bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic assessment of long-term survival in survivors with stage III non-small cell lung cancer: a novel conditional survival model with a web-based calculator
Authors: Meng Xiangdi , Wang Peihe , Liu Jie , Sun Daqing , Ju Zhuojun , Cai Yuanyuan
Published: January 2025

Background

Conditional survival (CS) analysis can estimate further survival probabilities based on the time already survived, providing dynamic updates for prognostic information. This study aimed to develop a CS-nomogram to promote individualized disease management for stage III non-small cell lung cancer (NSCLC).

Methods

This study included patients diagnosed with stage III NSCLC in the Surveillance, Epidemiology, and End Results database from 2010 to 2017 (N = 3,512). The CS was calculated as CS(y|x) = OS(y + x)/OS(x), where OS(y + x) and OS(x) were the overall survival (OS) in the year (y + x) and year x, respectively, calculated by the Kaplan–Meier method. We used the least absolute shrinkage and selection operator (LASSO) regression to identify predictors and developed the CS-nomogram based on these predictors and the CS formula.

Results

The CS analysis provided real-time updates on survival, with 5-year OS improving dynamically from 14.4 to 29.9%, 47.9, 66.0, and 80.8% (after 1–4 years of survival). Six independent predictors (age, tumor size, N status, surgery, radiotherapy and chemotherapy) were identified for the development of the CS-nomogram and its web version (https://dynapp.shinyapps.io/NSCLC/). The model performed with an excellent concordance index (C-index) of 0.71 (95% CI: 0.70–0.72), and a median time-dependent AUC of 0.71–0.73 from 200 iterations 5-fold cross-validation.

Conclusion

The study demonstrated the improvement in real-time OS over time in stage III NSCLC survivors and developed the novel CS-nomogram to provide patients with updated survival data. It provided novel insights into clinical decisions in follow-up and treatment for survivors, offering a convenient tool for optimize resource allocation.
Research on a traditional Chinese medicine case-based question-answering system integrating large language models and knowledge graphs
Authors: Duan Yuchen , Zhou Qingqing , Li Yu , Qin Chi , Wang Ziyang , Kan Hongxing , Hu Jili
Published: January 2025

Introduction

Traditional Chinese Medicine (TCM) case records encapsulate vast clinical experiences and theoretical insights, holding significant research and practical value. However, traditional case studies face challenges such as large data volumes, complex information, and difficulties in efficient retrieval and analysis. This study aimed to address these issues by leveraging modern data techniques to improve access and analysis of TCM case records.

Methods

A total of 679 case records from Wang Zhongqi, a renowned physician of Xin’an Medicine, a branch of TCM, covering 41 diseases, were selected. The study involved four stages: pattern layer construction, knowledge extraction, integration, and data storage and visualization. A large language model (LLM) was employed to automatically extract key entities, including symptoms, pathogenesis, treatment principles, and prescriptions. These were structured into a TCM case knowledge graph.

Results

The LLM successfully identified and extracted relevant entities, which were then organized into relational triples. A TCM case query system based on natural language input was developed. The system’s performance, evaluated using the RAGAS framework, achieved high scores: 0.9375 in faithfulness, 0.9686 in answer relevancy, and 0.9500 in context recall; In human evaluations, the levels of safety and usability are significantly higher than those of LLMs without using RAG.

Discussion

The results demonstrate that integrating LLMs with a knowledge graph significantly enhances the efficiency and accuracy of retrieving TCM case information. This approach could play a crucial role in modernizing TCM research and improving access to clinical insights. Future research may explore expanding the dataset and refining the query system for broader applications.
Effectiveness of the application of a digitalized repository on the quality of graduate and post-graduate education in the field of physical medicine and rehabilitation
Authors: Koleva Ivet B. , Yoshinov Borislav R. , Yoshinov Radoslav R.
Published: January 2025

Background

During last ten years, we have developed a digital library with educational materials in Physical medicine and rehabilitation.

Objectives

The objective of current article is the preparation of an electronic library with educational materials in the area of physical medicine, physical therapy and rehabilitation, and the comparative evaluation of the impact of this repository on the quality of education of students and trainees in the field.

Methodology

The electronic library includes e-books on different topics, elements of the specialty “Physical and rehabilitation medicine (PRM)” or Physiatry – with theoretical data, practical issues and case reports with videos of real patients. From the field of basic physiatry we included: books on kinesiological and pathokinesiological analysis, functional evaluation; physiotherapy (active exercises, soft-tissue techniques), ergotherapy (activities), balneotherapy (mineral baths and peloids, underwater gymnastics), manual therapy (tractions, mobilizations, manipulations), preformed physical factors (electric currents, magnetic field, ultrasound, light, laser, etc). In special physiatry we prepared manuals on: neurological and neurosurgical rehabilitation, orthopedic and traumatologic rehabilitation, rheumatologic rehabilitation, cardiac and cardiosurgical rehabilitation, etc. The digital library has been applied to educate 1,186 learners (graduate and post-graduate studies): students in Bachelor’s degree (Physiotherapy, Nursing, Midwifery, Medical assistants) and in Master’s degree (Physiotherapy, Medical rehabilitation and balneology), medical doctors—residents in Physical and Rehabilitation medicine (PRM), participants in long-life learning courses (physiatrists, physiotherapists and nurses). At the end of every educational course, we collected data from the practical and theoretical exams (investigation period—from April 2020 to October 2024). Additionally, we evaluated learners’ opinion using anonymous questionnaires on the usefulness of the electronic library.

Results

Comparative analysis of the results revealed significant improvement in theoretical knowledge and practical skills of students and trainees, as evidenced by online assessments, and face-to-face theoretical and practical exams. The majority of learners consider the electronic repository useful.

Conclusion and recommendations

The authors consider this electronic library (with books, manuals, video-presentations and case studies) a valuable resource in both graduate and post-graduate education within the rehabilitation field. We recommend the application of electronic repositories in the process of education of the students and trainees.
Comparing the corneal temperature of dry eyes with that of normal eyes via high-resolution infrared thermography
Authors: Wu Chunbo , Huang Yuanshen , Xu Banglian , Li Baicheng , Zhuang Songlin , Cao Guofan , Hu Yan , Gu Zhensheng
Published: January 2025

Purpose

This study compares the corneal temperature in dry eyes with normal eyes via high-resolution infrared thermography.

Methods

A total of 86 participants were enrolled, with 40 and 46 participants in the dry eye disease (DED) and control groups, respectively. All participants underwent non-invasive breakup time (NIBUT) measurement, an Ocular Surface Disease Index (OSDI) questionnaire and ocular thermography.

Results

In the DED group, the mean initial central corneal temperature (initial CCT) is 33.25 ± 0.66°C, the tenth-second central corneal temperature (10s-CCT) is 32.47 ± 0.84°C, and the mean change in central corneal temperature measured within 10 s (change in CCT within 10 s) is 0.78 ± 0.30°C. For the controls, the initial CCT, 10s-CCT, and change in CCT within 10 s are 33.14 ± 1.02°C, 32.90 ± 0.99°C, and 0.23 ± 0.20°C, respectively. Except for the initial CCT (p = 0.549), significant differences are observed in the 10s-CCT (p = 0.034) and the change in CCT within 10 s (p < 0.001) between the two groups. The standard deviation of the temperature values within the region of interest (SD of TVs within ROI) on the central cornea is calculated to compare the uniformity of corneal temperature. In the DED group, the mean standard deviation of the initial temperature values within the region of interest (SD of initial TVs within ROI) is similar to that in the control group (0.23 ± 0.07°C vs. 0.22 ± 0.05°C, p = 0.926). In contrast, the mean standard deviation of the tenth-second temperature values within the region of interest (SD of 10s-TVs within ROI) in the DED group is greater than that in the control group, and there is a significant difference (0.44 ± 0.20°C vs. 0.35 ± 0.15°C, p = 0.016). In the DED group, the mean change in CCT within 3 s after tear film break-up is significantly greater than that before tear film break-up (0.19 ± 0.08°C vs. 0.10 ± 0.10°C, p < 0.001).

Conclusion

As the time with eyes open increases, dry eyes present a significantly faster decrease in central corneal temperature (CCT) and a significantly worse uniformity of corneal temperature compared with normal eyes.
Global perspectives on the biodegradation of LDPE in agricultural systems
Authors: Mendoza Jani E. , Tineo Daniel , Chuquibala-Checan Beimer , Atalaya-Marin Nilton , Taboada-Mitma Victor H. , Tafur-Culqui Josué , Tarrillo Ever , Gómez-Fernández Darwin , Goñas Malluri , Reyes-Reyes María Andrea
Published: January 2025

The increasing use of plastics globally has generated serious environmental and human health problems, particularly in the agricultural sector where low-density polyethylene (LDPE) and other plastics are widely used. Due to its low recycling rate and slow degradation process, LDPE is a major source of pollution. This paper addresses the problem of plastic accumulation in agriculture, focusing on LDPE biodegradation strategies. The studies reviewed include recent data and the methodologies used include state-of-the-art technologies and others that have been used for decades, to monitor and measure the degree of biodegradation that each treatment applied can have, including SEM, GCMS, HPLC, and microscopy. The countries investigating these biodegradation methodologies are identified, and while some countries have been developing them for some years, others have only begun to address this problem in recent years. The use of microorganisms such as bacteria, fungi, algae, and insect larvae that influence its decomposition is highlighted. A workflow is proposed to carry out this type of research. Despite the advances, challenges remain, such as optimizing environmental conditions to accelerate the process and the need for further research that delves into microbial interactions in various environmental contexts.
Bacteriophage LDT325 enhances Pseudomonas syringae tolerance by improving antioxidant defense in tea plant [Camellia sinensis (L.) O. Kuntze]
Authors: Liu Li , Huang Anqi , Zhang Hua , Li Yubao , Wang Lei
Published: January 2025

Bud blight caused by Pseudomonas syringae is a serious disease affecting tea plants and causing severe damage to production output and quality. Phages play an important role in controlling the development of bacterial diseases in plants. Previous studies have shown that the tolerance of phage-treated tea plants to bud blight was notably greater compared with that of the control group. In the present study, we determined the effect of bacteriophage therapy on physiological and biochemical parameters of tea leaves. Transmission electron microscopy (TEM) was used to analyze the cellular structure of tea leaves, and bioinformatics was used to analyze the phage. Results revealed that bacteriophage treatment can enhance the expression of antioxidant enzyme genes (CsSOD, CsCAT, and CsPOD). The levels of osmotic adjustment compounds, including proline and soluble sugars, were also elevated, suggesting that bacteriophage enhances the osmotic adjustment capacity in tea plants. TEM analysis revealed that the integrity of the cell structure of the tea leaves treated with phage was notably better compared with that of the control group. Interestingly, we also observed that the phage lysed the animal pathogen Salmonella as well as the plant pathogen P. syringae. Using NCBI BLASTn to compare the entire genome with other nucleotide sequences, we found that the phage LDT325 exhibited cross-species characteristics that had not been previously reported. In summary, our findings demonstrate that bacteriophages can protect tea plants from damage caused by bacterial diseases by regulating antioxidant systems.
Threshold effects of sleep duration and cognitive function in older adults with BMI ≥ 25 kg/m2
Authors: Qiu Kunyu , Liu Yilei , Hu Chengwei , Gu Jie , Huang Yanyan
Published: January 2025

Background

It has been demonstrated that older adults’ cognitive capacities can be improved with sleep duration. However, the relationship between overweight, obesity, and cognitive decline remains a subject of debate. The impact of sleep duration on cognitive performance in seniors with a body mass index (BMI) ≥ 25 kg/m2 is largely unknown. This makes it an intriguing subject to explore further.

Methods

This study used data from the National Health and Nutrition Examination Survey (NHANES) (2011–2014) with 2,243 participants. Weighted multivariate linear regression and smooth curve fitting were employed to investigate linear and non-linear relationships. A two-part linear regression model was used to determine the threshold effects. Additionally, subgroup analysis and interaction tests were conducted.

Results

Results showed that a negative association was found between sleep duration and scores in the fully adjusted model in the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) test, the Animal Fluency test (AFT), and the Digit Symbol Substitution test (DSST). A two-piecewise linear regression model was then applied to explore the threshold effect of sleep duration on cognitive performance. When sleep duration was less than 5 and 6 h per day, sleep duration was positively correlated with CERAD test scores [ß (95% CI): 2.11 (1.17, 3.05), p < 0.0001], AFT scores [β (95% CI): 0.25 (−0.17, 0.67), p = 0.2376], and DSST scores [ß (95% CI): 0.49 (−0.57, 1.56), p = 0.3654]. However, there was a threshold effect where sleep duration reached the three inflection points.

Conclusion

In overweight and obese older adults, there is a clear inverted U-shaped relationship between sleep duration and cognitive function, with consistent results across different subgroups. Sleep durations of around 5–6 h may help prevent cognitive decline in older adults with a BMI ≥ 25 kg/m2.
Influence of physicochemical factors on the interaction of metallic nanoparticles with immune system cells
Authors: Gutiérrez-Cruz Sinai G. , Muñoz-Diosdado Alejandro , Gutiérrez-Calleja Ramón A. , Rodríguez-Cortés Octavio , Ortiz-Reyez Ana E. , Flores-Mejía Raúl
Published: January 2025

Different physicochemical factors, such as size, concentration, shape, exposure time, area, and surface chemistry, influence the interaction between metallic nanoparticles (MNPs) and immune system cells. Particle size is particularly significant, as smaller particles facilitate easier cell internalization, while larger particles exhibit lower immunogenicity. Concentration also plays a critical role; high concentrations may trigger toxic responses, while low concentrations may act beneficially. Additionally, the morphology of nanoparticles affects their affinity for different cell types. It modulates the intensity of immune responses, while exposure time determines whether the immune response manifests as acute or chronic. The material composition of nanoparticles influences the initial interaction with cells, including protein adsorption and recognition by cell receptors. Understanding and controlling physicochemical factors is essential for developing therapeutic applications based on MNPs and minimizing potential adverse effects on the immune system. This paper reviews the reported biological effects of MNPs on various immune cell types, including B and T lymphocytes, neutrophils, monocytes, macrophages, dendritic cells, natural killer cells, mast cells, basophils, and eosinophils.
Prognostic analysis of endovascular mechanical thrombectomy in stroke patients with acute internal carotid artery obstruction based on circle of Willis variation
Authors: Qiu Tianlun , Luo Huagang , Bao Wuqiao
Published: January 2025

Objective

Endovascular mechanical thrombectomy (EVMT) is widely employed in patients with acute intracranial carotid artery occlusion (AIICAO). This study aimed to predict the outcomes of EVMT following AIICAO by utilizing anatomic classification of the circle of Willis and its relative position to the thrombus.

Methods

In this study, we retrospectively analyzed a cohort of 108 patients with AIICAO who underwent endovascular mechanical thrombectomy (EVMT) at Shaoxing People’s Hospital. Based on variations in the circle of Willis, as well as the size and location of the thrombus occluding the middle cerebral artery (MCA), anterior cerebral artery (ACA), and posterior cerebral artery (PCA), we classified AIICAO into four grades using digital subtraction angiography (DSA). EVMT was initiated upon admission, and baseline data including demographic characteristics, vascular risk factors, angiographic features, initial National Institutes of Health Stroke Scale (NIHSS) scores, Alberta Stroke Program Early CT Score (ASPECT), and etiology classification were compared across these four grades. The prognosis and mortality rates at 90 days post-stroke were evaluated for the different grades and within each grade, patients were further categorized into two subtypes based on vascular compensation and occluded vessels.

Results

Significant differences were observed among the four grades of Willis compensation concerning etiologic classification (p = 0.008), postoperative modified treatment in cerebral ischemia (mTICI, p = 0.017), postoperative symptomatic intracranial hemorrhage (sICH, p = 0.007), NIHSS score at admission (p = 0.001), and favorable outcomes at 90 days (modified Rankin Score 0–2) (p = 0.003). The mortality rate at 90 days exhibited a significant difference across the four grades of Willis compensation (p = 0.05). However, prognosis did not reveal any significant differences among the various subtypes within the same grade (p > 0.05).

Conclusion

The assessment of the degree of Willis compensation can be improved by evaluating the integrity of the circle of Willis, as well as the size and location of the clot in cases of isolated internal carotid artery occlusion (iICAo). This approach provides valuable prognostic indicators and important insights for the pre-selection of patients prior to endovascular mechanical thrombectomy (EVMT).
Associations of reverse triiodothyronine serum levels with anxiety, depression, and health related quality of life after experiencing acute ischemic stroke
Authors: Taroza Saulius , Plamondon Helene , Podlipskyte Aurelija , Kazukauskiene Nijole , Linares Nicolas Francisco Narvaez , Poitras Marilou , Burkauskas Julius , Mickuviene Narseta
Published: January 2025

Aim

This study intended to explore associations of reverse triiodothyronine (rT3) with emotional disturbances and health-related quality of life (HRQoL) after experiencing acute ischemic stroke (AIS).

Materials and methods

Serum samples from individuals with AIS were collected on admission to three Lithuania stroke centers and investigated for free tetraiodothyronine, free triiodothyronine (fT3), rT3, and thyroid stimulating hormone levels. At discharge, emotional disturbance was evaluated using the Hospital Depression and Anxiety Scale (HADS), and HRQoL using the EQ-5D-5L scale.

Results

Analyses included 159 individuals (59.7% male and 40.3% female; mean (SD) aged 66.4 [10.3] years), 52.83% of which showed increased rT3 levels upon admission. After adjustment for age, sex, National Institutes of Health Stroke Scale scores, previous stroke, modified Rankin Scale before AIS ≤ 2, and diabetes mellitus, multivariable linear regression revealed negative associations of rT3 with HADS total score (β = −0.163; p = 0.046) and HADS-D subscale score (β = −0.187; p = 0.019). Analyses supported a positive relationship between the fT3 ratio to rT3 with HADS-D score (β = 0.157; p = 0.046) and rT3, rT3 × fT3 product with EQ-5D index score (β = 0.157; p = 0.044 and β = 0.179; p = 0.023, respectively).

Conclusion

We found that individuals who experienced AIS and had higher levels of rT3 at hospital admission had less emotional disturbance and better HRQoL when discharged.
The clinical impact of recent amphetamine exposure in aneurysmal subarachnoid hemorrhage patients
Authors: Vitt Jeffrey R. , Cheng Roger C. , Chung Jason , Caton Travis , Zhou Bo , Ko Nerissa , Meisel Karl , Amorim Edilberto
Published: January 2025

Background

Amphetamines possess sympathomimetic properties that can affect cerebral vasculature though conflicting reports exist about their effect on vasospasm risk and clinical outcomes in aneurysmal subarachnoid hemorrhage. This study aimed to characterize the impact of recent amphetamine use on vasospasm development in aneurysmal subarachnoid hemorrhage as well as neurological outcomes.

Methods

We retrospectively screened 441 consecutive patients admitted with a diagnosis of subarachnoid hemorrhage who underwent at least one cerebral digital subtraction angiogram. Patients were excluded if no urinary toxicology screen was performed within 24 h of admission, if there was a diagnosis of non-aneurysmal subarachnoid hemorrhage, or if ictus was greater than 72 h from hospital admission. Vasospasm characteristics were collected from digital subtraction angiography and transcranial Doppler studies.

Results

129 patients were included and 24 tested positive for amphetamines on urine drug screen. No significant differences were found in respect to patient age, sex, or admission clinical severity scales (Hunt-Hess and modified Fisher) based on amphetamine use. There was no difference in the severity of vasospasm or time to peak severity based on recent amphetamine use. A trend toward more isolated posterior circulation vasospasm was observed in the amphetamine present group (16.7% vs. 4.8%, p = 0.06), while there was higher incidence of anterior circulation vasospasm in the amphetamine absent group (79.2% vs. 94.3%, p = 0.03). There was no difference in delayed cerebral ischemia incidence, length of hospital stay, need for ventriculoperitoneal shunt placement, functional outcome at discharge or hospital mortality based on amphetamine use.

Interpretation

Recent amphetamine use was not associated with worse vasospasm severity or delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage patients. Further investigations about localized effects in the posterior circulation and impact on long-term functional outcomes are warranted.
Statins and the incidence of post-stroke depression: a systematic review and meta-analysis
Authors: Cui Chaohua , Li Jue , Chen Weicong
Published: January 2025

Introduction

Post-stroke depression (PSD) can lead to poorer functional outcomes and prognosis. Brain inflammation is a risk factor for PSD. Statins might be beneficial due to their anti-inflammatory properties. Different studies have yielded varying results regarding the effects of statins. Therefore, this meta-analysis aims to clarify the effect of statins on PSD.

Methods

Objectives: To evaluate the relationship between PSD and the use of statins. Data Sources: Databases including PubMed, Web of Science, Embase, and Cochrane Library. Eligibility Criteria: Original observational cohort studies. Participants: Patients with ischemic stroke. Interventions: Use of statins. Appraisal and Synthesis Methods: Forest plot to display pooled results; I2 test to evaluate heterogeneity.

Results

Of the 37 studies selected, four were eligible. The four studies included 93,893 patients (with statins: 45,598) and more than 17,470 PSD patients. The mean age ranged from 62.1 to 70.8 years. The percentage of female participants ranged from 42.1% to 57.9%. For PSD in different regions, the pooled OR for all regions using random-effects methods was 1.21 (95% CI: 0.44–3.33). The pooled OR for Asian populations was 1.42 (95% CI: 0.37–5.40), and for European populations, it was 0.76 (95% CI: 0.73–0.78). The pooled OR for all regions using fixed-effects methods was 0.84 (95% CI: 0.81–0.86). The pooled OR for Asian populations was 2.62 (95% CI: 2.34–2.93).

Conclusion

Depending on the pooling method used, statin use in Asia either increased or had no relationship with PSD. For European patients, statin use reduced the incidence of PSD.
Low hemoglobin is associated with postoperative cerebral infarction in moyamoya disease: development of a predictive model based on low hemoglobin
Authors: Wu Haitao , Wang Tingxuan , Li Fangbao , Bao Yue , Lu Bin , Li Luo
Published: January 2025

Background

Anemia is considered a risk factor for cardiovascular disease. However, there is little evidence regarding the relationship between hemoglobin (HB) and cerebral infarction after revascularization in patients with moyamoya disease (MMD). This study aimed to explore the relationship between postoperative cerebral infarction and HB in patients with MMD and to establish a predictive model.

Methods

Demographic information and different HB levels (the preoperative and postoperative HB, highest and lowest HB, and mean HB during hospitalization) of 112 patients with MMD were collected, of which 11 had cerebral infarction after revascularization.

Results

In the binomial logistic regression analysis, low HB levels were an independent risk factor for cerebral infarction after revascularization, which also led to a worse long-term prognosis in patients with MMD. The risk factors, including Pre-HB, Post-HB, type of MMD, and hypertension (HTN), were incorporated into the receiver operating characteristic curve, which yielded an area under the curve (AUC) of 0.83.

Conclusion

The prediction model was visualized using a nomogram, and a clinical decision curve was drawn to evaluate the net benefit of clinical decisions.
Intravenous fosphenytoin therapy for the rescue of acute trigeminal neuralgia crisis in pre- and post-neurosurgical patients: a retrospective observational study
Authors: Noro Shusaku , Endo Hideki , Asayama Bunsho , Amano Yuki , Okuma Masahiro , Nomura Ryota , Honjo Kaori , Seo Yoshinobu , Nakamura Hirohiko
Published: January 2025

Background

There is no established treatment for the acute exacerbation of trigeminal neuralgia. We aimed to investigate the efficacy and safety of intravenous fosphenytoin for this disease.

Methods

We conducted a retrospective observational study of data from 41 patients with trigeminal neuralgia who received intravenous fosphenytoin therapy. Fosphenytoin diluted with physiological saline was administered intravenously at a loading dose of 9.8–20.7 mg/kg or at a dose of 7.5–9.5 mg/kg when maintenance therapy was needed. Pain was evaluated using a numerical rating scale (NRS), assessed immediately before administration (baseline) and at 2, 12, and 24 h after administration.

Results

The mean (± standard deviation) NRS score was 9.85 ± 0.69, 0.49 ± 1.47, 1.60 ± 2.19, and 3.46 ± 3.19 at baseline, 2, 12, and 24 h after administration, respectively (p < 0.001). Intravenous fosphenytoin therapy was effective for the acute exacerbation of trigeminal neuralgia regardless of whether it was administered during the perioperative period of microvascular decompression (MVD) or the type of drugs used concomitantly. Fosphenytoin was effective when re-administered (n = 14) or at a maintenance dose (n = 2). The adverse drug reactions observed were mild dizziness in six patients, abnormal auditory perception and thirst in three patients each, and somnolence, decreased SpO2, and drug eruption in one patient each, all of which were transient.

Conclusions

Intravenous fosphenytoin therapy can immediately eliminate pain during acute exacerbation of trigeminal neuralgia and can be a useful therapeutic drug in emergency response or until elective treatment, such as MVD, is performed.
Enhancing intracranial aneurysm rupture risk prediction with a novel multivariable logistic regression model incorporating high-resolution vessel wall imaging
Authors: Wang Zihang , Yan Chang , Yuan Wenqing , Jiang Shuangyan , Jiang Yongxiang , Chen Ting
Published: January 2025

Objective

This study aimed to develop and validate a multivariate logistic regression model for predicting intracranial aneurysm (IA) rupture by integrating clinical data, aneurysm morphology, and parent artery characteristics using high-resolution vessel wall imaging (HR-VWI).

Methods

A retrospective analysis was conducted on 298 patients with 386 aneurysms. Patients were randomly divided into training (n = 308) and validation (n = 78) sets. Key predictors, including aneurysm size, shape, aneurysm wall and parent artery wall enhancement, were identified through univariate analysis and then used to build the prediction model using multivariate logistic regression. The model was visualized as a nomogram and compared to PHASES and ELAPSS scores.

Results

The logistic regression model demonstrated superior predictive performance with an area under the curve of 0.814, which was significantly higher than PHASES and ELAPSS scores (p < 0.05). The model revealed strong calibration and good agreement between predicted and observed rupture probabilities.

Conclusion

The multivariate model based on HR-VWI, which incorporates aneurysm and parent artery features, provides a more accurate prediction of IA rupture risk than conventional scoring systems, offering a valuable tool for clinical decision-making.
Retrospective cohort study based on the MIMIC-IV database: analysis of factors influencing all-cause mortality at 30 days, 90 days, 1 year, and 3 years in patients with different types of stroke
Authors: Fan Xuehui , Xu Jing , Ye Ruixue , Zhang Qiu , Wang Yulong
Published: January 2025

Objective

This study aims to evaluate key factors influencing the short-term and long-term prognosis of stroke patients, with a particular focus on variables such as body weight, hemoglobin, electrolytes, kidney function, organ function scores, and comorbidities. Stroke poses a significant global health burden, and understanding its prognostic factors is crucial for clinical management.

Methods

This is a retrospective cohort study based on data from the MIMIC-IV database, including stroke patients from 2010 to 2020. A total of 5,110 patients aged 18 and older were included in the study. The exposure variables included body weight and hemoglobin levels, while the outcome variables were the 30-day, 90-day, 1-year, and 3-year mortality risks. Covariates included electrolyte levels, kidney function, organ function scores, and comorbidities. Random forest and gradient boosting tree models were employed for data analysis to assess mortality risk.

Results

Kaplan–Meier survival analysis showed that ischemic stroke patients had the highest 30-day mortality rate at 8.5%, with only 20% 1-year survival. Traumatic subarachnoid hemorrhage patients had the best prognosis, with a 1-year survival rate of 60%. Multivariable Cox regression analysis revealed that each 1-point increase in the Charlson Comorbidity Index raised the 1-year and 3-year mortality risks by 1.39 times (95% CI: 1.10–1.56) and 1.44 times, respectively. Each 1-point increase in the SOFA score increased the 30-day, 90-day, 1-year, and 3-year mortality risks by 2.11 times, 2.03 times, and 1.84 times, respectively. Additionally, lower hemoglobin levels were significantly associated with increased mortality, with 30-day, 90-day, and 1-year mortality risks increasing by 3.33 times, 3.34 times, and 4.16 times, respectively (p < 0.005). Age ≥ 71 years, longer hospital stays, and organ dysfunction were also significant factors affecting mortality.

Conclusion

This study highlights the critical role of stroke type, comorbidity index, SOFA score, hemoglobin levels, and length of hospital stay in stroke prognosis. These findings provide valuable insights for clinical risk assessment and the development of individualized treatment strategies, which may improve the management and outcomes of stroke patients. The predictive model constructed effectively assesses mortality risks in stroke patients, offering support for future clinical practice.
Prebiotics as an adjunct therapy for posttraumatic stress disorder: a pilot randomized controlled trial
Authors: Voigt Robin M. , Engen Phillip A. , Villanueva Michelle , Bambi Simona A. , Green Stefan J. , Naqib Ankur , Raeisi Shohreh , Shaikh Maliha , Hamaker Bruce R. , Cantu-Jungles Thaisa M. , Pridgen Sarah A. , Held Philip , Keshavarzian Ali
Published: January 2025

Introduction

Posttraumatic stress disorder (PTSD) is a debilitating disorder characterized by intrusive memories, avoidance, negative thoughts and moods, and heightened arousal. Many patients also report gastrointestinal symptoms. Cognitive behavioral therapy (CBT) is an evidence-based treatment approach for PTSD that successfully reduces symptoms. However, many patients still meet criteria for PTSD after treatment or continue to have symptoms indicating the need for new treatment strategies for PTSD. Patients with PTSD have a disrupted intestinal microbiome (i.e., dysbiosis) which can promote neuroinflammation; thus, modulation of the microbiome could be an alternative or adjunct treatment approach for PTSD.

Methods

The current study was a 12-week, double-blind, placebo-controlled trial seeking to understand if CBT combined with a microbiota-modifying, prebiotic fiber intervention would beneficially impact clinical outcomes in veterans with PTSD (n = 70). This proof-of-concept, pilot trial was designed to assess: (1) the relationship between severity of PTSD symptoms and microbiota composition and SCFA levels (i.e., acetate, propionate, butyrate), (2) if CBT treatment with a concomitant prebiotic fiber intervention would beneficially impact clinical outcomes in veterans with PTSD, (3) evaluate the feasibility and acceptability of a prebiotic intervention as an adjunct treatment to CBT, and (4) assess the impact of treatment on the intestinal microbiota and stool SCFA (i.e., mechanism).

Results

This study found that PTSD severity may be associated with reduced abundance of taxa capable of producing the SCFA propionate, and that a subset of individuals with PTSD may benefit from a microbiota-modifying prebiotic intervention.

Conclusion

This study suggests that targeting the intestinal microbiome through prebiotic supplementation could represent a promising avenue for enhancing treatment outcomes in some individuals with PTSD.

Clinical trial registration

https://clinicaltrials.gov/, identifier NCT05424146.
ClinClip: a Multimodal Language Pre-training model integrating EEG data for enhanced English medical listening assessment
Authors: Sun Guangyu
Published: January 2025

Introduction

In the field of medical listening assessments,accurate transcription and effective cognitive load management are critical for enhancing healthcare delivery. Traditional speech recognition systems, while successful in general applications often struggle in medical contexts where the cognitive state of the listener plays a significant role. These conventional methods typically rely on audio–only inputs and lack the ability to account for the listener's cognitive load, leading to reduced accuracy and effectiveness in complex medical environments.

Methods

To address these limitations, this study introduces ClinClip, a novel multimodal model that integrates EEG signals with audio data through a transformer-based architecture. ClinClip is designed to dynamically adjust to the cognitive state of the listener, thereby improving transcription accuracy and robustness in medical settings. The model leverages cognitive-enhanced strategies, including EEG-based modulation and hierarchical fusion of multimodal data, to overcome the challenges faced by traditional methods.

Results and discussion

Experiments conducted on four datasets–EEGEyeNet, DEAP, PhyAAt, and eSports Sensors–demonstrate that ClinClip significantly outperforms six state-of-the-art models in both Word Error Rate (WER) and Cognitive Modulation Efficiency (CME). These results underscore the model's effectiveness in handling complex medical audio scenarios and highlight its potential to improve the accuracy of medical listening assessments. By addressing the cognitive aspects of the listening process. ClinClip contributes to more reliable and effective healthcare delivery, offering a substantial advancement over traditional speech recognition approaches.
A study on the exploration of mild cognitive impairment in Parkinson’s disease based on decision-making cognitive computing
Authors: Huang Shouqiang , Li Kai , Wang Chen , Liu Jiakang , Li Shuwu , Tu Yuting , Wang Bo , Feng Huangqin , Yu Qin , Lin Hongzhou , Xu Yuzhe , Wu Jinghang , Zhang Ting , Chen Tong
Published: January 2025

Mild cognitive impairment in Parkinson’s disease (PD-MCI) as an independent risk factor for dementia in Parkinson’s disease has prognostic value in predicting dementia in PD patients. It was found that the calculation of cognitive function decision-making could better evaluate the cognitive function of PD-MCI. Therefore, this study explored deficits in decision-making cognitive function in PD-MCI population, and mined novel digital biomarkers for recognizing early cognitive decline in PD-MCI through an independently designed maze decision-making digital assessment paradigm. This study included 30 healthy controls 37 PD with normal cognition (PD-NC) and 40 PD-MCI patients. Through difference comparison and stepwise regression analysis, two digital decision-making biomarkers, total decision time and performance average acceleration, were screened, and their joint area under curve for the ability to discriminate between PD-MCI and PD-NC was 0.909, and for the ability to discriminate between PD-MCI and NC was 0.942. In addition, it was found that maze digital decision-making biomarkers had greater early warning efficacy in men than in women. Unlike traditional methods, this study used digital dynamic assessment to reveal possible decision-making cognitive deficits in the PD-MCI populations, which provides new ideas for effective screening for PD-MCI.
A novel pulse-current waveform circuit for low-energy consumption and low-noise transcranial magnetic stimulation
Authors: Tan Xinhua , Guo Ao , Tian Jiasheng , Li Yingwei , Shi Jian
Published: January 2025

Introduction

Transcranial magnetic stimulation (TMS) is widely used for the noninvasive activation of neurons in the human brain. It utilizes a pulsed magnetic field to induce electric pulses that act on the central nervous system, altering the membrane potential of nerve cells in the cerebral cortex to treat certain mental diseases. However, the effectiveness of TMS can be compromised by significant heat generation and the clicking noise produced by the pulse in the TMS coil. This study proposes a novel, non-resonant, high-frequency switching design controlled by high-frequency pulse-width modulation (PWM) voltage excitation to achieve ideal pulse-current waveforms that minimize both clicking noise and heat generation from the TMS coil.

Method

First, a particle swarm optimization algorithm was used to optimize the pulse-current waveform, minimizing both the resistance loss and clicking noise (vibration energy) generated by the TMS coils. Next, the pulse-current waveform was modeled based on the principles of programmable transcranial magnetic stimulation circuits. The relationships between the parameters of the pulse-current waveform, vibration energy, and ohmic resistance loss in the TMS coil were explored, ensuring the necessary depolarization of the nerve membrane potential. Finally, four insulated-gate bipolar transistors, controlled by a series of PWM pulse sequences, generated the desired pulse-current duration and direction in the H-bridge circuit. The duration and slope of the rising and falling segments of the current waveform were adjusted by the PWM pulse duration.

Results

The optimized current waveform, represented by three segmented functions, reduces heat loss and noise while inducing a greater change in neural membrane potential compared with those obtained with conventional symmetric waveforms. Spectral analysis further confirmed that the noise spectrum of the optimized current waveform, particularly the peak spectrum, is significantly lower than that of the conventional triangular symmetric waveform.

Conclusion

The study provide a method and new ideas for low energy consumption and low-noise transcranial magnetic stimulation by using TMS circuit design techniques as well as waveform optimization.
Association between dietary mineral intake and new onset diabetes/pre-diabetes after chronic pancreatitis
Authors: Li Bingqing , Guo Shan , Zong Wenlu , Chu Yuning , Zhang Qi , Yin Xiaoyan , Mao Tao , Li Xiaoyu
Published: January 2025

Background and aims

As the main type of pancreatic diabetes, patients with new diabetes after chronic pancreatitis are often difficult to manage and have poor prognosis. This study aimed to figure out the association between dietary mineral intake and glucose metabolism with chronic pancreatitis.

Method

The study included 114 patients with chronic pancreatitis, who were grouped based on the sequence of onset for chronic pancreatitis and diabetes: normoglycaemia after chronic pancreatitis (NCP), type 2 diabetes (T2DM), and new-onset diabetes or pre-diabetes after chronic pancreatitis (NODCP). The habitual intake of 10 minerals (calcium, chlorine, iodine, iron, magnesium, phosphorus, potassium, selenium, sodium, and zinc) was assessed using a dietary health questionnaire. The differences in mineral intake between the groups were compared, and the relationship between mineral intake and key glucose metabolism markers, including fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and fasting insulin, was analyzed using regression models.

Results

Compared with normal glycaemic status after chronic pancreatitis, the intake of iron and phosphorus in patients with new diabetes/pre-diabetes after chronic pancreatitis (NODCP) has changed significantly. In the NODCP group, FPG levels were significantly negatively correlated with magnesium intake, while HbA1c levels were significantly negatively correlated with average phosphorus intake. In addition, there is a correlation between fasting insulin and average magnesium intake in the NODCP group. No correlation was found between the intake of other minerals and glucose metabolism in chronic pancreatitis.

Conclusion

The intake of minerals in the diet affects the glycaemic status after chronic pancreatitis. It is necessary to further explore the possible causal relationship and mechanism between mineral intake and diabetes after chronic pancreatitis, so as to provide evidence for nutritional intervention of high-risk patients.
Effect of packaging materials and storage temperature on the shelf stability of Awaze paste
Authors: Kefale Biadge , Delele Mulugeta Admasu , Fanta Solomon Workneh , Abate Solomon
Published: January 2025

Background

It is well known that deterioration is a big concern in the food supply chain. The problem is more serious in handling of traditional foods in developing country such as Ethiopia, due to the limited knowledge about the optimum processing, packaging and storage conditions.

Objective

This study aimed to investigate the effect of packaging material and storage condition on the shelf life of Ethiopian traditional Awaze paste.

Methods

Six types of packaging materials were employed: Shekella pot, Gourd (Qelle), high-density polyethylene (plastic bag), plastic bottle, glass bottle and metal can. These packaging materials are traditionally used by household producers and cottage industries in Ethiopia. The paste was stored at two temperatures: room temperature (21 ± 2°C) and refrigeration temperature (4°C).

Results

Physical changes, color (a) value, pH, acidity, yeast and mold levels, total bacterial count (TBC), and lactic acid bacteria count (LAB) were assessed every 60 days over a period of 300 days. pH value, acidity, yeast and mold, TBC, and LAB count were significantly (p < 0.05) affected by packaging material, storage temperature and storage period. After 300 days of storage, the highest yeast and mold count, 4.06 log CFU/g, was observed in samples stored in plastic bags. The highest total bacterial count (TBC), 4.12 log CFU/g, was found in samples stored in metal cans. The samples stored in glass bottles at refrigeration temperature (4°C) were found to have a color (a*) value difference of 11.5 to 13.85, a yeast and mold count value of 3.2 log cfu/g, and a TBC value of 2.97 log cfu/g, which were acceptable after 300 days of storage as per the international food standards.

Conclusion

Taking into account all parameters including physical changes (color, mold growth, texture), acidity, yeast and mold, TBC, and LAB count, Awaze paste could be stored in glass bottles at 4°C for up to 300 days.
Efficacy and safety of Jianpi Qinghua granules for non-erosive reflux disease with spleen deficiency and damp-heat syndrome: a multicenter, randomized, double-blind, placebo-controlled clinical trial
Authors: Zhang Tai , Bai Guang , Wang Wei , Liu Lin , Zhou Zhenghua , Ji Haijie , Zhang Beihua , Tang Xudong
Published: January 2025

Background

Non-erosive reflux disease (NERD), the most frequent phenotype of gastroesophageal reflux disease, presents without visible esophageal mucosal damage but significantly impacts patients' quality of life. Current treatments like proton pump inhibitors show limited efficacy for many NERD patients, necessitating alternative approaches. Jianpi Qinghua (JQ) granules, a traditional Chinese medicine, have shown promise in treating NERD by targeting symptoms of spleen deficiency and damp-heat syndrome.

Purpose

This study aims to evaluate the efficacy and safety of JQ granules in treating patients with NERD characterized by spleen deficiency and damp-heat syndrome.

Study design

A multicenter, randomized, double-blind, placebo-controlled clinical trial was conducted with a total of 78 NERD patients randomly assigned to receive either JQ granules or placebo for 4 weeks, followed by a 4-week follow-up period.

Methods

Seventy-eight NERD patients with spleen deficiency and damp-heat syndrome were recruited and randomly assigned to receive either JQ granules (n = 39) or placebo (n = 39). The trial included a 1-week lead-in, followed by a 4-week double-blind treatment, and a 4-week follow-up. Primary endpoints were the improvement rates of reflux and heartburn symptoms and VAS score changes. Secondary endpoints included atypical symptom scores, total TCM syndrome scores, GERD Health-Related Quality-of-Life (HRQL), and self-rated depression and anxiety scales. Safety assessments involved routine blood, urine, and liver and kidney function tests.

Results

After 4 weeks, the improvement rate for reflux or heartburn symptoms was 79.49% in the JQ group vs. 58.97% in the placebo group (P < 0.05). VAS scores showed significant reductions in both groups but without notable inter-group differences. Total TCM syndrome scores significantly decreased in both groups, with the JQ group showing greater improvement trends. The JQ group had higher rates of effective TCM syndrome improvement and better GERD-HRQL scores. Both groups saw significant reductions in self-rated depression and anxiety scores, with trends favoring JQ granules. Safety assessments were comparable between groups.

Conclusion

JQ granules significantly outperform placebo in treating NERD symptoms and display long-term effectiveness. They effectively address spleen deficiency and damp-heat syndrome, improving patients' social functioning, and have a favorable safety profile.

Clinical trial registration

https://clinicaltrials.gov/study/NCT04324138?term=NCT04324138&rank=1, identifier: NCT04324138.