bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating Systemic Burnout in Medical Oncology Through a National Oncology Mentorship Program
Authors: Nindra Udit , Shivasabesan Gowri , Mellor Rhiannon , Chua Wei , Ng Weng , Karikios Deme , Richards Bethan , Liu Jia 
Published: January 2024

PURPOSE
Mentorship has a positive influence on trainee skills and well-being. A 2022 Pilot Mentorship Program in New South Wales involving 40 participants revealed high burnout rates in Medical Oncology trainees. As part of an Australia-wide inaugural National Oncology Mentorship Program in 2023 (NOMP23), a national survey was undertaken to assess the prevalence of burnout, anxiety, depression, professional fulfilment, and drivers of distress in the Australian medical oncology workforce.

METHODS
NOMP23 is a 1-year prospective cohort study that recruited medical oncology trainees and consultants using e-mail correspondence between February and March 2023. Each participant completed a baseline survey which included the Maslach Burnout Index (MBI), Stanford Professional Fulfilment Index, and Patient Health Questionnaire-4 for anxiety and depression.

RESULTS
One hundred and twelve participants (56 mentors, 56 mentees) were enrolled in NOMP23, of which 86 (77%) completed the baseline survey. MBI results at baseline demonstrated that 77% of consultants and 82% of trainees experienced burnout in the past 12 months. Professional fulfilment was noted to be <5% in our cohort. Screening rates of anxiety and depression in trainees were 32% and 16%, respectively, compared with 7% and 2% for consultants. When assessing reasons for workplace stress, two thirds stated that heavy patient load contributed to stress, while almost three quarters attributed a heavy administrative load. Lack of supervision was a key stressor for trainees (39%), as was lack of support from the training college (58%).

CONCLUSION
Trainees and consultant medical oncologists demonstrate high rates of burnout and low professional fulfilment. The NOMP23 program has identified a number of key stress factors driving burnout and demonstrated concerning levels of anxiety and depression. Ongoing mentorship and other well-being initiatives are needed to address these issues.
Changes in Intrinsic Connectivity Networks Topology Across Levels of Dexmedetomidine-Induced Alteration of Consciousness
Authors: Staquet Cecile , Vanhaudenhuyse Audrey , Kandeepan Sivayini , Sanders Robert D. , Ribeiro de Paula Demetrius , Brichant Jean François , Laureys Steven , Bonhomme Vincent , Soddu Andrea 
Published: January 2024

BACKGROUND:
Human consciousness is generally thought to emerge from the activity of intrinsic connectivity networks (resting-state networks [RSNs]) of the brain, which have topological characteristics including, among others, graph strength and efficiency. So far, most functional brain imaging studies in anesthetized subjects have compared wakefulness and unresponsiveness, a state considered as corresponding to unconsciousness. Sedation and general anesthesia not only produce unconsciousness but also phenomenological states of preserved mental content and perception of the environment (connected consciousness), and preserved mental content but no perception of the environment (disconnected consciousness). Unresponsiveness may be seen during unconsciousness, but also during disconnectedness. Deep dexmedetomidine sedation is frequently a state of disconnected consciousness. In this study, we were interested in characterizing the RSN topology changes across 4 different and steady-state levels of dexmedetomidine-induced alteration of consciousness, namely baseline (Awake, drug-free state), Mild sedation (drowsy, still responding), Deep sedation (unresponsive), and Recovery, with a focus on changes occurring between a connected consciousness state and an unresponsiveness state.

METHODS:
A functional magnetic resonance imaging database acquired in 14 healthy volunteers receiving dexmedetomidine sedation was analyzed using a method combining independent component analysis and graph theory, specifically looking at changes in connectivity strength and efficiency occurring during the 4 above-mentioned dexmedetomidine-induced altered consciousness states.

RESULTS:
Dexmedetomidine sedation preserves RSN architecture. Unresponsiveness during dexmedetomidine sedation is mainly characterized by a between-networks graph strength alteration and within-network efficiency alteration of lower-order sensory RSNs, while graph strength and efficiency in higher-order RSNs are relatively preserved.

CONCLUSIONS:
The differential dexmedetomidine-induced RSN topological changes evidenced in this study may be the signature of inadequate processing of sensory information by lower-order RSNs, and of altered communication between lower-order and higher-order networks, while the latter remain functional. If replicated in an experimental paradigm distinguishing, in unresponsive subjects, disconnected consciousness from unconsciousness, such changes would sustain the hypothesis that disconnected consciousness arises from altered information handling by lower-order sensory networks and altered communication between lower-order and higher-order networks, while the preservation of higher-order networks functioning allows for an internally generated mental content (or dream).
A Pilot Study of Renin-Guided Angiotensin-II Infusion to Reduce Kidney Stress After Cardiac Surgery
Authors: Sadjadi Mahan , von Groote Thilo , Weiss Raphael , Strauß Christian , Wempe Carola , Albert Felix , Langenkämper Marie , Landoni Giovanni , Bellomo Rinaldo , Khanna Ashish K. , Coulson Tim , Meersch Melanie , Zarbock Alexander 
Published: January 2024

BACKGROUND:
Vasoplegia is common after cardiac surgery, is associated with hyperreninemia, and can lead to acute kidney stress. We aimed to conduct a pilot study to test the hypothesis that, in vasoplegic cardiac surgery patients, angiotensin-II (AT-II) may not increase kidney stress (measured by [TIMP-2]*[IGFBP7]).

METHODS:
We randomly assigned patients with vasoplegia (cardiac index [CI] > 2.1l/min, postoperative hypotension requiring vasopressors) and Δ-renin (4-hour postoperative–preoperative value) ≥3.7 µU/mL, to AT-II or placebo targeting a mean arterial pressure ≥65 mm Hg for 12 hours. The primary end point was the incidence of kidney stress defined as the difference between baseline and 12 hours [TIMP-2]*[IGFBP7] levels. Secondary end points included serious adverse events (SAEs).

RESULTS:
We randomized 64 patients. With 1 being excluded, 31 patients received AT-II, and 32 received placebo. No significant difference was observed between AT-II and placebo groups for kidney stress (Δ-[TIMP-2]*[IGFBP7] 0.06 [ng/mL]2/1000 [Q1–Q3, −0.24 to 0.28] vs −0.08 [ng/mL]2/1000 [Q1–Q3, −0.35 to 0.14]; P = .19; Hodges-Lehmann estimation of the location shift of 0.12 [ng/mL]2/1000 [95% confidence interval, CI, −0.1 to 0.36]). AT-II patients received less fluid during treatment than placebo patients (2946 vs 3341 mL, P = .03), and required lower doses of norepinephrine equivalent (0.19 mg vs 4.18mg, P < .001). SAEs were reported in 38.7% of patients in the AT-II group and in 46.9% of patients in the placebo group.

CONCLUSIONS:
The infusion of AT-II for 12 hours appears feasible and did not lead to an increase in kidney stress in a high-risk cohort of cardiac surgery patients. These findings support the cautious continued investigation of AT-II as a vasopressor in hyperreninemic cardiac surgery patients.
Comparison of Dentatorubrothalamic Tractography Methods Based on the Anatomy of the Rubral Wing
Authors: Berger Assaf , Chung Jongchul , Schnurman Zane , Stepanov Valentin , Pan Ling , Shepherd Timothy M. , Mogilner Alon 
Published: January 2024

BACKGROUND AND OBJECTIVES:
Precise localization of the dentatorubrothalamic (DRT) tract can facilitate anatomic targeting in MRI-guided high-intensity focused ultrasound (HIFU) thalamotomy and thalamic deep brain stimulation for tremor. The anatomic segment of DRT fibers adjacent to the ventral intermediate nucleus of the thalamus (VIM), referred to as the rubral wing (RW), may be directly visualized on the fast gray matter acquisition T1 inversion recovery. We compared reproducibility, lesion overlap, and clinical outcomes when reconstructing the DRT tract using a novel anatomically defined RW region of interest, DRT-RW, to an existing tractography method based on the posterior subthalamic area region of interest (DRT-PSA).

METHODS:
We reviewed data of 23 patients with either essential tremor (n = 18) or tremor-predominant Parkinson's disease (n = 5) who underwent HIFU thalamotomy, targeting the VIM. DRT tractography, ipsilateral to the lesion, was created based on either DRT-PSA or DRT-RW. Volume sections of each tract were created and dice similarity coefficients were used to measure spatial overlap between the 2 tractographies. Post-HIFU lesion size and location (on postoperative T2 MRI) was correlated with tremor outcomes and side effects for both DRT tractography methods and the RW itself.

RESULTS:
DRT-PSA passed through the RW and DRT-RW intersected with the ROIs of the DRT-PSA in all 23 cases. A higher percentage of the RW was ablated in patients who achieved tremor control (18.9%, 95% CI 15.1, 22.7) vs those without tremor relief (6.7%, 95% CI% 0, 22.4, P = .017). In patients with tremor control 6 months postoperatively (n = 12), those with side effects (n = 6) had larger percentages of their tracts ablated in comparison with those without side effects in both DRT-PSA (44.8, 95% CI 31.8, 57.8 vs 24.2%, 95% CI 12.4, 36.1, P = .025) and DRT-RW (35.4%, 95% CI 21.5, 49.3 vs 21.7%, 95% CI 12.7, 30.8, P = .030).

CONCLUSION:
Tractography of the DRT could be reconstructed by direct anatomic visualization of the RW on fast gray matter acquisition T1 inversion recovery-MRI. Anatomic planning is expected to be quicker, more reproducible, and less operator-dependent.
Beyond barriers, towards diversity: how hybrid student conferences can drive accessibility
Authors: Castellano Bueno Janire , Vezyrakis Alexandros , Xu Peter , Miller Christopher W. 
Published: January 2024

ABSTRACT
The third International Student Symposium on Animal Behaviour and Cognition (ISSABC) aimed to address barriers for early career researchers, hosting a conference both in-person and online at the Universidad Nacional Autónoma de México (UNAM). The conference, attended by 101 in-person and 79 virtual participants from 24 countries, featured 81 presentations, 29 posters, five plenary talks, three workshops, and a career development round-table discussion. A user-friendly website and digital platforms facilitated communication and real-time discussions between in-person and online participants. Transparent fund management, support from sponsors and societies, and sustainable practices ensured financial accountability and minimised environmental impact. The conference emphasised sustainability measures, including eco-friendly catering and local reusable mugs. Future organisers of similar events are encouraged to prioritise local representation, plan contingencies, select plenary speakers rigorously, and employ effective marketing. With this meeting review, we highlight how hybrid conferences like the third ISSABC, through innovative approaches and sustainable practices, enhance accessibility, inclusivity, and empower the next generation of scientists.
THE IMPORTANCE OF P16 GENE EXPRESSION AS A FACTOR OF TUMOR BLAST CELL TRANSFORMATION (literature review)
Authors: Subbotina Tat'yana , Guseynov Arif , Gol'cova E. , Chizhova V. , Rudneva A. 
Published: January 2024

For a more accurate prediction of tumor behavior and individualization of treatment approach, it is necessary to improve new methods of early diagnosis of precancerous conditions. The article provides an overview of the modern understanding of the mechanisms of gene p16 expression as a factor in tumor growth. Data on the relevance of studying the pathogenesis of tumor blast transformation in invasive breast cancer are presented. These tumors require the combined interdisciplinary work of highly qualified specialists and ultra-modern technologies to achieve a positive result. The link between the formation of malignant breast tumors and human papillomavirus is described.
The purpose of this study was to review the futuristically significant immunohistochemical analysis of p16 in patients of different age groups with common cervical cancer and breast cancer.
The possibility of using the determination of p16 expression as a prognostic marker for breast cancer is shown, as well as the results of studying the expression of p16 and p53 in triple-negative breast cancer. The data reflecting the dependence of the suppressor function efficiency on the localization of p16 expression in squamous cell carcinoma of the cervix are analyzed. The dependence of p16INK4a expression on the severity of malignant cervical lesions is indicated, and the effect of chemotherapy on p16 expression is considered. By studying and applying information on the ontogenetic variability of the p16 gene, it is possible to significantly increase the accuracy of predicting the clinical and pathomorphological course of cancer of any nature of occurrence and to select adequate therapy: gene, chemotherapy, radiation therapy.
Cefepime-induced non-convulsive status epilepticus
Authors: Duarte-Celada Walter , Thakolwiboon Samathorn , Pan Jie , Bueso Tulio , Ferdous Jannatul 
Published: January 2024

Cefepime-induced non-convulsive status epilepticus (NCSE) can develop in patients with advanced age, renal impairment, and previous central nervous system disorders. Its clinical presentation varies from confusion, mutism, and decreased level of consciousness to coma. The typical electroencephalogram (EEG) findings are generalized spike and wave discharges of 1-3 Hz. We present a case series of 4 patients with cefepime-induced NCSE, including the clinical presentation and EEG findings. Electroencephalograms should be part of the workup of acute confusional state in patients on this antibiotic, and physicians should be aware of this uncommon complication.

Keywords: Non-convulsive status epilepticus, cefepime, confusion, mutism, electroencephalogram.
O ERÓTICO COMO RESISTÊNCIA EM “LUAMANDA” E “MAIS ILUMINADA QUE OUTRAS”
Authors: De Vasconcelos Lidiane Lima , Santos Gilvaneide de Sousa 
Published: January 2024

Este estudo se propõe a trazer uma leitura comparativa dos contos “Luamanda” de Conceição Evaristo e “Mais iluminada que as outras” de Jarid Arraes. O nosso objetivo foi explorar o erótico das narrativas para que seja visto como resistência e não como projeção da hipersexualização quando é associado aos corpos das mulheres negras. Além disso, pretendemos romper com a história hegemônica que se utilizou da sexualidade feminina como dispositivo de controle social, sufocando potencialidades dos corpos femininos. Usamos como suporte teórico os estudos de Chimamanda Ngozi Adichie em O Perigo de uma história única (2009), o conceito de “escrevivência” de Conceição Evaristo (2020), o conceito de erótico de Audre Lorde (2019) e as imagens que foram lançadas sobre as mulheres negras brasileiras pela perspectiva de Beatriz Nascimento (2021) e de Lélia Gonzalez (2020).
COVID-19 in Custody: Responding to Pandemics in Prisons in England and Wales
Authors: Kay Christopher 
Published: January 2024

The first cases of COVID-19 in England and Wales saw a sudden and significant strain placed on a range of public services, with general practitioner surgeries, hospitals, schools, adult social care and others having to adapt quickly to life with the virus. While the impact of the pandemic on such services cannot be denied, the virus also posed a ‘very real threat … to our other, often unfairly overlooked, frontline service: our prisons’ (Neill, 2020). This chapter focuses on the impact of the first two waves of the COVID-19 pandemic on the prison system in England and Wales, along with the lessons learned from these waves in relation to pandemic management within the system itself and to the dichotomy that exists between populist penal politics and public health.
Combined analyses of within-host SARS-CoV-2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of Omicron and Delta variants
Authors: Russell Timothy W. , Townsley Hermaleigh , Abbott Sam , Hellewell Joel , Carr Edward J. , Chapman Lloyd A. C. , Pung Rachael , Quilty Billy J. , Hodgson David , Fowler Ashley S. , Adams Lorin , Bailey Chris , Mears Harriet V. , Harvey Ruth , Clayton Bobbi , O’Reilly Nicola , Ngai Yenting , Nicod Jerome , Gamblin Steve , Williams Bryan , Gandhi Sonia , Swanton Charles , Beale Rupert , Bauer David L. V. , Wall Emma C. , Kucharski Adam J. 
Published: January 2024

The emergence of successive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) during 2020 to 2022, each exhibiting increased epidemic growth relative to earlier circulating variants, has created a need to understand the drivers of such growth. However, both pathogen biology and changing host characteristics—such as varying levels of immunity—can combine to influence replication and transmission of SARS-CoV-2 within and between hosts. Disentangling the role of variant and host in individual-level viral shedding of VOCs is essential to inform Coronavirus Disease 2019 (COVID-19) planning and response and interpret past epidemic trends. Using data from a prospective observational cohort study of healthy adult volunteers undergoing weekly occupational health PCR screening, we developed a Bayesian hierarchical model to reconstruct individual-level viral kinetics and estimate how different factors shaped viral dynamics, measured by PCR cycle threshold (Ct) values over time. Jointly accounting for both interindividual variation in Ct values and complex host characteristics—such as vaccination status, exposure history, and age—we found that age and number of prior exposures had a strong influence on peak viral replication. Older individuals and those who had at least 5 prior antigen exposures to vaccination and/or infection typically had much lower levels of shedding. Moreover, we found evidence of a correlation between the speed of early shedding and duration of incubation period when comparing different VOCs and age groups. Our findings illustrate the value of linking information on participant characteristics, symptom profile and infecting variant with prospective PCR sampling, and the importance of accounting for increasingly complex population exposure landscapes when analysing the viral kinetics of VOCs.
Trial Registration: The Legacy study is a prospective observational cohort study of healthy adult volunteers undergoing weekly occupational health PCR screening for SARS-CoV-2 at University College London Hospitals or at the Francis Crick Institute (NCT04750356) (22,23). The Legacy study was approved by London Camden and Kings Cross Health Research Authority Research and Ethics committee (IRAS number 286469). The Legacy study was approved by London Camden and Kings Cross Health Research Authority Research and Ethics committee (IRAS number 286469) and is sponsored by University College London Hospitals. Written consent was given by all participants.
Markers of prolonged hospitalisation in severe dengue
Authors: Recker Mario , Fleischmann Wim A. , Nghia Trinh Huu , Truong Nguyen Van , Nam Le Van , Duc Anh Do , Song Le Huu , The Nguyen Trong , Anh Chu Xuan , Hoang Nguyen Viet , My Truong Nhat , Toan Nguyen Linh , Kremsner Peter G. , Velavan Thirumalaisamy P. 
Published: January 2024

Background
Dengue is one of the most common diseases in the tropics and subtropics. Whilst mortality is a rare event when adequate supportive care can be provided, a large number of patients get hospitalised with dengue every year that places a heavy burden on local health systems. A better understanding of the support required at the time of hospitalisation is therefore of critical importance for healthcare planning, especially when resources are limited during major outbreaks.

Methods
Here we performed a retrospective analysis of clinical data from over 1500 individuals hospitalised with dengue in Vietnam between 2017 and 2019. Using a broad panel of potential biomarkers, we sought to evaluate robust predictors of prolonged hospitalisation periods.

Results
Our analyses revealed a lead-time bias, whereby early admission to hospital correlates with longer hospital stays ‐ irrespective of disease severity. Importantly, taking into account the symptom duration prior to hospitalisation significantly affects observed associations between hospitalisation length and previously reported risk markers of prolonged stays, which themselves showed marked inter-annual variations. Once corrected for symptom duration, age, temperature at admission and elevated neutrophil-to-lymphocyte ratio were found predictive of longer hospitalisation periods.

Conclusion
This study demonstrates that the time since dengue symptom onset is one of the most significant predictors for the length of hospital stays, independent of the assigned severity score. Pre-hospital symptom durations need to be accounted for to evaluate clinically relevant biomarkers of dengue hospitalisation trajectories.
Evolution of insulin therapy: past, present, future
Authors: Kurkin D. V. , Bakulin D. A. , Robertus A. I. , Kolosov Yu. A. , Krysanov I. S. , Morkovin E. I. , Strygin A. V. , Gorbunova J. V. , Makarenko I. E. , Drai R. V. , Makarova E. V. , Pavlova E. V. , Kudrin R. А. , Ivanova O. V. 
Published: January 2024

2021 marks the 100th anniversary of the discovery of insulin, an event that forever changed the lives of people with diabetes mellitus. At present patients around the world experience the miracle of insulin therapy every day. A disease that used to kill children and teenagers in 2 years in 1920 has become a disease that can be controlled with a possibility to lead a long productive life. Over the past century, the great discovery of Banting, Best and Collip has forever changed the world and saved millions of lives. This review is devoted to the history of the development of insulin and its further improvement: from the moment of discovery to the present days. Various generations of insulin are considered: from animals to modern ultrashort and basal analogues. The article ends with a brief review of current trends in the development of new delivery methods and the development of new insulin molecules. Over the past century, insulin therapy has come a long way, which has significantly improved the quality of life of our patients. But research is actively continuing, including in the field of alternative methods of insulin delivery, which are more convenient for the patient, as well as in the development of «smart» molecules that will have a glucose-dependent effect.