bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mindfulness in sex therapy and intimate relationships: a feasibility and randomized controlled pilot study in a cross-diagnostic group
Authors: Krieger Julie Fregerslev , Kristensen Ellids , Marquardsen Mikkel , Ofer Shlomy , Mortensen Erik Lykke , Giraldi Annamaria 
Published: June 2023

Abstract

Background
Mindfulness facets can be trained with structured mindfulness interventions, but little is known regarding application on a broader level within sex therapy (e.g. men, partners and different sexual dysfunctions).

Aim
To evaluate the feasibility and preliminary efficacy of an 8-week intervention—specifically, mindfulness for sex and intimacy in relationships (MSIR)—as a supplement to treatment as usual (TAU) as compared with only TAU in a clinical sample of men and women referred for sexual difficulties with or without a partner.

Methods
In this randomized controlled feasibility pilot study, 34 participants were randomized to MSIR + TAU (n = 15) or TAU (n = 19). Six healthy partners were also included in the study. MSIR was administered as 2 individual evaluations and six 2-hour group sessions of mixed gender and different types of sexual dysfunction.

Outcomes
The primary outcome measures were as follows: (1) feasibility, defined as the implementation of recruitment, acceptance, and attendance of intervention in daily clinical practice and the MSIR completion rate; (2) sexual functioning, as measured on a visual analog scale (“bothered by problem”) and by validated questionnaires (Changes in Sexual Function Questionnaire for Females and Males, Female Sexual Function Index, Female Sexual Distress Scale, International Index of Erectile Function).

Results
MSIR was feasible and well received by patients, with high rates of acceptance and intervention completion. As compared with pretreatment, the MSIR + TAU group and TAU control group were significantly less bothered by their sexual problems at the end of treatment, but the change was significantly larger in the MSIR + TAU group (P = .04). Participants in the MSIR + TAU group did not receive fewer TAU sessions than the TAU group (MSIR + TAU mean, 6 sessions; TAU mean, 8 sessions).

Clinical Implications
MSIR could be effectively used in a clinical setting as an add-on to TAU in the treatment of female and male sexual dysfunction and healthy partners.

Strengths and Limitations
The major strength of the study is that it is a randomized controlled study. This study is novel in the sense that it included men and women with different types of sexual dysfunction in the same mindfulness group. Limitations include the pilot nature of the study (e.g. a small sample size), and statistical conclusions should be made with caution. More accurate results may be found in a larger sample.

Conclusion
Results from this study support already existing evidence that mindfulness-based interventions are feasible and effective for targeting sexual dysfunctions in men and women.
Subsistence Farming and Factor Misallocation: Evidence from Ugandan Agriculture
Authors: Morando Bruno 
Published: June 2023

Abstract
This paper presents a model where misallocation in the agricultural factors of production is caused by transportation costs to and from local markets, which result in an inefficiently large share of inputs operated by less productive subsistence farmers. The model derives some testable predictions which are verified in the empirical analysis, based on a representative census of Ugandan farms. Specifically, subsistence farmers operate inefficiently high shares of land and capital and the efficiency losses are more severe in areas where subsistence farming is more widespread, due to lower connectivity with local markets. Conversely, there is no relationship between the level of misallocation and credit access and/or land-market activity. These findings suggest that transportation costs play a key role in determining the efficiency of agricultural input distribution and that land-market liberalization is a necessary but not sufficient condition to tackle misallocation.
Postpartum Home Blood Pressure Monitoring
Authors: Steele Dale W. , Adam Gaelen P. , Saldanha Ian J. , Kanaan Ghid , Zahradnik Michael L. , Danilack-Fekete Valery A. , Stuebe Alison M. , Peahl Alex F. , Chen Kenneth K. , Balk Ethan M. 
Published: June 2023

OBJECTIVE:
To assess the effectiveness of postpartum home blood pressure (BP) monitoring compared with clinic-based follow-up and the comparative effectiveness of alternative home BP–monitoring regimens.

DATA SOURCES:
Search of Medline, Cochrane, EMBASE, CINAHL, and ClinicalTrials.gov from inception to December 1, 2022, searching for home BP monitoring in postpartum individuals.

METHODS OF STUDY SELECTION:
We included randomized controlled trials (RCTs), nonrandomized comparative studies, and single-arm studies that evaluated the effects of postpartum home BP monitoring (up to 1 year), with or without telemonitoring, on postpartum maternal and infant outcomes, health care utilization, and harm outcomes. After double screening, we extracted demographics and outcomes to SRDR+.

TABULATION, INTEGRATION, AND RESULTS:
Thirteen studies (three RCTs, two nonrandomized comparative studies, and eight single-arm studies) met eligibility criteria. All comparative studies enrolled participants with a diagnosis of hypertensive disorders of pregnancy. One RCT compared home BP monitoring with bidirectional text messaging with scheduled clinic-based BP visits, finding an increased likelihood that at least one BP measurement was ascertained during the first 10 days postpartum for participants in the home BP–monitoring arm (relative risk 2.11, 95% CI 1.68–2.65). One nonrandomized comparative study reported a similar effect (adjusted relative risk [aRR] 1.59, 95% CI 1.36–1.77). Home BP monitoring was not associated with the rate of BP treatment initiation (aRR 1.03, 95% CI 0.74–1.44) but was associated with reduced unplanned hypertension-related hospital admissions (aRR 0.12, 95% CI 0.01–0.96). Most patients (83.3–87.0%) were satisfied with management related to home BP monitoring. Home BP monitoring, compared with office-based follow-up, was associated with reduced racial disparities in BP ascertainment by approximately 50%.

CONCLUSION:
Home BP monitoring likely improves ascertainment of BP, which is necessary for early recognition of hypertension in postpartum individuals, and may compensate for racial disparities in office-based follow-up. There is insufficient evidence to conclude that home BP monitoring reduces severe maternal morbidity or mortality or reduces racial disparities in clinical outcomes.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42022313075.
A novel prognostic signature contributes to precision treatment in colon adenocarcinoma with KRAS mutation
Authors: Dong Weiwei , Zhang He , Li Qingyan , Guan Na , Yun Chao , Zhao Huixia , Zhang Fengyun , Zeng Zhiyan , Hu Yanyan , Li Qiuwen , Yang Jingwen , Ma Zihuan , Chen Meiling , Xiao Wenhua 
Published: June 2023

Background
Approximately 40% of colon cancer harbor Kirsten rat sarcoma viral oncogene (KRAS) mutations, but the prognostic value of KRAS mutations in colon cancer is still controversial.

Methods
We enrolled 412 colon adenocarcinoma (COAD) patients with KRAS mutations, 644 COAD patients with KRAS wild-type and 357 COAD patients lacking information on KRAS status from five independent cohorts. A random forest model was developed to estimate the KRAS status. The prognostic signature was established using least absolute shrinkage and selection operator-Cox regression and evaluated by Kaplan–Meier survival analysis, multivariate-Cox analysis, receiver operating characteristic curve and nomogram. The expression data of KRAS-mutant COAD cell lines from the Cancer Cell Line Encyclopedia database and the corresponding drug sensitivity data from the Genomics of Drug Sensitivity in Cancer database were used for potential target and agent exploration.

Results
We established a 36-gene prognostic signature classifying the KRAS-mutant COAD as high and low risk. High risk patients had inferior prognoses compared to those with low risk, while the signature failed to distinguish the prognosis of COAD with KRAS wild-type. The risk score was the independent prognostic factor for KRAS-mutant COAD and we further fabricated the nomograms with good predictive efficiency. Moreover, we suggested FMNL1 as a potential drug target and three drugs as potential therapeutic agents for KRAS-mutant COAD with high risk.

Conclusion
We established a precise 36-gene prognostic signature with great performance in prognosis prediction of KRAS-mutant COAD providing a new strategy for personalized prognosis management and precision treatment for KRAS-mutant COAD.
Changes in early postoperative outcomes and complications observed in a single center during the 2022 COVID-19 pandemic wave in China: A single-center ambispective cohort study
Authors: Wang Lini , Zheng Ziyu , Zhu Shouqiang , Luo Gang , Gao Baobao , Ma Yumei , Xu Shuai , Dong Hailong , Lei Chong 
Published: June 2023

Abstract

Background:
Currently, the effect of the 2022 nationwide coronavirus disease 2019 (COVID-19) wave on the perioperative prognosis of surgical patients in China is unclear. Thus, we aimed to explore its influence on postoperative morbidity and mortality in surgical patients.

Methods:
An ambispective cohort study was conducted at Xijing Hospital, China. We collected 10-day time-series data from December 29 until January 7 for the 2018–2022 period. The primary outcome was major postoperative complications (Clavien–Dindo class III–V). The association between COVID-19 exposure and postoperative prognosis was explored by comparing consecutive 5-year data at the population level and by comparing patients with and without COVID-19 exposure at the patient level.

Results:
The entire cohort consisted of 3350 patients (age: 48.5 ± 19.2 years), including 1759 females (52.5%). Overall, 961 (28.7%) underwent emergency surgery, and 553 (16.5%) had COVID-19 exposure (from the 2022 cohort). At the population level, major postoperative complications occurred in 5.9% (42/707), 5.7% (53/935), 5.1% (46/901), 9.4% (11/117), and 22.0% (152/690) patients in the 2018–2022 cohorts, respectively. After adjusting for potential confounding factors, the 2022 cohort (80% patients with COVID-19 history) had a significantly higher postoperative major complication risk than did the 2018 cohort (adjusted risk difference [aRD], 14.9% (95% confidence interval [CI], 11.5–18.4%); adjusted odds ratio [aOR], 8.19 (95% CI, 5.24–12.81)). At the patient level, the incidence of major postoperative complications was significantly greater in patients with (24.6%, 136/553) than that in patients without COVID-19 history (6.0% [168/2797]; aRD, 17.8% [95% CI, 13.6–22.1%]; aOR, 7.89 [95% CI, 5.76–10.83]). Secondary outcomes of postoperative pulmonary complications were consistent with primary findings. These findings were verified through sensitivity analyses using time-series data projections and propensity score matching.

Conclusion:
Based on a single-center observation, patients with recent COVID-19 exposure were likely to have a high incidence of major postoperative complications.

Registration:
NCT05677815 at https://clinicaltrials.gov/.
Outcomes of XEN Stent in Patients With Glaucoma and Previous Corneal Transplantation
Authors: Oliver Cameron , Gupta Priya , Yeung Sonia N. , Iovieno Alfonso 
Published: June 2023

Précis:
The XEN stent safely and effectively controls intraocular pressure in select patients with history of corneal transplantation.

Purpose:
Glaucoma is a common complication after corneal transplantation and can be difficult to manage in these patients. This study reports outcomes of XEN stent implantation in eyes with glaucoma in the setting of previous corneal transplantation.

Patients and Methods:
Noncomparative retrospective case series including eyes with a history of corneal transplantation and subsequent XEN stent implantation by a single glaucoma surgeon in Surrey, British Columbia, between 2017 and 2022. The analysis included patient demographics, pre and postoperative intraocular pressure (IOP), pre and postoperative glaucoma medications, peri and postoperative complications and interventions, and incidence of repeat corneal transplantation and additional glaucoma procedures to control IOP.

Results:
Fourteen eyes with previous cornea transplantation underwent XEN stent implantation. Mean age was 70.1 years (range: 47–85 y). Mean follow-up was 18.2 months (range: 1.5–52 mo). The most common glaucoma diagnosis was secondary open angle glaucoma (50.0%). There was a significant reduction in IOP and the number of glaucoma agents at all postoperative time points (P < 0.05). IOP decreased from 32.7 ± 10.0 mm Hg at baseline to 12.5 ± 4.7 mm Hg at the most recent follow-up. Glaucoma agents decreased from 4.0 ± 0.7 to 0.4 ± 1.0. Two eyes required additional glaucoma surgery to control IOP, with an average time to reoperation of 7 weeks. Two eyes underwent repeat corneal transplantation, with an average time to reoperation of 23.5 months.

Conclusions:
In selected patients with previous corneal transplants and refractory glaucoma, the XEN stent was safely implanted and effectively reduced IOP in the short term.
Train Drivers’ Work Related Stress and Job Satisfaction
Authors: Fredin-Knutzén Johan , Olsson Niklas , Rosberg Tomas , Thorslund Birgitta , Lidestam Björn 
Published: June 2023

ObjectivesThis study investigated which work-related stressors are rated highest by train drivers and which are strongest correlated with consideration to change profession.MethodsIn a questionnaire, a total of 251 Swedish train drivers rated 17 work-related stressors, to which extent they had considered quitting their profession, and if they had experienced a PUT (person under train) accident.ResultsPUTs (when experienced) and irregular work hours are the main stressors, but the strongest predictors of consideration to change profession are those that are encountered often, and last over time (eg, irregular work hours,r= 0.61, and major organizational changes,r= 0.51).ConclusionsFor effective reduction of stress and improved job satisfaction, focus should be on aspects that affect everyday life for drivers, such as better working shifts, less delays, and improved social climate.
Seeking Treatment Profile of Male Shift Workers With Hypertension and Diabetes
Authors: Adi Nuri Purwito , Nagata Tomohisa , Mori Koji , Kubo Tatsuhiko , Fujimoto Kenji , Ohtani Makoto , Odagami Kiminori , Nagata Masako , Kajiki Shigeyuki , Fujino Yoshihisa , Matsuda Shinya 
Published: June 2023

ObjectiveThis study was identified seeking treatment for hypertension and diabetes among male shift workers.MethodThis retrospective cohort study included nine large companies in Japan. Data were collected from health checkup, health insurance records, and self-administered questionnaires in 2017 and 2020. Data were analyzed using Kaplan-Meier curves and Cox regression.ResultPerson-days shift workers and day workers seeking treatment for hypertension were 41,604 and 327,301, respectively and, for diabetes, were 7326 and 60,735, respectively. The log ranks were statistically significant. Shift workers were 46% and 56% less likely to seek treatment for hypertension and diabetes, respectively, than day workers were after adjustment for age, marital status, education level, and intention to modify lifestyle (model 2) (P< 0.01).ConclusionsMale shift workers are less likely to seek treatment for hypertension and diabetes compared with day workers.
Adenosine response and failure to convert paroxysmal supraventricular tachycardia in the emergency department
Authors: Alghadeer Sultan M. , Almohammed Omar A. , Alshaya Abdulrahman I. , Alsaif Sara , Albogami Sara , Althunayyan Saqer M. 
Published: June 2023

Background and importance
Although adenosine is the recommended first-line therapy for patients with paroxysmal supraventricular tachycardia (SVT), it may fail to restore normal sinus rhythm. The factors associated with this failure remain unclear.

Objective
To assess the response rate to adenosine and identify the factors causing adenosine failure in the management of paroxysmal SVT.

Design, setting, and participants
This retrospective study was conducted on adult patients diagnosed with paroxysmal SVT and treated with adenosine in the emergency departments of two large tertiary hospitals between June 2015 and June 2021.

Outcome measure and analysis
The primary outcome of the study was the patient response to adenosine, defined as the restoration of sinus rhythm documented in the patients’ files. Backward-stepwise multivariate logistic regression was used to examine the predictors of adenosine failure based on the overall response to adenosine therapy.

Main results
A total of 404 patients, with a mean age of 49 (SD 15) years and a BMI of 32 (SD 8) kg/m2, and treated with adenosine for paroxysmal SVT, were included. Sixty-nine percent of patients were women. The overall response rate to any adenosine dose was 86% (n = 347). The baseline heart rate did not significantly differ between adenosine responders and non-responders (179.6 ± 23.1 vs. 183.2 ± 23.4). An association was observed between the history of paroxysmal SVT and successful response to adenosine (odds ratio = 2.08; 95% confidence interval 1.05–4.11).

Conclusion
The findings of this retrospective study suggested that the use of adenosine restored normal sinus rhythm in 86% of patients with paroxysmal SVT. Furthermore, a history of paroxysmal SVT and older age were associated with an increased chance of adenosine success.
Computed tomography brain scan utilization in patients with headache presenting to emergency departments: a multinational study
Authors: Chu Kevin , Kelly Anne-Maree , Keijzers Gerben , Kinnear Frances , Kuan Win Sen , Graham Colin , Laribi Said , Roberts Tom , Karamercan Mehmet , Cardozo-Ocampo Alejandro , Kamona Sinan , Body Richard , Horner Daniel , Klim Sharon , Brown Nathan , Wijeratne Tissa ,   , on behalf of the HEAD study investigators
Published: June 2023

Background and importance
Recommended indications for emergency computed tomography (CT) brain scans are not only complex and evolving, but it is also unknown whether they are being followed in emergency departments (EDs).

Objective
To determine the CT utilization and diagnostic yield in the ED in patients with headaches across broad geographical regions.

Design
Secondary analysis of data from a multinational cross-sectional study of ED headache presentations over one month in 2019.

Setting and participants
Hospitals from 10 participating countries were divided into five geographical regions [Australia and New Zealand (ANZ); Colombia; Europe: Belgium, France, UK, and Romania; Hong Kong and Singapore (HKS); and Turkey). Adult patients with nontraumatic headache as the primary presenting complaint were included. Patients were identified from ED management systems.

Outcome measures and analysis
The outcome measures were CT utilization and diagnostic yield. CT utilization was calculated using a multilevel binary logistic regression model to account for clustering of patients within hospitals and regions. Imaging data (CT requests and reports) were sourced from radiology management systems.

Main results
The study included 5281 participants. Median (interquartile range) age was 40 (29–55) years, 66% were women. Overall mean CT utilization was 38.5% [95% confidence interval (CI), 30.4–47.4%]. Regional utilization was highest in Europe (46.0%) and lowest in Turkey (28.9%), with HKS (38.0%), ANZ (40.0%), and Colombia (40.8%) in between. Its distribution across hospitals was approximately symmetrical. There was greater variation in CT utilization between hospitals within a region than between regions (hospital variance 0.422, region variance 0.100). Overall mean CT diagnostic yield was 9.9% (95% CI, 8.7–11.3%). Its distribution across hospitals was positively skewed. Regional yield was lower in Europe (5.4%) than in other regions: Colombia (9.1%), HKS (9.7%), Turkey (10.6%), and ANZ (11.2%). There was a weak negative correlation between utilization and diagnostic yield (r = −0.248).

Conclusion
In this international study, there was a high variation (28.9–46.6%) in CT utilization and diagnostic yield (5.4–11.2%) across broad geographic regions. Europe had the highest utilization and the lowest yield. The study findings provide a foundation to address variation in neuroimaging in ED headache presentations.
Prediction of In-hospital Mortality Among Intensive Care Unit Patients Using Modified Daily Laboratory-based Acute Physiology Score, Version 2
Authors: Kohn Rachel , Weissman Gary E. , Wang Wei , Ingraham Nicholas E. , Scott Stefania , Bayes Brian , Anesi George L. , Halpern Scott D. , Kipnis Patricia , Liu Vincent X. , Dudley Raymond Adams , Kerlin Meeta Prasad 
Published: June 2023

Background:
Mortality prediction for intensive care unit (ICU) patients frequently relies on single ICU admission acuity measures without accounting for subsequent clinical changes.

Objective:
Evaluate novel models incorporating modified admission and daily, time-updating Laboratory-based Acute Physiology Score, version 2 (LAPS2) to predict in-hospital mortality among ICU patients.

Research design:
Retrospective cohort study.

Patients:
ICU patients in 5 hospitals from October 2017 through September 2019.

Measures:
We used logistic regression, penalized logistic regression, and random forest models to predict in-hospital mortality within 30 days of ICU admission using admission LAPS2 alone in patient-level and patient-day-level models, or admission and daily LAPS2 at the patient-day level. Multivariable models included patient and admission characteristics. We performed internal-external validation using 4 hospitals for training and the fifth for validation, repeating analyses for each hospital as the validation set. We assessed performance using scaled Brier scores (SBS), c-statistics, and calibration plots.

Results:
The cohort included 13,993 patients and 107,699 ICU days. Across validation hospitals, patient-day-level models including daily LAPS2 (SBS: 0.119−0.235; c-statistic: 0.772−0.878) consistently outperformed models with admission LAPS2 alone in patient-level (SBS: 0.109−0.175; c-statistic: 0.768−0.867) and patient-day-level (SBS: 0.064−0.153; c-statistic: 0.714−0.861) models. Across all predicted mortalities, daily models were better calibrated than models with admission LAPS2 alone.

Conclusions:
Patient-day-level models incorporating daily, time-updating LAPS2 to predict mortality among an ICU population performs as well or better than models incorporating modified admission LAPS2 alone. The use of daily LAPS2 may offer an improved tool for clinical prognostication and risk adjustment in research in this population.
Pediatric intestine and multivisceral transplant
Authors: Maklad Mohamed , Mazariegos George , Ganoza Armando 
Published: June 2023

Purpose of review
Intestinal and multivisceral transplantation (ITx, MVTx) is the cornerstone in treatment of irreversible intestinal failure (IF) and complications related to parenteral nutrition. This review aims to highlight the unique aspects of the subject in pediatrics.

Recent findings
Etiology of intestinal failure (IF) in children shares some similarity with adults but several unique considerations when being evaluated for transplantation will be discussed. Owing to significant advancement in IF management and home parenteral nutrition (PN), indication criteria for pediatric transplantation continues to be updated. Outcomes have continued to improve with current long-term patient and graft survival in multicenter registry reports reported at 66.1% and 48.8% at 5 years, respectively. Pediatric specific surgical challenges such abdominal closure, post transplantation outcomes, and quality of life are discussed in this review.

Summary
ITx and MVTx remain lifesaving treatment for many children with IF. However long-term graft function is still a major challenge.