bluuebunny/crossref_metadata_2025_split huggingface dataset:
The risk of sexual dysfunction associated with alcohol consumption in women: a systematic review and meta-analysis
Authors: Salari Nader , Hasheminezhad Razie , Almasi Afshin , Hemmati Mahvan , Shohaimi Shamarina , Akbari Hakimeh , Mohammadi Masoud 
Published: May 2023

Abstract
Background
Alcohol abuse among women is a significant health problem. Consuming alcohol in high amounts causes decreased sexual stimulation, vaginal lubrication, dyspareunia, and difficulty reaching orgasm. Due to the different effects of alcohol consumption on sexual function, this study aimed to investigate the effect of alcohol consumption on sexual dysfunction in women.

Methods
In this study, the researchers conducted a systematic search of several databases, including PubMed, Google Scholar, Scopus, Web of Science, Embase, and ScienceDirect, as well as the Google Scholar search engine, to identify studies reporting the impact of alcohol consumption on female sexual dysfunction. The search was conducted up until July 2022. A total of 225 articles were searched in the databases, and an additional 10 relevant articles were identified through manual search. After removing 93 articles due to duplication, 90 articles were excluded based on the study's inclusion and exclusion criteria. During the merit evaluation phase, 26 articles were excluded through the full-text study based on the study’s inclusion and exclusion criteria, while 26 articles were excluded due to their low quality. Ultimately, only 7 studies were deemed suitable for the final evaluation. The analysis was conducted using a random effects model, while the heterogeneity of the studies was assessed using the I2 index. Data analysis was performed using the Comprehensive Meta-Analysis Version 2 software.

Results
Based on the review of 7 studies involving a total sample size of 50,225 women and using the random effects method, the calculated odds ratio was 1.74 (95% CI: 1.006–3.04). This indicates that alcohol consumption increases the likelihood of sexual dysfunction in women by 74%. The Begg and Mazumdar rank correlation test, was used to analyze the distribution bias, but the results were not significant at the 0.1 significance level (p = 0.763).

Conclusion
The findings of this study demonstrate a significant correlation between alcohol consumption and an increased risk of sexual dysfunction in women. These results highlight the need for policymakers to prioritize this issue and raise awareness regarding the harmful effects of alcohol consumption on female sexual function and its impact on population health and reproduction.
Factors associated with the perception of university professors about academic dishonesty in dental students from two peruvian universities: analysis under multivariable regression model
Authors: Ladera-Castañeda Marysela , León-Málaga Flavia , Espinoza-Olórtegui Mary , Nicho-Valladares Miriam , Cervantes-Ganoza Luis , Verástegui-Sandoval Arturo , Solís-Dante Fredy , Castro-Rojas Miriam , Cayo-Rojas César Félix 
Published: May 2023

AbstractBackgroundAcademic dishonesty is an intentional behavior that transgresses ethics in the teaching-learning process. The present study aimed to evaluate the factors associated with the perception of university professors about academic dishonesty in dental students from two universities in the Peruvian capital.MethodsThis cross-sectional, analytical study evaluated 181 professors from two Peruvian universities between March and July 2022. A validated 28-item questionnaire was used to measure the perceived academic dishonesty of their students. Alogitmodel was used to evaluate the influence of the variables gender, marital status, place of origin, academic degree, specialization, academic area, years of teaching experience, scientific publications, ethical training and university of origin, considering a significance level of p < 0.05.ResultsAccording to the median, professors perceived that their students sometimes had attitudes and motivations to commit academic dishonesty. The professors whose origin was the capital city were twice as likely to perceive dishonest attitudes in dental students as those whose origin was a province (OR = 2.04; 95% CI: 1.06–3.93). University professors in pre-clinical courses were 0.37 times less likely to perceive dishonest attitudes than those teaching in the dental clinic (OR = 0.37; CI: 0.15–0.91). University professors in basic science courses and professors in preclinical courses were 0.43 times (OR = 0.43; CI: 0.19–0.96) and 0.39 times (OR = 0.39; CI: 0.15–0.98) less likely to perceive dishonest motivations in their students compared to university professors in the dental clinic. Gender, marital status, academic degree, specialty, years of teaching experience, scientific publications and ethical training were not found to be influential factors (p > 0.05).ConclusionAlthough all university professors surveyed perceived dishonest attitudes and motivations in their students, university professors from the capital city perceived such attitudes more. In addition, being a preclinical university professor was a hindered factor for perceiving such dishonest attitudes and motivations. It is advisable to implement and constantly disseminate regulations that empower academic integrity as well as to manage a system for reporting misconduct and to make students aware of the impact of dishonesty in their professional training.
Burnout and coping strategies among health system pharmacists in Lebanon: a cross-sectional study
Authors: Abilmona Rosa , Dimassi Hani , Aboulhosn Rafah , Chamoun Nibal 
Published: May 2023

AbstractBackgroundBurnout in health system pharmacists has been studied in several countries. To date, no data exists on burnout among healthsystem pharmacists in Lebanon. This study aimed to determine the prevalance of burnout, identify factors and describe coping strategies related to burnout among healthsystem pharmacists in Lebanon.MethodsA cross-sectional study utilizing the Maslach Burnout Inventory- Human Services Survey for Medical Personnel (MBI-HSS (MP))was conducted in Lebanon. A convenience sample of hospital pharmacists in Mount Lebanon and Beirut area filled a paper-based survey in person or via a phone interview. Burnout was defined as having an emotional exhaustion score ≥ 27 and/or depersonalization score ≥ 10. To identify factors associated with burnout, the survey also contained questions on socio-demographic characteristics, professional status, hospital characteristics, professional stressors and professional satisfaction. Participants were also asked about their coping strategies. To adjust for potential confounding, a multivariable logistic regression was used to estimate the adjusted odds ratios of factors and coping strategies associated with burnout. The authors also evaluated burnout according to the broader definition, emotional exhaustion score ≥ 27 or depersonalization score ≥ 10 or low personal accomplishment ≤ 33.ResultsOf the 153 health system pharmacists who were contacted, 115 filled the survey (response rate of 75.1%). The overall burnout prevalence reported was n = 50 (43.5%) and was largely driven by high emotional exhaustion n = 41(36.9%). Following multivariate logistic regression, seven factors were associated with increased burnout: older age, B.S. in Pharmacy degree, involvement in student training, no involvement in procurement, divided attention at work, overall dissatisfaction with career, dissatisfaction to neutrality with balance between professional and personal life. Low personal accomplishment was noted in n = 55 (49.5%). The main coping strategies identified were holidays, leisure, hobbies, sports activities, and relaxation. There was no association between the coping strategies used and burnout. The prevalence of burnout according to the broader definition was n = 77 (67%). The factors associated with the broader definition of burnout were older age, overall dissatisfaction with career and dissatisfaction with work life balance.ConclusionApproximately n = 50(43.5%)of health system pharmacists in Lebanon may be at risk for burnout. If using broader definitions incorporating all three subscales of the (MBI-HSS (MP)), the prevalence of burnout was n = 77(67%). This study highlights the need to advocate for pratice reforms to improve the low personal acoomplishment and recommends strategies to mitigate burnout. Further research to assess the current prevalence of burnout and evaluate effective interventions in alleviating burnout amongst health system pharmacists is needed.
Social determinants of health and adolescent childbearing in WHO Eastern Mediterranean countries
Authors: Boutayeb Abdesslam 
Published: May 2023

Abstract
Objectives
Teenage pregnancy and motherhood is a crucial problem in countries of the World Health Organisation Eastern Mediterranean Region (WHO–EMR). The aim of this paper is to describe and analyse the phenomenon of adolescent childbearing in ten countries according to social determinants like milieu (rural–urban), education level, wealth quintiles, territoriality (countries, regions) and nationality.

Methods
Inequity in terms of adolescent childbearing was analysed using disaggregated data given by Demographic Health Surveys (DHS), UNICEF Multiple Indicator Cluster Surveys (MICS) and the Pan Arab Project for Family Health (PAPFAM) surveys. Beside the absolute differences (gaps) and relative differences (ratios), the index of dissimilarity (ID) was used to compare the distributions of adolescent pregnancy and motherhood by social determinants in each country.

Results
Data analysis indicates that the average percentage of adolescent women aged 15–19 years who have begun childbearing shows a large difference between countries, varying from 0.4% in Tunisia to 15.1% in Sudan, combined with huge gaps within each country as indicated by the values of the index of dissimilarity. Poor, rural and non-educated adolescent girls are more exposed to teenage childbearing than their counterparts—rich, urban and educated girls.

Conclusion
According to different social determinants, sensible variations are seen in terms of adolescent pregnancy and motherhood within the ten countries considered in this study. This is a clear appeal to decision makers to reduce child marriage and pregnancy by acting on social determinants of health, targeting disadvantaged girls coming mainly from marginalised groups and poor families living in remote rural zones.
Genomic alterations of cerebrospinal fluid cell-free DNA in leptomeningeal metastases of gastric cancer
Authors: Chen Xin , Bai Kaixuan , Zhang Yu , Xu Yang , Huo Yinghao , Wang Sha , Zou Yueli , Qi Xuejiao , Guo Rongyun , Ou Qiuxiang , Liu Dengxiang , Yin Shaohua , Chen Shubo , Bu Hui 
Published: May 2023

Abstract
Background
Leptomeningeal metastases (LM) were rare in gastric cancer (GC), and GC patients with LM (GCLM) generally suffer from poor prognosis. Nevertheless, the clinical utility of cerebrospinal fluid (CSF) circulating tumor DNA (ctDNA) was underinvestigated in GCLM.

Methods
We retrospectively studied 15 GCLM patients, and all patients had paired primary tumor tissue samples and post-LM CSF samples while 5 patients also had post-LM plasma samples. All samples were analyzed using next-generation sequencing (NGS), and the molecular and clinical features were correlated with clinical outcomes.

Results
CSF had higher mutation allele frequency (P = 0.015), more somatic mutations (P = 0.032), and more copy-number variations (P < 0.001) than tumor or plasma samples. Multiple genetic alterations and aberrant signal pathways were enriched in post-LM CSF, including CCNE1 amplification and cell cycle-related genes, and CCNE1 amplification was significantly associated with patients’ overall survival (P = 0.0062). More potential LM progression-related markers were detected in CSF samples than in tumor samples, including PREX2 mutation (P = 0.014), IGF1R mutation (P = 0.034), AR mutation (P = 0.038), SMARCB1 deletion (P < 0.001), SMAD4 deletion (P = 0.0034), and TGF-beta pathway aberration (P = 0.0038). Additionally, improvement in intracranial pressure (P < 0.001), improvement in CSF cytology (P = 0.0038), and relatively low levels of CSF ctDNA (P = 0.0098) were significantly associated with better PFS. Lastly, we reported a GCLM case whose CSF ctDNA dynamic changes were well correlated with his clinical assessment.

Conclusions
CSF ctDNA could more sensitively detect molecular markers and metastasis-related mechanisms than tumor tissues in GCLM patients, and our study sheds light on utilizing CSF ctDNA in prognostic estimation and clinical assessment in GCLM.
Results of salvage therapy with mini-hyper-CVD and inotuzumab ozogamicin with or without blinatumomab in pre-B acute lymphoblastic leukemia
Authors: Kantarjian Hagop , Haddad Fadi G. , Jain Nitin , Sasaki Koji , Short Nicholas J. , Loghavi Sanam , Kanagal-Shamanna Rashmi , Jorgensen Jeffrey , Khouri Issa , Kebriaei Partow , Alvarado Yesid , Kadia Tapan , Paul Shilpa , Garcia-Manero Guillermo , Dabaja Bouthaina , Yilmaz Musa , Jacob Jovitta , Garris Rebecca , O’Brien Susan , Ravandi Farhad , Jabbour Elias 
Published: May 2023

AbstractBackgroundHistorically, adults with relapsed-refractory acute lymphoblastic leukemia (ALL) experienced poor outcomes with intensive chemotherapy. This mature analysis explores the benefit of the addition of sequential blinatumomab to low-intensity mini-Hyper-CVD chemotherapy with inotuzumab ozogamicin in this setting.MethodsMini-Hyper-CVD (cyclophosphamide and dexamethasone at 50% dose reduction, no anthracycline, methotrexate at 75% dose reduction, cytarabine at 83% dose reduction) was combined with inotuzumab during the first 4 courses. From Patient #68 and onwards, inotuzumab was given in reduced and fractionated doses, and blinatumomab was added sequentially for 4 courses. Maintenance therapy with prednisone, vincristine, 6-mercaptopurine and methotrexate was given for 12 courses, and blinatumomab for 4 additional courses.ResultsAmong 110 patients (median age, 37 years) treated, 91 (83%) responded (complete response, 69 patients, 63%). Measurable residual disease negativity was documented in 75 patients (82% of responders). Fifty-three patients (48%) received allogeneic stem cell transplantation (SCT). Hepatic sinusoidal obstruction syndrome occurred in 9/67 patients (13%) on the original inotuzumab schedule and in 1/43 (2%) on the modified schedule. With a median follow-up of 48 months, the median overall survival (OS) was 17 months, and the 3 year OS was 40%. The 3 year OS was 34% with mini-Hyper-CVD plus inotuzumab and 52% with additional blinatumomab (P = 0.16). By landmark analysis at 4 months, the 3 year OS was 54%, similar between patients who did or did not receive allogeneic SCT.ConclusionLow-intensity mini-Hyper-CVD plus inotuzumab with or without blinatumomab showed efficacy in patients with relapsed-refractory ALL, with better survival after the addition of blinatumomab.Trial registrationThe trial was registered on clinicaltrials.gov with the identifier NCT01371630.
Multiple trauma in pregnant women: injury assessment, fetal radiation exposure and mortality. A multicentre observational study
Authors: Abback Paer-Selim , Benchetrit Alison , Delhaye Nathalie , Daire Jean-Luc , James Arthur , Neuschwander Arthur , Boutonnet Mathieu , Cook Fabrice , Vinour Hélène , Hanouz Jean-Luc , Cotte Jean , Pastene Bruno , Jouffroy Viridiana , Gauss Tobias , Group Traumabase 
Published: May 2023

Abstract
Background
Fetal radiation exposure in pregnant women with trauma is a concern. The purpose of this study was to evaluate fetal radiation exposure with regard to the type of injury assessment performed.

Methods
It is a multicentre observational study. The cohort study included all pregnant women suspected of severe traumatic injury in the participating centres of a national trauma research network. The primary outcome was the cumulative radiation dose (mGy) received by the fetus with respect to the type of injury assessment initiated by the physician in charge of the pregnant patient. Secondary outcomes were maternal and fetal morbi-mortality, the incidence of haemorrhagic shock and the physicians’ imaging assessment with consideration of their medical specialty.

Results
Fifty-four pregnant women were admitted for potential major trauma between September 2011 and December 2019 in the 21 participating centres. The median gestational age was 22 weeks [12–30]. 78% of women (n = 42) underwent WBCT. The remaining patients underwent radiographs, ultrasound or selective CT scans based on clinical examination. The median fetal radiation doses were 38 mGy [23–63] and 0 mGy [0–1]. Maternal mortality (6%) was lower than fetal mortality (17%). Two women (out of 3 maternal deaths) and 7 fetuses (out of 9 fetal deaths) died within the first 24 h following trauma.

Conclusions
Immediate WBCT for initial injury assessment in pregnant women with trauma was associated with a fetal radiation dose below the 100 mGy threshold. Among the selected population with either a stable status with a moderate and nonthreatening injury pattern or isolated penetrating trauma, a selective strategy seemed safe in experienced centres.
Geriatric Nutrition Risk Index as a predictor of cardiovascular and all-cause mortality in older Americans with diabetes
Authors: Shen Xia , Yang Long , Gu Xue , Liu Yuan-Yuan , Jiang Lei 
Published: May 2023

Abstract
Background and aims
Few studies have examined the relationship between malnutrition, as defined by the Geriatric Nutrition Risk Index (GNRI), and all-cause mortality and cardiovascular mortality events, particularly in persons with diabetes. The study aimed at the association between GNRI and all-cause mortality and cardiovascular mortality in older Americans with diabetes.

Methods
Data from this retrospective study were obtained from the National Health and Nutrition Examination (NHANES) 1999–2016. Using data from The NHANES Public-Use Linked Mortality Files to assess all-cause mortality (ACM) and cardiovascular mortality (CVM). After excluding participants younger than 60 years and without diabetes, and with missing follow-up data, 4400 cases were left in this study. Persons with diabetes were divided by GNRI into 3 groups: GNRI ≥ 98; 92 ≤ GNRI < 98; and GNRI < 92; (No; Low; Moderate/Severe (M/S) group). We used Cox proportional hazard regression model to explore the predictive role of GNRI on ACM and CVM in elderly persons with diabetes. Restricted cubic splines to investigate the existence of a dose–response linear relationship between them.

Result
During a median follow-up period of 89 months, a total of 538 (12.23%) cardiovascular deaths occurred and 1890 (42.95%) all-cause deaths occurred. Multifactorial COX regression analysis showed all-cause mortality (hazard ratio [HR]: 2.58, 95% CI: 1.672–3.994, p < 0.001) and cardiovascular mortality (HR: 2.29, 95% CI: 1.063–4.936, p = 0.034) associated with M/S group risk of malnutrition in GNRI compared to no group. A negative association between GNRI and all-cause mortality was observed across gender and ethnicity. However, the same negative association between GNRI and cardiovascular mortality was observed only for males (HR:0.94, 95% CI:0.905–0.974, p < 0.001) and other races (HR:0.92, 95% CI:0.861–0.976, p = 0.007). And there was no significant correlation between low malnutrition and cardiovascular mortality (p = 0.076). Restricted cubic splines showed a nonlinear relationship between GNRI and all-cause mortality and cardiovascular mortality (non-linear p < 0.001, non-linear p = 0.019).

Conclusions
Lower GNRI levels are associated with mortality in older patients with diabetes. GNRI may be a predictor of all-cause mortality and cardiovascular mortality risk in older patients with diabetes.
Long-term effects of immunotherapy with a brain penetrating Aβ antibody in a mouse model of Alzheimer’s disease
Authors: Gustavsson Tobias , Metzendorf Nicole G. , Wik Elin , Roshanbin Sahar , Julku Ulrika , Chourlia Aikaterini , Nilsson Per , Andersson Ken G. , Laudon Hanna , Hultqvist Greta , Syvänen Stina , Sehlin Dag 
Published: May 2023

AbstractBackgroundBrain-directed immunotherapy is a promising strategy to target amyloid-β (Aβ) deposits in Alzheimer’s disease (AD). In the present study, we compared the therapeutic efficacy of the Aβ protofibril targeting antibody RmAb158 with its bispecific variant RmAb158-scFv8D3, which enters the brain by transferrin receptor-mediated transcytosis.MethodsAppNL−G−Fknock-in mice received RmAb158, RmAb158-scFv8D3, or PBS in three treatment regimens. First, to assess the acute therapeutic effect, a single antibody dose was given to 5 months oldAppNL−G−Fmice, with evaluation after 3 days. Second, to assess the antibodies’ ability to halt the progression of Aβ pathology, 3 months oldAppNL−G−Fmice received three doses during a week, with evaluation after 2 months. Reduction of RmAb158-scFv8D3 immunogenicity was explored by introducing mutations in the antibody or by depletion of CD4+T cells. Third, to study the effects of chronic treatment, 7-month-oldAppNL−G−Fmice were CD4+T cell depleted and treated with weekly antibody injections for 8 weeks, including a final diagnostic dose of [125I]RmAb158-scFv8D3, to determine its brain uptake ex vivo. Soluble Aβ aggregates and total Aβ42 were quantified with ELISA and immunostaining.ResultsNeither RmAb158-scFv8D3 nor RmAb158 reduced soluble Aβ protofibrils or insoluble Aβ1-42 after a single injection treatment. After three successive injections, Aβ1-42 was reduced in mice treated with RmAb158, with a similar trend in RmAb158-scFv8D3-treated mice. Bispecific antibody immunogenicity was somewhat reduced by directed mutations, but CD4+T cell depletion was used for long-term therapy. CD4+T cell-depleted mice, chronically treated with RmAb158-scFv8D3, showed a dose-dependent increase in blood concentration of the diagnostic [125I]RmAb158-scFv8D3, while concentration was low in plasma and brain. Chronic treatment did not affect soluble Aβ aggregates, but a reduction in total Aβ42 was seen in the cortex of mice treated with both antibodies.ConclusionsBoth RmAb158 and its bispecific variant RmAb158-scFv8D3 achieved positive effects of long-term treatment. Despite its ability to efficiently enter the brain, the benefit of using the bispecific antibody in chronic treatment was limited by its reduced plasma exposure, which may be a result of interactions with TfR or the immune system. Future research will focus in new antibody formats to further improve Aβ immunotherapy.
Inaccessibility of care and inequitable conceptions of suffering: a collective response to the construction of “terminal” anorexia nervosa
Authors: Sharpe Sam L. , Adams Marissa , Smith Emil K. , Urban Bek , Silverstein Scout 
Published: May 2023

AbstractInformed by our lived experiences with eating disorders, our work providing direct support to communities underserved by existing healthcare structures, and our commitment to social justice, we are deeply troubled by several aspects of the proposed characteristics for “terminal” anorexia nervosa outlined by Gaudiani et al. in Journal of Eating Disorders (10:23, 2022). We have identified two substantial areas of concern in the proposed characteristics provided by Gaudiani et al. and the subsequent publication by Yager et al. (10:123, 2022). First, the original article and the subsequent publication fail to adequately address the widespread inaccessibility of eating disorder treatment, the lack of parameters for what constitutes “high quality care”, and the prevalence of trauma experienced in treatment settings for those who do access treatment. Second, the characteristics proposed for “terminal” anorexia nervosa are constructed largely based on subjective and inconsistent valuations of suffering which build on and contribute to harmful and inaccurate eating disorder stereotypes. Overall, we believe these proposed characteristics in their current form stand to detract from, rather than assist, the ability of patients and providers to make informed, compassionate, and patient-centered decisions about safety and autonomy both for individuals with enduring eating disorders and for individuals with more recently diagnosed eating disorders.