bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining pediatric trauma center resource utilization: Multidisciplinary consensus-based criteria from the Pediatric Trauma Society
Authors: Snyder Christopher W. , Kristiansen Karl O. , Jensen Aaron R. , Sribnick Eric A. , Anders Jennifer F. , Chen Catherine X. , Lerner E. Brooke , Conti Michael E. 
Published: October 2023

BACKGROUND
Pediatric trauma triage and transfer decisions should incorporate the likelihood that an injured child will require pediatric trauma center (PTC) resources. Resource utilization may be a better basis than mortality risk when evaluating pediatric injury severity. However, there is currently no consensus definition of PTC resource utilization that encompasses the full scope of PTC services.

METHODS
Consensus criteria were developed in collaboration with the Pediatric Trauma Society (PTS) Research Committee using a modified Delphi approach. An expert panel was recruited representing the following pediatric disciplines: prehospital care, emergency medicine, nursing, general surgery, neurosurgery, orthopedics, anesthesia, radiology, critical care, child abuse, and rehabilitation medicine. Resource utilization criteria were drafted from a comprehensive literature review, seeking to complete the following sentence: “Pediatric patients with traumatic injuries have used PTC resources if they...” Criteria were then refined and underwent three rounds of voting to achieve consensus. Consensus was defined as agreement of 75% or more panelists. Between the second and third voting rounds, broad feedback from attendees of the PTS annual meeting was obtained.

RESULTS
The Delphi panel consisted of 18 members from 15 institutions. Twenty initial draft criteria were developed based on literature review. These criteria dealt with airway interventions, vascular access, initial stabilization procedures, fluid resuscitation, blood product transfusion, abdominal trauma/solid organ injury management, intensive care monitoring, anesthesia/sedation, advanced imaging, radiologic interpretation, child abuse evaluation, and rehabilitative services. After refinement and panel voting, 14 criteria achieved the >75% consensus threshold. The final consensus criteria were reviewed and endorsed by the PTS Guidelines Committee.

CONCLUSION
This study defines multidisciplinary consensus-based criteria for PTC resource utilization. These criteria are an important step toward developing a criterion standard, resource-based, pediatric injury severity metric. Such metrics can help optimize system-level pediatric trauma triage based on likelihood of requiring PTC resources.

LEVEL OF EVIDENCE
Diagnostic Test/Criteria; Level II.
Identifying Signs and Symptoms of Urinary Tract Infection from Emergency Department Clinical Notes Using Large Language Models
Authors: Iscoe Mark , Socrates Vimig , Gilson Aidan , Chi Ling , Li Huan , Huang Thomas , Kearns Thomas , Perkins Rachelle , Khandjian Laura , Taylor R. Andrew 
Published: October 2023

AbstractObjectivesSymptom characterization is critical to urinary tract infection (UTI) diagnosis, but identification of symptoms from the electronic health record (EHR) is challenging, limiting large-scale research, public health surveillance, and EHR-based clinical decision support. We therefore developed and compared two natural language processing (NLP) models to identify UTI symptoms from unstructured emergency department (ED) notes.MethodsThe study population consisted of patients aged ≥ 18 who presented to the (ED) in a north-eastern United States health system between June 2013 and August 2021 and had a urinalysis performed. We annotated a random subset of 1,250 ED clinician notes from these visits for a list of 17 UTI symptoms. We then developed two task-specific large language models (LLMs) to perform the task of named entity recognition (NER): a convolutional neural network (CNN)-based model (SpaCy) and a transformer-based model designed to process longer documents (Longformer). Models were trained on 1,000 notes and tested on a holdout set of 250 notes. We compared model performance (precision, recall, F1 measure) at identifying the presence or absence of UTI symptoms at the note level.Results8,135 entities were identified in 1,250 notes; 83.6% of notes included at least one entity. Overall F1 measure for note-level symptom identification weighted by entity frequency was 0.84 for the SpaCy model and 0.88 for the Longformer model. F1 measure for identifying presence or absence of any UTI symptom in a clinical note was 0.96 (232/250 correctly classified) for the SpaCy model and 0.98 (240/250 correctly classified) for the Longformer model.ConclusionsThe study demonstrated the utility of LLMs and transformer-based models in particular for extracting UTI symptoms from unstructured ED clinical notes; models were highly accurate for detecting the presence or absence of any UTI symptom on the note level, with variable performance for individual symptoms.
Relationship between circulating FSH levels and body composition and bone health in patients with prostate cancer who undergo androgen deprivation therapy. The BLADE study
Authors: Bergamini M , Dalla Volta A , Palumbo C , Zamboni S , Triggiani L , Zamparini M , Laganà M , Rinaudo L , Di Meo N , Caramella I , Bresciani R , Valcamonico F , Borghetti P , Guerini A , Farina D , Antonelli A , Simeone C , Mazziotti G , Berruti A 
Published: October 2023

AbstractBackgroundAmongst its extragonadal effects, Follicle-Stimulating Hormone (FSH) has an impact on body composition and bone metabolism. Since androgen deprivation therapy (ADT) has a profound impact on circulating FSH concentrations, this hormone could potentially be implicated in the changes of fat body mass (FBM), lean body mass (LBM) and bone fragility induced by ADT. The objective of this study is to correlate FSH serum levels with body composition parameters, bone mineral density (BMD) and bone turnover markers at baseline conditions and after 12 months of ADT.Methods29 consecutive non-metastatic prostate cancer (PC) patients were enrolled from 2017 to 2019 in a phase IV study. All patients underwent administration of the Luteinizing Hormone-Releasing Hormone antagonist degarelix. FBM, LBM and BMD were evaluated by dual-energy x-ray absorptiometry at baseline and after 12 months of ADT. FSH, alkaline phosphatase (ALP) and C-terminal telopeptide of type I collagen (CTX) were assessed at baseline and after 6 and 12 months. For outcome measurements and statistical analysis, T-test or sign test and Pearson or Spearman tests for continuous variables were used when indicated.ResultsAt baseline conditions, a weak, non-significant, direct relationship was found between FSH serum levels and FBM at arms (r=0.36) and legs (r=0.33). Conversely, a stronger correlation was observed between FSH and total FBM (r=0.52, p=0.006), fat mass at arms (r=0.54, p=0.004) and fat mass at trunk (r=0.45, p=0.018) assessed after 12 months. On the other hand, an inverse relationship between serum FSH and appendicular lean mass index (ALMI)/FBM ratio was observed (r=0.64, p=0.001). This is an ancillary study of a prospective trial and this is the main limitation.ConclusionsFSH serum levels after ADT could have an impact on body composition, in particular on fat body mass. Therefore, FSH could be a promising marker to monitor the risk of sarcopenic obesity and cardiovascular complications in PC patients undergoing ADT.Fundingthis research was partially funded by Ferring Pharmaceuticals. The funder had no role in design and conduct of the study, collection, management, analysis, and interpretation of the data and in preparation, review, or approval of the manuscript.Clinical trial numberclinicalTrials.govNCT03202381, EudraCT Number 2016-004210-10.
Enhanced Myocardial Tissue Visualization: A Comparative Cardiovascular Magnetic Resonance Study of Gradient-Spin Echo-STIR and Conventional STIR Imaging
Authors: Dehghani Sadegh , Shirani Shapoor , gharehbagh Elahe Jazayeri 
Published: October 2023

AbstractPurposeTo assess the performance of gradient-spin echo (GraSE) based STIR (GraSE-STIR) sequence in CMR imaging compared to turbo spin echo based conventional STIR for myocardial visualization.MethodsIn a prospective study, we examined forty-four normal volunteers and seventeen patients referred for CMR imaging using a conventional STIR and GraSE-STIR techniques. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality, T2signal intensity (SI) ratio, specific absorption rate (SAR), and image acquisition time were compared between both sequences.ResultsGraSE-STIR showed significant improvements in image quality (4.15 ± 0.8 vs. 3.34 ± 0.9, P = 0.024) and cardiac motion artifact reduction (7 vs. 18 out of 53, p = 0.038) compared to conventional STIR. Furthermore, the acquisition time (27.17 ± 3.53 vs. 36.9 ± 4.08 seconds, p = 0.041) and the local torso SAR (< % 13 vs. < % 17, p = 0.047) were significantly lower for GraSE-STIR compared to conventional STIR in short axis plan. However, no significant differences were shown in T2SI ratio (p = 0.141), SNR (p = 0.093), CNR (P = 0.068), and SAR (p = 0.071) between these two sequences.ConclusionsGraSE-STIR offers notable advantages over conventional STIR sequence, with improved image quality, reduced motion artifacts, and shorter acquisition times. These findings highlight the potential of GraSE-STIR as a valuable technique for routine clinical CMR imaging.
Mapping Alzheimer’s Molecular Pathologies in Large-Scale Connectomics Data: A Publicly Accessible Correlative Microscopy Resource
Authors: Han Xiaomeng , Li Peter H. , Wang Shuohong , Blakely Tim , Aggarwal Sneha , Gopalani Bhavika , Sanchez Morgan , Schalek Richard , Meirovitch Yaron , Lin Zudi , Berger Daniel , Wu Yuelong , Aly Fatima , Bay Sylvie , Delatour Benoît , Lafaye Pierre , Pfister Hanspeter , Wei Donglai , Jain Viren , Ploegh Hidde , Lichtman Jeff 
Published: October 2023

AbstractConnectomics using volume-electron-microscopy enables mapping and analysis of neuronal networks, revealing insights into neural circuit function and dysfunction. In Alzheimer’s disease (AD), where amyloid-β (Aβ) and hyperphosphorylated-Tau (pTau) are implicated, connectomics offers an approach to unravel how these molecules contribute to circuit alterations by enabling the study of these molecules within the context of the complete local neuronal and glial milieu. We present a volumetric-correlated-light-and-electron microscopy (vCLEM) protocol using fluorescent nanobodies to localize Aβ and pTau within a large-scale connectomics dataset from the hippocampus of the 3xTg AD mouse model. A key outcome of this work is a publicly accessible vCLEM dataset, featuring fluorescent labeling of Aβ and pTau in the ultrastructural context with segmented neurons, glia, and synapses. This dataset provides a unique resource for exploring AD pathology in the context of connectomics and fosters collaborative opportunities in neurodegenerative disease research. As a proof-of-principle, we uncovered new localizations of Aβ and pTau, including pTau-positive spine-like protrusions at the axon initial segment and changes in the number and size of synapses near Aβ plaques. Our vCLEM approach facilitates the discovery of both molecular and structural alterations within large-scale EM data, advancing connectomics research in Alzheimer’s and other neurodegenerative diseases.
Convergent evolution of complex adaptive traits enabled human life at high altitudes
Authors: Ferraretti Giulia , Rill Aina , Abondio Paolo , Smith Kyra , Ojeda-Granados Claudia , De Fanti Sara , Izzi Massimo , Sherpa Phurba T. , Cocco Paolo , Tiriticco Massimiliano , di Marcello Marco , Dezi Agnese , Gnecchi-Ruscone Guido Alberto , Natali Luca , Corcelli Angela , Marinelli Giorgio , Garagnani Paolo , Peluzzi Davide , Luiselli Donata , Pettener Davide , Sarno Stefania , Sazzini Marco 
Published: October 2023

AbstractConvergent adaptations represent paradigmatic examples of the capacity of natural selection to influence organisms’ biology. However, the possibility to investigate genetic determinants underpinning convergent complex adaptive traits has been offered only recently by methods for inferring polygenic adaptations from genomic data. Relying on this approach, we demonstrate how high-altitude Andean human groups experienced pervasive selective events at angiogenic pathways, which resemble those previously attested for Himalayan populations despite partial convergence at the single-gene level was observed. This provides unprecedented evidence for the drivers of convergent evolution of enhanced blood perfusion in populations exposed to hypobaric hypoxia for thousands of years.
Digital Screener of Socio-Motor Agency Balancing Autonomy and Control
Authors: Bermperidis Theodoros , Rai Richa , Torres Elizabeth B 
Published: October 2023

AbstractDyadic social interactions evoke complex dynamics between two agents that while exchanging unequal levels of body autonomy and motor control, may find a fine balance to take turns and gradually build social rapport. To study the evolution of such complex interactions, we currently rely exclusively on subjective pencil and paper means. Here we complement this approach with objective biometrics of socio-motor behaviors conducive of socio-motor agency. Using a common clinical test as the backdrop of our study to probe social interactions between a child and a clinician, we demonstrate new ways to streamline the detection of social readiness potential in both typically developing and autistic children. We highlight differences between males and females and uncover a new data type amenable to generalize our results to any social settings. The new methods convert dyadic bodily biorhythmic activity into spike trains and demonstrates that in the context of dyadic behavioral analyses, they are well characterized by a continuous gamma process independent from corresponding binary spike rates. We offer a new framework that combines stochastic analyses, nonlinear dynamics, and information theory, to facilitate scaling the screening and tracking of social interactions with applications to autism.
Maternal risk factors for stillbirths in a semi-rural municipality in Ghana: Findings from a retrospective observational study
Authors: Adjei-Gyamfi Silas , Asirifi Abigail , Mamudu Gafaru , Peprah Wisdom , Asobuno Clotilda , Dapaah Constance Siakwan , Aryee Paul Armah 
Published: October 2023

AbstractBackgroundStillbirths do not only trigger maternal psychological trauma but also affect the socio-economic growth in developing countries. Since the prevalence and predictors of stillbirths and their dynamics are diverse in different low-resource settings like Ghana, it requires adequate knowledge to mitigate these factors for reducing perinatal deaths. Moreover, data are scarce on the maternal factors of stillbirth in Ghana. This study, therefore, aimed to determine the prevalence and associated factors of stillbirths in a semi-rural municipality in Northern Ghana.MethodsA retrospective observational study was conducted among 422 mothers who delivered in public health facilities and reside in a semi-rural municipality of Northern Ghana. Sociodemographic, obstetric, and medical-related data were collected through semi-structured interviews and from records review. We used binary logistic regression to identify the independent factors of stillbirths at a confidence level of 95%.ResultsStillbirth rate was estimated at 4.0% (95%CI: 2.4%–6.4%). The analysis revealed that anaemia in the third trimester of pregnancy (aOR:3.15; 95%CI:2.94–10.6; p=0.034), positive sickle cell status (aOR:2.91; 95%CI:1.50–7.01; p=0.018), and non-use of insecticide-treated bed nets during pregnancy were significantly associated with increased risk of stillbirths (aOR:7.75; 95%CI:2.33–9.8; p=0.001).ConclusionThe relatively high stillbirth prevalence in the municipality was affected by medical and lifestyle factors. Management of the municipal health directorate (Ghana Health Service), program planners, and other stakeholders who are engaged in improving perinatal and maternal health should target and implement effective programs on anaemia and lifestyle modifications for the prevention and reduction of stillbirths.
Teenage Blues: predictors of depression among adolescents in Nigeria
Authors: Nzeakah C W , DadeMatthews A O , Onofa U O , DadeMatthews O D , Ogundare T 
Published: October 2023

AbstractBackgroundDepressive disorders, with a prevalence of 15 – 21%, are among the most common disorders in children and adolescents, and increases the risk of suicide, the second leading cause of death in children aged 10 to 19.AimTo determine the prevalence and correlates of depressive disorders among senior students attending secondary schools in Abeokuta.MethodThe study was conducted in five schools randomly selected from a representative sample and was carried out in 2 phases. In the first phase, students were selected via systematic random sampling and given consent forms and GHQ-12 to administer to the parents. In the second phase, students who returned a signed informed consent form and filled out GHQ-12 were interviewed using MINI-KID, Rosenberg’s Self-Esteem Scale, Family-APGAR, and sociodemographic questionnaire. Multivariate regression analyses were conducted with p-value <0.05 as level of significance.ResultsThe mean age was 15.3 years (SD=1.27); 48.8% were male. The twelve-month prevalence of major depression was 11.3% and dysthymia was 1.4%. In the final regression analysis, female gender [OR=4.3, p=0.046], the experience of bullying [OR=7.96, p=0.004], difficulty getting along with friends, [OR=7.5, p=0.004], history of sexual abuse [OR=8.1, p=0.01], and perceived family dysfunction [OR=4.9, p=0,023] were found to be independent predictors of depressive disordersConclusionDepressive syndromes are a significant health burden in adolescents. Being female, being bullied, having a history of sexual abuse, and family dysfunctionality are risk factors associated with depression among these population.
Standardising the structure of routinely collected data for childhood ocular inflammation: a SNOMED-CT mapping project
Authors: Kellett Salomey , Solebo Ameenat Lola ,   the Paediatric Ocular Inflammation UNICORN Study Group
Published: October 2023

AbstractBackground and aimsMulticentre, longitudinal research methods are usually necessary for rare disease research. SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms), the comprehensive and standardized terminology system can be used to enhance the interoperability of data collected across different settings. Childhood uveitis is a rare, blinding disorder, with uncertainties around disease distribution and outcome. To enhance the interoperability of uveitis data, we created a SNOMED CT coded dataset derived from a core clinical dataset.MethodsData elements were selected from a published list developed through a consensus exercise undertaken by a national disease research group, the United Kingdom’s Paediatric Ocular Inflammatory Group (POIG). Items were organised using a three level priority score, based on the National Institute for Health (NIH) model for common data elements, and grouped using the Heath Level 7 (HL7) standard "Fast Healthcare Interoperability Resources" (FHIR) generic data structure, and then mapped across to the SNOMED CT codes.ResultsFrom the POIG consensus exercise, 160 elements were selected: 89 as high priority items, with 35 as medium and 29 as low priority items. These elements, and response items where appropriate, were grouped into Patient (n= 13 items), Observation (n= 63 items), Condition (n= 20 items), Procedure (n= 44 items), Medication (n= 18 items). There were four items for which a SNOMED CT ID could not be found.ConclusionThrough this mapping activity, using international coding and terminologies, we have created a dataset for childhood onset uveitis care and research. This dataset provides a standardised vocabulary for describing clinical concepts, with a semantic interoperability which will support the exchange of data across different systems, organizations, and international or supranational groups. Future expansion of the dataset will be needed to ensure coverage of international concepts and care structures.Author summaryThrough a mapping activity, in which data items from a consensus developed core clinical dataset were mapped across to SNOMED CT terminologies, we have created a dataset for childhood onset uveitis care and research. This dataset provides a standardised vocabulary for describing clinical concepts, with a semantic interoperability which will support the exchange of data across different systems, organizations, and international or supranational groups.
Changes in emergency department utilization in vulnerable populations after COVID-19 shelter in place orders
Authors: Wang Philip R. , Anand Akhil , Bena James , Morrison Shannon , Weleff Jeremy 
Published: October 2023

AbstractPurposeTo compare emergency department (ED) utilization and admission rates for patients with a history of mental health (MH), substance use disorder (SUD) and social determinants of health (SDOH) before and after implementing COVID-19’s shelter-in-place (SIP) orders.MethodsThis was a retrospective, multicenter study leveraging electronic medical record data from 20 EDs across a large Midwest integrated healthcare system from 5/2/2019 to 12/31/2019 (pre-SIP) and from 5/2/2020 to 12/31/2020 (post-SIP). Diagnoses were documented in the patient’s medical records. Poisson and logistic regression models were used to evaluate ED utilization and admission rate changes.Results871,020 total ED encounters from 487,028 unique patients were captured. 2,572 (0.53%) patients had a documented Z code for SDOH. Patients with previously diagnosed MH or SUDs were more likely to seek ED care after the SIP orders were implemented (RR: 1.20, 95% CI: 1.18 – 1.22, p<0.001), as were patients with SDOH (RR: 2.37, 95% CI: 2.19 – 2.55, p<0.001). Patients with both previously diagnosed MH or SUD and a documented SDOH had even higher ED utilization (RR: 3.31, 95% CI: 2.83 – 3.88, p<0.001) than those with either condition alone. Patients with MH and SUDs (OR: 0.89, 95% CI: 0.86 – 0.92, p<0.001) or SDOH (OR: 0.67, 95% CI: 0.54, 0.83, p<0.001) were less likely to be admitted post-SIP orders while patients with a history of diseases of physiologic systems were more likely to be admitted.ConclusionsVulnerable populations with a history of MH, SUD, and SDOH experienced increased ED utilization but a lower rate of hospital admissions after the implementation of SIP orders. The findings highlight the importance of addressing these needs to mitigate the impact of public health crises on these populations.
M6A reduction relieves FUS-associated ALS granules
Authors: Di Timoteo Gaia , Giuliani Andrea , Setti Adriano , Biagi Martina C. , Lisi Michela , Grandioso Alessia , Mariani Davide , Castagnetti Francesco , Perego Eleonora , Zappone Sabrina , Vicidomini Giuseppe , Rotili Dante , Sabatelli Mario , Lattante Serena , Bozzoni Irene 
Published: October 2023

AbstractAmyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease due to gradual motorneurons (MN) degeneration1. Among the processes associated to ALS pathogenesis, there is the formation of cytoplasmic inclusions produced by mutant protein aggregation, among which the RNA binding protein FUS2.In this work we show that such inclusions are significantly reduced in number and dissolve faster when the RNA m6A content is diminished as a consequence of the m6A writer METTL3 knock-down. These effects were observed both in neuronal cell lines and in iPSC-derived human motor neurons expressing mutant FUS. Importantly, stress granules formed in ALS condition showed a distinctive transcriptome with respect to control cells; interestingly, after METTL3 downregulation, it reverted to similar to control. Finally, we show that FUS inclusions are reduced also in patient-derived fibroblasts treated with STM-2457, a well characterized inhibitor of METTL3 activity, paving the way for its possible use for counteracting aggregate formation in ALS.