bluuebunny/crossref_metadata_2025_split huggingface dataset:
Targeting Serotonin With Common Antidepressants Induces Rapid Recovery From Cytopenia
Authors: Fouquet Guillemette , Rossignol Julien , Garcelon Nicolas , Hermine Olivier , Côté Francine , Coman Tereza 
Published: August 2022

Abstract
The hematopoietic system uses several, yet undiscovered, factors to adapt to stresses such as chemotherapy, infections, or bleeding. Serotonin is commonly known as a neurotransmitter but is also produced and used in peripheral organs. In particular, we have shown that serotonin synthesized in the bone marrow is necessary for erythroid progenitors’ survival and proliferation. Serotonin levels can be increased by FDA approved antidepressants called selective serotonin reuptake inhibitors (SSRI). In this work, we report a previously unknown role of SSRI in the recovery of cytopenia, after autologous hematopoietic stem cell transplantation in patients and after sub-lethal irradiation in mice. We also observed an unexpected cooperation between SSRI and G-CSF on the improvement of the 3 hematopoietic lineages. Of note, SSRI do not seem to affect blood cells production in the absence of stress-induced hematopoiesis. We propose that the serotonergic system could be a valuable therapeutic target in stress-induced cytopenia, especially as a rescue after radiation or chemotherapy.
Leading as Servant in Times of Crisis
Authors: Tagliareni M. Elaine , Sipe Margie Hamilton , Hill Rebecca , Reidy Patricia A. , Ciesielski Steven , Lucey Jason R. 
Published: August 2022

Abstract
Using servant leadership as a framework, leaders within a school of nursing guided faculty during the COVID-19 pandemic and called them to address social injustice in the summer of 2020. A model was developed to sustain growth and build resilience of students, faculty, and staff. Influenced by external and internal drivers that stimulated the need for change, strategies were implemented based on core principles of servant leadership. Outcomes emerged in three categories: collaborative strengths demonstrated by students, faculty, and staff; performance of the community to be intentional about change; and transformative practices leading to enhancement of internal and external partnerships.
Teaching in Times of Crisis Through a Palliative Care Lens
Authors: Bigelow April , Price Deborah , Mason Heidi , Harden Karen 
Published: August 2022

Abstract
The disruption of classroom and clinical education caused by the COVID-19 pandemic resulted in student distress and worry regarding the future of their education. Faculty trained in palliative care adapted the SPIKES mnemonic and applied it to real-time interactions with students in an effort to decrease distress and enable continued learning. Palliative care concepts, approaches, and techniques can be used to successfully facilitate faculty-student interactions during times of crisis and rapidly changing educational environments.
Foundations of Nursing
Authors: Perez Amelia , Andrews Angela , Reed Amy , Patino Jasmin 
Published: August 2022

Abstract
Research focusing on blended learning for foundations of nursing courses is limited. The purpose of this study was to compare course performance outcomes when teaching foundations using blended learning compared to face-to-face instruction and to evaluate learner satisfaction and perceptions of effectiveness regarding blended learning. No significant differences were found in exam or final course grades between the two modalities. Most participants perceived blended learning as effective in meeting the course objectives and rated the course as either excellent, very good, or good. Blended learning was a useful strategy for teaching foundations of nursing.
Can I Ask a Question About URiM Awards That I Don’t Know the Answer to? Designing an Award for Underrepresented Medical Education Researchers
Authors: Zaidi Zareen , Sewell Justin L. , Schumacher Daniel , Sukhera Javeed , Hunderfund Andrea N. Leep , Balmer Dorene F. , Park Yoon Soo , Kulasegaram Kulamakan , Young Meredith E. , Fung Cha-Chi , LaDonna Kori A. 
Published: August 2022

Meaningful Equity, Diversity, and Inclusion (EDI) efforts may be stymied by concerns about whether proposed initiatives are performative or tokenistic. The purpose of this project was to analyze discussions by the Research in Medical Education (RIME) Program Planning committee about how best to recognize and support underrepresented in medicine (URiM) researchers in medical education to generate lessons learned that might inform local, national, and international actions to implement meaningful EDI initiatives. Ten RIME Program Planning Committee members and administrative staff participated in a focus group held virtually in August 2021. Focus group questions elicited opinions about “if and how” to establish a URiM research award. The focus group was recorded, transcribed, and thematically analyzed.
Recognition of privilege, including who has it and who doesn’t, underpinned the focus group discussion, which revolved around 2 themes: (1) tensions between optics and semantics, and (2) potential unintended consequences of trying to level the medical education playing field. The overarching storyline threaded throughout the focus group discussion was intentionality. Focus group participants sought to avoid performativity by creating an award that would be meaningful to recipients and to career gatekeepers such as department chairs and promotion and tenure committees. Ultimately, participants decided to create an award that focused on exemplary Equity, Diversity, and Inclusion (EDI) scholarship, which was eventually named the “RIME URiM Research Award.” Difficult but productive conversations about EDI initiatives are necessary to advance underrepresented in medicine (URiM) scholarship. This transparent commentary may trigger further critical conversations.
Improvisational and Standup Comedy, Graphic Medicine, and Theatre of the Oppressed to Teach Advancing Health Equity
Authors: Chin Marshall H. , Orlov Nicola M. , Callender Brian C. , Dolan James A. , Miller Doriane C. , Peek Monica E. , Rusiecki Jennifer M. , Vela Monica B. 
Published: August 2022

Ninety-minute virtual workshops that used improvisational comedy, standup comedy, graphic medicine, and Theatre of the Oppressed were implemented in 2020 within a required health equity course at the University of Chicago Pritzker School of Medicine to train 90 first-year medical students in advancing health equity. Learning objectives were to (1) deepen understanding of diverse human experiences by developing relationship skills, such as empathy, active listening, engagement, and observation; (2) recognize how diverse patients perceive students and how students perceive them to gain insight into one’s identity and how intersectional systems of oppression can stigmatize and marginalize different identities; and (3) engage in free, frank, fearless, and safe conversations about structural racism, colonialism, White and other social privileges, and systemic factors that lead to health inequities. With a 61% (109/180 [90 students × 2 workshops per student]) survey response rate, 72% of respondents thought workshops were very good or excellent, and 83% agreed or strongly agreed they would recommend workshops to others. Key recommendations are to (1) incorporate experiential storytelling and discussion; (2) define clear learning goals for each workshop, map exercises to these goals, and explain their relevance to students; and (3) create a safe, courageous, brave space for exploration and discussion.
For health equity, transformation happens as students share their perspectives of curriculum content from their intersectional identities, experiences, and varied privileges; are challenged by others’ perspectives; and attempt to understand how others can experience the same content differently. The arts create a powerful form of sharing beyond routine conversations or discussions, which is critical for honest dialogue on difficult topics, such as racism, homophobia, and White privilege and other social privileges. Educators should enable students to have the space, time, and courage to share their true perspectives and engage in authentic discussions that may be uncomfortable but transformative.
Competency-Based Frameworks in Medical School Education Programs: A Thematic Analysis of the Academic Medicine Snapshots, 2020
Authors: Ryan Michael S. , Blood Angela D. , Park Yoon Soo , Farnan Jeanne M. 
Published: August 2022

Purpose
Educational program objectives (EPOs) provide the foundation for a medical school’s curriculum. In recent years, the Liaison Committee on Medical Education (LCME) endorsed an outcomes-based approach to objectives, to embrace the movement toward competency-based medical education (CBME). The purpose of this study was to explore the CBME frameworks used by medical schools in formulating their EPOs. A secondary aim was to determine factors related to the selection of specific frameworks.

Method
The authors performed a quantitative content analysis of entries to the 2020 Academic Medicine Snapshot. Publicly available data gathered included demographic features of each program (e.g., year founded, accreditation status, affiliation, etc.), participation in national medical education consortia, and presence of specific CBME frameworks identified in EPOs. Descriptive statistics were used to examine trends in frameworks used by medical schools. Bivariate comparisons between factors and frameworks were conducted using chi-square tests. Logistic regression was used to examine factors predicting use of more recently developed CBME frameworks.

Results
A total of 135 institutions submitted Snapshots (RR = 88%). All institutions endorsed 1 or more CBME frameworks, with 37% endorsing 2 and 20% endorsing 3 or more. The most common was the Accreditation Council for Graduate Medical Education core competencies (63%). In addition to published frameworks, 36% of institutions developed their own competencies. Schools with pending LCME visits were 2.61 times more likely to use a more recently developed curricular framework, P = .022.

Conclusions
Medical schools in the United States have embraced the CBME movement through incorporation of competency-based frameworks in their EPOs. While it is encouraging that CBME frameworks have been integrated in medical school EPOs, the variability and use of multiple frameworks identifies the pressing need for a unified CBME framework in undergraduate medical education.
Clinician Teacher as Leader: Creating Psychological Safety in the Clinical Learning Environment for Medical Students
Authors: McClintock Adelaide Hearst , Fainstad Tyra Leigh , Jauregui Joshua 
Published: August 2022

Purpose
Psychological safety is the perception that a group environment is safe for interpersonal risk taking, exposing vulnerability, and contributing perspectives without fear of negative consequences. The presence of psychological safety has been tied to wellness, retention, and inclusiveness. National data demonstrate that many of the fundamental components of psychological safety are lacking in clinical learning environments. There is evidence that leadership behaviors can create psychological safety in traditional work environments. The authors sought to understand how clinical teachers’ leadership behaviors can create, destroy, and rescue psychological safety in the clinical learning environment.

Method
This was a multicenter, cross-sectional, qualitative study of fourth-year medical students from 2 institutions using semistructured interviews. Verbatim transcripts underwent constant comparison and iterative data reduction and analysis, continuing beyond thematic sufficiency.

Results
Eighteen students participated in interviews. Participants described key themes of relationships, an emphasis on learning, clear expectations, autonomy, and frequent feedback as promoting psychological safety. Safe environments lead to a sense of belonging and agency. They reported educator disinterest in students, dismissal of questions, lack of autonomy, and unclear expectations as destructive of psychological safety. Unsafe environments lead to withdrawal and a high extraneous cognitive load. Most students were unable to describe a time psychological safety was restored if lost.

Conclusions
Clinical teachers’ leadership behaviors can directly impact students’ perception of psychological safety in the clinical learning environment. Psychological safety increases students’ sense of belonging, self-efficacy, and engagement. The findings demonstrate that while it is difficult to repair an atmosphere that is psychologically unsafe, there are several actions that can be put into motion early on to ensure the learning environment is safe and remains so. Future research should investigate whether psychologically safe environments lead to meaningful differences in assessments of student learning and effective cultural change.
Self-Assessment in Feedback Conversations: A Complicated Balance
Authors: Robb Katharine A. , Rosenbaum Marcy E. , Peters Lauren , Lenoch Susan , Lancianese Donna , Miller Jane L. 
Published: August 2022

Purpose
Learner-centered feedback models encourage educators to ask learners to self-assess at the start of feedback conversations. This study examines how learners perceive and respond to self-assessment prompts during feedback conversations and assesses medical students’ perceptions of and approach to self-assessment used as the basis for these conversations.

Method
All rising second-, third-, and fourth-year medical students at a midwestern U.S. medical school were invited to participate in this study. Students participated in 1-on-1 interviews between June and August 2019 during which they were asked open-ended questions about their experiences with self-assessment and feedback during medical school. The interviews were audio recorded and transcribed, and comments related to self-assessment in feedback conversations were extracted. Thematic analysis was used to identify recurrent ideas and patterns within the transcripts, and all excerpts were reviewed and coded to ensure that the identified themes adequately captured the range of student responses.

Results
A total of 25 students participated in the study. Although some students noted improvement in their self-assessment abilities with increasing experience, no consistent gender, race, or training-level differences were found in reported attitudes or preferences. Students identified many benefits of self-assessment and generally appreciated being asked to self-assess before receiving feedback. Students had varied responses to specific self-assessment prompts, with no clear preferences for any particular self-assessment questions. Students described weighing multiple factors, such as image concerns and worries about impact on subsequent evaluations, when deciding how to respond to self-assessment prompts.

Conclusions
The process by which learners formulate and share self-assessments in feedback conversations is not straightforward. Although educators should continue to elicit self-assessments in feedback discussions, they should recognize the limitations of these self-assessments and strive to create a safe environment in which learners feel empowered to share their true impressions.
Hands-free Femoral Traction Using the Bookwalter Retractor System During Anterior Approaches to the Acetabulum
Authors: Tyler Andrew F. , Vincent Chris , Stevens Nicole M. , Payton Harris , Boyce Robert H. , Collinge Cory A. , Mitchell Phillip M. 
Published: August 2022

Summary:
Displaced acetabular fractures with medial and cranial displacement of the femoral head commonly require an anterior approach for reduction and stabilization. Restoration of the femoral head to its native position under the reduced acetabular dome is a primary goal of surgery. We present a surgical technique for applying traction to the proximal femur using the Bookwalter retractor system during the repair of acetabular fractures when using an anterior approach. By placing traction in line with the femoral neck, the femoral head is moved to a more anatomical position allowing acetabular fracture fragments to be reduced unimpeded and the femoral head may be used as a reconstructive template. We review a case series of 116 patients treated using this technique and report the short- and long-term radiographic and clinical results of treatment.
Functional Outcomes of Dorsal Bridge Plating for Lisfranc Injuries With Routine Implant Retention: A Major Trauma Center Experience
Authors: Onochie Elliot , Bua Nelson , Mmerem Kingsley , Heidari Nima , Vris Alexandros , Malagelada Francesc , Parker Lee , Jeyaseelan Luckshmana 
Published: August 2022

Objectives:
To assess medium-term functional outcomes and the complication profile for unstable Lisfranc injuries treated with dorsal bridge plate (DBP) fixation when implants are not routinely removed.

Design:
Large single-center retrospective case series.

Setting:
Level-1 Trauma Center, London, United Kingdom.

Patients:
Consecutive cases of skeletally mature individuals with unstable Lisfranc injuries treated operatively between 2014 and 2019.

Intervention:
Open reduction and DBP fixation with implants not routinely removed.

Main Outcome Measurements:
Patient-reported outcome measures at final follow-up. The Manchester-Oxford Foot Questionnaire summary index was the primary outcome measure. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale, complications, and all-cause reoperation rates were secondary outcome measures. Logistic regression models were used to identify risk factors that influenced outcomes.

Results:
Eighty-five patients were included. Mean follow-up was 40.8 months (24–72). The mean Manchester-Oxford Foot Questionnaire Summary Index was 27.0 (SD 7.1) and mean AOFAS score 72.6 (SD 11.6). The presence of an intra-articular fracture was associated with poorer outcomes, with worse MOXFQ and AOFAS scores (both P < 0.001). Eighteen patients (21%) required implants removal, with this more likely in female patients (OR 3.89, 95% confidence interval, 1.27 to 12.0, P = 0.02). Eight patients (9%) required secondary arthrodesis.

Conclusions:
This is the largest series of Lisfranc injuries treated with DBP fixation reported to-date and the only to routinely retain implants. Medium-term outcomes are comparable to existing literature in which implants are routinely removed. The presence of an intra-articular fracture is a poor prognostic indicator. Implant removal is more likely to be needed in female patients.

Level of Evidence:
Therapeutic Level IV. See Instructions for authors for a complete description of levels of evidence.
Preweaning environmental enrichment alters neonatal ultrasonic vocalisations in a rat model for prenatal infections
Authors: Wilkin-Krug Linda C. M. , Macaskill Anne C. , Ellenbroek Bart A. 
Published: August 2022

Objective
Maternal infections are a well-known risk factor for neurodevelopmental defects. Such defects are associated with a range of symptoms, and environmental enrichment (EE) could be a promising approach to rehabilitate these. We used the well-established prenatal poly I:C (polyinosinic-polycytidylic acid) model in rats to examine the effects of preweaning EE on rat pups’ ultrasonic vocalisations (USVs) when separated from their mothers. USVs are one of the earliest indicators of a pup’s functional level and, thus, well-suited as a marker of neurodevelopmental abnormalities.

Methods
We used a two-by-two factorial design in which pregnant Sprague–Dawley rats received either saline or the viral mimic poly I:C, and one group of pups was exposed to preweaning enrichment. We measured maternal separation-induced USVs both before postnatal day (PND) 7 and after preweaning enrichment on PND 14.

Results
Poly I:C significantly reduced the number of USVs on PND 7. EE interacted with the poly I:C treatment in that poly I:C pups in the enrichment group called more, whereas saline pups in the enriched environment called less on PND 14 than the respective controls.

Conclusion
We showed that the effects of maternal poly I:C on the offspring’s USVs could be reduced by early EE. If replicated, it could open novel and safe avenues for treating children of mothers who were exposed to infections during pregnancy.
Changes in intraocular pressure after pharmacological pupil dilatation in an elderly Chinese population in Taiwan: The Shipai eye study
Authors: Kuang Tung-Mei , Tsai Su-Ying , Liu Catherine Jiu-Ling , Lee Shui-Mei , Chou Pesus 
Published: August 2022

Background:
Mydriatic drugs are often used in ophthalmic clinics for pupil dilatation to assess the optic nerve and retina. Clinical studies have indicated that an increase in intraocular pressure (IOP) after pupil dilation is noted in open-angle glaucoma patients, those with narrow angles and in normal subjects. Asians are more likely to have narrow angles. Moreover, age-related cataract may increase the crowdedness of the angle. This study aimed to assess the effects of mydriatic pupil dilatation on IOP in an elderly Chinese population.

Methods:
The Shihpai Eye Study was a community-based, cross-sectional survey of vision and eye diseases among noninstitutionalized subjects aged 65 years and older in Shihpai, Taipei, Taiwan. IOP was taken using noncontact tonometry. The pupil was dilated with 1% tropicamide. IOP was measured again after maximal pupil dilatation 1 hour after mydriasis.

Results:
Of the 2045 participants, 1361 (66.6%) participated in both the questionnaire and eye examinations. The mean IOP before pupil dilatation was 12.9 ± 3.1 mmHg. and was 12.8 ± 3.4mmHg (range: 5- 36 mmHg) after pupil dilatation. IOP higher than 21 mmHg after pupil dilation was noted in 17 (1.34%) participants, of whom IOP exceeded 30 mmHg in two (0.16%). Overall, the changes in IOP before and after pupil dilatation were insignificant (p=0.04). In the final regression analyses, refractive status towards hyperopia (p<0.01) was the only significant factor associated with an increase in IOP of at least 4 mmHg after pupil dilatation.

Conclusion:
Our results revealed that the increase in IOP after pharmacological pupil dilatation was minimal, and the incidence of acute angle-closure attack was insignificant. Hyperopic status was the only factor related to an increase in intraocular pressure of > 4 mmHg. Caution should be exercised if one is hyperopic or having a history of glaucoma and rechecking IOP in these subjects is suggested after pharmacological mydriasis.