bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe Acute Respiratory Failure Associated With Trimethoprim/Sulfamethoxazole Among Adolescent and Young Adults: An Active Comparator-Restricted Disproportionality Analysis From the FDA Adverse Event Reporting System (FAERS) Database
Authors: Ahmadi Fatemeh , Chalabianloo Niaz , McArthur Eric , Omrani Mohammad Ali , Abdullah Sheikh S. , Garcia-Bournissen Facundo , Muanda Flory T 
Published: February 2025

Background: The US Food and Drug Administration (FDA) has raised concerns about a potential link between trimethoprim/sulfamethoxazole (TMP-SMX) and an increased risk of acute respiratory failure/acute respiratory distress syndrome (ARF/ARDS) in healthy adolescents and young adults. Objective: To assess the association between TMP-SMX and the risk of ARF/ARDS using data from the FDA Adverse Event Reporting System (FAERS). Methods: We analyzed adverse drug events (ADEs) reported in FAERS from January 1, 2004, to December 31, 2023. We focused on reports where TMP-SMX, amoxicillin-clavulanic acid, or azithromycin were the primary suspect drugs for ADEs in individuals aged 10 to 24 years. The outcomes of interest—ARF/ARDS—were identified using MedDRA-preferred terms. We used an active comparator-restricted disproportionality analysis (ACR-DA) to estimate the reporting odds ratio (ROR) and 95% confidence interval (CI), adjusting for age, sex, acne, and urinary tract infections. Bayesian Confidence Propagation Neural Networks (BCPNN) were used to calculate the Information Components (IC025). Due to the amount of missing information, a case-by-case analysis could not be performed. Results: 3171 ICSRs (810 for TMP-SMX, 1617 for azithromycin, and 744 for amoxicillin-clavulanic acid) were included in the study. ACR-DA showed an unadjusted 8-fold increase in the reports of ARF/ARDS with TMP-SMX compared with azithromycin (unadjusted ROR, 7.98; 95% CI, 4.09 to 15.60) and an adjusted 3-fold increase after adjustment for age, sex, acne, and urinary tract infection (adjusted ROR, 2.80; 95% CI, 1.28 to 6.11). BCPNN analysis confirmed significant disproportionality (IC025, 0.75). No cases of ARF/ARDS were reported for amoxicillin-clavulanic acid. Conclusion and Relevance: TMP-SMX may increase the risk of ARF/ARDS, requiring further validation in larger pharmacoepidemiological studies. Our findings lay the groundwork for future research to further investigate the safety profile of TMP-SMX in adolescent populations. If confirmed, prescribers should exercise greater caution when prescribing TMP-SMX to adolescents and young adults.
How do transgender young people experience talking about trauma with services?
Authors: Crockford Georgia , Hawthorne Oliver , Leeuwerik Tamara 
Published: February 2025

Background Transgender young people are more likely than their cisgender peers to experience trauma. Through talking about trauma, services may be able to support transgender young people to manage the impact of these events. However, research has highlighted that many trans people are concerned that disclosing trauma would be used to discredit their sense of their gender identity. Aim To explore how transgender young people experience having conversations about trauma with services and how they understand these conversations. Method Six semi-structured interviews were carried out with young transgender people. Interpretative phenomenological analysis was used. Results The study found that all participants were aware of discourses linking experiences of trauma with transgender identities. All participants recognised these conversations as significant. Some experienced conversations to be supportive and transformative. Others found them deeply distressing, reminiscent of trauma experiences. Relationships with professionals seemed to influence these experiences, as did transphobia and relationships with other services. Discussion A trauma-informed approach should be used and professionals are encouraged to consider the potential for harm that can arise from these conversations, as well as the therapeutic element. Clinical implications and future research directions are discussed, in particular considering the recently published Cass Review (2024).
Challenges to preserve vascular access functioning after surgical correction for arteriovenous access ischemic steal in hemodialysis patients: A single-center study
Authors: Weselius Eeva-Maija , Söderström Maria , Venermo Maarit 
Published: February 2025

Background and Aims: Arteriovenous access ischemic steal (AVAIS) is a rare complication that causes morbidity and threatens hemodialysis access usability in patients with end-stage kidney disease (ESKD). This study aimed to determine the incidence of AVAIS over a 15-year period and assess the access usability after surgical correction. Methods: Access operations between January 2007 and August 2022 at Helsinki University Hospital were reviewed. Demographics, clinical, duplex, and contrast examinations with brachial artery volume flows, finger pressures, and delays to surgery were evaluated. Symptom relief, complications, access closures/re-interventions, primary, secondary, and functional patencies were assessed. Endpoints were permanent cessation of access use due to complication(s), transplantation, closure, definitive occlusion, or death. Results: Among 2914 access-related operations, the overall incidence of AVAIS was 2.2%. At the first vascular consultation 52% had ulcer(s) or gangrene(s) resulting in 28 direct closures, and 30 corrections as follows: 20 proximalization of arterial inflow (PAI), 6 flow reduction procedures, 2 distal revascularization with interval ligation (DRIL), 1 distal radial artery ligation (DRAL), and 1 venous bypass. The median time from consultation to surgery was 18 days (range: 0–348 days) for direct closures and 43 days (0–170 days) for corrective surgery. The functional patencies after correction were 60% at 1 year and 55% at 2 years; the primary patencies were 45% and 28% and secondary patencies 61% and 57%, respectively. The functional patencies after PAI were 41% and 31%, respectively. Conclusion: In AVAIS, access preservation is challenging in ESKD patients with multiple diseases. Attention should be paid to the original choice of vascular access by considering each patient’s risks. Delay to vascular consultation and intervention should be minimized. PAI should be reserved for selected patients when no other option is preferable.
From RAGs to riches: Utilizing large language models to write documents for clinical trials
Authors: Markey Nigel , El-Mansouri Ilyass , Rensonnet Gaetan , van Langen Casper , Meier Christoph 
Published: February 2025

Background/Aims Clinical trials require numerous documents to be written: Protocols, consent forms, clinical study reports, and many others. Large language models offer the potential to rapidly generate first-draft versions of these documents; however, there are concerns about the quality of their output. Here, we report an evaluation of how good large language models are at generating sections of one such document, clinical trial protocols. Methods Using an off-the-shelf large language model, we generated protocol sections for a broad range of diseases and clinical trial phases. Each of these document sections we assessed across four dimensions: Clinical thinking and logic; Transparency and references; Medical and clinical terminology; and Content relevance and suitability. To improve performance, we used the retrieval-augmented generation method to enhance the large language model with accurate up-to-date information, including regulatory guidance documents and data from ClinicalTrials.gov. Using this retrieval-augmented generation large language model, we regenerated the same protocol sections and assessed them across the same four dimensions. Results We find that the off-the-shelf large language model delivers reasonable results, especially when assessing content relevance and the correct use of medical and clinical terminology, with scores of over 80%. However, the off-the-shelf large language model shows limited performance in clinical thinking and logic and transparency and references, with assessment scores of ≈40% or less. The use of retrieval-augmented generation substantially improves the writing quality of the large language model, with clinical thinking and logic and transparency and references scores increasing to ≈80%. The retrieval-augmented generation method thus greatly improves the practical usability of large language models for clinical trial-related writing. Discussion Our results suggest that hybrid large language model architectures, such as the retrieval-augmented generation method we utilized, offer strong potential for clinical trial-related writing, including a wide variety of documents. This is potentially transformative, since it addresses several major bottlenecks of drug development.
Impact of a 3-year transformational change project in family violence clinical response: Qualitative evaluation of the depth and breadth of knowledge in hospital clinicians by training level
Authors: Troy Kirsty , Rushan Catherine , Withiel Toni D , Felmingham Kim L , Fisher Caroline A 
Published: February 2025

Clinician family violence knowledge has traditionally been evaluated using quantitative measures via self-rating of skills. Qualitative methods have been used less frequently, in ways that require clinicians to provide specific information to demonstrate their skill base. Objectives: This study aimed to investigate the impact of different levels of training in family violence (no training, some training, clinical champions), on the clinician knowledge of key family violence response skills, using qualitative, survey obtained text-box responses. Design: A cross-sectional, online, survey of hospital clinicians in a major trauma hospital was conducted. Methods: The Assisting Patient/Clients Experiencing Family Violence: Royal Melbourne Hospital Clinician Survey tool was utilised and open for clinicians to complete, anonymously over a 6-week period. Free-text survey responses were analysed using an inductive thematic analysis approach. Results: Five hundred twenty-six clinical staff participated, 30% with no training, 52% with some training and 18% who were trained as clinical champions. A clear pattern was observed across training levels. Those with no training opted to demonstrate their family violence knowledge base less frequently. When they did, answers lacked specific information and details, showed limited knowledge of covert family violence indicators and provided a higher proportion of responses that did not align with best practice guidelines. Staff with some training showed a more sophisticated understanding in these areas. However, the quality of their responses did not match those of the clinical champions, who also provided an ongoing community of practice to further their skills. Conclusions: Providing some training in family violence yields a higher degree of family violence knowledge in clinicians, relative to no training. However, the extra resourcing required to train and maintain a clinical champions model in family violence provides demonstratable benefits, via a more sophisticated and nuanced understanding of indicators, enquiry and disclosure response skills, that align with best practice guidelines.
Exploring thermal balloon endometrial ablation with Foley’s catheter: Management for heavy menstrual bleeding
Authors: Khadawardi Khalid , Nasief Hisham , Hassan Amber , Katib Yasir A , Aldardeir Nashwa , B Alwazzan Ahmad 
Published: February 2025

Background: Heavy menstrual bleeding is a common gynecological issue that often requires prompt treatment. Our study aimed to assess thermal balloon endometrial ablation with Foley’s catheter as a viable, cost-effective, and minimally invasive procedure alternative to hysterectomy. Methods: An experimental study was carried out on 114 married women experiencing heavy menstrual bleeding who did not wish to have further children and had either failed standard treatments or were not suitable for medical treatment. These women had a uterine size of 12 cm or less and an endometrial thickness of less than 18 mm. A 3-min balloon inflation–deflation procedure was performed. After 3 months, the effectiveness of the treatment was assessed by examining overall heavy menstrual bleeding outcomes, posttreatment transvaginal ultrasound results, number of bleeding days and pain per cycle, and scores from the Menorrhagia Outcome Questionnaire. Results: The mean patient’s age was 44.46 ± 4.184 years and a disease duration of 2.84 ± 1.53 years. Most patients were multiparous (86.0%) or grand multiparous (14.0%). Significant improvements were observed in endometrial thickness, Menorrhagia Outcome Questionnaire scores, pain levels, and the number of bleeding days postprocedure ( p-value < 0.05). The majority of patients experienced a reduction in the pattern of irregular menstrual cycles. The procedure showed a success rate of 88.6%, with 11.4% of patients not responding. Some further interventions such as hysterectomy or repeated thermal balloon ablation were required due to complications like infection or balloon deflation. Conclusion: The thermal balloon endometrial ablation using Foley’s catheter is an effective treatment for heavy menstrual bleeding.
Arthroscopic Intra-articular Biceps Tenodesis With All-Suture Anchor
Authors: Wang Kevin C. , Theismann Jeffrey J. , Cole Elliot , Zhang Alan L. 
Published: February 2025

Background: Biceps tenodesis can be used to treat both superior labral anterior and posterior (SLAP) tears and degenerative biceps pathologies in the setting of rotator cuff pathology or as stand-alone techniques. Research has shown that arthroscopic biceps tenodesis has comparable outcomes to open tenodesis with the benefit of being less invasive. Indications: Surgical indications for intra-articular tenodesis of the long head of the biceps (LHB) include SLAP tear, failed SLAP repair, partial-thickness LHB tear, biceps instability, tenosynovitis, and clinical examination consistent with LHB pain. Technique Description: We present our technique for arthroscopic intra-articular biceps tenodesis with a top-of-the-groove all-suture anchor using percutaneous suture passage with a spinal needle and polydioxanone suture. Sutures are shuttled through the LHB in situ before releasing the tendon from the labrum. Results: The authors have seen excellent clinical results using this method without any cases of tenodesis failure. Prior studies have shown subpectoral, suprapectoral, and top-of-the-groove biceps tenodesis to have similar good clinical outcomes at multiple time points. Discussion/Conclusion: This technique is advantageous as it is time efficient and cost-effective, and tension on the biceps can be easily maintained as suture is passed through the tendon in situ before the tendon is released from the superior labrum. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Cancer prevention: past challenges and future directions
Authors: Seong HeeKyung , Izutsu Runa , Osaki Mitsuhiko , Okada Futoshi 
Published: February 2025

Abstract
Almost 70 years have passed since the molecular mechanism of carcinogenesis was hypothesized to involve multiple gene mutations. More than 1,000 cancer-related genes, including oncogenes and tumor suppressor genes, accelerate carcinogenesis by altering molecular functions and gene expression through mutations and epigenetic changes and have been shown to cause multistep carcinogenesis in several organ cancers. The elucidation of cancer-related gene abnormalities has led to the development of molecular-targeted therapies that focus on driver molecules, known as precision medicine, in addition to conventional treatments such as surgery, radiotherapy, and chemotherapy. Now that the mechanism of cancer development has been largely elucidated, options for cancer treatment and its outcomes have improved, and cancer research is moving to the next stage: cancer prevention. Cancer prevention using chemicals was first proposed approximately 50 years ago. It is the concept of stabilizing, arresting, or reverting precancerous lesions to normal tissues using synthetic vitamin A analogs (retinoids). Cancer chemoprevention is now considered to consist of three elements: “primary prevention,” which prevents the development of tumors and prevents benign tumors converting into more malignant ones; “secondary prevention,” which aims for early detection through cancer screening and treatment; and “tertiary prevention,” which reduces the risk of recurrence and extends the time until death from cancer through treatment. Consequently, there is no clear boundary between the prevention and treatment strategies. Therefore, chemoprevention targets the entire process, from normal cells to precancerous lesions, malignant progression of tumors, and death by cancer. Basic and clinical research has revealed that cancer prevention is influenced by race, regional, and national differences, as well as individual differences such as genetic factors, environmental factors, and lifestyle habits. This review provides an overview of the progress made in cancer prevention and summarizes future directions.
Exploring the association between rheumatoid arthritis and non-small cell lung cancer risk: a transcriptomic and drug target-based analysis
Authors: Wang Lyubo , Dong Yuxian , Yang Qingcheng , Liu Siyun , Wu Bencheng , Zhang Dahang , Shen Shuai , Xin Chenjun , Liu Zurui , Wu Qiuyang , Huang Guojian , Duan Lincan 
Published: February 2025

Abstract

Background
Non-small cell lung cancer (NSCLC) is a common subtype of lung cancer that has received considerable attention for its potential association with rheumatoid arthritis (RA). However, current understanding of the relationship between RA and NSCLC risk remains limited and in-depth studies of molecular mechanisms are lacking.

Methods
We obtained transcriptomic data of NSCLC from the Gene Expression Omnibus (GEO) database and performed Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of differential genes. We then used Mendelian randomisation (MR) analysis to explore the causal relationship between RA and NSCLC, but the results showed no direct causal relationship between RA and NSCLC. In light of this finding, we shifted our research focus to investigate the effect of RA therapeutics on NSCLC risk. A drug-targeted MR analysis of drugs available for the treatment of RA was performed by searching for drugs that target NSCLC differential genes associated with RA.

Results
We found that several of the drugs corresponding to NSCLC differential genes associated with RA are used to treat RA. By drug-targeted MR analysis of drugs, we found that some drugs do have an effect on the risk of developing NSCLC, increasing the risk of developing NSCLC.

Conclusion
This study employed transcriptomic analysis and MR of drug targets to elucidate the potential correlation between RA and the risk of developing NSCLC. The identification of NSCLC differentially expressed genes associated with RA and their drug targets has provided new perspectives for an in-depth understanding of the pathogenesis of NSCLC. Furthermore, an additional immune infiltration analysis demonstrated that, in NSCLC tissues, the infiltration levels of specific immune cell subpopulations, including regulatory T cells (Tregs), activated natural killer cells (NK cells) and unpolarised macrophages (M0), exhibited notable differences. These findings emphasise the significant role that immune cell interactions between RA and NSCLC may play in disease progression. Furthermore, through the analysis of validation histology, we have further confirmed the potential role of differential genes associated with RA in the development of NSCLC. The expression levels of these genes demonstrated significant differences in NSCLC samples, providing a basis for possible future therapeutic targets and biomarkers.
Heterogenesis and the Affective Economies of Catastrophes
Authors: Hai Peng 
Published: February 2025

Abstract
An emergent duo nan xing bang 多难兴邦 (catastrophes give rise to a stronger national community) discourse sets out appropriating major catastrophes befalling the disparate peoples in China into a totalizing signifying chain of national resilience and solidarity. Literary works and films assist this statist drive as they generate a common affective economy of suffering and national overcoming, not only to elicit the emotional labor of sympathy for those affected but also to nationalize the experiences of distraught individuals and specific localities. Closely reading two recently published literary treatments of the 1960 famines and the little-known 1920 Haiyuan earthquake, respectively, this article shows that literature could also participate in “rescuing history from the nation” by fully accentuating catastrophes’ role in fracturing landscapes, disrupting the myth of political cohesion, and, above all, dissenting from the narration of a unified, ascendant national community. The article uses a methodology of the Deleuzian heterogenesis in constituting the radical particularism in the two texts. It argues that the method of heterogenesis is most effective in questioning nationalism's reliance on homogeneity as its imaginative end.
Archive of the Missing: Speculative Visions and the Terms of Social Repair in Transnational Adoption
Authors: Kim Hosu , Kim Yeong Ran 
Published: February 2025

Abstract
This article examines Kate-hers RHEE's Noh-Chim (Missing) and Deann Borshay Liem's In the Matter of Cha Jung Hee, two films that employ the missing as a key motif to understand their personal adoption misinformation. In our close observation of these works, the article sees the missing as both a method and framework with which to imagine a vision of repair amid the debris of violence in the transnational adoption practice and archives. Both RHEE and Liem's experimental engagement with the search—the search for the missing—uncovers intercalated dimensions of archival violence—biopolitical, administrative, and rhetorical. Via artistic expression, each work disrupts the nationalistic and naturalistic narrative of search and reunion and offers speculative analytics via which to imagine the connections and visions from the missing. Drawing upon their brilliant aesthetic analysis of the missing, this article extrapolates the unexpected, ephemeral, encounter, entanglement, and empathy as a new horizon for ethics and politics of repair in transnational adoption practice.