bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early identification of patients at risk for iron-deficiency anemia using deep learning techniques
Authors: Garduno-Rapp Nelly Estefanie , Ng Yee Seng , Weon Jenny L , Saleh Sameh N , Lehmann Christoph U , Tian Chenlu , Quinn Andrew 
Published: April 2024

Abstract

Objectives
Iron-deficiency anemia (IDA) is a common health problem worldwide, and up to 10% of adult patients with incidental IDA may have gastrointestinal cancer. A diagnosis of IDA can be established through a combination of laboratory tests, but it is often underrecognized until a patient becomes symptomatic. Based on advances in machine learning, we hypothesized that we could reduce the time to diagnosis by developing an IDA prediction model. Our goal was to develop 3 neural networks by using retrospective longitudinal outpatient laboratory data to predict the risk of IDA 3 to 6 months before traditional diagnosis.

Methods
We analyzed retrospective outpatient electronic health record data between 2009 and 2020 from an academic medical center in northern Texas. We included laboratory features from 30,603 patients to develop 3 types of neural networks: artificial neural networks, long short-term memory cells, and gated recurrent units. The classifiers were trained using the Adam Optimizer across 200 random training-validation splits. We calculated accuracy, area under the receiving operating characteristic curve, sensitivity, and specificity in the testing split.

Results
Although all models demonstrated comparable performance, the gated recurrent unit model outperformed the other 2, achieving an accuracy of 0.83, an area under the receiving operating characteristic curve of 0.89, a sensitivity of 0.75, and a specificity of 0.85 across 200 epochs.

Conclusions
Our results showcase the feasibility of employing deep learning techniques for early prediction of IDA in the outpatient setting based on sequences of laboratory data, offering a substantial lead time for clinical intervention.
The Effects of Dehumanizing and Humorous Language in Social Protests on Behavioral Expressions of Support
Authors: Karpinska-Krakowiak Malgorzata , Pierzgalski Michal 
Published: April 2024

Abstract
Little is still known about how the language used in social protests affects people’s behavioral expressions of support. This study aims to bridge this gap and investigates the impact of dehumanizing and humorous language employed by protesters in their slogans on the decisions of other individuals to join or openly support such protests. Two experiments were conducted, revealing that exposure to dehumanizing language did not significantly alter the likelihood of supporting protests compared to non-dehumanizing language. However, when combined with humor, dehumanizing language had a positive effect on behavioral expressions of support. In the second experiment we replicated this effect and revealed the mechanism behind it: humor diminished the perceived violence associated with a message containing dehumanizing language, thus increasing the likelihood of individuals acting upon and supporting the social protest. These findings shed light on the factors influencing the varying levels of support observed across different social movements.
Structural analysis of the female reptile reproductive system by micro-computed tomography and optical coherence tomography
Authors: Kircher Bonnie K , McCown Michaela A , Scully Deirdre M , Behringer Richard R , Larina Irina V 
Published: April 2024

Abstract
Volumetric data provide unprecedented structural insight to the reproductive tract and add vital anatomical context to the relationships between organs. The morphology of the female reproductive tract in non-avian reptiles varies between species, corresponding to a broad range of reproductive modes and providing valuable insight to comparative investigations of reproductive anatomy. However, reproductive studies in reptilian models, such as the brown anole studied here, have historically relied on histological methods to understand the anatomy. While these methods are highly effective for characterizing the cell types present in each organ, histological methods lose the 3D relationships between images and leave the architecture of the organ system poorly understood. We present the first comprehensive volumetric analyses of the female brown anole reproductive tract using two non-invasive, non-destructive imaging modalities: micro-computed tomography (microCT) and optical coherence tomography (OCT). Both are specialized imaging technologies that facilitate high-throughput imaging and preserve three-dimensional information. This study represents the first time that microCT has been used to study all reproductive organs in this species and the very first time that OCT has been applied to this species. We show how the non-destructive volumetric imaging provided by each modality reveals anatomical context including orientation and relationships between reproductive organs of the anole lizard. In addition to broad patterns of morphology, both imaging modalities provide the high resolution necessary to capture details and key anatomical features of each organ. We demonstrate that classic histological features can be appreciated within whole-organ architecture in volumetric imaging using microCT and OCT, providing the complementary information necessary to understand the relationships between tissues and organs in the reproductive system. This side-by-side imaging analysis using microCT and OCT allows us to evaluate the specific advantages and limitations of these two methods for the female reptile reproductive system.
Real-world data of 5-aminolaevulinic acid-mediated photodynamic therapy for Bowen disease: a 10-year retrospective study in patients with darker-coloured skin (2011–2021)
Authors: Fang Shan , Zhang Linglin , Wang Peiru , Shi Lei , Zhang Haiyan , Liao Caihe , Zhao Zijun , Zhou Zongxia , Zhao Yan , Yan Guorong , Wu Yun , Wu Yuhao , Zheng Zhe , Wang Ruiping , Liu Yeqiang , Zhang Guolong , Wang Xiuli 
Published: April 2024

Abstract

Background
Photodynamic therapy (PDT) has been strongly recommended as an excellent alternative treatment for Bowen disease (BD). However, reported data on 5-aminolaevulinic acid-mediated PDT (ALA-PDT) with red-light irradiation are limited and the long-term effectiveness remains to be determined, especially in dark-skinned populations.

Objectives
We aimed to review routine clinical practice in the field of BD treatment with ALA-PDT over an extended study period (2011–2021), calculate the overall clearance rate, and explore and evaluate factors that might affect the effectiveness of therapy in a real-world setting.

Methods
The medical records of patients with BD who received ALA-PDT with red-light irradiation between February 2011 and June 2021 were reviewed and summarized. Univariate and multivariate analyses of clinically relevant variables that may affect treatment outcomes were conducted to identify risk predictors.

Results
The overall clearance rate of 122 BD lesions was 89.3% with a median follow-up time of 36 months. The correlation between the effectiveness and fluorescence intensity of pre-PDT or PDT sessions was statistically significant after eliminating the interference of confounding factors. All recurrences occurred in the first 2 years following ALA-PDT.

Conclusions
ALA-PDT is an effective treatment for BD in patients with darker-coloured skin. Well-executed operations and effective pretreatment are the determinants of effectiveness. Fluorescence intensity of pre-PDT appeared to be a significant predictor of final effectiveness. In addition, 2 years of follow-up is necessary following ALA-PDT.
Obesity differs from diabetes mellitus in antibody and T-cell responses post-COVID-19 recovery
Authors: Ali Mohammad , Longet Stephanie , Neale Isabel , Rongkard Patpong , Chowdhury Forhad Uddin Hassan , Hill Jennifer , Brown Anthony , Laidlaw Stephen , Tipton Tom , Hoque Ashraful , Hassan Nazia , Hackstein Carl-Philipp , Adele Sandra , Akther Hossain Delowar , Abraham Priyanka , Paul Shrebash , Rahman Md Matiur , Alam Md Masum , Parvin Shamima , Mollah Forhadul Hoque , Hoque Md Mozammel , Moore Shona C , Biswas Subrata K , Turtle Lance , de Silva Thushan I , Ogbe Ane , Frater John , Barnes Eleanor , Tomic Adriana , Carroll Miles W , Klenerman Paul , Kronsteiner Barbara , Chowdhury Fazle Rabbi , Dunachie Susanna J 
Published: April 2024

Abstract
Objective: Obesity and type 2 diabetes (DM) are risk factors for severe coronavirus disease 2019 (COVID-19) outcomes, which disproportionately affect South Asian populations. This study aims to investigate the humoral and cellular immune responses to SARS-CoV-2 in adult COVID-19 survivors with overweight/obesity (Ov/Ob, BMI ≥ 23 kg/m2) and DM in Bangladesh. Methods: In this cross-sectional study, SARS-CoV-2-specific antibody and T-cell responses were investigated in 63 healthy and 75 PCR-confirmed COVID-19 recovered individuals in Bangladesh, during the pre-vaccination first wave of the COVID-19 pandemic in 2020. Results: In COVID-19 survivors, SARS-CoV-2 infection induced robust antibody and T-cell responses, which correlated with disease severity. After adjusting for age, sex, DM status, disease severity, and time since onset of symptoms, Ov/Ob was associated with decreased neutralizing antibody titers, and increased SARS-CoV-2 spike-specific IFN-γ response along with increased proliferation and IL-2 production by CD8 + T cells. In contrast, DM was not associated with SARS-CoV-2-specific antibody and T-cell responses after adjustment for obesity and other confounders. Conclusion: Ov/Ob is associated with lower neutralizing antibody levels and higher T-cell responses to SARS-CoV-2 post-COVID-19 recovery, while antibody or T-cell responses remain unaltered in DM.
Long-term Risk of Serious Infections and Mortality Among Patients Surviving Drug Use–Associated Infective Endocarditis
Authors: Figgatt Mary C , Rosen David L , Chu Vivian H , Wu Li-Tzy , Schranz Asher J 
Published: April 2024

Abstract
Among a statewide cohort of 1874 patients surviving hospitalization for drug use–associated endocarditis during 2017–2020, the 3-year risk of death or future hospitalization was 38% (16% for death before later infection, 14% for recurrent endocarditis, 14% for soft tissue, 9% for bacteremia, 5% for bone/joint, and 4% for spinal infections).
The “Totally ’80s” Eating Matters of Lyn Hejinian’s My Life
Authors: Seiler Claire 
Published: April 2024

Abstract
This essay brings the discourse of “weak theory” to bear on Lyn Hejinian’s feminist experimental poem of the 1980s, My Life. It argues that the eating matters of My Life—the poem’s steady references to eating, cooking, grocery shopping, dieting, and so forth—open up a fresh account of the poem’s feminist and cultural historicity. Bracketing accustomed readings of the poem as exemplary of poetic postmodernism or as what Hejinian calls an “open text,” the essay situates My Life instead in the 1970s-80s emergence of anorexia as both a popular and a theoretical keyword. It revalues the range of eating matters that shape the feminist poetics of Hejinian’s best-known work.
Epigenetic processes involved in response to pesticide exposure in human populations: a systematic review and meta-analysis
Authors: Rohr Paula , Karen Shimoyama , Francisco Luiza Flávia Veiga , Oliveira Marco Antônio , Santos Neto Martins Fidelis dos , Silveira Henrique C S 
Published: April 2024

Abstract
In recent decades, the use of pesticides in agriculture has increased dramatically. This has resulted in these substances being widely dispersed in the environment, contaminating both exposed workers and communities living near agricultural areas and via contaminated foodstuffs. In addition to acute poisoning, chronic exposure to pesticides can lead to molecular changes that are becoming better understood. Therefore, the aim of this study was to assess, through a systematic review of the literature, what epigenetic alterations are associated with pesticide exposure. We performed a systematic review and meta-analysis including case-control, cohort and cross-sectional observational epidemiological studies to verify the epigenetic changes, such as DNA methylation, histone modification and differential microRNA expression, in humans who had been exposed to any type of pesticide. Articles published between the years 2005 and 2020 were collected. Two different reviewers performed a blind selection of the studies using the Rayyan QCRI software. Post-completion, the data of selected articles were extracted and analyzed. Most of the 28 articles included evaluated global DNA methylation levels, and the most commonly reported epigenetic modification in response to pesticide exposure was global DNA hypomethylation. Meta-analysis revealed a significant negative correlation between Alu methylation levels and β-hexachlorocyclohexane, p,p'-dichlorodiphenyldichloroethane and p,p′-dichlorodiphenylethylene levels. In addition, some specific genes were reported to be hypermethylated in promoter regions, such as CDKN2AIGF2, WRAP53α and CDH1, while CDKN2B and H19 were hypomethylated due to pesticide exposure. The expression of microRNAs was also altered in response to pesticides, as miR-223, miR-518d-3p, miR-597, miR-517b and miR-133b that are associated with many human diseases. Therefore, this study provides evidence that pesticide exposure could lead to epigenetic modifications, possibly altering global and gene-specific methylation levels, epigenome-wide methylation and microRNA differential expression.
Spontaneous pregnancy-associated coronary artery dissection: a case report on diagnostic and therapeutic challenges
Authors: Haney Ailís Ceara , Siry Deborah , Hoerbrand Isabel Amber-Rose , Ehlermann Philipp , Beckendorf Jan 
Published: April 2024

Abstract

Background
One of the main causes of myocardial infarction during pregnancy is spontaneous coronary artery dissection. This is ascribed to hormonal changes during pregnancy leading to a weakening of the vessel wall and haemodynamic changes especially during childbirth. Management options include conservative medical treatment and percutaneous coronary intervention, depending on clinical presentation.

Case summary
A 37-year-old woman presented with typical chest pain six weeks after giving birth to her third child. Echocardiography revealed a moderate reduction in systolic function. Initial invasive coronary angiography showed no abnormalities. After cardiac magnetic resonance demonstrated extensive scar, invasive coronary angiography was repeated including intravascular imaging. A dissection of the left anterior descending artery was visualized and treated by percutaneous coronary intervention and stenting. Left ventricular function was normalized at three-month follow-up. In this educational case report, we highlight the diagnostic and therapeutic challenges when treating this special patient cohort and the importance of cardiovascular imaging.

Discussion
Pregnancy-associated spontaneous coronary dissection is a potential differential diagnosis when treating post-partum women with recent onset chest pain. Management is challenging and intravascular imaging to visualize dissection should be performed during invasive coronary angiography. Patients require interdisciplinary care within a pregnancy heart team.
Successful intervention for decompensated heart failure with complicated pathophysiologies with complex interdependence: a case report
Authors: Muraishi Makio , Noguchi Masahiko , Makihara Yu , Obunai Kotaro 
Published: April 2024

Abstract

Background
There is limited evidence regarding the optimal strategy for treating patients with acute decompensated heart failure complicated by severe left ventricular dysfunction, functional mitral regurgitation (FMR), and atrial septal defect (ASD) that cannot be controlled despite optimal medical treatment.

Case summary
A 72-year-old man with non-ischaemic cardiomyopathy presented with acute heart failure and recurrent atrial fibrillation. An electrocardiogram after electrical cardioversion revealed left bundle block with QRS duration of 152 ms. Transthoracic echocardiography revealed severe left ventricular dysfunction, severe FMR, and a left-to-right shunt through an iatrogenic ASD (IASD). Despite initial optimal medical therapy for heart failure, the patient’s condition was not completely controlled. After a discussion among the heart team, we performed cardiac resynchronization therapy (CRT) as the next strategy. Two weeks after CRT device implantation, heart failure was controlled, with improvement in cardiac function and FMR. The left-to-right shunts through the IASD also improved.

Discussion
When treating decompensated heart failure with complicated pathophysiologies, it is crucial to prioritize the predominant pathophysiological factor and engage in thorough discussions with the heart team regarding the most appropriate intervention.
Non-coding RNA therapeutics in the treatment of heart failure
Authors: Paterek Aleksandra , Załęska-Kocięcka Marta , Surzykiewicz Mateusz , Wojdyńska Zuzanna , Leszek Przemysław , Mączewski Michał 
Published: April 2024

Abstract
Non-coding RNA (ncRNA) therapeutics can target either ncRNAs or conventional messenger RNA, offering both superior pharmacokinetics and selectivity to conventional therapies and addressing new, previously unexplored pathways. Although no ncRNA has yet been approved for the treatment of heart failure, in this review we present five most promising pathways and agents that either are in human clinical trials or offer great promise in the near future.
The neglected floral polymorphism: mirror-image flowers emerge from the shadow of heterostyly
Authors: Barrett Spencer C H , Fairnie Alice L M 
Published: April 2024

Abstract
Morphological asymmetries in plants and animals raise intriguing questions concerning their function and how they have evolved. One of the most conspicuous asymmetries in plants involves mirror-image flowers (enantiostyly) in which styles are deflected to either the left or right sides (L or R, respectively) of the flower. Species with this floral polymorphism often possess two types of stamens (heteranthery): centrally located feeding anthers and a pollinating anther orientated in the opposite direction to the style (reciprocal enantiostyly). However, some species lack heteranthery and sex-organ reciprocity can be partial or absent (non-reciprocal enantiostyly). Many enantiostylous species have nectarless flowers and are ‘buzz-pollinated’ by pollen-collecting bees. In contrast to other stylar polymorphisms such as heterostyly, enantiostyly exists as either monomorphic or dimorphic conditions, with L and R flowers on the same plant in the former, and genetically determined floral morphs with either L or R flowers in the latter. Enantiostyly has been reliably reported from 11 angiosperm families, but in only two is there convincing evidence that dimorphic enantiostyly occurs. Various hypotheses concerning developmental or selective constraints attempt to explain the rarity of this genetic polymorphism. Experimental studies on the function of enantiostyly indicate that the reciprocity of stigmas and pollinating anthers promotes pollinator-mediated cross-pollination and limits geitonogamous selfing. Insufficient or inferior pollinator service can result in the evolutionary breakdown of enantiostyly, including reduced stigma–anther separation, increased selfing, and dissolution of heteranthery. In this article we review recent advances and knowledge gaps in understanding these curious asymmetries and discuss why they have received less attention than heterostyly.
Outcomes of different perioperative management strategies of patients on chronic anticoagulation in elective total hip and knee arthroplasty: a systematic review
Authors: Andronic Diana , Andronic Octavian , Ammann Elias , Pravin Edward , Cubberley Rachael 
Published: April 2024

Abstract

Introduction
There are currently different management guidelines for patients undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) that are on long-term anticoagulation. The timing of discontinuation and restarting the anticoagulation is challenging during the postoperative care, which often involves general practitioners and physiotherapists.

Methods
The systematic review followed the PRISMA guidelines and included 3 databases: PubMed/MEDLINE, EMBASE, and Web of Science Core Collection. It was registered in the International Prospective Register for Systematic Reviews and Meta-analysis (PROSPERO) under the registration number: CRD42023408906. The risk of bias assessment was performed using the Methodological index for non-randomized studies (MINORS) criteria.

Results
Six retrospective studies involving 727 patients with therapeutic anticoagulation (1,540 controls) for elective THA, TKA and revision arthroplasty have been included. The follow-up ranged from 30 days to 1 year postoperatively. All studies evaluated outcomes of warfarin therapeutic anticoagulation versus prophylactic dosages of one or more of the following: warfarin, aspirin, low-molecular-weight heparin (LMWH) and unfractionated low-dose heparin (UFH). One study did not discontinue therapeutic anticoagulation. Two studies reported no significant differences in complications between groups, whilst 3 studies had significantly higher rates of superficial wound infections, revision surgeries, postoperative haematomas, and prosthetic joint infections (PJI).

Conclusion
Different anticoagulation-related perioperative management strategies achieve different outcomes following elective arthroplasty in patients with therapeutic chronic anticoagulation. There is contradictory evidence regarding the need for the discontinuation of therapeutic warfarin. Retrospective data showed that individual risk stratification with multi-modal prophylaxis resulted in minimal complications.

Level of Evidence
Systematic Review of Level III studies.
The true complexities of “standard” family practice visits unmasked: an observational cross-sectional study in Regina
Authors: Heidel Mackenzie M M , Clay Adam T , Dash Megan , Cutts Danielle 
Published: April 2024

Abstract

Background
Many patients present to their family medicine clinic with more than one health concern, placing an increased demand on family physicians. Research into the average number of concerns per regular family medicine visit is limited. Recognition of the frequency that family physicians address more than one concern per visit and adapting practices accordingly is important for improving patient care.

Objective
To examine whether family physicians routinely address multiple different patient concerns during a single visit and if this is influenced by patient demographics.

Methods
This study was conducted at a multi-physician family medicine clinic in Regina, Saskatchewan, Canada. Five physicians contributed their 500 most recent charts, extending retrospectively from 1 June 2023, from in-person visits by patients over 18 years of age and billed as regular appointments without billed procedures. Each chart was reviewed for the number of concerns addressed in the visit.

Results
Fifty percent of visits addressed more than 1 concern (range = 1–8). A generalized linear mixed model using Poisson distribution showed certain physicians (incident rate ratio [IRR]: 1.192, 95% CI: 1.087–1.307, P &lt; 0.001) and adults older than 65 years compared to adults less than 40 years (IRR 1.151, 95% CI: 1.069–1.239, P &lt; 0.001) were more likely to present with multiple concerns, but patient sex was not a significant predictor.

Conclusions
Family physicians routinely address more than one concern per visit. Standard visit length and billing practices should be adapted to reflect this complexity.