bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Public Health Service “Increased Risk” 2020 Policy Change Has not Improved Organ Utilization in the United States: A Nationwide Cohort Study
Authors: Paneitz Dane C. , Wolfe Stanley B. , Giao Duc , Tessier Shannon N. , Dageforde Leigh Anne , Elias Nahel , Rabi Seyed Alireza , Michel Eriberto , D’Alessandro David A. , Osho Asishana A. 
Published: January 2024

Objective:
To assess the effects of the 2020 United States Public Health Service (PHS) “Increased Risk” Guidelines update.

Background:
Donors labeled as “Increased Risk” for transmission of infectious diseases have been found to have decreased organ utilization rates despite no significant impact on recipient survival. Recently, the PHS provided an updated guideline focused on “Increased Risk” organ donors, which included the removal of the “Increased Risk” label and the elimination of the separate informed consent form, although the actual increased risk status of donors is still ultimately transmitted to transplant physicians. We sought to analyze the effect of this update on organ utilization rates.

Methods:
This was a retrospective analysis of the Organ Procurement and Transplantation Network database which compared donor organ utilization in the 2 years before the June 2020 PHS Guideline update for increased-risk donor organs (June 2018–May 2020) versus the 2 years after the update (August 2020–July 2022). The organ utilization rate for each donor was determined by dividing the number of organs transplanted by the total number of organs available for procurement. Student t test and multivariable logistic regression models were used for analysis.

Results:
There were 17,272 donors in the preupdate cohort and 17,922 donors in the postupdate cohort; of these, 4,977 (28.8%) and 3,893 (21.7%) donors were considered “Increased Risk”, respectively. There was a 2% decrease in overall organ utilization rates after the update, driven by a 3% decrease in liver utilization rates and a 2% decrease in lung utilization rates. After multivariable adjustment, donors in the postupdate cohort had 10% decreased odds of having all organs transplanted.

Conclusions:
The 2020 PHS “Increased Risk” Donor Guideline update was not associated with an increase in organ utilization rates in the first 2 years after its implementation, despite a decrease in the proportion of donors considered to be at higher risk. Further efforts to educate the community on the safe usage of high-risk organs are needed and may increase organ utilization.
Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in Japan
Authors: Matsuda Takeru , Takemasa Ichiro , Endo Hideki , Mori Shinichiro , Hasegawa Suguru , Hida Koya , Tokunaga Takuya , Tanaka Keitaro , Mukai Toshiki , Watanabe Jun , Kawamura Junichiro , Kimura Kei , Kakeji Yoshihiro , Watanabe Masahiko , Yamamoto Seiichiro , Naitoh Takeshi ,   Ta-Ta-Mi study group collaboratives in Japan Society of Laparoscopic Colorectal Surgery
Published: January 2024

Objective:
To investigate the oncological outcomes after transanal total mesorectal excision (TaTME) for rectal cancer and risk factors for local recurrence (LR).

Background:
A high LR rate with a multifocal pattern early after TaTME has been reported in Norway and the Netherlands, causing controversy over the oncological safety of this technique.

Methods:
Twenty-six member institutions of the Japan Society of Laparoscopic Colorectal Surgery participated in this retrospective cohort study. A total of 706 patients with primary rectal cancer who underwent TaTME between January 2012 and December 2019 were included for analysis. The primary endpoint was the cumulative 3-year LR rate.

Results:
A total of 253 patients had clinical stage III disease (35.8%) and 91 (12.9%) had stage IV. Intersphincteric resection was performed in 318 patients (45.0%) and abdominoperineal resection in 193 (27.3%). There was 1 urethral injury (0.1%). A positive resection margin (R1) was seen in 42 patients (5.9%). Median follow-up was 3.42 years, and the 2- and 3-year cumulative LR rates were 4.95% (95% confidence interval: 3.50–6.75) and 6.82% (95% confidence interval: 5.08–8.89), respectively. A multifocal pattern was observed in 14 (25%) of 56 patients with LR. Tumor height from the anal verge, pathological T4 disease, pathological stage III/IV, positive perineural invasion, and R1 resection were significant risk factors for LR in multivariable analysis.

Conclusions:
In this selected cohort in which intersphincteric resection or abdominoperineal resection was performed in more than half of cases, oncological outcomes were acceptable during a median follow-up of more than 3 years.
Shedding light on slipped capital femoral epiphysis: a nationwide study on Turkish population
Authors: Taşci Murat , Turhan Yalçin , Yaşar Niyazi Erdem , Bozkurt İbrahim , Dumlupinar Ebru , Ata Naim , Ülgü M. Mahir , Birinci Şuayip , Bingöl İzzet 
Published: January 2024

Objectives
This comprehensive study aimed to describe the epidemiologic and demographic distribution of slipped capital femoral epiphysis (SCFE) in Türkiye, a condition that globally presents at a rate of 10.8 cases per 100 000 children. Utilizing data from the Ministry of Health, we examined the specifics of SCFE in Türkiye, comparing the findings with those of other populations to clarify the country’s unique epidemiological profile.

Methods
In this retrospective analysis, the Ministry of Health’s database was used to extract medical records of children under the age of 16 diagnosed with SCFE from 2016 to 2023. Patients were evaluated based on sex, age at diagnosis, comorbidities, complications, time of diagnosis and BMI.

Results
Our analysis identified 720 children with SCFE, with the average age at diagnosis being 12.9 years. The prevalence of SCFE in Türkiye was found to be 0.005% for the year 2022. The occurrence of SCFE showed no correlation with seasons. It was noted that the majority of patients received treatment at university and high-level hospitals (59.9%), with none being treated at lower-level public hospitals. A total of 58 patients were found to have additional growth and developmental diseases. Notably, only 33 cases (4.6%) involved avascular necrosis during follow-up.

Conclusion
This study provides the first epidemiological and demographic analysis of SCFE in Türkiye. Interestingly, our data suggest that male patients are twice as likely to develop SCFE compared to their female counterparts.
The Importance of Having a Single, Dedicated Medical Team to Treat Congenital Talipes Equinovarus Using the Ponseti Method: A Retrospective Analysis of Treatment Outcomes After 3 Years of Follow-up
Authors: Tabard-Fougère Anne , Bonnefoy-Mazure Alice , Dayer Romain , Vazquez Oscar , De Coulon Geraldo 
Published: January 2024

Background:
Congenital talipes equinovarus (CTEV) is a relatively common pediatric orthopaedic disorder and a frequent cause of disability in adult populations. The Ponseti method has emerged as the generally preferred for treating children with CTEV. Strict adherence to this technique’s basic principles is critical to achieving favorable outcomes. In 2013, our institution decided that every case of pediatric CTEV would be treated by a single dedicated medical team. The present study aimed to compare the treatment outcomes of children with CTEV treated using the Ponseti method in period I (multiple surgeons) versus those in period II (single dedicated team).

Patients and Methods:
We included respectively the children with CTEV treated using the Ponseti method in Geneva University Hospitals’ pediatric units from 2007 to 2018. Data on patient demographics, clinical characteristics, and the treatment outcomes were collected. The primary outcome was the number of relapsed feet (treatment failure) after 3 years of follow-up. The 2 periods’ outcomes were compared using χ2 and independent Student t-tests. Run charts were used to report yearly rates of complications, minor and major recurrences, treatment failure, brace noncompliance, and feet that underwent tenotomy.

Results:
A total of 48 feet (32 patients) and 42 feet (29 patients) in periods I and II were included. The periods showed similar rates for participants’ characteristics. The run charts illustrated the overall improvements in treatment outcomes in period II. A total of 8 relapsed feet (5 patients) were reported, all during period I.

Conclusions:
Since all the pediatric CTEV patients at our institution began to be treated by a single dedicated medical team, we have observed a decrease in all recurrences and complications and an absence of treatment failure. These results highlight the importance of the continuity of care and strict adherence to the Ponseti method.

Level of Evidence:
Level—III Retrospective comparative study.
Streamlining the diagnostic pathway for Lynch syndrome in colorectal cancer patients: a 10-year experience in a single Italian Cancer Center
Authors: Puccini Alberto , Nardin Simone , Trevisan Lucia , Lastraioli Sonia , Gismondi Viviana , Ricciotti Ilaria , Damiani Azzurra , Bregni Giacomo , Murialdo Roberto , Pastorino Alessandro , Martelli Valentino , Gandini Annalice , Mastracci Luca , Varesco Liliana , Dono Maria , Battistuzzi Linda , Grillo Federica , Sciallero Stefania 
Published: January 2024

Background
Universal screening of colorectal cancer (CRC) patients for Lynch syndrome (LS) through MisMatch Repair (MMR) testing is recommended. BRAFV600E
mutation and/or MLH1 promoter methylation (Reflex Testing, RefT)generally rule out LS in MLH1-deficient (dMLH1) patients. We estimated the impact of RefTon genetic counseling (GC) and on the diagnostic yield of genetic testing (GT).

Methods
Overall, 3199 CRC patients were referred to our center between 2011 and 2021. Patients referred until January 2019 (n=2536) underwent universal MMR testing and were termed ‘Cohort A’; among patients after February 2019 (n=663), ‘Cohort B’, RefT was also performed in dMLH1 patients.

Results
Overall, 401/3199 patients (12.5%) were MMR-deficient (dMMR); 312 (77.8%) in cohort A and 89 (22.2%) inB; 346/401 were dMLH1 (86.3%), 262/312 (83.9%) in cohort A and 84/89 (94.3%) in B. In Cohort A, 91/312 (29.1%) dMMR patients were referred to GC, 69/91 (75.8%) were in the dMLH1 group; 57/69 (82.6%) dMLH1 patients underwent GT and 1/57 (1.7%) had LS. In Cohort B, 3/84 dMLH1 patients did not undergo BRAF testing. Three BRAF wt and not hypermethylated of the remaining 81 dMLH1 patients were referred to GC and GT, and one had LS. This diagnostic pathway reduced GC referrals by 96% (78/81) in Cohort B and increased the diagnostic yield of GT by about 20 times.

Conclusion
Our findings support RefT in dMLH1 CRC patients within the LS diagnostic pathway, as it reduces the number of GC sessions needed and increases the diagnostic yield of GT.
PROVIDENT: Development and Validation of a Machine Learning Model to Predict Neighborhood-level Overdose Risk in Rhode Island
Authors: Allen Bennett , Schell Robert C. , Jent Victoria A. , Krieger Maxwell , Pratty Claire , Hallowell Benjamin D. , Goedel William C. , Basta Melissa , Yedinak Jesse L. , Li Yu , Cartus Abigail R. , Marshall Brandon D. L. , Cerdá Magdalena , Ahern Jennifer , Neill Daniel B. 
Published: January 2024

Background:
Drug overdose persists as a leading cause of death in the United States, but resources to address it remain limited. As a result, health authorities must consider where to allocate scarce resources within their jurisdictions. Machine learning offers a strategy to identify areas with increased future overdose risk to proactively allocate overdose prevention resources. This modeling study is embedded in a randomized trial to measure the effect of proactive resource allocation on statewide overdose rates in Rhode Island (RI).

Methods:
We used statewide data from RI from 2016 to 2020 to develop an ensemble machine learning model predicting neighborhood-level fatal overdose risk. Our ensemble model integrated gradient boosting machine and super learner base models in a moving window framework to make predictions in 6-month intervals. Our performance target, developed a priori with the RI Department of Health, was to identify the 20% of RI neighborhoods containing at least 40% of statewide overdose deaths, including at least one neighborhood per municipality. The model was validated after trial launch.

Results:
Our model selected priority neighborhoods capturing 40.2% of statewide overdose deaths during the test periods and 44.1% of statewide overdose deaths during validation periods. Our ensemble outperformed the base models during the test periods and performed comparably to the best-performing base model during the validation periods.

Conclusions:
We demonstrated the capacity for machine learning models to predict neighborhood-level fatal overdose risk to a degree of accuracy suitable for practitioners. Jurisdictions may consider predictive modeling as a tool to guide allocation of scarce resources.
Adolescent Tuberculosis: 6 Years of Experience in a Tertiary Care Pediatric Hospital in Buenos Aires, Argentina
Authors: Carril Sofía S. , Neyro Silvina E. , Pena Amaya Paula , Vazquez Miryam , Squassi Isabel R. , López Eduardo L. 
Published: January 2024

Introduction:
Adolescence is a key risk period for tuberculosis disease and its adverse outcomes. This group commonly develops infectious forms of tuberculosis and has a wider range of social contacts outside the household. There are few specific data on the behavior of tuberculosis disease in this population.

Methods:
A total of 292 patients 10–19 years of age with tuberculosis between January 2016 and December 2021 were retrospectively analyzed in the Department of Phthisiology of the Children’s Hospital “Dr. Ricardo Gutiérrez” of Buenos Aires, Argentina.

Results:
The median patient age was 14 years (interquartile range 12–16). Most patients were previously healthy, and 55% were unaware of the source of the infection. However, 75% sought medical advice owing to the presence of symptoms, with hemoptysis and weight loss being most frequent in those older than 15 years. Lung imaging findings consistent with severe disease were significantly associated with an age of >15 years. Respiratory cultures were positive in 62% of the samples obtained. Half of the patients required hospitalization, while 45% showed extrapulmonary involvement. Evolution was as follows: 74% recovered from the illness, 13% were lost to follow-up, 11% were referred to a less complex facility, 1% experienced treatment failure, and 3 (1%) patients died. Pulmonary cavities and positive bacilloscopy were associated with the presence of pulmonary sequelae at the end of treatment.

Conclusions:
Tuberculosis in adolescents, particularly in those >15 years of age, may present characteristics similar to those of adults, with a higher frequency of severe pulmonary disease leading to pulmonary sequelae.
Contribution of mechanoreceptors to spinal cord injury–induced mechanical allodynia
Authors: Sliwinski Christopher , Heutehaus Laura , Taberner Francisco J. , Weiss Lisa , Kampanis Vasileios , Tolou-Dabbaghian Bahardokht , Cheng Xing , Motsch Melanie , Heppenstall Paul A. , Kuner Rohini , Franz Steffen , Lechner Stefan G. , Weidner Norbert , Puttagunta Radhika 
Published: January 2024

Abstract
Evidence from previous studies supports the concept that spinal cord injury (SCI)-induced neuropathic pain (NP) has its neural roots in the peripheral nervous system. There is uncertainty about how and to which degree mechanoreceptors contribute. Sensorimotor activation-based interventions (eg, treadmill training) have been shown to reduce NP after experimental SCI, suggesting transmission of pain-alleviating signals through mechanoreceptors. The aim of the present study was to understand the contribution of mechanoreceptors with respect to mechanical allodynia in a moderate mouse contusion SCI model. After genetic ablation of tropomyosin receptor kinase B expressing mechanoreceptors before SCI, mechanical allodynia was reduced. The identical genetic ablation after SCI did not yield any change in pain behavior. Peptidergic nociceptor sprouting into lamina III/IV below injury level as a consequence of SCI was not altered by either mechanoreceptor ablation. However, skin-nerve preparations of contusion SCI mice 7 days after injury yielded hyperexcitability in nociceptors, not in mechanoreceptors, which makes a substantial direct contribution of mechanoreceptors to NP maintenance unlikely. Complementing animal data, quantitative sensory testing in human SCI subjects indicated reduced mechanical pain thresholds, whereas the mechanical detection threshold was not altered. Taken together, early mechanoreceptor ablation modulates pain behavior, most likely through indirect mechanisms. Hyperexcitable nociceptors seem to be the main drivers of SCI-induced NP. Future studies need to focus on injury-derived factors triggering early-onset nociceptor hyperexcitability, which could serve as targets for more effective therapeutic interventions.
Relationship Between Multiple Roles and Leisure-Time Physical Activities in Working-Age Women
Authors: CHAO Mei-Ling , TSENG Yu-Hwei , CHEN Ya-Mei , CHIANG Tung-Liang 
Published: January 2024

ABSTRACT

Background
Multiple role theory has proven effective in predicting variations in health, and a growing body of research has shown the importance of taking women's roles into account when analyzing physical activity levels. Nonetheless, researchers have yet to characterize the interaction between the various roles played by women and their physical activity.

Purpose
The objectives of this study were to elucidate the relationship between multiple roles and leisure-time physical activities (LTPAs) and to determine whether LTPA varies among women across different roles.

Methods
Data were derived from the 2013 National Health Interview Survey database provided by the Health Promotion Administration of Taiwan's Ministry of Health and Welfare, which includes 5,147 working-age women. The current study focused on women aged 20–50 years. The roles considered in this study included living with a partner, living with children, and employment status. LTPA levels were categorized as regular, inactive, or insufficient based on the LTPA metabolic equivalent in the previous week. The associations among level of LTPA, multiple roles, and demographic characteristics were analyzed using multiple regression analysis.

Results
We found single mothers with children to be more inactive than partnered mothers, and women living with a partner and those living with children were more likely to be inactive, whereas women working full-time were not at risk of inactivity. Women who assumed a larger number of roles were at a greater risk of inactivity. These findings are consistent with role strain theory.

Conclusions
Single mothers with children are more inactive than partnered mothers, and appropriate social support programs are necessary to reduce further disparities. Second, multiple demands on working-age women limit the time available for LTPAs, particularly among women living with a partner and children and engaged in full-time work. A physical activity intervention is a program or initiative designed to promote physical activity and improve health outcomes. We should develop and provide sustainable physical activity resources through the help of partners' housework to better promote physical activity intervention for working-age women.
Religion and Spiritual Health in Patients With and Without Depression Receiving Hemodialysis: A Cross-Sectional Correlational Study
Authors: LIU Hsiao-Hui , WU Chia-Ling , CHIANG Yi-Chien , TSAI Kun-Hung , CHU Tsung-Lan , HSIAO Ya-Chu 
Published: January 2024

ABSTRACT

Background
Hemodialysis is the most common therapy for managing patients with end-stage renal disease. Depression is one of the most common psychological problems faced by dialysis patients, and there is limited research on the influences of religion and spirituality on dialysis patients.

Purpose
This study was designed to compare religion and spiritual health status between hemodialysis patients with and without depressive symptoms.

Methods
A cross-sectional survey was conducted on 137 hemodialysis patients living in Taiwan. The self-report instruments used included the Religious Beliefs Scale, Spiritual Health Scale-Short Form, and Beck Depression Inventory-II. Data were analyzed using t test, chi-square test, point-biserial correlation of variance, and logistic regression.

Results
Most (63.5%) of the participants were classified with depression, of which most were male (70.1%), older (mean = 62.56 years), and unemployed (73.6%) and had less formal education. Fifty-two of the participants with depression had a 1- to 5-year duration of hemodialysis, whereas the nondepressed group had a higher mean score for number of religious activities, positive religious beliefs, and total score for spiritual health. Logistic regression showed an increased odds ratio (OR) of depression for participants with a duration of hemodialysis of 1–5 years (OR = 3.64, 95% CI [1.01, 13.15]). Participants with higher scores for spiritual health had a lower risk of depression (OR = 0.82, 95% CI [0.75, 0.90]), indicating a positive association between spiritual health and lower depression risk.

Conclusions/Implications for Practice
The prevalence rate of depression in hemodialysis patients is higher than that in the general population. Providing screenings for spiritual health and depression as part of routine medical care for hemodialysis patients is recommended to detect spiritual distress and depression early.
Laminin γ-2 (LAMC2) promotes the proliferation and invasion of pancreatic cancer cells by regulating PI3K/Akt signaling
Authors: Wang Qi , Zhang Fusheng , Long Di , Liu Weikang , Chen Yiran , Ma Yongsu , Yang Yinmo , Mao Zebin , Tian Xiaodong 
Published: January 2024

Background:
Pancreatic ductal adenocarcinoma (PDAC) poses a serious threat to human health with high mortality and poor prognosis, and there is an urgent need to explore the pathogenesis of PDAC in order to search for new therapeutic targets.

Methods:
The expression of LAMC2 in PDAC and its effect on the prognosis of tumor patients were predicted by an online database, and the expression level of LAMC2 in pancreatic cancer was verified by PCR and western blot; flow cytometry, wound healing assay, CCK8 assay, and colony formation assay were used to explore the effect of LAMC2 on the proliferation and migration of pancreatic cancer cells; and we also probed the potential relationship between LAMC2 and PI3K/Akt signaling.

Results:
High levels of LAMC2 in pancreatic cancer may benefit tumor proliferation migration and invasion and lead to poor prognosis of tumor patients. And the mechanism by which LAMC2 promotes PDAC progression may be related to the activation of PI3K/Akt signaling to influence apoptosis, cell cycle.

Conclusions:
LAMC2 promotes proliferation migration invasion of PDAC and leads to poor prognosis in pancreatic cancer patients.