bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Cross-sectional Relationship Between Use of Automatic Insulin Delivery Systems and Eating Styles Among Older Adults With Type 1 Diabetes: An Exploratory Analysis
Authors: Kahkoska Anna R. , Sprinkles Jessica , Gopisetty Nikhita , Ercolino Gabriella , Fruik Angela , Muthukkumar Rashmi , Qu Xiaorui , Mayer-Davis Elizabeth J. , Cristello Sarteau Angelica 
Published: November 2024

Background: The number of older adults with type 1 diabetes (T1D) is increasing. Use of automated insulin delivery (AID) may influence nutrition and eating behaviors. We explored how three eating styles (restrained, external, emotional) differ between older adults with T1D who use and do not use AID. Methods: We administered a one-time electronic survey from September to November 2023 to adults ≥65 years with T1D receiving care through a university-affiliated hospital system. Clinical and demographic information was collected from medical records. Eating styles were characterized with the Dutch Eating Behavior Questionnaire. Results: Our sample ( n = 77, 95% non-Hispanic white) had mean (SD) age: 71.8 (4.1) years, diabetes duration: 33 (18) years, hemoglobin A1c (HbA1c): 6.83 (1.12%), and body mass index (BMI): 27.3 (4.7) kg/m2. Respondents reported variable eating styles, with the highest median scores for external and restrained eating and lower scores for emotional eating. Older adults using AID systems had higher median scores for emotional and external eating, and more varied restrained eating scores compared to those not using AID systems. Weak correlations were found between eating styles and HbA1c (restrained: r = −0.14; external: r = 0.08; emotional: r = 0.15), as well as between restrained ( r = 0.09) and external ( r = 0.04) eating with BMI, with a small correlation between emotional eating and BMI ( r = 0.27). Conclusions: Eating styles may vary between older adult AID users and non-users. To our knowledge, this is the first study to characterize eating styles in this population, though generalizability is limited by a non-diverse and small sample with high technology use overall (eg, continuous glucose monitoring, insulin pumps).
Impact of TiO2, ZnO, and Ag nanoparticles on anammox activity in enriched river Nile sediment cultures: unveiling differential effects and environmental implications
Authors: Abd EL-Aziz Mohamed A. , Saeed Ali M. , Ibrahim Mohamed K. , El-Sayed Wael S. 
Published: November 2024

Abstract
Background
The increasing use of nanoparticles (NPs) necessitates investigation of their impact on wastewater treatment processes, particularly anammox, a critical biological nitrogen removal pathway. This study explored the effects of short-term exposure to TiO2, ZnO, and Ag-NPs on anammox activity in enriched cultures derived from River Nile sediments.

Materials and methods
Anammox bacteria were identified and enriched, with activity confirmed through 16S rRNA and hydrazine oxidoreductase (hzo) gene amplification and sequencing. Activity assays demonstrated efficient ammonium removal by the enriched culture. Subsequently, the impact of different sized and concentrated NPs on anammox activity was assessed.

Results
XRD analysis confirmed NP behavior within the microcosms: TiO2 transformed, ZnO partially dissolved, and Ag remained ionic. hzo gene expression served as a biomarker for anammox bacterial activity. Interestingly, 100 nm TiO2-NPs up-regulated hzo expression, potentially indicating a non-inhibitory transformed phase. Conversely, ZnO and Ag-NPs across all sizes and concentrations significantly down-regulated hzo expression, suggesting detrimental effects. Ag-NPs amended microcosms showed a significant reduction (79%) in hzo gene expression and a detrimental effect on bacterial populations. Overall, anammox activity mirrored hzo expression patterns, with TiO2 (21 and 25 nm, respectively) exhibiting the least inhibition, followed by ZnO and Ag-NPs.

Conclusion
This study highlights the differential effects of NPs on anammox, with the order of impact being Ag > ZnO > TiO2. These findings provide valuable insights into the potential environmental risks of NPs on anammox-mediated nitrogen cycling in freshwater ecosystems.
Evidence pointing toward invalidity of the SF-8 physical and mental scales: a fusion validity assessment
Authors: Hayduk Leslie A. , Hoben Matthias , Estabrooks Carole 
Published: November 2024

Abstract
Background
The SF-8™ Short Form Health Survey creates physical and mental health scale scores from responses to eight survey questions. These widely used scales demonstrate reasonable reliablity, and some forms of validity but have not been assessed for fusion validity. We assess the fusion validity of the SF-8 physical and mental health scales, and provide comments assisting fusion validity assessment of other scales.

Methods
Checking the fusion validity of a scale requires including the scale and its constituent indicators in a structural equation model that has at least one variable causally downstream from the scale. We assessed fusion validity of the SF-8 physical and mental health scales in the context of work-related variables for care aides working in Canadian long-term care homes. Variables causally downstream from physical and mental health, such as work burnout, permit checking whether the SF-8 indicator items fuse to form cogent physical and mental scales, irrespective of whether those indicators share common-factor foundations.

Results
We found that the SF-8 physical and mental health scales did not function appropriately. The scales inappropriately claimed effects for several items that had no effects and provided biased estimates of other effects. These deficiencies seem grounded in the scales’ developmental history, which implicitly bolstered selection of some causally ambiguous items and paid insufficient attention to component factor model testing.

Conclusion
Our observations of causal incongruities question whether the SF-8 can provide valid assessments of physical and mental health. However, it would be imprudent to discontinue SF-8 use on the basis of a single study suggesting invalidity. This uncomfortable conclusion can be rechecked by re-analyzing data from any project that employed the SF-8 and recorded even one causal consequence of physical or mental health. The power of fusion validity assessment comes from connecting the recorded consequences simultaneously to both the scale and the items from which that scale is calculated.
Depression in geriatrics: a systematic review and meta-analysis of prevalence and risk factors in Egypt
Authors: Ahmed Hebatalla , Khaled Heba , Allam Ahmed A. , Alodini Bassima , Azzam Ahmed , Hjazeen Anees Adel , Hassan Hassan Samy , Hussein Sarah Mohamed , Hassan Fatma E. 
Published: November 2024

Abstract
Background
Depression is the most common psychiatric disorder in older adults, even though it is commonly misdiagnosed and undertreated, leading to exacerbations of preexisting medical conditions and even a higher mortality rate. In the present systematic review with meta-analysis, we quantify the magnitude of depression and its associated risk factors among the older adult population in Egypt.

Methods
A thorough literature search was performed from 2010 up to October 2023. The results were presented as proportions or risk difference with a 95% confidence interval (CI) calculated using the random effects model. A sensitivity analysis was performed to examine the robustness of the results.

Results
Our study included 14 articles with 5857 older adults published between 2011 and 2023. All the included studies assessed depression in geriatrics using the Geriatric Depression Scale. Of the 14 studies, 5 were for community-dwelling older adults, 3 were for older adults attending primary health care (PHC) centers, 2 were for hospitalized older adults, 3 were for residing in geriatric homes, and one for residing in geriatric homes, hospitalized older adults, and community-dwelling older adults. The overall prevalence of depression among Egyptian geriatrics was 64.6%. The pooled prevalence of depression was 59.6%, 67.0%, 67.0%, and 62.0% for community-dwelling older adults, older adults people attending PHC, hospitalized older adults, and older adults residing in geriatric homes, respectively. Older adults with chronic illness, female sex, and low-income elders and elders who were not employed had a higher risk for depression with pooled risk differences of 34.9%, 17.8%, 23.8%, and 15.1% (P < 0.05), respectively. In contrast, there was no significant difference in risk for depression in the older adults residing in urban areas compared to rural areas, the older adults aged + 70 compared to those less than 70, individuals with low levels of education or who are illiterate compared with those with higher levels of education and the older adults who live alone compared with those living with family.

Conclusion
More than half of the older adults in Egypt suffer from depressive symptoms. Chronic diseases, female sex, unemployment, and low-income inequality are the most significant factors contributing to depression among Egypt’s older adults.
Multicriteria optimization achieves superior normal tissue sparing in volumetric modulated arc therapy for gastric cancer
Authors: He Ling , Gao Xinrui , Li Tao , Li Xia , Sun Xiaowen , Wei Zhigong , Peng Xingchen , Xiao Jianghong 
Published: November 2024

Abstract
Objective
To evaluate the benefits of volumetric modulated arc therapy (VMAT) based on multicriteria optimization (MCO) for gastric cancer patients, particularly the protection of serial organs at risk (OARs) that overlap with the target volume.

Methods
MCO and single-criterion optimization (SCO) VMAT plans were conducted among 30 gastric cancer patients, with a prescription dose of 50.4 Gy delivered in 28 fractions. All treatment plans underwent review, and a comparison was made between the active planning time and different dose-volume parameters.

Results
Both the MCO and SCO VMAT plans achieved the target dose coverage, with no significant difference in the conformity index (CI) for the planning target volume (PTV), at median CI values of 0.887 and 0.891, respectively (P = 0.417). The MCO plans showed a slight but significant increase in the homogeneity index of the PTV, with a median increase of 0.029 (P < 0.001). Additionally, the MCO plans resulted in a lower D2% to the small intestine and duodenum, with reductions of 3.43 Gy and 0.3 Gy, respectively (P < 0.05). Furthermore, the Dmax to the small intestine correlated moderately with the overlapping volume between the small intestine and the target volume (ρ = 0.42, P = 0.023). Except for the mean dose to the liver, the MCO plans performed better in terms of dose indicators for other OARs. Moreover, compared to the SCO plans, the median active planning time in the MCO plans was significantly reduced by 53.2 min (P < 0.0001).

Conclusions
MCO can effectively help the physicians to quickly select an optimal treatment plan for patients with gastric cancer. It has been shown that MCO VMAT plans can significantly reduce the dose to OARs and shorten the active planning time, with acceptable target coverage. In addition, these plans take less dosimetric time, thereby streamlining the treatment planning process.
Participant and group facilitator perspectives on a novel culturally tailored diabetes self-management program for African Americans
Authors: Tarfa Adati , Salihu Ejura Yetunde , Xiong Phanary , Brewer Cierra , Maurer Martha , Liu Yao , Shiyanbola Olayinka 
Published: November 2024

Abstract
Background
African Americans with type 2 diabetes experience disparities in their care and diabetes health-related outcomes. Diabetes self-management programs such as Healthy Living with Diabetes (HLWD) are important but do not account for the unique cultural experiences of African Americans. Also, a culturally tailored program focused on addressing sociocultural beliefs and providing race-congruent peer support, Peers LEAD (Peers Supporting Health Literacy, Self-Efficacy, Self-Advocacy, and Adherence) was implemented in two midwestern cities to improve medication adherence but does not include diabetes self-management topics included in HLWD. In an attempt to fill the gaps from both HLWD and Peers LEAD, Peers EXCEL (Peers’ Experience in Communicating and Engaging in Healthy Living) was designed to integrate both programs.

Methods
Our study explored the perceptions of African American participants and facilitators of the separate HLWD and Peers LEAD programs, on the proposed new Peers EXCEL program using focus groups and interviews. Findings were analyzed by research assistants trained in qualitative research using deductive and inductive open coding approaches.

Results
Participants appreciated the cultural fit of Peers EXCEL for African American communities which is a feature that was lacking in HLWD. They shared the need to include topics such as the relationships between systemic racism and diabetes.

Conclusion
Participants’ feedback of Peers EXCEL reveals the importance of including various community members’ perspectives in the design of new diabetes self-management programs tailored for African Americans.
Mixed-methods to explore barriers to the use of food security initiatives in a historically black college and university (HBCU)
Authors: Antwi Janet , Olawuyi Yetunde , Ifafore Modupe , Opara Innocent 
Published: November 2024

AbstractBackgroundTo assess students’ use and perception of the initiatives to tackle food insecurity (FI) in a Texas historically black college and university (HBCU).MethodsHBCU students > 18 years (288 students). A mixed-methods approach involving an online survey, focus group discussions and key informant interviews were conducted among the students and major stakeholders to evaluate the prevalence of FI, and gain insights into the challenges to accessing, utilizing and effectively implementing food security (FS) initiatives.ResultsFI affected 63.5% of the participants. The awareness and utilization of the food pantry were 27.9% and 8.1% respectively while for the meal share programs, awareness and utilization were 30.1% and 15.0%, respectively. A significant association was found between FI and the place of residence (p = 0.027). Binary logistic regression model showed that students’ school year was a predictor of food pantry awareness (p < 0.05), residence and FI status were predictors of the meal share program utilization (p < 0.05). Five themes, including poor awareness and visibility of campus resources, bureaucratic process and logistics, insufficient funds, personnel and other resources to run the initiatives, ineffective communication, and stigma due to location emerged as the main barriers to the use of the resources.ConclusionsThis study emphasizes the necessity for HBCUs to address these hurdles in order to successfully help students in need with FI resources.
Psychometric properties of a COVID-19 health literacy scale in a sample of German school principals applying Rasch analysis
Authors: Meyer Marlene , Dadaczynski Kevin , Messer Melanie , Okan Orkan 
Published: November 2024

Abstract
Background
During the COVID-19 pandemic, health literacy was found to be an asset to manage health-related information. The HLS-COVID-Q22 has been developed to measure COVID-19 health literacy. External validation needs to be assessed in different populations to verify the questionnaire’s functioning. The present study aimed to evaluate the psychometric properties of the HLS-COVID-Q22 in a sample of German school principals.

Methods
The sample consisted of 2187 German school principals who completed the HLS-COVID-Q22 online from April to March 2021. The data was analyzed using Rasch analysis, applying the Partial Credit Model for polytomous data. Dimensionality, item fit statistics and rating scale functioning was tested. Values for item difficulty and person ability as well as reliability indices were computed.

Results
Unidimensionality could be confirmed. The rating scale categories worked as intended, participants used every rating step category. Generally, item fit was verified. One item showed potential misfit but could remain in the questionnaire as excluding the item did not reduce reliability. A person separation index of 3.41 and person reliability of 0.92 showed excellent differentiation between COVID-19 health literacy levels. Furthermore, the values for item separation of 20.08 and item reliability of 1.0 indicate good construct validity.

Conclusions
The German version of the HLS-COVID-Q22 appears to be a reliable measurement tool for the target population. Evidence for construct, statistical and fit validity was collected. Future studies need to test additional types of validity like convergent and divergent validity to further evaluate the questionnaire. Moreover, the psychometric properties of the translated versions of the HLS-COVID-Q22 should be compared using Rasch analysis.
An interactive dashboard for analyzing user interaction patterns in the i2b2 clinical data warehouse
Authors: Baum Lena , Müller Armin , Johns Marco , Abu Attieh Hammam , Halilovic Mehmed , Milicevic Vladimir , Neves Diogo Telmo , Otte Karen , Pasquier Anna , Wirth Felix Nikolaus , Segelitz Patrick , Schönrath Katharina , Weber Joachim E. , Prasser Fabian 
Published: November 2024

Abstract
Background
Clinical data warehouses provide harmonized access to healthcare data for medical researchers. Informatics for Integrating Biology and the Bedside (i2b2) is a well-established open-source solution with the major benefit that data representations can be tailored to support specific use cases. These data representations can be defined and improved via an iterative approach together with domain experts and the medical researchers using the platform. To facilitate these discussions, it is important to understand how users interact with the system.

Objective
The objective of this work was to develop metrics for describing user interactions with clinical data warehouses in general and i2b2 in particular. Moreover, we aimed to develop a dashboard featuring interactive visualizations that inform data engineers and data stewards about potential improvements.

Methods
We first identified metrics for different data usage dimensions and extracted the relevant metadata about previous user queries from the i2b2 database schema for further analysis. We then implemented associated visualizations in Python and integrated the results into an interactive dashboard using Dash.

Results
The identified categories of metrics include frequency of use, session duration, and use of functionality and features. We created a dashboard that extends our local i2b2 data warehouse platform, focusing on the latter category, further broken down into the number of queries, frequently queried concepts, and query complexity. The implementation is available as open-source software.

Conclusion
A range of metrics can be derived from metadata logged in the i2b2 database schema to provide data engineers and data stewards with a comprehensive understanding of how users interact with the platform. This can help to identify the strengths and limitations of specific instances of the platform for specific use cases and aid their iterative improvement.
Clinical values of nuclear morphometric analysis in fibroepithelial lesions
Authors: Lee Conrad , Yip Heilum , Li Joshua J.X. , Ng Joanna , Tsang Julia Y. , Loong Thomson , Tse Gary M. 
Published: November 2024

Abstract
Background
Fibroepithelial lesions (FELs) of the breast encompass a broad spectrum of lesions, ranging from commonly encountered fibroadenomas (FAs) to rare phyllodes tumors (PTs). Accurately diagnosing and grading these lesions is crucial for making management decisions, but it can be challenging due to their overlapping features and the subjective nature of histological assessment. Here, we evaluated the role of digital nuclear morphometric analysis in FEL diagnosis and prognosis.

Methods
A digital nuclear morphometric analysis was conducted on 241 PTs and 59 FAs. Immunohistochemical staining for cytokeratin and Leukocyte common antigen (LCA) was used to exclude non-stromal components, and nuclear area, perimeters, calipers, circularity, and eccentricity in the stromal cells were quantified with QuPath software. The correlations of these features with FEL diagnosis and prognosis was assessed.

Results
All nuclear features, including area, perimeter, circularity, maximum caliper, minimum caliper and eccentricity, showed significant differences between FAs and benign PTs (p ≤ 0.002). Only nuclear area, perimeter, minimum caliper and eccentricity correlated significantly with PT grading (p ≤ 0.022). For differentiation of FAs from benign PTs, the model integrating all differential nuclear features demonstrated a specificity of 90% and sensitivity of 70%. For PT grading, the nuclear morphometric score showed a specificity of 78% and sensitivity of 96% for distinguishing benign/borderline from malignant PTs. In addition, a relationship of nuclear circularity was found with PT recurrence. The Kaplan-meier analysis, using the best cutoff determined by ROC curve, showed shorter event free survival in benign PTs with high circularity (chi-square = 4.650, p = 0.031).

Conclusions
Our data suggested the digital nuclear morphometric analysis could have potentials to objectively differentiate different FELs and predict PT outcome. These findings could provide the evidence-based data to support the development of deep-learning based algorithm on nuclear morphometrics in FEL diagnosis.
SpottedPy quantifies relationships between spatial transcriptomic hotspots and uncovers environmental cues of epithelial-mesenchymal plasticity in breast cancer
Authors: Withnell Eloise , Secrier Maria 
Published: November 2024

AbstractSpatial transcriptomics is revolutionizing the exploration of intratissue heterogeneity in cancer, yet capturing cellular niches and their spatial relationships remains challenging. We introduce SpottedPy, a Python package designed to identify tumor hotspots and map spatial interactions within the cancer ecosystem. Using SpottedPy, we examine epithelial-mesenchymal plasticity in breast cancer and highlight stable niches associated with angiogenic and hypoxic regions, shielded by CAFs and macrophages. Hybrid and mesenchymal hotspot distribution follows transformation gradients reflecting progressive immunosuppression. Our method offers flexibility to explore spatial relationships at different scales, from immediate neighbors to broader tissue modules, providing new insights into tumor microenvironment dynamics.
Multilayer textile-based concept for non-invasive biosensor platform
Authors: Soekoco Asril Senoaji , Septiani Ni Luh Wulan , Iqbal Muhammad , Irzaman  , Nugroho Widagdo Sri , Rusydi Febdian , Nugraha  , Yuliarto Brian 
Published: November 2024

AbstractThe surface area of the working electrode plays a crucial role in determining the sensor’s performance, especially in enzymatic sensors. Increasing the surface area of the working electrode has a significant impact on the sensor’s functionality. This research focused on developing textile-based sensors using a multi-layer concept, employing the direct coating method. Two different sensors which are multilayer textile-based sensor (MTBS) and single-layer textile-based sensor (STBS) were prepared, while commercial screen-printed carbon electrode (SPCE) was also used as a comparison. The measurements were carried out using potassium ferricyanide solutions with concentrations of 0.01 M, 0.02 M, 0.03 M, 0.04 M, and 0.05 M at a voltage of 1 V, with a maximum duration up to the end of the measurement and a time interval of 0.5 s. According to the research findings, the fluid spreading speed of the SPCE is the lowest when compared to the spreading speeds of the MTBS and STBS. Specifically, the fluid spreading speed of the SPCE is 4.3 times slower than that of the STBS and 51 times slower than that of the MTBS. Utilizing a multi-layer concept with specific coatings can lead to better-performing sensors in terms of stability and sensitivity. The MTBS exhibits the greatest sensitivity, as indicated by its linear equation slope of 717.230 µA µM−1 cm−2.