bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep and Association With Cardiovascular Risk Among Midwestern US Firefighters
Authors: Romero Cabrera Juan Luis , Sotos-Prieto Mercedes , García Ríos Antonio , Moffatt Steven , Christophi Costas A. , Pérez-Martínez Pablo , Kales Stefanos N. 
Published: November 2021

IntroductionCardiovascular disease is the leading cause of on-duty fatalities among U.S. firefighters. Research has demonstrated that many modifiable risk factors are contributors to the high prevalence of cardiometabolic risk factors. The current study aimed to assess whether sleep is associated with cardiometabolic risk factors among Indianapolis firefighters. The findings could support improving sleep hygiene in this population.Material and MethodsThis cross-sectional study was conducted from the baseline data of eligible firefighters enrolled in “Feeding America’s Bravest”, a Mediterranean diet lifestyle intervention within the Indiana Fire Departments. Participants’ sleep quality was categorized as “good” (≤ 8 points) or “bad” (&gt;8 points) by a sleep quality questionnaire based on some questions from Pittsburgh Sleep Quality Index. In addition, firefighters’ sleep duration was stratified based on the number of hours slept per night (≤6 as “short sleep” or &gt;6 hours as normal). Linear and logistic regression models were used to examine the association of sleep with cardiometabolic risk factors.ResultsA total of 258 firefighters were included. Bad sleepers had higher weight, greater waist circumference, higher body mass index (BMI), and increased body fat (all p&lt;0.01) compared to good sleepers. Similarly, participants with short sleep duration were heavier (p&lt;0.02), had greater BMI (p&lt;0.02) and increased body fat (p&lt;0.04) compared with participants with normal sleep duration. Both bad and short sleepers had a higher prevalence of hypertension and obesity (p &lt;0.05).ConclusionsOur study supports that both sleep quality and quantity are associated with cardiometabolic risk among firefighters.
A Novel Serum tsRNA for Diagnosis and Prediction of Nephritis in SLE
Authors: Yang Ping , Zhang Xiaoshan , Chen Shanshan , Tao Yue , Ning Mingzhe , Zhu Yijia , Liang Jun , Kong Wei , Shi Bo , Li Zhiyang , Shen Han , Wang Yanbo 
Published: November 2021

ObjectiveDysregulation of transfer RNA (tRNA)-derived small noncoding RNA (tsRNA) signatures in human serum has been found in various diseases. Here, we determine whether the signatures of tsRNAs in serum can serve as biomarkers for diagnosis or prognosis of systemic lupus erythematosus (SLE).MethodsInitially, small RNA sequencing was employed for the screening serum tsRNAs obtained from SLE patients, followed by validation with TaqMan probe-based quantitative reverse transcription-PCR (RT-PCR) assay. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic efficacy. The biological functions of tsRNAs were identified by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) assay.ResultsWe first analyzed tsRNA signatures in SLE serum and identified that tRF-His-GTG-1 was significantly upregulated in SLE serum. The combination of tRF-His-GTG-1 and anti-dsDNA could serve as biomarkers for diagnosing SLE with a high area under the curve (AUC) of 0.95 (95% CI = 0.92–0.99), sensitivity (83.72%), and specificity (94.19%). Importantly, the noninvasive serum tRF-His-GTG-1 could also be used to distinguish SLE with LN or SLE without LN with AUC of 0.81 (95% CI, 0.73–0.88) and performance (sensitivity 66.27%, specificity 96.15%). Moreover, the serum tsRNA is mainly secreted via exosome and can directly target signaling molecules that play crucial roles in regulating the immune system.ConclusionIn this study, it has been demonstrated for the first time that serum tsRNAs can be employed as noninvasive biomarkers for the efficient diagnosis and prediction of nephritis in SLE.
Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging
Authors: He Di , Sun Yilan , Gao Musong , Wu Qiong , Cheng Zongxue , Li Jun , Zhou Yong , Ying Kejing , Zhu Yimin 
Published: November 2021

Background: Preserved ratio impaired spirometry (PRISm), characterized by the decreased forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) with a preserved FEV1/FVC ratio, is highly prevalent and heterogeneous. We aimed to identify the subtypes of PRISm and examine their differences in clinical characteristics, long-term mortality risks, and longitudinal transition trajectories.Methods: A total of 6,616 eligible subjects were included from the English longitudinal study of aging. Two subtypes of the PRISm were identified as mild PRISm (either of FEV1 and FVC &lt;80% predicted value, FEV1/FVC ≥0.7) and severe PRISm (both FEV1 and FVC &lt;80% predicted values, FEV1/FVC ≥0.7). Normal spirometry was defined as both FEV1 and FVC ≥80% predicted values and FEV1/FVC ≥0.7. Hazard ratios (HRs) and 95% CIs were calculated by the multiple Cox regression models. Longitudinal transition trajectories were described with repeated spirometry data.Results: At baseline, severe PRISm had increased respiratory symptoms, including higher percentages of phlegm, wheezing, dyspnea, chronic bronchitis, and emphysema than mild PRISm. After an average of 7.7 years of follow-up, severe PRISm significantly increased the risks of all-cause mortality (HR=1.91, 95%CI = 1.58–2.31), respiratory mortality (HR = 6.02, 95%CI = 2.83–12.84), and CVD mortality (HR = 2.11, 95%CI = 1.42–3.13) compared with the normal spirometry, but no significantly increased risks were found for mild PRISm. In the two longitudinal transitions, mild PRISm tended to transition toward normal spirometry (40.2 and 54.7%), but severe PRISm tended to maintain the status (42.4 and 30.4%) or transition toward Global Initiative for Chronic Obstructive Lung Disease (GOLD)2–4 (28.3 and 33.9%).Conclusion: Two subtypes of PRISm were identified. Severe PRISm had increased respiratory symptoms, higher mortality risks, and a higher probability of progressing to GOLD2–4 than mild PRISm. These findings provided new evidence for the stratified management of PRISm.
Professionals' Views and Experiences of Using Rehabilitation Robotics With Stroke Survivors: A Mixed Methods Survey
Authors: Li Lutong , Tyson Sarah , Weightman Andrew 
Published: November 2021

Objective: To understand the reason for low implementation of clinical and home-based rehabilitation robots and their potential.Design: Online questionnaire (November 2020 and February 2021).Subjects: A total of 100 professionals in stroke rehabilitation area were involved (Physiotherapists n = 62, Occupation therapists n = 35).Interventions: Not applicable.Main Measures: Descriptive statistics and thematic content analysis were used to analyze the responses: 1. Participants' details, 2. Professionals' views and experience of using clinical rehabilitation robots, 3. Professionals' expectation and concerns of using home-based rehabilitation robots.Results: Of 100 responses, 37 had experience of rehabilitation robots. Professionals reported that patients enjoyed using them and they increased accessibility, autonomy, and convenience especially when used at home. The main emergent themes were: “aims and objectives for rehabilitation robotics,” “requirements” (functional, software, and safety), “cost,” “patient factors” (contraindications, cautions, and concerns), and “staff issues” (concerns and benefits). The main benefits of rehabilitation robots were that they provided greater choice for therapy, increased the amount/intensity of treatment, and greater motivation to practice. Professionals perceived logistical issues (ease of use, transport, and storage), cost and limited adaptability to patients' needs to be significant barriers to tier use, whilst acknowledging they can reduce staff workload to a certain extent.Conclusion: The main reported benefit of rehabilitation robots were they increased the amount of therapy and practice after stroke. Ease of use and adaptability are the key requirements. High cost and staffing resources were the main barriers.
Sex Differences in Hemostatic Factors in Patients With Ischemic Stroke and the Relation With Migraine—A Systematic Review
Authors: van der Weerd Nelleke , van Os Hine J. A. , Ali Mariam , Schoones Jan W. , van den Maagdenberg Arn M. J. M. , Kruyt Nyika D. , Siegerink Bob , Wermer Marieke J. H. 
Published: November 2021

Background: Women are more affected by stroke than men. This might, in part, be explained by sex differences in stroke pathophysiology. The hemostasis system is influenced by sex hormones and associated with female risk factors for stroke, such as migraine.Aim: To systematically review possible sex differences in hemostatic related factors in patients with ischemic stroke in general, and the influence of migraine on these factors in women with ischemic stroke.Results: We included 24 studies with data on sex differences of hemostatic factors in 7247 patients with ischemic stroke (mean age 57–72 years, 27–57% women) and 25 hemostatic related factors. Levels of several factors were higher in women compared with men; FVII:C (116% ± 30% vs. 104% ± 30%), FXI (0.14 UI/mL higher in women), PAI-1 (125.35 ± 49.37 vs. 96.67 ± 38.90 ng/mL), D-dimer (1.25 ± 0.31 vs. 0.95 ± 0.24 μg/mL), and aPS (18.7% vs. 12.0% positive). In contrast, protein-S (86.2% ± 23.0% vs. 104.7% ± 19.8% antigen) and P-selectin (48.9 ± 14.4 vs. 79.1 ± 66.7 pg/mL) were higher in men. Most factors were investigated in single studies, at different time points after stroke, and in different stroke subtypes. Only one small study reported data on migraine and hemostatic factors in women with ischemic stroke. No differences in fibrinogen, D-dimer, t-PA, and PAI-1 levels were found between women with and without migraine.Conclusion: Our systematic review suggests that sex differences exist in the activation of the hemostatic system in ischemic stroke. Women seem to lean more toward increased levels of procoagulant factors whereas men exhibit increased levels of coagulation inhibitors. To obtain better insight in sex-related differences in hemostatic factors, additional studies are needed to confirm these findings with special attention for different stroke phases, stroke subtypes, and not in the least women specific risk factors, such as migraine.
Abnormal Brain Functional Network Dynamics in Acute CO Poisoning
Authors: Zheng Hongyi , Liu Hongkun , Zhang Gengbiao , Zhuang Jiayan , Li Weijia , Zheng Wenbin 
Published: November 2021

Aims: Carbon monoxide poisoning is a common condition that can cause severe neurological sequelae. Previous studies have revealed that functional connectivity in carbon monoxide poisoning is abnormal under the assumption that it is resting during scanning and have focused on studying delayed encephalopathy in carbon monoxide poisoning. However, studies of functional connectivity dynamics in the acute phase of carbon monoxide poisoning may provide a more insightful perspective for understanding the neural mechanisms underlying carbon monoxide poisoning. To our knowledge, this is the first study that explores abnormal brain network dynamics in the acute phase of carbon monoxide poisoning.Methods: Combining the sliding window method and k-means algorithm, we identified four recurrent dynamic functional cognitive impairment states from resting-state functional magnetic resonance imaging data from 29 patients in the acute phase of carbon monoxide poisoning and 29 healthy controls. We calculated between-group differences in the temporal properties and intensity of dFC states, and we also performed subgroup analyses to separately explore the brain network dynamics characteristics of adult vs. child carbon monoxide poisoning groups. Finally, these differences were correlated with patients’ cognitive performance in the acute phase of carbon monoxide poisoning and coma duration.Results: We identified four morphological patterns of brain functional network connectivity. During the acute phase of carbon monoxide poisoning, patients spent more time in State 2, which is characterized by positive correlation between SMN and CEN, and negative correlation between DMN and SMN. In addition, the fractional window and mean dwell time of State 2 were positively correlated with coma duration. The subgroup analysis results demonstrated that the acute phase of childhood carbon monoxide poisoning had greater dFNC time variability than adult carbon monoxide poisoning.Conclusion: Our findings reveal that patients in the acute phase of carbon monoxide poisoning exhibit dynamic functional abnormalities. Furthermore, children have greater dFNC instability following carbon monoxide poisoning than adults. This advances our understanding of the pathophysiological mechanisms underlying acute carbon monoxide poisoning.
Dose Prediction Using a Three-Dimensional Convolutional Neural Network for Nasopharyngeal Carcinoma With Tomotherapy
Authors: Liu Yaoying , Chen Zhaocai , Wang Jinyuan , Wang Xiaoshen , Qu Baolin , Ma Lin , Zhao Wei , Zhang Gaolong , Xu Shouping 
Published: November 2021

PurposeThis study focused on predicting 3D dose distribution at high precision and generated the prediction methods for nasopharyngeal carcinoma patients (NPC) treated with Tomotherapy based on the patient-specific gap between organs at risk (OARs) and planning target volumes (PTVs).MethodsA convolutional neural network (CNN) is trained using the CT and contour masks as the input and dose distributions as output. The CNN is based on the “3D Dense-U-Net”, which combines the U-Net and the Dense-Net. To evaluate the model, we retrospectively used 124 NPC patients treated with Tomotherapy, in which 96 and 28 patients were randomly split and used for model training and test, respectively. We performed comparison studies using different training matrix shapes and dimensions for the CNN models, i.e., 128 ×128 ×48 (for Model I), 128 ×128 ×16 (for Model II), and 2D Dense U-Net (for Model III). The performance of these models was quantitatively evaluated using clinically relevant metrics and statistical analysis.ResultsWe found a more considerable height of the training patch size yields a better model outcome. The study calculated the corresponding errors by comparing the predicted dose with the ground truth. The mean deviations from the mean and maximum doses of PTVs and OARs were 2.42 and 2.93%. Error for the maximum dose of right optic nerves in Model I was 4.87 ± 6.88%, compared with 7.9 ± 6.8% in Model II (p=0.08) and 13.85 ± 10.97% in Model III (p&lt;0.01); the Model I performed the best. The gamma passing rates of PTV60 for 3%/3 mm criteria was 83.6 ± 5.2% in Model I, compared with 75.9 ± 5.5% in Model II (p&lt;0.001) and 77.2 ± 7.3% in Model III (p&lt;0.01); the Model I also gave the best outcome. The prediction error of D95 for PTV60 was 0.64 ± 0.68% in Model I, compared with 2.04 ± 1.38% in Model II (p&lt;0.01) and 1.05 ± 0.96% in Model III (p=0.01); the Model I was also the best one.ConclusionsIt is significant to train the dose prediction model by exploiting deep-learning techniques with various clinical logic concepts. Increasing the height (Y direction) of training patch size can improve the dose prediction accuracy of tiny OARs and the whole body. Our dose prediction network model provides a clinically acceptable result and a training strategy for a dose prediction model. It should be helpful to build automatic Tomotherapy planning.
Participatory Development and Pilot Testing of an Adolescent Health Promotion Chatbot
Authors: Maenhout Laura , Peuters Carmen , Cardon Greet , Compernolle Sofie , Crombez Geert , DeSmet Ann 
Published: November 2021

Background:The use of chatbots may increase engagement with digital behavior change interventions in youth by providing human-like interaction. Following a Person-Based Approach (PBA), integrating user preferences in digital tool development is crucial for engagement, whereas information on youth preferences for health chatbots is currently limited.Objective:The aim of this study was to gain an in-depth understanding of adolescents' expectations and preferences for health chatbots and describe the systematic development of a health promotion chatbot.Methods:Three studies in three different stages of PBA were conducted: (1) a qualitative focus group study (n= 36), (2) log data analysis during pretesting (n= 6), and (3) a mixed-method pilot testing (n= 73).Results:Confidentiality, connection to youth culture, and preferences when referring to other sources were important aspects for youth in chatbots. Youth also wanted a chatbot to provide small talk and broader support (e.g., technical support with the tool) rather than specifically in relation to health behaviors. Despite the meticulous approach of PBA, user engagement with the developed chatbot was modest.Conclusion:This study highlights that conducting formative research at different stages is an added value and that adolescents have different chatbot preferences than adults. Further improvement to build an engaging chatbot for youth may stem from using living databases.
Relevance of Frequency-Domain Analyses to Relate Shoe Cushioning, Ground Impact Forces and Running Injury Risk: A Secondary Analysis of a Randomized Trial With 800+ Recreational Runners
Authors: Malisoux Laurent , Gette Paul , Backes Anne , Delattre Nicolas , Cabri Jan , Theisen Daniel 
Published: November 2021

Cushioning systems in running shoes are used assuming that ground impact forces relate to injury risk and that cushioning materials reduce these impact forces. In our recent trial, the more cushioned shoe version was associated with lower injury risk. However, vertical impact peak force was higher in participants with the Soft shoe version. The primary objective of this study was to investigate the effect of shoe cushioning on the time, magnitude and frequency characteristics of peak forces using frequency-domain analysis by comparing the two study groups from our recent trial (Hard and Soft shoe group, respectively). The secondary objective was to investigate if force characteristics are prospectively associated with the risk of running-related injury. This is a secondary analysis of a double-blinded randomized trial on shoe cushioning with a biomechanical running analysis at baseline and a 6-month follow-up on running exposure and injury. Participants (n = 848) were tested on an instrumented treadmill at their preferred running speed in their randomly allocated shoe condition. The vertical ground reaction force signal for each stance phase was decomposed into the frequency domain using the discrete Fourier transform. Both components were recomposed into the time domain using the inverse Fourier transform. An analysis of variance was used to compare force characteristics between the two study groups. Cox regression analysis was used to investigate the association between force characteristics and injury risk. Participants using the Soft shoes displayed lower impact peak force (p &lt; 0.001, d = 0.23), longer time to peak force (p &lt; 0.001, d = 0.25), and lower average loading rate (p &lt; 0.001, d = 0.18) of the high frequency signal compared to those using the Hard shoes. Participants with low average and instantaneous loading rate of the high frequency signal had lower injury risk [Sub hazard rate ratio (SHR) = 0.49 and 0.55; 95% Confidence Interval (CI) = 0.25–0.97 and 0.30–0.99, respectively], and those with early occurrence of impact peak force (high frequency signal) had greater injury risk (SHR = 1.60; 95% CI = 1.05–2.53). Our findings may explain the protective effect of the Soft shoe version previously observed. The present study also demonstrates that frequency-domain analyses may provide clinically relevant impact force characteristics.Clinical Trial Registration:https://clinicaltrials.gov/, identifier: 9NCT03115437.
Changes in Anti-nutritional Factors and Functional Properties of Extruded Composite Flour
Authors: Duguma Haile Tesfaye , Forsido Sirawdink Fikreyesus , Belachew Tefera , Hensel Oliver 
Published: November 2021

Background: Development of complementary foods by mixing plant-based (cereals, pulses, oilseeds, and others) ingredients and employing various processing techniques is widely reported. However, information on comparison of anti-nutritional factors and functional properties of extruded and unextruded complementary flours made from a multi-mix is limited. In this regard, this study aims to investigate the influence of extrusion cooking on anti-nutritional and functional properties of newly developed extruded oats, soybean, linseed, and premix composite complementary flours.Methods: Thirteen different blending ratios of oats, soybean, linseed, and premix were generated using a constrained D-optimal design of the experiment. Each of the 13 blends was divided into two groups: extrusion cooked and unextruded composite flour sample. Anti-nutritional and functional properties were determined using standard methods for both composite flours. ANOVA was used to determine if there was a significant difference for extruded and unextruded composite flours and paired t-tests were used to check variation between extruded and unextruded.Results: The phytate content of the extruded and unextruded composite flours was 158.93–191.33 mg/100 g and 175.06–203.10 mg/100 g, respectively, whereas the tannin content of the extruded and unextruded composite flours was 8.4–22.89 mg/100 g and 23.67–36.97 mg/100 g, respectively. There was a statistically significant (p &lt; 0.05) difference among the extruded composite flours in terms of phytate and condensed tannin content. Paired t-test has indicated a significant (p &lt; 0.05) difference between extruded and unextruded composite flours for phytate and tannin. Water absorption capacity and bulk density have shown a significant (p &lt; 0.05) difference among extruded and unextruded composite flours. An increase in the proportion of soybean and linseed flour was associated with an increase in phytate, tannin, and water absorption capacity of composite flours. However, bulk density was increased with an increasing proportion of oat in the blend.Conclusion: The findings revealed that extrusion cooking significantly reduced phytate and condensed tannin content and improved the functional properties of the composite complementary food flour. Further investigation is needed on other anti-nutritional factors that are not included in this report.