bluuebunny/crossref_metadata_2025_split huggingface dataset:
Training surgeons to optimize communication and symptom management in patients with life-limiting conditions: systematic review
Authors: Zucker Benjamin E , Leandro Lorna , Forbes Karen , Blazeby Jane M , Chamberlain Charlotte 
Published: April 2023

Abstract

Background
Surgeons routinely care for patients with life-limiting illness, requiring communication and symptom management skills supported by appropriate training. The objective of this study was to appraise and synthesize studies that assessed surgeon-directed training interventions that aimed to optimize communication and symptom management for patients with life-limiting illness.

Methods
A PRISMA-concordant systematic review was undertaken. MEDLINE, Embase, Allied and Complementary Medicine Database (AMED), and the Cochrane Central Register of Controlled Trials were searched from inception until October 2022 for studies reporting on the evaluation of surgeon-training interventions intending to improve surgeons’ communication or symptom management of patients with life-limiting disease. Data on the design, trainer and patient participants, and the intervention were extracted. Risk of bias was assessed.

Results
Of 7794 articles, 46 were included. Most studies employed a before–after approach (29 studies) and nine included control groups with five being randomized studies. General surgery was the most frequently included sub-specialty (22 studies). Trainers were described in 25 of 46 studies. Most training interventions aimed to improve communication skills (45 studies) and 13 different training interventions were described. Eight studies reported a measurable improvement in patient care, such as increased documentation of advance care discussions. Most study outcomes focused on surgeons’ knowledge (12 studies), skills (21 studies), and confidence/comfort (18 studies) in palliative communication skills. Studies had a high risk of bias.

Conclusion
Whilst interventions exist to improve the training of surgeons managing patients with life-threatening conditions, evidence is limited, and studies measure the direct impact on patient care insufficiently. Improved research is needed to lead to better methods for training surgeons to benefit patients.
MCM6 promotes intrahepatic cholangiocarcinoma progression by upregulating E2F1 and enhancing epithelial–mesenchymal transition
Authors: Gao Chongqing , Li Jing , Zeng Fuling , Wang Lijuan , Chen Kaiyun , Chen Dong , Hong Jian , Qu Chen 
Published: April 2023

Abstract
Minichromosome maintenance complex component 6 (MCM6), a member of the MCM family, plays a pivotal role in DNA replication initiation and genome duplication of proliferating cells. MCM6 is upregulated in multiple malignancies and is considered a novel diagnostic biomarker. However, the functional contributions and prognostic value of MCM6 in intrahepatic cholangiocarcinoma (ICC) remain unexplored. In this study, we investigated the molecular function of MCM6 in ICC. Data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO, GSE107943) indicated an upregulation of MCM6 in tumor tissues. Immunohistochemical analysis performed on 115 cases of ICC samples confirmed the upregulation of MCM6 and further suggested that a high level of MCM6 expression predicted shorter overall and disease-free survival in ICC patients. Functional studies suggested that MCM6 knockdown significantly suppressed cell viability, blocked cell cycle progression and inhibited metastasis, while the enhancement of MCM6 expression promoted the proliferation and migration of ICC cells both in vitro and in vivo. Mechanistically, Gene Set Enrichment Analysis (GSEA) suggested that the epithelial–mesenchymal transition (EMT) and E2F1-correlated genes were enriched in ICC tissues with high MCM6 expression. Further verification indicated that MCM6 promoted the EMT of ICC cells via upregulating E2F1. In addition, E2F1 knockdown partially blocked the pro-malignant effects of MCM6 overexpression. In summary, MCM6 was found to be a novel prognostic and predictive marker for ICC. MCM6 promoted ICC progression via activation of E2F1-mediated EMT.
Scaffolding dermatological learning with near-peer teaching for preclinical-year medical students
Authors: Ting Jason S K , Tan Yu L , Veasuvalingam Bhavani , Yap Ashley Y M , Ghui Shi M , Yong Jade L   , Goodson Michaela 
Published: April 2023

Abstract

Background
To date, to our knowledge, there has not been a study on dermatological teaching in the preclinical years (usually the first 2 years of medical school), where the majority of learning takes place in the form of lectures and seminars. Near-peer teaching (NPT) involves students who are at least one academic year more senior imparting knowledge to junior students. The principles behind scaffolding are having a more experienced teacher to guide learning, breaking down learning into smaller tasks and helping to build interest in learning.

Objectives
To investigate the feasibility and effectiveness of NPT in scaffolding dermatological learning among preclinical-year medical students.

Methods
Near-peer teachers who are content experts in dermatology taught alongside conventional teaching with lecturers. We employed five quiz questions before and after the case launch lecture, where students were first exposed to dermatology. We also invited students to provide feedback using a questionnaire on NPT in dermatology at the end of the case 8 teaching week.

Results
In total, 74 students participated in the pre- and post-lecture quiz questions, and 47 completed feedback. There was overwhelmingly positive feedback towards NPT, and various learning theories can help explain the success of this project.

Conclusions
Preclinical students enjoy dermatological teaching with the involvement of suitable near-peers. With the professional barrier removed, students can better relate to near-peers (and vice versa). Helping students understand the relevance of dermatology in the clinical setting at an early stage and adopting learning tools such as mnemonics, summary tables, comparison tables and mapping teaching with the learning curriculum clearly helped students learn about dermatology.
Treatment of severe atopic dermatitis with tralokinumab in clinical practice: short-term effectiveness and safety results
Authors: Pereyra-Rodríguez José-Juan , Herranz Pedro , Ruiz-Villaverde Ricardo , Elosua-González Marta , Galán-Gutiérrez Manuel , Figueras-Nart Ignasi , Miquel Javier , de la Cueva Pablo , Serra-Baldrich Esther , Munera-Campos Monica , Melé-Ninot Gemma , Expósito-Serrano Vicente , Perez Bibiana , Serrano Amalia , Ortiz de Frutos Javier F , Armario-Hita José C 
Published: April 2023

Abstract

Background
Tralokinumab was recently approved for the treatment of moderate-to-severe atopic dermatitis (AD) and is the first selective interleukin (IL)-13 inhibitor that specifically neutralizes IL-13 with high affinity.

Objectives
To determine the real-life short-term effectiveness and safety of tralokinumab treatment in patients with moderate-to-severe AD.

Methods
A multicentre retrospective study was conducted including adult patients with moderate-to-severe AD who started tralokinumab treatment from 1 April to 30 June 2022 in 16 Spanish hospitals. Demographic and disease characteristics, severity and quality of life scales were collected at the baseline visit and at weeks 4 and 16.

Results
Eighty-five patients were included. Twenty-seven patients (32%) were non-naive to advanced therapy (biological or Janus kinase inhibitors inhibitors). All included patients had severe disease with baseline Eczema Area and Severity Index (EASI) scores of 25.4 (SD 8.1), Dermatology Life Quality Index (DLQI) 15.8 (5.4) and peak pruritus numerical rating scale (PP-NRS) 8.1 (1.8) and 65% had an Investigator’s Global Assessment (IGA) of 4. At week 16, there was improvement on all scales. The mean EASI decreased to 7.5 (SD 6.9, 70% improvement), SCORing Atopic Dermatitis improved 64% and PP-NRS, 57%. Also, 82%, 58% and 21% of the patients achieved EASI 50, 75 and 90, respectively. The percentage of EASI 75 responders was significantly higher among the naive vs. non-naive groups (67% vs. 41%). The safety profile was acceptable.

Conclusions
Patients, with a long history of disease and prior multidrug failure, showed a good response to tralokinumab, confirming clinical trial results.
SARS-CoV-2 infection is associated with anti-desmoglein 2 autoantibody detection
Authors: Ward Kerensa E , Steadman Lora , Karim Abid R , Reynolds Gary M , Pugh Matthew , Chua Winnie , Faustini Sian E , Veenith Tonny , Thwaites Ryan S , Openshaw Peter J M , Drayson Mark T , Shields Adrian M , Cunningham Adam F , Wraith David C , Richter Alex G 
Published: April 2023

Abstract
Post-acute cardiac sequelae, following SARS-CoV-2 infection, are well recognized as complications of COVID-19. We have previously shown the persistence of autoantibodies against antigens in skin, muscle, and heart in individuals following severe COVID-19; the most common staining on skin tissue displayed an inter-cellular cement pattern consistent with antibodies against desmosomal proteins. Desmosomes play a critical role in maintaining the structural integrity of tissues. For this reason, we analyzed desmosomal protein levels and the presence of anti-desmoglein (DSG) 1, 2, and 3 antibodies in acute and convalescent sera from patients with COVID-19 of differing clinical severity. We find increased levels of DSG2 protein in sera from acute COVID-19 patients. Furthermore, we find that DSG2 autoantibody levels are increased significantly in convalescent sera following severe COVID-19 but not in hospitalized patients recovering from influenza infection or healthy controls. Levels of autoantibody in sera from patients with severe COVID-19 were comparable to levels in patients with non-COVID-19-associated cardiac disease, potentially identifying DSG2 autoantibodies as a novel biomarker for cardiac damage. To determine if there was any association between severe COVID-19 and DSG2, we stained post-mortem cardiac tissue from patients who died from COVID-19 infection. This confirmed DSG2 protein within the intercalated discs and disruption of the intercalated disc between cardiomyocytes in patients who died from COVID-19. Our results reveal the potential for DSG2 protein and autoimmunity to DSG2 to contribute to unexpected pathologies associated with COVID-19 infection.
The link between T cell activation and development of functionally useful tumour-associated high endothelial venules
Authors: Milutinovic Stefan , Gallimore Awen 
Published: April 2023

Summary
High endothelial venules (HEVs) are specialized postcapillary venules that specifically serve to recruit circulating lymphocytes to secondary lymphoid organs (SLOs) where cognate antigens can be encountered, and immune responses can be initiated. The presence of HEV-like vessels in primary human solid tumours and their association with lymphocyte infiltration and favourable clinical outcomes and response to immunotherapy have provided a rationale for therapeutically inducing these vessels in tumours for immunotherapeutic benefit. Here we specifically discuss evidence for a link between T-cell activation and development of useful tumour-associated HEV (TA-HEV). We discuss the molecular and functional features of TA-HEV, highlighting the benefits for promoting tumour immunity and the important unanswered questions that need to be addressed before TA-HEV induction can be optimized for immunotherapeutic benefit.
Rare case of infective endocarditis from invasive aspergillosis encasing the pulmonary valve: a case report
Authors: Basyal Binaya , Clark Paul A , Cohen Jeffrey E , Srichai Monvadi B 
Published: April 2023

Abstract

Background
Aspergillus endocarditis is a rare cause of infective endocarditis and requires high index of suspicion for diagnosis.

Case summary
We describe a case of a 50-year-old man with history of metastatic thymoma on immunosuppression (gemcitabine and capecitabine) who presented with progressive dyspnoea. Echocardiography and computed tomography (CT) of chest showed filling defect in the pulmonary artery. The initial differential diagnosis was of pulmonary embolism and metastatic disease. The mass was subsequently excised, which revealed a diagnosis of Aspergillus endocarditis of the pulmonary valve. Unfortunately, he passed away despite medical treatment with antifungal therapy after surgery.

Discussion
Aspergillus endocarditis should be suspected in immunosuppressed hosts with negative blood cultures and large vegetations on echocardiography. Diagnosis is made by tissue histology but may be difficult or delayed. Optimal treatment involves aggressive surgical debridement and prolonged antifungal therapy; prognosis is poor with high mortality.
Catheter ablation of intramural outflow tract premature ventricular complexes: a multicentre study
Authors: Hanson Matthew , Futyma Piotr , Bode Weeranun , Liang Jackson J , Tapia Carlos , Adams Christian , Zarębski Łukasz , Wrzos Aleksandra , Saenz Luis , Sadek Mouhannad , Muser Daniele , Baranchuk Adrian , Marchlinski Francis , Santangeli Pasquale , Garcia Fermin , Enriquez Andres 
Published: April 2023

Abstract

Aims
Ablation of outflow tract ventricular arrhythmias may be limited by a deep intramural location of the arrhythmogenic source. This study evaluates the acute and long-term outcomes of patients undergoing ablation of intramural outflow tract premature ventricular complexes (PVCs).

Methods and results
This multicenter series included patients with structurally normal heart or nonischemic cardiomyopathy and intramural outflow tract PVCs defined by: (a) ≥ 2 of the following criteria: (1) earliest endocardial or epicardial activation &lt; 20ms pre-QRS; (2) Similar activation in different chambers; (3) no/transient PVC suppression with ablation at earliest endocardial/epicardial site; or (b) earliest ventricular activation recorded in a septal coronary vein. Ninety-two patients were included, with a mean PVC burden of 21.5±10.9%. Twenty-six patients had had previous ablations. All PVCs had inferior axis, with LBBB pattern in 68%. In 29 patients (32%) direct mapping of the intramural septum was performed using an insulated wire or multielectrode catheter, and in 13 of these cases the earliest activation was recorded within a septal vein. Most patients required special ablation techniques (one or more), including sequential unipolar ablation in 73%, low-ionic irrigation in 26%, bipolar ablation in 15% and ethanol ablation in 1%. Acute PVC suppression was achieved in 75% of patients. Following the procedure, the PVC burden was reduced to 5.8±8.4%. The mean follow-up was 15±14 months and 16 patients underwent a repeat ablation.

Conclusion
Ablation of intramural PVCs is challenging; acute arrhythmia elimination is achieved in 3/4 patients, and non-conventional approaches are often necessary for success.
Aging as Adaptation
Authors: Watkins Susan , Raisborough Jayne , Connor Rachel 
Published: April 2023

Abstract
In traditional gerontological terms, adaptation is usually understood as the production of physical aids to mitigate the impairment effects caused by age-related disabilities, or as those alterations organizations need to make under the concept of reasonable adjustment to prevent age discrimination (in the UK, e.g., age has been a protected characteristic under the Equality Act since 2010). This article will be the first to examine aging in relation to theories of adaptation within cultural studies and the humanities. It is thus an interdisciplinary intervention within the field of cultural gerontology and cultural theories of adaptation. Adaptation studies in cultural studies and the humanities have moved away from fidelity criticism (the issue of how faithful an adaptation is to its original) toward thinking of adaptation as a creative, improvisational space. We ask if theories of adaptation as understood within cultural studies and the humanities can help us develop a more productive and creative way of conceptualizing the aging process, which reframes aging in terms of transformational and collaborative adaptation. Moreover, for women in particular, this process of adaptation involves engagement with ideas of women’s experience that encompass an adaptive, intergenerational understanding of feminism. Our article draws on interviews with the producer and scriptwriter of the Representage theater group’s play My Turn Now. The script for the play is adapted from a 1993 coauthored book written by a group of 6 women who were then in their 60s and 70s, who founded a networking group for older women.
On the time-stability of resonance frequencies in deep basins
Authors: Lattanzi Giovanni , Castellaro Silvia , Di Donato Miriana 
Published: April 2023

SUMMARY
Determining the resonance frequencies of sediment-filled basins is important in seismic site effects assessment and to infer information about the geometrical and mechanical properties of the basins. Being intrinsic properties of elastic bodies, resonance frequencies are not expected to change over time, at least in the short term and under small excitations, in this type of basins. By analysing multi-annual time-series at some seismic stations located on markedly alpine and subalpine 2-D basins, we first state under what type of exciting function (ambient noise) these resonances can be identified and with what uncertainty. The analysis will reveal a clear annual and daily oscillation of the resonance frequencies, increasing in the summertime and at daytime (i.e. directly correlated with temperature). We attempt to provide different explanations to this not yet so systematically documented experimental evidence. A clear and unique answer is yet to come.
Capacity optimization strategy for energy storage system to ensure power supply
Authors: Fu Huimin , Shi Ming , Feng Miaomiao 
Published: April 2023

AbstractPhotovoltaic (PV) and wind power generation are very promising renewable energy sources, reasonable capacity allocation of PV–wind complementary energy storage (ES) power generation system can improve the economy and reliability of system operation. In this paper, the goal is to ensure the power supply of the system and reduce the operation cost. The PV, wind and ES system models are analyzed. The differential evolutionary (DE) algorithm is adopted to optimize the particle swarm optimization (PSO) algorithm, and the parameters of the PSO algorithm are changed through the DE algorithm to obtain better performance. We use MATLAB to verify that when the system is composed of 100 kW PV and 100 kW wind power, the battery capacity obtained by PSO algorithm is 400 kWh, while the algorithm proposed in this paper only requires 330 kWh. Although the loss of load probability of the system is improved by about 0.12%, the cost is saved by 17.5%. To improve the system operation reliability, we recommend increasing PV, wind and ES capacity at the same time rather than increasing ES capacity separately.
Identification of candidate genes associated with carcass component weights in commercial crossbred pigs through a combined GWAS approach
Authors: Qiu Yibin , Zhuang Zhanwei , Meng Fanming , Ruan Donglin , Xu Cineng , Ma Fucai , Peng Longlong , Ding Rongrong , Cai Gengyuan , Yang Ming , Wu Zhenfang , Yang Jie , Zheng Enqin 
Published: April 2023

AbstractIn the pork industry chain, carcass cutting is crucial for enhancing the commercial value of pork carcasses. However, the genetic mechanisms underlying carcass component weights remain poorly understood. Here, we used a combined genome-wide association study (GWAS) approach that integrated single- and multi-locus models to map genetic markers and genes associated with the weights of seven carcass components in Duroc × Landrace × Yorkshire (DLY) pigs. As multi-locus GWAS captures more single nucleotide polymorphisms (SNPs) with large effects than single-locus GWAS, the combined GWAS approach detected more SNPs than using the single-locus model alone. We identified 177 nonredundant SNPs associated with these traits in 526 DLY pigs, including boneless butt shoulder (BBS), boneless picnic shoulder (BPS), boneless leg (BL), belly (BELLY), front fat (FF), rear fat (RF), and skin-on whole loin (SLOIN). Using single-locus GWAS, we identified a quantitative trait locus (QTL) for SLOIN on Sus scrofa chromosome 15 (SSC15). Notably, a single SNP (ASGA0069883) in the proximity of this QTL was consistently detected by all GWAS models (one single-locus and four multi-locus models) and explained more than 4% of the phenotypic variance. Our findings suggest that the involved gene, MYO3B, is proposed to be a strong candidate for SLOIN. Further analysis also identified several candidate genes related to BBS (PPP3CA and CPEB4), BPS (ECH1), FF (CACNB2 and ZNF217), BELLY (FGFRL1), BL (CHST11), and RF (LRRK2). The identified SNPs can be used as molecular markers for the genetic improvement of pork carcasses in the molecular-guided breeding of modern commercial pigs.
Circumscribed Masses on Breast MRI: Can MRI Features Guide Management?
Authors: Myers Kelly S , Shey Erica , Ambinder Emily B , Mullen Lisa A , Panigrahi Babita , Di Carlo Philip A , Yenokyan Gayane , Oluyemi Eniola T 
Published: April 2023

Abstract

Objective
Management of circumscribed breast masses seen on MRI is largely extrapolated from mammography and US data with limited MRI-specific data available. This study aimed to assess clinical and MRI imaging features of malignant circumscribed breast masses.

Methods
In this IRB-approved retrospective study, breast MRIs performed between April 1, 2008, and August 30, 2020, containing circumscribed masses, excluding multiple bilateral circumscribed masses, were reviewed. Clinical and imaging features of all eligible masses were recorded, and associations with malignant outcomes were assessed using Fisher’s exact test and Wilcoxon rank sum test, with P &lt; 0.05 considered significant.

Results
For the 165 masses that met study criteria in 158 women, the mean age was 48 years (SD 12.0 years). Nine of 165 masses were malignant (5.5%). Round masses were significantly more likely to be malignant (7/37, 18.9%) compared to oval masses (2/128, 1.7%) (P &lt; 0.001). Among masses with available dynamic contrast kinetics data, the malignancy rate was 0/84 (0%) for persistent kinetics, 2/23 (8.7%) for plateau kinetics, and 4/24 (16.7%) for washout kinetics (P = 0.002). The malignancy rate for oval masses without washout kinetics was 0% (0/92). T2 hyperintense masses had a malignancy rate of 7/104 (6.7%), and homogeneously enhancing masses had a malignancy rate of 5/91 (5.5%).

Conclusion
These data support the use of mass shape and dynamic contrast enhancement kinetics to guide management of circumscribed breast masses seen by MRI, with oval masses without washout kinetics and any circumscribed mass with persistent kinetics showing no malignancies in this study.
Aberrant right subclavian artery: a case of vertebrobasilar insufficiency
Authors: Kimyaghalam A , Gabay A , Singh K 
Published: April 2023

Abstract
Aberrant right subclavian artery (ARSA) is a rare congenital malformation, wherein the aorta gives rise to the right subclavian artery as a branch off the aortic arch distal to the takeoff of the left subclavian artery. We presented a case of a patient with ARSA that manifested vertebrobasilar symptoms. PubMed search was preformed using keywords ‘aberrant right subclavian artery’, ‘right subclavian steal’ and ‘vertebrobasilar’, which generated nine articles. We found only seven case reports through a PubMed search that discuss ARSA in association with Subclavian steal syndrome. Approximately 71% (n = 5) of the patients in our literature review manifested with signs and symptoms of vertebrobasilar insufficiency. Given the complex anatomy in this condition, treatment should be aimed at symptom resolution. Carotid-subclavian bypass ultimately resolved the symptoms in our patient. Management in symptomatic patient is surgical. In addition to open technique, endovascular interventions can be an option.