bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning Outcomes of Nursing Students’ Experience With Cadaveric Dissection: A Scoping Review
Authors: Horiuchi-Hirose Miwa , Fukuoka Tomoko , Saito Shinji 
Published: August 2024

Introduction Cadaver dissection in anatomy, a cornerstone of medical school education, has been replaced by digital technologies. This study aimed to determine the learning outcomes nursing students could achieve through cadaveric dissection practice (CDP). Methods This scoping review was carried out using the checklist outlined in the Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews through August 2023. Articles from PubMed, ERIC, and CINAL were included. This scoping review included studies that focused on the learning effects of nursing students’ experiences with cadaver dissection, written in English, and covered all study types. Results The cadaveric dissection exercise resulted in a strong interest in the human body and a thorough understanding of anatomy and physiology. It also allows for creating an image of care for the patient before death, the meaning of existence after death, acceptance that death is not frightening, and an understanding of the afterlife. Furthermore, the cadaveric dissection exercise has been reported to improve confidence in patient care, lead to a better understanding of what other professions practice, and involve the development of professional identity. Conclusions Studies on the learning effects of CDP have differed in subject matter and educational methodologies. In the future, while determining how the experience of CDP is related to nursing practice of nursing students and graduates, we must explore effective CDP and develop educational methodologies that can achieve similar learning effects.
Awareness, knowledge, and practice towards medication overuse headache in Thailand: A university hospital-based survey in residency training programs
Authors: Anukoolwittaya Prakit , Pongpitakmetha Thanakit , Hiransuthikul Akarin , Thanprasertsuk Sekh , Rattanawong Wanakorn 
Published: August 2024

Background Medication overuse headache (MOH) presents a considerable challenge in patient care, with physicians playing a critical role in its prevention and management. However, awareness, knowledge, and practices regarding MOH among physicians are often found to be inadequate. Methods A cross-sectional study was conducted at King Chulalongkorn Memorial Hospital to investigate the awareness, knowledge, and practices concerning MOH among residents from family medicine, internal medicine, and neurology specialties. Participants were surveyed using an internet-based questionnaire. Results Of the 130 residents, 70 participated in the study. Ten percent were unaware that analgesics could exacerbate headaches, a finding particularly notable among family medicine residents. Furthermore, 11.4% of participants were uncertain about the classification of MOH, while 31.4% and 44.3% were uncertain about the frequency with which the use of simple analgesics and migraine-specific drugs could lead to MOH, respectively. This uncertainty was prevalent among residents in internal medicine and family medicine. Additionally, 22.9% of participants, especially those in internal medicine, prescribed opioids for abortive treatment in migraine patients. Residents in neurology generally performed better across various aspects compared to those in other specialties. Conclusion The study highlights a significant gap in the awareness, knowledge, and practices regarding MOH, particularly in non-neurology residency programs. Addressing these issues may require continuous medical education utilizing a multifaceted approach, encompassing undergraduate courses, postgraduate training, and public outreach.
Training and Assessment of Clinician’s Utilization of the Los Angeles Classification for Reflux Esophagitis
Authors: Dadgar Kayla , Wang Dennis , Yuan Yuhong , Sinclair Paul , Sharma Prateek , Armstrong David 
Published: August 2024

Background: Endoscopic recognition of reflux esophagitis is critical for the evaluation and treatment of patients with gastroesophageal reflux disease; however, there are limited data on the need for education to minimize interobserver disagreement in clinical practice. Methods: We created an educational program for the LA classification on the International Working Group for the Classification of Oesophagitis (IWGCO) website that included endoscopic video recordings of the distal esophagus. Participants completed an entry survey before the training module and were able to proceed to subsequent training videos once they provided the correct LA classification. Participants then completed a test module—an 80% score was required to pass. Descriptive analyses and regression analyses were performed to analyze data. Results: In the entry survey, 83/90 (92%) participants reported using the LA classification for the majority or all patients with reflux symptoms. However, only 31/90 (34%) participants reported feeling very or completely confident in the use of the LA classification. Only 3/71 (4.2%) participants correctly classified all 9 training videos on their first attempt. The testing module was completed by 60 participants, 16 (26.7%) of whom passed after one attempt, with 32 (53.3%), 8 (13.3%), and 1 (1.7%) passing after 2, 3, and 4 attempts, respectively. There was no significant correlation between the number of attempts to successfully pass the testing module and participant characteristics. Conclusion: Even after a training module, >75% of participants required more than one attempt to correctly classify the test videos. Further structured education around the LA classification is needed.
Spatial transcriptomics reveals profound subclonal heterogeneity and T-cell dysfunction in extramedullary myeloma
Authors: John Mara , Helal Moutaz , Duell Johannes , Mattavelli Greta , Stanojkovska Emilia , Afrin Nazia , Leipold Alexander M. , Steinhardt Maximilian J. , Zhou Xiang , Žihala David , Anilkumar Sithara Anjana , Mersi Julia , Waldschmidt Johannes M. , Riedhammer Christine , Kadel Sofie-Katrin , Truger Marietta , Werner Rudolf A. , Haferlach Claudia , Einsele Hermann , Kretzschmar Kai , Jelínek Tomáš , Rosenwald Andreas , Kortüm K. Martin , Riedel Angela , Rasche Leo 
Published: August 2024

Abstract
Extramedullary disease (EMD) is a high-risk feature of multiple myeloma (MM) and remains a poor prognostic factor, even in the era of novel immunotherapies. Here, we applied spatial transcriptomics (RNA tomography for spatially resolved transcriptomics [tomo-seq] [n = 2] and 10x Visium [n = 12]) and single-cell RNA sequencing (n = 3) to a set of 14 EMD biopsies to dissect the 3-dimensional architecture of tumor cells and their microenvironment. Overall, infiltrating immune and stromal cells showed both intrapatient and interpatient variations, with no uniform distribution over the lesion. We observed substantial heterogeneity at the copy number level within plasma cells, including the emergence of new subclones in circumscribed areas of the tumor, which is consistent with genomic instability. We further identified the spatial expression differences between GPRC5D and TNFRSF17, 2 important antigens for bispecific antibody therapy. EMD masses were infiltrated by various immune cells, including T cells. Notably, exhausted TIM3+/PD-1+ T cells diffusely colocalized with MM cells, whereas functional and activated CD8+ T cells showed a focal infiltration pattern along with M1 macrophages in tumor-free regions. This segregation of fit and exhausted T cells was resolved in the case of response to T-cell–engaging bispecific antibodies. MM and microenvironment cells were embedded in a complex network that influenced immune activation and angiogenesis, and oxidative phosphorylation represented the major metabolic program within EMD lesions. In summary, spatial transcriptomics has revealed a multicellular ecosystem in EMD with checkpoint inhibition and dual targeting as potential new therapeutic avenues.
Longitudinal detection of prion infection in preclinical sheep blood samples compared using 3 assays
Authors: Thomas Charlotte M. , Salamat M. Khalid F. , Almela Florian , Cooper Jillian K. , Ladhani Kaetan , Arnold Mark E. , Bougard Daisy , Andréoletti Olivier , Houston E. Fiona 
Published: August 2024

Abstract
Variant Creutzfeldt-Jakob disease (vCJD) is a devastating disease caused by transmission of bovine spongiform encephalopathy to humans. Although vCJD cases are now rare, evidence from appendix surveys suggests that a small proportion of the United Kingdom population may be infected without showing signs of disease. These “silent” carriers could present a risk of iatrogenic vCJD transmission through medical procedures or blood/organ donation, and currently there are no validated tests to identify infected asymptomatic individuals using easily accessible samples. To address this issue, we evaluated the performance of 3 blood-based assays in a blinded study, using longitudinal sample series from a well-established large animal model of vCJD. The assays rely on amplification of misfolded prion protein (PrPSc; a marker of prion infection) and include real-time quaking-induced conversion (RT-QuIC), and 2 versions of protein misfolding cyclic amplification (PMCA). Although diagnostic sensitivity was higher for both PMCA assays (100%) than RT-QuIC (61%), all 3 assays detected prion infection in blood samples collected 26 months before the onset of clinical signs and gave no false-positive results. Parallel estimation of blood prion infectivity titers in a sensitive transgenic mouse line showed positive correlation of infectivity with PrPSc detection by the assays, suggesting that they are suitable for detection of asymptomatic vCJD infection in the human population. This study represents, to our knowledge, the largest comparison to date of preclinical prion detection in blood samples from a relevant animal model. The outcomes will guide efforts to improve early detection of prion disease and reduce infection risks in humans.
Genotyped RhD+ red cells for D-positive patients with sickle cell disease with conventional RHD and unexpected anti-D
Authors: Chou Stella T. , Mewha Julia , Friedman David F. , Lazariu Victoria , Makrm Shaimaa , Ochoa Gorka , Vege Sunitha , Westhoff Connie M. 
Published: August 2024

Abstract
Anti-D can occur in D-positive patients who inherit RHD genetic variants encoding partial D antigen expression, but unexpected anti-D is also found in the plasma of patients with sickle cell disease who have conventional RHD gene(s) and are transfused with units from Black donors. These anti-D are likely stimulated by variant Rh expressed on donor cells; however, patients with anti-D, regardless of cause, are transfused for a lifetime with D-negative (Rh-negative) blood. This results in significant increased use of Rh-negative units, especially for those requiring chronic transfusion, which can strain Rh-negative blood inventories. We tested whether D-positive patients who made anti-D and had conventional RhD by RHD genotyping could safely be returned to D-positive transfusions without anti-D reappearance or compromised red blood cell survival using RHD genotype-matched units from Black donors. Five patients receiving chronic red cell exchange received an increasing number of D-positive units per procedure with a total of 72 D-positive RHD genotyped units transfused, with no anti-D restimulation. Unexpected anti-C and anti-E were identified during the study associated with donors with variant RHCE alleles. RH genotyping of D-positive units for transfusion may improve use and allocation of valuable Black donor units and reduce demand for Rh-negative blood. This trial was registered at www.clinicaltrials.gov as NCT04156906.
Evolving consolidation patterns and outcomes for a large cohort of patients with primary CNS lymphoma
Authors: Tringale Kathryn R. , Scordo Michael , Yahalom Joachim , White Charlie , Zhang Zhigang , Schefflein Javin , Cederquist Gustav , Schaff Lauren R. , DeAngelis Lisa , Imber Brandon S. , Grommes Christian 
Published: August 2024

Abstract
Consolidation for primary central nervous system lymphoma (PCNSL) after induction chemoimmunotherapy include whole-brain radiotherapy (WBRT; ≤24 Gy reduced-dose [RD], &gt;24 Gy standard-dose) and cytarabine, nonmyeloablative chemotherapy (NMC), or autologous hematopoietic cell transplantation (AHCT). Comparative outcomes are lacking. Outcomes from 1983-2020 were stratified by decade and Memorial Sloan Kettering Cancer Center recursive partitioning analysis (RPA) class. Clinicodemographic associations were analyzed by multinomial logistic regression. Progression-free survival (PFS) and overall survival (OS) were analyzed by proportional hazards. Of 559 patients, 385 (69%) were consolidated. Median follow-up and OS were 7.4 and 5.7 years, respectively. WBRT use declined (61% (1990s) vs 12% (2010s)), whereas AHCT (4% (1990s) vs 32% (2010s)) and NMC (27% (1990s) vs 52% (2010s)) rose. Compared with RPA 1, RPA 2 was more likely to receive NMC. Those with partial response to induction were less likely to receive AHCT (odds ratio, 0.36; P = .02). Among 351 with complete response to consolidation, only receipt of rituximab, methotrexate, procarbazine, and vincristine induction was associated with improved PFS (hazard ratio, 0.5; P = .006). Among RPA 1, median PFS and OS were not reached for AHCT or RD-WBRT, vs 2.5 and 13.0 years, respectively, after NMC. Among RPA class 3, median PFS and OS after RD-WBRT were 4.6 and 10 years, vs 1.7 and 4.4 years after NMC. No significant adjusted survival differences were seen across consolidation strategies. NMC is increasingly used in lieu of RD-WBRT despite a trend toward less favorable PFS. RD-WBRT can be considered in patients ineligible for AHCT.
Priorities and barriers for research related to primary ciliary dyskinesia
Authors: Goutaki Myrofora , Lam Yin Ting , Rubbo Bruna , Chalmers James D. , Kouis Panayiotis , Marsh Gemma , Papon Jean-François , Raidt Johanna , Robinson Phil , Behan Laura , Lucas Jane S. 
Published: August 2024

BackgroundDespite advances in primary ciliary dyskinesia (PCD) research, many questions remain; diagnosis is complex and no disease-specific therapies exist. Using a mixed-methods approach, we aimed to identify priorities for clinical and epidemiological research and explore barriers to research.MethodsTo obtain rich, relevant, diverse data, we performed in-depth semi-structured interviews with PCD specialists selected using purposive sampling. We transcribed, coded and analysed interview data using thematic analysis. Based on interview themes that we identified, we developed an anonymous survey and circulated it widely through the BEAT-PCD network.ResultsWe interviewed 28 participants from 15 countries across different disciplines and expertise levels. The main themes identified as priorities for PCD research were improving diagnosis; understanding prevalence and disease course; phenotypic variability; disease monitoring; treatment strategies; clinical trial end-points; and poorly researched areas. In total, 136 participants (49% paediatric pulmonologists) from 36 countries completed the survey. Most commonly reported barriers for research were low awareness about PCD and difficulties securing funding – in more than one-third of cases, participants reported undertaking predominantly unfunded research. Research questions ranked highest included priorities related to further improving diagnosis, treating PCD, managing upper and lower airway problems, and studying clinical variability and disease prognosis.ConclusionWe need to overcome barriers of limited funding and low awareness and promote collaborations between centres, disciplines, experts and patients to address identified PCD priorities effectively. Our results contribute to the ongoing efforts of guiding the use of existing limited research resources and setting up a roadmap for future research activities.
Chronic Cough Patient Perspective: questionnaire validation and symptom impact
Authors: Braido Fulvio , Candeliere Maria Giulia , Bondi Benedetta , Arnaboldi Enrico , Bruno Matteo , Colombo Nicole , de Tommaso Cesare , Fassio Omar , Ferraris Melissa , Martinelli Sofia , Melissari Laura , Napoli Ludovica , Terracciano Federica , Folli Chiara , Baiardini Ilaria 
Published: August 2024

BackgroundChronic cough (CC) is underevaluated and underreported. The introduction of a tool that is easy to complete, score and interpret and with the psychometric properties requested for use in individual patients could improve clinical practice.ObjectiveThis cross-sectional study aimed to validate the Chronic Cough Patient Perspective (CCPP) for assessing CC in daily practice.MethodsA provisional CCPP was created by iteratively reducing the Chronic Cough Impact Questionnaire (CCIQ). Its psychometric properties were tested in CC patients at baseline (visit 1) and after 1 month (visit 2).ResultsThe reduction process yielded an 8-item provisional version, subsequently validated in 150 patients (36.33% males, mean age 50±16.9 years). Exploratory factor analysis revealed a one-dimensional structure, with one item being deleted as it did not align with the extracted dimension. The 7-item version of the CCPP showed a strong correlation with the CCIQ (r=0.902 at visit 1, r=0.932 at visit 2) and internal consistency (Cronbach's alpha values: 0.85 at visit 1, 0.93 at visit 2); discriminant and convergent validity were satisfactory. The reliability, assessed in 21 patients with no change in CC (Global Rating Scale=0), was high (concordance correlation coefficient=0.815; interclass coefficient=0.823). A score ≤5 indicates optimal health-related quality of life (HRQoL) attainment, with a minimum important difference of 3. The mean CCPP score was 20.5±6.24 at enrolment, and only 37.33% of the participants achieved an optimal HRQoL at visit 2.ConclusionThe CCPP exhibited good psychometric properties suitable for clinical use, providing a valid, reliable and standardised assessment of CC's impact on HRQoL.
Surfactant-derived protein type B: a new biomarker linked to respiratory failure and lung damage in mild to moderate SARS-CoV-2 pneumonia
Authors: Mapelli Massimo , Salvioni Elisabetta , Mattavelli Irene , Banfi Cristina , Ghilardi Stefania , Greco Arianna , Biondi Maria Luisa , Rovai Sara , Mancini Elisabetta , Harari Sergio , Agostoni Piergiuseppe 
Published: August 2024

BackgroundThe COVID-19 pandemic has led to significant concern due to its impact on human health, particularly through pneumonia-induced lung damage. Surfactant proteins A and D (SP-A and SP-D) are implicated in COVID-19 lung damage, but the role of surfactant protein B (SP-B) remains unclear.MethodsWe conducted a single-centre, prospective observational study involving 73 hospitalised COVID-19 pneumonia patients. SP-B levels were measured within 48 h of admission, alongside SP-A and SP-D in a subset. Clinical data were collected, and follow-up visits were conducted after 6 months.ResultsAt hospitalisation, circulating immature SP-B levels measured in 73 patients (median 26.31 arbitrary units (AU) (interquartile range 14.27–41.31)) correlated significantly with lung involvement (r=0.447, p<0.001) and oxygen support requirement (p=0.005). SP-B levels did not predict mechanical ventilation or intensive care unit admission. SP-B decreased significantly (p<0.001) from 25.53 AU (14.36–41.46) at the acute hospitalisation to 12.73 AU (9.12–20.23) at the 6-month follow-up, whereas SP-A and SP-D did not change significantly. Immature SP-B (but not SP-A and SP-D) was confirmed to be significantly associated with the need for oxygen support (n=26, 58%) during the hospitalisation (p<0.05).ConclusionImmature SP-B emerges as a potential biomarker for COVID-19 pneumonia severity and prognosis. Its dynamic changes suggest utility in monitoring disease progression and long-term outcomes, despite limitations in predicting hard end-points. Larger studies are needed to validate these findings and understand the underlying mechanisms of surfactant protein dysregulation in COVID-19 pathogenesis.
Utility of adding oesophageal to endobronchial endosonography when staging lung cancer: a randomised trial
Authors: Oki Masahide , Saka Hideo , Seki Yukio , Kogure Yoshihito , Niwa Hideyuki , Yamada Arisa , Torii Atsushi , Kitagawa Chiyoe , Ando Masahiko 
Published: August 2024

IntroductionBoth combined endobronchial ultrasonography (EBUS) and transoesophageal bronchoscopic ultrasonography (EUS-B) and EBUS alone have been recommended for preoperative mediastinal staging of nonsmall cell lung cancer (NSCLC). However, no randomised study comparing these two methods has been published. The purpose of the present study was to compare the sensitivity of EBUS and that of combined EBUS and EUS-B (EBUS/EUS-B) in terms of detecting N2/N3 disease during staging of NSCLC.MethodsPatients with known or suspected, potentially operable NSCLC were recruited and randomised to undergo EBUS or EBUS/EUS-B under conscious sedation. The primary end-point was a comparison of the sensitivity of EBUS alone and EBUS/EUS-B.ResultsA total of 240 patients were enrolled and randomised, among whom 219 (105 EBUS group; 114 EBUS/EUS-B group) were included in the analysis. The sensitivities of EBUS and EBUS/EUS-B in terms of detecting N2/N3 disease were 75.0% and 79.3% respectively (p=0.698). In the EBUS/EUS-B group, only EUS-B yielded diagnostic results in two patients; the sensitivity thus increased from 72.4% to 79.3% on addition of EUS-B to EBUS.ConclusionsThe difference in the sensitivities of EBUS alone and EBUS/EUS-B in terms of diagnosing N2/N3 disease was not statistically significant. Although the increase in sensitivity with the addition of EUS-B is modest, it is maximised when EUS-B is used to sample lymph nodes not accessible by EBUS alone.
The Canadian Bronchiectasis and Nontuberculous Mycobacteria Registry: a study protocol
Authors: Thornton Christina S. , Boechler Nicole , Desai Vidhi , Somayaji Ranjani , Purighalla Swathi , Brode Sarah , Marras Theodore K. , Cooper Ryan , Smith Maeve , Jarand Julie 
Published: August 2024

BackgroundBronchiectasis is a complex, chronic disease with geographic and ethnic diversity. While the most substantial cohort studies have been conducted in Europe and the USA, Canada also faces considerable challenges. The comprehensive Canadian Bronchiectasis and Nontuberculous Mycobacterial (NTM) Registry aims to 1) outline the clinical characteristics and natural history of bronchiectasis in Canada, 2) identify risk factors contributing to disease progression within Canadians, 3) integrate comprehensive clinical information to better understand the phenotypes of bronchiectasis and 4) support the development of large-scale, randomised controlled trials in Canada.MethodsThe Canadian Bronchiectasis and NTM Registry is an ongoing prospective, longitudinal, multi-centre, observational cohort study. It aims to enrol at least 2000 participants to collect data such as medical history, aetiological assessments, lung function tests, microbiological profiles, radiographic evaluations, comorbidities and quality of life (QoL) metrics. Participants will undergo annual follow-ups to gather longitudinal information regarding outcomes, treatments and changes in QoL. The inclusion criteria are a diagnosis of bronchiectasis by clinical history and computed tomography and/or pulmonary NTM infection as defined by American Thoracic Society/Infectious Diseases Society of America guidelines. The study's protocol received ethical approval from the lead site, the University of Calgary, with future additional approval from local ethics committees at all participating centres.DiscussionThe outcomes of the registry will be instrumental in uncovering the clinical traits and natural history of bronchiectasis. This longitudinal study will be used for analysis to form evidence-based clinical practices and serve as a resource in Canada to inform future studies in NTM and bronchiectasis.