bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Hierarchical Unit Culture and Power Distance Orientation on Nurses’ Silence Behavior: The Roles of Perceived Futility and Hospital Management Support for Patient Safety
Authors: Lee Seung Eun , Lee Jeong Won 
Published: November 2024

Background: Patient safety is paramount in healthcare, and effective communication is a cornerstone of preventing adverse patient events. Despite nurses’ crucial role in improving patient safety, they often keep silent about their concerns. This study investigated links among hierarchical unit culture, nurses’ power distance orientation, perception of futility, and silence behavior in healthcare environments. Moreover, we aimed to determine whether nurse‐perceived hospital management support for patient safety moderated the association between nurses’ perceived futility and silence behavior.Methods: This cross‐sectional, correlational study utilized survey data from 730 direct‐care nurses working in 88 medical, surgical, or medical–surgical units across 34 hospitals in South Korea. Validated psychometric scales measured the study variables, and data were analyzed using a 2‐1‐1 type of multilevel structural equation model.Results: Hierarchical unit culture and power distance orientation showed significant positive associations with nurses’ perception of futility (b = 0.62, p < 0.001, and b = 0.37, p < 0.001, respectively) and subsequently with their silence behavior (b = 0.22, p < 0.01, and b = 0.31, p < 0.001, respectively). Futility was found to mediate the relationship of both hierarchical unit culture (indirect effect = 0.222, 95% confidence interval (CI) [0.006, 0.438]) and power distance orientation (indirect effect = 0.132, 95% CI [0.003, 0.261]) to silence behavior. Hospital management support for patient safety significantly moderated the relationship between futility and silence behavior (b = 0.04, p < 0.05); nurses were less likely to remain silent when they perceived high management support as opposed to low support, regardless of their futility level.Conclusion: Our findings highlight the crucial influence of organizational culture on nurses’ silence behavior. The findings also underscore the importance of hospital management support with respect to patient safety. Management support may be necessary to combat nurses’ perceived futility and to promote open communication.
A Phase II Study of Fulvestrant plus Abemaciclib in Hormone Receptor–Positive Advanced or Recurrent Endometrial Cancer
Authors: Green Angela K. , Zhou Qin , Iasonos Alexia , Zammarrelli William A. , Weigelt Britta , Ellenson Lora H. , Chhetri-Long Rashmi , Shah Pooja , Loh Jade , Hom Vania , Selenica Pier , Erinjeri Joseph , Petkovska Iva , Chandarlapaty Sarat , Cohen Seth , Grisham Rachel , Konner Jason , Rubinstein Maria M. , Tew William , Troso-Sandoval Tiffany , Aghajanian Carol , Makker Vicky 
Published: November 2024

Abstract

Purpose:
Inhibition of the cyclin D–cyclin-dependent kinase (CDK)4/6–INK4–retinoblastoma pathway can overcome acquired or de novo treatment resistance to endocrine monotherapy. Responses to endocrine monotherapy in advanced endometrial cancer are suboptimal, perhaps due to genomic alterations that promote estrogen receptor–independent cyclin D1–CDK4/6 activation. We hypothesized that the addition of abemaciclib, a CDK4/6 kinase inhibitor, to antiestrogen therapy with fulvestrant would be an effective therapeutic strategy in patients with advanced or recurrent endometrial cancer.

Patients and Methods:
In this phase II study, patients with advanced or recurrent endometrial cancer received 150 mg of abemaciclib orally twice daily with 500 mg of fulvestrant intramuscularly monthly with a 2-week loading dose. Eligibility included estrogen receptor or progesterone receptor expression ≥1% by IHC, measurable disease, ≤2 prior lines of chemotherapy, and ≤1 prior lines of hormonal therapy. The primary endpoint was the objective response rate by RECIST v1.1.

Results:
Twenty-seven patients initiated therapy, and 25 were evaluable for efficacy. Eleven patients achieved partial response; 10 responses (91%) were in copy number–low/no specific molecular profile tumors, 1 response (9%) was in a microsatellite instability–high tumor, and no responses were observed in copy number–high/TP53abnormal tumors. The objective response rate was 44% (90% confidence interval, 27.0%–62.1%). The median duration of response was 15.6 months. The median progression-free survival was 9.0 months (90% confidence interval, 1.8–20.4). The most common grade ≥3 treatment-related adverse events were neutropenia (26%) and anemia (19%); no new safety signals were identified.

Conclusions:
The combination of abemaciclib and fulvestrant has promising activity with durable responses in advanced or recurrent endometrial cancer; a randomized trial is planned.
NOTCH1 Drives Sexually Dimorphic Immune Responses in Hepatocellular Carcinoma
Authors: Lindblad Katherine E. , Donne Romain , Liebling Ian , Barcena-Varela Marina , Lozano Anthony , Ruiz de Galarreta Marina , Dhainaut Maxime , Param Nesteene J. , Giotti Bruno , Cappuyns Sarah , Kodama Takahiro , Wang Yulei , Kamphorst Alice O. , Tsankov Alexander M. , Lujambio Amaia 
Published: November 2024

Abstract
Hepatocellular carcinoma presents strong sexual dimorphism, being two to three times more frequent in males than in females; however, the role of sex in response to immunotherapies in HCC remains unknown. We demonstrate that NOTCH1, an understudied oncogene in HCC, elicits sexually dimorphic antitumor immunity and response to FDA-approved immunotherapies. Surprisingly, males harboring NOTCH1-driven tumors displayed enhanced antitumor immune responses, which, in mice, were mediated by dendritic and T cells. Conversely, females harboring NOTCH1-driven tumors presented immune evasion and resistance to immunotherapies through a defect in dendritic cell (DC)–mediated priming and activation of CD8+ T cells in mice, which was restored therapeutically with CD40 agonism. Mechanistically, the sexually dimorphic immunity was mediated by genes in the sex chromosomes but not by sex hormones. Together, our study unravels an unexpected association between NOTCH1 and sex in cancer immunity and highlights the potential of restoring the DC−CD8+ T-cell axis with CD40 agonism to improve outcomes.

Significance:
Although HCC presents strong sexual dimorphism, the role of sex in response to immunotherapies remains elusive. With a novel HCC mouse model and validation in patients with HCC, we demonstrate that NOTCH1 disrupts antitumor immunity specifically in females through a mechanism mediated by sex chromosome genes, which is reversed with CD40 agonism.
EXCELLENT Registry: A Prospective, Multicenter, Global Registry of Endovascular Stroke Treatment With the EMBOTRAP Device
Authors: Nogueira Raul G. , Andersson Tommy , Haussen Diogo C. , Yoo Albert J. , Hanel Ricardo A. , Zaidat Osama O. , Hacke Werner , Jovin Tudor G. , Fiehler Jens , De Meyer Simon F. , Brinjikji Waleed , Doyle Karen M. , Kallmes David F. , Liebeskind David S. , Virmani Renu , Kokoszka Malgosia A. , Inoa Violiza , Humphries William , Woodward Keith B. , Jabbour Pascal M. , François Olivier , Levy Elad I. , Bozorgchami Hormozd , Boor Stephan , Cohen Jose E. , Dashti Shervin R. , Taqi Muhammad A. , Budzik Ronald F. , Schirmer Clemens M. , Hussain M. Shazam , Estrade Laurent , De Leacy Reade A. , Puri Ajit S. , Chitale Rohan V. , Brekenfeld Caspar , Siddiqui Adnan H. 
Published: November 2024

BACKGROUND:
The EXCELLENT registry aimed to evaluate the effectiveness of the EMBOTRAP Revascularization Device in an all-comer population in a real-world setting, with a focus on the composition of retrieved clots.

METHODS:
EXCELLENT is a prospective, global registry of patients with acute ischemic stroke treated with EMBOTRAP as the first-line mechanical thrombectomy device conducted at 34 sites (25 sites contributing clot) from September 2018 to March 2021, utilizing core imaging and central histology laboratories blinded to clinical data, independent 90-day modified Rankin Scale assessment and Clinical Events Committee.

RESULTS:

After screening 3799 patients, a total of 997 subjects (mean age, 70.0±14.2 years; 51.8% women; 19.7% non-White) were included. The first-pass modified Treatment in Cerebral Infarction (mTICI) ≥2b rate was 64.5% (623/966), first-pass mTICI ≥2c was 39.1% (378/966), and final mTICI ≥2b was 94.5% (931/985). A total of 427/912 (46.8%) patients achieved a 90-day modified Rankin Scale of 0 to 2 or ≤baseline. Embolization to a new territory occurred in 0.2% (2/984), and symptomatic intracranial hemorrhage at 24 hours in 1.6% (16/997). The 90-day mortality was 19.1% (175/918). Device- and/or procedure-related serious adverse events occurred in 5.9% (54/912) through 90 days. The mean RBC percentage of retrieved clots was 45.62±21.372. Among patients who achieved mTICI ≥2b with the first pass, 15.7% (52/331) and 9.7% (32/331), respectively, had RBC-poor (<25%) and RBC-rich (>75%) clots. Patients with no clot retrieved in any procedural pass had a lower percentage of hyperdense or susceptibility vessel sign on baseline imaging (58.9% versus 74.7%;
P
<0.001), pointing to a potential preprocedure indicator of challenging clot.

CONCLUSIONS:
The EXCELLENT registry informs real-world practices in mechanical thrombectomy and sheds light on the range of clots effectively retrieved by current technology. This is the first report of detailed patient characteristics where mechanical thrombectomy maneuvers failed to remove any clot material. Although the composition of nonretrievable clots cannot be assessed histologically, the results support the notion that no retrieval may be correlated with imaging findings suggesting clots lower in RBC.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03685578.
Incidence of Complications With Precontoured Allograft Wedges in Foot and Ankle Surgery
Authors: Boden Allison L. , El Masry Seif , DiGiovanni Grace M. , Demetracopoulos Constantine A. , Cody Elizabeth A. 
Published: November 2024

Background: Precontoured cancellous allograft wedges have gained popularity in foot and ankle procedures in recent years because of their ease of use and ability to decrease operative time. A high rate of resorption of such wedges was noted anecdotally by the senior authors, particularly in 2022. The purpose of this study was to identify the resorption and complication rates of precontoured allograft wedges over time. Methods: A retrospective review was performed of patients who had a precontoured allograft wedge from a single source implanted during foot and ankle surgery between 2017 and 2022 at a single institution. Patient demographics, indication for graft use, and fixation method were obtained from chart review, and differences between patients with and without nonunion were analyzed. Radiographic review was completed to identify patients with graft resorption and/or nonunion. Results: Of the 334 wedges implanted, 24 grafts (7.2%) resorbed and an additional 10 wedges (2.9%) developed a nonunion without resorption. Resorption was noted as early as 5.7 weeks postoperatively and as late as 36.6 weeks postoperatively. Older patient age, body mass index (BMI) >30, and the Lapidus graft type were significantly associated with greater risk of resorption or nonunion. Conclusion: We observed an overall radiographic complication rate of 10% with the use of precontoured cancellous wedges. Older age, BMI >30, and Lapidus wedge type were associated with increased risk of radiographic complication. Patients should be counseled on the risk of resorption and nonunion, and caution should be exercised when contemplating the use of precontoured allograft cancellous wedges in foot and ankle surgery.
Virtual discharge counseling: An assessment of scalability of a novel patient educational process across a multi-site urban emergency department
Authors: Leybov Victoria , Ross Joshua , Grabinski Zoe , Smith Silas W , Wang Yelan , Wittman Ian G , Caspers Christopher G , Tse Audrey Bree , Conroy Nancy 
Published: November 2024

Background Inadequate counseling at patient discharge from the emergency department can lead to adverse patient outcomes. Virtual discharge counseling can address gaps in discharge counseling and improve patients’ understanding of instructions. Methods A previously established virtual discharge counseling program was scaled across three emergency departments and expanded to 13 diagnoses. Utilizing a standardized protocol and script, counselors performed virtual discharge counseling via a remote, secure teleconference platform in the patients’ preferred language. Results Virtual discharge counseling was performed with 166 patients. COVID-19, back pain, and headache were the most frequent diagnoses. The median counseling time was 14 min. Median counseling time for English was 11 min, versus 20 min for other languages ( p < 0.001). Counseling times were the longest for COVID-19 and diabetes (18 min for each). Conclusion We demonstrate the scalability of a virtual discharge counseling program. Our findings can assist in targeting virtual discharge counseling resources for limited English-proficiency patients and specific diagnoses that require longer counseling times.
Implementation of a nationwide program for total pancreatectomy and islet autotransplantation in chronic pancreatitis: A Scandinavian single-center observational study
Authors: Waage Anne , Khan Ammar , Labori Knut Jørgen , Birkeland Kåre Inge , Scholz Hanne , Jensen Trond Geir , Tholfsen Tore , Line Pål-Dag , Hagness Morten 
Published: November 2024

Background: Tailoring surgical treatment is mandatory to optimize outcomes in chronic pancreatitis. Total pancreatectomy (TP) offers pain relief in a subset of patients. TP with islet autotransplantation (IAT) has the potential to reduce the burden of postsurgical diabetes. We present the first Scandinavian prospective study assessing outcomes following total pancreatectomy and islet autotransplantation (TPIAT) in chronic pancreatitis. Our aim was to assess short- and long-term outcomes following implementation of a nationwide program of TPIAT at a tertiary reference center for pancreatic surgery in Norway. Methods: A prospective, observational single-center study enrolling consecutive patients undergoing TPIAT for chronic pancreatitis at Oslo University Hospital. The selection of potential candidates for TPIAT was based on discussions at multidisciplinary team (MDT) meetings, focusing on tailored surgery in chronic pancreatitis. Patients were finally evaluated in a dedicated TPIAT team. The outcome measures included pain relief, quality of life (QoL) assessed by EORTC QLQ-C30, complications, and glycemic control. Results: Between August 2017 and November 2022, 15 patients underwent TPIAT. The follow-up rate was 87% with a median follow-up of 26 months (range = 14–65). Pain relief was achieved in 92%. EORTC QLQ-C30 analysis revealed clinically significant improvements in 28 of 30 domains, particularly in pain and role- and social-functioning. The Clavien-Dindo ≥IIIa complications occurred in one patient. There was no 90 days mortality. All patients maintained C-peptide positivity, although none of the patients reached insulin independence. Conclusion: TPIAT was as a safe and effective treatment for a selected group of patients with chronic pancreatitis, providing substantial pain relief and enhanced QoL. Islet autotransplantation prevented complete insulin deficiency, reducing diabetes severity postpancreatectomy. Dedicated chronic pancreatitis MDT meetings were key factor in the success of the program.
Effectiveness and safety of first-line pembrolizumab plus chemotherapy in patients with advanced/recurrent or metastatic esophageal squamous cell carcinoma in China: a real-world multicenter study
Authors: Lin Yu , Shen Wenbin , Ye Jinjun , Luo Honglei , Zhang Xizhi , Xu Yuanji , Lin Qin , Liu Wenyang , Zhang Yingying , Xu Yujin , Jiang Wei , Zhao Lina , Liu Anwen , Wu Lei , Ge Hong , Xie Conghua , Zhao Kuaile , Chen Junqiang , Wang Luhua , Liu Qi 
Published: November 2024

Background: There are currently limited real-world data on the effectiveness and safety of first-line pembrolizumab combined with chemotherapy in patients with advanced/recurrent or metastatic esophageal squamous cell carcinoma (ESCC) in China. This study was conducted to address this knowledge gap. Methods: This multicenter retrospective cohort study was conducted at 17 hospitals in China and included adults (⩾18 years) with stage IV primary ESCC, or recurring 6 months after radical radiotherapy/surgery-based combination therapy, who had received first-line pembrolizumab plus chemotherapy. Data were collected from electronic medical records. Endpoints included objective response rate (ORR), disease control rate (DCR) progression-free survival (PFS), overall survival (OS), and safety. Subgroup analyses were conducted to identify patient characteristics and treatment patterns associated with treatment response. Results: In total, 202 patients who had received treatment from 2018 to 2023 were included: 125 (61.9%) newly diagnosed and 77 (38.1%) with recurrence, 181 (89.1%) were male. Pembrolizumab was most commonly combined with paclitaxel + platinum (69.8%) or fluorouracil + platinum (19.3%). After a median follow-up of 22.6 months (95% confidence interval (CI) 20.1–25.4), the ORR and DCR were 60.9% and 87.6% and the median PFS and OS were 10.8 months (95% CI 9.1–13.5) and 17.3 months (95% CI 14.9–19.9), respectively. OS was similar in patients with treatment-naïve and recurrent disease. Among the combination chemotherapy regimens, paclitaxel + platinum was associated with the longest median OS (18.2 months, 95% CI 16.1–22.5). Favorable survival outcomes were observed in patients with oligometastases. No new safety signals were observed. Conclusion: These real-world data indicate that the first-line treatment with pembrolizumab plus chemotherapy is effective and safe in Chinese patients with advanced ESCC and show that paclitaxel + platinum is the most commonly used and most effective partner chemotherapy in China.
Study on the Mechanism of Compound Zeqi Granule in Treating Psoriasis vulgaris Based on Network Pharmacology and Experimental Verification
Authors: Wu Min , Dong Tongtong , Zhang Ting , Wang Jiuxiang , Liu Taofeng , Wang Changzhong 
Published: November 2024

Background This study used a holistic network pharmacological approach to clarify the mechanism of Compound Zeqi Granule (CZG) in treating psoriasis vulgaris (PV). Methods The potential bioactive compounds and corresponding targets of CZG were collected and searched via the TCMSP database. Disease targets of PV were obtained from the GeneCards database. The targets of CZG and PV were standardized by the UniProt database. GO and KEGG enrichment analyses were performed using the Metascape database. Then, molecular docking verification was conducted using the CB-Dock database. Animal experiments were conducted to validate the effects of CZG on PV. Results This approach identified 99 bioactive compounds, 579 potential drug targets, 822 PV-related targets, and 108 potential target proteins. The biological processes were primarily related to regulation of defense response, regulation of inflammatory responses, and cellular response to lipid. The targets of CZG for treating PV were significantly associated with 20 pathways including JAK-STAT signaling pathway. Animal experiments confirmed that CZG exerted its therapeutic effects on PV by promoting the expression of IL-10 and JUN, and inhibiting the activation of STAT1 and STAT3. Conclusion The present study provides evidence supporting the efficacy of CZG for the treatment of PV through a multi-compound, multi-target and multi-pathway approach and lays a theoretical foundation for further experimental research in this field.
ESG Scores and Its Impact on Firm Performance: Study from Nifty100 Firms
Authors: Deb Rajat , Behra Anita , Dusmanta Karkaria 
Published: November 2024

The study examines how environmental, social and governance (ESG) scores impact the operational, financial and market performance of firms indexed in the Nifty 100 index for short and long observation periods. Return on assets (ROA), return on equity (ROE) and Tobin’s Q are employed as proxies to evaluate the firms’ performance. The longitudinal research design draws upon secondary data from Bloomberg for ESG scores and Prowess for Interactive Querying for performance indicators. It employs panel regression analysis, and the results indicate a significant difference in the short and long observation periods. ESG adversely affects firms’ operational and financial performance over an extended observation period and has insignificant effects over a short observation period. Conversely, it reports a statistically significant positive impact on market performance in short and long observation periods. It concludes by recognizing its limitations, discussing policy implications and sketching a roadmap for future research. JEL Classification: Q51, Q56
One Health and Oral Health: A Scoping Review to Inform Research and Present Challenges
Authors: Huang S. , Li J.W. , Zheng L.W. , Qiao W.W. , McGrath C. 
Published: November 2024

Background: “One health” is an integrated, unifying approach that recognizes the interconnectedness between the health of people, animals, and the environment. Oral diseases are the most common diseases to affect humankind, and it is increasingly acknowledged that key determinants of oral heath are social and environmental. However, there is a dearth of information on the relationship between oral health and one health. Aims: A scoping review was conducted to examine how animal and environmental health affects human oral health and vice versa, to examine the interest in the field overtime, and to provide a synthesis of the literature concerning one health in the oral health context to date. Methods: A broad standardized search strategy was employed across 5 electronic databases. Screening of publications with defined inclusion and exclusion criteria followed PRISMA-ScR (the Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Results: The initial search yielded 345 articles; 163 remained after removal of duplicates. Nineteen articles were identified as “potentially effective studies,” and after consideration of the full text, 13 articles were identified as “effective studies” to inform this review. Most studies were published since 2020 (60.5%, 8/13), and there were reports from 5 of the 6 World Health Organization regions (except the Eastern Mediterranean region). Most studies were observation in nature and mostly of cross-sectional study design (84.7%, 11/13 studies). More than half of the studies (53.8%, 7/13) were concerned with how environmental factors such as chemical exposures affect human oral health. Studies involving animals (46.2%, 6/13) highlighted the risk of zoonotic infections from horses and livestock to humans. Conclusions: There is a recent and growing interest in “one health” in the oral health context. Qualitative synthesis of data highlighted the interconnectedness between the health of animals and environment with human health with implications for consideration and action by dentistry. Knowledge Transfer Statement: The results of this scoping review address the importance of dentistry in the “one health” concept. This scoping review will allow other researchers to be aware of and fill literature gaps with respect to the impact of animal health and environment on oral health and contribute to future research.