bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing e-Learning in CPD: Preferences and Perceptions of Health Professionals
Authors: Samuel Anita , Cervero Ronald M. , King Beth , Durning Steven J. 
Published: September 2024

Introduction:
Continuing professional development for health professionals increasingly relies on e-learning. However, there is insufficient research into the instructional strategies health professionals prefer to engage with in e-learning. An empirical study was undertaken to answer the research question: What instructional strategies do learners prefer in e-learning modules to improve their learning experience?

Methods:
The Department of Health Professions Education at the Uniformed Services University of Health Sciences developed six, stand-alone, self-paced modules for health professionals focusing on education and leadership. The module evaluation survey consisted of six Likert scale questions and two open-ended questions. Responses from these anonymized module evaluations from 2019 to 2022 were analyzed. Descriptive statistics for the Likert scale questions were calculated. Responses to the two open-ended questions were compiled and analyzed thematically.

Results:
All survey respondents found the content of the modules helpful and met their stated learning objectives. A majority (94%) agreed or strongly agreed that readings and videos increased their knowledge in the topic area and that quizzes effectively strengthened their understanding of the topics. Four themes emerged from the qualitative data: pedagogical strategies, technology issues, feedback and interaction, and transfer of learning.

Conclusions:
This study foregrounds the voice of the learner, which emphasizes health professionals' preference for instructional strategies that align with their needs as adult learners. The findings highlight the value of content relevance, expert creation, and authentic examples in enhancing learner satisfaction.
Developing and Validating a Bundle for Safe Intra-Hospital Transporting of the Critically Ill Patients
Authors: Mahran Ghada Shalaby Khalaf , Mekawy Mimi M. , Abd El-Aziz Wafaa W. , Ali Aida F. A. , El Demerdash Doaa A. , Sayed Magdy M. M. 
Published: September 2024

The aim of this study was to develop a bundle to increase safety of intra-hospital transport in critically ill patients. A qualitative design with Delphi approach was conducted for creation of an intra-hospital transport bundle in 3 steps. First, doctors and nurses were questioned about their encounters with intra-hospital transport incidents. Second, several databases were looked through to find published checklists and recommendations for intra-hospital transport. Third, using this strategy, a bundle was created and reviewed with subject matter experts. The content validity index (CVI), which assesses the degree of expert agreement, was utilized to evaluate each item in the generated bundle.
Two evaluation cycles were required before a minimal index could be reached. We looked at the content validity and important weighting of the items. The scale-CVI was calculated using the average of all the elements, and it was 1. The created bundle serves as a framework for directing doctors and nurses during intra-hospital transportation and offers continuity of care to improve patient safety. The techniques suggested in this study can be used to adapt this bundle to the needs of other hospitals.
Effectiveness of the ABCDEF Bundle to Manage and Prevent Delirium
Authors: Nagy Nagm Eldean Tahany , Hassan Bakri Mohamed , Anwar Abdel Aziz Mervet , Shalaby Khalaf Ghada 
Published: September 2024

Purpose:
To investigate effectiveness of the ABCDEF bundle to manage and prevent delirium. Background: ICU delirium is a common hospital problem that 80% of critically ill patients in the ICU experience. The ABCDEF bundle is one of the tools that included in Delirium guidelines to manage critically ill patients. Research design: Pre- and post intervention a quasi-experimental design was utilized in the present study. Setting: This study was conducted in the intensive care units of Assiut University Hospital. Methods: A total of 60 mechanically ventilated patients were recruited using inclusion and exclusion criteria. The ABCDEF bundle was implemented every day for the first 7 days of ICU admission, and patient sedation and delirium status were assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Sedation instrument measures were utilized in data collection. Results: Significant differences were found in the incidence of delirium: 20% in the study group versus 70% in the control group. The increased mean of days without delirium ICU stay was 4.6333 in the study group and 1.1000 in the control group, with P value = .001. Conclusion: The mechanically ventilated patients exposed to the implementation of the ABCDE bundle experienced fewer delirium signs than before the ABCDE bundle was implemented.
Significance of a Simulation for the Relocation of an Intensive Care Unit
Authors: Yanagawa Youichi , Nagasawa Hiroki , Tada Shinya , Nakamura Saori , Onitsuka Mika , Suzuki Eiko , Sasaki Shino 
Published: September 2024

There have been few reports concerning simulation drills for the relocation of severely ill or injured patients treated in intensive care units (ICUs). We herein report our experience of one such simulation drill. It is a Narrative method. A simulation drill was performed on a weekday 2 weeks prior to the actual relocation. We selected 3 mock patients. The first one was a severely ill and unstable patient, the second had severe stroke, and the third had severe trauma. After the simulation, the average transportation time was 15 minutes. The simulation revealed that mock patients with a percutaneous cardiopulmonary support system and intra-aortic balloon pumping in a standard ICU bed could not be accommodated in the elevator. Furthermore, working the elevator controls resulted in wasted time while transferring the patients. As a result, the number of people, who controlled the elevator, was therefore increased during the actual relocation. During the actual relocation, all patients were transported safely and more quickly than predicted based on the results of the simulation drill. Most physicians and paramedical staff have little experience with relocating ICUs, so a simulation drill was necessary to ensure the safe and prompt transport of patients.
Implementation and Evaluation Strategies for Pharmacogenetic Testing in Hospital Settings: A Scoping Review
Authors: Wu Angela , Raack Edward J. , Ross Colin J. D. , Carleton Bruce C. 
Published: September 2024

Background:
Pharmacogenetic testing in clinical settings has improved the safety and efficacy of drug treatment. There is a growing number of studies evaluating pharmacogenetic implementation and identifying barriers and facilitators. However, no review has focused on bridging the gap between identifying barriers and facilitators of testing and the clinical strategies adopted in response. This review was conducted to understand the implementation and evaluation strategies of pharmacogenetic testing programs.

Methods:
A PRISMA-compliant scoping review was conducted. The included studies discussed pharmacogenetic testing programs implemented in a hospital setting. Quantitative, qualitative, and mixed design methods were included.

Results:
A total of 232 of the 7043 articles that described clinical pharmacogenetic programs were included. The most common specialties that described pharmacogenetic implementation were psychiatry (26%) and oncology (16%), although many studies described institutional programs implemented across multiple specialties (19%). Different specialties reported different clinical outcomes, but all reported similar program performance indicators, such as test uptake and the number of times the test recommendations were followed. There were benefits and drawbacks to delivering test results through research personnel, pharmacists, and electronic alerts, but active engagement of physicians was necessary for the incorporation of pharmacogenetic results into clinical decision making.

Conclusions:
Further research is required on the maintenance and sustainability of pharmacogenetic testing initiatives. These findings provide an overview of the implementation and evaluation strategies of different specialties that can be used to improve pharmacogenetic testing.
Efficacy, Safety, and Longevity of Hyaluronic Acid Filler Injection in Treating Temple Hollowness by Sonographic Identifying 17 Soft Tissue Layers
Authors: Kim Jong-Seo 
Published: September 2024

Background:
Successful aesthetic interventions in upper-face aging require a profound understanding of the intricate anatomy of temporal. This study aimed to comprehensively evaluate the effect of hyaluronic acid (HA) injection in temple areas by combining quantitative analysis with detailed anatomical insights.

Methods:
Twenty-five women received HA injections for temple hollowness. The injections targeted the interfacial layer between superficial and deep temporal fascia. Three-dimensional scanning, hollowness examination, and sonographic measurements were conducted 3 and 6 months postprocedure.

Results:
Sonography identified 17 soft tissue layers in the temple, each with distinct characteristics. The notable layers include the epidermis, dermis, superficial and deep temporal fasciae, innominate fasciae, and superficial and deep temporal fat compartments. Three-dimensional volume was 0.86 mL at 3 months and 0.72 mL at 6 months. The average thickness of HA was 3.82 mm (immediately), 3.00 mm (3 mo), and 2.51 mm (6 mo). The depression on the temple was 4.33 mm (preprocedure), 0.71 mm (3 mo), and 1.62 mm (6 mo). The grade improved by 2.41 and 1.74 levels at 3 and 6 months.

Conclusions:
Identifying detailed superficial and deep layers of the deep temporal fascia challenged traditional descriptions, with detailed dividing of superficial and deep temporal fascia in sonography. Innominate fascia was also distinguished. This study provided a comprehensive evaluation of the effects of HA injections in temple areas. Precise anatomical insights and quantitative assessments contribute to a deeper understanding of the structural changes induced by this procedure. Sonography is valuable for delineating distinct layers and guiding aesthetic interventions in the temporal region.
Netherton Syndrome
Authors: Brown Riley H. , Morrissette Summer V. , McClees Sarah F. , Huynh Thy N. 
Published: September 2024

ABSTRACT
This case describes a 9-day-old female infant who presented with severe skin peeling and diffuse erythema. As the patient was refractory to standard treatment, a working differential diagnosis was built and included infectious, inflammatory, and inherited etiologies. The patient’s workup pointed toward Netherton syndrome, a rare autosomal recessive condition that presents at birth or within the first few weeks of life and is characterized by widespread erythroderma with ichthyosis.
Survey of Clinical Knowledge and Procedural Readiness of Pulmonary Fellows to Start Interventional Pulmonary Fellowship
Authors: DeMarco Benjamin , Ibanez Harold , Pai Cheryl , Batra Hitesh , Argento Angela Christine , Thiboutot Jeffrey , Akulian Jason , Yarmus Lonny , Lee Hans 
Published: September 2024

Background:
Entry into the interventional pulmonary (IP) fellowship requires prerequisite training in pulmonary and critical care medicine (PCCM) fellowship in the United States. IP fellowship has become standardized, but the prerequisite training may be quite variable depending on the learner’s exposure to IP during their PCCM fellowship. A survey study was conducted to identify potential foundational knowledge and/or skills gaps of new fellows entering IP fellowships. This may help both PCCM and IP fellowship directors to identify common knowledge gaps within PCCM training specific to IP.

Methods:
Based on components of the ACGME’s common program requirements for PCCM fellowships, a survey was developed and categorized into 5 domains: nonprocedural skills, didactic knowledge, diagnostic bronchoscopy, pleural procedures, and airway/percutaneous procedures. The survey was then sent to 42 IP fellowship directors after the content validity review and approval by the Association of Interventional Pulmonary Program Directors.

Results:
The survey response rate was 88.1% (37/42). The overall mean scores in all 5 domains were perceived as below competent (<3). The highest mean domain was nonprocedural skills, and the lowest was airway/percutaneous procedures. Within the domains, there were 4/ 30 topics that were considered competent with a score of ≥3 as competent or higher; bronchoscopy lavage (mean: 3.5/5, SD: 0.87), interpersonal skills (mean: 3.03/5, SD: 0.76), thoracentesis (mean: 3.14/5, SD: 0.89), and ultrasound for pleural effusion (mean: 3.19/5, SD: 0.84).

Conclusion:
There are perceived gaps in PCCM training pertaining to IP fellowship readiness.
Informing Decision-making for Transected Margin Reresection in Intraductal Papillary Mucinous Neoplasm-derived PDAC
Authors: Habib Joseph R. , Rompen Ingmar F. , Kinny-Köster Benedict , Campbell Brady A. , Andel Paul C.M. , Sacks Greg D. , Billeter Adrian T. , van Santvoort Hjalmar C. , Daamen Lois A. , Javed Ammar A. , Müller-Stich Beat P. , Besselink Marc G. , Büchler Markus W. , He Jin , Wolfgang Christopher L. , Molenaar I. Quintus , Loos Martin 
Published: September 2024

Objective:
To assess the prognostic impact of margin status in patients with resected intraductal papillary mucinous neoplasms (IPMN)-derived pancreatic ductal adenocarcinoma (PDAC) and to inform future intraoperative decision-making on handling differing degrees of dysplasia on frozen section.

Summary Background Data:
The ideal oncologic surgical outcome is a negative transection margin with normal pancreatic epithelium left behind. However, the prognostic significance of reresecting certain degrees of dysplasia or invasive cancer at the pancreatic neck margin during pancreatectomy for IPMN-derived PDAC is debatable.

Methods:
Consecutive patients with resected and histologically confirmed IPMN-derived PDAC (2002-2022) from six international high-volume centers were included. The prognostic relevance of a positive resection margin (R1) and degrees of dysplasia at the pancreatic neck margin were assessed by log-rank test and multivariable Cox-regression for overall survival (OS) and recurrence-free survival (RFS).

Results:
Overall, 832 patients with IPMN-derived PDAC were included with 322 patients (39%) having an R1-resection on final pathology. Median OS (mOS) was significantly longer in patients with an R0 status compared to those with an R1 status (65.8 vs. 26.3 mo P<0.001). Patients without dysplasia at the pancreatic neck margin had similar OS compared to those with low-grade dysplasia (mOS: 78.8 vs. 66.8 months, P=0.344). However, high-grade dysplasia (mOS: 26.1 mo, P=0.001) and invasive cancer (mOS: 25.0 mo, P<0.001) were associated with significantly worse OS compared to no or low-grade dysplasia. Patients who underwent conversion of high-risk margins (high-grade or invasive cancer) to a low-risk margin (low-grade or no dysplasia) after intraoperative frozen section had significantly superior OS compared to those with a high-risk neck margin on final pathology (mOS: 76.9 vs. 26.1 mo P<0.001).

Conclusions:
In IPMN-derived PDAC, normal epithelium or low-grade dysplasia at the neck have similar outcomes while pancreatic neck margins with high-grade dysplasia or invasive cancer are associated with poorer outcomes. Conversion of a high-risk to low-risk margin after intraoperative frozen section is associated with survival benefit and should be performed when feasible.
Deep Learning-Based Detection of Reticular Pseudodrusen in Age-Related Macular Degeneration on Optical Coherence Tomography
Authors: Kumar Himeesh , Bagdasarova Yelena , Song Scott , Hickey Doron G. , Cohn Amy C. , Okada Mali , Finger Robert P. , Terheyden Jan H. , Hogg Ruth E. , Gabrielle Pierre-Henry , Arnould Louis , Jannaud Maxime , Hadoux Xavier , van Wijngaarden Peter , Abbott Carla J. , Hodgson Lauren A.B. , Schwartz Roy , Tufail Adnan , Chew Emily Y. , Lee Cecilia S. , Fletcher Erica L. , Bahlo Melanie , Ansell Brendan R.E. , Pébay Alice , Guymer Robyn H. , Lee Aaron Y. , Wu Zhichao 
Published: September 2024

ABSTRACTReticular pseudodrusen (RPD) signify a critical phenotype driving vision loss in age-related macular degeneration (AMD). Their detection is paramount in the clinical management of those with AMD, yet they remain challenging to reliably identify. We thus developed a deep learning (DL) model to segment RPD from 9,800 optical coherence tomography B-scans, and this model produced RPD segmentations that had higher agreement with four retinal specialists (Dice similarity coefficient [DSC]=0·76 [95% confidence interval [CI] 0·71–0·81]) than the agreement amongst the specialists (DSC=0·68, 95% CI=0·63–0·73;p<0·001). In five external test datasets consisting of 1,017 eyes from 812 individuals, the DL model detected RPD with a similar level of performance as two retinal specialists (area-under-the-curve of 0·94 [95% CI=0·92–0·97], 0·95 [95% CI=0·92–0·97] and 0·96 [95% CI=0·94–0·98] respectively;p≥0·32). This DL model enables the automatic detection and quantification of RPD with expert-level performance, which we have made publicly available.
Adjusting for specificity of symptoms reveals higher prevalence of asymptomatic SARS-CoV-2 infections than previously estimated
Authors: Tiwari Akshay , Chowdhury Shreya , James Ananthu , Chatterjee Budhaditya , Dixit Narendra M. 
Published: September 2024

ABSTRACTAccurate estimates of the prevalence of asymptomatic SARS-CoV-2 infections,ψ, have been important for understanding and forecasting the trajectory of the COVID-19 pandemic. Two-part population-based surveys, which test the infection status and also assess symptoms, have been used to estimateψ. Here, we identified a widely prevalent confounding effect that compromises these estimates and devised a formalism to adjust for it. The symptoms associated with SARS-CoV-2 infection are not all specific to SARS-CoV-2. They can be triggered by a host of other conditions, such as influenza virus infection. By not accounting for the source of the symptoms, the surveys may misclassify individuals experiencing symptoms from other conditions as symptomatic for SARS-CoV-2, thus underestimatingψ. We developed a rigorous formalism to adjust for this confounding effect and derived a facile formula for the adjusted prevalence,ψadj. We applied it to data from 50 published serosurveys, conducted on the general populations from 28 nations. We found thatψadjwas significantly higher than the reported prevalence,ψc(P=3×10−8). The medianψadjwas ∼60%, whereas the medianψcwas ∼40%. In several instances,ψadjexceededψcby >100%. These findings suggest that asymptomatic infections have been far more prevalent than previously estimated. Our formalism can be readily deployed to obtain more accurate estimates ofψfrom standard population-based surveys, without additional data collection. The findings have implications for understanding COVID-19 epidemiology and devising more effective interventions.
Gendered resistances and emotions to neo-liberalism in a post-1992 university in England
Authors: Tsouroufli Maria , Walton Anita , Thompson David 
Published: September 2024

PurposeIn this paper we explore the gendered ways in which academic staff resistance and compliance is configured in a post-1992 University in England, including the emotions implicated in the navigation of neo-liberalisation and research intensification of their academic institution and its associated disciplinarian mechanisms.Design/methodology/approachWe draw on data from an interview study of a diverse sample of 32 academics of different gender, discipline and academic grade. Analysis informed by a feminist post-structuralist framework of power and discourse explored different forms of academic resistance and compliance; how the embodied academic subject was (re)negotiated within gendered discourses of neo-liberal research excellence and managerialism and the gendered emotions generated in processes of resistance and compliance.FindingsInstitutional change and expectations to engage with research performativity generated fear, anxiety and anger. Female staff appeared to actively resist the masculinized research subject performing all hours work and individualism in the context of private and institutional gendered relations and labour. Male staff though actively resisted the feminization of higher education and the neo-liberal instrumentalization of caring and therapeutic cultures and ideologically resisted the surveillance mechanisms of higher education including the REF.Research limitations/implicationsOur work contributes to scholarship problematizing the assumed neutrality of resistance and compliance and highlighting women’s symbolic struggle to (dis)identify with a masculine professional norm. In terms of theorising academic resistance to neo-liberalism and identity construction, further attention should be given to the mobilization and symbolic capital of academics and emotions positioned differently due to their gender and intersecting differences.Originality/valueOur study addresses a gap in the scholarship of academic resistance and compliance by advancing the understanding of gender inequalities and emotions implicated in the process of resistance and compliance against neo-liberalism.
The impact of superstition on corporate tax avoidance: how do CEOs trade off risks associated with tax avoidance?
Authors: He Guanming , Shen Dongxiao 
Published: September 2024

PurposeWe examine how superstition shapes corporate tax avoidance and do so by taking a risk perspective and focusing on the zodiac-year belief prevalent in China.Design/methodology/approachWe adopt a difference-in-differences research design to compare the degree of corporate tax avoidance in the CEOs’ zodiac year with that in the adjacent years. We do propensity-score matching to form a sample of Chinese listed firms for the regression analysis.FindingsWe find causal evidence that firms exhibit a greater magnitude of tax avoidance in the CEOs’ zodiac years, a result attributable to relatively weak tax enforcement in the Chinese context. We also find that the zodiac-year effect on corporate tax avoidance is more pronounced for firms with tight financial constraints, firms with high business risk, firms headquartered in regions with a high degree of superstition and non-state-owned firms.Originality/valueThis study is the first to show that superstition is a determinant factor of tax avoidance and contributes to the tax literature by shedding light on the behavioral risk factors that shape corporate tax avoidance. We take the perspective of CEOs’ risk appetite to analyze how tax avoidance is influenced by the CEOs’ trade-off between the costs and benefits of avoiding taxes. Our results suggest that, when CEOs are more risk-averse, they attach more importance to financial risk than the risk of reputational losses and litigation associated with corporate tax avoidance. The findings imply that tax avoidance can be curbed by increasing (or decreasing) the tax (financial) risk confronting the CEOs.