bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automated Derivation of Diagnostic Criteria for Lung Cancer using Natural Language Processing on Electronic Health Records: A pilot study
Authors: Houston Andrew , Williams Sophie , Ricketts William , Gutteridge Charles , Tackaberry Chris , Conibear John 
Published: December 2024

AbstractBackgroundThe digitisation of healthcare records has generated vast amounts of unstructured data, presenting opportunities for improvements in disease diagnosis when clinical coding falls short, such as in the recording of patient symptoms. This study presents an approach using natural language processing to extract clinical concepts from free-text which are used to automatically form diagnostic criteria for lung cancer from unstructured secondary-care data.MethodsPatients aged 40 and above who underwent a chest x-ray (CXR) between 2016-2022 were included. ICD-10 and unstructured data were pulled from their electronic health records (EHRs) over the preceding 12 months to the CXR. The unstructured data were processed using named entity recognition to extract symptoms, which were mapped to SNOMED-CT codes. Subsumption of features up the SNOMED-CT hierarchy was used to mitigate against sparse features and a frequency-based criteria, combined with univariate logarithmic probabilities, was applied to select candidate features to take forward to the model development phase. A genetic algorithm was employed to identify the most discriminating features to form the diagnostic criteria.Results75002 patients were included, with 1012 lung cancer diagnoses made within 12 months of the CXR. The best-performing model achieved an AUROC of 0.72. Results showed that an existing ‘disorder of the lung’, such as pneumonia, and a ‘cough’ increased the probability of a lung cancer diagnosis. ‘Anomalies of great vessel’, ‘disorder of the retroperitoneal compartment’ and ‘context-dependent findings’, such as pain, statistically reduced the risk of lung cancer, making other diagnoses more likely. The performance of the developed model was compared to the existing cancer risk scores, demonstrating superior performance.ConclusionsThe proposed methods demonstrated success in leveraging unstructured secondary-care data to derive diagnostic criteria for lung cancer, outperforming existing risk tools. These advancements show potential for enhancing patient care and results. However, it is essential to tackle specific limitations by integrating primary care data to ensure a more thorough and unbiased development of diagnostic criteria. Moreover, the study highlights the importance of contextualising SNOMED-CT concepts into meaningful terminology that resonates with clinicians, facilitating a clearer and more tangible understanding of the criteria applied.
Mapping ODI onto EQ-5D-5L in Chinese Low Back Pain Patients
Authors: Li Jia , Du Shuzhang , Chen Chengqun , Ye Ziping 
Published: December 2024

AbstractMapping can translate utility values from other health-related quality-of-life scales, giving researchers and policymakers more comprehensive information. The primary objective of the study is to develop mapping algorithms that convert scores from the Oswestry Disability Index (ODI) to the 5-level EuroQol-5 Dimension (EQ-5D-5L). Data for this analysis was sourced from 272 patients suffering from low back pain. The development of the mapping algorithms involved the application of three distinct regression methods across four different settings: ordinary least squares regression, beta regression, and multivariate ordered probit regression. To evaluate the internal validity of these algorithms, we adopted a ‘hold-out’ approach for predictive performance assessment. Furthermore, to discern the most effective model, three goodness-of-fit tests were employed: the mean absolute error (MAE), the root-mean-square error (RMSE), and the Spearman rank correlation coefficients between the predicted and observed utilities. The study successfully developed several models capable of accurately predicting health utilities in the specified context. The best performing models for ODI to EQ-5D-5L mapping were beta regressions. Mapping algorithms developed in this study enable the estimation of utility values from the ODI. The algorithms formulated in this study facilitate the estimation of utility values based on the ODI, providing a valuable empirical foundation for estimating health utilities in scenarios where EQ-5D data is unavailable.
Epidemiological description and analysis of factors associated with cholera morbidity and mortality in Cameroon from 2018 to 2023
Authors: Mboringong Akenji Blaise , Ngomtcho Sen Claudine , Armel Evouna , Linda Esso , Luc Dibog , Patricia Mendjime , Sandrine Belinga , Flore Balana , Ntamack Theodore , Mballa Etoundi , Ndip Roland 
Published: December 2024

ABSTRACTIntroductionCameroon has faced frequent and severe cholera outbreaks since 1971, with high lethality. Previous studies have examined some risk factors and groups, but not for the 2018–2023 period. We analysed the profiles of cholera epidemics and determined factors associated with morbidity and mortality from cholera during this period.Materials and methodsWe conducted an analytical cross-sectional study using Ministry of Health cholera databases from 2018–2023. We described the socio-demographic, clinical and geographical distribution of cholera cases and used multiple regression to identify factors associated with cholera lethality.ResultsBetween May 2018 and March 2023, there were four cholera epidemics with 18,986 cases, affecting 8/10 regions. The three coastal regions notified 83.4% (15,839/18,986) of cases. The most represented age group were those aged 25–35 years (21.9%; 4,163/1,876) and the M/F sex ratio was 1.27. The overall CFR was 2.7% (478 deaths/17,967 cases) and was highest among persons >65 years (6.8%; 59/869). Urban areas notified more cases than rural areas (13,267 vs 5,484). Factors associated with increased mortality were female sex (aOR 0.62, 95% CI 0.49-0.77), rainy season (aOR 0.60, 95% CI 0.45-0.78) and age below 45 years (aOR 0.56, 95% CI 0.45-0.69). Severe dehydration at consultation (aOR 12.76, 95% CI 7.66-21.25) was associated with higher mortality.ConclusionThere were frequent cholera epidemics affecting nearly all administrative regions in Cameroon from 2018 to 2023. Factors associated with decreased mortality from cholera were female sex, living in urban areas, the rainy season, and age less than 45 years. The high caseloads and case fatality rates further reiterate the need for a multisectoral approach to the fight against cholera in Cameroon.
Disparities in ABO Blood Type Determination Across Diverse Ancestries: A Systematic Review and Validation in theAll of UsResearch Program
Authors: Martinez Kiana L. , Klein Andrew , Martin Jennifer R. , Sampson Chinwuwanuju U. , Giles Jason B. , Beck Madison L. , Bhakta Krupa , Quatraro Gino , Farol Juvie , Karnes Jason H. 
Published: December 2024

AbstractBackgroundABO blood types have widespread clinical use and robust associations with cardiovascular disease. Many studies determine ABO blood types using tag single nucleotide polymorphisms (tSNPs) to characterize functional variation. However, tSNPs with low linkage disequilibrium (LD) may promote misinference of ABO blood types, particularly in diverse populations.MethodsBibliographic databases were searched for studies (2005-2022) using tSNPs to determine ABO alleles in accordance with PRISMA 2020 guidelines. We calculated linkage between tSNPs and functional variants across inferred continental ancestry groups from 1000 Genomes (AFR, AMR, EAS, EUR). We compared r2across ancestry and assessed real-world consequences by comparing tSNP-derived blood types to serology in a large, diverse population from theAll of UsResearch Program (AoURP).ResultsWe observe a lack of phasing and frequent use of inappropriate tSNPs in blood type determination, particularly for O alleles. Linkage between functional variants and O allele tSNPs was significantly lower in African (median r2=0.443) compared to East Asian (r2=0.946, p=1.1×10-5) and European (r2=0.869, p=0.023). In AoURP, discordance between tSNP-derived blood types and serology was high across all SNPs in African ancestry individuals and linkage was strongly correlated with discordance across all ancestries (ρ=-0.90, p=3.08×10-23).ConclusionWe observe common use of inappropriate tSNPs to determine ABO blood type, particularly for O alleles and with some tSNPs mistyping up to 58% of individuals. Our results highlight the lack of transferability of tSNPs across ancestries and potential exacerbation of disparities in genomic research for underrepresented populations.
Safety and efficacy of the Plasma Directed Electron Beam (PDEB™) - implications for enhanced wound healing treatment in military operational medicine and beyond
Authors: Bauer Joseph A. , Blocklin Adrianne R. , Sysel Annette M. , Sheperak Thomas J. 
Published: December 2024

ABSTRACTIntroductionWound healing presents a critical challenge in military operational medicine and combat casualty care, especially for soldiers in high-risk environments such as combat zones and training exercises. In these scenarios, wounds often result from bullets, shrapnel, burns, and blasts, affecting soft tissue, bone, and internal organs, and are frequently contaminated with hazardous substances like debris and bacteria. Limited resources in these environments make rapid and effective treatment difficult, often leading to delayed medical care and poorer healing outcomes. Emerging technologies like nonthermal plasma (NTP), also known as cold plasma, may provide superior wound healing treatment efficacy in these environments, owing to the ability to effectively kill pathogens, stimulate tissue regeneration, and minimize collateral damage compared to traditional methods. The Plasma Directed Electron Beam™ (PDEB™), an innovative advancement in nonthermal plasma research, shows promise in addressing these challenges.Materials and MethodsThe antibiofilm efficacy of the PDEB™ was investigated on Acinetobacter baumannii and Streptococcus mutans. Cytotoxicity was assessed using primary human epithelial cells and TR146 cells, immortalized epithelial cells. Cell proliferation assays, immunoblotting, and lactate dehydrogenase (LDH) release were evaluated.ResultsOur study demonstrates the effectiveness of the PDEB™ handheld in inhibiting the growth of bacterial pathogens implicated in biofilms. Acinetobacter baumannii and Streptococcus mutans showed zones of inhibition starting at lower power levels, achieving complete inhibition at 14 watts (W) and 7W respectively for 90-120 seconds. The safety of the PDEB™ was assessed through cell proliferation assays using human epithelial cells and semi-confluent TR146 cells, which were exposed to similar conditions as the bacterial assays. TR146 cells showed negligible differences in cleaved caspase 3 levels compared to controls. Cytotoxicity and apoptosis assays further confirmed the safety of PDEB™, as lactate dehydrogenase (LDH) release in epithelial cells and activated caspase 3 levels in cell extracts were comparable to untreated and helium-treated cells, indicating minimal cellular damage.ConclusionThe PDEB™ handheld, a first-generation device, has demonstrated significant efficacy in inhibiting the growth of bacteria. Concurrently, its application on human epithelial cells has shown encouraging safety profiles. These findings align with the effectiveness of traditional nonthermal plasma devices, positioning the PDEB™ as a viable and promising option for wound healing applications in Combat Casualty Care and Military Operational Medicine.
A co-produced community engagement workshop in South London to reduce psychosis related stigma
Authors: Cai Shujun , Koroma Joelyn N’Danga , Graham Charlotte , McKay Meagan , Bray Caroleen , Colgan Lauren , Lynch Sarah , Fitzell Sharon , Akande Isaac , Spencer Thomas J 
Published: December 2024

AbstractBackgroundEarly access to services is essential for those suffering a psychotic illness or at risk for the condition. Lack of knowledge of services and public stigma are major barriers to care and are associated with increased duration of untreated psychosis and delays in those at clinical high-risk for psychosis (CHR-P) from accessing support. Education and contact programmes have shown promise in reducing stigmatizing views, however, few have been co-produced and delivered by service users and clinical staff. A three-hour co-produced educational workshop was developed and delivered by service users and Outreach and Support in South London (OASIS) staff. The aim was to assess the feasibility of delivering a co-produced workshop to youth community workers, to see if it improved knowledge of psychosis, attitudes to mental health services and reduced stigma towards people with psychosis as well as seeing if the workshop increased community referrals to OASIS.MethodEducational workshops were developed by community stakeholders and service users. Pre- and post-workshop questionnaires assessed knowledge of psychosis, attitudes towards mental health teams and stigma towards individuals with a psychotic disorder. Participants’ and service users’ views on the workshop were explored through two focus groups.Results9 workshops were delivered to 75 community participants. Following the workshop participants’ questionnaire scores showed improvements in knowledge of psychosis, improved attitudes towards mental health teams and a reduction in stigmatizing views towards people with psychosis. The workshop was overwhelmingly well received with 97% agreeing with the statement that they learnt something valuable from the workshop. Referrals to the OASIS service increased by 22% following the workshops.ConclusionThe co-produced educational workshop designed and delivered by service users and OASIS staff was successful in improving participants’ knowledge, attitudes and reducing stigma. We observed an increase in the rate of referrals to the OASIS service, although it is difficult to whether this was due to the workshops or to other outreach activities. Future research should examine whether these effects are long-lasting and explore online delivered workshops to reach more participants in the wider community.
Evaluation value of bedside ultrasound monitoring of peak flow velocity of abdominal aorta and its branches in volume status of patients with septic shock
Authors: Wenchong Chen , Weixin Guo , Xiaodan Zeng , Deping Li , Jianli Luo , Yafeng Zhou , Sicheng Zhao , Pinghui Lu 
Published: December 2024

AbstractObjectiveTo explore the value of bedside ultrasound in monitoring peak flow velocity of abdominal aorta and its branches in assessing the volume status of patients with septic shock.MethodsA total of 80 patients with septic shock admitted to the Foshan Rehabilitation Hospital(The Fifth People’s Hospital of Foshan) and the Guangdong Provincial People’s Hospital from June 2022 to June 2023 were selected as the research subjects. All patients were treated with mechanical ventilation,and deep venous catheters were placed in the internal jugular vein or subclavian vein to monitor central venous pressure (CVP).PiCCO catheters were placed in the femoral artery to monitor hemodynamic data.At the same time,the maximum internal diameter of the inferior vena cava (IVCmax),the respiratory variation of the inferior vena cava (□IVC),the peak flow velocity of the abdominal aorta (VpeakAA),the peak flow velocity of the celiac artery (VpeakCA),and the peak flow velocity of the superior mesenteric artery (VpeakSMA)were monitored under bedside ultrasound.The global end-diastolic volumn index(GEDI)was used as a grouping indicator,with GEDI≤680ml/m2 as the low-volume group and GEDI≥800ml/m2 as the high-volume group.Compare the differences in peak flow velocity between the abdominal aorta,celiac artery,and superior mesenteric artery between the two groups,and analyze the correlation between peak flow velocity of the abdominal aorta,celiac artery,and superior mesenteric artery and IVCmax,ΔIVC,CVP,and stroke volume variability (SVV);draw a receiver operating characteristic (ROC) curve for the subjects,calculate the area under the curve,and find the diagnostic threshold.ResultsThere was no significant difference in general data between the two groups (P>0.05).The VpeakAA,VpeakCA,and VpeakSMA in the high-volume group were all higher than those in the low-volume group, and the differences were statistically significant (P<0.05). However,VpeakCA and VpeakSMA were significantly correlated with IVCmax, △ IVC,CVP,and SVV (P<0.05).The ROC curve analysis showed that VpeakAA,VpeakCA,and VpeakSMA could effectively evaluate the volume status of patients with septic shock, and the area under the VpeakSMA curve was 0.846,with a 95% confidence interval of 0.693-0.999,and had high sensitivity and specificity.ConclusionBedside ultrasound can dynamically monitor VpeakAA,VpeakCA,and VpeakSMA,which has great value in the evaluation of volume status in patients with septic shock.
Ursodeoxycholic acid for trans intestinal cholesterol excretion stimulation: a randomized placebo controlled cross-over study
Authors: Oostveen R.F. , Kaiser Y. , Hartgers M.L. , Meessen E.C.E. , Grefhorst A. , Hovingh G.K. , Kuipers F. , Stroes E.S.G. , Groen A.K. , Reeskamp L.F. 
Published: December 2024

AbstractObjectiveThe Trans Intestinal Cholesterol Excretion (TICE) pathway is a potential therapeutic target to reduce plasma low-density lipoprotein (LDL) cholesterol levels. TICE encompasses the direct excretion of cholesterol by enterocytes into feces. In mice TICE has been shown to be stimulated by a hydrophilic bile acid pool, resulting in increased fecal neutral sterols (FNS) loss and reduced plasma cholesterol levels. We investigated whether treatment with a hydrophilic bile acid – ursodeoxycholic acid (UDCA) - would increase FNS in humans as a proxy for TICE.Approach and resultsWe performed a randomized double-blind placebo controlled cross-over trial in 20 male participants aged >18 years, with plasma LDL cholesterol levels ≥2.6mmol/L. After a run-in period of ezetimibe 20mg once daily for three weeks, patients were randomized to UDCA 600mg or placebo orally once daily for two weeks. After a three week wash-out, patients underwent the alternate treatment.At baseline, mean (SD) age, BMI, and plasma LDL cholesterol were 59±11.3 years, 26.4±3.1 kg/m2, and 3.9±0.8 mmol/L, respectively. After UDCA treatment, the plasma bile acid hydrophobicity index was reduced compared to placebo (-115.88% versus +1.85%, p<0.001). The FNS did not change (-5.8% versus +18.8%, p=0.51) and treatment with UDCA increased LDL cholesterol with 0.39 mmol/L (+10.95% versus -3.24%, p=0.002) when compared with placebo.ConclusionUDCA in combination with ezetimibe increased plasma bile acid hydrophilicity in hypercholesterolaemic subjects, but did not result in increased FNS or decreased LDL cholesterol. This suggests that TICE is not stimulated by an increase in the hydrophilicity of the bile acid pool in humans.
Blood lead levels and bladder cancer among US participants: NHANES 1999–2018
Authors: Huang Mei , Li Hongxiao , Chen Jiahui , Li Liuqiang , Zhan Yifei , Bian Jun , Chen Meiling , Lai Dehui 
Published: December 2024

BackgroundLead is a toxic metal for human health, but its carcinogenicity is controversial, and the effect on bladder cancer is still unknown. The object of this study was to demonstrate the link between blood lead and bladder cancer.ObjectivesWe investigated associations of lead exposures with bladder cancer.MethodsWe used the database from the National Health and Nutrition Examination Survey (NHANES, 1999–2018) to perform a cross-sectional study. We performed Weighted multivariate logistic regression to examine the association between blood lead level with bladder cancer, and then a subgroup analysis was performed. The nonlinear association between BLL and bladder cancer was described using fitted smoothing curves.ResultsA total of 40,486 participants were included in this study, the mean (SD) BMI was 28.71 ± 6.68 kg/m2. A fully adjusted model showed that BLL was parallel associated with bladder cancer (Odds ratio [OR] = 2.946, 95% Confidence interval [CI] = 1.025 to 8.465, P = 0.047) in people with BMI < 28kg/m2. However, no difference was found in BMI≥28kg/m2 subgroup and in General population. In subgroup analysis of participants with BMI < 28kg/m2, blood lead was associated with bladder cancer in the male, non-hypertensive, < 70 year old subgroup (p< 0.05), but was not significantly different from the other subgroups. Additionally, we discovered a non-linear association between BLL and bladder cancer using a linear regression model.DiscussionIn this cross-sectional study, we identified higher BLL level was independently associated with Bladder cancer in People with BMI<28kg/m2.The results compensated for earlier investigations, but more large-scale prospective cohorts were required for validation.
18F-NaF Uptake on Vascular PET Imaging in Symptomatic versus Asymptomatic Atherosclerotic Disease: a Meta-Analysis
Authors: Bhakta S , Chowdhury MM , Tarkin JM , Rudd JHF , Warburton EA , Evans NR 
Published: December 2024

AbstractIntroduction18F-sodium fluoride (NaF) positron-emission tomography (PET) is increasingly being used to measure microcalcification in atherosclerotic diseasein vivo. Correlations have been drawn between sodium fluoride uptake and the presence of high-risk plaque features, as well as its association with clinical atherosclerotic sequelae. The aim of this review was to perform a meta-analysis of NaF uptake on PET imaging and its relation to symptomatic and asymptomatic disease.MethodsA systematic review was performed according to PRISMA guidelines, via searching the MEDLINE database up to August 2023. The search strategy included the terms “NaF”, “PET” and “plaque”, and all studies were included where there was data listed regarding the degree of microcalcification, as measured by18F-NaF uptake in symptomatic and asymptomatic atherosclerotic plaques. Analysis involved calculating standardized mean differences between uptake values and comparison using a random-effects model.ResultsA total of 15 articles, involving 423 participants, were included in the meta-analysis. Comparing18F-NaF uptake in symptomatic vs asymptomatic atherosclerotic plaques, a standardized mean difference of 0.42 (95% CI 0.29-0.56; p<0.001, I2= 54.1%) was noted for those studies comparing symptomatic and asymptomatic plaques in the same participant, with no significant change in effect based on arterial territory studied (QM= 5.02, p = 0.08). In those studies where data was included from participants with and without symptomatic disease, the standardized mean difference between symptomatic and asymptomatic plaques was 0.44 (95% CI 0.03-0.85, p=0.037, I2= 40.4%). All studies including asymptomatic participants were investigating carotid disease.ConclusionsPET imaging using18F-NaF can detect differences in microcalcification between symptomatic and asymptomatic atherosclerotic plaques within and between individuals, and is a marker of symptomatic disease. The standardization of18F-NaF PET imaging protocols, and its future use as a risk stratification tool or outcome measure, requires further study.