bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing an Inclusive Scholarship Curriculum for Medical Students
Authors: Deptola Amber , Hudson Darrell , Mattar Caline , Chung Koong-Nah , Kallogjeri Dorina , Chamberlain Aaron , Aagaard Eva 
Published: July 2023

Abstract

Problem
As part of a curriculum renewal, in 2020, Washington University School of Medicine in St. Louis sought to create an integrated curriculum that allows students to explore 4 academic career pathways (advocacy/global health, education, innovation, and research) and engage in scholarship activities—the Inquiry Curriculum. The curriculum needed to focus on foundational scholarship skills that would be applicable to all pathways. This article describes the process used to develop the curriculum learning objectives and lessons learned from initial implementation.

Approach
The authors used a modified Delphi process to survey faculty experts from the 4 pathways to determine the objectives (March–May 2020). Twenty-four faculty were surveyed about 48 initial objectives created using Glassick’s scholarship criteria. After 2 rounds, 28 objectives met consensus. Further oversight committee review and revisions by session leads resulted in 77 unique objectives for 23 sessions in the curriculum that launched in spring 2021.

Outcomes
Four themes were identified from student feedback: (1) the Inquiry Curriculum framework creates opportunities for students to gain exposure to various approaches to understanding and addressing health care problems, (2) the curriculum targeted higher-level objectives for traditional research content and lower-level objectives for nontraditional content, (3) Glassick’s criteria provided a useful structure for students to understand the rationale for and ordering of content, and (4) the curriculum had natural overlap with content often taught elsewhere in the curriculum, including evidence-based medicine, health equity, public and population health, and quality improvement and patient safety.

Next Steps
The authors plan to consolidate sessions where there is redundancy, expand other sessions that require more time, and more purposefully discuss prior content when redundancy is intentional. Exploring other potential measures of curricular success, such as student learning outcomes, scholarly productivity, and impact on future scholarship engagement and career paths, is part of ongoing work.
Radiomic Signatures Based on Mammography and Magnetic Resonance Imaging as New Markers for Estimation of Ki-67 and HER-2 Status in Breast Cancer
Authors: Fan Ying , Zhao Dan , Su Juan , Yuan Wendi , Niu Shuxian , Guo Wei , Jiang Wenyan 
Published: July 2023

Objective
The aim of the study is to investigate the values of intratumoral and peritumoral regions based on mammography and magnetic resonance imaging for the prediction of Ki-67 and human epidermal growth factor (HER-2) status in breast cancer (BC).

Methods
Two hundred BC patients were consecutively enrolled between January 2017 and March 2021 and divided into training (n = 133) and validation (n = 67) groups. All the patients underwent breast mammography and magnetic resonance imaging screening. Features were derived from intratumoral and peritumoral regions of the tumor and selected using the least absolute shrinkage and selection operator regression to build radiomic signatures (RSs). Receiver operating characteristic curve analysis and the DeLong test were performed to assess and compare each RS.

Results
For each modality, the combined RSs integrating features from intratumoral and peritumoral regions always showed better prediction performance for predicting Ki-67 and HER-2 status compared with the RSs derived from intratumoral or peritumoral regions separately. The multimodality and multiregional combined RSs achieved the best prediction performance for predicting the Ki-67 and HER-2 status with an area under the receiver operating characteristic curve of 0.888 and 0.868 in the training cohort and 0.800 and 0.848 in the validation cohort, respectively.

Conclusions
Peritumoral areas provide complementary information to intratumoral regions of BC. The developed multimodality and multiregional combined RSs have good potential for noninvasive evaluation of Ki-67 and HER-2 status in BC.
An Illustrative Review of the Pathomechanisms of Symptomatic Developmental Venous Anomalies
Authors: Ahmed Sabha , Saini Jitender , Gorantla Padmasri , Kulanthaivelu Karthik , Shashidhar Abhinith , Deora Harsh , Holla Vikram V. , Arora Ankit 
Published: July 2023

Objective
Symptomatic developmental venous anomalies (DVAs) are rare. Here, we illustrate the varied clinicoradiologic profiles of symptomatic DVAs and contemplate the mechanisms that render these (allegedly) benign entities symptomatic supported by a review of literature.

Methods
Institutional databases were searched to identify cases of symptomatic DVAs. Clinical and imaging (angiographic and cross-sectional) data of 9 cases with 11 neurovascular symptoms consequent to inflow/outflow perturbations and mechanical obstruction that manifested because of the strategic topography of underlying DVAs were analyzed. A review of the existing literature on DVAs in agreement with our case series was performed on publications retrieved from the PubMed database.

Results
Symptoms secondary to venous hypertension arising from flow-related perturbations were broadly divided into those arising from restricted outflow and increased inflow. Restricted outflow occurred because of collector vein stenosis (n = 2) and collector vein/DVA thrombosis (n = 3), whereas the latter pathomechanism was initiated by arterialized/transitional DVAs (n = 2). A mechanical/obstructive pathomechanism culminating in moderate supratentorial ventriculomegaly was noted in 1 case. One patient was given a diagnosis of hemorrhage associated with a cavernoma.

Conclusions
Awareness and contextualization of potential flow-related perturbations and mechanical insults that render DVAs symptomatic aid in accurate diagnosis, management, and prognostication.
The Role of Airway Management on Feeding Difficulties in Children With Pfeiffer Syndrome
Authors: Salem Joseph , Blumenow Wendy , Markey Anne , Hogg Emma S. , McCann Emma , Yassaie Emily , Hennedige Anusha , De Sujata , Sharma Sunil D. 
Published: July 2023

Background:
Pfeiffer syndrome is characterized by craniosynostosis, mid-face hypoplasia, broad thumbs, and often multilevel airway obstruction. Airway management is often required, including the use of positive airway ventilation, nasopharyngeal airway (NPA), or tracheostomy.

Objective:
The objective of this study was to assess the impact an airway adjunct can have on feeding difficulties in children with Pfeiffer syndrome.

Methods:
Retrospective review of patients diagnosed with Pfeiffer syndrome from January 1998 to January 2020 at one of England’s 4 supraregional Craniofacial Units, Alder Hey Children’s Hospital. Speech & Language Therapy case notes and medical notes were used to gather data, as well as the Oral Feeding Score component of the UK Craniofacial Outcome Score.

Results:
Eleven patients were included. Six patients had no airway adjunct (55%): 3 had tracheostomy (27%) and 2 patients had NPA (18%). All patients with airway adjuncts were percutaneous endoscopic gastrostomy/percutaneous endoscopic jejunostomy fed. Those who did not require an airway adjunct had an Oral Feeding Score of 4.60 (SD: 0.49). The children who went on to have an airway adjunct had a mean preintervention Oral Feeding Score of 2.4 (SD: 0.8). The mean feeding score (postairway adjunct) in the NPA group was 2.0, compared with the tracheostomy group scoring 3.0.

Conclusions:
Children with Pfeiffer syndrome who require airway intervention have more significant feeding problems requiring feeding intervention. Although there were small numbers included in this study, there is a suggestion that airway adjuncts can contribute to feeding difficulties, particularly NPAs.
Falls and Fall-Related Injuries in an Evidence-Based Tai Ji Quan Intervention in Rural West Virginia Churches
Authors: Jones Dina L. , Selfe Terry Kit , Wilcox Sara , Cosner Clinton Tyler , Mitchell Justin , Ray Benjamin D. , Stipec Craig , Switay David , Mancinelli Corrie A. 
Published: July 2023

Background:
This article identifies the independent predictors of falls in an implementation study of Tai Ji Quan: Moving for Better Balance® (TJQMBB) in older adults in rural West Virginia churches.

Methods:
Falls and injuries were identified via calendars, questionnaire, and verbal reports.

Results:
Fall predictors were gait speed (odds ratio [OR]: 0.27; 95% confidence interval [CI]: 0.08-0.90); low back pain (OR: 8.04; 95% CI: 1.71-37.79); and pain, stiffness, or swelling limiting activity (OR: 2.44; 95% CI: 1.09-5.45).

Conclusions:
Determining differences between fallers and nonfallers may identify people with different fall risk profiles and ultimately better tailor fall prevention programming to individual needs.
How sustainable is the governance for sustainability in higher education? Insights from an Italian case study
Authors: Sacchi Alessandra , Molino Monica , Dansero Egidio , Rossi Alessia Antonella , Ghislieri Chiara 
Published: July 2023

Purpose
Higher education (HE) institutions can play a fundamental role in achieving the Sustainable Development Goals. However, universities often face various obstacles to sustainability management, leading to a lack of strategies for implementing governance for sustainability (GFS). The purpose of this paper is to propose a model, based on work and organizational psychology (WOP), for the analysis, promotion and implementation of GFS in HE. The model includes five dimensions: culture, leadership, teamwork, communication and transition management.

Design/methodology/approach
Using a mixed methods approach, GFS was investigated in four Piedmontese (Northern Italy) universities and in their sustainability network, applying the model proposed in this paper.

Findings
The five dimensions of the model have proven to be fundamental to the development of GFS in HE. Each dimension was filled with experiences from specific contexts through data collection, highlighting specificities and barriers. Furthermore, the mixed methods approach and the WOP perspective proved to be effective in addressing sustainable transitions in HE.

Originality/value
A practical proposal for analyzing and improving HE sustainable transitions in a WOP perspective is still missing, as well as a model that identifies organizational dimensions that should be monitored. This study not only provides an example of this transition but also confirms the importance that the literature attributes to the specificities and barriers of dimensions such as culture, leadership, teamwork, communication and transition management in this context.
Functional trait variability supports the use of mean trait values and identifies resistance trade‐offs for marine macroalgae
Authors: Ryznar E. R. , Smith L. L. , Hà B. A. , Grier S. R. , Fong P. 
Published: July 2023

Abstract

Trait‐based ecology (TBE) has proven useful in the terrestrial realm and beyond for collapsing ecological complexity into traits that can be compared and generalized across species and scales. However, TBE for marine macroalgae is still in its infancy, motivating research to build the foundation of macroalgal TBE by leveraging lessons learned from other systems.

Our objectives were to evaluate the utility of mean trait values (MTVs) across species, to explore the potential for intraspecific trait variability, and to identify macroalgal ecological strategies by clustering species with similar traits and testing for bivariate relationships between traits. To accomplish this, we measured thallus toughness, a trait associated with resistance to herbivory, and tensile strength, a trait associated with resistance to physical disturbance, in eight tropical macroalgal species across up to seven sites where they were found around Moorea, French Polynesia.

We found interspecific trait variation generally exceeded intraspecific variation across species. Furthermore, MTV within species varied across sites, suggesting future research should focus on whether these traits are influenced by site‐specific differences in biotic and abiotic drivers. Species grouped into three clusters representing different ecological strategies: species that were defended against herbivores but not strong, species that were strong but not defended and species that were neither. Intraspecific standardized major axis regressions revealed five species exhibited significant or marginally significant positive relationships between these two traits, suggesting trait syndromes within species. Only one species exhibited a significant intraspecific trade‐off, as indicated by a negative regression slope.

Synthesis. Our results point to three key takeaways that should provide a foundation to rapidly advance development of TBE for macroalgae in the future. First, our evidence supports the use of MTVs for macroalgae. Second, we identified significant spatial variability in macroalgal traits that may indicate an ability to respond to shifting environmental drivers. Third, measuring even a few traits can be a powerful tool to identify different ecological strategies to resist disturbances such as herbivory and removal by wave action. We hope these novel findings motivate future research into a wider suite of macroalgal traits, functions and strategies to further develop trait‐based approaches for marine macroalgae.
Food allergy knowledge, attitude and management among preschool personnel in Malaysia
Authors: Lim See Meng , Law Bee Pek 
Published: July 2023

AbstractBackgroundChildren are vulnerable, and they may experience their first serious food allergy reaction at school, where they spend much of their time. The present study aims to determine the level of food allergy knowledge, attitude and management (KAM) among preschool personnel in Klang Valley, Malaysia.MethodsA cross‐sectional study was conducted with 292 personnel working in Klang Valley preschools. The participants completed an online questionnaire asking about sociodemographic information and food allergy KAM. Mann–Whitney U and chi‐squared tests were used to compare the KAM level between public and private preschool personnel and examine the association of KAM of food allergy with various sociodemographic factors, respectively.ResultsSome 86.3% of the participants demonstrated a low level of food allergy knowledge, 64.7% showed a negative food allergy attitude and 57.9% indicated fair food allergy management. The total mean score for food allergy knowledge was higher (p < 0.01) among the private preschool personnel compared to the public group, although there was no significant difference in attitude (p = 0.244) or practice (p = 0.171). Age group (p < 0.01) and monthly income (p < 0.05) were significantly associated with the level of attitude, whereas no sociodemographic factor was associated with knowledge and management of food allergy.ConclusionsMost preschool personnel in Klang Valley have a low level of food allergy knowledge, negative attitudes and a fair level of ability to manage food allergy reactions. The findings of the present study may guide future studies to improve the food allergy KAM of preschool personnel and provide a safer environment for children with food allergies.
The early Paleozoic Wuyi–Yunkai orogeny in South China: a collisional orogeny with a major lag in time between onset of collision and peak metamorphism in subducted continental crust
Authors: Lin Shoufa , Wang Lijun , Xiao Wenjiao , Xing Guangfu , Niu Zhijun , Zhao Xilin , Yin Changqing , Zhang Shuai , Liu Hang 
Published: July 2023

Abstract
Collisional orogeny is characterized by deep subduction of continental crust and major crustal thickening, leading to high-pressure/high-temperature metamorphism and anataxis of the subducted continental crust. Since conductive heating of large slabs of cold, subducted continental crust is a slow process, heating to a temperature that is high enough to generate significant partial melting can take tens of millions of years. Where the spatial and temporal relationships are obscured due to later modification (e.g. post-collisional rifting), the peak metamorphism and magmatism may be interpreted as an orogeny that is separate from the collision, or may be interpreted as an intraplate orogeny as no contemporaneous arcs or ophiolite may be present. We propose here that this is the case for the early Paleozoic orogeny in South China. In our model, the West Cathaysia terrane of South China was part of a continent (possibly Australia) on the lower plate and collided with another continent (possibly India) in the Cambrian–Ordovician, at a late stage of Gondwana assembly, and the late Ordovician–Silurian Wuyi–Yunkai orogeny, characterized by amphibolite–granulite facies metamorphism and extensive anataxis, was a continuation of the Cambrian–Ordovician collisional orogeny. In this interpretation, the Wuyi–Yunkai orogen was part of the Kuunga orogen before Gondwana break-up.
Single-Cell Characterization of Pulmonary Nodules Implicates Suppression of Immunosurveillance across Early Stages of Lung Adenocarcinoma
Authors: Yanagawa Jane , Tran Linh M. , Salehi-Rad Ramin , Lim Raymond J. , Dumitras Camelia , Fung Eileen , Wallace William D. , Prosper Ashley E. , Fishbein Gregory , Shea Conor , Hong Rui , Kahangi Bitta , Deng John J. , Gower Adam C. , Liu Bin , Campbell Joshua D. , Mazzilli Sarah A. , Beane Jennifer E. , Kadara Humam , Lenburg Marc E. , Spira Avrum E. , Aberle Denise R. , Krysan Kostyantyn , Dubinett Steven M. 
Published: July 2023

Abstract

A greater understanding of molecular, cellular, and immunological changes during the early stages of lung adenocarcinoma development could improve diagnostic and therapeutic approaches in patients with pulmonary nodules at risk for lung cancer. To elucidate the immunopathogenesis of early lung tumorigenesis, we evaluated surgically resected pulmonary nodules representing the spectrum of early lung adenocarcinoma as well as associated normal lung tissues using single-cell RNA sequencing and validated the results by flow cytometry and multiplex immunofluorescence (MIF). Single-cell transcriptomics revealed a significant decrease in gene expression associated with cytolytic activities of tumor-infiltrating natural killer and natural killer T cells. This was accompanied by a reduction in effector T cells and an increase of CD4+ regulatory T cells (Treg) in subsolid nodules. An independent set of resected pulmonary nodules consisting of both adenocarcinomas and associated premalignant lesions corroborated the early increment of Tregs in premalignant lesions compared with the associated normal lung tissues by MIF. Gene expression analysis indicated that cancer-associated alveolar type 2 cells and fibroblasts may contribute to the deregulation of the extracellular matrix, potentially affecting immune infiltration in subsolid nodules through ligand–receptor interactions. These findings suggest that there is a suppression of immune surveillance across the spectrum of early-stage lung adenocarcinoma.

Significance:
Analysis of a spectrum of subsolid pulmonary nodules by single-cell RNA sequencing provides insights into the immune regulation and cell–cell interactions in the tumor microenvironment during early lung tumor development.
Liquid Biopsies with Circulating Plasma HPV–DNA Measurements—A Clinically Applicable Surveillance Tool for Patients with HPV-Positive Oropharyngeal Cancer
Authors: Jakobsen Kathrine K. , Bendtsen Simone K. , Pallisgaard Niels , Friborg Jeppe , Lelkaitis Giedrius , Grønhøj Christian , von Buchwald Christian 
Published: July 2023

Abstract

Purpose:
To evaluate the accuracy of cell-free human papillomavirus-DNA (cfHPV-DNA) measurements in liquid biopsies in predicting disease in patients with HPV-positive/p16-positive (HPV+/p16+) oropharyngeal squamous cell carcinoma (OPSCC).

Experimental Design:
This was a prospective cohort study. Plasma samples were collected before treatment, serially after curative intended therapy at follow-up visits 2 weeks, and 6, 9, 12, 18, 24, and 30 months after treatment. A droplet digital PCR assay comprising eight HPV genotypes was used. HPV genotypes found in plasma and tumor tissue were compared. We correlated biopsy- or imaging-verified tumor progression to cfHPV-DNA in follow-up samples.

Results:
We enrolled 72 patients with HPV+/p16+ OPSCC. Baseline sensitivity for cfHPV-DNA detection was 97.2% (95% confidence interval, 90.3%–99.6%). CfHPV-DNA copy number/milliliter plasma correlated with tumor stage. We found a 100% concordance between HPV genotype in tumor tissue and plasma. Fifty-four patients were followed with serial blood samples for a median of 19.7 months (interquartile range, 13.5–25.5 months). Forty-one patients had undetectable plasma cfHPV-DNA in all follow-up samples, and none developed recurrences. Thirteen patients were classified as cfHPV-DNA–positive in a follow-up plasma sample. Of these, five patients developed a recurrence, and three had residual cancer. It was possible to detect cfHPV-DNA in plasma 97 to 166 days prior to the proven recurrence.

Conclusions:
To our knowledge, to date, our study, comprising the largest study of patients with HPV+/p16+ OPSCC, using an ultrasensitive multiplex HPV gene panel, revealed a high sensitivity of cfHPV-DNA detection in the liquid biopsies. We recommend serial plasma HPV samples for clinical monitoring of patients with HPV+/p16+ OPSCC.
Illness Perception and the Impact of a Definitive Diagnosis on Women With Ischemia and No Obstructive Coronary Artery Disease: A Qualitative Study
Authors: Tseng Leslie Yingzhijie , Göç Nükte , Schwann Alexandra N. , Cherlin Emily J. , Kunnirickal Steffne J. , Odanovic Natalija , Curry Leslie A. , Shah Samit M. , Spatz Erica S. 
Published: July 2023

BACKGROUND:
Ischemia and no obstructive coronary artery disease (INOCA) disproportionately impacts women, yet the underlying pathologies are often not distinguished, contributing to adverse health care experiences and poor quality of life. Coronary function testing at the time of invasive coronary angiography allows for improved diagnostic accuracy. Despite increased recognition of INOCA and expanding access to testing, data lack on first-person perspectives and the impact of receiving a diagnosis in women with INOCA.

METHODS:
From 2020 to 2021, we conducted structured telephone interviews with 2 groups of women with INOCA who underwent invasive coronary angiography (n=29) at Yale New Haven Hospital, New Haven, CT: 1 group underwent coronary function testing (n=20, of whom 18 received a mechanism-based diagnosis) and the other group who did not undergo coronary function testing (n=9). The interviews were analyzed using the constant comparison method by a multidisciplinary team.

RESULTS:
The mean age was 59.7 years, and 79% and 3% were non-Hispanic White and non-Hispanic Black, respectively. Through iterative coding, 4 themes emerged and were further separated into subthemes that highlight disease experience aspects to be addressed in patient care: (1) distress from symptoms of uncertain cause: symptom constellation, struggle for sensemaking, emotional toll, threat to personal and professional identity; (2) a long journey to reach a definitive diagnosis: self-advocacy and fortitude, healthcare interactions brought about further uncertainty and trauma, therapeutic alliance, sources of information; (3) establishing a diagnosis enabled a path forward: relief and validation, empowerment; and (4) commitment to promoting awareness and supporting other women: recognition of sex and racial/ethnic disparities, support for other women.

CONCLUSIONS:
Insights about how women experience the symptoms of INOCA and their interactions with clinicians and the healthcare system hold powerful lessons for more patient-centered care. A coronary function testing-informed diagnosis greatly influences the healthcare experiences, quality of life, and emotional states of women with INOCA.