bluuebunny/crossref_metadata_2025_split huggingface dataset:
Collecting evidence of validity for an assessment tool for Norwegian medical students’ non-technical skills (NorMS-NTS): usability and reliability when used by novice raters
Authors: Prydz Katrine , Dieckmann Peter , Fagertun Hans , Musson David , Wisborg Torben 
Published: November 2023

Abstract
Background
The NorMS-NTS tool is an assessment tool for assessing Norwegian medical students’ non-technical skills (NTS). The NorMS-NTS was designed to provide student feedback, training evaluations, and skill-level comparisons among students at different study sites. Rather than requiring extensive rater training, the tool should capably suit the needs of busy doctors as near-peer educators. The aim of this study was to examine the usability and preliminary assess validity of the NorMS-NTS tool when used by novice raters.

Methods
This study focused on the usability of the assessment tool and its internal structure. Three raters used the NorMS-NTS tool to individually rate the team leader, a medical student, in 20 video-recorded multi-professional simulation-based team trainings. Based on these ratings, we examined the tools’ internal structure by calculating the intraclass correlation coefficient (ICC) (version 3.1) interrater reliability, internal consistency, and observability. After the rating process was completed, the raters answered a questionnaire about the tool’s usability.

Results
The ICC agreement and the sum of the overall global scores for all raters were fair: ICC (3,1) = 0.53. The correlation coefficients for the pooled raters were in the range of 0.77–0.91. Cronbach’s alpha for elements, categories and global score were mostly above 0.90. The observability was high (95%-100%). All the raters found the tool easy to use, none of the elements were redundant, and the written instructions were helpful. The raters also found the tool easier to use once they had acclimated to it. All the raters stated that they could use the tool for both training and teaching.

Conclusions
The observed ICC agreement was 0.08 below the suggested ICC level for formative assessment (above 0.60). However, we know that the suggestion is based on the average ICC, which is always higher than a single-measure ICC. There are currently no suggested levels for single-measure ICC, but other validated NTS tools have single-measure ICC in the same range. We consider NorMS-NTS as a usable tool for formative assessment of Norwegian medical students’ non-technical skills during multi-professional team training by raters who are new to the tool. It is necessary to further examine validity and the consequences of the tool to fully validate it for formative assessments.
Comparative study of 360° virtual reality and traditional two-dimensional video in nonface-to-face dental radiology classes: focusing on learning satisfaction and self-efficacy
Authors: Im Ji-Eun , Gu Ja-Young , Bae Jung-Hee , Lee Jae-Gi 
Published: November 2023

Abstract
Background
Acquiring adequate theoretical knowledge in the field of dental radiography (DR) is essential for establishing a good foundation at the prepractical stage. Currently, nonface-to-face DR education predominantly relies on two-dimensional (2D) videos, highlighting the need for developing educational resources that address the inherent limitations of this method. We developed a virtual reality (VR) learning medium using 360° video with a prefabricated head-mounted display (pHMD) for nonface-to-face DR learning and compared it with a 2D video medium.

Methods
Forty-four participants were randomly assigned to a control group (n = 23; 2D video) and an experimental group (n = 21; 360° VR). DR was re-enacted by the operator and recorded using 360° video. A survey was performed to assess learning satisfaction and self-efficacy. The nonparametric statistical tests comparing the groups were conducted using SPSS statistical analysis software.

Results
Learners in the experimental group could experience VR for DR by attaching their smartphones to the pHMD. The 360° VR video with pHMD provided a step-by-step guide for DR learning from the point of view of an operator as VR. Learning satisfaction and self-efficacy were statistically significantly higher in the experimental group than the control group (p < 0.001).

Conclusions
The 360° VR videos were associated with greater learning satisfaction and self-efficacy than conventional 2D videos. However, these findings do not necessarily substantiate the educational effects of this medium, but instead suggest that it may be considered a suitable alternative for DR education in a nonface-to-face environment. However, further examination of the extent of DR knowledge gained in a nonface-to-face setting is warranted. Future research should aim to develop simulation tools based on 3D objects and also explore additional uses of 360° VR videos as prepractical learning mediums.
Patients’ perspectives and preferences toward telemedicine versus in-person visits: a mixed-methods study on 1226 patients
Authors: Moulaei Khadijeh , Sheikhtaheri Abbas , Fatehi Farhad , Shanbehzadeh Mostafa , Bahaadinbeigy Kambiz 
Published: November 2023

Abstract
Introduction
Despite the fact that telemedicine can eliminate geographical and time limitations and offer the possibility of diagnosing, treating, and preventing diseases by sharing reliable information, many individuals still prefer to visit medical centers for in-person consultations. The aim of this study was to determine the level of acceptance of telemedicine compared to in-person visits, identify the perceived advantages of telemedicine over in-person visits, and to explore the reasons why patients choose either of these two types of visits.

Methods
We developed a questionnaire using the rational method. The questionnaire consisted of multiple-choice questions and one open-ended question. A total of 2059 patients were invited to participate in the study. Chi-square tests and descriptive statistics were employed for data analysis. To analyze the data from the open-ended question, we conducted qualitative content analysis using MAXQDA 18.

Results
Out of the 1226 participants who completed the questionnaire, 865 (71%) preferred in-person visits, while 361 (29%) preferred telemedicine. Factors such as education level, specific health conditions, and prior experience with telemedicine influenced the preference for telemedicine. The participants provided a total of 183 different reasons for choosing either telemedicine (108 reasons) or in-person visits (75 reasons). Avoiding infectious diseases, saving cost, and eliminating and overcoming geographical distance barriers were three primary telemedicine benefits. The primary reasons for selecting an in-person visit were: more accurate diagnosis of the disease, more accurate and better examination of the patient by the physician, and more accurate and better treatment of the disease.

Conclusion
The results demonstrate that despite the numerous benefits offered by telemedicine, the majority of patients still exhibit a preference for in-person visits. In order to promote broader acceptance of telemedicine, it becomes crucial for telemedicine services to address patient preferences and concerns effectively. Employing effective change management strategies can aid in overcoming resistance and facilitating the widespread adoption of telemedicine within the population.
Guideline evaluation and implementation mechanisms in school health services (GuideMe): protocol for a hybrid randomized factorial trial
Authors: Sagatun Åse , Engell Thomas , Brekke Malene , Sjølie Hege , Ekornes Stine M. , Waldum-Grevboe Kristin Sofie , Pape Kristine , Kvaløy Kirsti , Jeneson Annette , Trøan Anna Stigum , Askeland Anne Liv , Stien Line , Holen Solveig 
Published: November 2023

AbstractBackgroundNorwegian school health services received a national best-practice guideline in 2017. To promote healthy life skills and identify adolescents needing support, the guideline includes strong recommendations for individual consultations with all 8th graders and increased collaboration with schools. To help implement the recommendations, a blended implementation strategy (SchoolHealth) was co-created with school nurses, students, and stakeholders. SchoolHealth consists of three implementation elements: Digital dialog and administration tool (audit and feedback +), Dialog support (external consultation), and Collaboration materials (targeted dissemination). This hybrid study will test the main and combined effects of the elements on guideline fidelity and effectiveness.MethodsThe GuideMe study is a factorial cluster randomized controlled trial examining SchoolHealth's effectiveness on guideline fidelity and guideline effectiveness goals. Forty Norwegian secondary schools will be randomized to eight different combinations of the elements in SchoolHealth. Participants will include school nurses and school personnel from these schools, and 8thgrade students (n = 1200).Primary outcomes are school nurses' fidelity to the guidelines and student's ability to cope with their life (i.e., health literacy, positive health behaviors and self-efficacy). Quantitative methods will be used to test effects and mechanisms, while mixed- and qualitative methods will be used to explore mechanisms, experiences, and other phenomena in depth. Participants will complete digital questionnaires at the start and end of the schoolyear, and after the consultation during the schoolyear. The study will run in two waves, each lasting for one school year. The multifactorial design allows testing of interactions and main effects due to equal distribution of all factors within each main effect. Sustainment and scale-up of optimized SchoolHealth elements using national infrastructure are simultaneously prepared.DiscussionThe study will investigate possible effects of the implementation elements in isolation and in combination, and hypothesized implementation mechanisms. In-depth study of user experiences will inform improvements to elements in SchoolHealth. The results will yield causal knowledge about implementation strategies and the mechanisms through which they assert effects. Mixed-methods will provide insights into how and when the elements work. Optimizing guideline implementation elements can support adolescents in a crucial life phase.Trail registrationISRCTN24173836. Registration date 8 August 2022.
Experiences of Alaska Native people living with burn injury and opportunities for health system strengthening
Authors: Smith Mallory B. , Brownson Elisha , Newman Andrea K. , Madison Christopher , Fuentes Molly , Amtmann Dagmar , Carrougher Gretchen J. , Gibran Nicole S. , Stewart Barclay T. 
Published: November 2023

Abstract
Background
Injuries are a leading cause of death and disability for Alaska Native (AN) people. Alaska Native Tribal Health Consortium (ANTHC) is supporting the development of a burn care system that includes a partnership between Alaska Native Medical Center (ANMC) in Anchorage, AK and UW Medicine Regional Burn Center at Harborview Medical Center (HMC) in Seattle, WA. We aimed to better understand the experiences of AN people with burn injuries across the care continuum to aid development of culturally appropriate care regionalization.

Methods
We performed focus groups with twelve AN people with burn injury and their caregivers. A multidisciplinary team of burn care providers, qualitative research experts, AN care coordinator, and AN cultural liaison led focus groups to elicit experiences across the burn care continuum. Transcripts were analyzed using a phenomenological approach and inductive coding to understand how AN people and families navigated the medical and community systems for burn care and areas for improvement.

Results
Three themes were identified: 1-Challenges with local burn care in remote communities including limited first aid, triage, pain management, and wound care, as well as long-distance transport to definitive care; 2-Divergence between cultural values and medical practices that generated mistrust in the medical system, isolation from their support systems, and recovery goals that were not aligned with their needs; 3-Difficulty accessing emotional health support and a survivor community that could empower their resilience.

Conclusion
Participants reported modifiable barriers to culturally competent treatment for burn injuries among AN people. The findings can inform initiatives that leverage existing resources, including expansion of the Extension for Community Healthcare Outcomes (ECHO) telementoring program, promulgation of the Phoenix Society Survivors Offering Assistance in Recovery (SOAR) to AK, coordination of regionalized care to reduce time away from AK and provide more comfortable community reintegration, and define rehabilitation goals in terms that align with personal goals and subsistence lifestyle skills. Long-distance transport times are non-modifiable, but better pre-hospital care could be achieved by harnessing existing telehealth services and adapting principles of prolonged field care to allow for triage, initial care, and resuscitation in remote environments.
Diabetic microvascular disease in non-classical beds: the hidden impact beyond the retina, the kidney, and the peripheral nerves
Authors: Mauricio Dídac , Gratacòs Mònica , Franch-Nadal Josep 
Published: November 2023

AbstractDiabetes microangiopathy, a hallmark complication of diabetes, is characterised by structural and functional abnormalities within the intricate network of microvessels beyond well-known and documented target organs, i.e., the retina, kidney, and peripheral nerves. Indeed, an intact microvascular bed is crucial for preserving each organ’s specific functions and achieving physiological balance to meet their respective metabolic demands. Therefore, diabetes-related microvascular dysfunction leads to widespread multiorgan consequences in still-overlooked non-traditional target organs such as the brain, the lung, the bone tissue, the skin, the arterial wall, the heart, or the musculoskeletal system. All these organs are vulnerable to the physiopathological mechanisms that cause microvascular damage in diabetes (i.e., hyperglycaemia-induced oxidative stress, inflammation, and endothelial dysfunction) and collectively contribute to abnormalities in the microvessels’ structure and function, compromising blood flow and tissue perfusion. However, the microcirculatory networks differ between organs due to variations in haemodynamic, vascular architecture, and affected cells, resulting in a spectrum of clinical presentations. The aim of this review is to focus on the multifaceted nature of microvascular impairment in diabetes through available evidence of specific consequences in often overlooked organs. A better understanding of diabetes microangiopathy in non-target organs provides a broader perspective on the systemic nature of the disease, underscoring the importance of recognising the comprehensive range of complications beyond the classic target sites.
From pressure to tension: a model of damaging inflation stress
Authors: Marini John J. , Thornton Lauren T. , Rocco Patricia R. M. , Crooke Philip S. 
Published: November 2023

AbstractAlthough the stretch that generates ventilator-induced lung injury (VILI) occurs within the peripheral tissue that encloses the alveolar space, airway pressures and volumes monitor the gas within the interior core of the lung unit, not its cellular enclosure. Measured pressures (plateau pressure, positive end-expiratory pressure, and driving pressure) and tidal volumes paint a highly relevant but incomplete picture of forces that act on the lung tissues themselves. Convenient and clinically useful measures of the airspace, such as pressure and volume, neglect the partitioning of tidal elastic energy into the increments of tension and surface area that constitute actual stress and strain at the alveolar margins. More sharply focused determinants of VILI require estimates of absolute alveolar dimension and morphology and the lung’s unstressed volume at rest. We present a highly simplified but informative mathematical model that translates the radial energy of pressure and volume of the airspace into its surface energy components. In doing so it elaborates conceptual relationships that highlight the forces tending to cause end-tidal hyperinflation of aerated units within the ‘baby lung’ of acute respiratory distress syndrome (ARDS).
Design, spectral, molecular modeling, antimitotic, analytical and mechanism studies of phenyl isothiocyanate Girard's T derived metal complexes
Authors: Akl Magda A. , El Mahdy Nora A. , Elbadrawy Zizi , El-Zeny Abdelrahman S. , Mostafa Mohsen M. 
Published: November 2023

AbstractThe ligand N-{[(phenyl amino) thioxomethyl] hydrazino carbonyl methyl} trimethyl ammonium chloride (PTHAC) was prepared by the refluxing phenyl isothiocyanate and Girard-T (trimethyl ammonium-acethydrazide) in a molar ratio (1:1). The metal complexes derived from NiCl2.6H2O, CuCl2.2H2O and Co(CH3COO)2.6H2O were synthesized and purified. The PTHAC and its Cu(II), Co(II), and Ni(II) metal complexes(1–3) were characterized using a variety of various instrumental performances such as elemental analysis, magnetic moment, spectra (IR, UV–Vis, 1H NMR, mass) and thermal analysis (TGA and DTG).The results of element analysis, magnetic moment, spectra (IR, UV–Vis, 1H NMR, mass), and thermal (TGA and DTA) analyses provide the structures of the produced ligand and its (1–3) complexes. According to the spectroscopic results, PTHAC acts as an O, N and S tridentate donor, creating a mononuclear complex with copper(II), cobalt(II), and nickel(II) ions with an octahedral geometry. All of the atomic properties, including bond lengths, bond angles, HOMO, LUMO, dipole moments, and charges, have been determined. The cytotoxic activities of the PTHAC and the produced (1–3) complexes against breast carcinoma cells have been studied and correlated to the molecular modeling. When compared to the free ligand, CoII-L, and NiII-L, the CuII-L complex inhibits breast cancer cell growth more effectively. Furthermore, the PTHAC ligand was successfully applied for separation via flotation and spectrophotometric determination of Co(II) in several natural water, certified ore and pharmaceutical samples using oleic acid surfactant (HOL). At pH 6.5, PTHAC reacted with Co(II) to create a dark green (1:1) Co(II):PTHAC complex that was floated significantly using oleic acid (HOL) surfactant. The different experimental variable affecting the separation procedure e.g. pH, concentration of Co(II), HOL, PTHAC, temperature etc.…, were investigated. Co(II) had a linear range of (0.1–7.0) mgL−1. In the aqueous and scum layers, the molar absorptivities for the coloured complex are 0.14 × 104 and 0.16 × 105Lmol−1 cm−1, respectively. The LOD was 0.04 mgL−1, which is related to Sandell sensitivity of 3.7 × 10−3 µg cm−2 with a preconcentration factor of 200 and a RSD, % (n = 5) less than 4.2%. In addition, the mechanisms involved in the process of coordination of PTHAC with Cu(II), Co(II) and Ni(II) and the mechanism involved in the process of flotation of the PTHAC-Co(II) complex using HOL surfactant were elucidated.
Using geometric wing morphometrics to distinguish Aedes japonicus japonicus and Aedes koreicus
Authors: Sauer Felix G. , Pfitzner Wolf Peter , Jöst Hanna , Rauhöft Leif , Kliemke Konstantin , Lange Unchana , Heitmann Anna , Jansen Stephanie , Lühken Renke 
Published: November 2023

Abstract
Background
Aedes japonicus japonicus (Theobald, 1901) and Aedes koreicus (Edwards, 1917) have rapidly spread in Europe over the last decades. Both species are very closely related and occur in sympatry. Females and males are difficult to distinguish. However, the accurate species discrimination is important as both species may differ in their vectorial capacity and spreading behaviour. In this study, we assessed the potential of geometric wing morphometrics as alternative to distinguish the two species.

Methods
A total of 147 Ae. j. japonicus specimens (77 females and 70 males) and 124 Ae. koreicus specimens (67 females and 57 males) were collected in southwest Germany. The left wing of each specimen was removed, mounted and photographed. The coordinates of 18 landmarks on the vein crosses were digitalised by a single observer. The resulting two-dimensional dataset was used to analyse the differences in the wing size (i.e. centroid size) and wing shape between Ae. j. japonicus and Ae. koreicus using geometric morphometrics. To analyse the reproducibility of the analysis, the landmark collection was repeated for 20 specimens per sex and species by two additional observers.

Results
The wing size in female Ae. koreicus was significantly greater than in Ae. j. japonicus but did not differ significantly for males. However, the strong overlap in wing size also for the females would not allow to discriminate the two species. In contrast, the wing shape clustering was species specific and a leave-one-out validation resulted in a reclassification accuracy of 96.5% for the females and 91.3% for the males. The data collected by different observers resulted in a similar accuracy, indicating a low observer bias for the landmark collection.

Conclusions
Geometric wing morphometrics provide a reliable and robust tool to distinguish female and male specimens of Ae. j. japonicus and Ae. koreicus.

Graphical Abstract
Effect of six-week short-duration deep breathing on young adults with chronic ankle instability-a pilot randomized control trial
Authors: Ramalingam Vinodhkumar , Cheong Soon Keng , Lee Poh Foong 
Published: November 2023

Abstract
Background
Chronic ankle instability (CAI) is the most common injury in youth sports, which leads to psychological stress from doubting their performance. Cost effective and easy to access tool to reduce the stress among this target group are desired. Therefore, the purpose of this study was to investigate the effect of adding on intervention with short-duration deep breathing (SDDB) alongside with conventional physiotherapy (CP) among young adults with chronic ankle instability (CAI).

Methods
Total of 30 CAI participants attended physiotherapy, who were randomly assigned into control and experimental groups. The participants in the experimental group received combined intervention (SDDB + CP), and the control group received CP for 6 weeks. The effectiveness of interventions was assessed at 3 intervals with a battery of questionnaires (Visual Analog Score, Cumberland Ankle Instability Tool, Mindful Attention Awareness Scale, and Oxford Happiness Questionnaire) at the end of week 3, week 6, and week 12 as follow-up. A two-way repeated measures of ANOVA was applied to report the statistical significance at p < 0.05.

Results
The results showed a better improvement in pain, balance, happiness, and mindfulness attention among participants in the experimental group, with a significant improvement in mindful attention over the time point as compared to the control group.

Conclusion
The findings provide insight into incorporating SDDB additions to the existing CP for better CAI management. Breathing techniques that improve attention and happiness play a vital role in CAI, which recommends the biopsychosocial approach in chronic injury rehabilitation.

Trial registration
Current Controlled Trials using Clinical Trials Registry under ID number NCT04812158 retrospectively registered on 23/03/2021.