bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience of Medical School Faculty in the Transition From Lectures to Active Learning: A Phenomenographic Study
Authors: Huggett Kathryn N. , Smith Gary A. , Hsieh Peggy H. , Ownby Allison R. 
Published: January 2025

Abstract

Purpose
Although there is a robust literature on the benefits and outcomes of active learning in medical education, little is known about the faculty experience of transitioning from lecture-based teaching to active learning in the preclinical, foundational science curriculum. The authors explored how faculty describe changing from lecture to active learning and how that change relates to the loci of control and basic psychological needs of faculty.

Method
Using a phenomenographic approach, the authors interviewed faculty at 3 medical schools who taught before, during, and after required shifts to active learning. Interviews were conducted, recorded, and transcribed between February and May 2022. Open-ended interview questions were developed to allow participants to share significant experiences and perspectives. The researchers collaboratively attributed participants’ statements into categories of description of the change phenomenon. These categories were then grouped into an outcome space that represented aspects of the phenomenon and the relationships among them.

Results
The 15 participants described the change in instructional focus from lecture to active learning in 2 fundamentally different ways, defining the outcome space as 2 parallel sets of categories of description. A process set of categories describes the change in instructional focus from lecture to active learning as a process of instructional change, change in role, and socialization with other educators. The other categories correspond to motivation or demotivation via external and internal regulations related to self-determination theory.

Conclusions
This study offers valuable insights into the interconnected aspects of this educational transformation, providing perspectives that can guide future efforts in curriculum redesign and faculty support programs. Recommendations include engaging faculty in all stages of the transition, acknowledging and building on existing pedagogical innovation at the school, and providing options for faculty rather than a single prescribed approach. Future research should explore optimal approaches, timing, and support for curricular transitions.
Electronic Flashcards in Health Professions Education: A Scoping Review
Authors: Barrison Philip D. , Balczewski Emily A. , Capellari Emily , Landis-Lewis Zach , Vinson Alexandra H. 
Published: January 2025

Abstract

Purpose
Electronic flashcards (EFs) are a widely used learning resource in medical education. This scoping review provides a comprehensive overview of the existing empirical research on EFs and a direction for future research on EF interventions. The authors organized the reviewed articles into 4 nonmutually exclusive categories: development, delivery, utilization, and associated outcomes.

Method
In this scoping review, search queries were composed for 6 databases (PubMed, Embase, Education Resource Information Center, Web of Science, PsychInfo, and the Cumulative Index to Nursing and Allied Health Literature). The database search was conducted on April 12, 2024, for articles published before this date using the following keywords (as well as other keywords): anki, quizlet, firecracker, osmosis, flashcard, spaced repetition, spaced interval training, spaced interval learning, spaced test, and parallel curriculum. Two reviewers screened the studies for eligibility and performed data extraction between August 12, 2024, and September 26, 2024.

Results
Sixty-four studies were included in the review. Most articles were published in the last 6 years (2019-2024) (49 [77%]), in the United States (45 [7%]), and in the context of undergraduate medical education (42 [66%]). The studies predominantly focused on the utilization (51 [78%]) and associated outcomes (38 [59%]) of EFs. In contrast, EF development (12 [19%]) and delivery methods (16 [25%]) were less frequently examined.

Conclusions
This review of the rapidly increasing body of research on EFs suggests broad use and satisfaction among health professions learners; however, much work remains to be done to systematically understand EF development and delivery. Future research directions may consider more systematic investigations of how decisions made during the development and delivery of EFs affect downstream use and learning outcomes. Addressing these gaps will deepen the understanding of how EFs affect medical education pedagogy and facilitate the informed integration and refinement of these tools within curricula.
A Systems Approach to Improving Well-Being in Graduate Medical Education
Authors: Adibe Bryant , Brown Lawrence , Goulder Alison , Lee Elizabeth , Owen Leena , Roberts William , Yarru Gabrielle 
Published: January 2025

Abstract
The imperative to improve the well-being of graduate medical education (GME) trainees has been well documented. While existing interventions have largely centered on increasing individual trainee resilience, less focus has been on the role of national health policy, economics, and the overall U.S. care delivery system in acting as antecedent contributors to burnout among learners. To explore the impact of these national system level factors, Princeton University hosted the Systems Summit on Clinical Wellbeing in October 2023. Co-sponsored by the Accreditation Council for Graduate Medical Education, American Medical Association, and Healing Works Foundation, the event brought together thought leaders, policymakers, and experts from a myriad of backgrounds, including GME leaders and trainees.
Through a systems lens, summit attendees identified opportunities and barriers for well-being at both the national and health care organization levels. At the national level, identified barriers included historical national policy decisions, longstanding economic pressures in health care, and their combined cumulative impact on trainees. At the health care organization level, trainees pointed to an incongruity between common institutional wellness offerings and their more immediate support needs, along with unsustainable workload expectations, including the added toll of non-physician tasks (e.g., scheduling). A lack of appropriate tools for assessing well-being through a systems lens further compounds these issues. More actionable outputs may be achievable through the integration of operationally oriented well-being metrics (e.g., clinical and academic workload hours, call frequency, stay intent).
Long overdue updates to ill-fated national policy decisions, along with a redirection of the focus of GME well-being efforts at the programmatic level, could, in combination, fundamentally reshape the experience of trainees, contributing to lower incidences of depression, exhaustion, and burnout.
Role of follicular homing natural killer cells in HIV infection
Authors: Ponnan Sivasankaran Munusamy , Govindaraj Sakthivel , Velu Vijayakumar 
Published: January 2025

Purpose of review
Natural killer (NK) cells are integral components of the innate immune system, serving a vital function in eliminating virally infected cells. This review highlights the significance of CXCR5+ NK cells in the context of chronic HIV/SIV infection and viral control.

Recent findings
Controlled HIV/SHIV infection results in a substantial increase in the population of CXCR5+ NK cells within the B-cell follicles of secondary lymphoid organs (SLOs). These CXCR5+ NK cells display enhanced functional characteristics, including elevated expression of activation markers and increased cytokine production, which are essential for effective viral control. These follicular NK cells are shown to be enriched in IL-15 signaling, and CXCR5 NK cells are negatively associated with viral burden during chronic HIV and SHIV infection.

Summary
The distinct phenotypic and functional attributes of CXCR5+ NK cells, particularly in the lymphoid tissues of individuals living with HIV, emphasize their critical contribution to the anti-HIV-1 immune response. A comprehensive understanding of the mechanisms and roles of CXCR5+ NK cells may present novel therapeutic strategies aimed at enhancing NK-mediated viral control.
Workplace physical activity, sitting time, and menopause symptoms
Authors: Carter Sophie E. , Beaumont Alexander J. , Campbell Amy K. 
Published: January 2025

Abstract

Objective
Increasing numbers of women are in employment during the menopause; however, menopause symptoms can negatively impact capacity to work. Aspects of the work environment, such as the amount of time spent in physical activity (PA) and sitting, may influence symptoms, yet this is unexplored. This study aimed to explore relationships between workplace PA and sitting, and menopause symptom severity.

Methods
Using a cross-sectional study design, 264 perimenopausal or postmenopausal women were recruited to complete an online questionnaire assessing their self-reported workplace PA and sitting time, and their menopause symptom severity (menopause quality of life, hot flash interference, symptom severity). Multiple linear regression analyses examined the associations between menopause symptom severity and the time spent in PA (standing, walking, and physically demanding tasks) and sitting during work hours. Binomial logistical regression was used to assess if menopause symptom severity predicts whether women meet workplace activity guidelines.

Results
No significant associations were observed between the time spent in PA or sitting while at work and menopause symptom severity (P > 0.05). Menopause symptom severity did not significantly predict whether women met workplace activity guidelines (P > 0.05).

Conclusions
In a cohort of perimenopausal and postmenopausal women, self-reported time spent in PA and sitting while at work is not associated with menopause symptom severity. Further research is needed using device-based methods to assess PA and sitting time, to explore in more detail the influence of the time spent in these behaviors while at work on menopause symptoms.
Safety of Nirmatrelvir-Ritonavir Administration in Children With Immunodeficiency and/or Comorbidities With SARS-CoV-2 Infection: A Retrospective Clinical Report
Authors: Bernardi Stefania , Roversi Marco , Torelli Antonio , Musolino Antonio , Nicastri Emanuele , Palma Paolo , Rossi Paolo , Vallesi Leonardo , Corsetti Tiziana , Lancella Laura , Lucarelli Barbarella , Galaverna Federica , Villani Alberto , Perno Carlo Federico , Raponi Massimiliano ,   KIDS Study Group
Published: January 2025

Introduction:
Despite the generally mild course of COVID-19 in children, immunocompromised patients may experience complications or severe infection. This study reports the clinical outcomes of pediatric patients treated with nirmatrelvir and ritonavir (N/R) for SARS-CoV-2 infection.

Methods:
We retrospectively reported the data of children with any immunodeficiency with COVID-19 who received N/R treatment between March 2022 and June 2023 at the Bambino Gesù Children’s Hospital. Patients were treated with N/R for 5 days. We compared liver and kidney function before and after treatment with N/R and looked for a relationship between the duration of COVID-19 infection and the time from positivity to administration of N/R administration.

Results:
A total of 85 pediatric immunocompromised patients with COVID-19 were included in the study, with a mean age of 10.7 years (SD 4.8), mostly males (60%). We found a significant difference in the viral load before and after N/R administration. Four patients (4.7%) experienced adverse events related to N/R therapy. One of these had to discontinue N/R administration. Three patients (3.5%) experienced negative effects of drug interactions during N/R therapy, namely an increase of sirolimus and ciclosporin serum levels. A significant positive correlation was found between the time from SARS-CoV-2 positivity to N/R administration and the duration of SARS-CoV-2 swab positivity (R = 0.78, P < 0.001), suggesting that the earlier N/R is administered, the shorter the duration of COVID-19 in the study sample.

Conclusion:
Our experience shows that N/R is reasonably safe in the pediatric population and could favor viral clearance, thus reducing the duration of infection.
Improved Uptake of Vaccinations in Children With Adverse Events Following Immunization After Specialist Immunization Service Intervention in an Australian Pediatric Hospital
Authors: Yee Jialin Sabrina , Doyle Rebecca , Wen Sophie Chien-Hui 
Published: January 2025

Background:
Adverse Events Following Immunization (AEFI) have significant implications for public health, potentially leading to decreased immunization rates and vaccine hesitancy. Understanding the characteristics and outcomes of children experiencing AEFI is crucial for effective intervention strategies and informed decision-making. This study aimed to describe the diverse range of AEFI presentations, identify common referral sources and assess factors influencing vaccination uptake following specialist consultation.

Methods:
A single-center retrospective cohort study was conducted from 2019 to 2022, analyzing AEFI data from 191 children referred to a Specialist Immunization Service (SIS) at an Australian pediatric health service. Demographic data, referral details, vaccination history, and AEFI types were considered. Statistical analyses, including univariate and multivariate models, were employed to predict vaccination outcomes post-SIS consultation.

Results:
The median age of children referred was 2 years. General practitioners were the major referral source (68%). Urticarial rash was the most prevalent AEFI referred (29%). Pneumococcal conjugate vaccine was the most implicated vaccine (38%). The majority (69%) were successfully vaccinated following SIS consultation with 3% experiencing a subsequent AEFI (all mild). Older age is found to be associated with less likelihood for vaccination (odds ratio = 0.93, 95% confidence interval: 0.88–0.99, P = 0.027). Formal reporting of AEFI was low (26%).

Conclusions:
Severe adverse events, including anaphylaxis, were rare, and a SIS played an important role in vaccinating children following AEFI. Vaccination following urticarial rash is likely safe, and options such as a drop-in immunization center in a hospital setting may reduce delay to the next dose in scheduled vaccinations following AEFI. AEFI reporting needs to be promoted, and a patient-initiated reporting system may enhance this.
Cardiac arrest following blunt trauma-induced tension viscerothorax mimicking tension pneumothorax: A rare case report
Authors: Yuan Zhuo , Liao Changsheng , Zhang Songtao , Wang Aiwen , Zhou Congcong , Yi Wenbin , Han Zehao , Xue Shaoxiong , Shen Xuefeng 
Published: January 2025

Rationale:
Tension viscerothorax is a severe condition characterized by significant increases in thoracic pressure due to the herniation of abdominal organs into the thoracic cavity. It is commonly observed in children with congenital diaphragmatic hernias or as a postoperative complication, while tension viscerothorax resulting from blunt trauma is rare.

Patient concerns:
A 48-year-old male was urgently admitted to the emergency department with dyspnea following a fall from a height of 15 m.

Diagnoses:
The patient, presenting in shock and based on clinical signs, was initially diagnosed with a tension pneumothorax (TPT). Bedside point-of-care ultrasound (POCUS) revealed substantial parenchymal echo abnormalities in the left thoracic cavity and cardiac displacement to the right, suggesting a left-sided tension viscerothorax. Thoracic and abdominal computed tomography confirmed the diagnosis of a rare left-sided tension viscerothorax.

Interventions:
Due to the delayed diagnosis, the patient experienced a cardiac arrest. Following cardiopulmonary resuscitation and advanced life support, the patient regained spontaneous circulation and underwent an emergency laparotomy to reduce abdominal organs and repair a diaphragmatic hernia. Postoperatively, the patient received comprehensive medical care.

Outcomes:
The patient recovered well postsurgery and was discharged after an 18-day hospital stay. Follow-up over 2 years revealed no significant complications.

Lessons:
Blunt trauma-induced tension viscerothorax is rare and can easily be confused with TPT, leading to misdiagnosis. Early use of bedside POCUS is recommended for suspected cases to expedite identification and management, thereby improving survival rates.
Efficacy of topical carbonic anhydrase inhibitors in treating taxane drug-induced cystoid macular edema: A case report
Authors: Hou Xianbing , Chen Dandan , Lu Yingxue 
Published: January 2025

Rationale:
Taxanes, derived from Taxus chinesnsis, stabilize microtubules and include drugs like Paclitaxel, Docetaxel, and Nab-paclitaxel. These are commonly used to treat various malignant tumors. However, Taxane-drug-induced cystoid macular edema (TDICME) is a rare and often under-recognized complication.

Patient concerns:
A male patient, aged sixty-three, who was diagnosed with poorly differentiated gastric adenocarcinoma, experienced a progressive decline in visual acuity in both eyes after a 4-month course of nab-paclitaxel therapy.

Diagnoses:
Upon Fundus examination, bilateral cystoid macular edema (CME) was seen.

Interventions:
Undergo treatment with carbonic anhydrase inhibitors and discontinue the use of nab-paclitaxel.

Outcomes:
After eleven days of treatment with carbonic anhydrase inhibitors, the patient reported significant improvement in visual acuity. Furthermore, CME was completely resolved in both eyes 8 weeks after stopping nab-paclitaxel.

Lessons:
This case highlights the potential therapeutic effectiveness of topical carbonic anhydrase inhibitors in treating TDICME. Our findings underscore the importance of monitoring and addressing ocular side effects in patients undergoing Taxane therapy, ultimately contributing to enhanced patient quality of life and treatment outcomes.
Berry syndrome, a rare congenital cardiac structural abnormality with 1-stage surgical repair: A case report
Authors: Su Yueqiu , Leng Zhou 
Published: January 2025

Rationale:
Berry syndrome is a complex congenital heart anomaly characterized by a combination of aortopulmonary window, interrupted aortic arch or hypoplastic aortic arch or coarctation of the aorta, anomalous origin of the right pulmonary artery, patent ductus arteriosus, and intact ventricular septum. It is an extremely rare condition, with approximately 100 reported cases to date.

Patient concerns:
In this article, we report a case of a 6-year-old girl with Berry syndrome who presented with significant ischemic and hypoxic symptoms.

Diagnoses:
Based on the patient’s medical history and examinations, a definitive diagnosis of Berry syndrome was established.

Interventions:
She underwent a 1-stage surgical treatment and had a successful discharge. The surgical process was aimed to preserve the growth potential of the aorta and pulmonary arteries while achieving unobstructed left ventricular outflow and continuity of the aortic arch, ensuring no shunting between the main pulmonary arteries.

Outcomes:
Intraoperative transesophageal echocardiography confirmed continuous flow through the aortic arch and no shunting between the MPA and the aorta.
Efficacy and safety of herbal medicine treatment on postsurgical recovery in gastric cancer patients: A systematic review and meta-analysis
Authors: Kim Soo-Dam , Pyo Sook-Jin , Kim Dong-Hyeon , Yoo Hwa-Seung , Park So-Jung 
Published: January 2025

Background:
Gastric cancer (GC) is the second most prevalent cancer in Korea, and is associated with significant morbidity and mortality. Although advancements in early detection and treatment have improved survival rates, management of postsurgical recovery remains vital. Herbal medicine (HM) has emerged as a potential adjunct therapy for enhancing the recovery and quality of life (QoL) of patients post-GC surgery.

Methods:
This systematic review and meta-analysis evaluated the efficacy and safety of HM in the postsurgical recovery of patients with GC. We searched both Korean and international databases and identified 16 randomized controlled trials that met our inclusion criteria. We assessed the study quality using the Cochrane Risk of Bias tool and analyzed the data using the Review Manager Software (RevMan).

Results:
Our analysis included 1546 patients from selected studies, demonstrating that HM significantly improved gastrointestinal recovery times, including the time to first flatus, bowel movement, and return of bowel sounds. Significant improvements were also observed in nutritional markers, such as albumin and prealbumin, along with beneficial effects on immune markers, such as CD3+ and CD4+ levels. QoL assessments using the WHOQOL-BREF and QLQ-C30 indicated substantial improvements. HM had a favorable safety profile, showing a reduced incidence of adverse effects compared to the controls.

Conclusion:
The findings suggest that HM can significantly enhance recovery and improve quality of life following GC surgery, with a favorable safety profile. However, due to the considerable heterogeneity in study results, extended clinical trials and rigorous follow-ups are recommended to comprehensively assess long-term effects and side effects.
Study on mechanism of iridoid glycosides derivatives from Fructus Gardeniae in treatment of hepatic encephalopathy by network pharmacology and molecular docking technology
Authors: Liu Fangzhou , Li Meng , Li Yuanbai , Du Yu , Li Yihao , Yang Yang 
Published: January 2025

Background:
This study aims to explore the mechanism of the iridoid glycosides from Fructus Gardeniae (IGFG) in treating hepatic encephalopathy (HE) by combining network pharmacology and molecular docking technology.

Methods:
Firstly, we collected the targets of IGFG and HE. The targets of IGFG were predicted through the CTD, SWISS and TCMSP database and the targets of HE were screened through the DisGeNET database. Then the targets of IGFG and HE were mapped to attain the common target of IGFG in treating HE. Then, chemicals-target-disease network was constructed. Secondly, we constructed protein–protein interactions (PPI) network using STRING database and Cytoscape software. Moreover, we screened the core targets according to the degree value. Thirdly, the mechanism of IGFG in treating HE was revealed by Gene ontology and KEGG enrichment analysis. Meanwhile, chemicals-target-pathway network was constructed. Finally, to further verify the analysis results, molecular docking study was conducted.

Results:
Network pharmacology indicates that there are 12 common targets between IGFG and HE. Eleven core targets were identified by the construction of PPI network. Association for core targets, and related pathways was analyzed, implying that core targets related to these pathways are AKT1, tumor necrosis factor, MTOR, CHUK, PPP2CA, IKBKB, AKT2, IKBKG, IL1B, NFKBIA, and CASP8. The main mechanism of IGFG in treating HE is closely related to inhibit inflammatory reaction, regulate immunity, promote hepatocyte regeneration, reduce hepatocyte apoptosis, maintain liver function homeostasis and antiviral function. Finally, the results of molecular docking showed that the binding free energy of geniposide with the core target was less than −5 kJ/mol, which indicated that geniposide could spontaneously bind to the receptor protein and had strong binding force.

Conclusion:
IGFG can achieve simultaneous intervention of HE by inhibit inflammatory reaction, regulate immunity, promote hepatocyte regeneration, reduce hepatocyte apoptosis, maintain liver function homeostasis and antiviral function. It presents the network regulation mechanism of mutual influence and complex correlation. This study provides a scientific basis for IGFG in the treatment of patients with HE.