bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning team-based quality improvement in a virtual setting: a qualitative study
Authors: Hovlid Einar , Husabø Gunnar , Valestrand Eivind Alexander , Hartveit Miriam 
Published: June 2022

ObjectiveThe objective was to explore students’ perceptions of learning quality improvement (QI) in a virtual setting and identify factors that promote or inhibit virtual learning.DesignWe used an exploratory case study design with focus group interviews. The data were analysed using a thematic analysis approach, with an analytical framework derived from activity theory and Bloom’s revised taxonomy of six categories of cognitive processes of learning.SettingPostgraduate students participating in a virtual 1-day simulation module to learn QI at two universities in Norway.ParticipantsFour focus groups with a total of 12 participants.ResultsThe students’ descriptions of learning outcomes indicate that the learning activity involved a variety of cognitive activities, including higher-order cognitive processes. We identified three themes pertaining to the students’ experiences of the virtual learning activity: learning through active participation, constructing a virtual learning opportunity and creating a virtual learning environment. The students described that participation and active engagement led to a greater understanding and an integration of theory and practical improvement skills. They reported that to engage in the virtual learning opportunity, it was necessary to create a learning environment where they felt psychologically safe.ConclusionOur findings indicate that it is possible to facilitate collaborative learning integrating theoretical knowledge and practical skills in a virtual setting. Students experienced that engaging in the virtual learning activity contributed to the integration of theoretical knowledge and practical skills. Psychological safety seems to be important for students’ engagement in the virtual learning activity. A virtual learning environment alters prior common norms for interaction based on physical presence, which in turn affect students feeling of psychological safety. Educators need to be aware of this and facilitate a virtual learning environment where students feel comfortable to engage.
Behind the athletic body: a clinical interview study of identification of eating disorder symptoms and diagnoses in elite athletes
Authors: Lichtenstein Mia Beck , Johansen Karen Krogh , Runge Eik , Hansen Marina Bohn , Holmberg Trine Theresa , Tarp Kristine 
Published: June 2022

Eating disorders are more prevalent in athletes than in the general population and may have severe consequences for sports performance and health. Identifying symptoms can be difficult in athletes because restrictive eating and slim body images are often idealised in a sports setting. The Eating Disorders Examination Questionnaire (EDE-Q) and the SCOFF (Sick, Control, One stone, Fat and Food) questionnaire (SCOFF) are widely used generic instruments to identify symptoms of eating disorders. This study aimed to investigate the instruments’ validity and explore eating disorder symptoms in a sample of athletes.A sample of 28 athletes (25 females) competing at a national level was interviewed based on the diagnostic criteria for eating disorders. We interviewed 18 athletes with a high score on EDE-Q and 10 with a low score. All interviews were transcribed and analysed from a general inductive approach. We identified 20 athletes with an eating disorder diagnosis, while 8 had no diagnosis. EDE-Q found 90% of the cases, while SCOFF found 94%. EDE-Q found no false-positive cases, while SCOFF found one.The qualitative results showed that most athletes reported eating concerns, restrictive eating, eating control (counting calories), weight concerns, body dissatisfaction (feeling fat and non-athletic), excessive exercise and health problems (eg, pain, fatigue).In conclusion, EDE-Q and SCOFF seem valid instruments to screen athletes’ samples but may fail to find 6%–10% cases with eating disorders. Despite athletic bodies and normal body mass index, many athletes report severe eating problems and dissatisfaction with weight and body appearance. Implementation of regular screening may identify these symptoms at an early stage.
Health challenges and acute sports injuries restrict weightlifting training of older athletes
Authors: Huebner Marianne , Ma Wenjuan 
Published: June 2022

ObjectivesTo quantify acute injuries sustained during weightlifting that result in training restrictions and identify potential risk factors or preventative factors in Master athletes and to evaluate potentially complex interactions of age, sex, health-related and training-related predictors of injuries with machine learning (ML) algorithms.MethodsA total of 976 Masters weightlifters from Australia, Canada, Europe and the USA, ages 35–88 (51.1% women), completed an online survey that included questions on weightlifting injuries, chronic diseases, sport history and training practices. Ensembles of ML algorithms were used to identify factors associated with acute weightlifting injuries and performance of the prediction models was evaluated. In addition, a subgroup of variables selected by six experts were entered into a logistic regression model to estimate the likelihood of an injury.ResultsThe accuracy of ML models predicting injuries ranged from 0.727 to 0.876 for back, hips, knees and wrists, but were less accurate (0.644) for shoulder injuries. Male Master athletes had a higher prevalence of weightlifting injuries than female Master athletes, ranging from 12% to 42%. Chronic inflammation or osteoarthritis were common among both men and women. This was associated with an increase in acute injuries.ConclusionsTraining-specific variables, such as choices of training programmes or nutrition programmes, may aid in preventing acute injuries. ML models can identify potential risk factors or preventative measures for sport injuries.
Hypoxia-inducible lentiviral gene expression in engineered human macrophages
Authors: Chinn Harrison K , Gardell Jennifer L , Matsumoto Lisa R , Labadie Kevin P , Mihailovic Tara N , Lieberman Nicole A P , Davis Amira , Pillarisetty Venu G , Crane Courtney A 
Published: June 2022

BackgroundHuman immune cells, including monocyte-derived macrophages, can be engineered to deliver proinflammatory cytokines, bispecific antibodies, and chimeric antigen receptors to support immune responses in different disease settings. When gene expression is regulated by constitutively active promoters, lentiviral payload gene expression is unregulated, and can result in potentially toxic quantities of proteins. Regulated delivery of lentivirally encoded proteins may allow localized or conditional therapeutic protein expression to support safe delivery of adoptively transferred, genetically modified cells with reduced capacity for systemic toxicities.MethodsIn this study, we engineered human macrophages to express genes regulated by hypoxia responsive elements included in the lentiviral promoter region to drive conditional lentiviral gene expression only under hypoxic conditions. We tested transduced macrophages cultured in hypoxic conditions for the transient induced expression of reporter genes and the secreted cytokine, interleukin-12. Expression of hypoxia-regulated genes was investigated both transcriptionally and translationally, and in the presence of human tumor cells in a slice culture system. Finally, hypoxia-regulated gene expression was evaluated in a subcutaneous humanized-mouse cancer model.ResultsEngineered macrophages were shown to conditionally and tranisently express lentivirally encoded gene protein products, including IL-12 in hypoxic conditions in vitro. On return to normoxic conditions, lentiviral payload expression returned to basal levels. Reporter genes under the control of hypoxia response elements were upregulated under hypoxic conditions in the presence of human colorectal carcinoma cells and in the hypoxic xenograft model of glioblastoma, suggesting utility for systemic engineered cell delivery capable of localized gene delivery in cancer.ConclusionsMacrophages engineered to express hypoxia-regulated payloads have the potential to be administered systemically and conditionally express proteins in tissues with hypoxic conditions. In contrast to immune cells that function or survive poorly in hypoxic conditions, macrophages maintain a proinflammatory phenotype that may support continued gene and protein expression when regulated by conditional hypoxia responsive elements and naturally traffic to hypoxic microenvironments, making them ideal vehicles for therapeutic payloads to hypoxic tissues, such as solid tumors. With the ability to fine-tune delivery of potent proteins in response to endogenous microenvironments, macrophage-based cellular therapies may therefore be designed for different disease settings.
WT1-specific TCRs directed against newly identified peptides install antitumor reactivity against acute myeloid leukemia and ovarian carcinoma
Authors: van Amerongen Rosa A , Hagedoorn Renate S , Remst Dennis F G , Assendelft Danique C , van der Steen Dirk M , Wouters Anne K , van de Meent Marian , Kester Michel G D , de Ru Arnoud H , Griffioen Marieke , van Veelen Peter A , Falkenburg J H Frederik , Heemskerk Mirjam H M 
Published: June 2022

BackgroundTranscription factor Wilms’ tumor gene 1 (WT1) is an ideal tumor target based on its expression in a wide range of tumors, low-level expression in normal tissues and promoting role in cancer progression. In clinical trials, WT1 is targeted using peptide-based or dendritic cell-based vaccines and T-cell receptor (TCR)-based therapies. Antitumor reactivities were reported, but T-cell reactivity is hampered by self-tolerance to WT1 and limited number of WT1 peptides, which were thus far selected based on HLA peptide binding algorithms.MethodsIn this study, we have overcome both limitations by searching in the allogeneic T-cell repertoire of healthy donors for high-avidity WT1-specific T cells, specific for WT1 peptides derived from the HLA class I associated ligandome of primary leukemia and ovarian carcinoma samples.ResultsUsing broad panels of malignant cells and healthy cell subsets, T-cell clones were selected that demonstrated potent and specific anti-WT1 T-cell reactivity against five of the eight newly identified WT1 peptides. Notably, T-cell clones for WT1 peptides previously used in clinical trials lacked reactivity against tumor cells, suggesting limited processing and presentation of these peptides. The TCR sequences of four T-cell clones were analyzed and TCR gene transfer into CD8+ T cells installed antitumor reactivity against WT1-expressing solid tumor cell lines, primary acute myeloid leukemia (AML) blasts, and ovarian carcinoma patient samples.ConclusionsOur approach resulted in a set of naturally expressed WT1 peptides and four TCRs that are promising candidates for TCR gene transfer strategies in patients with WT1-expressing tumors, including AML and ovarian carcinoma.
Increased suicide attempt risk in people with epilepsy in the presence of concurrent psychogenic nonepileptic seizures
Authors: Faiman Irene , Hodsoll John , Young Allan H , Shotbolt Paul 
Published: June 2022

ObjectivesTo test the hypothesis that people with concurrent diagnosis of epilepsy and psychogenic nonepileptic seizures (PNES) are at increased risk of attempting suicide as compared to people with epilepsy or PNES alone. To report on suicide rates.MethodsRetrospective cohort study from the UK largest tertiary mental health care provider, with linked nationwide admission and mortality data from the Hospital Episode Statistics and Office for National Statistics. Participants were 2460 people with a primary or secondary diagnosis of epilepsy, PNES or concurrent epilepsy and PNES attending between 1 January 2007 and 18 June 2021. The primary outcome was a first hospital admission for suicide attempt (International Classification of Diseases, version 10 X60–X84).Results9% of participants had at least one suicide attempt-related hospital admission. For people with concurrent diagnosis of epilepsy and PNES, the odds for suicide attempt-related admissions were 2.52 times the odds of people with epilepsy alone (OR 0.40; 95% CI 0.21 to 0.79; p=0.01). Odds were comparable between people with concurrent diagnosis and people with PNES alone (OR 0.75; 95% CI 0.41 to 1.48; p=0.40). Post hoc analyses revealed that the odds of people with PNES alone were 1.93 times the odds of people with epilepsy alone (OR 0.52; 95% CI 0.38 to 0.70; p<0.001).ConclusionsPeople with concurrent diagnosis of epilepsy and PNES or PNES alone have significantly increased odds of hospitalisation due to suicide attempt as compared to people with epilepsy alone (152% and 93% increase, respectively). These findings have direct implications for the clinical management of suicide risk in people with epilepsy.
Excessive platelet inhibition following Pipeline embolization of intracranial aneurysms
Authors: Miller Timothy R , Khunte Mihir , Caffes Nicholas , Anders Megan , Rock Peter , Beitelshees Amber L , Malhotra Ajay , Cannarsa Gregory , Cherian Jacob , Simard J Marc , Jindal Gaurav , Gandhi Dheeraj 
Published: June 2022

BackgroundHigh levels of platelet inhibition have been associated with hemorrhagic complications following Pipeline embolization of intracranial aneurysms. We therefore titrate clopidogrel dosing to maintain a moderate level of platelet inhibition using the VerifyNow P2Y12 assay. However, many patients demonstrate dramatic increases in platelet inhibition following treatment despite being on a consistent antiplatelet regimen. We therefore elected to explore the incidence of this phenomenon and possible predisposing factors.MethodsAll successful Pipeline aneurysm treatments performed at our institution from 2011 to 2019 with moderate procedure-day platelet inhibition levels as indicated by a VerifyNow PRU of 60–235 were included. Patients who received glycoprotein IIb/IIIa inhibitors and those treated for ruptured/symptomatic lesions were excluded. The incidence of excessive platelet inhibition defined by a PRU<60 within 8 weeks of treatment was noted. Multivariable logistic regression was performed to determined independent predictors of the phenomenon.ResultsSome 190 treatments were performed in 178 qualifying patients. A post-procedure PRU <60 occurred following 79% of treatments, documented on average after 8.5 (range 1–47) days. A higher procedure day hematocrit level (P=0.003, OR 1.09, 95% CI 1.029 to 1.152) was an independent predictor of reaching a PRU <60, while intra-procedural midazolam exposure (P=0.044, OR 0.44, 95% CI 0.201 to 0.980) and a higher procedure-day PRU (P=0.047, OR 0.99, 95% CI 0.982 to 1.000) were associated with a reduced odds. Time-since-procedure and hematocrit levels were associated with excessive platelet inhibition when excluding patients who initially demonstrated hyperresponse.ConclusionElevations in platelet inhibition were frequently observed following flow diversion with Pipeline.
Progression of aortic stenosis after an acute myocardial infarction
Authors: Paquin Amélie , Marsit Ons , Deschênes Valérie , Rouabhia Dounia , Hadjadj Sandra , Clisson Marine , Robitaille Charlotte , Aikawa Elena , Levine Robert A , Pibarot Philippe , Clavel Marie-Annick , Beaudoin Jonathan 
Published: June 2022

BackgroundMyocardial infarction (MI) has been shown to induce fibrotic remodelling of the mitral and tricuspid valves. It is unknown whether MI also induces pathological remodelling of the aortic valve and alters aortic stenosis (AS) progression. We thus compared AS progression after an acute MI and in patients with/without history of MI, and assessed post-MI pathobiological changes within the aortic valve leaflets in a sheep model.MethodsSerial echocardiograms in human patients with AS were retrospectively analysed and compared between 3 groups: (1) acute MI at baseline (n=68), (2) prior history of MI (n=45) and (3) controls without MI (n=101). Annualised progression rates of AS severity were compared between these 3 groups. In addition, aortic valves were harvested from 15 sheep: (1) induced inferior MI (n=10) and (2) controls without MI (n=5), for biological and histological analyses.ResultsIn humans, the acute MI, previous MI and control groups had comparable baseline AS severity. Indexed aortic valve area (AVAi) declined faster in the acute MI group compared with controls (−0.07±0.06 vs −0.04±0.04 cm2/m2/year; p=0.004). After adjustment, acute MI status was significantly associated with faster AVAiprogression (mean difference: −0.013 (95% CI −0.023 to −0.003) cm2/m2/year, p=0.008). In the post-MI experimental animal model, aortic valve thickness and qualitative/quantitative expression of collagen were significantly increased compared with controls.ConclusionsThe results of this study suggest that AS progression is accelerated following acute MI, which could be caused by increased collagen production and thickening of the aortic valve after the ischaemic event.
Characteristics of Cheyenne little filtered cigar Instagram ads, 2019–2020
Authors: Mead-Morse Erin L , Delnevo Cristine D , Singh Binu , Wackowski Olivia A 
Published: June 2022

IntroductionLittle is known about little filtered cigar (LFC) marketing on social media. We examined the characteristics of Instagram posts by Cheyenne—a popular LFC brand—from 2019 to 2020.MethodsWe conducted a content analysis of 323 images posted in 2019 and 2020. Descriptive statistics were examined, and χ2and Fisher’s exact tests were used to test differences by year.ResultsMost posts (76.0%) showed ≥1 pack and/or LFC stick, which look highly similar to cigarette packs and sticks. The pack was often flavoured (62.2%). Images of lit LFC sticks increased from 2019 (12.2%) to 2020 (26.7%, p=0.005). Warning labels were present on the ad in 79.9% of posts, but always at the bottom, and used the same single warning statement that they are not a safe alternative to cigarettes. The depiction of people nearly doubled from 2019 (18.1%) to 2020 (34.8%, p=0.001), and women (50.6%) were more commonly depicted than men (32.1%). Popular depictions and themes included the outdoors (57.6%) and seasonal imagery (36.2%) among others.DiscussionCheyenne actively used Instagram to market its product and grow its brand. Posts seemed designed to promote the similarity of their LFC to cigarettes, through depictions of cig-a-like packs/sticks. Although warning labels were prevalent on Cheyenne Instagram posts, the warnings were not compliant with FDA warning guidelines and might have been counterproductive by emphasising their viability as cigarette alternatives rather than their dangerous health effects. Future surveillance is needed, and regulation of LFC advertising on social media may be warranted.
Dinosaur tracks in a Cretaceous (lower Albian) braid delta system (Basque–Cantabrian Basin, western Pyrenees): linking trace fossils suites and short-term preservation windows
Authors: Díaz-Martínez Ignacio , López-Horgue Mikel A. , Agirrezabala Luis M. , Cónsole-Gonella Carlos , Pereda-Suberbiola Xabier 
Published: June 2022

Abstract

Albian dinosaur tracks from the Monte Grande Formation (Basque–Cantabrian Basin) are described. Sedimentary succession shows seven different facies associations (FAs) with four track-bearing levels (levels 1–4) of a braid delta system. FA 4, a proximal crevasse subdelta, preserves in levels 2 and 3 theropod, possibly sauropod and undetermined dinosaur tracks, as well as
Ophiomorpha
and
Skolithos
traces. FA 5, a middle crevasse subdelta, presents undetermined cross-section tracks in levels 1 and 4, besides
Ophiomorpha
,
Skolithos
and locally
Teichichnus
in other layers. Both FAs have the same general ichnoassociation, although with preservational variations. The sedimentary succession represents an area with periods of crevasse subdelta progradation and colonization of opportunistic organisms, and other periods of subdelta abandonment represented by short sedimentary hiatuses in which the water sheet would be shallow or even absent and where dinosaurs would be roaming. Particularly, the traces of levels 2 and 3 represent the same ichnocoenosis constituting two different suites and may be envisaged as penecontemporaneous, produced within a short-term preservational window. This tracksite is one of the scarce Albian dinosaur ichnological records in the southwestern European island palaeoarchipelago and one of the few worldwide localities where Albian dinosaur tracks have been found in deltaic facies.
Right Heart Failure Following Left Ventricular Device Implantation: Natural History, Risk Factors, and Outcomes: An Analysis of the STS INTERMACS Database
Authors: Kapelios Chris J. , Lund Lars H. , Wever-Pinzon Omar , Selzman Craig H. , Myers Susan L. , Cantor Ryan S. , Stehlik Josef , Chamogeorgakis Themistocles , McKellar Stephen H. , Koliopoulou Antigone , Alharethi Rami , Kfoury Abdallah G. , Bonios Michael , Adamopoulos Stamatis , Gilbert Edward M. , Fang James C. , Kirklin James K. , Drakos Stavros G. 
Published: June 2022

Background:
Our current understanding of right heart failure (RHF) post-left ventricular assist device (LVAD) is lacking. Recently, a new Interagency Registry for Mechanically Assisted Circulatory Support definition of RHF was introduced. Based on this definition, we investigated natural history, risk factors, and outcomes of post-LVAD RHF.

Methods:
Patients implanted with continuous flow LVAD between June 2, 2014, and June 30, 2016 and registered in the Interagency Registry for Mechanically Assisted Circulatory Support/Society of Thoracic Surgeons Database were included. RHF incidence and predictors, and survival after RHF were assessed. The manifestations of RHF which were separately analyzed were elevated central venous pressure, peripheral edema, ascites, and use of inotropes.

Results:

Among 5537 LVAD recipients (mean 57±13 years, 49% destination therapy, support 18.9 months) prevalence of 1-month RHF was 24%. Of these, RHF persisted at 12 months in 5.3%. In contrast, de novo RHF, first identified at 3 months, occurred in 5.1% and persisted at 12 months in 17% of these, and at 6 months occurred in 4.8% and persisted at 12 months in 25%. Higher preimplant blood urea nitrogen (ORs,1.03–1.09 per 5 mg/dL increase;
P
<0.0001), previous tricuspid valve repair/replacement (ORs, 2.01–10.09;
P
<0.001), severely depressed right ventricular systolic function (ORs,1.17–2.20;
P
=0.004); and centrifugal versus axial LVAD (ORs,1.15–1.78;
P
=0.001) represented risk factors for RHC incidence at 3 months. Patients with persistent RHF at 3 months had the lowest 2-year survival (57%) while patients with de novo RHF or RHF which resolved by 3 months had more favorable survival outcomes (75% and 78% at 2 years, respectively;
P
<0.001).

Conclusions:
RHF at 1 or 3 months post-LVAD was a common and frequently transient condition, which, if resolved, was associated with relatively favorable prognosis. Conversely, de novo, late RHF post-LVAD (>6 months) was more frequently a persistent disorder and associated with increased mortality. The 1-, 3-, and 6-month time points may be used for RHF assessment and risk stratification in LVAD recipients.