bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population-based user-perceived experience ofRheumatic?: a novel digital symptom-checker in rheumatology
Authors: Lundberg Karin , Qin Ling , Aulin Cecilia , van Spil Willem Evert , Maurits Marc P , Knevel Rachel 
Published: April 2023

ObjectiveDigital symptom-checkers (SCs) have potential to improve rheumatology triage and reduce diagnostic delays. In addition to being accurate, SCs should be user friendly and meet patient’s needs. Here, we examined usability and acceptance ofRheumatic?—a new and freely available online SC (currently with >44 000 users)—in a real-world setting.MethodsStudy participants were recruited from an ongoing prospective study, and included people ≥18 years with musculoskeletal complaints completingRheumatic?online. The user experience survey comprised five usability and acceptability questions (11-point rating scale), and an open-ended question regarding improvement ofRheumatic?Data were analysed in R using t-test or Wilcoxon rank test (group comparisons), or linear regression (continuous variables).ResultsA total of 12 712 people completed the user experience survey. The study population had a normal age distribution, with a peak at 50–59 years, and 78% women. A majority foundRheumatic?useful (78%), thought the questionnaire gave them an opportunity to describe their complaints well (76%), and would recommendRheumatic?to friends and other patients (74%). Main shortcoming was that 36% thought there were too many questions. Still, 39% suggested more detailed questions, and only 2% suggested a reduction of questions.ConclusionBased on real-world data from the largest user evaluation study of a digital SC in rheumatology, we conclude thatRheumatic?is well accepted by women and men with rheumatic complaints, in all investigated age groups. Wide-scale adoption ofRheumatic?, therefore, seems feasible, with promising scientific and clinical implications on the horizon.
Methotrexate therapy associated with a reduced rate of new-onset uveitis in patients with biological-naïve juvenile idiopathic arthritis
Authors: van Straalen Joeri W , Akay Görkem , Kouwenberg Carlyn V , de Roock Sytze , Kalinina Ayuso Viera , Wulffraat Nico M , de Boer Joke , Swart Joost F 
Published: April 2023

ObjectiveTo study the effect of methotrexate (MTX) therapy on new-onset uveitis in patients with biological-naïve juvenile idiopathic arthritis (JIA).MethodsIn this matched case–control study, we compared MTX exposure between cases with JIA-associated chronic uveitis (JIA-U) and patients with JIA and without JIA-U at the time of matching (controls). Data were collected from electronic health records of the University Medical Centre Utrecht, the Netherlands. Cases with JIA-U were matched 1:1 to JIA control patients based on JIA diagnosis date, age at JIA diagnosis, JIA subtype, antinuclear antibodies status and disease duration. The effect of MTX on JIA-U onset was analysed using a multivariable time-varying Cox regression analysis.ResultsNinety-two patients with JIA were included and characteristics were similar between cases with JIA-U (n=46) and controls (n=46). Both ever-use of MTX and exposure years were lower in cases with JIA-U than in controls. Cases with JIA-U significantly more often discontinued MTX treatment (p=0.03) and out of those who did, 50% afterwards developed uveitis within 1 year. On adjusted analysis, MTX was associated with a significantly reduced new-onset uveitis rate (HR: 0.35; 95% CI: 0.17 to 0.75). No different effect was observed between a low (<10 mg/m2/week) and standard MTX dose (≥10 mg/m2/week).ConclusionThis study demonstrates an independent protective effect of MTX on new-onset uveitis in patients with biological-naïve JIA. Clinicians might consider early initiation of MTX in patients at high uveitis risk. We advocate more frequent ophthalmologic screening in the first 6–12 months after MTX discontinuation.
Passport: Improving Automated Formal Verification Using Identifiers
Authors: Sanchez-Stern Alex , First Emily , Zhou Timothy , Kaufman Zhanna , Brun Yuriy , Ringer Talia 
Published: April 2023

Formally verifying system properties is one of the most effective ways of improving system quality, but its high manual effort requirements often render it prohibitively expensive. Tools that automate formal verification by learning from proof corpora to synthesize proofs have just begun to show their promise. These tools are effective because of the richness of the data the proof corpora contain. This richness comes from the stylistic conventions followed by communities of proof developers, together with the powerful logical systems beneath proof assistants. However, this richness remains underexploited, with most work thus far focusing on architecture rather than on how to make the most of the proof data. This article systematically explores how to most effectively exploit one aspect of that proof data: identifiers.We develop the Passport approach, a method for enriching the predictive Coq model used by an existing proof-synthesis tool with three new encoding mechanisms for identifiers: category vocabulary indexing, subword sequence modeling, and path elaboration. We evaluate our approach’s enrichment effect on three existing base tools: ASTactic, Tac, and Tok. In head-to-head comparisons, Passport automatically proves 29% more theorems than the best-performing of these base tools. Combining the three tools enhanced by the Passport approach automatically proves 38% more theorems than combining the three base tools. Finally, together, these base tools and their enhanced versions prove 45% more theorems than the combined base tools. Overall, our findings suggest that modeling identifiers can play a significant role in improving proof synthesis, leading to higher-quality software.
Lipoprotein(a) Is Associated With the Progression and Vulnerability of New-Onset Carotid Atherosclerotic Plaque
Authors: Duan Youling , Zhao Dong , Sun Jiayi , Liu Jun , Wang Miao , Hao Yongchen , Li Jiangtao , Liu Tianxiao , Xiao Luoxi , Hao Yiming , Wang Haimei , Qi Yue , Liu Jing 
Published: April 2023

Background:
Although important progress has been made in understanding Lp(a) (lipoprotein[a])-mediated stroke risk, the contribution of Lp(a) to the progression of vulnerable plaque features associated with stroke risk remains unclear. This study aims to evaluate whether Lp(a) is associated with carotid plaque progression, new-onset plaque features, and plaque vulnerability in a prospective community-based cohort study.

Methods:
Baseline Lp(a) levels were measured using latex-enhanced turbidimetric immunoassay among 804 participants aged 45 to 74 years and free of cardiovascular disease in the Chinese Multi-provincial Cohort Study—Beijing project. Carotid atherosclerosis was measured twice by B-mode ultrasonography over a 10-year interval during the 2002 and 2012 surveys to assess the progression of total, vulnerable and stable plaques, and plaque vulnerability. The total plaque area and plaque vulnerability score were calculated.

Results:

The median baseline Lp(a) level was 10.20 mg/dL (interquartile range, 6.20 to 17.18 mg/dL). Modified Poisson regression analysis showed that Lp(a) ≥50 mg/dL was significantly associated with 10-year progression of total carotid plaque (relative risk [RR], 1.41 [95% CI, 1.21–1.64];
E
-value=2.17), vulnerable plaque (RR, 1.93 [95% CI, 1.54–2.41]), and stable plaque (RR, 1.51 [95% CI, 1.11–2.07]) compared with Lp(a) <50 mg/dL. Moreover, among participants without plaque at baseline, Lp(a) ≥50 mg/dL was related to an increased total plaque area (β=0.36 [95% CI, 0.06–0.65];
P
=0.018) and increased plaque vulnerability score (β=0.30 [95% CI, 0.01–0.60];
P
=0.045) in multivariable linear regression.

Conclusions:
Elevated Lp(a) levels were associated with 10-year carotid plaque progression and plaque vulnerability, providing a basis for Lp(a) as a treatment target for stroke prevention.
Price Discrimination in Selection Markets
Authors: Veiga Andre 
Published: April 2023

Abstract
Should insurance prices vary with age? I consider competitive markets for lemons where a signal (e.g., age) partitions consumers (e.g., young and old). I study the continuum of policies from zero price-discrimination (zero- PD, equal prices) to full-PD (no restrictions). Restricting PD can increases welfare if high-cost markets exhibit greater adverse selection, or when the high-cost market “unravels.” I characterize optimal PD, and show how it is affected by changes in cost. In a calibration, optimal PD increases welfare by about $30/person-year. I extend the model to arbitrary signal structures, behavioral consumers, a monopolized industry, and multi-product firms.
Prevalence and predictive risk factors of self-stigmatization in patients with rare diseases: Based on health ecology model
Authors: Liang Haixu , Zheng Jiaqi , Sun Yongkang 
Published: April 2023

Background and aims: Given the cause of self-stigmatization of patients with rare diseases is complicated, and the self-stigmatization can be prevented by managing the related risk factors. This study aimed to report the prevalence as well as influencing factors associated with self-stigmatization in patients with rare diseases. Methods: From January to April 2022, the respondent-driven sampling (RDS) method was used to select patients with rare diseases through the Chinese Organization for Rare Disorders as the subjects. Based on the theoretical model of health ecology, logistic regression analysis was used to explore the association between self-stigmatization level and sample characteristics of patients with rare diseases. Results: A total of 530 patients were included, 50.2% of whom were male, and most of them are under 45 years old (86.5%). The prevalence of self-stigmatization in patients with rare diseases was 85.7%. Logistic regression analysis indicated that age (OR: 0.624, 95% CI: [0.399, 0.976]), mental health status (OR: 0.184, 95% CI: [0.076, 0.445]), family relations (OR: 0.180, 95% CI: [0.074, 0.434]), full time work (OR: 2.835, 95% CI: [1.024, 7.849]) and medical insurance (OR: 0.296, 95% CI: [0.105, 0.835]) were risk factors for self-stigmatization of patients with rare diseases. Conclusions: Chinese patients with rare diseases have a high level of self-stigmatization, and the potential risk factors are multi-level and multi-dimensional.
Localization of the Adductor Tubercle in the Skeletally Immature: A Computed Tomography Study With Patellofemoral Surgical Implications
Authors: Jabbouri Sahir S. , McLaughlin William , Joo Peter , Cooperman Daniel , Fulkerson John P. , Frumberg David B. 
Published: April 2023

Background: The adductor tubercle of the distal femur is utilized by surgeons as an anatomic landmark to identify graft anchor placement during medial patellofemoral ligament (MPFL) and medial quadriceps tendon femoral ligament (MQTFL) reconstruction for patellofemoral instability. In the skeletally immature population, its location relative to the physis has not been well defined. Purpose: To identify the location of the adductor tubercle relative to the distal femoral physis in skeletally immature individuals and gain insight regarding optimal graft anchor placement for pediatric patients undergoing MPFL and MQTFL reconstruction. Study Design: Descriptive laboratory study. Methods: Thin-cut computed tomography scans of 37 male cadaveric specimens (age, 4-16 years) were obtained from the New Mexico Decedent Image Database. A measurement protocol to identify the adductor tubercle was created with guidance from a fellowship-trained musculoskeletal radiologist. By utilizing axial, coronal, and sagittal views of knee computed tomography scans, the adductor magnus tendon was identified and followed distally to its insertion (adductor tubercle) on the distal femur. Distance from the midpoint of the adductor magnus tendon insertion relative to the physis in the proximal-distal orientation was measured. The anterior-posterior distance of the midpoint tendon insertion relative to the posterior femoral cortex line was also evaluated. Results: The midpoint of the adductor magnus tendon was at the physis in 30 specimens. One 8-year-old cadaveric specimen had an insertion 1.1 mm distal to the physis. In all specimens ≥15 years old (n = 6), the adductor magnus tendon insertion was distal to the physis with a mean distance of 2.73 mm. The location of the adductor tubercle was always posterior (mean, 5.1 mm) with respect to the posterior femoral cortex line. Conclusion: The location of the adductor tubercle in male pediatric patients is likely at or distal to the physis. Thus, the findings of this study directly conflict with previous studies that suggested a more proximal location. Clinical Relevance: Optimal graft anchor placement during MPFL and MQTFL reconstruction in the skeletally immature patient can be challenging because of the variability reported in previous studies of the medial patellofemoral complex origin relative to the physis. This study suggests that distal—rather than proximal—graft anchor placement might better help restore patellofemoral isometry.
Axial length and corneal curvature of normal eyes in the first decade of life
Authors: Oke Isdin , Nihalani Bharti R , VanderVeen Deborah K 
Published: April 2023

Background/Aims To establish normative curves for axial length and corneal curvature in the first decade of life. Methods This is a cross-sectional study from a single institution in the United States. Children from 0- to 10-years of age with no underlying ocular pathology were prospectively enrolled to obtain ultrasound biometry and hand-held keratometry while under anaesthesia for an unrelated procedure. Older cooperative children had optical biometry obtained in-office. Logarithmic quantile regression models were used to determine the change in axial length and average keratometry as a function of age. Results Single-eye measurements from 100 children were included. 75% of children were White and 49% female. Median axial length ranged from 20.6 mm (IQR, 20.2 to 21.1 mm) at age one year to 23.1 mm (IQR, 22.5 to 23.8 mm) at age ten years. Median average keratometry ranged from 44.1 D (IQR, 42.6 to 45.4 D) at age one year to 43.5 (IQR, 42.2 to 44.0 D) at age ten years. As age increased, there was a significant increase in axial length (0.74 mm per doubling of age; 95% CI, 0.62 to 0.82 mm), and a non-significant trend towards lower average keratometry (−0.21 D per doubling of age; 95% CI, −0.62 to 0.08 D). Conclusions We provide a set of normative charts for axial length and corneal curvature which may facilitate the identification of eyes outside the normal range and assist in the management of ocular conditions such as glaucoma or cataract.
Short-term clinical results with a trifocal diffractive toric intraocular lens using an optimized preoperative and intraoperative protocol
Authors: Paredes Beatriz , Mora Javier , Martín M. Dolores , Larrosa Adrian , Piñero David P. 
Published: April 2023

Purpose To evaluate the short-term clinical outcomes of a specific toric diffractive trifocal intraocular lens (IOL) implanted following an optimized clinical protocol in a large population. Methods Retrospective analysis of 337 eyes of 231 patients (mean age, 62.2 years) undergoing cataract surgery with implantation of the trifocal diffractive IOL AT.LISA tri toric 939M/MP (Carl Zeiss Meditec). A strict and careful clinical protocol was followed, including an accurate measurement of corneal astigmatism, use of a latest generation IOL power calculator, photography-based method intraoperative control of IOL alignment and IOL reposition at 1 week postoperatively if needed. Clinical outcomes in terms of visual acuity, refraction, efficacy of astigmatic correction analysed by vector analysis and patient satisfaction were evaluated during a 3-month follow-up. Results A total of 82% and 98% of eyes achieved a postoperative uncorrected distance visual acuity of 0.00 and 0.10 logMAR or better, respectively. Furthermore, 99.7%, and 100.0% of eyes showed a postoperative spherical equivalent within ± 0.50 D and ± 1.00 D, with 97.9% of eyes having a postoperative cylinder ≤ 0.50 D. Uncorrected near and intermediate visual acuities were 0.2 logMAR or better in 89.0% and 99.1% of eyes, respectively. Mean difference vector, magnitude of error and angle of error were 0.02  ±  0.14 D, 0.02  ±  0.13 D and 0.11  ±  1.18°. Patient satisfaction was referred as high or very high by 97.6% of patients. Conclusions The implantation of the trifocal toric IOL evaluated following a careful clinical protocol provides an efficacious visual rehabilitation and astigmatic correction, leading to high levels of patient satisfaction.
Performance of Pretreatment MRI-Based Radiomics in Recombinant Human Endostatin Plus Concurrent Chemoradiotherapy Response Prediction in Nasopharyngeal Carcinoma: A Retrospective Study
Authors: Huang Lixuan , Yang Zongxiang , Kang Min , Ren Hao , Jiang Muliang , Tang Cheng , Hu Yao , Shen Mingjun , Lin Huashan , Long Liling 
Published: April 2023

Purpose To investigate the capability of an Magnetic resonance imaging (MRI) radiomics model based on pretreatment texture features in predicting the short-term efficacy of recombinant human endostatin (RHES) plus concurrent chemoradiotherapy (CCRT) for nasopharyngeal carcinoma (NPC). Methods We retrospectively enrolled 65 patients newly diagnosed as having NPC and treated with RHES + CCRT. A total of 144 texture features were extracted from the MRI before RHES + CCRT treatment of all the NPC patients. The maximum relevance minimum redundancy (mRMR) method was used to remove redundant, irrelevant texture features, and calculate the Rad score of the primary tumor. Multivariable logistic regression was used to select the most predictive features subset, and prediction models were constructed. The performance of the 3 models in predicting the early response of RHES + CCRT for NPC was explored. Results The diagnostic efficiency of combined model and radiomics model in distinguishing between the effective and the ineffective groups of patients was found to be moderate. The area under the ROC curve (AUC) of the combined model and radiomics model was 0.74 (95% confidence interval [CI]: 0.62-0.86) and 0.71 (95% CI: 0.58-0.84), respectively, with both being higher than the AUC of the clinics model (0.63, 95% CI: 0.49-0.78). Compared with the radiomics model, the combined model showed marginally improved diagnostic performance in predicting RHES + CCRT treatment response. The accuracy of combined model and radiomics model for RHES + CCRT response assessment in NPC were higher than those of the clinics model (0.723, 0.723 vs 0.677). Conclusion The pretreatment MRI-based radiomics may be a noninvasive and effective method for the prediction of RHES + CCRT early response in patients with NPC.
Identification of biomarkers, pathways, and potential therapeutic targets for heart failure using next-generation sequencing data and bioinformatics analysis
Authors: Ganekal Prashanth , Vastrad Basavaraj , Vastrad Chanabasayya , Kotrashetti Shivakumar 
Published: April 2023

Background: Heart failure (HF) is the most common cardiovascular diseases and the leading cause of cardiovascular diseases related deaths. Increasing molecular targets have been discovered for HF prognosis and therapy. However, there is still an urgent need to identify novel biomarkers. Therefore, we evaluated biomarkers that might aid the diagnosis and treatment of HF. Methods: We searched next-generation sequencing (NGS) dataset (GSE161472) and identified differentially expressed genes (DEGs) by comparing 47 HF samples and 37 normal control samples using limma in R package. Gene ontology (GO) and pathway enrichment analyses of the DEGs were performed using the g: Profiler database. The protein–protein interaction (PPI) network was plotted with Human Integrated Protein–Protein Interaction rEference (HiPPIE) and visualized using Cytoscape. Module analysis of the PPI network was done using PEWCC1. Then, miRNA-hub gene regulatory network and TF-hub gene regulatory network were constructed by Cytoscape software. Finally, we performed receiver operating characteristic (ROC) curve analysis to predict the diagnostic effectiveness of the hub genes. Results: A total of 930 DEGs, 464 upregulated genes and 466 downregulated genes, were identified in HF. GO and REACTOME pathway enrichment results showed that DEGs mainly enriched in localization, small molecule metabolic process, SARS-CoV infections, and the citric acid tricarboxylic acid (TCA) cycle and respiratory electron transport. After combining the results of the PPI network miRNA-hub gene regulatory network and TF-hub gene regulatory network, 10 hub genes were selected, including heat shock protein 90 alpha family class A member 1 (HSP90AA1), arrestin beta 2 (ARRB2), myosin heavy chain 9 (MYH9), heat shock protein 90 alpha family class B member 1 (HSP90AB1), filamin A (FLNA), epidermal growth factor receptor (EGFR), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), cullin 4A (CUL4A), YEATS domain containing 4 (YEATS4), and lysine acetyltransferase 2B (KAT2B). Conclusions: This discovery-driven study might be useful to provide a novel insight into the diagnosis and treatment of HF. However, more experiments are needed in the future to investigate the functional roles of these genes in HF.
Concordance Between Active Partial Thromboplastin Time and Anti-Factor Xa Assays in Neurocritically Ill Patients Receiving Subcutaneous Heparin Prophylaxis
Authors: Shinn Grace , Berger Karen , Roh David , Doyle Kevin , Boehme Amelia K. , Connolly Edward Sander , Park Soojin , Agarwal Sachin , Claassen Jan , Der-Nigoghossian Caroline 
Published: April 2023

Background Laboratory monitoring is not recommended when subcutaneous unfractionated heparin (SQ-UFH) is administered at prophylactic doses. However, aPTT prolongation and associated hemorrhage has been reported in the neurocritically ill. At our institution, Neuroscience Intensive Care Unit (Neuro-ICU) patients with prolonged aPTT are further evaluated with a follow up aPTT and anti-factor Xa. Purpose The purpose of this study was to describe concordance between aPTT and anti-factor Xa in neurocritically ill patients receiving prophylactic SQ-UFH with evidence of aPTT prolongation. Methods A retrospective chart review of adult patients admitted to the Neuro-ICU from June 2017 to June 2019 was performed. Patients were included if they received SQ-UFH with aPTT levels and at least one anti-factor Xa level drawn within one hour of each other. Concordance between paired aPTT and anti-factor Xa was evaluated using Cohen’s weighted kappa. Results Forty two patients with 56 paired aPTT and anti-factor Xa levels were included. The most prescribed SQ-UFH regimen was 5000 units every 8 hours (60.7%) and anti-factor Xa levels were drawn a median (IQR) of 5.7 (3.1-10.7) hours after the SQ-UFH dose. Only 16 (28.6%) pairs were in concordance. The analysis showed a weighted kappa of .09; 95% CI [−.05 to .22] indicating poor agreement. Conclusions In neurocritically ill patients receiving prophylactic SQ-UFH with aPTT prolongation, there was poor concordance between aPTT and anti-factor Xa. This suggests that aPTT prolongation may not be solely driven by heparin activity and further evaluation of mechanistic drivers for coagulopathy in this population is necessary.