bluuebunny/crossref_metadata_2025_split huggingface dataset:
Context-Based Human Influence and Causal Responsibility for Assisted Decision-Making
Authors: Saad Yossef , Meyer Joachim 
Published: February 2025

Objective The impact of the context in which automation is introduced to a decision-making system was analyzed theoretically and empirically. Background Previous work dealt with causality and responsibility in human-automation systems without considering the effects of how the automation’s role is presented to users. Methods An existing analytical model for predicting the human contribution to outcomes was adapted to accommodate the context of automation. An aided signal detection experiment with 400 participants was conducted to assess the correspondence of observed behavior to model predictions. Results The context in which the automation’s role is presented affected users’ tendency to follow its advice. When automation made decisions, and users only supervised it, they tended to contribute less to the outcome than in systems where the automation had an advisory capacity. The adapted theoretical model for human contribution was generally aligned with participants’ behavior. Conclusion The specific way automation is integrated into a system affects its use and the perceptions of user involvement, possibly altering overall system performance. Application The research can help design systems with automation-assisted decision-making and provide information on regulatory requirements and operational processes for such systems.
Prediction of postoperative disease-free survival in colorectal cancer patients using CT radiomics nomogram: a multicenter study
Authors: Xu Guodong , Feng Feng , Cui Yanfen , Fu Yigang , Xiao Yong , Chen Wang , Li Manman 
Published: February 2025

Background Radiomics analysis is widely used to assess tumor prognosis. Purpose To explore the value of computed tomography (CT) radiomics nomogram in predicting disease-free survival (DFS) of patients with colorectal cancer (CRC) after operation. Material and Methods A total of 522 CRC patients from three centers were retrospectively included. Radiomics features were extracted from CT images, and the least absolute shrinkage and selection operator Cox regression algorithm was employed to select radiomics features. Clinical risk factors associated with DFS were selected through univariate and multivariate Cox regression analysis to build the clinical model. A predictive nomogram was developed by amalgamating pertinent clinical risk factors and radiomics features. The predictive performance of the nomogram was evaluated using the C-index, calibration curve, and decision curve. DFS probabilities were estimated using the Kaplan–Meier method. Results Integrating the retained eight radiomics features and three clinical risk factors (pathological N stage, microsatellite instability, perineural invasion), a nomogram was constructed. The C-index for the nomogram were 0.819 (95% CI=0.794–0.844), 0.782 (95% CI=0.740–0.824), 0.786 (95% CI=0.753–0.819), and 0.803 (95% CI=0.765–0.841) in the training set, internal validation set, external validation set 1, and external validation set 2, respectively. The calibration curves demonstrated a favorable congruence between the predicted and observed values as depicted by the nomogram. The decision curve analysis underscored that the nomogram yielded a heightened clinical net benefit. Conclusion The constructed radiomics nomogram, amalgamating the radiomics features and clinical risk factors, exhibited commendable performance in the individualized prediction of postoperative DFS in CRC patients.
A Retrospective Study Evaluating the Safety and Clinical Impact of High Dose (6.75 grams) Piperacillin-Tazobactam Dosing in Critically Ill Obese Patients for Pneumonia
Authors: Tran Christina X. , Crotty Matthew P. , Akins Ronda L. 
Published: February 2025

Background: Piperacillin-tazobactam (PTZ) demonstrates time-dependent bactericidal activity, potentially increasing the need for higher dosing in obese and critically ill patients. However, limited information is available on the safety of higher dosing strategies. Objective: To evaluate the safety and clinical impact of high dose 6.75 g IV PTZ for the treatment of pneumonia in critically ill, obese (≥120 kg) patients vs standard dose 4.5 g IV PTZ. Methods: Retrospective, cohort study, multicenter in health-system consisting of four acute-care teaching hospitals. Adult patients weighing at least 120 kg on PTZ for pneumonia in the intensive care unit (ICU) from January 2013 to September 2018 were included. The primary outcome of the study was acute nephrotoxicity defined as initiation of renal replacement therapy and/or serum creatinine increase within 48 hours of last PTZ dose. Secondary outcomes included thrombocytopenia, 14-day all-cause mortality, and ICU length of stay (LOS). Results: One hundred thirty-six patients were included with 52 and 84 in 4.5 g PTZ and 6.75 g PTZ respectively. The rate of acute nephrotoxicity was comparable between cohorts (50% 4.5 g vs 40.5% 6.75 g, P = 0.277). High dose PTZ was not independently associated with acute nephrotoxicity after control for selected confounders. All secondary outcomes were similar. Concomitant vancomycin and calculated supratherapeutic vancomycin area under curve were not independently associated with increased nephrotoxicity. Conclusions: High dose PTZ was not associated with increased acute nephrotoxicity, thrombocytopenia, 14-day all-cause mortality, or ICU LOS. Additionally, more robust trials are needed to fully assess the clinical impact of 6.75 g PTZ dosing for critically ill, obese patients, for pneumonia.
Application of enhanced recovery after surgery in pediatric patients with obstructive sleep apnea-hypopnea syndrome
Authors: Qi Xiang , Yang Changjun , Huang Wei , Han Wei , Li Yujie 
Published: February 2025

Background Enhanced Recovery After Surgery (ERAS) has demonstrated effectiveness in accelerating recovery and reducing complications across surgical fields, with limited application in Ear-Nose-Throat surgeries. Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS), a prevalent condition affecting pediatric patients, calls for innovative management due to its impact on health and the need for surgical interventions like tonsillectomy. Objective The present study aimed to investigate the efficacy of ERAS in pediatric patients with OSAHS. Methods Review and analyze 1100 cases of pediatric patients with OSAHS who underwent plasma-coblation tonsillectomy and adenoidectomy using nasal endoscopy from June 2016 to June 2022 in our hospital. Among these cases, a total of 564 patients were managed according to ERAS theory, while 536 patients were treated with classical theory. The incidence of preoperative discomfort, postoperative pain, bleeding, and other complications between the two groups were compared. Results ERAS group showed comparable preoperative-discomfort rates to the control ( P = 0.799). However, ERAS patients exhibited significantly lower pain scores at 24-, 48-, and 72-h post-operation ( P < 0.05). Mental state scores were similar between ERAS and control 4 h pre-surgery ( P > 0.05), but notably lower in ERAS at 30 min pre-op and 6-, 12-, and 24-h post-operation ( P < 0.05). ERAS had lower complication rates and intra/postoperative bleeding, quicker ambulation/oral intake, and shorter hospital stays than control ( P < 0.05). Conclusion ERAS management in patients with OSAHS resulted in notable reductions in postoperative pain and incidence of complications, along with improved postoperative recovery and shorter hospital stays.
Evaluation of the ED MHAOD Hub at St Vincent’s hospital
Authors: Akhlaghi Hamed , Mullins Kelly , Freeman Sam , Vasan Shradha (Sherry) , Moon Greta , Bonomo Yvonne , Karro Jonathan 
Published: February 2025

Introduction In response to the 2021 Royal Commission into Victoria’s Mental Health System, the Victorian government established six purpose-built Mental Health Alcohol and Other Drug (MHAOD) emergency department (ED) Hubs. This study evaluates the MHAOD Hub at St Vincent’s Hospital Melbourne (SVHM), which opened in March 2022 as metropolitan Melbourne’s first multidisciplinary Mental Health and Drug or Alcohol Hub integrated into the St Vincent’s Emergency Department. Methods This retrospective analysis covers patient admissions to the MHAOD Hub from March 2022 to June 2024, documenting demographics, clinical characteristics and outcomes. Results 8553 MHAOD admissions were recorded. The Hub admitted a high proportion of vulnerable populations, including 8.4% Aboriginal and/or Torres Strait Islanders and 36.5% homeless individuals. 76.5% of presentations to the Hub were categorised as Australasian Triage Category (ATS) 1, 2 or 3. The most common discharge diagnosis was alcohol-related diagnosis (18.95%) followed by suicidality (14.71%) and psychosis (5.66%). 17.1% of presentations were admitted to the psychiatric ward. Conclusion This study highlights the effectiveness of MHAOD Hub care in improving timely access to care and addressing the needs of vulnerable populations. Future research should focus on qualitative assessments to capture the nuanced patient and staff experiences and further evaluate long-term outcomes.
Iron chelation by oral deferoxamine treatment decreased brain iron and iron signaling proteins
Authors: Thorwald Max A , Sta Maria Naomi S , Chakhoyan Ararat , O’Day Peggy A , Jacobs Russell E , Zlokovic Berislav , Finch Caleb E 
Published: February 2025

Background Deferoxamine (DFO) and other iron chelators are clinically used for cancer and stroke. They may also be useful for Alzheimer's disease (AD) to diminish iron from microbleeds. DFO may also stimulate antioxidant membrane repair which is impaired during AD. DFO and other chelators do enter the brain despite some contrary reports. Objective Low dose, oral DFO was given in lab chow to wildtype (WT) C57BL/6 mice to evaluate potential impact on iron levels, iron-signaling and storage proteins, and amyloid-β protein precursor (AβPP) and processing enzymes. Young WT mice do not have microbleeds or disrupted blood-brain barrier of AD mice. Methods Iron was measured by MRI and chemically after two weeks of dietary DFO. Cerebral cortex was examined for changes in iron metabolism, antioxidant signaling, and AβPP processing by western blot. Results DFO decreased brain iron 18% ( p < 0.01) estimated by R2 MRI and decreased seven major proteins that mediate iron metabolism by at least 25%. The iron storage proteins ferritin light and heavy chain decreased by at least 30%. AβPP and secretase enzymes also decreased by 30%. Conclusions WT mice respond to DFO with decreased AβPP, amyloid processing enzymes, and antioxidant repair. Potential DFO treatment for early-stage AD by DFO should consider the benefits of lowered AβPP and secretase enzymes.
Longitudinal and concurrent C-reactive protein and diet associations with cognitive function in the population-based Tromsø study
Authors: Iakunchykova Olena , Schirmer Henrik , Roe James M , Sørensen Øystein , Wilsgaard Tom , Hopstock Laila A , Eggen Anne Elise , Benros Michael E , Chen Chi-Hua , Wang Yunpeng 
Published: February 2025

Background Immune dysregulation has been implicated in Alzheimer's disease; however, precise mechanisms and timing have not been established. Objective To investigate the concurrent and longitudinal associations of serum C-reactive protein (CRP) and dietary inflammatory index (DII) with cognitive decline as observed in Alzheimer's disease. Methods The study was based on 7613 individuals who participated in Tromsø6 (2007–2008) and Tromsø7 (2015–2016). We analyzed the relationship between CRP levels, DII, and cognitive function cross-sectionally using linear regression. We used mediation analysis to examine if CRP mediates the effects of DII on cognitive function. Further, we related baseline serum CRP to cognitive function and to change in cognitive function after 7 years of follow up. We used linear mixed models to relate changes in CRP levels to changes in cognitive function measured at two time points with 7 years apart. Results Both CRP level and DII were cross-sectionally inversely associated with cognitive function (psychomotor speed, executive function). There was no prospective relationship between CRP level at baseline and cognitive function after 7 years of follow up. Increase in CRP levels was associated with decrease in cognitive function (psychomotor speed, executive function, and verbal memory) observed between two measurements 7 years apart. The mediation model did not show convincing evidence of a mediating effect of CRP in the association between diet and cognitive function. Conclusions After comprehensive analysis of associations between CRP, DII and cognitive function, we conclude that CRP is likely to reflect the changes in inflammatory environment occurring in parallel with cognitive decline.
The use of machine learning based models to predict the severity of community acquired pneumonia in hospitalised patients: A systematic review
Authors: Lythgoe Caitlin , Hamilton David Oliver , Johnston Brian W , Ortega-Martorell Sandra , Olier Ivan , Welters Ingeborg 
Published: February 2025

Background: Community acquired pneumonia (CAP) is a common cause of hospital admission. CAP carries significant risk of adverse outcomes including organ dysfunction, intensive care unit (ICU) admission and death. Earlier admission to ICU for those with severe CAP is associated with better outcomes. Traditional prediction models are used in clinical practice to predict the severity of CAP. However, accuracy of predicting severity may be improved by using machine learning (ML) based models with added advantages of automation and speed. This systematic review evaluates the evidence base of ML-prediction tools in predicting CAP severity. Methods: MEDLINE, EMBASE and PubMed were systematically searched for studies that used ML-based models to predict mortality and/or ICU admission in CAP patients, where a performance metric was reported. Results: 11 papers including a total of 351,365 CAP patients were included. All papers predicted severity and four predicted ICU admission. Most papers applied multiple ML algorithms to datasets and derived area under the receiver operator characteristic curve (AUROC) of 0.98 at best performance and 0.57 at worst, with a mixed performance against traditional prediction tools. Conclusion: Although ML models showed good performance at predicting CAP severity, the variables selected for inclusion in each model varied significantly which limited comparisons between models and there was a lack of reproducible data, limiting validity. Future research should focus on validating ML predication models in multiple cohorts to derive robust, reproducible performance measures, and to demonstrate a benefit in terms of patient outcomes and resource use.
Gender Difference in Cardiology Publications in South Asia
Authors: Sharma Akash , Varghese Anila , Shalini  , Venkatesh U. 
Published: February 2025

Introduction Women are still underrepresented in prestigious author positions in medical publications. This study was done to evaluate gender differences in the first authorship of cardiology-related publications in South Asia over the past two decades. Methodology This is a cross-sectional study, and we strictly followed the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. An electronic search was conducted in PubMed on January 15, 2023, using specific MeSH terms and keywords for articles published from 2002 to 2022. The easyPubMed package of R statistical software was used to retrieve articles. The gender of the author was determined by first name. We used the www.genderapi.io and also did a manual search of the public profile of authors to determine the gender. Mann–Kendall’s trend test was used to know the trend for gender disparities. Results A total of 5,105 publications are included in the final analysis. The study found that a total of 1,470 (28.8%) studies have female first authors, and 3,632 (71.1%) have male first authors. According to the countries, 29 (31.5%) in Afghanistan, 104 (24.1%) in Bangladesh, 2 (33.3%) in Bhutan, 879 (27.8%) in India, 1 (25%) in Maldives, 84 (28.9%) in Nepal, 322 (33.4%) in Pakistan, and 49 (33.1%) in Sri Lanka publications have female first authors. It was found that from 2002 to 2022, there has been a significant increase in female first authors. Only 16.3% of publications had a female first author in 2002, which increased to 32.9% in 2022. Conclusion Gender disparities in the authorship of cardiology research publications persist despite the declining trend.
Epidemiology of clinically significant migraine in Israel: a retrospective database study
Authors: Shifrin A. , Domany E. , Tirosh M. , Davidovici D. , Vinker S. , Forschner I. , Israel A. 
Published: February 2025

Abstract

Background
Epidemiological studies on migraine are valuable for tracking disease trends, identifying risk factors, and informing treatment strategies. This study assessed the prevalence and annual incidence of clinically significant migraine in Israel from 2017 to 2022, with analyses stratified by age, sex, socioeconomic status, and district. Additionally, we compared relevant characteristics between adult migraine and non-migraine members of Leumit Healthcare Services (LHS), a national health provider in Israel.

Methods
This retrospective study used LHS electronic health records to evaluate migraine prevalence and annual incidence from 2017 to 2022 among adult LHS members. Clinically significant migraine patients were identified using stringent criteria, including repeated diagnostic codes for migraine, confirmation by a neurologist, or the use of migraine-specific therapies. Each migraine patient was matched 1:1 with a control individual of similar age, sex, socioeconomic status, and ethnic background.

Results
The prevalence of clinically significant migraine increased from 4.5% in 2017 to 5.2% in 2022, with significantly higher rates in women compared to men (8% vs. 2.4% in 2022). The mean age of migraine patients was 46.8 years in 2022. The annual incidence of migraine in 2022 was 43 per 10,000 individuals over 18, with approximately 75% of new cases occurring in women, with a mean age of 36.5 years. The annual incidence of migraine slightly decreased over the period. Approximately two-thirds of new patients were diagnosed by neurologists, with only 19% diagnosed by family physicians. Compared to a matched control population, migraine patients showed a higher prevalence of low body mass index (BMI) and higher diastolic blood pressure (BP). Additionally, distinct differences in laboratory findings were observed among migraine patients, notably lower glucose and hemoglobin A1c levels, lower rate of microalbuminuria, with higher hemoglobin, which may be associated with migraine pathophysiology.

Conclusion
This study provides a detailed epidemiological and clinical profile of patients with clinically significant migraine in LHS from 2017 to 2022. Notable trends include higher rates of migraine among patients with lower BMI, higher diastolic BP, lower glucose, and higher hemoglobin, suggesting potential modifiable risk factors.
Oakland score to identify low-risk patients with lower gastrointestinal bleeding performs well among emergency department patients
Authors: DiLena Daniel D. , Bouvet Sean C. , Somers Madeline J. , Merchant Maqdooda A. , Levin Theodore R. , Rauchwerger Adina S. , Sax Dana R. 
Published: February 2025

Abstract

Background
The Oakland Score predicts risk of 30-day adverse events among hospitalized patients with lower gastrointestinal bleeding (LGIB) possibly identifying patients who may be safe for discharge. The Oakland Score has not been studied among emergency department (ED) patients with LGIB. The Oakland Score composite outcome includes re-bleeding, defined as additional blood transfusion requirements and/or a further decrease in hematocrit (Hct) >/= 20% after 24 h in clinical stability; red blood cell transfusion; therapeutic intervention to control bleeding, including surgery, mesenteric embolization, or endoscopic hemostasis; in-hospital death, all cause; and re-admission with further LGIB within 28 days. Prediction variables include age, sex, previous LGIB admission, systolic blood pressure, heart rate, and hemoglobin concentration, and scores range from 0 to 35 points, with higher scores indicating greater risk.

Methods
Retrospective cohort study of adult (≥ 18 years old) patients with a primary ED diagnosis of LGIB across 21 EDs from March 1st, 2018, through March 1st, 2020. We excluded patients who were more likely to have upper gastrointestinal bleeding (esophago-gastroduodenoscopy without LGIB evaluation), patients who left against medical advice or prior to ED provider evaluation, ED patients without active health plan membership, and patients with incomplete Oakland Score variables. We assessed predictive accuracy by reporting the area under the receiver operator curve (AUROC) and sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios at multiple clinically relevant thresholds.

Results
We identified 8,283 patients with LGIB, 52% were female, mean age was 68, 49% were non-White, and 27% had an adverse event. The AUROC for predicting an adverse event was 0.85 (95% CI 0.84–0.86). There were 1,358 patients with an Oakland Score of </=8; 4.9% had an adverse event, and sensitivity of the Oakland Score at this threshold was 97% (95% CI 96%−98%).

Conclusion
The Oakland Score had high predictive accuracy among ED patients with LGIB. Prospective evaluation is needed to understand if the risk score could augment ED decision-making and improve outcomes and resource utilization.