bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can teaching serious illness communication skills foster multidimensional empathy? A mixed-methods study
Authors: Yuen Jacqueline K. , See Christopher , Cheung Johnny T. K. , Lum Chor Ming , Lee Jenny SW , Wong Wai Tat 
Published: January 2023

Abstract
Background
To investigate the impact of a serious illness communication skills training course on medical students’ attitudes regarding clinical empathy, self-efficacy in empathic communication, and learning on different dimensions of empathy.

Methods
A mixed-methods design was used. A blended learning Serious Illness Communication Skills Training (SI-CST) course was delivered to sixth-year medical students. Students (n=185) completed questionnaires with the 20-item Jefferson Scale of Empathy (JSE) and self-rated preparedness level for five empathic communication tasks at baseline (T1), six weeks (T2), and three-to-six months post-training (T3). Written reflections on key lessons learned were analyzed using inductive thematic analysis.

Results
Total JSE scores significantly improved from T1 to T2 (111.4 vs 113.9, P=.01) and from T1 to T3 (111.4 vs 113.9, P=.01). There was an increase in Standing in Patient’s Shoes subscale of the JSE with an effect size of 0.56 whereas the Perspective-Taking and Compassionate Care subscales showed no significant changes. Self-rated preparedness for all five empathic communication tasks significantly improved from T1 to T2 (P ≤ .001) and from T1 to T3 (P ≤ .001) with large effect sizes (1.09-1.41). Four key themes emerged from the qualitative analysis. They were appreciating the important role of empathy in clinical care (moral empathy), learning skills in detecting and understanding patient emotions (cognitive empathy), learning skills in responding to emotion with empathy (behavioral empathy), and appreciating that communication skills can be improved with continual practice and self-reflection.

Conclusions
Our results revealed that SI-CST improved medical students’ empathic attitudes and self-efficacy in empathic communication. Qualitative results found learning on the cognitive, behavioral and moral dimensions of empathy.
Lentiviral in situ targeting of stem cells in unperturbed intestinal epithelium
Authors: Garside George B. , Sandoval Madeline , Beronja Slobodan , Rudolph K. Lenhard 
Published: January 2023

Abstract
Background
Methods for the long-term in situ transduction of the unperturbed murine intestinal epithelium have not been developed in past research. Such a method could speed up functional studies and screens to identify genetic factors influencing intestinal epithelium biology. Here, we developed an efficient method achieving this long-sought goal.

Results
We used ultrasound-guided microinjections to transduce the embryonic endoderm at day 8 (E8.0) in utero. The injection procedure can be completed in 20 min and had a 100% survival rate. By injecting a small volume (0.1–0.2 μl) of concentrated virus, single shRNA constructs as well as lentiviral libraries can successfully be transduced. The new method stably and reproducibly targets adult intestinal epithelium, as well as other endoderm-derived organs such as the lungs, pancreas, liver, stomach, and bladder. Postnatal analysis of young adult mice indicates that single transduced cells at E8.0 gave rise to crypt fields that were comprised of 20–30 neighbouring crypts per crypt-field at 90 days after birth. Lentiviral targeting of ApcMin/+ mutant and wildtype mice revealed that heterozygous loss of Apc function suppresses the developmental normal growth pattern of intestinal crypt fields. This suppression of crypt field sizes did not involve a reduction of the crypt number per field, indicating that heterozygous Apc loss impaired the growth of individual crypts within the fields. Lentiviral-mediated shRNA knockdown of p53 led to an approximately 20% increase of individual crypts per field in both Apc+/+ and ApcMin/+ mice, associating with an increase in crypt size in ApcMin/+ mice but a slight reduction in crypt size in Apc+/+ mice. Overall, p53 knockdown rescued the reduction in crypt field size in Apc-mutant mice but had no effect on crypt field size in wildtype mice.

Conclusions
This study develops a novel technique enabling robust and reproducible in vivo targeting of intestinal stem cells in situ in the unperturbed intestinal epithelium across different regions of the intestine. In vivo somatic gene editing and genetic screening of lentiviral libraries has the potential to speed up discoveries and mechanistic understanding of genetic pathways controlling the biology of the intestinal epithelium during development and postnatal life. The here developed method enables such approaches.
Cord blood epigenome-wide meta-analysis in six European-based child cohorts identifies signatures linked to rapid weight growth
Authors: Alfano Rossella , Zugna Daniela , Barros Henrique , Bustamante Mariona , Chatzi Leda , Ghantous Akram , Herceg Zdenko , Keski-Rahkonen Pekka , de Kok Theo M. , Nawrot Tim S , Relton Caroline L , Robinson Oliver , Roumeliotaki Theano , Scalbert Augustin , Vrijheid Martine , Vineis Paolo , Richiardi Lorenzo , Plusquin Michelle 
Published: January 2023

Abstract
Background
Rapid postnatal growth may result from exposure in utero or early life to adverse conditions and has been associated with diseases later in life and, in particular, with childhood obesity. DNA methylation, interfacing early-life exposures and subsequent diseases, is a possible mechanism underlying early-life programming.

Methods
Here, a meta-analysis of Illumina HumanMethylation 450K/EPIC-array associations of cord blood DNA methylation at single CpG sites and CpG genomic regions with rapid weight growth at 1 year of age (defined with reference to WHO growth charts) was conducted in six European-based child cohorts (ALSPAC, ENVIRONAGE, Generation XXI, INMA, Piccolipiù, and RHEA, N = 2003). The association of gestational age acceleration (calculated using the Bohlin epigenetic clock) with rapid weight growth was also explored via meta-analysis. Follow-up analyses of identified DNA methylation signals included prediction of rapid weight growth, mediation of the effect of conventional risk factors on rapid weight growth, integration with transcriptomics and metabolomics, association with overweight in childhood (between 4 and 8 years), and comparison with previous findings.

Results
Forty-seven CpGs were associated with rapid weight growth at suggestive p-value <1e−05 and, among them, three CpGs (cg14459032, cg25953130 annotated to ARID5B, and cg00049440 annotated to KLF9) passed the genome-wide significance level (p-value <1.25e−07). Sixteen differentially methylated regions (DMRs) were identified as associated with rapid weight growth at false discovery rate (FDR)-adjusted/Siddak p-values < 0.01. Gestational age acceleration was associated with decreasing risk of rapid weight growth (p-value = 9.75e−04). Identified DNA methylation signals slightly increased the prediction of rapid weight growth in addition to conventional risk factors. Among the identified signals, three CpGs partially mediated the effect of gestational age on rapid weight growth. Both CpGs (N=3) and DMRs (N=3) were associated with differential expression of transcripts (N=10 and 7, respectively), including long non-coding RNAs. An AURKC DMR was associated with childhood overweight. We observed enrichment of CpGs previously reported associated with birthweight.

Conclusions
Our findings provide evidence of the association between cord blood DNA methylation and rapid weight growth and suggest links with prenatal exposures and association with childhood obesity providing opportunities for early prevention.
Brain endothelial CXCL12 attracts protective natural killer cells during ischemic stroke
Authors: Wang Shuaiwei , de Fabritus Lauriane , Kumar Praveen Ashok , Werner Yves , Ma Minglu , Li Dan , Siret Carole , Simic Milesa , Li Bin , Kerdiles Yann M. , Hou Lei , Stumm Ralf , van de Pavert Serge A. 
Published: January 2023

Abstract
Background
The innate lymphoid cell (ILC) family consists of NK cells, ILC type 1, 2, 3 and lymphoid tissue inducer cells. They have been shown to play important roles in homeostasis and immune responses and are generally considered tissue resident. Not much is known about the presence of ILC members within the central nervous system and whether they are tissue resident in this organ too. Therefore, we studied the presence of all ILC members within the central nervous system and after ischemic brain insult.

Methods
We used the photothrombotic ischemic lesion method to induce ischemic lesions within the mouse brain. Using whole-mount immunofluorescence imaging, we established that the ILCs were present at the rim of the lesion. We quantified the increase of all ILC members at different time-points after the ischemic lesion induction by flow cytometry. Their migration route via chemokine CXCL12 was studied by using different genetic mouse models, in which we induced deletion of Cxcl12 within the blood–brain barrier endothelium, or its receptor, Cxcr4, in the ILCs. The functional role of the ILCs was subsequently established using the beam-walk sensorimotor test.

Results
Here, we report that ILCs are not resident within the mouse brain parenchyma during steady-state conditions, but are attracted towards the ischemic stroke. Specifically, we identify NK cells, ILC1s, ILC2s and ILC3s within the lesion, the highest influx being observed for NK cells and ILC1s. We further show that CXCL12 expressed at the blood–brain barrier is essential for NK cells and NKp46+ ILC3s to migrate toward the lesion. Complementary, Cxcr4-deficiency in NK cells prevents NK cells from entering the infarct area. Lack of NK cell migration results in a higher neurological deficit in the beam-walk sensorimotor test.

Conclusions
This study establishes the lack of ILCs in the mouse central nervous system at steady-state and their migration towards an ischemic brain lesion. Our data show a role for blood–brain barrier-derived CXCL12 in attracting protective NK cells to ischemic brain lesions and identifies a new CXCL12/CXCR4-mediated component of the innate immune response to stroke.
The influence of share buybacks on ill-health and health inequity: an exploratory analysis using a socio-ecological determinants of health lens
Authors: Wood Benjamin , Sacks Gary 
Published: January 2023

Abstract
Introduction
Share buybacks, when a corporation buys back its own shares, are recognised as having potentially harmful impacts on society. This includes by contributing to economic inequalities, and by impeding investments with the potential to protect and promote the welfare of various stakeholders. Share buybacks, however, have received minimal analytical attention in the public health literature. This paper aimed to explore the potential influence of share buybacks on population health and health inequity using a socio-ecological determinants of health lens.

Methods
We conducted a descriptive analysis of share buybacks made by corporations listed on United States (US) stock exchanges between 1982 and 2021, using quantitative data sourced from Compustat. We examined annual trends in share buyback expenditure, including comparisons to dividend, net income, capital expenditure, and research and development expenditure data. We then purposively sampled a set of corporations to provide illustrative examples of how share buybacks potentially influence key socio-ecological determinants of health. The examples were: i) three COVID-19 vaccine manufacturers; ii) five of the world’s largest fossil fuel corporations; and iii) US car manufacturer General Motors. For these, we conducted an analysis of data from Compustat, company reports and grey literature materials, focusing on key sources of profits and their allocation to share buybacks and particular investments.

Results
US-listed corporations spent an estimated US$9.2 trillion in real terms on share buybacks between 2012 and 2021 (nearly 12 times more than from 1982 to 1991). The contribution of share buybacks to total shareholder ‘returns’ increased from 11% in 1982 to 55% in 2021, with expenditure on shareholder returns increasing considerably relative to capital, research and development expenditure over this period. The three examples illustrated how some corporations have prioritised the short-term financial interests of their shareholders, including via implementing large share buyback programs, over investments with considerable potential to protect and promote the public’s health.

Conclusion
The potentially substantial impacts of share buybacks on health warrant increased research and policy attention. Arguably, more must be done to regulate share buybacks as part of efforts to address the corporate drivers of ill-health and inequity.
Anemia and formation of deep vein thrombosis before operation in patients with knee osteoarthritis: a cross-sectional study
Authors: Xiong Xiaojuan , Li Ting , Cheng Bo 
Published: January 2023

Abstract
Background
Preoperative anemia is a common complication in knee osteoarthritis (KOA) patients. However, the association between anemia and preoperative deep vein thrombosis (DVT) in osteoarthritis patients remains unknown. The aim of this study was to investigate such association.

Methods
In this retrospective study, we included 1005 KOA patients undergoing total knee arthroplasty (TKA) in our hospital. According to preoperative hemoglobin levels, the patients were divided into anemia group and non-anemia group. According to the results of Doppler ultrasonography for the lower extremities, the patients were divided into DVT group and non-DVT group. A logistic model was established through propensity score matching (PSM), with anemia before TKA as the dependent variable, DVT-related variable as the covariate, and 0.03 as the Caliper value. The anemia group and non-anemia group were matched at a 1:1 ratio and 310 successfully matched. After matching, logistic regression analysis was used to evaluate the correlation between preoperative anemia and DVT in KOA patients.

Results
In this study, 342 cases (33.6%) had preoperative anemia and 73 cases (7.2%) had DVT before TKA. After matching, 46 DVT cases (7.42%) were found. By using binary logistic regression after PSM, we found that the risk for preoperative DVT formation in TKA patients with preoperative anemia increased by 1.97 times [95% (CI 1.05–3.69)], P = 0.035.

Conclusion
Preoperative anemia is considered as an independent risk factor for the formation of preoperative DVT in KOA patients.
Trial registration: ChiCRT2100054844.
Postoperative health-related quality of life in children with congenital heart disease: a short-term follow-up study
Authors: Dai Wang-Sheng , Lin Wen-Hao , Lin Shi-Hao , Chen Qiang , Cao Hua 
Published: January 2023

Abstract
Objective
This study aimed to explore changes in health-related quality of life in children with congenital heart disease from pre-surgery to 6 months after surgery.

Methods
A total of 87 children aged 2–12 years who underwent cardiac surgery in a provincial hospital in China from January 2021 to June 2021 were selected. After 6 months, the quality of life of all children was retrospectively analyzed. The Chinese version of the Pediatric Quality of Life Inventory 4.0 Scale was used to assess the quality of life of children before and after surgery.

Results
Parents of 85 children and 33 children aged 5–12 years completed the questionnaires. After surgical treatment, the quality of life scores reported by parents of children of all ages were significantly higher than those before surgery, the P value < 0.05; the self-evaluated quality of life scores of children of different ages were significantly higher than those before surgery, the P value < 0.05.

Conclusion
Surgical treatment can improve the health-related quality of life of children with congenital heart disease.
Efficacy and safety of corticosteroids in cardiac arrest: a systematic review, meta-analysis and trial sequential analysis of randomized control trials
Authors: Penn Jeremy , Douglas Will , Curran Jeffrey , Chaudhuri Dipayan , Dionne Joanna C. , Fernando Shannon M. , Granton David , Mathew Rebecca , Rochwerg Bram 
Published: January 2023

Abstract
Background
Post-cardiac arrest, outcomes for most patients are poor, regardless of setting. Many patients who do achieve spontaneous return of circulation require vasopressor therapy to maintain organ perfusion. There is some evidence to support the use of corticosteroids in cardiac arrest.

Research question
Assess the efficacy and safety of corticosteroids in patients following in- and out-of-hospital cardiac arrest.

Study design and methods
We searched databases CINAHL, EMBASE, LILACS, MEDLINE, Web of Science, CENTRAL, ClinicalTrails.gov, and ICTRP. We included randomized controlled trials (RCTs) that examined the efficacy and safety of corticosteroids, as compared to placebo or usual care in patients post-cardiac arrest. We pooled estimates of effect size using random effects meta-analysis and report relative risk (RR) with 95% confidence intervals (CIs). We assessed risk of bias (ROB) for the included trials using the modified Cochrane ROB tool and rated the certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation methodology.

Results
We included 8 RCTs (n = 2213 patients). Corticosteroids administered post-cardiac arrest had an uncertain effect on mortality measured at the longest point of follow-up (RR 0.96, 95% CI 0.90–1.02, very low certainty, required information size not met using trial sequential analysis). Corticosteroids probably increase return of spontaneous circulation (ROSC) (RR 1.32, 95% CI 1.18–1.47, moderate certainty) and may increase the likelihood of survival with good functional outcome (RR 1.49, 95% CI 0.87–2.54, low certainty). Corticosteroids may decrease the risk of ventilator associated pneumonia (RR 0.76, 95% CI 0.46–1.09, low certainty), may increase renal failure (RR 1.29, 95% CI 0.84–1.99, low certainty), and have an uncertain effect on bleeding (RR 2.04, 95% CI 0.53–7.84, very low certainty) and peritonitis (RR 10.54, 95% CI 2.99–37.19, very low certainty).

Conclusions
In patients during or after cardiac arrest, corticosteroids have an uncertain effect on mortality but probably increase ROSC and may increase the likelihood of survival with good functional outcome at hospital discharge. Corticosteroids may decrease ventilator associated pneumonia, may increase renal failure, and have an uncertain effect on bleeding and peritonitis. However, the pooled evidence examining these outcomes was sparse and imprecision contributed to low or very low certainty of evidence.
Incentivizing COVID-19 vaccination among racial/ethnic minority adults in the United States: $209 per dose could convince the hesitant
Authors: Chen Kevin , Wilson-Barthes Marta , Harris Jeffrey E. , Galárraga Omar 
Published: January 2023

Abstract
Background
More than two years into the coronavirus disease (COVID-19) pandemic, it remains unclear whether financial incentives can reduce vaccine hesitancy and improve uptake among key unvaccinated populations. This study estimated the willingness of racial/ethnic minority adults in the United States to accept financial incentives for COVID-19 vaccination and the minimum amount needed to vaccinate a sufficiently high percentage of this population.

Methods
From August through September 2021, we conducted an online survey of 367 Black/African American and Hispanic patients, age ≥ 18 years, from 8 community health centers in Rhode Island. Contingent valuation questions assessed respondents’ willingness-to-accept (WTA) incentives for COVID-19 vaccination using random-starting-points and iterative incentive offers of $5 to $50 per dose. Ordered logistic regression models examined associations between respondent characteristics and WTA. Predictive probabilities were modeled using both within-survey range and out-of-survey range incentive offer amounts and compared against vaccination thresholds needed to reach herd immunity.

Results
Less than 30% of unvaccinated survey respondents were WTA an incentive of $50/dose for vaccination. Models using out-of-survey incentive offer amounts greater than $50 suggested that 85% of respondents would agree $140/dose (95% CI: $43-$236) could convince other people to accept vaccination, while $209/dose (95% CI: -$91-$509) would be needed for 85% of respondents to accept vaccination themselves.

Conclusions
Findings from this analysis may inform the design of incentive schemes aiming to reduce racial/ethnic disparities in vaccine and booster uptake, which will continue to be important as new variants of SARS-CoV-2 emerge.
Bull spermatozoa selected by thermotaxis exhibit high DNA integrity, specific head morphometry, and improve ICSI outcome
Authors: Ruiz-Díaz Sara , Mazzarella Rosane , Navarrete-López Paula , Fernández-González Raúl , de Frutos Celia , Maroto María , Cucala Claudia , Beltrán-Breña Paula , Lombó Marta , Rizos Dimitrios , Gutiérrez-Adán Alfonso 
Published: January 2023

Abstract
Background
Sperm migration by thermotaxis is a guidance mechanism that operates along the oviduct and it has proved to be a valid method for selecting spermatozoa with low DNA fragmentation (SDF) in mice, humans, and stallions. This study aimed to analyse if bull spermatozoa could be selected by thermotaxis and to assess their quality in terms of SDF as well as determine the presence of a specific sperm subpopulation based on sperm morphometry and assess their fertilizing capacity by ICSI.

Methods
We used frozen-thawed sperm from 6 bulls and sperm selection by thermotaxis was performed with TALP medium supplemented with 25 mmol/L of HEPES and 5 mmol/L of caffeine. In these conditions, sperm selection was achieved, obtaining a net thermotaxis of 3.6%. Subsequently, we analysed the SDF of the migrated and not-migrated spermatozoa using the neutral COMET assay, and we evaluated the size of the sperm head using Hemacolor® staining with Motic Images Plus 3 software. Additionally, migrated and not-migrated spermatozoa by thermotaxis were used to fertilize bovine in vitro matured (IVM) oocytes by ICSI, a very inefficient procedure in cattle that is only successful when the oocyte is artificially activated.

Results
The results showed lower SDF (χ², P < 0.001, 13.3% reduction, n = 8) and lower head size parameters (length and width, P < 0.01; and perimeter and area, P < 0.001; n = 4) in those spermatozoa migrated in comparison to those not-migrated. The distribution of sperm subpopulations structure varied between groups, highlighting cluster 2, characterized by spermatozoa with small head size, and high ellipticity and elongated heads, as the most abundant in the thermotaxis migrated group. When performed ICSI (without oocyte artificial activation) with the thermotactic sperm, the blastocyst rate was 32.2% ± 9.3% in the group microinjected with the thermotactic spermatozoa vs. 8.3% ± 7.8% in the group of not-migrated sperm (χ², P < 0.05).

Conclusion
Our results showed that bull sperm selection by thermotaxis has a much higher DNA integrity, small and elongated head size parameters, and different sperm subpopulation structure than the not-selected spermatozoa. Additionally, we evidenced that thermotactic spermatozoa improve ICSI success rates.