bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Influencing Resilience and Burnout Among Resident Physicians - A National Survey
Authors: Nituica Cristina , Bota Oana Alina , Blebea John , Cheng Chin-I , Slotman Gus J. 
Published: April 2021

Abstract
Background

Residency training exposes young physicians to a challenging and high-stress environment, making them vulnerable to burnout. Burnout syndrome not only compromises the health and wellness of resident physicians but has also been linked to prescription errors, reduction in the quality of medical care, and decreased professionalism. This study explored burnout and factors influencing resilience among U.S. resident physicians.
Methods

A cross-sectional study was conducted through an online survey, which was distributed to all accredited residency programs by Accreditation Council of Graduate Medical Education (ACGME). The survey included the Connor-Davidson Resilience Scale (CD-RISC 25), Abbreviated Maslach Burnout Inventory, and socio-demographic characteristics questions. The association between burnout, resilience, and socio-demographic characteristics were examined.
Results

The 682 respondents had a mean CD-RISC score of 72.41(12.1), which was equivalent to the bottom 25th percentile of the general population. Males and upper-level trainees were more resilient than females and junior residents. No significant differences in resilience were found associated with age, race, marital status, or training program type. Resilience positively correlated with personal achievement, family, and institutional support (p < 0.001) and negatively associated with emotional exhaustion and depersonalization (p < 0.001).
Conclusions

High resilience, family, and institutional support were associated with a lower risk of burnout, supporting the need for developing a resilience training program to promote a lifetime of mental wellness for future physicians.
Evaluation of Microbial Culture and Antibiogram in Patients With Head and Neck Infections Who Referred to Shahid Rajaee Hospital of Shiraz Between 1392 to 1398
Authors: Ghorbani Farhad , Faryabi Zahra 
Published: April 2021

Abstract
Background: Head and neck infections happen due to different reasons and different microorganisms are responsible for them. These infections can be treated with various antibiotics. The purpose of this study was to specify most frequent etiology of infection, dominant bacterial species and most effective antibiotic in patients with head and neck infections who referred to Shahid Rajaee hospital of Shiraz.Methods: This study has been carried out in cross-sectional pattern from 2019-May to 2020-Oct in Oral & Maxillofacial Ward of Rajaee Hospital of Shiraz. Consent to access data and archive files was taken from the ethics committee of Shiraz University of Medical Sciences. Age, sex, etiology of infection, bacterial species, sensitivity or resistance reaction to Antibiotics and most frequently used antibiotic in patients who referred to this ward between 1392-Apr to 1398-Mar were collected on the basis of laboratory’s results. Data were analyzed with Chi-Square test.Results: statistical analysis showed that, 56 of patients were men (54.9%) and 46 were women (45.1%). The average of age was 38+/−17 and the minimum age was 6 and maximum age was 73. The most frequent etiology was odontogenic infections. Moreover, there was no statistically significant relationship between etiology and bacterial species (p-value=0.38) and Cefazolin had the most frequency in odontogenic infection group. Top three frequent bacterial species were respectively: Staphylococcus DNase & Coagulase Negative, Enterococci Sp., Streptococci Viridians and Klebsiella Sp. . There was no statistically significant relationship between bacterial species and sex (p-value=0.55). 94 (48.7 %) of bacterial species had Sensitive reaction to antibiotics. 21 (10.9 %) of them had Intermediate reactionand 78 (40%) of them had Resistant reaction and Cefazolin had the most frequency in sensitive group.Conclusion: The dominant bacterial species in head and neck infections are Staphylococcus DNase & coagulase negative. And, Cefazolin had the most sensitive reaction in odontogenic infections.
Collaborative care in secondary prevention of cardiovascular disease in India: Findings from a multi-stakeholder, qualitative analysis
Authors: Singh Kavita , Huffman Mark D. , Tandon Nikhil , Devarajan Raji , Prabhakaran Dorairaj , Mendenhall Emily 
Published: April 2021

Abstract
Background. Cardiovascular disease (CVD) is pervasive in India, and little is known about the perception of patients and providers about collaborative care in secondary prevention of CVD. To fill this gap, we performed a needs assessment and investigated the barriers and facilitators of the collaborative quality improvement (C-QIP) strategy for secondary prevention of CVD in India.Methods. Between September 2019 – February 2020, we conducted semi-structured in-depth interviews with providers, health administrators, patients and caregivers to understand the challenges and facilitators of the C-QIP strategy consisting of electronic health records-decision support system (EHR-DSS), non-physician health worker and text messages for healthy lifestyle. Also, data were analyzed from the lens of consolidated framework for implementation research (CFIR) to guide effective implementation of the C-QIP strategy. We used an iterative approach for qualitative data analysis based on the framework method. Results. We interviewed 38 physicians, 14 non-physician health workers (nurses, community health workers, pharmacists), 4 health administrators, 16 patients and their caregivers. Challenges perceived from providers’ and health administrators’ perspectives to implement quality in CVD care were related to CFIR actors and inner and outer settings: high patient volume, too few specialists, time-constraints, physician burnout, lack of robust communication system or referral linkage, paucity of electronic health records, lack of patient counsellors, polypharmacy and lack of sustainable financing schemes for outpatient services. In addition, low health literacy, high cost of treatment, misinformation bias, and difficulty in maintaining lifestyle changes were key barriers from patients’ and caregivers’ perspectives. Potential benefits of the C-QIP strategy emerged, such as standardized treatment protocol to minimize variation in care, reduced medication errors, improved physician-patient relationships, and enhanced self-care management. However, concerns were raised about feasibility, adoption, and implementation of EHR-DSS across heterogenous healthcare settings, including related to interoperability, patient confidentiality and data security, appropriateness across diverse patient groups, and care delivery costs.Conclusions. Our findings reveal context-specific, patient-, provider- and health system factors that will influence C-QIP strategy implementation in India. Strategies to optimize chronic care of CVD need to be low-cost, culturally acceptable, targeted, and integrated into existing systems and care pathways to be successful.
Effect of LINC00320 Regulating the Expression of PLEKHA1 through the Transcription Factor MYC in Glioma Cell Proliferation, Migration, Invasion and Apoptosis In vivo and In vitro
Authors: Ji Jianyong , Xue Pengfei , Zheng Juan , Li Rongrong , Fu Jinyue , Wang Zhaohao , Li Xin 
Published: April 2021

Abstract
Aim: This study was carried out to explore the mechanism and function of LINC00320 in the development of glioma by regulating PLEKHA1 expression through transcription factor MYC.Methods: By searching LINCDISEASE database and through difference analysis of glioma chip, glioma related lncRNAs were screened, and lncRNA-transcription factor-mRNA triplet was predicted through lncMAP database. The expressions of LINC00320 and PLEKHA1 were detected in glioma and normal controls, followed by the detection of the proliferation, invasion, migration, and apoptosis of glioma cells by using CCK-8 method, Transwell assay, and flow cytometry, respectively. In addition, the expression patterns of MMP9 and cleaved-Caspase 3 were detected with Western Blot. Furthermore, the possible mechanism of LINC00320 was predicted in gliomas by LncMAP. RIP assay was performed to verify the interaction between LINC00320 and MYC, and ChIP assay was applied to validate the binding of MYC and PLEKHA1 promoter. The existence of binding site between MYC and PLEKHA1 promoter were determined by dual luciferase reporter gene assay. Lastly, in vivo test was conducted by using nude mice as the objects of study for verification of the results obtained by in vitro tests.Results: LINC00320 was found to be significantly down-expressed in glioma, and patients with low expression levels of LINC00320 exhibited an even worse prognostic outcome. Over-expression of LINC00320 in glioma cells brought about a significant reduction in cell proliferation, migration, invasion, and promoted apoptosis. There was a significant decrease in the protein expression of MMP9 but remarkable increase in that of cleaved-Caspase 3 after LINC00320 over-expression. LncRNA-transcription factor-mRNA triplet prediction showed that LINC00320 regulated the expression of PLEKHA1 through MYC. RIP assay demonstrated that MYC could significantly enrich LINC00320, Chip assay showed that MYC bound with the PLEKHA1 promoter, and dual luciferase reporter gene assay further confirmed the presence of binding site between MYC and PLEKHA1 promoter. Cell function experiment verified that PLEKHA1 could reverse the effect of LINC00320 over-expression.Conclusion: Over-expression of LINC00320 can attenuate the binding of MYC with PLEKHA1 by recruiting MYC, and ultimately inhibit the proliferation, migration and invasion, and promote the apoptosis of glioma cells.
Serial Procalcitonin Levels and Bacterial Etiology in Hospitalized Patients with Community-Acquired Pneumonia
Authors: Ankomah Pierre , McCluskey Suzanne M , Abers Michael , Bearnot Benjamin , Schuetz Phillip , Chiappa Victor , Vyas Jatin M , Mansour Michael K. 
Published: April 2021

Abstract
Background: Accurate determination of the microbial etiology of pneumonia has important consequences for appropriate administration of antimicrobials and antimicrobial stewardship. Procalcitonin (PCT) is a biomarker that is finding increasing diagnostic and prognostic utility in lower respiratory infections, however, it remains unclear whether it can be helpful in predicting the bacterial etiology of pneumonia. In this study, we examined the relationship between serial PCT measurements and bacterial etiology in hospitalized patients with community-acquired pneumonia, including those at high risk for infections due to multi-drug resistant organisms (MDRO), to determine whether PCT at admission and its trajectory early in the hospital course of patients provides distinguishing information between different bacterial causes of pneumonia.Methods: We analyzed data collected from a prospective cohort study of 505 patients admitted to a tertiary care center with a clinical syndrome consistent with pneumonia. Bacterial etiology of pneumonia was determined from high quality respiratory samples, blood cultures and other relevant diagnostic tests according to standard protocols in conjunction with clinical review. Daily plasma procalcitonin levels were measured for these patients serially during the first four days of hospitalization. We compared procalcitonin levels associated with different bacterial etiologies of pneumonia over the first four days of admission, using the Mann-Whitney-U test to assess for statistical significance.Results: Out of 505 patients, the diagnosis of pneumonia was adjudicated in 322, and bacterial etiology determined in 64 cases. The predominant pathogens were Staphylococcus aureus (n = 19; 12 Methicillin Resistant (MRSA) and 7 Methicillin Susceptible (MSSA)), Pseudomonas aeruginosa (n = 12), Streptococcus pneumoniae (n = 6), and Haemophilus influenza (n=5). We found higher procalcitonin values for S. pneumoniae relative to other etiologies, a delayed rise for Pseudomonas over time, and consistently low PCT values for infections due to multiple bacteria. In addition, our results also suggest that procalcitonin values on the second day of hospitalization, rather than at admission, may have the most utility in distinguishing between bacterial etiologies.Conclusion: Serial procalcitonin values during the early course of bacterial pneumonia reveal a difference between pneumococcal and other bacterial etiologies, and may have an adjunct role in guiding antibiotic choice and duration.
Design an Optimum Energy Harvesting Model for Bidirectional Cognitive Radio Networks
Authors: Hasan Mohammad Kamrul Kamrul , Chowdhury Md. Monwar Jahan , Ahmed Shakil , Sabuj Saifur Rahman , Nibhen Jamel , Bakar Khairul Azmi Abu 
Published: April 2021

Abstract
The energy efficiency and spectrum shortage problem of wireless devices has become a concern for researchers worldwide as the number of wireless devices increases at an unparalleled speed. Many new solutions have been proposed to extend mobile devices' battery life, such as wireless energy harvesting from traditional radio frequency signals to design new smart battery chips. This paper considers a cognitive radio network model where primary users have their specific licensed band, and secondary users equipped with necessary hardware required for energy harvesting can use the licensed band of the primary user by smart sensing capability. First, the expression of outage probability is theoretically derived for uplink and downlink scenarios. Moreover, maximum energy efficiency for both uplink and downlink in the cognitive radio network model subject to interference and noise is investigated here. The theoretical analysis is then evaluated. It has been observed that outage probability improves low harvested power in the downlink scenario and high harvested power in the uplink scenario. Finally, the result signifies that energy efficiency is improved using optimum power for uplink and downlink scenarios.
Integrated microRNA and mRNA Gene Expression in Peripheral Blood Mononuclear Cells in Response to Acute Psychosocial Stress: A Repeated-Measures Within-Subject Pilot Study
Authors: Jurkiewicz Magdalena Maria , Müller-Alcazar Anett , Moser Dirk , Jayatilaka Indralatha , Mikhailik Anatoly , Ferri Jamie , Fogelman Nia , Canli Turhan 
Published: April 2021

Abstract
Objective: The impact of psychosocial stress on a variety of negative health outcomes is well documented, with current research efforts directed at possible mechanisms. Here, we focused on a potential mechanism involving differential expression of mRNA and microRNA in response to acute psychosocial stress. We utilized a validated behavioral paradigm, the Trier Social Stress Test (TSST), to induce acute psychosocial stress in a cohort of volunteers. Stress reactivity was assessed repeatedly during the TSST using saliva samples that were analyzed for levels of cortisol. Peripheral blood mononuclear cells were extracted from blood drawn at baseline and at two time points following the stress paradigm. Total RNA was extracted, and mRNA and microRNA microarrays were utilized to assess within-subject changes in gene expression between baseline and the two post-stressor time points. Results: For microarray gene expression analysis, we focused on 12 participants who showed a robust cortisol response to the task, as an indicator of robust HPA-axis activation. We discovered a set of mRNAs and miRNAs that exhibited dynamic expression change in response to the TSST in peripheral blood mononuclear cells, further characterizing the link between psychosocial stress and cellular response mechanisms.
Psychological symptom and its influencing factors among Chinese elementary school students during early COVID-19 outbreak: A cross-section survey
Authors: Li Xiaoshan , Sun Pengyong , Zhou Mingjie , Shen Youtian , Li Li , Huang Lingling , Huang Taohua 
Published: April 2021

Abstract
Background

This study aimed to examine the psychological symptom and its influencing factors among Chinese elementary school students during early COVID-19 outbreak.
Methods

A cross-section survey was used to investigate individual psychological response and its influencing factors among Chinese elementary school students. And the data were analyzed by the statistical software of SPSS 16.0.
Results

The results showed that students who experience large number of COVID-19-related stressors tend to report more depression and anxiety symptoms. Both problem-based coping and online learning satisfaction were protectors in predicting students’ symptoms of depression and anxiety, while emotion-based coping was a vulnerable factor. With regard to demographic variables, students with low family social status reported more symptoms of depression and anxiety than those with high family social status.
Conclusions

These findings present implications for psychological inventions and for education counselling services during the pandemics.
Complement Factor H-Related 3 induces inflammation and complosome activation in human RPE cells
Authors: Schäfer Nicole , Rasras Anas , Ceteras Delia , Amslinger Sabine , Enzmann Volker , Jägle Herbert , Pauly Diana 
Published: April 2021

Abstract
Background Complement Factor H-Related 3 (FHR-3) is a major regulator of the complement system, which is associated with different diseases, such as age-related macular degeneration. The non-canonical local, cellular functions of FHR-3 remained poorly understood.Methods Human retinal pigment epithelium (RPE) cells (ARPE-19 cells and primary human RPE cells (hpRPE)), cultivated in Transwell® inserts, were apically treated with either FHR‑3 alone or with the chimerized monoclonal anti‑FHR-3 antibody RETC-2-ximab, or with FHR-1, FH, Properdin or not treated for 5 – 24 h, respectively. Interaction of FHR-3 with oxidative stress epitopes was determined by ELISA. Internalization studies of FHR-3 or FH by ARPE‑19 cells was determined by immunofluorescence live cell imaging. Impact of FHR-3 on RPE cell-specific complement components and inflammation markers were analyzed on mRNA (RT-qPCR) and on protein level (Western Blot, ELISA, protein secretion assays, immunofluorescence). Results Here, we report that FHR-3 bound to oxidative stress epitopes and competed with FH for interaction. Furthermore, FHR-3 was internalized by senescent viable RPE cells and modulated time-dependently complement component (C3, CFB) and receptor (C3aR, CR3) expression of human RPE cells. Independently of any external blood-derived proteins, complement activation products were detected. Anaphylatoxin C3a was visualized in treated cells and showed a translocation from the cytoplasm to the cell membrane after FHR-3 exposure. Subsequently, FHR-3 induced a RPE cell dependent pro-inflammatory micro-environment. Inflammasome NLRP3 activation and pro-inflammatory cytokine secretion of IL-1ß, IL-18, IL-6 and TNF-α were induced after FHR-3-RPE interaction. Additionally, important pattern recognition molecules of the innate immune system, Toll-like receptors 1 and 3, as well as proteasome subunits were impaired in RPE cells after FHR-3 incubation. A chimerized monoclonal anti-FHR-3 antibody, RETC‑2‑ximab, ameliorated the effect of FHR-3 on ARPE-19 cells.Conclusion Our studies suggest FHR-3 as an exogenous trigger molecule for the RPE cell complosome and as a productive target for a new therapeutic approach using RETC‑2‑ximab for associated degenerative diseases.
Identification and functional significance of MicroRNAs in esophageal squamous cell carcinoma
Authors: Yu Jiarui , Wang Wei , Zeng Chao , Li Jianing , Zheng Qiangxin , Sun Guogui 
Published: April 2021

Abstract
Background: Oesophageal carcinoma is one of the most frequently seen malignancies, and its incidence ranks third among men and fifth among women in China. Among all the histological categories, oesophageal squamous cell carcinoma (ESCC) accounted for the most of the cases. At present, there are few therapeutic methods applied in clinical practice for ESCC due to the limited evidence with respect to the underlying signaling pathways and the miRNAs related to the ESCC. Methods: To identify the differentially-expressed miRNAs (DE-miRNAs) in different stages of ESCC, we performed a microarray on 92 ESCC and 3 normal tissues. At the mean time, the potentially targeted genes as well as the highly-enriched signaling pathways and the relevant protein–protein interaction (PPI) network were analyzed and constructed by using a series of bioinformatic methods. Moreover, the identified DE-miRNAs in different stages of the ESCC were verified by using the TCGA dataset. Results: According to our analysis, overall 37 DE-miRNAs were identified, including 6 up-regulated miRNAs and 31 down-regulated miRNAs. 1884 genes were selected as the potentially targeted genes for the above miRNAs, most of which were found to be enriched in the PI3K-Akt signaling pathway and the Hippo signaling pathway. Based on the PPI network we constructed, PIK3R1 and NOTCH1 were considered as the potential hub genes. Conclusion: Our study provided additional explanations regarding the molecular mechanisms and prognosis of ESCC through the identification of a number of potential targeted genes of the DE-miRNAs in different stages of ESCC as well as the mostly enriched signaling pathways of the above genes, which could promote the development of the targeted treatment and improve the prognosis evaluation of ESCC.