bluuebunny/crossref_metadata_2025_split huggingface dataset:
Separating the wheat from the chaff: How to measure hospital quality in routine data?
Authors: Bilger Jana , Pletscher Mark , Müller Tobias 
Published: January 2024

AbstractObjectiveTo measure hospital quality based on routine data available in many health care systems including the United States, Germany, the United Kingdom, Scandinavia, and Switzerland.Data Sources and Study SettingWe use the Swiss Medical Statistics of Hospitals, an administrative hospital dataset of all inpatient stays in acute care hospitals in Switzerland for the years 2017–2019.Study DesignWe study hospital quality based on quality indicators used by leading agencies in five countries (the United States, the United Kingdom, Germany, Austria, and Switzerland) for two high‐volume elective procedures: inguinal hernia repair and hip replacement surgery. We assess how least absolute shrinkage and selection operator (LASSO), a supervised machine learning technique for variable selection, and Mundlak corrections that account for unobserved heterogeneity between hospitals can be used to improve risk adjustment and correct for imbalances in patient risks across hospitals.Data Collection/Extraction MethodsThe Swiss Federal Statistical Office collects annual data on all acute care inpatient stays including basic socio‐demographic patient attributes and case‐level diagnosis and procedure codes.Principal FindingsWe find that LASSO‐selected and Mundlak‐corrected hospital random effects logit models outperform common practice logistic regression models used for risk adjustment. Besides the more favorable statistical properties, they have superior in‐ and out‐of‐sample explanatory power. Moreover, we find that Mundlak‐corrected logits and the more complex LASSO‐selected models identify the same hospitals as high or low‐quality offering public health authorities a valuable alternative to standard logistic regression models. Our analysis shows that hospitals vary considerably in the quality they provide to patients.ConclusionWe find that routine hospital data can be used to measure clinically relevant quality indicators that help patients make informed hospital choices.
Developing, purchasing, implementing and monitoring AI tools in radiology: Practical considerations. A multi‐society statement from the ACR, CAR, ESR, RANZCR & RSNA
Authors: Brady Adrian P , Allen Bibb , Chong Jaron , Kotter Elmar , Kottler Nina , Mongan John , Oakden‐Rayner Lauren , Pinto dos Santos Daniel , Tang An , Wald Christoph , Slavotinek John 
Published: January 2024

SummaryArtificial Intelligence (AI) carries the potential for unprecedented disruption in radiology, with possible positive and negative consequences. The integration of AI in radiology holds the potential to revolutionize healthcare practices by advancing diagnosis, quantification, and management of multiple medical conditions. Nevertheless, the ever‐growing availability of AI tools in radiology highlights an increasing need to critically evaluate claims for its utility and to differentiate safe product offerings from potentially harmful, or fundamentally unhelpful ones. This multi‐society paper, presenting the views of Radiology Societies in the USA, Canada, Europe, Australia, and New Zealand, defines the potential practical problems and ethical issues surrounding the incorporation of AI into radiological practice. In addition to delineating the main points of concern that developers, regulators, and purchasers of AI tools should consider prior to their introduction into clinical practice, this statement also suggests methods to monitor their stability and safety in clinical use, and their suitability for possible autonomous function. This statement is intended to serve as a useful summary of the practical issues which should be considered by all parties involved in the development of radiology AI resources, and their implementation as clinical tools.
Implication of IZUMO2 in the cell‐in‐cell phenomenon: A potential therapeutic target for triple‐negative breast cancer
Authors: Higashi Toshiya , Saigo Chiemi , Chikaishi Wakana , Hayashi Hirokatsu , Hanamatsu Yuki , Futamura Manabu , Matsuhashi Nobuhisa , Takeuchi Tamotsu 
Published: January 2024

AbstractBackgroundTriple‐negative breast cancer (TNBC) is characterized by the loss of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. The aggressive clinicopathological features and resistance to currently available therapeutics of the disease warrant an urgent need for the development of novel alternate therapeutic options. We have previously reported adiponectin‐expressing regulatory T cells (A‐Tregs), which can induce apoptosis in TNBC through the cell‐in‐cell phenomenon. In this study, we aimed to elucidate the molecule that allows TNBC cells to engulf A‐Tregs.MethodsA monoclonal antibody, which repressed the engulfment of A‐Tregs by TNBC cells, was developed. Immunoprecipitation followed by mass spectrometry and small interfering RNAs‐mediated gene silencing was performed to characterize the antigen.ResultsWe successfully generated a monoclonal antibody, designated G1D7, which abrogated the engulfment of A‐Tregs by TNBC and subsequent A‐Treg‐mediated apoptosis. G1D7 detected the immunoglobulin‐like type I membrane protein IZUMO2, a molecule related to IZUMO1 that is essential for cell–cell membrane binding and fusion of sperm to oocyte.ConclusionThe findings highlight the importance of IZUMO2 on TNBC cells in facilitating the cell‐in‐cell phenomenon by A‐Tregs.
Improving pollen and nectar supply by identifying the red clover (Trifolium pratense) cultivars that attract most pollinators
Authors: Harris Ciaran , Ratnieks Francis L.W. 
Published: January 2024

Abstract
Red clover (Trifolium pratense) is an important legume in agriculture for fodder and building soil fertility. Red clover flowers are also a valuable pollen and nectar source for pollinators during bloom.
Farmers can choose among hundreds of commercially available red clover cultivars to plant, but the value of different cultivars for pollinators is not currently assessed or used as a recommendation criterion for farmers.
Here, we compared the numbers of pollinators on 20 red clover accessions (12 cultivars and 8 breeding lines) grown under management typical for silage production in the UK in 2022 and 2023. Other potentially pollinator‐friendly traits (inflorescence density, florets per inflorescence, floret length and nectar sugar production) were also measured to help determine which would be desirable to integrate into red clover breeding programmes.
Accessions varied greatly, 50‐fold, in numbers of pollinators attracted per plot and varied significantly in all other traits examined. Only inflorescence density was significantly positively related to insect abundance and species richness. These results suggest that breeding and using red clover cultivars that produce more inflorescences can increase the value of red clover to pollinators.
We note that data on insect visitation can be gathered easily and could be provided to farmers to help improve the value of red clover fields to pollinators.
Feasibility and acceptability of facilitated advance care planning in outpatient clinics: A qualitative study of health‐care professionals experience
Authors: Marshall Kate H. , Riddiford‐Harland Diane L. , Meller Anne E. , Kruger Vanessa , Kirsebom Marie , Tran Michael , Caplan Gideon A. , Naganathan Vasi , Cullen John , Gonski Peter , Zwar Nicholas , O'Keeffe Julie‐Ann , Krysinska Karolina , Rhee Joel J. 
Published: January 2024

AbstractObjectiveThis study sought to determine the feasibility and acceptability of a facilitated advance care planning (ACP) intervention implemented in outpatient clinics, as perceived by health‐care professionals (HCPs).MethodsData from seven focus groups (n = 27) and nine semi‐structured interviews with HCPs recruited as part of a pragmatic, randomised controlled trial (RCT) were analysed using qualitative descriptive methodology. Components of the intervention included HCP education and training, tools to assist HCPs with patient selection, hardcopy information, and ACP documentation, and specialised nurse‐facilitators to support HCPs to complete ACP conversations and documentation with patients and caregivers.ResultsHealth‐care professionals working in tertiary outpatient clinics perceived the facilitated ACP intervention as feasible and acceptable. Health‐care professionals reported a high level of satisfaction with key elements of the intervention, including the specialised education and training, screening and assessment procedures and ongoing support from the nurse‐facilitators. Health‐care professionals reported this training and support increased their confidence and ACP knowledge, leading to more frequent ACP discussions with patients and their families. Health‐care professionals noted their ability to conduct ACP screening and assessment in clinic was impeded by large clinical caseloads and patient‐related factors (e.g., dementia diagnoses, and emotional distress). Additional barriers to ACP implementation identified by HCPs included poor collaboration, constrained time and clinical space, undefined roles and standardised recording procedures for HCPs.ConclusionsFacilitated ACP intervention in outpatient clinics is perceived by HCPs as feasible and acceptable. Addressing barriers and tailoring implementation strategies may improve the delivery of ACP as part of tertiary outpatient care.
Impact of body fat location and volume on incisional hernia development and its outcomes following repair
Authors: Li Junsheng , Wu Lisheng , Shao Xiangyu 
Published: January 2024

AbstractBackgroundObesity is known to increase the likelihood of developing abdominal wall hernias, body mass index (BMI) alone does not provide detailed information about the amount and location of body fat. The aim of this study was to investigate the link between various adipose tissue parameters and the incidence of incisional hernias (IHs), as well as the outcomes of hernia repair.MethodsWe conducted a comprehensive review of the existing literature to examine the relationship between various body fat parameters and the occurrence of IHs after abdominal surgeries, as well as the outcomes of hernia repair.ResultsThirteen studies were included for analysis. Eight trials evaluated the IH development after abdominal surgeries via specific fat parameters, and five studies evaluated the postoperative outcomes after IH repair. The findings of this study suggest that an increase in visceral fat volume (VFA or VFV) and subcutaneous fat (SFA or SFV) are linked to a higher incidence of IHs after abdominal surgeries. Higher levels of VFV or VFA were associated with more challenging fascia closure and greater postoperative recurrence rates following repair. Whereas BMI did not demonstrate a significant association.ConclusionMeasuring visceral and subcutaneous fat composition preoperatively can be a useful tool for assessing the risk of IH, and is more reliable than BMI. Elevated levels of these fat parameters have been linked to increased recurrence of IH following hernia repair, as well as the use of complex surgical techniques during repair.
Body mass index z‐scores in the first 2 years of life were associated with adverse metabolic and anthropometric outcomes at 3 years of age
Authors: Jakobsen Mikala E. , Stentebjerg Louise L. , Tanvig Mette H. , Jørgensen Jan S. , Ovesen Per G. , Christesen Henrik T. , Jensen Dorte M. , Vinter Christina A. 
Published: January 2024

AbstractAimWe investigated associations between body mass index (BMI) z‐scores for children aged 0–2 years and the BMI z‐scores, body fat percentage and metabolic risk factors at 3 years of age.MethodsThis was a secondary analysis of the Lifestyle in Pregnancy and Offspring randomised controlled trial, carried out at two university hospitals in Denmark. It comprised 149 mothers with BMI ≥30 kg/m2 who did or did not receive a lifestyle intervention during pregnancy and a reference group of 97 mothers with normal‐weight, with follow‐up of their 3‐year‐old offspring. The children in these three groups were pooled for the data analyses, due to similar characteristics between groups. The BMI z‐scores were calculated at 5 weeks, 5 months and 1, 2 and 3 years, using Danish reference groups. Their anthropometrics and metabolic outcomes were examined at 3 years of age.ResultsBMI z‐scores at 5 months to 2 years were associated with BMI z‐scores and body fat percentage at 3 years of age and BMI z‐scores were not associated with metabolic risk factors at 3 years.ConclusionBMI z‐scores from 5 weeks of age were associated with adverse anthropometric outcomes but not with metabolic risk factors at 3 years of age.
Progressive, multi‐organ, and multi‐layered nature of cancer cachexia
Authors: Nakamura Yuki , Saldajeno Don Pietro , Kawaguchi Kosuke , Kawaoka Shinpei 
Published: January 2024

AbstractCancer cachexia is a complex, multifaceted condition that negatively impacts the health, treatment efficacy, and economic status of cancer patients. The management of cancer cachexia is an essential clinical need. Cancer cachexia is currently defined mainly according to the severity of weight loss and sarcopenia (i.e., macrosymptoms). However, such macrosymptoms may be insufficient to give clinicians clues on how to manage this condition as these symptoms appear at the late stage of cancer. We need to understand earlier events during the progression of cancer cachexia so as not to miss a clinical opportunity to control this complex syndrome. Recent research indicates that cancer‐induced changes in the host are much wider than previously recognized, including disruption of liver function and the immune system. Furthermore, such changes are observed before the occurrence of visible distant metastases (i.e., in early, localized cancers). In light of these findings, we propose to expand the definition of cancer cachexia to include all cancer‐induced changes to host physiology, including changes caused by early, localized cancers. This new definition of cancer cachexia can provide a new perspective on this topic, which can stimulate the research and development of novel cancer cachexia therapies.
Comprehensive analysis of clinical and biological features in Parkinson's disease associated with the LRRK2 G2019S mutation: Data from the PPMI study
Authors: Sun Xiaohui , Dou Kaixin , Xue Li , Xie Yijie , Yang Yong , Xie Anmu 
Published: January 2024

AbstractThe Parkinson's Progression Marker Initiative (PPMI) aims to identify biomarkers for Parkinson's disease (PD) risk, onset, and progression. This study focuses on the G2019S missense mutation in the LRRK2 gene, which is associated with hereditary and sporadic PD. Utilizing data from the PPMI database, we conducted an analysis of baseline clinical characteristics, as well as serum and cerebrospinal fluid levels in two groups: patients with PD with the G2019S mutation (PD + G2019S) and patients with PD without the mutation (PD‐G2019S). Multiple linear regression and longitudinal analysis were performed, controlling for confounding factors. Compared to the PD‐G2019S group, the PD + G2019S group showed more obvious initial motor dysfunction—higher baseline Movement Disorder Society‐Sponsored Revision of the Unified Parkinson Disease Rating Scale (MDS‐UPDRS) scores (false discovery rate [FDR]‐adjusted p < 0.001), but progressed more slowly. Mechanism of Coordinated Access and activities of daily living (ADL) scores were lower at baseline (FDR‐adjusted p < 0.001), whereas Scales for Outcomes of Parkinson's Disease (SCOPA)‐Thermoregulatory (FDR‐adjusted p = 0.015) scores were higher, emphasizing the increase of non‐motor symptoms associated with LRRK2‐G2019S mutation. During the follow‐up period, the motor and non‐motor symptoms changed dynamically with time, and there were longitudinal differences in the scores of MDS‐UPDRS (FDR‐adjusted PI = 0.013, PII = 0.008, PIV < 0.001), Questionnaire for Impulsive‐Compulsive Disorders in Parkinson's Disease (FDR‐adjusted p = 0.027), SCOPA‐Thermoregulatory (FDR‐adjusted p = 0.021), and ADL (FDR‐adjusted p = 0.027) scale scores. PD associated with the LRRK2 G2019S mutation demonstrated more severe symptoms at baseline but slower progression. Motor complications and thermoregulatory disorders were more pronounced.
Cholinergic modulation of rearing in rats performing a spatial memory task
Authors: Cassity Skylar , Choi Irene Jungyeon , Gregory Billy Howard , Igbasanmi Adeleke Malik , Bickford Sarah Cristi , Moore Kiara Tyanni , Seraiah Anna Elisabeth , Layfield Dylan , Newman Ehren Lee 
Published: January 2024

AbstractSpatial memory encoding depends in part on cholinergic modulation. How acetylcholine supports spatial memory encoding is not well understood. Prior studies indicate that acetylcholine release is correlated with exploration, including epochs of rearing onto hind legs. Here, to test whether elevated cholinergic tone increases the probability of rearing, we tracked rearing frequency and duration while optogenetically modulating the activity of choline acetyltransferase containing (i.e., acetylcholine producing) neurons of the medial septum in rats performing a spatial working memory task (n = 17 rats). The cholinergic neurons were optogenetically inhibited using halorhodopsin for the duration that rats occupied two of the four open arms during the study phase of an 8‐arm radial arm maze win‐shift task. Comparing rats' behaviour in the two arm types showed that rearing frequency was not changed, but the average duration of rearing epochs became significantly longer. This effect on rearing was observed during optogenetic inhibition but not during sham inhibition or in rats that received infusions of a fluorescent reporter virus (i.e., without halorhodopsin; n = 6 rats). Optogenetic inhibition of cholinergic neurons during the pretrial waiting phase had no significant effect on rearing, indicating a context‐specificity of the observed effects. These results are significant in that they indicate that cholinergic neuron activity in the medial septum is correlated with rearing not because it motivates an exploratory state but because it contributes to the processing of information acquired while rearing.
Remote seizures and drug‐resistant epilepsy after a first status epilepticus in adults
Authors: Orlandi Niccolò , Giovannini Giada , Cioclu Maria Cristina , Biagioli Niccolò , Madrassi Laura , Vaudano Anna Elisabetta , Pugnaghi Matteo , Lattanzi Simona , Meletti Stefano 
Published: January 2024

AbstractBackground and purposeLong‐term consequences after status epilepticus (SE) represent an unsettled issue. We investigated the incidence of remote unprovoked seizures (RS) and drug‐resistant epilepsy (DRE) in a cohort of first‐ever SE survivors.MethodsA retrospective, observational, and monocentric study was conducted on adult patients (age ≥ 14 years) with first SE who were consecutively admitted to the Modena Academic Hospital, Italy (September 2013–March 2022). Kaplan–Meier survival analyses were used to calculate the probability of seizure freedom following the index event, whereas Cox proportional hazard regression models were used to identify outcome predictors.ResultsA total of 279 patients were included, 57 of whom (20.4%) developed RS (mean follow‐up = 32.4 months). Cumulative probability of seizure freedom was 85%, 78%, and 68% respectively at 12 months, 2 years, and 5 years. In 45 of 57 patients (81%), the first relapse occurred within 2 years after SE. The risk of RS was higher in the case of structural brain damage (hazard ratio [HR] = 2.1, 95% confidence interval [CI] = 1.06–4.01), progressive symptomatic etiology (HR = 2.7, 95% CI = 1.44–5.16), and occurrence of nonconvulsive evolution in the semiological sequence of SE (HR = 2.9, 95% CI = 1.37–6.37). Eighteen of 57 patients (32%) developed DRE; the risk was higher in the case of super‐refractory (p = 0.006) and non‐convulsive SE evolution (p = 0.008).ConclusionsThe overall risk of RS was moderate, temporally confined within 2 years after the index event, and driven by specific etiologies and SE semiology. Treatment super‐refractoriness and non‐convulsive SE evolution were associated with DRE development.
An efficient hybrid extreme learning machine and evolutionary framework with applications for medical diagnosis
Authors: Al Bataineh Ali , Jalali Seyed Mohammad Jafar , Mousavirad Seyed Jalaleddin , Yazdani Amirmehdi , Islam Syed Mohammed Shamsul , Khosravi Abbas 
Published: January 2024

AbstractIntegrating machine learning techniques into medical diagnostic systems holds great promise for enhancing disease identification and treatment. Among the various options for training such systems, the extreme learning machine (ELM) stands out due to its rapid learning capability and computational efficiency. However, the random selection of input weights and hidden neuron biases in the ELM can lead to suboptimal performance. To address this issue, our study introduces a novel approach called modified Harris hawks optimizer (MHHO) to optimize these parameters in ELM for medical classification tasks. By applying the MHHO‐based method to seven medical datasets, our experimental results demonstrate its superiority over seven other evolutionary‐based ELM trainer models. The findings strongly suggest that the MHHO approach can serve as a valuable tool for enhancing the performance of ELM in medical diagnosis.
“At the end of the day, someone done lost their child”: A mixed methods analysis of Black families' experiences of the sociopolitical climate
Authors: Osborne Kimberly R. , Morton LaRen B. , Anderson Leslie A. , O’Brien Caughy Margaret 
Published: January 2024

AbstractHow Black Americans in the United States (U.S.) make sense of a sociopolitical climate marked by racist imagery, tensions, and police violence is important to understand given the numerously documented detrimental effects of racism‐related stress on the well‐being of Black parents and children. Informed by Racism‐Related Stress Theory, the current study employed a convergent parallel mixed methods design to better understand the ways racism‐related stressors in the sociopolitical climate impacted the daily lives and mental health of a sample of Black families with low income. Seventy‐eight Black American preadolescents (Mage = 11.0; 43.6% girls) and their parents (79% mothers; 76% living below the U.S. federal poverty level [FPL]) from the southwestern U.S. reported their symptoms of depression and how they had been affected by racial stressors in the sociopolitical climate between Fall 2018 and Summer 2019. A nested sample of 10 parents (80% mothers; 80% living below the FPL) from the quantitative sample also participated in a semi‐structured interview. Meta‐inferences across methods were drawn pertaining to the influence of child gender on parents' interpretation of effects for children, the toll racism‐related stress in the sociopolitical climate takes on Black families, and the transferal of effects on parents to children through parenting and parental depressive symptoms. Findings spotlight the need for policies and family‐centered programming that address the racism‐related stress faced by many Black youth and their families. Providing families with opportunities and tools that can potentially mitigate harmful effects and foster empowerment could promote positive and lasting change.