bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing patient safety and risk management through clinical pathways in oncology
Authors: Milanesi Marco , Fiorito Rita , Caloccia Lara , Guglielmetti Chiara , Giganti Giulia , Andreasi Sara Elisa , Triarico Antonio 
Published: January 2025

The increasing emphasis on risk management and quality assessment in hospital management necessitates strict adherence to government and international standards. Those standards are particularly important, and certification requirements further underscore this need. The objective of this paper is to outline the application of the INTegrated Audit Model in a Comprehensive Cancer Center. This model represents a revised version of Tracer Methodology, for audit surveys, aimed at aligning audit activities with UNI EN ISO 9001:2015 and Joint Commission Standards for quality, patient safety and clinical risk management.Using the INTegrated Audit Model, a total of 7 tracers were conducted, and 31 units underwent auditing during the period spanning from 2022 to 2023. Each audit inquiry was documented, categorised and cross-referenced with International Organization for Standardization (ISO) and Joint Commission International (JCI) standards. Areas exhibiting the highest incidence of non-conformities and observations were systematically linked to relevant standards. Subsequently, a comprehensive analysis was conducted on the ensuing findings.The INTegrated Audit Model allowed for systematic data collection across clinical pathways, revealing prevalent issues and areas for improvement in patient care. By aligning identified topics with ISO and JCI standards, compliance with international guidelines was assessed, offering units insight into their current status and areas for enhancement.Overall, both auditees and auditors expressed satisfaction with the methodology and continuous training, highlighting its effectiveness in fostering collaboration, improving time management and promoting adherence to accreditation standards.The study highlights the effectiveness of the methodology in monitoring unit activities and adherence to clinical pathways and international standards applied to an oncological setting. Audits conducted with this approach provided a thorough assessment of critical areas impacting patient care and clinical governance, contributing to a comprehensive understanding of service delivery.
Resilience-building in palliative care professionals: scoping review
Authors: Yongpraderm Suwanan , Inpithuk Patcharanat , Wongprom Itthipon 
Published: January 2025

Resilience-building in palliative care professionals: scoping reviewBackgroundBurnout, demoralisation and compassion fatigue are common among palliative care professionals. Practising palliative care necessitates a quality of resilience in order to ensure constant and optimal patient care. However, there is no universal approach to prevent burnout or raise resilience among palliative care professionals. This study aims to provide an overview of interventions and explore their effectiveness in building resilience in palliative care professionals.MethodsThe search was conducted in four databases: MEDLINE, Embase, CINAHL, PsycINFO and Cochrane Database. Two independent investigators reviewed eligibility, with conflicts resolved by a third investigator. One reviewer performed data extraction, later reviewed by a second investigator. All eligible studies were manually re-reviewed. Quantitative and qualitative data synthesis were conducted.ResultsThe search initially revealed 11 470 potentially eligible citations. 12 studies were included in the analysis. Most studies had a small number of participants. The studies varied in sample size, interventions and assessment tools, making it challenging to identify the most effective resilience-building interventions. However, our analysis revealed commonly found elements among these interventions: five essential elements (regularity, self-care, mindfulness, reflective practice and cognitive–behavioural therapy) and three supporting elements (peer support, educational sessions and organisational support).DiscussionWhile the effectiveness of specific interventions remains inconclusive, this review highlights essential and supporting elements that should be considered in designing resilience-building programmes for palliative care professionals. Future research should focus on developing assessment tools specific to palliative care, conducting well-designed studies, and creating replicable, standardised interventions.
Parameter constraints on a black hole with Minkowski core through quasiperiodic oscillations
Authors: Guo Ming-Yu , Wu Meng-He , Kuang Xiao-Mei , Guo Hong 
Published: January 2025

Abstract
We investigate the geodesic motion of charged particles in the vicinity of regular black holes with a Minkowski core, embedded in a uniform magnetic field, and study the influences of magnetic field and regular black hole parameter on the radial effective potential and angular momentum of the particles’ orbits. We perturb the circular orbit and analyze the characteristic frequencies of the epicyclic oscillations, which are closely related with the quasiperiodic oscillations (QPOs) phenomena of the accretion disc surrounding the black hole. Then using the MCMC simulation, we fit our theoretical results with four observational QPOs events (GRO J1655-40, XTE J1550-564, XTE J1859+226, and GRS 1915+105) and provide constraints on the magnetic field strength B, the characteristic radius r, the mass M, and the regular black hole parameter g. In particular, since the parameter g describes the degree of deviation from the classical Schwarzschild black hole, our studies suggest that, within a certain level of confidence, the black holes in the current model can deviate from the classical singularity structure of Schwarzschild black holes, and exhibit quantum corrections near the core.
Isospin-breaking contribution to the model-independent axion-photon-photon coupling in U(3) chiral theory
Authors: Gao Rui , Hao Jin , Duan Chun-Gui , Guo Zhi-Hui , Oller J. A. , Zhou Hai-Qing 
Published: January 2025

Abstract
We pursue the calculation of the model-independent component of the axion-photon-photon coupling in the U(3) chiral perturbation theory up to next-to-leading order, with the emphasis on the isospin breaking effect. The mixing of the

$$\pi ^0$$

π
0

-

$$\eta $$

η

-

$$\eta '$$

η
′

-axion system is revised as well by working out the complete linear isospin-breaking terms. Our calculation shows that the isospin-breaking correction to the axion-photon-photon coupling amounts to more than 15%, comparing with the result in the isospin limit.
Popular Arborescences and Their Matroid Generalization
Authors: Kavitha Telikepalli , Makino Kazuhisa , Schlotter Ildikó , Yokoi Yu 
Published: January 2025

Consider a directed, rooted graph

\(G=(V\cup\{r\},E)\)

where each vertex in

\(V\)

has a partial order preference over its incoming edges. The preferences of a vertex naturally extend to preferences over arborescences rooted at

\(r\)

. We present a polynomial-time algorithm that decides whether a given input instance admits a popular arborescence, i.e., one for which there is no “more popular” arborescence.

In fact, our algorithm solves the more general popular common base problem in the intersection of two matroids: we are given an arbitrary matroid

\(M=(E,\mathcal{I})\)

and a partition matroid

\(M_{\text{part}}\)

over

\(E\)

, where partition classes correspond to a set

\(V\)

of agents with

\(|V|={\rm rank}(M)\)

and each agent has a partial order preference over its associated partition class; the problem asks for a common base of

\(M\)

and

\(M_{\text{part}}\)

such that there is no “more popular” common base. Our algorithm is combinatorial, and can be regarded as a primal–dual algorithm. It searches for a solution along with its dual certificate, a chain of subsets of

\(E\)

, witnessing its popularity. Our generalized results, expressed in terms of matroids, demonstrate that the identification of agents with vertices of the graph in the popular arborescence problem is not essential.

We also study the related popular common independent set problem. For the case with weak rankings, we formulate the popular common independent set polytope, and thus show that a minimum-cost popular common independent set can be computed efficiently. By contrast, we prove that it is

\(\mathsf{NP}\)

-hard to compute a minimum-cost popular arborescence, even when rankings are strict.
Case 337
Authors: Mu Brian H. , Galambo Faris , Al-Ali Hadeer W. , Dua Sumeet G. , Dixon Chanae D. , Zhang Xinhai R. , Mafraji Mustafa A. 
Published: January 2025

History A 38-year-old previously healthy male patient presented with left-sided facial pain over the prior 5 weeks. He first noticed the pain while washing and applying pressure to his face. The pain was described as shock-like, sharp and shooting, and radiating along the left cheek and temple. It began as 1–2-second episodes occurring two to three times per day, sometimes spontaneously, progressing in severity and frequency over time. Mild progressive left facial weakness also developed a few weeks after initial symptoms. Physical examination demonstrated reproducible pain in the distribution of the maxillary division of the trigeminal nerve (V2), with normal motor and sensory function. A recent routine dental examination demonstrated healthy teeth and gums, and there was no history of dental procedures or trauma. The rest of the physical and neurologic examinations revealed no abnormalities. The patient was afebrile with normal vital signs. Findings of routine laboratory testing, including complete blood count, metabolic panel with electrolytes, kidney and liver function, and inflammatory markers such as C-reactive protein, were all within normal limits. Following the neurologic and otolaryngologic evaluations, imaging was recommended. The patient was also started on treatment with carbamazepine for trigeminal neuralgia, with modest improvement of symptoms. He initially underwent MRI of the temporal bones at an outside hospital. After subsequent referral to our hospital, follow-up concomitant MRI and CT ( Figs 1 – 4 ) were performed approximately 3 months after the initial imaging.
Polymicrobial Osteomyelitis in a Patient With Isolation of Trueperella bernardiae: A Case Report and Literature Review
Authors: Delaye-Martínez Marco Antonio , Vanegas-Rodríguez Edgar Samuel , Mendez-Sotelo Braulio , García-Hernández María de Lourdes , Colín-Castro Claudia Adriana , Franco-Cendejas Rafael , López-Jácome Luis Esaú 
Published: January 2025

Background: Trueperella bernardiae is a Gram‐positive rod that has been described as an opportunistic pathogen in immunocompromised patients. In a significant number of documented cases, infections with Trueperella bernardiae have been associated with polymicrobial infections, which highlight the fact that important bacteria–bacteria relations might be involved in the natural course of these infections, especially in patients with chronic disease courses and a history of multiple antibiotic treatments.Case Presentation: We present a case of a 24‐year‐old woman with a 3‐year history of a chronic pressure ulcer on the right foot associated with varus and cavus deformity. As per relevant medical history, she was positive for multiple wound healing sessions with wound debridement and a large number of antibiotic treatments with minimal improvement. Microbiological cultures were taken from the wound, and a soft tissue infection diagnosis was initially made. Empirical treatment was initiated with levofloxacin. At 48 h, cultures were positive for Providencia stuartii, Pseudomonas aeruginosa, Proteus penneri, Streptococcus agalactiae, and Trueperella bernardiae, and the susceptibility test was performed. Three weeks later, the symptoms progressed to purulent exudate of the wound and foul‐smelling with the positive probe‐to‐bone test. Diagnosis was changed to polymicrobial osteomyelitis, and antibiotic therapy with ciprofloxacin and trimethoprim‐sulfamethoxazole was prescribed for a 4‐week course of treatment, achieving the complete remission of symptoms.Conclusions: Trueperella bernardiae represents an emerging bacterium that can be isolated in various clinical presentations. On osteoarticular infections, the presence of comorbidities, mobility limitations, and a history of multiple antibiotic treatments may be determinant. Their isolation as part of polymicrobial infections highlights relevant interspecies interactions. Research is still lacking in determining standardized methodologies for susceptibility testing and specific clinical breakpoints to guide clinical decisions.
Docosahexaenoic Acid Inhibits p62‐Dependent Autophagy by Targeting HSP70A1A/TGM‐2 Axis to Alleviate Arecoline‐Induced Oral Submucosal Fibrosis
Authors: Hu Zhaoyong , Dai Yuzhe , Wang Chenwei , Liu Yanli , Li Qun , Zuo Qiaojuan , Chen Ruiyi , Tan Jin 
Published: January 2025

Background: The role of docosahexaenoic acid (DHA) in fibrosis of other organs has been studied, but its function in oral submucous fibrosis (OSF) has not been reported. This study aimed to investigate the role and mechanism of DHA in OSF.Methods: OSF rat and cell models were established induced by arecoline. Through a series of in vivo and in vitro experiments, the function of DHA in OSF was investigated. Mechanistically, the interaction of TGM‐2 with HSP70A1A and p62 proteins was validated using co‐immunoprecipitation. Additionally, in cells transfected with overexpression vectors of HSP70A1A or TGM‐2 and treated with DHA and arecoline or co‐treated with a p62 inhibitor XRK3F2 along with DHA and arecoline, the function of the DHA/HSP70A1A/TGM‐2/p62 axis in OSF was explored.Results: In vivo, arecoline caused severe pathological damage and fibrosis in rat oral mucosal tissues and induced overexpression of HSP70A1A. Arecoline treatment also elevated tissue ROS levels and the expression of α‐SMA, Collagen I, TGM‐2, and LC3 II/I, while decreasing tissue p62 protein expression and serum GSH levels. Treatment with DHA reversed these changes and improved the pathological damage and fibrosis in OSF rats. In vitro, arecoline induced the expression of HSP70A1A in a concentration‐dependent manner, and DHA inhibited its expression by directly binding to HSP70A1A and reducing the expression of α‐SMA, Collagen I, TGM‐2, LC3 II/I, and ROS levels induced by arecoline in cells, while increasing p62 protein expression and GSH levels in cell supernatants. Furthermore, arecoline induced TGM‐2 expression, and overexpression of HSP70A1A counteracted the protective effect of DHA on cells and the suppression of TGM‐2 expression. TGM‐2 interacted with HSP70A1A and p62 proteins. Overexpression of TGM‐2 or treatment with XRK3F2 activated autophagy and abolished the protective effect of DHA on cells.Conclusion: DHA inhibits p62‐dependent autophagy through targeting the HSP70A1A/TGM‐2 axis, thereby alleviating arecoline‐induced OSF. These results suggest that DHA and its mediated autophagy regulation mechanism can be a therapeutic target for OSF.
Time Dependency for Human Papillomavirus Circulating Tumor DNA Detection after Chemoradiation as a Prognostic Biomarker for Localized Anal Cancer
Authors: Morris Van K. , Xiao Weihong , Lin Kangyu , Wong Chi Wut , Wotman Michael T. , Holliday Emma B. , Huey Ryan W. , Noticewala Sonal S. , Ludmir Ethan B. , Bent Alisha H. , Ludford Kaysia , Messick Craig , Koay Eugene J. , Smith Grace , Konishi Tsuyoshi , Bednarski Brian , Chang George J. , Koong Albert C. , You Y. Nancy , Das Prajnan , Gillison Maura L. 
Published: January 2025

Abstract

Purpose:
Although detection of ctDNA weeks after surgery is linked to recurrence for other solid tumors, the optimal time point for ctDNA assessment as a prognostic biomarker following chemoradiation for anal cancer is undefined.

Experimental Design:
Patients with stages I to III anal cancer treated with chemoradiation between December 2020 and March 2024 were evaluated for human papillomavirus (HPV) ctDNA status at baseline, at the end of chemoradiation, and during surveillance using a droplet digital HPV ctDNA PCR assay, targeting HPV E6 and E7 oncogenes for 13 oncogenic HPV types. Median recurrence-free survival (RFS) according to HPV ctDNA status was estimated via Kaplan–Meier and compared using a log-rank test.

Results:
Detection of HPV ctDNA at ≥3 months after chemoradiation was associated with recurrence (80% vs. 2%; OR, 168; 95% confidence interval (CI), 13.6–2,080; P &lt; 0.0001) and inferior RFS [4.9 months vs. not reached; HR, 39.2; 95% CI, 4.6–330; P &lt; 0.0001] relative to HPV ctDNA–negative status. Sensitivity and specificity for recurrence according to HPV ctDNA detection were 89% and 95%, respectively, with positive and negative predictive values of 80% and 98%, respectively. Differences in RFS according to HPV ctDNA status were not observed at the end of treatment (median RFS, not reached for both; HR, 1.6; 95% CI, 0.35–7.4; P = 0.48).

Conclusions:
With a novel, highly sensitive assay, detection of HPV ctDNA at least 3 months after chemoradiation was associated with unfavorable survival. Future clinical trials should incorporate this 3-month post-treatment time point to identify patients with HPV-positive anal cancer at elevated recurrence risk according to HPV ctDNA status.
Systematic review of 99 extremity bone malignancy survival prediction models
Authors: Lai Cheng-Yo , Yen Hung-Kuan , Lin Hao-Chen , Groot Olivier Quinten , Lin Wei-Hsin , Hsu Hao-Ping 
Published: January 2025

Abstract

Background
Various prediction models have been developed for extremity metastasis and sarcoma. This systematic review aims to evaluate extremity metastasis and sarcoma models using the utility prediction model (UPM) evaluation framework.

Methods
We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and systematically searched PubMed, Embase, and Cochrane to identify articles presenting original prediction models with 1-year survival outcome for extremity metastasis and 5-year survival outcome for sarcoma. Identified models were assessed using the UPM score (0–16), categorized as excellent (12–16), good (7–11), fair (3–6), or poor (0–2). A total of 5 extremity metastasis and 94 sarcoma models met inclusion criteria and were analyzed for design, validation, and performance.

Results
We assessed 5 models for extremity metastasis and 94 models for sarcoma. Only 4 out of 99 (4%) models achieved excellence, 1 from extremity metastasis and 3 from sarcoma. The majority were rated good (62%; 61/99), followed by fair (31%, 31/99) and poor (3%, 3/99).

Conclusions
Most predictive models for extremity metastasis and sarcoma fall short of UPM excellence. Suboptimal study design, limited external validation, and the infrequent availability of web-based calculators are main drawbacks.

Level of evidence
This study is classified as Level 2a evidence according to the Oxford 2011 Levels of Evidence.

Trial registration This study was registered in PROSEPRO (CRD42022373391, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=373391).
Comparative outcomes of thulium laser enucleation by prostate volume: a three-group analysis from a single-center study in Vietnam
Authors: Tran Hoai Nam , Tran Van Hinh , Nguyen Viet Cuong 
Published: January 2025

Abstracts

Purpose
To evaluate the impact of prostate volume on the safety and efficacy of Thulium Laser Enucleation of the Prostate (ThuLEP) in treating benign prostatic enlargement (BPE) across different prostate volume groups.

Materials and Methods
This prospective study included 92 BPE patients who underwent ThuLEP, stratified into three groups based on prostate volume: Group A (< 50 ml), Group B (50–80 ml), and Group C ( >80 ml). Preoperative and postoperative functional outcomes, intraoperative parameters, and complications were analyzed and compared among the groups. Statistical analysis was performed using IBM SPSS Statistics 27.

Results
Operative time significantly increased with prostate size (Group C: 105 ± 32.74 min vs. Group A: 71.45 ± 33.87 min, p < 0.001). Enucleation time per ml of prostate tissue was most efficient in Group C (0.98 ± 0.55 min/ml, p < 0.001). Postoperative improvements in IPSS, Qmax, QoL, and PVR were significant across all groups, with no notable differences among the groups at 6 months (p > 0.05). The overall complication rate was low (11.96%), with major complications (Clavien-Dindo grade II or higher) accounting for only 6.52%. No significant differences in complication rates were observed among the groups.

Conclusions
ThuLEP demonstrated excellent safety and efficacy in treating BPE, regardless of prostate size. Larger prostates required longer operative times but achieved comparable functional outcomes with low complication rates. These findings support ThuLEP as a reliable and versatile surgical option for a wide range of prostate volumes.
Correcting scale distortion in RNA sequencing data
Authors: Thron Christopher , Jafari Farhad 
Published: January 2025

Abstract
RNA sequencing (RNA-seq) is the conventional genome-scale approach used to capture the expression levels of all detectable genes in a biological sample. This is now regularly used for population-based studies designed to identify genetic determinants of various diseases. Naturally, the accuracy of these tests should be verified and improved if possible. In this study, we aimed to detect and correct for expression level-dependent errors which are not corrected by conventional normalization techniques. We examined several RNA-seq datasets from the Cancer Genome Atlas (TCGA), Stand Up 2 Cancer (SU2C), and GTEx databases with various types of preprocessing. By applying local averaging, we found expression-level dependent biases that differ from sample to sample in all datasets studied. Using simulations, we show that these biases corrupt gene-gene correlation estimations and t tests between subpopulations. To mitigate these biases, we introduce two different nonlinear transforms based on statistical considerations that correct these observed biases. We demonstrate that these transforms effectively remove the observed per-sample biases, reduce sample-to-sample variance, and improve the characteristics of gene-gene correlation distributions. Using a novel simulation methodology that creates controlled differences between subpopulations, we show that these transforms reduce variability and increase sensitivity of two population tests. The improvements in sensitivity and specificity were of the order of 3-5% in most instances after the data was corrected for bias. Altogether, these results improve our capacity to understand gene-gene relationships, and may lead to novel ways to utilize the information derived from clinical tests.