bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining labelling guidelines for AI‐based software as a medical device: A review and analysis of dermatology mobile applications in Australia
Authors: Oloruntoba Ayooluwatomiwa , Ingvar Åsa , Sashindranath Maithili , Anthony Ojochonu , Abbott Lisa , Guitera Pascale , Caccetta Tony , Janda Monika , Soyer H. Peter , Mar Victoria 
Published: May 2024

AbstractIn recent years, there has been a surge in the development of AI‐based Software as a Medical Device (SaMD), particularly in visual specialties such as dermatology. In Australia, the Therapeutic Goods Administration (TGA) regulates AI‐based SaMD to ensure its safe use. Proper labelling of these devices is crucial to ensure that healthcare professionals and the general public understand how to use them and interpret results accurately. However, guidelines for labelling AI‐based SaMD in dermatology are lacking, which may result in products failing to provide essential information about algorithm development and performance metrics. This review examines existing labelling guidelines for AI‐based SaMD across visual medical specialties, with a specific focus on dermatology. Common recommendations for labelling are identified and applied to currently available dermatology AI‐based SaMD mobile applications to determine usage of these labels. Of the 21 AI‐based SaMD mobile applications identified, none fully comply with common labelling recommendations. Results highlight the need for standardized labelling guidelines. Ensuring transparency and accessibility of information is essential for the safe integration of AI into health care and preventing potential risks associated with inaccurate clinical decisions.
Linking physico‐chemical parameters and macroinvertebrates for water quality assessment of Kakamega and the East Usambara montane ecosystems in Kenya
Authors: Ndungu Joseph G. , Marubu Rose M. , Ochola John B. , Onyimbo Nixon B. , Sevgan Subramanian , Muriuki Caroline W. , Komu Kalist E. , Gikungu Mary W. 
Published: May 2024

AbstractSub‐Saharan freshwater biodiversity is impacted by changes in land use and climate change. To evaluate the relationship between physico‐chemical variables and macroinvertebrate community assemblages in Kakamega and the East Usambara Mountains forests, we explored benthic macroinvertebrate community structure in relation to physico‐chemical conditions of the water along an anthropogenic stress gradient. Sampling was done in six selected streams during the rainy and dry seasons between April 2017 and November 2019. At Kakamega, 367 macroinvertebrate individuals were identified belonging to 22 families, while at Usambara, 456 individuals belonging to 25 families were identified. Spearman's correlation revealed significant interactions in species diversity, evenness, and richness between macroinvertebrates and several physico‐chemical parameters (pH, conductivity, total dissolved substances, salinity and temperature). At Usambara, species richness, evenness and diversity was significantly negatively correlated with conductivity, tds, salinity, temperature and pH. We demonstrated that macroinvertebrate indices can be used as a quick evaluation tool of water quality in response to stream systems in the region as well as help in pointing out early warnings to help mitigate and reduce threats to stream biodiversity from anthropogenic activities.
Effect of baseline prolactin levels on the pregnancy outcomes after fresh embryo transfer
Authors: Hu Yue , Song Di , Yan Jiuqiong , Liu Yuhuan , Yu Chaoqin 
Published: May 2024

AbstractBackground and aimsThere is clinical disagreement on whether to treat hyperprolactinemia with medication before embryo transfer. The aim of this study is to identify the impact of basal prolactin (PRL) levels on pregnancy outcomes in fresh embryo transfer cycles.MethodsThis retrospective study involved 2,648 women who underwent basal PRL level testing and fresh embryo transfer between January 2015 and December 2020 at our Hospital's Department of Assisted Reproduction. Basal PRL levels can be classified into three categories: <30 (n = 2339), 30‑60 (n = 255), and ≥60 (n = 54) µg/l. Pregnancy outcome was defined as the primary outcome measure, and the live birth rate was defined as the second outcome measure. Subsequently, univariate and multivariable logistic regression analysis was used to reveal the association between basal PRL levels and pregnancy outcomes after considering several potential confounding factors.ResultsElevated basal PRL levels were found not a risk factor for pregnancy outcomes in patients receiving good‐quality embryo transfer (p > .05). For pregnancy or not, female age (OR: 1.03; 95% CI: 1.01–1.05), embryos transferred (OR: 0.52; 95% CI: 0.41–0.65), and normal fertilization rate (OR: 0.68; 95% CI: 0.48–0.97) were found to be an independent risk factor. For ongoing pregnancy or not, female age (OR: 1.07; 95% CI: 1.03–1.11), embryos transferred (OR: 0.57; 95% CI: 0.37–0.88), and menstrual cycle (OR: 1.76; 95% CI: 1.22–2.54) were also independent risk factors.ConclusionThere is no adverse impact on pregnancy outcomes during embryo transfer cycles with good‐quality embryos when PRL levels are elevated.
Machine learning prediction model for postoperative ileus following colorectal surgery
Authors: Traeger Luke , Bedrikovetski Sergei , Hanna Jessica E. , Moore James W. , Sammour Tarik 
Published: May 2024

AbstractBackgroundPostoperative ileus (POI) continues to be a major cause of morbidity following colorectal surgery. Despite best efforts, the incidence of POI in colorectal surgery remains high (~30%). This study aimed to investigate machine learning techniques to identify risk factors for POI in colorectal surgery patients, to help guide further preventative strategies.MethodsA TRIPOD‐guideline‐compliant retrospective study was conducted for major colorectal surgery patients at a single tertial care centre (2018–2022). The primary outcome was the occurrence of POI, defined as not achieving GI‐2 (outcome measure of time to first stool and tolerance of oral diet) by day four. Multivariate logistic regression, decision trees, radial basis function and multilayer perceptron (MLP) models were trained using a random allocation of patients to training/testing data sets (80/20). The area under the receiver operating characteristic (AUROC) curves were used to evaluate model performance.ResultsOf 504 colorectal surgery patients, 183 (36%) experienced POI. Multivariate logistic regression, decision trees, radial basis function and MLP models returned an AUROC of 0.722, 0.706, 0.712 and 0.800, respectively. The MLP model had the highest sensitivity and specificity values. In addition to well‐known risk factors for POI, such as postoperative hypokalaemia, surgical approach, and opioid use, the MLP model identified sarcopenia (ranked 4/30) as a potentially modifiable risk factor for POI.ConclusionMLP outperformed other models in predicting POI. Machine learning can provide valuable insights into the importance and ranking of specific predictive variables for POI. Further research into the predictive value of preoperative sarcopenia for POI is required.
Recurrent postmenopausal bleeding: Pathological findings and predictive factors. A multicenter, prospective, observational study
Authors: van Maldegem Laura D. P. R. , van der Zande Johanna A. , van Werkhoven Lucy A. , Ewing‐Graham Patricia C. , Heemskerk‐Gerritsen Bernadette A. M. , van Doorn Helena C. 
Published: May 2024

AbstractIntroductionRecurrent postmenopausal bleeding (PMB) occurs in 6%–25% of postmenopausal women who have experienced a previous episode of PMB. The question of whether recurrent PMB leads to a higher risk of endometrial cancer (EC) in comparison to a single episode of PMB is, however, controversial. Furthermore, little is known about predictive factors for recurrent PMB.Material and MethodsA multicenter prospective cohort study was conducted over a 5‐year period in four hospitals in the Netherlands. Women with PMB undergoing endometrial sampling and aged 40 years and older were included. Occurrence of recurrent PMB was retrospectively determined. Primary outcomes included (1) the incidence of recurrent PMB and (2) differences in pathological findings between patients with a single episode vs recurrent PMB. Secondary outcomes included (1) the association between diagnosis of benign polyps at first PMB and pathological findings at recurrent PMB and (2) factors predictive for recurrent PMB.ResultsA total of 437 women with PMB were included, of whom 360 were at risk of recurrent PMB. With a median follow‐up of 61 months (IQR (Interquartile range) 44–73), 26.4% experienced recurrent PMB. Patients with recurrent PMB were more often diagnosed with benign polyps (34.7% vs. 25.1%, p‐value 0.015) and less frequently with a malignancy (5.3% vs. 17.8%, p‐value 0.015), compared to patients with a single episode of PMB. Benign polyps at initial PMB were not associated with a (pre)malignancy at recurrence (OR 4.16, 95% CI 0.75–23.03). Predictive factors for recurrent PMB included use of hormone replacement therapy (HRT) (OR 3.32, 95% CI 1.64–6.72), and benign polyps at initial PMB (OR 1.80, 95% CI 1.07–3.04).ConclusionsRecurrent PMB is common in women with a previous episode of PMB. Compared to patients with a single episode of PMB, patients with recurrent PMB and benign histological outcomes at accurate workup during their first episode were less often diagnosed with malignancies and more frequently with benign polyps. Benign polyps at first PMB are predictive for recurrent PMB, but not for a higher risk of (pre)malignancy.
The deep abdominal ultrasound transducer (DAX) increases the success rate and diagnostic accuracy of shear wave elastography for liver fibrosis assessment in patients with obesity—A prospective biopsy‐controlled study
Authors: Bauer David J. M. , Nixdorf Larissa , Dominik Nina , Schwarz Michael , Hofer Benedikt S. , Hartl Lukas , Semmler Georg , Jachs Mathias , Simbrunner Benedikt , Jedamzik Julia , Mozayani Behrang , Gensthaler Lisa , Felsenreich Daniel Moritz , Trauner Michael , Langer Felix Benedikt , Mandorfer Mattias , Prager Gerhard , Reiberger Thomas 
Published: May 2024

SummaryBackgroundObesity impacts the diagnostic accuracy of shear wave elastography (SWE). A deep abdominal ultrasound transducer (DAX) capable of point (pSWE) and two‐dimensional (2D)‐SWE has recently been introduced to address this issue.MethodsWe performed a prospective study in a cohort of mostly patients with obesity undergoing liver biopsy with a high prevalence of metabolic dysfunction‐associate steatotic liver disease (MASLD). Liver stiffness measurement (LSM) was measured using vibration‐controlled transient elastography (VCTE), as well as pSWE and 2D SWE on the standard (5C1) and the DAX transducers.ResultsWe included 129 patients with paired LSM and liver biopsy: median age 44.0 years, 82 (63.6%) women, median BMI: 43.2 kg/m2. Histologic fibrosis stages: F0: N = 55 (42.6%), F1: N = 14 (10.9%), F2: N = 50 (38.8%), F3: N = 2 (1.6%), F4: N = 8 (6.2%). VCTE‐LSM failed (N = 13) or were unreliable (IQR/median ≤30% in ≥7.1 kPa, N = 14) in 20.9% of patients. The Pearson correlation of reliable VCTE‐LSM with both pSWE and 2D SWE was strong (all >0.78). The diagnostic accuracy for all LSM techniques was poor for significant fibrosis (≥F2, AUC: 0.54–0.63); however, it was good to excellent for advanced fibrosis (≥F3, AUC: 0.87–0.99) and cirrhosis (F4, AUC: 0.86–1.00). In intention‐to‐diagnose analysis, pSWE on DAX was significantly superior to VCTE‐LSM.ConclusionspSWE‐ and 2D‐SWE enable the non‐invasive identification of advanced fibrosis and cirrhosis in patients with obese MASLD. The use of the DAX transducer for acoustic radiation force imaging (ARFI)‐LSM avoids technical failures in an obese population and subsequently offers advantages over VCTE‐LSM for the evaluation of fibrosis in an obese MASLD population at risk for fibrosis.
Conversion therapy for advanced hepatocellular carcinoma in the era of precision medicine: Current status, challenges and opportunities
Authors: Wang Ming‐Da , Xu Xue‐Jun , Wang Ke‐Chun , Diao Yong‐Kang , Xu Jia‐Hao , Gu Li‐Hui , Yao Lan‐Qing , Li Chao , Lv Guo‐Yue , Yang Tian 
Published: May 2024

AbstractHepatocellular carcinoma (HCC), the most prevalent malignancy of the digestive tract, is characterized by a high mortality rate and poor prognosis, primarily due to its initial diagnosis at an advanced stage that precludes any surgical intervention. Recent advancements in systemic therapies have significantly improved oncological outcomes for intermediate and advanced‐stage HCC, and the combination of locoregional and systemic therapies further facilitates tumor downstaging and increases the likelihood of surgical resectability for initially unresectable cases following conversion therapies. This shift toward high conversion rates with novel, multimodal treatment approaches has become a principal pathway for prolonged survival in patients with advanced HCC. However, the field of conversion therapy for HCC is marked by controversies, including the selection of potential surgical candidates, formulation of conversion therapy regimens, determination of optimal surgical timing, and application of adjuvant therapy post‐surgery. Addressing these challenges and refining clinical protocols and research in HCC conversion therapy is essential for setting the groundwork for future advancements in treatment strategies and clinical research. This narrative review comprehensively summarizes the current strategies and clinical experiences in conversion therapy for advanced‐stage HCC, emphasizing the unresolved issues and the path forward in the context of precision medicine. This work not only provides a comprehensive overview of the evolving landscape of treatment modalities for conversion therapy but also paves the way for future studies and innovations in this field.
Enhancing children's participation in dental research: A commentary
Authors: Attaran Kakhki Nona , Garber Peter , Dudubo Olawale , Salem Asma , Carnevale Franco A. , Macdonald Mary Ellen 
Published: May 2024

AbstractThe concept of childhood has evolved over the years, inspired by the United Nations Convention on the Rights of the Child in 1989, shifting from developmental models to a conception of childhood that recognizes children as moral agents. This evolution highlights the importance of respecting children's agency and their right to be heard in matters that are related to them. In conventional health research, however, children's voices are often inadequately accessed. In this commentary, we discuss the imperative to recognize children's agency in dental research and a shift from research on children to research with and by children. Moreover, we underscore the importance of actively seeking and listening to children's voices and recognizing their agency in shaping research and healthcare practices in the field of dentistry. Further, we explore the application of participatory research approaches in dental research and provide examples of studies that have involved children in various capacities. We conclude this commentary by emphasizing the potential benefits of participatory research in both qualitative and quantitative dental studies to promote deeper understanding, clearer communication, and stronger advocacy regarding children's interests. Primarily, we call for greater recognition of children's agency in dental research and advocate for more inclusive and child‐centred research methodologies.
Current utility of first‐line FT4 and TSH in screening for central hypothyroidism
Authors: Evans Carol , Jacob Jiya , Rodham Annabel , Gill Manjot , Parry Laura , Dodd Alan , El‐Farhan Nadia , Shore Angharad , Lansdown Andrew , Rees Aled , Okosieme Onyebuchi E. 
Published: May 2024

AbstractBackgroundThyroid testing strategies vary across laboratories. First‐line combined thyroid stimulating hormone (TSH) and freeT4 (FT4) have historically been preferred by many laboratories as this detects individuals with undiagnosed central hypothyroidism who can be missed with a first‐line TSH‐only strategy. However, an up‐to‐date evaluation of the utility of this approach is lacking.ObjectivesWe investigated the clinical utility of first‐line TSH and FT4 in the detection of central hypothyroidism in current day practice.Design, Patients, and MeasurementsThe All‐Wales laboratory information system was queried to identify thyroid function tests in patients aged ≥16 years with decreased FT4 and inappropriate TSH (low‐FT4). The 1‐year incidence of low‐FT4 was determined using mid‐year population data. Clinical information of patients with low‐FT4 was reviewed to determine causes of low‐FT4 and the incidence of central hypothyroidism.ResultsThe incidence of low‐FT4 varied according to FT4 assay method (range: 98–301 cases/100,000 population/year). Fifteen new cases of central hypothyroidism were detected in two health boards, equivalent to 2 cases/100,000 population/year. Positive predictive value of low‐FT4 for central hypothyroidism was 2%–4%. In a cross‐section of primary care patients, low‐FT4 was detected in 0.5% of all thyroid tests with assay‐related differences in detection rates.ConclusionsAlthough low‐FT4 is a common laboratory finding, the incidence of central hypothyroidism remains rare. With the currently increased rates of thyroid testing and increased use of medications that decrease FT4, low‐FT4 has a much lower predictive value for central hypothyroidism than previously reported. Thyroid screening strategies will need to balance the yield from first line TSH and FT4 testing with the cost of investigating individuals with non‐pathological laboratory abnormalities.
Clinical management and outcome of head and neck paragangliomas (HNPGLs): A single centre retrospective study
Authors: Darrat Milad , Lau Louis , Leonard Colin , Cooke Stephen , Shahzad Muhammad A. , McHenry Claire , McCance David R. , Hunter Steven J. , Mullan Karen , Lindsay John R. , Graham Una , Bailie Neil , Hampton Susie , Rajendran Simon , Houghton Fionnuala , Conkey David , Morrison Patrick J. , Johnston Philip C. 
Published: May 2024

AbstractContextHead and neck paragangliomas (HNPGLs) are rare, usually benign, slow‐growing tumours arising from neural crest‐derived tissue. Definitive management pathways for HNPGLs have yet to be clearly defined.ObjectiveTo review our experience of the clinical features and management of these tumours and to analyse outcomes of different treatment modalities.MethodsDemographic and clinical data were obtained from The Northern Ireland Electronic Care Record (NIECR) as well from a prospectively maintained HNPGL database between January 2011 through December 2023.ResultsThere were 87 patients; 50 females: 37 males with a mean age of 52.3 ± 14.2 years old (range 17–91 years old). 58.6% (n = 51) of patients had carotid body tumours, 25.2% (n = 22) glomus vagal tumours, 6.8% (n = 6) tumours in the middle ear, 2.2% (n = 2) in the parapharyngeal space and 1.1% (n = 1) in the sphenoid sinus. 5.7% (n = 5) of patients had multifocal disease. The mean tumour size at presentation was 3.2 ± 1.4 cm (range 0.5–6.9 cm). Pathogenic SDHD mutations were identified in 41.3% (n = 36), SDHB in 12.6% (n = 11), SDHC in 2.2% (n = 2) and SDHA in 1.1% (n = 1) of the patients. Overall treatment modalities included surgery alone in 51.7% (n = 45) of patients, radiotherapy in 14.9% (n = 13), observation in 28.7% (n = 25), and somatostatin analogue therapy with octreotide in 4.5% (n = 4) of patients. Factors associated with a significantly higher risk of recurrence included age over 60 years (p = .04), tumour size exceeding 2 cm (p = .03), positive SDHx variants (p = .01), and vagal and jugular tumours (p = .04).ConclusionThe majority of our patients underwent initial surgical intervention and achieved disease stability. Our results suggest that carefully selected asymptomatic or medically unfit patients can be safely observed provided lifelong surveillance is maintained. We advocate for the establishment of a UK and Ireland national HNPGL registry, to delineate optimal management strategies for these rare tumours and improve long term outcomes.
Price pass‐through in the U.S. beef industry: Implications of feedlot capacity utilization
Authors: McKendree Melissa G. S. , Tonsor Glynn T. , Dong Zekuan 
Published: May 2024

AbstractTransmission of prices, profits, and more generally, economic well‐being across vertically connected sectors of agriculture have a long history of interest—arguably of most current interest in meat and livestock markets. Disruptions in live animal harvesting, especially from COVID‐19, have corresponded with substantial market adjustment and hence elevated interest in inner‐industry relationships, including from policymakers. This paper's main contribution is assessing how price changes in the U.S. feedlot industry manifest in feeder cattle markets. We use Ricardian rent theory as a framework to quantify price transmission by testing how price fluctuations actually pass through the supply chain versus theoretical expectations. We posit that the capacity utilization of feedlots changes because of market shocks, impacting price relationships. In the empirical model, when feedlot capacity utilization rates are below the 65% critical point, we find that both fed to feeder cattle and corn to feeder cattle pass‐through rates are higher than hypothesized. When feedlot capacity utilization rates are high (>65%), estimated pass‐through rates are lower and not statistically different from Ricardian rent theory. Understanding how prices pass through in the beef industry can help inform policy discussions about beef market competitiveness and promote efficient resource allocation.
Ex ante transparency and corruption by networks
Authors: Bac Mehmet 
Published: May 2024

AbstractThis paper explains the structure of corruption networks as response to ex ante transparency, defined as visibility of authorities whose cooperation clients may need, in due course, to execute corrupt transactions. It also characterizes the optimal transparency policy given the network response, as a function of connection costs, sanctions, the corruption surplus and the detection probability (hence the anti‐corruption budget and ex post transparency). Corruption chains may emerge in equilibrium if authority is expected to be shared by multiple offices, where the office with higher solo assignment probability becomes the intermediary. Otherwise, clients penetrate the bureaucracy by inducing the star network, or contend with single connection. I show that the optimal policy always assigns one office, sometimes alone, sometimes jointly with others. It is often possible to deter corruption networks through an ex ante transparent policy that parcels out authority to multiple offices with probability 1—a common feature of many US bureaucracies. Decomposing transparency into its components reveals nuances in the transparency–corruption relationship, suggesting that ex ante transparency is instrumental except in environments in which anti‐corruption enforcement is extremely effective or extremely ineffective.