bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and influencing factors of suicidal ideation among doctors and nurses during the surge period of the COVID-19 pandemic in China: a multicenter cross-sectional study
Authors: Jing Shu , Dai Zhenwei , Liu Xiaoyang , Liu Xin , Zhang Ling , Wu Yijin , Ren Tianrui , Fu Jiaqi , Chen Xu , Wang Wenjun , Gu Xiaofen , Ma Li , Zhang Shaokai , Yu Yanqin , Li Li , Su Xiaoyou , Qiao Youlin 
Published: October 2024

Abstract

Background
From November 2022 to February 2023, China has experienced a surge period of COVID-19 pandemic and doctors and nurses working in hospitals have suffered from serious psychological crisis because of the medical crowding, which may result in the occurrence of suicidal ideation (SI). This study aims to explore the prevalence and influencing factors of SI during this surge phase.

Methods
A multicenter cross-sectional study was conducted in China from 5 January 2023 to 9 February 2023. Data were collected by online questionnaires, with SI measured by a single item. Ordinal logistic regression analysis and stratified analyses were preformed to identify influencing factors.

Results
A total of 5696 doctors and nurses were retained for further analysis, with 25.28% reporting SI during the COVID-19 surge phase. Participants experiencing anxiety symptoms or supporting other departments treating COVID-19 patients were more likely to report SI. Additionally, higher levels of resilience, mindfulness, and perceived social support were protective factors against SI.

Conclusion
During the COVID-19 surge phase, over a quarter of doctors and nurses in China suffered from SI, which should be of great concern. Tailored interventions should be implemented to alleviate SI among doctors and nurses when new infectious diseases outbreak in the future.
Support needs of gout patients and suitability of eHealth to address these needs
Authors: van der Ven Jeffrey , van den Bemt Bart J F , Ariaans Floor , Vriezekolk Johanna E , Flendrie Marcel , Verhoef Lise M 
Published: October 2024

Abstract

Objectives
To investigate the support needs of patients with gout regarding information, communication, treatment and disease monitoring, and patients’ views on and preferences for eHealth applications to address these needs.

Methods
A focus group study using purposive sampling was conducted. Three focus group sessions with a duration of 2 h per group were held with in total of 23 patients using urate-lowering therapy, recruited from primary and secondary care. Audio recordings were transcribed, and data were analysed using thematic analysis.

Results
Eight themes were identified. Five themes addressed support needs of gout patients and suitability of eHealth in addressing those needs: (1) Timely access to healthcare, especially during flares; (2) (personalized) information regarding diagnosis, medication, and diet; (3) insight into uric acid levels and medication side effects through blood monitoring; (4) better coordination across primary and secondary care; and (5) self-management and shared responsibility over care for maintaining health. Three themes addressed eHealth in general: (1) receptive towards eHealth in gout care; (2) the preference for eHealth to have a complementary role (i.e. not replacing face-to-face) contact with healthcare providers; and (3) preferences on eHealth use and functionalities.

Conclusion
Patients expressed various needs regarding their disease management and projected a supporting role for eHealth in (self)management of gout. Addressing the needs and preferences of patients could enhance their understanding of the disease and treatment, self-management, and possibly health outcomes.
Non-invasive fast assessment of hepatic injury through computed tomography imaging with renal-clearable Bi-DTPA dimeglumine
Authors: Ma Li , Pan Jinbin , Shu Gang , Pan Haiyan , Li Jingang , Li Dong , Sun Shaokai 
Published: October 2024

Abstract
Enhanced computed tomography (CT) imaging with iodinated imaging probes is widely utilized for the diagnosis and evaluation of various liver diseases. However, these iodine-based imaging probes face intractable limitations including allergic reactions and contraindications. Herein, we propose the utilization of renal-clearable iodine-free bismuth chelate (Bi-DTPA dimeglumine) for the non-invasive fast assessment of hepatic ischemia–reperfusion injury (HIRI) via CT imaging for the first time. Bi-DTPA dimeglumine offers several advantages such as simple synthesis, no purification requirement, a yield approaching 100%, large-scale production capability (laboratory synthesis &gt; 100 g), excellent biocompatibility and superior CT imaging performance. In a normal rat model, the administration of Bi-DTPA dimeglumine resulted in a significant 63.79% increase in liver CT value within a very short time period (30 s). Furthermore, in a HIRI rat model, Bi-DTPA dimeglumine enabled the rapid differentiation between healthy and injured areas based on the notable disparity in liver CT values as early as 15 min post-reperfusion, which showed a strong correlation with the histopathological analysis results. Additionally, Bi-DTPA dimeglumine can be almost eliminated from the body via the kidneys within 24 h. As an inherently advantageous alternative to iodinated imaging probes, Bi-DTPA dimeglumine exhibits promising prospects for application in liver disease diagnosis.
CD44: a stemness driver, regulator, and marker—all in one?
Authors: Sonnentag Steffen J , Ibrahim Nagwa S M , Orian-Rousseau Veronique 
Published: October 2024

Abstract
Although the concept of cancer stem cells is still controversial, previous studies have shown that blood cancers, as well as specific types of solid cancers such as colorectal cancer, rely on stem cells during the onset of tumor growth and further tumor development. Moreover, resistance to therapeutic treatment in leukemias such as acute myeloid leukemia and in colorectal cancer can be attributed to a small population of cells with stemness properties known as minimal residual disease. In this review, we look back on the discovery of cancer stem cells and the contribution of the findings in blood cancer to a parallel discovery in solid cancers. We focus on CD44 as a stem cell marker, both in blood cancers and in several types of solid cancers, particularly of the gastrointestinal tract. This review highlights newly discovered molecular mechanisms of action of CD44 which indicate that CD44 has indeed a function in stemness, stem cell maintenance, and drug resistance. We attempt here to make the link between the functions of CD44 isoforms in stemness and their involvement in specific steps of tumor growth and metastasis.
Erectile dysfunction as a holistic indicator of well-being: a narrative review
Authors: Saffati Gal , Seyan Zheyar , Rendon Daniela Orozco , Almuhaideb Mana , Hinojosa-Gonzalez David E , Kronstedt Shane , Khera Mohit 
Published: October 2024

Abstract

Introduction
Erectile dysfunction (ED), affecting around 52% of men aged 40–70, is a significant marker of overall health and a potential warning sign of multiple conditions like cardiovascular diseases (CVDs), diabetes, and mental health disorders. Recognizing and addressing ED through a holistic approach involving nutrition, physical activity, sleep, and stress management can improve both erectile and overall health outcomes.

Aims
To provide a narrative review of the available literature on the relationship between ED and overall health, elaborate on the possible mechanisms explaining this association, and discuss the effects of lifestyle on ED.

Methods
A search of the medical literature was carried out in PubMed and Medline, focusing on original research and systematic reviews of original research on ED and overall health.

Results
Due to shared pathophysiological mechanisms like endothelial dysfunction, ED is a significant indicator of overall health, particularly related to CVD and diabetes mellitus. Multiple studies have shown that ED frequently precedes cardiovascular events and is associated with increased cardiovascular risk, especially in younger men and those with diabetes. It also has a profound, bidirectional relationship with mental health conditions like depression and anxiety, creating a vicious cycle where each exacerbates the other. The four health pillars of nutrition, physical activity, sleep, and stress management play significant roles in erectile function and overall sexual health.

Conclusion
ED is not just a condition affecting sexual function but a critical indicator of broader health issues. By adopting an integrative approach that combines nutrition, physical activity, sleep, and stress management, healthcare providers can offer holistic and effective management strategies for this condition.
Binary and Nonbinary Transgender Patient Experiences Accessing Gender-affirming Top Surgery
Authors: Raner Gavin A. , Shapiro Jordan S. , Tse Tiffany , Armstrong Kathleen , Potter Emery 
Published: October 2024

Background:
Transgender and gender diverse (TGD) individuals face barriers when seeking top surgery, or bilateral mastectomies, as part of surgical transition, leading to delayed care and adverse health outcomes. Understanding differential experiences between nonbinary and binary patients is crucial for improving TGD patient care, but this distinction is seldom made in the current literature.

Methods:
This single-center cross-sectional mixed-methods survey study conducted between 2022 and 2023 enrolled all consecutive TGD patients undergoing top surgery. Significant differences between datasets were determined by two-sample unpaired t tests. Summative content analysis and descriptive analysis were performed for free-text responses.

Results:
Thirty-seven binary and 71 nonbinary patients completed the survey. Lack of funding, long wait times within the healthcare system, and long wait times to access surgery were the three most impactful barriers for both cohorts. Nonbinary patients were more impacted by a lack of TGD-friendly surgeons and community physicians, prejudice from surgical center staff and community doctors, and employment concerns. More binary patients desired a “masculine chest” and to stop using a binder. The nonbinary group more frequently desired a “smaller chest” and had greater variability of surgical goals.

Conclusions:
Binary and nonbinary TGD patients both experience barriers to top surgery; however nonbinary patients may experience distinct barriers and have differential surgical goals. It is important to discuss specific surgery goals and offer top surgery options beyond bilateral mastectomy with nipple grafting, especially with nonbinary patients.
Circulating T-lymphocyte subsets as promising biomarkers for the identification of sepsis-induced acute kidney injury
Authors: Guo Xue-Ling , Lu Cheng-Xiang , Luo Yan , Wang Ping-Ping , Su Wen-Song , Yang Si-Jiu , Zhan Ling-Hui 
Published: October 2024

Background:
This retrospective study investigated whether disturbances in circulating T-lymphocyte subsets could predict the incidence of acute kidney injury (AKI) and in-hospital mortality in patients with sepsis.

Methods:
Clinical data from patients with sepsis admitted to the intensive care unit were reviewed. Logistic regression analyses were used to identify independent predictors of in-hospital mortality and the development of AKI.

Results:
Of 81 patients with sepsis, 50 developed AKI. Both nonsurvivors and patients with septic AKI exhibited higher Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores. Nonsurvivors exhibited more organ damage, with significantly lower levels of peripheral T-lymphocyte subsets, including total circulating lymphocytes, and CD3+, CD3+CD4+, and CD3+CD8+ T-lymphocytes. Patients with septic AKI exhibited fewer total peripheral lymphocytes and fewer CD3+, CD3+CD4+, and CD3+CD8+ T-lymphocytes, with higher serum lactate levels and lower nadir platelet counts. Independent predictors of 30-day hospital mortality included maximum SOFA and APACHE II scores, occurrence of encephalopathy, and peripheral CD3+ and CD3+CD8+ T-lymphocyte counts. Moreover, the maximum SOFA score and CD3+ and CD3+CD8+ T-lymphocyte counts demonstrated good predictive power for AKI in receiver operating characteristic (ROC) curve analyses, with an area under the ROC curve of 0.810 (95% confidence interval [CI], 0.712-0.908) for SOFA score, 0.849 (95% CI, 0.764-0.934) for CD3+ T-lymphocytes, and 0.856 (95% CI, 0.772-0.941) for CD3+CD8+ T-lymphocytes.

Conclusion:
Patients with sepsis-induced AKI experienced T lymphopenia and increased in-hospital mortality. Higher maximum SOFA scores and reduced peripheral CD3+ and CD3+CD8+ T-lymphocyte levels were associated with in-hospital mortality and the development of AKI in patients with sepsis.
Topical Steroids Are Effective and Safe in Patients With Eosinophilic Esophagitis Over a Median of 6.5 Years of Chronic Use
Authors: McCallen Justin D. , Dave Mili , LaFata Sean S. , Cameron Brenderia A. , Xue Angela Z. , Kiran Akshatha , Ocampo Adolfo A. , Lee Christopher J. , Borinsky Stephanie A. , Redd Walker D. , Cotton Cary C. , Eluri Swathi , Reed Craig C. , Dellon Evan S. 
Published: October 2024

Goals:To determine long-term efficacy and safety of tCS for treatment of EoE.Background:Maintenance therapy with topical corticosteroids (tCS) is recommended for eosinophilic esophagitis (EoE), but data for long-term use are still needed.Study:This retrospective cohort study assessed newly diagnosed patients with EoE who were treated with a tCS and had a follow-up endoscopy with biopsy after at least 5 years. Histologic symptomatic and endoscopic responses were extracted from medical records. Patients who did and did not have long-term tCS treatment were compared at baseline, and outcomes for patients were assessed at their last endoscopy while on tCS.Results:Of 431 patients with EoE treated with tCS, 104 met inclusion criteria for long-term use. For patients with long-term tCS use, the median time (IQR) on tCS was 6.5 years (5.4 to 8.8 y). At the last endoscopy, 54% had histologic response (<15 eos/hpf), but those with excellent adherence had a histologic response of 64%. Endoscopic severity also decreased with improved adherence which was strongly associated with EREFS (1.7 vs. 2.8 vs. 4.0 for excellent, good, and poor adherence;P<0.001). Symptomatic response was 68% overall, but only 40% in those with poor adherence (P=0.07). Complications of taking tCS were uncommon (adrenal insufficiency: 1%; osteopenia: 1%; and esophageal candidiasis: 4% at final endoscopy).Conclusions:Long-term tCS (median 6.5 y) were generally effective, especially with better adherence, and also safe, with only rare serious complications. These data can be used to help patients make clinical decisions about chronic tCS use in EoE.
Low false-positive lymph nodes for 18F-fibroblast activation protein inhibitors PET/computed tomography in preoperative staging of patients with nonsmall cell lung cancer
Authors: Mu Xingyu , Lu Ludeng , Li Jingze , Zhang Lei , Deng Yanyun , Fu Wei 
Published: October 2024

Objective
This study aimed to evaluate the diagnostic accuracy of 18F-fibroblast activation protein inhibitor (FAPI) PET/computed tomography (CT) in identifying primary tumors and mediastinal lymph node metastases in nonsmall cell lung cancer (NSCLC), with histopathological findings serving as the reference standard.

Methods
Nineteen patients underwent preoperative 18F-FAPI PET/CT and subsequent surgery; of these, 13 also underwent 18F-fluorodeoxyglucose (FDG) PET/CT within 1 week. The diagnostic accuracy of primary tumors and lymph node metastases was evaluated for both modalities. Semiquantitative parameters, including maximum standardized uptake values (SUVmax) and target-to-background ratios (TBRs), for both primary tumors and lymph node metastases were assessed for both modalities.

Results
For primary tumors, 18 of 19 (94.7%) showed positive results on 18F-FAPI PET/CT scans. In 13 patients who also underwent 18F-FDG PET/CT, 18F-FAPI PET/CT demonstrated a higher detection rate compared with 18F-FDG PET/CT (100% vs. 69.1%). The overall accuracy of lymph node assessment with 18F-FAPI PET/CT (95.9–97.1%) was significantly higher compared to 18F-FDG PET/CT (51.0%). Malignant lymph nodes exhibited significantly higher SUVmax and TBR on 18F-FAPI scans (SUVmax: 7.0 vs. 0.9, P < 0.001; TBRmuscle: 5.0 vs. 0.8, P < 0.001) than on 18F-FDG scans (SUVmax: 3.9 vs. 1.8, P = 0.01), except for the liver TBR on 18F-FDG scans (TBRliver: 1.8 vs. 1.0, P = 0.055).

Conclusion

18F-FAPI could be utilized in the preoperative staging of NSCLC to mitigate the incidence of false positives associated with 18F-FDG, due to its higher accuracy in identifying mediastinal lymph node metastasis.
Hearing preservation in pediatric cochlear implantation
Authors: Marinelli John P. , Carlson Matthew L. 
Published: October 2024

Purpose of review
Pediatric cochlear implantation has evolved considerably over the past three decades to include more patients at earlier ages with greater degrees of residual hearing. As an extension, a significant focus of research over the past decade has surrounded preservation of existing acoustic hearing.

Recent findings
Multiple studies published within the last 5 years demonstrate aidable acoustic hearing preservation in 60–90% of pediatric patients, with 40–60% experiencing complete hearing preservation following cochlear implantation. Durability of preserved hearing varies among patients, with some patients losing residual hearing within 1 year of surgery whereas others maintain acoustic hearing through at least 5 years of follow-up. Speech outcomes appear superior among patients with preserved acoustic hearing, particularly in the presence of background noise. Several recent studies suggest a music appreciation advantage in children with preserved acoustic hearing following cochlear implantation.

Summary
Hearing preservation rates during cochlear implantation in children matches, if not often exceeds, hearing preservation rates observed among adults. Preservation of acoustic hearing during cochlear implantation confers multiple advantages for the pediatric population. Beyond improved speech understanding and music appreciation, minimizing intracochlear trauma and resultant scarring facilitates potential future regenerative treatments or revision surgery.
Acute renal failure requiring renal replacement therapy secondary to rhabdomyolysis due to rosuvastatin
Authors: Yadav Kundan K. , Shah Bikash K. , Yadav Srijana K. , Sherpali Aakash , Pourkamali Yesamin , Kantha Adesh , Timilsaina Manoj K. 
Published: October 2024

Introduction and importance:
Statins are the group of medicines that lower the level of low-density lipoprotein cholesterol. One of the life-threatening complications is rhabdomyolysis as the use of these drugs.

Case presentation:
Here, we report a case of a 69-year-old female who was diagnosed with non-ST elevation myocardial infarction one month and was on regular medication before presentation with generalized weakness and decreased urine output. Proximal muscle weakness was greater than distal muscle on the bilateral lower limb, and power at the hip, knee, and ankle was 3/5 in the bilateral area, with absent reflex at the knee and ankle bilateral area.

Clinical discussion:
A total of four hemodialysis sessions were performed; the first three sessions were performed at an interval of 24 h, then the last maintenance hemodialysis after 48 h of three sessions. The patient’s weakness in the bilateral lower limb returns to normal condition.

Conclusion:
Physicians need to be aware of the potential of developing severe rhabdomyolysis in patients taking rosuvastatin to prevent morbidity, extended hospital stay, and financial loss.
Evaluation of a Drug Checking Training Program for Frontline Harm Reduction Workers and Implications for Practice
Authors: Teal Taylor , Wallace Bruce , Hore Dennis 
Published: October 2024

Context
Drug checking, defined as the use of instruments (e.g. spectrometers), test strips, and other technologies to provide information on drug composition for harm reduction purposes, has emerged as a promising intervention to reduce harms of illicit drugs linked to overdose deaths. While demonstrating potential, these interventions remain limited in reach amid questions of how to reach the full population of people who use drugs and are at risk of overdose, including those outside urban areas. In response to these limitations, Substance, a drug checking project based in Victoria, Canada, developed a Distributed Model of Drug Checking and a concomitant training program.

Program
The Distributed Drug Checking Training program eliminates need for point-of-care spectrometry technicians, instead capacitating harm reduction workers to provide drug checking using software developed by the project, infrared spectrometers, and immunoassay test strips. The training includes 5 hours of group content that can be delivered virtually, and 2 hours of practice time per learner.

Implementation
Training and data collection took place between May 2022 and March 2024 with learners from 6 locations across Vancouver Island, Canada. We offered 13 training sessions, with evaluation data collected from 54 learners.

Evaluation
The training was evaluated across Kirkpatrick’s 4 levels of training evaluation. The training was highly acceptable to learners, attributable to intended changes in knowledge and skill related to drug checking, resulted in competence to deliver drug checking through the project’s Distributed Model, and facilitated expansion of drug checking services to 6 geographically distant locations.

Discussion
After completing the 7-hour training program, harm reduction workers were able to deliver drug checking without need for on-site drug checking technicians. The short duration of the training and its demonstrated success with the Distributed Model of Drug Checking make this a promising approach for expanding the reach of drug checking services.