bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaccine hesitancy in patients presenting to a specialized allergy center: clinical relevant sensitizations, impact on mental health and vaccination rates
Authors: Kogseder Natalie , Puxkandl Viktoria , Hoetzenecker Wolfram , Altrichter Sabine 
Published: May 2024

IntroductionThe COVID vaccination program with new types of vaccinations and early reports of allergic reactions to vaccines led to vaccination hesitancy in patients with allergies. In this study, we aimed to characterize patients who present at an allergy center with specific questions regarding risk assessment to COVID vaccines in comparison to regular allergy center patients.MethodsA total of 50 patient charts of patients with risk assessment for COVID vaccination (COV group) and 50 regular allergy center patients (ALL group) were assessed for documented allergies, comorbidities, total IgE, and tryptase levels and hospital anxiety and depression score (HADS). Skin prick testing (SPT) with additives of COVID vaccines [polyethylene glycol (PEG), polysorbate] were performed if indicated based on medical history.ResultsPatients who presented for examination prior to a possible COVID vaccination were mostly female (86%) and had more frequently reported allergic reactions to drugs in the past, but only in a minor group (28%) were the reactions qualified as anaphylaxis. The group COV patients scored significantly higher in the HADS for anxiety and depression than the regular group ALL patients. The same trend was observed when data were corrected for gender. It is worth noting that patients without any prior contact to COVID vaccines scored comparable regarding anxiety to patients with prior reaction to COVID vaccinations, but significantly higher in the depression score. In 19 patients (38%) who met the indications for SPT for the suspicious contents PEG and Polysorbate 80, the tests did not show a positive result. Furthermore, 84% of patients underwent the prick test, but only 15% of patients who received consultation alone agreed to vaccination at our center. No vaccination-related event was documented in these patients.DiscussionIn conclusion, vaccination hesitancy was frequently elicited by negative experiences with drugs and putative drug allergies. Female patients predominate in this patient group, and the anxiety and depression scores were significantly elevated. Allergological workup, including SPT, led to a high rate of subsequent vaccinations, whereas a discussion with the patients about risks and individualized advice for vaccination without testing only rarely resulted in documented vaccinations.
Mendelian randomization analysis reveals causal relationships between circulating cell traits and renal disorders
Authors: Shi Xing-yu , Zhang Qian-kun , Li Jie , Zhu Chao-yong , Jin Lie , Fan Shipei 
Published: May 2024

PurposeThe aim of this study was to investigate the causal relationships between circulating cell traits and risk of renal disorders.MethodsWe applied a comprehensive two-sample Mendelian randomization (MR) analysis. Single nucleotide polymorphisms (SNPs) from publicly available genome-wide association studies (GWAS) databases were utilized. Genetically predicted instrumental variables of human blood cell traits were extracted from Blood Cell Consortium (BCX) while data on renal diseases was obtained from Finngen consortium. The primary MR analysis was conducted using the inverse variance weighted (IVW) method, with the weighted median (WM) and MR-Egger models used as additional methods. Sensitivity analyses, including MR-PRESSO, radial regression and MR-Egger intercept were conducted to detect outliers and assess horizontal pleiotropy. We further utilized the leave-one-out analysis to assess the robustness of the results. Causal associations were considered significant based on false rate correction (FDR), specifically when the IVW method provided a pFDR &lt; 0.05.ResultsOur results demonstrated that both white blood cell (WBC) count (OR = 1.50, 95% CI = 1.10–2.06, pFDR = 0.033, pIVW = 0.011) and lymphocyte count (OR = 1.50, 95% CI = 1.13–1.98, pFDR = 0.027, pIVW = 0.005) were causally associated with a higher risk of IgA nephropathy. Furthermore, WBC count was identified as a significant genetic risk factor for renal malignant neoplasms (OR = 1.23, 95% CI = 1.06–1.43, pFDR = 0.041, pIVW = 0.007). Additionally, an increased level of genetically predicted eosinophils was found to be causally associated with a higher risk of diabetic nephropathy (OR = 1.21, 95% CI = 1.08–1.36, pFDR = 0.007, pIVW = 0.001). No evidence of pleiotropy was determined.ConclusionOur findings provide evidence of causal associations of circulating WBC count, lymphocyte count and IgA nephropathy, WBC count and renal malignant neoplasms, and eosinophil count and diabetic nephropathy. These results have the potential to contribute to the development of novel diagnostic options and therapeutic strategies for renal disorders.
Interpretable machine learning model for early prediction of delirium in elderly patients following intensive care unit admission: a derivation and validation study
Authors: Tang Dayu , Ma Chengyong , Xu Yu 
Published: May 2024

Background and objectiveDelirium is the most common neuropsychological complication among older adults admitted to the intensive care unit (ICU) and is often associated with a poor prognosis. This study aimed to construct and validate an interpretable machine learning (ML) for early delirium prediction in older ICU patients.MethodsThis was a retrospective observational cohort study and patient data were extracted from the Medical Information Mart for Intensive Care-IV database. Feature variables associated with delirium, including predisposing factors, disease-related factors, and iatrogenic and environmental factors, were selected using least absolute shrinkage and selection operator regression, and prediction models were built using logistic regression, decision trees, support vector machines, extreme gradient boosting (XGBoost), k-nearest neighbors and naive Bayes methods. Multiple metrics were used for evaluation of performance of the models, including the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, recall, F1 score, calibration plot, and decision curve analysis. SHapley Additive exPlanations (SHAP) were used to improve the interpretability of the final model.ResultsNine thousand seven hundred forty-eight adults aged 65 years or older were included for analysis. Twenty-six features were selected to construct ML prediction models. Among the models compared, the XGBoost model demonstrated the best performance including the highest AUC (0.836), accuracy (0.765), sensitivity (0.713), recall (0.713), and F1 score (0.725) in the training set. It also exhibited excellent discrimination with AUC of 0.810, good calibration, and had the highest net benefit in the validation cohort. The SHAP summary analysis showed that Glasgow Coma Scale, mechanical ventilation, and sedation were the top three risk features for outcome prediction. The SHAP dependency plot and SHAP force analysis interpreted the model at both the factor level and individual level, respectively.ConclusionML is a reliable tool for predicting the risk of critical delirium in elderly patients. By combining XGBoost and SHAP, it can provide clear explanations for personalized risk prediction and more intuitive understanding of the effect of key features in the model. The establishment of such a model would facilitate the early risk assessment and prompt intervention for delirium.
Primary mediastinal seminoma with azoospermia: case report and review of the literature
Authors: Li Zhiwei , Zhu Qiqi , Niu Shaorui , Xiao Kaibing , Xiao Zhiyang , Yang Pang 
Published: May 2024

IntroductionSince the first report, primary mediastinal seminoma has a low incidence in the population, and it mainly affects young and middle-aged men, is clinically rare, and accounts for a very small proportion of mediastinal tumors. In this study, we describe the first case of primary mediastinal seminoma with azoospermia and hypothesize that the coexistence of the two disorders may not be a coincidence.Case reportA 16-year-old man presented with chest tightness and chest pain, a mediastinal mass on chest CT, and abnormal 18F-fluoro-deoxyglucose uptake on a PET-CT scan. By biopsy of the mass, the pathological diagnosis was a primary mediastinal seminoma. Because chemotherapy is included in the treatment of the tumor, the patient underwent sperm freezing before treatment, considering that chemotherapy can affect fertility, but the patient was diagnosed with azoospermia. Finally, the patient underwent tumor resection and postoperative chemotherapy. No tumor recurrence was observed at the current follow-up.ConclusionPrimary mediastinal seminoma is mainly confirmed by histopathological examination, and surgery and chemoradiotherapy are the current treatments. In patients with mediastinal seminoma or azoospermia, doctors should be aware that the two disorders may coexist, especially in men who have fertility requirements or long-term infertility, and that examination of the mediastinum and semen may lead to unexpected findings in the diagnosis and treatment. For mediastinal germ cell tumors, genetic testing is of great value in the treatment of tumors and the prediction of associated diseases. Future studies exploring the potential correlation between mediastinal seminoma and azoospermia will be prospective.
Utility of artificial intelligence in the diagnosis and management of keratoconus: a systematic review
Authors: Goodman Deniz , Zhu Angela Y. 
Published: May 2024

IntroductionThe application of artificial intelligence (AI) systems in ophthalmology is rapidly expanding. Early detection and management of keratoconus is important for preventing disease progression and the need for corneal transplant. We review studies regarding the utility of AI in the diagnosis and management of keratoconus and other corneal ectasias.MethodsWe conducted a systematic search for relevant original, English-language research studies in the PubMed, Web of Science, Embase, and Cochrane databases from inception to October 31, 2023, using a combination of the following keywords: artificial intelligence, deep learning, machine learning, keratoconus, and corneal ectasia. Case reports, literature reviews, conference proceedings, and editorials were excluded. We extracted the following data from each eligible study: type of AI, input used for training, output, ground truth or reference, dataset size, availability of algorithm/model, availability of dataset, and major study findings.ResultsNinety-three original research studies were included in this review, with the date of publication ranging from 1994 to 2023. The majority of studies were regarding the use of AI in detecting keratoconus or subclinical keratoconus (n=61). Among studies regarding keratoconus diagnosis, the most common inputs were corneal topography, Scheimpflug-based corneal tomography, and anterior segment-optical coherence tomography. This review also summarized 16 original research studies regarding AI-based assessment of severity and clinical features, 7 studies regarding the prediction of disease progression, and 6 studies regarding the characterization of treatment response. There were only three studies regarding the use of AI in identifying susceptibility genes involved in the etiology and pathogenesis of keratoconus.DiscussionAlgorithms trained on Scheimpflug-based tomography seem promising tools for the early diagnosis of keratoconus that can be particularly applied in low-resource communities. Future studies could investigate the application of AI models trained on multimodal patient information for staging keratoconus severity and tracking disease progression.
A clinical evaluation and acceptability study of the innovative SurePulse VS wireless heart rate monitor across the neonatal journey
Authors: Peterson Jennifer , Jennings Clare , Mahaveer Ajit 
Published: May 2024

BackgroundThe SurePulse vital signs (VS) device is an innovative wireless heart rate monitor designed for neonatal patients. This study evaluates the application of SurePulse VS technology in clinical practice.MethodsData were collected about the quantitative metrics of the device itself when deployed on real infants and qualitative feedback from perinatal professionals and parents regarding their experiences using this novel technology.ResultsThis study recruited 101 infants and achieved target completion rates of 101 healthcare professional (HCP) and 51 parent questionnaires over the seven-month study period. The SurePulse device was deployed across a range of gestational ages (34–39 weeks) and birth weights (1.8–3.5 kg). Device deployment was performed across a range of clinical environments, with 51% of deployments at delivery and 47% within the neonatal unit. The data show clinically acceptable timings from device deployment to heart rate signal acquisition [median 20 s (IQR 15–76 s)]. HCP feedback rated SurePulse monitoring as “Always” or “Mostly” reliable in 80% of cases. Parental feedback reported that having the SurePulse device was reassuring, convenient and beneficial to them. These positive comments were reflected across device deployment in the delivery room and within the neonatal unit.ConclusionsThe study findings show that the SurePulse device has potential to be a significant advancement in the way neonatal patients are monitored in a variety of post-delivery circumstances. This study has demonstrated that the SurePulse device has utility throughout the neonatal journey, enabling accurate heart rate monitoring in a manner that promotes parent-infant contact and bonding.
Case Report: Double Pectus Up in severe pectus excavatum, the new frontier of modified taulinoplasty
Authors: Frediani Simone , Corbi Letizia , Pardi Valerio , Aloi Ivan Pietro , Bertocchini Arianna , Accinni Antonella , Reali Simone , Schingo Paolo Maria Salvatore , Inserra Alessandro 
Published: May 2024

IntroductionPectus excavatum, also known as “sunken chest” or “funnel chest,” is a congenital condition where the sternum caves inward, creating a noticeable depression in the chest. This deformity can range from mild to severe cases, and can affect appearance and lung and heart function. Treatment options vary depending on the severity of the condition and associated symptoms. A case study was conducted on three patients suffering from severe forms of pectus excavatum using modified taulinoplasty with two Pectus Up bars.Case descriptionThe patients were males, with an age of 15 years. Preoperatively, they underwent spirometry, an echocardiogram, and allergy tests. The procedure involved inserting two Pectus Up bars into the chest wall at the major sternal defect, allowing the implant to remain completely invisible. The procedure involved placing the sternal plate at the deepest point and anchored to the sternum with five self-tapping screws. The chest plate was then fixed to the bar using two screws.DiscussionThe use of Pectus Up was first reported in 2016 and has been a subject of scientific discussion and research. The double Pectus Up technique offers improved correction, increased stability, and reduced complications. However, it also presents challenges such as increased technical complexity and potential for prolonged operative times. Patient outcomes showed promising results in terms of short-term correction and long-term stability. The use of a double bar technique in the modified Taulinoplasty procedure is a key area of ongoing clinical research and innovation in pectus excavatum repair. Further studies will be needed, including more institutions that use this technique to validate our initial experience.
Water depth affects submersed macrophyte more than herbivorous snail in mesotrophic lakes
Authors: Ren Wenjing , Yao Yiqian , Gao Xiaoyu , Wang Hao , Wen Zihao , Ni Leyi , Zhang Xiaolin , Cao Te , Chou Qingchuan 
Published: May 2024

IntroductionWater depth (WD) and snail abundance (SA) are two key factors affecting the growth of submersed aquatic plants in freshwater lake ecosystems. Changes in WD and SA drive changes in nutrients and other primary producers that may have direct or indirect effects on submersed plant growth, but which factor dominates the impact of both on aquatic plants has not been fully studied.MethodsTo investigate the dominant factors that influence aquatic plant growth in plateau lakes, a one-year field study was conducted to study the growth of three dominant submersed macrophyte (i.e., Vallisneria natans, Potamogeton maackianus, and Potamogeton lucens) in Erhai Lake.ResultsThe results show that, the biomass of the three dominant plants, P.maackianus, is the highest, followed by P.lucens, and V.natans is the lowest. Meanwhile, periphyton and snails attached to P.maackianus are also the highest. Furthermore, WD had a positive effect on the biomass of two submersed macrophyte species of canopy-type P.maackianus and P.lucens, while it had a negative effect on rosette-type V.natans. Snail directly inhibited periphyton attached on V.natans and thereby increasing the biomass of aquatic plants, but the effect of snails on the biomass of the other two aquatic plants is not through inhibition of periphyton attached to their plants.DiscussionThe dominant factors affecting the biomass of submersed macrophyte in Erhai Lake were determined, as well as the direct and indirect mechanisms of WD and snails on the biomass of dominant submersed macrophyte. Understanding the mechanisms that dominate aquatic plant change will have implications for lake management and restoration.
Sense of agency at a gaze-contingent display with jittery temporal delay
Authors: Kim Junhui , Yoshida Takako 
Published: May 2024

IntroductionInconsistent jittery temporal delays between action and subsequent feedback, prevalent in network-based human–computer interaction (HCI), have been insufficiently explored, particularly regarding their impact on the sense of agency (SoA). This study investigates the SoA in the context of eye-gaze HCI under jittery delay conditions.MethodsParticipants performed a visual search for Chinese characters using a biresolutional gaze-contingent display, which displayed a high-resolution image in the central vision and a low-resolution in the periphery. We manipulated the delay between eye movements and display updates using a truncated normal distribution (μ to μ + 2 σ) with μ ranging from 0 to 400 ms and σ fixed at 50 ms. Playback of recorded gaze data provided a non-controllable condition.ResultsThe study revealed that both reported authorship and controllability scores, as well as the fixation count per second, decreased as μ increased, aligning with trends observed under constant delay conditions. The subjective authorship weakened significantly at a μ of 94 ms. Notably, the comparison between jittery and constant delays indicated the minimum value (μ) of the distribution as a critical parameter influencing both authorship perception and visual search time efficiency.DiscussionThis finding underscores the importance of the shortest delay in modulating SoA. Further examining the relative distribution for fixation duration and saccade amplitude suggests an adaptation in action planning and attention distribution in response to delay. By providing a systematic examination of the statistical attributes of jittery delays that most significantly affect SoA, this research offers valuable implications for the design of efficient, delay-tolerant eye-gaze HCI, expanding our understanding of SoA in technologically mediated interactions. Moreover, our findings highlight the significance of considering both constant and variable delay impacts in HCI usability design, marking a novel contribution to the field.
Hyperhomocysteinemia is associated with the risk of venous thromboembolism in patients with mental illness: a case-control study
Authors: Wang Jiaoyan , Zhang Yingchun , Ren Keming , Li Yeping , Ying Kejing 
Published: May 2024

ObjectiveThe risk of venous thromboembolism in patients with mental illness has been insufficiently addressed. This study aimed to assess the correlation between hyperhomocysteinemia and venous thromboembolism prevalence among this population.MethodsPatients with a diagnosis of mental illness and concurrent venous thromboembolism, admitted to Sir Run Run Shaw Hospital at Zhejiang University School of Medicine between January 2014 and December 2021, were included in the venous thromboembolism group. The control group, approximately twice the size, comprised individuals with mental illness but without venous thromboembolism. Basic clinical data were gathered for both cohorts.ResultsIn psychiatric patients, elevated D-dimer levels(OR=5.60,95% CI 3.28–10.00), hyperhomocysteinemia (OR=2.37,95% CI 1.10–5.14), and hyperprolactinemia(OR= 2.68,95% CI 1.12–6.42)were significant risk factors for venous thromboembolism. According to further subgroup analyses, hyperhomocysteinemia is a significant risk factor associated with pulmonary embolism, with an OR of 5.08 (95% CI 1.20–21.48). An interaction effect between gender and homocysteine level was found, with a p-interaction of 0.022. A subsequent analysis confirmed the association between hyperhomocysteinemia and venous thromboembolism in female psychiatric patients, with an OR of 3.34 (95% CI 1.68–6.65), indicating that hyperhomocysteinemia is a significant risk factor for venous thromboembolism in women.ConclusionPatients with psychiatric disorders were found to have an elevated risk of venous thromboembolism, which was associated with increased levels of D-dimer, hyperprolactinemia, and hyperhomocysteinemia. A strong correlation between hyperhomocysteinemia and pulmonary embolism was identified in patients with mental illnesses. Furthermore, the study revealed that female psychiatric patients with hyperhomocysteinemia constituted a high-risk group for venous thromboembolism. This finding holds significant clinical implications, suggesting that early preventative measures could be implemented for this high-risk population to reduce the incidence of thromboembolic events during hospitalization for psychiatric patients.