bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on Cantharidin Reversing the Drug-resistance of Non-small Cell Lung Cancer to DDP by Regulating the Expression of PD-L1
Authors: Jin Xing , Ma Chunhui , Tan Xiaojing , Qian Jian , Chen Yongbing , Wang Dongfeng 
Published: September 2024

Background and Purpose Cantharidin can or cannot reverse the drug resistance of non-small cell lung cancer to cisplatin (DDP) by reducing the expression of programmed cell death ligand 1 (PD-L1). Materials and Methods The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method was used to screen for sublethal doses of cantharidin and determine its sensitizing effect on DDP. Detect the apoptosis rate of A549/DDP cells treated with cantharidin, DDP, or the combination of cantharidin and DDP. The effects of cantharidin on the expressions of p53 and PD-L1 in the cell line were investigated. Furthermore, pifithrin-α (PFT-α) pretreatment was performed to inhibit the function of p53 and verify whether cantharidin can affect the expression of PD-L1 through p53. Results Cantharidin significantly enhanced the sensitivity of cells to DDP and increased the apoptosis of cells induced by DDP. Cantharidin upregulated the expression of p53 in A549/DDP cells with wild-type p53 and downregulated the expression of PD-L1. Pretreatment with PFT-α inhibited the apoptosis of cells induced by the combination treatment of cantharidin and DDP. Conclusion Cantharidin can regulate the expression of p53 and downregulate the PD-L1 in non-small cell lung cancer with wild-type p53. It may enhance the sensitivity of non-small cell lung cancer to DDP by further altering the levels of PD-L1 through the regulation of p53 expression.
Implementation of a pharmacist-guided pharmacogenomics dosing service at a rural NCI-designated comprehensive cancer center
Authors: Green Jenna K , Hackett Laura J , Green Donald C , Deharvengt Sophie J , Brooks Gabriel A , Khan Wahab A , Tsongalis Gregory J , Lewis Lionel D , Shah Parth S 
Published: September 2024

Introduction The goal of pharmacogenetic testing is to identify genetic variants with significant implications on drug safety and efficacy. Several professional organizations and institutions have demonstrated the value of pharmacist involvement in the implementation of pharmacogenomic services. Therefore, we aimed to establish a pharmacist-guided model for interpretation of pharmacogenetic results for all oncology patients seen at the Dartmouth Cancer Center (DCC) in Lebanon, NH. Methods A pilot of a pharmacist-guided pharmacogenomics dosing service was implemented at the DCC. Pharmacy services included review of results from a next generation sequencing panel for DPYD, TPMT, NUDT15, and UGT1A1 variants. The pharmacist wrote a note in the electronic health record (EHR) detailing actionable drug-gene interactions and drug-dosing guidance, which was then routed to the treating oncologist. Outcomes collected included highlighting actionable mutations and defining pharmacist interventions. In addition, time spent formulating and documenting patient-specific drug-dosing recommendations was collected. Results From February 2024 through May 2024, a total of 71 patients with pharmacogenetic results, provided by the clinical molecular laboratory at Dartmouth Health, were reviewed by the pharmacist. The majority of patients tested were diagnosed with a malignancy of gastrointestinal origin. Twenty-one patients were found to have actionable variants in at least one of the four genes evaluated, and five of the 21 identified patients had active treatment plans for which dose changes were then implemented. Conclusions Implementation of a pharmacist-guided pharmacogenomics based dosing service aided in optimizing drug therapy and has positioned Dartmouth Health for further expansion of pharmacogenomics and personalized patient care.
Suicide in Healthcare Workers: An Umbrella Review of Prevalence, Causes, and Preventive Strategies
Authors: Jain Lakshit , Sarfraz Zouina , Karlapati Surya , Kazmi Sibtain , Nasir Muhammad Jamal , Atiq Noor , Ansari Danya , Shah Darshini , Aamir Urooj , Zaidi Kashaf , Shakil Zubair Aarij , Jyotsana Pallawi 
Published: September 2024

Background: The medical profession faces a critical challenge with the mental health of its practitioners, leading to an alarming increase in suicide rates among healthcare workers (HCW). Factors such as the culture of perfectionism, excessive workloads, and stigma against seeking help exacerbate this issue. This umbrella review synthesizes the existing literature on HCW suicide, exploring the prevalence, causes, and potential preventive strategies. Methods: This study conducted a search of the literature from PubMed/Medline, Scopus, Web of Science, Cochrane Library, PsycINFO, and Google Scholar until April 2, 2024. The non-exhaustive search terms used were “doctor suicide,” “physician suicide,” “medical professional suicide,” "suicide in healthcare," “healthcare worker suicide prevention,” and “causes of healthcare worker suicide.” Hand-searches were also conducted. Of the 487 studies initially identified, a total of 10 systematic reviews/meta-analyses were included. Results: This umbrella review collates findings from 400 primary clinical studies conducted between the years 2004 and 2023. With a focus on mental health factors contributing to suicide in HCW, there are regional and specialty-specific variations in stress prevalence in the populace. Further, anesthesiologists and psychiatrics depicted higher rates of burnout compared to other HCW; causative factors such as seeking perfection and challenging work-life balance were key when assessing suicidal behaviors in these groups. Job demand level was found to correlate directly with suicidal thoughts, specifically among psychiatric ward HCW, where access to drugs and sharp instruments is readily available. In specific contexts, female HCWs showed a standardized mortality ratio (SMR), indicating that the rate of suicide was higher among them as compared to the general female population. Interventions such as cognitive behavioral therapy (CBT) and mindfulness were effective in decreasing depression, psychological distress, and anxiety in several included studies. This umbrella review also identified major obstacles to seeking help, including stigma and the fear of professional consequences. Conclusion: To reduce suicide rates among HCWs, it is the need of the hour to implement evidence-based interventions and create supportive work environments that encourage mutual care for each other’s emotional health. Further research is necessary to determine the effectiveness of various measures in preventing suicide among HCW.
Evaluation of Interprofessional Delivery of Diabetes Medication Management Training Among Family Medicine Residents
Authors: Davis Amanda , Davis Katherine , Moore Elise , Samuelson Britanee , Stonerock Lauren , Miller Nathaniel E. 
Published: September 2024

Objective: Diabetes-related care makes up approximately 24% of outpatient clinic visits. Therefore, confidence and understanding of diabetes management is necessary for family medicine residents. Methods: We developed a combined lecture and simulation lab curriculum utilizing a registered nurse and pharmacist to deliver education to 20 family medicine learners. Pre and post surveys of the educational material were completed in 2 sections including one gauging medical knowledge and a second part gauging level of comfort. Results: Of the learners who participated, fourteen completed the pre-post surveys. Most (53%) respondents improved their scores, while 20% scored the same 27% scored worse. The overall average score increased 57% to 70% and improvement was statistically significant ( P < .05). All learners improved confidence by at least 1 point. Conclusion: An interprofessional team utilizing a lecture curriculum focusing on providing education on effective prescribing, medication safety profiles, and resource availability, showed improvement in confidence but mixed knowledge benefit. Further modifications to the curriculum may yield further educational gains.
The Effect of the Metaverse Environment and Task Difficulty on Emotional Response and Cognitive Workload
Authors: Islam Fabiha , Bright Zipporah , Cheng Mu , Shi Chao 
Published: September 2024

Objective: People's mental workload and emotional responses were assessed while performing cognitive load demanding tasks in virtual and non-virtual environments. Background: The virtual world is providing fascinating experiences by offering a perpetual and persistent multiuser environment. Yet users report several side effects and degraded performance during and after the exposure to the virtual environment. Therefore, there exists a necessity to measure people’s emotional response and cognitive workload in virtual and non-virtual environments. Method: We designed a within-subject experiment and hired 20 participants to play Fruit Ninja 2 at two difficulty levels: easy and hard. An iPad presented the game in traditional 2D environment while a head mount device was used to project the game virtually. After each game the participants filled out the Positive and Negative Affect Schedule and NASA Task Load Index (NASA TLX) questionnaire. Results: The result revealed that, higher NASA TLX scores were associated with the virtual environment compared to the iPad environment. The Positive affect (PA) scores for the hard level were significantly smaller than the easy level at virtual environment. However, no significant differences were observed among the PA scores of two environments. The Negative Affect (NA) scores for virtual environment were significantly greater than the NA scores of iPad at the same difficulty level. Conclusion: We concluded that, people feel higher mental workload and more distressed in virtual world compared to traditional iPad environment. Nevertheless, they express equal positiveness towards both environments. Application: The results can help future researchers to take advantage of the metaverse to create emotion eliciting environment. Additionally, the findings of this study can guide healthcare professionals to tailor the metaverse environment as a digital therapeutic platform to treat individuals while maximizing their emotional engagement and optimizing cognitive workload.
Outcomes of Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyposis and Risk Factors of Recurrence in a Tertiary Care Teaching Hospital
Authors: Aldajani Ahmad , Alroqi Ahmad , Alrashidi Ali , Alsaif Anas , Almeshari Saif , Aldwaighri Mohammed , Alromaih Saud , Aloulah Mohammad O. , Alrasheed Abdulaziz S. , Aldousary Surayie , Alsaleh Saad 
Published: September 2024

Background Endoscopic sinus surgery (ESS) has become the gold standard for treating patients with chronic rhinosinusitis (CRS) refractory to medical therapy. It is considered a relatively safe and effective procedure in all age groups, with overall success rates ranging from 76% to 97.5%. However, failure of primary endoscopic sinus surgery (PESS) occurs at a rate ranging from 2% to 24%. Patients who are still symptomatic after PESS and optimal medical therapy are candidates for revision endoscopic sinus surgery (RESS). Objectives to study the outcomes of ESS and assess the risk factors of recurrence of nasal polyps, as well as to compare the outcomes of PESS and RESS at a tertiary care teaching hospital. Design A retrospective cross-sectional study. Methods This study is conducted on patients with CRS with nasal polyps (CRSwNP) who underwent ESS at King Saud University Medical City (KSUMC) between May 2015 and December 2021. During this period, ESS was performed 470 times for CRSwNP. The Sinonasal Outcome Test 22 (SNOT-22) questionnaire, the Lund–Kennedy (LK) score, the Lund–MacKay (LM) score, and the polyp grading system were used to evaluate subjective and objective outcomes. They were scored preoperatively and from 6 to 12 months postoperatively. Results Out of the 470 endoscopic sinus surgeries, 321 (68.3%) were PESS and 149 (31.7%) were RESS. Asthma, aspirin sensitivity, and Samter's triad were observed more in the RESS group. The LK and LM scores were significantly different between primary and revision sinus surgeries, revealing that PESS patients had better postoperative LK and LM scores. The RESS patients had significantly worse postoperative SNOT-22 scores compared to PESS patients. Conclusion Lund–MacKay, Lund–Kennedy, and SNOT-22 scores improved after ESS for both primary and revision ESS patients, with better outcomes observed after PESS compared to RESS. The presence of asthma, aspirin sensitivity, Samter's Triad, high-grade nasal polyps, and older age were identified as risk factors for CRSwNP recurrence, which may require RESS.
Physiological and communicative emotional disconcordance in children on the autism spectrum
Authors: Finkel Emma , Sah Eric , Spaulding McKenna , Herrington John D. , Tomczuk Liza , Masino Aaron , Pang Xueqin , Bhattacharya Anushua , Hedley Darren , Kushleyeva Yelena , Thomson Phoebe , Doppelt Natalie , Tan Jessica , Pennington Jeffrey , Dissanayake Cheryl , Bonafide Christopher P. , Nuske Heather J. 
Published: September 2024

Abstract
Background
Individuals on the autism spectrum commonly have differences from non-autistic people in expressing their emotions using communicative behaviors, such as facial expressions. However, it is not yet clear if this reduced expressivity stems from reduced physiological reactivity in emotional contexts or if individuals react internally, but do not show these reactions externally to others. We hypothesized that autism is characterized by a discordance between in-the-moment internal psychophysiological arousal and external communicative expressions of emotion.

Methods
Forty-one children on the autism spectrum and 39 non-autistic, typically developing (TD) children of two age groups (2–4 and 8–12 years) participated in a low-level stress task whilst wearing a wireless electrocardiogram. Children’s negative emotional expressions (facial, vocal, bodily) were coded following standardized protocols. Alexithymia traits were assessed using the Children’s Alexithymia Measure with school-aged children only. Data analyses involved ANOVAs, correlations, and sensitivity analyses.

Results
There were no group differences in physiological arousal (heart rate) or in communicative expressions of stress to the stress task. For TD preschoolers, physiological arousal during the stress task was associated with vocal expressions and for TD school-aged children, they were associated with facial and bodily expressions. By contrast, for children on the autism spectrum, physiological arousal during the stress tasks was not associated with communicative expressions across age groups.

Conclusions
Our findings suggest that children on the autism spectrum might experience emotional disconcordance, in that their physiological arousal does not align with their communicative expressions. Therefore, the internally experienced stress of children on the autism spectrum may be inadvertently missed by teachers and caregivers and, consequently, learning opportunities for teaching emotional communication and regulation may be also missed. Our results support the use of wearable biosensors to facilitate such interventions in children on the autism spectrum.
Digital music and movement intervention to improve health and wellbeing in older adults in care homes: a pilot mixed methods study
Authors: De Nys Len , Oyebola Esther F. , Connelly Jenni , Ryde Gemma C. , Whittaker Anna C. 
Published: September 2024

Abstract
Background
Low physical activity among older adults is related to adverse health outcomes such as depression and loneliness, poor physical function and increased risk of falls. This study was designed to increase physical activity through a digital, group-based, physical activity and music intervention and to examine its effectiveness on social, mental and physical health outcomes.

Methods
Participants were 34 older adults (65 years +) recruited across four care homes in Scotland to a pilot study. Surveys were administered at baseline and post-intervention, comprising measures of fear of falling, depression and anxiety, loneliness, sleep satisfaction and quality of life. A battery of physical function tests and saliva sampling for cortisol and dehydroepiandrosterone hormone analysis were also conducted at each time point. Additionally, process evaluation measures (recruitment, intervention fidelity, attendance, retention rates and safety) were monitored. The intervention comprised 12 weeks of three prescribed digital sessions per week: movement and music (n = 2) and music-only (n = 1), delivered by an activity coordinator in the care home. Post-intervention interviews with staff and participants were conducted to gain qualitative data on the acceptability of the intervention.

Results
An average of 88% of prescribed sessions were delivered. Pre- to post-intervention intention-to-treat analysis across all participants revealed significant improvements in anxiety, salivary DHEA, fear of falling and loneliness. There were no significant improvements in health-related quality of life, perceived stress, sleep satisfaction or physical function tests, including handgrip strength. Qualitative analysis highlighted benefits of and barriers to the programme.

Conclusions
The digital movement and music intervention was deemed acceptable and delivered with moderate fidelity, justifying progression to a full-scale trial. Although a proper control group would have yielded more confident causal relationships, preliminary psychosocial and biological effects were evident from this trial. To show significant improvements in physical function, it is likely that a bigger sample size providing sufficient power to detect significant changes, greater adherence, longer intervention and/or higher exercise volume may be necessary.

Trial registration
The trial is registered at ClinicalTrials.gov, number NCT05601102 on 01/11/2022.
Short-term outcomes of totally robotic versus robotic-assisted distal gastrectomy for gastric cancer: a single-center retrospective study
Authors: Ye Shan-Ping , Wu Can , Zou Rui-Xiang , Liu Dong-Ning , Yu Hong-Xin , Duan Jin-Yuan , Li Tai-Yuan 
Published: September 2024

Abstract
Background
Totally robotic distal gastrectomy (TRDG) is being used more and more in gastric cancer (GC) patients. The study aims to evaluate the short-term efficacy of TRDG and robotic-assisted distal gastrectomy (RADG) in the treatment of GC.

Methods
We retrospectively collected the clinical data of patients who underwent TRDG or RADG, of which 60 patients were included in the study: 30 cases of totally robotic and 30 cases of robotic-assisted. The short-term efficacy of the two groups was compared.

Results
There was no significant difference in the clinicopathological data between the two groups. Compared to RADG, TRDG had less intraoperative blood loss(P = 0.019), less postoperative abdominal drainage(P = 0.031), shorter time of exhaust( P = 0.001) and liquid diet(P = 0.001), shorter length of incision(P<0.01), shorter postoperative hospital stays(P = 0.033), lower postoperative C-reactive protein(CRP)(P = 0.024) and lower postoperative Visual Analogue Scale(VAS) scores(P = 0.048). However, no significant statistical differences were found in terms of total operation time(P = 0.108), number of lymph nodes retrieved(P = 0.307), time for anastomosis(P = 0.450), proximal resection margin(P = 0.210), distal resection margin(P = 0.202), postoperative complication(P = 0.506), total hospital cost(P = 0.286) and postoperative white blood cell(WBC)(P = 0.113).

Conclusions
In terms of security and technology, TRDG could serve as a better treatment method for GC.
Postoperative bleeding complications in breast conserving surgery and the role of antithrombotic medications: retrospective analysis of 4712 operations
Authors: Tamminen Anselm , Aaltonen Riitta I. , Ristola Marko T. 
Published: September 2024

Abstract
Background
This study aimed to evaluate the risk and timing of postoperative bleeding complications following breast-conserving surgery (BCS), with or without axillary surgery, especially in relation to perioperative management of antithrombotic medications.

Methods
Data from all patients who underwent BCS for breast cancer between 2010 and 2022 at a single university hospital were collected. Medical records were reviewed for reoperations, unplanned admissions, and patient characteristics.

Results
In total, 4712 breast-conserving surgeries and 3631 axillary surgeries were performed on 3838 patients. The risk of any bleeding complication was 1.1% (40/3571) in breast-conserving surgery, 0.3% (9/2847) in sentinel lymph node biopsy, and 0.5% (4/779) in axillary lymph node dissection. Upon arrival for treatment, 645 (17%) patients were taking antithrombotic medications. The risk of bleeding complications was not elevated in patients whose medication was discontinued at least a day before the surgery (OR 0.84, p = 0.76); but it was almost four-fold (OR 3.61, p = 0.026) in patients whose antithrombotic medication was continued. However, the absolute risk for bleeding complication was low in these patients as well (2.0%, 15/751). The majority of bleeding complications (85%, 47/55) occurred within 24 h after the surgery.

Conclusion
The risk for bleeding complications was elevated, but still low, after BCS with or without axillary surgery, when antithrombotic medications were continued through the surgical period. Discontinuing antithrombotic medications is not obligatory in these patients.
Cerebral physiologic insult burden in acute traumatic neural injury: a Canadian High Resolution-TBI (CAHR-TBI) descriptive analysis
Authors: Stein Kevin Y. , Gomez Alwyn , Griesdale Donald , Sekhon Mypinder , Bernard Francis , Gallagher Clare , Thelin Eric P. , Raj Rahul , Aries Marcel , Froese Logan , Kramer Andreas , Zeiler Frederick A. 
Published: September 2024

Abstract
Background
Over the recent decades, continuous multi-modal monitoring of cerebral physiology has gained increasing interest for its potential to help minimize secondary brain injury following moderate-to-severe acute traumatic neural injury (also termed traumatic brain injury; TBI). Despite this heightened interest, there has yet to be a comprehensive evaluation of the effects of derangements in multimodal cerebral physiology on global cerebral physiologic insult burden. In this study, we offer a multi-center descriptive analysis of the associations between deranged cerebral physiology and cerebral physiologic insult burden.

Methods
Using data from the Canadian High-Resolution TBI (CAHR-TBI) Research Collaborative, a total of 369 complete patient datasets were acquired for the purposes of this study. For various cerebral physiologic metrics, patients were trichotomized into low, intermediate, and high cohorts based on mean values. Jonckheere–Terpstra testing was then used to assess for directional relationships between these cerebral physiologic metrics and various measures of cerebral physiologic insult burden. Contour plots were then created to illustrate the impact of preserved vs impaired cerebrovascular reactivity on these relationships.

Results
It was found that elevated intracranial pressure (ICP) was associated with more time spent with cerebral perfusion pressure (CPP) < 60 mmHg and more time with impaired cerebrovascular reactivity. Low CPP was associated with more time spent with ICP > 20 or 22 mmHg and more time spent with impaired cerebrovascular reactivity. Elevated cerebrovascular reactivity indices were associated with more time spent with CPP < 60 mmHg as well as ICP > 20 or 22 mmHg. Low brain tissue oxygenation (PbtO2) only demonstrated a significant association with more time spent with CPP < 60 mmHg. Low regional oxygen saturation (rSO2) failed to produce a statistically significant association with any particular measure of cerebral physiologic insult burden.

Conclusions
Mean ICP, CPP and, cerebrovascular reactivity values demonstrate statistically significant associations with global cerebral physiologic insult burden; however, it is uncertain whether measures of oxygen delivery provide any significant insight into such insult burden.