bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of group-based acceptance and commitment therapy on older stroke survivors: study protocol for a randomized controlled trial
Authors: Chen Furong , Zhou Qiao , Wu Junqi , Xu Xianghua 
Published: October 2023

Abstract
Introduction
Older stroke survivors usually experience various psychology disorders, such as post-stroke depression (PSD), which may be associated with high experiential avoidance (EA) and can seriously affect their quality of life. To date, the efficacy of group-based acceptance and commitment therapy (ACT) for older stroke survivors has not been established. The aim of this study is to investigate the effectiveness of group-based ACT on EA, PSD, psychological distress, and quality of life in older stroke survivors after group-based ACT.

Methods and analysis
This study is a randomized, single-blind, wait-list controlled, parallel-arm trial. A total of 66 stroke survivors will be randomly assigned to wait-list control group or intervention group. Participants in wait-list control group will receive treatment as usual (TAU), while the intervention group will receive group-based ACT once a week for eight weeks. The primary outcome measure being EA, and the secondary outcome measures being PSD, psychological distress, and quality of life. Results of the two groups will be blindly assessed by professional evaluators at baseline (T0), post-treatment (T1), and one-month follow up (T2).

Discussion
The results of this study will provide the first evidence for the effectiveness of a group-based ACT intervention in reducing EA, PSD, psychological stress, and improving quality of life for post-stroke survivors.

Trial Registration
ChiCTR2200066361.
Developing a global medicine student pre- and post-travel curriculum
Authors: Mehta Natasha , Fernandes Caroline , Llerena Christopher , Weine Stevan , Bosland Maarten C. 
Published: October 2023

Abstract
Background
The popularity of short-term global health experiences amongst US medical students has been increasing. However, it remains a challenge for medical schools to comprehensively prepare students to work in an international environment and to contribute in ethically responsible and meaningful ways. Students of the Global Medicine program (GMED) of the UIC College of Medicine Center for Global Health set out to develop a pre-and-post travel curriculum that addresses some of these challenges.

Methods
The students surveyed the literature of 66 published global health curricula and identified aspects of pre-and-post travel training that were found to be under-addressed. They then developed a curriculum in conjunction with GMED faculty that incorporated these identified aspects of pre-and-post travel training.

Results
Five aspects of pre-and-post travel training were identified as being under-addressed in the literature while traveling. These domains include: [1] examining power relations associated with neo-colonization between and within countries; [2] training for bi-directional learning; [3] examining motivations and goals for participating in global health; [4] addressing personal resiliency and psychosocial wellbeing related to students’ travel, and; [5] reflecting on the challenging aspects of the fieldwork experience.

Conclusions
The student-driven curriculum is being integrated into the GMED program through structured didactic sessions, one-on-one mentor meetings and small group discussions. Once students have traveled, the curriculum will be evaluated with the foreign partners they visited.
The perceived impact of curricular and non-curricular factors on specialty interests and choice during medical school at a single center in the United States
Authors: Karthik Naveen , Greenfield Marjorie , Otteson Todd 
Published: October 2023

Abstract
Background
Limited information exists regarding how medical students’ specialty interests evolve throughout medical school, particularly interest in surgical versus non-surgical specialties. Our objective was to identify medical students’ specialty interests before and after medical school and the most important curricular and non-curricular factors that shaped their specialty choice.

Methods
An online 22-question voluntary, anonymized survey was designed to assess specialty interests and factors impacting specialty choice at a single medical school in the United States. The study was pilot-tested with focus groups. The final questionnaire was distributed to final-year medical students from the Classes of 2020 and 2021. Responses were measured on a 5-point Likert scale (1 = strong negative impact to 5 = strong positive impact).

Results
102 of 184 students (55%) from Class of 2020 and 85 of 174 students (49%) from Class of 2021 participated. Of 187 respondents, the majority (60%) decided on their specialty during third year. 74 of 147 students (50%) pursued a specialty among their initial specialty interests. Students with initial surgical interests were significantly (p < 0.001) less likely to choose surgical specialties (42%) compared to students with initial non-surgical interests choosing non-surgical specialties (79%). Pre-clinical years (3.67 ± 0.96) were perceived to have a significantly (p < 0.001) less positive impact on specialty interests and choice compared to clinical years. Among pre-clinical factors, physician shadowing (3.80 ± 0.83) was perceived to have the significantly (p < 0.001) greatest positive impact. During clinicals, 34% of respondents indicated that order of clerkships impacted specialty choice. 112 of 171 respondents (65%) indicated that mentorship impacted specialty choice. Physicians in the chosen specialty were perceived to have the strongest impact (4.67 ± 0.49). 65 of 171 respondents (38%) indicated that peers impacted specialty choice with classmates (3.98 ± 0.87) and near-peers (3.83 ± 0.74) perceived to have a positive impact.

Conclusions
Specialty interests changed during medical school for a significant portion of students (50%). Those with initial surgical interests were more likely to change their specialty interests. Pre-clinicals were reported to have less impact on specialty choice compared to clinicals. Implementing factors such as shadowing and physician/peer mentorship, which may positively impact specialty choice, into pre-clinical curricula warrants further investigation.
Prostate cancer detection using e-nose and AI for high probability assessment
Authors: Talens J. B. , Pelegri-Sebastia J. , Sogorb T. , Ruiz J. L. 
Published: October 2023

AbstractThis research aims to develop a diagnostic tool that can quickly and accurately detect prostate cancer using electronic nose technology and a neural network trained on a dataset of urine samples from patients diagnosed with both prostate cancer and benign prostatic hyperplasia, which incorporates a unique data redundancy method. By analyzing signals from these samples, we were able to significantly reduce the number of unnecessary biopsies and improve the classification method, resulting in a recall rate of 91% for detecting prostate cancer. The goal is to make this technology widely available for use in primary care centers, to allow for rapid and non-invasive diagnoses.
Research on the learning experience of virtual simulation class experimental teaching and learning based on the perspective of nursing students
Authors: Gao Yazhuo , Zhu Xuehua 
Published: October 2023

Abstract
Background
The enrichment of information technology has impacted traditional teaching modes. The emergence of virtual simulation class experimental teaching software has effectively improved the quality of nursing experiment teaching. The learning experience of virtual simulation class experiment teaching and learning based on the perspective of nursing students is explored to provide a basis for improving related learning effects in the future.

Methods
Fourteen undergraduate nursing students were selected using the purposive sampling method for semi-structured interviews. The Colaizzi seven-step analysis method was used to collate and analyse the interview data.

Results
Two themes and six sub-themes were considered during the data analysis. The two themes were positive experiences and negative experiences. In the positive learning experience, undergraduate nursing students showed a deep memory of authentic and diverse scenes, which presented knowledge in a clearly logical, visualised and stereoscopic manner. Negative experiences are manifested as significantly different learning efficiencies in different grades and subjects, and timing the delivery of teaching feedback is difficult.

Conclusion
Virtual simulation experimental teaching can promote the subjective initiative of nursing students’ learning and promote better coordination and unity in their image and theoretical thinking. Some advantages can be augmented by following the national educational policy, strengthening the information construction, combining the construction of virtual simulation experiments with the discipline’s characteristics and optimising the resources. This paper provides a reference for the future exploration of nursing education and further improving the construction of virtual simulation experimental teaching tools and resources.
Response to patient safety incidents in healthcare settings in Ghana: the role of teamwork, communication openness, and handoffs
Authors: Poku Collins Atta , Attafuah Priscilla Yeye Adumoah , Anaba Emmanuel Anongeba , Abor Patience Aseweh , Nketiah-Amponsah Edward , Abuosi Aaron Asibi 
Published: October 2023

Abstract
Background
Patient safety incidents (PSIs) in healthcare settings are a critical concern globally, and Ghana is no exception. Addressing PSIs to improve health outcomes requires various initiatives to be implemented including improving patient safety culture, teamwork and communication between healthcare providers during handoffs. It is essential to acknowledge the significance of teamwork, communication openness, and effective handoffs in preventing and managing such incidents. These factors play a pivotal role in ensuring the well-being of patients and the overall quality of healthcare services.

Aim
This study assessed the occurrence and types of PSIs in health facilities in Ghana. It also examined the role of teamwork, handoffs and information exchange, and communication openness in response to PSIs by health professionals.

Methods
A cross-sectional study was conducted among 1651 health workers in three regions of Ghana. Using a multi-staged sampling technique, the Survey on Patient Safety Culture Hospital Survey questionnaire and the nurse-reported scale were used to collect the data and it was analysed by descriptive statistics, Pearson correlation, and linear multiple regression model at a significance of 0.05.

Results
There was a reported prevalence of PSIs including medication errors (30.4%), wound infections (23.3%), infusion reactions (24.7%), pressure sores (21.3%), and falls (18.7%) at least once a month. There was a satisfactory mean score for responses to adverse events (3.40), teamwork (4.18), handoffs and information exchange (3.88), and communication openness (3.84) among healthcare professionals. Teamwork, handoffs and information exchange and communication openness were significant predictors of response to PSIs, accounting for 28.3% of the variance.

Conclusions
Effective teamwork, handoffs and information exchange, and communication openness in the healthcare environment are critical strategies to enhance PSI response. Creating a culture that encourages error response through teamwork, communication and handoffs provides healthcare professionals with opportunities for learning and improving patient outcomes. Training programs should therefore target health professionals to improve patient safety and competency. Through the implementation of evidence-based practices and learning from past incidents, the healthcare system will be able to deliver safe and high-quality care to patients nationwide. Patient safety must be recognized as an ongoing process. Therefore, a meaningful improvement in patient outcomes requires all stakeholders’ commitment.
The pandemic experiences of Ontario perinatal providers: a qualitative study
Authors: Shaw-Churchill Sigourney , Phillips Karen P. 
Published: October 2023

Abstract
Background
The COVID-19 pandemic has produced widespread disruptions for healthcare systems across Canada. Perinatal care in Ontario, Canada was subject to province-wide public health restrictions, reallocation of hospital beds and human health resources. To better understand the impacts of the pandemic on Ontario perinatal care, this study explored the perspectives of perinatal care providers about their clinical COVID-19 pandemic experiences.

Methods
Semi-structured key informant virtual interviews were conducted between August 2021 and January 2022 with 15 Ontario-based perinatal care providers. Recorded interviews were transcribed, and thematic content analysis used to identify major themes and subthemes.

Results
Participants were mainly women, practicing in Eastern and Central Ontario as health providers (obstetricians, nurses, midwives), allied regulated health professionals (social worker, massage therapist), and perinatal support workers (doula, lactation consultant). Major themes and subthemes were identified inductively as follows: (1) Impacts of COVID-19 on providers (psychosocial stress, healthcare system barriers, healthcare system opportunities); (2) Perceived impacts of COVID-19 on pregnant people (psychosocial stress, amplification of existing healthcare barriers, influences on reproductive decision making; minor theme- social and emotional support roles); (3) Vaccine discourse (provider empathy, vaccines and patient family dynamics, minor themes- patient vaccine hesitancy, COVID-19 misinformation); and (4) Virtual pregnancy care (benefits, disadvantages, adaptation of standard care practices).

Conclusions
Perinatal care providers reported significant stress and uncertainty caused by the COVID-19 pandemic and evolving hospital protocols. Providers perceived that their patients were distressed by both the pandemic and related reductions in pregnancy healthcare services including hospital limits to support companion(s). Although virtual pregnancy care impaired patient-provider rapport, most providers believed that the workflow efficiencies and patient convenience of virtual care is beneficial to perinatal healthcare.
Social determination of malaria in pregnancy in Colombia: a critical ethnographic study
Authors: Cardona-Arias Jaiberth Antonio , Higuita-Gutiérrez Luis Felipe , Carmona-Fonseca Jaime 
Published: October 2023

Abstract
Background
The meanings and experiences related to malaria in pregnancy (MiP) and its processes of social determination of health (PSDH) have not been reported in the world scientific literature. The objective was to understand the meanings and experiences of MiP, and to explain their PSDH in an endemic area from Colombia, 2022.

Methods
Critical ethnography with 46 pregnant women and 31 healthcare workers. In-depth and semi-structured interviews, focus group discussions, participant and non-participant observations, and field diaries were applied. A phenomenological-hermeneutic analysis, saturation and triangulation was carried out. The methodological rigor criteria were reflexivity, credibility, auditability, and transferability.

Results
At the singular level, participants indicated different problems in antenatal care and malaria control programmes, pregnant women were lacking knowledge about MiP, and malaria care was restricted to cases with high obstetric risk. Three additional levels that explain the PSDH of MiP were identified: (i) limitations of malaria control policies, and health-system, geographic, cultural and economic barriers by MiP diagnosis and treatment; (ii) problems of public health programmes and antenatal care; (iii) structural problems such as monetary poverty, scarcity of resources for public health and inefficiency in their use, lacking community commitment to preventive actions, and breach of institutional responsibilities of health promoter entity, municipalities and health services provider institutions.

Conclusion
Initiatives for MiP control are concentrated at the singular level, PDSH identified in this research show the need to broaden the field of action, increase health resources, and improve public health programmes and antenatal care. It is also necessary to impact the reciprocal relationships of MiP with economic and cultural dimensions, although these aspects are increasingly diminished with the predominance and naturalization of neoliberal logic in health.
Treg cells-derived exosomes promote blood-spinal cord barrier repair and motor function recovery after spinal cord injury by delivering miR-2861
Authors: Kong Guang , Xiong Wu , Li Cong , Xiao Chenyu , Wang Siming , Li Wenbo , Chen Xiangjun , Wang Juan , Chen Sheng , Zhang Yongjie , Gu Jun , Fan Jin , Jin Zhengshuai 
Published: October 2023

AbstractThe blood-spinal cord barrier (BSCB) is a physical barrier between the blood and the spinal cord parenchyma. Current evidence suggests that the disruption of BSCB integrity after spinal cord injury can lead to secondary injuries such as spinal cord edema and excessive inflammatory response. Regulatory T (Treg) cells are effective anti-inflammatory cells that can inhibit neuroinflammation after spinal cord injury, and their infiltration after spinal cord injury exhibits the same temporal and spatial characteristics as the automatic repair of BSCB. However, few studies have assessed the relationship between Treg cells and spinal cord injury, emphasizing BSCB integrity. This study explored whether Treg affects the recovery of BSCB after SCI and the underlying mechanism. We confirmed that spinal cord angiogenesis and Treg cell infiltration occurred simultaneously after SCI. Furthermore, we observed significant effects on BSCB repair and motor function in mice by Treg cell knockout and overexpression. Subsequently, we demonstrated the presence and function of exosomes in vitro. In addition, we found that Treg cell-derived exosomes encapsulated miR-2861, and miR-2861 regulated the expression of vascular tight junction (TJs) proteins. The luciferase reporter assay confirmed the negative regulation of IRAK1 by miR-2861, and a series of rescue experiments validated the biological function of IRAKI in regulating BSCB. In summary, we demonstrated that Treg cell-derived exosomes could package and deliver miR-2861 and regulate the expression of IRAK1 to affect BSCB integrity and motor function after SCI in mice, which provides novel insights for functional repair and limiting inflammation after SCI.
Systems that evaluate international equivalency in health-related professions: a scoping review with a focus on Canada
Authors: Lafave Mark , Amannejad Yasaman , Mammadova Ulkar , Eubank Breda 
Published: October 2023

AbstractHealth workforce planning has become a significant global problem considering there are estimates of an 18 million healthcare provider shortfall by 2030. There are two mechanisms to address healthcare worker shortages: (1) domestic education of those professions and (2) integration of internationally educated health professionals. Integration of internationally educated health professionals into the Canadian healthcare system requires: (1) reductions in systemic and administrative barriers and (2) development, testing, and implementation of credential equivalency recognition systems. The goal of this scoping review was to identify systems that are employed to determine credential equivalency, with a focus on Canada. The scoping review was carried by employing: (1) a systematic literature search (9) and (2) a website and grey literature Google search of professional governing bodies from a selection of medical/allied healthcare professions, but also other non-medical professions, such as law, engineering and accounting. Seven databases were searched to identify relevant sources: MEDLINE, CINAHL Plus with Full Text, PsycINFO, SPORT Discus, Academic Search Complete, Business Source Complete, and SCOPUS. The search strategy combined keyword, text terms, and medical subject headings (MeSH) and was carried out with the help of a health sciences librarian. Seven articles were included in the final manuscript review from the following professions: nursing; psychology; engineering; pharmacy; and multiple health professions. Twenty-four health-related professional governing body websites were hand searched to determine systems to evaluate international equivalency. There were many systems employed to determine equivalency, but there were no systems that were automated or that employed machine-learning or artificial intelligence to guide the evaluation process.
Assessment of technical and clinical utility of a bead-based flow cytometry platform for multiparametric phenotyping of CNS-derived extracellular vesicles
Authors: Brahmer Alexandra , Geiß Carsten , Lygeraki Andriani , Neuberger Elmo , Tzaridis Theophilos , Nguyen Tinh Thi , Luessi Felix , Régnier-Vigouroux Anne , Hartmann Gunther , Simon Perikles , Endres Kristina , Bittner Stefan , Reiners Katrin S. , Krämer-Albers Eva-Maria 
Published: October 2023

AbstractBackgroundExtracellular vesicles (EVs) originating from the central nervous system (CNS) can enter the blood stream and carry molecules characteristic of disease states. Therefore, circulating CNS-derived EVs have the potential to serve as liquid-biopsy markers for early diagnosis and follow-up of neurodegenerative diseases and brain tumors. Monitoring and profiling of CNS-derived EVs using multiparametric analysis would be a major advance for biomarker as well as basic research. Here, we explored the performance of a multiplex bead-based flow-cytometry assay (EV Neuro) for semi-quantitative detection of CNS-derived EVs in body fluids.MethodsEVs were separated from culture of glioblastoma cell lines (LN18, LN229, NCH82) and primary human astrocytes and measured at different input amounts in the MACSPlex EV Kit Neuro, human. In addition, EVs were separated from blood samples of small cohorts of glioblastoma (GB), multiple sclerosis (MS) and Alzheimer’s disease patients as well as healthy controls (HC) and subjected to the EV Neuro assay. To determine statistically significant differences between relative marker signal intensities, an unpaired samples t-test or Wilcoxon rank sum test were computed. Data were subjected to tSNE, heatmap clustering, and correlation analysis to further explore the relationships between disease state and EV Neuro data.ResultsGlioblastoma cell lines and primary human astrocytes showed distinct EV profiles. Signal intensities were increasing with higher EV input. Data normalization improved identification of markers that deviate from a common profile. Overall, patient blood-derived EV marker profiles were constant, but individual EV populations were significantly increased in disease compared to healthy controls, e.g. CD36+EVs in glioblastoma and GALC+EVs in multiple sclerosis. tSNE and heatmap clustering analysis separated GB patients from HC, but not MS patients from HC. Correlation analysis revealed a potential association of CD107a+EVs with neurofilament levels in blood of MS patients and HC.ConclusionsThe semi-quantitative EV Neuro assay demonstrated its utility for EV profiling in complex samples. However, reliable statistical results in biomarker studies require large sample cohorts and high effect sizes. Nonetheless, this exploratory trial confirmed the feasibility of discovering EV-associated biomarkers and monitoring circulating EV profiles in CNS diseases using the EV Neuro assay.