bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparing medical students for their educational task as physicians: important, desirable and unexplored territory
Authors: ter Brugge Bas PH , Fegg Lena Sophia , Wijnen-Meijer Marjo 
Published: April 2024

Abstract
Background
Physicians engage in educational activities in daily practice and take over an important role in providing information and transferring knowledge to patients and medical students. Therefore, it is important to focus on methods to develop teaching skills during medical school. Peer-teaching is a teaching method that is connected to different positive learning outcomes. This study aims to investigate the perspective of medical students regarding teaching as a core competency of physicians and peer-teaching as an opportunity to acquire educational skills. The study also aims to examine to what extent medical students are prepared for their teaching role at medical schools.

Methods
This cross-sectional study was performed by an online survey amongst Dutch medical students from all medical schools across all years of study. In total, 2666 medical students filled out the survey. The survey was part of the annual online survey of the Dutch medical advocacy group (DeGeneeskundestudent) amongst all medical students in the fall of 2017. The data were analysed with descriptive statistics and statistical tests (chi-squared-test and binomial test).

Results
The results show that 49% of medical students see teaching as one of the core tasks of a physician. However, only 25% feel well prepared by their medical school for this teaching role. Instead, there are many students who gain experiences and teaching skills on their own outside medical schools. 64% of the respondents agrees that senior medical students can educate junior medical students well.

Conclusions
Implementing peer-teaching in the curricular of medical schools could be an effective teaching method to prepare medical students for their future teaching role. It is important that medical schools focus on enhancing educational quality and designing learning environments for best learning outcomes to better prepare medical students for professional life.
Barriers to increasing paid parental leave in U.S. neurology residencies: a survey of program directors
Authors: Conway Sarah E. , Wang Wei , Prasad Sashank 
Published: April 2024

Abstract
Background
The American Board of Psychiatry and Neurology (ABPN) and the Accreditation Council for Graduate Medical Education (ACGME) require that residency programs allow at least 6 weeks of parental leave. The American Medical Association (AMA) recommends 12 weeks of paid parental leave. Despite these recommendations, there is little information about parental leave policies across U.S. neurology residencies. The objective of our study was to assess parental leave policies in U.S. adult neurology residencies and barriers to increasing the duration of leave.

Methods
We distributed an anonymous online survey to U.S. adult neurology program directors (PDs) to assess demographics, components and length of parental leave, perceived impact on residents’ clinical training and academic development, and barriers to increasing the length of leave.

Results
We contacted 163 PDs and received 54 responses (response rate of 33%). 87% reported policies for both childbearing and non-childbearing residents. The average maximal length of leave allowed without extension of training was 8.5 weeks (range 0–13) for childbearing and 6.2 weeks (range 0–13) for non-childbearing residents. Most PDs felt that parental leave had a positive impact on resident wellness and neutral impact on clinical competency, academic opportunities, and career development. The most common barriers to providing a 12-week paid policy were concerns about equity in the program (82%), staffing of clinical services (80%), and impact on clinical training (78%).

Conclusions
Although most programs in our study have parental leave policies, there is significant variability. Policies to improve parental leave should focus on addressing common barriers, such as additional solutions to staffing clinical services.
Final-year nursing students’ perceptions of humanistic education in nursing: a cross-sectional descriptive study
Authors: Zhang Jun , Tian Yangyang 
Published: April 2024

Abstract
Background
Humanistic education is an important part of nursing education. Final-year nursing students’ perceptions of nursing humanistic education are under-investigated. This study aimed to examined final-year nursing students’ perceptions of nursing humanistic education in both school and hospital.

Methods
This was a cross-sectional descriptive study conducted from May to June 2022 among 107 final-year nursing students with a self-designed questionnaire.

Results
Final-year nursing students recognized the importance of humanistic education, scoring above 4.0 on a 1–5 scale, while their initiative to enhance humanistic qualities was relatively low. Students’ satisfaction with the number of humanities courses offered was only 3.7 ± 0.862. Moreover, 62.6% of students believed there was a need to enhance humanistic environmental development including corridor culture. The “monotonous teaching format” (63.6%) and “teaching methods” (64.5%) have emerged as focal points that students identified as needing attention and improvement.

Conclusions
In the future, nursing humanistic education can be enhanced by increasing the proportion of humanities, improving teaching methods, stimulating students’ learning motivation, and strengthening the construction of humanistic environment.
Nurses’ perspectives on professional self-concept and its influencing factors: A qualitative study
Authors: Miao Chuyuan , Liu Chunqin , Zhou Ying , Zou Xiaofang , Song Liqin , Chung Joanne W.Y. , Tan Wenying , Li Xiaohua , Li Dong 
Published: April 2024

Abstract
Background
Nurses with a strong professional self-concept tend to exhibit a positive mindset and strong work engagement, delivering high-quality patient care. Although numerous quantitative studies have examined the factors impacting professional self-concept, there remains a limited exploration of these factors from the perspective of nurses themselves.

Methods
This qualitative descriptive study uses the PERMA theory and Social Cognitive Theory as the theoretical framework. Semi-structured interviews were conducted with 15 nurses from six public hospitals in China. The data were analyzed thematically using a combination of inductive and deductive approaches.

Results
Nurses’ understanding of professional self-concept could be divided into four categories: professional identity, competence, care, and knowledge. Factors influencing nurses’ professional self-concept were categorized into eight subthemes in three domains: (1) personal factors, including psychological qualities and attitude towards the nursing profession; (2) occupational-related behavioral factors, including role-oriented behavior and knowledge-oriented behavior; and (3) work environment and external factors, including external evaluation and perceptions of nurses, time allocation, nursing work tasks, work atmosphere, school education, and perceived supports.

Conclusions
This study found that, although nurses had different personal experiences, their perceptions of professional self-concept were similar. Nurses’ professional self-concept is a multidimensional concept and involves various factors, such as personality, work-related characteristics, environment, and family. To thrive in a nursing career, nurses must discern the factors that can enhance or hinder their professional self-concept. By identifying and adjusting these factors, personalized support and positive interventions can be tailored to meet nurses’ specific needs, which ultimately nurtures their professional development.

Trial registration
This study was registered on December 14, 2022, in the Chinese Clinical Trial Registry (ChiCTR2200066699) as part of our ongoing study.
Equine-assisted services for people living with dementia: a systematic review
Authors: Sebalj Menka , Lakhani Ali , Grindrod Andrea , Stuckey Rwth 
Published: April 2024

Abstract
Background
Dementia has a significant impact on the social, physical, and psychological wellbeing of people living with dementia, their families and society. Animal-assisted interventions can have positive effects on the health and wellbeing of people living with dementia. Equine-assisted services are animal-assisted non-pharmacological interventions which have improved the health and wellbeing of diverse populations. The impact of participating in equine-assisted services on the health and wellbeing of people with dementia is unclear. A systematic review was conducted to synthesise evidence investigating the effects of participating in equine-assisted services on the health and wellbeing of people living with dementia.

Design
Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Methods
The databases CINAHL, EMBASE, MEDLINE, and Web of Science were searched for any research published prior to 14 June 2023. Peer-reviewed publications in the English language utilizing methods deriving quantitative and/or qualitative data were eligible. Methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Findings from studies were synthesised using a deductive approach.

Results
Of the 223 articles screened, six met the inclusion criteria: four quantitative and two qualitative studies. The six studies represent four separate equine interventions. Studies were of moderate to strong quality. Participants were people living with dementia (n = 44, mean age range 70–83 years), dementia care partners (n = 5, mean age 58), and equine-assisted services providers (n = 5). Interventions varied in duration, activities conducted, outcomes measured, and measurement tools used. Studies found a favourable impact of participating in equine-assisted services on the neuropsychiatric symptoms and quality of life of people living with dementia. Participating in equine-assisted services improved well-being, functional abilities, social participation, and communication, while also having a positive effect on social, emotional, and behavioural outcomes, and physical health.

Conclusions
The limited but high-quality literature investigating the impact of equine-assisted services among people living with dementia suggests that equine-assisted services can have a positive impact on the health and wellbeing of people living with dementia. Additional robust studies contributing to the evidence base are warranted; such studies can support the development of programs and further elucidate the impact of participation.
Stacked-CNN-BiLSTM-COVID: an effective stacked ensemble deep learning framework for sentiment analysis of Arabic COVID-19 tweets
Authors: Abdelhady Naglaa , Hassan A. Soliman Taysir , F. Farghally Mohammed 
Published: April 2024

AbstractSocial networks are popular for advertising, idea sharing, and opinion formation. Due to COVID-19, coronavirus information disseminated on social media affects people’s lives directly. Individuals sometimes managed it well, but it often hampered daily activities. As a result, analyzing people’s feelings is important. Sentiment analysis identifies opinions or sentiments from text. In this paper, we present an effective model that leverages the benefits of Convolutional Neural Network (CNN) and Bidirectional Long Short-Term Memory (BiLSTM) to categorize Arabic tweets using a stacked ensemble learning model. First, the tweets are represented as vectors using a word embedding model, then the text feature is extracted by CNN, and finally the context information of the text is acquired by BiLSTM. Aravec, FastText, and ArWordVec are employed separately to assess the impact of the word embedding on the our model. We also compare the proposed method to various deep learning models: CNN, LSTM, and BiLSTM. Experiments are performed on three different Arabic datasets related to COVID-19 and vaccines. Empirical findings show that the proposed model outperformed the other models’ results by achieving F-measures of 76.76%, 87.%, and 80.5% on the SenWave, AraCOVID19-SSD, and ArCovidVac datasets, respectively.
Comparative analysis of metabolites and in vitro hypoglycemic activity of Taiwanofungus camphoratus cultured using various methods
Authors: Ming YongFei , Li Yin , Chu JianZhi , Zhou XiaoShuang , Huang YuXuan , Yang ShuDe , Mu YueJun , Wang Lin , Zhang Rui , Cheng XianHao 
Published: April 2024

AbstractTaiwanofungus camphoratus has attracted much attention because it can abundantly produce various active substances that exhibit blood-sugar lowering, immunity improving, and antioxidant properties. Currently, T. camphoratus is cultured using four main methods: cutting wood culture, solid-state fermentation, submerged fermentation, and dish culture. T. camphoratus produces different metabolites under different culture methods. In this study, nontargeted metabolomics was used to compare the metabolites of T. camphoratus produced under these four culture methods. Principal component analysis and supervised partial least squares-discriminant analysis were used to analyze the differences in the metabolites. Moreover, in vitro hypoglycemic activity of T. camphoratus extracts produced under four culture methods was compared by assessing their ability to inhibit the activity of α-glucosidase, α-amylase, and sucrase. A total of 186 metabolites were identified. In total, 127 metabolites were common under the four culture methods. Under solid-state fermentation, submerged fermentation, and cutting wood culture, 12, 1, and 4 metabolites were unique, respectively. The differential metabolites produced by T. camphoratus under four culture methods were mainly triterpenoids, phenolic compounds, and fatty acid compounds. α-glucosidase, α-amylase, and sucrase activity inhibition was the best using T. camphoratus extract obtained under cutting wood culture; the inhibition rates were 55.97%, 51.96%, and 78.02%, respectively, which were comparable to those exhibited by 0.001, 3, and 12 mg/mL acarbose (positive control). The metabolites produced by T. camphoratus and α-glucosidase, α-amylase, and sucrase inhibitory activities were different under the four culture methods. Cutting wood culture exhibited the best enzyme inhibitory activity. This study provided a theoretical basis for further use and development of various culture methods for the rational production of active metabolites of T. camphoratus.
Primary intracranial malignant melanoma in an adolescent female: a case report
Authors: Vishwajeet Vikarn , Saraf Pallavi , Elhence Poonam Abhay , Tiwari Sarbesh , Gosal Jaskaran Singh , Jha Deepak Kumar 
Published: April 2024

Abstract
Background
Primary central nervous system melanoma is an extremely rare entity and even rarer in children and adolescents as compared to adults. It is often difficult to consider a diagnosis of intracranial melanoma pre-operatively without any clinical evidence of neurocutaneous melanosis.

Case presentation
Herein, a case of primary melanoma of the brain is reported in a 17-year-old female who presented with headache, vomiting, and focal neurological deficit in the form of left-sided facial palsy and limb weakness. A contrast-enhanced computed tomography of head was performed which revealed a heterogeneously hyperattenuating mass lesion at left gangliocapsular region showing peripheral enhancement with internal non-enhancing cystic component. The patient underwent left frontotemporal craniotomy. The diagnosis was made on histopathological examination, which showed an invasive tumor comprising of epithelioid to spindled cells arranged in sheets, nests, and singly scattered. The special stains and immunohistochemical markers proved very helpful in establishing the diagnosis.

Conclusions
The case highlights the uncommon occurrence of primary intracranial melanoma in the pediatric age group, the perplexing histological features, and the rapid and fatal course.
Artificial intelligence-driven enhanced skin cancer diagnosis: leveraging convolutional neural networks with discrete wavelet transformation
Authors: Claret S. P. Angelin , Dharmian Jose Prakash , Manokar A. Muthu 
Published: April 2024

Abstract
Background
Artificial intelligence (AI) has shown great promise in the field of healthcare as a means of improving the diagnosis of skin cancer. The objective of this research is to enhance the precision and effectiveness of skin cancer identification by the incorporation of convolutional neural networks (CNNs) and discrete wavelet transformation (DWT). Making use of AI-driven techniques has the potential to completely transform the diagnosis process by providing quicker and more accurate evaluations of skin lesions. In an effort to improve dermatology and give physicians reliable resources for early and precise skin cancer diagnosis, this work explores the combination of CNNs with DWT.

Methods
The accurate and timely classification of skin cancer lesions plays a crucial role in early diagnosis and effective treatment. In this, we propose a novel approach for skin cancer classification using discrete wavelet transformation (DWT). The DWT is employed to extract relevant features from skin lesion images, which are then used to train a classification model. The effectiveness of the suggested approach is assessed through the examination of a dataset of skin lesion images with known classes (malignant or benign).

Results
The outcomes of the experiment demonstrate that the suggested model successfully attained a classification result of sensitivity as 94% and specificity as 91% when compared with artificial neural network (ANN) and multilayer perceptron methods.

Conclusions
The HAM 10000 dataset is employed to explore and evaluate the effectiveness of the proposed model, leading to improved accuracy compared to the existing machine learning algorithms in utilization. The results demonstrate the effectiveness of the DWT-based approach in accurately classifying skin cancer lesions, thus aiding in early detection and diagnosis.
Unpacking overuse of androgen deprivation therapy for prostate cancer to inform de-implementation strategies
Authors: Skolarus Ted A. , Hawley Sarah T. , Forman Jane , Sales Anne E. , Sparks Jordan B. , Metreger Tabitha , Burns Jennifer , Caram Megan V. , Radhakrishnan Archana , Dossett Lesly A. , Makarov Danil V. , Leppert John T. , Shelton Jeremy B. , Stensland Kristian D. , Dunsmore Jennifer , Maclennan Steven , Saini Sameer , Hollenbeck Brent K. , Shahinian Vahakn , Wittmann Daniela A. , Deolankar Varad , Sriram S. 
Published: April 2024

Abstract
Background
Many men with prostate cancer will be exposed to androgen deprivation therapy (ADT). While evidence-based ADT use is common, ADT is also used in cases with no or limited evidence resulting in more harm than benefit, i.e., overuse. Since there are risks of ADT (e.g., diabetes, osteoporosis), it is important to understand the behaviors facilitating overuse to inform de-implementation strategies. For these reasons, we conducted a theory-informed survey study, including a discrete choice experiment (DCE), to better understand ADT overuse and provider preferences for mitigating overuse.

Methods
Our survey used the Action, Actor, Context, Target, Time (AACTT) framework, the Theoretical Domains Framework (TDF), the Capability, Opportunity, Motivation–Behavior (COM-B) Model, and a DCE to elicit provider de-implementation strategy preferences. We surveyed the Society of Government Service Urologists listserv in December 2020. We stratified respondents based on the likelihood of stopping overuse as ADT monotherapy for localized prostate cancer (“yes”/“probably yes,” “probably no”/“no”), and characterized corresponding Likert scale responses to seven COM-B statements. We used multivariable regression to identify associations between stopping ADT overuse and COM-B responses.

Results
Our survey was completed by 84 respondents (13% response rate), with 27% indicating “probably no”/“no” to stopping ADT overuse. We found differences across respondents who said they would and would not stop ADT overuse in demographics and COM-B statements. Our model identified 2 COM-B domains (Opportunity–Social, Motivation–Reflective) significantly associated with a lower likelihood of stopping ADT overuse. Our DCE demonstrated in-person communication, multidisciplinary review, and medical record documentation may be effective in reducing ADT overuse.

Conclusions
Our study used a behavioral theory-informed survey, including a DCE, to identify behaviors and context underpinning ADT overuse. Specifying behaviors supporting and gathering provider preferences in addressing ADT overuse requires a stepwise, stakeholder-engaged approach to support evidence-based cancer care. From this work, we are pursuing targeted improvement strategies.

Trial registration
ClinicalTrials.gov, NCT03579680
Stereo-Electroencephalography–Guided Network Neuromodulation for Psychiatric Disorders: The Neurophysiology Monitoring Unit
Authors: Allawala Anusha B. , Bijanki Kelly R. , Adkinson Joshua , Oswalt Denise , Tsolaki Evangelia , Mathew Sanjay , Mathura Raissa K. , Bartoli Eleonora , Provenza Nicole , Watrous Andrew J. , Xiao Jiayang , Pirtle Victoria , Mocchi Madaline M. , Rajesh Sameer , Diab Nabeel , Cohn Jeffrey F. , Borton David A. , Goodman Wayne K. , Pouratian Nader , Sheth Sameer A. 
Published: April 2024

BACKGROUND AND OBJECTIVES:
Recent advances in stereotactic and functional neurosurgery have brought forth the stereo-electroencephalography approach which allows deeper interrogation and characterization of the contributions of deep structures to neural and affective functioning. We argue that this approach can and should be brought to bear on the notoriously intractable issue of defining the pathophysiology of refractory psychiatric disorders and developing patient-specific optimized stimulation therapies.

METHODS:
We have developed a suite of methods for maximally leveraging the stereo-electroencephalography approach for an innovative application to understand affective disorders, with high translatability across the broader range of refractory neuropsychiatric conditions.

RESULTS:
This article provides a roadmap for determining desired electrode coverage, tracking high-resolution research recordings across a large number of electrodes, synchronizing intracranial signals with ongoing research tasks and other data streams, applying intracranial stimulation during recording, and design choices for patient comfort and safety.

CONCLUSION:
These methods can be implemented across other neuropsychiatric conditions needing intensive electrophysiological characterization to define biomarkers and more effectively guide therapeutic decision-making in cases of severe and treatment-refractory disease.
Influenza, vaccines and new developments
Authors: Duncan Debbie Louise 
Published: April 2024

This article was sponsored by CSL Seqirus. CSL Seqirus had no involvement in the writing or editorial process of this article. Vaccines are the first step in prevention of many infectious disease such as influenzae and have has dramatically reduced the burden of infectious disease ( van Panhuis et al, 2013 ). Their aim is to induce an immune response to the targeted pathogen without developing the disease. Vaccines work by initiating an innate immune response which is the body's first line of defence against invading pathogens. The Influenza virus is a challenge for global immunisation programmes as the virus can change and adapt creating a need for an annual vaccine and continuous monitoring of the effectiveness of these interventions