bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Naltrexone Effective and Safe for Treating Amphetamine-Type Stimulant Use Disorder? A Systematic Review and Meta-analysis
Authors: Bastien Gabriel , McAnulty Christina , Sharafi Heidar , Mahroug Amani , Elkrief Laurent , Ziegler Daniela , Dubreucq Simon , Juteau Louis-Christophe , Jutras-Aswad Didier 
Published: November 2024

Objectives
We conducted a systematic review and meta-analysis (PROSPERO ID: CRD42023401796) of randomized placebo-controlled trials evaluating the effectiveness and safety of naltrexone as a standalone pharmacotherapy for amphetamine-type stimulant use disorder (ATSUD).

Methods
We searched EMBASE, MEDLINE, EBM Reviews, PsycINFO, CINAHL, Google Scholar, and trial registries on April 11, 2023, and updated on September 24, 2024, to identify randomized placebo-controlled trials evaluating the effectiveness of naltrexone for the treatment of ATSUD. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed for reporting the study. Risk of bias and quality of evidence were assessed with the Cochrane Risk-of-bias Assessment tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Risk ratios (RRs) or Peto odds ratio were estimated for binary outcomes as appropriate. Standardized mean differences were calculated for continuous outcomes.

Results
Five studies (n = 419 participants) were eligible. We found no significant difference between naltrexone and placebo for amphetamine-type stimulant use (RR = 0.903, 95% confidence interval [CI] = 0.698 to 1.167, P = 0.44, I
2 = 96.1%; 4 studies), study retention (RR = 1.055, 95% CI = 0.942 to 1.182, P = 0.35, I
2 = 45.0%; 4 studies), end-of-treatment craving (standardized mean difference = 0.069, 95% CI = −0.272 to 0.410, P = 0.69, I
2 = 0.0%; 2 studies), and serious adverse events (odds ratio = 1.086, 95% CI = 0.414 to 2.849, P = 0.87, I
2 = 0.0%; 3 studies). The quality of evidence was low to very low.

Conclusions
The available evidence does not support the use of standalone naltrexone to treat ATSUD. Significant research efforts must be put toward to identify effective pharmacotherapies to complement psychosocial interventions for ATSUD.
Robotic Versus Laparoscopic Liver Resection: A Nationwide Propensity Score Matched Analysis
Authors: Pilz da Cunha Gabriela , Sijberden Jasper P. , van Dieren Susan , Gobardhan Paul , Lips Daan J. , Terkivatan Türkan , Marsman Hendrik A. , Patijn Gijs A. , Leclercq Wouter K. G. , Bosscha Koop , Mieog J. Sven D. , van den Boezem Peter B. , Vermaas Maarten , Kok Niels F. M. , Belt Eric J. T. , de Boer Marieke T. , Derksen Wouter J. M. , Torrenga Hans , Verheijen Paul M. , Oosterling Steven J. , Rijken Arjen M. , Coolsen Marielle M. E. , Liem Mike S. L. , Tran T.C. Khé , Gerhards Michael F. , Nieuwenhuijs Vincent , Abu Hilal Mohammad , Besselink Marc G. , van Dam Ronald M. , Hagendoorn Jeroen , Swijnenburg Rutger-Jan ,   for the Dutch Hepatobiliary Audit Group
Published: November 2024

Objective:
To compare nationwide outcomes of robotic liver resection (RLR) with laparoscopic liver resection (LLR).

Background:
Minimally invasive liver resection is increasingly performed using the robotic approach as this could help overcome inherent technical limitations of laparoscopy. It is unknown if this translates to improved patient outcomes.

Methods:
Data from the mandatory Dutch Hepatobiliary Audit were used to compare perioperative outcomes of RLR and LLR in 20 centers in the Netherlands (2014–2022). Propensity score matching (PSM) was used to mitigate selection bias. Sensitivity analyses assessed the impact of the learning curve (≥50 procedures for LLR and ≥25 procedures for RLR), concurrent noncholecystectomy operations, high-volume centers, and conversion on outcomes.

Results:
Overall, 792 RLR and 2738 LLR were included. After PSM (781 RLR vs 781 LLR), RLR was associated with less blood loss (median: 100 mL [interquartile range (IQR): 50–300] vs 200 mL [IQR: 50–500], P = 0.002), less major blood loss (≥500 mL,18.6% vs 25.2%, P = 0.011), less conversions (4.9% vs 12.8%, P < 0.001), and shorter hospital stay (median: 3 days [IQR: 2–5] vs 4 days [IQR: 2–6], P < 0.001), compared with LLR. There were no significant differences in overall and severe morbidity, readmissions, mortality, and R0 resection rate. Sensitivity analyses yielded similar results. When excluding conversions, RLR was only associated with a reduction in reoperations (1.1% vs 2.7%, P = 0.038).

Conclusion:
In this nationwide analysis, RLR was associated with a reduction in conversion, blood loss and length of hospital stay without compromising patient safety, also when excluding a learning curve effect. The benefits of RLR seem to be mostly related to a reduction in conversions.
Knowledge Graph of Endoscopic Techniques Applied to the Treatment of Lumbar Disc Herniation
Authors: Zhao Jinlong , Zeng Lingfeng , Wei Wanjia , Liang Guihong , Yang Weiyi , Fu Haoyang , Zeng Yuping , Liu Jun , Zhao Shuai 
Published: November 2024

Study Design:
Bibliometric analysis.

Objective:
This study explored the current research status, hotspots, and trends in the application of endoscopic techniques for treating lumbar disc herniation (LDH).

Background:
Endoscopic techniques are widely used to treat LDH, but there are no bibliometric studies on endoscopic technology and LDH.

Methods:
The Web of Science Core Collection database was used as the data source. Based on the principles of bibliometrics, we apply VOSviewer and CiteSpace software to conduct the data statistics and visual analysis.

Results:
A total of 965 studies were included, with 11893 citations (12.32 per study). The top 3 countries with the largest number of papers published are China (529), South Korea (164), and the United States (108). Yong Ahn and Jin-Sung Kim are prolific authors in this field. Representative academic journals are World Neuroscience, Pain Physician, and BioMed Research International. The results of keyword cooccurrence analysis indicate that the research topics in this field in the past decade have mainly focused on microdiscectomy, complications, percutaneous endoscopic lumbar discectomy, decompression, and the learning curve. Keyword burst analysis suggested that endoscopic drug injection and the identification of risk factors for LDH are the frontiers and trends for future research.

Conclusion:
The application of endoscopic techniques for LDH has received widespread attention from researchers, and research in this field has focused on percutaneous endoscopic lumbar discectomy, endoscopic decompression, complications, and the learning curve of endoscopic techniques. Future research trends will focus on the efficacy of endoscopic drug injection therapy for LDH and the identification of risk factors for LDH treatment failure.
Previous Hip or Knee Arthroplasty is Associated With Less Favorable Patient-reported Outcomes of Lumbar Surgery
Authors: Duculan Roland , Mancuso Carol A. , Hambrecht Jan , Cammisa Frank P. , Sama Andrew A. , Hughes Alexander P. , Lebl Darren R. , Girardi Federico P. 
Published: November 2024

Study Design:
Review of cohort studies.

Objective:
To ascertain if previous hip (THA) or knee (TKA) arthroplasty was associated with patients’ outcomes assessments of subsequent lumbar surgery, specifically overall satisfaction, less disability due to pain, and an affective appraisal reflecting emotional assessment of results.

Background:
Hip, knee, and lumbar symptoms often co-exist and increasingly are managed with surgery. Whether previous total joint arthroplasty (TJA) impacts patients’ perspectives of results of subsequent lumbar surgery is not known.

Methods:
Identical and systematically acquired preoperative and postoperative data from 3 studies assessing psychosocial characteristics and outcomes of lumbar surgery were pooled. Data obtained during interviews included preoperative demographic and clinical variables and 2-year postoperative global overall assessment (very satisfied/satisfied, neither, dissatisfied/very dissatisfied) and global affective assessment (delighted/pleased, mostly satisfied/mixed/mostly dissatisfied, unhappy/terrible). Patients completed the ODI and preoperative to postoperative change was analyzed according to an MCID (15 points). At 2 years patients also reported any untoward events since surgery (ie, fracture, infection, or repeat lumbar surgery). Associations with outcomes were assessed with multivariable logistic ordinal regression controlling for untoward events. Type of arthroplasty was evaluated in subanalyses.

Results:
Among 1227 patients (mean: 59 y, 50% women), 12% had arthroplasty (+TJA) and 88% did not (-TJA). In multivariable analysis, +TJA was associated with less global satisfaction (OR: 1.9, CI: 1.3–2.7, P=0.0007), worse global affective assessment (OR: 1.6, CI: 1.1–2.2, P=0.009), and not meeting MCID15 (OR: 1.5, CI: 1.0–2.3, P=0.05). Covariables associated with less favorable outcomes were not working, positive depression screen, and prior lumbar surgery. Compared with -TJA, patients with THA had worse affective assessments and patients with TKA had less satisfaction and were less likely to meet MCID15.

Conclusions:
Previous hip or knee arthroplasty was associated with less favorable patient-reported outcomes of lumbar surgery. Surgeons and patients should discuss differences between procedures preoperatively and during shared postoperative outcome assessment.

Level of Evidence:
Level II.
Addressing Cross-Specialty Clinical Genetics Education Needs
Authors: Lindquist Karla J. , Ryan Matthew J. , Scheuner Maren T. , Tamraz Bani , Flowers Elena , Harris-Wai Julie , Biswas Sawona , Hyland Katherine 
Published: November 2024

Introduction:
Advances in genomics are transforming clinical practice, but there are too few genetics professionals to meet increasing demand. Moreover, many nongeneticist clinicians feel unprepared to incorporate genetics into practice. This study assessed clinicians' unmet genomics educational needs at a single academic institution.

Methods:
Qualitative interviews with Department and Division leaders informed a survey distributed to all clinicians at the institution. Survey questions focused on current practices, confidence, and desired educational resources around genetics and genomics. Data were analyzed using descriptive statistics and Fisher exact tests. Results were shared with an expert panel of Genetics-Genomics Champions to help meet educational needs across specialties.

Results:
Of the 215 survey respondents, 72% were faculty, 24% were trainees, and 4% were clinical staff, representing 18 departments. Less than half felt confident using genetics in the clinic. About 81% desired more training, which did not differ by role (P = .27) or department (P = .98). The Genetics-Genomics Champions proposed delivering just-in-time content via e-consults, online materials, and departmental meetings.

Discussion:
This study highlights clinicians' need and desire for more genetics training. It also underscores the importance of consulting genetics-savvy clinicians to identify challenges and solutions for addressing cross-specialty genetics education needs.
Using Theory and Technology to Build an Interprofessional Community of Human Trafficking Educators
Authors: Farrell Susan E. , Bosson Rahel , Stoklosa Hanni M. 
Published: November 2024

Introduction:
Human trafficking, a global health crisis, requires interprofessional responses. Skilled teachers are needed to train health care providers about human trafficking.

Methods:
To promote nonhierarchical interprofessional collaborative learning, we applied social cognitive and experiential learning theories within a dialectical constructivist program design to scaffold participants' knowledge and leveraged technology to build and sustain the program's community. WhatsApp and Flipgrid connected participants and faculty prior to the program. Participants' reflections on experiences were used to inform confidential and respectful information sharing. Live case presentations were interwoven with prerecorded didactics, Zoom break-out case analyses, and Q&A sessions with trafficking survivors. Participants used learning theories to cocreate and teach about labor and sex trafficking, disclosure, and the law. A reciprocal teaching activity facilitated participants' integration of new knowledge with authentic work responsibilities. Constructive peer feedback on the content, clarity, and engagement of their teaching reinforced participants' self-efficacy in expanding their education work in their home organizations.

Results:
As of 2021, 156 physicians, nurses, social workers, advanced practice providers, psychologists, and public health workers, from the United States, United Kingdom, Canada, and Trinidad/Tobago, have graduated from the program. Three-month postprogram surveys indicated lasting knowledge and skills changes in use of the Stop, Observe, Ask, Refer framework, teaching with adult learning principles, and creating organizational trafficking protocols.

Conclusion:
The strategic application of learning theory and technology has enabled us to foster a nonhierarchical community of interprofessional learners, cultivating a dynamic network of educators who continue to make international impacts on people with an experience of human trafficking.
Advanced Approaches to Generating High-validity Real-world Evidence in Asthma
Authors: Kilpatrick Karynsa , Cahill Katherine , Chandran Urmila , Riskin Daniel 
Published: November 2024

Background:
Asthma is a phenotypically complex disease requiring nuanced data to generate clinically and scientifically robust real-world evidence. A quantitative measure of data quality is important for variables key to the research questions at hand. Using electronic health record (EHR) data, this study compared accuracy for asthma features between traditional real-world evidence approaches using structured data and advanced approaches applying artificial intelligence technologies to unstructured clinical data.

Methods:
We extracted 18 protocol-defined features from 6037 healthcare encounters among 3481 patients. Features included asthma severity subtypes, comorbidities, symptoms, findings, and procedures. We created a manual reference standard through chart abstraction, with two annotators reviewing each record. We assessed interrater reliability using Cohen’s kappa score and accuracy against the reference standard as an F1-score.

Results:
In the traditional study arm, average recall was 40.8%, precision 72.5%, and F1-score across features was 52.2%. In the advanced study arm, average recall was 95.7%, precision 93.8%, and F1-score was 94.7%. There was an absolute increase of 42.5% and a relative increase of 81.4% in the F1-score between traditional and advanced approaches. Cohen’s kappa score indicated 0.80 inter-rater reliability, reflecting a credible reference standard.

Conclusions:
Use of advanced approaches can enable high-quality real-world data sets in asthma, including granular clinical features such as disease subtypes and symptomatic outcomes. Data quality can be measured and, when high, can support generation of high-validity real-world evidence using routinely collected healthcare data.
Parameterization of Beta Distributions for Bias Parameters of Binary Exposure Misclassification in Probabilistic Bias Analysis
Authors: Zhang Qi , MacLehose Richard F. , Collin Lindsay J. , Ahern Thomas P. , Lash Timothy L. 
Published: November 2024

Background:
To account for misclassification of dichotomous variables using probabilistic bias analysis, beta distributions are often assigned to bias parameters (e.g., positive and negative predictive values) based on data from an internal validation substudy. Due to the small sample size of validation substudies, zero-cell frequencies can occur. In these scenarios, it may be helpful to assign prior distributions or apply continuity corrections to the predictive value estimates.

Methods:
We simulated cohort studies of varying sizes, with a binary exposure and outcome and a true risk ratio (RR) = 2.0, as well as internal validation substudies, to account for exposure misclassification. We conducted bias adjustment under five approaches assigning prior distributions to the positive and negative predictive value parameters: (1) conventional method (i.e., no prior), (2) uniform prior beta (α = 1, β = 1), (3) Jeffreys prior beta (α = 0.5, β = 0.5), (4) using Jeffreys prior as a continuity correction only when zero cells occurred, and (5) using the uniform prior as a continuity correction only when zero cells occurred. We evaluated performance by measuring coverage probability, bias, and mean squared error.

Results:
For sparse validation data, methods (2)–(5) all had better coverage and lower mean squared error than the conventional method, with the uniform prior (2) yielding the best performance. However, little difference between methods was observed when the validation substudy did not contain zero cells.

Conclusion:
If sparse data are expected in a validation substudy, using a uniform prior for the beta distribution of bias parameters can improve the validity of bias-adjusted measures.
Association of oxidative balance score with blood pressure, all-cause and cardiovascular disease mortality among hypertensive patients: a prospective study
Authors: Yuan Menghan , Zhang Yingyue , Zuo Nina , Lei Haoying , Zhao Xuming , Xu Yong 
Published: November 2024

Objective:
The oxidative balance score (OBS) has emerged as a novel marker for assessing oxidative stress status. This study aimed to investigate the association of OBS with systolic blood pressure (SBP), diastolic blood pressure (DBP), all-cause, and cardiovascular disease mortality in hypertensive patients.

Methods:
We conducted an analysis of data from 7602 hypertensive patients from the National Health and Nutrition Examination Survey (NHANES) 2005–2018. Multiple linear regression, Cox proportional hazards models, Kaplan–Meier survival curves, restricted cubic spline, and subgroup analysis were used to examine the association between OBS and SBP, DBP, estimated pulse wave velocity (ePWV), and mortality risk.

Results:
The results showed that individuals in the highest OBS quartile (27 ≤ OBS ≤ 40) had a significant 2.41 mmHg reduction in SBP compared to the lowest quartile (5 ≤ OBS ≤ 15) (P
trend < 0.001). Compared to the lowest quartile, individuals in the highest OBS quartile had a 29% lower risk of all-cause mortality and a 44% lower risk of cardiovascular disease mortality (P
trend < 0.001). This inverse association persisted irrespective of antihypertensive medication use. OBS is inversely associated with SBP, all-cause, and cardiovascular disease mortality in hypertensive patients.

Conclusion:
This finding provides new evidence and suggestions for those with poor blood pressure control and low OBS (<15) to adjust their diet and lifestyle reasonably.
The Effect of Latanoprostene Bunod 0.024% on Optical Coherence Tomography Angiography in Newly Diagnosed Open Angle Glaucoma
Authors: Özer Ömer , Baysal Zeki , Yildirim Biçer Gamze , Doğan Levent 
Published: November 2024

Précis:
Treatment with LBN ophthalmic solution 0.024% reduced IOP by an average of 29.9% and 31.8% in patients with POAG and PXG, respectively, and improved VD in different quadrants in all slabs. Therefore, the importance of LBN in the treatment of glaucoma is likely to be that it increases macular microcirculation, possibly through NO, independent of its IOP-reducing effect.

Purpose:
The aim of this study was to investigate the effect of topical latanoprostene bunod 0.024% applied once daily on intraocular pressure and macular vessel density in newly diagnosed primary and pseudoexfoliative open angle glaucoma patients.

Methods:
A total of 66 patients with newly diagnosed open angle glaucoma were included in this study (group 1). Thirty-four patients had primary (POAG, group 1A) and 32 patients had secondary (pseudoexfoliative glaucoma, PXG, group 1B) open angle glaucoma. Thirty-two healthy participants (group 2) were included in this single-center, prospective study.

Results:
In group 1, the mean IOP decrease in first month of treatment with LBN was 7.7 mm Hg and IOP change was -30.8%. In the superficial slab, the vessel density (VD) in the superior and nasal quadrants was lower in group 1B compared with group 1A in the first month of treatment (P=0.038, 0.019, respectively). In the choriocapillaris slab, the VD in the superior quadrant at baseline (before treatment) was statistically lower in both groups compared with the VD in the superior quadrant in the first month of treatment (P<0.001, for both).

Conclusion:
In conclusion, treatment with LBN ophthalmic solution 0.024% reduced IOP by an average of 29.9% and 31.8% in patients with POAG and PXG, respectively, and improved VD in different quadrants in all slabs. Therefore, the importance of LBN in the treatment of glaucoma is likely to be that it increases macular microcirculation, possibly through NO, independent of its IOP-reducing effect.
The local molecular signature of human peripheral neuropathic pain
Authors: Sandy-Hindmarch Oliver P. , Chang Pao-Sheng , Scheuren Paulina S. , De Schoenmacker Iara , Hubli Michèle , Loizou Constantinos , Wirth Stephan , Mahadevan Devendra , Wiberg Akira , Furniss Dominic , Calvo Margarita , Bennett David L.H. , Denk Franziska , Baskozos Georgios , Schmid Annina B. 
Published: November 2024

Abstract
Focal nerve injuries are often associated with neuropathic pain. Preclinical research suggests altered neuroimmune signalling underlies such neuropathic pain; however, its cause remains poorly understood in humans. In this multicentre cohort study, we describe the local cellular and molecular signature of neuropathic pain at the lesion site, using Morton's neuroma as a human model system of neuropathic pain (n = 22; 18 women) compared with nerves from participants without nerve injury (n = 11; 4 women). Immunofluorescent staining revealed demyelination and chronic infiltration of immune cells in Morton's neuroma. RNA bulk sequencing identified 3349 differentially expressed genes between Morton's neuroma and controls. Gene ontology enrichment analysis and weighted gene co-expression network analyses revealed modules specific for host defence and neurogenesis. Deconvolution analysis confirmed higher densities of macrophages and B cells in Morton's neuroma than control samples. Modules associated with defence response, neurogenesis, and muscle system development as well as macrophage cell populations identified by deconvolution correlated with patients' paroxysmal or evoked pain. Of note, we identified a consistently differentially expressed gene signature (MARCO, CD163, STAB1), indicating the presence of a specific M(GC) subset of macrophages. MARCO gene expression correlated with paroxysmal pain. Targeted immunofluorescent analyses confirmed higher densities of intraneural CD163+MARCO+ macrophage subsets in Morton's neuroma. Our findings provide detailed insight into the local molecular signature in the context of human focal nerve injury. There is clear evidence for an ongoing role of the immune system in chronic peripheral neuropathic pain in humans, with macrophages and specifically the M(GC) MARCO+ subset implicated.