bluuebunny/crossref_metadata_2025_split huggingface dataset:
La contribution de l’usager au financement du service : l’exemple de l’enseignement supérieur britannique
Authors: Gabayet Nicolas 
Published: October 2022

Le besoin de financement des universités françaises doit conduire à explorer la piste que constitue la contribution financière des étudiants. À cet égard, l’exemple britannique semble particulièrement éclairant. Les universités britanniques, largement paupérisées entre les années 1980 et la fin des années 1990, ont bénéficié de financements importants dus à l’augmentation des droits d’inscription des étudiants.
Qui a peur des infirmier(ère)s en pratique avancée ?
Authors: Riou Bruno 
Published: October 2022

Les pratiques avancées infirmières ont lentement émergé en France avec les protocoles de coopération puis les formations d’infirmier en pratique avancée (IPA), mais la France est en retard sur ce sujet par rapport à de nombreux pays. Trois raisons principales sous-tendent la nécessité de développer les IPA : 1) la complexité de la médecine moderne et le constat d’un hiatus de fonction entre les infirmiers (bac + 3) et les médecins (bac + 9 à 12) ; 2) l’augmentation importante des besoins de santé du fait de l’allongement de la vie et du progrès médical ; 3) l’impérieuse nécessité de mettre en place des perspectives de progression de carrière pour les infirmiers dans la pratique du soin. Au-delà des mentions déjà mises en place (maladies chroniques, hémato-oncologie, maladies et transplantation rénales, et santé mentale, urgence), il est urgent de créer les mentions suivantes : petite enfance, grand âge, premier recours, et prélèvements d’organes et de tissus et transplantations. Des problèmes sont incomplètement résolus : grille salariale décourageante, responsabilité médico-judiciaire, encadrement médical, et surtout budgétisation des postes d’IPA dans les établissements de santé. La création des IPA en 2018 était une bonne orientation mais trop timide et empêchée de se développer à sa juste mesure. Il devient urgent d’agir.
Vingt ans après, quid des propositions du rapport Berland ?
Authors: Berland Yvon 
Published: October 2022

Par une lettre en date du 25 juin 2002, le ministre de la Santé Jean-François Mattei me confiait une mission d’étude et de propositions sur la démographie des professions de santé [1] pour laquelle Yvette Ract, médecin conseil national adjointe à la CNAMTS, Anthony Annereau, résident, Jean Berthet, praticien hospitalier, Gilles Errieau, médecin généraliste, Olivier Leroy, infirmier libéral, et Thierry Gausseron, rapporteur, ont prêté leur concours. Deux ambitions fondamentales ont été affichées : le champ de l’étude portait sur la démographie de l’ensemble des professions de santé ; la mission devait dépasser l’approche purement statisticienne pour étendre son analyse aux modes et aux conditions d’exercice et de formation des professionnels de santé. La mission a rencontré un très grand nombre de professionnels de santé pour dresser un constat partagé et porter des propositions. Ainsi, la mission faisait « dix propositions qui appellent des prises de position urgentes ». Vingt ans plus tard, il est à la fois intéressant et utile de savoir si et comment les propositions ont été suivies par les pouvoirs publics.
Investigation of Mobile Learning Readiness of Students According to Tablet Usage
Authors: Rysbayeva Akmaral , Kadirbayeva Roza , Baiyazovna Begaliyeva Saule , Baiseitova Nurila , Makhabbat Assylbek , Аbdigapbarova Ulzharkyn 
Published: October 2022

In this study, it was aimed to determine the mobile learning readiness of university students and to examine the change according to tablet usage. The research was carried out in the fall semester of 2021–2022. The study, which was carried out with the participation of 360 university students, was carried out using the survey model. In the research, a 4-week distance education mobile learning training was given to university students. In the study, ‘Mobile Learning Readiness Scale’ was used to collect data. The scale used in the research was delivered and collected by university students online. The analysis of the data was made by using the SPSS programme, frequency analysis and t-test. The results were added to the research in the form of tables. As a result of the research, it was determined that university students have advanced mobile learning readiness.
Keywords: Distance Education, Mobile Learning, Readiness, Tablet, University Students
Software Suite for Self-Paced Learning
Authors: Zhang Meng , Gu Zi Xu , Amer Adan , Sidhu Gaganpreet , Srinivasan Seshasai 
Published: October 2022

The faculty of engineering at XYZ University is very diverse with students coming from a variety of socio-economic backgrounds and nationalities. There is an expected level of prerequisite knowledge for courses in the program, especially for subjects in mathematics and physics. Yet, a significant number of students struggle to reach the same level of prior knowledge as their peers due to a lack of educational resources or due to language barriers. Entering lectures without the expected baseline understanding of the concepts increases the risk of cognitive overload because these students exert additional mental effort in retaining the pre-lecture information along with the lecture content. As a solution to this problem, we present a suite of web-based interactive programs that are accessible to the students outside the class. The Software Suite will provide supplementary material to assist with self-paced learning in a 3rd year undergraduate engineering course, i.e., Finite Element Analysis, at XYZ University’s ABC Department. It will enable students design and analyze various engineering applications, namely, Spring System, Trusses, Beams, Frames, and Heat Transfer along one or two dimensions. The purpose of the interactive platform with several programs is to actively engage the students with this cognitive tool to cement their understanding of the concepts instead of passively perceiving it as a tutor or repository of information.
Congestive heart failure masquerading as acute abdomen
Authors: Omar Eunizar , Persand Yasheen Krishna 
Published: October 2022

Rationale:
As an uncommon manifestation of congestive heart failure, congestive hepatopathy requires an early diagnosis in order to render appropriate care. Misdiagnosis as intraabdominal sepsis may lead to erroneous initial intervention, such as fluid boluses, that can potentially tip an already sick patient with poor reserves over into an extreme state.

Patient’s Concern:
A 65-year-old man was brought to the emergency department for excruciating abdominal pain, vomiting and jaundice. He also had lower limb pitting edema and was hypotensive en route.

Diagnosis:
Congestive hepatopathy.

Interventions:
Intravenous furosemide and fluid restriction.

Outcomes:
The patient declined admission to the cardiology ward and discharged himself against medical advice after his condition was improved in the emergency department.

Lessons:
It is important to pay attention to acute abdominal pain induced by extraabdominal pathologies. In this case of acute decompensated congestive heart failure, early recognition of the cause makes a difference to the management.
Revision of Roux-en-Y-Gastric Bypass – Our Experience in Indian Patients
Authors: Verma Naveen , Wadhawan Randeep , Sehgal Lalit , Veetil Deepa Kizhakke , Gupta Muneendra 
Published: October 2022

Background:
The indications for revision bariatric surgery include inadequate weight loss, weight regain, failure to resolve comorbidities, and complications associated with primary surgery.

Objectives:
The objective is to evaluate the outcome of revision of Roux-en-Y gastric bypass (RYGB) and compare the efficacy of different revision procedures for weight regain, resolution of comorbidities, and complications, if any.

Methods:
Revision cases performed between May 2017 and April 2021 were included. The analysis of collected data was carried out for weight loss, resolution of comorbidities, and adverse outcomes.

Results:
Twenty three revision procedures were performed. Two patients were lost to follow-up. The overall complication and reoperation rates were 14.29% and 4.76%, respectively. The follow-up duration was at 6, 12, and 36 months. Twenty-one (91.3%) patients completed 6-month, 18 (78.3%) 12-month, and nine (39.1%) completed 36-month follow-up. The mean postoperative body-mass index at 6, 12, 36 months were 33.07+/−4.15, 33.11+/−4.05, 34.5 ± 8.81, respectively. The mean %excess weight loss (EWL) at 6, 12, 36 months were 39.47+/−13.76, 43.70+/−13.70, 41.14+/−8.48%, respectively. The patients were divided into three groups. Group A - lengthening of biliopancreatic limb (BPL) by 100 cm (n = 6); Group B - placement of ring with a diameter of 7.5 cm in addition to BPL lengthening (n = 12); and Group C - pouch trimming with BPL lengthening by 100 cm (n = 3). %EWL at 6 months was 31.86, 47.69, and 53.49, in Groups A, B, and C, respectively. Similar trends in %EWL were observed in three groups at 12 and 36 months.

Conclusion:
Revision bariatric surgeries are complex procedures. In our study, banded RYGB with BPL lengthening had better outcomes, though a statistical significance could not be established due to the small sample size and retrospective nature of the study.
Long term outcome and late toxicity Of SIB-IMRT in definitive management of head and neck cancers in patients not suitable for chemo-radiotherapy
Authors: Singh Narayan Pratap , Khurana Rohini , Sapru Shantanu , Rastogi Madhup , Gandhi Ajeet Kumar , Rath Satyajeet , Hadi Rahat , Mishra Surendra Prasad , Srivastava Anoop Kumar , Bharti Avinav , Sahni Kamal , Ali Mohammad , Tiwari Ramakant 
Published: October 2022

Objective:
To evaluate efficacy and late toxicity of intensity-modulated radiotherapy with simultaneous integrated boost (IMRT-SIB) in definitive management of head-and-neck cancers.

Methods:
In this prospective interventional study, histological proven squamous cell carcinoma of oropharynx, hypopharynx, or larynx with stage T1-3 N0-3 M0 who were not candidates for concurrent chemotherapy were treated with IMRT-SIB with radical intent. Doses prescribed for IMRT-SIB to meet the clinical needs of nodal volumes were either SIB-66 schedule 66 Gray (Gy) prescribed to high risk (HR) planned target volume (PTV), 60 (Gy) to intermediate risk (IR) PTV and 54 Gy to low risk (LR) PTV in 30 fractions or SIB-70 schedule 70 Gy to PTV-HR, 59.4 Gy to PTV-IR and 56 Gy to PTV-LR in 33 fractions.

Result:
Forty-five patients were included. Forty-two patients were treated with SIB-66 schedule and three patients with SIB-70 schedule. The median follow-up period was 21 (6–68) months. There was residual disease in three patients. Recurrence was observed in 24 patients. Most recurrences were in HR volume (n = 19) and three patients had distant failure. Estimated 2-year locoregional control, disease-free survival, and overall survival were 55.55%, 49.7%, and 51.1%, respectively. Grade 3 late skin toxicity, subcutaneous fibrosis, and xerostomia were observed in three patients.

Conclusions:
Efficacy and late toxicity of IMRT-SIB observed in our study suggest it as a suitable treatment option for patients who are not fit for chemoradiation.
Using Learning Analytics to Examine Differences in Assessment Forms From Continuous Versus Episodic Supervisors of Family Medicine Residents
Authors: Lee Ann S. O. , Donoff Christopher , Ross Shelley 
Published: October 2022

ABSTRACT

Background
It is assumed that there is a need for continuity of supervision within competency-based medical education, despite most evidence coming from the undergraduate medical education rather than the graduate medical education (GME) context. This evidence gap must be addressed to justify the time and effort needed to redesign GME programs to support continuity of supervision.

Objective
To examine differences in assessment behaviors of continuous supervisors (CS) versus episodic supervisors (ES), using completed formative assessment forms, FieldNotes, as a proxy.

Methods
The FieldNotes CS- and ES-entered for family medicine residents (N=186) across 3 outpatient teaching sites over 3 academic years (2015-2016, 2016-2017, 2017-2018) were examined using 2-sample proportion z-tests to determine differences on 3 FieldNote elements: competency (Sentinel Habit [SH]), Clinical Domain (CD), and Progress Level (PL).

Results
Sixty-nine percent (6104 of 8909) of total FieldNotes were analyzed. Higher proportions of CS-entered FieldNotes indicated SH3 (Managing patients with best practices), z=-3.631, P&lt;.0001; CD2 (Care of adults), z=-8.659, P&lt;.0001; CD3 (Care of the elderly), z=-4.592, P&lt;.0001; and PL3 (Carry on, got it), z=-4.482, P&lt;.0001. Higher proportions of ES-entered FieldNotes indicated SH7 (Communication skills), z=4.268, P&lt;.0001; SH8 (Helping others learn), z=20.136, P&lt;.0001; CD1 (Doctor-patient relationship/ethics), z=14.888, P&lt;.0001; CD9 (Not applicable), z=7.180, P&lt;.0001; and PL2 (In progress), z=5.117, P&lt;.0001.

Conclusions
The type of supervisory relationship impacts assessment: there is variability in which competencies are paid attention to, which contexts or populations are included, and which progress levels are chosen.
A Reflection and Discussion Exercise on Racial Justice and Equity
Authors: Patnaik Rohan , Attlassy Nabil , Davids Susan , Fletcher Kathlyn E. 
Published: October 2022

ABSTRACT

Background
Residents have valuable perspectives about diversity and equity in medical training, yet many graduate medical education curricula lack dedicated activities focused on such issues.

Objectives
To describe and report feasibility and acceptability of an innovation that uses individual reflection and group discussion to create conversation in our residency program about equity and injustice through the lens of the Black Lives Matter movement.

Methods
In July 2020, we sent a survey with reflection prompts to all postgraduate year 2 and above internal medicine residents. In the discussion session (during required academic time), we presented 10 of the residents' responses to the reflection prompts. After each response was read aloud, the residents had an open discussion. We used thematic analysis to analyze the responses to the reflection prompts. Acceptability was tracked through free-text comments in the survey. Feasibility was measured by the time and resources needed to conduct the session.

Results
We received responses from 24 out of 72 (33%) residents. We identified 10 codes that fell into 4 themes. The most commonly identified codes included anger or frustration toward events, self-reflection on privilege, increased awareness and discussion of racism in daily life, and life being minimally impacted/homeostasis. The 4 overarching themes were (1) awareness, (2) motivation for change, (3) emotional response, and (4) self-reflection.

Conclusions
Using a format of reflection and sharing of anonymous responses was an inexpensive and effective method to begin a discussion about equity and injustice in medicine.
Racial Bias on the Emergency Medicine Standardized Letter of Evaluation
Authors: Kukulski Paul , Schwartz Alan , Hirshfield Laura E. , Ahn James , Carter Keme 
Published: October 2022

ABSTRACT

Background
Studies on components of residency applications have shown evidence of racial bias. The Standardized Letter of Evaluation (SLOE) is an assessment measure for emergency medicine (EM) residency applications and, as more specialties opt to use SLOEs in place of narrative letters of recommendation, understanding bias on standardized assessments is essential.

Objective
To determine whether there is a difference in rankings on the EM SLOE between underrepresented in medicine (UIM) and non-UIM applicants, White and non-White applicants, and to examine whether differences persist after controlling for other characteristics.

Methods
The sample was drawn from medical students who applied to EM residency at the study institution in 2019. We compared rankings between UIM and non-UIM students and between students of each individual race/ethnicity and White students, after controlling for United States Medical Licensing Examination Step scores, Alpha Omega Alpha status, type of school (US MD, US DO, internation medical graduate), Medical Student Performance Evaluation class percentile, affiliated program vs visiting clerkship SLOE, gender and the interaction of race/ethnicity and gender, and adjusted for students submitting multiple SLOEs, using ordinal regression.

Results
There were 1555 applicants to the study institution in 2019; 1418 (91.2%) had a SLOE and self-identified race/ethnicity. After controlling for applicant characteristics, non-UIM students were significantly more likely to be ranked higher than UIM students on “Rank Against Peers,” (OR 1.46, 95% CI 1.03-2.07) and Grade (OR 1.46, 95% CI 1.05-2.04).

Conclusions
Analysis of EM SLOEs submitted to our institution demonstrates racial bias on this standardized assessment tool, which persists after controlling for other performance predictors.
Ethnic and Racial Differences in Ratings in the Medical Student Standardized Letters of Evaluation (SLOE)
Authors: Alvarez Al'ai , Mannix Alexandra , Davenport Dayle , Gore Katarzyna , Krzyzaniak Sara M. , Parsons Melissa , Miller Danielle T. , Eraso Daniel , Monteiro Sandra , Chan Teresa M. , Gottlieb Michael 
Published: October 2022

ABSTRACT

Background
The Standardized Letter of Evaluation (SLOE) stratifies the assessment of emergency medicine (EM) bound medical applicants. However, bias in SLOE, particularly regarding race and ethnicity, is an underexplored area.

Objective
This study aims to assess whether underrepresented in medicine (UIM) and non-UIM applicants are rated differently in SLOE components.

Methods
This was a cross-section study of EM-bound applicants across 3 geographically distinct US training programs during the 2019-2020 application cycle. Using descriptive and regression analyses, we examine the differences between UIM applicants and non-UIM applicants for each of the SLOE components: 7 qualifications of an EM physician (7QEM), global assessment (GA) rating, and projected rank list (RL) position.

Results
Out of a combined total of 3759, 2002 (53.3%) unique EM-bound applicants were included. UIM applicants had lower ratings for each of the 7QEM questions, GA, and RL positions. Compared to non-UIM applicants, only some of the 7QEM components: “Work ethic and ability to assume responsibility,” “Ability to work in a team, and “Ability to communicate a caring nature,” were associated with their SLOE. “Commitment to EM” correlated more with GA for UIM than for non-UIM applicants.

Conclusions
This study shows a difference in SLOE rating, with UIM applicants receiving lower ratings than non-UIM applicants.
Theoretical Frameworks in Medical Education: Using a Systematic Review of Ophthalmology Education Research to Create a Theory of Change Model
Authors: Song Sophia L. , Yu Zane Z. , Pavlech Laura , Scott Ingrid U. , Greenberg Paul B. 
Published: October 2022

ABSTRACT

Background
Theoretical frameworks provide a lens to examine questions and interpret results; however, they are underutilized in medical education.

Objective
To systematically evaluate the use of theoretical frameworks in ophthalmic medical education and present a theory of change model to guide educational initiatives.

Methods
Six electronic databases were searched for peer-reviewed, English-language studies published between 2016 and 2021 on ophthalmic educational initiatives employing a theoretical framework. Quality of studies was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach; risk of bias was evaluated using the Medical Education Research Study Quality Instrument (MERSQI) and the Accreditation Council for Graduate Medical Education (ACGME) guidelines for evaluation of assessment methods. Abstracted components of the included studies were used to develop a theory of change model.

Results
The literature search yielded 1661 studies: 666 were duplicates, 834 studies were excluded after abstract review, and 132 after full-text review; 29 studies (19.2%) employing a theoretical framework were included. The theories used most frequently were the Dreyfus model of skill acquisition and Messick's contemporary validity framework. GRADE ratings were predominantly “low,” the average MERSQI score was 10.04, and the ACGME recommendation for all assessment development studies was the lowest recommendation. The theory of change model outlined how educators can select, apply, and evaluate theory-based interventions.

Conclusions
Few ophthalmic medical education studies employed a theoretical framework; their overall rigor was low as assessed by GRADE, MERSQI, and ACGME guidelines. A theory of change model can guide integration of theoretical frameworks into educational initiatives.
Modern views on skin biopsy in the diagnostic algorithm of dermatooncological diseases
Authors: Aslanyan S.A. , Gumeniuk K.V. , Lysenko D.A. 
Published: October 2022

Background. Malignant neoplasms of the skin are fairly common tumors in the world population and among the population of Ukraine. The main method of diagnosing skintumors is a biopsy, which allows establishing a diagnosis at an early stage and ensures the cure of most patients.
Purpose. To evaluate modern recommendations for skin biopsy in the diagnosis of dermato-onсological diseases.
Materials and methods. The search for sources of information was conducted using the MEDLINE/PubMed, EMBASE/ExcerptaMedica, CochraneLibrary, PubMed та Google Scholar databases using the following keywords: skin biopsy, skin tumors, diagnosis, melanoma. Among the identified sources, works without statistical analysis, descriptions of individual cases, articles without conclusions, and sources with duplicate results were excluded. The search depth was 10 years.
Results. As a result of the conducted search, 57 publications were found that corresponded to the declared purpose. The most common methods are: puncture, shaving, excisional and incisional biopsy. Most guidelines recommend full-thickness excisional biopsy as the preferred procedure for the diagnosis of suspected melanoma. It is indicated that a statistically significant mortality rate was found in the puncture biopsy group. Most observations showed no significant differences in melanoma recurrence between excisional biopsy and puncture groups. Given the clinical diversity of melanoma, there is no uniformity in the types of biopsies performed to diagnose melanoma. The most inaccurate method turned out to be the punch biopsy method, which is associated with an increased risk of underdiagnosis of melanoma.
Conclusions. A skin biopsy is a mandatory first step to establish a definitive diagnosis of a skin tumor. Excisional complete biopsy is the most justified in most cases of diagnosis. Rational biopsy technique remains an issue that needs further study.