bluuebunny/crossref_metadata_2025_split huggingface dataset:
The reporting quality of acupuncture-related traumatic adverse events: a systematic review of case studies in Korea
Authors: Kim Sung-A , Lee Ji-Su , Kim Tae-Hun , Lee Seunghoon , Lee Jae-Dong , Kang Jung Won 
Published: March 2024

Abstract
Background
Acupuncture is known for a harmless treatment when administered by well-trained clinicians. However, multiple case reports of traumatic adverse events (AEs) related to acupuncture treatments continue to be published in literature. In this review, we evaluated the reporting quality and conducted causality assessments of case studies that have reported acupuncture-related traumatic AEs in Korea.

Methods
Eight databases were searched from their inception to January 2024. Only Korean case studies that reported traumatic AEs following acupuncture procedures were included without any language restrictions. Reporting quality was evaluated based on patient characteristics, AEs, and acupuncture practice. Causality was assessed using the modified WHO-UMC causality criteria.

Results
Twenty-eight studies were included from a total of 1,154 identified studies. The quality of reporting in the included studies was low overall. While the descriptions of patient characteristics and AEs were relatively well detailed, most information on acupuncture practice was not reported at all. During the causality assessment, only three (10.7%) studies were judged to be “certain”. Twelve (42.9%) studies were “unassessable” because they inadequately described the information necessary for decision-making. It was practically difficult to establish the causality between acupuncture and AEs, as well as the appropriateness of acupuncture practice.

Conclusions
Insufficient and inappropriate reporting was observed in most case studies reporting acupuncture-related traumatic AEs in Korea. To overcome these limitations, we have suggested tentative guidelines in the form of a set of items that should be reported by future authors who plan to publish case studies on acupuncture-related traumatic AEs in a clinical setting.
Sociocultural factors affecting first-year medical students’ adjustment to a PBL program at an African medical school
Authors: Kebaetse Masego B. , Griffiths Dominic , Mokone Gaonyadiwe G. , Mogodi Mpho S. , Conteh Brigid G. , Nkomazana Oathokwa , Wright John , Falama Rosemary , Kebaetse Maikutlo 
Published: March 2024

Abstract
Background
Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students’ experiences during the first semester of an undergraduate problem-based learning medical program at an African medical school.

Method
We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework.

Results
Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach.

Conclusions
Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self-direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research-informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem-based learning process.
Descriptive feedback with targeted education to improve telephonic escalation of care: a simulation-based study
Authors: Kuriakose Aster , Arachchige Subodhini Puhambugoda , Emeto Theophilus I , Hiskens Matthew I , Hariharan Gopakumar 
Published: March 2024

Abstract
Background
Awareness of communication failures in healthcare has necessitated the implementation of standardized, validated handover tools such as Identification, Situation, Background, Assessment, Recommendation (ISBAR). Although educational sessions improve communication, the effectiveness of individualized care escalation communication training is unknown. The primary aim was to conduct a simulation-based study to assess individualized one-on-one communication training for junior medical doctors for improving care escalation in pediatric emergencies. The secondary aim was to assess the evaluation of the training.

Methods
The prospective observational study assessed participants pre- and post-intervention. In Session One, participants presented a written case scenario telephonically to two senior pediatricians. Fifty participants were scored using an 18-item checklist based on the ISBAR tool and “free text” responses. Immediately following case presentations, participants completed individualized one-on-one 30-minute educational sessions regarding self-reflection, didactic teaching, and constructive feedback based on the ISBAR. Session Two included a second case presentation and reassessment. We conducted qualitative analysis of supervisor’s feedback on performance and trainee doctor’s evaluation of the training.

Results
There was significant improvement in 8 of the 18 components of the ISBAR checklist. All elements of care escalation were significantly improved, and overall communication was higher post-intervention (P < 0.001); however, no improvement was noted in participants’ explorations of differential diagnoses (P = 0.263). The qualitative analysis identified themes of improved urgency in seeking senior support and conversational clarity from supervisors, and improved intervention quality and self-confidence from participants.

Conclusions
Individualized communication training may improve pediatric emergency care escalation and communication among junior doctors.
Effect of morality or capitalist ideology in choosing dentistry as a career in Türkiye: a cross sectional study
Authors: Gökay Gonca Deste , Görürgöz Cansu , Kılınç Ahmet 
Published: March 2024

Abstract
Background
Previous studies have provided important findings on the profession of dentistry and the motivators for choosing dentistry. This study has attempted to contribute to this accumulation by using a sociocultural perspective and interpreting the relationships among motivators from this perspective in a large Turkish sample. The aim of this study was to investigate what motivates dental students to choose dentistry as a career in Türkiye.

Methods
First-year dental students from different dental schools were included in a descriptive cross-sectional study. The questionnaire included sections covering demographics, motivators and career satisfaction. A total of 919 students from 29 different state dental schools and four private dental schools participated. Descriptive statistics such as percentages, means and standard deviations were used to summarize the sociodemographic information and the distribution of the motivators. Factorial analysis was carried out for the structural status of the questionnaire items. The relationships between the motivators were analyzed using Pearson’s correlation.

Results
Among the 919 students, 64.2% were female, and 35.8% were male. Half of them chose dentistry after seeing their higher education institution’s examination results, while the other half had already considered it a career during their preuniversity years. Communicating with people, artistic skills, and helping others were the main motivators for students to choose dentistry as a career in Türkiye, and students’ overall career satisfaction was moderately high. The strongest correlations were between communication with people and benefits (r =.74), between communication with people and helping others (r =.71), between communication with people and artistic skills (r =.66), between artistic skills and benefits (r =.69), between artistic skills and helping others (r =.65), between dental experience and benefits (r =.51), between dental experience and helping others (r =.50), and between benefits and helping others (r =.71).

Conclusion
Helping others, artistic skills, communicating with people, and benefits were the most important factors motivating dental students to choose a career, and positive relationships were detected between these four factors. This information may help to develop more effective career guidance and mentorship strategies for dental students.
How to select and understand guidelines for patient-reported outcomes: a scoping review of existing guidance
Authors: Kaneyasu Takako , Hoshino Eri , Naito Mariko , Suzukamo Yoshimi , Miyazaki Kikuko , Kojima Satomi , Yamaguchi Takuhiro , Kawaguchi Takashi , Miyaji Tempei , Nakajima Takako Eguchi , Shimozuma Kojiro 
Published: March 2024

Abstract
Background
Over the past few decades, patient-reported outcomes (PROs) have been used to understand patient health conditions better. Therefore, numerous PRO measures (questionnaires) and guidelines or guidance have been developed. However, it is challenging to select target guidance from among the many available guidance and to understand the chosen guidance. This study comprehensively collected the existing PRO guidance for clinical trials or studies and practices to support novice PRO users in academia, industry, clinical practice, and regulatory and reimbursement decision-making.

Methods
For the scoping review, we searched the MEDLINE, Embase, Google Books, WorldCat, and the National Library of Medicine (NLM) Bookshelf databases from 2009 to 2023. The eligibility criteria were PRO guidance for clinical trials, clinical practice, or application such as health technology assessment. Those guidance cover aspects such as quality of life (QOL), PRO, health-related QOL, health state utilities, psychometric requirements, implementation methods, analysis and interpretation, or clinical practice applications. After the systematic search, three researchers individually reviewed the collected data, and the reviewed articles and books were scrutinized using the same criteria.

Results
We collected the PRO guidance published in articles and books between 2009 and 2023. From the database searches, 1,455 articles and 387 books were identified, of which one book and 33 articles were finally selected. The collected PRO guidance was categorized into the adoption of PRO measures, design and reporting of trials or studies using PROs, implementation of PRO evaluation in clinical trials or studies or clinical practice, analysis and interpretation of PROs, and application of PRO evaluation. Based on this categorization, we suggest the following for novices: When selecting guidance, novices should clarify the “place” and “purpose” where the guidance will be used. Additionally, they should know that the terminology related to PRO and the scope and expectations of PROs vary by “places” and “purposes”.

Conclusions
From this scoping review of existing PRO guidance, we provided summaries and caveats to assist novices in selecting guidance that fits their purpose and understanding it.
Investigating the nexus of metabolic syndrome, serum uric acid, and dementia risk: a prospective cohort study
Authors: Chen Tara SR , Mi Ning-Ning , Lao Hubert Yuenhei , Wang Chen-Yu , Lo Wai Leung Ambrose , Mao Yu-Rong , Tang Yan , Pei Zhong , Yuan Jin-Qiu , Huang Dong-Feng 
Published: March 2024

AbstractBackgroundThe global dementia prevalence is surging, necessitating research into contributing factors. We aimed to investigate the association between metabolic syndrome (MetS), its components, serum uric acid (SUA) levels, and dementia risk.MethodsOur prospective study comprised 466,788 participants without pre-existing MetS from the UK Biobank. We confirmed dementia diagnoses based on the ICD-10 criteria (F00-03). To evaluate the dementia risk concerning MetS, its components, and SUA levels, we applied Cox proportional hazards models, while adjusting for demographic factors.ResultsOver a median follow-up of 12.7 years, we identified 6845 dementia cases. Individuals with MetS had a 25% higher risk of all-cause dementia (hazard ratio [HR] = 1.25, 95% confidence interval [CI] = 1.19–1.31). The risk increased with the number of MetS components including central obesity, dyslipidemia for high-density lipoprotein (HDL) cholesterol, hypertension, hyperglycemia, and dyslipidemia for triglycerides. Particularly for those with all five components (HR = 1.76, 95% CI = 1.51–2.04). Dyslipidemia for HDL cholesterol, hypertension, hyperglycemia, and dyslipidemia for triglycerides were independently associated with elevated dementia risk (p< 0.01). MetS was further linked to an increased risk of all-cause dementia (11%) and vascular dementia (VD, 50%) among individuals with SUA levels exceeding 400 μmol/L (all-cause dementia: HR = 1.11, 95% CI = 1.02–1.21; VD: HR = 1.50, 95% CI = 1.28–1.77).ConclusionsOur study provides robust evidence supporting the association between MetS, its components, and dementia risk. These findings emphasize the importance of considering MetS and SUA levels in assessing dementia risk, offering valuable insights for prevention and management strategies.
Assessing the impact of type 2 diabetes on mortality and life expectancy according to the number of risk factor targets achieved: an observational study
Authors: Wang Bin , Fu Yanqi , Tan Xiao , Wang Ningjian , Qi Lu , Lu Yingli 
Published: March 2024

Abstract
Background
Type 2 diabetes (T2D) is associated with an increased risk of premature death. Whether multifactorial risk factor modification could attenuate T2D-related excess risk of death is unclear. We aimed to examine the association of risk factor target achievement with mortality and life expectancy among patients with T2D, compared with individuals without diabetes.

Methods
In this longitudinal cohort study, we included 316 995 participants (14 162 with T2D and 302 833 without T2D) free from cardiovascular disease (CVD) or cancer at baseline between 2006 and 2010 from the UK Biobank. Participants with T2D were categorised according to the number of risk factors within target range (non-smoking, being physically active, healthy diet, guideline-recommended levels of glycated haemoglobin, body mass index, blood pressure, and total cholesterol). Survival models were applied to calculate hazard ratios (HRs) for mortality and predict life expectancy differences.

Results
Over a median follow-up of 13.8 (IQR 13.1–14.4) years, deaths occurred among 2105 (14.9%) participants with T2D and 18 505 (6.1%) participants without T2D. Compared with participants without T2D (death rate per 1000 person-years 4.51 [95% CI 4.44 to 4.57]), the risk of all-cause mortality among those with T2D decreased stepwise with an increasing number of risk factors within target range (0–1 risk factor target achieved: absolute rate difference per 1000 person-years 7.34 [4.91 to 9.78], HR 2.70 [2.25 to 3.25]; 6–7 risk factors target achieved: absolute rate difference per 1000 person-years 0.68 [-0.62 to 1.99], HR 1.16 [0.93 to 1.43]). A similar pattern was observed for CVD and cancer mortality. The association between risk factors target achievement and all-cause mortality was more prominent among participants younger than 60 years than those 60 years or older (P for interaction = 0.012). At age 50 years, participants with T2D who had 0–1 and 6–7 risk factors within target range had an average 7.67 (95% CI 6.15 to 9.19) and 0.99 (-0.59 to 2.56) reduced years of life expectancy, respectively, compared with those without T2D.

Conclusions
Individuals with T2D who achieved multiple risk factor targets had no significant excess mortality risk or reduction in life expectancy than those without diabetes. Early interventions aiming to promote risk factor modification could translate into improved long-term survival for patients with T2D.
Exploring the role of community pharmacies as a harm reduction environment for anabolic–androgenic steroid consumers: triangulating the perspectives of consumers and pharmacists
Authors: Piatkowski Timothy , Benn Sarah , Ayurzana Lkhagvadulam , King Michelle , McMillan Sara , Hattingh Laetitia 
Published: March 2024

Abstract
Background
While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic–androgenic steroid (AAS) consumers.

Objective
This study aimed to triangulate the attitudes and experiences of AAS consumers and community pharmacist’s regarding AAS harm reduction.

Methods
Semi-structured interviews were conducted with AAS consumers (n = 8) and community pharmacists (n = 15) between December 2022 and August 2023 in Australia. Interview data were analysed using reflexive thematic analysis.

Results
While consumers emphasised easy access to pharmacies, particularly in urban areas, challenges were noted in rural regions. AAS consumers expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with AAS consumers. Similarly, pharmacists expressed receptivity to providing harm reduction information but acknowledged knowledge gaps, suggesting a need for tailored education programs to support AAS consumers effectively.

Conclusions
Community pharmacies can be an important environment for AAS harm reduction. Strategies include utilising private spaces for open discussions with AAS consumers and enhancing pharmacists' understanding of AAS to foster trust and support. Further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.
CAR T cells and T cells phenotype and function are impacted by glucocorticoid exposure with different magnitude
Authors: Poiret Thomas , Vikberg Sara , Schoutrop Esther , Mattsson Jonas , Magalhaes Isabelle 
Published: March 2024

Abstract
Background
Chimeric antigen receptor (CAR) T cell therapy is associated with high risk of adverse events. Glucocorticoids (GCs) are cornerstone in the management of high-grade cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Given the potentially deleterious effects of GCs on CAR T cells anti-tumor activity, increasing our understanding of GCs impact on CAR T cells is crucial.

Methods
Using several CAR T cells i.e., CD19, mesothelin (MSLN)-CD28 and MSLN-41BB CAR T cells (M28z and MBBz), we compared phenotypical, functional, changes and anti-tumor activity between i) transduced CD19 CAR T cells with untransduced T cells, ii) M28z with MBBz CAR T cells induced by Dexamethasone (Dx) or Methylprednisolone (MP) exposures.

Results
Higher levels of GC receptor were found in less differentiated CAR T cells. Overall, Dx and MP showed a similar impact on CAR T cells. Compared to untreated condition, GCs exposure increased the expression of PD-1 and TIM-3 and reduced the expression of LAG3 and function of T cells and CAR T cells. GC exposures induced more exhausted (LAG3 + PD1 + TIM3 +) and dysfunctional (CD107a-INFγ-TNF-IL2-) untransduced T cells in comparison to CD19 CAR T cells. GC exposure impaired more CD4 + than CD8 + CD19 CAR T cells. GC exposures increased more PD-1 expression associated with reduced proliferative capacity and function of M28z as compared to MBBz CAR T cells. CAR T cells anti-tumor activity was greatly affected by repeated GC exposure but partly recovered within 48h after GCs withdrawal.

Conclusions
In summary, GCs impacted phenotype and function of untransduced and CAR T cell with different magnitude. The nature of the CAR costimulatory domain influenced the magnitude of CAR T cell response to GCs.
Support, not blame: safe partner disclosure among women diagnosed with HIV late in pregnancy in South Africa and Uganda
Authors: Twimukye Adelline , Alhassan Yussif , Ringwald Beate , Malaba Thokozile , Myer Landon , Waitt Catriona , Lamorde Mohammed , Reynolds Helen , Khoo Saye , Taegtmeyer Miriam 
Published: March 2024

Abstract
Background
HIV partner disclosure rates remain low among pregnant women living with HIV in many African countries despite potential benefits for women and their families. Partner disclosure can trigger negative responses like blame, violence, and separation. Women diagnosed with HIV late in pregnancy have limited time to prepare for partner disclosure. We sought to understand challenges around partner disclosure and non-disclosure faced by women diagnosed with HIV late in pregnancy in South Africa and Uganda and to explore pathways to safe partner disclosure.

Methods
We conducted in-depth interviews and focus group discussions with pregnant women and lactating mothers living with HIV (n = 109), disaggregated by antenatal care (ANC) initiation before and after 20 weeks of gestation, male partners (n = 87), and health workers (n = 53). All participants were recruited from DolPHIN2 trial sites in Kampala (Uganda) and Gugulethu (South Africa). Topic guides explored barriers to partner disclosure, effects of non-disclosure, strategies for safe disclosure. Using the framework analysis approach, we coded and summarised data based on a socio-ecological model, topic guides, and emerging issues from the data. Data was analysed in NVivo software.

Results
Our findings illustrate pregnant women who initiate ANC late experience many difficulties which are compounded by the late HIV diagnosis. Various individual, interpersonal, community, and health system factors complicate partner disclosure among these women. They postpone or decide against partner disclosure mainly for own and baby’s safety. Women experience stress and poor mental health because of non-disclosure while demonstrating agency and resilience. We found many similarities and some differences around preferred approaches to safe partner disclosure among female and male participants across countries. Women and male partners preferred healthcare workers to assist with disclosure by identifying the ‘right’ time to disclose, mentoring women to enhance their confidence and communication skills, and providing professional mediation for partner disclosure and couple testing. Increasing the number of counsellors and training them on safe partner disclosure was deemed necessary for strengthening local health services to improve safe partner disclosure.

Conclusion
HIV diagnosis late in pregnancy amplifies existing difficulties among pregnant women. Late ANC initiation is an indicator for the likelihood that a pregnant woman is highly vulnerable and needs safeguarding. Respective health programmes should be prepared to offer women initiating ANC late in pregnancy additional support and referral to complementary programmes to achieve safe partner disclosure and good health.