bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moral Intuitions About Stigmatizing Practices and Feeding Stigmatizing Practices: How Haidt’s Moral Foundations Theory Relates to Infectious Disease Stigma
Authors: Damsté C , Kramer K 
Published: March 2023

Abstract
Despite extensive stigma mitigation efforts, infectious disease stigma remains common. So far, little attention has been paid to the moral psychology of stigmatizing practices (i.e. beliefs, attitudes, actions) rather than the experience of being stigmatized. Addressing the moral psychology behind stigmatizing practices seems necessary to explain the persistence of infectious disease stigma and to develop effective mitigation strategies. Our article proposes building on Jonathan Haidt’s moral foundations theory, which states that moral judgements follow from intuitions rather than conscious reasoning. Conceptual analysis was conducted to show how Haidt’s five moral foundations can be connected to (i) moral judgements about stigmatizing practices and (ii) stigmatizing practices themselves. We found that care/harm, fairness/cheating, loyalty/betrayal and sanctity/degradation intuitions can inform moral judgements about stigmatizing practices. Loyalty/betrayal and sanctity/degradation intuitions can sometimes also feed stigmatizing practices. Authority/subversion intuitions can inform moral judgements and stigmatizing practices towards people who disrespect authoritative rules meant to protect public health. Moral dumbfounding and posthoc reasoning might explain the persistence of stigmatizing practices. In conclusion, this study demonstrates the relevance of Haidt’s approach to infectious disease stigma research and mitigation strategies. We hope that this study motivates researchers to further test and assess this approach.
GPX2 promotes EMT and metastasis in non‐small cell lung cancer by activating PI3K/AKT/mTOR/Snail signaling axis
Authors: Peng Fang , Xu Qiushi , Jing Xiaomeng , Chi Xinming , Zhang Zheming , Meng Xiangpeng , Liu Xinyuan , Yan Jiao , Liu Xuefeng , Shao Shujuan 
Published: March 2023

AbstractLung cancer, with non‐small cell lung cancer (NSCLC) being the main subtype, is the leading cause of cancer death worldwide, which is mainly due to the cancer metastasis. Glutathione peroxidase 2 (GPX2), an antioxidant enzyme, is involved in tumor progression and metastasis. Nevertheless, the role of GPX2 in NSCLC metastasis has not been clarified. In this study, we found that GPX2 expression was elevated in NSCLC tissues and high GPX2 expression was correlated with poor prognosis in patients with NSCLC. In addtion, GPX2 expression was related to the patient's clinicopathological features, including lymph node metastasis, tumor size, and TNM stage. Overexpression of GPX2 promoted epithelial–mesenchymal transition (EMT), migration, and invasion of NSCLC cells in vitro. Knockdown of GPX2 showed the opposite effects in vitro and inhibited the metastasis of NSCLC cells in nude mice. Furthermore, GPX2 reduced reactive oxygen species (ROS) accumulation and activated the PI3K/AKT/mTOR/Snail signaling axis. Therefore, our results indicate that GPX2 promotes EMT and metastasis of NSCLC cells by activating the PI3K/AKT/mTOR/Snail signaling axis via the removal of ROS. GPX2 may be an effective diagnostic and prognostic biomarker for NSCLC.
Association of Urine Fentanyl Concentration With Severity of Opioid Withdrawal Among Patients Presenting to the Emergency Department
Authors: Thakrar Ashish P. , Faude Sophia , Perrone Jeanmarie , Milone Michael C. , Lowenstein Margaret , Snider Christopher K. , Spadaro Anthony , Delgado M. Kit , Nelson Lewis S. , Kilaru Austin S. 
Published: March 2023

Background and Aims
Fentanyl is involved in most US drug overdose deaths and its use can complicate opioid withdrawal management. Clinical applications of quantitative urine fentanyl testing have not been demonstrated previously. The aim of this study was to determine whether urine fentanyl concentration is associated with severity of opioid withdrawal.

Design
This is a retrospective cross-sectional study.

Setting
This study was conducted in 3 emergency departments in an urban, academic health system from January 1, 2020, to December 31, 2021.

Participants
This study included patients with opioid use disorder, detectable urine fentanyl or norfentanyl, and Clinical Opiate Withdrawal Scale (COWS) recorded within 6 hours of urine drug testing.

Measurements
The primary exposure was urine fentanyl concentration stratified as high (>400 ng/mL), medium (40–399 ng/mL), or low (<40 ng/mL). The primary outcome was opioid withdrawal severity measured with COWS within 6 hours before or after urine specimen collection. We used a generalized linear model with γ distribution and log-link function to estimate the adjusted association between COWS and the exposures.

Findings
For the 1127 patients in our sample, the mean age (SD) was 40.0 (10.7), 384 (34.1%) identified as female, 332 (29.5%) reported their race/ethnicity as non-Hispanic Black, and 658 (58.4%) reported their race/ethnicity as non-Hispanic White. For patients with high urine fentanyl concentrations, the adjusted mean COWS (95% confidence interval) was 4.4 (3.9–4.8) compared with 5.5 (5.1–6.0) among those with medium and 7.7 (6.8–8.7) among those with low fentanyl concentrations.

Conclusions
Lower urine fentanyl concentration was associated with more severe opioid withdrawal, suggesting potential clinical applications for quantitative urine measurements in evolving approaches to fentanyl withdrawal management.
An Open-label Pilot Study of NicoBloc as a Novel Smoking Cessation Intervention
Authors: Chichester Keith R. , Sisson Michelle L. , Chana Sofia Mildrum , Wolford-Clevenger Caitlin , Hugley Mickeah J. , Hawes Elizabeth S. , Palenski Paige , Nguyen Angela , Dahne Jennifer , Hendricks Peter S. , Cropsey Karen L. 
Published: March 2023

Introduction
NicoBloc is a viscous fluid applied to the cigarette filter designed to block tar and nicotine. This novel and understudied smoking cessation device presents a nonpharmacological means for smokers to gradually reduce nicotine and tar content while continuing to smoke their preferred brand of cigarette. This pilot study aimed to assess the feasibility, acceptability, and initial efficacy of NicoBloc as compared with nicotine replacement therapy (nicotine lozenge).

Methods
A community sample of predominately Black smokers (N = 45; 66.7% Black) were randomized to receive NicoBloc or nicotine lozenge. Both groups engaged in 4 weeks of smoking cessation therapy followed by 2 months of independent usage with monthly check-ins to assess medication adherence. The intervention lasted 12 weeks, and the study concluded with a 1-month postintervention follow-up visit (week 16).

Results
NicoBloc was comparable with nicotine lozenge in smoking reduction, feasibility, symptom adverse effects, and reported acceptability at week 16. Participants in the lozenge group endorsed higher treatment satisfaction ratings during the intervention and lower cigarette dependence. Adherence to NicoBloc was superior throughout the study.

Conclusion
NicoBloc was feasible and acceptable to community smokers. NicoBloc presents a unique, nonpharmacological intervention. Future research is needed to examine whether this intervention may be most effective in subpopulations where pharmacological approaches are restricted or in combination with established pharmacological methods such as nicotine replacement therapy.
Comparison of the Diagnostic Accuracies of Monocyte Distribution Width, Procalcitonin, and C-Reactive Protein for Sepsis: A Systematic Review and Meta-Analysis
Authors: Huang Yu-Hsuan , Chen Ching-Jung , Shao Shih-Chieh , Li Chih‑Huang , Hsiao Chien-Han , Niu Kuang-Yu , Yen Chieh-Ching 
Published: March 2023

OBJECTIVES:
We performed a systemic review and meta‐analysis to evaluate the diagnostic accuracy of monocyte distribution width (MDW) and to compare with procalcitonin and C‐reactive protein (CRP), in adult patients with sepsis.

DATA SOURCES:
A systematic literature search was performed in PubMed, Embase, and the Cochrane Library to identify all relevant diagnostic accuracy studies published before October 1, 2022.

STUDY SELECTION:
Original articles reporting the diagnostic accuracy of MDW for sepsis detection with the Sepsis-2 or Sepsis-3 criteria were included.

DATA EXTRACTION:
Study data were abstracted by two independent reviewers using a standardized data extraction form.

DATA SYNTHESIS:
Eighteen studies were included in the meta‐analysis. The pooled sensitivity and specificity of MDW were 84% (95% CI [79–88%]) and 68% (95% CI [60–75%]). The estimated diagnostic odds ratio and the area under the summary receiver operating characteristic curve (SROC) were 11.11 (95% CI [7.36–16.77]) and 0.85 (95% CI [0.81–0.89]). Significant heterogeneity was observed among the included studies. Eight studies compared the diagnostic accuracies of MDW and procalcitonin, and five studies compared the diagnostic accuracies of MDW and CRP. For MDW versus procalcitonin, the area under the SROC was similar (0.88, CI = 0.84–0.93 vs 0.82, CI = 0.76–0.88). For MDW versus CRP, the area under the SROC was similar (0.88, CI = 0.83–0.93 vs 0.86, CI = 0.78–0.95).

CONCLUSIONS:
The results of the meta-analysis indicate that MDW is a reliable diagnostic biomarker for sepsis as procalcitonin and CRP. Further studies investigating the combination of MDW and other biomarkers are advisable to increase the accuracy in sepsis detection.
The History of Men in Nursing
Authors: Mulkey David C. 
Published: March 2023

ABSTRACT:
Men have a long-standing history in the nursing profession. Once a predominantly male-dominated field, the history of male nurses is not well documented. The history of men in nursing is filled with pioneers whose impact influenced the current climate and future of nursing and male nurses. Although there have been fewer men in nursing in modern times, their presence is significant for the profession.
Nursing Education's Dynamic History
Authors: Akers Shanna W. , Mauk Kristen L. 
Published: March 2023

ABSTRACT:
Professional nursing education has changed through the decades, from experiential training governed by religious sisters to formal education on theory and research for practice. Numerous types of nursing programs have been developed to meet professional and healthcare needs, and the popularity of different programs has varied over time. The purpose of this article is to explore the history of nursing education and the challenges the 21st century presents to nurse educators and clinicians. Strategies are offered for Christian nurse leaders to forge new pathways for education and move the profession forward.
The Impact of Concomitant Proton Pump Inhibitors Therapy on Clinical Outcome of Cancer Patients Treated With Immune Checkpoint Inhibitors
Authors: Cao Xing , Wang Yafei , Huang Wei , Li Panyun , Guo Chongjie , Li Yuhui 
Published: March 2023

Background:
In patients with advanced cancer receiving immune checkpoint inhibitors (ICIs) therapy, there are conflict perspectives about the influence of concomitant use of proton pump inhibitors (PPIs). We are aimed at exploring the influence of concomitant PPIs exposure on clinical outcome among cancer patients receiving ICIs treatment.

Methods:
We searched relevant literatures in PubMed, EMBASE, and the Cochrane Library without language restrictions. We extracted the data from selected studies and calculated the pooled hazard ratios (HRs) with 95% CIs through professional software for overall survival and progression-free survival among cancer patients undergoing ICIs therapy exposed to PPIs.

Results:
Fourteen studies including 6716 advanced cancer patients receiving ICIs treatment were appropriate for analysis judging by pre-set inclusion and exclusion criteria. The result indicated that concomitant PPIs exposure was significantly related to shorter overall survival (HR=1.388; 95% CI: 1.278-1.498, P<0.001) and progression-free survival (HR=1.285; 95% CI: 1.193-1.384, P<0.001) among multiple cancer patients receiving ICIs therapy.

Conclusions:
Our meta-analysis showed that concomitant PPIs exposure had an adverse impact on clinical outcome among patients receiving ICIs therapy. Clinical oncologists must be cautious of PPIs delivery during ICIs treatment.
The Safety and Efficacy of a Dual CO2 and 1570-nm Hybrid Laser for Periorbital Rejuvenation
Authors: Tsur Shenhav Leah , Shehade Waseem , Muravnik Gerardo , Horovitz Tamir , Artzi Ofir 
Published: March 2023

BACKGROUND
Many modalities are used for periorbital rejuvenation, with a wide range of efficacy and safety. To achieve favorable outcomes with minimal downtime and adverse effects, professionals developed a hybrid laser, which allows simultaneous treatment with 2 wavelengths: fractional ablative and fractional nonablative lasers.

OBJECTIVE
To evaluate the safety and efficacy of a new hybrid laser for periorbital rejuvenation.

MATERIALS AND METHODS
This retrospective single-center study includes 24 patients who underwent a single-pass treatment with a CO2 and 1570-nm hybrid laser for periorbital rejuvenation between 2020 and 2022. Patients' standardized clinical photographs before and after the treatment were assessed by 4 independent physicians for objective improvement. Treatment data, safety, and patients' satisfaction were also reviewed.

RESULTS
Statistically significant objective improvements were found in all investigated scales with an improvement of 1 to 2 points on each scale. Patients' satisfaction was 3.1/4. Average downtime was 5.9 ± 1.7 days. Most adverse effects were mild to moderate in severity (89.7%), including erythema, crusting, pruritis, edema, and hyperpigmentation.

CONCLUSION
After a single-pass treatment, the laser generates 26% to 50% improvement in the periorbital area, with a strong safety profile and a relatively simple recovery. Further research is needed to validate the efficacy of this technology compared with more aggressive modalities.
Public Perceptions of Climate Change and Plastic and Reconstructive Surgery
Authors: Hyland Colby J. , Yates Elizabeth F. , Gadiraju Goutam , Dey Tanujit , Broyles Justin Michael 
Published: March 2023

Background:
Healthcare has a major impact on climate change, and surgery is among the most energy-intensive hospital practices. Although most Americans believe climate change is happening, little is known regarding public awareness of the impact of healthcare on climate change and how this may impact perceptions of plastic surgery.

Methods:
A cross-sectional survey was administered to adults in the United States using Amazon Mechanical Turk in December 2021 to assess public perceptions of climate change, healthcare, and plastic surgery. Incomplete responses were excluded from analysis. Multivariable logistic regression models were used to determine predictors of responses.

Results:
There were 890 complete responses. Most participants strongly agreed or agreed that climate change is happening (89%). Fewer believed that healthcare has an impact on climate change (62%), with greater odds among respondents with an associate’s degree or higher (odds ratio 2.8, P < 0.001). After they were given information about the impact of healthcare on climate change, most respondents were more worried about the effects of cosmetic plastic surgery (64%). Many respondents would be willing to engage in personal climate change mitigation measures if undergoing surgery and pay higher professional fees to support sustainable hospital practices.

Conclusions:
Most Americans believe climate change is happening, but fewer believe healthcare has an impact on climate change. Knowledge regarding the impact of healthcare and surgery on climate change may make patients more worried about the effects of plastic surgery on climate change, but patients may be willing to personally mitigate climate impacts of surgery.
Double-flap Mandibular Reconstruction around the Condylar Head Using Fibula and Anterolateral Thigh Flaps
Authors: Tsuge Itaru , Yamanaka Hiroki , Katsube Motoki , Sowa Yoshihiro , Sakamoto Michiharu , Morimoto Naoki 
Published: March 2023

Summary:
We applied double-flap reconstruction with a vascularized fibula osteo flap and a Y-shaped anterolateral thigh (ALT) flap, which was separated into a fascial flap and a de-epithelialized fat flap to replace the temporomandibular joint capsule and temporal soft tissue volume, respectively. This technique achieved excellent functional and cosmetic results with acceptable operation time and donor site scarring. A 16-year-old girl had a rapidly growing mandibular osteosarcoma. Right mandibulectomy from the right first premolar tooth to right condylar head (including temporalis muscle, masseter muscle, buccal mucosa, and part of the right maxilla) was performed. A left fibula osteo flap and left ALT flap were prepared in a prefabricated manner using a three-dimensional model and a prebent titanium plate. The area of the ALT flap was 23 × 6 cm. A proximal 8 × 4 cm skin flap was positioned to replace the left cheek mucosa, and the distal part was divided into two layers: a de-epithelialized fat flap and a fascial flap. The de-epithelialized fat flap was used to prevent the depression deformation at the temporal area, and the fascial flap was used to cover around the alternate condylar head made by the fibula instead of the resected temporomandibular joint capsule. The peroneal artery and veins were microscopically anastomosed to the distal end of the artery and veins of the descending branch of the ALT flap in a flow-through manner. At 12 months after surgery, the occlusal function and aesthetic balance were excellent.
Low Baseline Expression of Fibrotic Genes in an Ex Vivo Human Skin Model is a Potential Indicator of Excessive Skin Scarring
Authors: Mouawad Joe E. , Heywood Jonathan , Armstrong Milton B. , Ogunleye Adeyemi , Feghali-Bostwick Carol 
Published: March 2023

Background:
One of the challenges plastic surgeons face is the unpredictability of postoperative scarring. The variability of wound healing and subsequent scar formation across patients makes it virtually impossible to predict if a patient’s surgery will result in excessive fibrosis and scarring, possibly amounting to keloids or hypertrophic scars. There is a need to find predictive molecular indicators of patients or skin location with high risk of excessive scarring. We hypothesized that baseline expression levels of fibrotic genes in the skin can serve as a potential indicator of excessive scarring.

Methods:
An ex vivo model of skin fibrosis was used with abdominal and breast skin tissue from 45 patients undergoing breast reduction and/or abdominoplasty. Fibrosis was induced in skin explants in organ culture with transforming growth factor-β (TFGβ). Fibrotic gene response was assessed via quantitative real-time polymerase chain reaction and correlated with skin location, age, and baseline levels of fibrotic genes.

Results:
The increase in TFGβ-induced fibronectin1 (FN1) gene expression in skin explants was significantly higher than for Collagen 1A1, alpha smooth muscle actin, and connective tissue growth factor. Also, FN1 expression positively correlated with donor age. Moreover, lower expression of the fibrotic genes FN1, Collagen 1A1, and alpha smooth muscle actin correlated with a more pronounced fibrotic response, represented by higher induction levels of these genes.

Conclusions:
Skin sites exhibit different baseline levels of profibrotic genes. Further, low baseline expression levels of fibrotic genes FN1, Collagen 1A1, and alpha smooth muscle actin, in donor skin may indicate a potential for excessive scarring of the skin.
Body Mass Index (BMI) Impact on Anesthetic Safety among Adolescents Undergoing Bilateral Reduction Mammaplasty
Authors: Cappitelli Alex T. , McNamara Catherine T. , Nuzzi Laura C. , Alrayashi Walid , Ganske Ingrid M. , Ganor Oren , Labow Brian I. 
Published: March 2023

Introduction:
Obesity is common in adolescents with macromastia seeking surgery, prompting concerns over anesthesia-related complications due to obesity. This may lead to weight-based surgical policies, despite limited research. This study’s purpose is to examine the impact of obesity status on perioperative anesthetic-related adverse events/surgical complications in adolescents/young adults undergoing bilateral reduction mammaplasty.

Methods:
A medical record query was performed to retrospectively identify patients who underwent bilateral reduction mammaplasty at our institution between January 2021 and December 2021. Patient demographics and clinical/surgical data were obtained from medical records. Pearson’s chi-square, Fisher exact, and Median tests were used to examine associations between body mass index (BMI) category and clinical/demographic data.

Results:
Two hundred patients were included in analyses, with a median age at surgery of 18.0 years. The majority of patients were obese (63.5%, n = 127), and none were underweight. The most common comorbidity was asthma (27.0%, n = 54). There were no anesthetic-related intraoperative complications or delayed waking. The following did not significantly differ by BMI category: proportion of patients who experienced oxygen desaturation (pre-, intra-, or postoperatively), frequency of postoperative complications, and length of postanesthesia care unit and total hospital stays (P > 0.05, all).

Conclusions:
While institutions may implement weight-based surgical policies due to anesthesia-related complication concerns in patients with obesity, our study showed that BMI category did not significantly impact anesthetic-related adverse events/surgical complications in our sample. This suggests that such policies are not warranted in all situations, and that decisions regarding their necessity be data-driven.
Severe Bilateral Mandibular Hyperplasia and Angle’s Class III Malocclusion in Indonesia: A Case Report
Authors: Bogari Melia , Hapsari Savitri , Hermawan Rahendra Wira , Andana Alki , Hutagalung Magda 
Published: March 2023

Summary:
Malocclusion is an abnormal relationship between the teeth of the upper and lower jaws, with irregular tooth position, including crossbite and underbite. Malocclusion can occur in the form of crooked, protruding, or crowded teeth, affecting appearance, pronunciation, and mastication. Many factors lead to malocclusions, such as heredity, growth disturbance, and bad habits. Many Indonesians undergo orthodontic treatment to improve both function and appearance. The large demand for orthodontic treatment is due to increasing public knowledge about the impact of untreated malocclusion and the rising standard of living. We present a severe and rare case of malocclusion in Indonesia. A 20-year-old man presented with bilateral mandibular condylar hyperplasia and Angle’s class III malocclusion. A multidisciplinary team, including plastic and oral surgeons, orthodontists, and psychologists, was created to address this problem. The first surgical procedure was chosen to achieve correction in the shortest possible time. Le Fort I osteotomy and mandibular bilateral sagittal split and anterior subapical osteotomies using Kole’s procedure were performed. The patient underwent preoperative and postoperative examinations. After surgery, the occlusion was corrected and facial symmetry significantly improved.