interview study
Authors: Li Edmond , Lounsbury Olivia , Clarke Jonathan , Ashrafian Hutan , Darzi Ara , Neves Ana Luisa
Published: December 2022

Background
In the era of electronic health records (EHR), the ability to share clinical data is a key facilitator of healthcare delivery. Since the introduction of EHRs, this aspect has been extensively studied from the perspective of healthcare providers. Less often explored are the day-to-day challenges surrounding the procurement, deployment, maintenance, and use of interoperable EHR systems, from the perspective of healthcare administrators, such as chief clinical information officers (CCIOs).
Objective
Our study aims to capture the perceptions of CCIOs on the current state of EHR interoperability in the NHS, its impact on patient safety, the perceived facilitators and barriers to improving EHR interoperability, and what the future of EHR development in the NHS may entail.
Methods
Semi-structured interviews were conducted between November 2020 – October 2021. Convenience sampling was employed to recruit NHS England CCIOs. Interviews were digitally recorded and transcribed verbatim. A thematic analysis was performed by two independent researchers to identify emerging themes.
Results
15 CCIOs participated in the study. Participants reported that limited EHR interoperability contributed to the inability to easily access and transfer data into a unified source, thus resulting in data fragmentation. The resulting lack of clarity on patients' health status negatively impacts patient safety through suboptimal care coordination, duplication of efforts, and more defensive practice. Facilitators to improving interoperability included the recognition of the need by clinicians, patient expectations, and the inherent centralised nature of the NHS. Barriers included systems usability difficulties, and institutional, data management, and financial-related challenges. Looking ahead, participants acknowledged that realising that vision across the NHS would require a renewed focus on mandating data standards, user-centred design, greater patient involvement, and encouraging inter-organisational collaboration.
Conclusion
Tackling poor interoperability will require solutions both at the technical level and in the wider policy context. This will involve demanding interoperability functionalities from the outset in procurement contracts, fostering greater inter-organisation cooperation on implementation strategies, and encouraging systems vendors to prioritise interoperability in their products. Only by comprehensively addressing these challenges would the full potential promised by the use of fully interoperable EHRs be realised.
False Atrial Fibrillation Alerts from Smartwatches are Associated with Decreased Perceived Physical Well-being and Confidence in Chronic Symptoms Management
Authors: Tran Khanh-Van , Filippaios Andreas , Noorishirazi Kamran , Ding Eric , Han Dong , Mohagheghian Fahimeh , Dai Qiying , Mehawej Jordy , Wang Ziyue , Lessard Darleen , Otabil Edith Mensah , Hamel Alex , Paul Tenes , Gottbrecht Matthew , Fitzgibbons Timothy , Saczynski Jane , Chon Ki , McManus David
Published: December 2022

Wrist-based wearables have been FDA approved for AF detection. However, the health behavior impact of false AF alerts from wearables on older patients at high risk for AF are not known. In this work, we analyzed data from the Pulsewatch (NCT03761394) study, which randomized patients (≥ 50 years) with history of stroke or transient ischemic attack to wear a patch monitor and a smartwatch linked to a smartphone running the Pulsewatch application vs to only the cardiac patch monitor over 14 days. At baseline and 14 days, participants completed validated instruments to assess for anxiety, patient activation, perceived mental and physical health, chronic symptom management self-efficacy, and medicine adherence. We employed linear regression to examine associations between false AF alerts with change in patient-reported outcomes. Receipt of false AF alerts was related to a dose-dependent decline in self-perceived physical health and levels of disease self-management. We developed a novel convolutional denoising autoencoder (CDA) to remove motion and noise artifacts in photoplethysmography (PPG) segments to optimize AF detection, which substantially reduced the number of false alerts. A promising approach to avoid negative impact of false alerts is to employ artificial intelligence driven algorithms to improve accuracy.
Configuring Conventional Dual Signal Controllers for Transit Priority Using the Response Surface Methodology in Congested Urban Traffic Networks
Authors: Hawas Yaser E. , Alam Md. Didarul
Published: December 2022

This paper discusses the methodology of reconfiguring ordinary traffic signal controllers such as dual controllers to provide more functionalities beyond the conventional way of operation, in an optimal and a robust manner, aiming at transforming such controllers into smart standalone ATMS components. This paper presents an applied simulation-based response surface methodology (RSM) for the optimization of the reconfigured controllers. This RSM method was applied to a conventional actuated dual-traffic signal controller after modifying it to support additional functionalities of transit preemption. The modified controller was optimized using the RSM to perform best in congested and highly congested traffic networks. Two simultaneous objective functions were considered to maximize the transit throughput and minimize the network overall travel time. The results were analyzed for congested and highly congested traffic conditions, and the notion of robustness of the optimized dual controller was introduced, estimated and discussed. The performance of optimized controller was assessed comparatively against the traditional dual controller (not optimized), in a hypothetical simulation network origin-destination demand pairs and multiple overlapping transit routes, using 75 and 45 congested and highly congested traffic scenarios, respectively. The optimal controller outperformed the one without optimization in 65% and 96% of the congested and highly congested traffic cases, respectively.
Characterization of Mercury Ameliorating Rhizobacteria for Enhancing Growth and Yield of Triticum Aestivum L. in Field. An In Vitro and In Silico Study
Authors: Amin Aatif , Naveed Muhammad , Rasheed Sunbul , Sarwar Arslan , Latif Zakia
Published: December 2022

Mercury resistant (HgR) and indole-3-acetic acid (IAA) producing rhizobacteria were isolated from mercury-contaminated areas near Itehad Chemicals (PVT) Limited, Kala Shah Kaku, District Sheikhupura and tanneries of district Kasur, Punjab, Pakistan. Out of 60 mercury-resistant bacterial isolates, three were selected based on high mercury resistance (20–40 µg/ml) and IAA production (15–40 µg/ml). Selected isolates were subjected to biochemical and molecular characterization. HPLC and GC-MS analyses were performed for the confirmation of IAA production by selected rhizobacterial in methanol extract. Pot and field experiments were conducted under controlled conditions on Triticum aestivum L. with a bacterial consortium consisting of AZ-3, Z-A15, and Z-A22. Selected bacterial isolates were identified as Bacillus cereus AZ-3, Enterobacter cloacae Z-A15, and Pseudomonas putida Z-A22. B. cereus AZ-3 showed 90% resistance against HgCl2 at 40 µg/ml due to the presence merT gene. E. cloacae Z-A15 and P. putida Z-A22 showed high production of IAA at 20 and 36 µg/ml respectively. High performance liquid chromatography (HPLC), and gas chromatography-mass spectrometry (GC-MS) confirmed the production of IAA by selected bacteria. Greenhouse experiment showed plant growth promoting ability of mercury resistant bacterial isolates with T. aestivum in both HgCl2 amended as well as in HgCl2 non-amended soils. Inoculation of bacterial consortium A7 (AZ-3, Z-A15, and Z-A22-Hg) posed a substantial increase such as 90, 3.2, 19.2, 70.4, and 13.2 in shoot length, tillers, spike length, number of spikelets/spike and seed weight/200 g respectively, as compared to (AZ-3, Z-A22, and Z-A15 + Hg). Field experiments showed 17, 40, 67, 13, 27, and 70% increases in shoot length, dry weight, number of tillers, spike length, number of spikelets, and yield per acre respectively in T. aestivum. In silico analysis showed the structural determination of MerT protein encoded by the merT gene of B. cereus AZ-3 (OM039465) using Domain and Motif analysis, physiochemical features, secondary and tertiary structure prediction, and structure validation by Ramachandran plot. These bioinformatics tools predicted the structural-based functional homology of MerT transmembrane protein associated with mer operon harboring bacteria involved in the Hg-detoxification system. It is concluded that the selected bacterial consortium A7 of the present study can be used as an excellent biofertilizer for lessening Hg pollution and promoting plant growth in Hg-contaminated soil to maintain sustainable agricultural land.
RUNX1 mutation has no prognostic significance in paediatric AML: A retrospective study of the AML-BFM study group
Authors: Sendker Stephanie , Awada Amani , Domagalla Sophia , Sendker Michael , Orhan Eser , Hoffmeister Lina , Antoniou Evangelia , Niktoreh Naghmeh , Reinhardt Dirk , von Neuhoff Nils , Schneider Markus
Published: December 2022

In acute myeloid leukaemia (AML) RUNX1 mutation is characterized by certain clinicopathological features with poor prognosis and adverse risk by the European LeukemiaNet recommendation. Though initially considered as provisional category, the recent World Health Organization (WHO) classification of 2022 removed RUNX1-mutated AML from the unique entity. However, the significance of RUNX1 mutation in paediatric AML remains unclear. We retrospectively analysed a German cohort of 488 paediatric patients with de novo AML, enrolled in the AMLR12 or AMLR17 registry of the AML-BFM Study Group (Essen, Germany). A total of 23 paediatric AML patients (4.7%) harboured RUNX1 mutations, 18 of which (3.7%) had RUNX1 mutation at initial diagnosis. RUNX1 mutations were associated with older age, male gender, number of coexisting alterations and presence of FLT3-ITD but mutually exclusive of KRAS, KIT and NPM1 mutation. RUNX1 mutations did not prognostically impact overall- or event-free survival. Response rates did not differ between patients with and without RUNX1 mutations. This comprehensive study, comprising the largest analysis of RUNX1 mutation in a paediatric cohort to date, reveals distinct but not unique clinicopathologic features, with no prognostic significance of RUNX1-mutated paediatric AML. These results broaden the perspective on the relevance of RUNX1 alterations in leukaemogenesis in AML.
Enhanced empathic pain by facial feedback
Authors: Lee Seoyoung , Yoo Yeonjoo , Moon Heeyoung , Lee In-Seon , Chae Younbyoung
Published: December 2022

Objectives
Based on the facial feedback hypothesis, the purpose of this study was to determine whether enhancing negative emotion by activating a facial muscle (corrugator supercilii) increases the intensity of cognitive and emotional components of empathic pain. We also assessed whether the muscle contraction changed the pupil size, which would indicate a higher level of arousal.
Methods
Forty-eight individuals completed 40 muscular contraction and relaxation trials while looking at images of five male and five female patients with neutral and painful facial expressions, respectively. Participants were asked to rate (1) how much pain the patient was in, and (2) how unpleasant their own feelings were. We also examined their facial muscle activities and changes in pupil size.
Results
No significant differences in pain or unpleasantness ratings were detected for the neutral face between the two conditions; however, the pain and unpleasantness ratings for the painful face were considerably higher in the contraction than relaxation condition. The pupils were considerably larger in the contraction than relaxation condition for both the painful and neutral faces.
Conclusion
Our findings indicate that, by strengthening the corrugator supercilii, facial feedback can affect both the cognitive evaluative and affective sharing aspects of empathic pain.
The impact of internet use on the subjective well-being of the elderly: New evidence from the China Family Panel Studies
Authors: Yuan Ziqi , Jia Guozhu
Published: December 2022

With the widespread availability of 5G technology in China, the internet has deeply affected the lives of the elderly. This research analyzes the impact of internet use on subjective well-being (SWB) of the elderly using the latest 2020 China Family Panel Studies (CFPS) data through machine learning (ML) techniques and traditional regression models. (1) Machine learning findings indicate that the factors order of importance from strong to weak is the internet as an information channel, contact with family and friends, and work, leisure and entertainment, daily life and using WeChat, watching online short videos and learning. (2) Ordinary least squares (OLS) regression results show the internet for daily life and watching short-form videos have a significant negative effect on the SWB of the elderly. (3) XGBoost with determination coefficients (R2) greater than 0.86 is significantly outperformed the OLS with determination coefficients of 0.35 in full sample sets. This work proves that the combination of machine learning and traditional regression methods can both take advantage of the interpretability of machine learning and reveal factors contributions through traditional regression models, having the ability to mine emerging and potential factors. Our research shows that continuously strengthening the digital construction of the elderly, promoting the digital literacy and skills cultivation of the elderly, and enhancing the sense of participation and happiness of the elderly can help improve the active digital aging of the elderly.
Whole-cell catalyze L-dopa to dopamine via co-expression of transport protein AroP in Escherichia coli
Authors: Gao Siyuan , Ma Ding , Wang Yongtao , Zhang Alei , Wang Xin , Chen Kequan
Published: December 2022

Dopamine is high-value compound of pharmaceutical interest, but its industrial scale production mostly focuses on chemical synthesis, possessing environment pollution. Bio-manufacturing has caused much attention for its environmental characteristic. Resting cells were employed to as biocatalysts with extraordinary advantages like offering stable surroundings, the inherent presence of expensive cofactors. In this study, whole-cell bioconversion was employed to convert dopa to dopamine. To increase the titer and yield of dopamine production through whole-cell catalysis, three kinds of aromatic amino acid transport protein, AroP, PheP and TyrP, were selected to co-expressed. The effects of the concentration of L-dopa, PLP, reaction temperature and pH were characterized for improvement of bioconversion. Under optimal conditions, dopamine titer reach to 1.44 g/L with molar yield of 46.3%, which is 6.62 times than that of initial conditions. The catalysis productivity of recombinant E. coli co-expressed DDC and AroP was further enhanced by repeated cell recycling, which maintained over 50% of its initial ability with eight consecutive catalyses. This study was the first to successfully bioconversion of dopamine by whole-cell catalysis and provided reference for whole-cell catalysis which is hindered by permeability.
Designed an Expert System for Diagnosis of Covid-19 Patients
Authors: Mishra Shashank , Aggarwal Mukul , Yadav Shivam , Sharma Yashika
Published: December 2022

The expert system solves problems within a specific area of the knowledge base. Prolog is a logical programming language which works on its knowledge base and effectively can be used to develop an expert system. Covid 19 is a pandemic deices and an expert system can be developed to diagnose this disease with the help of its symptoms that can be used as a knowledge base in Prolog. This expert system can make a fast diagnosis process for the covid 19 which is important to prevent the spread of the virus. Here we developed an expert system using prolog for the diagnosis purpose. Similar to humans, these systems can get better with time as they gain more experience. Expert systems combine their experiences and expertise into a knowledge base that is then used by an inference or rules engine, a set of rules that the software employs, to apply to certain scenarios. Prolog is ideal for use with intelligent systems for a number of reasons. Prolog can be viewed as a straightforward theorem prover or inference engine that derives from predefined rules. With the help of Prolog's built-in search and backtracking techniques, simple expert systems can be created.
DFT Study on Reaction Mechanism of Methanol Steam Reforming on MoS2(100)
Authors: Xu Lingjie , Huang Yanping , Yang Yunquan
Published: December 2022

As an excellent organic hydrogen energy storage medium with a high hydrocarbon ratio, methanol has a promising application prospect in on-board hydrogen production. Molybdenum-based catalysts, such as MoS2, have special electronic structure and exhibit catalytic performance similar to noble metals. At present, the reaction mechanism of methanol steam reforming (MSR) on the molybdenum sulfide is still unclear. In this work, DFT calculations were applied to examine the adsorption properties of the reactants, intermediates and products, to identify the transition state of reactions involved, and to explore the reaction mechanism of MSR on MoS2(100). It was found that the most probable path of carbon deposition is: CH3OH→CH2OH→CH2→CH→C. And the most probable path of methane formation is: CH3OH→CH3→CH4. The most advantageous reaction path is CH3OH→CH3O→ HCHO→CHO→HCOOH→COOH→CO2.
Source of Liquid Biopsy Biomarker: Exosome vs Whole Plasma, Fasting vs Non-fasting
Authors: Nasu Masaki , Khadka Vedbar , Jijiwa Mayumi , Kobayashi Ken , Deng Youping
Published: December 2022

Background
The liquid biopsy using plasma samples is being studied to find biomarkers for clinical applications. Exosomes encompass nucleic acids and metabolites that have been highlighted as a potential biomarker source. To test the efficacy of exosomes over plasma, we compared the profiles of small non-coding RNAs (ncRNAs) and metabolites extracted from exosomes (which were purified from plasma) to the profiles extracted directly from whole plasma. The fasting and non-fasting status of the samples were also compared.
Results
We found that ncRNA profiles were not affected by fasting for both exosomal and plasma samples. Our results showed that ncRNAs extracted from exosomes were found to have the more consistent profiles between fasting and non-fasting samples. The whole plasma RNA profiles contained high concentrations of cell-derived miRNAs that were likely based on hemolysis. We also found that some metabolites in whole plasma showed significant changes in concentration due to fasting status, whereas others did not.
Conclusions
Here, we propose that 1) fasting isn’t necessary for liquid biopsy study for both circulating ncRNA and metabolomic profiling as long as metabolites which aren’t affected by fasting status are chosen. 2) Exosomal RNAs must be used to obtain consistent results without batch effects in plasma samples due to different levels of hemolysis.