bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful use of left ventricular support device (Impella 5.0) and extracorporeal membrane oxygenation (ECMO) for postoperative cardiac arrest after lung cancer surgery: a case report
Authors: Hara Kantaro , Miyamoto Hikaru , Furukawa Nao , Kimura Takuya , Soeda Satsuki , Okabe Kazunori 
Published: May 2023

Abstract
Postoperative hemodynamic support with an Impella 5.0 was effective in a man who underwent lung lobectomy for lung cancer and cardiogenic shock. A 75-year-old man presented to hospital with an abnormal chest shadow on radiography. After thorough examination, the patient was diagnosed with lung cancer, and left lower lobectomy was performed. On the 2nd postoperative day, the patient experienced cardiac arrest because of a sudden drop in saturation of percutaneous oxygen. After a third defibrillation, his heartbeat resumed, and he was intubated and placed on a ventilator. Coronary angiography revealed acute coronary syndrome and the patient fell into a state of shock, which required venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. Nevertheless, the circulatory dynamics are unstable, and Impella 5.0 was introduced. VA-ECMO and the Impella 5.0 were discontinued on the 6th and 8th postoperative days, respectively. The patient was eventually transferred to a nearby facility for further rehabilitation 109 days later.
Ubiquitination from the perspective of plant pathogens
Authors: Sharma Shambhavi , Prasad Ashish , Prasad Manoj 
Published: May 2023

Abstract
The constant battle of survival between pathogens and host plants has played a crucial role in shaping the course of their co-evolution. However, the major determinants of the outcome of this ongoing arms race are the effectors secreted by pathogens into host cells. These effectors perturb the defense responses of plants to promote successful infection. In recent years, extensive research in the area of effector biology has reported an increase in the repertoire of pathogenic effectors that mimic or target the conserved ubiquitin–proteasome pathway. The role of the ubiquitin-mediated degradation pathway is well known to be indispensable for various aspects of a plant’s life, and thus targeting or mimicking it seems to be a smart strategy adopted by pathogens. Therefore, this review summarizes recent findings on how some pathogenic effectors mimic or act as one of the components of the ubiquitin–proteasome machinery while others directly target the plant’s ubiquitin–proteasome system.
Anatomy and physiology
Authors: Grotelüschen Rainer , Ghadban Tarik , Bachmann Kai , Izbicki Jakob R. 
Published: May 2023

Abstract
The oesophagus and stomach form the upper part of the gastrointestinal tract. In addition to the mechanical preparation of food, chemical digestion begins here. As a relatively strong muscular tube, the oesophagus essentially transports food by peristaltic waves. Anatomically, the pars cervicalis (cervical oesophagus) is distinguished from the pars thoracica (thoracic oesophagus) and the pars abdominalis (abdominal oesophagus). Three physiological constrictions are defined: the constrictio cricoidea, the constrictio partis thoracicae, and the constrictio diaphragmatica. In addition, the oesophagus has an upper and lower sphincter, which prevent reflux. Blood is supplied via the inferior thyroid artery, bronchial arteries, and branches of the aorta and in the abdominal part via the left gastric and inferior phrenic artery. The accompanying lymph nodes are found deeply cervical, mediastinal, coeliacal, and in the area of the left gastric artery. In the transition area to the stomach, the stratified squamous epithelium of the oesophagus changes to the simple column epithelium of the stomach, recognizable macroscopically as a z-line. The stomach is divided into the pars cardiaca, the fundus, the corpus gastricus, and the pars pylorica. The pyloric sphincter controls gastric emptying. The blood supply is via branches of the coeliac trunk, along which the regional lymph nodes also run. Digestion, which has already started orally, continues in the stomach. The digestive hormones pepsinogen, gastrin, cholecystokinin, and intrinsic factor are secreted by different cells of the stomach and partly digest proteins and fats in an acidic environment. In addition, the absorption of liquid, some vitamins, and many substances is already taking place here.
Upper gastrointestinal bleeding
Authors: Nabi Zaheer , Reddy D. Nageshwar 
Published: May 2023

Abstract
Upper gastrointestinal (GI) bleeding is defined as bleeding originating from the part of the GI tract proximal to the ligament of Treitz. Among the various causes of upper GI bleeding, bleeding from peptic ulcer disease is the most common and responsible for 30–40% of all cases. Other common causes of upper GI bleeding include oesophageal varices, gastritis, and oesophagitis. The management of upper GI bleeding has improved substantially with widespread utilization of endoscopy and the availability of potent acid-suppressive medications. Consequently, recent trends show a decline in the incidence of hospitalization and mortality due to non-variceal upper GI bleeding. Haemodynamic resuscitation precedes endoscopy and other therapeutic options irrespective of the aetiology of upper GI bleeding. Pre-endoscopic risk stratification allows for the selective need of hospitalization and inpatient management in cases with non-variceal upper GI bleeding. This strategy improves the utilization of healthcare resources and directs them preferentially to sicker patients. With endoscopic risk stratification, the requirement of endoscopic haemostasis can be ascertained effectively. Endoscopic haemostasis is effective in 80–90% of cases with bleeding due to variceal or non-variceal causes. Strategies to prevent re-bleeding are important to reduce future recurrences. Proton pump inhibitors and anti-Helicobacter pylori regimens are efficacious in preventing re-bleeding in cases with peptic ulcer bleeds. Non-selective beta blockers and several sessions of endoscopic variceal ligation effectively prevent bleeding from oesophageal varices. With the currently available pharmacotherapy and endoscopic haemostatic modalities, the requirement of surgery has declined in both variceal and non-variceal upper GI bleeding. The increasing utilization of interventional radiology has further reduced the need for surgery in cases with refractory upper GI bleeding.
Obesity
Authors: Shah Rishabh , Montorfano Lisandro , Lo Menzo Emanuele , Szomstein Samuel , Rosenthal Raul J. 
Published: May 2023

Abstract
Obesity has reached epidemic proportions across the globe, especially in the last 40 years. As a result, the medical and economic consequences of such a surge have increased exponentially. While multiple pharmaceutical options continue to be developed to induce weight loss, surgery continues to provide the most effective and most durable results. Consequently, the number of bariatric operations performed worldwide has been increasing rapidly. While the Roux-en-Y gastric bypass, first described in the 1960s, remains the gold standard, several new procedures have been described. This chapter discusses the most common medical and surgical options and bariatric complications.
Oesophageal cancer
Authors: Tang Andrew , Rice Thomas , Ahmad Usman 
Published: May 2023

Abstract
Internationally, squamous cell carcinoma of the upper third of the oesophagus, secondary to smoking and alcohol, is the most prevalent form of oesophageal cancer. However, in Western countries where obesity, gastro-oesophageal reflux, and Barrett’s oesophagus are more prevalent, adenocarcinoma is the more common form of oesophageal cancer. Dysphagia is the most common presenting symptom and is typically related to the degree of tumour growth. Oesophageal cancers are diagnosed with oesophagogastroduodenoscopy and staged with endoscopic ultrasound and computed tomography. The latest iteration of oesophageal cancer staging was designed to reflect the changes in tumour characteristics and behaviour over the course of time and treatments. As perioperative care continues to improve and treatment options continue to expand, this will allow for finer tuning of staging. Future iterations of cancer staging will likely incorporate tumour-specific biomarkers that will help provide patient-specific prognoses.
Oesophageal cancer
Authors: Eyck Ben M. , van der Wilk Berend J. , van der Sangen Maurice J.C. , van der Gaast Ate , van Lanschot J. Jan B. 
Published: May 2023

Abstract
Surgery has been the cornerstone of curative treatment for patients with locally advanced oesophageal cancer. Over the last decades, the addition of chemotherapy and radiotherapy to surgery has been extensively tested to improve survival outcomes. Several studies have shown that there is no clear benefit from adding neoadjuvant radiotherapy, adjuvant radiotherapy, or adjuvant chemotherapy without any preoperative chemotherapy to surgery. It has been shown that neoadjuvant or perioperative chemotherapy as well as neoadjuvant chemoradiotherapy improve survival outcomes when given in addition to surgery. For squamous cell carcinoma, neoadjuvant chemoradiotherapy followed by surgery has been widely adopted as the treatment standard. For adenocarcinoma, both perioperative chemotherapy and neoadjuvant chemoradiotherapy have shown to be effective and no clear advantage of one over the other has yet been reported. Patients for whom surgery is contraindicated can be treated curatively with definitive chemoradiotherapy. More recently, promising results have been reported for the use of targeted therapies to treat oesophageal cancer. In many countries, adjuvant nivolumab has been approved for treating patients with pathologically residual disease after neoadjuvant chemoradiotherapy and surgery. In future, organ preservation after a clinically complete response to neoadjuvant treatment could also become a new treatment option.
Oesophageal cancer
Authors: Rösch Thomas 
Published: May 2023

Abstract
Oesophageal cancer in its two forms—squamous cell carcinoma as well as Barrett-related distal oesophageal adenocarcinoma—are two major challenges for upper gastrointestinal endoscopists worldwide with respect to diagnosis. There are no systematic screening programmes for both diseases in most parts of the world, so diagnosis relies on recognition of subtle lesions during endoscopy for other reasons, as well as during surveillance of Barrett’s oesophagus when diagnosed. Early and superficial lesions can be treated by means of endoscopic resection, namely endoscopic mucosal resection and endoscopic submucosal dissection. The eradication of the remaining risk mucosa in Barrett’s oesophagus adds an additional workload to the endoscopist. Long-term results of endotherapy under certain histological conditions are excellent and comparable to surgery, while the complication rate is substantially lower.
Advanced Practice Palliative Nursing 2nd Edition
Authors: Dahlin Constance , Coyne Patrick 
Published: May 2023

Abstract
This is the seminal textbook for advanced practice palliative nurses. This edition has been completely reorganized to meet the needs of the APRN according to role delineation and practice issues. Current issues of health equity, managing through crisis, and meeting the needs of diverse populations have been brought to the forefront. There is foundational information on leadership and practice. The various roles of the APRN—administrator, educator, policy advocate, and researcher—are delineated to assist the APRN in influencing those spheres of practice. The roles of APRNs across settings are described, including the acute care settings (clinical care unit, intensive care unit, and emergency department), the clinic (specialty care, primary care, and palliative care), the community, rehabilitation, residential facilities, and telehealth. Pediatric care has its own section where the APRN role is described in caring for patients across the acute care setting, the clinic, and the community, including perinatal and neonatal care and the communication skills unique to caring for children. Attention to special populations includes chapters on health disparities, economically disadvantaged urban dwellers, the LCBTQ+ community, veterans, and cancer survivors. The essential skill of communication is covered for adults and children, as is advance care planning, family meetings, and communication at end of life. A section on the psychosocial, cultural, and spiritual aspects of care is included. There is a significant section devoted to physical and psychological symptoms. Finally, a section on ethics includes navigation of ethics, palliative sedation, and discontinuation of cardiac, respiratory, and other life sustaining therapies.
The Palliative and Hospice APRN in Hospice and Home Health Programs
Authors: Hooper Rikki N. , Price Chari , Rouse Jamie Lee 
Published: May 2023

Abstract
Advanced practice registered nurses (APRNs) have a unique skill set ideally suited to working with people who are chronically seriously ill or at the end of life, being cared for either through a hospice or home health program. Using the nursing process, APRNs address the complex issues of seriously ill people by synthesizing complex data to develop and implement advanced person-centered care plans. This includes employing a well-organized, consistent approach that is both comprehensive and proactive in providing symptom management and addressing other issues. APRNs combine palliative nursing’s focus on the whole person and their advanced education to perform comprehensive physical evaluations, order and interpret diagnostic tests, and prescribe medications, depending on the state-specific APRN certifying regulations. Acting as a case manager, the palliative APRN involves the interdisciplinary team in both hospice and home health settings to provide a holistic approach to the care of patients with complex needs due to their disease process and resultant problems.
The Palliative APRN in the Rural Community
Authors: Sickich Traci 
Published: May 2023

Abstract
Rural populations have their own unique healthcare challenges which can be amplified at end of life. The palliative advanced practice registered nurse (APRN) serves as a key community asset to assist with the complexity of providing care to those with serious illness in a rural community. Navigating challenges with healthcare access, healthcare provider shortages, and lack of overall available resources for patients and the APRN creates a dynamic environment to deliver competent care and requires an expert generalist approach to palliative care. Rural culture is rooted in concepts of resiliency, independence, and the use of informal networks of care. The landscape of providing quality, competent, end-of-life care for the rural population mirrors the complexity of healthcare needs of rural patients with serious illness.
The Pediatric Palliative APRN in Perinatal and Neonatal Palliative Care
Authors: Root Maggie C. , Fossa Mallory 
Published: May 2023

Abstract
Perinatal and neonatal palliative care address the needs of families and infants facing serious illness. Perinatal palliative care involves assessing and addressing the needs of the birthing woman, their support circle, and their family as they consider decisions regarding the care of their fetus before, during, and immediately after birth. Neonatal palliative care meets the family where they are, physically and metaphorically, in the neonatal intensive care unit. In both areas, the palliative care advanced practice registered nurse serves to elicit understanding of illness, support decision-making and advance care planning, communicate with other providers regarding the goals of care, and provide expert symptom management. This role can extend for months or years, through bereavement or survivorship.
The Pediatric Palliative APRN in Oncology
Authors: Haskamp Amy Corey , Greene Joanne M. 
Published: May 2023

Abstract
Pediatric hematology-oncology can be challenging for the palliative care advanced practice registered nurse (APRN). The palliative APRN must appreciate that children with a cancer or blood disease often suffer from a multitude of symptoms which threaten the intactness and quality of life of the child and family. Early integration of palliative care may mitigate suffering and fosters improved coping throughout the trajectory of the underlying disease. Specifically, the initiation of therapies with curative intent concurrently with those that ease suffering can promote quality of life and well-being. Due to the complexity of symptom management, essential crucial conversations, and the therapies’ impact on quality of life, the presence of a palliative APRN for these patients is vital.
Communication at the End of Life
Authors: McHugh Marlene E. , Buschman Penelope R. , Delisle Susan M. 
Published: May 2023

Abstract
Effective and compassionate communication is vital in palliative care, especially at the end of life. Using a family systems perspective, this chapter explores communication as the therapeutic thread woven through the fabric of a family’s grief over the trajectory of the patient’s illness and beyond the patient’s death. It discusses communication with families in person and by telephone when death is unexpected. It reviews significant barriers to end-of-life communication with vulnerable populations, such as those with sensory motor and cognitive deficits, severe and persistent mental illness, and developmental disabilities. It highlights communication challenges posed by COVID-19. It notes the importance of communication among advanced practice registered nurses to enhance their self-awareness and their ability to respond to patients at the end of life.
Life Review
Authors: Davis Jamil , Jenko Mimi , Pace James C. 
Published: May 2023

AbstractLife review is a therapeutic process that allows patients and families to recast the past in the context of the present. The process may involve one or more sessions. The ultimate goals of life review are to restore a lost sense of harmony by resolving unsettled conflicts, celebrating epochal memories, reframing disconcerting experiences, and reaching new levels of positive consensus with self, others, and one’s higher power. The end result is new-found meaning in life, especially at the end-of-life. The palliative advanced practice registered nurse (APRN) works closely within the context of a team; when issues arise beyond the APRN’s scope of practice or areas of specialty or comfort then, consultation is then requested (e.g., chaplains, mental health providers, counselors).
Grief and Bereavement
Authors: Adelstein Katharine , Archer-Nanda Elizabeth 
Published: May 2023

Abstract
Patients, family caregivers, and palliative care advanced practice registered nurses themselves will experience grief and bereavement throughout a palliative care encounter. Palliative care nurses will encounter a myriad of grief-related experiences, including loss of independence and functioning, role strain or changes, disruption in relationships, and the death of an individual. To expertly manage grief and bereavement, the advanced practice nurse should understand common terms including loss, grief, and bereavement; be able to identify normal grief from complicated bereavement; know when to refer patients for psychiatric services; and employ strategies for self-care. This chapter provides a review of grief theories, essential assessment components, and strategies for supportive counseling and mental health referrals.
Discontinuation of Respiratory Therapies
Authors: Winn Brenna 
Published: May 2023

Abstract
Many patients with respiratory failure have benefited from recent advances in medical and respiratory technology. However, there are many patients in whom continued aggressive medical care fails, and palliative advanced practice registered nurses (APRNs) are faced with having conversations regarding discontinuing or withdrawing respiratory technology. Examples of respiratory technology include mechanical ventilation, noninvasive positive-pressure ventilation (NPPV), continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), extracorporeal membrane oxygenation (ECMO), and high-flow nasal oxygen (AIRVO). The palliative APRN must have a clear understanding of all treatment modalities, the complexity of respiratory failure, and the process of respiratory support discontinuation to facilitate the best possible end-of-life situation for the patient.
Medical Assessment of the Psychiatric Patient
Authors: Thomas Seth 
Published: May 2023

Abstract
In the United States, emergency physicians medically assess millions of patients annually with psychiatric complaints before they are transferred to psychiatric facilities. The goal of the medical assessment is to identify and stabilize unstable medical conditions and medical mimics of psychiatric disease. Despite adequate evidence that the vast majority of significant medical conditions can be identified during the history and physical exam alone, clinicians are routinely required to order comprehensive laboratory testing prior to transferring patients to psychiatric facilities. This chapter analyzes the history and available evidence surrounding the practice previously referred to as “medical clearance,” and it makes recommendations for the emergency physician and psychiatrist to use in their daily practice.
Assessing for Suicidality and Overall Risk of Violence
Authors: Schabbing Megan B. 
Published: May 2023

Abstract
Suicide was the 10th leading cause of death in the United States in 2018. Regardless of chief complaint, 10% of people who present to the emergency department have been found to have suicidal thoughts or behaviors. Since 1999, suicide rates in the United States have increased by 35%, and more than 50% of people who die by suicide did not have a known mental health condition. Because the majority of people who die by suicide had contact with a primary care provider in the year prior to completing suicide, screening for suicide in primary care settings, including the emergency department, is essential to suicide prevention efforts. Once a patient is identified as being at risk for suicide, a thorough suicide risk assessment must be done in order to determine how to best modify the patient’s risk factors for suicide and minimize the likelihood of future suicide attempts. Although no single validated tool exists for the determination of suicide risk assessment, an optimal suicide risk assessment should entail thorough consideration of a patient’s risk factors and protective factors for suicide, as well as an exploration of the patient’s suicidal thoughts, intent, plan, and suicidal behaviors. An individualized treatment plan should be developed for each at-risk patient, with safety planning, timely follow-up, and lethal means restriction.
Cultural Competence in Emergency Psychiatry
Authors: Aggarwal Arpit , Popoola Oluwole 
Published: May 2023

Abstract
The evaluation and management of culturally diverse patients in the emergency setting require unique approaches and expertise while working under time constraints. Psychiatric evaluation and treatment are greatly influenced by the culture of both patient and clinician. Patients have perspectives about their illness, its origin and plausible remedy that often differ from the clinician’s perspective. Ethnocultural variations in medication metabolism also affect treatment outcomes across cultures. The culturally competent emergency clinician will employ knowledge of these factors to maximize patient outcomes. Given psychiatric emergency services’ unique set of cultural challenges, it is imperative for the psychiatric emergency clinician to be culturally competent to become fully clinically competent.