bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Sequential Electrospinning And Co-Electrospinning On Morphological And Fluid Mechanical Wall Properties of Polycaprolactone And Bovine Gelatin Scaffolds, For Potential Use In Small Diameter Vascular Grafts
Authors: Montoya Yuliet , Cardenas José , Bustamante John , Valencia Raúl 
Published: August 2021

Abstract
Background: Nowadays, the engineering vascular grafts with a diameter less than 6 mm by means of electrospinning, is an attracted alternative technique to create different three-dimensional microenvironments with appropriate physicochemical properties to promote the nutrient transport and to enable the bioactivity, dynamic growth and differentiation of cells. Although the performance of a well-designed porous wall is key for these functional requirements maintaining the mechanical function, yet predicting the flow rate and cellular transport are still not widely understood and many questions remain open about new configurations of wall can be used for modifying the conventional electrospun samples. The aim of the present study was to evaluate the effect of fabrication techniques on scaffolds composed of bovine gelatin and polycaprolactone (PCL) developed by sequential electrospinning and co-electrospinning, on the morphology and fluid-mechanical properties of the porous wall. Methodology: For this purpose, small diameter tubular structures were manufactured and experimental tests were performed to characterize the crystallinity, morphology, wettability, permeability, degradability, and mechanical properties. Some samples were cross-linked with Glutaraldehyde (GA) to improve the stability of the gelatin fiber. In addition, it was analyzed how the characteristics of the scaffold favored the levels of cell adhesion and proliferation in an in vitro model of T3T fibroblasts in incubation periods of 24, 48 and 72h. Results: It was found that in terms of the morphology of tubular scaffolds, the co-electrospun samples had a better alignment with higher values of fiber diameters and apparent pore area than the sequential samples. The static permeability was more significant in the sequential scaffolds and the hydrophilic was higher in the co-electrospun samples. Therefore, the gelatin mass losses were less in the co-electrospun samples, which promote cellular functions. In terms of mechanical properties, no significant differences were observed for different types of samples. Conclusion: This research concluded that the tubular scaffolds generated by sequential and co-electrospinning with modification in the microarchitecture could be used as a vascular graft, as they have better permeability and wettability, interconnected pores, and a circumferential tensile strength similar to native vessel compared to the commercial graft analyzed.
A Hospital-Based Independent Domestic Violence Advisor Service: Demand and Response During the COVID-19 Pandemic
Authors: Elvey Rebecca , Mason Thomas , Whittaker William 
Published: August 2021

Abstract
Background and aimRecent UK policy hasfocussed on improving support for victims of domestic violence and abuse (DVA), in healthcare settings. DVA victims attending hospital are often at highest risk of harm, yet DVA support in hospitals has been inadequate. A targeted service supportinghigh risk DVA victims, was implemented at a hospital Trust in North West England. The service was provided by Independent Domestic Violence Advisors (IDVAs).An evaluation exploredthe processes and outcomes associated with the service. The evaluation coincided with the COVID-19 pandemicand societal restrictions (lockdown), during which concern about DVA increased. This paper examines the hospital-based IDVA service during the COVID-19 period and addresses the research questions: What was the demand for the service? How did the service respond? What facilitated this response?MethodsA mixed-methods study was undertaken. Quantitative data on referrals to the service were examined using simple descriptive statistics and compared to other DVA services.Semi-structured interviews were undertaken with IDVAs and other hospital staff involved with the service and the data subjected to thematic analysis. ResultsThe quantitative analysis showed that referrals dropped at the start of lockdown, then increased and continued to rise; the qualitative findings reiterated this pattern. Referrals came from a range of departments across the Trust, with the majority from A&E. Pre-pandemic, the population supported by the service included higher proportions of males and people aged 40 and over than atother IDVA services; this continuedduring the pandemic. The qualitative findings indicated an effective, flexible response during the pandemic, enabled by strong working relationships and by using workarounds.ConclusionsThe hospital-based IDVA service provided a robust response to victims during the COVID-19 pandemic. Referrals increased during the firstlockdown and subsequent relaxing of restrictions. Locating the IDVAswithina team working across the organisation, and building good working relationships facilitatedan effective disclosure and referral route, which endured through social restrictions. The IDVAs supported high-risk victims who may otherwise not have been identified in traditional community-based DVA settings during the pandemic. Hospital-based IDVA services can broaden accessby supporting vulnerable, at risk populations whose needs may not be identified at other services.
Genomic Analysis of Molecular Bacterial Mechanisms of Resistance to Phage Infection
Authors: Ambroa Antón , Blasco Lucia , López María , Pacios Olga , Bleriot Inés , Fernández-García Laura , Ortiz-Cartagena Concha , Millard Andrew , Tomás María 
Published: August 2021

Abstract
BackgroundIn order to optimize phage therapy, we need to understand how bacteria evolve against phage attack. One of the main problems of the phage therapy is the appearance of bacterial resistance variants. The use of genomics to track antimicrobial resistance is increasingly developed and used in clinical laboratories. For that reason, it is important to consider, in an emerging future with phage therapy, to detect and avoid phage resistant strains, that can be overcomed by the analysis of metadata provided by WGS. Here, we identified genes associated with phage resistance in 18 Acinetobacter baumannii clinical strain belonging to the ST-2 clonal complex during a decade (Ab2000 vs 2010): 9 from 2000 and 9 from 2010.ResultsThe presence of genes putatively associated to phage resistance were detected. Genes detected were associated with an abortive infection system, restriction-modification system, genes predicted to be associated with defence systems but with unknown function and CRISPR-Cas system. Between 118 and 171 genes were found in the 18 clinical strains. On average, 26% of these genes were detected inside genomic islands (GIs) in the 2000 strains and 32% in 2010 strains. Furthermore, 38 potential CRISPR arrays in 17 of 18 of the strains were found, as well as 705 proteins associated with CRISPR-Cas systems.ConclusionsA moderately higher presence of these genes in the strains of the 2010 in comparison to those of the 2000 were found, especially those related to the R-M system and CRISPR-Cas system. The presence of these genes in GIs in a higher rate in the strains of the 2010 compared to those of the 2000 was also detected. WGS and bioinformatics could be powerful tools to avoid drawbacks when a personalized therapy is applied. In this study, it allows us to take care of the phage resistance in A. baumannii clinical strains to prevent a failure in a possible phage therapy.
Universe: the dynamics of the minimum and maximum expansion states
Authors: Petrakis Sócrates 
Published: August 2021

Abstract
Two hypotheses stand out in describing the evolution of the Universe. The predominant one predicts that the current expansion began at a certain instant and will not preserve any variation of energy that performs work; apparent flat Universe (Ω = 1) is advocated by relativistic calculations and observational data, with an end or thermal death at its maximum expansion (3D space). The other hypothesis considers that the Universe is cyclical (always alternating phases of expansion and contraction). This proposal aims to demonstrate that both hypotheses can be correct by not being distinct, but complementary. Supported by the immutability of physical laws, analyses of concepts such as space, mass, energy, gravity, spin, and entropy define an exclusive presence of 1D space in the minimum and maximum expansion states of the Universe. With our 3D space Universe created and existing between these extreme states, a complete universal evolution is outlined. More objectively, all the exposed dynamics complements the usual relativity. The concept of complete rest energy (1D space) was able to be applied, demonstrating that the evolution of the entire Universe is spatially dynamic in a perpetual time dimension, always recreating our Universe.
Evaluation of Different Imaging Modalities for Axillary Lymph Node Staging in Breast Cancer Patients to Provide A Personalized and Optimized Therapy Algorithm
Authors: Diessner Joachim , Anders Laura , Herbert Saskia , Kiesel Matthias , Bley Thorsten , Schlaiss Tanja , Sauer Stephanie , Wöckel Achim , Bartmann Catharina 
Published: August 2021

Abstract
Purpose The prognostic importance of lymph node infiltration in breast cancer patients before and after neoadjuvant therapy has increased significantly in recent years. For that reason, the reliable detection of tumor-infiltrated axillary lymph nodes at the time of diagnosis plays a decisive role in further therapy. We therefore focused on the sensitivity of different pretherapeutic imaging modalities (sonography, mammography, computed tomography [CT] and magnetic resonance imaging [MRI]) in nodal positive breast cancer patients and aimed to find out whether cross-sectional imaging techniques (MRI, CT) could improve sensitivity for pretherapeutic axillary staging compared to conventional imaging such as mammography and sonography. Methods Breast cancer patients with tumor-infiltrated axillary lymph nodes between 2014 and 2020 having a surgery for breast cancer were included in the study. Results All included 382 breast cancer patients had received conventional imaging, while 52.61% of the patients had received cross-sectional imaging. The sensitivity of the combination of all imaging modalities was 68.89%. The combination of MRI and CT showed 63.83% and the combination of sonography and mammography showed 36.11% sensitivity.Conclusion We could demonstrate that cross-sectional imaging can improve the sensitivity of the detection of tumor-infiltrated axillary lymph nodes in breast cancer patients. Considering the increasing importance of neoadjuvant and post-neoadjuvant therapeutic algorithms, the reliable detection of tumor-infiltrated lymph nodes gains increasing importance. Only the safe detection of tumor-infiltrated lymph nodes at the time of diagnosis enables the evaluation of the response to neoadjuvant therapy and thereby allows access to prognosis–improving post-neoadjuvant therapies.
The Role of Synovial Fluid Aspiration in Shoulder Joint Infections
Authors: Streck Laura Elisa , Forster Johannes , von Hertzberg-Boelch Sebastian Philipp , Reichel Thomas , Rudert Maximilian , Rueckl Kilian 
Published: August 2021

Abstract
Background: Joint aspiration with analysis of synovial fluid white blood cell count (WBC) and microbiological culture is a widely established aspect in the diagnosis of shoulder joint infections (SJI). In case of a two stage revision for SJI, joint aspiration before re-/implantation of an total shoulder arthroplasty (TSA) was used to rule out persistent infection for years but its value is under debate. Shoulder specific data on all aspects is rare. The current study aims to answer the following research questions: Joint aspiration has an insufficient predictive value in the diagnosis of SJI in (1) initial workup and (2) before definite arthroplasty with polymethylmethacrylate (PMMA)-Spacer in place. Methods: This retrospective evaluation investigates 35 patients that were treated for SJI with a two staged implantation of a TSA after debridement and implantation of an PMMA-Spacer. Joint aspirations were performed preoperatively (PA) and before re‑/implantation of the prosthesis while spacer was in place (interstage aspiration, IA). Samples were taken for microbiological culture and analysis of WBC. Sensitivity and specificity were calculated with reference to intraoperative microbiological samples. Receiver Operating Characteristic (ROC), Area-Under-Curve analysis (AUC) and calculation of the Youden index were performed to find optimum cut-off for WBC. Results: The sensitivity of microbiological cultures from PA was 58.3% and the specificity was 88.9%. The mean WBC was 27 800 leucocytes/mm3 (range 400-96 300). The maximum Youden index (0.857) was a cut-off of 2600 leucocytes/mm³ with a sensitivity of 85.7% and a specificity of 100.0%. The sensitivity and specificity of IA were 0.0% and 88.5%, respectively. Conclusions: PA is likely to miss Cutibacteria spp. Cuand CoNS and cannot rule out infection for sure. However, we recommend PA for its advantages of targeted antibiotic therapy in case of germ identification. Empiric antibiotic therapy should therefore cover these bacteria even if aspiration showed negative microbiological cultures. In contrast, diagnostic value of IA does not qualify for routine use. Trial registration: The study was approved by the ethic committee of the author`s institution (registration number 235/16-mk). The patients gave written informed consent to their inclusion in the study.
Prostate cancer histopathology with label-free multispectral deep UV microscopy quantifies phenotypes of tumor grade and aggressiveness
Authors: Soltani Soheil , Ojaghi Ashkan , Qiao Hui , Kaza Nischita , Li Xinyang , Dai Qionghai , Osunkoya Adeboye , Robles Francisco 
Published: August 2021

Abstract
Identifying prostate cancer patients that are harboring aggressive forms of prostate cancer remains a significant clinical challenge. To help address this problem, we develop an approach based on multispectral deep-ultraviolet (UV) microscopy that provides novel quantitative insight into the aggressiveness and grade of this disease. First, we find that UV spectral signatures from endogenous molecules give rise to a phenotypical continuum that differentiates critical structures of thin tissue sections with subcellular spatial resolution, including nuclei, cytoplasm, stroma, basal cells, nerves, and inflammation. Further, we show that this phenotypical continuum can be applied as a surrogate biomarker of prostate cancer malignancy, where patients with the most aggressive tumors show a ubiquitous glandular phenotypical shift. Lastly, we adapt a two-part Cycle-consistent Generative Adversarial Network to translate the label-free deep-UV images into virtual hematoxylin and eosin (H&E) stained images. Agreement between the virtual H&E images and the gold standard H&E-stained tissue sections is evaluated by a panel of pathologists who find that the two modalities are in excellent agreement. This work has significant implications towards improving our ability to objectively quantify prostate cancer grade and aggressiveness, thus improving the management and clinical outcomes of prostate cancer patients. This same approach can also be applied broadly in other tumor types to achieve low-cost, stain-free, quantitative histopathological analysis.
Existence and Stability of the Periodic Orbits Induced by Grazing Bifurcation in a Cantilever Beam System with Single Rigid Impacting Constraint
Authors: Liu Run , Yue Yuan , Xie Jianhua 
Published: August 2021

Abstract
Grazing which can induce many nonclassical bifurcations, is a special dynamic phenomenon in some non-smooth dynamical systems such as vibro-impact systems with clearance. In this paper, the existence and stability of the periodic orbits induced by the grazing bifurcation in a cantilever beam system with impacts are uncovered. Firstly, the Poincaré mapping of the system is obtained by the discontinuous mapping method. Secondly, the periodic orbits are determined by means of shooting method, and Jacobian matrix in the case of non-impact is obtained subsequently. Thirdly, for various impacting patterns, a combination of inhomogeneous equations and inequations is obtained to determine the existence of period orbits after grazing. Furthermore, the stability criterion of the grazing-induced periodic orbits is given. Numerical results verify the effectiveness of theoretical analysis. What’s more, we also give a conjecture about the relationship between eigenvalues and the type of periodic orbits when eigenvalues are imaginary numbers.
Assessing the Transition From Pre-Clerkship to Clerkship in a Four-Year Medical Program: Recommendations for Future Success
Authors: Mistry Neel , de Laplante Stefan , Campbell Craig Murray 
Published: August 2021

Abstract
Background: The transition from pre-clerkship to clinical clerkship is a pivotal moment for medical students. At the University of Ottawa Faculty of Medicine, Unit IV and the Link Block are designed to facilitate this transition. Improvements to the current curriculum, specifically in Unit IV, may better prepare students for clerkship. We aimed to summarize existing literary evidence on the transition to clerkship and collect student feedback to generate recommendations for success with regard to clerkship preparedness at the University of Ottawa Faculty of Medicine. Methods: We conducted a literature search using PubMed, MEDLINE, ERIC, and CINAHL for studies evaluating the transition to clerkship in a four-year medical program. Using this data, we created two different versions of our survey (pre-transition and post-transition) for dissemination to second, third, and fourth-year medical students, plus MD/PhD students, in the Anglophone and Francophone stream. The survey was open for three weeks from October 10 to October 31, 2020, with weekly reminders to all eligible participants. Microsoft Excel 2016 was used for data analysis. Results: We obtained 176 respondents, of which 158 (70% Anglophone and 30% Francophone) were included in the analysis. The majority of students were in the MD2023 cohort (40%) and had completed a 4-year Bachelor’s degree (61%) prior to medical school. Students in the post-transition group were less anxious about the transition to clerkship than their junior colleagues, although differences between streams were marginal. The most notable difference concerning Entrustable Professional Activities was in terms of obtaining a complete history and performing a physical examination, with the post-transition cohort reporting increased competency compared to the pre-transition cohort in the Anglophone stream (2.9/5.0 pre-transition vs. 3.3/5.0 post-transition, +0.33 difference, p<0.05). Top two stressors for incoming clerks were a lack of clinical skills or experience, and lack of clarity around clerkship roles, responsibilities, and expectations.Conclusion: There is limited training to facilitate a seamless transition for incoming clerks at the University of Ottawa Faculty of Medicine. Changes can be made at the pre-clerkship level in the form of small-group orientation sessions, formative OSCEs, accelerated review of pre-clerkship material, and clerkship simulation sessions.
Age-Related Differences in Auditory Statistical Learning of Complex Speech Streams: Evidence From ERPs
Authors: Soares Ana Paula , Gutiérrez-Domínguez Francisco-Javier , Lages Alexandrina , Oliveira Helena M. , Vasconcelos Margarida , Jiménez Luis 
Published: August 2021

Abstract
Statistical learning (SL), the ability to pick up regularities in the sensory environment, is a fundamental skill that allows us to structure the world in a regular and predictable way. Although extensive evidence has been gathered from children and adults, the changes that SL might undergo throughout development remain contentious, particularly in the auditory modality (aSL) with linguistic materials. Here, we collected Event-Related Potentials (ERPs) while 5 years-old children and young adults (university students) were exposed to a complex speech stream in which eight three-syllable nonsense words - four with high (1.0) and four with low (.50) transitional probabilities were embedded to further examine how aSL works under less predictable conditions and to enhance age-related differences in the neural correlates of aSL. Moreover, to ascertain how previous knowledge of the to-be-learned regularities might also affect the results, participants performed the aSL task, firstly, under implicit and, subsequently, under explicit conditions. Although behavioral signs of aSL were observed only for adult participants, ERP data showed evidence of aSL in both groups, as indexed by modulations in the N100 and N400 components. A detailed analysis of the neural responses suggests, however, that adults and children rely on different mechanisms to assist aSL.
Can We Be at Peace With Unsolvable Suffering? A Qualitative Study Exploring the Effectiveness of Supportive Communication and Resilience Building
Authors: Nagano Hiroaki , Chida Keiko , Ozawa Taketoshi 
Published: August 2021

Abstract
BackgroundSuper-aging, along with high death rates and limited social resources in Japan, has created an urgent need to assume responsibility for the wellbeing of older adults and patients who have reached the end of life in the local community. MethodsFrom January 2019 to December 2020, we held six workshops with the same contents of interpersonal assistance using the teaching materials provided by End-of-Life Care (ELC) Association. The study session lasted for 180 minutes: the first 90 minutes entailed a presentation on supportive communication. The last 90 minutes were centered on role-playing. The objective of the supportive communication was not to understand the other person perfectly but to lead suffering people to think of supporters an understanding people.The participants were asked to perform reflective journal writing immediately following each session to record their experiences and describe what they learned. We applied thematic analysis to the journal entries to identify key themes based on Kolb’s ELT (experiential learning theory). For the three-month follow-up, semi-structured interviews were conducted with each participant to assess their self-perceived changes.ResultsReflective journal writing was completed by 152 participants. Using thematic analysis of the journal content immediately following the workshop, we identified two domains and 10 key themes based on participants’ perceptions. Participants realized the importance of using listening techniques, such as repetition and silence and understanding another person. Some mentioned they could ease their sense of weakness when helping those who are suffering, and that this awareness could be applied to work, grief care, and daily life.Three months post-experience interviews were completed with 28 of the original 152 participants who had completed reflective journal writing. Two domains and six key themes were generated. Some of the participants continued to practice listening with repetition and silence. Some of them also asked questions that could help strengthen the support for the sufferers. Changes in relationships between the participants and patients were identified. ConclusionUsing role-playing to teach supportive communication, such as listening attentively and accepting others by practicing repetition, silence, and asking, may be effective in encouraging supporters to confidently engage with people experiencing incurable suffering.