bluuebunny/crossref_metadata_2025_split huggingface dataset:
Embedding Interprofessional Education in Clinical Settings: Medical and Dental Student Perceptions of a Patient Interview-Storytelling Experience
Authors: Miller Kelsey A. , Keeney Tamra , Singh Tara A. , Tolchin Dorothy W. , Kesselheim Jennifer C. , Farrell Susan E. 
Published: February 2024

Abstract

Problem
Interprofessional education (IPE) is valued but difficult to deliver, given logistical and other barriers. Centering IPE around patients and grounding it in authentic practice settings are challenging within early undergraduate medical education.

Approach
This intervention facilitated student–patient conversations to elicit patient reflections on the health care professionals who keep them healthy and care for them when they are unwell. After being introduced to the Interprofessional Education Collaborative (IPEC) core competencies, first-year medical (n = 127) and dental (n = 34) students conducted a brief semistructured patient interview, using an interview card with guiding questions, during a precepted outpatient clinic session in March–May 2021. Students transcribed patients’ stories and wrote their own reflections on the interview card. These reflections were used as a stimulus for a class IPE discussion. The authors employed a pragmatic qualitative research approach to explore what students learned about interprofessional collaboration from reflecting on patients’ stories.

Outcomes
Of the 161 students, 158 (98%) completed an interview card. Sixteen health professions were represented in patients’ stories. The patients’ stories prompted students to recognize and expand their understanding of the IPEC competencies. Students’ responses reflected synthesis of the competencies into 3 themes: students value patient-centered holistic care as the goal of interprofessional collaboration; students reflect emerging professional and interprofessional identities in relating to patients, teams, and systems; and students appreciate interprofessional care is complex and challenging, requiring sustained effort and commitment.

Next Steps
Next steps include continuing to integrate patient voices through structured conversations across the undergraduate and graduate medical education spectrum and adapting the model to support conversations with other health professionals engaged in shared patient care. These experiences could foster ongoing deliberate reflection by students on their professional and interprofessional identity development but would require investments in student time and faculty development.
Effect of Polypectomy Simulation-Based Mastery Learning on Skill Retention Among Practicing Endoscopists
Authors: Barsuk Jeffrey H. , Cohen Elaine R. , Patel Ronak V. , Keswani Rajesh N. , Aadam Abdul Aziz , Wayne Diane B. , Cameron Kenzie A. , Komanduri Srinadh 
Published: February 2024

Abstract

Purpose
Practicing endoscopists frequently perform and teach screening colonoscopies and polypectomies, but there is no standardized method to train and assess physicians who perform polypectomy procedures. The authors created a polypectomy simulation-based mastery learning (SBML) curriculum and hypothesized that completion of the curriculum would lead to immediate improvement in polypectomy skills and skill retention at 6 and 12 months after training.

Method
The authors performed a pretest-posttest cohort study with endoscopists who completed SBML and were randomized to follow-up at 6 or 12 months from May 2021 to August 2022. Participants underwent SBML training, including a pretest, a video lecture, deliberate practice, and a posttest. All learners were required to meet or exceed a minimum passing standard on a 17-item skills checklist before completing training and were randomized to follow-up at 6 or 12 months. The authors compared simulated polypectomy skills performance on the checklist from pretest to posttest and posttest to 6- or 12-month follow-up test.

Results
Twenty-four of 30 eligible participants (80.0%) completed the SBML intervention, and 20 of 24 (83.3%) completed follow-up testing. The minimum passing standard was set at 93% of checklist items correct. The pretest passing rate was 4 of 24 participants (16.7%) compared with 24 of 24 participants (100%) at posttest (P < .001). There were no significant differences in passing rates from posttest to combined 6- and 12-month posttest in which 18 of 20 participants (90.0%) passed.

Conclusions
Before training and despite years of clinical experience, practicing endoscopists demonstrated poor performance of polypectomy skills. SBML was an effective method for practicing endoscopists to acquire and maintain polypectomy skills during a 6- to 12-month period.
Physician Work-Personal Intersection: A Scoping Review of Terms, Definitions, and Measures
Authors: Webber Sarah , Semia Sanaa , Nacht Carrie L. , Garcia Sarahi , Kloster Heidi , Vellardita Lia , Kieren Madeline Q. , Kelly Michelle M. 
Published: February 2024

Abstract

Purpose
A substantial body of evidence describes the multidimensional relationship between the intersection of physicians’ work and personal lives and health care quality and costs, workforce sustainability, and workplace safety culture. However, there is no clear consensus on the terms, definitions, or measures used in physician work-personal intersection (WPI) research. In this scoping review, the authors aimed to describe the terms and definitions used by researchers to describe physician WPI, summarize the measurement tools used, and formulate a conceptual model of WPI that can inform future research.

Method
The authors searched PubMed, CINAHL, Scopus, and Web of Science for studies that investigated U.S. practicing physicians’ WPI and measured WPI as an outcome from January 1990 to March 2022. The authors applied thematic analysis to all WPI terms, definitions, and survey questions or prompts in the included studies to create a conceptual model of physician WPI.

Results
Ultimately, 102 studies were included in the final analysis. The most commonly used WPI terms were work-life balance, work-life integration, and work-home or work-life conflict(s). There was no consistency in the definition of any terms across studies. There was heterogeneity in the way WPI was measured, and only 8 (7.8%) studies used a validated measurement tool. The authors identified 6 key driver domains of WPI: work and personal demands; colleague and institutional support and resources; personal identity, roles, health, and values; work schedule and flexibility; partner and family support; and personal and professional strategies.

Conclusions
The authors found significant variability in the terms, definitions, and measures used to study physician WPI. They offer a conceptual model of the WPI construct that can be used to more consistently study physician WPI in the future. Future work should further investigate the validity of this model and generate consensus around WPI terms, definitions, and measures.
Retrospective Analysis of US Litigations Involving Dermatologists From 2011 to 2022
Authors: Lim Young H. , Saberi Shahin A. , Kamal Kanika , Jalian H. Ray , Avram Mathew 
Published: February 2024

BACKGROUND
Physician malpractice lawsuits are climbing, and the reasons underlying litigation against dermatologists are unclear.

OBJECTIVE
To determine the reasons patients pursue litigation against dermatologists or dermatology practices.

MATERIALS AND METHODS
A retrospective analysis of all state and federal cases between 2011 and 2022 was performed after a query using “Dermatology” and “dermatologist” as search terms on 2 national legal data repositories.

RESULTS
The authors identified a total of 48 (37 state and 11 federal) lawsuits in which a practicing dermatologist or dermatology group practice was the defendant. The most common reason for litigation was unexpected harm (26 cases, 54.2%), followed by diagnostic error (e.g. incorrect or delayed diagnoses) (16 cases, 33.3%). Six cases resulted from the dermatologist failing to communicate important information, such as medication side effects or obtaining informed consent. Male dermatologists were sued at a rate 3.1 times higher than female dermatologists.

CONCLUSION
Although lawsuits from patients against dermatologists largely involve injury from elective procedures, clinicians should practice caution regarding missed diagnoses and ensure critical information is shared with patients to safeguard against easily avoidable litigation.
Association of Interleukin-17 Inhibitors With Hypertension in Patients With Autoimmune Diseases: A Systematic Review and Meta-analysis on Randomized Controlled Trials
Authors: Jiang Kexin , Jia Yuheng , Chen Li , Huang Fangyang , Chen Mao 
Published: February 2024

Abstract:
The influence of interleukin (IL)-17 inhibition on blood pressure in patients with autoimmune diseases remains inconclusive. Our objective is to examine the risk of hypertension in patients with autoimmune diseases undergoing IL-17 inhibition therapies through meta-analysis of randomized, placebo-controlled trials. We obtained integrated data from PubMed, Embase, and ClinicalTrials.gov. Incident hypertension rates were calculated, and hazard ratios with 95% confidence intervals were analyzed, along with

statistics to assess heterogeneity. Sequential analysis ensured conclusion reliability. In 30 randomized controlled trials involving 9909 patients with diverse autoimmune diseases treated with anti-IL-17 agents, our meta-analysis revealed a significant increase in hypertension risk (risk ratio 1.69, 95% confidence interval 1.24–2.31, P = 0.001), robustly supported by trial sequential analysis. Among the 4 agents (secukinumab, ixekizumab, bimekizumab, and brodalumab), only secukinumab exhibited a notable association with hypertension. Patients with various primary autoimmune diseases, particularly those with psoriatic arthritis, had a higher likelihood of developing hypertension; in rheumatic arthritis patient cohorts, anti-IL-17 agents did not elevate hypertension risk. Prolonged treatment duration correlated with an increased hypertension risk. Stratifying by sex, studies with a female predominance demonstrated a higher risk ratio for hypertension compared with male-predominant studies. This highlights that anti-IL-17 treatment escalates hypertension risk, emphasizing the need for extra caution when managing patients with autoimmune diseases (Registered by PROSPERO, CRD42016053112).
Immunophenotypes of Newborns From SARS-CoV-2-infected Mothers
Authors: Stracuzzi Marta , Paradiso Laura , Panelli Simona , Amendola Antonella , Tanzi Elisabetta , Fappani Clara , Zuccotti Gianvincenzo , Giacomet Vania 
Published: February 2024

Background:
Little is known about the neonatal immunologic response to a maternal SARS-CoV-2 infection present during childbirth. Here we analyze a cohort of 75 neonates from SARS-CoV-2-infected mothers.

Methods:
The SARS-CoV-2 infection status was laboratory assessed by real-time reverse transcription polymerase chain reaction on nasopharyngeal swabs (NPS) in both mothers during childbirth and neonates within 24 hours of life. Immunophenotypes of peripheral blood mononucleated cells and SARS-CoV-2 antispike IgA, IgM and IgG of the newborns were recorded. Ten (13.3%) of 75 neonates had positive NPS for SARS-CoV-2; 17 of 75 (23%) were SARS-CoV-2-IgG seropositive, of which one with positive NPS. All the newborns resulted seronegative for SARS-CoV-2 IgA and IgM and were asymptomatic. Our cohort of newborns was divided into groups according to IgG seropositivity (IgG+/−) and NPS results (NPS+/−).

Results:
The count and proportion of lymphocyte subsets (evaluated measuring CD3, CD4, CD8 and CD19 markers) and of natural killer cells (evaluated by measuring the CD3−/CD16+/CD56+ subset) were all in the normal range, with no statistical differences among groups. We found a significant expansion of the T cell (CD3+) subset in the IgG+ group interpreted as the result of immune effects triggered by trained immunity in these newborns, but a decrease in CD4+ T cells for NPS+ neonates. It is therefore difficult to conclude that the decrease in CD4 can certainly be caused by an infection.

Conclusions:
A maternal SARS-CoV-2 infection resulted in an expansive effect of CD3+ T cells in IgG+ newborns; nonetheless, it seems not to affect structural and functional development of the newborn immune system.
Risk factors associated with hepatitis D virus infection and preventive strategies in Mongolia
Authors: Su Chien-Wei , Ochirkhuree Bayarmaa , Namdag Bira , Badamnachin Batsukh , Ganbold Sarangua , Gidaagaya Sarantuya , Ganbold Anar , Yang Sien-Sing , Duger Davaadorj , Wu Jaw-Ching 
Published: February 2024

Background:
Hepatitis D virus (HDV) infection is highly prevalent in Mongolia. We aimed to identify the risk factors associated with HDV infection, propose preventive strategies, and evaluate the outcomes of a 3-year collaborative project between Taiwan and Mongolia.

Methods:
In 2016 and 2018, we conducted onsite visits to Mongolia. Mongolian investigators collected questionnaires focusing on risk factors, demographic characteristics, and serum samples for acute HDV infections. Furthermore, 19 Mongolian seed teachers participated in a 1-week workshop on infection control in Taiwan. Subsequently, these seed teachers trained more than 400 medical personnel in Mongolia. To assess secular changes in acute HDV infection, we reviewed the registration data from the National Center for Communicable Disease (NCCD) in Mongolia between 2011 and 2021.

Results:
Among the 194 Mongolian patients, 108 had dual infection with hepatitis B virus (HBV) and HDV, while 86 had acute hepatitis B (AHB). Patients with HBV/HDV dual infections were older (28.6 vs 25.5 years, p = 0.030) and had lower rates of positive hepatitis B e antigen in their sera, lower rates of serum HBV DNA exceeding 2000 IU/mL, and higher rates of having received dental treatment (59.4% vs 40.5%, p = 0.014) and injection therapy (64.2% vs 44.0%, p = 0.009) compared with those with AHB. Analysis of NCCD data revealed that new HDV infection cases were more prevalent between 2011 and 2015 (111.20 ± 29.79 cases/y) and decreased to 54.67 ± 27.34 cases/y between 2016 and 2021 (p = 0.010).

Conclusion:
Dental treatment and injections were associated with a higher risk of acute HDV infections in Mongolia. Through collaborative efforts, the incidence rate of HDV infection has declined in recent years.
Racial and Ethnic Minorities With Acute Pancreatitis Live in Neighborhoods With Higher Social Vulnerability Scores
Authors: Sarraf Paya , Agrawal Rohit , Alrashdan Haya , Agarwal Mitali , Boulay Brian , Mutlu Ece R. , Tussing-Humphreys Lisa , Conwell Darwin , Kim Sage , Layden Brian T. , Yazici Cemal 
Published: February 2024

Objectives
The primary objective was to determine differences in Social Vulnerability Index (SVI) scores among minorities (African-Americans and Hispanics) with acute pancreatitis (AP) compared with non-Hispanic whites (NHWs) with AP. The secondary objectives were to determine differences in diet, sulfidogenic bacteria gene copy numbers (gcn) and hydrogen sulfide (H2S) levels between the 2 groups.

Materials and Methods
Patients with AP were enrolled during hospitalization (n = 54). Patient residential addresses were geocoded, and the Centers for Disease Control and Prevention’s SVI scores were appended. Dietary intake and serum H2S levels were determined. Microbial DNAs were isolated from stool, and gcn of sulfidogenic bacteria were determined.

Results
Minorities had higher SVI scores compared with NHWs (P = 0.006). They also had lower consumption of beneficial nutrients such as omega-3 fatty acids [stearidonic (P = 0.019), and eicosapentaenoic acid (P = 0.042)], vitamin D (P = 0.025), and protein from seafood (P = 0.031). Lastly, minorities had higher pan-dissimilatory sulfite reductase A (pan-dsrA) gcn (P = 0.033) but no significant differences in H2S levels (P = 0.226).

Conclusion
Minorities with AP have higher SVI compared with NHWs with AP. Higher SVI scores, lower consumption of beneficial nutrients, and increased gcn of pan-dsrA in minorities with AP suggest that neighborhood vulnerability could be contributing to AP inequities.
Treatment of Acute COVID-19 and COVID-19 Exposures in Children and Adolescents
Authors: Daniels Danielle , Conners Gregory P. 
Published: February 2024

Abstract
The landscape of acute COVID-19 therapeutics has dramatically evolved since the onset of the pandemic. The treatment of acute COVID-19 in children and adolescents requires knowledge of risk factors and clinical features to appropriately select antiviral and immunomodulatory therapies. This review article provides updated guidance for emergency physicians in the treatment of acute COVID-19 in children and adolescents.
Brain preparedness: The cortisol awakening response proacts dynamic organization of large-scale brain networks across emotional and executive functions
Authors: Zeng Yimeng , Xiong Bingsen , Gao Hongyao , Liu Chao , Chen Changming , Wu Jianhui , Qin Shaozheng 
Published: February 2024

AbstractEmotion and cognition involve an intricate crosstalk of neural and endocrine systems that support allostatic processes for maintenance of dynamic equilibrium and rapid adaptation for upcoming challenges. As a hallmark of human endocrine activity, the cortisol awakening response (CAR) is recognized to play a critical role in modulating emotional and executive functions. Yet, the underlying mechanisms of such effects remain elusive. By leveraging pharmacological neuroimaging technique and Hidden Markov Modeling of brain state dynamics, we show that the CAR proactively modulates rapid reconfigurations (state) of large-scale brain networks across multi-task demands. Behaviorally, suppression of CAR proactively and selectively impaired accuracy for emotional discrimination task but not for working memory (WM). In parallel, suppressed CAR led to a decrease in the occurrence rate of brain state dominant to emotional processing, but an increase in brain state linking to executive control under high WM demand. Further energy-based analyses revealed an increase in transition frequency and sequence complexity along with an increased entropy during emotional tasks when suppressed CAR, suggesting a decreased energy supply. Moreover, an increased transition frequency was observed when shifting from neutral to emotional conditions, but an opposite pattern during WM task, with n decreased transition frequency shifts from low to high-executive demands. Our findings establish a causal link between CAR and dynamic allocation of neural resources for emotional and executive functions, suggesting a cognitive neuroendocrine account for CAR-mediated proactive effects and human allostasis.
A patient-derived amyotrophic lateral sclerosis blood-brain barrier cell model reveals focused ultrasound-mediated anti-TDP-43 antibody delivery
Authors: Wasielewska Joanna M. , Castro Cabral-da-Silva Mauricio , Pecoraro Martina , Nguyen Tam Hong , Bella Vincenzo La , Oikari Lotta E. , Ooi Lezanne , White Anthony R. 
Published: February 2024

AbstractBackgroundAmyotrophic lateral sclerosis (ALS) is a rapidly progressing neurodegenerative disorder with minimally effective treatment options. An important hurdle in ALS drug development is the non-invasive therapeutic access to the motor cortex currently limited by the presence of the blood-brain barrier (BBB). Focused ultrasound and microbubble (FUS+MB) treatment is an emerging technology that was successfully used in ALS patients to temporarily open the cortical BBB. However, FUS+MB-mediated drug delivery across ALS patients’ BBB has not yet been reported. Similarly, the effects of FUS+MBon human ALS BBB cells remain unexplored.MethodsHere we established the first FUS+MB-compatible, fully-human ALS patient-cell-derived BBB model based on induced brain endothelial-like cells (iBECs) to study anti-TDP-43 antibody delivery and FUS+MBbioeffectsin vitro.ResultsGenerated ALS iBECs recapitulated disease-specific hallmarks of BBB pathology, including changes to BBB integrity, permeability and TDP-43 proteinopathy. Our results also identified differences between sporadic ALS and familial (C9orf72expansion carrying) ALS iBECs reflecting patient heterogeneity associated with disease subgroups. Studies in these models revealed successful ALS iBEC monolayer openingin vitrowith a lack of adverse cellular effects of FUS+MB. This was accompanied by the molecular bioeffects of FUS+MBin ALS iBECs including changes in expression of tight and adherens junction markers, and drug transporter and inflammatory mediators, with sporadic and C9orf72 ALS iBECs generating transient specific responses. Additionally, we demonstrated an effective increase in the delivery of anti-TDP-43 antibody with FUS+MBin C9orf72 (2.7-fold) and sporadic (1.9-fold) ALS iBECs providing the first proof-of-concept evidence that FUS+MBcan be used to enhance the permeability of large molecule therapeutics across the BBB in a human ALSin vitromodel.ConclusionsTogether, our study describes the first characterisation of cellular and molecular responses of ALS iBECs to FUS+MBand provides a fully-human platform for FUS+MB-mediated drug delivery screening on an ALS BBBin vitromodel.
A Multi-Omics Atlas of Sex-Specific Differences in Obstructive Hypertrophic Cardiomyopathy
Authors: Garmany Ramin , Dasari Surendra , Bos J. Martijn , Kim Evelyn T. , Martinez Katherine A. , Tester David J. , Remedios Cristobal dos , Maleszewski Joseph J. , Dearani Joseph A. , Ommen Steve R. , Geske Jeffrey B. , Giudicessi John R. , Ackerman Michael J. 
Published: February 2024

ABSTRACTBackgroundHypertrophic cardiomyopathy (HCM) is a common genetic heart disease. Women with HCM tend to have a later onset but more severe disease course. However, the underlying pathobiological mechanisms for these differences remain unknown.MethodsMyectomy samples from 97 patients (53 males/44 females) with symptomatic obstructive HCM and 23 control cardiac tissues were included in this study. RNA-sequencing was performed on all samples. Mass spectrometry-based proteomics and phosphoproteomics was performed on a representative subset of samples.ResultsThe transcriptome, proteome, and phosphoproteome was similar between sexes and did not separate on PCA plotting. Overall, there were 482 differentially expressed genes (DEGs) between control females and control males while there were only 53 DEGs between HCM females and HCM males. There were 1963 DEGs between HCM females and control females compared to 1064 DEGs between HCM males and control males. Additionally, there was increased transcriptional downregulation of hypertrophy pathways in HCM females and in HCM males. HCM females had 119 differentially expressed proteins compared to control females while HCM males only had 27 compared to control males. Finally, the phosphoproteome showed females had 341 differentially phosphorylated proteins (DPPs) compared to controls while males only had 184. Interestingly, there was hypophosphorylation and inactivation of hypertrophy pathways in females but hyperphosphorylation and activation in males.ConclusionThere are subtle, but biologically relevant differences in the multi-omics profile of HCM. This study provides the most comprehensive atlas of sex-specific differences in the transcriptome, proteome, and phosphoproteome present at the time of surgical myectomy for obstructive HCM.