bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teaching ethical principles through narrative-based story is more effective in the moral sensitivity among BSc nursing students than lecture method : A quasi-experimental study
Authors: Bagherian Behnaz , Mehdipour-rabori Roghayeh , Nematollahi Monirsadat 
Published: April 2022

Background Ethics education can be developed in undergraduate nursing curriculum using a variety of teaching and learning strategies, and the content of narrative-based stories has rarely been evaluated in ethics courses. Objective This study aimed to compare the effect of teaching ethical principles through narrative ethics and lectures on the moral sensitivity of undergraduate nursing students. Methods This was a pretest and posttest quasi-experimental study with a control group. A total of 105 undergraduate nursing students from the nursing department of Kerman University of medical science were included in the study (35 in the narrative-based story group, 36 in the lecture group and 34 in the control group). The narrative-based story and lecture lasted for four two-hour sessions. The outcomes were measured by a moral sensitivity questionnaire. Results The study results showed that teaching ethical principles had a significant effect on the mean score of moral sensitivity in the intervention groups after the intervention, but it was not significant in the control group ( p > 0.05). Based on the mean score of moral sensitivity, the students in the narrative story group got a higher score in all subscales of moral sensitivity questionnaire. Conclusion Based on this study’s findings, it can be concluded that narrative-based education is an effective way for undergraduate nursing students to promote their moral sensitivity and the ability to make ethical decisions.
Preclinical Evaluation of a Non-Customized Modular Inner Branched Stent Graft for Total Endovascular Aortic Arch Repair in a Porcine Model
Authors: Rong Dan , Zhang Hongpeng , Guo Wei , Liu Feng , Ge Yangyang , Zhu Yating , Zhang Minhong , Xu Yongle , Jia Xin , Xiaohui Ma , Xiong Jiang , Wang Lijun 
Published: April 2022

Objectives: The aim of this study was to evaluate the feasibility and safety of a non-customized modular inner branched stent graft for total endovascular aortic arch repair in a porcine model. Methods: The modular inner branched stent graft system with a split main body design included 1 proximal main component, 1 distal main component, and 1 branched covered stent. The gutter in the proximal main component was sealed with sutured membrane. Fatigue testing was performed to evaluate the durability of the stent graft. Fifteen pigs were used in this study. In each pig, a stent graft was delivered and deployed to the aortic arch through the femoral arterial access and right carotid arterial access. Angiography and computed tomography angiography were used to evaluate the morphological features before euthanasia. After euthanasia, the implanted device, surrounding tissue, and major organs were harvested for gross and histological examination. Results: There were no collapses and no stent graft fractures detected after fatigue testing. The technical success rate was 14/15, and the incidence of major adverse cardiovascular events was 2/15. Angiography performed at the end of follow-up revealed no endoleaks and no device migration. Histological examination demonstrated excellent biocompatibility of the stent graft. Conclusions: The non-customized modular inner branched stent graft system is safe and feasible for the endovascular reconstruction of the aortic arch in a porcine model.
Lessons Learned by Novice Nursing Investigators When Developing and Implementing a Research Protocol
Authors: Anderson Jeanette , McNeary-Garvin Antoinette , Morales Dawn 
Published: April 2022

Introduction This lessons learned paper provides recommendations for novice investigators to consider when writing a research protocol; specifically when it involves clinical staff with varying levels of research experience, multiple departments, and is conducted at a non-academic medical center. It further explores each specific lesson with generalizability to help future novice investigators successfully develop and implement their own research study. Methods There were several lessons learned during the development and implementation of the research teams’ original study. These lessons include: (1) Conduct feasibility assessments; (2) Assess external factors; (3) Partner with stakeholder(s); (4) Develop tools that promote transparency; (5) Coordinate with Information Technology personnel; and (6) Engage and educate stakeholders. Conclusion The aim of this study was to determine if unrestricted oral intake of low fat, low residue foods during labor impacts maternal and neonatal outcomes, with the goal of contributing an adequately powered study to the current literature. Due to the challenges experienced in executing this study, the findings were not able to be generalized. However, the challenges encountered are not specific to the original focus of the researchers’ study. Each of the lessons are generalizable and can be applied to nursing research. As nurses begin to develop clinical research protocols, utilizing the lessons learned in this paper may help ensure successful implementation and completion of their research.
Neutrophil Lymphocyte Ratio as a Marker of In-Hospital Deterioration in COVID-19: Observations From a Resource Constraint Setting
Authors: Perera Nilanka , de Silva Ashani , Kumbukage Mahesh , Rambukwella Roshan , Indrakumar Jegarajah 
Published: April 2022

Introduction and Objectives: The study was conducted to assess the association of neutrophil lymphocyte ratio (NLR) in COVID-19 and to identify the cut-off value that predicts mortality, need of respiratory support and admission to high-dependency or intensive care. Methods: A retrospective observational study was conducted to collect demographic data, clinical variables, the neutrophil-lymphocyte ratio on-admission and the outcome of confirmed COVID-19 patients admitted to a tertiary care center in Sri Lanka. Results: There were 208 patients with a median age of 56 years (IQR 43-67) and 98 (47.1%) males. The median neutrophil count was 4.07 × 103/µL (IQR 2.97-6.79) and the median lymphocyte count was 1.74 × 103/µL (IQR 1.36-4.75). The calculated NLR ranged from 0.12 to 48.28 with a median value of 2.32 (IQR 1.37-4.76). A NLR value >3.6 predicted development of severe disease requiring respiratory support, transfer to a high-dependency or an intensive care unit and/or succumbing to the illness with a sensitivity 80% and specificity 80% (area under the curve 0.8, 95% CI 0.72-0.88, P < .0001). The adjusted odds ratio of NLR > 3.6 on predicting severe disease was 11.1, 95% CI 4.5- 27.0, P < .0001. Conclusions: A NLR > 3.6 is a useful variable to be included in risk prediction scores in Sri Lanka.
ABO blood group type and risk of venous thromboembolism in patients with cancer
Authors: Englisch Cornelia , Moik Florian , Nopp Stephan , Raderer Markus , Pabinger Ingrid , Ay Cihan 
Published: April 2022

Abstract
Venous thromboembolism (VTE) is common in patients with cancer. Although in the general population blood type non-O is associated with increased VTE risk, the impact of ABO blood type on risk of cancer-associated VTE has not been clarified. To determine the influence of ABO blood type on cancer-associated VTE risk, we conducted an analysis within the Vienna Cancer and Thrombosis Study, a prospective cohort study including patients with newly diagnosed or recurrent cancer observed for the primary outcome VTE. Restricted cubic spline analysis was performed and specific time-restricted subdistribution hazard ratios (SHR) were calculated to investigate the association between non-O blood type and VTE over time. One thousand, seven hundred and eight patients were included in the analysis (median follow-up time: 24 months; interquartile range: 10-24), and 151 patients developed VTE (8.8%). During the first 3 months of follow-up, there was no association between non-O blood type and VTE risk (SHR: 1.00; 95% confidence interval [CI]: 0.60-1.67). Thereafter, non-O blood type was associated with a higher VTE risk (SHR: 1.79; 95% CI: 1.12-2.85). Furthermore, non-O blood type was associated with increased VTE risk in patients with intermediate and low thrombotic risk tumor types (SHR: 1.73; 95% CI: 1.09-2.73) but not in very high-risk types (pancreatic, gastroesophageal, and brain cancer; SHR: 0.94; 95% CI: 0.55-1.61). This association was weakened after adjustment for factor VIII. Non-O blood type is a time-dependent predictor of VTE in patients with cancer. It is associated with increased VTE risk beyond 3 months of follow-up and in patients with intermediate- and low-risk tumor types.
A systematic review and functional bioinformatics analysis of genes associated with Crohn’s disease identify more than 120 related genes
Authors: Garza-Hernandez Debora , Sepulveda-Villegas Maricruz , Garcia-Pelaez Jose , Aguirre-Gamboa Raul , Lakatos Peter L. , Estrada Karol , Martinez-Vazquez Manuel , Trevino Victor 
Published: April 2022

AbstractBackgroundCrohn’s disease is one of the two categories of inflammatory bowel diseases that affect the gastrointestinal tract. The heritability estimate has been reported to be 0.75. Several genes linked to Crohn’s disease risk have been identified using a plethora of strategies such as linkage-based studies, candidate gene association studies, and lately through genome-wide association studies (GWAS). Nevertheless, to our knowledge, a compendium of all the genes that have been associated with CD is lacking.MethodsWe conducted functional analyses of a gene set generated from a systematic review where genes potentially related to CD found in the literature were analyzed and classified depending on the genetic evidence reported and putative biological function. For this, we retrieved and analyzed 2496 abstracts comprising 1067 human genes plus 22 publications regarding 133 genes from GWAS Catalog. Then, each gene was curated and categorized according to the type of evidence associated with Crohn’s disease.ResultsWe identified 126 genes associated with Crohn’s disease risk by specific experiments. Additionally, 71 genes were recognized associated through GWAS alone, 18 to treatment response, 41 to disease complications, and 81 to related diseases. Bioinformatic analysis of the 126 genes supports their importance in Crohn’s disease and highlights genes associated with specific aspects such as symptoms, drugs, and comorbidities. Importantly, most genes were not included in commercial genetic panels suggesting that Crohn’s disease is genetically underdiagnosed.ConclusionsWe identified a total of 126 genes from PubMed and 71 from GWAS that showed evidence of association to diagnosis, 18 to treatment response, and 41 to disease complications in Crohn’s disease. This prioritized gene catalog can be explored athttp://victortrevino.bioinformatics.mx/CrohnDisease.
Identification and comparative analysis of long non-coding RNAs in the brain of fire ant queens in two different reproductive states
Authors: Tsai Cheng-Hung , Lin Tzu-Chieh , Chang Yi-Hsien , Tsai Huai-Kuang , Huang Jia-Hsin 
Published: April 2022

Abstract
Background
Many long non-coding RNAs (lncRNAs) have been extensively identified in higher eukaryotic species. The function of lncRNAs has been reported to play important roles in diverse biological processes, including developmental regulation and behavioral plasticity. However, there are no reports of systematic characterization of long non-coding RNAs in the fire ant Solenopsis invicta.

Results
In this study, we performed a genome-wide analysis of lncRNAs in the brains of S. invicta from RNA-seq. In total, 1,393 novel lncRNA transcripts were identified in the fire ant. In contrast to the annotated lncRNA transcripts having at least two exons, novel lncRNAs are monoexonic transcripts with a shorter length. Besides, the transcriptome from virgin alate and dealate mated queens were analyzed and compared. The results showed 295 differentially expressed mRNA genes (DEGs) and 65 differentially expressed lncRNA genes (DELs) between virgin and mated queens, of which 17 lncRNAs were highly expressed in the virgin alates and 47 lncRNAs were highly expressed in the mated dealates. By identifying the DEL:DEG pairs with a high association in their expression (Spearman’s |rho|> 0.8 and p-value < 0.01), many DELs were co-regulated with DEGs after mating. Furthermore, several remarkable lncRNAs (MSTRG.6523, MSTRG.588, and nc909) that were found to associate with particular coding genes may play important roles in the regulation of brain gene expression in reproductive transition in fire ants.

Conclusion
This study provides the first genome-wide identification of S. invicta lncRNAs in the brains in different reproductive states. It will contribute to a fuller understanding of the transcriptional regulation underpinning reproductive changes.
Mind the gap: covariate constrained randomisation can protect against substantial power loss in parallel cluster randomised trials
Authors: Kristunas Caroline , Grayling Michael , Gray Laura J. , Hemming Karla 
Published: April 2022

Abstract
Background
Cluster randomised trials often randomise a small number of units, putting them at risk of poor balance of covariates across treatment arms. Covariate constrained randomisation aims to reduce this risk by removing the worst balanced allocations from consideration. This is known to provide only a small gain in power over that averaged under simple randomisation and is likely influenced by the number and prognostic effect of the covariates.
We investigated the performance of covariate constrained randomisation in comparison to the worst balanced allocations, and considered the impact on the power of the prognostic effect and number of covariates adjusted for in the analysis.

Methods
Using simulation, we examined the Monte Carlo type I error rate and power of cross-sectional, two-arm parallel cluster-randomised trials with a continuous outcome and four binary cluster-level covariates, using either simple or covariate constrained randomisation. Data were analysed using a small sample corrected linear mixed-effects model, adjusted for some or all of the binary covariates. We varied the number of clusters, intra-cluster correlation, number and prognostic effect of covariates balanced in the randomisation and adjusted in the analysis, and the size of the candidate set from which the allocation was selected. For each scenario, 20,000 simulations were conducted.

Results
When compared to the worst balanced allocations, covariate constrained randomisation with an adjusted analysis provided gains in power of up to 20 percentage points. Even with analysis-based adjustment for those covariates balanced in the randomisation, the type I error rate was not maintained when the intracluster correlation is very small (0.001). Generally, greater power was achieved when more prognostic covariates are restricted in the randomisation and as the size of the candidate set decreases. However, adjustment for weakly prognostic covariates lead to a loss in power of up to 20 percentage points.

Conclusions
When compared to the worst balanced allocations, covariate constrained randomisation provides moderate to substantial improvements in power. However, the prognostic effect of the covariates should be carefully considered when selecting them for inclusion in the randomisation.
Development and evaluation of a novel fast broad-range PCR and sequencing assay (FBR-PCR/S) using dual priming oligonucleotides targeting the ITS/LSU gene regions for rapid diagnosis of invasive fungal diseases: multi-year experience in a large Canadian healthcare zone
Authors: Chow B. , Groeschel M. , Carson J. , Griener T. , Church D. L. 
Published: April 2022

AbstractBackgroundThis study evaluated the performance of a novel fast broad range PCR and sequencing (FBR-PCR/S) assay for the improved diagnosis of invasive fungal disease (IFD) in high-risk patients in a large Canadian healthcare region.MethodsA total of 114 clinical specimens (CS) including bronchoalveolar lavages (BALs) were prospectively tested from 107 patients over a 2-year period. Contrived BALs (n = 33) inoculated with known fungi pathogens were also tested to increase diversity. Patient characteristics, fungal stain and culture results were collected from the laboratory information system. Dual-priming oligonucleotide (DPO) primers targeted to the internal transcribed spacer (ITS) (~ 350 bp) and large subunit (LSU) (~ 550 bp) gene regions were used to perform FBR-PCR/S assays on extracted BALs/CS. The performance of the molecular test was evaluated against standard microbiological methods and clinical review for the presence of IFD.ResultsThe 107 patients were predominantly male (67, 62.6%) with a mean age of 59 years (range = 0–85 years): 74 (69.2%) patients had at least one underlying comorbidity: 19 (34.5%) had confirmed and 12 (21.8%) had probable IFD. Culture recovered 66 fungal isolates from 55 BALs/CS withCandidaspp. andAspergillusspp. being most common. For BALs, the molecular assay vs. standard methods had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), and efficiency of 88.5% vs.100%, 100% vs. 61.1%, 100% vs. 88.5%, 61.1% vs. 100%, and 90.2% for both. For other CS, the molecular assay had similar performance to standard methods with sensitivity, specificity, PPV, NPV and efficiency of 66.7%, 87.0%, 66.7%, 87.0% and 81.3% for both methods. Both methods also performed similarly, regardless of whether CS stain/microscopy showed yeast/fungal elements. FBR-PCR/S assays results were reported in ~ 8 h compared to fungal cultures that took between 4 and 6 weeks.ConclusionsRapid molecular testing compared to standard methods have equivalent diagnostic efficiency but improves clinical utility by reporting a rapid species-level identification the same dayshift (~ 8 h).
Clinical impact of a metagenomic microbial plasma cell-free DNA next-generation sequencing assay on treatment decisions: a single-center retrospective study
Authors: Shishido Akira A. , Noe Myint , Saharia Kapil , Luethy Paul 
Published: April 2022

Abstract
Background
Metagenomic next-generation sequencing of microbial cell-free DNA (mcfDNA) allows for non-invasive pathogen detection from plasma. However, there is little data describing the optimal role for this assay in real-world clinical decision making.

Methods
We performed a single-center retrospective cohort study of adult patients for whom a mcfDNA (Karius©) test was sent between May 2019 and February 2021. Clinical impact was arbitrated after review and discussion of each case.

Results
A total of 80 patients were included. The most common reason for sending the assay was unknown microbiologic diagnosis (78%), followed by avoiding invasive procedures (14%). The test had a positive impact in 34 (43%), a negative impact in 2 (3%), and uncertain or no impact in 44 (55%). A positive impact was observed in solid organ transplant recipients (SOTR, 71.4%, p = 0.003), sepsis (71.4%, p = 0.003), and those receiving antimicrobial agents for less than 7 days prior to mcfDNA testing (i.e., 61.8%, p = 0.004). Positive impact was driven primarily by de-escalation of antimicrobial therapy.

Conclusion
Clinical impact of mcfDNA testing was highest in SOTR, patients with sepsis and patients who had been on antimicrobial therapy for less than 7 days. Positive impact was driven by de-escalation of antimicrobial therapy which may highlight a potential role for mcfDNA in the realm of stewardship.
Transfer learning for medical image classification: a literature review
Authors: Kim Hee E. , Cosa-Linan Alejandro , Santhanam Nandhini , Jannesari Mahboubeh , Maros Mate E. , Ganslandt Thomas 
Published: April 2022

AbstractBackgroundTransfer learning (TL) with convolutional neural networks aims to improve performances on a new task by leveraging the knowledge of similar tasks learned in advance. It has made a major contribution to medical image analysis as it overcomes the data scarcity problem as well as it saves time and hardware resources. However, transfer learning has been arbitrarily configured in the majority of studies. This review paper attempts to provide guidance for selecting a model and TL approaches for the medical image classification task.Methods425 peer-reviewed articles were retrieved from two databases, PubMed and Web of Science, published in English, up until December 31, 2020. Articles were assessed by two independent reviewers, with the aid of a third reviewer in the case of discrepancies. We followed the PRISMA guidelines for the paper selection and 121 studies were regarded as eligible for the scope of this review. We investigated articles focused on selecting backbone models and TL approaches including feature extractor, feature extractor hybrid, fine-tuning and fine-tuning from scratch.ResultsThe majority of studies (n = 57) empirically evaluated multiple models followed by deep models (n = 33) and shallow (n = 24) models. Inception, one of the deep models, was the most employed in literature (n = 26). With respect to the TL, the majority of studies (n = 46) empirically benchmarked multiple approaches to identify the optimal configuration. The rest of the studies applied only a single approach for which feature extractor (n = 38) and fine-tuning from scratch (n = 27) were the two most favored approaches. Only a few studies applied feature extractor hybrid (n = 7) and fine-tuning (n = 3) with pretrained models.ConclusionThe investigated studies demonstrated the efficacy of transfer learning despite the data scarcity. We encourage data scientists and practitioners to use deep models (e.g. ResNet or Inception) as feature extractors, which can save computational costs and time without degrading the predictive power.