bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumor Suppressor Effect of RBMS3 in Breast Cancer
Authors: Wang Chunyang , Wu Yidan , Liu Yunqi , Pan Fushun , Zeng Huijuan , Li Xiaoxi , Yu Liang 
Published: April 2021

Background: RBMS3 (RNA-binding motif, single-stranded-intervacting protein 3) acts as a tumor-suppressive gene in a number of human cancers, however, its role in breast cancer is not fully understood. This study aimed to investigate the expression and clinicopathological significance of RBMS3 in breast cancer. Methods: A total of 998 breast cancer tissue samples in The Cancer Genome Atlas (TCGA) database with survival outcomes were divided into high RBMS3 expression and low expression groups using the median as the cutoff. Clinicopathological characteristics and prognosis were compared between the 2 groups. Results: TCGA showed that RBMS3 mRNA was downregulated in breast cancer tissues, and RBMS3 downregulation was correlated with poor prognosis. Immunohistochemistry staining of 127 paraffin-embedded breast cancer tissues showed that RBMS3 protein was localized in the cytoplasm and nucleus; however, nuclear staining was present in 90.0% of normal breast tissues but only 28.3% of breast cancer tissues. Decreased RBMS3 protein expression was significantly correlated with estrogen receptor (ER)-negative status and death at final follow-up. Patients with lower RBMS3 protein expression had substantially shorter survival than those with higher RBMS3 expression. Univariate and multivariate analysis indicated that the combination of RBMS3 expression and ER status (a variable designated as “cofactor”) was an independent prognostic factor in patients with breast cancer (hazard ratio [HR] = 0.420, 95% confidence interval [CI]: 0.223-0.791, P = 0.007). Conclusion: RBMS3 downregulation was correlated with poor prognosis in breast cancer patients, and the combination of RBMS3 expression and ER status was an independent prognostic factor.
The influence of shoulder abduction and external rotation on throwing arm kinetics in professional baseball pitchers
Authors: Manzi Joseph E , Dowling Brittany , Trauger Nicolas , Fu Michael C , Hansen Benjamin R , Dines Joshua S 
Published: April 2021

Background The relationships between shoulder abduction and external rotation with peak kinetic values at the shoulder and elbow in professional baseball pitchers are not well established. Methods Professional pitchers ( n = 322) threw 8–12 fastballs under 3D motion analysis (480 Hz). Pitchers were stratified into quartiles by shoulder abduction and external rotation at distinct timepoints. Regression analyses were performed to quantify associations between shoulder position and kinetics. Results Shoulder abduction remained relatively consistent throughout the pitch (foot contact–ball release: 85.5 ± 11.1–90.7 ± 8.4°); shoulder external rotation increased dramatically (foot contact–ball release: 30.8 ± 24.6–165.2 ± 9.7°). For every 10° increase in maximum shoulder rotation, shoulder superior force increased by 2.3% body weight ( p < 0.01), shoulder distraction force increased by 5.9% body weight ( p < 0.01), and ball velocity increased by 0.60 m/s ( p < 0.01). Shoulder abduction was significantly associated with shoulder superior force at all timepoints but not with ball velocity ( p > 0.05). For every 10° increase in shoulder abduction at ball release, shoulder superior force increased by 3.7% body weight ( p < 0.01) and shoulder distraction force increased by 11.7% body weight ( p < 0.01). Conclusion Increased shoulder abduction at ball release and increased maximum shoulder external rotation were associated with greater superior and distraction forces in the shoulder. Pitchers can consider decreasing shoulder abduction at later stages of the pitch to around 80° in order to minimize shoulder superior force, with no impact on ball velocity.
Astitva: An Unsustainable Social Entrepreneurship Journey
Authors: Singh Shikha , Mittal Shweta , Awasthi Anuraag 
Published: April 2021

Astitva was founded as a not-for-profit organization by Anamika Yaduvanshi, in 2013. The objective of the non-governmental organization (NGO) was to make a visible difference in the lives of disadvantaged sections of the society. Within a short period since its inception, the NGO had positively impacted the lives of individuals and families living in the Wazirpur area. The case helps to understand that even after venturing into vast philanthropic activities, Anamika could not create sustainable livelihoods for the disadvantaged sections of Wazirpur. Is it because of lack of focus on surplus management? The case also helps in understanding the challenges faced by NGOs at ground level. Research questions/Objective: The aim of this study is to explore the nuances of social entrepreneurship. It explores that there should be a balanced approach between social activities that are mostly provided free and generation of surplus to sustain them. The research questions answered are: Has Astitva created a long-term sustainable impact on the lives of marginalized women and children at Wazirpur? Does the business model of Astitva places even stresses on the social activities to engage the participants and generation of financial surplus to sustain the operation? Links to theory: The study is based on the business model canvas of Osterwalder and Pigneur (2010). The model explains that social enterprises should maintain a balance between philanthropy and commercial sense to be productive or else their sustainability is at a risk. Phenomenon studied: Anamika started Astitva with an aim of social transformation. She wanted to make a concrete difference in the lives of disadvantaged sections of the society as well as contribute in their integration with the mainstream society. Case context: The case can be discussed from the angle of business model of a sustainable entrepreneurship and what may go wrong in making a social enterprise successful. Since Anamika had not prepared any blueprint of plan of action, she faced several challenges. Findings: An entrepreneur driven by community spirit should not start working without creating a road map of generation of funds to support the social activities. Working model of Astitva is laden with lack of planning and absence of long-term vision that failed to create a sustainable livelihood generation for the marginalized women and children. Discussions: The case provokes students to study the need to start a sustainable social enterprise driven by community spirit to uplift the lives of a marginalized section of women and children. Further, the case challenges students to identify the streams of revenue generation and deployment in a business model of a social enterprise to make it sustainable.
What Do We Know About Treating Recalcitrant Auricular Keloids? A Systematic Review and Meta-Analysis
Authors: Zawadiuk Luke R. R. , Van Slyke Aaron C. , Bone Jeffrey , Redfern Baillie , Carr Nicholas J. , Arneja Jugpal S. 
Published: April 2021

Background: Recalcitrant auricular keloids are keloids that have recurred after any previous treatment. They have been shown to have an increased likelihood of recurrence. There is no consensus on how best to treat recalcitrant auricular keloids. Here, we perform the first systematic review and meta-analysis investigating the evidence for treating recalcitrant auricular keloids. Methods: We searched MEDLINE, EMBASE, CINAHL, and EBM Reviews using specific keywords. Prespecified inclusion and exclusion criteria were used to assess article eligibility. Data were extracted for number of recalcitrant keloids, treatment modality, recurrence, and minimum follow-up time. Included articles were stratified by treatment and assigned a level of evidence (LOE) based on the Oxford Centre for Evidence-Based Medicine guidelines. A meta-analysis was performed to estimate recurrence rates with 95% confidence intervals for each treatment modality. Results: A total of 887 unique articles were identified and 13 included. Eleven were LOE III and 2 were LOE IV. Recurrence rates were found to be 9% (95% CI: 3%-25%) for excision with adjuvant brachytherapy, 14% (95% CI: 12%-17%) for excision with adjuvant compression therapy, 17% (95% CI: 3%-56%) for excision with adjuvant external beam radiation, and 18% (95% CI: 4%-53%) for excision with adjuvant steroid injections. No statistical significant difference was found. Conclusions: Data for treatment of auricular keloids are heterogeneous with few high-quality studies. Excision with adjuvant brachytherapy has the lowest recurrence rate in our analysis. Narrow confidence intervals reported here for brachytherapy and compression therapy may help surgeons more confidently recommend either of these treatment modalities to patients.
Health care transitions for persons living with dementia and their caregivers
Authors: Ashbourne Jessica , Boscart Veronique , Meyer Samantha , Tong Catherine E. , Stolee Paul 
Published: April 2021

AbstractBackgroundPersons with dementia are likely to require care from various health care providers in multiple care settings, necessitating navigation through an often-fragmented care system. This study aimed to create a better understanding of care transition experiences from the perspectives of persons living with dementia and their caregivers in Ontario, Canada, through the development of a theoretical framework.MethodsConstructivist grounded theory guided the study. Seventeen individual caregiver interviews, and 12 dyad interviews including persons with dementia and their caregivers, were recorded and transcribed verbatim. The data were coded using NVivo 10 software; analysis occurred iteratively until saturation was reached.ResultsA theoretical framework outlining the context, processes, and influencing factors of care transitions was developed and refined. Gaining an in-depth understanding of the complex care transitions of individuals with dementia and their caregivers is an important step in improving the quality of care and life for this population.ConclusionThe framework developed in this study provides a focal point for efforts to improve the health care transitions of persons living with dementia.
High HSPA8 expression predicts adverse outcomes of acute myeloid leukemia
Authors: Li Jun , Ge Zheng 
Published: April 2021

AbstractBackgroundAcute myeloid leukemia (AML) remains one of the most common hematological malignancies, posing a serious challenge to human health. HSPA8 is a chaperone protein that facilitates proper protein folding. It contributes to various activities of cell function and also is associated with various types of cancers. To date, the role ofHSPA8in AML is still undetermined.MethodsIn this study, public datasets available from the TCGA (Cancer Genome Atlas) and GEO (Gene Expression Omnibus) were mined to discover the association between the expression ofHSPA8and clinical phenotypes of CN-AML. A series of bioinformatics analysis methods, including functional annotation and miRNA-mRNA regulation network analysis, were employed to investigate the role ofHSPA8in CN-AML.ResultsHSPA8was highly expressed in the AML patients compared to the healthy controls. The highHSPA8expression had lower overall survival (OS) rate than those with lowHSPA8expression. High expression ofHSPA8was also an independent prognostic factor for overall survival (OS) of CN-AML patients by multivariate analysis. The differential expressed genes (DEGs) associated withHSPA8high expression were identified, and they were enriched PI3k-Akt signaling, cAMP signaling, calcium signaling pathway.HSPA8high expression was also positively associated with micro-RNAs (hsa-mir-1269a, hsa-mir-508-3p, hsa-mir-203a), the micro-RNAs targeted genes (VSTM4, RHOB, HOBX7) and key known oncogenes (KLF5, RAN, andIDH1), and negatively associated with tumor suppressors (KLF12, PRKG1, TRPS1, NOTCH1, RORA).ConclusionsOur research revealedHSPA8 asa novel potential prognostic factor to predict the survival of CN-AML patients. Our data also revealed the possible carcinogenic mechanism and the complicated microRNA-mRNA network associated with theHSPA8high expression in AML.
Challenges and opportunities from the COVID-19 pandemic in medical education: a qualitative study
Authors: Hayat Ali Asghar , Keshavarzi Mohmmad Hasan , Zare Soolmaz , Bazrafcan Leila , Rezaee Rita , Faghihi Seyed Aliakbar , Amini Mitra , Kojuri Javad 
Published: April 2021

AbstractIntroductionSince the onset of the COVID-19 pandemic, many higher education and health centers have faced challenges. Educational leaders have tried to manage the new situation, but the human infrastructure was not ready for such an event. This study aims to explain the challenges and opportunities of the COVID-19 pandemic for medical education.MethodThis qualitative study used conventional content analysis to collect data from face-to-face and semi-structured interviews. The interviews continued until data saturation was reached. The participants were 12 students and 14 faculty members at Shiraz University of Medical Sciences. To ensure data rigor, we used member checks, peer checks and an external observer.ResultsThree main categories and 15 subcategories were extracted. The findings showed that four subcategories, e.g. perception on feasibility of e-learning, standardizing of e-learning, dedicated teaching, and networking and interdisciplinary collaborations, affected the development of medical e-learning. The main opportunities from the COVID-19 pandemic for medical education were classified into five subcategories: attitudes to e-learning and adaptability, preventing students’ separation from the educational environment, documentation and monitoring education, take control of own learning, and increasing perceived usefulness. The main challenges were divided into four subcategories, e.g. noncompliance with virtual classroom etiquette, inadequate interactions, time limitations, and infrastructure defects and problems. Finally, participants believed that methods of evaluation in e-learning were more suitable for diagnosis and formative evaluations. Generally, two subcategories were extracted, e.g. formative and summative.ConclusionMedical schools have necessarily moved towards e-learning to compensate for the interruption in classroom education, such that traditional classes have been replaced with e-learning. These rapid, extensive changes in teaching and learning approaches have consequences for medical schools.
A qualitative systematic review and thematic synthesis exploring the impacts of clinical academic activity by healthcare professionals outside medicine
Authors: Newington Lisa , Wells Mary , Adonis Adine , Bolton Lee , Bolton Saghdaoui Layla , Coffey Margaret , Crow Jennifer , Fadeeva Costa Olga , Hughes Catherine , Savage Matthew , Shahabi Lillie , Alexander Caroline M. 
Published: April 2021

AbstractBackgroundThere are increasing opportunities for healthcare professionals outside medicine to be involved in and lead clinical research. However, there are few roles within these professions that include time for research. In order to develop such roles, and evaluate effective use of this time, the range of impacts of this clinical academic activity need to be valued and understood by healthcare leaders and managers. To date, these impacts have not been comprehensively explored, but are suggested to extend beyond traditional quantitative impact metrics, such as publications, citations and funding awards.MethodsTen databases, four grey literature repositories and a naïve web search engine were systematically searched for articles reporting impacts of clinical academic activity by healthcare professionals outside medicine. Specifically, this did not include the direct impacts of the research findings, rather the impacts of the research activity. All stages of the review were performed by a minimum of two reviewers and reported impacts were categorised qualitatively according to a modified VICTOR (making Visible the ImpaCT Of Research) framework.ResultsOf the initial 2704 identified articles, 20 were eligible for inclusion. Identified impacts were mapped to seven themes: impacts for patients; impacts for the service provision and workforce; impacts to research profile, culture and capacity; economic impacts; impacts on staff recruitment and retention; impacts to knowledge exchange; and impacts to the clinical academic.ConclusionsSeveral overlapping sub-themes were identified across the main themes. These included the challenges and benefits of balancing clinical and academic roles, the creation and implementation of new evidence, and the development of collaborations and networks. These may be key areas for organisations to explore when looking to support and increase academic activity among healthcare professionals outside medicine. The modified VICTOR tool is a useful starting point for individuals and organisations to record the impact of their research activity. Further work is needed to explore standardised methods of capturing research impact that address the full range of impacts identified in this systematic review and are specific to the context of clinical academics outside medicine.
HRP2 and HRP3 cross-reactivity and implications for HRP2-based RDT use in regions with Plasmodium falciparum hrp2 gene deletions
Authors: Kong Amy , Wilson Scott A. , Ah Yong , Nace Douglas , Rogier Eric , Aidoo Michael 
Published: April 2021

Abstract
Background
The Plasmodium falciparum antigen histidine rich protein 2 (HRP2) is a preferred target for malaria rapid diagnostic tests (RDTs) because of its abundant production by the parasite and thermal stability. As a result, a majority of RDTs procured globally target this antigen. However, previous reports from South America and recent reports from sub-Saharan Africa and Asia indicate that certain P. falciparum parasites have deletions of the gene coding for HRP2. The HRP2 antigen is paralogous to another P. falciparum antigen HRP3 and some antibodies to HRP2 cross-react with HRP3. Multiple parasites have been described with deletions of one or both hrp2 and hrp3 genes. It is unclear how the various combinations of hrp2 and hrp3 deletion genotypes affect clinical sensitivity of HRP2-based RDTs.

Methods
Cross-reactivity between HRP2 and HRP3 was tested on malaria RDTs using culture-adapted P. falciparum parasites with both hrp2 and hrp3 intact or with one or both genes deleted. Ten-fold serial dilutions of four culture-adapted P. falciparum parasites [3D7 (hrp2+/hrp3+), Dd2 (hrp2−/hrp3+), HB3 (hrp2+/hrp3−) and 3BD5 (hrp2−/hrp3−)] ranging from 100,000 to 0.01 parasites/µL were prepared. HRP2, Plasmodium lactate dehydrogenase (pLDH) and aldolase concentrations were determined for the diluted samples using a multiplex bead assay. The samples were subsequently tested on three RDT products designed to detect P. falciparum by HRP2 alone or in combination with pLDH.

Results
At parasite densities of approximately 1000 parasites/µL, parasites that expressed either hrp2 or hrp3 were detected by all three RDTs. Multiplex based antigen measurement using HRP2- conjugated beads demonstrated higher antigen concentration when both hrp2 and hrp3 genes were intact (3D7 parasites, 47.9 ng/ml) compared to HB3 (3.02 ng/mL) and Dd2 (0.20 ng/mL) strains that had one gene deleted. 3D7 at 10 parasites/µL (0.45 ng/mL) was reactive on all three RDT products whereas none of the other parasites were reactive at that density.

Conclusions
Above a certain antigen threshold, HRP3 cross-reactivity on HRP2-based RDTs is sufficient to mask the effects of deletions of hrp2 only. Studies of hrp2 deletion and its effects on HRP2-based RDTs must be studied alongside hrp3 deletions and include clinical sample reactivity on HRP2-based tests.
Shaping applied epidemiology workforce training to strengthen emergency response: a global survey of applied epidemiologists, 2019–2020
Authors: Parry Amy Elizabeth , Kirk Martyn D. , Durrheim David N. , Olowokure Babatunde , Colquhoun Samantha M. , Housen Tambri 
Published: April 2021

Abstract
Background
Rapid and effective emergency response to address health security relies on a competent and suitably trained local and international workforce. The COVID-19 pandemic has highlighted that the health security workforce needs to be well equipped to tackle current and future challenges. In this study, we explored whether training in applied epidemiology was meeting the current needs of the applied epidemiology workforce.

Method
We conducted a cross-sectional online survey that was available in English and French. We used purposive and snowballing sampling techniques to identify potential survey respondents. An online social media advertisement campaign was used to disseminate a REDCap survey link between October 2019 and February 2020 through field epidemiology networks. Survey questions included demographic details of participants, along with their technical background, level of formal education, topics studied during epidemiology training, and years of experience as an epidemiologist. We used Pearson Chi-squared (Chi2) to test the difference between categorical variables, and content analysis to evaluate responses to open-ended questions.

Results
In total, 282 people responded to the survey. Participants had a range of formal public health and epidemiology training backgrounds. Respondents applied epidemiology experience spanned almost 30 years, across 64 countries. Overall, 74% (n = 210) were alumni of Field Epidemiology Training Programs (FETP). Basic outbreak and surveillance training was well reported by respondents, however training in specialised techniques related to emergency response, communication, and leadership was less common. FETP graduates reported higher levels of formal training in all survey topics.

Conclusion
It is critical for the health security workforce to be well-trained and equipped with skills needed to ensure a rapid and effective response to acute public health events. Leadership, communication, interpersonal skills, and specialist training in emergency response are lacking in current training models. Our study has demonstrated that applied epidemiology workforce training must evolve to remain relevant to current and future public health challenges.
Expression and regulatory roles of lncRNAs in G-CIMP-low vs G-CIMP-high Glioma: an in-silico analysis
Authors: Datta Indrani , Noushmehr Houtan , Brodie Chaya , Poisson Laila M. 
Published: April 2021

Abstract
Background
Clinically relevant glioma subtypes, such as the glioma-CpG island methylator phenotype (G-CIMP), have been defined by epigenetics. In this study, the role of long non-coding RNAs in association with the poor-prognosis G-CMIP-low phenotype and the good-prognosis G-CMIP-high phenotype was investigated. Functional associations of lncRNAs with mRNAs and miRNAs were examined to hypothesize influencing factors of the aggressive phenotype.

Methods
RNA-seq data on 250 samples from TCGA’s Pan-Glioma study, quantified for lncRNA and mRNAs (GENCODE v28), were analyzed for differential expression between G-CIMP-low and G-CIMP-high phenotypes. Functional interpretation of the differential lncRNAs was performed by Ingenuity Pathway Analysis. Spearman rank order correlation estimates between lncRNA, miRNA, and mRNA nominated differential lncRNA with a likely miRNA sponge function.

Results
We identified 4371 differentially expressed features (mRNA = 3705; lncRNA = 666; FDR ≤ 5%). From these, the protein-coding gene TP53 was identified as an upstream regulator of differential lncRNAs PANDAR and PVT1 (p = 0.0237) and enrichment was detected in the “development of carcinoma” (p = 0.0176). Two lncRNAs (HCG11, PART1) were positively correlated with 342 mRNAs, and their correlation estimates diminish after adjusting for either of the target miRNAs: hsa-miR-490-3p, hsa-miR-129-5p. This suggests a likely sponge function for HCG11 and PART1.

Conclusions
These findings identify differential lncRNAs with oncogenic features that are associated with G-CIMP phenotypes. Further investigation with controlled experiments is needed to confirm the molecular relationships.