bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hematology/oncology clinical investigator training: Is current model of education adequate?
Authors: Shergill Ardaman , Cahill Kirk , Major Ajay , Patel Anand Ashwin , Cohen Kenneth Stuart , O'Donnell Peter H. 
Published: June 2024

9005 Background: Clinical investigator training (CIT) is commonly performed in an apprenticeship manner rather than following a prospective education model. This may lead to disparities in educational prospects. There is greater accesiblity for training opportunites prevailing in larger academic institutions – an advantage not always within reach for majority of oncology patients and professionals. Lack of predefined standard competencies during fellowship training may lead to significant heterogeneity, weaken the current pipeline, and decrease the number of principal investigators (PIs) for clinical trials. We performed a national needs assessment to understand oncology trainee and faculty perceptions of CIT. Methods: Program directors and leaders at 102 U.S. hematology/oncology (hem/onc) fellowship programs were contacted via email to invite their respective trainees and faculty to answer a 32-question cross-sectional survey. The study was IRB excempt. The survey was developed with the University of Chicago Survey Lab. Four thematic areas were interrogated: current level of experience in CI, knowledge of PI roles and responsibilities (R/R), areas of perceived weakness/lack of confidence related to CI, and interest in a course that teaches CI. Response frequencies and descriptive statistics were analyzed, with the goal of informing future targeted educational initiatives. Results: 207 respondents from 47/102 (46%) institutions completed the survey between 5/2023 – 11/2023. Respondents included 92 (40%) trainees and 137 (60%) attendings, 47% were men, 47% women and 57% had more than 9 years of experience as an attending post-speciality training. Among attendings, only 4.4% reported never participating in CIT, compared to 55.4% of trainees. Informal or “on the job” teaching was the most common method of learning PI R/R with response rate of 58% in attendings and 62% in trainees. Trainees reported lack of confidence and need for education in all aspects of CIT, and 85% indicated high level of interest in enrolling in a CIT course. Most attendings reported lack of confidence in areas of budget development (57%), quality of life (70%) and translational correlatives (51%). Others reported feeling weaknesses in designing primary and secondary end points (32%), letter of intent writing (33%) and creating protocols (31%). 53% of the attendings were interested in enrolling in a CIT course. Conclusions: To our knowledge, this is the first reported survey formally assessing current perceptions of preparedness in CIT within hem/onc in the U.S. Our findings strongly indicate that CIT educational gaps exist, even for attendings with prior CIT experience, and that training deficits are marked for trainees. A structured, practical, and widely-accessible CIT program is urgently needed to prepare the future hem/onc workforce. Acknowledgement: MERITS program and Section of Hem/Onc at University of Chicago.
Artful oncology: A comprehensive psychosocial oncology curriculum for hematology/oncology fellows.
Authors: Al-Mondhiry Jafar , Walker Kimberly Lowery , Bires Jennifer , Caulkins Leigh Ann , Hughes Cheryl , Mohess Denise , Wadlow Raymond Couric 
Published: June 2024

9008 Background: Of patients with cancer, 46% experience significant psychosocial distress, a factor linked to higher morbidity, mortality and costs of care. Oncologists themselves face psychosocial distress, particularly during their fellowship training, with as many as 38% of hematology/oncology (H/O) fellows reporting burnout during training. The ACGME recognizes this risk and has recently included well-being skills in their professional milestones, in addition to milestones for assessing psychosocial issues and communication skills for addressing these complex patient needs, which are often a source of distress among clinicians. Very few published curricula are available to address these layered learning needs among H/O fellows. Methods: “Artful Oncology” is a multifaceted curriculum for H/O fellows focusing on four pillars: 1) monthly didactic lectures about psychosocial issues within cancer care; 2) bimonthly narrative medicine seminars reflecting on didactic themes; 3) quarterly communication skills training conducted with standardized patients; and 4) monthly cancer survivorship support group facilitation. This curriculum was instituted with the inaugural class of H/O fellows at Inova Schar Cancer Institute in 2021 (total 6 fellows to date) with iterative improvements. Outcomes were measured through self-assessed communication skills, scored feedback for each didactic, annual Physician Belief Scale (PBS) surveys, quarterly Professional Quality of Life (ProQOL)-Health and abbreviated Maslach Burnout Inventory (MBI) surveys. Results: Fellows rated didactics as being relevant to their work, prepared to implement the skills learned into clinical practice, and would recommend these sessions to others (average 4.58, 4.59, and 4.67 out of 5-point Likert scale). Among 19 evaluated didactic topics evaluated to date, the most highly rated sessions included Oncology Psychiatry, Integrative Approaches to Symptom Management, Hospice Behind the Scenes, and Moral Injury/Moral Distress (average 5.0); lowest rated included Mindfulness, Sexual Health, Recognizing Depression, Grief, and Adolescents/Young Adults (average 4.29). PBS scores numerically improved from 2022 to 2023 (78 to 68.8 out of 160, lower being associated with a more psychosocial approach to patient care). MBI and ProQOL Health scores were largely unchanged (<2 point difference on average). Self-assessed communication skills averaged across rising fellows increased from 4.38 to 7.44 out of 10 between 2022 and 2023. Conclusions: The Artful Oncology curriculum numerically improved self-assessed communication skills and attitudes regarding the physician role within psychosocial aspects of patient care. Didactic sessions were rated as highly relevant, actionable, and recommended by H/O fellows. Study of this curriculum over a longer timeframe with larger numbers of fellows is ongoing to better evaluate effects.
Improving goal concordant care clinician workshops: Do patients benefit?
Authors: Bitar Heather Nicole , Dale William , Razavi Marianne , Liou Eleana , Shaikh Mohammad Zameer Zameer , Morse Denise , Jun Christine , Mecusker Eric , Ramirez Carey , Leitner Andrew , Artz Andrew S. , Waisman James Ross , Buga Sorin , Clark Karen L. , Zachariah Finly 
Published: June 2024

9035 Background: From 2020-2023, the Alliance of Dedicated Cancer Centers (ADCC) undertook a national initiative to improve goal concordant care (IGCC) where all cancer patients and their families receive care that aligns with their values and priorities. One of the core components of the program was to implement a formal communications skills training program supporting the delivery of goal concordant care. As an ADCC member, City of Hope’s (COH) Department of Supportive Care Medicine created the Improving Goal Concordant Care Virtual Workshop Series to address this need. Methods: The 2-part workshop series covered: Goal concordant care, having difficult conversations, advanced care planning (ACP), advance directives, Physician Orders for Life Sustaining Treatment forms, and code status. Physicians and nurse practitioners (NPs) were independently evaluated regarding their quality of care pre-/post workshop #1 by their outpatients through the “Heard and Understood (HAU)” survey, a patient-reported quality measure with 4 items: I felt heard and understood (HU), Provider understood what was important my life (UL), Provider saw me as a person (SP), Provider put my best interests first (BI). Response categories ranged from 1, not at all trueto 5, completely true. Top-box rates and percentage of patients responding completely true for a given item were calculated for each clinician. Pre-/post changes in top-box rates were examined with paired t-tests. Differences in rates over time, by clinician type, were evaluated using mixed effect modeling. Survey items were initially analyzed individually, then combined. A p-value < 0.05 was considered statistically significant. Results: A total of 37 clinicians (26 Physicians and 11 NPs) were evaluated. Patients’ experience with physicians (NPs excluded) improved between pre/post training: The rates increased for the overall HAU scale (4.31, p=0.002), as well as for several individual items such as HU, UL and BI (5.24, 6.33 and 2.52 respectively, p-values<0.05). Notably, the rates for HU increased for physicians but not for NPs (5.24 vs -3.22, difference= 8.46, p=0.012), though NPs had a higher top-box rate at baseline compared to physicians (90.74 vs 78.04, p<0.001). Between group rate differences were not significant for the overall HAU scale over time. Conclusions: Patients’ experience with hematology and oncology physicians improved after physicians received IGCC communication skills training. Moreover, the patients’ experience with NPs was rated higher than physicians before training, but there were no significant differences after training. To further improve physician-patient communication regarding ACP and goal concordant care, the program will adapt and expand to additional departments throughout the COH clinical network.
The role of social media and email in hematology oncology fellowship program recruitment: Insights from national survey of program directors.
Authors: Thakur Rahul Kumar , Vegivinti Charan Thej Reddy , Yusuf Hasiya , Ray Barun , Gor Rajvi , Kumar Abhishek 
Published: June 2024

9049 Background: In the dynamically evolving medical landscape, the role of digital communication, encompassing both social media and email, in Hematology Oncology fellowship recruitment is increasingly prominent. This comprehensive study investigates how U.S. program directors (PDs) leverage these platforms, particularly in an era where virtual interviews are becoming the norm. By examining the utilization of social media alongside traditional email communications, this research aims to illuminate the dual strategies employed in engaging prospective fellows. Methods: From November to December 2023, a nationwide anonymous survey was conducted among all American Council for Graduate Medical Education (ACGME) accredited Hematology Oncology fellowship PDs. This survey sent via SurveyMonkey sought to collect demographic information of PDs, details about their programs, and insights into their use of social media platforms such as Twitter/X and Instagram, in addition to email, for both promoting their programs and reviewing fellowship applications. Results: In a survey of 183 Hematology Oncology fellowship programs, 32 program directors (PDs) responded, yielding an 18% response rate. The majority of PD were women (59%) with a predominant affiliation with university hospitals (69%). The responses indicated a broad geographical spread, especially in the South Atlantic and Pacific regions. Around 31% (10) of the program directors reported using Twitter/X, and 16% (5) utilized Instagram for promoting their fellowship programs. However, it was rarely used for applicant review (10% for Twitter/X, 0% for Instagram). Notably, there was no statistical difference in social media usage between university and community hospital PDs for program promotion or applicant engagement In contrast, email remains central in the recruitment process. On average, each PD receives about 57 emails expressing interest in their program. A considerable 71% (22) of PDs indicated that they would review an applicant who contacted them via email, with an average review rate of 80%. However, a relatively small percentage—18%—of the applicants reviewed were subsequently invited for an interview. Significantly, PDs from university hospitals were more inclined to review applicants via email compared to their counterparts in community hospitals (P-value<0.01). Conclusions: This survey sheds light on the evolving dynamics of Hematology Oncology fellowship recruitment, marking a significant transition in the way program directors connect with potential candidates. Our research reveals that social media is gradually becoming part of the promotional toolkit for fellowship programs, yet email remains the primary method for communicating with and reviewing applicants.
Development of equity, diversity, and inclusion competencies in residents and faculty in oncology through formal and informal learning.
Authors: Dadwal Shivani , Govaerts Marjan 
Published: June 2024

9053 Background: In recent years, a growing body of literature has suggested that patients need their clinicians to provide culturally competent care. A focus on integrated and longitudinal training within the domains of equity, diversity and inclusion (EDI) is needed to equip physicians to meet patients’ needs. Oncology is one such specialty that needs strong skillsets in EDI given its vulnerable and complex patient populations. This study explores how physicians within oncology learn about the domains of EDI through formal and informal learning. Methods: Using constructivist grounded theory (CGT), this study explores EDI competency formation at one academic center – the Juravinski Cancer Center in Hamilton ON, Canada. A purposive sample of 16 staff and resident physicians was taken to incorporate variation sampling - including a variety of ages, genders, and work/training experience. Participants were from both medical and radiation oncology. Semi-structured one-on-one interviews were conducted. Transcripts were generated, anonymized, and analyzed iteratively. Data analysis followed stages of open, axial, and selective coding through which themes were constructed. Interviews were continued until data saturation was reached. Results: Of the 16 participants, there was an even distribution between men (8) and women (8). Mean age was 43 (range 30-65). There were 5 residents and 11 faculty members. 9 were from medical oncology and 7 from radiation oncology. The major themes generated from the study were: the relationship between EDI competencies and professional identify formation, the role of culture and context in influencing exposure and learning about EDI, and the relationship between formal and informal learning opportunities. Conclusions: This study is the first to explore of how oncologists presently develop EDI competencies through formal and informal learning. The study has discovered the role of professional identify formation as a factor influencing learning, the impact of the culture and context of medicine, and the significant interplay between formal and informal learning in developing EDI skillsets. While much learning takes place informally, informed by clinical encounters and personal experiences, there is a need to marry the informal learning opportunities to more structured formal teaching in the training and clinical environment. [Table: see text]
Just Listening: An Introduction
Authors: Varsano Paula 
Published: June 2024

Abstract
The essays collected in this special issue all respond to a single question: how have the producers of Chinese literature, thought, art, science, and popular culture conceived of their relationship with the nonhuman beings—creatures organic and inorganic, animal or technological—that surround us as humans? While ranging across time periods and training their sights on vastly different objects, these essays manifest a particular interest in examining how voice (together with its notable absence)—as it slips from phenomenon to figuration and back again—appears to set the boundary that both separates and enacts engagement between the human and nonhuman realms. This introduction brings these essays into conversation with each other to highlight some of the unforeseen patterns they manifest as a whole. Among these is the chronological: read in order, these essays hint at a growing awareness of humans’ incapacity to connect, whether with one another or with the nonhuman: an emerging sense that voice does not necessarily correspond to the subjectivity of those that emit or withhold it or that, even if it did, there would be no sure way for a hearer to establish that correspondence, let alone respond with meaningful and appropriate actions or words.
Voices from the Other Side: Exploring Nonhuman Agents and Their Narrative Function in the Zhuangzi
Authors: Graziani Romain 
Published: June 2024

Abstract
In the history of Chinese literature, the Zhuangzi authors were the first to grant a voice to diverse forms of life, among them a snake, a tree, a dead man, a divine turtle, and even the wind. What exactly is the interest of incorporating nonhuman protagonists in brief literary fictions? Was there something at stake when trying out this pioneering narrative technique, or was it just for the sake of literary innovation and entertainment? Through a detailed analysis of a set of concise narratives, this study uncovers a consistent critique of the religious institutions (chiefly divination and sacrifice), as well as the economic practices prevalent during the Warring States period. It aims to demonstrate that the Zhuangzi's comprehensive critique of the Zhou cultural order achieves its “hearability” through a recurrent use of striking dualities, including day and night, dream and wakefulness, and humans and nonhumans. A heretofore silent and passive community of living beings raises its voice and is able to challenge the well-established discourse proclaiming human sovereignty over the natural world. These voices and the themes they raise serve, among other things, as a literary strategy intended to illuminate the universality of violence and the criminal essence of human culture (wen 文).
Dehumanized Voices and Traumatic Articulations in Late Nineteenth-Century Chinese Classical Tales
Authors: Wei Li 
Published: June 2024

Abstract
This study leverages trauma theory to examine Xuan Ding's 宣鼎 (1832–1880) Yeyu qiudeng lu 夜雨秋燈錄 (Recorded on Rainy Nights by Autumn Lamp), a collection of classical tales published in the aftermath of the Taiping Civil War (1850–1864). The analysis here delves into the concept of dehumanization, typically understood as the denial of one's intrinsic human traits by other people. In the late Qing context, dehumanization can occur when an individual is perceived as deviating from the path of self-cultivation, or as inept at or resistant to fulfilling prescribed social and gender roles, often leading to social ostracism. Xuan Ding conveys both the acute trauma of the Taiping war and the quotidian, gender- and class-based traumas imposed by late Qing society through the dramatic depiction of characters who undergo a metamorphosis into subhuman forms. This study also shows that in his preface to the collection, Xuan engages in the artistic dehumanization of his own literary persona. From this strategic position of moral self-exile, he is able to both provide a platform for dissenting voices and suggest the therapeutic potential of writing during times of suffering. This study explores how one writer's depiction of the trauma of dehumanization navigates and illuminates the nuanced boundary between the human and the nonhuman as understood at this time. By investigating the complex interplay of dehumanization and trauma, and their manifestation in literature, this study invites consideration of culturally specific nuances within trauma theory and opens up avenues for comparative analysis.
Molar pregnancy: a qualitative study of personal experiences and societal narratives of loss
Authors: Ross Emily , Ireson Jane , Singh Kam , Winter Matthew C 
Published: June 2024

Background/Aims Molar pregnancy is a rare complication of pregnancy. Patients face surgery, human chorionic gonadotropin monitoring and potentially systemic treatment, resulting in unique support needs. This study's aim was to explore the impacts of gestational trophoblastic disease on embodied and emotional experience. Methods This qualitative study considered stories of molar pregnancy from 20 women in the UK, US, Canada and Australia. These were drawn from 18 publicly available online blogs and eight semi-structured interviews, and analysed thematically. Results Three themes were developed: ‘loss’, describing women's responses to their pregnancy ending; ‘isolation’, comprising ‘rarity’, ‘lack of awareness’ and support seeking; and ‘alienation’, capturing the unfamiliarity of diagnosis, ‘failure’ and barriers to ‘moving forward’. Conclusions Experiences are shaped by wider narratives of ‘typical’ pregnancy. Patient care requires an individualised and responsive approach, and non-specialist practitioners should feel confident in discussing molar pregnancy and have access to up-to-date guidance.
A qualitative study of final year student veterinary nurses' career plans and expectations
Authors: Harniman Suzannah 
Published: June 2024

Introduction: The limited longevity of veterinary nurses' clinical careers is a current challenge faced in the veterinary industry. In order for veterinary nurse job vacancies to be filled, it is essential for graduate veterinary nurses to be motivated to seek employment in clinical practice. The aim of this study was to explore the career plans and expectations of final year student veterinary nurses. Method: Online semi-structured interviews with ten final year student veterinary nurses were used to collect qualitative data. Thematic analysis was used to analyse the data. Results: The results revealed that there were aspects of clinical practice the participants were looking forward to and others they perceived would be challenging and may threaten the longevity of their clinical career. An example was the demanding nature of the job role. Discussion: All participants expressed a desire to work in clinical practice following their graduation, but were aware that they were unlikely to have long-term clinical careers. It is recommended that veterinary nurse educators should support students to develop the resilience necessary for them to face the challenges of clinical practice and also help them to gain the transferrable skills they may require for alternative future career paths.
Performance evaluation of an 80  Gbps dual-polarization orbital-angular-momentum-based underwater optical wireless communication system
Authors: Abd El-Mottaleb Somia A. , Singh Mehtab , Atieh Ahmad , Aly Moustafa H. 
Published: June 2024

In this paper, a new underwater optical wireless communication (UOWC) system is proposed. It integrates dual-polarization (DP) states with orbital angular momentum (OAM) beams. By leveraging the inherent orthogonality of different OAM modes, the system achieves enhanced signal quality and increased transmission capacity. Each polarization state carries data of four OAM beams, with each capable of carrying 10 Gbps of information. Additionally, a single laser diode (LD) source operating at 532 nm is employed. To evaluate the performance of the proposed system, the effects of attenuation across various water types are considered. Propagation range, bit error rate (BER), and eye diagrams are utilized as comprehensive performance metrics. The obtained results indicate that, below the error correction threshold (3.8×10−3), our proposed UOWC system achieves impressive underwater transmission ranges. Specifically, we observe a longer range of 44 m for pure sea (PS) water that exhibits the lower attenuation, which is decreased to 26.5 m for clear ocean (CL) and 15.5 m for coastal ocean (CS). Furthermore, it decreased reaching shorter ranges of 8 m for harbor I (HI) and 4.45 m for harbor II (HII), which have the highest attenuation.