bluuebunny/crossref_metadata_2025 huggingface dataset:
Anxiety and Depression Among Patients Newly Diagnosed with Lymphoma and Myeloma
Authors: Odejide Oreofe O. , Cronin Angel M , Gray Tamryn F , Ablorh Tsotso , Ying Anna , Yang Amelia , Ashley Cheyenne Annette , Tidswell Anna Juanjuan , Shi Eleanor , Yusufov Miryam , Abel Gregory A. , Roemer Lizabeth
Published: January 2025

Although lymphoma and myeloma confer physical and psychological burden, data are limited regarding anxiety and depression symptoms in affected patients. We conducted a survey between 07/2021 and 09/2022 to characterize anxiety and depression in a cohort of adult patients, within six months of a lymphoma or myeloma diagnosis. Clinically significant anxiety and depression symptoms were defined as scores ≥8 on the corresponding subscales of the Hospital Anxiety and Depression Scale. We assessed sociodemographic factors associated with anxiety/depression symptoms and examined the relationship between anxiety/depression symptoms and quality of life (QOL) in multivariable analyses. Our cohort included 200 patients (response rate=74.9%), of which 45.5% were female, and 55.5% were ≥ 60years. Over half of the cohort (56.2%) had clinically significant anxiety and/or depression symptoms, with 52.0% (95%CI 44.9%-59.1%) meeting the cutoff for anxiety and 27.5% (95%CI 21.6%-34.3%) for depression. Lower financial satisfaction (adjusted odds ratio [AOR] 2.43, 95%CI 1.25-4.78) and greater levels of medical mistrust (AOR 2.09, 95% CI 1.10-4.02) were associated with higher odds of anxiety. Lower financial satisfaction (AOR 2.12, 95%CI 1.07-4.30) and lower levels of social support (AOR 2.88, 95%CI 1.42-6.00) were associated with higher odds of depression. Depression was associated with lower QOL (adjusted mean difference = -22.0, 95% CI -28.1 to -15.9). More than half of patients newly diagnosed with lymphoma or myeloma experience clinically significant anxiety or depression symptoms, with associated detriment to their QOL. These findings underscore the need for systematic mental health screening and psychological interventions for this population.
Scrotal exploration for suspected testicular torsion in adolescents and adults: analysis of a series of 135 cases
Authors: Kirakoya Brahima , Yameogo Clotaire , Kambou Morgane , Idogo Ouedan , Ayed Abdullah , Nacthagande Gille , Kabore Fasnewinde Aristide
Published: January 2025

Background

Testicular torsion (TT) is the abnormal twisting of the spermatic cord leading to strangulation of the testis. Any non-traumatic acute scrotal pain in adolescents and young adults is considered TT until proven otherwise. It is a urological emergency. The diagnosis is clinically based on symptoms and signs that raise a high index of suspicions. Scrotal exploration is necessary, which will provide diagnostic certainty and allow treatment.

Methods

This study aimed to assess the clinical predictors of TT. This was a retrospective cross-sectional study of patients aged 15 years and older who underwent surgical exploration for suspected TT from January 2005 to December 2021 at Teaching Hospital Yalgado Ouedraogo (Burkina Faso). We compared the demographic data and clinical findings of patients according to the intraoperative diagnosis.

Results

In total, 135 scrotal explorations were performed for suspected TT. The average age of the patients was 24.56 years. TT was found in 123 cases (91.11%), epididymo-orchitis in 8 cases (5.93%) and in 4 cases (2.96%) no abnormality was found. Scrotal swelling and elevation of the testicle were more common in TT than in other cases (p < 0.001 in both cases). Fever was more frequent when it was not a TT (p < 0.001). Scrotal Doppler ultrasound had a sensitivity of 91%. The orchiectomy rate was 60.16% (N = 74) in patients with TT.

Conclusion

The clinical findings based on scrotal pain and swelling, elevation of the testicle and the absence of fever are sufficient to suggest TT and to perform surgical exploration.
Genomic selection strategies to overcome genotype by environment interactions in biosecurity-based aquaculture breeding programs
Authors: Kang Ziyi , Kong Jie , Li Qi , Sui Juan , Dai Ping , Luo Kun , Meng Xianhong , Chen Baolong , Cao Jiawang , Tan Jian , Fu Qiang , Xing Qun , Luan Sheng
Published: January 2025

Background

Family-based selective breeding programs typically employ both between-family and within-family selection in aquaculture. However, these programs may exhibit a reduced genetic gain in the presence of a genotype by environment interactions (G × E) when employing biosecurity-based breeding schemes (BS), compared to non-biosecurity-based breeding schemes (NBS). Fortunately, genomic selection shows promise in improving genetic gain by taking within-family variance into account. Stochastic simulation was employed to evaluate genetic gain and G × E trends in BS for improving the body weight of L. vannamei, considering selective genotyping strategies for test group (TG) at a commercial farm environment (CE), the number individuals of the selection group (SG) genotyped at nucleus breeding center (NE), and varying levels of G × E.

Results

The loss of genetic gain in BS ranged from 9.4 to 38.9% in pedigree-based selection and was more pronounced when G × E was stronger, as quantified by a lower genetic correlation for body weight between NE and CE. Genomic selection, particularly with selective genotyping of TG individuals with extreme performance, effectively offset the loss of genetic gain. With a genetic correlation of 0.8, genotyping 20 SG individuals in each candidate family achieved 93.2% of the genetic gain observed for NBS. However, when the genetic correlation fell below 0.5, the number of genotyped SG individuals per family had to be increased to 50 or more. Genetic gain improved by on average 9.4% when the number of genotyped SG individuals rose from 20 to 50, but the increase in genetic gain averaged only 2.4% when expanding from 50 to 80 individuals genotyped. In addition, the genetic correlation decreased by on average 0.13 over 30 generations of selection when performing BS and the genetic correlation fluctuated across generations.

Conclusions

Genomic selection can effectively compensate for the loss of genetic gain in BS due to G × E. However, the number of genotyped SG individuals and the level of G × E significantly affected the extra genetic gain from genomic selection. A family-based BS selective breeding program should monitor the level of G × E and genotyping 50 SG individuals per candidate family to minimize the loss of genetic gain due to G × E, unless the level of G × E is confirmed to be low.
Epigenome-wide association study of objectively measured physical activity in peripheral blood leukocytes
Authors: Fragoso-Bargas Nicolas , Mcbride Nancy S. , Lee-Ødegård Sindre , Lawlor Deborah A. , Yousefi Paul D. , Moen Gunn-Helen , Opsahl Julia O. , Jenum Anne Karen , Franks Paul W. , Prasad Rashmi B. , Qvigstad Elisabeth , Birkeland Kåre I. , Richardsen Kåre R. , Sommer Christine
Published: January 2025

Background

Few studies have explored the association between DNA methylation and physical activity. The aim of this study was to evaluate the association of objectively measured hours of sedentary behavior (SB) and moderate physical activity (MPA) with DNA methylation. We further aimed to explore the association between SB or MPA related CpG sites and cardiometabolic traits, gene expression, and genetic variation.

Results

For discovery, we performed cross sectional analyses in pregnant women from the Epigenetics in pregnancy (EPIPREG) sample with both DNA methylation (Illumina MethylationEPIC BeadChip) and objectively measured physical activity data (SenseWear™ Pro 3 armband) (European = 244, South Asian = 109). For EWAS of SB and MPA, two main models were designed: model (1) a linear mixed model adjusted for age, smoking, blood cell composition, including ancestry as random intercept, and model (2) which was additionally adjusted for the total number of steps per day. In model 1, we did not identify any CpG sites associated with neither SB nor MPA. In model 2, SB was positively associated (false discovery rate, FDR < 0.05) with two CpG sites within the VSX1 gene. Both CpG sites were positively associated with BMI and were associated with several genetic variants in cis. MPA was associated with 122 significant CpG sites at FDR < 0.05 (model 2). We further analyzed the ten most statistically significant MPA related CpG sites and found that they presented opposite associations with sedentary behavior and BMI. We were not able to replicate the SB and MPA-related CpG sites in the Avon Longitudinal Study of Parents and Children (ALSPAC). ALSPAC had available objectively measured physical activity data from Actigraph (without steps/day available) and leucocyte DNA methylation data collected during adolescence (n = 408, European).

Conclusion

This study suggests associations of objectively measured SB and MPA with maternal DNA methylation in peripheral blood leukocytes, that needs to be confirmed in larger samples of similar study design.
ABO and RhD blood groups as contributors to dyslipidaemia – a cross-sectional study
Authors: Mickelsson Malin , Ekblom Kim , Stefansson Kristina , Liv Per , Själander Anders , Näslund Ulf , Hultdin Johan
Published: January 2025

Background

The ABO blood group system has shown an association with cardiovascular disease. The susceptibility to CVD is proposed to be partly mediated by dyslipidaemia in non-O individuals. Previous studies are scarce for the RhD blood group, but we recently showed that RhD − young individuals are associated with subclinical atherosclerosis. Hence, we sought to examine whether the ABO blood groups and RhD factor are associated with dyslipidaemia.

Methods

All participants were part of the VIPVIZA study, including 3532 individuals with available plasma lipid levels. Lipids were assessed as total, LDL, HDL, remnant, non-HDL cholesterol and triglycerides. Information about ABO and RhD was retrieved by linking VIPVIZA with the SCANDAT-3 database, where 85% of VIPVIZA participants were registered.

Results

For the ABO blood groups, no significant differences in lipid levels between non-O and O individuals were seen. In 40-year-old males, RhD − individuals compared to RhD + had higher levels of non-HDL cholesterol, LDL cholesterol, and remnant cholesterol, with ratios of geometric means of 1.21 (CI95% 1.03; 1.43), 1.20 (1.02; 1.41) and 1.38 (1.00; 1.92), respectively. No differences in lipid levels depending on the RhD blood group were seen in women or the older age groups.

Conclusion

Our study indicates that younger RhD − men have increased non-HDL, LDL, and remnant cholesterol levels. Thus, the RhD blood group, but not ABO, seems to be associated with dyslipidaemia and may act as a future possible risk marker of cardiovascular disease.

Graphical Abstract
Drug allergy
Authors: Jeimy Samira , Wong Tiffany , Ben-Shoshan Moshe , Copaescu Ana Maria , Isabwe Ghislaine A. C. , Ellis Anne K.
Published: January 2025

Drug allergy encompasses a spectrum of immunologically-mediated hypersensitivity reactions (HSRs) with varying mechanisms and clinical presentations. This type of adverse drug reaction (ADR) not only affects patient quality of life, but may also lead to delayed treatment, unnecessary investigations, and increased morbidity and mortality. Given the spectrum of symptoms associated with the condition, diagnosis can be challenging. Therefore, referral to an allergist experienced in the diagnosis and management of drug allergy is recommended if a drug-induced allergic reaction is suspected. Diagnosis relies on a careful history and physical examination and, in some instances, skin testing or in vitro testing and drug challenges. The most effective strategy for the management of allergist-confirmed drug allergy is avoidance or discontinuation of the offending drug. When available, alternative medications with unrelated chemical structures should be substituted. Cross-reactivity among drugs should also be taken into consideration when choosing alternative agents. Additional therapy for drug HSRs may include topical corticosteroids, oral antihistamines and, in severe cases, systemic corticosteroids and other immunomodulators. In the event of anaphylaxis, the treatment of choice is intramuscular epinephrine. If a patient with a history of anaphylaxis requires a specific drug and there is no acceptable alternative, desensitization to that drug may be considered. This article provides a background on drug allergy and strategies for the diagnosis and management of some of the most common drug-induced allergic reactions.
Glutamine-glutamate centered metabolism as the potential therapeutic target against Japanese encephalitis virus-induced encephalitis
Authors: Li Mengyuan , Yuan Hang , Yang Xiaofei , Lei Yingfeng , Lian Jianqi
Published: January 2025

Background

Japanese encephalitis (JE) induced by Japanese encephalitis virus (JEV) infection is the most prevalent diagnosed epidemic viral encephalitis globally. The underlying pathological mechanisms remain largely unknown. Given that viruses are obligate intracellular parasites, cellular metabolic reprogramming triggered by viral infection is intricately related to the establishment of infection and progression of disease. Therefore, uncovering and manipulating the metabolic reprogramming that underlies viral infection will help elucidate the pathogenic mechanisms and develop novel therapeutic strategies.

Methods

Metabolomics analysis was performed to comprehensively delineate the metabolic profiles in JEV-infected mice brains and neurons. Metabolic flux analysis, quantitative real-time PCR, western blotting and fluorescence immunohistochemistry were utilized to describe detailed glutamine-glutamate metabolic profiles during JEV infection. Exogenous addition of metabolites and associated compounds and RNA interference were employed to manipulate glutamine-glutamate metabolism to clarify its effects on viral replication. The survival rate, severity of neuroinflammation, and levels of viral replication were assessed to determine the efficacy of glutamine supplementation in JEV-challenged mice.

Results

Here, we have delineated a novel perspective on the pathogenesis of JE by identifying an aberrant low flux in glutamine-glutamate metabolism both in vivo and in vitro, which was critical in the establishment of JEV infection and progression of JE. The perturbed glutamine-glutamate metabolism induced neurotransmitter imbalance and created an immune-inhibitory state with increased gamma-aminobutyric acid/glutamate ratio, thus facilitating efficient viral replication both in JEV-infected neurons and the brain of JEV-infected mice. In addition, viral infection restrained the utilization of glutamine via the glutamate-α-ketoglutaric acid axis in neurons, thus avoiding the adverse effects of glutamine oxidation on viral propagation. As the conversion of glutamine to glutamate was inhibited after JEV infection, the metabolism of glutathione (GSH) was simultaneously impaired, exacerbating oxidative stress in JEV-infected neurons and mice brains and promoting the progression of JE. Importantly, the supplementation of glutamine in vivo alleviated the intracranial inflammation and enhanced the survival of JEV-challenged mice.

Conclusion

Altogether, our study highlights an aberrant glutamine-glutamate metabolism during JEV infection and unveils how this facilitates viral replication and promotes JE progression. Manipulation of these metabolic alterations may potentially be exploited to develop therapeutic approaches for JEV infection.

Graphical Abstract
Dietary supplementation of blend of organic acids and monoglycerides alleviated diarrhea and systemic inflammation of weaned pigs experimentally infected with enterotoxigenic Escherichia coli F18
Authors: Park Sangwoo , Sun Shuhan , Wongchanla Supatirada , Chen Ying , Li Xunde , Liu Yanhong
Published: January 2025

Background

The emergence of antibiotic resistant microorganisms associated with conventional swine production practices has increased interest in acid-based compounds having antimicrobial properties and other biological functions as nutritional interventions. Despite the interest in organic acids and monoglycerides, few studies have examined the effects of the combination of these acid-based additives in weaned pigs under disease challenge conditions. Therefore, this study aimed to investigate the effects of dietary supplementation with blend of organic acids and/or medium-chain fatty acid monoglycerides on intestinal health and systemic immunity of weaned pigs experimentally infected with an enterotoxigenic Escherichia coli (ETEC) F18 at 4-week of age.

Results

Dietary supplementation of organic acids, monoglycerides, or both organic acids and monoglycerides (combination) reduced (P < 0.05) the diarrhea frequency of ETEC F18-infected pigs throughout the experimental period (d −7 to 21 post-inoculation). This is consistent with the reduced (P < 0.05) proportion of β-hemolytic coliforms in feces observed for the organic acid and combination treatments on d 10 post-inoculation. Supplementation of organic acids, monoglycerides, or combination also reduced (P < 0.05) bacterial translocation in mesenteric lymph nodes on d 21 post-inoculation. Pigs fed with monoglycerides or combination had lower (P < 0.05) white blood cells on d 5 post-inoculation, and pigs fed the combination also had lower (P < 0.05) lymphocytes than pigs in control group. Monoglyceride supplementation increased (P < 0.05) white blood cells and neutrophils compared with control group on d 14 post-inoculation. However, supplementation with organic acid blend, monoglyceride blend, or combination did not affect growth performance in this experiment.

Conclusions

Supplementation with monoglycerides or organic acids alone or in combination improves the detrimental effects of ETEC F18 infection in weaned pigs, as indicated by reduced diarrhea, fecal shedding of β-hemolytic coliforms, and bacterial translocation, and thus enhancing disease resistance. Monoglycerides reduced the inflammatory response during peak infection, but their immunomodulatory and possible synergistic effects with organic acids need to be further investigated.
Capillary refill time paradoxically decreases in a blood loss shock model
Authors: Gustavsson Hugo , Meyer Frida , Fahlander Sara , Ölwegård Birgitta , Jonasson Hanna , Toll Rani , Henricson Joakim , Wilhelms Daniel
Published: January 2025

Background

This study aimed to investigate whether changes in capillary refill (CR) time precede macrovascular signs of deterioration in a human model of blood loss shock. The study was conducted at the Department of Emergency Medicine in Linköping, Sweden, and involved 42 healthy volunteers aged 18–45. Participants were randomized into two provocations of applied lower body negative pressure (LBNP): a stepwise escalation protocol and a direct application protocol, to simulate gradual and acute blood loss. The main outcome measure was CR time. Systolic, diastolic, and mean arterial pressures, heart rate, cardiac output, and systemic vascular resistance were measured continuously. CR time was assessed on the finger pulp using a standardized pressure and measured with a polarized reflectance imaging system.

Results

The provocation elicited pre-syncope reactions and clear decrease in blood pressure for all participants, yet two-thirds of the participants in both protocols reacted with shorter CR times at maximum provocation, and the overall median CR time decreased by 0.2 s (Wilcoxon W = − 395.0, range: − 6.3 to 3.2, IQR − 1.3 to 0.1, P = 0.0070). Participants with shorter CR times exhibited comparatively greater increases in systemic vascular resistance and a more pronounced decrease in cardiac output.

Conclusions

Our findings reveal that finger CR time paradoxically decreases in a majority of healthy volunteers in a lower body negative pressure model of blood loss, challenging traditional assumptions about the CR test’s reliability as a shock indicator in its present interpretation.
Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study
Authors: Schrage Theresa , Glissmann Claudia , Thomalla Götz , Rimmele David Leander , Schmidt Holger , Rosenkranz Michael , Boskamp Stefan , Härter Martin , Kriston Levente
Published: January 2025

Background

Implementation of interventions to improve follow-up stroke care is complex due to the involvement of various stakeholders and challenges of health care coordination. The aim of this study was to evaluate the process of implementing a cross-sectoral, coordinated follow-up care for stroke patients (the StroCare intervention).

Methods

As part of a multicenter interventional trial, this qualitative study was performed in a pre-post design with semi-structured interviews conducted with patients and health care employees. The multicomponent intervention was implemented in eight participating acute care and rehabilitation clinics. The interviews were analyzed using qualitative content analysis. Contents were coded using eight a priori defined categories (acceptability, adoption, appropriateness, feasibility, fidelity, sustainability, patient-centeredness, satisfaction with treatment, and pandemic-related effects) with the possibility of inductively developed categories.

Results

Interviews with 21 patients and 34 interviews with 23 employees were conducted. In addition to the deductive categories, three inductive categories (psychosocial implications, interconnectedness, and potential for improvement) emerged. Acceptability, adoption, and appropriateness were assessed positively before the intervention. However, poor feasibility had a negative impact on adoption and appropriateness. In contrast, outcomes related to patient care (patient-centeredness and psychosocial implications) were independent from this effect.

Conclusions

Similar to other implementation studies of stroke care interventions, implementation of eHealth Services in the StroCare project met barriers in usability and adaptability of new software. However, high adoption and appropriateness in regard to patient-centeredness, psychosocial implications, and an overall benefit for the patients supported continuation of the remaining intervention components.

Trial registration The trial is registered at ClinicalTrials.gov (NCT04159324), registration date 12/11/19.
Towards tetanus elimination
Authors: Ibrahim Hamdy , Zaky Samy , Hagag Mahmoud , Bahawashy Ahmed S. El , Elsawy Mohamed
Published: January 2025

Tetanus is a serious toxin-mediated disease caused by Clostridium tetani, and it was well-known to ancient physicians and in Greece. The disease is still prevalent in developing countries including Egypt with high morbidity and mortality. It is preventable with a safe and cost-effective vaccine and effective immunization programs. Based on the remarkable success of the World Health Organization (WHO) in reducing maternal and neonatal tetanus throughout the world, lowering tetanus among adults is also possible if a plan for disease elimination is promoted.
A Cursing Brain? The Histories of Tourette Syndrome, by Howard I. Kushner
Authors: Biswas Asit B. , Singhania Binod K. , Kiani Reza
Published: January 2025

Kushner's monograph (published in 2000) explores clinicians’ developing understanding of a syndrome first described 200 years ago. This article highlights changing concepts of the disorder, its aetiology and treatment over its long history, as described by Kushner, and considers the current differential diagnosis of DSM-5 ‘Tourette's disorder’. It points out Kushner's astute observation that the clinical syndrome originally described by Itard and Gilles de la Tourette as ‘maladie des tics’ is not what is defined in the 21st century as Tourette syndrome.
Cell-Based Therapies in GI Cancers: Current Landscape and Future Directions
Authors: Nakayama Izuma , Shitara Kohei
Published: January 2025

Cell-based therapies have become integral to the routine clinical management of hematologic malignancies. Tumor-infiltrating lymphocyte (TIL) therapy has demonstrated efficacy in immunogenic solid tumors, such as melanoma. However, in the GI field, evidence supporting the clinical success of cell-based therapies is still awaited. CLDN18.2, a key tight junction molecule in stomach epithelium, has emerged as a promising target for gastric cancer (GC) treatment. Because of its lineage-specific expression, significant efforts have been made to develop chimeric antigen receptor T-cell (CAR-T) therapies targeting CLDN18.2. These therapies have shown encouraging tumor shrinkage in patients with heavily pretreated GC. However, durable responses remain uncommon. CAR-T exhaustion driven by immune-suppressive cells in the tumor microenvironment, along with the heterogeneous expression of target molecules, poses significant challenges. In addition, managing on-target, off-tumor toxicities remains a critical issue in therapies targeting tissue-associated antigens. Next-generation CARs are expected to address these resistance mechanisms. Furthermore, adoptive macrophage and natural killer cell therapies hold promise for not only their efficacy but also for the ease off-the-shelf production. Advanced neoantigen prediction and identification of optimal T-cell activation targets could facilitate the clinical application of TIL and T-cell receptor-T therapies in GI cancers. Cell-based therapies might have the potential to transform the treatment landscape for GI cancers.
Integrative Oncology: Incorporating Evidence-Based Approaches for Patients With GI Cancers
Authors: Atreya Chloe E. , Leach Heather , Asiimwe Edgar , Bahri Natasha , Le Bryan Khuong , Macaire Greta , Wood Kelley C. , Van Blarigan Erin L. , Lee Richard T.
Published: January 2025

Data have matured to support incorporation of integrative oncology modalities into comprehensive cancer care. Clinical practice guidelines have recently been published by ASCO for diet and exercise (2022) and use of cannabinoids and cannabis (2024) and jointly by ASCO and the Society for Integrative Oncology (SIO) for application of integrative approaches in the management of pain (2022), anxiety and depression (2023), and fatigue (2024) among adults with cancer. Following the ASCO-SIO guidelines, clinicians should recommend mindfulness-based interventions (MBIs) to patients with symptoms of anxiety or depression and MBIs and exercise for management of fatigue during or after completion of cancer treatment. We will review the basis of these recommendations and evidence to support use of other mind-body approaches, exercise, nutrition, acupuncture/acupressure, and natural products in the specific contexts of GI cancers. For example, optimizing physical activity and diet is associated with improved survival after a colorectal cancer (CRC) diagnosis, in addition to conferring symptom management benefits. We will also highlight gaps in research, including that most studies enrolling patients with GI malignancies have focused on CRC. A limitation of nonpharmacologic evidence-based guidelines is that they list broad categories (eg, yoga or acupuncture) and lack implementation details.
How
to safely and equitably incorporate integrative approaches into conventional cancer care will be addressed. This ASCO Educational Book article aims to be both evidence-informed and practical, with attention to unique considerations for people with GI cancers.
Musician's Experience After Breast Cancer Treatment: Defining Musical Toxicity and its Frequency
Authors: Burlile Jessica F. , Cameron Joshua D. , Gunn Heather J. , Larson Nicole L. , Bradt Jennifer L. , Boughey Judy C. , Mrdutt Mary M. , Couch Fergus J. , Olson Janet E. , Cangie Valerie , Ehlers Shawna , Sharifzadeh Yasamin , Ruddy Kathryn J. , Shumway Dean A. , Loprinzi Charles L. , Cathcart-Rake Elizabeth J.
Published: January 2025

PURPOSE

Over 50% of households in the United States have at least one musician—many musicians are also breast cancer survivors. This group has not been well studied, and given the level of fine sensory-motor skill required for musicianship, we hypothesized that musicians experience unique manifestations of breast cancer treatment toxicities.

METHODS

A nine-item Musical Toxicity Questionnaire (MTQ) was distributed to patients who had consented to participate in the Mayo Clinic Breast Cancer Registry. The MTQ screened participants by asking if they played a musical instrument or sang in the last 10 years: questions populated for those who answered yes. Respondents were asked if they noticed difficulty with their musical endeavor during or after breast cancer treatment, defined as acute musical toxicity (AMT). The questionnaire asked which side effect and cancer-directed therapy most influenced musical ability, what musical attributes were affected, and the timeline of resolution. Multivariable and classification tree analyses assessed relationships between AMT and treatment characteristics.

RESULTS

Of 1,871 survey respondents, 29% (535/1,871) self-identified as musicians. Over a quarter (27%, 144/535) reported AMT, and for 57% (82/144), AMT had not resolved at the time of survey. Of the treatments each participant received, chemotherapy was most often reported as most negatively impactful (63/89 who received chemotherapy, 71%). Decreased endurance was the most common musical difficulty (64% of those with AMT, 92/144), followed by decreased accuracy, trouble playing/singing quickly, and difficulty using proper technique. Multivariable and classification tree analyses revealed that receipt of chemotherapy was most strongly correlated with AMT.

CONCLUSION

These results will help oncology care teams counsel musicians, answer questions about impacts on musicality, and provide a timeline for resolution of musical symptoms.
Assessment of vital pulp therapy education in undergraduate dental programs in Saudi Arabia: A cross-sectional study
Authors: Javed Muhammad Qasim , Badi B. Alotaibi  , Mohsin Syed Fareed , Ayman M. Abulhamael  , Bhatti Usman Anwer
Published: January 2025

Background & Objective: Dental caries remains a paramount public health concern among young children in Saudi Arabia. Vital pulp therapy is a vital component of regenerative endodontics that aims to maintain the vitality of the pulp. This study evaluates the teaching methods used for Vital pulp therapy (VPT) in undergraduate dental programs among Saudi Arabian dental schools.
Methods: This survey was conducted in fifteen dentistry colleges in Saudi Arabia, specifically targeting undergraduate institutions. The survey was administered through a Google form e-questionnaire. The colleges were classified according to their year of establishment. The study evaluated the implementation of VPT in lectures and pre-clinic/simulation sessions and identified the faculty members responsible for conducting these sessions.
Results: All surveyed colleges provided didactic teaching on VPT for permanent teeth. However, only 46.7% of the colleges included practical VPT training in their pre-clinic/simulation curriculum. Among colleges with founding years < 10 years, only 25% offered practical VPT training; however, established institutions over 20 years are more inclined to incorporate VPT into their pre-clinic/simulation sessions. The pre-clinical simulation sessions were mainly conducted by endodontists (85.7%), with a minor involvement from pedodontists (14.3%).
Conclusion: Saudi dental schools should standardize and enhance their VPT curricula to better prepare dental students for contemporary practice. Addressing current deficiencies and adopting the proposed changes will likely improve patient outcomes in vital pulp therapy.
doi: https://doi.org/10.12669/pjms.41.2.11022
How to cite this: Javed MQ, Alotaibi BB, Mohsin SF, Abulhamael AM, Bhatti UA. Assessment of vital pulp therapy education in undergraduate dental programs in Saudi Arabia: A cross-sectional study. Pak J Med Sci. 2025;41(2):415-419. doi: https://doi.org/10.12669/pjms.41.2.11022
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Perioperative care bundle versus conventional perioperative care in pediatric patients undergoing minimally invasive digestive endoscopy
Authors: Wang Liya , Zheng Lijuan , Zhao Xiaobo , Gong Xue , Su Zhengyi , Gong Shuokang
Published: January 2025

Objective: To investigate the effect of perioperative care bundle in pediatric patients undergoing minimally invasive digestive endoscopy.
Methods: This was a retrospective study using clinical records of pediatric patients who underwent minimally invasive digestive endoscopy surgery at Hebei Children’s Hospital from May 2020 to October 2023. Patients were divided into Care bundle group and Conventional care group based on the treatment received and matched for age, gender, and body mass index in 1:1 ratio. Perioperative vital signs, postoperative recovery, incidence of complications, and family members’ satisfaction with nursing care were analyzed.
Results: A total of 98 pediatric patients were included, with 49 patients in each group. After surgery, diastolic blood pressure (DBP), systolic blood pressure (SBP), heart rate (HR), and mean arterial pressure (MAP) of both groups increased compared to preoperative values and were significantly lower in the Care bundle group compared to the Conventional care group (P<0.05). The time for anal exhaust, time for defecation, time to first out-of-bed activity, time to start eating after surgery, and length of hospital stay were shorter in the Care bundle than the Conventional care group (all P<0.05). The incidence of complications in the Care bundle group (4.08%) was lower than the Conventional care group (16.32%) (P<0.05). The overall family members’ satisfaction with the nursing care was considerably higher in the Care bundle group (93.88%) compared to the Conventional care group (81.63%) (P<0.05).
Conclusions: Perioperative care bundle in pediatric patients undergoing minimally invasive digestive endoscopy was shown to be more efficacious than the conventional perioperative care.
doi: https://doi.org/10.12669/pjms.41.2.11369
How to cite this: Wang L, Zheng L, Zhao X, Gong X, Su Z, Gong S. Perioperative care bundle versus conventional perioperative care in pediatric patients undergoing minimally invasive digestive endoscopy. Pak J Med Sci. 2025;41(2):399-403. doi: https://doi.org/10.12669/pjms.41.2.11369
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Role of Pediatric Dentistry in Healthcare and Economy: A Global Perspective
Authors: Wyne Amjad
Published: January 2025

doi: https://doi.org/10.12669/pjms.41.2.11710
How to cite this: Wyne AH. Role of Pediatric Dentistry in Healthcare and Economy: A Global Perspective. Pak J Med Sci. 2025;41(2):347-348.  doi: https://doi.org/10.12669/pjms.41.2.11710
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Stochastic spanning applications in finance
Authors: Παπαβασιλείου Έλλη
Published: January 2025

Με την παρούσα διδακτορική διατριβή επεκτείνεται η υφιστάμενη επιστημονική γνώση στο πεδίο της Χρηματοοικονομικής επιστήμης αναλύοντας την ικανότητα νέων χρηματοοικονομικών προϊόντων να βελτιώσουν την απόδοση των παραδοσιακών χαρτοφυλακίων. Μελετάται πώς πρέπει να σχεδιαστούν τα GDP-linked ομόλογα ώστε να είναι ελκυστικά από τους επενδυτές, καθώς και ποια φορολογική πολιτική πρέπει να ισχύσει στα πράσινα ομόλογα ώστε να βελτιώνουν τη σχέση απόδοσης/κινδύνου των παραδοσιακών χαρτοφυλακίων. Τέλος μελετάται αν το ESG score είναι σημαντικός παράγοντας για την επιλογή χαρτοφυλακίου μετοχών.
Η αυτενέργεια μέσα από σύγχρονες αναγνώσεις αρχαιοελληνικών δραμάτων
Authors: Χαριτάτος Γεώργιος-Δημήτριος
Published: January 2025

Αντικείμενο της διατριβής είναι η διερεύνηση της δυνατότητας που έχουν σπουδαίοι ήρωες κομβικών τραγωδιών των τριών μεγάλων τραγικών ποιητών να εμφανίζουν περιθώρια ελευθερίας και δυνατότητας αυτόνομης υπόστασης, λειτουργώντας άλλοτε ως παραδείγματα αυτοκαθορισμού και άλλοτε ως αντιπαραδείγματα κοινωνικής ομαλότητας. Ταυτόχρονα, μελετάται το θέμα στη συγχρονία του, διερευνάται, δηλαδή, η υπόσταση των ηρώων από τον Αισχύλο με κατάληξη τη διαχείριση των τραγικών μορφών από τον Ευριπίδη, αλλά και στη διαχρονία του εστιάζοντας σε δραματουργικές προσεγγίσεις του γαλλικού μεσοπολεμικού και μεταπολεμικού θεάτρου, καταλήγοντας σε ποιητές-σταθμούς και έργα-ορόσημα της νεοελληνικής γραμματείας, ιδίως της Πρώτης, Δεύτερης και Τρίτης Μεταπολεμικής Γενιάς. Θα γίνει προσπάθεια να διερευνηθεί ως υπόθεση εργασίας το κατά πόσο έχει αναπροσαρμοστεί η έννοια της ανθρώπινης δυνατότητας για αμιγώς προσωπική επιλογή, ελεύθερη δράση και αυτόνομη τοποθέτηση στον ορίζοντα των κοινωνικών, πολιτικών, πολιτειακών και πολιτισμικών αξιών τριών μεγάλων ιστορικών στιγμών. Η ταλάντευση του εκκρεμούς από την αρχαία Ελλάδα συνεχίζεται στις γαλλικές αναπροσαρμογές του μυθολογικού υλικού και φτάνει στο ακρότατο σημείο του στη νεοελληνική μεταπολεμική ποίηση, ώστε να καταδειχθεί αφενός η εξέλιξη του ίδιου θέματος συγχρονικά και διαχρονικά και αφετέρου συγκριτολογικά και διεπιστημονικά. Ταυτόχρονα, εξετάζεται η λειτουργία του σώματος ως δείκτης εμπρόθετης δράσης. Μέσα από αυτή την επιλογή, η στοχοθεσία της παρούσας ερευνητικής πρότασης είναι η εξελικτική μελέτη της ηρωικής αυτενέργειας, ώστε να ιχνηλατηθεί κατά πόσο ο άνθρωπος, ανεξάρτητα από οποιαδήποτε θεϊκή ή θεοκρατική συνιστώσα, πόλεμο, ιστορική συνθήκη ή πολιτική συγκυρία, έχει κρατήσει αλώβητη την προσωπική του βούληση, σεβόμενος μεν τους θεσμούς, την κοινωνία και την ηθική, ορίζοντας δε τις προσωπικές του επιταγές. Εξετάζεται, ως εκ τούτου, ο τρόπος με τον οποίο διαμορφώνεται ο αξιακός χάρτης των ηρώων, οι οποίοι δεν είναι άθυρμα των θεών και, τέλος, η συγκρότηση ατομικών και συλλογικών ταυτοτήτων. Τέλος, γίνεται αναφορά στις σύγχρονες παραστατικές τέχνες, με σκοπό τη σύνδεση του θέματος με τη σύγχρονη επικαιρότητα.
Σχεδιασμός και ανάπτυξη φυσικών βιοδραστικών προσθέτων, με εφαρμογή στον τομέα των λειτουργικών ζωοτροφών
Authors: Λαϊνά Κωνσταντίνα-Θεοδώρα
Published: January 2025

Η παρούσα διδακτορική διατριβή επικεντρώνεται στη σχεδίαση και ανάπτυξη φυσικών βιοδραστικών προσθέτων, με εφαρμογή στον τομέα των λειτουργικών ζωοτροφών. Συγκεκριμένα, εξετάζονται οι περιβαλλοντικές και υγειονομικές επιπτώσεις από τη χρήση συνθετικών προσθέτων στις ζωοτροφές και προτείνονται εναλλακτικές λύσεις με τη χρήση φυσικών συστατικών όπως αιθέρια έλαια από φυτά (ρίγανη, δεντρολίβανο, βάλσαμο, χαμομήλι). Οι κύριοι στόχοι είναι η βελτίωση της υγείας των ζώων, η μείωση της εξάρτησης από συνθετικά πρόσθετα και αντιβιοτικά, και η προώθηση βιώσιμων πρακτικών στον αγροδιατροφικό τομέα. Η μελέτη χρησιμοποιεί προηγμένες τεχνικές ενθυλάκωσης (ηλεκτροϋδροδυναμική επεξεργασία, ξήρανση με ψεκασμό, ξήρανση με κατάψυξη) για την προστασία και βελτίωση της βιοπροσβασιμότητας των αιθέριων ελαίων. Στη συνέχεια, εξετάζεται η ενσωμάτωση αυτών των προσθέτων στις ζωοτροφές, με έμφαση στην παραγωγική διεργασία εκβολής (extrusion) που διευκολύνει την ελεγχόμενη απελευθέρωση των ενεργών συστατικών. Επιπλέον, διερευνάται η εφαρμογή αυτών των ζωοτροφών σε κρεοπαραγωγά ορνίθια, με ανάλυση της επίδρασής τους στα ποιοτικά χαρακτηριστικά του παραγόμενου κρέατος. Η έρευνα περιλαμβάνει επίσης την αξιολόγηση του περιβαλλοντικού αποτυπώματος και του κόστους παραγωγής μέσω της Αξιολόγησης Κύκλου Ζωής (LCA), παρέχοντας χρήσιμες πληροφορίες για τη βιωσιμότητα της βιομηχανικής εφαρμογής.
Tracheal perforation and subcutaneous emphysema secondary to pseudomembranous invasive Aspergillus tracheobronchitis successfully managed with endotracheal tube manipulation
Authors: Shiraishi Kazushige , Lo Takkin
Published: January 2025

Introduction: Aspergillus is a ubiquitous fungus causing various pulmonary diseases depending on the host’s immune status. Aspergillus tracheobronchitis, a rare form of invasive aspergillosis, primarily affects severely immunocompromised or critically ill patients. We present the first known case of Aspergillus tracheobronchitis complicated by tracheal perforation and subcutaneous emphysema successfully treated with conservative endotracheal tube manipulation. Case description: A 64-year-old male with type 2 diabetes mellitus presented with generalized weakness and abdominal discomfort, later diagnosed with a perforated cecum requiring right colectomy. His postoperative course in the intensive care unit was complicated by septic shock, acute kidney injury, and failed extubation due to airway compromise. Seven days after the failed extubation, he developed subcutaneous emphysema in the neck. Chest computed tomography scan showed neck, left chest wall, and mediastinal emphysema. Bronchoscopy identified a focal black necrotic lesion on the left proximal tracheal wall and multiple small mucosal ulcerations throughout the proximal to distal trachea. The endotracheal tube was advanced beyond proximal tracheal necrotic lesion. Subcutaneous emphysema reduced overnight, suggesting that the lesion was the source of the air leak. Bronchial washings confirmed Aspergillus fumigatus, establishing a diagnosis of invasive Aspergillus tracheobronchitis. Treatment with voriconazole prevented further expansion of emphysema, which gradually resolved. Conclusion: Subcutaneous emphysema in ventilated patients with tracheobronchitis is a rare and challenging complication. This case demonstrates successful management through endotracheal tube manipulation to tamponade the lesion, highlighting subcutaneous emphysema as a potential manifestation of Aspergillus tracheobronchitis and offering a minimally invasive treatment approach.
Seminar "Create A Great Leader and Master Communication" As an Effort to Improve Student Communication Skills in The Digital Era
Authors: Iswadi Iswadi , Iriansyah Herinto Sidik , Anom Erman
Published: January 2025

Background: Communication is an ability that has a significant impact on students. Training for this activity must always be carried out.
Contribution: The purpose of this study is to explain the impact of seminar activities to improve students' abilities and skills in conducting open and effective communication patterns in the digital era that is currently taking place.
Method: The research method used in this study is descriptive qualitative. Data collection techniques carried out include observation, interviews, and documentation studies.
Result: Based on data that has been collected, the seminar that has been done is known to have a positive impact and helps students have high enthusiasm to learn about effective communication and tips for maintaining communication ethics in the digital age.
Conclusion:  In addition, with the material presented, students can understand the urgency of the formation of communication skills to improve the image, confidence, as well as the responsibilities they have in the future.
Land Optimization for an Educational Greenhouse Through the Family Welfare Empowerment of Pengatigan Village, Rogojampi District, Banyuwangi
Authors: Utanaka Ahmad , Budhi Wahyu Satyaning , Indraloka Aldy Bahaduri
Published: January 2025

Background : Pengatigan Village aims to repurpose vacant land behind the Village Office into a productive greenhouse, addressing land use challenges and empowering the community through the PKK.
Contribution : The greenhouse will combine sustainable plant cultivation with education and empowerment, enhancing agricultural skills and fostering community development.
Metode : The project involves coordination between village leaders and the PKK, integrating modern agricultural technologies like automated irrigation. Socialization programs will train PKK members in greenhouse operations.
Results : The greenhouse transforms the land into an economic and educational resource, promoting sustainability, community empowerment, and serving as a model for other villages.
Conclusion : The project creates a thriving community greenhouse, boosting local knowledge, economy, and sustainability efforts
The Fourth of July and Partisan Histories
Authors: Hattem Michael D.
Published: January 2025

This chapter examines how the rise of the nation's first two political parties in the 1790s led to partisan commemorations of the Fourth of July and partisan histories of the Revolution.
Contesting the Centennial
Authors: Hattem Michael D.
Published: January 2025

This chapter explores the relationship between civil rights activists and the Centennial. African Americans used the anniversary to reinforce their claims to citizenship as did female suffragists.
The Founders’ Papers
Authors: Hattem Michael D.
Published: January 2025

This chapter examines the creation of large-scale projects dedicated to collecting, editing, and publishing the papers of individual founders in the 1940s and 1950s. These papers projects—funded in part by the federal government—were inspired by the need to inspire patriotism at the onset of the Cold War, and their methods and standards effectively created the modern field of documentary or scholarly editing.
Emancipation
Authors: Kolchin Peter
Published: January 2025

This book compares the process and consequences of abolition in the two largest nineteenth-century emancipations: the United States South and Russia. Despite apparent differences in context—Russia was an autocracy, the U.S. was a democracy—there were striking similarities in the responses of both masters and bondspeople to the new order. In both countries, the terms of emancipation led to lengthy struggles over the meaning of freedom and especially over access to land and control of labor. The Great Reforms in Russia and Reconstruction in the U. S. ushered in an era of change in every aspect of life, from the economy to education, to religion and family life, to politics and political representation. If the aftermath of emancipation in Russia led to an erosion of traditional ways of life, especially the authority of the peasant commune, in the United States it produced a new political and community consciousness among the formerly enslaved. In both countries, violence against the descendants of slaves and serfs and a profound sense of disillusionment were pervasive, and in the struggle between the former masters and former bondspeople, the balance gradually shifted in favor of the former owners. As a sequel to Peter Kolchin’s prizewinning book comparing American slavery and Russian serfdom, Emancipation demonstrates the value of bringing a comparative perspective to longstanding historical debates.
Not all emotions are the same: an intersectional analysis of women’s political action based on emotive responses
Authors: Slaughter Christine M. , Coronado Kennia L. , Burge-Hicks Camille , Brown Nadia E.
Published: January 2025

If there was ever a time in US history to understand women’s politics, that time is certainly now, as with the increase of women candidates, the rise of women’s political engagement, and women-led social movements, scholars have little intersectional insight into what motivates women’s political participation. Anger and fear are powerful forces in US politics, yet how negative emotions about race matter for women is less understood. Using the 2020 Collaborative Multiracial Postelection Survey, we find that fear about race is associated with engagement in costlier political acts. Women’s anger about race leads to more frequent non-electoral political engagement once accounting for time, money, and civic skills. No one emotion has the same effect on women’s non-electoral political participation. Not all women are similar in their emotional responses to race, which impacts how women look to political systems to address racial issues.