bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on the Relationship between Nurses' Compliance with Standard Precautions, Servant Leadership and Emotional Exhaustion:a Cross-Sectional Survey in China
Authors: Du Xin , Wang Huan , Chen Wen , Lei Wang , Feng Xue , Zhang Xi , Song Caiping 
Published: December 2023

Background: To prevent and control nosocomial infections, it is important to improve nurses' compliance with standard prevention techniques. Nurses' emotional exhaustion has increased in the context of the COVID-19 pandemic. It is crucial to pay attention to the impact of emotional exhaustion on compliance with standard prevention compliance from the perspective of organizational leadership.
Objective: This study aimed to analyze the effects of service-oriented leadership on nurses' emotional failure and compliance with standard prevention and to explore the moderating effect of individual resilience.
Methods: A convenience sampling method was used to collect questionnaire data from 924 clinical nurses in a third-class general hospital in Chongqing, China. A linear mixed model in SPSS 25.0 was used for multilevel regression analysis of the mediating role of emotional exhaustion on servant leadership and standard preventive compliance. PROCESS was used to further test the moderating role of individual resilience.
Results: The emotional exhaustion score (27.42±11.77) was at the general level, and standard preventive behavior compliance (11.41±5.01) was at the general level. Servant leadership mediated by emotional exhaustion had a significant positive predictive effect on standard prevention compliance, and the indirect effect accounted for 23.8% of the total effect. Personal resilience played a negative moderating role in the relationship between servant leadership and emotional exhaustion. For nurses with low resilience, servant leadership had a greater impact on emotional exhaustion. Conclusion: The current standard prevention compliance for clinical nurses is not high due to emotional exhaustion. The level of servant leadership can alleviate nurses' emotional exhaustion and improve compliance with standard prevention. Especially for nurses with low personal resilience, the care and support of department leaders are needed.
Key Words: Compliance with standard precautions by nurses, Servant leadership, Emotional exhaustion, Resilience
Clinical Outcome of Covid-19 in Haematologic Malignancy Patients with a Fourth Dose of Anti-Sars-Cov-2 Vaccine: A Final Epicovideha Report
Authors: Karthaus Meinolf , Salmanton-García Jon , Marchesi Francesco , Glenthoej Andreas , Bilgin Yavuz M , Van Praet Jens , Rahimli Laman , Cornely Oliver , Pagano Livio 
Published: December 2023

Background: There is a general scepticism on anti-SARS-CoV-2 fourth dose efficacy due to lack of data. In pts with haematological malignancies (HM), this results that only few individuals received a fourth dose. We evaluted the clinical outcome of breakthrough SARS-CoV2 infections in HM who previously received a fourth dose of anti-SARS-CoV-2 vaccine, in particular HM from a multi-national European registry.
Methods: Patients (pts) from the EPICOVIDEHA registry were eligible as long as they could fulfil these criteria: a) active HM within the last five years (ys) before COVID-19 diagnosis, b) pts ≥18 ys old, c) laboratory-based diagnosis of SARS-CoV-2 infection, and d) reception a fourth anti-SARS-CoV-2 dose before COVID-19 diagnosis.
Results. As of August 2023, 6867 HM pts with SARS-CoV-2 infection have been registered in the EPICOVIDEHA registry. Out of these, 51 (0.7%) were diagnosed with COVID-19 after having received a fourth vaccine dose. Most of those (30/51, 58.8%) were male; median age was 71 ys of age (IQR 65-73), with only three pts below the age of 50 ys of age. Twelve pts (12/51, 23.5%) did not present any baseline underlying conditions besides the HM. Lymphoproliferative malignancies were prevalent (47/51, 92%). Most pts had a controlled HM at the time of COVID-19 diagnosis (30, 58.8%). Pts had their fourth vaccine dose at a median of 32 days (IQR 13-54) before COVID-19 diagnosis, almost exclusively mRNA based (50/51, 98%). COVID-19 remained asymptomatic or mild in almost all pts (49/51, 96%), with only one patient with critical infection (2%) requiring intensive care. Hospital admission rate was 47.1% with a median hospital stay of 9 days (IQR 5-14). Only 26 pts (51%) received a specific treatment for SARS-CoV-2, with almost all of them (18/26, 69.2%) receiving monoclonal antibodies. Pts were followed up for a median of 65 days (IQR 26-86) and only two died (3.9%) due to COVID-19.
Conclusions. With the caution derived from the limited number of pts and the intrinsic nature of this study, our data show favourable clinical presentation and outcome of breakthrough SARS-CoV2 infections in HM who previously received a fourth dose of anti-SARS-CoV-2 vaccine. The data suggests that a second vaccine booster may be of particular importance to protect this vulnerable HM patient population from severe or potentially life-threatening COVID-19.
Euroflow-Based Ultrasensitive NGF for the Evaluation of Bone Marrow Minimal Residual Disease in Multiple Myeloma
Authors: Tabares Gaviria Paula , Schmiedgen Katharina , Dhanraj Jayabhuvaneshwari , Dagdeviren Hüsniye , Wilnit Amy , Ulbrich Maria , Paiva Bruno , Kortüm K. Martin , Rasche Leo , Einsele Hermann , Beilhack Andreas , Waldschmidt Johannes M 
Published: December 2023

Background:
Euroflow next-generation flow cytometry sensitively assesses minimal residual disease (MRD) in multiple myeloma (MM). It is widely adopted in labs worldwide for tracking disease progression, therapy efficacy, and decision-making in MM trials. Euroflow MRD significantly enhances MM patient outcomes, alongside advancements in anti-cancer approaches like BiTEs, CAR-T cells, and ADCs, resulting in increased overall survival rates. However, blood-based methods do not always align with bone marrow PC analysis, requiring heightened sensitivity to detect residual malignant cells post-therapy. The recent BloodFlow method, achieves remarkable sensitivity up to 10 -8 by enriching CD138 + PCs from 50 mL peripheral blood. In this study, we compare conventional Euroflow BM-MRD with the ultrasensitive method using CD138 enrichment of BM cells before analysis.
Methods:
BM-MRD followed Euroflow group guidelines. For ultrasensitive assessment, CD138 + plasma cells were isolated using CD138 MicroBeads. Data analysis was performed with Infinicyt software. Automatic gate and identification tool was used for conventional MRD, while data was manually analyzed for ultrasensitive MRD assessment.
Results:
We compared conventional and ultrasensitive MRD in the bone marrow of 70 MM patients. All positive MRDs using conventional NGF remained positive with ultrasensitive MRD. Notably, among 40 patients with negative conventional NGF-MRD, 5 cases turned positive after ultrasensitive MRD, by detecting aPCs from 0,0003 to 0,002% in all nucleated cells in the bone marrow. Patients 1, 2, and 3, diagnosed between 2020 and 2022, were in CR during assessment. Patients 4 and 5, diagnosed in 2016 and 2014 respectively, underwent multiple therapies, two autologous hematopoietic cell transplants, and patient 5 also had an allogeneic hematopoietic cell transplant. Ultrasensitive MRD for patients 4 and 5 was done after anti-BCMA CAR T cell therapy. The CD138 isolation approach allowed evaluating BM-MRD at detection levels of 10 -8 cells. Further studies using ultrasensitive MRD will prospectively evaluate the predictive value of the assay in patients with NDMM, especially with high and ultra-high-risk disease.
Conclusions:
This study demonstrates the significant advantages of direct CD138 enrichment over bulk lysis for detecting residual malignant PCs in MM. Ultrasensitive MRD offers superior sensitivity compared to conventional MRD, a critical factor in the era of more effective therapies leading to deeper responses. Currently, we are prospectively assessing the clinical benefits in a larger patient cohort.
Phase Separation Mediates RUNX1- Mutation Leukemic Transformation
Authors: Su Xiuhua , Sun Tao , Xia Yuan , Li Mingying , Wang Dongmei , Lu Fei , Ye Jingjing , Ji Chunyan 
Published: December 2023

B ackground :
The high degree of genetic heterogeneity in acute myeloid leukemia (AML) leads to refractory or relapse in some patients, so it is important to deepen the mechanistic studies and find specific drug targets.As a classical regulatory molecule associated with AML, the absence or down-regulation of RUNX1 can lead to the development of AML. Liquid-liquid phase separation is closely related to the occurrence and development of the disease, and it is not clear whether RUNX1 can participate in the pathogenesis of AML through phase separation. This study is the first to explore the involvement of RUNX1 in the pathogenesis of AML from the perspective of phase separation.
Methods:
The fluorescent expression of RUNX1 was detected by immunofluorescence. The extracellular phase separation of RUNX1 and the mutants were studied by prokaryotic expression of the target protein RUNX1. The intracellular phase separation of RUNX1 was studied by cellular transfection and live-cell imaging. The cellular differentiation ability after phase separation of AML cell lines was investigated by using Rachel Giemsa staining and flow cytometry. The specific mechanism of RUNX1 phase separation regulation of downstream target molecules was examined by Co-IP coupled with mass spectrometry and Western Blot. The effect of RUNX1 phase separation on the pathogenesis of AML was studied by using the AML mouse model.
Results:
In this study, we firstly confirmed that RUNX1 showed obvious spot aggregation during hematopoietic differentiation. We then confirmed that RUNX1 can perform liquid-liquid phase separation both in vitro and intracellularly. Furthermore, based on the structural domain of RUNX1 and the RUNX1 mutation sites in AML patients, it was confirmed that the IDR region of RUNX1 drove occurrence of phase separation, while the RHD region had an inhibitory effect on phase separation, and the RUNX1 point mutants associated with poor prognosis of AML had abnormal phase separation.The occurrence of phase separation of RUNX1 could regulate the differentiation function of AML cells, and the differentiation of AML cells in the phase separation-deficient type was inhibited. Transcriptome sequencing results showed that RUNX1 phase separation promoted the enrichment of signaling pathways such as cell differentiation, and it was also found that RUNX1 phase separation promoted downstream target molecules to participate in the regulation of AML cell function. In addition, we demonstrated that aberrant RUNX1 phase separation was involved in the pathogenesis of AML in the mouse model of AML.
Conclusion:
This study reveals for the first time that RUNX1 liquid-liquid phase separation is involved in the process of AML occurrence and development, and refines the functional regulation mechanism of RUNX1, providing new ideas for AML targeted therapy.
Efficacy and Prognostic Analysis of Percutaneous Vertebroplasty/Kyphoplasty in Patients with Newly Diagnosed Multiple Myeloma
Authors: Zhang Fujing , Liu Shuzhong , Zhou Xi , Liu Shuangjiao , Liu Yong , Zhuang Junling 
Published: December 2023

Objective To evaluate the efficacy and prognosis of percutaneous vertebroplasty/ kyphoplasty (PVP/PKP) in patients with newly diagnosed multiple myeloma (NDMM).
Methods Clinical data of NDMM patients who underwent PVP/PKP during front-line regimen at Peking Union Medical College Hospital from January 1 2003 to June 30, 2023, were retrospectively analyzed. Patients with comparable severity of bone disease and no orthopedic surgery were selected as controls. Visual analogue scale (VAS) score, progression-free survival (PFS), and overall survival (OS) were compared. Statistical methods mainly adopt χ 2-test, t-test, Kaplan Meier, and COX regression analysis.
Results Baseline characteristics were matched between the surgical group (n=51 with 56 surgeries) and non-surgical group(n=102), including gender, age, paraprotein type, serum M protein level, International Staging System(ISS), numbers of lytic lesions, cytogenetic abnormalities, first-line treatment, and autologous stem-cell transplantation (ASCT)（ P＞0.05). Bone lesions for PVP/PKP were located at thoracic vertebrae (53.6%, 30/56) or lumbosacral vertebrae (46.4%, 26/56). The postoperative VAS score was significantly improved (2.25±0.81 vs 5.92±1.05 , P&lt;0.001). The median follow-up time was 51[38,70] months. Kaplan-Meier survival analysis suggested that PFS (37[17,89] vs 23[12.61] months, HR 0.648, 95%CI 0.431-0.973, P=0.047) and OS (not reached vs 66[28, NR] months, HR 0.519, 95%CI 0.296-0.910, P=0.045) in the surgical group were significantly improved. COX multivariate analysis suggested that PVP/PKP was an independent prognostic factor for PFS ( P=0.021, HR 0.589，95%CI 0.376-0.922)and OS( P=0.038, HR 0.496，95%CI 0.255-0.963), while not receiving ASCT or ISS stage II/III were independent risk factors. Subgroup analysis confirmed that patients with ISS II/III or non-ASCT achieved better PFS and OS in the surgical group(PFS: P=0.033, P=0.040; OS: P=0.024, P=0.018), while patients with ISS I or receiving ASCT had similar survival outcome（PFS P＞0.05; OS P＞0.05) between two groups.
Conclusion For NDMM patients, PVP/PKP is associated better quality of life due to alleviating bone pain. Meanwhile, it improves the PFS and OS of patients with ISS stage II/III or non-transplant eligible, which suggests that shortening the gap from symptom onset to diagnosis by surgical pathology will improve response in MM.
Biological and Therapeutic Implications of NPM1-Mutated AML Receiving Allogeneic Hematopoietic Cell Transplantation
Authors: Yuan Xiaolin , Wu Yibo , Lai Xiaoyu , Yang Luxin , Shi Jimin , Liu Lizhen , Yu Jian , Zhao Yanmin , Zheng Weiyan , Wu Wenjun , Zhao Yi , Cai Zhen , Huang He , Luo Yi 
Published: December 2023

Background: The nucleophosmin 1( NPM1) gene mutations are the most common gene alteration in acute myeloid leukemia (AML) patients, occurring in approximately 30%-35% of adult AML cases. However, molecular and response to therapy heterogeneity are existed in this distinct group. Response to therapy, differing patterns of co-mutation and the prognosis of NPM1-mutated AML patients receving allogeneic hematopoietic stem cell transplantation (allo-HSCT) treatment were unknown.
Aims: To evaluate prognostic factors in the NPM1-mutated AML who underwent allo-HSCT treatment.
Methods: A total of 115 consecutive NPM1-mutated AML patients who underwent allo-HSCT from 2016 to 2022 were enrolled in this study. The primary endpoint was the cumulative incidence of relapse (CIR).
Results: The median patient age was 46 (IQR: 36-50) years. The most frequent co-mutations were FLT3-ITD(58.3%) and DNMT3A (40.0%), followed by IDH2(18.3%), NRAS (13.9%) and IDH1 (11.3%). The overall 3-year cumulative incidence of relapse (CIR) and leukemia-free survival (LFS) was 17.3% and 77.2%. The 3-year CIR of patients with FLT3-ITD was significantly higher than that without FLT3-ITD (24.3% vs. 7.0%; P=0.023). The 3-year CIR of patients with DTA mutations ( DNMT3A, TET2, and ASXL1) was significantly higher than that without DTA mutations (24.7% vs. 11.2%; P=0.030). Patients who received matched sibling donor (MSD) allo-HSCT had the highest CIR compared with unrelated donor (URD) allo-HSCT and haploidentical (HRD) allo-HSCT (46.2%, 10.0% and 11.2%, P=0.002). The 3-year CIR in patient with pre-HSCT measurable residual disease negative (MRD-), MRD+ and non-remission was 10.9%, 30.0% and 72.2%(P&lt;0.001). After multivariable adjustment, DTA mutations, pre-MRD+ or non-remission, MSD allo-HSCT remained statistically significantly associated with higher CIR as well as lower LFS and OS. In univariate and multivariate analyses, the cell of origin of AML did not impact the outcomes of NPM1-mutated AML patients accept allo-HSCT treatment .
Conclusion: The DTA mutations ( DNMT3A, TET2, and ASXL1) were identified a distinct group of patients with adverse prognosis in NPM1-mutated AML patients who received allo-HSCT. Our results indicate that NPM1-mutated patients accept HRD/URD donors can achieve lower CIR than MSD donors in transplantation. HRD allo-HSCT may suitable for high risk patients within this group.
Preliminary Results of a Phase Ⅱ Study of Lenalidomide Combined with Immunochemotherapy in Patients with Primary Central Nervous System Lymphoma
Authors: Yao Shuna , Yao Zhihua , Yan Zheng , Wang Haiying , Chu Junfeng , Zhao Shuang , Zhao Xinyang , Liu Yanyan 
Published: December 2023

Conclusion
Introduction：PCNSL is a diffuse large B cell lymphoma (DLBCL) occurring exclusively in the brain, spinal cord, cranial nerves, leptomeninges and/or eyes. Pathophysiology is incompletely understood, although a central role seems to comprise immunoglobulins binding to self-proteins expressed in the central nervous system (CNS) and alterations of genes involved in B cell receptor, Toll-like receptor and NF-κB signalling. Standard of care includes methotrexate-based polychemotherapy followed by age-tailored thiotepa-based conditioned autologous stem cell transplantation, whole-brain radiotherapy or singledrug maintenance。Lenalidomide, an immunomodulatory agent that penetrates the CNS, has shown promise in relapsed/refractory (R/R) aggressive NHL, with well-demonstrated singleagent activity and tolerability. We hypothesized that lenalidomide combined with immunochemotherapy(MTX-based regimen)might be a favorable option for PCNSL pts. Here, we present preliminary data from the phase 2 trial of lenalidomide combined with immunochemotherapy in PCNSL pts (NCT04737889).
To investigate the efficacy of lenalidomide combined with immunochemotherapy in untreated PCNSL.The primary objective is 2-year progression free survival(PFS). The secondary objectives are objective response rate (ORR), incidence of grade 3/4 adverse event (AE), and overall survival (OS).
aged 18-75 years untreated PCNSL and adequate organ function are being enrolled.Lenalidomide(25mg qd po,totally 10 days/cycle) plus R-MT(Rituximab-Methotrexate+Temozolomide) was administered in TN PCNSL. A totally of 6 cycles of treatment was planned for pts. Completed responders(CR) undergo autologous stem cell transplantation (ASCT) 、reduced dose whole brain radiotherapy or lenalidomide maintenance for 24 months, based on the patient's fitness and preference.
RESULTS：From March 2019 to 18 April 2023, 24 pts have been enrolled . Their baseline characteristics are displayed in Table 1.
By 30 May 2025, all pts had been evaluated for response. There were 19 CRs (79.2%), 3 PRs (12.5%) and 2 PDs(8.3%) . The median follow-up time was10 (1.2 - 51.4) months . One pt withdrew informed consent due to grade 3 renal toxicity , One died from non-tumor-related disease. Two year progression-free survival (PFS) and overall survival was 62% and 67%，respectively,the median PFS and OS not achieved.
The most common adverse events were hematologic toxicities. Grade 3/4 AEs occurred in ≥20% pts were neutropenia, leukopenia .Grade 3/4 non-hematologic AEs occurred in ≥20% pts was hepatic injury.
Lenalidomide combined with immunochemotherapy showed encouraging activity and acceptable tolerance in pts with TN PCNSL.The study is still ongoing and it is worth looking forward to updating the long-term survival data.
Measuring Minimal Residual Disease in Plasma of Multiple Myeloma Patients By Intact Mass Spectrometry
Authors: Genovesi Luca , Schirm Michael , Dupuis Nick , Pottiez Gwenael 
Published: December 2023

Multiple Myeloma (MM) is a hematological cancer that is currently treatable but incurable, and is characterized by the accumulation of malignant plasma cells in bone marrow. Clinical studies have shown that post-cancer treatment, the minimal residual disease (MRD) status is a prognostic factor indicative of the extent of disease remission. MRD assessment has been primarily assessed in bone marrow (BM) using flow cytometry or next generation sequencing. Not only these measurements may lead to false-negative results due to spatial heterogeneity in the BM, hemodilution and/or extramedullary disease as indicated by Derman et al. in Blood Cancer Journal ((2021), 11:19) but the procedure for BM collection is invasive and painful for the patient. These authors present a peripheral blood (PB)-based method that potentially can overcome the barriers in assessing for residual disease in MM patients.
We hereby present a non-invasive blood-test for measurement of MRD using mass spectrometry (intact mass approach) for the detection of Ig product in MM patients. We will describe the assay development, analytical characterization of assay performance, and data from the analysis of plasma/serum samples from MM patients enrolled in a clinical trial.
A very low volume of patient plasma/serum sample (10 μL) is required to perform this assay. The plasma/serum sample is diluted in purification buffer, applied to Melon gel resin and incubated for 5 min, followed by centrifugation and reduction with DTT. The supernatant is then analyzed by LC-MS on a Q-Exactive mass spectrometer. Deconvolution of the intact protein m/z spectra is performed to yield intact mass of the specific protein target species of interest.
Overall, the method can process up to 96 samples in parallel within 3 hrs, making this procedure highly scalable for clinical applications.
Data obtained from the assay characterization indicate that the assay is sensitive with an LOD &lt;500 ng/mL and differentiates MM patient from a healthy donor as well allows for the monitoring of MM patient before and after treatment.
In conclusion, although still an exploratory analysis, the blood-based mass spectrometry method can be used to screen for MRD in patients who have undetectable disease by flow cytometry or next generation sequencing.