bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of active learning methods by nurse educators in undergraduate nursing students’ programs – a group interview
Authors: Pivač Sanela , Skela-Savič Brigita , Jović Duška , Avdić Mediha , Kalender-Smajlović Sedina 
Published: September 2021

AbstractBackgroundModern and active learning methods form an important part in the education of Nursing students. They encourage the development of communication and critical thinking skills, and ensure the safe health care of patients. Our aim was to obtain naturalistic data from nurse educators regarding want the use and effects of implementing active learning methods (Peyton’s Four-Step Approach, Mind Mapping, Debriefing and Objective Structured Clinical Examination methods) in the study process of students of Nursing after a completed education module,Clinical skills of mentors, as part of the Strengthening Nursing in Bosnia and Herzegovina Project. We wish to learn about the perception of nurse educators regarding the use of active learning methods in the study process of Nursing in the future.MethodsQualitative research was conducted and a group interview technique was used for data collection. Beforehand, research participants were included in a two-day education module,Clinical skills of mentors, as part of the Strengthening Nursing in Bosnia and Herzegovina Project. Content analysis of the discussion transcriptions was conducted.ResultsFourteen nurse educators participated. Group interviews were conducted in September 2019. The obtained categories form four topics: (1) positive effect on the development of students’ communication skills (2) positive effect of learning methods on the development of students’ critical thinking skills (3) ensuring a safe learning environment (4) implementation of active learning methods.ConclusionsThe use of various active learning methods in simulation settings improves the Nursing students’ critical thinking and communication skills. Therefore, we believe that Peyton’s Four-Step Approach, Mind Mapping and Debriefing methods should be included as tools for effective student learning and as preparation for directly performing safe nursing interventions with a patient. Effective approaches to the assessment of Nursing students may ensure quality patient health care in accordance with the vision of the nursing profession.
Comparison of various insulin resistance surrogates on prognostic prediction and stratification following percutaneous coronary intervention in patients with and without type 2 diabetes mellitus
Authors: Zhao Qi , Cheng Yu-Jing , Xu Ying-Kai , Zhao Zi-Wei , Liu Chi , Sun Tie-Nan , Zhou Yu-Jie 
Published: September 2021

Abstract
Background
Insulin resistance (IR), evaluation of which is difficult and complex, is closely associated with cardiovascular disease. Recently, various IR surrogates have been proposed and proved to be highly correlated with IR assessed by the gold standard. It remains indistinct whether different IR surrogates perform equivalently on prognostic prediction and stratification following percutaneous coronary intervention (PCI) in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients with and without type 2 diabetes mellitus (T2DM).

Methods
The present study recruited patients who were diagnosed with NSTE-ACS and successfully underwent PCI. IR surrogates evaluated in the current study included triglyceride-glucose (TyG) index, visceral adiposity index, Chinese visceral adiposity index, lipid accumulation product, and triglyceride-to-high density lipoprotein cholesterol ratio, calculations of which were conformed to previous studies. The observational endpoint was defined as the major adverse cardiovascular and cerebrovascular events (MACCE), including cardiac death, non-fatal myocardial infarction, and non-fatal ischemic stroke.

Results
2107 patients (60.02 ± 9.03 years, 28.0% female) were ultimately enrolled in the present study. A total of 187 (8.9%) MACCEs were documented during the 24-month follow-up. Despite regarding the lower median as reference [hazard ratio (HR) 3.805, 95% confidence interval (CI) 2.581–5.608, P < 0.001] or evaluating 1 normalized unit increase (HR 1.847, 95% CI 1.564–2.181, P < 0.001), the TyG index remained the strongest risk predictor for MACCE, independent of confounding factors. The TyG index showed the most powerful diagnostic value for MACCE with the highest area under the receiver operating characteristic curve of 0.715. The addition of the TyG index, compared with other IR surrogates, exhibited the maximum enhancement on risk stratification for MACCE on the basis of a baseline model (Harrell’s C-index: 0.708 for baseline model vs. 0.758 for baseline model + TyG index, P < 0.001; continuous net reclassification improvement: 0.255, P < 0.001; integrated discrimination improvement: 0.033, P < 0.001). The results were consistent in subgroup analysis where similar analyses were performed in patients with and without T2DM, respectively.

Conclusion
The TyG index, which is most strongly associated with the risk of MACCE, can be served as the most valuable IR surrogate for risk prediction and stratification in NSTE-ACS patients receiving PCI, with and without T2DM.
Potential of combination of DCE-MRI and DWI with serum CA125 and CA199 in evaluating effectiveness of neoadjuvant chemotherapy in breast cancer
Authors: Zhang Jun , Huang Yongbo , Chen Jianghui , Wang Xia , Ma Hongyu 
Published: September 2021

Abstract
Background
To determine the potential of the combination of DCE-MRI imaging method with DWI and serum CA125 and CA199 levels in the evaluation of the efficacy of neoadjuvant chemotherapy in breast cancer patients.

Methods
Sixty-five breast cancer patients who received neoadjuvant chemotherapy in our hospital from April 2016 to April 2017 were selected as research subjects. The patients received 4 courses of neoadjuvant chemotherapy. Lesions were monitored using DCE-MRI and DWI, while ELISA was used to measure the serum expression levels of the tumour markers CA125 and CA199. The patients were divided into the remission group and ineffective group based on pathological diagnosis.

Results
There were significant differences in Kep, Ktrans, ADCmin, ADCmean, tumour volume, and serum levels of CA125 and CA199 in patients in the remission group, before and after neoadjuvant chemotherapy, and there were significant differences in post-chemotherapy values of these indexes between the remission group and the ineffective group (p < 0.01).

Conclusion
Combination of DCE-MRI diagnostic imaging with DWI can directly reflect the lesions in breast cancer patients after neoadjuvant chemotherapy. Serum levels of CA125 and CA199 levels are useful for evaluation of the impact of neoadjuvant chemotherapy on breast cancer patients, including risk of cancer cell metastasis and changes in some small lesions.
High-fat diet increases gliosis and immediate early gene expression in APOE3 mice, but not APOE4 mice
Authors: Jones Nahdia S. , Watson Katarina Q. , Rebeck G. William 
Published: September 2021

Abstract
Background
APOE4 is the strongest genetic risk factor for Alzheimer’s disease (AD), and obesity is a strong environmental risk factor for AD. These factors result in multiple central nervous system (CNS) disturbances and significantly increase chances of AD. Since over 20% of the US population carry the APOE4 allele and over 40% are obese, it is important to understand how these risk factors interact to affect neurons and glia in the CNS.

Methods
We fed male and female APOE3 and APOE4 knock-in mice a high-fat diet (HFD-45% kcal fat) or a "control" diet (CD-10% kcal fat) for 12 weeks beginning at 6 months of age. At the end of the 12 weeks, brains were collected and analyzed for gliosis, neuroinflammatory genes, and neuronal integrity.

Results
APOE3 mice on HFD, but not APOE4 mice, experienced increases in gliosis as measured by GFAP and Iba1 immunostaining. APOE4 mice on HFD showed a stronger increase in the expression of Adora2a than APOE3 mice. Finally, APOE3 mice on HFD, but not APOE4 mice, also showed increased neuronal expression of immediate early genes cFos and Arc.

Conclusions
These findings demonstrate that APOE genotype and obesity interact in their effects on important processes particularly related to inflammation and neuronal plasticity in the CNS. During the early stages of obesity, the APOE3 genotype modulates a response to HFD while the APOE4 genotype does not. This supports a model where early dysregulation of inflammation in APOE4 brains could predispose to CNS damages from various insults and later result in the increased CNS damage normally associated with the APOE4 genotype.
The Global Fund: why anti-corruption, transparency and accountability matter
Authors: Chang Zhihao , Rusu Violet , Kohler Jillian C. 
Published: September 2021

Abstract
Background
The creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria, also known as the Global Fund, was prompted by the lack of a timely and effective global response, and the need for financing to fight against three devastating diseases: HIV/AIDS, tuberculosis, and malaria. During the formation of the Global Fund, necessary anti-corruption, transparency, and accountability (ACTA) structures were not put in place to prevent fraud and corruption in its grants, which resulted in the misuse of funds by grant recipients and an eventual loss of donor confidence in 2011. The Global Fund has instituted various ACTA mechanisms to address this misuse of funding and the subsequent loss of donor confidence, and this paper seeks to understand these implementations and their impacts over the past decade, in an effort to probe ACTA more deeply.

Results
By restructuring the governing committees in 2011, and the Audit and Finance; Ethics and Governance; and Strategy Committees in 2016, the Global Fund has delineated committee mandates and strengthened the Board’s oversight of operations. Additionally, the Global Fund has adopted a rigorous risk management framework which it has worked into all aspects of its functioning. An Ethics and Integrity Framework was adopted in 2014 and an Ethics Office was established in 2016, resulting in increased conflict of interest disclosures and greater considerations of ethics within the organization. The Global Fund’s Office of the Inspector General (OIG) has effectively performed internal and external audits and investigations on fraud and corruption, highlighted potential risks for mitigation, and has implemented ACTA initiatives, such as the I Speak Out Now! campaign to encourage whistleblowing and educate on fraud and corruption.

Conclusions
From 2011 onwards, the Global Fund has developed a number of ACTA mechanisms which, in particular, resulted in reduced grant-related risks and procurement fraud as demonstrated by the decreased classification from high to moderate in 2017, and the reduction of investigations in 2018 respectively. However, it is crucial that the Global Fund continues to evaluate the effectiveness of these mechanisms; monitor for potential perverse impacts; and make necessary changes, when and where they are needed.
BRAF mutation correlates with worse local–regional control following radiation therapy in patients with stage III melanoma
Authors: Wolfe Adam R. , Chablani Priyanka , Siedow Michael R. , Miller Eric D. , Walston Steve , Kendra Kari L. , Wuthrick Evan , Williams Terence M. 
Published: September 2021

Abstract
Background
In patients with stage III melanoma, the use of adjuvant radiation therapy (RT) after lymph node dissection (LND) may be currently considered in selected high-risk patients to improve tumor control. Melanomas harbor BRAF mutations (BRAF+) in 40–50% of cases, the majority of which are on the V600E residue. This study sought to compare the clinical outcomes after RT between patients with BRAF+ and BRAF− melanoma.

Methods
This was a retrospective review of 105 Stage III melanoma patients treated at our institution with LND followed by adjuvant RT from 2006 to 2019. BRAF mutational status was determined on the primary skin or nodal tissue samples from all patients. We compared characteristics of the BRAF+ and BRAF− groups using Fisher’s exact test and Wilcoxon rank sum test and performed univariate and multivariate analysis using Kaplan–Meier estimates, log-rank tests, and Cox proportional hazards modeling with the clinical outcomes of local–regional lymph node control, distant metastasis-free survival (DMFS), recurrence-free survival (RFS), and overall survival (OS).

Results
Fifty-three (50%) patients harbored a BRAF mutation (92%, pV600E). BRAF+ patients were younger and had primary tumors more commonly found in the trunk vs head and neck compared to BRAF- patients (p < 0.05). The 5 year local–regional control in the BRAF + patients was 60% compared to 81% in the BRAF- patients (HR 4.5, 95% CI 1.3–15.5, p = 0.02). There were no significant differences in 5-year DMFS, RFS, and OS rates between the two BRAF patient groups. The presence of 4 or more positive LNs remained a significant prognostic factor for local–regional lymph node control, RFS, and OS in multivariate analysis.

Conclusions
Stage III melanoma patients with BRAF mutation treated with adjuvant RT had > 4 times increased risk of local recurrence or regional lymph node recurrence. These results could be useful for adjuvant RT consideration in lymph node positive melanoma patients and supports other data that BRAF mutation confers radiation resistance.
The incidence of acute myocardial infarction after elective spinal fusions or joint replacement surgery in the United States: a large-scale retrospective observational cohort study in 322,585 patients
Authors: Arena Patrick J. , Mo Jingping , Liu Qing , Zhou Xiaofeng , Gong Richard , Wentworth Charles , Murugesan Sundaresan , Huang Kui 
Published: September 2021

Abstract
Background
Acute myocardial infarction (AMI) is an uncommon but fatal complication among patients undergoing elective spinal fusion surgery (SF), total hip arthroplasty (THA), and total knee arthroplasty (TKA). Our objective was to estimate the incidence of AMI among adults undergoing elective SF, THA, and TKA in different post-operative risk windows and characterize high-risk sub-populations in the United States.

Methods
A retrospective cohort study was conducted using data from a longitudinal electronic healthcare record (EHR) database from January 1, 2007 to June 30, 2018. ICD codes were used to identify SF, THA, TKA, AMI, and selected clinical characteristics. Incidence proportions (IPs) and 95% confidence intervals were estimated in the following risk windows: index hospitalization, ≤ 30, ≤ 90, ≤ 180, and ≤ 365 days post-operation.

Results
A total of 67,533 SF patients, 87,572 THA patients, and 167,480 TKA patients were eligible for the study. The IP of AMI after SF, THA, and TKA ranged from 0.36, 0.28, and 0.25% during index hospitalization to 1.05, 0.93, and 0.85% ≤ 365 days post-operation, respectively. The IP of AMI was higher among patients who were older, male, with longer hospital stays, had a history of AMI, and had a history of diabetes.

Conclusion
The IP of post-operative AMI was generally highest among the SF cohort compared to the THA and TKA cohorts. Additionally, potential high-risk populations were identified. Future studies in this area are warranted to confirm these findings via improved confounder control and to identify effect measure modifiers.
ZNF507 affects TGF-β signaling via TGFBR1 and MAP3K8 activation in the progression of prostate cancer to an aggressive state
Authors: Kwon Wookbong , Choi Seong-Kyoon , Kim Daehwan , Kim Hyeon-Gyeom , Park Jin-Kyu , Han Jee Eun , Cho Gil-Jae , Yun Sungho , Yu Wookyung , Han Se-Hyeon , Ha Yun-Sok , Lee Jun Nyung , Kwon Tae Gyun , Cho Dong-Hyung , Yi Jun-Koo , Kim Myoung Ok , Ryoo Zae Young , Park Song 
Published: September 2021

Abstract
Background
The progression of prostate cancer (PC) to the highly aggressive metastatic castration-resistant prostate cancer (mCRPC) or neuroendocrine prostate cancer (NEPC) is a fatal condition and the underlying molecular mechanisms are poorly understood. Here, we identified the novel transcriptional factor ZNF507 as a key mediator in the progression of PC to an aggressive state.

Methods
We analyzed ZNF507 expression in the data from various human PC database and high-grade PC patient samples. By establishment of ZNF507 knockdown and overexpression human PC cell lines, we assessed in vitro PC phenotype changes including cell proliferation, survival, migration and invasion. By performing microarray with ZNF507 knockdown PC cells, we profiled the gene clusters affected by ZNF507 knockdown. Moreover, ZNF507 regulated key signal was evaluated by dual-luciferase reporter and chromatin immunoprecipitation (ChIP) assays. Finally, we performed xenograft and in vivo metastasis assay to confirm the effect of ZNF507 knockdown in PC cells.

Results
We found that ZNF507 expression was increased, particularly in the highly graded PC. ZNF507 was also found to be associated with metastatic PC of a high grade. Loss- or gain-of-function–based analysis revealed that ZNF507 promotes the growth, survival, proliferation, and metastatic properties of PC (e.g., epithelial-mesenchymal transition) by upregulating TGF-β signaling. Profiling of gene clusters affected by ZNF507 knockdown revealed that ZNF507 positively regulated the transcription of TGFBR1, MAP3K8, and FURIN, which in turn promoted the progression of PC to highly metastatic and aggressive state.

Conclusions
Our findings suggest that ZNF507 is a novel key regulator of TGF-β signaling in the progression of malignant PC and could be a promising target for studying the development of advanced metastatic PCs.
Fever during pregnancy as a risk factor for neurodevelopmental disorders: results from a systematic review and meta-analysis
Authors: Antoun Stephanie , Ellul Pierre , Peyre Hugo , Rosenzwajg Michelle , Gressens Pierre , Klatzmann David , Delorme Richard 
Published: September 2021

Abstract
Background
Fever during pregnancy is a relatively common and most often trivial event. However, under specific conditions, it could affect significantly fetal brain development. Few studies, with inconsistent results, investigated whether fever, regardless the pathogen, could represent a risk factor for neurodevelopmental disorders (NDD) in the offspring. We aimed to explore further this question by performing a systematic review and meta-analysis.

Methods
Peer-reviewed studies exploring the occurrence of NDD in offspring after a fetal exposure to maternal fever were included. We specifically considered the impact of fever severity and duration, taking into consideration some confounding variables such as the use of antipyretic during pregnancy, the trimester in which the fever arose, the maternal age or smoking at time of gestation. MEDLINE, EMBASE, PsycINFO, Cochrane and Web of Science were searched without language restriction. PRISMA recommendations were followed. Odds ratio (OR) were pooled using random-effects meta-analysis. Heterogeneity in effect size across studies was studied using random-effects meta-regression analysis. (PROSPERO CRD42020182801).

Results
We finally considered ten studies gathering a total of 10,304 children with NDD. Among them, 1394 were exposed to fever during pregnancy. The selected studies were divided into 5 case–control studies and 5 cohort studies. Maternal exposure to fever during pregnancy increased the risk of NDD in offspring with an OR of 1.24 [95% CI: 1.12–1.38]. Secondary analysis revealed an increased risk for NDD when fever occurred during the first trimester of gestation [OR 1.13–95% CI: 1.02–1.26].

Limitations
We excluded studies that considered infections with no evidence of fever. Another potential limitation may be the possible heterogeneity between study designs (cohorts and case–control).

Conclusion
Additional evidence supported the association between fever during pregnancy and increased risk for NDD in offspring. Careful monitoring should be considered for children born from mothers with a febrile episode during pregnancy (specifically during the first trimester).
Effect of COVID-19 on demand for healthcare in Togo
Authors: Tossou Yaovi 
Published: September 2021

Abstract
Background
Demand-side barriers to health care are as important as supply-side factors in deterring patients from obtaining effective treatment during COVID-19. Developing countries, including Togo, have focused on reducing the risk of health care utilization during this period by ensuring basic health care services as an important policy to improve health outcomes and meet international obligations to make health services accessible.

Methods
The data used to cover all 44 districts in the six (6) health regions of Togo, are from a national home survey. They are collected from July 8th to 17th, 2020. In each district chief town, a minimum of thirty (30) households were included by a systematic two-stage random draw (neighborhood and then home). Based on these data, the multinomial regression model was used to identify risk factors for the request for health care services during COVID-19.

Results
A total of 1946 (with a response rate of 98.3%) participants were addressed in the study. The finding on households with age above 60 years indicated that the relative risk ratio (RRR = 23.97; 95% CI = 0.93; 615.38) allowed them to practice self-medication in lieu of modern healthcare facilities. The multinomial model revealed that the relative risk ratio of pre-COVID-19 activities (RRR = 4.87; 95% CI = 1.018; 23.38) permits households to rely on their self-medication choice and (RRR = 3.14; 95% CI = 0.91; 0.83) prefer public health facilities. Given that the head of the households (RRR = 0.19; 95% CI = 0.017, 2.11) is educated, he prefers the choice of private health centers during COVID-19 pandemic to public health facilities.

Conclusion
This study has demonstrated that the majority (30.49%) of patients sought health care. The analysis shows that the loss of employment, activities before COVID-19 in households and areas not infected by the pandemics allow them to ask for health care (self-medication and public hospitals) despite the COVID-19 impacts. However, higher education and age determine a different choice of health care delivery by households. Thus, policy makers need to cast special emphasis on social policies to address home health shocks.
First detected case of rabbit Haemorrhagic disease virus 2 (RHDV2) in the Irish hare (Lepus timidus hibernicus)
Authors: Kennedy Aideen , Britton Louise , Byrne Andrew W. , Byrne Christina , Casey Mícheál , Flynn Orla , Lozano Jose Maria , Marnell Ferdia , McElroy Maire , Reid Neil , Wilson Margaret , FitzGerald William 
Published: September 2021

AbstractBackgroundRabbit haemorrhagic disease virus (RHDV) is aLagovirus, a subgroup of the familyCaliciviridae. RHDV2 is a variant first described in France in 2010, and has since spread globally. It has been reported in several Lagomorph species (rabbits, hares, and their relatives) as well as other mammals including voles and shrews. The disease has raised international concerns for its potential impact on population abundance trajectories, particularly as 25% of Lagomorphs are currently Red-Listed by the International Union for the Conservation of Nature (IUCN). The Irish hare (Lepus timidus hibernicus) is a subspecies of the mountain hare,L. timidus, and is endemic to Ireland, making it an Evolutionarily Significant Unit of intrinsic value.Case presentationThe first case of RHDV2 was detected in a wild Irish hare in July 2019. The individual exhibited atypical neurological behaviour (running in circles) prior to death. On necropsy, pink tinged foam was seen in the trachea and congestion was noted in the lungs, but there was no evidence of haemorrhages in any other organ. Both the liver and spleen were tested by reverse transcription real time qPCR confirming high levels of RHDV2 RNA. Histopathology confirmed multifocal necrotising hepatitis.ConclusionThe Irish hare is susceptible to RHDV2 infection. Further investigation is warranted to explore the clinical, epidemiological, and population biology implications.