bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peer evaluations of group work in different years of medical school and academic achievement: how are they related?
Authors: Linn Zayar , Tashiro Yasura , Morio Kunimasa , Hori Hiroki 
Published: February 2022

Abstract
Background
To develop the skills needed in health care teams, training communication and teamwork skills are important in medical education. Small group collaborative learning is one of the methods utilized in such trainings, and peer evaluation is suggested to be useful in reinforcing the effectiveness of group learning activities. In Mie University Faculty of Medicine, group work consisting of book review sessions of liberal arts education in the first grade and problem-based learning (PBL) sessions in preclinical years were conducted using the same peer evaluation system that included three domains: degree of prior learning, contribution to group discussion, and cooperative attitude. This study was conducted to determine the relationships among behaviors during group work and the academic achievement of medical students.

Methods
With the data from a cohort of medical students in three consecutive academic years (n = 340), peer evaluation scores in groupworks of book review sessions, those in PBL sessions and paper test scores of preclinical years were analyzed. The correlations were analyzed with Spearman’s correlation coefficient, and the respective scores were compared by using the Wilcoxon signed-ranked test.

Results
Significant correlations were observed among the evaluation scores of respective domains in group work and paper test scores. The degree of prior learning had the strongest relationship among the three domains (rs = 0.355, p < 0.001 between book review sessions and PBL; rs = 0.338, p < 0.001 between book review sessions and paper test score; rs = 0.551, p < 0.001 between PBL and paper test score). Peer evaluation scores of respective domains were found to be significantly higher in PBL.

Conclusion
Medical students maintained their groupwork behaviors to some extent from early school to preclinical years. Those behaviors were positively related to their academic achievement in the later years of the medical education curriculum. Our study highlighted the importance of the early introduction of group work. The results will be useful to motivate medical students to put more effort into group work.
Patient characteristics and utilization of an online patient portal in a rural academic general internal medicine practice
Authors: Liu Stephen K. , Osborn Annette E. , Bell Sigall , Mecchella John N. , Hort Shoshana , Batsis John A. 
Published: February 2022

Abstract
Background
Online patient portals have the potential to improve patient engagement and health care outcomes. This is especially true among rural patient populations that may live far from their health care providers and for whom transportation is a barrier to accessing care. This study compared the characteristics of active users of an online patient portal to non-users and assessed utilization among users in a rural academic primary care clinic to identify disparities in adoption and use.

Methods
We conducted a cross sectional study of 28,028 patients in a general internal medicine clinic between June 2019 and May 2020 to assess (a) characteristics of patients who had an online patient portal account and used the patient portal compared to those who did not register for an account, and (b) the frequency of use of the patient portal (number of logons and number of messages sent and received) by patients over the study period. We compared results based on demographic characteristics, focusing on gender, age, race, presence or absence of nine chronic illnesses, smoking status, and BMI.

Results
In the study cohort of 28,028 patients, 82% were active users of the patient portal. Females, patients aged 41–65, and non-smokers were more likely to use the portal than their counterparts. In total, patients with eight out of nine chronic illness groups studied (heart failure, cerebrovascular disease, history of a myocardial infarction, peripheral vascular disease, and renal disease) were less likely to use the patient portal than patients without these chronic conditions. On average, patients log onto the patient portal 25 times per year and send and receive 6 messages to and from the clinic. We found that females, patients older than 65, former smokers and obese patients logged on and sent and received more messages compared to the overall cohort. Although the sample size was small, on average Black patients logged onto the patient portal 19 times and sent and received 3.6 messages compared to White patients who logged on 25 times with 5.8 messages on average over the yearlong study period.

Conclusions
In a rural academic internal medicine clinic, female patients, aged 41–65, non-smokers, and those without certain chronic conditions were more likely to use an online patient portal. Recognizing and addressing barriers to patient portal use is essential for robust and sustained patient portal uptake and ensuring that the benefits of portal use are equally distributed among all patients.
Unprecedented organelle genomic variations in morning glories reveal independent evolutionary scenarios of parasitic plants and the diversification of plant mitochondrial complexes
Authors: Lin Yanxiang , Li Pan , Zhang Yuchan , Akhter Delara , Pan Ronghui , Fu Zhixi , Huang Mingqing , Li Xiaobo , Feng Yanlei 
Published: February 2022

Abstract
Background
The morning glories (Convolvulaceae) are distributed worldwide and produce economically important crops, medicinal herbs, and ornamentals. Members of this family are diverse in morphological characteristics and trophic modes, including the leafless parasitic Cuscuta (dodders). Organelle genomes were generally used for studying plant phylogeny and genomic variations. Notably, plastomes in parasitic plants always show non-canonical features, such as reduced size and accelerated rates. However, few organelle genomes of this group have been sequenced, hindering our understanding of their evolution, and dodder mitogenome in particular.

Results
We assembled 22 new mitogenomes and 12 new plastomes in Convolvulaceae. Alongside previously known ones, we totally analyzed organelle genomes of 23 species in the family. Our sampling includes 16 leafy autotrophic species and 7 leafless parasitic dodders, covering 8 of the 12 tribes. Both the plastid and mitochondrial genomes of these plants have encountered variations that were rarely observed in other angiosperms. All of the plastomes possessed atypical IR boundaries. Besides the gene and IR losses in dodders, some leafy species also showed gene and intron losses, duplications, structural variations, and insertions of foreign DNAs. The phylogeny reconstructed by plastid protein coding sequences confirmed the previous relationship of the tribes. However, the monophyly of ‘Merremieae’ and the sister group of Cuscuta remained uncertain. The mitogenome was significantly inflated in Cuscuta japonica, which has exceeded over 800 kb and integrated massive DNAs from other species. In other dodders, mitogenomes were maintained in small size, revealing divergent evolutionary strategies. Mutations unique to plants were detected in the mitochondrial gene ccmFc, which has broken into three fragments through gene fission and splicing shift. The unusual changes likely initially happened to the common ancestor of the family and were caused by a foreign insertion from rosids followed by double-strand breaks and imprecise DNA repairs. The coding regions of ccmFc expanded at both sides after the fission, which may have altered the protein structure.

Conclusions
Our family-scale analyses uncovered unusual scenarios for both organelle genomes in Convolvulaceae, especially in parasitic plants. The data provided valuable genetic resources for studying the evolution of Convolvulaceae and plant parasitism.
Liquid biopsy: Exosomal microRNAs as novel diagnostic and prognostic biomarkers in cancer
Authors: Preethi K. Auxzilia , Selvakumar Sushmaa Chandralekha , Ross Kehinde , Jayaraman Selvaraj , Tusubira Deusdedit , Sekar Durairaj 
Published: February 2022

Abstract
Background
Detecting cancer at an early stage before clinical manifestation could be an effective strategy to decrease cancer mortality. Thus, identifying liquid biopsy biomarkers with high efficacy could be a promising approach for non-invasive diagnosis of cancer.

Main text
Liquid biopsies are increasingly used as a supplement to biopsy, as it enables disease progression to be detected months before clinical and radiographic confirmation. Many bodily fluids contain exosomal microRNAs (miRNAs) which could provide a new class of biomarkers for early and minimally invasive cancer diagnosis due to the stability of miRNAs in exosomes. In this review, we mainly focused on the exosomal miRNAs (liquid biopsy) as biomarkers in the diagnosis and prognosis of various cancers.

Conclusion
Exosomal miRNAs can be used as diagnostic and prognosis biomarkers that provide unique insights and a more dynamic perspective of the progression and therapeutic responses in various malignancies. Therefore, the development of novel and more sensitive technologies that exploit exosomal miRNAs should be a priority for cancer management.
Low risk of haematomas with intramuscular vaccines in anticoagulated patients: a systematic review with meta-analysis
Authors: Caldeira Daniel , Rodrigues Bárbara Sucena , Alves Mariana , Pinto Fausto J. , Ferreira Joaquim J. 
Published: February 2022

AbstractIntroductionThe summary of product characteristics of vaccines administered intramuscularly, including the vaccine for coronavirus SARS-CoV-2 (COVID-19) and Influenza, warned for risks of bleeding in patients treated with oral anticoagulants. We aimed to estimate the incidence of major bleeding events in this setting and to compare these risks against other vaccination routes.MethodsThis systematic review included all prospective and retrospective studies enrolling anticoagulated patients that received intramuscular vaccination, published until December 2020 in CENTRAL, MEDLINE and EMBASE. The outcomes of interest were major bleeding and haematoma related with vaccination. The incidence of the outcomes was estimated through a random-effects meta-analysis using the Freeman-Turkey transformation. The results are expressed in percentages, with 95%-confidence intervals (95%CI), limited between 0 and 100%. When studies compared intramuscular vaccination vs. other route, the data were compared and pooled using random-effects meta-analysis. Risk ratios (RR) with 95%CI were reported.ResultsOverall 16 studies with 642 patients were included. No major bleeding event was reported. The pooled incidence of haematomas following vaccination (mostly against Influenza) in patients treated with oral anticoagulants (mostly warfarin; no data with DOACs / NOACs) was 0.46% (95%CI 0-1.53%). Three studies evaluated the intramuscular vs. subcutaneous route of vaccination. Intramuscular vaccines did not increase the risk of haematoma (RR 0.53, 95%CI 0.10-2.82) compared with subcutaneous route.ConclusionsIntramuscular vaccination in anticoagulated patients is safe with very low incidence of haematomas and the best available evidence suggests that using the intramuscular route does not increase the risk of haematomas compared with the subcutaneous route.
Effects of exercise on high-fat diet–induced non-alcoholic fatty liver disease and lipid metabolism in ApoE knockout mice
Authors: Huang Wen-Ching , Xu Jin-Wei , Li Shiming , Ng Xin Er , Tung Yu-Tang 
Published: February 2022

Abstract
Background
Non-alcoholic fatty liver disease (NAFLD), which is growing more common in the Western world, has become the main cause of chronic liver disease and is strongly associated with metabolism syndromes. NAFLD can indicate a wide spectrum of hepatic pathologies, ranging from simple hepatic steatosis and inflammatory non-alcoholic steatohepatitis to more severe stages of fibrosis and cirrhosis. Moreover, evidence has demonstrated that physical inactivity and westernized dietary habits may facilitate the development of NAFLD. Lipid modulation and metabolism could be important factors in the development of steatosis. Lipid species, characterized using a lipidomic approach with untargeted analysis, could provide potential biomarkers for the pathogenesis of NAFLD or therapeutic applications. Thus, in this study, the effects of exercise on the improvement of NAFLD were further investigated from a lipidomic perspective through the aspects of lipid regulation and metabolism.

Methods
Wild type (WT) C57BL/6 J and C57BL/6-ApoEem1Narl/Narl mice were assigned to one of four groups: WT mice fed a normal chow diet (CD), apolipoprotein E (ApoE) knockout mice fed a normal CD, ApoE knockout mice fed a high-fat diet (HFD), and ApoE knockout mice fed a HFD and provided with swimming exercise. The treatments (e.g., normal diet, HFD, and exercise) were provided for 12 consecutive weeks before the growth curves, biochemistry, fat composition, pathological syndromes, and lipid profiles were determined.

Results
Exercise significantly reduced the HFD-induced obesity (weight and fat composition), adipocyte hypertrophy, liver lipid accumulation, and pathological steatosis. In addition, exercise ameliorated HFD-induced steatosis in the process of NAFLD. The lipidomic analysis revealed that the changes in plasma triglyceride (14:0/16:0/22:2), phosphatidic acid (18:0/17:2), and phosphatidylglycerol (16:0/20:2) induced by the administration of the HFD could be reversed significantly by exercise.

Conclusions
The 12-week regular exercise intervention significantly alleviated HFD-induced NAFLD through modulation of specific lipid species in plasma. This finding could elucidate the lipids effects behind the hepatic pathogenesis with exercise.
Staff preferences towards electronic data collection from a national take-home naloxone program: a cross-sectional study
Authors: Ericson Øystein Bruun , Eide Desiree , Lobmaier Philipp , Clausen Thomas 
Published: February 2022

Abstract
Background
During the scaling-up of a national Norwegian take-home naloxone (THN) program, data collection methods shifted from paper-based to electronic. The aim of this study was to explore staff preferences towards the shift in data collection.

Methods
In January–February 2020, a survey was sent out via email to personnel involved with the THN program (n = 200). The survey included 17 questions, and covered staff demographics, experiences distributing THN, preferences towards data collection (both paper and electronically), and an open response section. Descriptive statistics were performed for the survey results. The open response section was recorded from each questionnaire and was coded into major themes by the authors.

Results
In total, 122 staff completed the survey. Of these, 62% had experience with both electronic and paper-based forms, and there was a near unanimous preference towards electronic data collection over paper-based forms. From the free-text responses, staff found the electronic form to be a useful tool for conversation and overdose prevention education, and that the electronic form was easier to manage than the paper forms.

Conclusion
The shift towards electronic data collection was necessary for the feasibility of the Norwegian national THN program. This study found that staff not only tolerated the shift, but in most cases preferred this organizational change.
How to reconstruct the lordosis of cervical spine in patients with Hirayama disease? A finite element analysis of biomechanical changes focusing on adjacent segments after anterior cervical discectomy and fusion
Authors: Lu Xiao , Zou Fei , Lu Feizhou , Ma Xiaosheng , Xia Xinlei , Jiang Jianyuan 
Published: February 2022

Abstract
Purpose
To compare the biomechanical changes of adjacent segments between patients with Hirayama disease and non-pathological people after anterior cervical discectomy and fusion (ACDF) operation, and to explore the optimal degree of local lordosis reconstruction during surgery.

Methods
A young male volunteer was recruited to establish a three-dimensional finite element model of the lower cervical spine based on the CT data. By adjusting the bony structures and simulating the operation process, the models of non-pathological individuals before and after ACDF, patients with Hirayama disease before and after ACDF, and different local lordosis angles were established. Then, the postoperative range of motion (RoM) and stress of the adjacent segments under flexion, extension, left bending, right bending, left rotation and right rotation were recorded and compared.

Results
The RoM and stress of all segments of lower cervical spine in patients with Hirayama disease are higher than those in non-pathological individual, and this trend still exists after ACDF surgery. When the local lordosis angle is under physiological conditions, the RoM and stress of the adjacent segments are minimum.

Conclusion
Compared with non-pathological people, Hirayama disease patients have differences in cervical biomechanics, which may lead to cervical hypermobility and overload. After ACDF, the possibility of adjacent segments degeneration is greater than that of non-pathological people. When the operation maintains the physiological local lordosis angle, it can slow down the degeneration.
Influence of percutaneous catheter intervention for congenital perimembranous ventricular septal defects in children on the cardiac conduction system and associated risk factors: a meta-analysis
Authors: Lei Yu-Qing , Lin Wen-Hao , Lin Shi-Hao , Xie Wen-Peng , Liu Jian-Feng , Chen Qiang , Cao Hua 
Published: February 2022

Abstract
Background
The aim of this study was to investigate adverse outcomes and risk factors for the cardiac conduction system in children with perimembranous ventricular septal defects (pmVSDs) who had been treated by catheter intervention.

Method
PubMed, EMBASE, Web of Science, and the Cochrane Library were searched for studies in English on interventional treatment of pmVSDs in pediatric patients published up to the end of October 15, 2020. We used random- or fixed-effect models to obtain pooled estimates of the success rate and postoperative complications.

Results
A total of 1650 pediatric patients from 8 publications were included, with a mean age ranging from 3.44 to 8.67 years old. The pooled estimate of successful implantation was 98.2% (95% CI 97.1–99.4%, I2 = 69.4%; P < 0.001), and the incidence of cardiac conduction system complications was 17.4% (95% CI 8.4–26.4%, I2 = 96.1%; P < 0.001), among which the incidence of heart block was 14.8% (95% CI 6.4–23.3%, I2 = 96.9%; P = 0.001). The incidence of impulse formation disorders was 4.1% (95% CI 0.7–7.6%, I2 = 91.7%; P = 0.019), and the incidence of complete atrioventricular block was 0.8% (95% CI 0.3–13%, I2 = 0.0%; P = 0.001). Risk factors for newly emerging arrhythmias included the VSD size MD = 0.89 (95% CI 0.46–1.32, I2 = 0%; P < 0.0001) and device size MD = 1.26 (95% CI 0.78–1.73, I2 = 0%; P < 0.00001).

Conclusions
Percutaneous catheter intervention is safe and effective in treating pediatric patients with pmVSD, and the risk factors leading to arrhythmias include the sizes of the pmVSD and device.
The influence of the windlass mechanism on kinematic and kinetic foot joint coupling
Authors: Williams Lauren R. , Ridge Sarah T. , Johnson A. Wayne , Arch Elisa S. , Bruening Dustin A. 
Published: February 2022

AbstractBackgroundPrevious research shows kinematic and kinetic coupling between the metatarsophalangeal (MTP) and midtarsal joints during gait. Studying the effects of MTP position as well as foot structure on this coupling may help determine to what extent foot coupling during dynamic and active movement is due to the windlass mechanism. This study's purpose was to investigate the kinematic and kinetic foot coupling during controlled passive, active, and dynamic movements.MethodsAfter arch height and flexibility were measured, participants performed four conditions: Seated Passive MTP Extension, Seated Active MTP Extension, Standing Passive MTP Extension, and Standing Active MTP Extension. Next, participants performed three heel raise conditions that manipulated the starting position of the MTP joint: Neutral, Toe Extension, and Toe Flexion. A multisegment foot model was created in Visual 3D and used to calculate ankle, midtarsal, and MTP joint kinematics and kinetics.ResultsKinematic coupling (ratio of midtarsal to MTP angular displacement) was approximately six times greater in Neutral heel raises compared to Seated Passive MTP Extension, suggesting that the windlass only plays a small kinematic role in dynamic tasks. As the starting position of the MTP joint became increasingly extended during heel raises, the amount of negative work at the MTP joint and positive work at the midtarsal joint increased proportionally, while distal‐to‐hindfoot work remained unchanged. Correlations suggest that there is not a strong relationship between static arch height/flexibility and kinematic foot coupling.ConclusionsOur results show that there is kinematic and kinetic coupling within the distal foot, but this coupling is attributed only in small measure to the windlass mechanism. Additional sources of coupling include foot muscles and elastic energy storage and return within ligaments and tendons. Furthermore, our results suggest that the plantar aponeurosis does not function as a rigid cable but likely has extensibility that affects the effectiveness of the windlass mechanism. Arch structure did not affect foot coupling, suggesting that static arch height or arch flexibility alone may not be adequate predictors of dynamic foot function.
Fistulotomy versus standard cannulation as the primary technique for all patients undergoing ERCP with a native papilla: a protocol for a single center randomized controlled trial
Authors: Hookey Lawrence , Rai Mandip , Bechara Robert 
Published: February 2022

Abstract
Background
Endoscopic retrograde cholangiopancreatography (ERCP) is an indispensable procedure for the management of pancreaticobiliary diseases. Post-ERCP pancreatitis (PEP) is the most common serious adverse event. One risk factor of PEP is difficulty achieving biliary access. The conventional ERCP technique involves the cannulation of the bile duct via the ampulla of Vater, followed by sphincter incision using electrocautery. Conventionally, if the standard method fails then, precut techniques have been utilized as an alternative means of gaining biliary access. The needle-knife fistulotomy (NKF) technique involves identifying the intra-duodenal segment of the bile duct and uses a needle knife to incise directly into the bile duct. This is done above and away from the natural office, thus minimizing thermal damage which may result in PEP. Our recent prospective study of 50 patients demonstrated the safety and feasibility of the NKF precut technique as a primary means of gaining biliary access. The next step is to conduct a randomized controlled trial to compare the efficacy and safety of initial NKF to the standard cannulation in a non-selective patient population undergoing ERCP.

Methods
A randomized control trial of 538 consecutive, non-selective patients with pancreaticobiliary disease undergoing ERCP at a tertiary care center in Kingston, Ontario, Canada, will be conducted. Patients will be randomized to one of two treatment groups, standard cannulation or NKF. The primary outcome of the study will be the incidence of PEP. Secondary outcomes will include rate of successful cannulation of the common bile duct (CBD), time to successful cannulation, total procedure time, difficulty of cannulation, and incidence of complications.

Discussion
This RCT will yield important answers regarding the efficacy and safety of initial NKF to the standard cannulation in a non-selective patient population undergoing ERCP. The results of our study could alter ERCP practices and outcomes if NKF is shown to reduce PEP risk.

Trial registration
ClinicalTrials.govNCT04559867. Registered on September 23, 2020