bluuebunny/crossref_metadata_2025_split huggingface dataset:
The costs of suboptimal breastfeeding in Ontario, Canada, and potential healthcare resource impacts from improving rates: a pediatric health system costing analysis
Authors: Onah Nnachebe Michael , Hoy Sandra , Slofstra Kathleen 
Published: February 2025

Abstract

Background
Human milk from the breast is the healthiest option for infants. Other sources of nutrition pose some risk to child, maternal, and environmental health. There are significant costs to suboptimal rates of breastfeeding for children, families and society. Over 92% of mothers in Ontario, Canada initiate breastfeeding, yet exclusivity and duration rates decline over time. This study estimates potential pediatric healthcare cost savings from increased exclusive breastfeeding.

Methods
We conducted a cost-effectiveness analysis to compare healthcare savings from enhanced breastfeeding rates against current practices by estimating pediatric healthcare costs associated with suboptimal breastfeeding and potential savings from improved rates. Savings are calculated from reduced incidence of childhood illnesses associated with breastfeeding, including lower respiratory tract infections (LRTI), gastrointestinal infections (GII), acute otitis media (AOM), acute lymphoblastic leukemia (ALL), necrotizing enterocolitis (NEC), childhood obesity, and asthma. Cost data were drawn from Canadian healthcare sources, supplemented with data from the UK and other international studies. We used initiation and exclusive breastfeeding rates at hospital discharge and six months postpartum.
The study assumes that the incidence of preventable conditions like LRTI, GII, and AOM is directly related to breastfeeding rates at these time points. A six-month threshold for exclusive breastfeeding, recommended by the World Health Organization, was selected for analysis. Partial breastfeeding rates were not separately modeled due to data limitations.

Results
Improving exclusive breastfeeding (EBF) rates at six months to match rates at hospital discharged and initiation rates could result in 47,114–91,457 fewer cases of LRTI, GII, and AOM, prevent 3,685–7,096 hospitalizations, and reduce 22,043–47,621 outpatient visits. Increased EBF rates could prevent cases of NEC (37–67), ALL (3–6), childhood obesity (1,199–2,661), and asthma (970–2,111). Suboptimal breastfeeding at 6 months for infants born in Ontario in 2019 cost the healthcare system US $72.2 million annually for treating four childhood illnesses and US $61.0 million for long-term conditions (ALL, obesity, and asthma). Increasing breastfeeding rates could save US $32–63 million in annual treatment costs and US $23.6–51.6 million in long-term healthcare costs.

Conclusions
Suboptimal breastfeeding rates impose a burden on the health of families and Ontario’s healthcare system. Supporting breastfeeding through evidence-based interventions could reduce this burden through lowering pediatric healthcare demands.
Using illicit drugs alone in Vancouver, Canada: a gender-based analysis
Authors: Gallant Kat , Hayashi Kanna , Sayre Eric C. , Choi JinCheol , Mansoor Manal , Kerr Thomas 
Published: February 2025

Abstract

Objectives
Canada continues to experience an epidemic of toxic drug-related overdose deaths. Public health messaging emphasizes the dangers of using drugs alone as it restricts timely overdose response or renders it impossible, yet this practice remains prevalent among people who use drugs. While drug use practices and associated harms are known to be highly gendered, little is known about how factors shaping solitary drug use may differ across genders (including cisgender men, cisgender women, transgender women, Two-Spirit people and gender diverse people). Thus, we sought to explore solitary drug use practices according to gender in Vancouver, Canada.

Methods
Data were collected through Vancouver Injection Drug Users Study, a prospective cohort study between June 2019 and May 2023. We used gender-stratified multivariable generalized estimating equation models to identify factors associated with using drugs alone.

Results
Among the 697 participants, 297 (42.6%) reported using drugs alone in the previous 6 months at baseline. In multivariable analyses, we found that being in a relationship was negatively associated with using alone for both cisgender men and cisgender women (adjusted odds ratio [AOR] = 0.25 and 0.34, respectively), while homelessness was negatively associated for cisgender men only (AOR = 0.45). Factors positively associated for cisgender men included daily illicit stimulant use (AOR = 1.90), and binge drug use (AOR = 2.18). For cisgender women, only depression was positively associated with using drugs alone (AOR = 2.16). All p-values < 0.05. While unable to conduct a multivariable analysis on transgender, Two-Spirit and gender diverse people due to small sample sizes, bivariate analyses showed larger impact of depression on using alone for Two-Spirit (OR = 8.00) and gender diverse people (OR = 5.05) compared to others, and only gender diverse people’s risk was impacted by experiences of violence (OR = 9.63). All p-values < 0.05.

Conclusion
The findings of this study suggest significant heterogeneity in gender-specific factors associated with using drugs alone. Factors exclusively impacting cisgender men’s risk included homelessness and daily stimulant use, and depression having a significant impact on cisgender women’s, but not cisgender men’s, risk. Ultimately, gender-specific factors must be recognized in public health messaging, and in developing policies and harm reduction measures to address the risks associated with using alone.
Bone turnover markers are risk factors for endplate injuries during lumbar interbody fusion: a retrospective case-control study
Authors: Kang Tae Hoon , Chung Sung Taek , Seo In-Wook , Cho Minjoon , Lee Jae Hyup 
Published: February 2025

Abstract

Background
Intraoperative endplate injury (IEI) is a type of fracture and a potential complication during lumbar interbody fusion (LIF). Osteoporosis diagnosed by bone mineral density (BMD) is a well-known risk factor for fracture itself and IEI also. The bone turnover markers (BTMs) are parameters of bone qualities and have some correlations with fractures, but there is no study about the BTMs and intraoperative fractures especially IEI. This study aims to identify the correlation between IEI and BTMs, especially in misTLIF.

Methods
We retrospectively reviewed 184 patients (230 spine levels). The IEI was diagnosed as the breakage of the endplate observed on postoperative 1 mm thin-cut CT scans. All surgical and endogenous risk factors of IEI were also checked including the bone resorption marker (serum CTX) and bone formation marker (serum P1NP) of BTMs. Additionally, the ratio (P1NP/CTX) and the subtype groups of BTMs were analyzed.

Results
The rate of total IEI was 38%. The sex, osteoporosis, spine BMD, femur BMD, CTX, P1NP/CTX, preoperative disc height, and the discrepancy between preoperative disc height and cage size were risk factors in multivariate logistic regression analyses. The subtypes according to BTMs showed a different rate of IEI, resulting in subtype 2 A (low CTX and P1NP and high P1NP/CTX ratio) having the lowest incidence and statistically significant odds ratios compared to other subtype groups.

Conclusion
This study demonstrated that the IEI is related to BTMs regardless of BMD in misTLIF. In addition, the P1NP/CTX ratio or subtypes could be helpful in predicting the risk of IEI due to the parallel dynamics of BTMs.
Unraveling the effect of choline-based choline based ionic liquids on the physicochemical properties and taste behavior of D( +)-glucose in aqueous solutions
Authors: Dorosti Sara , Shekaari Hemayat , Bagheri Mohammad , Ghaffari Fariba , Mokhtarpour Masumeh 
Published: February 2025

Abstract
To elucidate the mechanism by which choline-based ionic liquids potentially can enhance the sugar conversion to bioethanol, this work was conducted to study the thermodynamic behavior of D( +)-glucose in aqueous solutions of choline-based ionic liquids, choline salicylate [Ch][Sal], choline formate [Ch][For], and choline acetate [Ch][Ace]. This study involved measuring density, speed of sound, viscosity, and electrical conductivity at various concentrations and temperatures. Analysis of the calculated parameters, including apparent molar volume, V
φ, apparent molar isentropic compressibility (κ
φ), viscosity B-coefficient, and molar conductivity (Λ) values provide deep insights into intermolecular interactions between the components of the solutions studied. The standard partial molar volume values (

$$V_{\varphi }^{0}$$

V

φ

0

) of D( +)-glucose, show stronger interactions between D( +)-glucose and the [Ch][Sal]. The computed transfer volume values (

$$\Delta_{tr} V_{\varphi }^{0}$$

Δ

tr

V

φ

0

), with the help of co-sphere overlap model confirm intensified hydrophilic-hydrophilic interactions in [Ch][Sal] [(1.99 to 2.08) cm3·mol−1] solutions. Hepler's constants suggest that D( +)-glucose acts as a structure-maker in the presence of choline-based ILs, especially in [Ch][Sal] solutions. Also, the DFT-COSMO calculations result in [Ch][Sal] the most favorable interactions among the other choline based ILs. Apparent specific volume (ASV), and apparent specific isentropic compressibility, (ASIC), values revealed that D( +)-glucose exhibits the taste behavior with [Ch][Sal]. The hydration number of D( +)-glucose diminishes as the temperature rises due to weakened hydrogen bonds between D( +)-glucose and water molecules. These findings suggest that [Ch][Sal] could be a promising candidate for accelerating sugar conversion to bioethanol.

Graphical Abstract
Thrombocytopenia in the intensive care unit: diagnosis and management
Authors: Pène Frédéric , Russell Lene , Aubron Cécile 
Published: February 2025

Abstract

Background
This narrative review aims to describe the epidemiology and aetiologies of thrombocytopenia in critically ill patients, the bleeding risk assessment in thrombocytopenic patients, and provide an update on platelet transfusion indications.

Results
Thrombocytopenia is a common disorder in critically ill patients. The classic definition relies on an absolute platelet count below 150 × 109/L. Alternatively, the definition has extended to a relative decrease in platelet count (typically within a range of >30–>50% decrease) from baseline, yet remaining above 150 × 109/L. Thrombocytopenia may result from multiple mechanisms depending upon the underlying conditions and the current clinical setting. Regardless of the causes, thrombocytopenia accounts as an independent determinant of poor outcomes in critically ill patients, albeit often of unclear interpretation. Nevertheless, it is well established that thrombocytopenia is associated with an increased incidence of bleeding complications. However, alternative factors also contribute to the risk of bleeding, making it difficult to establish definite links between nadir platelet counts at the expense of potential adverse events. Platelet transfusion represents the primary supportive treatment of thrombocytopenia to prevent or treat bleeding. As randomised controlled trials comparing different platelet count thresholds for prophylactic platelet transfusion in the ICU are lacking, the prophylactic transfusion strategy is largely derived from studies performed in stable haematology patients. Similarly, the platelet count transfusion threshold to secure invasive procedures remains based on a low level of evidence. Indications of platelet transfusions for the treatment of severe bleeding in thrombocytopenic patients remain largely empirical, with platelet count thresholds ranging from 50 to 100 × 109/L. In addition, early and aggressive platelet transfusion is part of massive transfusion protocols in the setting of severe trauma-related haemorrhage.

Conclusion
Thrombocytopenia in critically ill patients is very frequent with various etiologies, and is associated with worsened prognosis, with or without bleeding complications. Interventional trials focused on critically ill patients are eagerly needed to better delineate the benefits and harms of platelet transfusions.
Immunological landscape of periodontitis and rheumatoid arthritis and their molecular crosstalk
Authors: Zhao Weimin , Liu Chenxu , Cui Xiangzhi , Chen Qianjiang 
Published: February 2025

Abstract

Background
The association between periodontitis (PT) and rheumatoid arthritis (RA) is well-established; however, the molecular mechanisms underlying this relationship remain poorly understood. This study aims to delineate shared genetic and molecular features between PT and RA to uncover potential common pathways involved in their pathogenesis.

Methods
Gene expression data sets for PT and RA were retrieved from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) and co-expressed gene modules were identified using weighted gene co-expression network analysis (WGCNA) and the DESeq2 package. Enrichment analyses, including KEGG and Gene Ontology (GO) pathways, as well as immune cell infiltration profiling, were performed to explore shared biological pathways. A protein–protein interaction (PPI) network was constructed to pinpoint key genes linking PT and RA. Functional assays were conducted by overexpressing the identified core gene, PTPRC, in MH7A cells via lentiviral transfection, followed by cell viability (CCK-8), migration, and invasion assays. In addition, transcription factor enrichment and connectivity map (cMAP) analyses were employed to identify common transcriptional regulators and potential therapeutic targets for both conditions.

Results
WGCNA and DESeq2 analyses revealed 154 shared DEGs between PT and RA, predominantly enriched in immune and inflammatory response pathways. PTPRC emerged as a pivotal shared gene, exhibiting significantly higher expression in PT patients compared to controls. In vitro assays confirmed that PTPRC overexpression enhanced fibroblast proliferation, migration, and invasion. Furthermore, transcription factor enrichment analysis and cMAP identified overlapping transcriptional regulators and potential pharmacological agents for both diseases.

Conclusions
This study provides novel insights into shared gene expression profiles and molecular mechanisms linking PT and RA, identifying PTPRC as a potential key regulator. These findings suggest that targeting PTPRC could offer therapeutic opportunities for RA driven by PT.
Responding to old problems in the Dutch work addiction scale: a psychometric approach in a Peruvian sample
Authors: Salas-Blas Edwin , Vallejos-Flores Miguel , Calderón-De la Cruz Gustavo , Manzanares-Medina Eduardo , Fonseca-Pedrero Eduardo , Mayo-Puchoc Nikol , Copez-Lonzoy Anthony 
Published: February 2025

Abstract

Background
Harmful work patterns have become a public health problem. These conditions are worrying since they can have an impact on mental health, social conflicts, and physical difficulties due to their normalization of pathological behaviors related to work addiction. Aims: (1) determine the psychometric properties and reliability of the DUWAS and (2) evaluate valid comparisons at the construct level. Methods: The Spanish version of DUWAS was used. For the evaluation of the psychometric model, 446 Peruvian workers responded to the Spanish version (60.5% women aged 18 to 65, M = 35.1 SD = 12.45). Results: The unidimensional version was confirmed (x
2 = 67.495(14); CFI = 0.96; TLI = 0.95; SRMR = 0.050 and RMSEA = 0.069). The reliability was acceptable (α = 0.735; 95% CI: 0.706 − 0.762; ω = 0.741; 95% CI: 0.712 − 0.767) and measurement invariance was confirmed for sex and age groups. Concurrent validity was mostly identified with mental health indicators. Conclusion: This study provides new information on dimensionality and the realization of valid comparisons that allow its use in Spanish-speaking workers.
Impact of food availability and predator presence on patterns of landscape partitioning among neighbouring Guinea baboon (Papio papio) parties
Authors: Ohrndorf Lisa , Mundry Roger , Beckmann Jörg , Fischer Julia , Zinner Dietmar 
Published: February 2025

Abstract

Background
Access to critical resources, including food, water, or shelter, significantly determines individual fitness. As these resources are limited in most habitats, animals may employ strategies of landscape partitioning to mitigate the impact of direct resource competition. Territoriality may be regarded as an aggressive form of landscape partitioning, but other forms of landscape partitioning exist in non-territorial species. Animals living in groups with greater flexibility in their association patterns, such as multilevel societies with fission–fusion dynamics, may adjust their grouping and space use patterns to short-term variations in ecological conditions such as food availability, predation pressure, or the presence of conspecific groups. This flexibility may allow them to balance the costs of competition while reaping the benefits of better predator detection and defence.

Methods
We explored patterns of landscape partitioning among neighbouring Guinea baboon (Papio papio) parties in the Niokolo-Koba National Park, Senegal. Guinea baboons live in a multilevel society in which parties predictably form higher-level associations (“gangs”). We used four years of locational data from individuals equipped with GPS collars to estimate annual home ranges, home range overlap, and average minimum distances between parties. We examined whether food availability and predator presence levels affected the cohesion between parties in 2022.

Results
We found substantial overlap in home range and core area among parties (33 to 100%). Food availability or predator presence did not affect the distance to the closest neighbouring party; the average minimum distance between parties was less than 100 m.

Conclusions
Our results suggest a low level of feeding competition between our study parties. Whether this is a general feature of Guinea baboons or particular to the situation in the Niokolo-Koba National Park remains to be investigated.
BDSM and masochistic sexual fantasies in women with borderline personality disorder: simply on the spectrum of “normality” or source of suffering?
Authors: Warkentin Hannah F. , Mazinan Rose Gholami , Fuss Johannes , Kratzer Leonhard , Biedermann Sarah V. 
Published: February 2025

Abstract

Background
Increasing research has contributed to the destigmatization of sadomasochistic sexual preferences. Nevertheless, persons diagnosed with Borderline Personality Disorder (BPD) frequently report self-harmful masochistic sexual practice under the pretext of BDSM, especially those reporting experiences of child sexual abuse (CSA). Empirical research on sexual preferences in the context of BPD is scarce, although related sexual behaviors may matter particularly regarding dysfunctional and self-harming behaviors.

Methods
Women with BPD (n = 115) and age-matched healthy controls (HC; n = 115) were compared regarding experiences with BDSM and masochistic fantasies, as well as associated arousal and distress. Regression and moderation analyses were conducted on cross-sectional data to examine the associations between sadomasochistic sexuality and BPD symptoms, traumatic experiences, sexual risk behavior, and sexual motivation.

Results
Women with BPD practiced BDSM more often (last year: 34% vs. 15%; lifetime: 51% vs. 23%) which was associated with more autonomous, self-determined forms of sexual motivation but at the same time associated with higher BPD symptoms and risky sexuality. While a similar number of women in both groups endorsed arousal through masochistic sexual fantasies (77% vs. 74%), significantly more of those women with BPD reported associated marked distress (53% vs. 21%). Distress from masochistic fantasies was associated with less autonomous sexual motivation, in which sexuality is used in order to regulate emotions and self-esteem, and was predicted by the interaction of the severity of childhood sexual abuse and this regulation tendency.

Conclusion
Sadomasochistic sexuality and corresponding fantasies in women can be an autonomous, self-determined form of sexuality. However, in women with BPD they tend to be associated with BPD symptoms, risky sexuality, problems with self-regulation and traumatization and are thus associated with marked distress. Our findings highlight the importance of considering sexual preferences in clinical context and the need for specific treatment for this subgroup suffering from their preference or acting them out in a dysfunctional or self-harming way.

Trial registration
This analysis is part of a larger ongoing study and was retrospectively registered (Registration trial DRKS00029716).
Renal mitochondria response to sepsis: a sequential biopsy evaluation of experimental porcine model
Authors: Müller Jiri , Chvojka Jiri , Ledvinova Lenka , Benes Jan , Tuma Zdenek , Grundmanova Martina , Jedlicka Jan , Kuncova Jitka , Matejovic Martin 
Published: February 2025

Abstract

Background
The pathophysiology of sepsis-induced acute kidney injury remains elusive. Although mitochondrial dysfunction is often perceived as the main culprit, data from preclinical models yielded conflicting results so far. The aim of this study was to assess the immune-metabolic background of sepsis-associated renal dysfunction using sequential biopsy approach with mitochondria function evaluation in a large clinically relevant porcine models mimicking two different paces and severity of sepsis and couple this approach with traditional parameters of renal physiology.

Methods
In this randomized, open-label study, 15 anaesthetized, mechanically ventilated and instrumented (renal artery flow probe and renal vein catheter) pigs were randomized in two disease severity groups—low severity (LS) sepsis (0.5 g/kg of autologous faeces intraperitoneally) and high severity (HS) sepsis (1 g/kg of autologous faeces intraperitoneally). Sequential cortical biopsies of the left kidney were performed and a pyramid-shaped kidney specimen with cortex, medulla and renal papilla was resected and processed at the end of the experiment. Oxygraphic data and western blot analysis of proteins involved in mitochondrial biogenesis and degradation were obtained.

Results
In contrast to increased mitochondrial activity observed in LS sepsis, a significant decrease in the oxidative phosphorylation capacity together with an increase in the respiratory system uncoupling was observed during the first 24 h after sepsis induction in the HS group. Those changes preceded alterations of renal haemodynamics. Furthermore, serum creatinine rose significantly during the first 24 h, indicating that renal dysfunction is not primarily driven by haemodynamic changes. Compared to cortex, renal medulla had significantly lower oxidative phosphorylation capacity and electron-transport system activity. PGC-1-alfa, a marker of mitochondrial biogenesis, was significantly decreased in HS group.

Conclusions
In this experimental model, unique sequential tissue data show that the nature and dynamics of renal mitochondrial responses to sepsis are profoundly determined by the severity of infectious challenge and resulting magnitude of inflammatory insult. High disease severity is associated with early and stepwise progression of mitochondria dysfunction and acute kidney injury, both occurring independently from later renal macro-haemodynamic alterations. Our data may help explain the conflicting results of preclinical studies and suggest that sepsis encompasses a very broad spectrum of sepsis-induced acute kidney injury endotypes.