bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trustworthiness of a machine learning early warning model in medical and surgical inpatients
Authors: Caraballo Pedro J , Meehan Anne M , Fischer Karen M , Rahman Parvez , Simon Gyorgy J , Melton Genevieve B , Salehinejad Hojjat , Borah Bijan J 
Published: January 2025

Abstract

Objectives
In the general hospital wards, machine learning (ML)-based early warning systems (EWSs) can identify patients at risk of deterioration to facilitate rescue interventions. We assess subpopulation performance of a ML-based EWS on medical and surgical adult patients admitted to general hospital wards.

Materials and Methods
We assessed the scores of an EWS integrated into the electronic health record and calculated every 15 minutes to predict a composite adverse event (AE): all-cause mortality, transfer to intensive care, cardiac arrest, or rapid response team evaluation. The distributions of the First Score 3 hours after admission, the Highest Score at any time during the hospitalization, and the Last Score just before an AE or dismissal without an AE were calculated. The Last Score was used to calculate the area under the receiver operating characteristic curve (ROC-AUC) and the precision-recall curve (PRC-AUC).

Results
From August 23, 2021 to March 31, 2022, 35 937 medical admissions had 2173 (6.05%) AE compared to 25 214 surgical admissions with 4984 (19.77%) AE. Medical and surgical admissions had significant different (P &lt;.001) distributions of the First Score, Highest Score, and Last Score among those with an AE and without an AE. The model performed better in the medical group when compared to the surgical group, ROC-AUC 0.869 versus 0.677, and RPC-AUC 0.988 versus 0.878, respectively.

Discussion
Heterogeneity of medical and surgical patients can significantly impact the performance of a ML-based EWS, changing the model validity and clinical discernment.

Conclusions
Characterization of the target patient subpopulations has clinical implications and should be considered when developing models to be used in general hospital wards.
Adolescents and young adults with germline CDH1 variants and the risk of overtreatment
Authors: Gallanis Amber F , Bowden Cassidy , Lopez Rachael , Fasaye Grace-Ann , Lang David , Rothschild Jill , Camargo M Constanza , Hernandez Jonathan M , Rai Anjali , Heller Theo , Blakely Andrew M , Davis Jeremy L 
Published: January 2025

Abstract

Background
Adolescents and young adults (AYA) with germline CDH1 variants are at risk of overtreatment when precancer lesions are detected with endoscopic screening. We characterize diffuse-type gastric cancer prevalence and survival in AYA managed with prophylactic total gastrectomy (PTG) or endoscopic surveillance.

Methods
Prospective cohort study of 188 individuals aged 39 and younger enrolled from January 27, 2017, to May 1, 2023. Clinicopathological data, prevalence of early gastric signet ring cell (SRC) lesions, advanced gastric cancer diagnoses, and cancer-specific survival were measured.

Results
Among 188 AYA patients, 104 chose surveillance and 67 pursued PTG for management of elevated gastric cancer risk. AYA who enrolled early in the study period and had SRC lesions detected on preoperative endoscopy were more likely to elect for PTG compared with surveillance. SRC lesions were detected on preoperative endoscopy in 48% of patients who subsequently had PTG, and yet nearly all (93%, 62/67) had multifocal SRC (pT1aN0) on final pathology. Median age at enrollment (30 vs 31 years, P = .21), biological sex (P = .17), and median number of family members with gastric cancer (3 vs 4, P = .14) were not different between groups. No patients under surveillance developed advanced cancer or developed cancer recurrence after PTG with a median follow-up of 2.5 years (IQR = 1.6-4.0) from initial endoscopy.

Conclusions
Cancer-specific outcomes were not different in AYA who harbored SRC and were managed with surveillance or PTG. Lack of cancer-specific deaths and low prevalence of advanced gastric cancer underscore the risk of overtreatment of SRC lesions and suggest that active surveillance is warranted.
Systematic review of emergency department management of vaso-occlusive episodes in adults with sickle cell disease
Authors: Hutcherson Timothy C , Rowlee Paige B , Abeles Jennifer , Cieri-Hutcherson Nicole E 
Published: January 2025

Abstract
The objective of this systematic review was to characterize the management of vaso-occlusive episodes (VOEs) in adult patients with SCD in the emergency department (ED) via implementation of a protocol or pathway intended to improve patient care for VOE-related pain.
A literature search was conducted spanning origin through May 31, 2023, using Embase, MEDLINE ALL, and International Pharmaceutical Abstracts databases. Primary literature reporting on adult patients with SCD in a SCD-specific pathway or protocol in an ED setting was included. Data extracted included report design characteristics, patient demographics, descriptors of the pathway/protocol, pain outcomes, and hospital length of stay. The Cochrane Risk of Bias 2.0 tool was used to assess risk-of-bias in randomized controlled trials (RCTs). The Risk of Bias for Non-Randomized Studies of Interventions was used to assess risk-of-bias in nonrandomized trials (NRTs). Certainty of evidence was assessed via the Grading of Recommendations, Assessment, Development, and Evaluations tool.
Nine reports met eligibility criteria: 2 reports of 1 RCT and 7 observational NRTs. The RCT had low risk-of-bias; 5 NRTs had moderate risk-of-bias, 2 had serious risk-of-bias. Improvements in time to first opioid, pain scores, length of ED treatment time, overall treatment time (length of stay), and inpatient readmission improved with policies/protocols for the management of VOEs in the ED setting. These 5 outcomes had a moderate certainty of evidence.
Institutions should consider implementing protocols or pathways to improve management of VOEs in the ED.
Association between serum testosterone level and cardiovascular health in US male adults: results from the 2013-2016 NHANES
Authors: Wu Xu , Zhang Yuyang , Zhang Xiansheng 
Published: January 2025

Abstract

Background
There have been many studies of the association between testosterone and cardiovascular disease (CVD). However, limited research has examined the association between testosterone and Life’s Essential 8 (LE8), a recently updated algorithm for assessing cardiovascular health (CVH).

Objectives
This study aims to investigate the association between serum total testosterone (TT) levels and LE8 scores—where higher LE8 scores indicate better CVH—among adult males in the United States.

Method
Data from 3308 adult males were extracted from the National Health and Nutrition Examination Survey conducted between 2013 and 2016. Weighted univariate and multivariate linear regression models [β and 95% confidence intervals (CIs)] and logistic regression models [odds ratios (ORs) and 95% CIs] were used to explore the association between testosterone and LE8 and high CVH risk. Additionally, a smoothed curve fit (penalized spline method) and generalized additive model regression were applied to further explore these relationships.

Outcomes
LE8 includes 4 health behaviors (nicotine exposure, diet, physical activity, and sleep duration) and 4 health factors (body mass index, non–high-density lipoprotein cholesterol, blood pressure, and blood glucose).

Results
Serum TT levels were strongly associated with LE8 scores after adjusting for all confounders (continuous: β = 2.75, 95% CI: 1.92, 3.57, P &lt; .0001; quartiles: Q4 vs Q1: β = 3.89, 95% CI: 2.78, 5.01, P &lt; .0001). Similarly, high levels of TT were associated with a significantly lower CVH risk (OR = 0.59, 95% CI: 0.49, 0.73, P &lt; .001). Compared to low TT levels, normal TT levels significantly reduced the risk of CVH (OR = 0.51, 95% CI: 0.38, 0.69, P &lt; .001). Smoothed curve fitting showed a positive linear correlation between TT levels and LE8 scores, as well as a consistent linear negative correlation with CVH risk.

Clinical Implications
These findings highlight the importance of endogenous TT levels in promoting CVH and provide new insights into factors influencing CVH.

Strengths and Limitations
This study is the first to investigate the association between serum TT level and LE8 scores as well as LE8-assessed CVH among adult males. However, the observational nature of this study precludes any assessment of causality.

Conclusions
This study demonstrates a robust positive association between serum TT levels and LE8 scores in a nationally representative sample of adult men in the United States.
Detection of multiple myositis-specific antibodies: prevalence and clinical significance
Authors: Jerbi Ameni , Karoui Sahar , Snoussi Mouna , Feki Sawsan , Damak Chifa , Bahloul Zouheir , Masmoudi Hatem , Marzouk Sameh , Hachcicha Hend 
Published: January 2025

Abstract

Background
The multipositivity of myositis-specific antibodies (MSAs) is uncommon. Our study aimed to assess the prevalence and the clinical relevance of multiple positive MSAs in routine practice.

Methods
A 10 year single-center retrospective study (2015-2024) was conducted reviewing all samples analyzed with the Dot Myositis EUROLINE (Euroimmun Germany). Clinical data corresponding to samples with multiple positive MSAs was reviewed.

Results
Among 140 samples positive for at least 1 MSA, 22 patients (15.7%) were positive for at least 2 MSAs on the same sample. The diagnosis of idiopathic inflammatory myopathies (IIMs) was confirmed in only 6 patients (27.2%). The frequency of double-positive MSAs was 100% in IIM patients and 60% in non-IIM patients. No IIM patients and 40% of non-IIM patients (P = .037) had 3 or more positive MSAs. MSA titers were higher in IIM patients than in non-IIM patients (49 vs 32 AU, P = .33). The clinical IIM subtype joined the IIM subtype corresponding to the predominant MSA. We had no mixed features of either IIM subtype or added severe prognosis.

Conclusion
Detection of multiple MSAs is uncommon but possible using immunodot techniques. Taking into account MSA number, level of positivity, and clinical data helps in the interpretation of the results.
Retail Availability of Oral Nicotine Pouches in Three US Cities: A Geographic Analysis
Authors: Giovenco Daniel P , Spillane Torra E , Lee Hye Myung , Ali Neha , Little Rose Monet P , Rahman Syed N , Yagoda Sophie S 
Published: January 2025

Abstract

Introduction
Sales of oral nicotine pouches (ONPs), including brands such as Zyn, on!, Velo, and Rogue, have risen precipitously in the United States. One potential driver of ONP use may be exposure to the products and their marketing in local tobacco retailers. This study examines the prevalence and correlates of ONP availability in a large, representative sample of tobacco retailers in three major US cities.

Aims and Methods
In 2023, research staff visited a stratified, random sample of 20% of licensed tobacco retailers in San Francisco, New York City, and Philadelphia (n = 1402) and documented the availability of ONPs. Binomial generalized linear mixed models estimated adjusted odds of ONP availability by city, store type, and district sociodemographic characteristics.

Results
ONPs were available in 28.7% of retailers and were most prevalent in chain convenience stores (60.5%), followed by smoke/vape shops (53.3%, p &lt; .0001). After adjusting for city and store type, the odds of a retailer carrying ONPs were higher in districts with a greater proportion of non-Hispanic White residents (adjusted odds ratio [aOR]: 2.33 [1.10, 4.94]), a higher median household income (aOR: 2.04 [1.23, 3.38]), and a lower proportion of youth residents (aOR: 0.25 [0.15, 0.43]).

Conclusions
ONP availability was greater in retailers located in predominantly White and higher-income neighborhoods and those with fewer youth. As researchers continue to evaluate the risks of ONPs as well as their potential as a tobacco harm reduction strategy, attention to variations in retail access and population patterns of use will be critical to determine impacts on health equity.

Implications
Sales of oral ONPs have increased precipitously in the United States, but little is known about patterns of retail access in neighborhoods, which may influence consumer use behaviors. This study found that over one in four tobacco retailers carried ONPs, but availability was greater in largely White and high-income neighborhoods and those with fewer youth. As researchers continue to evaluate ONP risks and potential benefits, this study provides insight into the role that retail access may play in shaping population patterns of use and subsequent impacts on health equity.
3D multiscale characterization of the human placenta: Bridging anatomy and histology by X-ray phase-contrast tomography
Authors: Reichmann Jakob , Schnurpfeil Anne , Mittelstädt Sylvia , Jensen Patrick Moller , Dahl Vedrana Andersen , Dahl Anders Bjorholm , Weide Carina , von Campenhausen Eva , Dejea Hector , Tafforeau Paul , Werlein Christopher , Jonigk Danny , Ackermann Maximilian , Engel Klaus , Gallwas Julia , Dietz Alexander , Hasanov Mir Fuad , Salditt Tim 
Published: January 2025

Abstract
The human placenta exhibits a complex three-dimensional (3D) structure with a interpenetrating vascular tree and large internal interfacial area. In a unique and yet insufficiently explored way, this parenchymal structure enables its multiple functions as a respiratory, renal, and gastrointestinal multiorgan. The histopathological states are highly correlated with complications and health issues of mother, and fetus or newborn. Macroscopic and microscopic examination has so far been challenging to reconcile on the entire organ. Here we show that anatomical and histological scales can be bridged with the advent of hierarchical phase-contrast tomography and highly brilliant synchrotron radiation. To this end, we are exploiting the new capabilities offered by the BM18 beamline at ESRF, Grenoble for whole organ as well as the coherence beamline P10 at DESY, Hamburg for high-resolution, creating unique multiscale datasets. We also show that within certain limits, translation to μCT instrumentation for 3D placenta examination becomes possible based on advanced preparation and CT protocols, while segmentation of the datasets by machine learning now remains the biggest challenge.
Towards faster quality control of personal radiation protective equipment using CT scout or a dedicated biplanar radiography device
Authors: Kellens Pieter-Jan , Bayart Sandrine , De Pooter Jan , Bacher Klaus 
Published: January 2025

Abstract
Quality control (QC) of personal radiation protective equipment (PRPE) is essential to detect tears and holes in the attenuating layers. Routinely, this QC is performed using fluoroscopy on a conventional X-ray table. However, such a QC procedure is laborious and time consuming. This study aims to establish faster PRPE QC using CT scout or a biplanar radiography device. A reproducible 0.25 mm lead-equivalent phantom of ten holes (diameter 10 mm – 1 mm) and two incisions (length 50 mm and 25 mm with a width of 0.63 mm) was created to assess the defect detection performance using fluoroscopy, CT scout (Siemens Somatom Definition Flash and GE Revolution) and a biplanar radiography device (EOS). Additionally, three pieces of PRPE were imaged on all modalities and compared in terms of speed and defect detection performance. Defect quantification was performed with an X-ray opaque grid, the modality’s line tool and the built-in wand tool in ImageJ software. All modalities could visualize the smallest defects (1 mm). However, for the Siemens Flash, the smallest defect was only visible when the scout length was at most 50 cm. Fluoroscopy was the most time consuming (&gt;1 min/piece). Both CT scout and the EOS allowed faster analysis (&lt;10 s). The EOS system had the highest resolution of 5.19 pixels/mm for all set scan speeds. However, to image the reference pieces, a seamstress doll was needed. The wand tool was found to be the most accurate for defect estimation. Both the EOS and a CT scout allowed faster QC of PRPE with equivalent defect detection performance. However, specific positioning and scan length must be considered.
Taxonomic revision of Chilean Liogenys (Coleoptera: Melolonthidae) and molecular assessment of a species complex
Authors: Cherman Mariana A , Basílio Daniel S , Clarkson Bruno , Mondaca José , Bezděk Aleš , Smith Andrew B T , Almeida Lúcia M 
Published: January 2025

Abstract
Liogenys is a neotropical genus widely distributed in South America and characterized by rhizophagous feeding habits. Taxonomy survey of Liogenys from Chile revealed a species complex consisting of L. palpalis, L. obesula and an undescribed morphotype. Morphological data alone are not sufficient to distinguish between them. The three-species hypothesis was tested using phylogenetic and preliminary phylogeographic analyses, as well as unilocus delimitation methods using mitochondrial (COI) and nuclear (ITS2) markers. The tree-based PTP method based on ITS2 considers both L. obesula and the undescribed morphotype to be variants of L. palpalis, a single, polymorphic species. Haplotypes from 12 localities along central Chile revealed four genetically structured populations, with statistical variance (54.34%) only within them. Isolated populations occur in Southern Santiagan Region and coastal desert. There are eight species of Liogenys in Chile. Diagnoses are provided for five species. Liogenys elguetai sp. nov. is described. Five synonyms are proposed for three species. Liogenys pubisternis, a new synonym of L. palpalis, is transferred from Diplotaxis. Lectotypes are provided for four names (L. castaneus, L. grandis, L. pubisternis, and Melolontha palpalis). Liogenys boliviensis is recorded for the first time from Chile and Peru, extending the distribution of Liogenys to northernmost Chile.
Biglycan stimulates retinal pathological angiogenesis via up‐regulation of CXCL12 expression in pericytes
Authors: Liu Miaomiao , Zhao Peiquan , Feng Huazhang , Yang Yuan , Zhang Xuerui , Chen Enguang , Xiao Haodong , Luo Jia , Chen Han , Yin Jiawei , Lin Min , Mao Ruixue , Zhu Xingping , Li Jing , Fei Ping 
Published: January 2025

AbstractRetinal pathological angiogenesis (PA) is a common hallmark in proliferative retinopathies, including age‐related macular degeneration (AMD), proliferative diabetic retinopathy (PDR), and retinopathy of prematurity (ROP). The mechanisms underlying PA is complex and incompletely understood. In this study, we investigated the role of extracellular matrix (ECM) protein biglycan (BGN) in PA using an oxygen‐induced retinopathy (OIR) mouse model, along with hypoxia (1% O2) conditions for incubating pericytes and endothelial cells in vitro. We found a significant upregulation of Bgn in the retinas of OIR mice. Intravitreal injection of Bgn‐specific small interfering RNA (siRNA) in OIR mice at postnatal day 12 (P12) effectively curbed retinal PA at P17. Using cultured cells, we found that BGN expression in pericytes was highly sensitive to hypoxic stimulation compared to endothelial cells. We further showed that BGN stimulated retinal PA via the upregulation of C‐X‐C motif chemokine ligand 12 (CXCL12). Inhibition of the CXCL12‐CXCR4 axis effectively diminished PA in OIR mouse. In conclusion, our study demonstrated the stimulatory role of BGN in retinal PA, identified the link between BGN and CXCL12 expression, and further highlighted the role of pericytes in retinal PA.
Mini-boomerang Approach for the Treatment of Specific Laterally-based Fracture Patterns of the Glenoid and Scapular Neck
Authors: LaRoque Michael C. , Pedri Tony G. , Brahme Indraneel S. , Cole Peter A. 
Published: January 2025

Background:
Several posterior approaches have been developed for scapula neck and body fractures undergoing operative management, with variations balancing priorities of visualization and minimization of soft tissue disruption. Seldom, consideration is given to adjusting the surgical approach based on specific and known fracture patterns. The purpose of this manuscript is to describe the mini-boomerang surgical technique for surgeons encountering a subtype of less common fracture patterns and report clinical outcomes for 7 patients after surgical treatment with this approach.

Methods:
For a subtype of laterally-based scapula fractures isolated to the scapular anatomic neck ± glenoid, and/or crossing the scapular spine, we describe and illustrate the mini-boomerang, a variation on the classic Judet incision. This cohort included 4 men and 3 women with a mean age of 39 years (range = 23 to 57). Postoperatively, all patient scores for disabilities of shoulder and hand (DASH), along with a range of motion and strength measurements for the injured and contralateral shoulder, were collected.

Results:
Seven patients underwent mini-boomerang incision for scapula fractures. Five patients achieved follow-up of 12 months or greater (mean= 24; range=14 to 31 months). The mean ROM for the injured versus uninjured shoulder at final follow-up was 99% for forward flexion (FF), 98% for abduction (ABD), and 75% for external rotation (ER). The mean postoperative strength of the injured versus uninjured shoulder at final follow-up was 81% for FF, 92% for ABD, and 70% for ER.

Conclusion:
The mini-boomerang approach decreases soft tissue exposure while enhancing visualization for fracture reduction and fixation.
Radiofrequency Microneedling in Treating Primary Hyperhidrosis: A Systematic Review and Meta-Analysis
Authors: Vaish Mayuri H. , Hadeler Edward , Guda Anisha , Goff Heather 
Published: January 2025

BACKGROUND
Radiofrequency microneedling (RFM) is a potential treatment for primary hyperhidrosis. However, its efficacy is unclear, and treatment parameters and outcomes vary across studies.

OBJECTIVE
To understand the effect of RFM on treating primary hyperhidrosis, as measured by changes in the Hyperhidrosis Disease Severity Score (HDSS) before and after treatment, and to clearly define treatment settings most likely to optimize results.

MATERIALS AND METHODS
A systematic literature search utilizing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted across PubMed, EMBASE, MEDLINE, Web of Science, and the Cochrane Library. Studies were evaluated for risk of bias via the ROBINS-I tool and Levels of Evidence/GRADE criteria. A random forest model identified RFM settings that predict HDSS score decrease.

RESULTS
Six publications met inclusion criteria. The level of evidence was classified as Grade B, indicating moderate quality. RFM intervention resulted in a mean HDSS score decrease of 1.63 (52% reduction, p < .05). The strongest predictors for HDSS score decrease were dwell time, energy, and depth, with feature importances of 0.43, 0.19, and 0.15 respectively.

CONCLUSION
Radiofrequency microneedling treatment significantly reduces HDSS scores in patients with primary hyperhidrosis. Moving forward, it would benefit physicians to standardize objective protocols in reporting RFM parameters and measuring outcomes.