bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global Nursing - A Qualitative Case Study of Tanzanian Nursing Students' Experiences of Student Exchange in Sweden
Authors: Alden-Joyce Tara , Scheers-Andersson Elina , Rogathi Jane , Kidayi Paulo , Cadstedt Jenny , Björling Gunilla 
Published: August 2020

Abstract
Background: Due to globalization and a shift in population demographics, needs within healthcare are changing and nurses require new skills and knowledge. Nursing education needs to facilitate these new demands and student exchange programmes provide an opportunity to develop necessary skills.Aim: The aim of this study was to explore Tanzanian nursing students' experiences of student exchange in Sweden. Method: A qualitative design was used for this empirical study. Semi-structured interviews were conducted with six Tanzanian nursing students who had participated in student exchange in Sweden. The participants were recruited by purposeful sampling. Inductive reasoning and qualitative content analysis were applied.Results: The findings revealed that the students experienced new approaches in Sweden, allowing them to develop skills and competences. Furthermore, they increased their global perspectives on nursing and interest in working with global health issues. However, they also experienced challenges in the new environment.Conclusion: The present study showed that the Tanzanian nursing students benefitted from their student exchange, both personally, as well as for their future careers as nurses. More research is needed examining nursing students from low-income countries participating in student exchange in high-income countries.
Ultrafast X-ray diffraction measurements of shock-compressed iron and iron alloys
Authors: Krygier Andrew , Harmand Marion , Albertazzi Bruno , McBride Emma , Miyanishi Kohei , Antonangeli Daniele , Inubushi Yuichi , Kodama Ryosuke , Koenig Michel , Matsuoka Takeshi , Mogni Gabriele , Pietrucci Fabio , Saitta Marco , Togashi Tadashi , Umeda Yuhei , Vinci Tommaso , Yabashi Makina , Yabuuchi Toshinori , Fiquet G. , Ozaki Norimasa 
Published: August 2020

Abstract
The extreme pressures achievable with dynamic compression holds great promise for studying planetary interiors. Phase stability of Fe-Si alloys, which are complex to address, is particularly relevant to understanding telluric planetary cores due to the widely varying properties produced by small changes in Si concentration. Here we report the study of phase stability of pure iron and Fe-Si alloys by x-ray diffraction measurements carried out on shocked samples using an x-ray free electron laser (XFEL). Our setup combined with the brilliance of the XFEL allows us to observe the rapid onset of high-pressure solid-solid phase transformation in Fe and Fe-Si8.5wt%; we observe no such evidence in Fe-Si16wt% up to 110 GPa on the nanosecond timescale. Density Functional Theory calculations provide the conceptual framework to rationalize these observations. Taken together our experiments and calculations support recent dynamic compression measurements and shed light on conflicting static compression results. Our work highlights the need to properly consider the differing intrinsic timescales of the static and dynamic experiments when comparing results, and the complementarity of the techniques in assessing phase diagram and transition mechanisms.
Dentists’ Entrepreneurial Intention and Associated Factors in Public Hospitals in Southeastern China: A Cross-sectional Study
Authors: Wang Jiabi , Peng Bin , Zhou Hongzhi , Zhang Jing Hua 
Published: August 2020

Abstract
Background: Due to the rising demand and fast growth opportunities, the private dental care sector in China tried to attracted experienced dentists from the public hospital system, which hence are faced with challenges of talents outflow and shortage.Methods：A dentist’s entrepreneurial intention (EI) was represented by his/her intention of leaving the public hospital system to be engaged in the private sector..Dentists from public hospitals in 9 major cities of 5 provinces in Southeastern China were surveyed in this study. Through a snowball sampling method, a total of 336 questionnaires were collected. The association between the dentists’ EI and their individual characteristics (basic demographic and professional characteristics, entrepreneurial behaviors) were analyzed using logistic regression analysis.Results: In the public hospitals in China studied, female dentists are consistently less likely to report entrepreneurial intention (EI) (OR=0.365, p=0.001). Dentists in the age group of 36 to 45 and those aged over 45 reported much stronger EI (OR=14.205, p=0.012; OR=8.45, p=0.066) than those in 20’s did. Compared with intern dentists, Attending Dentists (OR=7.812, p=0.016) and Associate/Chief Dentists (OR=9.857, p=0.021) were significantly more likely to report EI. Those with master level (OR=0.221, p=0.021) or Doctorate degrees (OR=0.118, p=0.005) are much less likely to report EI. Meanwhile, those in small hospitals ( with employee numbers < 50) reported much stronger EI than those in large hospitals (OR=2.398, p=0.044). Additionally, dentists’ entrepreneurial behaviors, risk aversion attitudes and their family background all have significant associations.Conclusions: The small public hospitals in China especially face a high risk of talented dentist outflow. As an offsetting strategy, these hospitals may consider more active recruiting policy for female dentists or those holding post-graduate degrees due to their good possibility of long term career path in the public hospital system.
Explaining Factors Affecting Help-Seeking Behaviors in Women with Urinary Incontinence for Early Diagnosis by Healthcare Providers: A Qualitative Study
Authors: Fakari Fahimeh Rashidi , Hajian Sepideh , Darvish Soodabeh , Majd Hamid Alavi 
Published: August 2020

Abstract
Background
Urinary incontinence is widely accepted to be among the most important issues in the global health system. However, only a limited number of women refer for treatment as different factors make help-seeking behaviors more complicated than they initially seem to be. The aim of this study was to explain the factors affecting help-seeking behaviors in women suffering from urinary incontinence.
Methods
The present study used a qualitative method, the conventional content analysis approach, and in-depth semi-structured interviews. The study was conducted between December 2018 and August 2019 in Tehran, Iran. The participants of the study included 34 women with urinary incontinence selected using purposive sampling method. The content analysis approach was based on the Graneheim and Lundman method, and qualitative data management software was used to analyze data.
Results
Data analysis illustrates two facilitating and deterring themes; the categories "not perceiving disease ", "shame", "negative influence of important others", and "the health care system" were among the deterrents and the categories "weakening the quality of life" and "positive effect of important others" were found to be facilitators.
Conclusions
The findings of the present study highlight the need for understanding the underlying facilitators and obstacles to help-seeking behaviors in women with urinary incontinence and suggest that healthcare providers consider an open dialogue with patients taking into account their subjective beliefs and life context during routine referrals so as to facilitate early diagnosis of the disease and ultimately lead to an improvement in the woman's quality of life.
Wearable Sensors for Turning Assessment to Discriminate Frailty Syndrome Among Community-Dwelling Older Adults
Authors: Chiu Huei-Ling , Tsai Chen-Ying , Liu Yu-Lin , Kang Chun-Wei , Lee Shu-Chun 
Published: August 2020

Abstract
Background: Mobile health technologies such as wearable inertial sensors are emerging as complementary clinical assessments and potential to evaluate and analyze postural stability, mobility and gait. Turning is a challenging task and is reported to be one of the daily activities that leads to falling in older populations. We investigated differences in 180° walking turns and 360° turning on the spot among frail, pre-frail, and non-frail older adults utilizing wearable sensors, and determined cutoff points of the turning measures that best discriminated older adults with frailty from those without.Methods: A cross-sectional study was conducted with community-dwelling older adults aged over 65 years. Frailty was assessed using Fried's phenotype method, and turning tasks were measured by wearable sensors. The turn duration (s) and angular velocity (°/s) in 180°and 360° turns were recorded for analysis.Results: In total, 109 participants were enrolled including 50 pre-frail and 12 frail individuals. Frail older adults took significantly longer and had slower angular velocities to complete the 180° and 360° turning than either pre-frail (p=0.002 and p<0.001, respectively) or non-frail (p=0.03 and p<0.001, respectively) older adults after adjustments for gait speed. Cutoff times of 2.45 and 3.46 s were found to best discriminate frail people from those without frailty in both 180° (sensitivity 83.3%, specificity 71.1%, AUC 0.796) and 360° (sensitivity 91.7%, specificity 74.2%, AUC 0.857) turn tasks.Conclusions: Older individuals with frailty syndrome had difficulty turning as evidenced by a longer turning duration and a slower angular velocity. The turn duration could be a potential biomarker of frailty in older populations. This simple and portable wearable technique could improve early detection of the onset of frailty, allowing the clinician to prescribe prevention and rehabilitation interventions for reversing their physical decline.
Analysis of Genomic DNA Methylation and Gene Transcription Modulation Induced by DNMT3A Deficiency in HEK293 Cells
Authors: Zhang Mengxiao , Wang Jiaxian , Tian Qiuxiang , Feng Lei , Yang Hui , Zhu Nan , Pan Xingchen , Zhu Jianwei , Chen Peng , Lu Huili 
Published: August 2020

Abstract
Background DNA methylation is an important epigenetic modification associated with transcriptional repression, and plays key roles in normal cell growth as well as oncogenesis. Among the three main DNA methyltransferases (DNMT1, DNMT3A, and DNMT3B), DNMT3A mediates de novo DNA methylation with partial functional redundancy with DNMT3B. However, the general effects of DNMT3A and its downstream gene regulation profile are yet to be unveiled. Results In the present study, we used CRISPR/Cas9 technology to successfully create DNMT3A deficient human embryonic kidney cell line HEK293, with frameshift mutations in its catalytic domain. Our results showed that the cell growth slowed down in DNMT3A knockout cells. UPLC-MS analysis of DNMT3A deficient cells showed that the genome-level DNA methylation was reduced by 21.5% and led to an impairment of cell proliferation as well as a blockage of MAPK and PI3K-Akt pathways. Whole genome RNA-seq revealed that DNMT3A knockout up-regulated expression of genes and pathways related to cell metabolism but down-regulated those involved in ribosome function, which explained the inhibition of cell growth and related signal pathways. Further, bisulfite DNA treatment showed that DNMT3A ablation reduced the methylation level of DNMT3B gene as well, indicating the higher DNMT3B activity and thereby explaining those down-regulated profiles of genes.Conclusions Our work is the first report on the effect of DNMT3A disruption in its catalytic domain, demonstrating that DNMT3A plays a key role on genomic DNA methylation and expression, and suggesting that DNMT3A could be an ideal target for the development of personalized treatment or to predict tumor prognosis.
Guidelines Translation for Distress Management in Cancer Patients Based on CAN-IMPLEMENT: Implementation Part
Authors: Fu Liang , Zhang Xiaoju , Hu Yan , Lu Zhenqi , Yang Yang , Huang Mingzhu , Li Yuanyuan , Zhu Fuzhong , Wang Yang , Huang Zhe 
Published: August 2020

Abstract
Background: Stomach cancer patients receiving chemotherapy suffered severe distress. This study aimed to align the Cancer-related Distress Management Guidelines into clinical practice among stomach cancer patients receiving chemotherapy, and to monitor the implementation process of Cancer-related Distress Management Guidelines, evaluate the effects of guidelines implementation, and maintain the guidelines implementation in clinical practice.Methods: A Guideline Adaptation and Implementation Planning Resource (CAN-IMPLEMENT) was used as the research framework, which include three phases. Here the Implementation Part (Phase 2 and Phase 3) was reported: alignment of Cancer-related Distress Management Guidelines in clinical practice among stomach cancer patients receiving chemotherapy, and process monitoring and outcome evaluation of Cancer-related Distress Management Guidelines.Results: After the guidelines implementation, the formal audit criteria, working pathways, assessment tools, multidisciplinary panels, training manual for healthcare professionals, education and handbook for patients and their caregivers of distress management were developed on institutional level, as well as the related assessment tools and record forms. The completion rate of distress management record was increased from 0.0% to 97.9% (P<0.001). The compliance of most items in the audit checklist for medical staff's distress management were improved, from 57.1% to 100.0% (P<0.001). The distress positive rate of stomach cancer patients receiving chemotherapy was decreased from 22.7% to 9.3% (P<0.05), and the distress scores were declined from 2 (0-9) to 0 (0-7) (P<0.001).Conclusions: The completion rate of distress management records increased significantly after guidelines implementation, revealing the process quality control of the distress management practice was good. At the institutional level, this guidelines implementation promoted the establishment of distress management system. To healthcare professionals, the guidelines implementation improved the distress management compliance. For stomach cancer patients receiving chemotherapy, distress management practices can effectively improve the distress of stomach cancer patients receiving chemotherapy.
Joint inference of CFC lifetimes and banks suggests previously unidentified emissions
Authors: Lickley Megan , Fletcher Sarah , Rigby Matt , Solomon Susan 
Published: August 2020

Abstract
Chlorofluorocarbons (CFCs) are harmful ozone depleting substances and greenhouse gases. CFC production was phased-out under the Montreal Protocol, however recent studies suggest new and unexpected emissions of CFC-11. Quantifying CFC emissions requires accurate estimates of both atmospheric lifetimes and ongoing emissions from old equipment (i.e. ‘banks’). In a Bayesian framework we simultaneously infer lifetimes, banks and emissions of CFC-11, 12 and 113 using available constraints. We find that lifetimes of all three gases are likely shorter than previous estimates, suggesting that best estimates of inferred emissions are larger than recent evaluations. Our analysis indicates that bank emissions are decreasing faster than inferred emissions, and we estimate new, unexpected emissions during 2014-2016 were 19.6, 16.2, and 7.7 Gg/yr for CFC-11, 12 and 113, respectively. While recent studies have focused on unexpected CFC-11 emissions, our results call for further investigation of potential sources of emissions of CFC-12 and CFC-113, along with CFC-11.
Loss-of-function of the NOMO1 Gene Causes Neuropsychiatric Disorder-related Phenotypes
Authors: Li Fei , Li Tingting , Lin Jia , Jian Jing , Zhang Qi , Zhang Yinglan , Liu Xiuyun , Ji Yongxia , Wang Xu , Li Qiang 
Published: August 2020

Abstract
Background: Clinical genome-wide analysis identified NOMO1 in human chromosome 16p13.11 as a candidate gene associated with neuropsychiatric disorders such as autism, schizophrenia and epilepsy. However, the important contributions underlying NOMO1 deficiency resulting in neuropsychiatric disorders is not understand, and the molecular and pathogenesis mechanisms of nomo1 gene are unclear. Therefore, it is necessary to construct animal models to systematically study the effects of nomo1 deficiency on neuropsychiatric system and explore pathogenic molecular mechanism of diseases.Methods: We developed a viable vertebrate model of loss-of-function of nomo1 using CRISPR/Cas9 and studied the characterization of nomo1 mutant zebrafish. Phenotypic research was performed in developing nomo1 mutant zebrafish, including morphological measurements, behavioral tests, and functional mechanism analyses.Results: The nomo1 loss-of-function zebrafish model accurately recapitulated key neuropsychiatric disorders traits. The mutant zebrafish showed decreased locomotion in the larval stage (7 dpf), increased spontaneous movement in infancy (15 dpf and 30 dpf), and social defects and repetitive behaviors in adolescence (2 mpf). More importantly, we demonstrated that these behavioral phenotypes stem from abnormal brain structure and neurotransmitter metabolism. Transcriptome analysis provided insights for studying the functional mechanism of nomo1 pathogenesis. Further results revealed that the neuroactive drug PTZ recovered the decreased locomotion phenotype in larval zebrafish, which provides functional basis for the exploration of drug sensitivity and intervention in behavioral phenotypes of nomo1 mutant zebrafish.Conclusion: This study firstly reveal the functional evidence that loss-of-function of nomo1 elicits neuropsychiatric disorders, and emphasize the relationship between nomo1 deficiency and neuropsychiatric disorders from the perspectives of behavioral phenotypes, brain development, and neurotransmitter metabolism.Limitation: The behavioral phenotype intervention of neuroactive drug in nomo1-/-zebrafish can be directly translated to the behavior of human associated diseases need further study.
Investigation of Equity in Arrival Time of Emergent Accidental Patient to Hospital in (2018-2019) in a City in North of Iran
Authors: Omidi Mohaddese , Zohrevandi Behzad , Rad Enayatollah Homaie 
Published: August 2020

Abstract
Background: Fairness is an important and controversial issue when allocating public resources. People need to be arrived early to the hospitals when they are injured in traffic accidents. Both the mean and equity of the time of arriving to the hospital are important. The aim of this study was to investigate of equity in arrival time of emergent accidental patient to hospital in 2018-2019 in a city in North of Iran.Methods: This study was a Descriptive-analytical study. In this study we extracted the information from Guilan province trauma system data for Poursina Hospital in Rasht in 2018 and 2019. Data included information on age, sex, level of education, place of residence, time of transfer from the scene of the accident to the hospital, type of vehicle, marriage and occupation. The Gini coefficient was used to calculate equity in access to pre-hospital emergency services and regression models were estimated for inequity in time to receive hospital services. Results: The study showed that the mean and standard deviation of patients' arrival time from the time of the accident to the time of arrival at the hospital was 64.48 ± 47.63 minutes (minimum 9 minutes and maximum 462 minutes). Gini coefficient was 0.31 (p <0.001) which shows in the Rasht city has a relative and appropriate equity when the patient arrives. The contribution of each factor using the regression model indicated the existence of a part of the inequity due to the way the patient was transferred. The transfer time of patients by car was 40 minutes longer (p-value <0.001) and by other methods (except ambulance and car) was 26 minutes longer (p = 0.036). In children, the transfer time was 42 minutes less (p = 0.003). Other variables did not explain the inequity (p> 0.05)Conclusion: According to the time of arrival of patients and Gini index, in Rasht, equity in providing services is in a good condition. This indicates that the emergency department does not systematically transport people to the hospital late.
Targeting TCTP sensitizes tumor to T cell-mediated therapy by reversing immune-refractory phenotypes
Authors: Lee Hyo-Jung , Song Kwon-Ho , Oh Se Jin , Kim Suyeon , Cho Eunho , Kim Jungwon , Park Yun gyu , Lee Kyung-Mi , Yee Cassian , Jung Sang Taek , Kim Tae Woo 
Published: August 2020

Abstract
The authors have requested that this preprint be removed from Research Square.
Regulation of CTGF Expression by miR-133b for the Treatment of Renal Interstitial Fibrosis in Old UUO Rats
Authors: Cao Dan , Wang Yuan , Zhang Yingjie , Zhang Yinping , Huang Qi , Yin Zhong , Cai Guangyan , Chen Xiangmei , Sun Xuefeng 
Published: August 2020

Abstract
Introduction: Renal interstitial fibrosis, an important pathological feature of kidney aging and chronic renal failure, is regulated by mesenchymal stem cells (MSCs). We have previously demonstrated the high expression of miR-133b in MSC-derived extracellular vesicles (MSC-EVs) from old rats, which mediated the inhibition of epithelial-mesenchymal transition (EMT) of renal tubules induced by transforming growth factor-β1 (TGF-β1). We investigated the effect of miR-133b for the treatment of geriatric renal interstitial fibrosis and evaluated its target genes.Methods: miR-133b expression induced during the EMT of HK2 cells by TGF-β1 at different concentrations (0, 6, 8, and 10 ng/mL) and time points (0, 24, 48, and 72 h) was detected using real-time polymerase chain reaction. The target genes of miR-133b were validated using a dual-luciferase reporter assay. In vitro experiments were performed to observe mRNA and protein expression of miR-133b targets, E-cadherin, α-smooth muscle actin (SMA), fibronectin, and collagen 3A1 (Col3A1), in HK2 cells transfected with miR-133b under TGF-β1 stimulation. A 24-week-old unilateral ureteral obstruction (UUO) mouse model was established and injected with transfection reagent and miR-133b into the caudal vein. miR-133b、 target gene and other indexes mentioned above mRNA and protein levels and renal interstitial fibrosis were detected at 7 and 14 days.Results: miR-133b expression gradually decreased with an increase in TGF-β1 concentration and treatment time, and miR-133b mimic downregulated connective tissue growth factor (CTGF) expression. Dual-luciferase reporter assay confirmed CTGF as a direct target of miR-133b. miR-133b mimic transfection inhibited the TGF-β1-induced EMT of HK2 cells; this effect was reversed by CTGF overexpression. miRNA-133b expression significantly increased (approximately 70-100 times) in mouse kidneys after injection of the miRNA-133b overexpression complex, significantly alleviating renal interstitial fibrosis in UUO mice.Conclusion: miR-133b exerted targeted inhibitory effects on CTGF expression, consequently reducing the TGF-β1-induced EMT of HK2 cells and renal interstitial fibrosis in old UUO mice.