bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological aspects of the longest, solo, unsupported one-way polar ski expedition in Antarctica by a female adventurer
Authors: Scheer Volker , Chandi H , Valero Burgos E , Thuany M , Knechtle B , Steinach M 
Published: June 2024

IntroductionAntarctic expeditions present exceptional physiological and mental challenges. Research data are lacking on psychological aspects of such endeavours. The aim of our study is to provide data on changes in mood, well-being, personality traits and personal experiences during an Antarctica crossing.MethodsThis is a study of a 33-year-old female British Army officer (height 175 cm; weight 75 kg; body mass index 24.49 kg/m2; VO2max49 mL/kg/min) who completed the longest, solo, unsupported, one-way polar ski expedition. The expedition started at Hercules Inlet and finished at Ross Ice Shelf, lasting 70 days and 16 hours covering 1484.53 km, with temperatures estimating from −12°C to −50°C and wind speeds of up to 60 miles per hour. The adventurer pulled all equipment and nutrition in a pulk (sled), weighing approximately 120 kg. Five psychometric questionnaires were completed pre post and during the expedition, including the International Personality Item Pool – Neuroticism, Extraversion and Openness-60, Brief Assessment of Mood, Positive and Negative Affective Schedule, Profile of Mood States, Wellness questionnaire, as well as an unstructured open questionnaire.ResultsMood generally deteriorated, particularly positive affective mood. Scores for fatigue and muscle soreness increased, with a reduction in sleep times. Personality traits of openness, agreeableness, and conscientiousness remained stable throughout the expedition, with some reduction in extraversion and an increase in neuroticism. Personal accounts give a unique insight into the increasing demands on the mental and physical impact of the expedition.ConclusionsMeticulous preparation and planning may have led to a successful expedition, including physical preparation, prior on-field experience, and psychological preparedness and resiliance. Some of these strategies may be applicable to a range of settings, including future Antarctic expeditions, expeditions in extreme environments, or missions within a military context.
Spatial genetic patterns of a long-lived tree species: the case of Pinus leiophylla in a human-altered landscape of central Mexico
Authors: Pérez-Alva Braulio R. , Galindo-Flores Gema L. , Navarro-Noya Yendi E. , Estrada-Torres Arturo , Flores-Manzanero Alejandro , Pérez-Flores Guillermo A. , Cruz-Salazar Bárbara 
Published: June 2024

In long-lived species, deforestation can modify the genetic diversity patterns of recent populations. The spatial-structure genetics of Pinus leiophylla Schiede ex Schltdl. & Cham. was investigated in adults and seedlings of remnant populations from central Mexico. Two chloroplast intergenic regions were sequenced of two cohorts (adults and seedlings) of 121 individuals of P. leiophylla from three localities. Higher genetic differentiation was found in adults ( ФST = 0.09) than in seedlings ( ФST = 0.03). The discriminant analysis of principal components detected four genetic clusters and the Mantel test found a weak but significant isolation by distance pattern ( r2 = 0.05, p = 0.002). Sixteen percent of genetic variation was explained by the spatial component according to the genetic neighborhood analysis. And the effect of three landscape features, i.e., elevation, aspect (sine and cosine), and land use, explored with ResistanceGA, detected that land use significantly restricts gene flow between populations, mostly in the farming category. This study emphasizes the critical role of preserving forest cover to maintain connectivity among remnants of P. leiophylla. Insights of this study will contribute to the conservation of conifers in Mexican temperate forests, especially within landscapes heavily altered by human activities.
KRAS Promotes GLI2-Dependent Transcription during Pancreatic Carcinogenesis
Authors: Sigafoos Ashley N. , Tolosa Ezequiel J. , Carr Ryan M. , Fernandez-Barrena Maite G. , Almada Luciana L. , Pease David R. , Hogenson Tara L. , Raja Arul Glancis L. , Mousavi Fatemeh , Sen Sandhya , Vera Renzo E. , Marks David L. , Flores Luis F. , LaRue-Nolan Kayla C. , Wu Chen , Bamlet William R. , Vrabel Anne M. , Sicotte Hugues , Schenk Erin L. , Smyrk Thomas C. , Zhang Lizhi , Rabe Kari G. , Oberg Ann L. , Zaphiropoulos Peter G. , Chevet Eric , Graham Rondell P. , Hagen Catherine E. , di Magliano Marina P. , Elsawa Sherine F. , Pin Christopher L. , Mao Junhao , McWilliams Robert R. , Fernandez-Zapico Martin E. 
Published: June 2024

Abstract

Aberrant activation of GLI transcription factors has been implicated in the pathogenesis of different tumor types including pancreatic ductal adenocarcinoma. However, the mechanistic link with established drivers of this disease remains in part elusive. In this study, using a new genetically engineered mouse model overexpressing constitutively active mouse form of GLI2 and a combination of genome-wide assays, we provide evidence of a novel mechanism underlying the interplay between KRAS, a major driver of pancreatic ductal adenocarcinoma development, and GLI2 to control oncogenic gene expression. These mice, also expressing KrasG12D, show significantly reduced median survival rate and accelerated tumorigenesis compared with the KrasG12D only expressing mice. Analysis of the mechanism using RNA sequencing demonstrate higher levels of GLI2 targets, particularly tumor growth–promoting genes, including Ccnd1, N-Myc, and Bcl2, in KrasG12D mutant cells. Furthermore, chromatin immunoprecipitation sequencing studies showed that in these cells KrasG12D increases the levels of trimethylation of lysine 4 of the histone 3 (H3K4me3) at the promoter of GLI2 targets without affecting significantly the levels of other major active chromatin marks. Importantly, Gli2 knockdown reduces H3K4me3 enrichment and gene expression induced by mutant Kras. In summary, we demonstrate that Gli2 plays a significant role in pancreatic carcinogenesis by acting as a downstream effector of KrasG12D to control gene expression.
KEBERHASILAN OPERASI TRABEKULEKTOMI PADA GLAUKOMA SUDUT TERBUKA PRIMER PERIODE 2019-2021
Authors: Radilia Fasya , Rifada R. Maula , Kartiwa R. Angga 
Published: June 2024

Introduction: Glaucoma represents a group of diseases defined by a characteristic optic neuropathy that is consistent with remodeling of the connective tissue elements of the optic nerve head and with loss of neural tissue associated with the eventual development of distinctive patterns of visual dysfunction. The most common surgery for glaucoma treatment is trabeculectomy, which in principle is done by creating a new channel that drains the aqueous humor, and return the intraocular pressure to normal levels.
Objective: This study aimed to know the success rate of trabeculectomy in primary open-angle glaucoma.
Methods: This study used a retrospective descriptive research method and was conducted in the Medical Records Center of the Cicendo National Eye Hospital, Bandung City with a data collection period of 21 July 2022 – 6 September 2022. The data collection process was carried out by looking at secondary data from medical records of patients with primary open-angle glaucoma for the period January 2019 – December 2021.
Results: Mean IOP decreased from 32.6±12.9 before surgery, to 19.8±10 one week after surgery, and 18.8±7.3 one month after surgery. The overall success rate reaches 82.1%.
Conclusions: The success rate for open-angle glaucoma treated with trabeculectomy at Cicendo National Eye hospital is considered good with a total success rate of 82.1% with or without anti-glaucoma medication to control IOP after surgery.
Trajectories of Frailty and Clinical Outcomes in Older Adults With Atrial Fibrillation: Insights From the Shizuoka Kokuho Database
Authors: Nakamaru Ryo , Nishimura Shiori , Kumamaru Hiraku , Shoji Satoshi , Nakatani Eiji , Yamamoto Hiroyuki , Miyachi Yoshiki , Miyata Hiroaki , Kohsaka Shun 
Published: June 2024

BACKGROUND:
The increasing prevalence of frailty has gained considerable attention due to its profound influence on clinical outcomes. However, our understanding of the progression of frailty and long-term clinical outcomes in older individuals with atrial fibrillation remains scarce.

METHODS:
Using data from 2012 to 2018 from a comprehensive claims database incorporating primary and hospital care records in Shizuoka, Japan, we selected patients aged ≥65 years with atrial fibrillation who initiated oral anticoagulant therapy. The trajectory of frailty was plotted using Sankey plots, illustrating the annual changes in their frailty according to the electronic frailty index during a 3-year follow-up after oral anticoagulant initiation, along with the incidence of clinical adverse outcomes. For deceased patients, we assessed their frailty status in the year preceding their death.

RESULTS:
Of 6247 eligible patients (45.1% women; mean age, 79.3±8.0 years) at oral anticoagulant initiation, 7.7% were categorized as fit (electronic frailty index, 0–0.12), 30.1% as mildly frail (>0.12–0.24), 35.4% as moderately frail (>0.24–0.36), and 25.9% as severely frail (>0.36). Over the 3-year follow-up, 10.4% of initially fit patients transitioned to moderately frail or severely frail. Conversely, 12.5% of severely frail patients improved to fit or mildly frail. Death, stroke, and major bleeding occurred in 23.4%, 4.1%, and 2.2% of patients, respectively. Among the mortality cases, 74.8% (N=1183) and 3.5% (N=55) had experienced moderately or severely frail and either a stroke or major bleeding in the year preceding their death, respectively.

CONCLUSIONS:
In a contemporary era of atrial fibrillation management, a minor fraction of older patients on oral anticoagulants died following a stroke or major bleeding. However, their frailty demonstrated a dynamic trajectory, and a substantial proportion of death was observed after transitioning to a moderately or severely frail state.
Childhood Opportunity and Acute Interstage Outcomes: A National Pediatric Cardiology Quality Improvement Collaborative Analysis
Authors: Zielonka Benjamin , Bucholz Emily M. , Lu Minmin , Bates Katherine E. , Hill Garick D. , Pinto Nelangi M. , Sleeper Lynn A. , Brown David W. 
Published: June 2024

BACKGROUND:
The interstage period after discharge from stage 1 palliation carries high morbidity and mortality. The impact of social determinants of health on interstage outcomes is not well characterized. We assessed the relationship between childhood opportunity and acute interstage outcomes.

METHODS:
Infants discharged home after stage 1 palliation in the National Pediatric Quality Improvement Collaborative Phase II registry (2016–2022) were retrospectively reviewed. Zip code–level Childhood Opportunity Index (COI), a composite metric of 29 indicators across education, health and environment, and socioeconomic domains, was used to classify patients into 5 COI levels. Acute interstage outcomes included death or transplant listing, unplanned readmission, intensive care unit admission, unplanned catheterization, and reoperation. The association between COI level and acute interstage outcomes was assessed using logistic regression with sequential adjustment for potential confounders.

RESULTS:

The analysis cohort included 1837 patients from 69 centers. Birth weight (
P
<0.001) and proximity to a surgical center at birth (
P
=0.02) increased with COI level. Stage 1 length of stay decreased (
P
=0.001), and exclusive oral feeding rate at discharge increased (
P
<0.001), with higher COI level. More than 98% of patients in all COI levels were enrolled in home monitoring. Death or transplant listing occurred in 101 (5%) patients with unplanned readmission in 987 (53%), intensive care unit admission in 448 (24%), catheterization in 345 (19%), and reoperation in 83 (5%). There was no difference in the incidence or time to occurrence of any acute interstage outcome among COI levels in unadjusted or adjusted analysis. There was no interaction between race and ethnicity and childhood opportunity in acute interstage outcomes.

CONCLUSIONS:
Zip code COI level is associated with differences in preoperative risk factors and stage 1 palliation hospitalization characteristics. Acute interstage outcomes, although common across the spectrum of childhood opportunity, are not associated with COI level in an era of highly prevalent home monitoring programs. The role of home monitoring in mitigating disparities during the interstage period merits further investigation.
Burnout Prevalence and Associated Factors Among Palliative and Hospice Care Professionals During the COVID-19 Endemic: An Exploratory Survey
Authors: Ng Wan Ru , Hamizah Nur , Chen Xiangyi , Yeo Zhi Zheng , Soh Keng Chuan , Chong Poh Heng 
Published: June 2024

Background Burnout is a significant issue for palliative and hospice professionals, exacerbated by the impact of Coronavirus Disease 2019 (COVID-19) on healthcare professionals. It is crucial to update our understanding of prevalence data, identify associated factors, and evaluate support resources during the COVID-19 pandemic. Methods We aimed to explore the prevalence of burnout among palliative and hospice care workers, 2 years into the COVID-19 pandemic by using the Maslach’s Burnout Inventory; anxiety, using General Anxiety Disorder-7 (GAD-7), workload, risk perception of COVID-19, confidence in protective measures (personal, workplace, and government), and usage and perceived helpfulness of support resources. Univariate logistic regression analysis was conducted to analyse burnout against these factors. Results Of the 115 respondents encompassing doctors, nurses and social workers (76.5% female; average age 40.9), 48.7% experienced burnout. Burnout correlated with increased anxiety, higher COVID-19 risk perception, heavier workload, and reduced confidence in protective measures. Peer support, COVID information, and psychological programs were rated as the most effective for coping. Conclusion The study indicates considerable levels of burnout among palliative and hospice care workers, linked to workload, anxiety, and perceived risk. Traditional mental health interventions had limited efficacy; respondents favoured peer support and organisational changes. The findings stress the need for a holistic approach, including diverse resources, workload management, and regular mental health assessments.
The Impact of Ketamine-Based Versus Non-Ketamine-Based ECT Anesthesia Regimens on the Severity of Patients’ Depression and Occurrence of Adverse Events: A Systematic Review with Meta-Analysis
Authors: Sicignano Dakota J. , Kantesaria Rohan , Mastropietro Matthew , Sedensky Ava , Kohlbrecher Roslyn , Hernandez Adrian V. , White C. Michael 
Published: June 2024

Objective: To compare efficacy and safety outcomes for ketamine anesthesia + electroconvulsive therapy (ECT) versus nonketamine anesthesia + ECT in treatment-resistant depression (TRD) patients. Data Sources: PubMed and Embase were searched from the earliest date through November 27, 2023. Study Selection and Data Extraction: Relevant randomized controlled trials (RCTs) of ketamine + ECT versus nonketamine anesthesia + ECT that reported data on remission (odds ratio [OR]), defined as a Hamilton Depression Rating Scale (HAM-D) and Montgomery-Asburg Depression Rating Scale (MADRS) score <8-10) and mean differences (MDs) in HAM-D scores after several ECT sessions were compared using inverse variance methods. The risk of bias (RoB) was assessed using the Cochrane RoB tool. Data Synthesis: Seventeen RCTs (RoB: Low N = 12, Moderate N = 2, High N = 3) with 1181 total patients met inclusion criteria. Patients receiving ECT experienced greater clinical remission (OR: 1.78, [95% confidence interval (CI): 1.08-2.93], I2 = 11%, N = 9) and lower HAM-D scores after the third through sixth ECT sessions as well as the eighth ECT session when ketamine versus nonketamine anesthesia was used. Ketamine use with ECT significantly increased fear with hallucinations (OR: 1.99, [95% CI: 1.11-3.58], I2 = 0%, N = 7) than with nonketamine anesthesia. Relevance to Patient Care and Clinical Practice: Selecting ketamine-based anesthesia could more quickly and profoundly enhance the beneficial effects of ECT for patients with severe TRD, but the balance of benefits to harm is unclear as there may be additional adverse events. Conclusion: Ketamine is a promising anesthesia adjunct to ECT that may enhance antidepressant effects in exchange for more adverse events.
Risk Factors of Poststroke Cognitive Impairment: A Meta-Analysis
Authors: Wang Jinyu , Cheng Guangyu , Yang Yuanyuan , Cheng Weiping 
Published: June 2024

Objective To explore the potential risk factors of post stroke cognitive impairment (PSCI) by conducting a meta-analysis. Methods Literature search was performed in databases (PubMed, Embase, Web of Science, CNKI) using keywords of PSCI. Cochrane ROB tool was adopted for evaluating the quality of the included studies. Afterwards, data was independently extracted by 2 investigators. Heterogeneity was quantified across studies by Chi-squared-based Q statistic test and I2 statistic. The random-effects model or fixed-effects model was employed to compute the pooled estimates depends on whether the heterogeneity was significant (I2 > 50% or P < .05) or not. Publication bias was evaluated by the funnel plot and Egger’s test. Sensitivity analysis was accomplished through eliminating studies 1 at a time to evaluate the stability of the pooled estimates. Results 23 high-quality studies with 13322 patients were included. Compared with patients with no cognitive impairment, PSCI was more likely to develop in the elderly (pooled MD = 3.58, 95% CI = [1.82, 5.34]), female (pooled RR = 1.23, 95% CI = [1.07, 1.41]), or less-educated (pooled MD = −1.63, 95% CI = [-2.96, −.31]) patients with a history of hypertension (pooled RR = 1.07, 95% CI = [1.03, 1.11]), diabetes mellitus (pooled RR = 1.10, 95% CI = [1.03, 1.17]), atrial fibrillation (pooled RR = 1.38, 95% CI = [1.10, 1.74]), or stroke (pooled RR = 1.36, 95% CI = [1.09, 1.70]). Smoking did not affect the development of PSCI in patients (pooled RR = .96, 95% CI = [.78, 1.19]). Ischemic heart disease and region represented the sources of significant heterogeneity across studies. The pooled estimates were robust, and no publication bias was seen. Conclusion Age, gender, education, hypertension, diabetes mellitus, atrial fibrillation, and stroke were the risk factors of PSCI. Controlling these risk factors can help prevent PSCI.
A Survey of Manual Therapy Techniques and Protocols Used to Prevent or Treat Dysphagia in Head and Neck Cancer Patients During and after Radiation Therapy
Authors: Daniels Kadesh , Chanda Anindita , Berry Lucas , Edke Arpita , Patel Parth , Wun Andy , Krisciunas Gintas P. 
Published: June 2024

Background Authoritative research demonstrating efficacy of traditional dysphagia therapy for Head & Neck Cancer (HNC) patients is limited. A 2019 survey reported speech-language-pathologists (SLPs) have started using Manual Therapy (MT) to prevent or rehabilitate dysphagia in HNC patients. This application of MT is supported theoretically but no research has established efficacy. Further, specific contents of MT protocols employed in this setting remain unknown. Objectives In the absence of HNC dysphagia specific MT protocols, this study aimed to better understand MT protocols employed by SLPs to prevent and treat dysphagia in HNC patients during and after Radiation Therapy (RT). Methods An internet-based questionnaire for SLPs who use MT with HNC patients was developed and tested for face/content validity. It was sent to SLPs practicing in the USA, twice, through three national listservs (ASHA-SIG13, ASHA-SIG3, University of Iowa Voiceserv). Results Of 64 respondents, 44 completed the survey. Of the 44, 15(34%) provided proactive MT during RT, 37(84%) provided proactive MT after RT (to prevent dysphagia), and 44(100%) provided reactive MT after RT (to treat dysphagia). 40(91%) were trained in MT through a CE course and 25(57%) had HNC-specific MT training. The most common MT techniques were laryngeal manipulation (LM) and myofascial release (MFR). During RT, MT protocols are gentler and highly tailored, with simple home programs of mild intensity. After RT, protocols are more regimented and aggressive, but still highly customized, with more diverse home programs of at least moderate intensity. Conclusion MT for HNC patients lacks a standard protocol or approach, but MFR and LM, or components of those techniques, are used most frequently. Given the frequency with which MFR and LM are employed to treat dysphagia during and post-RT, and the lack of empirical evidence supporting or refuting their use, a collaboratively designed RCT is warranted to establish the safety and efficacy of MT for HNC patients.
Pathogenic mechanisms of cardiovascular damage in COVID-19
Authors: Shao Hong-Hua , Yin Rui-Xing 
Published: June 2024

Abstract
Background
COVID-19 is a new infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Since the outbreak in December 2019, it has caused an unprecedented world pandemic, leading to a global human health crisis. Although SARS CoV-2 mainly affects the lungs, causing interstitial pneumonia and severe acute respiratory distress syndrome, a number of patients often have extensive clinical manifestations, such as gastrointestinal symptoms, cardiovascular damage and renal dysfunction.

Purpose
This review article discusses the pathogenic mechanisms of cardiovascular damage in COVID-19 patients and provides some useful suggestions for future clinical diagnosis, treatment and prevention.

Methods
An English-language literature search was conducted in PubMed and Web of Science databases up to 12th April, 2024 for the terms “COVID-19”, “SARS CoV-2”, “cardiovascular damage”, “myocardial injury”, “myocarditis”, “hypertension”, “arrhythmia”, “heart failure” and “coronary heart disease”, especially update articles in 2023 and 2024. Salient medical literatures regarding the cardiovascular damage of COVID-19 were selected, extracted and synthesized.

Results
The most common cardiovascular damage was myocarditis and pericarditis, hypertension, arrhythmia, myocardial injury and heart failure, coronary heart disease, stress cardiomyopathy, ischemic stroke, blood coagulation abnormalities, and dyslipidemia. Two important pathogenic mechanisms of the cardiovascular damage may be direct viral cytotoxicity as well as indirect hyperimmune responses of the body to SARS CoV-2 infection.

Conclusions
Cardiovascular damage in COVID-19 patients is common and portends a worse prognosis. Although the underlying pathophysiological mechanisms of cardiovascular damage related to COVID-19 are not completely clear, two important pathogenic mechanisms of cardiovascular damage may be the direct damage of the SARSCoV-2 infection and the indirect hyperimmune responses.