bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alda-1 Attenuates Hyperoxia-Induced Acute Lung Injury in Mice
Authors: Sidramagowda Patil Sahebgowda , Hernández-Cuervo Helena , Fukumoto Jutaro , Krishnamurthy Sudarshan , Lin Muling , Alleyn Matthew , Breitzig Mason , Narala Venkata Ramireddy , Soundararajan Ramani , Lockey Richard F. , Kolliputi Narasaiah , Galam Lakshmi 
Published: January 2021

Acute lung injury (ALI), a milder form of acute respiratory distress syndrome (ARDS), is a leading cause of mortality in older adults with an increasing prevalence. Oxygen therapy, is a common treatment for ALI, involving exposure to a high concentration of oxygen. Unfortunately, hyperoxia induces the formation of reactive oxygen species which can cause an increase in 4-HNE (4-hydroxy 2 nonenal), a toxic byproduct of lipid peroxidation. Mitochondrial aldehyde dehydrogenase 2 (ALDH2) serves as an endogenous shield against oxidative stress-mediated damage by clearing 4-HNE. Alda-1 [(N-(1, 3 benzodioxol-5-ylmethyl)-2, 6- dichloro-benzamide)], a small molecular activator of ALDH2, protects against reactive oxygen species-mediated oxidative stress by promoting ALDH2 activity. As a result, Alda-1 shields against ischemic reperfusion injury, heart failure, stroke, and myocardial infarction. However, the mechanisms of Alda-1 in hyperoxia-induced ALI remains unclear. C57BL/6 mice implanted with Alzet pumps received Alda-1 in a sustained fashion while being exposed to hyperoxia for 48 h. The mice displayed suppressed immune cell infiltration, decreased protein leakage and alveolar permeability compared to controls. Mechanistic analysis shows that mice pretreated with Alda-1 also experience decreased oxidative stress and enhanced levels of p-Akt and mTOR pathway associated proteins. These results show that continuous delivery of Alda-1 protects against hyperoxia-induced lung injury in mice.
Hirsutella Sinensis Fungus Regulates CD8+ T Cell Exhaustion Through Involvement of T-Bet/Eomes in the Tumor Microenvironment
Authors: Jin Lu , Jin Lushuai , Wu Renjie , Liu Xia , Zhu Xinhai , Shou Qiyang , Fu Huiying 
Published: January 2021

Background: Targeting exhausted T (Tex) cells is a promising strategy for anti-tumour treatment. Previously, we demonstrated that Hirsutella sinensis fungus (HSF) could significantly increase T cell infiltration and the effector T cell ratio in the tumor microenvironment, activating systemic immune responses. However, we do not know how HSF regulates Tex cells in the tumor microenvironment. Here, we explored the mechanism underlying HSF inhibition of Tex cells and tumor growth and metastasis in breast cancer.Methods: We examined the effects of HSF on various tumor mouse models using in vivo imaging technology. Lung metastasis was detected by H&amp;E staining and the T cell subsets in the tumor microenvironment were assayed with flow cytometry. The in vitro proliferation, function and apoptosis of CD8+ T cells were measured, as well as the T-bet and PD-1 mRNA expressions.Results: HSF inhibited tumor growth and lung metastasis in the mice, and had significantly higher CD44LowCD62LHi and CD44HiCD62LLowpopulations in the tumour-infiltrating CD8+ T cells. However, HSF significantly reduced levels of inhibitory receptors, such as PD-1, TIGIT, CTLA-4, and regulatory T cells. In vitro, HSF inhibited the CD8+ T cell apoptosis rate, and promoted CD8+ T cell proliferation and secretion of interferon (IFN)-γ and granzyme B. Furthermore, HSF treatment both in vivo and in vitro significantly increased Eomes expression, while decreasing T-bet expression.Conclusion: HSF exerted anti-tumour effects mainly through the immune system, by promoting effector/memory T cells and reducing Tex cell production in the tumor microenvironment. The specific mechanisms involved inhibiting T-bet and promoting Eomes to decrease the expression of immune inhibitor receptors and enhance the T cell function, respectively.
Characterizing Treatment-Resistant Anorexia Nervosa
Authors: Smith Sarah , Woodside D. Blake 
Published: January 2021

Background:The issue of treatment resistance in eating disorder care is controversial. Prior research has identified multiple failed treatment attempts as a common criterion for severe and enduring anorexia nervosa, but little is known about patients who have multiple failed treatment attempts. This study was designed to compare the clinical and demographic characteristics of eating disorder patients with multiple, incomplete inpatient admissions to those with good outcomes. Understanding if these patient populations differ at initial admissions has implications for the prediction and characterization of inpatient eating disorder treatment resistance.Methods:This study analyzed existing data from a specialist inpatient eating disorder program at a large Canadian teaching hospital collected between 2000 and 2016. Treatment resistance was defined as two or more incomplete admissions and no complete admissions in the study period. Data were available on 37 patients who met this criteria, and 38 patients who had completed their first admission and remained well (defined as a BMI &gt; 18.5 with no binging or purging behavior) 1 year after discharge. Variables of interest included age, weight, diagnoses, duration of illness, eating disorder psychopathology, eating disorder behavioral frequencies and depressive symptoms at the time of index inpatient admissions. Statistical analyses consisted of Mann–Whitney U tests, Chi-square tests, and a logistic regression.Results:In our main bivariate analyses, patients with multiple incomplete admissions were characterized by more severe eating disorder psychopathology and depressive symptoms at admission as well as an increased prevalence of the binge purge subtype of anorexia nervosa. In our exploratory multivariate analyses controlling for diagnostic subtype and depressive symptoms, severity of eating disorder psychopathology did not remain significant. No statistically significant difference in body mass index (BMI) or frequencies of eating disorder behaviors were found. A trend toward a longer duration of illness did not meet statistical significance.Conclusions:This study found that patients considered resistant to inpatient eating disorder treatment differ from those with good outcomes at initial admission. These results suggest that while treatment-resistant anorexia nervosa may be related to severe and enduring anorexia nervosa, it may also be a different concept that warrants additional research.
Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department
Authors: Kim Dong Wook , Cho Seo Eun , Kang Jae Myeong , Woo Soo Kyun , Kang Seung-Gul , Yeon Byeong Kil , Cho Seong-Jin 
Published: January 2021

Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department.Methods: Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age &lt;65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups.Results: Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p &lt; 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p &lt; 0.001), male sex (B = −0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = −0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale.Conclusions: Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.
From Learning Psychiatry to Becoming Psychiatrists: A Qualitative Study of Co-constructive Patient Simulation
Authors: Martin Andrés , Weller Indigo , Amsalem Doron , Adigun Ayodola , Jaarsma Debbie , Duvivier Robbert , de Carvalho-Filho Marco Antonio 
Published: January 2021

Objectives: Co-constructive patient simulation (CCPS) is a novel medical education approach that provides a participatory and emotionally supportive alternative to traditional supervision and training. CCPS can adapt iteratively and in real time to emergent vicissitudes and challenges faced by clinicians. We describe the first implementation of CCPS in psychiatry.Methods: We co-developed clinical scripts together with child and adolescent psychiatry senior fellows and professional actors with experience performing as simulated patients (SPs). We conducted the simulation sessions with interviewers blind to the content of case scenarios enacted by the SPs. Each hour-long simulation was followed by an hour-long debriefing session with all participants. We recorded and transcribed case preparation, simulation interactions, and debriefing sessions, and analyzed anonymized transcripts through qualitative analysis within a constructivist framework, aided by NVivo software.Results: Each of six CCPS sessions was attended by a median of 13 participants (range, 11–14). The first three sessions were conducted in person; the last three, which took place during the COVID-19 pandemic, via synchronized videoconferencing. Each of the sessions centered on clinically challenging and affectively charged situations informed by trainees' prior experiences. Through iterative thematic analysis we derived an alliterating “9R” model centered on three types of Reflection: (a) in action/“while doing” (Regulate, Relate, and Reason); (b) on action/“having done” (Realities, Restraints, and Relationships); and (c) for action/“will be doing” (with opportunities for Repair and Reaffirmation).Conclusions: CCPS is an experiential approach that fosters autonomous, meaningful, and individually tailored learning opportunities. CCPS and the 9R model for reflective practice can be effectively applied to psychiatry and have the potential to contribute uniquely to the educational needs of its trainees and practitioners.
Association Between Diabetic Retinopathy and Periodontitis—A Systematic Review
Authors: Alvarenga María Olimpia Paz , Miranda Giza Hellen Nonato , Ferreira Railson Oliveira , Saito Miki Taketomi , Fagundes Nathália Carolina Fernandes , Maia Lucianne Cople , Lima Rafael Rodrigues 
Published: January 2021

Background: Diabetic retinopathy is a common microvascular complication in diabetic patients and is considered the main cause of visual loss worldwide. Periodontitis is a chronic inflammatory condition, which compromises dental supporting tissues. The chronic bacterial challenge in periodontitis is a persistent source of inflammatory mediators that may be associated with insulin resistance, increasing the risk of complications of diabetes mellitus. This systematic review aimed to summarize the evidence in the association between diabetic retinopathy and periodontitis.Methods: This review was registered under the number CRD 42019142267. A search strategy in five electronic databases and a gray literature source was performed based on the PECO acronym. After data extraction, the qualitative synthesis and risk of bias analyses were performed using the Newcastle–Ottawa scale. The level of evidence of all studies taken together was evaluated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Results: Out of the 253 citations screened, five cross-sectional studies met the eligibility criteria and were included in the qualitative analysis, in which two were judged to be of good quality, one as fair quality, and two as poor quality. Among the included studies, a significant relationship between the severity of periodontitis (CAL &gt; 5 mm) and the severity of diabetic retinopathy (p &lt; 0.05) was reported by four studies. Also, an association between both diseases in non-obese adults was found after adjustments [OR 2.206 (1.114–4.366); p = 0.0232). However, the analysis of evidence by GRADE assessment was rated as low.Conclusions: Although the results of individual studies suggest an association between diabetic retinopathy and periodontitis, the quality of the body of evidence was judged to be low by the GRADE approach. Further studies with larger sample sizes, adequate models of cofounders' adjustments, and prospective analysis of periodontitis and diabetes conditions ought to be conducted to clarify this association.
Decreased CO2 Levels as Indicators of Possible Mechanical Ventilation-Induced Hyperventilation in COVID-19 Patients: A Retrospective Analysis
Authors: Hu Di , Li Jinpeng , Gao Rongfen , Wang Shipei , Li Qianqian , Chen Sichao , Huang Jianglong , Huang Yihui , Li Man , Long Wei , Liu Zeming , Guo Liang , Wu Xiaohui 
Published: January 2021

Background: Six months since the outbreak of coronavirus disease (COVID-19), the pandemic continues to grow worldwide, although the outbreak in Wuhan, the worst-hit area, has been controlled. Thus, based on the clinical experience in Wuhan, we hypothesized that there is a relationship between the patient's CO2 levels and prognosis.Methods: COVID-19 patients' information was retrospectively collected from medical records at the Leishenshan Hospital, Wuhan. Logistic and Cox regression analyses were conducted to determine the correlation between decreased CO2 levels and disease severity or mortality risk. The Kaplan-Meier curve analysis was coupled with the log-rank test to understand COVID-19 progression in patients with decreased CO2 levels. Curve fitting was used to confirm the correlation between computed tomography scores and CO2 levels.Results: Cox regression analysis showed that the mortality risk of COVID-19 patients correlated with decreased CO2 levels. The adjusted hazard ratios for decreased CO2 levels in COVID-19 patients were 8.710 [95% confidence interval (CI): 2.773–27.365, P &lt; 0.001], and 4.754 (95% CI: 1.380–16.370, P = 0.013). The adjusted odds ratio was 0.950 (95% CI: 0.431–2.094, P = 0.900). The Kaplan-Meier survival curves demonstrated that patients with decreased CO2 levels had a higher risk of mortality.Conclusions: Decreased CO2 levels increased the mortality risk of COVID-19 patients, which might be caused by hyperventilation during mechanical ventilation. This finding provides important insights for clinical treatment recommendations.
Mindfulness-based Virtual Reality Intervention in Hemodialysis Patients: A Pilot Study on End-user Perceptions and Safety
Authors: Hernandez Rosalba , Burrows Brett , Browning Matthew H.E.M. , Solai Killivalavan , Fast Drew , Litbarg Natalia O. , Wilund Kenneth R. , Moskowitz Judith T. 
Published: January 2021

Background
Virtual reality (VR) is an evolving technology that is becoming a common treatment for pain management and psychologic phobias. Although nonimmersive devices (e.g., the Nintendo Wii) have been previously tested with patients on hemodialysis, no studies to date have used fully immersive VR as a tool for intervention delivery. This pilot trial tests the initial safety, acceptability, and utility of VR during maintenance hemodialysis treatment sessions—particularly, whether VR triggers motion sickness that mimics or negatively effects treatment-related symptoms (e.g., nausea).

Methods
Patients on hemodialysis (n=20) were enrolled in a phase 1 single-arm proof-of-concept trial. While undergoing hemodialysis, participants were exposed to our new Joviality VR program. This 25-minute program delivers mindfulness training and guided meditation using the Oculus Rift head-mounted display. Participants experienced the program on two separate occasions. Before and immediately after exposure, participants recorded motion-related symptoms and related discomfort on the Simulator Sickness Questionnaire. Utility measures included the end-user’s ability to be fully immersed in the virtual space, interact with virtual objects, find hardware user friendly, and easily navigate the Joviality program with the System Usability Scale.

Results
Mean age was 55.3 (±13.1) years; 80% male; 60% Black; and mean dialysis vintage was 3.56 (±3.75) years. At the first session, there were significant decreases in treatment and/or motion-related symptoms after VR exposure (22.6 versus 11.2; P=0.03); scores >20 indicate problematic immersion. Hemodialysis end-users reported high levels of immersion in the VR environment and rated the software easy to operate, with average System Usability Scale scores of 82.8 out of 100.

Conclusions
Patients on hemodialysis routinely suffer from fatigue, nausea, lightheadedness, and headaches that often manifest during their dialysis sessions. Our Joviality VR program decreased symptom severity without adverse effects. VR programs may be a safe platform to improve the experience of patients on dialysis.
poética do inacabamento
Authors: Taborda Moreira Terezinha 
Published: January 2021

O artigo analisa a obra Negrices em flor, da poeta, compositora e atriz negra Maria Tereza, explorando como a escrita poética da autora expõe a invisibilidade, o silenciamento e a subalternização de sujeitos produzidos no encontro e na violência colonial. Atenta à dupla subalternização da mulher negra, a escrita assume um discurso que se volta não apenas para o corpo negro, mas, mais especificamente, para o corpo feminino negro. Desse lugar de fala a escrita se constrói como testemunho de uma memória negra, enquanto ressignificar a diáspora como ato gerador de um “corposolo” também negro. Esse corposolo negro, contrariando a colonialidade do poder, afirma-se como um “pensamento crítico de fronteira” por meio do qual a voz lírica redefine as ideias de cidadania, democracia, direitos humanos e humanidade, conforme impostas pela modernidade europeia, para permitir ao sujeito negro, especialmente o feminino, ancorar sua existência em outras cosmologias e outras epistemologias.
Literatura e resistência em Avalovara, de Osman Lins
Authors: Silva Raul Gomes da , Giroldo Ramiro 
Published: January 2021

O texto discute a configuração da personagem reconhecida apenas pelo símbolo ఠ, do romance Avalovara, de Osman Lins. Propõe que a personagem pode ser lida como uma confluência de diferentes sentidos abertos para o infinito e, também, como uma alegoria da própria literatura de resistência – no caso em pauta, resistência contra a ditadura militar brasileira. As reflexões sobre violência e autoritarismo de Hannah Arendt são trazidas à tona no decorrer da investigação, bem como os apontamentos de Antoine Compagnon sobre o potencial que a literatura tem de se voltar contra a opressão. Em seu percurso argumentativo, o texto ainda se ampara em proposições de, entre outros, Maria Aracy Bonfim e Elizabeth Hazin, no que cabe ao feitio da personagem em pauta; além de Jaime Ginzburg, acerca das marcas que a violência deixa na tessitura literária.
Analisis Loyalitas Pasien Pengguna BPJS Kesehatan di Klinik Pratama Iis Medika Kartasura Sukoharjo dipandang dari sudut Kualitas Pelayanan dan Kepuasan
Authors: Rahayu Saptani , Suwarni Endang Sri 
Published: January 2021

Tujuan penelitan ini adalah menganalisa pengaruh kualitas pelayanan dan kepuasan terhadap Loyalitas Pasien Pengguna BPJS Kesehatan, dengan sampel 100 orng pasien.Analisa data menggunakan Uji Regresi Jalur, Uji F, Uji t, Koefisien deerminasi dan uji korelasi. Hasil penelitian sebagai berikut : Dari uji regresi jalur tangible berpengaruh langsung terhadap loyalitas lebih besar dari pengaruh tidak langsung tangible terhadap loyalitas dengan mediasi kepuasan, reliability berpengaruh langsung terhadap loyalitas lebih besar dari pengaruh tidak langsung reliability terhadap loyalitas dengan mediasi kepuasan, responsiveness berpengaruh langsung terhadap loyalitas lebih besar dari pengaruh tidak langsung responsiveness terhadap loyalitas dengan mediasi kepuasan, sehingga untuk meningkatkan loyalitas pasien dipilih jalur langsung, Pengaruh langsung assurance terhadap loyalitas lebih besar dari pengaruh tidak langsung assurance terhadap loyalitas dengan mediasi kepuasan, emphaty berpengaruh langsung terhadap loyalitas lebih besar dari pengaruh tidak langsung emphaty terhadap loyalitas dengan mediasi kepuasan, , Total pengaruh responsiveness terhadap loyalitas paling dominan pengaruhnya dari pada total pengaruh variabel yang lain. Dari hasil analisa data dapat disimpulkan bahwa variabel kepuasan bukan sebagai variabel antara (intervening)Kata Kunci : Kualitas pelayanan, kepuasan, loyalitas
PENGEMBANGAN KOMPETENSI KEWIRAUSAHAAN PELAKU UKM YANG TINGGAL DI PINGGIRAN ALIRAN SUNGAI PROGO YOGYAKARTA BERBASIS NILAI KARAKTER DAN KEARIFAN LOKAL
Authors: Wartomo Wartomo 
Published: January 2021

Penelitian bertujuan mengungkap model pengembangan pelaku UKM (Usaha Kecil Menengah) berbasis nilai karakter dan kearifan lokal. Lebih spesifik tujuan penelitian ini, memahami kedudukan strategis nilai-nilai karakter dan keraifan lokal terhadap pengaruh ekonomi dalam membangun kehidupan sosial, ekonomi, dan pelaku UKM berbasis kearifan lokal. Subyek penelitian adalah pelaku UKM yang tinggal di pinggiran aliran Sungai Progo Yogyakarta yang masih melestarikan nilai karakter berbasis kearian lokal. Jenis penelitian Research and Development. Langkah-langkah penelitian diawali survey dan need assessment bagi masyarakat pelaku UKM, pembinaan nilai karakter lokal, media pelaksanaan model, aksi atau tindakan, dan evaluasi. Penelitian dilaksa-nakan di wilayah Kabupaten Kulonprogo Yogyakarta, khususnya di bantaran atau pinggiran aliran Sungai Progo Yogyakarta bagi kelompok UKM, dilaksanakan selama 6 (enam) bulan; yaitu bulan April-September 2015. Teknik pengumpulan data menggunakan observasi, interview, demonstrasi, dan simulasi. Analisis data menggunakan pendekatan kuantitatif dengan program LISREL (Linear Structural Relations). Hasil penelitian adalah: (1) diperoleh data dasar potensi desa di wilayah penelitian yang berkaitan dengan permasalahan dan penunjang pelaksanaan pengembangan jiwa dan kompetensi kewirausahaan bagi masyarakat miskin melalui nilai karakter dan kearifan lokal, (2) dapat diperoleh data dasar angka prevalensi jumlah masyarakat pelaku UKM; (3) dapat dilakukan need asessment dari masyarakat pelaku UKM pengembangan melalui nilai karakter dan kearifan lokal, yang berhasil dijaring dan terdidentifikasi, (4) dapat disusun model pengembangan jiwa dan kompetensi kewirausahaan bagi masyarakat kelompok UKM melalui nilai karakter; (5) dapat disusun tim instruktur dan pelaksana kegiatan program pengembangan jiwa dan kompetensi kewirausahaan bagi masyarakat pelaku UKM melalui nilai karakter; (6) memberikan peluang sejumlah kurang lebih 50 pelaku UKM untuk meningkatkan pengembangan jiwa dan kompetensi kewirausahaan melalui pembinaan nilai karakter dan kearifan lokal; (7) dapat meningkatkan pengembangan jiwa dan kompetensi kewirausahaan melalui pembinaan nilai karakter bagi masyarakat pelaku UKM; (8) menciptakan suasana berwirausaha melalui pembinaan nilai karakter bagi masyarakat pelaku UKM yang tinggal dibantaran atau pinggiran aliran Sungai Progo Yogyakarta; (9) dapat disusun artikel untuk ditulis dalam jurnal nasional maupun internasional, dan ditulis buku teks untuk kepentingan bahan kuliah mahasiswa.Kata Kunci: Pengembangan Kewirausahaan; Pelaku UKM; Nilai Karakter dan Kearifan Lokal.