bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Machine Learning to Predict Mortality for COVID-19 Patients on Day 0 in the ICU
Authors: Jamshidi Elham , Asgary Amirhossein , Tavakoli Nader , Zali Alireza , Setareh Soroush , Esmaily Hadi , Jamaldini Seyed Hamid , Daaee Amir , Babajani Amirhesam , Sendani Kashi Mohammad Ali , Jamshidi Masoud , Jamal Rahi Sahand , Mansouri Nahal 
Published: January 2022

Rationale: Given the expanding number of COVID-19 cases and the potential for new waves of infection, there is an urgent need for early prediction of the severity of the disease in intensive care unit (ICU) patients to optimize treatment strategies.Objectives: Early prediction of mortality using machine learning based on typical laboratory results and clinical data registered on the day of ICU admission.Methods: We retrospectively studied 797 patients diagnosed with COVID-19 in Iran and the United Kingdom (U.K.). To find parameters with the highest predictive values, Kolmogorov-Smirnov and Pearson chi-squared tests were used. Several machine learning algorithms, including Random Forest (RF), logistic regression, gradient boosting classifier, support vector machine classifier, and artificial neural network algorithms were utilized to build classification models. The impact of each marker on the RF model predictions was studied by implementing the local interpretable model-agnostic explanation technique (LIME-SP).Results: Among 66 documented parameters, 15 factors with the highest predictive values were identified as follows: gender, age, blood urea nitrogen (BUN), creatinine, international normalized ratio (INR), albumin, mean corpuscular volume (MCV), white blood cell count, segmented neutrophil count, lymphocyte count, red cell distribution width (RDW), and mean cell hemoglobin (MCH) along with a history of neurological, cardiovascular, and respiratory disorders. Our RF model can predict patient outcomes with a sensitivity of 70% and a specificity of 75%. The performance of the models was confirmed by blindly testing the models in an external dataset.Conclusions: Using two independent patient datasets, we designed a machine-learning-based model that could predict the risk of mortality from severe COVID-19 with high accuracy. The most decisive variables in our model were increased levels of BUN, lowered albumin levels, increased creatinine, INR, and RDW, along with gender and age. Considering the importance of early triage decisions, this model can be a useful tool in COVID-19 ICU decision-making.
The Independent Association of TSH and Free Triiodothyronine Levels With Lymphocyte Counts Among COVID-19 Patients
Authors: Lui David Tak Wai , Lee Chi Ho , Chow Wing Sun , Lee Alan Chun Hong , Tam Anthony Raymond , Pang Polly , Ho Tip Yin , Cheung Chloe Yu Yan , Fong Carol Ho Yi , Law Chun Yiu , To Kelvin Kai Wang , Lam Ching Wan , Tan Kathryn Choon Beng , Woo Yu Cho , Hung Ivan Fan Ngai , Lam Karen Siu Ling 
Published: January 2022

BackgroundBoth lymphopenia and thyroid dysfunction are commonly observed among COVID-19 patients. Whether thyroid function independently correlates with lymphocyte counts (LYM) remains to be elucidated.MethodsWe included consecutive adults without known thyroid disorder admitted to Queen Mary Hospital for COVID-19 from July 2020 to April 2021 who had thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3) and LYM measured on admission.ResultsA total of 541 patients were included. Median LYM was 1.22 x 109/L, with 36.0% of the cohort lymphopenic. 83 patients (15.4%) had abnormal thyroid function tests (TFTs), mostly non-thyroidal illness syndrome (NTIS). Patients with lymphopenia had lower TSH, fT4 and fT3 levels than those without. Multivariable stepwise linear regression analysis revealed that both TSH (standardized beta 0.160, p&lt;0.001) and fT3 (standardized beta 0.094, p=0.023), but not fT4, remained independently correlated with LYM, in addition to age, SARS-CoV-2 viral load, C-reactive protein levels, coagulation profile, sodium levels and more severe clinical presentations. Among the 40 patients who had reassessment of TFTs and LYM after discharge, at a median of 9 days from admission, there were significant increases in TSH (p=0.031), fT3 (p&lt;0.001) and LYM (p&lt;0.001). Furthermore, patients who had both lymphopenia and NTIS were more likely to deteriorate compared to those who only had either one alone, and those without lymphopenia or NTIS (p for trend &lt;0.001).ConclusionTSH and fT3 levels showed independent positive correlations with LYM among COVID-19 patients, supporting the interaction between the hypothalamic-pituitary-thyroid axis and immune system in COVID-19.
Clinical Characteristics of COVID-19 Patients in a Regional Population With Diabetes Mellitus: The ACCREDIT Study
Authors: Llanera Daniel Kevin , Wilmington Rebekah , Shoo Haika , Lisboa Paulo , Jarman Ian , Wong Stephanie , Nizza Jael , Sharma Dushyant , Kalathil Dhanya , Rajeev Surya , Williams Scott , Yadav Rahul , Qureshi Zubair , Narayanan Ram Prakash , Furlong Niall , Westall Sam , Nair Sunil 
Published: January 2022

ObjectiveTo identify clinical and biochemical characteristics associated with 7- &amp; 30-day mortality and intensive care admission amongst diabetes patients admitted with COVID-19.Research Design and MethodsWe conducted a cohort study collecting data from medical notes of hospitalised people with diabetes and COVID-19 in 7 hospitals within the Mersey-Cheshire region from 1 January to 30 June 2020. We also explored the impact on inpatient diabetes team resources. Univariate and multivariate logistic regression analyses were performed and optimised by splitting the dataset into a training, test, and validation sets, developing a robust predictive model for the primary outcome.ResultsWe analyzed data from 1004 diabetes patients (mean age 74.1 (± 12.6) years, predominantly men 60.7%). 45% belonged to the most deprived population quintile in the UK. Median BMI was 27.6 (IQR 23.9-32.4) kg/m2. The primary outcome (7-day mortality) occurred in 24%, increasing to 33% by day 30. Approximately one in ten patients required insulin infusion (9.8%). In univariate analyses, patients with type 2 diabetes had a higher risk of 7-day mortality [p &lt; 0.05, OR 2.52 (1.06, 5.98)]. Patients requiring insulin infusion had a lower risk of death [p = 0.02, OR 0.5 (0.28, 0.9)]. CKD in younger patients (&lt;70 years) had a greater risk of death [OR 2.74 (1.31-5.76)]. BMI, microvascular and macrovascular complications, HbA1c, and random non-fasting blood glucose on admission were not associated with mortality. On multivariate analysis, CRP and age remained associated with the primary outcome [OR 3.44 (2.17, 5.44)] allowing for a validated predictive model for death by day 7.ConclusionsHigher CRP and advanced age were associated with and predictive of death by day 7. However, BMI, presence of diabetes complications, and glycaemic control were not. A high proportion of these patients required insulin infusion warranting increased input from the inpatient diabetes teams.
Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency
Authors: Fojas Esphie Grace Fodra , Radha Saradalekshmi Koramannil , Ali Tomader , Nadler Evan P. , Lessan Nader 
Published: January 2022

BackgroundMelanocortin-4 receptor (MC4R) mutations are the most common of the rare monogenic forms of obesity. However, the efficacy of bariatric surgery (BS) and pharmacotherapy on weight and glycemic control in individuals with MC4R deficiency (MC4R-d) is not well-established. We investigated and compared the outcomes of BS and pharmacotherapy in patients with and without MC4R-d.MethodsPertinent details were derived from the electronic database among identified patients who had BS with MC4R-d (study group, SG) and wild-type controls (age- and sex-matched control group, CG). Short- and long-term outcomes were reported for the SG. Short-term outcomes were compared between the two groups.ResultsSeventy patients were screened for MC4R-d. The SG [six individuals (four females, two males); 18 (10–27) years old at BS; 50.3 (41.8–61.9) kg/m2 at BS, three patients with homozygous T162I mutations, two patients with heterozygous T162I mutations, and one patient with heterozygous I170V mutation] had a follow-up duration of up to 10 years. Weight loss, which varied depending on mutation type [17.99 (6.10–22.54) %] was stable for 6 months; heterogeneity of results was observed thereafter. BS was found superior to liraglutide on weight and glycemic control outcomes. At a median follow-up of 6 months, no significant difference was observed on weight loss (20.8% vs. 23.0%, p = 0.65) between the SG and the CG [eight individuals (four females, four males); 19.0 (17.8–36.8) years old at BS, 46.2 (42.0–48.3) kg/m2 at BS or phamacotherapeutic intervention]. Glycemic control in patients with MC4R-d and Type 2 diabetes improved post-BS.ConclusionOur data indicate efficacious short-term but varied long-term weight loss and glycemic control outcomes of BS on patients with MC4R-d, suggesting the importance of ongoing monitoring and complementary therapeutic interventions.
Network-Based Topological Exploration of the Impact of Pollution Sources on Surface Water Bodies
Authors: Sebestyén Viktor , Czvetkó Tímea , Abonyi János 
Published: January 2022

We developed a digital water management toolkit to evaluate the importance of the connections between water bodies and the impacts caused by pollution sources. By representing water bodies in a topological network, the relationship between point loads and basic water quality parameters is examined as a labelled network. The labels are defined based on the classification of the water bodies and pollution sources. The analysis of the topology of the network can provide information on how the possible paths of the surface water network influence the water quality. The extracted information can be used to develop a monitoring- and evidence-based decision support system. The methodological development is presented through the analysis of the physical-chemical parameters of all surface water bodies in Hungary, using the emissions of industrial plants and wastewater treatment plants. Changes in water quality are comprehensively assessed based on the water quality data recorded over the past 10 years. The results illustrate that the developed method can identify critical surface water bodies where the impact of local pollution sources is more significant. One hundred six critical water bodies have been identified, where special attention should be given to water quality improvement.
Effects of Cone Penetrometer Testing on Shallow Hydrogeology at a Contaminated Site
Authors: Putt Andrew D. , Kelly Erin R. , Lowe Kenneth A. , Rodriguez Miguel , Hazen Terry C. 
Published: January 2022

Penetration testing is a popular and instantaneous technique for subsurface mapping, contaminant tracking, and the determination of soil characteristics. While the small footprint and reproducibility of cone penetrometer testing makes it an ideal method for in-situ subsurface investigations at contaminated sites, the effects to local shallow groundwater wells and measurable influence on monitoring networks common at contaminated sites is unknown. Physical and geochemical parameters associated with cone penetrometer testing were measured from a transect of shallow groundwater monitoring wells adjacent to penetrometer testing. For wells screened above the depth of cone refusal, the physical advancement and retraction of the cone had a significant effect (p &lt; 0.01) on water level for several pushes within 10 meters of a monitoring well, and a measured increase in specific conductivity. No effect on geochemistry or water level was observed in continuous monitoring data from wells screened below the depth of cone refusal, but variability in specific conductivity from these wells during penetration testing was only a fraction of the natural variation measured during precipitation events. Continuous measurements of specific conductivity and water level demonstrated that the effects of penetration testing have limited spatial and temporal distributions with a null effect post-testing.
Compressive Behavior and Analytical Model of Ultra-Early Strength Concrete-Filled FRP Tube With Zero Curing Time
Authors: Liu Yue , Xie Jia-Zhan , Yan Jing-Liang 
Published: January 2022

Fiber-reinforced polymer (FRP) has been widely used in civil engineering due to its light weight, high strength, convenient construction, and strong corrosion resistance. One of the important applications of FRP composites is the concrete-filled FRP tube (CFFT), which can greatly improve the compressive strength and ductility of concrete as well as facilitate construction. In this article, the compressive performances of a normal concrete-filled FRP tube (N-CFFT) column with 5-hour curing time and an ultra-early strength concrete-filled FRP tube (UES–CFFT) column with zero curing time were studied by considering the characteristics of rapid early strength improvement of ultra-early strength concrete and the confinement effect of the FRP tube. Monotonic axial compression tests were carried out on 3 empty FRP tubes (FTs) without an internal filler and 6 CFFT (3 N-CFFTs and 3 UES-CFFTs) specimens. All specimens were cylinders of 200 mm in diameter and 600 mm in height, confined by glass fiber–reinforced polymer (GFRP). Test results indicated that the compressive bearing capacity of the specimens increased significantly by adopting the ultra-early strength concrete as the core concrete of the CFFT, although the curing time was zero. It was also shown that the compressive behavior of the UES–CFFT specimens with zero curing time increased significantly than that of the N-CFFT specimens with 5-hour curing time because the former was able to achieve rapid strength enhancement in a very short time than the latter. The ultimate compressive strength of UES–CFFT specimens with zero curing time reached 78.3 MPa, which was 66.2 and 97.2% higher than that of N-CFFT with 5-hour curing time and FT specimens, respectively. In addition, a simple confinement model to predict the strength of UES–CFFT with zero curing time in ultimate condition was introduced. Compared with the existing models, the proposed model could predict the ultimate strength of UES–CFFT specimens with zero curing time with better accuracy.
Varying Dose of Atropine in Slowing Myopia Progression in Children Over Different Follow-Up Periods by Meta-Analysis
Authors: Gan Jiahe , Li Shi-Ming , Wu Shanshan , Cao Kai , Ma Dandan , He Xi , Hua Ziyu , Kang Meng-Tian , Wei Shifei , Bai Weiling , Wang Ningli 
Published: January 2022

Purpose:To evaluate the efficacy and safety of atropine for slowing myopia progression and to investigate whether the treatment effect remains constant with continuing treatment.Method:Studies were retrieved from MEDLINE, EMBASE, and the Cochrane Library from their inception to May 2021, and the language was limited to English. Randomized controlled trials (RCTs) and cohort studies involving atropine in at least one intervention and placebo/non-atropine treatment in another as the control were included and subgroup analysis based on low dose (0.01%), moderate dose (0.01%–&lt;0.5%), and high dose (0.5–1.0%) were conducted. The Cochrane Collaboration and Newcastle-Ottawa Scale were used to evaluate the quality of RCTs and cohort studies, respectively.Results:Twelve RCTs and fifteen cohort studies involving 5,069 children aged 5 to 15 years were included. The weighted mean differences in myopia progression between the atropine and control groups were 0.73 diopters (D), 0.67 D, and 0.35 D per year for high-dose, moderate-dose, and low-dose atropine, respectively (χ2= 13.76;P= 0.001,I2= 85.5%). After removing studies that provided extreme findings, atropine demonstrated a significant dose-dependent effect on both refractive change and axial elongation, with higher dosages of atropine resulting in less myopia progression (r= 0.85;P= 0.004) and less axial elongation (r= −0.94;P= 0.005). Low-dose atropine showed less myopia progression (−0.23 D;P= 0.005) and less axial elongation (0.09 mm,P&lt; 0.001) in the second year than in the first year, whereas in high-dose atropine more axial elongation (−0.15 mm,P= 0.003) was observed. The higher dose of atropine was associated with a higher incidence of adverse effects, such as photophobia with an odds ratio (OR) of 163.57, compared with an OR of 6.04 for low-dose atropine and 8.63 for moderate-dose atropine (P= 0.03).Conclusion:Both the efficacy and adverse effects of atropine are dose-dependent in slowing myopia progression in children. The efficacy of high-dose atropine was reduced after the first year of treatment, whereas low-dose atropine had better efficacy in a longer follow-up period.
The Patterns of Morphological Change During Intracerebral Hemorrhage Expansion: A Multicenter Retrospective Cohort Study
Authors: Jianbo Chang , Ting Xiao , Yihao Chen , Xiaoning Wang , Hong Shang , Qinghua Zhang , Zeju Ye , Xingong Wang , Fengxuan Tian , Jianjun Chai , Wenbin Ma , Junji Wei , Ming Feng , Yao Jianhua , Renzhi Wang 
Published: January 2022

Objectives: Hemorrhage expansion (HE) is a common and serious condition in patients with intracerebral hemorrhage (ICH). In contrast to the volume changes, little is known about the morphological changes that occur during HE. We developed a novel method to explore the patterns of morphological change and investigate the clinical significance of this change in ICH patients.Methods: The morphological changes in the hematomas of ICH patients with available paired non-contrast CT data were described in quantitative terms, including the diameters of each hematoma in three dimensions, the longitudinal axis type, the surface regularity (SR) index, the length and direction changes of the diameters, and the distance and direction of movement of the center of the hematoma. The patterns were explored by descriptive analysis and difference analysis in subgroups. We also established a prognostic nomogram model for poor outcomes in ICH patients using both morphological changes and clinical parameters.Results: A total of 1,094 eligible patients from four medical centers met the inclusion criteria. In 266 (24.3%) cases, the hematomas enlarged; the median absolute increase in volume was 14.0 [interquartile range (IQR), 17.9] mL. The initial hematomas tended to have a more irregular shape, reflected by a larger surface regularity index, than the developed hematomas. In subtentorial and deep supratentorial hematomas, the center moved in the direction of gravity. The distance of center movement and the length changes of the diameters were small, with median values of less than 4 mm. The most common longitudinal axis type was anterior–posterior (64.7%), and the axis type did not change between initial and repeat imaging in most patients (95.2%). A prognostic nomogram model including lateral expansion, a parameter of morphological change, showed good performance in predicting poor clinical outcomes in ICH patients.Conclusions: The present study provides a morphological perspective on HE using a novel automatic approach. We identified certain patterns of morphological change in HE, and we believe that some morphological change parameters could help physicians predict the prognosis of ICH patients.
The Prevalence and Clinical Implications of Rectal SARS-CoV-2 Shedding in Danish COVID-19 Patients and the General Population
Authors: Holm-Jacobsen Julie Niemann , Bundgaard-Nielsen Caspar , Rold Louise Søndergaard , Jensen Ann-Maria , Shakar Shakil , Ludwig Marc , Kirk Karina Frahm , Donneborg Mette Line , Vonasek Julia Helena , Pedersen Benjamin , Arenholt Louise Thomsen Schmidt , Hagstrøm Søren , Leutscher Peter , Sørensen Suzette 
Published: January 2022

Background: SARS-CoV-2 has resulted in a global pandemic since its outbreak in Wuhan, 2019. Virus transmission primarily occurs through close contact, respiratory droplets, and aerosol particles. However, since SARS-CoV-2 has been detected in fecal and rectal samples from infected individuals, the fecal-oral route has been suggested as another potential route of transmission. This study aimed to investigate the prevalence and clinical implications of rectal SARS-CoV-2 shedding in Danish COVID-19 patients.Methods: Hospitalized and non-hospitalized adults and children who were recently tested with a pharyngeal COVID-19 test, were included in the study. A rectal swab was collected from all participants. Hospitalized adults and COVID-19 positive children were followed with both pharyngeal and rectal swabs until two consecutive negative results were obtained. RT-qPCR targeting the envelope gene was used to detect SARS-CoV-2 in the samples. Demographic, medical, and biochemical information was obtained through questionnaires and medical records.Results: Twenty-eight of 52 (53.8%) COVID-19 positive adults and children were positive for SARS-CoV-2 in rectal swabs. Seven of the rectal positive participants were followed for more than 6 days. Two of these (28.6%) continued to test positive in their rectal swabs for up to 29 days after the pharyngeal swabs had turned negative. Hospitalized rectal positive and rectal negative adults were comparable regarding demographic, medical, and biochemical information. Furthermore, no difference was observed in the severity of the disease among the two groups.Conclusions: We provided evidence of rectal SARS-CoV-2 shedding in Danish COVID-19 patients. The clinical importance of rectal SARS-CoV-2 shedding appears to be minimal.
United States Dietary Trends Since 1800: Lack of Association Between Saturated Fatty Acid Consumption and Non-communicable Diseases
Authors: Lee Joyce H. , Duster Miranda , Roberts Timothy , Devinsky Orrin 
Published: January 2022

We reviewed data on the American diet from 1800 to 2019.Methods: We examined food availability and estimated consumption data from 1800 to 2019 using historical sources from the federal government and additional public data sources.Results: Processed and ultra-processed foods increased from &lt;5 to &gt;60% of foods. Large increases occurred for sugar, white and whole wheat flour, rice, poultry, eggs, vegetable oils, dairy products, and fresh vegetables. Saturated fats from animal sources declined while polyunsaturated fats from vegetable oils rose. Non-communicable diseases (NCDs) rose over the twentieth century in parallel with increased consumption of processed foods, including sugar, refined flour and rice, and vegetable oils. Saturated fats from animal sources were inversely correlated with the prevalence of NCDs.Conclusions: As observed from the food availability data, processed and ultra-processed foods dramatically increased over the past two centuries, especially sugar, white flour, white rice, vegetable oils, and ready-to-eat meals. These changes paralleled the rising incidence of NCDs, while animal fat consumption was inversely correlated.