bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of missing data in Bayesian network structure learning: an application to linked biomedical and social survey data
Authors: Ke Xuejia , Keenan Katherine , Smith V. Anne 
Published: December 2022

Abstract
Background
Availability of linked biomedical and social science data has risen dramatically in past decades, facilitating holistic and systems-based analyses. Among these, Bayesian networks have great potential to tackle complex interdisciplinary problems, because they can easily model inter-relations between variables. They work by encoding conditional independence relationships discovered via advanced inference algorithms. One challenge is dealing with missing data, ubiquitous in survey or biomedical datasets. Missing data is rarely addressed in an advanced way in Bayesian networks; the most common approach is to discard all samples containing missing measurements. This can lead to biased estimates. Here, we examine how Bayesian network structure learning can incorporate missing data.

Methods
We use a simulation approach to compare a commonly used method in frequentist statistics, multiple imputation by chained equations (MICE), with one specific for Bayesian network learning, structural expectation-maximization (SEM). We simulate multiple incomplete categorical (discrete) data sets with different missingness mechanisms, variable numbers, data amount, and missingness proportions. We evaluate performance of MICE and SEM in capturing network structure. We then apply SEM combined with community analysis to a real-world dataset of linked biomedical and social data to investigate associations between socio-demographic factors and multiple chronic conditions in the US elderly population.

Results
We find that applying either method (MICE or SEM) provides better structure recovery than doing nothing, and SEM in general outperforms MICE. This finding is robust across missingness mechanisms, variable numbers, data amount and missingness proportions. We also find that imputed data from SEM is more accurate than from MICE. Our real-world application recovers known inter-relationships among socio-demographic factors and common multimorbidities. This network analysis also highlights potential areas of investigation, such as links between cancer and cognitive impairment and disconnect between self-assessed memory decline and standard cognitive impairment measurement.

Conclusion
Our simulation results suggest taking advantage of the additional information provided by network structure during SEM improves the performance of Bayesian networks; this might be especially useful for social science and other interdisciplinary analyses. Our case study show that comorbidities of different diseases interact with each other and are closely associated with socio-demographic factors.
Clinical outcomes and prognostic factors of patients with sepsis caused by intra-abdominal infection in the intensive care unit: a post-hoc analysis of a prospective cohort study in Korea
Authors: Park Chan Hee , Lee Jeong Woo , Lee Hak Jae , Oh Dong Kyu , Park Mi Hyeon , Lim Chae-Man , Hong Suk-Kyung ,   the Korean Sepsis Alliance (KSA) investigators, Lim Chae-Man , Hong Sang-Bum , Oh Dong Kyu , Suh Gee Young , Jeon Kyeongman , Ko Ryoung-Eun , Cho Young-Jae , Lee Yeon Joo , Lim Sung Yoon , Park Sunghoon , Lim Chae-Man , Hong Suk-Kyung , Kwak Sang Hyun , Lee Song-I. , Moon Jae Young , Kim Kyung Chan , Park Sunghoon , Park Tai Sun , Chang Youjin , Seong Gil Myeong , Lee Heung Bum , Heo Jeongwon , Lee Jae-myeong , Cho Woo Hyun , Jeon Kyeongman , Lee Yeon Joo , Lee Sang-Min , Lee Su Hwan , Ahn Jong-Joon , Choi Eun Young 
Published: December 2022

Abstract
Background
Sepsis is the most common cause of death in hospitals, and intra-abdominal infection (IAI) accounts for a large portion of the causes of sepsis. We investigated the clinical outcomes and factors influencing mortality of patients with sepsis due to IAI.

Methods
This post-hoc analysis of a prospective cohort study included 2126 patients with sepsis who visited 16 tertiary care hospitals in Korea (September 2019–February 2020). The analysis included 219 patients aged > 19 years who were admitted to intensive care units owing to sepsis caused by IAI.

Results
The incidence of septic shock was 47% and was significantly higher in the non-survivor group (58.7% vs 42.3%, p = 0.028). The overall 28-day mortality was 28.8%. In multivariable logistic regression, after adjusting for age, sex, Charlson Comorbidity Index, and lactic acid, only coagulation dysfunction (odds ratio: 2.78 [1.47–5.23], p = 0.001) was independently associated, and after adjusting for each risk factor, only simplified acute physiology score III (SAPS 3) (p < 0.001) and continuous renal replacement therapy (CRRT) (p < 0.001) were independently associated with higher 28-day mortality.

Conclusions
The SAPS 3 score and acute kidney injury with CRRT were independently associated with increased 28-day mortality. Additional support may be needed in patients with coagulopathy than in those with other organ dysfunctions due to IAI because patients with coagulopathy had worse prognosis.
The barriers and facilitators to health-promoting lifestyle behaviors among people with multiple sclerosis during the coronavirus disease 2019 pandemic: a content analysis study
Authors: Salmani Soheileddin , Mousavi Seyyed Hossein , Navardi Samira , Hosseinzadeh Fatemeh , Pashaeypoor Shahzad 
Published: December 2022

Abstract
Background and aim
Health-promoting lifestyle behaviors (HPLBs) have a significant impact on disease management among people with multiple sclerosis (MS). However, the coronavirus disease 2019 (COVID-19) pandemic has significantly affected lifestyle of all individuals, particularly patients with chronic diseases. The present study aimed to explore the barriers and facilitators to HPLBs among people with MS during the COVID-19 pandemic.

Methods
This qualitative study was conducted in Iran. Participants were sixteen people with MS purposively selected from the central MS clinic of a referral specialty neuroscience hospital in Tehran, Iran. Data were collected via in-depth semi-structured face-to-face interviews and concurrently analyzed through conventional content analysis.
Findings: The mean of participants’ age was 37.93 years and most participants were female (81.25%). The major barriers to HPLBs were lack of knowledge, limited access to resources, and poor health status, while the major facilitators were attention to inner abilities and social support.

Conclusion
Many different factors such as lack of knowledge, limited access to resources, poor health status, awareness, and social support can influence engagement in HPLBs among people with MS. Healthcare authorities and policymakers need to use quality educational and supportive interventions to improve knowledge, health literacy, perceived support, self-efficacy, and self-care ability among people with MS during the COVID-19 pandemic.
A female case with novel KDM5C heterozygous variation presenting with Claes-Jensen type-like phonotype
Authors: Shen Ruiyun , Li Yanyang , Liang Aiming , Li Shijie , Yang Chenlu , Huang Hongmei 
Published: December 2022

Abstract
Background
Lysine(K)-specific demethylase 5C (KDM5C) dysfunction causes X-linked syndromic intellectual developmental disorder Claes-Jensen type in male patients. The clinical presentations of female individuals with heterozygous KDM5C variations vary widely and are only now beginning to be characterized in detail.

Case presentation
Herein, we identified a novel de novo heterozygous nonsense variation of KDM5C (c.3533C > A, p.S1178X) in a sporadic 4-year-old Chinese girl, who presented with Claes-Jensen type-like phenotypes, such as moderate developmental delay, serious expressive language delay, short stature, microcephaly, and typical facial particularities. Moreover, X-chromosome inactivation (XCI) analysis showed no significant skewed X-inactivation.

Conclusion
The report expands the genotype of KDM5C variation in female patients, delineates the phenotype of affected females in this well-known X-linked disorder, and also reinforces the necessity to consider this X-linked gene, KDM5C, in sporadic female patients.
Sudden unilateral hearing loss and vertigo following isolated cerebellar hypoperfusion without infarction due to vertebral artery dissection
Authors: Kim Young Seo , Tehrani Ali S. Saber , Lee Hak Seung 
Published: December 2022

Abstract
Background
The definition of sudden sensorineural hearing loss (SSNHL) is broadly accepted as acute sensorineural hearing loss of more than 30 dB over at least three consecutive frequencies in a pure-tone audiogram (PTA). Acute audiovestibular loss is common with ischaemic stroke in the territory of the anterior inferior cerebellar artery (AICA). However, cases in which SSNHL and vertigo occur with hypoperfusion alone are very rare. We describe a patient who developed unilateral SSNHL and vertigo as initial symptoms caused by cerebellar hypoperfusion by vertebral artery (VA) dissection without the occurrence of infarction.

Case presentation
A 51-year-old man suddenly developed acute hearing loss (AHL) in his left ear and vertigo. On neurological examination, he had vibration-induced right-beating nystagmus and left-beating nystagmus after a head-shaking test. Additionally, he had apogeotropic nystagmus during head turns to either side. The head impulse test (HIT) was normal. PTA showed mild unilateral SSNHL in the left ear. Diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) showed territorial perfusion deficits in the left posterior inferior cerebellar artery (PICA) and anterior inferior cerebellar artery (AICA) without infarction. Two months later, the patient had no vertigo but still had hearing impairment in his left ear. A follow-up PTA documented persistent unilateral SSNHL in the left ear. Additionally, perfusion computed tomography (CT) showed that perfusion deficits remained in the left cerebellum along the PICA and AICA territories.

Conclusions
Our case highlights a case of AHL and vertigo presented by isolated cerebellar hypoperfusion without infarction. It is necessary to consider the possibility of a central cause in patients with AHL and vertigo, and it is important to confirm this possibility through brain magnetic resonance imaging (MRI), including PWI, and magnetic resonance angiography (MRA).
Hypersexual behaviour among young adults in Germany: characteristics and personality correlates
Authors: Jepsen Dennis , Brzank Petra J. 
Published: December 2022

Abstract
Background
Hypersexual behaviour (HB) is characterized by recurring unsuccessful efforts to control intense, repetitive sexual impulses that result in sexual activities and manifest in the behaviour of the concerning individual over an extended period. This study aims to describe the characterization of HB among the target group, identify personality correlates, and associations between HB and a lack of sexual education and reflection during school time.

Methods
A cross-sectional design was used to survey the participants (age 18–27; n = 609) online who were recruited via a web forum for addiction selfcare, a website for casual sex dating, Facebook and the mail distribution of the University of Applied Science Nordhausen (Germany). Standardised questionnaires were used to measure the key variables in the study. The sexual behaviour (masturbation, pornography consumption, promiscuity), several personality tendencies, and retrospective information about sexual education of the participants during school time were investigated. Correlation and binomial logistic regression were used to analyse the data with HB as the outcome variable.

Results
10.5% (n = 64) of the participants were identified as hypersexual. The assignment to male sex, a problematic pornography consumption, and impulsive tendencies were determined as predictors of HB. Strong correlates were identified between HB and promiscuity, and impairments in important areas of life. Weak to moderate correlates comprise between HB and all investigated personality traits, and several aspects of sexual risk behaviour. No association was found between HB and a lacking sexual education during school time. The descriptive analysis revealed further sexual problems within the sample (e.g. feelings of shame and guilt, sexual risk behaviour, sexual dysfunction). Conclusion. Young adults should get more attention as a vulnerable group for the development of hypersexuality in sexual education, prevention and therapy. Regarding to its treatment, HB therefore should be considered together with its associations with sociodemographic information, personality traits, and psychosocial factors.
Efficacy of eicosapentaenoic acid in inflammatory depression: study protocol for a match-mismatch trial
Authors: Suneson Klara , Ängeby Filip , Lindahl Jesper , Söderberg Gustav , Tjernberg Johanna , Lindqvist Daniel 
Published: December 2022

Abstract
Background
Most antidepressant treatment studies have included patients strictly based on the Diagnostic and Statistical Manual of Mental Disorders definition of Major Depressive Disorder (MDD). Given the heterogeneity of MDD, this approach may have obscured inter-patient differences and hampered the development of novel and targeted treatment strategies. An alternative strategy is ​​to use biomarkers to delineate endophenotypes of depression and test if these can be targeted via mechanism-based interventions. Several lines of evidence suggest that “inflammatory depression” is a clinically meaningful subtype of depression. Preliminary data indicate that omega-3 fatty acids, with their anti-inflammatory and neuroprotective properties, may be efficacious in this subtype of depression, and this study aims to test this hypothesis.

Method
We conduct a match-mismatch-trial to test if add-on omega-3 fatty acid eicosapentaenoic acid (EPA) reduces depressive symptoms in patients with MDD and systemic low-grade inflammation. MDD patients on a stable antidepressant treatment are stratified at baseline on high sensitivity-C-reactive protein (hs-CRP) levels to a high-inflammation group (hs-CRP ≥ 3 mg/L) or a low-inflammation group (hs-CRP < 3 mg/L). Both groups receive add-on EPA (2 g per day) for 8 weeks with three study visits, all including blood draws. Patients and raters are blind to inflammation status. Primary outcome measure is change in Hamilton Depression Rating Scale score between baseline and week 8. We hypothesize that the inflammation group has a superior antidepressant response to EPA compared to the non-inflammation group. Secondary outcomes include a composite score of “inflammatory depressive symptoms”, quality of life, anxiety, anhedonia, sleep disturbances, fatigue, cognitive performance and change in biomarkers relating to inflammation, oxidative stress, metabolomics and cellular aging.

Discussion
In this study we will, for the first time using a match-mismatch trial design, test if omega-3 is an efficacious treatment for inflammatory depression. If our study is successful, it could add to the field of precision psychiatry.

Trial registration
This trial was registered May 8, 2017 on clinicaltrials.gov under the reference number NCT03143075
Initial single surgeon evaluation comparing C-arm fluoroscopy with the Cirq robotic assistance device for instrumentation of the thoracolumbar spine
Authors: Desai Sohum K. , Adams Jennifer P. 
Published: December 2022

Abstract
Objective
To compare our experience with pedicle screw insertion of the thoracolumbar spine utilizing the Cirq robot assistance device compared with traditional paradigm using fluoroscopy.

Methods
We prospectively collected data of patients undergoing pedicle screw instrumentation in the thoracolumbar spine performed by a single surgeon at three different centers. One center took delivery of the Cirq robotic assistance device. Remaining two centers used C-arm fluoroscopy. Demographic information, diagnosis, total OR time, intraoperative complications, unexpected return to the operating room, and hospital readmissions within 90 days was compared between the two cohorts.

Results
A total of 166 screws were placed during the study period. Forty percent were placed using the Cirq. Two thirds the patients had traumatic diagnoses with remaining degenerative spine disease. There were no misplaced pedicle screws in either group. While total OR time was longer in the Cirq cohort by 123 min (p = 0.04), actual procedural time was not statistically different (p = 0.11). Nonetheless there were also more hospital readmissions in the Cirq cohort compared with the C arm group (p = 0.04).

Conclusions
Thoracolumbar screws inserted using C-arm fluoroscopy utilize less total operating room time with similar accuracy compared with the Cirq robotic assistance device. Further studies are warranted.
A FHIR has been lit on gICS: facilitating the standardised exchange of informed consent in a large network of university medicine
Authors: Bialke Martin , Geidel Lars , Hampf Christopher , Blumentritt Arne , Penndorf Peter , Schuldt Ronny , Moser Frank-Michael , Lang Stefan , Werner Patrick , Stäubert Sebastian , Hund Hauke , Albashiti Fady , Gührer Jürgen , Prokosch Hans-Ulrich , Bahls Thomas , Hoffmann Wolfgang 
Published: December 2022

Abstract
Background
The Federal Ministry of Education and Research of Germany (BMBF) funds a network of university medicines (NUM) to support COVID-19 and pandemic research at national level. The “COVID-19 Data Exchange Platform” (CODEX) as part of NUM establishes a harmonised infrastructure that supports research use of COVID-19 datasets. The broad consent (BC) of the Medical Informatics Initiative (MII) is agreed by all German federal states and forms the legal base for data processing. All 34 participating university hospitals (NUM sites) work upon a harmonised infrastructural as well as legal basis for their data protection-compliant collection and transfer of their research dataset to the central CODEX platform. Each NUM site ensures that the exchanged consent information conforms to the already-balloted HL7 FHIR consent profiles and the interoperability concept of the MII Task Force “Consent Implementation” (TFCI). The Independent Trusted Third-Party (TTP) of the University Medicine Greifswald supports data protection-compliant data processing and provides the consent management solutions gICS.

Methods
Based on a stakeholder dialogue a required set of FHIR-functionalities was identified and technically specified supported by official FHIR experts. Next, a “TTP-FHIR Gateway” for the HL7 FHIR-compliant exchange of consent information using gICS was implemented. A last step included external integration tests and the development of a pre-configured consent template for the BC for the NUM sites.

Results
A FHIR-compliant gICS-release and a corresponding consent template for the BC were provided to all NUM sites in June 2021. All FHIR functionalities comply with the already-balloted FHIR consent profiles of the HL7 Working Group Consent Management. The consent template simplifies the technical BC rollout and the corresponding implementation of the TFCI interoperability concept at the NUM sites.

Conclusions
This article shows that a HL7 FHIR-compliant and interoperable nationwide exchange of consent information could be built using of the consent management software gICS and the provided TTP-FHIR Gateway. The initial functional scope of the solution covers the requirements identified in the NUM-CODEX setting. The semantic correctness of these functionalities was validated by project-partners from the Ludwig-Maximilian University in Munich. The production rollout of the solution package to all NUM sites has started successfully.
Green immobilization and efficient proliferation of Escherichia coli cells in polyvinyl alcohol hydrogel membranes by unidirectional nanopore dehydration
Authors: Zhong Zhi-Hao , Zhang Yu-Qing 
Published: December 2022

Abstract
Background
The immobilized technology for microbial or cells has the advantages of high microbial activity, high microbial density per unit space, good tolerance, strong shock, load resistance, high processing efficiency, and high reuse rate. It is now widely used in environmental remediation, water quality treatment, biodegradation, food industry, chemical analysis, energy development, medicine and pharmaceuticals, and other fields.

Results
A novel Escherichia coli cell-immobilizing polyvinyl alcohol hydrogel membrane (ECI-PVAHM) was prepared by unidirectional nanopore dehydration (UND) from a 10% polyvinyl alcohol (PVA) aqueous solution containing enhanced green fluorescent protein-labeled E. coli. This bacteria-loaded film has high water stability, flexibility, transparency, and mechanical robustness. Its tensile strength, elongation rate, and swelling rate are in the ranges 0.66–0.90 MPa, 300–390%, and 330–800%, respectively. The effective bacterial load of ECI-PVAHM is 2.375 × 109–1010 CFU/g (dry weight), which does not affect the original crystal structure of the PVAHM. This biofilm has a porous network structure with pore sizes between 0.2 and 1.0 μm, and these cells are embedded in the PVAHM network. When the immobilized cells were continuously cultured for 20 days, and the medium was renewed twice daily, their relative proliferation efficiency after 40 cycles could still be maintained at ~ 91%.

Conclusion
The above results show that the cell division, proliferation ability, and metabolic activity of immobilized E. coli were not affected by the physical barrier of the porous network structure of the hydrogel. This UND-based ECI-PVAHM has potential applications in molecular biology, biopharmaceutical expression and production, bioreactors, and fuel cells.