bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community health workers at the dawn of a new era: 7. Recent advances in supervision
Authors: Westgate Carey , Musoke David , Crigler Lauren , Perry Henry B. 
Published: October 2021

Abstract
Background
Supervision is essential for optimizing performance and motivation of community health workers (CHWs). This paper, the seventh in our series, “Community health workers at the dawn of a new era”, supplements the existing evidence on CHW supervision in low- and middle-income countries by reviewing what supervision approaches are employed in specific contexts, identifying potential facilitators of CHW supervision including mobile health (mHealth) interventions, and noting challenges of supervision including the relationship between supervision and other CHW programme elements.

Methods
For this exploratory research study on CHW supervision, we reviewed the supervisory interventions described in a compendium of 29 case studies of large-scale CHW programmes, performed an electronic search of multiple databases to identify articles related to CHW supervision published between 15 June 2017 and 1 December 2020, and from those articles followed additional references that appeared to be relevant for our results.

Results
We reviewed 55 case studies, academic articles, and grey literature resources as part of this exploratory research. A variety of supervision approaches have been adapted over time, which we grouped into five categories: external supervision, community supervision, group supervision, peer supervision, and dedicated supervision. These approaches are frequently used in combination. Digital (mHealth) technologies are being explored as potential facilitators of CHW supervision in both small- and large-scale programmes; however, evidence of their effectiveness remains limited to date. Inadequate support for supervisors is a major challenge, particularly given the numerous and varied roles they are expected to fulfil, spanning administrative, clinical, and supportive activities. Supervisors can help CHWs acquire other critical elements needed from the health system for them to perform more effectively: incentives to foster motivation, clarity of roles and tasks, adequate tools and supplies, appropriate knowledge and skills, and a safe work environment.

Conclusion
In the absence of a universal “best approach” for CHW supervision, our recommendation is that countries and programmes prioritize homegrown evolution over time to suit the local context. In some cases, this may involve scaling up novel approaches that have proven effective at small scale or testing approaches that have worked in other countries.
Exploring safety culture in the Finnish ambulance service with Emergency Medical Services Safety Attitudes Questionnaire
Authors: Venesoja Anu , Lindström Veronica , Aronen Pasi , Castrén Maaret , Tella Susanna 
Published: October 2021

Abstract
Background
Emergency Medical Services (EMS) is, by its nature, a challenging context that may create risks for both patients and employees. It is also known that an organisation’s safety culture has an influence on both patient and employee safety. Finnish EMS organisations lack knowledge of how their safety culture is perceived by their employees.

Aim
This study aims to test the psychometric properties of the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) in a Finnish EMS setting. We also explore the connections between individual- and organisation-based characteristics and safety attitudes in the Finnish EMS.

Methods
A cross-sectional survey study design was used. The EMS-SAQ was used to collect data via social media. The instrument measures six domains of workplace safety culture: safety climate, teamwork climate, perceptions of management, job satisfaction, working conditions and stress recognition. The 5-point Likert scale was converted to a 100-point scale and mean ≥ 75 was dichotomized as a positive. Confirmatory factor analysis (CFA) was carried out to validate the EMS-SAQ in a Finnish setting. Other results were analysed by using non-parametric tests.

Results
327 responses were included in the analysis. CFA showed that the total EMS-SAQ model had acceptable goodness-of-fit values in the Finnish EMS setting. Total mean scores for each safety culture domain were identified non-positively (mean score < 75); safety climate 60.12, teamwork climate 60.92, perceptions of management 56.31, stress recognition 64.55, working conditions 53.43 and job satisfaction 70.36. Higher education was connected to lower job satisfaction and the teamwork climate within the individual characteristics. All organisation-based characteristics caused at least one significant variation in the safety culture domain scores. Working area significantly affected (p < 0.05) five out of the six safety culture domain scores.

Conclusions
The EMS-SAQ is a valid tool to evaluate safety culture among the Finnish EMS organisations; it offers a novel method to evaluate safety and patient safety within the Finnish EMS organisations. According to the findings, the organisation-based characteristics more likely had an impact on safety attitudes than did the individual-based characteristics. Therefore, it is suggested that the Finnish EMS organisations undertake safety culture development at the organisational level.
Germline mutations among Polish patients with acute myeloid leukemia
Authors: Bąk Aneta , Skonieczka Katarzyna , Jaśkowiec Anna , Junkiert-Czarnecka Anna , Heise Marta , Pilarska-Deltow Maria , Potoczek Stanisław , Czyżewska Maria , Haus Olga 
Published: October 2021

Abstract
Background
A small but important proportion of patients (4–10 %) with AML have germline mutations. They can cause the development of AML at an earlier age, confer a higher risk of relapse or predispose to secondary leukemias, including therapy-related leukemias. The analysis of germline mutations in a patient and his/her family is also critical for the selection of suitable family donors if the patient is a candidate for hematopoietic stem cell transplantation (HSCT).

Methods
103 unrelated consecutive patients with de novo AML were enrolled in the study. Control group consisted of 103 persons from the general population. We performed NGS sequencing of bone marrow cells and buccal swabs DNA of six genes: CEBPA, DDX41, ETV6, TERT, GATA2, and IDH2 to detect germline pathogenic mutations.

Results
In the investigated group, 49 variants were detected in six genes. 26 of them were somatic and 23 germline. Germline variants were detected in all six tested genes. Eight pathogenic germline mutations were detected in 7 AML patients, in three genes: CEBPA, ETV6, and IDH2. One patient had two pathogenic germinal mutations, one in ETV6 and one in CEBPA gene. We identified one novel pathogenic germline mutation in CEBPA gene. The difference in frequency of all pathogenic germline mutations between the tested (7.77 %) and control groups (0.97 %) was statistically significant (p = 0.046). In the tested group, the median age at AML diagnosis was 11 years lower in patients with pathogenic germline mutations than in patients without them (p = 0.028).

Conclusions
We showed higher frequency of CEBPA, ETV6, and IDH2 germline mutations in AML patients than in control group, which confirms the role of these mutations in the development of AML. We also showed that the median age at the onset of AML in patients with pathogenic germline mutations is significantly lower than in patients without them.
Fluid flow exposure promotes epithelial-to-mesenchymal transition and adhesion of breast cancer cells to endothelial cells
Authors: Fuh Kenneth F. , Shepherd Robert D. , Withell Jessica S. , Kooistra Brayden K. , Rinker Kristina D. 
Published: October 2021

Abstract
Background
Mechanical interactions between tumor cells and microenvironments are frequent phenomena during breast cancer progression, however, it is not well understood how these interactions affect Epithelial-to-Mesenchymal Transition (EMT). EMT is associated with the progression of most carcinomas through induction of new transcriptional programs within affected epithelial cells, resulting in cells becoming more motile and adhesive to endothelial cells.

Methods
MDA-MB-231, SK-BR-3, BT-474, and MCF-7 cells and normal Human Mammary Epithelial Cells (HMECs) were exposed to fluid flow in a parallel-plate bioreactor system. Changes in expression were quantified using microarrays, qPCR, immunocytochemistry, and western blots. Gene–gene interactions were elucidated using network analysis, and key modified genes were examined in clinical datasets. Potential involvement of Smads was investigated using siRNA knockdown studies. Finally, the ability of flow-stimulated and unstimulated cancer cells to adhere to an endothelial monolayer, migrate and invade membrane pores was evaluated in flow and static adhesion experiments.

Results
Fluid flow stimulation resulted in upregulation of EMT inducers and downregulation of repressors. Specifically, Vimentin and Snail were upregulated both at the gene and protein expression levels in flow stimulated HMECs and MDA-MB-231 cells, suggesting progression towards an EMT phenotype. Flow-stimulated SNAI2 was abrogated with Smad3 siRNA. Flow-induced overexpression of a panel of cell adhesion genes was also observed. Network analysis revealed genes involved in cell flow responses including FN1, PLAU, and ALCAM. When evaluated in clinical datasets, overexpression of FN1, PLAU, and ALCAM was observed in patients with different subtypes of breast cancer. We also observed increased adhesion, migration and invasion of flow-stimulated breast cancer cells compared to unstimulated controls.

Conclusions
This study shows that fluid forces on the order of 1 Pa promote EMT and adhesion of breast cancer cells to an endothelial monolayer and identified biomarkers were distinctly expressed in patient populations. A better understanding of how biophysical forces such as shear stress affect cellular processes involved in metastatic progression of breast cancer is important for identifying new molecular markers for disease progression, and for predicting metastatic risk.
A transcription factor DAF-5 functions in Haemonchus contortus development
Authors: Di Wenda , Li Fangfang , He Li , Wang Chunqun , Zhou Caixian , Liu Lu , Ye Lisa , Chen Jian , Hu Min 
Published: October 2021

Abstract
Background
Abnormal dauer formation gene (daf-5), located downstream of the DAF-7 signalling pathway, mainly functions in dauer formation and reproductive processes in the free-living nematode Caenorhabditis elegans. Although the structure and function of daf-5 have been clarified in C. elegans, they still remain totally unknown in Haemonchus contortus, a socio-economically important parasitic nematode of gastric ruminants.

Methods
A homologue of daf-5, Hc-daf-5, and its inferred product (Hc-DAF-5) in H. contortus were identified and characterized in this study. Then the transcriptional profiles of Hc-daf-5 and the anatomical expression of Hc-DAF-5 in H. contortus were studied using an integrated molecular approach. RNA interference (RNAi) was performed to explore its function in transition from the exsheathed third-stage larvae (xL3s) to the fourth-stage larvae (L4s) in vitro. Finally, the interaction between Hc-DAF-5 and Hc-DAF-3 (a co-Smad) was detected by bimolecular fluorescence complementation (BiFc) in vitro.

Results
It was shown that Hc-DAF-5 was a member of the Sno/Ski superfamily. Hc-daf-5 was transcribed in all developmental stages of H. contortus, with significant upregulation in L3s. Native Hc-DAF-5 was localized in the reproductive organs, cuticle, and intestine via immunohistochemistry. RNAi revealed that specific small interfering RNAs (siRNAs) could retard xL3 development. In addition, the interaction between Hc-DAF-5 and Hc-DAF-3 indicated that the SDS box of Hc-DAF-5 was dispensable for the binding of Hc-DAF-5 to Hc-DAF-3, and the MH2 domain was the binding region between Hc-DAF-3 and Hc-DAF-5.

Conclusions
In summary, these findings show that Hc-daf-5 functions in the developmental processes of H. contortus, and this study is the first attempt to characterize the daf-5 gene in parasitic nematodes.

Graphical abstract
Correlation of peripheral CD4+GranzB+CTLs with disease severity in patients with primary Sjögren’s syndrome
Authors: Wang Qi , Che Nan , Lu Chengyin , Sun Xiaoxuan , Wang Yanyan , Wang Qiang , Tan Wenfeng , Zhou Lanlan , Zhang Xiaojun , Xu Dong , Gu Lei , Zhang Miaojia 
Published: October 2021

Abstract
Introduction
Primary Sjögren’s syndrome (pSS) is a chronic systemic autoimmune disease which has focal lymphocytic infiltration including a majority of CD4+ T cells. This study was to investigate the correlation of peripheral granzyme B (GranzB)-expressing CD4+ T cells with disease severity and histological lesion in patients with pSS.

Methods
We recruited 116 pSS and 46 health control (HC) using flow cytometry to examine the percentage of CD4+GranzB+CTLs in the peripheral blood, and immunofluorescence to test their expression in the labial gland.

Results
The percentage of CD4+GranzB+CTLs was significantly upregulated in pSS than in HC (7.1 ± 4.9% vs 3.1 ± 1.9%, p < 0.0001) and positive correlation with ESSDAI. The frequency of them was markedly higher in pSS with extraglandular manifestations. After excluding the other risk factors associated with pSS, they were still related to ESSDIA and extraglandular manifestations independently (p < 0.05), and they are the risk factor of extraglandular involvement (odds ratio = 1.928). Moreover, they could be observed in the LSGs. ROC curve analysis indicated that the area under the curve (AUC) of CD4+GranzB+CTLs was 0.796 to predict the activity of pSS and 0.851 to presume extraglandular manifestations. The best diagnostic cutoff point was 4.865 for pSS patients.

Conclusion
In this study, we provide new evidence indicating the involvement of CD4+GranzB+CTLs over activation in the pathophysiology of pSS, which may serve as a new biomarker to evaluate the activity and severity of pSS.
Assessing the joint adoption and complementarity between in-field conservation practices of Kansas farmers
Authors: Gong Sheng , Bergtold Jason.S. , Yeager Elizabeth 
Published: October 2021

AbstractAgricultural conservation systems consist of a myriad of conservation practices. The mix and intensity of conservation practices adopted can benefit farmers and affect the entire production system in addition to soil and water conservation. The purpose of this study is to examine and analyze farmer adoption of and complementarity between conservation practices from a joint and conditional probabilistic perspective using Kansas as a case study. We develop a modeling framework that can analyze and examine farmers’ joint and conditional adoption decisions using a multinomial logistic regression model. This framework is used to estimate conditional probabilities of adopting conservation practices given adoption of other practices to better capture the complementarity between different conservation practices. These estimates allow for an assessment of linkages between adoption of different conservation practices and the socioeconomic factors that affect the likelihood of adopting conservation practices given other conservation practices have already been adopted on-farm. The results can help guide policy and outreach efforts to promote further intensification of adoption by farmers.
Altered saturation pulse with a high flip angle for venous saturation on 7 T time-of-flight magnetic resonance angiography
Authors: Kim Sangwoo , Lee Chulhyun 
Published: October 2021

AbstractThis study aimed to apply minimum-time variable-rate selective excitation (MinVER) to a presaturation pulse (PSP) with a high flip angle on 7 T time-of-flight magnetic resonance angiography (7T TOF-MRA), to attain a superior vessel-to-tissue contrast (VTCR), short acquisition time, and minor off-resonance effect. An altered PSP modified by using the 90° flip angle (FA)-MinVER was implemented in the 7 T TOF-MRA, and its performance was evaluated with a signal profile and vessel-tissue contrast ratios and compared to the conventional PSP and 45 FA-TOF. The 90 FA-MinVER showed a similar signal profile to that of the conventional PSP and improved the vessel-tissue contrast ratios (0.313 ± 0.80) compared to all conventional types (45 FA-TOF: 0.088 ± 0.84, 90 FA-TOF: 0.203 ± 0.72). Moreover, this noteworthy approach achieved substantially reduced total acquisition time (5 min and 55 s) with a short repeat-to-time (28 ms), indicating that at the 7 T TOF-MRA, the 90 FA-MinVER could be applied by default to suppress the venous signals regardless of individual human status and the specific absorption ratio constraint and with rapid imaging. Ultimately, its application could also help to observe subtle microvascular changes in the early stages and serve as key biomarkers in various vascular diseases.
Recent progress and perspectives on the mechanisms underlying Asbestos toxicity
Authors: Kuroda Akio 
Published: October 2021

AbstractMost cases of mesothelioma are known to result from exposure to asbestos fibers in the environment or occupational ambient air. The following questions regarding asbestos toxicity remain partially unanswered: (i) why asbestos entering the alveoli during respiration exerts toxicity in the pleura; and (ii) how asbestos causes mesothelioma, even though human mesothelial cells are easily killed upon exposure to asbestos. As for the latter question, it is now thought that the frustrated phagocytosis of asbestos fibers by macrophages prolongs inflammatory responses and gives rise to a “mutagenic microenvironment” around mesothelial cells, resulting in their malignant transformation. Based on epidemiological and genetic studies, a carcinogenic model has been proposed in which BRCA1-associated protein 1 mutations are able to suppress cell death in mesothelial cells and increase genomic instability in the mutagenic microenvironment. This leads to additional mutations, such as CDKN2A [p16], NF2, TP53, LATS2, and SETD2, which are associated with mesothelioma carcinogenesis. Regarding the former question, the receptors involved in the intracellular uptake of asbestos and the mechanism of transfer of inhaled asbestos from the alveoli to the pleura are yet to be elucidated. Further studies using live-cell imaging techniques will be critical to fully understanding the mechanisms underlying asbestos toxicity.
The TRUTH confirmed: validation of an intraindividual comparison of gadobutrol and gadoteridol for imaging of glioblastoma using quantitative enhancement analysis
Authors: Kuhn Matthew J. , Patriarche Julia W. , Patriarche Douglas , Kirchin Miles A. , Bona Massimo , Pirovano Gianpaolo 
Published: October 2021

Abstract
Background
Previous intraindividual comparative studies evaluating gadobutrol and gadoteridol for contrast-enhanced magnetic resonance imaging (MRI) of brain tumours have relied on subjective image assessment, potentially leading to misleading conclusions. We used artificial intelligence algorithms to objectively compare the enhancement achieved with these contrast agents in glioblastoma patients.

Methods
Twenty-seven patients from a prior study who received identical doses of 0.1 mmol/kg gadobutrol and gadoteridol (with appropriate washout in between) were evaluated. Quantitative enhancement (QE) maps of the normalised enhancement of voxels, derived from computations based on the comparison of contrast-enhanced T1-weighted images relative to the harmonised intensity on unenhanced T1-weighted images, were compared. Bland-Altman analysis, linear regression analysis and Pearson correlation coefficient (r) determination were performed to compare net QE and per-region of interest (per-ROI) average QE (net QE divided by the number of voxels).

Results
No significant differences were observed for comparisons performed on net QE (mean difference -24.37 ± 620.8, p = 0.840, r = 0.989) or per-ROI average QE (0.0043 ± 0.0218, p = 0.313, r = 0.958). Bland-Altman analysis revealed better per-ROI average QE for gadoteridol-enhanced MRI in 19/27 (70.4%) patients although the mean difference (0.0043) was close to zero indicating high concordance and the absence of fixed bias.

Conclusions
The enhancement of glioblastoma achieved with gadoteridol and gadobutrol at 0.1 mmol/kg bodyweight is similar indicating that these agents have similar contrast efficacy and can be used interchangeably, confirming the results of a prior double-blind, randomised, intraindividual, crossover study.
Perception of Iraqi youth towards social and psychological impact of COVID-19
Authors: Al Shawi Ameel F. , Lafta Riyadh 
Published: October 2021

Abstract
Background
COVID-19 pandemic is recently considered as the most public health challenge with global dramatic changes on different aspects of life and health, including the psychological burden on individuals and communities. A convenience sample of youth (university students) aged 18–24 years was chosen in this cross-sectional study that was conducted during the period from October through December 2020. The questionnaire included questions about COVID-19 and its effect on mental and social wellbeing.

Results
Out of the total 762 young adults who responded, 62% were females, with a mean age of 20.75+2.33; 40.4% of them reported severely impaired social leisure activities; 14.7% expressed severely impaired private leisure activities; and 15.5% had severely impaired ability to form and maintain close relationships. Continuous feeling of nervousness, anxiety, stress, or exaggerated worries about the coronavirus was reported by 18%, while 24.9% felt sad or depressed all the time, and 26.4% of the female respondents had depressive symptoms versus 22.5% males.

Conclusion
The findings of this study indicate that the COVID-19 pandemic had created severe limitations on people’s social activities that may be associated with negative changes in mental condition.
Evidence-based guidelines for protective actions and earthquake early warning systems
Authors: McBride Sara K. , Smith Hollie , Morgoch Meredith , Sumy Danielle , Jenkins Mariah , Peek Lori , Bostrom Ann , Baldwin Dare , Reddy Elizabeth , de Groot Robert , Becker Julia , Johnston David , Wood Michele 
Published: October 2021

Earthquake early warning (EEW) systems are becoming increasingly available or are in development throughout the world. As these systems develop, it is important to provide evidence-based recommendations for protective action so people know how to protect themselves when they receive an alert. However, many factors need to be considered when developing contextually relevant and appropriate recommendations. We have reviewed earthquake injury reports, protective action and communication theories, and behavioral research to determine what factors can guide inquiry and decision making when developing protective action guidelines. Factors that emerge from relevant literature include: (1) social, cultural, and environmental context, such as which people are present, what their social roles are, and in what type of building they are located when an earthquake happens, (2) demographic and experiential variables, such as gender and age as well as previous history with earthquakes; and (3) magnitude and intensity that influence the duration and impacts of the earthquake itself. Although we examine data from around the world, we focus largely on evidence-based recommendations for the U.S. system, ShakeAlert, because it provides a timely case study for understanding how people receive and respond to EEW messages. In addition to synthesizing relevant literature, we recommend pathways forward for this interdisciplinary research community that explores EEW and its application around the world. Consistency in collecting and reporting injury data globally may assist in aligning this fragmented literature to develop a richer understanding of how demographic, cultural, seismic, engineering, and technological issues can be addressed to reduce human suffering due to earthquakes.