bluuebunny/crossref_metadata_2025_split huggingface dataset:
Service provider perspectives on how COVID-19 and pandemic restrictions have affected intimate partner and sexual violence survivors in Canada: a qualitative study
Authors: Michaelsen Sonia , Djiofack Hervé , Nombro Elisabeth , Ferlatte Olivier , Vissandjée Bilkis , Zarowsky Christina 
Published: April 2022

Abstract
Background
The COVID-19 pandemic may increase risk of intimate partner and sexual violence and make relevant services less accessible. This study explored the perspectives of intimate partner and sexual violence workers across Canada on how the COVID-19 pandemic has affected the survivors with whom they work.

Methods
Using a qualitative descriptive design, we interviewed 17 management and frontline staff of organizations supporting survivors of intimate partner and sexual violence across Canada. Results: We identified 4 themes that describe the impacts of COVID-19 on intimate partner and sexual violence survivors, from the perspective of service providers: (1) No escape; (2) Isolation; (3) Tough decisions; and (4) Heightened vulnerability. These narrative findings are presented first, followed by an analysis within a social determinants of health framework. Interpreting our findings against such a framework revealed a complex interplay of social determinants, notably social support, access to services, and poverty, that produced several challenges for intimate partner and sexual violence survivors during COVID-19.

Conclusion
According to service providers, intimate partner and sexual violence survivors in Canada faced several challenges during the pandemic, including reduced ability to escape their situations, increased isolation, increasingly complex decisions, and heightened vulnerability. Our findings demonstrate the critical need to adopt a broader, more holistic approach in tackling intimate partner and sexual violence by also addressing socioeconomic issues such as poverty and marginalization.
Comparison of the effects of virtual training by serious game and lecture on operating room novices’ knowledge and performance about surgical instruments setup: a multi-center, two-arm study
Authors: Akbari Fakhridokht , Nasiri Morteza , Rashidi Neda , Zonoori Sahar , Amirmohseni Leila , Eslami Jamshid , Torabizadeh Camellia , Havaeji Fahimeh Sadat , Bigdeli Shamloo Marzieh Beigom , Paim Crislaine Pires Padilha , Naghibeiranvand Mehran , Asadi Masoomeh 
Published: April 2022

Abstract
Background
Game-based training is increasingly implemented in different nursing fields, as it allows students to learn experientially, with the flexibility to regulate their training based on their personal progresses and abilities. This study aimed to compare the effects of virtual training by the “Playing with Surgical Instruments (PlaSurIn)” game and the lecture on the surgical instruments setup knowledge and performance of Operating Room (OR) novices.

Methods
This study was conducted on 51 s-semester undergraduate OR technology students taking the course “An Introduction to Surgical Instruments and Equipment.” An additional virtual training session was held via a learning management system using two different methods. The students of the Game Training Group (GTG, n = 27) played individually with the “PlaSurIn” game during a week, while the students of the Lecture Training Group (LTG, n = 24) received the lecture-based training during a week. To measure knowledge, all the students participated in a theoretical test with 10 multiple-choice questions before and immediately after the training. They also participated in an Objective Structured Clinical Examination (OSCE) after the training, and their performance was evaluated by the remained time for setup completion and the scores, errors, and bonuses.

Results
The mean score of the theoretical test was significantly higher in the GTG than in the LTG after the training (p = 0.040). Additionally, the GTG participants had higher scores (p = 0.016), fewer errors (p = 0.001), and higher bonuses (p = 0.011) compared to the LTG ones. The remained time for setup completion was also significantly longer in the GTG than in the LTG (p < 0.001).

Conclusion
Virtual training by “PlaSurIn” was superior to the lecture-based method for the enhancement of surgical instruments setup knowledge and performance amongst OR novices.
Evaluation of the clinical application effect of eSource record tools for clinical research
Authors: Wang Bin , Hao Xinbao , Yan Xiaoyan , Lai Junkai , Jin Feifei , Liao Xiwen , Xie Hongju , Yao Chen 
Published: April 2022

Abstract
Background
Electronic sources (eSources) can improve data quality and reduce clinical trial costs. Our team has developed an innovative eSource record (ESR) system in China. This study aims to evaluate the efficiency, quality, and system performance of the ESR system in data collection and data transcription.

Methods
The study used time efficiency and data transcription accuracy indicators to compare the eSource and non-eSource data collection workflows in a real-world study (RWS). The two processes are traditional data collection and manual transcription (the non-eSource method) and the ESR-based source data collection and electronic transmission (the eSource method). Through the system usability scale (SUS) and other characteristic evaluation scales (system security, system compatibility, record quality), the participants’ experience of using ESR was evaluated.

Results
In terms of the source data collection (the total time required for writing electronic medical records (EMRs)), the ESR system can reduce the time required by 39% on average compared to the EMR system. In terms of data transcription (electronic case report form (eCRF) filling and verification), the ESR can reduce the time required by 80% compared to the non-eSource method (difference: 223 ± 21 s). The ESR accuracy in filling the eCRF field is 96.92%. The SUS score of ESR is 66.9 ± 16.7, which is at the D level and thus very close to the acceptable margin, indicating that optimization work is needed.

Conclusions
This preliminary evaluation shows that in the clinical medical environment, the ESR-based eSource method can improve the efficiency of source data collection and reduce the workload required to complete data transcription.
Using a model to design, implement, and evaluate a training program for improving cultural competence among undergraduate nursing students: a mixed methods study
Authors: Farokhzadian Jamileh , Nematollahi Monirsadat , Dehghan Nayeri Nahid , Faramarzpour Motahareh 
Published: April 2022

Abstract
Background
Due to changing population, culturally diverse clients with different perceptions of illness and health are present in healthcare settings. Therefore, it is increasingly important for nursing students to have high levels of cultural competence in order to meet diverse client needs. A training program is essential to enhance students’ cultural competence. This study aimed to design, implement, and evaluate a cultural care-training program to improve cultural competence of undergraduate nursing students.

Methods
This exploratory mixed methods study used six steps proposed in the Talbot and Verrinder model to design a training program. In the first step, a conventional qualitative study was conducted and 18 participants were interviewed using purposive sampling. In the second and third steps, literature review and the classic Delphi technique were used for initiation and finalization of the program. The fourth, fifth, and sixth steps were completed by implementing, monitoring, and evaluating the cultural care program (five two-hour sessions) among 73 nursing students using a quasi-experimental design. Finally, effectiveness of program was evaluated through the cultural care inventory before and 1 month after the program. Data were analyzed via SPSS25, independent samples t- test, paired t- test, chi-square test, analysis of covariance, and multivariate linear regression tests.

Results
A systematic model was used to identify key elements of a cultural care program, including main topics, educational objectives and contents, assignments and activities for students, teaching and evaluation methods. The curricular objectives and educational contents were implemented in five sessions to produce measurable results. The quantitative step showed that nursing students’ cultural competence in the intervention group (184.37 ± 22.43) improved significantly compared with the control group (153.19 ± 20.14) (t = 6.24, p = 0.001) after intervention.

Conclusion
A cultural care training program can be designed by the model applied in this study in order to improve cultural competence of nursing students. This training program will be effective if students’ learning needs, appropriate assignments, and acceptable teaching methods are addressed. Therefore, nurse educators can design comprehensive training programs to improve nursing students’ cultural competence in different cultures and contexts. This training program is highly efficient because it is applicable in many disciplines of nursing education.
Social relations and contact with general practitioner in a middle-aged Danish population: a prospective register- and survey-based cohort study
Authors: Mikkelsen Anne Sophie Bech , Lund Rikke , Siersma Volkert , Jørgensen Terese Sara Høj , Christensen Ulla , Kristiansen Maria 
Published: April 2022

Abstract
Background
Findings about the relationship between individuals’ social relations and general practitioner (GP) contact are ambiguous as to whether weak social relations are associated with an increased or decreased consultation pattern. Furthermore, social relations may affect GP contact differently for men compared to women, between socioeconomic groups and according to perceived need. The overall aim of the study is to examine the association between functional aspects of social relations, perceived emotional and instrumental social support, the tendency to consult a GP and the frequency of GP contact.

Methods
The study comprised 6911 individuals aged 49–61 at baseline from the Copenhagen Aging and Midlife Biobank (CAMB). We conducted a two-part regression to explore the association between perceived emotional and instrumental social support and GP contact (tendency and frequency), controlling for age, sex, occupational social class, cohabitation status and number of morbidities.

Results
Results show no overall effect of the perceived social support aspects of social relations on GP contact independent of health-related needs.

Conclusions
Our results do not support that perceived social support, reflecting functional aspects of social relations, are associated with general practitioner contact among middle-aged people.

Trial registration
The study has been registered and approved by the Danish Data Protection Agency and the local ethical committee (approval No.H-A-2008-126 and No. 2013-41-1814).Keywords: social relations, perceived social support, healthcare utilisation, general practitioner, middle-aged
The relationship between outpatient service use and emergency department visits among people treated for mental and substance use disorders: analysis of population-based administrative data in British Columbia, Canada
Authors: Lavergne M. Ruth , Loyal Jackson P. , Shirmaleki Mehdi , Kaoser Ridhwana , Nicholls Tonia , Schütz Christian G. , Vaughan Adam , Samji Hasina , Puyat Joseph H. , Kaulius Megan , Jones Wayne , Small William 
Published: April 2022

Abstract
Background
Research findings on the association between outpatient service use and emergency department (ED) visits for mental and substance use disorders (MSUDs) are mixed and may differ by disorder type.

Methods
We used population-based linked administrative data in British Columbia, Canada to examine associations between outpatient primary care and psychiatry service use and ED visits among people ages 15 and older, comparing across people treated for three disorder categories: common mental disorders (MDs) (depressive, anxiety, and/or post-traumatic stress disorders), serious MDs (schizophrenia spectrum and/or bipolar disorders), and substance use disorders (SUDs) in 2016/7. We used hurdle models to examine the association between outpatient service use and odds of any ED visit for MSUDs as well count of ED visits for MSUDs, stratified by cohort in 2017/8.

Results
Having had one or more MSUD-related primary care visit was associated with lower odds of any ED visit among people treated for common MDs and SUDs but not people treated for serious MDs. Continuity of primary care was associated with slightly lower ED use in all cohorts. One or more outpatient psychiatrist visits was associated with lower odds of ED visits among people treated for serious MDs and SUDs, but not among people with common MDs.

Conclusion
Findings highlight the importance of expanded access to outpatient specialist mental health services, particularly for people with serious MDs and SUDs, and collaborative models that can support primary care providers treating people with MSUDs.
The economic burden of prostate cancer in Eswatini
Authors: Ngcamphalala Cebisile , Östensson Ellinor , Ginindza Themba G. 
Published: April 2022

Abstract
Background
Prostate cancer is the fifth cause of cancer mortality among men worldwide. However, there is limited data on costs associated with prostate cancer in low- and middle-income countries particularly in the sub-Saharan region. From a societal perspective, this study aims to estimate the cost of prostate cancer in Eswatini.

Methods
This prevalence–based cost-of-illness study used diagnosis specific data from national registries to estimate costs associated to prostate cancer during 2018. The prevalence-based approach was used employing both top down and bottom up costing approaches. Costs data included health care utilization, transport, sick leave days and premature death.

Results
The total annual cost of prostate cancer was $6.2 million (ranging between $ 4.7 million and 7.8 million estimated with lower and upper bounds). Average cost-per patient for radiotherapy, chemotherapy and other non-medical direct costs (transport and lodging) were the highest cost drivers recording $16,648, $7,498 and $5,959 respectively whilst indirect costs including productive loss due to sick leave and pre-mature mortality was estimated at $58,320 and $113,760 respectively. Cost of managing prostate cancer increased with advanced disease and costs were highest for prostate cancer stages III and IV recording $1.1million, $1.9million respectively.

Conclusions
Prostate cancer is a public health concern in Eswatini, and it imposes significant economic burden to the society. This finding point areas for policy makers to perform cost containment regarding therapeutic procedures for prostate cancer and the need for strategies to increase efficiencies in the health care systems for increased value for health care services.
Potential contribution of intrinsic developmental stability toward body plan conservation
Authors: Uchida Yui , Shigenobu Shuji , Takeda Hiroyuki , Furusawa Chikara , Irie Naoki 
Published: April 2022

Abstract
Background
Despite the morphological diversity of animals, their basic anatomical patterns—the body plans in each animal phylum—have remained highly conserved over hundreds of millions of evolutionary years. This is attributed to conservation of the body plan-establishing developmental period (the phylotypic period) in each lineage. However, the evolutionary mechanism behind this phylotypic period conservation remains under debate. A variety of hypotheses based on the concept of modern synthesis have been proposed, such as negative selection in the phylotypic period through its vulnerability to embryonic lethality. Here we tested a new hypothesis that the phylotypic period is developmentally stable; it has less potential to produce phenotypic variations than the other stages, and this has most likely led to the evolutionary conservation of body plans.

Results
By analyzing the embryos of inbred Japanese medaka embryos raised under the same laboratory conditions and measuring the whole embryonic transcriptome as a phenotype, we found that the phylotypic period has greater developmental stability than other stages. Comparison of phenotypic differences between two wild medaka populations indicated that the phylotypic period and its genes in this period remained less variational, even after environmental and mutational modifications accumulated during intraspecies evolution. Genes with stable expression levels were enriched with those involved in cell-cell signalling and morphological specification such as Wnt and Hox, implying possible involvement in body plan development of these genes.

Conclusions
This study demonstrated the correspondence between the developmental stage with low potential to produce phenotypic variations and that with low diversity in micro- and macroevolution, namely the phylotypic period. Whereas modern synthesis explains evolution as a process of shaping of phenotypic variations caused by mutations, our results highlight the possibility that phenotypic variations are readily limited by the intrinsic nature of organisms, namely developmental stability, thus biasing evolutionary outcomes.
Single-cell analysis of p53 transitional dynamics unravels stimulus- and cell type-dependent signaling output motifs
Authors: Xie Jun , Zhang Lichun , Liu Bodong , Liang Xiao , Shi Jue 
Published: April 2022

Abstract
Background
To understand functional changes of complex biological networks, mathematical modeling of network topologies provides a quantitative measure of the way biological systems adapt to external stimuli. However, systemic network topology-based analysis often generates conflicting evidence depending on specific experimental conditions, leading to a limited mechanistic understanding of signaling networks and their differential dynamic outputs, an example of which is the regulation of p53 pathway responses to different stress stimuli and in variable mammalian cell types. Here, we employ a network motif approach to dissect key regulatory units of the p53 pathway and elucidate how network activities at the motif level generate context-specific dynamic responses.

Results
By combining single-cell imaging and mathematical modeling of dose-dependent p53 dynamics induced by three chemotherapeutics of distinct mechanism-of-actions, including Etoposide, Nutlin-3a and 5-fluorouracil, and in five cancer cell types, we uncovered novel and highly variable p53 dynamic responses, in particular p53 transitional dynamics induced at intermediate drug concentrations, and identified the functional roles of distinct positive and negative feedback motifs of the p53 pathway in modulating the central p53-Mdm2 negative feedback to generate stimulus- and cell type-specific signaling responses. The mechanistic understanding of p53 network dynamics also revealed previously unknown mediators of anticancer drug actions and phenotypic variations in cancer cells that impact drug sensitivity.

Conclusions
Our results demonstrate that transitional dynamics of signaling proteins such as p53, activated at intermediate stimulus levels, vary the most between the dynamic outputs of different generic network motifs and can be employed as novel quantitative readouts to uncover and elucidate the key building blocks of large signaling networks. Our findings also provide new insight on drug mediators and phenotypic heterogeneity that underlie differential drug responses.
Clinicopathological value of the upregulation of cyclin-dependent kinases regulatory subunit 2 in osteosarcoma
Authors: Mo Chaohua , Wu Yanxing , Ma Jie , Xie Le , Huang Yingxin , Xu Yuanyuan , Peng Huizhi , Chen Zengwei , Zeng Min , Mao Rongjun 
Published: April 2022

AbstractBackgroundCyclin-dependent kinase subunit 2 (CKS2) is a member of cyclin dependent kinase subfamily and the relationship between CKS2 and osteosarcoma (OS) remains to be further analyzed.Methods80 OS and 41 non-tumor tissue samples were arranged to perform immunohistochemistry (IHC) to evaluate CKS2 expression between OS and non-tumor samples. The standard mean deviation (SMD) was calculated based on in-house IHC and tissue microarrays, and exterior high-throughput datasets for further verification of CKS2 expression trend in OS. The effect of CKS2 expression on clinicopathological parameters of OS patients, and single-cell in OS tissues was analyzed through public high-throughput datasets and functional enrichment analysis was conducted for co-expression genes of CKS2 in accordance with weighted correlation network analysis.ResultsA total of 217 OS samples and 87 non-tumor samples (including tissue and cell line) were obtained from in-house IHC, microarrays and exterior high-throughput datasets. The analysis of integrated expression status demonstrated up-regulation of CKS2 in OS (SMD = 1.57, 95%CI [0.27–2.86]) and the significant power of CKS2 expression in distinguishing OS samples from non-tumor samples (AUC = 0.97 95%CI [0.95–0.98]). Clinicopathological analysis of GSE21257 indicated that OS patients with higher CKS2 expression was more likely to suffer OS metastasis. Although Kaplan–Meier curves showed no remarkable difference of overall survival rate between OS patients with high and low-CKS2, CKS2 was found up-regulated in proliferating osteosarcoma cells. Co-expression genes of CKS2 were mainly assembled in function and pathways such as cell cycle, cell adhesion, and intercellular material transport.ConclusionsIn summary, up-regulation of CKS2 expression in OS tissue was found through multiple technical approaches. In addition, scRNA-seq and co-expression analysis showed that CKS2 may have an impact on important biological process linked with cell cycle, cell adhesion, and intercellular material transport. Present study on CKS2 in OS indicated a promising prospect for CKS2 as a biomarker for OS.
Molecular mechanism by which CDCP1 promotes proneural-mesenchymal transformation in primary glioblastoma
Authors: Lin Zhiying , Zhang Zhu , Zheng Haojie , Xu Haiyan , Wang Yajuan , Chen Chao , Liu Junlu , Yi Guozhong , Li Zhiyong , Wang Xiaoyan , Huang Guanglong 
Published: April 2022

Abstract
Background
Compared with the proneural (PN) subtype of glioblastoma (GBM), the mesenchymal (MES) subtype is more invasive and immune evasive and is closely related to poor prognosis. Here, we used transcriptome data and experimental evidence to indicate that CUB domain-containing protein 1 (CDCP1) is a novel regulator that facilitates the transformation of PN-GBM to MES-GBM.

Methods
The mRNA expression data of CDCP1 in glioma were collected from the TCGA, CGGA and GEO databases, and in vitro experiments verified CDCP1 expression in glioma tissue samples. Independent prognostic analysis revealed the correlation of the CDCP1 expression level and patient survival. Bioinformatics analysis and experiments verified the biological function of CDCP1. Multivariate proportional hazards models and a PPI network were used to select key genes. A prognostic risk model for predicting the survival of glioma patients was constructed based on the selected genes.

Results
The results showed that the expression of CDCP1 increased with increasing tumor grade and that the overexpression of CDCP1 correlated with a poor prognosis. CDCP1 was highly expressed in MES-GBM but weakly expressed in PN-GBM. The risk model (considering CDCP1 combined with CD44 and ITGAM expression) could represent a tool for predicting survival and prognosis in glioma patients.

Conclusions
Our study indicates that CDCP1 plays an important role in facilitating the transformation of PN-GBM to MES-GBM.