bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supporting the Transition to Distance Education During the Pandemic and Beyond
Authors: Samuel Anita , Teng Yating , Soh Michael Y , King Beth , Cervero Ronald M , Durning Steven J 
Published: May 2023

ABSTRACT

Introduction
The coronavirus disease 2019 (COVID-19) pandemic affected almost every country around the world, and various forms of lockdown or quarantine measures were implemented. The lockdowns forced medical educators to step beyond traditional educational approaches and adopt distance education technologies to maintain continuity in the curriculum. This article presents selected strategies implemented by the Distance Learning Lab (DLL) at the Uniformed Services University of Health Sciences (USU), School of Medicine (SOM), in transitioning their instruction to an emergency distance education format during the COVID-19 pandemic.

Materials and Methods
When moving programs/courses to a distance education format, it is important to recognize that two primary stakeholders are involved in the process: faculty members and students. Therefore, to be successful in transitioning to distance education, strategies must address the needs of both groups and provide support and resources for both.
The DLL used two lenses of adult learning and targeted needs assessment to design faculty and student support during the pandemic. The DLL adopted a learner-centered approach to education, focusing on meeting the faculty members and students where they are. This translated into three specific support strategies for faculty: (1) workshops, (2) individualized support, and (3) just-in-time self-paced support. For students, DLL faculty members conducted orientation sessions and provided just-in-time self-paced support.

Results
The DLL has conducted 440 consultations and 120 workshops for faculty members since March 2020, serving 626 faculty members (above 70% of SOM faculty members locally) at USU. In addition, the faculty support website has had 633 visitors and 3,455 pageviews. Feedback comments provided by faculty members have specifically highlighted the personalized approach and the active, participatory elements of the workshops and consultations.
Evaluations of the student orientation sessions showed that they felt more confident in using the technologies after the orientation. The biggest increase in confidence levels was seen in the topic areas and technology tools unfamiliar to them. However, even for tools that students were familiar with before the orientation, there was an increase in confidence ratings.

Conclusion
Post-pandemic, the potential to use distance education remains. It is important to have support units that recognize and cater to the singular needs of medical faculty members and students as they continue to use distance technologies to facilitate student learning.
Military Medical Students’ Coping With Stress to Maintain Well-being
Authors: Ma Ting-Lan , Bell Kameha , Dong Ting , Durning Steven J , Soh Michael 
Published: May 2023

ABSTRACT

Introduction
Previous studies have shown that medical students experience a great level of burnout and poor well-being during their clinical training periods. In this study, we sought to understand how military medical students cope with stress to prevent burnout and support their well-being. We also investigated if these coping strategies are associated with military medical students’ self-reported well-being, burnout, and depression levels. The findings could help inform programming, resources, and educational strategies to better support students to thrive in their careers long term.

Methods
Using a cross-sectional research design, we surveyed military medical students and conducted content analysis on participant responses to the open-ended item by trained coders. Coding was based on the existing coping theory frameworks as well as categories that emerged inductively to represent the data.

Results
The primary four strategies military medical students utilized included social connection (59.9%), exercise (58.3%), personal relaxation (36%), and work–life balance (15.7%). The use of work–life balance strategy was significantly associated with more positive well-being and lower depression compared to those who did not use this strategy. Three main coping typologies were further extracted, including personal care, connection, and cognitive strategies. Based on the typologies, 62% of students were recognized as multi-type copers (who combined more than two coping typologies), who reported significantly more positive well-being compared to students who relied on a single typology.

Conclusions
The findings demonstrate that certain coping strategies are more positively associated with a good state of well-being and less burnout, and that utilization of multiple types of coping strategies is more supportive. This study amplifies the voice of military medical students concerning the importance of prioritizing self-care and available resources given the unique pressures and demands of their dual military medical curriculum.
Reflecting on LTCOS Scholarship and Implications for Educational Practice
Authors: Dong Ting , Reamy Brian V , Hemmer Col Paul A , Soh Michael , Barry Erin S , Jung Eulho , Durning Steven J 
Published: May 2023

ABSTRACT
The Long Term Career Outcome Study is a central program of research in the Center for Health Professions Education at the Uniformed Services University. The overarching goal of Long Term Career Outcome Study is to perform evidence-based evaluations before, during, and after medical school, and as such, it represents a form of educational epidemiology. In this essay, we highlighted the findings of the investigations published in this special issue. These investigations span from “before” medical school matriculation to “during” medical school and “after” learners go on to graduate training and practice. Furthermore, we discuss how this scholarship might shed light on improving the educational practices at the Uniformed Services University and potentially elsewhere. We hope that this work demonstrates how research can enhance medical education processes and connect research, policy, and practice.
“Primum Non Nocere”—First, Do No Harm: A Retrospective Review of the Impact of Curricular Reform on USUHS Graduates’ Performance During Their PGY-1 Year
Authors: Melton John L , Hemmer Col Paul A , Pock Col Arnyce , Moores COL Lisa K , Pangaro COL Louis N , Durning Steven J , Witkop Col Catherine T , Zapota Ramon , Schreiber-Gregory Deanna N , Dong Ting 
Published: May 2023

ABSTRACT

Purpose
To determine whether medical school curricular change impacted the assessment of graduates in their first year of postgraduate training.

Methods
The authors examined for differences in the survey of postgraduate year one (PGY-1) program directors for Uniformed Services University (USU) medical school graduates from the Classes of 2011 and 2012 (pre-curriculum reform, pre-CR), Classes of 2015, 2016, and 2017 (curriculum transition), and Classes of 2017, 2018, and 2019 (post-curriculum reform, post-CR). Multivariate analysis of variance was used to explore for differences among the cohorts in the 5 previously identified factors on the PGY-1 survey (Medical Expertise; Professionalism; Military Unique Practice, Deployments and Humanitarian Missions; System-Based Practice and Practiced-Based Learning; Communication and Interpersonal Skills). Nonparametric tests were used when the error variance between cohorts was found to be unequal across samples. Kruskal–Wallis (a rank ordered analysis of variance) and Tamhan’s T2 were used to characterize specific differences.

Results
There were 801 students included: 245 (pre-CR); 298 (curricular transition); and 212 (post-CR). Multivariate analysis of variance demonstrated significant differences in all survey factors among the comparison groups. From pre-CR to the curricular transition, ratings in all factors declined, but none reached the level of a statistical significance. Ratings of all 5 factors showed significant improvement from the curricular transition to post-CR, and scores from pre-CR to post-CR trended in the positive direction with Practice-Based Learning (effect size 0.77), showing significant gains.

Conclusion
Ratings by PGY-1 program directors of USU graduates over time demonstrated a very small decline soon after curriculum reform but later showed a large improvement in domains reflecting areas of emphasis in the curriculum. In the eyes of a key stakeholder, the USU curriculum reform did no harm and led to improved PGY-1 assessments.
Prior Enlisted Medical Students at the Uniformed Services University: Outcomes During Four Years of Medical School
Authors: Green Althea , Dong Ting , Schreiber-Gregory Deanna N , Tilley Laura , Durning Steven J 
Published: May 2023

ABSTRACT

Introduction
The Uniformed Services University (USU) implemented the Enlisted to Medical Degree Preparatory Program (EMDP2) with the goal of enhancing the diversity of the military physician corps. Programs like EMDP2 can assist students in making the social and intellectual transition from undergraduate studies to medical school and beyond. These types of programs are also opportunities to reduce health disparities and prepare students to work in multicultural settings. The purpose of this study was to evaluate whether there was any significant difference in performance between USU medical students who had attended the EMDP2 and those who had not.

Materials and Methods
We compared the results of National Board of Medical Examiners (NBME) Clinical Science Subjects, United States Medical Licensing Examination (USMLE) Step 1, and USMLE Step 2 Clinical Knowledge exams of EMDP2 learners from the School of Medicine classes of 2020 to 2023 to those of four similarly sized cohorts of their peers who varied by age and prior military service.

Results
We found that the performance of EMDP2 graduates was comparable to their peers who followed more traditional and other alternative paths to medical school. For example, regression models showed that EMDP2 status was not a statistically significant predictor of average clerkship NBME exam score, nor of USMLE Step 1 failure.

Conclusion
EMDP2 graduates performed on a par with their medical school peers, and EMDP2 status does not appear to influence NBME or USMLE performance. EMDP2 provides a focused curriculum and addresses the mandate to make medical education opportunities available to a more diverse population.
Veteran Experiences With Suicide Ideation, Suicide Attempt, and Social Support in Safety Planning Within the Department of Veterans Affairs
Authors: Matthieu Monica M , Morissette Sandra B , Clafferty Stephanie , Degutis Linda , Oliver Ciara M , Adkins David A , DeBeer Bryann B 
Published: May 2023

ABSTRACTIntroductionThis evaluation examined the role of safety plans, one of a host of clinical suicide prevention interventions available for veterans through the United States Department of Veterans Affairs’ national network of health care facilities managed by the Veterans Health Administration (VHA).Materials and MethodsInterviews were conducted with veterans who had experienced suicidal ideation or a suicide attempt since enrolling in the Department of Veterans Affairs health care system (N = 29). Topics included negative life experiences, triggers for suicidal ideation or a suicide attempt, ability to recall and utilize safety plans in crisis, safety plan elements found most and least useful, and improvements to safety planning.ResultsEighteen (62.07%) of the veterans in the sample had attempted suicide. Drug use was by far the most triggering and overdose was the most negative life event to subsequent ideation or attempt. Although all at-risk veterans should have a safety plan, only 13 (44.38%) created a safety plan, whereas 15 (51.72%) could not recall ever creating a safety plan with their provider. Among those who did recall making a safety plan, identifying warning signs was the most remembered portion. The most useful safety plan elements were: recognizing warning signs, supportive people and distracting social settings, names and numbers of professionals, giving the veteran personal coping strategies, options for using the plan, and keeping their environment safe. For some veterans, safety plans were seen as insufficient, undesirable, not necessary, or lacking a guarantee. The suggested improvements included involving concerned significant others, specific actions to take in a crisis, and potential barriers and alternatives.ConclusionsSafety planning is a critical component in suicide prevention within VHA. However, future research is needed to ensure safety plans are accessible, implemented, and useful to veterans when in crisis.
Disparate Risk Factors Among Pregnant Veterans Using Veterans Administration Health Benefits for Community-Based Obstetrical Care
Authors: Hansen Barbara , Picken Lauren K , Gould Sara 
Published: May 2023

ABSTRACT

Introduction
Veterans using the Veterans Administration Health Care System (VAHCS) for obstetrical care experience disparate pregnancy-related risks and health outcomes when compared to their pregnant counterparts. This study examined the prevalence of risk factors associated with pregnancy-related comorbidities among U.S. Veterans receiving obstetrical care using VAHCS benefits in Birmingham, Alabama.

Materials and Methods
A retrospective chart review was conducted of pregnant Veterans receiving care at a large Veterans Administration facility from 2018 to 2021. Using one-sample t-tests, the data from the study charts were compared to the Alabama overall prevalence of tobacco and alcohol use, pregnancy-related hypertension/preeclampsia, and gestational diabetes and, when the Alabama data were unavailable, the U.S. national average prevalence of overweight, obesity, pre-pregnancy hypertension, posttraumatic stress disorder, depression, and anxiety among patients receiving obstetrical care. The institutional review board at the Birmingham VAHCS approved the study, with an exemption for human subjects research.

Results
The study sample (N = 210) experienced higher levels of obesity (42.3% vs. 24.3%, P &lt; .001), tobacco (21.9% vs. 10.8%, P &lt; .001) and alcohol (19.5% vs. 5.4%, P &lt; .001) use, pre-pregnancy hypertension (10.5% vs. 2.1%, P &lt; .001), posttraumatic stress disorder (33.8% vs. 3.3%, P &lt; .001), anxiety (66.7% vs. 15.2%, P &lt; .001), and depression (66.7% vs. 15.0, P &lt; .001). Fewer patients in the study sample were classified as overweight (16.7% vs. 25.5%, P &lt; .001), developed pregnancy-related hypertension/preeclampsia (7.6% vs. 14.4%, P &lt; .001), or were diagnosed with gestational diabetes (7.1% vs. 10.2%, P &lt; .001). The results did not vary by race or age.

Conclusion
The findings highlight the need for further examination of social factors that may be driving disparities among pregnant Veterans, who may benefit from supplemental services to address modifiable comorbidities. Additionally, the implementation of a centralized database to track pregnancy-related outcomes for Veterans would allow these comorbidities to be more closely monitored and addressed. Heightened awareness of a patient’s Veteran status and associated increased risks can alert providers to screen for depression and anxiety more frequently and to familiarize themselves with additional services the VAHCS may offer to patients. These steps could improve referrals to counseling and/or targeted exercise interventions.
Automated evaluation with deep learning of total interstitial inflammation and peritubular capillaritis on kidney biopsies
Authors: Jacq Amélie , Tarris Georges , Jaugey Adrien , Paindavoine Michel , Maréchal Elise , Bard Patrick , Rebibou Jean-Michel , Ansart Manon , Calmo Doris , Bamoulid Jamal , Tinel Claire , Ducloux Didier , Crepin Thomas , Chabannes Melchior , Funes de la Vega Mathilde , Felix Sophie , Martin Laurent , Legendre Mathieu 
Published: May 2023

ABSTRACT

Background
Interstitial inflammation and peritubular capillaritis are observed in many diseases on native and transplant kidney biopsies. A precise and automated evaluation of these histological criteria could help stratify patients’ kidney prognoses and facilitate therapeutic management.

Methods
We used a convolutional neural network to evaluate those criteria on kidney biopsies. A total of 423 kidney samples from various diseases were included; 83 kidney samples were used for the neural network training, 106 for comparing manual annotations on limited areas to automated predictions, and 234 to compare automated and visual gradings.

Results
The precision, recall and F-score for leukocyte detection were, respectively, 81%, 71% and 76%. Regarding peritubular capillaries detection the precision, recall and F-score were, respectively, 82%, 83% and 82%. There was a strong correlation between the predicted and observed grading of total inflammation, as for the grading of capillaritis (r = 0.89 and r = 0.82, respectively, all P &lt; .0001). The areas under the receiver operating characteristics curves for the prediction of pathologists’ Banff total inflammation (ti) and peritubular capillaritis (ptc) scores were respectively all above 0.94 and 0.86. The kappa coefficients between the visual and the neural networks' scores were respectively 0.74, 0.78 and 0.68 for ti ≥1, ti ≥2 and ti ≥3, and 0.62, 0.64 and 0.79 for ptc ≥1, ptc ≥2 and ptc ≥3. In a subgroup of patients with immunoglobulin A nephropathy, the inflammation severity was highly correlated to kidney function at biopsy on univariate and multivariate analyses.

Conclusion
We developed a tool using deep learning that scores the total inflammation and capillaritis, demonstrating the potential of artificial intelligence in kidney pathology.
On the Road with Louis
Authors: Crease Stephanie Stein 
Published: May 2023

Abstract
In 1932, Webb’s band was heard on WMCA four times a week, and played for “breakfast dances” at the Savoy and the Alhambra Ballroom. That summer, it toured white resorts and dance halls along the Susquehanna River in Pennsylvania. In late fall, Webb’s band was chosen to accompany Louis Armstrong, then a huge national star, for the latest version of the show Hot Chocolates at Connie’s Inn, then on an East Coast tour. Armstrong, with Chick Webb’s Orchestra, made his debut record for RCA Victor. The session took place at RCA Victor’s famous Camden Studio, a converted church. Webb and Armstrong reunited for the tour back at the Howard Theater in Washington, DC, the week before Christmas, then at the Royal in Baltimore for Christmas week. They played a midnight dance on Christmas night, when Louis was in extraordinary pain but still stole the show, as Webb would through his own health struggles a few years later.
Reordering Adivasi Worlds
Authors: Dasgupta Sangeeta 
Published: May 2023

Abstract
Recounting the story of the Oraons and Tana Bhagats of Chhotanagpur in the present-day state of Jharkhand, this book questions postcolonial understandings of the category of ‘tribe’ and unravels the threads of a hierarchical adivasi world. It unpacks colonial ethnography, missionary narratives, and anthropological writings; explores issues of adivasi identity and resistance; and demonstrates how contemporary adivasi protest draws upon memories of the past. Dasgupta argues that nineteenth- and early twentieth-century ideas of ‘tribe’ were not abstract imaginaries but structured colonial interventions. These affected the shaping of customary rights; the understanding of the rural world; and the perception of customs and practices. She analyses the ways in which Tana Bhagats questioned hierarchies among the Oraons; opposed landlords, moneylenders, and the colonial state; and engaged with Gandhi and the Congress. Dasgupta delineates how Tanas allude to their diverse experiences and distinctive memories to negotiate with the sarkar even today.
Forms of Scripture in Early Judaism
Authors: Elledge C.D. 
Published: May 2023

Abstract
Early Jewish writings pose important implications for understanding the nature of scripture in ancient times, prior to the later formation of biblical canons. A review of early noncanonical literary collections unveils the diverse assumptions about scripture that existed within ancient Judaism. In their formative contexts, many of these writings present their religious claims as extensions of divine revelation, not merely as secondary, postbiblical compositions. Others endeavor to present themselves as essential complements to earlier scriptural books. Such high esteem for their authority appears to have been shared among some of their earliest audiences. Carefully studying the literature of this era thus reveals the extended horizon of authoritative traditions prevalent during the period of Christian origins. This realization arises from the modern study of literary collections known as Apocrypha (Deuterocanonical Books), Pseudepigrapha, Dead Sea Scrolls, and the writings of Philo and Josephus.
In the Wilderness
Authors: Elledge C.D. 
Published: May 2023

Abstract
New insights into Early Judaism have flourished over the past generation due to the modern discovery of the Dead Sea Scrolls. The scrolls revealed a previously unknown literary collection attesting to the religious beliefs and practices of a sectarian Jewish community. The community voluntarily separated from other Jews, forming a highly structured society with a strong priestly self-understanding and dualistic, apocalyptic beliefs. Their vast literary collection includes (1) scriptural manuscripts and their interpretation, (2) communal rules, (3) legal writings, (4) psalms, hymns, and prayers, and (5) wisdom and apocalyptic writings. Aspects of the collection have been especially important for understanding how Palestinian Jewish traditions informed Christian origins, even as the church adapted to its broader Mediterranean contexts. New Testament traditions surrounding John the Baptist, the communal structures of the early church, and messianic beliefs strike remarkable continuities and differences with the literature of the Dead Sea Scrolls.
The Overlap of Intellectual Property and Traditional Knowledge
Authors: Frankel Susy 
Published: May 2023

Abstract
This chapter elaborates on the overlap of intellectual property and traditional knowledge. The increase in global trade and the consequent cross-border flows of cultural and intellectual property-related goods and services resulted in an increased market in the developed world for new sources of knowledge and new ways to commodify and sell goods. However, many intellectual property products and related rights owned by businesses that trade across borders exploit traditional knowledge. Utilizing traditional knowledge became common to create copyrighted works and prospect the knowledge that contributes to the creation of new products. The chapter mentions how the most common objection to the protection of traditional knowledge is the perceived overlap with the public domain, which is known to be the absence of intellectual property.
The Political Safeguards of EU Foreign Relations Federalism
Authors: Verellen Thomas 
Published: May 2023

AbstractThis chapter argues that the EU Treaties provide for both strong formal and informal safeguards of foreign relations federalism in the EU. Member States have a strong formal voice in the EU foreign policy-making process, and, because of this voice, EU institutions cannot easily encroach on the autonomy of Member States. The comparatively strong voice of the Member States in EU foreign policy-making flips the stakes: whereas in the US and Canada, a concern about the autonomy of member units explains the need for political safeguards, in the EU the presence of strong safeguards raises a concern about the autonomy of the EU institutions vis-à-vis the Member States. In light of the central role of the EU Member States in the EU foreign policy-making process, this chapter also looks at whether there are any checks on the two Councils.