bluuebunny/crossref_metadata_2025_split huggingface dataset:
Students’ perceptions, engagement and satisfaction with the use of an e-rubric for the assessment of manual skills in physiotherapy
Authors: Pérez-Guillén Silvia , Carrasco-Uribarren Andoni , Celis Carlos López-de , González-Rueda Vanessa , Rodríguez-Rubio Pere R. , Cabanillas-Barea Sara 
Published: August 2022

Abstract
Introduction
In recent years, formative assessment has gained importance in health care education to facilitate and enhance learning throughout the training period. Within the frame of active methodologies, rubrics have become an essential instrument for formative assessment. Most rubric-based assessment procedures focus on measuring the effects of rubrics on teachers. However, few studies focus their attention on the perception that students have of the evaluation process through rubrics.

Methods
A cross-sectional survey study was carried out with 134 students enrolled in the pre-graduate Physiotherapy education. Assessment of manual skills during a practical examination was performed using an e-rubric tool. Peer-assessment, self-assessment and teacher´s assessment were registered. After completion of the examination process, students’ perceptions, satisfaction and engagement were collected.

Results
Quantitative results related to students’ opinion about e-rubric based assessment, students’ engagement, perceived benefits and drawbacks of the e-rubric as well as the overall assessment of the learning experience were obtained. 86.6% of the students agreed upon the fact that “the rubric allowed one to know what it is expected from examination” and 83.6% of the students agreed upon the fact that “the rubric allowed one to verify the level of competence acquired”. A high rate of agreement (87.3%) was also reached among students concerning feedback.

Conclusions
E-rubrics seemed to have the potential to promote learning by making criteria and expectations explicit, facilitating feedback, self-assessment and peer-assessment. The importance of students in their own learning process required their participation in the assessment task, a fact that was globally appreciated by the students. Learning experience was considered interesting, motivating, it promoted participation, cooperative work and peer-assessment. The use of e-rubrics increased engagement levels when attention was focused on their guidance and reflection role.
Experiences and contextual practices of family-centered care in Ghanaian nicus: a qualitative study of families and clinicians
Authors: Abukari Alhassan Sibdow , Acheampong Angela Kwartemaa , Aziato Lydia 
Published: August 2022

Abstract
Background
Families, whether at home or at the hospital, should be a vital part of newborn care. However, most families are excluded from hospital care, particularly in neonatal intensive care units (NICUs). This is incompatible with the concepts of Family-Centered Care (FCC) and may compromise care continuity and family satisfaction following discharge from neonatal intensive care facilities. The purpose of this study was to examine FCC practices in Ghanaian neonatal intensive care units and provide the experiences and contextual practices of FCC from the perspectives of families and clinicians.

Methods
The study qualitatively examined the contextual practices of FCC from the perspectives of families and clinicians in neonatal intensive care units using an exploratory descriptive design. With the help of MAXQDA software, 36 transcripts were generated and their contents were analyzed.

Results
Contextual practices of FCC, family experiences of FCC and clinician experiences of FCC emerged as three main categories from the data. Respect and dignity, culture and religion and a multidisciplinary approach were the contextual practices. Emotional stress, lack of information and coping strategies were all common family experiences. Support, counseling, education and financial problems have all been experienced by clinicians.

Conclusions
Shared decision-making, counseling and education, as well as respect/dignity amongst clinicians, managers and families using a multidisciplinary approach are the fundamental concepts of FCC approach in Ghana. Acceptance and integration of FCC approach into neonatal intensive care units may reduce the burden of care as well as improve the quality of care. Further studies are needed to map out strategies and interventions for the integration of FCC into intensive care units.
Cardiovascular health in the menopause transition: a longitudinal study of up to 3892 women with up to four repeated measures of risk factors
Authors: Clayton Gemma L. , Soares Ana Gonçalves , Kilpi Fanny , Fraser Abigail , Welsh Paul , Sattar Naveed , Nelson Scott M. , Tilling Kate , Lawlor Deborah A. 
Published: August 2022

Abstract
Background
Women experience adverse changes in cardiovascular health in mid-life; whether the menopausal transition influences these remains strongly debated. The aim of this study was to examine associations of reproductive age (time since final menstrual period (FMP)) with change in carotid intima media thickness (CIMT) and cardiovascular risk factors and determine the role of chronological and reproductive age.

Methods
We used data from 1702 women from a pregnancy-based UK cohort who had up to four repeat cardiovascular health measures between mean age 51 (SD = 4.0) and 56 (SD = 3.6) years and experienced a natural menopause. Multilevel models were used to assess the relationship between cardiovascular measures and time since FMP (reproductive age), whilst adjusting for the underlying effects of chronological age and confounders (socioeconomic factors, body mass index, smoking, alcohol, parity, age at menarche). In addition, we looked at the relationship between cardiovascular measures by chronological age according to menopausal stages (pre-menopause, peri-menopause and post-menopause) using information from women who had and had not experienced menopause (N = 3892).

Results
There was no strong evidence that reproductive age was associated with CIMT (difference in mean 0.8 μm/year, 95% CI − 0.4, 2.1), whereas there was a strong positive association of chronological age (7.6 μm/year, 95% CI 6.3, 8.9). Consistent with this, we found weaker linear associations of reproductive compared with chronological age for atherosclerotic risk factors, such as with systolic blood pressure (− 0.1 mmHg/year, 95% CI − 0.3, 0.1, and 0.4 mmHg/year, 95% CI 0.2, 0.5, respectively) and non-HDL-cholesterol (0.02 mmol/l/year, 95% CI 0.005, 0.03, and 0.06, 95% CI 0.04, 0.07, respectively). In contrast, associations with fat mass (0.06 kg/m2/year, 95% CI 0.03, 0.10, and 0 kg/m2/year, 95% CI − 0.04, 0.04, respectively) and C-reactive protein (0.01, 95% CI 0.001, 0.02, and 0.01, 95% CI − 0.001, 0.02 natural logged mg/l/year, respectively) were stronger for reproductive compared with chronological age. Both reproductive and chronological age were (weakly) positively associated with glucose (0.002, 95% CI 0.0001, 0.003, and 0.002, 95% CI 0.0001, 0.003 natural logged mmol/l/year, respectively).

Conclusions
Our results suggest that going through the menopausal transition does not further increase women’s risk of atherosclerosis (measured by CIMT) beyond effects of ageing. Menopausal transition may, in additional to ageing, modestly increase adiposity and glucose levels and therefore a possible associated diabetes risk.
Optimization of the production process for the anticancer lead compound illudin M: downstream processing
Authors: Chaverra-Muñoz Lillibeth , Briem Theresa , Hüttel Stephan 
Published: August 2022

Abstract
Background
Secondary metabolites have played a key role as starting points for drug development programs due to their often unique features compared with synthetically derived molecules. However, limitations related to the discovery and supply of these molecules by biotechnological means led to the retraction of big pharmaceutical companies from this field. The reasons included problems associated with strain culturing, screening, re-discovery, purification and characterization of novel molecules from natural sources. Nevertheless, recent reports have described technical developments that tackle such issues. While many of these reports focus on the identification and characterization of such molecules to enable subsequent chemical synthesis, a biotechnological supply strategy is rarely reported. This may be because production processes usually fall under proprietary research and/or few processes may meet the requirements of a pharmaceutical development campaign. We aimed to bridge this gap for illudin M—a fungal sesquiterpene used for the development of anticancer agents—with the intention to show that biotechnology can be a vital alternative to synthetic processes dealing with small molecules.

Results
We used µL-scale models to develop an adsorption and extraction strategy for illudin M recovery from culture supernatant of Omphalotus nidiformis and these findings were successfully transferred into lab-scale. By adsorbing and eluting the product using a fixed resin-bed we reduced the working volume by ~ 90% and removed the aqueous phase from the process. After a washing step, a highly concentrated illudin M fraction was obtained by isocratic elution with 80% methanol. The fraction was dried and extracted using a water/heptane mixture, enriching illudin M in the heptane phase. From heptane illudin M could be instantly crystalized by concentrating the solution, achieving a final purity > 95%.

Conclusion
We have developed a robust, scalable and low-cost downstream process to obtain highly pure illudin M. By using solid phase extraction we reduced the production of solvent waste. Heptane from the final purification step could be recycled. The reduced amounts of solvents required, and the short purification time render this method a very economic and ecologic alternative to published processes.
Judicialization of health: profile of demands for oncological medicines in a state in the central region of Brazil
Authors: Salha Leila Abou , Reis Flávia Costa , Gonçalves Roberta Moreira , Lima Jordão Horácio da Silva , Salha Nádia Abou , Pinto Roney Pereira , de Menezes José Elmo , Oliveira Eduardo Perez , Ferreira Pedro Lopes , Barbosa Maria Alves 
Published: August 2022

Abstract
Background
The significant increase in access to oncological medicines through court cases suggests that constitutional guarantees of integral and universal care in the Brazilian public health system are uncertain.

Methods
A retrospective observational study was conducted to analyze data from lawsuits requesting oncological medicines from 2014 to 2020 in the State of Goiás, Brazil, in state and federal courts. Sociodemographic, medical, and legal variables were statistically examined using descriptive, association, and correlation methods.

Results
Women brought more than half (54%) of the 301 processes analyzed. The most frequent age group was over 55 years, with income below 3 × the minimum wage (total about USD$600/month), and their cases were promoted through the public minister and public defender’s offices. The most requested medications, not on official public health system lists, were indicated for multiple myeloma and brain cancer.

Conclusions
Improved quality of life, frequently used as a justification, could be conceptually confused with increased survival. Finally, judicialization itself indicates that individual health needs arise even with properly defined and adequately implemented public policies. These needs should be considered for the adequate provisioning of services by the state to ensure the right to health.
Influencing factors on the tendency of general practitioners to join in urban family physician program: a cross-sectional survey on Iranian physicians
Authors: Bayati Mohsen , Rashidian Arash , Yazdi-Feyzabadi Vahid , Delavari Sajad 
Published: August 2022

Abstract
Background
Urban family physician program (UFPP) is initiated as pilot by policy makers as a main reform in future of primary health care in Iran. Despite an ongoing pilot implementation of this program from 2012, it remains a main question about providing sufficient number of general practitioners (GPs). This study aimed to investigate the factors which affect GPs’ decision to join in the UFPP.

Methods
In this national cross-sectional study a sample of 666 GPs, using convenience sampling, filled a self-report questionnaire. The multivariate logistic regression was applied to explore the demographic, practice and views determinants of the tendency of GPs to join in the UFPP.

Results
More than half of GPs (58.6%) participated in the study had a positive tendency to join in the UFPP. Older GPs (adjusted OR = 3.72; 95%CI 1.05–13.09), working in public sector (adjusted OR = 2.26; 95%CI 1.43–3.58), lower income level (adjusted OR = 6.69; 95%CI 2.95–15.16), higher economic expectations (adjusted OR = 2.08; 95%CI 1.19–3.63), and higher satisfaction from medicine profession (adjusted OR = 2.00; 95%CI 1.14–3.51) were the main factors which increased the GPs tendency to enter in UFPP.

Conclusions
Decision for joining in the program is mainly affected by GPs’ economic status. This clarifies that if the program can make them closer to their target income, they would be more likely to decide for joining in the program.
Lamprey immune protein triggers the ferroptosis pathway during zebrafish embryonic development
Authors: Du Zeyu , Zhang Duo , Li Jun , Li Qingwei , Pang Yue 
Published: August 2022

AbstractBackgroundPreviously, a novel lamprey immune protein (LIP) was identified, which plays an important role in immunity and the regulation of growth and development in lampreys. However, the mechanism of how LIP regulates growth and development remains unclear.MethodsIn this study, a zebrafish model of LIP overexpression was established by delivering a transgenic plasmid to the fertilized egg. The biological function of LIP was explored in vivo through phenotypic characterization, comparative transcriptome sequencing, and physiological and biochemical analyses.ResultsLIP caused developmental toxicity in zebrafish, increased embryo mortality and exhibited strong teratogenic, lethal, and developmental inhibitory effects. Comparative transcriptome analysis showed that LIP-induced large-scale cell death by triggering ferroptosis. Furthermore, LIP-induced lipid peroxidation and caused pericardial edema. Direct inhibition ofacsl4aandtfr1a, or silencing ofacsl4aandtfr1awith specific siRNA suppressed ferroptosis and pericardial edema.ConclusionsTaken together, we confirmed that LIP can participate in growth and development via the regulation of lipid peroxidation and ferroptosis. This lays the foundation for future studies on the function of LIP in lampreys.
Multiple-pinhole collimators improve intra- and between-rater agreement and the certainty of the visual interpretation in dopamine transporter SPECT
Authors: Mathies Franziska , Apostolova Ivayla , Dierck Lena , Jacobi Janin , Kuen Katja , Sauer Markus , Schenk Michael , Klutmann Susanne , Forgács Attila , Buchert Ralph 
Published: August 2022

Abstract
Background
Multiple-pinhole (MPH) collimators improve the resolution–sensitivity trade-off compared to parallel-hole collimators. This study evaluated the impact of MPH collimators on intra- and between-rater agreement, and on the certainty of visual interpretation in dopamine transporter (DAT)-SPECT.

Methods
The study included 71 patients (62.1 ± 12.7 y). Two SPECT acquisitions were performed in randomized order after a single injection of 182 ± 9 MBq 123I-FP-CIT, one with MPH and one with low-energy–high-resolution–high-sensitivity (LEHRHS) collimators. MPH projections were reconstructed with an iterative 3d Monte Carlo algorithm. LEHRHS projections were reconstructed with filtered backprojection (FBP) or with ordered-subsets expectation–maximization and resolution recovery (OSEM). Images were visually evaluated twice by three independent raters with respect to presence/absence of Parkinson-typical reduction of striatal 123I-FP-CIT uptake using a Likert 6-score (− 3 = clearly normal, …, 3 = clearly reduced). In case of intra-rater discrepancy, an intra-rater consensus was obtained. Intra- and between-rater agreement with respect to the Likert score (6-score and dichotomized score) was characterized by Cohen’s kappa.

Results
Intra-rater kappa of visual scoring of MPH/LEHRHS-OSEM/LEHRHS-FBP images was 0.84 ± 0.12/0.73 ± 0.06/0.73 ± 0.08 (6-score, mean of three raters) and 1.00 ± 0.00/0.96 ± 0.04/0.97 ± 0.03 (dichotomized score). Between-rater kappa of visual scoring (intra-rater consensus) of MPH/LEHRHS-OSEM/LEHRHS-FBP images was 0.70 ± 0.06/0.63 ± 0.08/0.48 ± 0.05 (6-score, mean of three pairs of raters) and 1.00 ± 0.00/0.92 ± 0.04/0.90 ± 0.06 (dichotomized score). There was a decrease of (negative) Likert scores in normal DAT-SPECT by 0.87 ± 0.18 points from the LEHRHS-OSEM to the MPH setting. The (positive) Likert scores of reduced DAT-SPECT did not change on average.

Conclusions
MPH collimators improve intra- and between-rater agreement as well as the certainty of the visual interpretation of DAT-SPECT.
Comparison of different clinical risk scores to predict long-term survival and neurological outcome in adults after cardiac arrest: results from a prospective cohort study
Authors: Blatter René , Amacher Simon A. , Bohren Chantal , Becker Christoph , Beck Katharina , Gross Sebastian , Tisljar Kai , Sutter Raoul , Marsch Stephan , Hunziker Sabina 
Published: August 2022

Abstract
Background
Several scoring systems have been used to predict short-term outcome in patients with out-of-hospital cardiac arrest (OHCA), including the disease-specific OHCA and CAHP (Cardiac Arrest Hospital Prognosis) scores, as well as the general severity-of-illness scores Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II). This study aimed to assess the prognostic performance of these four scores to predict long-term outcomes (≥ 2 years) in adult cardiac arrest patients.

Methods
This is a prospective single-centre cohort study including consecutive cardiac arrest patients admitted to intensive care in a Swiss tertiary academic medical centre. The primary endpoint was 2-year mortality. Secondary endpoints were neurological outcome at 2 years post-arrest assessed by Cerebral Performance Category with CPC 1–2 defined as good and CPC 3–5 as poor neurological outcome, and 6-year mortality.

Results
In 415 patients admitted to intensive care, the 2-year mortality was 58.1%, with 96.7% of survivors showing good neurological outcome. The 6-year mortality was 82.5%. All four scores showed good discriminatory performance for 2-year mortality, with areas under the receiver operating characteristics curve (AUROC) of 0.82, 0.87, 0.83 and 0.81 for the OHCA, CAHP, APACHE II and SAPS II scores. The results were similar for poor neurological outcome at 2 years and 6-year mortality.

Conclusion
This study suggests that two established cardiac arrest-specific scores and two severity-of-illness scores provide good prognostic value to predict long-term outcome after cardiac arrest and thus may help in early goals-of-care discussions.
Direct and indirect associations among mothers’ invalidating childhood environment, emotion regulation difficulties, and parental apology
Authors: Adams-Clark Alexis A. , Lee Angela H. , Everett Yoel , Zarosinski Arianna , Martin Christina Gamache , Zalewski Maureen 
Published: August 2022

Abstract
Background
Effective emotion regulation abilities are essential for engaging in positive, validating parenting practices. Yet, many parents report difficulties with both emotion regulation and positive parenting, and these difficulties may in part be the result of parents’ own childhood experiences of invalidation. Building upon prior literature documenting the intergenerational transmission of invalidation and emotion dysregulation, the present study examined the associations between these constructs and a specific parenting practice – parental apology – that can be conceptualized as a type of validating parenting practice.

Methods
Using a sample of 186 community mothers, we tested direct and indirect relationships via correlational and path analysis between participants’ retrospective reports of parental invalidation during childhood, difficulties with emotion regulation, and two aspects of parental apology – proclivity (i.e., participants’ self-reported propensity to apologize to their child) and effectiveness (i.e., participants’ inclusion of specific apology content when prompted to write a child-directed apology). Parental invalidation, difficulties with emotion regulation, and parental apology proclivity were measured via self-report questionnaires. Apology effectiveness was measured by coding written responses to a hypothetical vignette.

Results
There was a significant negative bivariate relationship between difficulties with emotion regulation and parental apology proclivity and effectiveness. Parents’ own childhood experiences of invalidation were linked to parental apology indirectly via emotion regulation difficulties.

Conclusions
Results suggest that mothers with greater difficulties regulating emotions may be less able to or have a lower proclivity to apologize to their child when appropriate. Thus, parent apology may be an important addition to current calls for parent validation training.
Survival and predictors of mortality among HIV-positive children on antiretroviral therapy in public hospitals
Authors: Biyazin Yalemgeta , Wondwossen Kalkidan , Wubie Azene Bantie , Getachew Melese , Gebremichael Bereket 
Published: August 2022

Abstract
Background
Human immunodeficiency virus and acquired immunodeficiency syndrome had created enormous challenges worldwide, and continues to be the world’s serious health and development challenges. Globally, at the end 2017, there were 1.8 million children (< 15 years) living with HIV. The survival of HIV-positive children treated with ART depends on a variety of factors, which might vary greatly with economic, socio-demographic, behavioral risk, and health factors. This study aimed to assess survival status and predictors of mortality among HIV-positive children on antiretroviral therapy at East Gojjam Zone Public hospitals, Northwest Ethiopia.

Methods
An institution-based retrospective cohort study was conducted in selected hospitals of the East Gojjam zone, Northwest Ethiopia, among < 15-year-old children who were newly enrolled in HIV care clinic from January 1st, 2014 to December 31, 2018. Data were collected from patient charts from March 1 to 22, 2019 using a standardized checklist. Data were analyzed by SPSS version 24. A Kaplan–Meier curve and log-rank test were used to estimate the survival time and compare survival curves between variables. Multivariable Cox proportional-hazards model was fitted to identify predictors of survival status taking p-value < 0.05 as statistically significant.

Result
In this study, a total of 251 HIV-positive children on ART were followed up for a total of 60 months, with a mean survival time of 55.54 (± 0.83) (95% CI: 53.90–57.17) months. The overall mortality incidence rate in the cohort during the 626 Child-Year-Observation (CYO) was 2.56/100 CYO. The overall estimated survival probability after starting ART was 0.90 at 60 months of follow-up. In this study age < 5 years, Hgb < 10 gm/dl, CD4 count below threshold, cotrimoxazole preventive therapy, and subnormal weight for height were statistically significant predictors of survival status (P < 0.05).

Conclusion and recommendation
Age, hemoglobin level, CD4 count, weight for height, and not taking cotrimoxazole preventive therapy were independent predictors of mortality. Therefore, concerned stakeholders should focus on the above-mentioned predictors of mortality and nutritional interventions to enhance the survival of HIV-infected children on antiretroviral therapy.