bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing sepsis detection using feed-forward neural networks with hyperparameter tuning techniques
Authors: N. Smitha , R. Tanuja , S. H. Manjula 
Published: February 2025

<p>This paper investigates the use of feed-forward neural networks for sepsis detection, emphasizing class imbalance mitigation and hyperparameter optimization. Leveraging random oversampling, synthetic minority over-sampling technique (SMOTE), and random sampling techniques, we address class imbalance, significantly improving feed-forward neural network performance. The resulting model achieves an impressive 83% accuracy on the test set, with notable enhancements in precision, recall, and F1-score for the positive class. Hyperparameter tuning using RandomizedSearchCV identifies optimal parameters, including an alpha value of 0.01 and the logistic activation function, leading to a remarkable 57.5% test accuracy. GridSearchCV also contributes to model refinement, albeit with a slightly lower test accuracy of 51.5%. These findings underscore the importance of robust hyperparameter tuning methods in optimizing feed-forward neural network models for imbalanced datasets, particularly in sepsis detection. The insights gained hold promise for the development of more accurate diagnostic tools, ultimately improving patient outcomes in clinical practice.</p>
Enhanced intrusion detection through dual reduction and robust mean
Authors: Taha Archi , Benattou Mohammed 
Published: February 2025

<p>The exponential growth of online networks necessitates a paradigm shift in intrusion detection systems (IDS). Traditionalmethods falter under the massive influx of data, resulting in high false positives and reduced detection accuracy. This research introduces a novel approach combining principal component analysis (PCA) and linear discriminant analysis (LDA), augmented by robust generalized sample mean, to enhance IDS performance. PCA efficiently reduces data dimensionality, while LDA extracts critical features that differentiate normal network traffic from anomalies. The robust generalized sample mean counteracts the influence of outliers, ensuring accurate and reliable analysis. Implemented on the UNSW-NB15 dataset, our method achieves an average 6% reduction in false positives and a 10% increase in detection rate. Additionally, our testing methodology closely mirrors real-world conditions, making the results more representative of practical scenarios compared to existing work. These advancements demonstrate substantial improvements in IDS performance and robustness over existing techniques.</p>
Prognostic Value of Myocardial T1 Mapping for Predicting Adverse Events in Hypertrophic Cardiomyopathy
Authors: Wang Jie , Zhang Jinquan , Liu Wei , Pu Lutong , Qi Weitang , Xu Yuanwei , Wan Ke , Gkoutos Georgios V. , Han Yuchi , Chen Yucheng 
Published: February 2025

BACKGROUND:
In patients with hypertrophic cardiomyopathy, the prognostic value of myocardial T1 and extracellular volume fraction for adverse cardiovascular events has not been well defined.

METHODS:
A total of 663 consecutive participants with hypertrophic cardiomyopathy who underwent 3T cardiovascular magnetic resonance were recruited. The follow-up end points included heart failure (HF)-related death, HF hospitalization, and sudden cardiac death or aborted sudden cardiac death.

RESULTS:

On Cox proportional hazards regression multivariable analyses, global native T1 excluding late gadolinium enhancement areas (hazard ratio [HR], 1.04 [95% CI, 0.99–1.09];
P
=0.094) and global extracellular volume fraction excluding late gadolinium enhancement (HR, 1.02 [95% CI, 0.95–1.10];
P
=0.565) were not associated with sudden cardiac death. Conversely, global native T1 (HR, 1.08 per 10 ms increase [95% CI, 1.02–1.16],
P
=0.014; HR, 1.05 per 10 ms increase [95% CI, 1.01–1.09];
P
=0.009) and global extracellular volume fraction (HR, 1.23 per 1% increase [95% CI, 1.11–1.36],
P
<0.001; HR, 1.10 per 1% increase [95% CI, 1.04–1.16];
P
<0.001) were independently associated with HF-related death and the composite end point of HF-related death or HF hospitalization in multivariable Cox models, respectively.

CONCLUSIONS:
In this study of patients with hypertrophic cardiomyopathy, we found global native T1 and global extracellular volume fraction (excluding late gadolinium enhancement) to be both independently associated with HF-related events, but not sudden cardiac death in multivariable analysis. These findings are hypothesis-generating and will require external validation in larger cohorts.

REGISTRATION:

URL:
https://www.chictr.org.cn
; Unique identifier: ChiCTR1900024094.
How Good Are Neurologists? A Diagnostic Accuracy Study on the Performance of Neurologists in the Emergency Room
Authors: Schankin Christoph J. , Popa‐Todirenchi Bianca‐Violeta , Eich Anne‐Sophie , Branca Mattia , Galimanis Aikaterini , Scutelnic Adrian , Goeldlin Martina B. , Beyeler Morin , Exadaktylos Aristomenis , Belachew Nebiyat , Heldner Mirjam R. , Kaesmacher Johannes , Meinel Thomas R. , Mattle Heinrich P. , Jung Simon , El‐Koussy Marwan , Fischer Urs 
Published: February 2025

BACKGROUND
In people with suspected stroke the first assessment occurs under time pressure in the emergency department and is based solely on clinical information. Working hypotheses include mechanism and localization of the clinical deficit on imaging. To assess the performance of neurologists in such situation, we investigated the accuracy with which board‐certified neurologists make the correct diagnosis based solely on clinical information.

METHODS
In this prospective diagnostic accuracy study done at an emergency department of a university hospital, neurologists had to commit themselves to a diagnosis in people with suspected acute stroke. The main analysis was the accuracy with which they distinguished vascular from nonvascular causes using the discharge diagnosis as a reference. Secondary analyses included the distinction of ischemic from hemorrhagic strokes, and the accuracy with which the lesion location and site of vessel occlusion were identified. The performance of neurologists was also compared to residents and medical students.

RESULTS
Of 800 people with suspected stroke, 567 (71%) had a vascular (508 ischemic stroke or transient ischemic attack and 59 hemorrhagic stroke) and 233 (29%) had a nonvascular disorder (72 seizures, 33 migraine auras, 12 functional neurological disorders, and 116 other diseases). Vessel occlusion was found in 227 of 410 people with ischemic stroke. Neurologists identified vascular origin with an accuracy of 0.86 (95% CI: 0.83–0.89), a sensitivity of 0.93 (0.90–0.95), and a specificity of 0.66 (0.58–0.73). The accuracy to identify ischemia compared with hemorrhage was 0.91 (0.87–0.93). Neurologists’ accuracy to predict the presence of vessel occlusion was 0.66 (0.61–0.71), of exact lesion location was 42%, and of the affected blood vessel 57%.

CONCLUSION
In people with acute neurological deficits, the accuracy with which neurologists identify vascular origin is high and depends on neurological education. Experienced physicians should be involved early in the management of people with “code stroke.”
Comparative analysis of Elecsys and ELISA for differentiating amyloid-PET status in a Korean memory clinic based on cerebrospinal fluid biomarkers
Authors: Park Sun Ah , An Young-Sil , Park Yong-Jin , Lee Ji-Yeong , Jeon Hyuna , Kim Yoon Seob , Lee Keun , Sun Kyunghwa , Lee Sun Min , Moon So Young 
Published: February 2025

Background The adoption of Alzheimer's disease (AD) biomarkers in clinical practice is expected to increase following recent approval of disease-modifying therapies. Fully automated immunoassays, Elecsys platform, offer convenience and enhanced reliability. Objective This study was performed to evaluate the performance of the Elecsys assay in a Korean clinical setting, comparing its effectiveness to ELISA for detecting amyloid-PET positivity. Methods Cerebrospinal fluid (CSF) Aβ42, pTau181, tTau, pTau181/Aβ42, and tTau/Aβ42 were evaluated using Elecsys kits on a Cobas e 411 analyzer and manual Innotest ELISA with paired frozen samples ( n = 118) from subjects with cognitive status ranging from unimpaired to mild cognitive impairment and dementia. Results Strong linear correlations were observed between Elecsys- and ELISA-measured Aβ42, pTau181, and tTau levels. Receiver operating characteristic-based cutoff points for pTau181/Aβ42 (0.0252) and tTau/Aβ42 (0.258) in Elecsys demonstrated the highest areas under the curve (0.97 and 0.96) and predictive values (96.6% for both) for detecting amyloid-PET abnormalities. No cases of abnormal amyloid PET status were found without concurrent abnormal CSF biomarkers when considering Elecsys Aβ42 and the pTau181/Aβ42 ratio simultaneously. In addition, previously established cutoffs for combined ratios effectively differentiated amyloid PET status in our samples. Conclusions This study demonstrated the utility of Elecsys-measured CSF AD biomarkers in agreement with amyloid-PET classification in the Korean population. The pTau181/Aβ42 and tTau/Aβ42 ratios were the most accurate in detecting amyloid-PET (+), with Elecsys showing higher accuracy than ELISA. The study also supported the applicability of common cutoffs from Western countries for these biomarkers in our samples.
Validation of a novel neuroimaging signature for dementia and clinical Alzheimer's disease in the population-based Rotterdam study
Authors: Claus Jacqueline J , Rosbergen Mathijs T , Roshchupkin Gennady V , Ikram M Arfan , Vernooij Meike W , Wolters Frank J 
Published: February 2025

Background A novel neuroimaging signature of regional cortical thickness on brain MRI recently showed high potential for Alzheimer's disease and related dementias (ADRD) risk stratification in the community. How these findings translate to other populations, remains undetermined. Objective We aimed to replicate this novel ADRD neuroimaging marker in the population-based Rotterdam Study. Methods We included all participants from the population-based Rotterdam Study with brain-MRI between 2005–2016, and derived the signature using FreeSurfer. We computed hazard ratios and C-statistics for 10-year dementia risk, and betas for cross-sectional associations with cognition, comparing the novel signature to hippocampal volume, mean cortical thickness, and another cortical thickness signature (Dickerson's). Results Of 3249 participants (mean age 71.3 ± 8.0 years), 294 developed dementia (74.8% clinical AD) during a mean follow-up of 8.1 years. The novel ADRD signature had similar magnitude of associations as Dickerson's signature and cortical thickness for AD dementia (HR per 1-SD increase 0.87;0.78–0.96), but performed worse than all markers for all-cause dementia. Of the four neuroimaging markers, hippocampal volume showed the strongest associations with both risk of all-cause dementia and clinical AD dementia. The ADRD had the weakest association with general cognitive function (β per 1-SD increase 0.04;0.02–0.06), and executive function (β per 1-SD increase 0.02;0.00–0.04), followed by cortical thickness and Dickerson's, and hippocampal volume showed the strongest associations. Conclusions In this community-based study, the novel cortical thickness signature did not outperform hippocampal volume for dementia risk stratification. The importance of replication studies underlines the value of the current study. Replicating research findings is essential to establish robust biomarkers for dementia risk prediction.
Association between plasma cytokine levels and multiple neuroimaging modalities in mild cognitive impairment
Authors: Nakamichi Atsuhito , Kimura Noriyuki , Hanaoka Takuya , Masuda Teruaki , Ataka Takuya , Matsubara Etsuro 
Published: February 2025

Background The relationship between peripheral cytokines and neuroimaging biomarkers for Alzheimer's disease (AD) is not yet well established. Objective To determine the association of cytokine plasma levels with brain amyloid deposition, cortical glucose metabolism, hippocampal volume, and white matter lesions (WMLs) in older adults with mild cognitive impairment (MCI). Methods We recruited 50 older individuals with amnestic MCI (25 men and 25 women; median age, 75 years) and performed plasma analysis, 11C-Pittsburgh compound-B positron-emission tomography (PiB-PET), 18F-fluorodeoxyglucose positron-emission tomography, and magnetic resonance imaging. Global PiB and fluorodeoxyglucose (FDG) uptake were assessed by the ratio of the voxel number-weighted average of the mean uptake in the frontal, temporoparietal, and posterior cingulate, in reference to the cerebellum. The Fazekas scale was used to evaluate WMLs. Plasma levels of 48 cytokines were simultaneously measured with bead-based multiplex assays. Results The plasma levels of IL-2Ra, IL-3, IL-5, IL-7, IL-9, IL-16, IL-18, fibroblast growth factor (FGF-basic), granulocyte colony-stimulating factor (G-CSF), granulocyte–macrophage colony-stimulating factor (GM-CSF), macrophage inflammatory protein-1α (MIP-1α), regulated on activation, normal T-cell expressed and secreted (RANTES), tumor necrosis factor-α (TNF-α), cutaneous T-cell attracting chemokine (CTACK), growth-regulated oncogene α (GROα), hepatocyte growth factor (HGF), interferon-α2 (IFN-α2), leukemia inhibitory factor (LIF), monocyte chemoattractant protein-3 (MCP-3), β-nerve growth factor (β-NGF), stem cell factor (SCF), stem cell growth factor-β (SCGF-β), and TNF-related apoptosis-inducing ligand (TRAIL) were significantly associated with global PiB uptake, whereas those of IL-7 and GROα were significantly associated with hippocampal volume after covariate adjustment and false discovery rate correction. Conclusions Plasma cytokines are associated with brain amyloid deposition rather than brain dysfunction or hippocampal atrophy. Moreover, cytokines may play important roles in early-stage AD pathophysiology.
Structural covariance network patterns linked to neuropsychiatric symptoms in biologically defined Alzheimer's disease: Insights from the mild behavioral impairment checklist
Authors: Michelutti Marco , Urso Daniele , Tafuri Benedetta , Gnoni Valentina , Giugno Alessia , Zecca Chiara , Dell’Abate Maria Teresa , Vilella Davide , Manganotti Paolo , De Blasi Roberto , Nigro Salvatore , Logroscino Giancarlo 
Published: February 2025

Background: The frequent presentation of Alzheimer's disease (AD) with neuropsychiatric symptoms (NPS) in the context of normal or minimally-impaired cognitive function led to the concept of Mild Behavioral Impairment (MBI). While MBI's impact on subsequent cognitive decline is recognized, its association with brain network changes in biologically-defined AD remains unexplored. Objective: To investigate the correlation of structural covariance networks with MBI-C checklist sub-scores in biologically-defined AD patients. Methods: We analyzed 33 biologically-defined AD patients, ranging from mild cognitive impairment to early dementia, all characterized as amyloid-positive through cerebrospinal fluid analysis or amyloid positron emission tomography scans. Regional network properties were assessed through graph theory. Results: Affective dysregulation correlated with decreased segregation and integration in the right inferior frontal gyrus (IFG). Impulse dyscontrol and social inappropriateness correlated positively with centrality and efficiency in the right posterior cingulate cortex (PCC). Global network properties showed a preserved small-world organization. Conclusions: This study reveals associations between MBI subdomains and structural brain network alterations in biologically-confirmed AD. The IFG's involvement is crucial for mood dysregulation, while the PCC could be involved in compensatory mechanisms for social cognition and impulse control. These findings underscore the significance of biomarker-based neuroimaging for the characterization of NPS across the AD spectrum.
Comparative study of holmium laser versus cold-knife optical internal urethrotomy in urethral stricture
Authors: Sharma Elias , Kumar Ravinder , Sharma Chetan 
Published: February 2025

Objective: One of the most difficult urological ailments is to cure the urethral stricture adequately. There are various methods employed for the treatment of urethral stricture. This analysis was conducted to compare the efficacy and safety of holmium laser versus cold-knife optical urethrotomy for operative time, complications, and recurrence. Methods: The study design is a comparative study. The study participants were enrolled after procuring voluntary informed consent. Fifty-six patients were included in the study from the Urology department Super Speciality Hospital, GMC, Jammu from 1 November 2017 to 31 October 2018 and were divided into Group 1 (holmium group) and Group 2 (cold-knife group). Patients were catheterised with 14 Fr Foley’s catheter after the procedure and the catheter was removed on the third postoperative day. Patients were followed for 6 months. At each follow-up physical examination and uroflowmetry were performed. On the 90th post-operative day, a retrograde urethrogram was performed. Results: Both the cold knife and holmium laser have been safe and effective in providing immediate relief to patients with single and short-segment (< 1 cm long) urethral strictures. The cold knife offers a significant advance over the holmium laser in terms of the operative time, which was shorter in the cold-knife group. The success rates for laser and cold knife were similar. Conclusion: The success rates for laser and cold knife were very similar, with the groups having a similar trend in success rates at different follow-up time points. The present findings may benefit from long-term follow-up analysis. Level of evidence: 4
Involvement of Husband During Antenatal Care Follow up of Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis
Authors: Abute Woiloro Lonsako , Adafrie Takele Tadesse , Kerbo Amene Abebe , Koyra Mengistu Meskele 
Published: February 2025

Background Involving husbands in pregnancy, childbirth, and postpartum care improves the outcomes for mothers and babies. In most developing countries involvement of husbands towards antenatal care follow up is influenced by different socio-cultural and traditional factors. In Ethiopia, the degree of husband involvement as indicated by several research varied greatly. Objective The aim of this study is to measure the overall prevalence of husband involvement during antenatal care follow up of pregnant women in Ethiopia. Methods Five databases including PubMed, Scopus, EMBASE, SAGE and Google Scholar were reviewed for relevant articles retrieved from 2011 to 2023. Literature search used keywords, including “male partner involvement,” “husband involvement,” “spouse involvement” “antenatal care,” and “perinatal care” and “Ethiopia”. The Joanna Briggs Institute guidelines were used for appraisal review of journals. Thirteen articles were included in the final systematic review and meta-analysis and random effect model was used to analyze. The presence of statistical heterogeneity was tested using I2, and publication bias was examined by various factors. Result Thirteen studies were finally identified and included in this systematic review and meta-analysis. The pooled estimated proportion of husband involvement during antenatal care follow up in Ethiopia was found to be 39.3[95%-CI (38.2, 40.4)]. Cochran Q test indicates that there is heterogeneity since I2 is 98.6%. Egger's and Begg's tests were conducted to check possible publication bias and p-value = 0.679 and 0.807 respectively, which indicates that there is no possible publication bias. Conclusion It was discovered that the total pooled proportion of Ethiopian husbands’ involvement towards antenatal care follow up was low. This demands that the nation take action to evaluate the health care policy in order to encourage husbands to participate in antenatal care and yield positive outcomes for the health of mothers and children.
Is there an advantage of using genomic information to estimate gametic variances and improve recurrent selection in animal populations?
Authors: Elsen Jean-Michel , Raoul Jérôme , Gilbert Hélène 
Published: February 2025

Abstract

Background
Gametic variances can be predicted from the outcomes of a genomic prediction for any genotyped individual. This is widely used in plant breeding, applying the utility criterion (UC). This paper aims to examine the conditions to use UC for recurrent selection in livestock. Here, the UC for a selection candidate is the linear combination of the expected value of the future progeny (half of the candidate’s breeding value) and its predicted gametic variance weighted by a coefficient

$$\theta$$

θ

to be optimized.

Results
First, generalizing previous results, we derived analytically the ratio of the variance of the candidate’s gametic variance and that of half of the candidate’s breeding value. This ratio depends strongly on the number of quantitative trait loci (QTL) affecting the trait and, to a lesser extent, on the distribution of QTL allele frequencies: highly unbalanced frequencies and a limited number of QTL (< 10) favor higher values of the ratio. Then, changes in average breeding values and genetic variances when recurrent selection in a population of infinite size is applied were analytically derived and analyzed for selection up to 15 generations: in this ideal situation, after 5 to 10 generations (depending on

$$\theta$$

θ

), the expected breeding values were higher with selection on UC and the genetic variance was always higher than with selection on estimated breeding values. To describe the potential of the UC in more general situations, simulations were applied to a population of 1000 males and 1000 females, with various selection rates, numbers and allele frequencies of QTL, and

$$\theta$$

θ

. These simulations were performed assuming independent QTL with known positions and effects. The best values for

$$\theta$$

θ

(i.e. providing the best genetic progress) were generally lower than 1, limiting the weight on the gametic variance. As expected from the analytical derivations, the gain in genetic progress from using UC was greatest when there were few QTL and allele frequencies were unbalanced, but they barely exceeded 5%.

Conclusions
We conclude that the key factor to choose selection on UC rather than on estimated breeding values is the ratio between the variance of the gametic standard deviations and the variance of the breeding values (GEBV), which should be carefully evaluated.
Excessively prolonged PR interval in a patient with worsening shortness of breath: a case report
Authors: Zhang Yanjuan , Jiang Zhenyang , Li Mingfang 
Published: February 2025

Abstract

Background
Excessive prolongation of the PR interval indicates the potential for atrioventricular (AV) asynchrony, resulting in severe impairment of cardiac function.
Case presentation.
A 72-year-old man presented to the cardiology department with a history of worsening shortness of breath and chest tightness over the past 3 years. The electrocardiogram (ECG) showed sinus rhythm with a prolonged PR interval of 400 ms. The echocardiogram revealed mild mitral valve regurgitation with mitral E-A fusion during ventricular diastole. The patient received left bundle branch area pacing to shorten the AV conduction time.

Conclusion
In patients with symptomatic AV block, reflected by an excessively prolonged PR interval, prompt decision-making regarding cardiac pacing therapy can help relieve clinical symptoms and enhance the patient's quality of life.