bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences using an instrument for non-technical skills in nurse anaesthesia education: a focus group study
Authors: Flynn Fiona M. , Valeberg Berit T. , Bing-Jonsson Pia C. , Lyberg Anne M. , Tønnessen Siri 
Published: April 2022

Abstract
Background
Although there is an increasing amount of research on the use of structured behavioural assessment instruments for non-technical skills in a simulation or clinical setting, there is currently little research into how healthcare professionals experience using these instruments. The structured behavioural assessment instrument, Nurse Anaesthetists’ Non-Technical Skills-Norway, has recently been introduced to nurse anaesthesia education as a means of developing and assessing non-technical skills in clinical practice. The aim of this study was therefore to explore the experiences of Norwegian student nurse anaesthetists, their mentors and clinical supervisors on using the instrument in clinical practice.

Methods
This study has a qualitative descriptive design. Data was collected through semi-structured interviews with four focus groups comprising twelve student nurse anaesthetists and thirteen mentors and clinical supervisors. The interviews were recorded and then transcribed verbatim. Data was analyzed using qualitative content analysis and an inductive approach.

Results
Six categories were identified that represented the manifest content. One main theme: Forging a path towards clinical excellence was identified representing the latent content, and three themes that described the participants’ experiences with using the instrument:
Promotion of excellent non-technical skills: Raising awareness of non-technical skills ensured professional suitability and shaping of a professional identity; internalizing the skills could lead to changes in behaviour.
Promotion of cooperative learning: Mentoring was more structured, based on a common language and understanding and clearly defined roles; measurable progress enabled a more reliable and objective evaluation.
Promotion of organizational acceptance: A lack of familiarity with the instrument, and challenges with scoring and the terminology impeded acceptance.

Conclusion
Increased awareness of non-technical skills when using Nurse Anaesthetists’ Non-Technical Skills-Norway contributes to a professionalization of the nurse anaesthetist role and mentoring/learning process in nurse anaesthesia education. Using Nurse Anaesthetists’ Non-Technical Skills-Norway promotes the ideal of clinical excellence, not only as an assessment instrument but also by guiding the student’s learning process. Despite a high level of commitment to using the instrument there is a need to promote further acceptance in the anaesthetic departments.
Examining the unit costs of COVID-19 vaccine delivery in Kenya
Authors: Orangi Stacey , Kairu Angela , Ngatia Anthony , Ojal John , Barasa Edwine 
Published: April 2022

Abstract
Background
Vaccines are considered the path out of the COVID-19 pandemic. The government of Kenya is implementing a phased strategy to vaccinate the Kenyan population, initially targeting populations at high risk of severe disease and infection. We estimated the financial and economic unit costs of procuring and delivering the COVID-19 vaccine in Kenya across various vaccination strategies.

Methods
We used an activity-based costing approach to estimate the incremental costs of COVID-19 vaccine delivery, from a health systems perspective. Document reviews and key informant interviews(n = 12) were done to inform the activities, assumptions and the resources required. Unit prices were derived from document reviews or from market prices. Both financial and economic vaccine procurement costs per person vaccinated with 2-doses, and the vaccine delivery costs per person vaccinated with 2-doses were estimated and reported in 2021USD.

Results
The financial costs of vaccine procurement per person vaccinated with 2-doses ranged from $2.89-$13.09 in the 30% and 100% coverage levels respectively, however, the economic cost was $17.34 across all strategies. Financial vaccine delivery costs per person vaccinated with 2-doses, ranged from $4.28-$3.29 in the 30% and 100% coverage strategies: While the economic delivery costs were two to three times higher than the financial costs. The total procurement and delivery costs per person vaccinated with 2-doses ranged from $7.34-$16.47 for the financial costs and $29.7-$24.68 for the economic costs for the 30% and 100% coverage respectively. With the exception of procurement costs, the main cost driver of financial and economic delivery costs was supply chain costs (47–59%) and advocacy, communication and social mobilization (29–35%) respectively.

Conclusion
This analysis presents cost estimates that can be used to inform local policy and may further inform parameters used in cost-effectiveness models. The results could potentially be adapted and adjusted to country-specific assumptions to enhance applicability in similar low-and middle-income settings.
Cardiac microstructural alterations in immune-inflammatory myocardial disease: a retrospective case-control study
Authors: Kwan Alan C. , Salto Gerran , Nguyen Trevor-Trung , Kim Elizabeth H. , Luong Eric , Hiremath Pranoti , Ouyang David , Ebinger Joseph E. , Li Debiao , Berman Daniel S. , Kittleson Michelle M. , Kobashigawa Jon A. , Patel Jignesh K. , Cheng Susan 
Published: April 2022

Abstract
Background
Immune-inflammatory myocardial disease contributes to multiple chronic cardiac processes, but access to non-invasive screening is limited. We have previously developed a method of echocardiographic texture analysis, called the high-spectrum signal intensity coefficient (HS-SIC) which assesses myocardial microstructure and previously associated with myocardial fibrosis. We aimed to determine whether this echocardiographic texture analysis of cardiac microstructure can identify inflammatory cardiac disease in the clinical setting.

Methods
We conducted a retrospective case-control study of 318 patients with distinct clinical myocardial pathologies and 20 healthy controls. Populations included myocarditis, atypical chest pain/palpitations, STEMI, severe aortic stenosis, acute COVID infection, amyloidosis, and cardiac transplantation with acute rejection, without current rejection but with prior rejection, and with no history of rejection. We assessed the HS-SIC’s ability to differentiate between a broader diversity of clinical groups and healthy controls. We used Kruskal-Wallis tests to compare HS-SIC values measured in each of the clinical populations with those in the healthy control group and compared HS-SIC values between the subgroups of cardiac transplantation rejection status.

Results
For the total sample of N = 338, the mean age was 49.6 ± 20.9 years and 50% were women. The mean ± standard error of the mean of HS-SIC were: 0.668 ± 0.074 for controls, 0.552 ± 0.049 for atypical chest pain/palpitations, 0.425 ± 0.058 for myocarditis, 0.881 ± 0.129 for STEMI, 1.116 ± 0.196 for severe aortic stenosis, 0.904 ± 0.116 for acute COVID, and 0.698 ± 0.103 for amyloidosis. Among cardiac transplant recipients, HS-SIC values were 0.478 ± 0.999 for active rejection, 0.594 ± 0.091 for prior rejection, and 1.191 ± 0.442 for never rejection. We observed significant differences in HS-SIC between controls and myocarditis (P = 0.0014), active rejection (P = 0.0076), and atypical chest pain or palpitations (P = 0.0014); as well as between transplant patients with active rejection and those without current or prior rejection (P = 0.031).

Conclusions
An echocardiographic method can be used to characterize tissue signatures of microstructural changes across a spectrum of cardiac disease including immune-inflammatory conditions.
Prevalence and risk factor of post-operative lower extremities deep vein thrombosis in patients undergoing gynecologic surgery: a single-institute cross-sectional study
Authors: Lorchaivej Supakorn , Suprasert Prapaporn , Srisuwan Tanop , Rujiwetpongstorn Jintana 
Published: April 2022

Abstract
Background and aim
The study of prevalence and risk factors of postoperative lower limb deep vein thrombosis (DVT) in Thai gynecologic patients was limited. The present study was conducted to evaluate this issue.

Methods
The patients were age > 15 years old without a history of DVT or pulmonary emboli (PE) scheduled for laparotomy or vaginal gynecologic surgery between May and November 2020 were invited to participate. All of these patients were scheduled for a complete duplex ultrasound to detect lower limb DVT 72 h before and within 14 days after the operation. The patients without DVT were scheduled for an interview by telephone about DVT symptoms 30 days after the operation. The clinical variables were compared using univariate and multivariate analysis to identify the independent factors related to the development of DVT.

Results
One hundred and twelve patients met the inclusion criteria. Of these patients, 44 cases (39.3%) were diagnosed as malignancy and 102 patients underwent a hysterectomy. Post-operative DVTs were detected in six patients (5.4%) and all except one had a malignancy. Thus, the prevalence of DVT in malignancy cases was five in 44 patients (11.4%). The independent risk factors for postoperative DVT were age > 60-year-old and receiving a perioperative blood transfusion. Five of six DVT patients received low molecular-weight heparin for treatment of DVT and none developed PE. The rest of the participants reported no symptom-related DVTs from the interview 30 days after the operation.

Conclusion
The prevalence of postoperative DVT in gynecologic patients was 5%, and the independent risk factors were elderly patients and receiving a perioperative blood transfusion.
Transformative effect of a Humanitarian Program for individuals affected by rare diseases: building support systems and creating local expertise
Authors: Verma I. C. , El-Beshlawy A. , Tylki-Szymańska A. , Martins A. , Duan Y.-L. , Collin-Histed T. , van der Linde M. Schoneveld , Mansour R. , Dũng V. C. , Mistry Pramod K. 
Published: April 2022

AbstractRare diseases affect > 400 million people globally with a disproportionate burden falling on children, resulting in high morbidity and mortality rates. Affected individuals in some under-resourced countries have limited access to expert care or treatments; moreover, they suffer long diagnostic journeys during which debilitating and life-threatening complications occur. Lysosomal storage disorders (LSD) are prototype rare diseases due, in the main, to inherited deficiencies of lysosomal enzymes/transporters that affect up to 1 in 5000 newborns. Recognizing the need to provide treatment access to people with LSDs everywhere, a collaborative partnership was pioneered and set up 30 years ago. Partnering with local authorities, non-government organizations across six continents, local as well as international experts, a robust, sustainable Humanitarian Program emerged that now represents the most enduring charitable access program for LSD treatment. Here we present the history, process, lasting beneficial effect of the program to develop healthcare systems and infrastructures, and the lessons learned from addressing major unmet needs for LSDs.
Health-related quality of life, direct medical and societal costs among children with moderate or severe haemophilia in Europe: multivariable models of the CHESS-PAEDs study
Authors: Rodriguez-Santana Idaira , DasMahapatra Pronabesh , Burke Tom , Hakimi Zalmai , Bartelt-Hofer José , Nazir Jameel , O’Hara Jamie 
Published: April 2022

Abstract
Background
Haemophilia bears substantial humanistic and economic burden on children and their caregivers. Characterising the differential impact of severe versus moderate paediatric haemophilia is important for clinical and health policy decisions. We analysed health-related quality of life (HRQoL), annual direct medical (excluding factor treatment costs), non-medical and societal costs among children and adolescents with moderate and severe haemophilia A or B without inhibitors from the European CHESS-PAEDs study. Information was reported by physicians and caregivers; patients aged ≥ 8 years self-reported their HRQoL. Descriptive statistics summarised demographic and clinical characteristics, costs, and HRQoL scores (EQ-5D-Y). Regression models estimated differences in HRQoL and costs for moderate versus severe haemophilia adjusting for age, body mass index z-score, country, number of comorbidities, and weight-adjusted annual clotting factor consumption.

Results
The analytic sample comprised 794 patients with a mean age of 10.5 years; most had haemophilia A (79%) and 58% had severe haemophilia. Mean predicted direct medical costs in moderate patients were two-thirds of the predicted costs for severe disease (€3065 vs. €2047; p < 0.001; N = 794), while societal costs were more than half of the predicted costs for children with severe haemophilia (€6950 vs. €3666; p < 0.001; N = 220). Mean predicted HRQoL scores were 0.74 and 0.69 for moderate and severe disease, respectively (p < 0.05; N = 185).

Conclusion
Children with haemophilia and their caregivers displayed a significant economic and humanistic burden. While severe patients showed the highest direct medical and societal costs, and worse HRQoL, the burden of moderate haemophilia on its own was substantial and far from negligible.
Overview of the practices of on-farm emergency slaughter of cattle in the Nordic countries
Authors: Skúladóttir Gíslína , Phythian Clare Joan , Holmøy Ingrid Hunter , Myhrene Guro , Alvåsen Karin , Martin Adam Dunstan 
Published: April 2022

AbstractOn farm mortality is an increasing problem in cattle production systems in the Nordic countries. It represents an economic loss to the farmer and raises questions of sustainability, food waste and animal welfare. On-farm emergency slaughter (OFES) represents, in some situations, an opportunity for a farmer to salvage some of the economic value from an animal that cannot be transported to a slaughterhouse. The basis of the regulation of OFES in the Nordic countries originates largely from legislation from the European Union. However, this review has found that the availability and practice of OFES in the Nordic countries differs considerably. For example, in Norway 4.2% of all cattle slaughter is OFES, whilst in Iceland OFES has never been recorded. National food safety authorities have issued differing regulations and guidelines regarding the suitability of sick and injured animals for OFES. This review shows there is a paucity of data regarding the incidence and reasons for the use of OFES of cattle in the Nordic countries and points out the need for more investigation into this area to improve veterinary education, consumer protection and animal welfare.
Tissue engineering of the gastrointestinal tract: the historic path to translation
Authors: Collier Claudia A. , Mendiondo Christian , Raghavan Shreya 
Published: April 2022

AbstractThe gastrointestinal (GI) tract is imperative for multiple functions including digestion, nutrient absorption, and timely waste disposal. The central feature of the gut is peristalsis, intestinal motility, which facilitates all of its functions. Disruptions in GI motility lead to sub-optimal GI function, resulting in a lower quality of life in many functional GI disorders. Over the last two decades, tissue engineering research directed towards the intestine has progressed rapidly due to advances in cell and stem-cell biology, integrative physiology, bioengineering and biomaterials. Newer biomedical tools (including optical tools, machine learning, and nuanced regenerative engineering approaches) have expanded our understanding of the complex cellular communication within the GI tract that lead to its orchestrated physiological function. Bioengineering therefore can be utilized towards several translational aspects: (i) regenerative medicine to remedy/restore GI physiological function; (ii) in vitro model building to mimic the complex physiology for drug and pharmacology testing; (iii) tool development to continue to unravel multi-cell communication networks to integrate cell and organ-level physiology. Despite the significant strides made historically in GI tissue engineering, fundamental challenges remain including the quest for identifying autologous human cell sources, enhanced scaffolding biomaterials to increase biocompatibility while matching viscoelastic properties of the underlying tissue, and overall biomanufacturing. This review provides historic perspectives for how bioengineering has advanced over time, highlights newer advances in bioengineering strategies, and provides a realistic perspective on the path to translation.
CTCF in parvalbumin-expressing neurons regulates motor, anxiety and social behavior and neuronal identity
Authors: Davis Liron , Rayi Prudhvi Raj , Getselter Dmitriy , Kaphzan Hanoch , Elliott Evan 
Published: April 2022

AbstractCCCTC-binding factor (CTCF) is a regulator of chromatin organization and has direct effects on gene transcription. Mutations in CTCF have been identified in individuals with neurodevelopmental conditions. There are wide range of behaviors associated with these mutations, including intellectual disabilities, changes in temperament, and autism. Previous mice-model studies have identified roles for CTCF in excitatory neurons in specific behaviors, particularly in regards to learning and memory. However, the role of CTCF in inhibitory neurons is less well defined. In the current study, specific knockout of CTCF in parvalbumin-expressing neurons, a subset of inhibitory neurons, induced a specific behavioral phenotype, including locomotor abnormalities, anxiolytic behavior, and a decrease in social behavior. The anxiolytic and social abnormalities are detected before the onset of locomotor abnormalities. Immunohistochemical analysis revealed a disbalance in parvalbumin-expressing and somatostatin-expressing cells in these mice. Single nuclei RNA sequencing identified changes in gene expression in parvalbumin-expressing neurons that are specific to inhibitory neuronal identity and function. Electrophysiology analysis revealed an enhanced inhibitory tone in the hippocampal pyramidal neurons in knockout mice. These findings indicate that CTCF in parvalbumin-expressing neurons has a significant role in the overall phenotype of CTCF-associated neurodevelopmental deficits.
Investigation of the mechanisms and experimental verification of Cuscuta-Salvia in the treatment of polycystic ovary syndrome (PCOS) via network pharmacology
Authors: Zhang Ying-ying , Ma Jian-xiong , Zhu Yu-tian , Wang Yi-xuan , Chen Wang-qiang , Sun Xin , Zhang Wei , Wang Chen-ye , Ding Cai-fei 
Published: April 2022

AbstractPolycystic ovary syndrome (PCOS) is an endocrine disease associated with reproduction. TheCuscuta-Salviaformula has been widely used to treat for PCOS in clinic. However, its chemical and pharmacological properties remain unclear. We identified the active components and related targets ofCuscuta-Salviausing UHPLC-ESI-Q-TOF-MS and TCMSP database. Disease targets were obtained from the DisGeNET and GeneCards databases. Subsequently, common targets betweenCuscuta-Salviaand PCOS were identified using a Venn diagram. PPI network was established. Core genes were selected using a Cytoscape software plugin. GO and KEGG enrichment analyses were performed for common targets using the “pathview” package inR. Several core targets were verified using molecular and Immunological methods. By combining UHPLC-ESI-Q-TOF-MS with a network pharmacology study, 14 active components and a total of 80 common targets were obtained. Ten core genes were regulated byCuscuta-Salviain PCOS, including IL6, AKT1, VEGFA, TP53, TNF, MAPK1, JUN, EGF, CASP3, and EGFR. GO results showed that cellular response to drugs, response to oxygen levels, response lipopolysaccharides, and response to molecule of bacterial origin in BP category; membrane, transcription regulator complex, nuclear chromatin, postsynaptic membrane, and vesicle lumen in CC category; DNA-binding transcription factor binding, RNA polymerase II-specific DNA-binding transcription factor binding, DNA-binding transcription activator activity, RNA polymerase II-specific, DNA-binding transcription activator activity, and cytokine receptor binding in MF terms. The KEGG enrichment pathway was mainly involved in the PI3K − Akt, MAPK, TNF, IL-17 signalling pathways, and in cellular senescence. Furthermore, the results of the experimental study showed thatCuscuta-Salviaameliorated the pathological changes in the ovaries, liver and adipose tissue. And it improved the expressions of the genes or proteins. Our results demonstrate thatCuscuta-Salviamay provide a novel pharmacological basis in an experimental model of PCOS by regulating gene expression. This study provides a basis for future research and clinical applications.
Safety and preliminary efficacy of sequential multiple ascending doses of solnatide to treat pulmonary permeability edema in patients with moderate to severe ARDS in a randomized, placebo-controlled, double-blind trial: preliminary evaluation of safety and feasibility in light of the COVID-19 pandemic
Authors: Schmid Benedikt , Kranke Peter , Lucas Rudolf , Meybohm Patrick , Zwissler Bernhard , Frank Sandra 
Published: April 2022

Abstract
Background
In May 2018, the first patient was enrolled in the phase-IIb clinical trial “Safety and Preliminary Efficacy of Sequential Multiple Ascending Doses of Solnatide to Treat Pulmonary Permeability Edema in Patients with Moderate to Severe ARDS.” With the onset of the COVID-19 pandemic in early 2020, the continuation and successful execution of this clinical study was in danger. Therefore, before the Data Safety Monitoring Board (DSMB) allowed proceeding with the study and enrollment of further COVID-19 ARDS patients into it, additional assessment on possible study bias was considered mandatory.

Methods
We conducted an ad hoc interim analysis of 16 patients (5 COVID-19- ARDS patients and 11 with ARDS from different causes) from the phase-IIB clinical trial. We assessed possible differences in clinical characteristics of the ARDS patients and the impact of the pandemic on study execution.

Results
COVID-19 patients seemed to be less sick at baseline, which also showed in higher survival rates over the 28-day observation period. Trial specific outcomes regarding pulmonary edema and ventilation parameters did not differ between the groups, nor did more general indicators of (pulmonary) sepsis like oxygenation ratio and required noradrenaline doses.

Conclusion
The DSMB and the investigators did not find any evidence that patients suffering from ARDS due to SARS-CoV-2 may be at higher (or generally altered) risk when included in the trial, nor were there indications that those patients might influence the integrity of the study data altogether. For this reason, a continuation of the phase IIB clinical study activities can be justified. Researchers continuing clinical trials during the pandemic should always be aware that the exceptional circumstances may alter study results and therefore adaptations of the study design might be necessary.