bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex differences in clinical characteristics and outcomes associated with alcoholic hepatitis
Authors: Pemmasani Gayatri , Tremaine William J , Suresh Kumar Vishnu Charan , Aswath Ganesh , Sapkota Bishnu , Karagozian Raffi , John Savio 
Published: August 2023

Background
Alcohol-associated liver disease is increasing among females with an earlier onset and more severe disease at lower levels of exposure. However, there is paucity of literature regarding sex differences related to alcoholic hepatitis.

Methods
Hospitalized patients with alcoholic hepatitis were selected from the US Nationwide readmissions database 2019. In this cohort, we evaluated sex differences in baseline comorbidities, alcoholic hepatitis related complications and mortality. A subset of patients with alcoholic hepatitis who were hospitalized between January and June 2019 were identified to study sex differences in 6 month readmission rate, mortality during readmission, and composite of mortality during index hospitalization or readmission.

Results
Among 112 790 patients with alcoholic hepatitis, 33.3% were female. Female patients were younger [48 (38–57) vs. 49 (39–58) years; both P < 0.001] but had higher rates of important medical and mental-health related comorbidities. Compared with males, females had higher rates of hepatic encephalopathy (11.5% vs. 10.1; P < 0.001), ascites (27.9% vs. 22.5%; P < 0.001), portal hypertension (18.5% vs. 16.4%; P < 0.001), cirrhosis (37.3% vs. 31.9%; P < 0.001), weight loss (19.0% vs. 14.5%; P < 0.001), hepatorenal syndrome (4.4% vs. 3.8%; P < 0.001), spontaneous bacterial peritonitis (1.9% vs. 1.7%; P = 0.026), sepsis (11.1% vs. 9.5%; P < 0.001), and blood transfusion (12.9% vs. 8.7%; P < 0.001). Females had a similar in-hospital mortality rate (4.3%) compared to males (4.1%; P = 0.202; adjusted odds ratio (OR) 1.02, 95% CI (cardiac index) 0.89–1.15; P = 0.994). In the subset of patients (N = 58 688), females had a higher 6-month readmission rate (48.9% vs. 44.9%; adjusted OR 1.12 (1.06–1.18); P < 0.001), mortality during readmission (4.4% vs. 3.2%; OR 1.23 (1.08–1.40); P < 0.01), and composite of mortality during index hospitalization or readmission (8.7% vs. 7.2%; OR 1.15 (1.04–1.27); P < 0.01).

Conclusion
Compared to their male counterparts, females with alcoholic hepatitis were generally younger but had higher rates of comorbidities, alcoholic hepatitis related complications, rehospitalizations and associated mortality. The greater risks of alcohol-associated liver dysfunction in females indicate the need for more aggressive management.
Application of preoperative fluorodeoxyglucose-PET/CT parameters for predicting prognosis of high-grade neuroendocrine cervical cancer
Authors: Song Changho , Lee Jong Jin , Lee Shin-Hwa , Park Jeong-Yeol , Kim Dae-Yeon , Suh Dae-Shik , Kim Jong-Hyeok , Kim Yong-Man , Kim Ju-Hyun 
Published: August 2023

Objective
High-grade neuroendocrine cervical cancer (HGNECC) is a rare and aggressive cervical cancer subtype. In this study, we aimed to evaluate the prognostic value of fluorodeoxyglucose-PET/computed tomography (CT) parameters for HGNECC.

Materials and methods
This single-center retrospective study included 29 patients with HGNECC who underwent fluorodeoxyglucose-PET/CT scan followed by surgery between 2006 and 2016.

Results
The median follow-up period was 40 (range, 4–184) months. After surgery, the resection margins were tumor-negative in 28 patients (96.6%), 8 (27.6%) patients had parametrial tumor invasion, and 7 patients (24.1%) tested positive for lymph node metastasis. The tumor recurred in 20 patients (69%) and 18 patients (62.1%) died during the observation period. In the univariate analyses, age and total lesion glycolysis (TLG) were associated with worse disease-free survival (DFS) (age, hazard ratio 1.056, 95% CI 1.014–1.100, P = 0.009; TLG2.5, hazard ratio 1.003, 95% CI 1–1.006, P = 0.033; and TLG3.0, hazard ratio 1.003, 95% CI 1–1.006, P = 0.034). In the multivariate analyses, older age and higher TLG3.0 were identified as independent poor prognostic factors for DFS (age, hazard ratio 1.058, 95% CI 1.014–1.104, P = 0.009; TLG3.0, hazard ratio 1.004, 95% CI 1–1.007, P = 0.033), while resection margin involvement was identified as an independent factor to predict poor overall survival (hazard ratio 20.717, 95% CI 1.289–332.964, P = 0.032).

Conclusion
Among the preoperative fluorodeoxyglucose-PET/CT parameters, TLG3.0 may be useful for predicting DFS in patients with HGNECC.
Quantitative uptake in 99mTc-EDDA/HYNIC-TOC somatostatin receptor imaging – the effect of long-acting release somatostatin analogue therapy
Authors: Gemmell Alastair J. , Brown Colin M. , Ray Surajit , Small Alexander 
Published: August 2023

Purpose
Withdrawal of long-acting release somatostatin analogue (LAR-SSA) treatment before somatostatin receptor imaging is based on empirical reasoning that it may block uptake at receptor sites. This study aims to quantify differences in uptake of 99mTc-EDDA/HYNIC-TOC between patients receiving LAR-SSA and those who were not.

Methods
Quantification of 177 patients (55 on LAR-SSA) imaged with 99mTc-EDDA/HYNIC-TOC was performed, with analysis of pathological tissue and organs with physiological uptake using thresholded volumes of interest. Standardised uptake values (SUVs) and tumour/background (T/B) ratios were calculated and compared between the two patient groups.

Results
SUVs were significantly lower for physiological organ uptake for patients on LAR-SSA (e.g. spleen: SUVmax 13.3 ± 5.9 versus 33.9 ± 9.0, P < 0.001); there was no significant difference for sites of pathological uptake (e.g. nodal metastases: SUVmax 19.2 ± 13.0 versus 17.4 ± 11.5, P = 0.552) apart from bone metastases (SUVmax 14.1 ± 13.5 versus 7.7 ± 8.0, P = 0.017) where it was significantly higher.

Conclusion
LAR-SSA has an effect only on physiological organ uptake of 99mTc-EDDA/HYNIC-TOC, reducing uptake. It has no significant effect on pathological uptake for most sites of primary and metastatic disease. This should be taken into account if making quantitative measurements, calculating T/B ratios or assigning Krenning Scores. There is the potential for improved dosimetric results in Peptide Receptor Radionuclide Therapy by maintaining patients on LAR-SSA.
Incidence and associated factors of post-dural puncture headache among orthopaedic patients after spinal anesthesia: a prospective cohort study
Authors: Oumer Keder Essa , Aychew Habtamu , Daniel Tenbite , Mekete Getachew , Belete Kumlachew Geta , Negash Tadese Tamire 
Published: August 2023

Background:
Post-dural puncture headache (PDPH) is one of a complication of spinal anaesthesia, influenced mostly by various factors including the patient’s age, spinal needle size and design and sex. This headache can be severe and debilitating, preventing ambulation and limiting daily living activities.

Objective:
This study assessed the incidence and associated factors of PDPH among patients who received spinal anaesthesia for orthopaedic procedures at the Debre Tabor Comprehensive Specialized Hospital from June to August 2022

Methods:
Prospective cohort study design was employed using Consecutive sampling method among patients who received spinal anaesthesia for orthopaedics procedure at Debre Tabor Comprehensive Specialized Hospital from June to August 2022. Data were collected by face to face interview and direct observation based on questionnaire. The data were entered to epidata 4.6 and analyzed by SPSS version 20 software. A total 95 patients aged 16–75 was participated in study. Those independent variable that were significant on binary logistic regression at P less than 0.2, were analyzed on multivariate regression, and considered significant association with PDPH at P value less than 0.05.

Result:
Ninety-five study participants were included in our study of which 19 (20%) had developed PDPH. Among patients who develop PDPH; 9.5% of the patients reported moderate pain while 10.5% experience mild PDPH and 80% of patient has no pain. The BMI and age were found to have significant association with PDPH [(P value 0.018, adjusted odds ratio 8.738, 95% CI, 1.461–52.269) and (P value 0.011, adjusted odds ratio 12.146, 95% CI, 1.753–84.170)], respectively) to PDPH.

Conclusion and recommendation:
The incidence of PDPH was found to be higher in Debre Tabor Comprehensive Specialized Hospital. The hospital management and the anaesthetists should minimize the magnitude of by strictly following different preventive strategies.
Challenges in Accessing Mental Health Care during Pregnancy and Postpartum in Rural Montana
Authors: Hanson Marcy N. , Reese Sarah , Newcomer Sophia R. 
Published: August 2023

Abstract

Purpose:
Postpartum depression is a well-known maternal health care concern. For women using substances or experiencing underlying mental health conditions, incidence of postpartum depression is higher than that of the general population. The purpose of this study was to identify barriers and facilitators associated with seeking mental health care among women with substance use disorder or mental health concerns.

Study Design and Methods:
Qualitative methods using interviews were conducted via the narrative inquiry approach. Women receiving care at a clinic in rural Montana and reporting substance use or mental health concerns were referred to the research team by the care manager. Participants were at least 18 years of age, English speaking, and pregnant or within 12 months postpartum at time of referral.

Results:
Twenty-five women met inclusion criteria and were referred for potential study participation. Seven women were interviewed. Four themes on family history, stigmatization, lack of postpartum depression awareness, and isolation were identified.

Clinical Implications:
Our findings provide a better understanding of barriers and facilitators to seeking mental health care during pregnancy and postpartum among women living in rural areas with mental health concerns or perinatal substance use. An environment where opportunities for women to receive mental health care in a location that is free of stigma and judgment, while understanding the effects of familial trauma and limited or inconsistent social support, is essential to promote optimal outcomes.
Sociodemographic Characteristics and Clinical Profile of Suicide Attempters Attending the Emergency Department at a Tertiary Care Hospital in Oman: A Retrospective Study
Authors: Al Khatri Mahmood , Al Huseini Salim , Almaqbali Mandhar , Cucchi Angie , Al Saadi Al-khatib , Al Farsi Abdulmunim , Jose Sachin , Al-Sibani Nasser , Al-Adawi Samir 
Published: August 2023

Objective:
This study examined the sociodemographic and clinical characteristics of individuals who attended the emergency department of a tertiary care center in Muscat, Oman following a suicide attempt.

Methods:
A retrospective study (N=154) was conducted between January 2015 and June 2018. Information that was collected included sociodemographic variables (age, nationality, sex, marital status, and occupation), risk (medical comorbidities, psychiatric history, substance misuse, alcohol misuse, and previous history of suicide attempts), and precipitating factors, as well as the chosen methods for the suicide attempts.

Results:
In all, 83.1% of the sample were Omanis, and women constituted 69.5%. The mean age of the sample was 27 years; 30% were students, 42% were unemployed, and 40.9% had a history of psychiatric disorders. Family conflict, suffering from chronic illness, and having social problems were the most common precipitating factors for the suicide attempt. The most common method used in the suicide attempt was drug overdose (48.1%), mainly involving paracetamol (acetaminophen) (40%). Significant gender differences emerged in precipitating factors, history of substance misuse, and methods of suicide.

Conclusions:
The data from this study are consistent with international trends that suggest that women and younger age groups are the most vulnerable to suicide attempts. Although in its infancy, the type of research presented here could lay the groundwork for preventive interventions and programs.
Pulmonary cystic echinococcosis
Authors: Weber Tim Frederik , Junghanss Thomas , Stojković Marija 
Published: August 2023

Purpose of review
The aim of our review is to summarize specific clinical, diagnostic and treatment aspects of pulmonary cystic echinococcosis. The lung is the organ second most affected by cystic echinococcosis with approximately a quarter of cystic echinococcosis cysts. Most cysts are in the liver. Apart from the watch and wait approach for selected inactive cysts [cystic echinococcosis CE4, CE5], the well established WHO cystic echinococcosis cyst classification-based treatment of hepatic cystic echinococcosis cannot be applied to pulmonary cystic echinococcosis cysts. Some standard interventions can even be harmful when applied to pulmonary cystic echinococcosis cysts.

Recent findings
Cystic echinococcosis is one of the neglected tropical diseases (NTDs). Development of new diagnostics and treatment modalities is hampered by low investment into research and is accordingly slow.

Summary
Surgery is the mainstay of treatment for pulmonary cystic echinococcosis cysts. Parenchyma-sparing surgical techniques should be used whenever possible. Albendazole induces decay of the parasitic cyst membrane, opening of cystobronchial fistulas and cyst complications, which can be life threatening. It is strongly recommended to seek advice from expert centres, including differential diagnoses, treatment and a long-term management plan.
The Feasibility of Deep Learning–Based Reconstruction for Low-Tube-Voltage CT Angiography for Transcatheter Aortic Valve Implantation
Authors: Kojima Tsukasa , Yamasaki Yuzo , Matsuura Yuko , Mikayama Ryoji , Shirasaka Takashi , Kondo Masatoshi , Kamitani Takeshi , Kato Toyoyuki , Ishigami Kousei , Yabuuchi Hidetake 
Published: August 2023

Objective
The purpose of this study is to evaluate the efficacy of deep learning reconstruction (DLR) on low-tube-voltage computed tomographic angiography (CTA) for transcatheter aortic valve implantation (TAVI).

Methods
We enrolled 30 patients who underwent TAVI-CT on a 320-row CT scanner. Electrocardiogram-gated coronary CTA (CCTA) was performed at 100 kV, followed by nongated aortoiliac CTA at 80 kV using a single bolus of contrast material. We used hybrid-iterative reconstruction (HIR), model-based IR (MBIR), and DLR to reconstruct these images. The contrast-to-noise ratios (CNRs) were calculated. Five-point scales were used for the overall image quality analysis. The diameter of the aortic annulus was measured in each reconstructed image, and we compared the interobserver and intraobserver agreements.

Results
In the CCTA, the CNR and image quality score for DLR were significantly higher than those for HIR and MBIR (P < 0.01). In the aortoiliac CTA, the CNR for DLR was significantly higher than that for HIR (P < 0.01) and significantly lower than that for MBIR (P ≤ 0.02). The image quality score for DLR was significantly higher than that for HIR (P < 0.01). No significant differences were observed between the image quality scores for DLR and MBIR. The measured aortic annulus diameter had high interobserver and intraobserver agreement regardless of the reconstruction method (all intraclass correlation coefficients, >0.89).

Conclusions
In low tube voltage TAVI-CT, DLR provides higher image quality than HIR, and DLR provides higher image quality than MBIR in CCTA and is visually comparable to MBIR in aortoiliac CTA.
Appendiceal Neuroendocrine Neoplasms: A Comprehensive Review
Authors: Padmanabhan Nair Sobha Renjith , Jensen Corey T. , Waters Rebecca , Calimano-Ramirez Luis Fernando , Virarkar Mayur K. 
Published: August 2023

Abstract
Appendiceal neuroendocrine neoplasm (NEN) is the most common adult appendiceal malignant tumor, constituting 16% of gastrointestinal NENs. They are versatile tumors with varying morphology, immunohistochemistry, secretory properties, and cancer genomics. They are slow growing and clinically silent, to begin with, or present with features of nonspecific vague abdominal pain. Most acute presentations are attributed clinically to appendicitis, with most cases detected incidentally on pathology after an appendectomy. Approximately 40% of them present clinically with features of hormonal excess, which is likened to the functional secretory nature of their parent cell of origin. The symptoms of carcinoid syndrome render their presence clinically evident. However, slow growing and symptomatically silent in its initial stages, high-grade neuroendocrine tumors and neuroendocrine carcinomas of the appendix are aggressive and usually have hepatic and lymph node metastasis at presentation. This review article focuses on imaging characteristics, World Health Organization histopathological classification and grading, American Joint Committee on Cancer/Union or International Cancer Control, European Neuroendocrine Tumor Society staging, European Neuroendocrine Tumor Society standardized guidelines for reporting, data interpretation, early-stage management protocols, and advanced-stage appendiceal NENs. Guidelines are also set for the follow-up and reassessment. The role of targeted radiotherapy, chemotherapy, and high-dose somatostatin analogs in treating advanced disease are discussed, along with types of ablative therapies and liver transplantation for tumor recurrence. The search for newer location-specific biomarkers in NEN is also summarized. Regarding the varying aggressiveness of the tumor, there is a scope for research in the field, with plenty of data yet to be discovered.
Childhood intelligence and risk of depression in later-life: A longitudinal data-linkage study
Authors: Ball Emily L , Altschul Drew M , Cox Simon R , Deary Ian J , McIntosh Andrew M , Iveson Matthew H 
Published: August 2023

AbstractBackgroundLower childhood intelligence test scores are reported in some studies to be associated with higher risk of depression in adulthood. The reasons for the association are unclear. This longitudinal data-linkage study explored the relationship between childhood intelligence (at age ∼11) and risk of depression in later-life (up to age ∼85), and whether environmental factors in childhood and adulthood accounted for some of this association.MethodsIntelligence test scores collected in the Scottish Mental Survey 1947 were linked to electronic health records (hospital admissions and prescribing data) between 1980-2020 (n=53,037), to identify diagnoses of depression. Mixed-effect Cox regression models were used to explore the relationship between childhood intelligence test scores and risk of depression in later-life. Analyses were also adjusted for environmental factors experienced in childhood (number of siblings) and adulthood (Carstairs index, urban/rural).ResultsTwenty-seven percent of participants were diagnosed with depression during follow-up (n=14,063/53,037). Greater childhood intelligence test scores were associated with a reduced risk of depression in an unadjusted analysis (HR=0.95, 95% CI=0.93 to 0.97, P<0.001), and after adjustment for environmental factors experienced in childhood and adulthood (HR=0.95, 95% CI=0.91 to 1.00, P=0.032).ConclusionsThis study provides additional evidence of an association between higher childhood intelligence and reduced risk of later depression. Of the environmental factors included in this study, childhood and adulthood environmental factors did not seem to be substantial confounders.Key messagesIdentifying modifiable environmental risk factors, may help to identify interventions for the primary prevention of depression.Greater childhood intelligence test scores (at age 11) were associated with a reduced risk of depression in later-life (up to age 85) following unadjusted analysis.The association between childhood intelligence and risk of depression in later-life remained even after adjusting for childhood environmental factors (number of siblings) and adulthood environmental factors (Carstairs and urban/rural).How depression is defined in epidemiological research (e.g., diagnostic codes in hospital admissions or being prescribed antidepressants) could influence the association between childhood intelligence and depression in later-life.
Can Deep Learning Models Differentiate Atrial Fibrillation from Atrial Flutter?
Authors: Ribeiro Estela , Soares Quenaz Bezerra , Dias Felipe Meneguitti , Krieger Jose Eduardo , Gutierrez Marco Antonio 
Published: August 2023

ABSTRACTAtrial Fibrillation (AFib) and Atrial Flutter (AFlut) are prevalent irregular heart rhythms that poses significant risks, particularly for the elderly. While automated detection systems show promise, misdiagnoses are common due to symptom similarities. This study investigates the differentiation of AFib from AFlut using standard 12-lead ECGs from the PhysioNet CinC Challenge 2021 (CinC2021) databases, along with data from a private database. We employed both one dimensional-based (1D) and image-based (2D) Deep Learning models, comparing different 1D and 2D Convolutional Neural Network (CNN) architectures for classification. For 1D models, LiteVGG-11 demonstrated the highest performed, achieving an accuracy (Acc) of 77.91 (±1.73%), area under the receiver operating characteristic curve (AUROC) of 87.17 (±1.29%), F1 score of 76.59 (±1.90%), specificity (Spe) of 71.69 (±4.73%), and sensitivity (Se) of 86.53 (±5.33%). On the other hand, for 2D models the EfficientNet-B2 outperformed other architectures, with an Acc of 75.20 (±3.38%), AUROC of 85.50 (±1.14%), F1 of 71.59 (±3.66%), Spe of 74.76 (±13.85%) and Se of 75.74 (±13.85%). Our findings indicate that distinguishing between AFib and AFlut is non-trivial, with 1D signals exhibiting superior performance compared to their 2D counterparts. Furthermore, it’s noteworthy that the performance of our models on the CinC2021 databases was considerably lower than on our private dataset.
Measures of Street Drug Availability and US Drug Overdose Mortality in the Era of Fentanyl and Stimulants
Authors: Cano Manuel , Timmons Patricia , Hooten Madeline , Sweeney Kaylin 
Published: August 2023

AbstractBackgroundStreet-sold drugs such as illicitly-manufactured fentanyl and stimulants have replaced prescription opioids as the primary contributors to fatal overdoses in the United States (US), yet the street availability of these substances is challenging to quantify. Building on the foundation of prior research on law enforcement drug seizures, the present study compares a variety of publicly-available drug seizure measures to identify which measures account for the most variation in drug overdose mortality between states, within states over time, and in various US demographic groups.MethodsDrug seizure counts from the National Forensic Laboratory Information System and drug overdose mortality rates from the Centers for Disease Control and Prevention were examined for all US states, 2013-2021 (459 state-years). State- and year-fixed effects models regressed drug overdose mortality rates (in the overall population and subpopulations by sex, age, and race/ethnicity) on various drug seizure measures, including rates per population and proportional shares of fentanyl-related, heroin, cocaine, methamphetamine, and xylazine seizures.ResultsFor drug overdose death rates in the overall population and all subpopulations examined by sex, race/ethnicity, and age (except ages 15-29), the model including all drug seizure proportional measures represented the best-performing model examined (as identified via the lowest Akaike Information Criterion and highest within R-squared value), followed by the model including only the fentanyl-related seizure proportion.ConclusionsFindings support the utility of publicly-available drug seizure composition measures, especially the proportion of fentanyl-related seizures, as potential proxies for street drug availability across the US and in various subpopulations.