bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of education background with clinical pharmacists’ clinical pharmacy workload in tertiary hospitals of China
Authors: Sun Qingran , Chen Lei , Huang Yuankai , Xi Xiaoyu 
Published: November 2022

Abstract
Background
Workload of healthcare providers may affect the quality of healthcare. Practical evidences have indicated that healthcare providers are differentially associated with workload due to their different education and training background. Clinical pharmacists are an indispensable part of medical teams. Under the precondition that clinical pharmacists in China generally undertake uneven clinical pharmacy workload, the relationship of workload and clinical pharmacists’ different education backgrounds remains unclear. This study aimed to assess the association between the education background of clinical pharmacists and their clinical pharmacy workload in China.

Methods
A field questionnaire survey using a stratified sampling was conducted to gather data on education background and clinical pharmacy workload through a self-developed instrument. Ordinary least squares regression was used to evaluate the association of the participants’ education background with their clinical pharmacy workload.

Results
A total of 625 clinical pharmacists from 311 tertiary hospitals in China participated. Two levels of education: less than bachelor’s degree in general pharmacy, or doctoral degree in clinical pharmacy was associated significantly with clinical pharmacy workload of the participants. Participants who had credentials of national level and provincial-level specialized training for clinical pharmacists had undertaken more work than those without. Moreover, the participants’ specialized field, such as respiratory medicine and nephrology, was associated with their clinical pharmacy workload.

Conclusion
Enhancing several aspects of education or training among clinical pharmacists in tertiary hospitals in China may help improve their capability to provide clinical pharmacy services. Efforts are needed to improve the education and training system of clinical pharmacists in China.
Ultrasound-guided versus traditional method for peripheral venous access: an umbrella review
Authors: Berlanga-Macías Carlos , Díez-Fernández Ana , Martínez-Hortelano José Alberto , Sequí-Domínguez Irene , Saz-Lara Alicia , Pozuelo-Carrascosa Diana , Martínez-Vizcaíno Vicente 
Published: November 2022

Abstract
Background
Short peripheral catheters (SPC) insertion technique has a high failure rate, one of the reasons why the ultrasound (US)-guided method has been proposed as a valid alternative to traditional technique in SPC insertion. This umbrella review aims to synthesize the available evidence comparing the US-guided method with the traditional method on SPC insertion in terms of effectiveness, safety and patient satisfaction.

Methods
An umbrella review addressing the comparison between US-guided versus traditional method for SPC insertion in which only systematic reviews of all comparative study designs were eligible was carried out. Previous systematic reviews and meta-analyses were systematically searched in MEDLINE, EMBASE, Web of Science and Cochrane Library. Methodological quality was assessed with AMSTAR-2 tool. The quality of evidence per association was assessed using the GRADE criteria and was stablished as high, moderate, low and very low.

Results
Twelve systematic reviews with a range of 75–1860 patients were included. Moderate certainty evidence supports the positive effect of US-guided method on first-attempt success rate and number of attempts. There is moderate certainty evidence that US-guided method does not reduce the time spent in SPC insertion. Low certainty evidence supports that US-guided method improves both overall success rates and patient satisfaction. Emergency department was the main hospital department where these findings were reported.

Conclusions
The best current evidence indicates that US-guided method for SPC insertion is postulated as a valid alternative for both adult and pediatric population, especially in patients with difficult venous access and in hospital departments where optimal vascular access in the shortest time possible is critical.

Trial registration
PROSPERO: CRD42021290824.
Mediating effects of emotion regulation between socio-cognitive mindfulness and empathy in nurses: a cross-sectional study
Authors: Lee Mikyoung , Park Hyunyoung 
Published: November 2022

Abstract
Background
Acknowledging the under-examined research of socio-cognitive mindfulness and Gross’s emotion regulation strategies in nursing, this study investigated the relationships between socio-cognitive mindfulness, emotion regulation (i.e., reappraisal and suppression), and empathy among nurses. It also explored the mediating effects of emotion regulation.

Methods
A cross-sectional quantitative study was conducted in a sample of 245 nurses from two university hospitals in South Korea. Convenience sampling was used to collect data between August 3 and September 29, 2020. Participants completed the questionnaire measuring their socio-cognitive mindfulness, emotion regulation, and empathy. Structural equation modeling and path analysis were conducted for data analysis.

Results
Socio-cognitive mindfulness positively influenced emotion regulation of reappraisal (β = 0.404, p < 0.01) and empathy (β = 0.402, p < 0.01), but negatively influenced emotion regulation of suppression (β = −0.149, p < 0.05). Reappraisal positively influenced empathy (β = 0.341, p < 0.01), whereas suppression negatively influenced empathy (β = −0.127, p < 0.05). Importantly, emotion regulation of reappraisal mediated the association between socio-cognitive mindfulness and empathy (a X b = 0.107, p < 0.01).

Conclusion
The findings indicate that socio-cognitive mindfulness is effective in improving empathy among nurses by enhancing reappraisal. This study can provide a foundation for developing socio-cognitive mindfulness or emotion regulation programs to improve empathy among nurses, which would ultimately lead to better nursing performance by increasing patient satisfaction.
Monitoring and management of chronic kidney disease in ambulatory care – analysis of clinical and claims data from a population-based study
Authors: Weckmann Gesine , Wirkner Janine , Kasbohm Elisa , Zimak Carolin , Haase Annekathrin , Chenot Jean-François , Schmidt Carsten Oliver , Stracke Sylvia 
Published: November 2022

Abstract
Background
Although chronic kidney disease (CKD) is highly prevalent in the general population, little research has been conducted on CKD management in ambulatory care.
Objective was to assess management and quality of care by evaluating CKD coding in ambulatory care, patient diagnosis awareness, frequency of monitoring and whether appropriate patients are referred to nephrology.

Methods
Clinical data from the population-based cohort Study of Health in Pomerania (SHIP-START) were matched with claims data of the Association of Statutory Health Insurance Physicians. Quality of care was evaluated according international and German recommendations.

Results
Data from 1778 participants (56% female, mean age 59 years) were analysed. 10% had eGFR < 60 ml/min/1.73m2 (mean age 74 years), 15% had albuminuria. 21% had CKD as defined by KDIGO. 20% of these were coded and 7% self-reported having CKD. Coding increased with GFR stage (G3a 20%, G3b 61%, G4 75%, G5 100%). Serum creatinine and urinary dip stick testing were billed in the majority of all participants regardless of renal function. Testing frequency partially surpassed recommendations. Nephrology consultation was billed in few cases with stage G3b-G4.

Conclusion
CKD coding increased with stage and was performed reliably in stages ≥ G4, while CKD awareness was low. Adherence to monitoring and referral criteria varied, depending on the applicability of monitoring criteria. For assessing quality of care, consent on monitoring, patient education, referral criteria and coordination of care needs to be established, accounting for patient related factors, including age and comorbidity.

Trial registration
This study was prospectively registered as DRKS00009812 in the German Clinical Trials Register (DRKS).
Socio-economic determinants of attendance at diabetes self-management education program: using Andersen’s behavioral model
Authors: Javan-Noughabi Javad , Tabatabaee Seyed Saeed , Vahedi Sajad , Sharifi Tahere 
Published: November 2022

AbstractBackgroundDiabetes self-management education is an effective factor for improving outcomes and quality of life in patients with diabetes. However, little information is available on the factors associated with participation or non-participation in self-management education programs in people with diabetes. The aim of this study was to explore the factors affecting on the attendance of patients with diabetes in the diabetes self-management education program.MethodsA cross-sectional study was conducted in 2019 on 384 patients with diabetes referred to the main comprehensive health centers of Mashhad, Iran. All patients were linked with a diabetes self-management education program that lasted three months and involved 12 sessions. We explore the factors affecting on attending in diabetes self-management education program using Andersen’s behavioral model. Data for independent variables (predisposing, enabling, and need factors) were gathered at the beginning of the training program using registration forms. Dependent variable (attendance of patients with diabetes in the training program) was checked at the end of the program. Univariate and multivariate analysis were done with SPSS v.25.ResultsThe results of this study showed that women were less likely to participate in the self-management education program than men (OR=0.414;P<0.05). Also, age, travel time, health status and years with diabetes have negative significantly correlated with participation in the education program (P<0.05). The study showed that patients with diabetes aged≥65 were less participated in the training program than those ≤40 (OR=0.159;P<0.05). Also, patients who lived farther than 40 min away from training center were less likely to participate for this program than patients that live in an area<20 min away from training center (OR=0.196;P<0.05). Odds of attending in training program for patients with poor health status was less than patients with excellent health status (OR=0.282;P<0.05). Participation in training program were low in patients with more than 5-year diabetes duration compared to less than 1 year (OR=0.176;P<0.05).ConclusionThe implementation of the classes at the right time and online, Reduce the distance between people and the place of the class, providing facilities and providing infrastructure may be appropriate to involve women and the elderly.
Temporal change in chromatin accessibility predicts regulators of nodulation in Medicago truncatula
Authors: Knaack Sara A. , Conde Daniel , Chakraborty Sanhita , Balmant Kelly M. , Irving Thomas B. , Maia Lucas Gontijo Silva , Triozzi Paolo M. , Dervinis Christopher , Pereira Wendell J. , Maeda Junko , Schmidt Henry W. , Ané Jean-Michel , Kirst Matias , Roy Sushmita 
Published: November 2022

Abstract
Background
Symbiotic associations between bacteria and leguminous plants lead to the formation of root nodules that fix nitrogen needed for sustainable agricultural systems. Symbiosis triggers extensive genome and transcriptome remodeling in the plant, yet an integrated understanding of the extent of chromatin changes and transcriptional networks that functionally regulate gene expression associated with symbiosis remains poorly understood. In particular, analyses of early temporal events driving this symbiosis have only captured correlative relationships between regulators and targets at mRNA level. Here, we characterize changes in transcriptome and chromatin accessibility in the model legume Medicago truncatula, in response to rhizobial signals that trigger the formation of root nodules.

Results
We profiled the temporal chromatin accessibility (ATAC-seq) and transcriptome (RNA-seq) dynamics of M. truncatula roots treated with bacterial small molecules called lipo-chitooligosaccharides that trigger host symbiotic pathways of nodule development. Using a novel approach, dynamic regulatory module networks, we integrated ATAC-seq and RNA-seq time courses to predict cis-regulatory elements and transcription factors that most significantly contribute to transcriptomic changes associated with symbiosis. Regulators involved in auxin (IAA4-5, SHY2), ethylene (EIN3, ERF1), and abscisic acid (ABI5) hormone response, as well as histone and DNA methylation (IBM1), emerged among those most predictive of transcriptome dynamics. RNAi-based knockdown of EIN3 and ERF1 reduced nodule number in M. truncatula validating the role of these predicted regulators in symbiosis between legumes and rhizobia.

Conclusions
Our transcriptomic and chromatin accessibility datasets provide a valuable resource to understand the gene regulatory programs controlling the early stages of the dynamic process of symbiosis. The regulators identified provide potential targets for future experimental validation, and the engineering of nodulation in species is unable to establish that symbiosis naturally.
Socio-economic inequalities in the use of drugs for the treatment of chronic diseases in Italy
Authors: Di Filippo A. , Perna S. , Pierantozzi A. , Milozzi F. , Fortinguerra F. , Caranci N. , Moro L. , Agabiti N. , Belleudi V. , Cesaroni G. , Nardi A. , Spadea T. , Gnavi R. , Trotta F. 
Published: November 2022

Abstract
Background
Since the use of medicines is strongly correlated to population health needs, higher drug consumption is expected in socio-economical deprived areas. However, no systematic study investigated the relationship between medications use in the treatment of chronic diseases and the socioeconomic position of patients. The purpose of the study is to provide a description, both at national level and with geographical detail, of the use of medicines, in terms of consumption, adherence and persistence, for the treatment of major chronic diseases in groups of population with different level of socioeconomic position.

Methods
A cross-sectional study design was used to define the “prevalent” users during 2018. A longitudinal cohort study design was performed for each chronic disease in new drug users, in 2018 and the following year. A retrospective population-based study, considering all adult Italian residents (i.e. around 50.7 million people aged ≥ 18 years). Different medications were used as a proxy for underlying chronic diseases: hypertension, dyslipidemia, osteoporosis, diabetes and chronic obstructive pulmonary disease. Only “chronic” patients who had at least 2 prescriptions within the same subgroup of drugs or specific medications during the year were selected for the analysis. A multidimensional measures of socio-economic position, declined in a national deprivation index at the municipality level, was used to identify and estimate the relationship with drug use indicators. The medicine consumption rate for each pharmacological category was estimated for prevalent users while adherence and persistence to pharmacologic therapy at 12 months were evaluated for new users.

Results
The results highlighted how the socioeconomic deprivation is strongly correlated with the use of medicines: after adjustment by deprivation index, the drug consumption rates decreased, mainly in the most disadvantaged areas, where consumption levels are on average higher than in other areas. On the other hand, the adherence and persistence indicators did not show the same trend.

Conclusions
This study showed that drug consumption is influenced by the level of deprivation consistently with the distribution of diseases. For this reason, the main levers on which it is necessary to act to reduce disparities in health status are mainly related to prevention. Moreover, it is worth pointing out that the use of a municipal deprivation indicator necessarily generates an ecological bias, however, the experience of the present study, which for the first-time deals with the complex and delicate issue of equity in Italian pharmaceutical assistance, sets the stage for new insights that could overcome the limits.
Single-cell and bulk RNA sequencing reveal ligands and receptors associated with worse overall survival in serous ovarian cancer
Authors: Carvalho Robson Francisco , do Canto Luisa Matos , Abildgaard Cecilie , Aagaard Mads Malik , Tronhjem Monica Søgaard , Waldstrøm Marianne , Jensen Lars Henrik , Steffensen Karina Dahl , Rogatto Silvia Regina 
Published: November 2022

Abstract
Background
Serous ovarian carcinoma is the most frequent histological subgroup of ovarian cancer and the leading cause of death among gynecologic tumors. The tumor microenvironment and cancer-associated fibroblasts (CAFs) have a critical role in the origin and progression of cancer. We comprehensively characterized the crosstalk between CAFs and ovarian cancer cells from malignant fluids to identify specific ligands and receptors mediating intercellular communications and disrupted pathways related to prognosis and therapy response.

Methods
Malignant fluids of serous ovarian cancer, including tumor-derived organoids, CAFs-enriched (eCAFs), and malignant effusion cells (no cultured) paired with normal ovarian tissues, were explored by RNA-sequencing. These data were integrated with single-cell RNA-sequencing data of ascites from ovarian cancer patients. The most relevant ligand and receptor interactions were used to identify differentially expressed genes with prognostic values in ovarian cancer.

Results
CAF ligands and epithelial cancer cell receptors were enriched for PI3K-AKT, focal adhesion, and epithelial-mesenchymal transition signaling pathways. Collagens, MIF, MDK, APP, and laminin were detected as the most significant signaling, and the top ligand-receptor interactions THBS2/THBS3 (CAFs)—CD47 (cancer cells), MDK (CAFs)—NCL/SDC2/SDC4 (cancer cells) as potential therapeutic targets. Interestingly, 34 genes encoding receptors and ligands of the PI3K pathway were associated with the outcome, response to treatment, and overall survival in ovarian cancer. Up-regulated genes from this list consistently predicted a worse overall survival (hazard ratio > 1.0 and log-rank P < 0.05) in two independent validation cohorts.

Conclusions
This study describes critical signaling pathways, ligands, and receptors involved in the communication between CAFs and cancer cells that have prognostic and therapeutic significance in ovarian cancer.
Long-term atorvastatin improves cognitive decline by regulating gut function in naturally ageing rats
Authors: Xu Tian-Ce , Lv Yan , Liu Quan-Ying , Chen Hui-Sheng 
Published: November 2022

Abstract
Background
Statins have been widely used to prevent cardiovascular disease in middle-aged and elderly populations; however, the effect of long-term treatment on cognitive function is controversial. To simulate clinical conditions, middle-aged rats were given atorvastatin for 9 consecutive months to investigate the effect on natural cognitive decline and the possible mechanisms.

Results
The results showed that compared with the control group, long-term atorvastatin treatment naturally improved cognitive decline. Furthermore, long-term treatment regulated intestinal retinoic acid (RA) metabolism and storage by altering retinol dehydrogenase 7 (Rdh7) expression in the intestine, while RA metabolism affected the proliferation of intestinal Treg cells and inhibited IL-17+γδ T-cell function. In addition, long-term atorvastatin increased intestinal flora richness and decreased IL-17 expression in hippocampal tissue.

Conclusion
Collectively, these findings provide the first evidence that long-term atorvastatin intervention may prevent cognitive decline in naturally ageing rats by inhibiting neuroinflammation via the gut-brain axis.
Personalized genome assembly for accurate cancer somatic mutation discovery using tumor-normal paired reference samples
Authors: Xiao Chunlin , Chen Zhong , Chen Wanqiu , Padilla Cory , Colgan Michael , Wu Wenjun , Fang Li-Tai , Liu Tiantian , Yang Yibin , Schneider Valerie , Wang Charles , Xiao Wenming 
Published: November 2022

AbstractBackgroundThe use of a personalized haplotype-specific genome assembly, rather than an unrelated, mosaic genome like GRCh38, as a reference for detecting the full spectrum of somatic events from cancers has long been advocated but has never been explored in tumor-normal paired samples. Here, we provide the first demonstrated use of de novo assembled personalized genome as a reference for cancer mutation detection and quantifying the effects of the reference genomes on the accuracy of somatic mutation detection.ResultsWe generate de novo assemblies of the first tumor-normal paired genomes, both nuclear and mitochondrial, derived from the same individual with triple negative breast cancer. The personalized genome was chromosomal scale, haplotype phased, and annotated. We demonstrate that it provides individual specific haplotypes for complex regions and medically relevant genes. We illustrate that the personalized genome reference not only improves read alignments for both short-read and long-read sequencing data but also ameliorates the detection accuracy of somatic SNVs and SVs. We identify the equivalent somatic mutation calls between two genome references and uncover novel somatic mutations only when personalized genome assembly is used as a reference.ConclusionsOur findings demonstrate that use of a personalized genome with individual-specific haplotypes is essential for accurate detection of the full spectrum of somatic mutations in the paired tumor-normal samples. The unique resource and methodology established in this study will be beneficial to the development of precision oncology medicine not only for breast cancer, but also for other cancers.