bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological, social and technical factors influencing electronic medical records systems adoption by United States physicians: a systematic model
Authors: El-Yafouri Raghid , Klieb Leslie , Sabatier Valérie
Published: May 2022

Background

Wide adoption of electronic medical records (EMR) systems in the United States can lead to better-quality medical care at lower cost. Despite the laws and financial subsidies by the United States government for service providers and suppliers, interoperability still lags. An understanding of the drivers of EMR adoption for physicians and the role of policy-making can translate into increased adoption and enhanced information sharing between medical care providers.

Methods

Physicians across the United States were surveyed to gather primary data on their psychological, social and technical perceptions towards EMR systems. This quantitative study builds on the theory of planned behaviour, the technology acceptance model and the diffusion of innovation theory to propose, test and validate an innovation adoption model for the healthcare industry. A total of 382 responses were collected, and data were analysed via linear regression to uncover the effects of 12 variables on the intention to adopt EMR systems.

Results

Regression model testing uncovered that government policy-making or mandates and other social factors have little or negligible effect on physicians’ intention to adopt an innovation. Rather, physicians are directly driven by their attitudes and ability to control, and indirectly motivated by their knowledge of the innovation, the financial ability to acquire the system, the holistic benefits to their industry and the relative advancement of the system compared to others.

Conclusions

Identifying physicians’ needs regarding EMR systems and providing programmes that meet them can increase the potential for reaching the goal of nationwide interoperable medical records. Government, healthcare associations and EMR system vendors can benefit from our findings by working towards increasing physicians’ knowledge of the proposed innovation, socializing how medical care providers and the overall industry can benefit from EMR system adoption, and solving for the financial burden of system implementation and sustainment.
Collective health research assessment: developing a tool to measure the impact of multistakeholder research initiatives
Authors: Kork Anna-Aurora , Antonini Carla , García-Torea Nicolás , Luque-Vílchez Mercedes , Costa Ericka , Senn Juliette , Larrinaga Carlos , Bertorello Deborah , Brichetto Giampaolo , Zaratin Paola , Andreaus Michele
Published: May 2022

Background

The need to more collaboratively measure the impact of health research and to do so from multidimensional perspectives has been acknowledged. A scorecard was developed as part of the Collective Research Impact Framework (CRIF), to engage stakeholders in the assessment of the impacts of health research and innovations. The purpose of this study was to describe the developmental process of the MULTI-ACT Master Scorecard (MSC) and how it can be used as a workable tool for collectively assessing future responsible research and innovation measures.

Methods

An extensive review of the health research impact literature and of multistakeholder initiatives resulted in a database of 1556 impact indicators. The MSC was then cocreated by engaging key stakeholders and conducting semi-structured interviews of experts in the field.

Results

The MSC consists of five accountability dimensions: excellence, efficacy, economic, social and patient-reported outcomes. The tool contains 125 potential indicators, classified into 53 impact measurement aspects that are considered the most relevant topics for multistakeholder research and innovation initiatives when assessing their impact on the basis of their mission and their stakeholders’ interests. The scorecard allows the strategic management of multistakeholder research initiatives to demonstrate their impact on people and society. The value of the tool is that it is comprehensive, customizable and easy to use.

Conclusions

The MSC is an example of how the views of society can be taken into account when research impacts are assessed in a more sustainable and balanced way. The engagement of patients and other stakeholders is an integral part of the CRIF, facilitating collaborative decision-making in the design of policies and research agendas. In policy making, the collective approach allows the evaluation perspective to be extended to the needs of society and towards responsible research and innovation. Multidimensionality makes research and innovations more responsive to systemic challenges, and developing more equitable and sustainable health services.
Activity, socket fit, comfort and community participation in lower limb prosthesis users: a Cambodian cohort study
Authors: Diment Laura , Nguon RaksmeyMutta , Seng Sovansereyrathna , Sit Vannsnavy , Lors Ply , Thor Phearsa , Srors Samedy , Kheng Sisary , Granat Malcolm , Donovan-Hall Maggie , Worsley Peter , Dickinson Alex
Published: May 2022

Background

After amputation, many people become less active, feel lonely and lose independence. Understanding the factors associated with low physical activity levels and participation could contribute to defining key interventions which can support prosthesis users so they can live a more active and socially included lifestyle. This longitudinal observational study aims to assess relationships between physical activity, community participation, prosthetic fit, comfort and user satisfaction using actimetry, 3D scans and questionnaires in a Cambodian cohort of established lower limb prosthesis users.

Methods

Twenty participants (5F:15M, nine transfemoral, eleven transtibial, 24–60 years old and 3–43 years since amputation) were recruited. They completed a questionnaire which included their demographics, community participation, prosthesis satisfaction and comfort at the start of the study, and between three and six months later. Their prosthetic sockets and residual limbs were 3D scanned at the start and end of the study. Accelerometers were embedded under the cosmesis on the shank of the prosthesis, to collect ten weeks of activity data.

Results

Participants averaged 4470 steps/day (743–7315 steps/day), and wore their prosthesis for most waking hours, averaging 13.4 h/day (4.5–17.6 h/day). Self-reported measures of activity and hours of wear correlated with these accelerometer data (Spearman’s rho rs = 0.59, and rs = 0.71, respectively). Participants who were more active wore their prosthesis for more hours/day (Pearson r = 0.73) and were more satisfied with socket fit (rs = 0.49). A longer residual limb correlated with better community participation (rs = 0.56) and comfort (rs = 0.56). Self-reported community participation did not correlate with a person’s activity level (rs = 0.13), or their prosthesis comfort (rs = 0.19), and there was only weak correlation between how important the activity was to an individual, and how often they participated in it (rs = 0.37). A simple 0–10 scale of overall comfort did not provide enough detail to understand the types and severity of discomfort experienced.

Conclusion

Associations between perceived and measured activity levels correlated with socket satisfaction in this cohort of people with established lower limb amputations. The small sample size means these correlations should be interpreted with caution, but they indicate variables worthy of further study to understand barriers to community engagement and physical activity for prosthesis users in Cambodia, and potentially in other settings.
Identified lncRNAs functional modules and genes in prediabetes with hypertriglyceridemia by weighted gene co-expression network analysis
Authors: Sun Mengzi , Yan Shoumeng , Zhao Di , Wang Ling , Feng Tianyu , Yang Yixue , Li Xiaotong , Hu Wenyu , Yao Nan , Cui Weiwei , Li Bo
Published: May 2022

Background

Hypertriglyceridemia (HTG) is one of the most important comorbidities in abnormal glucose patients. The aim of this study was to identify lncRNAs functional modules and hub genes related to triglyceride (TG) in prediabetes.

Methods

The study included 12 prediabetic patients: 6 participants with HTG and 6 participants with normal triglyceride (NTG). Whole peripheral blood RNA sequencing was performed for these samples to establish a lncRNA library. WGCNA, KEGG pathways analysis and the PPI network were used to construct co‐expression network, to obtain modules related to blood glucose, and to detect key lncRNAs. Meanwhile, GEO database and qRT-PCR were used to validate above key lncRNAs.

Results

We found out that the TCONS_00334653 and PVT1, whose target mRNA are MYC and HIST1H2BM, were downregulating in the prediabetes with HTG. Moreover, both of TCONS_00334653 and PVT1 were validated in the GEO database and qRT-PCR.

Conclusions

Therefore, the TCONS_00334653 and PVT1 were detected the key lncRNAs for the prediabetes with HTG, which might be a potential therapeutic or diagnostic target for the treatment of prediabetes with HTG according to the results of validation in the GEO database, qRT-PCR and ROC curves.
Factors associated with post NICU discharge exclusive breastfeeding rate and duration amongst first time mothers of preterm infants in Shanghai: a longitudinal cohort study
Authors: Jiang Xin , Jiang Hui
Published: May 2022

Background

Breastfeeding is crucial for the preterm infants. Breast milk is not only food but also medicine. Few studies have focused on the longitudinal effects of exclusive breastfeeding outcome of preterm infants separated from their mothers after discharge, especially in Shanghai. We aimed to examine the exclusive breastfeeding rate and duration amongst first time mothers of preterm infants after discharge and its determinants.

Methods

Analyses were based on 500 preterm infants separated from their mothers in a tertiary maternity and infant-specialized hospital in Shanghai from September 2018 to September 2019.The Socio-demographic characteristics, breastfeeding knowledge questionnaire, breastfeeding self-efficacy short form scale, Edinburgh postpartum depression scale and breastfeeding family support scale were used for the investigation and the exclusive breastfeeding rate of premature infants was followed up on 1 month, 3 months and 6 months after discharge. The changing trend of breastfeeding knowledge, breastfeeding self-efficacy, postpartum depression and family support were measured by ANOVA at different stages. Using the chi-square test and multiple logistic regression, factors impacting the breastfeeding rate of preterm infants at three time intervals after discharge were investigated. The Kaplan Meier survival curve and cox regression model were used to analyze the determinants of exclusive breastfeeding duration of premature infants after discharge.

Results

Exclusive breastfeeding rates were 19.0, 17.2 and 10.4% at 1 month, 3 months and 6 months after discharge of preterm infants, respectively. The average length of exclusive breastfeeding duration was(3.69 ± 1.80)months. Finally, type of delivery (adjusted odds ratio [AOR] 1.564; 95% confidence interval [CI] 0.513,3.116), gestational age(AOR 0.612, 95% CI 0.236, 3.418), maternal family support (AOR 6.125,95% CI 6.359, 98.452) were discovered to be independent predictors on the exclusive breastfeeding rate at 6 months after preterm infants were discharged. Through the cox regression model, we found that a maternal planned pregnancy (HR 0.681, 95%CI 0.531,0.873), delivering breast milk during hospitalization (HR 0.797, 95%CI 0.412,2.288), NICU feeding mode during hospitalization (HR 1.221, 95%CI 0.128,1.381) and family support (HR 0.561, 95%CI 0.004,2.428) were significantly associated with the exclusive breastfeeding duration after discharge.

Conclusions

The exclusive breastfeeding outcome of premature infants was affected by many factors, so we should focus on the three levels of individual, family, society and design targeted intervention measures to increase the exclusive breastfeeding rate and prolong exclusive breastfeeding duration.
miR-182-5p combined with brain-derived neurotrophic factor assists the diagnosis of chronic heart failure and predicts a poor prognosis
Authors: Fang Fang , Zhang Xiaonan , Li Bin , Gan Shouyi
Published: May 2022

Objective

Chronic heart failure (CHF) is a general progressive disorder with high morbidity and poor prognosis. This study analyzed the serum expression and clinical value of miR-182-5p and brain-derived neurotrophic factor (BDNF) in CHF patients.

Methods

A total of 82 CHF patients were selected as the study subjects (15 cases in NYHA stage I, 29 cases in stage II, 27 cases in stage III, and 11 cases in stage IV), with another 78 healthy people as the controls. The expression of serum miR-182-5p was detected by RT-qPCR. BDNF expression was measured by ELISA. Furthermore, the Pearson coefficient was used to analyze the correlation of miR-182-5p/BDNF with BNP and LVEF. ROC curve was employed to assess the potential of miR-182-5p or/and BDNF for the diagnosis of CHF. Kaplan–Meier survival curve was implemented to evaluate the prognostic value of miR-182-5p and BDNF.

Results

Serum miR-182-5p level was elevated and BDNF expression was lowered in CHF patients. Serum miR-182-5p in CHF patients was positively-related with BNP and inversely-correlated with LVEF, while serum BDNF was negatively-linked with BNP and positively-correlated with LVEF. ROC curve indicated the diagnostic value of serum miR-182-5p and BDNF for CHF and the diagnostic accuracy of miR-182-5p combined with BDNF was improved. Kaplan–Meier analysis unveiled that miR-182-5p low expression and BDNF high expression could predict the overall survival in CHF patients.

Conclusion

miR-182-5p expression is increased and BDNF level is decreased in CHF patients. miR-182-5p combined with BDNF can assist the diagnosis of CHF and predict a poor prognosis.
Alzheimer risk gene product Pyk2 suppresses tau phosphorylation and phenotypic effects of tauopathy
Authors: Brody A. Harrison , Nies Sarah Helena , Guan Fulin , Smith Levi M. , Mukherjee Bandhan , Salazar Santiago A. , Lee Suho , Lam Tu Kiet T. , Strittmatter Stephen M.
Published: May 2022

Background

Genetic variation at the PTK2B locus encoding the protein Pyk2 influences Alzheimer’s disease risk. Neurons express Pyk2 and the protein is required for Amyloid-β (Aβ) peptide driven deficits of synaptic function and memory in mouse models, but Pyk2 deletion has minimal effect on neuro-inflammation. Previous in vitro data suggested that Pyk2 activity might enhance GSK3β-dependent Tau phosphorylation and be required for tauopathy. Here, we examine the influence of Pyk2 on Tau phosphorylation and associated pathology.

Methods

The effect of Pyk2 on Tau phosphorylation was examined in cultured Hek cells through protein over-expression and in iPSC-derived human neurons through pharmacological Pyk2 inhibition. PS19 mice overexpressing the P301S mutant of human Tau were employed as an in vivo model of tauopathy. Phenotypes of PS19 mice with a targeted deletion of Pyk2 expression were compared with PS19 mice with intact Pyk2 expression. Phenotypes examined included Tau phosphorylation, Tau accumulation, synapse loss, gliosis, proteomic profiling and behavior.

Results

Over-expression experiments from Hek293T cells indicated that Pyk2 contributed to Tau phosphorylation, while iPSC-derived human neuronal cultures with endogenous protein levels supported the opposite conclusion. In vivo, multiple phenotypes of PS19 were exacerbated by Pyk2 deletion. In Pyk2-null PS19 mice, Tau phosphorylation and accumulation increased, mouse survival decreased, spatial memory was impaired and hippocampal C1q deposition increased relative to PS19 littermate controls. Proteomic profiles of Pyk2-null mouse brain revealed that several protein kinases known to interact with Tau are regulated by Pyk2. Endogenous Pyk2 suppresses LKB1 and p38 MAPK activity, validating one potential pathway contributing to increased Tau pathology.

Conclusions

The absence of Pyk2 results in greater mutant Tau-dependent phenotypes in PS19 mice, in part via increased LKB1 and MAPK activity. These data suggest that in AD, while Pyk2 activity mediates Aβ-driven deficits, Pyk2 suppresses Tau-related phenotypes.
Central and peripheral contributions of T-type calcium channels in pain
Authors: Harding Erika K. , Zamponi Gerald W.
Published: May 2022

Chronic pain is a severely debilitating condition that reflects a long-term sensitization of signal transduction in the afferent pain pathway. Among the key players in this pathway are T-type calcium channels, in particular the Cav3.2 isoform. Because of their biophysical characteristics, these channels are ideally suited towards regulating neuronal excitability. Recent evidence suggests that T-type channels contribute to excitability of neurons all along the ascending and descending pain pathways, within primary afferent neurons, spinal dorsal horn neurons, and within pain-processing neurons in the midbrain and cortex. Here we review the contribution of T-type channels to neuronal excitability and function in each of these neuronal populations and how they are dysregulated in chronic pain conditions. Finally, we discuss their molecular pharmacology and the potential role of these channels as therapeutic targets for chronic pain.
Construction of a lncRNA-associated competing endogenous RNA regulatory network after traumatic brain injury in mouse
Authors: Wang Siqi , Sun Yiyu , Hu Shaobo , Lou Cen , Pan Yuan-Bo
Published: May 2022

Traumatic brain injury (TBI) is a major public health problem worldwide which causes high mortality and disability. Functioning as microRNA (miRNA) sponges, long non-coding RNA (lncRNA) regulates the expression of protein-coding genes in a competing endogenous RNA (ceRNA) network. However, the lncRNA-associated ceRNA in TBI remains unclear. In this study, we processed the raw SRR files of mice cortex samples of sham injury (n = 3) and TBI groups (n = 3) to count files. Then, the expression profiles of lncRNAs and mRNAs were identified, and 86 differentially expressed (DE) lncRNAs and 1201 DEmRNAs between sham and TBI groups were identified. The DEmRNAs were used to perform enrichment analyses. Next, a lncRNA-miRNA-mRNA regulatory ceRNA network was constructed. The network consisted of 23 mRNAs, 5 miRNAs and 2 lncRNAs. The expression alternations of the 5 miRNAs were validated via qRT-PCR. The subnetwork of hub lncRNA Neat1 was extracted. We identified a potential inflammatory associated regulatory axis: Neat1/miR-31-5p/Myd88 axis. The PPI network based on DEmRNA involved in ceRNA network was constructed PPI networks to identify the hub genes. Finally, DElncRNAs and DEmRNAs were selected randomly and validated by qRT-PCR. In conclusion, with the lncRNA-miRNA-mRNA ceRNA network provided above, we can improve our understanding of the regulatory mechanisms and interaction among lncRNAs, miRNAs and mRNAs in TBI process.
Stanniocalcin 2 (STC2): a universal tumour biomarker and a potential therapeutical target
Authors: Qie Shuo , Sang Nianli
Published: May 2022

Stanniocalcin 2 (STC2) is a glycoprotein which is expressed in a broad spectrum of tumour cells and tumour tissues derived from human breast, colorectum, stomach, esophagus, prostate, kidney, liver, bone, ovary, lung and so forth. The expression of STC2 is regulated at both transcriptional and post-transcriptional levels; particularly, STC2 is significantly stimulated under various stress conditions like ER stress, hypoxia and nutrient deprivation. Biologically, STC2 facilitates cells dealing with stress conditions and prevents apoptosis. Importantly, STC2 also promotes the development of acquired resistance to chemo- and radio- therapies. In addition, multiple groups have reported that STC2 overexpression promotes cell proliferation, migration and immune response. Therefore, the overexpression of STC2 is positively correlated with tumour growth, invasion, metastasis and patients’ prognosis, highlighting its potential as a biomarker and a therapeutic target. This review focuses on discussing the regulation, biological functions and clinical importance of STC2 in human cancers. Future perspectives in this field will also be discussed.
Assessing the SAfety and FEasibility of bedside portable low-field brain Magnetic Resonance Imaging in patients on ECMO (SAFE-MRI ECMO study): study protocol and first case series experience
Authors: Cho Sung-Min , Wilcox Christopher , Keller Steven , Acton Matthew , Rando Hannah , Etchill Eric , Giuliano Katherine , Bush Errol L. , Sair Haris I. , Pitts John , Kim Bo Soo , Whitman Glenn
Published: May 2022

Background

To assess the safety and feasibility of imaging of the brain with a point-of-care (POC) magnetic resonance imaging (MRI) system in patients on extracorporeal membrane oxygenation (ECMO). Early detection of acute brain injury (ABI) is critical in improving survival for patients with ECMO support.

Methods

Patients from a single tertiary academic ECMO center who underwent head CT (HCT), followed by POC brain MRI examinations within 24 h following HCT while on ECMO. Primary outcomes were safety and feasibility, defined as completion of MRI examination without serious adverse events (SAEs). Secondary outcome was the quality of MR images in assessing ABIs.

Results

We report 3 consecutive adult patients (median age 47 years; 67% male) with veno-arterial (n = 1) and veno-venous ECMO (n = 2) (VA- and VV-ECMO) support. All patients were imaged successfully without SAEs. Times to complete POC brain MRI examinations were 34, 40, and 43 min. Two patients had ECMO suction events, resolved with fluid and repositioning. Two patients were found to have an unsuspected acute stroke, well visualized with MRI.

Conclusions

Adult patients with VA- or VV-ECMO support can be safely imaged with low-field POC brain MRI in the intensive care unit, allowing for the assessment of presence and timing of ABI.
Cardiopulmonary resuscitation duration and favorable neurological outcome after out-of-hospital cardiac arrest: a nationwide multicenter observational study in Japan (the JAAM-OHCA registry)
Authors: Matsuyama Tasuku , Ohta Bon , Kiyohara Kosuke , Kitamura Tetsuhisa
Published: May 2022

Objective

We aimed to assess the association between cardiopulmonary resuscitation (CPR duration) and outcomes after OHCA.

Methods

This secondary analysis of a prospective, multicenter, observational study included adult non-traumatic OHCA patients aged ≥ 18 years between June 2014 and December 2017. CPR duration was defined as the time from professional CPR initiation to the time of return of spontaneous circulation or termination of resuscitation. The primary outcome was 1-month survival, with favorable neurological outcomes defined by cerebral performance category 1 or 2. We performed multivariable logistic regression analysis to investigate the association between CPR duration and favorable neurological outcomes. We also investigated the association between CPR duration and favorable neurological outcomes stratified by case features, including the first documented cardiac rhythm, witnessed status, and presence of bystander CPR.

Results

A total of 23,803 patients were included in this analysis. Multivariable logistic regression analysis demonstrated that the probability of favorable neurological outcomes decreased with CPR duration (i.e., 20.8% [226/1084] in the ≤ 20 min group versus 0.0% [0/708] in the 91–120 min group, P for trend < 0.001). Furthermore, the impact of CPR duration differed depending on the presence of case features; those with shockable, witnessed arrest, and bystander CPR were more likely to achieve favorable neurological outcomes after prolonged CPR duration > 30 min.

Conclusion

The probability of favorable neurological outcome rapidly decreased within a few minutes of CPR duration. But, the impact of CPR duration may be influenced by each patient’s clinical feature.
Heterogeneity of mesenchymal stem cell-derived extracellular vesicles is highly impacted by the tissue/cell source and culture conditions
Authors: Almeria Ciarra , Kreß Sebastian , Weber Viktoria , Egger Dominik , Kasper Cornelia
Published: May 2022

Extracellular vesicles (EVs) are cell-derived membrane structures exerting major effects in physiological as well as pathological processes by functioning as vehicles for the delivery of biomolecules to their target cells. An increasing number of effects previously attributed to cell-based therapies have been recognized to be actually mediated by EVs derived from the respective cells, suggesting the administration of purified EVs instead of living cells for cell-based therapies. In this review, we focus on the heterogeneity of EVs derived from mesenchymal stem/stromal cells (MSC) and summarize upstream process parameters that crucially affect the resulting therapeutic properties and biological functions. Hereby, we discuss the effects of the cell source, medium composition, 3D culture, bioreactor culture and hypoxia. Furthermore, aspects of the isolation and storage strategies influences EVs are described. Conclusively, optimization of upstream process parameters should focus on controlling MSC-derived EV heterogeneity for specific therapeutic applications.

Graphical Abstract
Protocol for a systematic review exploring the psychometric properties of self-report health-related quality of life and subjective wellbeing measures used by adolescents with intellectual disabilities
Authors: Maguire Stephanie , Davison Jenny , McLaughlin Marian , Simms Victoria
Published: May 2022

Background

Whilst there are studies that have systematically reviewed the psychometric properties of quality of life measures for children and young people with intellectual disabilities, these narrowly focus on disease or health conditions. The objective of this planned systematic review is therefore to collate, summarise, and critically appraise the psychometric properties of self-report health-related quality of life (HRQoL) and subjective wellbeing measures used by adolescents (aged 11–16) with an intellectual disability.

Methods

We designed and registered a study protocol for a systematic review of studies which explores the psychometric properties of self-report HRQoL and subjective wellbeing measures used by adolescents with intellectual disabilities. Electronic databases including PsycINFO, CINAHL, MEDLINE, and ERIC will be searched using predefined search terms to identify relevant studies. Quantitative and mixed-methods studies, and studies published in peer-reviewed journals or grey literature, will be included. Review papers, editorials, and case studies will be excluded. Eligible studies should identify self-report measures which assess HRQoL and subjective wellbeing among adolescents with intellectual disabilities. The methodological quality of the included studies will be assessed by applying the COSMIN Risk of Bias checklist. The quality of the evidence (i.e. the total body of evidence used for the overall ratings on each psychometric property of an instrument) will be evaluated in accordance with the modified GRADE guidelines.

Discussion

This systematic review will be among the first to systematically explore the psychometric properties of self-report HRQoL and subjective wellbeing measures used by adolescents with intellectual disabilities. By providing evidence-based knowledge about measures being used in HRQoL and subjective wellbeing research amongst this population, and more importantly how reliable and valid these measures are, the most suitable for use will be identified. Our findings will be of potential interest to clinicians, researchers, and service providers who need information about the methodological quality and the characteristics of measures to make informed decisions about the most reliable and valid tool for a specific purpose. The findings from this study will contribute to the knowledge surrounding available and appropriate measures to use for measuring HRQoL and subjective wellbeing of adolescents with intellectual disabilities, which are necessary to inform intervention development and future health policy.

Systematic review registration

The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO). The registration number is CRD42021231697.
Reliability of Greek version of the Toronto empathy questionnaire in medical students and associations with sociodemographic and lifestyle factors
Authors: Voultsos Polychronis , Chatzinikolaou Fotios , Papana Angeliki , Deliligka Aspasia
Published: May 2022

Background

Empathy is an important key driver of any therapeutic relationship. It is beneficial for both physicians and patients. Enhancing physician’s empathy should be an important goal of medical education. As there was a literature gap regarding the topic of empathy among medical students in Greece, this study aimed to contribute to filling this gap.

Methods

A cross-sectional study was conducted. A socio-demographic questionnaire and the 52-item Greek version of the Toronto composite empathy scale (TCES) for measuring the cognitive and emotional aspects of empathy in both personal and professional life was administered to all the medical students in the Aristotle University of Thessaloniki, in Greece. Descriptive statistics were displayed for demographics. The associations of the variables were quantified by Chi-2 independence tests and Pearson’s Correlation Coefficient. The reliability and validity of the questionnaire was determined by Cronbach’s α, Hotelling's T-Squared Test, and Pearson correlation. Paired and Independent Sample T-Tests and One-way ANOVAs indicated statistically significant mean differences among the variables or subgroups of the variables.

Results

The 52‐item TCES, 26 for the personal (Per) setting and another 26 for professional (Pro) life, equally divided into cognitive (Cog) and emotional (Emo) empathy in each case. The overall reliability of the TCES questionnaire was found to be high (Cronbach's α = 0.895, significant positive correlations between the subscales). The mean total score of empathy showed that students had a moderately high empathy. Further, there was a statistically significant difference in means between the Per-Cog and Per-Emo settings (p < 0.001), the Pro-Cog and Pro-Emo (p < 0.001), the Per-Cog and Pro-Cog (p = 0.004), and the Per-Emo and Pro-Emo (p < 0.001). Females had significantly higher empathy scores (mean score 208.04) than males (192.5) on the Per-Cog, Per-Emo and Pro-Emo subscales. Furthermore, a positive correlation was found between empathy and factors such as love for animals, interest in medical ethics, belief in God, having an ill person in the family, class year or carrier intention.

Conclusions

The TCES is applicable to medical students. For the most part our findings were consistent with previous literature. However, we identified some nuances that might draw researchers’ attention. The results of this study may contribute to plan interventions in the curriculum to enhance empathy in the medical students.
Teacher beliefs, personal theories and conceptions of assessment literacy—a tertiary EFL perspective
Authors: Latif Muhammad Wasim , Wasim Arzoo
Published: May 2022

The purpose of this study was to pursue an enhanced understanding of teacher assessment literacy by investigating tertiary EFL practitioners’ assessment-related personal theories, conceptions and beliefs. The study was based on sociocultural theory as a theoretical framework and informed by interpretivism philosophical underpinnings. Twelve teachers from three tertiary educational institutions in the Eastern province of Saudi Arabia participated in semi-structured interviews. The data were analysed employing a thematic analysis approach. The findings revealed diversity, complexity and uncertainty in teacher beliefs and personal theories related to various aspects of assessment and testing. The findings also provided deeper insights into the role of contextual and institutional dynamics that influence teachers’ assessment-related decision-making process. These findings have implications for teacher education and professional development programmes in terms of assessment policy, procedures and practice.
Prevalence, pattern and predictors of self-medication for COVID-19 among residents in Umuahia, Abia State, Southeast Nigeria: policy and public health implications
Authors: Amuzie Chidinma Ihuoma , Kalu Kalu Ulu , Izuka Michael , Nwamoh Uche Ngozi , Emma-Ukaegbu Uloaku , Odini Franklin , Metu Kingsley , Ozurumba Chigozie , Okedo-Alex Ijeoma Nkem
Published: May 2022

Background

COVID-19 has led to restrictions on movements and lockdown measures, which have resulted to higher utilization of over-the-counter drugs compared to prescription-only drugs. This study determined the prevalence, pattern and predictors of self-medication for COVID-19 prevention and treatment.

Methods

A cross-sectional survey was conducted between October and November 2021 among the residents of Umuahia, Abia State. The respondents were selected using a snowball sampling technique, and a self-administered semi-structured questionnaire was used to collect data on the variables via Google forms. Descriptive, bivariate and multivariate analyses were done using IBM SPSS version 26. The level of significance was set at 5%.

Results

A total of 469 respondents participated in the survey. The overall prevalence of self-medication for COVID-19 prevention and treatment was 30.3% (95%CI: 26.7–34.1). The most commonly used medication was herbal products (43.7%). This was mainly self-prepared (41.5%). The major source of information for self-medication was from family members (39.4%). The majority of the respondents reported fear of isolation (76.3%), followed by fear of stigmatization (75.7%) as the triggers of self-medication. Older age (aOR = 1.87, 95% CI: 1.11–3.13), lower educational status [No formal education (aOR = 3.78, 95% CI: 1.28–11.19)], [Primary education (aOR = 2.15, 95% CI: 1.17–3.097)] and perception to cost (aOR = 2.29; 95CI: I.24–4.24) were the predictors of self-medication.

Conclusion

Every one in three residents of Umuahia, Abia State, practiced self-medication for COVID-19 prevention and treatment. Some economic and socio-demographic factors were significantly associated with self-medication. We recommend intensifying public awareness campaigns on the risk of self-medication.
Exposure of primary osteoblasts to combined magnetic and electric fields induced spatiotemporal endochondral ossification characteristic gene- and protein expression profiles
Authors: Dittmann Klaus H. , Mayer Claus , Stephan Heribert , Mieth Christin , Bonin Michael , Lechmann Beat , Rodemann H. Peter
Published: May 2022

Purpose

Molecular processes in primary osteoblasts were analyzed in response to magnetic and electric field exposure to examine its potential impact on bone healing.

Methods

Primary osteoblasts were exposed to a combination of a magnetic field and an additional electric field (EFMF) (20 Hz, 700 mV, 5 mT, continuous sinusoids) in vitro. mRNA- and protein-expressions were assessed during a time interval of 21 days and compared with expression data obtained from control osteoblasts.

Results

We observed an autonomous osteoblast differentiation process in vitro under the chosen cultivation conditions. The initial proliferative phase was characterized by a constitutively high mRNA expression of extracellular matrix proteins. Concurrent EFMF exposure resulted in significanly increased cell proliferation (fold change: 1.25) and reduced mRNA-expressions of matrix components (0.5–0.75). The following reorganization of the extracellular matrix is prerequisite for matrix mineralization and is characterised by increased Ca2+ deposition (1.44). On molecular level EFMF exposure led to a significant decreased thrombospondin 1 (THBS1) mRNA- (0.81) and protein- (0.54) expression, which in turn reduced the TGFß1-dependent mRNA- (0.68) and protein- (0.5) expression of transforming growth factor beta induced (ßIG-H3) significantly, an inhibitor of endochondral ossification. Consequently, EFMF exposure stimulated the expression of genes characteristic for endochondral ossification, such as collagen type 10, A1 (1.50), osteopontin (1.50) and acellular communication network factor 3 (NOV) (1.45).

Conclusions

In vitro exposure of osteoblasts to EFMF supports cell differentiation and induces gene- and protein-expression patterns characteristic for endochondral ossification during bone fracture healing in vivo.
Duodenum edema due to reduced lymphatic drainage leads to increased inflammation in a porcine endotoxemic model
Authors: Marchesi Silvia , Larsson Anders , Hedenstierna Göran , Abujazar Mohammed , Ahlström Håkan , Lipcsey Miklós
Published: May 2022

Background

Interventions, such as mechanical ventilation with high positive end-expiratory pressure (PEEP), increase inflammation in abdominal organs. This effect could be due to reduced venous return and impaired splanchnic perfusion, or intestinal edema by reduced lymphatic drainage. However, it is not clear whether abdominal edema per se leads to increased intestinal inflammation when perfusion is normal. The aim of the presented study was to investigate if an impaired thoracic duct function can induce edema of the abdominal organs and if it is associated to increase inflammation when perfusion is maintained normal. In a porcine model, endotoxin was used to induce systemic inflammation. In the Edema group (n = 6) the abdominal portion of the thoracic duct was ligated, while in the Control group (7 animals) it was maintained intact. Half of the animals underwent a diffusion weighted-magnetic resonance imaging (DW-MRI) at the end of the 6-h observation period to determine the abdominal organ perfusion. Edema in abdominal organs was assessed using wet–dry weight and with MRI. Inflammation was assessed by measuring cytokine concentrations in abdominal organs and blood as well as histopathological analysis of the abdominal organs.

Results

Organ perfusion was similar in both groups, but the Edema group had more intestinal (duodenum) edema, ascites, higher intra-abdominal pressure (IAP) at the end of observation time, and higher cytokine concentration in the small intestine. Systemic cytokines (from blood samples) correlated with IAP.

Conclusions

In this experimental endotoxemic porcine model, the thoracic duct’s ligation enhanced edema formation in the duodenum, and it was associated with increased inflammation.
12 weeks high intensity interval training versus moderate intensity continuous training in chronic low back pain subjects: a randomised single-blinded feasibility study
Authors: Cerini Tamara , Hilfiker Roger , Riegler Thomas F. , Felsch Quinten T. M.
Published: May 2022

Background

Currently, very little is known about the effects of an endurance high intensity interval training (HIIT) in chronic low back pain patients. Therefore, the feasibility and safety of the HIIT must be assessed first before Currently, very little is known about the effects of an endurance high intensity interval training in chronic low back pain patients. Therefore, the feasibility and safety of the HIIT has to be assessed first before it can be integrated safely into research and daily practice it can be integrated safely into research and daily practice. This study aims to answers the question if high intensity interval training and moderate intensity continuous training (MICT) have comparable adherence and feasibility.

Methods

Participants (age from 29 to 69 years) with non-specific chronic low back pain were recruited in this randomised, single-blinded, allocation concealed, feasibility study. The participants trained 30 min on a cycle ergometer for 12 weeks. One group had HIIT and the other MICT.

Results

Of 45 screened subjects 30 participated. The adherence rate was 94% in the HIIT group (median 0.94, IQR 0.23) versus 96% in the MICT group (median 0.96, IQR 0.08), without between-group differences: estimated median of the difference of − 0,01 [95% CI, − 0.11 to 0.06; p = 0.76]. Similar results in enjoyability (median 3, IQR 1 vs median 2, IQR 1.8) and willingness to continue the training (median 3, IQR 1 vs median 3, IQR 0.4).

Both groups improved in pain and disability, without between-group differences in pain [median of the difference, 0.5; 95% CI, − 1 to 2; p = 0.95] nor in disability [median of the difference, 1.78; 95% CI, − 6.44 to 9.56; p = 0.64].

Conclusion

There were no differences in adherence rates. HIIT is as feasible as MICT in non-specific chronic low back pain and can be used in future larger trials to deepen the knowledge about HIIT in this specific population.

Trial registration

ClinicalTrials.gov, NCT04055545. Registered 13 August 2019.
First two mitochondrial genomes for the order Filobasidiales reveal novel gene rearrangements and intron dynamics of Tremellomycetes
Authors: Li Qiang , Bao Zhijie , Tang Ke , Feng Huiyu , Tu Wenying , Li Lijiao , Han Yunlei , Cao Mei , Zhao Changsong
Published: May 2022

In the present study, two mitogenomes from theFilobasidiumgenus were assembled and compared with otherTremellomycetesmitogenomes. The mitogenomes ofF. wieringaeandF. globisporumboth comprised circular DNA molecules, with sizes of 27,861 bp and 71,783 bp, respectively. Comparative mitogenomic analysis revealed that the genetic contents, tRNAs, and codon usages of the twoFilobasidiumspecies differed greatly. The sizes of the twoFilobasidiummitogenomes varied greatly with the introns being the main factor contributing to mitogenome expansion inF. globisporum. Positive selection was observed in several protein-coding genes (PCGs) in theAgaricomycotina, Pucciniomycotina, andUstilaginomycotinaspecies, includingcob,cox2,nad2, andrps3genes. Frequent intron loss/gain events were detected to have occurred during the evolution of theTremellomycetesmitogenomes, and the mitogenomes of 17 species fromAgaricomycotina,Pucciniomycotina, andUstilaginomycotinahave undergone large-scale gene rearrangements. Phylogenetic analyses based on Bayesian inference and the maximum likelihood methods using a combined mitochondrial gene set generated identical and well-supported phylogenetic trees, whereinFilobasidiumspecies had close relationships withTrichosporonalesspecies. This study, which is the first report on mitogenomes from the orderFilobasidiales, provides a basis for understanding the genomics, evolution, and taxonomy of this important fungal group.
Combining ground-penetrating radar sections with different antenna frequencies including time-frequency domain noise suppression filters
Authors: Alemdağ Hilal , Şeren Aysel , Karslı Hakan
Published: May 2022

Ground-penetrating radar (GPR) is one of the most useful geophysical methods that rapidly and efficiently provide high-resolution subsurface images depending on antenna frequencies and target depth. Recently, to enrich the interpretation of GPR sections, multifrequency sections have been combined at deeper and shallower levels in a profile. In this context, the techniques of combination and image quality improving processes of GPR data also have gained importance. For this, simple summation (SS) and time-shifted balanced summation (TSBS) techniques, frequency-domain local mean notch filter (FDLMNF), frequency-space ( f- x) filter, and automatic gain control (AGC) processes are sequentially applied within a workflow. Although the FDLMNF is used to effectively remove single-frequency spike-like noises without distortion around the notch frequency, the f- x filter is applied to suppress the random noise and improve the lateral traceability of the section, and AGC provides a statistically based gain recovery. In the proposed workflow, after generating synthetic and field GPR data with 100 and 250 MHz frequencies, data were combined using SS and TSBS techniques. Finally, FDLMNF, f- x, and AGC were applied to increase the image quality of this combined section. The result sections were evaluated and compared using the Fourier average amplitude and f- k spectra. According to the spectra, the TSBS technique provides good spectral balancing and offers wider spectral content. At the same time, it was observed that the image quality of the combined GPR sections increased significantly after applying FDLMNF, f- x, and AGC processes. As a result, when the sections resulting from SS and TSBS techniques are examined, the image enhancement processes that protect and strengthen the spectral bandwidth of the data are successful. Thus, the temporal resolution and spatial continuity of GPR sections also will be increased, and a better quality interpretation will be provided.
President's Page: The geophysical landscape in the Middle East
Authors: Hanafy Sherif
Published: May 2022

The Middle East has experienced dramatic changes since the discovery of oil in Persia (now Iran) in 1908 and then in Saudi Arabia in 1938. Preceding these discoveries, geophysics as we now know it was not applied or even well known in the region. On the other hand, geology was well established in the Middle East by geologists from the region and abroad. One of the first geologic departments in the Middle East was the geology department at Cairo University, Egypt, which started with the university's establishment in 1925. The geophysics department, conversely, was not established until 1982. Historically, some may argue that the history of geophysics in the Middle East can be traced back to about 600 BC, although the first scientific book relating to geophysics (Fuyuzat-i Miknatissiye, which discussed earth's magnetism) was not translated and printed until 1731.
In-situ physical properties of reclaimed lands in Singapore
Authors: Niu Yanlong , Li Yunyue Elita , Chian Siau Chen , Nilot Enhedelihai , Fang Gang
Published: May 2022

Reclaimed land construction is crucial for sustainable development of the land-scarce city-state of Singapore. To characterize the physical properties of two different types of reclaimed lands — one with well-sorted sands and the other with municipal solid waste — we conduct both active and passive seismic surveys at the sites and compare them with natural geologic formations. From the multichannel surface wave analysis, we observe more complex features related to mode kissing, mode jump, and mode loss on the dispersion spectra of the reclaimed lands, indicating complex subsurface structures. To utilize multiple orders of Rayleigh waves for inversion, we design a quantitative procedure to optimize the mode-order assignment. Seismic data and inverted results show that an older municipal solid waste landfill is more heterogeneous and stronger in its shear strength compared to the younger landfill. The reclaimed land filled with sand is more homogeneous and weaker in shear strength than the natural sedimentary rock formation. The contrast of physical properties at the four sites suggest a significant acceleration in soil hardening when landfill materials are chemically reactive with each other and with the environment. These in-situ measurements are crucial for civil engineering constructions and redevelopment of reclaimed lands in the future.
Revisiting the Threshold for Cancer Genetics Referral in Patients With Wilms Tumor
Authors: Turner Joyce T. , Hill D. Ashley , Dome Jeffrey S.
Published: May 2022

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in the Journal of Clinical Oncology , to patients seen in their own clinical practice.