bluuebunny/crossref_metadata_2025_split huggingface dataset:
Food for Thought: A Qualitative Assessment of Medical Trainee and Faculty Perceptions of Nutrition Education
Authors: Kunitsky Olivia , Taye Mahdi , Feeley Karla , Johnson Hugh , Glynn Abigail , Stivale Avery , Hamers Matthew , Notarianni Alexis , Mamillapalli Sireesha , Waite Gabi , Lobo Sonia 
Published: December 2024

Abstract

Background: The American Society of Clinical Nutrition recommends 37 to 44 hours of undergraduate medical nutrition education. The Total Health Curriculum at Geisinger Commonwealth School of Medicine (GCSOM) contains 14 hours of objective-based nutritional instruction. This study aimed to examine the perceptions of key stakeholders regarding the role of nutrition in medicine and to identify barriers, opportunities for improvement, and roles/responsibilities for innovative implementation of nutrition education.
Methods: This exploratory, qualitative study employed a constructivist, grounded theory approach and inductive coding process. Purposive sampling recruited medical students, undergraduate medical education (UME) faculty, physicians, and other healthcare professionals at GCSOM and affiliated clinical sites. Semi-structured focus groups and one-on-one interviews were conducted via videoconferencing. Audio recordings were transcribed using NVivo 14. Transcripts were manually reviewed alongside the audio files to ensure accuracy. Data were systematically organized using the qualitative research methodology Rigorous and Accelerated Data Reduction (RADaR). Microsoft Copilot was used to assist with thematic analysis. Outcomes were compared, and consensus was obtained among raters.
Results: Twenty-five individuals were interviewed: 12 UME faculty, five students, and eight healthcare professionals, including two physicians. Participants included 18 females and seven males, aged 23 to 69 years. Ninety-two percent of participants believed that all physicians should receive nutrition education and forty percent felt unsatisfied with their nutritional training. For barriers, the qualitative analysis identified these themes: 1) time constraints, 2) assessment and prioritization, 3) insufficient faculty expertise, and 4) bias and stigma. For improvement opportunities, the qualitative analysis identified these themes: 1) curriculum design, 2) practical application, 3) patient-centered approach, and 4) trainee perceptions. For roles/responsibilities, the qualitative analysis identified these themes: 1) accreditation bodies, 2) stakeholder involvement, 3) public policy and legislation, and 4) multilevel responsibility.
Conclusion: Participants acknowledged a need for more medical nutrition education to prepare physicians who are equipped to manage the nutritional needs of patients. They recognized key challenges hindering the advancement of such education, proposed various forms of improvement, and identified roles for successful implementation. Future research will assess community perspectives and expand sample diversity.
A retrospective study on potential drug‒drug interactions in patients with severe asthma receiving biological therapy: a single-center experience
Authors: Momcilovic Mirna , Turcic Petra , Butković Franka , Grle Sanja Popovic 
Published: December 2024

Abstract

Background
Prevalence of potential drug-drug interactions (pDDIs) in adult patients with severe asthma on biological therapy and their clinical significance have not been fully addressed, thus the aim of this study was to investigate them.
Methods
In this retrospective observational study, patients who were diagnosed with severe asthma and to whom biological therapy was prescribed between September 2015 and December 2020, were enrolled. The study was conducted at the Department of Allergic and Obstructive Pulmonary Diseases, Clinic for Lung Diseases Jordanovac, Clinical Hospital Center Zagreb. Data on demographic characteristics as well as concomitant medication were collected. The analysis of pDDIs was conducted via Lexicomp® online software. Interactions of significance levels A and B were only recorded, while those of levels C, D and X were further analysed. The collected data was processed via Microsoft Excel 365 software.
Results
60 adult patients, 60% female and 40% male, with median age of 56.2 years, were enrolled. The incidence of pDDIs was 86.67%. Total number of pDDIs detected was 518, out of which 43.24%, 45%, 4.44% and 7.3% of clinical significance B, C, D and X. Interactions of level C, D and X were recorded in, as follows: 83.33%, 25% and 33.33% patients with an average of 4.66, 1.53 and 1.9 interactions per patient. Only 13.33% of the patients had none of the potential clinically significant DDI. Most drug pairs contained at least one antiasthmatic drug. Muscarinic receptor antagonists, oral corticosteroids, β2 agonists and methylxanthines showed potential of entering into clinically significant DDIs, while leukotriene antagonists and biologicals showed no potential for the above.
Conclusion
Prevalence of potential drug-drug interactions in patients with severe asthma on biological therapy is high. The majority of identified interactions have moderate to high level of clinical significance. Their identification, prevention and resolution could contribute to optimizing therapy, maximizing its therapeutic effect and avoiding undesirable adverse events.
Evaluating the Improvement of Expansive Soil Properties by Blending with Red Soils
Authors: Alehgn Habtamu Sewnet 
Published: December 2024

Abstract

One of the most abundant construction materials is soil; nevertheless, certain varieties provide serious engineering difficulties because of their low strength, low permeability, and rapid swell-shrink response to moisture changes. Through a variety of techniques, engineers have worked to increase the expansive soils' bearing capacity and shear strength over time. By mixing expansive soil with red soil, this study seeks to increase it’s the strength of expansive soil and make it more appropriate for construction. For laboratory testing, two types of expansive soil and three types of red soil-red-brownish, red gravel, and red fine soil were taken from Jimma Town. Combining expansive soil with red soil considerably enhanced its engineering properties, fulfilling design specifications for bearing capacity, plasticity, and compaction. Significant improvements were observed when red-brownish and red gravel soils were added at 15%, 30%, 45%, and 60%. As a result, the blended soil was deemed adequate for subgrade construction. The maximum dry density (MDD) increased from 1.40 g/cm³ to 1.62 g/cm³ and 1.61 g/cm³, respectively, while the California Bearing Ratio (CBR) increased from 2.75% to 17.79% and 17.62%. However, there were very few changes in CBR, index values, compaction characteristics, and free swell when red fine soil was mixed with expansive soil. The study's overall findings indicate that red-brownish and red gravel soils when combined with expansive soil greatly increase their qualities, but red fine soil just slightly improves them.
Advancing Precision Medicine in Esophageal Squamous Cell Carcinoma Using Patient-Derived Organoids
Authors: Shen Suya , Liu Bing , Guan Wenyan , Liu Ziyao , Han Yuqing , Hu Yingzhe , Chen Yiqiang , Liu Siyuan , He Jian , Li Zhiwen , Tang Weifeng , Zhang Pengju , Ren Wei , Qiu Yudong , Zheng Hongping , Li Jingjing 
Published: December 2024

Abstract

Background & Aims:
Patient-derived organoids (PDOs) represent a promising approach for replicatingthe characteristics of original tumors and facilitating drug testing for personalized treatments across diverse cancer types. However, clinical evidence regarding their application to esophageal cancer remains limited.This study aims to evaluate the efficacy of implementing PDOs in clinical practice to benefit patients with esophageal squamous cell carcinoma (ESCC).
Methods:
Fresh surgical biopsies were obtained from patients with esophageal cancer for the establishment of PDOs. These PDOswere subsequently characterized through histological analysis. A customized drug panel, based on standard-of-care chemotherapy regimens, was applied to the PDOs. The resulting drug sensitivity profiles were then correlated with the clinical responses observed in individual patients undergoing actual treatment.
Results:
A total of 34 PDOs were successfully established with a 61.8% success rate. The classification method based on chemotherapy sensitivity closely corresponded to clinical responses. The paclitaxel plus cisplatin (TP)-sensitive group demonstrated significantly longer progression-free survival (PFS) compared to the resistant groups, Hazard ratio (HR), 5.12; 95% confidence intervals (CI), 0.58-44.71; p <0.05), thus illustrating the potential of this approach for identifying personalized treatment strategies.
Conclusion:
Organoid biobanks wereestablished across multiple institutes to facilitate PDOs-based functional precision medicine. The findings demonstrate that this framework offers robust predictive value in clinical settings, enhances precision therapeutics, and advances drug discovery for esophageal cancer.
Assessment of Left Ventricular Strain Echocardiography in Individuals with Hashimoto’s Thyroiditis and Its Association with Serum TIMP-1 Concentration
Authors: DUZEN Irfan Veysel , TULUCE Selcen Yakar , OZTURK Sadettin , SAVCILIOGLU Mert Deniz , GOKSULUK Huseyin , ALTUNBAS Gokhan , KAPLAN Mehmet , VURUSKAN Ertan , TABUR Suzan , SUCU Murat , TAYSI Seyithan 
Published: December 2024

Abstract

Background and Aim:
Hashimoto's thyroiditis (HT), which is an autoimmune condition and the primary cause of hypothyroidism, has numerous impacts on the cardiovascular system. Speckle-tracking echocardiography (STE) enables earlier detection of left ventricular (LV) dysfunction compared to conventional echocardiography. The tissue inhibitor of metalloproteinase-1 (TIMP-1) is a key molecule that plays a role in cardiac remodeling in various pathologies. The objective of this study was to determine if any differences existed in TIMP-1 levels and LV strain values between euthyroid HT patients, hypothyroid HT patients, and healthy control subjects.
Materials and Methods:
Forty patients with hypothyroid HT, 40 HT patients who had become euthyroid with thyroid hormone replacement therapy, and 40 healthy controls were included in this study. In addition to conventional echocardiography, all subjects also underwent STE. Segmental and global LV longitudinal strain values (LVGLS) were obtained. Blood samples were collected from each participant to measure serum TIMP-1 levels, thyroid function tests and thyroid peroxidase (TPO) antibody (anti-TPO) levels.
Results:
Higher serum TIMP-1 levels were found in euthyroid and hypothyroid HT patients than in control group. Additionally, patients with euthyroid and hypothyroid HT displayed lower segmental and global LV strain values than the control group. A negative correlation was observed between strain values and TIMP-1 and anti-TPO levels. No significant difference was observed in serum TIMP-1 and strain values between euthyroid and hypothyroid HT patients. Patients with hypothyroid HT exhibited impaired diastolic function and reduced ejection fraction when compared to both euthyroid HT and control groups. However, diastolic function and ejection fraction were similar between euthyroid HT patients and the control group.
Conclusion:
Hashimoto's thyroiditis causes impairment of LV strain, regardless of thyroid hormone levels. Additionally, the condition is associated with elevated TIMP-1 levels. The relationship between LV strain values and anti-TPO levels indicates that the autoimmune component of the disease may be responsible for the impaired LV strain.
“Am I Doing Everything Right Enough?”: A Mixed Methods Evaluation Of The Early Post-Bariatric Surgery Period
Authors: KÖROĞLU Sevgi , BAŞ Nilgün SERT , DURAT Gülgün , AYGİN Dilek , YÜKSEL Adem , KARAMAN Kerem 
Published: December 2024

Abstract

Bariatric surgery is an effective obesity treatment, yet its success is often linked to psychological health. This study explores the impact of personality patterns and emotion regulation on the daily lives of bariatric surgery patients, emphasizing the importance of psychosocial factors post-surgery. Using a concurrent mixed-methods design, 95 participants completed quantitative surveys on personality, emotion dysregulation, and quality of life, while in-depth interviews with 18 participants provided qualitative insights. Integrated findings showed that personality patterns significantly influence biopsychosocial quality of life. Qualitative data indicated improvements in emotional coping and social relationships, though quantitative data did not find a direct link between emotion regulation difficulties and quality of life. Positive personality traits correlated with enhanced social engagement and body image; however, fears of weight regain and dependency on external control persisted. The study highlights the need for integrated mental health support focused on emotional resilience and personalized care to promote long-term well-being and adaptation after bariatric surgery.
Comparative cadaveric study of the Kocher–Langenbeck approach with and without trochanteric osteotomy in extended posterior wall fractures of the acetabulum
Authors: Orapiriyakul Wich , Kritsaneephaiboon Apipop , Dissaneewate Kantapon , Waewwanjitb Mukta , Jitprapaikulsarn Surasak , Chewakidakarn Chulin 
Published: December 2024

Abstract

Introduction:
Standard exposure, such as the Kocher–Langenbeck (KL) approach, has a limited ability to access the cranial and anterior portions of the posterior wall with an extended fracture line into the acetabular dome. Augmentation of the KL approach with trochanteric osteotomy (TO) has enhanced exposure in this area. This study aimed to compare the area of surgical exposure in the KL approach with and without additional TO and identify the most anterior exit point of the posterior wall in each surgical approach. The addition of TO to the KL approach significantly improves surgical exposure of the supero-anterior acetabular regions compared to the KL approach alone.
Materials and Methods
Ten fresh cadaveric hip specimens were used in this study. The KL approach was initially used for each specimen, followed by additional TO. Surgical exposures were marked, and measurements were taken for anterior and cranial exposure distances, surface area of bony exposure, and posterior wall arc angle (PWAA). Data were analysed using paired t-tests and Wilcoxon signed-rank tests.
Results
TO significantly increased the anterior exposure distance (65.83 mm vs. 49.07 mm) and acetabular surface area (43.95 cm2 vs. 33.51 cm2) compared to the KL approach alone. PWAA was also significantly higher in TO (52.55° vs. 27.63°), indicating enhanced anterior exposure. However, the increase in cranial exposure distance was not statistically significant.
Conclusion
The KL approach with TO significantly enhanced surgical exposure for posterior wall acetabular fractures, particularly in the anterior regions. For fractures with a PWAA of 0º–27º, the KL approach alone would be sufficient.
Level of evidence:
IV, cadaveric study
Substance P and Neurokinin-1 receptor are overexpressed in adamantinomatous craniopharyngioma than in the pituitary gland
Authors: Alcaide Carlos , Perez Francisco , Esteban Francisco , Muñoz Miguel 
Published: December 2024

Abstract

Background
Human adamantinomatous craniopharyngioma (ACP) is a brain tumor that originates at the base of the skull and shows aggressive local behavior, invading critical areas such as the optic pathways and hypothalamus. Since decades, conventional treatment is based in surgery and radiotherapy which derivate in serious patients’ disability. It is well known that Substance P (SP) peptide and Neurokinin-1 receptor (NK-1R) are involved in inflammation and cancer progression and its blockage with NK-1R antagonists has been shown to effectively counteract tumor development in preclinical trials. The oncogenic mechanism underlying ACP is based on a secretory phenotype associated with the production of paracrine biomarkers that establish an inflammatory and angiogenic microenvironment for the progression of ACP.
Methods
We studied by immunohistochemistry the localization of SP and NK-1R in human 43 ACP and pituitary gland samples.
Results
SP and the NK-1R were overexpressed in all ACP more than in pituitary glands samples. SP expression is found widespread the ACP and is preferentially localized in the nucleus than in cytoplasm of tumor cells. Likewise, areas of glial reaction and endothelial cells also express SP preferentially in the cell nuclei. NK-1R is expressed mainly in the glial reaction, especially in the nuclei and membranes of its inflammatory cells and less prominently in the cytoplasm. In ACP neovessels, NK-1R is expressed in endothelial cells and fibroblasts that constitute their basement membranes. Tumor cells did not show significant NK-1R expression.
Conclusions
These findings, reported here for the first time, suggest a role for SP and NK-1R in pituitary gland and ACP and opens the door to future clinical trials on treatment with NK-1R antagonist drugs in ACP patients.
Lactiplantibacillus plantarum and L. paraplantarum encode agr-like loci that interfere with quorum sensing and virulence gene expression in Staphylococcus aureus
Authors: Wang Weizhe , Kyrkou Ifigeneia , Bojer Martin S. , Kalloubi Dina , Kali Abdul Jabbar , Alena-Rodriguez Miguel , Leisner Jørgen , Fulaz Stephanie , Ingmer Hanne 
Published: December 2024

Abstract

The pathogenicity of Staphylococcus aureus is largely regulated by the agr quorum sensing (QS) system encoded by agrBDCA, which coordinates virulence factor production through secretion and sensing of auto-inducing peptides (AIPs). agr-like systems are present also in coagulase-negative staphylococci, and several of these encode AIPs that inhibit S. aureus QS. In lactic acid bacteria, a similar locus was previously identified in Lactiplantibacillus plantarum WCSF1 termed lamBDCA. Here, we characterized the lamBDCA locus in L. plantarum LMG 13556 and L. paraplantarum CIRM-BIA 1870, and explored the effects on S. aureus QS. Notably, we found that co-cultivation with L. paraplantarum significantly inhibits S. aureus QS and hemolysin production, while less so for L. plantarum. The inhibition by L. paraplantarum was lost upon disruption of its lamBDCA locus, suggesting that the L. paraplantarum AIP mediates cross-species interference with S. aureus agr activation. Transcriptomic analysis revealed that lamBDCA in L. paraplantarum controls the expression of genes belonging to various functional categories, including stress response and metabolism. The latter includes genes encoding riboflavin (B2 vitamin) biosynthesis, which enabled the growth of the L. paraplantarum lamB mutant in the presence of roseoflavin, a toxic riboflavin analogue. Collectively, our results show that L. paraplantarum CIRM-BIA 1870 interferes with S. aureus virulence gene expression through QS suppression, and they implicate QS in the probiotic properties of L. paraplantarum.
Re-intervention utility after endoscopic ultrasound-guided hepaticogastrostomy using a partially covered stent with anchoring flange
Authors: Shin Il Sang , Moon Jong Ho , Lee Yun Nah , Park Jae Woo , Lee Tae Hoon , Yang Jae Kook , Cho Young Deok , Park Sang-Heum 
Published: December 2024

Abstract

Background and Aim:
A long self-expandable metal stent (SEMS) with a sufficient intragastric portion is typically preferred for endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS). However, this type of stent can complicate endoscopic re-intervention for recurrent biliary obstruction (RBO). We evaluated the efficacy and safety of endoscopic re-intervention for RBO through the stent after EUS-HGS using a novel partially covered SEMS with an anchoring flange.
Methods
The partially covered SEMS was designed with a proximal uncovered portion measuring 1.5 cm in length and a resilient fold-back wide distal anchoring flange with a 2.0 cm diameter. Re-interventions were performed through the stent lumen while the stent was in situ. The evaluated outcomes were the technical and clinical success of the endoscopic re-intervention, procedure time, and adverse events.
Results
In total, 35 re-interventions for RBO were performed through the HGS route in 19 patients. Re-intervention was successfully conducted in 97.1% (34/35) of cases via the distal end of the stent in a retroflexed position. The overall technical and clinical success rates were 91.4% (32/35) and 85.7% (30/35), respectively. The re-intervention methods included stent cleaning (18.2%), additional HGS stent placement (33.3%), and antegrade stent placement (48.5%). Mild cholangitis occurred in 5.7% (2/35) of patients and was successfully managed with conservative treatment.
Conclusions
Endoscopic re-interventions can be effectively and safely performed through the lumen of the partially covered SEMS with an anchoring flange. The HPG route with a 2–3 cm intragastric portion renders it technically simple to access the biliary tract for re-intervention procedures.
Proteomics reveals biomarkers for the diagnosis and treatment of septic kidney injury
Authors: Zhu Weimin , He Xiaxia , Dai Hanzhi , Dong Cuicui , Zhang Jiatian , Chen Nanjin , Zhang Sheng , Xu Yubin , Chen Qi , Xu Yinghe , Jiang Yongpo 
Published: December 2024

Abstract

Background
Sepsis-associated acute kidney injury (SA-AKI) is a severe and life-threatening disease with high incidence and mortality rates among ICU patients. However, currently, there is still a lack of effective biomarkers for early diagnosis and treatment of kidney injury in septic patients.
Methods
In a multi-center prospective cohort study, 37 sepsis patients (sepsis-AKI, n = 19; sepsis-NoAKI, n = 18) and 31 healthy controls were enrolled. Peripheral blood samples were analyzed by protein mass spectrometry, and principal component analysis (PCA) was used to remove outliers. Differentially expressed proteins were identified based on p < 0.05 and |log2 fold change|>1, then functionally enriched using DAVID. An additional validation cohort of 65 sepsis patients ((sepsis-AKI, n = 38; sepsis-NoAKI, n = 27) from three other centers was used to further validate the target proteins. ELISA and ROC curve analysis were performed to evaluate the diagnostic accuracy of the target proteins for SA-AKI and the need for continuous renal replacement therapy (CRRT), using the area under the ROC curve (AUC) as the performance metric.
Results
Ultimately, 7 proteins were differently expressed between the two groups, with 6 of them being significantly up-regulated and 1 being significantly down-regulated. Functional enrichment analysis showed that the selected differentially expressed proteins were mainly involved in immune responses, complement activation, coagulation cascades, and neutrophil degranulation. Further external validation showed that the AUC values of CST3, B2M, IGFBP4, CFD, and CD59 in diagnosing SA-AKI were all above 0.7, and there were significant differences between the two groups (P < 0.05). For whether or not to receive CRRT treatment, IGFBP4 was found to have good predictive value, with an AUC of 0.84.
Conclusions
This study suggests that CST3, B2M, IGFBP4, CFD, and CD59 may serve as potential biomarkers for the diagnosis of SA-AKI, with IGFBP4 specifically aiding in determining whether CRRT treatment is necessary.