bluuebunny/crossref_metadata_2025_split huggingface dataset:
Considering health literacy in cardiovascular disease management: a qualitative study on healthcare professionals’ and patients' perspectives
Authors: PERRIN Adèle , Damiolini Eléonore , Schott Anne-Marie , Zermati Jéremy , Bravant Estelle , Delahaye François , Dima Alexandra L. , HAESEBAERT Julie 
Published: February 2022

Abstract
Background: Implementing practices adapted to patient health literacy (HL) is a promising avenue for improving their outcomes in the context of cardiovascular diseases (CVD). The health communication skills of healthcare professionals (HCPs) and the quality of information provided are essential for low-HL patients. We aimed to explore HCPs knowledge about HL, patients and HCPs views on current practices regarding low-HL patients, and facilitators and barriers to adapting communication to patients’ HL level, in order to prepare the implementation of a complex intervention dedicated to improve CVD management for low-HL patients.Methods: We conducted face-to-face semi-structured interviews with HCPs practicing in cardiology units and patients hospitalized for CVD. Study design and analysis were based on the Theory of Planned Behavior for HCPs and the framework of Health Literacy and Health Action for patients. Deductive and inductive thematic analysis were used. Barriers and facilitators were structured into an Ishikawa fishbone diagram and implementation strategies were selected to address resulting themes from the Expert Recommendations for Implementing Change (ERIC).Results: Fifteen patients and 14 HCPs were interviewed. HCPs had partial knowledge of HL dimensions. Perceptions of HCPs and patients were not congruent regarding HCP-patient interactions and information provided by hospital and community HCPs. HCPs perceived they lacked validated tools and skills, and declared they adapted spontaneously their communication when interacting with low-HL patients. Patients expressed unmet needs regarding communication during hospital discharge and at return to home. Conclusion: To implement HL-tailored practices in this setting, our results suggest that several implementation strategies will be valuable at individual (engaging patients and their family), interactional (educating and training of HCPs about HL) and organizational levels (creating a multidisciplinary HCPs interest group dedicated to HL). Trial registration: The study was registered on Clinical Trials: NCT03949309.
Identification of a Novel Secreted Metabolite Cyclo(phenylalanyl-prolyl) from Batrachochytrium Dendrobatidis and its Effect on Galleria Mellonella.
Authors: Starr Amanda Michelle , Zabet-Moghaddam Masoud , Francisco Michael San 
Published: February 2022

Abstract
The fungus, Batrachochytrium dendrobatidis, is the causative agent of chytridiomycosis and a leading cause of global decline in amphibian populations . The first stages of chytridiomycosis include: inflammation, hyperkeratosis, lethargy, loss of righting reflex, and disruption of internal electrolyte levels leading to eventual death of the host. Previous work indicates that B. dendrobatidis can produce immunomodulatory compounds and other secreted molecules that regulate the growth of the fungus. In this study, filtrates of the fungus grown in media and water were subjected to ultra performance liquid chromatography-mass spectrometry and analyzed using Compound Discoverer 3.0. Identification of cyclo(phenylalanyl-prolyl), chitobiose, and S-adenosylmethionine were verified by their retention times and fragmentation patterns from B. dendrobatidis supernatants. Previous studies have analyzed the effects of B. dendrobatidis on amphibian models, in vitro, or in cell culture. We studied the effects of live B. dendrobatidis cells, spent culture filtrates containing secreted metabolites, and cyclo(pheylalanyl-prolyl) on wax moth larvae ( Galleria mellonella) . Concentrated filtrates caused melanization within 24 hours, while live B. dendrobatidis caused melanization within 48 hours. Our results indicate B. dendrobatidis produces secreted metabolites previously unreported. These findings provide another alternative for the use of a non-amphibian model system to study pathogenicity traits in this fungus.
Applying and assessing the PEERS model on genetic counselling training in China: A mixed-method approach
Authors: Dong Dong , Xiong Shiyi , Nichini Elena , Chen Xiaoqiong , Liu Binjuan , Zhu Liling , Yip Faustina Fu , Sun Luming , Zhu Jianfeng 
Published: February 2022

Abstract
Background: Due to the changing medical demands in the healthcare system, there is a need for the implementation of a standardised and professionalised curriculum for genetic counsellors in the practice of genetic medicine. This mixed-method study will observe and evaluate the first Peer Experiential and Reciprocal Supervision (PEERS) training program on genetic counselling among medical practitioners in China; to provide feedback and recommendation for future genetic counselling training and practices.Methods: A genetic counsellor training programme was held in December 10 and 11, 2016 in a foetal medicine unit and prenatal diagnosis centre in Shanghai with 59 participants from various clinical centres, hospitals and organisations in China. An ethnographic reflexive assessment combined with a structured questionnaire were used to provide insights and feedback on the overall training experience.Results: Results indicate an inadequate mastery of genetic and foetal knowledge; a lack of empathetic understanding and cultural sensitivity; difficulties in adopting a non-directive counselling approach; distance between reality and fictionality in the training; the overall training’s helpfulness.Conclusions: The professionalization of genetic counselling in China is in the making with the soaring demands for genetic counselling services; this first experiment of PEERS training turned out to be a needed experience, worth to be adapted to more medical centres across China, to better understand and face the challenges rising from genetic counselling practice.
A web-based survey on factors for unvaccination and adverse reactions of SARS-CoV-2 vaccines in Chinese postoperative patients with breast cancer
Authors: xiao wang , Shen Minxue , Zhang Qian , Wang Xiaomin , Zhang Hanghao , Li Tingxuan , Hu Yuanping , Xia Fan , Liao Liqiu 
Published: February 2022

Abstract
Vaccination against SARS-COV-2 has been the most important strategy for preventing infection and controlling pandemics of Coronavirus disease 2019 (COVID-19). But there is a lack of research on the pandemics in postoperative patients with breast cancer. We conducted a web-based questionnaire survey on SARS-CoV-2 vaccination in these populations. Univariate and multivariable logistic regression was used to estimate the associations. Among 947 valid online questionnaires, 341 (36.0%) accepted SARS-CoV-2 vaccination, while 606 (64.0%) were not. There were significant differences in age, current treatment, the time since surgery, and the symptoms of anxiety and depression between the two groups. We identified current treatment (odds ratio, OR = 0.51 for endocrine therapy; 95% CI: 0.29–0.89), the time since surgery (OR = 22.49 for 1–2 years; 95% CI: 12.31–41.10; OR = 8.49 for 2–5 years ; 95% CI: 4.98–14.46; OR = 1.79 for > 5 years ; 95% CI: 1.11–2.89), and the symptoms of depression (OR = 2.48; 95% CI: 1.19–5.15) as significant factors for unvaccination. The overall incidence of adverse reactions was 43.1%, and the most common local and systemic adverse reactions were pain at the injection site (28.4%) and fatigue (8.8%), respectively. Postoperative patients with breast cancer have a lower rate of vaccination for SARS-CoV-2. Receiving treatment, a shorter time since surgery and symptom of depression were associated with unvaccination. But, about 76.6% of the unvaccinated participants were willing to be vaccinated when their breast cancer was stable. More importantly, a favorable safety profile of the vaccines is indicated.
The Relationship between Difficulty in Emotion Regulation and Alexithymia with Hostile attribution bias and Anger in in adolescent boys with high bullying: A Path Analysis
Authors: afrashteh majid yousei , hanifeh parinaz 
Published: February 2022

Abstract
Introduction: Adolescence is one of the critical stages and the period of evolution of human physical and mental development that occurs between childhood and youth. Successful completion of this course plays a role in mental health and personality. The aim of this study was to investigate the role of Difficulty in Emotion Regulation and Alexithymia with Hostile attribution bias and Anger in adolescent boys with bullying, which plays an important role in developmental outcomes in adolescents. Methods: This research was conducted by cross-sectional method. 345 adolescent boys with high bullying living in Zanjan, Iran participated in the study. To measure self-reporting tools, Difficulties in Emotion Regulation Scale (DERS), Toronto Alexithymia Scale (TAS-20), Questionnaire of Hostile attribution bias and State-Trait Anger Expression Inventory tools were used to collect data. Path analysis method was used to analyze the causal model. The results show a good fit of the model with the experimental data. Results: The results also showed a direct and significant effect between anger with Difficulty in Emotion Regulation (β =0.19, p <0.05), with Alexithymia (β = 0.17, p <0.05) and with Hostile attribution bias (β =0.32, p<0.05) in male adolescents high bullying. As well the mediating role of Hostile attribution bias in the relationship between Difficulties in emotion regulation with anger is significant (β = 0.32). Moreover the mediating role of Hostile attribution bias in the relationship between Alexithymia with anger is significant (β = 0.20). Conclusion: These results contribute to the theoretical knowledge of how Alexithymia and hostile attribution bias affect anger in adolescent populations. The findings supported the mediating role of hostile attribution bias in the relationship between Difficulty in Emotion Regulation and Alexithymia with anger in adolescents. All three predictor variables are trainable and can be used in anger reduction and bullying interventions in adolescents.
The relationship between structural analysis of the hand and clinical characteristics in psoriatic arthritis
Authors: Pfeil Alexander , Heinz Marcus , Hoffmann Tobias , Weise Tobias , Renz Diane M. , Franz Marcus , Malich Ansgar , Driesch Dominik , Oelzner Peter , Wolf Gunter , Böttcher Joachim 
Published: February 2022

Abstract
Background:
Up to now, there is only limited information available on a possible relationship between clinical characteristics and the mineralization of metacarpal bones and finger joint space distance (JSD) in patients with psoriasis arthritis (PsA). Computerized digital imaging techniques like digital X-ray radiogrammetry (DXR) and computer-aided joint space analysis (CAJSA) have significantly improved the structural analysis of hand radiographs and facilitate the recognition of radiographic damage. The objective of this study was to evaluate clinical features which potentially influence periarticular mineralization of the metacarpal bones and finger JSD in PsA-patients.
Methods:
201 patients with PsA underwent computerized measurements of the metacarpal bone mineral density (BMD) with DXR and JSD of all finger joints by CAJSA. DXR-BMD and JSD were compared with clinical features such as age and sex, disease duration, C-reactive protein (CRP) as well as treatment with prednisone and disease-modifying antirheumatic drugs (DMARDs).
Results:
A longer disease duration and an elevated CRP value were associated with a significant reduction of DXR-BMD, whereas JSD-parameters were not affected by both parameters. DXR-BMD was significantly reduced in the prednisone group (-6.6%), but prednisone showed no impact on finger JSD. Patients under the treatment with bDMARDs presented significant lower DXR-BMD (-9.1%), JSDMCP (-16.8%), and JSDPIP (-12.4%) values.
Conclusion:
Metacarpal BMD was influenced by inflammatory activity, prednisone use, and DMARDs. In contrast, finger JSD showed only a change compared to baseline therapy. Therefore, metacarpal BMD as well as finger JSD represent radiographic destruction under different aspects.
A physical function intervention in community-dwelling disabled and older adults in a Medicaid waiver: results of a multi-site pragmatic hybrid type III cluster randomized trial comparing two implementation strategies
Authors: Spoelstra Sandra , Schueller Monica , Basso Viktoria , Sikorskii Alla 
Published: February 2022

Abstract
Background: Evidence-based interventions that optimize physical function for disabled and older adults living in the community who have difficulty with daily living tasks are available. However, to date, their implementation has been limited, particularly in state Medicaid home and community-based waiver programs. Furthermore, it is unknown whether implementation strategies commonly used in other settings would result in adoption and sustainability of these effective interventions in resource-constrained Medicaid programs.Methods: In a hybrid type III trial, waiver sites (N=18) were randomly assigned to implement the intervention using a bundle of strategies with either internal facilitation (IF) or IF and external facilitation (EF). Adoption and sustainability were assessed via stages of implementation completion (SIC) for each site. Clinician attitudes toward evidence-based practice and self-efficacy were evaluated among 539 registered nurses, social workers, and occupational therapists. Medicaid beneficiary outcomes of activities of daily living, depression, pain, falls, emergency department visits, and hospitalizations were evaluated in a sample of N=7,030 as reflected by electronic health records data of the Medicaid waiver program. Linear mixed effects models were used to compare outcomes between trial arms while accounting for cluster-randomized design.Results: The mean SIC scores were 72.22 (standard deviation [SD]=16.98) in the IF arm (9 sites), and 61.33 (SD=19.29) in the IF+EF arm (9 sites). The difference was not statistically significant, but corresponded to the medium clinically important effect size Cohen’s d=0.60. Clinician implementation outcomes of attitudes and self-efficacy did not differ according to the IF versus IF+EF. Beneficiary depression was reduced significantly in IF+EF arm compared to IF (p=.04, 95% confidence interval for the difference [0.01, 0.24]). No differences between trial arms were found for other beneficiary outcomes. Conclusions: Level of facilitation did not enhance capacity for adoption and sustainability of an evidence-based intervention in an under-resourced Medicaid setting that cares for disabled and older adults. Improved beneficiary depression favored external and internal facilitation strategy, but no differences for other outcomes compared to interval facilitation only suggest that the addition of external facilitation may not be warranted.Trial registration: ClinicalTrials.gov, NCT03634033; date registered August 16, 2018. https://clinicaltrials.gov/ct2/show/NCT03634033
Spatial distribution, sources and bio-environmental risk appraisal of heavy metals in surface sediments from north western Karnataka, south India
Authors: Mir Ishfaq Ahmad , M SreePrabash , V Sridhar , KV Maruthi 
Published: February 2022

Abstract
This study presents spatial distribution, sources and toxicological risks of As, Cr, Cu, Hg, Ni, Pb, and Zn in the surface sediments from north-western Karnataka, southern India. Heavy metals (except Hg) are 1–5 times enriched than upper continental crust. High concentration of Cr, Ni, Cu, and Zn is in the central Kudalgaon, Devarayi, and Tavargatti and in the south-western Ganeshgudi area, whereas Arsenic is enriched in the north-eastern Alnavar, Kakkeri,Tavargatti and Pb, and Hg in the north-western Kapoli, Devarayi, Manjarpal villages. The ecological risk index, toxic risk index, and mean probable-effects-levels quotient of heavy metals suggest that ~ 40% of the area is prone to very high risk especially for Cr and As to the hydrological, biological, and ecological systems. Multivariate statistical analysis suggests possible geogenic sources for Ni, Cr, Cu, and Zn and anthropogenic sources such as emissions from vehicles and agricultural sectors for As, Hg, and Pb. This study is the first of its kind in the area, which will help, in better formulation of environmental pollution and risk related remedial measures to conserve the natural ecosystem and the well-being of humans.
Non-invasive diagnosis strategy of hepatocellular carcinoma in low-risk population
Authors: Xie Zonglin , Peng Zhenpeng , Zou Yujian , Xiao Han , Li Bin , Zhou Qian , Chen Shuling , Xu Lixia , Shen Jingxian , Mo Yunxian , Peng Sui , Kuang Ming , Long Jianting , Feng Shiting 
Published: February 2022

Abstract
Aims
With the increase prevalence of hepatocellular carcinoma (HCC) in the low-risk population (LRP), establishing a non-invasive diagnostic strategy becomes more and more urgent to spare unnecessary biopsies in this population. The purposes of this study were to find the imaging features of HCC and establish a proper non-invasive method to diagnosis HCC in LRP.
Methods
A total of 681 patients in LRP (defined by the population without cirrhosis, chronic HBV infection or HCC history) were collected from 2 institutions. The images of computed tomography (CT) and magnetic resonance imaging (MRI) were analyzed. We divided the patients into training cohort (n = 324) and internal validating cohort (n = 139) by admission time in the first institution. The second institution were viewed as the external validation (n = 218). A multivariate logistic regression model incorporating imaging features and previously confirmed independent risk predictors was further developed. C-statistics was used to evaluate the diagnostic performance.
Results
Except for the typical hallmark features of HCC (non-rim enhancement, washout and capsule enhancement), tumor necrosis or severe ischemia (TNSI) and two clinical characteristics (gender and alpha fetoprotein) were also independently associated with HCC diagnosis (all P < 0.01). A clinical-imaging model (using 3 typical hallmark features, TNSI, gender and AFP) were built to diagnose HCC and achieved good diagnostic performance (area under curve values were 0.954 in training cohort, 0.931 in internal validation cohort and 0.902 in external cohort).
Conclusions
The clinical-imaging model that this study developed achieved a satisfied non-invasive diagnostic performance for HCC in LRP.
Intervention Model of Returning to Work Based on the Experience of Breast Cancer Patients
Authors: Cao Huili , He Kun 
Published: February 2022

Abstract
Background: Currently, the breast cancer has become one of major threats to females’ health. However, the percentage of returning to work is low for those breast cancer patients in China. Return to work is beneficial for breast cancer patients to help them realize social rehabilitation.Purpose: To explore and build up the intervention model of returning to work based on the experience of breast cancer patients, it can provide help and guidance for relevant personal.Methods: A total of fourteen breast cancer patients who had returned to work voluntarily participated in the semi-structural interviews. The results of interviews were analyzed according to the Colaizzi's phenomenological analytic procedure.Results: The analysis indicates that the following five parts could have the positive effects on the returning to work of breast cancer patients: (1) overcoming negative emotions, (2) rebuilding confidence, (3) correcting mentality and establishing goals, (4) obtaining all-around social support, and (5) seeking balance between body and work. Based on these aspects, the requirement model and the innovative intervention model of returning to work for breast cancer patients were separately built up to provide help and guidance for relevant personnel.Conclusions: Breast cancer patients successfully returned to work, which required the own internal strength and the powerful external support. Their internal determination should be strengthened to initiate the belief of returning to work, and the external environment should also be enhanced to benefit their employment. In addition, the continuous professional guidance should be implemented to maintain their healthy behaviors and high quality of life.
An Efficient Design of QCA Binary to Gray Code Converter for Telecommunication Systems
Authors: Aditya Marupaka , K Srinivasa Rao , B Balaji , Srav K Girija , Soma Umamaheshwar , Swamy Cheruku , Reddy Naresh Kumar 
Published: February 2022

Abstract
Quantum Dot Cellular Automata (QCA) is a prominent technology in Quantum Electronics. This is implemented with the help of quantum cells which are also known as basic building blocks of Quantum Electronics. In QCA technology there are four different clock pulses, clock delay for each clock cycle is 0.25 ns. Using this technology now we are implementing the Binary to Gray code converter. In this paper, we are proposing a design to reduce the number of cells when compared to the previous designs and we are also extending the implementation of the converter up to 5-bits. The number of cells in the proposed design is improved by 2.5%, 36.44%, and 50.66% for 2-bit, 3-bit, and 4-bit respectively. Also, for 3-bit and 4-bit, the total occupied area is improved by 55.56% and 74.680% respectively. In our proposed design it helps us to decrease the area from the previous circuit, which may also lead to the decrease in the power consumption.
Identification of Novel Non-HFE Mutations in Chinese Patients with Hereditary Hemochromatosis
Authors: Zhang Wei , Li Yanmeng , Xu Anjian , Ouyang Qin , Wu Liyan , Zhou Donghu , Wu Lina , Zhang Bei , Zhao Xinyan , Wang Yu , Wang Xiaoming , Duan Weijia , Wang Qianyi , You Hong , Huang Jian , Ou Xiaojuan , Jia Jidong 
Published: February 2022

Abstract
Backgrounds
: Hereditary hemochromatosis (HH) is mainly caused by homozygous p.C282Y mutations in HFE in the Caucasians. We recently reported non-HFE mutations constitute the major cause of HH in Chinese. However, there is still a relatively high proportion of cases with primary iron overload from unexplained causes. We aimed to explore novel non-HFE mutations in Chinese patients with primary iron overload.
Methods
Whole exome sequence was conducted to screen mutations in novel HH-related genes in the 9 cases with unexplained primary iron overload. Then the representative candidate genes were screened for mutations in another cohort of 18 HH cases. The biological function of the selected genes and variants were analyzed in vitro.
Results
Whole exome sequencing of 9 cases with unexplained primary iron overload identified 42 missense variants in 40 genes associated with iron metabolism pathway genes such as UBE2O p.K689R and PCSK7 p.R711W. Subsequent Sanger sequencing of the UBE2O and PCSK7 genes in the 27 cases with primary iron overload identified p.K689R in UBE2O, p.R711W and p.V143F in PCSK7 at frequency of 2/27,1/27 and 2/27 respectively. In vitro siRNA interference of UBE2O and PCSK7 resulted in down-regulated HAMP mRNA expression. Adenovirus generation of UBE2O p.K689R in cell lines resulted in increased expression of SMAD6 and SMAD7 and downregulation of p-SMAD1/5 and HAMP expression, and the reduction of hepcidin level.
Conclusions
Our study identified a series of novel candidate non-HFE mutations in Chinese patients with HH. These may provide insights into the genetic basis of unexplained primary iron overload.