bluuebunny/crossref_metadata_2025_split huggingface dataset:
In Search of a “Metric System” for Measuring Faculty Effort: A Qualitative Study on Educational Value Units at U.S. Medical Schools
Authors: Maggio Lauren A. , Costello Joseph A. , Kolars Joseph C. , Cervero Ronald M. , Jackson Kevin M. , Durning Steven J. , Ma TingLan 
Published: April 2024

Abstract

Purpose
Faculty at academic health centers (AHCs) are charged with engaging in educational activities. Some faculty have developed educational value units (EVUs) to track the time and effort dedicated to these activities. Although several AHCs have adopted EVUs, there is limited description of how AHCs engage with EVU development and implementation. This study aimed to understand the collective experiences of AHCs with EVUs to illuminate benefits and barriers to their development, use, and sustainability.

Method
Eleven faculty members based at 10 AHCs were interviewed between July and November 2022 to understand their experiences developing and implementing EVUs. Participants were asked to describe their experiences with EVUs and to reflect on benefits and barriers to their development, use, and sustainability. Transcripts were analyzed using thematic analysis.

Results
EVU initiatives have been designed and implemented in a variety of ways, with no AHCs engaging alike. Despite differences, the authors identified shared themes that highlighted benefits and barriers to EVU development and implementation. Within and between these themes, a series of tensions were identified in conjunction with the ways in which AHCs attempted to mitigate them. Related to barriers, the majority of participants abandoned or paused their EVU initiatives; however, no differences were identified between those AHCs that retained EVUs and those that did not.

Conclusions
The collective themes identified suggest that AHCs implementing or sustaining an EVU initiative would need to balance benefits and barriers in light of their unique context. Study findings align with reviews on EVUs and provide additional nuance related to faculty motivation to engage in education and the difficulties of defining EVUs. The lack of differences observed between those AHCs that retained EVUs and those that did not suggests that EVUs may be challenging to implement because of the complexity of AHCs and their faculty.
Hypotension Prediction Index Is Equally Effective in Predicting Intraoperative Hypotension during Noncardiac Surgery Compared to a Mean Arterial Pressure Threshold: A Prospective Observational Study
Authors: Mulder Marijn P. , Harmannij-Markusse Mirjam , Fresiello Libera , Donker Dirk W. , Potters Jan-Willem 
Published: April 2024

Background
The Hypotension Prediction Index is designed to predict intraoperative hypotension in a timely manner and is based on arterial waveform analysis using machine learning. It has recently been suggested that this algorithm is highly correlated with the mean arterial pressure itself. Therefore, the aim of this study was to compare the index with mean arterial pressure–based prediction methods, and it is hypothesized that their ability to predict hypotension is comparable.

Methods
In this observational study, the Hypotension Prediction Index was used in addition to routine intraoperative monitoring during moderate- to high-risk elective noncardiac surgery. The agreement in time between the default Hypotension Prediction Index alarm (greater than 85) and different concurrent mean arterial pressure thresholds was evaluated. Additionally, the predictive performance of the index and different mean arterial pressure–based methods were assessed within 5, 10, and 15 min before hypotension occurred.

Results
A total of 100 patients were included. A mean arterial pressure threshold of 73 mmHg agreed 97% of the time with the default index alarm, whereas a mean arterial pressure threshold of 72 mmHg had the most comparable predictive performance. The areas under the receiver operating characteristic curve of the Hypotension Prediction Index (0.89 [0.88 to 0.89]) and concurrent mean arterial pressure (0.88 [0.88 to 0.89]) were almost identical for predicting hypotension within 5 min, outperforming both linearly extrapolated mean arterial pressure (0.85 [0.84 to 0.85]) and delta mean arterial pressure (0.66 [0.65 to 0.67]). The positive predictive value was 31.9 (31.3 to 32.6)% for the default index alarm and 32.9 (32.2 to 33.6)% for a mean arterial pressure threshold of 72 mmHg.

Conclusions
In clinical practice, the Hypotension Prediction Index alarms are highly similar to those derived from mean arterial pressure, which implies that the machine learning algorithm could be substituted by an alarm based on a mean arterial pressure threshold set at 72 or 73 mmHg. Further research on intraoperative hypotension prediction should therefore include comparison with mean arterial pressure–based alarms and related effects on patient outcome.

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Radiation Proctitis in Patients With Locally Advanced Cervical Cancer Treated by Chemoradiation
Authors: Sauvage Louis-Marie , Bentahila Rita , Tran Yohan , Guénégou-Arnoux Armelle , Fabiano Emmanuelle , Bats Anne-Sophie , Borghese Bruno , Durdux Catherine 
Published: April 2024

Background:
Radiation proctitis is a misunderstanding complication of chemoradiation in locally advanced cervical cancer. The objective of our study is to provide a detailed description and analysis of predictive factors associated with radiation proctitis in a retrospective cohort of patients treated by chemoradiation for locally advanced cervical cancer.

Methods:
All patients treated by exclusive chemoradiation or chemoradiation followed by brachytherapy for locally advanced cervical cancer from 2011 to 2017 were included in the study. A bivariate analysis was conducted to establish correlations between the occurrence of radiation proctitis and various clinical and technical variables.

Results:
A total of 128 patients were included in the study. The mean dose (SD) to the planning target volume was 47.1 Gy (6.2). Fifty-nine (46.1%) patients underwent brachytherapy. Sixteen patients (12.5%) developed radiation proctitis, grade 2 or higher in 12 patients (9.3%). In univariate analysis, anticoagulant or antiplatelet treatments (P=0.039), older age (P=0.049), rectal volume irradiated at 40 Gy (P=0.01) and 30 Gy (P=0.037) were significantly associated with the occurrence of a grade ≥2 radiation proctitis. The delivered dose to 2 cm3 of rectum (D2cm3) showed a potential association with the occurrence of radiation proctitis of all grades (P=0.064).

Conclusion:
This study highlights clinical and technical factors that should be considered in assessing the risk of radiation proctitis. These results contribute to a better understanding of this complication.
Implementation and Mixed-Methods Assessment of an Early Mobility Interprofessional Education Simulation
Authors: Smith Leslie M. , Campbell Denise , Prush Nicholas , Trojanowski Suzanne , Sherman Erica , Yost Elizabeth 
Published: April 2024

Introduction
Extended periods of bed rest and mechanical ventilation (MV) have devastating effects on the body.

Background
Early mobility (EM) for patients in respiratory failure is safe and feasible, and an interprofessional team is recommended. Using simulation to train EM skills improves student confidence. The purpose of this study was to enable health care student collaboration as an interprofessional team in providing safe management and monitoring during an EM simulation for a patient requiring MV.

Methods
Nursing (n = 33), respiratory (n = 7), occupational (n = 24), and physical therapist students (n = 55) participated in an EM interprofessional education (IPE) simulation experience. A mixed-methods analytic approach was used with pre/post quantitative analysis of the Student Perceptions of Interprofessional Clinical Education—Revised, Version 2 instrument and qualitative analysis of students' guided reflection papers.

Results
Pre/post surveys completion rate was 39.5% (n = 47). The Student Perceptions of Interprofessional Clinical Education—Revised, Version 2 instrument indicated a significant improvement (P = .037) in students' perceptions of interprofessional collaborative practice. Qualitative data showed a positive response to the EM simulation IPE. Themes reflected all 4 Interprofessional Education Collaborative competencies.

Discussion
This study demonstrated improved perception of interprofessional collaborative practice and better understanding of the Interprofessional Education Collaborative competencies.

Conclusion
Students collaborated in the simulation-based IPE to provide EM for a patient requiring MV and reported perceived benefits of the experience.
Nuclear KRT19 is a transcriptional corepressor promoting histone deacetylation and liver tumorigenesis
Authors: Han Shixun , Fan Haonan , Zhong Guoxuan , Ni Lei , Shi Wenhao , Fang Yushan , Wang Chenliang , Wang Li , Song Lang , Zhao Jianhui , Tang Mei , Yang Bing , Li Li , Bai Xueli , Zhang Qi , Liang Tingbo , Xu Yanhui , Feng Xin-Hua , Ding Chen , Fang Dong , Zhao Bin 
Published: April 2024

Background and Aims:
Epigenetic reprogramming and escape from terminal differentiation are poorly understood enabling characteristics of liver cancer. Keratin 19 (KRT19), classically known to form the intermediate filament cytoskeleton, is a marker of stemness and worse prognosis in liver cancer. This study aimed to address the functional roles of KRT19 in liver tumorigenesis and to elucidate the underlying mechanisms.

Approach and Results:
Using multiplexed genome editing of hepatocytes in vivo, we demonstrated that KRT19 promoted liver tumorigenesis in mice. Cell fractionation revealed a previously unrecognized nuclear fraction of KRT19. Tandem affinity purification identified histone deacetylase 1 and REST corepressor 1, components of the corepressor of RE-1 silencing transcription factor (CoREST) complex as KRT19-interacting proteins. KRT19 knockout markedly enhanced histone acetylation levels. Mechanistically, KRT19 promotes CoREST complex formation by enhancing histone deacetylase 1 and REST corepressor 1 interaction, thus increasing the deacetylase activity. ChIP-seq revealed hepatocyte-specific genes, such as hepatocyte nuclear factor 4 alpha (HNF4A), as direct targets of KRT19-CoREST. In addition, we identified forkhead box P4 as a direct activator of aberrant KRT19 expression in liver cancer. Furthermore, treatment of primary liver tumors and patient-derived xenografts in mice suggest that KRT19 expression has the potential to predict response to histone deacetylase 1 inhibitors especially in combination with lenvatinib.

Conclusions:
Our data show that nuclear KRT19 acts as a transcriptional corepressor through promoting the deacetylase activity of the CoREST complex, resulting in dedifferentiation of liver cancer. These findings reveal a previously unrecognized function of KRT19 in directly shaping the epigenetic landscape in cancer.
Efficacy and safety of stem cells in the treatment of ischemic stroke: A meta-analysis
Authors: Xiong Yu , Guo Xiumei , Gao Wen , Ke Chuhan , Huang Xinyue , Pan Zhigang , Chen Chunhui , Zheng Hanlin , Hu Weipeng , Zheng Feng , Yao Hao 
Published: April 2024

Background:
Stem cell therapy on ischemic stroke has long been studied using animal experiments. The efficacy and safety of this treatment in ischemic stroke patients remain uncertain.

Methods:
We searched for all clinical randomized controlled trials published before October 2023, on PubMed, EMBASE, and the Cochrane Library using predetermined search terms, and performed a meta-analysis of the efficacy of stem cell therapy in ischemic stroke patients.

Results:
13 studies that included 592 ischemic stroke patients were reviewed. The mRS (MD −0.32, 95% CI −0.64 to 0.00, I
2 = 63%, P = .05), NIHSS (MD −1.63, 95% CI −2.69 to −0.57, I
2 = 58%, P = .003), and BI (MD 14.22, 95% CI 3.95–24.48, I
2 = 43%, P = .007) showed effective stem cell therapy. The mortality (OR 0.42, 95% CI 0.23–0.79, I
2 = 0%, P = .007) showed improved prognosis and reduce mortality with stem cell therapy.

Conclusion:
Stem cell therapy reduces mortality and improves the neurological prognosis of ischemic stroke patients. However, due to the different types of stem cells used and the limited data in the reported studies, the safety of clinical applications of stem cells in patients with ischemic stroke must be carefully evaluated. Future randomized controlled trials with large sample sizes from controlled cell sources are warranted to validate this finding.
Unmasking a hidden culprit: late-presenting congenital diaphragmatic hernia beyond infancy: A case report and literature review
Authors: Koh Wen-Harn , Ko Po-Jui , Su Yu-Tsun , Tsai Yu-Cheng , Kek Ho-Poh , Tsai Ching-Chung 
Published: April 2024

Background:
Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with abnormal diaphragm development, typically diagnosed prenatally or soon after birth. Late-presenting CDH presents diagnostic challenges due to nonspecific symptoms that can lead to misdiagnoses.

Methods:
This report discusses a 35-month-old female initially presenting with predominant gastrointestinal symptoms and minimal respiratory distress. Initial radiographic findings suggested a left tension pneumothorax, prompting further investigation.

Results:
Subsequent diagnostic efforts revealed a Bochdalek-type left CDH, with several abdominal organs herniated into the thoracic cavity. The case was managed through laparotomy, where herniated contents were successfully repositioned into the abdominal cavity. This intervention underscores the need for high clinical suspicion and the importance of distinguishing between similar presentations, such as tension pneumothorax and tension gastrothorax, which require different management strategies.

Conclusion:
The case illustrates the importance of considering CDH in differential diagnoses for older pediatric patients with atypical symptoms. Early recognition and appropriate management are key to improving patient outcomes.
Early respiratory interventional therapy combined with antifungal agent for endobronchial cryptococcosis: A case report and literature review.
Authors: Li Qinglan , Wen Daxiong , Chen Yong , Yang Longfeng , Li Jing , Luo Shaohua 
Published: April 2024

Rationale:
Cryptococcosis presenting as endobronchial obstruction and lung collapse is an extremely rare occurrence. While these patients were treated with antifungal agents, unfortunately, half of them showed a suboptimal response.

Patient concerns:
A 45-year-old immunocompetent male was admitted to the hospital due to a cough, yellow phlegm, and dyspnea persisting for 5 months. Chest computer tomography revealed a mass in the right main bronchus accompanied by right lower lobe atelectasis.

Diagnoses:
Endobronchial cryptococcosis presenting as endobronchial obstruction and lung collapse.

Interventions:
Early rigid bronchoscopic therapy was performed to resect endobronchial obstruction, which combined with antifungal agent.

Outcomes:
The patient recovered well with completely clinical and radiologic resolution at 1 year follow-up.

Lessons:
This case provides a good example of successful utilization of the early respiratory interventional therapy combined with antifungal agent in obstructive endobronchial cryptococcosis.
A bibliometric analysis of non-coding RNA studies in acute pancreatitis
Authors: Zhu Xiaodong , Liu Kunrong , Tang Xiping , Chen Guozhong 
Published: April 2024

Background:
Non-coding RNA (ncRNA) is a type of RNA that does not code for proteins and plays a crucial role in the onset, progression, diagnosis, and therapy of acute pancreatitis. However, bibliometric, and visual analyses of studies on acute pancreatitis and ncRNA are lacking. This study seeks to provide a bibliometric overview of the knowledge structure and research hotspots of ncRNA in the field of acute pancreatitis research.

Materials and methods:
Literature search and collection of information in the field of ncRNA-related research in acute pancreatitis from 2000-2023 through the Web of Science Core Collection. Use CiteSpace and VOSviewer to visually analyze countries, institutions, authors, and keywords.

Results:
A total of 563 articles have been published in the field of ncRNA-related research in acute pancreatitis, and the number of publications in this field is gradually increasing. The largest number of publications was from China. Four clusters were produced by the co-occurrence cluster analysis of the top 89 keywords: studies of ncRNA in inflammation, autophagy, and apoptosis in acute pancreatitis; studies related to microRNA expression in pancreatic cancer among ncRNA; studies related to microRNAs as diagnostic and therapeutic markers in acute pancreatitis; and studies related to ncRNA in acute pancreatitis; The key words “injury,” “pathway” and “extracellular vesicles” are the key words of emerging research hotspots.

Conclusion:
In conclusion, ncRNA research in acute pancreatitis is an established discipline. Researchers can use the research hotspots and frontiers in this field as a guide for choosing their research direction.
The effect of hyperbaric oxygen therapy on hematological indices and biochemical parameters in patients with diabetic foot
Authors: Ercan Erdinç , Aydin Gamze , Erdoğan Bülent , Özçelik Fatih 
Published: April 2024

Background:
Diabetes Mellitus (DM) is a metabolic disease with a high morbidity and mortality and increasing in prevalence all over the world. Due to the hypoxic, ischemic, inflammatory, and infective environment in DM, diabetic foot ulcers have been treated with medico-surgical interventions and adjuvant hyperbaric oxygen Therapy (HBOT). The purpose of this study was to evaluate the effects of HBOT on hematological indices and biochemical parameters in patients with diabetic foot.

Methods:
The study group was formed from the file records of 103 male patients who applied to Yunus Emre State Hospital HBOT Center between September 1, 2016 and December 31, 2020, and were treated HBOT with a multidisciplinary approach.

Results:
There were negative low correlations between number of HBOT sessions and Mean Corpuscular Hemoglobin (MCH) (P = .037, r = −0.207) and Blood Urea Nitrogen (BUN) (P = .037, r = −0.222). White Blood Cell Count (WBC), Neutrophils (NEU), Monocytes (MON), Platelet Count (PLT), and Plateletcrit (PTC) parameters were found to be decreased, and an increase in lymphocytes (LYM), Eosinophils (EOS), Mean Corpuscular Hemoglobin Concentration (MCHC), and Red Cell Distribution Width (RDW) parameters were detected after the treatments (P < .05). Again, after the treatment, glucose (Glu), C-Reactive Protein (CRP), direct bilirubin, and total protein (TP) levels were decreased, and uric acid (UA) levels increased (P < .05).

Conclusion:
HBOT improved hematological indices in patients and had a beneficial effect on biochemical parameters, particularly Glu and CRP levels. Adjuvant HBOT alleviates diabetic inflammation and has a beneficial effect on diabetic patient treatment.
Comprehensive assessment of the effects of concurrent strength and endurance training on lipid profile, glycemic control, and insulin resistance in type 2 diabetes: A meta-analysis
Authors: Sun Yaowei , Lu Bin , Su Wenbo , Song Xu , Shang Xueyan , Zheng Jing , Wang Jing , Yun Hezhang 
Published: April 2024

Background:
To investigate the effect of concurrent strength combined with endurance training on the lipid and glucose profile of type 2 diabetes mellitus (T2DM) using Meta-analysis.

Methods:
The literature was searched from PubMed, Web of Science, EBSCO, and China National Knowledge Infrastructure(CNKI) databases for relevant randomized controlled trials with dates from the date of establishment to June 2023, and the included studies were individually assessed according to the Cochrane Risk of Bias tool in the Cochrane Systematic Assessor’s Handbook, and the data were analyzed using RevMan 5.4 analysis software to analyze and process the data.

Results:
A total of 9 articles were included, including 589 subjects, including 308 in the experimental group and 281 in the control group. The results of Meta analysis showed that concurrent strength combined with endurance training improved TC (SMD = −1.12, 95% CI = [−1.81, −0.44], P < 0.01), TG (SMD = −0.46, 95% CI = [−0.85, −0.07], P < 0.05), LDL-C (SMD = −1.3, 95% CI = [−2.09, −0.50], P < 0.01), HDL-C (SMD = 0.61, 95% CI = [0.05, 1.17], P < 0.05), FBG (SMD = −0.65, 95% CI = [−1.27, −0.04], P < 0.05), HOMA-IR (SMD = −1.23, 95% CI = [−2.40, −0.06], P < 0.05).

Conclusion:
Concurrent strength combined with endurance training has a positive effect on the improvement of lipid and glucose profile in patients with type 2 diabetes.
Immune checkpoint inhibitor-related adrenal hypofunction and Psoriasisby induced by tislelizumab: A case report and review of literature
Authors: Deng Yisi , Huang Manling , Deng Runpei , Wang Jun 
Published: April 2024

Rationale:
Immune-related adverse events following treatment with immune checkpoint inhibitors can affect almost every organ. Tislelizumab, a novel humanized Ig G4 programmed death receptor 1 inhibitor, was started for bladder cancer in 2019, but the adverse effects of this drug may not yet be known due to its short time on the market, and there are still some clinical safety concerns. There are few reports of adrenal insufficiency after tislelizumab treatment, which is easily missed, misdiagnosed and life-threatening.

Patient concerns:
A 67-year-old male with bladder cancer who developed rash, water-sodium retention, electrolyte disturbances, hypoalbuminemia, low-grade fever, nausea and vomiting, and fatigue after 2 cycles of tislelizumab.

Diagnosis:
Immune checkpoint inhibitor-related adrenal hypofunction and Psoriasisby.

Interventions:
Suspended tislelizumab treatment and continued glucocorticoid therapy.

Outcomes:
The patient showed significant improvement in the above symptoms. But bladder cancer reemerged at the same site.

Conclusions:
The advent of immune-related adverse events has increased the complexity of the application of tislelizumab in the treatment of bladder cancer and further research is needed to develop the best treatment guidelines. Early diagnosis and treatment are crucial since the adverse events could endanger lives.