bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid Intensive Care Unit Onboarding in Response to a Pandemic
Authors: Alroumi Fahad , Cota Donna , Chinea Jonathan , Ravikumar Nakul , Tiru Bogdan , Pinto-Plata Victor , Tidswell Mark 
Published: May 2021

Background: In the wake of the coronavirus disease 2019 (COVID-19) pandemic, hospital resources have been stretched to their limits. We introduced an innovative course to rapidly on-board a group of non-intensive care unit (ICU) nurse practitioners as they begin to practice working in a critical care setting. Objective: To assess whether a brief educational course could improve non-ICU practitioners’ knowledge and comfort in practicing in an intensive care setting. Methods: We implemented a multi-strategy blended 12-week curriculum composed of bedside teaching, asynchronous online learning and simulation. The course content was a product of data collected from a targeted needs assessment. The cognitive learning objectives were taught through the online modules. Four simulation sessions were used to teach procedural skills. Bedside teaching simultaneously occurred from critical care faculty during daily rounds. We assessed learning through a pre and post knowledge multiple choice question (MCQ) test. Faculty assessed learners by direct observation and review of clinical documentation. We evaluated learner reaction and comfort in critical practice by comparing pre and post surveys. Results: All 7 NPs were satisfied with the course and found the format to work well with their clinical schedules. The course also improved their self-reported comfort in managing critically ill patients in a medical ICU. There was an increase in the mean group score from the pre-to the post-course MCQ (60% vs 73%). Conclusions: The COVID-19 Critical Care Course (CCCC) for NPs was implemented in our ICU to better prepare for an anticipated second surge. It focused on delivering practical knowledge and skills as learners cared for critically ill COVID-19 patients. In a short period of time, it engaged participants in active learning and allowed them to feel more confident in applying their education.
Impact of Early Exposure to Simulation Program on Undergraduate Medical Students’ Interest in Urology
Authors: Kimura Tomokazu , Kojo Kosuke , Shiga Masanobu , Chihara Ichiro , Ikeda Atsushi , Kandori Shuya , Kojima Takahiro , Haruta Junji , Nishiyama Hiroyuki 
Published: May 2021

Background: Urological education is as important as surgical training for undergraduates. However, students in undergraduate medical schools have less exposure to urology as their curriculum focuses more on clinical skills, particularly community-based healthcare for a super-aging society. This study aimed to evaluate whether urology-related hands-on training could increase the interest of undergraduate medical students in urology. Methods: A 1-day elective program in urological surgery at the University of Tsukuba, particularly in robotic, laparoscopic, and endoscopic surgeries, was offered to 85 fourth-year medical students from 2018 to 2020, prior to their clinical clerkship. The average age of the participants was 22 (range: 21-25) years. We used a scoring system that comprised 1-5 Likert-type items to assess training activity, interest in surgery, and interest in urology before and after the course. Results: Before attending the program, the average scores of interest in urology were 3.53 in 2018, 3.15 in 2019, and 3.00 in 2020. The scores in surgery increased after the program; however, this was not significantly different from scores prior to the program. However, the average interest scores in urology were significantly increased to 3.91 ± 0.63 ( P < .05), 3.88 ± 0.58 ( P < .01), and 4.00 ± 0.61 ( P < 0.01) in 2018, 2019, and 2020, respectively. Total likely scores of this program in 2018, 2019, and 2020 were 4.59, 4.76, and 4.88, respectively, indicating a motivation to study surgery and urology during clinical clerkship. Conclusions: Urological hands-on training facilitated interest in urology in medical students prior to their clinical clerkship.
Flourishing as a Measure of Global Well-being in First Year Residents: A Pilot Longitudinal Cohort Study
Authors: Lebares Carter C , Greenberg Anya L , Shui Amy , Boscardin Christy , van der Schaaf Marieke 
Published: May 2021

Background: Physician well-being is critical to optimal learning and performance, yet we remain without validated measures to gauge the efficacy of well-being curricula for trainees. This study evaluates initial evidence of flourishing as a valid measure of global well-being in postgraduate-year-1 residents (PGY-1s), providing a means of assessing well-being intervention efficacy. Study design: In this single-site study of PGY-1s participating in Enhanced Stress Resilience Training (ESRT), an online questionnaire of published measures was administered at baseline (T1, just before PGY-1), post-ESRT (T2, 7 weeks later), and at PGY-1 end (T3, 11 months later). The Mental Health Continuum (MHC) was used to assess our primary outcome variable, flourishing, a well-established metric of psychosocial thriving in non-physicians that can be treated continuously or categorically. Correlation between flourishing and both resilience (mindfulness and workplace support) and risk (emotional exhaustion, depersonalization, stress, depressive symptoms, anxiety, and workplace demand) factors was assessed at each time-point and longitudinally. Results: Forty-five interns completed the survey at T1, 37 at T2, and 21 at T3; 21 responded at all time points. MHC score was significantly positively correlated with mindfulness (β = 1.47, SE = 0.35, P < .001) and workplace support (β = 2.02, SE = 1.01, P = .05) longitudinally, and at all time points. Flourishing was significantly negatively correlated with depressive symptoms (β = −7.48, SE = 1.68, P < .001), stress (β = −1.28, SE = 0.29, P < .001), and anxiety (β = −1.74, SE = 0.38, P < .001) longitudinally and at all time points, and significantly negatively correlated with emotional exhaustion (β = −2.65, SE = 0.89, P = .003) longitudinally and at T1 (β = −3.36, SE = 1.06, P = .003). Conclusion: Flourishing showed appropriate correlation with established resilience and risk factors, thus supporting its concurrent validity as a measure of global well-being in this population. As such, the MHC may provide a simple, meaningful assay of well-being and an effective tool for evaluating the efficacy of well-being interventions. Further validation requires a larger, multi-center study.
Student Perception of Case-based Teaching by Near-Peers and Faculty during the Internal Medicine Clerkship: A Noninferiority Study
Authors: Ahmad Syed E , Farina Gino A , Fornari Alice , Pearlman Ruth Ellen , Friedman Karen , Olvet Doreen M 
Published: May 2021

Introduction: Third-year medical students traditionally receive their didactic or small group teaching sessions from clinical faculty during clerkship rotations. Near-peer teaching is increasingly recognized as an acceptable method for teaching, however most near-peer teaching takes place during the pre-clinical curriculum. We sought to determine if fourth year medical students were noninferior to faculty in facilitating small group discussions during clerkship rotations. Methods: Seventy-five third-year medical students participated in a small group session focused on rheumatologic diseases during their internal medicine clerkship rotation. Students were taught by fourth-year medical students who self-selected to participate as near-peer teachers at 1 clinical site (near-peers, N = 36) and by clinical faculty at another site (N = 39). At the end of the session, third-year medical students completed a survey evaluating teacher performance and effectiveness. Results: There was no significant difference between the 2 groups on each of the 17 survey items assessing teacher performance, the total teaching performance score, and the teaching effectiveness rating (all P-values >.05). A mean between-group difference of 2% in favor of the near-peers indicated noninferiority of the near-peer teachers compared with faculty teachers on the total teaching performance score. An absolute difference of 14% in favor of the near-peers indicated noninferiority of the near-peer teachers compared with faculty teachers on the teaching effectiveness score. Near-peer teachers reported several benefits, including improving their own medical knowledge and skills as a future educator. Discussion: Our data supports the noninferiority of the perceived performance and effectiveness of near-peer teachers compared to faculty teachers in the clerkship setting. Adding near-peer teachers to the clerkship setting is feasible and can be beneficial to all stakeholders.
Evaluating an International Facial Trauma Course for Surgeons: Did We Make a Difference?
Authors: Younas Ayesha , Shah Irfan , Lim Thiam Chye , Figari Marcelo , Louie Gorman , Matic Damir , van der Tas Justin T. , Wolvius Eppo B. , McVicar Iain 
Published: May 2021

Study Design: Retrospective data analysis study. Objective: Attending continuing professional development (CPD) and continuing medical education (CME) activities is a necessity for practicing surgeons in most parts of the world. To enhance best practices in conducting CME/CPD, objective evaluation of these events is crucial. This article aims to evaluate one such international standardized CPD course conducted for facial surgeons across the globe. The Management of Facial Trauma course was developed by an international planning committee of experienced surgeons and has been implemented in all regions of the world. Method: This 2-day course is delivered using a combination of short lectures, small group discussions, and practical hands-on activities. Data collected from pre- and post-course evaluations of 86 Management of Facial Trauma courses conducted worldwide from 2017-2019 were collated and analyzed. Results: Participant demographics and experience levels varied slightly across the regions. Evaluation of the course effectiveness revealed overall high ratings for educational impact, content usefulness, and faculty performance. Conclusion: Our results indicated that this standardized course met the audience needs and enabled participants to plan changes in clinical practice. In addition, it confirmed that the course was relevant across different specialties and across different cultures and countries.
Morphometric evaluation and measurements of primary pterygium by anterior segment optical coherence tomography and its relation with astigmatism
Authors: Raj Anuradha , Dhasmana Renu , Bahadur Harsh 
Published: May 2021

Purpose: To evaluate the relationship between measurements and various morphometric parameters of primary pterygium on anterior segment optical coherence tomography(AS-OCT) and refractive and keratometric astigmatism. Methods: In this cross-sectional study, patients with primary pterygium were included. The AS-OCT parameters of pterygium consisting of epithelial thickness near apex(µm), apical or head thickness(µm), its thickness at limbus(µm), horizontal length of pterygium(mm), central corneal thickness (µm) and maximum pterygium thickness(mm) were evaluated. Results: Sixty three patients comprising of 63 eyes with a primary pterygium were studied. The mean keratometric and refractive astigmatism were 1.69 ± 3.15 Diopter(D) and0.5 ± 1.4D, respectively. There was a significant association between pterygium grade and stocker’s line with keratometric astigmatism ( p = 0.02, 0.00) respectively. Vertical and horizontal length on slit lamp and horizontal length on AS-OCT showed significant association with keratometric astigmatism ( p = 0.05, 0.00,0.00), respectively. Limbal thickness on AS-OCT showed significant positive correlation with refractive astigmatism ( r = 0.29, p = 0.02). Conclusion: The pterygium grade influences the keratometric astigmatism. Increased limbal thickness of pterygium on AS-OCT leads to more refractive astigmatism.
Effect of face-layer moisture content and face–core–face ratio of mats on the temperature and vapor pressure behavior during hot-pressing of wood-based panel manufacturing
Authors: Murayama Kazushige , Kukita Kensuke , Kobori Hikaru , Kojima Yoichi , Suzuki Shigehiko , Miyamoto Kohta 
Published: May 2021

AbstractWood-based panels are made by consolidating mats of resinous wooden raw materials under a hot-pressing process. This study investigates the effect of face-layer moisture content (MC) and face–core–face (FCF) ratio of mats on the temperature and vapor pressure behavior during the hot-pressing process. Raising the face-layer MC and lowering the face-layer thickness was expected to reduce the time of reaching 100 °C in the hot-pressing process. When the temperature rise was limited or the core temperature decreased after reaching 100 °C (defined as plateau in this study), the mats with 25% and 30% face-layer MC with 1:2:1 FCF ratio reached the highest plateau core temperature, but required a longer time to complete the plateau. The relationship between core plateau temperature and maximum core vapor pressure was well described by the Antoine equation, which empirically models the vapor pressure as a function of temperature. The Antoine equation held across both face-layer MC series (varying face-layer MC at constant FCF ratio) and FCF series (varying FCF ratio at constant face-layer MC). The mat with 20% face-layer MC and 1:2:1 FCF ratio reached 180 °C within the shortest time, regardless of the evaluation conditions.
Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise
Authors: Kopiczko Anna , Adamczyk Jakub Grzegorz , Gryko Karol , Popowczak Marek 
Published: May 2021

Abstract
Background
The purpose of the study was to examine how bone mineral density (BMD) is related to body composition depending on the practiced sport (endurance, speed-power, throwing sports) in participants of the World Masters Athletics Championship.

Methods
Dual-energy X-ray absorptiometry (DXA) was used to determine BMD and bone mass (BMC). Body composition was analyzed by means of the JAWON Medical X-scan analyzer using bioelectrical impedance methods. Percentage body fat (%BF), body fat mass (BFM), lean body mass (LBM), total body water (TBW), soft lean mass (SLM), intracellular water (ICW), and extracellular water (ECW) were evaluated.

Results
Among men, the most important variables affecting the BMD norm were LBM (OR = 32.578; p = 0.023), ECW (OR = 0.003; p = 0.016) and ICW (OR = 0.011; p = 0.031), in the distal part and SLM (OR = 5.008; p = 0.020) and ICW (0.354, p = 0.008) in the proximal part. In women, the most important predictors of normal BMD were ICW (OR = 10.174; p = 0.003) and LBM (OR = 0.470; p = 0.020) in the distal part and ICW (OR = 5.254; p = 0.038) in the proximal part.

Conclusion
The representatives of strength based events had the most advantageous BMD levels. The condition of bone tissue evaluated by BMC and BMD of the forearm in masters athletes was strongly determined by the level of lean body components and the type of sports training associated with the track and field event. In the most important predictors of the BMD norm were also hydration components ECW and ICW. However, this relationship requires more research on the nature and mechanisms of these interactions.
Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall
Authors: Hamdani Moez , Bdioui Ahlem , Belkacem Oussama , Jelidi Nizar , Baccouche Atika , Majdoub Wiem , Belhaj Salah Sihem Hmissa 
Published: May 2021

Abstract
Background
The hydatid disease is a parasitic infestation caused by the larval stage of Echinococcus granulosus. The renal location of this infectious disease is uncommon compared to hepatic or pulmonary ones. Most patients remain asymptomatic for years and hydatiduria is the only pathognomonic clinical symptom. We report a rare case of renal hydatid cyst misdiagnosed and treated as a renal tumor.

Case presentation
A 45-year-old woman with no significant medical or surgical history presented with left lumber pain with hematuria. Magnetic Resonance Imaging (MRI) displayed a left renal mass with cystic and solid components, showing discreet enhancement, classified as Bosniak IV. The diagnosis of renal malignant tumor was made. The patient underwent a lumbotomy. Intraoperatively, the mass was adherent to the perirenal fat and seemed to invade the adrenal gland. An enlarged left nephrectomy with surrenalectomy was performed. The gross specimen showed a superior polar renal cyst (9 × 7 × 6cm). The cyst had a thick wall and contained multiple internal smaller cysts recalling the appearance of the hydatid cyst. The microscopic study showed a cyst wall consisting of acellular eosinophilic laminated membrane lined by a thin germinal layer from which merge daughter cysts. This cyst wall is surrounded by a dense fibrovascular tissue with chronic inflammatory cells. The diagnosis of renal hydatic cyst was made.

Conclusion
Although the renal hydatid cyst is relatively rare, this diagnosis must be considered in patients with renal cystic masses, especially endemic countries. Preoperative diagnosis is challenging, especially in type IV cysts which can mimic a renal tumor and lead to overtreatment.
A sequence-based multiple kernel model for identifying DNA-binding proteins
Authors: Qian Yuqing , Jiang Limin , Ding Yijie , Tang Jijun , Guo Fei 
Published: May 2021

Abstract
Background
DNA-Binding Proteins (DBP) plays a pivotal role in biological system. A mounting number of researchers are studying the mechanism and detection methods. To detect DBP, the tradition experimental method is time-consuming and resource-consuming. In recent years, Machine Learning methods have been used to detect DBP. However, it is difficult to adequately describe the information of proteins in predicting DNA-binding proteins. In this study, we extract six features from protein sequence and use Multiple Kernel Learning-based on Centered Kernel Alignment to integrate these features. The integrated feature is fed into Support Vector Machine to build predictive model and detect new DBP.

Results
In our work, date sets of PDB1075 and PDB186 are employed to test our method. From the results, our model obtains better results (accuracy) than other existing methods on PDB1075 ($$84.19\%$$

84.19
%

) and PDB186 ($$83.7\%$$

83.7
%

), respectively.

Conclusion
Multiple kernel learning could fuse the complementary information between different features. Compared with existing methods, our method achieves comparable and best results on benchmark data sets.
The holobiont transcriptome of teneral tsetse fly species of varying vector competence
Authors: Medina Munoz Miguel , Brenner Caitlyn , Richmond Dylan , Spencer Noah , Rio Rita V. M. 
Published: May 2021

Abstract
Background
Tsetse flies are the obligate vectors of African trypanosomes, which cause Human and Animal African Trypanosomiasis. Teneral flies (newly eclosed adults) are especially susceptible to parasite establishment and development, yet our understanding of why remains fragmentary. The tsetse gut microbiome is dominated by two Gammaproteobacteria, an essential and ancient mutualist Wigglesworthia glossinidia and a commensal Sodalis glossinidius. Here, we characterize and compare the metatranscriptome of teneral Glossina morsitans to that of G. brevipalpis and describe unique immunological, physiological, and metabolic landscapes that may impact vector competence differences between these two species.

Results
An active expression profile was observed for Wigglesworthia immediately following host adult metamorphosis. Specifically, ‘translation, ribosomal structure and biogenesis’ followed by ‘coenzyme transport and metabolism’ were the most enriched clusters of orthologous genes (COGs), highlighting the importance of nutrient transport and metabolism even following host species diversification. Despite the significantly smaller Wigglesworthia genome more differentially expressed genes (DEGs) were identified between interspecific isolates (n = 326, ~ 55% of protein coding genes) than between the corresponding Sodalis isolates (n = 235, ~ 5% of protein coding genes) likely reflecting distinctions in host co-evolution and adaptation. DEGs between Sodalis isolates included genes involved in chitin degradation that may contribute towards trypanosome susceptibility by compromising the immunological protection provided by the peritrophic matrix. Lastly, G. brevipalpis tenerals demonstrate a more immunologically robust background with significant upregulation of IMD and melanization pathways.

Conclusions
These transcriptomic differences may collectively contribute to vector competence differences between tsetse species and offers translational relevance towards the design of novel vector control strategies.
Acute kidney injury in children with COVID-19: a retrospective study
Authors: Kari Jameela Abdulaziz , Shalaby Mohamed A , Albanna Amr S , Alahmadi Turki S , Alherbish Adi , Alhasan Khalid A 
Published: May 2021

AbstractBackgroundAcute kidney injury (AKI) is a complication of coronavirus disease 2019 (COVID-19). The reported incidence of AKI, however, varies among studies. We aimed to evaluate the incidence of AKI and its association with mortality and morbidity in children infected with severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) who required hospital admission.MethodsThis was a multicenter retrospective cohort study from three tertiary centers, which included children with confirmed COVID-19. All children were evaluated for AKI using the Kidney Disease Improving Global Outcomes (KDIGO) definition and staging.ResultsOf 89 children included, 19 (21 %) developed AKI (52.6 % stage I). A high renal angina index score was correlated with severity of AKI. Also, multisystem inflammatory syndrome in children (MIS-C) was increased in children with AKI compared to those with normal kidney function (15 % vs. 1.5 %). Patients with AKI had significantly more pediatric intensive care admissions (PICU) (32 % vs. 2.8 %,p < 0.001) and mortality (42 % vs. 0 %,p < 0.001). However, AKI was not associated with prolonged hospitalization (58 % vs. 40 %,p = 0.163) or development of MIS-C (10.5 % vs. 1.4 %,p = 0.051). No patient in the AKI group required renal replacement therapy. Residual renal impairment at discharge occurred in 9 % of patients. This was significantly influenced by the presence of comorbidities, hypotension, hypoxia, heart failure, acute respiratory distress, hypernatremia, abnormal liver profile, high C-reactive protein, and positive blood culture.ConclusionsAKI occurred in one-fifth of children with SARS-CoV-2 infection requiring hospital admission, with one-third of those requiring PICU. AKI was associated with increased morbidity and mortality, and residual renal impairment at time of discharge.