bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polysomnographic indicators of restorative sleep and body mass trajectories in the Wisconsin Sleep Cohort Study
Authors: Reither Eric N , Barnet Jodi H , Palta Mari , Liu Yin , Hagen Erika W , Peppard Paul E 
Published: June 2021

AbstractStudy ObjectivesPrevious research suggests that reductions in restorative, slow-wave (N3), and rapid eye movement (REM) sleep are associated with weight gain and obesity in mid-to-late life. We extend prior work by examining how within-person (WP) changes and between-person (BP) differences in restorative sleep over several years are associated with body mass trajectories among participants in the Wisconsin Sleep Cohort Study (WSCS).MethodsWe used data from 4,862 polysomnographic (PSG) sleep studies and physical exams collected from 1,187 WSCS participants over an average duration of 14.9 years. Primary measures of interest included body mass index (BMI = kg/m2) and the percentages of time spent in N3 and REM sleep. We estimated a series of linear mixed regression models to examine how WP changes and BP differences in N3 and REM sleep affected BMI trajectories, controlling for other sleep measures, demographic characteristics, and health behaviors as potential confounders.ResultsWomen in the WSCS experienced more rapid BMI gain than men. With some variation by sex, we found that (1) below-average N3 and REM sleep is associated with above-average BMI, and (2) within-person decreases in N3 and REM sleep over time are associated with gains in BMI. These findings persisted after adjustment for sleep duration and other potential confounders.ConclusionsOur findings highlight the importance of PSG indices of restorative sleep in mid-to-late life, suggesting that future clinical treatments and public health policies will benefit from heightened attention to sleep quality.
PAX8/PAX8-AS1 DNA methylation levels are associated with objective sleep duration in persons with unexplained hypersomnolence using a deep phenotyping approach
Authors: Plante David T , Papale Ligia A , Madrid Andy , Cook Jesse D , Prairie Michael L , Alisch Reid S 
Published: June 2021

AbstractStudy ObjectivesPatients with unexplained hypersomnolence have significant impairment related to daytime sleepiness and excessive sleep duration, the biological bases of which are poorly understood. This investigation sought to examine relationships between objectively measured hypersomnolence phenotypes and epigenetic modification of candidate hypersomnolence genes to advance this line of inquiry.MethodsTwenty-eight unmedicated clinical patients with unexplained hypersomnolence were evaluated using overnight ad libitum polysomnography, multiple sleep latency testing, infrared pupillometry, and the psychomotor vigilance task. DNA methylation levels on CpG sites annotated to 11 a priori hypersomnolence candidate genes were assessed for statistical association with hypersomnolence measures using independent regression models with adjusted local index of significance (aLIS) P-value threshold of 0.05.ResultsNine CpG sites exhibited significant associations between DNA methylation levels and total sleep time measured using ad libitum polysomnography (aLIS p-value &lt; .05). All nine differentially methylated CpG sites were annotated to the paired box 8 (PAX8) gene and its related antisense gene (PAX8-AS1). Among these nine differentially methylated positions was a cluster of five CpG sites located in the body of the PAX8 gene and promoter of PAX8-AS1.ConclusionsThis study demonstrates that PAX8/PAX8-AS1 DNA methylation levels are associated with total sleep time in persons with unexplained hypersomnolence. Given prior investigations that have implicated single nucleotide polymorphisms in PAX8/PAX8-AS1 with habitual sleep duration, further research that clarifies the role of DNA methylation levels on these genes in the phenotypic expression of total sleep time is warranted.
Dopaminergic Basis of Spatial Deficits in Early Parkinson’s Disease
Authors: Hanna-Pladdy B , Pahwa R , Lyons K E 
Published: June 2021

Abstract
Dopaminergic mechanisms regulating cognitive and motor control were evaluated comparing visuoperceptual and perceptuomotor functions in Parkinson’s disease (PD). The performance of PD patients (n = 40) was contrasted with healthy controls (n = 42) across two separate visits (on and off dopaminergic medications) on computerized tasks of perception and aiming to a target at variable stimulus lengths (4, 8, 12 cm). Novel visuoperceptual tasks of length equivalence and width interval estimations without motor demands were compared with tasks estimating spatial deviation in movement termination. The findings support the presence of spatial deficits in early PD, more pronounced with increased discrimination difficulty, and with shorter stimulus lengths of 4 cm for both visuoperceptual and perceptumotor functions. Dopaminergic medication had an adverse impact on visuoperceptual accuracy in particular for length equivalence estimations, in contrast with dopaminergic modulation of perceptuomotor functions that reduced angular displacements toward the target. The differential outcomes for spatial accuracy in perception versus movement termination in PD are consistent with involvement of the direct pathway and models of progressive loss of dopamine through corticostriatal loops. Future research should develop validated and sensitive standardized tests of perception and explore dopaminergic selective deficits in PD to optimize medication titration for motor and cognitive symptoms of the disease.
Enrichment and Detection Method for the Prognostic Value of Circulating Tumor Cells in Ovarian Cancer: A Meta-analysis
Authors: Huang Chengying , Lin Xiaoli , He Jinmei , Liu Nan 
Published: June 2021

(Abstracted from Gynecol Oncol 2021;161:613–620)
In part due to a lack of early symptoms and robust screening strategies, ovarian cancer is often diagnosed in later stages and has the highest worldwide mortality among gynecologic malignancies. Tumor markers CA125 and HE4 are effective in the diagnosis of ovarian cancer; however, there is a need for prognostic tumor markers for ovarian cancer.
Treatment of Uterine Fibroid Symptoms With Relugolix Combination Therapy
Authors: Al-Hendy Ayman , Lukes Andrea S. , Poindexter Alfred N. , Venturella Roberta , Villarroel Claudio , Critchley Hilary O. D. , Li Yulan , McKain Laura , Arjona Ferreira Juan C. , Langenberg Andria G. M. , Wagman Rachel B. , Stewart Elizabeth A. 
Published: June 2021

(Abstracted from N Engl J Med 2021;384:630–642)
Approximately 25% of women with uterine fibroids experience symptoms, most commonly heavy menstrual bleeding (HMB) or fibroid-associated pain. Long-acting gonadotropin-releasing hormone (GnRH) agonists are effective for the medical management of uterine fibroids, but their duration of use is limited by hypoestrogenic sequelae.
Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses in the US, 2010–2017
Authors: Hirai Ashley H. , Ko Jean Y. , Owens Pamela L. , Stocks Carol , Patrick Stephen W. 
Published: June 2021

(Abstracted from JAMA 2021;325:146–155)
In the United States, the rates of maternal opioid use disorder (MOD) and neonatal abstinence syndrome (NAS) have seen substantial increases between 2000 and 2014. Although these rates vary across states, they were captured before the 2015 transition to International Classification of Diseases, Tenth Revision (ICD-10).
Bradycardia-to-Delivery Interval and Fetal Outcomes in Umbilical Cord Prolapse
Authors: Wong Lo , Tse Wing T. , Lai Chit Y. , Hui Annie S. Y. , Chaemsaithong Piya , Sahota Daljit S. , Poon Liona C. , Leung Tak Y. 
Published: June 2021

(Abstracted from Acta Obstet Gynecol Scand 2021;100:170–177)
Umbilical cord prolapse can lead to significant perinatal complications, including fetal hypoxia and birth asphyxia. In these cases, prompt delivery is required to preserve the life of the fetus and to reduce the risk of brain injury.
Fully Percutaneous Fetoscopic Repair of Myelomeningocele: 30-Month Follow-up Data
Authors: Diehl D. , Belke F. , Kohl T. , Axt-Fliedner R. , Degenhardt J. , Khaleeva A. , Oehmke F. , Faas D. , Ehrhardt H. , Kolodziej M. , Uhl E. , Windhorst A. C. , Neubauer B. A. 
Published: June 2021

(Abstracted from Ultrasound Obstet Gynecol 2021;57:113–118)
The 2011 Management of Myelomeningocele Study (MOMS) reported improved postnatal outcomes for fetuses with myelomeningocele (MMC) who underwent intrauterine repair by open surgery, via hysterectomy, compared with those who underwent traditional postnatal surgery. The study found that the need for shunt decreased by 50% in children who underwent intrauterine repair.
The Impact of Chorionicity on Pregnancy Outcome and Neurodevelopment at 2 Years Old Among Twins Born Preterm: The EPIPAGE-2 Cohort Study
Authors: Tosello B. , Garbi A. , Blanc J. , Lorthe E. , Foix-L'Hélias L. , D'Ercole C. , Winer N. , Subtil D. , Goffinet F. , Kayem G. , Resseguier N. , Gire C. 
Published: June 2021

(Abstracted from BJOG 2021;128:281–291)
Overall, as many as 60% of twins are born preterm, and are therefore at risk for neonatal and long-term complications. Some evidence has shown that outcomes for preterm twins differ by chorionicity-monochorionic (MC) versus dichorionic (DC).
CRISPR-Cas9 Gene Editing for Sickle Cell Disease and β-Thalassemia
Authors: Frangoul Haydar , Altshuler David , Cappellini M. Domenica , Chen Yi-Shan , Domm Jennifer , Eustace Brenda K. , Foell Juergen , de la Fuente Josu , Grupp Stephan , Handgretinger Rupert , Ho Tony W. , Kattamis Antonis , Kernytsky Andrew , Lekstrom-Himes Julie , Li Amanda M. , Locatelli Franco , Mapara Markus Y. , de Montalembert Mariane , Rondelli Damiano , Sharma Akshay , Sheth Sujit , Soni Sandeep , Steinberg Martin H. , Wall Donna , Yen Angela , Corbacioglu Selim 
Published: June 2021

(Abstracted from N Engl J Med 2021;384:252–260)
Transfusion-dependent β-thalassemia (TDT) and sickle cell disease (SCD) are the most common inherited hematologic disorders, affecting approximately 60,000 and 300,000 patients worldwide, respectively. Current therapies, including red blood cell (RBC) transfusion and iron chelation in TDT and transfusion, pain management, and hydroxyurea in SCD, help to manage the disorders but do not address the underlying cause.
Fertility Treatment and Cancers—The Eternal Conundrum: A Systematic Review and Meta-analysis
Authors: Barcroft Jennifer Frances , Galazis Nicolas , Jones Benjamin P. , Getreu Natalie , Bracewell-Milnes Timothy , Grewal Karen J. , Sorbi Flavia , Yazbek Joseph , Lathouras Kostas , Smith J. Richard , Hardiman Paul , Thum Meen-Yau , Ben-Nagi Jara , Ghaem-Maghami Sadaf , Verbakel Jan , Saso Srdjan 
Published: June 2021

(Abstracted from Hum Reprod 2021;36:1093–1107)
Given the increased risk of ovarian, breast, and endometrial cancers associated with nulliparity, there is a higher inherent cancer risk among patients pursuing fertility treatment (FT) than the general population. Endometrial and breast are hormone-sensitive cancers that carry elevated risk associated with estrogen predominant states including ovarian stimulation.
Harnessing the Power of Social Media to Understand the Impact of COVID-19 on People Who Use Drugs During Lockdown and Social Distancing
Authors: El-Bassel Nabila , Hochstatter Karli R. , Slavin Melissa N. , Yang Chenghao , Zhang Yudong , Muresan Smaranda 
Published: June 2021

Objectives:
This paper uses a social media platform, Reddit, to identify real-time experiences of people who use drugs during the COVID-19 lock-down.

Methods:
Reddit is a popular and growing social media platform, providing a large, publicly available dataset necessary for high performance of machine learning and topic modeling techniques. We used opioid-related “subreddits,” communities where Reddit users engage in conversations about drug use, to examine COVID-19-related content of posts and comments from March to May 2020. This paper investigates the latent topics of users’ posts/comments using Latent Dirichlet Allocation, an unsupervised machine learning approach that uncovers the thematic structure of a document collection. We also examine how topics changed over time.

Results:
The final dataset consists of 525 posts and 9284 comments, for a total of 9809 posts/comments (3756 posts/comments in r/opiates, 1641 in r/OpiatesRecovery, 1203 in r/suboxone, and 3209 in r/Methadone) among 2342 unique individuals. There were 5256 posts/comments in March; 3185 in April; and 1368 in May (until May 22). Topics that appeared most frequently in COVID-19-related discussions included medication for opioid use disorder experiences and access issues (22.6%), recovery (24.2%), and drug withdrawal (20.2%).

Conclusions:
During the first three months of the COVID-19 pandemic, people who use drugs were impacted in several ways, including forced or intentional withdrawal, confusion between withdrawal and COVID-19 symptoms, take-home medication for opioid use disorder issues, and barriers to recovery. As the pandemic progresses, providers and policymakers should consider these experiences among people who use drugs during the early stage of the pandemic.
Exercise Addiction Stability and Health Effects. A 6-Month Follow-up Postcompetition Study in Amateur Endurance Cyclists
Authors: Bueno-Antequera Javier , Oviedo-Caro Miguel A ´ ngel , Legaz-Arrese Alejandro , Paris-Garcia Federico , Guille´n-Correas Roberto , Munguı´a-Izquierdo Diego , Mayolas-Pi Carmen 
Published: June 2021

Objective
To study the longitudinal stability of exercise addiction and its health effects in apparently healthy amateur endurance cyclists from pre- to 6-month post-competition.

Methods
In total, 330 (30 women) adult cyclists were divided into 4 groups based on scores on the Exercise Addiction Inventory at both periods: nonrisk (n=262, 79.1%), transient (n=35, 10.6%), emerging (n=14, 4.2%) and persistent (n=20, 6.1%).

Results
The prevalence of high-risk exercise addiction was reduced postcompetition (16.7% vs 10.3%, P = 0.017). Of the cyclists with a high precompetition risk of exercise addiction, 63.6% (35/55) had a transient addiction associated with favorable effects on mental quality of life (effect size [ES]=0.52, 95% confidence interval: [0.20, 0.86]) and sleep quality (ES=–0.50 [–0.89, –0.12]) and avoided the worsening of depression symptom severity compared to the remaining groups (ES range=0.51–0.65). The 5.1% (14/275) of cyclists with a precompetition low risk of exercise addiction presented emerging exercise addiction that was associated with a worsened mental quality of life compared to the remaining groups (ES ranged 0.59–0.91), sleep quality compared to the nonrisk (ES=–0.56 [–0.02, –1.10]) and transient (ES=–0.72 [–1.36, –0.08]) groups and anxiety symptom severity compared to the persistent group (ES=0.51 [1.20,–0.19]).

Conclusions
Exercise addiction had a marked transitory component at 6-month postcompetition with associated health benefits in amateur endurance cyclists.
Associations of Current and Remitted Cannabis Use Disorder With Health-related Quality of Life and Employment Among US Adults
Authors: Rhee Taeho Greg , Rosenheck Robert A. 
Published: June 2021

Background
The associations of current and remitted cannabis use disorder (CUD) with health-related quality of life (HRQOL) and employment have not been studied, and we aim to address these gaps.

Methods
The 2012–2013 National Epidemiological Survey on Alcohol and Related Conditions III (NESARC III) surveyed a nationally representative sample of non-institutionalized civilian US adults (≥18 years) (n = 36,309 unweighted). Using DSM-5 criteria, adults with current CUD were compared with those with CUD in remission and no history of CUD on standard measures of the mental and physical component scores of HRQOL and of quality-adjusted life years (QALYs) along with employment in the past 12 months. Multivariable-adjusted regression analyses were used to adjust for and examine the role of covariates.

Results
Overall, 2.5% of the study sample, representing 6.0 million adults nationwide, met criteria for current CUD, and 3.7%, representing 8.8 million adults, met the criteria for CUD in remission. Adults with current or past CUD had lower mental HRQOL and QALYs, as compared to adults who never had CUD. However, these differences were no longer significant when adjusted for behavioral co-morbidities and personal histories. Current CUD was associated with lower odds of being employed (Adjusted odds ratio AOR = 0.76; 95% confidence intervals [CI], 0.60–0.96), but CUD in remission with a greater likelihood of employment (Adjusted odds ratio = 1.53; 95% CI, 1.23–1.91), both as compared to those never experiencing CUD.

Conclusions
Both current CUD and past CUD are adversely associated with HRQOL and current CUD with not being employed; Since CUD associations are not independent of comorbidities, treatment must take a wide-ranging approach.
Mitigation of Triceps Avulsion Fracture After Proximal Ulna Plate Fixation
Authors: Orbay Jorge , Vernon Lauren , Gibson Keegan , Lacau Gustavo , Mercer Deana , Hoekzema Nathan 
Published: June 2021

Objectives:
Triceps avulsion fractures have become an increasingly common postoperative complication of olecranon fracture repair with proximal ulna plate (PUP) fixation. The purpose of this study is to create an efficient, reproducible mechanism to mitigate this issue.

Methods:
Ten matched pair cadaveric specimens underwent a complete transverse osteotomy to simulate an olecranon fracture, followed by fracture reduction with a PUP. One arm from each pair underwent an additional augmented suture repair, where the triceps tendon was sutured directly to the plate. A custom jig was used to hold the specimen in position and apply a tensile force on the triceps until mechanical failure.

Results:
All control specimens (without augmented suture repair) failed through a full-thickness triceps avulsion fracture at an average force of 967.7 N. The augmented suture-repaired specimens failed at an average force of 1204.3 N through partial avulsion fractures, widening of the osteotomy site, and triceps ruptures.

Conclusions:
Our study demonstrated that an augmented suture repair of PUP fixation for olecranon fractures is a simple and effective way to significantly increase fixation strength and change the potential failure mechanism.
Clinical Outcomes and Surgical Complications Among Patients with Bleeding Disorders After Acute Hip Fracture Surgery
Authors: Darbandi Aria D. , Saadat Ghulam H. , Butler Bennet A. , Bokhari Faran 
Published: June 2021

Objective:
To compare short-term (≤30 days) outcomes of hip fracture between patients with and without bleeding disorders.

Design:
Retrospective database review.

Setting:
The study setting included hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program database.

Patients:
Patients with acute hip fractures were identified from the National Surgical Quality Improvement Program database between 2016 and 2019.

Intervention:
Open reduction internal fixation or hemiarthroplasty.

Main Outcome Measurements:
Mortality, readmission, reoperation, length of stay, and complication were main outcome measurements.

Results:
There were 63,718 patients undergoing hip surgery, and 16.0% had a bleeding disorder. After adjusting for confounders, multivariable regression models showed that cases with bleeding disorders were associated with higher rates of transfusion [odds ratio (OR) 1.404; confidence interval (CI), 1.335–1.479], myocardial infarction (OR 1.367; CI, 1.190–1.572), pneumonia (OR 1.193; CI, 1.078–1.321), renal failure (OR 1.843; CI, 1.363–2.491), surgical site infections (OR 1.429; CI, 1.185–1.175), sepsis (OR 1.25; CI, 1.034–1.511), and readmission (OR 1.314; CI, 1.224–1.408). However, bleeding disorders were not associated with mortality (OR 0.947; CI, 0.866–1.036) or reoperation (OR 1.061; CI, 0.925–1.220).

Conclusions:
Hip fracture surgery in patients with bleeding disorders is not associated with higher risks of short-term mortality or reoperation. However, special consideration should be taken when calculating preoperative risks of complications among bleeding disorder patients.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Treatment of Posttraumatic Tibial Diaphyseal Bone Defects: A Systematic Review and Meta-Analysis
Authors: Klifto Kevin M. , Azoury Saïd C. , Klifto Christopher S. , Mehta Samir , Levin L. Scott , Kovach Stephen J. 
Published: June 2021

Objective:
To describe evidenced-based treatment options for patients who sustained trauma and/or posttraumatic osteomyelitis of the tibia resulting in diaphyseal bone defects and to compare outcomes between patients treated with nonvascularized bone grafts (NBGs), bone transport (BT), or vascularized bone grafts (VBGs).

Data Source:
The Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data and Cochrane guidelines were followed. PubMed, EMBASE, Cochrane Library, Web of Science, Scopus, and CINAHL were searched from inception to June 2020.

Study Selection:
Patients who were ≥18 years, had sustained trauma to the tibia resulting in fracture and/or osteomyelitis with measurable diaphyseal bone defects, and were treated by interventions such as NBGs, BT, or VBGs were eligible. Excluded studies were non-English, reviews, nonreviewed literature, cadavers, animals, unavailable full texts, nondiaphyseal defects, atrophic nonunions, malignancy, and replantations.

Data Extraction:
A total of 108 studies were included with 826 patients. Two reviewers systematically/independently screened titles/abstracts, followed by full texts to ensure quality, accuracy, and consensus among authors for inclusion/exclusion of studies. A third reviewer addressed disagreements if investigators were unable to reach a consensus. Studies were quality assessed using “Methodological Quality and Synthesis of Case Series and Case Reports”.

Data Synthesis:
Analyses were performed with IBM SPSS version 25.0 (IBM Corporation, Armonk, NY) and G*Power3.1.9.2.

Conclusions:
NBGs may be considered first line for trauma defect sizes ≤ 10 cm or posttraumatic osteomyelitis defect sizes <5 cm. BT may be considered first line for posttraumatic osteomyelitis defect sizes <5 cm. VBGs may be considered first line for trauma and posttraumatic osteomyelitis defect sizes ≥5 cm.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.