bluuebunny/crossref_metadata_2025_split huggingface dataset:
Situational judgment test validity: An exploratory model of the participant response process using cognitive and think-aloud interviews.
Authors: Wolcott Michael D. , Lobczowski Nikki G. , Zeeman Jacqueline M. , McLaughlin Jacqueline E. 
Published: December 2020

Abstract
Background: Situational judgment tests (SJTs) are used in health sciences education to measure examinee knowledge using case-based scenarios. Despite their popularity, there is a significant gap in the validity research on the response process that demonstrates how SJTs measure their intended constructs. A model of SJT response processes has been proposed in the literature by Robert Ployhart; however, few studies have explored and expanded the factors. The purpose of this study was to describe the factors involved in cognitive processes examinees use as they respond to SJT items in a health professions education context.Methods: Thirty participants—15 student pharmacists and 15 practicing pharmacists—completed a 12-item SJT designed to measure empathy. Each participant engaged in a think-aloud interview while completing the SJT, followed by a cognitive interview probing their decision-making processes. Interviews were transcribed and independently coded by three researchers to identify salient factors that contributed to response processes.Results: The findings suggest SJT response processes include all four stages (comprehension, retrieval, judgment, and response selection) as initially proposed by Ployhart. The study showed factors from other published research were present, including job-specific knowledge and experiences, emotional intelligence, and test-taking. The study also identified new factors not yet described, including identifying a task objective in the scenario, assumptions about the scenario, perceptions about the scenario, and the setting of the item.Conclusions: This study provides additional SJT validity evidence by exploring participants’ response processes through cognitive and think-aloud interviews. It also confirmed the four-stage model previously described by Ployhart and identified new factors that may influence SJT response processes. This study contributes to the literature with an expanded SJT response process model in a health professions education context and offers an approach to evaluate SJT response processes in the future.
Drug repurposing and polypharmacology to fight SARS-CoV-2 through the inhibition of the main protease
Authors: Pinzi Luca , Tinivella Annachiara , Caporuscio Fabiana , Rastelli Giulio 
Published: December 2020

Abstract
Therapeutic options are urgently needed to fight the outbreak of a novel coronavirus (SARS-CoV-2), which causes the COVID-19 disease and is spreading rapidly around the world. Drug repurposing can significantly accelerate the identification of drug candidates suitable for clinical evaluation. Moreover, polypharmacological effects may increase antiviral activity and/or counteract severe complications concurrently affecting COVID-19 patients. Herein, we present the results of a computational drug repurposing campaign in search of potential inhibitors of the main protease of SARS-CoV-2. The screening allowed the selection of 22 promising drugs. Some of them have already entered clinical trials, but the vast majority of the identified compounds are new and have never been considered before. For each repurposed compound, its therapeutic relevance and potential beneficial polypharmacological effects that may arise due to its original therapeutic indication are thoroughly discussed.
Effectiveness of blended learning versus lectures alone&nbsp;on ECG analysis and interpretation by medical students
Authors: Viljoen Charle Andre , Millar Rob Scott , Manning Kathryn , Burch Vanessa Celeste 
Published: December 2020

Abstract
BackgroundMost medical students lack confidence and are unable to accurately interpret ECGs. Thus, better methods of ECG instruction are being sought. Current literature indicates that the use of e-learning for ECG analysis and interpretation skills (ECG competence) is not superior to lecture-based teaching. We aimed to assess whether blended learning (lectures supplemented with the use of a web application) resulted in better acquisition and retention of ECG competence in medical students, compared to conventional teaching (lectures alone).MethodsTwo cohorts of fourth-year medical students were studied prospectively. The conventional teaching cohort (n=67) attended four hours of interactive lectures, covering the basic principles of Electrocardiography, waveform abnormalities and arrhythmias. In addition to attending the same lectures, the blended learning cohort (n=64) used a web application that facilitated deliberate practice of systematic ECG analysis and interpretation, with immediate feedback. All participants completed three tests: pre-intervention (assessing baseline ECG competence at start of clinical clerkship), immediate post-intervention (assessing acquisition of ECG competence at end of six-week clinical clerkship) and delayed post-intervention (assessing retention of ECG competence six months after clinical clerkship, without any further ECG training). Diagnostic accuracy and uncertainty were assessed in each test.ResultsThe pre-intervention test scores were similar for blended learning and conventional teaching cohorts (mean 31.02±13.19% versus 31.23±11.52% respectively, p=0.917). While all students demonstrated meaningful improvement in ECG competence after teaching, blended learning was associated with significantly better scores, compared to conventional teaching, in immediate (75.27±16.22% vs 50.27±17.1%, p<0.001; Cohen’s d=1.58), and delayed post-intervention tests (57.70±18.54% vs 37.63±16.35%, p<0.001; Cohen’s d=1.25). Although diagnostic uncertainty decreased after ECG training in both cohorts, blended learning was associated with better confidence in ECG analysis and interpretation.ConclusionBlended learning achieved significantly better levels of ECG competence and confidence amongst medical students than conventional ECG teaching did. Although medical students underwent significant attrition of ECG competence without ongoing training, blended learning also resulted in better retention of ECG competence than conventional teaching. Web applications encouraging a stepwise approach to ECG analysis and enabling deliberate practice with feedback may, therefore, be a useful adjunct to lectures for teaching Electrocardiography.
Leaders'&nbsp;Perspectives on Learning Health Systems: a qualitative&nbsp;study
Authors: Enticott Joanne , Braaf Sandy , Johnson Alison , Jones Angela , Teede Helena 
Published: December 2020

Abstract
Background: Integrated utilisation of digital health data has the power to transform healthcare to deliver more efficient and effective services, and the learning health system (LHS) is emerging as a model to achieve this. The LHS uses routine data from service delivery and patient care to generate knowledge to continuously improve healthcare. The aim of this project was to explore key features of a successful and sustainable LHS to inform implementation in an Academic Health Science Centre context.Methods: We purposively identified and conducted semi-structured qualitative interviews with leaders, experienced in supporting or developing data driven innovations in healthcare. A thematic analysis using NVivo was undertaken.Results: Analysis of 26 interviews revealed five themes thought to be integral in an effective, sustainable LHS: (1) Systematic approaches and iterative, continuous learning with implementation into healthcare contributing to new best-practice care; (2) Broad stakeholder, clinician and academic engagement, with collective vision, leadership, governance and a culture of trust, transparency and co-design; (3) Skilled workforce, capability and capacity building; (4) Resources with sustained investment over time and; (5) Data access, systems and processes being integral to a sustainable LHS. Conclusions: This qualitative study provides insights into the elements of a sustainable LHS across a range of leaders in data-driven healthcare improvement. Fundamentally, an LHS requires continuous learning with implementation of new evidence back into frontline care to improve outcomes. Structure, governance, trust, culture, vision and leadership were all seen as important along with a skilled workforce and sustained investment. Processes and systems to optimise access to quality data were also seen as vital in an effective, sustainable LHS. These findings will inform a co-designed framework for implementing a sustainable LHS within the Australian healthcare and Academic Health Science Centre context. It is anticipated that application of these findings will assist to embed and accelerate the use of routine health data to continuously generate new knowledge and ongoing improvement in healthcare delivery and health outcomes.
Exploring the Usefulness of Medical Clowns in Elevating Satisfaction and Reducing Aggressive Tendencies in Pediatric and Adult Hospital Wards&nbsp;
Authors: Efrat-Treister Dorit , Altman Daniel , Friedmann Enav , Margalit Dalit Lev-Arai , Teodorescu Kinneret 
Published: December 2020

Abstract
Background – Most existing research on medical clowns in health care services has investigated their usefulness mainly among child health consumers. In this research we examined multiple viewpoints of medical staff, clowns, and health consumers aiming to identify the optimal audience (adult or child health consumers) for which medical clowns are most useful. We focused on exploring their usefulness in enhancing health consumers’ satisfaction and, in turn, reducing their aggressive tendencies. Methods – We conducted three studies that examined the placement fit of medical clowns from different points of view: medical staff (Study 1, n = 88), medical clowns (Study 2, n = 20), and health consumers (Study 3, n = 397). The main analyses in Studies 1 and 2 included frequencies and t-tests comparing perceived adult and child satisfaction with clowns’ performance. Study 3 used moderated-mediation PROCESS bootstrapping regression analysis to test the indirect effect of negative affectivity on aggressive tendencies via satisfaction. Exposure to the medical clown moderated this relationship differently for different ages.Results – Studies 1 and 2 show that the majority of medical clowns and medical staff report that the current placement of the medical clowns is in pediatric wards; about half (44% of medical staff, 54% of medical clowns) thought that this placement policy should change. In Study 3, data from health consumers in seven different hospital wards showed that clowns are useful in mitigating the effect of negative affectivity on satisfaction, thereby reducing aggressive tendencies among health consumers under the age of 21.6 years . Surprisingly, medical clowns had the opposite effect on most adults: for health consumers who were exposed to the medical clown and were above the age of 21.6 negative affectivity was related to decreased satisfaction, and an increase in aggressive tendencies was observed. Discussion - Medical clowns are most useful in elevating satisfaction and reducing aggressive tendencies of children. Older adults, on the other hand, exhibit lower satisfaction and higher aggressive tendencies following exposure to the performance of medical clowns. Conclusion – Medical clowns should be placed primarily in children’s wards.
County-Level Longitudinal Clustering of COVID-19 Mortality to Incidence Ratio in the United States
Authors: Vahabi Nasim , Salehi Masoud , Duarte Julio , Mollalo Abolfazl , Michailidis George 
Published: December 2020

Abstract
Background: As of November 12, 2020, the mortality to incidence ratio (MIR) of COVID-19 was 5.8% in the US. We utilized a longitudinal model-based clustering system based on the disease trajectories over time. We aimed to find the so-called “vulnerable” cluster of counties where to dedicate additional resources by the US policymakers. Methods: County-level COVID-19 cases and deaths (Mar-Nov 2020), and a set of potential risk factors were collected for 3050 U.S. counties during the 1st wave (Mar25-Jun3, 2020), 1344 counties (sunbelt region) during the 2nd wave (Jun4-Sep2, 2020), and 1055 counties (great plains) during the 3rd wave (Sep3-Nov12, 2020). We used growth mixture models to identify clusters of counties exhibiting similar COVID-19 MIR growth trajectories and risk-factors over time. Results: We identified the so-called “more vulnerable” clusters during the 1st, 2nd and 3rd waves of COVID-19. Tuberculosis (OR=1.3-2.1-3.2), drug use disorder (OR=1.1), hepatitis (OR=13.1), HIV/AIDS (OR=2.3), cardiomyopathy and myocarditis (OR=1.3), diabetes (OR=1.2), mesothelioma (OR=9.3) were significantly associated with increased odds of being in a more vulnerable cluster. Heart complications and cancer were the main risk factors increasing the COVID-19 MIR (range: 0.08%-0.52% MIR↑).Conclusion: We identified the so-called “more vulnerable” county-clusters exhibiting the highest COVID-19 MIR trajectories, indicating that enhancing the capacity and access to healthcare resources would be key to successfully manage COVID-19 in these clusters. These findings provide insights for public health policymakers on the groups of people and locations they need to pay particular attention while managing the COVID-19 epidemic.
Multi-trait GWAS using imputed high-density genotypes from whole-genome sequencing identifies genes associated with body traits in Nile tilapia
Authors: Yoshida Grazyella , Yáñez José Manuel 
Published: December 2020

Abstract
Background: Body traits are generally controlled by several genes in vertebrates (i.e. polygenes), which in turn make them difficult to identify through association mapping. Increasing the power of association studies by combining approaches such as genotype imputation and multi-trait analysis improves the ability to detect quantitative trait loci associated with polygenic traits, such as body traits.Results: A multi-trait genome-wide association study (mtGWAS) was performed to identify quantitative trait loci (QTL) and genes associated with body traits in Nile tilapia (Oreochromos niloticus) using genotypes imputed to whole-genome sequence (WGS). To increase the statistical power of mtGWAS for the detection of genetic associations, summary statistics from single-trait genome-wide association studies (stGWAS) for eight different body traits recorded in 1,309 animals were used. The mtGWAS increased the statistical power from the original sample size from 13% to 44%, depending on the trait analyzed. The better resolution of the WGS data combined with the increased power of the mtGWAS approach, allowed the detection of significant markers not previously found in the stGWAS. Some lead single nucleotide polymorphisms (SNPs) were found within important functional candidate genes previously associated with growth-related traits. For instance, we identified SNP within the α1,6-fucosyltransferase (FUT8), solute carrier family 4 member 2 (SLC4A2), A disintegrin and metalloproteinase with thrombospondin motifs 9 (ADAMTS9) and heart development protein with EGF like domains 1 (HEG1) genes, which have been associated with average daily gain in sheep, osteopetrosis in cattle, chest size in goats, and growth and meat quality in sheep, respectively.Conclusions: The high-resolution mtGWAS presented, allowed identification of significant SNPs, linked to strong functional candidate genes, associated with body traits in Nile tilapia. These results provide further insights about the genetic variants and genes underlying body trait variation in cichlid fish with high accuracy and strong statistical support.
VTR: an algorithm for identifying analogous contacts on protein structures and their complexes
Authors: Pimentel Vitor , Mariano Diego , Cantão Letícia Xavier Silva , Bastos Luana Luiza , Fischer Pedro , Lima Leonardo Henrique França de , Fassio Alexandre Victor , Melo-Minardi Raquel Cardoso de 
Published: December 2020

Abstract
Evolutionarily related proteins can present similar structures but very dissimilar sequences. Hence, understanding the role of the inter-residues contacts for the protein structure has been the target of many studies. Contacts comprise non-covalent interactions, which are essential to stabilize macromolecular structures such as proteins. Here we show VTR, a new method for the detection of analogous contacts in protein pairs. VTR performs structural alignment between proteins and detects interactions that occur in similar regions. To evaluate our tool, we proposed three case studies: (i) we compared a vertebrate myoglobin and a truncated invertebrate hemoglobin; (ii) analyzed interactions between the spike protein RBD of SARS-CoV-2 and the cell receptor ACE2; and (iii) compared a glucose-tolerant and a non-tolerant β-glucosidase enzyme used for biofuel production. The case studies demonstrate the potential of VTR for the understanding of functional similarities between distantly sequence-related proteins, as well as the exploration of important drug targets and rational design of enzymes for industrial applications. We envision VTR as a promising tool for understanding differences and similarities between homologous proteins with similar 3D structures but different sequences. VTR is available at http://bioinfo.dcc.ufmg.br/vtr.
Liver Fibrosis Staging with Gadolinium Ethoxybenzyl Diethylenetriamine Penta-Acetic Acid-enhanced: A Systematic Review and Meta-analysis
Authors: Lai Lu-Yao , Huang Meng-Ping , Su Song , Shu Jian 
Published: December 2020

Objective:
While liver biopsy is the golden standard for liver-fibrosis diagnosis, it is also
invasive and has many limitations. Non-invasive techniques such as Magnetic Resonance Imaging
(MRI) need to be further developed for liver fibrosis staging. This study aimed to evaluate the
diagnostic accuracy of Gadolinium Ethoxybenzyl Diethylenetriamine Penta-acetic Acid (Gd-EOBDTPA)-
enhanced MRI for liver fibrosis through systematic review and meta-analysis.

Methods:
This study comprehensively searched relevant article in PubMed, Embase, and the
Cochrane Library published from 2004 to 2018 to find studies analyzing the diagnostic accuracy of
Gd-EOB-DTPA-enhanced MRI for liver fibrosis. Two reviewers independently screened the retrieved
articles, extracted the required data from the included studies, and evaluated the methodological
quality of the studies. The pooled sensitivity, specificity, positive likelihood ratio, negative
likelihood ratio, diagnostic odds ratio, and Summary Receiver Operating Characteristics (SROC)
curve were assessed.

Results:
This study finally included 16 studies (n = 1,599) and selected a random-effects model based on the results of the
I
2 statistic to combine them. The areas under the SROC curve for the detection of F1 or greater, F2 or greater, F3 or
greater, or F4 liver fibrosis were 0.8669, 0.8399, 0.8481, and 0.8858, respectively.

Conclusion:
Gd-EOB-DTPA-enhanced MRI showed a good diagnostic performance for staging liver
fibrosis, especially for F4 liver fibrosis.
Traditional Medicine - A Possible Stop Codon for COVID-19
Authors: Reshi Nissar A. , Deshpande Anup S. , Raytekar Namita A. , Zambare Vasudeo P. 
Published: December 2020

:
A novel coronavirus (2019-nCov) has wreak havoc across the globe, especially in the
USA, Italy, Spain, France, Iran, UK, and China. The coronavirus infection has caused a pandemic
(COVID-19), which is an acute infectious pneumonia of the 21st Century. 2019-nCov, being novel
in nature has brought the world to a standstill and forced a global health emergency, which is attributed
to the unavailability of viable antiviral drug, and the only options left are supportive care
and non-specific treatment to improve the symptomatic conditions of patients. But still, it is not a
permanent solution and there is a need to find an effective antiviral drug. The earlier reported
SARS-CoV and recently emerged SARS-CoV-2 have similar homology in terms of epidemiology,
genomics and pathogenesis, and it has been observed that the SARS-CoV was contained by Traditional
Chinese Medicine (TCM). Thus, this review summarizes the information on natural traditional
medicine, including Indian Ayurvedic Medicine and TCM having antiviral potential which have
been used to control earlier pandemics, and their candidacy for the new drug development to control
the COVID-19. In the wake of the current unprecedented situation, it is imperative to find effective
and novel anti-SARS-CoV-2 agents by exploring traditional medicine which would be highly
precise in action with minimal side effects.
Uncovering the Bone-Muscle Interaction and Its Implications for the Health and Function of Older Adults (the Wellderly Project): Protocol for a Randomized Controlled Crossover Trial
Authors: Smith Cassandra , Lin Xuzhu , Scott David , Brennan-Speranza Tara C , Al Saedi Ahmed , Moreno-Asso Alba , Woessner Mary , Bani Hassan Ebrahim , Eynon Nir , Duque Gustavo , Levinger Itamar 
Published: December 2020

Background
Bone and muscle are closely linked anatomically, biochemically, and metabolically. Acute exercise affects both bone and muscle, implying a crosstalk between the two systems. However, how these two systems communicate is still largely unknown. We will explore the role of undercarboxylated osteocalcin (ucOC) in this crosstalk. ucOC is involved in glucose metabolism and has a potential role in muscle maintenance and metabolism.

Objective
The proposed trial will determine if circulating ucOC levels in older adults at baseline and following acute exercise are associated with parameters of muscle function and if the ucOC response to exercise varies between older adults with low muscle quality and those with normal or high muscle quality.

Methods
A total of 54 men and women aged 60 years or older with no history of diabetes and warfarin and vitamin K use will be recruited. Screening tests will be performed, including those for functional, anthropometric, and clinical presentation. On the basis of muscle quality, a combined equation of lean mass (leg appendicular skeletal muscle mass in kg) and strength (leg press; one-repetition maximum), participants will be stratified into a high or low muscle function group and randomized into the controlled crossover acute intervention. Three visits will be performed approximately 7 days apart, and acute aerobic exercise, acute resistance exercise, and a control session (rest) will be completed in any order. Our primary outcome for this study is the effect of acute exercise on ucOC in older adults with low muscle function and those with high muscle function.

Results
The trial is active and ongoing. Recruitment began in February 2018, and 38 participants have completed the study as of May 26, 2019.

Conclusions
This study will provide novel insights into bone and muscle crosstalk in older adults, potentially identifying new clinical biomarkers and mechanistic targets for drug treatments for sarcopenia and other related musculoskeletal conditions.

Trial Registration
Australia New Zealand Clinical Trials Registry ACTRN12618001756213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375925.

International Registered Report Identifier (IRRID)
DERR1-10.2196/18777