bluuebunny/crossref_metadata_2025_split huggingface dataset:
Construction and validation of a medical career readiness inventory
Authors: Godoi Amanda , Casteleyn Charlotte , Virk Farazi , McDade‐Kumar Mia , Byrne Matthew H. V. , Moussa Ahmed , Baptiste Patrice , Tombs Michal 
Published: January 2024

AbstractBackgroundMedical students' preparedness for clinical practice is well researched, yet little is known on the extent to which students are being prepared for a medical career. This paper reports the construction of a short medical inventory titled eXploring medical sTudents' caReer reAdiness (XTRA) to measure students' career readiness based on Super's theory of career maturity.ApproachWe designed an instrument consisting of a series of 5‐point Likert‐scale to identify participants competencies regarding career exploration and planning during their undergraduate studies. The instrument was completed by 348 medical students from 41 universities in the United Kingdom. We examined the validity and reliability of the instrument through Exploratory Factor Analysis, Cronbach's coefficient α and Pearson correlation.EvaluationExploratory Factor Analysis revealed that 16 of the 20‐items survey were aligned with the exploration stage of Super's theory: Crystallisation (Career goals), Specification (Career pathways) and Implementation (Career accomplishments). The four items that formed two separate statistical factors were specific to a current medical career in the UK. Internal reliability for Super's factor subscales were acceptable (α = 0.71 to α = 0.81). A significant positive relationship was found between students' overall rating of career readiness and the three factors, indicating construct validity.ImplicationsThe XTRA Inventory is a short instrument with construct and content validity specifically designed to measure career readiness of medical students. Further work on its psychometric properties will help establish this inventory to be used as a guidance and career counselling tool by medical educators and educational institutions in developing career development programmes.
Staphylococcus aureus
senses human neutrophils via PerR to coordinate the expression of the toxin LukAB
Authors: Savin Avital , Anderson Exene E. , Dyzenhaus Sophie , Podkowik Magdalena , Shopsin Bo , Pironti Alejandro , Torres Victor J. 
Published: January 2024

ABSTRACT

Staphylococcus aureus
is a gram-positive pathogen that poses a major health concern, in part due to its large array of virulence factors that allow infection and evasion of the immune system. One of these virulence factors is the bicomponent pore-forming leukocidin LukAB. The regulation of
lukAB
expression is not completely understood, especially in the presence of immune cells such as human polymorphonuclear neutrophils (hPMNs). Here, we screened for transcriptional regulators of
lukAB
during the infection of primary hPMNs. We uncovered that PerR, a peroxide sensor, is vital for hPMN-mediated induction of
lukAB
and that PerR upregulates cytotoxicity during the infection of hPMNs. Exposure of
S. aureus
to hydrogen peroxide (H
2
O
2
) alone also results in increased
lukAB
promoter activity, a phenotype dependent on PerR. Collectively, our data suggest that
S. aureus
uses PerR to sense the H
2
O
2
produced by hPMNs to stimulate the expression of
lukAB
, allowing the bacteria to withstand these critical innate immune cells.

IMPORTANCE

Staphylococcus aureus
utilizes a diverse set of virulence factors, such as leukocidins, to subvert human neutrophils, but how these toxins are regulated is incompletely defined. Here, we identified the peroxide-sensitive repressor, PerR, as a required protein involved in the induction of
lukAB
in the presence of primary human neutrophils, a phenotype directly linked to the ability of PerR to sense H
2
O
2
. Thus, we show that
S. aureus
coordinates sensing and resistance to oxidative stress with toxin production to promote pathogen survival.
Time-dependent pharmacodynamics of amikacin on
Mycobacterium abscessus
growth and resistance emergence
Authors: Gibson Joy E. , Nandanwar Nishant , Neely Michael N. 
Published: January 2024

ABSTRACT

Mycobacterium abscessus
pulmonary disease is increasing in prevalence globally, particularly for individuals with cystic fibrosis. These infections are challenging to treat due to a high rate of resistance. Amikacin is critical to treatment, but the development of toxicity, amikacin resistance, and treatment failure are significant challenges. Amikacin has been characterized previously as peak-dependent and extended-interval dosing is commonly used. In our hollow fiber infection model of
M. abscessus
, amikacin exhibited time-dependent rather than the expected peak-dependent pharmacodynamics. Humanized amikacin exposures with more frequent, short-interval dosing (continuous infusion or every 12 hours) yielded improved microbiological response compared to extended-interval dosing (every 24 hours or 1–3 times per week). Short-interval dosing inhibited growth with a mean (SD) maximum Δlog
10
colony forming units of −4.06 (0.52), significantly more than extended-interval dosing (
P
= 0.0013) every 24 hours, −2.40 (0.58), or 1–3 times per week, −2.39 (0.38). Growth recovery, an indicator of resistance emergence, occurred at 6.56 (0.70) days with short-interval dosing but was significantly earlier with extended-interval dosing (
P
= 0.0032) every 24 hours, 3.88 (0.85) days, and 1–3 times per week, 3.27 (1.72) days. Microbiological response correlated best with the pharmacodynamic index of %T > minimum inhibitory concentration (MIC), with an EC
80
for growth inhibition of ~40%T > MIC. We used a previously published population model of amikacin to determine the probability of achieving 40%T > MIC and show that current dosing strategies are far below this target, which may partially explain why treatment failure remains so high for these infections. These data support a cautious approach to infrequent amikacin dosing for the treatment of
M. abscessus
.

IMPORTANCE

Pulmonary disease caused by
Mycobacterium abscessus
complex (MABSC) is increasing worldwide, particularly in patients with cystic fibrosis. MABSC is challenging to treat due to high levels of antibiotic resistance. Treatment requires 2–4 antibiotics over more than 12 months and has a significant risk of toxicity but still fails to eradicate infection in over 50% of patients with cystic fibrosis. Antibiotic dosing strategies have been largely informed by common bacteria such as
Pseudomonas aeruginosa
. The “pharmacodynamic” effects of amikacin, a backbone of MABSC treatment, were thought to be related to maximum “peak” drug concentration, leading to daily or three times weekly dosing. However, we found that amikacin MABSC kill and growth recovery, an indicator of antibiotic resistance, are dependent on how long amikacin concentrations are above the minimum inhibitory concentration, not how high the peak concentration is. Therefore, we recommend a re-evaluation of amikacin dosing to determine if increased frequency can improve efficacy.
Are retired persons fitter in their psychological capacities than unemployed? A cross-sectional representative study in Germany
Authors: Muschalla Beate 
Published: January 2024

ObjectivesBeyond specific aspects of numerical or verbal intelligence or cognitive speed, a broad range of psychological capacities are generally important in school, job and social life for all age groups. People have to quit the labour market up from a certain age about 65, whereas (younger) unemployed are motivated for return to work. The question is which psychological capacity profiles can be found in different employment groups (employed, mini-jobbers, voluntary service, retired, unemployed).DesignA representative cross-sectional survey was conducted in Germany, reaching 2528 persons.SettingRepublic of Germany.ParticipantsRandomly selected inhabitants throughout Germany.Primary and secondary outcome measuresParticipants reported their sociodemographic and work characteristics, as well as their psychological capacity profiles (Mini-ICF-APP-S) and work-related specific mental health problems (work-anxiety, embitterment).ResultsThe unemployed had—compared with all other groups—highest rates of work-anxiety and embitterment (16.3%). In contrast to the unemployed, the ‘older’ (70 aged) retired group, who were no longer working on the labour market, seldomly reported work-anxiety (2.6%) or embitterment (4.2%). The unemployed had the worst capacity profiles, most frequently no school degree (11.5%), most unemployment in their history (four times, as compared with once in the older retired). The psychological capacity profiles of the retired were similar to employed persons.ConclusionsKeeping older persons with high psychological capacity levels in working life could be an alternative to forced reintegration of people with chronic participation problems into the competitive labour market. Unemployed persons with chronic health and participation problems might benefit from other social inclusion means.
Efficacy in bowel movement and change of gut microbiota on adult functional constipation patients treated with probiotics-containing products: a systematic review and meta-analysis
Authors: Ding Fei , Hu Mengyang , Ding Yifei , Meng Yingying , Zhao Yanchao 
Published: January 2024

ObjectivesThis study aimed to pool the efficacy in bowel movement and explore the change of gut microbiota on adult functional constipated patients after probiotics-containing products treatment.DesignSystematic review and meta-analysis.Data sourcesPubMed, Cochrane Library for published studies and ClinicalTrials.gov for ‘grey’ researches were independently investigated for randomised controlled trials up to November 2022.Eligibility criteria, data extraction and synthesisThe intervention was probiotics-containing product, either probiotics or synbiotics, while the control was placebo. The risk of bias was conducted. The efficacy in bowel movement was indicated by stool frequency, stool consistency and Patient Assessment of Constipation Symptom (PAC-SYM), while the change of gut microbiota was reviewed through α diversity, β diversity, change/difference in relative abundance and so on. The subgroup analysis, sensitivity analysis and random-effect meta-regression were conducted to explore the heterogeneity. The Grading of Recommendations Assessment Development and Evaluation was conducted to grade the quality of evidence.Results17 studies, comprising 1256 participants, were included with perfect agreements between two researchers (kappa statistic=0.797). Compared with placebo, probiotics-containing products significantly increased the stool frequency (weighted mean difference, WMD 0.93, 95% CI 0.47 to 1.40, p=0.000, I²=84.5%, ‘low’), improved the stool consistency (WMD 0.38, 95% CI 0.05 to 0.70, p=0.023, I²=81.6%, ‘very low’) and reduced the PAC-SYM (WMD −0.28, 95% CI: −0.45 to −0.11, p=0.001, I²=55.7%, ‘very low’). In subgroup analysis, synbiotics was superior to probiotics to increase stool frequency. Probiotics-containing products might not affect α or β diversity, but would increase the relative abundance of specific strain.ConclusionsProbiotics-containing products, significantly increased stool frequency, improved stool consistency, and alleviated functional constipation symptoms. They increased the relative abundance of specific strain. More high-quality head-to-head randomised controlled trials are needed.
How do field epidemiologists learn? A protocol for a qualitative inquiry into learning in field epidemiology training programmes
Authors: Griffith Matthew Myers , Field Emma , Huang Angela Song-en , Shimada Tomoe , Battsend Munkhzul , Housen Tambri , Pamphilon Barbara , Kirk Martyn D 
Published: January 2024

IntroductionCOVID-19 underscored the importance of field epidemiology training programmes (FETPs) as countries struggled with overwhelming demands. Experts are calling for more field epidemiologists with better training. Since 1951, FETPs have been building public health capacities across the globe, yet explorations of learning in these programmes are lacking. This qualitative study will (1) describe approaches to training field epidemiologists in FETP; (2) describe strategies for learning field epidemiology among FETP trainees and (3) explain the principles and practices aligning training approaches with learning strategies in FETP.Methods and analysisThe research design, implementation and interpretation are collaborative efforts with FETP trainers. Data collection will include interviews with FETP trainers and trainees and participant observations of FETP training and learning events in four FETP in the Western Pacific Region. Data analysis will occur in three phases: (1) we will use the constant comparison method of Charmaz’s grounded theory during open coding to identify and prioritise categories and properties in the data; (2) during focused coding, we will use constant comparison and Polkinghorne’s analysis of narratives, comparing stories of prioritised categories, to fill out properties of those categories and (3) we will use Polkinghorne’s narrative analysis to construct narratives that reflect domains of interest, identifying correspondence among Carr and Kemmis’s practices, understandings and situations to explain principles and processes of learning in FETP.Ethics and disseminationWe have obtained the required ethics approvals to conduct this research at The Australian National University (2021/771) and Taiwan’s Ministry of Health and Welfare (112206). Data will not be available publicly, but anonymised findings will be shared with FETP for collaborative interpretation. Ultimately, findings and interpretations will appear in peer-reviewed journals and conferences.
Real-time monitoring and feedback to improve shared decision-making for surgery (the ALPACA Study): protocol for a mixed-methods study to inform co-development of an inclusive intervention
Authors: Hoffmann Christin , Avery Kerry N L , Macefield Rhiannon C , Snelgrove Val , Blazeby Jane M , Hopkins Della , Hickey Shireen , Cabral Christie , Hall Jennifer , Gibbison Ben , Rooshenas Leila , Williams Adam , Aning Jonathan , Bekker Hilary L , McNair Angus G K 
Published: January 2024

IntroductionHigh-quality shared decision-making (SDM) is a priority of health services, but only achieved in a minority of surgical consultations. Improving SDM for surgical patients may lead to more effective care and moderate the impact of treatment consequences. There is a need to establish effective ways to achieve sustained and large-scale improvements in SDM for all patients whatever their background. The ALPACA Study aims to develop, pilot and evaluate a decision support intervention that uses real-time feedback of patients’ experience of SDM to change patients’ and healthcare professionals’ decision-making processes before adult elective surgery and to improve patient and health service outcomes.Methods and analysisThis protocol outlines a mixed-methods study, involving diverse stakeholders (adult patients, healthcare professionals, members of the community) and three National Health Service (NHS) trusts in England. Detailed methods for the assessment of the feasibility, usability and stakeholder views of implementing a novel system to monitor the SDM process for surgery automatically and in real time are described. The study will measure the SDM process using validated instruments (CollaboRATE, SDM-Q-9, SHARED-Q10) and will conduct semi-structured interviews and focus groups to examine (1) the feasibility of automated data collection, (2) the usability of the novel system and (3) the views of diverse stakeholders to inform the use of the system to improve SDM. Future phases of this work will complete the development and evaluation of the intervention.Ethics and disseminationEthical approval was granted by the NHS Health Research Authority North West-Liverpool Central Research Ethics Committee (reference: 21/PR/0345). Approval was also granted by North Bristol NHS Trust to undertake quality improvement work (reference: Q80008) overseen by the Consent and SDM Programme Board and reporting to an Executive Assurance Committee.Trial registration numberISRCTN17951423; Pre-results.
Teaching by texting to promote positive health behaviours in pregnancy: a protocol for a randomised controlled trial of SmartMom
Authors: Janssen Patricia , Lecke Sara , Renner Regina , Zhang Wei , Vedam Saraswathi , Norman Wendy V , Bayrampour Hamideh , Tough Suzanne , Murray Jennifer , Muhajarine Nazeem , Dennis Cindy Lee 
Published: January 2024

IntroductionPrenatal education is associated with positive health behaviours, including optimal weight gain, attendance at prenatal care, acceptance of routine screening tests, smoking cessation, decreased alcohol consumption and breast feeding. Adoption of these behaviours has been associated with reduced rates of caesarean birth, preterm birth and low birth weight. Barriers to prenatal class attendance faced by parents in Canada include geography, socioeconomic status, age, education, and, among Indigenous peoples and other equity-deserving groups, stigma. To address the need for easily accessible and reliable information, we created ‘SmartMom’, Canada’s first prenatal education programme delivered by short message service text messaging. SmartMom provides evidence-based information timed to be relevant to each week of pregnancy. The overall goal of SmartMom is to motivate the adoption of positive prenatal health behaviours with the ultimate goal of improving health outcomes among women and their newborns.Methods and analysisWe will conduct a two-arm single-blinded randomised controlled trial. Blinding of participants to trial intervention will not be possible as they will be aware of receiving the intervention, but data analysts will be blinded. Our primary research questions are to determine if women experiencing uncomplicated pregnancies randomly assigned to receive SmartMom messages versus messages addressing general topics related to pregnancy but without direction for behaviour change, have higher rates of: (1) weight gain within ranges recommended for prepregnancy body mass index and (2) adherence to Canadian guidelines regarding attendance at prenatal care appointments.Ethics and disseminationThe study has been granted a Certificate of Approval, number H22-00603, by the University of British Columbia Research Ethics Board. To disseminate our findings, we are undertaking both integrated and end-of-grant knowledge translation, which will proactively involve potential end-users and stakeholders at every phase of our project.Trial registration numberNCT05793944.
Efficacy and safety of colchicine for the treatment of myopericarditis
Authors: Collini Valentino , De Martino Maria , Andreis Alessandro , De Biasio Marzia , Gaspard Francesca , Paneva Elena , Tomat Mariacristina , Deferrari Gaetano Maria , Isola Miriam , Imazio Massimo 
Published: January 2024

ObjectiveClinical trials have evaluated the efficacy and safety of colchicine only in simple pericarditis, excluding cases of concomitant myocarditis. The aim of this paper is to evaluate the efficacy and safety of colchicine for the treatment of the first attack of acute pericarditis with concomitant myocardial involvement.MethodsDouble-centre retrospective cohort study analysing consecutive patients admitted for first attack of pericarditis with myocarditis and treated with or without colchicine. The primary efficacy end point was the time to the first recurrence. Propensity score matching was used to generate two groups of patients with similar baseline characteristics. Colchicine-associated side effects were analysed as safety end-point.ResultsA total of 175 patients (mean age 46.2±20.1 years, 25.1% females, 88.6% with idiopathic/viral aetiology) were included. Seventy-nine (45.1%) patients were treated with colchicine. After a median follow-up of 25.3 (IQR 8.3–45.6) months, 58 (33.1%) patients had recurrences. The propensity score generated two groups of 73 patients with similar baseline characteristics but the use of colchicine. Patients treated with colchicine had a lower incidence of recurrences (respectively, 19.2% vs 43.8%; p=0.001) and a longer event-free survival (p=0.005). In multivariable analysis, women (HR 1.97, 95% CI 1.04 to 3.73; p=0.037) and corticosteroid use (HR 2.27, 95% CI 1.15 to 4.47; p=0.018) were independent risk factors for recurrences. Colchicine-associated side effects were mild and occurred in 3 (1.7%) patients.ConclusionIn patients with first attack of pericarditis associated with myocardial involvement, colchicine was safe and efficacious for the reduction of recurrences.
On the Axion Electrodynamics in a two-dimensional slab and the Casimir effect
Authors: Brevik Iver H. , Chaichian Moshe M. , Favitta Amedeo M. 
Published: January 2024

We analyze the Axion Electrodynamics in a two-dimensional slab of finite width L containing a homogeneous and isotropic dielectric medium with constant permittivity and permeability. We start from the known decomposition of modes in the nonaxion case and then solve perturbatively the governing equations for the electromagnetic fields to which the axions are also coupled. This is a natural approach, since the finiteness of L destroys the spatial invariance of the theory in the z-direction normal to the plates. In this way, we derive the value of the axion-generated rotation angle of the electric and magnetic fields after their passage through the slab, and use the obtained results to calculate the Casimir force between the two conducting plates. Our calculations make use of the same method as previously outlined by [J. S. Høye and I. Brevik, Eur. Phys. J. Plus 135, 271 (2020)] for the case of Casimir calculations in chiral media and extend former results on the Casimir force in Axion Electrodynamics.
Perceived Interpersonal Racism in Relation to Incident Coronary Heart Disease Among Black Women
Authors: Sheehy Shanshan , Brock Max , Palmer Julie R. , Albert Michelle A. , Cozier Yvette C. , Rosenberg Lynn 
Published: January 2024

BACKGROUND:
Racism is highly prevalent in the United States. Few data exist about whether perceived interpersonal racism is associated with risk of coronary heart disease (CHD).

METHODS:
We followed 48 305 participants in the Black Women’s Health Study through biennial mailed and Internet-based health questionnaires from 1997, when they provided information on perceived interpersonal racism and were free of cardiovascular disease and cancer, until the end of 2019. We averaged participant responses to 5 validated questions about perceived interpersonal racism in everyday activities, such as “people act as if they think you are dishonest.” We summed the positive responses to 3 questions about perceived racism in interactions that involved jobs, housing, and police; scores ranged from 0 (no to all) to 3 (yes to all). CHD cases were defined as nonfatal myocardial infarctions confirmed through medical records, fatal cases identified through the National Death Index, and self-reported revascularization events. We used Cox proportional hazard models adjusting for major confounders to estimate hazard ratios (HRs).

RESULTS:

During 22 years of follow-up, we identified 1947 incident CHD cases. For women who reported experiences of racism in employment, housing, or involving the police relative to women who reported no such experiences, the age-adjusted HR for CHD was 1.35 (95% CI, 1.13–1.61;
P
trend
=0.006), and the multivariable HR for CHD was 1.26 (95% CI, 1.05–1.51;
P
trend
=0.05). For women in the highest quartile of perceived interpersonal racism in daily life relative to women in the lowest quartile, the age-adjusted HR for CHD was 1.25 (95% CI, 1.07–1.46;
P
trend
=0.006). After multivariable adjustment, the HR was attenuated and no longer statistically significant.

CONCLUSIONS:
Perceived experiences of interpersonal racism in employment, in housing, and with the police were associated with higher incidence of CHD among Black women, whereas perceived racism in everyday life was not associated with higher risk.