bluuebunny/crossref_metadata_2025_split huggingface dataset:
The level of spiritual care competence of Polish nurses and the psychometric properties of the spiritual care competence scale (SCCS)
Authors: Machul Michał , van Leeuwen René , Ozga Dorota , Jurek Krzysztof , Boczkowska Sylwia , Dobrowolska Beata 
Published: May 2022

Abstract
Background
Providing effective spiritual nursing care requires development of professional competence which, when regularly evaluated, allows one to direct undergraduate and postgraduate nursing education in order to develop knowledge, skills and attitudes of nurses in the scope of spiritual care.

Aim
The aim of this study was to analyse the level of spiritual competence of professionally active nurses in Poland and, additionally, to analyse the psychometric properties of the Spiritual Care Competence Scale (SCCS).

Methods
A cross-sectional study among Polish nurses (n = 343) was performed in accordance with the STrengthening the Reporting of OBservational studies in Epidemiology guidelines.

Results
An exploratory factor analysis identified five factors with 27 items explaining a total variance of 64.75%. Cronbach’s alpha coefficient for the subscales ranged from 0.70 for ‘Attitude toward the patient’s spirituality’ to 0.92 for ‘Professionalisation and improving the quality of spiritual care’. Nurses reported a high level of spiritual competence (104.39 points) with better results in ‘Attitude toward the patient’s spirituality’ and ‘Communication, personal support and patient counselling’ than in the ‘Assessment and implementation of spiritual care’, ‘Professionalisation and improving the quality of spiritual care’, and ‘Referral, consultation and spiritual care’. Significant correlation was found between nurses’ age, job seniority and spiritual competence, and between religiosity and spiritual competence.

Conclusions
The study showed satisfactory psychometric properties of the Polish version of the Spiritual Care Competence Scale, confirming its potential to measure the level of spiritual competence of nurses, both in education and research processes. SCCS-PL revealed five-factor structure with good internal consistency. The findings highlight the importance of providing professional education in respect of spiritual nursing care, especially in its practical dimension regarding skills development in which nurses obtained lower scores.
The relative impact of barriers to care among military health services personnel: exploring differences using context specific scenarios
Authors: Born Jennifer , Frank Christine 
Published: May 2022

Abstract
Background
Military health care providers often under access both physical and mental health care, yet research has predominantly focused on barriers to mental health care. This study explored a comprehensive set of barriers using hypothetical scenarios to quantify barrier impact on access to both mental and physical health care.

Methods
Canadian military health services personnel (N = 1033) completed one of two electronic surveys (assessing either physical health or other mental health barriers) that captured participant’s demographics, health, endorsement of barriers, intent to seek care, and whether the respondent would access care in different health scenarios (pneumonia, back injury, depression and post-traumatic stress disorder). Logistic regression was used to calculate odds of not accessing care (versus accessing care) for each of the four health scenarios.

Results
All barrier factors independently predicted increased odds of not accessing care for all four scenarios. When entered into an adjusted model none of the barrier factors significantly predicted accessing care in the physical health scenarios. Staffing and workload resources and Treatment preferences (e.g., self-treat) were significant predictors of accessing care in the mental health scenarios. Weak general intentions to access care was the strongest predictors of not accessing care across all four scenarios.

Conclusions
The impact of barriers on hypothetical care-seeking behaviour differs depending on the context for which one is accessing care, with access to resources and preference to self-treat driving mental health care seeking. Intent appears to be the most impactful predictor of accessing care potentially mediating the effect of other barrier types on care seeking.
Influence of heart rate on right ventricular function assessed by right heart catheterization and echocardiography in healthy anesthetized dogs
Authors: Yuchi Yunosuke , Suzuki Ryohei , Kanno Haruka , Saito Takahiro , Teshima Takahiro , Matsumoto Hirotaka , Koyama Hidekazu 
Published: May 2022

Abstract
Background
Right ventricular (RV) functional assessment has received considerable attention in veterinary medicine since various diseases, such as cardiovascular, respiratory, endocrine, and neoplastic disease, may affect RV function. Heart rate (HR) is an important factor that can influence RV function through changes in loading condition and contractility. However, no study has yet evaluated the association between HR and RV function in the same individuals. This study aimed to evaluate the influence of elevated HR on RV function using right heart catheterization and echocardiography, and investigate the association between right heart catheterization and echocardiographic indices.

Results
Right atrial pacing was performed in eight dogs at 120, 140, 160, and 180 bpm. With an increase in HR, the RV systolic volume, RV diastolic volume, and stroke volume significantly decreased; however, the cardiac output, end-systolic elastance (Ees), and effective arterial elastance (Ea) significantly increased. Significant changes were not observed in RV pressure and Ees/Ea. The RV area normalized by body weight, RV fractional area change normalized by body weight (RV FACn), and tricuspid annular plane systolic excursion normalized by body weight (TAPSEn) significantly decreased with increased HR. Peak systolic myocardial velocity of the lateral tricuspid annulus (RV s’), RV strain, and RV strain rate of only the RV free wall analysis (RV-SrL3seg) showed no significant changes with the increase in HR; however, there was an increase in the RV strain rate of the RV global analysis (RV-SrL6seg). Multiple regression analysis revealed that HR, RV FACn, and RV- SrL6seg had significant associations with the Ees, and the TAPSEn and RV-SrL3seg with Ees/Ea.

Conclusions
Decreased venous return and shortened relaxation time decreased the RV FAC, TAPSE, RV s’, and RV strain, and might underestimate the RV function. Ees increased with the increase in HR, reflecting the myocardial force-frequency relation; as a result, RV-SrL6seg could be a useful tool for Ees estimation. Additionally, the RV-SrL3seg could detect RV performance, reflecting the balance between RV contractility and RV afterload.
M6A-mediated upregulation of circMDK promotes tumorigenesis and acts as a nanotherapeutic target in hepatocellular carcinoma
Authors: Du Ashuai , Li Shiqin , Zhou Yuzheng , Disoma Cyrollah , Liao Yujie , Zhang Yongxing , Chen Zongpeng , Yang Qinglong , Liu Pinjia , Liu Sixu , Dong Zijun , Razzaq Aroona , Tao Siyi , Chen Xuan , Liu Yuxin , Xu Lunan , Zhang Qianjun , Li Shanni , Peng Jian , Xia Zanxian 
Published: May 2022

Abstract
Background
Emerging evidence suggest the critical role of circular RNAs (circRNAs) in disease development especially in various cancers. However, the oncogenic role of circRNAs in hepatocellular carcinoma (HCC) is still largely unknown.

Methods
RNA sequencing was performed to identify significantly upregulated circRNAs in paired HCC tissues and non-tumor tissues. CCK-8 assay, colony formation, transwell, and xenograft mouse models were used to investigate the role of circRNAs in HCC proliferation and metastasis. Small interfering RNA (siRNA) was used to silence gene expression. RNA immunoprecipitation, biotin pull-down, RNA pull-down, luciferase reporter assay and western blot were used to explore the underlying molecular mechanisms.

Results
Hsa_circ_0095868, derived from exon 5 of the MDK gene (named circMDK), was identified as a new oncogenic circRNA that was significantly upregulated in HCC. The upregulation of circMDK was associated with the modification of N6-methyladenosine (m6A) and poor survival in HCC patients. Mechanistically, circMDK sponged miR-346 and miR-874-3p to upregulate ATG16L1 (Autophagy Related 16 Like 1), resulting to the activation of PI3K/AKT/mTOR signaling pathway to promote cell proliferation, migration and invasion. Poly (β-amino esters) (PAEs) were synthesized to assist the delivery of circMDK siRNA (PAE-siRNA), which effectively inhibited tumor progression without obvious adverse effects in four liver tumor models including subcutaneous, metastatic, orthotopic and patient-derived xenograft (PDX) models.

Conclusions
CircMDK could serve as a potential tumor biomarker that promotes the progression of HCC via the miR-346/874-3p-ATG16L1 axis. The PAE-based delivery of siRNA improved the stability and efficiency of siRNA targeting circMDK. The PAE-siRNA nanoparticles effectively inhibited HCC proliferation and metastasis in vivo. Our current findings offer a promising nanotherapeutic strategy for the treatment of HCC.

Graphical Abstract
Application of lipid nanovesicle drug delivery system in cancer immunotherapy
Authors: Ding Yinan , Wang Luhong , Li Han , Miao Fengqin , Zhang Zhiyuan , Hu Chunmei , Yu Weiping , Tang Qiusha , Shao Guoliang 
Published: May 2022

AbstractImmunotherapy has gradually emerged as the most promising anticancer therapy. In addition to conventional anti-PD-1/PD-L1 therapy, anti-CTLA-4 therapy, CAR-T therapy, etc., immunotherapy can also be induced by stimulating the maturation of immune cells or inhibiting negative immune cells, regulating the tumor immune microenvironment and cancer vaccines. Lipid nanovesicle drug delivery system includes liposomes, cell membrane vesicles, bacterial outer membrane vesicles, extracellular vesicles and hybrid vesicles. Lipid nanovesicles can be used as functional vesicles for cancer immunotherapy, and can also be used as drug carriers to deliver immunotherapy drugs to the tumor site for cancer immunotherapy. Here, we review recent advances in five kinds of lipid nanovesicles in cancer immunotherapy and assess the clinical application prospects of various lipid nanovesicles, hoping to provide valuable information for clinical translation in the future.
Maelstrom promotes tumor metastasis through regulation of FGFR4 and epithelial-mesenchymal transition in epithelial ovarian cancer
Authors: He Wei-Peng , Yang Gui-Ping , Yang Zun-Xian , Shen Hong-Wei , You Ze-Shan , Yang Guo-Fen 
Published: May 2022

Abstract
Background
Increasing evidence has indicated that Maelstrom (MAEL) plays an oncogenic role in various human carcinomas. However, the exact function and mechanisms by which MAEL acts in epithelial ovarian cancer (EOC) remain unclear.

Results
This study demonstrated that MAEL was frequently overexpressed in EOC tissues and cell lines. Overexpression of MAEL was positively correlated with the histological grade of tumors, FIGO stage, and pT/pN/pM status (p < 0.05), and it also acted as an independent predictor of poor patient survival (p < 0.001). Ectopic overexpression of MAEL substantially promoted invasiveness/metastasis and induced epithelial-mesenchymal transition (EMT), whereas silencing MAEL by short hairpin RNA effectively inhibited its oncogenic function and attenuated EMT. Further study demonstrated that fibroblast growth factor receptor 4 (FGFR4) was a critical downstream target of MAEL in EOC, and the expression levels of FGFR4 were significantly associated with MAEL. (P < 0.05).

Conclusion
Our findings suggest that overexpression of MAEL plays a crucial oncogenic role in the development and progression of EOC through the upregulation of FGFR4 and subsequent induction of EMT, and also provide new insights on its potential as a therapeutic target for EOC.
Effects on health-related quality of life of interventions affecting survival in critically ill patients: a systematic review
Authors: Pallanch Ottavia , Ortalda Alessandro , Pelosi Paolo , Latronico Nicola , Sartini Chiara , Lombardi Gaetano , Marchetti Cristiano , Maimeri Nicolò , Zangrillo Alberto , Cabrini Luca 
Published: May 2022

AbstractSurvival has been considered the cornerstone for clinical outcome evaluation in critically ill patients admitted to intensive care unit (ICU). There is evidence that ICU survivors commonly show impairments in long-term outcomes such as quality of life (QoL) considering them as the most relevant ones. In the last years, the concept of patient-important outcomes has been introduced and increasingly reported in peer-reviewed publications. In the present systematic review, we evaluated how many randomized controlled trials (RCTs) were conducted on critically ill patients and reporting a benefit on survival reported also data on QoL. All RCTs investigating nonsurgical interventions that significantly reduced mortality in critically ill patients were searched on MEDLINE/PubMed, Scopus and Embase from inception until August 2021. In a second stage, for all the included studies, the outcome QoL was investigated. The primary outcome was to evaluate how many RCTs analyzing interventions reducing mortality reported also data on QoL. The secondary endpoint was to investigate if QoL resulted improved, worsened or not modified. Data on QoL were reported as evaluated outcome in 7 of the 239 studies (2.9%). The tools to evaluate QoL and QoL time points were heterogeneous. Four interventions showed a significant impact on QoL: Two interventions improved survival and QoL (pravastatin in subarachnoid hemorrhage, dexmedetomidine in elderly patients after noncardiac surgery), while two interventions reduced mortality but negatively influenced QoL (caloric restriction in patients with refeeding syndrome and systematic ICU admission in elderly patients). In conclusion, only a minority of RCTs in which an intervention demonstrated to affect mortality in critically ill patients reported also data on QoL. Future research in critical care should include patient-important outcomes like QoL besides mortality. Data on this topic should be collected in conformity with PROs statement and core outcome sets to guarantee quality and comparability of results.
Androgen receptor reprogramming demarcates prognostic, context-dependent gene sets in primary and metastatic prostate cancer
Authors: Severson Tesa , Qiu Xintao , Alshalalfa Mohammed , Sjöström Martin , Quigley David , Bergman Andries , Long Henry , Feng Felix , Freedman Matthew L. , Zwart Wilbert , Pomerantz Mark M. 
Published: May 2022

AbstractThe androgen receptor (AR) is a prostate master transcription factor. It binds to genetic enhancers, where it regulates gene activity and plays a fundamental role in prostate pathophysiology. Previous work has demonstrated that AR-DNA binding is systematically and consistently reprogrammed during prostate tumorigenesis and disease progression. We charted these reprogrammed AR sites and identified genes proximal to them. We were able to devise gene lists based on AR status within specific histological contexts: normal prostate epithelium, primary prostate tumor, and metastatic prostate cancer. We evaluated expression of the genes in these gene sets in subjects from two distinct clinical cohorts—men treated with surgery for localized prostate cancer and men with metastatic prostate cancer. Among men with localized prostate cancer, expression of genes proximal to AR sites lost in the transition from normal prostate to prostate tumor was associated with clinical outcome. Among men with metastatic disease, expression of genes proximal to AR sites gained in metastatic tumors was associated with clinical outcome. These results are consistent with the notion that AR is fundamental to both maintaining differentiation in normal prostate tissue and driving de-differentiation in advanced prostate cancer. More broadly, the study demonstrates the power of incorporating context-dependent epigenetic data into genetic analyses.
Quantitative methods used to evaluate impact of health promotion interventions to prevent HIV infections: a methodological systematic review protocol
Authors: Ravalihasy Andrainolo , Kardaś-Słoma Lidia , Yazdanpanah Yazdan , Ridde Valéry 
Published: May 2022

Abstract
Background
Combination prevention is currently considered the best approach to combat HIV epidemic. It is based upon the combination of structural, behavioral, and biomedical interventions. Such interventions are frequently implemented in a health-promoting manner due to their aims, the approach that was adopted, and their complexity. The impact evaluation of these interventions often relies on methods inherited from the biomedical field. However, these methods have limitations and should be adapted to be relevant for these complex interventions. This systematic review aims to map the evidence-based methods used to quantify the impact of these interventions and analyze how these methods are implemented.

Methods
Three databases (Web of Science, Scopus, PubMed) will be used to identify impact evaluation studies of health promotion interventions that aimed at reducing the incidence or prevalence of HIV infection. Only studies based on quantitative design assessing intervention impact on HIV prevalence or incidence will be included. Two reviewers will independently screen studies based on titles and abstracts and then on the full text. The information about study characteristics will be extracted to understand the context in which the interventions are implemented. The information specific to quantitative methods of impact evaluation will be extracted using items from the Mixed Methods Appraisal Tool (MMAT), the guidelines for reporting Statistical Analyses and Methods in the Published Literature (SAMPL), and the guidelines for Strengthening The Reporting of Empirical Simulation Studies (STRESS). This review will be conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement.

Discussion
The impact evaluation of HIV prevention interventions is a matter of substantial importance given the growing need for evidence of the effectiveness of these interventions, whereas they are increasingly complex. These evaluations allow to identify the most effective strategies to be implemented to fight the epidemic. It is therefore relevant to map the methods to better implement them and adapt them according to the type of intervention to be evaluated.

Systematic review registration
PROSPERO CRD42020210825
Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020
Authors: Schlüter Benjamin-Samuel , Masquelier Bruno , Camarda Carlo Giovanni 
Published: May 2022

Abstract
Background
The COVID-19 pandemic has led to major shocks in mortality trends in many countries. Yet few studies have evaluated the heterogeneity of the mortality shocks at the sub-national level, rigorously accounting for the different sources of uncertainty.

Methods
Using death registration data from Belgium, we first assess change in the heterogeneity of districts’ standardized mortality ratios in 2020, when compared to previous years. We then measure the shock effect of the pandemic using district-level values of life expectancy, comparing districts’ observed and projected life expectancy, accounting for all sources of uncertainty (stemming from life-table construction at district level and from projection methods at country and district levels). Bayesian modelling makes it easy to combine the different sources of uncertainty in the assessment of the shock. This is of particular interest at a finer geographical scale characterized by high stochastic variation in annual death counts.

Results
The heterogeneity in the impact of the pandemic on all-cause mortality across districts is substantial: while some districts barely show any impact, the Bruxelles-Capitale and Mons districts experienced a decrease in life expectancy at birth of 2.24 (95% CI:1.33–3.05) and 2.10 (95% CI:0.86–3.30) years, respectively. The year 2020 was associated with an increase in the heterogeneity of mortality levels at a subnational scale in comparison to past years, measured in terms of both standardized mortality ratios and life expectancies at birth. Decisions on uncertainty thresholds have a large bearing on the interpretation of the results.

Conclusion
Developing sub-national mortality estimates taking careful account of uncertainty is key to identifying which areas have been disproportionately affected.
Evaluating metagenomic assembly approaches for biome-specific gene catalogues
Authors: Delgado Luis Fernando , Andersson Anders F. 
Published: May 2022

Abstract
Background
For many environments, biome-specific microbial gene catalogues are being recovered using shotgun metagenomics followed by assembly and gene calling on the assembled contigs. The assembly is typically conducted either by individually assembling each sample or by co-assembling reads from all the samples. The co-assembly approach can potentially recover genes that display too low abundance to be assembled from individual samples. On the other hand, combining samples increases the risk of mixing data from closely related strains, which can hamper the assembly process. In this respect, assembly on individual samples followed by clustering of (near) identical genes is preferable. Thus, both approaches have potential pros and cons, but it remains to be evaluated which assembly strategy is most effective. Here, we have evaluated three assembly strategies for generating gene catalogues from metagenomes using a dataset of 124 samples from the Baltic Sea: (1) assembly on individual samples followed by clustering of the resulting genes, (2) co-assembly on all samples, and (3) mix assembly, combining individual and co-assembly.

Results
The mix-assembly approach resulted in a more extensive nonredundant gene set than the other approaches and with more genes predicted to be complete and that could be functionally annotated. The mix assembly consists of 67 million genes (Baltic Sea gene set, BAGS) that have been functionally and taxonomically annotated. The majority of the BAGS genes are dissimilar (< 95% amino acid identity) to the Tara Oceans gene dataset, and hence, BAGS represents a valuable resource for brackish water research.

Conclusion
The mix-assembly approach represents a feasible approach to increase the information obtained from metagenomic samples.
Mature Australian VET markets: a data-driven case study of public policy implementation
Authors: Zoellner Don 
Published: May 2022

AbstractAustralian vocational education and training (VET) policy makers have persistently proposed more user choice when reforming the national training system. Increasing alternatives by encouraging multiple providers to trade in regulated contestable markets remains the cornerstone of governments’ policies. However, despite policy intentions, students’ options are declining. Longitudinal quantitative jurisdiction-level statistics identify well-established trends of a reduced variety of providers, a smaller range of qualifications on offer and decreased public funding. These outcomes are occurring notwithstanding the continuous supportive policy environment for intensified competition and amplified choice. Rather than portray reduced choice as policy failure, this research makes novel use of large nationally consistent regulatory and enrolment data sets to provide evidence of successful public policy implementation that is approaching the end of the market life cycle. The results invite an exploration of issues that arise when VET markets are considered to be mature rather than unrealised aspirations. Choices provided in these fully-fledged markets that balance public and private provision are still necessary, but no longer sufficient, to meet national skills needs. It is argued that policy success is not permanent and should be revisited in light of contemporary economic alternatives to guide future VET policy making.