bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hoots and harm reduction: a qualitative study identifying gaps in overdose prevention among women who smoke drugs
Authors: Bardwell Geoff , Austin Tamar , Maher Lisa , Boyd Jade 
Published: March 2021

Abstract
Background
Smoking or inhaling illicit drugs can lead to a variety of negative health outcomes, including overdose. However, most overdose prevention interventions, such as supervised consumption services (SCS), prohibit inhalation. In addition, women are underrepresented at SCS and are disproportionately impacted by socio-structural violence. This study examines women’s experiences smoking illicit drugs during an overdose epidemic, including their utilization of a women-only supervised inhalation site.

Methods
Qualitative research methods included on-site ethnographic observation and semi-structured interviews with 32 participants purposively recruited from the women-only site. Data were coded and analyzed using NVivo 12 and thematic analysis was informed by gendered and socio-structural understandings of violence.

Results
Participants had preferences for smoking drugs and these were shaped by their limited income, inability to inject, and perceptions of overdose risk. Participants expressed the need for services that attend to women’s specific experiences of gendered, race-based, and structural violence faced within and outside mixed-gender social service settings. Results indicate a need for sanctioned spaces that recognize polysubstance use and drug smoking, accommodated by the women-only SCS. The smoking environment further fostered a sociability where participants could engage in perceived harm reduction through sharing drugs with other women/those in need and were able to respond in the event of an overdose.

Conclusions
Findings demonstrate the ways in which gendered social and structural environments shape women’s daily experiences using drugs and the need for culturally appropriate interventions that recognize diverse modes of consumption while attending to overdose and violence. Women-only smoking spaces can provide temporary reprieve from some socio-structural harms and build collective capacity to practice harm reduction strategies, including overdose prevention. Women-specific SCS with attention to polysubstance use are needed as well as continued efforts to address the socio-structural harms experienced by women who smoke illicit drugs.
Does patient engagement affect IBD patients’ health-related quality of life? Findings from a cross-sectional study among people with inflammatory bowel diseases
Authors: Barello Serena , Guida Elena , Leone Salvatore , Previtali Enrica , Graffigna Guendalina 
Published: March 2021

AbstractBackgroundPatients diagnosed with inflammatory bowel disease (IBD) are required to deal with the unpredictability of this clinical condition, which is associated with poorer health-related quality of life (HRQoL) compared to other clinical conditions. Patient engagement is currently demonstrated to relate with chronic patients’ HRQoL, but few studies have been conducted among this population.MethodsA cross-sectional study was conducted among 1176 IBD patients. Data were collected on participants’ HRQoL (SIBD-Q) and patient engagement (PHE-s®). Regression analysis was used to examine the effects of patient engagement on HRQoL.ResultsAbout the half of the sample (47%) reported a low patient engagement level. 30% of the sample reported a low level of HRQoL. Psycho-emotional functioning resulted to be the aspect of HRQoL most impacted in the 37% of the sample. The regression model showed that PHE-s® is significantly related to the SIBD-Q total score (B = .585;p < .001; R squared = .343) and to the subscales’ scores—systemic symptoms (B = .572;p < .001; R squared = .327), bowel symptoms (B = .482;p < .001; R squared = .232), social (B = .485;p < .001; R squared = .234) and psycho-emotional (B = .607;p < .001; R squared = .369) functioning.ConclusionsPatients who are engaged in their IBD care pathway are more likely to report higher level of HRQoL, thus offering clues to potential therapeutic approaches to ameliorating IBD patients’ wellbeing. As this is a modifiable factor, screening for patient health engagement levels, coupled with appropriate interventions, could improve care, and ultimately improve HRQoL outcomes among IBD patients.
The neonatal assessment manual score (NAME) for improving the clinical management of infants: a perspective validity study
Authors: Manzotti Andrea , Chiera Marco , Galli Matteo , Lombardi Erica , La Rocca Simona , Biasi Pamela , Esteves Jorge , Lista Gianluca , Cerritelli Francesco 
Published: March 2021

Abstract
Background and objectives
The Neonatal Assessment Manual scorE (NAME) was developed to assist in the clinical management of infants in the neonatal ward by assessing their body’s compliance and homogeneity. The present study begins its validation process.

Methods
An expert panel of neonatal intensive care unit (NICU) professionals investigated the NAME face and content validity. Content validity was assessed through the content validity index (CVI). Construct validity was assessed using data collected from 50 newborns hospitalized in the NICU of “Vittore Buzzi” Children Hospital of Milan, Italy. Kendall’s τ and ordinal logistic regressions were used to evaluate the correlation between the NAME scores and infants’ gestational age, birth weight, post-menstrual age, weight at the time of assessment, and a complexity index related to organic complications.

Results
The CVIs for compliance, homogeneity, and the whole scale were respectively 1, 0.9, and 0.95. Construct validity analysis showed significant positive correlations between the NAME and infants’ weight and age, and a negative correlation between the NAME and the complexity index (τ = − 0.31 [95% IC: − 0.47, − 0.12], p = 0.016 and OR = 0.56 [95% IC: 0.32, 0.94], p = 0.034 for categorical NAME; τ = − 0.32 [95% IC: − 0.48, − 0.14], p = 0.005 for numerical NAME).

Conclusions
The NAME was well accepted by NICU professionals in this study and it demonstrates good construct validity in discriminating the infant’s general condition. Future studies are needed to test the NAME reliability and predictive capacity.
Methylation of rRNA as a host defense against rampant group II intron retrotransposition
Authors: Waldern Justin M. , Smith Dorie , Piazza Carol Lyn , Bailey E. Jake , Schiraldi Nicholas J. , Nemati Reza , Fabris Dan , Belfort Marlene , Novikova Olga 
Published: March 2021

Abstract
Background
Group II introns are mobile retroelements, capable of invading new sites in DNA. They are self-splicing ribozymes that complex with an intron-encoded protein to form a ribonucleoprotein that targets DNA after splicing. These molecules can invade DNA site-specifically, through a process known as retrohoming, or can invade ectopic sites through retrotransposition. Retrotransposition, in particular, can be strongly influenced by both environmental and cellular factors.

Results
To investigate host factors that influence retrotransposition, we performed random insertional mutagenesis using the ISS1 transposon to generate a library of over 1000 mutants in Lactococcus lactis, the native host of the Ll.LtrB group II intron. By screening this library, we identified 92 mutants with increased retrotransposition frequencies (RTP-ups). We found that mutations in amino acid transport and metabolism tended to have increased retrotransposition frequencies. We further explored a subset of these RTP-up mutants, the most striking of which is a mutant in the ribosomal RNA methyltransferase rlmH, which exhibited a reproducible 20-fold increase in retrotransposition frequency. In vitro and in vivo experiments revealed that ribosomes in the rlmH mutant were defective in the m3Ψ modification and exhibited reduced binding to the intron RNA.

Conclusions
Taken together, our results reinforce the importance of the native host organism in regulating group II intron retrotransposition. In particular, the evidence from the rlmH mutant suggests a role for ribosome modification in limiting rampant retrotransposition.
Development of a novel, sensitive translational immunoassay to detect plasma glial fibrillary acidic protein (GFAP) after murine traumatic brain injury
Authors: Button Emily B. , Cheng Wai Hang , Barron Carlos , Cheung Honor , Bashir Asma , Cooper Jennifer , Gill Jasmine , Stukas Sophie , Baron David C. , Robert Jerome , Rowe Elyn M. , Cripton Peter A. , Wellington Cheryl L. 
Published: March 2021

Abstract
Background
Glial fibrillary acidic protein (GFAP) has emerged as a promising fluid biomarker for several neurological indications including traumatic brain injury (TBI), a leading cause of death and disability worldwide. In humans, serum or plasma GFAP levels can predict brain abnormalities including hemorrhage on computed tomography (CT) scans and magnetic resonance imaging (MRI). However, assays to quantify plasma or serum GFAP in preclinical models are not yet available.

Methods
We developed and validated a novel sensitive GFAP immunoassay assay for mouse plasma on the Meso Scale Discovery immunoassay platform and validated assay performance for robustness, precision, limits of quantification, dilutional linearity, parallelism, recovery, stability, selectivity, and pre-analytical factors. To provide proof-of-concept data for this assay as a translational research tool for TBI and Alzheimer’s disease (AD), plasma GFAP was measured in mice exposed to TBI using the Closed Head Impact Model of Engineered Rotational Acceleration (CHIMERA) model and in APP/PS1 mice with normal or reduced levels of plasma high-density lipoprotein (HDL).

Results
We performed a partial validation of our novel assay and found its performance by the parameters studied was similar to assays used to quantify human GFAP in clinical neurotrauma blood specimens and to assays used to measure murine GFAP in tissues. Specifically, we demonstrated an intra-assay CV of 5.0%, an inter-assay CV of 7.2%, a lower limit of detection (LLOD) of 9.0 pg/mL, a lower limit of quantification (LLOQ) of 24.8 pg/mL, an upper limit of quantification (ULOQ) of at least 16,533.9 pg/mL, dilution linearity of calibrators from 20 to 200,000 pg/mL with 90–123% recovery, dilution linearity of plasma specimens up to 32-fold with 96–112% recovery, spike recovery of 67–100%, and excellent analyte stability in specimens exposed to up to 7 freeze-thaw cycles, 168 h at 4 °C, 24 h at room temperature (RT), or 30 days at − 20 °C. We also observed elevated plasma GFAP in mice 6 h after TBI and in aged APP/PS1 mice with plasma HDL deficiency. This assay also detects GFAP in serum.

Conclusions
This novel assay is a valuable translational tool that may help to provide insights into the mechanistic pathophysiology of TBI and AD.
A large-scale investigation of alcohol-based handrub (ABHR) volume: hand coverage correlations utilizing an innovative quantitative evaluation system
Authors: Voniatis Constantinos , Bánsághi Száva , Ferencz Andrea , Haidegger Tamás 
Published: March 2021

Abstract
Background
Current hand hygiene guidelines do not provide recommendations on a specific volume for the clinical hand rubbing procedure. According to recent studies volume should be adjusted in order to achieve complete coverage. However, hand size is a parameter that highly influences the hand coverage quality when using alcohol-based handrubs (ABHR). The purpose of this study was to establish a quantitative correlation between applied ABHR volume and achieved hand coverage.

Method
ABHR based hand hygiene events were evaluated utilizing a digital health device, the Semmelweis hand hygiene system with respect to coverage achieved on the skin surface. Medical students and surgical residents (N = 356) were randomly selected and given predetermined ABHR volumes. Additionally, hand sizes were calculated using specialized software developed for this purpose. Drying time, ABHR volume awareness, as well spillage awareness were documented for each hand hygiene event.

Results
Hand coverage achieved during a hand hygiene event strongly depends on the applied ABHR volume. At a 1 ml dose, the uncovered hand area was approximately 7.10%, at 2 ml it decreased to 1.68%, and at 3 ml it further decreased to 1.02%. The achieved coverage is strongly correlated to hand size, nevertheless, a 3 ml applied volume proved sufficient for most hand hygiene events (84%). When applying a lower amount of ABHR (1.5 ml), even people with smaller hands failed to cover their entire hand surface. Furthermore, a 3 ml volume requires more than the guideline prescribed 20–30 s to dry. In addition, results suggest that drying time is not only affected by hand size, but perhaps other factors may be involved as well (e.g., skin temperature and degree of hydration). ABHR volumes of 3.5 ml or more were inefficient, as the disinfectant spilled while the additional rubbing time did not improve hand coverage.

Conclusions
Hand sizes differ a lot among HCWs. After objectively measuring participants, the surface of the smallest hand was just over half compared to the largest hand (259 cm2 and 498 cm2, respectively). While a 3 ml ABHR volume is reasonable for medium-size hands, the need for an optimized volume of handrub for each individual is critical, as it offers several advantages. Not only it can ensure adequate hand hygiene quality, but also prevent unnecessary costs. Bluntly increasing the volume also increases spillage and therefore waste of disinfectant in the case of smaller hands. In addition, adherence could potentially decrease due to the required longer drying time, therefore, adjusting the dosage according to hand size may also increase the overall hand hygiene compliance.
Temporal trends, risk factors and outcomes of infections due to extended-spectrum β-lactamase producing Enterobacterales in Swiss solid organ transplant recipients between 2012 and 2018
Authors:   Swiss Transplant Cohort Study, Kohler Philipp , Wolfensberger Aline , Stampf Susanne , Brönnimann Andreas , Boggian Katia , van Delden Christian , Favre Melody , Hirzel Cédric , Khanna Nina , Kuster Stefan P. , Manuel Oriol , Neofytos Dionysios , Ragozzino Silvio , Schreiber Peter W. , Walti Laura , Mueller Nicolas J. 
Published: March 2021

Abstract
Background
The burden of antimicrobial resistance is high in solid organ transplant (SOT) recipients. Among Swiss SOT recipients, we assessed temporal trends of ESBL-producing Enterobacterales (ESBL-E), identified risk factors for ESBL-E, and assessed the impact of resistance on patient outcome.

Methods
Data from the Swiss Transplant Cohort Study (STCS), a nationwide prospective cohort of SOT-recipients, were analysed. Temporal trends were described for ESBL-detection among Escherichia coli and non-Escherichia coli. In a nested case–control study, cases with ESBL-E infection were 1:1 matched (by time since transplantation, organ transplant, pathogen) to controls infected with non-ESBL-E. Factors associated with resistance and with unfavourable 30-day outcome (death, infection relapse, graft loss) were assessed.

Results
From 2012 to 2018, we identified 1′212 infection episodes caused by Enterobacterales in 1′074 patients, thereof 11.4% (138/1′212) caused by ESBL-E. The proportion of ESBL-production among Escherichia coli remained stable over time (p = 0.93) but increased for non-E. coli (p = 0.02) Enterobacterales. In the case–control study (n = 102), antibiotic pre-treatment was independently associated with ESBL-production (aOR = 2.6, 95%-CI: 1.0–6.8, p = 0.046). Unfavourable outcome occurred in 24/51 (47%) cases and 9/51 (18%) controls (p = 0.003). Appropriate empiric antibiotic therapy was the only modifiable factor associated with unfavourable outcome.

Conclusions
In Swiss SOT-recipients, proportion of infections with ESBL-producing non-E. coli Enterobacterales increased in recent years. Antibiotic pre-treatment represents a risk factor for ESBL-E. Improving appropriateness of empiric antibiotic treatment might be an important measure to reduce unfavourable outcome, which was observed in almost half of SOT-recipients with ESBL-E infections.
Effect of fecal microbiota transplantation on neurological restoration in a spinal cord injury mouse model: involvement of brain-gut axis
Authors: Jing Yingli , Yu Yan , Bai Fan , Wang Limiao , Yang Degang , Zhang Chao , Qin Chuan , Yang Mingliang , Zhang Dong , Zhu Yanbing , Li Jianjun , Chen Zhiguo 
Published: March 2021

Abstract
Background
Spinal cord injury (SCI) patients display disruption of gut microbiome, and gut dysbiosis exacerbate neurological impairment in SCI models. Cumulative data support an important role of gut microbiome in SCI. Here, we investigated the hypothesis that fecal microbiota transplantation (FMT) from healthy uninjured mice into SCI mice may exert a neuroprotective effect.

Results
FMT facilitated functional recovery, promoted neuronal axonal regeneration, improved animal weight gain and metabolic profiling, and enhanced intestinal barrier integrity and GI motility in SCI mice. High-throughput sequencing revealed that levels of phylum Firmicutes, family Christensenellaceae, and genus Butyricimonas were reduced in fecal samples of SCI mice, and FMT remarkably reshaped gut microbiome. Also, FMT-treated SCI mice showed increased amount of fecal short-chain fatty acids (SCFAs), which correlated with alteration of intestinal permeability and locomotor recovery. Furthermore, FMT downregulated IL-1β/NF-κB signaling in spinal cord and NF-κB signaling in gut following SCI.

Conclusion
Our study demonstrates that reprogramming of gut microbiota by FMT improves locomotor and GI functions in SCI mice, possibly through the anti-inflammatory functions of SCFAs.
Cancer Immunotherapy Update: FDA-Approved Checkpoint Inhibitors and Companion Diagnostics
Authors: Twomey Julianne D. , Zhang Baolin 
Published: March 2021

AbstractImmune checkpoint inhibitors (ICIs) are considered a new standard-of-care across many cancer indications. This review provides an update on ICIs approved by the Food and Drug Administration (FDA), with focus on monoclonal antibodies that target the programmed cell death 1 (PD-1) or its ligand, PD-1 ligand 1 (PD-L1), including information on their clinical indications and associated companion diagnostics. The information is further discussed with strategies for identifying predictive biomarkers to guide the clinical use of PD-1/PD-L1-targeted therapies.
Cardiovascular Disease Risk Factors and Metabolic Morbidity in a Longitudinal Study of Congenital Adrenal Hyperplasia
Authors: Torky Ahmed , Sinaii Ninet , Jha Smita , Desai Jay , El-Maouche Diala , Mallappa Ashwini , Merke Deborah P 
Published: March 2021

Abstract

Context
Patients with congenital adrenal hyperplasia (CAH) are exposed to hyperandrogenism and supraphysiologic glucocorticoids, both of which can increase risk of metabolic morbidity.

Objective
Our aim was to evaluate cardiovascular and metabolic morbidity risk in a longitudinal study of patients with CAH spanning both childhood and adulthood.

Design and Setting
Patients with classic CAH followed for a minimum of 5 years during both childhood and adulthood (n = 57) at the National Institutes of Health were included and compared with the US general population using NHANES data.

Main outcome measures
Obesity, hypertension, insulin resistance, fasting hyperglycemia, and dyslipidemia.

Results
Compared to the US population, patients with CAH had higher (P &lt; 0.001) prevalence of obesity, hypertension, insulin resistance, fasting hyperglycemia, and low high-density lipoprotein (HDL) during childhood and obesity (P = 0.024), hypertension (P&lt;0.001), and insulin resistance (P &lt; 0.001) during adulthood. In our cohort, obesity, hypertension, fasting hyperglycemia, and hypertriglyceridemia began prior to age 10. During childhood, increased mineralocorticoid dose was associated with hypertension (P = 0.0015) and low HDL (P = 0.0021). During adulthood, suppressed androstenedione was associated with hypertension (P = 0.002), and high low-density lipoprotein (P = 0.0039) whereas suppressed testosterone (P = 0.003) was associated with insulin resistance. Elevated 17-hydroxyprogesterone, possibly reflecting poor disease control, was protective against high cholesterol (P = 0.0049) in children. Children whose mothers were obese (maternal obesity) had increased risk of obesity during adulthood (P = 0.0021). Obesity, in turn, contributed to the development of hypertension, insulin resistance, and hypertriglyceridemia in adulthood.

Conclusion
Patients with CAH develop metabolic morbidity at a young age associated with treatment-related and familial factors. Judicious use of glucocorticoid and mineralocorticoid is warranted.
How can medical schools combat declining mental health amongst their students during the COVID-19 quarantine period?
Authors: Subhaskaran Kajani , Young Francesca Naomi 
Published: March 2021

doi: https://doi.org/10.12669/pjms.37.3.4321
How to cite this:Subhaskaran K, Young FN. How can medical schools combat declining mental health amongst their students during the COVID-19 quarantine period?. Pak J Med Sci. 2021;37(3):926. doi: https://doi.org/10.12669/pjms.37.3.4321
Hubungan Motivasi Belajar dan Persepsi Siswa terhadap Gaya Mengajar Guru dengan Prestasi Belajar Matematika
Authors: Azka Raekha 
Published: March 2021

Penelitian ini bertujuan untuk mengetahui seberapa besar hubungan motivasi belajar dan persepsi siswa terhadap gaya mengajar guru dengan prestasi belajar matematika siswa MA.Penelitian ini merupakan penelitian kuantitatif . Teknik pengambilan data digunakan metode tes untuk mengetahui prestasi belajar matematika siswa dan metode angket untuk mengetahui motivasi belajar dan persepsi siswa terhadap gaya mengajar guru. Analisis data menggunakan analisis regresi linear ganda.Hasil penelitian menunjukkan ada hubungan yang positif dan signifikan antara motivasi belajar terhadap prestasi belajar matematika. Ada hubungan yang positif dan signifikan antara persepsi siswa terhadap gaya mengajar guru terhadap prestasi belajar matematika. Dan ada hubungan positif dan signifikan antara motivasi belajar dan persepsi siswa terhadapa gaya mengajar guru secara bersama-sama dengan prestasi belajar matematika siswa MA