bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with assertiveness among Japanese community pharmacists: a cross-sectional study
Authors: Ishii Mitsuaki , Ozone Sachiko , Masumoto Shoichi , Maeno Tetsuhiro 
Published: January 2025

Abstract

Background
Community pharmacists play a crucial role in promoting medication safety within the community healthcare team. Effective communication by community pharmacists with other health professionals is essential to facilitate the sharing of patient healthcare information. In the context of information sharing between physicians and community pharmacists, assertive self-expression (defined as ‘a style of openly expressing one's needs and feelings while respecting others’) is beneficial. The aim of this study is to identify factors associated with assertive self-expression among community pharmacists.

Methods
A cross-sectional study was conducted by surveying 3,446 Japanese community pharmacists working at pharmacies across 10 prefectures. Participants were invited to complete a survey form by email and assessed for assertive self-expression using the Interprofessional Assertiveness Scale. Characteristics of participants and pharmacies were compared using univariate analysis. A generalized linear model was used to explore the factors associated with assertive self-expression.

Results
A total of 961 responses by community pharmacists were included in the analysis. Univariate analysis identified significant differences in assertive self-expression scores based on age, employment status, education, years of working experience as a pharmacist, pharmacist home visit service, and participation in joint regional workshops or conferences. After adjustment, participation in joint regional workshops or conferences was significantly associated with assertive self-expression (odds ratio, 1.037; 95% confidence interval, 1.005–1.070; p = 0.023).

Conclusions
This study showed that assertive self-expression among community pharmacists was associated with participation in joint regional workshops and conferences. Further research is needed to examine whether enhancing assertive self-expression facilitates pharmacists' interprofessional communication skills and improves medication safety.
Efficacy and safety of avacopan in antineutrophil cytoplasmic autoantibody-associated vasculitis: a retrospective cohort study in Japan
Authors: Tagami Genri , Yamaguchi Makoto , Sugiyama Hirokazu , Kinashi Hiroshi , Imai Kentaro , Kamiya Keisuke , Katsuno Takayuki , Imaizumi Takahiro , Banno Shogo , Ito Yasuhiko , Ishimoto Takuji 
Published: January 2025

Abstract

Background
Avacopan, an oral C5a receptor antagonist, demonstrated efficacy as an alternative to glucocorticoid therapy in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in the phase 3 ADVOCATE trial. However, limited real-world data exist on the outcomes and experiences associated with avacopan use for AAV in Japan.

Methods
We performed a single-centre retrospective analysis and evaluated 21 patients with newly diagnosed or relapsed AAV who received avacopan. The co-primary outcomes were clinical remission at 6 and 12 months.

Results
Among the 21 patients, 20 (95.2%) achieved clinical remission at 6 months, and 19 (90.4%) sustained remission at 12 months. The median time from initiation of immunosuppressive therapy to the start of avacopan was 12 days (interquartile range, 5–26). Adverse events were reported in 10 patients (47.6%), with elevated liver enzyme levels observed in eight patients (38.1%) as the most frequent complication. Avacopan was discontinued in nine patients (42.9%). Despite early discontinuation, these patients achieved comparable rates of clinical remission at 6 months, sustained remission at 12 months, and experienced a reduction in glucocorticoid doses relative to those who continued avacopan.

Conclusions
A high incidence of adverse events, particularly liver enzyme elevation, and frequent early discontinuations of avacopan were observed. Nevertheless, favourable clinical outcomes and reduced glucocorticoid doses were achieved regardless of avacopan discontinuation. Further studies are warranted to validate the optimal use of avacopan in clinical practice.
Oral cannabidiol did not impair learning and memory in healthy adults
Authors: Gebregzi Hanna H. , Zeiger Joanna S. , Smith Jeffrey P. , Stuyt Libby , Cullen Luann , Carsella Jim , Rogers Daniel C. , Lafebre Jordan , Knalfec Jennah , Vargas Alfredo , Diawara Moussa M. 
Published: January 2025

Abstract

Background
The effect of oral Cannabidiol (CBD) on interference during learning and memory (L&M) in healthy human volunteers has not been studied.

Method
A two-arm crossover, randomized, double-blind, placebo-controlled trial was conducted at Colorado State University Pueblo (CSU Pueblo) to evaluate the effects of 246 mg oral CBD on L&M in healthy adults. Among 57 healthy volunteers enrolled, 35 were included in the analyses. For assessment of L&M, Montreal Cognitive Assessment (MOCA) was used to evaluate verbal baseline cognitive function; RAVLT-R tests (List A and List B recalls, Proactive and Retroactive Interference ratios, and Forgetting Speed ratio) were used to evaluate verbal declarative memory; and total prose recall was used to evaluate verbal logical memory. Linear Mixed Models with Bonferroni Corrections were used to compare L&M results between primary outcomes (CBD vs. placebo) and secondary demographic outcomes, with a two-tailed statistical significance of P < 0.05.

Results
CBD administration did not affect any of the dependent variables measured compared to the placebo group. There were no effects of THC, history of CBD use, or sex on CBD’s modulation of L&M. However, a highly significant interaction effect between treatment groups (CBD vs. placebo) and age of subjects was observed for the PI ratio (P = 0.008; n = 35).

Conclusions
The results of this study suggest that administration of oral CBD alone does not significantly impair L&M in healthy adults. However, age might influence CBD related modulation of proactive interference during human L&M. Future research involving a larger group of older adults is needed to confirm this potential effect.

Trial registration
The study was approved by the CSU Pueblo IRB, conducted in accordance with the Declaration of Helsinki, and registered with ClinicalTrials.gov (NCT06074172).
Fire, land use, and the long-term dynamics of a pitch pine woodland in coastal Maine, USA
Authors: Barton Andrew M. , Nurse Andrea M. , Lalemand Laura , Fowke Thomas , Grenier Daniel 
Published: January 2025

Abstract

Background
Pitch pine is a globally rare tree species that occurs on xeric sites in the largely mesic landscape of eastern North America. Supporting a rich assemblage of rare species, pitch pine communities are undergoing succession to more mesophytic species in the absence of natural and anthropogenic disturbance. We examined the multi-millennial dynamics of pitch pine in relation to fire and land use across a local moisture gradient in southern coastal Maine, USA.

Results
Fossil pollen revealed that pitch pine has inhabited the study area for at least 9000 years. A positive correlation of pitch pine pollen with macroscopic charcoal (> 250 μm) demonstrated the historical importance of fire for this species. Euro-American settlement profoundly altered the forest. The sediment record revealed a pulse of fire, settlement-associated weeds, and pitch pine establishment as intensive land use commenced, followed by a recent decline as forests regenerated after pasture abandonment and fire suppression. Tree age structures and current regeneration patterns revealed ongoing succession of pitch pine to more mesophytic species, such as red oak and red maple, except on the most xeric sites, where the species appears to be self-perpetuating.

Conclusions
The results support a conceptual model of varying pitch population dynamics across a xeric to mesic gradient. They also reveal current mesophication and contraction of pitch pine woodland, a pattern found across the species’ range. If maintenance of large areas of pitch pine woodlands in the study area is an important management goal, then active management to reduce competing vegetation should be considered. If other goals, such as carbon sequestration or restoration of pre-colonial conditions, when pitch pine was apparently less abundant are paramount instead, then allowing natural succession to more mesic forest would make sense.
β-Glucosidase VmGlu1 is required for toxin production and pathogenicity of Valsa mali
Authors: Cui Xinyue , Zhang Dewan , Gao Liyong , Liu Na , Lian Sen , Ren Weichao , Li Baohua , Wang Caixia 
Published: January 2025

Abstract
Flavonoids, serving as crucial secondary metabolites, are widely distributed in plants and play a key role in inhibiting microbial growth, protecting plants from pathogen invasion, and conserving energy. Our previous study revealed that the β-glucosidase VmGlu2 effectively catalyzes the degradation of phloridzin, a typical flavonoid in apples, and regulates the pathogenic process of Valsa mali. However, VmGlu2 exhibits a lower efficiency in degrading rutin, another characteristic flavonoid in apples. In this study, we found that the expression level of the β-glucosidase gene VmGlu1 was induced by 9.42-fold following rutin treatment, and VmGlu1 possessed the capability to degrade both rutin and phloridzin, but under the same conditions, VmGlu1 showed a distinct preference for rutin degradation, with an initial degradation rate 8.66 times higher than that of VmGlu2. Targeted deletion of VmGlu1 resulted in a 99.32% reduction in pycnidia production, a nearly 33% decrease in toxin production, and a significant decrease in pathogenicity on apple twigs and leaves. Furthermore, we verified that VmGlu1 and VmGlu2 exhibit functional redundancy in pycnidia production, toxin-related β-glucosidase activity, and pathogenicity by generating double-deletion mutants. The results of this study provide valuable insights into the roles of VmGlus in the interaction of V. mali and apple during the infection process.
Natural products targeting ubiquitination to combat kidney fibrosis
Authors: Li Lianhua , Huang Xinhui , Chen Yao , Liu Jibin , Qiao Yuhang , Fan Wenyu , Zhang Peiqing , Yan Xiaoming , Chen Ming 
Published: January 2025

Abstract

Background
Kidney fibrosis is a crucial component that contributes to end-stage renal disease and is the inevitable last pathological process in many progressive chronic kidney diseases (CKD). Ubiquitination, one of the most refined and widespread reversible post-translational modifications, plays a significant role in the development of renal fibrosis through its regulation and deubiquitination processes.

Main body of the abstract
Recent studies have shown that ubiquitination and deubiquitination represent promising intervention targets against renal fibrosis, with numerous natural products intervening in renal fibrosis by regulating the processes of ubiquitination and signal pathways such as transforming growth factor-β1/Smads (TGF-β1/Smads), Wnt/β-catenin, Janus kinase/signal transducer and activator of transcription/suppressor of cytokine signaling (JAK/STAT/SCOS), and nuclear factor erythroid-derived 2-like 2 (Nrf2), and then link.

Conclusion
Herein, we summarize the processes of ubiquitination and deubiquitination and introduce the interactions between ubiquitination and natural products. This is conducive to the development of new candidate drugs that intervene in renal fibrosis through the regulation of ubiquitination, representing a promising strategy to combat renal fibrosis with natural products.

Graphical abstract
Therapeutic potential of the neutralizing monoclonal antibody 45G3 against encephalomyocarditis virus
Authors: Zhang Yanfang , Wang Zhiying , Fang Yaohui , Zhu Qiong , Fu Jie , Hu Sijing , Jin Jiayin , Zhou Min , Liu Xijia , Zhang Danna , Huang Shouwei , Deng Yali , Xie Lingling , Shen Shu , Ye Jing , Deng Fei , Cao Shengbo 
Published: January 2025

Abstract
Encephalomyocarditis virus (EMCV), a potential zoonotic pathogen, poses significant socioeconomic and public health challenges across various host species. Although EMCV rarely triggers severe clinical symptoms in humans, its widespread prevalence and unique biological characteristics underscore the need for continuous surveillance and the development of effective therapeutics and prophylactics. In this study, we evaluated the neutralizing effects of a monoclonal antibody derived from the spleens of mice immunized with EMCV virus-like particles (VLPs), both in vitro and in vivo. Using recombinant DNA technology, we engineered a baculovirus system to express EMCVs P12A and 3C, facilitating the production of VLPs in Sf9 cells. These VLPs serve as antigens to immunize mice, leading to the isolation of the monoclonal antibody 45G3. This antibody exhibited high specificity for EMCV conformational epitopes, excluding linear epitopes, and demonstrated potent in vitro neutralizing activity, with an IC50 of 0.01873 μg/mL. Immunoelectron microscopy (IEM) revealed a strong direct interaction between the 45G3 antibody and EMCV particles. Virus adsorption inhibition assays demonstrated that 45G3 effectively blocked viral attachment, thereby preventing further infection of host cells. These findings further support the notion of a robust interaction between the virus and the antibody. Moreover, in vivo assessments revealed that 45G3 significantly reduced viral loads in treated mice and improved survival outcomes following EMCV exposure. Additionally, posttreatment analysis revealed reduced tissue damage and a markedly decreased inflammatory response in the brain, indicating that the 45G3 antibody effectively blocked viral infection, thereby mitigating tissue damage and enhancing survival. These findings position 45G3 as a promising candidate for EMCV management and provide a strong foundation for the future development of antiviral drugs targeting this widespread virus.
Extension for Community Healthcare Outcomes-Palliative Care in Africa and Quality of Life, Symptoms, Patient Experience, and Caregiver Distress Among Patients With Cancer
Authors: Yennurajalingam Sriram , Soyannwo Olaitan , Weru John , VND Addo Opare-Lokko Edwina Beryl , Burger Henriette , Nafulah Esther , Aikomo Oladayo , Adenipekun Adeniyi , Botchway Irene , Ocansey Mary , Deodhar Jayita , Dai Jianliang , Andersen Clark R. , Arthur Joseph Anthony , Rozman de Moraes Aline , Stanton Penny A. , Bruera Eduardo , Reddy Suresh 
Published: January 2025

PURPOSE
In this study, we aimed to evaluate the association between the Extension for Community Healthcare Outcomes-Palliative Care (ECHO-PC; ECHO Model–Based comprehensive educational and telementoring intervention) for health care professionals (HCPs) and change in patient-reported quality-of-life (QOL; Functional Assessment of Cancer Therapy-General [FACT-G]) among patients with advanced cancer. We also examined the association between ECHO-PC and changes in symptom distress (Edmonton Symptom Assessment Scale [ESAS]), patient experience and satisfaction, and caregiver distress scores.

METHODS
ECHO-PC Clinic sessions were conducted twice a month for 1 year by an interdisciplinary team of PC clinicians at the MD Anderson Cancer Center, with participation of experts in PC in sub-Saharan Africa, using standardized curriculum on the basis of PC needs in the region. Study participants included palliative HCPs from ECHO participating programs in Kenya, Nigeria, Ghana, and South Africa. HCPs, their patients, and caregivers were assessed at baseline, 3, 6, 9, and 12 months of the study for QOL (FACT-G), ESAS-Symptom Distress Score (prorated) (SDS), patient experience, satisfaction (FAMCARE-P-16-patient), and caregiver distress (FAMCARE-caregiver).

RESULTS

Two hundred seventy patients completed the assessments. Fifty-eight percent was female, the mean age was 56 years, and most common cancer type was breast cancer (24.3%). Multivariate generalized linear mixed model analysis found that ECHO-PC intervention was associated with significant improvement in QOL and symptom distress (FACT-G total score,
P
= .0433; FACT-G physical well-being,
P
< .013; FACT-G emotional well-being,
P
= .0232, and ESAS-SDS,
P
< .0001). No significant changes were found in patient experience, satisfaction, and caregiver distress scores.

CONCLUSION
Our preliminary study found that the ECHO-PC intervention was significantly associated with improvement in patient outcomes including QOL and symptom distress scores. Further studies are needed.
Development and Implementation of Oral Anticancer Agent Tools for a Thematic Quality Improvement Program: A Collaboration Between Hematology Oncology Pharmacist Association and ASCO Quality Training Program
Authors: Nachar Victoria , Adams Curry Marjorie , Kostoff Diana , Wood Angela , Farris Karen B. , Muluneh Benyam , Morris Amy , Keng Michael , Guerrier Vedner , Mackler Emily R. 
Published: January 2025

PURPOSE
The Hematology Oncology Pharmacist Association Oral Chemotherapy Collaborative (HOPA OCC) developed practice-based tools to use in program development and improvement for the management of patients receiving oral anticancer agents (OAAs).

METHODS
These tools include a baseline OAA program assessment, clinical OAA adherence tool, and OAA dashboard. HOPA OCC distributed these tools to teams participating in the 6-month HOPA ASCO Quality Training Programs (QTPs). Barriers in the delivery of OAA services across practice sites were determined through the use of baseline assessments, and the following domains were evaluated: (1) side-effect monitoring, (2) adherence monitoring, (3) use of patient-reported outcomes, (4) social determinants of health, and (5) collaborative practice agreements for oncology pharmacists. The OAA adherence tool offers clinical patient adherence questions and guidance for supporting adherence in practice. Finally, the dashboard includes multiple metrics that may be helpful for practices to measure their program outcomes. HOPA OCC used the Consolidated Framework for Implementation Research to assess tool usefulness by the QTP participants.

RESULTS
Barriers to implementation include deficits in information technology, resources, and competing priorities.

CONCLUSION
Standardized OAA tools can inform and support quality improvement initiatives and improve the care of patients receiving OAAs.
The effect of serum cortisol level on the outcomes of Persistent Inflammation, Immunosuppression and Catabolism Syndrome patients in the intensive care unit
Authors: Eroğlu Onur , Özgültekin Asu , Ekinci Osman 
Published: January 2025

Objective: This study sought to elucidate the potential association between serum cortisol level and clinical outcomes in patients diagnosed with Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (PIICS).
Methods: This prospective observational study, initiated in January 2023 and concluded in July 2023 enrolled 42 patients diagnosed with PIICS admitted to the intensive care unit (ICU) at Training and Research Hospital. For the purpose of analysis, serum cortisol levels were categorized as low (<15 μg/dL) and high (>15 μdL). To facilitate data organization and subsequent analysis, measurements were categorized into three time intervals following ICU admission: T1 (days 14-21), T2 (days 21-28), and T3 (days >28). Statistical analysis was performed using IBM-SPSS 28. A significance level of p < 0.05 was set to determine statistically significant differences between groups.
Results: Cortisol measured at T3 were significantly lower (p < 0.05) compared to T2. In contrast, SOFA scores were significantly higher (p < 0.05). No statistically significant differences were observed between the low and high cortisol level groups at T1, T2 and T3 in terms of gender, APACHE-2 score, SOFA score, ICU length of stay (days), duration of mechanical ventilation (days), mortality rate, or mechanical ventilation requirement at discharge. Patients in the low cortisol group at T3 exhibited a significantly higher mean age compared to those in the high cortisol group (p < 0.05).
Conclusion: Cortisol levels in ICU patients may change over time. That cortisol levels tend to decrease as the length of stay increases, in older patients, and in PIICS patients with elevated SOFA scores.
doi: https://doi.org/10.12669/pjms.41.2.10256
How to cite this: Eroglu O, Ozgultekin A, Ekinci O. The effect of serum cortisol level on the outcomes of Persistent Inflammation, Immunosuppression and Catabolism Syndrome patients in the intensive care unit. Pak J Med Sci. 2025;41(2):542-547. doi: https://doi.org/10.12669/pjms.41.2.10256
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Chavibetol Loaded Zinc Oxide Nanoparticles (CB-ZnONPs) for Activity-Enhanced Anticancer Applications against Human Lung (A549)
Authors: Balaji Murugesan  , Rajesh Pattulingam  , Syed Illiyas Syed Maqbool  
Published: January 2025

Chavibetol loaded Zinc oxide nanoparticles have demonstrated exceptional potential as anticancer agents when used together. Collectively, it possesses the capacity to serve as a substitute or addition to conventional anticancer medications. The current study focuses on examining the deliberate synthesis of biocompatible Zinc oxide nanoparticles (CB-ZnO-NPs) that are infused with chavibetol. We also assessed these nanoparticles for their ability to load and release chavibetol as a prodrug. Furthermore, the loaded particles were assessed for their ability to inhibit cell growth and induce programmed cell death in Human Lung (A549). The structure and morphological properties of the produced materials were analyzed by scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction analysis, dynamic light scattering analysis, and zeta potential analysis. Dynamic light scattering (DLS) and scanning electron microscopy (SEM) examination verifies that the synthesized CB-ZnONPs have a size of around 50-60 nm. Furthermore, the analysis confirms that the nanoparticles possess a highly crystalline structure and exhibit a rod shape. The FTIR measurement confirms the conjugation of chavibetol molecules with zinc oxide nanoparticles. The X-ray diffraction patterns reveal that the zinc oxide nanoparticles possess a spinel structure and exhibit a high level of purity. Chavibetol-loaded nanoparticles exhibit a regulated release pattern in accordance with different pH levels. We observed a notable suppression of cell growth in the group that received treatment, followed by the occurrence of programmed cell death as indicated by the study of fluorescence microscopy using AO/EtBr. The Synthesized material also showed that upregulation of apoptotic protein and down regulating the antiapoptotic protein. The results of our study clearly show that chavibetol loaded zinc oxide nanoparticles may effectively transport the desired medication and induce programmed cell death in specific human lung cancer cells. This has the potential to initiate a new field in polymer surface chemistry, focusing on the creation of drug delivery systems for cancer therapies using metal oxide materials.