bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anaesthetic implications of psilocybin and lysergic acid diethylamide: what is old is now new
Authors: Dave Mansi , Shore Ron , Cupido Tracy , Haley Chris , Clinkard David 
Published: February 2025

Psychedelic drugs, known for their perception-altering properties, are gaining popularity in the treatment of mental health and pain disorders. As exploratory studies demonstrate clinical efficacy with few adverse events, it is expected that more patients will ingest psychedelic drugs. For therapeutic reasons, as with any drug, anaesthesiologists must be aware of its physiological effects and contraindications to ensure the safe provision of anaesthesia.
Psilocybin is a 5HT1A and 5HT2A serotonin receptor agonist thought to act on excitatory and inhibitory neurons in the brain. Acute ingestion causes sympathetic nervous system activation, which can precipitate haemodynamic instability. Activation of the 5HT serotonin receptors can also place the patient at risk of serotonin syndrome. Chronic use increases plasma concentrations of cortisol, which has implications on prophylactic stress-dosing of glucocorticoids preoperatively. Lysergic acid diethylamide (LSD), a synthetic psychoactive substance, is also a 5HT2A agonist. LSD has been shown to potentiate opioid analgesics, and monoamine oxidase (MAO) inhibition. Historical reports suggest that LSD has anticholinesterase activity and can prolong neuromuscular block with depolarising muscle relaxants. Mescaline is a poorly understood psychedelic with similar autonomic effects. Historical studies have shown decreased neuromuscular transmission and an association with malignant hyperthermia.
When managing patients who have consumed psychedelics drugs, it is important to consider delaying surgery whenever possible, to allow acute intoxication to wane. A high degree of suspicion and an understanding of management principles is vital to the safe conduct of anaesthesia. Future research should explore therapeutic doses of psychedelic drugs to understand physiologic effects at various concentrations.
Multidrug-Resistant Organisms and Bacillus cereus Colonization in a Neonatal Intensive Care Unit: A Cohort Study
Authors: Camphuis Marie-Alix , Vincent Marine , Dauwalder Olivier , Dananché Cedric , Pastor-Diez Blandine , Masclef-Imbert Marion , Picaud Jean-Charles 
Published: February 2025

Background:
Surveillance of neonate microbiota carriage, particularly multidrug-resistant organisms (MDROs) and Bacillus cereus, could help prevent infection. We evaluated the presence of these in the stools of hospitalized infants, duration of isolation and risk of infection in infants with digestive carriage of MDROs or B. cereus.

Methods:
In a population-based retrospective study, we analyzed the results of weekly stool cultures performed from birth to discharge, in all hospitalized newborns from January 2018 to September 2020, in a single tertiary unit. Information regarding infections was collected.

Results:
In total, 1409 infants were included; 220 (15.6%) were carriers of MDROs and/or B. cereus: 74.1% (163/220) carried MDROs only, 20.5% (45/220) carried B. cereus only and 5.5% (12/220) were cocarriers. Eighteen MDROs were identified; Enterobacter cloacae (43.6%, 82/188) was the most frequent. There was no B. cereus infection in infants with B. cereus in the stool; 7.4% (13/175) of infants with MDROs were infected.

Conclusions:
MDROs and B. cereus were commonly found in stools in a large population of hospitalized neonates. Identification of carriage and duration of this according to the germ can help to adapt the isolation protocol duration to limit constraints for parents and caregivers and to guide antibiotic therapy.
Improving Care for LGBTQ+ Families: A Competency Bundle
Authors: Suttle Becky , Bordelon Curry , Jones Christopher , Talarico Nathan , Nguyen Somali , Bryant Pam 
Published: February 2025

Purpose: The purpose of this improvement initiative was to enhance cultural competence among healthcare providers within a Labor and Delivery Unit and Mother-Baby Unit through the implementation of an evidence-based LGBTQ+ competency bundle (CB). Background: The lack of knowledge and cultural competence among healthcare providers for the LGBTQ+ population remain 1 of the leading causes of discrimination in healthcare and a barrier to achieving optimal health, safety, and well-being for individuals in this community. Conscious and unconscious bias of providers further leads to discrimination, oppression, and potential delivery of substandard care. Discussion: The evidence-based LGBTQ+ CB consists of (1) cultural competency assessment using the Ally Identity Measure (AIM) survey, (2) provider training, (3) a sexual orientation/gender identity questionnaire within the electronic health record, and (4) resource bundle. The AIM survey was used to assess the knowledge and skills to support LGBTQ+ persons, awareness of LGBTQ+ oppression, and engagement in action among heterosexual allies to the LGBTQ+ community. AIM scores revealed an overall increase in knowledge and preparedness in providing support for the LGBTQ+ patient/family. The providers’ “Knowledge and Skill” experienced the most increase in AIM scoring followed by “Openness and Support” and “Oppression Awareness,” respectively. Implications for Practice: The implementation of the CB interventions increased health care providers’ knowledge and understanding of LGBTQ individuals while reducing perceived bias.
Small Cluster Invasion Is an Efficient Pathological Predictor for Extraurothelial Recurrence-Free and Overall Survival in Patients With Upper Urinary Tract Urothelial Carcinoma
Authors: Hamamoto Koetsu , Miyai Kosuke , Kawamura Kazuki , Kobayashi Hiroaki , Matsukuma Susumu , Tsuda Hitoshi , Ito Keiichi 
Published: February 2025

Purpose:
Histological parameters of tumor invasiveness such as tumor budding (BD) are effective prognostic indicators in various cancer types. However, histological evaluation of BD is sometimes challenging, particularly in the setting of predominantly single tumor cells and/or a mixture of dense inflammatory cells. This study aimed to define small cluster invasions (SCIs) as larger cell clusters than BD, which are observed in the invasive frontal region, and investigate their prognostic effects on upper urinary tract urothelial carcinoma (UUTUC).

Materials and Methods:
This retrospective study included 157 patients with invasive UUTUCs (86 and 71 with renal pelvic and ureteral cancers) who underwent total nephroureterectomy or partial ureteral resection at our institution. The cutoff point for the number of cancer cells composing a single SCI was set at ≥ 5 and < 15; high SCI was defined as ≥ 10 SCIs under ×20 objective magnification. The correlation between SCI status and clinicopathological parameters and the effects of SCI status on recurrence and prognosis were examined.

Results:
The median observation period was 58.8 months. High SCI was observed in 53 (34%) tumors and significantly associated with ureteral location, postoperative chemotherapy, higher pathological T category, lymphovascular invasion, pathological lymph node metastasis, nonpapillary gross finding, positive surgical margin, concomitant subtype histology, and high BD. Using multivariate analysis, only high SCI was independently associated with shorter extraurothelial recurrence-free survival (P < .0001, hazard ratio [HR] = 11.0) and overall survival (P < .0001, HR = 10.7).

Conclusions:
SCI might be a novel prognostic factor in patients with invasive UUTUC.
An Application Based Nomogram to Predict Clinically Significant Diseases in Patients With an Elevated PSA and MRI Prior to Prostate Biopsy
Authors: Amason Reagan , Stratton Kelly L. , Dvorak Justin , Djang Robin , Bouvette Max , Blittschau Benjamin , Gillan Hamza , Cookson Michael S. 
Published: February 2025

Introduction and Objective:
A nomogram-based approach can accurately predict the outcome of prostate biopsy (PBx) in biopsy naïve men with an elevated PSA using known traditional risk factors. However, MRI of the prostate has been shown to be of value before performing a PBx. This study aimed to predict clinically significant prostate cancer (csPC) on PBx by combining traditional clinical risk factors with the addition of MRI imaging findings in biopsy naïve men before PBx. An application was then created to improve accessibility to predicted outcomes and aid in decision-making.

Methods:
A cohort of 448 biopsy-naive men with elevated PSA, prostate MRI, and who underwent transrectal ultrasound-guided prostate biopsy were included. Age, race, PSA, prostate volume, PSA density, Prostate Imaging Reporting & Data System, digital rectal examination, and Gleason score were evaluated. CsPC was defined as Gleason Grade Group 2 or higher. Logistical models were created with the aforementioned factors. A nomogram with model performance using 10-fold cross-validation was then developed with subsequent application development. The calibration plot, ROC, and decision curve were developed to evaluate nomogram performance.

Results:
Of the 448 men, 36% were diagnosed with csPC. The mean age of the cohort was 65.97 ± 7.74 years, and 81% of the cohort were White. The mean PSA of the men was 12.60 ± 13.04 ng/mL. An interaction with age was found, so stratified models were developed above and below 67 years of age. The model achieved 82% AUC, with 61% sensitivity, 82% specificity, and 74% overall accuracy.

Conclusions:
The application-based nomogram combines the significant traditional risk factors for prostate cancer with findings on MRI to predict csPC in biopsy naïve men. By combining these variables, the nomogram provides a powerful predictive tool for guiding decision-making in the discovery of csPC. Our model outperformed traditional risk factors in predicting clinically significant cancer before PBx (82% AUC). The nomogram is especially specific (82%) and effective in ruling out the need for biopsy in low-risk patients. In addition, the development of an accurate and user-friendly application increases usefulness to urologists and patients alike.
Ustekinumab for ulcerative colitis: a nationwide real-life observational cohort study
Authors: Molander Pauliina , af Björkesten Clas-Göran , Henricson Hans , Koskela Ritva , Nuutinen Heikki , Käräjämäki Aki , Tillonen Jyrki , Tauriainen Milla-Maria , Kellokumpu Mikko , Eronen Heli , Suhonen Ulla-Maija , Vihriälä Ilkka , Hallinen Taru , Oksanen Minna , Soini Erkki , Koivunen Minni , Kuronen Mervi , Wirth Daniel , Sipponen Taina 
Published: February 2025

Objective
This nationwide retrospective chart review study assessed ustekinumab treatment persistence and clinical outcomes of ustekinumab treatment in Finnish patients with ulcerative colitis in a real-world setting.

Methods
Data was collected retrospectively until April 2022 from patient charts for all patients with ulcerative colitis who started ustekinumab between September 2019 and December 2021 in 16 Finnish inflammatory bowel disease centers. The primary outcomes were persistence on ustekinumab and clinical remission/steroid-free clinical remission, defined as partial Mayo score <3 and a combined stool frequency and rectal bleeding subscore of ≤1 at 16 weeks and 1 year.

Results
The study included 221 patients with an average follow-up of 14.7 months and a median disease duration of 5.5 years. Disease status was endoscopically evaluated as severely active in more than 91% of the patients at baseline. Treatment persistence was 87% at 16 weeks and 63% at 1 year. The clinical/steroid-free remission rate was 49%/46% at 16 weeks and 68%/62% at 52 weeks, respectively. Decreases in fecal calprotectin and partial Mayo scores were observed. Concomitant corticosteroid use decreased from 60% at baseline to 28% at 16 weeks and to 16% at 1 year during ustekinumab maintenance therapy. Antibodies to ustekinumab were detected in very few patients (<5, <21%), and discontinuation was observed due to adverse effects even less frequently (<5, <6%).

Conclusion
This real-world study demonstrated that ustekinumab has sustained efficacy in the treatment of ulcerative colitis in a real-world setting.
Correlation of 18F-FDG PET/CT metabolic parameters with Ki-67 expression and tumor staging in nasopharyngeal carcinoma
Authors: Guo ChengMao , Luo JunJia , Liang MeiNa , Xiao JingXing 
Published: February 2025

Purpose
The study aimed to investigate the imaging parameters of 18F-fluorodeoxyglucose (18F-FDG) PET/computed tomography (PET/CT) in nasopharyngeal carcinoma (NPC), specifically examining the relationship between mean standardized uptake value (SUVmean), maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) with Ki-67 expression, T-stage, and tumor node metastasis (TNM) stage.

Methods
A retrospective analysis was conducted on 143 consecutive NPC patients from January 2015 to December 2023 who underwent 18F-FDG PET/CT for initial disease assessment. SUVmax, SUVmean, MTV, and TLG were quantified from PET/CT images. Immunohistochemical staining was used to assess Ki-67 protein expression. Correlations between 18F-FDG PET/CT metabolic parameters, Ki-67 expression, T-stage, and TNM-stage were evaluated using statistical methods, with significance set at P < 0.05.

Results
All primary NPC lesions demonstrated elevated 18F-FDG uptake. Significant positive correlations were observed between SUVmax (r = 0.234, P = 0.005), SUVmean (r = 0.223, P = 0.007), MTV (r = 0.218, P = 0.009), and TLG (r = 0.232, P = 0.005) with Ki-67 labeling index. The univariate analysis indicated that all the parameters (SUVmax, SUVmean, MTV, and TLG) in the group with Ki-67 ≥ 50% were significantly higher than those in the group with Ki-67 < 50% (P = 0.001). Additionally, binary logistic regression analysis revealed that SUVmax was an independent risk factor for the group with Ki-67 ≥ 50% (P = 0.003). The univariate analysis revealed that all parameters (SUVmax, SUVmean, MTV, and TLG) in the T3–4 group and clinical stage IV group were significantly higher than those in the T1–2 group and stages I–III group (P both <0.05), respectively. Furthermore, binary logistic regression analysis demonstrated that MTV was an independent risk factor for both comparisons (P both <0.05).

Conclusion
The metabolic parameters derived from 18F-FDG PET/CT in NPC indirectly reflect tumor biological behavior, suggesting their potential utility in guiding individualized comprehensive treatment strategies.
A Systematic Review on Nurse-Physician Collaboration and Its Relationship With Nursing Workforce Outcomes
Authors: Labrague Leodoro J. 
Published: February 2025

OBJECTIVE
This systematic review appraised and synthesized the literature examining the relationship between nurse-physician collaboration and nursing workforce outcomes.

BACKGROUND
Nurse-physician collaboration is vital for effective healthcare delivery, with implications for nursing workforce outcomes. Knowledge of this relationship is crucial when designing strategies and interventions to enhance collaboration and improve nursing practice and outcomes.

METHODS
This is a systematic review of 19 articles. Two independent researchers extracted and analyzed the data from articles that met the inclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to ensure transparency and rigor in the review process.

RESULTS
Content analysis identified nursing workforce outcomes of nurse-physician collaboration, which were clustered into motivation-based outcomes (eg, professional autonomy), behavior/performance-based outcomes (eg, job performance, turnover intention), and affective-based outcomes (eg, job satisfaction, moral distress).

CONCLUSION
The findings of this review underscore the value of fostering collaborative relationships between nurses and physicians to improve nursing workforce outcomes and promote a supportive work environment.
Exploring Working Relationships Between Clinical Nurse Specialists and Clinical Nurse Leaders to Better Understand Opportunities for Improvement
Authors: Iseler Jackeline , Luciani Mary , Graham Bridget 
Published: February 2025

OBJECTIVE
The aim of this descriptive qualitative study was to describe the experiences between clinical nurse specialists (CNS) and clinical nurse leaders (CNLs) at a Midwestern hospital.

BACKGROUND
Clinical nurse specialists and CNLs are both nurses with advanced degrees yet differing specialties and responsibilities. Both focus on improving nursing and patient care but face challenges such as role definition and resource constraints.

METHODS
A sample of 8 CNSs and 9 CNLs from a Midwestern hospital were recruited to participate in focus groups to explore their experiences working together within the same organization.

RESULTS
Six themes were identified from the interviews: 1) organizational factors; 2) role identity and function; 3) communication practices and challenges; 4) value and visibility; 5) challenges and barriers; and 6) strategies and solutions.

CONCLUSIONS
It is important for administrative leadership to have a clear understanding of the scopes and unique significant contributions that the CNS and CNL each bring to healthcare.
Current status and exploration of nurse-led cardiac telerehabilitation: a narrative review
Authors: Wu Xuejiao , Xu Linqi , Yu Tianzhu , Zhang Xin , Bai Xinyang , Zhang Lijuan , Yu Tianyue , Li Feng 
Published: February 2025

Abstract
Coronary Heart Disease (CHD) remains a leading cause of mortality globally, exerting a significant burden on healthcare systems, particularly in China. Cardiac Rehabilitation (CR), endorsed by major cardiovascular organizations, aims to improve recovery and long-term health outcomes of CHD. Cardiac Telerehabilitation (CTR) uses remote communication technologies to deliver CR, thus enhancing patient engagement by overcoming geographical and socioeconomic barriers. Nurses play crucial roles in CTR, acting as primary care providers and optimizing program implementation. However, it’s still unclear about the implementation of nurse-led CTR. The purpose of this study is to conduct an in-depth analysis of the current application status of nurse-led CTR in patients with CHD and to explore the opportunities and challenges encountered during its implementation. The findings are expected to provide theoretical and practical support for promoting nurse-led CTR implementation and reducing healthcare-related economic burdens. Studies show that nurse-led CTR can effectively improve both physical and psychological outcomes for CHD patients, with sustained benefits over time, particularly in the context of secondary CHD prevention. Successful nurse-led CTR programs have incorporated innovations such as teleconsultations and gamificated interventions, proving remote health care and enhacing patient engagement. These interventions enhance exercise capacity, increase physical activity, improve quality of life, promote healthy behaviors and lifestyle modifications, and provide effective social support. On the other hand, the socioeconomic benefits include faster return-to-work time and increased quality-adjusted life years (QALYs), demonstrating its cost-effectiveness and potential for long-term healthcare savings. Technology and form are the dual challenges for the future implementation of nurse-led CTR . Integrating intelligent methods and hybrid models that combine online and offline interventions can enhance efficiency and patient satisfaction. Behavioral counseling, motivational interviewing, and real-time feedback are key to encouraging adherence. Digital platforms such as WeChat and independently developed telerehabilitation tools have proven effective for CTR delivery, though usability improvements and further technical problem-solving are needed, especially for elderly patients. Future efforts should focus on enhancing the usability of CTR tools, including optimizing the accurate and secure collection of health data via wearable devices. In conclusion, nurse-led CTR offers significant clinical benefits and nurse-involved CTR offers economic benefits, potentially revolutionizing secondary prevention for CHD. Standardization and tailored implementation, especially in resource-constrained settings, could further amplify these benefits, promoting broader and more effective adoption of CTR practices.
Increasing Pediatric Palliative Care Consultation for Patients with Heart Disease and Prolonged Cardiac Intensive Care Stay
Authors: Headrick Andrew , Wawrzynski Sarah , Moore Judson , Winder Melissa , Masih Jasmine R. , De Leon Jauregui Michele , Flaherty Brian , Moresco Benjamin , Millar Morgan M. , Codden Rachel R. , Moore Dominic , Delgado-Corcoran Claudia 
Published: February 2025

Introduction:
Patients with congenital heart disease are medically complex and experience high rates of morbidity and mortality. Pediatric palliative care (PPC) supports families navigating complex medical scenarios. This study evaluates the effect of quality improvement (QI) interventions towards increasing PPC consultations in patients with heart disease and cardiac intensive care unit (CICU) length of stay (LOS) ≥ 14 days.

Methods:
We conducted a mixed methods QI study using CICU team members and family survey assessments of PPC involvement. Patients with CICU LOS ≥14 days were eligible and comprised our study cohort. Interventions included the implementation of a digital prompt screening for eligible patients sent to CICU and PPC providers, as well as the implementation of weekly huddles to discuss consulted and eligible patients. Through the pre- and postintervention phases, family members of consulted patients and CICU team members were surveyed.

Results:
Preintervention (January 2020 to December 2021), PPC consultation rates were 35% (n = 34) and increased to 63% (n = 43) postintervention (January 2022 to February 2023) (P < 0.01). The timing of consultation was similar between phases. Survey results from family members (n = 19, 39% of 49 participants) and CICU team members (n = 80, 40% of eligible) revealed predominantly positive perceptions regarding PPC involvement.

Conclusions:
QI interventions, including collaborative huddles and digital prompts based on discrete screening criteria, lead to significantly increased rates of PPC consultation in patients with heart disease in the CICU. Survey results support PPC consultation as a positive contribution for families and CICU team members.
Just Autoimmunity? The Role of the Innate Immune Response in Lupus
Authors: Rodriguez Martin A. , Blasini Ana M. 
Published: February 2025

Abstract
Systemic lupus erythematosus is considered a prototype of human autoimmune disease based on the appearance of multiple autoantibodies, some of which can have a direct pathogenic effect on tissues. Most therapeutic modalities aim to check the enhanced humoral responses by targeting T and B cells with conventional or biologic drugs. However, in some cases, the clinical response is limited and frequently takes a high toll of toxicity in patients. The last 2 decades have brought up novel discoveries showing profound disturbances of innate immune cell function in systemic lupus erythematosus, including dysregulated NETosis, increased apoptosis, type 1 interferon, and granulopoiesis signatures that are grounded in basic cell biology abnormalities, including response to excessive oxidative stress, mitochondrial dysfunction, and upregulation of the cGAS-STING pathway. Whether the prominent autoimmunity component of lupus patients is sufficient to drive this chronic disease or follows a breakdown of innate immune homeostasis in response to the environmental factors triggering disease is the subject of this revision.