bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster 396: Performing Sports Medicine Procedures in Ambulatory Surgery Centers Is More Cost Effective than Hospital Outpatient Departments for Medicare Recipients
Authors: Khan Zeeshan , McCormick Johnathon , Federico Vincent , Morgan Vince , Browning Robert , Harkin William , Salazar Luis , Jackson Garrett , Kaplan Daniel , Verma Nikhil , Cole Brian , Chahla Jorge 
Published: September 2024

Objectives: To compare the overall cost of sports medicine procedures for Medicare beneficiaries in both ambulatory surgery centers (ASC) and hospital outpatient department (HOPD) settings. Secondary aims were to compare facility fees, surgeon fees, Medicare payments, and patient payments between ASCs and HOPDs. Methods: Publicly available data from The Centers for Medicare & Medicaid Services (CMS) was accessed via the Medicare Procedure Price Lookup Tool. Current Procedural Terminology (CPT) codes were used to identify sports medicine procedures approved for the outpatient setting by CMS. Facility fees, surgeon fees, total costs, Medicare payment, and patient payment were extracted. Descriptive statistics were used to calculate means and standard deviations. Cost differences were analyzed using Mann Whitney U tests. Results: Sixty-two CPT codes were identified. Shoulder procedures (n=25) at ASCs had lower total costs (3,622±1,156 vs 6,262±1,759; p<0.001), facility fees (2,777±1,020 vs 5,416±1,606; p<0.001), Medicare payments (2,898±928 vs 5,009±1,407 p<0.001), and patient payments (724±232 vs 1,252±352; p<0.001) compared to HOPDs. Knee procedures (n=31) at ASCs had lower total costs (4,236±2,741 vs 6,668±3,341; p=0.006), facility fees (3,408±2,507 vs 5,840±3,116; p=0.006), Medicare payments (3,389±2,193 vs 5,458±2,955; p=0.006), and patient payments (847±548 vs 1,209±429; p=0.011). Hip procedures (n=6) at ASCs had lower total costs (3,583±698 vs 6,671±1,451; p=0.025), facility fees (2,725±6689 vs 5,813±1,431; p=0.025), Medicare payments (2,866±558 vs 5,336±1,161; p=0.025), and patient payments (716±139 vs 1,333±290; p=0.025). Conclusions: Sports medicine procedures performed at ASCs for Medicare recipients were found to have overall average total cost savings of 40% compared to those performed at HOPDs (42% savings for shoulder, 36% for knee, and 46% for hip procedures). ASC use conferred lower facility fees, patient payments, and Medicare payments in all cohorts. These results inform surgeons, patients, and insurance officials of the cost-effectiveness of outpatient surgical facilities for Medicare recipients undergoing sports medicine procedures.
Academic Ethical Awareness among Undergraduate Nursing Students of a Private University in Nigeria: A Cross-Sectional Descriptive Study
Authors: Dosumu Taiwo Omotayo , Olabisi Oluwaseyi Isaiah , Olatubi Mathew Idowu , Olayanju Grace , Okedele Deborah , Ndikom Chizoma Millicent 
Published: September 2024

Introduction Academic ethical awareness is a crucial prerequisite for practice, serving as the cornerstone for a professional demeanor in clinical settings and ensuring future adherence to nursing ethics. Objectives This study assessed academic ethical awareness as well as its related characteristics among undergraduate Nursing students of a private university in Nigeria. Methods A descriptive cross-sectional research design was utilized. The study was conducted among undergraduate nursing students of a private university in Nigeria. A convenience sample of 158 nursing students from 300 level to 500 level voluntarily participated in this study. Data were collected using the Academic Ethical Awareness Questionnaire and descriptive statistics, mean and standard deviation were employed to analysis the data collected. Results The mean age of nursing students was 21.1. Majority of the respondents were females, Christians and claimed average financial status with 87%, 94%, and 68%, respectively. Nursing students demonstrated moderate academic ethical awareness (69.5%), a mean score of 3.68 ± 0.81. They knew that revealing patient information in public places of the hospital, disregarding, slandering, or making fun of patients in face-to-face interaction, and having someone else attend class as a substitute were unethical behaviors with mean scores of 3.96, 3.90, 3.88, and 3.88, respectively. Academic ethical awareness was low for submitting cut and paste report, not paying attention in class and being late to class, with mean scores 1.81, 2.05, and 2.80, respectively. Gender, level of study, and satisfaction with Nursing as a course of choice are significant determinant of ethical academic awareness with P value of .018, .005, and .011, respectively. Conclusion Nursing students assessed demonstrated moderate academic ethical awareness. Improved instruction is required regarding the value of appropriate classroom behavior and emphasis on the implications of plagiarism in practice.
Defining Caring Efficacy for Nursing Students in South Korea: A Mixed-Method Analysis
Authors: Choi Hyun Ju 
Published: September 2024

Introduction Caring efficacy is a core nursing concept, but its application in nursing practice remains unclear. Objective This study analyzed the meaning and attributes of caring efficacy among nursing students, defined caring efficacy in this context, and identified the substantive constituents of the concept. Methods This hybrid study analyzed and compared data from a literature review and in-depth interviews with students in the clinical practice stage of a nursing program, according to the model suggested by Schwartz-Barcott and Kim. Results The results revealed five attributes of nursing caring efficacy and 17 indicators across two dimensions. Considering the attributes identified in theoretical work and fieldwork, this study defined nursing students’ care efficiency based on their “qualifications and personality for caring” as “self-confidence in caring capabilities,” rooted in their “growth through caring experience” and the conditions of their “educational environment for learning caring and social support.” Conclusion The findings could guide the development of nursing caring efficacy scales. Future studies should explore caring efficacy among professional and student nurses in various clinical fields.
Adaptive networks driven by partner choice can facilitate coordination among humans in the graph coloring game: Evidence from a network experiment
Authors: Chiang Yen-Sheng , Cho Heng-Chin , Chang Chia-Jung 
Published: September 2024

Background Many instances of coordination problems in social networks can be characterized by the well-known graph coloring game—a task in which agents are incentivized to choose an attribute, represented by a color, to be different from linked neighbors. Past work on this topic, however, is limited to static networks of specific topologies of interest. Purpose This study aims to explore whether dynamic networks, where players can choose their partners, perform better in the graph coloring game. Research Design We replicate the conventional graph coloring game experiment and introduce a new version where players can change their network neighbors. Study Sample and Data Collection We recruited over 300 human participants for the experiment, with each session involving an average of 20 participants per network. Results We found that dynamic networks that allow agents to switch network neighbors works more effectively and efficiently in solving coloring conflicts than static networks in which people are allowed to change color alone. The networks in the experiment updated by people’s selection of neighbors tend to evolve to a state similar in structure to the small-world network characterized by short path distance and high triadic clustering. Conclusion We argue that a self-organized approach demonstrated by our experiment can inspire search of behavioral strategies and network topologies for solving coordination problems in social networks.
A randomized phase II trial on the addition of dutasteride to combined androgen blockade therapy versus combined androgen blockade therapy alone in patients with advanced or metastatic salivary duct carcinoma – the DUCT study protocol
Authors: Weijers Jetty A. M. , Verhaegh Gerald W. , Lassche G. , van Engen-van Grunsven Adriana C. H. , Driessen Chantal M. L. , van Erp Nielka P. , Jonker Marianne A. , Schalken Jack A. , van Herpen Carla M. L. 
Published: September 2024

Abstract
Background
Salivary duct carcinoma (SDC) is a rare and aggressive subtype of salivary gland cancer, frequently associated with incurable recurrences and distant metastases (R/M). Proliferation of SDC relies on androgen receptor (AR) signalling, prompting the use of combined androgen blockade (CAB, i.e., luteinizing hormone-releasing hormone agonist and/or AR antagonists) to R/M SDC patients. However, only a subset of patients benefits from such treatments. We have shown that response to CAB is associated with steroid 5α-reductase 1 (SRD5A1) mRNA expression. SRD5A1 catalyses the intracellular conversion of testosterone into the more potent AR-agonist dihydrotestosterone. This conversion can be inhibited by dutasteride, a potent SRD5A1-inhibitor, which is currently prescribed for benign prostatic hyperplasia. We hypothesize that repurposing dutasteride to target AR signalling in SDC could enhance therapeutic response and clinical outcome in SDC patients.

Methods
This prospective, open-label, randomized controlled phase II clinical trial, is designed to investigate whether dutasteride as an adjunct drug to CAB improves response rate and clinical outcome in patients with AR-positive R/M SDC. Patients are divided in two cohorts based on their prior systemic treatments. In cohort A, CAB-naïve patients (n = 74) will be randomly assigned to either a control arm (Arm 1) receiving CAB (goserelin 10.8 mg/3m and bicalutamide 50 mg/OD) or an experimental arm (Arm 2) where dutasteride (0.5 mg/OD) is added to the CAB regimen. In cohort B, patients with disease progression after adjuvant or first-line palliative CAB therapy (max. n = 24) will receive goserelin, bicalutamide, and dutasteride to assess whether the addition of dutasteride can overcome therapy resistance. The primary endpoints are the objective response rate and duration of response. Secondary endpoints are progression-free survival, overall survival, clinical benefit rate, quality of life, and safety. Translational research will be performed to explore molecular target expression differences and their correlation with clinical outcome.

Discussion
The DUCT study addresses an unmet medical need by investigating the repurposing of dutasteride to enhance treatment response and improve clinical outcome for patients with R/M SDC, especially those with limited alternative treatment options, such as HER2-negative cases. By repurposing a registered low-cost drug, this trial’s findings could be readily applied into clinical practice.

Trial registration
Clinicaltrials.gov Identifier: NCT05513365. Date of registration: August 24, 2022.

Protocol version
Current protocol version 4.0, February 21, 2024.
Type 2-like polarization and elevated CXCL4 secretion of monocyte derived macrophages upon internalization of plasma-derived exosomes from head and neck cancer patients
Authors: Theodoraki Marie-Nicole , Huber Diana , Hofmann Linda , Werner Lotte , Idel Christian , Fleckner Jonas , Plötze-Martin Kirstin , Schütt Lutz , Brunner Cornelia , Depping Reinhard , Hoffmann Thomas K. , Bruchhage Karl-Ludwig , Pries Ralph 
Published: September 2024

Abstract
Background
Exosomes are closely associated with different aspects of tumor-progression in patients with head and neck squamous cell carcinoma (HNSCC), such as angiogenesis or immune regulation. As extracellular vesicles they are involved in the intercellular communication by transferring their cargo such as proteins and nucleic acids from one cell to another. However, the influence of tumor related plasma-derived exosomes on the polarization and characteristics of monocyte derived macrophages is not fully understood.

Methods
Exosomes were isolated from plasma samples of healthy donors (HD) and HNSCC patients and further evaluated with regard to morphology, size and protein composition via transmission electron microscopy, nanoparticle tracking, western blot analysis and cytokine assays. Differentiation and characteristics of monocyte derived macrophages upon exosome internalization were analyzed using flow cytometry and fluorescence microscopy. Macrophage cytokine secretion patterns were analyzed by human cytokine antibody arrays and ELISA measurements.

Results
Our data revealed elevated overall plasma levels of CTLA-4, PD-L1, and TIM-3 as well as elevated exosome-associated CTLA-4, PD-L2, TIM-3, and LAG-3 levels in HNSCC patients compared to HD. Furthermore, we observed a significant type 2-like polarization and elevated CXCL4 secretion of monocyte derived macrophages upon internalization of plasma-derived exosomes from HNSCC patients, which could be visualized by fluorescence microcopy of membrane stained exosomes.

Conclusions
The study provides new insights regarding exosome driven pro-tumorigenic immune regulation in the circulation of patients with head and neck cancer and could help to better understand the individual immunologic situation.
Educational differences in years lived with disability due to mental and substance use disorders: a cohort study using nationwide Norwegian and Danish registries
Authors: Weye Nanna Oerslev , Plana-Ripoll Oleguer , Baravelli Carl Michael , Agardh Emilie E. , van der Velde Lode , Kinge Jonas Minet , Knudsen Ann Kristin Skrindo 
Published: September 2024

Abstract
Background
Findings from the Global Burden of Disease (GBD) study have shown that the burden of mental and substance use disorders is considerable, and unevenly distributed across demographic groups in the population. However, there is a lack of knowledge on how this burden differs by socioeconomic position. The aim of this study was to examine educational differences in years lived with disability (YLDs) from mental and substance use disorders among males and females in two high-income countries, taking comorbidity with other diseases into account.

Methods
The study included all registered residents in Denmark and Norway from 2011 to 2021. Diagnostic information was retrieved from records in the Norwegian National Patient Registry (NPR) and the Danish Psychiatric Central Research Register (PCRR) and used as proxy measures for disorder prevalence. Demographical and educational information was taken from administrative registries. The YLD is a measure of the non-fatal health loss in the population and was calculated by multiplying the duration of a disorder with a disability weight (DW), scaled between 0 and 1. Information on remission and DWs were retrieved from the GBD study and other sources, and disorder specific DWs were averaged by severity levels and adjusted for comorbidity.

Results
Educational gradients in YLD rates were found for mental and substance disorders overall, and for most of the specific disorders. The educational gradient was more pronounced for schizophrenia, intellectual disability and substance use disorders than for eating, anxiety, and affective disorders. Both higher YLD rates, and a larger attributed proportion of the total YLDs, were found for schizophrenia, intellectual disability, and substance use disorders in the groups with low versus high education. YLD rates for eating, anxiety, and affective disorders were more equal across educational levels, but constituted a smaller proportion of the total YLDs among the groups with low versus the groups with high educational level.

Conclusion
Most of the disease burden related to mental and substance use disorders falls on those with the fewest years of education. This should be taken into consideration when public health targets aimed at improving mental health and reducing social inequalities in health are developed and implemented.
Clinical application of flexible fiberoptic bronchoscopy in neonatal respiratory diseases
Authors: Zhuang Xuee , Liu Zhiyong , Zheng Jingyang , Xu Jinglin , Chen Dongmei 
Published: September 2024

Abstract
Background
Respiratory disease is a predominantly observed problem in neonates. Moreover, the application of flexible bronchoscopy in newborns is gradually increasing. This study aimed to investigate the value of bronchoscopy in neonates respiratory abnormalities and evaluate the safety of bronchoscopy application.

Methods
Clinical data and outcomes of 56 neonates who underwent flexible bronchoscopy were retrospectively analyzed. Correlations among indications for bronchoscopy, findings, and clinical diseases were assessed.

Results
A total of 56 neonates had a minimum weight of 1200 g at the time of bronchoscopy, while the minimum gestational age at birth was 26 + 1 weeks. A total of 22 cases (39.3%) had two or more clinical indications; the five most common indications were respiratory distress in 24 (42.9%), stridor in 22 (39.3%), pulmonary atelectasis in 10 (17.6%), feeding difficulty in 10 (17.6%), and difficult weaning from mechanical ventilation in 6 (10.7%) cases. A total of 13 types of abnormalities were detected in the respiratory tract. The most common abnormalities were laryngomalacia in 29 (59.2%), tracheobroncomalacia in 8 (16.3%), and vocal cord paralysis in 6 (12.2%) cases. Bronchoalveolar lavage was performed in 39 cases. Eight cases were diagnosed by bronchoscopy and then treated with surgery in the Thoracic Surgery/Otolaryngology Department; all of them were cured and discharged from the hospital after surgery. No serious complications, such as pneumothorax or shock, occurred in any of the children, of whom none died.

Conclusions
Flexible bronchoscopy could play an important role in diagnosing and identifying respiratory disorders in neonates and be safely used with few serious complications.
Chronic stress and functional health in older adults with concerns about falling: a study protocol of a randomized controlled trial with multicomponent exercise intervention (FEARFALL)
Authors: Britting Sabine , Kob Robert , Görlitz Anja , Sieber Cornel C. , Freiberger Ellen , Rohleder Nicolas 
Published: September 2024

Abstract
Background
Maintenance of physical function, mobility, and independent living are important goals for older adults. However, concerns about falling (CaF) play a central role in the vicious cycle of CaF, inflammation, loss of muscle mass, and decreasing physical function ultimately resulting in negative health outcomes. CaF, like other states of chronic stress and anxiety, can be considered as enduring adverse stimuli affecting the stress systems and the inflammatory system. Therefore, the aim of this study is to investigate whether a reduction of CaF leads to a reduction of stress and therefore possibly reduces chronic low-grade inflammation. Understanding the role and directionality of the effects of inflammation on CaF increases our understanding of age-related loss of mobility and physical function.

Methods
In this study, community-dwelling older adults, aged 70 years and older, will be randomly assigned to either a 4-month, multi-component intervention with exercise training and cognitive-behavioral components or to a sham control group with light stretching exercises, cognitive training, and educational health lectures. For the operationalization of specific CaF, the Falls Efficacy Scale—International will be used. Stress and related psychological symptoms will be monitored using established self-reports and by measuring salivary cortisol. Concentrations of C-reactive protein, interleukin 6, interleukin 10, and tumor-necrosis-factor-alpha, as well as gene expression of selected inflammatory transcripts, will be used as surrogate parameters of the inflammatory status at baseline, after the 4-month intervention and 8-month follow-up.

Discussion
This study will be the first to test whether CaF are related with stress system activity or reactivity or with markers of inflammation in the context of a multi-component intervention with exercise training and cognitive-behavioral components addressing CaF. The reduction of specific CaF or general psychological symptoms should reverse alterations in stress systems, and / or slow down low-grade inflammation. Changes in activity, as well as psychological and biological pathways leading from CaF to muscle loss will be measured, to disentangle the individual contribution to sarcopenia, and to provide an additional pathway to break or slow-down the vicious cycle of CaF and sarcopenia.

Trial registration
German Clinical Trials Register (DRKS): DRKS00029171. Registered 22 July 2022.
Sustainable and technically smart spectrophotometric determination of PAXLOVID: a comprehensive ecological and analytical performance rating
Authors: Aboras Sara I. , Maher Hadir M. , Alzoman Nourah Z. , Elbordiny Haydi S. 
Published: September 2024

AbstractThe Food and Drug Administration (FDA) authorized the administration of ritonavir (RIT)-boosted nirmatrelvir (NMV) on May 25, 2023, for the treatment of mild to moderate COVID-19 in patients who are at high risk of developing severe COVID-19. In accordance with sustainability and environmental friendliness, simple, eco-friendly, and sustainable spectrophotometric methods were established for concurrently estimating RIT and NMV in newly launched copackaged pills. The suggested solutions for resolving the spectral overlap between RIT and NMV involve the following mathematical methods: the first derivative method (1D), second derivative method (2D), and dual-wavelength zero-order method (DWZ). When ethanol was used as a green dilution solvent, the linearity range was adjusted (10–250 µg/mL) for both drugs. The procedures resulted in a high correlation coefficient (not less than 0.9996) and satisfactory levels of detection and quantification. Additionally, method validation was performed in accordance with International Council for Harmonization norms. Moreover, a detailed ecological and sustainability evaluation protocol was established to confirm the greenness and whiteness of the methods. Finally, the proposed method, along with previously reported methods for analysing NMV and RIT, were reviewed analytically and ecologically.
Leucinostatins from fungal extracts block malaria transmission to mosquitoes
Authors: Niu Guodong , Wang Xiaohong , Gao Wenda , Cui Liwang , Li Jun 
Published: September 2024

Abstract
Background
Malaria is a mosquito-transmitted disease that kills more than half a million people annually. The lack of effective malaria vaccines and recently increasing malaria cases urge innovative approaches to prevent malaria. Previously, we reported that the extract from the soil-dwelling fungus Purpureocillium lilacinum, a common fungus from the soil, reduced Plasmodium falciparum oocysts in Anopheles gambiae midguts after mosquitoes contacted the treated surface before feeding.

Methods
We used liquid chromatography to fraction fungal crude extract and tract the active fraction using a contact-wise approach and standard membrane feeding assays. The purified small molecules were analyzed using precise mass spectrometry and tandem mass spectrometry.

Results
We isolated four active small molecules from P. lilacinum and determined them as leucinostatin A, B, A2, and B2. Pre-exposure of mosquitoes via contact with very low-concentration leucinostatin A significantly reduced the number of oocysts. The half-maximal response or inhibition concentration (EC50) via pre-exposure was 0.7 mg/m2, similar to atovaquone but lower than other known antimalarials. The inhibitory effect of leucinostatin A against P. falciparum during intraerythrocytic development, gametogenesis, sporogonic development, and ookinete formation, with the exception of oocyst development, suggests that leucinostatins play a part during parasite invasion of new cells.

Conclusions
Leucinostatins, secondary metabolites from P. lilacinum disrupt malaria development, particular transmission to mosquitoes by contact. The contact-wise malaria control as a nonconventional approach is highly needed in malaria-endemic areas.

Graphical Abstract