bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potency Ranking of Per- and Polyfluoroalkyl Substances Using High-Throughput Transcriptomic Analysis of Human Liver Spheroids
Authors: Reardon Anthony J F , Rowan-Carroll Andrea , Ferguson Stephen S , Leingartner Karen , Gagne Remi , Kuo Byron , Williams Andrew , Lorusso Luigi , Bourdon-Lacombe Julie A , Carrier Richard , Moffat Ivy , Yauk Carole L , Atlas Ella 
Published: August 2021

Abstract
Per- and polyfluoroalkyl substances (PFAS) are some of the most prominent organic contaminants in human blood. Although the toxicological implications of human exposure to perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) are well established, data on lesser-understood PFAS are limited. New approach methodologies (NAMs) that apply bioinformatic tools to high-throughput data are being increasingly considered to inform risk assessment for data-poor chemicals. The aim of this study was to compare the potencies (ie, benchmark concentrations: BMCs) of PFAS in primary human liver microtissues (3D spheroids) using high-throughput transcriptional profiling. Gene expression changes were measured using TempO-seq, a templated, multiplexed RNA-sequencing platform. Spheroids were exposed for 1 or 10 days to increasing concentrations of 23 PFAS in 3 subgroups: carboxylates (PFCAs), sulfonates (PFSAs), and fluorotelomers and sulfonamides. PFCAs and PFSAs exhibited trends toward increased transcriptional potency with carbon chain-length. Specifically, longer-chain compounds (7–10 carbons) were more likely to induce changes in gene expression and have lower transcriptional BMCs. The combined high-throughput transcriptomic and bioinformatic analyses support the capability of NAMs to efficiently assess the effects of PFAS in liver microtissues. The data enable potency ranking of PFAS for human liver cell spheroid cytotoxicity and transcriptional changes, and assessment of in vitro transcriptomic points of departure. These data improve our understanding of the possible health effects of PFAS and will be used to inform read-across for human health risk assessment.
Neonatal Exposure to BPA, BDE-99, and PCB Produces Persistent Changes in Hepatic Transcriptome Associated With Gut Dysbiosis in Adult Mouse Livers
Authors: Lim Joe Jongpyo , Dutta Moumita , Dempsey Joseph L , Lehmler Hans-Joachim , MacDonald James , Bammler Theo , Walker Cheryl , Kavanagh Terrance J , Gu Haiwei , Mani Sridhar , Cui Julia Yue 
Published: August 2021

AbstractRecent evidence suggests that complex diseases can result from early life exposure to environmental toxicants. Polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs) are persistent organic pollutants (POPs) and remain a continuing risk to human health despite being banned from production. Developmental BPA exposure mediated-adult onset of liver cancer via epigenetic reprogramming mechanisms has been identified. Here, we investigated whether the gut microbiome and liver can be persistently reprogrammed following neonatal exposure to POPs, and the associations between microbial biomarkers and disease-prone changes in the hepatic transcriptome in adulthood, compared with BPA. C57BL/6 male and female mouse pups were orally administered vehicle, BPA, BDE-99 (a breast milk-enriched PBDE congener), or the Fox River PCB mixture (PCBs), once daily for three consecutive days (postnatal days [PND] 2–4). Tissues were collected at PND5 and PND60. Among the three chemicals investigated, early life exposure to BDE-99 produced the most prominent developmental reprogramming of the gut-liver axis, including hepatic inflammatory and cancer-prone signatures. In adulthood, neonatal BDE-99 exposure resulted in a persistent increase in Akkermansia muciniphila throughout the intestine, accompanied by increased hepatic levels of acetate and succinate, the known products of A. muciniphila. In males, this was positively associated with permissive epigenetic marks H3K4me1 and H3K27, which were enriched in loci near liver cancer-related genes that were dysregulated following neonatal exposure to BDE-99. Our findings provide novel insights that early life exposure to POPs can have a life-long impact on disease risk, which may partly be regulated by the gut microbiome.
Children with Amalgam Dental Restorations Have Significantly Elevated Blood and Urine Mercury Levels
Authors: Yin Lei , Lin Simon , Summers Anne O , Roper Van , Campen Matthew J , Yu Xiaozhong 
Published: August 2021

Abstract
Human exposure to organic mercury (Hg) as methylmercury (MeHg) from seafood consumption is widely considered a health risk because pure methylmercury is extremely neurotoxic. In contrast, the clinical significance of Hg exposure from amalgam (AMG) dental restorations, the only other major nonoccupational source of Hg exposure, has long been debated. Here, we examined data from the two most recent National Health and Nutrition Examination Surveys (NHANES) on 14 181 subjects to assess the contributions of seafood consumption versus AMG to blood total mercury (THg), inorganic mercury (IHg), and methyl mercury (MeHg) and to urine creatinine corrected mercury (UTHg). All subjects were also classified as to their self-reported qualitative consumption of seafood (59% fish and 44% shellfish). Subjects with restorations were grouped into three groups (0) those without AMG (64.4%), (1) those with 1–5 dental AMG restorations (19.7%), (2) those with more than five AMG (16%). Seafood consumption increased total mercury in urine (UTHg) and total mercury (THg) and methyl mercury (MeHg) in blood, but unlike AMG, seafood did not increase blood inorganic mercury (IHg). Using stratified covariate (ANOVA) and multivariate (GLM) analyses revealed a strong correlation of blood (THg and IHg) and urine (UTHg) levels with the number of AMGs. In a subpopulation without fish consumption, having more than five AMG restorations raised blood THg (103%), IHg (221%), and urine UTHg (221%) over the group without AMG. The most striking difference was noted in classification by age: subjects under 6 years old with more than five AMG restorations had the highest blood IHg and urine UTHg among all age groups. Elevation of bivalent IHg on a large scale in children warrants urgent in-depth risk assessment with specific attention to genetic- and gender-associated vulnerabilities.
A Framework for Developing Antiracist Medical Educators and Practitioner–Scholars
Authors: Sotto-Santiago Sylk , Poll-Hunter Norma , Trice Traci , Buenconsejo-Lum Lee , Golden Sherita , Howell Joy , Jacobs Nicole , Lee Winona , Mason Hyacinth , Ogunyemi Dotun , Crespo Waleska , Lamba Sangeeta 
Published: September 2021

With an increasing awareness of the disparate impact of COVID-19 on historically marginalized populations and acts of violence on Black communities in 2020, academic health centers across the United States have been prioritizing antiracism strategies. Often, medical students and residents have been educated in the concepts of equity and antiracism and are ready to tackle these issues in practice. However, faculty are not prepared to respond to or integrate antiracism topics into the curriculum. Leaders in faculty affairs, education, diversity, and other departments are seeking tools, frameworks, expertise, and programs that are best suited to meet this imminent faculty development need.
In response to these demands for guidance, the authors came together to explore best practices, common competencies, and frameworks related to antiracism education. The focus of their work was preparing faculty to foster antiracist learning environments at traditionally predominantly White medical schools. In this Scholarly Perspective, the authors describe their collaborative work to define racism and antiracism education; propose a framework for antiracism education for faculty development; and outline key elements to successfully build faculty capacity in providing antiracism education.
The proposed framework highlights the interplay between individual learning and growth and the systemic and institutional changes needed to advance antiracist policies and practices. The key elements of the framework include building foundational awareness, expanding foundational knowledge on antiracism, embedding antiracism education into practice, and dismantling oppressive structures and measuring progress. The authors list considerations for program planning and provide examples of current work from their institutions. The proposed strategies aim to support all faculty and enable them to learn, work, and educate others in an antiracist learning environment.
Growth of surgically confirmed leiomyomas in postmenopausal women: analysis of the influencing factors
Authors: Shen Minghong , Duan Hua , Chang Yanan , Wang Sha 
Published: September 2021

Abstract

Objectives:
The aim of this study was to examine the growth of uterine leiomyomas in postmenopausal women and evaluate the influencing factors associated with fibroid growth.

Methods:
We retrospectively analyzed the medical records of postmenopausal women with fibroids between 2015 and 2020. All women received at least 2 transvaginal ultrasound examinations within a 6-month interval. All fibroids were verified via surgery. The postoperative pathology of all tumors was uterine fibroid. We calculated the fibroid volume using the ellipsoid volume formula and evaluated the growth rate of fibroids within 6 months simultaneously. Univariable analysis and a linear mixed-effects model were used to assess the factors influencing fibroid growth.

Results:
A total of 102 postmenopausal women with a total of 132 fibroids were assessed. The median growth rate of surgically confirmed fibroids in postmenopausal women was 12.9% every 6 months (from −61.4% to 184.1%). Obesity was associated with fibroid growth (P < 0.05). Notably, the estimated growth rates of fibroids in obese and overweight women were 26.6% (95% confidence interval [CI]: 2.3-50.9) and 15.9% (95% CI: 0.4-31.4) higher than those in women of normal weight, respectively. The growth of fibroids varied by the initial tumor size (P < 0.05). The estimated growth rate of larger fibroids (≥5.0 cm diameter) was reduced 30.0% (95% CI: −52.4 to −7.5) compared with that of small fibroids (<3.0 cm diameter).

Conclusions:
Uterine fibroids continually grow in some postmenopausal women. Obesity and small fibroids (<3.0 cm diameter) may contribute to higher growth rates of fibroids.
Massive hemorrhage after resection of uterine endocervical polyp and endometrial polyps with hysteroscopic tissue removal system
Authors: Takasaki Kazuki , Henmi Hirofumi , Ikeda Utako , Sakuhara Yusuke , Endo Toshiaki 
Published: September 2021

Abstract

Rationale:
Hysteroscopic tissue removal system has clinical benefits of short operation time, high total resection rate, and high patient acceptability. It has been reported to be as safe as electrosurgical resection with fewer complications. We report a case of massive hemorrhage after resection of endocervical polyp and endometrial polyps with TruClear, hysteroscopic morcellator.

Patient concerns:
A 47-year-old woman visited our hospital with vaginal discomfort. Diagnosis: Based on the hysteroscopic findings and imaging findings, endocervical polyp and multiple endometrial polyps were diagnosed.

Interventions:
Hysteroscopic resection with TruClear was performed. Thirteen hours after the surgery, massive hemorrhage from uterus was observed. Imaging examination revealed bleeding from left uterine artery and uterine artery embolization was performed.

Outcomes:
After uterine artery embolization, bleeding stopped, and further hospitalization course was uneventful. Pathological diagnosis was endocervical polyp and endometrial polyps with no malignant findings.

Lessons:
Hysteroscopic tissue removal has several clinical benefits. However, our case report shows that there is a possibility of significant hemorrhage associated with hysteroscopic tissue removal system.
Self-Care Efficacy–Mediated Associations Between Healthcare Provider-Patient Communication and Psychological Distress Among Patients With Gastrointestinal Cancers
Authors: Chen Yongfeng , Chen Yanrong , Zhang Liyuan , Li Jilian , Bai Jinbing 
Published: September 2021

Background
Both healthcare provider-patient communication and self-care efficacy affect psychological distress, which is prevalent among patients with gastrointestinal (GI) cancers. It is essential to explore the underlying mechanism among them to relieve psychological distress.

Objective
The aim of this study was to examine whether self-care efficacy mediated the association between healthcare provider-patient communication and psychological distress among patients with GI cancers.

Methods
A cross-sectional study was conducted between March 2018 and May 2019 in China. In total, 219 patients with GI cancers were recruited before discharge from chemotherapy. Healthcare provider-patient communication was assessed by the revised Physician-Patient Communication Scale; patient self-care efficacy was assessed by the Strategies Used by People to Promote Health; and psychological distress was assessed by the Distress Thermometer and the Hospital Anxiety and Depression Scale. Mediation analyses were conducted to examine the mediating effect of self-care efficacy on the association between healthcare provider-patient communication and psychological distress.

Results
A total of 54.34% of patients experienced psychological distress. Patients reported a mean score of 89.93 (SD, 13.81) for healthcare provider-patient communication and 93.91 (SD, 23.39) for self-care efficacy. Self-care efficacy completely mediated the association between healthcare provider-patient communication and psychological distress, and communication outcome was the only domain that significantly influenced self-care efficacy.

Conclusion
Psychological distress is prevalent among patients with GI cancers. Healthcare provider-patient communication, especially communication outcome, promoted patients’ self-care efficacy to reduce psychological distress.

Implications for Practice
Healthcare providers should design interventions to improve communication outcomes and eventually increase self-care efficacy to relieve psychological distress among patients with GI cancers.
Stress and Resilience Among Healthcare Workers During the COVID-19 Pandemic
Authors: Liljestrand Rebecca , Martin Sarah 
Published: September 2021

Abstract
The COVID-19 pandemic has caused a significant increase in stress for frontline healthcare workers, including rehabilitation workers. Contributing factors include disrupted workflows, heavier workloads, increased time restraints, and fear of contracting/passing the virus. Prolonged high stress levels can produce adverse health outcomes when unaddressed. Resilience can mitigate the negative effects of prolonged stress. Four healthcare workers relate their experiences from the frontlines of the pandemic, discussing their strategies to build resilience and maintain health. Highlighted strategies include mindfulness (the purposeful act of paying attention to the present moment without judgment), gratitude (the practice of being grateful for the positive things in life), self-care (the maintenance of a healthy lifestyle using physical, psychological, and emotional tools), and social support (the sense of belonging that comes from being cared for and valued). These strategies reduce negative outcomes produced by elevated stress levels and promote resilience in frontline healthcare workers.
Choledochoduodenostomy Versus Hepaticogastrostomy in Endoscopic Ultrasound-guided Drainage for Malignant Biliary Obstruction: A Meta-analysis and Systematic Review
Authors: Mao Kejie , Hu Binbin , Sun Feng , Wan Kaiming 
Published: September 2021

Objectives:
This study aimed to estimate the safety and efficacy of endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) and endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for malignant biliary obstruction.

Methods:
We conducted a literature search using PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. Studies that compared EUS-CDS and EUS-HGS were included in this study.

Results:
Thirteen studies were eligible for inclusion. The technical [odds ratio (OR): 0.95; 95% confidence interval (CI): 0.51-1.74) and clinical (OR: 1.13; 95%CI: 0.66-1.94) success rates of EUS-CDS were comparable to those of EUS-HGS. However, EUS-CDS had less reintervention (OR: 0.31; 95%CI: 0.16-0.63) and stent obstruction (OR: 0.48; 95%CI: 0.21-0.94) than EUS-HGS. Both groups had similar adverse events (OR: 1.00; 95%CI: 0.70-1.43) and overall survival (hazard ratio: 1.07; 95%CI: 0.58-1.97).

Conclusions:
EUS-CDS and EUS-HGS have comparable technical and clinical success rates, adverse events, and overall survival. However, EUS-CDS has less reintervention and stent obstruction.
Decreased Immune Response to COVID-19 mRNA Vaccine in Patients with Inflammatory Bowel Diseases Treated with Anti TNFα
Authors: Edelman-Klapper Hadar , Zittan Eran , Shitrit Ariella Bar-Gil , Rabinowitz Keren Masha , Goren Idan , Avni-Biron Irit , Ollech Jacob E. , Lichtenstein Lev , Banai-Eran Hagar , Yanai Henit , Snir Yifat , Pauker Maor H. , Friedenberg Adi , Levy-Barda Adva , Segal Arie , Broitman Yelena , Maoz Eran , Ovadia Baruch , Golan Maya Aharoni , Shachar Eyal , Ben-Horin Shomron , Perets Tsachi-Tsadok , Eliakim Rami , Goren Sophy , Navon Michal , Krugliak Noy , Werbner Michal , Alter Joel , Dessau Moshe , Gal-Tanamy Meital , Freund Natalia T. , Cohen Dani , Dotan Iris 
Published: August 2021

AbstractBackgroundPatients with inflammatory bowel diseases (IBD), specifically those treated with anti-tumor necrosis factor (TNF)α biologics are at high risk for vaccine preventable infections. Their ability to mount adequate vaccine responses is unclear.Aimto assess immune responses to mRNA-COVID-19 vaccine, and safety profile, in patients with IBD stratified according to therapy, compared to healthy controls (HC).MethodsProspective, controlled, multi-center Israeli study. Subjects enrolled received two BNT162b2 (Pfizer/BioNTech) doses. Anti-spike (S) antibodies levels and functional activity, anti-TNFα levels and adverse events (AEs) were detected longitudinaly.ResultsOverall 258 subjects: 185 IBD (67 treated with anti-TNFα), and 73 HC. After the first vaccine dose all HC were seropositive, while some patients with IBD, regardless of treatment, remained seronegative. After the second dose all subjects were seropositive, however anti-S levels were significantly lower in anti-TNFα treated compared to untreated patients, and HC (p<0.001; p<0.001, respectively). Neutralizing and inhibitory functions were both lower in anti-TNFα treated compared to untreated patients, and HC (p<0.03; p<0.0001, respectively). Anti-TNFα drug levels and vaccine responses did not affect anti-S levels. Infection rate (∼2%) and AEs were comparable in all groups. IBD activity did not change in response to BNT162b2.ConclusionsIn this prospective study in patients with IBD stratified according to treatment all patients mounted an immune response to two doses of BNT162b2. However, its magnitude was significantly lower in patients treated with anti-TNFα, regardless of administration timing and drug levels. Vaccine was safe. As vaccine immune response longevity in this group may be limited, vaccine booster dose should be considered.
Community-Based Culturally Tailored Education Programs for Black Adults with Cardiovascular Disease, Diabetes, Hypertension, and Stroke: A Systematic Review Protocol
Authors: Fulton Joseph Hawkins , Singh Hardeep , Pakkal Oya , Uleryk Elizabeth M , Nelson Michelle LA 
Published: August 2021

AbstractBackgroundChronic conditions and stroke disproportionately affect Black adults in communities all around the world due patterns of systemic racism, disparities in care, and lack of resources. To address unequal care received by Black communities, a shift to community-based programs that deliver culturally-tailored programs to meet the needs of the communities they serve, including Black adults who tend to have reduced access to postacute services, may give an alternative to a healthcare model which reinforces health inequities. However, community-based culturally-tailored programs (CBCT) are relatively understudied but show promise to improve the delivery of services to marginalized communities. The objectives of this review are to: (i) determine key program characteristics and outcomes of CBCT programs that are designed to improve health outcomes in Black adults with cardiovascular disease, hypertension, diabetes, or stroke and (ii) identify which of the five categories of culturally appropriate programs from Kreuter and colleagues have been used to implement CBCT programs.MethodsThis is a protocol for a systematic review that will search MEDLINE, EMBASE, and CINAHL databases to identify community-based culturally-tailored programs for Black adults with cardiovascular disease, hypertension, diabetes, or stroke.DiscussionHealth inequities have disproportionately impacted Black communities and will continue to persist if adjustments are not prioritized within healthcare to provide services, care, and programs meant to address the specific barriers to better health experienced. Many interventions meant to improve the health outcomes of marginalized groups are created with little input from target communities, leading to interventions that may not address the specific barriers contributing to poor health outcomes and are designed and implemented from an outsider’s perspective. The inclusion of community members allows for a deeper understanding of the issues facing the community and provides an opportunity to incorporate cultural values to potentially increase the efficacy, tailoring the intervention to distinct communities. An alternative to current healthcare interventions must be explored to reduce the health gap experienced by Black adults.Trial registrationPROSPERO CRD42021245772