bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of neural tube defects in Finland: a nationwide register study 1987–2018
Authors: Lempinen Jenny , Koskimies-Virta Eeva , Kauppala Tuuli , Malm Heli , Gissler Mika , Kiuru-Kuhlefelt Sonja , Ritvanen Annukka , Leinonen Maarit K 
Published: July 2024

Abstract

Background
Our aim was to evaluate the prevalence, mortality, regional and sex distribution of neural tube defects (NTDs) in Finland.

Methods
Data for this population-based study were collected from 1987 to 2018 from the national health and social welfare registers.

Results
There were in total 1634 cases of NTDs, of which 511 were live births, 72 pregnancies ended in stillbirth and 1051 were terminations of pregnancy due to fetal anomaly (TOPFA). The total prevalence of NTDs was 8.6 per 10 000 births and it increased slightly annually (OR 1.008; 95% CI: 1.002, 1.013) during the 32-year study period. The birth prevalence of NTDs decreased (OR 0.979; 95% CI: 0.970, 0.987), but the prevalence of TOPFA increased annually (OR 1.024; 95% CI 1.017, 1.031). The perinatal mortality of NTD children was 260.7 per 1000 births and the infant mortality was 184.0 per 1000 live births, whereas these measures in the general population were 4.6 per 1000 births and 3.3 per 1000 live births, respectively. There was no difference in the NTD prevalence between males and females (P-value 0.77). The total prevalence of NTDs varied from 7.1 to 9.4 per 10 000 births in Finland by region.

Conclusions
Although the majority of NTDs are preventable with an adequate folic acid supplementation, the total prevalence increased in Finland during the study period when folic acid supplementation was mainly recommended to high-risk families and to women with folic acid deficiency. NTDs remain an important cause of infant morbidity and mortality in Finland.
Measuring the overall development of patient safety in a new hospital using trigger tools
Authors: Adamovic Ivan , Dahlem Peter , Brachmann Johannes 
Published: July 2024

Abstract
The new building of the Hospital in Lichtenfels (Germany) was put into operation in mid-July 2018. Neither the medical personnel nor medical departments have been changed. We want to evaluate how ‘safe’ or ‘insecure’ the new hospital or department in the beginning might have been. Our objective is to investigate if safety decreases at the beginning in a new hospital, despite modern environments and conditions. Adverse events (AEs) associated with treatment were included to evaluate the total number of AEs resulting from medical care and medications. Patients’ records had to be closed and completed, the length of stay had to be at least 24 h, and the patient had to have been formally admitted to the hospital [Institute for Healthcare Improvement (IHI) ‘Global Trigger Tool’ (GTT) recommendation]. The identified AEs were grouped into 27 categories of the IHI ‘GTT’. We randomly reviewed 40 patient records per month 6 months before and 6 months after moving to the new hospital. Statistical analysis showed that there was no significant difference in individual AEs. The sum of AEs was statistically higher after moving into a new hospital. A complete number of harms did reach statistical significance (χ2 = 6.62; df = 1; P &lt; .05; Cramer’s V = 0.12), indicating that new environments ‘trigger’ significantly more potential errors (50%) in comparison to the old environments (38.33%). According to our findings, the new hospital appears to be slightly insecure in the first 6 months after opening.
Evaluating ChatGPT’s moral competence in health care-related ethical problems
Authors: Rashid Ahmed A , Skelly Ryan A , Valdes Carlos A , Patel Pruthvi P , Solberg Lauren B , Giordano Christopher R , Modave François 
Published: July 2024

Abstract

Objectives
Artificial intelligence tools such as Chat Generative Pre-trained Transformer (ChatGPT) have been used for many health care-related applications; however, there is a lack of research on their capabilities for evaluating morally and/or ethically complex medical decisions. The objective of this study was to assess the moral competence of ChatGPT.

Materials and methods
This cross-sectional study was performed between May 2023 and July 2023 using scenarios from the Moral Competence Test (MCT). Numerical responses were collected from ChatGPT 3.5 and 4.0 to assess individual and overall stage scores, including C-index and overall moral stage preference. Descriptive analysis and 2-sided Student’s t-test were used for all continuous data.

Results
A total of 100 iterations of the MCT were performed and moral preference was found to be higher in the latter Kohlberg-derived arguments. ChatGPT 4.0 was found to have a higher overall moral stage preference (2.325 versus 1.755) when compared to ChatGPT 3.5. ChatGPT 4.0 was also found to have a statistically higher C-index score in comparison to ChatGPT 3.5 (29.03 ± 11.10 versus 19.32 ± 10.95, P =.0000275).

Discussion
ChatGPT 3.5 and 4.0 trended towards higher moral preference for the latter stages of Kohlberg’s theory for both dilemmas with C-indices suggesting medium moral competence. However, both models showed moderate variation in C-index scores indicating inconsistency and further training is recommended.

Conclusion
ChatGPT demonstrates medium moral competence and can evaluate arguments based on Kohlberg’s theory of moral development. These findings suggest that future revisions of ChatGPT and other large language models could assist physicians in the decision-making process when encountering complex ethical scenarios.
Epidemiology of candidemia during COVID-19 pandemic era in a teaching hospital: A non-concurrent cohort study
Authors: Brandt Flávio Pasa , Sawazaki Jonas Atique , Cavalcante Ricardo de Souza 
Published: July 2024

Abstract
During the COVID-19 pandemic, an increase in the incidence of bloodstream infections caused by fungi of the Candida genus, also known as candidemia, was observed in patients with SARS-CoV-2 infection. This study aimed to assess the incidence of candidemia, the factors related to COVID-19-associated candidemia (CAC), and prognostic factors. A non-concurrent cohort of 87 cases of patients aged over 18 years with candidemia between March 2020 and February 2022 was evaluated. Incidence density (ID) was calculated by the number of patient-days during the period. All causes of mortality within 30 days of observation were considered. Logistic regression and Cox proportional hazards regression were used, respectively, to determine factors associated with CAC and prognostic factors. Values &lt;0.05 were considered significant. The ID of CAC was eight times higher than candidemia in patients without COVID-19 [2.40 per 1000 person-days vs. 0.27 per 1000 person-days; P &lt; .01]. The corticosteroid therapy was as an independent factor associated with CAC [OR = 15.98 (3.64–70.03), P &lt; .01], while abdominal surgery was associated with candidemia in patients without COVID-19 [OR = 0.09 (0.01–0.88), P = .04]. Both patients with and without COVID-19 had a high 30 days-mortality rate (80.8% vs. 73.8%, respectively; P = .59). Liver disease [HR = 3.36 (1.22–9.27); P = .02] and the Charlson score [HR = 1.17 (1.01–1.34); P = .03] were independent factors of death, while the use of antifungals [HR = 0.15 (0.07–0.33); P &lt; .01] and removal of the central venous catheter [HR = 0.26 (0.12–0.56); P &lt; .01] independently reduced the risk of death. These findings highlight the high incidence of candidemia in COVID-19 patients and its elevated mortality.
X-ray observations of two Type Ia supernovae with an Hα line in their optical spectrum
Authors: Dwarkadas Vikram V 
Published: July 2024

ABSTRACT
We report on Chandra X-ray observations of SN 2016jae and SN 2018cqj, both low-luminosity Type Ia supernova (SN) that showed the presence of an H line in their early optical spectrum. No X-ray emission is detected at the location of either SN. Upper limits to the luminosity of up to 2 $\times 10^{40}$ erg s$^{-1}$ are calculated for each SN, depending on the assumed spectral model, temperature, and column density. This luminosity is comparable to that of another low-luminosity Type Ia SN, SN 2018fhw, that was observed with Chandra. It is generally lower than upper limits calculated for Type Ia-CSM SNe observed in X-rays, and also below that of SN 2012ca, the only Type Ia-CSM SN to have been detected in X-rays. Comparisons are made to other Type Ia SN with an H line observed in X-rays. The observations suggest that while the density into which the SN is expanding may have been high at the time the H$\alpha$ line was detected, it had decreased considerably by the time of X-ray observations.
The effect of the Solar System Ephemeris on the search for the nano-Hz gravitational wave background
Authors: Guo Y J , Caballero R N , Champion D J , Lee K J 
Published: July 2024

ABSTRACT
The detection of the nano-Hz gravitational-wave background (GWB) is one of the main targets of Pulsar timing arrays (PTAs). The detection can be achieved via searching for a common signal with quadrapolar correlation between pulsar pairs. Errors in the Solar-System ephemeris (SSE) can induce dipolar correlations in PTA data, which may affect the results of GWB searches, especially when the data quality is not high enough to constrain the correlation pattern. We investigate the effect of unmodelled SSE errors on GWB searches with PTAs, using simulations with properties based on the European Pulsar Timing Array data set. When the GWB signal is strong, SSE errors have little effect on the GWB search results, including parameter inference and model selection. When the GWB signal is weak, SSE errors can lead to overestimation of the GWB amplitude. However, model comparison would show strong support for dipolar correction, which implies the source of the common signal to be SSE-related and helps avoid its misidentification as a GWB signal. This indicates that SSE error is unlikely to be the main source of the common signal detected recently with real PTA data. We also use simulations to test the ability of the SSE model LINIMOSS in absorbing SSE-error signals and leaving the GWB signal intact. We show that marginalizing LINIMOSS planetary parameters with infinite priors is good at absorbing SSE errors, but may also lead to improper absorption of a GWB signal. Caution is therefore required when setting appropriate limits on the priors of SSE parameters.
Data-driven probabilistic definition of the low energy conformational states of protein residues
Authors: Gavalda-Garcia Jose , Bickel David , Roca-Martinez Joel , Raimondi Daniele , Orlando Gabriele , Vranken Wim 
Published: July 2024

Abstract
Protein dynamics and related conformational changes are essential for their function but difficult to characterise and interpret. Amino acids in a protein behave according to their local energy landscape, which is determined by their local structural context and environmental conditions. The lowest energy state for a given residue can correspond to sharply defined conformations, e.g. in a stable helix, or can cover a wide range of conformations, e.g. in intrinsically disordered regions. A good definition of such low energy states is therefore important to describe the behaviour of a residue and how it changes with its environment. We propose a data-driven probabilistic definition of six low energy conformational states typically accessible for amino acid residues in proteins. This definition is based on solution NMR information of 1322 proteins through a combined analysis of structure ensembles with interpreted chemical shifts. We further introduce a conformational state variability parameter that captures, based on an ensemble of protein structures from molecular dynamics or other methods, how often a residue moves between these conformational states. The approach enables a different perspective on the local conformational behaviour of proteins that is complementary to their static interpretation from single structure models.
Frequent Alzheimer’s disease neuropathological change in patients with glioblastoma
Authors: Greutter Lisa , Miller-Michlits Yelyzaveta , Klotz Sigrid , Reimann Regina , Nenning Karl-Heinz , Platzek Stephan , Krause Elena , Kiesel Barbara , Widhalm Georg , Langs Georg , Baumann Bernhard , Woehrer Adelheid 
Published: July 2024

Abstract

Background
The incidence of brain cancer and neurodegenerative diseases is increasing with a demographic shift towards aging populations. Biological parallels have been observed between glioblastoma and Alzheimer’s disease (AD), which converge on accelerated brain aging. Here, we aimed to map the cooccurrence of AD neuropathological change (ADNC) in the tumor-adjacent cortex of patients with glioblastoma.

Methods
Immunohistochemical screening of AD markers amyloid beta (Abeta), amyloid precursor protein (APP), and hyperphosphorylated tau (pTau) was conducted in 420 tumor samples of 205 patients. For each cortex area, we quantified ADNC, neurons, tumor cells, and microglia.

Results
Fifty-two percent of patients (N = 106/205) showed ADNC (Abeta and pTau, Abeta or pTau) in the tumor-adjacent cortex, with histological patterns widely consistent with AD. ADNC was positively correlated with patient age and varied spatially according to Thal phases and Braak stages. It decreased with increasing tumor cell infiltration (P &lt; .0001) and was independent of frequent expression of APP in neuronal cell bodies (N = 182/205) and in tumor necrosis-related axonal spheroids (N = 195/205; P = .46). Microglia response was most present in tumor cell infiltration plus ADNC, being further modulated by patient age and sex. ADNC did not impact patient survival in the present cohort.

Conclusions
Our findings highlight the frequent presence of ADNC in the glioblastoma vicinity, which was linked to patient age and tumor location. The cooccurrence of AD and glioblastoma seemed stochastic without clear spatial relation. ADNC did not impact patient survival in our cohort.
A case report of squamous cell carcinoma mimicking interdigital intertrigo
Authors: Snoussi Ilham , Boulifa Safa , Abbad Faiçal , El Jouari Ouiame , Gallouj Salim 
Published: July 2024

Abstract
Squamous cell carcinoma (SCC), also known as epidermoid carcinoma, represents the most common malignant tumor affecting the nails. A 60-year-old tailor with no significant medical history presented with a three-year history of macerated skin between the toes, previously treated with a topical antifungal. Dermatological examination revealed a verrucous, infected ulceration with infiltrated and hyperkeratotic edges, characterized by a whitish, fissured base. This lesion in the fourth interdigital space and extended onto the dorsal surface of the foot without any other associated symptoms. The clinical diagnosis identified it as a neoplastic ulceration. An initial biopsy found keratoacanthoma but showed no malignant features. However, follow-up biopsy at our department revealed moderately differentiated SCC. Surgical resection was successful in treating our patient. Diagnostic errors due to insufficient understanding of the pathology and inadequate biopsy methods contribute to the progression of SCC. Surgery is the main treatment for such malignant tumors.
Onset of Prolonged High-Potency Benzodiazepine Use Among ICU Survivors: A Nationwide Cohort Study
Authors: Lindström Ann-Charlotte , von Oelreich Erik , Eriksson Jesper , Eriksson Mikael , Mårtensson Johan , Larsson Emma , Oldner Anders 
Published: July 2024

OBJECTIVES:
Exposure to critical illness and intensive care may lead to long-term psychologic and physical impairments. To what extent ICU survivors become prolonged users of benzodiazepines after exposure to critical care is not fully explored. This study aimed to describe the extent of onset of prolonged high-potency benzodiazepine use among ICU survivors not using these drugs before admission, identify factors associated with this use, and analyze whether such usage is associated with increased mortality.

DESIGN:
Retrospective cohort study.

SETTING:
Sweden, including all registered ICU admissions between 2010 and 2017.

PATIENTS:
ICU patients surviving for at least 3 months, not using high-potency benzodiazepine before admission, were eligible for inclusion.

INTERVENTIONS:
Admission to intensive care.

MEASUREMENTS AND MAIN RESULTS:
A total of 237,904 patients were screened and 137,647 were included. Of these 5338 (3.9%) became prolonged users of high-potency benzodiazepines after ICU discharge. A peak in high-potency benzodiazepine prescriptions was observed during the first 3 months, followed by sustained usage throughout the follow-up period of 18 months. Prolonged usage was associated with older age, female sex, and a history of both somatic and psychiatric comorbidities, including substance abuse. Additionally, a longer ICU stay, a high estimated mortality rate, and prior consumption of low-potency benzodiazepines were associated with prolonged use. The risk of death between 6 and 18 months post-ICU admission was significantly higher among high-potency benzodiazepine users, with an adjusted hazard ratio of 1.8 (95% CI, 1.7–2.0; p < 0.001). No differences were noted in causes of death between users and nonusers.

Conclusions:
Despite the lack of evidence supporting long-term treatment, prolonged usage of high-potency benzodiazepines 18 months following ICU care was notable and associated with an increased risk of death. Considering the substantial number of ICU admissions, prevention of benzodiazepine misuse may improve long-term outcomes following critical care.
Medical Students' Preferences on Practicing Intravenous Insertion on Each Other and Via Simulation
Authors: Kiernan Risa , Smith Shannon , Kikel Michelle , Forkey Blake , Rembert Avarie , Jung Min-Kyung , Krishnamachari Bhuma , Gindi Michael 
Published: July 2024

Summary Statement
Medical students have traditionally practiced painful procedures such as intravenous (IV) line insertion on each other. Recently, there has been more emphasis on learning through simulation. Our study investigated students' attitudes regarding IV line insertion training, focusing on their anxiety, expectation to learn empathy, learning preference, and litigiousness. A 24-question survey was taken regarding anxiety and empathy when learning IV placement on each other versus on mannequins.
Many students believed that they could learn empathy skills and better appreciate patient discomfort by learning IV placement through person-based practice. However, students who reported feeling anxious about having a student practice IV placement on them believed they were less likely to learn empathy through having a student practice IV insertion on them. The preferred method of learning painful procedures, such as IV placement, may be through a combination of simulation and person-based practice to mitigate anxiety while also enhancing empathy skills.
Tau phosphorylation suppresses oxidative stress-induced mitophagy via FKBP8 receptor modulation
Authors: Isei Michael O , Crockett Meredith , Chen Emily , Rodwell-Bullock Joel , Caroll Trae , Girardi Peter A , Nehrke Keith , Johnson Gail VW 
Published: July 2024

AbstractNeurodegenerative diseases are often characterized by mitochondrial dysfunction. In Alzheimer’s disease, abnormal tau phosphorylation disrupts mitophagy, a quality control process through which damaged organelles are selectively removed from the mitochondrial network. The precise mechanism through which this occurs remains unclear. Previously, we showed that tau which has been mutated at Thr-231 to glutamic acid to mimic an Alzheimer’s-relevant phospho-epitope expressed early in disease selectively inhibits oxidative stress-induced mitophagy inC. elegans. Here, we use immortalized mouse hippocampal neuronal cell lines to extend that result into mammalian cells. Specifically, we show that phosphomimetic tau at Ser-396/404 (EC) or Thr-231/Ser-235 (EM) partly inhibits mitophagy induction by paraquat, a potent inducer of mitochondrial oxidative stress. Moreover, a combination of immunologic and biochemical approaches demonstrates that the levels of the mitophagy receptor FKBP8, significantly decrease in response to paraquat in cells expressing EC or EM tau mutants, but not in cells expressing wildtype tau. In contrast, paraquat treatment results in a decrease in the levels of the mitophagy receptors FUNDC1 and BNIP3 in the presence of both wildtype tau and the tau mutants. Interestingly, FKBP8 is normally trafficked to the endoplasmic reticulum during oxidative stress induced mitophagy, and our results support a model where this trafficking is impacted by disease-relevant tau, perhaps through a direct interaction. We provide new insights into the molecular mechanisms underlying tau pathology in Alzheimer’s disease and highlight FKBP8 receptor as a potential target for mitigating mitochondrial dysfunction in neurodegenerative diseases.
EM-Compressor: Electron Microscopy Image Compression in Connectomics with Variational Autoencoders
Authors: Li Yicong , Park Core Francisco , Xenes Daniel , Bishop Caitlyn , Berger Daniel R. , Samuel Aravi D.T. , Wester Brock , Lichtman Jeff W. , Pfister Hanspeter , Li Wanhua , Meirovitch Yaron 
Published: July 2024

AbstractThe ongoing pursuit to map detailed brain structures at high resolution using electron microscopy (EM) has led to advancements in imaging that enable the generation of connectomic volumes that have reached the petabyte scale and are soon expected to reach the exascale for whole mouse brain collections. To tackle the high costs of managing these large-scale datasets, we have developed a data compression approach employing Variational Autoencoders (VAEs) to significantly reduce data storage requirements. Due to their ability to capture the complex patterns of EM images, our VAE models notably decrease data size while carefully preserving important image features pertinent to connectomics-based image analysis. Through a comprehensive study using human EM volumes (H01 dataset), we demonstrate how our approach can reduce data to as little as 1/128th of the original size without significantly compromising the ability to subsequently segment the data, outperforming standard data size reduction methods. This performance suggests that this method can greatly alleviate requirements for data management for connectomics applications, and enable more efficient data access and sharing. Additionally, we developed a cloud-based application named EM-Compressor on top of this work to enable on-thefly interactive visualization:https://em-compressor-demonstration.s3.amazonaws.com/EM-Compressor+App.mp4.
Humans forage for reward in reinforcement learning tasks
Authors: Zid Meriam , Laurie Veldon-James , Levine-Champagne Alix , Shourkeshti Akram , Harrell Dameon , Herman Alexander B. , Ebitz R. Becket 
Published: July 2024

AbstractHow do we make good decisions in uncertain environments? In psychology and neuroscience, the classic answer is that we calculate the value of each option and then compare the values to choose the most rewarding, modulo some exploratory noise. An ethologist, conversely, would argue that we commit to one option until its value drops below a threshold, at which point we start exploring other options. In order to determine which view better describes human decision-making, we developed a novel, foraging-inspired sequential decision-making model and used it to ask whether humans compare to threshold (“Forage”) or compare alternatives (“Reinforcement-Learn” [RL]). We found that the foraging model was a better fit for participant behavior, better predicted the participants’ tendency to repeat choices, and predicted the existence of held-out participants with a pattern of choice that was almost impossible under RL. Together, these results suggest that humans use foraging computations, rather than RL, even in classic reinforcement learning tasks.