bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexmedetomidine Reduces Propofol-Induced Hippocampal Neuron Injury by Modulating the miR-377-5p/Arc Pathway
Authors: Chen Zong , Ding Yong , Zeng Ying , Zhang Xue-Ping , Chen Jian-Yan 
Published: September 2021

Abstract
BackgroundPropofol and dexmedetomidine (DEX) are widely used in general anesthesia, and exert toxic and protective effects on hippocampal neurons, respectively. The study sought to investigate the molecular mechanisms of DEX-mediated neuroprotection against propofol-induced hippocampal neuron injury in mouse brains.MethodsHippocampal neurons of mice were treated with propofol, DEX, and propofol+DEX in vitro and in vivo. Neuronal apoptosis was evaluated by a means of TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) or Hochest 33258 staining; Arc positive expression in hippocampus tissues was detected using a microscope in immunohistochemistry assays; miRNA-377-5p expression levels were quantified by RT-PCR; the protein levels of Arc, DNMT3A, and DNMT3B were determined using western blot; CCK-8 kit was used to evaluated neuron viability; methylation analysis in miR-377-5p promoter was performed through the methylated DNA immunoprecipitation (MeDIP) assay; luciferase reporter assay was performed to confirm whether Arc was under targeted regulation of miR-377-5p.Results In the current study, both in vitro and in vivo, propofol treatment induced hippocampal neuron apoptosis and suppressed cell viability. DNMT3A and DNMT3B expression levels were decreased following propofol treatment, resulting in lowered methylation in the miR-377-5p promoter region and then enhanced expression of miR-377-5p, leading to a decrease in the expression level of downstream Arc. Conversely, the expression levels of DNMT3A and DNMT3B were increased following DEX treatment, thus methylation in miR-377-5p promoter region was improved, and miR-377-5p expression levels were decreased, leading to an increase in the expression level of downstream Arc. Finally, DEX pretreatment protected hippocampal neurons against propofol-induced neurotoxicity by recover the expression levels of DNMT3A, miR-377-5p, and Arc to the normal levels.ConclusionsDEX reduced propofol-induced hippocampal neuron injury via the miR-377-5p/Arc signaling pathway.
Sex Differences in Treatment Strategy and Adverse Outcomes Among Patients 75 and Older With Atrial Fibrillation in the MarketScan Database
Authors: Subramanya Vinita , Claxton J’Neka S. , Lutsey Pamela L. , MacLehose Richard F. , Chen Lin Y. , Chamberlain Alanna M. , Norby Faye L. , Alonso Alvaro 
Published: September 2021

Abstract
Background: Women with atrial fibrillation (AF) experience greater symptomatology, worse quality of life, and have a higher risk of stroke as compared to men, but are less likely to receive rhythm control treatment. Whether these differences exist in elderly patients with AF, and whether sex modifies the effectiveness of rhythm versus rate control therapy has not been assessed.Methods: We studied 135,850 men and 139,767 women aged ≥75 years diagnosed with AF in the MarketScan Medicare database between 2007-2015. Anticoagulant use was defined as use of warfarin or a direct oral anticoagulant. Rate control was defined as use of rate control medication or atrioventricular node ablation. Rhythm control was defined by use of anti-arrhythmic medication, catheter ablation or cardioversion. We used multivariable Poisson and Cox regression models to estimate the association of sex with treatment strategy and to determine whether the association of treatment strategy with adverse outcomes (bleeding, heart failure and stroke) differed by sex. Results: At the time of AF, women were on average (SD) 83.8 (5.6) years old and men 82.5 (5.2) years, respectively. Compared to men, women were less likely to receive an anticoagulant or rhythm control treatment. Rhythm control (vs. rate) was associated with a greater risk for heart failure with a significantly stronger association in women (HR women = 1.41, 95%CI 1.34-1.49; HR men= 1.21, 95%CI 1.15-1.28, p <0.0001 for interaction). No sex differences were observed for the association of treatment strategy with the risk of bleeding or stroke. Conclusion: Sex differences exist in the treatment of AF among patients aged 75 years and older. Women are less likely to receive an anticoagulant and rhythm control treatment. Women were also at a greater risk of experiencing heart failure as compared to men, when treated with rhythm control strategies for AF. Efforts are needed to enhance use AF therapies among women. Future studies will need to delve into the mechanisms underlying these differences.
Competency Assessment for Community Health Nurses:A Focus Group Expert Panel Discussion
Authors: Kisut Ramlah , Sulaiman Hajah Jamilah Haji Awang , Rahman Hanif Abdul , Abdul-Mumin Khadizah H. 
Published: September 2021

Abstract
Background: General Practice setting in the Primary Health Care Services are the utmost visited by the public. It is important that the nurses’ competencies in this area be assessed to ensure provision of safe and quality services.Aim/objective: To explore perceptions and experiences of competencies assessment tool for community health nurses working at the General Practice setting in the Primary Health Care Services.Methods: An exploratory qualitative study utilizing focus group discussions were conducted on purposive sample of 12 officers with expertise in competency assessment and community health nursing from higher nursing education institutions, the Nursing Training and Development Centre, the Nursing Board and the Community Health Nursing Services in Brunei Darussalam. The existing competencies assessment tool was revised, the participants were divided into two groups of expert panel review team and two focus group discussions were held with each team. The focus group discussions encompassed components and methods of assessment; methods of grading; and overall organization and structure of the revised competency assessment tool. Findings: Four themes emerged: 1) International equivalent core competencies components; 2) Multi-methods approach to assessment; 3) Definitive guidelines as framework for assessment; and 4) Understanding and acceptability of the competency assessment tool. Conclusions/Implications to practice: The expert panel reviews provide practical input that were inculcated in the preliminary developed competencies assessment tool. Identification of eligible assessors were recommended based on standardized criteria, and socialization and training held to set direction and guidance for implementing the utilization of the competencies assessment tool. Further studies are deemed important to critically evaluate and validate the preliminary competencies assessment tool for development of a more robust assessment instrument.
Study on Long-Term Exposure to Carbon Emissions and Lung Cancer Incidence Rate in China
Authors: He Fengdie , Lin Yongqing , Wang Baohua , Dong Shaoxia 
Published: September 2021

Abstract
Background: This study has shown the incidence of lung cancer in association with exposure to air pollution. We investigated the relationship, focusing on long-term exposure to carbon emissions (CE) and lung cancer incidence rate (LIR) in China.Methods: We collected the incidence rate of lung cancer from 2013 to 2015, and the data of carbon emissions from 1997 to 2015. We modeled the panel data of 30 provinces and cities in China from 2013 to 2015 and applied a spatial Durbin model (SDM) to explore the spatial effect of CE on the LIR. Pearson test to determine the long-term impact of CE on LIR.Findings: The results showed that the direct effect coefficient of CE and UR were 0.132 and 0.425, respectively, both significant at a 1% level, which showed that CE and UR had an obvious positive effect on LIR. The value of Moran’s I indicated that there was a positive spatial correlation between the LIR and CE in China from 2013 to 2015, while the indirect effect coefficient of all the variables was nonsignificant at a 10% level, which indicated that CE had not impact on the LIR of its surrounding areas. on the whole, the effect cofficient of CE is 0.005 ,which is significant at a 1% level, which points out that the average effect of a change in CE in a certain region on LIR in all regions. Therefore, the research results indicated that there were geographical differences in carbon emissions but there is no spatial spillover effects. In the time fixed effects, the coefficients of CE were positive at the 10% significance level, which pointed out that CE exposure had a long-term impact on LIR from 2013 to 2015. Besides, the Pearson test implied that CE in the period had the greatest impact on the LIR in 2015 in China, and the lag period was about 17 years.Interpretation: The impact of CE on LIR had geographical distribution differences and long-term effects in China. We recommend that adopting policies to reduce carbon emission will have a positive health impact.
Barriers To Participation in Research As Perceived By Undergraduate Medical Students: A Cross-Sectional Study From Qassim
Authors: Elmannan Abeer Abuzeid Atta , Alrebish Saleh A , Alqarzai Rahaf Khalid , Alshubrmi Atheen Ahmad , Alammar Abdulrahman Yousef , Alsaeed Hammad Saleh 
Published: September 2021

Abstract
Background
It is vital for healthcare practitioners to have the necessary skills and competence to review the literature and critically appraise research evidence. However, medical students` engagement in research activities continues to be below the expectation. In this study we aimed to investigate students` views about research, and to identify the barriers preventing them from participation in research projects.
Methods
A cross-sectional study was carried out in the College of Medicine in Qassim University. A total of 230 students were included. Data were collected online through a self- administered questionnaire .The perceptions of students were assessed using a 16-item questionnaire organized as ; Students` attitudes towards research, Students` perception of research benefits, Students` willingness to participate in research, and Students` perception of research barriers. The mean scores of these four subscales were compared between students using Mann-Whitney test .Factors associated with students` perception of research barriers were analyzed using four separate logistic regression models.
Results
The overall response rate was 89.4%. The results indicate that the students generally possess a moderately positive attitude towards research with a mean score of 14.8 ± 2.7 (range: 5–25). A substantial number of participants reported their willingness to take part in any research-related task (77.0%). However, the participants highly agreed that lack of time (70.4%), lack of supervision and guidance (72.6%), lack of research training and support (73.9%), and lack of research exposure and opportunities (75.2%) were major barriers to their participation in research .We found that students having lower CGPA ranks are almost three times more likely to indicate lack of time as a challenge (AOR: 2.94; 95% CI: 1.09,7.94; p.value = 0.033). Overall, female students were more likely to report concerns about research training and availability of research opportunities, while male students were more likely to indicate lack of time and lack of supervision as research barriers.
Conclusions
The barriers addressed in the current study —both discretely and cumulatively—are highly demotivating for students, and negatively affect their participation in research. Efforts should be invested to shift the focus from providing superficial research exposure to incorporating more in-depth and effective research training for undergraduate students
How Do Simulated Interviews Increase the Self-efficacy of Medical Students? - Quasi-experimental Research-
Authors: Aoki Shuntaro , Shikama Yayoi , Yasui Kiyotaka , Moroi Yoko , Sakamoto Nobuo , Suenaga Hiroki , Tang Zunyi , Yasuda Megumi , Chiba Yasuko , Stanyon Maham , Otani Koji 
Published: September 2021

Abstract
Background Self-efficacy is crucial in improving medical student communication skills. This study aims to clarify whether the self-efficacy of medical students conducting medical interviews increased after simulated interviews or after feedback discussions. Methods A total of 162 medical students (109 men, 53 women) in their fourth or fifth year at a university in Japan participated in this study. The degree of self-efficacy in medical interviewing was measured before and after a medical interview with a simulated patient, and after the subsequent feedback session. Results ANOVA analysis revealed that self-efficacy for medical interviews was higher after both the interview and the feedback session than before the interview. Self-efficacy was highest after the feedback session among all three time points. Conclusions Feedback following a simulated interview with a simulated patient is important to improve the self-efficacy of medical students learning medical interviewing skills.
RETRACTED: Dioxomolybdenum (VI) and Oxomolybdenum (IV) Complexes With N, O, and S Bidentate Ligands, Spectral Characterization, and DFT Studies
Authors: Alajrawy Othman Ibrahim , Almhmdi Ayad A. 
Published: September 2021

Abstract

The authors have requested that this preprint be removed from Research Square. The authors' request does not imply errors or misconduct.
Long-term Effectiveness of Overnight Shiftwork Implementation on Pediatric Residents’ Wellness: A Cross-Sectional Survey
Authors: Nakao Hiro , Nomura Osamu , Kubota Mitsuru , Ishiguro Akira 
Published: September 2021

Abstract
BackgroundIn Japan, the “Work Style Reform Bill” was partially enacted in 2019. In 2011, an Overnight Call Shift (OCS) system was introduced for pediatric training at the National Center for Child Health and Development (NCCHD). A questionnaire survey was conducted twice during the introduction of this system, finding a decrease in working hours, but no change in the depressive tendency of the residents. We conducted a follow-up survey in 2019 to investigate the long-term effectiveness of the OCS system to improve the pediatric residents’ wellness at NCCHD.MethodsA questionnaire-based cross-sectional survey was conducted for pediatric residents in 2019, and the results were compared to those of the previous survey in 2012. The questionnaire includes demographic data, working conditions data, and wellness assessment by the Center for Epidemiologic Studies Depression scale (CES-D) and the Maslach Burnout Inventory (MBI).ResultsThe collection rate for the 2019 survey was 94.5% (37 participants/39 eligible). Compared to 2012, there were no significant changes in demographic data and working hours, a significant increase by about 30% in residents who took daytime off after night work, about 10% decrease in residents who scored 16 and above on the CES-D, and a significant decrease in the mean score for depersonalization (DP) in the MBI.ConclusionsThis survey demonstrated the long-term effectiveness of the implemented OCS system to improve pediatric residents’ wellness. This study provides evidence for the further initiative to improve pediatricians’ wellness for preparing for the government’s overtime regulations for physicians scheduled for 2024.
Uncertainties In The Effectiveness of Biological Control of Stem Borers Under Different Climate Change Scenarios In Eastern Africa
Authors: Jendritzki Ines Gwendolyn , Tonnang Henri E. Z. , Calatayud Paul-André , Borgemeister Christian , Johansson Tino , Biber-Freudenberger Lisa 
Published: September 2021

Abstract
Climate change (CC) is expected to significantly affect biodiversity and ecosystem services. Adverse impacts from CC in the Global South are likely to be exacerbated by limited capacities to take adequate adaptation measures and existing developmental challenges. Insect pests today are already causing considerable yield losses in agricultural crop production in East Africa. Studies have shown that insects are strongly responding to CC by proliferation, shift in distribution or by altering their phenology, which is why an impact on agriculture can also be expected. Biological control (BC) has been proposed as an alternative measure to sustainably contain insect pests but few studies predict its efficacy under future CC. Using the species distribution modelling approach Maxent, we predict the current and future distribution of three important lepidopteran stem borer pests of maize in eastern Africa, i.e., Busseola fusca (Fuller, 1901), Chilo partellus (Swinhoe, 1885) and Sesamia calamistis (Hampson, 1910), and two of their parasitoids that are currently used for BC, i.e., Cotesia flavipes (Cameron, 1891) and Cotesia sesamiae (Cameron, 1906) . Based on these potential distributions and data collected during household surveys with local farmers in Kenya and Tanzania, future maize yield losses are predicted for a business-as-usual scenario and a sustainable development scenario. Accordingly, we found that BC of the three stem borer pests by C. flavipes and C. sesamiae will be less effective under more severe CC resulting in a reduced ability to curb maize yield losses caused by the stem borers. These results highlight the need to adapt BC measures to future CC to maintain its potential for environmentally-friendly pest management strategies. The findings of this research are thus of particular relevance to policy makers, extension officers and farmers in the region and will aid the adaptation of smallholder agricultural practices to current and future impacts of CC.
Partial Upper Sternotomy for Extensive arch Repair in Older Acute type A Aortic Dissection Patients
Authors: Qiu Zhihuang , Xiao Jun , Wu Qingsong , Chai Tianci , Zhang Li , Li Yumei , chen Liangwan 
Published: September 2021

Abstract
Objectives: The partial upper sternotomy (PUS) approach is acceptable for aortic valve replacement, and even aortic root operation. However, the efficiency of PUS for extensive arch repair of acute type A aortic dissection (AAAD) in older adult patients has not been well investigated.Methods: Between January 2012 and December 2019, 222 older adult patients (≥65 years) diagnosed with AAAD went through extensive arch repair, among which 127 received PUS, and 95 underwent full sternotomy (FS). Logistic regression analysis was used to identify risk factors for early death, and negative binomial regression analysis was applied to explore risk factors related to post-operative ventilator-supporting time and intensive care unit stay time. Results: Total early mortality was 8.1% (18/222 patients). The PUS group had shorter Cardiopulmonary bypass time (133.0 vs.155.0 minutes, P<0.001), cross-clamp time (44.0 vs. 61.0 minutes, P<0.001) and shorter selective cerebral perfusion time (11.0 vs. 21.0 minutes, P<0.001) than the FS group. Left ventricle ejection fraction (LVEF)<50% (odds ratio [OR], 17.05; 95% confidence interval [CI] 1.87-155.63; P=0.012) and malperfusion syndromes (OR, 65.83; 95% CI 11.53-375.86; P<0.001) were related to early death. In the multivariate model, the PUS approach contributed to shorter ventilator-supporting time (incidence rate ratio [IRR], 0.76; 95% CI 0.64-0.91; P=0.003) , when compared with the FS group. Conclusions: The early results of emergency extensive arch repair of AAAD via PUS in older adult patients were satisfactory. However, the long-term results remain to be investigated.
Source Apportionment and Health Risk Assessment of Zn (II) Ions Based on Gridded Spatial Interpolation and Geochemical Equilibrium Simulation
Authors: Miao Fangfang , Zhang Yimei , Li Yu , Lin Qianguo 
Published: September 2021

Abstract
Soil heavy metal pollution had become a global issue involving environmental safety and human health risks. A methodology was explored to quantify the sources of heavy metals in the soils and investigate the spatial distributions of heavy metals by the gridded spatial scale. The case study was implemented in the industrial waste sites in Suzhou city, Jiangsu province. Zinc (Zn) was screened out as the targeted metal (TM) through the potential ecological risk assessment, the species of which was simulated by the geochemical software PHREEQC. The aim of this research was to determine the dominant metal species of TM with potential hazardous health risk to local people to achieve key prevention and pollution control. Herein, according to the morphological evolution of metal species, the activity and concentration of the Zn species was calculated for both carcinogenic and non-carcinogenic health risk assessment. The evaluation of the optimized human health risk demonstrated that the associated health risk of Zn (II) depended predominantly on its metal speciation and was also affected by acidity and soil organic matter. Overall, the optimized carcinogenic and non-carcinogenic risk value of Zn2S32− for adults was 2.01E-04 and for children was 1.31 respectively, resulting in corresponding hazardous risk to human, which accounted for high risk level of 61.5% and 58.5%, respectively. This method could provide a reference for the decision-making of soil heavy metal pollution control and targeted hypotoxic convertion of metal species and remediation for certain heavy metal of polluted area.
Awareness and Perceptions Regarding Evidence Based Practice Among Nurses and Midwives in Two Ugandan National Referral Hospitals: A Cross-Sectional Study
Authors: Mwitende Francine , Muhindo Richard 
Published: September 2021

Abstract
Background: Integration of evidence-based practice (EBP) in nursing and midwifery increases patient satisfaction, patient safety and reduced length of hospital stay, which all contribute to better patient outcomes and improved quality of care. Little is known about awareness and perception regarding evidence-based practice among nurses and midwives in Uganda. Objective: This study sought to assess awareness and perceptions regarding evidence-based practice among nurses and midwives.Methods: A descriptive cross-sectional study using self-administered questionnaires was conducted among 384 nurses and midwives in Mulago and Kawempe National Referral Hospitals. The participants were recruited consecutively until when the desired sample size was obtained. Statistical Package for Social Sciences (SPSS) version 26 was used to analyze and summarize data using frequency and percentages. We performed Chi-square test to assess the factors association with awareness and perception. The independent variables with p-value <0.05 were significant. Results: Most of the participants were female (81.8%) and were practicing as nurses (76.2%). The results indicated that less than a half (46.2%, n=138) of participants were aware of EBP. Majority of the participants (96.3%- 97.7%) felt that EBP is highly important, necessary and an obligation in nursing and midwifery practice, although only 68.0% were routinely practicing it in their practice. Awareness was associated with level of education attained (p= 0.000), gender (0.001), going back to school after first qualification (p=0.000), access to learning resources at work place (p=0.000) and attendance of continuous medical education (p= 0.000), whereas, perception was associated with attendance of continuous medical education (0.017).Conclusion: Data show that nurses and midwives’ awareness regarding evidence-based practice was low in this study, however, they possessed positive perceptions regarding evidence-based practice. Moreover, only about two-thirds were practicing EBPs. Therefore, I recommend increased calls for interventions to sensitize nurses and midwives about EBP like continuous medical education (CME) and Continuous professional development (CPD) or refreshing training