bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to research productivity amongst postgraduate trainees: results from a survey of 333 medical and surgical residents
Authors: Bakhshi Saqib K , Abdul Rahim Komal , Merchant Asma A H , Afzal Noreen , Qadeer Shaikh Namra , Noorali Ali A , Lakhdir Maryam P A , Mahmood Saad B Z , Tariq Muhammad , Haider Adil H 
Published: August 2023

AbstractPurposeWe aimed to determine the perceptions of, barriers to, and predictors of research engagement amongst residents at a national level in Pakistan.MethodsThis cross-sectional study used REDCap for online survey dissemination to residents from 12 institutes accredited by the national accreditation body (College of Physicians and Surgeons Pakistan) for core medical and surgical specialties. Logistic regression was used to estimate associations between likelihood of publications and participant characteristics.ResultsThe response rate was 79% (333/423), with 171 (51%) medical and 162 (49%) surgical residents. The mean ± standard deviation age was 28.8 ± 2.7 years; 137 (41%) were males and 195 (59%) females. More than half the residents, 202 (61%), had received research training, but 189 (57%) scored &lt;33% on basic research knowledge. While most residents agreed on the positive impact of research on their careers (P = .012) and realized that they should be involved in it (P = .33), they also strongly believed that it was difficult to engage in research during training (P &lt; .01). Only 60 (18%) trainees had published a paper in local and 37 (11%) in international journals, respectively. The most significant barriers to conducting research included time limitation due to clinical work, lack of financial support, and unavailability of data (P &lt; .01).ConclusionResidents have a positive attitude towards research. However, research engagement among residents is low. Improving research mentorship and creating systems that enable protected time and institutional access to data are needed to increase research output of postgraduate trainees.Key messages What is already known on this topic Postgraduate trainees benefit academically from research conducted during residency training. However, in low- and middle-income countries like Pakistan, research output among residents has remained low over the years. The nation has consistently produced very little research. What this study adds The current study helped shed light on the reasons for low research productivity amongst medical and surgical residents in Pakistan. How this study might affect research, practice, or policy The potential predictors for low research involvement highlighted in this study necessitate modification of the existing national residency curriculum to increase research engagement and productivity among residents. Not only can the potential factors be improved, but the study also helps in bringing stakeholders’ attention to increasing research opportunities in Pakistan.
Major cardiovascular disease risk in men with testosterone deficiency (hypogonadism): appraisal of short, medium and long-term testosterone therapy – a narrative review
Authors: Traish Abdulmaged M 
Published: August 2023

AbstractIntroductionLow testosterone (T) levels are associated with obesity, metabolic syndrome, type 2 diabetes mellitus and altered lipid profiles, thus contributing to increased cardiovascular disease risk. Hence T deficiency has a detrimental effect on men’s vascular health, quality of life and increased mortality.ObjectivesThis review aims to present summary of data in the contemporary clinical literature pertaining to the benefits of T therapy in clinical studies with varying durations on vascular health in men with T deficiency.MethodsA Medline search using PubMed and EMBASE was performed using the following key words: “testosterone deficiency,” “testosterone therapy,” major cardiovascular adverse events”, “cardiovascular disease”. Relevant studies were extracted, evaluated, and analyzed. We evaluated findings from clinical trials, observational studies and systematic reviews and meta-analyses to develop a comprehensive account of the critical role of T in maintaining vascular health.ResultsConsiderable evidence beginning with studies published in 1940s concomitant with findings from the utmost recent clinical studies suggests a clinical value of T therapy in maintaining vascular health and reducing cardiovascular mortality. The current scientific and clinical evidence demonstrates strong relationship between low circulating T levels and risk of cardiovascular disease and T therapy is deemed safe in men with hypogonadism when given in the physiological range with no apparent harm.ConclusionWhat emerges from the current clinical literature is that, irrespective of the length of study durations, testosterone therapy provides significant health benefits and reduces risk of cardiovascular disease. More important is that data from many observational and registry studies, demonstrated that longer durations of testosterone therapy were associated with greater health benefits and reduced cardiovascular risk. T therapy in men with T deficiency reduces the incidence of major adverse cardiovascular events attributed to improving overall metabolic function.
First Branchial Cleft Fistula Piercing through the Main Trunk of the Facial Nerve
Authors: Moriyama Masazumi , Kuwahara Kosuke , Nakagawa Masahiro , Kamochi Hideaki 
Published: August 2023

Summary:
First branchial cleft fistulas are congenital malformations that result from the incomplete closure of the ectodermal portion of the first branchial cleft. These fistulas typically appear as small pits or subcutaneous masses in the upper neck and cheek and can cause pain due to infection and inflammation. Surgical excision is the most effective treatment, but special attention is necessary to avoid facial nerve injury due to the proximity of the lesion to the nerve and variations in their arrangement. Here, we report the successful treatment of a first branchial cleft fistula piercing through the main trunk of the facial nerve in a 3-year-old girl. Intraoperative findings revealed that the fistula in the parotid gland opened into the cheek area from the ear canal. Identification of the facial nerve trunk was challenging due to the malformation of the lower end of the auricular cartilage, which is an anatomical landmark of the facial nerve. The trunk of the facial nerve was divided proximally by the fistula and merged just past the fistula. Preoperative magnetic resonance is important for determining the fistula location, surrounding anatomical variations, and fistula-facial nerve arrangement. Furthermore, early surgical treatment should be considered to prevent tissue scarring and adhesion due to infection, which can lead to facial nerve injury.
A Methodology for Calculating Inhalation Dose to Public Health Personnel Exposed to Material Resuspended from Evacuees Following the Detonation of a Fission Device
Authors: Anspaugh Lynn R. , Mauro John , Briggs Nicole , Porrovecchio Joseph , Amann William , Salame-Alfie Adela , Ansari Armin 
Published: August 2023

Abstract
Following a nuclear fission event, there likely would be a large number of contaminated persons who would seek assistance at community reception centers to be established outside the affected area. This paper provides a methodology for calculating inhalation doses to public health and other response personnel at such facilities who would be receiving and assisting potentially contaminated persons from whom particles can be resuspended. Three hypothetical facilities were considered: the Base Case is a rather small room with no forced air ventilation. The Preferred Case, which is more realistic, is a mid-sized room with an operating HVAC system with air being recirculated through a filter. The Gymnasium Case has only fresh air intake. Initial bounding calculations for the Base Case indicated the need for pre-screening of arrivals to avoid unacceptable doses to staff. The screening criterion selected was 1.67 × 106 Bq m−2. Calculations are presented for radionuclide concentrations in air, dose to staff from inhalation, and how exposures and the resulting doses can be altered by air-turnover rates and the use of filters with varying efficiency. Doses are presented for various arrival times and for both plutonium- and uranium-fueled detonations. The highest calculated dose via inhalation with no respiratory protection was 0.23 mSv for the Base Case. The more important radionuclides contributing to dose with exposure starting at day D + 1 were 239Np and 133I. At day D + 30, 131I and 140Ba were the more important dosimetrically. The variable creating the highest uncertainty was the slough-off factor for resuspension of contamination from people arriving at the reception center.
Comparative Evaluation of RT-PCR Kits Available in Sri Lanka for Diagnosis of COVID-19
Authors: Amarasinghe Kanchana P. , Murugananthan Arumugam , Amalraajan Ponnuthurai T. , Thavaththurai Mithusha , Ravindran Gayathri , Murugananthan Kalamathy , Gunathilake Shakila K. 
Published: August 2023

Abstract
Identification of gene targets by real-time reverse transcriptase PCR (rRT-PCR) is considered as the gold standard for diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Although many commercial rRT-PCR kits are currently used in Sri Lanka, analytical performance of these kits have not been investigated adequately. Therefore, the objective of the present study was to evaluate the analytical performance of rRT-PCR kits used in the laboratory of the Faculty of Medicine, University of Jaffna (five kits). Performance of the five rRT-PCR kits selected for this study was compared with the CDC 2019-Novel Coronavirus (2019-nCoV) RT-PCR Diagnostic Panel as reference standard. The sensitivity, specificity, positive predictive value, negative predictive value and Cohen’s κ coefficient of the five different commercial kits were analyzed. SARS-CoV-2 positive (62) and negative (32) respiratory samples collected respectively from symptomatic individuals and asymptomatic healthy individuals were used in this study. Comparison of the cycle threshold (Ct) values of the five commercial kits revealed heterogeneity. Among them, the TaqPathTM kit showed the highest sensitivity (98.4%) and interrater reliability (0.976). The HBRT-COVID-19 kit showed the lowest sensitivity (91.9%), specificity (93.7%) and interrater reliability (0.838). Although the five RT-PCR kits exhibited varying sensitivity, specificity and Ct values, all of them are suitable for the routine diagnosis of SARS-CoV-2 infections as all values were higher than 90%.
Endoscopic treatment of gastroesophageal reflux: a narrative review
Authors: Lopes Samuel Oliveira , Gonçalves Ana Raquel , Macedo Guilherme , Santos-Antunes João 
Published: August 2023

Abstract
Gastroesophageal reflux disease (GERD) is a common chronic disease that affects one-third of the population worldwide. In recent years, there have been significant advances for diagnostic workup, which leads to better identification of reflux-related complications. Classically, the mainstay of therapy has been proton pump inhibitor and lifestyle and dietary modifications. For refractory GERD the gold-standard therapies are surgical antireflux procedures. Recently, endoscopic procedures have emerged as safe and efficient alternatives to surgery. These could represent a less invasive approach, with scarce morbidity and with a well-tolerated profile. Each of the existing endoscopic techniques for the treatment of GERD are addressed in this report, highlighting their potential advantages, aiming at helping decide the best management of these patients. Future studies, with larger numbers of patients, may allow a definitive role for these techniques in the management of GERD to be established.
Exploring the Difficulties and Strategies of Family Caregivers in Caring for Patients With Dementia in Acute Care Wards
Authors: CHEN Ko-Xin , HSU Pei-Chen , LIN Jong-Ni , LEE Feng-Ping , WANG Jing-Jy 
Published: August 2023

ABSTRACT

Background
Providing appropriate care to patients with dementia in acute care settings can be a challenge for healthcare professionals. A key factor is working closely with family caregivers.

Purpose
This study aims to explore the difficulties and strategies involved in caring for patients with dementia who have been admitted to an acute care ward from the perspective of family caregivers.

Methods
Exploratory research was conducted using a qualitative data collection approach. Data were collected by means of in-depth interviews carried out with participants. Semistructured interviews were conducted with nine participants. Content analysis was performed to analyze the data.

Results
A number of themes and subthemes were identified based on the primary research purposes. The first theme is “vicious cycle due to multiple factors,” with the following subthemes: (a) communication disturbance, (b) endless worries, (c) inadequate care skills of paid caregivers, and (d) physical and psychological exhaustion. The second theme is “do everything,” with the following subthemes: (a) management of the behavioral and psychological symptoms of dementia, (b) constant accompaniment of the patient, and (c) seeking sources of support.

Conclusions/Implications for Practice
The results may be used to help healthcare professionals better anticipate the difficulties faced by family caregivers while providing assistance to patients with dementia and understand the related strategies they use. Acute care wards should consider the specific needs of family caregivers to ensure patients with dementia receive adequate care from the relevant parties in the ecological care chain during the care process.
Red cell extracellular vesicles and coagulation activation pathways
Authors: Noubouossie Denis F. , Key Nigel S. 
Published: August 2023

Purpose of review
Packed red blood cells (PRBCs) are the most commonly transfused blood products. Preparation of PRBCs requires blood collection from donors, processing, and storage prior to transfusion to recipients. Stored red blood cells (RBCs) undergo structural and metabolic changes collectively known as the storage lesion. RBC extracellular vesicles (sREVs) are released in PRBC units during storage, and are transfused along with intact RBCs into recipients. For several decades, extracellular vesicles have been the focus of intense research, leading to the discovery of a wide variety of endogenous biological properties that may impact numerous physiologic and/or pathologic pathways.

Recent findings
This study reviews the characteristics of extracellular vesicles present in PRBC units and the impact of prestorage and pretransfusion processing, as well as storage conditions, on their generation. Importantly, we discuss recently described interactions of sREVs with coagulation pathways and related interplay with inflammatory pathways in vitro and in vivo using animal models.

Summary
Extracellular vesicles present in stored PRBC units are capable of activating coagulation pathways. However, it remains unclear whether this affects clinical outcomes in recipients of PRBC units. Further understanding of these pathways and their relationship to any adverse outcomes may yield novel strategies to mitigate complications of blood transfusion.
A new SPRING in lipid metabolism
Authors: Hendrix Sebastian , Zelcer Noam 
Published: August 2023

Purpose of review
The SREBP transcription factors are master regulators of lipid homeostasis owing to their role in controlling cholesterol and fatty acid metabolism. The core machinery required to promote their trafficking and proteolytic activation has been established close to 20 years ago. In this review, we summarize the current understanding of a newly identified regulator of SREBP signaling, SPRING (formerly C12ORF49), its proposed mechanism of action, and its role in lipid metabolism.

Recent findings
Using whole-genome functional genetic screens we, and others, have recently identified SPRING as a novel regulator of SREBP signaling. SPRING is a Golgi-resident single-pass transmembrane protein that is required for proteolytic activation of SREBPs in this compartment. Mechanistic studies identified regulation of S1P, the protease that cleaves SREBPs, and control of retrograde trafficking of the SREBP chaperone SCAP from the Golgi to the ER as processes requiring SPRING. Emerging studies suggest an important role for SPRING in regulating circulating and hepatic lipid levels in mice and potentially in humans.

Summary
Current studies support the notion that SPRING is a novel component of the core SREBP-activating machinery. Additional studies are warranted to elucidate its role in cellular and systemic lipid metabolism.
Dysphagia and dementia: a ‘double dilemma’
Authors: Leonard Rebecca 
Published: August 2023

Purpose of reviewDementia and its variants, including Alzheimer's disease, become more prevalent with age. Dysphagia, that is, difficulty swallowing, also occurs with aging, and is often associated with dementia. Currently, there is no cure for dementia, and dysphagia, unrecognized or untreated, can have life-altering, even fatal consequences. Prolonged ability to eat safely and effectively could contribute to improved quality of life in a fragile population. In this review, difficulties associated with the management of dysphagia in individuals with dementia, as well as promising possibilities for continued investigation, will be discussed.Recent findingsRecent reports point to unique problems related to understanding the comorbidities of dysphagia and dementia. These include delays in identifying dysphagia in affected individuals, as well as a lack of prevalence data for dysphagia in types and stages of dementia, or according to setting, for example, residential center, hospital. Emphasis on new tools, and new applications of existing tools, are needed.SummaryNew evidence not only underscores complexities and shortcomings of our understanding of dysphagia in dementia but also points to existing applications with potential for improving the situation, and new investigational directions that may elaborate our further understanding of these comorbidities.
Advances in and applications of imaging and radiomics in head and neck cancer survivorship
Authors: Wishart Laurelie R. , Ward Elizabeth C. , Galloway Graham 
Published: August 2023

Purpose of Review
Radiological imaging is an essential component of head/neck cancer (HNC) care. Advances in imaging modalities (including CT, PET, MRI and ultrasound) and analysis have enhanced our understanding of tumour characteristics and prognosis. However, the application of these methods to evaluate treatment-related toxicities and functional burden is still emerging. This review showcases recent literature applying advanced imaging and radiomics to the assessment and management of sequelae following chemoradiotherapy for HNC.

Recent findings
Whilst primarily early-stage/exploratory studies, recent investigations have showcased the feasibility of using radiological imaging, particularly advanced/functional MRI (including diffusion-weighted and dynamic contrast-enhanced MRI), to quantify treatment-induced tissue change in the head/neck musculature, and the clinical manifestation of lymphoedema/fibrosis and dysphagia. Advanced feature analysis and radiomic studies have also begun to give specific focus to the prediction of functional endpoints, including dysphagia, trismus and fibrosis.

Summary
There is demonstrated potential in the use of novel imaging techniques, to help better understand pathophysiology, and improve assessment and treatment of functional deficits following HNC treatment. As larger studies emerge, technologies continue to progress, and pathways to clinical translation are honed, the application of these methods offers an exciting opportunity to transform clinical practices and improve outcomes for HNC survivors.
Transitions in tracheostomy care: from childhood to adulthood
Authors: Edwards Louise , McRae Jackie 
Published: August 2023

Purpose of reviewThe purpose of this review is to explore the evidence around children and young people who require a tracheostomy and transition into adult services, reflecting on the challenges and considerations for clinical practice as these needs increase.Recent findingsThere are a lack of data on the incidence and prevalence of children and young people with a tracheostomy transitioning to adult services for ongoing care. There are significant variations in care needs, technology and previous experiences that demand more than a simple handover process. Examples of service models that support the transition of care exist, however these lack specificity for children and young people with a tracheostomy.SummaryFurther exploration of the needs of children and young people requiring airway technology is indicated, particularly considering the short and long-term education, health, and social care needs.
CenteringPregnancy: A Review of Implementation and Outcomes
Authors: Moyett Julia M. , Ramey-Collier Khaila , Zambrano Guevara Linda M. , MacDonald Amy , Kuller Jeffrey A. , Wheeler Sarahn M. , Dotters-Katz Sarah K. 
Published: August 2023

Importance
CenteringPregnancy (CP) is a model for group prenatal care associated with improved perinatal outcomes for preterm birth and low birthweight, increased rates of breastfeeding, and higher rates of patient and clinician satisfaction.

Objective
The study aims to review the literature related to perinatal outcomes associated with CP, benefits and barriers to implementation, and utility of the model.

Evidence
An electronic-based search was performed in PubMed using the search terms “CenteringPregnancy” OR “Centering Pregnancy,” revealing 221 articles.

Results
The CP model improves patient centeredness, efficiency, and equality in prenatal care. Challenges include administrative buy-in, limited resources, and financial support. Multisite retrospective studies of CP demonstrate improved maternal, neonatal, postpartum, and well-being outcomes, especially for participants from minority backgrounds; however, prospective studies had mixed results. CenteringPregnancy is feasibly implemented with high tenet fidelity in several low- and middle-income settings with improved perinatal outcomes compared with traditional care.

Conclusions
CenteringPregnancy is feasible to implement, largely accepted by communities, and shows positive qualitative and quantitative health outcomes. This body of literature supports CP as a potential tool for decreasing racial inequalities in prenatal access, quality of care, and maternal mortality. Further investigation is necessary to inform obstetric clinicians about the potential outcome differences that exist between group and traditional prenatal care.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to explain the core components and structure of the CP model; discuss the benefits and challenges of CP implementation and its impact on perinatal and neonatal outcomes; and describe the effect of CP on racial/ethnic disparities in perinatal outcomes.