bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcorneal but not transpalpebral electrical stimulation disrupts mucin homeostasis of the ocular surface
Authors: Yang Menglu , Lennikov Anton , Chang Karen , Ashok Ajay , Lee Cherin , Cho Kin-Sang , Utheim Tor Paaske , Dartt Darlene A. , Chen Dong Feng 
Published: December 2022

Abstract
Purpose
Transcorneal electrical stimulation (TcES) is increasingly applied as a therapy for preserving and improving vision in retinal neurodegenerative and ischemic disorders. However, a common complaint about TcES is its induction of eye pain and dryness in the clinic, while the mechanisms remain unknown.

Method
TcES or transpalpebral ES (TpES) was conducted in C57BL6j mice for 14 days. The contralateral eyes were used as non-stimulated controls. Levels of intracellular [Ca2+] ([Ca2+]i) were assessed by Fura-2AM. The conductance resistances of the eye under various ES conditions were measured in vivo by an oscilloscope.

Results
Although TcES did not affect tear production, it significantly induced damage to the ocular surface, as revealed by corneal fluorescein staining that was accompanied by significantly decreased mucin (MUC) 4 expression compared to the control. Similar effects of ES were detected in cultured primary corneal epithelium cells, showing decreased MUC4 and ZO-1 levels after the ES in vitro. In addition, TcES decreased secretion of MUC5AC from the conjunctiva in vivo, which was also corroborated in goblet cell cultures, where ES significantly attenuated carbachol-induced [Ca2+]i increase. In contrast to TcES, transpalpebral ES (TpES) did not induce corneal fluorescein staining while significantly increasing tear production. Importantly, the conductive resistance from orbital skin to the TpES was significantly smaller than that from the cornea to the retina in TcES.

Conclusion
TcES, but not TpES, induces corneal epithelial damage in mice by disrupting mucin homeostasis. TpES thus may represent a safer and more effective ES approach for treating retinal neurodegeneration clinically.
Neutrophil CD64 index for diagnosis of infectious disease in the pediatric ICU: a single-center prospective study
Authors: Cao Lu-Lu , Wang Wei-Wei , Zhao Li , Li Ji-Ru , Kong Xiang-Mei , Zhu Yue-Niu , Zhu Xiao-Dong 
Published: December 2022

Abstract
Background
Infection is a major cause of death in children, and it is particularly important to identify biological indicators of early infection. Previous studies showed that the neutrophil CD64 (nCD64) index may be a useful biomarker for infection. The purpose of this study was to investigate use of the nCD64 index to identify infection in children from a pediatric ICU (PICU) in China.

Methods
This prospective observational study enrolled 201 children who were admitted to our PICU and were divided into an infection group and a non-infection group. In each patient, C-reactive protein (CRP), nCD64 index, procalcitonin (PCT), and white blood cell count were measured during the first 24 h after admission. Receiver operating characteristic (ROC) analyses were used to determine the sensitivity, specificity, and diagnostic value of the nCD64 index for infection.

Results
Among all 201 children, the infection group had greater levels of CRP, nCD64 index, and PCT (all p < 0.05). ROC analysis indicated the nCD64 index had a sensitivity of 68.8%, specificity of 90.7%, accuracy of 80.5%, and an optimal cut-off value of 0.14, which had better diagnostic value than CRP or PCT. For children with postoperative fever, the nCD64 index also distinguished systemic inflammatory response syndrome (SIRS) from infection with accuracy of 79%.

Conclusions
The nCD64 index is a useful biomarker for the diagnosis of early infection in children admitted to the PICU.
The effect of the demonstration-based progressive muscle relaxation technique on stress and anxiety in nurses caring for COVID-19 patients: a randomized clinical trial
Authors: Ganjeali Samaneh , Farsi Zahra , Sajadi Seyedeh Azam , Zarea Kourosh 
Published: December 2022

AbstractBackgroundCaring for patients with coronavirus disease 2019 (COVID-19) challenges nurses and causes them to experience stress and anxiety. From this perspective, it is of utmost importance to develop quick and effective intervention strategies to prevent numerous complications. This study aimed to investigate the effect of the progressive muscle relaxation technique, using the demonstration method on the stress and anxiety of nurses who care for COVID-19 patients.MethodsThis randomized clinical trial was conducted in 2021. Forty-six nurses working in two referral hospitals with wards for COVID-19 patients in Tehran, Iran recruited by convenience sampling method and then randomly assigned to experimental or control groups. The nurses in the experimental group educated the progressive muscle relaxation by the demonstration method, and they were encouraged to practice it. The Depression Anxiety Stress Scale-21 was utilized to measure the stress and anxiety levels in the nurses.ResultsBefore the intervention, the levels of stress in the experimental and control groups were 13.91 ± 2.41 vs. 14.34 ± 2.74 (p = 0.571), and their anxiety was 13.34 ± 3.41 vs. 12.78 ± 2.21 (p = 0.510), respectively. After the intervention, the levels of stress in the experimental and control groups were 10.95 ± 2.01 vs. 14.17 ± 2.34 (p < 0.001), and their anxiety was 9.47 ± 2.37 vs. 12.91 ± 1.85 (p < 0.001), respectively. Moreover, the levels of stress and anxiety in the experimental group significantly diminished after intervention (p < 0.001), but no significant changes were observed in the control group (p > 0.05).ConclusionConcerning the effectiveness of the progressive muscle relaxation technique in relieving the stress and anxiety of the nurses caring for COVID-19 patients, it is suggested to include this relaxation technique in nursing courses.
Impact of social and cultural factors on incidence, transmission and control of Coronavirus disease in Iran: a qualitative study
Authors: Falla-Aliabadi Saeed , Heydari Ahad , Fatemi Farin , Yoshany Nooshin , Lotfi Mohammad Hasan , Sarsangi Alireza , Hanna Fahad 
Published: December 2022

AbstractIntroductionCOVID-19 pandemic has had mixed reactions from nations, people and governments about ways to cope with, prevent and control the disease. The current study identifies social, cultural and policy factors affecting the incidence and control of Coronavirus disease in Iran.MethodsA qualitative study consists of content analysis as well as the views of 20 experienced and knowledgeable subjects specialized in social and cultural health management. The data were gathered using three semi-structured interviews and then continued by 17 semi-structured interviews. Data analysis was done using Graneheim approach. After each interview, the recorded audio files transcript and reviewed. Then codes extracted and divided to categories and sub-categories.ResultsThere are distinct social and cultural factors in coping with Coronavirus disease. These consisted of three categories of governance, individual and community related factors. A total of 17 subcategories and 215 primary codes that were extracted from the text of interviews as variables of the study and in relation to the research question. Ten subdomains of governance including vaccination, political issues, knowledge, support services, administrative services, transportation, health and treatment, culturalization, legislation and, managerial and financial policies impacted the spread and mitigation of the pandemic at various levels.ConclusionThe management of pandemics requires a comprehensive capacity for identifying and determining social and cultural criteria. A healthy partnership between governments and the community may be required to remove unnecessary obstacles that hinder public health attempt to alleviate the risk. The obtained criteria and indicators from this study may be utilized by policy makers in an attempt to strengthen protocols for mitigating pandemics. Further studies may be warranted to confirm these findings.
Arthroscopic repair of rotator cuff injury with bioabsorbable suture anchor vs. all-suture anchor: a non-inferiority study
Authors: Di Gennaro Stefano , Lecce Domenico , Tarantino Alessio , De Cupis Mauro , Bassetti Erica , Scarnera Pierpaolo , Ciminello Enrico , Calvisi Vittorio 
Published: December 2022

Abstract
Background
Compare all-suture anchors to traditional anchors through clinical and radiological evaluation at pre-established end-points.

Materials and methods
We performed a two-arms non-inferiority study on all-suture anchor (2.3 iconix™, Stryker) device with respect to traditional anchor (5.5 healix Advance™ BR, Depuy/Mitek) device under unpaired samples with size equal to 30 patients per group, all suffering from supraspinatus tendon rupture. We administrated DASH (Disabilities of the Arm, Shoulder and Hand); constant; and SST (Simple Shoulder Test) questionnaires in pre-operative, 3 ± 1 months post-intervention and 8 ± 1 months post-intervention. Questionnaires scores were the primary outcome. We also evaluated RMI at 3 and at 8 months after surgery to assess the presence of oedema or any loosening of the implant.

Results
All-suture anchor approach has been proven to have non-inferior performances with respect to traditional anchor approach, according to questionnaires scores at the 3-month endpoint. We observed 26 patients with oedema by MRI (18 in control group, 6 in experimental group). In the 8-month endpoint we found persistent edema in 12 patients (all treated with healix), 2 had mobilitazions (healix), 10 had partial retears (8 healix, 2 iconix) and 1 implant failure (healix).

Conclusions
All suture devices have clinical and functional results comparable to traditional devices, while they tend to give fewer complications in terms of bone edema, loosening and retear rate. The effectiveness of all-suture devices should be further investigated in rotator cuff suture arthroscopic revision surgery, given the advantages they offer.
Triglyceride glucose index was linearly associated with abdominal aortic calcification based on NHANES 2013–2014
Authors: Zhou Ying , Zhi Fu , Gao Beibei , Liao Shengen 
Published: December 2022

Abstract
Purpose
To study the relationship between the TyG index and the risk of AAC.

Methods
We enrolled 1,486 participants from the National Health and Nutrition Examination Survey (NHANES). The TyG index was calculated in the log-transformed of triglycerides multipled by glucose, and the presence of AAC was diagnosed as AAC score above than 0.

Results
Our suggested found that TyG level was positively correlated with the presence of AAC and log-transformed AAC score. After adjusted for other variables, comparing with the lowest quartile of TyG index, the highest quartile of TyG level was significantly associated with the presence of AAC (OR 2.12, 95%CI 1.05–4.35, p = 0.038) and severe AAC (OR 2.12, 95%CI 1.05–4.35, p = 0.038).

Conclusions
TyG index was significantly associated with the risk of AAC and severe AAC, which could be a marker in clinical practice.
Hospice preference of the family decision-makers for cancer patients in China: an exploratory study
Authors: Yao Nian , Chen Hao , Lai Xiaobin 
Published: December 2022

Abstract
Background
The reasons for hospice underuse in China need exploration from the perspective of patients with cancer and their families. Furthermore, existing literature about hospice decision-making among Chinese families with cancer patients is limited. This study aimed to investigate the awareness of hospice care among families with cancer patients, their preference for healthcare at the end-of-life stage of care, and the predictors of hospice preference.

Methods
This was an exploratory study conducted between July 2021 and January 2022. Overall, 300 decision-makers of cancer patients were recruited from the oncology ward of seven hospitals in Shanghai, China. Of these, 285 valid responses were included in the data analysis. A self-developed questionnaire about their preference for healthcare when the patient was at the end-of-life stage was completed. Descriptive analysis, t-test, chi-square test, and multivariable logistic regression were conducted to analyze the data.

Results
Only 46.0% of the participants have heard of hospice care. Most participants (78.2%) reported no introduction to hospice care from their doctors. More than half of the participants (58.2%) did not have a preference for healthcare at the end-of-life stage. Seventy-eight (65.5%) of the 119 participants who had a preference chose hospice care, and the other 41 participants (34.5%) refused hospice care. Having heard of hospice care had a significant impact on preferring healthcare at the end-of-life stage (adjusted OR = 14.346, 95%CI 7.219–28.509, p < 0.001). Not being sure whether the doctor introduced hospice care before had a significant impact on having no preference for healthcare at the end-of-life stage (adjusted OR = 0.180, 95%CI 0.052–0.617, p = 0.006). Another family member being cared for at home had a significant impact on the participants’ hospice preference (adjusted OR = 2.739, 95%CI 1.159–6.470, p = 0.022).

Conclusion
The end-of-life communication between healthcare providers and the families of cancer patients is insufficient. More efforts should be made in increasing the awareness of hospice care among patients with cancer and their families. Further study is needed to explore the reasons for a lack of discussion on hospice options between healthcare providers and the patients’ families. Additionally, the impact of the at-home care burden on the hospice choice of families with cancer patients requires further study.
Is there an increase over time in the complexity of teacher questions and student responses in case-based clinical seminars? A cross-sectional video study
Authors: Gartmeier Martin , Hapfelmeier Alexander , Grünewald Marc , Häusler Janina , Pfurtscheller Theresa , Seidel Tina , Berberat Pascal 
Published: December 2022

Abstract
Background
Case-based group discussions (CBGD) are a specific, interaction-focused format dedicated to fostering medical students’ skills in applying basic biomedical knowledge to patient cases. Existing conceptions of CBGD suggest that a gradient towards increased opportunities for students to make elaborative verbal contributions is an important element of such seminars. To verify this assumption, we investigate empirically if clinical teachers progress from more basic, knowledge-oriented questions towards more advanced, elaboration-oriented questions in such seminars.

Methods
We videotaped 21 different clinical teachers and 398 medical students in 32 CBGD-seminars on surgery and internal medicine. We coded closed-reproductive and open-elaborative teacher questions as well as reproductive and elaborative student responses to these questions. Inter-rater reliability was satisfactory. To determine trends regarding the teacher questions / student responses, we compared eight time-segments of equal duration per seminar.

Results
Overall, clinical teachers asked more closed-reproductive than open-elaborative questions. Students gave more reproductive than elaborative responses. Regarding the frequencies of these forms of teacher questions / student responses, we found no significant differences over time.

Conclusions
Clinical teachers did not deliberately modify the types of questions over time to push students towards more elaborative responses. We conclude that the critical question to which degree promising teaching approaches are actually put into clinical teaching practice should be raised more purposefully in medical education research.
Developing and validating a survival prediction model based on blood exosomal ceRNA network in patients with PAAD
Authors: Wang Shanshan , Xu Lijun , Zhu Kangle , Zhu Huixia , Zhang Dan , Wang Chongyu , Wang Qingqing 
Published: December 2022

Abstract
Background
Among the most lethal cancers, pancreatic adenocarcinoma (PAAD) is an essential component of digestive system malignancies that still lacks effective diagnosis and treatment methods. As exosomes and competing endogenous RNA (ceRNA) regulatory networks in tumors go deeper, we expect to construct a ceRNA regulatory network derived from blood exosomes of PAAD patients by bioinformatics methods and develop a survival prediction model based on it.

Methods
Blood exosome sequencing data of PAAD patients and normal controls were downloaded from the exoRbase database, and the expression profiles of exosomal mRNA, lncRNA, and circRNA were differentially analyzed by R. The related mRNA, circRNA, lncRNA, and their corresponding miRNA prediction data were imported into Cytoscape software to visualize the ceRNA network. Then, we conducted GO and KEGG enrichment analysis of mRNA in the ceRNA network. Genes that express differently in pancreatic cancer tissues compared with normal tissues and associate with survival (P < 0.05) were determined as Hub genes by GEPIA. We identified optimal prognosis-related differentially expressed mRNAs (DEmRNAs) and generated a risk score model by performing univariate and multivariate Cox regression analyses.

Results
205 DEmRNAs, 118 differentially expressed lncRNAs (DElncRNAs), and 98 differentially expressed circRNAs (DEcircRNAs) were screened out. We constructed the ceRNA network, and a total of 26 mRNA nodes, 7 lncRNA nodes, 6 circRNA nodes, and 16 miRNA nodes were identified. KEGG enrichment analysis showed that the DEmRNAs in the regulatory network were mainly enriched in Human papillomavirus infection, PI3K-Akt signaling pathway, Osteoclast differentiation, and ECM-receptor interaction. Next, six hub genes (S100A14, KRT8, KRT19, MAL2, MYO5B, PSCA) were determined through GEPIA. They all showed significantly increased expression in cancer tissues compared with control groups, and their high expression pointed to adverse survival. Two optimal prognostic-related DEmRNAs, MYO5B (HR = 1.41, P < 0.05) and PSCA (HR = 1.10, P < 0.05) were included to construct the survival prediction model.

Conclusion
In this study, we successfully constructed a ceRNA regulatory network in blood exosomes from PAAD patients and developed a two-gene survival prediction model that provided new targets which shall aid in diagnosing and treating PAAD.
Exercise capacity and physical activity in COPD patients treated with a LAMA/LABA combination: a systematic review and meta-analysis
Authors: Miravitlles Marc , García-Rivero Juan Luís , Ribera Xavier , Galera Jordi , García Alejandra , Palomino Rosa , Pomares Xavier 
Published: December 2022

Abstract
Background
Persistent airflow limitation and dyspnoea may reduce chronic obstructive pulmonary disease (COPD) patients exercise capacity and physical activity, undermining their physical status and quality of life. Long-acting muscarinic antagonists and long-acting beta-2 agonists (LAMA/LABA) combinations are amongst moderate-to-severe COPD recommended treatments. This article analyses LAMA/LABA combinations effect on COPD patients exercise capacity and physical activity outcomes.

Methods
A systematic review and meta-analysis of double-blind randomized controlled trials comparing LAMA/LABA combinations against monotherapy or placebo was conducted.

Results
Seventeen articles were identified (N = 4041 patients). In endurance shuttle walk test and constant work rate cycle ergometry, LAMA/LABA combinations obtained better results than placebo, but not monotherapy, whereas in 6-min walking test, results favoured LAMA/LABA over monotherapy (four studies), but not over placebo (one study). Moreover, LAMA/LABA combinations obtained better results than placebo in number of steps per day, reduction in percentage of inactive patients and daily activity-related energy expenditure, and better than monotherapy when measuring time spent on ≥ 1.0–1.5, ≥ 2.0 and ≥ 3.0 metabolic equivalents of task activities.

Conclusions
LAMA/LABA combinations in COPD patients provided better results than monotherapy or placebo in most exercise capacity and physical activity outcomes.
Obtaining EQ-5D-3L utility index from the health status scale of traditional Chinese medicine (TCM-HSS) based on a mapping study
Authors: Wang Li , Lu Yuqiong , Dai Zhanjing , Shi Penghua , Xu Jiayi , Chang Feng , Lu Yun 
Published: December 2022

Abstract
Background
Almost all traditional Chinese medicine (TCM) quality of life measures are non-preference-based measures (non-PBMs), which do not provide utilities for cost-utility analysis in pharmacoeconomic evaluation. Whereas the mapping has become a new instrument to obtain utilities, which builds a bridge between non-PBMs and PBMs.

Purpose
To develop mapping algorithms from the health status scale of traditional Chinese medicine (TCM-HSS) onto the three-level EuroQol five-dimensional questionnaire (EQ-5D-3L).

Methods
The cross-sectional data were collected by questionnaire survey from a tertiary hospital visit population and community residents in China, and randomly divided into training and validation set by 2:1. Based on the training set, direct and indirect mapping methods (7 regression methods and 4 model specifications) were conducted to establish alternative models, which were comprehensively evaluated based on the validation set by mean absolute error, root mean square error, and Spearman correlation coefficient between predicted and observed values. Based on the whole sample, the preferred mapping algorithm was developed.

Results
A total of 639 samples were included, with an average age of 45.24 years and 61.66% of respondents were female. The mean EQ-5D-3L index was 0.9225 [SD = 0.1458], and the mean TCM-HSS index was 3.4144 [SD = 3.1154]. The final mapping algorithm was a two-part regression model including the TCM-HSS subscales, interaction terms, and demographic covariates (age and gender). The prediction performance was good. The mean error was 0.0003, the mean absolute error was 0.0566, the root mean square error was 0.1039, and 83.10% of the prediction errors were within 0.1; the Spearman correlation coefficient between predicted and observed EQ-5D-3L values was 0.6479.

Conclusion
It is the first study to develop a mapping algorithm between the TCM-HSS and EQ-5D-3L, which demonstrates excellent prediction accuracy and estimates utility value for economic evaluation from TCM quality of life measures.