bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compulsive sexual behavior disorder in an inpatient sample with substance use disorder
Authors: Golder Sarah , Walter Bertram , Bengesser Isabel , Kramer Dietmar , Muhl Christian , Tahmassebi Nadja , Storz Florian , Markert Charlotte , Stark Rudolf 
Published: March 2024

Abstract

Background
Several studies indicate that compulsive sexual behavior disorder (CSBD) shares core elements with substance use disorder (SUD). These findings support the assumption of common mechanisms in addiction, which may lead to a higher tendency in patients with SUD to have comorbid CSBD. Nevertheless, this relationship between CSBD and SUD is poorly understood to date.

Aim
This study aimed to compare the prevalence of CSBD and its subtype pornography use disorder (PUD) between a SUD group and a matched control group. Herein, we aimed to test whether patients with SUD are more likely to have a comorbid CSBD/PUD. We further hypothesized that a higher CSBD/PUD prevalence in patients with SUD is accompanied by more pronounced CSBD- and PUD-related personal characteristics.

Methods
We assessed CSBD, PUD, and related personal characteristics in an inpatient SUD sample (N = 92) and a healthy control sample matched by age, gender, and educational level.

Outcomes
Primary outcomes were the diagnoses of CSBD/PUD as assessed by questionnaires. CSBD/PUD-related personal characteristics were the early onset of problematic pornography consumption, relationship status as a single person, a high sexual motivation, a high level of time spent watching pornography, and a high degree of problematic pornography consumption (Problematic Pornography Consumption Scale, short version).

Results
There was no significant difference between groups regarding CSBD prevalence (SUD sample, 3.3%; control sample, 7.6%) and PUD prevalence (SUD sample, 2.2%; control sample, 6.5%). We found relationship status as a single person and the sexual motivation dimension of importance of sex to be the only CSBD-related personal characteristics that were more pronounced in the SUD sample than the matched control group.

Clinical Implications
Results indicate no higher tendency for patients with SUD to develop comorbid CSBD/PUD, yet important vulnerabilities (eg, emotional dysregulation) should be considered when treating addictive disorder to prevent possible symptom displacement.

Strengths and Limitations
A strength of the study is that we compared a sample of patients with SUD with a matched control sample and used an instrument based on ICD-11 criteria for CSBD. Possible limitations are significant differences between the groups because of the restrictions in an inpatient clinic that may have influenced responses (eg, roommates) and that the control group was not screened for SUD. Therefore, the results should be interpreted with some caution.

Conclusion
We found no evidence of an overcomorbidity of SUD and CSBD/PUD. However, a higher rate of vulnerability factors for CSBD/PUD in the SUD sample might suggest some similarities between SUD and CSBD/PUD.
Safety assessment of transgenic maize CC-2 by 90-day feeding study in Sprague-Dawley rats
Authors: Chen Chen , Shi Lili , Mao Hongmei , Han Chao , Zhao Jinpeng , Zhuo Qin , Li Yan 
Published: March 2024

Abstract

Objective
The purpose of this study was to assess the safety of transgenic maize CC-2 through a 90-day feeding study in Sprague-Dawley rats.

Methods
Transgenic maize CC-2 and its parental counterpart maize Zhengdan 958 were respectively incorporated into diets at levels of 70%, 35% or 17.5% (w/w) and were administrated to rats (n = 10/sex/group) for 90 days. An additional control group of rats (n = 10/sex/group) were fed with the AIN93 breeding diet. All formulated diets were nutritionally balanced.

Results
There was no death and obvious toxic symptom in all rats. Food consumption, body weight, total food consumption rate, hematology, urinalysis, organ weight and organ coefficient were comparable between transgenic groups and the corresponding dose parental groups. There were significant differences of food consumption rate on some timepoint between high dose transgenic group and high dose parental group; male rats in high dose transgenic group showed significantly higher ALT/AST than high dose parental group on the middle or end of the experiment; but the differences showed no biological significance. There were no significant differences of other serum biochemistry parameters and pathological changes.

Conclusion
The results in this study demonstrated that the transgenic maize CC-2 didn't cause any related toxicity in rats.
Metformin switches cell death modes to soothe the apical periodontitis via ZBP1
Authors: Liu Hui , Liu Yu‐Xuan , Fan Wei , Fan Bing 
Published: March 2024

AbstractApical periodontitis (AP) is a disease caused by pathogenic microorganisms and featured with the degradation of periapical hard tissue. Our recent research showed the crucial role of Z‐DNA binding protein 1 (ZBP1)‐mediated necroptosis and apoptosis in the pathogenesis of AP. However, the specific regulatory mechanisms of ZBP1 in AP are not fully elucidated. It was found that metformin has a regulatory role in cell necroptosis and apoptosis. But whether and how metformin regulates necroptosis and apoptosis through the ZBP1 in the context of AP remains unknown. This study provided evidence that lipopolysaccharide (LPS) promotes the synthesis of left‐handed Z‐nucleic acids (Z‐NA), which in turn activates ZBP1. Knockout of Zbp1 by CRISPR/Cas9 technology significantly reduced LPS‐induced necroptosis and apoptosis in vitro. By using Zbp1‐knockout mice, periapical bone destruction was alleviated. Moreover, type I interferon induced the expression of interferon‐stimulated genes (ISGs), which serve as a major source of Z‐NA. In addition, the RNA‐editing enzyme Adenosine Deaminase RNA specific 1 (ADAR1) prevented the accumulation of endogenous Z‐NA. Meanwhile, metformin suppressed the ZBP1‐mediated necroptosis by inhibiting the expression of ZBP1 and the accumulation of ISGs. Metformin also promoted mitochondrial apoptosis, which is critical for the elimination of intracellular bacterial infection. The enhanced apoptosis further promoted the healing of infected apical bone tissues. In summary, these results demonstrated that the recognition of Z‐NA by ZBP1 plays an important role in AP pathogenesis. Metformin suppressed ZBP1‐mediated necroptosis and promoted apoptosis, thereby contributing to the soothing of inflammation and bone healing in AP.
Does Epidural Corticosteroid Application During Spinal Surgery Reduce Postoperative Pain?: An Adjunct to Multimodal Analgesia
Authors: Song Hyun , Edwards Charles , Curto Ryan , Perez Alejandro , Cruess Cailin , Schell Adam , Park Justin 
Published: March 2024

Study Design:
A prospective, randomized, placebo-controlled, double-blinded study.

Objective:
To examine the effect of intraoperative epidural administration of Depo-Medrol on postoperative back pain and radiculitis symptoms in patients undergoing Transforaminal Lumbar Interbody Fusion (TLIF).

Summary of Background Data:
Postoperative pain is commonly experienced by patients undergoing spinal fusion surgery. Adequate management of intense pain is necessary to encourage early ambulation, increase patient satisfaction, and limit opioid consumption. Intraoperative steroid application has been shown to improve postoperative pain in patients undergoing lumbar decompression surgeries. There have been no studies examining the effect of epidural steroids on both back pain and radicular pain in patients undergoing TLIF.

Method:
In all, 151 patients underwent TLIF surgery using rh-BMP2 with 3 surgeons at a single institution. Of those, 116 remained in the study and were included in the final analysis. Based on a 1:1 randomization, a collagen sponge saturated with either Saline (1 cc) or Depo-Medrol (40 mg/1 cc) was placed at the annulotomy site on the TLIF level. Follow-up occurred on postoperative days 1, 2, 3, 7, and postoperative months 1, 2, and 3. Lumbar radiculopathy was measured by a modified symptom- and laterality-specific Visual Analog Scale (VAS) regarding the severity of back pain and common radiculopathy symptoms.

Results:
The patients who received Depo-Medrol, compared with those who received saline, experienced significantly less back pain on postoperative days 1, 2, 3, and 7 (P<0.05). There was no significant difference in back pain beyond day 7. Radiculopathy-related symptoms such as leg pain, numbness, tingling, stiffness, and weakness tended to be reduced in the steroid group at most time points.

Conclusion:
This study provides Level 1 evidence that intraoperative application of Depo-Medrol during a TLIF surgery with rh-BMP2 significantly reduces back pain for the first week after TLIF surgery. The use of epidural Depo-Medrol may be a useful adjunct to multimodal analgesia for pain relief in the postoperative period.
Simple blood tests to diagnose compensated advanced chronic liver disease and stratify the risk of clinically significant portal hypertension
Authors: Semmler Georg , Hartl Lukas , Mendoza Yuly Paulin , Simbrunner Benedikt , Jachs Mathias , Balcar Lorenz , Schwarz Michael , Hofer Benedikt Silvester , Fritz Laurenz , Schedlbauer Anna , Stopfer Katharina , Neumayer Daniela , Maurer Jurij , Szymanski Robin , Meyer Elias Laurin , Scheiner Bernhard , Quehenberger Peter , Trauner Michael , Aigner Elmar , Berzigotti Annalisa , Reiberger Thomas , Mandorfer Mattias 
Published: March 2024

Background and Aims:
Compensated advanced chronic liver disease (cACLD) identifies patients at risk for clinically significant portal hypertension (CSPH), and thus, for liver-related complications. The limited availability of liver stiffness measurements (LSM) impedes the identification of patients at risk for cACLD/CSPH outside of specialized clinics. We aimed to develop a blood-based algorithm to identify cACLD by fibrosis-4 (FIB-4) and CSPH by von Willebrand factor/platelet count ratio (VITRO).

Approach and Results:
Patients with (suspected) compensated chronic liver disease undergoing FIB-4+LSM were included in the LSM/FIB-4 cohorts from Vienna and Salzburg. The HVPG/VITRO cohorts included patients undergoing HVPG-measurement + VITRO from Vienna and Bern.
LSM/FIB-4–derivation-cohort: We included 6143 patients, of whom 211 (3.4%) developed hepatic decompensation. In all, 1724 (28.1%) had LSM ≥ 10 kPa, which corresponded to FIB-4 ≥ 1.75. Importantly, both LSM (AUROC:0.897 [95% CI:0.865–0.929]) and FIB-4 (AUROC:0.914 [95% CI:0.885–0.944]) were similarly accurate in predicting hepatic decompensation within 3 years. FIB-4 ≥ 1.75 identified patients at risk for first hepatic decompensation (5 y-cumulative incidence:7.6%), while in those <1.75, the risk was negligible (0.3%).
HVPG/VITRO–derivation cohort: 247 patients of whom 202 had cACLD/FIB-4 ≥ 1.75 were included. VITRO exhibited an excellent diagnostic performance for CSPH (AUROC:0.889 [95% CI:0.844–0.934]), similar to LSM (AUROC:0.856 [95% CI:0.801–0.910], p = 0.351) and the ANTICIPATE model (AUROC:0.910 [95% CI:0.869–0.952], p = 0.498). VITRO < 1.0/ ≥ 2.5 ruled-out (sensitivity:100.0%)/ruled-in (specificity:92.4%) CSPH. The diagnostic performance was comparable to the Baveno-VII criteria.
LSM/FIB-4–derivation cohort findings were externally validated in n = 1560 patients, while HVPG/VITRO–derivation-cohort findings were internally (n = 133) and externally (n = 55) validated.

Conclusions:
Simple, broadly available laboratory tests (FIB-4/VITRO) facilitate cACLD detection and CSPH risk stratification in patients with (suspected) liver disease. This blood-based approach is applicable outside of specialized clinics and may promote early intervention.
Boucher-Neuhauser Syndrome: Chorioretinal Changes in a Single Case Over Time
Authors: Adeghate Jennifer O. , Sherman Jerome , Bass Sherry , Liu James , Hufnagel Robert B. , Yannuzzi Lawrence A. 
Published: March 2024

Abstract

Purpose:
To describe chorioretinal changes in a single case of Boucher-Neuhauser Syndrome (BNHS) over 45 years of follow-up. Methods: Retrospective chart review was performed. Color fundus photography from 1977 to 2003 was obtained and digitized. Current fundus photography was obtained with widefield imaging. High-resolution spectral-domain optical coherence tomography (OCT) was performed. Genetic analysis was performed using an inherited retinal disorders panel. Results: Fundus examination demonstrated central chorioretinal atrophy with sclerotic choroidal vessels. Short posterior ciliary arteries became more prominent and tortuous over time. Mid-peripheral atrophy extends to the equator and demonstrates a scalloped pattern with islands of atrophy intervening with areas of normal retina. The far periphery remained minimally affected. High-resolution OCT demonstrated outer retinal atrophy and choriocapillaris loss. Genetic testing showed a homozygous variant for PNPLA6 and a heterozygous variant for TYRP1. Conclusion: Chorioretinal changes in BNHS vary in onset and severity. It is important to diagnose this condition in order to begin timely management of visual and systemic sequelae.
Prevalence of Burn Pit Associated Symptoms Among US Veterans Who Utilize Non-Veteran’s Affairs Private Healthcare
Authors: Conti Michael A. , Bardes James M. , Oury Jeffrey , Goodboy Alan K. , Shin Matt , Wilson Alison 
Published: March 2024

Objective
Do the 3.5 million US veterans, who primarily utilize private healthcare, have similar burn pit exposure and disease compared to the VA Burn Pit registry?

Methods
This is an online volunteer survey of Gulf War and Post-9/11 veterans.

Results
Burn pit exposure had significantly higher odds of extremity numbness, aching pain and burning, asthma, chronic obstructive pulmonary disease, interstitial lung disease, constrictive bronchiolitis, pleuritis, and pulmonary fibrosis. Chi-square did not reveal a difference in burn pit exposure and cancer diagnoses.

Conclusions
These data demonstrate increased risk of neurological symptoms associated with burn pit exposure, which are not covered in the 2022 federal Promise to Address Comprehensive Toxics Act. Additional data will allow for the continued review and consideration for future medical benefits.
Personalized circulating tumor DNA monitoring improves recurrence surveillance and management after curative resection of colorectal liver metastases: A prospective cohort study
Authors: Li Yaqi , Xu Jing , Hu Xiang , Chen Yikuan , Liu Fangqi , Chen Yun , Ma Xiaoji , Dong Qiduo , Sun Lei , Mo Shaobo , Zhang Long , He Xingfeng , Tong Shanyou , Wu Huizi , Li Wenhua , Cai Sanjun , Zhu Shida , Pan Qi , Peng Junjie 
Published: March 2024

Background:
Approximately 60% of patients with CRLM experience relapse within 2 years after radical resection, previous studies have proven that repeat local treatment (LT) could prolong survival, however, it is difficult to seize the window for LT due to the lack of a high-sensitive surveillance method. In this study, we aim to examine the value of longitudinal circulating tumor DNA (ctDNA) in guiding adjuvant chemotherapy (ACT), optimizing clinical surveillance strategy, and thereby improving CRLM outcomes.

Materials and Methods:
We conducted a prospective clinical trial using a personalized, tumor-informed ctDNA assay to monitor 60 CRLM patients undergoing resection with curative intent. Formalin-fixed paraffin-embedded (FFPE) tumor samples were collected after surgery. Blood samples were collected before surgery, 30 days after surgery (post-OP), and every third month until relapse or up to 2 years.

Results:
A total of 394 plasma samples from 60 eligible patients were analyzed, with a median follow-up time of 31.3 months. Landmark analyses revealed that detectable ctDNA at post-OP (HR, 4.8), post-ACT (HR, 6.0), and end-of-treatment (EOT) (HR, 5.6) were associated with higher recurrence risk (P < 0.001). Post-OP ctDNA positivity served as the only independent prognostic marker in the multivariant analysis (HR, 5.1; P < 0.001). Longitudinal ctDNA analysis identified relapsed patients at both sensitivity and specificity of 100%. Most (75%) patients were found with radiological relapse within 6 months after the first detectable ctDNA with a median lead time of 3.5 months. In relapsed patients, 73.2% had oligometastatic disease and 61% were liver-restricted, of which 72.0% received repeat LTs, and 60.0% achieved a secondary no evidence of disease (NED) status.

Conclusions:
Longitudinal ctDNA monitoring assists in early prediction of relapse, and thereby improves survival of CRLM patients by increased secondary resection rate and secondary NED rate.
Development of interpretable machine learning models for prediction of acute kidney injury after noncardiac surgery: a retrospective cohort study
Authors: Sun Rao , Li Shiyong , Wei Yuna , Hu Liu , Xu Qiaoqiao , Zhan Gaofeng , Yan Xu , He Yuqin , Wang Yao , Li Xinhua , Luo Ailin , Zhou Zhiqiang 
Published: March 2024

Background:
Early identification of patients at high risk of postoperative acute kidney injury (AKI) can facilitate the development of preventive approaches. This study aimed to develop prediction models for postoperative AKI in noncardiac surgery using machine learning algorithms. We also evaluated the predictive performance of models that included only preoperative variables or only important predictors.

Materials and methods:
Adult patients undergoing noncardiac surgery were retrospectively included in the study (76,457 patients in the discovery cohort and 11,910 patients in the validation cohort). AKI was determined using the KDIGO criteria. The prediction model was developed using 87 variables (56 preoperative variables and 31 intraoperative variables). A variety of machine learning algorithms were employed to develop the model, including logistic regression, random forest, extreme gradient boosting, and gradient boosting decision trees (GBDT). The performance of different models was compared using the area under the receiver operating characteristic curve (AUROC). Shapley Additive Explanations (SHAP) analysis was employed for model interpretation.

Results:
The patients in the discovery cohort had a median age of 52 years (IQR: 42-61 y), and 1179 patients (1.5%) developed AKI after surgery. The GBDT algorithm showed the best predictive performance using all available variables, or only preoperative variables. The AUROCs were 0.849 (95% CI, 0.835-0.863) and 0.828 (95% CI, 0.813-0.843), respectively. The SHAP analysis showed that age, surgical duration, preoperative serum creatinine and gamma-glutamyltransferase, as well as American Society of Anesthesiologists physical status III were the most important five features. When gradually reducing the features, the AUROCs decreased from 0.852 (including the top 40 features) to 0.839 (including the top 10 features). In the validation cohort, we observed a similar pattern regarding the models’ predictive performance.

Conclusions:
The machine learning models we developed had satisfactory predictive performance for identifying high-risk postoperative AKI patients. Further, we found that model performance was only slightly affected when only preoperative variables or only the most important predictive features were included.
Prognostic implication of residual inflammatory trajectories in acute type I aortic dissection: dual-center prospective cohort study
Authors: Liu Hong , Diao Yi-fei , Shao Yong feng , Qian Si-chong , Zeng Zhi-hua , Fan Guo-liang , Ma Lu-yao , Zhang Hong-jia ,   on the behalf of the Additive Anti-inflammatory Action for Aortopathy & Arteriopathy (5A) Investigators
Published: March 2024

Background:
Peripheral platelet-white blood cell ratio (PWR) integrating systemic inflammatory and coagulopathic pathways is a key residual inflammatory measurement in the management of acute DeBakey type I aortic dissection (AAD); however, trajectories of PWR in AAD is poorly defined.

Methods:
Two AAD cohorts were included in two cardiovascular centers (2020–2022) if patients underwent emergency total arch replacement with frozen elephant trunk implantation. PWR data were collected over time at baseline and five consecutive days after surgery. Trajectory patterns of PWR were determined using the latent class mixed modelling (LCMM). Cox regression was used to determine independent risk factors. By adding PWR Trajectory, a user-friendly nomogram was developed for predicting mortality after surgery.

Results:
Two hundred forty-six patients with AAD were included with a median follow-up of 26 (IRQ 20–37) months. Three trajectories of PWR were identified [cluster α 45(18.3%), β105 (42.7%), and γ 96 (39.0%)]. Cluster γ was associated with higher risk of mortality at follow-up (crude HR, 3.763; 95% CI: 1.126–12.574; P=0.031) than cluster α. By the addition of PWR trajectories, an inflammatory nomogram, composed of age, hemoglobin, estimated glomerular filtration rate, and cardiopulmonary time was developed and internally validated, with adequate discrimination [the area under the receiver-operating characteristic curve 0.765, 95% CI: 0.660–0.869)], calibration, and clinical utility.

Conclusion:
Based on PWR trajectories, three distinct clusters were identified with short-term outcomes, and longitudinal residual inflammatory shed some light to individualize treatment strategies for AAD.
The Impact of Market Factors on Meaningful Use of Electronic Health Records Among Primary Care Providers
Authors: Alexandre Pierre K. , Monestime Judith P. , Alexandre Kessie 
Published: March 2024

Background:
Using federal funds from the 2009 Health Information Technology for Economic and Clinical Health Act, the Centers for Medicare and Medicaid Services funded the 2011–2021 Medicaid electronic health record (EHR) incentive programs throughout the country.

Objective:
Identify the market factors associated with Meaningful Use (MU) of EHRs after primary care providers (PCPs) enrolled in the Florida—EHR incentives program through Adopting, Improving, or Upgrading (AIU) an EHR technology.

Research Design:
Retrospective cohort study using 2011–2018 program records for 8464 Medicaid providers.

Main Outcome:
MU achievement after first-year incentives.

Independent Variables:
The resource dependence theory and the information uncertainty perspective were used to generate key-independent variables, including the county’s rurality, educational attainment, poverty, health maintenance organization penetration, and number of PCPs per capita.

Analytical Approach:
All the county rates were converted into 3 dichotomous measures corresponding to high, medium, and low terciles. Descriptive and bivariate statistics were calculated. A generalized hierarchical linear model was used because MU data were clustered at the county level (level 2) and measured at the practice level (level 1).

Results:
Overall, 41.9% of Florida Medicaid providers achieved MU after receiving first-year incentives. Rurality was positively associated with MU (P<0.001). Significant differences in MU achievements were obtained when we compared the “high” terciles with the “low” terciles for poverty rates (P=0.002), health maintenance organization penetration rates (P=0.02), and number of PCPs per capita (P=0.01). These relationships were negative.

Conclusions:
Policy makers and health care managers should not ignore the contribution of market factors in EHR adoption.