bluuebunny/crossref_metadata_2025_split huggingface dataset:
–A cross-sectional study of clinical learning environments across four undergraduate programs using the undergraduate clinical education environment measure
Authors: Sellberg Malin , Palmgren Per J. , Möller Riitta 
Published: May 2021

AbstractBackgroundThe clinical learning environment (CLE) influences students’ achievement of learning outcomes and the development of their professional behaviors. However, CLEs are not always optimal for learning because of clinical productivity expectations and a lack of support from supervisors. The purpose of this study was to describe and compare students’ perceptions of their CLEs across four undergraduate programs.MethodsThis study is cross-sectional. In total, 735 students who were registered in the medical, nursing, physiotherapy, and speech-language pathology (SLP) programs were invited to participate. Data were collected using an online survey, which included demographics and the Undergraduate Clinical Education Environment Measure (UCEEM). The UCEEM consists of 26 items congregated into two overarching dimensions—experiential learning and social participation—with four subscales: opportunities to learn in and through work and quality of supervision, preparedness for student entry, workplace interaction patterns and student inclusion, and equal treatment.ResultsIn total 280 students (median age 28; range: 20–52; 72% females) returned the questionnaire. The mean total UCEEM score was 98.3 (SD 18.4; range: 91–130), with physiotherapy students giving the highest scores and medical students the lowest. The mean scores for the dimensions experiential learning and social participation for all the students were 62.8 (SD 13.6; range 59–85) and 35.5 (SD 6.2; range 13–45), respectively. Medical students rated the lowest for all subscales. The items receiving the highest ratings concerned equal treatment, whereas those receiving the lowest ratings concerned supervisors’ familiarity with the learning objectives. There were few statistically significant differences between the semesters within each program.ConclusionsThe students generally hold positive perceptions toward their CLEs. However, the students from the medical and nursing programs rated their learning environment lower than did the students from the physiotherapy and SLP programs. Importantly, in several aspects, the medical students provided significantly lower ratings for their CLE compared with the students from the other programs. The medical students’ low ratings for their supervisors’ familiarity with the learning objectives underscore the need to ensure that the prerequisites for optimal supervision are met.
Knowledge and preparedness of healthcare providers towards bioterrorism
Authors: Nofal Abdullah , AlFayyad Isamme , AlJerian Nawfal , Alowais Jalal , AlMarshady Meshal , Khan Anas , Heena Humariya , AlSarheed Ayah Sulaiman , Abu-Shaheen Amani 
Published: May 2021

Abstract
Background
Several emergent circumstances require healthcare providers to recognize the unusual and dangerous and pathogenic agents. An in-depth literature review showed that studies about bioterrorism preparedness amongst healthcare providers are lacking. Therefore, this study aimed to investigate the knowledge and preparedness level of first emergency respondents towards bioterrorism events.

Methods
This study has a cross-sectional design and was carried out at the Emergency departments and poison control centers/clinical laboratories three in major tertiary care hospitals in Riyadh, Saudi Arabia. The subjects were randomly selected to complete the self-administered questionnaire to collect study outcomes.

Results
A total of 1030 participants were included in the final data analysis. The mean knowledge score in the basic concepts of bioterrorism and introductory clinical presentations of bioterrorism-related agents was 4.92 ± 1.86 out of 12 points.
Moreover, the findings showed a mean knowledge score of 22.80 ± 3.92 out of 38 in the bioterrorism preparedness and governing policies and procedures. Respondents who received previous training in bioterrorism preparedness had a significantly higher number of perceived benefits than those not sure and without prior training (z = − 2.67, p = 0.008) and (z = − 4.4, p < 0.0001), respectively. About 79.4% of participants did not have previous training in bioterrorism preparedness, but 68.7% expressed willingness in the institution’s response and control to assist in a bioterrorist attack incident.

Conclusion
Although healthcare professionals have reported their desire to help in bioterrorism events, they need to enhance their knowledge of bioterrorism preparedness.
The impact of E-cigarette vaping and vapour constituents on bone health
Authors: Nicholson Thomas , Scott Aaron , Newton Ede Matthew , Jones Simon W. 
Published: May 2021

Abstract
Background
In contrast to cigarettes, electronic cigarette use (E-cigarettes) has grown substantially over the last decade. This is due to their promotion as both a safer alternative to cigarettes and as an aide to stop smoking. Critically, upon E-cigarette use, the user may be exposed to high doses of nicotine in addition to other compounds including flavouring chemicals, metal particulates and carbonyl compounds, particularly in highly vascularised tissues such as bone. However, there has been limited investigation into the impact of E-cigarette usage on bone physiology, particularly over extended time periods and there are no clinical recommendations regarding E-cigarette usage in relation to orthopaedic surgery. This literature review draws together data from studies that have investigated the impact of E-cigarette vapour and its major constituents on bone, detailing the models utilised and the relevant mechanistic and functional results.

Main body
Currently there is a lack of studies both in vivo and in vitro that have utilised E-cigarette vapour, necessary to account for changes in chemical composition of E-cigarette liquids upon vaping. There is however evidence that human bone and bone cells express nicotine receptors and exposure of both osteoblasts and osteoclasts to nicotine, in high concentrations may reduce their viability and impair function. Similarly, it appears that aldehydes and flavouring chemicals may also negatively impact osteoblast viability and their ability to form bone. However, such functional findings are predominantly the result of studies utilising bone cell lines such as MG-63 or Saos-2 cells, with limited use of human osteoblasts or osteoclasts. Additionally, there is limited consideration for a possible impact on mesenchymal stem cells, which can also play an import role in bone repair.

Conclusion
Understanding the function and mechanism of action of the various components of E-cigarette vapour in mediating human bone cell function, in addition to long term studies to determine the potential harm of chronic E-cigarette use on human bone will be important to inform users of potential risks, particularly regarding bone healing following orthopaedic surgery and injury.
The unpredictable carbon nanotube biocorona and a functionalization method to prevent protein biofouling
Authors: García-Hevia Lorena , Saramiforoshani Mahsa , Monge Jorge , Iturrioz-Rodríguez Nerea , Padín-González Esperanza , González Fernando , González-Legarreta Lorena , González Jesús , Fanarraga Mónica L. 
Published: May 2021

Abstract
Background
The intrinsic physicochemical properties of carbon nanotubes (CNTs) make them unique tools in nanotechnology. Their elemental composition, resilience, thermal properties, and surface reactivity make CNTs also of undisputed interest in biotechnology. In particular, their extraordinary ability to capture biomolecules on their surface makes them essential in this field. The proteins adsorbed on the CNTs create a biological coating that endows them the ability to interact with some cell receptors, penetrate membranes or interfere with cell biomechanics, thus behaving as an active bio-camouflage. But some of these proteins unfold, triggering an immune response that unpredictably changes the biological activity of CNTs. For this reason, the control of the biocorona is fundamental in the nanobiotechnology of CNTs.

Results
Using TEM and AFM here we demonstrate a significant increase in CNTs diameter after protein functionalization. A quantitative analysis using TGA revealed that between 20 and 60% of the mass of functionalized nanotubes corresponds to protein, with single-walled CNTs capturing the highest amounts. To qualitatively/quantitatively characterize these biocoatings, we studied the biochemical "landscape" of the proteins captured by the different nanotubes after functionalization under various conditions. This study revealed a significant variability of the proteins in the corona as a function of the type of nanotube, the functionalization temperature, or the time after exposure to serum. Remarkably, the functionalization of a single type of CNT with sera from various human donors also resulted in different protein landscapes. Given the unpredictable assortment of proteins captured by the corona and the biological implications of this biocoating, we finally designed a method to genetically engineer and produce proteins to functionalize nanotubes in a controlled and customizable way.

Conclusions
We demonstrate the high unpredictability of the spontaneous protein corona on CNTs and propose a versatile functionalization technique that prevents the binding of nonspecific proteins to the nanotube to improve the use of CNTs in biomedical applications.
Evaluation of vitamin D receptor expression in uterine leiomyoma and nonneoplastic myometrial tissue: a cross‐sectional controlled study
Authors: Lima Maria Simone Oliveira , da Silva Benedito Borges , de Medeiros Menandro Lima , dos Santos Alesse Ribeiro , do Nascimento Brazil Emerson Davi , Filho Walberto Monteiro Neiva Eulálio , Ibiapina Jerusia Oliveira , Brito Antônio Gilberto Albuquerque , Costa Pedro Vitor Lopes 
Published: May 2021

Abstract
Background
Uterine myomas are the most frequent benign solid pelvic tumors in women of reproductive age. At present, uterine myomas are the most common indication for hysterectomy because of the morbidity they cause, including intense bleeding, compression of adjacent organs, pain, and infertility. Some studies show that vitamin D receptor (VDR) expression is correlated with the etiology of uterine leiomyomas. This study aimed to assess the expression of VDR in uterine leiomyoma and nonneoplastic myometrial tissue.

Methods
A controlled cross-sectional study involving 40 women who underwent abdominal hysterectomy the Department of Gynecology of the Getúlio Vargas Hospital of Federal University of Piauí, Brazil, was performed to compare the immunohistochemical expression of VDR in samples of uterine leiomyoma tissue with adjacent nonneoplastic myometrial tissue. The mean percetages of stained nuclei in the two groups was compared by Student’s t teste, with significance established at p < 0.05.

Results
The percentage of cells with nuclei stained by anti-VDR in the myometrial and leiomyoma tissue was 79.52 % (± 4.32) and 60.22 % (± 7.24), respectively (p < 0.0001).

Conclusions
The mean percentage of nuclei expressing VDR was significantly lower in the uterine leiomyoma than in nonneoplastic myometrial tissue.
Case report: histopathology and molecular pathology analysis on enteric tissue of a COVID-19 patient
Authors: Feng Yanling , Zeng Dong , Hu Lvyin , Yang Yuexiang , Song Shu , Shi Yuhan , Xu Jingjing , Guo Wenjuan , Ling Yun , Qi Tangkai , Wu Qingguo , Li Feng , Cheng Jilin , Lu Hongzhou 
Published: May 2021

Abstract
Aims
Patients with COVID-19 can also have enteric symptoms. Here we analyzed the histopathology of intestinal detachment tissue from a patient with COVID-19.

Methods
The enteric tissue was examined by hematoxylin & eosin stain, PAS (Periodic acid–Schiff) staining, Gram staining, Ziehl–Neelsen stain and Grocott’s Methenamine Silver (GMS) Stain. The distribution of CD3, CD4, CK20 and CD68, cytomegalovirus (CMV) and Herpes Simplex Virus (HSV) antigen were determined by immunohistochemistry. In situ hybridization (ISH) of SARS-CoV-2 and Epstein-Barr virus-encoded small RNA (EBER) were also performed.

Results
We observed mucosal epithelium shedding, intestinal mucosal erosion, focal inflammatory necrosis with hemorrhage, massive neutrophil infiltration, macrophage proliferation accompanied by minor lymphocyte infiltration. Fungal spores and gram positive cocci but not mycobacteria tuberculosis were identified. Immunohistochemistry staining showed abundant CD68+ macrophages but few lymphocytes infiltration. HSV, CMV and EBV were negative. ISH of SARS-CoV-2 RNA showed positive signal which mostly overlapped with CD68 positivity.

Conclusions
The in situ detection of SARS-CoV-2 RNA in intestinal macrophages implicates a possible route for gastrointestinal infection. Further study is needed to further characterize the susceptibility of enteric cells to SARS-CoV-2 infection.
High-throughput soybean seeds phenotyping with convolutional neural networks and transfer learning
Authors: Yang Si , Zheng Lihua , He Peng , Wu Tingting , Sun Shi , Wang Minjuan 
Published: May 2021

Abstract
Background
Effective soybean seed phenotyping demands large-scale accurate quantities of morphological parameters. The traditional manual acquisition of soybean seed morphological phenotype information is error-prone, and time-consuming, which is not feasible for large-scale collection. The segmentation of individual soybean seed is the prerequisite step for obtaining phenotypic traits such as seed length and seed width. Nevertheless, traditional image-based methods for obtaining high-throughput soybean seed phenotype are not robust and practical. Although deep learning-based algorithms can achieve accurate training and strong generalization capabilities, it requires a large amount of ground truth data which is often the limitation step.

Results
We showed a novel synthetic image generation and augmentation method based on domain randomization. We synthesized a plenty of labeled image dataset automatedly by our method to train instance segmentation network for high throughput soybean seeds segmentation. It can pronouncedly decrease the cost of manual annotation and facilitate the preparation of training dataset. And the convolutional neural network can be purely trained by our synthetic image dataset to achieve a good performance. In the process of training Mask R-CNN, we proposed a transfer learning method which can reduce the computing costs significantly by finetuning the pre-trained model weights. We demonstrated the robustness and generalization ability of our method by analyzing the result of synthetic test datasets with different resolution and the real-world soybean seeds test dataset.

Conclusion
The experimental results show that the proposed method realized the effective segmentation of individual soybean seed and the efficient calculation of the morphological parameters of each seed and it is practical to use this approach for high-throughput objects instance segmentation and high-throughput seeds phenotyping.
Down regulation of the expression of mitochondrial phosphopantetheinyl-proteins in pantothenate kinase-associated neurodegeneration: pathophysiological consequences and therapeutic perspectives
Authors: Álvarez-Córdoba Mónica , Talaverón-Rey Marta , Villalón-García Irene , Povea-Cabello Suleva , Suárez-Rivero Juan M. , Suárez-Carrillo Alejandra , Munuera-Cabeza Manuel , Salas Joaquín J. , Sánchez-Alcázar José A. 
Published: May 2021

Abstract
Background
Neurodegeneration with brain iron accumulation (NBIA) is a group of genetic neurological disorders frequently associated with iron accumulation in the basal nuclei of the brain characterized by progressive spasticity, dystonia, muscle rigidity, neuropsychiatric symptoms, and retinal degeneration or optic nerve atrophy. Pantothenate kinase-associated neurodegeneration (PKAN) is the most widespread NBIA disorder. It is caused by mutations in the gene of pantothenate kinase 2 (PANK2) which catalyzes the first reaction of coenzyme A (CoA) biosynthesis. Thus, altered PANK2 activity is expected to induce CoA deficiency as well as low levels of essential metabolic intermediates such as 4′-phosphopantetheine which is a necessary cofactor for critical proteins involved in cytosolic and mitochondrial pathways such as fatty acid biosynthesis, mitochondrial respiratory complex I assembly and lysine and tetrahydrofolate metabolism, among other metabolic processes.

Methods
In this manuscript, we examined the effect of PANK2 mutations on the expression levels of proteins with phosphopantetheine cofactors in fibroblast derived from PKAN patients. These proteins include cytosolic acyl carrier protein (ACP), which is integrated within the multifunctional polypeptide chain of the fatty acid synthase involved in cytosolic fatty acid biosynthesis type I (FASI); mitochondrial ACP (mtACP) associated with mitocondrial fatty acid biosynthesis type II (FASII); mitochondrial alpha-aminoadipic semialdehyde synthase (AASS); and 10-formyltetrahydrofolate dehydrogenases (cytosolic, ALD1L1, and mitochondrial, ALD1L2).

Results
In PKAN fibroblasts the expression levels of cytosolic FAS and ALD1L1 were not affected while the expression levels of mtACP, AASS and ALD1L2 were markedly reduced, suggesting that 4′-phosphopantetheinylation of mitochondrial but no cytosolic proteins were markedly affected in PKAN patients. Furthermore, the correction of PANK2 expression levels by treatment with pantothenate in selected mutations with residual enzyme content was able to correct the expression levels of mitochondrial phosphopantetheinyl-proteins and restore the affected pathways. The positive effects of pantothenate in particular mutations were also corroborated in induced neurons obtained by direct reprograming of mutant PANK2 fibroblasts.

Conclusions
Our results suggest that the expression levels of mitochondrial phosphopantetheinyl-proteins are severely reduced in PKAN cells and that in selected mutations pantothenate increases the expression levels of both PANK2 and mitochondrial phosphopantetheinyl-proteins associated with remarkable improvement of cell pathophysiology.
Effects of the COVID-19 pandemic and lockdown on the mental and physical health of adults with Prader-Willi syndrome
Authors: Mosbah Helena , Coupaye Muriel , Jacques Flavien , Tauber Maithé , Clément Karine , Oppert Jean-Michel , Poitou Christine 
Published: May 2021

Abstract
Background
Prader-Willi syndrome (PWS) is a neurodevelopmental disorder with hypothalamic dysfunction leading to obesity and behavioral disabilities, including eating disorders (EDs). We evaluated the effects of the COVID-19 infection and lockdown on mental and physical health in PWS. At the end of April, 85 adults with PWS completed a self-administered questionnaire, including lockdown conditions, physical activity (PA), ED, and medical and behavioral outcomes. Body weight was measured at home and self-reported.

Results
Patients (52.9% women, 44.8% disomic) were assessed, with a mean age of 28.05 ± 8.73 years and body mass index (BMI) of 36.76 ± 10.74 kg/m2. Seventy percent lived in the Paris region (France) and were confined with their parents. The mean weight change was 0.96 ± 3.28 kg. We compared patients showing weight loss (n = 39, − 3.30 ± 2.93 kg) to patients showing weight gain (n = 22, + 2.35 ± 1.54 kg): the BMI was lower (34.60 ± 9.18 versus 40.45 ± 9.45 kg/m2, p = 0.02), PA increased (25.6% versus 4.5%, p = 0.04), and EDs improved (51.3% versus 13.6%, p = 0.005). Behavioral disorders increased for 12.9% of the cohort. Three individuals (3.5%) were diagnosed with non-severe COVID-19.

Conclusion
Lockdown during the COVID-19 pandemic was associated with positive effects for most French adults with PWS, with weight loss probably associated with a more favourable environment during this period. We observed no severe forms of COVID-19.
The prevalence of intestinal nematodes among red foxes (Vulpes vulpes) in north-western Poland
Authors: Tylkowska Agnieszka , Pilarczyk Bogumiła , Tomza-Marciniak Agnieszka , Pilarczyk Renata 
Published: May 2021

Abstract
Background
The red fox (Vulpes vulpes) is widely distributed in the Northern Hemisphere and Australia. The presence of nematode-infected foxes in urbanized areas increases the risk of transmission of nematodes to domestic dogs and thus, to humans. The aim of this study was to determine the prevalence and species composition of intestinal nematodiasis in red foxes in Western Pomerania, a province in north-western Poland. The intestinal contents of 620 red foxes killed during a government reduction shooting programme were examined for adult nematodes using the sedimentation and counting technique (SCT).

Results
Intestinal nematodes, including Toxocara canis, Toxascaris leonina, Uncinaria stenocephala and Trichuris vulpis, were found in 77.3% (95% CI 73.8–80.4%) of the examined foxes with a mean infection burden of 20.1 nematode per animal. Male and female foxes had similar infection burdens.

Conclusions
The nematodes are present in high prevalence and intensity among foxes in north-western Poland. Furthermore, this high prevalence of nematodes in foxes may likely constitute a health risk to humans and domestic animals due to increasing fox densities in urban and periurban areas.
Temporal patterns of organ dysfunction after severe trauma
Authors: Eriksson Jesper , Nelson David , Holst Anders , Hellgren Elisabeth , Friman Ola , Oldner Anders 
Published: May 2021

Abstract
Background
Understanding temporal patterns of organ dysfunction (OD) may aid early recognition of complications after trauma and assist timing and modality of treatment strategies. Our aim was to analyse and characterise temporal patterns of OD in intensive care unit-admitted trauma patients.

Methods
We used group-based trajectory modelling to identify temporal trajectories of OD after trauma. Modelling was based on the joint development of all six subdomains comprising the sequential organ failure assessment score measured daily during the first two weeks post trauma. Further, the time for trajectories to stabilise and transition to final group assignments were evaluated.

Results
Six-hundred and sixty patients were included in the final model. Median age was 40 years, and median ISS was 26 (IQR 17–38). We identified five distinct trajectories of OD. Group 1, mild OD (n = 300), median ISS of 20 (IQR 14–27), had an early resolution of OD and a low mortality. Group 2, moderate OD (n = 135), and group 3, severe OD (n = 87), were fairly similar in admission characteristics and initial OD but differed in subsequent OD trajectories, the latter experiencing an extended course and higher mortality. In group 3, 56% of the patients developed sepsis as compared with 19% in group 2. Group 4, extreme OD (n = 40), received most blood transfusions, had the highest proportion of shock at admission and a median ISS of 41 (IQR 29–50). They experienced significant and sustained OD affecting all organ systems and a 28-day mortality of 30%. Group 5, traumatic brain injury with OD (n = 98), had the highest mortality of 35% and the shortest time to death for non-survivors, median 3.5 (IQR 2.4–4.8) days. Groups 1 and 5 reached their final group assignment early, > 80% of the patients within 48 h. In contrast, groups 2 and 3 had a prolonged time to final group assignment.

Conclusions
We identified five distinct trajectories of OD after severe trauma during the first two weeks post-trauma. Our findings underline the heterogeneous course after trauma and describe some potentially important clinical insights that are suggested by the groupings and temporal trajectories.