bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing women’s satisfaction with well-woman services at the Manhyia Government Hospital, Ghana
Authors: Agyei Agnes Ampofo , Amponsah-Tabi Seth , Dassah Edward Tieru , Ansong Eric Sarpong , Kankam Maxwell , Peprah Amponsah , Senaya Charles , Annan John Jude Kweku , Reindorff Roderick Larsen , Opare-Addo Henry S 
Published: February 2025

Introduction: The provision of well-woman services to women is a very good intervention for promoting good health and well-being among women. Despite data needed to inform increasing accessibility to well-woman services, there is limited information about client’s satisfaction with well-woman services. Objective: This study was conducted to determine factors influencing women’s satisfaction with well-woman services at Manhyia Government Hospital. Design: An analytical cross-sectional study was conducted among women attending the well-woman clinic at the Manhyia Government Hospital, Kumasi from 10 May 2023 to 15 November 2023. Methods: A systematic sampling method was employed. A pretested structured questionnaire was used to collect data on participants’ socio-demographic and clinical characteristics, health-facility-related factors, barriers to utilization and client satisfaction. A face-to-face interview was conducted for every woman included in the study. Data were analyzed using multivariable logistic regression analysis. p-Value for statistical significance was set at p < 0.05. Results: Of the 344 women who were recruited for the study, majority (65.7%) of them were satisfied with care at the well-woman clinic. About 59.3% of the women were willing to continue care at the clinic. The age range was 18–60 with mean of 34.6 ± 12.0 years. Some of the challenges the women reported in accessing well-woman services at the clinic included long waiting times (17.7%) and inadequately skilled staff (8.1%). After adjusting for significant variables in the multivariable logistic regression analysis (adjusted odds ratio (AOR)), comfortability of the waiting area (AOR: 7.71, 95% CI: 1.54–38.60), <6 months duration of accessing care (AOR: 8.82, 95% CI: 3.25–23.98) and friendly attitude of health workers (AOR: 27.03, 95% CI: 4.28–170.83) were significantly associated with the client’s satisfaction with well-woman services. Conclusion: There was high satisfaction with well-woman services at the clinic, and this was associated with factors such as duration of service, comfortability of the waiting area and the attitude of health workers. Training more skilled staff and expanding the clinic will help improve well-woman services.
Evaluating Medical Student Engagement in Flipped Classrooms: Insights on Motivation and Peer Learning
Authors: Khadawardi Khalid , Mirdad Dahlia , Nasief Hisham , Hassan Amber , Waseem Humaira , Butt Ammara , Aldardeir Njoud E. , Salah Wed , Zakariyah Abeer F. , Alboog Abdulrahman 
Published: February 2025

BACKGROUND Flipped classrooms have gained popularity for their ability to improve educational outcomes by flipping traditional teaching approaches and fostering interactive learning settings. Our study aims to assess the impact of these classrooms on medical students’ motivation, critical thinking skills, and facilitation of collaborative learning. METHODS A quasi-experimental study was conducted to involve quantitative surveys administered to students both before and after the teaching session. A predefined questionnaire was used to assess 5 key outcomes: Motivation, Critical Thinking, Student-centered learning, Learning benefits, and Peer-Assisted Learning. Data were collected at 2 points to capture changes throughout the intervention. RESULTS The introduction of the flipped classroom approach led to a significant improvement in medical student performance, with average test scores rising from 13.25 ± 2.36 to 16.08 ± 1.5 ( P < .05). Students’ perceptions of the flipped classroom also improved, with the impact scale score increasing from 41.91 ± 4.9 to 69.71 ± 9.72 ( P < .05). There was a statistically significant difference before and after the engagement, suggesting that the flipped classroom approach successfully improved students’ motivation, engagement, collaborative learning, and critical thinking skills. CONCLUSION Our findings highlight the positive efficacy of flipped classrooms in creating a more interactive and supportive learning environment. The study concludes with recommendations for educators on how to implement best practices to enhance student engagement and improve learning outcomes in flipped classroom settings.
Mannose-6-phosphate attenuates acute lung injury by competitive release of acid sphingomyelinase from the mannose-6-phosphate receptor in endothelial caveolae
Authors: Jiang Tian , Samapati Rudi , Klassen Sergej , Winoto-Morbach Supandi , Mohamed Zain H. , Göggel Rolf , Yin Jun , Tan Lijie , Arenz Christoph , Schulz Sabrina , Erfinanda Lasti , Preissner Robert , Simmons Szandor , Schütze Stefan , Uhlig Stefan , Kuebler Wolfgang M. 
Published: February 2025

BackgroundPlatelet-activating factor (PAF)-induced pulmonary endothelial barrier failure is mediated by acid sphingomyelinase (ASM) translocation to caveolae. ASM, however, lacks a transmembrane domain for anchoring inside caveolae. We hypothesized that ASM may anchor to cation-independent mannose-6-phosphate receptor (CI-M6PR) in caveolae from where it can be competitively released by M6P.MethodsWe probed for ASM-CI-M6PR interaction by co-immunoprecipitation (Co-IP) and proximity ligation assay (PLA) in isolated lungs and human pulmonary microvascular endothelial cells (hPMVECs). ASM release by M6P was determined in hPMVECs, isolated lungs andin vivo. Effects of M6P i) on PAF-induced lung edema formation and endothelial Ca2+concentration ([Ca2+]i), and ii) lung injury in acid instilled, overventilated mouse lungs were tested. ASM levels were measured in serum and bronchoalveolar lavage fluid (BALF) of ARDS patients. The TriNetX database was probed for the association of ASM-inhibiting tricyclic antidepressants (TCA) with outcome.ResultsCo-IP and PLA revealed ASM interaction with CI-M6PR in endothelial caveolae, which was further increased by PAF. M6P, but not glucose-6-phosphate (Glu6P) caused ASM release, thereby decreasing ASM content and activity in caveolaein vitro,in situandin vivo. Analogously, M6P, yet not Glu6P attenuated PAF-induced endothelial [Ca2+]isignaling and lung edemain situ, and acute lung injuryin vivo. ASM levels were increased in serum, yet not BALF in ARDS patients. Use of TCA was associated with better outcome in patients with severe respiratory infections.ConclusionsCI-M6PR anchors ASM in caveolae. M6P may hence present a promising strategy against ASM-related lung injury and edema.
Factors associated with low adherence to inhaled therapy in patients with chronic respiratory diseases: a cross-sectional study
Authors: Murillo Esther Ribes , Mora Josep Ramon Marsal , Bachiller Marta Micol , Santiago Leonardo Galván , Braqué Núria Nadal , Bravo Marta Ortega 
Published: February 2025

Abstract

Background
Because of their high prevalence, chronic respiratory diseases, like asthma and chronic obstructive pulmonary disease, represent main public health problems. They are mainly treated through inhaled therapy. There is low adherence to such therapy, resulting in poor control of chronic respiratory diseases. However, more research is needed on the association of several factors with low adherence.
The purpose of this study was to estimate the association of age, sex, type of drug, and frequency of administration with low adherence to inhaled therapy. In order to do this, we performed a cross-sectional study.

Methods
We selected all patients treated with long-acting anticholinergics (LAMA), long-acting β2-adrenergics (LABA), LAMA/LABA, or inhaled corticosteroid (ICS)/LABA in the Health Area of Lleida on 16 March 2017. For each treatment, we determined the percentage of patients showing low adherence to therapy (less than 50%), calculated as drug boxes collected from the pharmacy with respect to the prescribed ones. Then, we analysed the association of age, sex, type of drug, and frequency of administration, with low adherence to therapy through a multivariate linear model.

Results
11,128 people had electronic prescriptions for one of the inhaled therapy; of them, 24.6% (2,741) showed low adherence. The highest percentage of people with low adherence was found among young patients and women. Women 25–34 years of age included the highest percentage of patients with low adherence. As for drugs, the highest percentage of patients with low adherence was found among the ones treated with LABA and ICS/LABA. Finally, a higher percentage of patients with an administration frequency of 12 h presented low adherence, in comparison with patients treated every 24 h, in general and in the LABA and ICS/LABA groups.

Conclusions
The differences that we observed in adherence to inhaled therapy according to the different factors analysed should be considered when managing chronic respiratory diseases and their impact on patients’ clinical burden, quality of life, and costs for the health system.
Benefits of a near-peer program from the tutors’ perspective: a survey of Australian junior doctors in a regional teaching program
Authors: Medveczky David , Mitchell Alicia , Leopardi Eleonora , Dawson Amanda 
Published: February 2025

Abstract

Background
Near-peer teaching has been shown to provide diverse benefits for both tutees and tutors in senior medical student and junior trainee settings. However, junior trainees may face more obstacles in teaching including competing clinical priorities and time management. We sought to investigate the challenges and benefits of engaging in near-peer teaching for junior trainees within our local context. Our Near-Peer Medical Teaching (NPMT) teaching program is designed and facilitated by junior doctors for medical students at the Central Coast Clinical School (University of Newcastle) of the Joint Medical Program.

Methods
Current and past NPMT tutors participated in an online survey from October 2022 to April 2023. Tutors were asked about feasibility of teaching within a work environment, perceived benefits from their experience and attitudes towards medical education.

Results
Teaching experience appears to be influenced by competing clinical priorities and convenience of session times, but it does not appear to exert considerable stress on tutors likely due to self-selection of tutors with prior enjoyable teaching experience. Furthermore, this study indicates that junior doctors derived enjoyment and developed clinical skills and professional qualities, which are important factors in increasing job satisfaction and ameliorating burn-out in this cohort.

Conclusions
Junior doctors appear to benefit from engaging in near-peer programs in the Australian teaching hospital setting. Further research should include qualitative methodologies to explore the perspectives of Australian junior doctors’ more deeply.
Cancer rehabilitation in clinical practice: a qualitative study exploring contact nurses’ views on prerequisites
Authors: Melander Wenche , Rosell Linn , Larsson Anna-Maria , Lagergren Pernilla , Malmström Marlene 
Published: February 2025

Abstract

Background
Individualized cancer rehabilitation should be an integral part of cancer care. Contact nurses play a key role in identifying patient needs and coordinating evidence-based interventions to support rehabilitation. However, cancer rehabilitation remains marginal in current practice, as contact nurses face challenges due to the lack of systematic processes for assessment, intervention, and follow-up, limiting its implementation across the cancer care trajectory. This study aims to explore contact nurses in cancer care views on their role in and prerequisites for cancer rehabilitation.

Methods
Data were collected through 20 individual interviews with contact nurses working in Swedish cancer care and analyzed using qualitative content analysis.

Results
A holistic approach to cancer rehabilitation was emphasized, yet establishing routines for assessment and addressing patients’ changing needs was described as challenging. Contact nurses experienced themselves as responsible for rehabilitation even though their role often was unclear. Rehabilitation was further seen as a process often determined by the medical trajectory rather than patients’ needs. To establish prerequisites for cancer rehabilitation supportive leadership and sufficient resources is essential.

Conclusion
There is a gap between cancer rehabilitation guidelines and their implementation in clinical practice, emphasizing the need for structure to support contact nurses to provide evidence-based individualized cancer rehabilitation. To enable cancer rehabilitation, supportive leadership at the organizational level is essential for contact nurses to establish routines in their clinical practice. These routines should align the rehabilitation process with patient needs, ensuring that rehabilitative services are effectively integrated into regular healthcare visits.

Clinical trial number
Not applicable.
Examining the impact of video-feedback and academic engagement on students’ feedback perceptions, feedback reviews, and academic achievement
Authors: Máñez Ignacio , Serrano-Mendizábal Marian , Descals Adela , García-Ros Rafael 
Published: February 2025

Abstract
Although student’s decision to review digitally-delivered feedback has received more attention over the last decade, the relationship of audiovisual formats of feedback and student’s academic engagement have rarely been investigated. This quasi-experimental study explores how written feedback and two video-feedback formats, each showcasing the instructor’s presence in different ways (audible or visual), influence students’ perceptions of feedback effectiveness, their decisions to review the messages, and their academic achievement. Given the pivotal role of student engagement in effectively processing instructor feedback, we further examine whether student engagement mediates or moderates the relationship between feedback format and both feedback review and academic achievement. Utilizing a digital learning platform, a total of 176 undergraduate students received generic feedback messages the day after submitting each assignment. Feedback was delivered in video format, with a particular focus on the instructor’s audible (VFA, n = 66) and visual presence (VFV, n = 72), or in written format (WF, n = 38). Results indicated that students were highly satisfied with the perceived effectiveness of the feedback format they received, and no significant differences in feedback review rates were observed across formats. However, students in both the VFV and VFA groups outperformed those in the WF group, with no significant differences between the VFV and VFA groups. Additionally, academic engagement moderated the relationship between feedback format and feedback review decisions, and mediated the relationship between feedback format and academic performance. These findings underscore the complexity of feedback effectiveness and suggest that instructor presence in video-feedback may impact academic outcomes. This study provides valuable insights for instructional designers and educators aiming to optimize feedback delivery in digital learning environments.
Clinical Characteristics of Toxicities of Immune Checkpoint Inhibitors and Their Impact on Efficacy in Solid Cancers: An Analysis of Real-World Data in Moroccan Patients
Authors: Batlamous Badiaa , Lkhoyaali Sihame , Omri Loubna , Nguema-Mipaka Magaly-Gwen-Farnely , Khalis Mohamed , Inrhaoun Hanane , Naciri Sarah , El Ghissassi Ibrahim , Mrabti Hind , Boutayeb Saber , Errihani Hassan 
Published: February 2025

PURPOSE
Patients receiving immune checkpoint inhibitors (ICIs) may induce immune-related adverse events (irAEs). This study aimed to evaluate the toxicity induced by ICIs and explore the correlation between efficacy and toxicity in a Moroccan population.

METHODS

We conducted a prospective study of patients with solid tumors who received pembrolizumab or atezolizumab at the
National Institute of Oncology, Rabat
from July 2018 to December 2023. We identified irAEs according to ASCO 2021 guidelines and graded them according to the Common Terminology Criteria for Adverse Events Version 4.0. Efficacy with respect to progression-free survival (PFS) and overall survival (OS) was determined. A Cox regression model was used to determine the association between irAEs and survival.

RESULTS

Eighty-six patients with solid tumors who received ICIs were included. The primary tumor types were lung (40.7%), skin (29.1%), and GI cancer (14%). The ICIs most commonly used included pembrolizumab (67.4%) and atezolizumab (32.6%). ICIs were used as monotherapy (77.9%) or in combination (22.1%). A total of 58 (67.4%) patients presented any kind of irAEs. The most common toxicities in both the monotherapy and combination groups were GI, with rates of 25.3% and 31.5%, respectively. Patients with irAEs showed significantly longer median PFS compared with those without irAEs (9
v
3.6 months; hazard ratio [HR], 0.5 [95% CI, 0.32 to 0.99];
P
= .04). The median OS was longer in patients with irAEs than in those without irAEs but was not statistically significant (19
v
10.3 months; HR, 0.8 [95% CI, 0.39 to 1.7];
P
= .5).

CONCLUSION
Our results indicated that ICIs have the potential to induce irAEs in patients with solid tumors. These adverse effects were commonly GI. The development of irAEs was associated with improved effectiveness of ICI treatment across different malignancies.
Radiotherapy and Nuclear Medicine Equipment Shortages in Vietnam: A Critical Gap in Cancer Care
Authors: Nguyen Dang Van , Pham Manh Duy , Hoang Thai Huu , Nguyen Binh Thanh 
Published: February 2025

PURPOSE
The aim of this study was to evaluate the current availability and distribution of radiotherapy (RT) and nuclear medicine equipment in Vietnam, focusing on the shortage of linear accelerators (LINACs), positron emission tomography/computed tomography (PET/CT) scanners, and brachytherapy units. The study seeks to quantify these shortages and highlight the implications for cancer treatment access and outcomes.

METHODS
Data were collected from 50 hospitals across Vietnam that provide RT services or nuclear medicine imaging. The availability of LINACs, PET/CT devices, brachytherapy units, and other essential equipment was assessed, alongside patient loads and machine utilization rates. National data were compared with the standard in developed countries, with a particular focus on the International Atomic Energy Agency's (IAEA) recommendations for RT infrastructure.

RESULTS
Vietnam has a total of 82 LINACs, resulting in a LINAC density of 0.82 per million people, which is far below the standard in developed countries of 4-8 per million. Of the existing LINACs, 43% are outdated and unable to deliver advanced RT techniques such as volumetric modulated arc therapy. Additionally, the country has only 12 PET/CT scanners and three cyclotrons, which limits access to early cancer diagnosis and treatment planning. The central region of Vietnam is particularly underserved, with only 1 PET/CT device and limited access to brachytherapy services. Long wait times for RT—often up to 2 weeks—are common, leading to delayed treatments and reduced treatment efficacy. Patients, particularly those with conditions requiring timely RT after chemotherapy, face increased risks because of these delays.

CONCLUSION
The shortage of modern RT and nuclear medicine equipment in Vietnam critically limits timely access to cancer treatment, affecting patient outcomes and placing a heavy burden on health care providers. Expanding access to advanced RT technology through government investment, public-private partnerships, and international collaborations with organizations such as the IAEA could alleviate these challenges. Increasing Vietnam's RT capacity is essential for improving cancer care outcomes and managing the rising burden of cancer across the country.
Governments' policies and public vaccination under major epidemics: An evolutionary game perspective
Authors: Fan Hongjie , Wang Jun , Wang Kai , Zhu Yanling 
Published: February 2025

Abstract
Using government vaccine subsidies, public trust and individual physical and mental health losses as the core factors, this study develops a finite rationality-based evolutionary game model aimed at exploring evolutionary stabilisation strategies (ESS) in different contexts. Through simulation analyses, it is found that the strict control strategy adopted by the government can significantly enhance its benefits in the context of voluntary public vaccination against the vaccine. Further, when the government implements a strict prevention and control policy and the benefits of public vaccination are significantly increased under this policy, the system will tend to reach the optimal equilibrium state (vaccination, strict prevention and control
Introduction: Narrating and Translating Sexual Violence in Wartime in the Middle East and North Africa (MENA) Region
Authors: Daoudi Anissa 
Published: February 2025

Abstract
This article is part of a larger project that explores the phenomenon of sexual violence as a weapon of war in the MENA region. In particular, it demonstrates the “untranslatability” of memories of rape in the Algerian Civil War—that is, both the inability to put into words this experience of trauma and the challenge of translating testimonies from the many languages used in Algeria into Arabic. The importance of translating this issue stems from the multilingual nature of the region, Algeria in particular, and the need to bridge the gap in knowledge between what is published in these languages. The key findings of this research relate to the relationship between language, narration, and memories of violence and the effect of (national) silence on the individual's experience of trauma. Women's empowerment begins by giving them a platform to narrate their stories to complete the missing pages of history. By doing so, women are not only putting the record straight but also helping other women (locally, regionally, and globally) to advance in their just fight against patriarchy, injustice, and inequality.
Richard Wright Theorizes Surrealism
Authors: Garcia Jay 
Published: February 2025

Abstract
The posthumous 2021 publication of the full unexpurgated version of Richard Wright's The Man Who Lived Underground, paired with his essay “Memories of My Grandmother,” also published for the first time, opens a new phase of inquiry into his work. The essay, in particular, reveals how immersed Wright became in discussions of surrealism and how he worked to give it specific inflections as he moved toward new projects in the early to mid-1940s. Developing his own terms, among them “enforced severance,” Wright brings them into the realm of surrealist aesthetic theorization. The essay demonstrates the highly antinomian and intellectually hybrid quality of Wright's thought as he moved away from the political and theoretical grounding that had been supplied by his CPUSA years. Returning to this moment of Wright's trajectory with an emphasis on the essay, this consideration offers an alternative picture of the canonical author and suggests pathways into his work made available by the newly available writings.