bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing Group Dynamics in Pharmaceutical Education: An Examination of Instructor- Led Team Formation Methods
Authors: Shimomura Yuki , Utsumi Miho 
Published: May 2024

Abstract

Background: Problem-based learning (PBL) has evolved as a prominent educational approach in medical and pharmaceutical education, shifting from traditional knowledge-intensive methods to a learner-centered model. It emphasizes the development of problem-solving skills and self-learning abilities. However, despite the effectiveness of PBL, challenges such as free riding in group settings have been identified, impacting group dynamics and overall learning outcomes. Therefore, this study aimed to determine the influence of grouping methods on student behavior and how it influences the presence of free riders and active learners within the educational setting. It also aimed to elucidate the distinctive characteristics and attributes that differentiate free riders from active learners, thus providing a comprehensive understanding of the dynamics in pharmaceutical education.
Methods:
The study involved 255 second-year students from Kobe Gakuin University, randomly assigned to three groups: motivation (formed on career aspirations), grade point average (GPA; academic performance), and randomized groups. Students engaged in PBL activities, including case presentations, problem definition, brainstorming, formulation of learning objectives, self-study, and synthesis of new information. After PBL class, students answered questionnaires. Data collection included demographic information, self and peer evaluations, and qualitative comments. Students were categorized as "free riders," "active learners," or "general learners" based on their peer evaluation scores.
Results: Teams formed based on GPA were more prone to free riding behavior, while motivation-based teams exhibited a higher level of active participation. Additionally, active learners generally had higher GPAs and positive self-evaluations compared to free riders.
Conclusion: Motivation-based teams could effectively enhance active learning and reduce the incidence of free riders in PBL settings. In contrast, grouping students solely based on GPA may promote passive learning behaviors. These findings suggest that instructors should consider students’ interests when forming teams for PBL in pharmaceutical education. Such an approach could foster a more engaging and productive learning environment, potentially improving educational outcomes.
Identification and validation of drugs for repurposing in Glioblastoma: a computational and experimental workflow
Authors: Gonzalez Nazareno , Küper Melanie Pérez , Fallit Matías Garcia , Agudelo Jorge A. Peña , Candia Alejandro J. Nicola , Velandia Maicol Suarez , Videla-Richardson Guillermo A. , Candolfi Marianela 
Published: May 2024

Abstract

Purpose
Glioblastoma (GBM) remains a formidable challenge in oncology due to its invasiveness and resistance to treatment, i.e. surgery, radiotherapy, and chemotherapy with temozolomide. This study aimed to develop and validate an integrated model to predict the sensitivity of GBM to alternative chemotherapeutics and to identify novel candidate drugs and combinations for the treatment of GBM.
Methods
We utilized the drug sensitivity response data of 272 compounds from CancerRxTissue, a validated predictive model, to identify drugs with therapeutic potential for GBM. Using the IC50, we selected 'potentially effective' drugs among those predicted to be blood-brain barrier permeable via in silico algorithms. We ultimately selected drugs with targets overexpressed and associated with worse prognosis in GBM for experimental in vitro validation.
Results
The workflow proposed predicted that GBM is more sensitive to Etoposide and Cisplatin, in comparison with Temozolomide, effects that were validated in vitro in a set of GBM cellular models. Using this workflow, we identified a set of 5 novel drugs to which GBM would exhibit high sensitivity and selected Daporinad, a blood-brain barrier permeant NAMPT inhibitor, for further preclinical in vitro evaluation, which aligned with the in silico prediction.
Conclusion
Our results suggest that this workflow could be useful to select potentially effective drugs and combinations for GBM, according to the molecular characteristics of the tumor. This comprehensive workflow, which integrates computational prowess with experimental validation, could constitute a simple tool for identifying and validating compounds with potential for drug repurposing in GBM and other tumors.
Development of 3D scaffolds models using parameterized modeling
Authors: Bié Gabriel de Souza Vieira , Silveira Zilda de Castro , Aroca Rafael Vidal , Branciforti Marcia Cristina 
Published: May 2024

Abstract

Tissue engineering is a technique for regenerating living tissue using portions of the patient's own tissue, which are dissociated into cells and cultured on biological or synthetic supports before being transferred to the patient. In this context, the present work seeks to develop implant models (scaffolds) for the replacement of trabecular bone tissue, in accordance with requirements like porosity and interconnected pores. All design development was aimed at the manufacturing of scaffolds using material extrusion process. For the development of this work, the Grasshopper program was utilized, an extension of Rhino that facilitates the creation of structures easily modifiable by parameters. The model developed involves applying the Voronoi 2D diagram in two perpendicular planes to generate extruded structures along a vector perpendicular to the plane of the respective diagram. This approach aims to create a pore structure interconnected in two directions. Prototypes have been produced that fulfill most of the properties required by a scaffold. In addition, the geometry of the prototypes was very close to the original model, even using low resolution 3D printers.
A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ intervention on person-centered maternity care in Kenya and Ghana: Study Protocol
Authors: Afulani Patience A. , Getahun Monica , Ongeri Linnet , Aborigo Raymond , Kinyua Joyceline , Ogolla Beryl A. , Okiring Jaffer , Moro Ali , Oluoch Iscar , Dalaba Maxwell , Odiase Osamuedeme , Nutor Jerry , Mendes Wendy Berry , Walker Dilys , Neilands Torsten B. 
Published: May 2024

Abstract

Background
Poor person-centered maternal care (PCMC) contributes to high maternal mortality and morbidity, directly and indirectly, through lack of, delayed, inadequate, unnecessary, or harmful care. While evidence on poor PCMC prevalence, as well as inequities, expanded in the last decade, there is still a significant gap in evidence-based interventions to address PCMC. We describe the protocol for a trial to test the effectiveness of the “Caring for Providers to Improve Patient Experience” (CPIPE) intervention, which includes five strategies for provider behavior change, targeting provider stress and bias as intermediate factors to improve PCMC and to address inequities.
Methods
The trial will assess the effect of CPIPE on PCMC, as well as on intermediate and distal outcomes, using a two-arm cluster randomized controlled trial in 40 health facilities in Migori and Homa Bay Counties in Kenya and Upper East and Northeast Regions in Ghana. Twenty facilities in each country will be randomized to 10 intervention and 10 control sites. The primary intervention targets are all healthcare workers who provide maternal health services. The intervention impact will also be assessed first among providers, and then among women who give birth in health facilities. The primary outcome is PCMC measured with the PCMC scale, via multiple cross-sectional surveys of mothers who gave birth in the preceding 12 weeks in study facilities at baseline (prior to the intervention), midline (6 months after intervention start), and endline (12 months post-baseline) (N = 2000 across both countries at each time point). Additionally, 400 providers in the study facilities across both countries will be followed longitudinally at baseline, midline, and endline, to assess intermediate outcomes. The trial incorporates a mixed-methods design; survey data alongside in-depth interviews (IDIs) with healthcare facility leaders, providers, and mothers to qualitatively explore factors influencing the outcomes. Finally, we will collect process and cost data to assess intervention fidelity and cost-effectiveness.
Discussion
This trial will be the first to rigorously assess an intervention to improve PCMC that addresses both provider stress and bias and will advance the evidence base for interventions to improve PCMC and contribute to equity in maternal and neonatal health.
Low levels of PTH predict early mortality in incident patients on hemodialysis: results from a large cohort
Authors: Aquino Hugo B.S. , Canziani Maria Eugenia F. , Barra Ana Beatriz L. , Roque-da-Silva Ana Paula , Strogoff-de-Matos Jorge Paulo , Dalboni Maria Aparecida , Moyses Rosa M.A. , Elias Rosilene M 
Published: May 2024

Abstract

Purpose: Parathyroid hormone (PTH) is merit as a risk factor for mortality in patients with chronic kidney disease starting dialysis in a U-shape. Most studies, however, do not focus on incident patients and those who died within the first 90 days of therapy. We evaluated PTH as a risk factor for mortality in a large cohort population in Brazil.
Methods: This is an observational cohort study that included 4,317 adult patients who initiated hemodialysis between July 1st, 2012, and June 30, 2017. The main outcome was all-cause mortality. Fine-gray sub-distribution hazard models were used to evaluate survival in the presence of a competing event (kidney transplant).
Results: median PTH levels of 252 (118, 479) pg/mL. There were 331 deaths during the first 90 days of therapy (6.7%), 430 in a 1-year follow-up (10.7%) and 1,282 (32%) during the 5-year study period. Deaths according to PTH < 150, 150-600 and > 600 pg/mL corresponded to 38.1%, 33.0% and 28.5%, respectively (p <0.001). In an adjusted model, patients who started dialysis with PTH < 150 pg/mL had a higher mortality risk within the first 90 days, but not in 1 year and 5 years after starting dialysis. Analyses in a subset of patients with a repeated PTH in 1 year (N=1,954) showed that although persistent PTH low levels (<150 pg/mL) at 1 year were significantly associated with all-cause mortality this result was not sustained after multiple adjustments.
Conclusion: PTH <150 pg/mL confers a high mortality risk in the first 90 days of dialysis. If this result reflects poor nutritional conditions deserves further investigation.
Feed-feces-fertilizer: Greenhouse study and interviews with fertilizer producers indicate persistence and negative effect of glyphosate residue in manure-based fertilizers
Authors: Birge Traci , Saloniemi Irma , Saikkonen Kari , Helander Marjo 
Published: May 2024

Abstract

BACKGROUND: The herbicide glyphosate is the most widely used active ingredient in pesticides globally. Residues have been found in people, livestock, food and animal feed, and in the environment, but little is known about glyphosate residue in manure-based fertilizer. “Feed-feces-fertilizer” describes how manure fertilizer can be contaminated with glyphosate. This exposure can harm sensitive plants, such as tomato, and pose a risk to effective waste disposal and nutrient cycling along principles of the circular economy. We review the use and history and present a mixed methods research based on a real-world case from Finland where glyphosate residue in poultry manure fertilizer was suspected of inhibiting commercial organic tomato production. To test the fertilizer, we grew 72 ‘Encore’ variety tomatoes for 14 weeks using the same commercial greenhouse methods. To ascertain awareness and potential contamination mitigation measures, we also contacted five fertilizer companies with sales of biogenic fertilizer in Finland, representatives of two farming organizations, and two government organizations working on nutrient cycling and agricultural circular economy.
RESULTS: The total harvest of tomatoes grown with fertilizer with glyphosate residue was 35% smaller and the yield of first-class tomatoes 37% lower than that of the control. Two of the five fertilizer companies identified poultry manure as a source of glyphosate contamination. Companies with awareness of pesticide residues reported interest in establishing parameters for pesticide residues.
CONCLUSIONS: The extent of glyphosate contamination of recycled fertilizers is unknown, but this study shows that such contamination occurs with negative impacts on crop production. The example from Finland shows that a model of co-production between fertilizer producers and state regulatory agencies to establish safe limits can benefit both fertilizer producers and their customers.
PD1 inhibitors combined with chemotherapy versus re-irradiation /chemoradiotherapy for unresectable locally recurrent T3-4 nasopharyngeal carcinoma: a retrospective study
Authors: Liu Tongxin , Sun Quanquan , Hua Yonghong , Tao Changjuan , Jiang Feng 
Published: May 2024

Abstract

Background
The aim of this study was to evaluate the efficacy, toxicity, and long-term outcomes of PD1 inhibitors plus chemotherapy versus re-irradiation/chemoradiotherapy in patients with unresectable locally recurrent T3-4 nasopharyngeal carcinoma (NPC).
Methods
A retrospective analysis was conducted on 42 patients with recurrent nasopharyngeal cancer (NPC) after receiving immunochemotherapy or reradiation between February 2018 and May 2022. Overall survival (OS), progression-free survival (PFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were determined using the Kaplan-Meier method, log-rank test, and Cox proportional hazard regression.
Results
With a median follow-up duration of 28.7 months (ranging from 7.2 to 63.9 months), the 3-year OS rate was 23.3% in the re-irradiotherapy (RI) group (N = 24) and 59.6% in the immunochemotherapy (IC) group (N = 18) (p = 0.042). The 3-year PFS, LRFS, and DMFS rates were not significantly different between the two groups (PFS: 45.3% vs. 62.6%, P = 0.482; LRFS: 54.4% vs. 62.6%, P = 0.891; DMFS: 89.8% vs. 100.0%, P = 0.489). The univariate analysis revealed that regimen (HR: 0.354, 95% CI: 0.130–0.962, P = 0.042) was significantly correlated with OS. Multivariate analysis also showed that treatment regimen (HR: 0.329, 95% CI: 0.12–0.970, P = 0.044) was the only significant prognostic factor associated with OS. The most common late toxicities in the RI group were xerostomia, deafness, and nasopharyngeal necrosis. Of these, nasopharyngeal necrosis was present in 16 patients (66.7%) and in 10 patients (41.7%) at a grade 3 or above. Nasopharyngeal necrosis is the main cause of death in the RI group. In contrast, in the IC group, grade 3 or higher immune-related adverse events or late adverse events were not observed.
Conclusion
For unresectable locally recurrent NPC, re-irradiation is an effective treatment; nevertheless, the survival obtains are usually surpassed by serious late complications. For these individuals, chemotherapy in addition to an anti-PD-1 checkpoint inhibitor may be a helpful course of treatment.
A Novel Model Based on Cnn–vit Fusion and Ensemble Learning for Automatic Detection of Pes Planus
Authors: SELÇUK Turab , Yılmaz Abdurrahman 
Published: May 2024

Abstract

Pes planus, commonly known as flatfoot, is a condition in which the medial arch of the foot is abnormally low or absent, leading to the inner part of the foot having less curvature than normal. With the availability of large datasets, deep neural networks have shown promising capabilities in recognizing foot structures and accurately identifying pes planus. In this study, we developed a novel fusion model by combining the Vgg16 convolutional neural network (CNN) model with the vision transformer ViT-B/16 to enhance the detection of pes planus. This fusion model leverages the strengths of both CNN and ViT architectures, resulting in improved performance compared to reports in the literature. Additionally, ensemble learning techniques were employed to ensure the robustness of the model. Through 10-fold cross-validation, the model demonstrated high sensitivity, specificity, and F1 score values of 97.4%, 96.4%, and 96.8%, respectively. These results highlight the effectiveness of the proposed model in quickly and accurately diagnosing pes planus, making it suitable for deployment in clinics or healthcare centers. By facilitating early diagnosis, the model can contribute to better management of treatment processes, ultimately leading to improved quality of life for patients.
Coronary heart disease with pulmonary embolism: a case report
Authors: Xu Junqing , Jiang Mengxin , Wang Feng , Yang Kaiqiang , Xu Yingjiang , Wang Yujiu , Dong Shengjun 
Published: May 2024

Abstract

Background: Coronary heart disease and pulmonary embolism are both thrombotic diseases, and now, patients with coronary heart disease and pulmonary embolism are not uncommon in clinical practice. However, there are some challenges in clinical diagnosis of pulmonary embolism due to their overlapping primary symptoms such as chest tightness and dyspnea. This confluence frequently leads to underdiagnosis or misdiagnosis of pulmonary embolism, thus precipitating treatment delays and compromising patient outcomes. Here we reported a patient who successfully diagnosed with both diseases and ultimately underwent coronary artery bypass grafting, anticoagulant and antiplatelet drug therapy, with a good prognosis.
Case presentation: A 51-year-old male with a history of hypertension for 2 years, came to local hospital due to paroxysmal chest tightness for 1 day and was diagnosed with coronary heart disease, but he refused hospitalizationour. Then, he came to our hospital for treatment due to recurring symptoms. After admission, a comprehensive examination found that D-dimer was elevated, and further computer tomography pulmonary angiography was performed to confirm the diagnosis of pulmonary embolism. This patient finally successfully received coronary artery bypass grafting with anticoagulant and antiplatelet drugs, whose prognosis is good.
Conclusions: This case has guiding significance for the treatment of patients with coronary heart disease combined with pulmonary embolism. Coronary artery bypass grafting combined with anticiagulation and antiplatelet therapy is feasible for such patients. Clinically, when diagnosing coronary heart disease, D-dimer screening should be performed, and if PE is suspected, computer tomography pulmonary angiography should be performed as soon as possible to confirm the diagnosis to decide personalized treatment strategy.
Regional lymph node changes on breast MRI in patients with early-stage breast cancer receiving neoadjuvant chemo-immunotherapy
Authors: Jacob Saya , Christofferson Anika , Fisch Samantha , Norwood Peter , Castillo Paolo , Yu Hongmei , Hirst Gillian , Soliman Hatem , Nanda Rita , Mukhtar Rita A. , Ewing Cheryl , Majure Melanie , Melisko Michelle , Rugo Hope S. , Esserman Laura , Price Elissa , Chien A. Jo 
Published: May 2024

Abstract

Purpose
Establishing breast MRI imaging patterns associated with neoadjuvant immunotherapy is needed to monitor response. We analyzed serial breast MRIs in patients receiving neoadjuvant chemo-immunotherapy on the ISPY-2 clinical trial.
Methods
Patients had stage 2–3 HER2-negative breast cancer in a single institution. Regimens included: weekly paclitaxel (control), weekly paclitaxel in combination with pembrolizumab, or weekly paclitaxel in combination with pembrolizumab and intra-tumoral injection of SD-101, a TLR9 agonist. All patients then received AC and underwent surgery. Regional lymph nodes were retrospectively evaluated on breast MRI at baseline, 3 wks, 12 wks and 20 wks by a single blinded radiologist. MRIs were assessed for development of new regional lymphadenopathy, or increase in longest diameter or cortical thickness of largest regional lymph node.
Results
Between 12/2015-4/2021, a total of 43 patients enrolled to the control (n = 16) and paclitaxel + pembrolizumab +/- SD-101 (n = 27) arms. 25 patients had hormone-receptor positive disease and 18 patients had triple negative disease. 12 of 27 patients (44.4%) receiving chemo-immunotherapy experienced increased lymphadenopathy within the first 12 weeks compared to 1 of 16 patients (6.3%) in the control group (p = 0.014). Increased lymphadenopathy was observed despite concomitant decrease in breast tumor size at all time points. 11 of 12 patients with increased lymphadenopathy had pathologically negative nodes at surgery. There was no association between lymphadenopathy and lower residual cancer burden (p = 0.696) or immune-related toxicity.
Conclusions
Chemo-immunotherapy was associated with early increases in regional lymphadenopathy despite decreased breast tumor size. Increased lymphadenopathy was not associated with node-positive disease at surgery.
Multi-loaded PLGA microspheres as neuroretinal therapy in a chronic glaucoma animal model
Authors: Aragón-Navas Alba , Rodrigo Maria Jesus , Munuera Ines , Garcia-Herranz David , Subias Manuel , Villacampa Pilar , García-Feijóo Julián , Pablo Luis , Garcia-Martin Elena , Herrero-Vanrell Rocío , Bravo-Osuna Irene 
Published: May 2024

Abstract

This work focused on the co-encapsulation and simultaneous co-delivery of three different neuroprotective drugs in PLGA (poly(lactic-co-glycolic acid) microspheres for the treatment of glaucoma. For formulation optimization, dexamethasone (anti-inflammatory) and ursodeoxycholic acid (anti-apoptotic) were co-loaded by the solid-in-oil-in-water emulsion solvent extraction-evaporation technique as a first step. The incorporation of a water-soluble co-solvent (ethanol) and different amounts of dexamethasone resulted critical for the encapsulation of the neuroprotective agents and their initial release. The optimized formulation was obtained with 60 mg of dexamethasone and using an 80:20 dichloromethane:ethanol ratio. In the second step in the microencapsulation process, the incorporation of the glial cell line-derived neurotrophic factor (GDNF) was performed. The final prototype showed encapsulation efficiencies for each component above 50% with suitable properties for long-term application for at least 3 months. Physicochemical studies were performed by SEM, TEM, DSC, XRD, and gas chromatography. The evaluation of the kinetic release by the Gallagher-Corrigan analysis with Gorrasi correction helped to understand the influence of the co-microencapsulation on the delivery of the different actives from the optimized formulation. The final prototype was tested in a chronic glaucoma animal model. Rats received two intravitreal injections of the neuroprotective treatment within a 24-week follow-up study. The proposed formulation improved retinal ganglion cell (RGC) functionality examined by electroretinography. Also, it was able to maintain a neuroretinal thickness similar to that of healthy animals scanned by in vivo optical coherence tomography, and a higher RGC count on histology compared to glaucomatous animals at the end of the study.