bluuebunny/crossref_metadata_2025_split huggingface dataset:
NORMAN guidance on suspect and non-target screening in environmental monitoring
Authors: Hollender Juliane , Schymanski Emma L. , Ahrens Lutz , Alygizakis Nikiforos , Béen Frederic , Bijlsma Lubertus , Brunner Andrea M. , Celma Alberto , Fildier Aurelie , Fu Qiuguo , Gago-Ferrero Pablo , Gil-Solsona Ruben , Haglund Peter , Hansen Martin , Kaserzon Sarit , Kruve Anneli , Lamoree Marja , Margoum Christelle , Meijer Jeroen , Merel Sylvain , Rauert Cassandra , Rostkowski Pawel , Samanipour Saer , Schulze Bastian , Schulze Tobias , Singh Randolph R. , Slobodnik Jaroslav , Steininger-Mairinger Teresa , Thomaidis Nikolaos S. , Togola Anne , Vorkamp Katrin , Vulliet Emmanuelle , Zhu Linyan , Krauss Martin 
Published: September 2023

AbstractIncreasing production and use of chemicals and awareness of their impact on ecosystems and humans has led to large interest for broadening the knowledge on the chemical status of the environment and human health by suspect and non-target screening (NTS). To facilitate effective implementation of NTS in scientific, commercial and governmental laboratories, as well as acceptance by managers, regulators and risk assessors, more harmonisation in NTS is required. To address this, NORMAN Association members involved in NTS activities have prepared this guidance document, based on the current state of knowledge. The document is intended to provide guidance on performing high quality NTS studies and data interpretation while increasing awareness of the promise but also pitfalls and challenges associated with these techniques. Guidance is provided for all steps; from sampling and sample preparation to analysis by chromatography (liquid and gas—LC and GC) coupled via various ionisation techniques to high-resolution tandem mass spectrometry (HRMS/MS), through to data evaluation and reporting in the context of NTS. Although most experience within the NORMAN network still involves water analysis of polar compounds using LC–HRMS/MS, other matrices (sediment, soil, biota, dust, air) and instrumentation (GC, ion mobility) are covered, reflecting the rapid development and extension of the field. Due to the ongoing developments, the different questions addressed with NTS and manifold techniques in use, NORMAN members feel that no standard operation process can be provided at this stage. However, appropriate analytical methods, data processing techniques and databases commonly compiled in NTS workflows are introduced, their limitations are discussed and recommendations for different cases are provided. Proper quality assurance, quantification without reference standards and reporting results with clear confidence of identification assignment complete the guidance together with a glossary of definitions. The NORMAN community greatly supports the sharing of experiences and data via open science and hopes that this guideline supports this effort.
Prediction of American Society of Anesthesiologists Physical Status Classification from preoperative clinical text narratives using natural language processing
Authors: Chung Philip , Fong Christine T. , Walters Andrew M. , Yetisgen Meliha , O’Reilly-Shah Vikas N. 
Published: September 2023

Abstract
Background
Electronic health records (EHR) contain large volumes of unstructured free-form text notes that richly describe a patient’s health and medical comorbidities. It is unclear if perioperative risk stratification can be performed directly from these notes without manual data extraction. We conduct a feasibility study using natural language processing (NLP) to predict the American Society of Anesthesiologists Physical Status Classification (ASA-PS) as a surrogate measure for perioperative risk. We explore prediction performance using four different model types and compare the use of different note sections versus the whole note. We use Shapley values to explain model predictions and analyze disagreement between model and human anesthesiologist predictions.

Methods
Single-center retrospective cohort analysis of EHR notes from patients undergoing procedures with anesthesia care spanning all procedural specialties during a 5 year period who were not assigned ASA VI and also had a preoperative evaluation note filed within 90 days prior to the procedure. NLP models were trained for each combination of 4 models and 8 text snippets from notes. Model performance was compared using area under the receiver operating characteristic curve (AUROC) and area under the precision recall curve (AUPRC). Shapley values were used to explain model predictions. Error analysis and model explanation using Shapley values was conducted for the best performing model.

Results
Final dataset includes 38,566 patients undergoing 61,503 procedures with anesthesia care. Prevalence of ASA-PS was 8.81% for ASA I, 31.4% for ASA II, 43.25% for ASA III, and 16.54% for ASA IV-V. The best performing models were the BioClinicalBERT model on the truncated note task (macro-average AUROC 0.845) and the fastText model on the full note task (macro-average AUROC 0.865). Shapley values reveal human-interpretable model predictions. Error analysis reveals that some original ASA-PS assignments may be incorrect and the model is making a reasonable prediction in these cases.

Conclusions
Text classification models can accurately predict a patient’s illness severity using only free-form text descriptions of patients without any manual data extraction. They can be an additional patient safety tool in the perioperative setting and reduce manual chart review for medical billing. Shapley feature attributions produce explanations that logically support model predictions and are understandable to clinicians.
Pulmonary fat embolism: a potentially new fatal complication of SARS-CoV-2 infection. A case report
Authors: Kong Jiangwei , Yang Tengfei , Zhang Fu , Liao XinBiao , Du Sihao , Yang Xingan , Li Dongri 
Published: September 2023

Abstract
Background
So far, there have been more than 761 million confirmed cases of SARS-CoV-2 worldwide, with more than 6.8 million deaths. The most common direct causes of death for COVID-19 are diffuse alveolar injury and acute respiratory distress syndrome. Autopsy results have shown that 80-100% of COVID-19 patients have microthrombi which is 9 times higher than in patients with influenza. There are reported cases of fat embolism associated with Covid-19, but relevant epidemiological investigations and fatal cases of pulmonary fat embolism are lacking. In this report, we describe the first COVID-19 patient to die from pulmonary fat embolism.

Case presentation
A 54-year-old woman suddenly felt unwell while at work. She had difficulty breathing for 40 min and lost consciousness for 20 min before being taken to the hospital. On admission, her temperature was 36 ℃, but her respiration, heart rate, and blood pressure were undetectable. Laboratory examination revealed C-reactive protein, 26.55 mg/L; D-dimer, 11,400 µg/L; and procalcitonin, 0.21 ng/mL. She was declared clinically dead 2 h after admission due to ineffective rescue efforts. At autopsy, both lungs were highly oedematous with partial alveolar haemorrhage. The presence of microthrombi and pulmonary fat embolism in small interstitial pulmonary vessels was confirmed by phosphotungstic acid haematoxylin staining and oil red O staining. The immunohistochemical results of spike protein and nucleocapsid protein in laryngeal epithelial cells confirmed SARS-CoV-2 infection.

Conclusions
Pulmonary fat embolism may be another fatal complication of COVID-19 infection, and clinicians should pay more attention to it.
Exploring Heterogeneity in perinatal depression: a comprehensive review
Authors: Waqas Ahmed , Nadeem Mahnoor , Rahman Atif 
Published: September 2023

AbstractPerinatal depression (PND) is a significant contributor to maternal morbidity globally. Recognized as a major cause of poor infant development, epidemiological and interventional research on it has increased over the last decade. Recently, studies have pointed out that PND is a heterogeneous condition, with variability in its phenotypes, rather than a homogenous latent entity and a concrete diagnosis, as previously conceptualized in psychometric literature and diagnostic systems. Therefore, it is pertinent that researchers recognize this to progress in elucidating its aetiology and developing efficacious interventions.This systematic review is conducted in accordance with the Meta-analysis of observational studies in epidemiology (MOOSE). It aims to provide an updated and comprehensive account of research on heterogeneity in phenotypes of PND and its implications in research, public health, and clinical practice. It provides a synthesis and quality assessment of studies reporting heterogeneity in PND using cutting-edge statistical techniques and machine learning algorithms. After reporting the phenotypes of PND, based on heterogeneous trajectories and symptom profiles, it also elucidates the risk factors associated with severe forms of PND, followed by robust evidence for adverse child outcomes. Furthermore, recommendations are made to improve public health and clinical practice in screening, diagnosis, and treatment of PND.
The theory of planned behavior and dietary behaviors in competitive women bodybuilders
Authors: Haubenstricker John E. , Lee Jerry W. , Segovia-Siapco Gina , Medina Ernesto 
Published: September 2023

AbstractBackgroundWomen bodybuilders build their ideal physique by manipulating their diet, supplement, and exercise regimens to extreme levels. Excess protein intake and dietary supplement use is ubiquitous in women bodybuilders preparing for a competition, i.e., in-season competitors, however the impetus for these two dietary behaviors are relatively unknown. The Theory of Planned Behavior (TPB) has been used to explain dietary behaviors. The purpose of the study was to examine how the TPB can explain protein intake and dietary supplement use in in-season competitors.MethodsUsing a cross-sectional design, an online questionnaire was developed, validated, and administered to collect dietary supplement use, TPB variables, and other measures from 112 in-season competitors. Protein intake was assessed using multiple 24-h dietary recalls. Associations between TPB and protein intake and dietary supplement use were determined with multiple regression analysis while adjusting for confounders.ResultsFor protein intake: attitude, subjective norm, and perceived behavioral control explained 8% of the variance in intention; subjective norm independently predicted intention. Behavioral beliefs predicted attitude; subjective norm was predicted by trainer/coach, workout partners, and social media influencers. For dietary supplement use: intention explained 5% of the variance in dietary supplement use; attitude, subjective norm, and perceived behavioral control together explained 38% of the variance in intention. Attitudes towards dietary supplements use were predicted by five factors (not a waste of money, help improve physique, sustain energy levels, provide enough calories, help with recovery). Primary determinants of subjective norm were fellow competitors, social media influencers, and trainer/coach. Perceived behavioral control was predicted by three factors (ease of purchase, affordability to purchase, availability to purchase).ConclusionsTPB predicted dietary supplement use in women bodybuilders during in-season but there was little evidence for the prediction of protein intake using the TPB. Health professionals should develop effective interventions using strategies that align health education messages with in-season competitors’ outcome beliefs and collaborate with their referent others to influence safer and effective dietary supplement use.
Association between uveitis onset and economic development in mainland China
Authors: Tan Handan , Feng Xiaojie , Yang Peizeng 
Published: September 2023

Abstract
Background
Economic prosperity has fostered numerous changes that may translate into better or worse outcomes across all domains of health. This study aims to explore the associations of economic development with uveitis onset in mainland China.

Methods
We used Poisson regression with generalized estimated equations to quantify the associations of per capita gross domestic product (GDP) with uveitis onset in 31 provinces of mainland China from 2006 to 2017. We further estimated the effects mediated by economic growth on the temperature-uveitis and PM2.5-uveitis associations established in our previous studies.

Results
A total of 12,721 uveitis patients from 31 provinces of mainland China were studied. Overall, every 10,000 Chinese yuan ($ 1491.278, 2006–2017) increase in per capita GDP, with no weighted value or weighted by population, corresponded to 1.85% (95% confidence interval, 1.19–2.52%) and 1.43% (95% confidence interval, 0.37–2.51%) lnRR decrease in the uveitis onsets. Stratified analysis showed this negative association between per capita GDP and uveitis onset, only existed in male patients (P < .001), individuals aged 20–50 years (P < 0 .05), non-infectious uveitis, uveitis with systemic disease, and Bechet’s disease (all P < 0 .05). Moreover, the increased per capita GDP, if above the national level, could reinforce both temperature-uveitis and PM2.5-uveitis association (both P < 0.001).

Conclusions
The findings suggest that economic development is negatively associated with uveitis onset. However, it may facilitate the uveitis onset mediated by both increased temperature and PM2.5 exposure if the per capita GDP is above national level.
Pulmonary inflammatory leiomyosarcoma represents a potential diagnostic pitfall of DNA methylation-based classification of sarcomas: a case report
Authors: Shibayama Takahiro , Satomi Kaishi , Tanaka Ryota , Yoshida Akihiko , Nagahama Kiyotaka , Hayashi Akimasa , Hibiya Takashi , Suda Kazuharu , Fujiwara Masachika , Shibahara Junji 
Published: September 2023

Abstract
Background
Pulmonary inflammatory leiomyosarcoma (PILMS) is a rare type of myogenic tumor with prominent lymphohistiocytic infiltration. Despite their histological similarities, PILMS is immunohistochemically and genetically distinct from soft tissue inflammatory leiomyosarcoma, and its clinicopathological picture including DNA methylome data remains still unknown.

Case presentation
Here we present a case of PILMS in an 18-year-old male who underwent lobectomy. As reported previously, the current case demonstrated spindle myoid cell proliferation with smooth muscle differentiation within a prominent lymphohistiocytic infiltration and a diploid genome with a MUC3A gene alteration. DNA methylation analysis predicted this case to be an “inflammatory myofibroblastic tumor” (IMT) according to the Deutsches Krebsforschungszentrum (DKFZ) classifier. The data was analyzed by t-distributed stochastic neighbor embedding, which plotted the case tumor in the vicinity of IMT, however, there were no IMT histological features. These discordant results could be due to background non-neoplastic inflammatory cells.

Conclusions
As the DNA methylation classification of PILMS might be a potential diagnostic pitfall, an integrative histological and genetic approach is required for its accurate diagnosis.
Influence of lymphadenectomy on survival and recurrence in patients with early-stage epithelial ovarian cancer: a meta-analysis
Authors: Yang Chenchen , Zhang Ting , Gong Aifeng , Shi Can 
Published: September 2023

Abstract
Background
This meta-analysis aimed to evaluate the effectiveness of lymphadenectomy on survival and recurrence in patients with early-stage epithelial ovarian cancer (eEOC).

Methods
Relevant studies were searched from four online databases. Hazard ratios (HRs) with 95% confidence intervals (CIs) or risk ratios (RRs) with 95% CIs were used to evaluate the effects of lymphadenectomy on overall survival (OS), progression-free survival (PFS), and recurrence rates. A subgroup analysis was performed to explore the sources of heterogeneity, followed by sensitivity and publication bias assessments.

Results
Fourteen articles involving 22,178 subjects were included. Meta-analysis revealed that lymphadenectomy was significantly associated with improved OS (HR = 0.72; 95% CI:0.61, 0.84; P < 0.001), improved PFS (HR = 0.74; 95% CI: 0.67, 0.80; P < 0.001), and reduced recurrence rates (RR = 0.72; 95% CI: 0.60, 0.85; P < 0.001). Subgroup analysis showed that factors including area, histology, and source of the control group were significantly related to improved OS and PFS in patients with eEOC. Sensitivity analysis showed that the combined results were stable and reliable, and no significant publication bias was observed.

Conclusions
Patients with eEOC can benefit from lymphadenectomy, with improved survival outcomes (OS and PFS) and a lower recurrence rate.
The anti-allergic potential of stingless bee honey from different botanical sources via modulation of mast cell degranulation
Authors: Yong Poi Yi Aw , Yip Ashley Jia Wen , Islam Fahmida , Hong Hui Jing , Teh Yi En , Tham Chau Ling , Tan Ji Wei 
Published: September 2023

AbstractBackgroundAllergy is an inflammatory disorder affecting around 20% of the global population. The adverse effects of current conventional treatments give rise to the increased popularity of using natural food products as complementary and alternative medicine against allergic diseases. Stingless bee honey, commonly known as Kelulut honey (KH) in Malaysia, has been used locally as a traditional remedy to relieve cough and asthma. This study evaluated the anti-allergic potential of KH collected from four different botanical sources on phorbol ester 12-myristate-3-acetate and calcium ionophore-activated human mast cells.MethodsThe present study examined the inhibitory effects of all collected honey on the release of selected inflammatory mediators, such as tumor necrosis factor-α (TNF-α), interleukin (IL)-4, IL-6, IL-8, histamine, and β-hexosaminidase in an activated HMC. Besides that, all honey's total phenolic content (TPC) was also examined, followed by using liquid chromatography with tandem mass spectrometry (LC–MS/MS) to identify the phytochemicals in the honey. Further examination of the identified phytochemicals on their potential interaction with selected signaling molecules in an activated mast cell was conducted using computational methods.ResultsThe results indicated that there were significant inhibitory effects on all selected inflammatory mediators’ release by KH sourced from bamboo (BH) and rubber tree (RH) at 0.5% and 1%, but not KH sourced from mango (AH) and noni (EH). BH and RH were found to have higher TPC values and were rich in their phytochemical profiles based on the LC–MS/MS results. Computational studies were employed to determine the possible molecular target of KH through molecular docking using HADDOCK and PRODIGY web servers.ConclusionsIn short, the results indicated that KH possesses anti-allergic effects towards an activated HMC, possibly by targeting downstream MAPKs. However, their anti-allergic effects may vary according to their botanical sources. Nevertheless, the present study has provided insight into the potential application of stingless bee honey as a complementary and alternative medicine to treat various allergic diseases.
Physicians’ knowledge, attitude and perceptions towards vaccine-hesitant parents: a cross-sectional study
Authors: Albaker Asma R. , Azer Samy A. , AlKhorayef Muneera , Dakheel Njoud K. Bin , AlMutairi Shahad , AlHelal Sarah , Aljohani Roaa , Maghrabi Sarah 
Published: September 2023

Abstract
Objectives
Research has shown that physicians are encountering an increase in vaccine-hesitant parents (VHPs) numbers. This study examined physicians' vaccination knowledge, vaccine-related discussions with VHPs, beliefs about and responses to vaccine hesitancy, and challenges faced while discussing immunization with VHPs.

Methods
This cross-sectional, descriptive study was performed at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia, in September 2020. The data were collected through a questionnaire distributed via email. The sample comprised 90 physicians who routinely treat children and reported they frequently have appropriate vaccine discussions when encountering VHPs.

Results
Ninety participants (59% were females) completed the questionnaire. Of these, 37.8% were from family medicine, 7.8% from primary care, and 54.4% from paediatrics. The most discussed topics were vaccine necessity, reasons for vaccine refusal, and vaccine safety. Seventeen participants (18.8%) reported being extremely confident, and (42.2%) were confident in their vaccine-specific knowledge. Regarding confidence in communication skills, 22.2% reported being extremely confident and (45.6%) were confident. Determinants of higher confidence in the knowledge and communication skills were physician age (p = 0.001 and p = 0.0001, respectively), years of practice (p = 0.002 and (p = 0.005), and patients seen per workday (p = 0.0001 and p = 0.024). Other factors such as physician sex (p = 0.062), the field of practice (p = 0.329), and hours of work per week (p = 0.061) were not significantly different. Forty-six (51%) physicians sometimes find it challenging to conduct appropriate vaccine-related discussions because of having too many other issues to discuss during the consultation. Furthermore, 53 (59%) participants agreed/strongly agreed that parental refusal to vaccinate would raise suspicions of negligence. On the other hand, 59 (65%) disagreed/strongly disagreed that parental refusal of vaccines is a parental right. Participants expressed the need to refer VHPs to a specialised advisory clinic with excellent experience and negotiation skills to overcome the challenges.

Conclusion
Vaccine safety and necessity are the topics of most concern to VHPs, and a knowledgeable physician with competent communication skills is critical in responding to such situations. This study highlights the most reported barriers to successful vaccine-related discussions. It raises underlying ethical principles such as parental autonomy and the need to train physicians in VHPs. To train physians for succucful vaccine counceling of VHPs.
Hand hygiene and biomedical waste management among medical students: a quasi-experimental study evaluating two training methods
Authors: Mlouki Imen , Ayed Souha Ben , Chebbi Faouzia , Rezg Nejla , Khouildi Aida , Sassi Amel Haj , El Mhamdi Sana 
Published: September 2023

AbstractBackgroundSeveral studies revealed that medical students have low performance levels of hand hygiene (HH) and biomedical waste management (BMWM). However, there have been limited interventions directed at young students targeting HH and BMWM enhancement. Given these data, we aimed at assessing HH and BMWM among medical students after two training methods.MethodsWe performed a quasi-experimental study from September 2021 to May 2022, which included fifth-year medical students enrolled in the faculty of Medicine of Monastir (Tunisia). We relied on a conventional training based on presentations and simulations guided by the teacher and a student-centred training method based on courses and simulated exercises prepared by students. We used the WHO HH Knowledge Questionnaire and the “BMWM audit” validated by The Nosocomial Infection Control Committee in France.ResultsA total of 203 medical students were included (105 in the control group and 98 in the experimental group) with a mean age of 23 ± 0.7 years. Regarding HH, we found a statistically significant increase in post-test scores for both training methods. A higher post-test mean score was noted for student-centred method (14.1 ± 1.9 vs. 13.9 ± 2.3). The overall improvement in good HH knowledge rates was greater after student-centred method compared to conventional training (40.5% vs. 25%). Concerning infectious waste, mean scores were higher after student-centred learning in all hazardous waste management steps (25 ± 3.3 vs. 23.6 ± 5.5).ResultsCoupling student-centred teaching and continuous supervision could improve HH and BMWM knowledge and practices among medical students.