bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exon–Intron Circular RNA circRNF217 Promotes Innate Immunity and Antibacterial Activity in Teleost Fish by Reducing miR-130-3p Function
Authors: Zheng Weiwei , Su Hui , Lv Xing , Xin Shiying , Xu Tianjun 
Published: January 2022

Abstract
Circular RNA (circRNA) is produced by splicing head to tail and is widely distributed in multicellular organisms, and circRNA reportedly can participate in various cell biological processes. In this study, we discovered a novel exon–intron circRNA derived from probable E3 ubiquitin-protein ligase RNF217 (RNF217) gene, namely, circRNF217, which was related to the antibacterial responses in teleost fish. Results indicated that circRNF217 played essential roles in host antibacterial immunity and inhibited the Vibrio anguillarum invasion into cells. Our study also found a microRNA miR-130-3p, which could inhibit antibacterial immune response and promote V. anguillarum invasion into cells by targeting NOD1. Moreover, we also found that the antibacterial effect inhibited by miR-130-3p could be reversed with circRNF217. In mechanism, our data revealed that circRNF217 was a competing endogenous RNA of NOD1 by sponging miR-130-3p, leading to activation of the NF-κB pathway and then enhancing the innate antibacterial responses. In addition, we also found that circRNF217 can promote the antiviral response caused by Siniperca chuatsi rhabdovirus through targeting NOD1. Our study provides new insights for understanding the impact of circRNA on host–pathogen interactions and formulating fish disease prevention to resist the severely harmful V. anguillarum infection.
γδ T Cells Activated in Different Inflammatory Environments Are Functionally Distinct
Authors: Sun Deming , Chan Nymph , Shao Hui , Born Willi K , Kaplan Henry J 
Published: January 2022

Abstract
γδ T cells are important immunoregulatory cells in experimental autoimmune uveitis (EAU), and the activation status of γδ T cells determines their disease-enhancing or inhibitory effects. Because γδ T cells can be activated via various pathways, we questioned whether the nature of their activation might impact their function. In this study, we show that γδ T cells activated under different inflammatory conditions differ greatly in their functions. Whereas anti-CD3 treatment activated both IFN-γ+ and IL-17+ γδ T cells, cytokines preferentially activated IL-17+ γδ T cells. γδ T cells continued to express high levels of surface CD73 after exposure to inflammatory cytokines, but they downregulated surface CD73 after exposure to dendritic cells. Although both CD73high and CD73low cells have a disease-enhancing effect, the CD73low γδ T cells are less inhibitory. We also show that polarized activation not only applies to αβ T cells and myeloid cells, but also to γδ T cells. After activation under Th17-polarizing conditions, γδ T cells predominantly expressed IL-17 (gdT17), but after activation under Th1 polarizing conditions (gdT1) they mainly expressed IFN-γ. The pro-Th17 activity of γδ T cells was associated with gdT17, but not gdT1. Our results demonstrate that the functional activity of γδ T cells is strikingly modulated by their activation level, as well as the pathway through which they were activated.
Knowledge and Attitude of Nurses Toward Delirium
Authors: Grover Sandeep , Mehra Aseem , Sharma Neha , Sahoo Swapnajeet , Dua Devakshi 
Published: January 2022

Aim:
This cross-sectional study aimed to evaluate the attitude, practice, and knowledge among the nurses about the delirium in a tertiary care hospital.

Materials and Methods:
The study included 138 nurses working in a tertiary care multispecialty hospital in North India. The knowledge and attitude toward delirium were assessed by using a self-designed questionnaire (33 questions), of which 26 items specifically evaluated the knowledge and attitude toward various aspects of delirium.

Results:
The majority of the participants were females (83.3%), had done graduation (92.8%) in nursing, were junior nursing staff, and were directly in contact with the patient's care. The study shows that the majority of the nurses have poor knowledge about the etiology, prevalence, symptoms, and not aware of the screen procedure and instruments for delirium. Further, they lacked knowledge about the pharmacological and nonpharmacological management of delirium. A majority (83.3%) of the nurses opined that the psychiatry ward is the best place to manage patients with delirium. The majority of the nurses routinely did not screen their patients with delirium and did not know the screening instruments (84.4%) available for delirium. A majority (92.8%) of the nurses opined that they were never trained specifically to assess and manage delirium, and 98.6% expressed willingness for training.

Conclusion:
This study suggests that nurses working in intensive care unit and emergency settings in a tertiary care hospital in India have poor knowledge, negative attitudes, and poor practices about delirium.
Association of Vitamin D with Macrophage Migration Inhibitory Factor and Interleukin-8 in Diabetic Foot Infection
Authors: Tiwari Shalbha , Pratyush Daliparthy D. , Gupta Sanjeev K. , Singh Surya K. 
Published: January 2022

Background:
Diabetic foot wound is an important health challenge throughout the world. Interleukin 8 (IL8) and macrophage-migration inhibitory factor (MIF) play a significant role in host defense and in wound healing. Immune perturbation and Vitamin D deficiency also contribute to nonhealing of diabetic foot wounds. We aimed to evaluate the serum concentration of IL8 and MIF in diabetic patients with and without foot infection and its association with Vitamin D status.

Material and Methods:
Serum concentrations of 25 dihydroxyvitamin Vitamin D and cytokines (IL8 and MIF) were measured by radioimmunoassay and enzyme-linked immunosorbent assay, respectively, from 100 subjects with diabetes and foot infection as cases and 73 subjects with diabetes without foot infection as controls. Data were presented as mean (± standard error of mean [SE]) unless otherwise indicated and were analyzed by SPSS 16.0.

Results:
There was no significant difference in the mean (±SE) of age, duration of diabetes, hemoglobin A1C, and body mass index between the two groups. The mean (±SE) concentration of IL8 was significantly higher and MIF was significantly lower in cases than controls. Vitamin D correlated negatively with IL8 (r = −0.191) and positively (r = 0.1) with MIF. However, only the former correlation was statistically significant (P = 0.01). IL8 was also significantly high in patients with severe Vitamin D deficiency (<10 ng/ml) compared to patients with Vitamin D more than 10 ng/ml.

Conclusion:
Serum concentration of IL8 is significantly higher in diabetic foot infections compared to controls. Severe Vitamin D deficiency was associated with IL8 concentration in patients with diabetes.
Insulin Resistance in Early and Advanced Diabetic Kidney Disease
Authors: Purandare Vedavati B. , Kakrani Arjun L. , Bale Charan B. , Tiwari Shalbha , Unnikrishnan Ambika G. 
Published: January 2022

Background:
Insulin resistance (IR) is commonly seen in diabetic kidney disease (DKD) and could contribute to the progression of renal disease and cardiovascular risk. In this study, we aim to measure homeostasis model assessment IR (HOMA-IR) in DKD and see the effect of advancing kidney disease on HOMA IR.

Material and Methods:
We recruited 120 subjects with type 2 diabetes mellitus and divided them into people without kidney disease (controls; n = 20), early DKD (n = 40), and advanced DKD (n = 60). Biochemical tests including fasting plasma glucose and fasting serum C-peptide were done in 120 subjects. IR was calculated by the HOMA model in 109 subjects. Data were presented as median (interquartile range [IQR]). Univariable and multivariable analysis was done.

Results:
Median of HOMA-IR in the control group was 2.0 (IQR: 1.5–2.8; n = 20), early DKD group was 2.3 (1.8–2.9; n = 37), and advanced DKD group was 3.67 (1.6–3.9; n = 52). P = 0.03 indicated a significant increase in the HOMA IR with advancing kidney disease.

Conclusion:
In patients with DKD, with advancing kidney disease, there was a significant increase in the HOMA IR, a marker of IR. IR is a modifiable metabolic risk factor, and if it is managed by novel therapeutic ways, it might improve clinical outcomes in DKD.
Impact of Online Courses and Grading Framework on Student Learning and Motivation
Authors: Stowe Devorah M , Schoenfeld-Tacher Regina M , Hammond Sarah , Hedgpeth Mari-Wells , Neel Jennifer A 
Published: January 2022

Background:
At our institution, the COVID-19 pandemic led to an abrupt change from traditional in-person instruction to remote teaching along with a concurrent change from letter grades to satisfactory/marginal/unsatisfactory grading.

Objectives:
The aims of this study were to explore the effects of changes in instructional delivery on students’ learning and retention of the material and to assess students’ motivation to learn.

Methods:
The study consisted of two phases. Phase 1 involved the administration of an academic motivation survey and a clinical pathology exam using online platforms. Phase 2 involved conducting a focus group to further explore student experiences during the change in course instruction.

Results:
The academic motivation survey revealed that both prior to and during the pandemic, the main drivers for student achievement were an interest in learning the content due to anticipated relevance in clinical practice, as well as a desire to master course goals. While the students predicted feeling more confident in their data interpretation ability in the traditionally taught topics vs. topics modified due to social distancing, the data from the content exam suggests that students showed better retention of topics taught in a modified manner. Lastly, the focus group revealed that participants perceived online learning to be more challenging due to the lack of in-person contact and increased frustration with technical issues.

Conclusion:
While moving courses online may make it more difficult to engage with the materials, peers, and instructors, there did not appear to be adverse effects on the overall student learning or content retention.
Impact of Voice Conservation Sensitization Program in Nursing Trainees
Authors: Yeshoda Krishna , Rajasudhakar Rathinaswamy , Lokheshwar Shanmugasundaram 
Published: January 2022

Introduction:
Vocal hygiene sensitization programs help in propagating the information about conservation of voice in a swift manner to a target population. Nurses being bridge between patients and doctors help patients understand or convey important information. Hence, nursing trainees formed the target group for the sensitization program on voice conservation and care.

Materials and Methods:
Ninety-two nursing trainees and their faculty participated in a one-day sensitization program on vocal hygiene. The program consisted of two lectures on the anatomy and physiology of voice and vocal hygiene for voice conservation and voice care. Participants’ familiarity of the topic was assessed using a questionnaire before and after the lectures.

Results:
There was a significant increase in percent correct response from 77.41% to 91.46% after the program. Out of 10 questions, eight had increase in scores, one had decreased score, and one question remained the same.

Conclusion:
Improved percent correct response scores of the participants in the post test implied better awareness about the voice production mechanism and conservation of voice and its care. The results could imply that such programs could improve dissemination of information pertaining to voice use, conservation of voice, and helping in reducing the occurrence of voice problems in different groups of professional voice users.
Near-peer Learning in Medical Education
Authors: Spratte Brooke Namboodri , Hollis Alison Nancy , Hollis Emily Susan , Cole Yasemin Cunan , Bennett William Cannon , Alexander Seth Mckenzie , Parton Trevor , Beck Dallaghan Gary L 
Published: January 2022

Background:
The coronavirus disease-2019 stressed health science education across many science disciplines. At one public medical school, faculty educators responded with the design and delivery of an online COVID-19 pandemic course for clinical phase students. However, faculty resources were limited, and no official course was offered to preclinical students, despite reported interest. Subsequently, clinical students created an 8-week online, student-run curriculum. We aimed to assess how effectively the course improved medical student knowledge on COVID-19, created community, and improved other professional skills.

Methods:
Participants and instructors completed four surveys—two pre-course surveys and two post-course surveys. Average ratings for each question were calculated and analyzed using independent sample t tests.

Results:
Of the 188 students in the preclinical cohort, 143 enrolled in the course with 63.64% attending all, 91% attending ≥7 out of 8, and 96% attending ≥6 out of 8 sessions. Students and instructors reported an overall mean increase in knowledge on all course topics, peer teaching, learning in an online format, and overall preparedness with regards to a public health crisis. Overall, 79.2% of student participants and instructors reported being satisfied with the experience.

Conclusion:
Peer teaching and learning offers a valuable educational experience for participants and instructors alike. Student-driven curricula may provide an effective teaching model for medical education, contributing to efforts that improve student confidence and leadership skills, provide role models for junior students, and prepare students for their future role as educations.
Decision-Making Experiences and Decisional Regret in Patients Receiving Implanted Cardioverter-Defibrillators
Authors: Pourshams Idean Ahmad , Lin Bryant , Wang Paul J. , Stafford Randall S. 
Published: January 2022

Background:
Patient education before the placement of an implantable cardioverter-defibrillator (ICD) is strongly recommended to prevent or mitigate feelings of regret and frustration in ICD recipients. Medicare guidelines for ICDs require a shared decision-making approach that focuses on patients' health goals, values, and preferences before implantation. However, many patients are not fully informed of what to expect when recovering from ICD placement or living with an ICD long-term.

Objectives:
Our objective is to understand decision-making processes and decisional regret in patients requiring ICDs using in-depth interviews.

Methods:
Nineteen patients at Stanford University Medical Center were recruited to participate in individual interviews using closed-ended and open-ended questions to engage dialogue. Notes taken during interviews were assessed and used to identify major themes.

Results:
Participants described a lack of adequate education about ICD postoperative recovery and long-term, postimplantation considerations such as avoiding electromagnetic fields, false-positive ICD shocks, and the esthetic effect of ICD implantation. In addition, feelings of fear and anxiety were prevalent in participants' recollections of accepting an ICD.

Conclusion:
Further improvement in patient education before ICD placement is needed. The decision-making process can be simplified and patient regret and frustration minimized by providing reliable information that is accessible and interactive.
Socioeconomic and Clinical Factors Associated with Disease-Related Knowledge of Cardiac Rehabilitation Patients in Brazil
Authors: Loures Jessica B. , Chaves Gabriela S.S. , Ribas Renata C. , Britto Raquel R. , Marchiori Marian P. , Ghisi Gabriela L.M. 
Published: January 2022

Objective:
The objective of this study was to identify socioeconomic and clinical factors associated with disease-related knowledge of cardiac rehabilitation (CR) patients.

Methods:
Adults with coronary artery disease (CAD) were recruited during CR Phase 1 and completed questionnaires on the 1st day of Phase 2. Disease-related knowledge was assessed by the short version of the CAD Education Questionnaire. Socioeconomic status was defined by educational level, family income, and employment status. MannWhitney U and Spearman correlation were calculated to determine the association of knowledge with socioeconomic factors, number of risk factors, and wait time between hospital discharge and start of outpatient CR.

Results:
A convenience sample of 39 patients were recruited. Overall, the mean knowledge was 12.00 ± 3.3, which corresponds to 60% of possible scores. Monthly family income and number of risk factors influenced medical condition knowledge (P < 0.05), and employment status influenced total knowledge (P = 0.005) and risk factor knowledge (P = 0.002). Participants with three or more risk factors presented significantly higher knowledge (P = 0.02). Those that waited more than 17 weeks to start the CR presented significantly lower knowledge (P = 0.04).

Conclusion:
Participants with low income and unemployed were more likely to have inadequate disease-related knowledge; however, the entire sample presented low understanding of their condition. Public health strategies and educational interventions must continue to focus on these vulnerable groups.
Vicissitudes in the Placental Cotyledon Number in a Singleton Pregnancy with Gestational Diabetes
Authors: Elamin Abdalla Ahmed , Mohammed Ahmed Mohammed Noah , El Elhaj Abubaker , Ahmed Hussien Tarig Mahmoud , Abdelrahman Mohamed Abdelrahim Awadelkarim , Mohamed Hamza , Idris Saadeldin Ahmed 
Published: January 2022

Background:
Placenta is a transient organ during pregnancy, connects the fetus to the uterine wall. Pregnancy is frequently complicated by gestational diabetes, which might cause morphological changes in the placenta (weight, diameter, and cotyledons number); consequently, it may affect both fetus and mother.

Aim:
The aim of this study was to determine the difference in placental cotyledons number between pregnant with gestational diabetes versus without gestational diabetes, then correlate it with the weight and diameter between groups.

Materials and Methods:
A comparative study (gestational diabetes Group A and nongestational diabetes Group B) included mothers with a singleton baby delivered at term (37–40 weeks) after acceptance of the informed consent. Women with pregestational diabetes and other chronic diseases and those with intrauterine fetal death were excluded. Postdelivery placentae were accurately prepared and examined in detail. The placental weight, diameter, and cotyledons number were recorded and analyzed by SPSS version 21. The correlation was measured between the two groups in terms of cotyledons count, placental diameter, and weight.

Results:
The study included 385 participants (128 Group A and 257 Group B). Placental number of cotyledons, weight, and diameter in Group A were higher than in Group B, and the difference was significant (P = 0.000, P = 0.021, and P = 0.000, respectively). In Group A, there was a significant correlation between the placental weight, diameter, and number of its cotyledons (r = 0.23, P = 0.011). Cotyledon count was significantly affected by diabetic control (P = 0.021).

Conclusions:
Gestational diabetes increases placental cotyledons number, weight, and diameter.
Serum Creatinine versus Corrected Cockcroft-Gault Equation According to Poggio Reference Values in Patients with Arterial Hypertension
Authors: Šečić Damir , Turohan Adnan , Begić Edin , Rebić Damir , Pepić Esad , Begić Zijo , Iglica Amer , Begić Nedim , Metović Azra , Mušanović Jasmin 
Published: January 2022

Introduction:
Serum creatinine is not enough sensitive marker for the evaluation of glomerular filtration rate (GFR). Cockcroft-Gault (CG) formula is often used to assess GFR, but it is necessary to correct original one for body surface area (BSA), adipositas, and the creatinine tubular secretion. The values of the estimated creatinine clearance and GFR are considered to Poggio reference ones according to biological parameters (age and gender). The aim of the study was to determine the difference in renal function estimation between serum creatinine and corrected CG equation according to the Poggio reference values in the arterial hypertension patients.

Materials and Methods:
The research included 124 patients of both gender with arterial hypertension, excluding ones with the already verified chronic kidney disease. We estimated creatinine clearance and GFR by CG method corrected for the BSA, body mass index (BMI), and the creatinine tubular secretion according to Poggio reference values.

Results:
There was no significant difference in both age and gender groups among patients with physiological and pathological values of the renal function determined by the serum creatinine and estimated creatinine clearance by CG equation corrected for BMI, BSA. In both age and gender groups there was significant difference among subjects with physiological and pathological values of the renal function determined by serum creatinine and estimated GFR by CG method corrected for BMI, BSA, and creatinine tubular secretion.

Conclusion:
There is the most striking difference in the assessment of renal function between serum creatinine and estimated GFR by CG method with three corrections (BSA, BMI, the creatinine tubular secretion). Estimated GFR by CG method with three corrections can help in the early diagnosis of renal dysfunction and optimal treatment in patients with arterial hypertension.
Assessment of the Radio-contrast Media-Induced Self-Reported Adverse Drug Reactions in a Tertiary Care Hospital of North India
Authors: Singh Pushpinder , Gill Manraj Kaur , Kaur Mandeep , Mahajan Rajiv , Kaur Manjot 
Published: January 2022

Background:
Radio-contrast media are the agents which are used on daily basis in the radiological practice for either diagnostic or therapeutic purpose. Currently used agents are considered to be safe but not devoid of side effects.

Objectives:
Objectives of the study were to assess the incidence of adverse drug reactions (ADRs) in the patients who receive radiographic contrast media for computed tomography (CT) and intravenous pyelography (IVP), to stratify the ADRs into different types based on their time of appearance and as per their severity.

Materials and Methods:
A prospective and observational study of 1-year duration was done on all the patients who received radio-contrast media (Iohexol) intravenously for CT and IVP in the radiodiagnosis department. Patients who experienced ADRs were recorded for the basic demographic characteristics and types of ADRs. Stratification of ADRs as per their severity was done using common terminology criteria for adverse events scale and Modified Hartwig and Siegel ADR Severity Assessment Scale, and casualty assessment was done using Naranjo's Algorithm.

Results:
Out of the total 3522 patients who were included in the study, eight patients got 12 suspected ADRs with some of the patients having more than one type of ADR. The most frequent ADR was nausea and vomiting (25%), followed by fever, chills, or sweating. Incidence of ADRs was 0.23%. All the ADRs were acute and occurred within 30 min of contrast administration. As per the severity scales used, all the ADRs were mild (75%) to moderate (25%) in nature with none of the reactions to be severe. Causality assessment showed 87.5% of the reactions to be “probable” in nature.

Conclusion:
Low osmolar nonionic radio contrast media are associated with very low incidence of ADRs in the North Indian population.