bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical students’ experiences of working with simulated patients in challenging communication training
Authors: Isaksson Johan , Krabbe Julia , Ramklint Mia 
Published: October 2022

Abstract
Background
Physicians’ communication skills are important for patient-centered care. Although working with simulated patients (SPs) in case simulations is common for training communication skills, studies seldom include a wide range of challenging behaviors or explore students’ own experiences of learning communication skills with SPs. Therefore, this study was aimed at investigating how medical students perceive communication training involving challenging consultations with SPs and the impact on their learning experiences.

Methods
Twenty-three medical students from the same class were interviewed in focus groups about their experiences of simulation training with actors as SPs. In the simulation training, the students were instructed to deliver bad news, manage negative patient reactions, and encourage behavioral changes in reluctant patients. This was followed by feedback and a debriefing exercise. The interviews were analyzed with content analysis.

Results
Students reported that actors as SPs made the simulations more realistic and enabled them to practice various communication skills for challenging consultations in a safe way and manage their own feelings, thereby promoting new learning experiences. Elements such as actors’ flexibility in changing behaviors during role-play and exposure to different challenging behaviors, like negative emotions, were regarded as valuable. The importance of an accepting and permissive climate for the debriefing exercise was highlighted, though without taking too much time from the simulation training. Feedback directly from the SP was appreciated.

Conclusions
Actors as SPs were perceived as a valuable part of challenging communication training and added elements to the learning process. Future studies should include a wider range of challenging behaviors in training with SPs and evaluate the effects of such training on students’ use of communication skills.
Risk factor profiles for depression following childbirth or a chronic disease diagnosis: case–control study
Authors: Jermy Bradley S. , Hagenaars Saskia , Coleman Jonathan R. I. , Vassos Evangelos , Lewis Cathryn M. 
Published: October 2022

BackgroundProgress towards understanding the aetiology of major depression is compromised by its clinical heterogeneity. The variety of contexts underlying the development of a major depressive episode may contribute to such heterogeneity.AimsTo compare risk factor profiles for three subgroups of major depression according to episode context.MethodUsing self-report questionnaires and administrative records from the UK Biobank, we characterised three contextual subgroups of major depression: postpartum depression (3581 cases), depression following diagnosis of a chronic disease (409 cases) and a more typical (named heterogeneous) major depression phenotype excluding the two other contexts (34 699 cases). Controls with the same exposure were also defined. We tested each subgroup for association with the polygenic risk scores (PRS) for major depression and with other risk factors previously associated with major depression (bipolar disorder PRS, neuroticism, reported trauma in childhood and adulthood, socioeconomic status, family history of depression, education).ResultsMajor depression PRS was associated with all subgroups, but postpartum depression cases had higher PRS than heterogeneous major depression cases (OR = 1.06, 95% CI 1.02–1.10). Relative to heterogeneous depression, postpartum depression was more weakly associated with adulthood trauma and neuroticism. Depression following diagnosis of a chronic disease had weaker association with neuroticism and reported trauma in adulthood and childhood relative to heterogeneous depression.ConclusionsThe observed differences in risk factor profiles according to the context of a major depressive episode help provide insight into the heterogeneity of depression. Future studies dissecting such heterogeneity could help reveal more refined aetiological insights.
Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review
Authors: Asper Michaela , Osika Walter , Dalman Christina , Pöllänen Elin , Simonsson Otto , Flodin Pär , Sidorchuk Anna , Marchetti Laura , Awil Fatima , Castro Rosa , Niemi Maria E. 
Published: October 2022

BackgroundA rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors.AimsThe aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health.MethodSearches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health.ResultsThe 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure.ConclusionsOur findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.
A tumor-suppressive function for Notch3 in the parous mammary gland
Authors: Chung Wen-Cheng , Egan Sean E. , Xu Keli 
Published: October 2022

ABSTRACT
Notch3 promotes mammary luminal cell specification and forced Notch3 activation can induce mammary tumor formation. However, recent studies suggest a tumor-suppressive role for Notch3. Here, we report on Notch3 expression and functional analysis in the mouse mammary gland. Notch3 is expressed in the luminal compartment throughout mammary gland development, but switches to basal cells with initiation of post-lactational involution. Deletion of Notch3 caused a decrease of Notch activation in luminal cells and diminished luminal progenitors at puberty, as well as reduced alveolar progenitors during pregnancy. Parous Notch3−/− mammary glands developed hyperplasia with accumulation of CD24hiCD49flo cells, some of which progressed to invasive tumors with luminal features. Notch3 deletion abolished Notch activation in basal cells during involution, accompanied by altered apoptosis and reduced brown adipocytes, leading to expansion of parity-identified mammary epithelial cells (PI-MECs). Interestingly, the postpartum microenvironment is required for the stem cell activity of Notch3−/− PI-MECs. Finally, high expression of NOTCH3 is associated with prolonged survival in patients with luminal breast cancer. These results highlight an unexpected tumor-suppressive function for Notch3 in the parous mammary gland through restriction of PI-MEC expansion.
Pattern of hospital antibiotic use in term neonates using WHO Access, Watch and Reserve Classification (AWaRe)
Authors: Khalid Muhammad , Rasheed Javaria , Nawaz Iram 
Published: October 2022

Background and Objective: Pakistan has high neonatal mortality rate and antibiotic utilization data in hospitalized term neonates from Pakistan is lacking. The study aimed to determine the pattern of hospital antibiotic use in term neonates using World Health Organization (WHO) Access, Watch, and Reserve classification (AWaRe).
Methods: This cross-sectional chart review study was conducted at the neonatal unit of Pediatric Medicine Department of University Hospital over a period of one year from 1st January 2020 to 31st December 2020. Hospitalized full term newborns up to 28-days of life, of either gender were consecutively included in the study. Data on demographic characteristics, admission diagnoses and antibiotic prescribed (class, agent and duration) were extracted from clinical charts. Descriptive statistics in the form of mean ± SD and frequency and percentages were calculated.
Results: A total of 2276 term neonates consisting of 69% (n=1570) males were included in the study. Antibiotic prescription rate was 92.8%. Most common reason for admission was birth asphyxia (36.1%) followed by sepsis (33%). Most commonly prescribed antibiotic Ampicillin (84%) belonged to Access group of WHO – AWaRe classification. More than 97% of prescriptions were two or more antimicrobial combinations belonging to Watch group. Ampicillin and Cefoperazone was the most commonly prescribed (42.8%) two drug combination. Meropenem and vancomycin was prescribed to 20% of the neonates – mostly for sepsis and pneumonia. Mortality rate was 7.7% in current study.
Conclusion: High antibiotic prescription rate particularly from Watch-group is demonstrated in this study. There is high need of antimicrobial stewardship program in neonatal units.
doi: https://doi.org/10.12669/pjms.38.8.6098
How to cite this:Khalid M, Rasheed J, Nawaz I. Pattern of hospital antibiotic use in term neonates using WHO Access, Watch and Reserve Classification (AWaRe). Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.6098
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Predicting common bile duct stones: Comparison of SAGES, ASGE and ESGE criteria for accuracy
Authors: Yousaf Muhammad Nadeem , Mahmud Yasir , Sarwar Shahid , Ahmad Muhammad Nauman , Ahmad Mahmood , Abbas Ghulam 
Published: October 2022

Objective: To determine accuracy of SAGES, ASGE and ESGE criteria for predicting presence of common bile duct (CBD) stones.
Methods: In a prospective study at Jinnah Hospital Lahore from March 2021 to February 2022, patients with suspected CBD stone were stratified in High risk (HR), intermediate risk (IR) and low risk (LR) for SAGES, ASGE and ESGE criteria. All patients underwent ERCP and risk strata were analyzed using SPSS 22® for sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy.
Results: In 90 patients with mean age 45.18(±14.87) and male/female ratio 0.64(35/55), area Under Curve (AUC) for predicting CBD stones was 0.75, 0.81and 0.83 for HR and 0.28, 0.52 and 0.52 for IR group while it was 0.53, 0.81 and 0.53 for absence of stone in LR group of SAGES, ASGE and ESGE criteria respectively. HR groups had accuracy of 81.1%, 86.7% and 87.8% in predicting CBD stone while LR criteria had 68.8%, 86.7% and 68.1% accuracy in predicting absence of CBD stone for SAGES, ASGE and ESGE respectively.
Conclusion: HR strata of SAGES, ASGE and ESGE scores have excellent accuracy in predicting CBD stones whereas IR and LR criteria are suboptimal for excluding CBD stones.
doi: https://doi.org/10.12669/pjms.38.8.6666
How to cite this:Yousaf MN, Mahmud Y, Sarwar S, Ahmad MN, Ahmad M, Abbas G. Predicting common bile duct stones: Comparison of SAGES, ASGE and ESGE criteria for accuracy. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.6666
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
A YOLOv3-Based Rice Vortex Detecting System Using Dual Collaborative UAVs
Authors: Hu Xiaodan , Li Yifan , Wu Han , Liu Zhijie , Li Jiyu 
Published: October 2022

HighlightsUsed dual collaborative UAVs to track the rice vortex formed on rice canopy.A trained YOLOv3-tiny model was used to recognize and calculate the rice vortex parameters with high accuracy.Discovered a quantitative relationship between rice vortex parameters and UAV flight parameters.Aligned the time axis of data process to enhance the accuracy of the vortex parameter calculation.Abstract. A rice vortex generated by the downwash airflow of the agricultural UAV has a great connection to pesticide droplet deposition. In this study, an unmanned aircraft system (UAS) was designed to obtain rice vortex parameters including position coordinates, area, and relative distance to the UAV. The system uses the flight control system mounted Beidou RTK positioning system and Manifold onboard computer to localize the spraying UAV and trains a YOLOv3-tiny model to recognize motion images of dynamic rice vortices in real-time, achieving a mean accuracy of 98.15% with 0.9326 IOU. Moreover, to optimize the system, a data time axis alignment method based on the robot operating system (ROS) was proposed to alleviate the transmission delay and image processing time-consumption, which increased the accuracy of the vortex parameter by 3.48%. The rice vortex area acquired by the UAS was highly relevant to UAV flight parameters and the relative distance was just correlated to the UAV height. The instantaneous status of the rice vortex helps to lay a data foundation for adjusting the flight parameters of the plant protection UAV. Keywords: Precision agriculture, Rice vortex, ROS, Spray operation, UAV, YOLOv3-tiny.
Potential drivers for schistosomiasis persistence: Population genetic analyses from a cluster-randomized urogenital schistosomiasis elimination trial across the Zanzibar islands
Authors: Pennance Tom , Neves M. Inês , Webster Bonnie L. , Gower Charlotte M. , Knopp Stefanie , Khamis Iddi Simba , Ame Shaali M. , Ali Said M. , Rabone Muriel , Emery Aidan , Allan Fiona , Muhsin Mtumweni Ali , Suleiman Khamis Rashid , Kabole Fatama , Walker Martin , Rollinson David , Webster Joanne P. 
Published: October 2022

The World Health Organization’s revised NTD Roadmap and the newly launched Guidelines target elimination of schistosomiasis as a public health problem in all endemic areas by 2030. Key to meeting this goal is elucidating how selective pressures imposed by interventions shape parasite populations. Our aim was to identify any differential impact of a unique cluster-randomized tri-armed elimination intervention (biannual mass drug administration (MDA) applied alone or in association with either mollusciciding (snail control) or behavioural change interventions) across two Zanzibarian islands (Pemba and Unguja) on the population genetic composition of Schistosoma haematobium over space and time. Fifteen microsatellite loci were used to analyse individual miracidia collected from infected individuals across islands and intervention arms at the start (2012 baseline: 1,522 miracidia from 176 children; 303 from 43 adults; age-range 6–75, mean 12.7 years) and at year 5 (2016: 1,486 miracidia from 146 children; 214 from 25 adults; age-range 9–46, mean 12.4 years). Measures of genetic diversity included allelic richness (Ar), Expected (He) and Observed heterozygosity (Ho), inbreeding coefficient (FST), parentage analysis, estimated worm burden, worm fecundity, and genetic sub-structuring. There was little evidence of differential selective pressures on population genetic diversity, inbreeding or estimated worm burdens by treatment arm, with only the MDA+snail control arm within Unguja showing trends towards reduced diversity and altered inbreeding over time. The greatest differences overall, both in terms of parasite fecundity and genetic sub-structuring, were observed between the islands, consistent with Pemba’s persistently higher mean infection intensities compared to neighbouring Unguja, and within islands in terms of infection hotspots (across three definitions). These findings highlight the important contribution of population genetic analyses to elucidate extensive genetic diversity and biological drivers, including potential gene-environmental factors, that may override short term selective pressures imposed by differential disease control strategies.
Trial Registration: ClinicalTrials.gov ISRCTN48837681.
Genome-wide association study for Chagas Cardiomyopathy identify a new risk locus on chromosome 18 associated with an immune-related protein and transcriptional signature
Authors: Sabino Ester Cerdeira , Franco Lucas Augusto Moysés , Venturini Gabriela , Velho Rodrigues Mariliza , Marques Emanuelle , Oliveira-da Silva Lea Campos de , Martins Larissa Natany Almeida , Ferreira Ariela Mota , Almeida Paulo Emílio Clementino , Silva Felipe Dias Da , Leite Sâmara Fernandes , Nunes Maria do Carmo Pereira , Haikal Desiree Sant’Ana , Oliveira Claudia Di Lorenzo , Cardoso Clareci Silva , Seidman Jonathan G. , Seidman Christine E. , Casas Juan P. , Ribeiro Antonio Luiz Pinho , Krieger Jose E. , Pereira Alexandre C. 
Published: October 2022

Background
Chronic Chagas Cardiomyopathy (CCC) usually develops between 10 and 20 years after the first parasitic infection and is one of the leading causes of end-stage heart failure in Latin America. Despite the great inter-individual variability in CCC susceptibility (only 30% of infected individuals ever present CCC), there are no known predictors for disease development in those chronically infected.

Methodology/Principal findings
We describe a new susceptibility locus for CCC through a GWAS analysis in the SaMi-Trop cohort, a population-based study conducted in a Chagas endemic region from Brazil. This locus was also associated with CCC in the REDS II Study. The newly identified locus (rs34238187, OR 0.73, p-value 2.03 x 10−9) spans a haplotype of approximately 30Kb on chromosome 18 (chr18: 5028302–5057621) and is also associated with 80 different traits, most of them blood protein traits significantly enriched for immune-related biological pathways. Hi-C data show that the newly associated locus is able to interact with chromatin sites as far as 10Mb on chromosome 18 in a number of different cell types and tissues. Finally, we were able to confirm, at the tissue transcriptional level, the immune-associated blood protein signature using a multi-tissue differential gene expression and enrichment analysis.

Conclusions/Significance
We suggest that the newly identified locus impacts CCC risk among T cruzi infected individuals through the modulation of a downstream transcriptional and protein signature associated with host-parasite immune response. Functional characterization of the novel risk locus is warranted.
Leishmaniasis epidemiology in endemic areas of metropolitan France and its overseas territories from 1998 to 2020
Authors: Pasquier Grégoire , Demar Magalie , Lami Patrick , Zribi Asma , Marty Pierre , Buffet Pierre , Desbois-Nogard Nicole , Gangneux Jean Pierre , Simon Stéphane , Blaizot Romain , Couppié Pierre , Thiebaut Louis , Pratlong Francine , Dedet Jean-Pierre , Bastien Patrick , Sterkers Yvon , Ravel Christophe , Lachaud Laurence ,   Working Group for the Notification of Human Leishmanioses in France
Published: October 2022

Background
In France, leishmaniasis is endemic in the Mediterranean region, in French Guiana and to a lesser extent, in the French West Indies. This study wanted to provide an updated picture of leishmaniasis epidemiology in metropolitan France and in its overseas territories.

Methodology/Principal findings
Leishmaniasis cases were collected by passive notification to the French National Reference Centre for Leishmaniases (NRCL) in Montpellier from 1998 to 2020 and at the associated Centre in Cayenne (French Guiana) from 2003 to 2020. In metropolitan France, 517 autochthonous leishmaniasis cases, mostly visceral forms due to Leishmania infantum (79%), and 1725 imported cases (French Guiana excluded), mainly cutaneous leishmaniasis from Maghreb, were recorded. A slight decrease of autochthonous cases was observed during the survey period, from 0.48 cases/100,000 inhabitants per year in 1999 (highest value) to 0.1 cases/100,000 inhabitants per year in 2017 (lowest value). Conversely, imported cases increased over time (from 59.7 in the 2000s to 94.5 in the 2010s). In French Guiana, 4126 cutaneous and mucocutaneous leishmaniasis cases were reported from 2003 to 2020. The mean incidence was 103.3 cases per 100,000 inhabitants/year but varied in function of the year (from 198 in 2004 to 54 in 2006). In Guadeloupe and Martinique (French West Indies), only sporadic cases were reported.

Conclusions/Significance
Because of concerns about disease expansion and outbreaks in other Southern Europe countries, and leishmaniasis monitoring by the NRCL should be continued and associated with a more active surveillance.
Evaluation of circulating microRNA profiles in Brazilian women with polycystic ovary syndrome: A preliminary study
Authors: De Nardo Maffazioli Giovana , Baracat Edmund Chada , Soares José Maria , Carvalho Kátia Cândido , Maciel Gustavo Arantes Rosa 
Published: October 2022

Objective
Polycystic ovary syndrome (PCOS) is a heterogeneous endocrinopathy, which etiology encompasses complex genetic traits associated with epigenetic factors, including differences in microRNA (miRNA) expression in a variety of tissues. The circulating form of these molecules is raising attention in the syndrome not only as potential biomarkers of PCOS but also as possible therapeutic targets. The aim of this study was to explore the circulating miRNA profiles present in a cohort of Brazilian women with and without PCOS and to evaluate the potential role of miRNAs in the pathophysiology of the syndrome.

Methods
Cross-sectional study of 36 well-characterized PCOS women and 16 healthy controls. Clinical, hormone and metabolic data were recorded and evaluated. The expression profile of the 201 circulating miRNA selected were analyzed by taqman quantitative real time polymerase chain reactions (RT-PCR) using a customized Open Array platform. Statistical and bioinformatic analyzed were performed.

Results
Circulating miR-21-5p, miR-23a-3p and miR-26a-5p were upregulated, and miR-103a-3p, miR-376a-3p, miR-19b-3p and miR-222-3p were downregulated in women with PCOS compared to healthy normo-ovulatory controls. miR-21-5p, miR-103a-3p and miR-376a-3p levels correlated positively with androgen levels. These miRNAs, in combination, were related to pathways involved in insulin signaling, steroids biosynthesis and endothelial regulation as well as in folliculogenesis.

Conclusion
In this study, we identified a specific circulating miRNA signature in Brazilian women with PCOS. According to our data, circulating miR-21-5p, miR-23a-3p, miR-26a-5p, miR-103a-3p, miR-376a-3p, miR-19b-3p and miR-222-3p may represent potential candidates for differential diagnosis of PCOS in the future.