bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do peer group reflection meetings support medical students’ learning and personal development during clinical rotations?
Authors: van den Eertwegh Valerie , Stalmeijer Renée E. 
Published: July 2023

Abstract
Background
Medical schools look to support students in coping with challenges and stressors related to clinical rotations. One potential approach is implementing Intervision Meetings (IM): a peer group reflection method during which students address challenging situations and personal development issues with peers, guided by a coach. Its implementation and perceived effectiveness in undergraduate medical education has however not yet been widely studied and described. This study evaluates how students perceive the effect of a three-year IM-programme during their clinical rotations, and explores which processes and specific factors support students’ personal development and learning during clinical rotations.

Methods
Using an explanatory Mixed Methodology, medical students participating in IM were asked to evaluate their experiences through a questionnaire at three time points. Questionnaire results were further explored through three focus groups. Data were analysed using descriptive statistics and thematic analysis.

Results
Three hundred fifty seven questionnaires were filled out by students across the three time points. Students perceived IM to contribute to their ability to cope with challenging situations during clinical rotations. Participants in the focus groups described how IM created an increase in self-awareness by active self-reflection supported by peers and the coach. Sharing and recognizing each other’s’ situations, stories or problems; as well as hearing alternative ways of coping, helped students to put things into perspective and try out alternative ways of thinking or behaving.

Conclusions
IM can help students to better deal with stressors during clinical rotations and approach challenges as learning opportunities under the right circumstances. It is a potential method medical schools can use to aid their students on their journey of personal and professional development.
What is the mind map of the hospital’s future changes in a developing country like Iran? A qualitative study
Authors: Masoud Ali , Dehnavieh Reza , Yazdi-Feyzabadi Vahid , Poursheikhali Atousa , Noori Hekmat Somayeh , kazemi Mohammad , Moghadam Mina Ghasemi 
Published: July 2023

AbstractBackgroundHospitals have a vital role in the future of health systems with upcoming structure, resources, and process changes. Identifying the potential aspects of change helps managers proactively approach them, use the opportunities, and avoid threats. This study presents a mind map of future changes in Iranian hospitals to develop a base for further related studies or prepare evidence for interventions and future-related decisions.MethodsThis study is a qualitative-exploratory one, conducted in two phases. In the first phase, in-depth and semi-structured interviews were conducted to identify future hospital changes over 15 years. The interviews were analyzed using the content analysis method and MAXQDA 2018 software and holding two expert panels to develop the mind map using the 2016 Visio software.ResultsIn the first phase, 33 interviews led to 144 change patterns. In the second phase, a mind map of changes was drawn according to experts’ opinions with ten categories: structure and role, knowledge management and research, service delivery, health forces, political and legal, economic, demographic and disease, technological, and values and philosophy, and environmental.ConclusionsMany changes affecting hospitals rooted in the past continue to the future, but the point is the increasing intensity and speed of changes. Healthcare systems need a systematic approach to monitoring the environment to be updated, agile and proactive. These monitoring systems are essential in providing evidence for Macro-level decision-makers.
Overlapping research efforts in a global pandemic: a rapid systematic review of COVID-19-related individual participant data meta-analyses
Authors: Maxwell Lauren , Shreedhar Priya , Levis Brooke , Chavan Sayali Arvind , Akter Shaila , Carabali Mabel 
Published: July 2023

Abstract
Background
Individual participant data meta-analyses (IPD-MAs), which involve harmonising and analysing participant-level data from related studies, provide several advantages over aggregate data meta-analyses, which pool study-level findings. IPD-MAs are especially important for building and evaluating diagnostic and prognostic models, making them an important tool for informing the research and public health responses to COVID-19.

Methods
We conducted a rapid systematic review of protocols and publications from planned, ongoing, or completed COVID-19-related IPD-MAs to identify areas of overlap and maximise data request and harmonisation efforts. We searched four databases using a combination of text and MeSH terms. Two independent reviewers determined eligibility at the title-abstract and full-text stages. Data were extracted by one reviewer into a pretested data extraction form and subsequently reviewed by a second reviewer. Data were analysed using a narrative synthesis approach. A formal risk of bias assessment was not conducted.

Results
We identified 31 COVID-19-related IPD-MAs, including five living IPD-MAs and ten IPD-MAs that limited their inference to published data (e.g., case reports). We found overlap in study designs, populations, exposures, and outcomes of interest. For example, 26 IPD-MAs included RCTs; 17 IPD-MAs were limited to hospitalised patients. Sixteen IPD-MAs focused on evaluating medical treatments, including six IPD-MAs for antivirals, four on antibodies, and two that evaluated convalescent plasma.

Conclusions
Collaboration across related IPD-MAs can leverage limited resources and expertise by expediting the creation of cross-study participant-level data datasets, which can, in turn, fast-track evidence synthesis for the improved diagnosis and treatment of COVID-19.

Trial registration
10.17605/OSF.IO/93GF2.
The importance of context—a qualitative study exploring healthcare practitioners’ experiences of working with patients at home after a stroke
Authors: Elf Marie , Rasoal Dara , Zingmark Magnus , Kylén Maya 
Published: July 2023

Abstract

Background

Stroke significantly impacts individuals, leading to the need for long-lasting rehabilitation and adaptation to environmental demands. Rehabilitation after stroke is increasingly performed in patients’ homes, and it is argued that rehabilitation in this context is more person-centred and positively impacts client outcomes. However, the role of environmental factors in this process is largely unknown. The aim of this study was to explore how multidisciplinary healthcare practitioners working with rehabilitation in the home after stroke consider possibilities and challenges in the environment and how environmental factors are documented in patients’ records.

Methods

Eight multidisciplinary healthcare practitioners working with home-based rehabilitation after stroke participated in two semistructured focus group sessions. Thematic analysis was used to analyse the transcripts of recorded focus group discussions. Data were also collected from patient history records (N = 14) to identify interventions to increase patients’ opportunities to participate in activities inside and outside the home. These records were analysed using life-space mobility as a conceptual framework.

Results
The analysis generated four overarching themes concerning possibilities and challenges in the environment: (1) the image of rehabilitation conflicts with place, (2) the person in the home reveals individual needs and capabilities, (3) environmental characteristics influence the rehabilitation practice, and (4) the person is integrated within a social context. The patient record analysis showed that most patients were discharged from hospital to home within four days. Assessments at the hospital mainly focused on basic activities of daily living, such as the patient’s self-care and walking ability. Also at home, the assessments and actions primarily focused on basic activities with little focus on participation in meaningful activities performed in different life situations outside the home.

Conclusions
Our research suggests that one way to improve practice is to include the environment in the rehabilitation and consider the person´s life space. Interventions should focus on supporting out-of-home mobility and activities as part of person-centred stroke rehabilitation. This must be supported by clear documentation in the patient records to strengthen clinical practice as well as the communication between stakeholders.
Therapeutic properties of Helicobacter pylori-derived vacuolating cytotoxin A in an animal model of chronic allergic airway disease
Authors: Raspe Jonas , Schmitz Mona S. , Barbet Kimberly , Caso Georgia C. , Cover Timothy L. , Müller Anne , Taube Christian , Reuter Sebastian 
Published: July 2023

Abstract
Background
It has previously been shown that the Helicobacter pylori (H. pylori)-derived molecule vacuolating cytotoxin A (VacA) could be suitable for the treatment of allergic airway disease. The therapeutic activity of the protein, which acts through modulation of dendritic cells (DC) and regulatory T cells (Tregs), was demonstrated in murine short-term acute models. The aim of this study is to further evaluate the therapeutic potential of VacA by determining the effectiveness of different application routes and the suitability of the protein for treating the chronic phase of allergic airway disease.

Methods
VacA was administered by the intraperitoneal (i.p.), oral (p.o.) or intratracheal (i.t.) routes, and long-term therapeutic effectiveness, allergic airway disease hallmarks, and immune phenotype were analyzed in murine models of acute and chronic allergic airway disease.

Results
Administration of VacA via the i.p., p.o or i.t. routes was associated with a reduction in airway inflammation. The i.p. route showed the most consistent effect in reducing airway inflammation and i.p. treatment with VacA was the only treatment that significantly reduced mucus cell hyperplasia. In a murine model of chronic allergic airway disease, both short- and long-term treatment with VacA showed a therapeutic effect, with a reduction in a variety of asthma hallmarks, including bronchoalveolar lavage eosinophilia, lung inflammation and goblet cell metaplasia. Short-term treatment was associated with induction of Tregs, while repetitive long-term administration of VacA influenced immunological memory in the lung.

Conclusions
In addition to showing therapeutic efficacy in short-term models, treatment with VacA also appeared to be effective in suppressing inflammation in a chronic airway disease model. The observation that treatment was effective after administration via several different routes highlights the potential of VacA as a therapeutic agent with different routes of administration in humans.
Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes
Authors: Fang Qianhua , Shi Juan , Zhang Jia , Peng Ying , Liu Cong , Wei Xing , Hu Zhuomeng , Sun Lin , Hong Jie , Gu Weiqiong , Wang Weiqing , Zhang Yifei 
Published: July 2023

Abstract
Background
Glycemic variability plays an important role in the development of cardiovascular disease (CVD). This study aims to determine whether long-term visit-to-visit glycemic variability is associated with aortic stiffness progression in participants with type 2 diabetes (T2D).

Methods
Prospective data were obtained from 2115 T2D participants in the National Metabolic Management Center (MMC) from June 2017 to December 2022. Two brachial-ankle pulse wave velocity (ba-PWV) measurements were performed to assess aortic stiffness over a mean follow-up period of 2.6 years. A multivariate latent class growth mixed model was applied to identify trajectories of blood glucose. Logistic regression models were used to determine the odds ratio (OR) for aortic stiffness associated with glycemic variability evaluated by the coefficient of variation (CV), variability independent of the mean (VIM), average real variability (ARV), and successive variation (SV) of blood glucose.

Results
Four distinct trajectories of glycated hemoglobin (HbA1c) or fasting blood glucose (FBG) were identified. In the U-shape class of HbA1c and FBG, the adjusted ORs were 2.17 and 1.21 for having increased/persistently high ba-PWV, respectively. Additionally, HbA1c variability (CV, VIM, SV) was significantly associated with aortic stiffness progression, with ORs ranging from 1.20 to 1.24. Cross-tabulation analysis indicated that the third tertile of the HbA1c mean and VIM conferred a 78% (95% confidence interval [CI] 1.23–2.58) higher odds of aortic stiffness progression. Sensitivity analysis demonstrated that the SD of HbA1c and the highest HbA1c variability score (HVS) were significantly associated with the adverse outcomes independent of the mean of HbA1c during the follow-up.

Conclusions
Long-term visit-to-visit HbA1c variability was independently associated with aortic stiffness progression, suggesting that HbA1c variability was a strong predictor of subclinical atherosclerosis in T2D participants.
TRAF2 promotes M2-polarized tumor-associated macrophage infiltration, angiogenesis and cancer progression by inhibiting autophagy in clear cell renal cell carcinoma
Authors: Xu Yawei , Li Lei , Yang Wuping , Zhang Kenan , Zhang Zedan , Yu Chaojian , Qiu Jianhui , Cai Lin , Gong Yanqing , Zhang Zheng , Zhou Jingcheng , Gong Kan 
Published: July 2023

Abstract
Background
The management of advanced clear cell renal cell carcinoma (ccRCC) remains a major challenge in clinical practice, and the construction of more reliable prognostic prediction models and the further elucidation of key molecular mechanisms of tumor progression are topics in urgent need of in-depth investigation.

Methods
We used CIBERSORT to estimate the proportion of 22 tumor-infiltrating immune cell types in the TCGA-KIRC cohort. Weighted gene co-expression network analysis, least absolute shrinkage and selection operator regression analysis were used to build risk prediction models. Expression patterns and clinical significance of TRAF2 were determined through bioinformatics analysis, real-time qPCR, Western Blot, immunohistochemistry. GSEA analysis, transmission electron microscopy, 2D/3D colony formation assay, cell migration and invasion assay, and tube-formation assay were used to investigate the underlying function and mechanism of the TRAF2/M2 macrophage/autophagy axis.

Results
We constructed a novel prognostic prediction model based on M2 macrophage-related genes, which was identified as an accurate, independent and specific prognostic risk model for ccRCC patients. A reliable nomogram was constructed to predict 1-, 3-, and 5-year overall survival for patients with ccRCC. As one of the constituent genes of the risk model, TRAF2 was determined to be upregulated in ccRCC and associated with poor clinical prognosis. We found that TRAF2 promotes malignant progression of ccRCC by regulating macrophage polarization, migration and angiogenesis. Mechanistically, we found that TRAF2 promotes the polarization of M2 macrophages, and this chemotaxis is achieved in an autophagy-dependent pathway. Orthotopic tumor growth assay results revealed that TRAF2 plays a key role as a promotor of ccRCC growth and metastasis.

Conclusions
In conclusion, this risk model is highly predictive of prognostic in ccRCC patients, which is expected to promote improved treatment evaluation and comprehensive management of ccRCC. Moreover, our findings reveal that the TRAF2/M2 macrophage/autophagy axis plays a key regulatory role in the malignant progression of ccRCC, and suggest that TRAF2 is a potential novel therapeutic target for advanced ccRCC.
Trauma-induced disturbances in ionized calcium levels correlate parabolically with coagulopathy, transfusion, and mortality: a multicentre cohort analysis from the TraumaRegister DGU®
Authors: Helsloot Dries , Fitzgerald Mark , Lefering Rolf , Verelst Sandra , Missant Carlo ,   the TraumaRegister DGU
Published: July 2023

Abstract
Background
To which extent trauma- induced disturbances in ionized calcium (iCa2+) levels have a linear relationship with adverse outcomes remains controversial. The goal of this study was to determine the association between the distribution and accompanying characteristics of transfusion-independent iCa2+ levels versus outcome in a large cohort of major trauma patients upon arrival at the emergency department.

Methods
A retrospective observational analysis of the TraumaRegister DGU® (2015–2019) was performed. Adult major trauma patients with direct admission to a European trauma centre were selected as the study cohort. Mortality at 6 h and 24 h, in-hospital mortality, coagulopathy, and need for transfusion were considered as relevant outcome parameters. The distribution of iCa2+ levels upon arrival at the emergency department was calculated in relation to these outcome parameters. Multivariable logistic regression analysis was performed to determine independent associations.

Results
In the TraumaRegister DGU® 30 183 adult major trauma patients were found eligible for inclusion. iCa2+ disturbances affected 16.4% of patients, with hypocalcemia (< 1.10 mmol/l) being more frequent (13.2%) compared to hypercalcemia (≥ 1.30 mmol/l, 3.2%).
Patients with hypo- and hypercalcemia were both more likely (P < .001) to have severe injury, shock, acidosis, coagulopathy, transfusion requirement, and haemorrhage as cause of death. Moreover, both groups had significant lower survival rates. All these findings were most distinct in hypercalcemic patients. When adjusting for potential confounders, mortality at 6 h was independently associated with iCa2+ < 0.90 mmol/L (OR 2.69, 95% CI 1.67–4.34; P < .001), iCa2+ 1.30–1.39 mmol/L (OR 1.56, 95% CI 1.04–2.32, P = 0.030), and iCa2+  ≥ 1.40 mmol/L (OR 2.87, 95% CI 1.57–5.26; P < .001). Moreover, an independent relationship was determined for iCa2+ 1.00–1.09 mmol/L with mortality at 24 h (OR 1.25, 95% CI 1.05–1.48; P = .0011), and with in-hospital mortality (OR 1.29, 95% CI 1.13–1.47; P < .001). Both hypocalcemia < 1.10 mmol/L and hypercalcemia ≥ 1.30 mmol/L had an independent association with coagulopathy and transfusion.

Conclusions
Transfusion-independent iCa2+ levels in major trauma patients upon arrival at the emergency department have a parabolic relationship with coagulopathy, need for transfusion, and mortality. Further research is needed to confirm whether iCa2+ levels change dynamically and are more a reflection of severity of injury and accompanying physiological derangements, rather than an individual parameter that needs to be corrected as such.

Graphical Abstract
Moderate exercise-induced dynamics on key sepsis-associated signaling pathways in the liver
Authors: Osuru Hari Prasad , Ikeda Keita , Atluri Navya , Thiele Robert H. 
Published: July 2023

Abstract
Background
There is a clear relationship between quantitative measures of fitness (e.g., VO2 max) and outcomes after surgical procedures. Whether or not fitness is a modifiable risk factor and what underlying biological processes drive these changes are not known. The purpose of this study was to evaluate the moderate exercise training effect on sepsis outcomes (survival) as well as the hepatic biological response. We chose to study the liver because it plays a central role in the regulation of immune defense during systemic infection and receives blood flow directly from the origin of infection (gut) in the cecal ligation and puncture (CLP) model.

Methods
We randomized 50 male (♂) and female (♀) Sprague–Dawley rats (10 weeks, 340 g) to 3 weeks of treadmill exercise training, performed CLP to induce polymicrobial “sepsis,” and monitored survival for five days (Part I). In parallel (Part II), we randomized 60 rats to control/sedentary (G1), exercise (G2), exercise + sham surgery (G3), CLP/sepsis (G4), exercise + CLP [12 h (G5) and 24 h (G6)], euthanized at 12 or 24 h, and explored molecular pathways related to exercise and sepsis survival in hepatic tissue and serum.

Results
Three weeks of exercise training significantly increased rat survival following CLP (polymicrobial sepsis). CLP increased inflammatory markers (e.g., TNF-a, IL-6), which were attenuated by exercise. Sepsis suppressed the SOD and Nrf2 expression, and exercise before sepsis restored SOD and Nrf2 levels near the baseline. CLP led to increased HIF1a expression and oxidative and nitrosative stress, the latter of which were attenuated by exercise. Haptoglobin expression levels were increased in CLP animals, which was significantly amplified in exercise + CLP (24 h) rats.

Conclusions
Moderate exercise training (3 weeks) increased the survival in rats exposed to CLP, which was associated with less inflammation, less oxidative and nitrosative stress, and activation of antioxidant defense pathways.

Graphical abstract
Development of microsatellite markers for the invasive mosquito Aedes koreicus
Authors: Soresinetti Laura , Arnoldi Irene , Negri Agata , Naro Giovanni , Michelutti Alice , Montarsi Fabrizio , Mosca Andrea , Bandi Claudio , Gabrieli Paolo , Epis Sara 
Published: July 2023

Abstract
Background
Aedes koreicus is a mosquito species native to East Asia which has recently invaded several countries in Europe. In Italy, this mosquito was first detected in the North-East in 2011 and is now widely distributed in the entire northern part of the country. The development of specific genetic markers, such as microsatellites, is necessary to uncover the dispersal routes of this mosquito from its native areas and, eventually, to plan future control interventions.

Methods
Available raw sequences of genomic DNA of Ae. koreicus were screened in silico using BLASTn to identify possible microsatellite-containing sequences. Specific primer pairs were then designed, and their efficiency was determined through polymerase chain reaction (PCR) on 32 individuals of Ae. koreicus collected in Italy. PCR conditions were optimised in three multiplex reactions. Genotyping of individual mosquitoes was performed on both single and multiplex PCR reactions. Finally, analysis of intra-population variation was performed to assess the level of polymorphism of the markers.

Results
Mosquito genotyping provided consistent results in both single and multiplex reactions. Out of the 31 microsatellite markers identified in the Ae. koreicus genome raw sequences, 11 were polymorphic in the examined mosquito samples.

Conclusions
The results show that the 11 microsatellite markers developed here hold potential for investigating the genetic structure of Ae. koreicus populations. These markers could thus represent a novel and useful tool to infer the routes of invasion of this mosquito species into Europe and other non-native areas.

Graphical Abstract
HUST bearing: a practical dataset for ball bearing fault diagnosis
Authors: Thuan Nguyen Duc , Hong Hoang Si 
Published: July 2023

AbstractObjectivesThe rapid growth of machine learning methods has led to an increase in the demand for data. For bearing fault diagnosis, the data acquisition is time-consuming with complicated processes. Existing datasets are only focused on only one type of bearing, which limits real-world applications. Therefore, the objective of this work is to propose a diverse dataset for ball bearing fault diagnosis based on vibration.Data descriptionIn this work, we introduce a practical dataset namedHUST bearing, which provides a large set of vibration data on different ball bearings. This dataset contains 99 raw vibration signals of 6 types of defects (inner crack, outer crack, ball crack, and their 2-combinations) on 5 types of bearing (6204, 6205, 6206, 6207, and 6208) at 3 working conditions (0 W, 200 W, and 400 W). Each vibration signal is sampled at a rate of 51,200 samples per second for 10 s. The data acquisition system is elaborately designed with high reliability.