bluuebunny/crossref_metadata_2025_split huggingface dataset:
Engineering student experience and self-direction in implementations of blended learning: a cross-institutional analysis
Authors: Evenhouse David , Lee Yonghee , Berger Edward , Rhoads Jeffrey F. , DeBoer Jennifer 
Published: March 2023

AbstractBackgroundMuch of researchers’ efforts to foster wider implementation of educational innovations in STEM has focused on understanding and facilitating the implementation efforts of faculty. However, student engagement in blended learning and other innovations relies heavily on students’ self-directed learning behaviors, implying that students are likely key actors in the implementation process. This paper explores the ways in which engineering students at multiple institutions experience the self-directed selection and implementation of blended learning resources in the context of their own studies. To accomplish this, it adopts a research perspective informed by Actor-Network Theory, allowing students themselves to be perceived as individual actors and implementors rather than a population that is implemented upon.ResultsA thematic analysis was conducted in two parts. First, analysis identified sets of themes unique to the student experience at four participant institutions. Then, a second round of analysis identified and explored a subset of key actors represented in students’ reported experiences across all institutions. The findings show clear similarities and differences in students’ experiences of blended learning across the four institutions, with many themes echoing or building upon the results of prior research. Distinct institutional traits, the actions of the instructors, the components of the blended learning environment, and the unique needs and preferences of the students themselves all helped to shape students’ self-directed learning experiences. Students’ engagement decisions and subsequent implementations of blended learning resulted in personally appropriate, perhaps even idiosyncratic, forms of engagement with their innovative learning opportunities.ConclusionThe institutional implementation of blended learning, and perhaps other educational innovations, relies in part on the self-directed decision-making of individual students. This suggests that instructors too hold an additional responsibility: to act as facilitators of their students’ implementation processes and as catalysts for growth and change in students’ learning behaviors. Developing a greater understanding of students’ implementation behaviors could inform the future implementation efforts of faculty and better empower students to succeed in the innovative classroom.
A simple method for taxon-specific purification of diatom frustules from ocean sediments using a cell sorter
Authors: Kato Yuji , Morono Yuki , Ijiri Akira , Terada Takeshi , Ikehara Minoru 
Published: March 2023

AbstractIt is necessary to purify diatom frustules by taxon to perform accurate geochemical analyses of diatom fossils preserved in sediments. However, the small size of diatoms has hitherto prevented taxon-specific purification; therefore, previous geochemical analyses of diatom frustules have been performed with mixtures of various taxa. In this study, we developed a taxon-selective collection method of diatom fossils that uses a cell sorter. The experimental material comprised six samples from a sediment core of Hole U1538A in the Scotia Sea, Atlantic sector of the Southern Ocean drilled during the International Ocean Discovery Program Expedition 382. Following conventional pretreatments (removal of organic matter and carbonates as well as clay minerals), we conducted cell sorter experiments focusing on the optical and fluorescence characteristics of the diatom fossils. We succeeded in selectively isolating with high purity five diatom taxa representing the Southern Ocean diatom flora: (1) discoid diatoms (mainly Thalassiosira) with a moderate degree of fluorescence; (2) Fragilariopsis (mainly Fragilariopsis kerguelensis), which exhibits the highest fluorescence values; (3) Rhizosolenia; (4) Eucampia antarctica; and (5) needle-shaped diatoms (Thalassiothrix). This taxon-specific diatom purification method will enable more accurate geochemical analyses, such as the oxygen isotope ratio (δ18O) of diatom frustules, which is likely to lead to significant advances in paleoceanography, especially at high latitudes or in upwelling zones where diatoms are abundant. This method will also be useful in paleolimnology, ocean biology, and phycology.
The predictive value of precipitating factors on clinical outcomes in hospitalized patients with decompensated heart failure: insights from the Egyptian cohort in the European Society of Cardiology Heart Failure long-term registry
Authors: Bendary Ahmed , Hassanein Mahmoud , Bendary Mohamed , Smman Ahmed , Hassanin Ahmed , Elwany Mostafa 
Published: March 2023

Abstract
Background
Knowledge of the frequency of precipitating factors for acute heart failure (AHF) is important (either new-onset heart failure [NOHF] or worsening heart failure [WHF]), as this can guide strategies for prevention and treatment. Most data come only from Western Europe and North America; nevertheless, geographic differences do exist. We set out to study the prevalence of precipitating factors of AHF and their connection to patient characteristics and in-hospital and long-term mortality in patients from Egypt hospitalized for decompensated HF. Using the ESC-HF-LT Registry which is a prospective, multicenter, observational study of patients confessed to cardiology centers in the nations of Europe and the Mediterranean, patients presenting with AHF were recruited from 20 centers all over Egypt. Enrolling physicians were requested to report possible precipitants from among several predefined reasons.

Results
We included 1515 patients (mean age 60 ± 12 years, 69% males). The mean LVEF was 38 ± 11%. Seventy-seven percent of the total population had HFrEF, 9.8% had HFmrEF, and 13.3% had HFpEF. The commonly reported precipitating factors for AHF hospitalization among study population were as follows (in decreasing order of frequency): infection in 30.3% of patients, acute coronary syndrome/myocardial ischemia (ACS/MI) in 26%, anemia in 24.3%, uncontrolled hypertension in 24.2%, atrial fibrillation (AF) in 18.3%, renal dysfunction in 14.6%, and non-compliance in 6.5% of patients. HFpEF patients had significantly higher rates of AF, uncontrolled hypertension, and anemia as precipitants for acute decompensation. ACS/MI were significantly more frequent in patients with HFmrEF. WHF patients had significantly higher rates of infection and non-compliance, whereas new-onset HF patients showed significantly higher rates of ACS/MI and uncontrolled hypertension. One-year follow-up revealed that patients with HFrEF had a significantly higher rate of mortality compared to patients with HFmrEF and HFpEF (28.3%, 19.5, and 19.4%, P = 0.004). Patients with WHF had a significantly higher rates of 1-year mortality when compared to those with NOHF (30.0% vs. 20.3%, P < 0.001). Renal dysfunction, anemia, and infection were independently connected to worse long-term survival.

Conclusions
Precipitating factors of AHF are frequent and substantially influence outcomes after hospitalization. They should be considered goals for avoiding AHF hospitalization and depicting those at highest risk for short-term mortality.
Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) 2.0 QUERI: study protocol for a cluster-randomized hybrid type 3 effectiveness-implementation trial
Authors: Hamilton Alison B. , Finley Erin P. , Bean-Mayberry Bevanne , Lang Ariel , Haskell Sally G. , Moin Tannaz , Farmer Melissa M. ,   the EMPOWER QUERI Team
Published: March 2023

Abstract
Background
Women Veterans are the fastest-growing segment of Veterans Health Administration (VA) users. The VA has invested heavily in delivering care for women Veterans that is effective, comprehensive, and gender-tailored. However, gender disparities persist in cardiovascular (CV) and diabetes risk factor control, and the rate of perinatal depression among women Veterans is higher than that among civilian women. Challenges such as distance, rurality, negative perception of VA, discrimination (e.g., toward sexual and/or gender minority individuals), and harassment on VA grounds can further impede women’s regular use of VA care. Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) 2.0 builds on work to date by expanding access to evidence-based, telehealth preventive and mental health services for women Veterans with high-priority health conditions in rural and urban-isolation areas.

Methods
EMPOWER 2.0 will evaluate two implementation strategies, Replicating Effective Practices (REP) and Evidence-Based Quality Improvement (EBQI), in supporting the implementation and sustainment of three evidence-based interventions (Virtual Diabetes Prevention Program; Telephone Lifestyle Coaching Program; and Reach Out, Stay Strong Essentials) focused on preventive and mental health care for women Veterans. We will conduct a mixed-methods implementation evaluation using a cluster-randomized hybrid type 3 effectiveness-implementation trial design to compare the effectiveness of REP and EBQI on improved access to and rates of engagement in telehealth preventive lifestyle and mental health services. Other outcomes of interest include (a) VA performance metrics for telehealth care delivery and related clinical outcomes; (b) progression along the Stages of Implementation Completion; (c) adaptation, sensemaking, and experiences of implementation among multilevel stakeholders; and (d) cost and return on investment. We will also generate implementation playbooks for program partners to support scale-up and spread of these and future evidence-based women’s health programs and policies.

Discussion
EMPOWER 2.0 provides a model for mixed-methods hybrid type 3 effectiveness-implementation trial design incorporating evaluation of performance metrics, implementation progress, stakeholder experience, and cost and return on investment, with the ultimate goal of improving access to evidence-based preventive and mental telehealth services for women Veterans with high-priority health conditions.

Trial registration
ClinicalTrials.gov, NCT05050266. Registered on 20 September 2021.
Prevalence and associated risk factors of gastrointestinal helminths and coccidian infections in domestic goats, Capra hircus, in Minya, Egypt
Authors: Mohamed Hend Ibrahim , Arafa Waleed M. , El-Dakhly Khaled Mohamed 
Published: March 2023

AbstractBackgroundHelminth and coccidian infections are among potential parasitic infections in the livestock production. The present study aimed to determine the prevalence and intensity of gastrointestinal helminths as well asEimeiaspecies in domestic goats.ResultsThe overall prevalence of parasitic infections was 50.24% (206/410). Twenty two species of helminth eggs/Eimeriaspp. oocysts were revealed. The prevalence of helminths was 21.95% (90/410) and that ofEimeriaspp. was 39.27% (161/410). Mixed infection was reported in 10.98% (45/410). The highest prevalence was found in young animals (75.0%; 60/80) followed by yearlings (58.46%; 76/130) and the lowest one was in adults (35.0%; 70/200). The infection rate was higher in females (59.02%; 180/305) than males (24.76%; 26/105). The prevalence was mostly highest in summer (63.85%; 83/130) followed by winter (57.78%; 52/90), autumn (40.0%; 28/70) and the lowest one was in spring (35.83%; 43/120). Age, sex and seasonal variations revealed significant (P ≤ 0.05) differences among examined goats. The infection with both nematodes andEimeriaspp. were detected in 7.32% (30/410). The co-infection withEimeriaspp. and tapeworms were found in 2.93% (12/410). Both trematodes andEimeriaspp. were seen in 0.73% (3/410) of examined specimens. NineEimeriaspecies were recorded;Eimeria ninakohlyakim-ovae,E. hirci,E.caprinova,E. caprina,E. christenseni,E. jolchijevi,E. arloingi, E. apsheronicaandE. alijevi. The most predominantEimeriaspecies wasE. arloingi(23.17%; 95/410) and the least abundant one wasE. apsheronica(0.73%; 3/410). The revealed trematodes wereFasciolaspp. (0.49%) andParamphistomumspp. (0.24%). Among cestodes, tapeworms belonged to Anoplocephalids includedMonieziaspp. (7.31%) andAvitellinasp. (0.49%) were detected. Meanwhile, coproculture revealed that the prevalence of nematodes infection was 13.41% (55/410) including nine species;Chabertia ovina,Ostertagia ostertagi,Haemonchus contortus,Trichostrongylus axei,T. colubriformis,Bunostomumsp.,Cooperia oncophora,Cooperia curticeiandStrongyloidesspp.ConclusionIn the present study, the prevalence of helminths was 21.95% and that ofEimeriaspp. was 39.27%, which is considered a high infection rate. Accordingly Strict hygienic measures as well as regular deworming are highly recommended to avoid wide spread of both helminth and coccidial infections.
Clinicopathologic Features of Breast Cancer in Egypt—Contemporary Profile and Future Needs: A Systematic Review and Meta-Analysis
Authors: Azim Hamdy A. , Elghazawy Hagar , Ghazy Ramy M. , Abdelaziz Ahmed H. , Abdelsalam Marwa , Elzorkany Amira , Kassem Loay 
Published: March 2023

PURPOSE Breast cancer (BC) is the most common cancer among Egyptian females. No current national cancer database is available in Egypt to provide reliable data on the specific clinicopathologic features of BC in this population. Herein, we investigated the clinical profile of BC among Egyptian women. METHODS A systematic review of studies on BC published from inception until December 2021 was performed. We explored pooled estimated proportions of different stages of BC at presentation in Egypt and other clinicopathologic features including age, menopausal status, tumor (T) and lymph node (N) stages, and biological subtypes. Data analysis was performed using meta package (R). RESULTS Twenty-six studies were eligible for our systematic review and meta-analysis, including 31,172 BC cases. In 12 studies, including 15,067 patients with BC, the estimated mean age was 50.46 years (95% CI, 48.7 to 52.1; I2, 99%), with a pooled proportion of premenopausal/perimenopausal women of 57% (95% CI, 50 to 63; I2, 98%). Among 9,738 patients with BC, pooled proportions of stage I, II, III, and IV were 6% (95% CI, 4 to 8; I2, 90%), 37% (95% CI, 31 to 43; I2, 93%), 45% (95% CI, 42 to 49; I2, 78%), and 11% (95% CI, 9 to 15; I2, 87%), respectively. The pooled proportions of patients with T3 and T4 tumors were 21% (95% CI, 14 to 31; I2, 99%) and 8% (95% CI, 5 to 12; I2, 96%), respectively, while those with positive lymph nodes were 70% (95% CI, 59 to 79; I2, 99%). CONCLUSION Dominance of advanced stage and young age at diagnosis represented the two main features of BC among Egyptian women. Our data may serve to guide the policymakers in Egypt as well as other countries with lower resources to prioritize the diagnostic and therapeutic needs in this context.
Magrolimab in Combination With Azacitidine in Patients With Higher-Risk Myelodysplastic Syndromes: Final Results of a Phase Ib Study
Authors: Sallman David A. , Al Malki Monzr M. , Asch Adam S. , Wang Eunice S. , Jurcic Joseph G. , Bradley Terrence J. , Flinn Ian W. , Pollyea Daniel A. , Kambhampati Suman , Tanaka Tiffany N. , Zeidner Joshua F. , Garcia-Manero Guillermo , Jeyakumar Deepa , Komrokji Rami , Lancet Jeffrey , Kantarjian Hagop M. , Gu Lin , Zhang Yajia , Tan Anderson , Chao Mark , O'Hear Carol , Ramsingh Giridharan , Lal Indu , Vyas Paresh , Daver Naval G. 
Published: March 2023

PURPOSE Magrolimab is a monoclonal antibody that blocks cluster of differentiation 47, a don't-eat-me signal overexpressed on cancer cells. Cluster of differentiation 47 blockade by magrolimab promotes macrophage-mediated phagocytosis of tumor cells and is synergistic with azacitidine, which increases expression of eat-me signals. We report final phase Ib data in patients with untreated higher-risk myelodysplastic syndromes (MDS) treated with magrolimab and azacitidine (ClinicalTrials.gov identifier: NCT03248479 ). PATIENTS AND METHODS Patients with previously untreated Revised International Prognostic Scoring System intermediate-/high-/very high-risk MDS received magrolimab intravenously as a priming dose (1 mg/kg) followed by ramp-up to a 30 mg/kg once‐weekly or once‐every-2-week maintenance dose. Azacitidine 75 mg/m2 was administered intravenously/subcutaneously once daily on days 1-7 of each 28-day cycle. Primary end points were safety/tolerability and complete remission (CR) rate. RESULTS Ninety-five patients were treated. Revised International Prognostic Scoring System risk was intermediate/high/very high in 27%, 52%, and 21%, respectively. Fifty-nine (62%) had poor-risk cytogenetics and 25 (26%) had TP53 mutation. The most common treatment-emergent adverse effects included constipation (68%), thrombocytopenia (55%), and anemia (52%). Median hemoglobin change from baseline to first postdose assessment was −0.7 g/dL (range, −3.1 to +2.4). CR rate and overall response rate were 33% and 75%, respectively. Median time to response, duration of CR, duration of overall response, and progression-free survival were 1.9, 11.1, 9.8, and 11.6 months, respectively. Median overall survival (OS) was not reached with 17.1-month follow-up. In TP53-mutant patients, 40% achieved CR with median OS of 16.3 months. Thirty-four patients (36%) had allogeneic stem-cell transplant with 77% 2-year OS. CONCLUSION Magrolimab + azacitidine was well tolerated with promising efficacy in patients with untreated higher-risk MDS, including those with TP53 mutations. A phase III trial of magrolimab/placebo + azacitidine is ongoing (ClinicalTrials.gov identifier: NCT04313881 [ENHANCE]).
Undergraduate Anesthesia Skills for a Global Surgery Agenda: Students’ Self-Reported Competence
Authors: Spijkerman Sandra , Manning Dianne Mary , Green-Thompson Lionel Patrick 
Published: March 2023

BACKGROUND:
Safe anesthesia is imperative for the Global Surgery agenda and Sustainable Development Goal 3. Due to a shortage of specialists in South Africa (SA), anesthetic services are often provided by nonspecialist doctors, often newly qualified and frequently without immediate supervision. The burden of disease in the developing world demands fit-for-purpose, day-one medical graduates. Although undergraduate anesthesia training is mandatory for medical students in SA, no outcomes are specified, and these are decided autonomously at each medical school. This study describes the current self-perceived anesthetic competence of medical students in SA as a needs assessment directed at achieving the goals of Global Surgery in SA and other developing countries.

METHODS:
In this cross-sectional observational study, 1689 students (89% participation rate), representing all medical schools in SA, rated their self-perceived competence at graduation in 54 anesthetic-related Likert scale items in 5 themes: patient evaluation, patient preparation for anesthesia, practical skills performance, administration of anesthesia, and the management of intraoperative complications. Medical schools were divided into clusters A (≥25 days of anesthetic training) and B (<25 days). Descriptive statistics, Fisher exact test, and a mixed-effects regression model were used in the statistical analysis.

RESULTS:
Students felt more prepared for history-taking and patient examination than for managing emergencies and complications. The self-perceived competence of students at cluster A schools was higher across all 54 items and all 5 themes. The same was observed for general medical skills and skills relating to maternal mortality in SA.

CONCLUSIONS:
Time-on-task, capacity for repetition, and student maturity might have impacted self-efficacy and should be considered in curriculum development. Students felt less prepared for emergencies. Focused training and assessment aimed at emergency management should be considered. Students did not feel competent in general medical areas, in which anesthetists are experts, including resuscitation, fluid management, and analgesia. Anesthetists should take ownership of this training at the undergraduate level. Cesarean delivery is the most performed surgical procedure in sub-Saharan Africa. The Essential Steps in Managing Obstetric Emergencies (ESMOE) program was designed for internship training but can be introduced at undergraduate level. This study suggests that curriculum reform is required. The achievement of an agreed-upon set of standardized national undergraduate anesthetic competencies may ensure fit-for-purpose practitioners. Undergraduate and internship training should align to form part of a continuum of basic anesthetics training in SA. The findings of this study might benefit curriculum development in other regions with similar contexts.
Did God WriteMoby-Dick?
Authors: Coviello Peter 
Published: March 2023

AbstractThis essay takes up two conceptual formations of great consequence to Herman Melville: “religion” and “literature.” Part of what binds them so tightly for Melville is a set of transformative upheavals in liberal culture that we have lately come to know by a different name: “secularism.” Melville helps us think secularism not as the extirpation of religion in modernity but as an ensemble of broadly disciplinary interventions, whose aim was both to exalt Protestant Christianity as the authorizing sign for planetary white dominion and to demote theology itself into a practice of gentle suasion, private consciousness-raising, influence. Moby-Dick is a novel shouting not into the void of a world abandoned by God—or not only—but into the empty space where the theocratic authority of the pulpit once was, where words fired by the titanic power of Godliness itself narrated, shaped, made history. In his fury and his despair, Melville maps out in cartographic detail the solidification of what would become “literature” as such as a by-product of secular discipline.
Reading Christian Experience
Authors: Mason Emma 
Published: March 2023

AbstractThe radicalism of Christianity is often underplayed in literary studies by scholars who perceive its theology as politically suspect and inflexible. Yet an unwillingness to engage with Christian theology and experience produces critical misreadings of literary texts that reveal Christianity’s doctrines and ideas as anything but myopic. This essay explores the doctrine of kenosis as integral to Christianity’s compassionate vision in the work of two writers associated with the nineteenth-century Catholic revival: Christina Rossetti and Gerard Manley Hopkins. Kenosis describes Christ’s becoming human as a temporary letting go of his divinity; for Rossetti and Hopkins, this models a way of being and thinking in which the subject is untied from an ego desirous of control and power. Both writers consequently embraced the interdependence of the Father, Son, and Holy Spirit in the Trinity as a way of conceptualizing faith through shared humility and weakness. This approach to the self, the world, and God is an important one to identify in Christian texts, but it also exemplifies a Christian way of thinking more broadly attuned to the depiction of vulnerability and introspection in literature and culture.