bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between Clinical Simulation Design Features and Novice Healthcare Professionals’ Cognitive Load: A Systematic Review and Meta-Analysis
Authors: Lapierre Alexandra , Arbour Caroline , Maheu-Cadotte Marc-André , Vinette Billy , Fontaine Guillaume , Lavoie Patrick 
Published: August 2022

Background Clinical simulations are complex educational interventions characterized by several design features, which have the potential to influence cognitive load, that is, the mental effort required to assimilate new information and learn. This systematic review and meta-analysis explored the associations between simulation design features and cognitive load in novice healthcare professionals. Methods Based on the Joanna Briggs Institute methodology, a search was performed in five databases for quantitative studies in which the cognitive load of novice healthcare professionals was measured during or after a simulation activity. Each clinical simulation was coded to describe its design features. Univariate and multivariate mixed model analyses were performed to explore the associations between simulation design features and cognitive load. Results From 962 unique records, 45 studies were included and 27 provided enough data on subjective cognitive load (i.e., Paas Scale and NASA-Task Load Index scores) to be meta-analyzed. In the multivariate analysis for the NASA-Task Load Index scores, each repetition of a simulation using the same scenario resulted in a linear decrease in cognitive load. In contrast, technology-based instruction before or during a simulation activity was associated with higher cognitive load. In the univariate analyses, other features such as feedback and instructor presence were also statistically associated with cognitive load. Regarding the univariate analyses of the Paas Scale scores, simulator type, briefing, debriefing, and repetitive practice were statistically associated with cognitive load. Conclusion This is the first meta-analysis exploring the relationship between clinical simulation design features and novice healthcare professionals’ cognitive load. Although the findings show that several design features can potentially increase or decrease cognitive load, several gaps and inconsistencies in the current literature make it difficult to appreciate how such reciprocity influences novice healthcare professionals’ learning. These limitations are discussed and avenues for educators and further research are suggested.
Roles of Serious Game in Diabetes Patient Education
Authors: Ling Chen , Seetharaman Shriram , Mirza Lubna 
Published: August 2022

Background Diabetes affects many people across the world. Diabetes education plays a critical role in helping people with diabetes to perform diabetes self-management at home. Intervention We explored whether serious games can be used as a supplementary tool for diabetes education. Two online video games- the “Diabetic Dog” game and “Carb Counting with Lenny the Lion” game, were used for the study. Methods Fourteen patients with Type II diabetes were recruited from the Norman Diabetes Center by personal invitations. After initial training, the patients played the games a minimum of four times per week during the two-week study duration. Pre- and post-assessments of patients' diabetes knowledge and self-efficacy in diabetes self-management behaviors were performed using questionnaires, and an interview was conducted at the end to gauge the effectiveness of the game intervention. Results The results from the questionnaires show a general trend of improvement in patient diabetes knowledge and self-efficacy in diabetes self-management. A general trend of improvements in patients’ self-efficacy in controlling blood sugar level, handling abnormal blood sugar levels, taking insulin, and complying with a diabetes diet was observed. The interview results showed that the patients reinforced their diabetes knowledge and became more aware of their own lifestyles by playing diabetes educational games. They perceived the games as fun and easy to play. They also provided suggestions for the game design for diabetes education. Conclusion The study showed that serious game intervention had good potential to be a useful supplement to clinic-based diabetes education in improving patient diabetes knowledge and increasing patient self-efficacy in diabetes self-management behavior.
Modulation of Breast Cancer Cell FASN Expression by Obesity-Related Systemic Factors
Authors: McClellan Bryan , Pham Tommy , Harlow Brittany , Lee Gabby , Quach Duan , Jolly Christopher , Brenner Andrew , deGraffenried Linda 
Published: August 2022

Purpose: The objective of this study is to determine the impact of exposure to obesity-related systemic factors on fatty acid synthase enzyme (FASN) expression in breast cancer cells. Methods: MCF-7 breast cancer cells were exposed to sera from patients having obesity or not having obesity and subjected to quantitative reverse transcription polymerase chain reaction (RT-qPCR). Subsequent MTT and colony-forming assays using both MCF-7 and T-47D cells exposed to sera and treated with or without FASN inhibitor, TVB-3166, were used. MCF-7 cells were then treated with insulin and the sterol regulatory element–binding protein (SREBP) processing inhibitor, betulin, prior to analysis of FASN expression by quantitative RT-qPCR and western blot. Insulin-induced SREBP-FASN promoter binding was analyzed by chromatin immunoprecipitation with an anti-SREBP antibody. Results: In response to sera exposure (body mass index [BMI] >30) there was an increase in FASN expression in breast cancer cells. Furthermore, treatment with the FASN inhibitor, TVB-3166, resulted in a decreased breast cancer cell survival and proliferation while increasing apoptosis upon sera exposure (BMI >30). Insulin-exposed MCF-7 cells exhibited an increased FASN messenger RNA and protein expression, which is abrogated upon SREBP inhibition. In addition, insulin exposure induced enhanced SREBP binding to the FASN promoter. Conclusions: Our results implicate FASN as a potential mediator of obesity-induced breast cancer aggression and a therapeutic target of patients with obesity-induced breast cancer.
Where exactly between utopia and dystopia? A framing analysis of AI and automation in US newspapers
Authors: Cools Hannes , Van Gorp Baldwin , Opgenhaffen Michael 
Published: August 2022

Over the last 60 years, media outlets have been covering emerging technologies like artificial intelligence (AI) and automation. This countrylevel study wants to give a nuanced overview of how these technologies were covered in US newspapers. First, a Latent Dirichlet allocation (LDA) topic modeling was conducted on articles on AI and automation in The New York Times and The Washington Post between 1985 and 2020. Second, an inductive manual framing analysis was conducted to distinguish the frames that both newspapers applied over time. Results from the topic modeling show that articles on AI and automation are most prominent within ‘Work’, ‘Art’, and ‘Education’. Concerning the manual framing analysis, the coverage has been more optimistic than pessimistic over time. However, when dystopian frames are considered, the results show that there has been more attention in the corpus on the impact of AI and automation on ethical conundrums involved with these technologies.
Performance status: A key factor in predicting mortality in the first wave of COVID-19 in South-East Scotland
Authors: Mutch Callum P , Ross Daniella A , Bularga Anda , Nicola Rose Cave Roo , Chase-Topping Margo E , Anand Atul , Mills Nicholas L , Koch Oliver , Mackintosh Claire L , Perry Meghan R ,   DataLoch COVID-19 Collaborative
Published: August 2022

Background: COVID-19 mortality risk factors have been established in large cohort studies; long-term mortality outcomes are less documented. Methods: We performed multivariable logistic regression to identify factors associated with in-patient mortality and intensive care unit (ICU) admission in symptomatic COVID-19 patients admitted to hospitals in South-East Scotland from 1st March to 30th June 2020. One-year mortality was reviewed. Results: Of 726 patients (median age 72; interquartile range: 58–83 years, 55% male), 104 (14%) required ICU admission and 199 (27%) died in hospital. A further 64 died between discharge and 30th June 2021 (36% overall 1-year mortality). Stepwise logistic regression identified age >79 (odds ratio (OR), 4.77 (95% confidence interval (CI), 1.96–12.75)), male sex (OR, 1.83 (95% CI, 1.21–2.80)) and higher European Cooperative Oncology Group/World Health Organization performance status as associated with higher mortality risk. Discussion: Poor functional baseline was the predominant independent risk factor for mortality in COVID-19. More than one-third of individuals had died by 1 year following admission.
A new generalized shift-splitting method for nonsymmetric saddle point problems
Authors: Wei Tao , Zhang Li-Tao 
Published: August 2022

Recently, Huang and Huang [ Journal of Computational and Applied Mathematics, 328 (2018) 381–399] proposed a modified generalized shift-splitting preconditioned (denoted by MGSSP) method for solving large sparse saddle point problems, and gave the corresponding theoretical analysis and numerical experiments. In this paper, based on the modified generalized shift-splitting preconditioned (MGSSP) method, we generalize the MGSSP algorithms and further present the new generalized shift-splitting preconditioned (NGSSP) method for nonsymmetric saddle point problems. Moreover, by similar theoretical analysis, we analyze the convergence conditions of the corresponding matrix splitting iteration methods of the NGSSP preconditioned saddle point matrices. In final, one example is provided to confirm the effectiveness. MSC: 65F10, 65F15, 65F50
Reliability of functional outcome measures in adults with neurofibromatosis 2
Authors: Mullin Rebecca Louise , Smith Rebecca , Wood Susan , Swampillai Angela , Afridi Shazia 
Published: August 2022

Objective: To determine inter- and intra-rater reliability of functional performance outcome measures in people with neurofibromatosis 2. To ascertain how closely objective and subjective measures align. Methods: Twenty-nine people with neurofibromatosis 2 were recorded performing the modified clinical test of sensory integration and balance, four square step test and modified nine-hole peg tests. Three raters scored each measure to determine inter-rater reliability. One rater scored the measures a second time to determine intra-rater reliability. Participants also completed a disease-specific quality of life questionnaire and dynamic visual acuity testing. Results: Inter-rater and intra-rater reliability scores (intra-class correlation coefficient) were excellent for all tests (intra-class correlation coefficient r ⩾ 0.9). The four square step test correlated with perceived walking challenges and modified clinical test of sensory integration and balance correlated with perceived balance challenges in a neurofibromatosis 2 quality of life patient report outcome measure. Conclusion: The modified clinical test of sensory integration and balance, four square step test and modified nine-hole peg tests are potentially useful measures for monitoring neurofibromatosis 2.
Using Virtual Learning to Develop Palliative Care Skills Among Humanitarian Health Workers in the Rohingya Refugee Response in Bangladesh
Authors: Doherty Megan , Lynch-Godrei Anisha , Azad Tasnim , Ladha Fatima , Ferdous Lailatul , Ara Rowsan , Richardson Kathryn , Groninger Hunter 
Published: August 2022

Background Palliative care is an essential component of health responses in humanitarian settings, yet it remains largely unavailable in these settings, due to limited availability of palliative care training for healthcare professionals. Online training programs which connect experts to clinicians in the field have been proposed as an innovative strategy to build palliative care capacity humanitarian settings. Objective To describe the implementation and evaluate the impact of delivering palliative care education using an established virtual learning model (Project ECHO) for healthcare clinicians working in the Rohingya refugee response in Bangladesh. Program acceptability and the impacts on learners’ self-reported knowledge, comfort, and practice changes were evaluated. Methods Using the Project ECHO model, an education program consisting of 7 core sessions and monthly mentoring sessions was developed. Each session included a didactic lecture, case presentation and interactive discussion. Surveys of participants were conducted before and after the program to assess knowledge, confidence, and attitudes about palliative care as well as learning experiences from the program. Results This virtual palliative care training program engaged 250 clinicians, including nurses (35%), medical assistants (28%) and physicians (20%). Most participants rated the program as a valuable learning experience (96%) that they would recommend to their colleagues (98%). Participants reported improvements in their knowledge and comfort related to palliative care after participation in the program, and had improved attitudes towards palliative care with demonstrated statistical significance (p < 0.05). Conclusions Virtual training is a feasible model to support healthcare providers in a humanitarian health response. Project ECHO can help to address the urgent need for palliative care in humanitarian responses by supporting healthcare workers to provide essential palliative care to the growing number of individuals with serious health-related suffering in humanitarian settings.
Absolute neutrophil count by Duffy status among healthy Black and African American adults
Authors: Merz Lauren E. , Story Charlotte M. , Osei Miriam A. , Jolley Katherine , Ren Siyang , Park Hae Soo , Yefidoff Freedman Revital , Neuberg Donna , Smeland-Wagman Robin , Kaufman Richard M. , Achebe Maureen O. 
Published: August 2022

AbstractMany people of African ancestry have lower absolute neutrophil counts (ANCs) without increased risk for infection. This is associated with the Duffy-null phenotype (nonexpression of the Duffy antigen on red blood cells), which is commonly found in those of African descent. Currently, there are no studies that compare the ANC of individuals with Duffy-null phenotype to those with Duffy non-null phenotypes within a self-identified Black population. The aim of this study was to assess the impact of Duffy status on ANCs based on complete blood counts with differential and Duffy testing in a healthy population of self-identified Black individuals at a single primary care center. This study found that 66.7% (80 of 120) of Black individuals have the Duffy-null phenotype and that there is a significant difference in ANCs between Duffy-null and Duffy non-null individuals (median, 2820 cells per μL vs 5005 cells per μL; P &lt; .001). Additionally, 19 of 80 (23.8%) Duffy-null individuals had an ANC of &lt;2000 cells per μL compared with no (0) Duffy non-null individuals. The Duffy-null phenotype is clinically insignificant; however, inappropriate reference ranges can propagate systemic racism. Therefore, we advocate for the development of Duffy-null–specific ANC reference ranges as well as replacing the term benign ethnic neutropenia with Duffy-nullassociated neutrophil count.
Role of miRNA dysregulation in sepsis
Authors: Formosa Amanda , Turgeon Paul , dos Santos Claudia C. 
Published: August 2022

Abstract
Background
Sepsis is defined as a state of multisystem organ dysfunction secondary to a dysregulated host response to infection and causes millions of deaths worldwide annually. Novel ways to counteract this disease are needed and such tools may be heralded by a detailed understanding of its molecular pathogenesis. MiRNAs are small RNA molecules that target mRNAs to inhibit or degrade their translation and have important roles in several disease processes including sepsis.

Main body
The current review adopted a strategic approach to analyzing the widespread literature on the topic of miRNAs and sepsis. A pubmed search of “miRNA or microRNA or small RNA and sepsis not review” up to and including January 2021 led to 1140 manuscripts which were reviewed. Two hundred and thirty-three relevant papers were scrutinized for their content and important themes on the topic were identified and subsequently discussed, including an in-depth look at deregulated miRNAs in sepsis in peripheral blood, myeloid derived suppressor cells and extracellular vesicles.

Conclusion
Our analysis yielded important observations. Certain miRNAs, namely miR-150 and miR-146a, have consistent directional changes in peripheral blood of septic patients across numerous studies with strong data supporting a role in sepsis pathogenesis. Furthermore, a large body of literature show miRNA signatures of clinical relevance, and lastly, many miRNAs deregulated in sepsis are associated with the process of endothelial dysfunction. This review offers a widespread, up-to-date and detailed discussion of the role of miRNAs in sepsis and is meant to stimulate further work in the field due to the potential of these small miRNAs in prompt diagnostics, prognostication and therapeutic agency.
Cortical spreading depression can be triggered by sensory stimulation in primed wild type mouse brain: a mechanistic insight to migraine aura generation
Authors: Hanalioglu Sahin , Taskiran-Sag Aslihan , Karatas Hulya , Donmez-Demir Buket , Yilmaz-Ozcan Sinem , Eren-Kocak Emine , Gursoy-Ozdemir Yasemin , Dalkara Turgay 
Published: August 2022

Abstract
Background
Unlike the spontaneously appearing aura in migraineurs, experimentally, cortical spreading depression (CSD), the neurophysiological correlate of aura is induced by non-physiological stimuli. Consequently, neural mechanisms involved in spontaneous CSD generation, which may provide insight into how migraine starts in an otherwise healthy brain, remain largely unclear. We hypothesized that CSD can be physiologically induced by sensory stimulation in primed mouse brain.

Methods
Cortex was made susceptible to CSD with partial inhibition of Na+/K+-ATPase by epidural application of a low concentration of Na+/K+-ATPase blocker ouabain, allowing longer than 30-min intervals between CSDs or by knocking-down α2 subunit of Na+/K+-ATPase, which is crucial for K+ and glutamate re-uptake, with shRNA. Stimulation-triggered CSDs and extracellular K+ changes were monitored in vivo electrophysiologically and a K+-sensitive fluoroprobe (IPG-4), respectively.

Results
After priming with ouabain, photic stimulation significantly increased the CSD incidence compared with non-stimulated animals (44.0 vs. 4.9%, p < 0.001). Whisker stimulation also significantly increased the CSD incidence, albeit less effectively (14.9 vs. 2.4%, p = 0.02). Knocking-down Na+/K+-ATPase (50% decrease in mRNA) lowered the CSD threshold in all mice tested with KCl but triggered CSDs in 14.3% and 16.7% of mice with photic and whisker stimulation, respectively. Confirming Na+/K+-ATPase hypofunction, extracellular K+ significantly rose during sensory stimulation after ouabain or shRNA treatment unlike controls. In line with the higher CSD susceptibility observed, K+ rise was more prominent after ouabain. To gain insight to preventive mechanisms reducing the probability of stimulus-evoked CSDs, we applied an A1-receptor antagonist (DPCPX) to the occipital cortex, because adenosine formed during stimulation from ATP can reduce CSD susceptibility. DPCPX induced spontaneous CSDs but only small-DC shifts along with suppression of EEG spikes during photic stimulation, suggesting that the inhibition co-activated with sensory stimulation could limit CSD ignition when K+ uptake was not sufficiently suppressed as with ouabain.

Conclusions
Normal brain is well protected against CSD generation. For CSD to be ignited under physiological conditions, priming and predisposing factors are required as seen in migraine patients. Intense sensory stimulation has potential to trigger CSD when co-existing conditions bring extracellular K+ and glutamate concentrations over CSD-ignition threshold and stimulation-evoked inhibitory mechanisms are overcome.
Evaluation of the use of individualized patient care plans in frequent emergency department visitors with pain complaints
Authors: Blind Fred , Melton James , Karp Juliana , Oldano Karen , Homa Karen , Blanco Alexandra , Leoni Reanna , Pazanese Anthony 
Published: August 2022

Abstract
Background
Pain is one of the most common complaints that patients present to the emergency department for; emergency medicine providers are tasked with providing appropriate pain relief while simultaneously limiting the risk of personal and societal harm that may result from opioid misuse. The Lakeland Regional Medical Center developed a medical management program that identified frequent emergency department visitors with a chief complaint of pain. Individualized care plans were developed for these patients. A retrospective review was then conducted to assess the efficacy of these care plans in reducing the number of emergency department visits for pain-related complaints by the patients entered into the medical management program.

Results
There were 294 patients; 65% were male, and the median age was 41 (interquartile range: 33 to 51). A total of 80% percent of the patients were white, and the payors were as follows: 53% were self-pay, 42% were government programs, and 5% had private insurance. The three most common chronic pain complaints were 39% abdominal pain, 24% back/neck pain, and 23% headache/migraine (patients could have more than one area of pain). A total of 60% of the patients had a primary care provider, and another 18% had a pain management provider in addition to primary care.
Post plan admissions were significantly reduced to a median of 1 (IQR 0 to 3) with the Wilcoxon signed-rank test’s p-value of less than 0.001.

Conclusion
The authors describe their experience with a quality improvement initiative that identifies frequent emergency department visitors with a chief complaint of pain and provides individualized care plans to these patients. The goals of the program are to improve patient’s quality and consistency of care, through interventions that eliminate the prescribing of opioids while providing non-opioid alternatives.