bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accelerometer-derived sleep metrics in adolescents reveal shared genetic influences with obesity and stress in a Brazilian birth cohort study
Authors: Carpena Marina Xavier , Sanchez-Luquez Karen , Xavier Mariana Otero , Santos Ina S , Matijasevich Alicia , Wendt Andrea , Crochemore-Silva Inacio , Tovo-Rodrigues Luciana 
Published: October 2024

Abstract
We aimed to test the association between sleep-related polygenic scores (PGSs) and accelerometer-based sleep metrics among Brazilian adolescents and to evaluate potential mechanisms underlying the association through the enrichment of obesity, and cortisol pathway-specific polygenic scores (PRSet). Utilizing data from The 2004 Pelotas (Brazil) Birth Cohort, sleep time window and sleep efficiency were measured at the 11-year-old follow-up using ActiGraph accelerometers. Three sleep PGSs were developed based on the most recent genome-wide association study of accelerometer-based sleep measures. PRSet, calculated using variants linked to body mass index (BMI) and plasmatic cortisol concentration, aimed to assess pleiotropic effects. Linear regression models, adjusted for sex and the first 10 principal components of ancestry, were employed to explore the impact of sleep PGS and specific-PRSet on sleep phenotypes. The number of nocturnal sleep episodes-PGS was positively associated with sleep time window (β = 2.306, SE: 0.92, p = .011). Nocturnal sleep episodes were also associated with sleep time window when restricted to BMI-PRSet (β = 2.682, SE: 0.912, competitive p = .003). Both the number of sleep episodes and sleep time window cortisol-PRSets were associated (β = .002, SE: 0.001, p = .013; β = .003, SE: 0.001, p = .003, respectively) and exhibited enrichment in molecular pathways (competitive p = .011; competitive p = .003, respectively) with sleep efficiency. Sleep polygenetic components observed in European adults may partially explain the accelerometer-based sleep time window in Brazilian adolescents. Specific BMI molecular pathways strengthened the association between sleep PGS and sleep time window, while the cortisol concentration pathway had a significant impact on the genetic liability for sleep efficiency. Our results suggest genetic overlap as a potential etiological pathway for sleep-related comorbidities, emphasizing common genetic mechanisms.
Outcomes of patients with acute liver failure not listed for liver transplantation: A cohort analysis
Authors: Dong Victor , Durkalski Valerie , Lee William M. , Karvellas Constantine J. ,   and the United States Acute Liver Failure Study Group
Published: October 2024

Background:
Acute liver failure (ALF) is a rare condition leading to morbidity and mortality. Liver transplantation (LT) is often required, but patients are not always listed for LT. There is a lack of data regarding outcomes in these patients. Our aim is to describe outcomes of patients with ALF not listed for LT and to compare this with those listed for LT.

Methods:
Retrospective analysis of all nonlisted patients with ALF enrolled in the Acute Liver Failure Study Group (ALFSG) registry between 1998 and 2018. The primary outcome was 21-day mortality. Multivariable logistic regression was done to identify factors associated with 21-day mortality. The comparison was then made with patients with ALF listed for LT.

Results:
A total of 1672 patients with ALF were not listed for LT. The median age was 41 (IQR: 30–54). Three hundred seventy-one (28.9%) patients were too sick to list. The most common etiology was acetaminophen toxicity (54.8%). Five hundred fifty-eight (35.7%) patients died at 21 days. After adjusting for relevant covariates, King’s College Criteria (adjusted odds ratio: 3.17, CI 2.23–4.51), mechanical ventilation (adjusted odds ratio: 1.53, CI: 1.01–2.33), and vasopressors (adjusted odds ratio: 2.10, CI: 1.43–3.08) (p < 0.05 for all) were independently associated with 21-day mortality. Compared to listed patients, nonlisted patients had higher mortality (35.7% vs. 24.3%). Patients deemed not sick enough had greater than 95% survival, while those deemed too sick still had >30% survival.

Conclusions:
Despite no LT, the majority of patients were alive at 21 days. Survival was lower in nonlisted patients. Clinicians are more accurate in deeming patients not sick enough to require LT as opposed to deeming patients too sick to survive.
Referral Pattern and Comanagement of Patients With Keratoconus in West Africa: A Survey-Based Study of Optometrists in Ghana and Nigeria
Authors: Junior Obinwanne Chukwuemeka , Barrah Sharon , Kobia-Acquah Emmanuel , Titiati Perfect Emefa , Karikari Lucy Akua Afriyie , Akowuah Prince 
Published: October 2024

Objectives:
To investigate the referral and management patterns of patients with keratoconus among primary eye care practitioners in Ghana and Nigeria.

Methods:
A questionnaire adapted from previous studies was modified and created using Google Forms. The online survey was distributed to prospective participants using e-mails and other social media platforms. Data were analyzed using the Statistical Product and Service Solutions software (version 25.0; IBM Corp, Armonk, NY; Released 2017).

Results:
One hundred and sixty-nine optometrists responded to the survey (61.54% from Nigeria and 38.46% from Ghana). Most (88.6%) practiced without corneal topographers. Most respondents (77.7%, n=136) reported not fitting rigid gas-permeable (RGP) contact lenses in a year and 68% were willing to refer for contact lens fitting to another practitioner. The major barriers to RGP fitting were lack of experience (44.4%, n=72), cost to practice (15.4%, n=25), and other reasons (12.4%), whereas 27.8% (n=45) preferred not to answer. Seventy-six percent of respondents (n=133) were willing to fit RGPs if the respondents received the training to do so. About half of the respondents (53.8%) reported progression of cornea signs as the reason for referral to an ophthalmologist. Half of the respondents (n=51.4%) did not have a cornea surgeon in the area the respondents practiced, and 76.3% reported not comanaging patients at all with ophthalmologists.

Conclusion:
This study highlights the current standard of care of patients with keratoconus in West Africa. The findings from this study suggest that clinical guidelines and further training of eye care practitioners in West Africa are needed to better manage patients with keratoconus.
Clinical Investigation of Short-Term Axial Elongation Control After Orthokeratology Lens Correction: Exploring Its Predictive Role in Long-Term Therapeutic Efficacy
Authors: Han Xuemei , Li Feifei , Zhang Yu , Tang Jinfei 
Published: October 2024

Objective:
This study was developed with the goal of exploring the efficacy of orthokeratology (OK) as an approach to controlling axial length (AL) growth and identifying factors predictive of the long-term efficacy of this approach.

Methods:
This was a retrospective study that enrolled 157 myopic children 7 to 15 years of age undergoing OK correction for over 3 years. The short- and long-term effectiveness of this approach at 1 and 3 years post-OK correction, respectively, was assessed. All participants were classified into two groups based on whether they exhibited good or poor long-term efficacy outcomes. Measurements of changes in AL were made at baseline and at 1 and 3 years post-OK. Univariate analyses and binary logistic regression approaches were used to evaluate baseline age, baseline spherical equivalent refraction, baseline keratometry (K) values of flat and steep meridians, and short-term effectiveness with the goal of identifying predictors of long-term efficacy.

Results:
Univariate analyses led to the identification of significant differences in baseline age, baseline spherical equivalent refraction, baseline AL, and short-term efficacy between these two groups (P<0.05), whereas gender, baseline flat K, and baseline steep K did not differ significantly (P>0.05). In binary logistic regression analyses, baseline AL (P=0.017) and short-term efficacy (P<0.001) were both found to significantly influence long-term efficacy. Receiver operating characteristic curves demonstrated that short-term efficacy offered an area under the curve value >0.8, consistent with its highly accurate performance as a predictor of long-term efficacy.

Conclusion:
These results suggest that short-term efficacy outcomes can feasibly be used to predict the long-term effectiveness of OK correction in children. In patients exhibiting poor short-term efficacy, timely replacement or the incorporation of additional treatment modalities may aid efforts to better control the progression of myopia.
Reporting outcomes of minimally invasive glaucoma surgery
Authors: Gutkind Naomi E. , Gedde Steven J. 
Published: October 2024

Purpose of review
This review presents guidelines for designing studies and reporting efficacy and safety outcomes in minimally invasive glaucoma surgery (MIGS) research.

Recent findings
Adherence to reporting guidelines in MIGS studies is crucial for providers and patients to appraise surgical options. Recent guidelines have outlined appropriate methodology, efficacy outcomes, and safety reporting, so that study results are presented in an interpretable and uniform manner.

Summary
MIGS are changing the glaucoma treatment paradigm by offering safer, less invasive alternatives to traditional filtering surgery. However, inconsistent reporting of outcomes in MIGS trials hampers comparison and clinical decision-making. Recent guidelines have aimed to highlight appropriate methodology and encourage standardization in reporting outcomes to improve the quality of MIGS literature. Key considerations include defining baseline intraocular pressure, reporting standardized demographic data, using consistent endpoints, presenting standardized figures, evaluating medication use, and documenting adverse events. By adhering to these guidelines, MIGS trials can offer clearer insights into surgical outcomes, aiding both surgeons and patients in treatment decisions.
Spinal hyperexcitability in patients with chronic musculoskeletal pain or headache as evidenced by alterations in the nociceptive withdrawal reflex: a systematic review and meta-analysis
Authors: Van Oosterwijck Sophie , Billens Amber , Cnockaert Elise , Danneels Lieven , Mertens Timoti , Dhondt Evy , Van Oosterwijck Jessica 
Published: October 2024

Abstract
The nociceptive withdrawal reflex (NWR) is a spinal withdrawal reflex induced by painful stimulation. It is a measure of spinal hyperexcitability, which is believed to contribute to chronic musculoskeletal pain (MSKP) and headache. Previous syntheses of the evidence for alterations in the NWR in patients with chronic MSKP and headache needed a comprehensive update. This systematic review and meta-analysis was performed after the Preferred Items for Systematic reviews and Meta-Analyses guidelines. Studies examining NWR-related outcome measures in patients with chronic MSKP and headache compared to pain-free controls were identified through electronic database searches and included after screening against predefined eligibility criteria. Standardized mean differences or mean differences and 95% confidence intervals (CI) were calculated. Thirty-one studies were included in the systematic review and 25 in the meta-analysis. Moderate-quality evidence was found indicating lower NWR threshold (−3.68; 95% CI, −4.56 to −2.80; P < 0.001), larger NWR area (standardized mean difference = 0.69; 95% CI, 0.37-1.01; P < 0.001), and shorter NWR latency (mean difference = −13.68; 95% CI, −22.69, −4.67; P = 0.003) in patients compared to controls. These findings remained robust when performing meta-regressions based on subgroups (ie, headache, fibromyalgia, whiplash-associated disorder, and osteoarthritis). Low-quality evidence demonstrated facilitated temporal summation of NWR threshold (−2.48; 95% CI, −3.13 to −1.83; P < 0.001) in patients compared to controls. Spinal hyperexcitability as evidenced by lowered NWR threshold values and temporal summation of the NWR is present in patients with chronic MSKP and headache. No evidence was found for alterations in NWR duration and NWR magnitude. Future research is needed to address the gap in research on NWR-related outcome measures other than NWR threshold.
Predicting postoperative atrial fibrillation after cardiac surgery using the Naples prognostic score
Authors: Oksen Dogac , Guven Baris , Donmez Ayca , Yesiltas Mehmet Ali , Koyuncu Ahmet Ozan , Gulbudak Seran , Oktay Veysel 
Published: October 2024

Introduction
The Naples prognostic score (NPS) is a novel indicator of nutritional and inflammatory statuses in cancer patients. Development of atrial fibrillation after cardiac surgery (POAF) is a common complication that increases the incidence of adverse events. Numerous studies have investigated predictors of POAF. Yet, this study is the first to evaluate the prognostic value of NPS in predicting the development of POAF.

Materials and methods
The population of this retrospective single-center case–control study consisted of all consecutive patients who underwent cardiac surgery between January 2021 and December 2023. The patients included in the study sample were divided into two groups according to whether they had POAF (group POAF) or remained in sinus rhythm (group RSR). Univariate and multivariate analyses were conducted to identify the variables that significantly predicted the development of POAF.

Results
This study consisted of 860 patients with a mean age of 61.77 ± 9.13 years and 77.5% (n = 667) were male. The incidence of POAF in the sample was 24.8% (n = 214). NPS was significantly higher in group POAF than in group RSR (2.18 ± 0.99 vs. 1.96 ± 1.02, P = 0.008). Multivariate analysis revealed age [odds ratio (OR): 1.242, 95% confidence interval (CI): 1.020–1.304, P < 0.001] and high NPS (OR: 1.698, 95% CI: 1.121–1.930, P < 0.010) as independent predictors of POAF.

Conclusion
High NPS values, along with advanced age, were found to be strongly associated with an increased risk of developing POAF. Therefore, it is concluded that NPS is a significant and independent predictor of POAF in patients undergoing cardiac surgery.
Schizophrenia and magnetic resonance imaging research: A scientometric analysis during 2014 to 2023
Authors: Jin Lu , Jiang Yuchao , Hu Hongxing , Wang Yunling , Fu Songnian , Xu Bin , Sun Xiyao , Gao Shuaishuai , Wang Hongmei , Zhao Cong , Yang Ruixue , Zhao Wei , Yi Qizhong 
Published: October 2024

Background:
Recently, magnetic resonance imaging (MRI) has emerged as a leading technique for investigating schizophrenia (SZ) pathological mechanisms, prompting an increase in related studies. This study aims to examine the field’s research status and trends via bibliometric analysis.

Method:
The publications on SZ and MRI over the past decade were retrieved from the Web of Science Core Collection (WOSCC) On October 15, 2023. CiteSpace and VOSviewer were used to conduct scientometric and visualized analysis, covering countries, institutions, authors, journals, co-cited literature, and keywords.

Results:
A total of 4840 publications were retrieved from 2014 to 2023. The United States leads with 1863 articles, followed by China with 1127 articles. King’s College London had the highest number of publications, with 332 articles. Schizophrenia Research ranks first in the journal that published the research on schizophrenia and MRI, the most published journal, Neuroimage is the most cited journal. Calhoun is the most prolific author with 145 articles, and Fischl is the most cited author, receiving 1188 citations. The literature co-citation network (2014 to 2023) revealed 16 clusters with robust structure (Q = 0.8719) and high confidence (S = 0.9421) involving MRI studies of SZ, genetic imaging and treatment of schizophrenia. Keywords include MRI, psychosis and functional magnetic resonance imaging (fMRI), MRI and neuroimaging, MRI and neuroimaging and white matter and diffusion tensor imaging.

Conclusion:
This study offers an overview of the research status and trends of publications on SZ and MRI, aiming to inspire future research directions.
Fatal invasive Aspergillus infection in an elderly patient with hepatitis E: A case report and literature review
Authors: Wu Junjun , Yu Jin , Li Huaming , Wang Yufang , Xu Rong 
Published: October 2024

Rationale:
Elderly patients with acute liver failure are highly susceptible to severe complications, such as invasive fungal infections, due to weakened immune systems and altered gut microbiota. A thorough understanding of liver failure and opportunistic infections is crucial for effective management.

Patient concerns:
An 84-year-old male with acute liver failure from hepatitis E experienced worsening jaundice despite standard treatments. He also developed respiratory symptoms, including blood-streaked sputum, raising concerns about a potential fungal infection.

Diagnoses:
The patient was diagnosed with acute liver failure secondary to hepatitis E and an invasive fungal infection caused by Aspergillus fumigatus. Initial treatments included artificial liver plasma exchange and antifungal prophylaxis. Further diagnostics, including bronchoscopy and next-generation sequencing of alveolar lavage fluid, confirmed the Aspergillus infection.

Lessons:
Elderly liver failure patients are particularly prone to opportunistic infections, underscoring the need for vigilant monitoring and early intervention. Despite aggressive treatments, including antifungal therapy and artificial liver support, prognosis remains poor, highlighting the importance of prompt diagnosis and comprehensive management to enhance patient outcomes.
Clinical management and complications of acute appendicitis in 3 children with SARS-CoV-2 infection: Case report
Authors: Filip Florin , Terteliu-Baitan Monica , Avramia Ramona , Filip Roxana , Cocuz Maria Elena 
Published: October 2024

Rationale:
Sporadic cases of acute appendicitis (AA) in children with SARS-CoV-2 infection were still recorded at the end of COVID-19 pandemics. We consider that analyses of clinical courses and outcomes is useful to improve the clinical management of such cases in the setting of a general hospital.

Patient concerns:
Patient #1 was a 14-year-old girl who presented with nausea, right lower quadrant (RLQ) pain, myalgia, ad low-grade fever for 24 hours. Patient #2 was a 7-year-old boy with a 3-day history of abdominal pain, nausea and vomiting, and fever lasting for 4 days. Patient # 3 was a 16-year-old girl RLQ pain, nausea and vomiting, and fever lasting for 7 days.

Diagnoses:
The patients were diagnosed with acute appendicitis (AA) based on the clinical picture, labs and abdominal ultrasound (US) findings. SARS-CoV- 2 infection was diagnosed using rapid antigen test performed at admission.

Interventions:
The patients were started on i.v. Ceftriaxone and Metronidazole, antalgics and i.v. fluids at admission. Appendectomy was performed the day after admission in patients # 1 and #2, and after 48 hours in patient #3.

Outcomes:
Patient #1 had no complications and was discharged on postoperative day (POD) #5. Patient #2 developed a cecal fistula on POD #4 which was treated conservatively with Ertapenem, i.v. fluids, and local placement of colostomy bag. The fistula closed spontaneously on POD #12. He was discharged on POD #17. Patient #3 developed a postoperative abscess on POD # 6 and required laparoscopic surgical drainage of the abscess. She was discharged after another 6 days (POD #12). No patient required ICU admission, steroids, or supplemental O2 use during their hospitalization. There were no late complications or readmissions in these patients.

Lessons:
We consider that AA in these SARS-CoV-2 positive children had a similar course with SARS-CoV-2 negative cases. Compliance to previously established COVID-19 protocols was useful to improve the outcome. The parents should bring the sick child early to the hospital in order to avoid complications related to delayed presentation and not to SARS-CoV-2 infection itself.
Infraclavicular versus supraclavicular nerve block for upper limb surgeries: A meta-analysis
Authors: Zhang Guorong , Hou Xiaosai , Wang Haonan , Han Chaoqian , Fan Dongsheng 
Published: October 2024

Background:
The impact of infraclavicular versus supraclavicular nerve block on the analgesia for upper limb surgeries is unclear. This meta-analysis and systematic review aims to study the analgesic efficacy of infraclavicular versus supraclavicular nerve block for upper limb surgeries.

Methods:
We searched several databases including PubMed, EMbase, Web of science, EBSCO and Cochrane library databases from inception to December 2023, and randomized controlled trials (RCTs) assessing the effect of infraclavicular versus supraclavicular nerve block for upper limb surgeries were included. We excluded studies reporting other nerve block approaches. The methodological quality of the included studies was evaluated by the modified Jadad scale. Standard mean difference with 95% confidence interval (CI) was used to assess continuous outcomes. This meta-analysis was conducted by the fixed-effect model or random-effect model based on the heterogeneity.

Results:
Eight RCTs and 725 patients were included in this meta-analysis. Compared with supraclavicular nerve block for upper limb surgeries, infraclavicular nerve block was able to significantly increase duration of motor block (SMD = 0.34; 95% CI = 0.12 to 0.56) and decrease readiness for surgery (SMD = −0.43; 95% CI = −0.77 to −0.10), but showed similar duration of sensory block (SMD = 0.17; 95% CI = −0.05 to 0.39), block performance time (SMD = −0.14; 95% CI = −0.51 to 0.22), onset of sensory blockade (SMD = −0.13; 95% CI = −0.59 to 0.33) and onset of motor blockade (SMD = −0.17; 95% CI = −0.26 to 0.12). No high heterogeneity was seen among the included studies.

Conclusion:
Infraclavicular nerve block may be superior to control the analgesia for upper limb surgeries than supraclavicular nerve block.
Delayed diagnosis of cholangiocarcinoma presenting with shoulder pain: A case report
Authors: Kim Jaesuk , Park Seongjin , Kwon So Young 
Published: October 2024

Rationale:
Shoulder pain is a common type of musculoskeletal pain. While musculoskeletal issues are primary causes of shoulder pain, it is important to note that referred pain in the shoulder area can also originate from non-musculoskeletal problems.

Patient concerns:
A 60-year-old male presented with a month-long stabbing pain in the right shoulder that was worsened by deep breathing. He had no trauma history or neurological symptoms. He also experienced a 5 kg weight loss over 3 months. Physical examination was normal. Shoulder X-ray suggested degenerative arthritis. Despite medication including opioids, his pain persisted and worsened to a 10/10 severity, spreading to the right flank and anterior chest.

Diagnosis:
An abdominal CT scan revealed multiple hepatic nodules, ascites, and right pleural effusion, suggesting a systemic condition.

Interventions:
This prompted immediate referral to oncology, where subsequent investigations confirmed the diagnosis of intrahepatic cholangiocarcinoma.

Outcomes:
The patient deteriorated and passed away during the buildup phase for cancer treatment.

Lessons:
This case underscores the importance of considering systemic conditions in patients presenting with seemingly localized symptoms such as shoulder pain. It highlights the significance of thorough evaluation and prompt referral for further investigations when necessary.