bluuebunny/crossref_metadata_2025_split huggingface dataset:
EGFR Inhibition by Cetuximab Modulates Hypoxia and IFN Response Genes in Head and Neck Squamous Cell Carcinoma
Authors: Chaudhary Ritu , Slebos Robbert J.C. , Noel Leenil C. , Song Feifei , Poole Maria I. , Hoening Dirk S. , Hernandez-Prera Juan C. , Conejo-Garcia Jose R. , Guevara-Patino Jose A. , Wang Xuefeng , Xie Mengyu , Tan Aik Choon , Chung Christine H. 
Published: May 2023

Head and neck squamous cell carcinoma (HNSCC) has one of the most hypoxic and immunosuppressive tumor microenvironments (TME) among solid tumors. However, there is no proven therapeutic strategy to remodel the TME to be less hypoxic and proinflammatory. In this study, we classified tumors according to a Hypoxia-Immune signature, characterized the immune cells in each subgroup, and analyzed the signaling pathways to identify a potential therapeutic target that can remodel the TME. We confirmed that hypoxic tumors had significantly higher numbers of immunosuppressive cells, as evidenced by a lower ratio of CD8+ T cells to FOXP3+ regulatory T cells, compared with nonhypoxic tumors. Patients with hypoxic tumors had worse outcomes after treatment with pembrolizumab or nivolumab, anti-programmed cell death-1 inhibitors. Our expression analysis also indicated that hypoxic tumors predominantly increased the expression of the EGFR and TGFβ pathway genes. Cetuximab, an anti-EGFR inhibitor, decreased the expression of hypoxia signature genes, suggesting that it may alleviate the effects of hypoxia and remodel the TME to become more proinflammatory. Our study provides a rationale for treatment strategies combining EGFR-targeted agents and immunotherapy in the management of hypoxic HNSCC.

Significance:
While the hypoxic and immunosuppressive TME of HNSCC has been well described, comprehensive evaluation of the immune cell components and signaling pathways contributing to immunotherapy resistance has been poorly characterized. We further identified additional molecular determinants and potential therapeutic targets of the hypoxic TME to fully leverage currently available targeted therapies that can be administered with immunotherapy.
Adolescent Hypertension Is Associated With Stroke in Young Adulthood: A Nationwide Cohort of 1.9 Million Adolescents
Authors: Fishman Boris , Bardugo Aya , Zloof Yair , Bendor Cole D. , Libruder Carmit , Zucker Inbar , Lutski Miri , Ram Amit , Hershkovitz Yael , Orr Omri , Omer Ma’ayan , Furer Ariel , Goldman Adam , Yaniv Gal , Tanne David , Derazne Estela , Tzur Dorit , Afek Arnon , Grossman Ehud , Twig Gilad 
Published: May 2023

Background:
Adult hypertension is a well-established risk factor for stroke in young adults (aged <55 years), and the effects are even more deleterious than at an older age. However, data are limited regarding the association between adolescent hypertension and the risk of stroke in young adulthood.

Methods:
A nationwide, retrospective cohort study of adolescents (aged 16–19 years) who were medically evaluated before compulsory military service in Israel during 1985 to 2013. For each candidate for service, hypertension was designated after constructed screening, and the diagnosis was confirmed through a comprehensive workup process. The primary outcome was ischemic and hemorrhagic stroke incidence as registered at the national stroke registry. Cox proportional-hazards models were used. We conducted sensitivity analyses by excluding people with a diabetes diagnosis at adolescence or a new diabetes diagnosis during the follow-up period, analysis of adolescents with overweight, and adolescents with baseline unimpaired health status.

Results:
The final sample included 1 900 384 adolescents (58% men; median age, 17.3 years). In total, 1474 (0.08%) incidences of stroke (1236 [84%] ischemic) were recorded, at a median age of 43 (interquartile range, 38–47) years. Of these, 18 (0.35%) occurred among the 5221 people with a history of adolescent hypertension. The latter population had a hazard ratio of 2.4 (95% CI, 1.5–3.9) for incident stroke after adjustment for body mass index and baseline sociodemographic factors. Further adjustment for diabetes status yielded a hazard ratio of 2.1 (1.3–3.5). We found similar results when the outcome was ischemic stroke with a hazard ratio of 2.0 (1.2–3.5). Sensitivity analyses for overall stroke, and ischemic stroke only, yielded consistent findings.

Conclusions:
Adolescent hypertension is associated with an increased risk of stroke, particularly ischemic stroke, in young adulthood.
Effect of an Educational Intervention for Primary Stroke Risk Reduction in Ghana and Nigeria: Pilot Randomized Controlled Trial
Authors: Sarfo Fred Stephen , Akinyemi Joshua Odunayo , Obiako Reginald , Nichols Michelle , Fakunle Adekunle Gregory , Adusei Nathaniel , Ampofo Michael , Arulogun Oyedunni , Jenkins Carolyn , Akpa Onoja M. , Aribisala Benjamin , Abdulrasaq Saheed , Akinyemi Rufus , Ovbiagele Bruce , Owolabi Mayowa O. 
Published: May 2023

Background:
Using tailored mobile health interventions to improve global vascular risk awareness and control is yet to be investigated for primary stroke prevention in Africa.

Methods:
This 2-arm pilot randomized controlled trial involved 100 stroke-free adults with at least 2 vascular risk factors for stroke. Eligible participants were assigned randomly to a control arm offering 1-time counseling (n=50) or a 2-month educational intervention arm (n=50) comprising a stroke video and riskometer app aimed at improving stroke risk factor awareness and health-seeking behavioral modification to control total vascular risk. Reduction in total stroke risk score was the primary outcome while feasibility and process measures were secondary outcomes.

Results:

All enrolled participants completed the 2-month follow-up (retention rate=100%). The mean (SD) age of participants was 59.5 (±12.5) years, 38% were males. The mean change in stroke risk score at 2 months was −11.9% (±14.2) in the intervention arm versus −1.2% (±9.1) in the control arm,
P
=0.0001. Stroke risk awareness improved by 16.1% (±24.7) in the intervention arm versus 8.9% (±24.7) in the control arm,
P
=0.08. The intervention arm had 11.1 mm Hg reduction in systolic blood pressure compared with 4.8 mm Hg reduction in the control arm.

Conclusions:
The intervention demonstrated a positive signal of effect over a 2-month period. A definitive clinical trial with a longer duration of follow-up is warranted on the premise of these promising findings from this pilot randomized clinical trial.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT05619406.
Cannabis Regulation Through the “Without Right” Clause in Article 2(1) of EU Framework Decision 2004/757/jha on Illicit Drug Trafficking
Authors: van Kempen Piet Hein , Fedorova Masha 
Published: May 2023

Abstract
Several EU states have shown initiatives towards a more lenient approach to the regulation of cannabis cultivation and trade for recreational use. One possibility that is being investigated is whether a national regulatory system for controlled trade of recreational cannabis can be developed in accordance of the EU Framework Decision 2004/757/jha. The ‘without right’ -clause in Article 2(1) of this decision, from a linguistic point of view, does seem to allow the introduction of such a licensing system. In fact, such a system would not cross the system or the purpose of the Framework Decision, if such licensing system does not result in cross-border effects or the hindering of transnational cooperation in combatting cross-border drug trafficking. However, this possibility is only of theoretical nature considering the clear and strict obligations ensuing from the UN narcotic drugs conventions. In order to regulate recreational cannabis within the boundaries of public international law, states can: (1) denounce the UN narcotic drugs conventions; (2) deviate from the obligations of the UN conventions on the basis of positive human rights obligations; (3) create an inter se agreement between like-minded states that deviates from the UN conventions; and (4) denounce the UN drugs conventions and re-access subsequently with a reservation allowing for regulation of recreational cannabis. We argue that these options can have a combined strengthening effect and indeed present a legally sound and politically viable opportunity to regulate recreational cannabis without denouncing the whole UN drug control system.
First description of nymphal stages of Hoplopleura edentula (Anoplura: Hoplopleuridae) and a global checklist of the Hoplopleura associated with Clethrionomys
Authors: Kozina Paulina , Izdebska Joanna N. 
Published: May 2023

Abstract
We present the first record of the characteristics of the three nymphal stages of Hoplopleura edentula, one of the common Eurasian species of the genus Hoplopleura. Lastly, a list of all species of Hoplopleura parasitizing the host genus Clethrionomys is provided. The descriptions of sucking louse species usually lack the features of the nymphal stages. In addition, it is impossible to determine whether the host is the main one or an accidental when there is a co-occurance of two or more lice species, unless we observe nymphs of the same species. As a result, data on the host cycle, the range of host specificity and other aspects of parasite-host system functioning, the possibility of transfer between hosts, and the possibility of transmission of pathogens, are incomplete. This study examines 114 specimens of the bank vole Clethrionomys glareolus, in which 38 Hoplopleura edentula were found.
The Impact of Relocating a Trauma Center: Retrospective Observations on Payer Demographics and Cost-Analysis
Authors: Punja Viren , Capasso Thomas , Stokes Laura , Ray Kelley , Narveson Joel R. , Walters Ryan W. , Fernandez Carlos , Patel Neil D. , Ewing Kaily , Kuncir Eric 
Published: May 2023

Background Standardization of trauma centers improves quality of care, yet that comes with financial challenges. The decision to designate a trauma center typically focuses on access, quality of care, and the needs of the local community, but less often considers the financial viability of the trauma center. A level-1 trauma center was relocated in 2017 and this presented an opportunity to compare financial data at two separate locations in the same city. Methods A retrospective review was performed on the local trauma registry and billing database in all patients aged ≥19 years on the trauma service before and after the move. Results 3041 patients were included (pre-move: 1151; post-move: 1890). After the move, patients were older (9.5 years), and more were females (14.9%) and white (16.5%). Increases in blunt injuries (7.6%), falls (14.8%), and motor vehicle accidents (1.7%) were observed after the move. After the move, patients were less likely to be discharged home (6.5%) and more likely to go to a skilled nursing facility (3%) or inpatient rehabilitation (5.5%). Post-move more patients had Medicare (12.6%) or commercial (8.5%) insurance and charges per patient decreased by $2,833, while charges collected per patient increased by $2425. Patients were seen from a broader distribution of zip codes post-move. Discussion Relocating a trauma center did improve financial viability for this institution. Future studies should consider the impact on the surrounding community and other trauma centers. Level of evidence Level IV.
Clinical characteristics and laparoscopic surgical outcomes of ovarian dermoid cysts complicated by spontaneous rupture: nine cases and a literature review
Authors: Takeda Akihiro , Koike Wataru 
Published: May 2023

Objective To clarify the clinical characteristics and laparoscopic surgical outcomes of dermoid cysts complicated by spontaneous rupture. Methods This was a single-center retrospective observational study of patients with dermoid cysts treated between January 2005 and December 2021. Results Among 1205 cases of dermoid cysts, spontaneous rupture occurred in nine and torsion occurred in 83 cases. No obvious triggers for rupture were identified, except for one postpartum case with fundal uterine pressure maneuver. Rupture was identified by computed tomography (CT) in six cases. Patients with ruptured cysts had significantly higher serum C-reactive protein (CRP), cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), and squamous cell carcinoma antigen (SCC) levels compared with patients with uncomplicated dermoid cysts or cysts with torsion. Laparoscopic management was possible except for one case with severe adhesion, which required laparotomy. Two patients required prolonged postoperative administration of antibiotics due to refractory chemical peritonitis. Conclusion Combined use of CT imaging and elevated levels of CRP, CA125, CA19-9, and SCC may help to differentiate cyst rupture from torsion. Laparoscopic surgery may be a feasible option; however, prompt laparotomic conversion should be considered in cases with difficult adhesiolysis. Refractory chemical peritonitis may occur after successful surgical management.
COVID-19 vaccination elicited de novo and recurrence of cluster headache: A case series
Authors: Chen Shih-Pin , Takizawa Tsubasa , Sekiguchi Koji , Nakahara Jin , Wang Shuu-Jiun 
Published: May 2023

Background Recent pharmacovigilance studies suggested that cluster headache could be a potential adverse effect after coronavirus disease-2019 (COVID-19) vaccination; however, the possibility of coincidence could not be excluded. Detailed case studies might help elucidate their potential link and implicate potential pathogenic mechanisms. Methods Patients who developed cluster headache in close temporal relationship to COVID-19 vaccination were identified from two tertiary medical centers in Japan and Taiwan respectively through 2021–2022. Detailed characteristics of the headaches and time between the onset of the index cluster episode and antecedent COVID-19 vaccination were reported. In patients with previous cluster headaches, the duration from previous bout was also recorded. Results Six patients with new cluster headache bout 3–17 days after COVID-19 vaccination were identified. Two of them were de novo cases. The others either had been attack-free for a long time or developed new cluster bout in seasons atypical to prior bouts. The vaccines included mRNA, viral vector, or protein subunit vaccines. Conclusions COVID-19 vaccines, regardless of vaccine types, may elicit de novo or relapse of cluster headache. Future studies are needed to confirm the potential causality and explore the potential pathogenic mechanism.
Research on Predatory Publishing in Health Care: A Scoping Review
Authors: Oermann Marilyn H. , Waldrop Julee , Nicoll Leslie H. , Peterson Gabriel M. , Drabish Kerry Simmons , Carter-Templeton Heather , Owens Jacqueline K. , Moorman Teresa , Webb Bridget , Wrigley Jordan 
Published: May 2023

Background Predatory publishers and their associated journals have been identified as a threat to the integrity of the scientific literature. Research on the phenomenon of predatory publishing in health care remains unquantified. Purpose To identify the characteristics of empirical studies on predatory publishing in the health care literature. Methods A scoping review was done using PubMed/MEDLINE, CINAHL, and Scopus databases. A total of 4967 articles were initially screened; 77 articles reporting empirical findings were ultimately reviewed. Results The 77 articles were predominantly bibliometric analyses/document analyses (n = 56). The majority were in medicine (n = 31, 40%) or were multidisciplinary (n = 26, 34%); 11 studies were in nursing. Most studies reported that articles published in predatory journals were of lower quality than those published in more reputable journals. In nursing, the research confirmed that articles in predatory journals were being cited in legitimate nursing journals, thereby spreading information that may not be credible through the literature. Conclusion The purposes of the evaluated studies were similar: to understand the characteristics and extent of the problem of predatory publishing. Although literature about predatory publishing is abundant, empirical studies in health care are limited. The findings suggest that individual vigilance alone will not be enough to address this problem in the scholarly literature. Institutional policy and technical protections are also necessary to mitigate erosion of the scientific literature in health care.
Lactation Induction in a Transgender Woman: Macronutrient Analysis and Patient Perspectives
Authors: Weimer Amy K. 
Published: May 2023

Introduction Induction of lactation in a non-gestational parent has numerous potential benefits including parent–child bonding, optimal nutrition, and health benefits to the child and breast- or chest-feeding parent. For transgender women and nonbinary people on estrogen-based, gender-affirming hormone therapy, the ability to nourish their infants through production of their own milk may also be a profoundly gender-affirming experience. Two prior case studies have been published describing induced lactation in transgender women, but analysis of the nutritional quality of the milk produced has not been previously described. Main issue Here we describe the experience of a transgender woman who underwent successful induction of lactation in order to breastfeed her infant, who was gestated by her partner. Management Through modification of exogenous hormone therapy, use of domperidone as a galactogogue, breast pumping, and ultimately direct breastfeeding, the participant was able to co-feed her infant for the first 4 months of life. We provide a detailed description and timeline of the medications used, laboratory and electrocardiographic measurements, results of the participant’s milk analysis showing robust macronutrient content, and description of the participant’s experience in her own words. Conclusion These findings provide reassurance about the adequacy of nutrition from human milk produced by non-gestational transgender female and nonbinary parents on estrogen-based, gender-affirming hormone therapy, and support the importance of this experience on a personal level.
Sub-categories of moral distress among nurses: A descriptive longitudinal study
Authors: Morley Georgina , Bena James F , Morrison Shannon L , Albert Nancy M 
Published: May 2023

Background There is ongoing debate regarding how moral distress should be defined. Some scholars argue that the standard “narrow” definition overlooks morally relevant causes of distress, while others argue that broadening the definition of moral distress risks making measurement impractical. However, without measurement, the true extent of moral distress remains unknown. Research aims To explore the frequency and intensity of five sub-categorizations of moral distress, resources used, intention to leave, and turnover of nurses using a new survey instrument. Research design A mixed methods embedded design included a longitudinal, descriptive investigator-developed electronic survey with open-ended questions sent twice a week for 6 weeks. Analysis included descriptive and comparative statistics and content analysis of narrative data. Participants Registered nurses from four hospitals within one large healthcare system in Midwest United States. Ethical considerations IRB approval was obtained. Results 246 participants completed the baseline survey, 80 participants provided data longitudinally for a minimum of 3 data points. At baseline, moral-conflict distress occurred with the highest frequency, followed by moral-constraint distress and moral-tension distress. By intensity, the most distressing sub-category was moral-tension distress, followed by “other” distress and moral-constraint distress. Longitudinally, when ranked by frequency, nurses experienced moral-conflict distress, moral-constraint distress, and moral-tension distress; by intensity, scores were highest for moral-tension distress, moral-uncertainty distress, and moral-constraint distress. Of available resources, participants spoke with colleagues and senior colleagues more frequently than using consultative services such as ethics consultation. Conclusions Nurses experienced distress related to a number of moral issues extending beyond the traditional understanding of moral distress (as occurring due to a constraint) suggesting that our understanding and measurement of moral distress should be broadened. Nurses frequently used peer support as their primary resource but it was only moderately helpful. Effective peer support for moral distress could be impactful. Future research on moral distress sub-categories is needed.
Evaluation of an Association Between Enoxaparin Dose per Estimated Blood Volume and Clinically Relevant Bleeding in Low-Weight Trauma Patients
Authors: Carter Chris , Denny Kailey , Carver Thomas W. , Jung Benjamin , Rein Lisa , Peppard William J. 
Published: May 2023

Background: The optimal dosing for enoxaparin venous thromboembolism (VTE) prophylaxis in low-weight trauma patients is unknown. Estimated blood volume (EBV) has shown promise as a dose modifier. Objective: To characterize the association of enoxaparin dose per EBV with the prevalence of VTE and bleeding in low-weight trauma patients. Methods: This was a retrospective study of trauma patients admitted over a 4-year period. Included patients were adults weighing <60 kg who received a minimum of 3 consecutive doses of enoxaparin. The primary endpoint was a comparison of enoxaparin dose per EBV in patients experiencing bleeding and VTE. Secondary endpoints included comparisons of dose per body mass index (BMI) and total body weight (TBW) and the ability of dose per EBV to predict clinical endpoints. Subgroup analyses for patients weighing <50 kg were performed for all endpoints. Results: A total of 189 patients were included. Statistical comparisons for VTE were not performed because of low prevalence. The dose of enoxaparin per EBV was not statistically different between patients who did and did not bleed in all analyses. Doses per BMI and TBW were also not statistically different between the groups. In patients weighing <50 kg, numerically higher doses per EBV, BMI, and TBW were noted in patients that bled versus those that did not. Enoxaparin dose per EBV was not a statistically significant predictor of bleeding in logistic regression models. Conclusion and Relevance: No significant associations between enoxaparin dose per EBV, BMI, or TBW and bleeding were noted in the study. Future analyses of EBV and other dose modifiers should consider inclusion of patients weighing <50 kg.
Healthcare Organizations Management: Analyzing Characteristics, Features and Factors, to Identify Gaps “Scoping Review”
Authors: Alsaqqa Hatem H 
Published: May 2023

Background: Studying the organizational characteristics, factors and features in healthcare organizations will have its prompt in achieving the desired outcomes of the provided services. Addressing these variables, the subsequent study conducts a scoping review methodology to systematically evaluate existing information while focusing on conclusions and gaps representing organizational variables that have been shown to influence the management of healthcare organizations. Methods: A scoping review was performed to shed the light on the healthcare organizations’ characteristics, features and factors. Results: Fifteen articles were included in the final analysis of this study. Among the relevant studies, 12 were research articles and 8 were quantitative studies. Continuity of care, organizational culture, patient trust, strategic factors and operational factors are among the explored features that have an impact in the management of healthcare organizations. Conclusion: This review shows the gaps in the management practice and in the management studies that address healthcare organizations.