bluuebunny/crossref_metadata_2025_split huggingface dataset:
A competency framework for simulation facilitation in low‐resource settings: a modified Delphi study
Authors: Mossenson Adam I. , Livingston Patricia , Brown Janie A. , Khalid Karima , Rubio Martinez Rodrigo 
Published: October 2024

SummaryBackgroundSkilled facilitators are essential to drive effective simulation training in healthcare. Competency‐based frameworks support the development of facilitation skills but, to our knowledge, there are no frameworks that specifically address context‐sensitive priorities developed with practitioners working in low‐resource settings.MethodsWe aimed to develop a core competency framework for healthcare simulation facilitation in low‐resource settings using a modified Delphi process. We drew on the domain expertise of members of the Vital Anaesthesia Simulation Training Community of Practice, with the study guided by a four‐member steering group experienced in the conduct of simulation in low‐resource settings. In survey round 1, participants (n = 54) were presented with an initial competency set derived from a previous qualitative study and co‐created a set of 57 competencies for effective simulation facilitation in low‐resource settings. In survey round 2, participants (n = 52) ranked competencies by relevance into three performance categories: techniques; artistry; and values. In survey round 3, participants (n = 50) ranked competencies on their importance. The steering group collated results and presented a draft core competency framework. In survey round 4, participants (n = 50) voted with 98% agreement that this framework represented the most relevant and important competencies for effective facilitation of simulation sessions in low‐resource settings.ResultsThe final 32‐item framework encompasses core competencies found in existing standards and includes important new concepts such as demonstration of cultural sensitivity; humility; ability to recognise and respond to potential language barriers; facilitation team collaboration; awareness of logistics; and contingency planning.DiscussionThis competency‐based framework highlights specific practices required for effective simulation facilitation in low‐resource settings. Further work is required to refine and validate this tool to train simulation facilitators to deliver effective training to improve patient safety.
More the merrier? influence of mango orchards on the composition of the reptile communities of the lateritic plateaus, Maharashtra, India
Authors: Amberkar Prathamesh , Mungikar Rahul 
Published: October 2024

AbstractChange in land‐use patterns affects a landscape by changing the composition of local flora and fauna. The lateritic plateaus in Konkan are one such example of this rapid land‐use change. Although these plateaus are rich in endemic flora and fauna, they are considered as “wastelands” due to lack of woody vegetation and thus, are subjected to various land‐uses. Mango cultivation in this region has become a major source of income due to its Alphonso variety of mangoes. Hence, over the last few decades, many plateaus have been converted into mango orchards. However, how the conversion of plateaus to mango orchards has affected species composition of different groups of organisms remains unclear. In the present study, we sampled the lateritic plateaus and plateaus converted into mango orchards in Ratnagiri, Maharashtra, to investigate the response of the reptile communities. We observed more species heterogeneity in the orchards compared to the unaltered sites. Moreover, it appeared that there was a species turnover when the plateaus were converted into orchards. The generalist and widespread species such as agamids and skinks and very few specialist species were comparatively more abundant in the orchards. On the contrary, the plateaus without orchards harbored more specialist species such as Hemidactylus albofasciatus (n = 62, in unaltered sites vs. n = 5 in the orchards), Echis carinatus (n = 15 in unaltered sites and none in the orchards) and Ophisops jerdonii (n = 45 in unaltered site vs. n = 12 in the orchards) compared to the generalist species.
Outcomes reported in elective colorectal cancer surgery research for older patients: A scoping review
Authors: Xavier Hepsi H. , Bhattacharya Yagnaseni , Poobalan Amudha , Brazzelli Miriam , Ramsay George 
Published: October 2024

AbstractAimColorectal cancer rates are increasing in older populations, who often have comorbidities and face higher surgical risks and mortality rates. Therefore, surgical outcomes, such as 5‐year mortality rates, may not be appropriate, necessitating a focus on postoperative quality of life. However, determining optimal postoperative outcome measures for older colorectal cancer patients poses a challenge. This scoping review aimed to explore currently available data describing postoperative outcomes used to assess older patients undergoing elective colorectal cancer surgery.MethodWe conducted a comprehensive literature search of major electronic databases from inception to March 2023. Studies exploring frail or older individuals with colorectal cancer undergoing elective surgical procedures, and which reported postoperative outcomes, were included. Outcomes were categorized as surgery‐specific versus person‐centred and summarized using narrative synthesis. The type and rate of surgery‐specific outcomes were tabulated.ResultsOf 1366 identified citations, 16 studies focused on person‐centred outcomes and 66 reported exclusively on surgery‐specific outcomes. Nine ‘person‐centred outcome’ studies reported discharge destination, primarily home discharge. Postoperative delirium ranged from 8.2% to 18.1% in six studies. Four studies explored geriatric syndromes, three analysed activities of daily living, and three studies reported significant quality of life improvement. The 66 ‘surgery‐specific outcome’ studies assessed mortality (N = 61); length of stay (N = 40); postoperative complications (N = 47); readmission (N = 18); reoperation (N = 16); and survival (N = 42).ConclusionPerson‐centred outcomes are underreported, but crucial for guiding patient management. Older patients require adequate information about their postoperative recovery period to enhance wellbeing. Future research must address this gap to improve care for older people undergoing elective colorectal cancer surgery.
Diagnostic ability and adverse events of mucosal incision‐assisted biopsy for gastric subepithelial tumors: Systematic review and meta‐analysis
Authors: Koizumi Eriko , Goto Osamu , Matsuda Akihisa , Otsuka Toshiaki , Ishikawa Yumiko , Nakagome Shun , Niikawa Masahiro , Habu Tsugumi , Yoshikata Keiichiro , Kirita Kumiko , Noda Hiroto , Higuchi Kazutoshi , Onda Takeshi , Omori Jun , Akimoto Naohiko , Yoshida Hiroshi , Iwakiri Katsuhiko 
Published: October 2024

ObjectivesThis systematic review and meta‐analysis aimed to evaluate the diagnostic ability and examine the efficacy of countermeasures to adverse events of mucosal incision‐assisted biopsy (MIAB) for gastric subepithelial tumors (SETs).MethodsWe performed a literature search and identified 533 relevant articles. Eleven articles, including 339 lesions, were ultimately used in the meta‐analysis. The primary end‐point was the pathological diagnostic rate of MIAB for gastric SETs, and the secondary end‐point was the incidence of adverse events. The efficacy of acid secretion inhibitors in preventing postoperative bleeding and that of local injection before incision to prevent perforation were also examined.ResultsNine studies were conducted in Japan and two in South Korea, of which only two were prospective studies. The pooled pathological diagnostic rate of MIAB for gastric SETs was 87.8% (95% confidence interval [CI] 80.2–94.0; I2 = 68.7%). The adverse event rate of the pooled population was 0.2% (95% CI 0–1.4; I2 = 0%). The acid secretion inhibitors significantly reduced postoperative bleeding (odds ratio 0.06, 95% CI 0.01–0.66, P = 0.02). Perforation occurred in 0% and 2.6% of the local and nonlocal injection cohorts, respectively, and the pathological diagnostic rates were 50% and 66.7%, respectively.ConclusionsMIAB is a reliable technique with a favorable diagnostic rate and few adverse events. Acid secretion inhibitors may effectively prevent postoperative bleeding; however, the efficacy of local injection remains unclear. This technique could be an option for tissue sampling in gastric SETs.
Time to response with ravulizumab, a long‐acting terminal complement inhibitor, in adults with anti‐acetylcholine receptor antibody‐positive generalized myasthenia gravis
Authors: Habib Ali A. , Benatar Michael , Vu Tuan , Meisel Andreas , Attarian Shahram , Katsuno Masahisa , Liao Serena , Beasley Kathleen N. , Howard James F. 
Published: October 2024

AbstractBackground and PurposeThe efficacy and safety of ravulizumab, a terminal complement C5 inhibitor, in adults with anti‐acetylcholine receptor antibody‐positive (AChR Ab+) generalized myasthenia gravis (gMG) were demonstrated in the CHAMPION MG study (NCT03920293). This analysis aimed to characterize the latency to onset of a clinically meaningful therapeutic effect for ravulizumab.MethodsPost hoc analysis of data collected for up to 60 weeks from CHAMPION MG was performed to assess the timing of response to ravulizumab. Response was analyzed based on reductions of ≥2 and ≥3 points (minimal clinically important differences [MCIDs]) in Myasthenia Gravis–Activities of Daily Living (MG‐ADL) and Quantitative Myasthenia Gravis (QMG) total scores, respectively, and on more rigorous reductions of ≥3 and ≥5 points, respectively. Time to first response was assessed using the Kaplan–Meier product‐limit method.ResultsThe median (95% confidence interval) time to first response was 2.1 (2.1–2.6) and 4.1 (2.3–10.0) weeks for reductions of ≥2 and ≥3 points in MG‐ADL total score, respectively (n = 139), and 4.1 (2.1–10.0) and 18.3 (11.0–33.4) weeks for reductions of ≥3 and ≥5 points in QMG total score, respectively (n = 134). Cumulative response rates at Week 60 (data cut‐off) were 88% and 82% for ≥2‐ and ≥3‐point MG‐ADL score reductions, respectively, and 86% and 59% for ≥3‐ and ≥5‐point QMG score reductions, respectively.ConclusionsThe median times to MCID with ravulizumab treatment in patients with AChR Ab+ gMG were ~2 weeks and ~4 weeks based on MCID MG‐ADL and QMG total score reductions, respectively.
Increased CRHR1 expression on monocytes from patients with AA enables a pro‐inflammatory response to corticotrophin‐releasing hormone
Authors: Guo Hong‐Wei , Lai Hui‐Jun , Long Bo‐Quan , Xu Li‐Xin , Wang Eddy Hsi Chun , Shapiro Jerry , McElwee Kevin J. 
Published: October 2024

AbstractStress may play a key role in alopecia areata (AA), though the exact interactions of stress with AA remain undefined. Corticotropin‐releasing hormone (CRH), the proximal regulator of the stress axis, has been recognized as an immunomodulatory factor in tissues and peripheral blood mononuclear cells (PBMCs). We used multicolour flow cytometry to identify receptor CRHR1 expression on PBMC subsets in AA patients (n = 54) and controls (n = 66). We found that CRHR1 was primarily expressed by circulating monocytes. CRHR1 expression on monocytes was enhanced in AA compared with controls (3.17% vs. 1.44%, p = 0.002, chi‐squared test). AA incidence was correlated to elevated CD14+ monocyte numbers (R = 0.092, p = 0.036) and markedly independently correlated with increased CRHR1 expression (R = 0.215, p = 0.027). High CRHR1 expression was significantly related to chronic AA (disease duration >1 year; p = 0.003, chi‐squared test), and large lesion area (AA area >25%; p = 0.049, chi‐squared test). We also observed enhanced percentages of active monocytes and reduced CD16+ CD3− NK cell numbers in AA patients' PBMCs (p = 0.010; 0.025, respectively). In vitro CRH treatment of PBMCs and human monocyte cell line THP‐1 promoted CD86 upregulation. The findings imply that stress‐related factors CRH and CRHR1 contribute to AA development and progression where higher CRHR1 expression is associated with chronic AA and larger lesions.
Lentigo Maligna and Lentigo Maligna Melanoma of the External Ear: Clinical and Dermoscopic Features of 19 Patients
Authors: Dika Emi , Venturi Federico , Veronesi Giulia , Veneziano Leonardo , Scotti Biagio 
Published: October 2024

ABSTRACTExternal ear lentigo maligna/lentigo melanoma (LM/LMM) represents approximately 1%–4% of all primary cutaneous melanomas. Over the past 20 years, dermoscopy has proven highly effective in early detection of LM/LMM, with recent studies identifying perifollicular linear projections (PLP) as a specific diagnostic criterion for early LM. However, in clinical practice, LM and LMM turn out to be very difficult to distinguish based on dermoscopic findings. Therefore, our retrospective monocentric study aimed to investigate dermoscopic characteristics, as well as the epidemiological and clinical data of 19 patients diagnosed with the external ear (EE) LM/LMM at the Oncologic Dermatology Unit in Bologna. Dermoscopic images were obtained using the FotoFinder Medicam 800HD, and specific criteria validated by the International Dermoscopy Society (IDS) for atypical pigmented facial lesions were assessed. Fisher's exact test was primarily used for statistical comparisons. As results, most of the patients were male (74%) with an average age (± SD) at diagnosis of 69.8 (± 15.1) years old. LMM appeared more commonly observed in elderly patients as compared to LM (mean 71.6 vs. 66.7, p = 0.514), presenting as pigmented macule (89.5%) of the ear lobule (23.9%). A statistically significant difference (p = 0.01) of tumour’ diameter between LMM and LM was reported with the first resulting more than twice the size of the latter. Concerning dermoscopic findings, asymmetric pigmented follicles, obliteration of the follicular openings and grey circles were more frequently observed in LMM compared to LM (63.2% vs. 31.6%; 63.2% vs. 26.3%; 47.4% vs. 15.8%, respectively).
Nrf2 Activation in Keratinocytes: A Central Role in Diabetes‐Associated Wound Healing
Authors: Kaussikaa Srinivasan , Prasad Murali Krishna , Ramkumar Kunka Mohanram 
Published: October 2024

ABSTRACTWound healing is a complex biological process crucial for tissue repair, wherein keratinocytes play a pivotal role in initiating, sustaining and completing the cascade. Various local and systemic factors, such as lifestyle, age metabolic disorders and vascular insufficiency, can influence this process, and in the context of diabetic wounds, disrupted biological mechanisms, including inflammation, tissue hypoxia, decrease in collagen production along with increased oxidative stress and keratinocyte dysfunction, contribute to delayed healing. During re‐epithelialisation, keratinocytes undergo rapid multiplication and migration, forming a dense hyperproliferative epithelial layer that restores the epidermal barrier. Nuclear factor‐erythroid 2‐related factor (Nrf2), a vital transcription factor, emerges as a central regulator in managing antioxidant proteins and detoxifying enzymes, serving as a guardian against elevated reactive oxygen species (ROS) levels during stress. Nrf2 also orchestrates angiogenesis and anti‐inflammatory responses crucial for wound repair. Studies demonstrate that under high‐glucose conditions, Nrf2 activation promotes wound healing by enhancing cell proliferation and migration while reducing apoptosis. Nrf2 activators stimulate endogenous antioxidant production, thereby mitigating oxidative stress. Furthermore, Nrf2 upregulation is associated with decreased expression of cytokines such as TNF‐α and IL‐ 6. Recent research underscores the potential of bioactive molecules, including dietary polyphenols, traditional medicinal compounds and pharmacological agents, in activating Nrf2 and preventing diseases such as diabetes due to their robust antioxidative properties. This review aims to investigate the activation of Nrf2 by these bioactive molecules in cultured keratinocytes and animal models, elucidating the key molecular regulatory mechanisms involved in alleviating oxidative stress and facilitating the diabetic wound healing process. Understanding these complex pathways may offer insights into novel therapeutic strategies for enhanced wound healing in diabetes‐associated complications.
The Love Jones Cohort and singlehood are family law issues
Authors: Martinez Phillips Kimberly , Marsh Kris 
Published: October 2024

AbstractThis article reviews the changing Black family and households. The core theme is to understand the uniqueness of those single and living alone in the Black middle class—the “Love Jones Cohort”—and how their intersecting identities of race, class, gender, and singleness inform their lifestyle, shape how they manage life decisions, and their relationship to policy as well as family law and family court. This essay moves beyond the popularized and omnipresent inquiry: “Why are Black women not getting married?” or “Why are there so many single professional Black women?” This line of questioning throws the spotlight squarely on Black women's individual dating practices, while often ignoring structural factors that undergird those decision‐making processes. It implies that because of the individual actions of the Love Jones Cohort, specifically Black women, they are somehow at a deficiency if they are not married and child‐free, rendering them invisible as a family. This article discusses the legal implications of the presence of the Love Jones Cohort.
A HOUSE WITH EXPOSED BEAMS: INQUIRY‐BASED LEARNING AND HISTORIANS’ ETHICAL RESPONSIBILITIES AS SCHOLAR‐TEACHERS
Authors: Conn Zachary 
Published: October 2024

ABSTRACTThis is an article about the relationship between historical scholarship and pedagogy. The teaching of history can itself be seen as a meaningful form of historical scholarship and poses some of the same methodological, theoretical, and ethical questions as historical research, albeit usually generating quite different answers to the queries. I delve into three sets of questions that are of significance to historians in our roles as researchers and as teachers. In scholarship and in teaching, it pays to consider the relationship between authority and humility. In the library and the classroom, there is a balance to be struck between narrative and analysis. In both settings, one must at times choose between historicist particularity and human universalism. I discuss each set of tensions with reference to such thinkers as Paulo Freire, bell hooks, and Friedrich Nietzsche. In each case, I also draw on my own experience in the classroom, particularly my time teaching tenth‐grade world history. Throughout, I suggest that intellectually and ethically flourishing history classrooms are often “houses with exposed beams,” in which teachers initiate students as junior members in communities of historical inquiry, often, though not always, through collaborative analyses of revealing primary documents.
Duration versus accuracy—what matters for computerised adaptive testing in schools?
Authors: Ebenbeck Nikola , Bastian Morten , Mühling Andreas , Gebhardt Markus 
Published: October 2024

AbstractBackgroundComputerised adaptive tests (CATs) are tests that provide personalised, efficient and accurate measurement while reducing testing time, depending on the desired level of precision. Schools have different types of assessments that can benefit from a significant reduction in testing time to varying degrees, depending on the area of application, but for which the loss of measurement accuracy has a different impact. The implementation of CAT can take several approaches, each of which can potentially affect the resulting test length and accuracy.ObjectivesWe compare the methods of estimation‐based CAT and binary‐search‐based CAT to determine the extent to which they are suitable for school assessment in terms of their length and accuracy.MethodsThis study uses simulations based on empirical data from a cohort of pupils with and without special needs (n = 400) to examine the effects of probabilistic estimation‐based CAT and deterministic binary‐search‐based CAT on the length and accuracy of an adaptive reading test for pupils with different ability levels.Results and ConclusionsEstimation‐based CAT leads to a 40% test reduction with an average accuracy of r = 0.96, while binary‐search‐based CAT leads to a test reduction of up to 88% with an average accuracy of r = 0.83. Both methods demonstrate the applicability of CAT in educational environments. Practical advantages and disadvantages of both methods for learning environments are discussed, as well as which method is best suited for specific assessment needs.
Understanding the Experiences of Nurses' Work: Development and Psychometric Evaluation of an End of Shift Survey
Authors: Parr Jenny M. , Slark Julia , Lawless Jane , Teo Stephen T. T. 
Published: October 2024

ABSTRACTAimTo explore and validate an end of shift survey with a low response burden, practical application and generated evidence of related associations between workload, quality of work and patient care, missed care and job satisfaction.DesignA retrospective cross‐sectional survey of the experiences of nursing staff.MethodsData were collected from 265 nurses who responded to a questionnaire at the end of their shift in 2022. Exploratory factor analysis was undertaken using IBM SPSS v.27 and confirmatory factor analysis was undertaken using IBM AMOS v27. Hypotheses testing was undertaken using IBM SPSS v.27 using multiple regression analyses.ResultsAll of the hypotheses were supported. There was a negative association between workload and quality of work and job satisfaction. Quality of work was negatively associated with workload and missed care and positively associated with job satisfaction. The association between missed care and job satisfaction was negative.ConclusionThe EOSS is a valid and reliable tool with a low response burden. The tool supports previous research which demonstrated there is a negative relationship between level of workload and shift type with satisfaction, quality of work and potentially nurse retention.Implications for the Profession and/or Patient CareIn the context of a global nursing shortage nursing leaders must ensure that care we provide is of the highest quality. We must take every action to address high workload to reduce the risk that fundamental care is not sacrificed, job satisfaction is improved and nurses remain in the profession. The EOSS gives nurse leaders a reliable, practical, consistent, applied tool that will better enable associations to be observed between resource configuration, workload and critical impacts on nursing and patient care.Reporting MethodWe have adhered to the relevant EQUATOR guidelines using the STROBE reporting method.Patient or Public ContributionNo Patient or Public Contribution.