bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting nursing students’ intention to use a 3D game to learn field triage skills: a structural equation modelling analysis
Authors: Chow Meyrick C. M. , Hung Maria S. Y. , Chu JoJo W. K. , Lam Stanley K. K. 
Published: February 2022

Abstract
Background
As mass casualty incidents are low-probability events, students often do not have the chance to practise field triage skills during their clinical placement. This study used a 3D game to engage participants in experiential learning in a realistic virtual environment. The purpose of the study was to explore factors affecting nursing students’ intention to use a 3D game to learn field triage skills.

Methods
This was a cross-sectional survey study. The technology acceptance model augmented by computer self-efficacy was used as a research model and a questionnaire was used to evaluate students’ intention to use the 3D game to learn field triage. Data was collected from nursing students of a degree-awarding higher education institution in Hong Kong.

Results
A total of 177 valid questionnaires were returned, and structural equation modeling was used to test the research model and hypotheses. Consistent with the technology acceptance model, perceived usefulness (0.21, p < 0.05) and perceived ease of use (0.91, p < 0.001) had a positive effect on the behavioral intention to use the 3D game. Computer self-efficacy positively influenced both perceived usefulness (0.66, p < 0.001) and perceived ease of use (0.73, p < 0.001). The research model explained 42 percent of the variance in the behavioral intention to use the 3D game.

Conclusion
Students believed that using the 3D game would enhance their field triage skills and found the game easy to use. Using 3D games to facilitate learning is a worthwhile educational approach for preparing healthcare professionals to handle low-probability clinical tasks, such as field triage in mass casualty incidents. Insights provided by findings of this study included the best way to design and promote interactive education programmes in a virtual environment.
Heart rate variability is associated with left ventricular systolic, diastolic function and incident heart failure in the general population
Authors: Arshi Banafsheh , Geurts Sven , Tilly Martijn J. , van den Berg Marten , Kors Jan A. , Rizopoulos Dimitris , Ikram M. Arfan , Kavousi Maryam 
Published: February 2022

Abstract
Background
HRV has mostly shown associations with systolic dysfunction and more recently, with diastolic dysfunction in Heart failure (HF) patients. But the role of sympathetic nervous system in changes of left ventricular (LV) systolic and diastolic function and new-onset HF has not been extensively studied.

Methods
Among 3157 men and 4405 women free of HF and atrial fibrillation retrospectively included from the population-based Rotterdam Study, we used linear mixed models to examine associations of RR-interval differences and standard deviation of RR-intervals corrected for heart rate (RMSSDc and SDNNc) with longitudinal changes of LV ejection fraction (LVEF), E/A ratio, left atrial (LA) diameter, E/e’ ratio. Afterwards, using cox regressions, we examined their association with new-onset HF.

Results
Mean (SD) age was 65 (9.95) in men and 65.7 (10.2) in women. Every unit increase in log RMSSDc was accompanied by 0.75% (95%CI:-1.11%;-0.39%) and 0.31% (− 0.60%;-0.01%) lower LVEF among men and women each year, respectively. Higher log RMSSDc was linked to 0.03 (− 0.04;-0.01) and 0.02 (− 0.03;-0.003) lower E/A and also − 1.76 (− 2.77;− 0.75) and − 1.18 (− 1.99;-0.38) lower LVM index in both sexes and 0.72 mm (95% CI: − 1.20;-0.25) smaller LA diameters in women. The associations with LVEF in women diminished after excluding HF cases during the first 3 years of follow-up. During a median follow-up of 8.7 years, hazard ratios (95%CI) for incident HF were 1.34 (1.08;1.65) for log RMSSDc in men and 1.15 (0.93;1.42) in women. SDNNc showed similar associations.

Conclusions
Indices of HRV were associated with worse systolic function in men but mainly with improvement in LA size in women. Higher HRV was associated with higher risk of new-onset HF in men. Our findings highlight potential sex differences in autonomic function underlying cardiac dysfunction and heart failure in the general population.
Comparison of porcine ALG and rabbit ATG on outcomes of HLA-haploidentical hematopoietic stem cell transplantation for patients with acquired aplastic anemia
Authors: Chen Juan , Zhang Yuanfeng , Chen Xin , Pang Aiming , Zhao Yuanqi , Liu Li , Ma Runzhi , Wei Jialin , He Yi , Yang Donglin , Zhang Rongli , Zhai Weihua , Ma Qiaoling , Jiang Erlie , Han Mingzhe , Zhou Jiaxi , Feng Sizhou 
Published: February 2022

Abstract
Objective
To evaluate the efficacy and safety of P-ALG (porcine anti-lymphocyte globulin) and R-ATG (rabbit anti-thymocyte globulin) in the conditioning regime for patients with acquired aplastic anemia who underwent HLA-haploidentical hematopoietic stem cell transplantation (halpo-HSCT).

Methods
A total of 91 patients with acquired aplastic anemia who received haplo-HSCT at our center between January 2014 and December 2020 were retrospectively reviewed. Twenty-eight patients were in the P-ALG group while sixty-three patients were in the R-ATG group.

Results
The median time was 11 versus 13 days (P = 0.294) for myeloid engraftment and 12.5 versus 15 days (P = 0.465) for platelet engraftment in the P-ALG and R-ATG groups, respectively. There were no significant difference in 5-year overall survival (74.83% ± 8.24% vs 72.29% ± 6.26%, P = 0.830), GVHD-free, failure-free survival (71.05% ± 8.65% vs 62.71% ± 6.22%, P = 0.662), failure-free survival (74.83% ± 8.24% vs 66.09% ± 5.84%, P = 0.647) and transplantation-related mortality (25.17% ± 8.24% vs 26.29% ± 6.22%, P = 0.708) between the two groups. The incidence of aGVHD (acute graft versus host disease) (65.39% ± 9.33% vs 62.71% ± 6.30%, P = 0.653), II–IV aGVHD (38.46% ± 9.54% vs 35.64% ± 6.24%, P = 0.695), III–IV aGVHD (19.23% ± 7.73% vs 10.53% ± 4.07%, P = 0.291), cGVHD (chronic graft versus host disease) (22.22% ± 12.25% vs 22.31% ± 6.30%, P = 0.915), and moderate to severe cGVHD (5.56% ± 5.40% vs 9.28% ± 4.46%, P = 0.993) were not significantly different. Similar outcomes were observed between the P-ALG and R-ATG groups for severe bacterial infection (17.9% vs 25.4%, P = 0.431), invasive fungal diseases (3.6% vs 9.5%, P = 0.577) and graft rejection (0% vs 9.5%, P = 0.218). However, the incidence of cytomegalovirus infection and Epstein-Barr virus infection was significantly lower in the P-ALG group (46.4% vs 71.4%, P = 0.022; 3.6% vs 25.4%, P = 0.014).

Conclusion
The efficacy and safety of P-ALG were similar with R-ATG in the setting of haplo-HSCT for patients with acquired aplastic anemia patients. P-ALG could be an alternative for R-ATG.
Black phosphorus-Au-thiosugar nanosheets mediated photothermal induced anti-tumor effect enhancement by promoting infiltration of NK cells in hepatocellular carcinoma
Authors: Jia Changchang , Zhang Fan , Lin Jiamei , Feng Liwen , Wang Tiantian , Feng Yuan , Yuan Feng , Mai Yang , Zeng Xiaowei , Zhang Qi 
Published: February 2022

Abstract
Background
Hepatocellular carcinoma (HCC) is a heterogeneous cancer required combination therapy, such as photothermal therapy and chemotherapy. In recent years, cancer immunotherapies are rapidly evolving and are some of the most promising avenues to approach malignancies. Thus, the combination of the traditional therapies and immunotherapy in one platform may improve the efficacy for HCC treatment.

Results
In this work, we have prepared a black phosphorus (BP)-Au-thiosugar nanosheets (BATNS), in which Au-thiosugar coating and functionalization improved the stability of both black phosphorus nanosheets (BPNS) and gold ions in different simulated physiological environments. The compression of the BATNS band gap can convert more photon energy to heat generation compared with BPNS, resulting in higher photothermal conversion efficiency. The in vitro and in vivo results also revealed a stronger reduction on the hepatocellular carcinoma of mice and prolonged survival of disease models compared with BPNS. More importantly, BATNS showed an additional immune effect by increasing local NK cell infiltration but not T cell on the liver cancer treatment, and this immune effect was caused by the thermal effect of BATNS photothermal treatment.

Conclusions
The novel BATNS could improve the stability of BPNS and simultaneously combine the cancer thermotherapy and immunotherapy leaded by local NK cell infiltration, resulting in a better therapeutic efficacy on hepatocellular carcinoma. This work also provided a new path to design BP-based materials for biomedical applications.

Graphical Abstract
The value of tumor deposits in evaluating colorectal cancer survival and metastasis: a population-based retrospective cohort study
Authors: Wu Wenhao , Zeng Shun , Zhang Xianbin , Liu Peng , Qiu Tong , Li Shulin , Gong Peng 
Published: February 2022

AbstractBackgroundThe role of tumor deposits (TDs) in TNM staging of colorectal cancer is controversial, especially the relationship with distant metastasis.PurposeThis study aimed to determine the effect of TDs on the survival of colorectal cancer and the occurrence of distant metastasis and to determine whether TDs (+) patients behaved similarly to stage IV patients.MethodsA retrospective analysis of CRC patients from two large independent cohorts from the Surveillance Epidemiology and End Results (SEER) database (n= 58775) and the First Affiliated Hospital of Dalian Medical University (n= 742).ResultsUnivariate logistic analyses revealed that TDs are an independent predictor of liver metastasis [p< 0.001; odds ratio (OR): 5.738; 95% confidence interval (CI): 3.560–9.248] in the First Affiliated Hospital of Dalian Medical University’s patients. Meanwhile, TDs are also an independent predictor of isolated organ metastasis [p<0.001; odds ratio (OR): 3.028; 95% confidence interval (CI): 2.414–3.79; multiple organ metastases [p< 0.001; odds ratio (OR): 4.778; 95% confidence interval (CI): 4.109–5.556]; isolated liver metastasis [p< 0.001; odds ratio (OR): 4.395; 95% confidence interval (CI): 4.099–4.713] and isolated lung metastasis [p< 0.001; odds ratio (OR): 5.738; 95% confidence interval (CI): 3.560–9.248] in the SEER database. Multivariate analyses suggested TDs are an independent poor prognostic factor for distant metastasis (p<0.001).ConclusionsOur results have shown that compared with patients with negative TDs, CRC patients with positive TDs are more likely to develop distant metastasis. Patients categorized as T4aN2bM0 TDs (+) and T4bN2M0 TDs (+) have a similar prognosis as those with stage IV, and hence these patients should be classified as stage IV.
The barriers and facilitators of Iranian men's involvement in perinatal care: a qualitative study
Authors: Hajian Sepideh , Mehran Nahid , Simbar Masoumeh , Alavi Majd Hamid 
Published: February 2022

Abstract
Introduction
Pregnancy and childbirth are crucial events in women's lives that can be done well with the support of people around them, especially their husbands. However, a number of factors can reduce or increase the supportive role of spouses during this period. The aim of the present study was to explore the barriers and facilitators of Iranian men's involvement in perinatal care.

Materials and methods
This was a qualitative phenomenological study that sampling of respondents (pregnant women or the women who have recently given birth (one week to six months after childbirth), spouses, policy makers and midwifery service providers) was done through purposive sampling. The inclusion criteria included: being Iranian, the ability to understand and transfer the concepts into Persian, and employment in a midwifery center for at least one year (for service providers). Data were collected through in-depth interviews until the data saturation. The collected data were analyzed by conventional content analysis based on Graneheim and Lundman method steps. MAXQDA version 10 software was used to manage the data and Guba and Lincoln criteria were also used to ensure the trustworthiness of findings.

Results
Men's involvement in perinatal care was found to be influenced by certain incentives, particular constraints and some gender authoritarian attitudes. There were 5, 4, and 3 subcategories in incentives, constraints, and gender attitudes respectively.

Conclusion
The results revealed that men face a dual mechanism in participating in perinatal care, in which some of these factors can facilitate their participation and others can reduce it.
Pain cognitions and impact of low back pain after participation in a self-management program: a qualitative study
Authors: Joern Lise , Kongsted Alice , Thomassen Line , Hartvigsen Jan , Ravn Susanne 
Published: February 2022

Abstract
Background
Benefits from low back pain (LBP) treatments seem to be related to patients changing their pain cognitions and developing an increased sense of control. Still, little is known about how these changes occur. The objective of this study was to gain insights into possible shifts in the understanding of LBP and the sense of being able to manage pain among patients participating in a LBP self-management intervention.

Methods
Using a qualitative study and a content analytic framework, we investigated the experiences of patients with LBP who participated in ‘GLA:D® Back’, a group-based structured patient education and exercise program. Data were generated through qualitative semi-structured interviews conducted between January 2019 and October 2019. Interviews focused on experiences with pain and were analysed using a thematic analytical approach. The Common Sense Model and self-efficacy theory formed the theoretical framework for the interpretations. Participants were sampled to represent people who were either dissatisfied or satisfied with their participation in GLA:D® Back. Fifteen participants aged 26–62, eight women and seven men, were interviewed from February to April 2020.

Results
Four main themes, corresponding to the characterisation of four patient groups, were identified: ‘Feeling miscast, ‘Maintaining reservations', ‘Struggling with habits’ and ‘Handling it’. The participants within each group differed in how they understood, managed, and communicated about their LBP. Some retained the perception of LBP as a threatening disease, some expressed a changed understanding that did not translate into new behaviors, while others had changed their understanding of pain and their reaction to pain.

Conclusions
The same intervention was experienced very differently by different people dependent on how messages and communication resonated with the individual patient's experiences and prior understanding of LBP. Awareness of the ways that individuals’ understanding of LBP interact with behaviour and physical activities appear central for providing adaptive professional support and meeting the needs of individual patients.
Effects of posterior lumbar nonfusion surgery with isobar devices versus posterior lumbar interbody fusion surgery on clinical and radiological features in patients with lumbar degenerative diseases: a meta-analysis
Authors: Guan Jianbin , Liu Tao , Li Wenhao , Zhao He , Yang Kaitan , Li Chuanhong , Feng Ningning , Jiang Guozheng , Yang Yongdong , Yu Xing 
Published: February 2022

Abstract
Purpose
The aim of this study was to systematically evaluate the efficacy of posterior lumbar isobar nonfusion with isobar devices versus posterior lumbar interbody fusion (PLIF) in the treatment of patients with lumbar degenerative diseases (LDDs).

Materials and method
We performed a literature review and meta-analysis in accordance with the Cochrane methodology. The analysis included a Group Reading Assessment and Diagnostic Evaluation assessments, Jadad Quality Score evaluations, and Risk of Bias in Randomized Studies of Interventions assessments. The PubMed, Ovid, EMBASE, Web of Science, MEDLINE, CNKI, VIP and WanFang databases were searched to collect and compare relevant randomized controlled trials and cohort studies of isobar nonfusion and PLIF in the treatment of lumbar degenerative diseases. The retrieval time was from database inception to June 2021. Two evaluators independently screened the literature, extracted data, and evaluated the quality of the included studies. Outcome measures of interest included low back pain, disability, and radiological features. The protocol for this systematic review was registered on INPLASY (2021110059) and is available in full on inplasy.com (https://inplasy.com/inplasy-2021-11-0059/).

Results
Of the 7 RCTs, 394 patients met the inclusion criteria. The meta-analysis results showed that isobar nonfusion surgery shortened the surgical duration (P = 0.03), reducing intraoperative bleeding (P = 0.001), retained the ROM of surgical segment (P < 0.00001) and the ROM of the lumbar spine (P < 0.00001), and reduced the incidence of ASD (P = 0.0001). However, no significant difference in the postoperative ODI index (P = 0.81), VAS score of LBP (P = 0.59, VAS score of lower limb pain (P = 0.05, and JOA score (P = 0.27) was noted.

Conclusions
Posterior lumbar nonfusion surgery with isobar devices is superior to PLIF in shortening the surgical duration, reducing intraoperative bleeding, retaining the ROM of surgical segments and the lumbar spine to a certain extent, and preventing ASD. Given the possible publication bias, we recommend further large-scale studies.
Genomic variations and epigenomic landscape of the Medaka Inbred Kiyosu-Karlsruhe (MIKK) panel
Authors: Leger Adrien , Brettell Ian , Monahan Jack , Barton Carl , Wolf Nadeshda , Kusminski Natalja , Herder Cathrin , Aadepu Narendar , Becker Clara , Gierten Jakob , Hammouda Omar T. , Hasel Eva , Lischik Colin , Lust Katharina , Sokolova Natalia , Suzuki Risa , Tavhelidse Tinatini , Thumberger Thomas , Tsingos Erika , Watson Philip , Welz Bettina , Naruse Kiyoshi , Loosli Felix , Wittbrodt Joachim , Birney Ewan , Fitzgerald Tomas 
Published: February 2022

Abstract
Background
The teleost medaka (Oryzias latipes) is a well-established vertebrate model system, with a long history of genetic research, and multiple high-quality reference genomes available for several inbred strains. Medaka has a high tolerance to inbreeding from the wild, thus allowing one to establish inbred lines from wild founder individuals.

Results
We exploit this feature to create an inbred panel resource: the Medaka Inbred Kiyosu-Karlsruhe (MIKK) panel. This panel of 80 near-isogenic inbred lines contains a large amount of genetic variation inherited from the original wild population. We use Oxford Nanopore Technologies (ONT) long read data to further investigate the genomic and epigenomic landscapes of a subset of the MIKK panel. Nanopore sequencing allows us to identify a large variety of high-quality structural variants, and we present results and methods using a pan-genome graph representation of 12 individual medaka lines. This graph-based reference MIKK panel genome reveals novel differences between the MIKK panel lines and standard linear reference genomes. We find additional MIKK panel-specific genomic content that would be missing from linear reference alignment approaches. We are also able to identify and quantify the presence of repeat elements in each of the lines. Finally, we investigate line-specific CpG methylation and performed differential DNA methylation analysis across these 12 lines.

Conclusions
We present a detailed analysis of the MIKK panel genomes using long and short read sequence technologies, creating a MIKK panel-specific pan genome reference dataset allowing for investigation of novel variation types that would be elusive using standard approaches.
Germline specification from pluripotent stem cells
Authors: Yao Chunmeng , Yao Ruqiang , Luo Haining , Shuai Ling 
Published: February 2022

AbstractReproduction is a key event in life guaranteeing the propagation and evolution of a species. Infertility caused by abnormal germ cell development is a topic of extensive concern. Herein, in vitro germline specification studies provide a modeling platform to investigate gametogenesis. The differentiation of pluripotent stem cells (PSCs) into germ cells has been studied for more than 30 years, and there have been many astonishing breakthroughs in the last decade. Fertile sperm and oocytes can be obtained from mouse embryonic stem cells (ESCs) through a primordial germ cell (PGC)-based method. Moreover, human PGC-like cells (PGCLCs) can be derived with a similar strategy as that used for mouse PGCLC derivation. In this review, we describe the reconstitution of PGCs and the subsequent meiosis, as well as the signaling pathways and factors involved in these processes.
Dietary patterns of persons with chronic conditions within a multi-ethnic population: results from the nationwide Knowledge, Attitudes and Practices survey on diabetes in Singapore
Authors: Tan Yeow Wee Brian , Lau Jue Hua , AshaRani PV , Roystonn Kumarasan , Devi Fiona , Lee Ying Ying , Whitton Clare , Wang Peizhi , Shafie Saleha , Chang Sherilyn , Jeyagurunathan Anitha , Chua Boon Yiang , Abdin Edimansyah , Sum Chee Fang , Lee Eng Sing , Subramaniam Mythily 
Published: February 2022

Abstract
Background
Chronic conditions are a leading cause of death and disability worldwide and respective data on dietary patterns remain scant. The present study aimed to investigate dietary patterns and identify sociodemographic factors associated with Dietary Approaches to Stop Hypertension (DASH) scores within a multi-ethnic population with various chronic conditions.

Methods
The present study utilised data from the 2019-2020 Knowledge, Attitudes, and Practices study on diabetes in Singapore – a nationwide survey conducted to track the knowledge, attitudes, and practices pertaining to diabetes. The study analysed data collected from a sample of 2,895 Singapore residents, with information from the sociodemographic section, DASH diet screener, and the modified version of the World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0 checklist of chronic physical conditions.

Results
Respondents with no chronic condition had a mean DASH score of 18.5 (±4.6), those with one chronic condition had a mean DASH score of 19.2 (±4.8), and those with two or more chronic conditions had a mean DASH score of 19.8 (±5.2). Overall, the older age groups [35– 49 years (B = 1.78, 95% CI: 1.23 – 2.33, p <0.001), 50–64 years (B = 2.86, 95% CI: 22.24 – 3.47, p <0.001) and 65 years and above (B = 3.45, 95% CI: 2.73 – 4.17, p <0.001)], Indians (B = 2.54, 95% CI: 2.09 – 2.98, p <0.001) reported better diet quality, while males (B = -1.50, 95% CI: -1.87 – -1.14, p <0.001) reported poorer diet quality versus females.

Conclusion
Overall, respondents with two or more chronic conditions reported better quality of diet while the sociodemographic factors of age, gender and ethnicity demonstrated a consistent pattern in correlating with diet quality, consistent with the extant literature. Results provide further insights for policymakers to refine ongoing efforts in relation to healthy dietary practices for Singapore.