bluuebunny/crossref_metadata_2025_split huggingface dataset:
Language Barriers in Appendicitis: What is the Cost?
Authors: Levy Brittany E. , Castle Jennifer T. , Devara Lekha P. , Manauis Elena C. , McDonald Hannah G. , Stephens Wesley A. , Davenport Daniel L. , Rellinger Eric J. , Worhunsky David J. 
Published: February 2025

Background In clinical scenarios, pediatricians prefer patient history over imaging to diagnose pediatric appendicitis because they wish to limit their patients’ exposure to radiation. Language barriers between providers and patients with limited English proficiency may increase adverse outcomes, require more imaging studies, and lead to higher costs in cases of pediatric appendicitis. Methods We queried the pediatric-National Surgical Quality Improvement Project database for patients under age 16 who received appendectomies from 2011-2021 at a single institution. Patients were propensity matched based on age, gender, Hispanic ethnicity, and insurance status. Medical records and hospital billing were merged to obtain primary language, initial hospitalization cost, diagnostic work up modalities, and operative findings. Patients identifying English as their primary language were termed English proficient (EP). Those selecting an alternate primary language made up the limited English proficiency (LEP) cohort. Health care utilization outcomes including cost, length of stay (LOS), and imaging usage were compared across cohorts. Results 400 patients were matched for analysis: 92 were EP and 109 LEP. When compared with the EP cohort, patients with LEP had higher rates of diagnostic imaging, longer median LOS, and higher median hospital costs. Imaging costs were also higher in patients with LEP. We also observed higher rates of negative appendectomy in the EP patients, compared to the LEP cohort. Discussion In patients with LEP, language diversity creates communication barriers resulting in higher health care utilization. Significant variations in the cost of care, efficiency of care, and clinical outcomes related to language diversity should be reduced to ensure equitable health care delivery to all pediatric surgical patients.
Considerations for Use of the Cornell Scale for Depression in Dementia Among Assisted Living Residents: Factor Analysis Results
Authors: McPherson Rachel , Resnick Barbara , Galik Elizabeth , Gruber-Baldini Ann L. , Holmes Sarah , Kusmaul Nancy 
Published: February 2025

The Cornell Scale for Depression in Dementia (CSDD) is widely used to assess depressive symptoms, but its factor structure has not been well explored in assisted living (AL) residents. An appropriate measure of depressive symptoms for this population is crucial to ensure accurate detection of depression. This study tested the CSDD’s factor structure in 511 AL residents from 85 facilities using baseline data from a randomized trial. Confirmatory factor analyses and chi-square difference tests were conducted. Three items were removed due to low factor loadings. The five-factor model fit significantly better (χ2 = 796.08, ∆χ2 = 22.86, ∆ df = 4, p < .001) than the four-factor model, although both showed poor fit. These results offer partial support for the modified five-factor CSDD in assessing depression among AL residents. Future research should explore more appropriate depression measures for this population, potentially incorporating items that more accurately capture depressive symptoms in AL residents. Parent study trial registry name Dissemination and Implementation of Function Focused Care for Assisted Living (NCT03459118).
Functional activity and mobility: A new technology-aided program to support people with intellectual and visual disabilities
Authors: Lancioni Giulio E , Alberti Gloria , Pezzuoli Francesco , Olivieri Alessandro , Singh Nirbhay N , O’Reilly Mark F , Sigafoos Jeff , Desideri Lorenzo 
Published: February 2025

Background People with intellectual disability and severe visual impairment or blindness tend to have low levels of functional activity engagement and low levels of mobility/ambulation. Objective The study assessed a new technology-aided program to support four adults with intellectual disability and blindness in their activity and mobility engagement. Methods The program was implemented following single-case research methodology. The activity consisted of completing object kits. The objects needed for the kits were distributed over a relatively large space and the participants moved around that space to collect them and distribute them in the kits. The program (a) was based on the use of a smartphone, tags with radio frequency identification codes, and a tag reader linked to the smartphone, and (b) ensured that the participants would receive physical support, verbal instructions, and preferred stimulation. Results During the baseline phase (without the program), the participants were unable to engage in activity and mobility. During the intervention (using the program), all participants managed to engage in activity and mobility correctly completing the object kits available during the sessions. Conclusions The results suggest that the program might be useful to support activity and mobility in people like the participants of this study.
Treatment effects of cladribine tablets on data-driven patterns of regional grey matter atrophy in multiple sclerosis
Authors: Barrantes-Cepas Mar , Noteboom Samantha , Colato Elisa , Battaglini Marco , Sormani Maria Pia , De Stefano Nicola , Steenwijk Martijn D , Koubiyr Ismail , Schoonheim Menno M 
Published: February 2025

Background: Treatment with cladribine tablets (CladT) in relapsing–remitting multiple sclerosis (RRMS) reduced global grey matter (GM) atrophy, but the effects on regional GM are unknown. Objectives: This study aimed to investigate the effect of CladT compared with placebo on magnetic resonance imaging (MRI)-derived patterns of GM atrophy. Methods: We used MRI and clinical data from the CLARITY study, including 393 people with RRMS (CladT (3.5 mg/kg), n = 200 or placebo, n = 193) at baseline, 24, 48 and 96 weeks after treatment initiation. SynthSeg-derived volume changes and GM atrophy patterns derived from source-based morphometry were analysed for group differences over time and associations with disability using mixed-effect models. Results: Deep GM (β = −0.03, p < 0.01), thalamus (β = −0.04, p < 0.01) and the brainstem–thalamus pattern (β = −0.03, p < 0.05) showed higher reduction in the placebo compared with treated group. These regions showed no effect during a predefined pseudo-atrophy period, where global volume loss was worse in the treatment group. Between W24 and W96, Expanded Disability Status Scale (EDSS) scores were associated with lower deep GM volume (β = −0.16, p = 0.001), thalamic volume (β = −0.16, p < 0.001), and the brainstem–thalamus pattern (β = −0.12, p < 0.05). Conclusion: CladT are associated with clinically relevant and slower neurodegeneration in RRMS. Strongest effects were seen in deep GM, thalamus, and brainstem, underlining the importance of regional MRI measures for assessing treatment effects.
Positional roles, match outcomes, and location: Understanding performance dynamics in second division soccer
Authors: Revesz Laszlo , Stengl Violet , Kadar Laszlo , Rado Daniel , Safar Sandor , Csaki Istvan 
Published: February 2025

The aim of this study was to uncover how different positional roles, match outcomes and match location impacts psychomotor performance, which was investigated among Hungarian soccer players. The sample consisted of 201 players, who were tracked across 38 matches by using GPS devices. Metrics, such as distance covered, high intensity running among others were observed. Results based on ANOVA tests and independent samples t-tests showed several significant values. According to our findings, central midfielders accounted for the greatest endurance, while wide midfielders excelled in high-speed activities during match play. Furthermore, players tended to cover more distance and perform higher intensity running during lost matches. In terms of explosive actions, they were more prevalent during matches that were played abroad. Interestingly, home-field advantage did not show a significant result in locomotor variables, yet a higher count of explosive actions was recorded during away matches. Positional roles have a significant impact on player performance, with central midfielders and wide midfielders showing different activity profiles. Match results are closely related to physical effort, with losing matches requiring more effort. Contrary to conventional views, the home field advantage is not reflected in locomotor variables, although increased explosive actions in away matches suggest adaptive behavior. These results may inform training and match preparation strategies, emphasizing the endurance of central midfielders and the high intensity actions of wide midfielders.
Tryptophan metabolites profile predict remission with dietary therapy in pediatric Crohn’s disease
Authors: Sigall Boneh Rotem , van der Kruk Nikki , Wine Eytan , Verburgt Charlotte M. , de Meij Tim G. J. , Löwenberg Mark , Gecse Krisztina B. , Wierdsma Nicolette , Derikx Joep P. M. , de Jonge Wouter J. , D’Haens Geert , Ghiboub Mohammed , Van Limbergen Johan E. 
Published: February 2025

Background: Crohn’s disease (CD) exclusion diet combined with partial enteral nutrition (CDED + PEN) or exclusive enteral nutrition (EEN) is effective in inducing remission in mild-to-moderate pediatric CD. Although CDED + PEN is better tolerated and has higher compliance compared to EEN, a subset of patients does not achieve remission. Diet-induced remission is shown to be positively associated with specific changes in tryptophan-metabolites. Objectives: To investigate whether the abundance of baseline fecal tryptophan-metabolites predicts dietary therapy outcomes in pediatric CD. Design: Diagnostic accuracy study and secondary analysis of previously conducted Randomized Controlled Trial (RCT). Methods: Twenty-six patients from previously performed RCT of mild-to-moderate pediatric CD were included. The patients were classified as having clinical remission (R) ( n = 19 in total; CDED + PEN = 10 and to EEN = 9) or No-Remission (NR) ( n = 7 in total; CDED + PEN = 3 and EEN = 4) following 6 weeks of therapy, based on the Pediatric Crohn’s Disease Activity Index score (⩽10 = remission). We performed a targeted quantitative analysis of 21 tryptophan-metabolites in baseline ( t = 0) fecal samples from both groups, utilizing liquid chromatography coupled with quadrupole mass spectrometry. Receiver operator characteristic curve (ROC) and random forest analysis (RFA) were used to assess the predictive power of fecal tryptophan-metabolites for dietary outcomes at baseline. Ratios of tryptophan-metabolites were compared to investigate different downstream tryptophan pathways. Results: Baseline fecal kynurenine level was significantly higher in NR compared to R for CDED + PEN ( p = 0.02) and EEN ( p = 0.04). ROC analysis highlighted the robust predictive power of kynurenine for CDED + PEN (area under the curve (AUC = 0.97)) and EEN (AUC = 0.88)-induced remission. RFA corroborated these observations. The ratio serotonin/kynurenine was the strongest predictor of CDED + PEN-induced remission (AUC = 1). The ratio 5-hydroxytryptophan/kynurenine (AUC = 0.88) predicted EEN-induced remission. By combining data from CDED + PEN and EEN, kynurenine (AUC = 0.91) and ratios of quinolinic acid/kynurenine (AUC = 0.93) and kynurenine/indole-3-acetic acid (AUC = 0.88) demonstrated strong predictive performance for dietary therapy-induced remission. Conclusion: Baseline tryptophan metabolites have the potential to serve as a biomarker for dietary remission in pediatric CD. Some tryptophan metabolite ratios showed the most promising predictive capabilities. If confirmed in validation studies, baseline fecal tryptophan markers may be able to provide much-needed guidance to personalize dietary intervention within the management of pediatric CD. Trial registration: NCT01728870.
Differentiating idiopathic Parkinson’s disease from multiple system atrophy-P using brain MRI-based radiomics: a multicenter study
Authors: Huang Yin-Hui , Yang Mei-Li , Li Yuan-Zhe , Chen Ya-Fang , Cai Chi , Huang Jing , Wang Yi , Li Tie-Qiang , Ye Qin-Yong 
Published: February 2025

Background: Differentiating idiopathic Parkinson’s disease (IPD) from multiple system atrophy-parkinsonian type (MSA-P) is essential for optimizing patient care and prognosis, given the differences in disease progression and treatment response. Objectives: This study aimed to develop and evaluate a radiomics-based model using magnetic resonance imaging (MRI)-derived features to distinguish IPD from MSA-P. Design: A multicenter retrospective study. Methods: A multicenter retrospective study was conducted with 287 patients (186 IPD and 101 MSA-P) who underwent brain MRI. Radiomic features were extracted from T1-weighted imaging and T2-weighted imaging sequences, and various machine learning classifiers were applied, including logistic regression, support vector machine (SVM), ExtraTrees, extreme gradient boosting, and Light Gradient Boosting Machine. Model performance was assessed using area under the curve (AUC), accuracy, sensitivity, and specificity. A nomogram combining clinical and radiomic features was also evaluated. Results: The SVM model, selected as the base for the Rad-signature, achieved the best diagnostic performance, with AUCs of 0.885 and 0.900 in the training and testing cohorts, respectively. The Rad-signature significantly outperformed clinical-only models in distinguishing IPD from MSA-P. The nomogram incorporating radiomic and clinical features yielded the highest diagnostic accuracy (AUC = 0.973 and 0.963 for training and testing cohorts, respectively) and balanced sensitivity and specificity. Decision curve analysis confirmed the nomogram’s clinical utility. Conclusion: Radiomics-based MRI analysis offers a powerful tool for distinguishing IPD from MSA-P, enhancing diagnostic accuracy, and aiding personalized treatment planning. Integrating radiomic and clinical data may improve diagnostic workflows in clinical practice.
Is Overweight Protective Against Fracture Occurrence? Age and Site-Dependent Different Association Between Body Mass Index and the Incidence of Hip and Vertebral Fractures
Authors: Bae Kunhyung , Han Sangsoo , Han Kyoungdo , Park Jiwon , Hong Jae-Young , Choi Sung Hoon 
Published: February 2025

Study Design Retrospective observational study. Objective To investigate the effects of body mass index (BMI), age, and sex on the occurrence of hip and vertebral fractures in the South Korean population. Methods We enrolled participants who underwent routine health screenings conducted by the Korean National Health Insurance Service in 2009 and followed up from 2010 to 2018. Cox proportional analyses assessed the hazard ratios for hip and vertebral fractures compared to individuals with a normal BMI. Results A total of 2,515,078 individuals were included in this analysis, the mean age was 53.8 years, and 50.1% were men. Low BMI emerged as a risk factor for both hip and vertebral fractures, with a stronger association observed for hip fractures ( P < 0.01). Hip fracture incidence decreased with increasing BMI in all patients. However, compared to the normal BMI group, the incidence of vertebral fractures in patients under 65 years was 10.4%, 12.8%, and 24.1% higher in the underweight, obese I, and obese II groups, respectively ( P < 0.001) and that of women, 4.4%, 4.1%, 9%, and 13.4% higher in the underweight, overweight, obese I, and obese II groups, respectively ( P < 0.001). Conclusions Our findings showed that regardless of sex and age, higher BMI consistently correlates with a lower risk of hip fractures. However, elevated BMI may increase the risk of vertebral fractures in women and those under 65 years. This study underscores the complexity of the relationship between BMI and fracture risks, highlighting the necessity for specific guidelines to mitigate fracture risks across diverse populations.
Menstrual migraine prevalence and features in women with endometriosis: A common disabling comorbidity
Authors: Merki-Feld Gabriele S , Neumeier Maria S , Dietrich Hanna , Niggli Angela , Leeners Brigitte , Schankin Christoph J. , Andreas Gantenbein , Sandor Peter 
Published: February 2025

Introduction: Endometriosis is a highly prevalent disabling comorbidity of women with migraine. The aim of the current study was to identify menstrual migraine prevalence and features in women with endometriosis. Methods: This observational study included data from patients visiting our outpatient clinic from 2015 to 2021. Information was collected from charts and through structured phone interviews. Patients with surgically confirmed endometriosis and migraine were included. Results: A total of 92 from 344 endometriosis patients suffered from migraine and a subset of 35 from menstrual migraine (MM). From the subset of women with MM 42.9% reported to have auras. Groups did not differ with regard to rASRM stage. Women with MM reported significantly more pain days/month at present and 5 years ago and more often a MIDAS Grade 4 ( p < 0.01). Both groups had less migraine attacks/month now, compared with monthly attacks 5 years ago. All women experienced endometriosis surgery in this interval. There was a trend towards more severe dysmenorrhoea with onset at menarche and towards higher use of analgesics for menstrual pain during the bleeding in the MM group. Less deliveries were noted in the group with MM. Conclusion: In women with similar endometriosis stages MM is associated with a higher migraine frequency, more dysmenorrhoea days and a higher burden of disease. Future studies are needed to better understand a potential influence of menstrual migraine on the number of deliveries. Our findings suggest, that close collaboration of neurologists with gynaecologists and shared treatment decisions might be of advantage for patients with the comorbidity.
Instantaneous dose rate as a crucial factor in reducing mortality and normal tissue toxicities in murine total-body irradiation: a comparative study of dose rate combinations
Authors: Zhu Hongyu , Liu Shihua , Qiu Jiaqi , Hu Ankang , Zhou Wanyi , Wang Jian , Gu Weihang , Zhu Yinuo , Zha Hao , Xiang Rong , Li Junli , Qiu Rui , Zhao Chong , Huang Peng , Deng Xiaowu 
Published: February 2025

Abstract

Purpose
The ultra-high dose rate (UHDR) radiation shows promise in eradicating tumors while reducing normal tissue toxicities. However, the biological outcomes of UHDR are influenced by various factors, particularly the mean dose rate and instantaneous dose rate. Additionally, the UHDR response at large field sizes is lacking. This study aimed to explore the impact of different dose rate combinations on gastrointestinal biological outcomes following total-body irradiations (TBI) and to examine the involved molecular signaling pathways.

Method
Female C57BL6/J mice received 10 Gy TBI using three modes: ultra-high mean and ultra-high instantaneous dose rate irradiation (HH mode), low mean and ultra-high instantaneous dose rate irradiation (LH mode), and low mean and low instantaneous dose rate irradiation (LL mode). Mice were euthanized at 3 h and 48 h post irradiation to assess acute normal tissue damage and perform transcriptome sequencing. Furthermore, a subset of mice was monitored for 30 days to evaluate survival.

Results
We found that when the instantaneous dose rate is sufficiently high (> 105 Gy/s), both ultra-high or low mean dose rate irradiation reduced mice mortality, myelosuppression, DNA damage, and cell apoptosis. The survival probabilities 30 days after 10 Gy TBI were 4/7, 4/6, and 0/6 in the HH, LH, and LL groups, respectively. Myelosuppression was lower at 3 h and 48 h post HH and LH irradiations than LL irradiation. The better regulated inflammatory response was evident at 48 h post HH and LH irradiation compared to LL irradiation. Additionally, DNA damages and cell apoptosis in the intestinal tissue were significantly reduced after HH and LH irradiations compared to LL irradiation. Transcriptome sequencing of intestinal tissues revealed that HH irradiation activated immune response pathways and suppressed mitochondrial related pathways compared to LL irradiation.

Conclusion
Our findings underscore the pivotal role of instantaneous dose rate in reducing radiation damages. When the instantaneous dose rate is sufficiently high (> 105 Gy/s), both ultra-high or low mean dose rate irradiation (HH and LH mode) reduced mice mortality, myelosuppression, DNA damage, and cell apoptosis. Understanding these dose rate effects and biological responses are crucial for optimizing radiotherapy strategies and exploring the potential benefits of UHDR irradiation.
Social isolation induces sexually aggressive behaviour in male Wistar rats
Authors: Ngala Mbiydzenyuy Elvis , Hemmings Sian Megan Joanna , Womersley Jacqueline Samantha , Shabangu Thando W. , Qulu-Appiah Lihle 
Published: February 2025

Abstract

Background
Sexual violence, a pervasive global issue, significantly impacts individuals and societies, necessitating a deeper understanding of its underlying biological mechanisms. This study aimed to elucidate the role of stress-induced dysregulation of the hypothalamus-pituitary-adrenocortical axis in sexual aggression in male Wistar rats. Employing a sexual aggression paradigm, we investigated the effects of social isolation on aggression, anxiety-like behaviour, and neurochemistry in virgin adult male Wistar rats.

Results
The results showed that social isolation significantly escalated aggressive behaviours and induced anxiety-like responses in male rats. The sexual aggression test revealed that socially isolated males exhibited heightened aggression towards non-receptive females. Neurochemical analyses indicated significant alterations in key markers, such as corticotrophin-releasing hormone, oxytocin, and arginine vasopressin, correlating with the observed behavioural changes. Gene expression analyses revealed significant findings, particularly in the expression of the oxytocin receptor (OXTR) and vasopressin receptor 1 A (AVPR1A) genes. Social isolation and the duration of aggressive behaviour prior to the sexual aggression test significantly influenced OXTR expression in the hippocampus and AVPR1A expression in both the prefrontal cortex and hippocampus, highlighting the complex interplay between environmental stressors, neurochemical responses, and gene expression in the manifestation of sexual aggression behaviour.

Conclusions
This study underscores the critical impact of stress and social isolation on sexual aggression, providing valuable insights into possible neurobiological underpinnings of sexual violence. Understanding these mechanisms is crucial for developing effective interventions to mitigate the consequences of sexual aggression.
Point-of-care ultrasound training among anesthesiology residency programs in the United States
Authors: Edwards Jordon , Ahn Daniel , Alcaraz Daniel , Chiles Collin , Khuu Tina , Soni Nilam J. , Goyal Varun , Manohar Crystal 
Published: February 2025

Abstract

Background
Point-of-care ultrasound (POCUS) use has become ubiquitous in the field of anesthesiology. However, POCUS training curriculum in anesthesiology residencies vary widely. We performed a survey study to better understand the structure of existing POCUS training and identify barriers to instituting a POCUS curriculum for anesthesiology trainees.