bluuebunny/crossref_metadata_2025_split huggingface dataset:
The educational use of social networking sites among medical and health sciences students: a cross campus interventional study
Authors: Dash Nihar Ranjan , Hasswan Ahmed Alrazzak , Dias Jacqueline Maria , Abdullah Natasya , Eladl Mohamed Ahmed , Khalaf Khaled , Farooq Ajmal , Guraya Salman Yousuf 
Published: July 2022

Abstract
Background
In recent years, social networking sites (SNSs) have evolved beyond connection and networking to become a powerful instructional tool. There is still a dearth of knowledge on the professional use of SNSs for education particularly among students from diverse backgrounds. This study examined the extent and pattern of SNSs usage for education across six institutions and then conducted an interventional workshop to fortify and regulate the educational use of SNSs.

Methods
This multicenter study was done in two phases. In the first phase, an online cross-sectional survey using a validated inventory was administered to determine the prevalence, extent, and preferences of SNSs usage by undergraduate students in medicine, health sciences and dentistry across five centers. Later, the second phase of the study was undertaken in a 75-min guided live workshop about the appropriate use of SNSs in academia. Additionally, pre- and post-test surveys were conducted to assess the impact and outcome of workshop.

Results
Of the 1722 respondents, 1553 (90%) reported using SNSs with the frequency of once a month to three to five times per day for education and to stay in touch with others. Most students agreed with the benefits of SNSs for education mainly in terms of information gathering, networking and collaboration. Twitter, Instagram, and Pinterest were noted as the most preferred SNSs for education. Nevertheless, 63% perceived that proper instruction was required for the efficient use of SNSs. Following the guided workshop, there was a significant improvement in web technology understanding, digital professionalism, skills and knowledge on the productive use of SNSs. Students rated the efficient for conceptual learning, connection to community practice, e-portfolio, and collaborative learning as the top four major teaching and learning strategies, respectively, in the post-workshop survey.

Conclusion
Our study demonstrates that SNSs can be used as learning tools in medical education. However, SNSs usage should be regulated and guided for a more collegial and coherent learning climate in the digital realm. We urge medical educators to integrate SNSs into their courses for a technologically advanced and impactful curriculum.
Protective role of VEGF/VEGFR2 signaling against high fatality associated with hepatic encephalopathy via sustaining mitochondrial bioenergetics functions
Authors: Tsai Ching-Yi , Wu Jacqueline C. C. , Wu Chiung-Ju , Chan Samuel H. H. 
Published: July 2022

Abstract
Background
The lack of better understanding of the pathophysiology and cellular mechanisms associated with high mortality seen in hepatic encephalopathy (HE), a neurological complication arising from acute hepatic failure, remains a challenging medical issue. Clinical reports showed that the degree of baroreflex dysregulation is related to the severity of HE. Furthermore, mitochondrial dysfunction in the rostral ventrolateral medulla (RVLM), a key component of the baroreflex loop that maintains blood pressure and sympathetic vasomotor tone, is known to underpin impairment of baroreflex. Realizing that in addition to angiogenic and vasculogenic effects, by acting on its key receptor (VEGFR2), vascular endothelial growth factor (VEGF) elicits neuroprotection via maintenance of mitochondrial function, the guiding hypothesis of the present study is that the VEGF/VEGFR2 signaling plays a protective role against mitochondrial dysfunction in the RVLM to ameliorate baroreflex dysregulation that underpins the high fatality associated with HE.

Methods
Physiological, pharmacological and biochemical investigations were carried out in proof-of-concept experiments using an in vitro model of HE that involved incubation of cultured mouse hippocampal neurons with ammonium chloride. This was followed by corroboratory experiments employing a mouse model of HE, in which adult male C57BL/6 mice and VEGFR2 wild-type and heterozygous mice received an intraperitoneal injection of azoxymethane, a toxin used to induce acute hepatic failure.

Results
We demonstrated that VEGFR2 is present in cultured neurons, and observed that whereas recombinant VEGF protein maintained cell viability, gene-knockdown of vegfr2 enhanced the reduction of cell viability in our in vitro model of HE. In our in vivo model of HE, we found that VEGFR2 heterozygous mice exhibited shorter survival rate and time when compared to wild-type mice. In C57BL/6 mice, there was a progressive reduction in VEGFR2 mRNA and protein expression, mitochondrial membrane potential and ATP levels, alongside augmentation of apoptotic cell death in the RVLM, accompanied by a decrease in baroreflex-mediated sympathetic vasomotor tone and hypotension. Immunoneutralization of VEGF exacerbated all those biochemical and physiological events.

Conclusions
Our results suggest that, acting via VEGFR2, the endogenous VEGF plays a protective role against high fatality associated with HE by amelioration of the dysregulated baroreflex-mediated sympathetic vasomotor tone through sustaining mitochondrial bioenergetics functions and eliciting antiapoptotic action in the RVLM.
COVID-19 vaccination efficacy in numbers including SARS-CoV-2 variants and age comparison: a meta-analysis of randomized clinical trials
Authors: Sobczak Marharyta , Pawliczak Rafał 
Published: July 2022

Abstract
Background
New vaccines are being developed to fight the ongoing COVID-19 pandemic. In our study we compared the efficacy of COVID-19 vaccines to prevent COVID-19-related infections and mortality.

Methods
17 randomized clinical trials of COVID-19 vaccines were included after search in databases. We compared COVID-19 vaccines based on symptomatic and severe infections, number of deaths and hospitalizations related to COVID-19. Also, we analyzed the efficacy of COVID-19 against different variants of SARS-CoV-2 as well as according to different age groups. Random effects model using Mantel–Haenzeal method was used to pool relative risk (RR).

Results
Our meta-analysis shows that full vaccination could decrease not only the risk of symptomatic or severe COVID-19, the risk of hospitalization and death caused by COVID-19. COVID-19 vaccines were also effective against variants of SARS-CoV-2 (RR = 0.36; 95% CI [0.25; 0.53], p < 0.0001). However, efficacy of vaccination varied in COVID-19 variant-dependent manner. Moreover, the analysis in different age groups showed that COVID-19 vaccines had the similar results: the risk was slightly lower in adults compared to elderly cohort $$(\ge$$

(
≥

65 years): (RR = 0.16, 95% CI [0.11; 0.23]) and (RR = 0.19, 95% CI [0.12; 0.30]), respectively.

Conclusions
Data obtained from clinical trials of COVID-19 vaccines looks promising, in order to fully investigate efficacy of the vaccines further clinical examination is required especially considering new SARS-CoV-2 variants.
Aberrant salience correlates with psychotic dimensions in outpatients with schizophrenia spectrum disorders
Authors: Pugliese Valentina , de Filippis Renato , Aloi Matteo , Rotella Paola , Carbone Elvira Anna , Gaetano Raffaele , De Fazio Pasquale 
Published: July 2022

Abstract
Background
Aberrant salience is a well-known construct associated with the development and maintenance of psychotic symptoms in schizophrenia. However, only a few studies have investigated aberrance salience as a trait, with no study investigating the association between the five aberrant salience domains and psychotic symptoms. We aimed to explore the role of aberrant salience and its domains on psychotic dimensions in both clinically remitted and non-remitted patients.

Methods
A sample of 102 patients diagnosed with schizophrenia spectrum disorders was divided according to the Positive and Negative Syndrome Scale (PANSS) remission criteria into two groups: remitted and non-remitted. Differences regarding psychotic symptomatology assessed by the PANSS and aberrant salience measured by the Aberrant Salience Inventory (ASI) were explored. Finally, a correlation analysis between the PANSS and the ASI was run.

Results
Significantly higher ASI scores were evident among non-remitted patients. Positive symptoms (i.e. delusions, conceptual disorganization, and hallucinatory behaviour) and general psychopathology (i.e. postural mannerisms, unusual thought content) were correlated to the aberrant salience subscales ‘sharpening of senses’, ‘heightened emotionality’ and ‘heightened cognition’ and with the ASI total score. Significant correlations emerged between negative symptoms (blunted affect and social withdrawal) and ‘heightened cognition'. Finally, lack of spontaneity of conversation was related to the subscales ‘heightened emotionality’ and ‘heightened cognition’, as well as to the ASI total score.

Conclusions
These preliminary results support the hypothesis of an association between aberrant salience and psychotic symptoms in schizophrenia. Further research is needed, especially into the mechanisms underlying salience processing, in addition to social and environmental factors and cognitive variables.
An updated HACOR score for predicting the failure of noninvasive ventilation: a multicenter prospective observational study
Authors: Duan Jun , Chen Lijuan , Liu Xiaoyi , Bozbay Suha , Liu Yuliang , Wang Ke , Esquinas Antonio M. , Shu Weiwei , Yang Fuxun , He Dehua , Chen Qimin , Wei Bilin , Chen Baixu , Li Liucun , Tang Manyun , Yuan Guodan , Ding Fei , Huang Tao , Zhang Zhongxing , Tang ZhiJun , Han Xiaoli , Jiang Lei , Bai Linfu , Hu Wenhui , Zhang Rui , Mina Bushra 
Published: July 2022

Abstract
Background
Heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR) have been used to predict noninvasive ventilation (NIV) failure. However, the HACOR score fails to consider baseline data. Here, we aimed to update the HACOR score to take into account baseline data and test its predictive power for NIV failure primarily after 1–2 h of NIV.

Methods
A multicenter prospective observational study was performed in 18 hospitals in China and Turkey. Patients who received NIV because of hypoxemic respiratory failure were enrolled. In Chongqing, China, 1451 patients were enrolled in the training cohort. Outside of Chongqing, another 728 patients were enrolled in the external validation cohort.

Results
Before NIV, the presence of pneumonia, cardiogenic pulmonary edema, pulmonary ARDS, immunosuppression, or septic shock and the SOFA score were strongly associated with NIV failure. These six variables as baseline data were added to the original HACOR score. The AUCs for predicting NIV failure were 0.85 (95% CI 0.84–0.87) and 0.78 (0.75–0.81) tested with the updated HACOR score assessed after 1–2 h of NIV in the training and validation cohorts, respectively. A higher AUC was observed when it was tested with the updated HACOR score compared to the original HACOR score in the training cohort (0.85 vs. 0.80, 0.86 vs. 0.81, and 0.85 vs. 0.82 after 1–2, 12, and 24 h of NIV, respectively; all p values < 0.01). Similar results were found in the validation cohort (0.78 vs. 0.71, 0.79 vs. 0.74, and 0.81 vs. 0.76, respectively; all p values < 0.01). When 7, 10.5, and 14 points of the updated HACOR score were used as cutoff values, the probability of NIV failure was 25%, 50%, and 75%, respectively. Among patients with updated HACOR scores of ≤ 7, 7.5–10.5, 11–14, and > 14 after 1–2 h of NIV, the rate of NIV failure was 12.4%, 38.2%, 67.1%, and 83.7%, respectively.

Conclusions
The updated HACOR score has high predictive power for NIV failure in patients with hypoxemic respiratory failure. It can be used to help in decision-making when NIV is used.
Sepsis subphenotyping based on organ dysfunction trajectory
Authors: Xu Zhenxing , Mao Chengsheng , Su Chang , Zhang Hao , Siempos Ilias , Torres Lisa K. , Pan Di , Luo Yuan , Schenck Edward J. , Wang Fei 
Published: July 2022

Abstract
Background
Sepsis is a heterogeneous syndrome, and the identification of clinical subphenotypes is essential. Although organ dysfunction is a defining element of sepsis, subphenotypes of differential trajectory are not well studied. We sought to identify distinct Sequential Organ Failure Assessment (SOFA) score trajectory-based subphenotypes in sepsis.

Methods
We created 72-h SOFA score trajectories in patients with sepsis from four diverse intensive care unit (ICU) cohorts. We then used dynamic time warping (DTW) to compute heterogeneous SOFA trajectory similarities and hierarchical agglomerative clustering (HAC) to identify trajectory-based subphenotypes. Patient characteristics were compared between subphenotypes and a random forest model was developed to predict subphenotype membership at 6 and 24 h after being admitted to the ICU. The model was tested on three validation cohorts. Sensitivity analyses were performed with alternative clustering methodologies.

Results
A total of 4678, 3665, 12,282, and 4804 unique sepsis patients were included in development and three validation cohorts, respectively. Four subphenotypes were identified in the development cohort: Rapidly Worsening (n = 612, 13.1%), Delayed Worsening (n = 960, 20.5%), Rapidly Improving (n = 1932, 41.3%), and Delayed Improving (n = 1174, 25.1%). Baseline characteristics, including the pattern of organ dysfunction, varied between subphenotypes. Rapidly Worsening was defined by a higher comorbidity burden, acidosis, and visceral organ dysfunction. Rapidly Improving was defined by vasopressor use without acidosis. Outcomes differed across the subphenotypes, Rapidly Worsening had the highest in-hospital mortality (28.3%, P-value < 0.001), despite a lower SOFA (mean: 4.5) at ICU admission compared to Rapidly Improving (mortality:5.5%, mean SOFA: 5.5). An overall prediction accuracy of 0.78 (95% CI, [0.77, 0.8]) was obtained at 6 h after ICU admission, which increased to 0.87 (95% CI, [0.86, 0.88]) at 24 h. Similar subphenotypes were replicated in three validation cohorts. The majority of patients with sepsis have an improving phenotype with a lower mortality risk; however, they make up over 20% of all deaths due to their larger numbers.

Conclusions
Four novel, clinically-defined, trajectory-based sepsis subphenotypes were identified and validated. Identifying trajectory-based subphenotypes has immediate implications for the powering and predictive enrichment of clinical trials. Understanding the pathophysiology of these differential trajectories may reveal unanticipated therapeutic targets and identify more precise populations and endpoints for clinical trials.
The obesity paradox for survivors of critically ill patients
Authors: Zhou Dawei , Wang Chao , Lin Qing , Li Tong 
Published: July 2022

AbstractThe obesity paradox has been observed in short-term outcomes from critical illness. However, little is known regarding the impact of obesity on long-term outcomes for survivors of critically ill patients. We aimed to evaluate the influence of obesity on long-term mortality outcomes after discharge alive from ICU. The adult patients who were discharged alive from the last ICU admission were extracted. After exclusion, a total of 7619 adult patients discharged alive from ICU were included, with 4-year mortality of 32%. The median body mass index (BMI) was 27.2 (IQR 24–31.4) kg/m2, and 2490 (31.5%) patients were classified as obese or morbidly obese. The morbidly obese patients had the highest ICU and hospital length of stay. However, higher BMI was associated with lower hazard ratio for 4-year mortality. The results showed the obesity paradox may be also suitable for survivors of critically ill patients.
Penalty method for a class of differential nonlinear system arising in contact mechanics
Authors: Chu Xu , Chen Tao , Huang Nan-jing , Xiao Yi-bin 
Published: July 2022

AbstractThe main goal of this paper is to study a class of differential nonlinear system involving parabolic variational and history-dependent hemivariational inequalities in Banach spaces by using the penalty method. We first construct a penalized problem for such a nonlinear system and then derive the existence and uniqueness of its solution to obtain an approximating sequence for the nonlinear system. Moreover, we prove the strong convergence of the obtained approximating sequence to the solution of the original nonlinear system when the penalty parameter converges to zero. Finally, we apply the obtained convergence result to a long-memory elastic frictional contact problem with wear and damage in mechanics.

First part title: Introduction

Second part title: Preliminaries

Third part title: Convergence result for (1.1)

Fourth part title: An application
Multi-family therapy for bulimia nervosa: a qualitative pilot study of adolescent and family members’ experiences
Authors: Escoffié Anabel , Pretorius Natalie , Baudinet Julian 
Published: July 2022

Abstract
Background
Multi-family therapy (MFT-BN) is a new treatment for adolescent bulimia nervosa with emerging empirical support. It extends the bulimia nervosa focussed family therapy model, by offering treatment in a group setting. Up to nine families work together with a team of clinicians over the course of 20 weeks. No qualitative study to date has investigated the experience of MFT-BN. This study aimed to explore this from the adolescent and parent/caregiver perspective.

Methods
Participants from two consecutive MFT-BN groups facilitated at the Maudsley Hospital in London, UK, were invited to participate in either a focus group or individual qualitative interview about the experience of MFT-BN. Of the 19 eligible participants (from 9 families), 15 (8 parents, 1 older sibling, 6 adolescents) consented and participated. Audio-recordings of interviews and focus groups were transcribed verbatim and analysed using reflexive thematic analysis.

Results
Three main themes were identified; (1) seeing and being seen, (2) holistic shift, (3) the unspoken. Participants reported overall shifts in cognitions, emotions, behaviours, and relationships both individually and within the family as a result of attending MFT-BN. Meeting other families with similar struggles and sharing experiences, skills and learning helped reduce isolation and promote change. There was also a sense from participants that some things did not, or could not, be spoken about in the group context and that more direct and challenging conversations might have been helpful at times.

Discussion
The current study identifies some of the perceived benefits and challenges of MFT-BN. The three themes demonstrate the holistic nature of change that can occur across the treatment, as well as the power and limits of the group therapy setting and process. Further research is needed to explore the experience of MFT-BN and its outcomes across a more diverse range of participants and treatment settings.
A randomized controlled trial on mobile phone text messaging to improve sexo-reproductive health among adolescent girls in Cameroon
Authors: Wirsiy Frankline Sevidzem , Atuhaire Catherine , Ngonzi Joseph , Cumber Samuel Nambile 
Published: July 2022

Abstract
Background
We conducted a single-centered randomized controlled single-blinded trial (i.e. trained interviewers; blinded to group allocation). The target population included adolescent girls in the Kumbo West Health District (KWHD) of Cameroon. This trial tested the efficacy of weekly educational one-way text messages to improve perception of adolescent girls on sexo-reproductive health.

Methods
Allocation concealment (1:1) was determined by sequentially numbered sealed opaque envelopes. A total of 398 participants either received the mobile phone sexo-reproductive health text messages (199) or not (199). A blinded program secretary send out text messages and recorded delivery. Data was collected and managed at baseline and at 6 month intervals using an interviewer-administered questionnaire before and after intervention, then analysed using the independent T-test (mean differences) and ANOVA on SPSS version 21.

Results
The mean knowledge, attitude and practice scores respectively increased significantly from 6.03, 4.01 and 3.45 at baseline to 7.99, 5.83 and 4.99 at the end of the study. After performing ANOVA for the overall correct knowledge, positive attitudes and good practices respectively for between and within the intervention groups, we obtained: (F = 15.12, P = 0.023), (F = 60.21, P = 0.001) and (F = 57., P = 0.013) which showed statistical significance thus indicating the overall improvement in adolescents girls perception as a result of the intervention and not by chance. Majority (65.3%) of the participants were satisfied with the Short Message Service (SMS).

Conclusion
This trial has contributed to the body of knowledge and evidence on the use of mobile phone technology using educative SMS to improve adolescent girl’s perception on sexo-reproductive health in Cameroon.

Trial registration
Pan African Clinical Trials Registry, PACTR201805003259293. Registered 28 March 2018.
Improving equity, diversity, and inclusion in academia
Authors: Dewidar Omar , Elmestekawy Nour , Welch Vivian 
Published: July 2022

AbstractThere are growing bodies of evidence demonstrating the benefits of equity, diversity, and inclusion (EDI) on academic and organizational excellence. In turn, some editors have stated their desire to improve the EDI of their journals and of the wider scientific community. The Royal Society of Chemistry established a minimum set of requirements aimed at improving EDI in scholarly publishing. Additionally, several resources were reported to have the potential to improve EDI, but their effectiveness and feasibility are yet to be determined. In this commentary we suggest six approaches, based on the Royal Society of Chemistry set of requirements, that journals could implement to improve EDI. They are: (1) adopt a journal EDI statement with clear, actionable steps to achieve it; (2) promote the use of inclusive and bias-free language; (3) appoint a journal’s EDI director or lead; (4) establish a EDI mentoring approach; (5) monitor adherence to EDI principles; and (6) publish reports on EDI actions and achievements. We also provide examples of journals that have implemented some of these strategies, and discuss the roles of peer reviewers, authors, researchers, academic institutes, and funders in improving EDI.
Persistence and time challenges in an open online university: a case study of the experiences of first-year learners
Authors: Xavier Marlon , Meneses Julio 
Published: July 2022

AbstractStudent persistence in the first year of studies is a crucial concern in online higher education. Recent accelerated growth in online programs due to the COVID pandemic has increased concerns over higher dropout rates, which are often connected to students’ time challenges—time poverty, juggling multiple commitments, and fitting studies into busy lives. However, research seldom focuses on students’ perceptions of time issues related to persistence. This study addresses this gap by exploring how 20 second-year students retrospectively viewed their experiences of time challenges and how they impacted their persistence in their first year at an online open university. Content analysis of in-depth interviews demonstrated that time pressure and time-conflicts were crucial barriers for success in the foundational semester; the main barrier was juggling study with multiple priorities. Most persisters had good time management and high levels of intrinsic motivation, satisfaction, and self-determination. However, even procrastinators with heavy work-family duties managed to persevere due to their resilience and personal motivation. Lastly, recommendations and strategies for effective student-based interventions to foster persistence are suggested.