bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunotherapy in Stage III–IV Colon Cancer: A Propensity Score-Matched Analysis of the National Cancer Database
Authors: Horesh Nir , Emile Sameh H. , Garoufalia Zoe , Gefen Rachel , Zhou Peige , Nagarajan Arun , Wexner Steven D. 
Published: April 2024

Summary:
Immunotherapy for the systemic treatment of cancer offers new treatment possibilities for advanced malignancies. Despite promising initial results, evidence on efficacy of immunotherapy for colon cancer is lacking. Thus, we aimed to assess short-term and long-term outcomes of immunotherapy in patients with advanced colon cancer. A US National Cancer Database was searched for patients with stage III–IV colonic adenocarcinoma between 2010 and 2019. Propensity score matching was used to classify the cohort into 2 groups: patients who received immunotherapy and controls. Main outcome measures were primary outcome was overall survival (OS). A total of 23,778 patients with stage III–IV colonic adenocarcinoma were treated with immunotherapy during the study period compared to 114,753 controls. Immunotherapy treated patients were younger (median age 61 vs. 67 y; P<0.001), more often male (57.3% vs. 50.7%, P<0.001), had more private insurance (44.1% vs. 33.7%; P<0.001), had more left-sided tumors (49.5% vs. 39.1%; P<0.001) and liver metastasis (80.2% vs. 61.7%; P<0.001) than controls. Immunotherapy patients received more standard chemotherapy (49.8% vs. 41.6%; P<0.001). After propensity-score matching, mean OS was significantly shorter in the immunotherapy group compared with controls (34.7 vs. 36.2 mo; P=0.008). Cox regression analysis demonstrated that immunotherapy was associated with increased risk for mortality (HR: 1.1; 95% CI: 1.02–1.18; P=0.005). Patients who received immunotherapy had lower 90-day mortality rates compared with controls (2.3% vs. 3.6%; P=0.004), but the groups had equivalent 30-day mortality rates (0.7% vs. 0.8%; P=0.76). Immunotherapy showed no improvement in OS in patients with stage III–IV colon cancer.
Establishing national reference materials for genetic testing of cytochrome P450
Authors: Jia Zheng , Huang Junju , Yang Ying , Yang Yong , Lin Wei , Qu Shoufang , Sun Nan , Zhang Wenxin , Han Lulu , Huang Jie 
Published: April 2024

Objectives
Reference materials for in-vitro diagnostic reagents play a critical role in determining the quality of reagents and ensuring the accuracy of clinical test results. This study aimed to establish a national reference material (NRM) for detecting cytochrome P450 (CYP) genes related to drug metabolism by screening databases on the Chinese population to identify CYP gene polymorphism characteristics.

Methods
To prepare the NRM, we used DNA extracted from healthy human immortalized B lymphoblastoid cell lines as the raw material. Samples of these cell lines were obtained from the Chinese Population PGx Gene Polymorphism Biobank. Further, we used Sanger sequencing, next-generation sequencing, and commercial assay kits to validate the polymorphic genotypes.

Results
Among the CYP superfamily genes, we confirmed 24 riboswitch loci related to drug metabolism, with evidence levels of 1A, 2A, 3, and 4. We confirmed the polymorphic loci and validated their genotypes using various sequencing techniques. Our results were consistent with the polymorphism information of samples obtained from the biobank, thus demonstrating high precision and stability of the established NRM.

Conclusion
An NRM (360 056–202 201) for CYP genetic testing covering 24 loci related to drug metabolism was established and approved to assess in-vitro diagnostic reagents containing CYP family gene polymorphisms and perform clinical inter-room quality evaluations.
Repeated Fluid Accumulation around a Breast Implant Related to Synovial Metaplasia of the Capsule
Authors: Honda Ayano , Tsuge Itaru , Kitamura Kyohei , Ito Hiroaki , Yamanaka Hiroki , Katsube Motoki , Sakamoto Michiharu , Morimoto Naoki 
Published: April 2024

Summary:
We must take special care when treating postoperative fluid accumulation around breast implants (BIs) to exclude any serious complications, including BI-associated anaplastic large cell lymphoma. However, most late-onset fluid accumulation is caused by other conditions, such as traumatic hematoma and residual postoperative seroma. Surgeons must choose whether to conservatively observe or remove such BIs, while also determining whether to perform partial capsulectomy or total capsulectomy to solve the problem of fluid accumulation. We treated a 72-year-old woman who noticed swelling in her right breast 4 years after undergoing bilateral BI reconstruction. Before she was referred to our hospital, the fluid had been drained by needle aspiration five times, but the swelling returned to a similar size within a month. No malignant findings were observed by needle-aspirated cytology or flow cytometry. The patient requested the simultaneous removal of the left BI. Therefore, we performed both BI removal with total capsulectomy on the right side and partial capsulectomy of the superficial layer on the left side. A pathological examination of the capsule on the right side indicated a chronic expanding hematoma and synovial metaplasia characterized by papillary projections rich in CD68-positive cells, thus indicating reactive synovial cells. In contrast, the left superficial capsule was much thinner and showed less synovial metaplasia. Our findings indicate the advantages of total capsulectomy to solve the problem of repeated serous fluid accumulation around BIs, according to histological changes in the capsule.
Poor Psychosocial Safety Climate Increases Teleworker Vulnerability to Suicidal Ideation
Authors: Kikunaga Kazuki , Nakata Akinori , Tondokoro Tsukumi , Dollard Maureen 
Published: April 2024

Objective
Suicide is the leading cause of death among the working-age population in Japan. Unlike task-level occupational factors, the relation between suicidal ideation and psychosocial safety climate (PSC), a crucial organization-level factor to protect workers’ psychological health, is understudied, especially among teleworkers.

Methods
A cross-sectional web-based survey was used to select 1988 participants. A series of multivariable logistic regression analyses with the interaction term of PSC and teleworking arrangements was performed.

Results
Poor PSC was associated with a higher risk of having suicidal ideation (adjusted odds ratio = 1.57, P = 0.008), and its relation was pronounced among teleworkers (adjusted odds ratio for the interaction term = 1.96, P = 0.035), even after adjusting for task-level occupational factors.

Conclusions
This empirical study highlights the heightened risk of suicidal ideation by poor PSC, especially among teleworkers.
Teaching Future Physician Assistants to Provide ADEPT-CARE to Disabled Patients: A Novel Application of Disability Curriculum
Authors: Smeltz Lydia , Whitney Larissa , King Tonya , Newcomb Nora , DeWaters Ami L. 
Published: April 2024

Introduction
Physician assistant (PA) students will be certain to provide care to patients with disabilities in their future careers. However, there is a dearth of literature on disability-related education in PA training. This curriculum sought to fill this need. The specific aims of this study were to (1) evaluate the implementation of a 3-part disability-focused education curriculum in PA education, (2) assess changes in PA students' self-perceived confidence and attitudes toward patients with disabilities, and (3) assess students' attitudes toward ADEPT-CARE.

Methods
A 3-part disability curriculum was implemented into the first-year PA curriculum at a single Mid-Atlantic institution. Students could voluntarily complete pre and post-surveys which assessed their self-perceived confidence and attitudes toward people with disabilities, perception of the curriculum, and attitudes toward ADEPT-CARE and disability health.

Results
Thirty students participated in the study, with a 100% survey response rate. Nearly all participants agreed or strongly agreed that this curriculum enhanced their medical education (n = 28, 96.6%, frequency missing n = 1). After curriculum completion, there was a statistically significant improvement in participants' confidence in their ability to assess patients with disability (46.7%–93.3%, P < 0.001), ability to provide the same quality of care to patients with disability as those without disability (80.0%–96.7%, P = 0.025), and perception of quality of life of persons with disabilities (P = 0.030).

Discussion
This curriculum was well received by PA students and improved their attitudes toward patients with disabilities, thereby fulfilling a critical need for PA educators.
A Guide to Innovation in Physician Associate/Assistant Education: Using Instructional Technology for Improved Engagement
Authors: Massey Amy , Stephens Ben 
Published: April 2024

Abstract
For physician associate/assistant (PA) educators, the path of least resistance often is to focus our cognitive energies on topics with which we are most comfortable and to deliver content in the style in which we are most accustomed. The consequence of this approach is that many didactic curricula are delivered in a traditional, lecture-based format, which then aligns with how the faculty were taught. Studies show that lecture-based teaching may not be the most effective and that blending teaching modalities can improve knowledge acquisition. In addition, scheduling several classroom lectures week to week can be challenging, especially in a program that uses numerous guest lecturers to deliver the curriculum. One solution to this problem may be through innovative, engaging resources that enable faculty to deliver content asynchronously. Developing and implementing such tools can be challenging to PA faculty because they are often not formally trained in education nor are they up to date on the most current innovations in educational technology. Furthermore, change can be difficult, and it could seem an insurmountable feat to step outside the comfort zone of a traditional lecture. This work describes a collaboration between PA faculty and a University Instructional Support Specialist where the Analysis, Design, Develop, Implement, Evaluate ADDIE model, a widely used system for developing training tools, was used to create an asynchronous lecture for students in the form of an interactive series of modules to replace a traditional classroom lecture.
Clot removAl with or without decompRessive craniectomy under ICP monitoring for supratentorial IntraCerebral Hemorrhage (CARICH): a randomized controlled trial
Authors: Zhang Chao , Zhang Shuixian , Yin Yi , Wang Long , Li Lan , Lan Chuan , Shi Jiantao , Jiang Zhouyang , Ge Hongfei , Li Xuegang , Ao Zaiyong , Hu Shengli , Chen Jingyu , Feng Hua , Hu Rong 
Published: April 2024

Background:
Decompressive craniectomy (DC), a surgery to remove part of the skull and open the dura mater, maybe an effective treatment for controlling intracranial hypertension. It remains great interest to elucidate whether DC is beneficial to intracerebral hemorrhage (ICH) patients who warrant clot removal (CR) to prevent intracranial hypertension.

Methods:
The trial was a prospective, pragmatic, controlled trial involving adult patients with ICH who were undergoing removal of hematoma. ICH patients were randomly assigned at a 1:1 ratioto undergo CR with or without DC under the monitoring of intracranial pressure. The primary outcome was the proportion of unfavorable functional outcome (modified Rankin Scale 3–6) at 3 months. Secondary outcomes included the mortality at 3 months and the occurrence of reoperation.

Results:
A total of 102 patients were assigned to the CR with DC group and 102 to the CR group. Median hematoma volume was 54.0 ml (range 30–80 ml) and median preoperative Glasgow Coma Scale was 10 (range 5–15). At 3 months, 94 patients (92.2%) in CR with DC group and 83 patients (81.4%) in the CR group had unfavorable functional outcome (P=0.023). Fourteen patients (13.7%) in the CR with DC group died versus five patients (4.9%) in the CR group (P=0.030). The number of patients with reoperation was similar between the CR with DC group and CR group (5.9 vs. 3.9%; P=0.517). Postoperative intracranial pressure values were not significantly different between two groups and the mean values were less than 20 mmHg.

Conclusions:
CR without DC decreased the rate of modified Rankin Scale score of 3–6 and mortality in patients with ICH, compared with CR with DC.
Assessment of Gender Differences in Letters of Recommendation for Physical Therapy Residency Applications
Authors: Calley Darren Q. , Fu Sunyang , Hamilton Marissa D. , Kalla Austin W. , Lee Christopher K. , Rasmussen Veronica A. , Hollman John H. , Liu Hongfang 
Published: April 2024

Introduction.
Letters of recommendation (LOR) are an integral component of physical therapy residency applications. Identifying the influence of applicant and writer gender in LOR will help identify whether potential implicit gender bias exists in physical therapy residency application processes.

Review of Literature.
Several medical and surgical residency education programs have reported positive, neutral, or negative LOR female gender bias among applicants and writers. Little research exists on gender differences in LOR to physical therapy education programs or physical therapy residency programs.

Subjects.
Seven hundred sixty-eight LOR were analyzed from 256 applications to 3 physical therapy residency programs (neurologic, orthopaedic, sports) at one institution from 2014 to 2020.

Methods.
Thematic categories were developed to identify themes in a sample of LOR. Associations between writer and applicant gender were analyzed using summary statistics, word counts, thematic and psycholinguistic extraction, and rule-based and deep learning Natural Language Processing .

Results.
No significant difference in LOR word counts were found based on writer or applicant gender. Increased word counts were seen in sports residency LOR compared with the orthopaedic residency. Thematic analysis showed LOR gender differences with male applicants receiving more positive generalized recommendations and female applicants receiving more comments regarding interpersonal relationship skills. No thematic or psycholinguistic gender differences were seen by LOR writer. Male applicants were 1.9 times more likely to select all male LOR writers, whereas female applicants were 2.1 times more likely to choose all female LOR writers.

Discussion and Conclusion.
Gender differences in LORs for physical therapy residencies were found using a comprehensive Natural Language Processing approach that identified both a positive recommendation male applicant gender bias and a positive interpersonal relationship skill female applicant gender bias. Applicants were not harmed nor helped by selecting LOR writers of the opposite gender. Admissions committees and LOR writers should be mindful of potential implicit gender biases in LOR submitted to physical therapy residency programs.
Comparative study between remifentanil (or fentanyl) and dexmedetomidine for the analgesia of rhinoplasty: A meta-analysis of randomized controlled trials
Authors: Yang Jiao , Wu Xuejun , Nie Jinfeng 
Published: April 2024

Background:
Remifentanil (or fentanyl) and dexmedetomidine may have some potential to improve the analgesia of rhinoplasty, and this meta-analysis aims to compare their efficacy for the analgesia of rhinoplasty.

Methods:
PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were systematically searched, and we included randomized controlled trials (RCTs) assessing the analgesic effect of remifentanil (or fentanyl) versus dexmedetomidine for rhinoplasty.

Results:
Four RCTs were finally included in the meta-analysis. In patients undergoing rhinoplasty, remifentanil (or fentanyl) infusion and dexmedetomidine infusion resulted in similar good patient satisfaction (odd ratio [OR] = 2.71; 95% confidence interval [CI] = 0.63 to 11.64; P = .18), good surgeon satisfaction (OR = 1.68; 95% CI = 0.02 to 181.40; P = .83), extubation time (mean difference [MD] = 7.56; 95% CI = −11.00 to 26.12; P = .42), recovery time (MD = −2.25; 95% CI = −23.41 to 18.91; P = .83), additional analgesic requirement (OR = 0.16; 95% CI = 0 to 8.65; P = .37) and adverse events (OR = 8.50; 95% CI = 0.47 to 153.30; P = .15).

Conclusions:
Remifentanil (or fentanyl) and dexmedetomidine may have comparable analgesia for patients undergoing rhinoplasty.
Bibliometric and visualization analysis of risk management in the doctor–patient relationship: A systematic quantitative literature review
Authors: Li Hui , Zhang Chenchen , Li Limin , Liu Tong , Zhang Liping , Hao Jiqing , Sun Jiangjie 
Published: April 2024

Objectives:
This paper analyzed the research on risk management in the doctor–patient relationship (DPR) based on a systematic quantitative literature review approach using bibliometric software. It aims to uncover potential information about current research and predict future research hotspots and trends.

Methods:
We conducted a comprehensive search for relevant publications in the Scopus database and the Web of Science Core Collection database from January 1, 2000 to December 31, 2023. We analyzed the data using CiteSpace 6.2.R2 and VOSviewer 1.6.19 software to examine the annual number of publications, countries/regions, journals, citations, authors, and keywords in the field.

Results:
A total of 553 articles and reviews that met the criteria were included in this study. There is an overall upward trend in the number of publications issued; in terms of countries/regions, the United States and the United Kingdom are the largest contributors; Patient Education and Counseling is the most productive journal (17); Physician communication and patient adherence to treatment: a meta-analysis is the most cited article (1637); the field has not yet to form a stable and obvious core team; the analysis of high-frequency keywords revealed four main research directions: the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor–patient risk characteristics; the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor–patient risk characteristics; the keyword burst analysis revealed several shifts in the research hotspots for risk management in the DPR, suggesting that chronic disease management, is a future research direction for the continued development of risk management in the DPR.

Conclusions:
The visualization analysis of risk management literature in the DPR using CiteSpace and VOSviewer software provides insights into the current research status and highlights future research directions.
Acupuncture therapy for isolated ischemic oculomotor nerve palsy: A case report
Authors: Xu Guan , He Kelin , Ye Xiao , Ning Songhao , Zhang Quanai 
Published: April 2024

Background:
Isolated ischemic oculomotor nerve palsy as a type of ophthalmic disease is rarely observed in clinical practice. Quality of life is frequently impacted by isolated ischemic oculomotor nerve palsy due to its lack of treatment options and long-term visual impairment. We describe an acupuncture-treated instance of isolated ischemic oculomotor paralysis.

Methods:
Acupoints including Jingming (BL 1), Chengqi (ST 1), Cuanzhu (BL 2), and Sizhukong (TE 23) on the right side, and bilateral Fengchi (GB 20), Waiguan (TE 5), Hegu (LI 4), and Zulinqi (GB 41) were selected for needling. Each treatment lasted for 30 minutes, once every other day. Acupuncture treatment was administered for a total of 11 times.

Results:
Acupuncture is a promising treatment option for isolated ischemic oculomotor nerve palsy.

Conclusions:
Ischemic oculomotor nerve paralysis can affect the quality of life of patients. Acupuncture intervention can promote the recovery of the disease is a very effective treatment measure.
Over-the-scope clip as a rescue treatment for massive bleeding due to Dieulafoy lesion at the colorectal anastomosis: A case report
Authors: Han Ping , Li Demin , Guo Qiaozhen , Lei Yu , Liu Jingmei , Tian Dean , Yan Wei 
Published: April 2024

Rationale:
The bleeding of Dieulafoy lesion predominantly involves the proximal stomach and leads to severe gastrointestinal bleeding. However, these lesions have also been reported in the whole gastrointestinal tract. Bleeding of Dieulafoy lesions at the anastomosis was seldomly reported and was very easy to be ignored clinically.

Patient concerns:
We describe a 72-year-old woman with a past history of surgery for rectal carcinoma hospitalized with chief complaint of massive rectal bleeding. No gross bleeding lesion was found during the first emergency colonoscopy. Despite multiple blood transfusions, her hemoglobin rapidly dropped to 5.8 g/dL.

Diagnosis:
She was diagnosed with Dieulafoy lesion at the colorectal anastomosis during the second emergency colonoscopy.

Interventions:
Primary hemostasis was achieved by endoscopic hemostatic clipping. However, she experienced another large volume hematochezia 3 days later, and then received another endoscopic hemostatic clipping. She was improved and discharged. However, this patient underwent hematochezia again 1 month later. Bleeding was arrested successfully after the over-the-scope clip (OTSC) was placed during the fourth emergency colonoscopy.

Outcomes:
This patient underwent 4 endoscopic examinations and treatments during 2 hospitalizations. The lesion was overlooked during the first emergency colonoscopy. The second and third endoscopes revealed Dieulafoy lesion at the colorectal anastomosis and performed endoscopic hemostatic clippings, but delayed rebleeding occurred. The bleeding was stopped after the fourth emergency colonoscopy using OTSC. There was no further rebleeding during hospitalization and after 2-year of follow-up.

Lessons:
As far as we know, there is no reported case of lower gastrointestinal bleeding caused by Dieulafoy lesion at the colorectal anastomosis, OTSC is a safe and effective rescue treatment for Dieulafoy lesions.
Endoscopic submucosal dissection for the treatment of a large inflammatory fibroid polyp in the gastric antrum prolapsing into the duodenum: A case report
Authors: Wang Xiaoyun , Ma Ru , Ma Jizhou , Tang Na , Li Rui , Ma Xiaojin 
Published: April 2024

Rationale:
Inflammatory fibroid polyp (IFP), also known as Vanek tumor, is a rare, benign gastrointestinal lesion characterized by its inflammatory and fibroid histological features. IFP is often discovered incidentally during endoscopic examinations. It is exceedingly rare for an IFP to prolapse into the duodenum and results in incomplete obstruction of the pylorus.

Patient concerns:
A 64-year-old male patient was admitted to the hospital with recurrent episodes of melena over a 6-month period, along with complaints of dizziness and fatigue in the past 10 days.

Diagnoses:
Gastroscopy showed a giant polypoid mass on the posterior wall of the gastric antrum, prolapsing into the duodenum. Abdominal computer tomography (CT) confirmed the tumor protruding into the duodenum. Pathologic examination of the resected specimen confirmed the IFP diagnosis.

Interventions:
The giant tumor was completely and successfully excised using endoscopic submucosal dissection (ESD). After the surgery, the patient underwent acid suppression and fluid replenishment therapy.

Outcomes:
The patient responded well to ESD and was discharged in stable condition. As of the submission of the case report, there has been no recurrence of the tumor after a 5-month follow-up, and the patient is still under follow-up.

Lessons:
While IFPs have traditionally been managed surgically, ESD demonstrates promising treatment outcomes, avoiding the need for surgical distal gastrectomy, and emerges as a safe and effective treatment option.