bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ellagic acid ameliorates aging-induced renal oxidative damage through upregulating SIRT1 and NRF2
Authors: Naghibi Niloufar , Sadeghi Asie , Movahedinia Sajjadeh , Rahimi Naiini Mahdis , Rajizadeh Mohammad Amin , Bahri Faegheh , Nazari-Robati Mahdieh 
Published: March 2023

Abstract
Background
Aging is associated with impaired renal function and structural alterations. Oxidative stress plays a vital role in renal senescence and damage. Sirtuin 1 (SIRT1) is thought to protect cells from oxidative stress through nuclear factor erythroid 2-related factor 2 (NRF2). Ellagic acid (EA), a natural antioxidant, has been demonstrated to have renoprotective roles in vitro and in vivo. This study investigated if SIRT1 and NRF2 mediate the protective effects of EA in aged kidneys.

Methods
Male Wistar rats were divided into three groups including young (4 months), old, and old + EA (25 months). Young and old groups received EA solvent, while the old + EA group was treated with EA (30 mg/kg) by gavage for 30 days. Then, the level of renal oxidative stress, SIRT1 and NRF2 expression, kidney function parameters, and histopathological indices were measured.

Results
Treatment with EA significantly increased the level of antioxidant enzymes and reduced malondialdehyde concentration (P < 0.01). Moreover, EA administration remarkably upregulated mRNA and protein levels of SIRT1 and NRF2 as well as deacetylated NRF2 protein (P < 0.05). Additionally, EA treated rats improved kidney function and histopathological scores (P < 0.05).

Conclusions
These findings suggest that ellagic acid exerts protective effects on aged kidneys by activating SIRT1 and NRF2 signaling.
Clinical experience can compensate for inferior academic achievements in an undergraduate objective structured clinical examination
Authors: Tsikas Stefanos A. , Afshar Kambiz 
Published: March 2023

AbstractBackgroundPractical and non-cognitive skills are essential to medical professions; yet, success in medical studies is primarily assessed with cognitive criteria. We show that practical exams can benefit students who have only average high school final grades, but working experience in medical professions.MethodsWith a cross-sectional study, we compare the performance of undergraduate medical students with working experience in adjacent health-care professions (and below-average school leaving-grades) with students who entered medical school directly based on their excellent school records in an Objective Structured Clinical Examination (OSCE). For a sample of more than 1,200 students, we use information on OSCE scores in medical and practical skills, doctor-patient communication/interaction, performance in MC-exams, and core sociodemographic variables.ResultsWaiting list students outperformed their classmates in the demonstration of practical skills. Students admitted via their excellent school grades scored best overall. This difference vanishes once we control for school-leaving grade and age, the two main factors separating the analysed groups. Students from the waiting list have a significantly smaller overall chance to reach excellent grades in the first two years of study.ConclusionsStudents who gathered experiences in health-care professions before enrolling at medical school can benefit from an expanded role of practical elements in medical studies. Student selection instruments should take these different starting positions and qualities of applicants into account, for example with a quota for the professionally experienced.
Preparing allied health students for placement: a contrast of learning modalities for foundational skill development
Authors: Rossiter Laura , Turk Ruth , Judd Belinda , Brentnall Jennie , Grimmett Chloe , Cowley Emma , McCormick Keith , Thackray Deborah 
Published: March 2023

Abstract
Background
With increasing pressure on placement capacity for allied health students, a need for novel and creative means through which students can develop foundational skills and prepare for practice-based learning opportunities has arisen. This study aimed to explore the experiences of domestic and international first-year students completing pre-clinical preparation programs, contrasting between in-person simulation and online options to contribute to best practice evidence for program design and delivery.

Methods
First-year students from physiotherapy, podiatry and occupational therapy self-selected to either a one-weeklong in-person simulation program or an online preparation for placement program. An integrative mixed-methods approach was employed. Qualitative findings from student focus groups were analyzed by reflexive thematic analysis and complemented by quantitative pre-post questionnaires which were examined for patterns of findings.

Results
There were 53 student participants in the study (simulation n = 29; online n = 24). Self-selecting, international students disproportionately opted for the simulation program while older students disproportionately selected the online program. Students appeared to benefit more from the simulation program than the online program, with alignment of focus group findings to the quantitative questionnaire data. The in-person simulation allowed students to apply their learning and practice patient communication. All simulation students reported asubsequent increase in confidence, although this seemed particularly marked for the international students. By contrast, the online program was most effective at developing students’ clinical reasoning and proficiency with documentation. Both programs faced minor challenges to student perceived relevance and skill development.

Conclusion
Both online and in-person simulation preparation programs were perceived to enhance readiness and foundational skills development for novice allied health students, with the practical nature of simulation generating more advantageous findings. This study provides useful information on the benefits and challenges of both types of delivery for foundational skills development and/or clinical preparation of allied health students.
The development, implementation and early learnings of a training program to advance interest in behavioral research careers among undergraduate BIPOC students majoring in psychology
Authors: Lent Michelle R. , Gaither-Hardy Denise , Favor Kevin E. , Harris Diana , Cos Travis A. , Millard Conor , Kone Zatio , Van Riper Ashley , Dugosh Karen L. 
Published: March 2023

Abstract
Objectives
Black, indigenous and people of color (BIPOC) remain underrepresented in research occupations. This report discusses a collaboration to train undergraduate BIPOC students in clinical research between a public health institute, two medical schools, and a historically Black College or University (HBCU). This nine-month program trained BIPOC undergraduates in research methodology, psychology, and addiction science, and immersed trainees in real-world research. The program included didactic seminars, experiential activities, and a mentored research project culminating in a poster and oral presentation.

Methods
Key learnings, program satisfaction survey results, and preliminary outcomes from the first three program cohorts (N = 6 students) are presented. This program addressed several barriers hypothesized to contribute to the limited number of BIPOC students pursuing research careers, including mentorship from BIPOC faculty and financial concerns.

Results
Students reported moderate to high satisfaction with the program and endorsed gaining new research skills. Limitations and future directions are discussed.

Conclusion
The expansion of the BIPOC health and research workforce is an urgent priority given the importance of BIPOC professionals to the health of our nation.

Trial registration
ClinicalTrials.gov Identifier: NCT04650386.
Perception of National Youth Service Corps (NYSC) among corps medical doctors in Nigeria: a cross-sectional study
Authors: Nwachukwu Chibuike Emmanuel , Olufunmilayo Edward Oluwatobi , Chiroma Gideon Bulus , Okoye Chukwuebuka Francis 
Published: March 2023

Abstract
Background
The National Youth Service Corps (NYSC) is a compulsory one-year programme for graduates of tertiary schools including doctors. This study was conducted to find out the benefits and challenges of the programme among corps medical doctors as well as their treatment in their places of primary assignment (PPAs). The study would influence policymaking so as to improve the experiences of corps medical doctors and help NYSC to achieve its objectives.

Methods
A descriptive cross-sectional survey was conducted among 399 medical doctors doing their compulsory national youth service in Nigeria. The research instrument was developed by the researchers and pretested before use. The outcome variables were: overall benefit, overall challenge and overall PPA treatment. The data obtained were analyzed using descriptive statistics and chi-square test using p < 0.05.

Results
Majority of respondents (83.5%) believed that the scheme offered one or more benefits to corps medical doctors (overall benefit). These benefits include exposure to new culture (47.6%), gaining medical/surgical skills (36.3%) and finding a lover/spouse (4.5%). Similarly, most of respondents (89.2%) reported one or more challenges (overall challenge). Some of the challenges reported include; no provision of accommodation (51.6%), poor remuneration (44.7%) and exploitation of corps doctors by their employers (41.4%). There was a statistically significant association between overall benefit and region of deployment (p value: 0.013). Region of deployment and marital status were found to have a statistically significant association with the overall challenge with p-values of 0.031 and < 0.001 respectively. Overall treatment at PPAs was mostly reported to be bad (77.2%) and it had a statistically significant association with marital status (p-value: 0.002) and religion (p-value: 0.024).

Conclusion
Most respondents reported poor PPA treatment and this calls on the government and other stakeholders to take drastic measures to improve the welfare of corps medical doctors in order to positively influence their perception of the scheme and encourage their continued participation.
A national qualitative investigation of the impact of service change on doctors’ training during Covid-19
Authors: Silkens M. E. W. M. , Alexander K. , Viney R. , O’Keeffe C. , Taylor S. , Noble L. M. , Griffin A. 
Published: March 2023

Abstract
Background
The Covid-19 crisis sparked service reconfigurations in healthcare systems worldwide. With postgraduate medical education sitting within these systems, service reconfigurations substantially impact trainees and their training environment. This study aims to provide an in-depth qualitative understanding of the impact of service reconfiguration on doctors’ training during the pandemic, identifying opportunities for the future as well as factors that pose risks to education and training and how these might be mitigated.

Methods
Qualitative parallel multi-centre case studies examined three Trusts/Health Boards in two countries in the United Kingdom. Data were collected from online focus groups and interviews with trainees and supervisors using semi-structured interview guides (September to December 2020). A socio-cultural model of workplace learning, the expansive-restrictive continuum, informed data gathering, analysis of focus groups and coding.

Results
Sixty-six doctors participated, representing 25 specialties/subspecialties. Thirty-four participants were male, 26 were supervisors, 17 were specialty trainees and 23 were foundation doctors. Four themes described the impact of pandemic-related service reconfigurations on training: (1) Development of skills and job design, (2) Supervision and assessments, (3) Teamwork and communication, and (4) Workload and wellbeing. Service changes were found to both facilitate and hinder education and training, varying across sites, specialties, and trainees’ grades. Trainees’ jobs were redesigned extensively, and many trainees were redeployed to specialties requiring extra workforce during the pandemic.

Conclusions
The rapid and unplanned service reconfigurations during the pandemic caused unique challenges and opportunities to doctors’ training. This impaired trainees’ development in their specialty of interest, but also presented new opportunities such as cross-boundary working and networking.
Flipping the classroom in neurological bedside teaching: a prospective controlled study
Authors: Heitmann Henrik , Fischer Elisabeth , Wagner Philipp , Pötter Dennis , Gartmeier Martin , Schmidt-Graf Friederike 
Published: March 2023

Abstract
Background
Bedside teaching is essential to foster core clinical competences in medical education, especially in Neurology. However, bedside skills are declining and new concepts to enhance the effectiveness of bedside teaching are needed, also in view of limited in-person teaching possibilities in the ongoing pandemic situation. If theoretical knowledge is taught prior to in-person sessions this might allow to better focus on practical application aspects during bedside teaching. We thus aimed to answer the question to what extent such an approach can enhance the effectiveness of neurological bedside teaching.

Methods
In this prospective controlled study, neurological bedside courses following a traditional and a flipped classroom (FC) approach were compared with regards to their effects on theoretical knowledge and practical skills of medical students. Evaluations were obtained from 161 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and July 2021. Students were randomly assigned to course dates. However, the 74 students assigned to course dates from May to July 2021 completed a mandatory online preparation course prior to the bedside teaching. These students served as the interventional group (IG) and the remaining 87 students formed the control group (CG). Ratings of knowledge and skills provided by the students and their lecturers on numerical rating scales served as primary outcome measures. Moreover, the time needed to recapitulate theoretical contents during the in-person teaching session was assessed as a secondary outcome measure. Group comparisons were performed using t-statistics.

Results
Theoretical knowledge upon entering the course was rated significantly higher in the IG by the students (p < 0.001) and lecturers (p = 0.003). Lecturers also rated the practical skills of students in the IG significantly higher (p < 0.001). Furthermore, significantly less time was needed to recapitulate theoretical contents during the in-person session in the IG (p = 0.03).

Conclusions
Using a FC approach enhances the effectiveness of in-person neurological bedside teaching. Thus, these concepts are particularly valuable in the ongoing pandemic situation. Moreover, they might allow to reuse e-learning contents developed during the pandemic and to develop future bedside teaching concepts.
The current status of “spirituality and health” teaching in Brazilian medical schools: a nationwide survey
Authors: Lucchetti Giancarlo , de Araujo Almeida Paulo Othavio , Martin Elena Zuliani , Góes Leonardo Garcia , Cotta Keylla Cássia Gomes , Lima Andressa Correia , da Silva Ezequiel Oscarina , Lucchetti Alessandra Lamas Granero 
Published: March 2023

Abstract
Background
Recent data on the teaching of “spirituality and health” (S/H) in medical schools are needed. In this study, we aimed to investigate the current status of S/H teaching in Brazilian medical schools, the opinions of medical directors/deans on this topic and the factors associated with its incorporation into the curriculum.

Methods
A nationwide cross-sectional survey was carried out in 2021. Information concerning the S/H content in the curricula of medical schools was obtained through medical school representatives and other sources. Medical school representatives were asked about their opinions of and barriers to S/H teaching. Regression models were used to evaluate the factors associated with the incorporation of such content into the curriculum.

Results
Information on the incorporation of S/H content in medical curricula was retrieved from different sources for all 342 (100%) Brazilian medical schools. Among the representatives, 150 (43.9%) completed the online form. An increase in the S/H content in Brazilian medical schools was observed (from 40% to 2011 to 65.5% in 2021). Most medical school representatives agreed that this issue is important in medical training and that more space in the curriculum is needed. However, they also observed several barriers, such as a lack of knowledge of medical teachers/faculty, a lack of time, and the topic not being included in teaching plans. The most important factors that influenced the incorporation of S/H teaching in medical schools and representatives’ opinions were a lack of time and knowledge, professor preparedness and standardized national competency requirements.

Conclusion
These results could help medical educators rethink the incorporation of S/H content into their curricula.
Knowledge, attitudes and practices of university students toward COVID-19 in Southern region, Afghanistan: a cross-sectional study
Authors: Sirat Rahmatullah , Sahrai Mohammad Sediq , Rahimi Bilal Ahmad , Asady Abdullah , Wasiq Abdul Wahed 
Published: March 2023

Abstract
Background
Successful implementation of preventive measures and level of awareness in particular among university students in Afghanistan could play a crucial role in spreading the information for better control of the ongoing pandemic. Therefore, the aim of this study was to determine the level of knowledge, attitudes and practices (KAP) regarding COVID-19 among Kandahar university students.

Methods
A cross-sectional study conducted among undergraduate students to investigate their KAP regarding COVID-19 from January to March, 2021. The data were collected using a structured questionnaire (socio-demographic characteristics, KAP questionnaire) by phone call interviews.

Results
From 359 participants, 88.9% were males, 81.3% were single, 65.1% lived in urban areas, and more than 64% of the students were less than 23 years old. Overall, 86.6% of the study participants had adequate level of knowledge and 87.5% had positive attitudes toward COVID-19. Almost one-third of the participants had good practices regarding COVID-19. All KAP scores were higher in male students. Significant difference of good practice (p < 0.001) was observed among students who were in high socioeconomic status (SES) group. In univariate analysis, female sex (β: -0.75, p = 0.007) was negatively and watching television (β: 0.44; p = 0.014) was positively associated with knowledge score. However, in multivariate linear regression analysis, the knowledge score was significantly associated with age (β: -0.115; p = 0.004); attitude score was significantly associated with female sex (β: -2.776; p < 0.001) and radio use (β: -0.974; p = 0.031); and practice score was significantly associated with female sex (β: -3.704; p = 0.002) and urban area (β: 1.702; p = 0.016).

Conclusions
The overall knowledge and attitudes regarding COVID-19 among university students were desirable. Higher university year, young age, male sex and living in urban areas were significantly associated with good KAP regarding COVID-19. Good practices towards COVID-19 should be increased through awareness programs.
Active legs: Impact of physical activity as an adjuvant treatment in the healing of venous ulcers in primary care: a RCT protocol study
Authors: Herraiz-Ahijado Borja , Folguera-Álvarez Carmen , Verdú-Soriano José , Mori-Vara Pilar , Rico-Blázquez Milagros 
Published: March 2023

Abstract
Background
Venous ulcers usually present a torpid evolution with a negative impact on patients’ quality of life. In primary care, they account for 2.5% of nursing consultations and their treatment represents high costs for national health systems. These patients usually have a low level of physical activity, with muscle pump dysfunction of the lower limbs, which may improve with increased physical activity. The purpose of this study is to analyse the effectiveness of a structured intervention involving physical activity and exercise (Active Legs) as an adjuvant treatment in improving healing of chronic venous ulcers at 3 months follow-up.

Methods
A randomized, multicentre clinical trial. A total of 224 individuals receiving primary nursing care with a diagnosis of venous ulcer, with a diameter of 1 cm or greater and an ankle-brachial index between 0.8 and 1.3, able to comply with the study requirements and consenting to participate, will be sequentially included (112 per group).
Both groups will receive the standard treatment in primary care, with cleansing, debridement and healing in a moist environment together with multilayer compression therapy. The intervention group will also receive a structured educational intervention involving lower limb physical exercise and daily ambulation guidelines.
The primary response variables will be complete healing –understood as complete and sustained epithelialisation for at least 2 weeks– and time to healing. The secondary variables will be degree of healing, ulcer area, quality of life, pain and variables related to the healing process, prognosis, and recurrences. Sociodemographic variables, adherence to treatment and satisfaction variables will also be recorded. Data will be collected at baseline, at 3 months and at 6 months follow-up. Survival analysis (Kaplan-Meier and Cox) will be performed to measure primary effectiveness. Intention-to-treat analysis.

Discussion
If the intervention is effective, a cost-effectiveness analysis could be conducted and implemented as an additional intervention in the usual venous ulcer treatment in primary care.

Trial registration
NCT04039789. [https://ClinicalTrials.gov]. 07/11/2019.