bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lecture, Online, Flipped, and Blended: A Mixed-Methods Study on Ultrasound Student Outcomes and Perceptions
Authors: Custer Tanya , Wampler Kathryn , Lambing Lea , Sayles Harlan , Michael Kim 
Published: June 2022

Objective: The purpose of this study was to examine the effects of course delivery methods on examination grades and student perceptions in a sonography course. Materials and Methods: The participant included all sonography students (n = 103), enrolled at a Midwestern university, during the academic years (AY) of 2010–2021. A retrospective, convergent mixed-methods design was used to collect and analyze data, related to the course delivery method. Results: The highest overall mean examination score and course satisfaction rating resulted from the blended learning format and the lowest mean examination scores and course satisfaction resulted from the flipped learning format. Conclusion: Health professions students are a diverse group of learners. Pedagogical practices should include course design and delivery methods which educate all learners. Courses that balance both face-to-face learning with opportunities for self-directed learning improve student satisfaction which could lead to improved student outcomes and provide the foundation for students to become competent health care professionals.
ISM1 suppresses LPS-induced acute lung injury and post-injury lung fibrosis in mice
Authors: Nguyen Ngan , Xu Simin , Lam Terence Yin Weng , Liao Wupeng , Wong W. S. Fred , Ge Ruowen 
Published: June 2022

Abstract
Background
Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) are clinical syndromes characterized by acute lung inflammation, pulmonary edema and hypoxemia, with up to 50% mortality rate without effective pharmacological therapy. Following the acute inflammation, repair and remodeling occurs which in some cases resulting in lung fibrosis. The pathophysiology of ALI/ARDS remains incompletely understood. Lipopolysaccharide (LPS)-induced ALI in mice have been widely used as a model to study human ALI/ARDS. Isthmin 1 (ISM1) is a secreted protein highly abundant in mouse lung. We have previously reported that upon intratracheal LPS instillation, ISM1 expression in the lung is further upregulated. Recently, we also reported that ISM1 is an anti-inflammatory protein in the lung with Ism1-/- mice presenting spontaneous chronic low-grade lung inflammation and obvious emphysema at young adult stage. However, what role ISM1 plays in ALI/ARDS and lung fibrosis remain unclear.

Methods
Using Ism1-/- mice and intratracheal LPS-induced ALI, and local delivery of recombinant ISM1 (rISM1), we investigated the role ISM1 plays in ALI and post-ALI lung fibrosis using flow cytometry, Western blot, antibody array, immunohistochemistry (IHC), immunofluorescent and other histological staining.

Results
We reveal that ISM1 deficiency in mice led to an intensified acute lung inflammation upon intratracheal LPS challenge, with a heightened leukocyte infiltration including neutrophils and monocyte-derived alveolar macrophages, as well as upregulation of multiple pro-inflammatory cytokines/chemokines including tumor necrosis factor α (TNF-α). Although innate immune cells largely subsided to the baseline by day 7 post-LPS challenge in both wild-type and Ism1−/− mice, Ism1−/− lung showed increased post-ALI fibrosis from day 9 post-LPS treatment with increased myofibroblasts, excessive collagen accumulation and TGF-β upregulation. The heightened lung fibrosis remained on day 28 post-LPS. Moreover, intranasal delivered recombinant ISM1 (rISM1) effectively suppressed LPS-induced acute lung inflammation and ALI, and rISM1 suppressed LPS-induced NF-κB activation in cultured mouse alveolar macrophages.

Conclusion
Together with our previous report, this work further established ISM1 as an endogenous anti-inflammation protein in the lung, restraining excessive host inflammatory response to LPS-triggered ALI and suppressing post-ALI lung fibrosis likely through suppressing NF-κB activation and pro-inflammatory cytokine/chemokine production.
An Initial Residual Stress Inference Method by Incorporating Monitoring Data and Mechanism Model
Authors: Wang Shuguo , Li Yingguang , Liu Changqing , Zhao Zhiwei 
Published: June 2022

AbstractInitial residual stress is the main reason causing machining deformation of the workpiece, which has been deemed as one of the most important aspects of machining quality issues. The inference of the distribution of initial residual stress inside the blank has significant meaning for machining deformation control. Due to the principle error of existing residual stress detection methods, there are still challenges in practical applications. Aiming at the detection problem of the initial residual stress field, an initial residual stress inference method by incorporating monitoring data and mechanism model is proposed in this paper. Monitoring data during machining process is used to represent the macroscopic characterization of the unbalanced residual stress, and the finite element numerical model is used as the mechanism model so as to solve the problem that the analytic mechanism model is difficult to establish; the policy gradient approach is introduced to solve the gradient descent problem of the combination of learning model and mechanism model. Finally, the initial residual stress field is obtained through iterative calculation based on the fusing method of monitoring data and mechanism model. Verification results show that the proposed inference method of initial residual stress field can accurately and effectively reflect the machining deformation in the actual machining process.
Development of a Wearable Upper Limb Rehabilitation Robot Based on Reinforced Soft Pneumatic Actuators
Authors: Chen Xinbo , Zhang Shuai , Cao Kaibin , Wei Chunjie , Zhao Wumian , Yao Jiantao 
Published: June 2022

AbstractDyskinesia of the upper limbs caused by stroke, sports injury, or traffic accidents limits the ability to perform the activities of daily living. Besides the necessary medical treatment, correct and scientific rehabilitation training for the injured joint is an important auxiliary means during the treatment of the effected upper limb. Conventional upper-limb rehabilitation robots have some disadvantages, such as a complex structure, poor compliance, high cost, and poor portability. In this study, a novel soft wearable upper limb rehabilitation robot (SWULRR) with reinforced soft pneumatic actuators (RSPAs) that can withstand high pressure and featuring excellent loading characteristics was developed. Driven by RSPAs, this portable SWULRR can perform rehabilitation training of the wrist and elbow joints. In this study, the kinematics of an SWULRR were analyzed, and the force and motion characteristics of RSPA were studied experimentally. The results provide a reference for the development and application of wearable upper limb rehabilitation robots. An experimental study on the rotation angle of the wrist and the pressure of the RSPA was conducted to test the effect of the rehabilitation training and verify the rationality of the theoretical model. The process of wrist rehabilitation training was tested and evaluated, indicating that SWULRR with RSPAs will enhance the flexibility, comfort, and safety of rehabilitation training. This work is expected to promote the development of wearable upper-limb rehabilitation robots based on modular reinforced soft pneumatic actuators.
Identification and expression analysis of GARP superfamily genes in response to nitrogen and phosphorus stress in Spirodela polyrhiza
Authors: Zhao Xuyao , Yang Jingjing , Li Xiaozhe , Li Gaojie , Sun Zuoliang , Chen Yan , Chen Yimeng , Xia Manli , Li Yixian , Yao Lunguang , Hou Hongwei 
Published: June 2022

Abstract
Background
GARP transcription factors perform critical roles in plant development and response to environmental stimulus, especially in the phosphorus (P) and nitrogen (N) sensing and uptake. Spirodela polyrhiza (giant duckweed) is widely used for phytoremediation and biomass production due to its rapid growth and efficient N and P removal capacities. However, there has not yet been a comprehensive analysis of the GRAP gene family in S. polyrhiza.

Results
We conducted a comprehensive study of GRAP superfamily genes in S. polyrhiza. First, we investigated 35 SpGARP genes which have been classified into three groups based on their gene structures, conserved motifs, and phylogenetic relationship. Then, we identified the duplication events, performed the synteny analysis, and calculated the Ka/Ks ratio in these SpGARP genes. The regulatory and co-expression networks of SpGARPs were further constructed using cis-acting element analysis and weighted correlation network analysis (WGCNA). Finally, the expression pattern of SpGARP genes were analyzed using RNA-seq data and qRT-PCR, and several NIGT1 transcription factors were found to be involved in both N and P starvation responses.

Conclusions
The study provides insight into the evolution and function of GARP superfamily in S. polyrhiza, and lays the foundation for the further functional verification of SpGARP genes.
Real-time ultrasound-guided versus anatomic landmark-based thoracic epidural placement: a prospective, randomized, superiority trial
Authors: Pakpirom Jatuporn , Thatsanapornsathit Kanthida , Kovitwanawong Nalinee , Petsakul Suttasinee , Benjhawaleemas Pannawit , Narunart Kwanruthai , Boonchuduang Somrutai , Karmakar Manoj Kumar 
Published: June 2022

Abstract
Background
Thoracic epidural placement (TEP) using the conventional anatomic landmark-based technique is technically challenging, may require multiple attempts, and is associated with a high failure rate (12–40%). We hypothesized that real-time ultrasound guidance would be superior in the “first-pass” success rate of TEP, when compared with the conventional technique.

Methods
This prospective, randomized, superiority trial was conducted in a University hospital, and recruited 96 patients undergoing elective major abdominal or thoracic surgery and scheduled to receive a TEP for postoperative analgesia. Patients were randomly allocated to receive TEP using either the conventional technique (Gp-Conv, n = 48) or real-time ultrasound guidance (Gp-Usg, n = 48). The success of TEP was defined as eliciting loss of resistance technique and being able to insert the epidural catheter. The primary outcome variable was the “first-pass success rate” meaning the successful TEP at the first needle insertion without redirection or readvancement of the Tuohy needle. The secondary outcomes included the number of skin punctures, number of attempts, the overall success rate, TEP time, and total procedure time.

Results
The first-pass success rate of TEP was significantly higher (p = 0.002) in Gp-Usg (33/48 (68.8%); 95%CI 55.6 to 81.9) than in Gp-Conv (17/48 (35.4%); 95%CI 21.9 to 49.0). There was no statistically significant difference (p = 0.12) in the overall success rate of TEP between the 2 study groups (Gp-Usg; 48/48 (100%) vs. Gp-Conv; 44/48 (91.7%); 95%CI 83.9 to 99.5). Ultrasound guidance reduced the median number of skin punctures (Gp-Usg; 1 [1, 1] vs Gp-Conv; 2 [1, 2.2], p < 0.001) and attempts at TEP (Gp-Usg; 1 [1, 2] vs Gp-Conv; 3 [1, 7.2], p < 0.001) but the procedure took longer to perform (Gp-Usg; 15.5 [14, 20] min vs Gp-Conv; 10 [7, 14] min, p < 0.001).

Conclusions
This study indicates that real-time ultrasound guidance is superior to a conventional anatomic landmark-based technique for first-pass success during TEP although it is achieved at the expense of a marginally longer total procedure time. Future research is warranted to evaluate the role of real-time ultrasound guidance for TEP in other groups of patients.

Trial registration
Thai Clinical Trials Registry; http://www.thaiclinicaltrials.org/; Trial ID: TCTR20200522002, Registration date: 22/05/2020.
Prognostic value of plasma level of superoxide dismutase in HBV-related acute-on-chronic liver failure
Authors: Yao Naijuan , He Yajuan , Wu Yuchao , Wang Fei , Tian Zhen 
Published: June 2022

Abstract
Background
Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is the most prevalent type of ACLF in China. The mortality rate of HBV-ACLF has decreased in recent years due to advances in treatment therapies; however, it is still above 50%. Many cases of HBV-ACLF are caused by HBV reactivation due to discontinuation of nucleoside analog treatment. The present study focused on plasma levels of superoxide dismutase (SOD) in HBV-ACLF patients and investigated whether the plasma level of SOD is a useful biomarker in assessing disease severity and predicting outcomes of HBV-ACLF patients, including patients treated with Entecavir (ETV) and patients who were withdrawn from ETV treatment.

Methods
Plasma samples and clinical data from 200 HBV-ACLF patients and from age- and sex-matched cirrhotic and healthy controls were collected and analyzed. Plasma levels of SOD were measured using an ELISA commercial kit.

Results
Among the HBV-ACLF patients, in the ETV withdrawal group, the mortality rate was higher than in the ETV group (69.95% vs 46.71%, P < 0.05). Moreover, HBV-DNA and SOD plasma levels were higher in the ETV withdrawal group than in the ETV group (Log10(HBV-DNA): 6.49 ± 0.24 vs 4.79 ± 0.14, P < 0.01; SOD: 463.1 ± 27.61 U/mL vs 397.2 ± 10.97 U/mL, P < 0.05). The mortality and liver transplantation rates were significantly higher in HBV-ACLF patients with plasma levels of SOD > 428 U/mL than in patients with plasma SOD levels ≤ 428 U/mL.

Conclusions
Reactivation of HBV and elevated oxidative stress caused by discontinuation of ETV treatment are crucial factors in the pathogenesis of HBV-ACLF. Plasma level of SOD may serve as a useful biomarker in estimating disease severity and predicting outcomes of HBV-ACLF patients who stop ETV treatment.
Comparison of factors influencing fall recurrence in the young-old and old-old: a cross-sectional nationwide study in South Korea
Authors: Kim Mi Young , Kim Yujeong 
Published: June 2022

Abstract
Background
Recurrent falls are a concerning problem in the elderly. Elderly people aged > 65 years who are prone to fall often require medical treatment for severe fall-related injuries, which is associated with a substantial financial burden. Therefore, this study aimed to identify factors related to recurrent falls in the community-dwelling young-old (65–74 years old) and old-old (≥ 75 years) in South Korea.

Methods
This study used a cross-sectional, correlation design. Data from the 2017 National Survey of Older Koreans were used, and 5,838 young-old and 4,205 old-old elderly people were included in the analysis. The questionnaire included general characteristics, fall experience, physical status, mental status, and presence of chronic diseases. The data were analyzed using the chi-square test, one-way analysis of variance, and logistic regression analysis.

Results
In the young-old elderly people, limitations in activities of daily living (p < .001), use of visual aids (p = .002), cognitive function (p < .001), presence of suicidal ideations (p = .005), number of chronic diseases (p < .001), and number of prescribed medications used (p = .006) associated with fall recurrence. In the old-old elderly people, having a spouse (p = .034), being a beneficiary of the National Basic Livelihood Security System (p = .025), less exercise (p = .003), limitations in activities of daily living (p < .001), visual aid use (p = .002), presence of suicidal ideations (p = .015), number of chronic diseases (p < .001), and presence of Parkinson's disease (p < .001) associated with fall recurrence.

Conclusions
This study identified differences in factors related to fall recurrence between the young-old and old-old elderly. The results of this study indicate that it is necessary to implement an intervention program to prevent fall recurrence by age group in consideration of the risk factors for fall recurrence in each elderly people group.
Prescribing Alzheimer’s Disease treatments by provider type and geographic region: a comparison among physicians, nurse practitioners, and physician assistants
Authors: Park Jenny Y. , Veenstra David L. , Wallick Christopher J. , Marcum Zachary A. 
Published: June 2022

Abstract
Background
The estimated increase in Alzheimer’s Disease (AD) caseload may present a logistical challenge to the US healthcare system. While nurse practitioners (NPs) and physician assistants (PAs) are increasingly delivering primary care to patients with chronic diseases, the nature of their prescribing of AD medications is largely unknown. The primary objective of this study was to compare the prescribing of AD medications across provider types (physician, NP, and PA) and geographic regions.

Methods
We conducted a retrospective cohort study using IBM MarketScan® commercial and Medicare supplemental claims to examine unique AD prescriptions prescribed between January 1, 2016, and December 31, 2019. Parallel analysis of prescriptions for another geriatric condition, osteoporosis (OP), was also conducted for comparison.

Results
A total of 103,067 AD prescriptions and 131,773 OP prescriptions were included in analyses. Physicians prescribed most AD prescriptions (95.65%), followed by NPs (3.37%) and PAs (0.98%). Small differences were identified among individual AD medications prescribed by physicians compared to NP/PAs. NPs/PAs prescribed a significantly higher proportion of AD prescriptions in rural as compared to urban areas (z = 0.023, 95%CI [0.018, 0.028]).

Conclusion
Minimal variation exists in AD prescribing among physicians, NPs, and PAs, but NPs/PAs prescribe more AD prescriptions in rural areas. NPs/PAs, especially in rural areas, may play critical roles in alleviating projected workforce constraints. Further research assessing AD care, health outcomes, and costs by provider type and region is necessary to better guide healthcare workforce planning for AD care.
Residents’ perspectives of mobile X-ray services in support of healthcare-in-place in residential aged care facilities: a qualitative study
Authors: Dollard Joanne , Edwards Jane , Yadav Lalit , Gaget Virginie , Tivey David , Inacio Maria , Maddern Guy , Visvanathan Renuka 
Published: June 2022

Abstract
Background
Mobile X-ray services (MXS) could be used to investigate clinical issues in aged care residents within familiar surroundings, reducing transfers to and from emergency departments and enabling healthcare to be delivered in residential aged care facilities. There is however little research exploring consumer perspectives about such services. The objective of this research was to explore the perspectives and preferences of residents about the provision of MXS in residential aged care facilities, including their knowledge about the service, perceived benefits, and factors that require consideration for effective implementation.

Methods
A qualitative study design was used. The setting for the study included four residential aged care facilities of different sizes from different parts of a South Australian city. Purposive sampling was used to recruit participants. 16 residents participated in semi-structured interviews that were audio-recorded and transcribed verbatim. Data were inductively derived using thematic analysis.

Results
Participants had a mean age of 85 years, 56% were female, 25% had dementia and 25% had had a mobile X-ray in the last 12 months. Four themes were developed. Participants preferred mobile X-rays, provided as healthcare-in-place, to improve accessibility to them and minimize physical and psychological discomfort. Participants had expectations about the processes for receiving mobile X-rays. Costs of X-rays to people, family and society were a consideration. Decision making required residents be informed about mobile X-rays.

Conclusions
Residents have positive views of MXS as they can receive healthcare-in-place, with familiar people and surroundings. They emphasised that MXS delivered in residential aged care facilities need to be of equivalent quality to those found in other settings. Increased awareness of mobile X-ray services is required.
Comorbidities and COVID-19 status influence the survival rate of geriatric patients in intensive care units: a prospective cohort study from the Indonesian Society of Anaesthesiology and Intensive Therapy
Authors: Rehatta Nancy Margarita , Chandra Susilo , Sari Djayanti , Lestari Mayang Indah , Senapathi Tjokorda Gde Agung , Nurdin Haizah , Wirabuana Belindo , Pramodana Bintang , Pradhana Adinda Putra , Isngadi Isngadi , Anggraeni Novita , Sikumbang Kenanga Marwan , Halimi Radian Ahmad , Jasa Zafrullah Khany , Nasution Akhyar Hamonangan , Mochamat Mochamat , Purwoko Purwoko 
Published: June 2022

Abstract
Background
With the more advanced science in the field of medicine and disease management, the population of geriatric intensive care patients is increasing. The COVID-19 pandemic has impacted healthcare management around the globe, especially on critically-ill elderly patients. We aim to analyse the relationship between underlying illnesses, including COVID-19, and the survival rate of elderly patients who are treated in the intensive care setting.

Methods
We conducted a prospective cohort study at 14 teaching hospitals for Anaesthesiology and Intensive Therapy Education in Indonesia. We selected all subjects with 60 years of age or older in the period between February to May 2021. Variables recorded included subject characteristics, comorbidities, and COVID-19 status. Subjects were followed for 30-day mortality as an outcome. We analysed the data using Kaplan-Meier survival analysis.

Results
We recruited 982 elderly patients, and 728 subjects were in the final analysis (60.7% male; 68.0 ± 6.6 years old). The 30-day mortality was 38.6%. The top five comorbidities are hypertension (21.1%), diabetes (16.2%), moderate or severe renal disease (10.6%), congestive heart failure (9.2%), and cerebrovascular disease (9.1%). Subjects with Charlson’s Comorbidity Index Score > 5 experienced 66% death. Subjects with COVID-19 who died were 57.4%. Subjects with comorbidities and COVID-19 had lower survival time than subjects without those conditions (p < 0.005). Based on linear correlation analysis, the more comorbidities the geriatric patients in the ICU had, the higher chance of mortality in 30 days (p < 0.005, R coefficient 0.22).

Conclusion
Approximately one in four elderly intensive care patients die, and the number is increasing with comorbidities and COVID-19 status.