bluuebunny/crossref_metadata_2025_split huggingface dataset:
“It was one of those complicated cases”: health practitioners’ perspectives and practices of providing end-of-life care for people with profound intellectual and multiple disability
Authors: Voss Hille , Loxton April , Anderson Julie , Watson Joanne 
Published: November 2021

Abstract
Background
Due to developments in health and social care, people with profound intellectual and multiple disability (PIMD) are living longer than ever before, meaning they are increasingly experiencing life-threatening health conditions requiring palliative care. Little is known about providing end-of-life care for people with PIMD. The aim of this study was to explore health practitioners’ perspectives and practices relating to end-of-life decision-making and planning for people with PIMD.

Methods
Seven in-depth semi-structured interviews were conducted with health practitioners employed in a range of hospital and community services throughout Melbourne, Australia. Questions were designed to gather information about their experience, perceptions, and attitudes relating to people with PIMD during and at the end of their life. Each interview, ranging from 40 to 60 min in length, was audio recorded and transcribed. Inductive thematic analysis was used to analyse the data.

Results
Four main themes emerged: limited participation, bias, dignity, and quality of death. Health practitioners indicated that people with PIMD are frequently excluded from participating in decision-making related to end-of-life care. Participants discussed reasons for this exclusion including challenges with communication and cognition. Participants reported a need for additional support and guidance in providing care for people with PIMD at the end of life. Professional and family bias played a role in end-of-life decision-making for people with PIMD. Participants reported a disproportional focus by palliative care practitioners on physical as opposed to emotional and spiritual well-being for patients with PIMD at the end of life. Finally, participants reported that people with PIMD generally did not die in specialised palliative care settings, but in segregated supported living environments.

Conclusions
Due to negative perceptions of a person with PIMD’s decision-making capacity, people with PIMD are likely to be assessed as unable to express choice and preference regarding end-of-life care and are offered limited opportunity to be involved in their own end-of-life care. This research provides guidance for the development of training and professional development relating to people with PIMD at the end of life. It is hoped that this will increase the accessibility of end-of-life services for people with PIMD, ensuring that a respectful and dignified death can be a reality for all humankind regardless of disability.
Bayesian network-based missing mechanism identification (BN-MMI) method in medical research
Authors: Yue Tingyan , Zhang Tao 
Published: November 2021

Abstract
Background
Traditional approaches to identify missing mechanisms are usually based on the hypothesis test and confronted with both theoretical and practical challenges. It has been proved that the Bayesian network is powerful in integrating, analyzing and visualizing information, and some previous researches have verified the promising features of Bayesian network to deal with the aforementioned challenges in missing mechanism identification. Based on the above reasons, this paper explores the application of Bayesian network to the identification of missing mechanisms for the first time, and proposes a new method, the Bayesian network-based missing mechanism identification (BN-MMI) method, to identify missing mechanism in medical research.

Methods
The procedure of BN-MMI method consists three easy-to-implement steps: estimating the missing data structure by the Bayesian network; assessing the credibility of the estimated missing data structure; and identifying the missing mechanism from the estimated missing data structure. The BN-MMI method is verified by simulation research and empirical research.

Results
The simulation study verified the validity, consistency and robustness of BN-MMI method, and indicated its outperformance in contrast to the traditional logistic regression method. In addition, the empirical study illustrated the applicability of BN-MMI method in the real world by an example of medical record data.

Conclusions
It was confirmed that the BN-MMI method itself, together with human knowledge and expertise, could identify the missing mechanisms according to the probabilistic dependence/independence relations among variables of interest. At the same time, our research shed light upon the potential application of BN-MMI method to a broader range of missing data issues in medical studies.
Fermentation quality of herbal tea residue and its application in fattening cattle under heat stress
Authors: Zhuang Xiaona , Chen Zujing , Sun Xiaohong , Li Fangjun , Luo Junyi , Chen Ting , Xi Qianyun , Zhang Yongliang , Sun Jiajie 
Published: November 2021

Abstract
Background
Herbal tea residue (HTR) is generally considered to be the waste of herbal tea beverage production while it still retains rich nutrients and active substances. The main aim of the present study was to investigate the effect of fermentation technology on improving the quality of HTRs, and focus on the fermented HTR-induced alleviation of summer heat stress in fattening cattle.

Results
In this study, the waste HTR was fermented and then fed to a total of 45 fattening cattle that were divided into 3 groups (fermented HTR replaced 0, 15, 30% of the forage component of the diet), and the feeding experiment was lasted for 40 days. The physiological indexes, growth performance and fecal microbiota of fattening cattle were evaluated and results showed that fermented HTR could effectively reduce the respiratory rate and rectal temperature of fattening cattle under heat stress, increase the daily feed intake and daily gain, and improve the antioxidant content and blood immune index. In addition, we studied the fecal microbiota composition of 6 fattening cattle in control and 30% HTR substitution groups and found fermented HTR significantly changed the composition of fecal microbiota and increased microbial diversity, and correlation analysis suggested that the bacteria were closely related to fecal SCFA levels of fattening cattle under heat stress.

Conclusions
In this study, fermented HTR replaced 30% of the forage component of the diet that can change the intestine microorganisms, maintain health and alleviate the heat stress of fattening cattle.
Analysis of genetic variation in human papillomavirus type 16 E1 and E2 in women with cervical infection in Xinjiang, China
Authors: Wang Luyue , Wang Fang , Fu Shaowei , Zhang Chunhe , Zhe Xiangyi , Li Hongtao , Li Dongmei , Shao Renfu , Pan Zemin 
Published: November 2021

Abstract
Background
Xinjiang is one of the regions with a high incidence of cervical cancer, and the genetic variation of human papillomavirus may increase its ability to infect the human body and enhance virus-mediated immune escape ability.

Methods
Sanger sequencing of the HPV16 genome from 165 samples positive for HPV16 infection and phylogenetic analysis of the E1 and E2 genes revealed the gene polymorphism of HPV16 in Xinjiang.

Results
The results showed that there were 109 samples with variations in HPV16 E1, 48 sites with nucleotide variations (19 missense variations and 29 synonymous variations), and 91 samples with variations in HPV16 E2, 25 sites with nucleotide variations (20 missense variations and five synonymous variations).

Conclusions
From the phylogenetic tree results, 149 samples were of the European variant and 16 samples were of the Asian variant. No African or North American/Asian variant types were found.
Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: multiple effects of social support on quality of life
Authors: Qi Xinye , Xu Jiao , Chen Guiying , Liu Huan , Liu Jingjing , Wang Jiahui , Zhang Xin , Hao Yanhua , Wu Qunhong , Jiao Mingli 
Published: November 2021

Abstract
Objective
Elderly patients with type 2 diabetes mellitus are highly vulnerable due to severe complications. However, there is a contradiction in the relationship between social support and quality of life, which warrants further exploration of the internal mechanism. This study assessed the quality of life and its interfering factors in this patient population.

Methods
In total, 571 patients with type 2 diabetes mellitus over 60 years old were recruited from two community clinics in Heilongjiang Province, China. We collected data on health status, quality of life, self-management behavior, fasting plasma glucose (FPG) level, and social support. Structural equation modeling and the bootstrap method were used to analyze the data.

Results
The average quality of life score was − 29.25 ± 24.41. Poorly scored domains of quality of life were “Psychological feeling” (− 8.67), “Activity” (− 6.36), and “Emotion” (− 6.12). Of the 571 patients, 65.32% had normal FPG, 9.8% had high-risk FPG, 15.94% had good self-management behavior, and 22.07% had poor social support. Significant correlations among social support, self-management behavior, FPG level, and quality of life were noted. A multiple mediator model revealed that social support influenced quality of life in three ways: (1) directly (c′ = 0.6831); (2) indirectly through self-management behavior (a1*b1 = 0.1773); and (3) indirectly through FPG control (a2*b2 = 0.1929). Self-management behavior influenced the quality of life directly and indirectly through FPG control.

Conclusion
Improving self-management behavior and monitoring hypoglycemia should become priority targets for future intervention. Scheduled social support to self-management projects should be put into the standardized management procedure. Physicians should provide substantial and individualized support to the elderly patients with type 2 diabetes mellitus regarding medication, blood glucose monitoring, and physical exercise.
Remotely sensed estimation of total iron content in soil with harmonic analysis and BP neural network
Authors: Jiang Xueqin , Luo Shanjun , Fang Shenghui , Cai Bowen , Xiong Qiang , Wang Yanyan , Huang Xia , Liu Xiaojuan 
Published: November 2021

Abstract
Background
The estimation of total iron content at the regional scale is of much significance as iron deficiency has become a routine problem for many crops.

Methods
In this study, a novel method for estimating total iron content in soil (TICS) was proposed using harmonic analysis (HA) and back propagation (BP) neural network model. Several data preprocessing methods of first derivative (FD), wavelet packet transform (WPT), and HA were conducted to improve the correlation between the soil spectra and TICS. The principal component analysis (PCA) was exploited to obtained three kinds of characteristic variables (FD, WPT-FD, and WPT-FD-HA) for TICS estimation. Furthermore, the estimated accuracy of three BP models based on these variables was compared.

Results
The results showed that the BP models of different soil types based on WPT-FD-HA had better estimation accuracy, with the highest R2 value of 0.95, and the RMSE of 0.68 for the loessial soil. It was proved that the characteristic variable obtained by harmonic decomposition improved the validity of the input variables and the estimation accuracy of the TICS models. Meanwhile, it was identified that the WPT-FD-HA-BP model can not only estimate the total iron content of a single soil type with high accuracy but also demonstrate a good effect on the estimation of TICS of mixed soil.

Conclusion
The HA method and BP neural network combined with WPT and FD have great potential in TICS estimation under the conditions of single soil and mixed soil. This method can be expected to be applied to the prediction of crop biochemical parameters.
“That’s the whole thing about vaping, it’s custom tasty goodness”: a meta-ethnography of young adults’ perceptions and experiences of e-cigarette use
Authors: Ranjit Ananth , McCutchan Grace , Brain Katherine , Poole Ria 
Published: November 2021

AbstractBackgroundE-cigarettes are increasing in popularity, particularly among young adults. With public health organisations contesting the possible benefits of e-cigarettes, research is required to explore young adults’ use of e-cigarettes as a smoking cessation and recreational tool. This study examined existing qualitative data to understand how transition into adulthood and issues of identity affect young adults’ perceptions and experiences of e-cigarette use.MethodsA meta-ethnography was conducted to examine how young adults perceive and use e-cigarettes. Data were synthesised using Noblit and Hare’s (1988) meta-ethnographic approach. Bronfenbrenner’s socio-ecological model (1979) was used to conceptualise themes and map findings.ResultsA total of 34 studies were included in the review. Young adults viewed e-cigarettes as a safer alternative to traditional cigarette smoking and perceived e-cigarettes as an effective cessation tool. Users were able to personalise their e-cigarette use due to the variety of flavours and devices available. E-cigarettes were found to be a sociable tool as they allowed users to align themselves with their peers who used e-cigarettes and facilitated use within smoke-free environments. Young adults demonstrated high levels of self-efficacy with regards to obtaining e-cigarettes from various retailers and were active consumers of e-cigarette marketing.ConclusionThis meta-ethnography provides an in-depth insight into social norms around e-cigarette use and beliefs that e-cigarettes could be a safer alternative to traditional cigarettes. As young adults increasingly engage with e-cigarettes, there is a need for informed policy decisions regarding appropriate use. Engagement with e-cigarettes is often reflected within social media, so this medium could be a key platform for creating tailored interventions which inform young adults about the appropriate use of these products.
Small molecule inhibitors of α-synuclein oligomers identified by targeting early dopamine-mediated motor impairment in C. elegans
Authors: Chen Kevin S. , Menezes Krystal , Rodgers Jarlath B. , O’Hara Darren M. , Tran Nhat , Fujisawa Kazuko , Ishikura Seiya , Khodaei Shahin , Chau Hien , Cranston Anna , Kapadia Minesh , Pawar Grishma , Ping Susan , Krizus Aldis , Lacoste Alix , Spangler Scott , Visanji Naomi P. , Marras Connie , Majbour Nour K. , El-Agnaf Omar M. A. , Lozano Andres M. , Culotti Joseph , Suo Satoshi , Ryu William S. , Kalia Suneil K. , Kalia Lorraine V. 
Published: November 2021

Abstract
Background
Parkinson’s disease is a disabling neurodegenerative movement disorder characterized by dopaminergic neuron loss induced by α-synuclein oligomers. There is an urgent need for disease-modifying therapies for Parkinson’s disease, but drug discovery is challenged by lack of in vivo models that recapitulate early stages of neurodegeneration. Invertebrate organisms, such as the nematode worm Caenorhabditis elegans, provide in vivo models of human disease processes that can be instrumental for initial pharmacological studies.

Methods
To identify early motor impairment of animals expressing α-synuclein in dopaminergic neurons, we first used a custom-built tracking microscope that captures locomotion of single C. elegans with high spatial and temporal resolution. Next, we devised a method for semi-automated and blinded quantification of motor impairment for a population of simultaneously recorded animals with multi-worm tracking and custom image processing. We then used genetic and pharmacological methods to define the features of early motor dysfunction of α-synuclein-expressing C. elegans. Finally, we applied the C. elegans model to a drug repurposing screen by combining it with an artificial intelligence platform and cell culture system to identify small molecules that inhibit α-synuclein oligomers. Screen hits were validated using in vitro and in vivo mammalian models.

Results
We found a previously undescribed motor phenotype in transgenic α-synuclein C. elegans that correlates with mutant or wild-type α-synuclein protein levels and results from dopaminergic neuron dysfunction, but precedes neuronal loss. Together with artificial intelligence-driven in silico and in vitro screening, this C. elegans model identified five compounds that reduced motor dysfunction induced by α-synuclein. Three of these compounds also decreased α-synuclein oligomers in mammalian neurons, including rifabutin which has not been previously investigated for Parkinson’s disease. We found that treatment with rifabutin reduced nigrostriatal dopaminergic neurodegeneration due to α-synuclein in a rat model.

Conclusions
We identified a C. elegans locomotor abnormality due to dopaminergic neuron dysfunction that models early α-synuclein-mediated neurodegeneration. Our innovative approach applying this in vivo model to a multi-step drug repurposing screen, with artificial intelligence-driven in silico and in vitro methods, resulted in the discovery of at least one drug that may be repurposed as a disease-modifying therapy for Parkinson’s disease.
Auditory-cognitive training for adult cochlear implant recipients: a study protocol for a randomised controlled trial
Authors: Lawrence Blake J. , Eikelboom Robert H. , Jayakody Dona M. P. 
Published: November 2021

Abstract
Background
There is an urgent need to develop new therapies to improve cognitive function in adults following cochlear implant surgery. This study aims to determine if completing at-home computer-based brain training activities improve memory and thinking skills in adults following their first cochlear implant.

Methods
This study will be conducted as a single-blind, head-to-head, randomised controlled trial (RCT). It will determine whether auditory training combined with adaptive computerised cognitive training will elicit greater improvement in cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients, when compared to auditory training combined with non-adaptive (i.e. placebo) computerised cognitive training. Participants 18 years or older who meet the clinical criteria for a cochlear implant will be recruited into the study.

Results
The results of this trial will clarify whether the auditory training combined with cognitive training will improve cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients.

Discussion
We anticipate that our findings will have implications for clinical practice in the treatment of adult cochlear implant recipients.

Trial registration
Australian New Zealand Clinical Trials Registry ACTRN12619000609156. Registered on April 23 2019.
Zika virus and temperature modulate Elizabethkingia anophelis in Aedes albopictus
Authors: Onyango Maria G. , Lange Rachel , Bialosuknia Sean , Payne Anne , Mathias Nicholas , Kuo Lili , Vigneron Aurelien , Nag Dilip , Kramer Laura D. , Ciota Alexander T. 
Published: November 2021

Abstract
Background
Vector-borne pathogens must survive and replicate in the hostile environment of an insect’s midgut before successful dissemination. Midgut microbiota interfere with pathogen infection by activating the basal immunity of the mosquito and by synthesizing pathogen-inhibitory metabolites.

Methods
The goal of this study was to assess the influence of Zika virus (ZIKV) infection and increased temperature on Aedes albopictus midgut microbiota. Aedes albopictus were reared at diurnal temperatures of day 28 °C/night 24 °C (L) or day 30 °C/night 26 °C (M). The mosquitoes were given infectious blood meals with 2.0 × 108 PFU/ml ZIKV, and 16S rRNA sequencing was performed on midguts at 7 days post-infectious blood meal exposure.

Results
Our findings demonstrate that Elizabethkingia anophelis albopictus was associated with Ae. albopictus midguts exposed to ZIKV infectious blood meal. We observed a negative correlation between ZIKV and E. anophelis albopictus in the midguts of Ae. albopictus. Supplemental feeding of Ae. albopictus with E. anophelis aegypti and ZIKV resulted in reduced ZIKV infection rates. Reduced viral loads were detected in Vero cells that were sequentially infected with E. anophelis aegypti and ZIKV, dengue virus (DENV), or chikungunya virus (CHIKV).

Conclusions
Our findings demonstrate the influence of ZIKV infection and temperature on the Ae. albopictus microbiome along with a negative correlation between ZIKV and E. anophelis albopictus. Our results have important implications for controlling vector-borne pathogens.

Graphical Abstract
Assessing the viability of Legionella pneumophila in environmental samples: regarding the filter application of Ethidium Monoazide Bromide
Authors: Consonni Michela , Grassi Anna , Scuri Stefania , Gori Maria , Tanzi Elisabetta , Tesauro Marina 
Published: November 2021

AbstractPurposeAnalyses of 34 water samples from 13 healthcare structures revealed how culture method and quantitative PCR (qPCR) often differ in the detection ofLegionella pneumophila(Lp). With these considerations in hand, culture method, PCR and Ethidium Monoazide Bromide (EMA) qPCR have all been compared in order to detectLpin water samples, identify a method able to speed up the procedures, detect the “viable but not cultivable” bacteria (VBNC) and exclude non-viable bacteria using a commercial kit for extraction and amplification as well as modification of the protocol.MethodsPure water samples artificially spiked with viable, non-viable and VBNCLpATCC 33152 were analyzed using a commercial kit for both qPCR and EMA-qPCR, while ISO 11731-2-2004 was used for culture method.ResultsOnly 35% (12/34) of the environmental samples were positive in both culture and qPCR methods. With regard to EMA-qPCR, results showed the absence of dye toxicity on viable and VBNC strains and an incomplete effectiveness on the non-viable ones. In both viable and VBNC strains, a decrease of bacterial DNA amplification was recorded as a function of sample dilution but not of EMA concentration.ConclusionsDiscrepancies between culture method and EMA-qPCR were observed and may be due to different causes such as membrane-dye interactions, presence of interfering compounds and the sensitivity of the kit used.Study significance and impactIn the presence of one or more suspected cases of nosocomial legionellosis, the application of a rapid molecular method able to identify only the viable and VBNCLpwould be useful in order to quickly identify the source of infection and to intervene with sanitation treatments. However, seeing that in our experience EMA pretreatment on the filter membrane did not come up with the expected results, it would be necessary to proceed with other experiments and/or different dyes.Graphical Abstract
Umbilical cord blood plasma-derived exosomes as a novel therapy to reverse liver fibrosis
Authors: Huang Yu-Jen , Cao Jerry , Lee Chih-Yuan , Wu Yao-Ming 
Published: November 2021

Abstract
Background
Cirrhosis is a chronic liver disease whereby scar tissue replaces healthy liver parenchyma, leading to disruption of the liver architecture and hepatic dysfunction. Currently, there is no effective disease-modifying therapy for liver fibrosis. Recently, our group demonstrated that human umbilical cord blood (UCB) plasma possesses therapeutic effects in a rat model of acute liver failure.

Methods
In the current study, we tested whether exosomes (Exo) existed in UCB plasma and if they produced any antifibrotic benefits in a liver fibrosis model.

Results
Our results showed that UCB-Exo improved liver function and increased matrix metalloproteinase/tissue inhibitor of metalloproteinase degradation to reduce the degree of fibrosis. Moreover, UCB-Exo were found to suppress hepatic stellate cell (HSC) activity in vitro. These effects were associated with suppression of transforming growth factor-β/inhibitor of DNA binding 1 signaling.

Conclusions
These results further support that UCB-Exo have antifibrotic effects in mice with liver fibrosis and activated HSCs and may herald a new cell-free antifibrotic therapy.