bluuebunny/crossref_metadata_2025_split huggingface dataset:
Grounded large language models for diagnostic prediction in real-world emergency department settings
Authors: Niset Alexandre , Melot Ines , Pireau Margaux , Englebert Alexandre , Scius Nathan , Flament Julien , El Hadwe Salim , Al Barajraji Mejdeddine , Thonon Henri , Barrit Sami 
Published: February 2025

AbstractBackgroundEmergency departments face increasing pressures from staff shortages, patient surges, and administrative burdens. While large language models (LLMs) show promise in clinical support, their deployment in emergency medicine presents technical and regulatory challenges. Previous studies often relied on simplistic evaluations using public datasets, overlooking real-world complexities and data privacy concerns.MethodsAt a tertiary emergency department, we retrieved 79 consecutive cases during a peak 24-hour period constituting a siloed dataset. We evaluated six pipelines combining open- and closed-source embedding models (text-embedding- ada-002 and MXBAI) with foundational models (GPT-4, Llama3, and Qwen2), grounded through retrieval-augmented generation with emergency medicine textbooks. The models’ top-five diagnostic predictions on early clinical data were compared against reference diagnoses established through expert consensus based on complete clinical data. Outcomes included diagnostic inclusion rate, ranking performance, and citation sourcing capabilities.ResultsAll pipelines showed comparable diagnostic inclusion rates (62.03-72.15%) without significant differences in pairwise comparisons. Case characteristics, rather than model combinations, significantly influenced predictive diagnostic performance. Cases with specific diagnoses were significantly more diagnosed versus unspecific ones (85.53% vs. 31.41%, p<0.001), as did surgical versus medical cases (79.49% vs. 56.25%, p<0.001). Open-source foundational models demonstrated superior sourcing capabilities compared to GPT-4-based combinations (OR: 33.92 to ∞, p<1.4e-12), with MBXAI/Qwen2 achieving perfect sourcing.ConclusionOpen and closed-source LLMs showed promising and comparable predictive diagnostic performance in a real-world emergency setting when evaluated on siloed data. Case characteristics emerged as the primary determinant of performance, suggesting that current limitations reflect AI alignment fundamental challenges in medical reasoning rather than model-specific constraints. Open-source models’ demonstrated superior sourcing capabilities—a critical advantage for interpretability. Continued research exploring larger-scale, multi-centric efforts, including real-time applications and human-computer interactions, as well as real- world clinical benchmarking and sourcing verification, will be key to delineating the full potential of grounded LLM-driven diagnostic assistance in emergency medicine.
The Role of Interleukin-6 in Predicting Adverse Cardiac Outcomes in Asian Hypertrophic Cardiomyopathy
Authors: Le Thu-Thao , Pua Chee Jian , Aw Tar-Choon , Lim Shiqi , Yang Chengxi , Bryant Jennifer Ann , Han Yiying , Tang Hak Chiaw , Kong Siew Ching , Phua Soon Kieng , Cook Stuart Alexander , Chin Calvin Woon-Loong 
Published: February 2025

ABSTRACTBackgroundInterleukin-6 (IL-6) is a pro-inflammatory cytokine implicated in adverse cardiac remodeling and outcomes in various cardiovascular diseases. Its role in hypertrophic cardiomyopathy (HCM), particularly in risk stratification and prognosis, remains underexplored. This study evaluates serum IL-6 levels alongside cardiac magnetic resonance (CMR) imaging parameters as predictors of major adverse cardiac events (MACE) in patients with apical HCM (ApHCM) and non-apical HCM (Non-ApHCM).MethodA cohort of 255 patients was recruited between 2013 and 2023, with blood samples collected for genetic analysis and biomarker testing. A subset of 196 patients underwent CMR imaging to assess left ventricular morphology, function, and myocardial fibrosis. MACE was defined as the composite occurrence of ventricular arrhythmias, heart failure, atrial fibrillation, stroke, or all-cause mortality.ResultsPatients with elevated IL-6 levels (above the median) demonstrated significantly higher MACE rates compared to those with lower levels (7.5 vs. 3.3 events/100 patient-years; pairwise log-rank P < 0.001). IL-6 levels correlated with adverse CMR markers, including myocardial fibrosis, increased left atrial volume, and impaired strain, regardless of HCM subtype. Combining IL-6 levels with morphological classification revealed stepwise risk stratification, with MACE rates escalating from 0.9 (ApHCM with low IL-6) to 8.8 events/100 patient-years (Non-ApHCM with high IL-6) (pairwise log-rank P < 0.001).ConclusionThis study highlights IL-6 as a critical biomarker associated with adverse outcomes in HCM. When integrated with morphological assessment, IL-6 enhances risk stratification and provides a novel approach to assessing disease severity. These findings underscore the potential for IL-6 to guide clinical decision-making and inform therapeutic strategies in HCM.
Highly Pathogenic Avian Influenza A (H5N1) Clade 2.3.2.1a virus infection in domestic cats, India, 2025
Authors: Raut Ashwin Ashok , Aasdev Ashutosh , Kumar Naveen , Pathak Anubha , Mishra Adhiraj , Sehgal Prakriti , Pateriya Atul K , Pandey Megha , Bhatia Sandeep , Mishra Anamika 
Published: February 2025

AbstractIn January 2025, the highly pathogenic avian influenza A(H5N1) virus clade 2.3.2.1a infection was detected in domestic cats and whole-genome sequencing of two cat H5N1 isolates was performed using the Oxford Nanopore MinION sequencing platform. Phylogenetic analysis revealed the circulation of triple reassortant viruses in cats. Although cat viruses lacked classic mammalian adaptation markers they carried mutations associated with enhanced polymerase activity in mammalian cells and increased affinity for α2–6 sialic acid receptor suggesting their potential role in facilitating infection in cats. The identification of reassortant HPAI H5N1 clade 2.3.2.1a viruses in domestic cats in India highlights the urgent need for enhanced surveillance in domestic poultry, wild birds, and mammals, including humans, to track genomic diversity and molecular evolution of circulating strains.
Hematopoietic stem cells undergo bidirectional fate transitionsin vivo
Authors: Fukushima Tsuyoshi , Kristiansen Trine Ahn , Wong Lai Ping , Keyes Samuel , Tanaka Yosuke , Mazzola Michael , Zhao Ting , He Lingli , Yagi Masaki , Hochedlinger Konrad , Yamazaki Satoshi , Sadreyev Ruslan I. , Scadden David T 
Published: February 2025

SummaryTransitions between subsets of differentiating hematopoietic cells are widely regarded as unidirectionalin vivo. Here, we introduce clonal phylogenetic tracer (CP-tracer) that sequentially introduces genetic barcodes, enabling high-resolution analysis of ∼100,000 subclones derived from ∼500 individual hematopoietic stem cells (HSC). This revealed previously uncharacterized HSC functional subsets and identified bidirectional fate transitions between myeloid-biased and lineage-balanced HSC. Contrary to the prevailing view that the more self-renewing My-HSCs unidirectionally transition to balanced-HSCs, phylogenetic tracing revealed durable lineage bidirectionality with the transition favoring My-HSC accumulation over time1,2. Further, balanced-HSCs mature through distinct intermediates—My-HSCs and lymphoid-biased-HSCs—with lymphoid competence here shown by CRISPR/Cas9 screening to be dependent on the homeobox gene,Hhex. Hhex enables Ly-HSC differentiation, but its expression declines with age. These findings establish HSC plasticity andHhexas a determinant of myeloid-lymphoid balance with each changing over time to favor the age-related myeloid bias of the elderly.HighlightsSequenctial introduction of DNA barcodes in vivo was developed to assess time dependent changes in cell fate.Clonal phylogenetic tracer (CP-tracer) enabled high-resolution phylogenetic analysis of ∼100,000 subclones derived from ∼500 individual hematopoietic stem cells (HSC).Bidirectional fate transitions between myeloid-biased haematopoietic stem cells (My-HSCs) and lineage-balanced haematopoietic stem cells (balanced-HSCs) were observed.Hhex was identified as a molecular driver of HSC lymphoid competence.
Canonical Hedgehog Signaling Controls Astral Microtubules and Mitotic Spindle Orientation in Neural Progenitors and iPSCs
Authors: Liu Fengming , Medyukhina Anna , Olesen Kris M , Shirinifard Abbas , Jin Hongjian , Li Lei , Mapelli Marina , Khairy Khaled , Han Young-Goo 
Published: February 2025

AbstractMitotic spindle orientation is crucial for cell fate determination and tissue organization. Although the intracellular machinery governing spindle orientation is well characterized, whether and how secreted factors, such as morphogens, regulate this process remains poorly understood. This study investigated the role of Hedgehog (HH) signaling in modulating mitotic spindle orientation in neural progenitor cells and in induced pluripotent stem cells (iPSCs). Time-lapse microscopy of cerebral organoids and iPSCs revealed that HH signaling increases the angle of the mitotic spindle relative to the apical surface, prolongs mitosis, and enhances spindle rotation. Mechanistically, HH signaling reduces both the number and the length of astral microtubules, key regulators of spindle orientation. This reduction correlates with increased spindle angle in iPSCs. Furthermore, we show that canonical HH signaling, involving GLI-dependent transcriptional regulation, contributes to these effects. RNA sequencing and gene set enrichment analysis (GSEA) revealed that HH signaling upregulates genes associated with microtubule depolymerization, suggesting a transcriptional mechanism by which HH signaling influences astral microtubule dynamics and, consequently, mitotic spindle orientation. These findings highlight a novel link between a morphogen, transcriptional regulation, and the control of mitotic spindle orientation, with implications for development and tissue homeostasis.
The Role of Regional and Practice Trial Sites in Distorted Randomized Cancer Trial Enrollment
Authors: Shah Sachin J. , Manz Christopher R. , Balthis Brendan , Raman Hari S. , Abaluck Jason , Keating Nancy L , Agha Leila 
Published: February 2025

AbstractRepresentative trials are critical to advancing cancer treatment, yet little is known about how geographic siting contributes to non-representative enrollment. Using patient-level data, we determined how the choice of trial-enrolling regions and practices impacts representativeness. We created a SEER-Medicare cohort of people ≥65 years old with lung, breast, pancreatic, or renal cancer (2014-2019). We identified randomized cancer drug trial participants and determined the prevalence of age ≥75, sex, race, ethnicity, and rural residence in the full cohort, trial-enrolling regions, trial-enrolling practices, and trials. The choice of region and practice contributed to >50% of the under-enrollment of Black, Hispanic, and rural patients. Cancer trials enrolled 45% fewer Black patients than expected with proportional representation. Trial recruitment in regions and practices with proportionately fewer Black patients accounted for 27% and 35% of this disparity, respectively. These findings suggest that diversifying cancer trials requires changing the regions and practices referring and enrolling patients.
Understanding Ethiopian farmers' intention to adopt biofortified orange-flesh sweet potatoes
Authors: Samuel Lidya , Dutra de Barcellos Marcia , Watabaji Mulugeta D. , De Steur Hans 
Published: February 2025

PurposeBiofortification is a promising strategy for addressing malnutrition and food insecurity by enriching staple crops with nutrients. However, farmers’ adoption is crucial for their success. This study aims to shed light on Ethiopian farmers' intentions to adopt biofortified orange-fleshed sweet potatoes (OFSP) using the motivation, opportunity and ability (MOA) framework.Design/methodology/approachThis study used data from a cross-sectional survey of 370 sweet potato farmers in Ethiopia. Binary logistic regression analysis was employed to examine the factors influencing farmers' intention to adopt OFSP.FindingsAbility-, motivation- and opportunity-related factors significantly influenced adoption intention. Specifically, knowledge of OFSP benefits, production skills, crop characteristics and access to institutional services positively influences adoption. However, farming experience has a negative effect.Practical implicationsThese findings emphasize the importance of educating farmers about OFSP’s high vitamin A content and favourable agronomic features. Additionally, understanding farmers' experiences and enhancing their production skills are crucial for increasing adoption rates. Targeted educational programs and support services can address these gaps and deficiencies.Originality/valueThis study is the first to analyse Ethiopian farmers' adoption of OFSP using an MOA framework. It offers a novel approach to understanding the complex interplay of psychological factors that influence adoption intentions. Furthermore, this study provides valuable insights into the Ethiopian context, filling a gap in the literature. These findings contribute to the development of targeted strategies for promoting biofortified crops in Ethiopia and other similar global contexts.
Risk prioritization in manufacturing processes: a hybrid approach to group decision-making under hesitation
Authors: Magalhães Wauires Ribeiro de , Lima Junior Francisco Rodrigues 
Published: February 2025

PurposeThis article aims to propose a model to support the assessment and prioritization of risk in manufacturing processes.Design/methodology/approachThe model integrates the failure modes and effects analysis (FMEA) criteria with the evaluation procedures of a new hesitant fuzzy linguistic-technique for Order of Preference by Similarity to Ideal Solution (HFL-TOPSIS) variation. A case study evaluating failure risk in a wiring harness assembly process demonstrated the model's applicability. A sensitivity analysis was performed to verify the effect of the variation in the weights assigned to the decision-makers (DMs).FindingsThe failure mode (FM) ranking was FM4 > FM9 > FM17 > FM2>FM8>FM12 > FM16 > FM19 > FM11 > FM3>FM18 > FM15 > FM13 > FM10 > FM14 > FM7 > FM1 > FM5 > FM6. These outcomes suggest that “stripping length less than specified” was the top priority among the 19 FMs evaluated. Sensitivity tests demonstrated the effect of the DMs’ weights on the ranking of FMs. A comparison with FMEA and HFL-TOPSIS demonstrates the model's greater capacity to discriminate levels of risk priority, as it identifies a total of 19 risk levels compared with 9 levels in the other approaches.Practical implicationsThe adoption of the proposed model can drive substantial improvements in risk management practices across industries, provided that the organization has a decision-making team experienced with FMEA. Therefore, this approach promotes the continuous improvement of operations and ensures that mitigation actions effectively address critical FMs.Originality/valueThis is the first study to propose a risk evaluation model that accounts for DMs' hesitation in defining criteria weights through linguistic expressions. Additionally, it addresses uncertainty when assessing weights for the DMs’ opinions and considers multiple factors that affect these weights in decision-making for risk prioritization.
The impact of ethical logos on purchase intention: the mediating role of product social responsibility
Authors: Collange Véronique , Bernard Yohan , Ingarao Aurore , Zarrouk-Karoui Sarra 
Published: February 2025

Purpose
This paper aims to better understand an increasingly prevalent practice whereby firms affix certified ethical logos (e.g. Fairtrade, 100% organic, Ecolab, etc.) to their products, leveraging perceived product social responsibility (PSR) to enhance purchase intention.

Design/methodology/approach
A between-subjects experiment was conducted among 484 French consumers, focusing on two brands of chocolate bars.

Findings
The study reveals a significant increase in purchase intentions when products feature an ethical logo, with PSR acting as a mediator. Additionally, three variables – logo equity, brand equity and the attribution of altruistic motivations to the brand – emerge as significant predictors of PSR in the presence of an ethical logo. Surprisingly, neither the fit between the brand and the logo nor the attribution of strategic motivations influence PSR. Moreover, the impact of PSR on purchase intention is found to be moderated by consumers’ moral identity.

Research limitations/implications
The research continues and deepens the work of Brown and Dacin (1997) by precisely defining and measuring PSR. In addition, its antecedents are identified, and it is shown that PSR is almost a complete mediator of the identified variables on purchase intention. This result demonstrates that the PSR construct provides both greater explanatory and predictive power than similar concepts and is therefore very useful. The research also contributes to a better understanding of ethical logos as a special kind of brand and sheds light on the complex mechanism of consumers’ attribution.

Practical implications
From a managerial perspective, this work contributes to explaining why, how and for which target it is relevant to certify consumer goods with ethical logos. Some guidelines on labeling strategy are thus provided.

Originality/value
This research contributes to the literature on labeling and social responsibility by delineating the concept of PSR, assessing its measurement and identifying its antecedents and consequences for purchase intention.
Navigating ethical complexities in social entrepreneurship: insights from Portuguese social entrepreneurs
Authors: Paswan Raju Ranjan Kumar 
Published: February 2025

Purpose
Social entrepreneurship is increasingly recognised for addressing complex social issues, yet its definition remains vague. Although social entrepreneurs are often celebrated as virtuous agents of positive change, they experience complex challenges and ethical dilemmas in their daily work. This paper aims to explore the lived experiences of social entrepreneurs in Portugal and to identify the ethical issues influencing their work.

Design/methodology/approach
By using a phenomenological research approach, this study conducted 20 in-depth semi-structured interviews with Portuguese social entrepreneurs. The interviews examine their life experiences to uncover the challenges and ethical issues they face.

Findings
This study identifies key areas where ethical tensions arise influencing the emergence of challenges for social entrepreneurs. These areas include the absence of a specific legal framework for social enterprises, complexities in human resource management, partnership dynamics, financial sustainability pressures, issues of transparency and accountability and the risk of mission drift.

Practical implications
This study offers valuable insights into the ethical dimensions of social entrepreneurship, emphasising that social entrepreneurs, like those in non-profit sectors, face significant ethical dilemmas. These findings offer valuable insights for researchers and practitioners to expand their understanding of social entrepreneurship. By recognising these challenges scholars and policymakers can foster a more informed and nuanced discourse on the field.

Originality/value
This study contributes to the underexplored intersection of ethics and social entrepreneurship, providing new insights into the ethical realities faced by social entrepreneurs in Portugal.
An empirical study of truck driver detention time: a shipper’s perspective
Authors: Cheng Feng , Han Chaodong , Tomasi Stella 
Published: February 2025

PurposeThis study aims to conduct a regression analysis of factors contributing to truck driver detention time, including shipper, carrier and customer facility characteristics. Specifically, we examine how the impact of private fleets versus for-hire carriers on detention time varies with customer facilities that have different operating hours and cargo processing efficiency.Design/methodology/approachBased on time-stamped shipment data collected from a large US fresh producer, this study assesses the impacts of contributing factors on detention time through a regression analysis of a large dataset consisting of 16,227 shipment records over a three-month period.FindingsResults show that private fleets are associated with less detention time than for-hire carriers. The advantage of private fleets over for-hire carriers is more pronounced at customer facilities with 24-h shifts or fast processing speeds. The impact differences between private fleets and for-hire carriers are not statistically significant at slow-processing customer facilities or those without 24-h shifts. There appears to be an inverted U-shaped relationship between carrier size and detention time.Practical implicationsThis study offers evidence-based recommendations to shippers, carriers, receivers and policymakers on the reduction of detention time.Originality/valueThis is the first empirical study to examine detention time using a comprehensive shipment-level dataset collected from a major US fresh producer. The findings offer managerial insights and policy recommendations to address detention, a significant challenge facing the US trucking industry.
Process mapping for laser hot wire additive manufacturing of Ti­6Al­4V
Authors: Abranovic Brandon , Chang-Davidson Elizabeth , Beuth Jack L. 
Published: February 2025

Purpose
Laser hot wire additive manufacturing (LHWAM) is a newer technology within the space of large-scale directed energy deposition (DED) additive manufacturing (AM) processes. This study aims to map known AM flaw types such as lack of fusion and keyholing, as well as a dripping flaw unique to hot wire processes, across process parameter space using a small number of single-track experiments.

Design/methodology/approach
A semianalytical model was calibrated using a small initial set of experimental data. Lack of fusion and keyholing flaws were mapped across process space using existing models. The dripping flaw was modeled via analytical methods calibrated with experimental data, and then mapped across processing space. Further experimental data beyond the small initial set was used to evaluate the accuracy of the process maps developed. A website and executable were deployed to users of the process for convenient rapid process parameter selection.

Findings
With the process maps generated during this work, users can easily and rapidly generate desirable parameter sets for a range of conditions, enabling the intelligent utilization of the entire stable processing regime.

Practical implications
The methodology developed can be applied to other LHWAM machines or DED processes to rapidly and inexpensively generate a systematic understanding of processing space for build planning.

Originality/value
LHWAM shows advantages over other large-scale DED processes, but a systematic physically informed study of the key flaw regions across process space had not been conducted, limiting more widespread use of the process and creating a gap that this study fills.