bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipstick on a pig: Understanding efforts to redesign audit and feedback reports for primary care.
Authors: Rouleau Geneviève , Reis Catherine , Ivers Noah Michael , Desveaux Laura 
Published: February 2022

Abstract
Background: In Ontario, Canada, a government agency known as Ontario Health is responsible for making audit and feedback reports available to all family physicians. The confidential report provides summary data on three key areas of practice: safe prescribing, cancer screening, and diabetes management. This report was redesigned to improve its usability and the objective of this study was to explore how the redesign was perceived. Methods: We conducted qualitative semi-structured interviews with family physicians who had experience with both versions of the report, recruited through purposeful and snowball sampling. We analysed the transcripts following an emergent and iterative approach. Results: Saturation was reached after 17 family physicians participated. Two key themes emerged as factors that impacted the perceived usability of the report: (1) alignment between report and recipients’ expectations and (2) capacity to engage in quality improvement. Family physicians expected the report and its quality indicators to reflect best practice, to be valid and accurate. They also expected the report to offer feedback on clinical activities they perceived were within their control to change. Further, family physicians expected the goal of the report to be aligned with their perspective on feasible quality improvement activities. Most of these expectations were not met, limiting the perceived usability of the report. The capacity to engage with audit and feedback was hindered by several organizational and physician-level barriers including the lack of fit with existing workflow, competing priorities, time constraints, and insufficient skills for bridging the gaps between their data and the corresponding desired actions.Conclusions: Overall, the redesigned feedback report was not perceived as highly usable, given the misalignement between report and family physicians’ expectations as well as limited capacity to engage with the report. Consequently, the potential impact on clinical practice may be limited. Co-interventions to address the barriers of using audit and feedback report, as well as creating space for bridging together audit and feedback designers and recipients are avenues to consider for improving usability and effectiveness such quality improvement initiatives.
Simulation Based Clinical Skill Training; A Need Of Time
Authors: Nisar Sumera , Rehman Durraiz , Rehman Areeb 
Published: February 2022

Abstract
Objective: To explore the perception and attitude about simulation-based learning (SBL) of clinical skills in undergraduate medical students.Place and Duration of Study: College of Medicine, Princess Noura bint Abdulrehman university; Riyadh, Saudi Arabia, from March to September 2019.Method: A pre-tested structured self-administered questionnaire was used to collect the data about student’s perception about simulation-based learning. Informed written consent was taken from the students. Data analysis was done by SPSS version 21 and Chi square test was used to see the association between the variables of the interest.Result: Mean age of the students was 21.5 (standard deviation ±1.8) years. Majority of the students (81.6%) found SBL as a favorable mode of learning clinical skills. 59% of the students found it useful to manage to see the rarest cases in medicine. Many of them believed it useful to overcome the problems of uncooperative patients (59.1%) and to solve the problem in getting the patients during exam (60.2%). They also strongly believed that simulation should be integrated in medical school curriculum as an efficient tool for learning clinical skillsConclusion: The study strongly suggests student’s positive perspective towards learning through simulation. Medical educators and curriculum designers can use the results of the study to incorporate simulation in undergraduate curriculum to train and enhance student’s clinical skills and maintain patient safety.
On Occurrence of Mixed-torus Bursting Oscillations Induced by Non-Smoothness
Authors: Bi Qinsheng , Chen Shaomin 
Published: February 2022

Abstract
The paper devotes to the slow-fast behaviors of a higher dimensional non-smooth system with the coupling of two scales. Some novel bursting attractors and interesting phenomena are presented, especially the so-called mixed-torus bursting oscillations, in which the trajectory moves along different tori in turn, though the bursting attractor still behaves in quasi-periodic form. Based on a 4-D hyper-chaotic model with two scrolls, a modified non-smooth slow-fast version is established by introducing a non-smooth boundary as well as a periodic external excitation, which can also be easily implemented by circuit. When the exciting frequency is far less than the natural frequency, implying the coupling of two scales in frequency domain exists, the whole exciting term can be regarded as a slow-varying parameter. Upon the bifurcations analysis of the subsystems in the two regions divided by the boundary, together with the non-smooth bifurcations on the boundary, the coexisted attractors with the variation of the slow-varying parameter are derived.
From the dynamical evolution of the full system with the increase of the exciting amplitude, bursting oscillations may change from periodic to quasi-periodic attractor, the mechanism of which is obtained by employing the overlap of the transformed phase portrait and coexisted attractors as well as the bifurcations. Sliding along the boundary on the trajectory can be observed on the bursting attractor, the mechanism of which can be accounted for by employing the non-smooth theory or by the in-turn influence of two pseudo attractors in different regions. Super-cone defined by a unstable focus may leading to the period-adding or period-decreasing phenomena in the spiking oscillations, while fold limit cycle bifurcation may result in the dramatically change of the spiking amplitude. The trajectory may pass across or graze at the boundary, while grazing bifurcation may cause the period-doubling bifurcation of the stable non-smooth limit cycle. Numerical simulation reveals that the grazing point on the trajectory can be removed by increasing the exciting amplitude, which can be used for controlling purpose. Furthermore, it is found that when the amplitude increases to an extent, both the non-smooth limit cycle as well as the cycle bifurcated from it via period-doubling bifurcation may involve the full vector field, resulting in the so-called mixed-torus bursting oscillations, in which the quiescent states seems to be pivots of the oscillations.
A Journey of Digital Co-Production: Introducing the “E-Nabling Digital Co-Production” Framework and Its Performance in Dementia Research
Authors: Molinari-Ulate Mauricio , Woodcock Rebecca , Smith Isabelle , Roest Henriëtte G. van der , Franco-Martín Manuel A. , Craven Michael P. 
Published: February 2022

Abstract
Background
The rapid transition to digital working, accelerated due to the response to the COVID-19 pandemic, has impacted the involvement of patients and public in research. For this reason, this paper presents a narrative of a co-production journey experienced by a Participant and Public Involvement (PPI) group since the lockdowns and recommendations regarding digital working in England, followed by a practical implementation of a framework within the context of dementia research.
Methods
Three online workshops were performed with a group of researchers, facilitators and contributors with experience in PPI in dementia research, and a dementia PPI group that kept working during the pandemic. Thematic analysis was chosen for the data analysis. The project was targeted as a PPI activity and the MindTech Involvement Team (PPI group) was involved in the entire process.
Results
After a refinement of the coding structure, the MindTech Involvement Team and Project Leaders identified the potential of using four coding areas resulting in the ‘E-nabling Digital Co-production' Framework. Through this framework, conflicting positions were identified associated with the transition to digital working. Two main remarks were shared by the participating groups regarding e-PPI; the wider potential in terms of non-geographical constraints, and the perspective of more business-like sessions with reduce social interactions and communication. Specifically for dementia research, e-PPI may allow participants to attend more meetings, although the mutually supportive environment of face-to-face meetings is diminished, and carers can miss out on respite opportunities.
Conclusions
This public engagement activity introduced the ‘E-nabling Digital Co-production' Framework showing an initial potential for the analysis of e-PPI flaws and benefits. It was possible to identify insights of e-PPI regarding general concerns and specific to dementia research. However, the most significant contribution of the framework is the potential to support local journeys of co-production in ongoing public involvement activities.
AR Artificial Antagonist HC-1119 Regulated TNBC BT549 Cells Proliferation and Metastasis via PI3K/Akt/mTOR Signaling Pathway
Authors: Huang Qian , Zhang Qing , Ren Qiuyu , Ma Lu , Li Xinghai , He Tao , Gan Lin 
Published: February 2022

Abstract
Background: Triple negative breast cancer (TNBC) was a specific refractory and aggressive malignancy subtype of breast cancer with high mortality. Our study aimed to explore the underlying molecular mechanism of androgen receptor (AR) antagonist HC-1119 on BT549 cells. Methods: AR, estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor 2 (HER2) were detected by western blotting in common breast cancer cell lines. The cell viability was detected by Cell Counting Kit-8 (CCK8) assay. The apoptotic percentage and cell cycle distribution were assessed by flow cytometry, the cells motility and invasion capability were analyzed by Transwell assay. The potential signaling pathway was explored by RNA-Seq and bioinformatics analysis in BT549 cells treated with HC-1119, and was determined by western blotting. Results: BT549 cells hardly expressed HER2, PR and ER, but highly expressed AR. HC-1119 significantly inhibited the AR expression. HC-1119 and bicalutamide both inhibited the cell proliferation in a concentration-dependent manner and in a time-dependent manner of BT549 cells. HC-1119 and bicalutamide could significantly increase the percentage of apoptosis and S-phase percentage of BT549 cells and reduced BT549 cells motility and invasion capabilities. RNA-Seq and Bioinformatics results showed that HC-1119 regulated BT549 cells proliferation via the PI3K/Akt/mTOR signaling pathway. Western blotting data convinced that HC-1119 could inhibit the expressions of p-mTOR, p-Akt, S6, p-S6 and P21.Conclusions: Our study revealed that the artificial AR antagonist HC-1119 inhibited BT549 cells cell proliferation, motility and invasion capabilities, induced cells apoptosis and arrested the cell cycle progression at the S phase. And HC-1119 may regulate cells proliferation via the PI3K/Akt/mTOR signaling pathway.
A Mobile Web Application Enhancing Knowledge and Providing Health Services Concerning Sexually Transmitted Diseases and Unplanned Pregnancy Prevention Among Akha Adolescents in Chiangrai Province, Northern Thailand
Authors: Chansiri Suphaphan , Wongwatkit Charoenchai 
Published: February 2022

Abstract
Background: Akha adolescents in Chiang Rai lack knowledge about safe sex, the severity of sexually transmitted diseases, and unplanned pregnancy. This research aimed to develop innovative applications to serve as an important tool for enhancing knowledge and understanding of sexual health.Methods: The study consisted of three phases. The first phase was a survey of the needs of Akha adolescents on Doi Mae Salong and Doi Wawee in Chiang Rai Province, using an exploratory qualitative research method. A semi-structured interview was used with a total of 48 subjects in both the formal and non-formal education system. Data were analyzed by content analysis. The second phase was the designing and development of the mobile web application prototype which was given to a group of 37 people, both males and females to try out. The third phase was to test the users’ knowledge improvement and a questionnaire survey of users’ satisfaction and opinions about the mobile web application using a sample of 108 users. Data were analyzed using descriptive statistics: frequency; percentage; mean; and standard deviation including a paired sample t-test.Results: The findings revealed a statistical significance (p ≤ 0.001) in the improvement of users’ knowledge (both males and females) between the pretest (x̅ = 4.15) and the posttest (x̅ = 7.23). Users’ satisfactions were also revealed with their impressions in 3 areas: 1) learning; 2) ease of use; 3) information display. The users found the mobile web application was useful, interesting, and attractive.Conclusions: This innovative application can increase knowledge and practices and prevent pregnancies and sexually transmitted diseases. It can be used in various learning contexts.
CD97 Serves as a Novel Biomarker of Immune Cell Infiltration in Hepatocellular Carcinoma
Authors: Su Qiuming , Li Lu , Li Xiaokai , Li Wang , Zhang Xibing , Dong Yun , Han Lei , Wang Duo , Ran Jianghua 
Published: February 2022

Abstract
Background
CD97 is the most widely expressed G protein-coupled receptor in the epidermal growth factor seven-span transmembrane family. It plays a vital role in cell adhesion, migration, and cell connection regulation. We explored the role of CD97 in hepatocellular carcinoma (HCC).
Methods
We evaluated CD97 mRNA expression in HCC using TNMplot and the Gene Expression Omnibus database. The clinical prognostic significance of CD97 in HCC was evaluated by gene expression profiling interactive analysis, the Kaplan–Meier plotter, and the UALCAN database. The Tumor Immune Estimation Resource (TIMER) and CIBERSORT databases were used to analyze the relationships among CD97, CD97 co-expression genes, and tumor-infiltrating immune cells.
Results
CD97 was highly expressed in HCC and was associated with a poor prognosis. CD97 and its co-expressed genes were positively correlated with tumor-infiltrating immune cells and strongly correlated with tumor-infiltrating macrophages (all r ≥ 0.513, P < 0.0001). CD97 was closely related to M2 macrophage and tumor-associated macrophage markers (both r ≥ 0.464, P < 0.0001). CD97 was found to be an immune-related gene in HCC and positively correlated with the TOX, PD-L1, PD-L2, CTLA4, and PD-1 immune checkpoint genes. CD97 copy number alterations affect the level of immune cell infiltration and mRNA expression.
Conclusions
CD97 can be used as a potential molecular marker of prognosis in HCC, which is associated with immune cell infiltration.
Thermal Decomposition and Kinetic Parameter of Bridgeman- Grown In2Se3-xSbx (x= 0.3) Single Crystals
Authors: Patel P. J. , Vyas S. M. , Patel V. A. , Varasada R. 
Published: February 2022

Abstract
The thermal analysis of the vertical Bridgman-grown In2Se2.7Sb0.3 single crystals was carried out by recording the Thermogravimetric (TG), Differential Thermogravimetric (DTG) and Differential Thermal Analysis (DTA) curves. All the three thermo-curves were recorded simultaneously by thermal analyzer in the temperature range of ambient to 650 0 C in air atmosphere. The thermo-curves were recorded for single heating rates of 10 °C/min. The thermal kinetic parameters of the vertical Bridgman-grown In2Se2.7Sb0.3 single crystals were determined employing the non-mechanistic H-M (Horowitz and Metzger), P-N (Piloyan-Novikova), C-R (Coats-Redfem) and Broido relation from TGA and PRN (Piloyan, Ryabchikov and Novikova) and BD (Borchardt and Daniels) relation from DTA curves. The determined kinetic parameters support the observations of the thermo-curves.
Maternal And Neonatal Exposure To Risk Factors For Neonates With Moderate Or Severe Hypoxic Ischemic Encephalopathy: A Cross-Sectional Study
Authors: wang yiran , luo shuying , wang kaijuan , hou yuwei , yan hui , zhang yaodong 
Published: February 2022

Abstract
Background:To investigate the association between maternal and neonatal exposure to the relevant influencing factors and risk of moderate or severe hypoxic ischemic encephalopathy(HIE),and the possible interactions in the Chinese population. Methods:A cross-sectional study comprising 228 neonates from Henan Children’s Hospital during the five-year period 2015-2020 in China was conducted. All neonatal basic demographic information and clinical records were documented from the neonatal HIE database. Comparisons between mild HIE and moderate or severe HIE were conducted with the t-test or Wilcoxon rank-sum test for continuous variables and the Chi-square test for categorical variables.Unconditional multiple logistic regression models were used to generate the odds ratios(ORs) and 95% confidence intervals(CIs). In addition, we also used an additive model to test for possible biological interactions among the factors. Results: Of the 228 neonates, the males had a statistically significantly higher frequency compared with the females between the two groups (P=0.030). Trend analysis results found that with the decreased of the neonatal birth weight, the detection rates of moderate or severe HIE in males and females were gradually increased (Ptrend＜0.05). The detection of moderate or severe HIE in males and females increased with the decreased of neonatal gestational age at birth(Ptrend＜0.05). However, no interaction was detected between neonatal birth weight and gestational age at birth based on the additive model, the Relative Excess Risk of Interaction and 95% CI was 3.856(-1.753,5.217). The adjusted multiple logistic regression model showed that low birth weight(ORadj:1.965, 95%CI:1.086-4.127),premature infant(ORadj:1.557, 95%CI:1.589-4.862),1-min Apgar’s score＜7(ORadj:5.618, 95%CI:3.724-7.353),intrauterine distress(ORadj:4.916, 95%CI:3.431-7.398),amniotic fluid contamination (ORadj:3.965, 95%CI:2.153-5.782) significantly increased the risk of neonatal moderate or severe HIE. Conclusion:Neonates with low birth weight, premature infant,1-min Apgar’s score＜7, intrauterine distress, amniotic fluid contamination are risk factors for moderate or severe HIE. Notably, we found no biological interaction between risk factors based on the additive model, these findings may help to inform prevention strategies, as this may effectively reduce the incidence of neonatal moderate or severe HIE.
Post-Operative Copeptin Analysis Predicts Which Patients Do Not Develop Diabetes Insipidus After Pituitary Surgery
Authors: Rostom Hussam , Noronha Sean , Jafar-Mohammadi Bahram , May Christine , Borg Anouk , Halliday Jane , Cudlip Simon , James Tim , Guha Nishan , Shine Brian , Pal Aparna 
Published: February 2022

Abstract
Background: Diabetes insipidus (DI) is a recognised complication of pituitary surgery, with diagnosis requiring clinical observation aided by plasma and urine electrolytes and osmolalities. Copeptin is a stable surrogate marker of AVP release and has potential to facilitate prompt diagnosis of post-operative DI. This assay has been shown to accurately predict which patients are likely to develop DI following pituitary surgery. Objective: To determine whether copeptin analysis can be used to predict which patients are at risk of developing DI following transsphenoidal adenomectomy (TSA).Methods: 78 patients undergoing TSA had samples taken for copeptin pre-operatively and at day 1 post-TSA. The majority of patients also had samples from day 2, day 8, and week 6 post-TSA. Results from patients who developed post-operative DI (based on clinical assessment, urine and plasma biochemistry and the need for treatment with DDAVP) were compared to those who did not. Patients with any evidence of pre-operative DI were excluded.Results: Of 78 patients assessed, eleven were clinically determined to have developed DI. Differences were observed between patients with DI and those without in post-operative samples. Of note, there was a significant difference in plasma copeptin at day 1 post-operation (p=0.010 on Kruskal-Wallis test), with copeptin levels greater than 3.4 pmol/L helping to rule out DI (91% sensitivity, 55% specificity at this cut off).Conclusion: In the post-TSA setting, copeptin is a useful rule-out test in patients with values above a defined threshold, which may facilitate earlier decision making and shorter hospital stays.
Identification Of PPIA As A Prognostic Biomarker Of Lung Adenocarcinoma From Bioinformatics Analysis
Authors: li lan , Yu Junlin , Chen Zhengting , Lu Fei , Cao Ke , Gao Jingyan , Chang Li , Li Wenhui 
Published: February 2022

Abstract
Background: We aim to investigate the expression of the peptidylprolyl isomerase A (PPIA) gene in lung adenocarcinoma(LUAD),and to investigate the diagnostic, prognostic value and correlation with immune infiltrates of PPIA in LUAD.Methods: Transcriptional expression profiles of PPIA between LUAD tissues and normal tissues were downloaded from the Cancer Genome Atlas (TCGA).The PPIA protein expression was assessed by the Clinical Proteomic Tumor Analysis Consortium (CPTAC) .Receiver operating characteristic(ROC) curve was used to differentiate LUAD from adjacent normal tissues.Kaplan-Meier method was conducted to assess the effect of PPIA on survival.Protein-protein interaction (PPI) networks were constructed by the STRING.Functional enrichment analyses were performed using the“ClusterProfiler”package.The relationship between PPIA mRNA expression and immune infiltrates was determined by tumor immune estimation resource (TIMER) and tumor-immune system interaction database (TISIDB).Results: The expression of PPIA in LUAD tissues was significantly upregulated than those in adjacent normal tissues. High PPIA mRNA expression was associated with lymph node metastases and high TNM stage. The ROC curve analysis showed that PPIA had an AUC value of 0.804(95% CI: 0.764-0.843).Kaplan-Meier survival analysis showed LUAD patients with high-PPIA had a worse prognosis than those with low-PPIA(mOS: 42.2months VS 87.2months,P＜0.001). Correlation analysis indicated PPIA mRNA expression was correlated with immune infiltrates.PPIA expression had correlations with CD4+ T cell (r = -0.29, P = 5.51e-11),macrophage M1 (r = 0.106, P = 1.84e-02), and B cell (r = -0.181, P =5.40e-5).Conclusion: Our research showed that PPIA could be used as a prognostic biomarker.Up-regulation of PPIA expression is significantly related to poor prognosis and immune infiltration of LUAD and may be a potential therapeutic molecular target for LUAD patients.