bluuebunny/crossref_metadata_2025_split huggingface dataset:
Remediating Unprofessionalism Among Trainees
Authors: Wasserman Jason Adam , Redinger Michael J. , Gibb Tyler S 
Published: January 2025

Abstract
Professionalism is an essential trait for physicians, but it is a complex and multifaceted concept that is difficult to define and teach. There has been substantial focus on including professionalism in general curricula, but less emphasis on addressing and remedying instances of unprofessional behavior. Reframing professionalism lapses as analogous to medical errors and adopting a “just culture” approach both creates a safe learning environment and addresses problematic behaviors by trainees fairly and constructively. This approach views professionalism as a set of skills that require a supportive environment for development and recognizes that trainees may sometimes fall short as they learn to navigate ethical dilemmas and prioritize the needs of others over their own interests. This chapter articulates a just culture framework for addressing unprofessionalism and then describes methods and practices for addressing professionalism lapses.
Advocating for Diversity, Equity, Inclusion, and Social Justice
Authors: Smith Carlos S. , Razack Saleem , Reynolds P. Preston 
Published: January 2025

Abstract
Diversity, equity, inclusion, belonging, and justice (DEIBJ) are priorities in the education of health professionals today and will be into the future. Foundational aspects of DEIBJ education include skills in advocacy and community engagement and a deep understanding of historic injustices that continue to shape clinical encounters in all healthcare settings. Historically, every health profession denied admission to minority students and discriminated against minoritized patients well into the late twentieth century. Vestiges and impacts of those historic practices that continue as lived experiences of many patients today cannot be overstated. Fulfilling twenty-first century societal expectations of access to and care by competent health professionals who are skilled in communicating across ethnic and socioeconomic differences requires a reimagined professionalism with a focus on an anti-oppressive professionalism ethic as well as transformed learning environments, faculty, and curricula. Many events in the year 2020, such as a global outcry over racial injustices and a COVID-19 pandemic of unprecedented proportions, thrust a demand on academic health centers to provide a more inclusive learning experience and participation in a more equitable healthcare delivery system. This chapter addresses two priority areas: professionalism and the learning environment as primary actors in both professional identity formation and care delivery, as well as an anti-oppressive professionalism of inclusion as foundational to transformative learning.
Ibandronate Compared to Radiotherapy for Metastatic Bone Pain in Patients With Solid Tumors
Authors: Barlow Ashley , Bruera Eduardo 
Published: January 2025

Abstract
Bone pain related to metastatic solid tumors can contribute to significant morbidity and mortality. Beyond supportive care management with analgesics, radiation therapy has long been the standard of care to reduce the symptoms associated with metastatic bone pain. A single infusion of ibandronate, a bisphosphonate, was studied and found to have similar outcomes to radiation therapy, allowing for an expansion of treatment options in patients suffering from metastatic bone pain.
Methadone as a Coanalgesic
Authors: Bemben Nina M. 
Published: January 2025

Abstract
Inadequately controlled pain remains a challenge in patients receiving palliative care. This study sought to evaluate the efficacy of methadone as an adjunctive analgesic. It is a retrospective and prospective cohort study of patients treated with methadone as an adjunctive analgesic. Low-dose methadone improved analgesia by at least 30% in 49% of patients treated by a palliative care team when used as an adjunctive therapy. The median time to response was 7 days. Low-dose methadone is an effective add-on therapy for patients with inadequate analgesia on their current opioid regimen.
Efficacy of Oral Risperidone, Haloperidol, or Placebo for Symptoms of Delirium Among Patients in Palliative Care
Authors: Davis Mellar P. 
Published: January 2025

Abstract
This randomized trial compared placebo, haloperidol, and risperidone in 247 patients with delirium. Delirium failed to improve with risperidone or haloperidol relative to placebo. Both antipsychotics had worse outcomes than placebo.
Haloperidol as an Adjunct Therapy for Pain and Nausea in Acute Gastroparesis
Authors: DiScala Sandra , Vartan Christine M. 
Published: January 2025

Abstract
This is a review and case application of a study by Roldan et al. titled “Randomized Controlled Double-Blind Trial Comparing Haloperidol Combined With Conventional Therapy to Conventional Therapy Alone in Patients With Symptomatic Gastroparesis.” Patients received either haloperidol 5 mg intravenously or placebo given in conjunction with conventional treatment. This trial demonstrated a significant trend of improved abdominal pain and nausea within 1 hour after haloperidol administration in adult patients with acute gastroparesis presenting to the emergency department. Secondary outcomes of hospitalization and length of stay also favored the haloperidol group. Haloperidol is used widely to treat nausea in the palliative care setting; therefore, this knowledge was used to apply a similar treatment strategy in the setting of acute gastroparesis.
Neuroleptic Strategies for Terminal Agitation in Patients With Cancer and Delirium at an Acute Palliative Care Unit
Authors: Jordan Allison E. , Gamble Alexander 
Published: January 2025

Abstract
This is a single-center, double-blind, parallel-group, randomized trial of patients with advanced cancer with refractory agitation who were treated for terminal delirium after not responding to low-dose haloperidol. Patients were randomized to dose escalation of intravenous haloperidol, neuroleptic rotation to chlorpromazine, or combined haloperidol and chlorpromazine. The primary outcome was a reduction in Richmond Agitation Sedation Scale (RASS) score in the first 24 hours. The RASS score decreased after 30 minutes of receiving the masked study medication and remained low for 24 hours for all 3 groups. The most serious adverse event was hypotension. No patients died from treatment.
Methylnaltrexone for Opioid-Induced Constipation
Authors: Higgins Elizabeth , Cain Joan , Blair Dwight 
Published: January 2025

Abstract
Opioid-induced constipation (OIC) is distressing for patients and may lead to inadequate pain control. Laxatives are often inadequate and burdensome for patients with OIC. Methylnaltrexone is a drug with selective antagonism of peripheral μ-opioid receptors (PAMORA) and does not affect the central nervous system. This study looked at patients with OIC and advanced illness and randomized them to receive either a placebo or methylnaltrexone at a dose of 0.15 mg/kg subcutaneously. The investigators were blinded. The study found that almost half of the methylnaltrexone group achieved laxation within 4 hours of the first study dose compared to only 15% in the placebo group. Methylnaltrexone appears to be a safe and effective drug that does not affect analgesia.
Donepezil and Memantine for Moderate-to-Severe Alzheimer Disease
Authors: Marchand Kristina , McGehrin Kevin 
Published: January 2025

Abstract
Palliative care clinicians encounter patients with late-stage Alzheimer disease who have been prescribed cholinesterase inhibitors and must decide whether to modify pharmacologic therapy. The Donepezil and Memantine in Moderate-to-Severe Alzheimer’s Disease (DOMINO) study evaluated patients already receiving donepezil after making adjustments to their therapy. Interventions included continuing donepezil alone, discontinuing donepezil, changing donepezil to memantine, or adding memantine to donepezil. Changes in cognitive and functional decline were measured 1 year after making adjustments to therapy. This study demonstrated a statistically significant difference in cognitive decline in patients continued on donepezil, but the clinical benefits were minimal.
Olanzapine for the Treatment of Advanced Cancer-Related Chronic Nausea and/or Vomiting
Authors: Nguyen Cindy 
Published: January 2025

Abstract
Olanzapine is an effective second-generation atypical antipsychotic and antiemetic agent due to its antagonism at the dopamine, histamine, serotonin, and muscarinic receptors. Previous reports have revealed the effectiveness of olanzapine as an antiemetic agent for patients with advanced cancer, independent of chemotherapy. In this randomized, double-blinded, placebo-controlled trial, low-dose olanzapine 5 mg daily demonstrated statistical significance in reducing nausea and vomiting in patients with advanced cancer compared to placebo. After 7 days of treatment, the placebo arm’s median nausea scores were 9 out of 10 (range 8–10), compared to 1 out of 10 (range 0–3) in the olanzapine arm. Patients in the olanzapine arm experienced less sedation, less fatigue, and better well-being.
Ketamine
Authors: Wahlberg Lara , Singh Navendra 
Published: January 2025

Abstract
Ketamine is used to treat refractory cancer pain; there is poor evidence to suggest its continued use. A randomized, double-blinded, placebo-controlled trial assessed the efficacy of subcutaneous ketamine versus placebo in the setting of standard opioid and adjuvant therapy in the management of uncontrolled cancer pain over 3–5 days. There were no significant differences between the ketamine arm and the placebo arm in pain scores. There were more adverse events in the ketamine arm compared to the placebo arm. Ketamine does not have clinical benefit when used as an adjunct to standard therapy for cancer pain.
Imaging headache
Authors: Sulkin Tom , Mannava Amoolya , Kruger Ross 
Published: January 2025

Abstract
Over the past 50 years, radiological development has revolutionized investigation of headache. This chapter outlines the key principles of computed tomography and magnetic resonance imaging. Not everyone with a headache should be imaged. There will inevitably be a trade-off between clinical utility, cost, availability. The problem of incidental abnormalities should be discuss with the patient and imaging should be rarely undertaken for reassurance. A range of images and their diagnoses are added in the appendix.
Efficacy of Army Combat Fitness Test 12-Week Exercise Program Among Females
Authors: Heijnen Michel J H , Berni Angila , McNabb Phoebe , Caldwell Steven , Holland Stephen , Kawczynski Bill , McDaniel Alexander T , Noland Sarah , Strayhorn Shaila , Tseh Wayland 
Published: January 2025

ABSTRACT

Introduction
The dearth of research investigating the efficacy of virtual Army Combat Fitness Test (ACFT) training programs among female populations necessitates further exploration. This study aims to evaluate the effectiveness of a 12-week ACFT virtual exercise program among female participants.

Materials and Methods
Nine female participants (age = 19.7 ± 1.3 years, height = 165.9 ± 4.9 cm, and body mass = 62.7 ± 5.9 kg) volunteered to complete 2 assessment sessions and the 12-week ACFT virtual exercise training program. In session 1, baseline height, body mass, body composition, and ACFT scores were collected. Upon completion of session 1, under supervisory guidance, all participants were scheduled to complete the 12-week exercise training program in-person. The ACFT exercise training program required participants to complete a warmup/cool down and exercise with suspension training straps 4 days per week, 60 minutes for 12 weeks. In session 2, post-assessments of body mass, body composition, and ACFT scores were collected. Statistical analyses were conducted utilizing paired sample t-tests to assess differences between pre- and post-intervention ACFT scores with P ≤ .05. Cohen’s d was calculated to quantify the magnitude of the observed effect.

Results
Overall mean ACFT pre-intervention scores (487.2 ± 66.5) increased significantly when compared to mean ACFT post-intervention scores (521.6 ± 44.0) (Cohen’s d = 0.86, P = .03). No statistical differences were displayed among the individual mean ACFT pre- versus post-intervention scores. A consistent decline in adherence of 3.9% per week ensued from week 1 through week 12.

Conclusions
Following the intervention, female participants experienced a significant increase of approximately 7% in their overall ACFT scores, with upward trends observed across all 6 individual ACFT events. These findings suggest that 12-week virtual suspension training can be a valuable tool for enhancing physical fitness and performance among female participants, particularly within the context of military readiness.
The gas-to-dust ratio investigation in the massive star-forming region M17
Authors: Zhao Qi , Jiang Zhibo , Wu Chao-Jian , Zheng Jie , Cheng Cheng , Zhu YiNan , Wu Hong 
Published: January 2025

ABSTRACT
M17 is a well-known massive star-forming region, and its gas-to-dust ratio (GDR) may vary significantly compared to the other areas. The mass of gas can be traced by the ${\rm CO}$ emission observed in the Milky Way Imaging Scroll Painting project. The dust mass can be traced by analysing the interstellar extinction magnitude obtained from the United Kingdom Infrared Telescope. We computed the ratio ${W({\rm CO})/A_\mathit{ V}}$: for ${A_\mathit{ V} \le }$ 10 mag, ${{ W(^{12}{\rm CO})/ A_\mathit{ V}}= (6.27 \pm 0.19)}$${\mathrm{{K \, km\,s^{-1}}\, mag^{-1}}}$ and ${{ W(^{13}{\rm CO})/ A_\mathit{ V}} = (0.75 \pm 0.72)}$${ \mathrm{{K \, km\,s^{-1}} \, mag^{-1}}}$; whereas for ${{A_\mathit{ V}} \ge 10}$ mag, ${{ W(^{12}{\rm CO})/ A_\mathit{ V}} = (15.8 \pm 0.06) }$ ${\mathrm{{K \, km\,s^{-1}} \, mag^{-1}}}$, and ${{ W(^{13}{\rm CO})/ A_\mathit{ V}} = (3.11 \pm 0.25)}$ ${ \mathrm{{K \, km\,s^{-1}} \, mag^{-1}}}$. Then, we converted the ${W({\rm CO})/A_\mathit{ V}}$ into ${N(\rm H)/\mathit{ A}_\mathit{ V}}$. Using the WD01 model, we derived the GDR: for ${A_\mathit{ V} \le }$ 10 mag, the GDRs were ${118 \pm 9}$ for ${^{12}{\rm CO}}$ and ${83 \pm 62}$ for ${^{13}{\rm CO}}$, comparable to those of the Milky Way; however, for ${A_\mathit{ V} \ge }$ 10 mag, the GDRs increased significantly to ${296 \pm 3}$ for ${^{12}{\rm CO}}$ and ${387 \pm 40}$ for ${^{13}{\rm CO}}$, approximately three times higher than those of the Milky Way. In the discussion, we compared the results of this work with previous studies and provided a detailed discussion of the influence of massive stars and other factors on GDR.
Extracellular Vesicles Released by Glioblastoma Cancer Cells Drive Tumor Invasiveness via Connexin-43 Gap Junctions
Authors: Tamborini Matteo , Ribecco Valentino , Stanzani Elisabetta , Sironi Arianna , Tambalo Monica , Franzone Davide , Florio Elena , Fraviga Edoardo , Saulle Chiara , Gagliani Maria C , Pizzocri Marco , Mattioli Milena , Cortese Katia , Jiang Jean X , Martano Giuseppe , Politi Letterio S , Riva Marco , Pessina Federico , Pozzi Davide , Lodato Simona , Passoni Lorena , Matteoli Michela 
Published: January 2025

Abstract

Background
Although invasiveness is one of the major determinants of the poor glioblastoma (GBM) outcome, the mechanisms of GBM invasion are only partially understood. Among the intrinsic and environmental processes promoting cell-to-cell interaction processes, eventually driving GBM invasion, we focused on the pro-invasive role played by Extracellular Vesicles (EVs), a heterogeneous group of cell-released membranous structures containing various bioactive cargoes, which can be transferred from donor to recipient cells.

Methods
EVs isolated from patient-derived GBM cell lines and surgical aspirates were assessed for their pro-migratory competence by spheroid migration assays, calcium imaging, and PYK-2/FAK phosphorylation. Brain invasiveness was investigated in human cortical organoids-based assembloids and in vivo orthotopic xenografts. EV molecular features were specified by multiplex bead-based flow cytometry.

Results
Results unveil a self-sustaining mechanism triggering migration through autocrine release and engagement of a specific population of EVs of large size (L-EVs), isolated from either patient-derived cell lines or surgical aspirates. L-EVs act through modulation of calcium transients via Connexin 43-Gap Junctions (Cx43-GJ) and phospho-activation of PYK2. Pre-incubation with blocking antibodies targeting Cx43 hemichannels demonstrated a dose-dependent inhibition of the L-EV-mediated GBM migration. By exploiting patients’ surgical aspirates, we show that only L-EVs deriving from tumoral cells, and not those with immune origin, promote tumor migration, impacting more prominently the tumoral cells with mesenchymal subtype.

Conclusions
We demonstrate that L-EVs released by GBM cells, but not by the immune cells of the tumor microenvironment, represent a relevant and unique autocrine pro-migratory input for the tumor.
Race and ‘omic’ data in glioma: a systematic review of contemporary research to explore the digital divide
Authors: Dada Olaoluwa Ezekiel , Chisango Zvipo , Nkansah-Poku Kwadwo Antwi Boasiako , Sowah Mareshah N , Rodrigues Amanda Cyntia Lima Fonseca , Duru Olivia , Myers Matthew , Williams Sophie T , Ushewokunze Shungu , Collis Spencer J , Shlobin Nathan A , Omoruyi Sylvester , Rominiyi Ola 
Published: January 2025

Abstract

Background
The expanding repertoire of studies generating genome-scale omic datasets from glioma samples provides a generational opportunity to uncover mechanisms driving aggressive biology and develop new treatments. However, ensuring such studies reflect the breadth of racial groups and ethnicities affected by gliomas is critical to support equity in future therapeutic advances. We therefore report a contemporary snapshot of the representation of race and ethnicity in omic glioma studies.

Methods
We searched PubMed, Embase, Web of Science and Scopus and systematically reviewed articles published between January and November 2023 reporting de novo genome-scale sequencing data generated using samples from patients diagnosed with a glioma (according to WHO 2021 criteria) to characterise the reporting and composition of race and ethnicity data.

Results
Thirty-five studies involving 5,601 patients were analysed. Race or ethnicity data was reported in only 3 studies (8.6%), of which none provided omic data in a format that could be stratified by race or ethnicity. Reporting varied by continent with all 3 studies including race or ethnicity data based in North America. Where racial data was available, we found that samples used for genome-scale characterisation came from patients reported as being White in 91.1% cases (41 patients), with 6.7% (3 patients) reported as Black and 2.2% (1 patient) as Hispanic.

Conclusions
These studies underscore an urgent need for improved reporting and representation to enhance our understanding of glioma biology across different populations and guide targeted initiatives from policy makers and funders to support equitable improvements in healthcare.
Everything Everywhere All At Once: competition policy and industrial policy choices in an era of structural change
Authors: Coyle Diane 
Published: January 2025

Abstract:
There is a clear revival of active industrial policy in many OECD economies. There is also a renewed activism in competition policy, with broad issues such as digital market power, the green transition, and geopolitics on the agenda of competition authorities. The new activism reflects technological transformations that are reshaping economic structures and hence presenting policy-makers with long-run supply-side economic challenges. In this context, there is no clear assignment of policy tools to different bodies, but rather a need for coordination of policies across domains. Nor can technical decision-making by economic regulators be separated from the need to make normative judgments about the strategic direction of the economy. This implies two fundamental unsolved institutional challenges: how to combine expert analysis with political legitimacy; and how to coordinate policies across bodies whose responsibilities or remits sometimes conflict.
Abuse of dominance: has the effects-based analysis gone too far?
Authors: Geradin Damien , Huijts Stijn 
Published: January 2025

Abstract
In 2008, following a long period of a so-called ‘formalistic’ approach to competition law, the European Commission adopted a more economic, effects-based, approach to the analysis of abuses of a dominant position. This included the use of an as-efficient competitor (AEC) test for price-based exclusionary conduct. However, more recently the EC warned about an overly rigid implementation of the effects-based approach. Moreover, in the period after 2008, the Commission and national authorities started to prioritize cases in digital markets, for which some of the concepts adopted in 2008 were less suitable. This ultimately led to the introduction of ex ante regulation of certain digital services in the Digital Markets Act. Against this background, the article seeks to answer whether the Commission did indeed pursue an effects-based analysis after 2008, whether this approach was responsible for the length of investigations and the Commission’s inability to deliver meaningful outcomes, whether ex ante regulation is a helpful response to these difficulties, and how the Commission should address the criticisms against the ineffectiveness of its enforcement of the prohibition against abuse of a dominant position.
Assessing coastal zooplankton in the St. Lawrence estuary: spatio-temporal patterns of taxonomic and functional biodiversity
Authors: Santo Mélanie , Calosi Piero , Winkler Gesche 
Published: January 2025

Abstract
Biodiversity assessment promotes information on the state of an ecosystem. Zooplankton, as a sentinel group at the basis of aquatic food webs, are, thus, an important component to monitor for ecosystem conservation and management. For the first time, we characterized biodiversity of coastal zooplankton along the shallow Northern shoreline of the lower St. Lawrence estuary (LSLE) using an integrated taxonomic and trait-based approach. For 3 years (2019–2021), in July and October, the zooplankton community and environmental parameters were sampled at &lt; 35 m depth. Mesozooplankton were identified at the lowest possible taxonomic level and assigned functional traits. Community structure and diversities revealed high spatio-temporal variations among three different geographic sectors and between seasons, mainly driven by water temperature, Chlorophyll-a concentration and less by salinity. Hotspots of taxonomic and functional diversities occurred in different sectors in the same month, underlining the complementarity of the two approaches. Seasonal shifts in functional diversity hotspots highlight how environmental variability affects biodiversity beyond taxonomic metrics alone. The results of our study in the LSLE establish a first robust baseline to improve our understanding of zooplankton dynamics in the coastal LSLE, to allow future tracking of ongoing change due to the increase of anthropogenic activities and climate changes and to support future monitoring efforts.