bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy outcomes of Fabry disease in Austria (PROFABIA)-a retrospective cohort-study
Authors: Haninger-Vacariu Natalja , Anastopoulos Kyra , Aigner Christof , Sunder-Plassmann Raute , Gatterer Constantin , Ponleitner Markus , Sunder-Plassmann Gere , Schmidt Alice 
Published: April 2024

Abstract
Background
Pregnancy and delivery outcomes in women with Fabry disease are not well described.

Methods
Retrospective cohort-study of women with Fabry disease in Austria using a specific questionnaire and the Austrian Mother–Child Health Passport.

Results
Out of a total of 44 enrolled women (median age at study entry 44 years, p25: 30, p75: 51), 86.4% showed signs and symptoms of Fabry disease with an increase in pain burden during pregnancy, primarily in women with moderate pain before pregnancy. Thirty-two of 44 women with Fabry disease reported a total of 70 pregnancies (median age at first pregnancy 24 years, p25: 21, p75: 31), 61 (87.1%) of which resulted in 64 live births including 3 sets of twins, six miscarriages (8.6%) in five women, and three induced abortions (4.3%) in two women. Risk factors for poor maternal and foetal outcomes during pregnancy, overrepresented in our cohort as compared to the general population, were hypertension (n = 10, 16.4%), proteinuria (n = 17, 27.9%) and smoking (n = 24, 39.3%). Preeclampsia was reported in 7 pregnancies (11.5%). Fifty-one (79.7%) children were born at term and 13 (20.3%) were preterm (including one neonatal death), with a median gestational age of 39 weeks (p25: 38, p75: 40) and delivery by C-section in 15 pregnancies (24.6%). Thirteen (20.3%) children presented with low birth weight and 18 (28.1%) were small for their gestational age. In comparison to global and national data-sets, preeclampsia, prematurity, low birth weight, being small for their gestational age as well as inpatient stay were significantly more common in patients with Fabry disease.

Conclusions
Our cohort-study in women with Fabry disease shows an increase of pain burden during pregnancies and clearly points to an increased risk for preeclampsia, prematurity, and neonates small for gestational age. With a substantial number of high-risk pregnancies, neonatal outcomes are somewhat worse in Fabry disease than in the general public. Thus, we provide valuable data enabling informed decision-making in pregnancy counselling for Fabry disease.
The emergence of highly resistant and hypervirulent Klebsiella pneumoniae CC14 clone in a tertiary hospital over 8 years
Authors: Hala Sharif , Malaikah Mohammed , Huang Jiayi , Bahitham Wesam , Fallatah Omniya , Zakri Samer , Antony Chakkiath Paul , Alshehri Mohammed , Ghazzali Raeece Naeem , Ben-Rached Fathia , Alsahafi Abdullah , Alsaedi Asim , AlAhmadi Ghadeer , Kaaki Mai , Alazmi Meshari , AlhajHussein Baraa , Yaseen Muhammad , Zowawi Hosam M. , Alghoribi Majed F. , Althaqafi Abdulhakeem O. , Al-Amri Abdulfattah , Moradigaravand Danesh , Pain Arnab 
Published: April 2024

Abstract
Background
Klebsiella pneumoniae is a major bacterial and opportunistic human pathogen, increasingly recognized as a healthcare burden globally. The convergence of resistance and virulence in K. pneumoniae strains has led to the formation of hypervirulent and multidrug-resistant strains with dual risk, limiting treatment options. K. pneumoniae clones are known to emerge locally and spread globally. Therefore, an understanding of the dynamics and evolution of the emerging strains in hospitals is warranted to prevent future outbreaks.

Methods
In this study, we conducted an in-depth genomic analysis on a large-scale collection of 328 multidrug-resistant (MDR) K. pneumoniae strains recovered from 239 patients from a single major hospital in the western coastal city of Jeddah in Saudi Arabia from 2014 through 2022. We employed a broad range of phylogenetic and phylodynamic methods to understand the evolution of the predominant clones on epidemiological time scales, virulence and resistance determinants, and their dynamics. We also integrated the genomic data with detailed electronic health record (EHR) data for the patients to understand the clinical implications of the resistance and virulence of different strains.

Results
We discovered a diverse population underlying the infections, with most strains belonging to Clonal Complex 14 (CC14) exhibiting dominance. Specifically, we observed the emergence and continuous expansion of strains belonging to the dominant ST2096 in the CC14 clade across hospital wards in recent years. These strains acquired resistance mutations against colistin and extended spectrum β-lactamase (ESBL) and carbapenemase genes, namely blaOXA-48 and blaOXA-232, located on three distinct plasmids, on epidemiological time scales. Strains of ST2096 exhibited a high virulence level with the presence of the siderophore aerobactin (iuc) locus situated on the same mosaic plasmid as the ESBL gene. Integration of ST2096 with EHR data confirmed the significant link between colonization by ST2096 and the diagnosis of sepsis and elevated in-hospital mortality (p-value < 0.05).

Conclusions
Overall, these results demonstrate the clinical significance of ST2096 clones and illustrate the rapid evolution of an emerging hypervirulent and MDR K. pneumoniae in a clinical setting.
Accuracy of automated computer-aided risk scoring systems to estimate the risk of COVID-19: a retrospective cohort study
Authors: Faisal Muhammad , Mohammed Mohammed Amin , Richardson Donald , Fiori Massimo , Beatson Kevin 
Published: April 2024

Abstract
Background
In the UK National Health Service (NHS), the patient’s vital signs are monitored and summarised into a National Early Warning Score (NEWS) score. A set of computer-aided risk scoring systems (CARSS) was developed and validated for predicting in-hospital mortality and sepsis in unplanned admission to hospital using NEWS and routine blood tests results. We sought to assess the accuracy of these models to predict the risk of COVID-19 in unplanned admissions during the first phase of the pandemic.

Methods
Adult ( > = 18 years) non-elective admissions discharged (alive/deceased) between 11-March-2020 to 13-June-2020 from two acute hospitals with an index NEWS electronically recorded within ± 24 h of admission. We identified COVID-19 admission based on ICD-10 code ‘U071’ which was determined by COVID-19 swab test results (hospital or community). We assessed the performance of CARSS (CARS_N, CARS_NB, CARM_N, CARM_NB) for predicting the risk of COVID-19 in terms of discrimination (c-statistic) and calibration (graphically).

Results
The risk of in-hospital mortality following emergency medical admission was 8.4% (500/6444) and 9.6% (620/6444) had a diagnosis of COVID-19. For predicting COVID-19 admissions, the CARS_N model had the highest discrimination 0.73 (0.71 to 0.75) and calibration slope 0.81 (0.72 to 0.89) compared to other CARSS models: CARM_N (discrimination:0.68 (0.66 to 0.70) and calibration slope 0.47 (0.41 to 0.54)), CARM_NB (discrimination:0.68 (0.65 to 0.70) and calibration slope 0.37 (0.31 to 0.43)), and CARS_NB (discrimination:0.68 (0.66 to 0.70) and calibration slope 0.56 (0.47 to 0.64)).

Conclusions
The CARS_N model is reasonably accurate for predicting the risk of COVID-19. It may be clinically useful as an early warning system at the time of admission especially to triage large numbers of unplanned admissions because it requires no additional data collection and is readily automated.
Intravenous infusion of dexmedetomidine during the surgery to prevent postoperative delirium and postoperative cognitive dysfunction undergoing non-cardiac surgery: a meta-analysis of randomized controlled trials
Authors: Wang Di , Liu Zhi , Zhang Wenhui , Zu Guo , Tao He , Bi Congjie 
Published: April 2024

Abstract
Background
Dexmedetomidine plays a pivotal role in mitigating postoperative delirium and cognitive dysfunction while enhancing the overall quality of life among surgical patients. Nevertheless, the influence of dexmedetomidine on such complications in various anaesthesia techniques remains inadequately explored. As such, in the present study, a meta-analysis was conducted to comprehensively evaluate its effects on postoperative delirium and cognitive dysfunction.

Methods
A number of databases were searched for randomised controlled trials comparing intravenous dexmedetomidine to other interventions in preventing postoperative delirium and cognitive dysfunction in non-cardiac and non-neurosurgical patients. These databases included PubMed, Embase, and Cochrane Library. Statistical analysis and graphing were performed using Review Manager, STATA, the second version of the Cochrane risk-of-bias tool for randomised controlled trials, and GRADE profiler.

Main results
This meta-analysis comprised a total of 24 randomised controlled trials, including 20 trials assessing postoperative delirium and 6 trials assessing postoperative cognitive dysfunction. Across these 24 studies, a statistically significant positive association was observed between intravenous administration of dexmedetomidine and a reduced incidence of postoperative delirium (RR: 0.55; 95% CI 0.47 to 0.64, p < 0.00001, I2 = 2%) and postoperative cognitive dysfunction (RR: 0.60; 95% CI 0.38 to 0.96, p = 0.03, I2 = 60%). Subgroup analysis did not reveal a significant difference in the incidence of postoperative delirium between the general anaesthesia and non-general anaesthesia groups, but a significant difference was observed in the incidence of postoperative cognitive dysfunction. Nonetheless, when the data were pooled, it was evident that the utilisation of dexmedetomidine was associated with an increased incidence of hypotension (RR: 1.42; 95% CI 1.08 to 1.86, p = 0.01, I2 = 0%) and bradycardia (RR: 1.66; 95% CI 1.23 to 2.26, p = 0.001, I2 = 0%) compared with other interventions. However, there was no significantly higher occurrence of hypertension in the DEX groups (RR = 1.35, 95% CI 0.81–2.24, p = 0.25, I2 = 0%).

Conclusion
Compared with other interventions, intravenous dexmedetomidine infusion during non-cardiac and non-neurosurgical procedures may significantly reduce the risk of postoperative delirium and cognitive dysfunction. The results of subgroup analysis reveal a consistent preventive effect on postoperative delirium in both general and non-general anaesthesia groups. Meanwhile, continuous infusion during general anaesthesia was more effective in reducing the risk of cognitive dysfunction. Despite such findings, hypotension and bradycardia were more frequent in patients who received dexmedetomidine during surgery.
Accelerated construction of projection-based reduced-order models via incremental approaches
Authors: Agouzal Eki , Taddei Tommaso 
Published: April 2024

AbstractWe present an accelerated greedy strategy for training of projection-based reduced-order models for parametric steady and unsteady partial differential equations. Our approach exploits hierarchical approximate proper orthogonal decomposition to speed up the construction of the empirical test space for least-square Petrov–Galerkin formulations, a progressive construction of the empirical quadrature rule based on a warm start of the non-negative least-square algorithm, and a two-fidelity sampling strategy to reduce the number of expensive greedy iterations. We illustrate the performance of our method for two test cases: a two-dimensional compressible inviscid flow past a LS89 blade at moderate Mach number, and a three-dimensional nonlinear mechanics problem to predict the long-time structural response of the standard section of a nuclear containment building under external loading.
Reducing anti-fat bias toward the self and others: a randomized controlled trial
Authors: Kramer Emily B. , Pietri Evava S. , Bryan Angela D. 
Published: April 2024

AbstractDespite strong evidence linking anti-fat bias directed toward others with markers of self-directed anti-fat bias, there is a dearth of theory-based research examining the cognitive pathways underlying this relationship, and existing bias-reduction intervention efforts have thus far been conducted with exclusive focus on one domain or the other. Cognitive dissonance (CD)-based interventions have been identified as viable for reducing anti-fat bias directed toward the self and others. However, no study has yet examined whether the effects of these domain-specific interventions (e.g., anti-fat bias towards the self) extend to anti-fat bias in the non-targeted domain (e.g., anti-fat bias towards others). The present study aimed to address these gaps in the literature by comparing effects of brief CD-based interventions targeting anti-fat bias directed toward either the self or others on measures of anti-fat bias. Participants (N = 197, female-identifying undergraduates) were randomized to a writing activity prompting cognitive dissonance about either self-directed or other-directed anti-fat bias, or a bias-consistent control condition. Results indicated that participants in the CD intervention conditions showed significantly greater reductions in both explicit self- and other-directed anti-fat biases than those in the control condition, but results did not significantly differ across CD conditions. This supports the potential utility of interventions simultaneously targeting anti-fat bias in both domains and provides insight into the cognitive pathways underlying these related forms of bias.
Ineffectiveness of hemoadsorption in large animals with abdominal sepsis: a randomized controlled porcine study
Authors: Tegl Vaclav , Horak Jan , Nalos Lukas , Horakova Michala , Stengl Milan , Matejovic Martin , Benes Jan 
Published: April 2024

Abstract
Objectives
The use of hemoadsorption (HA) has become popular in the treatment of vasoplegic states associated with massive cytokine release, including septic shock. However, this approach does not seem to be based on robust evidence, and it does not follow international guidelines. To understand the pathophysiological rationale and timing of HA, we conducted a large animal septic shock experiment.

Design
Prospective randomized large-animal peritoneal septic shock experiment.

Setting
Laboratory investigation.

Subjects
Twenty-six anesthetized, mechanically ventilated, and instrumented pigs randomly assigned into (1) sham-operated group with HA (SHAM, n = 5); (2) sepsis animals without HA (SEPSIS, n = 5); (3) sepsis group with HA at norepinephrine initiation (EARLY, n = 8); and (4) sepsis group with HA initiated at norepinephrine rate reaching 0.5 μg/kg/min (LATE, n = 8).

Interventions
Peritoneal sepsis was induced by cultivated autologous feces inoculation. A CytoSorb cartridge (200 g) with a blood flow rate of 200 mL/min and heparin anticoagulation was used to perform HA. The animals received sedation and intensive organ support up to 48 h or until they experienced cardiovascular collapse.

Measurements and main results
Systemic hemodynamics, multiple-organ functions, and immune-inflammatory response were measured at predefined periods. The HA treatment was not associated with any measurable benefit in terms of systemic hemodynamics and organ support. The systemic inflammatory markers were unaffected by any of the treatment timings. In contrast, the HA resulted in higher vasopressor load and decreased 36-h survival (5 animals in SHAM (100%), 4 (80%) in SEPSIS, 4 (57%) in EARLY, and 2 (25%) in LATE; p = 0.041). The HA exposure in healthy animals was associated with hemodynamic deterioration, systemic inflammatory response, and cytopenia.

Conclusions
In this large-animal-controlled fulminant sepsis study, the HA was unable to counteract the disease progression in the early or advanced septic shock phase. However, findings from the HA-exposed sham animals suggest potential safety concerns.
A cross-sectional survey of hepatitis B virus screening in patients who received immunosuppressive therapy for rheumatoid arthritis in Japan
Authors: Yanagisawa Yuki , Imai Shungo , Kizaki Hayato , Hori Satoko 
Published: April 2024

Abstract
Background
Patients with a history of hepatitis B virus (HBV) infection who are receiving immunosuppressive therapy are at risk of HBV reactivation and disease. Therefore, HBV screening is required prior to administering antirheumatic drugs with immunosuppressive effects. This study aimed to determine the status of hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis B surface antibody (HBsAb) screening prior to the initiation of drug therapy, including new antirheumatic drugs, in patients with rheumatoid arthritis.

Methods
This retrospective cross-sectional study used data from April 2014 to August 2022 from the Japanese hospital-based administrative claims database. The inclusion criteria were rheumatoid arthritis and first prescription date of antirheumatic drugs.

Results
A total of 82,282 patients with rheumatoid arthritis who were first prescribed antirheumatic drugs between April 2016 and August 2022 were included. Of the eligible patients, 9.7% (n=7,959) were screened for all HBV (HBsAg, HBsAb, and HbcAb) within 12 months prior to the date of initial prescription. The HBsAg test was performed in 30.0% (n=24,700), HBsAb test in 11.8% (n=9,717), and HBcAb test in 13.1% (n=10,824) of patients. The proportion of patients screened for HBV infection has been increasing since 2018; however, the proportion of patients screened for rheumatoid arthritis remains low.

Conclusions
Our findings suggest that HBV screening may be insufficient in patients who received antirheumatic drugs. With the increasing use of new immunosuppressive antirheumatic drugs, including biological agents, healthcare providers should understand the risk of HBV reactivation and conduct appropriate screening.
Fatal pulmonary embolism after surgery for small intestinal necrosis caused by idiopathic portal vein thrombosis: a case report
Authors: Iwasaki Hitoshi , Uehara Hideo , Fujimoto Yugo , Hasuda Hirofumi , Kusumoto Eiji , Hisamatsu Yuichi , Yoshida Rintaro , Sakaguchi Yoshihisa , Kusumoto Tetsuya 
Published: April 2024

Abstract
Background
Portal vein thrombosis (PVT) and venous thromboembolism (VTE) both result from partial or complete occlusion of a blood vessel by a blood clot. The prognosis of PVT is generally good; however, PVT with VTE, including pulmonary embolism (PE), has a high mortality rate. We report here a case of PE after surgery for small intestinal necrosis caused by idiopathic PVT.

Case presentation
A 69-year-old female attended our hospital with a chief complaint of upper abdominal discomfort, and was diagnosed with necrosis of the small intestine as a result of unexplained PVT. She underwent partial resection of the small intestine. On the second postoperative day, she suffered from respiratory distress and went into cardiopulmonary arrest. The patient recovered following cardiopulmonary resuscitation, but PE was detected. Extracorporeal veno-arterial cardiopulmonary resuscitation and anticoagulation therapy were initiated immediately and the thrombus was aspirated as much as possible. Two days later, extracorporeal veno-arterial cardiopulmonary resuscitation was withdrawn and anticoagulation therapy was continued. The patient subsequently recovered with no neurological damage and was discharged on day 26 after the above procedure.

Conclusions
Idiopathic PVT is often associated with VTE, and a prompt diagnosis and intervention may result in a good prognosis.
The impact of using ovarian-adnexal reporting data system magnetic resonance imaging (O-RADS MRI) score on risk stratification of sonographically indeterminate adnexal masses
Authors: Hassan Rania Mostafa A. , Ebrahim Saeed Abdel Monem , Kamal Marwa Rashad Ahmad , Tantawy Heba Fathy Ahmad 
Published: April 2024

Abstract
Background
Adnexal masses (AMs) are prevalent, leading to a substantial clinical effort including imaging for diagnosis, surgery, and pathology.

Aim of the study
The goal of this research was to evaluate the reliability of the Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) scale for diagnosing the sonographically indeterminate adnexal masses and to discriminate between malignant and benign ones using the O-RADS MRI scoring system.

Methods
This study included 72 cases with indeterminate adnexal masses in any age group. We excluded patients with previous history of operated adnexal lesion and patients who had contraindications for MRI as pacemakers or iron clips.

Results
Based on O-RADS MRI score, 44.4% of masses were diagnosed as O-RADS II indicating that they were almost certainly benign, 11.1% as O-RADS III indicating low risk malignancy, 8.3% as O-RADS IV indicating intermediate risk malignancy and 36.1% were diagnosed as O-RADS V indicating high risk malignancy. O-RADS MRI score for malignancy gave sensitivity of 92.31% (95%CI 63.97–99.81), specificity of 82.61% (95%CI 61.22–95.05), PPV of 75% (95%CI 54.84–88.11) and NPV of 95% (95%CI 74.12–99.21) with an overall accuracy of 86.11% (95%CI 70.50–95.33).

Conclusions
The O-RADS MRI score has excellent accuracy and validity in determining whether an AM is malignant or benign. Using this score in clinical practice may enable a tailored, patient-centered approach for masses that are sonographically indeterminate, avoiding unnecessary surgery, and in certain cases allows less extensive surgery, or even fertility preservation when appropriate.
Seasonal forecasting of
Bactrocera dorsalis
Hendel, 1912 (Diptera: Tephritidae) in bioclimatic zones of Sri Lanka using the SARIMA model
Authors: Wijekoon W. M. C. D. , Ganehiarachchi G. A. S. M. , Wegiriya H. C. E. , Vidanage S. P. 
Published: April 2024

Abstract

Bactrocera dorsalis
Hendel is a severe fruit pest that causes significant economic losses globally. Despite
B. dorsalis
having been distributed mostly across Asia, studies on its current and future density variation in Sri Lanka are sparse to date. The present study was thus carried out to assess the contemporary density variation (2020–2022) and future density fluctuation (2023–2025) of
B. dorsalis
in bioclimatic zones of Sri Lanka. The density was assessed using the monthly-based fruit fly trap collection method from randomly selected 40 locations in all bioclimatic zones (wet, intermediate, dry, and arid). The SARIMA modelling technique was applied for delineating the best-fit model and for density forecasting in each bioclimatic zone. The density variations were depicted for the year and for the bioclimatic zone (2020–2025) by colour intensity maps using QGIS. According to the findings,
B. dorsalis
shows a seasonal component to its year-round density variation and an ascending trend in its density from 2020 to 2025. Density forecasting records a 20%, 30%, 26%, and 37% density increase in the wet, intermediate, dry, and arid zones, respectively, in 2025. In 2025, the highest predicted
B. dorsalis
density from the arid zone and the lowest predicted density from the wet zone were recorded. This study contains the first forecasting attempt for
B. dorsalis
density using the SARIMA approach as well as the application of colour-intensity depiction for its density variation in Sri Lanka, which leads decision makers and stakeholders in economic agriculture to plan the scientific management of
B. dorsalis
to avoid its current and potential future threat to the country’s fruit industry.