bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship satisfaction and self-esteem in patients with breast cancer and healthy women: the role of expected and actual personal projects support from the partner
Authors: Csuka Sára Imola , Désfalvi Judit , Konkolÿ Thege Barna , Sallay Viola , Martos Tamás 
Published: August 2023

Abstract
Background
For breast cancer patients, the partner’s support for personal projects can serve as a means of adaptation. We aimed to investigate the associations between the intimate partner’s personal project support and women’s well-being.

Methods
A sample of 274 Hungarian women (breast cancer patients n = 137, control n = 137) took part in the study. Expected and actually received autonomy-, directive- and emotional project support was assessed by the procedure of Personal Project Assessment. Well-being was measured by the Relationship Assessment Scale and the Rosenberg Self-Esteem Scale. For investigating the associations between project support and well-being in a multivariate way, structural equation modelling was used.

Results
Except for autonomy support, participants expected more support than they received. A path model indicated multiple associations between types of project support and relationship satisfaction and self-esteem. The partner’s emotional project support was predictive of women’s relationship satisfaction and self-esteem, while directive support was predictive of self-esteem only. The associations showed similar patterns in the subgroups of patients with breast cancer and control.

Conclusions
Our results highlight the importance of involving women’s subjective perspectives regarding the partner’s project support while also have implications for praxis. Teaching women how to communicate their needs to their partner effectively (whether it is the need for autonomy or directive guidance) can help close the gap between expected and received support, which may in turn enhance relationship satisfaction and self-esteem.
The quantified analysis of the correlation between medical humanities curriculums and medical students’ performance
Authors: Huang Shiau‑Shian , Ho Chao-Chung , Chu Yeong-Ruey , Wu Jr-Wei , Yang Ying-Ying 
Published: August 2023

Abstract
Background
A high-quality medical humanities (MH) education program is essential to developing a successful medical practitioner and can influence clinical performance. It is also vital to improve the evaluation of MH education to restore harmonious mutual relationships in medical care. However, studies have yet to discuss the correlation between the learning quality and quantity of medical humanities curriculums (MHC) and medical students' scores of clinical curriculums and clinical performance. The study aimed to assess the correlation between the learning quality and quantity of MHC and medical students' performance.

Methods
We conducted a retrospective cohort study by analyzing a dataset of students' learning records. After excluding students with missing demographic information (n = 1) and overseas Chinese students (n = 15), the study included six- and seven-year program medical school students (n = 354) at National Yang-Ming University who were admitted between 2012 and 2014. The correlation between learning quality and quantity in MHC and students' following performance was evaluated by multivariable-adjusted regression analyses.

Results
After adjusting for potential confounders (gender, residential area, age at enrollment, type of administration, and school program), the number of MHC with good learning outcomes was significantly correlated with clinical curriculum scores (p < 0.05), clerkship performance (p < 0.001), and weighted average mark (p < 0.001).

Conclusions
Our study found a correlation between MHC with good learning outcomes and medical students' following performance. A future study of improving the quality of MH education is warranted.
“An invitation to think differently”: a narrative medicine intervention using books and films to stimulate medical students’ reflection and patient-centeredness
Authors: Leijenaar Elsemarijn , Eijkelboom Charlotte , Milota Megan 
Published: August 2023

Abstract
Background
Narrative medicine purports to improve medical students’ communication skills, self-reflection, empathy and professional development. These interpersonal skills and attitudes can facilitate more patient-centered care and positively impact patients’ treatment outcomes. However, current studies report mainly on small study populations, leaving the efficacy of narrative medicine in larger study groups unknown. Therefore, this study aimed to evaluate a mandatory narrative medicine lesson in a large sample of medical students. We assessed if this narrative medicine lesson stimulated meaningful self-reflection on patient-centeredness in medical students.

Methods
All fourth-year medical students of a Dutch medical school participated in this mandatory narrative medicine lesson. The four-step activity consisted of an introductory lecture, close reading and watching of a book and film, a discussion group and a short reflective writing exercise. Students were divided over three thematic pairings (or book and film combinations): ‘The doctor as a patient,’ ‘The mysterious brain,’ and ‘Until death do us part.’ A mixed-methods design was used. First, we qualitatively analyzed the content of 203 essays from the reflective writing exercise. A quantitative analysis of the reflective quality was conducted using a scoring-system based on the REFLECT rubric.

Results
Students demonstrated reflection on a professional level and connected this to future intentions as medical practitioners, for example to use specific communication strategies or to deliver healthcare in a broader sense. They also reflected on a personal level by questioning their own worldview or beliefs. Furthermore, they stressed the importance of individual patient stories to gain understaning of patients’ perspectives. Approximately half of the students showed an in-depth and authentic reflection, according to the REFLECT rubric. Additionally, reflection levels differed between book and film pairings.

Conclusions
This study supports the value of narrative medicine in the medical curriculum by validating its outcomes in a larger study population and in a mandatory course. Students reflected on themes related to the principles of patient-centeredness, namely personal attitudes towards patients and the uniqueness of patient stories. In additon, the majority of students demonstrated higher levels of reflection, which suggests that this exercise contributes to self-awareness and self-reflection, important qualities for delivering patient-centered healthcare.
Afghan medical students’ perceptions, and experiences of their medical education and their professional intentions: a cross-sectional study
Authors: Stanikzai Muhammad Haroon , Wafa Mohammad Hashim , Akbari Khalid , Anwary Zabihullah , Baray Ahmad Haroon , Sayam Hadia , Wasiq Abdul Wahed 
Published: August 2023

Abstract
Background
Numerous challenges have crippled the Afghan healthcare system on individual, organizational, and societal levels. The Afghans have acknowledged that an evidence-based perspective is paramount to enhancing medical training capacities across the country, which may, in turn, best ensure appointing highly competent authorities to address health system problems on such multiple levels.

Objectives
This study assessed current Afghan senior medical students’ perceptions, and experiences of their medical education and their future professional intentions.

Methods
We conducted this cross-sectional study at seven public and private Afghan medical institutes from March to April 2022. We invited 665 senior medical students through an anonymous survey using the Google survey online forms via social-media platforms, such as WhatsApp Messenger. Descriptive statistics were employed for the data analyses.

Results
The mean age (± SD) of the students was 23.7 (± 2.2) years and males constituted 79.9% (510) of the study sample. About 22.6% of them rated their medical training as excellent, and nearly a third of them (37%) said that it is good. Nearly half (48.7%) of the students would prefer to stay in Afghanistan. The leading motives for moving overseas were to obtain more advanced and quality education (69.9%), and a decent personal life (43.9%). Nearly two-thirds (67.4%) of them asserted that current political and armed conflicts in Afghanistan may have influenced their professional choices.

Conclusion
This study epitomizes that the quality of medical education in Afghanistan has room for growth and development to meet the standards set on regional and global grounds.
A qualitative study of professionals’ perspectives on the ethics of medically-delivered safer injection education for people who inject drugs
Authors: Demina Anastasia , Desprès Caroline , Mamzer Marie-France 
Published: August 2023

Abstract
Background
In this qualitative analysis we aimed to explore addiction physicians’ perspectives on safer injection education for people who inject drugs, especially: (1) on possible means of introducing safer injection education in the medical environment, (2) on the compatibility of safer injection education with each physician’s core values and goals, and (3) on possible reasons for the ethical dilemma in safer injection education.

Methods
We conducted semi-structured interviews with eleven physicians practicing addiction medicine in France in clinical and harm reduction settings.

Results
All participants were in favor of educational interventions for people who inject drugs. Nonetheless, these interventions varied from simple advice to injection supervision and they were seen as less acceptable when they concerned the practical and material aspects of injection. Some participants found that physicians practicing in clinical settings, where patients consult mostly to stop their drug use, should not practice safer injection education. On the contrary, other participants claimed that safer injection education was essential in all settings and was not a choice but rather a duty for addiction physicians. The ethical dilemma of such intervention when delivered by medical staff was viewed as a complex phenomenon, related to the representations of intravenous drug use and to societal expectations from physicians.

Conclusion
Physicians’ views on safer injection education for people who inject drugs reveal an emotionally charged subject related to the structural organization of addiction management in France. Such education is marked by an arduous history of harm reduction policies in France.

IRB registration:
#00011928.
Discrepancy between perceptions and acceptance of clinical decision support Systems: implementation of artificial intelligence for vancomycin dosing
Authors: Liu Xinyan , Barreto Erin F. , Dong Yue , Liu Chang , Gao Xiaolan , Tootooni Mohammad Samie , Song Xuan , Kashani Kianoush B. 
Published: August 2023

Abstract
Background
Artificial intelligence (AI) tools are more effective if accepted by clinicians. We developed an AI-based clinical decision support system (CDSS) to facilitate vancomycin dosing. This qualitative study assesses clinicians' perceptions regarding CDSS implementation.

Methods
Thirteen semi-structured interviews were conducted with critical care pharmacists, at Mayo Clinic (Rochester, MN), from March through April 2020. Eight clinical cases were discussed with each pharmacist (N = 104). Following initial responses, we revealed the CDSS recommendations to assess participants' reactions and feedback. Interviews were audio-recorded, transcribed, and summarized.

Results
The participants reported considerable time and effort invested daily in individualizing vancomycin therapy for hospitalized patients. Most pharmacists agreed that such a CDSS could favorably affect (N = 8, 62%) or enhance (9, 69%) their ability to make vancomycin dosing decisions. In case-based evaluations, pharmacists' empiric doses differed from the CDSS recommendation in most cases (88/104, 85%). Following revealing the CDSS recommendations, we noted 78% (69/88) discrepant doses. In discrepant cases, pharmacists indicated they would not alter their recommendations. The reasons for declining the CDSS recommendation were general distrust of CDSS, lack of dynamic evaluation and in-depth analysis, inability to integrate all clinical data, and lack of a risk index.

Conclusion
While pharmacists acknowledged enthusiasm about the advantages of AI-based models to improve drug dosing, they were reluctant to integrate the tool into clinical practice. Additional research is necessary to determine the optimal approach to implementing CDSS at the point of care acceptable to clinicians and effective at improving patient outcomes.
Exploring interdependencies, vulnerabilities, gaps and bridges in care transitions of patients with complex care needs using the Functional Resonance Analysis Method
Authors: Hedqvist Ann-Therese , Praetorius Gesa , Ekstedt Mirjam 
Published: August 2023

Abstract
Background
Hospital discharge is a complex process encompassing multiple interactions and requiring coordination. To identify potential improvement measures in care transitions for people with complex care needs, intra- and inter-organisational everyday work needs to be properly understood, including its interdependencies, vulnerabilities and gaps. The aims of this study were to 1) map coordination and team collaboration across healthcare and social care organisations, 2) describe interdependencies and system variability in the discharge process for older people with complex care needs, and 3) evaluate the alignment between discharge planning and the needs in the home.

Methods
Data were collected through participant observations, interviews, and document review in a region of southern Sweden. The Functional Resonance Analysis Method (FRAM) was used to model the discharge process and visualise and analyse coordination of care across healthcare and social care organisations.

Results
Hospital discharge is a time-sensitive process with numerous couplings and interdependencies where healthcare professionals’ performance is constrained by system design and organisational boundaries. The greatest vulnerability can be found when the patient arrives at home, as maladaptation earlier in the care chain can lead to an accumulation of issues for the municipal personnel in health and social care working closest to the patient. The possibilities for the personnel to adapt are limited, especially at certain times of day, pushing them to make trade-offs to ensure patient safety. Flexibility and appropriate resources enable for handling variability and responding to uncertainties in care after discharge.

Conclusions
Mapping hospital discharge using the FRAM reveals couplings and interdependencies between various individuals, teams, and organisations and the most vulnerable point, when the patient arrives at home. Resilient performance in responding to unexpected events and variations during the first days after the return home requires a system allowing flexibility and facilitating successful adaptation of discharge planning.
An automated, low-latency environment for studying the neural basis of behavior in freely moving rats
Authors: Jankowski Maciej M. , Polterovich Ana , Kazakov Alex , Niediek Johannes , Nelken Israel 
Published: August 2023

Abstract
Background
Behavior consists of the interaction between an organism and its environment, and is controlled by the brain. Brain activity varies at sub-second time scales, but behavioral measures are usually coarse (often consisting of only binary trial outcomes).

Results
To overcome this mismatch, we developed the Rat Interactive Foraging Facility (RIFF): a programmable interactive arena for freely moving rats with multiple feeding areas, multiple sound sources, high-resolution behavioral tracking, and simultaneous electrophysiological recordings. The paper provides detailed information about the construction of the RIFF and the software used to control it. To illustrate the flexibility of the RIFF, we describe two complex tasks implemented in the RIFF, a foraging task and a sound localization task. Rats quickly learned to obtain rewards in both tasks. Neurons in the auditory cortex as well as neurons in the auditory field in the posterior insula had sound-driven activity during behavior. Remarkably, neurons in both structures also showed sensitivity to non-auditory parameters such as location in the arena and head-to-body angle.

Conclusions
The RIFF provides insights into the cognitive capabilities and learning mechanisms of rats and opens the way to a better understanding of how brains control behavior. The ability to do so depends crucially on the combination of wireless electrophysiology and detailed behavioral documentation available in the RIFF.
Prenatal genetic diagnosis of disseminated infantile myofibromatosis: a case report and literature review
Authors: Lü Yan , Jiang Yulin , Wu Huanwen , Qi Qingwei , Zhou Xiya , Guo Qi , Hao Na , Liu Juntao , Meng Hua 
Published: August 2023

Abstract
Background
Infantile myofibromatosis (IM) is a rare disorder characterized by the formation of nodules in the skin, muscle, bone, and, more rarely, visceral organs. Very few cases are detected prenatally, and the final diagnosis cannot be made until pathology is completed after birth. Here, we present a case of disseminated form IM (DFIM) with a diagnosis established on prenatal genetic grounds.

Case presentation
A woman at 23 weeks of gestation was referred for ultrasound evaluation of fetal kidney abnormality. Generalized masses in the skin and muscle of the fetus developed at 28 weeks. Prenatal genetic testing identified the pathogenic heterozygous variant c.1681C > T (p.R561C) of the PDGFRB gene inherited from the asymptomatic father. Intrauterine demise occurred at 31 weeks. Autopsy confirmed DFIM with involvement of the heart and kidney. All cases of prenatally detected IM were reviewed, revealing an association of high mortality with DFIM.

Conclusions
Prenatal IM diagnosis is difficult. Initial detection is always based on ultrasound. DFIM has high mortality. The germline p.R561C mutation in PDGFRB may cause fetal demise due to severe visceral involvement of IM. Prenatal genetic testing provides a diagnosis before pathological results are available, leading to better counseling and management of pregnancy with a fetus with IM.
Acid ceramidase gene therapy ameliorates pulmonary arterial hypertension with right heart dysfunction
Authors: Katz Michael G. , Hadas Yoav , Vincek Adam , Freage-Kahn Lina , Shtraizent Nataly , Madjarov Jeko M. , Pastuszko Peter , Eliyahu Efrat 
Published: August 2023

Abstract
Background
Up-regulation of ceramides in pulmonary hypertension (PH), contributing to perturbations in sphingolipid homeostasis and the transition of cells to a senescence state. We assessed the safety, feasibility, and efficiency of acid ceramidase gene transfer in a rodent PH model.

Methods
A model of PH was established by the combination of left pneumonectomy and injection of Sugen toxin. Magnetic resonance imaging and right heart catheterization confirmed development of PH. Animals were subjected to intratracheal administration of synthetic adeno-associated viral vector (Anc80L65) carrying the acid ceramidase (Anc80L65.AC), an empty capsid vector, or saline. Therapeutic efficacy was evaluated 8 weeks after gene delivery.

Results
Hemodynamic assessment 4 weeks after PH model the development demonstrated an increase in the mean pulmonary artery pressure to 30.4 ± 2.13 mmHg versus 10.4 ± 1.65 mmHg in sham (p < 0.001), which was consistent with the definition of PH. We documented a significant increase in pulmonary vascular resistance in the saline-treated (6.79 ± 0.85 mm Hg) and empty capsid (6.94 ± 0.47 mm Hg) groups, but not in animals receiving Anc80L65.AC (4.44 ± 0.71 mm Hg, p < 0.001). Morphometric analysis demonstrated an increase in medial wall thickness in control groups in comparison to those treated with acid ceramidase. After acid ceramidase gene delivery, a significant decrease of pro-inflammatory factors, interleukins, and senescence markers was observed.

Conclusion
Gene delivery of acid ceramidase provided tropism to pulmonary tissue and ameliorated vascular remodeling with right ventricular dysfunction in pulmonary hypertension.

Graphical Abstract
Recent advances in non-small cell lung cancer targeted therapy; an update review
Authors: Araghi Mahmood , Mannani Reza , Heidarnejad maleki Ali , Hamidi Adel , Rostami Samaneh , Safa Salar Hozhabri , Faramarzi Fatemeh , Khorasani Sahar , Alimohammadi Mina , Tahmasebi Safa , Akhavan-Sigari Reza 
Published: August 2023

AbstractLung cancer continues to be the leading cause of cancer-related death worldwide. In the last decade, significant advancements in the diagnosis and treatment of lung cancer, particularly NSCLC, have been achieved with the help of molecular translational research. Among the hopeful breakthroughs in therapeutic approaches, advances in targeted therapy have brought the most successful outcomes in NSCLC treatment. In targeted therapy, antagonists target the specific genes, proteins, or the microenvironment of tumors supporting cancer growth and survival. Indeed, cancer can be managed by blocking the target genes related to tumor cell progression without causing noticeable damage to normal cells. Currently, efforts have been focused on improving the targeted therapy aspects regarding the encouraging outcomes in cancer treatment and the quality of life of patients. Treatment with targeted therapy for NSCLC is changing rapidly due to the pace of scientific research. Accordingly, this updated study aimed to discuss the tumor target antigens comprehensively and targeted therapy-related agents in NSCLC. The current study also summarized the available clinical trial studies for NSCLC patients.
Combination strategies to overcome drug resistance in FLT+ acute myeloid leukaemia
Authors: Yang Jingmei , Friedman Ran 
Published: August 2023

Abstract
Background
Acute myeloid leukaemia (AML) remains difficult to treat despite the development of novel formulations and targeted therapies. Activating mutations in the FLT3 gene are common among patients and make the tumour susceptible to FLT3 inhibitors, but resistance to such inhibitors develops quickly.

Methods
We examined combination therapies aimed at FLT3+-AML, and studied the development of resistance using a newly developed protocol. Combinations of FLT3, CDK4/6 and PI3K inhibitors were tested for synergism.

Results
We show that AML cells express CDK4 and that the CDK4/6 inhibitors palbociclib and abemaciclib inhibit cellular growth. PI3K inhibitors were also effective in inhibiting the growth of AML cell lines that express FLT3-ITD. Whereas resistance to quizartinib develops quickly, the combinations overcome such resistance.

Conclusions
This study suggests that a multi-targeted intervention involving a CDK4/6 inhibitor with a FLT3 inhibitor or a pan-PI3K inhibitor might be a valuable therapeutic strategy for AML to overcome drug resistance. Moreover, many patients cannot tolerate high doses of the drugs that were studied (quizartinib, palbociclib and PI3K inhibitors) for longer periods, and it is therefore of high significance that the drugs act synergistically and lower doses can be used.