bluuebunny/crossref_metadata_2025_split huggingface dataset:
Team players and helpers – describing professional identity among finnish physicians in a cross-sectional study
Authors: Mattila Pyry , Hyppölä Harri , Heikkilä Teppo , Heistaro Sami , Kaila Minna , Kulmala Petri , Sumanen Markku , Mäntyselkä Pekka 
Published: March 2024

Abstract
Background
Every physician has a unique professional identity. However, little is known about the diversity of identities among physicians. This study aimed to quantitatively assess the professional identity of physicians in Finland using descriptions of professional identity.

Methods
This study was part of a larger cross-sectional Finnish Physician 2018 Study. The target population consisted of all Finnish physicians under the age of 70 (N = 24,827) in 2018. The sample was drawn from physicians born on even numbered days (N = 11,336) using the Finnish Medical Association register. A total of 5,187 (46%) physicians responded. Professional identity was examined by 27 given characterisations using a five-point Likert scale. Multivariate logistic regression was used in assessing how place of work, graduation year and gender were associated with identity descriptions.

Results
The descriptions which most physicians identified with were “member of a working group/team” (82%), “helper” (82%), and “health expert” (79%); the majority reported these as describing them very or quite well. Identity descriptions such as “prescriber of medications” (68% vs. 45%), “prioritiser” (57% vs. 35%) and “someone issuing certificates” (52% vs. 32%) were more popular among junior than senior physicians. The biggest differences between the genders were found in the descriptions “provider of comfort” (62% vs. 40%) and “someone engaged in social work” (45% vs. 25%), with which women identified more frequently than men.

Conclusions
Strong identification as a member of a team is an important finding in the increasingly multiprofessional world of health care. Importantly, most physicians shared several core professional identity descriptions (i.e., helper, health expert) that reflect the traditional image of an exemplary doctor.
Objective structured clinical examination to teach competency in planetary health care and management – a prospective observational study
Authors: Teichgräber Ulf , Ingwersen Maja , Sturm Max-Johann , Giesecke Jan , Allwang Manuel , Herzog Ida , von Gierke Frederike , Schellong Paul , Kolleg Matthias , Lange Kathleen , Wünsch Daniel , Gugel Katrin , Wünsch Anne , Zöllkau Janine , Petruschke Inga , Häseler-Ouart Kristin , Besteher Bianca , Philipp Swetlana , Mille Urte , Ouart Dominique , Jünger Jana ,   Jena Planetary Health Collaboration Group, Kamradt Thomas , Pletz Mathias , Stallmach Andreas , Coldewey Sina M. , Schleußner Ekkehard , Wedding Ulrich , Walter Martin 
Published: March 2024

Abstract
Background
Health professionals are increasingly called upon and willing to engage in planetary health care and management. However, so far, this topic is rarely covered in medical curricula. As the need for professional communication is particularly high in this subject area, this study aimed to evaluate whether the objective structured clinical examination (OSCE) could be used as an accompanying teaching tool.

Methods
During the winter semester 2022/2023, 20 third- and fifth-year medical students voluntarily participated in a self-directed online course, three workshops, and a formal eight-station OSCE on planetary health care and management. Each examinee was also charged alternatingly as a shadower with the role of providing feedback. Experienced examiners rated students’ performance using a scoring system supported by tablet computers. Examiners and shadowers provided timely feedback on candidates` performance in the OSCE. Immediately after the OSCE, students were asked about their experience using a nine-point Likert-scale survey and a videotaped group interview. Quantitative analysis included the presentation of the proportional distribution of student responses to the survey and of box plots showing percentages of maximum scores for the OSCE performance. The student group interview was analyzed qualitatively.

Results
Depending on the sub-theme, 60% -100% of students rated the subject of planetary health as likely to be useful in their professional lives. Similar proportions (57%-100%) were in favour of integrating planetary health into required courses. Students perceived learning success from OSCE experience and feedback as higher compared to that from online courses and workshops. Even shadowers learned from observation and feedback discussions. Examiners assessed students’ OSCE performance at a median of 80% (interquartile range: 83%-77%) of the maximum score.

Conclusions
OSCE can be used as an accompanying teaching tool for advanced students on the topic of planetary health care and management. It supports learning outcomes, particularly in terms of communication skills to sensitise and empower dialogue partners, and to initiate adaptation steps at the level of individual patients and local communities.
Evolution of compound eye morphology underlies differences in vision between closely related Drosophila species
Authors: Buffry Alexandra D. , Currea John P. , Franke-Gerth Franziska A. , Palavalli-Nettimi Ravindra , Bodey Andrew J. , Rau Christoph , Samadi Nazanin , Gstöhl Stefan J. , Schlepütz Christian M. , McGregor Alistair P. , Sumner-Rooney Lauren , Theobald Jamie , Kittelmann Maike 
Published: March 2024

Abstract
Background
Insects have evolved complex visual systems and display an astonishing range of adaptations for diverse ecological niches. Species of Drosophila melanogaster subgroup exhibit extensive intra- and interspecific differences in compound eye size. These differences provide an excellent opportunity to better understand variation in insect eye structure and the impact on vision. Here we further explored the difference in eye size between D. mauritiana and its sibling species D. simulans.

Results
We confirmed that D. mauritiana have rapidly evolved larger eyes as a result of more and wider ommatidia than D. simulans since they recently diverged approximately 240,000 years ago. The functional impact of eye size, and specifically ommatidia size, is often only estimated based on the rigid surface morphology of the compound eye. Therefore, we used 3D synchrotron radiation tomography to measure optical parameters in 3D, predict optical capacity, and compare the modelled vision to in vivo optomotor responses. Our optical models predicted higher contrast sensitivity for D. mauritiana, which we verified by presenting sinusoidal gratings to tethered flies in a flight arena. Similarly, we confirmed the higher spatial acuity predicted for Drosophila simulans with smaller ommatidia and found evidence for higher temporal resolution.

Conclusions
Our study demonstrates that even subtle differences in ommatidia size between closely related Drosophila species can impact the vision of these insects. Therefore, further comparative studies of intra- and interspecific variation in eye morphology and the consequences for vision among other Drosophila species, other dipterans and other insects are needed to better understand compound eye structure–function and how the diversification of eye size, shape, and function has helped insects to adapt to the vast range of ecological niches.
Incidence of new-onset hypertension before, during, and after the COVID-19 pandemic: a 7-year longitudinal cohort study in a large population
Authors: Trimarco Valentina , Izzo Raffaele , Pacella Daniela , Trama Ugo , Manzi Maria Virginia , Lombardi Angela , Piccinocchi Roberto , Gallo Paola , Esposito Giovanni , Piccinocchi Gaetano , Lembo Maria , Morisco Carmine , Rozza Francesco , Santulli Gaetano , Trimarco Bruno 
Published: March 2024

Abstract
Background
While the augmented incidence of diabetes after COVID-19 has been widely confirmed, controversial results are available on the risk of developing hypertension during the COVID-19 pandemic.

Methods
We designed a longitudinal cohort study to analyze a closed cohort followed up over a 7-year period, i.e., 3 years before and 3 years during the COVID-19 pandemic, and during 2023, when the pandemic was declared to be over. We analyzed medical records of more than 200,000 adults obtained from a cooperative of primary physicians from January 1, 2017, to December 31, 2023. The main outcome was the new diagnosis of hypertension.

Results
We evaluated 202,163 individuals in the pre-pandemic years and 190,743 in the pandemic years, totaling 206,857 when including 2023 data. The incidence rate of new hypertension was 2.11 (95% C.I. 2.08–2.15) per 100 person-years in the years 2017–2019, increasing to 5.20 (95% C.I. 5.14–5.26) in the period 2020–2022 (RR = 2.46), and to 6.76 (95% C.I. 6.64–6.88) in 2023. The marked difference in trends between the first and the two successive observation periods was substantiated by the fitted regression lines of two Poisson models conducted on the monthly log-incidence of hypertension.

Conclusions
We detected a significant increase in new-onset hypertension during the COVID-19 pandemic, which at the end of the observation period affected ~ 20% of the studied cohort, a percentage higher than the diagnosis of COVID-19 infection within the same time frame. This observation suggests that increased attention to hypertension screening should not be limited to individuals who are aware of having contracted the infection but should be extended to the entire population.
CVOT Summit Report 2023: new cardiovascular, kidney, and metabolic outcomes
Authors: Schnell Oliver , Barnard-Kelly Katharine , Battelino Tadej , Ceriello Antonio , Larsson Helena Elding , Fernández-Fernández Beatriz , Forst Thomas , Frias Juan-Pablo , Gavin James R. , Giorgino Francesco , Groop Per-Henrik , Heerspink Hiddo J. L. , Herzig Stephan , Hummel Michael , Huntley George , Ibrahim Mahmoud , Itzhak Baruch , Jacob Stephan , Ji Linong , Kosiborod Mikhail , Lalic Nebosja , Macieira Sofia , Malik Rayaz A. , Mankovsky Boris , Marx Nikolaus , Mathieu Chantal , Müller Timo D. , Ray Kausik , Rodbard Helena W. , Rossing Peter , Rydén Lars , Schumm-Draeger Petra-Maria , Schwarz Peter , Škrha Jan , Snoek Frank , Tacke Frank , Taylor Bruce , Jeppesen Britta Tendal , Tesfaye Solomon , Topsever Pinar , Vilsbøll Tina , Yu Xuefeng , Standl Eberhard 
Published: March 2024

AbstractThe 9th Cardiovascular Outcome Trial (CVOT) Summit: Congress on Cardiovascular, Kidney, and Metabolic Outcomes was held virtually on November 30-December 1, 2023. This reference congress served as a platform for in-depth discussions and exchange on recently completed outcomes trials including dapagliflozin (DAPA-MI), semaglutide (SELECT and STEP-HFpEF) and bempedoic acid (CLEAR Outcomes), and the advances they represent in reducing the risk of major adverse cardiovascular events (MACE), improving metabolic outcomes, and treating obesity-related heart failure with preserved ejection fraction (HFpEF). A broad audience of endocrinologists, diabetologists, cardiologists, nephrologists and primary care physicians participated in online discussions on guideline updates for the management of cardiovascular disease (CVD) in diabetes, heart failure (HF) and chronic kidney disease (CKD); advances in the management of type 1 diabetes (T1D) and its comorbidities; advances in the management of CKD with SGLT2 inhibitors and non-steroidal mineralocorticoid receptor antagonists (nsMRAs); and advances in the treatment of obesity with GLP-1 and dual GIP/GLP-1 receptor agonists. The association of diabetes and obesity with nonalcoholic steatohepatitis (NASH; metabolic dysfunction-associated steatohepatitis, MASH) and cancer and possible treatments for these complications were also explored. It is generally assumed that treatment of chronic diseases is equally effective for all patients. However, as discussed at the Summit, this assumption may not be true. Therefore, it is important to enroll patients from diverse racial and ethnic groups in clinical trials and to analyze patient-reported outcomes to assess treatment efficacy, and to develop innovative approaches to tailor medications to those who benefit most with minimal side effects. Other keys to a successful management of diabetes and comorbidities, including dementia, entail the use of continuous glucose monitoring (CGM) technology and the implementation of appropriate patient-physician communication strategies. The 10th Cardiovascular Outcome Trial Summit will be held virtually on December 5–6, 2024 (http://www.cvot.org).
Protective effects of imeglimin on the development of atherosclerosis in ApoE KO mice treated with STZ
Authors: Sanada Junpei , Kimura Tomohiko , Shimoda Masashi , Iwamoto Yuichiro , Iwamoto Hideyuki , Dan Kazunori , Fushimi Yoshiro , Katakura Yukino , Nogami Yuka , Shirakiya Yoshiko , Yamasaki Yuki , Ikeda Tomoko , Nakanishi Shuhei , Mune Tomoatsu , Kaku Kohei , Kaneto Hideaki 
Published: March 2024

Abstract
Background
Imeglimin is a new anti-diabetic drug which promotes insulin secretion from pancreatic β-cells and reduces insulin resistance in insulin target tissues. However, there have been no reports examining the possible anti-atherosclerotic effects of imeglimin. In this study, we investigated the possible anti-atherosclerotic effects of imeglimin using atherosclerosis model ApoE KO mice treated with streptozotocin (STZ).

Methods
ApoE KO mice were divided into three groups: the first group was a normoglycemic group without injecting STZ (non-DM group, n = 10). In the second group, mice were injected with STZ and treated with 0.5% carboxymethyl cellulose (CMC) (control group, n = 12). In the third group, mice were injected with STZ and treated with imeglimin (200 mg/kg, twice daily oral gavage, n = 12). We observed the mice in the three groups from 10 to 18 weeks of age. Plaque formation in aortic arch and expression levels of various vascular factors in abdominal aorta were evaluated for each group.

Results
Imeglimin showed favorable effects on the development of plaque formation in the aortic arch in STZ-induced hyperglycemic ApoE KO mice which was independent of glycemic and lipid control. Migration and proliferation of vascular smooth muscle cells and infiltration of macrophage were observed in atherosclerotic lesions in STZ-induced hyperglycemic ApoE KO mice, however, which were markedly reduced by imeglimin treatment. In addition, imeglimin reduced oxidative stress, inflammation and inflammasome in hyperglycemic ApoE KO mice. Expression levels of macrophage makers were also significantly reduced by imeglimin treatment.

Conclusions
Imeglimin exerts favorable effects on the development of plaque formation and progression of atherosclerosis.
Effects of immediate loading directionality on the mechanical sensing protein PIEZO1 expression and early-stage healing process of peri-implant bone
Authors: Mao Chuanyuan , Yu Weijun , Li Guanglong , Xu Ziyuan , Gong Yuhua , Jin Min , Lu Eryi 
Published: March 2024

Abstract
Background
The reduced treatment time of dental implants with immediate loading protocol is an appealing solution for dentists and patients. However, there remains a significant risk of early peri-implant bone response following the placement of immediately loaded implants, and limited information is available regarding loading directions and the associated in vivo characteristics of peri-implant bone during the early stages. This study aimed to investigate the effects of immediate loading directionality on the expression of mechanical sensing protein PIEZO1 and the healing process of peri-implant bone in the early stage.

Methods
Thirty-two implants were inserted into the goat iliac crest models with 10 N static lateral immediate loading applied, followed by histological, histomorphological, immunohistochemical, X-ray microscopy and energy dispersive X-ray spectroscopy evaluations conducted after 10 days.

Results
From evaluations at the cellular, tissue, and organ levels, it was observed that the expression of mechanical sensing protein PIEZO1 in peri-implant bone was significantly higher in the compressive side compared to the tensile side. This finding coincided with trends observed in interfacial bone extracellular matrix (ECM) contact percentage, bone mass, and new bone formation.

Conclusions
This study provides a novel insight into the immediate loading directionality as a potential influence factor for dental implant treatments by demonstrating differential effects on the mechanical sensing protein PIEZO1 expression and related early-stage healing processes of peri-implant bone. Immediate loading directions serve as potential therapeutic influence factors for peri-implant bone during its early healing stage.
Economic evaluations in medical technological innovations a mapping review of methodologies
Authors: van Lieshout C. , Frederix G. W. J. , Schoonhoven L. 
Published: March 2024

Abstract
Rationale
Economic evaluations play an important role in the development and implementation of healthcare innovations. For pharmaceutical products, the methodologies used are laid down in guidelines, whereas for medical technologies the guidelines are not as strenuous. The aim of this review was therefore to analyze what types of methodologies are used in economic evaluations of medical technologies.

Methods
We performed a mapping review to identify economic evaluations for medical technologies. We decided to limit our search to one year (2022) and included cost utility and cost effectiveness analyses in which health technologies were evaluated. For each included study we identified the main methodological characteristics.

Results
A total of 364 papers were included in the analysis, 268 (74%) contained cost-utility analyses and 91 (25%) cost-effectiveness analyses. A model was used in 236 (64%) analyses, 117 analyses were trial based evaluations. Probabilistic sensitivity analyses and/or bootstrapping was performed in 266 (73%) analyses. Deterministic sensitivity analyses were used in 306 (84%). Time horizon and perspective were underreported in 15–25% of the included studies.

Conclusions
This review shows the wide range of methodologies used in economic evaluations as well as the extent and rigor in which these methodologies are used. Many of the included papers did no use or did not sufficiently report the use of appropriate standard methods. This may lead to research waste, a delay in successful implementation of valuable innovations and in the end may delay improvement patient outcomes.
Drivers of consumer food choices of multinational corporations’ products over local foods in Ghana: a maximum difference scaling study
Authors: Nyarko Eric , Bartelmeß Tina 
Published: March 2024

Abstract
Introduction
The fundamental transformation of food systems and retail environments in low-income countries is influencing consumers' food choices and dietary habits in unfavourable directions through the consumption of highly processed, energy-dense foods, predominantly manufactured by multinational food corporations. This study aims to identify the principal factors driving consumers' preference for multinational foods over local foods in the urban Accra region of Ghana.

Method
This cross-sectional survey involving a random sample of 200 consumers conducted in March/April 2023 using interviewer-administered questionnaires employed a maximum difference scaling approach to investigate the drivers of urban Ghanaian consumer food choices for multinational food corporations' products over local foods. The maximum difference scaling modelling analysis utilized in this study identifies the primary drivers of multinational food corporations' product preferences and the associated trade-offs.

Result
The study discovered that food quality and safe packaging, perceived healthiness, taste and flavour, and nutritional value were the most significant factors driving consumer preference for multinational food corporations' products over local foods in Ghana. The criterion food quality and safe packaging had the significantly highest utility than all other attributes in terms of consumer preference for products/meals from multinational food corporations over local foods.

Conclusion
The results of this study provide significant contributions to the existing body of research, as previous studies have not identified these factors as primary drivers of multinational food products. Public health authorities and nutritionists can use the study's findings to implement targeted quality assurance measures in local markets and to address the drivers in health education campaigns.
Successful surgical treatment of impending paradoxical embolism with pulmonary embolism and myocardial infarction
Authors: Liu Yong , Yang Zhiyun , Sun Xinxin , Yang Mei , Zhang Tao , Li Ruilin , Wei Ying , Cao Hao 
Published: March 2024

Abstract
Background
Paradoxical embolism is a rare cause of acute arterial occlusion. This phenomenon arises when embolic material travels from the venous system crosses an abnormal shunt such as patent foramen ovale, atrial septal defects, ventricular septal defects, or pulmonary arteriovenous malformations, into the arterial system. Impending paradoxical embolism refers to the presence of an entrapped thrombus in the patent foramen ovale.

Case presentation
We report a case of a 68-year-old female patient who presented with an impending paradoxical embolism, alongside both concomitant pulmonary embolism and myocardial infarction with ST-segment elevation. Swiftly addressed through emergency cardiac surgery and systemic anticoagulation, the patient’s condition was effectively treated.

Conclusions
While the ideal treatment strategy for impending paradoxical embolism remains a topic of debate due to limited and inconclusive evidence, emergent open surgery should be contemplated in patients as it signifies a critical clinical emergency.