bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upskilling health and care workers with augmented and virtual reality: protocol for a realist review to develop an evidence-informed programme theory
Authors: Gasteiger Norina , van der Veer Sabine N , Wilson Paul , Dowding Dawn 
Published: July 2021

IntroductionAugmented reality (AR) and virtual reality (VR) are increasingly used to upskill health and care providers, including in surgical, nursing and acute care settings. Many studies have used AR/VR to deliver training, providing mixed evidence on their effectiveness and limited evidence regarding contextual factors that influence effectiveness and implementation. This review will develop, test and refine an evidence-informed programme theory on what facilitates or constrains the implementation of AR or VR programmes in health and care settings and understand how, for whom and to what extent they ‘work’.Methods and analysisThis realist review adheres to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) standards and will be conducted in three steps: theory elicitation, theory testing and theory refinement. First, a search will identify practitioner, academic and learning and technology adoption theories from databases (MEDLINE, Scopus, CINAHL, Embase, Education Resources Information Center, PsycINFO and Web of Science), practitioner journals, snowballing and grey literature. Information regarding contexts, mechanisms and outcomes will be extracted. A narrative synthesis will determine overlapping configurations and form an initial theory. Second, the theory will be tested using empirical evidence located from the above databases and identified from the first search. Quality will be assessed using the Mixed Methods Appraisal Tool (MMAT), and relevant information will be extracted into a coding sheet. Third, the extracted information will be compared with the initial programme theory, with differences helping to make refinements. Findings will be presented as a narrative summary, and the MMAT will determine our confidence in each configuration.Ethics and disseminationEthics approval is not required. This review will develop an evidence-informed programme theory. The results will inform and support AR/VR interventions from clinical educators, healthcare providers and software developers. Upskilling through AR/VR learning interventions may improve quality of care and promote evidence-based practice and continued learning. Findings will be disseminated through conference presentations and peer-reviewed journal articles.
Synthesising evidence regarding hospital to home transitions supported by volunteers of third sector organisations: a scoping review protocol
Authors: Nelson Michelle LA , Armas Alana , Thombs Rachel , Singh Hardeep , Fulton Joseph , Cunningham Heather V , Munce Sarah , Hitzig Sander , Bettger Janet Prvu 
Published: July 2021

IntroductionGiven the risks inherent in care transitions, it is imperative that patients discharged from hospital to home receive the integrated care services necessary to ensure a successful transition. Despite efforts by the healthcare sector to develop health system solutions to improve transitions, problems persist. Research on transitional support has predominantly focused on services delivered by healthcare professionals; the evidence for services provided by lay navigators or volunteers in this context has not been synthesised. This scoping review will map the available literature on the engagement of volunteers within third sector organisations supporting adults in the transition from hospital to home.Methods and analysisUsing the well-established scoping review methodology outlined by the Joanna Briggs Institute, a five-stage review is outlined: (1) determining the research question, (2) search strategy, (3) inclusion criteria, (4) data extraction and (5) analysis and presentation of the results. The search strategy will be applied to 10 databases reflecting empirical and grey literature. A two-stage screening process will be used to determine eligibility of articles. To be included in the review, articles must describe a community-based programme delivered by a third sector organisation that engages volunteers in the provisions of services that support adults transitioning from hospital to home. All articles will be independently assessed for eligibility, and data from eligible articles will be extracted and charted using a standardised form. Extracted data will be analysed using narrative and descriptive analyses.Ethics and disseminationEthics approval is not required for this scoping review. Members of an international special interest group focused on the voluntary sector will be consulted to provide insight and feedback on study findings, help with dissemination of the results and engage in the development of future research proposals. Dissemination activities will include peer-reviewed publications and academic presentations.
Factors associated with serious psychological distress during the COVID-19 pandemic in Japan: a nationwide cross-sectional internet-based study
Authors: Yoshioka Takashi , Okubo Ryo , Tabuchi Takahiro , Odani Satomi , Shinozaki Tomohiro , Tsugawa Yusuke 
Published: July 2021

ObjectiveTo investigate the factors associated with serious psychological distress (SPD) during the COVID-19 pandemic in Japan.DesignNationwide cross-sectional study using survey data.SettingInternet survey using sampling weights for national estimates conducted between 25 August and 30 September 2020 in Japan.ExposuresDemographics (age, gender), socioeconomic status (income level, employment type, educational attainment, marital status, family composition and caregiving burden); the experience of domestic violence (DV), the state of emergency and fear of and stigma related to COVID-19.Main outcome measuresPrevalence of SPD, defined as Kessler 6 Scale score ≥13.ResultsAmong 25 482 respondents, 10.0% met the criteria of SPD. Overall, women (adjusted OR (aOR) 1.59; 95% CI 1.17 to 2.16; p=0.003), ages 15–29 (aOR 2.35 compared with ages 45–59 years; 95% CI 1.64 to 3.38; p<0.001), low-income level (aOR 1.70 compared with intermediate income; 95% CI 1.16 to 2.49; p=0.007), providing caregiving to family members (aOR 5.48; 95% CI 3.51 to 8.56; p<0.001), experiencing DV (aOR 5.72; 95% CI 3.81 to 8.59; p<0.001) and fear of COVID-19 (aOR 1.96; 95% CI 1.55 to 2.48; p<0.001) were associated with SPD. Among women aged 15–29 years, who have a higher risk of suicide during the COVID-19 pandemic in Japan, caregiving, DV, fear of COVID-19 and COVID-19-related stigma were associated with SPD.ConclusionsEconomic situation, caregiving burden, DV and fear of COVID-19 were independently associated with SPD during the COVID-19 pandemic. Among young women, similar factors, except economic situation, were associated with SPD. Targeted interventions based on age and gender may be more effective in mitigating the negative impact of the COVID-19 pandemic on the population’s mental health.
Chlorhexidine gluconate 0.2% as a treatment for recalcitrant fungal keratitis in Uganda: a pilot study
Authors: Arunga Simon , Mbarak Tumu , Ebong Abel , Mwesigye James , Kuguminkiriza Dan , Mohamed-Ahmed Abeer H A , Hoffman Jeremy John , Leck Astrid , Hu Victor , Burton Matthew 
Published: July 2021

ObjectiveFungal keratitis is a major ophthalmic public health problem, particularly in low-income and middle-income countries. The options for treating fungal keratitis are limited. Our study aimed to describe the outcomes of using chlorhexidine 0.2% eye-drops as additional treatment in the management of patients with recalcitrant fungal keratitis.MethodsThis study was nested within a large cohort study of people presenting with microbial keratitis in Uganda. We enrolled patients with recalcitrant fungal keratitis not improving with topical natamycin 5% and commenced chlorhexidine 0.2%. Follow-up was scheduled for 3 months and 1 year. The main outcome measures were healing, visual acuity and scar size at final follow-up.ResultsThirteen patients were followed in this substudy. The patients were aged 27–73 years (median 43 years). Filamentous fungi were identified by microscopy of corneal scrape samples in all cases. Isolated organisms includedAspergillusspp, Fusariumspp, Candidaspp, Bipolarissppand Acremoninumspp. At the final follow-up, nine patients (75%) had healed; three had vision of better than 6/18. Three patients lost their eyes due to infection. In the remaining nine cases, corneal scarring was variable ranging from 4.6 to 9.4 mm (median 6.6 mm, IQR 5.9–8.0 mm); of these five had dense scars, three had moderate scars and one had a mild scar. None of the patients demonstrated signs of chlorhexidine toxicity during the follow-up.ConclusionChlorhexidine 0.2% was found to be a useful sequential adjunctive topical antifungal in cases of fungal keratitis not responding to natamycin 5%, which warrants further evaluation.
Pharmacophore-based screening and modification of amiloride analogs for targeting the NhaP-type cation-proton antiporter in Vibrio cholerae
Authors: Mourin Muntahi , Bhattacharjee Arittra , Wai Alvan , Hausner Georg , O’Neil Joe , Dibrov Pavel 
Published: July 2021

The genome of Vibrio cholerae contains three structural genes for the NhaP-type cation-proton antiporter paralogues, Vc-NhaP1, Vc-NhaP2, and Vc-NhaP3, mediating exchange of K+ and or Na+ for protons across the membrane. Based on phenotypic analysis of chromosomal Vc-NhaP1, Vc-NhaP2, and Vc-NhaP3 triple deletion mutants, we suggest that Vc-NhaP paralogues are primarily K+/H+ antiporters and might play a role in the acid tolerance response of V. cholerae as it passes through the gastric acid barrier of the stomach. Comparison of the biochemical properties of Vc-NhaP isoforms revealed that Vc-NhaP2 was the most active among all three paralogues. Therefore, the Vc-NhaP2 antiporter is a plausible therapeutic target for developing novel inhibitors targeting these ion exchangers. Our structural and mutational analysis of Vc-NhaP2 identified a putative cation-binding pocket formed by antiparallel extended regions of two transmembrane segments (TMSs V and XII) along with TMS VI. Molecular dynamics simulations suggested that the flexibility of TMSs V and XII is crucial for intramolecular conformational events in Vc-NhaP2. In this study, we developed putative Vc-NhaP2 inhibitors from amiloride analogs. Molecular docking of the modified amiloride analogs revealed promising binding properties. The four selected drugs potentially interacted with functionally important amino acid residues located on the cytoplasmic side of TMS VI, the extended chain region of TMSs V and XII, and the loop region between TMSs VIIII and IX. Molecular dynamics simulations revealed that binding of the selected drugs can potentially destabilize Vc-NhaP2 and alter the flexibility of functionally important TMS VI. This work presents the utility of in silico approaches for the rational identification of potential targets and drugs that could target NhaP2 cation proton antiporters to control V. cholerae. The goal was to identify potential drugs that could be validated in future experiments.
Bulk entanglement and its shape dependence
Authors: Fan Zhong-Ying 
Published: July 2021

AbstractWe study bulk entanglement entropy in even spacetime dimensions using the heat kernel method, which captures the universal piece of entanglement entropy, a logarithmically divergent term in even dimensions. In four dimensions, we perform explicit calculations for various shapes of boundary subregions. In particular, for a cusp subregion with an arbitrary opening angle, we find that the bulk entanglement entropy always encodes the same universal information about the boundary theories as the leading entanglement entropy in the large N limit, up to a fixed proportional constant. By smoothly deforming a circle in the boundary, we find that to leading order of the deformations, the bulk entanglement entropy shares the same shape dependence as the leading entanglement entropy and hence the same physical information can be extracted from both cases. This establishes an interesting local/nonlocal relation for holographic $$\mathrm {CFT}_3$$

CFT
3

. However, the result does not hold for higher dimensional holographic theories.
Splay states and two-cluster states in ensembles of excitable units
Authors: Ronge Robert , Zaks Michael A. 
Published: July 2021

AbstractFocusing on systems of sinusoidally coupled active rotators, we study the emergence and stability of periodic collective oscillations for systems of identical excitable units with repulsive all-to-all interaction. Special attention is put on splay states and two-cluster states. Recently, it has been shown that one-parameter families of such systems, containing the parameter values at which the Watanabe–Strogatz integrability takes place, feature an instantaneous non-local exchange of stability between splay and two-cluster states. Here, we illustrate how in the extended families that circumvent the Watanabe–Strogatz dynamics, this abrupt transition is replaced by the “gradual transfer” of stability between the 2-cluster and the splay states, mediated by mixed-type solutions. We conclude our work by recovering the same kind of dynamics and transfer of stability in an ensemble of voltage-coupled Morris–Lecar neurons.
Impact of the COVID-19 Pandemic on Trauma Encounters
Authors: Sheets Nicholas W. , Fawibe Oluwatosin S. , Mahmoud Ahmed , Chawla-Kondal Bhani , Ayutyanont Napatkamon , Plurad David S. 
Published: July 2021

Objectives The Coronavirus Disease 2019 pandemic has affected the health care system significantly. We compare 2019 to 2020 to evaluate how trauma encounters has changed during the pandemic. Methods Retrospective analysis using a large US health care system to compare trauma demographics, volumes, mechanisms of injury, and outcomes. Statistical analysis was used to evaluate for significant differences comparing 2019 to 2020. Results Data was collected from 88 hospitals across 18 states. 169 892 patients were included in the study. There were 6.3% fewer trauma patient encounters in 2020 compared to 2019. Mechanism of injury was significantly different between 2019 and 2020 with less blunt injuries (89.64% vs. 88.39%, P < .001), more burn injuries (1.84% vs. 2.00%, P = .021), and more penetrating injuries (8.58% vs. 9.75%, P < .001). Compared to 2019, patients in 2020 had higher mortality (2.62% vs. 2.88%, P < .001), and longer hospital LOS (3.92 ± 6.90 vs. 4.06 ± 6.56, P < .001). Conclusion The COVID-19 pandemic has significantly affected trauma patient demographics, LOS, mechanism of injury, and mortality.
Trends in U.S. Insulin Use and Glucose Monitoring for People with Diabetes: 2009-2018
Authors: Perez-Nieves Magaly , Juneja Rattan , Fan Ludi , Meadows Eric , Lage Maureen J , Eby Elizabeth L 
Published: July 2021

Background: The delivery and administration of insulin has undergone many changes over the years. This research examines U.S. trends in insulin use among people with type 1 diabetes (T1D) or type 2 diabetes (T2D) in the U.S. from 2009 to 2018. Methods: The IBM® MarketScan® Commercial and Medicare databases were used to identify trends in insulin use over 10 years. The study included people with T1D or T2D who filled a prescription for insulin in any calendar year from 2009 to 2018. The analyses examined insulin regimen and delivery and the use of glucose monitoring systems. Generalized estimating equations were used to test whether trends were statistically significant. Results: Individuals with T1D were most commonly prescribed a basal and bolus insulin regimen or short/rapid insulin only, while for people with T2D the use of basal-only insulin increased significantly over the study period. In both groups there was a significant decline in the use of premix insulin from 2009 to 2018. Insulin pump use increased for individuals with T1D, while disposable pen use increased for people in both cohorts. In both cohorts, there was a statistically significant increase in the use of continuous glucose monitoring, although this increase was more pronounced and occurred earlier among individuals with T1D. Conclusions: Results indicate significant changes in insulin regimens and delivery and glucose monitoring from 2009 to 2018. These findings suggest that insulin prescribing continues to change in response to the development of new therapeutics, advances in insulin delivery technology, and glucose monitoring systems.
Unique Glutelin Expression Patterns and Seed Endosperm Structure Facilitate Glutelin Accumulation in Polyploid Rice Seed
Authors: Gan Lu , Huang Baosheng , Song Zhaojian , Zhang Yachun , Zhang Yujie , Chen Si , Tong Liqi , Wei Zhisong , Yu Lingxiang , Luo Xiangbo , Zhang Xianhua , Cai Detian , He Yuchi 
Published: July 2021

Abstract
Background
Rice is not only an essential food but also a source of high quality protein. Polyploidy is an evolutionary trajectory in plants, and enhancing glutelin by polyploidization is an attractive strategy for improving the nutritional value of rice seeds and presents a great potential for enhancing the commercial value of rice. Elucidating the mechanisms underlying glutelin synthesis and accumulation in tetraploid rice is of great significance.

Results
To enhance the nutritional value of rice, we developed tetraploid rice and evaluated the contents of various nutrient elements in mature seeds. The results revealed a significant increase in protein contents, including the total seed storage proteins, glutelins, and amino acids in tetraploid rice when compared with those in diploid rice. Tandem mass tag-based quantitative proteomic analyses of seeds revealed that glutelins regulated by several glutelin genes in 9311-4x were significantly up-regulated (≥1.5-fold), which was further verified by immunoblot analyses. In addition, temporal expression patterns of various glutelin subunits in different rice lines were investigated. The results revealed significant differences in the expression patterns between diploid and tetraploid rice seeds. Cytohistological analyses results revealed that the thickness of aleurone cell layers increased significantly by 32% in tetraploid rice, the structures of protein storage vacuoles (PSVs) in sub-aleurone cells were more diverse and abundant than those of diploid rice. Temporal expression and proteomic analyses results revealed that protein disulfide isomerase-like 1–1 expression levels were higher in tetraploid rice than in diploid rice, and that the gene responded to oxidative folding with increased levels of proglutelin and appropriate distribution of seed glutelins in tetraploid rice.

Conclusion
The results of the present study revealed that polyploidization increased glutelin content by influencing glutelin biosynthesis, transport, and deposition, while variations in glutelin accumulation between tetraploid and diploid rice were largely manifested in the initial time, duration, and relative levels of various glutelin gene expressions during seed filling stages. These findings provide novel insights into improving the protein quality and nutritional value of rice seeds by polyploid breeding.
Isoamyl 2-cyanoacrylate interposition in the urethro-cutaneous fistula repair: A randomized controlled trial
Authors: Tawfeek A. M. , Mohareb Andrew Makeen , Higazy Ahmed , Farouk Ahmed , Elsaeed Karim Omar , Tawfick Ahmed , Radwan Ahmed 
Published: July 2021

Abstract
Background
We aim to evaluate isoamyl 2-cyanoacrylate as an intervening layer in the surgical repair of the urethra-cutaneous fistula (UCF) after hypospadias in comparison with the classic surgical repair technique.

Methods
Between January 2017 and July 2018, 40 patients with UCF were randomized into two equal groups. Group I represented a multilayered closure with dartos fascia flap while using cyanoacrylate glue as an interposition layer, while group II represented the same procedure without applying the glue. We followed up our patients for 6 months following the procedure to evaluate a successful closure.

Results
Forty patients were available for evaluation at the end of our study. There was no statistically significant difference between the two groups regarding their demographic data. The mean fistula size was 3.25 ± 0.64 and 3.15 ± 0.75 mm in group I and II, respectively, with a statistically significant difference. Successful UCF closure was achieved in 80% of cases in group I (16/20) and 70% of group II (14/20) with no statistically significant difference. There was no statistically significant difference between both groups as regards the occurrence of mild complications in the postoperative period, which was 10% in both groups.

Conclusion
The application of cyanoacrylate during UCF repair was feasible and safe. The successful repair of UCF was found to be higher with cyanoacrylate. However, we could not demonstrate a statistically significant difference between the two groups.
Trial registration number The trial is registered at clinicaltrial.gov with trial registration number: NCT04876976 (retrospective registration)
Chick fetal organ spheroids as a model to study development and disease
Authors: Dakhel Soran , Davies Wayne I. L. , Joseph Justin V. , Tomar Tushar , Remeseiro Silvia , Gunhaga Lena 
Published: July 2021

Abstract
Background
Organ culture models have been used over the past few decades to study development and disease. The in vitro three-dimensional (3D) culture system of organoids is well known, however, these 3D systems are both costly and difficult to culture and maintain. As such, less expensive, faster and less complex methods to maintain 3D cell culture models would complement the use of organoids. Chick embryos have been used as a model to study human biology for centuries, with many fundamental discoveries as a result. These include cell type induction, cell competence, plasticity and contact inhibition, which indicates the relevance of using chick embryos when studying developmental biology and disease mechanisms.

Results
Here, we present an updated protocol that enables time efficient, cost effective and long-term expansion of fetal organ spheroids (FOSs) from chick embryos. Utilizing this protocol, we generated FOSs in an anchorage-independent growth pattern from seven different organs, including brain, lung, heart, liver, stomach, intestine and epidermis. These three-dimensional (3D) structures recapitulate many cellular and structural aspects of their in vivo counterpart organs and serve as a useful developmental model. In addition, we show a functional application of FOSs to analyze cell-cell interaction and cell invasion patterns as observed in cancer.

Conclusion
The establishment of a broad ranging and highly effective method to generate FOSs from different organs was successful in terms of the formation of healthy, proliferating 3D organ spheroids that exhibited organ-like characteristics. Potential applications of chick FOSs are their use in studies of cell-to-cell contact, cell fusion and tumor invasion under defined conditions. Future studies will reveal whether chick FOSs also can be applicable in scientific areas such as viral infections, drug screening, cancer diagnostics and/or tissue engineering.