bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep learning to predict lymph node status on pre‐operative staging CT in patients with colon cancer
Authors: Bedrikovetski Sergei , Zhang Jianpeng , Seow Warren , Traeger Luke , Moore James W , Verjans Johan , Carneiro Gustavo , Sammour Tarik 
Published: September 2023

AbstractIntroductionLymph node (LN) metastases are an important determinant of survival in patients with colon cancer, but remain difficult to accurately diagnose on preoperative imaging. This study aimed to develop and evaluate a deep learning model to predict LN status on preoperative staging CT.MethodsIn this ambispective diagnostic study, a deep learning model using a ResNet‐50 framework was developed to predict LN status based on preoperative staging CT. Patients with a preoperative staging abdominopelvic CT who underwent surgical resection for colon cancer were enrolled. Data were retrospectively collected from February 2007 to October 2019 and randomly separated into training, validation, and testing cohort 1. To prospectively test the deep learning model, data for testing cohort 2 was collected from October 2019 to July 2021. Diagnostic performance measures were assessed by the AUROC.ResultsA total of 1,201 patients (median [range] age, 72 [28–98 years]; 653 [54.4%] male) fulfilled the eligibility criteria and were included in the training (n = 401), validation (n = 100), testing cohort 1 (n = 500) and testing cohort 2 (n = 200). The deep learning model achieved an AUROC of 0.619 (95% CI 0.507–0.731) in the validation cohort. In testing cohort 1 and testing cohort 2, the AUROC was 0.542 (95% CI 0.489–0.595) and 0.486 (95% CI 0.403–0.568), respectively.ConclusionA deep learning model based on a ResNet‐50 framework does not predict LN status on preoperative staging CT in patients with colon cancer.
Pupillary dilation velocity is reduced in intensive care unit patients with septic shock
Authors: Uhrenholt Stine , Linér Signe Maria , Stokholm Jannik , Christensen Thomas , Bestle Morten H. 
Published: September 2023

AbstractBackgroundSeptic shock is common in the intensive care unit (ICU). The pathophysiology is poorly understood but prolonged sympathetic activation leading to autonomic dysfunction may be involved. Pupillary light response (PLR) is a fast, inexpensive, noninvasive way to measure autonomic nervous system function. The aim of the study was to observe dilation velocity of the PLR (PLRdil.vel.) in patients with and without septic shock and explore whether other factors influenced the possible association. We hypothesized that the presence of septic shock in intensive care patients is associated with changes in sympathetic autonomic tone, which can be observed as changes in PLRdil.vel.MethodsIn this prospective observational cohort study, we included 91 adult patients acutely admitted to a mixed ICU. The patients were followed for the development of septic shock until ICU discharge. PLRdil.vel. was measured with a portable pupillometer two times a day. We used linear mixed models to analyze for an association between PLRdil.vel and septic shock along with several covariables.ResultsNinety‐one patients were enrolled and of these, 35 were in septic shock. Septic shock was associated with a slowed PLRdil.vel of 0.3 mm/s (95% confidence intervals [CI −0.4; −0.2]).ConclusionsSeptic shock may be associated with changes in sympathetic autonomic tone which is supported by the findings from this study that septic shock was associated with a slower dilation velocity in the pupillary light reflex. Further studies should examine if the pupillary dilation velocity may serve as surrogate marker for changes in sympathetic autonomic nervous system activity in intensive care patients in septic shock. If so, future interventional studies should test if use of the pupillary dilation velocity may be used for earlier detection of septic shock, which could mean earlier institution of treatment measures for this condition.
Association of biological age with health outcomes and its modifiable factors
Authors: Liu Wei‐Shi , You Jia , Ge Yi‐Jun , Wu Bang‐Sheng , Zhang Yi , Chen Shi‐Dong , Zhang Ya‐Ru , Huang Shu‐Yi , Ma Ling‐Zhi , Feng Jian‐Feng , Cheng Wei , Yu Jin‐Tai 
Published: September 2023

AbstractIdentifying the clinical implications and modifiable and unmodifiable factors of aging requires the measurement of biological age (BA) and age gap. Leveraging the biomedical traits involved with physical measures, biochemical assays, genomic data, and cognitive functions from the healthy participants in the UK Biobank, we establish an integrative BA model consisting of multi‐dimensional indicators. Accelerated aging (age gap >3.2 years) at baseline is associated incident circulatory diseases, related chronic disorders, all‐cause, and cause‐specific mortality. We identify 35 modifiable factors for age gap (p < 4.81 × 10−4), where pulmonary functions, body mass, hand grip strength, basal metabolic rate, estimated glomerular filtration rate, and C‐reactive protein show the most significant associations. Genetic analyses replicate the possible associations between age gap and health‐related outcomes and further identify CST3 as an essential gene for biological aging, which is highly expressed in the brain and is associated with immune and metabolic traits. Our study profiles the landscape of biological aging and provides insights into the preventive strategies and therapeutic targets for aging.
Health claims denial for alcohol intoxication: State laws and structural stigma
Authors: Azagba Sunday , Ebling Todd , Hall Mark 
Published: September 2023

AbstractBackgroundSome alcohol exclusion laws (AELs) allow health insurers to deny coverage to individuals injured due to being intoxicated. Evidence has shown that such AELs disincentivize health‐care providers to screen for alcohol while they deter treatment utilization by people with an alcohol use disorder (AUD). Certain states have changed AELs to enhance the health of people with an AUD, but these changes are not well documented in the extant literature. This study examined the current status and historical trends in AELs across US states.MethodsWe conducted a systematic legal analysis in 2023 to examine how state alcohol exclusion laws vary across the United States. These laws allow or prohibit insurers from denying coverage for injuries or deaths related to alcohol use. We classified the states into three categories: (1) States that explicitly permit alcohol exclusions, (2) States that explicitly ban alcohol exclusions, and (3) States that have no clear policy on alcohol exclusions.ResultsWe found that 18 states still have alcohol exclusion laws, down from 37 in 2004. Meanwhile, the number of states that have explicitly banned AELs and prohibited insurers from applying alcohol exclusions (AEs) to their policies has increased from 3 to 15 in the same period. The remaining 17 states have no clear laws on AEs. We also noted that five states that repealed their AELs did not adopt any specific prohibition on AEs, and four states limited their prohibition to policies that cover hospital, medical, or surgical expenses.ConclusionsOur systematic mapping reveals that some states have prohibited AELs in response to their detrimental effects. However, some states maintain these policies, and none has effectively outlawed AEs in the last 10 years, despite their possible role in reinforcing stigma.
Bovine Meissner‐like corpuscle and evolutionary ecology of mammalian somatosensory acuity
Authors: Bhat Ghulam M. , Bashir Samina , Jan Shah S. , Banoo Shamima , Khan Javeed A. 
Published: September 2023

AbstractThe mammalian snout has Meissner's corpuscles (MCs), which transmit epicritic sensations as the animal explores its surroundings. To comprehend the somatosensory acuity in mammals, we examined the structural organization and density of bovine Meissner‐like corpuscles (BMLCs) at various ages and compared the changes with other mammalian MCs. The skin from the snout of cows or oxen (2–11 years old) was obtained and processed through routine histological technique. Five‐μm thick sections were prepared, silver stained according to the Bielschowsky technique as modified by Winkelman and Schmidt (Mayo Clinic Proceedings, 1957, 217), and observed under a compound light microscope quantitatively and qualitatively. The glabrous skin of the cow snout consisted of two types of BMLCs: One was a cylindrical or elongated structure found in the dermal papillae. The other type was spherical and developed in the superficial layers of the epidermis. BMLCs consisted of both coarse and fine nerve fibres. In the young, the corpuscle comprised thin nerve fibres with indistinct cell outlines. In adults, nerve fibres in the corpuscles were closely packed, and networks, varicosities and end bulbs were well developed. With advancing age, the MCs attenuated into a disorganized mass of nerve fibres. The bovine snout is a highly evolved somatosensory organ due to its rich nerve supply and functionally resembles the anthropoid fingertip. Somatosensory acuity will be lower in the glabrous bovine skin than in primate glabrous skin of the fingertip, as the nerve terminals within the BMLCs are less elaborate in content and structural complexity.
Exploring alternatives for securing anatomical structures in capturing digital images: A comparative analysis
Authors: Turchenski Daniela G. , Franco Acir J. , Turchenski Rafael G. , Werner Laís C. , Weber Saulo H. , Gumiel Yohan B. , Michelotto Pedro V. 
Published: September 2023

AbstractTeaching veterinary anatomy using digital platforms requires improved image quality, which may influence the fixation process. This study aimed to compare four embalming solutions for high‐colour‐quality images of different tissues compared to the original image. Four equine left pelvic limbs were cut into metameres and divided equally for application of 10% formaldehyde, 96% glycerine, 33% hypersaturated NaCl solution and modified Larssen solution, respectively, which was maintained for 3 days. After drying for 3 days at room temperature, photographs were obtained at time 0 (T0), without any fixation process (original colour); time 1 (T1), immediately after removal from the solutions; and every 24 h for 3 days (T2–T4). The image colour quality was investigated by digitally evaluating the cortical bone, tendon and bone marrow using histograms and CIEDE2000 as well as by 10 specialists in an online survey. CIEDE2000 and histograms revealed that all fixation solutions changed the original tissue colour at all the time points (p < 0.0001). According to the specialists, the 33% saline solution produced the best results compared to the original one. The modified Larssen solution demonstrated better results for the tendon, marrow and cortical bone at T3 (p = 0.0015). Considering the colour of digital images, the modified Larssen solution provided the best results; however, the visual evaluation by the specialists revealed the 33% saline solution as the best.
Social networks and technology adoption: Evidence from church mergers in the U.S. Midwest
Authors: Burlig Fiona , Stevens Andrew W. 
Published: September 2023

AbstractHow do social networks impact technology adoption? Exploiting a natural experiment in the mid‐20th century U.S. Upper Midwest, we find that social network expansions, in the form of mergers between congregations of the American Lutheran Church, led to increased rates of agricultural technology adoption among farmers. In counties that experienced a merger, the number of farms using chemical fertilizer increased by over 5%, and the total fertilized acreage increased by over 10% relative to counties without a merger. These effects are consistent with increased information sharing between farmers due to congregational mergers.
Small‐for‐gestational‐age fetus diagnosed in the second trimester: Possible etiologies and short‐term neonatal outcomes
Authors: Pasquini Lucia , Masini Giulia , Cagninelli Greta , Polimeno Teresa , Fratelli Nicola , Fichera Anna , Prefumo Federico 
Published: September 2023

AbstractIntroductionThe aim of our study was to investigate the causes of fetal growth <10th centile diagnosed <26 weeks’ gestation in singleton pregnancies and compare pregnancy outcomes in relation to the identified etiology.Material and methodsHistorical cohort study conducted in two Italian hospitals which included all small‐for‐gestational‐age fetuses diagnosed between 18+0 and 26+0 weeks over a 10‐year period. Fetuses were divided into three groups depending on the prenatally suspected etiology: chromosomal abnormalities (Group 1), malformations (Group 2) and isolated (Group 3). These groups were compared regarding pregnancy outcomes. Fetuses in Group 3 were divided into small‐for‐gestational‐age and fetal growth restriction following the Delphi Consensus criteria and the outcomes were further compared. Fisher's Exact or Mann–Whitney test were used for comparison of groups.ResultsIn all, 435 fetuses were included. Of these, 20 cases (4.6%) were associated with chromosomal abnormalities (Group 1), 98 (22.5%) with fetal malformations (Group 2) and 317 (72.9%) were isolated (Group 3). A higher percentage of live births was reported for Group 3 (P < 0.001). Termination of pregnancy was more common in Group 1 (P < 0.001). No differences in gestational age at delivery, birthweight, intrauterine death or neonatal death were detected within groups. Growth‐restricted fetuses had lower gestational age at delivery, birthweight and number of live births (P < 0.001), higher rates of termination of pregnancy, intrauterine death (P < 0.001) and neonatal death <10 days (P = 0.002) compared to small‐for‐gestational‐age. In 17 cases a chromosomal abnormality, genetic syndrome or adverse neurological outcome was diagnosed after birth: six from Group 2 (11.3% of live births in this group) and 11 from Group 3 (4.3%).ConclusionsWe report that fetal growth <10th percentile diagnosed before 26 weeks is not isolated before birth in 27% of cases. Malformations and chromosomal abnormalities are common etiologies; therefore, detailed anomaly scans and invasive testing should be offered. In addition, there is a residual risk of neonatal death and postnatal diagnosis of a genetic syndrome or neurodevelopmental impairment despite normal prenatal tests. These results expand the small amount of information on the outcome of cases with very early diagnosis of impaired fetal growth currently available and highlight the importance of detailed counseling with couples.
Driveline infections in left ventricular assist devices—Incidence, epidemiology, and staging proposal
Authors: Dettbarn Elisabeth , Prenga Marjeta , Stein Julia , Müller Markus , Hoermandinger Christoph , Schoenrath Felix , Falk Volkmar , Potapov Evgenij , Mulzer Johanna , Knierim Jan 
Published: September 2023

AbstractBackgroundDriveline infections (DLI) are a serious complication in patients with left ventricular assist devices (LVAD). Apart from the differentiation between superficial and deep DLI, there is no consensus on the classification of the severity of DLI. Little is known about risk factors and typical bacteria causing DLI in centrifugal‐flow LVADs.MethodsIn this single‐center study with 245 patients, DLI were classified by their local appearance using a modification of a score suggested by the Sharp Memorial group. The driveline exit site was inspected routinely every 6 months.ResultsSevere DLI were detected in 34 patients (15%) after 6 months and in 24 patients (22%) after 24 months. The proportion of patients with DLI increased significantly during the follow‐up (p = 0.0096). The most common bacteria in local smears were Corynebacterium, coagulase‐negative Staphylococcus, and Staphylococcus aureus. Fifty‐nine patients were hospitalized more than once for DLI. In these patients, S. aureus was the most common bacterium. It was also the most common bacterium in blood cultures. Higher BMI, no partnership, and a HeartMate 3 device were identified as risk factors for DLI in a multivariable cause‐specific Cox regression.ConclusionThis study is a standardized analysis of DLI in a large cohort with centrifugal‐flow LVADs.
Coping with a global crisis—Changes in worries about the Russo–Ukrainian War
Authors: Saalwirth Christina , Leipold Bernhard 
Published: September 2023

AbstractGlobal crises, such as the Russo–Ukrainian War, can lead to worrying, which in turn can result in health problems when not positively coped with. This study investigates how the worries of Germans are related to general coping strategies. Three consecutive online surveys were distributed from the beginning of March until the beginning of May 2022. The surveys assessed participants' worries about the Russo–Ukrainian War and their use of four coping domains for the two preceding weeks. A total of 175 (54.3% female; Mage = 33.3, SD = 13.6, 18–66 years) participants completed all three questionnaires. Worries and coping (meaning‐focused, problem‐focused, social, and avoidance coping) declined over time. Cross‐sectionally all coping domains, except meaning‐focused coping, correlated positively with initial worries, indicating a higher use of coping strategies when worries were present. In line with this, the use of both social and avoidance coping declined over the course of the study when worries were reduced. Furthermore, a higher initial use of avoidance coping was associated with a stronger decline in worries. Worries and coping strategies both declined following the Russian invasion of Ukraine which suggests that worries and coping strategies adapt to one another over time.
MAFLD fibrosis score: Using routine measures to identify advanced fibrosis in metabolic‐associated fatty liver disease
Authors: Cheung Johnny T. K. , Zhang Xinrong , Wong Grace Lai‐Hung , Yip Terry Cheuk‐Fung , Lin Huapeng , Li Guanlin , Leung Howard Ho‐Wai , Lai Jimmy Che‐To , Mahadeva Sanjiv , Nik Mustapha Nik Raihan , Wang Xiao‐Dong , Liu Wen‐Yue , Wong Vincent Wai‐Sun , Chan Wah‐Kheong , Zheng Ming‐Hua 
Published: September 2023

SummaryBackgroundEarly screening may prevent fibrosis progression in metabolic‐associated fatty liver disease (MAFLD).AimsWe developed and validated MAFLD fibrosis score (MFS) for identifying advanced fibrosis (≥F3) among MAFLD patients.MethodsThis cross‐sectional, multicentre study consecutively recruited MAFLD patients receiving tertiary care (Malaysia as training cohort [n = 276] and Hong Kong and Wenzhou as validation cohort [n = 431]). Patients completed liver biopsy, vibration‐controlled transient elastography (VCTE), and clinical and laboratory assessment within 1 week. We used machine learning to select ‘highly important’ predictors of advanced fibrosis, followed by backward stepwise regression to construct MFS formula.ResultsMFS was composed of seven variables: age, body mass index, international normalised ratio, aspartate aminotransferase, gamma‐glutamyl transpeptidase, platelet count, and history of type 2 diabetes. MFS demonstrated an area under the receiver‐operating characteristic curve of 0.848 [95% CI 0.800–898] and 0.823 [0.760–0.886] in training and validation cohorts, significantly higher than aminotransferase‐to‐platelet ratio index (0.684 [0.603–0.765], 0.663 [0.588–0.738]), Fibrosis‐4 index (0.793 [0.735–0.854], 0.737 [0.660–0.814]), and non‐alcoholic fatty liver disease fibrosis score (0.785 [0.731–0.844], 0.750 [0.674–0.827]) (DeLong's test p < 0.05). MFS could include 92.3% of patients using dual cut‐offs of 14 and 15, with a correct prediction rate of 90.4%, resulting in a larger number of patients with correct diagnosis compared to other scores. A two‐step MFS‐VCTE screening algorithm demonstrated positive and negative predictive values and overall diagnostic accuracy of 93.4%, 89.5%, and 93.2%, respectively, with only 4.0% of patients classified into grey zone.ConclusionMFS outperforms conventional non‐invasive scores in predicting advanced fibrosis, contributing to screening in MAFLD patients.
Immune thrombotic thrombocytopenic purpura in older patients: Results from the Spanish TTP Registry (REPTT)
Authors: Gómez‐Seguí I. , Francés Aracil E. , Mingot‐Castellano M. E. , Vara Pampliega M. , Goterris Viciedo R. , García Candel F. , Pascual Izquierdo C. , del Río Garma J. , Guerra Domínguez L. , Vicuña Andrés I. , Garcia‐Arroba Peinado J. , Zalba Marcos S. , Vidan Estévez J. M. , González Arias E. , Campuzano Saavedra V. , García Gala J. M. , Ortega Sanchez S. , Martínez Nieto J. , Pardo Gambarte L. , Solé Rodríguez M. , Fernández‐Docampo M. , Avila Idrovo L. F. , Hernández L. , Cid J. , de la Rubia Comos J. ,   from the Spanish TTP Registry (REPTT, Registro Español de la Purpura Trombocitopénica Trombótica)
Published: September 2023

SummaryImmune thrombotic thrombocytopenic purpura (iTTP) is an ultra‐rare disease that seldom occurs in the elderly. Few reports have studied the clinical course of iTTP in older patients. In this study, we have analysed the clinical characteristics at presentation and response to therapy in a series of 44 patients with iTTP ≥60 years at diagnosis from the Spanish TTP Registry and compared them with 209 patients with <60 years at diagnosis from the same Registry. Similar symptoms and laboratory results were described in both groups, except for a higher incidence of renal dysfunction among older patients (23% vs. 43.1%; p = 0.008). Front‐line treatment in patients ≥60 years was like that administered in younger patients. Also, no evidence of a difference in clinical response and overall survival was seen in both groups. Of note, 14 and 25 patients ≥60 years received treatment with caplacizumab and rituximab, respectively, showing a favourable safety and efficacy profile, like that observed in patients <60 years.
Do both anticipated relief and anticipated regret predict decisions about influenza vaccination?
Authors: Lorimer Sara , McCormack Teresa , Hoerl Christoph , Johnston Matthew , Beck Sarah R. , Feeney Aidan 
Published: September 2023

AbstractObjectiveAnticipated regret has been found to predict vaccination intentions and behaviours. We examined whether anticipated relief also predicts seasonal influenza vaccination intentions and behaviour. Given claims about differences in their antecedents and function, we distinguished between counterfactual relief (relief that a worse outcome did not obtain) and temporal relief (relief that an unpleasant experience is over).DesignCross‐sectional.MethodsUnvaccinated participants (N = 295) were recruited online in November 2020. Participants completed measures of anticipated regret, anticipated counterfactual relief, and anticipated temporal relief and measures of theory of planned behaviour constructs (attitudes, norms, perceived control, and intentions). One month later, the same participants were re‐surveyed and asked to report their vaccination status.ResultsAlthough all anticipated emotion measures were associated with intentions and behaviour, only anticipated counterfactual relief and regret independently predicted vaccination intentions in regression analyses. Mediation analysis showed both anticipated counterfactual relief and regret were indirectly, via intentions, associated with behaviour.ConclusionsResults suggest that, regardless of valence, counterfactual emotions predict vaccination intention and, indirectly, behaviour. Furthermore, participants may differ in their sensitivity to the anticipation of positive versus negative counterfactual emotions. These findings may permit more precise targeting of interventions to increase vaccine uptake.