bluuebunny/crossref_metadata_2025_split huggingface dataset:
Curriculum Change toward Competency-Based Education: Exploring Medical Students’ Experiences
Authors: Karami Morteza , Hashemi Nooriyah , Merrienboer Jeroen van 
Published: November 2022

Abstract
Introduction:
Since the beginning of the 21st century, competency-based education has been proposed as an approach to education in many disciplines including the medical sciences and it has become a dominant approach in many countries. We aimed to explore the lived experiences of general medical students about the change toward competency-based curriculum.
Methods
We conducted a phenomenology method to study lived experiences of general medical students through selecting participants via a purposeful sampling strategy. Snowballing and maximum variation samplings were also applied to recruit additional participants. The study was conducted at a Medical School in Iran. Three successive phases of qualitative data analysis, namely, data reduction by coding, data structuring by categorization, and data interpretation by discussion were applied to analyze the interviews.
Results
The results of the research showed that students' lived experiences fall under 4 main themes with 9 subthemes. The main themes show that (1) the compartmentalized curriculum in basic courses is experienced as the missing parts in a puzzle, (2) the physiopathology curriculum is experienced as swimming on land, (3) the externship is experienced as touring to mysterious land, (4) the internship is experienced as unleashed arrows.
Discussion
Our findings reveal that despite the changes already made in the curriculum, its compartmentalization is still a main obstacle to achieving competency-based medical education. A strict requirement for leaving the discipline-based curriculum behind is to use an integrated approach, in which basic science courses are connected with clinical cases, and physiopathology courses are connected with externships and internships.
Microstructural and Mechanical Characteristics of Friction Stir Welded Al6101/C11000 Joints with Zinc and Silver Interlayer
Authors: PAYAK VIRESH , P Jawahar , Roy Barnik Saha , Bhargava Manish , Choudhury Smrity 
Published: November 2022

Abstract
This manuscript presents the microstructure, and mechanical analysis of 3 mm thick Al 6101 (aluminum alloy) and C11000 (Cu alloy) plates Friction Stir Welded joints with and without Silver and Zinc interlayers. The tool used to make joints is made of H 13 steel, having a shoulder with 18 mm diameter and a taper pin with 4 mm tip and 6 mm root diameter. The quality of welded joints has been inspected using tensile testing, micro-hardness tests, scanning electron microscopy, and energy dispersive X-ray analysis. Microstructural studies clarified the flow variation of constituents with and without interlayer. Incorporation of a Silver and Zinc interlayer between the joining surface of aluminum and copper alloy decreased the generation of brittle intermetallics. The joint made with hybrid interlayers (Silver and Zinc) has the highest tensile strength with complete ductile fracture compared to the other joints tested.
Body mechanics among pregnant women with lumbopelvic pain: A cross- sectional study
Authors: Muhammad Begard Othman , Ahmed Hamdia Mirkhan , Media Shwan Kader 
Published: November 2022

Abstract
This cross-sectional study aimed to assess the knowledge and practice of body mechanics (BMs) among pregnant women with lumbopelvic pain (LPP) and to determine the association between LPP and BMs. The study was conducted using a purposive sample of 110 pregnant women with LPP. A structured questionnaire was used to collect data. Descriptive statistics, a chi-square test (X2) (α = 5%), and a multinomial regression model were used. More than half (53.6%) of the participants were knowledgeable about BMs, and 55.5% did not perform their daily activities correctly. There was a significant association between the level of BMs knowledge and the severity of pain (p = 0.024), and the level of practice was significantly associated with pain severity (p = 0.038). The odds ratio (OR = 5.105) was higher among those with severe pain and those who did not practice correct BMs. The odds ratio (OR = 4.581) was higher among those with very severe pain and poor knowledge of BMs. Inadequate knowledge and limited practice of daily activities according to BMs principles were significantly associated with pain intensity in pregnant women with LPP in the 14th − 30th weeks of gestation.
Local Tool Path Smoothing Based on Symmetrical NURBS Transition Curve with Look Ahead Optimal Method: Experimental and Analytical Study
Authors: Lei Chunlin , Yusoff Nukman , Yap Hwa Jen , Abdelrazek Ali H. , Luo Mingbing 
Published: November 2022

Abstract
Linear tool path with the inherent shortcoming of tangential and curvature discontinuities which lead to poor machining efficiency and surface finish. A lot of local corner smoothing methods which inset a tiny spline curve at the corners have been proposed in literature. However, there exists potential overlap of the two adjacent spline curves while smoothing, and still no optimal solution for eliminating the overlaps. To optimally eliminate the overlaps and smooth the transition curve curvature in real-time, a symmetrical Non-uniform rational B-spline (NURBS) curve transition based on look ahead optimal method is proposed in this paper, by scanning a set of unconstrained pre-cornering transition curve information, analysing the overlap type and backward determining the optimal transition length, thus fully use the linear segment length of each corner, Thus fully increasing the feedrate at the corners. continuity, analytical expression of the curvature extreme, approximation error constraint and real-time performance are considered simultaneously in this paper. Simulation and real machining experiments are made to compare with the existing symmetrical rounding algorithms, the results show that the proposed method has a significant curvature decrease of 17.64% and 4.44% improvement of efficiency, and the curvature distribution of the adjacent curves are balanced, thus improved the machining velocity smoothness. In addition, the real machining experiment results validate the proposed method can work well in 125us real-time control period CNC system.
Application of optical coherence microscopy in Hirschsprung's disease diagnosis
Authors: Wu Zhiwei , Song Jialun , Zeng Xianxu , Cao Zhenjie , Zhao Xinxin , Wang Peng , Ma Qian , Ma Huan , Wang Baojin , Du Junpeng 
Published: November 2022

Abstract
Objective: This study was a prospective study on the diagnosis of congenital Hirschsprung's disease (HSCR) using optical coherence microscopy (OCM).
Methods: A total of 109 HSCR patients admitted to a Chinese hospital were included and all underwent barium enema angiography preoperatively, and the resected diseased intestinal tubes were evaluated intraoperatively followed by OCM scanning and histopathological examination, and the OCM images were compared with the corresponding tissue sections for analysis. 10 non-HSCR fetal colorectal tissues at the same period were retained for OCM, the characteristics of which with and without HSCR under OCM imaging were analyzed.
Results: It showed that the structural features of HSCR tissue could be observed in the OCM images, which is consistent with the corresponding histopathological findings matching. Compared with the pathological findings, the OCM sensitivity, specificity, Kappa value, and AUC area reached 92.66%, 90.00%, 0.627, and 0.913, respectively.
Conclusion: OCM, as a non-invasive, high-resolution, real-time rapid imaging technology, has high sensitivity and specificity in congenital megacolon diagnosis, which will provide a more reliable basis for non-invasive diagnosis and pathological classification of patients with congenital megacolon, and has a certain potential for clinical application.
Hydroxypropyl-β-Cyclodextrin depletes membrane cholesterol and inhibits SARS-COV-2 entry into HEK293T-ACEhi cells
Authors: Alboni Silvia , Secco Valentina , Papotti Bianca , Vilella Antonietta , Adorni Maria Pia , Zimetti Francesca , Schaeffer Laurent , Tascedda Fabio , Zoli Michele , Leblanc Pascal , Villa Erica 
Published: November 2022

Abstract
Vaccination has drastically decreased mortality due to COVID-19 but not the rate of SARS-CoV-2 infection. Alternative strategies like inhibition of virus entry by interference with ACE2 receptors, could be warranted. Cyclodextrins (CDs) are cyclic oligosaccharides able to deplete cholesterol from membrane lipid raft, thus inducing ACE2 receptors to relocate to areas devoid of lipid rafts. To explore the possibility of reducing SARS-CoV-2 entry, we tested hydroxypropyl-β-cyclodextrin (HPβCD) in a HEK293T-ACE2hi cell line stably overexpressing human ACE2 and pseudotyped SARS-CoV-2 particles. We showed that HPβCD is not toxic to the cells for concentrations up to 5 mM and that this concentration has no significant effect on cell cycle parameters in any experimental condition tested. Exposure of HEK293T-ACEhi cells to concentrations of HPβCD starting from 2.5 mM to 10 mM showed a concentration-dependent reduction down to about 50% of the initial membrane cholesterol content. In addition, incubation of HEK293T-ACEhi cells with HIV-S-CoV2 pseudotyped particles in presence of increasing concentrations of HPβCD (from 0.1 to 10 mM) displayed a concentration-dependent effect on SARS-CoV-2 entry efficiency, with concentrations at least one order of magnitude lower than the lowest concentration showing toxic effects. These data indicate HPβCD as a strong candidate as a SARS-CoV-2 prophylactic agent.
Attitudes, beliefs and knowledge regarding medical cannabis among healthcare students in Cyprus: A cross-sectional descriptive correlational study
Authors: sokratous Sokratis , Kaikoushi Katerina , Alexandrou George , Rousou Elena , N.M Maria Karanikola 
Published: November 2022

Abstract
Background: Although the international research-based literature from the last two decades seems to favour medical cannabis (MC) use, there is a lack of evidence concerning healthcare students’ education on MC in Cyprus and across the world. Therefore, this study explored Cyprus healthcare students’ attitudes, beliefs and knowledge regarding MC use. We paid special attention to differences across specific sociodemographic (gender, age and religion status) and educational (level, year and study field) characteristics.
Methods: A descriptive cross-sectional study with internal comparisons was performed from November 2019 to March 2020. All active undergraduate/postgraduate healthcare students (N= 900) studying in public and private universities in Cyprus were eligible to participate (final sample involved N = 819, response rate = 91%). To collect the data, we used the Attitudes, Beliefs and Knowledge towards Medical Cannabis Questionnaire (MCQ) questionnaire. To analyse the data, we employed the Pearson chi-square test for group differences, in addition to assessing descriptive and inferential statistics.
Results: Healthcare students had a generally positive attitude towards MC. Statistically significant differences were observed between genders and in terms of beliefs/risk associated with using MC, with males being likelier to believe that there are significant mental-health benefits associated with using ΜC (x2 = 8.06, OR: 0.6, 95% CI: 0.49–0.89) and females being likelier to believe that using MC poses serious physical (x2 = 23.00, OR: 1.6, 95% CI: 1.35–2.0, p < .001) and mental-health (x2 = 13.06, OR: 1.4, 95% CI: 1.2–1.81) risks. Moreover, healthcare students who received specific (formal) education about MC during their study/training, they were more prepared to answer patient/client questions about ΜC (x2 = 17.27, df = 1, p < .001). In addition, the participants who received formal education had more friends (x2=12.69, df=1, p <.001) or family member who uses/has used MC (x2=4.03, df=1, p <.05).
Conclusions: This study provides useful information for curriculum development, educational changes and policy decisions related to cannabis use for medical purposes in Cyprus. The results show that the majority of healthcare students in Cyprus are in favour of MC use. However, the participants reported a dearth of knowledge and recommended additional evidence-based research and education to enhance their knowledge of MC use. Therefore, we recommend the implementation of formal education about MC in healthcare students in Cyprus during their study and clinical training. Furthermore, it is important to add MC-related theoretical and clinical/laboratory courses during studies and clinical practice.
Genome-Wide Identification of the CER1 Gene Family in Plants and Stress-Responsive Expression of the MdCER1 Genes
Authors: Gao Yanlong , Zhang Zhongxing , Cheng Jiao , Xian Xulin , Li Cailong , Wang Yanxiu 
Published: November 2022

Abstract
Plant cuticular wax is an important factor affecting the growth and quality of plants through protecting the plant from drought, and other diseases. It is reported that CER1 encodes a core enzyme involved in VLC alkane biosynthesis which can affect plant response to stress, but no characterization of CER1 gene and its family has been reported in apples. In this study, we identified 3 MdCER1 genes in Malus domestica and named MdCER1-1 to MdCER1-3, then we analyzed their sequences feature, expression patterns to screen highly expressed genes for cloning and functional verification. Expression analysis by real-time PCR showed that drought stress could induce MdCER1-like overexpression. The experiment of water loss showed that overexpression of MdCER1-like could effectively prevent water loss in apple calli, and the effect was more significant under drought stress. Meanwhile, the expression of wax metabolism related genes MdYPB5, MdCER3 and MdKCS1 was significantly up-regulated, GC-MS analysis of wax fraction showed that overexpression of MdCER1-like significantly increased the content of alkanes. The enzyme activities (SOD, POD) of overexpressed apple calli increased signifcantly, while the contents of malondialdehyde and proline decreased. In a word, MdCER1-like plays an important role in wax metabolism and tissue water retention, and provides a theoretical basis for exploring its role in drought stress.
The Association between the Thyroid Feedback Quantile-based Index and Serum Uric Acid in U.S. Adults
Authors: Xie Haitao , Li Ning , Zhou Guowei , He Zhiyuan , Xu Xiaoqing , Liu Qian , Wang Haiyan , Han Jie , Shen Le , Yu Peng , Chen Jiandong , Chen Xiaohu 
Published: November 2022

Abstract
OBJECTIVE
Previous studies have shown that there may be a positive correlation between serum uric acid level and hyperthyroidism. However, the relationship between thyroid function and serum uric acid in healthy people is not clear. The purpose of this study was to analyze the relationship between sensitivity to thyroid hormones and serum uric acid levels, and to present them in quantitative form.
RESEARCH DESIGN AND METHODS
This study is a cross-sectional study of 4,600 adults (male: 2,366; female: 2,234) who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2010. Parameters representing central sensitivity to thyroid hormones were calculated as: Thyroid Feedback Quantile-based Index (TFQIFT4), TSH index (TSHI), and thyrotropin T4 resistance index (TT4RI); Peripheral sensitivity to thyroid hormone was evaluated by FT3/FT4 ratio. In addition, we have innovated TT3RI and TFQIFT3 indices based on FT3 and TSH. The relationship between thyroid hormone sensitivity and serum uric acid concentration was analyzed by multiple linear regression.
RESULTS
Higher levels of serum uric acid were associated with decreased sensitivity to thyroid hormones in euthyroid individuals. Further analysis revealed that TFQIFT4, TFQIFT3, TT4RI, TT3RI, TSHI had a significant correlation with serum uric acid levels in women and obese people; in people aged 20-39, except for TFQIFT4, other thyroid sensitivity indexes were positively correlated with serum uric acid levels.
CONCLUSIONS
Decreased sensitivity to thyroid hormones was associated with high levels of serum uric acid in people with normal thyroid function, and subgroup analyses showed similar results. It is possible to use the findings of this study to gain a better understanding of the effects of decreased thyroid hormone sensitivity on uric acid metabolism, and to provide clinical diagnosis and treatment references.
Viral replication probably promoted by EV71 VP4 protein via activating the PI3K/AKT and MAPK pathways in RD cell
Authors: Gao Xinghong , Liu Dongying , Zhang Xinquan , Wang Ying , Guo Xiao , Huang Yukai , Xiong Yongai 
Published: November 2022

Abstract
Enterovirus 71 (EV71) internal capsid protein (VP4) conserves in picornaviridae family and plays critical role in viral infection and replication by unknown mechanisms. In this study, mRNA sequencing was performed to analyze Differentially Expressional Genes (DEGs) in VP4 protein overexpressing Human Rhabdomyosarcoma Cells. It had been showed that Focal Adhesion, PI3K/AKT and MAPK pathways were mainly activated by the significant DEGs. Co-immunoprecipitation (Co-IP) assay indicated that ITGA5 of DEGs interacted with VP4. After knockdown of the ITGA5, WB showed that PI3K/AKT and MAPK pathways were activated, RT-qPCR experiments confirmed that viral copies were increasing. Thus, it is indicated that viral replication probably can be promoted by VP4 protein with activating the PI3K/AKT and MAPK pathways and a subsequent interaction with ITGA5.
Exploratory Analysis of L1 retrotransposons expression in Autism
Authors: Spirito Giovanni , Filosi Michele , Domenici Enrico , Mangoni Damiano , Gustincich Stefano , Sanges Remo 
Published: November 2022

Abstract
Background
Autism Spectrum Disorder (ASD) is a set of highly heterogeneous neurodevelopmental diseases whose genetic etiology is not completely understood. Several investigations have relied on transcriptome analysis from peripheral tissues to dissect ASD into homogenous molecular phenotypes. Recently, alterations of gene expression from post-mortem brain tissues have identified sets of genes with altered expression, mapping on pathways known to be involved in ASD etiology. In addition to protein-coding transcripts, the human transcriptome is composed by a large set of non-coding RNAs and transposable elements (TEs). Advancements in sequencing technologies have proved that TEs can be transcribed in a regulated fashion, and their dysregulation have a role in neural diseases.
Methods
We exploited published datasets comprising RNA-seq data from 1) post-mortem brain of ASD subjects, 2) in vitro cell cultures where ten different ASD-relevant genes were knocked out and 3) blood of discordant siblings. We measured the expression levels of evolutionarily young full-length transposable L1 elements and characterized the genomic location of deregulated L1s assessing their potential impact on the transcription of ASD-relevant genes.
Results
We detected a strong upregulation of intronic full length L1s exclusively in a subset of samples where the number of deregulated genes correlates with L1 upregulation. In brain tissue, specific upregulated L1s overlap ASD-relevant downregulated genes, suggesting the existence of a negative effect of L1 transcription on host transcripts for a subset of ASD genes.
Limitations
Our analyses are limited by the low number of samples and by the lack of replicates among post-mortem brain samples. Measuring the transcription of locus-specific TEs is complicated by the repetitive nature of their sequence, which reduces the accuracy in mapping sequencing reads to the correct genomic locus.
Conclusions
We observed L1s upregulation in a subset of ASD samples. In these cases, L1 upregulation might directly impair the expression of ASD-relevant genes by a mechanism not yet understood. L1s upregulation in autism appears to be limited to a subset of subjects probably harbouring mutations in genes related to DNA/chromatin modification.
Outcome after allogeneic stem cell transplantation with haploidentical versus HLA-matched donors in patients with higher-risk MDS
Authors: d'Aveni-Piney Maud , Michel Claire , Robin Marie , Morisset Stephane , Blaise Didier , Maertens Johan , Chevalier Patrice , CASTILLA-LLORENTE Cristina , Forcade Edouard , Ceballos Patrice , Yakoub-Agha Ibrahim , Poiré Xavier , Carre Martin , BAY Jacques-Olivier , Beguin Yves , Loschi Michael , Huynh Anne , Guillerm Gaelle , FRANCOIS Sylvie , Mear Jean-Baptiste , Dulery Remy , Suarez Felipe , Bilger Karin , Cornillon Jerome , Chalandon Yves , Maillard Natacha , labussiere helene , Charbonnier-Gouin Amandine , TURLURE Pascal , BERCEANU Ana , Chantepie Sylvain , Maury Sébastien , Bazarbachi Ali , Menard Anne-Lise , QUOC Stephanie NGUYEN , Rubio Marie-Thérèse 
Published: November 2022

Abstract
Allogeneic hematopoietic stem cell transplantation remains the best curative option for higher-risk myelodysplastic syndrome. The presence of monosomal karyotype and/or complex karyotype abnormalities predicts inferior survival after allo-SCT in MDS patients. Haploidentical allo-SCT has been increasingly used in acute leukemia (AL) and has similar results as using HLA-matched donors, but data on higher-risk MDS is sparse. We compared outcomes in 266 patients with higher-risk MDS after HLA-matched sibling donor (MSD, n = 79), HLA-matched unrelated donor (MUD, n = 139) and HLA haploidentical donor (HID, n = 48) from 2010 to 2019. Median donor age differed between the three groups (p < 0.001). The overall survival was significantly different between the three groups with a better OS observed in the MUD group (p = 0.014). This observation could be explained by a lower progression-free survival with MUD (p = 0.014). The cumulative incidence of grade 2–4 acute GvHD was significantly higher in the HID group (p = 0.051). However, in multivariable analysis, patients transplanted using an HID had comparable mortality to patients transplanted using a MUD (subdistribution hazard ratio [sHR]: 0.58 [0.32–1.07]; p = 0.080) and a MSD ([sHR]: 0.56 [0.28–1.11]; p = 0.094). MUD do not remain a significant positive predictor of survival, suggesting that beyond the donor-recipient HLA matching, the donor age might impact recipient outcome.
Perception and Awareness Towards Malaria Vaccine Policy Implementation in Nigeria by Health Policy Actors
Authors: Nnaji Adaugo , Ozdal Macide Artac 
Published: November 2022

Abstract
Background of study: The study aimed to assess perception and awareness of health policy actors on malaria vaccine policy implementation in Nigeria. A descriptive study was conducted to assess opinions and perception of policy actors on implementation of a vaccine program against malaria in Nigeria. Descriptive statistics were carried out to study the characteristics of the population and the univariate analysis of the responses to the questions raised to the participants. Multinomial logistic regression was conducted to evaluate the association between demographic characteristics and the responses. Results: The study revealed that the malaria vaccine awareness was poor with only 48.9% of the policy actors who have previous knowledge of malaria vaccine. Majority of participants (67.8%) declared that they are aware of the importance of vaccine policy in the efforts on tackling the diseases transmission. The more the year of work experience of the participants increases, the odds of being more likely to be aware of the malaria vaccine increases [OR 2.491 (1.183–5.250), p-value < 0.05]. Conclusion: It is recommended that policy makers develop methods of educating populations and increase the awareness on the acceptability of the vaccine and ensure that an affordable malaria vaccine program is implemented in the population.