bluuebunny/crossref_metadata_2025_split huggingface dataset:
Granulomatosis With Polyangiitis of Spinal Dura Presenting With “Bottle Brush Sign” on 18F-FDG PET/CT
Authors: Zhang Yue , Wu Chunyan , Shi Qinwen , Su Minggang 
Published: February 2024

Abstract
A 72-year-old man with fever and weakness in both lower limbs underwent thoracolumbar MRI and 18F-FDG PET/CT. The PET/CT scan revealed diffused FDG uptake along the spinal dura mater from T7 to S2 level like a “bottle brush.” Pathologic examination after biopsy of spinal canal lesions manifested granulomatous inflammation. The blood test showed cytoplasmic antineutrophil cytoplasmic antibody (ANCA) and myeloperoxidase-ANCAs were positive, whereas the perinuclear ANCA was negative. Eventually, he was diagnosed with granulomatosis with polyangiitis.
Continued Diabetes Remission Despite Weight Recurrence: Gastric Bypass Long-Term Metabolic Benefit
Authors: Ghanem Omar M , Abi Mosleh Kamal , Kerbage Anthony , Lu Lauren , Hage Karl , Abu Dayyeh Barham K 
Published: February 2024

BACKGROUND:
Roux-en-Y gastric bypass (RYGB) demonstrates high rates of type 2 diabetes mellitus (T2DM) remission, a phenomenon hypothesized to be mediated mainly by weight loss. Compared with procedures that do not bypass the proximal small intestines, such as sleeve gastrectomy (SG), RYGB exhibits weight loss–independent intestinal mechanisms conducive to T2DM remission. We investigated continued diabetes remission (CDR) rates despite weight recurrence (WR) after RYGB compared with an SG cohort.

STUDY DESIGN:
A retrospective review of patients who underwent successful primary RYGB or SG with a BMI value of 35 kg/m2 or more and a preoperative diagnosis of T2DM was performed. Patients with less than 5 years of follow-up, absence of WR, or lack of T2DM remission at nadir weight were excluded. After selecting the optimal procedure for glycemic control, rates of CDR were then stratified into WR quartiles and compared.

RESULTS:
A total of 224 RYGB and 46 SG patients were analyzed. The overall rate of CDR was significantly higher in the RYGB group (75%) compared with the SG group (34.8%; p < 0.001). The odds of T2DM recurrence were 5.5 times higher after SG compared with RYGB. Rates of CDR were stratified into WR quartiles (85.5%, <25%; 81.7%, 25% to 44.9%; 63.2%, 45% to 74.9%; and 60%, >75%). Baseline insulin use, higher preoperative glycosylated hemoglobin, and longer preoperative duration of T2DM were associated with T2DM recurrence, whereas WR was not.

CONCLUSIONS:
T2DM remission rates after RYGB are maintained despite WR, arguing for a concurrent weight loss–independent metabolic benefit likely facilitated by bypassing the proximal small intestine.
Feasibility of Identifying Factors Related to Alzheimer’s Disease and Related Dementia in Real-World Data
Authors: Chen Aokun , Li Qian , Huang Yu , Li Yongqiu , Chuang Yu-neng , Hu Xia , Guo Serena , Wu Yonghui , Guo Yi , Bian Jiang 
Published: February 2024

ABSTRACTA comprehensive view of factors associated with AD/ADRD will significantly aid in studies to develop new treatments for AD/ADRD and identify high-risk populations and patients for prevention efforts. In our study, we summarized the risk factors for AD/ADRD by reviewing existing meta-analyses and review articles on risk and preventive factors for AD/ADRD. In total, we extracted 477 risk factors in 10 categories from 537 studies. We constructed an interactive knowledge map to disseminate our study results. Most of the risk factors are accessible from structured Electronic Health Records (EHRs), and clinical narratives show promise as information sources. However, evaluating genomic risk factors using RWD remains a challenge, as genetic testing for AD/ADRD is still not a common practice and is poorly documented in both structured and unstructured EHRs. Considering the constantly evolving research on AD/ADRD risk factors, literature mining via NLP methods offers a solution to automatically update our knowledge map.HIGHLIGHTSWe summarized the risk factors for AD/ADRD by reviewing existing meta-analyses and review articles on risk and preventive factors for AD /ADRD.Drawing from this literature review and identified AD/ADRD factors, we explored the accessibility of these risk and preventive factors in both structured and unstructured EHR data.We constructed an interactive knowledge map that can be used to aid in the design of future AD/ADRD studies that aim to leverage large collections of RWD to generate RWE.
Deep learning-based Spatial Feature Extraction for Prognostic Prediction of Hepatocellular Carcinoma from Pathological Images
Authors: Hu Huijuan , Tan Tianhua , Liu Yerong , Liang Wei , Zhang Wei , Cui Ju , Song Jinghai , Li Xuefei 
Published: February 2024

AbstractThe spatial structures of various cell types in tumor tissues have been demonstrated to be able to provide useful information for the evaluation of the disease progression as well as the responsiveness to targeted therapies. Therefore, powered by machine-learning, several image segmentation methods have been developed to identify tumor-cells, stromal, lymphocytes, etc., in hematoxylin and eosin (H&E) stained pathological images. However, the quantitative and systematic characterization of the spatial structures of various cell types is still challenging. In this work, we first developed a robust procedure based on deep learning to precisely recognize cancer cells, stromal and lymphocytes in H&E-stained pathological images of hepatocellular carcinoma (HCC). In order to quantitatively characterize the composition and spatial arrangement of the tumor microenvironment, we then systematically constructed 109 spatial features based on locations of the 3 major types of cells in the H&E images. Interestingly, we discovered that the absolute values of several spatial features are significantly associated with patient overall survival in two independent patient cohorts, such as the cellular diversity around stromal cells (StrDiv), the average distance between stromal cells (StrDis), the coefficient of variation of the tumor-cell polygon area in the Voronoi diagram (TumCV),etc., based on univariate analysis. In addition, multivariate Cox regress analyses further demonstrated that StrDiv and StrDis are independent survival prognostic factors for HCC patient from The Cancer Genome Atlas Program (TCGA). Furthermore, we demonstrated that a combination analysis with cell spatial features,i.e. StrDiv or TumCV, and another important clinical feature,i.e. microvascular invasion (MVI), can further improve the efficacy of prognostic stratification for patients from the Beijing Hospital cohorts. In summary, the spatial features of tumor microenvironment enabled by the digital image analysis pipeline developed in this work can be effective in patient stratification, which holds the promise for its usage in predicting the therapeutic response of patients in the future.
IMPROVING ANTIBIOTICS USE IN PEDIATRIC HOSPITALS IN ARGENTINA: FEASIBILITY STUDY
Authors: Jorro-Baron Facundo , Echave Cecilia , Rodriguez Viviana , Aguilar Maria-Jose , Balboa Romina , Guglielmino Marina , Garcia-Causarano Florencia , Del Negro Veronica , Dondoglio Patricia , Falcon Esteban , Gibbons Luz , Guerrero Celeste , Juarez Ximena , López Analía , Matteucci Erika , Rodriguez Ana Paula , Vitar Emilse , Roberti Javier , Garcia-Elorrio Ezequiel , Falaschi Andrea 
Published: February 2024

AbstractBackgroundWe aimed to test the feasibility of a multifaceted intervention to enhance the quality of antibiotic prescription by reducing its overuse and increasing the use of narrow-spectrum agents, comprising a range of antimicrobial stewardship strategies in LMIC pediatric hospitals.MethodsWe implemented a quality improvement (QI) initiative for the treatment of three groups of infections: acute lower respiratory infections (ALRI), urinary tract infections (UTI), and skin and soft tissue infections (SSTI) in six units of two academic pediatric hospitals. We used an uncontrolled before-and-after design, preceded by a formative phase, to identify barriers and facilitators. The target population was Healthcare workers (HCWs). The strategy comprised an antibiotic audit and feedback, ward- or pathway-specific treatment guidelines, infection-based interventions focused on improving diagnostic accuracy, tailoring therapy to culture results, optimizing treatment duration (antibiotic time out), pharmacy-based interventions, and education.ResultsWe recruited 617 patients: 249 in the baseline period (BP) and 588 in the implementation period (IP). The patients in the IP group were younger, weighed less, had higher critical care requirements, and had higher ALRI.With implementation, we observed an increase in antibiotic days of therapy (1051 vs. 831; RR: 1.23 (1.14;1.33); p<0.001). After adjusting for age and place of hospitalization, the differences were significant. This increase was at the expense of a higher use of Access group antibiotics (382 vs. 310; RR: 1.23 (1.14;1.33); p<0.001) and lower use of the Watch group according to the WHO classification (552 vs. 623; RR: 0.89 (0.84; 0.94); p<0.001).We observed a decrease in antibiotic resistance in the IP group (5% vs. 13%; p<0.001) at the expense of extended-spectrum β-lactamase.We found no differences in mortality rates between the two periods.ConclusionThrough a QI initiative, the use of antibiotic stewardship programs in pediatric hospitals was shown to be feasible and may improve antibiotic use. We observed a decrease in antibiotic resistance, which may be due to an increase in antibiotic Access group use.
Mucin 5AC is a sensitive surface marker for sessile serrated lesions: results from a systematic review and meta-analysis
Authors: Liu Kevin , Sachar Moniyka , Popov Violeta , Pei Ziheng , Quarta Giulio 
Published: February 2024

AbstractSessile serrated lesions (SSLs) are a class of colon polyps which are challenging to detect through current screening methods but are highly associated with colon cancer. We reasoned that a biomarker sensitive for SSLs would be clinically useful to improve detection. Recent endoscopic and histopathologic studies suggest that SSLs are associated with alterations in intestinal mucin expression but the frequency with which this occurs is not known. We performed a meta-analysis of available pathologic studies comparing mucin expression on SSLs to normal colonic mucosa, tubular adenomas (TAs), villous adenomas (VAs), traditional serrated adenomas (TSAs), and hyperplastic polyps (HPs). We searched Medline, Pubmed, and Embase and found 440 publications in this topic, and 18 total studies met inclusion. We found that MUC5AC expression was more common in SSLs compared to normal colonic mucosa (OR=82.9, p<0.01), TAs (OR=11, p<0.01), and TSAs (OR=3.6, p=0.04). We found no difference in MUC5AC expression between SSLs versus HPs (OR=2.1, p=0.09) and no difference in MUC5AC expression between left colon and right colon HPs, with an OR=1.8, p=0.23. We found that MUC5AC expression was found commonly on VAs, SSLs, and TSAs while the frequency on colon cancers declined. MUC5AC is also upregulated in inflammatory bowel disease and in response to intestinal infections. MUC5AC expression highlights the potential of mucins as sensitive biomarkers, though not specific to SSLs. Further research into the clinical utilization of MUC5AC could enhance SSL detection.
Tau-PET in early cortical Alzheimer brain regions in relation to mild behavioral impairment in older adults with either normal cognition or mild cognitive impairment
Authors: Naude James , Wang Meng , Leon Rebeca , Smith Eric , Ismail Zahinoor 
Published: February 2024

AbstractMild Behavioral Impairment (MBI) leverages later-life emergent and persistent neuropsychiatric symptoms (NPS) to identify a high-risk group for incident dementia. Phosphorylated tau (p-tau) is a hallmark biological manifestation of Alzheimer disease (AD). We investigated associations between MBI and tau accumulation in early-stage AD cortical regions. In 442 Alzheimer’s Disease Neuroimaging Initiative participants with normal cognition or mild cognitive impairment, MBI status was determined alongside corresponding p-tau and Aβ. Two meta-regions of interest were generated to represent Braak I and III neuropathological stages. Multivariable linear regression modelled the association between MBI as independent variable and tau tracer uptake as dependent variable. Among Aβpositive individuals, MBI was associated with tau uptake in Braak I (β=0.45(0.15),p<.01) and Braak III (β=0.24(0.07),p<.01) regions. In Aβnegative individuals, MBI was not associated with tau in the Braak I region (p=.11) with a negative association in Braak III (p=.01). These findings suggest MBI may be a sequela of neurodegeneration, and can be implemented as a cost-effective framework to help improve screening efficiency for AD.
Cranial sexual dimorphism levels in modern humans: Supporting a global expansion originating in southern Africa
Authors: Cenac Zarus 
Published: February 2024

AbstractModern humans are acknowledged to have expanded across Earth from Africa. Biological measures have appeared to reflect this expansion, such as genetic diversity and cranial sexual size dimorphism. Admixture is known to be an issue for using diversity to locate where the expansion set out from in Africa; using cranial dimorphism should make admixture less of an issue. Therefore, cranial dimorphism could be of importance for clarifying the origin. This study used data sourced from the Howells dataset to infer if cranial form and shape dimorphisms indicate the expansion, and understand why cranial size dimorphism looks indicative. Form and shape dimorphisms were calculated through RMET. Size dimorphism was calculated beforehand. Cranial form and shape dimorphisms increased with distance from Africa. Form dimorphism suggested an area of origin which was predominantly in Africa and marginally in Asia. For shape dimorphism, locations spanned much farther beyond Africa. Hence, cranial form dimorphism seemed to be quite indicative of the expansion, unlike cranial shape dimorphism. Form is known to feature size and shape – cranial form dimorphism may signify the expansion mainly, or only, due to cranial size dimorphism. It seemed unsettled why cranial size and form dimorphisms seem related to the expansion because it was vague whether cranial size indicates the expansion more for males than females. Previously, a collective estimate of the origin (from biological measures including cranial size dimorphism) pointed to southern Africa; in the collective estimation process, cranial size dimorphism supported the south as would cranial form and shape dimorphisms.
Contemporary Administrative Codes For Identifying Pulmonary Vein Isolation Procedures for Atrial Fibrillation
Authors: Ferro Enrico G , Reynolds Matthew R. , Jiaman Xu , Song Yang , Cohen David J. , Wadhera Rishi K , d’Avila Andre , Zimetbaum Peter J , Yeh Robert W , Kramer Daniel B 
Published: February 2024

AbstractIntroductionUse of pulmonary vein isolation (PVI) to treat atrial fibrillation continues to grow. Despite great interest in leveraging administrative data for real-world analyses, reliability of contemporary procedural codes for identifying PVI have not been carefully examined.MethodsInpatient PVIs were identified among US Medicare fee-for-service beneficiaries using Current Procedural Terminology (CPT) code 93656 in the Carrier Line Files. Each patient was cross-matched by procedure date with claims from Medicare Provider Analysis and Review Files (MedPAR) in order to compare CPT claims with International Classification of Diseases-10thRevision Procedure Coding System (ICD-10-PCS) claims submitted by healthcare facilities to bill for the same procedure. We performed the reverse analysis for commonly matched ICD-10-PCS codes to identify their corresponding CPT-billed procedures. Lastly, we reviewed a random selection of 100 institutional cases for additional comparison of CPT and ICD-10-PCS assignation.ResultsWe identified 25,617 inpatient PVIs from 1/2017 to 12/2021, of which 18,165 (71%) were linked to MedPAR by same-day procedure date. Of these, 16,672 (92%) were coded as ICD-10 02583ZZ “Destruction of Conduction Mechanism, Percutaneous Approach”, with lower use of other codes. The reverse process yielded heterogeneous results: among 75,003 procedures billed as ICD-10 02583ZZ, only 15,691 (21%) matched with CPT 93656 (PVI), as several other procedures were interchangeably billed under this same ICD-10 code. Institutional case review confirmed the greater specificity of CPT codes for identifying PVIs.ConclusionsThe ICD-10-PCS code most commonly associated with CPT-billed PVI procedures actually refers to ablation of the atrio-ventricular junction. Yet this same ICD-10-PCS code also matches with a wide range of other procedures distinct from PVI. We conclude that ICD-10-PCS codes alone are neither sensitive nor specific for identifying PVIs in claims. CPT codes should be used for health services research on this important procedure.
Liver Intrinsic Function Evaluation (LIFE): Multi-parametric Liver Function Profiles of Patients Undergoing Hepatectomy
Authors: Simonsson Christian , Bartholomä Wolf Claus , Larsson Anna Lindhoff , Karlsson Markus , Cai Shan , Tellman Jens , Norén Bengt , Björnsson Bergthor , Cedersund Gunnar , Dahlström Nils , Sandström Per , Lundberg Peter 
Published: February 2024

AbstractBackground & AimsFor a range of liver malignancies, the only curative treatment option may be hepatectomy, which may have fatal complications. Therefore, an unbiased pre-operative risk assessment is vital, however, at present the assessment is typically based on global liver function only. Magnetic resonance imaging (MRI) modalities have the possibility to aid this assessment, by introducing additional characterization of liver parenchymal, such as non-invasive quantification of steatosis, fibrosis, and uptake function, both for global and regional assessment. To this cause, we here present a prospective observation study (LIFE), in which patients underwent extensive MR-examinations both before and after resective-surgery.Approach and ResultsA total of 13 patients undergoing hepatectomy underwent a pre- (n=13) and post (m=5) multimodal MRI examination (within 3-5 days of the surgery) (Fig. 1B). The multimodal MR-examination included DCE, 3D-MRE, fat fraction measurements (PDFF by MRS, 6PD). Using these measurements, we also construct individual patient profiles by including conventional functional, and volumetric measurements, into a multi-parametric space. As a proof of concept, the areas of each profile, denoted ‘multiparametric profile area’ (MPA, and aMPA) were calculated, to create a measurement comprising information from all modalities.At a group-level, no clear pattern emerged of MPA or aMPA between groups with different extent of resection. In contrast, on a case-by-case basis, several parameters contributed to high individual MPA or aMPA-values, suggesting tissue abnormalities. With respect to regional DCE measurements,i.e., relative enhancement at 20 minutes, a clear variation between function in segments, within and between the individuals, was observed.ConclusionsIn this combined pre- and post-observational case-based study ranging from very extensive (i) liver surgery to minor (ii), or none (iii), we aimed to describe how a multi-modal MRI examination before hepatectomy could yield valuable information for the pre-operative assessment, with a particular focus on a Couinaud-segmental level. The use of a multi-modal approach allows for a broad spectral characterization of several aspects of the remnant tissue. However, the effectiveness and clinical benefit of each parameter, and how to further optimize an abbreviated clinical MR-protocol needs to be confirmed.
Deep Learning for Multi-Label Disease Classification of Retinal Images: Insights from Brazilian Data for AI Development in Lower-Middle Income Countries
Authors: Gould Dewi S.W. , Yang Jenny , Clifton David A. 
Published: February 2024

AbstractRetinal fundus imaging is a powerful tool for disease screening and diagnosis in opthalmology. With the advent of machine learning and artificial intelligence, in particular modern computer vision classification algorithms, there is broad scope for technology to improve accuracy, increase accessibility and reduce cost in these processes. In this paper we present the first deep learning model trained on the first Brazilian multi-label opthalmological datatset. We train a multi-label classifier using over 16,000 clinically-labelled fundus images. Across a range of 13 retinal diseases, we obtain frequency-weighted AUC and F1 scores of0.92and0.70respectively. Our work establishes a baseline model on this new dataset and furthermore demonstrates the applicability and power of artificial intelligence approaches to retinal fundus disease diagnosis in under-represented populations.
Association of multidrug-resistant bacteria and clinical outcomes in patients with infected diabetic foot in a Peruvian Hospital: A retrospective cohort analysis
Authors: Yovera-Aldana Marlon , Sifuentes-Hermenegildo Paola , Cervera-Ocaña Martha Sofia , Mezones-Holguin Edward 
Published: February 2024

ABSTRACTObjectiveTo evaluate the association of multidrug-resistant bacteria (MDRB) and adverse clinical outcomes in patients with infected diabetic foot (IDF) in a Peruvian hospital.Materials and MethodsThis retrospective cohort study evaluated patients treated in the Diabetic Foot Unit of a General Hospital in Lima, Peru. MDRB was based on resistance to more than two pharmacological groups across six clinically significant genera. The primary outcome was death due to complications of the IDF and/or major amputation. Other outcomes included minor amputation, hospitalization, and a hospital stay longer than 14 days. Relative risks were estimated using Poisson regression for all outcomes.ResultsThe study included 192 IDF patients with a mean age of 59.9 years; 74% were males. A total of 80.8% exhibited MDRB. The primary outcome had an incidence rate of 23.2% and 5.4% in patients with and without MDRB, respectively (p = 0.01). After adjusting for sex, age, bone involvement, severe infection, ischemia, diabetes duration, and glycosylated hemoglobin, MDRB showed no association with the primary outcome (RR 3.29; 95% CI, 0.77 - 13.9), but did with hospitalization longer than 14 days (RR 1.43; 95% CI, 1.04 - 1.98).ConclusionsOur study found no association between MDRB and increased mortality and/or major amputation but did find a correlation with prolonged hospitalization. The high proportion of MDRB could limit the demonstration of the relationship. It is urgent to apply continuous evaluation of bacterial resistance, implement a rational plan for antibiotic use, and maintain biosafety to confront this threat.