bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of PATS: A tool to assess professionalism
Authors: Khan humaira Fayyaz , Yasmeen raheela , Ali Shabana , sadiq Tahira 
Published: October 2019

Abstract
Background:
Professionalism has become a specific requirement for medical graduates because of dissatisfaction regarding their preparedness to adequately deal with the challenges of the medical world. It should be assessed as a competency in the final year of study using a valid and reliable instrument. The purpose was to develop and validate a tool to assess the development of professionalism in final year medical students in the local context to assess the readiness of medical graduates.
Method:
This was a mixed method study. Micro scenarios for the preliminary instrument were developed after a focus group meeting. These were validated using a 3-round modified Delphi technique by email. Twenty-four participants responded in the first round, and 15 in the second and third rounds. After the first round, relevance of the item was obtained. The content validity ratio was calculated after second round. Cut off value for items were approximated to be 0.6 and 0.73 for modification and 0.8 for item retention. The second round revised analysis was sent to participants for the third round and the content validity index average and universal agreement were calculated. Cognitive pretesting was performed. Cronbach’s Alpha for reliability and Confirmatory factor analysis were carried out.
Results:
The focus group produced 46 micro-scenarios using a manual qualitative analysis. The first round of Delphi produced 35 items. On calculation of Content validity ratio 12 items were retained, 18 were revised and 5 were removed. Content validity index (I-CVI) and content validity scale (S-CVI) were 0.94 and 0.64 respectively. Pre-cognitive testing resulted in the modification of 4 items. The Confirmatory factor analysis was 4.1. Cronbach’s Alpha was 0.96.
Conclusion:
The final instrument developed has a 27 item 5-point Likert scale. It has good content validity, reliability and acceptable construct validity. The strength of the instrument is in its process of development i.e. focus group discussion, the iterative Delphi rounds, cognitive pre-testing and piloting. It can be used to assess the development of professionalism in final year medical students.
Keywords:
Professionalism, respect, altruism, honor and integrity, accountability, content validity, construct validity, cognitive pre-testing, and confirmatory factor analysis
Simple Carbohydrate Derivatives Diminish the Formation of Biofilm of Candida albicans
Authors: Ishchuk Olena P. , Sterner Olov , Ellervik Ulf , Manner Sophie 
Published: October 2019

Abstract
The opportunistic human fungal pathogen Candida albicans rely on cell morphological transitions to develop biofilm and invade the host. In the current study, we developed new regulatory molecules, which inhibit the morphological transition of C. albicans from yeast-form cells to cells forming hyphae. These compounds, benzyl α-L-fucopyranoside and benzyl β-D-xylopyranoside, inhibit the morphological switching and adhesion of C. albicans to a polystyrene surface, resulting in a reduced biofilm formation. The addition of cAMP to cells treated with α-L-fucopyranoside restored the yeast-hyphae switch and the biofilm level to that of the untreated control. In the β-D-xylopyranoside treated cells, the biofilm level was only partially restored by the addition of cAMP, and these cells remained mainly as yeast-form cells.
neoANT-HILL: an integrated tool for identification of potential neoantigens
Authors: Coelho Ana Carolina , de Souza Sandro 
Published: October 2019

Abstract
Background Cancer neoantigens have attracted great interest in immunotherapy due to their capacity to elicit antitumoral responses. These molecules arise from somatic mutations in cancer cells, resulting in alterations on the original protein. Neoantigens identification remains a challenging task due largely to a high rate of false-positives.Results We have developed an efficient and automated pipeline for the identification of potential neoantigens. neoANT-HILL integrates several immunogenomic analyses to improve neoantigen detection from NGS data. The pipeline has been compiled in a pre-built Docker image such that minimal computational background is required for download and setup. NeoANT-HILL was applied in the TCGA melanoma dataset and found several putative neoantigens including ones derived from the recurrent RAC1:P29S and SERPINB3:E250K mutations. neoANT-HILL was also used to identify potential neoantigens in RNA-Seq data with a high sensitivity and specificity.Conclusion neoANT-HILL is a user-friendly tool with a graphical interface that performs neoantigens prediction efficiently. neoANT-HILL is able to process multiple samples, provides several binding predictors, enables quantification of tumor-infiltrating immune cells and considers RNA-Seq data for identifying potential neoantigens. The software is available on Github at https://github.com/neoanthill/neoANT-HILL.
Psychometric properties of the new Persian version of the Geriatric Anxiety Inventory (GAI-PV) and its short form (GAI -PV-SF)
Authors: Shati Mohsen , mortazavi Seyede salehe , Malakouti Seyed Kazem , Mehravaran Shiva ASCEND Center for Biomedical Research , Norouzi Ali , Pachana Nancy A. 
Published: October 2019

Abstract
Background The aim of this research was to analyze the psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-PV) and its short form (GAI-PV-SF) in a sample of older adults in Iran.Methods In this cross-sectional study, a sample of 150 community-dwelling and a psychogeriatric sample of 48 adults older than 60 years completed the GAI-PV and GAI-PV-SF, the anxiety sub-scale of the General Health Questionnaire (GHQ-28), the Geriatric Depression Scale (GDS-15), and the Structured Clinical Interview for DSM-IV (SCID-I).Results Both the GAI-PV and GAI-PV-SF exhibited excellent internal consistency and desirable concurrent validity against GHQ-28 and GDS-15. The optimal cutpoint score to detect current generalized anxiety disorder (GAD) was 10/11 and 13/14 for GAI-PV in the community-dwelling and psychogeriatric samples, respectively, and 3/4 for GAI-PV-SF in both study samples. A good test-retest reliability and a single-factor structure were also demonstrated.Conclusion Sound psychometric properties of the GAI-PV in both subsamples suggest that the instrument could be used successfully as an accurate screening instrument in the elderly Iranian population.
Another face Of DMSO: Effects of dimethyl sulfoxide (DMSO) on the pluripotency and differentiation capacity of mouse embryonic stem cells
Authors: Yi JunKoo , Ha Jae-Jung , Kim Dae-Hyun , Ryoo Zae-Young , Kim Sung-Hyun , Kim Myoung-Ok 
Published: October 2019

Abstract
Background Mouse embryonic stem cells (mESCs) go through self-renewal in the existence of the cytokine leukemia inhibitory factor (LIF). LIF is add to the mouse stem cells culture medium, and its removal results in fast differentiation. Dimethyl sulfoxide (DMSO) is one of the most general used solvents in drug test. Methods We exposed 4-day mESC cultures to different concentrations of DMSO (0.1%, 0.5%, 1.0%, and 2.0%) to identify the safest dose exhibiting efficacy as a solvent. mESCs grown under general pluripotency conditions in the absence of LIF were treated with DMSO. In addition, as a control for differentiation, mESCs were grown absence of LIF. Results DMSO downregulated the mRNA expression level of pluripotency markers. Moreover, DMSO reduced the mRNA expression levels of ectodermal marker (β-tubulin3) and a mesodermal marker (Hand1) and endodermal markers (Foxa2 and Sox17) in mESCs. These results indicate that DMSO treatment enhances the pluripotency and disrupts the differentiation of mESCs. We also show that members of the Tet oncogene family are critical to inhibiting the differentiation and methylation of mESCs. Conclusion DMSO is appropriate to sustain the pluripotency of mESCs in the absence of LIF, and that mESCs can be sustained in an undifferentiated state using DMSO. Therefore, DMSO may, in part, function as a substitute for LIF.
Recombinant rabies virus expressing chimeric Omp31/sodC or AHCY gene from Brucella melitensis elicits high level of antibodies and secretary cytokines in mice
Authors: Li Zhenguang , Zhu Hongwei , Yang Yanling , Wang Fengxue , Wang Menghang , Sun Na , Cheng Shipeng , Fu Zhen F. , Wen Yongjun 
Published: October 2019

Abstract
Background: The rabies virus (RV) vector LBNSE expressing foreign antigens has shown considerable promise as vaccines against viral and bacteria diseases, which is effective and safe. We produced a new RV-based vaccine vehicle expressing Brucella melitensis Omp31/sodC or AHCY gene by reverse genetics technology. The aim of this study was to investigate the cellular and humoral immunity of recombinant viruses.
Results: The recombinant virus rLBNSE-SOD and rLBNSE-AHC retained growth properties similar to those of vector rLBNSE both in BSR and mNA cell culture. The Omp31/SODC and AHCY gene was expressed and detected by immunostaining. To compare the immunogenicity of LBNSE-SOD and LBNSE-AHC, mice were immunized with each of recombinant virus by intramuscular (i.m.). Then mice were bled at days 7, 14 after the immunization for the measurement of cytokines and virus neutralizing antibody (VNAs). The parent virus (LBNSE) without expression of any foreign molecules was included for comparison. It was found that mice inoculated with LBNSE-SOD and LBNSE-AHC showed no any signs of disease and exhibited seroconversion against RV. Our findings showed that mice were immunized with each of these recombinant RVs by intramuscular (i.m.) developed efficacy cellular and humoral immunity. The mRNA level of cytokines (IFN-γ and IL-2; IL-4 and IL-10) and VNA level against rabies virus in the blood of mice were increasing after immunization with recombinant RVs. There were no obvious histopathological changes in the brain samples of all mice.
Conclusions: The studies suggested that recombinant RVs expressing Omp31/SodC or AHCY gene would elicit high level of antibodies and secretary cytokines and provided a promising vaccine candidate in mice.
Is tranexamic acid effective and safe for patients undergoing revision total&nbsp;hip and knee&nbsp;arthroplasty: a meta-analysisIs
Authors: Wu Qian , Xu Jiang nan , Zong Lu jie , Wang Sheng hao , Xu Wu , Huang Lixin , Li Li song 
Published: October 2019

Abstract
Background: The use of tranexamic acid (TXA) during primary total joint arthroplasty （pTJA） is well documented. However, whether TXA is safe for patients undergoing revision total joint arthroplasty (rTJA) remains to be resolved.
Methods: This meta-analysis included 12 studies that involved 2195 cases. The primary outcomes were indicators of TXA effectiveness during perioperative perid, including blood loss, haemoglobin (Hb) level changes, allogeneic blood transfusion (ABT) rate, and number of red blood cell (RBC) units transfused per patient. The secondary outcomes included thromboembolic complications, non-thromboembolic complications, and length of hospital stay.
Results: TXA administration was associated with statistically significant decreases in the primary outcomes, including ABT rate (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.14–0.41; P < 0.00001), change in Hb level (mean difference [MD], −0.84; 95% CI, −1.28 to −0.41; P=0.002), and number of RBC units transfused per patient (MD, −0.49; 95% CI, −0.61 to −0.38; P < 0.00001) in the patients undergoing rTJA. Secondary outcome assessments showed no statistically significant differences in venous thromboembolism (OR, 0.99; 95% CI, 0.31–3.14; P=0.98) and non-thromboembolic complications (OR, 0.54; 95% CI, 0.18–1.68; P=0.29) between the patients who received and those who did not receive TXA in the revision total knee arthroplasty subgroup, while a significant decrease in length of hospital stay was found in those who received TXA (MD, −2.89; 95% CI, −4.85 to −0.93; P=0.004).
Conclusion: In this meta-analysis, we found that the use of TXA acid can effectively reduce the number of blood transfusions in patients undergoing TJA without increasing the complication rate.
Incidence of Hemidiaphragmatic Paralysis with Patient Controlled Infusion of Low Volume of Ropivacaine after Ultrasound Guided Low Dose Interscalene Brachial Plexus Block, A Prospective Observational Study
Authors: KUSHAL PANKAJ , SAMRA TANVIR , Saini Vikas , Sethi Sameer , Chouhan Devendra Kumar , Kathuria Rahul 
Published: October 2019

Abstract
BACKGROUND Hemidiaphragmatic paralysis is a complication of single shot and continuous interscalene brachial plexus block that can be minimised by ultrasound guided extrafascial catheter placements and by limiting the amount of local anaesthetic administered. We hypothesized that patient controlled infusion of low volume of ropivacaine for a period of 24 hours would not cause hemidiaphragmatic paralysis and would provide adequate analgesia.METHODS 54 patients aged 18-65 years undergoing surgery for shoulder dislocation or proximal humerus fracture were recruited and allocated into two groups of 27 each, patient controlled interscalene analgesia (PCIA) and multimodal analgesia (MA). Interscalene catheter was inserted at end of surgery and 10 ml of 0.5% ropivacaine was administered as single bolus dose. PCIA was initiated after four hours to deliver background infusion of 2 ml/hr, bolus of 5ml (0.2% of ropivacaine) with lockout interval of 30 minutes for a total duration of 24 hours. Incidence of hemidiaphragmatic paralysis using M-mode ultrasonography was recorded at extubation,4,6,12 and 24hrs. Numerical rating scale (NRS) for pain, patient satisfaction score and complications were also recorded. Acetaminophen (1 gm) and diclofenac 75 gm were used in MA group.RESULT No diaphragmatic paresis was reported in patients administered the background infusion or single bolus doses of ropivacaine and scanned at 4, 6,12 and 24 hrs. Partial paresis was noted in all patients in which two bolus doses/hour were administered 30 minutes after the second bolus. All patients with paresis had diaphragmatic excursion normalized in the next recording made at 4 hours and no complication was reported in any patient. NRS was below 3 at all time points in PCIA and the cumulative fentanyl and tramadol consumption was significantly higher in MA group. The incidence of complete and partial paresis of diaphragm was 85%and 3.7% after single shot bolus dose respectively and had resolved before start of infusion after 4 hours.CONCLUSION Patient controlled low volume continous infusion of ropivacaine (2 ml/hr of 0.2% of ropivacaine) with administration of a single bolus dose of 5ml in an hour does not cause unilateral phrenic paresis. Partial paresis is reported with two bolus doses/hour.Clinical trial number NCT03081728 (clinicaltrials.gov;)
Detection of genes mutations in cerebrospinal fluid circulating tumor DNA from neoplastic meningitis patients using next generation sequencing
Authors: Zhao Yue , He JunYing , Guo Li , Zou YueLi , Cui JunZhao , Guo XiaoSu , Chen Xin , Han WeiXin , Wang Xueliang , Li Chunyan , Bu Hui 
Published: October 2019

Abstract
Background This study profiled the somatic gene mutations and the copy number variations (CNVs) in cerebrospinal fluid (CSF)-circulating tumor DNA (ctDNA) from patients with neoplastic meningitis (NM).Methods A total of 62 CSF ctDNA samples were collected from 58 NM patients for the next generation sequencing. The data were blasted in GenBank and bioinformatically analyzed.Results Cancer-associated gene mutations occurred in all 62 CSF ctDNA samples in TP53 (54/62; 87.10%), EGFR (44/62; 70.97%), PTEN (39/62; 62.90%), CDKN2A (32/62; 51.61%), APC (27/62: 43.55%), TET2 (27/62; 43.55%), GNAQ (18/62; 29.03%), NOTCH1 (17/62; 27.42%), VHL (17/62; 27.42%), FLT3 (16/62; 25.81%), PTCH1 (15/62; 24.19%), BRCA2 (13/62; 20.97%), KDR (10/62; 16.13%), KIT (9/62; 14.52%), MLH1 (9/62; 14.52%), ATM (8/62; 12.90%), CBL (8/62; 12.90%), and DNMT3A (7/62; 11.29%). The mutated genes enriched by the KEGG pathway analysis were the PI3K-Akt, which included the genes of TP53 , EGFR , PTEN , KIT and KDR. After receiving intrathecal and systemic chemotherapy, the ERK1/2 signaling pathways of these CSF samples were activated. Furthermore, the CNVs of these genes were also identified in these 62 samples.Conclusions This study identified gene mutations in all CSF ctDNA samples, indicating that such an approach could be useful as a second-line diagnostic strategy for NM patients. PI3K-Akt signaling may be the potential NM metastasis mechanism.
Assessment of Predictive Validity and Feasibility of Edmonton Frailty Scale in Identifying Postoperative Complications among Asian Elderly Patients A Prospective Observational Study
Authors: He Yingke , Li Lydia Weiling , Ying Hao , Sim Eileen Yilin , Ng Kai Lee , Lee Rui , Lim Mattheaus , Poopalalingam Ruban , Abdullah Hairil Rizal 
Published: October 2019

Abstract
Background
Frailty is defined as diminished physiological reserve predisposing one to adverse outcomes when exposed to stressors. Currently, there is no standardized frailty assessment tool used perioperatively. Edmonton Frail Scale (EFS), which is validated for use by non-geriatricians and in selected surgical populations, is a candidate for this role. Scores ranging from “non-frail” (<=5 points), “vulnerable” (6<=n<=7 points) and “frail” (>=8 points). However, little evaluation of its use has been carried out in the Asians so far. The primary aim of this study is to assess if frailty measured by EFS is predictive of postoperative complications in elderly Asian patients undergoing elective major abdominal surgery. We also aim to assess the feasibility of implementing EFS as a standard tool in the outpatient preoperative assessment clinic setting.
Methods
This is a prospective observational study done among patients aged 70 years and above attended PAC in Singapore General Hospital prior to major abdominal surgery from December 2017 to September 2018. The Comprehensive Complication Index (CCI) and Postoperative Morbidity Survey (POMS) were used to assess their postoperative morbidity respectively. Patient’s acceptability of EFS was measured using the QQ-10 questionnaire and the inter-rater variability of EFS was also assessed using Bland Altman plot.
Results
EFS score was found to be a significant predictor of postoperative morbidity. (OR 1.35, p < 0.001) Each point increase in EFS score was associated with a 3 point increase in CCI score. (Coefficient b 2.944, p < 0.001) EFS score more than 4 has a fair predictability of early and 30-day postoperative complications. Feasibility study demonstrated an overall acceptance of the EFS among our patients with good inter-rater agreement.
Conclusion
These results show that EFS is able to predict postoperative complications in elderly Asian patients undergoing elective major abdominal surgery. It is also feasible to be incorporated as a standard assessment in the outpatient preoperative clinic setting.
A scoping review of age-related health conditions among geriatric populations in sub-Saharan Africa
Authors: Naidoo Keshena , Wyk Jacqueline van 
Published: October 2019

Abstract
Background Globally people are living longer, resulting in an increased demand for primary care services to be responsive to geriatric health needs. There is however, little information on the nature and prevalence of age-related health conditions among older adults in the sub-Saharan African (SSA) region. This scoping review was undertaken to synthesise evidence on the scope and nature of age-related health needs among people aged 60 years and older in SSA. Methods We systematically searched five electronic databases for studies published prior to 30 June 2019. Using the keywords “Africa”, “older adult” or “geriatric”, and “health”, two independent reviewers used a set of eligibility criteria to extract and screen the abstracts and full-text publications. Particular focus was given to age-dependent disorders in people over 60 years such as dementia, disability and falls Results Sixty-four studies met the inclusion criteria. The review revealed a noticeable absence of studies from the majority of Sub-Saharan African countries. Publications included for review represent twelve countries from this region. The morbidities reported on included dementia, functional impairment, mental health, falls, sarcopenia and nutritional disorders, sensory impairment, frailty and musculoskeletal disorders. Many of these conditions co-existed among older adults, resulting in impaired quality of life and disability. Modifiable factors for geriatric morbidity such as hypertension, depression, cognitive and sensory impairments were under-diagnosed and often untreated. Low awareness and management of these conditions were noted among health providers and communities in SSA region. Conclusions The body of empiric research and evidence on age-related health conditions in geriatric people in SSA remains small. Further research is required on screening and management programs for age-related conditions in people over 60 years in SSA, and health professions training in the care of older adults. Ethics and dissemination : This study did not include human participants. Data was sourced from published literature. Keywords: older adult - geriatric - aged - health - Africa
Acoustic vibration response and power generation characteristics of airborne acoustic generator system
Authors: Li Zhipeng , Chen Hejuan 
Published: October 2019

Aiming at the problem of insufficient power supply in modern intelligent fuze, it is of great theoretical significance and practical guidance to study the relationship between acoustic vibration response and power generation characteristics of airborne piezoelectric generators and maximum energy output. Theoretical analysis and experimental verification show that: 1. As long as the frequency of the acoustic wave induced by the flow coincides with the frequency of the acoustical modal in the cavity, a sinusoidal vibration excitation signal will be generated in the cavity; 2. With the increase of the flow rate, the frequency of the vibration signal coupled by the fluid sound source also increases. If the frequency of the acoustic wave is near the anti-resonance frequency of the piezoelectric vibrator, the displacement amplitude of the piezoelectric vibrator increases greatly. The maximum output open circuit voltage is the maximum power generated when the external circuit is connected; 3. The amplitude of the open circuit voltage of the electromechanical coupling output is linear with the amplitude of the displacement of the piezoelectric vibrator, the frequency is the same, the phase angle is the same, and the displacement and the exciting force of the piezoelectric vibrator have the characteristics of the same frequencies and backward phases, the maximum displacement of the piezoelectric vibrator is related to the amplitude of the exciting force and the angular frequency of the exciting force. This characteristic can be used to solve the piezoelectric stress factor under different initial conditions from the experimental point of view.