bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community networks of sport and physical activity promotion: an analysis of structural properties and conditions of cooperation
Authors: Wolbring Laura , Schmidt Steffen Christian Ekkehard , Niessner Claudia , Woll Alexander , Wäsche Hagen 
Published: October 2022

AbstractBackground:The importance of intersectoral cooperation networks among community organizations located in people’s immediate environments in addressing population health problems such as physical inactivity has come into focus in recent years. To date, there is limited evidence on how and why such networks emerge. Therefore, the aims of this study were (a) to analyze thestructural propertiesand (b) to identify theconditions of cooperationin interorganizational community networks of sport and physical activity promotion.Methods:Survey data on cooperative relationships and organizational attributes of sports and physical activity providers as well as sports administrating organizations in two community networks located in urban districts in southern Germany were collected (Network I: n = 133 organizations; Network II: n = 50 organizations). Two quantitative descriptive procedures – network analysis and stochastic analyses of network modeling (exponential random graphs) – were applied.Results:Similar structures and conditions of cooperation were found in the networks (e.g. low density, centralization). The community sports administrations had the most central positions in both networks. Exponential random graph modeling showed that cooperation took place more frequently in triangular structures (closure effect) and revolved around a few central actors (preferential attachment effect). Organizations from different sectors cooperated more often than organizations from the same sector (heterophily effect).Conclusion:The study provided valid and robust findings on significant mechanisms and conditions of interorganizational cooperation in community networks focused on sport and physical activity promotion. Based on the results, implications for the development and most efficient governance of these networks can be derived.
A novel surgical technique in transforaminal lumbar interbody fusion by the bone graft delivery device: evaluation of therapeutic effect in patients with minimally invasive spine surgery
Authors: Yang Kai-shun , Chen Chih-Wei , Yau Ru-Bin , Liang Huang-Chien , Ko Ching-Chung , Kuo Jinn-Rung , Chio Chung-Ching , Lim Sher-Wei 
Published: October 2022

Abstract
Background
Transforaminal Lumbar Interbody Fusion (TLIF) is commonly associated with higher complications and longer operative time. This study aims to evaluate the effectiveness, safety, and usability of a novel minimally invasive surgery (MIS) bone graft delivery device.

Methods
73 consecutive patients with lumbar spondylosis, degenerative disc disease, spondylolisthesis, scoliosis or trauma were enrolled in this randomized controlled trial. Group 1 comprised 39 patients treated with the novel MIS bone graft delivery device. Group 2 consisted of 34 patients treated with the conventional system. The primary objective of the study was the assessment of the amount of bone graft delivery using the device. The secondary objectives were the effect of the device on operative time, pain relief, disability improvement, and bone fusion grade.

Results
Bone delivery amount was significantly higher in the MIS device group (6.7 ± 2.9 mL) compared to the conventional group (2.3 ± 0.5 mL), p < 0.001. Regarding the operation time, the MIS device group was associated significantly lower duration than the conventional group (p < 0.001). After a 3-month follow-up, 39.5% of the patients in the MIS device group and 3.5% of the patients in the conventional group were observed to achieve grade I fusion (complete fusion). There was a significant difference in fusion success rates (p < 0.01).

Conclusion
The novel MIS bone graft delivery device was associated with successful bone delivery. Our MIS device provides promising modality with less operative time and higher bone fusion rates than conventional modalities.
Trial Registration This trial was retrospectively registered on ClinicalTrials.gov (Registration date: 11/19/2021; Registration number: NCT05190055).
Type 2 diabetes remission after Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one anastomosis gastric bypass (OAGB): results of the longitudinal assessment of bariatric surgery study
Authors: Moradi Marziyeh , Kabir Ali , Khalili Davood , Lakeh Maziar Moradi , Dodaran Masoud Solaymani , Pazouki Abdolreza , Kermansaravi Mohammad , Alibeigi Peyman , Moazenzadeh Hashem , Abdolhosseini Mohammad Reza , Eghbali Foolad , Baradaran Hamid Reza 
Published: October 2022

Abstract
Background
Several studies on various bariatric surgeries involving patients with type 2 diabetes mellitus (T2DM) showed an overall rate of remission of hyperglycemia. However, there is little known about predictive factors on remission after different types of surgeries. The aim of this study was to identify the T2DM remission rate and to determine the effects of preoperative factors characteristics of remission of type 2 diabetes in Iran.

Methods
We conducted a retrospective analysis of 1351 patients with T2DM operated by three different types of surgeries (Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and One Anastomosis Gastric Bypass (OAGB)). Diabetes remission was defined according to the American Diabetes Association (ADA) criteria. Binary logistic regression analyses were employed.

Results
A total of 1351 patients, 675 patients (50.0%) undergoing OAGB, 475 (35.2%) RYGB, and 201 (14.9%) SG. 80.6%, 84.2% of OAGB, 81.7%, 82.6% of RYGB, and 77.1%, 81.5% of SG participants were in T2DM remission after 1 and 3 years, respectively. 1- and 3-year remission were associated with preoperative age, duration of T2DM, FBS and HbA1c, BMI, insulin therapy, and a family history of obesity (p < 0.05).

Conclusion
The remission of T2DM after RYGB, SG, and OAGB surgery is dependent on various preoperative factors. Patients with younger age, shorter duration of T2DM, lower preoperative HbA1c and FBS, higher BMI, who were not on insulin therapy, and not having a family history of obesity were the best candidates to achieve a prolonged diabetes remission.
Association between triglyceride–glucose index and nonalcoholic fatty liver disease in type 2 diabetes mellitus
Authors: Li Wei , Wang Yan , He Feng , Liu Zhuo , Dong Jie , Zhang Yuqi , Li Tianfang , Liu Shengyun , Chen En 
Published: October 2022

Abstract
Background
Lipid and glucose metabolism abnormalities are associated with nonalcoholic fatty liver disease (NAFLD). The triglyceride–glucose (TyG) index is a recently developed indicator that can identify individuals at risk for NAFLD. However, the applicability of the TyG index for identifying NAFLD in patients with type 2 diabetes mellitus (T2DM) is unclear. The aim of this study was to investigate the ability of the TyG index to identify individuals at risk for NAFLD in the T2DM population.

Methods
A total of 2280 participants with T2DM were recruited in this cross-sectional study. The TyG index was calculated, and NAFLD was diagnosed by ultrasonography. Binary logistic regression models were used to evaluate the association of the TyG index, glycemic parameters and lipid parameters with NAFLD.

Results
Logistic regression analysis showed that the TyG index was significantly associated with NAFLD in subjects with T2DM, the odds ratio (OR) were 3.27 (95% confidence interval [CI], 2.03–5.27; P < 0.001) for NAFLD in the highest TyG quartile after adjustment for known confounders. In stratified analysis, an elevated TyG index were more remarkably associated with NAFLD in younger patients (< 65 years; OR, 2.35; 95% CI, 1.83–3.02; P < 0.001), females (OR, 2.69; 95% CI, 1.67–4.32; P < 0.001), patients with BMI < 25 kg/m2 (OR, 2.80; 95% CI, 2.01–3.91; P < 0.0001), and with lower high-density lipoprotein cholesterol (< 1 mmol/L; OR, 2.76; 95% CI, 1.98–3.83; P < 0.001).

Conclusion
The TyG index is significantly associated with NAFLD and shows superior ability for identify NAFLD risk compared with other lipid and glycemic parameters in T2DM.
The oncological and obstetric results of radical trachelectomy as a fertility-sparing therapy in early-stage cervical cancer patients
Authors: Chen Tao , Li Jia , Zhu Yan , Lu An-Wei , Zhou Li , Wang Jian-San , Zhang Ying , Wang Jun-Tao 
Published: October 2022

Abstract
Purpose
This study explored the oncological and obstetric results of radical trachelectomy (RT) in early-stage cervical cancer patients.

Methods
A retrospective analysis was conducted the oncological and obstetric results of 23 patients with early cervical cancer (stages IA2–IB3; International Federation of Gynecology and Obstetrics, 2018) who underwent RT in The Maternal and Child Health Care Hospital of Guiyang, China, from October 2004 to September 2018.

Results
23 patients had cervical tumors of the squamous cell carcinoma histological type. All 23 patients retained reproductive function. The mean follow-up time was 112.87 ± 55.75 (36–199) months. The median tumor size was 2.00 ± 1.35 cm (imperceptible to the eyes 5.00 cm). No recurrence was observed in any of the patient cases. Among the patients with a tumor size > 4 cm (up to 5 cm), three patients who wished to preserve fertility accepted RT following neoadjuvant chemotherapy The pregnancy outcomes were as follows: 8 cases (47.06%) out of 17 cases who attempting pregnancy conceived 12 times.First-trimester abortion and the voluntary abandonment of pregnancy occurred in 4 cases (33.33%), respectively, one patient performed deliberate termination at 24 weeks of gestation. Second-trimester abortion occurred in three cases (25.0%) for chorioamnionitis. Premature delivery at 32 weeks occurred in one case (8.33%).

Conclusion
Radical trachelectomy is a safe and effective treatment for women with early-stage cervical cancer preserving fertility biology. Patients with a cervical tumor sized > 4 cm can be pregnant after neoadjuvant chemotherapy and RT. Accordingly, this treatment is worthy of further exploration.
Enriching operating room based student learning experience: exploration of factors and development of curricular guidelines
Authors: Waseem Talat , Baig Hadia Munir , Yasmeen Rahila , Khan Rehan Ahmad 
Published: October 2022

AbstractBackgroundOperating Room (OR) is a high-pressure setting where multiple complex surgical, educational, and administrative facets interplay. Contrary to resident training, the dynamics of undergraduate medical students’ learning process is highly demanding, opportunistic, unstandardized, and suboptimal owing to many reasons. Upon reviewing the existing published literature regarding the medical students’ experience in the OR setting, it was clear that this field is still to date, unstructured, and ambiguous, with many grey areas that need to be worked on. To achieve an optimized and enhanced theatre experience, it is of immense importance to recognize the recurrent themes affecting medical students within this setting and deduce ways to overcome these challenges. This study explores and prioritizes factors influencing OR-based student learning quality and develops guidelines for structured clinical encounters within the OR setting.MethodsThe study involved an extensive literature review and thematic analysis to generate themes and subthemes, which were subjected to a modified Delphi technique where students and teachers participated to identify, debate, and produce a consensus on the relative value of these factors. Finally, expert-validated guidelines were developed for OR curricular designs.ResultsOperating theater-based student learning is multifactorial. Structured learning through optimized course planning, content selection, assessment, and administration are decisive in determining the quality of OR learning experience. The teacher’s interest, attitude, and students’ desire and preparedness to learn play a central role in OR-based student learning, suggesting an enhanced need for adequate faculty training. Similarly, emotional, socio-environmental, and organizational factors can influence students’ learning in a significant way. A new model for undergraduate student learning in OR has been proposed based on these factors and the stakeholders’ interplay. In this model, the teacher’s role is responsible despite OR learning being student- led. Guidelines for the OR curricular designs have been developed.ConclusionStructured learning process within the OR setting can lead to optimized lesson planning, content selection, assessment, and administration for a more meaningful and enriched OR learning experience.
Methods of teaching evidence-based practice: a systematic review
Authors: Howard Bethany , Diug Basia , Ilic Dragan 
Published: October 2022

AbstractBackgroundTo identify the effectiveness of different teaching modalities on student evidence-based practice (EBP) competency.MethodsElectronic searches were conducted in MEDLINE, Cochrane central register of controlled trials, PsycINFO, CINAHL, ERIC, A + Education and AEI through to November 2021. We included randomised-controlled trials comparing EBP teaching modes on EBP knowledge, skills, attitudes or behaviour in undergraduate and post-graduate health professions education. Risk of bias was determined using the Cochrane risk of bias tool.ResultsTwenty-one studies were included in the review. Overall, no single teaching modality was identified as being superior to others at significantly increasing learner competency in EBP. Changes in learner knowledge, skills, attitudes and behaviour were conflicting, with studies either reporting no change, or a moderate increase in EBP behavioural outcomes when directly compared to another intervention.ConclusionCurrent evidence highlights the lack of a single teaching modality that is superior than others regarding learner competency in EBP, regardless of health professions discipline or graduate status. The poor quality, heterogeneity of interventions and outcome measures limited conclusions. Further research should focus on the development of high-quality studies and use of psychometrically validated tools to further explore the impact of different EBP teaching modalities.
Clinical nursing education during the COVID-19 pandemic: perspectives of students and clinical educators
Authors: Kaveh Omolhoda , Charati Fahimeh Ghasemi , Kamali Mahsa , Mojarrad Fereshteh Araghian 
Published: October 2022

Abstract
Background
The outbreak of the COVID-19 pandemic has thus far disrupted clinical nursing education (CNE) around the world and in Iran; which has encountered numerous challenges to this point for students and clinical educators. Therefore, this qualitative study was conducted to identify the perspectives of nursing students and clinical educators during the COVID-19 pandemic.

Methods
In this qualitative descriptive study, 15 participants, including nursing students and clinical educators, were selected through the purposive sampling method. The data were collected from March to September 2021 in nursing school through in-depth semi-structured interviews, and then analyzed based on the Graneheim and Lundman method.

Results
Two main themes, “CNE in the shadows of threats and opportunities” and “CNE recovery” and five themes (Injured CNE, CNE under fear, Lessons from the COVID-19 crisis, Providing optimal CNE by eradicating COVID-19, and Adapting CNE to existing conditions) were extracted from the data analysis.

Conclusions
The results of this qualitative study demonstrated that the COVID-19 pandemic had led the participants to experience new conditions, also referred to as “combined threats and opportunities”. Based on this, nursing managers and planners are advised to take great steps towards the development and improvement of CNE by considering and applying these results in their plans to overcome the challenge of CNE with effective and useful actions in the COVID-19 pandemic.
Prevalence and factors associated with burnout among nurses in Jeddah: a single-institution cross-sectional study
Authors: Qedair Jumanah T. , Balubaid Renad , Almadani Raghad , Ezzi Suzana , Qumosani Tarteel , Zahid Rania , Alfayea Turki 
Published: October 2022

Abstract
Background
Health care workers, especially nurses, experience significantly elevated levels of emotional and social stressors in the work environment. Therefore, nurses develop high levels of burnout as the stress persists for prolonged periods. The main purpose of this paper is to measure burnout levels amongst nurses and find a relation between burnout levels and demographic factors.

Methods
This descriptive cross-sectional study was held from the 23rd of May till the 6th of September 2021 in King Abdulaziz Medical City of National Guard Health Affairs (KAMC-JD) in Jeddah. Data had been collected voluntarily from the nurses through electronic surveys that included demographic data and the Maslach Burnout Inventory (MBI) that measures three dimensions of burnout which are emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). The association between demographic variables and burnout had been studied using the Fisher Exact test and binary logistic regression.

Results
Out of the 1300 nurses working in KAMC-JD, 250 completed the survey. Burnout had been detected in 112 nurses (44.8%). Out of the 250 nurses, 26.4% were found to be at a high risk of burnout, which means they have high or moderate scores of EE and DP, with low ones in PA. The majority of the participants had high burnout levels in each of burnout components, and 99.6% of them scored high in at least one of the three dimensions. Level of burnout was significantly correlated to certain demographic factors which were the nationality (p-value = 0.01) and working unit (p-value = 0.02). On the other hand, there was no significant association between burnout and age, gender, or marital status.

Conclusion
This study proves that a high percentage of nurses fell victims to burnout with a strong association between certain demographic data namely nationality as well as working unit and burnout levels. Taking into consideration the negative impact of burnout on both nurses and patients, conducting more studies about burnout among nurses, its effect on them, and the risk factors behind it is needed. Early treatment and management are also recommended to avoid the undesirable outcomes.
The pathogenesis of coronavirus-19 disease
Authors: Borczuk Alain C. , Yantiss Rhonda K. 
Published: October 2022

AbstractSevere acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) is the causal agent of coronavirus disease-2019 (COVID-19), a systemic illness characterized by variably severe pulmonary symptoms, cardiac conduction abnormalities, diarrhea, and gastrointestinal bleeding, as well as neurologic deficits, renal insufficiency, myalgias, endocrine abnormalities, and other perturbations that reflect widespread microvascular injury and a pro-inflammatory state. The mechanisms underlying the various manifestations of viral infection are incompletely understood but most data suggest that severe COVID-19 results from virus-driven perturbations in the immune system and resultant tissue injury. Aberrant interferon-related responses lead to alterations in cytokine elaboration that deplete resident immune cells while simultaneously recruiting hyperactive macrophages and functionally altered neutrophils, thereby tipping the balance from adaptive immunity to innate immunity. Disproportionate activation of these macrophages and neutrophils further depletes normal activity of B-cells, T-cells, and natural killer (NK) cells. In addition, this pro-inflammatory state stimulates uncontrolled complement activation and development of neutrophil extracellular traps (NETS), both of which promote the coagulation cascade and induce a state of “thrombo-inflammation”. These perturbations have similar manifestations in multiple organ systems, which frequently show pathologic findings related to microvascular injury and thrombosis of large and small vessels. However, the pulmonary findings in patients with severe COVID-19 are generally more pronounced than those of other organs. Not only do they feature inflammatory thromboses and endothelial injury, but much of the parenchymal damage stems from failed maturation of alveolar pneumocytes, interactions between type 2 pneumocytes and non-resident macrophages, and a greater degree of NET formation. The purpose of this review is to discuss the pathogenesis underlying organ damage that can occur in patients with SARS-CoV-2 infection. Understanding these mechanisms of injury is important to development of future therapies for patients with COVID-19, many of which will likely target specific components of the immune system, particularly NET induction, pro-inflammatory cytokines, and subpopulations of immune cells.
Engineering of global transcription factor FruR to redirect the carbon flow in Escherichia coli for enhancing l-phenylalanine biosynthesis
Authors: Chen Minliang , Liang Hengyu , Han Chao , Zhou Peng , Xing Zhiwei , Chen Qianqian , Liu Yongyu , Xie Gou-an , Xie Rufei 
Published: October 2022

Abstract
Background
The catabolite repressor/activator protein (FruR) is a global regulatory protein known to control the expression of several genes concerned with carbon utilization and energy metabolism. This study aimed to illustrate effects of the FruR mutant on the L-phenylalanine (L-PHE) producing strain PHE01.

Results
Random mutagenesis libraries of fruR generated in vitro were first integrated into the chromosome of PHE01 by CRISPR/Cas9 technique, and then the best mutant PHE07 (FruRE173K) was obtained. With this mutant, a final L-PHE concentration of 70.50 ± 1.02 g/L was achieved, which was 23.34% higher than that of PHE01. To better understand the mechanism, both transcriptomes and metabolomes of PHE07 were carried out and compared to that of PHE01. Specifically, the transcript levels of genes involved in gluconeogenesis pathway, pentose phosphate pathway, Krebs cycle, and glyoxylate shunt were up-regulated in the FruRE173K mutant, whereas genes aceEF, acnB, and icd were down-regulated. From the metabolite level, the FruRE173K mutation led to an accumulation of pentose phosphate pathway and Krebs cycle products, whereas the products of pyruvate metabolism pathway: acetyl-CoA and cis-aconic acid, were down-regulated. As a result of the altered metabolic flows, the utilization of carbon sources was improved and the supply of precursors (phosphoenolpyruvate and erythrose 4-phosphate) for L-PHE biosynthesis was increased, which together led to the enhanced production of L-PHE.

Conclusion
A novel strategy for L-PHE overproduction by modification of the global transcription factor FruR in E. coli was reported. Especially, these findings expand the scope of pathways affected by the fruR regulon and illustrate its importance as a global regulator in L-PHE production.