bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Risk Factors Associated with Symptomatic Dry Eye in Nurses in Palestine During the COVID-19 Pandemic
Authors: Allayed Riyad , Ayed Ahmad , Fashafsheh Imad 
Published: September 2022

Introduction Working in closed wards at hospitals during night-time shifts and using electronic health records may raise the risk of dry eye disease in nurses. Objective The purpose of the current study was to assess the prevalence and associated factors of dry eye disease among hospital nurses in the North West Bank, Palestine. Methods A descriptive cross-sectional study. The study included 300 nurses who work at hospitals in the North West Bank, Palestine. The Ocular Surface Disease Index (OSDI) questionnaire on dry eye disease was used to estimate the prevalence of symptomatic dry eye disease. Results The percentage of dry eye disease prevalence among study participants was 62% with an OSDI score of >13 (mild to moderate and severe OSDI status). Nurses who wore contact lenses worked during the night-time, and worked in the intensive care unit were more likely to report significantly higher OSDI scores ( p < .05). Moreover, gender, smoking, and computer use were not statistically associated with dry eye disease ( p > .05). Conclusion Symptomatic dry eye disease is one of the most common ocular diseases among hospital nurses in Palestine.
Assembly and comparative analysis of the complete mitochondrial genome of Bupleurum chinense DC
Authors: Qiao Yonggang , Zhang Xinrui , Li Zheng , Song Yun , Sun Zhe 
Published: September 2022

Abstract
Background
Bupleurum chinense(B. chinense) is a plant that is widely distributed globally and has strong pharmacological effects. Though the chloroplast(cp) genome of B. chinense has been studied, no reports regarding the mitochondrial(mt) genome of B. chinense have been published yet.

Results
The mt genome of B.chinense was assembled and functionally annotated. The circular mt genome of B. chinense was 435,023 bp in length, and 78 genes, including 39 protein-coding genes, 35 tRNA genes, and 4 rRNA genes, were annotated. Repeat sequences were analyzed and sites at which RNA editing would occur were predicted. Gene migration was observed to occur between the mt and cp genomes of B. chinense via the detection of homologous gene fragments. In addition, the sizes of plant mt genomes and their GC content were analyzed and compared. The sizes of mt genomes of plants varied greatly, but their GC content was conserved to a greater extent during evolution. Ka/Ks analysis was based on code substitutions, and the results showed that most of the coding genes were negatively selected. This indicates that mt genes were conserved during evolution.

Conclusion
In this study, we assembled and annotated the mt genome of the medicinal plant B. chinense. Our findings provide extensive information regarding the mt genome of B. chinense, and help lay the foundation for future studies on the genetic variations, phylogeny, and breeding of B. chinense via an analysis of the mt genome.
Genome wide association analysis for yield related traits in maize
Authors: Zeng Tingru , Meng Zhaodong , Yue Runqing , Lu Shouping , Li Wenlan , Li Wencai , Meng Hong , Sun Qi 
Published: September 2022

Abstract
Background
Understanding the genetic basis of yield related traits contributes to the improvement of grain yield in maize.

Results
Using 291 excellent maize inbred lines as materials, six yield related traits of maize, including grain yield per plant (GYP), grain length (GL), grain width (GW), kernel number per row (KNR), 100 kernel weight (HKW) and tassel branch number (TBN) were investigated in Jinan, in 2017, 2018 and 2019. The average values of three environments were taken as the phenotypic data of yield related traits, and they were statistically analyzed. Based on 38,683 high-quality SNP markers in the whole genome of the association panel, the MLM with PCA model was used for genome-wide association analysis (GWAS) to obtain 59 significantly associated SNP sites. Moreover, 59 significantly associated SNPs (P < 0.0001) referring to GYP, GL, GW, KNR, HKW and TBN, of which 14 SNPs located in yield related QTLs/QTNs previously reported. A total of 66 candidate genes were identified based on the 59 significantly associated SNPs, of which 58 had functional annotation.

Conclusions
Using genome-wide association analysis strategy to identify genetic loci related to maize yield, a total of 59 significantly associated SNP were detected. Those results aid in our understanding of the genetic architecture of maize yield and provide useful SNPs for genetic improvement of maize.
Mitigating inequalities in community care needs of older adults with dementia: a qualitative case study of an integrated model of community care operated under the proportionate universalism principle
Authors: Chan Siu-Ming , Chung Gary Ka-Ki , Kwan Michelle Ho-Wing , Woo Jean 
Published: September 2022

Abstract
Background
Population ageing and community care on older adults, as well as the marked social inequalities in health, have received growing concern by the government and the community. This study evaluated the medico-social integrated day care model of the Cadenza Hub for older adults with dementia. We also examined whether services subsidized by the publicly funded graded financial support of the Community Care Service Voucher for the Elderly (CCSV) could mitigate social inequalities in community care needs, from the perspective of the caregivers.

Methods
In this qualitative case study, we adopted purposeful sampling strategy to recruit 14 caregivers of active day care service users with dementia, with different socioeconomic background and duration of service use, for face-to-face semi-structured in-depth interviews between June and August 2021. The transcribed data were closely read to capture key themes using thematic analyses.

Results
Caregivers faced tremendous caregiving burden in the absence of community care support and struggled in choosing care services. Most informants benefited from the day care service, whereas the financial support of CCSV was crucial to ensure equitable access to community care. Non-governmental organizations and social workers were the key to bridging the information gap.

Conclusion
The integrated day care of the Cadenza Hub appeared to have addressed the unmet needs of older adults with dementia and their caregivers, including the socioeconomically disadvantaged with the CCSV support. The community care service delivery model might be applicable to address other health inequalities problems.
Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery: a systematic review and meta-analysis of randomized controlled trials
Authors: Zhuo Qing , Xu Jia-Bin , Zhang Jing , Ji Bin 
Published: September 2022

Abstract
Background
Perioperative hypothermia and shivering commonly occur in pregnant women undergoing cesarean section. The warming method is usually used to prevent hypothermia and shivering. However, the effect of active warming (AW) prior to passive warming (PW) on the perioperative outcomes of pregnant women and their offspring remains controversial.

Methods
This study aimed to investigate the effects of AW and PW on maternal and newborn perioperative outcomes during cesarean delivery. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PubMed, Embase, Scopus, and the Cochrane Library were used to search for randomized controlled trials (RCTs) up to August 7, 2022. The Cochrane risk of bias assessment tool was used to assess articles selected for the systematic review. Continuous data were analyzed using weighted mean differences (WMDs) with 95% confidence intervals (CIs), and categorical data were analyzed by the random-effects model.

Results
A total of 1241 participants from twelve RCTs were selected for the final meta-analysis. AW was associated with a lower risk of maternal hypothermia (RR: 0.77, 95% CI: 0.63–0.93, P = 0.007) and shivering (RR: 0.56, 95% CI: 0.37–0.85; P = 0.007). AW was associated with high maternal temperature (WMD: 0.27, 95%CI: 0.14 to 0.40, P < 0.001). No significant difference was observed between AW and PW in terms of hypothermia (RR: 0.60, 95% CI: 0.24–1.51, P = 0.278), temperature (WMD: 0.31, 95% CI: − 0.00 to 0.62; P = 0.050), and umbilical vein PH in newborns (WMD: -0.00; 95% CI: − 0.02 to 0.02, P = 0.710).

Conclusions
These findings suggested that AW can better prevent maternal hypothermia and shivering than PW. In contrast, no significant effect was observed in newborns. Overall, the quality of the included studies is high due to RCTs, low risk of bias, consistency, and precision. We identified the quality of the overall evidence from the survey to be GRADE I.
Profiles of women’s adjustment after cancer based on sexual and psychosocial wellbeing: results of a cluster analysis
Authors: Arthur Elizabeth K. , Menon Usha , Reese Jennifer Barsky , Browning Kristine , Overcash Janine , Rose Karen , Wills Celia E. 
Published: September 2022

Abstract
Background
Sexual wellbeing is a critical yet often overlooked aspect of overall wellbeing for women across cancer diagnoses.

Objective
We identified profiles of women cancer survivors by sexual and psychosocial outcomes and compared groups for differences in relevant outcomes and individual characteristics.

Methods
Partnered women treated for cancer (n = 226; M age = 51.1 (12.6); 54% breast cancer; 86% White) completed a cross-sectional survey assessing sexual and psychosocial wellbeing. K-means cluster analysis modeled subgroups (clusters) with similar response patterns on measures of sexual wellbeing (sexual function, distress, sexual communication, and self-efficacy for communication), psychosocial wellbeing (quality of life (QOL), anxiety and depressive symptoms), and time since treatment. ANOVAs with Tukey post-hoc analyses and chi-square analyses tested cluster mean differences.

Results
Three distinct clusters of women differed by levels of adjustment in sexual and psychosocial wellbeing: higher-adjustment (32.7%), intermediate (37.6%), and lower-adjustment (29.6%). Significant differences among the clusters were found for all outcomes, with largest effect sizes for sexual distress (η2p = 0.66), sexual communication (η2p = 0.51), sexual satisfaction (η2p = 0.44), and anxiety and self-efficacy for communication (η2p = 0.32). The intermediate adjustment group was characterized by lower adjustment on measures of sexual and relationship function, and better adjustment on measures of QOL and mood.

Conclusions
Findings suggest that for women cancer survivors, measures of sexual and psychosocial wellbeing can model distinct profiles to inform targeted interventions to meet women’s needs. Evidence-based targeted interventions could lead to better sexual function, and ultimately to better QOL and overall wellbeing.

Implications for practice
A stepped intervention approach to sexual health care for women with cancer, where content and format depend on degree of sexual and psychosocial adjustment after cancer, may be most appropriate. Interdisciplinary teams may address sexual, emotional, and relationship functioning.
Impact of educational training and C-reactive protein point-of-care testing on antibiotic prescribing in rural and urban family physician practices in Latvia: a randomised controlled intervention study
Authors: Likopa Zane , Kivite-Urtane Anda , Silina Vija , Pavare Jana 
Published: September 2022

Abstract
Background
Although self-limiting viral infections are predominant, children with acute infections are often prescribed antibiotics by family physicians. The aim of the study is to evaluate the impact of two interventions, namely C-reactive protein point-of-care testing and educational training, on antibiotic prescribing by family physicians.

Methods
This randomised controlled intervention study included acutely ill children consulted by 80 family physicians from urban and rural practices in Latvia. The family physicians were divided into two groups of 40. The family physicians in the intervention group received both interventions, i.e. C-reactive protein point-of-care testing and educational training, whereas the family physicians in the control group continued to dispense their standard care. The primary outcome measure was the antibiotic prescribing at the index consultation (delayed or immediate prescription) in both study groups. The secondary outcome was CRP testing per study group. Patient- and family physician- related predictors of antibiotic prescribing were analysed as associated independent variables. Practice location effect on the outcomes was specially addressed, similar to other scientific literature.

Results
In total, 2039 children with acute infections were enrolled in the study. The most common infections observed were upper and lower respiratory tract infections. Overall, 29.8% (n = 607) of the study population received antibiotic prescription. Our binary logistic regression analysis did not find a statistically significant association between antibiotic prescriptions and the implemented interventions. In the control group of family physicians, a rural location was associated with more frequent antibiotic prescribing and minimal use of CRP testing of venous blood samples. However, in the intervention group of family physicians, a rural location was associated with a higher level of C-reactive protein point-of-care testing. Furthermore, in rural areas, a significant reduction in antibiotic prescribing was observed in the intervention group compared with the control group (29.0% (n = 118) and 37.8% (n = 128), respectively, p = 0.01).

Conclusion
Our results show that the availabilty of C-reactive protein point-of-care testing and educational training for family physicians did not reduce antibiotic prescribing. Nevertheless, our data indicate that regional variations in antibiotic-prescribing habits exist and the implemented interventions had an effect on family physicians practices in rural areas.
Experiences and challenges faced by community mental health workers when providing care to people with mental illness: a qualitative study
Authors: Li Chaoyang , Yang Fen , Yang Bing Xiang , Chen Wencai , Wang Qinyu , Huang Haishan , Liu Qian , Luo Dan , Wang Xiao Qin , Ruan Juan 
Published: September 2022

Abstract
Background
Mental illness is a major burden of disease worldwide. Community Mental Health Services (CMHS) are key to achieving community-based recovery for people with mental illness. In China, even though the community management of patients with mental illness is improving, the barriers faced by Community Mental Health Workers (CMHWs) are unclear. This study explores the difficulties and challenges in CMHS from the perspective of CMHWs. The results of this study may provide a practical basis for the training of CMHWs.

Methods
We carried out a qualitative study using an empirical phenomenological approach. Nine CMHWs were recruited from nine communities in Wuhan, Hubei Province, using purposive and snowball sampling. Face to face semi-structured in-depth interviews were conducted with them from December 27 to 28, 2019. Interview recordings were converted to text content by Nvivo 11.0 software and analyzed using Colaizzi’s phenomenological method.

Results
Three main themes were identified in this study: 1) Lack of role orientation leads to role ambiguity, 2) Failure to establish a therapeutic trust relationship with patients, and 3) Lack of communication and collaboration with various departments and peers. Seven sub themes were also identified. In these themes, CMHWs emphasized the importance of role clarity, therapeutic trusting relationships, and effective communication and coordination mechanisms.

Conclusion
Although China has made great efforts on the road to improving the quality of CMHS, several salient issues regarding CMHWs must be addressed to optimize the quality of services provided by CMHWs. Community mental health institutions should help CMHWs overcome these difficulties, by maximizing its value and promoting the development of CMHS.
Expert consultation using the on-line Delphi method for the revision of syndromic groups compiled from emergency data (SOS Médecins and OSCOUR®) in France
Authors: Thiam Marie-Michèle , Simac Leslie , Fougère Erica , Forgeot Cécile , Meurice Laure , Naud Jérôme , Le Strat Yann , Caserio-Schönemann Céline 
Published: September 2022

Abstract
Background
Consultation data from emergency general practitioners known as SOS Médecins and emergency departments (ED) from OSCOUR® network to the French syndromic surveillance system SurSaUD® (Surveillance sanitaire des urgences et décès). These data are aggregated and monitored on a daily basis through groupings of one or more medical symptoms or diagnoses (“syndromic groups” (SG)).
The objective of this study was to evaluate, revise and enrich the composition of SGs through a consensus of experts who contributed or have experience in syndromic surveillance.

Methods
Three rounds of a Delphi survey were organised, involving 15 volunteers from SOS Médecins and 64 ED physicians in the OSCOUR® network as well as 8 international epidemiologists. Thirty-four SOS Médecins and 40 OSCOUR® SGs covering major medical specialities were put to the experts, along with their diagnostic codes and their surveillance objectives. In each round, the experts could retain or reject the codes according to the surveillance objective. The panel could also put forward new diagnostic codes in the 1st round, included in subsequent rounds. Consensus was reached for a code if 80% of participants had chosen to keep it, or less than 20% to reject it.

Results
A total of 12 SOS Médecins doctors (80%), 30 ED doctors (47%) and 4 international experts (50%) participated in the three rounds. All of the SGs presented to the panel included 102 initial diagnostic codes and 73 additional codes for SOS Médecins, 272 initial diagnostic codes and 204 additional codes for OSCOUR®. At the end of the 3 rounds, 14 SOS Médecins (40%) and 11 OSCOUR® (28%) SGs achieved a consensus to maintain all of their diagnostic codes. Among these, indicators of winter seasonal surveillance (bronchiolitis and gastroenteritis) were included.

Conclusion
This study involved a panel of national experts with international representation and a good level of involvement throughout the survey. In the absence of a standard definition, the Delphi method has been shown to be useful in defining and validating syndromic surveillance indicators.
Characteristics of pleural effusion with a high adenosine deaminase level: a case–control study
Authors: Shimoda Masafumi , Hirata Aya , Tanaka Yoshiaki , Morimoto Kozo , Yoshiyama Takashi , Yoshimori Kozo , Saraya Takeshi , Ishii Haruyuki , Ohta Ken 
Published: September 2022

Abstract
Background
Increased pleural fluid adenosine deaminase (ADA) is useful for diagnosing tuberculous pleurisy (TB), but high ADA levels are associated with other diseases. In this study, we compare various disease characteristics in patients with high-ADA pleural effusion.

Methods
We retrospectively collected data for 456 patients with pleural fluid ADA levels of ≥ 40 U/L from January 2012 to October 2021. Cases were classified as TB (n = 203), pleural infection (n = 112), malignant pleural effusion (n = 63), nontuberculous mycobacteria (n = 22), malignant lymphoma (ML) (n = 18), autoimmune diseases (n = 11), and other diseases (n = 27), and data were compared among those diseases. Predictive factors were identified by comparing data for a target disease to those for all other diseases. A diagnostic flowchart for TB was developed based on those factors.

Results
The most frequent disease was TB, though 60.0% of patients were diagnosed with other diseases. Median ADA levels in patients with TB were 83.1 U/L (interquartile range [IQR] 67.2–104.1), higher than those of patients with pleural infection (median 60.9 [IQR 45.3–108.0], p = 0.004), malignant pleural effusion (median 54.1 [IQR 44.8–66.7], p < 0.001), or autoimmune diseases (median 48.5 [IQR 45.9–58.2], p = 0.008), with no significant difference from NTM (p = 1.000) or ML (p = 1.000). Pleural fluid lactate dehydrogenase (LDH) levels of < 825 IU/L were beneficial for the diagnosis of TB. Neutrophil predominance or cell degeneration, white blood cell count of ≥ 9200/µL or C-reactive protein levels of ≥ 12 mg/dL helped in diagnosing pleural infection. Pleural fluid amylase levels of ≥ 75 U/L and a pleural fluid ADA/total protein (TP) ratio of < 14 helped in diagnosing malignant pleural effusion. High serum LDH and high serum/pleural fluid eosinophils helped in diagnosing ML and autoimmune diseases, respectively. The flowchart was comprised of the following three factors: pleural fluid LDH < 825 IU/L, pleural fluid ADA/TP of < 14, and neutrophil predominance or cell degeneration, which were decided by a decision tree. The diagnostic accuracy rate, sensitivity, and specificity for the diagnosis of TB were 80.9%, 78.8%, and 82.6%, respectively.

Conclusion
Cases involving high pleural fluid ADA levels should be investigated using several factors to distinguish TB from other diseases.
CDH1 overexpression predicts bladder cancer from early stage and inversely correlates with immune infiltration
Authors: Fan Tao , Xue Liang , Dong Bingzheng , He Houguang , Zhang Wenda , Hao Lin , Ma Weiming , Zang Guanghui , Han Conghui , Dong Yang 
Published: September 2022

Abstract
Background
Bladder cancer (BC) seriously endangers public health, but effective biomarkers for BC diagnosis, particularly in the early stage, are still lacking. Identification of reliable biomarkers associated with early-stage BC is of great importance to early treatment and an improved outcome.

Methods
Differentially expressed genes (DEGs) were identified using four publicly available early-stage BC gene-expression profiles. Protein–protein interaction (PPI) and survival analysis for hub genes was evaluated. The correlation between methylation of genes and prognosis was evaluated using the MethSurv database. Co-expressed genes were explored using Cancer Cell Line Encyclopedia database and the corresponding expression were assessed in vitro. The competing endogenous RNA network and the immune cell infiltration in BC were generated using data of The Cancer Genome Atlas.

Results
Ten hub genes of the 213 integrated DEGs were identified, including CDH1, IGFBP3, PPARG, SDC1, EPCAM, ACTA2, COL3A1, TPM1, ACTC1, and ACTN1. CDH1 appeared to increase from tumor initiation stage and negatively correlated with methylation. Six methylated sites in CDH1 indicated a good prognosis and one site indicated an aberrant prognosis. High CDH1 expression was negatively correlated with infiltrations by most immune cells, such as plasmacytoid dendritic cells (pDCs), regulatory T cells, macrophages, neutrophils, DCs, and natural killer cells. CDH1 was highly positively correlated with EPCAM and appeared to be directly regulated by miR-383.

Conclusions
The identified oncogenic alterations provide theoretical support for the development of novel biomarkers to advance early-stage BC diagnosis and personalized therapy.