bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transition to a new nursing information system embedded with clinical decision support: a mixed-method study using the HOT-fit framework
Authors: Yue Zhai , Zhenghong Yu , Qi Zhang , Wei Qin , Chun Yang , Yuxia Zhang 
Published: May 2022

Abstract
Background
Nursing information systems embedded with standardized nursing language and clinical decision support have been increasingly introduced in health care settings. User experience is key to the adoption of health information technologies. Despite extensive research into the user experience with nursing information systems, few studies have focused on the interaction between user, technology and organizational attributes during its implementation. Guided by the HOT-fit framework, this study aimed to investigate nurses’ perceptions and experiences with transition to a new nursing information system (Care Direct) two years after its first introduction.
Methods
This is a mixed-method study using an embedded design. An online survey was launched to collect nurses’ self-reported use of the new system, perceived system effectiveness and experience of participation in system optimization. Twenty-two semi structured interviews were conducted with twenty nurses with clinical or administrative roles. The quantitative and qualitative data were merged using the Pillar Integration Process.
Results
Nurses had medium-level perceptions of system effectiveness and participation in system development. They demonstrated good system use behavior and generally positive experiences with management and technical support. Eight main categories emerged from the integrated findings, which were further condensed into three themes: perceptions on system content, structure and functionality; perceptions on interdisciplinary and cross-level cooperation; and accepting the new thing.
Conclusions
Effective collaboration between clinicians, administrators and technical staff is required during system promotion to enhance system usability and user experience. Clear communication of organizational missions to staff and support from top management is needed to smooth the system implementation process and achieve broader system adoption.
One’s trash is someone else’s treasure: Sequence read archives from Lepidoptera genomes provide material for genome reconstruction of their endosymbionts
Authors: Twort Victoria Gwendoline , Blande Daniel , Duplouy Anne 
Published: May 2022

Abstract
Background:Maternally inherited bacterial symbionts are extremely widespread in insects. They owe their success to their ability to promote their own transmission through various manipulations of their hosts’ life-histories. Many symbionts however very often go undetected. Consequently, we have only a restricted idea of the true symbiont diversity in insects, which may hinder our understanding of even bigger questions in the field such as the evolution or establishment of symbiosis.Results:In this study, we screened publicly available Lepidoptera genomic material for two of the most common insect endosymbionts, namely Wolbachia and Spiroplasma, in 1 904 entries, encompassing 106 distinct species. We compared the performance of two screening software, Kraken2 and Metaphlan2, to identify the bacterial infections and using a baiting approach to reconstruct endosymbiont genome assemblies. Of the 106 species screened, 20 (19%) and nine (8.5%) were found to be infected with either Wolbachia or Spiroplasma, respectively. Construction of partial symbiotic genomes identified the Wolbachia supergroup B to be the most prevalent. While, Spiroplasma positive samples generally fell into three clades. Conclusions:Our results indicate that many of the host-symbiont associations remain largely unexplored, with the majority of associations we identify never being recorded before. This highlights the usefulness of public databases to explore the hidden diversity of symbiotic entities, allowing the development of hypotheses regarding host-symbiont associations. The ever-expanding genomic databases provide a diverse databank from which one can characterize and explore the true diversity of symbiotic entities.
Efficacy of alogliptin/metformin fixed-dose combination tablets and vildagliptin/metformin fixed-dose combination tablets on glycemic control in real-world clinical practice for the patients with type 2 diabetes: A multicenter, open-label, randomized, parallel group, comparative trial
Authors: Abe Tomoe , Takeda Yasutaka , Sakuma Ichiro , Okada Mizuho , Sasaki Ayaka , Bessho Ryoichi , Sato Mao , Kitsunai Hiroya , Takiyama Yumi , Sakurai Masaru 
Published: May 2022

Abstract
Background: This study was aimed to compare the efficacy of two combination tablets of DPP-4 inhibitors and metformin with different dosages, alogliptin/metformin (AM) and vildagliptin/metformin (VM), on glycemic control in patients with type 2 diabetes (T2D).Methods: This was a prospective, multicenter, open-label, randomized, parallel group, comparative trial. After a run-in period of treatment with metformin alone, a total of 59 Japanese outpatients with T2D, aged 20-79 years with glycated hemoglobin (HbA1c) levels of 6.5-10% were randomly assigned to 12-week AM treatment, alogliptin 25 mg/metformin 500 mg combination tablet orally once a day, or VM treatment, vildagliptin 50 mg/metformin 250 mg combination tablet orally twice a day. The primary endpoints were the changes in HbA1c and fasting plasma glucose (FPG) levels from baseline to week 12 between the two groups. Blinded intermittently scanned continuous glucose monitoring (isCGM) was performed between weeks 10 and 12. Incidence of adverse events during the study were also evaluated. Results: In all, 52 participants were analyzed. Significant decreases in HbA1c and FPG levels from baseline to week 12 were observed in both treatment groups. However, there were no significant differences between the AM and VM groups in the change in HbA1c level (–0.3% and –0.4%, P = 0.309) or the FPG level (–9.0 mg/dL and –15.0 mg/dL, P = 0.789). The isCGM revealed that both treatments achieved the recommended glycemic target range. No adverse events, such as severe hypoglycemia, were observed in either group.Conclusions: We concluded that there were no significant differences in the efficacy of two combination tablets of DPP-4 inhibitors and metformin with different dosages on glycemic control in patients with T2D.Trial registration: The study was approved by University Hospital Medical Information Network Clinical Trial Registry on the 23rd of August 2018 (Registration No. 000033867).
EZH2-mediated epigenetic activation of the CCL22/CCR4 causing EMT process remodeling in cervical carcinoma
Authors: Zhang Li , Tian Sijuan , Chang Jie , Quan Shimin , Yang Ting , Zhao Minyi , Wang Li , Yang Xiaofeng 
Published: May 2022

Abstract
Purpose It has been found the regulatory functions of EZH2 in promoting the immune disturbance and tumorigenesis in cervical cancer (CC). Our previous study has found that the chemokine CCL22 and its receptor CCR4 are elevated in CC tissues. The present study aims to investigate the potential role of EZH2-induced epigenetic activation of CCL22/CCR4 and caused EMT remodeling in CC. Methods and results CCL22 and CCR4 were significant up-regulated in CC samples compare to normal cervix tissues, an obvious induction of promoter DNA methylation levels of CCL22 and CCR4 were shown in CC tissues. Demethylation could reactivate the transcription activity of CCL22 and CCR4. DNMT3A directly binds to the CCL22 and CCR4 promoter regions in vitro. Down-regulation the expression of EZH2 in CC cell lines could induce DNMT3A expression augment, induced CCL22 and CCR4 promoters’ methylation level as well, caused CCL22 and CCR4 mRNA expression decreased. Moreover, in an in vivo assay, the expression profile of EZH2 regulates the expression of CCL22/CCR4 through DNMT3A was consistent with the cellular level. In EZH2-silenced CC cells, migration was reduced, levels of EMT related markers, including vimentin, slug, snail and β-catenin, were all reduced, and ZO-1 increased. In DNMT3A-silenced CC cells, migration was induced and vimentin, slug, snail and β-catenin were all induced, ZO-1 reduced. Inhibition of CCL22 protein significantly decreased migration of CC cells and vimentin, slug, snail and β-catenin, increased ZO-1. Conclusion EZH2 thus appears to regulate CCL22/CCR4 expression via epigenetic activation, causing EMT process remodeling in CC progression, making EZH2 and CCL22/CCR4 be potential prognostic biomarkers and therapeutic targets in CC patients.
Clinical Associate students’ perceptions of factors that influence their developing professional identity: A Qualitative Study.
Authors: Mgobozi Aviwe , Namee Lakshini Mc , Couper Ian 
Published: May 2022

Abstract
Background
New cadres of clinicians, known as clinical associates, physician assistants, or clinical officers have evolved globally within many health systems to broaden access to care by increasing the availability of human resources. The training of such mid-level health workers targets knowledge acquisition, clinical skills, and developing the characteristics required of healthcare professionals. Less formal educational attention has been focused on the process of developing personal and professional identities.
Method
This study utilized a qualitative interpretivist approach to explore professional identity development. A convenient sample of 42 clinical associate students at the University of Witwatersrand in Johannesburg were interviewed using focus groups to explore their perceptions of factors that influenced their professional identity formation. A semi-structured interview guide was used in six focus group discussions, involving 22 first-year and 20 third-year students. The transcriptions from the focus group audio recordings were thematically analyzed.
Results
The multi-dimensional and complex factors that were identified were organized into three overarching themes, identified as individual factors which derive from personal needs and aspirations, training-related factors consisting of influences from the academic platforms, and lastly student perceptions of the collective identity of the clinical associate profession influenced their developing professional identity.
Conclusion
The newness of the identity of the profession in South Africa has contributed to a dissonance in student identities. The study recognizes an opportunity for strengthening the identity of the clinical associate profession in South Africa through improving educational platforms to limit barriers to identity development and effectively enhancing the role and integration of the profession in the healthcare system. This can be achieved by increasing stakeholder advocacy, communities of practice, inter-professional education, and visibility of role models.
Anti-inflammatory effects of salbutamol on human bronchial epithelial cells stimulated by cigarette smoke extract
Authors: Gouveia Gustavo Cintra , Sousa Henrique Ismarsi , Salermo Bruno Sada , Pereira Aline Beatriz Mahler , Santos Wanessa Maria dos , Silva Paulo Roberto da , Uddin Mohib , Rogério Alexandre de Paula 
Published: May 2022

Abstract

Cigarette smoking, the major cause of chronic obstructive pulmonary disease (COPD), induces activation of pro-inflammatory pathways in the airway epithelium. Salbutamol, a selective and short-acting β2-adrenoceptor agonist, is used for bronchospasm relief in patients with asthma and COPD. In addition, salbutamol also present anti-inflammatory effects. Here, we evaluated whether salbutamol (10-5-10- 7 M) can reduce on bronchial epithelial cells (BEAS-2B cells) the inflammatory parameters induced by cigarette smoke extract (CSE; 1%). After 24h, Salbutamol reduced the IL-1β production induced by CSE in a concentration-response manner. Salbutamol (10-6 M) reduced the IL-8 production and increased the IL-10 production on CSE-stimulated cells. In addition, salbutamol (10-6 M) decreased the ICAM-1 expression and the reactive oxygen species production. These anti-inflammatory effects could be associated with the down regulation of activation of NF-κB. Salbutamol may be a potential alternative treatment to airway inflammation caused by cigarette smoking such as in COPD patients.
Are HOMA-IR and HOMA-B good predictors for diabetes and pre- diabetes subtypes?
Authors: Khayamzadeh Marjan , Moeini Ali Siamak Habibi , Kohansal Karim , Ahanchi Noushin Sadat , Hadaegh Farzad , Tohidi Maryam , Azizi Fereidoun , Khalili Davood 
Published: May 2022

Abstract
Background: To investigate the association between Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Homeostasis Model Assessment of Beta-cell function (HOMA-B) with the incidence of diabetes and pre-diabetes subtypes.Methods: A total of 3101 normoglycemic people aged 20-70 years were included in the 6-year follow-up study. Multinomial logistic regression was used to calculate the incidence possibility of isolated Impaired Fasting Glucose (iIFG), isolated Impaired Glucose Tolerance (iIGT), Combined impaired fasting glucose & impaired glucose tolerance (CGI), and Diabetes Mellitus (DM) per standard deviation (SD) increment in HOMA-IR and HOMA-B in the crude and multivariable model. Results: In the multivariate model, per unit SD increase in HOMA-IR increased the odds of iIFG, iIGT, CGI, and DM by 43%, 42%, 75%, and 92%, respectively. There was a positive correlation between the increase in HOMA-B and incidence of iIGT; however, after adjusting the results for metabolic syndrome components, it was inversely correlated with the incidence of iIFG [Odds Ratio = 0.86(0.75-0.99)]. Conclusions: HOMA-IR is positively correlated with diabetes and pre-diabetes subtypes’ incidence, and HOMA-B is inversely correlated with the incidence of iIFG but positively correlated with iIGT incidence. However, none of these alone is a good criterion for predicting diabetes and pre-diabetes.
metaSpectraST: an unsupervised and database-independent analysis workflow for metaproteomic MS/MS data using spectrum clustering
Authors: Hao Chunlin , Elias Joshua E. , Lee Patrick K. H. , Lam Henry 
Published: May 2022

Abstract
Background: The high diversity and complexity of the microbial community make it a formidable challenge to identify and quantify the large number of proteins expressed in the community. Conventional metaproteomics approaches largely rely on accurate identification of the MS/MS spectra to their corresponding short peptides in the digested samples, followed by protein inference and subsequent taxonomic and functional analysis of the detected proteins. These approaches are dependent on the availability of protein sequence databases derived either from metagenomic sequencing of the same sample, or from public repositories. Due to the incompleteness or imperfections of these protein sequence databases, and the preponderance of homologous proteins expressed by different bacterial species in the community, this computational process of peptide identification and protein inference is challenging and error-prone, which hinders the comparison of metaproteomes across multiple samples. Results: We developed metaSpectraST, an unsupervised and database-independent workflow to analyze metaproteomic samples by clustering experimentally observed MS/MS spectra based on their spectral similarity. We applied metaSpectraST to fecal samples collected from littermates of two different mother mice right after weaning. Quantitative proteome profiles of the microbial communities of different mice could be obtained without peptide identification, and used to evaluate the overall similarity between samples and highlight any differentiating markers. Compared to the conventional database-dependent metaproteomics analysis, metaSpectraST is more successful in classifying the samples and detecting the subtle microbiome changes of mouse gut microbiomes post-weaning. metaSpectraST could also be used as a tool for selecting the suitable biological replicates from samples with wide inter-individual variation. Conclusions: metaSpectraST enables rapid profiling of metaproteomic samples without the need for constructing the protein sequence database or identification of the MS/MS spectra. It maximally preserves information contained in the experimental MS/MS spectra by clustering all of them first, and thus is able to better profile the complex microbial communities and highlight their functional changes, as compared with conventional approaches.
The effect of inflammation and oxidative stress on DNA damage in COVID-19 patients
Authors: Tepebaşı Muhammet Yusuf , İlhan İlter , Temal Esra Nurlu , Sancer Okan , Öztürk Önder 
Published: May 2022

Abstract
Background: COVID-19 disease, which spreads all over the world, is a disease characterized by widespread inflammation and affects many organs, especially the lungs. The resulting inflammation can lead to the generation of reactive oxygen radicals, leading to oxidative DNA damage.Methods and Results: Pneumonia severity of a total of 95 hospitalized patients with positive RT-PCR test was determined and divided into three groups mild, moderate, and severe/critical. Inflammation markers (Neutrophil-lymphocyte ratio, serum reactive protein, procalcitonin, etc.) were determined, and IL-10 and IF γ measurements were analyzed using the enzyme-linked immunosorbent assay method. In the evaluation of oxidative damage, total thiol, native thiol, disulfide, and IMA levels were determined by measuring spectrophotometrically. The percentage of tail DNA obtained by the comet assay method was used to determine oxidative DNA damage. As a result, when mild and severe/critical groups were compared, we found that total thiol, native thiol, and disulfide levels decreased significantly in the severe/critical group due to the increase in inflammation markers and cytokine levels (p <0.05). We could not detect any significance in IMA levels between the groups (p> 0.05). At the same time, we determined that there was an increase in the tail DNA percent level, that is, DNA damage, due to the increased oxidative effect.Conclusion: As a result, we found that increased inflammation and reactive oxygen species due to the increase in pneumonia increased in those with severe and severe pneumonia, which in turn damaged DNA. We think that it would be useful to follow up on the DNA damage in these patients in terms of neurodegenerative diseases and cancer development.
SARS-CoV-2 Omicron BA.2.12.1, BA.4, and BA.5 subvariants evolved to extend antibody evasion
Authors: Ho David , Wang Qian , Guo Yicheng , Iketani Sho , Li Zhiteng , Mohri Hiroshi , Wang Maple , Yu Jian , Bowen Anthony , Chang Jennifer , Shah Jayesh , Nguyen Nadia , Meyers Kathrine , Yin Michael , Sobieszczyk Magdalena , Sheng Zizhang , Huang Yaoxing , Liu Lihong 
Published: May 2022

Abstract
The Omicron subvariant BA.2 accounts for a large majority of the SARS-CoV-2 infection worldwide today. However, its recent descendants BA.2.12.1 and BA.4/5 have surged dramatically to become dominant in the United States and South Africa, respectively. That these novel Omicron subvariants carry additional mutations in their spike proteins raises concerns that they may further evade neutralizing antibodies, thereby further compromising the efficacy of our COVID-19 vaccines and therapeutic monoclonals. We now report findings from a systematic antigenic analysis of these surging Omicron subvariants. BA.2.12.1 is only modestly (1.8-fold) more resistant to sera from vaccinated and boosted individuals than BA.2. On the other hand, BA.4/5 is substantially (4.2-fold) more resistant and thus more likely to lead to vaccine breakthrough infections. Mutation at spike residue L452 found in both BA.2.12.1 and BA.4/5 facilitates escape from some antibodies directed to the so-called Class 2 and Class 3 regions of the receptor-binding domain (RBD). The F486V mutation found in BA.4/5 facilitates escape from certain Class 1 and Class 2 antibodies to the RBD but compromises the spike affinity for the cellular receptor ACE2. The R493Q reversion mutation, however, restores receptor affinity and consequently the fitness of BA.4/5. Among therapeutic antibodies authorized for clinical use, only bebtelovimab (LY-COV1404) retains full potency against both BA.2.12.1 and BA.4/5. The Omicron lineage of SARS-CoV-2 continues to evolve, successively yielding subvariants that are not only more transmissible but also more evasive to antibodies.
A Pragmatic Context Assessment Tool (pCAT): Using a think aloud method to develop a practical assessment of contextual barriers to change
Authors: Robinson Claire , Damschroder Laura J. 
Published: May 2022

Abstract
Background: The Consolidated Framework for Implementation Research (CFIR) is a determinant framework that can be used to guide context assessment prior to implementing change. Though a few quantitative measurement instruments have been developed based on the CFIR, most assessments using the CFIR have relied on qualitative methods. One challenge to measurement is to translate conceptual constructs which are often described using highly abstract, technical language into lay language that is clear, concise, and meaningful yet generalizable. The purpose of this study was to develop a pragmatic quantitative context assessment tool based on the CFIR for use by frontline teams in a clinical setting. Methods: Twenty-seven interviews based on the Think Aloud (TA) method (asking participants to verbalize thoughts as they respond to assessment questions) were conducted with frontline employees to identify areas of disconnect, misinterpretation, and misunderstanding of assessment questions. Interviews were recorded and transcribed verbatim. CFIR constructs were deductively applied as codes. Results: Participants identified several areas where language in the assessment tool needed to be modified, clarified, or made more nuanced and thus more useful and applicable for frontline employees. Participants found it easier to respond to elements in the tool when they had a recent, specific project in mind. They found it much more difficult to give meaningful responses when being asked to answer questions based on an abstract, general change; barriers and facilitators tend to be unique to each specific implementation. Participants also identified new concepts they felt were missing from the tool or that were conflated, leading to refinements that made the tool more comprehensive, accurate, and useful. Conclusions: Quantitative context assessment instruments must be designed to be practical and better align with everyday language used by frontline employees. The pCAT is short (14 items), freely available, uses accessible language, requires little proficiency or experience in assessment, and is designed to draw on the expertise and knowledge of individuals most familiar with their own clinical context. If rapid assessment tools are to have wide-spread use and utility, technical implementation science language must be translated using everyday language so frontline employees can capture accurate assessments of their context.