bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Unfolding Case-Based Learning on Clinical Judgment Among Undergraduate Nursing Students
Authors: Liu Wei 
Published: October 2023

Background:
To prepare students for Next Generation National Council Licensure Examination-Registered Nurse (NCLEX-RN), nurse educators need to develop teaching strategies to foster students’ clinical judgment.

Purpose:
This study examined the effects of unfolding case-based learning (CBL) on baccalaureate nursing students’ clinical judgment upon graduation.

Methods:
A prospective cohort design was adopted. Students’ self-reported responses to the Lasater Clinical Judgment Rubric were compared between the unfolding CBL (n = 140) and non-CBL (n = 126) cohorts at a school of nursing in the United States.

Results:
While students’ responses were similar between the study cohorts, a trend was noted for improved clinical judgment among students in the unfolding CBL cohort. Furthermore, unfolding CBL significantly enhanced students’ perceived proficiency in conducting focused observation.

Conclusions:
The findings support early introduction and consistent use of the unfolding CBL throughout the undergraduate nursing program so that students have ample opportunities and contexts to cultivate clinical judgment skills in the classroom.
Teaching Social Determinants of Health in Nursing Programs
Authors: Liu Cheng-Ching , McIntire Emily , Ling Jiying , Sullivan Katie , Ng Teresa , Kaur Loveleen , Sender Jessica 
Published: October 2023

Background:
Incorporating social determinants of health (SDoH) into clinical decision-making can clarify disease causes, enhance care planning, and improve health outcomes. Nurse educators should know which strategies are most effective for teaching SDoH in bachelor of science in nursing (BSN) programs.

Objective:
This integrative review synthesizes the literature on familiarizing BSN students with SDoH and identifies effective teaching interventions for SDoH in these programs.

Methods:
The researchers searched CINAHL, PubMed, Web of Science, and ERIC databases, and 21 articles met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines were followed for reporting.

Results:
The curriculum method, service learning, and international outreach experiences were frequently used teaching strategies. Qualitative evaluation was used to evaluate student outcomes.

Conclusions:
Nurse educators should be mindful of these strategies. Interdisciplinary teamwork can bolster students' understanding of disadvantaged populations while integrating SDoH in nursing curricula. Quantitative evaluations of learning outcomes are needed to determine teaching effectiveness.
Impact of Extraction Time During Donation After Circulatory Death Organ Procurement on Kidney Function After Transplantation in The Netherlands
Authors: van Straalen Erika , Rijkse Elsaline , van Staa AnneLoes , Rebers Paul M. , Hagenaars Hanneke J.A.M. , van de Wetering Jacqueline , Ijzermans Jan N.M. , Minnee Robert C. 
Published: October 2023

Background.
In The Netherlands, 60% of deceased-donor kidney offers are after donation after circulatory death. Cold and warm ischemia times are known risk factors for delayed graft function (DGF) and inferior allograft survival. Extraction time is a relatively new ischemia time. During procurement, cooling of the kidneys is suboptimal with ongoing ischemia. However, evidence is lacking on whether extraction time has an impact on DGF if all ischemic periods are included.

Methods.
Between 2012 and 2018, 1524 donation after circulatory death kidneys were procured and transplanted in The Netherlands. Donation and transplantation-related data were obtained from the database of the Dutch Transplant Foundation. The primary outcome parameter was the incidence of DGF.

Results.
In our cohort, extraction time ranged from 14 to 237 min, with a mean of 62 min (SD 32). In multivariate logistic regression analysis, extraction time was an independent risk factor for incidence of DGF (odds ratio per minute increase 1.008; 95% confidence interval, 1.003-1.013; P = 0.001). The agonal phase, hypoperfusion time, and anastomosis time were not independent risk factors for incidence of DGF.

Conclusions.
Considering all known ischemic periods during the donation after the circulatory death process, prolonged kidney extraction time increased the risk of DGF after kidney transplantation.
Real-world Experiences in the Transplantation of Hepatitis C-NAAT–positive Organs
Authors: Steinbrink Julie M. , Byrns Jennifer , Berg Carl , Kappus Matthew , King Lindsay , Ellis Matthew J. , Sanoff Scott , Agarwal Richa , DeVore Adam D. , Reynolds John M. , Hartwig Matthew G. , Milano Carmelo , Sudan Debra , Maziarz Eileen K. , Saullo Jennifer , Alexander Barbara D. , Wolfe Cameron R. 
Published: October 2023

Background.
Hepatitis C virus (HCV) nucleic acid amplification test (NAAT)–positive donors have increased the organ pool. Direct-acting antivirals (DAAs) have led to high rates of treatment success and sustained virologic response (SVR) in recipients with donor-derived HCV infection without significant adverse effects, although variability remains in the timing and duration of antivirals.

Methods.
This retrospective study analyzed all adult HCV-NAAT–negative transplant recipients who received an organ from HCV-NAAT–positive donors from November 24, 2018, to March 31, 2022, at Duke University Medical Center with protocolized delay of DAA initiation until after hospital discharge, with at least 180-d follow-up on all patients. Transplant and HCV-related outcomes were analyzed.

Results.
Two hundred eleven transplants (111 kidneys, 41 livers, 34 hearts, and 25 lungs) were performed from HCV-NAAT–positive donors to HCV-NAAT–negative recipients. Ninety percent of recipients became viremic within 7 d posttransplant. Ninety-nine percent of recipients were initiated on pangenotypic DAAs in the outpatient setting a median of 52 d posttransplant, most commonly with 12-wk courses of sofosbuvir–velpatasvir (lungs) and glecaprevir–pibrentasvir (heart, kidney, and liver). Ninety-seven percent of recipients had SVR after a first-line DAA; all ultimately achieved SVR at 12 wk after subsequent treatment courses. The median peak HCV RNA for all organ systems was 2 436 512 IU/mL; the median time from antiviral to undetectable RNA was 48 d, although differences were noted between organ groups. No patient deaths or graft losses were directly attributable to HCV infection.

Conclusions.
One hundred percent of transplant recipients of HCV-NAAT–positive organs ultimately developed SVR without significant adverse effects when HCV antivirals were initiated in the outpatient setting after transplant hospitalization, suggesting that this real-world treatment pathway is a viable option.
Characterizing the role of autaptic feedback in enhancing precision of neuronal firing times
Authors: Vahdat Zahra , Gambrell Oliver , Singh Abhyudai 
Published: October 2023

AbstractIn a chemical synapse, information flow occurs via the release of neurotransmitters from a presynaptic neuron that triggers an Action potential (AP) in the postsynaptic neuron. At its core, this occurs via the postsynaptic membrane potential integrating neurotransmitter-induced synaptic currents, and AP generation occurs when potential reaches a critical threshold. This manuscript investigates feedback implementation via an autapse, where the axon from the postsynaptic neuron forms an inhibitory synapse onto itself. Using a stochastic model of neuronal synaptic transmission, we formulate AP generation as a first-passage time problem and derive expressions for both the mean and noise of AP-firing times. Our analytical results supported by stochastic simulations identify parameter regimes where autaptic feedback transmission enhances the precision of AP firing times consistent with experimental data. These noise attenuating regimes are intuitively based on two orthogonal mechanisms - either expanding the time window to integrate noisy upstream signals; or by linearizing the mean voltage increase over time. Interestingly, we find regimes for noise amplification that specifically occur when the inhibitory synapse has a low probability of release for synaptic vesicles. In summary, this work explores feedback modulation of the stochastic dynamics of autaptic neurotransmission and reveals its function of creating more regular AP firing patterns.
Review of Teleradiology Applications in Some Selected African Countries
Authors: Nortey Jacob Nii Noye , Agbotsigah Linda Akorfa , Osei Eric Opoku , Adabo Andrew , Gborgblah Miriam , Suleiman Rashida 
Published: October 2023

AbstractThe role of radiology is central to disease management however, its application is hindered by the low distribution of radiology worldwide with the situation direr in Africa. Information and communication technology (ICT) methods have been used to s healthcare systems and lessen the negative after-effects of widespread unavailability of high-quality radiological services. Telemedicine, specifically teleradiology was identified as a prime mitigator resulting in increased access to quality radiological services and effective diagnostic reporting thus contributing to achieving universal health coverage. Around the world, teleradiology adoption and implementation has seen significant boost and healthcare benefits but in Africa, the situation is reversed. Africa’s low adoption can be linked to policymakers not having adequate evidence-based data to inform decisions and policies on teleradiology implementation. In this study, we review the implementation of teleradiology in five (5) African countries: South Africa, Egypt, Morocco, Kenya, and Ghana. Articles were searched on Databases such as PubMed, Google Scholar, and ScienceDirect using defined search strings. Sixty papers were initially downloaded, but only those meeting the inclusion criteria were retained after the titles and abstracts were reviewed. Nineteen articles were found suitable for the study after careful assessment. All of these were summed up, and the study’s most important takeaways were plotted. Few studies met our inclusion criteria, indicating that teleradiology is not widely used in the nations we looked at. As a result, it is necessary to conduct extensive investigations to direct the widespread implementation of teleradiology in Africa. The findings show that teleradiology is been implemented in these countries however, there exists the challenge of lack of technology, policies, human sources, and training that are hindering teleradiology practices. Therefore, it recommended that various governments and scholars should address the challenges facing teleradiology and examine the limitations identified in this study.
Modeling magnesium and calcium transport along male rat kidney and the effects of diuretics
Authors: Dutta Pritha , Layton Anita T. 
Published: October 2023

AbstractCalcium (Ca2+) and magnesium (Mg2+) are essential for cellular function. The kidneys play an important role in maintaining the homeostasis of these cations. Their reabsorption along the nephron is dependent on distinct trans- and paracellular pathways, and is coupled to the transport of other electrolytes. Notably, sodium (Na+) transport establishes an electrochemical gradient to drive Ca2+reabsorption. Consequently, alterations in renal Na+handling, under pathophysiological conditions or pharmacological manipulations, can have major effects on Ca2+transport. One such condition is the administration of diuretics, which are used to treat a large range of clinical conditions, but most commonly for the management of blood pressure and fluid balance. While the pharmacological targets of diuretics typically directly mediate Na+transport, they also indirectly affect renal Ca2+and Mg2+handling, i.e., by establishing a prerequisite electrochemical gradient. Thus, substantial alterations in divalent cation handling can be expected following diuretic treatment. To investigate renal Ca2+and Mg2handling, and how those processes are affected by diuretics treatment, we have developed sex-specific computational models of electrolyte transport along the nephrons. Model simulations indicate that along the proximal tubule and thick ascending limb, the transport of Ca2+and Mg2+occusr in parallel with Na+, but those processes are dissociated along the distal convoluted tubule. We also simulated the effects of acute administration of loop, thiazide, and K-sparing diuretics. The model predicted significantly increased Mg2+excretion, no significant alteration in Mg2+excretion, and significantly decreased Mg2+excretion on treatment with loop, thiazide, and K-sparing diuretics, respectively, in agreement with experimental studies. The present models can be used to conductin silicostudies on how the kidney adapts to alterations in Ca2+and Mg2+homeostasis during various physiological and pathophysiological conditions, such as pregnancy, diabetes, and chronic kidney disease.
BatchEval Pipeline: Batch Effect Evaluation Workflow for Multiple Datasets Joint Analysis
Authors: Zhang Chao , Kang Qiang , Li Mei , Xie Hongqing , Fang Shuangsang , Xu Xun 
Published: October 2023

ABSTRACTAs genomic sequencing technology continues to advance, it becomes increasingly important to perform joint analyses of multiple datasets of transcriptomics. However, batch effect presents challenges for dataset integration, such as sequencing data measured on different platforms, and datasets collected at different times. Here, we report the development of BatchEval Pipeline, a batch effect workflow used to evaluate batch effect on dataset integration. The BatchEval Pipeline generates a comprehensive report, which consists of a series of HTML pages for assessment findings, including a main page, a raw dataset evaluation page, and several built-in methods evaluation pages. The main page exhibits basic information of the integrated datasets, a comprehensive score of batch effect, and the most recommended method for removing batch effect from the current datasets. The remaining pages exhibit evaluation details for the raw dataset, and evaluation results from the built-in batch effect removal methods after removing batch effect. This comprehensive report enables researchers to accurately identify and remove batch effects, resulting in more reliable and meaningful biological insights from integrated datasets. In summary, the BatchEval Pipeline represents a significant advancement in batch effect evaluation, and is a valuable tool to improve the accuracy and reliability of the experimental results.Availability & ImplementationThe source code of the BatchEval Pipeline is available athttps://github.com/STOmics/BatchEval.
Genomic landscape of endometrial, ovarian and cervical cancers in Japan from database in the Center for Cancer Genomics and Advanced Therapeutics
Authors: Xi Qian , Kage Hidenori , Ogawa Miho , Matsunaga Asami , Nishijima Akira , Sone Kenbun , Kawana Kei , Oda Katsutoshi 
Published: October 2023

AbstractObjectiveThis study aimed to comprehensively clarify genomic landscape, and its association with tumor mutation burden-high (TMB-H, ≧10 mut/Mb) and microsatellite instability-high (MSI-H) in endometrial, cervical, and ovarian cancers.MethodsWe obtained genomic datasets of a comprehensive genomic profiling test, FoundationOne® CDx, with clinical information by using the “Center for Cancer Genomics and Advanced Therapeutics” (C-CAT) database in Japan. The patients could take the tests only after the standardized treatments under universal health insurance coverage.ResultsEndometrial cancers (n=561) were characterized by high frequency of tumor mutational burden-high (TMB-H) (13.9%) and MSI-high (MSI-H) (10.8%), especially in endometrioid carcinomas. The lower ratio ofPOLEexonuclease mutations (1.4%) and higher ratio ofTP53mutations (54.4%) than previous reports suggested the prognostic impact of the molecular subtypes. Among 839 cervical cancers, frequent mutations ofKRAS(32.2%),TP53(29.4%),PIK3CA(22.2%),STK11(22.2%),CDKN2A(18.3%), andERBB2(16.7%) were observed in adenocarcinomas, while the ratio of TMB-H was significantly higher in squamous cells carcinomas (20.6%). Among 1,606 ovarian cancers, genomic profiling of serous (n=784), clear cell (n=333), endometrioid (n=92), and mucinous carcinomas (n=91) was characterized. Pathogenic mutations in thePOLEexonuclease domain were linked to high TMB (TMB >100 mut/Mb), and the mutation ratio was low in both cervical (0.0%) and ovarian cancer (0.19%).ConclusionThe C-CAT database is useful to provide mutational landscape of each cancer type and each histological subtype. As the dataset is collected exclusively from patients after the standardized treatments, the information of “druggable” alterations highlights the unmet needs for drug development in major gynecological cancers.
Neural consequences of 5-Hz transcranial alternating current stimulation over right hemisphere: an eLORETA EEG study
Authors: Lee Tien-Wen , Li Chiang-Shan R. , Tramontano Gerald 
Published: October 2023

ABSTRACTIntroductionTranscranial alternating current stimulation (tACS) at 5-Hz to the right hemisphere can effectively alleviate symptoms of anxiety. The objective of this study was to explore the neural mechanisms that drive the therapeutic benefits.MethodsWe collected electroencephalography (EEG) data from 24 participants with anxiety disorders both before and after the tACS treatment during a single session. We applied the stimulation over the right hemisphere, with 1.0 mA at F4, 1.0 mA at P4, and 2.0 mA at T8, following the 10-10 EEG convention. With eLORETA, we transformed the scalp signals into the current source density in the cortex. We then assessed the differences between post- and pre-treatment brain maps across multiple spectra (delta to low gamma) with non-parametric statistics.ResultsWe observed a trend of heightened power in alpha and reduced power in mid-to-high beta and low gamma, in accord with the EEG markers of anxiolytic effects reported in previous studies. Additionally, contrary to the widely circulated entrainment theory of the neural effects of tACS, we observed a consistent trend of de-synchronization at the stimulating sites across spectra.ConclusionWe confirmed that tACS 5-Hz over the right hemisphere demonstrated EEG markers of anxiety reduction. Regarding changes in power spectra, the effects of tACS on the brain are intricate and cannot be explained solely by entrainment theory.
Trends, Outcomes, and Healthcare Disparities of Asian patients with Heart Failure and Advanced Chronic Kidney Disease
Authors: Tan Samuel S. , Tan Wenchy YY. , Zheng Lucy S. , Kumar Shasawat 
Published: October 2023

AbstractBackgroundData on outcomes and risk factors for Asian patients with advanced chronic kidney disease admitted for heart failure are limited. The purpose of this study was to investigate contemporary racial and socioeconomic disparities in Asian patients with advanced kidney disease admitted for heart failure exacerbation.MethodsThis was a retrospective cohort study that utilized data from the National Inpatient Sample between January 2016 and December 2020. Patients who had a primary diagnosis of HF and a concomitant diagnosis of advanced CKD were included. The primary outcome of interest was in-hospital mortality. Secondary outcomes include hospital cost, length of stay, and other clinical outcomes. Weighted multivariable logistic regression was used to adjust for comorbidities.ResultsA total of 186,431 admissions for heart failure exacerbation with advanced kidney disease were identified, of which 10.7% (n =20,006) were of Asian descent. Asian patients had the lowest prevalence of comorbidities compared with all other ethnicities. After adjusting for comorbidities, sex, and age, Whites (OR: 1.11; 95% CI 1.03 to 1.20; p<0.009) had higher odds of mortality, while Black (OR: 0.58; 95% CI 0.53 to 0.63; p< 0.001) and Hispanic patients (OR: 0.69; 95% CI 0.62 to 0.78; p< 0.001) had lower odds of mortality compared to Asian patients.ConclusionDespite recent efforts to address healthcare inequality, health disparities among Asian patients with HF and CKD remain. The significant difference in odds of mortality and complications, despite a lower comorbidity burden, indicates the importance of further research regarding the possible causality of such disparities.
How does the macroenvironment influence brain and behaviour – a review of current status and future perspectives
Authors: Polemiti Elli , Hese Soeren , Schepanski Kerstin , Yuan Jiacan , Schumann Gunter ,   environMENTAL consortium
Published: October 2023

ABSTRACTThe environment influences mental health, both detrimentally and beneficially. Current research has emphasized the individual psychosocial ‘microenvironment’. Less attention has been paid to ‘macro-environmental’ challenges including climate change, pollution, urbanicity and socioeconomic disparity. With the advent of large-scale big-data cohorts and an increasingly dense mapping of macroenvironmental parameters, we are now in a position to characterise the relation between macroenvironment, brain, and behaviour across different geographic and cultural locations globally. This review synthesises findings from recent epidemiological and neuroimaging studies, aiming to provide a comprehensive overview of the existing evidence between the macroenvironment and the structure and functions of the brain, with a particular emphasis on its implications for mental illness. We discuss putative underlying mechanisms and address the most common exposures of the macroenvironment. Finally, we identify critical areas for future research to enhance our understanding of the aetiology of mental illness and to inform effective interventions for healthier environments and mental health promotion.
Dissecting the causal relationships between childhood-onset asthma and major mental disorders: a univariable and multivariable Mendelian randomization study
Authors: Chen Banghong , Xue Mingzhu , Zhang Lan , Ren Peng 
Published: October 2023

AbstractBackgroundAsthma with a childhood-onset is found to be associated with increased risk of severe mental illnesses in later life. However, the causal relationships between childhood-onset asthma and major mental disorders remained unclear.MethodsWe conducted a two-sample Mendelian randomization (MR) analysis to investigate the causal effects of childhood-onset asthma (n=327,670) on six major mental illnesses, including major depressive disorders (n=143,265), bipolar disorder (n=353,899), schizophrenia (n=130,644), anxiety (n=10,240), autism (n=46,350), and ADHD (n=225,534) using summary statistics of genome-wide association studies (GWAS). The inverse variance weighted (IVW) method, along with weighted median and MR-Egger were employed for the causal estimates. Multiple sensitivity analyses were conducted to examine the robustness of the estimates. Moreover, the direct effects of childhood-onset asthma on mental disorders after accounting for the effects of adult-onset asthma were evaluated through the multivariable MR (MVMR) analysis.ResultsWe found that genetically determined childhood-onset asthma significantly increased the risk of depression (IVW OR=1.059, 95%CI:1.025-1.095, p=5.72e-04) and bipolar disorder (IVW OR=1,065, 95%CI:1.027-1.105, p=6.75e-04), but not associated with other mental disorders. Further MVMR analysis indicated that the causal relationships remained significant with the adjustment of adult-onset asthma. Interestingly, we found that childhood-and adult-onset asthma exerted distinct causal effects on depression and bipolar disorders. No significant heterogeneity and horizontal pleiotropy were found to influence the causal estimates.ConclusionsMR analysis indicated a significant causal relationship between genetically determined childhood-onset asthma and increased risk of depression and bipolar disorder in later life. The causal effects of childhood-onset asthma were distinct to the adult-onset asthma. Further studies were warranted to investigate the mechanisms underlying the causal relationships.