bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parity, Poverty, and Physician Aid in Dying: Policy Recommendations for PAD in Light of Social Injustices
Authors: Walsh Em 
Published: November 2024

AbstractIn light of the proposed expansion of eligibility for physician aid in dying (PAD) in Canada to people with psychiatric disorders, there is a new subset of individuals seeking PAD—those with poverty‐induced depression. The dominant account defending the expansion is known as the “parity argument.” Defenders of the parity argument maintain that the expansion of PAD to those with psychiatric conditions is needed to reflect that the seriousness of a patient's suffering does not depend on the cause of that suffering. Parity accounts, as they stand, would allow cases of poverty‐induced depression to qualify. I raise a moral dilemma that the parity theorist must face considering this new subset of cases—expanding access to PAD, without adequate social protections, could produce more social inequality by aiming to reduce it. I propose six recommendations that policy‐makers should consider before expanding PAD given these cases, social injustice, and the social determinants of mental health.
Gender, Pediatric Care, and Evidence
Authors: Gorin Moti 
Published: November 2024

AbstractThis letter responds to the Other Voices commentaries “Troubling Trends in Health Misinformation Related to Gender‐Affirming Care,” by Stef M. Shuster and Meredithe McNamara; “Values and Evidence in Gender‐Affirming Care,” by Os Keyes and Elizabeth Dietz; “Breaking Binaries: The Critical Need for Feminist Bioethics in Pediatric Gender‐Affirming Care,” by Lisa Campo‐Engelstein, Grayson Jackson, and Jacob Moses; and “Minors Lack the Autonomy to Consent to Gender‐Affirming Care: Best Interests Must Be Primary,” by John C. Bester, in the May‐June 2024 issue of the Hastings Center Report.
Adam Omelianchuk, Alexander Morgan Capron, Lainie Friedman Ross, Arthur R. Derse, James L. Bernat, and David Magnus reply:
Authors: Omelianchuk Adam , Capron Alexander Morgan , Ross Lainie Friedman , Derse Arthur R. , Bernat James L. , Magnus David 
Published: November 2024

AbstractThis letter responds to letters by Garson Leder and by Harrison Lee in the same issue, September‐October 2024, of the Hastings Center Report.
Moral Nuances in Broad Policies
Authors: Haupt Laura 
Published: November 2024

AbstractIn the September‐October 2024 issue of the Hastings Center Report, two pieces examine attitudes toward and policy on medical aid in dying (MAID). An essay by Anna Elsner and colleagues analyzes terminology, including euphemistic language, used in Canada and other countries to refer to this practice. The authors recommend explicit public discussion of the values at stake in the use of this terminology. An article by Em Walsh concerns a subset of people who could become eligible for MAID under Canada's proposed expansion of eligibility for this assistance: people suffering from poverty‐induced depression. Cautioning that the expansion of PAD could exacerbate inequality, Walsh offers six recommendations for policy‐makers’ consideration. The issue's lead article, by Eric Juengst and colleagues, focuses on governance issues that could be raised by human genome editing research that aims to strengthen individuals’ resistance to disease beyond what is regarded as the human functional range. Juengst et al. identify and analyze three potential principles that could help policy‐makers navigate what can be a blurry line between goals of prevention and enhancement in human genome editing research.
Frontoparietal Structural Network Disconnections Correlate With Outcome After a Severe Stroke
Authors: Frontzkowski Lukas , Fehring Felix , Frey Benedikt M. , Wróbel Paweł P. , Reibelt Antonia , Higgen Focko , Wolf Silke , Backhaus Winifried , Braaß Hanna , Koch Philipp J. , Choe Chi‐un , Bönstrup Marlene , Cheng Bastian , Thomalla Götz , Gerloff Christian , Quandt Fanny , Schulz Robert 
Published: November 2024

ABSTRACTStructural disconnectome analyses have provided valuable insights into how a stroke lesion results in widespread network disturbances and how these relate to deficits, recovery patterns, and outcomes. Previous analyses have primarily focused on patients with relatively mild to moderate deficits. However, outcomes vary among survivors of severe strokes, and the mechanisms of recovery remain poorly understood. This study assesses the association between lesion‐induced network disconnection and outcome after severe stroke. Thirty‐eight ischaemic stroke patients underwent MRI brain imaging early after stroke and longitudinal clinical follow‐up. Lesion information was integrated with normative connectome data to infer individual disconnectome profiles on a localized regional and region‐to‐region pathway level. Ordinal logistic regressions were computed to link disconnectome information to the modified Rankin Scale after 3–6 months. Disconnections of ipsilesional frontal, parietal, and temporal cortical brain areas were significantly associated with a worse motor outcome after a severe stroke, adjusted for the initial deficit, lesion volume, and age. The analysis of the underlying pathways mediating this association revealed location‐specific results: For frontal, prefrontal, and temporal brain areas, the association was primarily driven by relatively sparse intrahemispheric disconnections. In contrast, the ipsilesional primary motor cortex, the dorsal premotor cortex, and various parietal brain regions showed a remarkable involvement of either frontoparietal intrahemispheric or additionally interhemispheric disconnections. These results indicate that localized disconnection of multiple regions embedded in the structural frontoparietal network correlates with worse outcomes after severe stroke. Specifically, primary motor and parietal cortices might gain particular importance as they structurally link frontoparietal networks of both hemispheres. These data shed novel light on the significance of distinct brain networks for recovery after a severe stroke.
The Role of Radiotherapy in Indolent Ocular Adnexal and Orbital Lymphomas
Authors: Yazici Gozde , Akin Serkan , Kahvecioglu Alper , Yigit Ecem , Turker Fatma Alev , Yildiz Ferah 
Published: November 2024

ABSTRACTBackgroundThis study evaluates the oncological outcomes and toxicities of indolent ocular adnexal and orbital lymphomas (OOLs) treated with radiotherapy (RT) ± systemic therapy.MethodsA retrospective analysis of 44 patients with indolent OOLs treated with RT was conducted.ResultsMost patients (87%) had early‐stage disease. Treatment involved RT alone (34%) or RT + systemic therapy (66%). The median RT dose was 30 Gy, with a median follow‐up of 45 months. Local and systemic recurrence rates were 4% and 9%, respectively. Five‐year overall and disease‐free survival (DFS) rates were 96.2% and 83.6%. Early‐stage patients showed similar DFS rates regardless of whether they received RT alone or RT plus systemic therapy. No grade 3 RT‐related toxicity occurred, but systemic therapy led to grade 3 toxicity in 17% of patients.ConclusionsRT is essential for treating indolent OOLs, and combination with systemic therapies does not enhance outcomes for early‐stage patients.
A silent pandemic of violence against providers in obstetrics and gynecology: A mixed‐methods study based on a global survey
Authors: Endler Margit , Ramirez‐Negrin Atziri , Sohail Rubina ,   the FIGO Committee on Women Facing Crises
Published: November 2024

AbstractObjectivesTo quantify and qualify the experience of workplace violence (WPV) in a global sample of providers in obstetrics and gynecology (OBGYN).MethodsWe performed a mixed‐methods analysis on data from a global survey. Survey content was designed around categorical and open‐ended questions in relation to WPV; the occurrence and character, the physical and psychological consequences, training and support structures, and perceived triggers of the experience of WPV. Quantitative data were analyzed using descriptive statistics and text data using mixed deductive‐inductive content analysis. These data were integrated using convergent joint display.ResultsBetween October 2023 and January 2024, survey responses were collected from 77 individual countries. Among the final sample, 764/1016 (75.2%) had experienced WPV, 699/1016 (68.8%) verbal, and 123/1016 (12.1%) physical violence. The violence affected physical health, psychological health, or job satisfaction for 106/764 (13.9%), 36/7642 (47.4%), and 222/764 (29.1%) of individuals respectively; 216/764 (28.3%) received support. Main WPV triggers were staff shortages, lack of security personnel, and long waiting times, identified by 38.8%, 37.5%, and 37.3% of respondents respectively. Qualitative data indicated that violence caused severe and long‐lasting suffering. Catalysts for WPV were often reported as complex interplays between unmet or unrealistic expectations and insufficient resources. Lack of support for WPV was explained as violence being “part of the job” and a culture of assumed resilience among providers.ConclusionWPV against OBGYN providers seems to be ubiquitous, arises from a complex interplay of factors, and causes significant injury while receiving insufficient mitigation and support.
Telemedicine ultrasound assessment for placenta accreta spectrum: Utility and interobserver reliability of asynchronous remote imaging review
Authors: Nieto‐Calvache Albaro José , Benavides‐Calvache Juan Pablo , Aryananda Rozi , Palacios‐Jaraquemada Jose M. , Jauniaux Eric , Fox Karin A. , Coutinho Conrado Milani , Adu‐Bredu Theophilus , Shih Jin‐Chung , Hussein Ahmed M. , Timor‐Tritsch Ilan E. , Bartels Helena C. , Hamer Jorge , Cali Giuseppe , D'Antonio Francesco , Nieto‐Calvache Alejandro Solo , López Jaime Octavio , Rivera‐Torres Luisa Fernanda , Pajkrt Eva , Rijken Marcus J. 
Published: November 2024

AbstractObjectiveManagement of patients with placenta accreta spectrum (PAS) by trained multidisciplinary teams is associated with improved outcomes. Ultrasound can predict intraoperative risks, but expert ultrasound imaging of PAS is often limited. Telemedicine is used increasingly in obstetrics, permitting expert consultation when essential resources are not available locally. Our objective was to evaluate the feasibility of teleconsultation using standardized ultrasound image acquisition and reporting, and to correlate prognosis with intraoperative findings in patients at risk for PAS.MethodsA total of 12 PAS imaging experts (teleconsultants) were selected to asynchronously review deidentified standardized grayscale and color Doppler ultrasound images for five patients who had completed treatment for PAS, resulting in 60 individual teleconsultations. All patients were managed at a center using standardized imaging acquisition and intraoperative topographic classification to individualize surgical management. Teleconsultants reported the predicted topographic classification and recommended a surgical approach based on the topographic classification algorithm. Prognoses were compared with that reported by the local sonologist and with intraoperative findings.ResultsIn all five patients, local sonologist prognosis and antenatal topographic classification was confirmed during surgery and the final surgical approach matched that which was recommended preoperatively. Teleconsultant antenatal evaluation and management plans matched those of the local team in 71.7% of the cases. When reports differed, PAS severity was overestimated in nine reviews (16.9%) and was underestimated in six reviews (11.3%).ConclusionRemote imaging teleconsultation provides accurate prenatal staging in most patients at risk for PAS. Teleconsultation is a feasible strategy to improve prenatal imaging, management planning, and guidance for local teams in settings with limited healthcare resources.
Aminoacyl‐tRNA synthetase defects in neurological diseases
Authors: Zhang Hong , Ling Jiqiang 
Published: November 2024

AbstractAminoacyl‐tRNA synthetases (aaRSs) are essential enzymes to support protein synthesis in all organisms. Recent studies, empowered by advancements in genome sequencing, have uncovered an increasing number of disease‐causing mutations in aaRSs. Monoallelic aaRS mutations typically lead to dominant peripheral neuropathies such as Charcot–Marie–Tooth (CMT) disease, whereas biallelic aaRS mutations often impair the central nervous system (CNS) and cause neurodevelopmental disorders. Here, we review recent progress in the disease onsets, molecular basis, and potential therapies for diseases caused by aaRS mutations, with a focus on biallelic mutations in cytoplasmic aaRSs.
3D Bioprinting a Novel Skin Co‐Culture Model Using Human Keratinocytes and Fibroblasts
Authors: Andrade Thiago A. M. , da Silva Victor Allisson , Scheck Kali , Garay Tania , Sharma Ruchi , Willerth Stephanie M. 
Published: November 2024

ABSTRACT3D bioprinting can generate the organized structures found in human skin for a variety of biological, medical, and pharmaceutical applications. Challenges in bioprinting skin include printing different types of cells in the same construct while maintaining their viability, which depends on the type of bioprinter and bioinks used. This study evaluated a novel 3D bioprinted skin model containing human keratinocytes (HEKa) and human dermal fibroblasts (HDF) in co‐culture (CC) using a high‐viscosity fibrin‐based bioink produced using the BioX extrusion‐based bioprinter. The constructs containing HEKa or HDF cells alone (control groups) and in CC were evaluated at 1, 10, and 20 days after bioprinting for viability, immunocytochemistry for specific markers (K5 and K10 for keratinocytes; vimentin and fibroblast specific protein [FSP] for fibroblasts). The storage, loss modulus, and viscosity properties of the constructs were also assessed to compare the effects of keratinocytes and fibroblasts individually and combined, providing important insights when bioprinting skin. Our findings revealed significantly higher cell viability in the CC group compared to individual keratinocyte and fibroblast groups, suggesting the combined cell presence enhanced survival rates. Additionally, proliferation rates of both cell types remained consistent over time, indicating non‐competitive growth within the construct. Interestingly, keratinocytes exhibited a greater impact on the viscoelastic properties of the construct compared to fibroblasts, likely due to their larger size and arrangement. These insights contribute to optimizing bioprinting strategies for skin tissue engineering and emphasize the important role of different cell types in 3D skin models.
Coinciding Diabetic Retinopathy and Diabetic Macular Edema Grading With Rat Swarm Optimization Algorithm for Enhanced Capsule Generation Adversarial Network
Authors: Ramshankar N. , Murugesan S. , K. V. Praveen , Prathap P. M. Joe 
Published: November 2024

ABSTRACTIn the worldwide working‐age population, visual disability and blindness are common conditions caused by diabetic retinopathy (DR) and diabetic macular edema (DME). Nowadays, due to diabetes, many people are affected by eye‐related issues. Among these, DR and DME are the two foremost eye diseases, the severity of which may lead to some eye‐related problems and blindness. Early detection of DR and DME is essential to preventing vision loss. Therefore, an enhanced capsule generation adversarial network (ECGAN) optimized with the rat swarm optimization (RSO) approach is proposed in this article to coincide with DR and DME grading (DR‐DME‐ECGAN‐RSO‐ISBI 2018 IDRiD). The input images are obtained from the ISBI 2018 unbalanced DR grading data set. Then, the input fundus images are preprocessed using the Savitzky–Golay (SG) filter filtering technique, which reduces noise from the input image. The preprocessed image is fed to the discrete shearlet transform (DST) for feature extraction. The extracting features of DR‐DME are given to the ECGAN‐RSO algorithm to categorize the grading of DR and DME disorders. The proposed approach is implemented in Python and achieves better accuracy by 7.94%, 36.66%, and 4.88% compared to the existing models, such as the combined DR with DME grading for the cross‐disease attention network (DR‐DME‐CANet‐ISBI 2018 IDRiD), category attention block for unbalanced grading of DR (DR‐DME‐HDLCNN‐MGMO‐ISBI 2018 IDRiD), combined DR‐DME classification with a deep learning‐convolutional neural network‐based modified gray‐wolf optimizer with variable weights (DR‐DME‐ANN‐ISBI 2018 IDRiD).
Predictors of long‐term success after high‐density mapping‐guided substrate ablation procedures for ventricular tachycardia in patients with ischemic cardiomyopathy
Authors: Balt J. C. , Abeln B. G. S. , van Dijk V. F. , Wijffels M. C. E. F. , Liebregts M. , Boersma L. V. A. 
Published: November 2024

AbstractIntroductionHigh‐density (HD) substrate mapping may increase success of catheter ablation targeting ventricular tachycardia (VT). However, despite its use, recurrent VT is not uncommon. We aim to investigate factors that are associated with outcomes after HD mapping‐guided substrate ablation procedures for VT in patients with ischemic cardiomyopathy.MethodsObservational cohort study includes patients with ischemic heart disease who underwent HD mapping‐guided substrate ablation of VT. Baseline and procedural characteristics were associated with outcomes after VT ablation.ResultsVT ablation employing HD mapping was performed in 80 patients. Median follow‐up was 2.3 years. VT‐free survival at one, two, and five years were 65%, 49%, and 40%. One‐, two‐, and five‐year implantable cardioverter defibrillator (ICD) shock‐free survival rates were 90%, 81%, and 70%. Complications occurred in 3 patients (3.8%, 1 vascular, 2 tamponades). Left ventricular ejection fraction (LVEF) and 45 W (vs. 35 W) ablation power were associated with VT‐free survival. High ablation power was also associated with shock‐free survival. All‐cause mortality during follow‐up was associated with higher age, the presence of chronic obstructive pulmonary disease (COPD), LVEF, and urgent ablation.ConclusionsIn patients with ischemic cardiomyopathy that had HD substrate mapping‐guided VT ablation, ablation power was associated with both VT‐free and shock‐free survival, underlining the importance of effective target elimination. All‐cause mortality during follow‐up was associated with several factors (age, COPD, LVEF, and urgent vs. elective ablation), which could be used to guide patient selection for VT ablation.
Incidence, diagnostics, therapeutic management and outcomes of paediatric intestinal pseudo‐obstruction in the Netherlands: A 20‐year retrospective cohort study
Authors: Demirok Aysenur , Nagelkerke Sjoerd C. J. , Veldt Malou , Gorter Ramon , de Jong Justin R. , Damen Gerard M. , de Koning Barbara A. E. , Meijer Caroline , van Rheenen Patrick F. , Wolters Victorien M. , Benninga Marc A. , Tabbers Merit M. 
Published: November 2024

AbstractObjectivesTo describe incidence, clinical course, diagnostic and therapeutic management and long‐term follow‐up of paediatric intestinal pseudo‐obstruction (PIPO) in the Netherlands between 2000 and 2020.MethodsMulticenter, national, retrospective, observational study including patients aged <18 years diagnosed with PIPO and treated between 2000 and 2020 in Dutch academic medical centres. Outcomes included demographics, incidence, symptoms, diagnostic‐ and treatment methods used during follow‐up, number of hospital admissions and mortality.ResultsBetween 2000 and 2020, 43 children (median age 120 months, range 13–301, 54% female) were diagnosed with PIPO in the Netherlands. Mean incidence was 0.008/100,000/years (range 0/100 000–0.029/100 000). Twenty‐six patients developed PIPO in the neonatal period. Initial symptoms were vomiting (n = 21/35, 60%) and abdominal distension (n = 14/35, 40%). Diagnostic strategies included imaging, manometry, histopathology, metabolic‐ and genetic screening, endoscopy and exploratory surgery. Treatment was divided in nutritional support, pharmacotherapy, colonic irrigation and surgical interventions, of which nutrition and surgery were the cornerstones for care. During the observed study period, the median number of hospital admissions was 22.5 (range 1–176) with a median of 157.5 days (range 3–840) during 20‐year follow‐up. Two patients (6%) died: one from sepsis and one due to a severe underlying neurological disease. Heterogeneity in diagnostic‐ en treatment methods existed between patients.ConclusionsPIPO is a rare, long‐lasting complex disease requiring a high number of diagnostic and therapeutic interventions and hospital admissions. However, mortality rate is relatively low. Based on our results, we recommend centralization and standardization of care for this complex rare disease.
Scoping the barriers to influenza and pneumococcal vaccinations from the perspectives of patients with cancer: is there a role for the pharmacist?
Authors: Johnstone Kristoffer , Smithson John , Cooper Joyce , Glass Beverley 
Published: November 2024

AbstractBackgroundRoutine immunisation for influenza and pneumococcal disease has the potential to reduce morbidity and mortality in patients with cancer.AimThis scoping review aims to determine barriers to influenza and pneumococcal vaccinations from the perspective of patients with cancer and to discuss the potential role of the pharmacist in impacting these barriers.DesignA systematic search of seven databases, including MEDLINE (Ovid), Cochrane Library, Informit (health), PubMed, and CINAHL (complete), from database inception to 6 June 2023 was conducted. Search terms included: 'cancer', 'vaccination', 'influenza', 'pneumococcal', and 'barrier'. Articles published in English that describe barriers to receiving vaccinations from the perspectives of patients with cancers were included. Barriers were thematically analysed.ResultsTwenty‐five articles met the inclusion criteria. Barriers identified in the literature were analysed into three key themes: healthcare professionals, patients, and healthcare system barriers. A key healthcare professional barrier was lack of recommendations from the treating oncologist or haematologist. Patient barriers included lack of information about the indication for vaccination as part of patients' cancer treatment and fear of side effects. Access to vaccination services was reported as a healthcare system barrier.ConclusionThis scoping review highlights the significant barriers to influenza and pneumococcal vaccination according to patients with cancer. Healthcare professionals, patients, and health systems were identified as key barriers. Enablers to improve vaccination rates include patient education, increased healthcare professional vaccine recommendations, and improved access. Although pharmacists have a potential role to play in addressing these barriers, the feasibility and impact of their involvement requires further research.