bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of state Medicaid eligibility and benefits policy on neonatal abstinence syndrome hospitalizations
Authors: Soni Aparna , Bullinger Lindsey , Andrews Christina , Abraham Amanda , Simon Kosali 
Published: August 2023

AbstractRates of neonatal abstinence syndrome (NAS) resulting from opioid misuse are rising. However, policies to treat opioid misuse during pregnancy are unclear. We apply a difference‐in‐differences design to national pediatric discharge records to examine the effects of state Medicaid policies on NAS. Among states in which Medicaid covered two clinically‐recommended medications for treating opioid misuse (buprenorphine, methadone), the Affordable Care Act's Medicaid expansion reduced Medicaid‐covered NAS hospitalizations. Medicaid expansion did not affect NAS hospitalizations in other expansion states. These findings imply a nuanced relationship between Medicaid policy and NAS that should be considered in addressing opioid misuse among pregnant women.
Effect of blood flow restriction with low‐load exercise on muscle damage in healthy adults: A systematic review of randomized controlled trials
Authors: Yang Jinchao , Ma Fenghao , Wang Qian , Cui Yuanfen , Zheng Jun 
Published: August 2023

AbstractIntroductionBlood flow restriction (BFR) is a relatively new rehabilitative technique and low‐load exercise combined with BFR (LL‐BFR) can increase muscle strength and muscle mass. However, it is currently unknown whether LL‐BFR causes muscle damage. Therefore, the aim of this study is to investigate the effects of LL‐BFR on muscle damage and provide recommendations for sports training and physical exercise.Materials and MethodsA systematic search was conducted using PubMed, Web of Science, Medline, Cochrane Library and Physiotherapy Evidence Database (PEDro) with a cut‐off of March 2022. Randomized controlled trials (RCTs) and English‐language studies were selected. Two independent assessors used the PEDro scoring scale to evaluate the methodological quality and risk of bias of the included studies.ResultsOf the 2935 articles identified, 15 RCTs were included in this systematic review. Two studies demonstrated that LL‐BFR could induce muscle damage in healthy individuals; however, two studies presented contrasting findings in the short term. Four studies found that no muscle damage occurred after LL‐BFR in the long term. The remaining seven articles showed that it was unclear if LL‐BFR could cause muscle damage, regardless of whether these participants were trained or not.ConclusionAlthough LL‐BFR may induce muscle damage within 1 week, it will help gain long‐term muscle strength and muscle hypertrophy. However, the lack of sufficient evidence on the effect of LL‐BFR on muscle damage in clinical practice warrants additional RCTs with large sample sizes in the future.
Repeat pediatric heart transplantation: A united network for organ sharing database analysis
Authors: Rowe Georgina , Gill George , Zubair M. Mujeeb , Chen Qiudong , Thomas Jason , Timbalia Shrishiv A. , Osho Asishana A. , Emerson Dominic , Kim Richard , Bowdish Michael E. , Chikwe Joanna , Turek Joseph W. 
Published: August 2023

AbstractBackgroundA history of congenital heart disease and previous transplantation are each independently associated with worse survival following pediatric heart transplantation. This study aimed to evaluate the characteristics and outcomes of children undergoing repeat heart transplantation in the United States based on the underlying diagnosis.MethodsThe United Network for Organ Sharing database was used to identify 8111 patients aged <18 years undergoing isolated heart transplantation from 2000 to 2021, including 435 (5.4%) repeat transplants. Restricted cubic spline analysis assessed the non‐linear relationship between inter‐transplant interval and the primary outcome of all‐cause mortality or re‐transplantation. Multivariable Cox regression assessed the impact of re‐transplantation on the primary outcome. Median follow‐up was 5.0 (interquartile range 1.9–9.9) years.ResultsRepeat transplant patients were older (median age 12 vs. 4 years; p < .001), and less likely to be in UNOS status 1A (66.0%, n = 287 vs. 81.0% n = 6217; p < .001) than primary transplant patients. Freedom from the primary outcome was 51.4% (95% confidence interval [CI] 45.5–57.2) among repeat transplants and 70.5% (95% CI 69.2–71.8) among primary transplants at 10 years (p < .001). Among repeat transplant patients, the relative hazard of the primary outcome became non‐significant when the inter‐transplant interval >3.6 years. Congenital heart disease was an independent predictor of mortality among primary (HR 1.8, 95% CI 1.6–1.9) but not repeat transplant (HR 1.1, 95% CI .8–1.6) patients.ConclusionsLong‐term outcomes remain poor for patients undergoing repeat heart transplantation, particularly those with an inter‐transplant interval <3.6 years. Underlying diagnosis does not impact outcomes after repeat transplantation, after accounting for other risk factors.
Factors associated with a positive phosphatidylethanol test during liver transplantation evaluation
Authors: Segal Antú , Pearl Elise , Fatabhoy Megha , Zohr Samantha J. , Bryce Kelly , Gonzalez Humberto C. , Miller‐Matero Lisa R. 
Published: August 2023

AbstractBackgroundEarly identification of alcohol use is crucial for informing recommendations of appropriate follow‐up treatment pre‐liver transplant and optimizing post‐liver transplant outcomes. The purpose of the study was to investigate whether there are psychosocial factors associated with a positive PEth test.MethodsAll patients who underwent a routine pre‐surgical psychological evaluation for liver transplant listing (all etiologies, including acute liver failure, dual organ, and re‐transplantation) at a single health care system in 2020 were included in a retrospective chart review. Data extraction included results from PEth testing and information from the psychological evaluation (i.e., demographic, psychiatric symptoms, and cognitive functioning).ResultsThere were 158 patients (73.8%) who had a PEth test, of whom 21.5% had a positive result (n = 34). Younger age was associated with a positive PEth (p < .001). ALD status and type of ALD (hepatitis vs. cirrhosis) were also associated with a positive PEth test. Other demographic characteristics and psychiatric symptoms were not associated with a positive PEth result (p > .05).ConclusionYounger age was the only significant demographic variable associated with a positive PEth test. Given the difficulty of predicting who may be using alcohol, it may be useful to use PEth testing for all patients during the pre‐liver transplant evaluation and while patients are listed for liver transplant. Early identification of alcohol use through routine PEth testing will help identify patients who are using alcohol and need further treatment for alcohol use to optimize health and post‐transplant outcomes.
Automatische Körperteil‐Identifikation in dermatologischen klinischen Bildern durch maschinelles Lernen
Authors: Sitaru Sebastian , Oueslati Talel , Schielein Maximilian C , Weis Johanna , Kaczmarczyk Robert , Rueckert Daniel , Biedermann Tilo , Zink Alexander 
Published: August 2023

ZusammenfassungHintergrundDermatologische Erkrankungen sind in allen Bevölkerungsgruppen weit verbreitet. Das betroffene Körperteil ist für ihre Diagnose, Therapie und Forschung von Bedeutung. Die automatische Identifizierung der abgebildeten Körperteile in dermatologischen Krankheitsbildern könnte daher die klinische Versorgung verbessern, indem sie zusätzliche Informationen für klinische Entscheidungsalgorithmen liefert, schwer zu behandelnde Bereiche aufdeckt und die Forschung durch die Identifizierung neuer Krankheitsmuster unterstützt.Patienten und MethodikIn dieser Studie wurden 6219 annotierte dermatologische Bilder aus unserer klinischen Datenbank verwendet, womit ein neuronales Netz trainiert und validiert wurde. Als Anwendung wurden mit diesem System qualitative Heatmaps für die Verteilung von Körperteilen bei häufigen dermatologischen Erkrankungen erstellt.ErgebnisseDer Algorithmus erreichte eine mittlere balancierte Genauigkeit (Accuracy) von 89% (74,8%–96,5%). Die Fotos von nichtmelanozytärem Hautkrebs betrafen vor allem das Gesicht und den Oberkörper, während die größte Häufigkeit der Ekzem‐ und Psoriasis‐Bildverteilung den Oberkörper, die Beine und die Hände umfassten.SchlussfolgerungenDie Genauigkeit dieses Systems ist vergleichbar mit den besten bisher veröffentlichten Algorithmen für Bildklassifizierungsaufgaben, was darauf hindeutet, dass dieser Algorithmus die Diagnose, Therapie und Forschung bei dermatologischen Erkrankungen verbessern könnte.
The role of candidate transport proteins in β‐cell long‐chain fatty acid uptake: Where are we now?
Authors: Clavelo‐Farrow Christina , Thomas Patricia 
Published: August 2023

AbstractType 2 diabetes (T2D) in humans is typically preceded by elevated levels of circulatory long‐chain free fatty acids (LC‐FFA). These excess LC‐FFA are widely thought to be taken up by pancreatic β‐cells, contributing to their dysfunction and death during the development of T2D; a process that has been termed lipotoxicity. Depending on their degree of saturation and carbon chain length, LC‐FFA can exert different effects on pancreatic β‐cells viability and function in vitro. Long‐chain saturated fatty acids (LC‐SFA) are thought to be toxic, whereas monounsaturated fatty acids are not and may even offer protection against the toxic effects of LC‐SFAs. However, the mechanism of LC‐FFA uptake into pancreatic β‐cells is poorly understood, partly because it has been an understudied area of research. Determining how LC‐FFA are taken up into β‐cells is crucial for later formulation of therapies to prevent potential cellular overload of LC‐FFA, thereby slowing the onset of T2D. In this work, we detail more than 40 years of literature investigating the role of membrane‐associated transport proteins in LC‐FFA uptake. By focussing on what is known in other cell types, we highlight where we can extrapolate our current understanding of protein‐mediated transport to β‐cells and uncover where further understanding is required.
Risk prediction of bladder cancer among person with diabetes: A derivation and validation study
Authors: Wong Martin C. S. , Huang Junjie , Wang Harry H. X. , Yau Sarah T. Y. , Teoh Jeremy Y. C. , Chiu Peter K. F. , Ng Chi‐Fai , Leung Eman Yee‐Man 
Published: August 2023

AbstractAimsThis study aimed to devise and validate a clinical scoring system for risk prediction of bladder cancer to guide urgent cystoscopy evaluation among people with diabetes.MethodsPeople with diabetes who received cystoscopy from a large database in the Chinese population (2009–2018). We recruited a derivation cohort based on random sampling from 70% of all individuals. We used the adjusted odds ratios (aORs) for independent risk factors to devise a risk score, ranging from 0 to 5: 0–2 ‘average risk’ (AR) and 3–5 ‘high risk’ (HR).ResultsA total of 5905 people with diabetes, among whom 123 people with BCa were included. The prevalence rate in the derivation (n  = 4174) and validation cohorts (n  = 1731) was 2.2% and 1.8% respectively. Using the scoring system constructed, 79.6% and 20.4% in the derivation cohort were classified as AR and HR respectively. The prevalence rate in the AR and HR groups was 1.57% and 4.58% respectively. The risk score consisted of age (18–70: 0; >70: 2), male sex (1), ever/ex‐smoker (1) and duration of diabetes (≥10 years: 1). Individuals in the HR group had 3.26‐fold (95% CI = 1.65–6.44, p  = 0.025) increased prevalence of bladder than the AR group. The concordance (c‐) statistics was 0.72, implying a good discriminatory capability of the risk score to stratify high‐risk individuals who should consider earlier cystoscopy.ConclusionsThe risk prediction algorithm may inform urgency of cystoscopy appointments, thus allowing a more efficient use of resources and contributing to early detection of BCa among people planned to be referred.
Improving data quality from routine clinical appointments—Development of a minimum dataset for traumatic dental injuries in children and adolescents
Authors: Kenny Kate P. , Pavitt Sue , Foy Robbie , Day Peter F. 
Published: August 2023

AbstractBackground/AimsIt is currently difficult to evaluate the success or not of treatment for dental injuries due to poor recording of diagnostic and treatment codes in clinical dentistry. A minimum dataset comprises a standardised minimum set of outcomes along with a specified outcome measurement instrument, to allow aggregated use of data from routine clinical care appointments. This study aimed to determine which outcomes should be included in a minimum dataset for traumatic dental injuries (TDI).Materials and MethodsThis is a three‐stage sequential, mixed‐methods study, using evidence‐based best practice for dataset development. Normalisation process theory informed the development of the study protocols. In Stage 1, semi‐structured interviews with patients and their parent or guardian were undertaken to identify outcomes of importance to patients. In Stage 2, an online Delphi survey was undertaken to identify outcomes of importance to clinicians. In Stage 3, a National Consensus Meeting was undertaken involving patient representatives, clinicians and other stakeholders, to agree which outcomes should be included in the minimum dataset.ResultsStage 1: Eleven participants were recruited, five children and six parents. Two key themes emerged from the analysis—communication and aesthetics. In Stage 2, 34 dentists were recruited, and 32 completed both rounds of the survey (97% retention). Most outcomes were deemed by participants to be of ‘critical importance’, with three outcomes deemed ‘important’ and none to be ‘of limited importance’. In Stage 3, 15 participants took part in the consensus meeting. Participants agreed that the dataset should comprise a list of clinician‐important outcomes (pulp healing, periodontal healing, discolouration, tooth loss) and a list of patient‐important outcomes (communication, aesthetics, pain, quality of life).ConclusionA Minimum Dataset for TDI has been developed using a robust and transparent methodology.
Is online‐only learning as effective as blended learning? A longitudinal study comparing undergraduate students' performance in oral radiology
Authors: Mücke Katharina , Busch Caroline , Becker Jürgen , Drescher Dieter , Becker Kathrin 
Published: August 2023

AbstractIntroductionBlended learning seems to be an effective teaching concept in oral radiology. During the COVID‐19 pandemic, blended learning shifted towards online‐only learning. The aim of the present study was to compare the effectiveness of pandemic online‐only and pre‐pandemic blended learning in three consecutive oral radiology courses (C1, C2 and C3) and to examine whether additional video‐based e‐learning modules (VBLMs) had a positive impact on undergraduate students' performance during pandemic semesters.Materials and MethodsData from 205 undergraduate dental students participating either in a blended learning or an online‐only learning concept were analysed. Pre‐pandemic blended learning comprised face‐to‐face seminars and access to an oral radiology platform (ORP). Pandemic online‐only learning comprised online seminars, access to the ORP and additional VBLMs (two VBLMs for C1, four VBLMs for C2 and six VBLMs for C3). Through standardised e‐exams at the beginning and end of each semester, performance in final exams and knowledge gain were compared between the two groups.ResultsNo significant differences in scores in final exams (p = .11) and knowledge gain (p = .18) were found when comparing the pre‐pandemic and pandemic groups. On course level, however, students receiving a lower number of VBLMs performed significantly worse in final exams (C1: p < .01, C2: p = .02) and showed inferior knowledge gain (C2: p < .01) during the pandemic.ConclusionsWithin the limitations of the study, the present investigation confirmed that pandemic online‐only learning involving VBLMs might be as effective as pre‐pandemic blended learning.
Frequency and phenotypic spectrum of spinocerebellar ataxia 27B and other genetic ataxias in a Spanish cohort of late‐onset cerebellar ataxia
Authors: Iruzubieta Pablo , Pellerin David , Bergareche Alberto , Albajar Inés , Mondragón Elisabet , Vinagre Ana , Fernández‐Torrón Roberto , Moreno Fermín , Equiza Jon , Campo‐Caballero David , Poza Juan José , Ruibal Marta , Formica Alessandro , Dicaire Marie‐Josée , Danzi Matt C. , Zuchner Stephan , Croitoru Ioana , Ruiz Montserrat , Schlüter Agatha , Casasnovas Carlos , Pujol Aurora , Brais Bernard , Houlden Henry , López de Munain Adolfo , Ruiz‐Martínez Javier 
Published: August 2023

AbstractBackground and purposeDominantly inherited GAA repeat expansions in the fibroblast growth factor 14 (FGF14) gene have recently been shown to cause spinocerebellar ataxia 27B (SCA27B). We aimed to study the frequency and phenotype of SCA27B in a cohort of patients with unsolved late‐onset cerebellar ataxia (LOCA). We also assessed the frequency of SCA27B relative to other genetically defined LOCAs.MethodsWe recruited a consecutive series of 107 patients with LOCA, of whom 64 remained genetically undiagnosed. We screened these 64 patients for the FGF14 GAA repeat expansion. We next analysed the frequency of SCA27B relative to other genetically defined forms of LOCA in the cohort of 107 patients.ResultsEighteen of 64 patients (28%) carried an FGF14 (GAA)≥250 expansion. The median (range) age at onset was 62.5 (39–72) years. The most common clinical features included gait ataxia (100%) and mild cerebellar dysarthria (67%). In addition, episodic symptoms and downbeat nystagmus were present in 39% (7/18) and 37% (6/16) of patients, respectively. SCA27B was the most common cause of LOCA in our cohort (17%, 18/107). Among patients with genetically defined LOCA, SCA27B was the main cause of pure ataxia, RFC1‐related disease of ataxia with neuropathy, and SPG7 of ataxia with spasticity.ConclusionWe showed that SCA27B is the most common cause of LOCA in our cohort. Our results support the use of FGF14 GAA repeat expansion screening as a first‐tier genetic test in patients with LOCA.
Real‐world challenges in the diagnosis of primary progressive multiple sclerosis
Authors: Blok Katelijn M. , Smolders Joost , van Rosmalen Joost , Martins Jarnalo Carine O. , Wokke Beatrijs , de Beukelaar Janet 
Published: August 2023

AbstractBackground and purposeDespite the 2017 revisions to the McDonald criteria, diagnosing primary progressive multiple sclerosis (PPMS) remains challenging. To improve clinical practice, the aim was to identify frequent diagnostic challenges in a real‐world setting and associate these with the performance of the 2010 and 2017 PPMS diagnostic McDonald criteria.MethodsClinical, radiological and laboratory characteristics at the time of diagnosis were retrospectively recorded from designated PPMS patient files. Possible complicating factors were recorded such as confounding comorbidity, signs indicative of alternative diagnoses, possible earlier relapses and/or incomplete diagnostic work‐up (no cerebrospinal fluid examination and/or magnetic resonance imaging brain and spinal cord). The percentages of patients fulfilling the 2010 and 2017 McDonald criteria were calculated after censoring patients with these complicating factors.ResultsA total of 322 designated PPMS patients were included. Of all participants, it was found that n = 28/322 had confounding comorbidity and/or signs indicative of alternative diagnoses, n = 103/294 had possible initial relapsing and/or uncertainly progressive phenotypes and n = 73/191 received an incomplete diagnostic work‐up. When applying the 2010 and 2017 diagnostic PPMS McDonald criteria on n = 118 cases with a full diagnostic work‐up and a primary progressive disease course without a better alternative explanation, these were met by 104/118 (88.1%) and 98/118 remaining patients (83.1%), respectively (p = 0.15).ConclusionAccurate interpretation of the initial clinical course, consideration of alternative diagnoses and a full diagnostic work‐up are the cornerstones of a PPMS diagnosis. When these conditions are met, the 2010 and 2017 McDonald criteria for PPMS perform similarly, emphasizing the importance of their appropriate application in clinical practice.
The impact of specific program components on romantic relationship satisfaction
Authors: Kanter Jeremy B. , Lannin Daniel G. , McCaig Jessica , Sprecher Susan , Rauer Amy J. , Yazedjian Ani 
Published: August 2023

AbstractObjectiveThe goal was to determine if time spent in specific Healthy Marriage Initiative program components (relationship education courses, supplemental activities, and family support services) was associated with future relationship satisfaction and to examine if effects differed depending on the degree of economic disadvantage.BackgroundHealthy Marriage Initiatives (HMI) generally have small, short‐term positive effects on relationship outcomes. It remains unclear, however, which programming components are responsible for those effects and for whom programming is most effective.MethodUsing two waves of data from over 2,000 lower‐income couples in the Supporting Healthy Marriages study, we conducted path models and a multigroup model to address our research aims.ResultsTime spent in family support services was the only component positively associated with future satisfaction, controlling for the influence of other program components, initial relationship satisfaction, and expectations of the program's effectiveness. Economic disadvantage did not moderate any of these associations.ConclusionResults suggest that many HMI programs may potentially be beneficial to relationship functioning because of the provision of supplementary support services that partially aim to alleviate external stressors and provide personalized assistance to families.ImplicationsPractitioners should not only consider how relationship education programming may influence intimate bonds, but also how complementary programs may also factor into program efficacy.