bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetic Ketoacidosis in Pregnancy: A Systematic Review of the Reported Cases
Authors: Stathi Dimitra , Lee Florence Ning , Dhar Mili , Bobotis Stergios , Arsenaki Elisavet , Agrawal Taruna , Triantafyllidis Konstantinos Katsikas , Kechagias Konstantinos S 
Published: January 2025

Background: Diabetic ketoacidosis (DKA) is a rare but serious complication that can develop during pregnancy, with up to 30% of patients presenting with euglycemia, making prompt recognition challenging. It is associated with increased perinatal mortality rates, although the exact risk of maternal mortality remains unclear. The purpose of this systematic review was to examine the available literature and provide an overview of reported cases of DKA during pregnancy. Methods: PubMed, Web of Science and Scopus library databases were screened from inception until January 2024. Included studies provided data on classic or euglycemic DKA during pregnancy. All study designs were considered eligible for inclusion. Results: We identified 66 eligible articles, which included 57 case reports and case series with individual patient data, and 9 studies without individual patient data. The mean age at diagnosis was 28.8 years, and the average gestational age at diagnosis was 29.5 weeks. The majority of women had type 1 diabetes mellitus (T1DM) (45.9%), followed by gestational diabetes (GDM) (40.5%). Most cases were classified as classic DKA (70.3%), with nearly one-third developing euglycemic DKA (29.7%). The most common trigger factors were infections (28%), followed by poor adherence to treatment (13.5%). The most frequent symptoms included nausea (32.4%), vomiting (32.4%), osmotic symptoms (21.6%), and abdominal pain (20.2%). All cases were treated with intravenous insulin and fluids. The vast majority (98.9%) of women eventually fully recovered, with only 1 reported death due to organ failure (1.3%). Intrauterine death or stillbirth occurred in one-third of cases (35.2%), including 1 instance of a twin pregnancy. Conclusions: DKA is a condition that clinicians may encounter during pregnancy. Although rare, increased awareness and early recognition are crucial for optimal management and improved maternal and neonatal outcomes.
Predictive potential of circular walking in prodromal Parkinson's disease
Authors: Micó-Amigo M Encarna , Kingma Idsart , Heinzel Sebastian , Solbrig Susanne , Hobert Markus A , Elshehabi Morad , Brockmann Kathrin , Metzger Florian G , van Lummel Rob C , Berg Daniela , Maetzler Walter , van Dieën Jaap H 
Published: January 2025

Background Development of objective, reliable and easy-to-use methods to detect the onset of motor changes in Parkinson's disease (PD) is required to identify the temporal window in which neuromodulatory therapies could be implemented. Turning impairments are present at early stages of PD. However, it is unclear, to date, whether circular walking is also altered in prodromal PD. Objective Explore the predictive potential of circular walking in prodromal PD. Methods We included 102 subjects from a nine-year prospective cohort study (with 712 participants) in the current nested case-control analysis: 16 diagnosed with PD during follow-up (incident PD) and 96 healthy controls, matched in gender, age, and education with a 1:6 ratio. Forty-one gait features were extracted from baseline assessments with accelerometers under single and dual-tasking conditions. A Cox proportional hazards regression analysis was used to test the temporal association of non-correlated gait features to the probability of being diagnosed with PD. Results We identified associations between time from baseline measurement to PD diagnosis for eleven gait features, mostly based on harmonic ratios, step and stride variability, and index of harmonicity, partially in combination with gait speed. Most significant associations indicated that low gait symmetry and low rhythmicity were associated with larger hazard of being diagnosed with PD. Area under the curve ranged 0.63-0.69. Conclusions Despite low sensitivity and specificity, the findings potentially reflect prodromal motor impairments of PD manifested during circular walking, assessed quantitatively with a low-cost and wearable instrument. This will contribute to the characterization of pre-diagnostic PD motor symptoms.
Pre- and Intraoperative Factors Associated With Improvement of Neck Pain After Laminoplasty for the Treatment of Cervical Myelopathy
Authors: Lee Dong-Ho , Cagulada Arnold Joseph P. , Hwang Chang Ju , Cho Jae Hwan , Park Sehan 
Published: January 2025

Study Design Retrospective cohort study. Objective To (1) determine whether preoperative neck pain improves after laminoplasty for cervical myelopathy and identify factors that could predict improvements in neck pain. Methods A total of 88 patients with preoperative neck pain visual analogue scale (VAS) of ≥4, who underwent laminoplasty for cervical myelopathy, and were followed-up for >2 years were retrospectively reviewed. Patients demonstrating ≥50% improvement in VAS scores for neck pain 2 years postoperatively compared toㅇ preoperative assessment were included in neck pain improved (NP-improved) group. The remaining patients were assigned to neck pain unimproved (NP-unimproved) group. Results Overall, 54 patients (61.4%) were included in NP-improved group and 34 patients (38.6%) were included in NP-unimproved group. NP-unimproved group more frequently underwent C3 laminectomy ( P = 0.026) and had lesser degree of preoperative C2-C7 lordosis ( P = 0.006) in the extension position compared to that in the NP-improved group. Furthermore, undergoing C3 laminectomy was associated with lower probability of achieving a ≥50% improvement in neck pain VAS scores ( P = 0.018), while greater preoperative C2-C7 lordosis in the extension position was associated with a higher possibility of neck pain improvement ( P = 0.048). A cut-off value of 20.5° for C2-C7 lordosis in the extension position predicted a ≥50% improvement in neck pain. Conclusion Preoperative neck pain should not be considered contraindication for laminoplasty as 61.4% of patients experienced ≥50% improvement in neck pain post-operatively. C3 laminectomy decreases the probability of neck pain improvement after laminoplasty, while greater C2-C7 lordosis in the extension position is associated with neck pain improvement.
Nurse workforce change and metropolitan medically underserved areas in the United States
Authors: Bowser Diana , Mauricio Kaili , Ruscitti Brielle 
Published: January 2025

Abstract

Background
The continued healthcare crisis in the United States (US) is worrisome, especially as workforce shortages, particularly for nurses, are highlighted, often in some of the highest need areas. As the need for healthcare services grows, especially for services that nurses can deliver, the inability to meet those needs exacerbates existing disparities in access to care and can jeopardize the quality and timeliness of healthcare delivery in underserved communities. Prior investigations have used varying definitions to describe underserved, under-resourced, rural, or health professional shortage areas to examine the relationship between these areas and workforce shortages. Therefore, this study examines the relationship between changes in the nursing labor force changes and metropolitan medically underserved areas (MUA), defined by Health Resources and Services Administration (HRSA).

Methods
Secondary data were utilized to conduct descriptive and regression analyses of the nursing workforce population in metropolitan statistical areas from 2012 to 2022. The key outcome variable for the analyses was nurse workforce change per 10,000 population. Occupational Employment and Wage dataset from the Bureau of Labor Statistics was used to determine the number of nurses employed, at the level of the metropolitan statistical area from 2012 to 2022. The Index of Medical Underservice was extracted for each MUA from HRSA and geographically weighted to the metropolitan area.

Results
The results of descriptive trends for nursing professions show that all nursing occupations reviewed have experienced positive change over both five- and ten-year periods. However, the results of nurse change models show that neither the change in Registered Nurses nor Nurse Practitioners is correlated with medically underserved areas.

Conclusions
These results emphasize the need for adaptive strategies in the nursing workforce to respond to the evolution of healthcare requirements over time. The findings from this study suggest the need for careful planning in workforce policy and education to grow the nurse workforce needs to meet evolving healthcare needs effectively.
Impact of worklist selection on point-of-care ultrasound workflow – a quality improvement project
Authors: Rowland Jonathan , Baker Jessa , Dunn Natassia , Whited Matthew , Saadat Soheil , Fox J. Christian 
Published: January 2025

Abstract

Background
Research demonstrates that Point-of-care ultrasound (POCUS) improves clinical outcomes for patients. Improving clinician satisfaction with POCUS should promote utilization into everyday practice, leading to improved clinical outcomes. Despite this benefit, there are still barriers to use including POCUS workflow. This project was undertaken to improve the functionality of the existing POCUS workflow and move toward an “encounter-based” system by automating worklist generation. It aimed to streamline the POCUS workflow, primarily determine if there was improved clinician satisfaction with the new workflow, and secondarily determine the change in revenue generation from decreased errors in data entry.

Methods
A new workflow was created which automatically populated every registered Emergency Department (ED) patient into the worklist upon patient registration. Clinician feedback on their use of the new workflow was sought via survey after implementation. The number of medical record number (MRN) entry errors prior to and following implementation was manually reviewed and calculated.

Results
There was a strong preference for the new workflow, with 36 of 38 (94.7%) clinicians finding it to be more convenient and 37 of 38 (97.4%) finding it to be preferable to use compared to the old workflow. Implementation also resulted in a 36% reduction in database studies containing an MRN data entry error.

Conclusions
An “encounter-based” workflow is strongly preferred over manual data entry for POCUS workflow among clinicians. Additionally, there was no cost to the intervention and the total data entry errors were significantly reduced, allowing for improved quality review and increased revenue.
A new phase of China-ASEAN health cooperation: the China-ASEAN Beijing Declaration on Cooperation in Innovation of Health Products and Technologies
Authors: Qiao Jie , Zhan Siyan , Ren Minghui , Wang Haijun , Huang Yangmu , Zhang Zhenyu , Luo Yanan , Yin Hui , Jia Zhongwei , Huang Wei , Zhou Hong , Liu Jue , Liu Xiaoyun , Sun Qiudan , Li Xiaojia , Bai Jing , Liu Fangjing , Liu Yihong , Jin Yinzi , Xu Ming ,   on behalf of China-ASEAN Science and Technology Cooperation Center for Public Health
Published: January 2025

Abstract
Utilizing innovative methods to advance the research and development (R&D) of health products and enhance their accessibility has become crucial to achieving universal health coverage, addressing public health emergencies, and promoting population health and wellbeing. However, structural contradictions do exist in the supply and demand of health products in the Association of Southeast Asian Nations (ASEAN). With the joint support of the Ministry of Science and Technology of China, the Ministry of Education, and the China-ASEAN Center, Peking University established the China-ASEAN Science and Technology Cooperation Center for Public Health in April 2023. The Center held the Second Annual Forum on China-ASEAN Cooperation in Public Health on June 26–28, 2024, and the participants reached consensus on launching the China-ASEAN Beijing Declaration on Cooperation in Innovation of Health Products and Technologies, which calls on China and ASEAN countries to carry out the following actions: (1) Establish a more effective, open, and inclusive cooperation mechanism for health product innovation towards a China-ASEAN innovation ecosystem; (2) Enhance R&D capabilities by targeting new technologies, methods and appropriate and affordable health products for key populations and addressing diseases prevalent in China and ASEAN; (3) Establish a China-ASEAN Collaboration Center for Health Product Innovation, coordinate regional development plans, and enhance equitable access to pharmaceutical products at the regional level; (4) Accelerate regulatory harmonization in the region by optimizing and improving regulatory modalities of China and ASEAN Countries; and (5) Strengthen cross-sectoral cooperation to build resilient health system and achieve sustainable development of innovation cooperation. The Declaration will play an active role in regional public health governance and development cooperation, in order to promote the R&D and accessibility of health products in the region and to help achieve faster and more equitable access to health products for a broader population.
Differences in technical and clinical perspectives on AI validation in cancer imaging: mind the gap!
Authors: Chouvarda Ioanna , Colantonio Sara , Verde Ana S. C. , Jimenez-Pastor Ana , Cerdá-Alberich Leonor , Metz Yannick , Zacharias Lithin , Nabhani-Gebara Shereen , Bobowicz Maciej , Tsakou Gianna , Lekadir Karim , Tsiknakis Manolis , Martí-Bonmati Luis , Papanikolaou Nikolaos 
Published: January 2025

Abstract
Good practices in artificial intelligence (AI) model validation are key for achieving trustworthy AI. Within the cancer imaging domain, attracting the attention of clinical and technical AI enthusiasts, this work discusses current gaps in AI validation strategies, examining existing practices that are common or variable across technical groups (TGs) and clinical groups (CGs). The work is based on a set of structured questions encompassing several AI validation topics, addressed to professionals working in AI for medical imaging. A total of 49 responses were obtained and analysed to identify trends and patterns. While TGs valued transparency and traceability the most, CGs pointed out the importance of explainability. Among the topics where TGs may benefit from further exposure are stability and robustness checks, and mitigation of fairness issues. On the other hand, CGs seemed more reluctant towards synthetic data for validation and would benefit from exposure to cross-validation techniques, or segmentation metrics. Topics emerging from the open questions were utility, capability, adoption and trustworthiness. These findings on current trends in AI validation strategies may guide the creation of guidelines necessary for training the next generation of professionals working with AI in healthcare and contribute to bridging any technical-clinical gap in AI validation.

Relevance statement
This study recognised current gaps in understanding and applying AI validation strategies in cancer imaging and helped promote trust and adoption for interdisciplinary teams of technical and clinical researchers.

Key Points

Clinical and technical researchers emphasise interpretability, external validation with diverse data, and bias awareness in AI validation for cancer imaging.

In cancer imaging AI research, clinical researchers prioritise explainability, while technical researchers focus on transparency and traceability, and see potential in synthetic datasets.

Researchers advocate for greater homogenisation of AI validation practices in cancer imaging.

Graphical Abstract
Can ChatGPT4-vision identify radiologic progression of multiple sclerosis on brain MRI?
Authors: Kelly Brendan S. , Duignan Sophie , Mathur Prateek , Dillon Henry , Lee Edward H. , Yeom Kristen W. , Keane Pearse A. , Lawlor Aonghus , Killeen Ronan P. 
Published: January 2025

Abstract

Background
The large language model ChatGPT can now accept image input with the GPT4-vision (GPT4V) version. We aimed to compare the performance of GPT4V to pretrained U-Net and vision transformer (ViT) models for the identification of the progression of multiple sclerosis (MS) on magnetic resonance imaging (MRI).

Methods
Paired coregistered MR images with and without progression were provided as input to ChatGPT4V in a zero-shot experiment to identify radiologic progression. Its performance was compared to pretrained U-Net and ViT models. Accuracy was the primary evaluation metric and 95% confidence interval (CIs) were calculated by bootstrapping. We included 170 patients with MS (50 males, 120 females), aged 21–74 years (mean 42.3), imaged at a single institution from 2019 to 2021, each with 2–5 MRI studies (496 in total).

Results
One hundred seventy patients were included, 110 for training, 30 for tuning, and 30 for testing; 100 unseen paired images were randomly selected from the test set for evaluation. Both U-Net and ViT had 94% (95% CI: 89–98%) accuracy while GPT4V had 85% (77–91%). GPT4V gave cautious nonanswers in six cases. GPT4V had precision (specificity), recall (sensitivity), and F1 score of 89% (75–93%), 92% (82–98%), 91 (82–97%) compared to 100% (100–100%), 88 (78–96%), and 0.94 (88–98%) for U-Net and 94% (87–100%), 94 (88–100%), and 94 (89–98%) for ViT.

Conclusion
The performance of GPT4V combined with its accessibility suggests has the potential to impact AI radiology research. However, misclassified cases and overly cautious non-answers confirm that it is not yet ready for clinical use.

Relevance statement
GPT4V can identify the radiologic progression of MS in a simplified experimental setting. However, GPT4V is not a medical device, and its widespread availability highlights the need for caution and education for lay users, especially those with limited access to expert healthcare.

Key Points

Without fine-tuning or the need for prior coding experience, GPT4V can perform a zero-shot radiologic change detection task with reasonable accuracy.

However, in absolute terms, in a simplified “spot the difference” medical imaging task, GPT4V was inferior to state-of-the-art computer vision methods.

GPT4V’s performance metrics were more similar to the ViT than the U-net.

This is an exploratory experimental study and GPT4V is not intended for use as a medical device.

Graphical Abstract
Complexities in post-wildfire governance: lessons from Colorado’s 2020 wildfires
Authors: Carney Clint P. , Schultz Courtney A. , Greiner Michelle S. 
Published: January 2025

Abstract

Background
The increasing size and severity of western U.S. wildfires in recent years has generated greater attention towards post-wildfire response and recovery. Post-fire governance requires coordinating response and recovery capacities across jurisdictions, landscapes, and time scales. The presence of wildfire on federal public lands necessitates federal agency involvement in both suppression and recovery efforts, and program coordination with lower levels of government and non-governmental organizations. Using semi-structured interviews, we investigated experiences of leaders across the governance system with federal post-fire policies and programs following the record-breaking Cameron Peak and East Troublesome wildfires in the state of Colorado.

Results
Our research found that persistent administrative and coordination challenges exist within and among federal agencies in the post-fire response and recovery space. Challenges included cross-jurisdictional coordination of key emergency response programs, program rules that affect post-fire project timing and effectiveness, the absence of a formal federal post-fire response strategy, and program funding issues. These factors revealed and exacerbated scale mismatches between existing agency capacities and the post-fire landscapes that result from unprecedentedly longer, larger, and more severe wildfires occurring in the western USA. Non-federal and non-governmental organizations were instrumental in overcoming these challenges through coordinating response and recovery efforts across both federal and private lands. To improve the federal post-fire response capacity, study participants stressed the importance of broader cross-jurisdictional use of federal resources, longer timeframes for recovery activities, and reforming the federal funding process.

Conclusions
Our findings revealed a persistence of post-fire coordination and funding issues within federal land management agencies, and current agency capacities remain insensitive to the scale of twenty-first-century post-wildfire settings. Addressing the mismatches between existing agency resources and the spatial and temporal scale complexities of post-fire environments will require broader federal support for existing programs along with re-envisioning the overall approach to the post-fire response and recovery process.
Hospitalizations with post-traumatic stress disorder in France between 2013 and 2022: a nationwide retrospective study
Authors: Demesmaeker Alice , Dufrenois Florian , Saint-Dizier Chloé , Vaiva Guillaume , Lamer Antoine , Horn Mathilde , D’Hondt Fabien 
Published: January 2025

Abstract

Introduction
The lifetime prevalence of PTSD ranges from 6 to 20% and is often associated with comorbid disorders. Despite the significant impact of PTSD, specific data on healthcare utilization related to PTSD remain limited. This study aims to characterize PTSD-related hospitalizations in France over the past decade.

Methods
This nationwide longitudinal retrospective study analyzed PTSD-related hospitalizations in France from 2013 to 2022 using the French National Hospitals Database. Data included discharge records from general and psychiatric hospitals, detailing demographics, admission/discharge dates, ICD-10 diagnoses, and hospitalization specifics.

Results
Between 2013 and 2022, 69,108 patients underwent 125,349 hospitalizations with a PTSD diagnosis (0.4% of all inpatient cases) in France. Psychiatric facilities accounted for 74,988 hospitalizations (1% of all psychiatric inpatient cases in France), while general hospitals recorded 50,361 hospitalizations (0.02% of all non-psychiatric inpatient cases). The percentage of inpatients diagnosed with PTSD increased from 0.68 to 2.22% in psychiatric facilities and from 0.02 to 0.04% in general hospitals over the study period. Females were younger in both settings and had longer stays compared to males in psychiatric facilities. Over time, there was a decrease in median age and an increase in part-time hospitalizations in psychiatric facilities. Mood disorders, stress-related disorders, and substance use disorders were prevalent comorbidities in both settings.

Conclusions
This study highlights a rise in PTSD-related hospitalizations in France, particularly in psychiatric facilities and after 2019, with high rates among women and an increase in hospitalization of younger individuals. These findings highlight the necessity for improved care strategies tailored to the increasing number of younger patients with PTSD.