bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling and effectiveness of a training intervention for the developmentof professional skills in Family and Community Medicine and Nursing Residents: Cross-Sectional Study
Authors: Chacón-Docampo Macarena , Asensio-Martínez Ángela , Rodríguez-Pastoriza Sara , Liñares-Mariñas David , Martín-Miguel María Victoria , Bartolomé-Moreno Cruz , González-Formoso Clara , Clavería Ana 
Published: September 2024

Abstract

Introduction: Healthcare workers, especially medical and nursing residents, are exposed to situations that can lead to burnout. The main factors are organizational. However, it is more feasible for professionals to act on personal factors. There is a growing interest in interventions to prevent and reduce burnout. Objective: To design and evaluate the effectiveness of a face-to-face training intervention compared to its online counterpart and to regular training. The study protocol is presented. Method:Cross-sectional analysis of baseline data from a pragmatic non-randomized clinical trial of a training intervention to reduce burnout. Family and community care medical and nursing residents 2018, 2019, 2020 and 2021 promotions of the teaching units of Vigo, Zaragoza and Mallorca. Variables: Sociodemographic, professional, burnout, empathy, resilience, social support, sense of coherence, anxiety and depression, personality, locus of control. Registered in Clinical Trials with ID: NCT04625582 (November 10, 2020) Results: 177 residents. Mean age 27.7 (SD: 3.46), working hours per week 49.3 (SD: 9.78), patients per consultation per day 30.5 (SD: 14.1), and on-call time per month 4.52 (SD: 1.35). When comparing the intervention and control groups, the number of patients per consultation was significant (95% CI: [29.5–34.3], [19.4–27.0]; p < 0.001). Personal, work and patient burnout were positively and significantly correlated with a Pearson correlation greater than 0.4. Conclusions: They show high levels of burnout and correlate with personal and organizational variables. The data obtained are the starting point for the development of intervention programs.
Predictors of dura-brain neoangiogenesis after combined revascularization for patients with symptomatic atherosclerotic cerebral artery occlusion: A multivariate regression analysis
Authors: Ling Cong , Mo Ni , Zhang Baoyu , Tai Chuyang , Yang Yang , Wei Lei , Wang Hui , Chen Chuan 
Published: September 2024

Abstract

Background
The predictors of the efficacy of indirect revascularization in nonmoyamoya patients have not been determined. Our study was designed to investigate the independent predictors of dura-brain neoangiogenesis (DBN) after superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass combined with dural inversion (DI) in patients with symptomatic atherosclerotic cerebral arterial occlusion (SACAO).
Methods
We retrospectively analyzed SACAO patients who had undergone STA-MCA bypass combined with DI at our center between November 2014 and October 2021. DBN was evaluated by super-selective digital subtraction angiography and scored by the DBN scoring system. Independent predictors of DBN were identified by multivariate logistic regression analysis. The differences in clinical outcomes between patients with “good” and “poor” DBN were also analyzed.
Results
A total of 179 SACAO patients with an average age of 61.3 ± 7.0 years and an average follow-up of 63.0 ± 22.0 months were studied. Ninety-nine patients (55.3%) had good DBN, and 80 patients (44.7%) had poor DBN. Multivariate analysis revealed that old age (p < 0.001, OR [95% CI] 1.288 [1.184–1.400]) was an independent predictor of poor DBN, with an optimal cutoff of 64.5 years. Diabetes (p = 0.005, OR [95% CI] 3.358 [1.434–7.867]) also independently predicted poor DBN. The recurrence rate of ischemic events in the good DBN group was significantly lower than that in the poor DBN group (2.0% vs. 10.0%, p = 0.044). The neurological status of patients in the good DBN group was significantly better than that of patients in the poor DBN group.
Conclusion
Old age and diabetes status were found to be independent predictors of poor DBN after combined revascularization in SACAO patients. Good DBN was associated with a lower recurrence rate of stroke and better neurological status. Future studies are needed to clarify the underlying pathophysiological mechanisms involved.
Global, Regional, and National Burden of Hip Fractures From 1990 to 2021: Results from Global Burden of Disease Study 2021
Authors: Su Jian-hao , Xiao Zhi-kang , Sun Chang-hao , Xu Gao-xiang , He Jian-feng 
Published: September 2024

Abstract

Background:Hip fracture is a kind of injury with complex nature, difficult treatment and the high proportion of elderly female patients, which is known as the last fracture for elderly. It is an important cause of reducing health level in elderly. Current reports on burden and tendencies of global hip fractures are still incomplete.
Methods: Through the Global Burden of Disease study (GBD) database, we extracted the incidence and years lived with disability (YLD) associated with hip fractures from 1990 to 2021. Our study used an estimate of the 95% uncertainty interval. Trends in hip fracture burden were assessed by estimated annual percentage change. Spearman correlation analysis was used for examining the correlation of age-standardization rate with socio-demographic index (SDI).
Results: In 2021, the incidence and YLD of global hip fractures were 16.9 million and 3.1 million, which increased by 126.4% and 75.2% compared with 1990, respectively. In the past 32 years, global incidence rate kept relatively stable in both genders, while YLD rate declined. There was a slight increase of incidence in male, while the both rates were consistently higher in female. The incidence of hip fracture had a positive correlation with SDI, but there was no significant correlation with YLD. Hip fractures appear more frequently for patients over 70 years old. Falls were the pivotal cause of hip fracture, which accounted for 83.1% of total incidence and 79.7% of total YLD.
Conclusions: Hip fractures remain a significant burden on global healthcare systems, with falls being the pivotal cause. The incidence and burden was higher in women, but incidence rate increased slightly in men. The majority of patients were over 70 years old. Countries with high SDI had a higher incidence, while countries with low SDI had a greater burden of disease. Policies should focus on improving malnutrition, promoting public health education on the lifestyle for bone protecting, choosing appropriate measures to prevent falls in the elderly, and raising awareness of osteoporosis screening and treatment (especially for men).
Exploring U.K. cancer doctors’ attitudes toward psilocybin-assisted psychotherapy for cancer-related distress
Authors: Mageean Shane , Daniel Anderson , Tai Sara 
Published: September 2024

Abstract

Background
A diagnosis of cancer is often associated with significant psychological distress. Current approaches to cancer-related distress predominantly fall short of meeting the needs of patients. Recent investigations have shown that administering psilocybin in combination with psychotherapy might be effective at reducing distress in cancer patients. Oncologists are often ‘gatekeepers’, who oversee cancer patient care; if this intervention were to become more routinely available, it is important to understand doctors’ attitudes toward psilocybin-assisted psychotherapy.
Method
Nine oncologists who worked across two National Health Service Trusts in England were interviewed using a semi-structured interview approach. Thematic analysis was used to analyse the interviews and guide the development of overarching themes and subthemes.
Results
The analysis revealed five overarching themes relating to oncologists’ experiences of cancer-related distress and attitudes towards psilocybin-assisted psychotherapy: current approaches to distress; attitudes towards psychedelics and psilocybin; quality research; service design and delivery; distress and patients from different backgrounds.
Limitations:
Future research should aim to explore the experiences and attitudes of other professionals, such as specialist cancer nurses, who are more likely to broach the subject of distress with cancer patients.
Conclusions
Oncologists are open to novel interventions for supporting patients experiencing cancer-related psychological distress. Future research should aim to address their concerns regarding the safety and potential interactions of psilocybin with anticancer treatments and should stratify trials with different patient groups, owing to the idiosyncratic nature of specific types of cancer.
Neoadjuvant chemoradiation in older Irish adult patients with oesophageal cancer: A retrospective institutional review of clinical outcomes and hematological toxicity
Authors: McLaughlin Ronan Andrew , McMahon David , Cluxton Christopher , Fitzpatrick Orla Meave , Conroy Michael , Almeraikhi Majid , Alkaabi Humaid , Bligh Fianait , O’Neill Brian , Robb William , Arumugasamy Mayilone , Breathnach Oscar Seamus , Grogan William , Hennessy Bryan T , Murphy Adrian , Naidoo Jarsuhka , Greally Megan , Bennett Kathleen , Morris Patrick G 
Published: September 2024

Abstract

Background and Objectives:
Neoadjuvant chemo-radiotherapy improves survival compared with surgery alone in locally advanced oesophageal cancer. In the Chemo-Radiotherapy for Oesophageal cancer followed by Surgery Study (CROSS) randomised controlled trial (RCT), the median age was 60. However, one third of patients diagnosed with oesophageal cancer are aged ≥70 years. The reported outcomes and toxicities from the CROSS RCT are therefore limited in their application to older adult patients. The proportion of older patients with oesophageal cancer is increasing globally due to prolonged life expectancy and an aging population. The aim of this study was to investigate the clinical outcomes and toxicity reported in older patients (≥70 years) treated with neoadjuvant chemo-radiation for oesophageal cancer compared with those aged < 70 years in a tertiary Irish cancer centre.
Methods:
A retrospective cohort of patients treated with neoadjuvant chemo-radiation for oesophageal cancer was identified between 1st January 2015 and 1st January 2021. Eligible patients with cT1-4aNxM0 oesophageal cancer were identified in the Beaumont RCSI Cancer Centre database. Baseline characteristics and haematological toxicities were reported. Pathological response was reported. Chemotherapy toxicity was reported using the CTCAE Version 5.0. Survival was estimated using the Kaplan-Meier method. Survival between groups was compared using the log-rank test, and the Cox proportional hazards model was used to identify factors associated with overall survival (OS).
Results:
In total 105 patients with potentially curable oesophageal cancer were included. One third (n=35) of patients were ≥70 years (older cohort) and 70 (67%) aged <70 years (younger cohort). In the older cohort, the median age was 75 (range: 70-86) and the younger cohort median age was 60 (29-69). The majority in both cohorts were male (73%). In 5 (14%) of the older and 7 (10%) younger cohort, individuals experienced ≥ grade 3 neutropoenia. In total, 80% of the older and 86% of the younger cohort proceeded to surgery. There was no difference in OS between the cohorts. There was also no difference in disease free survival (DFS) between the cohorts.
Conclusion:
In conclusion, in patients aged ≥ 70 years compared to those aged < 70 years, we confirm that neoadjuvant chemoradiation is tolerable. There was no evidence to suggest any differences in OS and DFS between the cohorts. Neoadjuvant therapy in appropriately selected patients aged ≥ 70 years with oesophageal cancer is a reasonable treatment choice.
Association between cardiometabolic index and female infertility: a cross-sectional analysis
Authors: Zhao Yiran , Shi Weihui , Liu Yang , Qin Ningxin , Huang Hefeng 
Published: September 2024

Abstract

Background
Adverse lipid profile leads to female infertility. The correlation between the cardiometabolic index (CMI) and female infertility merits further investigation.
Methods
The data for this study were acquired from the 2013–2020 National Health and Nutrition Examination Survey (NHANES), with 2333 women enrolled. The cardiometabolic index (CMI) of each participant was calculated as the ratio of triglycerides and high-density lipoprotein cholesterol multiplied by waist-to-height ratio. Weighted multivariate logistic regression models were used to assess the independent association between the log-transformed CMI and infertility. Subgroup analyses were carried out to assess the reliability of the findings. Interaction tests were employed to find out if variables affected infertility by interacting with log CMI.
Results
A total of 2333 participants aged 18–45 years were enrolled, 274 of whom were infertile. Log CMI of the infertility group was significantly higher than that of the non-infertility group (P < 0.001). After adjustment for potential confounders, women with higher CMI were more prevalent of infertility (OR = 2.411, 95% CI: 1.416–4.112), and this association was still consistent in subgroups aged under 35 years (P < 0.001). Furthermore, restricted cubic spline analysis showed a positive non-linear relationship between log CMI and infertility.
Conclusions
Cardiometabolic index levels were positively associated with increased risk of infertility in American females. Our study demonstrated the predictive capacity of CMI for female infertility; nevertheless, additional clarification is required to establish the direct relationship between CMI and female infertility, which will serve as a foundation for future efforts to prevent female infertility.
Immune cells, circulating inflammatory factors and neurodevelopmental disorders: a bidirectional mendelian randomization and mediation analysis
Authors: Liu Zhiyue , Wang Lihong , Yu Lianhu , Zhao Yongheng , Zhu Mengna , Wang Yu , Cao Aihua 
Published: September 2024

Abstract

The roles of various immune cells and circulating inflammatory factors in neurodevelopmental disorders (NDDs) remain controversial. Therefor we employed a two sample and bidirectional mendelian randomization and mediation method to explore the causal relationships between immune cells, circulating inflammatory factors, and NDDs. All data were originated from GWAS datasets. We found a significant positive causal relationship between 13 immune cells and ASD, including six CD8 + T cell, one CD3 + T cell, two CD20 + B cell, one CD38 + B cell, and two plasmacytoid DC. 9 inflammatory factors showed significant causal relationships with ASD: four interleukins (IL-7, IL-2, IL-18) were negatively associated, while five inflammatory factors were positively associated, such as TNF-α. 14 immune cells exhibited significant causal relationships with ADHD. CD3 on naive CD8br and CD4 on activated Treg were positively associated, while four CD27-expressing B cells were positively associated with ASD. Four CD40-expressing monocytes were negatively associated with ADHD. 7 inflammatory factors had significant causal relationships with ADHD: Fibroblast Growth Factor 23 levels (FGF-23), CD40L receptor levels, Glial Cell Line-Derived Neurotrophic Factor levels(GDNF), TNF-α were more important among these. Mediation analysis identified 12 mediating relationships, with three showing strong evidence: Natural killer cell receptor 2B4 levels (19.9%), Fibroblast Growth Factor 23 levels (11%) and Eotaxin levels (-5.95%). There were strongly causal relationships between immune cells, circulating inflammatory factors, and NDDs. Inflammatory factors mediated the pathways between immune cells and NDDs.
Epidemiology of Idiopathic Pulmonary Fibrosis in Central and Western Pennsylvania
Authors: Linkov Faina , Chang Yue-Fang , Ramanan Harshitha , Morgan Richard S. , McTigue Kathleen M , Dimmock Anne EF , Bascom Rebecca , Kass Daniel J 
Published: September 2024

Abstract

Background/Rationale: Idiopathic Pulmonary Fibrosis (IPF) is a chronic, progressive disease of unknown origin. Establishing the epidemiology of IPF has been challenging due to diagnostic complexity, poor survival, low prevalence, and heterogeneity of ascertainment methodologies.
Objectives: This research aimed to estimate the rates of IPF in central and western Pennsylvania and to pilot the use of capture recapture (CR) methods to estimate the disease incidence.
Methods: We identified adults ≥ 30 years old diagnosed with IPF (by ICD-9/10 coding) between 2013 to 2021 from two health systems (UPMC Health System and Penn State Health) participating in the PaTH Clinical Research Network. We extracted information on patients’ sex, race, date of birth and 3-digit zip code from electronic health records (EHR). Incidence rate of IPF among Pennsylvania residents was calculated using three case definitions (broad and two restricted) and piloted the use of CR in estimating IPF incidence.
Results: IPF incidence rates were 8.42, 6.95 and 4.4 per 100,000 person-years for the unrestricted (n=3148), partially restricted (n=2598) and fully restricted (n=1661) samples, respectively. Low case overlap between two sites resulted in a highly inflated estimate of IPF incidence, using the CR methodology.
Conclusions: The rate of IPF in central and western Pennsylvania was similar to previously published statistics. The application of CR to IPF epidemiology could be further investigated in health systems with greater overlap of patients utilizing more than one system.
Clinical Trial Registration: N/A
Comparative Survival Analysis of HER2-Positive Pregnancy-Associated Breast Cancer and Non-Pregnant Cohorts: A matched control study
Authors: Al-Masri Mahmoud , Aljalabneh Basim , AlMasri Rama , Alayyan Osama , Almasri Mohammad , Safi Yasmin 
Published: September 2024

Abstract

Purpose: This retrospective matched cohort single-center study focused on comparing prognosis between HER2-positive PABC and non-pregnant individuals with HER2-positive breast cancer.
Methods: Clinical and histopathological data were collected from a prospectively maintained patient database at King Hussein Cancer Center, a tertiary cancer-care center in Jordan. The study analyzed overall survival (OS), recurrence-free survival (RFS), and event-free survival (EFS) in HER2-positive PABC matched 1:1 to non-pregnant patients with HER2-positive breast cancer (non-PABC).
Results: The analysis encompassed 128 patients, divided into two main groups: 64 patients diagnosed with PABC and 64 patients classified as non-PABC cases. Although there was not a statistically significant difference in OS between non-pregnant and pregnant individuals (p=0.12), it was notable that pregnant individuals experienced a significant delay in the initiation of anti-HER2 treatment (23.8± 19.3 weeks, p= 0.02). Additionally, there was a higher risk of recurrence or events in pregnant individuals, emphasizing the potential impact of pregnancy on these survival outcomes (HR=1.93, p=0.029 and HR=2.00, p=0.02, respectively). Furthermore, PABC individuals who completed the 12-months of anti-HER2 treatment were comparable to non-PABC individuals who completed the same treatment (p=0.3), while incomplete treatment significantly affected survival outcomes (HR=4.94, 95% CI: 1.41 to 17.3, p=0.012).
Conclusion: Despite a notable delay in the initiation of anti-HER2 treatment in PABC patients compared to non-PABC cases, both cohorts exhibited similar prognostic outcomes in terms of overall survival when anti-HER2 treatment has been completed. This discovery emphasizes the importance of promptly initiating and completing anti-HER2 treatment in pregnant individuals to optimize prognosis.
Surgery for Brain Metastases: Review of outcomes and focused analysis of multiple metastases and recurrent metastases following stereotactic radiosurgery
Authors: Shaikh Salman T. , Pattankar Sanjeev , Nambiar Rohit , Sahibzada Haseeb , D'Urso Pietro , Coope David , Bailey Matthew , Maye Helen , Karabatsou Konstantina 
Published: September 2024

Abstract

Purpose: Brain metastases require multimodal and multidisciplinary management. We have reviewed our outcomes of surgically treated brain metastases in the modern era and also performed a sub-analysis of multiple intracranial metastases and recurrent metastases resected following stereotactic radiosurgery.
Methods: A single institute, retrospective, statistical analysis of patients with surgically excised brain metastases over 10 years performed at Salford Royal Hospital, Manchester, United Kingdom. Patient records accessed from the Neurooncology database and electronic records.
Results: A total of 345 patients had 379 surgeries for resection of their brain metastases from January 2013 until December 2022. Mean age of the group was 59.49 ± 12.25 years. Lung (35%) and breast (19%) were the most common primaries. There were 138 patients with multiple metastases at the time of surgery, amongst which 23 underwent simultaneous resection of > 1 metastasis. There were 37 patients post-SRS who had surgery for an enlarging lesion. Mean overall survival (OS) was 31.083 months with a 2-year OS of 30.63% whereas mean progression free survival (PFS) was 22.33 months. Adjuvant therapy was the common statistically significant factor for both OS and PFS while redo surgery for OS and age for PFS was an additional significant parameter. Amongst surgically treated patients, ones receiving preoperative SRS and any adjuvant therapy had statistically significant longer OS (39 months) and PFS (20 months).
Conclusions: Multimodal approach encompassing surgical resection either at diagnosis or revisional for recurrence post SRS/surgery, offers the best survival and progression-free outcomes. Surgery alleviates neurological manifestations and improves patient compliance for adjuvant therapy improving overall prognosis.
Machine learning aided UV Absorbance Spectroscopy for microbial contamination in cell therapy products
Authors: Chelvam Shruthi Pandi , Ng Alice , Huang Jiayi , Lee Elizabeth , Baranski Maciej , Yong Derrick , Williams Rohan B.H. , Springs Stacy L. , J Rajeev 
Published: September 2024

Abstract

We demonstrate the use of machine-learning aided UV absorbance spectroscopy to detect contamination during cell therapy product (CTP) manufacturing. The proposed method leverages a one-class support vector machine model to analyse the absorbance spectra of cell cultures and predict if a sample is sterile or contaminated. This label-free and non-invasive method provides a rapid output (30 minutes) with minimal sample preparation and sample volume (<1mL). Spiking of 7 bacterial species into mesenchymal stromal cells supernatant aliquots from 6 commercial donors showed that contamination events could be detected at low inoculums with mean true positive and negative rates of 92.7% and 77.7% respectively. Accounting for donor variation improved specificity to 92.0%. In cells spiked with 10 CFUs/mL of E.coli, contamination was detected at the 21-hour timepoint, demonstrating comparable sensitivity to compendial USP <71> test (~24 hours). We hypothesize that spectral differences between nicotinic acid and nicotinamide in the UV region are the underlying mechanisms for contamination detection. This technique can be deployed as a preliminary test during different CTP manufacturing stages where cultures can be monitored real-time to detect early onset of microbial contamination, assuring safety of CTP prior to infusion into patients.