bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Foundational Importance of Arts and Humanities in Medical Professionalism
Authors: Kowalsky Rachel H. , Baruch Jay 
Published: January 2025

Abstract
The arts and humanities provide a foundational lens through which medical professionalism can be understood, interrogated, and developed over the course of one’s career. This chapter reviews the history of the field, explores the role of the arts and humanities in professional identity formation in a constantly evolving healthcare landscape, and demonstrates the ways in which narrative-based skills of hearing, seeing, and empathy can be engaged in developing medical professionalism. The critical role of ambiguity and uncertainty in catalyzing the evolution of professional behavior is discussed, as are ways in which the humanities support this work. Finally, the application of humanities content and pedagogy to social justice is discussed, including discussions of historic narratives and the power of counternarratives, and the contributions that the humanities can make in mitigating implicit bias. Suggestions are given for modes of integrating the arts and humanities into professionalism curricula.
Assessing Professional Identity Formation
Authors: Goh Suzanne , Sarraf-Yazdi Shiva , Radha Krishna Lalit Kumar 
Published: January 2025

Abstract
A fundamental goal of medical education, professional identity formation (PIF) is essential for promoting self-efficacy, belonging, and meaning across the continuum of medical education. Although implied as a goal of medical education, attending to PIF has not always been explicit. While ultimately a highly individualized construct, PIF is heavily influenced by contextual and psychosocial factors at interpersonal, institutional, and societal levels. This complexity poses a challenge to the study of PIF, its systemic support, and by extension, its assessment. Challenges notwithstanding, this chapter provides an overview of the current state of PIF assessment strategies, particularly at the medical school level, with a focus on reflective portfolios.
Compassion and Professional Formation
Authors: Rosenzweig Steven 
Published: January 2025

Abstract
Compassion means attunement to suffering in a way the brings greater comfort and ease to both patient and physician. Empathy registers the pain and distress of another person; by contrast, compassion is characterized by the heartwarming pleasure of caring, kindness, and human connection. Compassion can be recognized as a capacity to sustain empathy and be with suffering in ways that are open-hearted and comforting. This chapter explores the psychological, neurobiological, and moral dimensions of compassion, and distinguishes the vicarious pain of empathy from the positive affective experience of compassion. It assesses compassion as central to fulfilling the mission of medicine, and antidotal to empathic distress and burnout. Finally, this chapter provides a conceptual and practical framework for developing and sustaining compassion throughout medical training and practice.
Cultivating Professionalism Through Difficult Conversations
Authors: Carlin Nathan 
Published: January 2025

Abstract
This chapter outlines how Samuel Shem’s The House of God can be used to host difficult conversations about professionalism in graduate medical education. The House of God is the most widely read book in medical humanities, yet, because of its use of satire, the novel was and remains controversial. Some feel that the book is so unprofessional that it should not be read. Also, despite its influence among doctors, the novel has not received much scholarly attention. The purpose of this chapter is twofold: (1) to provide some context for The House of God so that it can be appropriately understood; and (2) to demonstrate how the novel can be used to encourage the professional identity formation of medical interns and residents.
Professionalism and Employment Issues
Authors: Harter Thomas D. 
Published: January 2025

Abstract
Explorations of medical professionalism in terms of physicians as employees are underdeveloped. There is an abundance of literature on what it means for physicians to develop and express professionalism in patient care, but very little regarding what it means—or may mean—for physicians to develop and express professionalism in their roles as employees. The chapter takes an organizational view to assess what it is for physicians to be an employee, why physicians constitute a unique type of profession, and what sorts of commitments and obligations exist between physicians and healthcare employers. This chapter further identifies core concepts and values that ground the obligations between physicians and their employers, as well as examines two ongoing threats to physician professionalism: a growth in physicians becoming locums and the increased growth and utilization of advanced practice clinicians.
Supporting the Safe Practice of Physicians as They Age
Authors: Gallagher Thomas H. , White Andrew A. 
Published: January 2025

Abstract
Self-regulation is a pillar of professionalism. Supporting the safe practice of physicians as they age presents a test case of self-regulation that the profession is currently failing. Other safety-conscious industries scrutinize the performance of their practitioners more closely as they age. Yet historically the profession has relied solely on traditional peer review and credentialing processes regardless of physician age. A growing literature links increasing physician age to worse patient outcomes. In response, organizations are increasingly adopting formal late career practitioner (LCP) programs that screen all physicians over a certain age for physical and cognitive well-being. When Yale New Haven Hospital conducted screening cognitive assessments on physicians over 70, 12.7% of the 141 clinicians screened had deficits likely to impair the practice of medicine. Taking a more proactive approach to promoting the safe practice of physicians over the course of their career represents an important new frontier of medical professionalism.
Maintaining Ethical Physician-Industry Relationships
Authors: Singh Armaan , Singer Eric A. , Modi Parth K. 
Published: January 2025

Abstract
Financial relationships between physicians and the healthcare industry are common and are increasingly concerning to patients, physicians, and policymakers. After the passage of the Affordable Care Act and the development of the Open Payments Program (Sunshine Act), considerably more data have become available to researchers and the general public. As a result, more is now known more about the breadth and effects of physician financial relationships with health care industry entities. This chapter reviews the recent empirical work examining financial relationships between physicians and industry, guidance for the management of these relationships from professional societies, and strategies for addressing these relationships.
Health Quality of Life
Authors: Deimling Gary T. 
Published: January 2025

Abstract
Considerable research has already documented that the long-term and late effects of cancer and its treatment may persist into later life for long-term survivors. The National Cancer Institute and the National Institute on Aging have both noted that understanding the contribution of cancer to the older individual’s health, comorbidities, and functional health is critical in reducing the burden of cancer among older cancer survivors. These are examined in the context of continuing symptoms reported by survivors, often referred to as late or long-term effects, focusing on three symptoms common among both cancer survivors and older adults: pain, fatigue, and weakness. The chapter concludes by examining survivors’ assessment of their overall health satisfaction. Both foundational and recent research findings are discussed, including those from the Cancer Survivors Research Program (CSRP) research and cancer survivors’ narratives.
Altered Life Perspectives After Cancer
Authors: Eva  , Kahana Boaz 
Published: January 2025

Abstract
This final chapter of the book appropriately focuses on the possible altered life perspectives and transformations that cancer has the potential to make among older adult long-term survivors. These life changes are viewed as the ultimate outcomes of cancer survival, as portrayed in the accompanying model. This figure identifies the key issues that have been introduced in the preceding seven chapters that may give rise to an altered life perspective after cancer. As with all prior chapters, it provides a review of the foundational and recent research including that of the Cancer Survivors Research Program (CSRP) and as well as those from the Elderly Care Research Center (ECRC) focusing on the posttraumatic transformation that may be reflected in the altered life perspectives of cancer survivors. The chapter ends, like the previous chapters, with a review of the narratives provided by the cancer survivor participants in our research, which, in this chapter, focuses on significant life changes that reflect both their hopes and fears after cancer.
Dexamethasone in the Prophylaxis of Radiation-Induced Pain Flare After Palliative Radiotherapy for Bone Metastases
Authors: Maxwell Meredith , Quest Tammie E. 
Published: January 2025

Abstract
Two-hundred ninety-eight patients from Canadian medical centers with nonhematologic malignancy and painful bone metastasis were enrolled in a double-blind, randomized, placebo-controlled phase 3 trial. Patients received either dexamethasone or placebo prior to a single 8-Gy dose to bone metastases and for 4 days thereafter. Participants in the group treated with dexamethasone had reduced radiation-induced pain flares and mean pain scores on days 1–5 after radiation treatment. There was no difference in the overall response to radiation therapy.
Psilocybin for Depression and Anxiety in Cancer Patients
Authors: Quest Tammie E. , Zarrabi Ali John 
Published: January 2025

Abstract
Fifty-one cancer patients with symptoms of depression and anxiety were enrolled in a randomized, double-blind, crossover trial using low-dose psilocybin (placebo) and high-dose psilocybin (intervention group) combined with psychotherapy with 5 weeks between dosing sessions and at 6-month follow-up. Participants in the intervention group had large decreases in clinician- and self-rated measures of depression and anxiety. They also had improvements in quality of life, life meaning, and optimism and decreases in death anxiety at 5 weeks. Significant changes in depression and anxiety were durable for around 80% of participants at 6-month follow-up. A mystical-type experience on the drug session day mediated the effect of psilocybin dose on the therapeutic outcomes.
The Use of Opioids for Breakthrough Pain in Acute Palliative Care Unit by Using Doses Proportional to Opioid Basal Regimen
Authors: Malik Jimi S. , Quest Tammie E. 
Published: January 2025

Abstract
The optimal choice of opioid to treat breakthrough cancer-related pain is still controversial. Over a 6-month period in a single acute palliative care unit, 503 episodes of breakthrough pain among 66 cancer patients were studied, showing statistically significant improvement in pain severity among all the opioids given, regardless of the opioid choice and modality of administration used. The majority (84.9%) of breakthrough pain episodes were treated with the first opioid administration. Intravenous morphine and oral transmucosal fentanyl were the most frequently administered opioids. This study helps to clarify the efficacy and safety of different opioids used in proportion to the basal opioid regimen.
Randomized Controlled Trial of Oral Docusate in Patients on Hospice
Authors: Stevens Abby 
Published: January 2025

Abstract
This trial compared a bowel regimen of docusate + senna to placebo + senna among people admitted to inpatient hospice receiving opioid analgesics. The study found no significant differences in stool frequency, volume, or consistency when comparing the 2 groups. There was no statistical difference in the Edmonton Symptom Assessment Scale between the groups. While this study is not definitive and should be interpreted with caution, clinicians can use these findings to scrutinize the routine use of docusate to prevent or treat opioid-induced constipation. Avoiding or deprescribing docusate when not beneficial can reduce the pill burden on patients and caregivers and focus scarce hospice resources on more effective interventions to prevent constipation.
Equianalgesic Conversion From Intravenous Hydromorphone to Oral Opioids
Authors: Strassels Scott A. 
Published: January 2025

Abstract
In “The Conversion Ratio From Intravenous Hydromorphone to Oral Opioids in Cancer Patients,” Reddy et al. provide guidance to clinicians who need to rotate patients from intravenous (IV) hydromorphone (HM) to oral HM. Data for this analysis were derived from the electronic health record from nearly 400 people who were admitted to a comprehensive cancer center in the United States between 2010 and 2014. The median conversion ratio for this change was 1 mg HM:2.5 oral HM, while the median opioid rotation ratio from IV HM to an equivalent morphine dose was 11.46. To help avoid calculation errors, the authors suggested using an opioid rotation ratio of 10. Further research is needed to understand the application of equianalgesic conversion in people who were excluded from this study.
Guideline-Driven Versus Single-Agent Antiemetic Therapy in Patients With Advanced Cancer
Authors: Stayer Sarah , Tatum Paul 
Published: January 2025

Abstract
Nausea is a common symptom in patients with advanced cancer. Current practice encourages providers to identify the etiology and associated neurotransmitters and prescribe an agent that targets the cause. Other studies use single-agent therapy, regardless of cause, and report symptom improvement. This study randomized patients to treatment by clinical-based guidelines with physician-identified causes of nausea versus single-agent haloperidol. Clinical-based guidelines controlled the nausea more quickly after 24 hours, but both methods were effective at 72 hours. This study concluded that either single-agent or etiology-based approaches were effective, and most nausea can be treated with affordable, widely available medications. More expensive alternative medications should be reserved for refractory nausea.
Headache associated with cough, exertion, sex, and sport
Authors: Kernick David , Moreno David 
Published: January 2025

Abstract
This chapter covers a range of headaches precipitated by exertion, including cough, exercise, and sexual activity. Excluding an underlying secondary cause is an important first step, but in many cases mechanisms are unclear and evidence-based treatment limited. A classification and clinical approach to headache in sport is described.
Headache in the older person
Authors: Kernick David 
Published: January 2025

Abstract
Although less common than among younger age groups, headache can present a diagnostic challenge in the older adult. Temporal arteritis should be considered in all cases. Older people may view pain as a normal part of ageing, and self-reporting and referral decline with increasing cognitive impairment. This chapter describes the diagnosis and management of the most common headache types in the older person.
Facial pain and cranial neuralgias
Authors: Khalil Hisham 
Published: January 2025

Abstract
Facial pain is common in primary care and hospital-based practice, and a multidisciplinary approach involving the GP, neurologist, maxillofacial surgeon, and otolaryngologist is often required. This chapter describes a management framework set within a pragmatic classification of pain associated with the upper respiratory tract and sinuses, primary headache syndromes, neuralgias, pain arising from the eye, and pure facial pain without neurological signs.
Building your psychotherapy skills
Authors: Rinaldi Matthew 
Published: January 2025

Abstract
The concept of co-constructed transference is explained along with clear guidance on how to identify the transference. This starts with identifying countertransference and some questions that the psychodynamic psychotherapy trainee might want to ask themselves to clarify it in their minds. It is recommended that new trainees draw their patient’s increasing attention to the transference over a session and over the course of their first therapy. Finally, the chapter explores whether therapists need to interpret the transference, or whether thinking about it alone is sufficient to promote change.
Supervision
Authors: Rinaldi Matthew 
Published: January 2025

Abstract
Supervision for trainees learning psychodynamic psychotherapy is different and similar to other forms of supervision wherein the trainee can expect to get feedback on their performance and develop their understanding. The process can vary, particularly if the trainee is in a group or individual supervision, and between different supervisors. Trainees are encouraged to direct their learning, make the most of process notes, understand and work through difficulties in supervision, and understand psychodynamic psychotherapy alongside adapted models. The patient assessment process is summarized along with opportunities for further development in this specialty.
Changing-look inspirals: trends and switches in AGN disc emission as signposts for merging black hole binaries
Authors: Zrake Jonathan , Clyburn Madeline , Feyan Samuel 
Published: January 2025

ABSTRACT
Using grid-based hydrodynamics simulations and analytic modeling, we compute the electromagnetic (EM) signatures of gravitational wave (GW) driven inspirals of massive black hole binaries that accrete gas from circumbinary discs, exploring the effects of varying gas temperatures, viscosity laws, and binary mass ratios. Our main finding is that active galactic nuclei (AGNs) that host inspiraling binaries can exhibit two sub-types of long-term secular variability patterns: Type-A events which dim before merger and brighten afterward, and Type-B events which brighten before merger and dim afterward. In both types, the merger coincides with a long-lasting chromatic change of the AGN appearance. The sub-types correspond to the direction of angular momentum transfer between the binary and the disc, and could thus have correlated GW signatures if the gas-induced torque can be inferred from GW phase drift measurements by LISA. The long-term brightness trends are caused by steady weakening of the disc-binary torque that accompanies orbital decay, it induces a hysteresis effect whereby the disc ‘remembers’ the history of the binary’s contraction. We illustrate the effect using a reduced model problem of an axisymmetric thin disc subjected at its inner edge to the weakening torque of an inspiraling binary. The model problem yields a new class of self-similar disc solutions, which capture salient features of the multidimensional hydrodynamics simulations. We use these solutions to derive variable AGN disc emission signatures within years to decades of massive black hole binary mergers in AGNs. Spectral changes of Mrk 1018 might have been triggered by an inspiral-merger event.
The prototype double-faced white dwarf has a thin hydrogen layer across its entire surface
Authors: Bédard Antoine , Tremblay Pier-Emmanuel 
Published: January 2025

ABSTRACT
Some white dwarfs undergo significant changes in atmospheric composition owing to the diffusion and mixing of residual hydrogen in a helium-rich envelope. Of particular interest are a few objects exhibiting hydrogen and helium line variations modulated by rotation, revealing surface composition inhomogeneities. Recently, the hot ultramassive white dwarf ZTF J203349.80+322901.1 emerged as the most extreme such specimen, with hydrogen and helium lines successively appearing and vanishing in antiphase, suggesting a peculiar double-faced configuration. However, standard atmosphere models fail to reproduce the observed spectrum at all rotation phases, hampering further interpretation. Here, we perform a new analysis of ZTF J203349.80+322901.1 using stratified atmosphere models, where hydrogen floats above helium, and obtain excellent fits to the phase-resolved spectra. Our results imply that an extremely thin hydrogen layer covers the entire surface but varies from optically thick to optically thin across the surface, thus producing the observed spectral variations. We present new envelope models indicating that the hydrogen layer arises from a delicate interplay between diffusion and convection. We discuss possible explanations for the surface layer asymmetry, including an asymmetric magnetic field and a non-uniform internal hydrogen distribution. Finally, we highlight implications for expanding and understanding the emerging class of inhomogeneous white dwarfs.
The effect of task switching on productivity: evidence from major league baseball pitchers
Authors: Farnell Alex , Mills Brian , O’Sullivan Vincent , Simmons Robert , Berri David 
Published: January 2025

Abstract
There are few opportunities, outside of a laboratory setting, to study how workers respond to the demands of task switching. A priori, task switching might either harm or benefit productivity, and thus it becomes an empirical question. Faced with difficulties in the measurement of productivity and task switching, we turn to an industry that produces accurate, detailed, and comparable measures of worker production, namely starting pitchers in Major League Baseball. Our results suggest that task switching, between pitching and batting, can improve subsequent pitching performance, though heterogeneity in this effect is present. We discuss implications for wider labour market settings.
Identification of a novel stomatal opening chemical, PP242, that inhibits early abscisic acid signal transduction in guard cells
Authors: Oh Airi , Kimura Riku , Inoue Shinpei , Sato Taiyo , Hayashi Yuki , Sato Ayato , Takahashi Yohei , Kinoshita Toshinori 
Published: January 2025

Abstract
Plants control their stomatal apertures to optimize carbon dioxide uptake and water loss. Stomata open in response to light through the phosphorylation of the penultimate residue, Thr, of plasma membrane (PM) H+-ATPase in guard cells. Stomata close in response to drought and the phytohormone abscisic acid (ABA), and ABA suppresses the light-induced activation of PM H+-ATPase. However, the signaling pathways that regulate the stomatal aperture remain unclear. Previously, we identified a target of rapamycin (TOR) inhibitor, temsirolimus, to induce stomatal opening through chemical screening. In the present study, we further investigated other TOR inhibitors and identified PP242 as a novel stomatal opening chemical. PP242 induced stomatal opening even in the dark, as well as phosphorylation of the penultimate Thr of PM H+-ATPase in guard cells. Interestingly, PP242 completely suppressed ABA-induced stomatal closure, and inhibited ABA-induced activation of SNF1-related protein kinase 2s (SnRK2s), which are essential kinases for ABA signal transduction in guard cells. In vitro biochemical analysis revealed that PP242 did not directly inhibit SnRK2 but rather inhibited upstream ABA-signaling components, specifically B3 clade Raf-like kinases. A quadruple mutant of B3 clade Raf-like kinases exhibited an open stoma phenotype that resembled the effect of PP242. However, PP242 still induced stomatal opening in this mutant, suggesting that PP242 also targets other guard cell components. Together, these results reveal that PP242 induces stomatal opening partly by inhibiting steady-state ABA signal transduction.