bluuebunny/crossref_metadata_2025_split huggingface dataset:
Entrustable professional activities in postgraduate general surgery training: a scoping review protocol
Authors: Nel Daniel , Jonas Eduard , Burch Vanessa , Nel Amy , Cairncross Lydia , Alseidi Adnan , George Brian , ten Cate Olle 
Published: March 2023

IntroductionThe competency-based medical education (CBME) movement continues to gain momentum in postgraduate physician training, resulting in increasing interest among surgical training programmes on how to implement it effectively. Entrustable professional activities (EPAs) were introduced to connect competencies (characteristics/abilities of learners) and the professional activities to be entrusted to them on qualification/graduation. Although reviews related to the field of general surgery have been published on specific aspects of CBME, for example, workplace-based assessment, there is a paucity of published guidance available for surgeon-educators to plan and implement CBME using an EPA framework. This scoping review aims to provide an overview of the current use of EPAs in general surgery.Methods and analysisThis scoping review will be based on the original five-stage approach described by Arksey and O’Malley with the addition of protocol-specific items from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols extension for scoping reviews. The primary research question focuses on describing how EPAs have been used in general surgery and where potential gaps remain that warrant further study. The review will include peer-reviewed journal publications and an extensive review of grey literature sources. The following databases will be searched for published literature from 1 January 2005 to 31 December 2022: PubMed; CINAHL, Africa-Wide Information, PsycInfo and ERIC (via EBSCOhost); Scopus; and SciELO (via Web of Science). Studies that describe the use of EPAs for curriculum design, teaching and/or assessment of competence in postgraduate general surgery training will be eligible for inclusion.Ethics and disseminationThe institutional ethics board of the University of Cape Town has granted a waiver of formal approval requirement. The dissemination strategy includes publication of results in peer-reviewed journals, presentation at international conferences and presentation to relevant stakeholders as deemed appropriate.
Growth patterns in childhood and adolescence and adult body composition: a pooled analysis of birth cohort studies from five low and middle-income countries (COHORTS collaboration)
Authors: Poveda Natalia E , Adair Linda S , Martorell Reynaldo , Patel Shivani A , Ramirez-Zea Manuel , Bhargava Santosh K , Bechayda Sonny A , Carba Delia B , Kroker-Lobos Maria F , Horta Bernardo Lessa , Lima Natália Peixoto , Mazariegos Mónica , Menezes Ana Maria Baptista , Norris Shane A , Nyati Lukhanyo H , Richter Linda M , Sachdev Harshpal , Wehrmeister Fernando C , Stein Aryeh D 
Published: March 2023

ObjectiveWe examined associations among serial measures of linear growth and relative weight with adult body composition.DesignSecondary data analysis of prospective birth cohort studies.SettingsSix birth cohorts from Brazil, Guatemala, India, the Philippines and South Africa.Participants4173 individuals followed from birth to ages 22–46 years with complete and valid weight and height at birth, infancy, childhood and adolescence, and body composition in adult life.ExposuresBirth weight and conditional size (standardised residuals of height representing linear growth and of relative weight representing weight increments independent of linear size) in infancy, childhood and adolescence.Primary outcome measuresBody mass index, fat mass index (FMI), fat-free mass index (FFMI), fat mass/fat-free mass ratio (FM/FFM), and waist circumference in young and mid-adulthood.ResultsIn pooled analyses, a higher birth weight and relative weight gains in infancy, childhood and adolescence were positively associated with all adult outcomes. Relative weight gains in childhood and adolescence were the strongest predictors of adult body composition (β (95% CI) among men: FMI (childhood: 0.41 (0.26 to 0.55); adolescence: 0.39 (0.27 to 0.50)), FFMI (childhood: 0.50 (0.34 to 0.66); adolescence: 0.43 (0.32 to 0.55)), FM/FFM (childhood: 0.31 (0.16 to 0.47); adolescence: 0.31 (0.19 to 0.43))). Among women, similar patterns were observed, but, effect sizes in adolescence were slightly stronger than in childhood. Conditional height in infancy was positively associated with FMI (men: 0.08 (0.03 to 0.14); women: 0.11 (0.07 to 0.16)). Conditional height in childhood was positively but weakly associated with women’s adiposity. Site-specific and sex-stratified analyses showed consistency in the direction of estimates, although there were differences in their magnitude.ConclusionsPrenatal and postnatal relative weight gains were positive predictors of larger body size and increased adiposity in adulthood. A faster linear growth in infancy was a significant but weak predictor of higher adult adiposity.
Unravelling the link between periodontitis and abdominal aortic calcification in the US adult population: a cross-sectional study based on the NHANES 2013–2014
Authors: Kadier Kaisaierjiang , Abulizi Anniwaer , Ainiwaer Aikeliyaer , Rehemuding Rena , Ma Xiang , Ma Yi-Tong 
Published: March 2023

ObjectiveWe aimed to explore the association between periodontitis and abdominal aortic calcification (AAC) among a nationally representative sample of US adults.DesignCross- sectional study.SettingThe National Health and Nutrition Examination Survey (2013–2014).ParticipantsA total of 2149 participants aged 40 years or older who have complete information for periodontitis and AAC assessment test were included in this study.Primary and secondary outcome measuresAAC scores can be accurately identified on lateral spine images obtained by dual-energy X-ray absorptiometry, and both the AAC-24 and AAC-8 semiquantitative scoring tools were used for AAC evaluation. Linear regression analysis was used to investigate the relationship between periodontitis and the AAC-8 and AAC-24 scores. Multivariate logistic regression models and reported ORs were used to examine the relationship between periodontitis and AAC.ResultsThe prevalence of severe periodontitis combined with severe AAC was 8.49%–8.54%. According to the AAC-8 and AAC-24 score classifications, patients with severe periodontitis had higher odds of severe AAC (AAC-8 score ≥3: (OR: 2.53; 95% CI 1.04 to 6.17) and AAC-24 score >6: (OR: 3.60; 95% CI 1.48 to 8.78)). A positive association between mild–moderate periodontitis and severe AAC was found only when the AAC-24 score was applied (OR: 2.25; 95% CI 1.24 to 4.06). In the subgroup analyses, the likelihood ratio test showed no multiplicative interaction (all p value for interaction >0.05).ConclusionsThe findings showed that periodontitis is associated with an increased risk of severe AAC in the US population aged 40 years and older; this requires further large-scale prospective studies for confirmation.
Comprehensive Geriatric Assessment for younger outpatients with severe mental illness: protocol for a feasibility study
Authors: Arnautovska Urska , Siskind Dan , Pearson Ella , Baker Andrea , Reid Natasha , Kwan Winona Wing Ling , Wang Nancy , Gordon Emily , Hubbard Ruth , Warren Nicola 
Published: March 2023

IntroductionIndividuals with severe mental illness are at risk of becoming prematurely frail. There is a critical unmet need for an intervention that reduces the risk of frailty and minimises the associated negative outcomes in this population. This study aims to provide novel evidence on the feasibility, acceptability and preliminary effectiveness of Comprehensive Geriatric Assessment (CGA) to improve health outcomes among people with co-occurring frailty and severe mental illness.Methods and analysisTwenty-five participants with frailty and severe mental illness, aged 18–64 years, will be recruited from Metro South Addiction and Mental Health Service outpatient clinics and provided with the CGA. Primary outcome measures will include the feasibility and acceptability of the CGA embedded in routine healthcare. Other variables of interest will include frailty status, quality of life, polypharmacy, and a range of mental and physical health factors.Ethics and disseminationAll procedures involving human subjects/patients were approved by Metro South Human Research Ethics Committee (HREC/2022/QMS/82272). Study findings will be disseminated through peer-reviewed publications and conference presentations.
Household structure, composition and child mortality in the unfolding antiretroviral therapy era in rural South Africa: comparative evidence from population surveillance, 2000–2015
Authors: Houle Brian , Kabudula Chodziwadziwa , Gareta Dickman , Herbst Kobus , Clark Samuel J 
Published: March 2023

ObjectivesThe structure and composition of the household has important influences on child mortality. However, little is known about these factors in HIV-endemic areas and how associations may change with the introduction and widespread availability of antiretroviral treatment (ART). We use comparative, longitudinal data from two demographic surveillance sites in rural South Africa (2000–2015) on mortality of children younger than 5 years (n=101 105).DesignWe use multilevel discrete time event history analysis to estimate children’s probability of dying by their matrilineal residential arrangements. We also test if associations have changed over time with ART availability.SettingRural South Africa.ParticipantsChildren younger than 5 years (n=101 105).Results3603 children died between 2000 and 2015. Mortality risks differed by co-residence patterns along with different types of kin present in the household. Children in nuclear households with both parents had the lowest risk of dying compared with all other household types. Associations with kin and child mortality were moderated by parental status. Having older siblings lowered the probability of dying only for children in a household with both parents (relative risk ratio (RRR)=0.736, 95% CI (0.633 to 0.855)). Only in the later ART period was there evidence that older adult kin lowered the probability of dying for children in single parent households (RRR=0.753, 95% CI (0.664 to 0.853)).ConclusionsOur findings provide comparative evidence of how differential household profiles may place children at higher mortality risk. Formative research is needed to understand the role of other household kin in promoting child well-being, particularly in one-parent households that are increasingly prevalent.
Charged Gauss–Bonnet black holes supporting non-minimally coupled scalar clouds: analytic treatment in the near-critical regime
Authors: Hod Shahar 
Published: March 2023

AbstractRecent numerical studies have revealed the physically intriguing fact that charged black holes whose charge-to-mass ratios are larger than the critical value $$(Q/M)_{\text {crit}}=\sqrt{2(9+\sqrt{6})}/5$$

(
Q
/
M
)

crit

=

2
(
9
+

6

)

/
5

can support hairy matter configurations which are made of scalar fields with a non-minimal negative coupling to the Gauss–Bonnet invariant of the curved spacetime. Using analytical techniques, we explore the physical and mathematical properties of the composed charged-black-hole-nonminimally-coupled-linearized-massless-scalar-field configurations in the near-critical $$Q/M\gtrsim (Q/M)_{\text {crit}}$$

Q
/
M
≳

(
Q
/
M
)

crit

regime. In particular, we derive an analytical resonance formula that describes the charge-dependence of the dimensionless coupling parameter $$\bar{\eta }_{\text {crit}}=\bar{\eta }_{\text {crit}}(Q/M)$$

η

¯

crit

=

η

¯

crit

(
Q
/
M
)

of the composed Einstein–Maxwell-nonminimally-coupled-scalar-field system along the existence-line of the theory, a critical border that separates bald Reissner–Nordström black holes from hairy charged-black-hole-scalar-field configurations. In addition, it is explicitly shown that the large-coupling $$-\bar{\eta }_{\text {crit}}(Q/M)\gg 1$$

-

η

¯

crit

(
Q
/
M
)

≫
1

analytical results derived in the present paper for the composed Einstein–Maxwell-scalar theory agree remarkably well with direct numerical computations of the corresponding black-hole-field resonance spectrum.
Loss of LGR5 through Therapy-induced Downregulation or Gene Ablation Is Associated with Resistance and Enhanced MET-STAT3 Signaling in Colorectal Cancer Cells
Authors: Posey Tressie A. , Jacob Joan , Parkhurst Ashlyn , Subramanian Shraddha , Francisco Liezl E. , Liang Zhengdong , Carmon Kendra S. 
Published: March 2023

Abstract
Leucine-rich repeat-containing, G protein-coupled receptor 5 (LGR5) is highly expressed in colorectal cancer and cancer stem cells (CSCs) that play important roles in tumor initiation, progression, and metastasis. Loss of LGR5 has been shown to enhance therapy resistance. However, the molecular mechanisms that mediate this resistance remain elusive. In this study, we demonstrate conversion of LGR5+ colorectal cancer cells to an LGR5− state in response to chemotherapy, LGR5− targeted antibody–drug conjugates (ADCs), or LGR5 gene ablation led to activation of STAT3. Further investigation revealed increased STAT3 activation occurred as a result of increased mesenchymal epithelial transition (MET) factor receptor activity. LGR5 overexpression decreased MET-STAT3 activity and sensitized colorectal cancer cells to therapy. STAT3 inhibition suppressed MET phosphorylation, while constitutively active STAT3 reduced LGR5 levels and increased MET activity, suggesting a potential feedback mechanism. Combination treatment of MET-STAT3 inhibitors with irinotecan or antibody–drug conjugates (ADCs) substantiated synergistic effects in colorectal cancer cells and tumor organoids. In colorectal cancer xenografts, STAT3 inhibition combined with irinotecan enhanced tumor growth suppression and prolonged survival. These findings suggest a mechanism by which drug-resistant LGR5− colorectal cancer cells acquire a survival advantage through activation of MET-STAT3 and provide rationale for new treatment strategies to target colorectal cancer.
Anti–PD-1 and Extended Half-life IL2 Synergize for Treatment of Murine Glioblastoma Independent of Host MHC Class I Expression
Authors: Tritz Zachariah P. , Ayasoufi Katayoun , Wolf Delaney M. , Owens Carley A. , Malo Courtney S. , Himes Benjamin T. , Fain Cori E. , Goddery Emma N. , Yokanovich Lila T. , Jin Fang , Hansen Michael J. , Parney Ian F. , Wang Chensu , Moynihan Kelly D. , Irvine Darrell J. , Wittrup K. Dane , Diaz Marcano Rosa M. , Vile Richard G. , Johnson Aaron J. 
Published: March 2023

Abstract

Glioblastoma (GBM) is the most common malignant brain tumor in adults, responsible for approximately 225,000 deaths per year. Despite preclinical successes, most interventions have failed to extend patient survival by more than a few months. Treatment with anti—programmed cell death protein 1 (anti–PD-1) immune checkpoint blockade (ICB) monotherapy has been beneficial for malignant tumors such as melanoma and lung cancers but has yet to be effectively employed in GBM. This study aimed to determine whether supplementing anti–PD-1 ICB with engineered extended half-life IL2, a potent lymphoproliferative cytokine, could improve outcomes. This combination therapy, subsequently referred to as enhanced checkpoint blockade (ECB), delivered intraperitoneally, reliably cures approximately 50% of C57BL/6 mice bearing orthotopic GL261 gliomas and extends median survival of the treated cohort. In the CT2A model, characterized as being resistant to CBI, ECB caused a decrease in CT2A tumor volume in half of measured animals similar to what was observed in GL261-bearing mice, promoting a trending survival increase. ECB generates robust immunologic responses, features of which include secondary lymphoid organ enlargement and increased activation status of both CD4 and CD8 T cells. This immunity is durable, with long-term ECB survivors able to resist GL261 rechallenge. Through employment of depletion strategies, ECB's efficacy was shown to be independent of host MHC class I–restricted antigen presentation but reliant on CD4 T cells. These results demonstrate ECB is efficacious against the GL261 glioma model through an MHC class I–independent mechanism and supporting further investigation into IL2-supplemented ICB therapies for tumors of the central nervous system.
Emotions at Work: Acknowledging Interspecies Emotional Labor of Guide Dog Mobility Instructors
Authors: Warda Tiamat 
Published: March 2023

Abstract
Emotional labor is the management of feelings to present appropriate emotion displays in work-related interactions. This paper acknowledges the emotional labor of guide dog mobility instructors in their work for and with guide dogs. It is interspersed with personal vignettes from my time as a guide dog mobility instructor. While educating canines, instructors conduct both deep and surface acting to improve their relationship with and education of the canines they live and work with. Although challenging, it has the potential to be enjoyable. During their work with visually impaired clients, instructors may place a stronger focus on acoustic versus visual emotion displays. The hope is that initiating this discussion can motivate efforts to proactively support the emotional labor of instructors and improve their relationships with their guide dog co-workers and clients as a result.
Utility of Abbreviated Small Bowel Follow Through Study in the Management of Small Bowel Obstruction
Authors: Peterson John , Cox Caroline , Unrue Emily , Steed R. , Mentzer Caleb , Currence Cragin , Mount Michael 
Published: March 2023

Introduction Small bowel obstruction is a common surgical complaint. Most small bowel obstructions are managed successfully nonoperatively. Unanimous guidelines for nonoperative management of small bowel obstruction do not exist. Methods A standardized protocol for water-soluble contrast administration and abbreviated small bowel follow through imaging was implemented in January of 2021. A retrospective chart review identified 111 patients admitted for SBO from 6/2019 to 9/2019 for a control group. A planned follow-up review identified 158 patients managed according to the new protocol from 3/2021 to 10/2021. The primary outcome was in-hospital length of stay. Standard statistical analyses were performed and pre-specified. Results Before implementation of the standardized protocol patients that were managed strictly nonoperatively, the mean length of stay (LOS) was 8.3 days. After implementation, the average LOS was 4.8 (P < .0001). Comparatively, patients admitted after protocol implementation were more likely to undergo CT scan with PO contrast on admission (98.1% vs 90.1%; P < .005), undergo NG tube decompression (84.7% vs 68.5%; P < .005), and undergo water-soluble contrast with abbreviated or formal SBFT (75.3% vs 37.8%; P < .0001). Conclusion Implementation of a standardized protocol utilizing abbreviated SBFT with water-soluble contrast for the management of SBO at our institution resulted in a decrease in the average length of stay for patients definitively managed in a nonoperative fashion.
Retention of Knowledge After Opioid Education in Surgical Interns
Authors: Arndt Kevin R. , Robinson Kortney A. , Yorkgitis Brian , Brat Gabriel 
Published: March 2023

Background In many academic centers, opioid prescribing is managed primarily by residents with little or no formal opioid education. The present study evaluates intern knowledge and comfort with appropriate opioid prescribing 7 months after an organized opioid education effort. Materials and Methods A repeat knowledge and attitude survey was sent to surgical interns who had completed an initial opioid education training session 7 months before the study. Results were compared to post-education assessment results in the same cohort. Setting 16 general surgery and podiatric surgery interns at a single academic medical center. Results The mean percentage of correct answers on follow-up was 67.6% identical to the average post-session score of 67.6%. Interns reported comfort with opioid prescribing increased to a mean score of 5.9 (out of 10) on follow-up compared to post-session score of 5.19. Conclusions Surgical interns have significant gaps in knowledge for optimal prescribing and management of opioid prescriptions. Targeted education demonstrates significant and lasting improvement in opioid assessment scores, but there remains room for improvement.
Shielding performances of short carbon fibers and tungsten particles reinforced benzoxazine resin matrix composites
Authors: Daham Abbas , Zegaoui Abdeldjalil , Derradji Mehdi , Khan Gorar Athar Ali , Wang Jun , Tian Bo , Pan Zhong-Cheng , Liu Wen-Bin , Moussa Zaoui 
Published: March 2023

This present investigation reports, for the first time, the properties of the polybenzoxazine bio-based furfurylamine reinforced using the hybrid short carbon fibers and tungsten particles. The results revealed good compatibility between the matrix and the filers using scanning electron microscopy, due to the use of the silane treatment that led to enhanced interfacial bonding. In addition, the mechanical data disclosed that the bending and impact values were respectively increased to 210 MPa and 9 KJ/m2 for the composites containing 20%wt of the short carbon fibers and 20%wt tungsten particles. The hybrid composite shielding properties were evaluated using the cobalt-60 as an irradiation source, and the nuclear results depicted that the half-value length and the tenth-value length were increased as compared to those of the pure polymers. Based on the thermal stability studies, the reinforced hybrid composites also showed excellent thermal resistance.
Feasibility of a Modified Otago Exercise Program for Older Adults With Cognitive Vulnerability
Authors: Mangione Kathleen K. , Darreff Hope , Welsh McKenna , Ni Weihong , Wolff Edward , Booth Julie T. , Glenney Susan S. , Fortinsky Richard H. 
Published: March 2023

Cognitive vulnerability, that is, clinically significant symptoms of dementia, depression, or delirium, puts older adults at high risk for physical inactivity and falls. Programs addressing activity and falls are needed. The purpose was to determine feasibility of an in-home, modified, Otago Exercise Program (OEP) for those with cognitive vulnerability, based on acceptability (retention and adherence), safety (pain intensity and falls), and potential positive effects (change in short physical performance battery (SPPB)). This secondary analysis of a randomized controlled trial included 80 participants who received the OEP; 64 completed it, 48% had depression, 22% had dementia, and 30% had a combination dementia/depression/delirium. Adherence to home exercise was low to moderate; pain was stable over 16 weeks; 31% of participants reported falls unrelated to OEP. SPPB increased from 6.95 to 7.74 ( p < .01); age by time and diagnosis by time interactions were not significant. The modified OEP shows promising feasibility for older adults with cognitive vulnerability.