bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine Learning Approach for Sepsis Risk Assessment in Ischemic Stroke Patients
Authors: Mao Fengkai , Lin Leqing , Liang Dongcheng , Cheng Weiling , Zhang Ning , Li Ji , Wu Siming 
Published: January 2025

Background Ischemic stroke is a critical neurological condition, with infection representing a significant aspect of its clinical management. Sepsis, a life-threatening organ dysfunction resulting from infection, is among the most dangerous complications in the intensive care unit (ICU). Currently, no model exists to predict the onset of sepsis in ischemic stroke patients. This study aimed to develop the first predictive model for sepsis in ischemic stroke patients using data from the MIMIC-IV database, leveraging machine learning techniques. Methods A total of 2238 adult patients with a diagnosis of ischemic stroke, admitted to the ICU for the first time, were included from the MIMIC-IV database. The outcome of interest was the development of sepsis. Model development adhered to the TRIPOD guidelines. Feature selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression, identifying 28 key variables. Multiple machine learning algorithms, including logistic regression, k-nearest neighbors, support vector machines, decision trees, and XGBoost, were trained and internally validated. Performance metrics were assessed, and XGBoost was selected as the optimal model. The SHAP method was used to interpret the XGBoost model, revealing the impact of individual features on predictions. The model was also deployed on a user-friendly platform for practical use in clinical settings. Results The XGBoost model demonstrated superior performance in the validation set, achieving an area under the curve (AUC) of 0.863 and offering greater net benefit compared to other models. SHAP analysis identified key factors influencing sepsis risk, including the use of invasive mechanical ventilation on the first day, excessive body weight, a Glasgow Coma Scale verbal score below 3, age, and elevated body temperature (>37.5 °C). A user interface had been developed to enable clinicians to easily access and utilize the model. Conclusions This study developed the first machine learning-based model to predict sepsis in ischemic stroke patients. The model exhibited high accuracy and holds potential as a clinical decision support tool, enabling earlier identification of high-risk patients and facilitating preventive measures to reduce sepsis incidence and mortality in this population.
Emerging sexually transmitted infections outbreak: Dermatophytosis among men who have sex with men in Milan, Italy
Authors: Maci Chiara , Raccagni Angelo Roberto , Lolatto Riccardo , Messina Emanuela , Canetti Diana , Tassan Din Chiara , Garcia Martearena Maria del Carmen , Torkjazi Golnaz , Bottanelli Martina , Candela Caterina , Castagna Antonella , Nozza Silvia 
Published: January 2025

Background Dermatophytosis is an infection of the skin or adnexa, which is extremely widespread in the environment. Sexually transmitted infections (STIs) are an increasing global public health threat, especially among men who have sex with men (MSM). This study aims to describe an outbreak of sexually transmitted dermatophytosis among MSM in our cohort between April 2022 and October 2023. Methods This is a retrospective monocentric study including outpatients who were diagnosed with at least one episode of dermatophytosis between March 2010 and October 2023 at the Infectious Diseases Unit of San Raffaele Scientific Institute, Milan, Italy. Mycosis diagnosis was mainly clinical following the medical visit and physical examination. Results Overall, 107 people were diagnosed with dermatophytosis between March 2010 and October 2023. All 56 cases observed since April 2022 included 55 MSM and 1 female; compared to before 2022 there was a total diagnosis of 51 cases. Conclusions These results highlight the evident increase in the incidence of mycotic infections among MSM, followed in our center. We are dealing with a new entity of sexually transmissible infections, in addition to the existing diseases that are being studied.
Effectiveness of ultrasound-guided hip injections on pain and functioning in patients with hip osteoarthritis: A systematic review
Authors: Bernetti Andrea , Agostini Francesco , Finamore Nikolaos , Dal Borgo Marco , Mangone Massimiliano , Ammendolia Antonio , Paoloni Marco , de Sire Alessandro 
Published: January 2025

Background Osteoarthritis is the most common form of arthritis, causing pain, functional disability, and a reduction in terms of quality of life. Minimally invasive treatments like intra-articular hip injections are a therapeutic option and ultrasound guidance might improve the results of these injections. Objective To summarize the evidence about the effectiveness of ultrasound-guided hip injections in terms of pain and functioning in patients affected by hip osteoarthritis. Methods A systematic search of the literature was performed on three electronic databases: PubMed, Cochrane and PEDro, using a specific search strategy. We evaluated for inclusion all articles according to the following participants, intervention, comparison, and outcomes (PICO) model: P) Population: human patients affected by hip osteoarthritis; I) Intervention: intra-articular hip injections performed with a ultrasound-guidance; C) Comparator: sham therapy or every other conservative or oral, non-invasive, minimally invasive or surgical technique; O) Outcome measures: pain assessed by Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS); functional outcomes. Results At the end of the search, 43 articles were included in the review. Several drugs have been considered in the included studies: hyaluronic acid, platelet-rich plasma, corticosteroids, micro-fragmented adipose tissue, bone marrow concentrates, amniotic suspension allograft. Conclusion Ultrasound-guided injections of hyaluronic acid might be effective on pain relief and functioning in patients affected by hip osteoarthritis. Also, other rehabilitative infiltrative techniques (i.e., corticosteroids and platelet-rich plasma) showed a positive effect in the short-term period.
Comparison of clinical efficacy between femoral neck system and cannulated screw in Pauwels type III femoral neck fracture: A meta-analysis
Authors: Zhuang Kailun , Wu Jingyi , Yang Yusen , Bai Tianmo , Li Baofeng 
Published: January 2025

Background In recent years, the femoral neck system (FNS) has become increasingly widely used for Pauwels type III femoral neck fractures. Objective We performed a meta-analysis to investigate the safety and efficacy of FNS and the mainstream internal fixation method, cannulated screw (CS), in the treatment of Pauwels type III femoral neck fractures. Methods We systematically searched all research studies from PubMed, Embase, Web of Science, Cochrane, WANFANG, and the Chinese Academic Journal Full-Text Database (CNKI) from 2018 to July 2024 and conducted data extraction. The study was conducted on July 26, 2024. We used the PRISMA guidelines to assess the quality of the results of all included studies. In addition, we searched for references to relevant articles. After completing the literature search, we performed a manual literature screening to obtain studies that met the inclusion criteria. The outcomes were Harris Hip Score, operation duration, intraoperative blood loss, hospital stay, healing time, and postoperative complications. Results This meta-analysis ultimately included nine studies (n = 524) and conducted quality evaluations. All nine articles were retrospective cohort studies. The study exhibited statistically significant variations between the FNS and CS groups in relation to total complications (95% confidence interval (CI)= [0.11, 0.40], odds ratio (OR) = 0.21, P < 0.001), Harris Hip Score (95%CI = [2.14, 3.65], mean difference (MD) = 2.89, P < 0.001), Femoral head necrosis (95%CI = [0.17, 0.86], OR = 0.38, P = 0.02), Internal fixation failure (95%CI = [0.06, 0.50], OR = 0.17, P = 0.001), Medium femoral neck shortening (95%CI = [0.17, 0.53], OR = 0.30, P < 0.001), intraoperative blood loss (95%CI = [11.57, 26.80], MD = 19.19, P < 0.001), Operation duration (95%CI = [−15.20, −2.17], MD = −8.69, P = 0.009), and healing time (95%CI = [−1.30, −0.32], MD = −0.81, P = 0.001). Conclusion This meta-analysis showed that in Pauwels type III femoral neck fractures, the femoral neck system has a shorter operative time, a lower rate of postoperative complications, a shorter healing time, less shortening of the femoral neck, and a higher Harris Hip Score compared with cannulated screws, but increases intraoperative blood loss. However, more clinical studies are needed to confirm our conclusions due to our small sample size and lack of randomized controlled trials.
The statistical stability of clavicle fracture management: A systematic review of randomized controlled trials with fragility analysis
Authors: Megafu Michael N. , Point Du Jour Elisabeth , Nguyen Janet , Megafu Emmanuel , Mian Hassan , Singhal Sulabh , Tornetta Paul , Parisien Robert L. 
Published: January 2025

Background Randomized controlled trials (RCTs) represent the highest level of evidence in guiding the management of clavicle fractures. They are conducted to ensure that evidence drives the basis of treatment algorithms. Relying solely on P values to assess orthopedic RCTs may be deceptive and challenge the validity of the studies. Objective To evaluate the degree of statistical fragility in the clavicle fracture literature using the fragility index (FI) and fragility quotient (FQ). Methods A systematic search strategy using the Medline, PubMed, and Embase databases was used to find all dichotomous data for randomized controlled trials (RCTs) in clavicle fracture research from 2000 to 2024. The FI of each outcome was calculated by reversing a single outcome event until significance was reversed. The FQ was calculated by dividing each fragility index by the study sample size. The interquartile range (IQR) was also calculated for the FI and FQ. Results Of the 3646 articles screened, 81 met the search criteria, with 30 RCTs evaluating clavicle fractures included for analysis. There were 250 total outcomes, where 62 significant and 188 nonsignificant outcomes were identified. The overall FI and FQ were 4 (IQR 3–5) and 0.045 (IQR 0.024–0.080). Statistically significant and nonsignificant outcomes had an FI of 3.5 (IQR 2–7) and 4 (IQR 3–5), respectively. Regarding loss to follow-up (LTF), 63.3% (19) reported LTF greater or equal to the overall FI of 4. Conclusion When scrutinizing management algorithms relying on statistical analysis, we recommend including the FI and FQ alongside the P value.
Comparative retrospective analysis of magnetic field therapy and extracorporeal shock wave therapy in pain management for heel spur
Authors: Akkoyun Sert Ozlem , Yilmaz Kamil 
Published: January 2025

Background Heel spurs, caused by inflammation and overstretching of the plantar fascia, are a common source of heel pain. Although various conservative and invasive treatments are used, evidence on their effectiveness remains limited. Objective This study aims to evaluate the effect of extracorporeal shock wave therapy (ESWT) and magnetic field application on pain levels in heel spur patients. Methods The files of 80 patients diagnosed with heel spurs were accessed. Patients with missing demographic information in the files, incomplete Visual Analogue Scale (VAS) values, and patients with heel pain complaints for less than 5 months were excluded from the study. A total of 39 patients who met the study criteria were included in the study. While ESWT was applied to 21 of these patients (ESWT group), magnetic field was applied to 18 patients (MA group). All patients were given plantar fascia stretching exercises as a home program. Pain scores before and after treatment were evaluated with VAS. Results A significant decrease was found in VAS values after the 5th session and 2 months later in both the ESWT group and the magnetic field group (p < 0.001). On the other hand, neither treatment method was found to be superior to each other (p > 0.05). Conclusion It was observed that the pain of the patients decreased in both the early and late periods in both applications.
A study of effective exercise methods and resistance intensity for selective strengthening of the infraspinatus muscle
Authors: Kim Tae-Gyu , Ma Rui , Yu Il-Young 
Published: January 2025

Background To selectively strengthen target muscles, resistance intensity as well as limb position should be considered. Objective This study aimed to identify the most effective exercise positions and the optimal resistance intensity to selectively strengthen the infraspinatus muscle. Methods This study included 18 healthy men who underwent four different external rotation (ER) exercises in prone external rotation (PER), side-lying wiper, sitting external rotation, and standing external rotation (STER) exercise by varying the shoulder positions under low, medium, and high resistance intensity conditions randomly. Infraspinatus and posterior deltoid muscle activities and the infraspinatus to posterior deltoid activity ratio were measured based on ER exercise positions and resistance intensities. Results This study revealed a significant interaction and main effects of exercise position and resistance intensity on muscle activity and muscle activity ratio. Both muscle activities were increased as the resistance intensity increased, but the muscle activity ratio was decreased. Infraspinatus muscle activity and muscle activity ratio were higher in the PER and STER exercises than in other exercises. Conclusion We indicate that PER and STER are effective exercises to selectively strengthen the infraspinatus muscle. Additionally, performing the exercise at low or medium resistance intensity rather than high resistance intensity is recommended to activate the infraspinatus selectively while minimizing the involvement of the posterior deltoid.
Functional Capacity Incorporating Dynamic Ventilation in Systemic Sclerosis: Agreement Analysis Between Performance on the 6-Minute Walk Test and Glittre–ADL Test
Authors: Reis Filipe da Silva , Reis Luis Felipe da Fonseca , Ferreira Isabelle da Nobrega , Farias Iasmim de Oliveira , Pessoa Laura Franco , Costa Lohana Resende da , Olímpio Júnior Hebert , Ferreira Arthur de Sá , Lopes Agnaldo José 
Published: January 2025

Background Functional capacity at submaximal exercise levels has become more popular as an outcome measure in systemic sclerosis (SSc). However, it is necessary to know the ventilatory requirements of the different field tests. Objectives To verify the agreement of the ventilatory dynamics measured at submaximal exercise between the the Glittre-ADL test (TGlittre) and the 6-min walk test (6MWT) and, secondarily, to evaluate the correlations of these measurements with clinical and functional variables in women with SSc (wwSSc). Methods This was a cross-sectional study in which 30 wwSSc underwent the 6MWT and TGlittre while hooked to a device reading their ventilatory demand. Physical function was assessed on the Health Assessment Questionnaire Disability Index (HAQ-DI), and lung function was assessed by spirometry. Results The median 6-min walking distance (6MWD) was 344 (282–410) metres, and 25 (83.3%) participants did not reach 80% of the predicted distance. The median TGlittre time was 147 (107–188) seconds, and 18 (60%) participants exceeded 120% of the predicted time. There was agreement between the two tests on the following variables: heart rate (ICC = 0.883, P < 0.0001), breathing reserve (ICC = 0.816, P < 0.0001), peripheral oxygen saturation (ICC = 0.752, P = 0.0009), inspiratory capacity (ICC = 0.690, P < 0.0001), and peak minute ventilation (ICC = 0.433, P = 0.007). There was a weak correlation between 6MWD and TGlittre time ( rs=–0.353, P = 0.05). 6MWD correlated significantly with the HAQ-DI score ( rs=–0.606, P = 0.0004) and forced vital capacity (FVC, rs = 0.427, P = 0.018). TGlittre time correlated significantly with HAQ-DI ( rs = 0.440, P = 0.015) and FVC ( rs=–0.404, P = 0.026). Conclusion In wwSSc, the 6MWT and TGlittre have almost the same ventilatory requirements, although these patients perform worse in the 6MWT. 6MWD and TGlittre time are weakly correlated. Both 6MWD and TGlittre time are associated with physical function and lung function. Therefore, both tests should be used in clinical practice for the monitoring of these patients as they are complementary.
Adolescent idiopathic scoliosis causes pelvic floor dysfunction: A cross-sectional study
Authors: Dericioğlu Batuhan İbrahim , Özgören Adile Öniz , Angın Salih 
Published: January 2025

Background Scoliosis is a complex three-dimensional deformity of the spine and causes spinal misalignment and pelvic structure changes. Objective This cross-sectional study was designed to investigate the relationship between postural deviation, scoliosis angle and pelvic floor dysfunctions in individuals with adolescent idiopathic scoliosis (AIS). Methods Twelve AIS aged between 12 and 18 years were included in the study. Standard scoliosis radiography was used for Cobb angle measurement. The posture screen mobile (PSM) application was used for determining postural deviation, and a real-time ultrasound image was obtained for pelvic floor muscle activity. The pelvic floor distress inventory was used for the evaluation of pelvic floor dysfunctions. Results There was a significant negative correlation between bladder base elevation and the following variables, including thoracic and lumbar Cobb angles (r = −0.640, p < 0.05; r = −0.779, p < 0.05), Dysfunctional Voiding Scoring System (DVSS) (r = −0.753, p < 0.05), Pelvic Floor Distress Inventory (PFDI) (r = −0.722, p < 0.05) and Urinary Distress Inventory (UDI) (r = −0.585, p < 0.05). The apical shift in the frontal plane was found to be positively correlated with DVSS (r = 0.701, p < 0.05), UDI (r = 0.641, p < 0.05) and PFDI-20 (r = 0.628, p < 0.05) and negatively correlated with bladder base elevation (r = −0,615, p < 0.05). The average pelvic shift in frontal plan was found to be positively correlated with DVSS (r = 0.810, p < 0.05), PFDI-20 (r = 0.722, p < 0.05), Pelvic Organ Prolapse Distress Inventory (POPDI) and UDI (r = 0.626, p < 0.05) and negatively correlated with bladder base elevation (r = −0.626, p < 0.05). Conclusion Scoliosis negatively affects pelvic floor muscle activity, and pelvic floor functions, resulting in urinary dysfunction. Pelvic floor assessment may be added to the evaluation process in patients with AIS.
Evaluating the Use of a 3D Exoscope to Improve Ergonomics in Cleft Surgery
Authors: Lee Kwang Chear , Frearson Benjamin , Alagbe Bashirat Adedoyin , ElSafti Mohamed Gamal Abdelazim Salem , Nightingale Craig , Cooke Jane , Panagamuwa Channa , Echlin Kezia , Khan Khurram 
Published: January 2025

The aim of this study was to investigate and compare the technical feasibility, ergonomics, and educational value of the 3D exoscope in comparison with traditional and prism loupes in cleft surgery. A variety of cleft and pharyngeal operations were performed with the VITOM® 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany), traditional/prism loupes, and microscope. The cervical neck angulation of the operating surgeon was recorded in real-time with an inertia measurement unit system (Mbient, San Francisco, USA) and experiences of the surgeon and assistant were prospectively evaluated with 5-point Likert scales. National Health Service, England. Eleven patients were recruited in whom 12 procedures were performed. Two main surgeons, 3 assistant surgeons, and 3 scrub nurses were recruited into the study. Four procedures were performed with the VITOM® 3D exoscope, and as the comparison groups, 5 procedures were performed with normal loupes, 3 with prism loupes, and 2 were done in combination with a microscope and analyzed separately. Neck angle measurements and feedback from surgeons, assistants, and scrub nurses. The VITOM® system improved surgeon ergonomics with reduced procedure time in cervical flexion when compared to the other visualization methods (versus loupes, P < .01, and prism, P < .01). The VITOM® system also scored favorably in terms of image-related fields, ergonomics, and ease of use. Use of the 3D exoscope in cleft surgery yielded improved experiences for both surgeons, assistants, and nurses in comparison with loupes and microscopes without increasing operating time.
Evaluation of a point-of-care test for quantitative determination of total thyroxine in feline serum
Authors: Spada Eva , Perego Roberta , Baggiani Luciana , Proverbio Daniela 
Published: January 2025

Objectives Total thyroxine (TT4) evaluation is the most commonly used first-line test for the diagnosis and monitoring of cats with hyperthyroidism. Vcheck T4 is a point-of-care immunoassay that measures TT4 using a Vcheck V200 analyser. This study aimed to evaluate the analytic performance of the Vcheck T4 assay in feline sera and the agreement in the classification of normal, high and low TT4 concentrations of Vcheck T4 with those measured by an enzyme immunoassay (EIA). Methods Assay precision, reproducibility and linearity were evaluated for the Vcheck T4. For method comparison, TT4 concentrations in 73 serum samples were analysed by both methods. Results Vcheck T4 demonstrated good precision, reproducibility (intra- and inter-assay coefficients of variation between 3% and 13.5%) and linearity in the diagnostic range of <0.5 and >8 μg/dl. The correlation coefficient was 0.87, Passing–Bablok regression showed a proportional, but not constant bias, Bland–Altman plots revealed a mean difference of +0.5 μg/dl. The overall inter-rater agreement ( K) between TT4 EIA and Vcheck results was substantial ( K = 0.69), with 82.2% of concordant results. As a diagnostic test for hyperthyroidism, Vcheck T4 showed a sensitivity and specificity of 88.9% and 84.4%, and a positive predictive value (PPV) and negative predictive value (NPV) of 44.5% and 98.2%, respectively. Conclusions and relevance Vcheck T4 assay provided precise and reproducible results in substantial agreement with the EIA. Given the high NPV, Vcheck T4 is useful in ruling out hyperthyroidism when screening cats, but, based on low PPV, samples with results with high TT4 need to be analysed by another reference method. Further analysis with haemolytic, icteric and lipaemic samples is needed to assess the test performance. Finally, the reference intervals provided by the manufacturer require verification, and TT4 intervals specific to this method must be established in future studies.