bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidural steroid injections and fracture incidence among older individuals with radiculopathy
Authors: Yun Huifeng , Liu Ye , Curtis Jeffrey R , Saag Kenneth , D’Erasmo Giavanna , Haseltine Katherine , Stein Emily M 
Published: September 2024

Abstract
Epidural steroid injections (ESIs) are a common and often effective treatment for radicular back pain. While oral glucocorticoids increase fracture incidence, little is known regarding fracture risk after ESI. This study investigated the incidence of fractures among individuals who received ESI and those who did not. We hypothesized that ESI exposure would be associated with an increased incidence of osteoporotic fractures and specifically vertebral fractures. Using 2005-2018 5% Medicare data, individuals with radicular pain who had ≥1 ESI and those who did not (non-ESI) were matched 1:10 by age, sex, and month of radicular pain diagnosis using exposure density sampling (EDS). Using a high-dimensional propensity score (HDPS) calculated based on the top 500 covariates across multiple data dimensions, ESI and non-ESI individuals were matched 1:1. Fractures were identified using validated ICD-9/10 diagnosis codes. Fracture incidence rate (IR) was calculated by group, and hazard ratios (HR) compared using Cox regression. 25 062 ESI patients and 221 735 non-ESI patients who met eligibility criteria were identified using EDS. Mean age was 76 yr (74% female). Among ESI-treated individuals, there were 2296 fractures, IR 49.1 (95% CI: 47.2-51.2) per 1000 person yr. For non-ESI individuals, there were 11 917 fractures, IR 35.2 (95% CI: 34.5-35.8). Individuals who received ESI had a greater hazard of fracture at typical osteoporotic sites, HR 1.39 (95% CI 1.33-1.46) by EDS and 1.32 (1.12-1.54) by HDPS, and a greater hazard of vertebral fracture, 1.54 (1.45-1.64) by EDS and 1.69 (1.38-2.07) by HDPS. Patients who received greater cumulative ESI doses (≥3 in 1 yr) had a higher risk of fractures within the first 6 mo of follow-up. ESI exposure in older individuals is associated with an increased risk of fracture, suggesting there may be lasting detrimental skeletal effects of ESI. Further research into strategies to reduce fracture risk in this population is warranted.
Unfair competition law in Ghana: unravelling the scope, evolving jurisprudence, challenges and future directions
Authors: Kunko Isaac Kundakogo 
Published: September 2024

Abstract
Despite its implications for businesses and consumer welfare, unfair competition law has received limited scholarly attention in Ghana. This article fills a significant research gap by examining Ghana’s legal framework for unfair competition, focusing on legislative measures and court decisions in an attempt to facilitate comprehensive academic inquiry into the subject. The article explores how Ghana addresses unfair competition in line with international standards, particularly Article 10bis of the Paris Convention and the Trade-Related Aspects of Intellectual Property Rights Agreement. It assesses how Ghanaian courts have developed unfair competition protection jurisprudence over time with co-existing statutory and common law regimes. Additionally, it highlights the challenges in applying the law and areas for improving it. The study demonstrates how Ghana adopts various approaches to unfair competition, comprising a single source statutory reference point which coexists with the common law tort of passing off. The statutory approach, alone or with the other approaches, meets Ghana’s international obligations. However, there is a need for coherence and effectiveness in the interaction between statutory law and common law principles. Understanding this interaction is essential for ensuring Ghana’s consistent and effective application of unfair competition laws.
Trends in breast cancer–specific death by clinical stage at diagnoses between 2000 and 2017
Authors: Marczyk Michal , Kahn Adriana , Silber Andrea , Rosenblit Mariya , Digiovanna Michael P , Lustberg Maryam , Pusztai Lajos 
Published: September 2024

Abstract

Background
Approximately 40 000 individuals die from metastatic breast cancer each year. We examined what fractions of annual breast cancer–specific death are due to stage I, II, III, and IV disease and if these proportions changed over time.

Methods
We used data from Surveillance, Epidemiology, and End Results Program covering 1975-2017. After filtering for female sex at birth, 1 primary tumor type, surgery, American Joint Committee on Cancer Staging Manual (6th edition) stage above 0, no bilateral cancer, and survival data available, the final analysis included 972 763 patients. Temporal trends were assessed using a linear model and analysis of variance test.

Results
The contribution of stage I and II cancers to breast cancer–specific death increased statistically significantly from 16.2% to 23.1% and from 30.7% to 39.5%, respectively, between 2000 and 2017. The contribution of stages III and IV cancers decreased from 36.4% to 30.3% and from 16.7% to 7.1%, respectively. In 2000, 0.92%, 4.0%, and 10.7% breast cancer–specific deaths were due to T1a, T1b, and T1c node-negative cancers, respectively, which increased significantly to 1.9%, 5.8%, and 14.7% by 2017. These temporal trends were similar for hormone receptor–positive and hormone receptor–negative cancers. The contribution of breast cancer–specific death to all-cause mortality declined from 23.9% to 16.6% for stage I and from 47.7% to 36.9% for stage II cancers by 2017.

Conclusions
Patients with stage I and II breast cancers have excellent prognosis, yet these cancers account for more than 60% of current breast cancer–specific death because of their large absolute numbers. To further reduce breast cancer death, strategies are needed to identify and treat patients with stage I and II disease who remain at risk for recurrence.
Automated patient selection and care coaches to increase advance care planning for patients with cancer
Authors: Gensheimer Michael F , Teuteberg Winifred , Patel Manali I , Gupta Divya , Noroozi Mahjabin , Ling Xi , Fardeen Touran , Seevaratnam Briththa , Lu Ying , Alves Nina , Rogers Brian , Asuncion Mary Khay , DeNofrio Jan , Hansen Jennifer , Shah Nigam H , Chen Thomas , Cabebe Elwyn , Blayney Douglas W , Colevas Alexander D , Ramchandran Kavitha 
Published: September 2024

Abstract

Background
Advance care planning and serious illness conversations can help clinicians understand patients’ values and preferences. Data are limited on how to increase the number of these conversations and what their effects are on care patterns. We hypothesized that using a machine learning survival model to select patients for serious illness conversations, along with trained care coaches to conduct the conversations, would increase uptake in patients with cancer at high risk of short-term mortality.

Methods
We conducted a cluster-randomized, stepped-wedge study on the physician level. Oncologists entered the intervention condition in a random order over 6 months. Adult patients with metastatic cancer were included. Patients with a less than 2-year computer-predicted survival and no prognosis documentation were classified as high priority for serious illness conversations. In the intervention condition, clinicians received automated weekly emails highlighting high-priority patients and were asked to document prognoses for them. Care coaches contacted these patients to conduct the remainder of the conversation. The primary endpoint was the proportion of visits with prognosis documentation within 14 days.

Results
We included 6372 visits with 1825 patients in the primary analysis. The proportion of visits with prognosis documentation within 14 days was higher in the intervention condition than in the control condition: 2.9% vs 1.1% (adjusted odds ratio = 4.3, P &lt; .001). The proportion of visits with advance care planning documentation was also higher in the intervention condition: 7.7% vs 1.8% (adjusted odds ratio = 14.2, P &lt; .001). For high-priority visits, the advance care planning documentation rate in intervention visits was 24.2% and in control visits was 4.0%.

Conclusion
The intervention increased documented conversations, with contributions by both clinicians and care coaches.
Family communication and courageous coping in Korean adolescents and young adults: a cross-sectional study
Authors: Son Heeyeon , Silva Susan G , Hong Sungsil , Haase Joan E , Han Jung Woo , Docherty Sharron L 
Published: September 2024

Abstract

Objective
Adolescents and young adults (AYAs) with cancer are a vulnerable population during a critical developmental transition that can benefit from the adoption of courageous coping. Parental support is crucial in enhancing adjustment and coping skills. The linkage between parent–adolescent communication (PAC) and the use of courageous coping (UCC), however, remains unclear. This study examined the association between PAC and UCC and possible mediators of this relationship among Korean AYAs with cancer.

Methods
In this cross-sectional, correlational study, self-report data were collected from 144 AYAs aged 11–26 years. A path analytic approach was employed using a hierarchical regression model to test for the direct relationship between PAC and UCC and the indirect effects of a proposed primary mediator (family cohesion) and two intermediary mediators (uncertainty of illness, hope) on PAC–UCC relationship.

Results
The mean age of the sample was 17 years (SD = 3.8), with 42% currently receiving cancer treatment. Greater PAC was significantly associated with increased UCC (mother figure: p = .0024, father figure: p  = .0042). Increased family cohesion significantly mediated the PAC–UCC relationship, indicated by a diminished PAC-UCC relationship after controlling for family cohesion (mother: p = .2753; father: p = .8107). Mediated mediation models indicated that increased hope stemming from decreased uncertainty was the mechanism through which family cohesion impacted the PAC–UCC relationship.

Conclusions
Findings underscore that greater PAC can facilitate UCC among Korean AYAs with cancer and provide insights for therapeutic parent–child communication. Results further demonstrate the complex mediating role of fostering family cohesion, reducing uncertainty, and fostering hope can play in the PAC–UCC relationship.
Code review in digital humanities
Authors: Damerow Julia , Koeser Rebecca Sutton , Carver Jeffrey C , Vogl Malte 
Published: September 2024

Abstract
Software and computational methods offer tremendous possibilities for digital humanities research, both accelerating existing work and opening up entirely new questions. However, software also has the potential to introduce new kinds of errors into the research workflow. How do we know that the software developed for a digital humanities project is error free and does what we think it does? Code review is a widespread technique to improve software quality and reduce the number of flaws, where a programmer other than the author reviews and comments on the source code. However, given that many digital humanities developers work in developer teams of one, code review is often not possible. In this article, we share progress and insights from an effort to establish a community code review process for digital humanities, and provide background to help understand the need and potential impacts of this work.
Long-term retention rate, adverse event temporal patterns and rescue treatment strategies of mycophenolate mofetil in systemic sclerosis: insights from real-life
Authors: De Lorenzis Enrico , Natalello Gerlando , Pellegrino Greta , Verardi Lucrezia , Batani Veronica , Lepri Gemma , Stano Stefano , Armentano Giuseppe , De Pinto Marco , Motta Francesca , Di Donato Stefano , Kakkar Vishal , Fiore Silvia , Bisconti Ilaria , Campochiaro Corrado , Cometi Laura , Tonutti Antonio , Spinella Amalia , Truglia Simona , Cavalli Silvia , De Santis Maria , Giuggioli Dilia , Del Papa Nicoletta , Guiducci Serena , Cacciapaglia Fabio , De Luca Giacomo , Iannone Fiorenzo , Ricceri Valeria , Matucci Cerinic Marco , D’Agostino Maria Antonietta , Del Galdo Francesco , Bosello Silvia Laura 
Published: September 2024

Abstract

Objectives
MMF is a mainstay for the treatment of SSc. The occurrence and implications of MMF-related adverse events (AEs) on drug retention rates in real life remain poorly defined. We aimed to determine the MMF retention rate and to investigate the causes and patterns of discontinuation, AEs and treatment options used after discontinuation.

Methods
SSc patients who started MMF treatment underwent a retrospective longitudinal assessment for up to 5 years. We documented the incidence, predictors and impacts of MMF treatment on gastrointestinal intolerance, infections, laboratory abnormalities and cancer. Rescue strategies implemented after MMF discontinuation were recorded.

Results
The 5-year MMF retention rate of 554 patients stood at 70.7%, and 19.6% of them stopped MMF due to AEs. One out of every four patients experienced a dose reduction or discontinuation of MMF due to AEs, with gastrointestinal intolerance being the predominant cause. The 5-year cumulative incidence rates for gastrointestinal intolerance, cancer, severe infections and laboratory toxicity leading to MMF discontinuation were 6.4%, 4.1%, 3.1% and 2.1%, respectively. Lower respiratory tract was the most affected, with bacteria being the predominant causative agent. Intestinal and pulmonary circulation involvement were tied to elevated AE rates and MMF discontinuation. The most common approaches post-MMF cessation were ‘watch and wait’ and switch to rituximab.

Conclusions
: MMF use in SSc appears to be limited by the occurrence of AEs, both in terms of persistence and dosing of the drug. Rescue options after MMF discontinuation are limited and many patients remain without immunosuppressant.
Corticotropin-releasing hormone and vasopressin challenge affects metabolic, hematologic, and rumen fermentation parameters of growing beef steers
Authors: Geeslin Meagan D , Richeson John T , Hernandez Gifford Jennifer A , Soto-Navarro Sergio A , Burdick Sanchez Nicole C , Samuelson Kendall L 
Published: September 2024

Abstract
The objective of this study was to evaluate the impacts of stress challenge duration on metabolic, hematologic, and rumen fermentation parameters of beef steers. Thirty steers (416 ± 19 kg) were used in a randomized complete block design with 2 blocks and 3 treatments. Treatments were intravenous injection of (1) saline at 0, 24, 48, and 72 h (n = 10; control); (2) corticotropin-releasing hormone (CRH) and vasopressin (VP) at 0 h and saline at 24, 48, and 72 h (n = 10; acute); or (3) CRH and VP at 0, 24, 48, and 72 h (n = 10; chronic). Serum samples were collected at various time points for analysis of serum chemistry and nonesterified fatty acids (NEFA). Whole blood was collected for analysis of complete blood count, and ruminal fluid was collected via oral lavage to evaluate volatile fatty acid (VFA) composition. Serum cortisol was greater (treatment × hour; P ≤ 0.01) for cattle receiving acute and chronic than control at 1 h (P &lt; 0.01) and greater for chronic than acute and control at 25, 26, 49, 50, 73, and 74 h (P &lt; 0.01). Similarly, there was a treatment × hour interaction (P &lt; 0.01) for serum glucose concentrations such that cattle receiving acute and chronic had greater glucose at 1 h than control (P &lt; 0.01), and cattle receiving chronic had greater glucose at 25, 49, 73, and 74 h than acute and control (P ≤ 0.04). Serum insulin concentrations were greater (treatment × hour P &lt; 0.01) in chronic and acute than control at 1 h (P &lt; 0.01) and greater for chronic compared to acute and control at 25, 49, and 73 h (P ≤ 0.01). Serum NEFA tended (P = 0.09) to be greater in stressed cattle compared to control. There was a treatment × hour interaction (P = 0.003) for total white blood cell count such that chronic had greater concentration than control at 72 h (P &lt; 0.01). Conversely, monocyte concentration was less (treatment × hour interaction P &lt; 0.01) for chronic than acute and control at 144 h (P &lt; 0.01) and eosinophil concentration was greater (treatment × hour interaction P = 0.02) for chronic than control steers at 48 h (P = 0.02) and greater for chronic than acute at 72 and 144 h (P ≤ 0.03). Minimal differences were observed in VFA concentrations with the exception of acetate (treatment × hour interaction P = 0.05). These results demonstrate that administration of CRH and VP affects complete blood count and serum chemistry, and longer duration of treatment exposure prolongs the physiological responses to a stress challenge.
Schisandrin C prevents regorafenib-induced cardiotoxicity by recovering EPHA2 expression in cardiomyocytes
Authors: Xu Bo , Liu Ning , Zhou Taicheng , Chen Jian , Jiang Liyu , Wu Wentong , Fu Huangxi , Chen Xueqin , Yan Hao , Yang Xiaochun , Luo Peihua , Yang Bo , Xu Zhifei , He Qiaojun 
Published: September 2024

Abstract
Regorafenib, an oral multikinase inhibitor of angiogenic, stromal, and oncogenic receptor tyrosine kinases, has been approved for the treatment of metastatic colorectal cancer, gastrointestinal stromal tumors, and hepatocellular carcinoma by the US Food and Drug Administration and European Medicines Agency. However, regorafenib-induced cardiotoxicity increases the risk of mortality. Despite reports that regorafenib can cause mitochondrial dysfunction in cardiomyocytes, the molecular mechanism of regorafenib-induced cardiotoxicity is much less known and there is an urgent need for intervention strategies. Here, we treated mice with vehicle or 200 mg/kg regorafenib daily for 42 d by gavage or treated cardiomyocyte lines with 8, 16, or 32 μM regorafenib, and we found that regorafenib could cause apoptosis, mitochondrial injury, and DNA damage in cardiomyocytes. Mechanistically, regorafenib can reduce the expression of EPHA2, which inhibits AKT signaling, leading to cardiomyocyte apoptosis and cardiotoxicity. In addition, we showed that recovering EPHA2 expression via plasmid-induced overexpression of EPHA2 or schisandrin C, a natural product, could prevent regorafenib-induced cardiotoxicity. These findings demonstrated that regorafenib causes cardiomyocyte apoptosis and cardiac injury by reducing the expression of EPHA2 and schisandrin C could prevent regorafenib-induced cardiotoxicity by recovering EPHA2 expression, which provides a potential management strategy for regorafenib-induced cardiotoxicity and will benefit the safe application of regorafenib in clinic.
Effects of unilateral nasal obstruction on mandibular condyle in mice of different ages: An exploration based on H‐type angiogenesis coupling osteogenesis
Authors: Hu Yun , Li Hegang 
Published: September 2024

AbstractNasal obstruction leads to a hypoxia condition throughout the entire body. In this study, the unilateral nasal obstruction (UNO) mouse model was established by blocking the left nostril of mice. The aim of this study was to investigate the effects of UNO‐induced hypoxia on mandibular condyle in juvenile (3‐week‐old), adolescent (6‐week‐old) and adult (12‐week‐old) male C57BL/6J mice from the perspective of H‐type angiogenesis coupling osteogenesis. Firstly, UNO exerted a significant inhibitory effect on weight gain in mice of all ages. However, only in adolescent mice did UNO have an obvious detrimental effect on femoral bone mass accrual. Subsequently, micro‐computed tomography (CT) analysis of mandibular condylar bone mass revealed that UNO significantly retarded condylar head volume gain but increased condylar head trabecular number (Tb.N) in juvenile and adolescent mice. Furthermore, UNO promoted the ratio of proliferative layer to cartilage layer in condylar cartilage and facilitated the chondrocyte‐to‐osteoblast transformation in juvenile and adolescent mice. Moreover, although UNO enhanced the positive expression of hypoxia‐inducible factor (HIF)‐1α in the condylar subchondral bone of mice in all ages, an increase in H‐type vessels and Osterix+ cells was only detected in juvenile and adolescent mice. In summary, on the one hand, in terms of condylar morphology, UNO has a negative effect on condylar growth, hindering the increase in condylar head volume in juvenile and adolescent mice. However, on the other hand, in terms of condylar microstructure, UNO has a positive effect on condylar osteogenesis, promoting the increase of condylar Tb.N, chondrocyte‐to‐osteoblast transformation, HIF‐1α expression, H‐type angiogenesis and Osterix+ cells in juvenile and adolescent mice. Although the changes in condylar morphology and microstructure caused by UNO have not yet been fully elucidated, these findings improve our current understanding of the effects of UNO on condylar bone homeostasis.
Autologous hematopoietic stem cell transplant for systemic sclerosis associated interstitial lung disease
Authors: Zielonka Jana , Higuero Sevilla Jean Paul 
Published: September 2024

Purpose of review
Over the last 25 years, the role of autologous hematopoietic stem cell transplant (HSCT) in the treatment of diffuse cutaneous systemic sclerosis (dcSSc) has been elucidated. However, multiple critical questions remain regarding this therapy. Of particular interest is the role of HSCT in the treatment of systemic sclerosis (SSc)-associated interstitial lung disease since this is the leading cause of death in SSc.

Recent findings
Most clinical trials and observational studies of HSCT for the treatment of dcSSc have reported pulmonary outcomes as secondary outcomes, Also, most studies have excluded patients with significant pulmonary function impairment. Despite these limitations, there is increasing evidence that suggests that HSCT leads to interstitial lung disease stabilization and possibly improvement of lung function based on pulmonary function tests and imaging.

Summary
HSCT has demonstrated improved long-term outcomes compared to conventional therapies for dcSSC. Future research is needed to refine or expand patient selection, optimize conditioning regimens, and evaluate the potential role of maintenance immunosuppression. We recommend an increased focus on interstitial lung disease since this is the primary cause of death in SSc.
Global status and trends in coronary chronic total occlusion over the period 2000–2023: a bibliometric analysis
Authors: Wen Song , Tan Qing , Xu Zhengyu , Huang Zehan , Han Feihuang , Zhang Bin , Huang Yuqing 
Published: September 2024

Background and purpose:
Chronic total occlusion (CTO) affects 25% to 30% of individuals with coronary heart disease (CHD), posing significant challenges in percutaneous revascularization. This study investigates the advancement sand research trends in CTO by analyzing publication contributions from diverse countries, institutions, journals, and authors.

Methods:
We conducted a comprehensive literature review of CTO publications spanning from 2000 to 2023, utilizing the Web of Science Core Collection (WoSCC). Articles included were limited to those published in English. Research trends in the field were analyzed using CiteSpace 6.2.R4 (Chaomei Chen, Drexel University, Philadelphia, PA, USA) and VOSviewer 1.6.19 (Leiden University, Leiden, The Netherlands).

Results:
A total of 2,202 articles related to CTO were identified. The United States (US) emerged as the top contributor with 438 papers, followed by China with 305 papers, and Italy with 185 papers. Leading institutions included the US Department of Veterans Affairs with 353 publications, and Minneapolis Heart Institute Foundation with 217 publications. The Journal of the American College of Cardiology was the journal with the most publications in the field of CTO. Emmanouil S. Brilakis was identified as the most prolific author, while Gerald S. Werner had the highest average citation count. Cluster analysis highlighted chronic total occlusion percutaneous coronary intervention (CTO-PCI) as a focal area of research attention, indicating a promising trajectory for the field.

Conclusions:
This study provides a comprehensive analysis of the global research trends of CTO. The substantial increase in high-quality publications over the past 24 years highlights a promising future for the research and advancement of CTO-PCI.