bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the impact of social media marketing from the perspective of orthodontists
Authors: Değirmencioğlu Eyüp , Kılıçoğlu Hülya 
Published: July 2024

Abstract
Objective
In developed countries, orthodontists utilize social media platforms as a pivotal component of their marketing strategies. However, there exists a gap in understanding the broader perspective of healthcare professionals on the utilization of social media in healthcare service delivery. Therefore, this study aims to evaluate the perceptions of healthcare professionals in Turkey regarding the integration of social media within healthcare service delivery.

Materials & methods
This cross-sectional study, conducted between January and February 2023, surveyed 378 members of the Turkish Orthodontic Society. The survey consisted of two parts: a demographic questionnaire with 28 items and a 21-item “Social Media Marketing Activities Scale,” developed with input from three experts. Data analysis will include an explanatory factor analysis. This study provides a snapshot of orthodontists’ perspectives on social media marketing practices.

Results
When participants’ views of patient communication through social media were examined, 19.8% said they “thought it was right” and 80.2% said they “thought it was wrong”. The treatment and treatment alternatives shared with patients through social media were implemented in 16.5% of cases and not implemented in 83.5% of cases. When examining the social media accounts used by participants to communicate with patients, 56.8% used personal accounts, 43.2% used professional accounts, and when analyzing the social media accounts they used for promotional purposes, 15.8% had personal accounts, 84.2% of them used professional accounts. More than half (59.8%) of orthodontists believed that communicating with patients on social media could cause legal problems. The majority of orthodontists (88.7%) followed their competitors.

Conclusion
The prevalence of participants’ use of social media posts for advertising purposes was low, and it was determined that the main reason for this was the prohibition of advertising in the provision of health services.
Understanding learners’ experiences across three major transitions in undergraduate medical education
Authors: Weyant-Cheeseman Morgan E. , Abrams Matthew P. , Toselli Nicholas , Castiglioni Analia 
Published: July 2024

Abstract
Background
Medical students in the United States undergo three significant transitions as they progress from pre-clinical to clinical rotations, to acting interns, and ultimately to first-year resident. However, there is limited understanding of whether the factors and strategies that impact these transitions remain consistent or are unique to each individual transition.

Methods
Qualitative data was collected from three Nominal Group Technique (NGT) sessions held separately for third-year students (M3), fourth-year students (M4), and first-year residents (PGY-1). The participants were asked to share their perceptions on their most recent medical school transition. These responses were independently coded into thematic categories.

Results
The NGT session with M3 students (n = 9) identified 67 transition factors and 64 coping strategies. The M4 (n = 8) session identified 33 transition factors and 72 strategies to manage their transition. The PGY-1 (n = 5) session identified 28 factors and 25 strategies. The coping strategies for each session were categorized into seven themes and the transition factors were assigned to ten thematic categories.

Conclusion
Just as each transition is unique, so too are the number and variety of factors and strategies to manage each transition. Despite these differences, the themes of “Professional socialization” and “Prioritization, efficiency, and delegation” emerged as impactful in all three transitions.
Factors influencing research productivity among Syrian medical professionals amidst conflict: a case-control study
Authors: Hanafi Ibrahem , Kheder Kheder , Sabouni Rami , Rahmeh Ahmad Rami , Alsalkini Marah , Hanafi Mouaz , Naeem Ahmad , Alahdab Fares 
Published: July 2024

Abstract
Background
Medical research productivity is globally increasing, with a lagging progress in third-world countries due to significant challenges, including inadequate training and brain drain. Syria had been showing a slow upward trend until the war broke out and severely hindered academic growth and productivity. A deeper understanding of the factors influencing research productivity in this context are fundamental to guide educational policies and resource allocation. Previous cross-sectional studies that evaluated the perspectives of Syrian academics on the issue were limited by the small sample size of published healthcare workers, making it difficult to identify the factors that enabled them to pursue research.

Methods
To address this challenge, we employed a case-control design. We isolated published early-career Syrian healthcare workers and compared their characteristics and perceptions to unpublished matched controls. Authors in the fields of medicine, dentistry, and pharmacy affiliated with any Syrian University were identified through an extensive search of PubMed and Google Scholar.These authors were invited to complete a questionnaire that covered participants’ research contributions, alongside their self-assessed knowledge, attitudes, and barriers towards research. The questionnaire was publicly published to recruit an equal sample of matching controls, with half consisting of unpublished researchers and the other half of participants without prior research contributions.

Results
Six-hundred-sixteen participants were recruited. Their knowledge, attitudes, and perceived barriers explained 46% and 34% of the variability in research involvement and publication, respectively (P < 0.001). Getting involved in and publishing research studies associated with higher research-related knowledge and attitudes (P < 0.001). Respondents’ assessment of research-related barriers and their academic scores did not differ between cases and controls. Superior research-related knowledge and attitudes were associated with male gender, higher English competency, and better internet connectivity. Meanwhile, extracurricular training and mentors’ support were associated with more positive research-related attitudes and less perceived barriers.

Conclusions
Research productivity of medical professionals in Syria exhibits a positive correlation with their knowledge and favorable attitudes towards medical research. Noteworthy, the demographic variations are linked to disparities in research-related knowledge and motivation. In conclusion, these results suggest a potential avenue for enhancement through concentrated efforts on improving extracurricular training interventions and mentors’ support.
Access to colorectal cancer screening for Pakistani immigrants in Norway – a qualitative study
Authors: Iqbal Nadia , Berstad Paula , Solbjør Marit , Diaz Esperanza , Czapka Elżbieta , Hofvind Solveig , Bhargava Sameer 
Published: July 2024

Abstract
Background
The Norwegian colorectal cancer (CRC) screening program started in May 2022. Inequalities in CRC screening participation are a challenge, and we expect that certain groups, such as immigrants, are at risk of non-participation. Prior to the start of the national screening program, a pilot study showed lower participation rates in CRC screening among immigrants from Pakistan. These immigrants are a populous group with a long history in Norway and yet have a relatively low participation rate also in other cancer screening programs. The purpose of this study was to identify and explore perspectives and factors influencing CRC screening participation among immigrants from Pakistan in Norway.

Materials and methods
In this study we used a qualitative study design and conducted 12 individual interviews with Pakistani immigrants aged between 50 and 65 years. The participants varied in terms of gender, age, education, work, residence time in Norway and familiarity with the Norwegian language and culture. We performed thematic analysis with health literacy as a theoretical framework to understand Pakistani immigrants’ perspectives on CRC screening.

Results
We identified four main themes: Health-related knowledge, the health care system, screening, and social factors. Within these themes we identified several factors that affect Pakistani immigrants’ accessibility to CRC screening. These factors included knowledge of the causes and development of cancer, sources of health-related information, the general practitioner’s role, understanding of screening and the intention behind it, language skills and religious beliefs.

Conclusion
There are many factors influencing Pakistani immigrants’ decision of participation in CRC screening. The roles of the general practitioner and adult children are particularly important. Key elements to improve accessibility to CRC screening and enable informed participation for Pakistani immigrants are measures that improve personal and organizational health literacy.
Challenges of pre-hospital emergency care at Addis Ababa Fire and Disaster Risk Management Commission, Addis Ababa, Ethiopia: a qualitative study
Authors: Seid Feleku Yimer , Gete Birhanu Chekol , Endeshaw Amanuel Sisay 
Published: July 2024

Abstract
Background
A challenge to pre-hospital emergency care is any barrier or obstacle that impedes quality pre-hospital care or impacts community pre-hospital utilization. The Addis Ababa Fire and Disaster Risk Management Commission (AAFDRMC) provides pre-hospital emergency services in Addis Ababa, Ethiopia. These services operate under a government-funded organization that delivers free emergency services, including out-of-hospital medical care and transportation to the most appropriate health facility. This study aimed to assess the challenges of pre-hospital emergency care at the Addis Ababa Fire and Disaster Risk Management Commission in Addis Ababa, Ethiopia.

Methods
A qualitative descriptive study was conducted from November 20 to December 4, 2022. Data were collected through in-depth, semi-structured interviews with 21 experienced individuals in the field of pre-hospital emergency care, who were selected using purposeful sampling. A thematic analysis method was used to analyze the data.

Results
This study includes twenty-one participants working at the Addis Ababa Fire and Disaster Risk Management Commission. Three major themes emerged. The themes that arose were the participants’ perspectives on the challenges of pre-hospital emergency care in Addis Ababa, Ethiopia.

Conclusion and recommendation
The Fire and Disaster Risk Management Commission faces numerous challenges in providing quality pre-hospital emergency care in Addis Ababa. Respondents stated that infrastructure, communication, and resources were the main causes of pre-hospital emergency care challenges. There has to be more focus on emergency management in light of infrastructure reform, planning, staff training, and education, recruiting additional professional power, improving communication, and making pre-hospital emergency care an independent organization in the city.
Transcriptome- and DNA methylation-based cell-type deconvolutions produce similar estimates of differential gene expression and differential methylation
Authors: Hannon Emily R. , Marsit Carmen J. , Dent Arlene E. , Embury Paula , Ogolla Sidney , Midem David , Williams Scott M. , Kazura James W. 
Published: July 2024

Abstract
Background
Changing cell-type proportions can confound studies of differential gene expression or DNA methylation (DNAm) from peripheral blood mononuclear cells (PBMCs). We examined how cell-type proportions derived from the transcriptome versus the methylome (DNAm) influence estimates of differentially expressed genes (DEGs) and differentially methylated positions (DMPs).

Methods
Transcriptome and DNAm data were obtained from PBMC RNA and DNA of Kenyan children (n = 8) before, during, and 6 weeks following uncomplicated malaria. DEGs and DMPs between time points were detected using cell-type adjusted modeling with Cibersortx or IDOL, respectively.

Results
Most major cell types and principal components had moderate to high correlation between the two deconvolution methods (r = 0.60–0.96). Estimates of cell-type proportions and DEGs or DMPs were largely unaffected by the method, with the greatest discrepancy in the estimation of neutrophils.

Conclusion
Variation in cell-type proportions is captured similarly by both transcriptomic and methylome deconvolution methods for most major cell types.
Fluid management for sepsis-induced hypotension in patients with advanced chronic kidney disease: a secondary analysis of the CLOVERS trial
Authors: Jorda Anselm , Douglas Ivor S. , Staudinger Thomas , Heinz Gottfried , Bergmann Felix , Oberbauer Rainer , Sengölge Gürkan , Zeitlinger Markus , Jilma Bernd , Shapiro Nathan I. , Gelbenegger Georg 
Published: July 2024

Abstract
Background
Early fluid management in patients with advanced chronic kidney disease (CKD) and sepsis-induced hypotension is challenging with limited evidence to support treatment recommendations. We aimed to compare an early restrictive versus liberal fluid management for sepsis-induced hypotension in patients with advanced CKD.

Methods
This post-hoc analysis included patients with advanced CKD (eGFR of less than 30 mL/min/1.73 m2 or history of end-stage renal disease on chronic dialysis) from the crystalloid liberal or vasopressor early resuscitation in sepsis (CLOVERS) trial. The primary endpoint was death from any cause before discharge home by day 90.

Results
Of 1563 participants enrolled in the CLOVERS trial, 196 participants had advanced CKD (45% on chronic dialysis), with 92 participants randomly assigned to the restrictive treatment group and 104 assigned to the liberal fluid group. Death from any cause before discharge home by day 90 occurred significantly less often in the restrictive fluid group compared with the liberal fluid group (20 [21.7%] vs. 41 [39.4%], HR 0.5, 95% CI 0.29–0.85). Participants in the restrictive fluid group had more vasopressor-free days (19.7 ± 10.4 days vs. 15.4 ± 12.6 days; mean difference 4.3 days, 95% CI, 1.0–7.5) and ventilator-free days by day 28 (21.0 ± 11.8 vs. 16.5 ± 13.6 days; mean difference 4.5 days, 95% CI, 0.9–8.1).

Conclusions
In patients with advanced CKD and sepsis-induced hypotension, an early restrictive fluid strategy, prioritizing vasopressor use, was associated with a lower risk of death from any cause before discharge home by day 90 as compared with an early liberal fluid strategy.

Trial Registration
NCT03434028 (2018-02-09), BioLINCC 14149.
Breast Cancer in Women in Gaza: A Review of Clinical Characteristics and Short-Term Survival
Authors: AlWaheidi Shaymaa , Sullivan Richard , Davies Elizabeth A. 
Published: July 2024

PURPOSE To understand how breast cancer is diagnosed in Gaza, and disease stage distribution, treatment, and survival. MATERIALS AND METHODS A clinical record case series study of women diagnosed in 2017 and 2018 was conducted with follow-up until December 31, 2020. Breast cancer crude incidence rates and age-specific incidence rates were calculated. Clinical characteristics, including investigation, diagnosis, and treatment methods by year of diagnosis, were compared using the chi-square test. The 2-year cumulative risk of death from any cause was estimated using the Kaplan-Meier method, and univariate and multivariate Cox proportional hazard regressions estimated hazard ratios and their 95% CIs. RESULTS Five hundred twenty-four new diagnoses (mean age, 53 years; range, 23-100) were recorded, giving a crude annual incidence rate of 27 per 100,000 population. Six percent (32/524) were diagnosed at stage I, 35% (185/524) at stage II, 33% (171/524) at stage III, and 19% (99/524) at stage IV. More than one half (52%, 271/524) underwent modified radical mastectomy. Seventy-seven percent (405/524) received chemotherapy, 70% (368/524) hormone therapy, and 39% (204/524) radiotherapy. Data on key prognostic factors were mostly available—stage (93%), estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2; 82%), tumor grade (77%), and tumor size (70%). The overall survival was 95.4% at 1 year and 86.6% at 2 years. CONCLUSION Women with breast cancer in Gaza have a high short-term survival after diagnosis. However, one half were diagnosed with advanced disease, and their investigations were incomplete. Better reporting on family history, tumor grade, size, and ER, PR, and HER2 receptor status is needed for future studies.
Prostate Cancer Awareness in the Middle East: A Cross-Sectional International Study
Authors: Sayan Mutlay , Eren Ayfer Ay , Tuac Yetkin , Langoe Astrid , Alali Bader , Aynaci Ozlem , Mohammadipour Sepideh , Vahedi Farzin , Daneshmand Behrooz , Abbas Wajid , Hawsawi Yousef , Nader Toni , Joseph Jessie , Wahby Rowan , Ozgenc Ismail , Mula-Hussain Layth , Moningi Shalini , Orio Peter F. , Atalar Banu , Eren Mehmet Fuat 
Published: July 2024

PURPOSE Prostate cancer has emerged as a significant public health challenge in the Middle East, characterized by rising incidence rates and a concerning mortality-to-incidence ratio. Yet, despite these alarming trends, data regarding prostate cancer awareness in the region remain limited. To address this critical knowledge gap, this study investigates prostate cancer awareness within the Middle East. MATERIALS AND METHODS A cross-sectional survey was performed among 5,913 men age 40 years and older across 14 Middle Eastern countries between January 1, 2022, and July 31, 2023. Excluding those with a history of prostate cancer, a validated questionnaire assessed prostate cancer awareness. Data were analyzed using frequencies and percentages for categorical variables, medians and ranges for continuous variables, and Pearson chi-square analysis for relationships between education levels and awareness of prostate cancer. RESULTS The survey achieved a 74.9% response rate, with 4,431 male participants. Regarding prostate cancer awareness, 83.8% of participants had heard of the disease. However, only 31.0% correctly identified it as the most common malignancy in men, and 21.8% believed it affects both sex. Awareness of screening was limited, with just 19.1% recognizing the prostate-specific antigen test's role. Additionally, participants had a pessimistic view, with a mean perception that 75% of patients with prostate cancer die from the disease, rather than from other causes. Higher education levels were associated with significantly increased awareness of prostate cancer ( P < .001). CONCLUSION This study reveals that while general awareness of the disease exists, crucial knowledge deficits regarding risk factors, screening, and prognosis are evident. Addressing these knowledge gaps through culturally tailored education may improve early detection rates, treatment outcomes, and ultimately reduce the burden of prostate cancer in the Middle East.
The predictive value of the mature B cell signature in early Her2-positive breast cancer treated with neoadjuvant therapy.
Authors: Lin Po-Han , Lo Chiao , Kuo Sung-Hsin , Huang Chiun-Sheng 
Published: July 2024

606 Background: Neoadjuvant therapy (NAT) by combining polychemotherapy and HER2-targeted drugs has become the golden standard treatment for patients with early-stage Her2-positive breast cancer. Pathologic complete response (pCR) is a surrogate marker that predicts a favorable prognosis. Tumor infiltration lymphocytes (TILs) and immune profiling had been reported as a biomarker associated with the pCR. There are several types of immune cells such as monocytes, T and B cell; however, it’s uncertain which kind of immune cells and immune profile play the most important role to predict the pCR in Her2-positive breast cancer. Methods: We enrolled 188 breast cancer patients who were diagnosed of having stage I-III Her2-positive breast cancer. All patients received taxane in combination with Her2-targeted therapies. We performed RNA sequencing on the breast cancer samples which were collected before treatment. Immunohistochemical staining of immune markers were done, too. Results: 103 patients were treated with trastuzumab-based NAT and 85 patients were treated with dual-blockade (trastuzumab plus pertuzumab) based NAT. Among the clinical and tumor characteristics, high expression of Her2 and low expression of ESR1 were associated with the pCR (both p <0.01). Dual blockade therapy tended towards pCR, but lacked statistical significance. For the microenvironment, we deconvoluted the immune cells from the RNA-seq data to measure the cell populations. The proportion of immune cells was correlated to the TILs that was measured from the pathology slides (p<0.01). Both the TILs and the immune cell amounts from the RNA-seq were significantly associated with the pCR (both p<0.01). By the deconvoluted cell types, higher abundance of B cells was significantly associated with the pCR, compared to lower B cell amount (p<0.001). The total T cells, CD8 T cells and monocytes were trended to the pCR but not statistical significance. We then subgroup B cells into the mature B populations which express immunoglobulin genes and immature B populations which express RAG-1 gene without immunoglobulin. We found that only the mature B cells predicted the pCR and immature B cell didn’t. Multivariate logistic regression analysis adjusted for ESR1 expression, Her2 expression and dual blockade therapy, only the mature B cell independently predicted the pCR (odds ratio, 2.63; 95%CI, 1.34-5.16; p = 0.005). The total TILs by pathology slide and other immune cell types didn’t. In addition to pCR, the mature B cells were independently related to the superior recurrence-free survival by the multivariate Cox regression model after adjusting the ESR1 expression, Her2 expression, dual blockade therapy, TIL and immune cell types (hazard ratio, 0.32 ;95% CI, 0.11-0.98; p=0.047). Conclusions: Our result suggested that the mature B cell signature was more strongly associated with the pCR and recurrence-free survival than TILs.
Disparate Rates of Germline Variants in Cancer Predisposition Genes in African American/Black Compared With Non-Hispanic White Individuals Between 2015 and 2022
Authors: Wyatt Castillo Rachel B. , Nielsen Sarah M. , Chen Elaine , Heald Brandie , Ellsworth Rachel E. , Esplin Edward D. , Tomlinson Gail E. 
Published: July 2024

PURPOSE African American/Black (AA/B) individuals are under-represented in genomic databases and thus less likely to receive definitive information from germline genetic testing (GGT) than non-Hispanic White (NHW) individuals. With nearly 500,000 AA/B and NHW individuals having undergone multigene panel testing (MGPT) for hereditary cancer risk at a single commercial laboratory, to our knowledge, we present the largest study to date investigating cancer GGT results in AA/B and NHW individuals. METHODS MGPT results from a retrospective cohort of AA/B (n = 48,684) and NHW (n = 444,831) patients were evaluated. Frequencies of pathogenic germline variants (PGVs) and variants of uncertain significance (VUS) were compared between AA/B and NHW individuals. Changes in frequency of VUS over time were determined. Pearson's chi-squared test was used to compare categorical variables among groups. All significance tests were two-tailed, and P < .05 was considered statistically significant. RESULTS Between 2015 and 2022, rates of VUS decreased 2.3-fold in AA/B and 1.8-fold in NHW individuals; however, frequencies of VUS and PGV remained significantly higher (46% v 32%; P < .0001) and lower (9% v 13%; P < .0001) in AA/B compared with NHW individuals. Rates of VUS in ATM, BRCA1, BRCA2, PALB2, and PMS2 were significantly higher in AA/B compared with NHW individuals, whereas rates of PGV in BRCA1, BRCA2, and PALB2 were higher in AA/B compared with NHW individuals ( P < .001). CONCLUSION Despite reductions in VUS frequencies over time, disparities in definitive GGT results persist. Increasing inclusion of AA/B populations in both testing and research will further increase knowledge of genetic variants across these racial groups.