bluuebunny/crossref_metadata_2025_split huggingface dataset:
The progress test as a structuring initiative for programmatic assessment
Authors: Alavarce Débora Cristina , de Medeiros Melyssa Lima , de Araújo Viana Danylo , Abade Flávia , Vieira Joaquim Edson , Machado José Lúcio Martins , Collares Carlos Fernando 
Published: May 2024

Abstract
Background
The Progress Test is an individual assessment applied to all students at the same time and on a regular basis. The test was structured in the medical undergraduate education of a conglomerate of schools to structure a programmatic assessment integrated into teaching. This paper presents the results of four serial applications of the progress test and the feedback method to students.

Methods
This assessment comprises 120 items offered online by means of a personal password. Items are authored by faculty, peer-reviewed, and approved by a committee of experts. The items are classified by five major areas, by topics used by the National Board of Medical Examiners and by medical specialties related to a national Unified Health System. The correction uses the Item Response Theory with analysis by the “Rasch” model that considers the difficulty of the item.

Results
Student participation increased along the four editions of the tests, considering the number of enrollments. The median performances increased in the comparisons among the sequential years in all tests, except for test1 – the first test offered to schools. Between subsequent years of education, 2nd-1st; 4th-3rd and 5th-4th there was an increase in median scores from progress tests 2 through 4. The final year of undergraduate showed a limited increase compared to the 5th year. There is a consistent increase in the median, although with fluctuations between the observed intervals.

Conclusion
The progress test promoted the establishment of regular feedback among students, teachers and coordinators and paved the road to engagement much needed to construct an institutional programmatic assessment.
Ethical perspectives regarding Euthanasia, including in the context of adult psychiatry: a qualitative interview study among healthcare workers in Belgium
Authors: Verhofstadt Monica , Moureau Loïc , Pardon Koen , Liégeois Axel 
Published: May 2024

Abstract
Introduction
Previous research has explored euthanasia’s ethical dimensions, primarily focusing on general practice and, to a lesser extent, psychiatry, mainly from the viewpoints of physicians and nurses. However, a gap exists in understanding the comprehensive value-based perspectives of other professionals involved in both somatic and psychiatric euthanasia. This paper aims to analyze the interplay among legal, medical, and ethical factors to clarify how foundational values shape the ethical discourse surrounding euthanasia in both somatic and psychiatric contexts. It seeks to explore these dynamics among all healthcare professionals and volunteers in Belgium.

Methods
Semi-structured interviews were conducted with 30 Dutch-speaking healthcare workers who had encountered patients requesting euthanasia for psychiatric conditions, in Belgium, from August 2019 to August 2020. Qualitative thematic analysis was applied to the interview transcripts.

Findings
Participants identified three pivotal values and virtues: religious values, professional values, and fundamental medical values encompassing autonomy, beneficence, and non-maleficence, linked to compassion, quality care, and justice. These values interwove across four tiers: the patient, the patient’s inner circle, the medical realm, and society at large. Irrespective of their euthanasia stance, participants generally displayed a blend of ethical values across these tiers. Their euthanasia perspective was primarily shaped by value interpretation, significance allocation to key components, and tier weighting. Explicit mention of varying ethical values, potentially indicating distinct stances in favor of or against euthanasia, was infrequent.

Conclusion
The study underscores ethical discourse’s central role in navigating euthanasia’s intricate landscape. Fostering inclusive dialogue, bridging diverse values, supports informed decision-making, nurturing justice, and empathy. Tailored end-of-life healthcare in psychiatry is essential, acknowledging all involved actors’ needs. The study calls for interdisciplinary research to comprehensively grasp euthanasia’s multifaceted dimensions, and guiding policy evolution. While contextualized in Belgium, the implications extend to the broader euthanasia discourse, suggesting avenues for further inquiry and cross-cultural exploration.
Sustainability consciousness among nursing students in Egypt: a cross-sectional study
Authors: Mohamed Marwa Ahmed El-Sayed , Ghallab Eman , Hassan Ragaa Abdullah Ahmed , Amin Shaimaa Mohamed 
Published: May 2024

Abstract
Background
Recognizing nurses as pivotal change agents and urgent preparation for the next generation is crucial for addressing sustainability issues and cultivating a sustainable healthcare system. Reports highlight gaps in the integration of sustainable development goals (SDGs) into nursing curricula, prompting the International Council of Nurses to stress the importance of sustainable development in nursing education. The extent to which nursing students are aware of sustainability issues remains to be determined. This study addresses a global and Egyptian research gap by evaluating and comparing Sustainability Consciousness (SC) levels among nursing students at three universities, providing insights into awareness, attitudes, and behaviors related to sustainability.

Methods
This descriptive comparative study was conducted across three nursing faculties within three Egyptian public universities. The target population for this study was undergraduate nursing students enrolled in these universities during the academic year 2022-2023. This study used the extended version of the Sustainability Consciousness Questionnaire (SCQ-L) to measure individuals' knowingness, attitudes, and behaviors related to the three dimensions of sustainable development: environmental, social, and economic.

Results
More than half of the nursing students across the three universities expressed unfamiliarity with the SDGs. Social media was the most common source of information across the three universities. Sohag University recorded the highest median (IQR) scores in sustainability knowingness (72.0, IQR: 70.0-81.0), attitudes (56.0, IQR: 53.0-61.5), and behavior (65.0, IQR: 60.0-69.0) across their respective dimensions, as well as in overall SC (195, IQR: 184.5-208.5). This was followed by Damanhour University, with a median score of 179.0 (IQR: 124.5-194), and then Alexandria University, with a median score of 116.0 (IQR: 85.5-153), all of which were significantly different (all with p values=0.000). Older students from rural areas exhibited higher SC median scores, while students with insufficient family income and no familiarity with the SDGs had lower SC scores.

Conclusions
This study highlighted the prevalent reliance on social media for information among nursing students across these universities, emphasizing the pivotal role of academic institutions in integrating sustainability development concepts in nursing education. Sohag University's notable commitment to sustainability practices has contributed to the higher SC of its students compared to Alexandria and Damanhour Universities. The study also identified age, place of residence, family income, and familiarity with the SDGs as consistent predictors of sustainability consciousness.
The mediating effects of self-efficacy and study engagement on the relationship between specialty identity and career maturity of Chinese nursing students: a cross-sectional study
Authors: Liu Yanjia , Chong Mei Chan , Han Yanhong , Wang Hui , Xiong Lijuan 
Published: May 2024

Abstract
Background
Career maturity is a crucial indicator of career preparedness and unpreparedness can cause the turnover of new nurses. Considerable empirical work demonstrates the potential associations between specialty identity, self-efficacy, study engagement, and career maturity. This study aimed to explore the mediation role of self-efficacy and study engagement on the relationships between specialty identity and career maturity among Chinese nursing students.

Methods
Four hundred twenty-six Chinese nursing students were recruited between September 11 and October 30, 2022. The online survey was conducted following the CHERRIES checklist. Electronic questionnaires assessed their perceived specialty identity, self-efficacy, study engagement, and career maturity. The descriptive analysis, Harman single-factor analysis, Pearson correlation tests, structural equation modeling, and the bootstrap method were employed in data analysis.

Results
Bivariate correlation analysis identified a positive correlation between specialty identity, self-efficacy, study engagement, and career maturity (r = 0.276–0.440, P < 0.001). Self-efficacy and study engagement partially mediated the relationship between specialty identity and career maturity. Self-efficacy and study engagement played a chain mediating role between specialty identity and career maturity.

Conclusions
The underlying mechanism can explain the relationships between specialty identity and career maturity: a direct predictor and an indirect effect through self-efficacy and study engagement. Policymakers and educators should emphasize the importance of specialty identity and provide tailored strategies for improving care maturity depending on nursing students’ specialty identity, self-efficacy, study engagement in the early stages of career development.
New-generation advanced PROTACs as potential therapeutic agents in cancer therapy
Authors: Wang Chao , Zhang Yujing , Chen Wujun , Wu Yudong , Xing Dongming 
Published: May 2024

AbstractProteolysis-targeting chimeras (PROTACs) technology has garnered significant attention over the last 10 years, representing a burgeoning therapeutic approach with the potential to address pathogenic proteins that have historically posed challenges for traditional small-molecule inhibitors. PROTACs exploit the endogenous E3 ubiquitin ligases to facilitate degradation of the proteins of interest (POIs) through the ubiquitin–proteasome system (UPS) in a cyclic catalytic manner. Despite recent endeavors to advance the utilization of PROTACs in clinical settings, the majority of PROTACs fail to progress beyond the preclinical phase of drug development. There are multiple factors impeding the market entry of PROTACs, with the insufficiently precise degradation of favorable POIs standing out as one of the most formidable obstacles. Recently, there has been exploration of new-generation advanced PROTACs, including small-molecule PROTAC prodrugs, biomacromolecule-PROTAC conjugates, and nano-PROTACs, to improve the in vivo efficacy of PROTACs. These improved PROTACs possess the capability to mitigate undesirable physicochemical characteristics inherent in traditional PROTACs, thereby enhancing their targetability and reducing off-target side effects. The new-generation of advanced PROTACs will mark a pivotal turning point in the realm of targeted protein degradation. In this comprehensive review, we have meticulously summarized the state-of-the-art advancements achieved by these cutting-edge PROTACs, elucidated their underlying design principles, deliberated upon the prevailing challenges encountered, and provided an insightful outlook on future prospects within this burgeoning field.
Lipoproteins and metabolites in diagnosing and predicting Alzheimer’s disease using machine learning
Authors: Wang Fenglin , Wang Aimin , Huang Yiming , Gao Wenfeng , Xu Yaqi , Zhang Wenjing , Guo Guiya , Song Wangchen , Kong Yujia , Wang Qinghua , Wang Suzhen , Shi Fuyan 
Published: May 2024

Abstract
Background
Alzheimer’s disease (AD) is a chronic neurodegenerative disorder that poses a substantial economic burden. The Random forest algorithm is effective in predicting AD; however, the key factors influencing AD onset remain unclear. This study aimed to analyze the key lipoprotein and metabolite factors influencing AD onset using machine-learning methods. It provides new insights for researchers and medical personnel to understand AD and provides a reference for the early diagnosis, treatment, and early prevention of AD.

Methods
A total of 603 participants, including controls and patients with AD with complete lipoprotein and metabolite data from the Alzheimer’s disease Neuroimaging Initiative (ADNI) database between 2005 and 2016, were enrolled. Random forest, Lasso regression, and CatBoost algorithms were employed to rank and filter 213 lipoprotein and metabolite variables. Variables with consistently high importance rankings from any two methods were incorporated into the models. Finally, the variables selected from the three methods, with the participants’ age, sex, and marital status, were used to construct a random forest predictive model.

Results
Fourteen lipoprotein and metabolite variables were screened using the three methods, and 17 variables were included in the AD prediction model based on age, sex, and marital status of the participants. The optimal random forest modeling was constructed with “mtry” set to 3 and “ntree” set to 300. The model exhibited an accuracy of 71.01%, a sensitivity of 79.59%, a specificity of 65.28%, and an AUC (95%CI) of 0.724 (0.645–0.804). When Mean Decrease Accuracy and Gini were used to rank the proteins, age, phospholipids to total lipids ratio in intermediate-density lipoproteins (IDL_PL_PCT), and creatinine were among the top five variables.

Conclusions
Age, IDL_PL_PCT, and creatinine levels play crucial roles in AD onset. Regular monitoring of lipoproteins and their metabolites in older individuals is significant for early AD diagnosis and prevention.
Mapping the needs of healthcare workers caring for COVID-19 patients using the socio-ecological framework: a rapid scoping review
Authors: Konstantinou Pinelopi , Theofanous Vaso , Karekla Maria , Kassianos Angelos P. 
Published: May 2024

AbstractUndoubtedly, the mental health of healthcare workers (HCWs) was negatively affected because of caring for patients during the COVID-19 pandemic. However, literature is limited on mapping the challenges and needs of HCWs during COVID-19 pandemic. A widely used framework in public health for mapping evidence includes the socio-ecological models, suggesting behavior can be influenced by individual, interpersonal, organizational, and community factors. The aim of this rapid scoping review was to use the socio-ecological model to map and compile lessons learnt from the literature regarding primarily the challenges and needs and secondly available psychological interventions for HCWs caring for COVID-19 patients. PubMed, CINAHL and Scopus databases were searched, with 21 studies finally included examining challenges and needs of HCWs and 18 studies presenting psychological interventions. Organizational-level challenges and needs such as inadequate staff preparation and supplies of protective equipment, flexible work policies and paid rest periods were the most reported. Individual-level challenges and needs included COVID-19-related fears and reduced mental health, whereas interpersonal-related needs included support provision. Community-level challenges included societal stigma. Certain psychological interventions were found to be promising for HCWs, but these were utilized to address only individual-level challenges and needs. Given that well-being entails an interaction of factors, multi-level interventions addressing multiple socio-ecological levels (interpersonal, organizational, community) and that place HCWs in their social context should be administrated to increase and maintain intervention’ effects long-term and possibly aid in better coping with future pandemics.
Effects of marketing claims on toddler food products on parents’ product preferences, perceptions and purchasing intentions: an online experiment
Authors: Dixon Helen Gwenda , Awoke Mamaru Ayenew , Scully Maree , McCann Jennifer , Martin Jane , Morley Belinda , Rhodes Anthea , McAleese Alison , Schmidtke Andrea 
Published: May 2024

AbstractBackgroundThe retail market for toddler-specific packaged foods is growing. Many of these products are ultra-processed and high in nutrients of concern for health, yet marketed in ways that may make them appear wholesome. This study aims to assess parents’ responses to claims on unhealthy, ultra-processed toddler food products and test whether removing such claims promotes more accurate product perceptions and healthier product preferences.MethodsParents of toddlers aged 12 to < 36 months (N = 838) were recruited for an online experiment testing four on-pack claim conditions: control (no claim); 'contains "good" ingredient'; 'free from "bad" ingredient'; and unregulated 'child-related' claim. Participants were randomly assigned to one condition, then viewed images of toddler food products that varied in nutrition content and the claims displayed. Participants completed tasks assessing product preferences (unhealthy product displaying claim vs. a healthier option with no claim, across four food categories (banana bars, strawberry snacks, blueberry yogurt snacks and veggie snacks)), purchase intentions and product perceptions. Poisson regression (count variable) and linear regression (continuous outcomes) analyses were employed to test for mean differences by marketing claim conditions.ResultsFor the overall sample, brief exposure to ‘free from "bad" ingredient’ claims increased participant’s intentions to purchase unhealthy food products for their toddlers, but there was no clear evidence that ‘contains "good" ingredient’ claims and ‘child-related’ claims significantly impacted parent’s preferences, purchase intentions and perceptions of toddler foods. However, certain claims influenced particular parent subgroups. Notably, parents with three or more children chose more unhealthy products when these products displayed ‘contains "good" ingredient’ or ‘free from "bad" ingredient’ claims; the latter claims also promoted stronger purchase intentions and enhanced product perceptions among this subgroup.ConclusionsFindings indicate that ‘free from "bad" ingredient’ claims on unhealthy toddler foods are of most concern, as they boost the appeal of these products to parents. ‘Contains "good" ingredient’ claims and ‘child-related’ claims showed limited effects in this study. Considering available evidence, we recommend claims should not be permitted on child-oriented foods, as they may promote inaccurate product perceptions and unhealthy product choices by parents, that can detract from their children’s diets and health.
Adherence to the Mediterranean Diet and its association with gastric cancer: health benefits from a Planeterranean perspective
Authors: Reytor-González Claudia , Zambrano Ana Karina , Montalvan Martha , Frias-Toral Evelyn , Simancas-Racines Alison , Simancas-Racines Daniel 
Published: May 2024

AbstractThe Mediterranean Diet (MD) has garnered increasing attention for its potential protective effects against gastric cancer (GC). The MD’s rich content of antioxidants, polyphenols, and other bioactive compounds contributes to its ability to modulate gene expression, inhibit tumor growth, and regulate apoptosis. Studies have shown significant reductions in inflammatory markers such as C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) among individuals adhering to the MD, suggesting its pivotal role in mitigating chronic inflammation-associated with cancer development. Furthermore, the MD’s anti-angiogenic properties, particularly in components like olive oil, red wine, fish, and tomatoes, offer promising avenues for reducing GC risk by inhibiting tumor angiogenesis. Additionally, the MD’s influence on intestinal microbiota composition underscores its potential in maintaining immune homeostasis and reducing systemic inflammation, factors crucial in GC prevention. Despite challenges such as variability in dietary adherence scoring systems and the need for further gender and geographical-specific studies, evidence supports the MD as a cost-effective and holistic approach to GC prevention. Emphasizing the role of nutrition in public health is a promising strategy with broad implications for global health and cancer prevention initiatives. Therefore, this review explores the multifaceted impacts of the MD on GC prevention, delving into its anti-inflammatory, anti-angiogenic, and molecular mechanisms.
In silico analysis of the wild-type and mutant-type of BRCA2 gene
Authors: Li Jingjing , Ge Rui , Lu Guanming , Cai Yuanxuan , Teng Yuan , Fan Zhe , Liao Liangyan , Kong Lingjie , Zhang Jinze , Wei Tao , Li Qian , Long Tianzhu , Yu Hongyan , Li Jie 
Published: May 2024

Abstract
Background
The aim of this study was to conduct an in silico analysis of a novel compound heterozygous variant in breast cancer susceptibility gene 2 (BRCA2) to clarify its structure–function relationship and elucidate the molecular mechanisms underlying triple-negative breast cancer (TNBC).

Methods
A tumor biopsy sample was obtained from a 42-year-old Chinese woman during surgery, and a maxBRCA™ test was conducted using the patient’s whole blood. We obtained an experimentally determined 3D structure (1mje.pdb) of the BRCA2 protein from the Protein Data Bank (PDB) as a relatively reliable reference. Subsequently, the wild-type and mutant structures were predicted using SWISS-MODEL and AlphaFold, and the accuracy of these predictions was assessed through the SAVES online server. Furthermore, we utilized a high ambiguity-driven protein–protein docking (HADDOCK) algorithm and protein–ligand interaction profiler (PLIP) to predict the pathogenicity of the mutations and elucidate pathogenic mechanisms that potentially underlies TNBC.

Results
Histological examination revealed that the tumor biopsy sample exhibited classical pathological characteristics of TNBC. Furthermore, the maxBRCA™ test revealed two compound heterozygous BRCA2 gene mutations (c.7670 C > T.pA2557V and c.8356G > A.pA2786T). Through performing in silico structural analyses and constructing of 3D models of the mutants, we established that the mutant amino acids valine and threonine were located in the helical domain and oligonucleotide binding 1 (OB1), regions that interact with DSS1.

Conclusion
Our analysis revealed that substituting valine and threonine in the helical domain region alters the structure and function of BRCA2 proteins. This mutation potentially affects the binding of proteins and DNA fragments and disrupts interactions between the helical domain region and OB1 with DSS1, potentially leading to the development of TNBC. Our findings suggest that the identified compound heterozygous mutation contributes to the clinical presentation of TNBC, providing new insights into the pathogenesis of TNBC and the influence of compound heterozygous mutations in BRCA2.