bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and Management of Patients with Fulminant Myocarditis
Authors: D’Ettore Nicoletta , Eghbalzadeh Kaveh , Oezkur Mehmet , Bertoldi Letizia , Bossard Matthias , Pappalardo Federico 
Published: February 2025

Abstract
Fulminant myocarditis (FM) is a progressive and severe form of acute myocarditis, complicated by cardiogenic shock. The clinical presentation and etiologies of FM is often heterogeneous, making it difficult to diagnose. Irrespective of how FM presents, it rapidly evolves to hemodynamic deterioration and requires prompt treatment to stabilize. As such, the use of mechanical circulatory support (MCS) devices has emerged as a critical intervention to achieve hemodynamic support, early unloading, systemic perfusion and to prevent multiorgan dysfunction in patients with FM. Although scientific societies have proposed recommendations and management pathways, due to the heterogeneity in FM there remains a lack of clarity in the diagnostic pathway and selection of MCS device for this young patient population. This review provides an updated and integrated overview of the diagnostic flow and important clinical considerations when managing patients with FM.
Deep learning analysis of Google Street View to assess residential built environment and cardiovascular risk in a Midwestern US retrospective cohort
Authors: Chen Zhuo , Salerno Pedro R V O , Dazard Jean-Eudes , Makhlouf Mohamed He , Deo Salil , Rajagopalan Sanjay , Al-Kindi Sadeer 
Published: February 2025

Abstract

Aims
Cardiovascular disease (CVD) is a leading global cause of mortality. Environmental factors are increasingly recognized as influential determinants of cardiovascular health. Nevertheless, a finer-grained understanding of the effects of the built environment remains crucial for comprehending CVD. We sought to investigate the relationship between built environment features, including residential greenspace and sidewalks, and cardiovascular risk using street-level imagery and deep learning techniques.

Methods and results
This study employed Google Street View (GSV) imagery and deep learning techniques to analyse built environment features around residences in relation to major adverse cardiovascular events (MACE) risk. Data from a Northeast Ohio cohort were utilized. Various covariates, including socioeconomic and environmental factors, were incorporated in Cox proportional hazards models. Of 49 887 individuals included, 2083 experienced MACE over a median follow-up of 26.86 months. Higher tree–sky index and sidewalk presence were associated with reduced MACE risk [hazard ratio (HR) = 0.95, 95% confidence interval (CI): 0.91–0.99, and HR = 0.91, 95% CI: 0.87–0.96, respectively], even after adjusting for demographic, socioeconomic, environmental, and clinical factors.

Conclusion
Visible vertical greenspace and sidewalks, as discerned from street-level images using deep learning, demonstrated potential associations with cardiovascular risk. This innovative approach highlights the potential of deep learning to analyse built environments at scale, offering new avenues for public health research. Future research is needed to validate these associations and better understand the underlying mechanisms.
The perspectives and experiences of older LGBTI+ adults about long-term care: A qualitative systematic review and meta-synthesis
Authors: McMullen-Roach Sarah , Kumar Saravana , Inacio Maria , Murray Carolyn 
Published: February 2025

Abstract

Background and Objectives
LGBTI+ older adults have experienced historical and systemic discrimination. Such discrimination has led to health inequities and avoidance of services. As LGBTI+ people age, they may need to access services, but information about this experience is situated in small scale qualitative studies. As such this, meta-synthesis aimed to bring together the perspectives and experiences of LGBTI+ older adults in literature about engagement with long-term care services.

Research Design and Methods
A meta-synthesis with a meta-ethnographic approach was conducted with qualitative published and grey literature. Findings were then confirmed through community consultation conducted with LGBTI+ adults aged 50+

Results
A total of 55 qualitative studies were included in the meta synthesis. LGBTI+ older adults’ perspectives and experiences were synthesised into 4 key themes: 1) We see it as being heterosexualised, 2) With no-one there to guard us, 3) You have to hide 90% of yourself, 4) I don’t want a different service, I want a good service.

Discussion and Implications
Overarching heterosexism, experiences of discrimination, and complexities in maintaining identity all contributed to a predominately negative experience for LGBTI+ adults when engaging with long-term care. These experiences were found to align with ‘minority stress’ theory. Our review found a multilevel approach that included staff education, LGBTI+ affirmative care and signs and symbols of inclusivity was required to reduce the impact of minority stress experienced by LGBTI+ older adults and increased their engagement in long-term care services.
Ordinary Men or Ideological Executioners?: Finnish SS Volunteers and the Atrocities on the Eastern Front
Authors: Swanström André 
Published: February 2025

Abstract
In 1941, approximately twelve hundred Finns volunteered for the Waffen-SS. They were placed in the multinational Wiking division. Some Finnish volunteers participated in mass executions and other atrocities. This article examines in depth the motivations and ideological influences behind the atrocities that Finnish SS volunteers perpetrated during the Holocaust. To this end, it examines and applies to this case study Christopher Browning’s “Ordinary Men” theory, which posits that perpetrators were often ordinary men motivated by peer pressure and obedience, and Daniel Goldhagen’s “Willing Executioners” theory, which maintains that antisemitism was the primary driving factor in the Holocaust. Ultimately, the evidence shows that Finnish SS men involved in atrocities were among the most ideologically committed to National Socialism and antisemitism. They came from a core group of recruits that were selected and given preferential treatment during the first week of recruitment, and for them, antisemitism and National Socialist ideology were significant motivating factors. While some volunteers refused to participate in atrocities, the majority of those who committed crimes were part of the ideologically committed core group. The study integrates multiple theoretical perspectives to emphasize the role of antisemitism and ideology in driving war crimes.
Citrus genomes: Past, present and future
Authors: Nakandala Upuli , Furtado Agnelo , Henry Robert J 
Published: February 2025

Abstract
Over the past decade, genome sequencing, and assembly approaches have been greatly improved resulting in the assembly of many genomes for citrus including wild, domesticated and citrus related genomes. Improvements in technologies have led to assembled genomes with higher completeness, contiguity, quality and accuracy that have greatly facilitated annotation and analysis. This review summarizes the evolution of the sequencing, assembly and annotation technologies leading to citrus genomes over the past 11 years, a comprehensive evaluation of their quality, contiguity, and completeness, and their major findings and applications. Of the 50 genomes now available, 35 have been assembled to chromosome level, 15 to draft level, and 14 were haplotype-resolved assemblies. To date there have been four pangenome wide studies for citrus. The very recent genomes assembled with long read sequencing have achieved more than 99% and more than 98% assembly and annotation completeness (BUSCO) respectively. However, some early genomes are not of the same high quality as more recently sequenced genomes and would benefit from re-sequencing. A more comprehensive pan genome based upon of a larger set of species and genotypes at assembled at the haplotype level would allow genomics to deliver the maximum benefits for citrus improvement and research.
Multi-channel price and service level competition with the impact of coordination contracts
Authors: Roy B , Das S 
Published: February 2025

Abstract
In this paper, we consider a two-echelon supply chain model with a single manufacturer and multiple retailers handling a single product. The demand at the retailers’ end is dependent on the retail price and service level of the retailer. The retailers compete with each other over the retail price and the service level. At first, we study the centralized and the decentralized systems, and then try to coordinate the decentralized system with several contracts. We use the service cost sharing contract, retail fixed markup (RFM) contract and RFM plus service cost sharing contract in our model. Our study establishes that among the aforementioned contracts, the RFM strategy yields the most profit and come out as the most beneficial for all parties involved. Finally, we validate the proposed model with a numerical example. Through sensitivity analysis, we illustrate the impact of different model parameters on the optimal decisions.
Imaging Antigen Processing and Presentation in Cancer
Authors: Lau Doreen , Elliott Tim 
Published: February 2025

Abstract

Introduction
Antigen processing and presentation are vital processes of the adaptive immunity. These processes involve a series of intracellular and extracellular events, including the enzymology within cells during antigen processing, the loading and presentation of antigenic peptides on major histocompatibility complexes, the recruitment of T cells, their interaction with antigen-presenting cells, and the expression of adhesion, co-stimulatory and co-inhibitory molecules at the T cell immunological synapse. These events collectively fine-tune and sustain antigen recognition and T cell function. Dysregulation of this machinery can profoundly impact the efficacy of cancer immunotherapy. Imaging technologies have emerged as powerful tools for elucidating the mechanisms underlying antigen processing and presentation. By providing complementary perspectives into the cellular and molecular interactions at play, imaging has significantly enhanced our understanding of these complex immunological events in cancer. Such insights can improve the monitoring of immunotherapy responses, facilitate the identification of effective treatments, and aid in predicting patient outcomes.

Methods
This review explores the role of imaging in studying antigen processing and presentation in the context of cancer.

Conclusion
It highlights key considerations for developing imaging tools and biomarkers to detect components of these pathways. Additionally, it examines the strengths and limitations of various imaging approaches and discusses their potential for clinical translation.
Circulating Soluble Factors and T-Cell Subsets as Immunological Predictors of Therapy Response in Human Cutaneous Leishmaniasis
Authors: Figueiredo Amanda B , Morais Katia L P , Silva Israel T , Maia Lorhenn B L , Buttura Jaqueline R , Barros Bruna D F , Alves Natalia S , Pignataro-Oshiro Flavio , Shimon Samara M M , Teixeira-Carvalho Andrea , Almeida Lucas , Carvalho Edgar , Machado Paulo , Blackwell Jenefer M , Castellucci Lea , Dutra Walderez O , Gollob Kenneth J 
Published: February 2025

Abstract

Background
Human cutaneous leishmaniasis, a neglected tropical disease caused by Leishmania braziliensis, presents treatment challenges due to varying therapeutic responses. Current therapies often encounter limited efficacy and treatment failure, demanding a deeper understanding of immunopathogenesis and predictive markers.

Methods
We explored the immunological determinants influencing therapy response in human cutaneous leishmaniasis, focusing on the intricate host–parasite immune interactions. We evaluated blood and lesions from the same individuals before therapeutic intervention and followed the patients for 60 days to determine treatment efficacy. We employed multiparameter flow cytometry methods for peripheral blood analysis of soluble factors and T-cell subpopulations, and RNA sequencing for analysis of lesion biopsies.

Results
Our investigation identified a combined set of circulating soluble factors as promising noninvasive predictive markers for treatment outcomes. Additionally, we reveal an association between circulating CD8+ mucosal-associated invariant T (MAIT) cells with increased lesion pathology, and a gene signature in lesions associated with CD8+ MAIT cells in refractory patients.

Conclusions
These findings highlight the potential for tailored interventions and novel immunomodulatory strategies to enhance treatment efficacy and address challenges in unresponsive cases of this debilitating disease.
Detection of Crystals in Gram-Stained Synovial Fluid
Authors: Szlembarski Steven J , Agger William A , Pendley Sarah R , Bloechl Stephen J , Cogbill Christopher H , Sabin Arick P , Fischer Cathy Mikkelson , White Douglas W 
Published: February 2025

Abstract

Background
Gout and calcium pyrophosphate deposition (CPPD) disease are common crystalline arthropathies. Identification of crystals in synovial fluid using polarized light microscopy (PLM) aids diagnosis. In routine clinical practice, the volume of synovial fluid available for PLM is frequently insufficient, especially when fluid is also needed for other analyses, such as Gram stain and culture. Few studies have investigated the reliability of microscopic examination for crystals, with or without polarization, using Gram-stained synovial fluid specimens. This study estimated the sensitivity and specificity of microscopy with and without polarization on Gram-stained specimens for identification of crystals compared with standard PLM on unstained samples.

Methods
In total, 105 unstained synovial and bursal fluid samples were processed and examined by laboratory personnel using routine PLM procedures. Gram-stained samples of the same fluid were independently interpreted by microbiologists trained in examining fluid for crystals using standard light microscopy, followed by at least 2 pathologists using PLM.

Results
Compared with standard PLM on unstained samples, the sensitivity and specificity of crystal examination by microbiologists on Gram-stained samples were 16% and 98%, respectively. Pathologists, using PLM on these Gram-stained samples, achieved slightly better sensitivity (24.5% and 96%, respectively). Concordance regarding crystal type was 100% and unaffected by Gram stain.

Conclusions
Crystal examination of Gram-stained synovial and bursal fluid by trained personnel has low sensitivity but high specificity compared with standard evaluation of unstained samples. Examination of Gram-stained samples with PLM may be helpful when sample volumes are limited and, when positive, has sufficient specificity to support crystalline arthropathy diagnoses.
Evaluation of Immunoassay Performance for the Detection of Opioids in Urine
Authors: Walsh Michael E , Kelliher Michael T , Hubbard Jacqueline A , Cervinski Mark A 
Published: February 2025

Abstract

Background
Immunoassay drug screens provide rapid analysis of urine for the presence of therapeutics and drugs of abuse. Compared to definitive (confirmatory) methods, immunoassays are prone to false-positive and -negative results. Laboratories generally rely on manufacturers’ claims regarding method sensitivity and specificity; few have the resources to independently verify performance. In this study, we review the performance of our opioid immunoassay drug screens in comparison to a definitive method.

Methods
Results of 859 urine samples tested via opioid immunoassay screens for buprenorphine, fentanyl, methadone metabolite (2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine; EDDP), opiates, and oxycodone were compared to definitive results obtained via liquid chromatography–tandem mass spectrometry (LC-MS/MS). The data examined here included multiple samples from individual patients. Our quantitative LC-MS/MS method includes 19 opioid compounds (parent drugs plus metabolites).

Results
Immunoassay sensitivity and specificity ranged from 96% to 100% and 84% to 99%, respectively. The sensitivity and specificity of these screens were similar to manufacturers’ claims with some exceptions. The opiates immunoassay had poor performance when limiting the comparison to its target compound, morphine, but improved when including all compounds listed in the manufacturer’s instructions for use (IFU). While demonstrating good sensitivity, the buprenorphine immunoassay demonstrated lower specificity than stated in the IFU.

Conclusions
The opioid immunoassay screens in use at our facility compared favorably to a definitive LC-MS/MS method. The urine fentanyl screen had the lowest sensitivity (96%) and had a specificity of 97%. The urine buprenorphine assay was the least specific (84%) and had a sensitivity of 99%.
Using dataflow diagrams to support research informed consent data management communications: participant perspectives
Authors: McInnis Brian J , Pindus Ramona , Kareem Daniah H , Cakici Julie , Vital Daniela G , Hekler Eric , Nebeker Camille 
Published: February 2025

Abstract

Objectives
Digital health research involves collecting vast amounts of personal health data, making data management practices complex and challenging to convey during informed consent.

Materials and Methods
We conducted eight semi-structured focus groups to explore whether dataflow diagrams (DFD) can complement informed consent and improve participants' understanding of data management and associated risks (N = 34 participants).

Results
Our analysis found that DFDs could supplement text-based information about data management and sharing practices, such as by helping raise new questions that prompt conversation between prospective participants and members of a research team. Participants in the study emphasized the need for clear, simple, and accessible diagrams that are participant centered. Third-party access to data and sharing of sensitive health data were identified as high-risk areas requiring thorough explanation. Participants generally agreed that the design process should be led by the research team, but it should incorporate many diverse perspectives to ensure the diagram was meaningful to potential participants who are likely unfamiliar with data management. Nearly all participants rejected the idea that artificial intelligence could identify risks during the design process, but most were comfortable with it being used as a tool to format and simplify the diagram. In short, DFDs may complement standard text-based informed consent documents, but they are not a replacement.

Discussion
Prospective research participants value diverse ways of learning about study risks and benefits. Our study highlights the value of incorporating information visualizations, such as DFDs, into the informed consent procedures to participate in research.

Conclusion
Future research should explore other ways of visualizing consent information in ways that help people to overcome digital and data literacy barriers to participating in research. However, creating a DFD requires significant time and effort from research teams. To alleviate these costs, research sponsors can support the creation of shared infrastructure, communities of practice, and incentivize researchers to develop better consent procedures.
Alert design in the real world: a cross-sectional analysis of interruptive alerting at 9 academic pediatric health systems
Authors: Kandaswamy Swaminathan , Yarahuan Julia K W , Dobler Elizabeth A , Molloy Matthew J , Knake Lindsey A , Hernandez Sean M , Fallon Anne A , Hess Lauren M , McCoy Allison B , Fortunov Regine M , Kirkendall Eric S , Muthu Naveen , Orenstein Evan W , Dziorny Adam C , Chaparro Juan D 
Published: February 2025

Abstract

Objective
To assess the prevalence of recommended design elements in implemented electronic health record (EHR) interruptive alerts across pediatric care settings.

Materials and Methods
We conducted a 3-phase mixed-methods cross-sectional study. Phase 1 involved developing a codebook for alert content classification. Phase 2 identified the most frequently interruptive alerts at participating sites. Phase 3 applied the codebook to classify alerts. Inter-rater reliability (IRR) for the codebook and descriptive statistics for alert design contents were reported.

Results
We classified alert content on design elements such as the rationale for the alert's appearance, the hazard of ignoring it, directive versus informational content, administrative purpose, and whether it aligned with one of the Institute of Medicine’s (IOM) domains of healthcare quality. Most design elements achieved an IRR above 0.7, with the exceptions for identifying directive content outside of an alert (IRR 0.58) and whether an alert was for administrative purposes only (IRR 0.36). IRR was poor for all IOM domains except equity. Institutions varied widely in the number of unique alerts and their designs. 78% of alerts stated their purpose, over half were directive, and 13% were informational. Only 2%-20% of alerts explained the consequences of inaction.

Discussion
This study raises important questions about the optimal balance of alert functions and desirable features of alert representation.

Conclusion
Our study provides the first multi-center analysis of EHR alert design elements in pediatric care settings, revealing substantial variation in content and design. These findings underline the need for future research to experimentally explore EHR alert design best practices to improve efficiency and effectiveness.
Validating the use of pen scores to capture behaviors expressed by cattle unrestrained in a pen1
Authors: Parham Jamie T , Schmidt Jessica J , Tanner Amy E , Wahlberg Mark L , Grandin Temple , Lewis Ronald M 
Published: February 2025

Abstract
Many subjective methods exist to assist producers in evaluating temperament. Use of a pen test, which allows behavior to be observed in a non-restrained setting, may be an effective method to evaluate temperament by allowing more variation among animals to be expressed as compared to a restrained test. The objective of this study was to analyze video recordings of penned calves to determine whether the repertoire of behaviors they expressed were adequately captured by their individual (IPS) and group (GPS) pen scores. In each of 3 yr, 40 predominantly Angus commercial Bos taurus heifers, 2-wk post weaning, were assessed monthly in 3 consecutive months (recording periods). After routine handling through a weigh crate and squeeze chute, each heifer was released individually into a pen (12 x 6 m). Their response to 30 s of human presence within the pen was evaluated. They were then joined in groups of four in a larger (12 x 8 m) pen and re-evaluated for 30 s in a group setting. An IPS and GPS was assigned using an ethogram ranging from 1 (docile) to 6 (aggressive). This interaction was also video recorded. Using the videos, the explicit behaviors captured by each pen score were investigated using Noldus Observer software. Data were analyzed with ANOVA using SAS. Within each recording period, the concordance of pen scores with the repertoire of behaviors expressed were compared. In the group setting, heifers could not be clearly distinguished on video and were instead assigned the average GPS of the group. Heifers with higher IPS and average GPS categories had larger flight zone sizes and reached faster paces for longer periods of time. Furthermore, heifers with lower IPS appeared more neutral to the presence of a human and moved around less often. Ethograms for pen score successfully delineated the temperament of heifers. The use of such scores can provide a valuable on-farm assessment of cattle behavior during routine handling.