bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eating Behaviors Associated With Suicidal Behaviors and Overall Risk
Authors: Sutphin Terran M.S. , Hicks Adam D. , McCord David 
Published: October 2024

Objective:
Maladaptive eating behaviors remain prevalent in the US population, and a significant percentage of US college students acknowledge engaging in maladaptive eating. Formally defined eating disorders (EDs) have one of the highest mortality rates among all mental illnesses. Suicide risk is substantially elevated among individuals diagnosed with EDs, and even subclinical levels of maladaptive eating behaviors are associated with suicidality. The current study examined associations between specific problematic eating behaviors measured dimensionally (eg, purging, binging, laxative use) and specific suicide-related constructs and behaviors as well as overall suicide risk.

Methods:
College students (N=188; 62% women) completed the Eating Disorder Examination-Questionnaire, a well-established measure of dysfunctional eating, as well as several self-report measures of theoretical components of suicidality, and, finally, a semistructured clinical interview to specify suicide risk category.

Results:
Results showed a general pattern of moderate and strong associations between the subscales and the overall score of the Eating Disorder Examination-Questionnaire and core suicide constructs of the interpersonal-psychological theory of suicide. Many substantive correlations were found between specific eating behaviors and specific suicide-related behaviors; for example, purging was the highest correlate of overall suicide risk (ρ=0.36).

Discussion:
These results are discussed in terms of consistency with the interpersonal-psychological theory of suicide as well as practical implications for intervention.
The Financial Impact of a Co-Surgeon in Breast Microsurgery
Authors: DeVito Robert G. , Ke Benjamin G. , Park Rachel H. , Hollenbeck Scott T. , Campbell Chris A. , Stranix John T. 
Published: October 2024

Introduction:
Co-surgeon approaches for autologous breast reconstruction have demonstrated improvements in operative efficiency. The health system financial impact, however, warrants further investigation.

Methods:
Retrospective review of consecutive autologous reconstructions between 2017-2022. Primary outcome measures: length of stay (LOS), operative time, and financial metrics. Cases were stratified by co-surgeon presence, timing, and laterality.

Results:
264 cases met inclusion criteria; there were 117 co-surgeon and 147 single surgeon cases. Co-surgeon cases demonstrated decreased LOS (2.4 vs. 3.1 days; p < 0.01), decreased operative time in unilateral (269 vs. 370 minutes; p < 0.01) and bilateral cases (399 vs. 582 minutes; p < 0.01). Co-surgeon cases were also associated with decreased total cost ($25,160 vs. $31,758; p < 0.01), direct cost ($15,558 vs. $19,283; p < 0.01), indirect cost ($9,602 vs. $12,475; p < 0.01), decreased total charges ($98,728 vs. $120,981; p < 0.01), and increased margin ($1,099 vs. -$6,255; p < 0.01). Post hoc analysis revealed significant differences, albeit at varying magnitudes, in these particular metrics across all levels of reconstruction timing with the inclusion of a co-surgeon.

Conclusion:
Co-surgeon breast microsurgery not only improves operative efficiency, but also translates to improved financial metrics. As we transition to value-based care models, this is particularly relevant to health systems offering microsurgical breast reconstruction. Analyses of downstream benefits including optimized patient throughput and surgeon opportunity cost warrant investigation.
“Metabolic Bridge Therapy Prior to Microvascular Breast Reconstruction in the Morbidly Obese: A Proof-of-Concept Risk Analysis”
Authors: Hammond Jacob B. , Tillotson McKinna , Yoon YooJin , Meza Monge Kenneth , Esch Elena M. , Madura James A. , Pratap Akshay , Winocour Julian , Mathes David W. , Kaoutzanis Christodoulos 
Published: October 2024

Background:
Obese patients experience more complications after autologous breast reconstruction. This study evaluates how bariatric surgery modulates risk of complications in the setting of microvascular breast reconstruction.

Methods:
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) databases were queried for patients with body mass index (BMI) ≥35 kg/m2 undergoing bariatric surgery from 2017-2022. Outcomes included BMI and obesity-related comorbidities before and 1 year after bariatric surgery. Paired Breast Reconstruction Risk Assessment (BRA) scores were analyzed to evaluate risk modulation before and after bariatric surgery in the setting of microvascular breast reconstruction.

Results:
A total of 1,026 patients were included with an average age of 47 and BMI of 44.7 kg/m2. Comorbidities included hypertension (601, 59%), type 2 diabetes (291, 28%), and cardiovascular disease (10, 1%). One-year outcomes after bariatric surgery included an average BMI of 32.7 kg/m2, with remission of type 2 diabetes in 29% of patients. Paired BRA risk analysis for microvascular breast reconstruction before and after bariatric surgery showed reduction in 30-day surgical complications (40.4% vs. 24.8%, P<0.0001), with an absolute risk reduction (ARR) of 15%, relative risk reduction (RRR) of 36%, and a number needed to treat (NNT) of 7. Each 1 kg/m2 reduction in preoperative BMI was associated with a 3.4% reduction in surgical complications (P<0.0001).

Conclusions:
There is potential efficacy for metabolic bridge therapy in reducing complications for obese patients undergoing microvascular breast reconstruction.
The Statistical Fragility of Outcomes on Breast Reconstruction with Acellular Dermal Matrix: A Systematic Review of Randomized Controlled Trials
Authors: Wang Anya , Kim Esther , Kwon Daniel , Coleman-Belin Janet , Oleru Olachi , Seyidova Nargiz , Taub Peter J 
Published: October 2024

Introduction:
Acellular dermal matrix (ADM) is pivotal in breast surgery, yet the statistical robustness of surgical outcomes remains underexplored. This study employs the fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ) to investigate the statistical fragility of ADM breast reconstruction outcomes.

Methods:
Randomized controlled trials (RCTs) (2013-present) with dichotomous outcomes were sourced from PubMed, Embase, SCOPUS, Medline, and Cochrane databases. FI and rFI–event reversals needed to alter outcome significance–and FQ–standardized fragility across trials–were computed and reported as median (IQR). Subgroup analysis focused on intervention types.

Results:
Out of 33 studies screened, 19 RCTs comprising 204 outcomes were included, with a median FI of 4 (3 - 5) and FQ of 0.039 (0.029 - 0.070). Twenty-six outcomes achieved statistical significance, with a median FI of 3.5 (1 - 5) and FQ of 0.033 (0.010 - 0.073). The remaining 178 outcomes were nonsignificant, exhibiting a median FI of 4 (3 - 5) and FQ of 0.040 (0.030 - 0.070). Of the 204 outcomes, 18% had a number of patients lost to follow up equal to or surpassing the FI. By intervention type, the median FIs were similar in value but remained low.

Conclusion:
ADM-related breast reconstruction outcomes are statistically fragile, so reversal of a few outcomes or maintaining follow-up with patients may alter the significance of findings. Future researchers are thus recommended to report FI and FQ metrics with P-values to accurately portray reconstructive surgery outcomes.
Superior Identification of Metastatic Lesions by 68Ga-FAPI-46 PET/CT Than 18F-FDG PET/CT in Hepatic Solitary Fibrous Tumor
Authors: Fu Kaili , Zhao Liang , Cai Jiayu , Yu Lingyu , Chen Haojun 
Published: October 2024

Abstract
Solitary fibrous tumors (SFTs) are fibroblast tumors that occur mainly in the pleura. Hepatic SFT with skeleton metastases was rarely documented. In this case, we report the contrast-enhanced CT, 18F-FDG, and 68Ga-FAPI-46 PET/CT findings of a rare hepatic SFT with bone metastases. 68Ga-FAPI-46 PET/CT showed much higher tumor-to-background contrast of hepatic tumors and revealed more metastatic bone lesions than 18F-FDG PET/CT. This case demonstrated the superiority of 68Ga-FAPI-46 PET/CT over 18F-FDG for identifying metastatic lesions in malignant SFTs. This observation may add information on the benefit of FAPI PET/CT in SFT staging.
Integrated 68Ga-Pentixafor and 68Ga-FAPI-04 PET/MR for Diagnosing Adrenal Aldosterone-Producing Adenoma and Accessory Splenic Nodules
Authors: Ding Jie , Wang Weilun , Chen Xing , You Zhiwen , Zhao Jun 
Published: October 2024

Abstract
A 57-year-old man with primary aldosteronism exhibited multiple nodules in the left adrenal, pancreatic tail, and splenic region. The left adrenal nodule showed positive 68Ga-pentixafor and negative 68Ga-FAPI-04 uptake, suggesting an aldosterone-producing adrenal adenoma. The nodule in the pancreatic tail exhibited high 68Ga-pentixafor and low 68Ga-FAPI-04 uptake, similarity with the nodule in splenic region, indicating accessory splenic nodule. Postoperative pathology confirmed an adrenal cortical adenoma and an accessory splenic nodule in the pancreas. This case underscores the complementary role of 68Ga-pentixafor and 68Ga-FAPI-04 PET/MR in diagnosing complex adrenal and pancreatic pathologies.
Guidance for Circumflex Scapular Artery Flap Utilization in Pediatric Reconstruction
Authors: Lasky Sasha , Moshal Tayla , Roohani Idean , Manasyan Artur , Jolibois Marah , Wolfe Erin M. , Munabi Naikhoba C.O. , Fahradyan Artur , Daar David A. , Lee Jessica A. , Hammoudeh Jeffrey A. 
Published: October 2024

Background
The circumflex scapular artery (CSA) flap system, consisting of scapular, parascapular, and chimeric flaps, is useful for pediatric reconstruction in many anatomical locations. The objectives of this case series are to offer insights into our decision-making process for selecting the CSA flap in particular pediatric reconstructive cases and to establish a framework for choosing a scapular or parascapular skin paddle. We also aim to emphasize important technical considerations of CSA flap utilization in pediatric patients.

Methods
Pediatric reconstruction with CSA flaps performed at our institution between 2006–2022 was retrospectively reviewed. Patient demographics, indications, flap characteristics, complications, and operative data were abstracted. Functional donor site morbidity was assessed through postoperative physical examinations. Unpaired t test analyzed scapular versus parascapular flap size.

Results
Eleven CSA flaps were successfully performed in 10 patients (6 scapular and 5 parascapular flaps). Patient ages ranged from 2 to 17 years. Scapular fasciocutaneous free flaps (n = 4) were performed in patients' ages 2–5 years for hand and forearm scar contractures. Two pedicled scapular flaps were performed for a single patient for bilateral axillary hidradenitis suppurativa. The 5 parascapular flaps were performed in patients' ages 2–14 years for calcaneus and forearm avulsion wounds and reconstruction after resection of hidradenitis suppurativa, nevus sebaceous, and Ewing sarcoma. In the sarcoma resection case, a chimeric flap with latissimus dorsi was employed. Average flap size was 101.6 ± 87.3 cm2 (range: 18–300 cm2). Parascapular flaps were significantly larger than scapular flaps (156.60 ± 105.84 cm2 vs 55.83 ± 26.97 cm2, P = 0.0495). Overall, 3 complications occurred (27.3% of cases) including venous congestion (n = 2) and wound dehiscence (n = 1). There were no reported cases of compromised shoulder function at 1.9 ± 2.5-year follow-up. The successful reconstruction rate for scapular, parascapular, and chimeric flaps was 100%.

Conclusions
The CSA flap treated a wide variety of indications demonstrating the flap's attributes: large vessel caliber, wide arc of rotation, reliable vascular anatomy, minimal donor site morbidity, and ability to incorporate bone and muscle. Our cases also highlight important pediatric considerations such as vascular mismatch and limited scapular bone stock. We recommend selection of the parascapular over the scapular flap with reconstruction of larger, complex defects given its ability to be harvested with a large skin paddle.
Frequency and Natural History of Emergency General Surgery Conditions in Cancer Patients
Authors: Jolissaint Joshua S. , Lobaugh Stephanie M. , Goldman Debra A. , McIntyre Sarah M. , Vos Elvira L. , Panageas Katherine S. , Wei Alice C. 
Published: October 2024

Objective:
To determine if cancer patients experience variability in incidence or management of emergency general surgery (EGS) conditions compared to non-cancer patients.

Background:
The true frequency, and natural history of EGS conditions among cancer patients has not been characterized.

Methods:
We utilized SEER-Medicare data from January 2006–December 2015 to compare patients with breast, prostate, and lung cancer to a non-cancer cohort. Patients were followed from date of cancer diagnosis, or an index date for non-cancer patients, to the development of an EGS condition, death or last follow up. We assessed the cumulative incidence of EGS conditions over time, and fit multivariable Cox proportional hazards models to evaluate the impact of time-dependent surgical intervention on mortality.

Results:
We identified 322,756 patients with breast (N=82,147), lung (N=128,618), and prostate cancer (N=111,991) and 210,429 non-cancer patients.. Cancer patients had a higher incidence of an EGS condition within the first year after diagnosis (4.8% vs. 3.2%), with lung (6.8%) and breast cancer (4.0%) showing consistent rends. Cancer patients were less likely to undergo surgery for (13% vs. 14%, P=0.005), though this varied by cancer type and EGS conditions. Patients with breast (HR 1.27, 95%CI 1.17-1.39) and lung cancer (HR 3.27, 95%CI 3.07-3.48) were more likely to die within 30-days of an EGS diagnosis.

Conclusions:
Cancer patients experience a higher incidence of EGS conditions within the first year following diagnosis, but are less likely to undergo surgery. Future research is needed to explore the interplay between EGS conditions, their management, and receipt of intended oncologic therapy, and resulting outcomes.
Disseminated tuberculosis with rare coccygeal involvement: a case report
Authors: Baziaa Sarra , Zegmout Adil , beaouiss Mohamed , el fathi soufiane , Rafik Aniss , souhi hicham , Rhorfi Ismail , El Ouazzani Hanane 
Published: October 2024

Introduction : Tuberculosis (TB) is a preventable and usually curable disease but remains a major health problem worldwide, particularly in developing countries. TB of the lumbosacral junction is rare and occurs in only 1% to 2% of all cases of spinal TB. Moreover, isolated sacrococcygeal TB is extremely rare.
Case report : We present a case of a 64-year-old patient with a history of diabetes who presented with chronic back pain and cough. Physical examinations revealed a peri-anal fistula and left elbow joint arthritis. the patient is diagnosed with disseminated tuberculosis with coccygeal involvement. Diagnosis was achieved non-invasively using Xpert MTB/RIF confirming Mycobacterium tuberculosis infection. The patient experienced complete resolution of symptoms following the commencement of anti-tuberculosis therapy.
Conclusion : We highlight the importance of this case due to the rare coccygeal localization of tuberculosis in an immunocompetent patient, diagnosed through non-invasive means.
Emergent glutamate & dopamine dysfunction in VPS35(D620N)knock-in mice and rapid reversal by LRRK2 inhibition
Authors: Kamesh A. , Kadgien C.A. , Kuhlmann N. , Coady S. , Hurley E.P. , Barron J.C. , Parsons M.P. , Milnerwood A.J. 
Published: October 2024

AbstractThe D620N variant in Vacuolar Protein Sorting 35 (VPS35) causes autosomal-dominant, late- onset Parkinson’s disease. VPS35 is a core subunit of the retromer complex that canonically recycles transmembrane cargo from sorting endosomes. Although retromer cargoes include many synaptic proteins, VPS35’s neuronal functions are poorly understood. To investigate the consequences of the Parkinson’s mutation, striatal neurotransmission was assessed in 1-, 3- & 6-month-old VPS35 D620N knock-in (VKI) mice. Spontaneous and optogenetically- evoked corticostriatal glutamate transmission was increased in VKI striatal spiny projection neurons by 6 months, when total striatal glutamate release, quantified by iGluSnFR imaging, showed similarities to wild-type. dLight imaging revealed robust increases in VKI striatal dopamine release by 6 months, which were reversed with acuteex vivoleucine-rich repeat kinase 2 (LRRK2) inhibition. We conclude that increased glutamate and dopamine transmission in VKI mice progressively emerges in young-adulthood, and that dopamine dysfunction is likely the result of sustained, rapidly-reversible, LRRK2 hyperactivity.
Evaluating Cross-Platform Normalization Methods for Integrated Microarray and RNA-seq Data Analysis
Authors: Sun Xuejun , Zhang Yu , Liu Chuwen , Zheng Xiaojing , Zou Fei 
Published: October 2024

AbstractIntegrated analysis of human gene expression data from multiple studies has become essential in genomics research for complex traits. However, integrating data generated from different cohorts with different platforms, such as microarray and RNA-seq, often requires data preprocessing, including normalization. In this study, we empirically evaluate 9 commonly used cross-platform normalization methods. We classify these methods into two main types: joint and separate normalization. Joint methods normalize multiple datasets together, while separate methods normalize each dataset independently. We further divide these methods into unsupervised and supervised approaches depending on whether they use outcomes during their nor-malization process. Examples of joint unsupervised methods include Quantile Nor-malization (QN), while Rank-in serves as an example of a joint supervised method. Training Distribution Matching (TDM) is an example of a separate unsupervised method. We assess each method’s ability to cluster samples, predict outcomes, and detect differentially expressed (DE) genes using three real datasets and simulated data. First, our real data analysis suggests that while joint supervised methods can cluster sample groups better than the other two method groups, they double use the outcome data with artificially inflated clustering performance. Their biases are further demonstrated by their inflated type I error in DE analysis and clustering results from simulated data with no DE genes. Second, for outcome prediction, supervised normalization is no longer applicable. Among the unsupervised methods, QN significantly outperforms the other approaches, regardless of whether RNA-seq data is used to predict microarray outcomes or vice versa. Finally, we compare normalization methods on downstream DE analysis using simulation. In addition to direct DE analysis on the combined normalized data using the non-parametric Wilcoxon rank-sum test, we also perform a meta-analysis that combines p-values of the DE analysis from each individual data. For DE analysis, the meta-analysis consistently achieves the best balance between controlling type I error and maximizing power for DE gene detection. Our research suggests that while normalization is critical for the integrated analysis of transcriptomics data, simple QN is the most efficient and unbiased normalization approach for outcome prediction, and meta-analysis is the most appropriate for DE analysis.
Differential benefit of adjuvant everolimus according to endocrine therapy backbone in the randomized UNIRAD trial
Authors: Saint-Ghislain Mathilde , Chabaud Sylvie , Dalenc Florence , Allouache Djelila , Cameron David , Martinez Mathilde , Grenier Julien , Barthelemy Philippe , Brunt Murray , Kaluzinski Laure , Mailliez Audrey , Legouffe Eric , Hardy-Bessard Anne-Claire , Giacchetti Sylvie , Mouret-Reynier Marie-Ange , Canon Jean-Luc , Bliss Judith , Lemonnier Jérôme , Andre Fabrice , Bachelot Thomas , Cottu Paul 
Published: October 2024

ABSTRACTBackgroundThe randomized, double-blind UNIRAD trial evaluating the addition of 2 years of everolimus to endocrine therapy in patients with high-risk, early luminal breast cancer failed to demonstrate a benefit. We report the subgroup analyses.Patients and MethodsWe randomized 1278 patients in a 1:1 ratio to receive 2 years of placebo or everolimus, added to endocrine therapy for up to 4 years after initiation. Randomization was stratified by endocrine therapy agent, prior adjuvant versus neoadjuvant therapy, progesterone receptor expression, and lymph node involvement. Subgroup analyses by each stratification factor were prespecified. Post hoc analyses were performed according to menopausal status and age. We also analyzed treatment adherence.ResultsWe observed a limited trend toward more favorable prognostic features in tamoxifen-treated patients, with more frequent ER+/PR+ tumors (88.5% vs. 84.1%, p=0.026) and less frequent pN2+ status (39.8% vs. 46%, p=0.032). In premenopausal women, we observed a numerical benefit of everolimus: 3y-DFS was 86% in the placebo group and 90% in the everolimus group [HR=0.76 (95%CI: 0.43-1.34)]. In premenopausal patients treated with tamoxifen (n=153; 12.3%), we observed an even stronger trend in favor of everolimus as 3-year DFS was 84% in the placebo group and 91% in the everolimus group [HR=0.54 (95%CI: 0.28-1.02)]. Early discontinuation of either everolimus or placebo was less frequent in the tamoxifen group than in the AI group: 48.0% vs. 56.9% (p=0.028).ConclusionsThe present post-hoc analyses generate hypotheses regarding the interaction between menopausal status, tamoxifen and everolimus in patients with high-risk, ER-positive, HER2-negative early breast cancer. They suggest that tamoxifen alone is no longer the standard of care in high-risk premenopausal patients.
Evaluation of a Next Generation Sequencing Assay for Hepatitis B Antiviral Drug Resistance on the Oxford Nanopore System
Authors: Payne Michael , Ritchie Gordon , Lawson Tanya , Young Matthew , Jang Willson , Stefanovic Aleksandra , Romney Marc G. , Matic Nancy , Lowe Christopher F. 
Published: October 2024

AbstractBackgroundNext-generation sequencing (NGS) for Hepatitis B virus (HBV) antiviral resistance (AVR) testing is a highly sensitive diagnostic method, able to detect low-level mutant subpopulations. Our clinical virology laboratory previously transitioned from DNA hybridization (INNO-LiPA) to NGS, initially with the GS Junior System and subsequently the MiSeq. The Oxford Nanopore Technology (ONT) sequencing system was evaluated for HBV resistance testing, with regards to sequencing accuracy and turn-around time.MethodsWe performed amplicon sequencing of the HBV polymerase gene from patient plasma and external quality assessment (EQA) samples on the MiSeq Reagent Nano Kit v2 and GridION ONT with R10.4.1 flowcells. Mutational analysis and genotyping were performed by DeepChekAssay-HBV (version 2.0).ResultsA total of 49 patient samples and 15 EQA samples were tested on both the MiSeq and ONT. There was high agreement for both patient and EQA samples between the MiSeq and ONT systems, with regards to total drug resistance mutations detected and total patient sample agreement, 68/70 (97%) and 47/49 (96%), respectively.ConclusionThe ONT NGS platform provided accurate HBV AVR results, with improved turn- around times. Sequencing error rates at AVR codons were below 1%.