bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcoholic cardiomyopathy in patients with alcoholic liver cirrhosis: a study across 10 years
Authors: Wang Chunya , Gao Hai , Liu Weibin , Chen Jing , Guo Yupeng , Zhao Pan 
Published: March 2023

Background and objectives
Available data regarding cardiomyopathy in patients with alcoholic liver cirrhosis (ALC) are very limited because it often requires multidisciplinary assessments. The study aims to evaluate the prevalence of alcoholic cardiomyopathy in ALC and their clinical correlations.

Methods
Adult ALC patients without a previous diagnosis of cardiovascular diseases between January 2010 and December 2019 were included in the study. The prevalence rate of alcoholic cardiomyopathy in patients with ALC was calculated together with a 95% confidence interval (CI) using the Clopper–Pearson exact method.

Results
A total of 1022 ALC patients were included. Male patients predominated (90.5%). ECG abnormalities were observed in 353 patients (34.5%). Prolonged QT interval was most common in ALC patients with ECG abnormalities, which occurred in 109. Thirty-five ALC patients underwent the cardiac MRI examination and only one patient was found with cardiomyopathy. The estimated prevalence rate of alcoholic cardiomyopathy in all the ALC patients was 0.0286 (95% CI, 0.0007–0.1492). There was no statistical difference regarding the prevalence rate between the group of patients with ECG abnormalities and the group without ECG abnormalities (0.0400 vs. 0.0000, P = 1.000).

Conclusion
Although ECG abnormalities, especially QT prolongation, existed in a proportion of ALC patients, cardiomyopathy in the patient population was not common. Further larger-sample studies based on cardiac MRI are needed to verify our results.
Biopsies from ulcer edge yield higher histological activity scores than biopsies from non-ulcerated mucosa in active ulcerative colitis
Authors: Novak Gregor , Sever Nejc , Hanžel Jurij , Koželj Matic , Kurent Tina , Smrekar Nataša , Drobne David , Zidar Nina 
Published: March 2023

Background
The appropriate location for biopsy collection in ulcerative colitis is unknown.

Objectives
We aimed to determine the location for biopsy collection in the presence of ulcers which yields the highest histopathological score.

Design and methods
This prospective cross-sectional study enrolled patients with ulcerative colitis and ulcers in the colon. Biopsy specimens were obtained at the edge of the ulcer; at a distance of one open forceps (7–8 mm) from the ulcer edge; at a distance of three open forceps (21–24 mm) from the ulcer edge; further referred to as locations 1, 2 and 3 respectively. Histological activity was assessed using Robarts Histopathology Index and the Nancy Histological Index. Statistical analysis was performed using mixed effects models.

Results
A total of 19 patients were included. Decreasing trends with distance from the ulcer edge (P < 0.0001) were observed. Biopsies procured from the edge of the ulcer (location 1) yielded a higher histopathological score compared to biopsies procured at locations 2 and 3 (P ≤ 0.001).

Conclusion
Biopsies from the ulcer edge yield higher histopathological scores than biopsies next to the ulcer. In clinical trials with histological endpoints, biopsies should be obtained from the ulcer edge (if ulcers are present) to reliably assess histological disease activity.
Clinical features and outcomes of adult idiopathic megarectum
Authors: Wu Kyle , Little Robert D. , Long Andrew , Khera Angela , Kamm Michael A. , Basnayake Chamara 
Published: March 2023

Objective
Idiopathic megarectum is characterized by abnormal, pronounced rectal dilatation in the absence of identifiable organic pathology. Idiopathic megarectum is uncommon and under-recognized. This study aims to describe the clinical features and management of idiopathic megarectum.

Methods
A retrospective review was undertaken on patients diagnosed with idiopathic megarectum with or without idiopathic megacolon over a 14-year period until 2021. Patients were identified from the hospital’s International Classification of Diseases codes, and pre-existing clinic patient databases. Patient demographics, disease characteristics, healthcare utilization and treatment history data were collected.

Results
Eight patients with idiopathic megarectum were identified; half of the patients were female, with the median age of symptom onset being 14 years (interquartile range [IQR] 9–24). The median rectal diameter measured was 11.5 cm (IQR 9.4–12.1). The most common presenting symptom was constipation, bloating and faecal incontinence. All patients required prior sustained periods of regular phosphate enemas and 88% were using ongoing oral aperients. Concomitant anxiety and or depression were found in 63% of patients and 25% were diagnosed with an intellectual disability. Healthcare utilization was high with a median of three emergency department presentations or ward admissions related to idiopathic megarectum per patient over the follow-up period; 38% of patients required surgical intervention during the period of follow-up.

Conclusion
Idiopathic megarectum is uncommon and associated with significant physical and psychiatric morbidity and high healthcare utilization.
Risk factors of nosocomial infection in patients underwent artificial liver support system: a retrospective case–control study
Authors: Zhang Xu , Qin Deyu , Liu Guangwei , Li Feng , Peng Jingjing , Xiang Yanling 
Published: March 2023

Background
Although nosocomial infection is one of the most discussed problems in patients undergoing artificial liver support system (ALSS) treatment, only few solutions have been proposed so far. This study aimed to explore the risk factors of nosocomial infection in patients treated with ALSS in order to aid in the development of future preventive measures.

Methods
This retrospective case–control study included patients treated with ALSS at the Department of Infectious Diseases, First Affiliated Hospital of xxx Medical University between January 2016 and December 2021.

Results
One hundred seventy-four patients were included. There were 57 patients in the nosocomial infection group and 117 patients in the non-nosocomial infection group, of them 127 males (72.99%) and 47 females (27.01%) with an average age of 48.15 ± 14.19 years old. Multivariate logistic regression analysis revealed that total bilirubin [odds ratio (OR) = 1.004; 95% confidence interval (CI), 1.001–1.007; P = 0.020], number of invasive procedures (OR = 2.161; 95% CI, 1.500–3.313; P < 0.001), blood transfusion (OR = 2.526; 95% CI, 1.312–4.864; P = 0.006) were independent risk factors and haemoglobin (Hb) (OR = 0.973; 95% CI, 0.953–0.994; P = 0.011) was a protective factor for nosocomial infection in patients treated with ALSS.

Conclusion
The total bilirubin, transfusion of blood products and higher number of invasive operations were independent risk factors for nosocomial infection in patients treated with ALSS, while higher Hb was a protective factor.
A pilot, masked, randomized controlled trial to evaluate local gentamicin versus saline in open tibial fractures (pGO-Tibia)
Authors: Haonga Billy T. , Ngunyale Patrick , von Kaeppler Ericka P. , Donnelley Claire A. , Won Nae Y. , Eliezer Edmund N. , Brown Kelsey , Flores Michael , O'Marr Jamieson M. , Rodarte Patricia , Urva Mayur , Cortez Abigail , Porco Travis , Morshed Saam , Shearer David W. 
Published: March 2023

Abstract

Background:
Open tibial fractures have a high risk of infection that can lead to severe morbidity. Antibiotics administered locally at the site of the open wound are a potentially effective preventive measure, but there are limited data evaluating aminoglycoside antibiotics. The objective of this study was to assess the feasibility of a clinical trial to test the efficacy of local gentamicin in reducing the risk of fracture-related infection after open tibial fracture.

Methods:
This study is a single-center, pilot, masked, randomized controlled trial conducted at the Muhimbili Orthopaedic Institute. Participants were randomized intraoperatively after wound closure to receive gentamicin solution or normal saline solution injected at the fracture site. Follow-ups were completed at 2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 1 year postoperatively. The primary feasibility outcomes were the rate of enrollment and retention. The primary clinical outcome was the occurrence of fracture-related infection.

Results:
Of 199 patients screened, 100 eligible patients were successfully enrolled and randomized over 9 months (11.1 patients/month). Complete data were recorded at baseline and follow-up for >95% of cases. The rate of follow-up at 6 weeks, 3 months, 6 months, 9 months, and 1 year were 70%, 68%, 69%, 61%, and 80%, respectively. There was no difference in adverse events or any of the measured primary and secondary outcomes.

Conclusion:
This pilot study is among the first to evaluate locally administered gentamicin in open tibial fractures. Results indicate a rigorous clinical trial with acceptable rates of enrollment and follow-up to address this topic is possible in this setting.
Change in Pediatric Adenotonsillectomy Postoperative Visit Patterns After Opioid Food and Drug Administration Warning
Authors: Cohen Naiomi , Schissler Kathryn , Jeter Justin , Stathas Adam , Lozano Juan , Dave Sandeep , Lowe David 
Published: March 2023

Study Objective
This study aimed to determine the association between opioid prescriptions given after tonsillectomy with adenoidectomy (T + A) and pain-related return visit rates in pediatric patients. Determine association between Food and Drug Administration (FDA) black box warning against opioid use in this population and pain-related return visit rates.

Methods
This was a single-institution retrospective cohort study of pediatric patients who underwent T + A between April 2012 and December 2015 and had return visits to the emergency department or urgent care center. Data were obtained from the hospital electronic warehouse using International Classification of Diseases-9/10 procedure codes. Odds ratios (ORs) with 95% confidence intervals (CIs) for return visits were calculated. Multivariate logistic regression analysis was used to measure association between opioid prescriptions and return visit rates as well as FDA warning and return visit rates adjusting for confounders.

Results
There were 4778 patients who underwent T + A, median age, 5 years. Of these, 752 (15.7%) had return visits. Pain-related return visits were higher in patients who received opioid prescriptions (adjusted OR, 1.31; 95% CI, 1.09–1.57). After FDA warning, opioids were prescribed at a lower rate (47.9%) compared with previous (98.6%) (OR, 0.01; 95% CI, 0.008–0.02). Pain-related return visits were lower after FDA warning (OR, 0.73; 95% CI, 0.61–0.87). Steroid prescription rate increased after FDA warning (OR, 415; 95% CI, 197–874).

Conclusions
Opioid prescriptions were associated with higher pain-related return visits after T + A, whereas issuance of FDA black box warning against codeine use was associated with lower pain-related return visits. Our data suggest that the black box warning potentially had unintended benefits in pain management and health care usage.
Preoperative Optimization Before Ventral Hernia Repair: A Systematic Review and Meta-analysis
Authors: Marcolin Patricia , Mazzola Poli de Figueiredo Sérgio , Walmir de Araújo Sérgio , Mota Constante Marcella , Moura Fé de Melo Vítor , Ginar da Silva Shana , Mao Rui-Min Diana , DeJesus Jana , Lu Richard 
Published: March 2023

Background:
Obesity is associated with an increased risk of ventral hernia development and recurrence rates after ventral hernia repair (VHR). The metabolic derangements caused by obesity can also lead to many postoperative complications. Therefore, it is a common practice to attempt weight loss before VHR. However, there is still no consensus on optimal preoperative management for obese patients with a ventral hernia. This study aims to perform a meta-analysis to evaluate the effect of preoperative weight optimization on VHR outcomes.

Methods:
We performed a literature search of PubMed, Scopus, and Cochrane Library databases to identify studies comparing obese patients who underwent surgical or non-surgical weight loss interventions before undergoing hernia repair surgery to obese patients who underwent hernia repair surgery without prehabilitation. Postoperative outcomes were assessed by means of pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I2 statistics.

Results:
One thousand six hundred nine studies were screened and 13 were thoroughly reviewed. Five studies comprising 465 patients undergoing hernia repair surgery were included. No differences in hernia recurrence [odds ratio (OR) 0.66; 95% CI 0.23-1.89; P=0.44; I2=20%], seroma (OR 0.70; 95% CI 0.25-1.95; P=0.50; I2=5%), hematoma (OR 2.00; 95% CI 0.5-7.94; P=0.45; I2=0%), surgical site infection (OR 1.96; 95% CI 0.52-7.40; P=0.32; I2=0%), and overall complication (OR 0.80; 95% CI 0.37-1.74; P=0.58; I2=40%) rates were noted when comparing patients who underwent a preoperative weight loss intervention (prehabilitation or bariatric surgery) versus those who did not. In the subgroup analysis of patients who underwent bariatric surgery, we found no difference in hernia recurrence (OR 0.64; 95% CI 0.12-3.33; P= 0.59; I2=41%) or overall complications (OR 1.14; 95% CI 0.36-3.64; P=0.82; I2=64%). In the subgroup analysis of patients who lost weight versus patients who did not, there was no significant difference in overall complication rates (OR 0.86; 95% CI 0.34-2.21; P=0.76; I2=55%).

Conclusions:
We found similar hernia recurrence, seroma, hematoma, and surgical site infection rates in patients who underwent preoperative optimization. These findings underline the need for prospective studies to define the optimal role of preoperative optimization and weight loss in obese patients undergoing ventral hernia repair.
The associations of child screen time with psychiatric problems: the role of genetic confounding
Authors: Zhang Yingzhe , Choi Karmel W , Delaney Scott W. , Ge Tian , Pingault Jean-Baptiste , Tiemeier Henning 
Published: March 2023

AbstractImportanceChildren’s exposure to screen time has been associated with poor mental health outcomes, yet the role of genetic factors in this association remains largely unknown.ObjectiveWe examined (1) the longitudinal phenotypic association between child screen time and mental health outcomes and (2) the potential genetic confounding of this association. We hypothesized that genetics partially account for observed phenotypic associations.DesignLongitudinal (baseline and one-year follow-up) population-based cohort.SettingAdolescent Brain Cognitive Development, 21 sites in the United States.ParticipantsThis study included 4,262 children of genetically assigned European ancestry with mean age 9.9 years [SD = 0.6 years], 46.8% female.ExposureChildren’s daily screen time (in hours) was assessed both by child-report and parent-report questionnaires at baseline.Main Outcomes and MeasuresChild psychiatric problems, specifically attention and internalizing problems, were measured with the parent-rated Child Behavior Checklist at the one-year follow-up. We used Genetic sensitivity analyses (Gsens), based on structural equation models using polygenic risk scores (PRS) of both exposure and outcomes, and either single nucleotide polymorphism (SNP)-based heritability or twin-based heritability to estimate genetic confounding of associations between child screen time and attention or internalizing problems, separately.ResultsWe found that child screen time was positively associated with the different psychiatric problems. Further, the television time PRS was associated with child screen time (β=0.18 SD, 95% CI: 0.14, 0.23); the ADHD PRS was associated with attention problems (β=0.13 SD, 95% CI: 0.10, 0.16); and the depression PRS was associated with internalizing problems (β=0.10 SD, 95% CI: 0.07, 0.13). These PRSs were associated with cross-traits, suggesting genetic confounding. Using PRSs and SNP-based heritability, we estimated that genetic confounding entirely accounts for the association between child screen time and attention problems, and moderately (42.7%) accounts for the association between child screen time and internalizing problems. When PRSs and twin-based heritability estimates were used, genetic confounding fully explained both associations.Conclusions and RelevanceGenetic confounding may explain a substantial part of the associations between child screen time and psychiatric problems. Potential interventions to reduce screen time could be less effective in reducing psychiatric problems than previously hypothesized.
Rare genetic variants inSEC24Dmodify orofacial cleft phenotypes
Authors: Curtis Sarah W. , Carlson Jenna C. , Beaty Terri H. , Murray Jeffrey C. , Weinberg Seth M. , Marazita Mary L. , Cotney Justin L. , Cutler David J. , Epstein Michael P. , Leslie Elizabeth J. 
Published: March 2023

AbstractAs one of the most common structural birth defects, orofacial clefts (OFCs) have been studied for decades, and recent studies have demonstrated that there are genetic differences between the different phenotypic presentations of OFCs. However, the contribution of rare genetic variation genome-wide to different subtypes of OFCs has been understudied, with most studies focusing on common genetic variation or rare variation within targeted regions of the genome. Therefore, we used whole-genome sequencing data from the Gabriella Miller Kids First Pediatric Research Program to conduct a gene-based burden analysis to test for genetic modifiers of cleft lip (CL) vs cleft lip and palate (CLP). We found that there was a significantly increased burden of rare variants inSEC24Din CL cases compared to CLP cases (p=6.86×10−7). Of the 15 variants withinSEC24D, 53.3% were synonymous, but overlapped a known craniofacial enhancer. We then tested whether these variants could alter predicted transcription factor binding sites (TFBS), and found that the rare alleles destroyed binding sites for 9 transcription factors (TFs), including Pax1 (p=0.0009), and created binding sites for 23 TFs, including Pax6 (p=6.12×10−5) and Pax9 (p= 0.0001), which are known to be involved in normal craniofacial development, suggesting a potential mechanism by which these synonymous variants could have a functional impact. Overall, this study demonstrates that rare genetic variation contributes to the phenotypic heterogeneity of OFCs and suggests that regulatory variation may also contribute and warrant further investigation in future studies of genetic variants controlling risk to OFC.
Partial or complete loss of norepinephrine differentially alters contextual fear and catecholamine release dynamics in hippocampal CA1
Authors: Wilson Leslie R. , Plummer Nicholas W. , Evsyukova Irina Y. , Patino Daniela , Stewart Casey L. , Smith Kathleen G. , Fry Sydney A , Deal Alex L. , Kilonzo Victor W. , Sciolino Natale R. , Cushman Jesse D. , Jensen Patricia 
Published: March 2023

ABSTRACTContextual fear learning is heavily dependent on the hippocampus. Despite evidence that catecholamines contribute to contextual encoding and memory retrieval, the precise temporal dynamics of their release in the hippocampus during behavior is unknown. In addition, new animal models are required to probe the effects of altered catecholamine synthesis on release dynamics and contextual learning. Utilizing GRABNEand GRABDAsensors,in vivofiber photometry, and two new mouse models of altered locus coeruleus norepinephrine (LC-NE) synthesis, we investigate norepinephrine (NE) and dopamine (DA) release dynamics in dorsal hippocampal CA1 during contextual fear conditioning. We report that aversive foot-shock increases both NE and DA release in dorsal CA1, while freezing behavior associated with recall of fear memory is accompanied by decreased release. Partial loss of LC-NE synthesis reveals that NE release dynamics are modulated by sex. Moreover, we find that recall of recent fear memory is sensitive to both partial and complete loss of LC-NE synthesis throughout prenatal and postnatal development, similar to prior observations of mice with global loss of NE synthesis beginning postnatally. In contrast, remote recall is compromised only by complete loss of LC-NE synthesis beginning prenatally. Overall, these findings provide novel insights into the role of NE in contextual fear and the precise temporal dynamics of both NE and DA during freezing behavior, and highlight a complex relationship between genotype, sex, and NE signaling.
Systematic evaluation of the environmental effect on depressive symptoms in late adolescence and early adulthood: exposome-wide association study and twin modeling
Authors: Wang Zhiyang , Zellers Stephanie , Whipp Alyce M. , Heinonen-Guzejev Marja , Foraster Maria , Júlvez Jordi , van Kamp Irene , Kaprio Jaakko 
Published: March 2023

AbstractThe exposome represents the totality of environmental effects, but systematic evaluation between it and depressive symptoms is scant. We sought to comprehensively identify the association of the exposome with depressive symptoms in late adolescence and early adulthood and determine genetic and environmental covariances between them. Based on the FinnTwin12 cohort (3025 participants in young adulthood and 4127 at age 17), the exposome-wide association study (ExWAS) design was used to identify significant exposures from 12 domains. Bivariate Cholesky twin models were fitted to an exposome score and depressive symptoms. In ExWASes, 29 and 46 exposures were significantly associated with depressive symptoms in young adulthood and at age 17, respectively, and familial exposures were the most influential. Twin models indicated considerable genetic and environmental covariances between the exposome score and depressive symptoms with sex differences. The findings underscore the systematic approach of the exposome and the consideration of relevant genetic effects.
Effect of an enhanced public health contact tracing intervention on the secondary transmission of SARS-CoV-2 in educational settings: the four-way decomposition analysis
Authors: Djuric Olivera , Larosa Elisabetta , Cassinadri Mariateresa , Cilloni Silvia , Bisaccia Eufemia , Pepe Davide , Bonvicini Laura , Vicentini Massimo , Venturelli Francesco , Giorgi Rossi Paolo , Pezzotti Patrizio , Mateo Urdiales Alberto , Bedeschi Emanuela ,   the Reggio Emilia Covid-19 Working Group.
Published: March 2023

AbstractBackgroundWe assessed the impact of testing contacts immediately instead of at the end of quarantine on the transmission of SARS-CoV-2 in schools in Reggio Emilia Province.MethodsWe analysed surveillance data on notification of COVID-19 cases in schools between 1 September 2020 and 4 April 2021.ResultsMedian tracing delay decreased from 7 to 3.1 days and the percentage of the known infection source increased from 34% to 54.8% (IRR 1.61 1.40-1.86). Implementation of prompt contact tracing was associated with a 10% decrease in the number of secondary cases (excess relative risk, EER -0.1 95%CI -0.35 to 0.15). Knowing the source of infection of the index case led to a decrease in secondary transmission (IRR 0.75 95% CI 0.63-0.91) while the decrease in tracing delay was associated with decreased risk of secondary cases (1/IRR 0.97 95%CI 0.94-1.01 per one day of delay). The direct effect of the intervention accounted for the 29% decrease in the number of secondary cases (EER -0.29 95% -0.61 to 0.03).ConclusionsPrompt contact testing in the community seems to reduce the time of contact tracing and increases the ability to identify the source of infection in school outbreaks. Yet, observed differences can be also due to differences in the force of infection and to other control measures put in place.FundingThis project was carried out with the technical and financial support of the Italian Ministry of Health – CCM 2020 and Ricerca Corrente Annual Program 2023.