bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D and focal brain atrophy in PD with non-dementia: a VBM study
Authors: Xu Yingying , Wang Erlei , Zhang Qilin , Liu Jing , Luo Weifeng 
Published: November 2024

BackgroundThe status of vitamin D has been proposed to have an impact on cognition. Gray matter volume (GMV) is a potential marker of cognitive function. We investigated whether lower serum 25-hydroxyvitamin D level was associated with reduced cerebral GMV in Parkinson’s disease with non-dementia (PDND) patients.MethodsBaseline neuropsychiatric performance and serum 25-hydroxyvitamin D levels were examined in 24 PDND patients and 24 healthy controls (HCs). A set of cognitive scales were used to evaluate the cognition. Voxel-based morphometry (VBM) was performed to calculate each PDND patient’s GMV, based on structural magnetic resonance imaging data. Associations between serum 25-hydroxyvitamin D levels, cognition, and GMV were evaluated.ResultsThe serum 25-hydroxyvitamin D levels of the PDND group were significantly lower than those of the HC group. The simple linear regression analyses between serum 25-hydroxyvitamin D levels and the scores of subtests that analyzed cognitive function showed that serum 25-hydroxyvitamin D levels were negatively correlated with Trail Making Test-A scores and positively correlated with Symbol Digit Modalities Test and Auditory Verbal Learning Test scores. Multiple regression analyses revealed a positive correlation between the right fusiform gyrus GMV and serum 25-hydroxyvitamin D levels.ConclusionWe hypothesized that the lower serum 25-hydroxyvitamin D level in patients with PDND might affect auditory word learning and spatial cognition ability by reducing the gray matter volume of the right fusiform gyrus, thereby leading to deterioration of semantic understanding and memory function.
Revealing the causal role of immune cells in malignant neoplasms of the head and neck: insights from Mendelian randomization
Authors: Zhou En , Yuan MingHao , Zhong JiaYu , Xiao XuPing 
Published: November 2024

BackgroundImmune escape and immunosuppression play crucial roles in the onset and progression of head and neck malignant neoplasms (HNMN). However, previous studies on the relationship between immune cells and HNMN have yielded inconsistent results.MethodsIn this study, we performed bidirectional two-sample Mendelian randomisation (MR) analyses using genome-wide association study (GWAS) and FinnGen databases to examine the association between 731 immune cell features and the risk of HNMN. We conducted sensitivity analyses to assess the robustness of the findings.ResultsSubsequent to false discovery rate (FDR) correction, three immune cell phenotypes were found to have a significant correlation with the risk of HNMN: CD28−CD8+ absolute cells (AC) (inverse-variance weighted [IVW] using the multiplicative random effects model: OR [95%]: 1.325 [1.413 to 1.539], P = 0.0002, Pfdr = 0.054), CD3 on secreting Treg (IVW: OR [95%]: 0.887 [0.835 to 0.941], P = 0.00007, Pfdr = 0.025), and CD3 on resting Treg (IVW: OR [95%]: 0.891 [0.842 to 0.943], P = 0.00006, Pfdr = 0.026). The results of the sensitivity analysis were aligned with the primary findings. No statistically significant effects of HNMN on the immunophenotypes were observed.ConclusionsOur research indicates causal relationships among the three immune cell phenotypes and vulnerability to HNMN, providing new insights into immune infiltration within the HNMN tumour microenvironment and the development of immunotherapy drugs targeting checkpoint inhibitors of HNMN.
Establishment of a prognostic nomogram based on the clinical and inflammatory parameters as well as acute radiation enteritis for patients with cervical cancer receiving radiotherapy
Authors: Hu Jing , Shi Qianjin , Gong Xiaoqin , You Tao , Dai Chunhua , Chen Fei 
Published: November 2024

ObjectiveAcute radiation enteritis is one of the most common complications of radiotherapy for patients with cervical cancer. This study aims to investigate the effect of acute radiation enteritis on the prognosis of patients with cervical cancer receiving radiotherapy and to establish a nomogram predicting the patients’ overall survival (OS).MethodsThe clinical data of 288 patients with cervical cancer who were admitted to our department from 2014 to 2020 were retrospectively analyzed, and the survival of patients were followed up. The Kaplan-Meier method was used to calculate the survival rate and for univariate analysis, and the Cox regression model was used for multivariate prognostic analysis. A nomogram survival prediction model was established based on independent risk factors, and the concordance index (C-index), receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive accuracy of the model. The clinical applicability of the model was assessed by the decision curve. External validation of the nomogram prediction model was performed in 74 patients admitted to our hospital from 2020 to 2021.Results60 patients (20.8%) developed grade 2 or higher acute radiation enteritis. The 1-, 3-, and 5-year OS rates were 94.4%, 80.9%, and 77.4%, respectively. Multivariate Cox regression analysis showed that: Age ≥ 60 years, diabetes/hypertension, anemia, FIGO stage III-IV, poor differentiation, pelvic lymph node metastasis, NLR ≥ 2.54 and grade 2 or higher acute radiation enteritis were independent risk factors for OS in cervical cancer patients undergoing radiotherapy (P &lt; 0.05). The C-index of OS nomogram model was 0.815 (95% CI: 0.766-0.864). The AUC of 3-year and 5-year OS were 0.849 (95%CI: 0.789-0.909) and 0.840 (95%CI: 0.782-0.899), respectively. The AUC value of 3-year OS in the external validation set was 0.779 (95%CI: 0.635-0.922). The calibration curve showed that the model was well calibrated, and the decision curve verified the clinical applicability of the constructed nomogram.ConclusionThis study established an accurate predicting nomogram based on independent prognostic factors in cervical cancer patients receiving radiotherapy, and patients with grade 2 or higher acute radiation enteritis should be paid more attention to in clinical practice.
Surgical treatment for complete resection of transthoracic and abdominal schwannoma with diaphragm invasion using the transthoracic approach: a case report and literature review
Authors: Zhang Wen-jun , Pang Li-song , Hu Dong-xia , Le Yi-guan 
Published: November 2024

BackgroundThe removal of schwannomas involving the chest and abdominal cavities is difficult, which requires a high level of overall proficiency and technical expertise from surgeons. Therefore, this study explored a safe and feasible surgical method for the complete resection of this type of tumor.MethodsWe collected the medical records of a 44-year-old female patient with space-occupying lesions near the thoracic vertebrae.ResultsThe transthoracic approach could effectively expose the relationship between the tumor and adjacent tissues, reduce the patient’s additional injury, completely remove the tumor tissue, and repair the diaphragm defect well. The amount of blood loss during the operation was approximately 600 ml. After the operation, there was a small amount of pleural effusion, the patient recovered well, and no other complications occurred. Through follow-up for 3 months after the surgery, the patient had no other complications and his physical condition had recovered.ConclusionsFor patients with transthoracic and abdominal schwannoma complicated by diaphragmatic invasion, performing tumor resection using the transabdominal approach may be difficult, but the transthoracic approach may be a safe and feasible surgical option.
Rasch analysis and targeting assessment of the teach-CVI survey tool in a cohort of CVI patients
Authors: Martin Jem , Bradley Chris , Kran Barry S. , Ross Nicole C. 
Published: November 2024

PurposeCerebral Visual Impairment (CVI) is the leading cause of pediatric visual impairment. Given the diversity of clinical presentations of CVI, we are interested in whether questionnaires appropriately target the spectrum CVI cases, specifically the Teach-CVI Screening Tool. Rasch analysis is a standard psychometric technique for assessing the targeting of questionnaire items, however this analysis technique has not yet been applied to this questionnaire.MethodsWe performed a retrospective review of clinical CVI cases from the NECO Center for Eye Care at Perkins School for the Blind from January 2016 to December 2022. Electronic medical records were reviewed to identify patients with an ICD-9 or ICD-10 code of CVI or other neurological visual impairment. Age, gender, diagnoses, visual acuity, contrast sensitivity, visual fields, ocular alignment, and Teach-CVI responses were collected. We applied the method of successive dichotomizations, a polytomous Rasch model, to estimate item measures and person measures from the survey. Targeting of questionnaire items to the sample population was explored by comparing estimated item measures to person measures. Multiple linear regression was used to determine which factors influence patient visual ability (i.e., Teach-CVI person measure).Results119 patient records were included, 54% of which were male. The mean age was 8.9 years (SD = 6.12) with a range of 0 to 33 years of age. Mean visual acuity was 0.46 logMAR (SD = 0.40), or 20/57. The majority of patients in the sample had a co-occurring visual disorder in addition to CVI (84%), the most frequent being strabismus (69.9%) or visual field loss (25.3%). Item measures ranged from -2.67 to 1.77 logits (SD = 0.76), with a mean of 0 logit by convention. Estimated person measures ranged from -2.19 to 3.08 logits (SD = 1.10) with a mean of -0.03 logit. The range of item measures covered 93.3% of the person measures, and all person measures, except one, were within one logit of an item measure. Visual measures were not statistically significantly associated with Teach-CVI person measures.ConclusionThe findings from this study suggest that the Teach-CVI survey is well targeted and an appropriate patient reported outcome measure for CVI.
BHC-YOLOV8 : improved YOLOv8-based BHC target detection model for tea leaf disease and defect in real-world scenarios
Authors: Zhan BaiShao , Xiong Xi , Li Xiaoli , Luo Wei 
Published: December 2024

IntroductionThe detection efficiency of tea diseases and defects ensures the quality and yield of tea. However, in actual production, on the one hand, the tea plantation has high mountains and long roads, and the safety of inspection personnel cannot be guaranteed; on the other hand, the inspection personnel have factors such as lack of experience and fatigue, resulting in incomplete and slow testing results. Introducing visual inspection technology can avoid the above problems.MethodsFirstly, a dynamic sparse attention mechanism (Bi Former) is introduced into the model backbone. It filters out irrelevant key value pairs at the coarse region level, utilizing sparsity to save computation and memory; jointly apply fine region token to token attention in the remaining candidate regions. Secondly, Haar wavelets are introduced to improve the down sampling module. By processing the input information flow horizontally, vertically, and diagonally, the original image is reconstructed. Finally, a new feature fusion network is designed using a multi-head attention mechanism to decompose the main network into several cascaded stages, each stage comprising a sub-backbone for parallel processing of different features. Simultaneously, skip connections are performed on features from the same layer, and unbounded fusion weight normalization is introduced to constrain the range of each weight value.ResultsAfter the above improvements, the confidence level of the current mainstream models increased by 7.1%, mAP0.5 increased by 8%, and reached 94.5%. After conducting ablation experiments and comparing with mainstream models, the feature fusion network proposed in this paper reduced computational complexity by 10.6 GFlops, increased confidence by 2.7%, and increased mAP0.5 by 3.2%.DiscussionThis paper developed a new network based on YOLOv8 to overcome the difficulties of tea diseases and defects such as small target, multiple occlusion and complex background.
Proactive personality, burnout, and teaching enjoyment: exploring relationships in Chinese English teachers
Authors: Chunyan Hu , Ying Liao 
Published: November 2024

IntroductionThis study examines the relationships between proactive personality, burnout, and teaching enjoyment among Chinese English as a Foreign Language (EFL) teachers. The research aims to clarify how proactive personality traits relate to teaching enjoyment and burnout and to explore their interactions in the context of EFL instruction.MethodsThe study included a sample of 420 Chinese EFL teachers, and Structural Equation Modeling (SEM) was used to assess the relationships among proactive personality, burnout, and teaching enjoyment. Data underwent detailed statistical analysis to identify both direct and mediating effects within the proposed model.ResultsThe findings from the SEM analysis revealed significant direct relationships between proactive personality, burnout, and teaching enjoyment among Chinese EFL educators. Proactive personality was associated with a decrease in burnout (β = −0.366, SE = 0.159, p &lt; 0.001). For every unit increase in proactive personality, teachers reported experiencing higher levels of teaching enjoyment (β = 0.487, SE = 0.176, p &lt; 0.001). Teaching enjoyment, in turn, was a significant mediator in the relationship between proactive personality and burnout (β = −0.249, SE = 0.102, p &lt; 0.001). These findings suggest that proactive personality is positively associated with teaching enjoyment, which, in turn, may relate to lower levels of burnout among EFL teachers.DiscussionThis study highlights the importance of proactive personality traits in enhancing teaching enjoyment and reducing burnout among Chinese EFL teachers. The findings emphasize how proactive tendencies contribute to teachers’ well-being, professional satisfaction, and, ultimately, the quality of EFL instruction. These results suggest practical applications, such as developing interventions that encourage proactive traits and increase teaching enjoyment among EFL educators, which may improve the educational experience for EFL students.
Suboptimal nutritional status of school-age children in Addis Ababa: evidence from the analysis of socioeconomic, environmental, and behavioral factors
Authors: Mihretie Adugna Yimer , Ayelign Abebe , Zerfu Taddese Alemu 
Published: November 2024

BackgroundSchool-aged children (6–14 years old) are susceptible to malnutrition and micronutrient deficiencies. Environmental and behavioral factors greatly influence their nutritional status. This study aimed to examine the association between dietary factors and the nutritional status of school-aged children attending public and private schools in Addis Ababa.MethodsA community-based cross-sectional study design was employed from March to August 2023. A total of 309 study participants were randomly selected from 10 schools. Data were entered into Epidata version 3.1 and exported to SPSS version 23.0 for analysis. WHO Anthro Plus 1.0.4 was used to assess the measurements of weight-for-age (WAZ), height-for-age (HAZ), and BMI-for-age (BAZ) for overweight, stunting, and underweight, while wasting was assessed using MUAC. A Poisson regression model was used to determine the association between predictor variables and stunting, wasting, underweight, and overweight, with adjusted prevalence ratios (APR). APR and 95% CI were used to identify statistically significant variables.ResultsFindings revealed the prevalence of wasting (15%), stunting (24%), underweight (36%), and overweight (19%) among school-aged children. Factors influencing stunting include marital status, house ownership, education level of parents/caregivers, child sex, and meal skipping. Wasting was linked to wealth index, child age, dietary diversity, dietary habits, water access, and toilet facilities. Underweight predictors include parent/caregiver age, marital status, and meal frequency. Moreover, school type appeared as a significant factor for overweight.ConclusionsThe overall nutritional status of school-aged children is suboptimal, influenced by sociodemographic, environmental, and behavioral factors. Addressing these factors through targeted interventions is crucial, particularly for the most vulnerable groups.
Colposuspension in girls with refractory stress-incontinence, a critical evaluation of a last-resort treatment
Authors: van Geen Frank-Jan , Nieuwhof-Leppink Anka , Klijn Aart , de Kort Laetitia , Chrzan Rafal 
Published: November 2024

IntroductionWe previously presented promising results with a Burch-type colposuspension (BC) in a heterogeneous group of girls with therapy-resistant daytime incontinence (DUI). In view of our clinical observations, we expect that a small group of girls with refractory DUI based on stress-urinary incontinence (SUI) might also benefit from a BC in order to achieve continence.ObjectiveTo assess the (long-term) effect of BC on refractory DUI in girls with SUI, and to identify predictive factors for success.Study designA retrospective chart study including all girls with refractory DUI who underwent an open or laparoscopic BC at our tertiary referral center between 2003-2017 (n=34) was performed. Patients were considered refractory after having failed all non-invasive treatment methods. The main outcome measurement was continence, expressed as the percentage of children with decreased incontinence at post-surgical follow-up without any additional treatment (complete response 4-6 months after surgery). Additionally, a cross-sectional follow-up was carried out, assessing the long-term effect of BC on DUI and patient satisfaction by means of standardized questionnaires.ResultsComplete continence after surgery was achieved in 12% (4/34) and 12% (4/34) showed a decrease in frequency of incontinence episodes. Patients with an abnormal flow pattern more often failed complete continence or improved incontinence. After a mean duration of 8 years, 84% (16/19) still experienced DUI. 68% (13/19) of those patients would opt for the BC again.ConclusionAlthough 84% of children still experienced any degree DUI after a mean duration of 8 years after BC, most patients do not regret the decision of surgical treatment. Given the limited benefit and invasiveness of the procedure, however, we discourage to routinely perform BC in children with refractory DUI and SUI. Our results should be taken into account when discussing expectations and chances of success.
Training loads and practices of competitive organ-recipients at the British and World Transplant Games
Authors: Hames Thomas , Leddington-Wright Sheila , Thake C. Douglas , De Smet Stefan , Price Mike 
Published: November 2024

BackgroundLittle information is available regarding the TL and training practices of competitive athletes who are solid-organ recipients. This study characterized TL and practices of competitive organ-recipients at the British and World Transplant Games, 2017.MethodsQuestionnaire data was gathered from 220 participants regarding sporting events and type, frequency, duration and intensity of training sessions undertaken. TL for each training session (session duration × session rating of perceived exertion [RPE]) and total TL were determined.ResultsOverall participants trained 5 ± 3 times per week at an RPE of 5 ± 2 AU for between 60 and 75 min per session (TL ∼1,500–1,875 AU). Most participants (n = 176; 79.7%) reported training three or more times each week. Approximately half (49%) the participants reported undertaking resistance training each week (3 ± 2 sessions per week, RPE of 6 ± 2 AU, 45–60 min per session; TL ∼810–1,080 AU, respectively). Of those participants undertaking resistance training 75% undertook two or more sessions each week. Participants generally undertook most events within a predominant sport with one or two events in a secondary sport. Typical weekly TL for the whole group was 2,762 ± 3,583 AU with considerable variation within and across sports (cycling 4,383 ± 4,005 AU; field athletics 3,671 ± 6,181 AU; court-based sports 2,645 ± 3,308 AU; high physical demand sports [e.g., skiing, triathlon] 2,595 + 2,247 AU; track athletics 2,547 ± 2,664 AU; swimming 2,091 ± 1,070 AU; low physical demand sports [e.g., darts, petanque, walking] 1,182 + 801 AU). Sports-specific TL for predominant and secondary sports was ∼1,500 AU. Resistance training and gym-based aerobic training were the most frequent non-specific training components undertaken. Most competitors (79%) were active in sport prior to transplant.ConclusionThe wide range of TL and components undertaken by athletes with solid-organ transplants likely reflects the multiple and diverse event participation of competitive organ-recipients as well as the diverse physical fitness profiles and incentives to participate. Optimization of TL both for multiple competitive sports and maintenance of health should be considered for these athletes.
Case Report: Robotic Repair of a Perineal Hernia Following Abdominoperineal Resection
Authors: Brune Madison , Hotop Austin , Silliman William , Bartow Kevin 
Published: November 2024

IntroductionPerineal hernias, protrusions through the pelvic diaphragm, are a rare complication post-abdominoperineal resection. The shift to extralevator APR techniques could be linked to a potential increase in these hernias. This case series evaluates the surgical management of perineal hernias, focusing on the evolving role of robotic surgery. Given the limited existing research on robotic repairs in this context, it highlights its potential as an innovative approach.Presentation of CaseIn a case series, we report three patients who underwent robotic abdominoperineal resection (APR) for rectal and anal canal carcinoma after neoadjuvant chemoradiation. The 65-year-old female developed a perineal hernia 7 months post-operatively, the 67-year-old male after 4 years, and the 63-year-old female presented with a recurrent perineal hernia post-APR with gracilis flap reconstruction. All patients underwent successful robotic hernia repairs with mesh placement and demonstrated symptomatic improvement post-operatively.DiscussionPerineal hernia management lacks a standardized protocol, with methods ranging from open to laparoscopic techniques. A review of recent literature suggests increasing favorability towards laparoscopic and robotic approaches due to their less invasive nature. Our cases demonstrate the advantages of robotic surgery’s precision and improved visualization, supporting its use in perineal hernia repair, although more research is needed to confirm.ConclusionRobotic-assisted surgery for perineal hernia repair post-APR shows promise, enhancing the benefits of laparoscopic methods. This series underlines the potential of this approach, though further investigation in larger studies is essential to establish its advantages.