bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neural networks based on attention architecture are robust to data missingness for early predicting hospital mortality in intensive care unit patients
Authors: Zeng Zhixuan , Liu Yang , Yao Shuo , Liu Jiqiang , Xiao Bing , Liu Chenxue , Gong Xun 
Published: May 2023

Background Although the machine learning model developed on electronic health records has become a promising method for early predicting hospital mortality, few studies focus on the approaches for handling missing data in electronic health records and evaluate model robustness to data missingness. This study proposes an attention architecture that shows excellent predictive performance and is robust to data missingness. Methods Two public intensive care unit databases were used for model training and external validation, respectively. Three neural networks (masked attention model, attention model with imputation, attention model with missing indicator) based on the attention architecture were developed, using masked attention mechanism, multiple imputation, and missing indicator to handle missing data, respectively. Model interpretability was analyzed by attention allocations. Extreme gradient boosting, logistic regression with multiple imputation and missing indicator (logistic regression with imputation, logistic regression with missing indicator) were used as baseline models. Model discrimination and calibration were evaluated by area under the receiver operating characteristic curve, area under precision-recall curve, and calibration curve. In addition, model robustness to data missingness in both model training and validation was evaluated by three analyses. Results In total, 65,623 and 150,753 intensive care unit stays were respectively included in the training set and the test set, with mortality of 10.1% and 8.5%, and overall missing rate of 10.3% and 19.7%. attention model with missing indicator had the highest area under the receiver operating characteristic curve (0.869; 95% CI: 0.865 to 0.873) in external validation; attention model with imputation had the highest area under precision-recall curve (0.497; 95% CI: 0.480–0.513). Masked attention model and attention model with imputation showed better calibration than other models. The three neural networks showed different patterns of attention allocation. In terms of robustness to data missingness, masked attention model and attention model with missing indicator are more robust to missing data in model training; while attention model with imputation is more robust to missing data in model validation. Conclusions The attention architecture has the potential to become an excellent model architecture for clinical prediction task with data missingness.
Workflow assessment of an augmented reality application for planning of perforator flaps in plastic reconstructive surgery: Game or game changer?
Authors: Berger Matthias Fabian , Winter Raimund , Tuca Alexandru-Cristian , Michelitsch Birgit , Schenkenfelder Bernhard , Hartmann Robert , Giretzlehner Michael , Reishofer Gernot , Kamolz Lars-Peter , Lumenta David Benjamin 
Published: May 2023

Objective In contrast to the rising amount of financial investments for research and development in medical technology worldwide is the lack of usability and clinical readiness of the produced systems. We evaluated an augmented reality (AR) setup under development for preoperative perforator vessel mapping for elective autologous breast reconstruction. Methods In this grant-supported research pilot, we used magnetic resonance angiography data (MR-A) of the trunk to superimpose the scans on the corresponding patients with hands-free AR goggles to identify regions-of-interest for surgical planning. Perforator location was assessed using MR-A imaging (MR-A projection) and Doppler ultrasound data (3D distance) and confirmed intraoperatively in all cases. We evaluated usability (System Usability Scale, SUS), data transfer load and documented personnel hours for software development, correlation of image data, as well as processing duration to clinical readiness (time from MR-A to AR projections per scan). Results All perforator locations were confirmed intraoperatively, and we found a strong correlation between MR-A projection and 3D distance measurements (Spearman r = 0.894). The overall usability (SUS) was 67 ± 10 (=moderate to good). The presented setup for AR projections took 173 min to clinical readiness (=availability on AR device per patient). Conclusion In this pilot, we calculated development investments based on project-approved grant-funded personnel hours with a moderate to good usability outcome resulting from some limitations: assessment was based on one-time testing with no previous training, a time lag of AR visualizations on the body and difficulties in spatial AR orientation. The use of AR systems can provide new opportunities for future surgical planning, but has more potential for educational (e.g., patient information) or training purposes of medical under- and postgraduates (spatial recognition of imaging data associated with anatomical structures and operative planning). We expect future usability improvements with refined user interfaces, faster AR hardware and artificial intelligence-enhanced visualization techniques.
Unintended consequences of disseminating behavioral health evidence to policymakers: Results from a survey-based experiment
Authors: Purtle Jonathan , Nelson Katherine L. , Lê-Scherban Félice , Gollust Sarah E. 
Published: May 2023

Background Communication research demonstrates that messages often have unintended consequences, but this work has received limited attention in implementation science. This dissemination experiment sought to determine whether state-tailored policy briefs about the behavioral health consequences of adverse childhood experiences (ACEs), compared to national policy briefs on the topic, increased state legislators’/staffers’ perceptions of the policy brief relevance and parental blame for the consequences of ACEs, and whether effects differed between Democrats and Republicans. Method A preregistered, web-based survey experiment with U.S. state legislators/staffers was conducted in 2021 ( n  =  133). Respondents were randomized to view a policy brief about the behavioral health consequences of ACEs that included state-tailored data (intervention condition) or national data (control condition) and then answered survey questions. Dependent variables were perceived policy brief relevance and parental blame for the consequences of ACEs. Results The mean policy brief relevance score was 4.1% higher in the intervention than in the control condition ( p  =  .24), but the mean parental blame score was 16.5% higher ( p  =  .02). When outcomes were dichotomized, 61.2% of respondents in the intervention condition rated parents as “very much to blame” for the consequences of ACEs compared to 37.1% in the control condition ( p  =  .01). When the sample was stratified by political affiliation, the effect of the state-tailored policy brief on parental blame was larger in magnitude among Democrats and not significant among Republicans. The intervention policy brief increased the mean parental blame score by 22.8% among Democrats relative to the control policy brief ( p  =  .007) and doubled the proportion rating parents as “very much to blame” (52.2% vs. 26.1%, p  =  .03). Conclusions Despite limited statistical power, state-tailored policy briefs significantly increased state legislators’/staffers’ perceptions of parental blame for the behavioral health consequences of ACEs, relative to a policy brief with national data. Unintended messaging effects warrant greater attention in dissemination research and practice.
Trace amine-associated receptor 1 regulation of Kv1.4 channels in trigeminal ganglion neurons contributes to nociceptive behaviors
Authors: Zhang Yuan , Wang Hua , Sun Yufang , Huang Zitong , Tao Yu , Wang Yiru , Jiang Xinghong , Tao Jin 
Published: May 2023

AbstractBackgroundTrace amines, such as tyramine, are endogenous amino acid metabolites that have been hypothesized to promote headache. However, the underlying cellular and molecular mechanisms remain unknown.MethodsUsing patch-clamp recording, immunostaining, molecular biological approaches and behaviour tests, we elucidated a critically functional role of tyramine in regulating membrane excitability and pain sensitivity by manipulating Kv1.4 channels in trigeminal ganglion (TG) neurons.ResultsApplication of tyramine to TG neurons decreased the A-type K+current (IA) in a manner dependent on trace amine-associated receptor 1 (TAAR1). Either siRNA knockdown of Gαo or chemical inhibition of βγ subunit (Gβγ) signaling abrogated the response to tyramine. Antagonism of protein kinase C (PKC) prevented the tyramine-inducedIAresponse, while inhibition of conventional PKC isoforms or protein kinase A elicited no such effect. Tyramine increased the membrane abundance of PKCθin TG neurons, and either pharmacological or genetic inhibition of PKCθblocked the TAAR1-mediatedIAdecrease. Furthermore, PKCθ-dependentIAsuppression was mediated by Kv1.4 channels. Knockdown of Kv1.4 abrogated the TAAR1-inducedIAdecrease, neuronal hyperexcitability, and pain hypersensitivity. In a mouse model of migraine induced by electrical stimulation of the dura mater surrounding the superior sagittal sinus, blockade of TAAR1 signaling attenuated mechanical allodynia; this effect was occluded by lentiviral overexpression of Kv1.4 in TG neurons.ConclusionThese results suggest that tyramine induces Kv1.4-mediatedIAsuppression through stimulation of TAAR1 coupled to the Gβγ-dependent PKCθsignaling cascade, thereby enhancing TG neuronal excitability and mechanical pain sensitivity. Insight into TAAR1 signaling in sensory neurons provides attractive targets for the treatment of headache disorders such as migraine.
The characteristics of the intestinal bacterial community from Oreochromis mossambicus and its interaction with microbiota from artificial fishery habitats
Authors: Bi Sheng , Lai Han , Guo Dingli , Yi Huadong , Li Haiyang , Liu Xuange , Chen Qiuxian , Chen Jiahui , Zhang Zhilun , Wei Xuchong , Li Guifeng , Xin Guorong 
Published: May 2023

Abstract
Background
Artificial habitats can allow many fish to flock together and interact and have been widely used to restore and protect fishery resources. The piece of research intends to elucidate the relationship of microbial communities between tilapia (Oreochromis mossambicus) intestines and artificial fishery habitats (water and sediments). Hence, 16 S rDNA sequencing technology was used to study the bacterial communities from intestines, water, and sediments.

Results
The results showed that the tilapia intestines had the lowest richness of Operational Taxonomic Units (OTUs) and the lowest diversity of the bacterial community compared to water and sediments. The intestine, water, and sediment microbial communities shared many OTUs. Overall, 663 shared OTUs were identified from the tilapia intestines (76.20%), the surrounding water (71.14%), and sediment (56.86%) in artificial habitats. However, there were unique OTUs that were detected in different sample types. There were 81, 77 and 112 unique OTUs observed in tilapia intestines, the surrounding water and sediment, respectively. Proteobacteria, Cyanobacteria, Actinobacteria, Firmicutes, Fusobacteria, and Bacteroidetes were the most common and dominant bacterial phyla between the tilapia intestines and habitats. In the two groups, the microbial communities were similar in the taxonomic composition but different in the abundance of bacterial phyla. Interestingly, Firmicutes increased, while Fusobacteria decreased in artificial habitats. These findings indicated that the artificial habitats had fewer effects on the water environment and indicated that the mode of artificial habitats could have an effect on the enriched bacteria in the tilapia intestines.

Conclusions
This study analysed the bacterial communities of artificial habitats from the intestines, water, and sediments, which can explain the relationship between the tilapia intestines and habitats and strengthen the value of ecological services provided by artificial habitats.
The impact of self-employment on mental health of the younger elderly in China
Authors: Zhou Deshui , Zhan Qianqian , Li Lele 
Published: May 2023

Abstract
Background
With the prolongation of the life expectancy of the Chinese population and the intensification of the aging process of the population, the mental health problems of the elderly have become increasingly prominent. This study aims to explore whether self-employment can promote and how to promote the mental health of the elderly.

Method
Based on the 2018 China Longitudinal Aging Social Survey (CLASS) data, this paper uses OLS model and KHB method to verify the impact of self-employment on the mental health of the younger elderly and its mechanism.

Results
The results indicate that self-employment can significantly reduce the depression tendency of the younger elderly and promote their mental health. Heterogeneity analysis shows that self-employment has a more significant positive impact on the mental health of the younger elderly who are self-rated healthy, free of chronic diseases and low-level medical service utilization. The mechanism shows that self-employment can indirectly improve the mental health of the younger elderly through income growth effect and self-worth realization effect, in which the self-worth realization effect is greater than the economic effect. It illustrates that with the development of China’s economy, the elderly are pursuing more intrinsic values brought by self-employment than economic benefits.

Conclusion
In view of the above research results, it is suggested to encourage the elderly to actively participate in social activities, provide policy support for the younger elderly to engage in self-employment, increase government support as well as health guarantee level, and improve the subjective initiative of the elderly to participate in self-employment, so that the society can truly realize the healthy aging of “being useful and productive for the elderly”.
Comparing the performance of dengue virus IgG and IgG-capture enzyme-linked immunosorbent assays in seroprevalence study
Authors: Tsai Jih-Jin , Tsai Ching-Yi , Lin Ping-Chang , Chen Chun-Hong , Tsai Wen-Yang , Dai Yu-Ching , Lin Yen-Chia , Pedroso Celia , Brites Carlos , Wang Wei-Kung 
Published: May 2023

Abstract
Background
Dengue virus (DENV) is the leading cause of arboviral diseases in humans worldwide. Currently Dengvaxia, the first dengue vaccine licensed in 20 countries, was recommended for DENV seropositive individuals aged 9–45 years. Studying dengue seroprevalence can improve our understanding of the epidemiology and transmission dynamics of DENV, and facilitate future intervention strategies and assessment of vaccine efficacy. Several DENV envelope protein-based serological tests including IgG and IgG-capture enzyme-linked immunosorbent assays (ELISAs) have been employed in seroprevalence studies. Previously DENV IgG-capture ELISA was reported to distinguish primary and secondary DENV infections during early convalescence, however, its performance over time and in seroprevalence study remains understudied.

Methods
In this study, we used well-documented neutralization test- or reverse-transcription-polymerase-chain reaction-confirmed serum/plasma samples including DENV-naïve, primary and secondary DENV, primary West Nile virus, primary Zika virus, and Zika with previous DENV infection panels to compare the performance of three ELISAs.

Results
The sensitivity of the InBios IgG ELISA was higher than that of InBios IgG-capture and SD IgG-capture ELISAs. The sensitivity of IgG-capture ELISAs was higher for secondary than primary DENV infection panel. Within the secondary DENV infection panel, the sensitivity of InBios IgG-capture ELISA decreased from 77.8% at < 6 months to 41.7% at 1–1.5 years, 28.6% at 2–15 years and 0% at > 20 years (p < 0.001, Cochran-Armitage test for trend), whereas that of IgG ELISA remains 100%. A similar trend was observed for SD IgG-capture ELISA.

Conclusions
Our findings demonstrate higher sensitivity of DENV IgG ELISA than IgG-capture ELISA in seroprevalence study and interpretation of DENV IgG-capture ELISA should take sampling time and primary or secondary DENV infection into consideration.
Expression of IL-13Rα2 and FUS in glioma: clinicopathological and prognostic correlation
Authors: Cheng Guang , Wang Meng , Zhang Xiyue , Zhang Yun 
Published: May 2023

Abstract
Background
IL-13Rα2 is one of the most widely studied tumor-associated antigens in glioma research. Fused in sarcoma (FUS) is a DNA/RNA binding protein that is dysfunctional in various malignant tumors. However, the expression of IL-13Rα2 and FUS, their relationship with clinicopathological parameters and their prognostic value in glioma remain unclear.

Methods
In the present study, the expression of IL-13Rα2 and FUS was measured in a glioma tissue array by immunohistochemistry. Pearson’s X2 test was used to determine the correlation between immunohistochemical expressions and clinicopathological parameters. Pearson’s or Spearman's correlation test was used to determine the association between these two proteins expression. The Kaplan–Meier analysis was used to investigate the effect of these proteins on prognosis.

Results
The expressions of IL-13Rα2 were significantly higher in high-grade gliomas (HGG) than that in low-grade gliomas (LGG) and was associated with IDH mutation status, whereas FUS location demonstrated no significant correlation with clinicopathological parameters. Moreover, a positive relationship was found between nuclear and cytoplasmic co-localization FUS and IL-13Rα2 expression. Kaplan–Meier analysis revealed that patients with IDH wide type or IL-13Rα2 had worst overall survival (OS) compared to other biomarkers. In HGG, IL-13Rα2 combined with nuclear and cytoplasmic co-localization of FUS was associated with worse OS. Multivariate analysis showed that tumor grade, Ki-67, P53 and IL-13Rα2 could be the independent prognostic factors for OS.

Conclusion
IL-13Rα2 expression was significantly associated with cytoplasmic distribution of FUS in human glioma samples and could be the independent prognostic factors for OS, while the prognostic value of its co-expression with cytoplasmic FUS in glioma need to be addressed in the future studies.
Indigenous maternal health and health services within Canada: a scoping review
Authors: Bacciaglia Meagan , Neufeld Hannah Tait , Neiterman Elena , Krishnan Akanksha , Johnston Sophie , Wright Kyla 
Published: May 2023

AbstractBackgroundGlobally, there are disparities in access to maternal health care services and equity in maternal health outcomes between Indigenous and non-Indigenous populations. While the literature is growing, it has not been systematically synthesized. This review addresses this gap by synthesizing the existing literature on the organizational structure of maternity care, accessibility and delivery of services, and clinical disparities impacting Indigenous maternal health within Canada. It also identifies current knowledge gaps in research on these topics.MethodsA scoping review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines and the extension for scoping reviews. The search for relevant papers was performed in PubMed, CINAHL, and SCOPUS electronic databases and included any empirical literature written in English and published during 2006 – 2021. The research team inductively coded 5 articles to develop a coding scheme, which was then applied to the remaining articles.ResultsA total of 89 articles were included in the review, of which 32 were qualitative papers, 40 quantitative, 8 were mixed-methods publications, and 9 were review papers. The analysis of the articles resulted in identifying a range of overarching themes pertaining to the maternal health of Indigenous women within Canada including provision of services, clinical issues, education, health disparities, organization, spatial context, and impact of informal support. The results suggest that physical, psychological, organizational, and systemic barriers inhibit the quality-of-care pregnant Indigenous women receive, and that maternal health services are not consistently provided in a culturally safe manner. Results also suggest that, compared to non-Indigenous pregnant women, Indigenous women are more likely to develop clinical complications during pregnancy, reflecting the structural impacts of colonization that continue to negatively influence Indigenous maternal health and well-being.ConclusionsThere are many complex barriers that prevent Indigenous women from receiving high quality and culturally appropriate maternal care. Possible areas that could address the service gaps illuminated through this review include the implementation of cultural considerations across health care jurisdictions within Canada.
Circulating microRNAs as diagnostic biomarkers for melanoma: a systematic review and meta-analysis
Authors: Wu Nan , Sun Hongyan , Sun Qian , Zhang Fangqing , Ma Lingli , Hu Yue , Cong Xianling 
Published: May 2023

Abstract
Background
Recent studies have shown that circulating microRNAs (miRNAs) can be used as diagnostic biomarkers for melanoma. This study aimed to evaluate the diagnostic value of circulating miRNAs for melanoma.

Methods
A comprehensive literature search was conducted and the quality of the included literature was evaluated using QUADAS-2 (Quality Assessment for diagnostic accuracy studies), and the diagnostic accuracy was assessed by pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC). We used Deeks’ funnel plot to evaluate publication bias.

Results
The meta-analysis included 10 articles covering 16 studies, and the results showed that circulating miRNAs provide high diagnostic accuracy for melanoma. The overall pooled sensitivity was 0.87 (95% CI: 0.82–0.91), specificity was 0.81 (95% CI: 0.77–0.85), PLR was 4.6 (95% CI: 3.7–5.8), NLR was 0.16 (95% CI: 0.11–0.23), DOR was 29 (95% CI: 18–49), and AUC was 0.90 (95% CI: 0.87–0.92), respectively. Subgroup analysis showed better diagnostic value in miRNA clusters, European population, plasma miRNAs, and upregulated miRNAs compared to other subgroups.

Conclusions
The results indicated that circulating microRNAs can be used as a non-invasive biomarker for the diagnosis of melanoma.
Unilateral pigmented paravenous retinochoroidal atrophy with acute angle-closure glaucoma: a case report
Authors: Lv Kun , Liang Zhiqiao , Yang Kangyi , Chen Xuanzhu , Ma Yao , Wu Huijuan 
Published: May 2023

Abstract
Background
Pigmented paravenous retinochoroidal atrophy (PPRCA) is an uncommon fundus disease characterized by perivenous aggregations of pigment clumps and retinochoroidal atrophy distributed along the retinal veins. We report a Chinese female case of unilateral PPRCA with acute angle-closure glaucoma (AACG).

Case presentation
A 50-year-old Chinese female presented with vision loss and elevated intraocular pressure (IOP) in the right eye and then underwent trabeculectomy. She referred to our clinic for further evaluation and treatment. The funduscopic examination revealed grayish retinochoroidal atrophy and osteocyte-like pigment clumping lesions along the retinal veins and peripapillary preretinal hemorrhage in the right eye. The patient also presented with AACG in the same eye on the basis of past medical history of acute attack, shallow anterior chamber depth (ACD), narrow angle showed by ultrasound biomicroscopy (UBM) and glaucomatous neuropathy identified by optical coherence tomography (OCT). Other examinations like fluorescein fundus angiography (FFA), electroretinogram (ERG) and electrooculography (EOG) all confirmed the aforementioned diagnose.

Conclusion
PPRCA is a rare disease, uncommon in females and symmetrical in both eyes. We present a rare case of unilateral PPRCA accompanied with AACG.