bluuebunny/crossref_metadata_2025_split huggingface dataset:
What outcomes of moral case deliberations are perceived important for healthcare professionals to handle moral challenges? A national cross-sectional study in paediatric oncology
Authors: Bartholdson Cecilia , Billstein Isabelle , Molewijk Bert , Pergert Pernilla 
Published: November 2022

Abstract
Background
In paediatric oncology, healthcare professionals face moral challenges. Clinical ethics support services, such as moral case deliberation (MCD), aim to assist them in dealing with these challenges. Yet, healthcare professionals can have different expectations and goals related to clinical ethics support services.

Methods
In this study, the perceptions held by healthcare professionals (nursing assistants, registered nurses, physicians, and others) regarding the importance of possible outcomes of MCDs, prior to implementation of MCDs, were investigated. A multisite, cross-sectional, quantitative study was performed at all six Paediatric Oncology Centres in Sweden. Healthcare professionals answered the Euro-MCD instrument with 26 potential MCD outcomes using a scale from Not important (1) to Very important (4). Descriptive and comparative statistical analyses were carried out.

Results
All outcomes were rated high, i.e., between 3.12 and 3.78. More open communication, developing skills to analyse ethically difficult situations, better mutual understanding, and deciding on concrete actions were rated as most important. Understanding of ethical theories and critical examination of policies were rated less important. Most often nursing assistants rated higher and physicians lower than the other professions did. Women and participants without previous experience of MCDs perceived outcomes as more important. There were differences between centres as one centre had significantly higher, and one centre had significantly lower ratings compared to the others.

Conclusion
It is clear that healthcare professionals want MCDs to improve teamwork and skills in order to analyse and manage ethically difficult situations. When comparing to previous research about important MCD outcomes, there were similarities in what healthcare professionals consider to be important when handling moral challenges regardless of country and potential differences in healthcare settings and systems, such as paediatric vs. adult care.
Health services access, utilization, and barriers for Arabic-speaking refugees resettled in Connecticut, USA
Authors: Elreichouni Ali , Aly Sarah , Maciejewski Kaitlin , Salem Islam , Ghossein Noah , Mankash M. Salah , Dziura James , Mowafi Hani 
Published: November 2022

Abstract
Background
Arabic-speaking refugees are the largest group of refugees arriving in the United States since 2008, yet little is known about their rates of healthcare access, utilization, and satisfaction after the end of the Refugee Medical Assistance (RMA) period.

Methods
This study was a cross-sectional observational study. From January to December 2019, a household survey was conducted of newly arrived Arabic-speaking refugees in Connecticut between 2016 and 2018. Households were interviewed in Arabic either in person or over the phone by one of five researchers. Descriptive statistics were generated for information collected on demographics, prevalence of chronic conditions, patterns of health seeking behavior, insurance status and patient satisfaction using the Patient Satisfaction Questionnaire (PSQ-18).

Results
Sixty-five households responded to the survey representing 295 Arabic-speaking refugees – of which 141 (48%) were children. Forty-seven households (72%) reported 142 chronic medical conditions among 295 individuals, 62 persons (21%) needed daily medication, 285 (97%) persons were insured. Median patient satisfaction was > 4.0 out of 5 for 6 of 7 domains of the PSQ-18 but wide variation (scores from 1.0 – 5.0).

Conclusion
Arabic-speaking refugees in Connecticut participating in this study were young. The majority remained insured after their Refugee Medical Assistance lapsed. They expressed median high satisfaction with health services but with wide variation. Inaccessibility of health services in Arabic and difficulty obtaining medications remain areas in need of improvement.
A mitochondria-targeted molecular phototheranostic platform for NIR-II imaging-guided synergistic photothermal/photodynamic/immune therapy
Authors: Yang Sha , Wu Gui-long , Li Na , Wang Minghui , Wu Peixian , He Yuxuan , Zhou Wei , Xiao Hao , Tan Xiaofeng , Tang Li , Yang Qinglai 
Published: November 2022

AbstractPhototherapy is a conducive and non-invasive strategy for cancer therapy under light irradiation. Inspiringly, fluorescence imaging in the second near-infrared window (NIR-II, 1000–1700 nm) holds a great promise for imaging-guided phototherapy with deep penetration and high spatiotemporal resolution. However, most phototherapeutics still face great challenges, including complicated synthesis of agents, potential biotoxicity and unsatisfied therapeutic outcomes. Herein, a near-infrared laser triggered molecular photosensitizer FEPT, modified with triphenylphosphine PEGylation (PEG2000-TPP), is developed for NIR-II imaging-guided mitochondria-targeting synergistic photothermal therapy (PTT)/photodynamic therapy (PDT)/immune therapy (IMT). The mitochondria-targeting photosensitizer FEPT can produce reactive oxygen species (ROS) and hyperpyrexia upon 808 nm laser irradiation, resulting in mitochondrial dysfunction and photo-induced apoptosis via caspase-3 pathway. Phototherapy-induced hyperthermia or ROS triggers the release of immunogenic intracellular substrates from dying tumor cells, thereby promoting the activation of antitumor immunity. Herein, this work provides a practicable strategy to develop a molecular phototheranostic platform for imaging-guided cancer therapy via mitochondria-targeting.
Graphical Abstract
Locally invasive recurrence or metastasis of pheochromocytoma into the liver?—clinicopathological challenges
Authors: Tang Sarah S. , Lee James W. K. , Wijerethne Sujith , Iyer Shridhar Ganpathi , Hue Susan , En Nga Min , Parameswaran Rajeev 
Published: November 2022

AbstractPheochromocytomas (PCC) are rare and functional neuroendocrine tumors developing from adrenal chromaffin cells. Predicting malignant behavior especially in the absence of metastasis can be quite challenging even in the era of improved understanding of the molecular mechanisms involved in PCCs. Currently, two histopathological grading systems Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) and Grading of Adrenal Pheochromocytoma and Paraganglioma (GAPP) score are used in clinical practice, but these are subject to significant interobserver variability. Some of the most useful clinical factors associated with malignancy are large size ([4–5 cm), and genetic features such as presence of SDHB germline mutations. Local invasion is uncommon in PCC and metastasis seen in 10 to 17% but higher in germline mutations and when this occurs management can be challenging. Here, we report on a case with challenges faced by the pathologist and clinicians alike in diagnosis and management of PCC recurrence.
Downregulation of zinc finger protein 71 in laryngeal squamous cell carcinoma tissues and its potential molecular mechanism and clinical significance: a study based on immunohistochemistry staining and data mining
Authors: Jiang Fang-Cheng , Luo Jia-Yuan , Dang Yi-Wu , Lu Hui-Ping , Li Dong-Ming , Huang Zhi-Guang , Tang Yu-Lu , Fang Ye-Ying , Tang Yu-Xing , Su Ya-Si , Dai Wen-Bin , Pan Shang-Ling , Feng Zhen-Bo , Chen Gang , He Juan 
Published: November 2022

Abstract
Background
The molecular mechanism of laryngeal squamous cell carcinoma (LSCC) is not completely clear, which leads to poor prognosis and treatment difficulties for LSCC patients. To date, no study has reported the exact expression level of zinc finger protein 71 (ZNF71) and its molecular mechanism in LSCC.

Methods
In-house immunohistochemistry (IHC) staining (33 LSCC samples and 29 non-LSCC samples) was utilized in analyzing the protein expression level of ZNF71 in LSCC. Gene chips and high-throughput sequencing data collected from multiple public resources (313 LSCC samples and 192 non-LSCC samples) were utilized in analyzing the exact mRNA expression level of ZNF71 in LSCC. Single-cell RNA sequencing (scRNA-seq) data was used to explore the expression status of ZNF71 in different LSCC subpopulations. Enrichment analysis of ZNF71, its positively and differentially co-expressed genes (PDCEGs), and its downstream target genes was employed to detect the potential molecular mechanism of ZNF71 in LSCC. Moreover, we conducted correlation analysis between ZNF71 expression and immune infiltration.

Results
ZNF71 was downregulated at the protein level (area under the curve [AUC] = 0.93, p < 0.0001) and the mRNA level (AUC = 0.71, p = 0.023) in LSCC tissues. Patients with nodal metastasis had lower protein expression level of ZNF71 than patients without nodal metastasis (p < 0.05), and male LSCC patients had lower mRNA expression level of ZNF71 than female LSCC patients (p < 0.01). ZNF71 was absent in different LSCC subpopulations, including cancer cells, plasma cells, and tumor-infiltrated immune cells, based on scRNA-seq analysis. Enrichment analysis showed that ZNF71 and its PDCEGs may influence the progression of LSCC by regulating downstream target genes of ZNF71. These downstream target genes of ZNF71 were mainly enriched in tight junctions. Moreover, downregulation of ZNF71 may influence the development and even therapy of LSCC by reducing immune infiltration.

Conclusion
Downregulation of ZNF71 may promote the progression of LSCC by reducing tight junctions and immune infiltration; this requires further study.
Behavioral problems in psychotic, clinically high-risk, and non-psychotic adolescent patients
Authors: Rogantini Chiara , Provenzi Livio , Borgatti Renato , Mensi Martina ,   Clinical High Risk State For Psychosis Research Group, Iorio Melanie , Orlandi Marika , Vecchio Arianna 
Published: November 2022

Abstract
Background
A growing body of research provides evidence for social and behavioral problems observed among adolescents with psychosis and also as precursors of vulnerability to psychosis, long before the illness onset, especially in females patients. As such, the main aim of the current study was to investigate from a patient perspective the presence of differences in the behavioral problems self-disclosed by psychotic, clinically high-risk, and non-psychotic adolescents. Moreover, since adolescent girls may present higher risk of internalizing problems, we explored the additional role of sex in interaction with psychotic risk or clinical condition in altering the self-disclosed severity of behavioral problems among the three groups of adolescents.

Methods
One-hundred and fifty-eight adolescent patients were interviewed by a trained child neuropsychiatrist applying the Comprehensive Assessment of At Risk Mental States in order to identify a quantitative index of risk for full-blown and attenuated psychosis. All patients self-reported on their behavioral problems filing in the well-validated Italian version of the Youth Self-Report, which quantifies internalizing, externalizing, and total behavioral problems.

Results
Regarding Youth Self-Report’s scores, non-psychotic adolescents had reported lower total and internalizing scores compared to clinically high-risk and psychotic counterparts. Additionally, in our sample a significant group × sex interaction effect emerged for total and internalizing scores: females reported greater risk of total and internalizing behavioral problems, only in the clinically high-risk group.

Conclusions
Higher variability should be expected in the behavioral profile of high-risk adolescents in comparison to psychotic ones. Elevations of internalizing behavioral symptoms, thus, might be considered as a much more relevant risk factor in girls during adolescence.
Ecological apparency, ethnobotanical importance and perceptions of population status of wild-growing medicinal plants in a reserve of south-central Mexico
Authors: López-Patiño Elinor Josefina , Vibrans Heike , Moctezuma-Pérez Sergio , Chávez-Mejía María Cristina 
Published: November 2022

Abstract
Background
The apparency hypothesis in ethnobotany (common plants are used more than less frequent ones) has been studied mostly by comparing usefulness with woody plant density, or large plants (trees) with herbs, with uneven results. Here, we explore the hypothesis for wild-growing medicinal plants, separately for different life forms. Two methodological subjects relevant for testing the hypothesis are also treated: We compare various importance indicators, including recent use, and evaluate active healers’ knowledge of plant population size. The study area was the Tenancingo-Malinalco-Zumpahuacán Protected Natural Area in central Mexico in the upper part of the Balsas River Basin, a biogeographic region with a long tradition of using wild medicinal species.

Methods
Previous work on the vegetation of the protected area contributed information from 100 survey plots and a species list, which included preliminary data on the medicinal plants. Then, in 2019–2020, we held in-depth and repeated interviews with 13 traditional healers in three rural communities. They were interviewed on uses and population size of a selection of 52 medicinal species of different life forms and abundance (number of individuals in survey plots). The data were analyzed with descriptive statistics, use values and linear regression models.

Results
For all species, use value correlated significantly with abundance. When separated by life forms, only herbs and shrubs/lianas showed this association, though with statistical limitations. Trees did not, perhaps because some of the most useful trees have been overcollected. We found a good correlation of recent use with frequency of mention and most other importance indicators; the correlation was weakest for number of uses. Also, active healers had a good estimation of population of their collected species.

Conclusions
The apparency hypothesis should be studied separating life forms to reduce the influence of this variable. To measure importance for the study of this hypothesis, the data show that frequency of mention is a good indicator and correlated with actual use. Also, local plant users’ appreciations of population size are quite accurate in the aggregate and may be more efficient than costly vegetation surveys.
How structural and symbolic violence during resettlement impacts the social and mental wellbeing of forced migrant women: the lived experiences of Arabic speaking survivors of IPV resettled in Melbourne, Australia
Authors: Hourani Jeanine , Jarallah Yara , Block Karen , Murray Linda , Chen Jasmin , Hach Maria , Vaughan Cathy 
Published: November 2022

AbstractForced migrant women experience high levels of violence across their journeys and violence can be characterised as having three overarching forms: structural, symbolic, and interpersonal. It is important to understand the intersecting nature of gendered forms of symbolic, structural and interpersonal violence, and their impact on the mental health of forced migrant women in order to develop holistic IPV and resettlement programs and interventions. This article adopts an ecological framework of violence and qualitative methods with mental health service providers and survivors of IPV to understand the intersections of different forms of violence and their impact on mental health as they relate to the lived experiences of Arabic-speaking forced migrant survivors currently residing in Melbourne, Australia. Our research has three key findings: (1) that forced migrant women living in Melbourne, Australia experience intersecting forms of violence during resettlement (2) Structural and symbolic violence against forced migrant women persists regardless of marital status (3) Autonomy and independence plays a vital role in the mental health and wellbeing of forced migrant women. Our findings reveal that structural and symbolic violence increase the risk of IPV for forced migrant women during resettlement and that even when forced migrant women leave IPV situations, structural and symbolic violence persist and exacerbate mental ill-health. This article also reveals the importance autonomy and independence in both the perpetration of violence and in healing and recovery.
The Mourning of My Birth in the Wake of Grandma’s One Hundredth Year
Authors: Quick Hall K. Melchor 
Published: November 2022

Abstract
In this essay the author describes how she orchestrates her own death for her mother’s survival and begins to travel with her dying grandmother. She shares lessons from her grandmother’s elongated, memory-less, graceless dying through a series of vignettes. While her mother accepts the author’s proclamation of her own death, the mother mourns the simultaneous loss of her daughter and mother. In the midst of her mother’s suffering, the author shares the joyous mourning of her travels with Grandma.
A Light for a Light
Authors: Ruiz Sandra 
Published: November 2022

AbstractHow does loss tear a hole in the world and produce a collective remaking of a new social order in which grief-work is not contained singularly but is a process done in feminist, queer, and Black and Brown ensemble? Interested in how we deliberately incorporate loss into collective grief-work, this article pulls from feminist and queer theorists of color who move across social and psychical constructions of sorrow. Highlighting contemporary art by minoritarian artists such as Eva Margarita Reyes and Pedro Lopez, who embrace loss, the author argues that grief-work is a communal labor we undergo together in acts of intimate meditation, suffering, spillage, and transformation. Happening in feminist and queer ensemble, grief-work is a deliberate decision to assemble in nonlinear feelings and attachments; it is an intention to work together to defend not only the dead but also the living, tending to immaterial energies that shift the fecund terrain of both life and death.
Synthesis, Structures, and Properties of Tropone-Fused Coumarin Dyes
Authors: Amishiro Sae , Ueda Masafumi , Mazaki Yasuhiro 
Published: November 2022

Abstract
A nonbenzenoid aromatic ring, tropone-fused 7-methoxycoumarin dye (1a) and its chlorinated product (1b) were designed and successfully synthesized via transannulation of a coumarin derivative and dehydrobromination of the dibromo- and tribromoprecursors. X-ray crystallography revealed that 1a and 1b are distorted at the annulated tropone skeleton with bond alternation, unlike typical 3,4-annulated π-extended coumarin dyes. These tropone-fused coumarin dyes exhibited redshifted absorption and emission bands compared with that of planar 3,4-benzo-7-methoxycoumarin. These compounds demonstrated relatively efficient fluorescence emission (ΦF = 2–10%) despite their curved skeletons, and solvent dependency owing to the intramolecular charge transfer in the excited state. A computational study clarified that compound 1 changes to a flat structure including the tropylium unit in the excited state. Furthermore, in the fluorescence spectra of 1a with trifluoroacetic acid, the emission intensity increased dramatically to ΦF = 19% owing to the formation of a charge-separated structure with the tropylium cation.
Characterization of longitudinal nasopharyngeal microbiome patterns in maternally HIV-exposed Zambian infants
Authors: Odom Aubrey R. , Gill Christopher J. , Pieciak Rachel , Ismail Arshad , Thea Donald , MacLeod William B. , Johnson W. Evan , Lapidot Rotem 
Published: November 2022

Background: Previous studies of infants born to HIV-positive mothers have linked HIV exposure to poor outcomes from gastrointestinal and respiratory illnesses, and to overall increased mortality rates. The mechanism behind this is unknown, but it is possible that differences in the nasopharyngeal (NP) microbiome between HIV-unexposed and HIV-exposed infants could play a role in perpetuating some outcomes. Methods: We conducted a longitudinal analysis of 170 NP swabs of healthy HIV-exposed, uninfected (HEU; n=10) infants and their HIV(+) mothers and HIV-unexposed, uninfected (HUU; n=10) infants and their HIV(-) mothers. These swabs were identified from a sample library collected in Lusaka, Zambia between 2015 and 2016. Using 16S rRNA gene sequencing, we characterized the maturation of the microbiome over the first 14 weeks of life to determine what quantifiable differences exist between HEU and HUU infants, and what patterns are reflected in the mothers' NP microbiomes. Results: In both HEU and HUU infants, Staphylococcus and Corynebacterium began as primary colonizers of the NP microbiome but were in time replaced by Dolosigranulum, Streptococcus, Moraxella and Haemophilus. When studying differences between infants, the microbe Staphylococcus haemolyticus indicated a distinctive high association with HIV exposure at birth, even when accounting for the interaction between HIV exposure status and time of sampling. When comparing infants to their mothers with paired analyses, HEU infants’ NP microbiome composition was only slightly different from their HIV(+) mothers at birth or 14 weeks, including in their carriage of S. pneumoniae, H. influenzae, and S. haemolyticus. Conclusions: Our analyses indicate that the HEU infants in our study exhibit subtle differences in the NP microbial composition throughout the sampling interval. Given our results and the sampling limitations of our study, we believe that further research must be conducted in order to confidently understand the relationship between HIV exposure and infants’ NP microbiomes.
Vaginal atrophy: what is it and how can it be treated?
Authors: Holloway Debra 
Published: November 2022

Vaginal atrophy is common and can impact on quality of life for many women. Debra Holloway explores how the condition can be managed in primary care Vaginal atrophy is a common, chronic and progressive condition that occurs due to oestrogen deficiency. It is an under-recognised condition that can have a negative impact on quality of life. Vaginal atrophy can be treated and the aims of treatment are to promote comfort and ensure that symptoms are reduced. Practice nurses need to be comfortable asking sensitive questions and be able to give advice and signpost women to relevant and up to date information.