bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monitoring lung recruitability during recruitment maneuvers in children with respiratory failure on ECMO using electrical impedance tomography: case report
Authors: Clausen Jan-Christoph , Krauß Annemarie , Schulz Antonia , Miera Oliver 
Published: February 2025

IntroductionCurrently, there are no clear guidelines regarding the use of recruitment maneuvers in pediatric patients with severe respiratory failure who are on extracorporeal membrane oxygenation (ECMO), nor is there consensus on how they should be performed.MethodsIn this report, we describe pulmonary recruitment maneuvers performed in four children with respiratory failure on ECMO (three on VA-ECMO and one on VV-ECMO), all of whom were monitored using electrical impedance tomography (EIT) between March and December 2024.ResultsOur findings demonstrate that EIT is a feasible tool for evaluating lung recruitability in children with severe respiratory failure on ECMO. Additionally, EIT aids in distinguishing between responders and non-responders to recruitment maneuvers.
Impact of levetiracetam on direct oral anticoagulant level and outcomes among older Asian patients with atrial fibrillation
Authors: Huang Yu-Ting , Chen Tzu-Ling , Huang Yun-Lin , Kuo Ching-Hua , Peng Yu-Fong , Tang Sung-Chun , Jeng Jiann-Shing , Huang Chih-Feng , Lin Shin-Yi , Lin Fang-Ju 
Published: February 2025

ObjectiveThis purpose of this study is to analyze the influence of levetiracetam (LEV) on direct oral anticoagulant (DOAC) exposure and its implications for clinical outcomes.MethodsThis investigation comprised a retrospective cohort study utilizing the integrated medical database and a prospective observational study conducted in a tertiary hospital. Patients aged &gt;65 years with atrial fibrillation and undergoing DOAC therapy were included and were categorized as LEV users and non-users based on LEV exposure status. In retrospective cohort, clinical outcomes between LEV users and non-users were compared, included ischemic stroke or transient ischemic attack (IS/TIA), systemic thromboembolism (STE) and major bleeding. In prospective cohort, DOAC trough concentration was measured.ResultsThe retrospective study included 191 LEV users and 694 matched LEV non-users. The risk of IS/TIA and STE were not significantly different between two groups (hazard ratio [HR], 0.99 [0.51–1.91] and 0.94 [0.49–1.79], respectively). For major bleeding, a non-significant higher risk was observed in the LEV-user group in contrast to the LEV-non-user group (HR 2.65 [0.43, 16.33]). The prospective analysis included 19 LEV users and 76 matched LEV non-users. Low DOAC concentrations were observed in 5.3% of LEV-users and 14.5% of LEV non-users (P = 0.53). High DOAC concentration were observed in 10.5% of LEV-users and 11.8% LEV non-users (P = 0.57). The association between LEV therapy and low or high DOAC concentration was non-significant.ConclusionConcurrent use of LEV and DOAC did not significantly affect DOAC exposure or clinical outcomes. LEV may be a safe anti-seizure medication for patients receiving DOAC therapy.
Association between hyperuricemia and all-cause mortality in people taken Statins: a retrospective cohort study
Authors: Zhu Bin , He Zijun , Wu Mingfen , Huo Jiping , Zhao Zhigang , Guo Wei , Yang Li 
Published: February 2025

BackgroundStatins are one of the most widely prescribed medicines in clinical practice. Their benefits have extended beyond cardiovascular applications to reduce serum uric acid levels. This study aims to investigate the relationship of hyperuricemia with the risk of all-cause mortality among individuals taking statins.MethodA retrospective cohort study was performed using data from the National Health and Nutrition Examination Survey (NHANES) database between 2005 and 2018. The weighted Cox proportional hazards models were used to investigate the relationship between hyperuricemia and all cause-mortality.ResultsA total of 1,958 participants were enrolled for analysis. Of them 1,429 participants were with normal uric acid levels and 529 people were with hyperuricemia. After 12 years of follow-up, there were 267 participants who died from all-cause mortality in the non-hyperuricemia group and 136 died in the hyperuricemia group. Additionally, 32.49% of participants took more than five kinds of medicines in the non-hyperuricemia group compared to 42.05% participants in the hyperuricemia group. Even after adjusting for confounding factors, we found that the serum uric acid (SUA) level was significantly correlated with all-cause mortality among statin users (HR = 1.13, 95% CI:1.02–1.24, p = 0.0161). Additionally, hyperuricemia resulted in significant increases in all-cause mortality relative to non-hyperuricemia participants in three models (HR = 1.51, 95% CI:1.16–1.96, P = 0.0023).ConclusionAlthough statins have been shown to reduce uric acid levels, hyperuricemia is still significantly associated with the all-cause mortality in people taking statins. Those taking statins and having hyperuricemia should pay special attention to their SUA level.
TCMRD - KG: innovative design and development of rheumatology knowledge graph in ancient Chinese literature assisted by large language models
Authors: Li Haotian , Xia Congmin , Hou Youjuan , Hu Sile , Liu Yanjun , Jiang Quan 
Published: February 2025

IntroductionRheumatic immune diseases are a type of immune-inflammatory disease that affects muscles, bones, joints, and surrounding soft tissues. They have a long course and a high disability rate, seriously affecting the quality of life of patients. Traditional Chinese medicine plays an important role in the diagnosis and treatment of rheumatic immune diseases. The unique theoretical system and rich treatment methods of traditional Chinese medicine are preserved in ancient Chinese medical books.MethodsThis study takes the content related to rheumatism in ancient traditional Chinese medicine books as the research object, integrates ontology theory and technology into the knowledge graph, and realizes the reconstruction of traditional Chinese medicine information knowledge. It provides a basic data structure for data mining and knowledge discovery.ResultsThis study is the first rheumatism-specific knowledge graph constructed based on ancient traditional Chinese medicine books. It has explored the construction method of a knowledge graph from ancient books by combining automatic labeling of mainstream large language models with manual review. Considering the knowledge characteristics of ancient traditional Chinese medicine books, where existing word segmentation technology struggles to accurately reproduce the original meaning, a new type of entity extraction method is proposed.DiscussionThis provides an important foundation for improving the clinical diagnosis and treatment level of traditional Chinese medicine in treating rheumatism, further exploring the knowledge representation and application of traditional Chinese medicine in rheumatism treatment, and it has potential for future expansion and improvement.
Association between the lactate-to-albumin ratio (LAR) index and risk of acute kidney injury in critically ill patients with sepsis: analysis of the MIMIC-IV database
Authors: Hua Yiming , Ding Ning , Jing Huaizhi , Xie Yifei , Wu Hao , Wu Yue , Lan Beidi 
Published: February 2025

BackgroundLactate-to-albumin ratio (LAR) is an emergency predictive indicator of sepsis-related mortality. An elevated LAR is associated with poor outcomes in critically ill patients. However, its predictive value for acute kidney injury (AKI) in patients with sepsis remains unclear. Therefore, this study aimed to investigate the relationship between LAR and AKI in patients with sepsis.MethodsThe study population was derived from the Medical Information Mart for Intensive Care-IV (2.0) database and stratified into quartiles based on the LAR. The primary endpoint was the occurrence of AKI. The secondary endpoints were the use of renal replacement therapy (RRT) and in-hospital mortality. Kaplan–Meier survival analysis and Cox proportional hazards models were used to assess the association between the LAR index and risk of AKI in patients with sepsis.ResultsIn this study, 5,222 patients with sepsis were included, of whom 3,029 were male (58%). Kaplan–Meier survival analysis demonstrated significant differences in the cumulative incidence of AKI and cumulative usage rate of RRT among patients with sepsis based on the quartiles of the LAR index. Additionally, Cox proportional hazards analysis adjusted for confounding factors showed a significant association between the LAR index and incidence of AKI in patients with sepsis.ConclusionOur study indicated that a high LAR index can serve as an independent predictor of AKI in patients with sepsis.
Web-based machine learning application for interpretable prediction of prolonged length of stay after lumbar spinal stenosis surgery: a retrospective cohort study with explainable AI
Authors: Yasheng Paierhati , Yusufu Alimujiang , Yimiti Yasenjiang , Luan Haopeng , Peng Cong , Song Xinghua 
Published: February 2025

ObjectivesLumbar spinal stenosis (LSS) is an increasingly important issue related to back pain in elderly patients, resulting in significant socioeconomic burdens. Postoperative complications and socioeconomic effects are evaluated using the clinical parameter of hospital length of stay (LOS). This study aimed to develop a machine learning-based tool that can calculate the risk of prolonged length of stay (PLOS) after surgery and interpret the results.MethodsPatients were registered from the spine surgery department in our hospital. Hospital stays greater than or equal to the 75th percentile for LOS was considered extended PLOS after spine surgery. We screened the variables using the least absolute shrinkage and selection operator (LASSO) and permutation importance value and selected nine features. We then performed hyperparameter selection via grid search with nested cross-validation. Receiver operating characteristics curve, calibration curve and decision curve analysis was carried out to assess model performance. The result of the final selected model was interpreted using Shapley Additive exPlanations (SHAP), and Local Interpretable Model-agnostic Explanations (LIME) were used for model interpretation. To facilitate model utilization, a web application was deployed.ResultsA total of 540 patients were involved, and several features were finally selected. The final optimal random forest (RF) model achieved an area under the curve (ROC) of 0.93 on the training set and 0.83 on the test set. Based on both SHAP and LIME analyses, intraoperative blood loss emerged as the most significant contributor to the outcome.ConclusionMachine learning in association with SHAP and LIME can provide a clear explanation of personalized risk prediction, and spine surgeons can gain a perceptual grasp of the impact of important model components. Utilization and future clinical research of our RF model are made simple and accessible through the web application.
The impact of undergraduate nursing students’ time management disposition on innovative behavior: the chain mediating role of academic self-efficacy and flow experience
Authors: Lin Ye , Wang Xixi , Zhang Xinyi , Hu Hongli , Liu Li , Pang Keyi , Li Yan , Hu Chaoqun , Sun Zhiqin , Li Xiaona 
Published: February 2025

ObjectiveTo explore the chain intermediary effect of academic self-efficacy and flow experience of undergraduate nursing students in the influence mechanism of time management disposition on innovative behavior.MethodsSeven hundred and sixty-three undergraduate nursing students from 3 universities in Jiangsu Province were investigated with Adolescent time Management Disposition Scale, Academic Self-efficacy Scale, Flow Short Scale and Innovation Behavior Scale. The chain intermediary model was constructed and verified.ResultsThe time management disposition of undergraduate nursing students was positively correlated with their average scores in academic self-efficacy, flow experience, and innovative behavior. The direct impact of time management disposition on innovative behavior was significant, and academic self-efficacy and flow experience exhibited both independent mediating effects and a chain mediating effect.ConclusionThe time management disposition of undergraduate nursing students can significantly positively predict innovative behavior, in which academic self-efficacy and flow experience play a significant independent intermediary role and chain intermediary role. Nursing teachers and students can promote innovative behavior from the point of view of improving time management skills, enhancing academic self-efficacy and flow experience.
Differences between musicians and athletes in personal characteristics: mental toughness, imagery and personality
Authors: Budnik-Przybylska Dagmara , Huzarska-Rynasiewicz Izabela , Jurek Paweł , Przybylski Jacek 
Published: February 2025

IntroductionIt appears that music and sports share many common elements. However, it turns out that mental toughness and imagery are present in both musicians and athletes, but they are understood and conceptualized differently within these domains. The aim of the study was to explore the relationship between mental toughness, personality, and imagery in two unique groups.MethodsThe sample consisted of a group of athletes (N = 164, 82 females and 82 males) and a group of musicians (N = 97, 61 females and 36 males), aged between 13 and 46 (M = 23.65; Median = 21), with varying levels of experience. The participants filled in the Imagination in Sports Questionnaire, the Short Scale of Mental Toughness in Sport Questionnaire-19, and the Big Five Inventory—Short, with indicators adjusted to both research groups. The results proved significant differences between the two groups.ResultsOur findings indicated that musicians tend to exhibit lower levels of mental toughness compared to athletes. Additionally, musicians demonstrated reduced conscientiousness but higher levels of neuroticism and openness to experiences, as opposed to athletes. In the group of musicians, mental toughness was associated with lower extraversion, neuroticism, higher levels of agreeableness, and lower physiological feelings in imagery. Mentally tough athletes were characterized by lower neuroticism and higher situational and general imagery. Personality and imagery explained 21% of the variance in mental toughness among athletes and 37% among musicians. Neuroticism was the main predictor in both groups. Imagery, however, predicted mental toughness only in the athletes’ group.DiscussionThe comparison of the unique groups brings a fresh perspective on theoretical and practical work in terms of individual differences, confirming the need of creating mental toughness-building interventions in mental preparation for performance in both music and sports.
Opening the window to the children’s mind: the superior efficacy of open-ended physical games in the development of attention and socio-emotional skills
Authors: Lyu Shanshan , Zhang Weixiao 
Published: February 2025

BackgroundThe promotional effects of physical exercise on children’s attention and social–emotional skills have been widely confirmed. However, the advantages of open physical games in intervention effects still need further exploration. Therefore, this study discusses the intervention effects of open physical games on children’s attention and social–emotional skills.MethodsThis study adopted a quasi-experimental design. Two administrative classes were divided into the experimental group (15 boys and 16 girls) and the control group (16 boys and 15 girls) using the coin-toss method. The intervention intensity was moderate (60–69% of HRmax), lasting for 12 weeks, with 3 sessions per week, each lasting 40 min. Both groups focused on the teaching of fundamental motor skills (FMS). The experimental group was intervened with open physical games, while the control group was intervened with closed physical games. The Adolescent Attention Test was used to measure attention quality; the Children’s Social and Emotional Skills Scale was used to measure social–emotional skills; the Test of Gross Motor Development-Third Edition was used to measure locomotors and manipulative skills; and the Fundamental Movement Skill Development Test for Children Aged 3 to 10 was used to measure stability skills. Based on SPSS 25.0 and GraphPad Prism 8 software, statistical analysis was conducted using independent samples t-tests, χ2 tests, MANOVA, and Pearson partial correlation analysis.ResultsAfter the intervention, open physical games had a more positive effect on children’s attention distribution (F = 6.223, p = 0.022, η2 = 0.090). Open physical games had a more positive effect on children’s self-awareness (F = 11.027, p = 0.002, η2 = 0.165), others’ awareness (F = 10.315, p = 0.002, η2 = 0.156), collective awareness (F = 6.494, p = 0.014, η2 = 0.104), collective management (F = 12.108, p = 0.001, η2 = 0.178), and overall social–emotional skills (F = 38.453, p &lt; 0.001, η2 = 0.407). Open physical games had a more positive effect on locomotors skills (F = 6.458, p = 0.014, η2 = 0.104), manipulative skills (F = 6.380, p = 0.014, η2 = 0.102), and overall FMS (F = 10.333, p = 0.002, η2 = 0.156). In addition, there is a certain degree of positive correlation between FMS, attention, and social–emotional skills (p &lt; 0.05).ConclusionOpen physical games have superior effects on children’s attention, social–emotional skills, and FMS compared to closed physical games. This has guiding significance for subsequent physical education practices and the formulation of public health policies.
Nutritional, bioactive, and antimicrobial analysis of powders and ethanolic extracts of three important halophyte plants (Anabasis articulata, Lycium shawii, and Zilla spinosa), and their application in bakery product
Authors: Hussain Ashiq , Mouhaddach Aziz , Khalid Ibtissame , Kausar Tusneem , Bouhrim Mohamed , Shahat Abdelaaty A. , Noman Omar M. , Eto Bruno , Yaqub Shazia , Arshad Rizwan , Farooq Humna , Firdous Nida , Bilal Muhammad 
Published: February 2025

IntroductionNew alternate food and pharma sources, halophyte plants have long been displaying exceptional nutritional and functional qualities.MethodsPresent investigations were carried out to explore three important halophyte herbs; Anabasis articulata, Lycium shawii, and Zilla spinosa,harvested from deserts, for phytochemical composition and potential food application.Results and discussionPlant leaves, converted into powders showed significant amounts of ash, fiber, and important minerals as contents (%) of ash and fiber in Anabasis articulata, Lycium shawii, and Zilla spinosa were 6.39 and 6.79, 8.19 and 9.14, and 4.35 and 8.87, respectively, while Mg, Zn, Cu and Mn were significantly higher in Anabasis articulata, with values 52.40, 50.59, 16.33 and 48.25 mg/kg, respectively, whereas Zilla spinosa presented Fe as 120.95 mg/kg, highest from all. Total phenolic contents (45.92 mg gallic acid equivalent/g), total flavonoid contents (11.31 mg quercetin equivalent/g) and total antioxidant activity (22.85 mg Trolox/g) were found highest in ethanolic extract of Lycium shawii, while in remaining two plants these values were also prominent. Extracts of these three halophytes leaves exhibited prominent antimicrobial activities, as calculated zone of inhibitions (mm) were comparable to reference drugs. Incorporation of powders of all three halophytes resulted in significant increment in ash fiber and minerals (Mg, Zn, Fe, Cu and Mn) content of biscuits but with slight decrement in moisture, fat and protein. Formulated biscuits were also found boosted in total phenolic and flavonoid contents with elevated antioxidant activity as a result of incorporation of halophytes powders. Assessment of biscuits revealed that 5% levels of all halophyte’s powders produced acceptable product in terms of color, taste, texture and overall acceptability. Thus, halophyte plant powders and extracts could be used as new and sustainable source for food and pharma products.
High internal phase Pickering emulsion by ultrasound-modified almond protein isolate particles as a new fat substitute to improve oxidative stability of pork sausages
Authors: Yang Qingrui , Han Peng , Qi Wenhui , Shao Yutong , Zhang Xu , Wu Fengyang , Zhang Zhisheng 
Published: February 2025

IntroductionIn this study, high-internal-phase Pickering emulsions (HIPPE) were used to produce low-fat meat products. The oxidative stability of HIPPE is a critical factor determining its suitability for this application.MethodsAccordingly, an investigation was conducted to ascertain the impact of substituting 25–100% pig back fat with HIPPE (75% soybean oil, v/v) stabilized with ultrasound-modified almond isolate protein (UAPI) particles on the stability of sausages.ResultsThe 300 W-UAPI sample exhibited the highest surface hydrophobicity value and emulsification activity index (87.65 m2/g), as well as the most optimal foaming stability (90.93%). Compared to the control emulsion, 300 W-UAPI-HIPPE exhibited the smallest average droplet size (30.49 μm), the highest oil loading ratio (82.26%), and improved antioxidant properties. The incorporation of UAPI-HIPPEs in sausages resulted in enhanced textural properties, including hardness, elasticity, chewiness, adhesion, and resilience, as well as increased densification. In addition, cooking loss and thiobarbituric acid-reactive substances content were reduced. Among the samples, those with 100% backfat substitution exhibited the most favorable textural properties and micromorphology, with a 67% reduction in cooking loss and the lowest fat oxidation.DiscussionThese findings indicate that UAPI-HIPPEs may serve as viable alternatives to animal fat in meat products, exhibiting desirable characteristics.
Consumer-driven prepared food consumption policies: a sustainability perspective on reducing food waste
Authors: Hou Bo , Chen Ying , Wang Zhiwei 
Published: February 2025

IntroductionFood waste is a global issue intricately linked to food crises and ecological degradation. The development of the prepared food industry and markets is a promising practice to reduce food waste globally and achieve carbon neutrality.MethodsThis study is grounded in the motivation -opportunity -ability (MOA) theory and employs a structural equation model (SEM) to establish an analytical framework to explore factors influencing the intentions of Chinese consumers to consume prepared food.ResultsEmpirical analysis reveals that motivation, opportunity, and ability positively influence consumers’ intentions to consume prepared food. Furthermore, opportunity and ability exert a mediating effect on motivation through convenience and health factors.DiscussionThis study innovatively applies the MOA theory to food waste issues, providing a new policy perspective. The conceptual framework developed offers a theoretical foundation for future research on pathways to reduce food waste, especially within the context of prepared food consumption in China, and serves as a theoretical starting point for academia, industry, and policymakers.