bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of an instrument to determine oral health knowledge, attitudes, and practices during pregnancy
Authors: Ramírez-Trujillo María de los Ángeles , Villanueva-Vilchis María del Carmen , Aguilar-Díaz Fátima del Carmen , de la Fuente-Hernández Javier , Faustino-Silva Daniel Demétrio , Gaitán-Cepeda Luis Alberto 
Published: October 2021

Abstract
Background
Oral health of the mother-infant dyad is important to preserve general health. However, there are few instruments in Spanish for the evaluation of knowledge, attitudes and practices that determine this construct. Therefore, this research aimed to develop and evaluate the psychometric properties of the Maternal Oral Health Knowledge, Attitudes and Practices Questionnaire (CAPSOM in Spanish).

Methods
In this instrument development study that carried out in 2018–2019, involving pregnant women between the ages of 18 and 45 in the city of Leon, Guanajuato, Mexico. The sample size was calculated based on 10 women per questionnaire item (n = 10 k). The study used Cronbach’s alpha, the modified Lawshe test of validity criteria, factor analysis, and the level of difficulty and discrimination of the items.

Results
207 women took part with their signed, informed consent (25 ± 6 years). The internal consistency of the instrument, both total and by dimension was α = 0.70, α = 0.66 knowledge, α = 0.74 attitudes, and α = 0.66 practices. Values of Content Validity Ratio’ ≥ 0.60 were obtained for the final 10 items and Content Validity Index’ = 0.90. The average difficulty index of items was 0.40, and there were significant differences (Kruskall–Wallis, p < 0.001) in the discrimination test. Factor analysis demonstrated three main components.

Conclusions
A valid and reliable 10-item Spanish questionnaire was designed to measure pregnant women’s oral health knowledge, attitudes, and practices.
Sustainability in Quality Improvement (SusQI): challenges and strategies for translating undergraduate learning into clinical practice
Authors: Marsden Oliver , Clery Philippa , D’Arch Smith Stuart , Leedham-Green Kathleen 
Published: October 2021

Abstract
Background
The healthcare sector is a major contributor to climate change and there are international calls to mitigate environmental degradation through more sustainable forms of clinical care. The UK healthcare sector has committed to net zero carbon by 2040 and sustainable healthcare is a nationally mandated outcome for all UK graduating doctors who must demonstrate their ability to address social, economic, and environmental challenges. Bristol Medical School piloted successful Sustainability in Quality Improvement (SusQI) workshop, but identified challenges translating classroom learning into clinical practice. This paper aims to identify and address those challenges.

Methods
We conducted five focus groups that identified and iteratively explored barriers and facilitators to practice among medical students, comparing a range of experiences to generate a conceptual model. We then combined our findings with behaviour change theory to generate educational recommendations.

Results
Students that applied their learning to the clinical workplace were internally motivated and self-determined but needed time and opportunity to complete projects. Other students were cautious of disrupting established hierarchies and practices or frustrated by institutional inertia. These barriers impacted on their confidence in suggesting or achieving change. A minority saw sustainable healthcare as beyond their professional role.

Conclusions
We present a series of theoretically informed recommendations. These include wider curricular engagement with concepts of sustainable clinical practice; supportive workplace enablement strategies such as workplace champions and co-creation of improvement goals; and time and headspace for students to engage through structured opportunities for credit-bearing project work.
The impact of medical student research as a discussion topic during the residency interview process
Authors: Daus Kelly , McEchron Matthew 
Published: November 2021

Abstract
Background
Students with a greater number of research experiences are more successful in the National Residency Match Program (NRMP.) As a result, approximately two-thirds of allopathic medical schools have implemented a scholarly research project (SP) as a part of their curriculum. While inclusion of an SP in the medical school curriculum increases research productivity, literature to date has not investigated the frequency with which it is a discussion topic during residency interviews.

Methods
One hundred twenty-three students from the graduating class of 2019 and 2020 at the University of Arizona College of Medicine - Phoenix (UACOMP) completed a 17-question survey examining the student’s SP and whether they completed additional research, with an overall response rate of 82.6%. Survey participants were asked to quantify how many residency interviewers asked about their SP or additional research during the interview process.

Results
Twenty-seven percent of interviewers asked students about their SP and 41% of interviewers asked students about additional non-SP research. 40% of interviewers asked about research overall to include SP and/or non-SP research. A greater percentage of interviewers (50%) asked students about their SP if they had undertaken additional research compared to interviewers of students who did not undertake additional research (29%, p = 0.0237). A greater percentage of interviewers at academic institutions (31%) asked students about their SP, compared with a smaller percentage of interviewers at predominantly non-academic programs (22%, p = 0.0054). There were no significant differences in the proportion of interviewers asking about the SP based on the type of specialty, competitiveness of specialty, relatedness project topic to specialty, and publication/presentation status of project.

Conclusion
Student research experiences may serve as a frequent discussion topic during the residency interview. Approximately one-quarter of interviewers ask about the SP regardless of specialty, research topic, and publication/presentation status of the project. Students with additional research experiences beyond their SP may experience a higher percentage of interviewers asking about their SP. Also, students applying to predominantly academic programs may experience a higher proportion of interview questions about research compared to peers interviewing at non-academic programs.
Managing patients on extracorporeal membrane oxygenation support during the COVID-19 pandemic – a proposal for a nursing standard operating procedure
Authors: Puslecki Mateusz , Dabrowski Marek , Baumgart Konrad , Ligowski Marcin , Dabrowska Agata , Ziemak Piotr , Stefaniak Sebastian , Szarpak Lukasz , Friedrich Tammy , Szlanga Lidia , Skorupa Paulina , Steliga Aleksandra , Hebel Kazimiera , Andrejanczyk Blazej , Ladzinska Malgorzata , Wieczorek Magdalena , Puslecki Lukasz , Smereka Jacek , Tukacs Monika , Swol Justyna , Jemielity Marek , Perek Bartlomiej 
Published: October 2021

Abstract
Background
Extracorporeal membrane oxygenation (ECMO) is effective in a selected critically ill patient population with promising results in refractory hypoxemia related to the novel coronavirus disease (COVID-19). However, it requires specialized clinicians and resources in advanced technology. Moreover, the COVID-19 remains an ongoing global emergency, and there is no evidence-based practice in preparedness. This article proposes an innovative and optimized nursing care protocol, the Standard Operating Procedure (SOP), that regulates safety and efficiency in using personal protective equipment (PPE) during ECMO-relevant procedures while providing ECMO therapy for patients with COVID-19.

Methods
After performing a narrative literature search, we developed a high-fidelity translational simulation scenario. It included practicing appropriate donning and doffing PPE during work organization, ECMO-related procedures, and routine daily nursing care and management of ECMO over nine hours. In addition, we held supplementary constructive debrief meetings to consult international expert in the field.

Results
A proposal for nursing standardized operating procedures was created, divided into categories. They included work organization, workload references, competences, infrastructural conditions, cannulation equipment, daily routine nursing care, and procedures during ECMO.

Conclusions
High-fidelity medical simulation can play an important role in staff training, improvement in previously gained proficiency, and development of optimal SOP for nursing care and management during ECMO in patients with COVID-19. Optimal SOPs may further guide multidisciplinary teams, including intensive care units and interventional departments.
Task shifting of intravitreal injections from physicians to nurses: a qualitative study
Authors: Bolme Stine , Austeng Dordi , Gjeilo Kari Hanne 
Published: October 2021

Abstract
Background
Intravitreal injections of anti-vascular endothelial growth factor are high-volume procedures and represent a considerable workload on ophthalmology departments. Several departments have tried to meet this increase by shifting the task to nurses. To maintain high-quality patient care, we developed a training program for nurses that certifies them to administer injections. This qualitative study aimed to evaluate whether the nurses were confident and in control after participating in the training program and whether they were satisfied with the training and the new task.

Methods
Between 2014 and 2018, 12 registered nurses were trained in a tertiary hospital in central Norway. All the nurses were interviewed, either individually (n = 7) or in a group (n = 5). We analysed the interviews using Graneheim and Lundman’s qualitative content analysis.

Results
Eight subthemes were clustered within four main themes: 1) procedure and challenges, 2) motivation, 3) cooperation and confidence, and 4) evaluation. The nurses felt confident and in control when administering injections but experienced moments of insecurity. The new task gave the nurses a sense of achievement, and they highlighted improvement of patients’ lives as positive. A greater level of responsibility gave the nurses pride in their profession. They had suggestions that could improve training efficiency but were overall satisfied with the training program.

Conclusions
Our study showed that the nurses were satisfied with the training and that learning a new task led to higher self-esteem and increased respect from patients and colleagues. Suggestions to improve the training were identified; these should be considered before implementation by other departments.
Nanobodies: a tool to open new horizons in diagnosis and treatment of prostate cancer
Authors: Hosseindokht Maryam , Bakherad Hamid , Zare Hamed 
Published: October 2021

Abstract
Background
Prostate cancer is one of the most common cancers in men and its incidence has increased dramatically in the last decade. This increase in the detection of this type of cancer is based more on the detection of PSA or PSMA antigens as the most important specific antigens of this cancer, and this early detection has greatly helped in the more optimal treatment of patients.

Main body
Many methods have been proposed by researchers for early detection of prostate cancer, but most of the methods used today to detect this type of cancer have been using classical antibodies. Although classical antibodies are able to detect tumor cell markers, but instability, large size, costly and laborious production, and random immobility characteristics, causes many problems. Nanobodies or VHHs, which are derived from camel heavy chain antibodies, have special advantages and have eliminated the disadvantages of classical antibodies which makes them attractive to use in biosensors and cancer diagnostic kits. The research that has been done so far shows that the introduced nanobodies are created for the purpose of targeting, detecting and sensing prostate cancer cells with two main purposes. The first is the efficient identification of prostate cancer and the second is the elimination of cancer cells.

Conclusion
Research shows the use of specific nanobodies against prostate cancer antigens in the design of biosensors and target therapy will be very interesting. In this review article, these nanobodies are introduced and categorized based on their performance.
Advances and insights in the diagnosis of viral infections
Authors: Dronina Julija , Samukaite-Bubniene Urte , Ramanavicius Arunas 
Published: October 2021

AbstractViral infections are the most common among diseases that globally require around 60 percent of medical care. However, in the heat of the pandemic, there was a lack of medical equipment and inpatient facilities to provide all patients with viral infections. The detection of viral infections is possible in three general ways such as (i) direct virus detection, which is performed immediately 1–3 days after the infection, (ii) determination of antibodies against some virus proteins mainly observed during/after virus incubation period, (iii) detection of virus-induced disease when specific tissue changes in the organism. This review surveys some global pandemics from 1889 to 2020, virus types, which induced these pandemics, and symptoms of some viral diseases. Non-analytical methods such as radiology and microscopy also are overviewed. This review overlooks molecular analysis methods such as nucleic acid amplification, antibody-antigen complex determination, CRISPR-Cas system-based viral genome determination methods. Methods widely used in the certificated diagnostic laboratory for SARS-CoV-2, Influenza A, B, C, HIV, and other viruses during a viral pandemic are outlined. A comprehensive overview of molecular analytical methods has shown that the assay's sensitivity, accuracy, and suitability for virus detection depends on the choice of the number of regions in the viral open reading frame (ORF) genome sequence and the validity of the selected analytical method.
Biomimetic 2D layered double hydroxide nanocomposites for hyperthermia-facilitated homologous targeting cancer photo-chemotherapy
Authors: Wang Jingjing , Sun Luyao , Liu Jie , Sun Bing , Li Li , Xu Zhi Ping 
Published: October 2021

Abstract
Background
Multi-modal therapy has attracted increasing attention as it provides enhanced effectiveness and potential stimulation of the immune community. However, low accumulation at the tumor sites and quick immune clearance of the anti-tumor agents are still insurmountable challenges. Hypothetically, cancer cell membrane (CCM) can homologously target the tumor whereas multi-modal therapy can complement the disadvantages of singular therapies. Meanwhile, moderate hyperthermia induced by photothermal therapy can boost the cellular uptake of therapeutic agents by cancer cells.

Results
CCM-cloaked indocyanine green (ICG)-incorporated and abraxane (PTX-BSA)-loaded layered double hydroxide (LDH) nanosheets (LIPC NSs) were fabricated for target efficient photo-chemotherapy of colorectal carcinoma (CRC). The CCM-cloaked LDH delivery system showed efficient homologous targeting and cytotoxicity, which was further enhanced under laser irradiation to synergize CRC apoptosis. On the other hand, CCM-cloaking remarkably reduced the uptake of LDH NSs by HEK 293T cells and macrophages, implying mitigation of the side effects and the immune clearance, respectively. In vivo data further exhibited that LIPC NSs enhanced the drug accumulation in tumor tissues and significantly retarded tumor progression under laser irradiation at very low therapeutic doses (1.2 and 0.6 mg/kg of ICG and PTX-BSA), without observed side effects on other organs.

Conclusions
This research has demonstrated that targeting delivery efficiency and immune-escaping ability of LIPC NSs are tremendously enhanced by CCM cloaking for efficient tumor accumulation and in situ generated hyperthermia boosts the uptake of LIPC NSs by cancer cells, a potential effective way to improve the multi-modal cancer therapy.

Graphical Abstract
Diverse antiviral IgG effector activities are predicted by unique biophysical antibody features
Authors: Cheng Hao D. , Dowell Karen G. , Bailey-Kellogg Chris , Goods Brittany A. , Love J. Christopher , Ferrari Guido , Alter Galit , Gach Johannes , Forthal Donald N. , Lewis George K. , Greene Kelli , Gao Hongmei , Montefiori David C. , Ackerman Margaret E. 
Published: October 2021

Abstract
Background
The critical role of antibody Fc-mediated effector functions in immune defense has been widely reported in various viral infections. These effector functions confer cellular responses through engagement with innate immune cells. The precise mechanism(s) by which immunoglobulin G (IgG) Fc domain and cognate receptors may afford protection are poorly understood, however, in the context of HIV/SHIV infections. Many different in vitro assays have been developed and utilized to measure effector functions, but the extent to which these assays capture distinct antibody activities has not been fully elucidated.

Results
In this study, six Fc-mediated effector function assays and two biophysical antibody profiling assays were performed on a common set of samples from HIV-1 infected and vaccinated subjects. Biophysical antibody profiles supported robust prediction of diverse IgG effector functions across distinct Fc-mediated effector function assays. While a number of assays showed correlated activities, supervised machine learning models indicated unique antibody features as primary contributing factors to the associated effector functions. Additional experiments established the mechanistic relevance of relationships discovered using this unbiased approach.

Conclusions
In sum, this study provides better resolution on the diversity and complexity of effector function assays, offering a clearer perspective into this family of antibody mechanisms of action to inform future HIV-1 treatment and vaccination strategies.
Population variation alters aggression-associated oxytocin and vasopressin expressions in brains of Brandt’s voles in field conditions
Authors: Huang Shuli , Li Guoliang , Pan Yongliang , Liu Jing , Zhao Jidong , Zhang Xin , Lu Wei , Wan Xinrong , Krebs Charles J. , Wang Zuoxin , Han Wenxuan , Zhang Zhibin 
Published: October 2021

AbstractDensity-dependent change in aggressive behavior contributes to the population regulation of many small rodents, but the underlying neurological mechanisms have not been examined in field conditions. We hypothesized that crowding stress and aggression-associated oxytocin (OT) and arginine vasopressin (AVP) in specific regions of the brain may be closely related to aggressive behaviors and population changes of small rodents. We analyzed the association of OT and AVP expression, aggressive behavior, and population density of Brandt’s voles in 24 large semi-natural enclosures (0.48 ha each) in Inner Mongolia grassland. We tested the effects of population density on the OT/AVP system and aggressive behavior by experimentally manipulating populations of Brandt’s voles in the grassland enclosures. High density was positively and significantly associated with more aggressive behavior, and increased expression of mRNA and protein of AVP and its receptor, but decreased expression of mRNA and protein of OT and its receptor in specific brain regions of the voles. Our study suggests that changes in OT/AVP expression are likely a result of the increased psychosocial stress that these voles experience during overcrowding, and thus the OT/AVP system can be used as indicators of density-dependent stressors in Brandt’s voles.
Visual feedback improves movement illusions induced by tendon vibration after chronic stroke
Authors: Le Franc Salomé , Bonan Isabelle , Fleury Mathis , Butet Simon , Barillot Christian , Lécuyer Anatole , Cogné Mélanie 
Published: October 2021

Abstract
Background
Illusion of movement induced by tendon vibration is commonly used in rehabilitation and seems valuable for motor rehabilitation after stroke, by playing a role in cerebral plasticity. The aim was to study if congruent visual cues using Virtual Reality (VR) could enhance the illusion of movement induced by tendon vibration of the wrist among participants with stroke.

Methods
We included 20 chronic stroke participants. They experienced tendon vibration of their wrist (100 Hz, 30 times) inducing illusion of movement. Three VR visual conditions were added to the vibration: a congruent moving virtual hand (Moving condition); a static virtual hand (Static condition); or no virtual hand at all (Hidden condition). The participants evaluated for each visual condition the intensity of the illusory movement using a Likert scale, the sensation of wrist’s movement using a degree scale and they answered a questionnaire about their preferred condition.

Results
The Moving condition was significantly superior to the Hidden condition and to the Static condition in terms of illusion of movement (p < 0.001) and the wrist’s extension (p < 0.001). There was no significant difference between the Hidden and the Static condition for these 2 criteria. The Moving condition was considered the best one to increase the illusion of movement (in 70% of the participants). Two participants did not feel any illusion of movement.

Conclusions
This study showed the interest of using congruent cues in VR in order to enhance the consistency of the illusion of movement induced by tendon vibration among participants after stroke, regardless of their clinical severity. By stimulating the brain motor areas, this visuo-proprioceptive feedback could be an interesting tool in motor rehabilitation.
Record number in Clinical Trials: NCT04130711, registered on October 17th 2019 (https://clinicaltrials.gov/ct2/show/NCT04130711?id=NCT04130711&draw=2&rank=1).
Nanomaterial- and shape-dependency of TLR2 and TLR4 mediated signaling following pulmonary exposure to carbonaceous nanomaterials in mice
Authors: Danielsen Pernille Høgh , Bendtsen Katja Maria , Knudsen Kristina Bram , Poulsen Sarah Søs , Stoeger Tobias , Vogel Ulla 
Published: October 2021

Abstract
Background
Pulmonary exposure to high doses of engineered carbonaceous nanomaterials (NMs) is known to trigger inflammation in the lungs paralleled by an acute phase response. Toll-like receptors (TLRs), particularly TLR2 and TLR4, have recently been discussed as potential NM-sensors, initiating inflammation. Using Tlr2 and Tlr4 knock out (KO) mice, we addressed this hypothesis and compared the pattern of inflammation in lung and acute phase response in lung and liver 24 h after intratracheal instillation of three differently shaped carbonaceous NMs, spherical carbon black (CB), multi-walled carbon nanotubes (CNT), graphene oxide (GO) plates and bacterial lipopolysaccharide (LPS) as positive control.

Results
The LPS control confirmed a distinct TLR4-dependency as well as a pronounced contribution of TLR2 by reducing the levels of pulmonary inflammation to 30 and 60% of levels in wild type (WT) mice. At the doses chosen, all NM caused comparable neutrophil influxes into the lungs of WT mice, and reduced levels were only detected for GO-exposed Tlr2 KO mice (35%) and for CNT-exposed Tlr4 KO mice (65%). LPS-induced gene expression was strongly TLR4-dependent. CB-induced gene expression was unaffected by TLR status. Both GO and MWCNT-induced Saa1 expression was TLR4-dependent. GO-induced expression of Cxcl2, Cxcl5, Saa1 and Saa3 were TLR2-dependent. NM-mediated hepatic acute phase response in terms of liver gene expression of Saa1 and Lcn2 was shown to depend on TLR2 for all three NMs. TLR4, in contrast, was only relevant for the acute phase response caused by CNTs, and as expected by LPS.

Conclusion
TLR2 and TLR4 signaling was not involved in the acute inflammatory response caused by CB exposure, but contributed considerably to that of GO and CNTs, respectively. The strong involvement of TLR2 in the hepatic acute phase response caused by pulmonary exposure to all three NMs deserves further investigations.