bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demographics, clinical interests, and ophthalmology skills confidence of medical student volunteers and non-volunteers in an extracurricular community vision screening service-learning program
Authors: Burton Eleanor , Assi Lama , Vongsachang Hursuong , Swenor Bonnielin K. , Srikumaran Divya , Woreta Fasika A. , Johnson Thomas V. 
Published: March 2022

AbstractBackgroundMedical school curricular hours dedicated to ophthalmology are low and declining. Extracurricular ophthalmology activities, such as participation in community vision screenings, may serve an important adjunctive role in medical school curricula. The Johns Hopkins University (JHU) Vision Screening In Our Neighborhoods (ViSION) Program is an example of a voluntary medical student-directed community service-learning program.MethodsWe used a mixed-methods cross-sectional approach, including an online survey and semi-structured interviews. JHU School of Medicine students enrolled in MD or MD/PhD programs during the 2019–2020 academic year were surveyed regarding demographics, career and service interests, involvement in ophthalmology-related activities, and confidence in their ophthalmology-related skills. Survey responses were compared between ViSION volunteers and non-volunteers using Fisher’s exact chi-square tests. Semi-structured interviews were conducted via webconference with 8 prior or current ViSION volunteers and responses analyzed using inductive thematic analysis. Data were collected when ViSION volunteers were in variable stages of their medical education and involvement with the ViSION program.ResultsA total of 118 medical students were included, representing an overall response rate of 24.6% of JHU medical students. ViSION volunteers reported greater involvement in ophthalmology-related research (42% vs. 4%,p < 0.001), intent to apply to ophthalmology residency programs (35% vs. 1%,p = 0.001), and confidence with multiple ophthalmology knowledge and clinical skill domains. In particular, ViSION volunteers were more likely to feel confident estimating cup-to-disc ratio using direct ophthalmoscopy (20% vs. 0%,p < 0.001). In open-ended survey and interview questions, most volunteers attributed at least some degree of their ophthalmology skill development and desire to pursue ophthalmology and public health careers to their ViSION experience.ConclusionsMedical students who volunteered with a student-led community vision screening program were more likely to have a prior interest in ophthalmology than those who did not volunteer, but only 1/3 of volunteers planned to pursue a career in ophthalmology. Overall, volunteers reported higher confidence performing ophthalmology-related clinical skills, suggesting that student-led community vision screening programs may provide an important avenue for medical students to explore public health aspects of ophthalmology, while practicing ophthalmology exam skills and learning about common ophthalmic pathologies, regardless of their career intentions.
“Not yet a doctor”: medical student learning experiences and development of professional identity
Authors: Park Gyu Mi , Hong Ah Jeong 
Published: March 2022

AbstractBackgroundTo become a good doctor, developing a professional identity is as important as having the right knowledge and skills. Great attention has been given to professional identity in medical school because it plays an important role in the transition from student to doctor. Nonetheless, the necessity of acquiring a tremendous amount of knowledge and skill during medical school training does not create sufficient opportunities for students to develop their professional identities. Thus, this paper pays careful attention to how students’ learning experiences in medical school affect this development. The research questions are as follows. 1) How do medical students’ perceptions of doctors change or strengthen after entering medical school in the process of professional identity development? 2) What kinds of knowledge have medical students accumulated while attending medical school? How do their learning experiences affect professional identity development? 3) What is a doctor’s role and the career’s meaning to medical students, and what understanding does this awareness bring to their learning experiences and lives as future doctors?MethodsIn-depth semi-structured interviews were conducted with 20 Korean students in their fourth year of medical school; all had more than one year of experience in clinical settings. The students’ learning experiences and professional identity development were used to analyze the data using inductive thematic analysis.ResultsWhen students first entered medical school, they perceived their identities as “given to” them by society. However, various learning experiences during the medical school years affected them, causing them to think about becoming a doctor according to their own perceptions and the meaning of becoming a doctor in the profession. Although an isolated medical community and a competitive student culture hindered them from searching for their professional identities, informal learning experiences, including active interaction with patients, senior doctors, and others outside the medical community, enabled them to develop their professional identities. The medical students experienced a conflict between individual and professional values as they considered what kind of doctor they would be in the future.ConclusionsThe findings noted in this study extend the understanding of professional identity and informal learning experiences in medical school.
Establishing and evaluating physician-pharmacist collaborative clinics to manage patients with type 2 diabetes in primary hospitals in Hunan province: study protocol of a multi-site randomized controlled trial in the era of COVID-19 pandemic
Authors: Tan Sheng-Lan , Xiao Jie , Yuan Hai-Yan , Chen Lei , Wang Qing , Xiang Da-Xiong , Li Xia , Zhou Yan-Gang , Guo Yan , Huang Hai-Ying , Zhao Dan-Hui , Li Yue , Wang Li , Li Qun , Liu Juan , Xu Ping 
Published: March 2022

Abstract
Background
The COVID-19 pandemic has exerted an unprecedented and universal impact on global health system, resulting in noticeable challenges in traditional chronic disease care, of which diabetes was reported to be most influenced by the reduction in healthcare resources in the pandemic. China has the world’s largest diabetes population, and current diabetes management in China is unsatisfactory, particularly in rural areas. Studies in developed countries have demonstrated that physician-pharmacist collaborative clinics are efficient and cost-effective for diabetes management, but little is known if this mode could be adapted in primary hospitals in China. The aim of this proposed study is to develop and evaluate physician-pharmacist collaborative clinics to manage type 2 diabetes mellitus (T2DM) in primary hospitals in Hunan province.

Methods
A multi-site randomized controlled trial will be conducted to evaluate the effectiveness and cost-effectiveness of the physician-pharmacist collaborative clinics compared with usual care for Chinese patients with T2DM. Six primary hospitals will participate in the study, which will recruit 600 eligible patients. Patients in the intervention group will receive services from both physicians and pharmacists in the collaborative clinics, while the control group will receive usual care from physicians. Patients will be followed up at the 3rd, 6th, 9th and 12th month. Comparison between the two groups will be conducted by assessing the clinical parameters, process indicators and costs on diabetes. A satisfaction survey will also be carried out at the end of the study.

Discussion
If effective, the physician-pharmacist collaborative clinics can be adapted and used in primary hospitals of China to improve glycemic control, enhance medication adherence, decrease incidence of complications and reduce patients’ dependence on physicians. Findings from the present study are meaningful for developing evidence-based diabetes care policy in rural China, especially in the COVID-19 pandemic era.

Trial registration
Chinese Clinical Trial Registry, ChiCTR2000031839, Registered 12 April 2020.
A refined procedure for esophageal resection using a full minimally invasive approach
Authors: Ashiku Simon K. , Patel Ashish R. , Horton Brandon H. , Velotta Jeffrey , Ely Sora , Avins Andrew L. 
Published: March 2022

Abstract
Objective
Newer minimally invasive approaches to esophagectomy have brought substantial benefits to esophageal-cancer patients and continue to improve. We report here our experience with a streamlined procedure as part of a comprehensive perioperative-care program that provides additional advances in the continued evolution of this procedure.

Methods
All patients with primary esophageal cancer referred for resection to the Oakland Medical Center of the Kaiser-Permanente Northern California health plan who underwent this approach between January 2013 and August 2018 were included. Operative and clinical outcome variables were extracted from the electronic medical record, operating-room files, and manual chart review.

Results
142 patients underwent the new procedure and care program; 121 (85.2%) were men with mean age of 64.5 years. 127 (89.4%) were adenocarcinoma; 117 (82.4%) were clinical stage III or IVA. 115 (81.0%) required no jejunostomy. Median hospital length-of-stay was 3 days and 8 (5.6%) patients required admission to the intensive care unit. Postoperative complications occurred in 22 (15.5%) patients within 30 days of the procedure. There were no inpatient deaths; one patient (0.7%) died within 30 days following discharge and three additional deaths (2.1%) occurred through 90 days of follow-up.

Conclusions
This approach resulted in excellent clinical outcomes, including short hospital stays with limited need for the intensive care unit, few perioperative complications, and relatively few patients requiring feeding tubes on discharge. This comprehensive approach to esophagectomy is feasible and provides another clinically meaningful advance in the progress of minimally invasive esophagectomy. Further development and dissemination of this method is warranted.
Bi-allelic mutation of CTNNB1 causes a severe form of syndromic microphthalmia, persistent foetal vasculature and vitreoretinal dysplasia
Authors: Taylor Rachel L. , Soriano Carla Sanjuro , Williams Simon , Dzulova Denisa , Ashworth Jane , Hall Georgina , Gale Theodora , Lloyd I. Christopher , Inglehearn Chris F. , Toomes Carmel , Douzgou Sofia , Black Graeme C. 
Published: March 2022

Abstract
Background
Inherited vitreoretinopathies arise as a consequence of congenital retinal vascularisation abnormalities. They represent a phenotypically and genetically heterogeneous group of disorders that can have a major impact on vision. Several genes encoding proteins and effectors of the canonical Wnt/β-catenin pathway have been associated and precise diagnosis, although difficult, is essential for proper clinical management including syndrome specific management where appropriate. This work aimed to investigate the molecular basis of disease in a single proband born to consanguineous parents, who presented with microphthalmia, persistent foetal vasculature, posterior lens vacuoles, vitreoretinal dysplasia, microcephaly, hypotelorism and global developmental delay, and was registered severely visually impaired by 5 months of age.

Methods
Extensive genomic pre-screening, including microarray comparative genomic hybridisation and sequencing of a 114 gene panel associated with cataract and congenital ophthalmic disorders was conducted by an accredited clinical laboratory. Whole exome sequencing (WES) was undertaken on a research basis and in vitro TOPflash transcriptional reporter assay was utilised to assess the impact of the putative causal variant.

Results
In the proband, WES revealed a novel, likely pathogenic homozygous mutation in the cadherin-associated protein beta-1 gene (CTNNB1), c.884C>G; p.(Ala295Gly), which encodes a co-effector molecule of the Wnt/β-catenin pathway. The proband’s parents were shown to be heterozygous carriers but ophthalmic examination did not detect any abnormalities. Functional assessment of the missense variant demonstrated significant reduction of β-catenin activity.

Conclusions
This is the first report of a biallelic disease-causing variation in CTNNB1. We conclude that this biallelic, transcriptional inactivating mutation of CTNNB1 causes a severe, syndromic form of microphthalmia, persistent foetal vasculature and vitreoretinal dysplasia that results in serious visual loss in infancy.
Mild disease course of SARS-CoV-2 infections and mild side effects of vaccination in Pompe disease: a cohort description
Authors: Ismailova G. , Mackenbach M. J. , van den Hout J. M. P. , van der Ploeg A. T. , Brusse E. , Wagenmakers M. A. E. M. 
Published: March 2022

AbstractIntroductionPatients with Glycogen Storage Disease type II (GSDII), an inheritable metabolic myopathy also known as Pompe disease, are considered to be at risk for severe COVID-19 due to a reduced respiratory function and a tendency to be overweight. However, so far little is known about the course of SARS-CoV-2 infection and side effects of COVID-19 vaccinations in patients with GSDII.Methods169 Dutch Pompe patients are followed at the Erasmus MC Rotterdam. During the COVID-19 pandemic patients were requested to directly inform their physicians about SARS-CoV-2 infection. Infected patients were interviewed regularly by telephone until their symptoms subsided. Furthermore, all patients eligible for vaccination on 16-7-2021 (≥ 17 years, n = 122) were asked to complete a questionnaire.ResultsTo date, fifteen patients (8.9% of our cohort) reported a SARS-CoV-2 infection (classic infantile Pompe disease n = 5, late onset n = 10). No patients were admitted to hospital or needed intensivation of ventilatory support. All patients made a recovery within 19 days. 41.8% of patients filled in our questionnaire regarding vaccination, of whom 98% were vaccinated. Besides one case of perimyocarditis, only mild side effects were reported.ConclusionOverall, patients with Pompe disease showed mild symptoms from infection with SARS-CoV-2. All patients made a full recovery. Side effects after vaccination were mostly mild.
Activity of putative orexin neurons during cataplexy
Authors: Zhou Shi , Yamashita Akira , Su Jingyang , Zhang Yang , Wang Wuyang , Hao Liying , Yamanaka Akihiro , Kuwaki Tomoyuki 
Published: March 2022

AbstractIt is unclear why orexin-deficient animals, but not wild-type mice, show cataplexy. The current hypothesis predicts simultaneous excitation of cataplexy-inhibiting orexin neurons and cataplexy-inducing amygdala neurons. To test this hypothesis, we measured the activity of putative orexin neurons in orexin-knockout mice during cataplexy episodes using fiber photometry. We created two animal models of orexin-knockout mice with a GCaMP6 fluorescent indicator expressed in putative orexin neurons. We first prepared orexin-knockout mice crossed with transgenic mice carrying a tetracycline-controlled transactivator transgene under the control of the orexin promoter. TetO-GCaMP6 was then introduced into mice via an adeno-associated virus injection or natural crossing. The resulting two models showed restricted expression of GCaMP6 in the hypothalamus, where orexin neurons should be located, and showed excitation to an intruder stress that was similar to that observed in orexin-intact mice in our previous study. The activity of these putative orexin neurons increased immediately before the onset of cataplexy-like behavior but decreased (approximately − 20% of the baseline) during the cataplexy-like episode. We propose that the activity of orexin neurons during cataplexy is moderately inhibited by an unknown mechanism. The absence of cataplexy in wild-type mice may be explained by basal or residual activity-induced orexin release, and emotional stimulus-induced counter activation of orexin neurons may not be necessary. This study will serve as a basis for better treatment of cataplexy in narcolepsy patients.
Spatiotemporal parameters and gait variability in people with psoriatic arthritis (PsA): a cross‐sectional study
Authors: Walha Roua , Gaudreault Nathaly , Dagenais Pierre , Boissy Patrick 
Published: March 2022

AbstractBackgroundFoot involvement is a major manifestation of psoriatic arthritis (PsA) and can lead to severe levels of foot pain and disability and impaired functional mobility and quality of life. Gait spatiotemporal parameters (STPs) and gait variability, used as a clinical index of gait stability, have been associated with several adverse health outcomes, including risk of falling, functional decline, and mortality in a wide range of populations. Previous studies showed some alterations in STPs in people with PsA. However, gait variability and the relationships between STPs, gait variability and self‐reported foot pain and disability have never been studied in these populations. Body‐worn inertial measurement units (IMUs) are gaining interest in measuring gait parameters in clinical settings.ObjectivesTo assess STPs and gait variability in people with PsA using IMUs, to explore their relationship with self‐reported foot pain and function and to investigate the feasibility of using IMUs to discriminate patient groups based on gait speed‐critical values.MethodsTwenty‐one participants with PsA (age: 53.9 ± 8.9 yrs.; median disease duration: 6 yrs) and 21 age‐ and sex‐matched healthy participants (age 54.23 ± 9.3 yrs) were recruited. All the participants performed three 10‐m walk test trials at their comfortable speed. STPs and gait variability were recorded and calculated using six body‐worn IMUs and Mobility Lab software (APDM®). Foot pain and disability were assessed in participants with PsA using the foot function index (FFI).ResultsCadence, gait speed, stride length, and swing phase were significantly lower, while double support was significantly higher, in the PsA group (p < 0.006). Strong correlations between STPs and the FFI total score were demonstrated (|r| > 0.57, p < 0.006). Gait variability was significantly increased in the PsA group, but it was not correlated with foot pain or function (p < 0.006). Using the IMUs, three subgroups of participants with PsA with clinically meaningful differences in self‐reported foot pain and disability were discriminated.ConclusionSTPs were significantly altered in participants with PsA, which could be associated with self‐reported foot pain and disability. Future studies are required to confirm the increased gait variability highlighted in this study and its potential underlying causes. Using IMUs has been useful to objectively assess foot function in people with PsA.Trial registrationClinicalTrials.gov, NCT05075343, Retrospectively registered on 29 September 2021.
miR-4324 inhibits ovarian cancer progression by targeting FEN1
Authors: Wu Haixia , Yan Youliang , Yuan Jialin , Luo Mengze , Wang Yingjian 
Published: March 2022

Abstract
Background
Ovarian cancer is one of the most lethal malignancies, with a 1.9% mortality rate worldwide. The dysregulation of the FEN1 gene and miR-4324 has been associated with cancer progression. However, the relationship between miR-4324 and-FEN1 requires further investigation.

Methods
miR-4324 and FEN1 expressions in ovarian cancer tissues and cell lines were measured via RT-qPCR. The interaction between miR-4324 and FEN1 was assessed using luciferase and RNA pull-down assays. The effects of miR-4324 and FEN1 on cell proliferation, adhesion and apoptosis were determined by CCK-8, BrdU, colony formation, cell adhesion, Caspase-3 and western blot assays in ovarian cancer cell lines CaOV3 and OVCAR3, respectively.

Results
The results showed that miR-4324 expression was significantly decreased and FEN1 expression was enhanced in ovarian cancer tissues and cell lines. miR-4324 inhibitor promoted cell proliferation, adhesion and migration, and prevented apoptosis. Furthermore, the downregulation of FEN1 inhibited ovarian cancer cell growth and increased apoptosis. miR-4324 inhibited FEN1 expression and repressed ovarian cancer progression.

Conclusion
Our study found that miR-4324 inhibited FEN1 expression, suppressed cell growth, and increased apoptosis in ovarian cancer cells. Therefore, we identified miR-4324 and FEN1 as potential therapeutic targets for ovarian cancer treatment.
Hospital management of hyperglycemia in the context of COVID-19: evidence-based clinical considerations
Authors: Mendes Thiago Bosco , Câmara-de-Souza Alexandre Barbosa , Halpern Bruno 
Published: March 2022

AbstractThe COVID-19 pandemic led to an unprecedented crisis, and early on, it has been shown that diabetes is an important risk factor for complications and mortality in infected patients, as demonstrated by several studies. Moreover, hyperglycemia, regardless of whether patients have diabetes, is associated with poorer outcomes, which suggests that adequate monitoring and treatment of elevated glycemia in the hospital setting can improve patient outcomes. In patients with COVID-19, glycemic control may be impaired as a consequence of the infection itself (aggravating pre-existing diabetes and potentially precipitating new-onset diabetes), inflammation, or corticosteroid use—a well-established therapy to reduce COVID-19 complications, especially in the intensive care unit. This article reviews the link between diabetes and hyperglycemia, and COVID-19, with a brief review of potential mechanisms, along with emerging evidence on the effect of glycemic control on COVID-19 outcomes, especially in hospital settings.
Unexpected benefits of and lessons learned from shifting to virtual focus group discussions in the BEECON trial
Authors: Lindau Helen , Ramos-Gomez Francisco , Garza Jeremiah , Finlayson Tracy , Pareja Morgan , Liu Jenny , Gansky Stuart 
Published: March 2022

Abstract
Objective
The COVID-19 pandemic has forced many human subjects research to halt in-person activities and pivot to virtual engagement, including Focus Groups (FGs). We highlight learnings from our experience of hosting virtual FGs from our BEhavioral EConomics for Oral health iNnovation (BEECON) study focusing on oral hygiene behaviors among low-income, predominantly Hispanic families, including practical tips and potential pitfalls to avoid for researchers considering virtual engagement.

Results
There can be particular benefits to holding virtual sessions among minority parents of young children—to provide flexibility, comfort, and reduced logistical barriers for participation—while still facilitating friendly conversation with minimal distractions. However, extensive preparation is needed to ensure smooth execution and minimal distractions.