bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the experiences of dentistry students of Tabriz University of Medical Sciences of academic motivation: a content analysis study
Authors: Katebi Katayoun , Ghaffarifar Saeideh , Dehghani Gholamali , Pourabbas Ahmad 
Published: March 2024

AbstractBackgroundStudents’ academic motivation is crucial to their academic performance, success, and future career performance. Understanding the experiences of students regarding academic motivation can help address this issue. This qualitative study aimed to explore the experiences of dentistry students of Tabriz University of Medical Sciences regarding academic motivation.MethodsThis qualitative content analysis study collected data through semi-structured individual interviews with open-ended questions. The collected data were then organized into codes, subcategories, categories, and themes. Extensive interviews, meetings, and active engagement with the participants were conducted to ensure the strength of the data collected.ResultsThe results of this study yielded 20 subclasses and 11 classes. These codes, categories, and sub-categories were summarized into seven themes: self-efficacy, outcome expectations, outcome expectancies, emotional coping, self-regulation, situational perception, and environment.ConclusionThis study showed that various concepts, from personal processes to environmental and social processes, play a role in students’ academic motivation. This study’s findings can contribute to developing more effective interventions to improve the motivation level of dentistry students.
AI in medical education: uses of AI in construction type A MCQs
Authors: Rezigalla Assad Ali 
Published: March 2024

Abstract
Background
The introduction of competency-based education models, student centers, and the increased use of formative assessments have led to demands for high-quality test items to be used in assessments. This study aimed to assess the use of an AI tool to generate MCQs type A and evaluate its quality.

Methods
The study design was cross-sectional analytics conducted from June 2023 to August 2023. This study utilized formative TBL. The AI tool (ChatPdf.com) was selected to generate MCQs type A. The generated items were evaluated using a questionnaire for subject experts and an item (psychometric) analysis. The questionnaire to the subject experts about items was formed based on item quality and rating of item difficulty.

Results
The total number of recurrent staff members as experts was 25, and the questionnaire response rate was 68%. The quality of the items ranged from good to excellent. None of the items had scenarios or vignettes and were direct. According to the expert’s rating, easy items represented 80%, and only two had moderate difficulty (20%). Only one item out of the two moderate difficulties had the same difficulty index. The total number of students participating in TBL was 48. The mean mark was 4.8 ± 1.7 out of 10. The KR20 is 0.68. Most items were of moderately difficult (90%) and only one was difficult (10%). The discrimination index of the items ranged from 0.77 to 0.15. Items with excellent discrimination represented 50% (5), items with good discrimination were 3 (30%), and only one time was poor (10%), and one was none discriminating. The non-functional distractors were 26 (86.7%), and the number of non-functional distractors was four (13.3%). According to distractor analysis, 60% of the items were excellent, and 40% were good. A significant correlation (p = 0.4, r = 0.30) was found between the difficulty and discrimination indices.

Conclusion
Items constructed using AI had good psychometric properties and quality, measuring higher-order domains. AI allows the construction of many items within a short time. We hope this paper brings the use of AI in item generation and the associated challenges into a multi-layered discussion that will eventually lead to improvements in item generation and assessment in general.
External inspection approaches and involvement of stakeholders’ views in inspection following serious incidents - a qualitative mixed methods study from the perspectives of regulatory inspectors
Authors: Øyri Sina Furnes , Wiig Siri , Anderson Janet E. , Bergerød Inger Johanne 
Published: March 2024

Abstract
Objective
The objective was to gain knowledge about how external inspections following serious incidents are played out in a Norwegian hospital context from the perspective of the inspectors, and whether stakeholders’ views are involved in the inspection.

Methods
Based on a qualitative mixed methods design, 10 government bureaucrats and inspectors situated at the National Board of Health Supervision and three County Governors in Norway, were strategically recruited, and individual semi-structured interviews were conducted. Key official government documents were selected, collected, and thematically analyzed along with the interview data.

Results
Our findings overall demonstrate two overarching themes: Theme (1) Perspectives on different external inspection approaches of responding and involving stakeholders in external inspection following serious incidents, Theme (2) Inspectors’ internal work practices versus external expectations. Documents and all participants reported a development towards new approaches in external inspection, with more policies and regulatory attention to sensible involvement of stakeholders. Involvement and interaction with patients and informal caregivers could potentially inform the case complexity and the inspector’s decision-making process. However, stakeholder involvement was sometimes complex and challenging due to e.g., difficult communication and interaction with patients and/or informal caregivers, due to resource demands and/or the inspector’s lack of experience and/or relevant competence, different perceptions of the principle of sound professional practice, quality, and safety. The inspectors considered balancing the formal objectives and expectations, with the expectations of the public and different stakeholders (i.e. hospitals, patients and/or informal caregivers) a challenging part of their job. This balance was seen as an important part of the continuous development of ensuring public trust and legitimacy in external inspection processes.

Conclusions and implications
Our study suggests that the regulatory system of external inspection and its available approaches of responding to a serious incident in the Norwegian setting is currently not designed to accommodate the complexity of needs from stakeholders at the levels of hospital organizations, patients, and informal caregivers altogether. Further studies should direct attention to how the wider system of accountability structures may support the internal work practices in the regulatory system, to better algin its formal objectives with expectations of the public.
Differentiated adaptative genetic architecture and language-related demographical history in South China inferred from 619 genomes from 56 populations
Authors: Sun Qiuxia , Wang Mengge , Lu Tao , Duan Shuhan , Liu Yan , Chen Jing , Wang Zhiyong , Sun Yuntao , Li Xiangping , Wang Shaomei , Lu Liuyi , Hu Liping , Yun Libing , Yang Junbao , Yan Jiangwei , Nie Shengjie , Zhu Yanfeng , Chen Gang , Wang Chuan-Chao , Liu Chao , He Guanglin , Tang Renkuan 
Published: March 2024

Abstract
Background
The underrepresentation of human genomic resources from Southern Chinese populations limited their health equality in the precision medicine era and complete understanding of their genetic formation, admixture, and adaptive features. Besides, linguistical and genetic evidence supported the controversial hypothesis of their origin processes. One hotspot case was from the Chinese Guangxi Pinghua Han people (GPH), whose language was significantly similar to Southern Chinese dialects but whose uniparental gene pool was phylogenetically associated with the indigenous Tai-Kadai (TK) people. Here, we analyzed genome-wide SNP data in 619 people from four language families and 56 geographically different populations, in which 261 people from 21 geographically distinct populations were first reported here.

Results
We identified significant population stratification among ethnolinguistically diverse Guangxi populations, suggesting their differentiated genetic origin and admixture processes. GPH shared more alleles related to Zhuang than Southern Han Chinese but received more northern ancestry relative to Zhuang. Admixture models and estimates of genetic distances showed that GPH had a close genetic relationship with geographically close TK compared to Northern Han Chinese, supporting their admixture origin hypothesis. Further admixture time and demographic history reconstruction supported GPH was formed via admixture between Northern Han Chinese and Southern TK people. We identified robust signatures associated with lipid metabolisms, such as fatty acid desaturases (FADS) and medically relevant loci associated with Mendelian disorder (GJB2) and complex diseases. We also explored the shared and unique selection signatures of ethnically different but linguistically related Guangxi lineages and found some shared signals related to immune and malaria resistance.

Conclusions
Our genetic analysis illuminated the language-related fine-scale genetic structure and provided robust genetic evidence to support the admixture hypothesis that can explain the pattern of observed genetic diversity and formation of GPH. This work presented one comprehensive analysis focused on the population history and demographical adaptative process, which provided genetic evidence for personal health management and disease risk prediction models from Guangxi people. Further large-scale whole-genome sequencing projects would provide the entire landscape of southern Chinese genomic diversity and their contributions to human health and disease traits.
Cannabis donation as a harm reduction strategy: a case study
Authors: Duhart Clarke Sarah E. , Victor Grant , Lynch Pamela , Suen Leslie W. , Ray Bradley 
Published: March 2024

Abstract
Background
The United States (US) continues to experience unprecedented rates of overdose mortality and there is increased need to identify effective harm reduction practices. Research from Canada describes cannabis donation through harm reduction agencies as an adjunctive strategy to mitigate the negative consequences of more harmful drugs. This case study describes the operational logistics, feasibility, and potential benefits of a cannabis donation program that was operated through a harm reduction program in rural Michigan.

Case presentation
We applied a community driven research approach to gather information from harm reduction program staff about the implementation and evolution of cannabis donation efforts in Michigan. We also examined 20-months (September 2021 through May 2023) of administrative data from a cannabis company to compare the sale and donation of cannabis products. Ten cannabis-experienced harm reduction clients received cannabis donations, with clinical staff determining client interest and appropriateness, and providing weekly pick-up or delivery. To expand product availability and sustainability, we examined administrative data from a commercialcannabis company that volunteered to provide donations. This administrative data suggests that while flower products constitute most of the adult and medical sales, edible, oil, and topical products predominated donations. Further, cost analysis suggests that donations represent only 1% of total gross sales and account for much less than the expected yearly donation amount.

Conclusions
Research suggests there is potential to reduce alcohol and drug use related harms of more dangerous substances through substitution with cannabis. This case study is the first to document cannabis donation as a harm reduction practice in the US and suggests potential for sustainability dependent on state laws. Findings from this case study provide a starting point for inquiry into cannabis donation as a harm reduction strategy in the US; future research is needed to fully understand the individual-level outcomes, public health impacts, necessary legal regulations, and best practices for cannabis donation programs through harm reduction organizations.
Interleukin-4 from curcumin-activated OECs emerges as a central modulator for increasing M2 polarization of microglia/macrophage in OEC anti-inflammatory activity for functional repair of spinal cord injury
Authors: Guo Jianbin , Tang Xiangwen , Deng Peng , Hui Hao , Chen Bo , An Jing , Zhang Gaorong , Shi Kuohao , Wang Jinchao , He Yuqing , Hao Dingjun , Yang Hao 
Published: March 2024

AbstractMicroglia/macrophages are major contributors to neuroinflammation in the central nervous system (CNS) injury and exhibit either pro- or anti-inflammatory phenotypes in response to specific microenvironmental signals. Our latest in vivo and in vitro studies demonstrated that curcumin-treated olfactory ensheathing cells (aOECs) can effectively enhance neural survival and axonal outgrowth, and transplantation of aOECs improves the neurological outcome after spinal cord injury (SCI). The therapeutic effect is largely attributed to aOEC anti-inflammatory activity through the modulation of microglial polarization from the M1 to M2 phenotype. However, very little is known about what viable molecules from aOECs are actively responsible for the switch of M1 to M2 microglial phenotypes and the underlying mechanisms of microglial polarization. Herein, we show that Interleukin-4 (IL-4) plays a leading role in triggering the M1 to M2 microglial phenotype, appreciably decreasing the levels of M1 markers IL‑1β, IL‑6, tumour necrosis factor-alpha (TNF-α) and inducible nitric oxide synthase (iNOS) and elevating the levels of M2 markers Arg-1, TGF-β, IL-10, and CD206. Strikingly, blockade of IL-4 signaling by siRNA and a neutralizing antibody in aOEC medium reverses the transition of M1 to M2, and the activated microglia stimulated with the aOEC medium lacking IL-4 significantly decreases neuronal survival and neurite outgrowth. In addition, transplantation of aOECs improved the neurological function deficits after SCI in rats. More importantly, the crosstalk between JAK1/STAT1/3/6-targeted downstream signals and NF-κB/SOCS1/3 signaling predominantly orchestrates IL-4-modulated microglial polarization event. These results provide new insights into the molecular mechanisms of aOECs driving the M1-to-M2 shift of microglia and shed light on new therapies for SCI through the modulation of microglial polarization.
Multiregion WES of metastatic pancreatic neuroendocrine tumors revealed heterogeneity in genomic alterations, immune microenvironment and evolutionary patterns
Authors: Jiang Yu , Dong Yi-han , Zhao Shi-wei , Liu Dong-yu , Zhang Ji-yang , Xu Xiao-ya , Chen Hao , Chen Hao , Jin Jia-bin 
Published: March 2024

AbstractPancreatic neuroendocrine tumors (PanNETs), though uncommon, have a high likelihood of spreading to other body parts. Previously, the genetic diversity and evolutionary patterns in metastatic PanNETs were not well understood. To investigate this, we performed multiregion sampling whole-exome sequencing (MRS-WES) on samples from 10 patients who had not received prior treatment for metastatic PanNETs. This included 29 primary tumor samples, 31 lymph node metastases, and 15 liver metastases. We used the MSK-MET dataset for survival analysis and validation of our findings. Our research indicates that mutations in the MEN1/DAXX genes might trigger the early stages of PanNET development. We categorized the patients based on the presence (MEN1/DAXXmut, n = 7) or absence (MEN1/DAXXwild, n = 3) of these mutations. Notable differences were observed between the two groups in terms of genetic alterations and clinically relevant mutations, confirmed using the MSK-MET dataset. Notably, patients with mutations in MEN1/DAXX/ATRX genes had a significantly longer median overall survival compared to those without these mutations (median not reached vs. 43.63 months, p = 0.047). Multiplex immunohistochemistry (mIHC) analysis showed a more prominent immunosuppressive environment in metastatic tumors, especially in patients with MEN1/DAXX mutations. These findings imply that MEN1/DAXX mutations lead PanNETs through a unique evolutionary path. The disease’s progression pattern indicates that PanNETs can spread early, even before clinical detection, highlighting the importance of identifying biomarkers related to metastasis to guide personalized treatment strategies.
Modified gastro-soleus turn-down flap for chronic or neglected achilles tendon ruptures
Authors: Ibrahim Mohamed A. A. , Abdelkader Mohamed G. , Nematallah Samir A. , Elsawy Gamal A. , Alghandour Sameh A. , Shwitter Lotfy M. 
Published: March 2024

Abstract
Background
Achilles’ tendon chronic rupture is a common entity that is usually misdiagnosed or mistreated. Hence, she was presented to us later or with complications affecting her gait. Surgical resection is needed to either bridge the gap or reinforce the strength of the tendon repair.

Objectives
Our study's goal was to assess the clinical results of repairing chronic Achilles’ tendon lesions employing the middle segment of the proximal portion of the tendon (gastro-soleus), as a turn-down flap.

Methods
Our prospective interventional single arm study included 18 patients with chronic Achilles’ tendon rupture attending at Al-Azhar university hospitals in Cairo, Egypt from May 2020 to April 2023. Diagnosis of the patients was confirmed by radiographic and clinical investigations. They were all treated with the same open reconstruction procedure using a modified GSF. The average follow-up was 12 months. The results of this study were assessed by the Achilles tendon rupture score (ATRS), American Orthopedic Foot and Ankle Society (AOFAS) score, and capacity to perform repeated heel raises on the affected side.

Results
The mean operative time was 72.77 min. The median (IQR) time of reconstruction was 10 (8–12) after the injury. The median (IQR) length of flab was 4.5 (4.3–5) 9 (Table 2). No intraoperative complications occurred. The typical follow-up period was 12 months (6–18 months). In terms of the ATRS, we found a significant reduction from 82.8 ± 3 preoperatively to 20.8 ± 6.7 at 12 months postoperatively (P value = 0.001). As regards the AOFAS score, it was increased from 49.5 ± 10 preoperatively to 83.8 ± 8.5 12 months postoperatively (P = 0.001). In terms of the post operative complications, there was no re-rupture. Two patients experienced superficial wound infection which improved with daily dressing and antibiotics. Additionally, two patients had slight ankle stiffness four months after the operation, which improved after programmed rehabilitation at the sixth month.

Conclusion
The modified GSTF is a simple, safe, well-tolerated and effective method of treatment with excellent functional results and greater patient content.
Community-based surveillance programme evaluation using the platform Nyss implemented by the Somali Red Crescent Society—a mixed methods approach
Authors: Jung Julia , Larsen Tine Mejdell , Beledi Abdifatah Hussein , Takahashi Emi , Ahmed Abdirahman Omer , Reid Jenny , Kongelf Ida Anine 
Published: March 2024

Abstract
Background
Somali Red Crescent Society (SRCS), supported by Norwegian Red Cross, has implemented community-based surveillance (CBS) in Somaliland. This methodology aims to reduce the high risk of epidemics by strengthening early warning and response from and at community level, particularly where there is a weak public health surveillance system. CBS is implemented through SRCS community volunteers, who report signals from the community via SMS to the software platform Nyss. This paper presents key findings from the CBS programme evaluation.

Methods
A retrospective observational mixed-methods approach to evaluate the CBS programme was conducted, using routine CBS data from 2021 for Awdal and Togdheer regions and qualitative interviews with stakeholders’ representatives.

Results
The usefulness of the CBS programme in preventing, detecting, and responding to disease outbreaks was acknowledged by the stakeholders’ representatives. 83% of the signals in Awdal region matched a Community Case Definition (CCD) and were escalated to the Ministry of Health and Development (MoHD)). For Togdheer region, 97% were escalated. Verification of signals by supervisors and escalation to the authorities was done timely.Alert outcome and response action was not well recorded, therefore there is limited evidence on sensitivity. The programme was shown to be simple and can be flexibly adjusted for new diseases and changing CCDs.Stakeholders appreciated being engaged, the good collaboration, their participation throughout the implementation and expressed high acceptance of the programme.

Conclusion
CBS can support early warning and response for a variety of public health risks. Improved documentation for alert outcomes could help to better evaluate the sensitivity of CBS. A participatory approach is vital to achieve successful community volunteer engagement. Software tools, such as the Nyss platform, can be useful to support effective and efficient CBS implementation.
Preliminary efficacy of a transdiagnostic parent-led internet-delivered intervention for children with anxiety and depressive symptoms: a pilot randomized controlled trial
Authors: Poetar Costina-Ruxandra , Dobrean Anca , Andersson Gerhard 
Published: March 2024

Abstract
Background
There is extensive research indicating that transdiagnostic interventions are effective for adults and children with anxiety and depressive disorders; however, limited research has been conducted on the efficacy of such programs targeting parents of children with anxiety and depressive symptoms delivered via the Internet. This study aims to investigate the preliminary efficacy of a transdiagnostic Internet-delivered intervention for Romanian parents of children with elevated anxiety and depressive symptoms.

Methods
We conducted a single-blinded pilot randomized controlled trial. Forty-two parents of children with anxiety and depressive symptoms (Mage = 39.79, 78.6% women) from Romania were randomly assigned to one of the two groups, to ParentKIT, an Internet-delivered intervention based on Rational Emotive and Behavioral Therapy (n = 21), or to a delayed treatment condition (waitlist group) (n = 21). ParentKIT consisted of a brief transdiagnostic intervention delivered through nine modules with therapist guidance.

Results
A significant Group by Time effect was found for child emotional problems as reported by parents (Cohen’s d = − 0.85) and for parental self-efficacy (Cohen’s d = 0.71).

Conclusion
A transdiagnostic Internet-delivered intervention addressed to parents of children with elevated anxiety and depressive symptoms is a promising approach. Future research should include blind assessments as well as multiple outcome assessors and investigate the long-term efficacy of the intervention.

Trial registration
NCT05341297.